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Abstract Background With a rapidly ageing society, healthy ageing has become a key challenge. Engagement in physical activity, and particularly walking, is a key strategy that contributes to healthy ageing amongst older adults. The purpose of the present study was to evaluate the efficacy of a group walking program for older adults that incorporates the 5R Shared Leadership Program (5RS). By implementing a structure of shared leadership and strengthening peer leaders’ identity leadership, 5RS aims to cultivate a shared social identity amongst participants, which has in other contexts been associated with greater performance and well-being. Methods A cluster randomised controlled trial was conducted to test the efficacy of the 5RS group walking program on group identification, group cohesion, walking activity, and well-being, compared to a regular group walking program for older adults. Nineteen older adult walking groups (i.e., the clusters; N = 503; M age = 69.23 years, SD = 6.68) all participated in a 12-week structured group walking program. Nine walking groups (n = 304) were randomly assigned to the intervention in which participants received the 5RS program in addition to regular group walking. Results 5RS was successful in strengthening the identity leadership qualities of the appointed peer leaders. Multilevel regressions showed that 5RS succeeded in increasing group cohesion and walking activity to a greater extent than a regular group walking program, while participants’ group identification and well-being increased to a similar extent in both conditions. Furthermore, structural equation modelling revealed that group identification mediated the impact of peer leaders’ identity leadership on group cohesion and well-being (but not walking activity). Conclusion By harnessing the capacity of the group and its peer leaders, the 5RS program offers a promising intervention to engage older adults in physical activity. Trial registration The study was retrospectively registered as clinical trial on 9 September 2021 ( NCT05038423 ).

Most leadership studies primarily focus on formal leaders, often overlooking the influence of leaders within the team. While prior research has shown that peer leaders can have a beneficial impact on various team outcomes, it is yet unclear which peer leadership behaviors precisely foster a supportive and sustainable work environment. Building upon the recent identification of 10 peer leadership roles and 37 underlying functions, the current study aims to investigate the relationships between these peer leadership roles and functions and key outcomes (i.e., job satisfaction, team cohesion, team effectiveness, and OCB). A total of 31 organizational teams, comprising 182 employees from diverse sectors, participated in a quantitative survey. Employing multilevel modeling analysis, the findings demonstrated that each leadership role and nearly every function predicted at least one outcome, highlighting their significance within organizational teams. Additionally, Necessary Condition Analysis revealed that specific roles and functions were necessary for generating one or more outcomes. Finally, we found that most of the significant relationships remained consistent across teams, regardless of their size, tenure, or level of team identification. These findings refine our understanding of shared leadership and how peer leaders can create a sustainable workplace by fostering employee well-being and productivity in organizational teams.

A vast stream of empirical work has revealed that coach and athlete leadership are important determinants of sport teams’ functioning and performance. Although coaches have a direct impact on individual and team outcomes, they should also strive to stimulate athletes to take up leadership roles in a qualitative manner. Yet, the relation between coach leadership behavior and the extent of high-quality athlete leadership within teams remains underexposed. Based on organizational justice theory and the social identity approach, the present research tested whether perceived justice of the coach positively predicts the quality of athlete leadership. Furthermore, we examined the role of group dynamic processes (i.e., team identification and task cohesion) within this relation. Belgian volleyball (N = 161) and basketball players (N = 78) were asked to rate the justice of their coach, their team identification, the task cohesion, and the athlete leadership quality in the team. Structural equation modeling indicated that coaches’ perceived justice positively predicted the quality of athletes’ leadership, and that this relation was established through three intermediate steps (i.e., from team identification to task cohesion, to athlete leadership quality). These results suggest that fair coach behavior does not only bridge the gap between leadership and followership, it also has the potential to improve the quality of athletes’ leadership within sport teams. More specifically, findings suggest that coaches’ perceived justice cultivates a shared social identity characterized by high levels of players’ identification with their team, which in turn increased their perceptions of the team’s task cohesion. Finally, this increased task cohesion encouraged the athlete leaders to demonstrate high-quality leadership.

