Background Family involvement in nursing homes is generally recognized as highly valuable for residents, staff and family members. However, family involvement continues to be challenging in practice. Aim To contribute to the dialogue about family involvement and develop strategies to improve family involvement in the nursing home. Methods This interpretative synthesis consists of a thematic analysis and care ethical interpretation of issues regarding family involvement from the perspective of families (...) in nursing homes reported in literature. Findings This study reveals the complexities of family involvement in the nursing home by drawing attention to the moral dimension of the issues experienced by families, as seen through the theoretical lens of Baier’s care ethical concept of trust as a theoretical lens. The synthesis of literature resulted in a thematic categorization of issues reported by families, namely, family–staff relationship, psychosocial factors and organizational circumstances. The care ethical interpretation of the synthesis of literature showed that the concept of trust resonates with all reported issues. Trust evolves over time. Early issues are mostly related to getting to know each other. Secondly, families want to experience that staff are competent and of good will. Difficult feelings families may have, such as guilt or loneliness, and dealing with the deterioration of the loved one puts families in a vulnerable position. This power imbalance between family and staff impedes a trusting relationship. Issues related to organizational circumstances, such as understaffing, also undermine families' trust in staff and the nursing home. Discussion and conclusion Baier’s theoretical concept of trust provides a deeper insight into the moral dimension of family involvement from the perspective of families in the nursing home. To improve family involvement in practice, we propose to aim future interventions at reinforcing trust in the relationship between family and staff as well as in the organizational context in which these care relationships occur. (shrink)

In this article, we report the findings from a qualitative study that explored how relatives of terminally ill, alert and competent intensive care patients perceived their involvement in the end-of-life decision-making process. Eleven family members of six deceased patients were interviewed. Our findings reveal that relatives narrate about a strong intertwinement with the patient. They experienced the patients’ personal individuality as a fragile achievement. Therefore, they viewed their presence as crucial with their primary role to support and protect (...) the patient, thereby safeguarding his values and interests. However, their inclusion in decision making varied from active participation in the decision-making process to acceptance of the physicians’ decision or just receiving information. We conclude that models of informed shared decision making should be utilised and optimised in intensive care, where nurses and physicians work with both the patient and his or her family and regard the family as partners in the process. (shrink)

This article explores the links between our roles as academics, advocates, and activists, focusing on our research on treatment decisions for patients in vegetative and minimally conscious states. We describe how our work evolved from personal experience through traditional social science research to public engagement activities and then to advocacy and activism. We reflect on the challenges we faced in navigating the relationship between our research, advocacy, and activism, and the implications of these challenges for our research ethics and methodology—giving (...) practical examples of how we worked with research participants, wrote up case studies and developed interventions into legal debates. We also address the implications of the impact agenda—imposed by the British Research Excellence Framework— for our actions as scholar‐activists. Finally, we ask how practicing at the borders of academia, advocacy, and activism can inform research—helping to contextualize, sensitize, and engage theory with practice, leading to a more robust analysis of data and its implications, and helping to ensure a dialogue between research, theory, lived experience, front‐line practice, law, and public policy. (shrink)

Does home-based family involvement influence academic performance? To answer this question, a case study research was carried out with 96 children from all six levels of primary education at a public school, and their families. Data regarding home-based family involvement were collected using a questionnaire. Academic achievement was measured from school marks. The results reveal that, apart from two of the factors considered, home–family involvement as a whole is not significantly related to academic achievement. (...) These two factors are access to informal education resources and parents’ employment. Family involvement related to the access of children to informal education resources is significantly related to a better academic achievement. Those students with both parents working perform best, and those with none working, worst. Although gender does not appear to significantly influence academic achievement and family involvement, the results show that girls attain better school performance and re... (shrink)

This paper sheds light on the incongruent findings concerning the relationship between family involvement and firms’ corporate social responsibility. While prior studies have mainly taken the perspective of families’ socioemotional wealth preservation, we approach this relationship from the perspective of behavioral agency theory, highlighting the important role played by CEOs’ family memberships. Specifically, we posit that family firms are more likely to invest in CSR when their CEOs are members of the controlling families. Furthermore, we examine (...) how family firms can employ long-term incentives to encourage non-family CEOs to act in the interests of the controlling families to preserve SEW and thus enhancing family firms’ CSR performance. We tested our hypotheses using hand-collected data of family firms included in the S&P 500 index, in the period of 2003–2010. The empirical findings support our hypotheses that family firms with family members as the CEOs have better CSR performance and family firms tend to provide a high level of long-term incentives to non-family than family CEOs. In addition, long-term incentives strongly motivate CEOs to improve firms’ CSR performance, regardless of their family memberships. (shrink)

