Updated Framework Research Articles

Evolving the Control-Chaos Continuum: Part 1 - Translating Knowledge to Enhance On-Pitch Rehabilitation.

BACKGROUND: On-pitch rehabilitation is a crucial part of returning to sport after injury in elite soccer. The control-chaos continuum (CCC) initially offered a framework for practitioners to plan on-pitch rehabilitation, focusing on physical preparation and sport specificity. However, our experiences with the CCC, combined with recent research in injury neurophysiology, point to a need for an updated model that integrates practice design and physical-cognitive interactions. CLINICAL QUESTION: What are the insights from injury neurophysiology, soccer performance, and coaching science needed to update the CCC and improve the planning, delivery, and progression of on-pitch rehabilitation in elite soccer? KEY RESULTS: Drawing on extensive experience in elite sport, we explain how recent research on neurophysiological recovery from injury, game models, and practice design has been applied to update the CCC and evolve the existing framework. CLINICAL APPLICATION: The evolution of the CCC expands on the original model to enhance planning, delivery, and progression of on-pitch rehabilitation. The updated framework incorporates elements of visual cognition, attentional challenges, decision-making, and progressive representation of the game model to enhance sport-specific preparation for returning to sport. J Orthop Sports Phys Ther 2025;55(2):1-11. Epub 3 January 2025. doi:10.2519/jospt.2025.13158.

EXPRESS: The Role of National Culture: an Updated Framework for Cross-Cultural Research in Operations Management

EXPRESS: The Role of National Culture: an Updated Framework for Cross-Cultural Research in Operations Management

Facilitators and barriers in the implementation of patient-centred care interventions among general practitioners: a systematic review protocol

BackgroundChallenges in the patient–provider relationship are prevalent, underscoring the importance of patient-centred care, which is respectful and responsive to patients’ needs. General practitioners (GPs), also known as family doctors, serve as gatekeepers in primary care and are well positioned to deliver this type of care. However, effectively implementing patient-centred care remains a challenge. While behaviour change interventions have been developed to enhance patient-centred care in general practices, a comprehensive understanding of the facilitators and barriers to their implementation is lacking. This review aims to examine contextual factors of implementing interventions for patient-centred care by GPs. Implementation research analyses all aspects of application, including factors influencing it, processes involved and outcomes achieved within different contexts. The review will use the updated Consolidated Framework for Implementation Research (CFIR 2.0) to analyse influential factors and the Behaviour Change Wheel (BCW) to define interventions to promote behaviour change in patient-centred care.MethodsThis systematic literature review will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search of five databases (Ovid MEDLINE, CINAHL, EMBASE, Cochrane Library and Web of Science) will be conducted to identify barriers and facilitators for implementing interventions in promoting patient-centred care by GPs. The CFIR 2.0 framework will guide the categorization and synthesis of barriers and facilitators, while the BCW will be employed to define the interventions. Two independent reviewers will conduct study screening, data extraction, quality appraisal and data analysis. Any disagreements between the reviewers will be resolved through the involvement of additional reviewers.DiscussionThis protocol outlines a systematic review utilizing an updated framework-based approach to identify and synthesize evidence on barriers and facilitators to implementing behaviour change interventions by GPs. The findings will provide insights into the effectiveness of these interventions in enhancing patient-centred care and will inform future research and clinical practice. This review will identify gaps and challenges in existing studies and propose strategies for the effective implementation of behavior change interventions among GPs. Additionally, it will inform clinical practice by refining behaviour change interventions to enhance the delivery of patient-centred care by GPs.Trial registration: PROSPERO: CRD42023485014.

Nationwide guideline implementation: a qualitative study of barriers and facilitators from the perspective of guideline organizations

