Cross-sectional Multivariate Regression Research Articles

Do online social networks affect information asymmetry?

This paper empirically explores the impact of online social networks on information asymmetry, based on an international survey conducted in January - August 2021, with 930 respondents. The methodology follows cross-sectional multivariate regressions augmented by a Structural Equation Modeling (SEM) approach. The findings show that young people living in their origin country are more prone to check the veracity of information read, especially those who are Non-Governmental Organization (NGO) activists. Europeans are very sensitive regarding the veracity of posted information. The number of spoken languages facilitating both processes. Additionally, the information asymmetry is attenuated when the users spend more hours on online social networks or use more platforms. The core result is very interesting, showing that the posted information without serious filters during the reading stage is a serious source of asymmetry. Not least, the owner and government restrictions nonlinearly affect information asymmetry by inverted U-shape. This reinforces the idea that none of those characteristics can be absolutized to improve information asymmetry.

Auditors' narcissism and their professional skepticism: evidence from Iran

PurposeThis study aims to examine the association between Iranian auditors' narcissism and the auditors' professional skepticism.Design/methodology/approachThe authors' sample is comprised of 355 professional auditors working in the private and public sectors in Iranian firms in 2022. The authors use cross-sectional multivariate regression as the main methodology, along with the structural equation modeling (SEM) technique.FindingsThe authors find that a higher level of narcissism leads to a greater level of professional skepticism among auditors, which ultimately can enhance the quality of the audit process. The results provided via the robustness tests also supported this finding.Originality/valueThe authors' findings further the understanding of the role of narcissistic personality traits in improving professional skepticism among auditors of an Islamic and emerging country. In addition, audit firms and audit partners can also consider the findings of this study and enhance the effectiveness of audit processes by assigning appropriate employees with certain personalities to specific tasks.

Absent Relations of Religious Coping to Telomere Length in African American and White Women and Men

ABSTRACT Objectives This study investigated whether race and sex moderated the relations of religious coping to telomere length (TL), a biomarker of cellular aging implicated in race-related health disparities. Methods Participant data were drawn from the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study, which included 252 socioeconomically diverse African American and White men and women aged (30–64 years old). Cross-sectional multivariable regression analyses examined interactive associations of religious coping, race, and sex to TL, adjusting for other sociodemographic characteristics. Results Religious coping was unrelated to TL in this sample (p’s > .05). There were no notable race or sex differences. Post hoc exploratory analyses similarly found that neither secular social support coping use nor substance use coping was associated with TL. Conclusion There was no evidence to support that religious coping use provided protective effects to TL in this sample of African American and White women and men. Nevertheless, future studies should use more comprehensive assessments of religious coping and intersectional identities to provide an in-depth examination of religiosity/spirituality as a potential culturally salient protective factor in cellular aging among African Americans in the context of specific chronic stressors such as discrimination.

Glasgow climate pact and the global clean energy index constituent stocks

PurposeThis study examined the impact of the Glasgow Climate Pact on the abnormal returns of global clean energy stocks. Further, this study examines which country-specific and firm-specific variables drive the cumulative abnormal returns (CARs) of clean energy stocks.Design/methodology/approachThe authors used the event study method and cross-sectional multivariate regression model. The clean energy stocks in this study are limited to 81 constituent firms of the S&P Global Clean Energy Index across 17 nations. The final sample includes 80 firms and the sample period ranges from January 26, 2021, to December 07, 2021.FindingsThe study finds that the Glasgow Climate Pact negatively affects the stock returns of clean energy firms. Moreover, the climate change performance index (CCPI) positively impacts cumulative abnormal returns (CARs), signifying that clean energy investors react positively to firms in nations with good CCPI scores. The environmental, social and governance (ESG) measure for the shorter window (−1, +1) exhibited a negative relationship with CARs. The firm-specific variables (BTM, stock liquidity, size and past returns) exhibit a negative relationship with CARs in different event windows.Research limitations/implicationsThe authors use the CCPI as a proxy for the stringency of environmental policies in any nation. The authors extend the existing literature by employing firm-specific variables and supporting previous findings. Their findings have policy implications for clean energy investors, policymakers and other market participants.Practical implicationsClimate risks impact the global financial market, so the findings have implications for global regulatory bodies. Currently, there are bankruptcy cases due to climate risks. Because financial markets must play a critical role in shifting the economy toward a green one, regulators can use the cross-sectional drivers of this study to shape policy. It is also critical for regulators to reduce stock price volatility in the event of the implementation of environmental regulations and improve environmental disclosures by publicly traded companies. Furthermore, governments are interested in researching the effects of environmental regulations to protect stakeholders' interests. These regulations significantly impact emerging markets because they lack the same solid institutional frameworks as developed markets.Originality/valueThe authors provide evidence that firms with better ESG scores and larger firm sizes have experienced fewer abnormal returns, as these firms have stable financial and non-financial fundamentals. This timely study on the ongoing regulatory shift in environmental policy will help investors, policymakers, firms and other stakeholders make relevant decisions.

