Functional status, postural stability and falls among older adults with glaucoma

Visual impairment is an important contributing factor in falls among older adults, which is one of the leading causes of injury and injury-related death in this population. Visual impairment is also associated with greater disability among older adults, including poorer health-related quality of life, increased frailty and reduced postural stability. The majority of this evidence, however, is based on measures of central visual function, rather than peripheral visual function. As such, there is comparatively limited research on the associations between peripheral visual function, disability and falls, and even fewer studies involving older adults with specific diseases which affect peripheral visual function, the most common of which is glaucoma. Glaucoma is one of the leading causes of irreversible vision loss among older adults, affecting around 3 per cent of adults aged over 60 years. The condition is characterised by retinal nerve fibre loss, primarily affecting peripheral visual function. Importantly, the number of older adults with glaucomatous visual impairment is projected to increase as the ageing population grows. The first component of the thesis examined the cross-sectional association between glaucomatous visual impairment and health-related quality of life (Study 1a), functional status (Study 1b) and postural stability (Study 1c) among older adults. A cohort of 74 community-dwelling adults with glaucoma (mean age 74.2 ± 5.9 years) was recruited and completed a baseline assessment. A number of visual function measures was assessed, including central visual function (visual acuity and contrast sensitivity), motion sensitivity, retinal nerve fibre analysis and monocular and binocular visual field measures (monocular 24-2 and binocular integrated visual fields (IVF): IVF-60 and IVF-120). The analyses focused on the associations between the outcomes measures and severity and location of visual field loss, as this is the primary visual function affected by glaucoma. In Study 1a, we examined the association between visual field loss and health-related quality of life, measured by the Short Form 36-item Health Survey (SF-36). Greater binocular visual field loss, on both IVF measures, was associated with lower SF-36 physical component scores, adjusted for age and gender (Pearson's r =|0.32| to |0.36|, p<0.001). Furthermore, inferior visual field loss was more strongly associated with the SF-36 physical component than superior field loss. No association was found between visual field loss and SF-36 mental component scores. The association between visual field loss and functional status was examined in Study 1b. Functional status outcomes measures included a physical activity questionnaire (Physical Activity Scale for the Elderly, PASE), performance tests (six-minute walk test, timed up and go test and lower leg strength) and an overall functional status score. Significant, but weak, correlations were found between binocular visual field loss and PASE and overall functional status scores, adjusted for age and gender (Pearson's r =|0.24| to |0.33|, p<0.05). Greater inferior visual field loss, independent of superior visual field loss, was significantly associated with poorer physical performance results and lower overall functional status scores. In Study 1c, we examined the association between visual field loss and postural stability, using a swaymeter device which recorded body movement during four conditions: eyes open and closed, on a firm and foam surface. Greater binocular visual field loss was associated with increased postural sway, both on firm and foam surfaces, independent of age and gender (Pearson’s r =|0.44| to |0.46|, p <0.001). Furthermore, inferior visual field was a stronger contributor to postural stability, more so than the superior visual field, particularly on the foam condition with the eyes open. Greater visual field loss was associated with a reduction in the visual contribution to postural sway, which underlies the observed association with postural sway. The second component of the thesis examined the association between severity and location of visual field loss and falls during a 12-month longitudinal follow-up. The number of falls was assessed prospectively using monthly fall calendars. Of the 71 participants who successfully completed the follow up (mean age 73.9 ± 5.7 years), 44% reported one or more falls, and around 20% reported two or more falls. After adjusting for age and gender, every 10 points missed on the IVF-120 increased the rate of falls by 25% (rate ratio 1.25, 95% confidence interval 1.08 - 1.44) or every 5dB reduction in IVF-60 increased the rate of falls by 47% (rate ratio 1.47, 95% confidence interval 1.16 - 1.87). Inferior visual field loss was a significant predictor of falls, more so than superior field loss, highlighting the importance of the inferior visual field area in safe and efficient navigation. Further analyses indicated that postural stability, more so than functional status, may be a potential mediating factor in the relationship between visual field loss and falls. Future research is required to confirm this causal pathway. In addition, the use of topical beta-blocker medications was not associated with an increased rate of falls in this cohort, compared with the use of other topical anti-glaucoma medications. In summary, greater binocular visual field loss among older adults with glaucoma was associated with poorer health-related quality of life in the physical domain, reduced functional status, greater postural instability and higher rates of falling. When the location of visual field loss was examined, inferior visual field loss was consistently more strongly associated with these outcomes than superior visual field loss. Insights gained from this research improve our understanding of the association between glaucomatous visual field loss and disability, and its link with falls among older adults. The clinical implications of this research include the need to include visual field screening in falls risk assessments among older adults and to raise awareness of these findings to eye care practitioners and adults with glaucoma. The findings also assist in developing further research to examine strategies to reduce disability and prevent falls among older adults with glaucoma to promote healthy ageing and independence for these individuals.