Leadership has been shown to be a fundamental factor influencing the performance of sport teams. Within these teams, leadership can be provided by coaches, formal athlete leaders, such as team captains, and other ‘informal’ athlete leaders. The role of the athlete leader in a team, either formal or informal, has been consistently reported over the last 10 years to have a significant impact upon a teams’ functioning and effectiveness, as well as teammates’ general health and mental wellbeing. As such, cultivating the provision of this leadership within a team has emerged as an important focus for managers, coaches, sport psychologists and scholars alike. While the recognition of the importance of athlete leadership is well established, there has been a lag in the development of systematic approaches to enhance and develop the leadership skills and capabilities of the athletes within sport teams. As a result, this paper seeks to review contemporary examples and current understanding of approaches to athlete leadership development. The paper will also highlight future areas for research and applied practice development.

Abstract Background Sexually transmitted infections, such as HIV and syphilis, are one of the major health care problems worldwide, especially in low- and middle income countries. HIV screening programmes have been widely used for many years. The introduction of rapid point-of-care tests (RDTs) that can detect both HIV and syphilis, using one single blood specimen, would be a promising tool to integrate the detection of syphilis into HIV programmes and so improve the accessibility of syphilis testing and treatment. Methods As part of the World Health Organization pre-qualification of in vitro diagnostics assessment, the laboratory performance of four dual HIV-Syphilis rapid diagnostic tests (SD Bioline HIV/Syphilis Duo, DPP HIV-Syphilis Assay, Multiplo Rapid TP/HIV Antibody Test and Insti Multiplex HIV-1/HIV-2/Syphilis Antibody Test) was assessed using a well characterized multiregional panel of stored sera specimens. Results In total 400 specimens were tested with each assay, resulting in excellent sensitivities and specificities for HIV, ranging from 99.5 to 100% and from 93.5 to 99.5%, respectively. Results obtained for the Treponema pallidum antibodies were lower, with the lowest sensitivity of 73.5% for Multiplo and the highest of 87% for SD Bioline. Specificities ranged from 99.0 to 100%. Conclusion Although these results suggest that the tests could further improve in accuracy in detection of treponemal antibodies, their introduction into screening programmes to increase the accessibility of HIV/Syphilis diagnosis and treatment for difficult to reach populations in the world is promising.

There seems to be some initial evidence that team captains are selected based on non-leadership factors such as team tenure, technical abilities, being the daughter of the club president, or playing position. This is concerning since players expect their ideal team captain to have superior motivational and social skills. Adding to this literature on captain selection, the present study investigates relationships between the reasons for which team captains are selected and their (a) perceived leadership quality; and (b) perceived acceptance. To accomplish this, we recruited 450 coaches and 198 players from Flemish football and volleyball teams. Participants evaluated 41 reasons on the extent to which they played a role in the selection of their team captain. Additionally, participants rated their team captain’s leadership quality and level of acceptance. The results consistently indicated that captains who were selected for having good motivational and social competencies were given higher ratings on perceived leadership quality and acceptance by participants. In conclusion, athletes who are motivated, good at motivating others and have superior social skills tend to be better suited for captaincy than those selected based on non-leadership factors.

Leadership plays an essential part in creating competitive advantage and well-being among employees. One way in which formal leaders can deal with the variety of responsibilities that comes with their role is to share their responsibilities with team members (i.e., shared leadership). Although there is abundant literature on how high-quality peer leadership benefits team effectiveness (TE) and well-being, there is only limited evidence about the underpinning mechanisms of these relationships and how the formal leader can support this process. To address this lacuna, we conducted an online survey study with 146 employees from various organizations. The results suggest that an empowering leadership style of the formal leader is associated with higher perceived peer leadership quality (PLQ) on four different leadership roles (i.e., task, motivational, social, and external leader). In addition, formal leaders who empower their team members are also perceived as better leaders themselves. Moreover, the improved PLQ was in turn positively related to TE and work satisfaction, while being negatively related to burnout. In line with the social identity approach, we found that team identification mediated these relationships. Thus, high-quality peer leaders succeeded in creating a shared sense of “us” in the team, and this team identification in turn generated all the positive outcomes. To conclude, by sharing their lead and empowering the peer leaders in their team, formal leaders are key drivers of the team’s effectiveness, while also enhancing team members’ health and well-being.

