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This study sheds light on the contingent effect that employee human capital may have on the relationship between family involvement and internationalisation via exporting —both in terms of entry mode (how to export) and degree (how much to export). We formulate several hypotheses by drawing mainly on arguments from the resource-based view and stewardship theory. The empirical setting is a large sample of Spanish manufacturing firms (family and non-family) operating between 1991 and 2016. Our results reveal that the positive (negative) relationship between family involvement and export intensity (direct exporting) is boosted (mitigated) at higher levels of employee human capital. Our findings thus provide statistical support for a positive and significant contingent approach to the effect human capital has on the connection between family involvement and internationalisation.

Many older patients with cancer depend on their family members for care and support and involve their family members in treatment decision-making in different stages of the cancer trajectory. Although family involvement is advocated in person-centered care, little is known about family involvement in decision-making specifically for older patients, and evidence-based strategies are scarce. The aim of this scoping review is to provide deeper understanding of factors influencing family involvement in treatment decision-making for older patients with cancer. Four databases were searched for quantitative-, qualitative- and mixed-method empirical studies describing factors influencing family involvement in treatment decision-making for older patients with cancer: PubMed, EMBASE, CINAHL and PsycINFO. Three independent researchers reviewed the papers for eligibility and quality and contributed to the data extraction and analysis. Twenty-seven papers were included, sixteen quantitative studies, nine qualitative studies and two mixed-method studies. Five categories of factors influencing family involvement emerged: 1) patient characteristics, 2) family member characteristics, 3) family system characteristics, 4) physician’s role and 5) cultural influences. These factors affect the level of family control in decision-making, treatment choice, decision agreement, and levels of stress and coping strategies of patients and family members. This review reveals a complex interplay of factors influencing family involvement in treatment decision-making for older patients with cancer that is rooted in characteristics of the family system. The findings underscore the need for development and implementation of evidence-based strategies for family involvement in treatment decision-making as part of patient-centered care for older patients with cancer.

Controlling families of family firms strive to preserve their socioemotional wealth (SEW) through family involvement in company leadership. Prior research points to a potential trade-off of family ...

This paper examines the impact of family ownership, management, and generations on IPO underpricing and the long-run performance of publicly listed firms in Indonesia from 2004 to 2015. This study is based on agency theory, which discusses the relationship between shareholders and management, as well as controlling and non-controlling shareholders. Study results show that IPO underpricing was 28% higher for family firms than non-family firms. Among family firms, a family member’s presence as a Chief Executive Officer (CEO) significantly reduced the level of IPO underpricing. A negative relationship between family CEO and IPO underpricing was only observed if a CEO at the time of IPO was the founder instead of family descendants. A long-run return of family-firm IPOs was more likely to underperform their non-family-firm counterparts. The findings in the primary market suggest that investors predict bigger issues of agency conflicts between controlling and non-controlling shareholders in family firms than the issues of agency conflicts between shareholders and management in non-family firms. Since investors consider family-firm IPOs to be riskier than non-family firms, they demand a higher level of IPO underpricing to compensate for such risks. The results in the secondary market confirm the findings in the primary market.

Although corporate social responsibility (CSR) has attracted increasing attention in recent years, systematic studies on the CSR of Chinese enterprises are absent from academic publications. This study examines the effects of family involvement in the CSR of private enterprises. Using private enterprise data in China, the article reveals that, on the one hand, family involvement will improve CSR investment toward community stakeholders; on the other hand, family involvement has a negative effect on the CSR of contractual stakeholders. With the influence of “chaxu geju,” the author argues that Chinese families tend to shift between different logics of behavior when faced with people with whom they have different types of relationships and incorporate this behavioral mode into company practices when they engage themselves in management and business affairs.

Based on the socioemotional wealth approach and a sample of 3,904 subsidiary ownership choices made by 586 family firms, this study shows that family-managed firms (i.e., those family firms with a family member in a leadership position) prefer wholly owned subsidies over joint ventures when entering foreign markets. Family-managed firms are also more likely to revise their subsidiary ownership choices and form joint ventures when in vulnerability conditions, that is, when they experience performance below aspirations and when entering a culturally distant market.

This paper re-examines the factors influencing debt-financing decisions in family firms, considering the importance of socioemotional wealth and heterogeneity issues. In particular, we explore the board of directors and generational stage as key explicative factors of heterogeneity in family businesses. Focusing on a large sample of Spanish family firms, we estimate a partial least squares model, whose results show that the higher the level of family involvement on the board of directors and the lower the generational stage, the higher the debt level of the family firm. Consequently, in addition to traditional determinants of the level of debt, the above variables should be considered to better understand the heterogeneous debt-financing decisions of family firms, and this has practical implications for them and their internal and external relationships.

