Independent Impact Research Articles

The independent and combined impact of moral injury and moral distress on post-traumatic stress disorder symptoms among healthcare workers during the COVID-19 pandemic

ABSTRACT Background: Healthcare workers (HCWs) across the globe have reported symptoms of Post-Traumatic Stress Disorder (PTSD) during the COVID-19 pandemic. Moral Injury (MI) has been associated with PTSD in military populations, but is not well studied in healthcare contexts. Moral Distress (MD), a related concept, may enhance understandings of MI and its relation to PTSD among HCWs. This study examined the independent and combined impact of MI and MD on PTSD symptoms in Canadian HCWs during the pandemic. Methods: HCWs participated in an online survey between February and December 2021, with questions regarding sociodemographics, mental health and trauma history (e.g. MI, MD, PTSD, dissociation, depression, anxiety, stress, childhood adversity). Structural equation modelling was used to analyze the independent and combined impact of MI and MD on PTSD symptoms (including dissociation) among the sample when controlling for sex, age, depression, anxiety, stress, and childhood adversity. Results: A structural equation model independently regressing both MI and MD onto PTSD accounted for 74.4% of the variance in PTSD symptoms. Here, MI was strongly and significantly associated with PTSD symptoms (β = .412, p < .0001) to a higher degree than MD (β = .187, p < .0001), after controlling for age, sex, depression, anxiety, stress and childhood adversity. A model regressing a combined MD and MI construct onto PTSD predicted approximately 87% of the variance in PTSD symptoms (r 2 = .87, p < .0001), with MD/MI strongly and significantly associated with PTSD (β = .813, p < .0001), after controlling for age, sex, depression, anxiety, stress, and childhood adversity. Conclusion: Our results support a relation between MI and PTSD among HCWs and suggest that a combined MD and MI construct is most strongly associated with PTSD symptoms. Further research is needed better understand the mechanisms through which MD/MI are associated with PTSD.

THE IMPACT OF AN AUDITOR'S ADHERENCE TO THE PRINCIPLES OF NEUTRALITY, PROFESSIONAL INDEPENDENCE, PROFESSIONAL CONFIDENTIALITY, AND TRUST IN THE TAX ACCOUNTING PROCESS

Objective: This study aims to demonstrate the impact of the auditor's adherence to the principles of neutrality, professional independence, confidentiality and trust in the tax accounting process and the importance of this commitment to the tax administration. The study also examines the extent to which the tax administration relies on the auditor's report and financial statements in determining the taxable income of taxpayers.&#x0D; &#x0D; Methodology: The study's objectives were achieved by collecting data from a survey distributed to certified auditors working for the Iraqi Board of Accountancy and Audit, employees of the Federal Financial Control Bureau, and employees of the General Tax Authority. A total of 230 questionnaires were distributed, 200 of which were returned and verified for statistical analysis.&#x0D; &#x0D; Results: The results indicate a statistically significant positive effect at the 5% level for the impact of neutrality and professional independence on the tax accounting process. This means that an increased focus on auditor neutrality and independence will contribute to a 0.469 increase in the efficiency of the tax accounting process. In addition, there is a positive and statistically significant moral impact below the 5% level for the impact of professional duty of confidentiality and trust in the tax accounting process. In other words, ensuring auditors follow the rule of professional confidentiality and trust can improve tax accounting efficiency by 0.350.&#x0D; &#x0D; Conclusion: Professional ethics and codes of conduct serve as guides for auditors to exhibit appropriate professional behavior while performing their duties to meet society's ethical requirements. The professional code of ethics is the outcome of the profession's efforts to develop and organize rules. It assures the tax administration that the financial statements submitted by the taxpayer (companies) and approved by the auditor who adheres to those rules are truthful and fair.

Emergent Esophagectomy in Patients with Esophageal Malignancy Is Associated with Higher Rates of Perioperative Complications but No Independent Impact on Short-Term Mortality.