BackgroundAlthough the number of Dutch guidelines is growing, their uptake and impact in clinical practice lag behind. Dutch guideline organizations, including guideline developers, governmental agencies, health insurers and other national organizations, play a crucial role in developing, authorizing and/or supporting the use of guidelines. They influence end users' awareness, accessibility, understanding, acceptability and applicability of guidelines. In this study, we explored the barriers and facilitators that representatives of guideline organizations perceive in nationwide guideline implementation.MethodsIn this qualitative study, we conducted semi-structured interviews with 35 representatives of 24 different guideline organizations. We employed framework analysis, using the updated Consolidated Framework for Implementation Research (CFIR), and thematic analysis to guide our data analysis and synthesis.ResultsWe found 45 different implementation barriers and 35 implementation facilitators. We identified seven overarching themes of interrelated barriers and facilitators that extended across the stakeholders involved and domains within the updated CFIR. These included 1) healthcare demand and resource availability, 2) implementation knowledge and expertise, 3) guideline characteristics: representation, evidence base and design, 4) partnerships and collaboration, 5) characteristics of guideline implementation planning, execution and evaluation strategies, 6) characteristics of healthcare professionals: need, capability, opportunity and motivation, and 7) legal and regulatory compliance.ConclusionsWe obtained valuable insights into the complex dynamics of barriers and facilitators perceived by guideline organizations in nationwide guideline implementation. Our findings help explain why healthcare professionals and healthcare facilities may (not), slowly or inconsistently adhere to guideline recommendations in practice. The identified barriers and facilitators provide guidance for policymakers to re-evaluate and improve nationwide quality and guideline implementation policies, to eventually improve clinical practice and health outcomes for patients.

Check dams on China's Loess Plateau: An overview

AbstractCheck dams are widely constructed on China's Loess Plateau, which had a total number of 58,776 by the end of 2019. Great achievements in check dam construction have been gained regarding the economic and environmental impacts. This study reviews the remarkable benefits of check dams on the land reclamation and environmental improvement on the Loess Plateau, and sediment reduction entering the Yellow River. However, the flood incidents on check dams have been frequently reported for the past decades, which has attracted more attention in the context of climate change and extreme rainfall events recently. Advances in the flood migration techniques achieved by the research group led by the first author have been highlighted to migrate the breach risk of check dams due to floods. The “family tree method” has been proposed to determine the survival status and critical rainfall threshold of each check dam in the complicated dam system. An updated dam breach flood evaluation framework and the corresponding numerical algorithm (i.e., DB‐IWHR) have been developed. Moreover, innovative types of water‐release facilities for check dams, including geobag stepped spillway and prestressed concrete cylinder pipe in the underlying conduit, have been proposed and developed. Finally, the perspectives concerning the check dam construction on the Loess Plateau have been put forward.

Self-Care Practices in the Context of Older Adults Living Independently

Supporting practices around self-care is crucial for enabling older adults to continue living in their own homes and "ageing in place". While existing assistive technology and research concerning self-care practices have been centered on a medicalized viewpoint, it neglects a holistic perspective of older adults' preferences in self-care. This paper presents a study involving 12 older adults aged 65 and above in a semi-structured interview study, where we aimed to understand participants' practices around self-care. Our findings show that self-care in such cases involves activities across the physical, emotional and psychological, social, leisure and spiritual domains. This paper provides a comprehensive understanding of the daily self-care practices of older adults including an updated self-care framework identifying key aspects, and a set of design implications for self-care assistive technologies.

Screening properties of the updated normative framework for the Italian MMSE in MCI and dementia.

This study aimed to assess the screening properties of Foderaro et al.s' updated normative framework for the Italian MMSE in detecting mild cognitive impairment (MCI) and dementia due to neurodegenerative, chronic cerebrovascular, and mixed etiologies, as well as in differentiating between these two syndromes. Data on 234 patients with either MCI (N = 83) or dementia (N = 151) due to Alzheimer's disease (N = 112), Lewy body disease (N = 11), frontotemporal lobar degeneration (N = 20), chronic cerebrovascular disease (N = 39), or mixed (N = 47) etiologies having been administered Foderaro et al.'s version of the MMSE were retrospectively recruited. Moreover, N = 247 healthy controls (HCs) with a normal Montreal Cognitive Assessment performance were prospectively recruited. Receiver-operating characteristics analyses were run to test the capability of both raw and demographically adjusted MMSE scores to discriminate both HCs from MCI/dementia and MCI from dementia. For these comparisons, screening metrics were also computed at Foderaro et al.'s cut-off (<26.02). The capability of demographically adjusted MMSE scores to discriminate both HCs from dementia and MCI from dementia was excellent (AUC = 0.91 and 0.93, respectively), whilst good for MCI case-finding (AUC = 0.85). Consistently, the screening metrics associated with the cut-off at hand were optimal-to-excellent for dementia case-finding (sensitivity = 0.95; specificity = 0.99) and for the differentiation between MCI and dementia (sensitivity = 0.95; specificity = 0.64), whilst imbalanced for detecting MCI (sensitivity = 0.35; specificity = 0.99). Foderaro et al.'s updated normative framework for the Italian MMSE has optimal screening properties for both dementia case-finding and the discrimination between MCI and dementia, being at variance unbalanced towards specificity when it comes to detecting MCI.

