Transactional Model Of Stress Research Articles

The relevance of risk perception and coping strategies for COVID-19 situation reports

Introduction: Various measures have been implemented worldwide to contain the COVID-19 pandemic. In contrast to epidemiological data, psychosocial parameters such as coping strategies in the population were rarely considered in assessments of the course of the pandemic, a point that experts criticized. Based on the transactional model of stress and coping as well as the psychometric paradigm of risk perception, this paper addresses the relevance of psychosocial data for COVID-19 situation reports by highlighting the role of risk perception and coping within the German population. Method: We collected quantitative data on risk perception and coping strategies in four surveys conducted at the height of the COVID-19 pandemic in 2020 and 2021 in Germany. We present descriptive as well as bivariate results to examine our research questions statistically. Results: Data contribute to psychosocial aspects of the general situation report such as variations of risk perception during the pandemic (e.g., declining risk perception) and by sociodemographic (e.g., age) as well as location. Furthermore, Germans characterize the COVID-19 pandemic as a crisis with catastrophic potential, but as easily reducible through behavior. Besides, coping strategies are more problem-focused and most respondents listen to experts’ advice and try to behave appropriately. Conclusion: These data are helpful and necessary to provide a complete and substantial situation report in crises and disasters and support crisis managers and public authorities to adequately address the public regarding their concerns.

Psychological stress of general practitioners in the care of patients with palliative care needs: an exploratory study

BackgroundIn Germany, general practitioners play a pivotal role in palliative care provision. Caring for patients with palliative care needs can be a burden for general practitioners, highlighting the importance of self-care and mental health support. This study aimed to explore the role of palliative care in general practitioners’ daily work, the stressors they experience, their coping mechanisms, and the potential benefits of Advance Care Planning in this context.MethodsAn exploratory approach was employed, combining a short quantitative survey with qualitative interviews. The analysis was based on a structuring qualitative content analysis, following a deductive-inductive procedure and integrating the Stress-Strain Model and Lazarus’ Transactional Model of Stress and Coping. We recruited eleven general practitioners to take part in the study.ResultsGeneral practitioners viewed palliative care as integral to their practice but faced challenges such as time constraints and perceived expertise gaps. Societal taboos often hindered conversations on the topic of death. Most general practitioners waited for their patients to initiate the topic. Some general practitioners viewed aspects of palliative care as potentially distressing. They used problem-focused (avoiding negative stressors, structuring their daily schedules) and emotion-focused (discussions with colleagues) coping strategies. Still, general practitioners indicated a desire for specific psychological support options. Advance Care Planning, though relatively unfamiliar, was acknowledged as valuable for end-of-life conversations.ConclusionsPalliative care can be associated with negative psychological stress for general practitioners, often coming from external factors. Despite individual coping strategies in place, it is advisable to explore concepts for professional psychological relief.Trial registrationNot registered.

How does the anthropomorphism of service robots impact employees’ role service behavior in the workplace?

The rapid adoption of service robots has altered employees’ role boundaries and tasks. Anthropomorphism plays a key role in understanding human responses to robots. However, empirical research on how anthropomorphism influences employees’ cognitive and behavioral responses is lacking. Based on the transactional model of stress and coping, this study builds a conceptual model to reveal how the anthropomorphism of service robots affects employees’ service behavior. An analysis of 295 valid questionnaire responses shows that the anthropomorphism of service robots affects employees’ service behavior through warmth and smart technology, artificial intelligence, robotics, and algorithms (STARA) awareness. Further, a competitive psychological climate strengthens the impact of the anthropomorphism of service robots on STARA awareness and weakens its effect on warmth.

Trajectories of mindfulness, flow experience, and stress during an online-based MBSR program: the moderating role of emotional exhaustion.

