Conceptualising customer value in a leisure service setting: value is in the eye of the beholder.

Currently there is little research that considers value or value creation from a sport and physical activity context or from the participant’s perspective. Despite the emerging importance of value as an incentive for customers to perform desired behaviours, this study’s investigation represents the first examination of the value construct as it pertains to the consumption of sport and physical activity opportunities. Sheth & Uslay (2007:303) called for marketers to use the value creating paradigm to ‘reach beyond value in exchange and even value in use’ to think about other types of value, whilst this research was focused specifically on identifying the various dimensions of customer-perceived value in a sport and physical activity setting, insights gained from this study also question the simplicity of value being conceived as an either (value-in-exchange) or (value-in-use) concept, and this is where the paper’s significant contribution to further our theoretical understanding can be found. Whilst accepting further work is required to refine the original S&PAVAL model that is presented here, and to test it in a wider variety of settings, this paper contributes to a deeper and more meaningful investigation into customer value theory

Value-in-exchange or value-in-use? Empirical insights into consumer perceptions.

This paper considers consumer perceptions of value against the background of emerging paradigm shifts in marketing moving away from traditional transactional ‘value-in-exchange’ approaches where marketers create value for consumers, towards a concept of ‘value-in-use’ where it is the consumer who creates the value with the organisation deemed to be at best only a co-creator. Much of the relevant literature on governmental interventions is located within the public health arena, yet there is little which examines issues of value or value creation. This paper also therefore addresses this gap in the extant literature by considering issues of value in relation to engagement in physical activity and health in a leisure service setting

Towards developing understanding of the drivers, constraints from the consumption values underpinning participation in physical activity.

Overall participation rates in physical activity across the UK have remained relatively static since the mid 1980s, with attendant causes for concern about the inequality of participation rates amongst various target groups that may be worthy of specific investigation. Behaviour change models from the fields of leisure studies, consumer behaviour and social psychology offer conceptualisation of a notion of exchange underpinning the expectancy-value process, noting that, in order to facilitate a voluntary exchange there needs to be a value proposition that induces action and/or motivates effort from the consumer. It is therefore reasonable to assume that such value expectations will also influence health behaviour intentions. This paper therefore aims to offer a more developing understanding of the drivers, constraints and experiential consumption values underpinning participation in physical activity. Results suggest that, rather than focusing on the social and altruistic values of behavioural changes, and given that the functional value of participation is already well-known (if not always acted upon) through social marketing campaigns’ educational efforts and through the media, it may be worth policymakers and leisure service providers focusing more on highlighting the emotional benefits to be gained, especially when targeting women to increase their participation in physical activit

Why don’t people do what’s good for them? : an examination of the value(s) which affect physical activity.

One of the 21st Century’s major public health issues is physical inactivity. Therefore one of the greatest public policy challenges is to find new ways of conferring to an inactive population the health related benefits that arise from being physically active in a way that not only leads to knowledge acquisition, but which also leads to increased levels of participation in physical activity. Participation rates in physical activity across the UK have remained stubbornly static since the mid‐ 1980s and retain a range of gender, age, social‐economic and ethnic participation inequalities. Research has indicated that, when compared to men, women are more likely to: lead sedentary lifestyles (Hausenblas and Symons‐Downs, 2005), experience poor health (Bertakis et al., 2000), and feel more uncomfortable about their body image (Liechty et al., 2006), factors which impact on and/or result in lower participation levels, suggesting that social marketing campaigns to date have been largely ineffective. A central tenet of social marketing is to achieve a voluntary, not forced or coerced behaviour change by emphasising a value proposition that induces action from the consumer. Set in the context of publicly funded leisure facilities this paper offers empirical insights regarding the drivers, constraints and consumption values underpinning women’s participation in physical activity. Our results suggest that value perceptions regarding the costs, benefits and enjoyment of exercise do not differ with gender. However, statistically significant differences exist between the genders regarding: the physical environment within which exercise occurs; the quality of service experience; and intrinsic factors such as social and altruistic value. Insights gained from this research may be able to inform policymakers and leisure services providers regarding more effective methods of engaging ‘hard‐to‐reach’ groups, such as women. Specifically, our findings suggest that exercise adoption is likely to be increased with targeted social marketing campaigns which focus on emphasising the experiential aspects of consuming physical activity viewed from the perspective of value‐in‐use rather than from the traditional price‐based perspective that tends to focus on the trade off of costs against benefits

Community composition of nitrous oxide reducing bacteria investigated using a functional gene microarray

The diversity and environmental distribution of the nosZ gene, which encodes the enzyme responsible for the consumption of nitrous oxide, was investigated in marine and terrestrial environments using a functional gene microarray. The microbial communities represented by the nosZ gene probes showed strong biogeographical separation. Communities from surface ocean waters and agricultural soils differed significantly from each other and from those in oceanic oxygen minimum zones. Atypical nosZ genes, usually associated with incomplete denitrification pathways, were detected in all the environments, including surface ocean waters. The abundance of nosZ genes, as estimated by quantitative PCR, was highest in agricultural soils and lowest in surface ocean waters

