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Role-based frameworks have long been the cornerstone of organizational coordination, providing clarity in role expectations among team members. However, the rise of “fluid participation”—a constant shift in team composition and skill sets—poses new challenges to traditional coordination mechanisms. In particular, with fluid participation, a team’s roles can oscillate between disconnected and intersecting, or between lacking and having overlap in the capabilities and expectations of different roles. This study investigates the possibility that a disconnected set of roles creates a structural constraint on the flexible coordination needed to perform in volatile contexts, as well as the mitigating role of cognitive versatility in a team’s strategically-central member. Utilizing a sample of 342 teams from a hospital Emergency Department, we find that teams with a disconnected role set are less effective than teams with an intersecting role set as demonstrated by longer patient stays and increased handoffs during shift changes. Importantly, the presence of a cognitively versatile attending physician mitigates these negative outcomes, enhancing overall team effectiveness. Our findings remain robust even after accounting for other variables like team expertise and familiarity. This research extends the Carnegie School’s seminal work on fluid participation by integrating insights from psychology and organizational behavior, thereby identifying key individual attributes that can bolster team coordination in dynamic settings.

Abstract Objective: The primary objectives of this study were to assess the usefulness of C-reactive protein (CRP) and procalcitonin (PCT) in the diagnosis of bacterial co-infections in coronavirus disease 2019 (COVID-19) and if their incorporation in antimicrobial stewardship (AMS) programs is safe and useful, stratified by severity of disease as level of care, intensive care unit (ICU) or non-ICU. Our secondary objectives were to identify cut-off values for antibiotic decision-making and identify reported results from low- and middle-income countries (LMICs). Design: A scoping review of published literature, adhering to the PRISMA statement for Systematic Reviews and Meta-analyses Extension for Scoping Reviews guidelines. The last search was performed in January 2024. Results: Fifty-nine studies were included in this scoping review: 20 studies reporting predictive values and/or sensitivity/specificity results for PCT, 8 reporting clear objectives on AMS, and 3 studies from LMICs. Conclusion: In the context of non-ICU hospitalized COVID-19 patients in high-income countries, a PCT value below 0.25 mg/L can be a useful tool to rule out bacterial co-infection. The wide range of reported negative predictive values suggests that PCT should be interpreted in the context of other clinical findings. Our results do not support the use of CRP in the same manner as PCT. There is a clear need for more studies in LMICs.

ABSTRACT: Objectives: Iraq has suffered unrest and conflicts in the past decades, leaving behind a weakened healthcare system. In 2018, Médecins Sans Frontières (MSF) opened a tertiary orthopaedic care centre in Mosul providing reconstructive surgery with access to microbiological analysis. Methods: A retrospective cross-sectional analysis of microbiological and clinical data of patients admitted between April 2018 and December 2019. Results: There were 174 patients who were included in this study; there were more males than females (135 to 38, respectively), and the mean age was 32.6 y. Of the 174 patients, the majority had more than one bacterial isolate detected (n = 122, 70.1%); 141 (81.0%) had at least one multidrug-resistant (MDR) isolate detected during their hospital stay. Staphylococcus aureus (n = 197, 48.2%) was the most common organism isolated. Overall, most isolates detected were MDR (n = 352, 86%), mostly methicillin-resistant S. aureus (n = 186, 52.8%) or extended-spectrum beta-lactamase–producing Enterobacterales (n = 117, 33.2%). Among patients admitted to the operating department (n = 111, 63.7%), 81.1% (n = 90) were admitted for violent trauma injuries. Patients who had more than one procedure performed per surgery had significantly increased odds of having at least one MDR organism isolated (OR 8.66, CI 1.10–68.20, P = 0.03). Conclusion: This study describes a high prevalence of antibiotic resistance in patients with trauma-related wounds in Mosul, Iraq. It highlights the importance of microbiological analysis and ongoing surveillance to provide optimal treatment. Additionally, it underscores the importance of infection prevention and control measures as well as antibiotic stewardship.

[This corrects the article DOI: 10.1371/journal.pone.0247655.].