Geographic and socioeconomic access disparities to Phase 3 clinical trials in ophthalmology in the United States.

To identify geographic and socioeconomic variables associated with residential proximity to Phase 3 ophthalmology clinical trial sites. The geographic location of clinical trial sites for Phase 3 clinical trials in ophthalmology was identified using ClinicalTrials.gov. Driving time from each United States (US) census tract centroid to nearest clinical trial site was calculated using real traffic patterns. Travel data were crosslinked to census-tract level public datasets from United States Census Bureau American Community Survey (ACS). Cross-sectional multivariable regression was used to identify associations between census-tract sociodemographic factors and driving time (>60 min) from each census tract centroid to the nearest clinical trial site. There were 2330 unique clinical trial sites and 71,897 census tracts. Shortest median time was to retina sites [33.7 min (18.7, 70.1 min)]. Longest median time was to neuro-ophthalmology sites [119.8 min (48.7, 240.4 min)]. Driving >60 min was associated with rural tracts [adjusted odds ratio (aOR) 7.60; 95% CI (5.66-10.20), p < 0.0001]; Midwest [aOR 1.84(1.15-2.96), p = 0.01], South [aOR 2.57 (1.38-4.79), p < 0.01], and West [aOR 2.52 (1.52-4.17), p < 0.001] v. Northeast; and tracts with higher visual impairment [aOR 1.07 (1.03-1.10), p < 0.001)]; higher poverty levels [4th v.1st Quartile of population below poverty, aOR 2.26 (1.72-2.98), p < 0.0001]; and lower education levels [high school v. Bachelor's degree or higher aOR 1.02 (1.00-1.03), p = 0.0072]. There are significant geographic and socioeconomic disparities in access to ophthalmology clinical trial sites for rural, non-Northeastern, poorer, and lower education level census tracts, and for census tracts with higher levels of self-reported visual impairment.

Police Discrimination and Depressive Symptoms in African American Women: The Intergenerational Impact of Genetic and Psychological Factors on Blood Pressure Study.

Introduction:There are significant and pervasive disparities in police violence and discrimination toward African Americans/Blacks. It is possible that these disparities may lead to heightened vulnerability for poor mental health outcomes. The purpose of this study was to ascertain the associations between experiences of police discrimination and depressive symptoms in a community-based sample of African American/Black women.Methods:We performed a cross-sectional multivariable regression analysis using data from the Intergenerational Impact of Genetic and Psychological Factors on Blood Pressure Study that were collected over a 4-year period from September 2015 to June 2019. Depressive symptoms were assessed using 21 items from the Beck Depression Inventory. Police discrimination was assessed by questionnaires ascertaining experiences of discrimination by police; harassment by police or security guards; and experiences of being unfairly stopped, searched, threatened, or abused by police.Results:The analytical sample included 214 participants. Nineteen percent of participants indicated that they believed they experienced harassment from security guards/police due to their race/ethnicity. Fourteen percent of participants indicated that they had been unfairly stopped, searched, questioned, or abused by police. Police harassment was associated with higher depressive symptoms by an average of 4.48 (standard error [SE]=1.35, p<0.001). African American/Black women who were unfairly stopped, searched, or abused by police had higher depressive symptoms by an average of 4.54 (SE=1.57, p<0.01).Conclusion:African American/Black women who experienced police discrimination experienced higher prevalence of depressive symptoms. There is an urgent need for reliable population-level data on police mistreatment and interventions at the individual, community, and societal levels.

