Organizational Structures Research Articles

Disrupting Structural Racism in LGBTQ+ Health Organizations Through Equity Committee Work

Diversity, Equity, and Inclusion (DEI) efforts and facilitation have historically been focused on bias awareness, training on microaggressions, individual awareness, and affinity groups. This approach is often devoid of systems-level analysis and more profound work toward the cultural transformation of spaces, organizations, and agencies. To explore adding depth to the work of dismantling white hegemonic culture, we designed an equity committee process at the intersection of public health and social justice. The resulting tool, the Designing Equity Continuum, includes four phases (identity, formation, priorities and strategies, and implementation and evaluation) with two particles each. It was presented at four meetings of 90 staff at 50 nonprofit organizations in New York State. All participants evaluated the presentations as “very satisfied” with content. Six implications for practice are given, including varied organizational readiness, inadequate organizational structures, need for advanced capacity building, additional time needed to understand the tool, support for additional racial identity-based affinity groups, and ensuring equity committees operate separately from employee resource groups.

Multidisciplinary Care in a Public University Family Medicine Group in Québec (Canada): Data on Patients’ Follow-Up and Cardiometabolic Risk Management

Background/Objectives: Generating real-world data on the efficacy of multidisciplinary care in cardiometabolic risk management is essential to ensure that guidelines are both applicable and effective, especially in public healthcare settings, where organizational structures may impede healthcare professionals’ agility. This study aimed to generate data on patient follow-up and cardiometabolic risk management during the early years of a public university family medicine group in Québec (Canada) that provides multidisciplinary care to adults with cardiometabolic conditions, in order to evaluate the implementation and effectiveness of its care model. Methods: This was a retrospective longitudinal study. Patients treated at the clinic from 31 January 2020 (clinic opening) to 8 May 2024 (n = 96) were invited to consent to the use of their medical data for research. Results: A total of 52 patients consented and were included in the study. Upon entry at the clinic, >90% of patients had anthropometry and blood pressure (BP) measured, but plasma glucose and lipids were assessed among 50% and 79% of patients, respectively. A total of 36 patients completed the personalized multidisciplinary care program. No evidence of associations between the total number of appointments or appointments with the registered dietitian specifically with changes in BMI, waist circumference, and BP was found. However, each pharmaceutical intervention was associated with a −0.51 cm (95%CI: −1.03, 0.02; p = 0.06) change in waist circumference and a −1.49 mm Hg (95%CI: −2.56, −0.43, p = 0.01) change in diastolic BP. Conclusions: These data highlight the challenges of implementing a research-oriented clinic within Québec’s public healthcare system.

Impact of Herzberg’s Two-Factor Theory and Its Influence on Employee Retention: A Sectoral Comparative Study in Bangladesh

This study investigates the influence of Herzberg’s Two-Factor Theory on employees’ retention across four key industries in Bangladesh manufacturing, banking, telecommunications, and services selected for their economic significance and diverse organizational structures. Focusing on full-time employees in non-executive to mid-level positions, the research examines how motivator factors (e.g., achievement, recognition, advancement) and hygiene factors (e.g., pay, job security, working conditions) impact retention decisions. A quantitative research design was adopted, utilizing a structured questionnaire administered to a randomly selected sample of 500 respondents. Descriptive statistics and multiple regression analysis were employed to assess the relationships among variables. The findings reveal that both hygiene and motivator factors significantly influence employees’ retention, with job security and recognition emerging as the most impactful predictors. Additionally, sectoral comparisons highlight notable variations in how these factors affect retention, underscoring the need for industry-specific human resource strategies. This study contributes to the literature by contextualizing Herzberg’s theory within Bangladesh’s evolving employment landscape and offers practical guidance for developing targeted retention policies. Future research could examine the role of leadership style and organizational culture in moderating these relationships.

