Customer-to-customer co-creation of value in the context of festivals.

The notion of customers co-creating value with the firm has recently gained considerable attention within the service marketing discipline. The Service-Dominant (S-D) and the Customer-Dominant (C-D) logic in marketing in particular emphasise the active role of customers in the co-creation of value. But further theoretical insights are needed into the process of value co-creation. Specifically, customer-to-customer (C2C) value co-creation that takes place as customers come together to socialise, interact with each other and to be co-present in socially dense service settings, requires further conceptualisation. C2C value co-creation is explored in this thesis in the socially dense service setting of multi-day outdoor festivals, using the concept of value-forming social practices as a theoretical lens. The methodological design is guided by the social constructionist stance, which complements the practice-based value approach in co-creation research by emphasising the importance of social contexts. Methods adopted include ethnographic-style participant observation, document and visual materials analysis, and a total of 52 in-depth interviews at five different UK-based outdoor multi-day festivals. Interpretive analysis identifies six distinctive C2C co-creation practices: Belonging, Bonding, Detaching, Communing, Connecting and Amiability. Each practice is described in terms of the actions in which it is embodied. The practices are positioned in a two-dimensional framework, with the Value orientation and the Value immersion dimensions reflecting the complexities and ambiguities that exist in social contexts. Aspects of subject- and situation-specific practice elements are examined with regard to their role in influencing the C2C co-creation process at festivals. Practice-based segmentation and social servicescape design strategies are proposed, which can be used to support and facilitate C2C co-creation. A theoretical contribution is made to the body of knowledge in service marketing, and the S-D and C-D logics in particular, by advancing understanding of what specifically is involved in C2C value co-creation. The thesis also offers holistic insights relevant for service marketing practice. It provides tangible recommendations that could lead to more favourable social outcomes for customers and consequently, competitive advantage for the firm

Flow cytometric minimal residual disease assessment in multiple myeloma

W świetle wysokiej skuteczności nowych metod leczenia szpiczaka plazmocytowego oraz zwiększającego się odsetka osiąganych całkowitych remisji (CR) ocena minimalnej choroby resztkowej (MRD) jest obecnie istotną metodą określającą głębokość odpowiedzi. Wieloparametryczna cytometria przepływowa (MFC) jest obecnie najczęściej wykorzystywaną metodą monitorowania MRD w szpiku kostnym pacjentów ze szpiczakiem plazmocytowym, jednak w tym celu można również stosować metody molekularne. Rodzaj protokołu stosowanego przy badaniu MRD metodą MFC może istotnie wpływać na uzyskiwane wyniki, jednak obecnie jest już dostępny wystandaryzowany i wysoce czuły protokół cytometrii następnej generacji (NGF). Wykazano, że głębokość odpowiedzi oceniona na podstawie pomiaru MRD koreluje z przeżyciem wolnym od progresji (PFS) oraz przeżyciem całko¬witym (OS) chorych na szpiczaka plazmocytowego. Ponadto ujemny wynik badania w kierunku MRD jest lepszym czynnikiem prognostycznym w odniesieniu do PFS oraz OS niż osiągnięcie CR. Z tych względów wynik oceny MRD, uzyskany wysoce czułą oraz powtarzalną metodą MFC, jest potencjalnie użytecznym klinicznie biomarkerem do oceny skuteczności różnych strategii leczniczych i może być podstawą do podejmowania decyzji terapeutycznej oraz użytecznym czynnikiem prognostycznym w szpiczaku plazmocytowym.Minimal residual disease (MRD) assessment in light of the effectiveness of new multiple myeloma (MM) treatment modalities and related to it increasing ratios of achieved complete remissions (CR), becomes an important tool in recognition of the depth of the response. Multiparametric flow cytometry (MFC) is currently the most popular method for monitoring of MRD presence in bone marrow of MM patients; however, molecular techniques may also be used for MRD assessment. The choice of protocol utilized for MFC-MRD measurement can significantly affect the obtained results, nevertheless standardized and highly sensitive approach of next generation flow (NGF) is already available. The depth of response based on MRD assessment was shown to be an inde-pendent predictor of progression-free survival (PFS) and overall survival (OS). Furthermore, the MRD-negative status surpasses the prognostic value of CR achievement for PFS and OS. Thus, MRD status detected by highly sensitive and reproducible MFC is potentially a clinically applicable biomarker for evaluation of different treatment strategies efficacy potentially influencing treatment decisions, and acting as prognostic factor in MM patients