In Flanders the term 'flandrien' refers to cyclists who display a strong work ethic, great perseverance, are powerful and who perform best in adverse weather conditions. Until the 1960s, only leading cyclists originating from the province of West- and East-Flanders were considered as 'flandriens'. After 1960, the media extended the use of this term to Belgian cyclists in general and even to international cyclists. The present study examined whether Flemish citizens agree with this generalization considering that the term 'flandrien' still plays a highly symbolical role in the public discourse on Flemish identity. First, the main aim was to investigate whether having an ethno-cultural identity representation of the Flemish identity is positively related to perceived regional exclusivity of the term 'flandrien'. Second, this study explored whether Flemish identification moderates this relation (i.e. this relation is only expected for high identifiers) and also predicts Flemings’ regional exclusivity of the term. Results revealed that the more Flemings endorse an ethno-cultural identity representation the more they consider a 'flandrien' as an exclusively Flemish cyclist, and the less they will include international cyclists in their consideration of a 'flandrien'. Flemish identification did not moderate this relation but did predict the consideration of a flandrien as a Flemish cyclist. These findings indicate that the current interpretation of the historical cycling term 'flandrien' is influenced by cultural conceptualizations of Flemish identity.

Abstract Background There is today no gold standard method to accurately define the time passed since infection at HIV diagnosis. Infection timing and incidence measurement is however essential to better monitor the dynamics of local epidemics and the effect of prevention initiatives. Methods Three methods for infection timing were evaluated using 237 serial samples from documented seroconversions and 566 cross sectional samples from newly diagnosed patients: identification of antibodies against the HIV p31 protein in INNO-LIA, SediaTM BED CEIA and SediaTM LAg-Avidity EIA. A multi-assay decision tree for infection timing was developed. Results Clear differences in recency window between BED CEIA, LAg-Avidity EIA and p31 antibody presence were observed with a switch from recent to long term infection a median of 169.5, 108.0 and 64.5 days after collection of the pre-seroconversion sample respectively. BED showed high reliability for identification of long term infections while LAg-Avidity is highly accurate for identification of recent infections. Using BED as initial assay to identify the long term infections and LAg-Avidity as a confirmatory assay for those classified as recent infection by BED, explores the strengths of both while reduces the workload. The short recency window of p31 antibodies allows to discriminate very early from early infections based on this marker. BED recent infection results not confirmed by LAg-Avidity are considered to reflect a period more distant from the infection time. False recency predictions in this group can be minimized by elimination of patients with a CD4 count of less than 100 cells/mm3 or without no p31 antibodies. For 566 cross sectional sample the outcome of the decision tree confirmed the infection timing based on the results of all 3 markers but reduced the overall cost from 13.2 USD to 5.2 USD per sample. Conclusions A step-wise multi assay decision tree allows accurate timing of the HIV infection at diagnosis at affordable effort and cost and can be an important new tool in studies analyzing the dynamics of local epidemics or the effects of prevention strategies.

Much importance has been assigned to the role of the team captain. In this article, we test whether today’s team captains live up to these high expectations. Furthermore, we provide greater insight into the selection procedures leading to a captain’s appointment and assess how this process impacts upon the captain’s perceived leadership qualities. Adopting a mixed methods design, a total of 398 participants (226 players and 172 coaches) listed the attributes of both their current team captain and their ideal captain. Altogether, participants listed 635 attributes for their current team captain and 919 attributes for their ideal team captain. Both inductive and deductive approaches were used to analyze these qualitative data. Furthermore, quantitative data were obtained on the perceived influencers in the captain’s selection process. The results indicated that, although players and coaches expect their team captains to have good motivational and social leadership skills, the selection process is often underpinned by non-leadership factors, such as experience, sport-specific competence, or irrelevant attributes, such as being the daughter of the club president. This discrepancy held for both coaches’ and players’ perspectives, for male and female teams, across sports, and across competition levels. Although coaches were identified as main influencers in the selection process, giving players the deciding vote did not result in captains with better perceived leadership skills. The significant gap between participants’ expectations of the captain and reality highlights the need for implementing a structure of shared leadership. Furthermore, evidence-based leadership development programs are needed to maximize the team’s leadership potential.

