An investigation into export market orientation in UK universities from the international marketing managers’ perspective: A mixed-method approach

This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University.Recent developments in the theories of export marketing have resulted in the conceptualisation of export market orientation in the manufacturing industry. However, little research investigating the concept of export market orientation in the higher education context exists, despite the importance of the export market in shaping the direction of the marketing of higher education. Building on the existing literature on export marketing and higher education marketing, this research offers a conceptualisation of export market orientation in universities and its antecedents and consequences from a managerial perspective. A mixed-method research design was adopted, consisting of two main phases. The first phase involved conducting key informant interviews with the international marketing managers of UK universities. Together with the literature review, an analysis of the key themes led to the development of research hypotheses and an operational model. The model was tested in the second phase with a survey directed at the international marketing managers of different UK universities. Partial Least Squares structural equation modelling was used to analyse the survey responses. The structural model showed a good fit with the data and good convergent, discriminant and nomological validity and reliability stability. This research is the first to formulate and develop the concepts of export market orientation and export performance in the higher education context. The outcome of this research adds new perspectives to the growing body of higher education marketing literature, and suggests directions for future research. This research also offers important implications for management bodies in universities, academia and public policy-makers alike

An investigation into export market orientation in UK universities from the international marketing manager's perspective : a mixed-method approach

Recent developments in the theories of export marketing have resulted in the conceptualisation of export market orientation in the manufacturing industry. However, little research investigating the concept of export market orientation in the higher education context exists, despite the importance of the export market in shaping the direction of the marketing of higher education. Building on the existing literature on export marketing and higher education marketing, this research offers a conceptualisation of export market orientation in universities and its antecedents and consequences from a managerial perspective. A mixed-method research design was adopted, consisting of two main phases. The first phase involved conducting key informant interviews with the international marketing managers of UK universities. Together with the literature review, an analysis of the key themes led to the development of research hypotheses and an operational model. The model was tested in the second phase with a survey directed at the international marketing managers of different UK universities. Partial Least Squares structural equation modelling was used to analyse the survey responses. The structural model showed a good fit with the data and good convergent, discriminant and nomological validity and reliability stability. This research is the first to formulate and develop the concepts of export market orientation and export performance in the higher education context. The outcome of this research adds new perspectives to the growing body of higher education marketing literature, and suggests directions for future research. This research also offers important implications for management bodies in universities, academia and public policy-makers alike.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Sports events and interaction among spectators: examining antecedents of spectators’ value creation

Research question: Spectating at sports events comprises on-pitch and off-pitch benefits. Value may also derive from spectator-to-spectator interaction, however, we do not know whether all types of interaction have similar effects on value creation and subsequent word-of-mouth (WOM) behaviours. We investigate two types of spectator-to-spectator interaction – between known/familiar others, and between unknown-others. We study their effects within a framework grounded in Customer Dominant Logic and sport value framework, integrating on-pitch sport performance, off-pitch service quality, overall satisfaction, team identification and WOM intention. Research methods: Hypotheses were tested using a survey of 1002 spectators of a British Premier League football club. Respondents were asked about the last game they attended. Data were analysed using Structural Equations Modelling and PROCESS analysis. Results and findings: Customer-to-customer interaction was antecedent to overall satisfaction and team identification. Satisfaction and team identification led to WOM intention, with team identification having greater effect. Evaluation of on-pitch performance (the football match) influenced overall satisfaction more than off-pitch service quality. The study contributes to knowledge in finding that customer-to-customer interaction with familiar accompaniers influenced satisfaction more than interaction with anonymous-other spectators. However, the latter contributed more to team identification and indirectly to WOM. Implications: The study highlights the importance to sports events organisers of facilitating customer-to-customer interaction. While promotion of many sports events focuses on game performance, this study highlights the importance of promoting the social benefits of attendance in increasing positive WOM. Suggestions are made, including provision of social media platforms within events to promote interaction among spectators

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Anticipating the show or the social experience? - examining customer-to-customer interaction in the performing arts

This study contributes to the services marketing literature by examining the relationship between anticipation and different aspects of the service encounter and their effects on related outcomes, namely positive emotions and WOM. The study hypothesises and tests a model in the context of the performing arts, with structural equation modelling (SEM) analysis providing the methodology to test the model. The study uses a sample of 470 show goers. The results show that: (1) anticipation is a good predictor to both core service and customers’ interaction; (2) both core service and customers’ interaction directly elicit positive emotions of show attendees; moreover, (3) customers’ interaction is the highest predictor of WOM. A number of theoretical and managerial implications are extracted and directions for future research provided

Anticipating the show or the social experience? - examining customer-to-customer interaction in the performing arts

This study contributes to the services marketing literature by examining the relationship between anticipation and different aspects of the service encounter and their effects on related outcomes, namely positive emotions and WOM. The study hypothesises and tests a model in the context of the performing arts, with structural equation modelling (SEM) analysis providing the methodology to test the model. The study uses a sample of 470 show goers. The results show that: (1) anticipation is a good predictor to both core service and customers’ interaction; (2) both core service and customers’ interaction directly elicit positive emotions of show attendees; moreover, (3) customers’ interaction is the highest predictor of WOM. A number of theoretical and managerial implications are extracted and directions for future research provided

Linking engagement at cultural festivals to legacy impacts

Cultural festivals typically celebrate and reinforce a cultural identity, while becoming embedded in tourism experiences. They have sought to establish their sustainability through legacies of enduring involvement with the cultures and communities they serve. Although studies have examined the effects of attendance on festival impacts and legacy, we contribute further understanding by investigating the effects of visitors’ level of behavioural engagement during a festival on subsequent cultural and social post-festival legacies. Basing our conceptual development on van Doorn et al.’s Customer Engagement Behaviour framework and Service-Dominant-Logic, we incorporate behavioural engagement, emotions, festival loyalty, and post-festival cultural and social involvement intentions. Hypotheses are tested in two studies with data from 1,335 visitors covering consecutive years of a national cultural festival, using cluster and mediation analyses. Findings highlight the importance of engagement and joyful emotions on festival legacy benefits. We validate an “engagement ladder” comprising four distinct clusters – ‘Disengaged’, ‘Observers’, ‘Learners’, ‘Doers’. The most engaged clusters – ‘Learners’ and ‘Doers’ - have significantly higher association with legacy impacts, manifested through post-festival cultural and community involvement intentions. Our results have implications for sponsors and organisers of cultural festivals whose sustainability may be justified by encouraging visitor engagement rather than merely promoting attendance

Brand identification in higher education: a conditional process analysis

The dimensions and dynamics of higher education brands remain excessively informed by general principles of branding, with inadequate empirical testing in the specific context. This paper advances understanding of brand identification in higher education by empirically assessing its antecedents and relating brand identification to brand loyalty and brand support as outcome variables, moderated by time since direct experience of the university. Results of a conditional process analysis with a sample of 791 alumni indicate that recalled academic and social experiences significantly influence brand identification, and that brand identification is a good predictor of alumni brand loyalty and brand support. While the direct effects of recalled academic and social experience on brand loyalty decrease over time, the indirect effect of academic experience on loyalty via brand identification increases, indicating that the mediation effect of brand identification becomes stronger with the passage of time. The study makes important theoretical contributions to the branding literature by emphasizing the mediating role of brand identification and by examining the moderating effects of time on these variables. The results also inform marketing of higher education, suggesting that universities which focus on offering great academic experiences to their students will be more effective in developing strong brand identification over time which in turn leads to greater brand loyalty and brand support