The development of social enterprise initiatives within nonprofit organizations is a complex activity and the disruptive challenges of accommodating commercial processes within social organizations are often underestimated. This article is based on research that tracks four nonprofit organizations as they endeavor to develop their first social enterprise activities. Using a lens of institutional logics with the emerging empirical findings, six discernible differences are identified between nonprofits and for-profits which usefully inform our understanding of the challenges of accommodating both commercial and social logics. Building upon existing theory, this article offers a typology of structural options for a social enterprise that nonprofits might consider, with illustrative examples from the research findings.

Argues that the discourse of``managing diversity'', emerging from the US management literature, cannot be simply mapped on to organisations in other cultural contexts. It uses the example of Aotearoa/New Zealand to show that a``diversity'' based on the demographics and dominant cultural assumptions of the USA fails to address ± and may in fact obscure ± key local``diversity'' issues. It argues that the dominant discourse of``managing diversity'' has embedded in it cultural assumptions that are specific to the US management literature. It calls for a genuinely multi-voiced``diversity'' discourse that would focus attention on the local demographics, cultural and political differences that make the difference for specific organisations.

Purpose – The purpose of this paper is to provide empirical insights to understanding trust as a relational form of social capital, and its effects on entrepreneurial processes, in small- and medium-sized family businesses. Design/methodology/approach – This paper adopts a qualitative case-study approach, with data from fieldwork interviews, observations, and secondary sources analysed by using interpretative methods. Findings – Although multiple types of trust exist concurrently in small- and medium-sized Chinese family businesses, it is interpersonal trust on the basis of goodwill and competence that prevails, while contractual trust is weak and marginal. Three patterns of trusting relationships are identified, each of which has both positive and negative effects on entrepreneurship and innovation in family businesses. There is a potential “dark side” of trust, which incurs extra cost and commitment to small- and medium-sized family businesses in their entrepreneurial processes. Research limitations/implications – Future research with larger sample sizes is suggested to generalise the insights, by using both qualitative and quantitative methods. More empirical work is needed to further clarify the antecedents of trust as a social capital and the potential “dark side” of trust in small- and medium-sized family businesses, particularly across generations. Practical implications – Family business owner-managers should try to avoid relying on a single type of trust, which may incur extra costs to the entrepreneurial processes. They need to better understand why they trust certain actors in their business and social networks before assigning resources to specific business activities. Policy makers are suggested to recognise the “benefits” of the traditionally family-oriented values and that kinship-based trust is also a relational form of social capital and can produce entrepreneurial outcomes. Originality/value – The paper critically reviews existing literature on social capital, trust, entrepreneurship, and family business at their point of intersection and identifies gaps and oversights. Drawing on case studies from China, the paper explores different patterns in which trust develops in second-generation small- and medium-sized Chinese family businesses and their varying effects on entrepreneurship.