Real estate 2.0 : towards a value ecology?

This paper anatomises emerging developments in online community engagement in a major global industry: real estate. Economists argue that we are entering a ‘social network economy’ in which ‘complex social networks’ govern consumer choice and product value. In the light of this, organisations are shifting from thinking and behaving in the conventional ‘value chain’ model--in which exchanges between firms and customers are one-way only, from the firm to the consumer--to the ‘value ecology’ model, in which consumers and their networks become co-creators of the value of the product. This paper studies the way in which the global real estate industry is responding to this environment. This paper identifies three key areas in which online real estate ‘value ecology’ work is occurring: real estate social networks, games, and locative media / augmented reality applications. Uptake of real estate applications is, of course, user-driven: the paper not only highlights emerging innovations; it also identifies which of these innovations are actually being taken up by users, and the content contributed as a result. The paper thus provides a case study of one major industry’s shift into a web 2.0 communication model, focusing on emerging trends and issues.

Ownership structure and business evaluation practices in family SMEs : evidence from empirical research in Italy

This paper presents early results from a pilot project which aims to investigate the relationship between proprietary structure of small and medium- sized Italian family firms and their owners’ orientation towards a “business evaluation process”. Evidence from many studies point out the importance of family business in a worldwide economic environment: in Italy 93% of the businesses are represented by family firms; 98% of them have less than 50 employees (Italian Association of Family Firms, 2004) so we judged family SMEs as a relevant field of investigation. In this study we assume a broad definition of family business as “a firm whose control (50% of shares or voting rights) is closely held by the members of the same family” (Corbetta,1995). “Business evaluation process” is intended here both as “continuous evaluation process” (which is the expression of a well developed managerial attitude) or as an “immediate valuation” (i.e. in the case of new shareholder’s entrance, share exchange among siblings, etc). We set two hypotheses to be tested in this paper: the first is “quantitative” and aims to verify whether the number of owners (independent variable) in a family firm is positively correlated to the business evaluation process. If a family firm is led by only one subject, it is more likely that personal values, culture and feelings may affect his choices more than “purely economic opportunities”; so there is less concern about monitoring economic performance or about the economic value of the firm. As the shareholders’ number increases, economic aspects in managing the firm grow in importance over the personal values and "value orientation" acquires a central role. The second hypothesis investigates if and to what extent the presence of “non- family members” among the owners affects their orientation to the business evaluation process. The “Cramer’s V” test has been used to test the hypotheses; both were not confirmed from these early results; next steps will lead to make an inferential analysis on a representative sample of the population.

The role of the internet on international market growth of Australian firms : an exploratory study

The Internet has been shown to positively influence the internationalisation activities of firms through enhanced information, knowledge and network development. Although there has been evidence of a positive impact of the Internet on internationalisation process components, it is vague as to whether the Internet has an impact on firm international market growth. This paper examines the role of the Internet in the outward internationalisation of a cross-national sample of 224 firms from Australia. The results show evidence that a there is a link between Internet usage, Internet intensity and the international market growth of the firm. The findings indicate that firms are using Internet technologies beyond simple e-mail and websites in their international marketing. For example, Internet directories and Internet market spaces are assisting international market expansion of the firm. Firms are integrating the Internet into international marketing processes such as advertising, marketing, market research and international market management as well as in data transference between company and supplier and company and customer. Further, there is evidence in this study of the statistical relationships between the use of website, e-mail and online sales with the international market growth of the firm.