Data on perioperative outcomes of emergent versus elective resection in esophageal cancer patients requiring esophagectomy are lacking. We investigated whether emergent resection was associated with increased risks of morbidity and mortality. Data on patients with esophageal malignancy who underwent esophagectomy from 2005 to 2020 were retrospectively analyzed from the American College of Surgeons National Surgical Quality Improvement Program database. Thirty-day complication and mortality rates were compared between emergent esophagectomy (EE) and non-emergent esophagectomy. Logistic regression assessed factors associated with complications and mortality. Of 10,067 patients with malignancy who underwent esophagectomy, 181 (1.8%) had EE, 64% had preoperative systemic inflammatory response syndrome, sepsis, or septic shock, and 44% had bleeding requiring transfusion. The EE group had higher American Society of Anesthesiologists (ASA) class and functional dependency. More transhiatal esophagectomies and diversions were performed in the EE group. After EE, the rates of 30-day mortality (6.1% vs. 2.8%), overall complications (65.2% vs. 44.2%), bleeding, pneumonia, prolonged intubation, and positive margin (17.7% vs. 7.4%) were higher, while that of anastomotic leak was similar. On adjusted logistic regression, older age, lower albumin, higher ASA class, and fragility were associated with increased complications and mortality. McKeown esophagectomy and esophageal diversion were associated with a higher risk of postoperative complications. EE was associated with 30-day postoperative complications (odds ratio, 2.39; 95% confidence interval, 1.66-3.43; p<0.0001). EE was associated with a more than 2-fold increase in complications compared to elective procedures, but no independent increase in short-term mortality. These findings may help guide data-driven critical decision-making for surgery in select cases of complicated esophageal malignancy.

Impact of presentation timing in metastatic hormone-sensitive prostate cancer: Characterization of patients and identification of prognostic factors.

The treatment and surveillance of metastatic hormone-sensitive prostate cancer (mHSPC) has evolved since the introduction of several treatment intensification options associated with hormonal blockade and classifications based on the timing of metastatic disease presentation and disease volume. Using a hospital-based registry, we aimed to assess whether these new classifications are applicable to our population, as few studies have demonstrated their prognostic value for overall survival (OS) and time to development of castration-resistant prostate cancer (CRPC), and to establish prognostic factors in our population. A retrospective cohort of mHSPC patients who were attended at an oncology referral hospital in Bogota between 2017 and 2021 were included in this study. The primary and secondary endpoints were OS and time to CRPC. The distribution of outcome measures was estimated using the Kaplan-Meier method. Proportional hazard models were constructed using the Cox regression approach and stratified according to risk factors. The study cohort included 373 patients. The median castration resistance-free survival was 48 months (CI: 32-73 months), and OS was 43 months (CI: 37-48 months). In multivariate analysis, nodal staging, ECOG status, and surgical castration were independent prognostic factors. In our hospital-based registry, the independent impact of the time of presentation on castration-resistant-free survival or OS could not be demonstrated, nor could the grouping of prognostic categories based on metastatic presentation temporality and volume. Other independent prognostic factors have been proposed.

Neoadjuvant chemotherapy for breast cancer: Pathologic response rates but not tumor size, has an independent prognostic impact on survival.

We investigated the pathologic complete response rates (pCR) and survival outcomes of early breast cancer patients who underwent neoadjuvant chemotherapy (NAC) over 14 years at a French comprehensive cancer center and reported pCR and survival outcomes by tumor subtypes and size. From January 2005 to December 2018, 1150 patients receiving NAC were identified. Correlations between cT stage, breast tumor response, axillary lymph node response, pCR, surgery, and outcomes were assessed. pCR was defined as (ypT0/ypTis) and (ypN0/pN0sn). A pCR was reached in 31.7% (365/1150) of patients and was strongly associated with tumor subtypes, but not with tumor size (pretreatment cT category). Luminal-B Her2-negative and triple-negative (TN) subtypes, cN1 status, older age, and no-pCR had an independent negative prognostic value. Overall survival (OS), relapse-free survival (RFS), and metastasis-free survival (MFS) were not significantly different for cT0-1 compared to cT2 stages. In Cox-model adjusted on in-breast pCR and pN status, ypN1 had a strong negative impact (OS, RFS, and MFS: HR = 3.153, 4.677, and 6.133, respectively), higher than no in-breast pCR (HR = 2.369, 2.252, and 2.323). A negative impact of no pCR on OS was observed for cN0 patients and TN tumors (HR = 4.972) or HER2-positive tumors (HR = 11.706), as well as in Luminal-B Her2-negative tumors on MFS (HR = 2.223) and for Luminal-A on RFS (HR = 4.465) and MFS (HR = 4.185). Achievement of pCR, but not tumor size (pretreatment cT category), has an independent prognostic impact on survival. These results suggest potential NAC benefits in patients with small tumors (<2 cm), even in absence of clinically suspicious lymph nodes. Residual lymph node disease after NAC is the most powerful adverse prognostic factor.