Novel multi-physics simulation of transient dynamics in functionally graded porous multiferroic cylindrical shells under moving heat flux: A magneto-electro-thermoelastic analysis

Cylindrical structures, such as pipelines in power plants and novel energy-harvesting devices that combine flexible piezoelectric/piezomagnetic layers with other materials, are frequently exposed to moving heat fluxes. Understanding the physics of these structures can provide potential solutions for stress management and energy harvesting. This study investigates, for the first time, the effect of thermal wave propagation on the transient fully coupled magneto-electro-thermoelastic (METE) response of functionally graded porous (FGP) multiferroic cylindrical shells subjected to a partially distributed moving heat flux. The structure is supported by a distributed viscoelastic Winkler-Pasternak foundation, and its mechanical and electromagnetic boundary conditions are considered to be simply supported and suitably grounded. This approach is innovative as it represents the first extension of the three-dimensional (3D) Lord-Shulman coupled thermoelasticity theory to specifically address multiphysics materials. In this updated framework, the governing equations for the motion of each layer are derived following an orthotropic laminated model. To solve the problem, the state-space technique and the mathematical model of the transfer matrix are employed. The study evaluates the structure's vibrational behavior by examining four models of porosity distributions within the thermoelastic layer: symmetric, stiff non-symmetric, soft non-symmetric, and uniform. The key parameters of the dynamic response are calculated using Durbin’s numerical Laplace inversion algorithm. Subsequently, to validate the proposed model, the results are compared with the findings obtained by other researchers. Comprehensive numerical results concerning temporal and spatial variations of temperature, transverse displacement, and stress components are presented for various influencing parameters such as volume fraction index, open or closed-circuit conditions, heat flux speed, porosity, and smart layer thickness.

Trials and tribulations: a qualitative exploration of researcher perspectives on navigating the challenges of health system implementation research

ObjectiveWhile researchers are crucial to the successful delivery of implementation trials, their perspectives are rarely captured in the evaluation of these trials. This qualitative study aimed to capture the experiences...

Brain energy homeostasis: the evolution of the astrocyte-neuron lactate shuttle hypothesis.

The brain's substantial metabolic requirements, consuming a substantial fraction of the body's total energy despite its relatively small mass, necessitate sophisticated metabolic mechanisms for efficient energy distribution and utilization. The astrocyte-neuron lactate shuttle (ANLS) hypothesis has emerged as a fundamental framework explaining the metabolic cooperation between astrocytes and neurons, whereby astrocyte-derived lactate serves as a crucial energy substrate for neurons. This review synthesizes current understanding of brain energy metabolism, focusing on the dual roles of lactate as both an energy substrate and a signaling molecule. We examine the molecular underpinnings of metabolic compartmentalization, particularly the differential expression of lactate dehydrogenase (LDH) isozymes between astrocytes and neurons, which facilitates directional lactate flux. Recent evidence has challenged aspects of the classical ANLS model, revealing greater metabolic flexibility in neurons than previously recognized, including substantial LDHA expression and direct glucose utilization capabilities. Our recent studies on LDHB-deficient neurons provide new insights into the compensatory mechanisms and limitations of neuronal lactate metabolism, suggesting a more nuanced understanding of the ANLS hypothesis. Furthermore, we discuss lactate's emerging role as a signaling molecule in synaptic plasticity, memory formation, and neuroprotection, particularly in ischemic conditions where elevated lactate levels correlate with enhanced neuronal survival through prostaglandin E2-mediated vasodilation. This comprehensive review integrates classical perspectives with recent advances, providing an updated framework for understanding brain lactate metabolism and its therapeutic implications in neurological disorders.

