Team Model Research Articles

Team-centered IDAC: Modeling and simulation of operating crew in complex systems - Part 2: Simulation aspects and application

Complex systems operations, such as Nuclear Power Plants (NPPs), generally require professional operating teams. Factors associated with teamwork, such as inappropriate communication and coordination, are important contributing factors to accidents and unsafe behavior. The impact of crew interactions on team effectiveness and, consequently, on the entire system, has yet to be fully and quantitatively explored in high-risk environments such as NPPs. Since a team is an interactive social system, team-specific issues must be studied and evaluated from a “team perspective”—based on team dynamics and processes. This paper is a part of a two-papers series that presents a simulation-based Team Model for NPP control room operations. Part 1 describes the theoretical fundaments of the model and details its elements. The current paper, Part 2, describes the simulation aspects and a full application of the method to an NPP four-steam generator feedwater system pipe break. It presents how to set up the simulation elements, such as hardware and humans within a team, using MATLAB Simulink. The method is demonstrated through a case study of an NPP four-steam generator feed water system pipe break. The results are discussed and assessed against theoretical and experimental findings.

Multi-disciplinary team approach for pediatric hemimegalencephaly: Insights from a single institutional case series.

Recent genetic studies have revealed that hemimegalencephaly (HME) is a multi-system disorder associated with germline or mosaic variants within the PI3K-mTOR-GATOR1 signaling pathways. Patients with HME typically develop drug-resistant epilepsy necessitating extensive evaluation, hemispherectomy, and long-term management. We describe the role of a multidisciplinary team (MDT) for the diagnosis and management of recent patients with HME at UCLA who underwent hemispherectomy. Genetic evaluation identified nine patients with the following variants: NPRL3 x2 germline, PIK3CA mosaicism x4, MTOR mosaicism x1, AKT3 mosaicism x1, unknown x1. Each patient's MDT comprised 4-9 specialties. One child with a MTOR variant had persistent epilepsy after hemispherectomy, but addition of everolimus resulted in an 80% decrease in seizure frequency. Another child with hemihypertrophy and PIK3CA mosaic variant was offered targeted PIK3CA inhibitor treatment, alpelisib, for overgrowth. A third child with germline NPRL3 variant inherited from their unaffected mother resulted in a sibling being diagnosed with the variant who later developed seizures secondary to focal cortical dysplasia. The implementation of a MDT offers essential guidance for families affected by HME, encompassing prognostication, surveillance, and therapeutic strategies. Identifying the etiology of HME can facilitate the development of targeted treatments and enable timely genetic counseling. PLAIN LANGUAGE SUMMARY: Hemimegalencephaly (HME) is a complex brain disorder caused by genetic changes. It often leads to severe epilepsy that doesn't respond to standard treatments and frequently requires surgery. In this case series, nine patients with HME were identified and found to have genetic mutations in key growth-regulating genes. A multidisciplinary team model was developed to facilitate patients' care. For example, one patient's seizures improved with surgery, another with a new targeted medication, and another received treatment for symptoms of overgrowth. This team approach provides comprehensive care for patients and can lead to efficient care coordination and implementation of novel therapies.

Correction to: Examining ownership models in software teams

Correction to: Examining ownership models in software teams

Impact of Co-Management Mode on Diagnosis and Treatment Compliance in Community-Level Diabetic Patients with Retinopathy.