Abstract Background Selecting footwear with appropriate fit in children is challenging due the changes with foot size and dimensions which occur throughout childhood. Access to appropriate footwear is important but recent challenges with the COVID‐19 pandemic resulted in closure of retail stores for prolonged periods where parents/carers could not physically purchase footwear for their children and the footwear industry suffered disruption to their supply chain, and falls in retail sales. Simultaneously increased use of social media platforms for health information seeking throughout the pandemic have been documented. This likely would have included parents/carers seeking information online to support footwear purchases for their children. The primary aim of this work was to explore how searches for online fitting information for children changed throughout the COVID‐19 pandemic lockdown periods. A secondary aim was to identify how searches were influenced by footwear style. Methods We employed Google Trends to obtain search engine traffic related to footwear fitting information for children. We collected data spanning the three years pre, during and post the main national lockdown for three eight‐week windows: (1) first eight weeks of the U.K. national lockdown; (2) the first eight weeks of the calendaryear; (3) the eight weeks leading up to children going back‐to‐school for the new academic year in the U.K. The search terms reflected parents/carers searching for footwear fit information relating to children and were grouped by style of footwear: children, infants, babies and toddlers as well as school shoes. Results We identified increased searching for footwear fit information for children during the pandemic, which reduced following post pandemic in all except the searches which related to school shoes. We saw reductions in searching related to fit of school shoes as schools closed indefinitely and an increase in online searches with the pandemic. This was also maintained post‐pandemic despite shops reopening, suggesting that some of these changes in information reflect new consumer behaviours which may continue. Conclusions Increased searches for online resources regarding footwear fit highlights the importance of ensuring high quality accessible online information on footwear fit is available to support those buying footwear for their children.

Within just a few months, the coronavirus disease 2019 (COVID-19) pandemic managed to bring to the foreground the conversation that infection prevention and control (IPC) experts have been pushing for decades regarding the control of the spread of infections. Implementing the basics of IPC has been a challenge for all affected countries battling with an exponential COVID-19 curve of infection. Preventing nosocomial transmission of the disease has been difficult in highly resourced and stable contexts, but even more so in the conflict context of the Middle East. COVID-19 has added further challenges to the long list of existing ones, hindering the implementation of the optimal IPC measures that are necessary to break the chain of infection of both respiratory and non-respiratory infections in those settings. This paper outlines and gives examples of the challenges faced across the Middle East conflict setting and serves as a call for action for IPC to be prioritized, given the resources needed, and fed with contextualized evidence.

Abstract Background Despite potential savings to the National Health Service, the collection of data on outcomes of NHS orthotic services is patchy. Indeed, several reports into orthotic services in the UK have reported a lack of data relating to outcomes of care and highlighted the need to routinely measure outcomes to demonstrate efficacy of services. Whilst a previous study provided an overview of the use of outcome measures in orthotic practice and identified some barriers to their use, further questions emerged. Hence, this qualitative study aimed to explore orthotists’ opinions and personal experiences on the influences on outcomes, how appropriate and relevant outcomes can be measured and also how barriers to the use of outcome measures can be overcome. Methods Following a review of the literature, an initial advisory group informed semi-structured questions. These were used to create dialogue in a focus group of 12 orthotists. Data from the focus group was transcribed verbatim and analysed using thematic analysis, creating themes and subthemes for discussion. Results The setting of realistic and agreed goals through managing expectations, compromise and patient education/information were seen as factors that could inform and improve outcomes. Barriers to the collection of outcome measures were associated with inadequate technology to manage the data, lack of time to complete them, lack of training in them and difficulties selecting appropriate outcome measures for patients with complex problems managed by different health professionals. The participants discussed ways of addressing these barriers, such as the use of ‘snapshots’ and delegation of data collection. Conclusions This study has revealed that measuring outcomes is considered to be an important activity. In order to achieve good outcomes, it is important to address patient expectations, discuss and establish joint goals for care at the outset and inform and include patients in the decision-making process. The identified barriers to measuring outcomes can be overcome with the solutions revealed by these participants. Hence, this study has contributed to current knowledge which has relevance for clinical practice and may provide the theoretical basis for future research.