Trust as the Foundation of Effective Management: Between Control and Support in the Context of Douglas McGregor’s Theories X and Y

The article presents a comprehensive analysis of the applicability of Douglas McGregor’s managerial assumptions — Theories X and Y — in the context of contemporary project–based activity and flexible organizational structures. The research is grounded in an interdisciplinary approach, incorporating behavioral economics, management theory, and organizational psychology. Particular attention is given to visual and content analysis of both domestic and international sources that explore the specifics of authoritarian and trust–based management styles, including case studies from Agile, Scrum, and Management 3.0 practices. Key differences between the theories are identified across eight criteria: from types of motivation and control mechanisms to the level of delegation and the expected organizational outcomes. The comparative analysis demonstrates that Theory X remains relevant in environments characterized by high regulation and technological predictability, whereas Theory Y proves effective in creative, distributed, and research–oriented teams with a high level of maturity. The study also considers hybrid management models that combine elements of both theories, enabling the adaptation of leadership style to evolving conditions and workforce characteristics. The article proposes an original classification of employee types based on motivational traits, with a corresponding optimal managerial approach (X, Y, or hybrid). Special emphasis is placed on the role of trust, autonomy, and maturity in shaping a productive organizational culture. This article will be of interest to management researchers, HR professionals, project team leaders, and anyone engaged in the development of flexible leadership styles and organizational behavior under conditions of uncertainty.

Nickel cobalt selenide as a nano–moss electrocatalyst for detection of gaseous hydrogen peroxide

Nanoparticles composed specifically of transition metals have demonstrated significant potential not only in electrocatalysis but also in electroanalysis. In this context, this work presents a comprehensive investigation into the electrocatalytic properties of NiCo2Se4 nanomaterials, specifically designed for hydrogen peroxide (H2O2) detection. The unique needle–like nano–moss morphology of NiCo2Se4, confirmed through scanning electron microscopy (SEM), scanning and transmission electron microscopy (STEM), and high–angle annular dark–field (HAADF) analysis, reveals a highly organized structure with a large surface area, critical for enhanced catalytic performance. XRD analysis further establishes the material’s high crystallinity and purity. Electrochemical characterization using cyclic voltammetry (CV) demonstrated the electrocatalytic activity of NiCo2Se4 towards the reduction of H2O2 in both oxygenated and deoxygenated conditions. The study identified that H2O2 disproportionation leads to oxygen generation at the electrode surface, which significantly enhances the reduction process. Tafel analysis showed notable enhancement of the electrode kinetics due to the catalyst’s presence, affirming its efficacy in facilitating electron transfer. The influence of polyacrylic acid (PAA), used as a gas adsorbent, was also explored, confirming that while PAA slightly hinders diffusional mass transfer, it does not interfere with the overall catalytic process. Further investigation into the mechanistic aspects of the H2O2 reduction suggested a complex reaction pathway, likely involving a ChetE mechanism combined with electrocatalysis of the second kind. This process is strongly influenced by the interplay between chemical disproportionation and electrode reactions, with oxygen acting as a redox catalyst. Finally, the practical application of NiCo2Se4–modified screen–printed electrodes (SPE) for gas–phase detection of H2O2 was explored. The sensor demonstrated the capability to detect gaseous H2O2, providing valuable insights into its potential use for environmental monitoring and industrial safety applications.Graphical abstract

Unveiling intra-urban complexity and identifying urban cores through the lens of living structure using point-of-interest data

ABSTRACT The intra-urban space is essentially an organized structure of complexity that consists of centers at different hierarchical levels or scales. This kind of complexity can be measured from the perspective of living structure inspired by Christopher Alexander’s organic view of space. Previous studies have revealed that the living structure can be used to characterize the structural complexity of photos, satellite images and urban systems. However, its potential to measure intra-urban complexity using massive point-based datasets remains underexplored. This study introduces a recursive method to analyze intra-urban complexity using massive point-of-interest (POI) data. By recursively decomposing urban substructures, we quantified structural complexity based on the livingness of substructures using a unified criterion. Our findings indicate that cities or intra-urban areas with higher livingness exhibit greater structural complexity. The resulting substructures exhibit power-law distributions and align closely with human activity patterns across multiple spatial scales in four large cities in China. Remarkably, intra-urban structures can be effectively understood with no more than four levels of recursive decomposition. Furthermore, we found that the urban centers or core areas can be effectively located using the proposed method. These insights underscore the potential of living structure as a framework for understanding and measuring the organized complexity of intra-urban spaces.