Despite numerous papers focusing on mindfulness at work, our knowledge about how flow experience and stress as indicators of optimal functioning and wellbeing at work evolve over time during the common mindfulness-based stress reduction (MBSR) program remains limited. Drawing from the transactional model of flow and stress, we argue that a build-up of mindfulness over the training duration not only leads to a decrease in stress but also an increase in flow experience. Thereby, we examine the moderating role of emotional exhaustion amplifying the beneficial effects of mindfulness. In a quasi-experimental study, 91 participants completed weekly questionnaires over the course of 8 weeks. Forty six participants in the experimental group took part in the MBSR program, while 45 participants were part of an inactive control group. Mindfulness and flow showed a significant linear increase over time, whereas stress exhibited a linear decrease. Those who participated in the MBSR training reported an increase in mindfulness that positively and negatively predicted the trajectories of flow and stress, respectively. Emotional exhaustion amplified the effects of the trajectory of mindfulness on the trajectories of flow and stress. These findings suggest that mindfulness can not only reduce stress but can also foster the autotelic experience of flow, especially for chronically depleted individuals. However, more research is necessary to replicate these results and address the limitations of the current study, including the quasi-experimental design, the use of self-report measures, as well as the dropout during the study period.

Culture, emotion, and cognition: Understanding the psychological dynamics of Chinese sports with emotional regulation skills and cognitive reappraisal

This study illuminates the complex relationship between cultural orientation towards collectivism, emotional regulation skills, cognitive reappraisal ability, sports engagement, perceived coach support, and sports self-efficacy in Chinese athletes' performance satisfaction. Seven hundred and fifty athletes from Guangdong, Jiangsu, and Sichuan completed 5-point Likert scale assessments. The study employed structural equation modeling (SEM) to analyze variable connections. The results reveal significant relationships between performance satisfaction and cultural orientation towards collectivism (β = 0.35, p < 0.001), emotional regulation skills (β = 0.28, p < 0.001), cognitive reappraisal ability (β = 0.32, p < 0.01), sports engagement (β = 0.20, p < 0.05), perceived coach support (β = 0.25, p < 0.01), and self-efficacy in sports (β = 0.30, p < 0.001). These findings underscore the importance of psychological factors in shaping athlete well-being and performance satisfaction. These relationships linked the self-determination theory, social support theory, and the transactional model of stress and coping. Treatments that improve athlete self-efficacy, emotional control, and coach-athlete relationships may improve player happiness, retention, and organizational performance. These actions affect management and the economy. A supportive environment and athlete development initiatives may boost athlete well-being and performance, leading to long-term sports success and competitiveness.

Facilitator or barrier? The double-edged effects of leader perfectionism on employee innovation behavior

ABSTRACT Although there have been studies in the past that have highlighted the important role of leader traits in motivating employee innovation behavior, leader perfectionism has been scarcely investigated in this context. This study attempts to explore whether leader perfectionism directed toward employees can facilitate or hinder employee innovation behavior. Based on the transactional model of stress, we propose and test a moderated mediation model using data from a multi-wave, multi-source survey of 334 leader-employee questionnaires. The results show that, for employees with high self-efficacy, leader perfectionism has a positive effect on their challenge stress, which in turn promotes employee innovation behavior; Meanwhile, for employees with low self-efficacy, leader perfectionism has a positive effect on their hindrance stress, thereby discouraging employee innovation behavior. This study has significant theoretical and practical implications as it highlights the underlying relationship between leader perfectionism and employee innovation behavior.

Association between Healthcare Provider Communication and Patient Adherence to Treatment Plans in Australia

Purpose: The aim of the study was to analyze the association between healthcare provider communication and patient adherence to treatment plans in Australia. Methodology: This study adopted a desk methodology. A desk study research design is commonly known as secondary data collection. This is basically collecting data from existing resources preferably because of its low cost advantage as compared to a field research. Our current study looked into already published studies and reports as the data was easily accessed through online journals and libraries. Findings: Effective healthcare provider communication in Australia significantly enhances patient adherence to treatment plans. Clear explanations and empathetic engagement from providers positively influence patient compliance. Conversely, poor communication or unclear instructions lead to lower adherence rates. These findings underscore the pivotal role of effective communication in fostering patient adherence and improving healthcare outcomes nationwide. Unique Contribution to Theory, Practice and Policy: Social cognitive theory (SCT), health belief model (HBM) &amp; transactional model of stress and coping (TMSC) may be used to anchor future studies on association between healthcare provider communication and patient adherence to treatment plans in Australia. Implement targeted communication training programs for healthcare providers at all levels. These programs should emphasize skills such as active listening, patient-centered communication, and cultural competence. Advocate for policy initiatives that prioritize communication as a core component of quality healthcare delivery.

