Multiple Regression Analysis Research Articles

Pengaruh Thin Capitalization, Sales Growth, dan Transfer Pricing Terhadap Tax Avoidance

The research objective is to examine the influence of Thin Capitalization, Sales Growth, and Transfer Pricing on tax avoidance in property and real estate sector companies in 2019-2022. This research applies a quantitative research approach that utilizes secondary data obtained from financial reports and ongoing business reports. The research sample consisted of 89, the sample was selected using a purposive sampling technique, data was collected from 17 sample companies during the 4 year research period. Data analysis uses multiple regression analysis techniques to analyze the relationship between thin capitalization, sales growth, transfer pricing and tax avoidance. The research findings show that these factors have a considerable negative impact on tax avoidance. Therefore, if corporations apply a higher level of responsibility for thin capitalization, sales growth and transfer pricing in tax avoidance practices, this will effectively prevent potential tax avoidance from occurring.

Black identity and internal health attributions of second generation black immigrant women

ABSTRACT Objective Despite second generation Black immigrants being a rapidly growing population, they are often overlooked in health attribution research that treats Black populations as a monolithic group. Very few studies focus on how discrimination, societal pressure, and racial identity play a role in the health attributions of Black immigrant women. Even fewer studies have examined this relationship solely with second generation Black immigrant women. Research has shown, however, that increased racial and ethnic identity but decreased experiences with racism are related to higher internal health attributions in Black populations. Thus, we addressed this dearth in research in the current study by examining the relationship between racial centrality, racism stress, and internal health attributions in a sample of 123 second generation Black immigrant women. Design Health attributions were assessed using the Illness Attribution Scale, racism stress using the Schedule of Racist Events, and racial centrality using the Multidimensional Inventory of Black Identity. Multiple regression analyses were conducted to test the hypotheses that lower levels of racism stress, but higher ratings of racial centrality would relate to higher scores of internal health attributions. Results A positive relationship was found between racial centrality and internal health attributions but not racism stress. Conclusion The results indicated that stronger affirmations with Black identity are associated with a greater importance of the causes of illness to be within one’s perceived control for second generation Black immigrant women, which highlights the importance of examining wthin-group differences via collective identity measures to better explain health attribution behavioirs.

A single-center prospective study of vitamin D levels and its supplementary effect in the first trimester

Objective: To investigate vitamin D levels and the effect of exogenous vitamin D supplementation in the first trimester among pregnant women in our center. Methods: This was a prospective cohort study. A total of 98 women in the first trimester who were followed-up regularly in Peking Union Medical College Hospital from December 1st 2020 to December 1st 2021 were enrolled. Subjects who had medical conditions that affect vitamin D absorption or metabolism were excluded. Questionnaires were administered, and 25-hydroxyvitamin D [25(OH)D] levels were detected using liquid chromatography tandem mass spectrometry (LC/MS/MS) method. According to the basic 25(OH)D level, different dosages of exogenous vitamin D were supplemented. After 4 weeks, 25(OH)D levels were detected again to evaluate the effect of supplementation. T test, analysis of variance, χ2 test, and multiple linear regression analysis were used for analysis. Results: The mean age of enrolled subjects was (33.5±4.0) years. The baseline 25(OH)D level was (41.2±20.0) nmol/L. Briefly, 70.4% (69/98) subjects were deficient in vitamin D, and 42.9% (42/98) patients were using vitamin D supplementation at the time of 25(OH)D testing. Single-factor analysis showed that vitamin D supplementation (t=-4.21, P<0.001), season (t=2.59, P=0.011), and nut-eating frequency (t=2.67, P=0.009) were related to 25(OH)D levels. Multiple linear regression analysis showed that only vitamin D supplementation had a relationship with 25(OH)D level (B=13.84, P=0.006). According to the baseline 25(OH)D level, 400-5 000 U/d vitamin D3 was supplemented regularly for (4.1±2.5) weeks, and 25(OH)D levels significantly increased after supplementation [(64.1±18.1) vs (37.3±16.6) nmol/L, t=-9.36, P<0.001]. The ascending range was negatively associated with basic 25(OH)D level (B=-0.66, P<0.001) and positively associated with supplementary dosage (B=0.51, P<0.001). 25(OH)D levels increased by 0.51 nmol/L on average per 1 μg (40 U) of vitamin D supplementation daily. Conclusions: The proportion of vitamin D deficiency was high in the first trimester among pregnant women in our center. Exogenous vitamin D supplementation could significantly increase 25(OH)D levels, and the effect was negatively associated with basic 25(OH)D level but positively associated with supplementary dosage.