Towards causal benchmarking of bias in face analysis algorithms

Measuring algorithmic bias is crucial both to assess algorithmic fairness, and to guide the improvement of algorithms. Current methods to measure algorithmic bias in computer vision, which are based on observational datasets, are inadequate for this task because they conflate algorithmic bias with dataset bias. To address this problem we develop an experimental method for measuring algorithmic bias of face analysis algorithms, which manipulates directly the attributes of interest, e.g., gender and skin tone, in order to reveal causal links between attribute variation and performance change. Our proposed method is based on generating synthetic ``transects'' of matched sample images that are designed to differ along specific attributes while leaving other attributes constant. A crucial aspect of our approach is relying on the perception of human observers, both to guide manipulations, and to measure algorithmic bias. Besides allowing the measurement of algorithmic bias, synthetic transects have other advantages with respect to observational datasets: they sample attributes more evenly allowing for more straightforward bias analysis on minority and intersectional groups, they enable prediction of bias in new scenarios, they greatly reduce ethical and legal challenges, and they are economical and fast to obtain, helping make bias testing affordable and widely available. We validate our method by comparing it to a study that employs the traditional observational method for analyzing bias in gender classification algorithms. The two methods reach different conclusions. While the observational method reports gender and skin color biases, the experimental method reveals biases due to gender, hair length, age, and facial hair

Comparison of spontaneous with controlled mode of ventilation in tonsillectomy

Methods: This randomized study compares spontaneous versus controlled ventilation in 60 ASA I and II patients undergoing tonsillectomy as regards haemodynamic stability, recovery characteristics, intra- and immediate postoperative complications and surgical impressions.Results: The patients in the balanced anaesthesia (B) group showed less haemodynamic variability compared to baseline after tracheal intubation, mouth gag application and removal and incision. Two patients had dysrhythmias in the B group compared to six in the spontaneous breathing (S) group. Six patients in the S group had a rise in endtidal carbon dioxide concentration above 7.8 kPa (60 mmHg). Recovery scores were higher in the B group at 10 and 20 min into recovery. The surgical impression of bleeding and jaw relaxation was similar with both groups. The incidence of postoperative nausea and vomiting and agitation was higher in the S group but did not achieve statistical significance.CONCLUSION: Use of balanced anaesthesia offered more haemodynamic stability and a rapid recovery

Social media for dissemination and public engagement in neurosurgery-the example of Brainbook.

BACKGROUND: Public engagement has become one of the most effective tools in gaining feedback and perspectives from members of the public, involving patients with decisions, and inspiring young people to carry the medical profession forwards. Brainbook is a multi-platform, social media-based resource that was created specifically to enhance public engagement in neurosurgery and results from one of its case discussions will be reported in this paper. METHODS: A Brainbook case was created in collaboration with the NIHR Global Health Research Group on Neurotrauma and presented over 3 days (23-25 February 2018). YouTube videos were created depicting the management of an acute subdural haematoma using patient interviews, medical illustration, consultant-led discussion and operative footage. Content was shared across all Brainbook social media platforms and analytics were gathered through social media applications. RESULTS: Over a 72-hour time period, and across multiple social media accounts, 101,418 impressions were achieved (defined as penetrance onto individual media feeds and total views of the content), with active discussion on social media. CONCLUSIONS: Neurosurgical content published across multiple social media outlets represents an encouraging and exciting potential for global engagement across multiple audiences. Social media can be an effective method of not only disseminating neurosurgical knowledge, but activating and engaging the public, allied healthcare professionals, medical students and neurosurgeons

A Controlled Investigation of Optimal Internal Medicine Ward Team Structure at a Teaching Hospital

BACKGROUND: The optimal structure of an internal medicine ward team at a teaching hospital is unknown. We hypothesized that increasing the ratio of attendings to housestaff would result in an enhanced perceived educational experience for residents. METHODS: Harbor-UCLA Medical Center (HUMC) is a tertiary care, public hospital in Los Angeles County. Standard ward teams at HUMC, with a housestaff∶attending ratio of 5:1, were split by adding one attending and then dividing the teams into two experimental teams containing ratios of 3:1 and 2:1. Web-based Likert satisfaction surveys were completed by housestaff and attending physicians on the experimental and control teams at the end of their rotations, and objective healthcare outcomes (e.g., length of stay, hospital readmission, mortality) were compared. RESULTS: Nine hundred and ninety patients were admitted to the standard control teams and 184 were admitted to the experimental teams (81 to the one-intern team and 103 to the two-intern team). Patients admitted to the experimental and control teams had similar age and disease severity. Residents and attending physicians consistently indicated that the quality of the educational experience, time spent teaching, time devoted to patient care, and quality of life were superior on the experimental teams. Objective healthcare outcomes did not differ between experimental and control teams. CONCLUSIONS: Altering internal medicine ward team structure to reduce the ratio of housestaff to attending physicians improved the perceived educational experience without altering objective healthcare outcomes

Interprofessional communication with hospitalist and consultant physicians in general internal medicine : a qualitative study

This study helps to improve our understanding of the collaborative environment in GIM, comparing the communication styles and strategies of hospitalist and consultant physicians, as well as the experiences of providers working with them. The implications of this research are globally important for understanding how to create opportunities for physicians and their colleagues to meaningfully and consistently participate in interprofessional communication which has been shown to improve patient, provider, and organizational outcomes