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This study aims to evaluate the quality of transition from child and adolescent services to adult intellectual disability services, using the relevant National Institute for Health and Care Excellence (NICE) standard (QS140). In addition, this study also identifies any differences in transition quality between those young people with intellectual disability with and without autism.

Using routinely collected clinical data, this study identifies demographic and clinical characteristics of, and contextual complexities experienced by, young people in transition between 2017 and 2020. Compliance with the quality standard was assessed by applying dedicated search terms to the records.

The study highlighted poor recording of data with only 22% of 306 eligible cases having sufficient data recorded to determine compliance with the NICE quality standard. Available data indicated poor compliance with the standard. Child and adolescent mental health services, generally, did not record mental health co-morbidities. Compliance with three out of the five quality statements was higher for autistic young people, but this only reached statistical significance for one of those statements (i.e. having a named worker, p = 0.02).

Missing data included basic clinical characteristics such as the level of intellectual disability and the presence of autism. This required adult services to duplicate assessment procedures that potentially delayed clinical outcomes. This study highlights that poor compliance may reflect inaccurate recording that needs addressing through training and introduction of shared protocols.

To the best of the authors’ knowledge, this is the first study to examine the transition process between children’s and adults’ intellectual disability health services using NICE quality standard 140.

The purpose of this paper is to explore factors affecting implementing the National Institute for Health and Care Excellence (NICE) quality standard on alcohol misuse (QS11) and barriers and facilitators to its implementation.

Qualitative interview study analysed using directed and conventional content analyses. Participants were 38 individuals with experience of commissioning, delivering or using alcohol healthcare services in Southwark, Lambeth and Lewisham.

QS11 implementation ranged from no implementation to full implementation across the 13 statements. Implementation quality was also reported to vary widely across different settings. The analyses also uncovered numerous barriers and facilitators to implementing each statement. Overarching barriers to implementation included: inherent differences between specialist vs generalist settings; poor communication between healthcare settings; generic barriers to implementation; and poor governance structures and leadership.

QS11 was created to summarise alcohol-related NICE guidance. The aim was to simplify guidance and enhance local implementation. However, in practice the standard requires complex actions by professionals. There was considerable variation in local alcohol commissioning models, which was associated with variation in implementation. These models warrant further evaluation to identify best practice.

Little evidence exists on the implementing quality standards, as distinct from clinical practice guidelines. The authors present direct evidence on quality standard implementation, identify implementation shortcomings and make recommendations for future research and practice.

The purpose of the study was to examine whether there were differences in the provision of non-pharmacological interventions based on the level of intellectual disability and the presence or absence of autism. Mental health conditions are often underdiagnosed in adults with intellectual disability and do not always receive psychological interventions as recommended by the National Institute for Health and Care Excellent guidelines. To realise the national UK programme’s aim of stopping the overuse of medications in people with intellectual disability, it is important that these individuals have access to appropriate non-pharmacological interventions. The authors examined the relationship between an individual’s level of intellectual disability and the presence or absence of autism with access to relevant non-pharmacological interventions from specialist community intellectual disability services.

A cross-sectional study of adults accessing four specialist intellectual disability services in North West England in 2019.

There was a high prevalence of mental health comorbidity, even higher for autistic adults. However, a relatively small percentage of the study population was receiving psychological interventions. The most frequent non-pharmacological intervention was a positive behaviour support plan, irrespective of comorbid mental illnesses.

Not having access to psychological interventions for the treatment of mental illness could result in poor health outcomes and increasing health inequalities. The study highlights the need for developing psychological interventions, particularly for those with moderate to severe intellectual disability and for those with associated autism.

This large sample study examined the relationship between intellectual disability level and the presence of autism with accessing psychological interventions.

In order to create sustainable health systems, many countries are introducing ways to prioritise health services underpinned by a process of health technology assessment. While this approach requires technical judgements of clinical effectiveness and cost effectiveness, these are embedded in a wider set of social (societal) value judgements, including fairness, responsiveness to need, non-discrimination and obligations of accountability and transparency. Implementing controversial decisions faces legal, political and public challenge. To help generate acceptance for the need for health prioritisation and the resulting decisions, the purpose of this paper is to develop a novel way of encouraging key stakeholders, especially patients and the public, to become involved in the prioritisation process.

Through a multidisciplinary collaboration involving a series of international workshops, ethical and political theory (including accountability for reasonableness) have been applied to develop a practical way forward through the creation of a values framework. The authors have tested this framework in England and in New Zealand using a mixed-methods approach.

A social values framework that consists of content and process values has been developed and converted into an online decision-making audit tool.

The authors have developed an easy to use method to help stakeholders (including the public) to understand the need for prioritisation of health services and to encourage their involvement. It provides a pragmatic way of harmonising different perspectives aimed at maximising health experience.