Aims/Background To implement a co-management mode among community-level diabetes patients and analyze its impact on diagnosis and treatment compliance and diabetic retinopathy of the patients. Methods A total of 80 patients who underwent diabetic retinopathy examination in Lanxi People's Hospital from January 2021 to March 2022 were retrospectively selected as the study objects. The clinical data of the patients were analyzed, including 40 patients who adopted the conventional diabetes management mode from January 2021 to August 2021 as the control group. From September 2021 to March 2022, 40 patients in the county medical service community diabetes management team model were adopted as the management group. The two groups of patients were compared in terms of diabetic retinopathy indictors, biochemical examination indicators, self-management ability, and nursing management satisfaction. Results Number of patients complying with treatment protocols in the management group was higher than that in the control group (p < 0.05). The blood spot area, macular thickness, hemangioma volume, and visual-field grayscale value in the management group at the last follow-up were all lower than those in the control group (p < 0.05). The levels of diastolic blood pressure (DBP), systolic blood pressure (SBP), fasting blood glucose (FBG), hemoglobin A1C (HbA1c), total cholesterol (TC), and triglyceride (TG) in the management group at the last follow-up were all lower than those in the control group (p < 0.05). The scores of disease cognition ability, self-management ability, and nursing management satisfaction in the management group were all higher than those in the control group (p < 0.05). Conclusion By changing management concept and implementing the whole-process management and treatment mode for diabetic patients within the scope of the county medical service community, the diagnosis and treatment compliance of the patients can be improved, and the effective control of blood glucose, blood pressure, and blood lipid levels can be achieved, thereby improving the self-management ability and nursing management satisfaction of the patients and providing a new nursing mode for chronic disease management.

Team-centered IDAC: Modeling and simulation of operating crew in complex systems – Part 1: Team model and fundamentals

Operation of highly complex systems such as Nuclear Power Plants (NPPs) generally require highly trained professional operating teams. Factors associated with teamwork, such as ineffective communication and coordination, can be important contributing factors to accidents and unsafe behavior. The impact of crew interactions on team effectiveness and, consequently, on the entire system, has not been fully and quantitatively explored in high-risk environments such as NPPs. Since a team is an interactive social system, team-specific issues must be studied and evaluated from a “team perspective”—based on team dynamics and processes. This paper is part of a two-papers series that presents a simulation-based Team Model for NPP control room operations. The current paper, Part 1, describes the theoretical fundaments of the model and details its elements. The accompanying paper describes the simulation aspects, and a full application of the method to a pipe break accident in a four- four-loop steam generator feedwater system. The proposed model is based on the IDAC (Information, Decision, and Action in Crew context) cognitive model framework. The resulting model, Team-centered IDAC (Tc-IDAC), examines the team activities “Collaborative information collection,” “Shared decision making,” and “Distributed action execution” through specific modules for Team Error Management. These modules include error detection, error indication and error correction, and team performance shaping factors.

The application value of the multidisciplinary team model led by specialist nurses in pressure ulcer management.

The application value of the multidisciplinary team model led by specialist nurses in pressure ulcer management.

Considering best practice standards for routine whole-genome sequencing for TB care and control.

TB is a priority pathogen for the application of whole-genome sequencing (WGS) into routine public health practice. In low-incidence settings, a growing number of services have begun to incorporate routine WGS into standard practice. The increasing availability of real-time genomic information supports a variety of aspects of the public health response, including the detection of drug resistance, monitoring of laboratory and clinical practices, contact tracing investigations and active case finding. Optimal structures and approaches are needed to support the rapid translation of genomic information into practice and to evaluate outcomes and impact. In this consensus paper, we outline the elements needed to systemically incorporate routine WGS into the TB public health response, including the sustainability of services, multidisciplinary team models and monitoring and evaluation frameworks. If integrated in an efficient and thoughtful manner, routine WGS has the potential to significantly improve clinical TB care for individuals and the overall public health response.

Trisomy 21 and Congenital Heart Disease: Impact on Health and Functional Outcomes From Birth Through Adolescence: AScientific Statement From the American Heart Association.

Due to improvements in recognition and management of their multisystem disease, the long-term survival of infants, children, and adolescents with trisomy 21 and congenital heart disease now matches children with congenital heart disease and no genetic condition in many scenarios. Although this improved survival is a triumph, individuals with trisomy 21 and congenital heart disease have unique and complex care needs in the domains of physical, developmental, and psychosocial health, which affect functional status and quality of life. Pulmonary hypertension and single ventricle heart disease are 2 known cardiovascular conditions that reduce life expectancy in individuals with trisomy 21. Multisystem involvement with respiratory, endocrine, gastrointestinal, hematological, neurological, and sensory systems can interact with cardiovascular health concerns to amplify adverse effects. Neurodevelopmental, psychological, and functional challenges can also affect quality of life. A highly coordinated interdisciplinary care team model, or medical home, can help address these complex and interactive conditions from infancy through the transition to adult care settings. The purpose of this Scientific Statement is to identify ongoing cardiovascular and multisystem, developmental, and psychosocial health concerns for children with trisomy 21 and congenital heart disease from birth through adolescence and to provide a framework for monitoring and management to optimize quality of life and functional status.