The current health system must be revolutionized to meet the specific and real requirements of the largest population attended, older adults, and tailor the hospital to their needs, not the other way round. This is the goal of Hospital Universitario Infanta Leonor: senior-friendly hospital. The project was established as a business process management system integrated into the management's hospital map. Four subprocesses were defined, as were all activities and tasks to be performed. The subprocesses are health care (delirium and functional decline prevention and the identification of frail older patients), training, the environment and its structures, and patient and family involvement. The leadership corresponds to the geriatricians who coordinate a multidisciplinary team of the project's referents. Actions must be scientific, evidence-based, rigorous, and evaluable, and they should be audited. The final aim is to change established mentalities, routines, and habits to convert the hospital to a friendlier place for older adults.

This study investigated whether an intensive group-based cognitive-behavioral therapy program with family involvement for children with anxiety disorders and obsessive-compulsive disorder could help reduce parental distress by addressing the larger family system. This study also examined associations between parental distress and parent-reported child outcomes of treatment. Two hundred ninety-nine children and adolescents, ages 6–19, who were patients in the intensive treatment program and their caregivers participated in this intervention-based study. Parents reported significant reductions in their own distress from admission to discharge, and greater reductions in parent-reported distress predicted greater reductions in parents’ reports of their children’s anxiety symptoms and the degree of child functional impairment. Higher levels of parent-reported parent mental health symptoms at children’s admission and at discharge were associated with poorer levels of functioning in children at discharge. Parents’ mental health symptoms may play a critical role in children and adolescents’ treatment outcomes and therefore may need to be a separate treatment target.

This paper explores whether family and non‐family firms differ in terms of their capability to introduce green patenting. By considering the environmental performance as a corporate social responsibility related concern, the analysis is based on a large data set of patenting activities carried out by Italian manufacturing firms over the period 2009–2017. Results show that family firms are less likely than non‐family firms to implement innovations in green technologies. This holds true whatever the level of accumulation in green and non‐green knowledge.

Caring for LBW babies at home is must be intensively. One of the methods used is Kangaroo Mother Care (KMC) by providing warmth to LBW babies. Family involvement in the care of LBW babies is a very important. This community service aims to optimize the support of family in the care of LBW babies. Team members conducted this activity in Februari-Mei 2020 with the home visit & counseling method. Participants in this activity were 25 mothers who gave birth to LBW babies and who live in Malang Raya. Data Collection used questionnaires. The result of this activity, the majority of family support in the care of LBW babies was in good category (76%). In conclusion, family support plays an important role in the sustainability of the implementation of KMC at home.

Purpose Drawing on the resource-based view, this study aims to examine how family involvement in migrant-founded small businesses gives rise to distinctive resources that help these businesses survive. Design/methodology/approach Using microdata from the 2007 US survey of business owners (SBO), this study uses logit regression modeling to test the hypothesized relationships. Findings Results show that small businesses founded by migrant entrepreneurs are less likely to survive and that family involvement weakens the negative relationship between founder migrant status and business survivability. In addition, the positive moderating effect associated with family involvement is further strengthened by the use of external/borrowing startup capital, thus migrant families founded small businesses with access to external capital have the highest probability of survival. Originality/value This study contributes to the literature on both migrant entrepreneurship and family business. This paper finds family involvement in the business, interacting with the founder’s migrant status, tends to create distinctive resource endowments that help to compensate for the resource constraints associated with migrant entrepreneurs. Such resource endowments may take the form of high levels of solidarity among migrant family members and the spanning role of the migrant kinship networks extended from the country of origin to the country of residence.

Purpose Providing an overview of studies on family participation in physiotherapy-related tasks of critically ill patients, addressing two research questions (RQ): 1) What are the perceptions of patients, relatives, and staff about family participation in physiotherapy-related tasks? and 2) What are the effects of interventions of family participation in physiotherapy-related tasks? Material and methods Qualitative, quantitative and mixed-methods articles were identified using PubMed, Embase and CINAHL. Studies reporting on family participation in physiotherapy-related tasks of adult critically ill patients were included. A convergent segregated approach for mixed-methods reviews was used. Results Eighteen articles were included; 13 for RQ1, and 5 for RQ2. The included studies were quantitative, qualitative and mixed-method, including between 8 and 452 participants. The descriptive studies exhibit a general appreciation for involvement of relatives in physiotherapy-related tasks, although most of the studies reported on family involvement in general care and incorporated diverse physiotherapy-related tasks. One study explored the effectiveness of family participation on a rehabilitation outcome and showed that the percentage of patients mobilizing three times a day increased. Conclusion Positive attitudes were observed among patients, their relatives and staff towards family participation in physiotherapy-related tasks of critically ill patients. However, limited research has been done into the effect of interventions containing family participation in physiotherapy-related tasks.