Constitutive Activation of RpoH and the Addition of L-arabinose Influence Antibiotic Sensitivity of PHL628 E. coli.

Antibiotics are used to combat the ever-present threat of infectious diseases, but bacteria are continually evolving an assortment of defenses that enable their survival against even the most potent treatments. While the demand for novel antibiotic agents is high, the discovery of a new agent is exceedingly rare. We chose to focus on understanding how different signal transduction pathways in the gram-negative bacterium Escherichia coli (E. coli) influence the sensitivity of the organism to antibiotics from three different classes: tetracycline, chloramphenicol, and levofloxacin. Using the PHL628 strain of E. coli, we exogenously overexpressed two transcription factors, FliA and RpoH.I54N (a constitutively active mutant), to determine their influence on the minimum inhibitory concentration (MIC) and minimum duration of killing (MDK) concentration for each of the studied antibiotics. We hypothesized that activating these pathways, which upregulate genes that respond to specific stressors, could mitigate bacterial response to antibiotic treatment. We also compared the exogenous overexpression of the constitutively active RpoH mutant to thermal heat shock that has feedback loops maintained. While FliA overexpression had no impact on MIC or antibiotic tolerance, RpoH.I54N overexpression reduced the MIC for tetracycline and chloramphenicol but had no independent impact on antibiotic tolerance. Thermal heat shock alone also did not affect MIC or antibiotic tolerance. L-arabinose, the small molecule used to induce expression in our system, unexpectedly independently increased the MICs for tetracycline (>2-fold) and levofloxacin (3-fold). Additionally, the combination of thermal heat shock and arabinose provided a synergistic, 5-fold increase in MIC for chloramphenicol. Arabinose increased the tolerance, as assessed by MDK99, for chloramphenicol (2-fold) and levofloxacin (4-fold). These experiments highlight the potential of the RpoH pathway to modulate antibiotic sensitivity and the emerging implication of arabinose in enhanced MIC and antibiotic tolerance.

Circulating and Imaging Biomarkers of Radium-223 Response in Metastatic Castration-Resistant Prostate Cancer.

Radium-223 improves overall survival (OS) and reduces skeletal events in patients with bone metastatic castration-resistant prostate cancer (CRPC), but relevant biomarkers are lacking. We evaluated automated bone scan index (aBSI) and circulating tumor cell (CTC) analyses as potential biomarkers of prognosis and activity. Patients with bone metastatic CRPC were enrolled on a prospective single-arm study of standard radium-223. 99mTc-MDP bone scan images at baseline, 2 months, and 6 months were quantitated using aBSI. CTCs at baseline, 1 month, and 2 months were enumerated and assessed for RNA expression of prostate cancer-specific genes using microfluidic enrichment followed by droplet digital polymerase chain reaction. The median OS was 21.3 months in 22 patients. Lower baseline aBSI and minimal change in aBSI (<+0.7) from baseline to 2 months were each associated with better OS (P = .00341 and P = .0139, respectively). The higher baseline CTC count of ≥5 CTC/7.5 mL was associated with worse OS (median, 10.1 v 32.9 months; P = .00568). CTCs declined at 2 months in four of 15 patients with detectable baseline CTCs. Among individual genes in CTCs, baseline expression of the splice variant AR-V7 was significantly associated with worse OS (hazard ratio, 5.20 [95% CI, 1.657 to 16.31]; P = .00195). Baseline detectable AR-V7, higher aBSI, and CTC count ≥5 CTC/7.5 mL continued to have a significant independent negative impact on OS after controlling for prostate-specific antigen or alkaline phosphatase. Quantitative bone scan assessment with aBSI and CTC analyses are prognostic markers in patients treated with radium-223. AR-V7 expression in CTCs is a particularly promising prognostic biomarker and warrants validation in larger cohorts.

Surgical and oncological results after rectal resections with or without previous treatment for prostate cancer.

