The Dark Side Effect of Entrepreneurial Resilience Diversity on Pivoting: The Role of Team Reflexivity.

Resilience is widely recognized as a form of psychological capital that helps entrepreneurs cope with challenges in the face of adversity by actively adjusting business strategies. Prior research has investigated the effect of resilience on pivoting, which is an important entrepreneurial decision to forgo the original business opportunity and exploit new opportunities. Despite the increasing empirical evidence on the effect of resilience on strategic changes and the pivot, the literature may have overstated the benefits of entrepreneurial resilience while neglecting its potential dark sides. Hence, the current study focuses on the structure of resilience within an entrepreneurial team and introduces the concept of resilience diversity. Drawing from sensemaking theory, we develop a research framework that investigates the dark-side effects of resilience diversity on team reflexivity and pivoting and the moderating effect of environmental hostility. Empirical results from a two-wave survey of 112 entrepreneurial teams in China reveal that resilience diversity negatively affects pivoting by impairing the quality of team reflexivity. Moreover, the mediating effect of team reflexivity is strengthened in hostile environments. These findings contribute to the literature on entrepreneurial resilience, pivot, and team reflexivity, and provide important practical implications for entrepreneurial teams.

Altered structural networks in neuromyelitis optica spectrum disorder related with cognition impairment and clinical features.

OBJECTIVE: To investigate the topological properties alterations of white matter (WM) network in neuromyelitis optica spectrum disorder (NMOSD) patients and its correlation with clinical and cognitive performance. METHODS: Forty-eight NMOSD patients and fifty healthy controls (HC) underwent DTI and 3D-T1 scan on a 3.0 T MRI and clinical data and cognitive scales were collected. Structural networks were constructed and analyzed by using graph theory. The network metrics between-group comparisons were examined by using GRETNA. Differences in network parameters between two groups and grouped patients according to disease duration (DD) were compared to examine the impact of DD on WM network. The relationships between the network characteristics and clinical data and cognitive performances were also analyzed by partial correlation analysis. RESULTS: The NMOSD patients exhibited decreased global and local network efficiency and increased characteristic path length, which were pronounced more in long DD patients. Furthermore, altered nodal efficiencies were observed in several brain regions, which were mainly distributed in default mode and visual systems. The Expanded Disability Status Scale was positively related to nodal shortest path. NMOSD patients showed decreased cognitive performance in attention, short-term memory and verbal memory, which were associated with significantly decreased degree centrality, nodal efficiency and increased nodal shortest path of several brain regions (all p<0.05). CONCLUSIONS: This study illustrated the relationship between WM disruption and cognitive impairment in NMOSD patients, which advance the understanding of disrupted WM networks and provide insight into subtle WM pathology to cognitive impairment in NMOSD.

Functional connectivity impairment of postcentral gyrus in relapsing-remitting multiple sclerosis with somatosensory disorder.

PURPOSE: To characterize the spatial patterns of functional connectivity(FC) changes of whole brain in RRMS with somatosensory disorder(RRMS-SS) and to investigate the correlation between abnormal FC and clinical scores. METHODS: Twenty-six RRMS-SS patients and 23 healthy controls(HC) underwent resting-state functional magnetic resonance imaging(RS-fMRI) scanning. The clinical scores were collected including Expanded Disability Status Scores(EDSS), Disease Duration and Somatosensory Evaluation by the Fugl-Meyer sensory score(FMSS). With the voxel-wise methods, RS-fMRI data were analyzed using REST software, to assess the FC of the postcentral gyrus(PoCG). Correlation between clinical variables and the strength of FC was analyzed. RESULTS: Compared with HC, the left postcentral-based FC showed decreased FC of the right cerebellum_8, lingual lobe and Rolandic operculum gyrus, and increased FC of the left middle frontal lobe. The right postcentral-based FC revealed decreased FC with the right Heschl's gyrus lobule, and increased FC with bilateral middle frontal lobe (p <  0.001, AlphaSim corrected). Correlation analysis revealed that the FC of altered brain regions was associated with FMSS, EDSS and disease duration. CONCLUSION: The functional connectivity of PoCG at RS-fMRI has multi-network changes in patients with RRMS-SS. This suggests a complex pattern of abnormal connections between the somatosensory network regions and the whole brain. Moreover, the correlation between the FC and the FMSS, such as the left middle frontal lobe and the right PoCG, indicate that these two brain regions play an important role in RRMS-SS.

Altered volume and microstructural integrity of hippocampus in NMOSD.

OBJECTIVE: To assess whole and subfield volume and microstructural integrity of the hippocampus in patients with neuromyelitis optical spectrum disorder (NMOSD), and whether these alterations are correlated with expanded disability status scale (EDSS), anxiety score and depression score. METHODS: The volume of the hippocampus and twelve hippocampal subfields, together with fractional anisotropy (FA) and mean diffusivity (MD) were measured in thirty patients with NMOSD and twenty-six healthy controls. EDSS score, anxiety score and depression score were measured in all participants. The relationships between whole hippocampal volume, subfield volume, hippocampal microstructural integrity and clinical and behavioral test scores were investigated. RESULTS: Significantly decreased total volume, decreased FA and increased MD were observed in the hippocampus bilaterally in NMOSD. The reductions in left presubiculum, subiculum, CA1, CA4, GC-DG, molecular layer and right presubiculum (p < .004) remained significant after Bonferroni correction. Hippocampal volume reductions, FA reductions and MD increases were correlated with anxiety and depression scores. CONCLUSIONS: This study reveals that patients with NMOSD have decreased volume and altered microstructural integrity of the hippocampus. Furthermore, certain of these alterations are correlated with severity of anxiety and depression. Further investigation of these findings may provide insight to improve clinical management and treatment of NMOSD patients with mood disorders.

