Family Impact Research Articles

Physical, Cognitive, Emotional, and Social Health Outcomes of Parents in the First Six Months after Childhood Critical Illness: A Prospective Single Centre Study.

Childhood critical illness can have long-term effects on families, but the extent and trajectory of recovery for parents are unknown. Using prospective longitudinal design, we describe the health outcomes of parents and their trajectory six months after paediatric intensive care unit (PICU) discharge. Parents reported health outcomes at PICU discharge (baseline), and 1-, 3-, and 6-months post-discharge. We used the Pediatric Quality-of-Life Family Impact Module, Patient Health Questionnaire-4, and post-traumatic stress disorder (PTSD) Checklist for DSM-5. The group-based trajectory model was used to identify recovery patterns. We included 128 parents of children aged 1 month to 18 years, admitted to the PICU for ≥48 h. Three post-discharge composite health trajectory groups were classified: 54 mild (42%), 68 moderate (53%), and 6 severe (4%). Parents in the mild and moderate groups returned to baseline health within the first 3 months, but those in the severe group exhibited worse outcomes at 6-months. The mean (SD) PICU stay durations for mild, moderate, and severe groups were 9 (16), 7 (10), and 38 (61) days; days of mechanical ventilation were 4 (5), 4 (7), and 18 (25) days; and readmission rates were 12 (22%), 23 (34%), and 4 (66%), respectively. Identifying these trajectories enables novel, targeted interventions for at-risk parents, underscoring the significance of integrated PICU follow-up care.

The PRECISE-DYAD Neurodevelopmental substudy protocol: neurodevelopmental risk in children of mothers with pregnancy complications.

Over 250 million children are not reaching their developmental potential globally. The impact of prenatal factors and their interplay with postnatal environmental factors on child neurodevelopment, is still unclear-particularly in low- and middle-income settings. This study aims to understand the impact of pregnancy complications as well as environmental, psychosocial, and biological predictors on neurodevelopmental trajectories. This is an observational cohort study of female and male children (≈3,950) born to women (≈4,200) with and without pregnancy complications (pregnancy-induced hypertension, foetal growth restriction, and premature birth) previously recruited into PREgnancy Care Integrating Translational Science, Everywhere study with detailed biological data collected in intrapartum and post-partum periods. Children will be assessed at six weeks to 6 months, 11-13 months, 23-25 months and 35-37 months in rural and semi-urban Gambia (Farafenni, Illiasa, and Ngayen Sanjal) and Kenya (Mariakani and Rabai). We will assess children's neurodevelopment using Prechtls General Movement Assessment, the Malawi Development Assessment Tool (primary outcome), Observation of Maternal-Child Interaction, the Neurodevelopmental Disorder Screening Tool, and the Epilepsy Screening tool. Children screening positive will be assessed with Cardiff cards (vision), Modified Checklist for Autism in Toddlers Revised, and Pediatric Quality of Life Inventory Family Impact. We will use multivariate logistic regression analysis to investigate the impact of pregnancy complications on neurodevelopment and conduct structural equation modelling using latent class growth to study trajectories and relationships between biological, environmental, and psychosocial factors on child development. We aim to provide information regarding the neurodevelopment of infants and children born to women with and without pregnancy complications at multiple time points during the first three years of life in two low-resource African communities. A detailed evaluation of developmental trajectories and their predictors will provide information on the most strategic points of intervention to prevent and reduce the incidence of neurodevelopmental impairments.

Novel Framework of Financial Hardship in Childhood Cancer: Incorporating Stakeholder Perspectives.

Although financial hardship in childhood cancer contributes to poor outcomes, no standardized tool to assess its impact exists. Existing methods are heterogeneous and designed using high-income country (HIC), adult perspectives. This project aimed to construct a stakeholder-informed conceptual framework of financial hardship in childhood cancer with global relevancy. Group concept mapping, a participatory mixed-methods approach, was used. Participants were parents or caregivers of a child with cancer, childhood cancer survivors, and clinical or nonclinical support personnel, fluent in English, Spanish, or Portuguese. A representative panel established a comprehensive list of relevant items. Participants individually sorted these items into concepts and then rated each item for impact using a four-point Likert scale. Multidimensional scaling and hierarchical cluster analysis identified concepts. Descriptive statistics were calculated for impact ratings. One fourth (21/80) of participants were parents/caregivers or childhood cancer survivors. Participants worked in clinical (44/80), charity/volunteer (27/80), and other nonclinical (13/80) roles. Of the 41 represented countries, 78.0% (32) were low- and middle-income countries (LMICs). Conceptual themes spanned six distinct clusters: medical, nonmedical, assistance and support, treatment impact, family impact, and caregiver impact. These were distinct in composition compared with an existing framework for adult oncology. Caregiver impact (mean, 3.39) and treatment impact (mean, 3.29) were the highest rated clusters, and impact ratings were higher in LMICs compared with HICs. We developed a framework for financial hardship in childhood cancer that reflects the voices of stakeholders, including parents and caregivers, from diverse global contexts. The findings lay a foundation for the development and validation of tools to systematically assess financial hardship in families of children with cancer and inform effective policies and interventions.