Association between hearing loss and gout based on National Health and Nutrition Examination Survey and Mendelian randomization analysis

Hearing loss(HL) represents a significant public health concern. This study aimed to determine the association between hearing loss and gout and to elucidate the underlying causative mechanisms. Data for this study were obtained from the National Health and Nutrition Examination Survey (NHANES) and Mendelian randomization (MR) basic databases. Initially, baseline characteristics of individuals with and without gout were compared. A nonlinear relationship between pure tone audiometry (PTA) values and gout prevalence was confirmed through restricted cubic spline (RCS) curve analysis. Subsequently, hearing loss was categorized into different levels based on PTA values, and multiple logistic regression analysis was employed to calculate the impact of varying degrees of hearing loss on the risk of gout. Finally, MR analysis was conducted to further elucidate the causal relationship between hearing loss and gout. A total of 3,258 individuals were included in this study, with a gout prevalence of 3.7%. Significant differences were observed between the gout group and the non-gout group in variables such as age, gender, blood uric acid level, BMI, hypertension, and diabetes. RCS curve analysis revealed a significant nonlinear relationship between PTA values and gout risk, particularly when PTA values exceed a specific threshold, where the curve flattens. Based on different levels of hearing loss derived from PTA values, multiple logistic regression analysis demonstrated that mild and moderate hearing loss significantly increased the risk of gout, remaining statistically significant after adjusting for covariates (odds ratio (OR) = 2.10–3.48, P < 0.05). MR analysis further confirmed the causal relationship between hearing loss and gout. Inverse variance weighting (IVW) was employed as the primary method, revealing that both individuals with hearing difficulties (OR = 0.98, 95% confidence interval (CI) 0.96–0.999, P = 0.012) and those without hearing impairment (OR = 1.02, 95% CI 1.01–1.04, P = 0.012) exhibited a significant causal relationship with gout. Goodness-of-fit tests and sensitivity analyses were used to verify the reliability of the results. Hearing loss has a significant causal relationship with an increased risk of gout, providing a new perspective for the prevention and management of gout. Focused attention and prompt treatment of hearing loss, particularly mild and moderate hearing loss, may significantly reduce the risk of developing gout.

Factors related to preoperative anxiety in older patients with sensory impairment: A cross-sectional study.

To identify the factors related to preoperative anxiety in older adults with sensory impairment. Descriptive quantitative research design. Study participants were 120 older adults admitted to a tertiary hospital in Seoul, South Korea to undergo eye or ear surgery. Data were collected from 11 February to 30 April 2023. The collected data were analysed using descriptive statistics, t-tests, ANOVA, and multiple regression analysis using SPSS 28.0. The study was reported following the STROBE checklist. Preoperative anxiety differed significantly according to gender (p = .002), average monthly household income (p < .001), subjective health status (p = .003), subjective vision loss (p = .004), one-sided or both-sided eye discomfort (p = .002), use of glasses (p = .010), subjective hearing loss (p = .022) and anxiety coping mechanisms (p < .001). The results of a multiple regression analysis on the significant variables identified that gender (β = .178, p = .036) and anxiety coping mechanisms (β = .336, p < .001) had the most significant effect on preoperative anxiety, with an explanatory power of 34.5%. The development and practical application of tailored nursing interventions catering to specific genders and anxiety coping mechanisms would contribute to reducing preoperative anxiety and providing efficient nursing care for older adults with sensory impairment.

