bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of a psychometrically valid and reliable measure of primary care providers’ willingness to engage with value based payments and innovations in care coordination
Authors: Atherly Adam , van den Broek-Altenburg Eline , Jacobs Alicia , Mueller Josiah , Wulfman Carrie , van Eeghen Constance 
Published: December 2024

Abstract
Background
Most approaches to healthcare reform envision an enhanced role for primary care providers, supported by innovative payment methodology and improved resources. However, there are currently no instruments to measure providers’ ability and willingness to work with existing tools provided by payers, such as Accountable Care Organizations (ACO). In this study, we develop and psychometrically test a new instrument to measure provider engagement with ACOs.

Methodology/ approach
The instrument was developed based on a self-efficacy theory of the adoption of innovations. We hypothesized two underlying constructs: Ease of Use (“Ease”) and Perceived Usefulness (“Usefulness”). Constructs were tested using confirmatory factor analysis. Reliability was assessed with Cronbach's Alpha and convergent and divergent validity. Survey subjects were Primary Care Providers engaged with an ACO.

Results
Eigenvalue and scree plots indicated the hypothesized two factor model was appropriate. Four questions failed to load onto a single factor – three from Ease and one from Usefulness. Both scales have outstanding reliability, with an Alpha of 0.951 for Usefulness and 0.831 for Ease. For validity, the results are consistent with our prior hypotheses for convergent and divergent validity.

Conclusions
The new instrument is a valid and reliable measure of providers’ ability to work with and gain value from ACO participation.

Practice implications
The success of any health care reform will be highly dependent on primary care providers’ willingness and ability to engage with payers. This instrument provides a new tool to measure the value and difficulty of that engagement by primary care providers.
From applause to disappointment – appreciation among healthcare providers that provided end-of-life care during the COVID-19 pandemic and its impact on well-being – a longitudinal mixed methods study (the CO-LIVE study)
Authors: Zee Masha S. , Philipsen Bregje D. Onwuteaka , Witkamp Erica , Becqué Yvonne N. , Goossensen Anne , Pasman H. Roeline 
Published: December 2024

Abstract
Background
The healthcare sector is facing increasing work pressure, making a healthy workforce essential. Appreciation is a factor influencing well-being, and the COVID-19 pandemic offers valuable insights into this. This study aims to: 1) describe to what extent end-of-life care providers felt appreciated and understood during the first 18 months of the pandemic, 2) examine the impact of appreciation on their well-being, and 3) explore their perceptions of what appreciation should look like.

Methods
A longitudinal mixed methods study among healthcare providers in the Netherlands delivering end-of-life care during the COVID-19 pandemic. Surveys were conducted at four timepoints (n = 302), and interviews were conducted at three timepoints (n = 17) during the first 18 months of the pandemic. Generalized Estimating Equations analysis was performed on the quantitative data and thematic analysis was conducted on the interview data.

Results
This study shows that feeling of appreciation among healthcare providers peaked in the first wave of the pandemic, but significantly dropped in the second wave, with only about half of the healthcare providers feeling appreciated. This slightly improved afterwards. Furthermore, nearly half of healthcare providers felt misunderstood during the first 18 months of the pandemic. Additionally, this study shows that between September 2020 and September 2021 about 1 in 3 healthcare providers had a score on the Well-Being Index indicating higher risk for burnout. Feeling appreciated and not feeling understood were both significantly associated with worse well-being. Interviews revealed that nurses did not always feel understood and appreciated by society, employers, patients and their families, as well as their own friends and family, leading to feelings of sadness, anger, and frustration. Three major themes emerged: ‘recognizing real needs, ‘we are not in this together’ and ‘short-lived appreciation that failed to lead to structural changes’.

Conclusions
This study shows that during the COVID-19 pandemic, healthcare providers often felt neither appreciated nor understood, which is associated with lower scores of well-being. The expressed appreciation often did meet their needs or expectations, from both employers and society. With healthcare provider well-being still under strain, sustained attention to appreciation and understanding is important for retaining the workforce.
Are urban residents seeking appropriate care for malaria? evidence from an exploratory qualitative study in two cities in nigeria
Authors: Ogunwale Akintayo , Ajayi IkeOluwapo , Bamgboye Eniola , Adamu Al-Mukhtar , Bello Musa , Olawuwo Morenikeji , Fagbamigbe Adeniyi , Akinyemi Joshua , Ozodiegwu Ifeoma 
Published: December 2024

Abstract
Background
Unplanned and rapid urbanization within Nigerian cities with the attendant environmental consequences may hinder achieving malaria elimination goal. Presently, there are limited qualitative studies on malaria case management and care-seeking patterns by settlement type in urban areas in Nigeria. This study, investigated malaria-related health seeking behaviours among different settlement types in Ibadan and Kano metropolises, Nigeria.

