Team-based models of rheumatology care are increasingly recognised to improve outcomes across the Quintuple Aim, yet the evidence remains fragmented. This scoping review aimed to map the evidence on team-based outpatient rheumatology care across all domains of the Quintuple Aim (population health, patient experience, costs, provider wellbeing, and health equity). This scoping review followed Joanna Briggs Institute methodology and adhered to the PRISMA extension for scoping reviews (PRISMA-ScR) checklist. We searched MEDLINE, Embase, Web of Science, Cochrane CENTRAL, and CINAHL from inception to May 2024. We included peer-reviewed studies comparing outpatient team-based rheumatology care, involving at least one rheumatologist and one interdisciplinary health professional, to other models of care. Terminology describing care models was examined in relation to reported team composition and outcomes were mapped to the Quintuple Aim targets. The search identified 6,139 unique records, of which 76 reports representing 67 studies met inclusion criteria. Team-based models most frequently involved a rheumatologist and a nurse, although team composition varied widely. Terminology used to describe care models was inconsistent, and care delivery descriptions often lacked sufficient detail to allow replication. Most studies focused on clinical outcomes and patient experience, while few included economic, equity, or provider-related outcomes. This review highlights wide variation in team composition, collaboration, and terminology in team-based rheumatology care models. Advancing the field will require standardised terminology, detailed reporting of team roles and processes, and rigorous longterm cost-effectiveness evaluations to fully assess impact across all domains of the Quintuple Aim.

Vagus nerve stimulation (VNS) is a well-established FDA-approved option for drug-resistant epilepsy. Injury to the vagus nerve can result in vocal cord immobility, which can lead to significant dysphagia and communication deficits. We hypothesized that neurosurgery-otolaryngology collaboration for revision VNS implantation would reduce postoperative complications compared to neurosurgery-only revision. A retrospective chart review was conducted on all consecutive patients who underwent VNS at a tertiary care children's hospital from 2005 to 2023. Details of the cases were collected, including the reason for surgery, composition of the surgical team, patient outcomes, and pre- and postoperative flexible laryngoscopy findings. Postoperative completion of laryngoscopy and prevalence of symptoms were compared using Fisher's exact test, α = 0.05. A total of 104 patients underwent VNS placement during the study period; 49/104 (47.1%) were male. ENT intraoperative involvement (NSY + ENT) occurred in 14/104 (13.5%) cases, all of which were revisions. ENT follow-up with flexible laryngoscopy was completed in 7/14 (50.0%) of revision NSY + ENT cases compared with 10/57 (17.5%) of revision cases performed by NSY alone (p = 0.03). None (0/14) of the NSY + ENT revision cases reported postoperative voice changes compared with 7/57 (12.3%) of those performed by NSY alone (p = 0.3). Cough was more common in NSY + ENT (4/14, 28.6% vs 4/57, 7.0%, p = 0.03), while the prevalence of significant pain was comparable between cohorts (2/14, 14.3% vs 2/57, 3.5%, p = 0.6). No difficulty swallowing was reported following revision in either cohort. ENT involvement in VNS revisions could prevent common complications such as postoperative voice changes.

Zoliflodacin versus ceftriaxone plus azithromycin for treatment of uncomplicated urogenital gonorrhoea: an international, randomised, controlled, open-label, phase 3, non-inferiority clinical trial

Turner syndrome (TS) is a complex genetic condition requiring lifelong, multidisciplinary care. International consensus guidelines exist, but the organisation of paediatric TS services in the UK has not been systematically explored. A structured electronic survey was distributed to paediatric endocrinology centres across the UK with responses collected from June 2023 to February 2024. The survey collected information on service configuration, staffing, multidisciplinary team (MDT) composition, transition pathways, use of consensus guidelines, and engagement with patient registries and support societies. Responses were received from 20 UK tertiary centres. Six out of 20 centres operated a dedicated TS clinic. MDTs were limited in most centres to paediatric endocrine consultants and nurse specialists, and shared care models for outreach patients were common. Transition practices varied, with 45% of centres using TS-specific pathways, 45% using general endocrine transition pathways, and 10% without a transition pathway. Awareness of international TS guidelines, the Turner Syndrome Support Society, and the i-TS registry was high, but active engagement varied. Significant variability exists in UK paediatric TS service models. Centres without dedicated clinics were generally smaller with fewer patients. Geographic challenges may exacerbate inequalities for outreach patients. While some centres offer best practice examples, improvements in MDT availability, transition planning, and registry engagement are needed to align more closely with international care recommendations.

