OBJECTIVE: People with low back pain (LBP) exhibit altered coordination, possibly indicating guarded movement. The connection between these changes and pain-related threat remains unclear. We aimed to determine if pain-related threat was related to spinal coordination and variability, during a lifting task, in people with chronic LBP.
METHODS: Participants were adults with chronic LBP (n = 47). Upper lumbar, lower lumbar, and hipkinematics were measured during 10crate lifting/lowering repetitions. Coordination and variability of the Hip-Lower Lumbar, and Lower Lumbar-Upper Lumbar joint pairs were calculated. Pain-related threat was measured using the Tampa Scale for Kinesiophobia, the Pain Catastrophizing Scale, and task-specific fear. Linear regression analyses tested the relationship between pain-related threat and coordination.
RESULTS: Adding catastrophizing to our base model (sex) explained variance in Hip-Lower lumbar coordination (r2 change = 0.125, p = 0.013). General and task specific measures of fear were unrelated to coordination and variability at both joint pairs (r2 change < 0.064, p > 0.05). Exploratory t-tests revealed subgroups aligned with phenotypes of \"tight\" and \"loose\" control, where \"tight\" control was characterized by greater catastrophizing and disability.
CONCLUSIONS: Pain catastrophizing, but not measures of fear, was related to more in-phase (\"tight\") Hip-Lower Lumbar coordination during lifting/lowering. Considering this relationship based on subgroups may add clarity.

The analysis of gait kinematics requires to encode and collapse multidimensional information from multiple anatomical elements. In this study, we address this issue by analyzing the joints\' coordination during gait, borrowing from the framework of network theory. We recruited twenty-three patients with Parkinson\'s disease and twenty-three matched controls that were recorded during linear gait using a stereophotogrammetric motion analysis system. The three-dimensional angular velocity of the joints was used to build a kinematic network for each participant, and both global (average whole-body synchronization) and nodal (individual joint synchronization, i.e., nodal strength) were extracted. By comparing the two groups, the results showed lower coordination in patients, both at global and nodal levels (neck, shoulders, elbows, and hips). Furthermore, the nodal strength of the left elbow and right hip in the patients, as well as the average joints\' nodal strength were significantly correlated with the clinical motor condition and were predictive of it. Our study highlights the importance of integrating whole-body information in kinematic analyses and the advantages of using network theory. Finally, the identification of altered network properties of specific joints, and their relationship with the motor impairment in the patients, suggests a potential clinical relevance for our approach.

The operational environment of complex sociotechnical systems is inherently uncertain, demanding constant coordination restructuring to adapt to dynamic situational demands. However, coordination changes in the Human Factors and Ergonomics Field have primarily been studied using static methods, overlooking moment-by-moment adjustments. In the current study, we address coordination restructuring by using THEME, a digital analytical tool capable of visualising and exploring coordination restructuring from a multi-layered perspective. We examine restructuring in coordination patterns during NASA\'s Apollo 13 Mission, revealing significant shifts from stable, long-duration \'coordination hubs\' in routine operations to shorter-duration patterns during a crisis situation. Additionally, the results highlight the importance of flexible switching between reciprocal and one-directed coordination, along with enhanced role distribution. This study underscores how exploring temporality-sensitive phenomena like coordination through digital technologies such as THEME, advances our understanding of incident analysis and resilient performance within complex systems.