This paper analyzes the relationship between family involvement and a firm’s growth. Family businesses present unique features, which make them different from other companies. Therefore, their desire to achieve long-term growth and/or survival could be motivated by different reasons from those of non-family firms. One of the possible strategic alternatives to guarantee these long-term objectives is the internationalization strategy. The empirical study carried out is quantitative research based on the partial least squares (PLS) methodology. The study population comprises Spanish wine and olive oil production companies. Our results show how economic reasons account for the relationship between family involvement in the business and achievement of their growth. Likewise, we find that, depending on their international propensity as moderating variable, the mediation effect of the underlying business economic motivations is total for non-international firms, whereas that effect is a partial one if the firms have become international.

Family-centered care (FCC) improves the quality and safety of health care provision, reduces cost, and improves patient, family, and provider satisfaction. Despite several decades of advocacy, research, and evidence, there are still challenges in uptake and adoption of FCC practices in adult critical care. The objective of this study was to understand the supports and barriers to family-centered adult critical care (FcACC). A qualitative descriptive design was used to develop a taxonomy. Interviews and focus groups were conducted with 21 participants in Alberta, Canada, from 2013 to 2014. Analysis revealed two main domains of supports and barriers to FcACC: PEOPLE and STRUCTURES. These domains were further classified into concepts and subconcepts that captured all the reported data. Many factors at individual, group, and organizational levels influenced the enactment of FcACC. These included health care provider beliefs, influence of primary versus secondary tasks, perceptions of family work, nurses’ emotional labor, and organizational culture.

PurposeThis paper examines how differences in the family involvement in a family business can influence its level of indebtedness. Assuming the influence of family is not the same for all family firms, we consider each company as a combination of the family involvement in three dimensions of the business: ownership, management and governance structure.Design/methodology/approachUsing the partial least squares technique allows us to address the heterogeneity of family firms through an integral concept of family involvement in business that jointly considers the level of family participation in the ownership, management and governance structure of each firm.FindingsOur results demonstrate that the level of family involvement in a family firm, considering the heterogeneity existing within the family business group, directly influences its level of indebtedness. In addition, we find that family involvement in ownership and governance structures individually considered are positively related to the level of indebtedness of the family business.Originality/valueOur findings prove that some indebtedness patterns, which previous literature has described as common to all Spanish family businesses, may actually be valid only for specific family firms with a particular level of family involvement. In addition, the way of measuring family business heterogeneity through our integral concept of family involvement can be replicated by other authors because of the manageability of the items, thus contributing to an increased understanding of the effects of family involvement in firms' development.

Background: The Intensive care units acquired weakness detected in 30 to 50% of ICU patients leading to high morbidity and complication, family engaging family in early mobility process that reported benefits including reduced ICU-acquired weakness, improved functional recovery within the hospital, improved walking distance at hospital discharge and reduced hospital length of stay. This study aimed to Determine the effect of family involvement in patient care on preventing intensive care units acquired weakness. Methods: Quasi experimental research was conducted in surgical and general ICUs in the main Mansoura university and emergency hospitals, which included 60 adult newly ICU admitted patients. Tools: Three tools were used to collect the data of this study namely “Intensive care unit acquired weakness assessment”, “Early progressive mobility protocol” and “Patients’ family satisfaction with early mobility protocol involvement”. Results: Only 6.7% of the intervention group had a weakness at the end of the study with no significant difference (0.150) was found in muscle strength from the start and end of the study. While about a third of the control group (26.7%) had a weakness at the end of the study. A statistically significant difference (0.038) in muscle strength was found between intervention and control group. Furthermore, About two-thirds (70%) of patients' family members of the intervention group were satisfied by giving them a role in participation in their patient care. Conclusion: Critically ill patients whose families were involved in their mobility protocol had less intensive care units acquired weakness rates than those who were not. Recommendation: Evaluation of muscle strength should be a routine part of ICU examination. Family centered care concept should be adopted in ICUs by allocating them in daily activities involvement with enough support and cooperation