Association of nurse–mother partnerships with parenting stress and family resilience among South Korean mothers of children with congenital heart disease

PurposeAdvances in the management of congenital heart disease (CHD) have significantly decreased mortality rates, indicating a need for continuous care as a chronic condition throughout the child's lifespan. This study examined the association of nurse–mother partnerships with parenting stress and family resilience among South Korean mothers of children with CHD. Design and methodsThis descriptive study involved 93 mothers of children aged six years or younger with CHD admitted to a hospital. Data were collected from September to November 2020 and analyzed using SPSS/WIN (version 29.0) for t-tests, analyses of variance, Pearson's correlation coefficient, and multiple regression analyses. ResultsThe means and standard deviations of the nurse–mother partnership, parenting stress, and family resilience were 4.13 ± 0.47, 76.98 ± 16.6, and 56.54 ± 7.86 points, respectively. Parenting stress increased as the number of hospitalizations and surgeries increased and with complex types of CHD. Nurse–mother partnerships were stronger with longer hospital stays. Family resilience was higher with younger children, fewer rehospitalizations, and shorter hospital stays. A positive correlation was found between nurse–mother partnerships and family resilience, and a negative correlation between parenting stress and family resilience. Factors influencing parenting stress included family resilience, rehospitalizations, and complex types of CHD, and those affecting family resilience were nurse–mother partnerships, parenting stress, and the child's age. ConclusionNurse–mother partnerships significantly affect family resilience. Practical implicationsEnhancing nurse–mother partnerships can improve family resilience, which in turn can reduce parenting stress, thus offering guidance for future nursing interventions.

Gender Disparity in Academic Trauma Surgery: The Current State of Affairs.

Despite the increasing number of female surgeons in general surgery programs, women are still inadequately represented in leadership positions. This study aims to investigate the magnitude of gender bias in university-based trauma surgery fellowship programs and leadership positions in the United States of America. FRIEDA was used to identify trauma surgery programs. A thorough website review of each program obtained further information on faculty members, including their name, age, gender, and faculty rank. Trauma surgeons with an MD or DO qualification and a faculty rank of Professor, Associate Professor, or Assistant Professor were selected for inclusion in this study. SCOPUS was used to assess the H-index and the number of publications and citations of surgeons. The total number of programs included was 136, consisting of 715 faculty members. Less than a quarter (n = 166; 23.2%) comprised females and less than one-fifth (n = 30; 19%) of female surgeons were Professors. The difference in the research productivity of male and female trauma surgeons was statistically significant (P < .05), with the average H-index being 10 vs 7.5, respectively, amongst the top 50 surgeons of both genders. Based on a multiple regression analysis, academic rank was significantly associated (P < .05), and gender was not significantly associated (P > .05) with H-index. Gender disparity exists in the field of trauma surgery, as noted in senior faculty ranks and leadership positions. Female-inclusive state policies, appropriate mentorship, and supportive institutions can help to bridge this gap.

Relationship between corneal hysteresis and the site of damage to peripapillary retinal nerve fibre layer thickness in open-angle glaucoma

Corneal hysteresis (CH) is associated with glaucomatous structural changes. We retrospectively investigated the association between CH and the regional circumpapillary retinal nerve fibre layer thickness (cpRNFLT) in 419 eyes of 419 patients with normal-tension glaucoma (NTG) and primary open-angle glaucoma (POAG). CH was used as the explanatory variable, and cpRNFLT (total and quadrant) was used as the dependent variable. Standardized β coefficients were compared both overall and between the NTG and POAG groups. Multiple regression analysis with CH as the explanatory variable and cpRNFLT parameters as the dependent variables suggested that even after adjusting for age, sex, intraocular pressure (IOP), axial length, and central corneal thickness, all areas of the cpRNFLT were significantly associated with CH, except for the nasal quadrant. In the stratified analysis by glaucoma type, a positive relationship between CH and regional cpRNFLT tended to be maintained in the NTG group but not in the POAG group (P = 0.060 for interaction). Additionally, in the NTG group, the CH-inferior cpRNFLT relationship was particularly strong in the less-IOP fluctuation group. These results suggest that CH may be a potential predictor of anatomical vulnerability around the optic nerve, particularly enhancing the inferior regions of NTG.

Analysing influential factors in e-learning technology acceptance for digital learning effectiveness enhancement

This study aims to discover the factors that influence the acceptance of electronic learning media and its effect on the effectiveness of digital instruction. The study involved a learning management system and online tutorials using management system (MS) teams from various faculties at the Universitas Terbuka. These include the Faculty of Economics and Business, the Faculty of Teacher Training and Education, the Faculty of Science and Technology, and the Faculty of Law, Social Sciences, and Political Sciences. also conducted in three regional offices in Ambon, Gorontalo and Makassar, which were selected through purposive sampling. Primary data sources include participant questionnaires and interviews. Analytical methods include correlation and multiple regression analysis, with descriptive statistics used to summarize the dataset. Variable selection involves reliability and validity tests and classical assumption tests like multicollinearity. The F-test demonstrates a statistically significant and beneficial influence of utilizing e-learning media and individual ability, training, and intention to use it for digital learning success. The results of ttests and regression models provide empirical evidence supporting the significant effect of e-learning media and intention to use on the effectiveness of digital learning. However, variables related to training and ability do not show any significant influence.