UNASSIGNED: The implementation of family doctor contract service is a pivotal measure to enhance primary medical services and execute the hierarchical diagnosis and treatment system. Achieving service coordination among various institutions is both a fundamental objective and a central element of contract services.
UNASSIGNED: The study aims to assess residents\' evaluations and determining factors related to the coordination of health services within primary medical institutions across different regions of Shandong Province. The findings intend to serve as a reference for enhancing the coordination services offered by these institutions.
UNASSIGNED: The study employed a multi-stage stratified random sampling method to select three prefecture-level cities in Shandong Province with different economic levels. Within each city, three counties (districts) were randomly sampled using the same method. Within each county (district), three community health service centers and township health centers implementing family doctor contract services were selected randomly. Face-to-face questionnaire surveys were conducted with contracted residents using the coordination dimension of the revised Primary Care Assessment Tools Scale (PCAT) developed by the research team. Data analysis was conducted using such methods as one-way analysis of variance and multiple linear regression.
UNASSIGNED: The sample included 3,859 contracted residents. The coordination dimension score of primary medical institutions averaged 3.41 ± 0.18, with the referral service sub-dimension scoring 3.60 ± 0.58 and the information system sub-dimension scoring 3.34 ± 0.65. The overall score of the referral service sub-dimension surpassed that of the information system sub-dimension. Regression results indicated that the city\'s economic status, the type of contracted institutions, gender, education, marital status, income, occupation, health status, and endowment insurance payment status significantly influenced the coordinated service score of primary medical institutions (p < 0.05).
UNASSIGNED: The coordination of primary medical institutions in Shandong Province warrants further optimization. Continued efforts should focus on refining the referral system, expediting information infrastructure development, enhancing the service standards of primary medical institutions, and fostering resident trust. These measures aim to advance the implementation of the hierarchical diagnosis and treatment and two-way referral system.

BACKGROUND: This study explores how the goals of collaboration in the return-to-work (RTW) process for people with common mental disorders are described by the stakeholders involved, and how they experience stakeholders\' roles and responsibilities in relation to these goals.
METHODS: Interviews were conducted with 41 participants from three Swedish regions. Nine of the participants were workers, six employer representatives, four occupational health professionals, four social insurance officers, 18 RTW coordinators and five physicians. Thematic analysis was conducted.
RESULTS: Three main themes and overarching goals when collaborating on RTW were identified. In the first theme, \'creating an informative environment\', all stakeholders emphasised clear roles and responsibilities. The second theme, \'striving for consensus in an environment of negotiations\', addressed negotiations about when and how to collaborate, on what and with whom, and reveal different views on stakeholders\' goals, roles and responsibilities in collaboration. The third theme identified goals for \'creating a supportive environment\' for both workers and other stakeholders. Coordinators are found to have an important role in achieving a supportive environment, and in neutralising power imbalances between workers and their employers and social insurance officers.
CONCLUSIONS: Competing goals and priorities were identified as hindering successful collaboration, contributing to a spectrum of complex versus easy RTW collaboration. This study suggests some basic conditions for achieving a collaborative arena that is neutral in terms of power balance, where all stakeholders can share their views.

BACKGROUND: Coordination and balance are progressive motor skills that guide physical therapists in recognizing abnormal patterns during childish neurodevelopment. We aim to compare the efficacy of craniosacral therapy (CST) together with balance and coordination therapy (BCT) vs traditional BCT during neurodevelopment.
METHODS: Longitudinal, observational, and descriptive study with 111 apparently healthy children divided into 4 groups: craniosacral-balance and coordination therapy placebo (CS-BCTp), craniosacral-balance and coordination therapy (CS-BCT), balance and coordination therapy placebo (BCTp), and balance and coordination therapy (BCT).
RESULTS: Significant changes have been observed with the CS-BCT from the fourth session. Balance and coordination therapy is less effective. There are differences in the Battelle Scale at the beginning and after the 7 therapy sessions in the CS-BCT group.
CONCLUSIONS: The study shows that CST together with balance and coordination exercises can be a more effective and faster treatment to improve these motor skills, correcting and improving alterations during child neurodevelopment.

A systematic study has been conducted on barbiturate complexes of all five alkali metals, Li-Cs, prepared from metal carbonates or hydroxides in an aqueous solution without other potential ligands present, varying the stoichiometric ratio of metal ion to barbituric acid (BAH). Eight polymeric coordination compounds (two each for Na, K, and Rb and one each for Li and Cs) have been characterised by single-crystal X-ray diffraction. All contain some combination of barbiturate anion BA- (necessarily in a 1:1 ratio with the metal cation M+), barbituric acid, and water. All organic species and water molecules are coordinated to the metal centres via oxygen atoms as either terminal or bridging ligands. Coordination numbers range from 4 (for the Li complex) to 8 (for the Cs complex). Extensive hydrogen bonding plays a significant role in all the crystal structures, almost all of which include pairs of N-H···O hydrogen bonds linking BA- and/or BAH components into ribbons extending in one dimension. Factors influencing the structure adopted by each compound include cation size and reaction stoichiometry as well as hydrogen bonding.