Optic radiations are thinner and show signs of iron deposition in patients with long-standing remitting-relapsing multiple sclerosis: an enhanced T2*-weighted angiography imaging study.

OBJECTIVE: This study aimed to investigate iron deposition and thickness and signal changes in optic radiation (OR) by enhanced T2*-weighted angiography imaging (ESWAN) in patients with relapsing-remitting multiple sclerosis (RRMS) with unilateral and bilateral lesions or no lesions. METHODS: Fifty-one RRMS patients (42 patients with a disease duration [DD] ≥ 2 years [group Mor], nine patients with a DD < 2 years [group Les]) and 51 healthy controls (group Con) underwent conventional magnetic resonance imaging (MRI) and ESWAN at 3.0 T. The mean phase value (MPV) of the OR was measured on the phase image, and thickness and signal changes of the OR were observed on the magnitude image. RESULTS: The average MPVs for the OR were 1,981.55 ± 7.75 in group Mor, 1,998.45 ± 2.01 in group Les, and 2,000.48 ± 5.53 in group Con. In group Mor, 28 patients with bilateral OR lesions showed bilateral OR thinning with a heterogeneous signal, and 14 patients with unilateral OR lesions showed ipsilateral OR thinning with a heterogeneous signal. In the remaining nine patients without OR lesions and in group Con, the bilateral OR had a normal appearance. In the patients, a negative correlation was found between DD and OR thickness and a positive correlation was found between MPV and OR thickness. CONCLUSIONS: We confirmed iron deposition in the OR in the RRMS patients, and the OR thickness was lower in the patients than in the controls. KEY POINTS: • Enhanced T 2* -weighted magnetic resonance angiography (ESWAN) provides new insights into multiple sclerosis (MS). • Focal destruction of the optic radiation (OR) is detectable by ESWAN. • Iron deposition in OR can be measured on ESWAN phase image in MS patients. • OR thickness was lower in the patients than in the controls. • Iron deposition and thickness changes of the OR are associated with disease duration.

Work-family conflict and burnout among Chinese female nurses: the mediating effect of psychological capital.

BACKGROUND: Burnout among nurses not only threatens their own health, but also that of their patients. Exploring risk factors of nurse' burnout is important to improve nurses' health and to increase the quality of health care services. This study aims to explore the relationship between work-family conflict and burnout among Chinese female nurses and the mediating role of psychological capital in this relationship. METHODS: This cross-sectional study was performed during the period of September and October 2010. A questionnaire that consisted of the Maslach Burnout Inventory-General Survey (MBI-GS), the work-family conflict scale and the psychological capital questionnaire (PCQ-24) scale, as well as demographic and working factors, was distributed to nurses in Liaoning province, China. A total of 1,332 individuals (effective response rate: 78.35%) became our subjects. Hierarchical linear regression analyses were performed to explore the mediating role of psychological capital. RESULTS: Both work interfering family conflict and family interfering work conflict were positively related with emotional exhaustion and cynicism. However, work interfering family conflict was positively related with professional efficacy whereas family interfering work conflict was negatively related with it. Psychological capital partially mediated the relationship of work interfering family conflict with emotional exhaustion and cynicism; and partially mediated the relationship of family interfering work conflict with emotional exhaustion, cynicism and professional efficacy. CONCLUSION: Work-family conflict had effects on burnout and psychological capital was a mediator in this relationship among Chinese nurses. Psychological capital was a positive resource for fighting against nurses' burnout.

The mediating role of psychological capital on the association between occupational stress and depressive symptoms among Chinese physicians: a cross-sectional study.

BACKGROUND: Although occupational stress is an identified predictor of depressive symptoms, the mechanism behind the association is not well understood. The purpose of this study was to examine how psychological capital (PsyCap), a positive psychological state, mediates the association between occupational stress and depressive symptoms among Chinese physicians. METHODS: A cross-sectional survey was conducted in Liaoning Province, China, during September-October 2010. Self-administered questionnaires including items on depressive symptoms assessed by the Center for Epidemiologic Studies Depression Scale, occupational stress assessed by the effort-reward imbalance scale and PsyCap estimated by a 24-item Psychological Capital Questionnaire, together with age, gender, marital status and education were distributed to 1300 physicians employed in large general hospitals. The final sample consisted of 998 participants. Asymptotic and resampling strategies were used to examine how PsyCap mediates the association between occupational stress and depressive symptoms. RESULTS: Both the effort/reward ratio (ERR) and overcommitment were significantly associated with depressive symptoms among male and female physicians. There was a gender difference in the mediating role of PsyCap on the occupational stress-depressive symptoms association. For male physicians, PsyCap did not mediate the association between occupational stress and depressive symptoms. For female physicians, ERR and overcommitment were negatively associated with PsyCap, and PsyCap was negatively associated with depressive symptoms. As a result, PsyCap significantly mediated the associations of ERR and overcommitment with depressive symptoms. The proportion of PsyCap mediation was 19.07% for ERR, and 24.29% for overcommitment. CONCLUSIONS: PsyCap could be a positive resource for combating depressive symptoms in Chinese physicians. In addition to reducing occupational stress, PsyCap development should be included in depression prevention and treatment strategies, especially for female physicians.