The first global entertainment company : explaining Pathe's dominance in the pre-Hollywood film industry

For almost a decade before Hollywood existed, French firm Pathe towered over the early film industry with estimates of its share of all films sold around the world varying between 50-70%. Pathe was the first global entertainment company. This paper analyses its rise to market leadership by applying a theoretical framework drawn from the business literature on causes of industry dominance, which provides insights into how firms acquire and maintain market dominance and in this case the film industry. This paper uses evidence presented by film historians to argue that Pathe "fits" the expected theoretical model of a dominant firm because it had a marketing orientation, used an effective quality-based competitive strategy and possessed the six critical marketing capabilities that business research shows enable the best performing firms to consistently outperform rivals.

Measuring export readiness using a multiple-item index

Since the 1970s the internationalisation process of firms has attracted wide research interest. One of the dominant explanations of firm internationalisation resulting from this research activity is the Uppsala stages model. In this paper, a pre-internationalisation phase is incorporated into the traditional Uppsala model to address the question: What are the antecedents of this model? Four concepts are proposed as the key components that define the experiential learning process underlying a firm’s pre-export phase: export stimuli, attitudinal/psychological commitment, resources and lateral rigidity. Through a survey of 290 Australian exporting and non-exporting small-medium sized firms, data relating to the four pre-internationalisation concepts is collected and an Export Readiness Index (ERI) is constructed through factor analysis. Using logistic regression, the ERI is tested as a tool for analysing export readiness among Australian SMEs.

Export decisions within Taiwanese electrical and electronic SMEs : the role of management characteristics and attitudes

In this globalized environment, Taiwanese firms have been very successful in achieving growth via international market expansion. In particular, the Taiwanese electronics industry has shown a dynamism lacking in comparable industries around the world. However, in recent years there has been a move by many of the larger Taiwanese manufacturing firms to outsource their manufacturing to low-cost producers such as China in order to remain competitive. Conversely, most Taiwanese small- to medium-sized enterprises (SMEs) have retained their production facilities in Taiwan. These SMEs seek to expand their sales beyond the domestic market by employing an export strategy, making a significant socioeconomic contribution to the domestic and regional economies. This paper highlights the key dimensions such as enhancing factors (benefits/advantages), inhibiting factors (barriers/costs), and managerial factors (characteristics/commitment) that play an important role in the internationalization of SMEs located within the Taiwanese electronics industry. A logistic regression model is used to predict the probability of a firm being an exporter.

Internal market orientation and market-oriented behaviours

Purpose: The purpose of this empirical paper is to investigate internal marketing from a behavioural perspective. The impact of internal marketing behaviours, operationalised as an internal market orientation (IMO), on employees’ marketing and other in-role behaviours (IRB) were examined. ---------- Design/methodology/approach: Survey data measuring IMO, market orientation and a range of constructs relevant to the nomological network in which they are embedded were collected from the UK retail managers. These were tested to establish their psychometric properties and the conceptual model was analysed using structural equations modelling, employing a partial least squares methodology. ---------- Findings: IMO has positive consequences for employees’ market-oriented and other IRB. These, in turn, influence marketing success. Research limitations/implications – The paper provides empirical support for the long-held assumption that internal and external marketing are related and that organisations should balance their external focus with some attention to employees. Future research could measure the attitudes and behaviours of managers, employees and customers directly and explore the relationships between them. ---------- Practical implications: Firm must ensure that they do not put the needs of their employees second to those of managers and shareholders; managers must develop their listening skills and organisations must become more responsive to the needs of their employees. ---------- Originality/value: The paper contributes to the scarce body of empirical support for the role of internal marketing in services organisations. For researchers, this paper legitimises the study of internal marketing as a route to external market success; for managers, the study provides quantifiable evidence that focusing on employees’ wants and needs impacts their behaviours towards the market.

