Multilevel Construct Research Articles

Exploring the entrepreneurial ecosystem in the field of entrepreneurial support: a multi-level approach

The entrepreneurial ecosystem is an emerging but underdeveloped theoretical stream that needs to be better understood. This research explores a new perspective in the entrepreneurship field at the intersection of the ecosystem and multi-level approaches. The entrepreneurial ecosystem is a multi-level construct, comprised of several interacting sub-ecosystems. The explorative qualitative study uses a multi-level ecosystem analysis based on semi-structured interviews with main groups of actors in the entrepreneurial ecosystem. This enables the characterisation of three main ecosystems: the entrepreneurial ecosystem (macro level), the entrepreneurial support ecosystem (meso level), and the business incubator ecosystem (micro level). The results highlight the importance of studying the interplay among sub-ecosystems as the key to better understand the entrepreneurial ecosystem's success. The main contribution of the paper lies in supporting various entrepreneurial ecosystem actors to understand the ecosystem's composition and thus develop an effective overall strategy for both business incubators and policy makers.

Exploring the entrepreneurial ecosystem in the field of entrepreneurial support: a multi-level approach

The entrepreneurial ecosystem is an emerging but underdeveloped theoretical stream that needs to be better understood. This research explores a new perspective in the entrepreneurship field at the intersection of the ecosystem and multi-level approaches. The entrepreneurial ecosystem is a multi-level construct, comprised of several interacting sub-ecosystems. The explorative qualitative study uses a multi-level ecosystem analysis based on semi-structured interviews with main groups of actors in the entrepreneurial ecosystem. This enables the characterisation of three main ecosystems: the entrepreneurial ecosystem (macro level), the entrepreneurial support ecosystem (meso level), and the business incubator ecosystem (micro level). The results highlight the importance of studying the interplay among sub-ecosystems as the key to better understand the entrepreneurial ecosystem's success. The main contribution of the paper lies in supporting various entrepreneurial ecosystem actors to understand the ecosystem's composition and thus develop an effective overall strategy for both business incubators and policy makers.

Biomechanical evaluation of DTRAX(®) posterior cervical cage stabilization with and without lateral mass fixation.

IntroductionLateral mass screw (LMS) fixation with plates or rods is the current standard procedure for posterior cervical fusion. Recently, implants placed between the facet joints have become available as an alternative to LMS or transfacet screws for patients with cervical spondylotic radiculopathy. The purpose of this study was to evaluate the biomechanical stability of the DTRAX® cervical cage for single- and two-level fusion and compare this to the stability achieved with LMS fixation with rods in a two-level construct.MethodsSix cadaveric cervical spine (C3–C7) specimens were tested in flexion–extension, lateral bending, and axial rotation to ±1.5 Nm moment without preload (0 N) in the following conditions: 1) intact (C3–C7), 2) LMS and rods at C4–C5 and C5–C6, 3) removal of all rods (LMS retained) and placement of bilateral posterior cages at C5–C6, 4) bilateral posterior cages at C4–C5 and C5–C6 (without LMS and rods), and 5) C4–C5 and C5–C6 bilateral posterior cages at C4–C5 and C5–C6 with rods reinserted.ResultsBilateral posterior cervical cages significantly reduced range of motion in all tested directions in both single- and multilevel constructs (P<0.05). Similar stability was achieved with bilateral posterior cages and LMS in a two-level construct: 0.6°±0.3° vs 1.2°±0.4° in flexion–extension (P=0.001), (5.0°±2.6° vs 3.1°±1.3°) in lateral bending (P=0.053), (1.3°±1.0° vs 2.2°±0.9°) in axial rotation (P=0.091) for posterior cages and LMS, respectively. Posterior cages, when placed as an adjunct to LMS, further reduced range of motion in a multilevel construct (P<0.05).ConclusionBilateral posterior cages provide similar cervical segmental stability compared with a LMS and rod construct and may be an alternative surgical option for select patients. Furthermore, supplementation of a lateral mass construct with posterior cages increases cervical spine stability in single- and multilevel conditions.

Pediatric occipitocervical fusion: long-term radiographic changes in curvature, growth, and alignment.