Abstract Background Parents increasingly use the internet to seek health information, share information and for purchasing textiles and footwear. This shift in footwear purchasing habits raises concern about how (and if) parents are getting their children’s feet measured, and what support strategies are in place to support the fit of footwear. In response to this, some companies and healthcare organisations have developed resources to support home measurement of foot size, and link these measures to footwear selection, measurement and fitting. The aim of this research was to undertake an appraisal of web-based resources about measurement and fit of children’s footwear, focussing specifically on readability, usability and quality. Methods Search terms relating to children’s foot measurement were compiled and online searching was undertaken. Search results were saved and screened for relevance. Existing resources were categorised based on their source e.g. a footwear company or a health website. The 15 most commonly identified resources were reviewed by a professional panel for readability, content, usability and validity. One researcher also assessed the accessibility and reading ease of the resources. Results Online resources were predominantly from commercial footwear companies (54%). Health information sources from professional bodies made up 4.2% of the resources identified. The top 15 resources had appropriate reading ease scores for parents (SMOG Index 4.3–8.2). Accessibility scores (the product of the number of times it appeared in search results and its ranking in the results) were highest for commercial footwear companies. The panel scores for readability ranged from 2.7 to 9 out of 10, with a similar range for content, usability and validity. Conclusions Information for parents seeking to purchase footwear for their children is readily available online but this was largely dominated by commercial footwear companies. The quality and usability of this information is of a moderate standard; notable improvements could be made to the validity of the task the child is asked to undertake and the measures being taken. Improvements in these resources would improve the data input to the selection of footwear and therefore have a beneficial impact on footwear fit in children.

Background and study aim Endoscopic ultrasound (EUS) enables diagnostic evaluation and therapeutic interventions but is associated with adverse events. We conducted a population-based cohort study to determine the risk of adverse events for upper and lower EUS with and without fine-needle aspiration (FNA). Patients and methods All adults who underwent EUS and resided in Calgary in 2007–2013 were included. Endoscopy and provincial databases were used to identify EUS procedures, unplanned emergency department visits, and hospital admissions within 30 days of the procedures, which were then characterized through formal chart review. Adverse events were defined a priori and classified as definitely, possibly, or not related to EUS. The primary outcome was 30-day risk of adverse events classified as definitely or possibly related to EUS. Univariable and multivariable analyses were conducted with risk factors known to be associated with EUS adverse events. Results 2895 patients underwent 3552 EUS procedures: 3034 (85 %) upper EUS, of which 710 (23 %) included FNA, and 518 (15 %) lower EUS, of which 23 (4 %) involved FNA. Overall, 69 procedures (2 %) involved an adverse event that was either definitely or possibly related to EUS, with 33 (1 %) requiring hospitalization. None of the adverse events required intensive care or resulted in death. On multivariable analysis, only FNA was associated with increased risk of adverse events (odds ratio 6.43, 95 % confidence interval 3.92–10.55; P

Abstract Background Footwear is an important concern for people with gout, who often describe difficulty finding suitable footwear. Previous studies have identified footwear as a major concern for people with gout. The aim of this study was to carry out an exploration of the footwear experiences of people with gout. Methods A qualitative descriptive methodological approach was used for both data collection and analysis. A purposive sampling strategy was adopted with semi-structured interviews conducted, involving 11 participants with gout. Thematic analysis was employed to identify key meanings and patterns within the data. Results Four key themes derived from interviews included; (1) comfort as a priority, (2) knowing what to buy, (3) knowing what to wear, and (4) challenges of different environments. Footwear comfort was of great importance and linked to characteristics of footwear, with uncomfortable footwear negatively influencing participation in daily activities. The balancing of comfort, appearance and cost, led to less options and reduced confidence when shoe shopping. Footwear use was further limited by the presence of foot tophi and flares, resulting in compromise of footwear choice. Environments such as formal settings and the workplace, led to different footwear requirements. Conclusion People with gout experience problems with footwear which can impact many aspects of life. Health care professionals should consider these footwear-related issues to help facilitate those with gout in finding appropriate footwear.