Methods
This qualitative study involved conduct of nine Focus Group Discussions (FGDs) sessions among community members and 20 Key Informant interviews (KIIs) with healthcare providers and community stakeholders in each metropolis. Participants were purposively drawn from three settlement types – formal, informal and urban slum. Pretested FGD and KII guides were used to collect data. Data were subjected to thematic content analysis.

Results
Government-owned health facilities especially Primary Health Care (PHC) facilities was a major place identified as where many community members prefer to seek care for suspected malaria infection. Reasons adduced included proximity of facilities and services affordability. A common viewpoint was that most community members in informal and slum communities in both metropolises often patronize Proprietary Patent Medicine Vendors (PPMVs) or drug sellers as the first point for treatment of suspected malaria infection. Adduced reasons included poverty and non-availability of 24 h services in PHC facilities. High cost of treatment, poor attitude of health workers, long waiting time and cultural beliefs were identified as key factors influencing community members’ decision not to seek care in health facilities. It was noted that the rich prefer to seek treatment in private hospitals, while the poor usually visit PHCs or resort to other options like buying drugs from PPMVs or use herbal drugs.

Conclusion
The standard practice of seeking care in health facilities was influenced by diverse factors including treatment cost, health workers’ attitude and waiting time in health facilities. A commoner practice of seeking care from patent medicine vendors and herbal drug sellers among informal settlements and slums dwellers calls for public health interventions. Specifically, the provision of free or affordable malaria care in health facilities and patient-friendly environments; and training of non-formal care providers on appropriate malaria care and referral to health facilities are recommended.
Examining patient choice and provider competition under the National Health Insurance Fund outpatient cover in Kenya: does it enhance access and quality of care?
Authors: Kazungu Jacob , Barasa Edwine , Quaife Matthew , Nonvignon Justice 
Published: December 2024

Abstract
Background
While patient choice and provider competition are predicted to influence provider behaviour for enhancing access and quality of care, evidence on provider perceptions and response to patient choice and provider competition is largely missing in low-resource settings such as Kenya. We examined provider and purchaser perceptions about whether patient choice and provider competition influenced provider behaviour and enhanced access and quality of outpatient care in Kenya.

Methods
We conducted a qualitative study to explore this across two purposefully selected counties. We conducted 15 in-depth interviews (IDIs) with health facility managers and National Health Insurance Fund (NHIF) staff across the two counties. We examined these across five areas summarised as either local market conditions or patient feedback following the Vengberg framework.

Results
NHIF members’ choice of outpatient facilities compelled private and faith-based providers to compete for members while public providers did not view choice as a way of spurring competition. Besides, all providers did not receive any information regarding the exit of NHIF members from their facilities. Providers felt that that information would be crucial for their planning, especially in enhancing service accessibility and quality of care. Most providers ensured the availability of drugs, provided a wider range of services and leveraged on marketing to attract and retain NHIF members. Finally, providers highlighted their redesign of service delivery to meet NHIF members’ needs whilst enhancing the quality-of-care aspects such as waiting time and having qualified health workers.

Conclusion
There is a need for NHIF to share NHIF members’ exit information with providers to support their service delivery arrangements in response to NHIF members’ needs. Besides, this study contributes evidence on patient choice and provider competition and their influence on access and quality of care from a low-resource setting country which is crucial as NHIF transitioned to the Social Health Authority.
Aging in (a meaningful) place – appropriateness and feasibility of Outdoor Reablement in a rural Arctic setting
Authors: Eliassen Marianne , Hartviksen Trude Anita , Holm Solrun , Sørensen Bodil Anita , Zingmark Magnus 
Published: December 2024

Abstract
Background
As populations age in the Western world, interventions aiming for ‘aging in place’, such as reablement, have gained prominence. Reablement programs have focused on enabling older people to maintain independence in their home environment. However, while a growing body of research points to the considerable benefits of engaging in outdoor environments, reablement rarely addresses outdoor activities. People living in rural Arctic areas often tend to have strong cultural, social, and emotional attachments to outdoor places, emphasizing the outdoors as a meaningful arena for engagement. Concurrently, rural Arctic communities face unique obstacles in facilitating outdoor activities, such as geographic isolation, limited access to services, harsh climate conditions, and seasonal variations. Recognizing these challenges, our study sought to tailor an outdoor reablement model that is appropriate and feasible for the context of a rural Arctic setting.

Methods
The study design was inspired by a co-design methodology, incorporating data creation through workshops, focus groups, and individual interviews conducted over an eleven-month period. Three municipalities in rural Arctic Norway were involved, with a total of 35 participants, including older people receiving reablement services and healthcare professionals. A socioecological theory supported the thematic data analysis.