Substantial gender disparities in career advancement are still apparent, for instance in the gender pay gap, the overrepresentation of women in parttime work, and the underrepresentation of women in managerial positions. Regarding the developmental origins of these gender disparities, the current study examined whether children’s views about future career and family involvement were associated with children’s own gender schemas and parents’ career- and family-related gender roles. Participants were 142 Dutch families with a child between the ages of (...) 6 and 12 years old. The families had different compositions. Children completed a computer task assessing gender stereotypes about toys and questionnaires on gender identity and their views about future career and family involvement. Parents reported their occupation, work hours, and task division in the home, which were combined in a composite variable reflecting gender-typicality of career and family involvement. Generalized estimation equations were used to take into account dependency between family members. Results revealed that parents’, and especially mothers’, gender-typical career and family involvement was associated with children’s gender-typical views about future career and family involvement. In addition, children’s felt similarity to the same gender was associated with children’s gender-typical expectations about career and family involvement. These findings suggest that parents’ career, work hours, and task division in the home, together play an important role in how their children envision their future work and family roles. Children themselves also play an active role in developing this vision for the future by their own gender identity, specifically by how similar they feel to individuals of the same gender. To reduce gender disparities in the occupational and domestic domain, programs need to be designed that focus on parental role modeling in the family as well as children’s gender identity development. (shrink)

This study seeks to understand, in the context of intersectional theory, the roles of family members in nursing home care. The unique social locus at which each person sits is the result of the intersection of gender, status, ethnicity and class; it is situational, shifting with the context of every encounter. A content analysis of 15 qualitative interviews with relatives of nursing home residents in Sweden was used to gain a perspective on the relationships between relatives and residents, relatives (...) and the nursing home as an institution, and relatives and the nursing home staff. We sought to understand these relationships in terms of gendered notions of the family and the residents, which are handed down from generation to generation and thus condition who and how relatives should be involved in care, and the ways in which relationships change as care moves from home to nursing home. It requires knowledge and awareness that the nursing home culture is based on intersectional power structures in order for relatives to be involved in nursing home care in alternative and individual ways. (shrink)

Family involvement in healthcare decision-making for competent patients occurs to varying degrees in many communities around the world. There are different attitudes about who should make treatment decisions, how and why. Legal and professional ethics codes in most jurisdictions reflect and support the idea that competent patients should be enabled to make their own treatment decisions, even if others, including their healthcare professionals, disagree with them. This way of thinking contrasts with some cultural norms that put more emphasis (...) on the family as a decision-making entity, in some circumstances to the exclusion of a competent patient. Possible tensions may arise between various combinations of patient, family members and healthcare professionals, and healthcare professionals must tread a careful path in navigating family involvement in the decision-making process. These tensions may be about differences of opinion about which treatment option is best and/or on who should have a say or influence in the decision-making process. While some relevant cultural, legal and policy considerations vary from community to community, there are ethical issues that healthcare professionals need to grapple with in balancing the laws and professional codes on decision-making and the ethical principle of respecting patients and their autonomy. This paper will highlight and propose that a partial resolution to these issues may lie in relational understandings of autonomy, which in principle justify interventions by healthcare professionals and family that support patients in decision-making. (shrink)

BackgroundAs part of the research project “End-of-life Communication in Nursing Homes. Patient Preferences and Participation”, we have studied how Advance Care Planning is carried out in eight Norwegian nursing homes. The concept of ACP is a process for improving patient autonomy and communication in the context of progressive illness, anticipated deterioration and end-of-life care. While an individualistic autonomy based attitude is at the fore in most studies on ACP, there is a lack of empirical studies on how family members’ (...) participation and involvement in ACP- conversations may promote nursing home patients’ participation in decisions on future treatment and end-of-life care. Based on empirical data and family ethics perspectives, the purpose of this study is to add insights to the complexity of ACP-conversations and illuminate how a family ethics perspective may improve the quality of the ACP and promote nursing home patients’ participation in advance care planning.MethodsParticipant observations of ACP-conversations in eight nursing homes. The observations were followed by interviews with patients and relatives together on how they experienced being part of the conversation, and expressing their views on future medical treatment, hospitalization and end-of-life issues.ResultsWe found that the way nursing home patients and relatives are connected and related to each other, constitutes an intertwined unit. Further, we found that relatives’ involvement and participation in ACP- conversations is significant to uncover, and give the nursing home staff insight into, what is important in the nursing home patient’s life at the time. The third analytical theme is patients’ and relatives’ shared experiences of the dying and death of others. Drawing on past experiences can be a way of introducing or talking about death.ConclusionsAn individual autonomy approach in advance care planning should be complemented with a family ethics approach. To be open to family ethics when planning for the patient’s future in the nursing home is to be open to diversity and nuances and to the significance of the patient’s former life and experiences. (shrink)