This study examines the influence of green creativity to the green new product performances. Creativity is a key source of organization’s competitive advantage (Barney, 1991) and increases the likelihood of new product success by providing effective product differentiation (Song, 2018). Building on the thesis of Natural Resource-based view (Hart, 1995), we study the impact of green creativity on the performances of green new products. This study also shows that family involvement plays a role in the green performances of family businesses. We pay particular attention to family firms because of two reasons. First, family businesses represent a significant proportion of the corporate sector in both developed and developing countries (Faccio and Lang 2002). Second, family firms have different behavioral patterns when reacting to stakeholders’ pressures (Huaang, Ding, and Kao, 2009; Sharma and Sharma, 2011) for better environmental management practices. This study surveyed 134 family-owned, high-tech manufacturers in Taiwan. The findings show that the green creativity is positively and significantly related to green new product performances. Our analytical results also show that family involvement moderates the relationship between green creativity and green new product performances.

Based on the data of Chinese listed family firms from 2008 to 2016, we investigate the impact of family involvement on firm innovation and the moderating effect of family member composition. The results show that increased family involvement significantly reduces R&D investment intensity and the number of patent applications. With the increased richness of the kinship of family members involved in management, the negative impact of family involvement on patent applications is weakened, but family member composition does not have a significant moderating effect on the relationship between family involvement and R&D investment intensity. Further analysis shows that the number of invention patent applications decreases as the degree of family involvement increases, but family involvement has no significant effect on utility model patent and design patent applications. Family member composition has a significant moderating effect on the relationship between family involvement and invention patent applications. The results have value as a reference for exploring how family involvement affects firm innovation and can also help the actual controller to take effective measures to optimize family member composition and improve the innovation performance of family firms.

This article provides a brief background on critical care nursing in the Philippines, its trend on current practice, and its implication and future direction. An overview is given on the milieu and processes inherent in the critical care unit with the intensive care unit setup taken as its exemplar. The roles and responsibilities of critical care nurses within these units and nature of common issues within their practice is explored. The need for training in communication skills, conflict resolution, and palliative care is implied for these nurses to fully fulfill their roles as collaborative clinician and active patient advocate.

This study investigated the effect of social interaction including activity participation, relationships with residents, and communication with family/relatives and friends at baseline on the behavioral and psychological symptoms of dementia (BPSD) among long-term care facility residents over 1 year. This follow-up study was conducted among older adult residents with dementia or similar symptoms. Generalized linear mixed effect models were used to examine associations between social interaction and changes in the number and severity of BPSD symptoms over 1 year. Among 220 participants, rare participation in activities and poor relationships with other residents at baseline were associated with greater baseline BPSD. Less communication with family/relatives at baseline was associated with increased severity of BPSD over 1 year. Active interaction with family and relatives may prevent progression of BPSD severity among long-term care facility residents for at least 1 year. ? 2020 Elsevier Inc. All rights reserved.

Over the past few decades, there have been concerns regarding the humanization of healthcare and the involvement of family members in patients’ hospital care. The attitudes of hospitals toward welcoming families in this respect have improved. In Arab culture, the main core of society is considered to be the family, not the individual. The objective behind involving family in patient care is to meet patients’ support needs. Consequently, this involvement affects nurses and their attitudes toward the importance of family involvement in patient care. Objectives: To describe nurses’ and nursing students’ perceptions of family involvement in the care of hospitalized adult patients in Saudi Arabia. Design: This study used a quantitative descriptive cross-sectional design. The data were collected using a convenience sampling survey via social media. Results: A total of 270 participants (staff and students) took part in this study, including 232 (85.9%) females and 38 (14.1%) males. Moreover, a high percentage of participants (78.8%) acknowledged that family presence strongly affected the improvement of the patient’s condition. However, 69.3% of participants thought that involving family members during special care processes or cardiopulmonary resuscitation (CPR) would be traumatizing for these individuals. Moreover, there was a significant diffidence between the attitudes of the nurses and nursing students toward family involvement and the number of years of employment (F = 3.60, p &lt, 0.05). On the contrary, there were insignificant differences between the attitudes of the nurses and nursing students toward family involvement and their gender, nationality, age, education level, and years of work experience in Saudi Arabia (p &gt, 0.05). Furthermore, the regression analysis showed a significant negative correlation between nurses’ years of employment and their support of family involvement in patient care (ß = −0.20, SE = 0.08, t = −2.70, p = 0.01). Conclusions: Nurses with more experience showed no support for family involvement in patient care. We have to consider the clinical barriers that affect nurses’ support for family involvement in patient-centered care, such as hospital polices, guidelines, and the model used for family-centered care integration in the hospital system to facilitate the interaction between healthcare providers and family members.

