An empirical taxonomy of leadership situations: Development, validation, and implications for the science and practice of leadership.

The situation plays an important role in leadership, yet there exists no comprehensive, well-accepted, and empirically validated framework for modeling leadership situations. This research used situation ratings and narratives from 1,159 leaders to empirically develop a taxonomy of leadership situations. Natural language processing techniques were used to generate psychological situation characteristics that were then rated by leaders. Factor analyses of leader ratings resulted in a taxonomy of psychological leadership situation characteristics with six dimensions (Positive Uniqueness, Importance, Negativity, Scope, Typicality, and Ease). Topic modeling of leader narratives provided a preliminary accompanying typology of structural leadership situation cue combinations (Market/Business Needs, Barriers to Effectiveness, Interpersonal Resources, Deviations/Changes, Team Objectives, and Logistics). To facilitate the measurement of the perceptions of situations, we developed a 27-item measure of the six dimensions of psychological leadership situation characteristics: the Leadership Situation Questionnaire (LSQ). We used the LSQ to conduct initial tests of the nomological network of psychological leadership situation characteristics by assessing their relationships with leader personality, leader behavior, outcomes of leadership situations, and structural leadership situation cue combinations. The psychological leadership situation characteristics taxonomy and the resulting measure (the LSQ) provide an organizing framework for existing leadership research, lay a foundation for future research on situation-related leadership hypotheses, and offer important practical implications in areas such as leader assessment and development. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Examining Multiteam Systems Across Context and Type: A Historiometric Analysis of Failed MTS Performance.

Multiteam systems (MTSs) are complex organizational forms comprising interdependent teams that work towards their own proximal goals within and across teams to also accomplish a shared superordinate goal. MTSs operate within high-stakes, dangerous contexts with high consequences for suboptimal performance. We answer calls for nuanced exploration and cross-context comparison of MTSs "in the wild" by leveraging the MTS action sub-phase behavioral taxonomy to determine where and how MTS failures occur. To our knowledge, this is the first study to also examine how key MTS attributes (boundary status, goal type) influence MTS processes and performance. We conducted historiometric analysis on 40 cases of failed MTS performance across various contexts (e.g., emergency response, commercial transportation, military, and business) to uncover patterns of within- and between-team behaviors of failing MTSs, resulting in four themes. First, component teams of failing MTSs over-engaged in within-team alignment behaviors (vs. between-team behaviors) by enacting acting, monitoring, and recalibrating behaviors more often within than between teams. Second, failing MTSs over-focused on acting behaviors (vs. monitoring or recalibrating) and tended to not fully enact the action sub-phase cycle. Third and fourth, boundary status and goal type exacerbated these behavioral patterns, as external and physical MTSs were less likely to enact sufficient between-team behaviors or fully enact the action sub-phase cycle compared to internal and intellectual MTSs. We propose entrainment as a mechanism for facilitating MTS performance wherein specific, cyclical behavioral patterns enacted by teams align to facilitate goal achievement via three multilevel behavioral cycles (i.e., acting-focused, alignment-focused, and adjustment-focused). We argue that the degree to which these cycles are aligned both between teams and with the overarching MTS goal determines whether and how an MTS fails. Our findings add nuance beyond single-context MTS studies by showing that the identified behavioral patterns hold both across contexts and almost all types of MTS action-phase behaviors. We show that these patterns vary by MTS boundary status and goal type. Our findings inform MTS training best practices, which should be structured to integrate all component teams and tailored to both MTS attributes (i.e., boundary status, goal type) and situation type (e.g., contingency planning).

Development of a multicomponent implementation strategy to reduce upper gastrointestinal bleeding risk in patients using warfarin and antiplatelet therapy, and protocol for a pragmatic multilevel randomized factorial pilot implementation trial.