Increased T regulatory cells are associated with adverse clinical features and predict progression in multiple myeloma.

Background: Regulatory T (Treg) cells play an important role in the maintenance of immune system homeostasis. Multiple myeloma (MM) is a plasma cell disorder frequently associated with impaired immune cell numbers and functions. Methods: We analyzed Treg cells in peripheral blood (n = 207) and bone marrow (n = 202) of pre-malignant and malignant MM patients using flow cytometry. Treg cells and their subsets from MM patients and healthy volunteers were functionally evaluated for their suppressive property. A cohort of 25 patients was analyzed for lymphocytes, CD4 T cells and Treg cells before and after treatment with cyclophosphamide, thalidomide plus dexamethasone (CTD). Results: We found elevated frequencies of Treg cells in newly diagnosed (P<0.01) and relapsed MM patients (P<0.0001) compared to healthy volunteers. Also, Treg subsets including naive (P = 0.015) and activated (P = 0.036) Treg cells were significantly increased in MM patients compared to healthy volunteers. Functional studies showed that Treg cells and their subsets from both MM and healthy volunteers were similar in their inhibitory function. Significantly increased frequencies of Treg cells were found in MM patients with adverse clinical features such as hypercalcemia (.10 mg/dL), decreased normal plasma cell (<5%) count and IgA myeloma subtype. We also showed that MM patients with >5% of Treg cells had inferior time to progression (TTP) (13 months vs. median not reached; P = 0.013). Furthermore, we demonstrated the prognostic value of Treg cells in prediction of TTP by Cox regression analysis (P = 0.045). CTD treatment significantly reduced frequencies of CD4 T cells (P = 0.001) and Treg cells (P = 0.018) but not Treg cells/CD4 T cells ratio compared to pretreatment. Conclusions: Our study showed immune deregulation in MM patients which is evidenced by elevated level of functionally active Treg cells and patients with increased Treg cells have higher risk of progression

How do tour guides cope with knowledgeable tourists? Conceptualising knowledge/information asymmetry in tour-guiding contexts

Purpose Tourists’ resource integration both offers opportunities and presents challenges to tourism service providers. Focussing on the tour guide perspective, this paper explores how tour guides experience knowledge/information-based asymmetry in encounters with tourists, and identifies the roles and coping strategies used by guides to facilitate service co-production.Methodology Critical incident technique (CIT) is used in qualitative interviews with 47 tour guides in Scotland, broadly representative of the Scottish tour guiding context. 107 critical incidents were analysed, with an average of 2.32 incidents per interview. Narrative analysis of the incidents was performed inductively in four iterative steps using QSR NVivo.Findings Three resource asymmetry incident categories are identified: 1) Probing - Guide-Oracle is questioned by inquiring tourists and copes through diverting, evasion, and follow-up strategies; 2) Learning - Guide-Magpie learns from expert tourists through acknowledging and co-delivery; and 3) Negotiation - Guide-Diplomat with greater knowledge helps misguided tourists save face through appeasing, following the official line, and tactfully correcting.Originality The paper contributes to service co-production research in tourism by theorising about contexts where knowledge/information asymmetry exists between tour guides and tourists, particularly where fluid power relations between guides and knowledgeable tourists occur, or where misguided tourists co-produce the service by prioritising own meanings. Findings highlight the importance of soft skills and other non-content capabilities of guides, and suggestions are offered for effective training and resource sharing/ learning initiatives for tour guiding services