Family involvement is a cornerstone of early intervention (EI). Therefore, positive caregiver outcomes are vital, particularly in caregiver-implemented interventions. As such, caregiver instructional approaches should optimize adult learning. This study investigated the comparative efficacy of coaching and traditional caregiver instruction on caregiver outcomes across EI disciplines. A systematic search for articles was conducted using PRISMA guidelines. Meta-analysis methodology was used to analyze caregiver outcomes, and a robust variance estimate model was used to control for within-study effect size correlations. Seven relevant studies were ultimately included in the analysis. A significant, large effect of coaching on caregiver outcomes was observed compared to other models of instruction ( g = 0.745, SE = 0.125, p = .0013). These results support the adoption of a coaching framework to optimize caregiver outcomes in EI. Future research should examine how coaching and traditional instruction can be used in tiered intervention models with a variety of populations.

Purpose: The present work addresses the transformation process occurring within the services for minors regarding the relationship with families. This qualitative study aims to explore family-centered practice (FCA) by analyzing the practitioner's perceptions of social work with families in daily practice in the context of Italian social welfare. Methods: The authors conducted six focus groups with 38 social services workers and used grounded theory methods to elicit perceptions of the meaning and complexity of the transformation based on the statements of those performing social work with families. From the textual data, codes were identified and grouped into conceptual categories. Results: The authors defined two macro-categories called “Aims in practitioner's work with children and families” and “Tools in work with children and families”, which reflect the participants' attitudes and behaviors. Conclusion: Professionals and service providers can use our findings to reflect on current conceptualizations of family involvement and FCA in their work and to recognize possible psychological barriers to achieving family participation.

PurposeThe aim of this paper is to provide new evidence on the ability of family small- and medium-sized enterprises (SMEs) to develop ambidextrous innovations and their influence on the internationalization processes, showing how this relationship varies due to family involvement.Design/methodology/approachThe analysis is based on a sample of 186 Spanish family SMEs. Data were analyzed using structural equation modeling.FindingsThe results indicate that family SMEs' innovation activities are a stimulus for their internationalization process, and show the importance of family involvement in this relationship. Specifically, the findings suggest that family-specific characteristics such as the generation in charge of the business and the level of family involvement in the top management team (TMT) shape the relationship between innovation and internationalization.Practical implicationsFamily SMEs need to focus on exploratory and exploitative innovations to obtain a competitive advantage in foreign markets, and thus, increase their internationalization level. Furthermore, the study contributes to a better understanding of the consequences of family involvement, increasing our knowledge of family firms' idiosyncratic behaviors in strategic activities. The study suggests that in order to improve the effect of innovation on internationalization, family owners should consider involving new generations and non-family managers within the decision-making structures.Originality/valueTo date, research on innovation-internationalization link in family SMEs has been fragmented and has not obtained conclusive results. This study provides new evidence on the relationship between these two important strategies. Furthermore, it contributes to the understanding of the influence of the family in shaping strategic decisions.

Stunting is a health problem needs serious attention. In Bagan Deli Village, the proportion of children who are stunted was 10.37% and children with poor nutritional status was 2.9%. It has an impact on growth disorders, immune system, and furthermore, impaired children's intelligence. Optimizing the role of cadres and family involvement in stunting prevention is necessary. The aims of this activity was to educate cadres and parents in monitoring the growth of children under five, nutritional intake of children and implement of nutritional intake in daily life. From this activity, it can be seen that the cadres' knowledge increases in monitoring the growth and nutrition of children under five after training. From the health status examining on children, it was found that 33.3% of children under five were malnourished, 33.3% were with poor nutrition and 33.3% were with good nutrition. Education and family assistance are provided to parents in preparing a balanced healthy menu for children. It was suggested that parents prepared daily healthy menu and monitoring the nutrition of children under five. Therefore, community empowerment in preventing stunting in children under five is necessary

Family accommodation (FA) is significant in a range of disorders, yet it has never been explored in body dysmorphic disorder (BDD). Interviews were conducted with five young people with BDD, five parents, and five clinicians to explore the types, impact, and purpose of FA in BDD. Every participant reported significant FA of BDD, and the types reported were broadly similar to those found in other disorders. Reassurance giving/seeking and engagement in rituals were the two most common forms of FA reported with funding products being the third. Unsurprisingly, the driver for FA was to reduce the young person's distress and risk. Every participant commented on the negative impact FA had, including the financial burden, social implications, emotional well-being of family members, relationships, and conflict within the family, yet all young people also thought there were positive aspects to FA. Findings are discussed in the context of the limitations of this study.