OBJECTIVE Pain control is an important clinical consideration and quality-of-care metric. No studies have examined postoperative pain control following transsphenoidal surgery for pituitary lesions. The study goals were to 1) report postoperative pain scores following transsphenoidal surgery, 2) determine if multimodal opioid-minimizing pain regimens yielded satisfactory postoperative pain control, and 3) determine if intravenous (IV) ibuprofen improved postoperative pain scores and reduced opioid use compared with placebo. METHODS This study was a single-center, randomized, double-blinded, placebo-controlled intervention trial involving adult patients with planned transsphenoidal surgery for pituitary tumors randomized into 2 groups. Group 1 patients were treated with scheduled IV ibuprofen, scheduled oral acetaminophen, and rescue opioids. Group 2 patients were treated with IV placebo, scheduled oral acetaminophen, and rescue opioids. The primary end point was patient pain scores (visual analog scale [VAS], rated 0-10) for 48 hours after surgery. The secondary end point was opioid use as estimated by oral morphine equivalents (OMEs). RESULTS Of 136 patients screened, 62 were enrolled (28 in Group 1, 34 in Group 2). The study was terminated early because the primary and secondary end points were reached. Baseline characteristics between groups were well matched except for age (Group 1, 59.3 ± 14.4 years; Group 2, 49.8 ± 16.2 years; p = 0.02). Mean VAS pain scores were significantly different, with a 43% reduction in Group 1 (1.7 ± 2.2) compared with Group 2 (3.0 ± 2.8; p < 0.0001). Opioid use was significantly different, with a 58% reduction in Group 1 (26.3 ± 28.7 mg OME) compared with Group 2 (62.5 ± 63.8 mg OME; p < 0.0001). CONCLUSIONS Multimodal opioid-minimizing pain-management protocols resulted in acceptable pain control following transsphenoidal surgery. IV ibuprofen resulted in significantly improved pain scores and significantly decreased opioid use compared with placebo. Postoperative multimodal pain management, including a nonsteroidal antiinflammatory medication, should be considered after surgery to improve patient comfort and to limit opioid use. Clinical trial registration no.: NCT02351700 (clinicaltrials.gov) ■ CLASSIFICATION OF EVIDENCE Type of question: therapeutic; study design: randomized, controlled trial; evidence: Class III.

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Purpose – Continued research around innovation within small- and medium-sized enterprises (SME) family businesses is needed to better understand the influence of specific resources and capabilities that might promote and/or constrain entrepreneurial activities. The purpose of this paper is to develop an organising framework investigating SME family business innovation drawing on a Schumpeterian understanding of innovation as the introduction of new combinations. Design/methodology/approach – Four guiding principles are developed and applied to an illustrative case study of an entrepreneurial family business that highlights the usefulness of complexity thinking for understanding innovation. Findings – NZ Sock provides a rich illustrative case study to highlight how principles of complexity thinking along with Schumpeterian notions of innovation can usefully inform the authors’ understanding of entrepreneurial SME family businesses. The proposed guiding principles offered are borne out in application to the illustrative case example. Research limitations/implications – The findings suggest that complexity thinking and a Schumpeterian lens can usefully inform and extend the authors’ understanding of innovation within entrepreneurial SME family businesses. Further research would benefit from exploring the guiding principles proposed in other entrepreneurial SME family businesses to further substantiate this field of inquiry. Practical implications – Principles of complexity thinking may provide additional understanding and insight for SME family business members needing to innovate and adapt to ever-changing operating environments. Originality/value – Innovation is critical to the long-term survival and success of such firms; yet, to date little theoretical contribution and research has been offered in the field of innovation within the context of SME family businesses. Complex adaptive systems provide a lens from which to understand such businesses and that that a complexity framework helpfully allows attention to be given to such phenomena as emergence, adaptability and combinations through which innovation outcomes and processes may be understood. This paper offers four guiding principles that can be further tested and refined.

Purpose – The purpose of this paper is to use social identity theory to explore factors that contribute to the development of family social capital. Effects are investigated both for the family and the business. Design/methodology/approach – A single in-depth case study focussing on the family unit was coducted within a fourth-generation family business involved in the arts retailing. Findings – The findings suggest that social identity theory is a useful lens to explore the development of family social capital. The six themes identified highlight that there is a normative and an affective dimension, leading to family members’ desire to uphold the status of the business. Evidence suggests that the normative factors may be both positively and negatively related to the development of family social capital, due to their potentially restrictive nature. Originality/value – The paper’s findings imply that social identity can contribute to understanding family dynamics. Evidence highlights various factors for family members that are not involved in the family business to uphold its status. This is attributed to the emotional significance of the business to the family’s identity. Furthermore, this paper suggests that the strong focus on norms and values, which developed gradually, may have adverse effects on the identification with the business and the willingness to uphold its status. Propositions are offered to provide guidance for future research to investigate this controversial evidence regarding the impact of value orientation on family social capital.

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