The social conservatism of evangelical and fundamentalist groups includes their support for premarital sexual restraint, husband leadership, and father involvement. The authors explore whether religious conservatism affects work–family outcomes of men using the National Survey of Families and Households, 1988 and 1993 waves. The authors hypothesize that men from conservative households will make earlier transitions to adulthood, work fewer hours, and earn less money. Moreover, the belief in strong paternal involvement should lead religiously conservative men to spend (...) more time in housework and child care. Results show that conservative religious affiliation does not hasten the transition to adulthood among men. Current religious conservatism results in lower wages but not reduced work hours, and religious affiliation does not affect housework or child care. (shrink)

Family members do not have an official position in the practice of euthanasia and physician assisted suicide in the Netherlands according to statutory regulations and related guidelines. However, recent empirical findings on the influence of family members on EAS decision-making raise practical and ethical questions. Therefore, the aim of this review is to explore how family members are involved in the Dutch practice of EAS according to empirical research, and to map out themes that could serve as (...) a starting point for further empirical and ethical inquiry. A systematic mixed studies review was performed. The databases Pubmed, Embase, PsycInfo, and Emcare were searched to identify empirical studies describing any aspect of the involvement of family members before, during and after EAS in the Netherlands from 1980 till 2018. Thematic analysis was chosen as method to synthesize the quantitative and qualitative studies. Sixty-six studies were identified. Only 14 studies had family members themselves as study participants. Four themes emerged from the thematic analysis. 1) Family-related reasons to request EAS. 2) Roles and responsibilities of family members during EAS decision-making and performance. 3) Families’ experiences and grief after EAS. 4) Family and ‘the good euthanasia death’ according to Dutch physicians. Family members seem to be active participants in EAS decision-making, which goes hand in hand with ambivalent feelings and experiences. Considerations about family members and the social context appear to be very important for patients and physicians when they request or grant a request for EAS. Although further empirical research is needed to assess the depth and generalizability of the results, this review provides a new perspective on EAS decision-making and challenges the Dutch ethical-legal framework of EAS. Euthanasia decision-making is typically framed in the patient-physician dyad, while a patient-physician-family triad seems more appropriate to describe what happens in clinical practice. This perspective raises questions about the interpretation of autonomy, the origins of suffering underlying requests for EAS, and the responsibilities of physicians during EAS decision-making. (shrink)

This study examined the associations of family income and parental education with Chinese preschool children’s cognitive school readiness and the sequential mediating role of parenting style and parental involvement in these relations. A total of 307 5–6 years old kindergarten children from Shanghai, China and their parents participated in the study. Using structural equation modeling method, the results indicated that parental education was directly related to children’s cognitive school readiness, while no direct relationship was found for family (...) income. The link of parents’ education with children’s cognitive school readiness was sequentially mediated by authoritative parenting and home-based parental involvement. Authoritative parenting and parental involvement at home can be targeted by government administrators to effectively improve children’s cognitive school readiness skills. The theoretical and practical implications were discussed. (shrink)

Family firms not only play an important role in economic growth but should also be held partly responsible for environmental degradation. Employing normative stakeholder theory and analyzing unique Chinese survey data via stepwise regression models, our findings indicate that second-generation successors did not significantly impact family firms' environmental investment. However, among second-generation successors, we find that successors with international experience positively impacted environmental investment. The propensity score matching (PSM) and two-stage least squares estimation (2SLS) approaches confirm our results. (...) As an interdisciplinary study, our research is of great value to the environmental responsibility and family business literature. (shrink)

The purpose of this study was to examine parent-child relationship as a moderator of the association between family educational involvement and the social skills of preschoolers. A total of 4,938 children were sampled from 18 preschools in Hebei province, China, and their parents completed a survey packet to collect demographic information, as well as ratings of parental involvement, relationships with their children, and child social skill development. The results of multivariate regression analysis suggested that: both home-based (...) class='Hi'>involvement and home-school conferencing could significantly predict preschoolers’ social skills, there was stronger evidence for a relationship of home-based involvement and preschoolers’ social skills, closeness in parent-child relationship moderated the path from home-based involvement to preschoolers’ social skills, and there was no interactive effect between family educational involvement and parent-child conflict. These findings highlight the significance of the joint influences of family educational involvement and parent-child relationship in shaping children’s social skills. The impact of home-based involvement was boosted in the context of a close parent-child relationship. (shrink)