PurposeThis study aims to determine the direct effect of entrepreneurial orientation on family business performance. This study also discusses the role of family involvement as a mediating variable and the role of gender as a moderating variable in the relationship between entrepreneurial orientation and family business performance.Design/methodology/approachA total of 328 hotels in Yogyakarta, Indonesia, were selected as samples by the convenience sampling method. Primary data is collected through structured questionnaires that are delivered by themselves to key people in the hotel such as owners, directors and key staff (HRD, financial, relationship). Hypotheses are tested by structural equation modeling procedures using AMOS 22.0. Sobel test is used to determine the indirect effect of the mediation variable.FindingsThe results showed that entrepreneurial orientation had no significant effect on family business performance. Family involvement acts as a full mediation in the relationship between entrepreneurial orientation and family business performance. Gender acts as a moderating variable that can strengthen the relationship between entrepreneurial orientation and family business performance. The results showed support for previous research.Research limitations/implicationsThe results of the study cannot conclude the national family business because it adopts convenience sampling and the sampling area is limited in Yogyakarta. Future research can use a larger sample. This study only researches hotels managed by family businesses, so it is not feasible to conclude for family businesses in general. Future research may choose to use several types of family businesses so that more varied results can be obtained. Future research could also compare hotels managed by family businesses with non-family businesses. The results also found that in addition to gender roles, respondent heterogeneity was an important component in the study of social identity. Therefore, research examining the influence of different cultures on the relationship between entrepreneurial orientation and family business performance should be an extraordinary topic for future study. Other results from this study also indicate that there is a role for religion in improving hotel performance. Future research is needed to further explore Islamic business modeling for family businesses.Practical implicationsThis finding has significant implications that can help family businesses in developing strategies that are suitable for business management. Entrepreneurial orientation occupies a strategic position in developing sustainable competitive advantage in the family business of the tourism sector especially the hotel business in Yogyakarta for the better. Besides, the results of the study also showed that entrepreneurial orientation had no significant effect on performance. This relationship becomes significant when combined with active family involvement. This finding also shows that entrepreneurial orientation has the potential to have a more beneficial effect because of the active involvement of the family in helping with business management, alleviating business-related problems, and having a significant influence when the family also acts as management.Social implicationsResearch findings indicate the role of gender in strengthening the relationship between entrepreneurial orientation and family business performance. This provides a good position for women in the social environment to show achievement. To place women on the side of gender equality and justice in the family business in Indonesia. By opening wider access for Indonesian women in the realm of business management, expanding women's participation in a family business, increasing the role of control for women, and increasing women's knowledge and skills to increase the benefits in managing family businesses so that they have sustainable resilience in the face of global competition.Originality/valueThe results of this study provide a new model in providing an overview of the direct and indirect roles (mediating and moderating) in the assessment of family business performance. This study uses three variables which are important in performance appraisal, namely entrepreneurial orientation (independent variable), family involvement (mediating variable) and gender (moderating variable). Where research that combines these four variables, directly and indirectly, has never been done before.

Organizational ambidexterity is vital for family firms’ long-term success, yet we still lack sufficient insights into the role of family involvement in top management in this context. Building on research on family firm innovation and diversity, we argue there are curvilinear relationships between family involvement in top management and exploration, exploitation, and organizational ambidexterity. We further propose that these (inverse) U-shaped relationships are affected by family CEOs’ family-centered noneconomic goals. Multisource data on 109 family-managed firms support most of our hypotheses and provide a nuanced understanding of how diversity within top management affects family firms’ innovative behavior.

Aim To describe the family composition and living arrangements of persons diagnosed with coronary artery disease and those relationships to family involvement in self‐managed rehabilitation. Design A cross‐sectional study. Methods Data were collected with postal questionnaire from persons diagnosed with coronary artery disease (CAD) by using the Family Involvement in Rehabilitation (FIRE) scale. It measures family members' promotion of patients' rehabilitation and issues encumbering rehabilitation in family. Statistical methods were used to analyse the data. Results Patients' gender and having children in the family were predictors of issues encumbering rehabilitation in the family. But when examining living arrangements, patients who lived with a spouse or underage children had a better environment for recovery than those who lived alone or with adult children. More attention should be paid to targeting appropriate support for persons with coronary artery disease and their family members during the rehabilitation phase.