Abstract Background The delivery of healthcare is changing and aligned with this, the podiatry profession continues to change with evidence informed practice and extending roles. As change is now a constant, this gives clinicians the opportunity to take ownership to drive that change forward. In some cases, practitioners and their teams have done so, where others have been reluctant to embrace change. It is not clear to what extent good practice is being shared, whether interventions to bring about change have been successful, or what barriers exist that have prevented change from occurring. The aim of this article is to explore the barriers to changing professional practice and what lessons podiatry can learn from other health care professions. Main body A literature search was carried out which informed a narrative review of the findings. Eligible papers had to (1) examine the barriers to change strategies, (2) explore knowledge, attitudes and roles during change interventions, (3) explore how the patients/service users contribute to the change process (4) include studies from predominantly primary care in developed countries. Ninety-two papers were included in the final review. Four papers included change interventions involving podiatrists. The barriers influencing change were synthesised into three themes (1) the organisational context, (2) the awareness, knowledge and attitudes of the professional, (3) the patient as a service user and consumer. Conclusions Minimal evidence exists about the barriers to changing professional practice in podiatry. However, there is substantial literature on barriers and implementation strategies aimed at changing professional practices in other health professions. Change in practice is often resisted at an organisational, professional or service user level. The limited literature about change in podiatry, a rapidly changing healthcare workforce and the wide range of contexts that podiatrists work, highlights the need to improve the ways in which podiatrists can share successful attempts to change practice.

Abstract Background Footwear has an essential role including protection of the feet, overall performance, foot health and potentially, supporting normal development of the foot. In addition to these physical aspects which may influence choice of footwear design, there are psychological influences on what a person chooses to wear. The concept of footwear ‘comfort’ spans physical and psychological perceptions of comfort in adults. However, there is little understanding of what influences children's footwear choices, how children perceive footwear comfort, or the language used to describe footwear experiences. Therefore, this study aimed to explore these three parameters as the first step to informing the development of a scale to measure footwear comfort in children. Methods A pragmatic qualitative design with thematic analysis as an analytical approach was implemented. Passive observation and short interviews were carried out with 23 children (aged 1–12 years) at a footwear manufactures headquarters and store. Prompts included shoes being tried on and field‐notes were taken relating to verbal and non‐verbal communication. Field notes were coded then themes were identified, reviewed and named. Results Overall, the children equated comfort to softness. However, influences on footwear choice were multidimensional including aesthetics, psychosocial influences, identified ‘comfort’ and ‘discomfort’ areas, practical issues and predictive concerns; all interacting with the age of the child. Conclusions For children, footwear comfort is a complex phenomenon having physical, cognitive, social and emotional developmental components. This can be seen in how the children perceive the ‘feel’ of the shoe and how the shoe is assessed in the context of how the shoe meets the child's physical and psychosocial developmental needs. In younger children footwear preference is related to idiosyncratic tastes in aesthetics, physical ability and comfort. As children age, societal influences begin to expand the social function of footwear denoting group membership, to include themes that transcend the functional and social function of footwear. The knowledge from this study can inform the development of age group specific tools to evaluate comfort.

Collective intelligence (CI) is the ability of a group to solve a wide range of problems. Synchrony in nonverbal cues is critically important to the development of CI; however, extant findings are mostly based on studies conducted face-to-face. Given how much collaboration takes place via the internet, does nonverbal synchrony still matter and can it be achieved when collaborators are physically separated? Here, we hypothesize and test the effect of nonverbal synchrony on CI that develops through visual and audio cues in physically-separated teammates. We show that, contrary to popular belief, the presence of visual cues surprisingly has no effect on CI; furthermore, teams without visual cues are more successful in synchronizing their vocal cues and speaking turns, and when they do so, they have higher CI. Our findings show that nonverbal synchrony is important in distributed collaboration and call into question the necessity of video support.

Background Antibiotic resistance is a growing public health threat. In Afghanistan, high levels of indiscriminate antibiotic use exist, and healthcare programmes are not informed by understanding of local attitudes towards rational antibiotic use. Médecins Sans Frontières is an international non-governmental organization providing healthcare services to the Ahmad Shah Baba (ASB) District Hospital in Kabul, Afghanistan, since 2009. This mixed-methods study aimed to explore the perceptions and attitudes toward antibiotics among patients, prescribers, and pharmacists in the ASB District hospital outpatient department. Methods and findings Knowledge of antibiotics including their purpose and function, how and why they are used, and drivers for choice of antibiotic was examined at patient, prescriber, and provider-level. The first phase of the study, an exploratory qualitative component using an interpretative approach, was used to inform the second phase, a structured survey. Thirty-six interviews were conducted with 39 participants (21 patients or caretakers and 18 hospital health workers). Three hundred and fifty-one (351) patients and caretakers completed the second phase, the structured survey. This study found that poor knowledge of antibiotics and antibiotic resistance is a driving factor for inappropriate use of antibiotics. Participant perceptions of living in a polluted environment drove the high demand and perceived ‘need’ for antibiotics: patients, doctors and pharmacists alike consider dirty and dusty living conditions as causes of ‘disease’ in the body, requiring antibiotics to ‘clean’ and ‘strengthen’ it. Conclusions Findings highlight the need for strategies to improve awareness and knowledge of the general public, improve practice of doctors and pharmacists, regulate antibiotic dispensing in private pharmacies, and implement antibiotic stewardship in hospitals.