Previous treatment for prostate cancer (PC) may potentially affect the surgical and oncological outcomes of subsequent rectal cancer surgery, but there are only a few studies regarding this particular group. In this study, we present the 3-year surgical and oncological results of rectal cancer patients who had received previous treatment for PC at a single Finnish tertiary referral centre. Data regarding all male patients diagnosed with rectal cancer and treated at Tampere University Hospital (TAUH) between 1997 and 2016 were gathered from medical records. In total, this study included 553 rectal cancer patients who underwent curative surgery, and 54 of them (9.8%) had a prior history of treatment for prostate cancer. Patients in the PC group were older and had more comorbidities compared with those in the non-PC group. The PC patients had a significantly higher risk of permanent stoma compared with the non-PC patients (61.5% vs. 45.2%, respectively, p = 0.025). The PC patients seemed to have lower tumours than the non-PC patients (87% vs. 75%, respectively, p = 0.05). Overall, the 3-year overall survival (OS) for the PC and non-PC patients was 74.1% and 80.6%, respectively. No significant differences were observed between the study groups even in the age-adjusted comparison [hazard ratio (HR): 1.07, confidence interval (CI) 95%: 0.60-1.89]. In the univariable analysis, radically operated patients without a history of PC exhibited an improved overall survival, (HR: 2.46, 95% CI: 1.34-4.53, p = 0.004). However, only a higher age-adjusted Charlson comorbidity index (CCI) and a low tumour location (<10 cm) were found to have an independent prognostic impact on worse OS in the multivariable analysis (HR: 1.57, 95% CI: 1.36-1.82, p < 0.001 and HR: 2.74, 95% CI: 1.32-5.70, p = 0.007, respectively). No significant differences were observed between the groups in terms of disease-free or local recurrence-free survival. Rectal cancer is more frequently found in the middle or lower part of the rectum in patients who have previously received treatment for prostate cancer. These patients also have a higher likelihood of requiring a permanent stoma. In radically operated rectal cancer, the PC group had a worse OS rate, according to the univariable analysis. However, the only independent prognostic factors for a worse OS that were highlighted in the multivariable analysis included a higher CCI and a low tumour location.

Experience, Independence, Professional Commitment of Auditors, and Audit Quality (Study at the Sidoarjo Regency Inspectorate)

This research aims to investigate the impact of audit experience, auditor independence, and professional commitment on audit quality at the Sidoarjo Regency Inspectorate. The research methodology employed in this study is descriptive quantitative. The primary data for this research were collected through a questionnaire, and the sampling technique used was saturated sampling. The sample size for this study consisted of 34 auditors or respondents. Prior to analysis, the collected data underwent validity and reliability tests. Multiple linear regression analysis was employed to analyze the data. The hypothesis testing was conducted using SPSS. The findings of this study indicate that both auditor's work experience and professional commitment significantly influence audit quality, whereas auditor independence does not have a significant impact on audit quality.

Independence and Adaptability: Building Resilience and Competitiveness for Small and Medium-sized Enterprises in the Digital Era

This study aims to investigate the impact of independence and adaptability on business actors in Balikpapan City amidst the industrial revolution 4.0. The study focuses on Small and Medium Enterprises (SMEs) in the culinary sector of Balikpapan City, wit h a sample size of 30 business actors. A quantitative research approach utilizing primary data is employed, and data collection is conducted through the distribution of questionnaires. Statistical analysis using SPSS verifies the significance of the variables of independence (X1) and adaptability (X2) on the industrial revolution 4.0 when tested simultaneously. The findings reveal that both independence and adaptability substantially influence the industrial revolution 4.0. This study contributes to the existing literature by shedding light on the relationship between independence, adaptability, and the impact of the industrial revolution 4.0 on business actors. The findings provide valuable insights for policymakers, MSMEs, and stakeholders in Balikpapan City in navigating and harnessing the opportunities brought by the industrial revolution 4.0.

Identification of a Panel of miRNAs Associated with Resistance to Palbociclib and Endocrine Therapy.