The hybrid nature of social enterprises how does it affect their revenue sources?

PurposeThis paper aims to examine the applicability of the benefits theory of nonprofit finance to an international sample of social enterprises (SEs).Design/methodology/approachThis research analyzes the revenue sources of SEs through the lens of benefits theory. In particular, the authors test the links between revenue sources and the character of an enterprise’s mission. This study uses data on 545 SEs collected by the International Comparative Social Enterprise Models project, which was an international collaborative effort of more than 200 researchers. The authors use cross-sectional multivariate regression to identify the factors which influence the revenue portfolios of SEs.FindingsThe findings provide evidence of SE revenue portfolios that are nuanced and complicated. Benefits theory helps to illuminate this nuance. The application of benefits theory to SE goes beyond the traditional characterization of the publicness and privateness of goods and services to include the intended beneficiaries, the nature of benefits they receive and the management practices followed to assure distribution of benefits to intended beneficiary groups. By analyzing the public (and private) goals of SEs, such as employment generation and food security, the authors gain an understanding of what they really do, and hence, how they can be best financed.Originality/valueThis study provides empirical support to the applicability of benefits theory to SEs, which provides both theoretical advancement and practical implications.

Is late bedtime an overlooked sleep behaviour? Investigating associations between sleep timing, sleep duration and eating behaviours in adolescence and adulthood.

To examine whether bedtime is associated with usual sleep duration and eating behaviour among adolescents, emerging adults and young adults. Cross-sectional multivariable regression models, stratified by developmental stage, to examine: (1) association between bedtime and sleep duration and (2) associations between bedtime and specific eating behaviours at each developmental period, controlling for sleep duration. All models adjusted for sociodemographic characteristics, depressive symptoms and screen time behaviours. National Longitudinal Study of Adolescent to Adult Health, waves I-IV, USA. A national probability sample surveyed in adolescence (aged 12-18 years, wave I: 1994-1995, n 13 048 and wave II: 1996, n 9438), emerging adulthood (aged 18-24 years, wave III: 2001-2002, n 9424) and young adulthood (aged 24-34 years, wave IV: 2008, n 10 410). Later bedtime was associated with shorter sleep duration in all developmental stages, such that a 1-h delay in bedtime was associated with 14-33 fewer minutes of sleep per night (Ps < 0·001). Later bedtime was also associated with lower odds of consuming healthier foods (i.e. fruits, vegetables; range of adjusted OR (AOR), 0·82-0·93, Ps < 0·05) and higher odds of consuming less healthy foods and beverages (i.e. soda, pizza, desserts and sweets; range of AOR, 1·07-1·09, Ps < 0·05). Later bedtime was also associated with more frequent fast-food consumption and higher sugar-sweetened beverage consumption (Ps < 0·05). Later bedtime was associated with shorter sleep duration and less healthy eating behaviours. Bedtime may be a novel behaviour to address in interventions aiming to improve sleep duration and dietary intake.

The association of disordered eating with health-related quality of life in U.S. young adults and effect modification by gender.

To examine the relationship of disordered eating behaviors and eating disorder (ED) diagnosis in young adults with health-related quality of life (HRQL) and to assess the presence of effect modification by gender. In 2013, participants (N = 9440, ages 18-31years) in the U.S. Growing Up Today Study cohort reported use of disordered eating behaviors (dieting, diet pills, laxatives, or vomiting to control weight; binge eating with loss of control) over the past year, plus a lifetime history of ED diagnosis. The relative risk (RR) of less-than-full health (EQ-5D-5L health utility score < 1) and of any impairment (score > 1 on EQ-5D-5L dimensions) were compared across participants with and without disordered eating or ED diagnosis, using cross-sectional multivariable regression controlling for confounders. The association between HRQL and disordered eating or ED diagnosis was assessed using multivariable linear regression with the subsample reporting less-than-full health. The presence of effect modification by gender was also examined. Disordered eating behaviors and ED diagnosis were associated with significantly increased risk of less-than-full health. A significant gender interaction was found for only one variable-ED diagnosis; men who reported ever having received a diagnosis experienced worse decrements in HRQL than did women. Inclusion of BMI in estimation models revealed small attenuations. Across the weight spectrum, the presence of ED was associated with impairment across all EQ-5D-5L dimensions, except self-care. Disordered eating behaviors and a lifetime history of ED diagnosis are associated with significant decrements in HRQL, but only ED diagnosis is associated with a significant effect modification by gender.