BACKGROUND: Homecare client services are often distributed across several interdependent healthcare providers, making proper care coordination essential. However, as studies exploring care coordination in the homecare setting are scarce, serious knowledge gaps exist regarding how various factors influence coordination in this care sector. To fill such gaps, this study\'s central aim was to explore how external factors (i.e., financial and regulatory mechanisms) and homecare agency characteristics (i.e., work environment, workforce, and client characteristics) are related to care coordination in homecare.
METHODS: This analysis was part of a national multicentre, cross-sectional study in the Swiss homecare setting that included a stratified random sample of 88 Swiss homecare agencies. Data were collected between January and September 2021 through agency and employee questionnaires. Using our newly developed care coordination framework, COORA, we modelled our variables to assess the relevant components of care coordination on the structural, process, and outcome levels. We conducted both descriptive and multilevel regression analyses-with the latter adjusting for dependencies within agencies-to explore which key factors are associated with coordination.
RESULTS: The final sample size consisted of 1450 employees of 71 homecare agencies. We found that one explicit coordination mechanism (\"communication and information exchange\" (beta = 0.10, p <.001)) and four implicit coordination mechanisms-\"knowledge of the health system\" (beta = -0.07, p <.01), \"role clarity\" (beta = 0.07, p <.001), \"mutual respect and trust\" (beta = 0.07, p <.001), and \"accountability, predictability, common perspective\" (beta = 0.19, p <.001)-were significantly positively associated with employee-perceived coordination. We also found that the effects of agency characteristics and external factors were mediated through coordination processes.
CONCLUSIONS: Implicit coordination mechanisms, which enable and enhance team communication, require closer examination. While developing strategies to strengthen implicit mechanisms, the involvement of the entire care team is vital to create structures (i.e., explicit mechanisms) that enable communication and information exchange. Appropriate coordination processes seem to mitigate the association between staffing and coordination. This suggests that they support coordination even when workload and overtime are higher.

Although clinical and functional impairments in the lower limbs have been extensively studied in patients with MS, the upper limb (UL) are also frequently affected. Clinical impairment of the UL in patients with MS is very common with muscle strength and hand dexterity as critical factors in maintaining functional activities that are the basis for independence and quality of life in people with MS.
To investigate the effects of a training protocol using the Powerball® system in combination with conventional physiotherapy on muscle strength, coordination, fatigue, functionality, and quality of life in persons with MS over an 8-week period.
A double-blind randomized controlled trial was conducted. The control group received conventional treatment, while the experimental group received additional UL training using the Powerball® system. Both groups received the same number of sessions and weeks of intervention. The following outcome measures were used: isometric grip and pinch strength, Box and Block Test (BBT), Nine Hole Peg Test (NHPT), Abilhand scale, Fatigue Severity Scale (FSS), Multiple Sclerosis Impact Scale (MSIS-29), and Likert satisfaction questionnaire for the experimental group. All measures were administered at baseline, after the treatment, and during a 3-week follow-up period.
25 patients completed the study (12 in the experimental and 13 in the control group). The experimental group showed significant improvements in coordination and manual dexterity of the more affected UL as measured by the BBT comparing pre- to post-treatment (p = 0.048) and pre-treatment to follow-up (p = 0.001), and on the less affected UP comparing pre-treatment to follow-up (p < 0.001) and post-treatment to follow-up (p = 0.034). The Likert-type satisfaction questionnaire obtained a mean score of 89.10 (± 8.54) out of 100 points.
Upper limb treatment protocol using the Powerball® system, in combination with conventional physiotherapy for 8 weeks resulted in significant improvements in the intra-group analysis for UL coordination and manual dexterity in favor of the experimental group. The experimental group showed excellent satisfaction to the treatment.

[This corrects the article DOI: 10.3389/fnhum.2021.669902.].