All health care systems are facing increasing demands within finite resources. Although many countries are introducing ways to prioritise health services, the decisions often face legal, political, commercial and ethical challenge. The research will help health systems to respond to these challenges.

This study helps in increasing public involvement in complex health challenges.

No other groups have used this combination of approaches to address this issue.

A recent paradigm-shift in patient care advocates for long-term recovery and quality of life in survivors of critical illness. Evidence suggests that occupational therapists in critical care can contribute to recovery in areas such as functional outcomes, length of stay and delirium, although poor role understanding can limit service-utilisation. The purpose of this study is to investigate current and future roles and practices of critical care occupational therapists in the UK.

Occupational therapists with clinical experience in adult critical care were invited to participate in a mixed-methods design using a locally developed online questionnaire and semi-structured interviews, concurrently. Descriptive statistics were generated through SPSS. Qualitative data were analysed using the framework approach.

Twelve occupational therapists participated in the survey element, with five continuing to interview. Occupational therapists described a multifaceted role in critical care where the majority reported practice in upper limb function, seating/positioning, cognition, psychosocial sequelae and discharge planning. Role and internal characteristics impacted on service delivery. It is envisaged that earlier intervention in a greater percentage of patients, a greater evidence-base, raising awareness and adequate staffing will be features for future development.

This study provides new insight into the current role and practices of adult critical care occupational therapists in England and generates insights into their role in addressing physical and non-physical morbidity for this patient cohort. Findings are preliminary in nature; however, future research is warranted to evaluate the effectiveness of interventions.

This conceptual, multi-voiced paper aims to collectively explore and theorize family entrepreneuring, which is a research stream dedicated to investigating the emergence and becoming of entrepreneurial phenomena in business families and family firms.

Because of the novelty of this research stream, the authors asked 20 scholars in entrepreneurship and family business to reflect on topics, methods and issues that should be addressed to move this field forward.

Authors highlight key challenges and point to new research directions for understanding family entrepreneuring in relation to issues such as agency, processualism and context.

This study offers a compilation of multiple perspectives and leverage recent developments in the fields of entrepreneurship and family business to advance research on family entrepreneuring.

This study aims to increase the understanding of the emergence of a values-based (VB) premium private label (PL) brand reputation within a multiple-tier PL brand portfolio in retailing.

By building on the research on PLs, brand image, brand reputation and consumer values, this study creates a conceptual foundation for the emergence of VB PL brand reputation within a multiple-tier brand portfolio among consumers and examines the emergence of such reputation empirically using interpretive exploratory qualitative laddering interviews in the context of fast-moving consumer goods.

The findings of this study illustrate that the VB reputations of the premium PL product brand and the PL brand store intertwine, ultimately relating to two terminal values: pleasure and doing good. These reputations differ remarkably from the VB reputations of the economy PL brand and the umbrella brand of the retail chain (not doing good and financial security).

This study explains the emergence of VB brand reputation within a multiple-tier brand portfolio and introduces the use of the laddering technique in such research.

This study reminds brand managers to carefully design the relevant brand strategy for brands and their relationships under a brand umbrella.

Although much is known about PL brands and brand reputation, to the best of the authors’ knowledge, this study might be the first to increase the understanding of how a VB premium PL brand reputation emerges and accumulates from brand images within a multiple-tier brand portfolio.

There is widespread agreement that the tourism sector should address the issue of sustainability. The purpose of this study is to analyze the digital accessibility of the cities awarded as European Capitals of Smart Tourism for their innovative, accessible and sustainable practices by the European Commission.

An analysis of the digital level of accessibility of 50 uniform resource locator (URL) of European cities was undertaken. The analysis followed the international evaluation requirements of the World Wide Web (W3C).

The results show that none of the official Web pages analyzed obtained 100% in relation to the digital accessibility requirements. The main factors that pose barriers to communication and interaction were identified.

The paper encourages smart tourism destinations to overcome the challenge of matching both dimensions of accessibility to obtain barrier-free information to ensure cities are inclusive and sustainable in line with Agenda 2030 (sustainable development goal [SDG] 11).

The concept of tourism for all receives special attention in the sector, and this notion is reflected in the UN SDGs. However, accessibility has not been extensively analyzed in relation to the cohesion between the digital and the physical dimension. Tourism research tends to focus on accessible experiences within destinations. This paper introduces a new insight into the key issue of digital accessibility, which can promote destination choice and influence the tourism experience.