Obesity and dental caries in Saudi Arabia: a correlated study

BackgroundObesity and dental caries are two major global public health concerns. There have been conflicting reports about the relationship between obesity and dental caries. This study intends to examine the link between obesity and dental caries across the five regions of Saudi Arabia.MethodsThe study involved 380 participants, which was a cross-sectional survey, with an age range of 6 to 14. We distributed a self-reported questionnaire to assess the participants body mass index (BMI) and caries (dmft/DMFT). In this study, descriptive analysis, student t-test, one-way analysis of variance (ANOVA), and multiple linear regression analysis were used.ResultsThe study comprised 380 respondents, consisting of females (60.8%) and males (39.2%), with a mean age of 9.1 years and mean BMI of 26.3. The prevalence of caries among the study respondents was 66.6% (Table 2), and this prevalence was higher among females (67.5%), those who consumed sugar more than six times (77.5%), those who brushed their teeth once per day (80.3%), those who used no dental floss (68.4%), those who did not use mouthwash or rinse (68.4%), and those in the east and center regions (100%). The obese possess a statistically significant (P < 0.05) higher mean dmft/DMFT (dmft = 8.00 and DMFT = 6.00). Furthermore, BMI had a negative influence on the DMFT score (b = −0.01, P = 0.776), which was not statistically significant.ConclusionParticipants categorized as obese demonstrated a notably higher mean dmft/DMFT in comparison to their non-obese counterparts. Although BMI showed a negative impact on the DMFT score, this association did not reach statistical significance.

Glycated albumin in pregnancy correlates negatively with body mass index and contributes to the risk of gestational diabetes mellitus

ObjectivesThe aims of our study were to establish a reference interval for glycated albumin (GA) in gestational week 30, to investigate whether GA can replace or reduce the need for oral glucose tolerance test (OGTT) in pregnancy, and to reassess the usefulness of body mass-index (BMI), age and fasting glucose in detection of gestational diabetes (GDM). Designand methods: We measured GA in 486 healthy pregnant women. Reference interval was calculated using the central 95% of the results. ROC curves were created to assess the ability of GA, fasting glucose and BMI separately to detect GDM, and logistic regression analysis was used to estimate risk of developing GDM given the level of the same markers. Finally, multiple logistic regression analysis based on GA, fasting glucose and BMI was used to find a strategy of predicting a patient’s risk of GDM. ResultsThe reference interval for GA at week 30 of gestation is 6.8-10.3%. The analysis has a low AUC (0.53) with respect to detecting GDM. It increases slightly to 0.64 when corrected for BMI, as GA is inversely correlated to BMI. Combining GA with fasting glucose and BMI at gestational weeks 16-20 could raise the AUC to 0.80. ConclusionGA cannot be recommended to replace OGTT for the diagnosis of GDM. Nor can it be used to identify women at risk of developing GDM. GA combined with fasting glucose and BMI in early pregnancy could be a useful model to estimate risk of GDM.

Factors influencing COVID-19 vaccination intentions and mediating effects among older adults in Southwest China