The Impact of Knowledge Management on Performance Through Intellectual Capital in Yemen’s Telecom

In the contemporary knowledge-driven economy, organisations are increasingly dependent on knowledge management and intellectual capital as key drivers for enhancing organisational performance. Despite the growing academic interest in these domains, research examining their combined impact remains limited, particularly within the context of the telecommunications sector in developing economies. This study aims to address this gap by identifying the impact of knowledge management on organisational performance through intellectual capital in the Yemeni telecommunications sector. To achieve this objective, the present study employed the quantitative research methodology, incorporating descriptive and analytical approaches. SPSS was utilised for descriptive and preliminary statistical analysis, while PLS-SEM was employed to examine the effects among the variables. The questionnaire was the principal instrument used to collect the necessary data for this study. A structural model has been proposed for the study variables, illustrating the relationship between knowledge management, intellectual capital, and their subsequent impact on organisational performance. The non-proportional stratified random sampling method was employed to select the study sample individuals. The model was evaluated using data obtained from 289 individuals employed in the Yemeni telecommunications sector. The study's findings indicated that knowledge management positively impacts organisational performance (B=0.776; p < 0.05), suggesting that knowledge management plays a significant role in enhancing organisational performance. In addition, intellectual capital was found to have a statistically significant direct impact on organisational performance (B=0.557; p < 0.05), highlighting its contribution to enhancing organisational performance. Furthermore, the results revealed a significant effect of knowledge management on IC (B=0.852; p < 0.05), suggesting that knowledge management enhances intellectual capital, which in turn strengthens its impact on organisational performance. Moreover, the mediation analysis confirmed that intellectual capital mediated the relationship between knowledge management and organisational performance, demonstrating that knowledge management influences organisational performance both directly and indirectly through intellectual capital. The findings contribute to the development of the resource-based view (RBV) and the knowledge-based view (KBV) by demonstrating how knowledge management and intellectual capital interact and jointly influence organisational performance. Furthermore, this study contributes to the extant literature by presenting a model that connects these variables in the telecommunications sector, a field that has not been sufficiently studied in previous research. In light of the aforementioned findings, the study recommended an increased focus on organisational performance and the establishment of organisational units within the organisational structures of the Yemeni telecommunications sector concerned with knowledge management, due to its significant impact on enhancing organisational performance in the Yemeni telecommunications sector.

Structurational Divergence: A Contributing Factor to Moral Injury Among Health Care Workers

To provide quality patient care, health professionals must be able to effectively communicate interpersonally and in team environments. While a lack of communication and conflict negotiation skills certainly can create obstacles to patient care, the organizational structures in which health professionals do their work also can obstruct communication or make it more difficult. Structurational divergence theory helps identify and explain the negative communication cycles that result when individuals must fulfill obligations from multiple competing systems, each with its own social rules. The structure of health care delivery systems also can result in structurational divergence, as health care workers must often navigate the space between their clinician priorities of improved patient health and the corporate priorities of greater efficiency and profit. This divergence creates tension for the clinician that can lead to burnout and moral injury, especially when the clinician feels forced to act outside the patient’s best interests. Individual efforts to address moral injury are less likely to be successful than collective group action. However, medical education can take steps to prepare students with the knowledge and tools necessary to navigate competing role demands, systemic obstacles, and ethical dilemmas to ensure quality patient care.

Platform Governance for Established Companies

Summary This article explores platform governance in established companies that face unique challenges when adopting platform strategies because of their complex organizational structures, diverse product ranges, legacy systems, and existing networks of partners. It analyzes four established companies’ governance strategies and proposes a multi-layered governance model that addresses the varying needs of internal business units, core partners, and third-party developers. This model highlights the importance of custom governance strategies tailored to specific ecosystem actors and their relationships. The findings contribute to a deeper understanding of platform governance in established companies and present practical recommendations for managers embarking on digital transformation.