Comparative Study of Stress Levels and Coping Mechanisms among Women Bank Employees in Kanpur City: Public vs. Private Sector Banks

Purpose: The study compares stress levels and coping mechanisms among women bank employees in Kanpur City, focusing on key stressors, coping mechanisms, and differences in effectiveness. It aims to contribute to understanding stressors faced by women in the banking sector, inform strategies for improving well-being, and contribute to gender equity and workplace health efforts. Theoretical Framework: The study on stress levels and coping mechanisms among women bank employees in Kanpur City uses a theoretical framework. Key components include the transactional model of stress and coping, job demands-resources model, gender role theory, intersectionality theory, organizational factors, organizational culture and climate, and organizational support theory. The mixed-methods approach is used to capture the complexity of stress experiences and coping mechanisms. The framework also emphasizes creating healthy work environments to mitigate stress and enhance well-being. Design/Methodology/Approach: The study aims to assess stress levels and coping mechanisms among women bank employees in Kanpur City using a comparative design and mixed-methods approach. The target population includes women from public and private sector banks. Data collection methods include structured surveys and in-depth interviews. The study will analyze data using statistical techniques and qualitative analysis. Ethical considerations include informed consent, confidentiality, and ethical approval. Limitations include sampling biases and the study's specificity to Kanpur City. Practical implications include policy recommendations and contribution to existing literature on stress management and workplace support. Findings: The study on stress levels and coping mechanisms among women bank employees in Kanpur City is hypothetical. However, the findings can be presented and interpreted using a structured section. The summary should include a summary of the key findings, quantitative data comparison, demographic influences, qualitative themes, coping mechanisms, and sector differences. The findings should be compared and analyzed using theoretical frameworks, and the implications should be discussed for organizational policies and practices. Implications: The study on stress levels and coping mechanisms among women bank employees in Kanpur City suggests implementing gender-sensitive support programs, promoting work-life balance, and enhancing resilience training. It also emphasizes equal opportunities for career development and mentorship programs. The study also contributes to stress theory, gender equity, and policy development, urging regulatory oversight and industry collaboration. It also has societal implications, as it can lead to societal changes and inspire future generations. The findings can guide policy and practice in the banking sector.

The Role of Art Therapy in Enhancing Rehabilitation Outcomes for Athletes with Sports Injuries

Purpose: This study sought to analyze the role of art therapy in enhancing rehabilitation outcomes for athletes with sports injuries. Methodology: The study adopted a desktop research methodology. Desk research refers to secondary data or that which can be collected without fieldwork. Desk research is basically involved in collecting data from existing resources hence it is often considered a low cost technique as compared to field research, as the main cost is involved in executive’s time, telephone charges and directories. Thus, the study relied on already published studies, reports and statistics. This secondary data was easily accessed through the online journals and library. Findings: The findings reveal that there exists a contextual and methodological gap relating to the role of art therapy in enhancing rehabilitation outcomes for athletes with sports injuries. Preliminary empirical review revealed that art therapy offers significant benefits for athletes recovering from sports injuries. Through a review of empirical studies, it was found that art therapy facilitated emotional expression, coping skills development, and social support, leading to improved psychological well-being and holistic healing. The study emphasized the importance of addressing the biopsychosocial aspects of rehabilitation and highlighted the need for further research to understand the mechanisms underlying the therapeutic effects of art therapy. Overall, the findings underscored the transformative potential of art therapy in optimizing rehabilitation outcomes for athletes with sports injuries. Unique Contribution to Theory, Practice and Policy: Biopsychosocial Model of Health, Self- Determination theory (SDT) and Transactional Model of Stress and Coping may be used to anchor future studies on rehabilitation for athletes with sports injuries. The study provided several recommendations contributing to theory, practice, and policy in sports injury rehabilitation. It suggested further exploration of theoretical frameworks to understand art therapy's therapeutic mechanisms and its integration into existing models. In practice, it recommended incorporating art therapy into multidisciplinary rehabilitation programs, along with developing evidence-based guidelines for its implementation. Additionally, the study advocated for policy initiatives to increase access to art therapy services for athletes, emphasizing collaboration among stakeholders and interdisciplinary knowledge sharing. These recommendations aimed to promote holistic approaches to rehabilitation, improve outcomes, and enhance the overall well-being of injured athletes.