The role of the arts and bohemia in sustainable transportation and commuting choices in Chicago, Paris, and Seoul

ABSTRACTPast studies have shown that a denser, mixed urban form is a key determinant of alternative commuting choice. However, the role of cultural environments of neighborhoods and cities in the choices of sustainable transportation is rarely studied. This article examines the presence and the role of the arts and bohemia on measures of walking, bicycling, and public transit use in a cross-national context. I quantitatively measure bohemia and the arts in the cities of Chicago, Paris, and Seoul and test their association with alternative commuting choices and transit ridership. In cross-sectional multivariate regression analyses, I find that bohemia and the arts are strongly associated with alternative modes of transportation after controlling for density and demographic factors. In particular, bohemia in both the United States and France is significantly associated with bicycle commuting. In addition, the presence of the art amenities and artists shows a robust relationship with walking in Seoul.

Impact of long-term air pollution exposure on metabolic control in children and adolescents with type 1 diabetes: results from the DPV registry.

Studies on the association between air pollution and metabolic control in children and adolescents with type 1 diabetes are rare and findings are inconsistent. We examined the relationship between air pollution variables (particulate matter with an aerodynamic diameter <10μm [PM10], NO2 and accumulated ozone exposure [O3-AOT]) and metabolic variables (HbA1c and daily insulin dose [U/kg body weight]) in children and adolescents with type 1 diabetes. We investigated 37,372 individuals with type 1 diabetes aged <21years, documented between 2009 and 2014 in 344 German centres of the prospective diabetes follow-up registry (Diabetes-Patienten-Verlaufsdokumentation [DPV]). Long-term air pollution exposure (annual and quinquennial means) data were linked to participants via the five-digit postcode areas of residency. Cross-sectional multivariable regression analysis was used to examine the association between air pollution and metabolic control. After comprehensive adjustment, an interquartile range increase in O3-AOT was associated with a lower HbA1c (-3.7% [95% CI -4.4, -3.0]). The inverse association between O3-AOT and HbA1c persisted after additional adjustment for degree of urbanisation or additional adjustment for PM10. Moreover, the inverse association remained stable in further sensitivity analyses. No significant associations between HbA1c and PM10 or NO2 were found. No association was observed between any of the three air pollutants and insulin dose. The inverse association between O3-AOT and HbA1c could not be explained by regional differences in diabetes treatment or by other differences between urban and rural areas. Furthermore, our results remained stable in sensitivity analyses. Further studies on the association between air pollution and HbA1c in children and adolescents with type 1 diabetes are needed to confirm our observed association and to elucidate underlying mechanisms.

Sexual Minority Disparities in Substance Use Willingness Among Youth

ABSTRACTBackground: Disparities in substance use have been observed in sexual minority youth, but less is known about willingness to use substances, an important precursor to actual use. Objective: The goal of this study was to examine willingness to use cigarettes, alcohol, and marijuana among sexual minority youth compared to their non-sexual minority counterparts using both cross-sectional and longitudinal data. Methods: The present study drew on two waves (Times 1 and 2; 6 months apart) of data collected during high school as part of a prospective study of substance use initiation and progression in Rhode Island. At Time 1, participants (N = 443) ranged in age from 15 to 20 years (M age = 16.7 years, 26.6% sexual minority, 59.5% female, 72.0% White). Participants self-reported their sexual identity and attraction, lifetime use of alcohol, cigarettes and marijuana, and cigarette, alcohol, and marijuana use willingness (i.e., if offered by a best friend or group of friends). Results: In cross-sectional multivariate regression models, sexual minority youth were more likely to report willingness to use cigarettes (p <.05) and marijuana (p <.01) compared to their non-sexual minority counterparts. Longitudinal multivariate regression models revealed that sexual minorities were only significantly more likely to report cigarette willingness at Time 2 compared to their non-sexual minority counterparts (p <.01). There were no significant differences in alcohol use willingness in multivariable cross-sectional or longitudinal models by sexual minority status. Conclusions: Sexual minority youth reported more willingness than non-sexual minority youth to use substances offered by peers; however, longitudinal analyses revealed that peers appear to play a role only in willingness to smoke cigarettes for these youth, and thus peer influence may be a contributing factor in explaining tobacco-related disparities among sexual minority youth. Given that stigma and peer groups may a particular risk factor for tobacco among sexual minority youth, our findings highlight the importance of prevention programs such as social marketing approaches that correct social norms, reduce stigma, and provide refusal-skills training to reduce tobacco-related disparities among sexual minorities.