Epidemiological study on risk factors for anxiety disorder among Chinese doctors.

OBJECTIVES: Anxiety disorders are the most prevalent mental health problem. However, few studies are available pertaining to this problem among Chinese doctors, a special occupational population exposed to high stress, especially during the implementation of health system reform. The aim of this study was to assess anxiety disorder among Chinese doctors and clarify its risk factors. METHODS: A cross-sectional study was conducted in 7 teaching hospitals of China Medical University. Questionnaires pertaining to anxiety disorder indicated by the Zung Self-Rating Anxiety Scale (SAS) and demographic characteristics, health status, lifestyle factors, work conditions and work-related psychological status were distributed to all registered doctors during April-June 2009. There were 1,134 effective respondents (effective response rate 71.2%), and these respondents became our subjects (539 male doctors and 595 female doctors). RESULTS: The average standard scores of SAS for the male and female doctors were 46.8 and 46.7. General linear model analysis indicated that SAS was associated with, in standardized estimate (ß) sequence, cynicism, emotional exhaustion, professional efficacy, sleeping problem, chronic diseases and physical exercise in men and with professional efficacy, emotional exhaustion, cynicism, sleeping problem, chronic diseases, job satisfaction, alcohol consumption and meals in women. Work-related psychological status contributed the most to the model R-square. CONCLUSION: Chinese doctors were at considerably high risk of anxiety disorder and job burnout and sleeping problem had prominent roles. Interventions such as preventing exhaustion at work and improving sleep quality should be given attention during health care system reform with the aim of lessening anxiety disorder in doctors in China.

Factors associated with job satisfaction among Chinese community health workers: a cross-sectional study.

BACKGROUND: With the medical reform, the function of community health centres emerged to be more important recently in China. However, the health service capabilities were tremendously different between metropolitan cities and small cities. This study aims to clarify the level of job satisfaction of Chinese community health workers between a metropolitan (Shenyang) and a small city (Benxi) in Liaoning province and explore its associated factors. METHODS: A cross-sectional survey was conducted from December 2009 to February 2010. A multi-stage sample was used and a total of 2,100 Chinese community health workers from the two cities completed self-administered questionnaire pertaining to job satisfaction indicated by Minnesota Satisfaction Questionnaire (MSQ), demographic characteristic and working situations, stress and job burnout. The effective response rate was 80.7%. Hierarchical regression analysis was performed to explore the related factors. All data analyses for the two cities were performed separately. RESULTS: The averages of overall job satisfaction score of Chinese community health workers were 67.17 in Shenyang and 69.95 in Benxi. Intrinsic job satisfaction and extrinsic job satisfaction among Chinese community health workers were significantly different between Shenyang and Benxi (p < 0.05). In Shenyang, hierarchical regression analysis showed that the fourth model explained 36%, 32% of the variance of intrinsic and extrinsic job satisfactions, respectively. In Benxi, the fourth model explained 48%, 52% of the variance of intrinsic and extrinsic job satisfactions, respectively. Three significant predictors of intrinsic and extrinsic job satisfactions for the two cities were the two dimensions (social support and decision latitude) of stress and cynicism of burnout. CONCLUSION: From this study, the job satisfaction among Chinese community health workers in the two cities enjoyed a moderate level of job satisfactions, which represented they are not fully satisfied with their jobs. Community health workers in Shenyang had lower job satisfaction as compared to those in Benxi. This study strengthened the evidence that stress and burnout were important predictors of intrinsic and extrinsic job satisfactions.

Reliability and validity of the Chinese version of the Caregiver Reaction Assessment.

AIMS: The aim of this study was to examine the reliability and validity of the Chinese version of the Caregiver Reaction Assessment, as part of a psychosocial study among family caregivers of cancer patients. METHODS: Participants were derived from the Second Affiliated Hospital of China Medical University in Shenyang, China. The research established the internal consistent reliability, test-retest reliability and construct validity. RESULTS: The research comprised 400 family caregivers. The Chinese version of the Caregiver Reaction Assessment showed adequate internal consistency reliability, test-retest reliability and appropriate construct validity. After adjusting items 4, 8, 15 and 18, confirmatory factor analysis confirmed the five new factors of the Chinese version of the Caregiver Reaction Assessment had goodness of fit. CONCLUSIONS: These findings suggest that the Chinese version of the Caregiver Reaction Assessment is a reliable and valid instrument for measuring specific aspects of the caregiving experience in the Chinese population.