A NEW INSTITUTIONAL MODEL IN TURKISH PUBLIC ADMINISTRATION: A STRUCTURAL ANALYSIS ON AREA PRESIDENCIES

This study offers a comprehensive structural analysis of "Area Presidencies," a relatively new and distinctive institutional model within Turkish public administration, established to manage and protect cultural and natural heritage sites. The significance of the research lies in addressing the institutional ambiguities, governance challenges, and democratic deficits that these entities generate, particularly due to their overlapping duties with existing public institutions. Employing a qualitative research design, the study utilizes a comparative case analysis of Cappadocia, Gallipoli, and Uludağ Area Presidencies, supplemented by international examples such as Stonehenge (UK), Pompeii (Italy), and the Acropolis (Greece). Through document analysis of legal frameworks, organizational structures, and administrative practices, the research critically evaluates the positioning, functioning, and authority conflicts surrounding Area Presidencies. The findings reveal that these entities, while aiming to enhance heritage protection and administrative efficiency, exacerbate institutional overlaps, weaken local governance, and generate jurisdictional confusion. The study concludes by proposing legal and administrative reforms to clarify institutional boundaries, strengthen inter-institutional coordination, and enhance participatory governance. By highlighting an overlooked dimension of Area Presidencies, the research contributes to both the theoretical understanding and practical improvement of Türkiye's public administration system.

Workplace learning during organizational onboarding: integrating formal, informal, and self-regulated workplace learning

IntroductionIn knowledge-based work environments, workplace learning is essential for successful employee integration and long-term performance. Onboarding represents a crucial phase in which newcomers begin to acquire organizational knowledge, take on new tasks, and establish social connections. While existing research has highlighted the role of formal and informal learning formats, less is known about how different learning forms interact and how newcomers actively contribute to their onboarding by engaging in self-regulated learning behaviors.MethodsThis qualitative study investigates onboarding as a dynamic learning process, focusing on how newcomers engage in formal, informal, and self-regulated workplace learning behaviors across four content dimensions: compliance, clarification, connection, and culture. The study is based on 40 semi-structured interviews with newcomers and analyzed using qualitative content analysis.ResultsThe findings show that newcomers engage in diverse learning activities that vary in structure and learner involvement. These differences illustrate distinct patterns in observed workplace learning behaviors across the four content dimensions.DiscussionThe study contributes to onboarding and workplace learning theory by linking content dimensions to learning forms and highlighting how newcomers actively shape their onboarding experience. It challenges static models of onboarding and conceptualizes it instead as an individualized and interactive learning path shaped by both organizational structures and learner behavior. Practical implications include designing onboarding processes that combine structure with learner autonomy and recognize newcomers not only as recipients of information, but as active participants who can co-construct organizational learning through their engagement.

Organizational Management of the Arabic Language Program at Pondok Pesantren Darussalam Sumani: Implementation, Constraints, and Solutions

This study addresses the limited scholarly attention given to the organizing function in the management of Arabic language programs at Islamic boarding schools, despite its critical role in enhancing students’ language proficiency. Focusing on Darussalam Sumani Solok Islamic Boarding School, the research aims to examine how organizational structures and practices contribute to the effectiveness of its Arabic language program. Employing a qualitative case study approach, the study involves purposively selected program organizers and students as participants. Data were gathered through in-depth interviews, direct observations, and document analysis, and were subsequently analyzed thematically. The findings indicate that the program is systematically organized through OSPPD, featuring structured task delegation and scheduled activities such as ilqā’ mufradāt, muḥādathah, muḥāḍarah, kitāb kuning, and art performances that collectively foster a bi’ah lughawīyah (Arabic-speaking environment). Despite these strengths, the program faces persistent challenges, including low student motivation, limited vocabulary acquisition, an unconducive learning environment, and the absence of exemplary teaching models. The study concludes that while the organizing function is moderately effective, it requires reinforcement through cultural strategies, intensive coaching, and broader stakeholder engagement to ensure program sustainability. These findings underscore the significance of structured management and a coherent curriculum in advancing Arabic language acquisition within Islamic boarding school contexts. Further research should expand to multiple institutions and incorporate mixed-methods designs to enhance generalizability and depth of understanding.