Human immunodeficiency virus type 1 (HIV-1) non-B subtype infections occurred in Belgium since the 1980s, mainly amongst migrants and heterosexuals, whereas subtype B predominated in men-having-sex-with-men (MSM). In the last decade, the diagnosis of F1 sub-subtype in particular has increased substantially, which prompted us to perform a detailed reconstruction of its epidemiological history. To this purpose, the Belgian AIDS Reference Laboratories collected HIV-1 pol sequences from all sub-subtype F1-infected patients for whom genotypic drug resistance testing was requested as part of routine clinical follow-up. This data was complemented with HIV-1 pol sequences from countries with a high burden of F1 infections or a potential role in the global origin of sub-subtype F1. The molecular epidemiology of the Belgian subtype F1 epidemic was investigated using Bayesian phylogenetic inference and transmission dynamics were characterized based on birth-death models. F1 sequences were retained from 297 patients diagnosed and linked to care in Belgium between 1988 and 2015. Phylogenetic inference indicated that among the 297 Belgian F1 sequences, 191 belonged to a monophyletic group that mainly contained sequences from people likely infected in Belgium (OR 26.67, 95% CI 9.59–74.15), diagnosed in Flanders (OR 7.28, 95% CI 4.23–12.53), diagnosed at a recent stage of infection (OR 7.19, 95% CI 2.88-17.95) or declared to be MSM (OR 34.8, 95% CI 16.0–75.6). Together with a Spanish clade, this Belgian clade was embedded in the genetic diversity of Brazilian subtype F1 strains and most probably emerged after one or only a few migration events from Brazil to the European continent before 2002. The origin of the Belgian outbreak was dated back to 2002 (95% higher posterior density 2000–2004) and birth-death models suggested that its extensive growth had been controlled (Re < 1) by 2012, coinciding with a time period where delay in antiretroviral treatment initiation substantially declined. In conclusion, phylogenetic reconstruction of the Belgian HIV-1 sub-subtype F1 epidemic illustrates the introduction and substantial dissemination of viral strains in a geographically restricted risk group that was most likely controlled by effective treatment as prevention.

This study aimed to analyze the number of task, social and external athlete leaders within sports teams, and to examine the effectiveness of different leadership structures in male and female teams. The participants were 317 male and 214 female soccer players belonging to 18 teams playing in the third highest male division and to 13 teams playing in the highest female division in Spain, respectively. First, we identified the leadership structure in each team (i.e., having zero, one, two or three leaders); second, we grouped the teams according to these leadership structures; and third, MANOVA was used to compare different leadership groups in terms of their effectiveness. The results demonstrated that: (a) the most common structure within the teams was to have one task leader, one social leader, and two external leaders; (b) shared leadership across and within leadership roles was seen as the most effective leadership structure for male and female teams; and (c) male teams showed more benefits when having more task and external leaders, while female teams experienced more benefits when having more task and social leaders on the team. Based on these findings, coaches can optimize their team's functioning by implementing a structure of shared leadership within their teams, both across and within the different leadership roles.

The aim of this experiment was to study the growth-promoting and adverse impact of athlete leaders' competence-supportive and-thwarting behavior on the motivation and performance of team members. Male soccer players (N = 144; MAge = 14.2) were allocated to ad-hoc teams of five soccer players. These teams participated in two sessions, being randomly exposed to an athlete leader who acted either competence-supportive, competence-thwarting, or neutral during the second session. When the athlete leader was competence-supportive (versus competence-thwarting), his teammates' intrinsic motivation and performance increased (versus decreased) compared with the control condition. The leader's impact on intrinsic motivation was fully accounted for by team members' competence satisfaction. These findings recommend coaches to invest in the competence-supportive power of their athlete leaders to establish an optimally motivating and performance-enhancing team environment.

