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PurposeThe paper aims to examine the process of de‐internationalisation through an analysis of British Telecommunications' (BT's) experience. There is – to date – little research upon de‐internationalisation, this paper aims to contribute to the debate through assessing how businesses with a strong domestic position would respond to a turbulent commercial environment.Design/methodology/approachThe key research issue is addressed in the paper via the use of a single case study.FindingsThe paper finds that BT, throughout the 1990s, developed an aggressive global strategy. However, by the 1990s, BT was in a process of retreat. This failure was influenced by the form and nature with which this strategy was executed, which resulted in a declining commitment to an aggressive global strategy. With the failure of the global strategy, BT reverted to a more defensive corporate strategy.Originality/valueThe paper makes a contribution through adding to an emerging debate on the form and nature of de‐internationalisation. This process is explored from the standpoint of a business that has sought to pursue an aggressive international strategy whilst sustaining a commitment to a strong domestic position. The paper highlights how de‐internationalisation is linked into the form and nature initial strategy.

Business process re‐engineering (BPR), a management tool that initially advocated a revolution in the way businesses are driven, now carries the stigma of being a major cause of job elimination. This study reveals the depth of involvement of BPR practitioners in what, advocates claim, are the fundamental ingredients of BPR – business processes. The data alert the reader to the different understandings and practices related to business process analysis held by several UK and Brazilian companies. Possible reasons are given, accounting for why some of the companies investigated seemed to lose a BPR focus in favour of more urgent restructuring matters. The authors conclude that companies often lack a basic awareness of the business process concept, and that misconceptions about these issues can lead to unrealised expectations at various levels in the organization.

This study investigated the correlation between balance confidence, and physical and cognitive markers of wellbeing. The study was particularly focused on the demographic of older adults who were in receipt of government-funded aged-care services. The research also investigated whether progressive resistance plus balance training could positively influence change. The study was designed as an intervention study at a community-based, older-adult exercise clinic. Participants consisted of older adults (N=245) who had complex care needs and who were receiving government-funded aged-care support. The intervention consisted of 24 weeks of twice-weekly progressive resistance plus balance training, carried out under the supervision of accredited exercise physiologists. The primary outcome measure for the sutdy was the activity-specific balance confidence score. Secondary measures included the short physical performance battery, fall history, hierarchical timed balance tests, geriatric anxiety index, geriatric depression score, FRAIL scale and EuroQol 5D 3L. Results: At baseline, higher physical performance (r = 0.54, p < 0.01) and quality of life (r = 0.52, p < 0.01) predicted better balance confidence. In contrast, at baseline, higher levels of frailty predicted worse balance confidence (r = -0.55, p < 0.01). Change in balance confidence following the exercise intervention was accompanied by improved physical performance (+12%) and decreased frailty (-11%). Baseline balance confidence was identified as the most consistent negative predictor of change scores across the intervention. This study shows that reduced physical performance and quality of life, and increasing frailty, are predictive of poor balance confidence among older adults with aged-care needs. However, when a targeted intervention of resistance and balance exercise is implemented, reducing frailty and increasing physical performance, balance confidence will also improve. Given the influence of balance confidence on a raft of wellbeing ...

Progressive resistance plus balance training (PRBT) has been demonstrated as effective in reducing later life physical disability, falls risk and poor health, even among those with complex health care needs. However, few studies have examined the influence of PRBT on health service utilisation, cognitive wellbeing and training modality acceptance or undertaken a cost benefit analysis. This project will investigate the broad scope benefits of PRBT participation among community-dwelling older Australians receiving Government supported aged care packages for their complex health care needs. Using a modified stepped-wedge design, 248 community-dwelling adults 65 years and older with some level of government support aged care have been randomised into the study. Those randomised to exercise undertake six months of twice weekly machine-based, moderate to high intensity, supervised PRBT, followed by a six month unsupervised, unsupported follow-up. Controls spend six months undertaking usual activities, before entering the PRBT and follow-up phases. Data are collected at baseline and after each of the six month phases. Measures include level of and change in health and care needs, body composition, muscle capacity, falls, sleep, quality of life, nutritional and mental health status. In addition, acceptance and engagement is determined through telephone and focus group interviews complementing a multi-model health cost benefit evaluation. It is hypothesised this study will demonstrate the feasibility and efficacy of PRBT in improving primary and secondary health outcomes for older adults with aged care needs, and will support the value of this modality of exercise as an integral evidence-based service model of care.

In this article, the authors assessed the cost-effectiveness of center-based exercise training for older Australians. The participants were recipients of in-home care services, and they completed 24 weeks of progressive resistance plus balance training. Transport was offered to all participants. A stepped-wedge randomized control trial produced pre-, post-, and follow-up outcomes and cost data, which were used to calculate incremental cost-effectiveness ratios per quality-adjusted life year gained. Analyses were conducted from a health provider perspective and from a government perspective. From a health-service provider perspective, the direct cost of program provision was $303 per person, with transport adding an additional $1,920 per person. The incremental cost–utility ratio of the program relative to usual care was $70,540 per quality-adjusted life year over 6 months, decreasing to $37,816 per quality-adjusted life year over 12 months. The findings suggest that Muscling Up Against Disability offers good value for the money within commonly accepted threshold values.