Change in Organizational Structure Influences Perceived Leadership in a Dutch Radiotherapy Center

PurposeHealthcare organizations face challenges in balancing efficiency and innovation, known as ambidexterity. Leadership plays an important role, with transformational leadership driving innovation and transactional leadership supporting efficiency. The dominant leadership framework is the Full-Range Leadership Theory (FRLT), which identifies three leadership behaviors: transformational, transactional, and passive avoidant. Organizational structures, following Mintzberg, Pugh and Galbraith, including span of control (SoC), unit grouping, and lateral linkages, significantly influence leadership dynamics. This study examines the impact of structural changes on perceived leadership styles in a Dutch radiotherapy center (RTc) following the implementation of proton therapy, a radical innovation.Patients and MethodsA mixed-method approach combined leadership surveys, with data collected at three time points, before and after structural changes in 2022. The multifactor leadership questionnaire (MLQ) was distributed among the employees in November 2021, March 2022, and March 2023. Three interventions were introduced: (1) appointing dedicated team leaders (TLs) to improve information flow and reduce management SoC; (2) integrating a Patient Care (PC) manager into the advisory board to facilitate direct communication within the governance structure, including other hierarchical layers; and (3) adding a proton therapy manager as a liaison to improve coordination. Leadership perceptions were measured using the Multifactor Leadership Questionnaire (MLQ) at three time points (T1, T2, T3). The Independent-Samples Mann–Whitney U-Test (p<0.05), was used to compare T1, T2, and T3, managers’ self-ratings with employee ratings, and scores between photon and proton treatment employees.ResultsTransformational leadership significantly increased across all groups, with PC scores rising from 2.3 at T1/T2 to 2.5 at T3, and MT-PC scores from 1.8 at T1 to 2.4 at T3. Passive avoidant leadership significantly decreased (eg, MT-PC: 1.6 at T1 to 1.0 at T3). Transactional leadership showed less pronounced and non-significant changes. Photon therapy staff experienced earlier improvements in leadership perceptions, while proton therapy staff showed delayed but stronger shifts by T3.ConclusionIn this study, structural changes positively influenced leadership perceptions, supporting ambidexterity. Significant increases in transformational leadership and decreases in passive avoidant leadership align leadership styles with the dual demands of innovation and operational efficiency, demonstrating the importance of organizational design in healthcare leadership. Our findings show that healthcare management could use organizational structure changes to promote transformational leadership.

Enablers and barriers in the professional development of nurses employed full-time at university nursing studies in Croatia: a qualitative study

BackgroundMultiple studies have highlighted the challenges faced by nurse educators working in an academic setting. However, to date, no published research has explored this issue in the Croatian context. This study explored and described the enablers and barriers to the professional development of full-time nurses employed in university-level nursing education programs in Croatia.MethodsA qualitative study was conducted from February to March 2024. Participants were full-time nurse educators holding teaching positions at 12 university-level nursing programs across Croatia. Data were collected using a semi-structured interview guide and analyzed through reflexive thematic analysis.ResultsOf the 58 individuals who met the inclusion criteria, 52 (90%) nurse educators participated in the study. The sample comprised 10 men and 42 women, ranging in age from 28 to 64 years. Participants identified work overload, particularly the burden of administrative tasks and competing responsibilities, as the primary barrier to their professional development. Additional challenges included limited time and resources, difficulties in organising clinical practice and mentoring, and a perceived disconnect between academic and clinical settings. Despite these challenges, the majority of participants reported overall satisfaction with their academic careers, highlighting the intrinsic value of knowledge dissemination, student engagement, and professional growth. Institutional support was noted in the form of co-financed educational opportunities, mentorship, and involvement in decision-making processes.ConclusionThe findings of this study indicate that improvements in working conditions and employment policies are needed to enhance job satisfaction among nurses employed in university nursing programs in Croatia. Key areas for intervention include reducing administrative burdens, strengthening management and organizational structures, increasing institutional support, and promoting access to continuous professional education. These factors are essential to fostering the professional development of nurses within an academic setting.Clinical trial registrationNot applicable. This study was not a clinical trial.