Abstract Coordination of Services Teams (COSTs) facilitate interprofessional collaboration to improve school-based mental health (SBMH) services by bridging the education and mental health systems. There is a dearth of research on the core components and functions of COSTs. Through an embedded case study of COSTs at five schools within one county’s SBMH initiative, this study addresses the following two research questions: What are the key elements of a COST and how do COSTs operate in schools? Six group interviews were conducted with 32 participants, including COST members and county program leaders. Participants provided a comprehensive description of the structure and functions of a COST. Findings revealed three key elements of a COST: (a) a diverse and inclusive team composition, (b) a universal referral system for identifying student concerns, and (c) a coordinated system for centralizing student support services. Additionally, findings highlighted the importance of adapting COSTs to fit unique school contexts and meet the needs of local communities. This study provides actionable guidance for school leaders and mental health practitioners aiming to develop or refine COST processes to create more effective, comprehensive student support systems.

A Qualitative Analysis-Enhancing Faculty Academic Success Through Team-Based Mentorship: 5-Year Insights.

This study examines how university students’ MBTI personality sub-dimensions influence their team activity scores and overall project performance in team-based learning contexts. It also aims to identify performance differences across team composition types formed by combinations of personality traits. A total of 394 students enrolled in a general education course across four semesters participated in the study. Relationships between MBTI sub-dimensions and team performance were analyzed using correlation and multiple regression analyses. To investigate interaction effects among personality traits, multivariate analysis of variance (MANOVA) was conducted. In addition, based on significant effects observed for the P/J and N/S dimensions, eight team composition types were classified, and performance differences among these groups were compared using one-way ANOVA. The results revealed that the P/J dimension significantly influenced team activity scores, with Judging (J) learners achieving notably higher performance than Perceiving (P) learners. Some interaction effects among MBTI sub-dimensions also suggested potential influences on team activity outcomes. Furthermore, teams with a higher proportion of N/J or S/J members demonstrated significantly higher team activity and total project scores than those primarily composed of N/P members. These findings indicate that specific MBTI sub-dimensions—particularly the proportion of Judging (J)—may meaningfully contribute to structure, collaboration processes, and performance outcomes in team-based learning environments. Future research should verify these relationships using expanded samples that capture more diverse instructional contexts and team compositions.

Abstract Background Centralisation of gastrointestinal (GI) cancer surgical services has corresponded with improvements in post-operative outcomes over the last two decades. However, centralisation has been variably implemented, and the specific structural factors that confer benefit remain unclear. This systematic review aimed to summarise current evidence on the structural characteristics associated with quality outcomes following surgery for cancers of the GI tract. Method A systematic search of the Embase, MEDLINE, and Cochrane databases was performed to identify studies that evaluated the importance of structure, or individual structural characteristics, in GI cancer surgery. These were categorised into one of: volume/centralisation, hospital infrastructure, personnel/staffing, or standardised care protocols. Outcomes of interest included mortality, morbidity, length of hospital stay, failure to rescue, readmission and cost. Results Sixty studies were included in the review. Greater hospital, surgeon and anaesthetic operative volume were each associated with improved outcomes. Protocols such as enhanced recovery after surgery contributed to faster peri-operative recovery and shorter hospital length of stay. While evidence on optimal post-operative care team composition was limited, geriatric co-management, physiotherapy, and dietetic input were each found to be important. Conclusions Although increased operative volume following centralisation is associated with improved surgical outcomes, definitions of ‘high-volume’ are variable and operation-specific volume thresholds have yet to be defined. Additional research to establish the ideal demographics of the peri-operative care team is also needed. This likely comprises surgeons, peri-operative physicians, specialist anaesthetists, dieticians, and physiotherapists, with additional on-site support from specialties such as interventional radiology and gastroenterology.

ABSTRACT This study investigates the impact mechanism of different dimensions of failure learning on corporate innovation performance. Compared with the extensively researched field in the effects of organizational failure learning, this area remains largely underexplored. Drawing on dynamic capability theory and social information processing theory, we examined the relationships between single‐loop/double‐loop failure learning, organizational resilience (the bounce‐back dimension and the bounce‐forward dimension), the task‐related top management team (TMT) faultline, and corporate innovation performance. Accordingly, regression analysis using the structural equation modelling (SEM) method was conducted on a sample of 483 middle and senior executives from various enterprises. The findings reveal that both single‐loop failure learning and double‐loop failure learning positively influence corporate innovation performance. The bounce‐back dimension of organizational resilience partially mediates the relationship between single‐loop failure learning and corporate innovation performance. Conversely, the bounce‐forward dimension partially mediates the relationship between double‐loop failure learning and corporate innovation performance. Notably, the task‐related TMT faultline positively moderates only the relationship between double‐loop failure learning and the bounce‐forward dimension; its moderating effect on the relationship between single‐loop failure learning and the bounce‐back dimension is not significant. Our findings emphasize the role of organizational resilience bridging failure learning and innovation performance, and provide theoretical insights for the composition and adjustment of top management teams within enterprises.

