Tackling the primary healthcare workforce crisis: time to talk about health systems and governance-a comparative assessment of nine countries in the WHO European region.

Background: Primary healthcare has emerged as a powerful global concept, but little attention has been directed towards the pivotal role of the healthcare workforce and the diverse institutional setting in which they work. This study aims to bridge the gap between the primary healthcare policy and the ongoing healthcare workforce crisis debate by introducing a health system and governance approach to identify capacities that may help respond effectively to the HCWF crisis in health system contexts.

Methods: A qualitative comparative methodology was employed, and a rapid assessment of the primary healthcare workforce was conducted across nine countries: Denmark, Germany, Kazakhstan, Netherlands, Portugal, Romania, Serbia, Switzerland, and the United Kingdom/ England.

Reorganizing medical care for older persons in times of scarcity: A cybernetics analysis of work pressure and organizational change.

Capacity problems in healthcare lead organizations to seek new and fluid ways of organizing care to safeguard access to services. Task reallocation, triage and stepped care models are increasingly foregrounded as promising interventions that enhance the capacity, efficiency, and resilience of medical services and through which access can be maintained for a growing client base. In this paper, we argue that interventions meant to enhance capacity and increase efficiency have their limits in a system that is already under strain.

What Does Pharmaceutical 3D Printing Cost? A Framework and Case Study with Hydrocortisone for Adrenal Insufficiency.

Background: Pharmaceutical three-dimensional printing (3DP) technology offers an automated platform that can be utilized to manufacture personalized medicine, improving pharmacotherapy. Although 3D-printed products have entered clinical trials, no costing studies have been performed yet. Cost insights can aid researchers and industry in making informed decisions about the feasibility and scalability of 3DP.

Factors associated with patients' demand for low-value care: a scoping review.

Background: Low-value care is unnecessary care that contributes to inefficient use of health resources and constitutes a considerable proportion of healthcare expenditures worldwide. Factors contributing to patients' demand for low-value care have often been overlooked and are dispersed in the literature. Therefore, the current study aimed to systematically summarize factors associated with patients' demand for low-value care.

Toward value-based care using cost mining: cost aggregation and visualization across the entire colorectal cancer patient pathway.

Background: The aim of this study is to develop a method we call "cost mining" to unravel cost variation and identify cost drivers by modelling integrated patient pathways from primary care to the palliative care setting. This approach fills an urgent need to quantify financial strains on healthcare systems, particularly for colorectal cancer, which is the most expensive cancer in Australia, and the second most expensive cancer globally.

Methods: We developed and published a customized algorithm that dynamically estimates and visualizes the mean, minimum, and total costs of care at the patient level, by aggregating activity-based healthcare system costs (e.

Neural markers of error processing relate to task performance, but not to substance-related risks and problems and externalizing problems in adolescence and emerging adulthood.

Detecting errors and adapting behavior accordingly constitutes an integral aspect of cognition. Previous studies have linked neural correlates of error processing (e.g.

Patient-level cost analysis of subfertility pathways in the Dutch healthcare system.

Background: Health economic evaluations require cost data as a key input, and reimbursement policies and systems should incentivize valuable care. Subfertility is a growing global phenomenon, and Dutch per-treatment DRGs alone do not support value-based decision-making because they don't reflect patient-level variation or the impact of technologies on costs across entire patient pathways.

Methods: We present a real-world micro-costing analysis of subfertility patient pathways (n = 4.

Centenarians-the way to healthy vascular ageing and longevity: a review from VascAgeNet.

The prevalence of centenarians, people who lived 100 years and longer, is steadily growing in the last decades. This exceptional longevity is based on multifaceted processes influenced by a combination of intrinsic and extrinsic factors such as sex, (epi-)genetic factors, gut microbiota, cellular metabolism, exposure to oxidative stress, immune status, cardiovascular risk factors, environmental factors, and lifestyle behavior. Epidemiologically, the incidence rate of cardiovascular diseases is reduced in healthy centenarians along with late onset of age-related diseases compared with the general aged population.

Bodies as communication systems. The relevance of Michel Serres's philosophy of science for health care.

This article demonstrates the value of French philosophy of science for medical practice through an exposition of Michel Serres's philosophy of the body. It explores how Serres's examination of the similarity between scientific models and works of art can provide insight into different conceptions of the human body. What makes Serres's method of unique is that it does not see art and literature as subordinate to the natural sciences: they are both involved in mapping the communication lines of the body.

Sample size estimation for task-related functional MRI studies using Bayesian updating.

Task-related functional MRI (fMRI) studies need to be properly powered with an adequate sample size to reliably detect effects of interest. But for most fMRI studies, it is not straightforward to determine a proper sample size using power calculations based on published effect sizes. Here, we present an alternative approach of sample size estimation with empirical Bayesian updating.

Medically assisted integrated rehabilitation program for people with opioid dependence: a quasi-experimental evaluation using multi-criteria decision analysis.

Background: Opioid use disorders constitute a vast disease burden, need for comprehensive treatment, and substantial costs to individuals, families, and society. The multifaceted needs of people with opioid dependence call for integrated care. The study aims to assess the added value of an integrated medically assisted rehabilitation (MAR) program providing opioid agonist therapy for patients with opioid dependence as compared to the standard of care (SoC) in Norway.

Can criminology sway the public? How empirical findings about deterrence affect public punishment preferences.