[This corrects the article DOI: 10.1371/journal.pbio.2001855.].

HIV-1 set-point viral load-the approximately stable value of viraemia in the first years of chronic infection-is a strong predictor of clinical outcome and is highly variable across infected individuals. To better understand HIV-1 pathogenesis and the evolution of the viral population, we must quantify the heritability of set-point viral load, which is the fraction of variation in this phenotype attributable to viral genetic variation. However, current estimates of heritability vary widely, from 6% to 59%. Here we used a dataset of 2,028 seroconverters infected between 1985 and 2013 from 5 European countries (Belgium, Switzerland, France, the Netherlands and the United Kingdom) and estimated the heritability of set-point viral load at 31% (CI 15%-43%). Specifically, heritability was measured using models of character evolution describing how viral load evolves on the phylogeny of whole-genome viral sequences. In contrast to previous studies, (i) we measured viral loads using standardized assays on a sample collected in a strict time window of 6 to 24 months after infection, from which the viral genome was also sequenced; (ii) we compared 2 models of character evolution, the classical "Brownian motion" model and another model ("Ornstein-Uhlenbeck") that includes stabilising selection on viral load; (iii) we controlled for covariates, including age and sex, which may inflate estimates of heritability; and (iv) we developed a goodness of fit test based on the correlation of viral loads in cherries of the phylogenetic tree, showing that both models of character evolution fit the data well. An overall heritability of 31% (CI 15%-43%) is consistent with other studies based on regression of viral load in donor-recipient pairs. Thus, about a third of variation in HIV-1 virulence is attributable to viral genetic variation.

The present article provides a comprehensive examination of the relationship between playing position and leadership in sport. More particularly, it explores links between leadership and a player's interactional centrality-defined as the degree to which their playing position provides opportunities for interaction with other team members. This article examines this relationship across different leadership roles, team sex, and performance levels.Study 1 (N = 4443) shows that athlete leaders (and the task and motivational leader in particular) are more likely than other team members to occupy interactionally central positions in a team. Players with high interactional centrality were also perceived to be better leaders than those with low interactional centrality. Study 2 (N = 308) established this link for leadership in general, while Study 3 (N = 267) and Study 4 (N = 776) revealed that the same was true for task, motivational, and external leadership. This relationship is attenuated in sports where an interactionally central position confers limited interactional advantages. In other words, the observed patterns were strongest in sports that are played on a large field with relatively fixed positions (e.g., soccer), while being weaker in sports that are played on a smaller field where players switch positions dynamically (e.g., basketball, ice hockey). Beyond this, the pattern is broadly consistent across different sports, different sexes, and different levels of skill.The observed patterns are consistent with the idea that positions that are interactionally central afford players greater opportunities to do leadership-either through communication or through action. Significantly too, they also provide a basis for them to be seen to do leadership by others on their team. Thus while it is often stated that "leadership is an action, not a position," it is nevertheless the case that, when it comes to performing that action, some positions are more advantageous than others.