Objective: Total knee arthroplasty (TKA) is the gold-standard treatment for end-stage knee osteoarthritis, and the primary expectations are reduced pain and improved function. However, there is conflicting evidence regarding functional changes post-TKA. Commonly, functional changes are measured using Oxford Knee Score (OKS). No previous study has investigated physical behaviour (PB) changes in terms of volume and patterns post-TKA. The aims of this study were to explore volume and pattern changes in PB following TKA using an objective tool and to assess the correlation between this and OKS. Design: An activPAL measured the PB of individuals on a waiting list for TKA for a period of 7–8 days pre-TKA, and for the same length of time at 12 months post-TKA. OKS was completed at similar follow-up time points. Results: Thirty-three individuals completed the study, where stepping time, the number of steps and the time spent on moderate to vigorous physical activity (MVPA) (>100 steps/minute) improved significantly post-TKA p = 0.0001. Steps at 12 months post-TKA improved by 45.6% (from 4240 to 6174) and stepping time increased by 38.8% (from 0.98 to 1.36 h). MVPA improved by 35 min at 12 months (from 6.6 to 41.7 min). There were no significant correlations between PB and OKS. Conclusion: This is the first study to explore PB volumes and event-based patterns post-TKA. Activity improved in terms of volume and patterns. No correlation was found between OKS and ActivPAL, which emphasises the need to use objective methods in addition to patient-reported outcome measures.

SettingFemale genital mutilation (FGM) is a traditional surgical modification of the female genitalia comprising all procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs for cultural or nontherapeutic reasons. It can be harmful and violates girls' and women's human rights. FGM is a worldwide problem but mainly practiced in Africa. FGM is still widely practiced in Ethiopia despite being made a criminal offence in 2004.ObjectiveUsing data from three Ethiopian Demographic Health Surveys (EDHS) conducted in 2000, 2005 and 2016 the objective was to assess changes in prevalence of FGM and associated factors among women of reproductive age and their daughters.MethodsEDHS datasets for the three surveys included data on FGM prevalence and socio-demographic factors. After weighting, the data were analysed using frequencies, proportions and the chi square test for trend. Categorical variables associated with FGM in 2016 were compared using OpenEpi and presented as prevalence ratios (Pr) with 95% Confidence Intervals (CI). Levels of significance were set at 5% (PResultsThere was overall decline in FGM prevalence (from 79.9% to 74.3% to 65.2%, P95%, lack of school education, coming from rural areas and living in less wealthy households.ConclusionAlthough progress has been slow, the prevalence of FGM in Ethiopia has declined over time. Recommendations to quicken the trajectory of decline targeting integrated interventions to high prevalence areas focusing on mothers, fathers, youngsters, religious leaders and schools and ensuring that all girls receive some form of education.

Organizations are increasingly looking for ways to reap the benefits of cognitive diversity for problem solving. A major unanswered question concerns the implications of cognitive diversity for longer-term outcomes such as team learning, with its broader effects on organizational learning and productivity. We study how cognitive style diversity in teams—or diversity in the way that team members encode, organize and process information—indirectly influences team learning through collective intelligence, or the general ability of a team to work together across a wide array of tasks. Synthesizing several perspectives, we predict and find that cognitive style diversity has a curvilinear—inverted U-shaped—relationship with collective intelligence. Collective intelligence is further positively related to the rate at which teams learn, and is a mechanism guiding the indirect relationship between cognitive style diversity and team learning. We test the predictions in 98 teams using ten rounds of the minimum-effort tacit coordination game. Overall, this research advances our understanding of the implications of cognitive diversity for organizations and why some teams demonstrate high levels of team learning in dynamic situations while others do not.