Influence of Aerobic Exercise on Stress Reduction in Philippines

Purpose: The aim of the study was to analyze the influence of aerobic exercise on stress reduction. Methodology: This study adopted a desk methodology. A desk study research design is commonly known as secondary data collection. This is basically collecting data from existing resources preferably because of its low cost advantage as compared to a field research. Our current study looked into already published studies and reports as the data was easily accessed through online journals and libraries. Findings: Research in the Philippines indicates that aerobic exercise effectively reduces stress. It triggers the release of endorphins, lowers cortisol levels, and increases serotonin, leading to improved mood and relaxation. Engaging in activities like jogging, swimming, or cycling can be a valuable strategy for managing stress and promoting mental well-being in the Philippines. Unique Contribution to Theory, Practice and Policy: Biopsychosocial theory, transactional model of stress and coping &amp; psychophysiological stress adaptation theory may be used to anchor future studies on aerobic exercise on stress reduction. Health professionals should integrate aerobic exercise interventions into clinical practice as a primary or adjunctive treatment for stress management. Policymakers should prioritize the development and implementation of policies that support physical activity promotion and facilitate access to exercise facilities and resources.

Navigating the decision-making landscape of AI in risk finance: Techno-accountability unveiled.

The integration of artificial intelligence (AI) systems has ushered in a profound transformation. This conversion is marked by revolutionary extrapolative capabilities, a shift toward data-centric decision-making processes, and the enhancement of tools for managing risks. However, the adoption of these AI innovations has sparked controversy due to their unpredictable and opaque disposition. This study employs the transactional stress model to empirically investigate how six technological stressors (techno-stressors) impact both techno-eustress (positive stress) and techno-distress (negative stress) experienced by finance professionals and experts. To collect data for this research, an e-survey was distributed to a diverse group of 251 participants from various sources. The findings, particularly the identification and development of techno-accountability as a significant factor, contribute to the risk analysis domain by improving the failure mode and effect analysis framework to better fit the rapidly evolving landscape of AI-driven innovations.

Not all IT addictions are handled equally: guilt-vs shame-driven coping with IT addiction

PurposeWe build on the transactional model of stress and coping and the appraisal theory of emotions to theorize how users cognitively and emotionally cope with IT addiction-induced stress, distinguish between the roles of guilt and shame in shaping the coping responses and their effects on one’s psychological well-being.Design/methodology/approachWe test our theory via two complementary empirical studies in the context of social networking sites (SNS). Study 1 (n = 462) adopts a variable-centered approach using structural equation modeling to validate the research model. Study 2 (n = 409) uses Latent Profile Analysis to identify a typology of SNS users based on Study 1’s findings.FindingsThis paper provides a model of guilt-vs shame-driven cognitive-emotional coping with IT addiction and its effects on users’ psychological well-being. It also offers a typology of SNS users on this basis.Originality/valueThis paper sheds light on guilt-vs shame-driven coping with IT addiction and its consequences on users’ psychological well-being and identifies distinct classes of users based on their coping choices and their consequences.

Factors affecting caregiver burden among parents of children with cancer: A path analysis.

To investigate the relationships between parental resilience, illness perception and pain catastrophizing as factors affecting caregiver burden among parents of children with cancer, based on the Transactional Model of Stress and Coping. Parents, as the primary caregivers of children with cancer, often face universal challenges. These include adverse health impacts, work, financial disruptions, strained social and family relationships, and the need for specialised support and intervention. A cross-sectional design using path analysis. The STROBE guidelines for cross-sectional studies were followed. An online questionnaire was distributed through Facebook pages operated by various organisations that support parents of children with cancer, such as 'The Israel Cancer Association', 'Giving Hope' and 'Hayim Association' from October 2021 to February 2022. The participants completed a questionnaire about demographic and child-related characteristics, resilience, illness perception, pain catastrophizing, social support and caregiver burden. Associations between the variables were explored using Pearson's correlations and path analyses. The study included 67 parents of children with cancer with an average age of 41.79 (SD = 6.31). The majority were mothers (n = 54, 80.6%) with a steady partner (n = 62, 92.5%). The level of caregiver burden was M (SD) = 25.00 (7.15) out of 48 possible, indicating a high burden level. Illness perception was directly positively associated with caregiver burden (β = .280, p = .017) and pain catastrophizing (β = .340, p < .01), and directly negatively with resilience (β = -.318, p < .01). Illness perception and pain catastrophizing serially mediated the relationship between resilience and caregiver burden among parents of children with cancer (β = -.190, p = .001). This study found that both illness perception and pain catastrophizing serially mediated the relationship between personal resilience and caregiver burden. To ease caregiver burden for parents of children with cancer, programmes should address their psychological and emotional needs, including managing perceptions of illness and coping with pain-related distress.