“Belief Updating under Uncertainty: Probabilistic Epistemology and Its Limitations”

Probabilistic epistemology, especially the Bayesian model, provides a dynamically updated framework for the construction of knowledge under uncertainty. Starting from the shortcomings of the traditional view of knowledge, this paper analyzes how probabilistic theory can cope with uncertainty by adjusting the strength of beliefs, so as to gradually approach the truth. Bayesian epistemology has shown its unique application potential in the fields of science, medicine and economic forecasting. Especially, Bayesian epistemology can enhance rational belief in dynamic environment through the update mechanism of conditional probability. Although Bayesian epistemology has many advantages, it has obvious limitations in its application to non-empirical fields such as ethics and metaphysics. This paper also explores the importance of Bayesianism in knowledge construction and compares it with other epistemological models such as evidentialism and dependability. This paper argues that although Bayesianism provides flexible instrumental support for knowledge construction, it still has great limitations in dealing with fuzzy and non-quantitative knowledge and ethical decision-making, which limits its application to broader epistemological problems. At the same time, it is pointed out that probabilistic epistemology can be combined with other methods to expand its application scope.

ANALYSE PSYCHOPÉDAGOGIQUE ET MÉTHODOLOGIQUE DE LA FORMATION PROFESSIONNELLE CONTINUE : VERS UNE OPTIMISATION DES PRATIQUES DIDACTIQUES EN SCIENCES DE L’ÉDUCATION/PSYCHOPEDAGOGICAL AND METHODOLOGICAL ANALYSIS OF CONTINUING PROFESSIONAL TRAINING: TOWARDS AN OPTIMIZATION OF DIDACTIC PRACTICES IN EDUCATIONAL SCIENCES

This article focuses on the methodological and psychopedagogical dynamics underlying teachers' continuing professional training, emphasizing the integration of innovative approaches in educational practices. Based on an analytical review of psychological theories applied to lifelong learning, this study explores the interaction between advanced pedagogical strategies and their application contexts. This contribution aims to propose an updated theoretical framework that can enrich pedagogical practices, validating various intervention models while providing methodological guidelines tailored to the contemporary demands of lifelong training. An empirical and qualitative methodology, based on descriptive analysis of case studies and teacher groups, highlights current trends and optimal improvement methods.

Evaluating modeling approaches for Rb-129Xe spin-exchange optical pumping and the effect of Rb vapor density heterogeneity

The applicability of commonly used 129Xe nuclear polarization (PXe) buildup models to large optical cell polarizers, which operate at lower gas pressures when compared to small cell polarizers for which spin-exchange optical pumping (SEOP) models were originally developed, has yet to be systematically evaluated. In addition, spatial heterogeneity of Rb vapor density ([Rb]) and its impact on SEOP in low pressure, large optical cell polarizers remains poorly understood. In this theoretical study, it was shown that 1D analytical and numerical PXe buildup models yield diverging PXe and critical flow rate values at low flow rates and high laser absorption, contributing to the discrepancy between theoretical and experimentally measured production rates. Additionally, it was found that [Rb] heterogeneity leads to lower PXe buildup and an undesirable increase in optimal cell temperature, while the optimal laser absorption remains relatively unchanged. The updated simulation framework presented here can be utilized to model other SEOP systems.

Application of stepped care model in cancer patients: a scoping review.

To clarify the implementation steps, characteristics, effects, acceptability, and feasibility of the stepped care model (SCM) while also offering a resource for pertinent interventions in cancer care. We searched the PubMed, Embase, CINAHL, Web of Science, the Cochrane Library, and PsycINFO databases from inception to October 22, 2023. Two key concepts were used: cancer and stepped care model. Two reviewers independently screened the articles and extracted data by repeatedly reading the abstracts and full texts. The included literature was analyzed according to the updated framework for scoping reviews proposed by the Joanna Briggs Institute (JBI). A total of 14 studies were included. Most of the reviewed SCMs comprised two steps: self-management interventions in the first step and cognitive-behavior interventions in the second step. Most often, interventions were delivered electronically. The main applications of SCM included providing psychological support, treating insomnia and relieving cancer-related fatigue. SCM was effective in improving multiple outcomes for cancer patients with feasibility and acceptability. SCM has a promising future and is applicable to oncology care. Further research on facilitators and barriers to the application of this model in cancer care is needed to enhance patients' quality of life.

Perspectives of Policymakers on Barriers to and Enablers of the Uptake of Cardiac Rehabilitation in Saudi Arabia: A Qualitative Study.