OBJECTIVE The authors assessed the rate of vertebral growth, curvature, and alignment for multilevel constructs in the cervical spine after occipitocervical fixation (OCF) in pediatric patients and compared these results with those in published reports of growth in normal children. METHODS The authors assessed cervical spine radiographs and CT images of 18 patients who underwent occipitocervical arthrodesis. Measurements were made using postoperative and follow-up images available for 16 patients to determine cervical alignment (cervical spine alignment [CSA], C1-7 sagittal vertical axis [SVA], and C2-7 SVA) and curvature (cervical spine curvature [CSC] and C2-7 lordosis angle). Seventeen patients had postoperative and follow-up images available with which to measure vertebral body height (VBH), vertebral body width (VBW), and vertical growth percentage (VG%-that is, percentage change from postoperative to follow-up). Results for cervical spine growth were compared with normal parameters of 456 patients previously reported on in 2 studies. RESULTS Ten patients were girls and 8 were boys; their mean age was 6.7 ± 3.2 years. Constructs spanned occiput (Oc)-C2 (n = 2), Oc-C3 (n = 7), and Oc-C4 (n = 9). The mean duration of follow-up was 44.4 months (range 24-101 months). Comparison of postoperative to follow-up measures showed that the mean CSA increased by 1.8 ± 2.9 mm (p < 0.01); the mean C2-7 SVA and C1-7 SVA increased by 2.3 mm and 2.7 mm, respectively (p = 0.3); the mean CSC changed by -8.7° (p < 0.01) and the mean C2-7 lordosis angle changed by 2.6° (p = 0.5); and the cumulative mean VG% of the instrumented levels (C2-4) provided 51.5% of the total cervical growth (C2-7). The annual vertical growth rate was 4.4 mm/year. The VBW growth from C2-4 ranged from 13.9% to 16.6% (p < 0.001). The VBW of C-2 in instrumented patients appeared to be of a smaller diameter than that of normal patients, especially among those aged 5 to < 10 years and 10-15 years, with an increased diameter at the immediately inferior vertebral bodies compensating for the decreased width. No cervical deformation, malalignment, or detrimental clinical status was evident in any patient. CONCLUSIONS The craniovertebral junction and the upper cervical spine continue to present normal growth, curvature, and alignment parameters in children with OCF constructs spanning a distance as long as Oc-C4.

Bilateral posterior cervical cages provide biomechanical stability: assessment of stand-alone and supplemental fixation for anterior cervical discectomy and fusion.

IntroductionSupplemental posterior instrumentation has been widely used to enhance stability and improve fusion rates in higher risk patients undergoing anterior cervical discectomy and fusion (ACDF). These typically involve posterior lateral mass or pedicle screw fixation with significant inherent risks and morbidities. More recently, cervical cages placed bilaterally between the facet joints (posterior cervical cages) have been used as a less disruptive alternative for posterior fixation. The purpose of this study was to compare the stability achieved by both posterior cages and ACDF at a single motion segment and determine the stability achieved with posterior cervical cages used as an adjunct to single- and multilevel ACDF.MethodsSeven cadaveric cervical spine (C2–T1) specimens were tested in the following sequence: intact, C5–C6 bilateral posterior cages, C6–C7 plated ACDF with and without posterior cages, and C3–C5 plated ACDF with and without posterior cages. Range of motion in flexion–extension, lateral bending, and axial rotation was measured for each condition under moment loading up to ±1.5 Nm.ResultsAll fusion constructs significantly reduced the range of motion compared to intact in flexion–extension, lateral bending, and axial rotation (P<0.05). Similar stability was achieved with bilateral posterior cages and plated ACDF at a single level. Posterior cages, when placed as an adjunct to ACDF, further reduced range of motion in both single- and multilevel constructs (P<0.05).ConclusionThe biomechanical effectiveness of bilateral posterior cages in limiting cervical segmental motion is comparable to single-level plated ACDF. Furthermore, supplementation of single- and multilevel ACDF with posterior cervical cages provided a significant increase in stability and therefore may be a potential, minimally disruptive option for supplemental fixation for improving ACDF fusion rates.