Alzheimer’s disease is a very common, progressive and still incurable disease. Future possibilities for its cure lie in the promotion of research that will increase our knowledge of the disorder’s causes and lead to the discovery of effective remedies. Such research will necessarily involve individuals suffering from Alzheimer’s disease. This raises the controversial issue of whether patients with Alzheimer’s disease are competent to give their consent for research participation.

The recent process of deinstitutionalization of the psychiatric treatment system, in both Denmark and other European countries, has relied heavily on the involvement in treatment and recovery of cohabitant relatives of diagnosed people. However, political objectives regarding depression and involvement rely on a limited body of knowledge about people’s ways of managing illness-related problems in everyday life. Drawing on a discursive notion of gender laid out by Raewyn Connell, the aim of the article is to elucidate how the (...) involvement of relatives is guided by an extra- individual rationale about gender and caregiving, and how this gendered discourse might frame different challenges and burdens, depending on the gender of the diagnosed person and the cohabitant relative. Drawn from a larger, multisited field study on involvement processes in Danish psychiatry, t he article is based on field notes and 21 interviews with seven heterosexual couples. The analysis shows that gender works as a decisive premise for the division of caregiving labour among the couples, and clarifies how the couples’ gendered institution is disrupted after the onset of depression. The article argues that gender-blind involvement strategies could produce divergent treatment outcomes and varying social effects in relation to couples’ everyday family lives. (shrink)

The considerations and recommendations set out by Bhatia-Lin and colleagues (2019) for the appropriate use of social media platforms to locate and track research participants are timely and importa...

The purpose of this article is to present a classroom exercise and corresponding discussion for educators to use when teaching critical thinking skills to undergraduate students. The exercise involves applying critical thinking conccpts/questions offered by Browne and Keeley (2004) to a contemporary discussion about parenting issues among some African-American families. Comments by Dr. Bill Cosby have spurred debate about the parenting skills of some lower-income African-American parents. This article offers a classroom-based exercise that may be used to help undergraduate students (...) develop critical thinking that are useful in engaging in productive discourse in issues of importance. (shrink)

Recent studies have demonstrated that parental homework involvement may not always foster students’ desired school outcomes. Such studies have also concluded that the quality of parental homework involvement matters, rather than the quantity. Most importantly, previous studies have shown that strong family-school partnerships (FSP) may help to improve parental involvement. However, there is little research on how FSP is related to homework involvement. The aim of the present study is to examine the link between an (...) effective family-school communication (EFSC) – as one aspect of FSP – and the quality of parental homework involvement in the German context. For this purpose, we developed a new measure of EFSC. Taking a self-determination theory perspective on parental need support, the quality of parental homework involvement was differentiated into two dimensions of parental supportive behavior: autonomy support and competence support. We analyzed the data of 309 parents (82% mothers) of school students (52% girls) who participated in an online survey. The structural equation model revealed a positive relation between EFSC and the quality of parental homework involvement, which in turn was positively associated with school performance and well-being. Moreover, we found that the quality of parental homework involvement mediated the relations of EFSC with achievement and well-being. The results of our study highlight the role of EFSC as a key performance factor that helps to improve the quality of parental homework involvement, thereby promoting student achievement and well-being. (shrink)

Patients and their family members may become highly interdependent as patients near the end of life. To best help these patients, healthcare providers can try to become a member of the patient/family team. By becoming a member, careproviders can improve patients’ and family members’ access to medical information, more effectively offer advice, and assure patients and family members that they can still choose to do what they think is best.