Equity Issuance of Health Care Firms After the 2007 Market Crash and the 2010 Affordable Care Act

We provide an empirical analysis of 195 initial public offerings (IPOs) and 547 seasoned equity offerings (SEOs) of health care firms that issued between 2008 and October 2016. This period represents eight years after the US financial crisis of late 2007 and also includes all equity issuances since the passage of the Affordable Care Act of late 2010. We compare and contrast our results with those of Brau and Holloway (2009) who study health care equity issuances from 1970-2008. We find that global health care issues in both the IPO and SEO markets are significantly over-represented in both the post-crash (2008-2010) and post-ACA years (2011-2016) vis-a-vis the overall equity markets. Consistent with prior studies, we show the existence of first-day underpricing in both IPOs and SEOs, along with poor long-run abnormal stock returns. We estimate cross-sectional multivariate regression models to explain the underpricing and long-run returns.

Sources of meaning in family caregivers of terminally ill patients supported by a palliative nursing care team – A naturalistic three-month cohort study

ObjectivesTo identify possible change patterns or robustness in sources of meaning in family caregivers of pre-terminal patients after onset of support at home by an outreach palliative nursing team during a survey period of three months.MethodsOne hundred caregivers of terminally ill patients were included in a prospective observational trial. The Sources of Meaning and Meaning in Life Questionnaire (SoMe) was administered at four points of measurement: T0 (immediately before onset of palliative care); T1 (one week after T0); T2 (one month after T0); T3 (three months after T0). Descriptive statistics, random effects regression analyses; multivariate linear and quadratic regression models were performed for the full (n = 100) as well as for the reduced sample (n = 24).ResultsGrowth curve analyses reveal significant parabolic changes for the dimension “order” and for the subscales “social commitment”, “tradition”, “morality”, and “fun”. All other dimensions or subscales remained stable during the time of the study. Cross-sectional multivariate regression models (T0) showed negative associations of some dimensions with patients’ age and psychological burden of the family caregiver while psychological burden of patients was found to be positively associated with some dimensions. No significant effects of interaction variables with time (linear and quadratic).ConclusionsWith few exceptions, family carers seem to keep a stable sense of meaning in life during the final stage of their relatives’ terminal illness. Particular associations between sources of meaning and age of patients as well as psychological burden both of patients and carers have to be taken into consideration in support planning.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Intimate Partner Violence and Depression Symptom Severity among South African Women during Pregnancy and Postpartum: Population-Based Prospective Cohort Study.

BackgroundViolence against women by intimate partners remains unacceptably common worldwide. The evidence base for the assumed psychological impacts of intimate partner violence (IPV) is derived primarily from studies conducted in high-income countries. A recently published systematic review identified 13 studies linking IPV to incident depression, none of which were conducted in sub-Saharan Africa. To address this gap in the literature, we analyzed longitudinal data collected during the course of a 3-y cluster-randomized trial with the aim of estimating the association between IPV and depression symptom severity.Methods and FindingsWe conducted a secondary analysis of population-based, longitudinal data collected from 1,238 pregnant women during a 3-y cluster-randomized trial of a home visiting intervention in Cape Town, South Africa. Surveys were conducted at baseline, 6 mo, 18 mo, and 36 mo (85% retention). The primary explanatory variable of interest was exposure to four types of physical IPV in the past year. Depression symptom severity was measured using the Xhosa version of the ten-item Edinburgh Postnatal Depression Scale. In a pooled cross-sectional multivariable regression model adjusting for potentially confounding time-fixed and time-varying covariates, lagged IPV intensity had a statistically significant association with depression symptom severity (regression coefficient b = 1.04; 95% CI, 0.61–1.47), with estimates from a quantile regression model showing greater adverse impacts at the upper end of the conditional depression distribution. Fitting a fixed effects regression model accounting for all time-invariant confounding (e.g., history of childhood sexual abuse) yielded similar findings (b = 1.54; 95% CI, 1.13–1.96). The magnitudes of the coefficients indicated that a one–standard-deviation increase in IPV intensity was associated with a 12.3% relative increase in depression symptom severity over the same time period. The most important limitations of our study include exposure assessment that lacked measurement of sexual violence, which could have caused us to underestimate the severity of exposure; the extended latency period in the lagged analysis, which could have caused us to underestimate the strength of the association; and outcome assessment that was limited to the use of a screening instrument for depression symptom severity.ConclusionsIn this secondary analysis of data from a population-based, 3-y cluster-randomized controlled trial, IPV had a statistically significant association with depression symptom severity. The estimated associations were relatively large in magnitude, consistent with findings from high-income countries, and robust to potential confounding by time-invariant factors. Intensive health sector responses to reduce IPV and improve women’s mental health should be explored.