BACKGROUND: The concomitant use of anticoagulant and antiplatelet medications increases the risk of upper gastrointestinal (GI) bleeding. Two underused evidence-based practices (EBPs) can reduce the risk: de-prescribe unnecessary antiplatelet therapy or initiate a proton pump inhibitor. We describe the development of a multicomponent intervention to increase use of these EBPs in patients treated with warfarin and followed by an anticoagulation monitoring service (AMS), and the design of a pilot pragmatic implementation trial. METHODS: A participatory planning group iteratively used Implementation Mapping and the Multiphase Optimization Strategy to develop implementation strategies and plan the trial. Informed by qualitative interviews with patients and clinicians, we drew on several implementation science theories, as well as self-determination theory, to design interventions. For patients, we developed an activation guide to help patients discuss the EBPs with their clinicians. For clinicians, we developed two electronic health record (EHR)-based interventions: (1) clinician notification (CN) consists of a templated message that identifies a patient as high risk, summarizes the EBPs, and links to a guidance statement on appropriate use of antiplatelet therapy. (2) Clinician notification with nurse facilitation (CN+NF) consists of a similar notification message but includes additional measures by nursing staff to support appropriate and timely decision-making: the nurse performs a chart review to identify any history of vascular disease, embeds indication-specific guidance on antiplatelet therapy in the message, and offers to assist with medication order entry and patient education. We will conduct a pilot factorial cluster- and individual-level randomized controlled trial with a primary objective of evaluating feasibility. Twelve clinicians will be randomized to receive either CN or CN+NF for all their patients managed by the AMS while 50 patients will be individually randomized to receive either the activation guide or usual care. We will explore implementation outcomes using patient and clinician interviews along with EHR review. DISCUSSION: This pilot study will prepare us to conduct a larger optimization study to identify the most potent and resource conscious multicomponent implementation strategy to help AMSs increase the use of best practices for upper GI bleeding risk reduction. TRIAL REGISTRATION: ClinicalTrials.gov NCT05085405 . Registered on October 19, 2021-retrospectively registered.

Outcomes of open partial nephrectomies performed by Australian trainees.

BACKGROUND: Partial nephrectomy (PN) has become the standard of care for small renal tumours, with open partial nephrectomy (OPN) being superseded by minimally invasive PN. Advances in minimal access surgery have resulted in fewer relative contraindications, with subsequently fewer OPN being performed. Consequentially, trainees have less opportunity to gain skills and experience in open renal surgery. The aims of this study were to assess the standard of OPN performed by Australian urological trainees and to define whether OPN is a safe and suitable training opportunity. METHOD: A retrospective review was undertaken on patients who underwent OPN performed by urology trainees from 2010 to 2014 at two training hospitals in Western Australia. Data collected included patient demographics, surgical and oncological outcomes and morbidity. RESULTS: Sixty patients underwent OPN, with a mean age of 56 years. Most tumours were single, with mean size 31 mm. Mean operative time was 157 min, with a mean cold ischaemic time of 27 min. Mean pre- and post-operative creatinine levels were equivalent (77 µmol/L). The overall complication rate was 18%, with no documented urinary leaks, and 1.7% blood transfusion rate. Median length of stay was 4 days. There were no oncological positive margins or recurrence after a median follow-up of 2 years. CONCLUSION: Our data support the notion that Australian urological trainees can perform the majority of OPN cases, with equivalent oncological outcomes. We would advocate that when an OPN is being performed, the supervising consultant should use the case as an adjuvant for open renal surgery training.

Needle tract seeding following percutaneous biopsy of renal cell carcinoma.

A 66-year-old man underwent computed tomography-guided needle biopsy of a suspicious renal mass. Two months later he underwent partial nephrectomy. Histology revealed a 30-mm clear cell renal cell carcinoma, up to Fuhrman grade 3. An area of the capsule was interrupted, which corresponded to a hemorrhagic area on the cortical surface. Under microscopy, this area showed a tongue of tumor tissue protruding through the renal capsule. A tumor deposit was found in the perinephric fat. These features suggest that tumor seeding may have occurred during the needle biopsy.

Novel trifluoroacetophenone derivatives as malonyl-CoA decarboxylase inhibitors.

A series of trifluoroacetophenone derivatives were prepared and evaluated as malonyl-CoA decarboxylase (MCD) inhibitors. Some of the 'reverse amide' analogs were found to be potent inhibitors of MCD enzyme activity. The trifluoroacetyl group may interact with the MCD active site as the hydrate in a similar fashion to the hexafluoroisopropanol analogs reported previously. Adding electron-withdrawing groups to the phenyl ring stabilizes the hydrated species and enhances this interaction.