TIP: A trust inference and propagation model in multi-human multi-robot teams

Trust is a crucial factor for effective human–robot teaming. Existing literature on trust modeling predominantly focuses on dyadic human-autonomy teams where one human agent interacts with one robot. There is little, if not no, research on trust modeling in teams consisting of multiple human and robotic agents. To fill this important research gap, we present the Trust Inference and Propagation (TIP) model to model and estimate human trust in multi-human multi-robot teams. In a multi-human multi-robot team, we postulate that there exist two types of experiences that a human agent has with a robot: direct and indirect experiences. The TIP model presents a novel mathematical framework that explicitly accounts for both types of experiences. To evaluate the model, we conducted a human-subject experiment with 15 pairs of participants (N=30\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$N=30$$\\end{document}). Each pair performed a search and detection task with two drones. Results show that our TIP model successfully captured the underlying trust dynamics and significantly outperformed a baseline model. To the best of our knowledge, the TIP model is the first mathematical framework for computational trust modeling in multi-human multi-robot teams.

Accelerating rare disease detection: an experience of multidisciplinary team model in undiagnosed diseases program in a children's hospital.

A definite diagnosis goes undiscovered for a percentage of children with undiagnosed disorders, with significant medical, psychological, and social effects. Other than specialized clinical centers, exceptional molecular studies, common procedures, and devoted activities at the national and international levels, children with complex undiagnosed disorders require innovative approaches. In March 2016, Children's hospital of Fudan university represented the Children's Undiagnosed Diseases Program (UDP). The purpose of this study is to describe the project findings and underline the critical significance of multidisciplinary teamwork in China's undiagnosed rare illnesses program. We investigated the 758 cases in our UDP system retrospectively. Demographic information, laboratory test results, and genetic information were gathered. Between January 2017 and December 2021, 758 cases were examined. Males made up 436 (57.5%) of the total. Over half of the patients were children under the age of five. The average patient course time preceding admission to UDP was 6.0 months (95% CI 10.512.6). These patients visited an average of 1.8 clinics during their diagnostic journey. Except for 69 individuals (90.9%), all had more than one presenting symptom in various organs: 460 (60.7%) had neurology difficulties, 151 (19.9%) had endocrine problems, and 141 (18.6%) had immunology problems. UDP has a diagnosis rate of 61.3%. Genetic testing was performed on 469 of the 758 patients, for a genetic diagnosis rate of 15.8%. The UDP method has a sensitivity of 94.5%, a specificity of 86.4%, a positive predictive value of 92.8%, and an negative predictive value of 89.5%. Our UDP targets an unmet need, namely the diagnosis of patients with complicated, multisystem illnesses. Using a multidisciplinary team model approach, this UDP pilot study achieved a reasonable diagnosis success rate, increasing the possibility of more diagnoses and new scientific discoveries of difficult and rare diseases.

Undoing cultural studies: cultural economy at the Open University (1979–1997)

ABSTRACT This introduction article establishes the territory for the Symposium What Was Cultural Economy? After setting out the reasoning behind the collection and its eight contributions, the introduction describes the terms on which the ‘cultural economy’ concept was launched, within the Open University’s Faculty of Social Sciences, at the end of the 1990s. Noting the collective work involved, I highlight the role of Stuart Hall, and the brand of cultural studies he represents, as a key vector. Hall’s position as totemic public intellectual obscures his work as a teacher, curriculum designer and colleague, channelling the ‘cultural turn’ through this internal academic context. As such, I also stress the OU’s course team model of intellectual production, drawing from recent historiography on workshops as devices for the practice of collective intellectual and cultural work, coupling this to the figure of the ‘vanishing mediator’ as a driver of material and symbolic transformation. I then move to sketch out some of the key interpersonal relations, institutional contexts and intellectual trajectories through which cultural economy was first formulated. In conclusion, I ask what implications this little history might hold for a present-day journal engaged in the workshopping of ideas at increasingly international scale.