A comparison of urban and rural kindergarten teachers’ perceptions of school safety for young children: implications for quality teacher education

ABSTRACTAlthough a quality preschool supports young children's health and safety, ‘quality' has been defined diversely enough that its delivery has been varied among kindergarten teachers. The current study was the first to examine and compare perceptions of school safety between urban and rural kindergarten teachers. Sixty-seven Hong Kong teachers (from an urban region of China) and 111 Yunnan teachers (from a rural region of China) rated their perceived knowledge and attitudes regarding child safety and perceived school safety for young children. The results showed that although Yunnan teachers rated their schools’ safety less favourably than did Hong Kong teachers, they rated themselves as having better knowledge and stronger attitudes about child safety. Hong Kong teachers’ age and total teaching experience and Yunnan teachers’ perceived knowledge significantly predicted their perceived school safety for young children. The implications for ‘quality' as a multi-level construct in relation to quality teacher education are discussed.

Historical and Symbolic Aspects of Linguistic Representation of the World

The article is an attempt to offer a theoretical understanding of the notion of a “Linguistic world-image” (LWI) within symbolic contexts as represented in the current literature, define the symbol’s features, its influence on LWI in historic perspective, and investigate its functioning within idioms or metaphors. We have undertaken the review of previous LWI investigations and, as the methodological basis of our research, we have used ethno-semantic and linguistic-philosophical approaches to language; specifically, the method of multiple etymology, introduced by V. N. Toporov and developed by M.M. Makovsky, which permitted us to identify the correlation of LWI with linguistic signs as a carrier of symbolic meaning. It should be noted that studying symbolic language properties and linguistic signs within the linguistic world-image, which were not taken into account before, is conductive to a more profound comprehension of the correlation between language, culture, and mutual understanding index in the intercultural communication process.The LWI concept is considered as a subjective-objective dynamic multilevel construct, which presents its primary features through a lexical-semantic language system within a world and national culture formed as a result of the reflection of sensorial perception, facts, understanding and estimation of the objective phenomena in national linguistic consciousness, in the experience of correlation of language concepts, images and symbols throughout the cultural historical development of the language. Therefore, two approaches to studying LWI are evident - cognitive and cultural-philosophical - which are not so much conflicting as mutually reinforcing.

Time‐Space Distanciation: An Interdisciplinary Account of How Culture Shapes the Implicit and Explicit Psychology of Time and Space

AbstractThe growing body of research on temporal and spatial experience lacks a comprehensive theoretical approach. Drawing on Giddens’ framework, we present time‐space distanciation (TSD) as a construct for theorizing the relations between culture, time, and space. TSD in a culture may be understood as the extent to which (1) time and space are abstracted as separate dimensions and (2) activities are extended and organized across time and space. After providing a historical account of its development, we outline a multi‐level conceptualization of TSD supported by research on cultural differences in the experience of time and space. We impact this conceptualization by examining two ethnographic case studies. We conclude by highlighting future research directions. TSD is an integrative, interdisciplinary, multi level construct with the potential to guide the burgeoning social science of time and space.

A multilevel study of structural resilience in interfirm collaboration

Purpose – The purpose of this paper is to develop the concept of a high performance alliance macro-culture as a multilevel construct reflective of resilient collaborative systems of exchange within strategic alliances and explores the distinct capabilities of this multilevel approach in predicting alliance outcomes. Design/methodology/approach – The hypotheses developed in this study are tested using primary data collected from 650 members of 15 non-profit organizations in two multi-organizational collaborative networks. Considering the multilevel nature of the study the structural hypotheses are tested using a multilevel confirmatory factor analysis and the predictive hypotheses are tested using multilevel structural equation modeling. Findings – All but one structural hypothesis are supported and all predictive hypotheses are supported suggesting that a multilevel macro-cultural conceptualization is effective in exploring the relationship between collaborative exchange systems and their outcomes. Research limitations/implications – Limitations stem from the generalizability of the data collected as the alliances formed by non-profit firms may not be wholly reflective of the alliance structures and goals of other firm types. Originality/value – This study primarily contributes to multilevel study of strategic alliances and the study of collaborative norms and structures of allied groupings. The results of this study lend support to the importance of taking a network governance perspective and illustrate the limitations of traditional single-level approaches when studying interfirm collaborative networks and structural resilience therein.

