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This paper aims to understand the clinical practice of physiotherapists and occupational therapists in the Republic of Ireland in the assessment and treatment of spasticity in adults, to inform and improve spasticity management practice. This study also aims to describe therapists’ knowledge, confidence and perceived barriers in the management of spasticity.

A cross sectional survey design study was completed, and respondents were recruited through an online survey.

In total, 92 respondents from a wide range of clinical settings revealed there is considerable variation in services available nationally for adults presenting with spasticity. There were significant inconsistencies across all areas of practice. The majority of respondents (94%) did provide intervention to patients with spasticity, yet three quarters did not have access to a specialist spasticity clinic, and the majority (82%) did not feel they were providing sufficient treatment intensity for spasticity.

These findings provide a unique insight into the assessment and treatment practices of Irish physiotherapists and occupational therapists. These results demonstrate the need for further upskilling and specialist high-quality spasticity services nationally.

This study aims to examine the relationship between medication for opioid use disorder (MOUD) among pregnant individuals, referral source, mental health, political affiliation and substance use policies in all 50 states in the USA.

This study describes MOUD receipt among pregnant people with an opioid use disorder (OUD) in 2018. The authors explored sociodemographic differences in MOUD receipt, referrals and co-occurring mental health disorders. The authors included a comparison of MOUD receipt among states that have varying substance use policies and examined the impact of these policies and the political affiliation on MOUD. The authors used multilevel binary logistic regression to examine effects of individual and state-level characteristics on MOUD.

Among 8,790 pregnant admissions with OUD, the majority who received MOUD occurred in the Northeast region (71.52%), and 14.99% were referred by the criminal justice system (n = 1,318). Of those who were self-referred, 66.39% received MOUD, while only 30.8% of referrals from the criminal justice system received MOUD. Those referred from the criminal justice system or who had a co-occurring mental health disorder were least likely to receive MOUD. The multilevel model showed that while policies were not a significant predictor, a state’s political affiliation was a significant predictor of MOUD.

The study has some methodological limitations; a state-level analysis, even when considering the individual factors, may not provide sufficient description of community-level or other social factors that may influence MOUD receipt. This study adds to the growing literature on the ineffectiveness of prenatal substance use policies designed specifically to increase the use of MOUD. If such policies are consistently assessed as not contributing to substantial increase in MOUD among pregnant women over time, it is imperative to investigate potential mechanisms in these policies that may not facilitate MOUD access the way they are intended to.

Findings from this study aid in understanding the impact that a political affiliation may have on treatment access; states that leaned more Democratic were more likely to have higher rates of MOUD, and this finding can lead to research that focuses on how and why this contributes to greater treatment utilization. This study provides estimates of underutilization at a state level and the mechanisms that act as barriers, which is a stronger assessment of how state-specific policies and practices are performing in addressing prenatal substance use and a necessary step in implementing changes that can improve the links between pregnant women and MOUD.

To the best of the authors’ knowledge, this is the first study to explore individual-level factors that include mental health and referral sources to treatment that lead to MOUD use in the context of state-level policy and political environments. Most studies estimate national-level rates of treatment use only, which can be useful, but what is necessary is to understand what mechanisms are at work that vary by state. This study also found that while substance use policies were designed to increase MOUD for pregnant women, this was not as prominent a predictor as other factors, like mental health, being referred from the criminal justice system, and living in a state with more Democratic-leaning affiliations.

This study focuses on the triadic multilevel psychic distance (MPD) between the firm, target market and bridge-maker and its consequences for firm internationalization. Specifically, it spotlights the triadic psychic distance between firms, the levels of psychic distance in the target market (country and business) and the bridge-maker. Therefore, this study examines the triadic MPD among these three entities and its impact on firm internationalization.

This study uses qualitative and case study research approaches. It is based on 8 case companies and 24 internationalization cases. Secondary data were collected, and interviews with bridge-makers and industry experts were conducted.

The study found that MPD appeared in the triad. The MPD between firms and markets is related to country-specific differences and business difficulties. The MPD between the firm and the bridge-maker is based on the latter’s lack of knowledge vis-à-vis bridging the firm’s MPD. Finally, the MPD between bridge-makers and the market is based on the former’s lack of knowledge of the home country’s business difficulties.

This is the first study to develop and adopt a triadic multilevel psychic distance conceptualization that provides evidence for and sheds light on the triadic MPD and its effect on firm internationalization. This study identifies the reasons behind triadic MPD in connection to firm internationalization. Notably, firm internationalization is interdependent on the triadic MPD setting between the firm, bridge-maker and target market. It has theoretical value and contributes to the recent advancement in the understanding of MPD in international marketing literature.

Coronavirus disease (COVID-19) has challenged leadership in hospitals worldwide. The experiences of leadership during the pandemic changed leadership significantly. This study aims to describe nurse leaders’ perceptions of what future leadership in hospital settings in the post-pandemic era needs to be like.