Cognitive Modelling of Service Design Team Based on Genetic Algorithms

Currently, the development of the world economy plays a prominent role in the service industry. Modeling the service industry is an important issue that focuses on the service sector. Therefore, this study created a cognitive model for a service design team and how to build a team based on it. These models and methods aim to promote and realize commercial and social value innovations in service design. However, this study sets two objectives by focusing on the process and analysis as follows: (1) studying the process of cognitive mechanisms for service design and (2) analyzing and designing a model for the establishment of a service design team. This method defines the main focus of the service design team management study using genetic algorithms that search based on the probability of motivation. The process involves designing and creating a cognitive model for services using genetic algorithms. The results show a team management model designed using cognitive mechanisms. These models and methodologies promote the realization of innovative commercial and social value in service design, resulting in satisfactory and reliable results.

Understanding Team Cognition in Support of Long-Distance Space Missions

Future long-distance space missions (LDSM) present formidable challenges due to prolonged isolation, communication delays, and extreme conditions, which affect individual and team cognitive functions, crucial for mission success. This necessitates a higher degree of autonomy, emphasizing the importance of team cognition in managing the complexities of LDSMs. Although prior research has largely focused on individual cognition, the collective cognitive processes that support effective team performance in space have been less studied. This oversight is critical as factors like microgravity and isolation can impair individual level cognitive functions vital for teamwork, such as attention and working memory. This paper employs the Macrocognition in Teams Model to study publicly available transcripts from the Apollo space missions to understand the challenges to collaborative problem-solving in these complex and high stress environments.

Differential Effects of an Integrated Community-Based End-Of-Life Support Team (ICEST) Model for Terminally Ill Older Adults on Spousal and Adult-Children Caregivers.

Backgrounds: Family caregivers (FCs) play an essential role in delivering home-based end-of-life care. However, little is known about FCs'' experiences when undertaking this role. The integrated community end-of-life support team (ICEST) is a needs-driven, home-based, family-centered care model in Hong Kong. We evaluated its effects on FCs and compared outcomes for spouses and adult children. Method: A multicenter pre-post-test study was conducted. Eligible participants were primary FCs of terminally ill older adults (age ≥ 60) who had a life expectancy of ≤12months. Baseline (T0) and three-month post-intervention (T1) outcome measures included FCs'' caregiving strain, psychological distress, perceived external support, intimate relationships, and communications regarding care planning. Results: A sample of 628 FCs were enrolled at T0, and 40.0% completed the T1 assessments. The ICEST model was effective in reducing caregiving strain, depression, and worries about patients, whilst there were improvements in agreement about care planning with patients, and perceived external supports. At T0, spouses held more negative perceptions of caregiving and faced fewer adjustment demands than adult children. Compared with spouses, adult children were more intimate with patients. Between T0 and T1, spouses experienced a greater reduction in worries about patients, than adult children. Conclusions: The ICEST model contributed to better outcomes, individually and relationally, for FCs, regardless of relationship type. Spouses and adult children faced different challenges while delivering home-based end-of-life care. Effective interventions should modify the negative perceptions of caregiving in spousal caregivers and enable adult children to deal with multiple tasks and complex expectations.

Internal medicine in the 21st century: Back to the future

Healthcare systems face multiple challenges arising from demographic factors (population aging) and epidemiological factors (rise of chronic diseases and patients with multimorbidity) as well as threats to their financial sustainability when maintaining equitable access to medical and technological advances. Current healthcare models, based on specialized medical care, lead to fragmented care that can be harmful to the patient and is inefficient for the system due to the overuse of redundant, low-value medical acts. Internal medicine is the hospital-centered general medical specialty par excellence, providing a comprehensive and holistic vision that is centered on the patient and not on the disease. Internists should be the leading physicians in the hospital setting for complex patients with or those with an uncertain diagnosis. Internists must play a key role, as hospitalists do, in the continued care of acute patients hospitalized for medical or surgical diseases, establishing shared care models in multidisciplinary teams. Likewise, to guarantee continuity of care for chronic patients, internists must establish mechanisms for collaboration with primary care and nursing, participating in the development of new out-of-hospital care models that use the available technological resources. Internal medicine should play a leading role in graduate and postgraduate medical education to promote a holistic vision among medical students and residents in medical subspecialties.