人们普遍认为, 旅游业应该解决可持续性问题。本研究旨在分析被欧盟委员会授予欧洲智慧旅游之都的城市的数字可及性, 以了解其创新、可及和可持续的做法。

对50个欧洲城市的URL的数字可及性进行了分析。该分析遵循万维网（W3C）的国际评估标准。

结果显示, 所分析的官方网页中没有一个获得100%的数字无障碍要求。对交流和互动构成障碍的主要因素被确认。

全民旅游的概念在该领域受到特别关注, 这一概念也反映在联合国可持续发展目标（SDGs）中。然而, 无障碍性还没有被广泛地分析到数字和物理层面之间的凝聚力。旅游研究倾向于关注目的地内的无障碍体验。本文对数字可及性这一关键问题提出了新的见解, 它可以促进目的地的选择并影响旅游体验。

本文鼓励智能旅游目的地克服挑战, 使无障碍环境的两个维度相匹配, 以获得无障碍信息, 确保城市的包容性和可持续性符合2030年议程（SDG 11）。

Existe un acuerdo generalizado en el sector turístico para abordar la cuestión de la sostenibilidad. Este estudio pretende analizar la accesibilidad digital de las ciudades premiadas como Capitales Europeas del Turismo Inteligente por sus prácticas innovadoras, accesibles y sostenibles por la Comisión Europea.

Se realizó un análisis del nivel de accesibilidad digital de cincuenta (50) URL de ciudades europeas. El análisis siguió las normas internacionales de evaluación de la World Wide Web (W3C).

Los resultados muestran que ninguna de las páginas Web oficiales analizadas obtuvo el 100% en relación con los requisitos de accesibilidad digital. Se identificaron los principales factores que suponen barreras para la comunicación y la interacción.

El concepto de turismo para todos recibe especial atención en el sector y esta noción se refleja en los Objetivos de Desarrollo Sostenible (ODS) de la ONU. Sin embargo, la accesibilidad no se ha analizado ampliamente en relación con la cohesión entre la dimensión digital y la física. La investigación turística tiende a centrarse en las experiencias accesibles dentro de los destinos. Este artículo introduce una nueva perspectiva sobre la cuestión clave de la accesibilidad digital, que puede promover la elección del destino e influir en la experiencia turística.

El documento anima a los destinos turísticos inteligentes a superar el reto de hacer coincidir ambas dimensiones de la accesibilidad para obtener información sin barreras que garantice que las ciudades sean inclusivas y sostenibles en línea con la Agenda 2030 (ODS 11).

Drawing on upper echelons theory (UET) and arguments from behavioral theory of the firm, this paper aims to contribute to the debate on family involvement-performance relationship, by considering the mediating role of the propensity towards merger and acquisition (M&A) and the moderating role of performance feedback.

The hypotheses are tested by applying a moderated mediation analysis on a sample of 111 German family firms. First, a mediation model is run to verify the mediation role of the propensity towards M&A; then, to evaluate the magnitude of the mediation at different values of the moderator (performance feedback), conditional indirect effects are tested using normal-theory standard errors and bootstrapping procedure.

The main findings suggest that a higher percentage of family members sitting in TMT is related to better performance and that this effect is mediated by the propensity towards M&A. Furthermore, findings also show that a higher percentage of family managers is positively related to the propensity towards M&A and, in turn, exerts a positive effect of firm performance, especially when performance feedback is negative.

The paper suggests to family firms' managers that when performance feedback is negative, a riskier behavior, such as M&A, could represent a way to improve firm performance.

The paper provides a full application of UET to the context of family firms, offers the point of view of TMT, instead of that of ownership, to study the propensity towards M&A in family firms and goes beyond the rational view to explain family managers' risk-taking behaviors.

Secondary customers often experience secondary vulnerabilities that manifest in family-centred transformative services as other- and self-related customer needs. Yet, a relational perspective on primary and secondary customers’ needs is lacking. The study analyses secondary customers’ needs and their relationship to primary customers’ needs to enhance well-being in customer entities. The service inclusion lens is used to understand customers’ experiences of vulnerability.

The study uses an exploratory approach. The data consists of ethnographic observations and interviews of elderly residents (primary customers), their family members (secondary customers) and nurses in two nursing homes.

Primary and secondary customers’ needs are interrelated (or unrelated) in four ways: they are separate, congruent, intertwined or discrepant. The vulnerability experiences fluctuate in intensity and over time, individually reflecting on these need dimensions.

The study contributes to service research concerning customers’ experiences of vulnerability, secondary customers and their inclusion in services. Primary customers’ service inclusion may increase/decrease secondary customers’ service inclusion and their experience of vulnerability. Moreover, secondary customers’ inclusion is often necessary to foster primary customers’ inclusion and well-being.

Fostering service inclusion and well-being for primary and secondary customers requires balanced inclusion and acknowledging the needs of both groups. Service providers may need to act as moderators within customer entities if discrepant needs occur.

The study addresses the under-researched areas of family members’ customer needs, their relation to primary customers’ needs, experiences of secondary vulnerability and context-related vulnerability.