Shaping and re-shaping social capital in buyer-supplier relationships

Social capital plays an important role in explaining how value is created from firms' network relationships, but little is understood about how social capital is shaped over time and how it is re-shaped when firms consolidate their network ties. In response, this study explores the evolution of social capital in buyer–supplier relationships through a case study of a company undertaking radical product innovation, and examines the corresponding changes in the firm's network of buyer–supplier relationships. The analysis shows that social capital is built in a decidedly non-linear and non-uniform manner. The study also reveals considerable interaction among the dimensions of social capital throughout the evolution of the firm's network, and emphasizes the importance of the cognitive dimension—a feature receiving little attention thus far. The evidence shows, too, that efforts to strengthen social capital need to increase when network ties are sacrificed to prevent unintended consequences for firms' longer-term value creation.

Betting on the underdog : bricolage as an engine of resource advantage

Resource-based theory posits that firms achieve high performance by controlling resources that are rare, valuable and costly for others to duplicate or work around. Yet scholars have been less successful understanding processes and behaviours by which firms develop such resources. We draw on the behavioral theory of bricolage from the entrepreneurship literature to suggest one such mechanism by which firms may develop such resource-based advantages. The core of our argument is that idiosyncratic bundling processes synonymous with bricolage behavior may create advantageous resource positions by (i) allowing resource constrained firms to allocate more of their limited resources to activities that they view as more strategically important, and (ii) increasing the difficulties other firms face in trying to imitate these advantages. Based on this reasoning we develop several hypotheses which we test in the context of several samples from a large, longitudinal, Australian study of new firm development. The results support our arguments that bricolage will improve a firms’ overall resource positions while generating more areas of strong resource advantage and fewer areas of strong resource disadvantage. We find little support, however, for our arguments that bricolage will make a firms’ key resource advantages more difficult for other firms to imitate. We find some support for our argument that the role of bricolage in creating resource advantages will be enhanced by the quality of the opportunity with which a firm is engaged.

Flagging Spaces : exploring the myth of the Australian beach as an egalitarian space

The Australian beach is now accepted as a significant part of Australian national culture and identity. However, Huntsman (2001) and Booth (2001) both believe that the beach is dying: “intellectuals have failed to apply to the beach the attention they have lavished on the bush…” (Huntsman 2001, 218). Yet the beach remains a prominent image in contemporary literature and film; authors such as Tim Winton and Robert Drewe frequently set their stories in and around the coast. Although initially considered a space of myth (Fiske, Hodge, and Turner 1987), Meaghan Morris labelled the beach as ‘ordinary’ (1998), and as recently as 2001 in the wake of the Sydney Olympic Games, Bonner, McKee, and Mackay termed the beach ‘tacky’ and ‘familiar’. The beach, it appears, defies an easy categorisation. In fact, I believe the beach is more than merely mythic or ordinary, or a combination of the two. Instead it is an imaginative space, seamlessly shifting its metaphorical meanings dependent on readings of the texts. My studies examine the beach through five common beach myths; this paper will explore the myth of the beach as an egalitarian space. Contemporary Australian national texts no longer conform to these mythical representations – (in fact, was the beach ever a space of equality?), instead creating new definitions for the beach space that continually shifts in meaning. Recent texts such as Tim Winton’s Breath (2008) and Stephen Orr’s Time’s Long Ruin (2010) lay a more complex metaphorical meaning upon the beach space. This paper will explore the beach as a space of egalitarianism in conjunction with recent Australian fiction and films in order to discover how the contemporary beach is represented.

Workforce gender diversity: Is it a source of competitive advantage?