How parent stress and COVID-19 impact on the family are associated with parental pressure to eat during COVID-19

This study aimed to assess how parent stress and COVID-19 impact on the family are associated with parental pressure to eat during the COVID-19 pandemic. Parents of healthy preschool-aged children completed measures including pressure to eat (Child Feeding Questionnaire), parent perception of their stress (Perceived Stress Scale), household food insecurity (Hunger Vital Sign) and effects of COVID-19 on families (COVID-19 Exposure and Family Impact). Children (N = 228) were racially, ethnically, and socioeconomically diverse (34 % Black, 15 % Hispanic, and 29 % with household income <$20,000). Bivariate analyses showed that parent stress at Year 1 (β 0.02; 95 % CI 0.006, 0.04) was significantly associated with pressure to eat at Year 1 and that COVID-19 impact at Year 1 (β 0.02; 95 % CI 0.001, 0.03) was also significantly associated with pressure to eat. Multivariable linear regression analyses showed that parent stress at Year 1 was significantly associated with pressure to eat at Year 1 (β 0.39; 95 % CI 0.16, 0.61) while COVID-19 impact was not significantly associated with pressure to eat at Year 1. This study, consisting of racially and socioeconomically diverse children, found that while parent stress was significantly associated with increased parental utilization of pressure to eat feeding practice, COVID-19 impact was not significantly associated with pressure to eat in adjusted analyses. This suggests that overall perceived stress by parents could be an important factor in parent pressuring feeding practices.

The YTH domain-containing protein family: Emerging players in immunomodulation and tumour immunotherapy targets.

The modification of N6-methyladenosine (m6A) plays a pivotal role in tumor by altering both innate and adaptive immune systems through various pathways, including the regulation of messenger RNA. The YTH domain protein family, acting as "readers" of m6A modifications, affects RNA splicing, stability, and immunogenicity, thereby playing essential roles in immune regulation and antitumor immunity. Despite their significance, the impact of the YTH domain protein family on tumor initiation and progression, as well as their involvement in tumor immune regulation and therapy, remains underexplored and lacks comprehensive review. This review introduces the molecular characteristics of the YTH domain protein family and their physiological and pathological roles in biological behavior, emphasizing their mechanisms in regulating immune responses and antitumor immunity. Additionally, the review discusses the roles of the YTH domain protein family in immune-related diseases and tumor resistance, highlighting that abnormal expression or dysfunction of YTH proteins is closely linked to tumor resistance. This review provides an in-depth understanding of the YTH domain protein family in immune regulation and antitumor immunity, suggesting new strategies and directions for immunotherapy of related diseases. These insights not only deepen our comprehension of m6A modifications and YTH protein functions but also pave the way for future research and clinical applications.

Do Ethnic Identity, Familial, and Community Contexts Impact the Association Between Adverse Childhood Experiences and Psychopathology Among Latinx Adolescents?