Self-regulation, or the ability to effectively manage emotions and behavior, is a critical skill to develop in early childhood. Children living in a context of economic hardship are at an increased risk for developing self-regulation difficulties. However, few studies have comprehensively examined how multiple aspects of the caregiving environment, including fathers’ parenting and coparenting quality, may contribute to child self-regulation. Thus, this study applied a family systems perspective to examine whether coparenting and resident and non-resident fathers’ reports of parenting (...) quantity and quality were associated with observations of children’s self-regulation. Participants were drawn from the Embedded Developmental Study of the Three-City Study, a longitudinal study of children and families facing economic hardship. At Wave 1, when children were 2–4 years old, reports of parenting and coparenting were obtained. At Wave 2, when children were 3–6 years old, children participated in a snack delay and gift wrap task, which assessed their self-regulation. Multi-group path analyses indicated that resident fathers’ harsh parenting at Wave 1 predicted decreased levels of self-regulation at Wave 2. Non-resident fathers’ reported hours of involvement at Wave 1 predicted greater levels of self-regulation at Wave 2. Additionally, supportive coparenting among families with a non-resident father predicted greater self-regulation. Supportive coparenting was not associated with child self-regulation in families with a resident father. The implications for research focused on facilitating positive father–child relationships in diverse family contexts are discussed. (shrink)

This study explores nurses' experiences of workplace conflict with patients and their family members, how it differs by ethnic/racial identity, and highlights the coping strategies engaged to lessen these conflicts. Using a qualitative research design, this study draws on phenomenology and in‐depth interviews of 66 registered nurses and registered practical nurses from multiple sites in two Canadian cities to explore the experiences of nurses with multiple marginalized identities in relation to nurse–patient and nurse–patient's family member conflicts in direct (...) care practice. The results show that horizontal conflicts, especially, ones involving nurses, patients, and their family members are quite pervasive in the nursing profession. Direct care nurses, especially, ethnic minorities relative to majority groups experience excessive physical assaults, verbal aggressive behaviors, racial stereotyping and discrimination, and sexual harassment from patients and patients' family members. Institutional support through policies and practices designed to de‐escalate aggressive behavior from patients and their family members were identified as important support systems. We conclude that policies aimed at creating a safe and strong health‐care system call for holding patients and th'eir family members legally responsible for uncivil and aggressive behavior against caregivers. (shrink)

This study examines whether religious belief influences an entrepreneur’s political involvement and further explores the moderating role of corporate philanthropy. Using the data from the 2008 national survey of Chinese family firms, my study provides strong evidence to show that the likelihood of political involvement is significantly higher for entrepreneurs with religious beliefs than for their counterparts, suggesting that religious entrepreneurs in Chinese family firms are more likely to participate in political affairs. This finding echoes the (...) view that religious believers acquire civic skills through their associational memberships or experience in involving religious activities. In addition, corporate philanthropy attenuates the positive association between religious belief and political involvement. The above findings are robust to a variety of sensitivity tests and are still valid after controlling for the potential endogeneity between political involvement and religious belief. (shrink)

Internationally, there is considerable inconsistency in the recognition and regulation of children's genetic connections outside the family. In the context of gamete and embryo donation, challenges for regulation seem endless. In this paper, I review some of the paths that have been taken to manage children' being closely genetically related to people outside their families. I do so against the background of recognising the importance of children's interests as moral status holders. I look at recent qualitative research involving donor-conceived (...) people and borrow their own words to make sense of a purported interest to know (of) their close genetic ties. I also review ways in which gamete donation may have facilitated new kinds of kinship, which are at the same time genetic and chosen. In short, in this paper, I explore what meaning there could be in genetic connections that is not about parenthood. Further, I argue that the focus on parenthood in previous work in this area may be detrimental to appreciating some of the goods that can be derived from close genetic connections. (shrink)

So-called family values and their part in education are considered. ‘Traditional’‘modern’ and ‘deviant’ patterns of family relationships are discussed and the moral superiority of the first is questioned. The single life without family involvement is also proposed as a possibly fulfilling mode of existence in its own right.

Experiences of substitute decision-makers with requests for consent to non-therapeutic research participation during the dying process, including to what degree such requests are perceived as burdensome, have not been well described. In this study, we explored the lived experiences of family members who consented to non-therapeutic research participation on behalf of an imminently dying patient. We interviewed 33 family members involved in surrogate research consent decisions for dying patients in intensive care. Non-therapeutic research involved continuous physiological monitoring of (...) dying patients prior to and for 30 min following cessation of circulation. At some study centres participation involved installation of bedside computers. At one centre electroencephalogram monitoring was used with a subset of participants. Aside from additional monitoring, the research protocol did not involve deviations from usual end-of-life care. Thematic analysis of interviews suggests most family members did not perceive this minimal-risk, non-therapeutic study to affect their time with patients during the dying process, nor did they perceive research consent as an additional burden. In our analysis, consenting for participation in perimortem research offered families of the dying an opportunity to affirm the intrinsic value of patients’ lives and contributions. This opportunity may be particularly important for families of patients who consented to organ donation but did not proceed to organ retrieval. Our work supports concerns that traditional models of informed consent fail to account for possible benefits and harms of perimortem research to surviving families. Further research into consent models which integrate patient and family perspectives is needed. All data relevant to the study are included in the article. (shrink)