A realist evaluation protocol: assessing the effectiveness of a rapid response team model for mental state deterioration in acute hospitals.

Mental state deterioration poses significant challenges in healthcare, impacting patients and providers. Symptoms like confusion and agitation can lead to prolonged hospital stays, increased costs, and the use of restrictive interventions. Despite its prevalence, there's a lack of consensus on effective practices for managing mental state deterioration in acute hospital settings. To address this gap, a rapid response team model has been proposed as a potential intervention, aiming to provide early identification and targeted interventions. Based on realist evaluation steps, first, initial program theories are formulated to understand the logic behind the intervention. Second, literature synthesis identifies empirical evidence on contexts, mechanisms, and outcomes elements, refining initial theories. During the third step, data will be collected using qualitative methods such as field observations and interviews, as well as quantitative methods such as surveys of the staff, audits of electronic medical records, and analysis of incident records of mental state deterioration. Analysing this data informs configurations of contexts, mechanisms, and outcomes. In the fifth step, the configurations are synthesised, presenting refined, evidence-informed program theories. This study addresses the knowledge gap by evaluating the rapid response model's effectiveness in managing mental state deterioration in acute hospital settings. Realist principles guide the exploration of causal mechanisms and their interaction with specific implementation contexts. The objective is to identify what works, for whom, and under what circumstances, aiming to manage deterioration, reduce restrictive interventions, and enhance the experience for patients and staff by implementing a proactive model of care. The findings contribute to evidence-based approaches for managing mental state deterioration in hospital settings, informing policy and practice in this crucial area of healthcare.

Application of multidisciplinary team-based integrated traditional Chinese medicine and Western medicine in rotator cuff injury patients undergoing arthroscopic surgery.

Arthroscopic rotator cuff repair is a common surgical treatment for rotator cuff injuries (RCIs). Although this procedure has certain clinical advantages, it requires rehabilitation management interventions to ensure therapeutic efficacy. To investigate the effect of integrated traditional Chinese medicine and Western medicine (TCM-WM) under the multidisciplinary team (MDT) model on the postoperative recovery of patients undergoing arthroscopic surgery for RCIs. This study enrolled 100 patients who underwent arthroscopic rotator cuff repair for RCIs at the Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine between June 2021 and May 2024. They were divided into a control group (n = 48) that received routine rehabilitation treatment and an experimental group (n = 52) that received TCM-WM under the MDT model (e.g., acupuncture, TCM traumatology and orthopedics, and rehabilitation). The results of the Constant-Murley Shoulder Score (CMS), Visual Analogue Scale (VAS), Shoulder Pain and Disability Index (SPADI), muscular strength evaluation, and shoulder range of motion (ROM) assessments were analyzed. After treatment, the experimental group showed significantly higher CMS scores in terms of pain, functional activity, shoulder joint mobility, and muscular strength than the baseline and those of the control group. The experimental group also exhibited significantly lower VAS and SPADI scores than the baseline and those of the control group. In addition, the experimental group showed significantly enhanced muscular strength (forward flexor and external and internal rotator muscles) and shoulder ROM (forward flexion, abduction, and lateral abduction) after treatment compared with the control group. TCM-WM under the MDT model improved shoulder joint function, relieved postoperative pain, promoted postoperative functional recovery, and facilitated the recovery of muscular strength and shoulder ROM in patients with RCIs who underwent arthroscopic rotator cuff repair.

Strategic Approaches to Design Teams for Construction Quality Management and Green Building Performance