Few studies have explored the interplay of how individual identity, parental, familial, and contextual factors impact associations between Latinx adolescent adversities and psychopathology. This study aimed to examine whether these factors mediate the relationship between adversities and psychopathology in Latinx youth. Latinx youth (n= 2,411) data from the Adolescent Brain Cognitive Development (ABCD) Study were used to examine path models with adverse childhood experiences (ACEs) as the predictor and either youth- or caregiver-rated internalizing/externalizing scores over 4 timepoints as the outcome (ages 9-13 years). Models examined 3 potential mediators: (1) ethnic identity, (2) familial context (comprising parental monitoring, family conflict, and caregiver acceptance), and (3) community cohesion. Models were conducted separately for internalizing and externalizing symptoms. Greater adversity was associated with greater youth- and caregiver-rated internalizing/externalizing psychopathology over time. Greater adversity was associated with lower family functioning and lower ethnic identity, and greater family functioning was associated with lower psychopathology. Family functioning mediated associations between adversity and psychopathology over time (youth-reported internalizing: 95% CI= 0.012-0.019; youth-reported externalizing: 95% CI= 0.020-0.028). In contrast, there was not strong evidence for ethnic identity and community cohesion mediating associations between adversities and psychopathology over time. Unlike previous studies, ethnic identity did not influence the relationship between ACEs and psychopathology over time. Additional research is needed to identify whether possible tensions rise as Latinx youth acculturate into US culture and achieve optimal levels of ethnic identity formation. Providers need to assess specific Latinx parental and familial contexts that may interfere with youth identity formation.

Preliminary Reliability &amp; Validity of the PedsQL Family Impact Module in Families of Children With Barth Syndrome: Using Propensity Score Matching

Abstract Date Presented 03/21/24 This study applied a propensity score matching method to improve methodological rigor in examining the psychometric properties of the PedsQL Family Impact Module with parents of children with Barth syndrome in the field of OT. Primary Author and Speaker: Yoonjeong Lim Additional Authors and Speakers: Ickpyo Hong, Areum Han

The PedsQL Family Impact Module: Preliminary Reliability &amp; Validity in Families of Children With Congenital Muscular Dystrophy

Abstract Date Presented 03/21/24 This study applied a propensity score-matching method to improve methodological rigor in examining the psychometric properties of the PedsQL Family Impact Module with parents of children with congenital muscular dystrophy in OT. Primary Author and Speaker: Yoonjeong Lim Additional Authors and Speakers: Ickpyo Hong, Areum Han

A multi-center cross-sectional comparison of parent-reported quality of life and bowel function between anorectal malformation and Hirschsprung's disease patients with versus those without Down syndrome.

Down syndrome (DS) is a common abnormality associated with anorectal malformation (ARM) and Hirschsprung's disease (HD). However, quality of life (QOL) in ARM and HD patients with DS is under-researched. This study compares parent-reported QOL and bowel function in ARM and HD patients with DS to those without. Between December 2020 to February 2023, parents of ARM and HD patients with and without DS aged 3-17 years who had undergone surgery > 12 months prior at four tertiary referral centers were recruited. We used the Pediatric Quality of Life Inventory™ (PedsQL™) Generic Core Scales, General Well-Being (GWB) Scale and Family Impact (FI) Module questionnaires, and the Rintala bowel function score (BFS). There were 101 ARM, 9 (8.9%) of whom had DS; and 87 HD, of whom 6 (6.9%) had DS. Parent-reported Core scores in ARM and HD with DS were comparable to those without DS. However, ARM and HD with DS had worse scores in the FI Module and bowel function than those without DS. Although parent-reported QOL in ARM and HD with DS is similar to those without DS, family impact and BFS are worse. Our findings are limited by small sample size in proportion of DS patients.

HSPB1 alleviates acute-on-chronic liver failure via the P53/Bax pathway.

The mortality rate of acute-on-chronic liver failure (ACLF) remains significantly elevated; hence, this study aimed to investigate the impact of heat shock protein family B (small) member 1 (HSPB1) on ACLF in vivo and in vitro and the underlying mechanism. This study used the ACLF mouse model, and liver damage extent was studied employing Masson trichrome, hematoxylin and eosin (H&E), Sirius red staining, and serum biochemical indices. Similarly, hepatocyte injury in lipopolysaccharide (LPS)-induced L02 cells was evaluated using cell counting kit-8 assay, enzymatic activity, flow cytometry, and TUNEL assay, while the underlying mechanism was investigated using western blot. Results showed that the morphology of liver tissue in ACLF mice was changed and was characterized by cirrhosis, fibrosis, collagen fiber deposition, inflammatory cell infiltration, and elevated liver injury indices. Moreover, HSPB1 was upregulated in both ACLF patients and mice, where overexpressing HSPB1 was found to inhibit ACLF-induced liver damage. Similarly, the HSPB1 expression in LPS-treated L02 cell lines was also increased, where overexpressing HSPB1 was found to promote cell viability, inhibit liver injury-related enzyme activity, and suppress apoptosis. Mechanistic investigations revealed that HSPB1 was responsible for inhibiting p-P53 and Bax protein levels, where activated P53 counteracted HSPB1's effects on cellular behaviors. In conclusion, HSPB1 attenuated ACLF-induced liver injury in vivo and inhibited LPS-induced hepatocyte damage in vitro, suggesting that HSPB1 may be a novel target for ACLF therapy.