This study aimed to identify the barriers to and enablers of secondary prevention care and cardiac rehabilitation (CR) utilization by patients with coronary heart disease (CHD) following percutaneous coronary intervention (PCI) from the perspective of policymakers. A qualitative study involving an interpretive descriptive design was conducted through recorded semistructured interviews with key decision-makers in cardiology care in Saudi Arabia. The analysis was guided by the updated Consolidated Framework for Implementation Research (CFIR), which informed the resulting themes. Interviews were conducted with nine key decision-makers: four directors of major cardiac centers, four heads of cardiac rehabilitation units, and one president of a specialized cardiac society. Data coding identified 16 CFIR constructs as barriers, with seven prioritized by the participants. The most frequently cited barriers included lack of CR facilities, shortage of trained staff, and insufficient knowledge of CR among cardiologists. Seventeen constructs emerged as enablers to aid in overcoming these challenges, with nine receiving high consensus among policymakers. Key enablers included implementing alternative models, such as home-based programs; enhancing cardiologists' understanding of CR benefits; and involving higher authorities for support. This study highlights the significant barriers to CR utilization and proposes solutions to facilitate the implementation of these programs from the perspective of healthcare leaders. Successful implementation requires improved communication within institutions, collaboration with the broader healthcare system, and engagement with other stakeholders, such as the private sector, to expand access and ensure comprehensive service delivery.

Symptom Management Guideline Implementation Among Nurses in Cancer-Specific Outpatient Settings: A Scoping Review of Barriers, Facilitators, and Implementation Strategies.

Oncology outpatients experience high levels of distressing cancer-related symptoms. Nurses can provide high-quality outpatient cancer symptom management following clinical practice guideline recommendations; however, these guidelines are inconsistently used in practice. Understanding contextual factors influencing implementation is necessary to develop tailored implementation strategies. To identify and describe (1) barriers and facilitators influencing symptom management guideline adoption, implementation, and/or sustainability among nurses in cancer-specific outpatient settings and (2) components of strategies used to enhance guideline implementation. A scoping review was conducted following Joanna Briggs Institute methodology. CINAHL, EMBASE, EMCARE, MEDLINE, and gray literature sources were searched. Eligibility screening and data extraction were performed in duplicate. The updated Consolidated Framework for Implementation Research and Expert Recommendations for Implementing Change taxonomy informed data extraction and descriptive analysis. Thirty-six projects from 2004 to 2023 were included; most used quality improvement (n = 14) or quasi-experimental (n = 10) designs. Determinants were most often mapped to the "inner setting" and "individuals-roles/characteristics" Consolidated Framework for Implementation Research domains. Most projects used multiple discrete implementation strategies within the "train and educate stakeholders" (n = 29, 85%) and/or "develop stakeholder interrelationships" (n = 20, 59%) categories. Nurses may face several barriers to symptom management guideline implementation within cancer-specific outpatient setting workflows and may have limited opportunity to implement guidelines within their current roles. Most projects used educational strategies, which alone may be insufficient to address reported barriers. By identifying barriers, facilitators, and strategies, this scoping review can be used to design tailored strategies to implement symptom management guidelines within outpatient oncology nursing care.

Improving Lynch syndrome detection: a mixed-methods process evaluation of a hybrid type III effectiveness-implementation trial

IntroductionTranslating evidence-based practices into real-world healthcare settings is challenging, particularly in the rapidly evolving field of genomics. A pragmatic two-arm cluster-randomized clinical trial (Hide and Seek Project – HaSP) tested two implementation approaches for improving hereditary cancer referral practices with one key distinction: implementation strategies that were designed 1) explicitly using psychological theory, or 2) using healthcare professional intuition. This mixed-methods process evaluation aimed to provide insights into how and why change occurred by examining contextual determinants, identifying mechanisms of action, and exploring the role of theory.MethodsPost-implementation interviews were conducted with Implementation Leads and clinicians from participating HaSP sites. Transcripts were analysed using a mixed inductive and deductive approach, guided by the updated Consolidated Framework for Implementation Research (2.0). Findings were triangulated with other HaSP process evaluation data sources, including HaSP focus group observations, HaSP research team focus groups, MDT observations, and Implementation Lead project logs. Logic models and case studies were developed to articulate causal processes underlying strategy effectiveness and conditions necessary for implementation success.ResultsEighteen participants from seven HaSP sites were interviewed. Qualitative analysis identified themes related to Lynch syndrome complexity, pandemic disruptions, operational challenges, information technology constraints, multidisciplinary collaboration, cultural determinants, attitudes towards change, the value of theory, adaptations, and implementation support. Within these themes, a total of 39 contextual determinants were identified, with barriers and facilitators spanning 18 CFIR constructs across five domains. Logic models and case studies highlighted a number of mechanisms of action, producing variable clinical outcomes. Process evaluation findings, interpreted together with HaSP trial outcomes, indicate that theory-based implementation strategies may better support Lynch syndrome detection practices compared to intuition-based strategies.ConclusionsThe information gained from this process evaluation deepens understanding of the factors influencing the success of hospital-specific implementation strategies within the HaSP framework. Potential pathways for optimising the effectiveness of the overall HaSP implementation approach have been identified.Trial registrationAustralian New Zealand Clinical Trials Registry, ACTRN12618001072202. Registered 27 June 2018, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=375348&isReview=true.