Customer-to-customer co-creation practices in tourism: Lessons from Customer-Dominant logic

This study aims to explore specific customer-to-customer (C2C) co-creation practices and related value outcomes in tourism. The importance of C2C co-creation is first discussed in the context of the Service-Dominant logic, then a new approach to the study of tourists' social practices and related value-outcomes is proposed, drawing on the recently emerged Customer-Dominant logic in marketing. A pragmatic philosophy is adopted to best address the research questions in a purposively selected sample of five UK-based festivals. Qualitative interview- and observation-based methods are adopted to identify 18 C2C co-creation practices, placing these on a continuum of autotelicinstrumental and private-public practices. Four value-outcome categories are discussed: affective, social, functional and network value. The conclusions highlight the importance of value formed when tourists cocreate with each other in tourism settings and the authors identify specific opportunities for facilitating this process. Possible applications for future research are discussed, highlighting the merits of pragmatism

Practice-based segmentation: taxonomy of C2C co-creation practice segments

Purpose: This paper explores and evaluates practice-based segmentation as an alternative conceptual segmentation perspective that acknowledges the active role of consumers as value co-creators.Design/methodology/approach: Data comprising various aspects of customer-to-customer co-creation practices of festival visitors were collected across five UK-based festivals, using participant observation and semi-structured interviews with naturally occurring social units (individuals, couples and groups). Data were analysed using a qualitative thematic analysis procedure within QSR NVivo 10.Findings: Private, Sociable, Tribal and Communing practice segments are identified and profiled, using the interplay of specific subject- and situation-specific practice elements to highlight the ‘minimum’ conditions for each C2C co-creation practice. Unlike traditional segments, practice segment membership is shown to be fluid and overlapping, with fragmented consumers moving across different practice segments throughout their festival experience according to what makes most sense at a given time.Research limitations/implications: Although practice-based segmentation is studied in the relatively limited context of C2C co-creation practices at festivals, the paper illustrates how this approach could be operationalised in the initial qualitative stages of segmentation research. By identifying how the interplay of subject- and situation-specific practice elements affects performance of practices, managers can facilitate relevant practice-based segments, leading to more sustainable business.Originality/value: The paper contributes to segmentation literature by empirically demonstrating the feasibility of practice-based segments and by evaluating the use of practice-based segmentation on a strategic, procedural and operational level. Possible methodological solutions for future research are offered

Mega-events brand meaning co-creation: the Olympic case

Purpose: This study explores a multi-stakeholder perspective on brand meaning co-creation in the context of the Olympic Games as a unique mega sports event brand with a strong brand identity, in order to understand how the brand manager may integrate such co-created meanings in a negotiated brand identity. Design/methodology/approach: Utilizing a qualitative methodology, the paper provides a tentative framework of co-created Olympic brand meanings by exploring the narratives of stakeholders' brand experiences of the brand. 16 semi-structured interviews with a purposive sample of Olympic stakeholders were conducted and analysed to identify key meanings associated with the Olympic brand. Findings: Through their transformational and social experiences of the Olympic brand, stakeholders co-create brand meanings based on Olympic values of Excellence, Friendship and Respect. However, at the same time they offer their own interpretations and narratives related to competing meanings of Spectacle, Exclusion and Deceit. Alternative brand touchpoints were identified, including blogs, fan and sports community forums, educational and academic sources, and historical sources and literature. Practical implications: The brand manager must become a brand negotiator, facilitating multi-stakeholder co-creation experiences on a variety of online and offline engagement platforms, and exploring how alternative brand touchpoints can be utilised to access co-created brand meanings. Originality/value: The study contributes to tourism branding literature by providing exploratory evidence of how brand meanings are co-created in the relatively under researched multi-stakeholder sports mega-event context