Oral Health-related Quality of Life of Children with Special Health Care Needs in Riyadh: A Cross-sectional Study.

To assess children's OHRQoL and associated factors among a sample of children with special needs in Riyadh, Saudi Arabia. A sample of 6- to 12-year-old children was obtained using convenience sampling from rehabilitation centers. Data were collected through a questionnaire and dental examination. The questionnaire included items related to the children's and their families' characteristics, oral health-related quality of life scales (Parental-Caregivers Perceptions Questionnaire [P-CPQ] and Family Impact Scale [FIS]), perceived health status, and dental care utilisation. Clinical examination was performed by a trained and calibrated dentist. The data were analysed using SPSS; descriptive and inferential data analyses were also performed using SPSS. The mean P-CPQ was 1.10 ± 0.74, and the mean FIS was 1.39 ± 0.88. There was a statistically significant correlation between P-CPQ and caries (r = 0.36, p = 0.02). After controlling for confounders, caries was associated with poor P-CPQ (B = 0.06, p = 0.024). Compared to low-income families, higher-income families had better P-CPQ (4000-8000 SAR: B = -1.36, p = 0.001). Poor oral health-related quality of life in Saudi children is associated with caries and low income. Preventive measures addressing social determinants are vital to control caries and promote oral health in children with special health-care needs.

Politics for Exclusion and Strategies for Inclusion: A Scoping Review of Nordic Family Reunification Policies, Practices, and Impact on Refugees

Politics for Exclusion and Strategies for Inclusion: A Scoping Review of Nordic Family Reunification Policies, Practices, and Impact on Refugees

Cardiovascular malformation associated with esophageal atresia

Abstract Background Congenital heart disease (CHD) is the commonest abnormality associated with esophageal atresia (EA). EA is a rare congenital malformation occurring in 3-4 in 10,000 births, in 87% occurs along with a distal tracheoesophageal fistula (TEF). The coexistence of a cardiac malformation and in addition, prematurity can be challenging and affects the further treatment and quality of life (QOL) of the child and family. Knowledge of the anatomical type and physiological consequences of CHD allows a well-coordinated treatment plan. Purpose The aim of this paper is to investigate whether the presence of underlying associated malformations, disease-specific problems and prematurity would have a considerable influence on the family of a child after surgical repair of EA. Methods We used a crossed-sectional questionnaire study. The impact of EA was assessed using an Authors-Designed Questionnaire (ADQ) to collect medical and sociodemographic background data (gestational week (HBD), comorbidities, type of EA, according to the Gross classification) as well as standardized questionnaire: the PedsQL™ Family Impact Module (PedsQL-FIM). Results Of the 76 children born with EA/TEF included in this study, 26% had a vascular malformation. Mean age was 5.3 years (SD = 3.7 years). Cardiovascular malformation associated with EA significantly (p=0.037) affects the functioning of the family in the emotional domain (FIM – ED). The QOL (p &amp;lt; 0,034) of children born before 37th HBD is lower that children born in term The presence of concomitant anomalies does affect the overall generic QoL. No statistical correlation was found between the type of anomaly (with/without TEF) and patients' QoL. Conclusions Cardiovascular malformation and prematurity significantly affect child’s QOL and the functioning of the family with EA. Patients who have undergone EA treatment require specialist outpatient care, not only in the first years of life, but also in adolescence and adulthood.

“I would be so proud of you guys and myself:” Exploring guided play learning interactions among Black caregivers and their children within a Black history home learning intervention during the COVID-19 pandemic

Existing literature on Black caregiver’s interactions with their children has overwhelmingly focused on parenting deficits and interventions designed to “fix” Black families. In utilizing the BlackCreate framework (2023), this study explores how Black caregivers intentionally crafted learning spaces for their children within the context of a six month intervention. Brilliant Joy in a Box was a six-month intervention developed in partnership with a Black woman entrepreneur that delivered caregiver-child Black history home learning boxes to families during the COVID-19 pandemic with the goal of addressing the impacts of persistent historical educational inequities for Black youth, the disproportionate impact of the pandemic Black families, and requests from community members seeking additional programming during the winter months. In the current study, we analyzed videos of 77 families interacting during a guided play activity. We found that the learning spaces created by Black families focused on four subject matters and their domains: literacy, scientific curiosity, math, and identity. We also found that Black caregivers organically utilized guided play to promote joyful interaction and learning. Findings underscore the importance of educators and school staff learning from families in order to reimagine learning and design community based interventions.