This study examines the factors influencing COVID-19 vaccination intentions among Chinese residents over the age of 60, with a focus on the mediating roles of Health Beliefs and Cues to Vaccination Action in the relationship between vaccine knowledge and vaccination intentions. We conducted a cross-sectional online survey involving 1,305 participants from Southwest China. Multiple logistic regression analysis identified potential determinants of vaccination intention, including socioeconomic characteristics, knowledge, health beliefs, and cues to vaccination action. Furthermore, mediation analysis using the causal mediation analysis method explored the mediating effects within the knowledge-to-intention pathway. Vaccination intention and its related factors: among the 1212 elderly people included in the study, 92.9% expressed willingness to receive the COVID-19 vaccine. Main factors influencing their vaccination willingness included Residency (urban vs. rural, OR = 0.47, p < 0.01), Age (75 + vs. others, OR = 0.41, p < 0.05), Marital status (OR = 0.36, p < 0.01), Occupation ( business/service vs. others, OR = 0.33, p < 0.05), Awareness of vaccine effectiveness (OR = 1.23, p < 0.01), Cues to vaccination action (OR = 1.31, p < 0.01) and COVID-19 related knowledge (OR = 1.06, p < 0.01). The analysis revealed two significant mediators—Health Beliefs and Cues to Vaccination Action. These mediators (p<0.05 for both natural indirect effect and natural direct effect) acted along two key pathways: (1) From Knowledge of COVID-19 to Health Beliefs to Vaccination Intention: Natural Direct Effects (NDE) ranged from 0.012 to 0.016, with Natural Indirect Effects (NIE) from 0.001 to 0.003, indicating that mediators accounted for 4% to 18% of the total effect. (2) From Knowledge of COVID-19 to Cues of Vaccination Action to Vaccination Intention: NDE ranged from 0.012 to 0.016 and NIE from 0.002 to 0.003, with mediators accounting for 9% to 20% of the effect. The intention to vaccinate against COVID-19 among older adults varies significantly based on socioeconomic and health belief factors. The study identifies health beliefs and cues to action not only as direct contributors but also as crucial mediators in the pathway from knowledge to vaccination intention among older individuals. These findings can extend our understanding of the impact of sociodemographic factors and health beliefs on the COVID-19 vaccination willingness among older adults.

Digital Health Utilization in Spinal Cord Injury: A Descriptive Study of a Population-Based Prospective Cohort.

The objective of this study was to describe the use of digital health tools by people with spinal cord injury and associated factors. Cross-sectional data from the 2022 Swiss Spinal Cord Injury Cohort Study (SwiSCI) were analyzed. Descriptive statistics summarized data regarding sociodemographic characteristics, self-management, health, and digital health usage. Multiple logistic regression analysis examined the association of digital health use with reasons of use, concerns, confidence, sociodemographic characteristics, self-management, and comorbidities. Among 961 participants, 69% used digital health tools. Females were 1.79 times more likely to adopt them. People aged 60-70 had 3.84 times higher usage rates than 18-30 yrs old. Longer spinal cord injury duration increased usage by 0.98 times/year. Confidence using digital tools and positive health attitudes predicted usage. Comorbidities were positively correlated with usage. Concerns about digital health utilization had no significant impact. Our study provides one of the first comprehensive descriptions of digital health utilization in spinal cord injury. Its findings shed light on the intricate factors influencing digital health utilization, contribute to a deeper understanding of this patient population, and pave the way for more targeted and effective digital tools and strategies for their uptake.

Discriminant prediction equation using an optical biometer for identifying postmyopic laser vision correction eyes.

To create an equation for identifying postmyopic laser vision correction (M-LVC) eyes by using corneal shape parameters in a swept-source optical coherence tomography (SS-OCT) biometer and verify its accuracy. Nagoya Eye Clinic, Nagoya, Japan. Retrospective evaluation of a screening approach. Control participants were selected retrospectively from patients who visited the clinic for cataract surgery or refractive surgery. M-LVC patients were selected retrospectively from patients who visited the clinic for cataract surgery or M-LVC postoperative checkups. The control and post-M-LVC patients with keratometric values between 39 diopters (D) and 43 D were included in the final analysis. Patients were randomly assigned to equation-creation and validation groups in a 2:1 ratio. To discriminate post-M-LVC patients from control participants, multiple logistic regression analysis was performed with the corneal shape parameters from the optical biometer as independent variables. The M-LVC and control groups consisted of 90 eyes from 90 patients and 97 eyes from 97 patients, respectively. The average keratometry (Ave-K) values did not differ significantly between the control and M-LVC groups ( P = .187). The multiple logistic analysis identified the asymmetry component (regression coefficient, 5.357; odds ratio, 212.158) and corneal eccentricity index (regression coefficient, -5.088; odds ratio, 0.006) as explanatory variables. The area under the receiver operating characteristic curve in the predictive equation-creation group was 0.946. The sensitivity and specificity in the validation group were 93.3% and 87.5%, respectively. The M-LVC discriminant prediction equation with the topography-equipped SS-OCT biometer was effective in detecting post-M-LVC eyes with high accuracy.