Quality of Life in Caregivers of Alcohol Use Disorder Patients: Role of Family Functioning and Social Support

Background: Caring for alcohol use disorder (AUD) patients poses significant challenges, impacting caregivers’ quality of life (QOL) across all the dimensions. Following Lazarus and Folkman’s Transactional Model of Stress and Coping, family functioning (FF) and social support (SS) are crucial coping resources. Purpose: This study aims to explore how FF and SS relate to QOL in caregivers of individuals with AUD, recognising their pivotal role in navigating diverse caregiving-related stressors. Methods: A sample of 128 primary caregivers for AUD patients was collected from two psychiatric hospitals in Amritsar, Punjab. Data were collected using assessment tools, such as the World Health Organization Quality of Life Brief Version (WHOQOL–BREF), Family Assessment Device and PGI Social Support Questionnaire, and were analysed through the Pearson product moment correlation and multiple regression analysis. Results: FF ( r = –0.603) and SS ( r = 0.641) exhibited significant correlations with caregivers’ QOL. Multiple regression analysis confirmed that both FF (β = –0.345) and SS (β = 0.436) significantly predicted QOL among caregivers. Approximately 49% of the variance in QOL was explained by the linear combination of SS and FF. Conclusion: Developing tailored programs is essential to enhance caregivers’ physical, mental, social and environmental well-being. Healthcare professionals should recognise the intricate connections among these dimensions, crafting holistic approaches to nurture a supportive caregiving environment.

Retirement Preparedness: An Exploration of Coping Strategies and Psychological Resilience of Military Personnel Approaching Retirement

Military careers demand unwavering dedication and sacrifice, with retirement marking a significant transition to civilian life. This dissertation explores coping strategies, resilience, and retirement preparedness among Indian military personnel nearing retirement. Drawing on the Transactional Model of Stress and Coping, it examines how stressors, coping, and adaptation intersect during retirement. A literature review underscores the challenges of military retirement and the importance of coping and resilience. Using a quantitative approach, the study assesses coping and resilience in military personnel aged 40 to 60 approaching retirement. Findings reveal insights into coping strategies, resilience levels, and retirement readiness, informing policies and interventions to support military retirees. This research advances understanding of the transition from military to civilian life, addressing the unique needs of retiring military personnel.

Exploring eustress and fear: A new perspective on protection motivation in information security policy compliance within the financial sector

Information security policy (ISP) compliance has emerged as a significant challenge for contemporary businesses. This underscores the crucial role of employing fear appeals to encourage employee compliance with ISP. However, the existing literature is rife with mixed and inconsistent findings regarding the influence of fear appeals on employees' intentions to comply with ISP. In an effort to address this inconsistency and delve into the mechanisms through which fear appeals impact ISP compliance, we expanded the Protection Motivation Theory by incorporating the Transactional Model of Stress and Coping. Notably, we introduced a positive emotion, eustress, into the mediating mechanism alongside fear. Our hypothesis posited that fear appeals not only generate fear but also evoke eustress, subsequently positively influencing ISP compliance. We conducted a study among financial sector employees and validated our hypothesis using structural equation modeling techniques. Our primary theoretical contributions include highlighting the critical role of eustress in enhancing ISP compliance and proposing a parallel mechanism through which fear appeals impact ISP compliance. From a practical standpoint, we demonstrate that eustress plays a more significant role in motivating employees to comply with ISP. Furthermore, we provide insights into how organizations can design fear appeal messages by incorporating the concept of eustress, thereby optimizing their effectiveness in promoting ISP compliance.

Exploring the relationship between coping styles and well-being among Chinese university students: A longitudinal study based on the transactional stress model.