Infertility specialists may be confronted with the ethical dilemma of whether to disclose misattributed paternity (MP). Physicians should be prepared for instances when an assumed father’s evaluation reveals a condition known for lifelong infertility, for example, congenital bilateral absence of vas deferens (CBAVD). When there is doubt regarding a patient’s comprehension of his diagnosis, physicians must consider whether further disclosure is warranted. This article describes a case of MP with ethics analysis that concludes that limited nondisclosure is most consistent with (...) a physician’s principled duties to inform, to respect patients’ autonomy, and to employ nonmaleficence (including the avoidance of psychosocial harms). (shrink)

The Motin family proteins (Motins) are a class of scaffolding proteins consisting of Angiomotin (AMOT), AMOT‐like protein 1 (AMOTL1), and AMOT‐like protein 2 (AMOTL2). Motins play a pivotal role in angiogenesis, tumorigenesis, and neurogenesis by modulating multiple cellular signaling pathways. Recent findings indicate that Motins are components of the Hippo pathway, a signaling cascade involved in development and cancer. This review discusses how Motins are integrated into the Hippo signaling network, as either upstream regulators or downstream effectors, to modulate (...) cell proliferation and migration. The repression of YAP/TAZ by Motins contributes to growth inhibition, whereas subcellular localization of Motins and their interactions with actin fibers are critical in regulating cell migration. The net effect of Motins on cell proliferation and migration may contribute to their diverse biological functions. (shrink)

Studies of the familial association of physical activity and sedentary behavior have increased in recent years. However, there is a lack of studies that have objectively examined the correlates between parents, grandparents, and childrens' PA. Therefore, the purpose of this study was to measure PA using accelerometers to determine the extent to which PA and SB correlate among parents, grandparents, and children. A sample of 169 children between 11 and 14 years, 225 parents, and 52 grandparents were recruited for the (...) current study. Accelerometers RM42 were used to determine PA levels of children, parents, and grandparents. Epoch length was 6 s. Mothers' moderate-to-vigorous PA was associated with children's MVPA of children's MVPA. In contrast, grandfathers' sedentary behavior was a significant predictor of children's sedentary behavior. The results of the current study suggest that parental involvement in PA, particularly by mothers, is important for children's PA and, accordingly, healthy outcomes. (shrink)

This book concerns the ethics of having children through adoption or technologically-assisted reproduction. Some people who choose between these methods struggle between them. Others do not agonize in this way, perhaps because they have a profound desire for a genetic link to the child(ren) they will parent and so prefer assisted reproduction, they view adoption as the only morally decent choice in an overcrowded world, or for some other reason. This book critically examines moral choices that involve each of these (...) ways of making or expanding families with children. The contributors discuss how adoption and assisted reproduction are morally distinct from one another, but also emphasize how they are morally similar, given that both are forms of family‐making. (shrink)

Cancer care has transitioned from clinical-based to home-based care to support longterm care in a more familiar and comfortable environment. This care transition has put family caregivers (FCGs) in a strategic position as care providers. Cancer care at home involves psychological and emotional treatment at some point, making FCGs deal with the stress of cancer patients frequently. Due to their limited care competencies, they need supportive care from healthcare professionals in cancer stress management. This study aims to examine how (...) types of demanded healthcare information affect the FCG’s role in reducing the stress of female cancer patients. The mindsponge theory was used in conceptual development and interpretation. Bayesian Mindsponge Framework (BMF) analytics were used for statistical analysis on a dataset of 48 spouses (husbands) and 12 other family members in five congested communities of Surabaya, Indonesia. Results showed that among the six types of healthcare information, FCGs with higher demand for cancer-specific information were more likely to need support in reducing the stress of female cancer patients. Meanwhile, FCGs with a higher demand for information about support services were less likely to need support to reduce cancer patients’ stress. Other types of healthcare information have ambiguous effects on the need for support in reducing cancer-induced stress. This study reveals that the demanded cancer-specific information, e.g., cancer prognosis or likely outcome, must be prioritized to assist FCG’s role in managing cancer stress. (shrink)