Results
The study yielded experiences that generated a comprehensive model for implementing outdoor reablement that meet the specific needs that the participants experienced in the rural Arctic setting. The model includes the individual level, accounting for physical and mental functioning; the organizational level, necessitating access to aids and equipment and cross-sectorial collaboration; and the environmental level, adapting to climatic, seasonal, and geographic challenges.

Conclusion
This study contributes with knowledge that broadens the scope of reablement as an initiative to support aging in place to include outdoor environments. The tailored outdoor reablement model developed in this study addresses the complexity of aging in place in rural Arctic settings. The study underscores the importance of context-specific strategies that support older people in maintaining a healthy and meaningful life through active engagement with the outdoors.
Computer-assisted medical history taking prior to patient consultation in the outpatient care setting: a prospective pilot project
Authors: Hauber Roman , Schirm Maximilian , Lukas Mirco , Reitelbach Clemens , Brenig Jonas , Breunig Margret , Brenner Susanne , Störk Stefan , Puppe Frank 
Published: December 2024

Abstract
Background
Feeding patients’ self-reported medical history into the diagnostic care process may accelerate workflows in clinical routine.

Methods
We prospectively piloted a novel medical history documentation system in a German cardiological outpatient practice and evaluated its feasibility and perceived usefulness. Based on a generic software that allows to record structured information, a customized solution for the cooperating practice was developed and implemented. Prior to the consultation of the physician, the patient used a tablet that guided the user through a structured comprehensive workflow to document the medical history. The retrieved information was arranged by the software into a ready-to-use text format, presented to the physician in an editable form and added to her report. Three user-centered endpoints were explored: i) Appropriateness—measured by the duration of a patient interview; ii) Patient acceptance—assessed by three questions to patients; iii) Usefulness—operationalized by multiple ratings of the physician.

Results
A total of 2,513 patients were approached of which 2,415 provided complete histories. The system was assessed as appropriate for the practical workflow in terms of time and workflows. The patient-system interaction was rated favourably by patients including elderly ones. The system was regarded useful by the physician, reducing her daily workload by about one hour.

Conclusions
Automated history-taking tools deployed before consultation could support physicians in obtaining patients’ medical histories, thereby reducing professionals’ perceived workload. The technical and methodological limitations of our study should be respected, calling for additional future evaluations.
Feasibility of a Pharmabuddy Care Service for patients with Parkinson’s disease
Authors: Stuijt C. C. M. , Karapinar-Çarkit F. , van de Steeg – van Gompel C. , van Laar T. , van den Bemt B. J. F. , Heringa M. 
Published: December 2024

Abstract
Background
Pharmaceutical care for patients with Parkinson’s disease (PD) is complex. Specialized pharmaceutical care provided by a dedicated pharmacy team member (pharmabuddy) for these patients may reduce medication-related problems. The feasibility of this service for PD patients is unknown.

Objective
To evaluate the feasibility of a Pharmabuddy Care Service (PCS) for PD patients in primary care pharmacies.

Methods
Pharmabuddies who offered PCS were invited to fill in a questionnaire to evaluate the feasibility of PCS. Patients received a patient questionnaire and were invited for an interview. Patient records provided information on medication-related problems and interventions. Feasibility was evaluated conform four domains of Bowen’s Framework. First, acceptability included patients’ satisfaction ratings and experiences, Pharmabuddy impression on start and continuation of the service. Second, demand included use by patients and provision by pharmabuddies. Third, implementation/practicality: implementation indicators and barriers and facilitators from patient- and pharmabuddy perspective and fourth limited efficacy: effect of the PCS on PD symptoms, medication related problems identified and interventions from patient records.

Results
Twenty-three (59%) patients completed the questionnaire, 9 were interviewed, 12 (67%) pharmabuddies responded. Acceptability was high among patients (mean 9.5 (SD 1.3) out of 10), 6 (50%) pharmacies (still) provided PCS. Demand: 56% of patients had 1–2 contact moments, 28% two or more. Ten pharmacies provided up to 14 patients per pharmacy with PCS, one up to 24. Implementation/practicality: important barriers were time constraints and perception of other healthcare professionals. Positive reactions from patients encouraged pharmabuddies to carry out their PCS-activities. Patients were positive about pharmabuddy’s listening competency while knowledge could be improved. Limited efficacy: from patient records, 89 interventions were made in response to 93 (median 3 per patient (range 1–16)) medication related problems or questions, with 20 (87%) patients reporting a positive effect from their interaction with a pharmabuddy.