Residual-Free Micro–Nano Titanium Surfaces via Titanium Blasting and Single Acid-Etching: A Cleaner Alternative

Background: Traditional sandblasted large-grit acid-etched (SLA) surface treatments frequently utilize alumina (Al2O3) blasting, which may leave residual particles embedded in implant surfaces, potentially compromising biocompatibility and osseointegration. This study investigates a contamination-free alternative: titanium dioxide particle (TiO2) blasting followed by hydrochloric acid (HCl) etching, aimed at generating a cleaner, hierarchical micro–nano-textured surface. Methods: Grade IV titanium disks were treated either with TiO2 sandblasting alone or with an additional HCl etching step. Surfaces were analyzed via atomic force microscopy (AFM), scanning electron microscopy (SEM), contact angle measurements, and profilometry. hFOB osteoblasts were cultured to assess adhesion, proliferation, metabolic activity, and morphology. Results: The combination treatment produced a more homogeneous micro–nano structure with significantly increased roughness and a cleaner surface chemistry. Osteoblast proliferation and metabolic activity were notably improved in the TiO2 and HCl group. SEM imaging showed a more organized cytoskeletal structure and pronounced filopodia at 72 h. Conclusions: Titanium blasting combined with HCl etching yields a cost-effective, contamination-free surface modification with promising early-stage cellular responses. This approach represents a safer and effective alternative to conventional SLA treatment.

The relationship between knowledge sharing on intellectual capital in the Jordanian banking sector

The research aimed to identify the impact of knowledge sharing on developing intellectual capital, a field study on the Jordanian banking sector in Irbid Governorate, Jordan. The study relied on a descriptive-analytical approach; the study population consisted of Jordanian banks in Irbid Governorate. To achieve the study objectives, the researcher distributed the questionnaire to 217 individuals from Jordanian banks, and 205 valid questionnaires were retrieved for analysis. After analyzing the data using the Statistical Package for Social Sciences (SPSS), the study found several results, with the most significant being that knowledge sharing positively impacts the development of intellectual capital in the Jordanian banking sector. Based on these results, the researcher made several key recommendations, including promoting a culture of knowledge sharing in Jordanian banks by building and designing organizational structures that allow employees the freedom to manage their functional relationships both horizontally and vertically, as well as encouraging them to submit initiatives and proposals.

Implementing Evidence-Based Practice in Critical Care Nursing: An Ethnographic Case Study of Knowledge Use.

To explore how critical care nurses access, negotiate and apply knowledge in high-pressure clinical environments, focusing on organisational, cultural and leadership factors influencing evidence-based practice implementation in acute hospital settings. A focused ethnographic collective case study was conducted across two contrasting critical care units in England. Methods included non-participant observation (56 sessions), semi-structured interviews (36 participants) and document review. Spradley's Developmental Research Sequence guided data generation and analysis. Data were collected over an eight-month period (February to September 2022). Five major themes were identified: sources of knowledge and acquisition strategies; institutional and hierarchical influences on knowledge use; role of experiential knowledge and clinical intuition; challenges to evidence-based practice implementation; and strategies for integrating knowledge into practice. Organisational structures, leadership engagement, mentorship and access to updated digital resources were key enablers of evidence-based practice. Barriers included workload pressures, inconsistent guideline dissemination and hierarchical cultures. Adaptive blending of formal evidence, clinical experience and intuition characterised effective knowledge negotiation at the bedside. Knowledge use in critical care nursing is a dynamic, relational process shaped by leadership, organisational culture and systemic pressures. The availability of evidence alone is insufficient; visible leadership, peer learning, protected educational time and valuing of experiential knowledge are critical to embedding evidence-based practice into routine practice. Strengthening organisational systems, investing in nurse manager development, expanding simulation-based learning and legitimising experiential knowledge are vital strategies to enhance evidence-based critical care. This study provides actionable insights for healthcare leaders, educators and policymakers seeking to optimise evidence-based practice adoption in high-acuity clinical environments and improve patient outcomes. The Consolidated Criteria for Reporting Qualitative Research checklist guided reporting. Patients and the public were not involved in the design, conduct, reporting or dissemination of this research.