Exposure to household air pollution and childhood multimorbidity risk in Jimma, Ethiopia

BackgroundChildhood multimorbidity, characterized by the simultaneous occurrence of multiple medical conditions in children, is a global concern. Notably, exposure to household air pollution has been linked to various health issues, particularly affecting vulnerable segments of the population residing in poorly ventilated homes. However, evidence regarding the impact of household air pollution on the risk of multimorbidity in low-income settings remains scarce. Therefore, this study aims to investigate the association between household air pollution and childhood multimorbidity in Jimma, Ethiopia.MethodsA comparative cross-sectional study was conducted to collect data from 280 children under the age of five who lived in households using solid fuel (n = 140) and clean fuel (n = 140). The Demographic Health Survey morbidity questionnaire was used to collect information from mothers about common childhood illnesses. Multiple logistic regression analysis was employed to explore the relationship between the use of solid fuel for cooking in households and the likelihood of childhood multimorbidity. In addition, Poisson regression estimation was used to determine if exposure to solid fuel could increase the number of morbidities.ResultsThe overall prevalence of childhood multimorbidity was 34.3% [95% CI: 0.29–0.40]. Among these cases, 23.9% were among children from solid fuel user households, whereas about 10.4% were from clean fuel user households. Adjusted for all possible socioeconomic, demographic, water, sanitation, hygiene, and health care covariates, children living in solid fuel user households had more than three times the odds of childhood multimorbidity compared to children living in clean fuel user households (AOR = 3.14, 95% CI [1.42–6.95], p &amp;lt; 0.001). Moreover, household air pollution from solid fuel use was positively associated with an increased number of individual morbidity conditions, with an adjusted β coefficient of 0.46 (IRR = 1.58, 95% CI [1.17–2.13], p = 0.003).ConclusionSolid fuel use was an independent predictor of childhood morbidity risk. Efficient policies and strategies, such as the integration of environmental regulation policies into the healthcare system aimed at the reduction of harmful air pollutants and their adverse health effects on children, need to be implemented.

Health Literacy in Non-dialyzed Chronic Kidney Disease Patients: A Cross-Sectional Study

Objective: To explore the current status and influencing factors of health literacy in non-dialyzed chronic kidney disease (CKD) patients, and to provide a basis for developing more comprehensive and effective interventions. Methods: 206 CKD patients hospitalized or followed up in outpatient clinics in the Department of Nephrology of a tertiary hospital in Baoding City were conveniently selected from June to August 2024. General information questionnaire, Health Literacy Scale for Chronic Disease Patients, Perceived Social Support Scale, and Positive Psychological Questionnaire were used to conduct the survey. Results: The health literacy score of non-dialyzed CKD patients was (91.04±15.17); The results of multiple linear regression analysis showed that the number of comorbidities, education level, per capita monthly household income, family support, and optimism were the influencing factors of health literacy in CKD patients. Conclusion: The health literacy of non-dialyzed CKD patients is low, and healthcare professionals should develop scientific and reasonable intervention programs based on their influencing factors in order to enhance the health literacy and delay disease progression.

Entrepreneurial alertness and new firm performance: a moderated mediation model

Purpose Supported by the literature on dynamic capabilities, this study aims to propose a moderated mediation model to examine how entrepreneurial alertness advances new firm performance by identifying strategic flexibility as a pivotal mediator and absorptive capacity as a crucial contingency. Design/methodology/approach This paper collects data from 137 new firms regarding activities that were considered essential during the COVID-19 contingency in Mexico. The hypotheses are tested using hierarchical multiple regression analysis, complemented with the bootstrapping approach to confirm the indirect and conditional effects of entrepreneurial alertness on firm performance through strategic flexibility. Findings The results yielded general support for the study hypotheses, suggesting that entrepreneurs’ alertness facilitates the firms’ ability to respond to changes in their context, namely, strategic flexibility; strategic flexibility enables firms make useful changes, leading to better performance; entrepreneurial alertness indirectly affects new firm performance through strategic flexibility; absorptive capacity has a positive moderating impact on the entrepreneurial alertness-strategic flexibility relationship; and the positive influence of entrepreneurial alertness on strategic flexibility and ultimately new firm performance was increased in high rather than in low absorptive capacity. Practical implications This study highlights that entrepreneurs’ cognitive mechanisms shape the behaviour of their firms through strategic decisions. This paper studies the influence of entrepreneurs’ alertness on strategic flexibility, examines the interplay between entrepreneurial alertness and environmental conditions via absorptive capacity and proposes a moderated mediation model to understand the effect of entrepreneurs’ alertness on strategic flexibility and new firm performance. Originality/value The study investigates the influence of assertive message framing and individual value orientations on the reactance process in the context of environmentally friendly mobility. It finds individual value orientations to be a significant factor in the reactance process, further extending the psychological reactance theory. Moreover, it revalidates reactance as a construct consisting of anger and negative cognition.

