The evolution of networks and interaction in the co-creation of value : a case study of the development of a city museum

Vargo and Lusch (2004) proposed that marketing is moving to a new dominant logic where service is exchanged for service. Central to their proposal were eight foundational premises (Vargo and Lusch, 2004), subsequently extended to ten (Vargo and Lusch, 2008a). Key amongst them are: service is deemed to be the fundamental basis of exchange (FP1); operant resources are the fundamental source of competitive advantage (FP4); the customer is always a co-creator of value (FP6); the enterprise can only offer value propositions, it cannot deliver value (FP7); value creation occurs in networks through actors who are resource integrators (FP9); and value itself is ‘idiosyncratic, experiential, contextual and meaning-laden’ (FP10) (Vargo and Lusch, 2008a, p.375). Much discussion on S-D logic has focused on developing this theoretical context (see for example: Lusch and Vargo, 2006, 2009; Vargo and Lusch, 2008b, 2008c; Gummesson, Lusch, Vargo, 2010; Brodie et al., 2011). Alongside this, the debate has developed through studies which explore how the tenets of S-D logic operate in practical contexts such as financial services (Auh et al., 2007), art experiences (White, Hede and Rentschler, 2009), opera (Lund, 2010), the travel industry (Fyrberg and Juriado, 2009), electronic services (Blazevic and Lievens, 2008) and the Harry Potter phenomenon (Brown and Patterson, 2009) amongst others. Central to much of this work is the effort to understand how value is cocreated within varying contexts. Of particular interest to the current research is the work of Fryberg and Juriado (2009) who highlight the importance of networks in the co-creation of value, paying particular attention to the importance of interaction between network actors. Further, defining value and value propositions has received increasing attention (Gronroos, 2008; Kowalkowski, 2011). Through a case study of the Cardiff Story, a new museum for the people of Cardiff, this paper builds on previous work on S-D logic by exploring how networks and interaction evolve over time and the role they play in the evolving nature of value co-creation. The unique site of the work, the development from inception of a city museum, allows us to explore S-D logic in the public sector while taking into consideration the specific nature of arts and heritage in that context. The paper begins by reviewing pertinent S-D logic constructs to provide context for the current work. The methods section details the research position adopted before providing a justification for the single case study nature of this work. Context for the Cardiff Story is provided before the data collection methods are outlined. Findings are subsequently discussed before a conclusion is offered and areas for future research outlined

Thermodynamics of de Sitter black holes with a conformally coupled scalar field

We study the thermodynamics of de Sitter black holes with a conformally coupled scalar field. The geometry is that of the ``lukewarm'' Reissner-Nordstrom-de Sitter black holes, with the event and cosmological horizons at the same temperature. This means that the region between the event and cosmological horizons can form a regular Euclidean instanton. The entropy is modified by the non-minimal coupling of the scalar field to the geometry, but can still be derived from the Euclidean action, provided suitable modifications are made to deal with the electrically charged case. We use the first law as derived from the isolated horizons formalism to compute the local horizon energies for the event and cosmological horizons.Comment: 9 pages, 2 figures, REVTEX. Minor changes, accepted for publication in Phys. Rev.

Tiffany & Co.: a nineteenth century American retailer in Paris and London

Large American international retailers have been defining global consumers’ in-store experiences for decades. Firms such as Woolworths, and concepts such as the supermarket, have changed how we use stores and what we expect from them. American innovation in retailing in the twentieth century was synonymous with the notion of “big is beautiful”

Promoting Healthy Behaviour Choices: Understanding Patient Challenges by Undertaking a Personal Behaviour Change Task

INTRODUCTION: Unhealthy behaviours such as poor diet, smoking and physical inactivity contribute significantly to chronic disease. Our first year medical school project aims to increase student awareness of: the importance of these behaviours and their systematic measurement; recommended behaviour targets in health professional guidelines; challenges in achieving patient behaviour change; and psychological theories which aid behaviour change. METHODS: Students are provided with evidence-based health behaviour guidelines for prevention of heart disease. Students select whichever behaviour they would personally like to achieve improvement in, systematically record behaviour for one week (baseline), and then try to implement (healthy) behaviour change for the next two weeks, using psychological theory as an aide. Students report their results and discuss outcomes reflecting on explanations for the success or otherwise of their behaviour attempts. A virtual learning environment (Moodle) ensures project engagement and completion during the relevant timeframes. RESULTS: This assignment has been successfully completed by students over previous academic years. The use of deadlines for uploading sections of coursework to Moodle (e.g. baseline data) has increased the quality and completeness of the projects. Students learn to use standard instruments such as the Fagerstrom Test for Nicotine Dependence and also learn recommended professional guidelines on diet and physical activity at an early point in a medical training. Also, self-reported health behaviours improved over the course of the assignment. CONCLUSIONS: This project allows students to test the difficulty of adhering to professional advice they themselves will give to future patients. The assignment combines knowledge (e.g. education on chronic conditions, on the role of behaviour change and on professional guidelines), skills (e.g. documenting behaviours, planning and implementing change) and attitudes (e.g. on understanding the difficulties encountered by individuals when making and sustaining recommended behaviour change). The novel use of a virtual learning environment ensures high participation