Resilience in Intensive Care Unit Nurses: An Integrative Review.

The intensive care unit environment exposes nurses to high-stress situations that potentially affect their mental and physical health. Resilience is a protective factor that can enhance the well-being of intensive care unit nurses. To investigate the current evidence regarding resilience in intensive care unit nurses and identify factors that promote resilience. A comprehensive literature search was undertaken for primary research conducted between January 1990 and December 2022. The updated framework of Whittemore and Knafl was used as a guide. Studies were critically appraised for methodological quality by using the Johns Hopkins Nursing evidence-based practice appraisal tool. Twelve studies were included; most used quantitative methods to measure resilience. The findings indicate that intensive care unit nurses exhibit various levels of resilience, the literature contains inconsistencies about factors affecting resilience, and resilience protects nurses against negative psychological outcomes. Nurses' resilience levels should be regularly assessed to identify areas for improvement and gauge the impact of resilience interventions. By continuously monitoring and adapting support strategies on the basis of resilience changes over time, organizations can meet the needs of intensive care unit nurses. More research is needed to comprehend the factors that impact resilience and devise interventions to boost resilience in intensive care nurses.

Political Spaces Beyond the Nation State: The Global Commons in International Security Studies

Abstract The global commons have come to play an increasingly prominent role in the field of international security as scholars seek to better understand the causes and consequences of interstate cooperation, competition, and conflict in political spaces that lie beyond sovereign jurisdiction. In this piece, we make the case that by grouping all extraterritorial spaces into a single, not further differentiated conceptual category, the notion of the “global commons” as it is presently employed obscures important variation in the way these spaces are governed. Specifically, we argue that there exist two distinct types of spaces that legally do not belong to any one state: those that all states are effectively able to freely use for their own strategic purposes; and those that are de facto dominated and thus defy the ideal of universal accessibility their status as a global common supposedly entails. The updated conceptual framework we develop in response—which explicitly distinguishes between two distinct types of extraterritorial spaces—promises to advance security studies research on the global commons in several ways: it helps scholars avoid the issue of causal heterogeneity which current conceptual foundations introduce into causal analysis; it facilitates normative discussions about the global commons and their political future; and it produces novel insights into the governance problems policymakers will confront when seeking to maintain states’ access to extraterritorial spaces in the new age of great power competition.

Coupling dynamics of urban flood resilience in china from 2012 to 2022: A network-based approach

Urban flooding presents a significant challenge in Chinese cities, necessitating a deeper understanding of the coupling effects of China's urban flood resilience for effective resilience planning. This study introduces a four-component Environment-Institution-Infrastructure-Agent (EIFA) framework and utilizes an updated correlation network approach to analyze the temporal variation of coupling effects of urban flood resilience across 639 Chinese cities from 2012 to 2022. The findings indicate a decline in synergy and increased tradeoffs, primarily due to intensified competition within and between institutional and infrastructural sectors, marginal impacts of infrastructure investments, and socially excessive infrastructure. The study also highlights the agent component's strong internal and inter-component coupling effects, implying the effectiveness of China's people-centered resilience strategies, though risks of decoupling remain. Additionally, it notes a good match between societal urban flood resilience and natural flood risks, while natural vegetation loss due to urban expansion is noteworthy. The study further suggests that refining agent-focused deposit and insurance policies could coordinatively enhance urban flood resilience, as these elements are hubs within the network. The updated network-based framework and its findings offer insights for informing and optimizing urban flood resilience planning in China.