A qualitative descriptive study was used. A total of 20 nurse leaders from the Finnish central hospital were interviewed from June to October 2021. The data were analysed using inductive content analysis.

The analysis revealed five main categories describing nurse leaders’ perceptions of future leadership in hospital settings in the post-pandemic era: digitalisation and hybrid working culture, development of sustainable working conditions, moving smoothly to the post-pandemic era, dissolution of traditional regimes of organisation and flexibility in leadership.

In the post-pandemic era, the constantly changing demands and challenges currently facing healthcare systems have significantly increased the complexity of hospital organisations. This requires critical evaluation and change to traditional leadership. Enhancing flexibility and authenticity in leadership, strengthening competencies, implementing a wide range of digital resources and increasing the appeal of the nursing profession to build the next generation of nurses – all of these are needed to provide sustainability in future healthcare.

The results identify the critical points of leadership that need to be developed for future challenges and for maintaining a sufficient supply of qualified professionals. Acting on this information will enhance flexibility in organisations and lead to acceleration of changes and the development of new kinds of leadership in the future

This paper on the prevalence of attention deficit hyperactive disorder (ADHD) in schools holds immense significance due to its unique contribution to the existing body of knowledge. This study stands out as one of the few conducted in Uganda and the entire African continent. The purpose of this study is to establish the prevalence of ADHD symptoms in government primary schools in Wakiso District, Uganda. And also inform educational policies and interventions tailored to address the needs of children with ADHD in Uganda and globally.

The research paradigm adopted was pragmatism, an explanatory sequential mixed methods approach was used, with a quantitative sample of 1,067 participants (learners), 64 teachers who underwent a series of training to equip them with the necessary knowledge about ADHD filled questionnaires for the 1,067 learners, four teachers selected in each school, one teacher per class and a qualitative sample of 32 teachers and one key informant from 16 primary schools. Random and purposive sampling was used. The strengths and weaknesses of ADHD symptoms and normal behavior scale questionnaire was used for quantitative data collection, while qualitative data was gathered through interviews, observations and focus group discussion.

The results revealed an overall prevalence of ADHD symptoms of 11.60%, with inattention symptoms being more dominant than hyperactive/impulsivity symptoms (8.82%). There was no significant difference in prevalence between boys and girls, with primary one pupils having the highest prevalence of symptoms and primary four pupils having the lowest. Pupils aged 10–13 may be less susceptible to ADHD symptoms. The most prevalent symptoms were linked to interrupting or intruding behavior, failure to give attention to detail and inability to play quietly. Qualitative data from the key informant’s observations and teacher focus groups supported these findings.

Limited geographic scope: The study was conducted in only one district, Wakiso, in Uganda. However, this district is very densely populated with people from different cultural and economic background, making it representative of the entire country Uganda. While the response rates for both the quantitative and qualitative components were relatively high (95% and 84%, respectively), there is a possibility that those who chose to participate may have different experiences. But the response rate provided sufficient data for analysis according to the researcher.

The researcher recommends that further research is needed in other districts; also, there is a need to develop early intervention strategies for teachers and parents with ADHD children. More research is needed to better understand the primary causes and risk factors associated with ADHD in primary school children.

This study stands out as one of the few conducted in Uganda and the entire African continent on ADHD. By addressing this research gap, the paper adds valuable insights to the field of ADHD research, shedding light on the prevalence of ADHD symptoms, which can be used to investigate the impact of ADHD on academic performance within the Ugandan education system further. The findings of this study have the potential to inform educational policies and interventions tailored to address the needs of children with ADHD in Africa and beyond.

The purpose of this paper is to understand if and how industrialized house building (IHB) could support productivity developments for housebuilding on project and industry levels. The take is that fragmentation of construction is one explanation for the lack of productivity growth, and that IHB could be an integrating method of overcoming horizontal and vertical fragmentation.

Singe-factor productivity measures are calculated based on data reported by IHB companies and compared to official produced and published research data. The survey covers the years 2013–2020 for IHB companies building multi-storey houses in timber. Generalization is sought through descriptive statistics by contrasting the data samples to the used means to control vertical and horizontal fragmentation formulated as three theoretical propositions.

According to the results, IHB in timber is on average more productive than conventional housebuilding at the company level, project level, in absolute and in growth terms over the eight-year period. On the company level, the labour productivity was on average 10% higher for IHB compared to general construction and positioned between general construction and general manufacturing. On the project level, IHB displayed an average cost productivity growth of 19% for an employed prefabrication degree of about 45%.