Detection of HIV-1 p24 antigen permits early identification of primary HIV infection and timely intervention to limit further spread of the infection. Principally, HIV screening should equally detect all viral variants, but reagents for a standardised test evaluation are limited. Therefore, we aimed to create an inexhaustible panel of diverse HIV-1 p24 antigens.We generated a panel of 43 recombinantly expressed virus-like particles (VLPs), containing the structural Gag proteins of HIV-1 subtypes A-H and circulating recombinant forms (CRF) CRF01_AE, CRF02_AG, CRF12_BF, CRF20_BG and group O. Eleven 4th generation antigen/antibody tests and five antigen-only tests were evaluated for their ability to detect VLPs diluted in human plasma to p24 concentrations equivalent to 50, 10 and 2 IU/ml of the WHO p24 standard. Three tests were also evaluated for their ability to detect p24 after heat-denaturation for immune-complex disruption, a pre-requisite for ultrasensitive p24 detection.Our VLP panel exhibited an average intra-clade p24 diversity of 6.7%. Among the 4th generation tests, the Abbott Architect and Siemens Enzygnost Integral 4 had the highest sensitivity of 97.7% and 93%, respectively. Alere Determine Combo and BioRad Access were least sensitive with 10.1% and 40.3%, respectively. Antigen-only tests were slightly more sensitive than combination tests. Almost all tests detected the WHO HIV-1 p24 standard at a concentration of 2 IU/ml, but their ability to detect this input for different subtypes varied greatly. Heat-treatment lowered overall detectability of HIV-1 p24 in two of the three tests, but only few VLPs had a more than 3-fold loss in p24 detection.The HIV-1 Gag subtype panel has a broad diversity and proved useful for a standardised evaluation of the detection limit and breadth of subtype detection of p24 antigen-detecting tests. Several tests exhibited problems, particularly with non-B subtypes.

Over the last decade several phase III microbicides trials have been conducted in developing countries. However, laboratories in resource constrained settings do not always have the experience, infrastructure, and the capacity to deliver laboratory data meeting the high standards of clinical trials. This paper describes the design and outcomes of a laboratory quality assurance program which was implemented during a phase III clinical trial evaluating the efficacy of the candidate microbicide Cellulose Sulfate 6% (CS) [1].In order to assess the effectiveness of CS for HIV and STI prevention, a phase III clinical trial was conducted in 5 sites: 3 in Africa and 2 in India. The trial sponsor identified an International Central Reference Laboratory (ICRL), responsible for the design and management of a quality assurance program, which would guarantee the reliability of laboratory data. The ICRL provided advice on the tests, assessed local laboratories, organized trainings, conducted supervision visits, performed re-tests, and prepared control panels. Local laboratories were provided with control panels for HIV rapid tests and Chlamydia trachomatis/Neisseria gonorrhoeae (CT/NG) amplification technique. Aliquots from respective control panels were tested by local laboratories and were compared with results obtained at the ICRL.Overall, good results were observed. However, discordances between the ICRL and site laboratories were identified for HIV and CT/NG results. One particular site experienced difficulties with HIV rapid testing shortly after study initiation. At all sites, DNA contamination was identified as a cause of invalid CT/NG results. Both problems were timely detected and solved. Through immediate feedback, guidance and repeated training of laboratory staff, additional inaccuracies were prevented.Quality control guidelines when applied in field laboratories ensured the reliability and validity of final study data. It is essential that sponsors provide adequate resources for implementation of such comprehensive technical assessment and monitoring systems.ClinicalTrials.gov NCT00153777 and Current Controlled Trials ISRCTN95638385.

ABSTRACTThis study is the first prospective study to assess the prevalence, epidemiology, and risk factors of HIV-1 drug resistance in newly diagnosed HIV-infected patients in Belgium. In January 2003 it was initiated as part of the pan-European SPREAD program, and continued thereafter for four inclusion rounds until December 2006. Epidemiological, clinical, and behavioral data were collected using a standardized questionnaire and genotypic resistance testing was done on a sample taken within 6 months of diagnosis. Two hundred and eighty-five patients were included. The overall prevalence of transmitted HIV-1 drug resistance in Belgium was 9.5 (27/285, 95 CI: 6.613.4). Being infected in Belgium, which largely coincided with harboring a subtype B virus, was found to be significantly associated with transmission of drug resistance. The relatively high rate of baseline resistance might jeopardize the success of first line treatment as more than 1 out of 10 (30/285, 10.5) viruses did not score as fully susceptible to one of the recommended first-line regimens, i.e., zidovudine, lamivudine, and efavirenz. Our results support the implementation of genotypic resistance testing as a standard of care in all treatment-naive patients in Belgium. [ABSTRACT FROM AUTHOR]