There is little known about the behavior intervention plan (BIP) team composition for students with intellectual disability, developmental delay, and/or autism (i.e., IDD). We sought to understand whether students with IDD are included as part of the team to develop their BIPs and who is involved and the correlation with quality of the BIP. We reviewed and statistically analyzed records from 87 BIPs from one large school district. Of the records reviews, most BIP teams included a parent or guardian, administrator, general education teacher, and special education teacher. Less than 5% of BIPs included a student with IDD. Implications for policy and practice are provided. Specifically, federal and state policy guides are needed to ensure that BIP teams include both the individual with IDD and their parents or guardians, along with individuals with expertise in supporting students with IDD.

Purpose This study aims to examine how multidisciplinary expertise is disclosed in sustainability assurance statements and how such disclosures shape stakeholder perceptions of accountability. Drawing on legitimacy theory, the analysis considers how assurance providers disclose team composition, assurance level and engagement scope to signal competence and trustworthiness. Design/methodology/approach Qualitative content analysis was conducted on sustainability assurance statements from 67 FTSE 100 companies for the reporting years 2022 and 2023. A conceptual framework is used to interpret how multidisciplinary expertise and assurance level (limited vs reasonable) relate to accountability and legitimacy outcomes. Findings Limited assurance remains dominant (94% of engagements). Although many firms disclose multidisciplinary expertise, 29.8% of these still report only limited assurance, indicating a continuing expectation gap around the credibility and decision-usefulness of sustainability information. Practical implications Assurance providers and standard setters may strengthen perceived accountability by increasing transparency about team expertise and encouraging greater adoption of reasonable assurance where sustainability disclosures inform stakeholder decision-making. Originality/value The study shows how disclosures of multidisciplinary expertise operate as part of legitimacy-seeking strategies within sustainability assurance. It offers insight into how assurance level and team composition are positioned within FTSE 100 sustainability reporting.

Quality indicators assess and can improve care. Previous efforts used different methods to identify quality indicators for inflammatory bowel disease (IBD) care in Belgium. This study aimed to critically evaluate these efforts and establish a validated, multi-stakeholder consensus on an evidence-based quality indicator set. A focus group with consensus methodology experts (n = 8) evaluated prior exercises (one modified Delphi method and one with a pragmatic approach). Two additional focus groups with healthcare providers (n = 7) and patients (n = 5) reviewed findings and identified missing quality indicators. A consensus meeting (including 3 methodology experts, 4 patients, 2 IBD nurses, 6 IBD physicians) validated the final set. Participants agreed on the complementary nature of prior exercises but identified limitations, including the need for pre-prioritization, the core team composition, and suboptimal patient involvement. Missing indicators included one patient-reported outcome (mental health) and three patient-reported experience measures (satisfaction with care, patient-gastroenterologist dialogue, and therapy satisfaction). Consensus was reached on 37 indicators: 3 structure, 11 process, and 23 outcome indicators. These covered patient-reported outcomes/experiences, care team and clinic services, hospital service use and survival, care pathways, patient and disease characteristics, medication, steroid use, infection prevention, disease monitoring, and endoscopy guidelines. Two complementary exercises yielded unique insights into IBD quality indicators. Reflective focus groups and a consensus meeting identified 37 validated quality indicators with broad stakeholder agreement. Future work should focus on translating these quality indicators into clinical practice and assessing feasibility.

