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Breast cancer is a global public health dilemma and the most prevalent cancer in the world. Effective treatment plans improve patient survival rates and well-being. The five-year survival rate is often used to develop treatment selection and survival prediction models. However, unlike other types of cancer, breast cancer patients can have long survival rates. Therefore, the authors propose a novel two-level framework to provide clinical decision support for treatment selection contingent on survival prediction.

The first level classifies patients into different survival periods using machine learning algorithms. The second level has two models with different survival rates (five-year and ten-year). Thus, based on the classification results of the first level, the authors employed Bayesian networks (BNs) to infer the effect of treatment on survival in the second level.

The authors validated the proposed approach with electronic health record data from the TriNetX Research Network. For the first level, the authors obtained 85% accuracy in survival classification. For the second level, the authors found that the topology of BNs using Causal Minimum Message Length had the highest accuracy and area under the ROC curve for both models. Notably, treatment selection substantially impacted survival rates, implying the two-level approach better aided clinical decision support on treatment selection.

The authors have developed a reference tool for medical practitioners that supports treatment decisions and patient education to identify patient treatment preferences and to enhance patient healthcare.

This study is an analysis that aims to understand the rationale behind the concept of value creation contained in the integrated reporting (IR) framework. As such, the authors examined the quality of the disclosures made in integrated reports by measuring the level to which the six capitals (6Cs) have been integrated into disclosures on value creation.

The IR framework’s value creation model focuses on six content elements and three guiding principles. Hence, the present analysis combines content analysis with quantitative measures in the form of a bespoke Integrated Disclosure Index. The index measures the level of integration found in the disclosures instead of the mere presence or absence of mentioned capitals, content elements and guiding principles in isolation. The present sample comprised the 2016 integrated/sustainability reports for 184 listed companies sourced from the Integrated Reporting Examples Database.

The 6Cs are well disclosed in form but only partially disclosed in substance. Further, overall levels of integration between the capitals, the content elements and the guiding principles are higher than average. Disclosures on materiality, business models and stakeholder relationships are somewhat lacking, as are the related medium- and long-term disclosures on outlook.

The paper contributes to the academic debate on IR by building a case for holistically assessing the substance of integrated reports. Considering that the IR value creation model can underpin and align with the 17 UN sustainable development goals, the authors show how the fundamental concept of the 6Cs sustaining value creation is understood and implemented differently across the various elements and principles of the IR framework.

This research also provides guidance for overcoming some of the practical hurdles associated with assessing the quality of reports because the authors provide tools for spotlighting the substance of disclosures over their form.

This paper delves into the substance of integrated reports by assessing how well the 6Cs have been integrated into disclosures on the content elements and guiding principles of the IR framework. In contrast to previous IR research that has mainly analysed capital, elements and principles in isolation, the authors develop an index assessing the integration of these three fundamental concepts of IR.

Family businesses do not perpetuate themselves. Entrepreneurs must nurture and propagate the values that led to the creation of the very thing most precious to them‐their business.This of course depends on stability. Nor do these cherished values propagate themselves. To be made meaningful for others, and for future generations, family experiences, values, and achievements must be communicated to others via language, narrative and storytelling, or other forms embedded in the narrative such as symbols. Often a variety of different socially constructed stories may be necessary contingent upon situation, purpose, or need.

Despite agreement on the importance of adopting governance structures for developing competitive advantage, we still know little about why or how governance mechanisms are adopted in the first place. We also acknowledge that family businesses with formal governance mechanisms in place still resort to informal means to make decisions, and we lack knowledge about why certain governance mechanisms are sometimes, but not always, effective and functional. Given these research gaps, and drawing on institutional theory, we aim to explore: How are governance structures adopted and developed in family firms? Once adopted, how do family businesses perceive these governance structures?

Using Mokken Scale Analysis, a method suitable to uncover patterns/sequences of adoption/acquisition over time, we analyze a dataset of 1,488 Spanish family firms to explore if there is a specific pattern in the implementation of governance structures. We complement the analysis with descriptive data about perceived usefulness of such structures.

Our findings highlight two important issues. Family businesses follow a specific process implementing first business governance (board of directors, then executive committee), followed by family governance (family council then family constitution). We suggest they do so in response to institutional pressures, given the exposure they have to business practices, and their need to appear legitimate. Despite formal adoption of governance structures, family businesses do not necessarily consider them useful. We suggest that their perception about the usefulness of the implemented governance structures may lead to their ceremonial adoption, resulting in a gap between the implementation and functionality of such structures.

Our article contributes to the family business literature by bringing novel insights about implementation of governance structures. We take a step back to explain why these governance mechanisms were adopted in the first place. Using institutional theory we enrich governance and family business literatures, by offering a lens that explains why family businesses follow a specific process in adopting governance structures. We also offer a plausible explanation as to why governance structures are ineffective in achieving their theorized role in the context of family businesses, based on the family's perception of the unusefulness of such structures, and the concept of ceremonial adoption.

There is no single recipe that can serve the multiple needs of different family businesses. This indicates that family businesses may need diverse levels of development and order when setting up their governance structures. Accordingly, this study constitutes an important point of demarcation for practitioners interested in examining the effectiveness of governance structures in family firms. We show that an important pre-requisite for examining the effectiveness of governance structures is to start by investigating whether these structures are actually being used or are only adopted ceremonially.

Our paper expands current knowledge on governance in family firms by taking a step back hinting at why are governance structures adopted in the first place. Focusing on how governance is implemented in terms of sequence is novel and relevant for researcher and practitioners to understand how this process unfolds. Our study uses institutional theory, which is a strong theory to support the results. Our paper also uses a novel method to study governance structures in family firms.

Needs change as people get older. Procuring resources to satisfy them can generate anguish and insecurities in consumers due to their financial situation. This study aims to analyze the relationship between age and financial stress among Mexican adults and estimate the age of their maximum financial stress.

This study is based on constructing a financial stress indicator using the confirmatory factor analysis and linear regression models with a quadratic term, employing data from the National Survey on Financial Inclusion 2021.

Results show that the relationship between age and financial stress follows a quadratic pattern, with a maximum level at age 56, which varies according to sex, marital status, number of dependents, education and regions. These findings interest financial product designers and policy developers who aim to improve consumers' well-being.

Longitudinal studies and indicators, such as financial fragility, are needed to facilitate refining models over time.

There is no evidence of studies that have addressed the age of maximum financial stress in Latin America. Doing so is relevant because identifying the stages in life when adults are most vulnerable to financial stress helps assess its causes more precisely, thus mitigating its adverse effects.