We investigated whether we could identify a panel of miRNAs associated with response to treatment in tumor tissues of patients with Hormone Receptor-positive/HER2-negative metastatic breast cancer treated with endocrine therapy (ET) and the CDK4/6 inhibitor (CDK4/6i)i palbociclib. In total, 52 patients were evaluated, with 41 receiving treatment as the first line. The overall median PFS was 20.8 months (range 2.5-66.6). In total, 23% of patients experienced early progression (<6 months). Seven miRNAs (miR-378e, miR-1233, miR-99b-5p, miR-1260b, miR-448, -miR-1252-5p, miR-324-3p, miR-1233-3p) showed a statistically significant negative association with PFS. When we considered PFS < 6 months, miR-378e, miR-99b-5p, miR-877-5p, miR-1297, miR-455-5p, and miR-4536-5p were statistically associated with a poor outcome. In the multivariate analysis, the first three miRNAs confirmed a significant and independent impact on PFS. The literature data and bioinformatic tools provide an underlying molecular rationale for most of these miRNAs, mainly involving the PI3K/AKT/mTOR pathway and cell-cycle machinery as cyclin D1, CDKN1B, and protein p27Kip1 and autophagy. Our findings propose a novel panel of miRNAs associated with a higher likelihood of early progression in patients treated with ET and Palbociclib and may contribute to shed some light on the mechanisms of de novo resistance to CDK4/6i, but this should be considered exploratory and evaluated in larger cohorts.

English Teachers Views On Changes To The Independent Curriculum In English Language Learning

The aim of this research is to determine teachers' perceptions of curriculum changes independence in the context of learning methods regarding changes in the independence curriculum. On in this research, the method used is a qualitative descriptive research method and the data obtained is from the results of interviews. Teacher perceptions towards changes to the independent curriculum itself aims at teachers' perceptions of curriculum changes independence, namely how teachers understand the concept of an independent curriculum, analyzing the impact of the curriculum independence in teaching and learning as well as obstacles and challenges in implementing the curriculum independent. Where the curriculum is a very important and determining component in implementation of education. And functions as a tool for achieving educational goals, if the goal if education changes then automatically the curriculum must also be changed.

Impact of post-transplant stroke and subsequent functional independence on outcomes following heart transplantation under the 2018 United States heart allocation system

This study evaluates the clinical trends, risk factors, and effects of post-transplant stroke and subsequent functional independence on outcomes following orthotopic heart transplantation under the 2018 heart allocation system. The United Network for Organ Sharing registry was queried to identify adult recipients from October 18, 2018 to December 31, 2021. The cohort was stratified into 2 groups with and without post-transplant stroke. The incidence of post-transplant stroke was compared before and after the allocation policy change. Outcomes included post-transplant survival and complications. Multivariable logistic regression was performed to identify risk factors for post-transplant stroke. Sub-analysis was performed to evaluate the impact of functional independence among recipients with post-transplant stroke. A total of 9,039 recipients were analyzed in this study. The incidence of post-transplant stroke was higher following the policy change (3.8% vs 3.1%, p=0.017). Thirty-day (81.4% vs 97.7%) and 1-year (66.4% vs 92.5%) survival rates were substantially lower in the stroke cohort (p<0.001). The stroke cohort had a higher rate of post-transplant renal failure, longer hospital length of stay, and worse functional status. Multivariable analysis identified extracorporeal membrane oxygenation, durable left ventricular assist device, blood type O, and redo heart transplantation as strong predictors of post-transplant stroke. Preserved functional independence considerably improved 30-day (99.2% vs 61.2%) and 1-year (97.7% vs 47.4%) survival rates among the recipients with post-transplant stroke (p<0.001). There is a higher incidence of post-transplant stroke under the 2018 allocation system, and it is associated with significantly worse post-transplant outcomes. However, post-transplant stroke recipients with preserved functional independence have improved survival, similar to those without post-transplant stroke.

“I Would Prefer Not To”: Establishing the Missing Link between Invalid Voting and Public Protest in Latin America

ABSTRACTWhile invalid voting is often treated as protest behavior in an electoral context, its association with actual political protests has not yet been empirically demonstrated. The relative scarcity of research on the topic is likely due to the hybrid nature of invalid voting as a both formal and informal political gesture. The novel availability of event-based data for public protests in Latin America allows for testing whether their occurrence is connected with changes in spoiled and blank ballots. Using an appropriate dynamic regression model covering variations in the 148 intervals between Latin American legislative elections in the 1979–2021 period, this study finds a strong connection between the emergence of antigovernment protests and surges in invalid voting (and vice versa). This relationship still holds at parity of economic conditions and it is reinforced by a lack of alternation in the party of power. Conversely, the appearance of workers’ strikes appears to work as a substitute for this behavior, which is also chosen by voters when democracy deteriorates, while corruption has no independent impact on invalid voting. Overall this work’s findings promise to send the research agenda on invalid voting in a new direction, previously unexplored because of an absence of fitting data.

