Despite environmental and social goals being identified as key objectives for small-and medium-sized enterprises (SMEs), the literature has not provided an explanation of how these goals can be achieved alongside stable economic outcomes. Several researchers have argued that sustainability performance should be addressed through a process of constant adjustment, which can be facilitated by dynamic capabilities. The aim of this study is to investigate the effect of integrative dynamic capabilities on the social, environmental and economic performance of SMEs. This study is among the first to investigate this effect and uses unique survey data from 297 SMEs in the Netherlands. The empirical results highlight the importance of external integrative dynamic capabilities for all three pillars of sustainability performance in SMEs. These findings contribute to the debate on the ability/inability of SMEs to balance social, environmental and economic objectives by integrating new insights from the dynamic capabilities literature.
Multiple sclerosis (MS) is a multifocal demyelinating disease of the central nervous system, with lesions widespread through the brain and spinal cord. An important manifestation is cognitive impairment, which, though difficult to measure, may have a major social impact. To better understand the relationship between structural tissue damage and cognitive impairment, we examined the extent and spatial distribution of brain lesions, as measured by magnetic resonance imaging (MRI), in relation to abnormal cognitive performance as measured by the Brief Repeatable Battery (BRB) in 82 MS patients. Possible confounders, like fatigue, pain and depression were also assessed. Brain MR image analysis included hyperintense T2 and hypointense T1 lesion load in the whole brain and the four lobes separately, as well as whole brain volume measurements. Cognitive impairment (defined as more than two abnormal tests) was found in 67% of the patients. Moderately strong correlations were found between the subtests of the BRB and the lesion loads in the brain regions hypothesized to be associated with that cognitive test, although these correlations were in general not much stronger than those between the subtests and the overall lesion load (due to strong interrelationships). The Spatial Recall Test correlated best with parietal lesion load; the Symbol Digit Modalities Test, the Paced Auditory Serial Addition Task (PASAT) and the Word List Generation best with frontal, parietal and temporal lesion load; while the Verbal List Generation Test Index correlated only with atrophy. Atrophy and lesion load were the main factors determining the test scores, explaining 10-25% of the variance in the test results, and were more important than fatigue, pain and depression; only depression had a minor, but significant, additional effect on the PASAT. In conclusion, cognitive impairment in MS is moderately dependent on amount (and distribution) of structural brain damage, especially in the more physically impaired patients group.
Integrating circularity in business strategy is difficult to achieve for companies as it requires impactful changes in core business processes. While research has focused on identifying key barriers, little is known about the organizational attributes that can assist businesses in integrating circularity in their strategies. The purpose of this study is to investigate the implications of organizational managers and network interactions for the integration of circularity in business strategy. Through using survey data from 627 SMEs (small- and medium-sized enterprises) in the Netherlands, this study shows that managers who interpret circularity as an opportunity can have a positive direct and indirect effect on the integration of circularity in a company’s strategy. The results furthermore highlight the importance of circular network interactions for the integration of circularity in business strategy. This article contributes to recent calls for more empirical research into the integration of circularity and offers relevant insights for companies aiming to integrate circularity.
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