Background Setting: Punitive approaches to deter offending remain popular despite limited evidence of their effectiveness. This study investigated what effect presenting empirical criminological findings about the effectiveness of deterrence to a general public has on their punishment preferences. It builds on earlier research showing that such presentation reduces the public's inclination towards strict punishment.

Influence of the university campus environment on sociocultural engagement and satisfaction of health professions education students: role of the sense of belonging.

Background: Sociocultural competence is essential for health professions education (HPE) students. However, the relationships between university campus environment, sense of belonging, and sociocultural engagement of HPE students remain unclear. We hypothesized that a university environment promoting students' participation in social activities enhances their sociocultural engagement, which is mediated through the students' sense of belonging, ultimately increasing their satisfaction with university experience.

Optimization of a Mobile Transdiagnostic Emotion Regulation Intervention for University Students: A Micro-Randomized Trial.

Increasing mental health problems among university students highlight the need for scalable, effective solutions. We have developed a transdiagnostic mobile intervention called ROOM, promoting adaptive emotion regulation (ER) skills among university students. Understanding how the intervention works and optimising content and delivery is essential for creating an effective and adaptive system.

Combination of Bremachlorin PDT and immune checkpoint inhibitor anti-PD-1 shows response in murine immunological T-cell high and T-cell low PDAC models.

Pancreatic ductal adenocarcinoma (PDAC) is one of the most challenging types of cancer with little or no response to immune checkpoint inhibitors (ICIs). Photodynamic therapy (PDT) has been shown to ablate tumors and induce an immune response. In our study, we investigated the effect of photodynamic therapy (PDT), using the photosensitizer Bremachlorin, in its ability to reduce tumor burden and to sensitize immunologically T-cell high and T-cell low murine PDAC tumors to the ICI that blocks programmed cell death-1 (PD-1) immune checkpoint.

Perspectives on managing innovation readiness in long-term care: a Q-methodology study.

Background: The scarcity of resources in long-term care demands more than ever that organizations in this sector are prepared for innovation to ensure affordable access to care for older adults. Organizations that are innovation ready are more capable of implementing innovations. Therefore, a better understanding of how stakeholders view innovation readiness in long-term care can provide actionable strategies to enhance their innovative capacities.

Microbiome testing in Europe: navigating analytical, ethical and regulatory challenges.

Background: In recent years, human microbiome research has flourished and has drawn attention from both healthcare professionals and general consumers as the human microbiome is now recognized as having a significant influence on human health. This has led to the emergence of companies offering microbiome testing services. Some of these services are sold directly to the consumer via companies' websites or via medical laboratory websites.

Smoking and contraception containing ethinylestradiol: A mixed-methods study into women's intentions to quit smoking.

Background: Smoking while using contraception containing ethinylestradiol increases the risk of cardiovascular diseases. Therefore, it is especially important to stimulate women who use these contraceptives to quit smoking.

Objectives: This study aimed to examine the role of risk perception and coping in relation to the intention of these women to quit smoking, using the Protection Motivation Theory as the theoretical foundation.

The Impact of Leader-Member Relationships on Team Effectiveness Through Speaking Up and Silence: A Cross-Sectional Study in Rural Chinese Hospitals.

Introduction: Although the importance of leader-member relationships in teamwork is acknowledged in literature, a deeper understanding of this relationship is lacking, especially in rural areas. The impact of leader-member relationships on team outcomes is especially important in rural Chinese hospitals as improving teamwork forms a national health reform priority in these hospitals. This study investigates how leader-member relationships (ie leader-member perceived similarity and power distance orientation) influence team outcomes (ie perceived quality of care and job satisfaction) via speaking up and silence.

Recreational and Occupational Physical Activity and Risk of Adverse Events in Truncating Founder Variant Carriers.

Background: founder variants cause hypertrophic cardiomyopathy leading to heart failure and malignant ventricular arrhythmias. Exercise is typically regarded as a risk factor for disease expression although evidence is conflicting. Stratifying by type of exercise may discriminate low- from high-risk activities in these patients.

Quality Improvement Intervention for Reducing Acute Treatment Times in Ischemic Stroke: A Cluster Randomized Clinical Trial.

Importance: Efficient care processes are crucial to minimize treatment delays and improve outcome after endovascular thrombectomy (EVT) in patients with ischemic stroke. A potential means to improve care processes is performance feedback.

Objective: To evaluate the effect of performance feedback to hospitals on treatment times for EVT.

An early economic evaluation of active surveillance for low-risk ductal carcinoma .

Perform early economic evaluation comparing active surveillance (AS) to surgery for women with low-risk ductal carcinoma , a precursor of invasive breast cancer. A 10-year incremental costs (€) and quality-adjusted life years (QALYs) were compared between a simulated cohort of women undergoing breast conserving surgery ± radiotherapy, and a cohort with a low-risk subgroup undergoing AS using a semi-Markov model. Scenario and headroom analyses evaluated a better-performing biomarker to select low-risk women for AS.

Generalized Expectancy of Threat in Threatening compared to Safe Contexts.

Fear of threatening contexts often generalizes to similar, safe contexts but few studies have investigated how contextual information influences cue generalization. In this study we explored whether fear responses to cues would generalize more broadly in a threatening compared to a safe context. Forty-seven participants underwent a differential cue-in-context conditioning protocol followed by a generalization test while we recorded psychophysiological and subjective responses.