Recent research with face-to-face groups found that a measure of general group effectiveness (called "collective intelligence") predicted a group's performance on a wide range of different tasks. The same research also found that collective intelligence was correlated with the individual group members' ability to reason about the mental states of others (an ability called "Theory of Mind" or "ToM"). Since ToM was measured in this work by a test that requires participants to "read" the mental states of others from looking at their eyes (the "Reading the Mind in the Eyes" test), it is uncertain whether the same results would emerge in online groups where these visual cues are not available. Here we find that: (1) a collective intelligence factor characterizes group performance approximately as well for online groups as for face-to-face groups; and (2) surprisingly, the ToM measure is equally predictive of collective intelligence in both face-to-face and online groups, even though the online groups communicate only via text and never see each other at all. This provides strong evidence that ToM abilities are just as important to group performance in online environments with limited nonverbal cues as they are face-to-face. It also suggests that the Reading the Mind in the Eyes test measures a deeper, domain-independent aspect of social reasoning, not merely the ability to recognize facial expressions of mental states.

The dramatic expansion of internet communication tools has led to the increased use of temporary online groups to solve problems, provide services, or produce new knowledge. However, many of these groups need help to collaborate effectively. The rapid development of new tools and collaboration forms requires ongoing experimentation to develop and test new ways to support this novel form of teamwork. Building on research demonstrating the use of nudges to shape behavior, we report the results of an experiment to nudge teamwork in 168 temporary online groups randomly assigned to one of four different nudge treatments. Each nudge was designed to spur one of three targeted collaborative processes (collaborator skill use, effective task strategy, and the level of collective effort) demonstrated to enhance collective intelligence in extant research. Our results support the basic notion that digitally nudging collaborative processes can improve collective intelligence. However, to our surprise, a couple of nudges had unintended negative effects and ultimately decreased collective intelligence. We discuss our results using structured speculation to systematically consider the conditions under which we would or would not expect the same patterns to materialize in order to clearly articulate directions for future research. [ABSTRACT FROM AUTHOR]

As society has come to rely on groups and technology to address many of its most challenging problems, there is a growing need to understand how technology-enabled, distributed, and dynamic collectives can be designed to solve a wide range of problems over time in the face of complex and changing environmental conditions—an ability we define as "collective intelligence." We describe recent research on the Transaction Systems Model of Collective Intelligence (TSM-CI) that integrates literature from diverse areas of psychology to conceptualize the underpinnings of collective intelligence. The TSM-CI articulates the development and mutual adaptation of transactive memory, transactive attention, and transactive reasoning systems that together support the emergence and maintenance of collective intelligence. We also review related research on computational indicators of transactive-system functioning based on collaborative process behaviors that enable agent-based teammates to diagnose and potentially intervene to address developing issues. We conclude by discussing future directions in developing the TSM-CI to support research on developing collective human-machine intelligence and to identify ways to design technology to enhance it. [ABSTRACT FROM AUTHOR]

In spite of the recognized importance of team creativity for organizational success, the factors that influence it are not well understood. In this paper, we address an important gap in the literature on the impact of team diversity on team creativity. We show how team cognitive diversity both enhances and inhibits team cognition, or the manner in which information is organized and distributed within the team. We further demonstrate that team cognition is a key mechanism through which cognitive diversity influences team creativity. The paper introduces a new theoretical lens, the signal-detection perspective, which argues that cognitive diversity amplifies the signals to the location of critical cognitive resources within the team and aids in their detection, consequently enhancing the form of team cognition that is central to team creativity. We test the predictions in a longitudinal study with 112 MBA student project teams. This research advances our understanding of what makes teams creative by synthesizing and testing existing theory as well as providing a new perspective that highlights an alternative way in which a team's cognitive inputs impact team creativity. History: Accepted by Sendil Ethiraj, organizations. Keywords: team creativity * team cognition * team diversity * cognitive style * transactive memory system * team strategic consensus, Introduction In this era, described by some as the 'creativity era' (Kirstetter et al. 2013), there exists a growing reliance on creative solutions, largely produced by teams. Teams play a [...]