Buildings exert a profound influence on the environment, with the design phase recognized as the pivotal determinant of a building’s overall performance. Green building design, in particular, introduces heightened complexity, where the attributes of the design team play a pivotal role in shaping performance outcomes. Consequently, the characteristics of the design team emerge as crucial factors in the enhancement of both green building design performance and client attributes. This study aims to empirically examine a model formulated to gauge the extent to which Effective Design Team Attributes contribute to the enhancement of performance in designing green buildings and influencing client attributes. To achieve this objective, a comprehensive questionnaire survey was administered to professionals within the architecture and engineering domains actively engaged in the design and consulting sectors of the building industry. The collected data underwent meticulous scrutiny for authenticity and dependability using the WINSTEPS 5.2.5 software before undergoing subsequent analysis. Statistical analyses were conducted using SPSS version 19, with Principal Components Analysis (PCA) and the Structural Equation Modeling (SEM) approach implemented through Amos version 18 to derive the most robust model. The findings underscore the pivotal role of an adeptly managed design team in significantly improving both the performance of green building designs and the qualities of clients. Rasch’s analysis confirmed the validity of our 5-point Likert scale for Design Green Building Performance (DGBP), Effective Design Team Attributes (EDTA), and Client Qualities (CQ). All items demonstrated excellent reliability, separation, and discrimination, ensuring robust data quality. Dimensionality tests revealed the appropriateness of response categories, indicating satisfactory scale performance. The Effective Design Team Model, validated through Principal Components Analysis (PCA), exhibited a satisfactory fit, supported by significant chi-square statistics, high goodness-of-fit indices, and acceptable root mean square residual values. Client attributes displayed a strong association with effective design team management, validating key model elements. The intricacies inherent in the design process can be mitigated by adopting the green design charrette approach. Consequently, the establishment of an effective design team, coupled with green design leadership, active participation, and clarity in roles and responsibilities, emerges as a potent strategy for elevating the performance level of green building designs.

Values Spiral Development Method in the Implementation of Digitalization Projects in Syncretic Methodology

The article is devoted to the formulation of the method of spiral development of values in the implementation of digitalization projects of self-managed organizations, which was developed within the syncretic methodology of project management. The application of the proposed method is considered in the field of infrastructure restoration projects of Ukraine. A scientific problem regarding the availability of a project management methodology that meets modern challenges has been formulated. The gap between the practical needs of project-oriented organizations in a new unique methodology and the availability of established standards for solving typical project management tasks is revealed. A review of literary sources was carried out, modern project management trends were highlighted, including: increasing complexity of modern corporate project management methodologies, application of value-oriented management approaches, models of self-managed teams. The principles of value-oriented management for infrastructure restoration projects implemented by self-managed organizations within the syncretic methodology have been formulated. The method of values spiral development of a project-oriented organization, which uses models of self-management, through the implementation of digitalization projects within the syncretic methodology, is proposed. Within the scope of the method: a value model for digitalization projects of self-managed organizations is proposed; the concept of "stellarator project" is introduced, the definition of such a project is given. The results of the approbation of the method in a project-oriented organization working in the field of infrastructure restoration of Ukraine are presented and analyzed. Areas of improvement of the project-oriented activities of the specified organization have been determined. A SWOT analysis of the proposed method was carried out. Conclusions based on the research are formulated, prospects for further research in the chosen direction are outlined.

Values Spiral Development Method in the Implementation of Digitalization Projects in Syncretic Methodology

The article is devoted to the formulation of the method of spiral development of values in the implementation of digitalization projects of self-managed organizations, which was developed within the syncretic methodology of project management. The application of the proposed method is considered in the field of infrastructure restoration projects of Ukraine. A scientific problem regarding the availability of a project management methodology that meets modern challenges has been formulated. The gap between the practical needs of project-oriented organizations in a new unique methodology and the availability of established standards for solving typical project management tasks is revealed. A review of literary sources was carried out, modern project management trends were highlighted, including: increasing complexity of modern corporate project management methodologies, application of value-oriented management approaches, models of self-managed teams. The principles of value-oriented management for infrastructure restoration projects implemented by self-managed organizations within the syncretic methodology have been formulated. The method of values spiral development of a project-oriented organization, which uses models of self-management, through the implementation of digitalization projects within the syncretic methodology, is proposed. Within the scope of the method: a value model for digitalization projects of self-managed organizations is proposed; the concept of "stellarator project" is introduced, the definition of such a project is given. The results of the approbation of the method in a project-oriented organization working in the field of infrastructure restoration of Ukraine are presented and analyzed. Areas of improvement of the project-oriented activities of the specified organization have been determined. A SWOT analysis of the proposed method was carried out. Conclusions based on the research are formulated, prospects for further research in the chosen direction are outlined.