Understanding communication of health information: a lesson in health literacy for junior medical and physiotherapy students

Healthcare professional students should be engaged in best practice regarding communication with patients, including using good quality patient information leaflets (PILs) on health behaviours. A cross-sectional survey of 337 junior medical and physiotherapy students investigated the readability, health psychology theory content, and quality and reliability ratings of nine international PILs on smoking. Estimates of readability, theory content and quality/reliability ratings varied considerably across PILs. Importantly, additional theory-based content, as proposed by students, had no detrimental effect on readability scores. Results are discussed with regard to their potential for improving interactions between future healthcare providers and service users

Development and validation of a Clostridium difficile infection risk prediction model

OBJECTIVE: The purpose of this study was to develop and validate a risk prediction model that could identify patients at high risk for Clostridium difficile infection (CDI) before they develop disease. DESIGN: Retrospective cohort. SETTING: Tertiary care medical center. PATIENTS: Patients admitted to the hospital for ≥48 hours from 1-1-2003 through 12-31-2003. METHODS: Data were collected electronically from the hospital’s Medical Informatics database and analyzed with logistic regression to determine variables that best predicted patients’ risk for development of CDI. Model discrimination and calibration were calculated. The model was bootstrapped 500 times to validate the predictive accuracy. A receiver operating characteristic (ROC) curve was calculated to evaluate potential risk cut-offs. RESULTS: 35,350 admissions with 329 CDI cases were included. Variables in the risk prediction model were age, CDI pressure, admissions in previous 60 days, modified Acute Physiology Score, days on high risk antibiotics, low albumin, admission to an ICU, and receipt of laxatives, gastric acid suppressors, or antimotility drugs. The calibration and discrimination of the model were very good to excellent (C index=0.88; Brier score 0.009). CONCLUSIONS: The CDI risk prediction model performed well. Further study is needed to determine if it could be used in a clinical setting to prevent CDI-associated outcomes and reduce costs

Electronic surveillance for healthcare-associated central line-associated bloodstream infections outside the intensive care unit

Background.Manual surveillance for central line-associated bloodstream infections (CLABSIs) by infection prevention practitioners is time-consuming and often limited to intensive care units (ICUs). An automated surveillance system using existing databases with patient-level variables and microbiology data was investigated.Methods.Patients with a positive blood culture in 4 non-ICU wards at Barnes-Jewish Hospital between July 1, 2005, and December 31, 2006, were evaluated. CLABSI determination for these patients was made via 2 sources; a manual chart review and an automated review from electronically available data. Agreement between these 2 sources was used to develop the best-fit electronic algorithm that used a set of rules to identify a CLABSI. Sensitivity, specificity, predictive values, and Pearson's correlation were calculated for the various rule sets, using manual chart review as the reference standard.Results.During the study period, 391 positive blood cultures from 331 patients were evaluated. Eighty-five (22%) of these were confirmed to be CLABSI by manual chart review. The best-fit model included presence of a catheter, blood culture positive for known pathogen or blood culture with a common skin contaminant confirmed by a second positive culture and the presence of fever, and no positive cultures with the same organism from another sterile site. The best-performing rule set had an overall sensitivity of 95.2%, specificity of 97.5%, positive predictive value of 90%, and negative predictive value of 99.2% compared with intensive manual surveillance.Conclusions.Although CLABSIs were slightly overpredicted by electronic surveillance compared with manual chart review, the method offers the possibility of performing acceptably good surveillance in areas where resources do not allow for traditional manual surveillance.</jats:sec

A research and evaluation capacity building model in Western Australia

Evaluation of public health programs, services and policies is increasingly required to demonstrate effectiveness. Funding constraints necessitate that existing programs, services and policies be evaluated and their findings disseminated. Evidence-informed practice and policy is also desirable to maximise investments in public health. Partnerships between public health researchers, service providers and policymakers can help address evaluation knowledge and skills gaps. The Western Australian Sexual Health and Blood-borne Virus Applied Research and Evaluation Network (SiREN) aims to build research and evaluation capacity in the sexual health and blood-borne virus sector in Western Australia (WA). Partners’ perspectives of the SiREN model after 2 years were explored. Qualitative written responses from service providers, policymakers and researchers about the SiREN model were analysed thematically. Service providers reported that participation in SiREN prompted them to consider evaluation earlier in the planning process and increased their appreciation of the value of evaluation. Policymakers noted benefits of the model in generating local evidence and highlighting local issues of importance for consideration at a national level. Researchers identified challenges communicating the services available through SiREN and the time investment needed to develop effective collaborative partnerships. Stronger engagement between public health researchers, service providers and policymakers through collaborative partnerships has the potential to improve evidence generation and evidence translation. These outcomes require long-term funding and commitment from all partners to develop and maintain partnerships. Ongoing monitoring and evaluation can ensure the partnership remains responsive to the needs of key stakeholders. The findings are applicable to many sectors