In the context of the COVID-19 pandemic, university students were exposed to increased stress, which significantly affected their well-being. This study examines the coping mechanisms employed by Chinese university students during this crisis, with a particular focus on the potential protective role of coping flexibility in maintaining their well-being. Using the transactional stress model and the dual-process theory of coping flexibility, this longitudinal study analyzed the responses of 206 Chinese university students at three measurement points in late 2022. The findings suggest that disruptions in daily life during the pandemic likely led students to engage in problematic internet use as a coping strategy, which subsequently led to reduced well-being. However, the study also shows that coping flexibility plays a crucial protective role in maintaining students' well-being. These findings highlight the urgent need for targeted interventions aimed at enhancing coping flexibility among university students, especially in the evolving post-pandemic landscape.

From the bar to the cowshed: the impact of COVID-19 on female sex workers in Pattaya, Thailand

The COVID-19 pandemic had a devastating impact on the health and wellbeing of populations around the world, with vulnerable groups, including sex workers, being disproportionately affected. This study explored the effects of COVID-19 lockdown restrictions on the lives of female sex workers in Pattaya, Thailand. In-depth interviews with ten women were used to explore the ways in which they sought to cope during the crisis using Lazarus and Folkman’s transactional model of stress and coping. Findings suggest that those who could, tended to seek economic shelter with their parents in rural parts of the country during the pandemic. However, those who could not relocate to be with family were forced to try to eke out a living in other ways, which could be both challenging and dangerous. None reported receiving any financial support from national or local authorities, to whom they were invisible, and this placed tremendous pressure on both them and their families. The authors conclude that the pandemic further highlights the need for the Thai Government to accept the reality of sex work and seek to both legitimise and protect vulnerable women and their labour.

Fostering the digital mindset to mitigate technostress: an empirical study of empowering individuals for using digital technologies

PurposeTechnostress reduces employees' work performance and increases their turnover intentions, such that technostress harms organizations' success. This paper investigates how the digital mindset of employees, reflecting their cognitive filter while using digital technologies, influences reactions to techno-stressors.Design/methodology/approachIn this quantitative study, the authors conducted a survey among 151 employees who regularly use digital technologies and encounter various techno-stressors in their daily work. To build this research model and evaluate the influence of employees’ digital mindset on technostress, the authors followed arguments from the transactional model of stress. The authors evaluated our research model using the covariance-based structural equation model.FindingsThe study findings reveal that employees’ digital mindset influences technostress. Employees with high levels of digital mindset react with less adverse effects on perceived techno-stressors. Further, the authors find that employees with high levels of digital mindset perform well and are satisfied with their job. The authors contribute to technostress research by revealing that digital mindset buffers the adverse effects of techno-stressors. The authors also contribute to research on digital mindset by showing that it influences psychological and behavioral reactions to techno-stressors.Originality/valueThis study develops and empirically tests an integrated model of technostress to explain how digital mindset mitigates technostress. The study findings outline relevant research avenues for studies investigating employees’ characteristics and technostress.

The Costs of Coping: Long-Term Mortality Risk in Aging Men.

Prospective associations between coping and all-cause mortality risk are understudied, particularly among nonmedical samples. We assessed independent and joint associations of multiple components of the transactional stress and coping model with all-cause mortality in a cohort of community-dwelling men. We were particularly interested in how coping effort related to mortality. Participants included 743 men from the Veterans Affairs Normative Aging Study who completed 1+ stress and coping assessment in 1993-2002 (baseline age: M = 68.4, standard deviation [SD] = 7.1) and had mortality follow-up through 2020. The Brief California Coping Inventory assessed coping with a past-month stressor. Cox regression evaluated associations of problem stressfulness, coping strategies, total coping effort, and coping efficiency with all-cause mortality risk. Over a mean follow-up of 16.7 years (SD = 7.1), 473 (64%) men died. Problem stressfulness was not associated with mortality risk (hazard ratio [HR]: 1.07, 95% confidence interval [CI]: 0.98-1.17), adjusted for demographics and health conditions. When examining coping via specific strategies, only social coping was associated with higher mortality risk (HR: 1.15, 95% CI: 1.05-1.26) after Bonferroni correction. Total coping effort was associated with 14% greater risk of all-cause mortality (95% CI: 1.04-1.26), independent of problem stressfulness, demographics, and health conditions. Coping efficiency, a benefit-cost ratio of coping efficacy to total coping effort, was not associated with mortality risk in adjusted models. Total coping effort may be an important indicator for longevity among aging men, above and beyond problem stressfulness and specific coping strategies, which have been the foci in prior research.