Team Incivility Climate Scale: Development and Validation of the Team-Level Incivility Climate Construct

Guided by a framework for multilevel construct validation, this study identified incivility climate as a new facet-specific climate construct. Referring to shared perceptions about the uncivil behaviors, practices, and norms that exist within a team, the construct of incivility climate is fundamental for future research investigating and estimating the effect of workplace incivility at the team level. Data from three separate samples totaling 1,110 employees and 50 work teams were used to test the internal consistency, confirm factor structure, and assess convergent and incremental validity of a new measure at both the individual and team level. The results support the construct validity of incivility climate along with the utility of the Team Incivility Climate Scale. Theoretical implications and practical applications of the construct and measure are described.

Exploratory meta-analysis on dose-related efficacy and morbidity of bone morphogenetic protein in spinal arthrodesis surgery.

Bone morphogenetic protein (BMP) is frequently used for spinal arthrodesis procedures in an "off-label" fashion. Whereas complications related to BMP usage are well recognized, the role of dosage is less clear. The objective of this meta-analysis was to assess dose-dependent effectiveness (i.e., bone fusion) and morbidity of BMP used in common spinal arthrodesis procedures. A quantitative exploratory meta-analysis was conducted on studies reporting fusion and complication rates following anterior cervical discectomy and fusion (ACDF), posterior cervical fusion (PCF), anterior lumbar interbody fusion (ALIF), transforaminal lumbar interbody fusion (TLIF), posterior lumbar interbody fusion (PLIF), and posterolateral lumbar fusion (PLF) supplemented with BMP. A literature search was performed to identify studies on BMP in spinal fusion procedures reporting fusion and/or complication rates. From the included studies, a database for each spinal fusion procedure, including patient demographic information, dose of BMP per level, and data regarding fusion rate and complication rates, was created. The incidence of fusion and complication rates was calculated and analyzed as a function of BMP dose. The methodological quality of all included studies was assessed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Data were analyzed using a random-effects model. Event rates are shown as percentages, with a 95% CI. Forty-eight articles met the inclusion criteria: ACDF (n = 7), PCF (n = 6), ALIF (n = 9), TLIF/PLIF (n = 17), and PLF (n = 9), resulting in a total of 5890 patients. In ACDF, the lowest BMP concentration analyzed (0.2-0.6 mg/level) resulted in a fusion rate similar to the highest dose (1.1-2.1 mg/level), while permitting complication rates comparable to ACDF performed without BMP. The addition of BMP to multilevel constructs significantly (p < 0.001) increased the fusion rate (98.4% [CI 95.4%-99.4%]) versus the control group fusion rate (85.8% [CI 77.4%-91.4%]). Studies on PCF were of poor quality and suggest that BMP doses of ≤ 2.1 mg/level resulted in similar fusion rates as higher doses. Use of BMP in ALIF increased fusion rates from 79.1% (CI 57.6%-91.3%) in the control cohort to 96.9% (CI 92.3%-98.8%) in the BMP-treated group (p < 0.01). The rate of complications showed a positive correlation with the BMP dose used. Use of BMP in TLIF had only a minimal impact on fusion rates (95.0% [CI 92.8%-96.5%] vs 93.0% [CI 78.1%-98.0%] in control patients). In PLF, use of ≥ 8.5 mg BMP per level led to a significant increase of fusion rate (95.2%; CI 90.1%-97.8%) compared with the control group (75.3%; CI 64.1%-84.0%, p < 0.001). BMP did not alter the rate of complications when used in PLF. The BMP doses used for various spinal arthrodesis procedures differed greatly between studies. This study provides BMP dosing recommendations for the most common spine procedures.

Testing for Multilevel Dimensionality: A Higher-Order Factor Analysis of a Script Concordance Test

Background To date, few script concordance test (SCT) research studies have empirically investigated whether SCTs measure a single test dimension of clinical reasoning. Prior analyses have been inconclusive and unsuccessful at identifying exam dimensions through simple first-order factor analyses. Therefore, the principle objective of this work was to explore the higher-order factor structure of a problem-solving SCT to determine whether the dimensionality of the test conformed to a multilevel construct arrangement.