Feasibility of Acoustic Features of Vowel Sounds in Estimating the Upper Airway Cross Sectional Area during Wakefulness: A Pilot Study

Assessment of upper airway dimensions has shown great promise in understanding the pathogenesis of obstructive sleep apnea (OSA). However, the current screening system for OSA does not have an objective assessment of the upper airway. The assessment of the upper airway can accurately be performed by MRI or CT scans, which are costly and not easily accessible. Acoustic pharyngometry or Ultrasonography could be less expensive technologies, but these require trained personnel which makes these technologies not easily accessible, especially when assessing the upper airway in a clinic environment or before surgery. In this study, we aimed to investigate the utility of vowel articulation in assessing the upper airway dimension during normal breathing. To accomplish that, we measured the upper airway cross-sectional area (UA-XSA) by acoustic pharyngometry and then asked the participants to produce 5 vowels for 3 seconds and recorded them with a microphone. We extracted 710 acoustic features from all vowels and compared these features with UA-XSA and developed regression models to estimate the UA-XSA. Our results showed that Mel frequency cepstral coefficients (MFCC) were the most dominant features of vowels, as 7 out of 9 features were from MFCC in the main feature set. The multiple regression analysis showed that the combination of the acoustic features with the anthropometric features achieved an R2 of 0.80 in estimating UA-XSA. The important advantage of acoustic analysis of vowel sounds is that it is simple and can be easily implemented in wearable devices or mobile applications. Such acoustic-based technologies can be accessible in different clinical settings such as the intensive care unit and can be used in remote areas. Thus, these results could be used to develop user-friendly applications to use the acoustic features and demographical information to estimate the UA-XSA.

Do nurse spiritual responses to trauma explain nurse outcomes? A correlational observational study

BackgroundVarious facets of spirituality are associated with wellbeing. Given the current urgency to promote nurse wellbeing, nurse spirituality merits exploration. PurposeTo investigate how spiritual distress and growth (i.e., spiritual/religious struggle, moral injury, post-traumatic growth) contributed to nurse outcomes (i.e., burnout, job satisfaction, intent to leave). MethodsRNs providing direct patient care in three Southern California hospitals completed an online survey that included psychometrically robust measures. Hierarchical multiple regression analyses were used to test spiritual variables as predictors of nurse outcomes after accounting for demographic and work-related factors. FindingsIn this sample of 531 demographically diverse RNs, spiritual struggle contributed to burnout and turnover intention; posttraumatic growth and employer respect for nurse wellbeing contributed to all three nurse outcomes. DiscussionSpiritual distress and growth are understudied but potentially important influences on job outcomes for nurses. Results here suggest that continued development of interventions to address spiritual health is worth investment.

The relationships among family function, psychological resilience, and social network of patients with chronic disease in the community

This study aimed to examine the relationships among family function, psychological resilience, and social network of patients with chronic disease in the community and to further identify whether psychological resilience played a mediating role in the relationship between family function and social network. A cross-sectional survey including 460 convenient samples of patients with chronic disease in four Chinese communities was conducted using a general characteristics questionnaire, the Family APGAR Index, the Connor-Davidson Resilience Scale, and the Lubben Social Network Scale 6. Data were analyzed using descriptive analysis, Student's t-test, one-way ANOVA, Pearson/Spearman correlation, hierarchical multiple regression analysis, and mediation analysis using the PROCESS macro. Family function, psychological resilience, and social network were significantly related. Psychological resilience partially mediated the relationship between family function and social network. Interventions designed to enhance family function and psychological resilience may improve social network among patients with chronic disease in the community.