Conclusion
This study shows PCS is highly appreciated by responding patients and can be feasible for primary care pharmacies. Several implementation issues are still present. Future studies should focus on quantifiable effects of PCS services as well as resource and perception hurdles.
Collaborative design of a care pathway for pharmacy-based PrEP delivery in Nigeria: insights from stakeholder consultation
Authors: Ekwunife Obinna I. , Omenoba Theodora C. , Eyong Ugochi , Okelu Valentine , Alagbile Michael , Ume Ifeanyi , Eze Ambrose , Fisayo Aderinola , Aidoo-Frimpong Gloria , Shroff Farah , Anyakora Chimezie 
Published: December 2024

Abstract

Background
HIV remains a significant public health problem, particularly in Africa, where two-thirds of global cases occur. Nigeria is among the three countries with the highest burden. Despite free access to pre- and post-exposure prophylaxis (PrEP and PEP) in Nigerian hospitals, stigma, distance, and restrictive clinic hours hinder uptake, especially among vulnerable populations. Building on the successful pilot implementation of pharmacy-based PrEP delivery in Kenya, we engaged Nigerian stakeholders in adapting the model, addressing user and provider concerns to ensure effective implementation in Nigeria.

Methods
The stakeholder meeting took place in Abuja, Nigeria, which is selected for its central location and accessibility to various stakeholders, particularly those involved in HIV prevention efforts. The participants were purposefully selected to ensure diverse representations, including youth who are potential PrEP users, pharmacy providers, regulators, and representatives from civil society organizations. The meeting utilized the Nominal Group Technique (NGT)—a structured method for facilitating group decision-making and prioritizing ideas—to adapt the Kenyan pharmacy-delivered PrEP model for implementation in the Nigerian context. Mock role play was conducted to help participants understand the care pathway. The discussions culminated in identifying challenges and viable strategies for implementing the model in Nigeria.

Results
The one-day stakeholder meeting on 9 October 2024 was attended by 20 participants from various sectors involved in HIV prevention services. Stakeholders expressed enthusiasm for pharmacy-based PrEP delivery while acknowledging challenges associated with clinic-based services, such as stigma, limited hours, and long wait times. The key recommendations included training pharmacy providers, increasing awareness, ensuring confidentiality, establishing referral linkages, and integrating program data into the Health Management Information System (HMIS) as well as ensuring commodity availability and access. To enhance the success of the pilot study, stakeholders proposed engaging a research assistant, forming a monitoring team, and submitting the results to the Pharmacy Council of Nigeria (PCN) for review.

Conclusions
The identified challenges and strategies for implementing the model in Nigeria will inform the development of a refined pharmacy-delivered PrEP framework that is ready for pilot testing and potential scaling across the country.
Functional omics of ORP7 in primary endothelial cells
Authors: Taskinen Juuso H. , Holopainen Minna , Ruhanen Hanna , van der Stoel Miesje , Käkelä Reijo , Ikonen Elina , Keskitalo Salla , Varjosalo Markku , Olkkonen Vesa M. 
Published: December 2024

Abstract
Background
Many members of the oxysterol-binding protein-related protein (ORP) family have been characterized in detail over the past decades, but the lipid transport and other functions of ORP7 still remain elusive. What is known about ORP7 points toward an endoplasmic reticulum and plasma membrane-localized protein, which also interacts with GABA type A receptor-associated protein like 2 (GABARAPL2) and unlipidated Microtubule-associated proteins 1A/1B light chain 3B (LC3B), suggesting a further autophagosomal/lysosomal association. Functional roles of ORP7 have been suggested in cholesterol efflux, hypercholesterolemia, and macroautophagy. We performed a hypothesis-free multi-omics analysis of chemical ORP7 inhibition utilizing transcriptomics and lipidomics as well as proximity biotinylation interactomics to characterize ORP7 functions in a primary cell type, human umbilical vein endothelial cells (HUVECs). Moreover, assays on angiogenesis, cholesterol efflux, and lipid droplet quantification were conducted.

Results
Pharmacological inhibition of ORP7 leads to an increase in gene expression related to lipid metabolism and inflammation, while genes associated with cell cycle and cell division were downregulated. Lipidomic analysis revealed increases in ceramides and lysophosphatidylcholines as well as saturated and monounsaturated triacylglycerols. Significant decreases were seen in all cholesteryl ester and in some unsaturated triacylglycerol species, compatible with the detected decrease of mean lipid droplet area. Along with the reduced lipid stores, ATP-binding cassette subfamily G member 1 (ABCG1)-mediated cholesterol efflux and angiogenesis decreased. Interactomics revealed an interaction of ORP7 with AKT1, a central metabolic regulator.

Conclusions
The transcriptomics results suggest an increase in prostanoid as well as oxysterol synthesis, which could be related to the observed upregulation of proinflammatory genes. We envision that the defective angiogenesis in HUVECs subjected to ORP7 inhibition could be the result of an unfavorable plasma membrane lipid composition and/or reduced potential for cell division. To conclude, the present study suggests multifaceted functions of ORP7 in lipid homeostasis, angiogenic tube formation, and gene expression of lipid metabolism, inflammation, and cell cycle in primary endothelial cells.