초등학교 학생역량의 잠재계층 전이 유형 분류와 영향 요인 탐색

Objectives The study, in order to understand how elementary school student competencies appear and strengthen competency-based education, we confirmed the classification of latent classes in the 4th and 5th grades of elementary school, identified the patterns of student competency transition, and examined the impact of individual, family, and school-related factors on each latent class. Methods For this purpose, Latent Profile Analysis and Latent Transition Analysis were conducted, utilizing data from the first year (2021) and the second year (2022) of panel data for 4th graders (total sample size of 3,671) from the Gyeongnam Education Longitudinal Study Information collected by the Gyeongsangnam-do Office of Education. Results In the 4th grade of elementary school, the latent class of student competency was classified into three groups: ‘low competency,’ ‘medium competency,’ and ‘high competency.’ In the 5th grade of elementary school, the latent class of student competency was classified into two groups: ‘low competency’ and ‘high competency.’ It was confirmed that some of the low competency group and the medium competency group in the 4th grade of elementary school were integrated into the low-competency group in the 5th grade, and that some of the medium competency group and the high-competency group in the 4th grade of elementary school were integrated into the high competency group in the 5th grade. Conclusions Factors significantly influencing the transition from the 4th-grade student competency latent class to that of the 5th grade were found to be self-directed learning, communication with parents, parental academic support, attitude towards assessment, and satisfaction with remote learning. Based on the key research results influencing student competency, educational policy implications for enhancing student competency were derived and discussed.

Effects of Distracted Parenting and Housing on Juvenile's Bullying Children

Background and Aim: This study aimed to find out the effect distracted parenting and housing that lead towards Juvenile's Bullying children Methods: Descriptive-correlational research design was used to study the impact of broken family, and housing factors on juvenile delinquency. Researcher used a Non – probability (purposive) sampling technique and selected one hundred juvenile offenders from Juveniles Bullying Station for data collection belonged to the age range between fourteen to eighteen years from 3th April to 10th November 2023. Present study explored various effects of juvenile delinquency related with broken family, and housing factors on juvenile. Reliability of instrument was determined through the use of Alpha Cronbach approach and the instrument validity was determined through a panel of experts. The analysis of the data was used descriptive statistics frequencies, percentages, mean, standard deviation and Analysis of Variance (ANOVA). In order to assess the effect distracted parenting and housing on Bullying children. Results: The findings of the present study reveal that indicate to high percentage theft (29%), drug abuse (21%), murder (16%) and rape (14%); while there is positive association among types of offenses committed by the juveniles with residence area (r=0.219), father married another woman (r=0.224), mother married another man (r=0.289), divorce (r=0.225), father death (r= 0.257) and mother death (r=0.246). Conclusion: The study concluded that there is positive association among types of offenses and misdemeanor committed by the juveniles with distracted parenting and housing.

A pivotal nutritional potential of understory vascular plants in Patagonian forests

Native forests can support wild and domestic herbivores, but their nutritional potential of understory vascular plants is rarely explored. We analysed the composition of understory plant species and their biochemical components to reveal the nutritional potential of forest types (deciduous, evergreen, mixed) and their associated open-lands (e.g. grasslands in forestlands) in Northern Patagonia. We proposed an approach combining our data (e.g. plant composition, occurrence frequency) with bibliographic research (e.g. Scopus database) to develop our findings. Data were evaluated using descriptive statistical analyses and multivariate analyses. This study presents the nutritional values for the 20 pivotal species under examination. The results highlight the significant impact of taxonomic families on nutritional profiles, where the species that presented the most relevant occurrence frequency: the herbs T. officinale (60.4 % of total occurrence frequency-TOF) and T. repens (47.9 % TOF), the graminoid H. lanatus (58 % TOF), and the fern B. penna marina (44.4 % TOF). Multivariate analyses showed that the first two PCA axes explained 76.1 % (p = 0.001) and 10.5 % (p = 1.000) of forest type variation, with ñire forests and open-lands having the highest palatable plant coverage. Biochemical PCA axes explained 52.1 % (p = 0.024) and 22.5 % (p = 0.874) of the variation, distinguishing species by protein content and structural components. The deciduous forests exhibited the highest coverage of palatable plants, while target plants with low palatability and high coverage were predominantly found in evergreen forest types. The confirmed presence of pivotal species across forest types and open-lands underscores its nutritional potential, characterised by highly digestible dry matter, crude protein, highly digestible non-nitrogenous nutrients, and relative feed value. Considering their widespread distribution and nutritional factors, the native and non-native plants merit attention due to their pivotal nutritional potential.