Clinicians' perspectives on a primary healthcare intervention to reduce antibiotic prescription for acute lower respiratory tract infections in Barcelona (Spain): a qualitative study.

Interventions based on testing and communication training have been developed to reduce antibiotic prescribing in primary healthcare (PHC) for the treatment of acute lower respiratory infections (ALRTIs). However, research based on the experiences of PHC clinicians participating in ALTRIs interventions to reduce antibiotic prescribing in Barcelona is scanty. This study aimed to explore the perceptions and experiences of clinicians (physicians and nurses) on an intervention to reduce antibiotic prescription in PHC in Barcelona (Spain). This intervention was a randomised controlled study (cRCT) based on three arms: 1) use of a C-reactive protein (CRP) rapid test; 2) enhanced communication skills; and 3) combination of CRP rapid test and enhanced communication skills. In addition, the study aimed to explore the impact of COVID-19 on the detection of ALRTIs. This qualitative study used a socio-constructivist perspective. Sampling was purposive. Participants were selected based on age, sex, profession, intervention trial arm in which they participated, and the socioeconomic area of the PHC where they worked. They were recruited through the healthcare centres participating in the study. Nine participants (7 women and 2 men) participated in two focus groups, lasting 65-66 min, in September-October 2022. Framework analysis was used to analyse the data. Three themes were identified: '(The intervention) gave us reassurance': intervention experiences among health professionals. This theme includes accounts of clinicians' satisfaction with the intervention, particularly with CRP testing to support clinical diagnoses; 'We don't have time in primary healthcare': structural and community resources in healthcare services. This theme encompasses clinicians' experiences on healthcare pressures and PHC organisational structures barriers to PHC interventions; and 'I only did three CRP': impact of COVID-19 pandemic on the intervention. The last theme focuses on the impact of the COVID-19 pandemic on the intervention's implementation. CPR testing and promoting communication skills can be useful tools to support clinical decisions for ALRTIs. Structural barriers (e.g., healthcare pressures) and social inequities amongst service users were acknowledged as the main barriers for the implementation of ALRTIs interventions.

Australian infection prevention and control governance, strategy and structure: Design for success.

Governance, strategy and organisational structure for Infection Prevention and Control (IPC) programs across Australia remain variable. The standardisation and integration of these functions across jurisdictions are critical for effective advancement of IPC across health systems. Across the Australian Federal, State and Territory jurisdictions, the study examined a twofold research question: first, what are the governance, strategy and organisational structures of IPC programs?; and second, what are the essential elements for a standardised, consistent IPC governance framework? Comprising four integrated steps: preconference document analysis of key jurisdictional program information; a survey of conference participants; open discussion - an expert panel of jurisdictional leads and conference participants; and expert panel review, incorporating mixed methods and a modified Delphi approach for consensus and validated guidance. IPC representatives across Australia participated in this study with 44 % (226/513) responses. Structures reported included: patient safety, public health, or infectious diseases. Reported key elements for effective IPC governance included IPC leadership expertise (42 %), a consistent and transparent structure (30 %), and adequate resourcing and funding for IPC (18 %). IPC governance structures across Australia remain substantially variable. The Australian Centre for Disease Control (AusCDC) is considered the pre-eminent IPC governance agency, that could enhance IPC governance, structure and strategic direction. Clear governance, strategy, and organisational structures have a critical role in the effectiveness of IPC programs and healthcare associated infection reduction strategies. The developed framework provides additional insight towards a comprehensive, standardised national IPC governance framework, offering opportunity for improvement and informing future priorities.

Bacillus subtilisbiofilm expansion mediated by the interaction between matrix-producing cells formed "Van Gogh bundles" and other phenotypic cells.

Bacillus subtilisbiofilm expansion mediated by the interaction between matrix-producing cells formed "Van Gogh bundles" and other phenotypic cells.