Family income is associated with gray matter morphometry in children, but little is known about the relationship between family income and white matter structure. In this paper, using Tract-Based Spatial Statistics (TBSS), a whole brain, voxel-wise approach, we examined the relationship between family income (assessed by income-to-needs ratio) and white matter organization in middle childhood (N = 27, M = 8.66 years). Results from a nonparametric, voxel-wise, multiple regression (threshold-free cluster enhancement, p < 0.05, FWE corrected) indicated (...) that lower family income was associated with lower white matter organization (assessed by fractional anisotropy) for several clusters in white matter tracts involved in cognitive and emotional functions including fronto-limbic circuitry (uncinate fasciculus and cingulum bundle), association fibers (inferior longitudinal fasciculus, superior longitudinal fasciculus), and corticospinal tracts. Further, we examined the possibility that cumulative risk exposure might function as one of the potential pathways by which family income influences neural outcomes. Using multiple regressions, we found lower fractional anisotropy in portions of these tracts, including those found in the left cingulum bundle and left superior longitudinal fasciculus, was significantly related to greater exposure to cumulative risk (β = -0.47, p < 0.05 and β = -0.45, p < 0.05). (shrink)

This study investigates the internationalization of small family businesses by classifying the effects of external socioemotional wealth vs. internal socioemotional wealth. The study involved 2,704 small family businesses in China, and the results support the hypothesis that family reputation has a positive effect on internationalization, while family involvement has a negative effect on internationalization. Moreover, entrepreneurial spirit reinforces the positive effect of family reputation on internationalization and enhances the negative relationship between family (...) class='Hi'>involvement and internationalization. This study contributes by examining the effect of entrepreneurial spirit as a potential balancing factor for the paradoxical influence of internal vs. external socioemotional wealth. (shrink)

This article reflects on the research required in biographical studies. The biographical focus is on the role of three generations of the Schreiner family: W.P. Schreiner (one-time Prime Minister of the Cape Colony), Justice O.D. Schreiner (judge of the Appellate Division of the Supreme Court) and Professor G.D.L. Schreiner (scientist, academic, liberal and early conceptualiser of alternative models to apartheid). All three were involved in developing, defending and sustaining liberal policies and values in South Africa from the late 19th (...) century until the advent of democracy in 1994. The clarifications and contradictions within and between oral and written sources are examined, and individual cases are discussed in which they are highlighted. The research sources include family papers, official archives, publications and, crucially, oral testimony. The oral testimony includes formal and informal interviews. This study is a contribution to the history of a family, a university and a set of values. It covers a long period in South African history during which colonialism tightened into apartheid, resistance developed and the eventual vision of a democratic South Africa came to fruition. Contribution: The primary scientific contribution is the exploration of liberal policies and values in South African political and academic history through the prism of biography. Methodologically, the article discusses possible shortcomings with oral testimony when relied on as a sole source and examines how oral evidence can be utilised in conjunction with research based on archival and published sources to develop a fuller and more nuanced picture in biographical research. (shrink)

Goal: To assess public knowledge and attitudes towards the family’s role in deceased organ donation in Europe. -/- Methods: A systematic search was conducted in CINHAL, MEDLINE, PAIS Index, Scopus, PsycINFO, and Web of Science on December 15th, 2017. Eligibility criteria were socio-empirical studies conducted in Europe from 2008 to 2017 addressing either knowledge or attitudes by the public towards the consent system, including the involvement of the family in the decision-making process, for post-mortem organ retrieval. Screening (...) and data collection were performed by two or more independent reviewers for each record. -/- Results: Of the 1482 results, 467 studies were assessed in full-text form, and 33 were included in this synthesis. When the deceased has not expressed any preference, a majority of the public support the family's role as a surrogate decision-maker. When the deceased expressly consented, the respondents' answers depend on whether they see themselves as potential donors or as a deceased's next-of-kin. Answers also depend on the relationship between the deceased and the decision-maker(s) within the family, and on their ethnic or cultural background. -/- Conclusions: Public views on the authority of the family in organ donation decision-making require further research. A common conceptual framework and validated well-designed questionnaires are needed for future studies. The findings should be considered in the development of Government policy and guidance regarding the role of families in deceased organ donation. (shrink)