Prognostic impact of CEBPA mutational subgroups in adult AML.

Despite recent refinements in the diagnostic and prognostic assessment of CEBPA mutations in AML, several questions remain open, i.e. implications of different types of basic region leucin zipper (bZIP) mutations, the role of co-mutations and the allelic state. Using pooled primary data analysis on 1010 CEBPA-mutant adult AML patients, a comparison was performed taking into account the type of mutation (bZIP: either typical in-frame insertion/deletion (InDel) mutations (bZIPInDel), frameshift InDel or nonsense mutations inducing translational stop (bZIPSTOP) or single base-pair missense alterations (bZIPms), and transcription activation domain (TAD) mutations) and the allelic state (single (smCEBPA) vs. double mutant (dmCEBPA)). Only bZIPInDel patients had significantly higher rates of complete remission and longer relapse free and overall survival (OS) compared with all other CEBPA-mutant subgroups. Moreover, co-mutations in bZIPInDel patients (e.g. GATA2, FLT3, WT1 as well as ELN2022 adverse risk aberrations) had no independent impact on OS, whereas in non-bZIPInDel patients, grouping according to ELN2022 recommendations added significant prognostic information. In conclusion, these results demonstrate bZIPInDel mutations to be the major independent determinant of outcome in CEBPA-mutant AML, thereby refining current classifications according to WHO (including all dmCEBPA and smCEBPA bZIP) as well as ELN2022 and ICC recommendations (including CEBPA bZIPms).

Independence, Professional Skepticism, And Audit Quality: The Moderating Role Of Audit Fees

This research investigates the impact of auditor independence and professional scepticism on audit quality, focusing on audit fees as a moderating factor in Makassar City's public accounting firms. The study employs census sampling, involving 39 auditors from eight Makassar-based public accounting firms. Hypotheses are tested using multiple linear regression via Smart PLS 3.0 software, complemented by descriptive statistical tests. The research also conducts assessments, including convergent validity, discriminant validity, composite reliability, and inner model evaluations. Results indicate that auditor independence and professional scepticism positively and significantly affect audit quality. As a moderating variable, audit fees also positively and significantly impact audit quality. These findings offer public accounting firms valuable insights, emphasising the need to evaluate and potentially adjust their policies proactively. This proactive approach can help mitigate potential risks linked to declining audit quality.

Sodium and water dynamics in the progression of chronic kidney disease: mechanisms and clinical significance.

Lifestyle modifications can postpone the progression of chronic kidney disease toward its terminal stage.This mini-review aims to explore the impact of salt and water intake on the progression of chronic kidney disease (CKD) and provide insights into the optimal consumption levels to preserve the glomerular filtration rate. We reviewed relevant literature to examine the association between salt and water consumption and CKD progression. Our analysis includes discussions on the pathophysiology, findings from clinical trials, and recommended intake guidelines. Sodium intake, often linked to cardiovascular risk and CKD progression, has shown a complex J-shaped association in some studies, leading to uncertainty about the ideal salt intake level. Sodium and fluid retention are key factors contributing to hypertension, a well-established risk factor for CKD progression. Low-sodium diets have demonstrated promise in reducing blood pressure and enhancing the effects of renin-angiotensin-aldosterone system inhibitors in non-dialysis CKD patients. However, a debate persists regarding the independent effect of salt restriction on CKD progression. Despite medical recommendations, salt consumption remains high among CKD patients. Additionally, the role of water consumption in CKD remains controversial despite its established benefits for CKD prevention in the general population. Lifestyle modifications involving salt and water intake can influence the progression of CKD. While low-sodium diets have shown potential for mitigating hypertension and proteinuria in non-dialysis CKD patients, their independent impact on CKD progression warrants further investigation. The role of water consumption in CKD remains uncertain, and there is a need for additional research in this area. Clinicians should consider individualized dietary recommendations for CKD patients to help preserve the glomerular filtration rate and improve overall outcomes.