Background Family communication has been increasingly recognized as an important factor in decision making near the end of life. However, the role of the family in decision making is less studied in oncology settings, where most patients are conscious and able to communicate almost until dying. The aim of this study was to explore oncologists’ and nurses’ perceptions of family involvement in decision making about forgoing cancer‐specific treatment in patients with advanced cancer. Materials and Methods Qualitative semistructured interviews with 22 oncologists and 7 oncology nurses were analyzed according to the grounded theory approach. The results were discussed against the background of the clinical and ethical debate on family role near the end of life. Results We could identify two approaches shared by both oncologists and nurses toward family involvement. These approaches could be partly explained by different perception and definition of the concept of patients' autonomy: (a) a patient‐focused approach in which a patient's independence in decision making was the highest priority for oncologists and (b) a mediator approach with a family focus in which oncologists and nurses assigned an active role to patients' family in decision making and strived for building consensus and resolving conflicts. Conclusion The main challenge was to involve family, increasing their positive influences on the patient and avoiding a negative one. Thereby, the task of both oncologists and oncology nurses is to support a patient's family in understanding of a patient's incurable condition and to identify a patient's preference for therapy. Implications for Practice This study focused on oncologists’ and oncology nurses’ perceptions of family involvement in decision making about treatment limitation in patients with advanced cancer who are able to communicate in a hospital setting. Oncologists and oncology nurses should be aware of both positive aspects and challenges of family involvement. Positive aspects are patients’ emotional support and support in understanding and managing the information regarding treatment decisions. Challenges are diverging family preferences with regard to treatment goals that might become a barrier to advanced care planning, a possible increased psychological burden for the family. Especially challenging is involving the family of a young patient because increased attention, more time investment, and detailed discussions are needed., The role of family communication is recognized as an important factor in decision making for cancer patients near the end of life. This article discusses the value and role of family in end‐of‐life discussions and the challenges encountered by oncologist and oncology nurses when involving family in decision making.

BackgroundFamily inclusion in nursing homes is central to the provision of individualized care for people with dementia. Although positive effects can be recognized, barriers have been identified that hamper family inclusion in nursing homes. Specifically for people with dementia, insight into the content of interventions to foster family inclusion is lacking.MethodsA systematic review was performed by systematically searching the databases PubMed, Cinahl, PsycInfo and Embase. Studies were eligible if they examined (1) nursing home settings, (2) interventions to foster the inclusion of family members from people with dementia, (3) were original research articles in which effects/experiences of/with these interventions were evaluated, and (4) were written in English, Dutch or German. Findings were summarized systematically.ResultsTwenty-nine studies were included. Two interventions were targeted at creating family-staff partnerships from a two-way perspective. Other interventions focused on single components, such as including family members in formal decisions (n = 9), enabling them to make better informed decisions and/or participate more actively (n = 7), or providing psychoeducation for family members (n = 3). Within the interventions, family and staff members are often treated differently. Effects on actual increase in family inclusion remain unclear.ConclusionsVery few interventions exist that try to enhance equal family-staff partnerships in nursing homes. Future interventions should pay specific attention to mutual exchange and reciprocity between family and staff. As little is known about promising (components of) interventions to foster family inclusion in nursing homes for people with dementia, more effectiveness research is needed.

This study differentiates between internal corporate social responsibility (CSR) and external CSR to investigate the impact of family involvement on different dimensions of CSR. Using a sample of 2,114 Chinese listed firms, we show that family involvement is positively related to the level of firms' participation in external CSR but negatively related to the level of firms' participation in internal CSR. We further explore the roles of internal ownership structure and external institutional environment in influencing the incentives of family firms to invest in internal and external CSR. Results show that high levels of ownership balance and regional institutional development attenuate the negative effect of family involvement on internal CSR while a high level of regional institutional development strengthens the positive effect of family involvement on external CSR. These findings contribute to our understanding on the internal and external CSR strategies in family firms in emerging markets.