From Multiple Legal Cultures to One Legal Culture? Thinking About Culture, Tradition and Identity in European Private Law Development

This paper begins by briefly outlining private law’s evolution alongside the emergence of the Nation States; it then aims to set out the mutual influence of these concepts on national culture, tradition and identity in order to highlight the significance of the political, economic and legal as well as social and cultural contexts in which the processes of integration and Europeanisation occur. Against this background, the scope for European private law to emerge as a plural, multi-level construct and a dynamic endeavour is recognised. Building on this analysis of the significance of the diversity and commonality of cultures, traditions and identities in national private law development, institutionalised at the Union level in the principle of unitas in diversitate, the paper explores the need for a single, common European notion of culture, tradition or identity. This examination is undertaken with reference to an example, namely the evolution of the concept of consumer, from its national foundations to its engagement in Union legislation and CJEU jurisprudence. Drawing conclusions as to the need for such a common, European concept, the paper advances a plea for the recognition of a shift in the perspective of legal development, to one which acknowledges the dynamic evolution of private law within a pluralist, multi-level regulatory construct.

Systematic review of empowerment measures in health promotion.

Empowerment, a multi-level construct comprising individual, community and organizational domains, is a fundamental value and goal in health promotion. While a range of scales have been developed for the measurement of empowerment, the qualities of these have not been rigorously assessed. The aim of this study was to evaluate the measurement properties of quantitative empowerment scales and their applicability in health promotion programs. A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was done to evaluate empowerment scales across three dimensions: item development, reliability and validity. This was followed by assessment of measurement properties using a ratings scale with criteria addressing an a priori explicit theoretical framework, assessment of content validity, internal consistency and factor analysis to test structural validity. Of the 20 studies included in this review, only 8 (40%) used literature reviews, expert panels and empirical studies to develop scale items and 9 (45%) of studies fulfilled ≥5 criteria on the ratings scale. Two studies (10%) measured community empowerment and one study measured organizational empowerment, the rest (85%) measured individual empowerment. This review highlights important gaps in the measurement of community and organizational domains of empowerment using quantitative scales. A priority for future empowerment research is to investigate and explore approaches such as mixed methods to enable adequate measurement of empowerment across all three domains. This would help health promotion practitioners to effectively measure empowerment as a driver of change and an outcome in health promotion programs.

A model of within person variation in leadership: Emotion regulation and scripts as predictors of situationally appropriate leadership

Leadership has been described as a relational process with substantial research examining a leaders' ability to interact with followers. At the same time, there has been a swell of research that considers leadership as a multi-level construct. The majority of this research starts from the individual level examining the relationship between leaders and individuals and groups. In this article, we argue that a significant aspect of multi-level leadership has been overlooked, the within-person variation leaders are expected to engage in when they work with others. To address this theoretical gap and encourage empirical testing, we develop a conceptual model that highlights how the within-person interaction of emotion regulation and leader scripts influences followers' perceptions of situational appropriateness of the leader behaviors. Implications for theory and empirical testing are discussed.

Biomechanical Stability of the Stalif-C Stand-Alone Spacer in Multi-level and Hybrid Cervical Fusion Constructs

Introduction Anterior plate constructs for cervical discectomy and fusion have been linked to postoperative dysphagia, increased operative times, and wider surgical exposures. Several “low profile” integrated stand-alone spacers (SAS) have been developed. While these spacers have demonstrated successful clinical outcomes and similar biomechanical stability to anterior plate constructs in single-level fusions, their biomechanical stability in multi-level constructs has not yet been established. Methods Twelve human cadaveric cervical spines (C2-T2) were nondestructively tested with a six-degree-of-freedom simulator under axial rotation (AR), flexion-extension (FE), and lateral bending (LB) loading. After intact analysis, each specimen underwent sequential instrumentation and testing: (A) C5-6 spacer/plate with C6-7 SAS; (B) C5-7 SAS; (C) C5-7 spacer/plate. Range of motion (ROM) data was obtained and analyzed with paired t-tests and Bonferroni correction. Results The 2-level plate construct significantly reduced flexion-extension ROM compared to the 2-level SAS (5.6 ± 3.4 degrees versus 11.6 ± 4.6 degrees, respectively; p &lt; 0.05). There was a significantly increased segmental ROM in the 2-level SAS construct compared to the 2-level hybrid construct in flexion-extension as well (11.6 ± 4.6 degrees versus 7.2 ± 2.4 degrees, respectively, p &lt; 0.05). There was no significant difference in lateral bending and axial rotation ( p &gt; 0.05) between the three different 2-level constructs. Conclusions Our study found that hybrid and 2-level SAS constructs are comparable to conventional anterior plate constructs in lateral bending and axial rotation, but there was an increase in flexion-extension motion allowed with constructs that incorporated a SAS. Stand-alone cervical spacers with integrated screws for hybrid and 2-level SAS constructs are reasonable alternatives to two-level plate fixation; however, clinical trials are necessary to determine if the increased ROM in flexion-extension noted in the SAS constructs translates to clinical outcome.