Background. This study sought to better understand the psychometric properties of the SARC-F, by examining the baseline and training-related relationships between the five SARC-F items and objective measures of muscle function. Each of the five items of the SARC-F are scored from 0 to 2, with total score of four or more indicative of likely sarcopenia. Methods. This manuscript describes a sub-study of a larger step-wedge, randomised controlled 24-week progressive resistance and balance training (PRBT) program trial for Australian community dwelling older adults accessing government supported aged care. Muscle function was assessed using handgrip strength, isometric knee extension, 5-time repeated chair stand and walking speed over 4 m. Associations within and between SARC-F categories and muscle function were assessed using multiple correspondence analysis (MCA) and multinomial regression, respectively. Results. Significant associations were identified at baseline between SARC-F total score and measures of lower-body muscle function (r = −0.62 to 0.57; p ≤ 0.002) in 245 older adults. MCA analysis indicated the first three dimensions of the SARC-F data explained 48.5% of the cumulative variance. The initial dimension represented overall sarcopenia diagnosis, Dimension 2 the ability to displace the body vertically, and Dimension 3 walking ability and falls status. The majority of the 168 older adults who completed the PRBT program reported no change in their SARC-F diagnosis or individual item scores (56.5–79.2%). However, significant associations were obtained between training-related changes in SARC-F total and item scores and changes in walking speed and chair stand test performance (r = −0.30 to 0.33; p < 0.001 and relative risk ratio = 0.40–2.24; p < 0.05, respectively). MCA analysis of the change score data indicated that the first two dimensions explained 32.2% of the cumulative variance, with these dimensions representing whether a change occurred and the direction of change, respectively. ...

Objective: To investigate the associations of balance confidence with physical and cognitive markers of well-being in older adults receiving government-funded aged care services and whether progressive resistance plus balance training could positively influence change. Design: Intervention study. Setting: Community-based older adult–specific exercise clinic. Participants: Older adults (N=245) with complex care needs who were receiving government-funded aged care support. Interventions: Twenty-four weeks of twice weekly progressive resistance plus balance training carried out under the supervision of accredited exercise physiologists. Main Outcome Measures: The primary measure was the Activity-specific Balance Confidence Scale. Secondary measures included the Short Physical Performance Battery; fall history gathered as part of the health history questionnaire; hierarchical timed balance tests; Geriatric Anxiety Index; Geriatric Depression Scale; Fatigue, Resistance, Ambulation, Illness, Loss of Weight scale; and EuroQoL-5 dimension 3 level. Results: At baseline, better physical performance (r=.54; P<.01) and quality of life (r=.52; P<.01) predicted better balance confidence. In contrast, at baseline, higher levels of frailty predicted worse balance confidence (r=−.55; P<.01). Change in balance confidence after the exercise intervention was accompanied by improved physical performance (+12%) and reduced frailty (−11%). Baseline balance confidence was identified as the most consistent negative predictor of change scores across the intervention. Conclusions: This study shows that reduced physical performance and quality of life and increased frailty are predictive of worse balance confidence in older adults with aged care needs. However, when a targeted intervention of resistance and balance exercise is implemented that reduces frailty and improves physical performance, balance confidence will also improve. Given the influence of balance confidence on a raft of well-being determinants, including the capacity for positive physical and cognitive change, this study offers important insight to those looking to reduce falls in older adults. © 2018 American Congress of Rehabilitation Medicine

Background. This study sought to better understand the psychometric properties of the SARC-F, by examining the baseline and training-related relationships between the five SARC-F items and objective measures of muscle function. Each of the five items of the SARC-F are scored from 0 to 2, with total score of four or more indicative of likely sarcopenia. Methods. This manuscript describes a sub-study of a larger step-wedge, randomised controlled 24-week progressive resistance and balance training (PRBT) program trial for Australian community dwelling older adults accessing government supported aged care. Muscle function was assessed using handgrip strength, isometric knee extension, 5-time repeated chair stand and walking speed over 4 m. Associations within and between SARC-F categories and muscle function were assessed using multiple correspondence analysis (MCA) and multinomial regression, respectively. Results. Significant associations were identified at baseline between SARC-F total score and measures of lower-body muscle function (r = to 0.57; p <= 0.002) in 245 older adults. MCA analysis indicated the first three dimensions of the SARC-F data explained 48.5% of the cumulative variance. The initial dimension represented overall sarcopenia diagnosis, Dimension 2 the ability to displace the body vertically, and Dimension 3 walking ability and falls status. The majority of the 168 older adults who completed the PRBT program reported no change in their SARC-F diagnosis or individual item scores (56.5-79.2%). However, significant associations were obtained between trainin-grelated changes in SARC-F total and item scores and changes in walking speed and chair stand test performance (r = to 0.33; p < 0.001 and relative risk ratio = 0.40-2.24; p < 0.05, respectively). MCA analysis of the change score data indicated that the first two dimensions explained 32.2% of the cumulative variance, with these dimensions representing whether a change occurred and the direction of change, respectively. Discussion. The results advance our comprehension of the psychometric properties on the SARC-F, particularly its potential use in assessing changes in muscle function. Older adults' perception of their baseline and training-related changes in their function, as self-reported by the SARC-F, closely matched objectively measured muscle function tests. This is important as there may be a lack of concordance between self-reported and clinician-measured assessments of older adults' muscle function. However, the SARC-F has a relative lack of sensitivity to detecting training-related changes, even over a period of 24 weeks. Conclusions. Results of this study may provide clinicians and researchers a greater understanding of how they may use the SARC-F and its potential limitations. Future studies may wish to further examine the SARC-F's sensitivity of change, perhaps by adding a few additional items or an additional category of performance to each item.