Breaking the linear mould: exploring the non-linear relationship between board independence and investment efficiency

PurposeThis study examines the non-linear effect of board independence on the investment efficiency of listed firms worldwide. This study further tests whether the COVID-19 pandemic, industry competition and economic development influence the relationship between board independence and investment efficiency.Design/methodology/approachThe data are retrieved from the Thomson Reuters (Refinitiv) database and include international data from 33 countries, comprising 21,363 firm-year observations. The authors' regression analyses include firm-specific variables as controls that may impact investment efficiency. The authors also perform various robustness tests including, alternative measures of investment efficiency, weighted least squares regression, quantile regression and endogeneity issues.FindingsThe results reveal a non-linear relationship between board independence and investment efficiency. Specifically, the relationship follows a U-shaped pattern, indicating that the negative impact of board independence on investment efficiency becomes positive after it reaches its optimal point, thus supporting optimal board structure theory. Interestingly, the authors find no significant evidence of board independence’s effect on investment efficiency during the pandemic. In contrast, the relationship between board independence and investment efficiency is significant only during the non-pandemic period. Furthermore, the authors discover evidence of a U-shaped relationship in both emerging and developed markets, as well as in industries with high and low competition.Research limitations/implicationsThe authors' study discovers new evidence on the non-linear impact of board independence on investment efficiency, which has not been explored previously in existing research.Practical implicationsThis study has practical implications for investors by emphasising the importance of corporate governance and the appointment of independent directors. Investors should consider the findings of this study when making decisions related to corporate governance, as they can impact a firm's investment efficiency.Originality/valueDespite a considerable body of literature exploring the link between corporate governance and investment effectiveness, there is a dearth of research on the non-linear effects of board independence. Furthermore, the effects of the COVID-19 pandemic, industry competition and economic development remain unexplored.

Unveiling the hidden symphony: board dynamics and carbon emission disclosure – a meta-analysis study in the realm of developed markets

PurposeThis study conducts a meta-analysis to investigate the impact of board diversity, independence and size on carbon emission disclosure.Design/methodology/approachThe results of 22 empirical investigations on the association between board qualities and carbon emission disclosure are synthesised using a meta-analysis approach. Inclusion and exclusion criteria are established, and search strategies are devised to locate relevant material. Data extraction entails gathering important information such as the names of the authors, variables and correlation coefficients. Fisher's z-transformation is used to compute and synthesise effect sizes and assumptions, sensitivity testing and subgroup analysis are performed to assess the robustness of the findings.FindingsA substantial association was discovered between board characteristics and carbon emission disclosure. Board independence and gender diversity revealed small to medium-strength positive relationships, whilst board size had a medium-strength positive correlation. The study periods varied from 2011 to 2022, with 2018 having the most studies. However, highly heterogeneous groups were discovered; further subgroup analyses were then carried out to sort out this issue.Research limitations/implicationsSeveral limitations were recognised due to the limited number of studies and heterogeneity, although subgroup analysis was used to reduce the influence of heterogeneity. To investigate alternate outcomes, more analysis of the heterogeneity level and potential modifications to the model assumptions may be required.Practical implicationsCompanies should consider board size, independence and gender diversity when formulating long-term competitive strategies in the climate change movement. These characteristics can aid in bridging information gaps and garnering stakeholder support for carbon-reduction initiatives.Originality/valueThis meta-analysis addresses a gap in the literature by addressing prior studies' conflicting and inconsistent findings on the association between board characteristics and carbon emission disclosure. It employs a rigorous approach and synthesis strategy to provide a thorough and robust understanding of the crucial role of board characteristics in carbon emission disclosure.

Evaluating the impacts of a large-scale voluntary REDD+ project in Sierra Leone

Carbon offsets from the REDD+ (reducing emissions from deforestation and degradation) framework to protect forests are expected to see a 100-fold increase in market value by 2050. However, independent causal impact evaluations are scarce and only a few studies assess benefits to communities themselves, a core objective of REDD+. Following a pre-analysis plan, we use a before-after-control-intervention (BACI) framework to evaluate the impact of a large-scale voluntary REDD+ project in Sierra Leone—the Gola project. We use a panel of both satellite images and household surveys to provide causal evidence of the impact of the project on local deforestation rates and socioeconomic indicators over the first 5 yr of its implementation. We find that REDD+ slowed deforestation by 30% relative to control communities while not changing economic wellbeing and conservation attitudes. We find suggestive evidence that the programme increased the value of alternative income sources, by shifting labour away from forest-dependent farming activities. A cost-to-carbon calculation shows that REDD+ led to 340,000 tCO2 in avoided emissions per year, with an estimated cost of US$1.12 per averted tCO2. Our study contributes to developing an evidence base for voluntary REDD+ projects and offers a robust approach to carry out BACI assessments.