THE IMPACT OF FAMILY PLANNING ON MATERNAL HEALTH IN QUETTA, BALOCHISTAN: A QUALITATIVE STUDY

Balochistan, a region with one of the highest maternal mortality rates in Pakistan, faces significant challenges in maternal health. This qualitative study focuses on the impact of family planning on maternal health in Quetta, Balochistan, emphasizing the importance of understanding and improving health outcomes for women and their families. Objectives: The primary aim of this study is to explore the experiences and perspectives of women regarding the use of family planning methods and their impact on maternal health and well-being. It aims to compare the health outcomes of women who have utilized family planning methods with those who have not. Method: The research design includes in-depth interviews and focus group discussions (FGDs) with a diverse sample of women aged 18-45 years and healthcare providers at Sandeman Provincial Hospital, commonly known as Civil Hospital, in Quetta. Purposive sampling was employed to account for age, socioeconomic status, and education level variations. Forty-seven in-depth interviews were conducted to gather rich, contextual data. Thematic analysis was used to identify recurring themes and patterns in the responses. Results: Preliminary findings indicate several key themes, including the motivations for choosing family planning methods, the impact of these methods on reducing pregnancy risks, improving spacing between pregnancies, and enhancing postpartum recovery. Additional insights were gained into the factors influencing the adoption of family planning services, such as cultural norms, religious beliefs, and access to healthcare and information. Conclusion: The study underscores the critical role of family planning in enhancing maternal health outcomes in Quetta, Balochistan. It highlights the need for targeted educational and healthcare interventions to improve the accessibility and acceptance of family planning services, thereby contributing to the well-being of women and their families in the region.

Quality of life in pediatric patients on a paracorporeal ventricular assist device with a novel mobile driving system

BackgroundEXCOR VAD is the gold standard circulatory support for children with end-stage heart failure. Until recently, the only available driving unit was the stationary Ikus. This study (NCT04634708) investigates the impact of the novel mobile EXCOR Active driving unit on patients’ mobility and the quality of life (QoL) of their families. MethodsChildren on EXCOR VAD support with the Ikus who were mobilizable outside the hospital room were eligible for the prospective study. Patients remained on Ikus for 7 days, then switched to Excor Active and were observed for another 45 days. The endpoints were the rates of clinically relevant device exchanges (i.e., exchanges that could raise safety concerns for the patient) and successful patient outcomes, respectively. QoL of patients’ families was recorded through two validated questionnaires: the PedsQLTM Family Impact Module and DASS 21. Patients’ mobility and activity levels were monitored through diary entries. ResultsA total of 24 patients were enrolled of which 23 patients completed the study. No clinically relevant device exchanges occurred and there was a successful outcome in 22/23 (95.7%) patients. Changing from the Ikus to the EXCOR Active improved QoL as seen in family impact total score (from 53.8±19.8 to 66.5±20.8, p=0.005) and mental health (depression: moderate to mild, stress moderate to normal, both p < 0.05; anxiety: mild to normal, n.s.). Activity levels raised in both, mean time (from 100 to 300 minutes/day, p=0.011) and distance (from 30 to 1,110 meters/day, p=0.002). ConclusionsThe EXCOR Active driving unit is safe and performs equivalent to Ikus. This study indicates considerable improvement in patients’ mobility. In addition, data suggests that families’ QoL is positively affected by means of the novel driving unit.

Legacy: The meaning of lasting impact for family, business, and beyond

The concept of legacy exists at the core of family business research, yet as a construct, the nature of what legacy is and why and how legacy matters across generations has been poorly understood (Hammond, Pearson, & Holt, 2016). This lack of conceptual clarity has limited legacy research in the domain of family business. In this article, we provide a comprehensive definition of legacy that can be used to draw connections across existing legacy research and open new avenues of inquiry critical to understanding both family firms and legacy itself.