Empirical evidence is presented quantifying so far perceived advantages of IHB. By providing analysis of actual cost and project data derived from IHB companies, the article quantifies previous research that IHB is not only about prefabrication. The observed positive productivity growth in relation to the employed prefabrication degree indicates that off-site production is not a sufficient mean for reaching high productivity and productivity growth. Instead, the capabilities to integrate the operative logic of conventional housebuilding together with logic of IHB platform development and use is a probable explanation of the observed positive productivity growth.

This study aims to explore how managers exercise agency in strategic investment decisions (SIDs) by drawing on their knowledgeability of the strategic context. Specifically, the authors address the role of position–practice relations and irresistible causal forces in this conduct.

The authors examine SID-making (SIDM) practices in four case organisations operating in highly competitive markets, conducting interviews with managers at various levels and analysing company documents. Drawing on strong structuration theory, the authors show how managerial decision makers draw upon their knowledge of organisational context when exercising agency in SIDs.

The authors provide insights into how SIDM behaviour, specifically agents’ conduct, is shaped by a combination of position–practice relations and the agents’ comprehension of their organisation’s context.

The authors extend the SIDM literature by surfacing the issue of how actors’ conjuncturally-specific knowledge of external structures shapes the general dispositions they draw on in exercising agency in practice.

The authors extend the SIDM literature by surfacing the issue of how actors’ conjuncturally-specific knowledge of external structures shapes the general dispositions they draw on in exercising agency in practice. Particularly, the authors contribute to this literature by identifying irresistible causal forces and illuminating why actors might not resist in SIDM processes, despite having the potential to do so.

The purpose of this study is to investigate whether and how inter-firm cooperation and firm age moderate the relationship between family ownership and productivity.

We first estimate the total factor productivity (TFP) of a large sample of Italian firms observed over the period 2010–2018 and then apply a Poisson random effects model.

TFP is, on average, higher for non-family firms (non-FFs) than for FF. Furthermore, inter-organizational cooperation and firm age mitigate the negative effect of family ownership. In detail, it is found that belonging to a network acts as a moderator in different ways according to firm age. Indeed, young FFs underperform non-FF peers, although the TFP gap decreases with age. In contrast, the benefits of a formal network are high for older FFs, suggesting that an age-related learning process is at work.

The study provides evidence that FFs can outperform non-FFs when they move away from Socio-Emotional Wealth-centered reference points and exploit knowledge flows arising from high levels of social capital. In the case of mature FFs, networking is a driver of TFP, allowing them to acquire external resources. Since FFs often do not have sufficient in-house knowledge and resources, they must be aware of the value of business cooperation. While preserving the familiar identity of small companies, networks grant FFs the competitive and scale advantages of being large.

Despite the wide but ambiguous body of research on the performance gap between FFs and non-FFs, little is known about the role of FFs’ heterogeneity. This study has proven successful in detecting age as a factor in heterogeneity, specifically to explain the network effect on the link between ownership and TFP. Based on a representative sample, the study provides a solid framework for FFs, policymakers and academic research on family-owned companies.

Recent developments in the EU’s anti-corruption strategy have brought the EU closer to meeting the UNCAC’s objectives, i.e. the Proposal for a Directive on combating corruption (2023) and the Proposal for a Directive on Asset Recovery and Confiscation (2022). This paper aims to discuss these developments from the perspective of the UNCAC, to identify missing elements in the EU’s asset recovery mechanisms.

Critical approach towards EU anti-corruption policy (discussing the problems and solutions). Review of EU developments in asset recovery law.

There is a political will on the part of the EU to fight corruption through the rules enshrined in the UNCAC. However, improving EU law by introducing a new type of confiscation of unexplained wealth and criminalising illicit enrichment, without establishing convergent rules for the return of corrupt assets from EU territory to the countries of origin, cannot be seen as sufficient action to achieve the UNCAC’s objectives. In modelling mechanisms of the return of assets, the EU should search for solutions to overcome the difficulties resulting from the ordre public clause remaining a significant factor conditioning mutual legal assistance.

This paper discusses the possible input of the EU, as a non-State Party to the UNCAC, to advance implementing the UNCAC solutions on asset recovery by establishing convergent rules for the return of corrupt assets from EU territory to countries of origin.

This study aims to investigate why and how shared service centres (SSCs) are implemented as well as how they affect audit firm practice and audit quality.

In this qualitative study guided by the theoretical framework of institutional theory, the authors conducted 25 semi-structured interviews in seven European countries, including 16 interviews with audit partners from Big 4 firms, 6 with audit team members, 2 with interviewees from second-tier audit firms and 1 with a member of an oversight body.

The authors show that the central rationale for audit firms to implement SSCs is economic rather than external legitimacy. The authors find that SSC implementation has substantial effects on audit practices, particularly those related to standardisation, coordination and monitoring activities. The authors also highlight the potential impacts on audit quality.

By exploring the motivation for and effects of SSC implementation amongst audit firms, the authors offer insights into the best practices related to subsequent change processes and audit quality.