Positioning organisational culture in knowledge management research

Purpose– The purpose of this paper is to propose a conceptual model for understanding the impact of organisational culture on knowledge management processes and their link with organisational performance. It is suggested that organisational culture should be assessed as a multi-level construct comprising artefacts, espoused beliefs and values and underlying assumptions. A holistic view of organisational culture and knowledge management processes, and their link with organisational performance, is presented.Design/methodology/approach– A comprehensive review of previous literature was undertaken in the development of the conceptual model. Taken together, the literature and the proposed model reveal possible relationships between organisational culture, knowledge management processes and organisational performance.Findings– Potential implications of organisational culture levels for the creation, sharing and application of knowledge are elaborated. In addition, the paper offers possible new insight into the impact of organisational culture on various knowledge management processes and their link with organisational performance.Research limitations/implications– A number of possible relationships between organisational culture factors, knowledge management processes and their link with organisational performance were used to examine such relationships.Practical implications– The research model highlights the multi-level components of organisational culture. These are: the artefacts, the espoused beliefs and values and the underlying assumptions. Through a conceptualisation of the relationships between organisational culture, knowledge management processes and organisational performance, the study provides practical guidance for practitioners during the implementation of knowledge management processes.Originality/value– The focus of previous research on knowledge management has been on understanding organisational culture from the limited perspective of promoting knowledge creation and sharing. This paper proposes a more comprehensive approach to understanding organisational culture in that it draws on artefacts, espoused beliefs and values and underlying assumptions, and reveals their impact on the creation, sharing and application of knowledge which can affect the overall organisational performance.

Biomechanical Stability of the Stalif-C™ Stand-Alone Spacer in Multilevel and Hybrid Cervical Fusion Constructs

Biomechanical Stability of the Stalif-C™ Stand-Alone Spacer in Multilevel and Hybrid Cervical Fusion Constructs

Organizational Health: Delineation, Constructs and Development of a Measurement Model

The present study examines Organizational Health (OH) for the definition that has been inexplicably characterized and about whose significance has been a high level of variability in academician’s and practitioners understanding hitherto. The purpose of this paper is to develop constructs and factors influencing OH within the context of the system theory in order to create a measurement model that can be used to measure business performance with Organizational changes. Data is consolidated using the Delphi technique with the opinions of experts from diverse fields within Malaysia. The study identified an OH measurement model consisting three multilevel constructs such as Culture & Change Capacity, Goal Alignment and Competence Adequacy. There are 28 factors which collectively influence the degree of OH in an Organization. These factors are itemized to convert the model into a survey based instrument of measure. The measurement enables practitioners to identify potential deterioration of health conditions in the organization well in advance and vaccinate through appropriate and timely Organizational Development interventions.

Cross-Level Cultural Congruence: Implications For Managing Diversity In Multinational Corporations

Few models view culture as a multi-level construct and limited diversity management theories capture the significance of the configuration of individual, organizational, and national culture differences on employee and organizational outcomes. This paper seeks to bridge this gap by presenting a conceptual model that suggests that the interplay between this triad of cultural entities (individual, organizational, and national) influences the degree of cultural congruence that ultimately affects individual and organizational outcomes. Figures that serve as explanations of these cultural configurations are presented and implications for diversity management research and practice are offered.