Families play an essential role in deceased organ procurement. As the person cannot directly communicate his or her wishes regarding donation, the family is often the only source of information regarding consent or refusal. We provide a systematic description and analysis of the different roles the family can play, and actions the family can take, in the organ procurement process across different jurisdictions and consent systems. First, families can inform or update healthcare professionals about a person’s donation (...) wishes. Second, families can authorize organ procurement in the absence of deceased’s preferences and the default is not to remove organs, and oppose donation where there is no evidence of preference but the default is to presume consent; in both cases, the decision could be based on their own wishes or what they think the deceased would have wanted. Finally, families can overrule the known wishes of the deceased, which can mean preventing donation, or permitting donation when the deceased refused it. We propose a schema of 4 levels on which to map these possible family roles: no role, witness, surrogate, and full decisional authority. We conclude by mapping different jurisdictions onto this schema to provide a more comprehensive understanding of the consent system for organ donation and some important nuances about the role of families. This classificatory model aims to account for the majority of the world’s consent systems. It provides conceptual and methodological guidance that can be useful to researchers, professionals, and policymakers involved in organ procurement. (shrink)

Developing a care plan in a critical care context can be challenging when the therapeutic alliance between clinicians and families is compromised by anger. When these cases occur, clinicians often turn to clinical ethics consultants to assist them with repairing this alliance before further damage can occur. This paper describes five different reasons family members may feel and express anger and offers concrete strategies for clinical ethics consultants to use when working with angry families acting as surrogate decision makers (...) for critical care patients. We reviewed records of consults using thematic analysis between January 2015 and June 2016. Each case was coded to identify whether the case involved a negative encounter with an angry family. In our review, we selected 11 cases with at least one of the following concerns or reasons for anger: perceived or actual medical error, concerns about the medical team’s competence, miscommunication, perceived conflict of interest or commitment, or loss of control. To successfully implement these strategies, clinical ethics consultants, members of the medical team, and family members should share responsibility for creating a mutually respectful relationship. (shrink)

Rationale, aims and objectives To compare the pharmacotherapeutic approaches to diabetic hypertension of family physicians (FPs) and general practitioners (GPs). Methods A retrospective prescription-based study was conducted in 15 out of a total of 20 health centres, involving 115 primary care physicians – 77 FPs and 38 GPs, representing 74% of the primary care physicians of Bahrain. Prescriptions were collected during May and June 2000 to comprise a study population of 1266 diabetic-hypertensive patients. Results As monotherapy, angiotensin-converting enzyme (ACE) (...) inhibitors (37.9%) and β-blockers (38.3%) were the most commonly prescribed classes of antihypertensives by FPs and GPs, respectively. Calcium channel blockers (CCBs) were ranked third by both categories of physicians. For two-drug combinations, a β-blocker and an ACE inhibitor was the combination of choice for both physician categories. Patients managed by the FPs were more likely to receive a β-blocker–CCB combination (17.4 vs. 14.9%) or a diuretic–ACE inhibitor combination (16.7 vs. 11.4%) and less likely to receive a β-blocker–diuretic combination (11.8 vs. 16.7%) than those managed by the GPs. The proportion of patients receiving antihypertensive combinations was 40.6 and 38.5% for FPs and GPs, respectively. While the GPs prescribed CCB as a monotherapy to the elderly most often, the FPs choice was a β-blocker. Diuretics were less preferred by both FPs and GPs. β-Blocker–ACE inhibitor was again the most preferred combination of both FPs and GPs. FPs prescribed CCB–β-blocker combinations more often than GPs (P = 0.01), whereas CCB–ACE inhibitor combinations were less preferred (P = 0.09). A trend towards excessive use of short-acting nifedipine as monotherapy for elderly patients, both by FPs and by GPs, was noticed. Glibenclamide, alone or in combination with metformin, was the foremost antidiabetic drug prescribed by FPs and GPs. Middle-aged (45–64 years) patients seen by GPs were more likely to receive glibenclamide than those treated by FPs (P = 0.001) and less likely to receive gliclazide (P = 0.01). Combinations of a β-blocker with either glibenclamide or insulin were prescribed considerably more often by GPs.Conclusions Within the same practice setting, a substantial difference was observed between FPs and GPs in terms of preference for different classes of drugs in the management of diabetic hypertension. The compliance of both FPs and GPs was suboptimal; overall, the compliance of the FPs was closer to the recommended guidelines, however. Educational programmes should specifically address these inadequacies in order to improve the quality of health care. (shrink)

Based on the literature on stakeholder management and family firm dynamics, this research analyses the relationship between three constructs: the identification of business families with their family firms, FFs’ orientation toward key non-family stakeholders, and the achievement of better economic performance. Data analyses from 374 family and non-family members of 173 Spanish FFs show that a high level of family identification with their firms affects the orientation of FFs toward key non-family stakeholders in (...) setting corporate goals and that this orientation will lead to higher economic performance only when it is built on family identification with the firm. Our results also show that the significance of both relationships changes with the degree of family involvement in the management of the FF. (shrink)