Purpose
– This study aims to explore the impact of cultural values on the importance individuals assign to project success/failure factors (PSFFs).


Design/methodology/approach
– Themes emerging from 40 interviews of project practitioners based in Brazil, China, Greece, Nigeria, Thailand, the UAE, the UK and the USA are integrated with literature evidence to design a survey instrument. One thousand three hundred and thirteen practitioner survey responses from the eight countries are analysed using multi-group, structural equation modelling.


Findings
– Ten project success/failure indicators (PSFIs) are found to reduce to two main PSFFs: project control and extra-organisational goals and project team management/development and intra-organisational goals. It is found that the levels of importance individuals assign to both factors are dependent, not only on age and gender, but also cultural values measured as constructs based on Hofstede's individualism, masculinity, power distance and uncertainty avoidance dimensions.


Research limitations/implications
– The snowballing method used to gather survey data and analysis of relationships at individual level reduces generalisability.


Practical implications
– The results reveal insights on how best to match the cultural values of project participants to project characteristics. They also increase knowledge on the likely perceptual differences among culturally diverse individuals within projects.


Originality/value
– This research contributes to the literature on culture in project environments by defining a factor structure of multiple-dependent PSFIs and increases insight on how specific cultural values may impact on the perception of the so-defined PSFFs.

Background Physical inactivity across the lifespan remains a public health issue for many developed countries. Inactivity has contributed considerably to the pervasiveness of lifestyle diseases. Government, national and local agencies and organizations have been unable to systematically, and in a coordinated way, translate behavioral research into practice that makes a difference at a population level. One approach for mobilizing multi-level efforts to improve the environment for physical activity is to engage in a process of citizen science. Citizen Science here is defined as a participatory research approach involving members of the public working closely with research investigators to initiate and advance scientific research projects. However, there are no common measures or protocols to guide citizen science research at the local community setting. Objectives We describe overarching categories of constructs that can be considered when designing citizen science projects expected to yield multi-level interventions, and provide an example of the citizen science approach to promoting PA. We also recommend potential measures across different levels of impact. Discussion Encouraging some consistency in measurement across studies will potentially accelerate the efficiency with which citizen science participatory research provides new insights into and solutions to the behaviorally-based public health issues that drive most of morbidity and mortality. The measures described in this paper abide by four fundamental principles specifically selected for inclusion in citizen science projects: feasibility, accuracy, propriety, and utility. The choice of measures will take into account the potential resources available for outcome and process evaluation. Our intent is to emphasize the importance for all citizen science participatory projects to follow an evidence-based approach and ensure that they incorporate an appropriate assessment protocol. Conclusions We provided the rationale for and a list of contextual factors ...

Abstract Background Physical inactivity across the lifespan remains a public health issue for many developed countries. Inactivity has contributed considerably to the pervasiveness of lifestyle diseases. Government, national and local agencies and organizations have been unable to systematically, and in a coordinated way, translate behavioral research into practice that makes a difference at a population level. One approach for mobilizing multi-level efforts to improve the environment for physical activity is to engage in a process of citizen science. Citizen Science here is defined as a participatory research approach involving members of the public working closely with research investigators to initiate and advance scientific research projects. However, there are no common measures or protocols to guide citizen science research at the local community setting. Objectives We describe overarching categories of constructs that can be considered when designing citizen science projects expected to yield multi-level interventions, and provide an example of the citizen science approach to promoting PA. We also recommend potential measures across different levels of impact. Discussion Encouraging some consistency in measurement across studies will potentially accelerate the efficiency with which citizen science participatory research provides new insights into and solutions to the behaviorally-based public health issues that drive most of morbidity and mortality. The measures described in this paper abide by four fundamental principles specifically selected for inclusion in citizen science projects: feasibility, accuracy, propriety, and utility. The choice of measures will take into account the potential resources available for outcome and process evaluation. Our intent is to emphasize the importance for all citizen science participatory projects to follow an evidence-based approach and ensure that they incorporate an appropriate assessment protocol. Conclusions We provided the rationale for and a list of contextual factors along with specific examples of measures to encourage consistency among studies that plan to use a citizen science participatory approach. The potential of this approach to promote health and wellbeing in communities is high and we hope that we have provided the tools needed to optimally promote synergistic gains in knowledge across a range of Citizen Science participatory projects.