Highlights The Therapeutic Intervention Scoring System (TISS-28) revealed that the nursing staff was insufficient to meet the care requirements of the patients. There is a direct correlation between the workload quantified by the TISS-28 and the development of adverse events, the proportion of deaths, and hospital stays longer than 7 days. Direct care by nurses showed a lower proportion of adverse events and shorter hospital stays compared to the direct care model by nursing assistants. Some functions delegated to nursing assistants in the direct care model by nursing assistants do not correspond to their technical and legal competence. Introduction: Work overload is associated with missed care and a higher prevalence of adverse events. The study aims to generate empirical evidence on nursing workload in intensive care units in Colombia, considering differences in team composition based on qualifications, skills, and competencies (Skill Mix). Objective: To compare the workload and distribution of nursing activities in two intensive care units with different Nursing Care Models based on the application of the TISS-28. Materials and Methods: Quantitative and retrospective study with data from medical records of patients treated between 2018 and 2020 in Medellín. The TISS-28 was calculated upon admission and SAPS-3 was used to control for confounding variables. Mean and proportion comparison tests were used according to the type of variable and data distribution pattern. Results: The nurses in both ICUs had a patient assignment higher than indicated by the TISS-28. Surgical patients, those with vasoactive drugs, transfusions, adverse events, or those who died, had longer care times. The adverse events increased proportionally with the TISS-28 level. Discussion: Key elements include the relationship between care safety and staff qualification, experience and workload; the missed nursing care; and the undervaluation of care as a public good. Conclusions: It was identified that in both ICUs there is a higher workload for nurses regarding the time available for activities and patients. The majority of care provided by the nursing assistants in the ICU2-Assistants do not correspond with their level of training and legal responsibility. How to cite this article: Rojas Cárdenas Katherine, López Cárdenas William Iván, Henao Murillo Natalia Andrea. Comparison of workloads in two nursing care models in adult intensive care units. Revista Cuidarte. 2025;16(3):e4510. https://doi.org/10.15649/cuidarte.4510

Mobile Legends: Bang Bang is a widely played Multiplayer Online Battle Arena game in Southeast Asia, and its competitive ecosystem has driven the need for accurate match outcome prediction. Most existing studies analyze either the draft pick phase or the in game phase in isolation, limiting their ability to capture the full progression of a match. To address this limitation, this study evaluates the performance of Random Forest and Extreme Gradient Boosting (XGBoost) in predicting match outcomes across both phases using data from the MSC 2025 tournament. The dataset was collected from Liquipedia’s official API and match replay recordings. Draft pick features represent team composition factors such as synergy, hero strength, and patch impact, while in game features consist of statistical indicators including gold, kills, turrets, and objectives extracted from multiple time based snapshots. Both models were trained using qualification stage matches and tested on the main event. A phase separated hybrid feature engineering approach was employed to represent strategic differences between the draft pick and in game phases. Evaluation metrics include accuracy, precision, recall, F1 score, and ROC AUC. Results show that the draft pick models achieved a maximum accuracy of 57%, whereas the in game models reached 88% for Random Forest and 84% for XGBoost, with both achieving a ROC AUC of 0.94. These findings indicate that snapshot based in game features provide stronger predictive signals than draft pick composition features, which reflect only the initial strategic potential rather than actual match conditions.

This article examines how the organizational framework of the full-day school (years 1–4) conditions teachers’ professional development. We combine Klafki’s (2004) inner–outer distinction with Hargreaves & Fullan’s (2012) ‘professional capital’ to analyze how extended pupil time, meals, and activities shape teachers’ collaboration and planning. Based on eight individual interviews with teachers in a full-day school pilot (two school years), we applied a Stepwise-Deductive Inductive (SDI) analysis. Two themes emerged: (1) opportunities for collaboration, and (2) planning of practice. Our contribution is twofold: Conceptually, we integrate an inner–outer perspective with professional capital to illuminate how organizational expansion can unintentionally narrow pedagogical deliberation; empirically, we specify how time structures and team composition affect the development of social and decisional capital. Findings show that externally driven structural changes do not by themselves yield desired professional growth; rather, a careful coupling of external (organizational) and internal (pedagogical) design is required. A limitation is that we did not interview external stakeholders (e.g., leaders, assistants, policymakers); the analysis thus centres on teachers’ experiences. We discuss implications for school leadership and sustainable professional communities in full-day school settings.

Although focus groups gather early-stage input effectively, our initial literature review found few focus group studies conducted with autistic adolescents (ages 12–19), despite the potential for focus groups to provide a safe, peer-based setting that encourages autistic adolescent engagement in research. Scoping reviews of focus groups for children and people with disabilities exist, but not for autistic adolescents. We aim to fill this gap. Consequently, we plan to conduct a scoping review to identify the methods used to design inclusive focus groups for autistic adolescents. Because few relevant studies exist, we describe steps to search both academic databases and online sources (X, YouTube, Google). We detail how we will leverage our team composition, which is led by a large group of undergraduate students, some of whom are neurodiverse, to enhance the rigor and reproducibility of the scoping review. These steps include accounting for algorithms personalizing search results from online sources and the risk of encountering false information that could cause harm. We will analyze the results to show 1) the extent to which focus groups on autistic adolescents are conducted with autistic adolescents; 2) characteristics of autistic adolescents included in focus groups and underrepresented populations; 3) steps taken to design accessible focus groups for autistic adolescents; 4) which methods were feasible for and acceptable to autistic adolescents. The results of our scoping review will be an important step toward including input from autistic adolescents in the early stages of a project and, more broadly, in the research process.