Background: Treatment decisions based on guidelines rather than patients’ preferences determine adherence to and compliance with treatment, which, in turn, could improve health-related outcomes. Objectives: To summarize the stated treatment and care preferences of people with dementia (PwD). Methods: A systematic review was conducted to assess the stated preferences of PwD. The inclusion criterion was the use of quantitative methods to elicit stated preferences, enabling a ranking of preferences. Results: Eleven studies revealed preferences for diagnostics, treatment decisions, patient-related outcomes, care services, end-of-life care, leisure activities, and digital life story work. PwDs prefer accurate, pain-free, and comfortable diagnostic procedures without radioactive markers as well as being accompanied by a caregiver. PwD’s quality of life (QoL), self-efficacy, and depression were equally most important for PwD and caregivers. However, PwD memory was only important for caregivers but not for PwD, and caregiver QoL was moderately important for PwD but least important for caregivers. Additionally, comfort and family involvement were most important for patients’ end-of-life care, whereas caregivers most preferred good communication and pain management. Also, preferences depend on the living situation: Patients living not alone prefer a regular care provider most, whereas those living alone only want to live nearby the caregiver. Preferences for leisure activities did not differ between past and present ratings, indicating that PwD prefer activities that have always been carried out. Conclusion: Only a few studies have applied quantitative methods to elicit the preferences of PwD. More research is needed to capture the stated preferences for the treatment, care, and support of PwD to improve health-related outcomes and the allocation of healthcare resources.

Determining what factors influence firm performance constitutes an essential issue in both the management and the family firm research fields. This article, building on the resource-based view perspective, develops a mediation model that involves a unique intervening mechanism, namely, technological innovation efficiency (TI efficiency), with the potential to explain the inconsistencies found in prior work on the ways through which family involvement in management affects performance outcomes. Regression analyses utilizing a longitudinal sample of 1,118 Spanish private firms largely support the hypothesized mediating relationship, revealing that TI efficiency leads to richer firm performance in family firms with active family involvement in management. Overall, our findings help elucidate the black box of performance outcomes within family firms and make several contributions to theory and practice. JEL CLASSIFICATION L25; M12; O32

Background End-of-life care is provided in a variety of healthcare settings, not just palliative care hospitals. This is one reason why it is very important to assess all barriers to end-of-life care and to provide safe and quality services to patients. This study was aimed at describing nurses’ attitudes in providing end-of-life care and exploring barriers and facilitating behaviors of nurses in multi-profile hospitals in Eastern Europe. Methods A descriptive, correlational design was applied in this study, using a cross-sectional survey of 1320 registered nurses within 7 hospitals in Lithuania. Results Registered nurses working in the three different profiles emphasized safe and effective care and the importance of meeting the patient’s spiritual needs at the end of life. The main barriers assigned by nurses caring for patients at the end of life were angry family members, inadequate understanding of nursing care by the patient’s relatives; lack of time to talk to patients, lack of nursing knowledge to deal with the bereaved patient’s family, lack of evaluation of nurses’ opinions, and the evasion by physicians to talk about the diagnosis and their over-optimistic view of the situation. The main facilitating behaviors to improve nursing care were end-of-life training, volunteering, and family involvement. Conclusions Spiritual needs were identified by nurses as the primary needs of patients at the end of life. Family-related barriers remain one of the main barriers to end-of-life care. Also, the behavior of physicians and their relationship with nurses remains one of the most sensitive issues in end-of-life care.

Taking the right amount of risk is essential for successful business. As a response to the importance of risk management, the effectiveness and implementation of enterprise risk management (ERM) systems are recently discussed in literature. However, smaller firm entrepreneurs often deal with this challenge in practice in a more informal way. Most of these small and medium-sized enterprises (SME) are family firms, where family dynamics further influence their risk behaviour. Addressing the missing implementation of ERM in Small and Medium Family Enterprises (SMFE), we first analyse how ERM influences the performance of SMFE. In a second step, we investigate the impact of CEO tenure and family involvement as moderators on the ERM – performance relationship. Regression analysis on a sample of 116 Austrian SMFE shows that ERM implementation does not directly influence financial performance. CEO tenure and family involvement, however, both show significant moderating effects on the ERM – performance relationship. Adding to current literature on the topic, this study reveals that ERM performance is positively moderated by CEO tenure and negatively by family involvement.

Post-intensive care syndrome is a detrimental cluster of symptoms that can have a negative impact on life after discharge from the intensive care unit (ICU). The use of patient diaries while hospitalized in the ICU has been reported to help survivors and families create memories and fill in gaps from their hospitalization. A review of the literature revealed that patient selection, diary content, family involvement, and staff perceptions are essential to the implementation of a diary program. Understanding the importance and impact diaries can have on survivors increases compliance and sustainability of this program.