Research on workforce diversity at the organisational level gained momentum in the 1990s, because of the growing trend in HR research to link HR practices with organisational performance. The new parallel wave of research focused on the business case for diversity, in which diversity was linked to organisational performance. However, the results of these studies, mainly focusing on linear diversity-performance relationships, have been inconsistent. Based on contrasting theories, this paper proposes three competing predictions of the gender diversity-performance relationship at the organisational level: a positive linear relationship derived from the resource-based view of the firm, a negative linear relationship derived from self-categorisation and social identity theories, and a U-shaped curvilinear relationship derived from the integration of the resource-based view of the firm with self-categorisation and social identity theories. The U-shaped relationship accounts for the inconsistent findings in past research, because different proportions of men and women produce different social dynamics that have different effects on organisational performance. Further, the proposed U-shaped relationship can have different slopes in the manufacturing and services industries. The paper contributes to the field of diversity by strengthening its weak theoretical foundations and by highlighting the industry differences.

Strategic alliances in building construction : a tender evaluation tool for the public sector

Building construction is a highly competitive and risky business. This competitiveness is compounded where conflicting objectives amongst contracting and subcontracting firms set the stage for an adversarial and potentially destructive business relationship. Clients, especially those from the public sector, need broader tender evaluation criteria to complement the traditional focus on bid price. There is also a need for change in the construction industry—not only to a more cooperative approach between the constructing parties—but also from a confrontationist attitude to a more harmonious relationship between all stakeholders in providing constructed facilities. A strategic alliance is a cooperative relationship between two or more organisations that forms part of their overall strategies, and contributes to achieving their major goals and objectives. Strategic alliances in building construction may provide a useful tool to assist public sector construction managers evaluate tenders and concurrently encourage more cooperative relationships amongst construction stakeholders. This paper begins with an overview of the Australian building construction industry, then reviews the existing strategic alliance literature and describes an analysis framework comprising six attributes of strategic alliances for application to construction organisations—trust, commitment, interdependence, cooperation, communication, and joint problem solving. These attributes are currently being used to collect data from 70 building construction firms in Queensland to assess their respective levels of strategic alliance. Given the trend towards broader indicators of construction firm performance, these attributes are proposed as a tool for use in the tender evaluation process for public works.

Technology strategy for re-engineering design and construction

Automation technology can provide construction firms with a number of competitive advantages. Technology strategy guides a firm's approach to all technology, including automation. Engineering management educators, researchers, and construction industry professionals need improved understanding of how technology affects results, and how to better target investments to improve competitive performance. A more formal approach to the concept of technology strategy can benefit the construction manager in his efforts to remain competitive in increasingly hostile markets. This paper recommends consideration of five specific dimensions of technology strategy within the overall parameters of market conditions, firm capabilities and goals, and stage of technology evolution. Examples of the application of this framework in the formulation of technology strategy are provided for CAD applications, co-ordinated positioning technology and advanced falsework and formwork mechanisation to support construction field operations. Results from this continuing line of research can assist managers in making complex and difficult decisions regarding reengineering construction processes in using new construction technology and benefit future researchers by providing new tools for analysis. Through managing technology to best suit the existing capabilities of their firm, and addressing the market forces, engineering managers can better face the increasingly competitive environment in which they operate.

Towards more complete satisfaction of customers in construction

In an environment where economic, political and technological change is the rule, a fundamental business strategy should be the defence of traditional markets and thoughtful entry into new markets, with an aim to increase market penetration and stimulate profit. The success of such a strategy will depend on the success of firms to do more and better for customers than their competitors. In other words, the firm’s primary competitive advantage will come from changes they implement to please their customers. In the construction industry, complexity of technical knowledge and construction processes have traditionally encouraged clients to play a largely passive role in the management of their project. However, today’s clients not only want to know about internal efficiency of their projects but also need to know how they and their contractors compare and compete against their competitors. Given the vulnerability of construction activities in the face of regional financial crisis, constructors need to be proactive in the search to improve their internal firm and project processes to ensure profitability and market responsiveness. In this context, reengineering is a radical design that emphasises customer satisfaction rather than cost reduction This paper discusses the crucial role of the client-project interface and how project networks could facilitate and improve information dissemination and sharing, collaborative efforts, decision-making and improved project climate. An intra-project network model is presented, and project managers’ roles and competencies in forming and coordinating project workgroups is discussed.