Understanding emotion and emotional scarring in recurrent depression

BackgroundA single-item assessment of sad mood after remission from MDD is predictive of relapse, yet the mechanisms that play a role in depressive relapse remain poorly understood. MethodsIn 283 patients, remitted from recurrent depression (DSM-IV-TR criteria; HAM-D17 score ≤10), we examined emotional scarring, that is, whether the number of previous depressive episodes was associated with higher levels of sad mood as assessed with a 1-item Visual Analogue Mood Scale (VAMS). We then fitted a cross-sectional multivariate regression model to predict sad mood levels, including the Dysfunctional Attitude Scale Version-A, cognitive reactivity (Leiden Index of Depression Sensitivity), Ruminative Response Scale, and Everyday Problem Checklist. ResultsPatients with greater numbers of prior episodes experienced higher levels of sad mood after remission. In multivariate regression, intensity of daily stress and dysfunctional beliefs were associated with the VAMS (Adj. R2=.091) although not over and above depressive symptomatology (Adj. R2=.114). Cognitive reactivity was not associated with sadness. ConclusionsOur finding that patients with more previous MDEs reported higher levels of sad mood while remitted could be indicative of emotional scarring. Dysfunctional beliefs and intensity of daily stress were associated with sad mood but not over and above residual symptoms. Thus, illness related characteristics especially are associated with sad mood after remission. More negative affect after remission could result in lower stress tolerance or more stress intensity could result in negative affect. Future studies should examine premorbid sadness in a longitudinal cohort, and should study the exact pathway from stress, affect, and cognition to relapse.

Arterial stiffness and progression of structural brain changes: The SMART-MR study.

To examine the cross-sectional and prospective associations between arterial stiffness and structural brain changes within the Second Manifestations of Arterial Disease-Magnetic Resonance (SMART-MR) study, a prospective cohort study among patients with manifest arterial disease. Distension measurements of the common carotid arteries and a brain MRI were performed in 526 patients (mean age 59 ± 10 years). After a mean follow-up of 4.1 years (range 3.6-5.8), brain MRI was repeated in 308 patients. Brain segmentation was used to quantify total brain volume, cortical gray matter volume, ventricular volume, and white matter lesion (WML) volume (relative to intracranial volume). Infarcts were rated visually. Cross-sectional multivariable regression analyses showed that 1 SD decrease in carotid distension, indicating increased arterial stiffness, was associated with smaller relative total brain and cortical gray matter volumes (B = -0.24%, 95% confidence interval [CI] -0.44 to -0.04%, and B = -0.47%, 95% CI -0.75 to -0.19%), with larger WML volume (B = 0.09%, 95% CI -0.01 to 0.19%), and with higher risk of having nonlacunar (cortical or large subcortical) brain infarcts (relative risk = 1.44, 95% CI 1.14 to 1.81). However, our prospective findings showed that carotid distension was not significantly associated with progression of brain atrophy, WML volume, or brain infarcts. In this population of patients with manifest arterial disease, stiffening of the carotid arteries was cross-sectionally associated with more brain atrophy, WML volume, and nonlacunar infarcts, but did not lead to changes in brain volumes or infarcts after 4 years.