This study investigates the key success factors of IT project management in an emerging, innovation-oriented economy using evidence from Kazakhstan. Drawing on expert interviews and an anonymous enterprise survey, we rank 59 processes across the project life cycle and test three hypotheses concerning the roles of human factors and professional governance. The results confirm broad alignment with success factors commonly reported in mature economies yet reveal a distinctive pattern at earlier maturity stages: team composition, communication, and collaboration have a stronger impact on project success than formal controlling and detailed financial governance. We also identify a substantial gap between the declared importance of success factors and their actual implementation—particularly in integration-stage budgeting, acceptance testing and quality assurance, and lessons-learned practices—highlighting how limited practical experience constrains the adoption of governance routines. The findings refine contingency perspectives on project success by positioning key success factors along a development trajectory in which people-centric capabilities serve as prerequisites for the subsequent effectiveness of “hard” project-management methods. The study advances understanding of the role of IT project management in countries at an early stage of developing an innovation-driven economy.

Infection Prevention and Control nurses (IPCN) are members of infection prevention and control (IPC) teams in healthcare facilities. The aim of the study was to describe the composition of the IPC teams, the profile of the IPCN and to describe structural and functional dependencies in both the team and the organization. A cross-sectional descriptive study was carried out between July 2019 and January 2020 in Spanish hospitals with recruitment of IPCN through non-probabilistic snowball sampling. Based on the variables collected, a univariate and bivariate descriptive analysis was performed. 108 surveys were received from 108 centers, 83% public. 26 models of IPC were described. Of the centers, 45% declared ratios of one IPCN for more than 200 beds and only 13% declared ratios of one for less than 150 beds. Only 22% had all nurses trained at the postgraduate level. 84% of IPCN were structurally dependent on nursing and 70% were functionally dependent on physicians. According to the opinion of the IPCN, efficiency would be favored with: 1) multidisciplinarity (72.2%); 2) having reference nurses (93.5%); 3) IPCN with a management position (64.8%). Spanish IPCN are part of heterogeneous IPC teams, with ratios far from recommendations, deficient training and structurally dependent on nursing and functionally on medical services.

Abstract The need for interdisciplinarity to address global challenges has been expressed for decades, but the development of effective interdisciplinary work is slow. The tardiness might be related to the scarcity of literature on what interdisciplinarity means in practice that could guide new collaborations. This perspective presents a guide for interdisciplinary work in biodiversity research in practice. The focus is set on bridging between scholars from biology and from social science and humanities. The structure follows three overarching and interlinked dimensions of importance for interdisciplinary work: People, Process and Perspectives. People is about both the team composition and the characteristics of individual researchers. Process concerns how the work is planned and the organizing structure. Perspectives include approaches, concepts, and frameworks. Since the character of projects varies, there can be no detailed blueprint for interdisciplinary biodiversity research, but dialog and mutual respect are clearly key.

Since the publication of the National Institute for Care and Health Excellence's TA943 guidance, the uptake of continuous glucose monitoring and hybrid closed loop systems in type 1 diabetes care is expanding rapidly. Community diabetes specialist nurses and general practice nurses are both integral to implementing these technologies outside of hospital settings. To explore and understand the confidence levels, training and support available to community diabetes specialist nurses and general practice nurses in relation to continuous glucose monitoring and hybrid closed loop systems technologies, based on a national service evaluation. A national survey was distributed to UK nurses and midwives in May 2025. Confidence was measured across five continuous glucose monitoring and hybrid closed loop systems domains, with qualitative feedback analysed thematically. Community diabetes specialist nurses showed moderate to high confidence with continuous glucose monitoring and variable confidence with hybrid closed loop systems. General practice nurses reported low confidence across all domains, with minimal access to formal training. Differences in support structures and team composition contributed to capability gaps. Tailored training, system-wide support and commissioning reform are needed to ensure equitable technology-enabled diabetes care across community and primary care settings.