Determinants of greenhouse gas emissions from Swedish private consumption: Time-series and cross-sectional analyses

The relationships between consumption, energy use and greenhouse gas (GHG) emissions from Swedish households are analysed using both cross-sectional multivariate regressions and a decomposition analysis of GHG emissions between 1993 and 2006 into underlying trends. The analyses cover 104 consumption categories and include both direct and indirect energy use. The results from the cross-sectional analysis confirm previous results from other countries showing that total expenditures is by far the most important determinant of households' energy use and GHG emissions with expenditure elasticities of 0.77 and 0.85, respectively. Households living in single-family houses were also found to cause higher total energy demand than households living in apartments. Age also showed a positive relationship with both total energy use and emissions, while the level of education had a low significance. The decomposition analysis showed that improvements in technical energy efficiency over time had twice as large impact on energy use as the change in composition of consumption. When the effect of energy efficiency improvements was deducted from the energy trend, the relationship between total expenditures and energy use was found to be similar to the cross-sectional relationship.

Is Kyphosis Related to Mobility, Balance, and Disability?

The aim of this study was to determine the association of increased kyphosis with declines in mobility, balance, and disability among community-living older adults. The 18-mo follow-up visit data from 2006 to 2009 for 620 participants from the population-based Maintenance of Balance, Independent Living, Intellect, and Zest in the Elderly Boston Study of older adults was used. Cross-sectional multivariable regression analyses were performed to assess the relationship between kyphosis (measured using the kyphosis index) and measures of mobility performance (Short Physical Performance Battery), balance (Berg Balance Scale score), and disability (self-reported difficulty walking a quarter of a mile or climbing a flight of stairs). The authors then evaluated the men and the women separately. Adjustment variables included demographic factors (age, sex, race, and education), body mass index, self-rated health, comorbidities (heart disease, diabetes, stroke, and depressive symptoms), back pain, knee pain, and falls self-efficacy. After full adjustment, greater kyphosis index was associated with lower Short Physical Performance Battery scores (adjusted β = -0.08, P = 0.01) but not with lower Berg Balance Scale (adjusted β = -0.09, P = 0.23) or self-reported disability (adjusted β = 1.00; 95% confidence interval, 0.93-1.06) scores. In sex-specific analyses, kyphosis index was associated with only the Short Physical Performance Battery in the women. Greater kyphosis is associated with poorer mobility performance but not with poorer balance or self-reported disability. This association with the Short Physical Performance Battery was observed only among the women. Mechanisms by which increased kyphosis influences physical performance should be explored prospectively.

Predictors of discordance between physicians' and patients' appraisals of health-related quality of life in atrial fibrillation patients: Findings from the Angiotensin II Antagonist in Paroxysmal Atrial Fibrillation Trial

Assessing health status is fundamental when weighing treatment options for atrial fibrillation (AF) patients. Most health-related quality-of-life (HRQoL) data stem from self-ratings, whereas treatment decisions are based upon physicians' estimations. The degree of congruence between patients' and physicians' assessments of the patients' subjective health status was used as an indicator of good communication and shared understanding. A total of 334 patients with paroxysmal AF without significant concomitant heart diseases and their physicians were asked in a prospective blinded study to rate the patients' HRQoL. The Short Form-12 was used for self-ratings; the Short Form-8, for physician ratings. Using baseline data, intraclass correlations and Bland-Altman graphs were used to assess concordance; cross-sectional multivariate regression analyses assessed patient characteristics associated with discordance. On average, physicians rated their patients' HRQoL higher than patients did (∆mental component score [MCS] = -3.23, P < .0001, and ∆physical component score [PCS] = -2.21, P = .0001). Intraclass correlations and Bland-Altman graphs showed unsatisfactory concordance. Physical inactivity (∆ = 4.84) had the greatest bivariate effect on PCS discordance, and major depressive disorder (∆ = 7.01), on MCS discordance. In the regression analyses, depression was significantly associated with discord in the MCS (β = -0.94, P < .001) and the PCS (β = -0.37, P < .002). Sleeping disorder was associated with discord in the MCS (β = -4.13, P < .002), and physical inactivity, with discord in the PCS (β = -1.47, P = .006). In patients with AF, even in the absence of significant concomitant cardiac diseases, depression, followed by sleeping disorder and physical inactivity, was significantly associated with discordance. These findings should be considered by physicians when choosing treatment strategies.