The Applicability of the Human Sigma Model to Service Quality Management in the UK Tourism Industry: an operational analysis

The dominant focus in the service quality literature in general, and within the tourism and hospitality sector service literature in particular, has been on the drivers of customer-perceived service quality. That is, although the role of front-line employees in service quality has been acknowledged, few studies have actually identified the factors linked to the service encounter from the perspective of both the provider and customer. In practice, the role of front-line employees in service firms tends to be underappreciated, with the lowest paid, less experienced and trained ‘put’ on the front-line. Therefore, managing and measuring the employee-customer encounter becomes a vital determinant of service quality management. Consequently, there is need for more in-depth research from the perspective of both parties in service encounters. Traditionally, research into service quality has been undertaken from the perspective of a person’s (customer’s) satisfaction within service encounters through the expectancy-disconfirmation theory. Indeed, this has been one of the main concepts for assessing satisfaction (Oliver, Rust and Vark, 1997), including the well-known SERVQUAL scale for measuring service quality (Parasuraman, Zeithaml and Berry, 1988). However, a more recent focus on measuring and managing service quality through the service encounter and, ultimately, on business improvement has adopted a new approach: Human Sigma (Fleming and Asplund, 2007). This new approach has signified a shift away from isolated employee and customer satisfaction scales, described as meeting expectations, to an examination of the more powerful and emotional dimensions of engagement which are holistically measured and managed. This, in turn, can facilitate organisations in remaining highly competitive in attracting and retaining both customers and employees. Given, therefore, that this new approach has the potential to have a positive impact on service organisations in their quest to improve service quality, the purpose of this thesis is to explore the concept of Human Sigma within the context of the hospitality sector. More specifically, focusing on the UK tourism industry, which is primarily comprised of small to medium sized enterprises (SMEs), the purpose of this thesis is to appraise critically the philosophy of the Human Sigma concept of business improvement and to apply the Human Sigma model in a single service context, a UK tourism SME. Subsequently, in order to fully determine the applicability of Human Sigma, a postal questionnaire survey is first conducted amongst the managers of tourism SMEs to establish the extent of the utilisation and contribution of service management tools, techniques and approaches within contemporary small to medium businesses. Following, in-depth interviews are conducted with two key informants in order to enhance knowledge and understanding of the principles and practices of Human Sigma. Building on these results, the third and principal stage of the research applies the Human Sigma model in an operational analysis within a tourism SME. As a consequence, the research not only identifies potential limitations inherent in the Human Sigma model but also, and most significantly, enables the development of a new conceptual model and instrument for measuring and managing the service encounter. The thesis concludes by exploring the implications of this research for service managers and the future of service quality management

Targeted interventions for patellofemoral pain syndrome (TIPPS): classification of clinical subgroups

Introduction Patellofemoral pain (PFP) can cause significant pain leading to limitations in societal participation and physical activity. An international expert group has highlighted the need for a classification system to allow targeted intervention for patients with PFP; we have developed a work programme systematically investigating this. We have proposed six potential subgroups: hip abductor weakness, quadriceps weakness, patellar hypermobility, patellar hypomobility, pronated foot posture and lower limb biarticular muscle tightness. We could not uncover any evidence of the relative frequency with which patients with PFP fell into these subgroups or whether these subgroups were mutually exclusive. The aim of this study is to provide information on the clinical utility of our classification system. Methods and analysis 150 participants will be recruited over 18 months in four National Health Services (NHS) physiotherapy departments in England. Inclusion criteria: adults 18–40 years with PFP for longer than 3 months, PFP in at least two predesignated functional activities and PFP elicited by clinical examination. Exclusion criteria: prior or forthcoming lower limb surgery; comorbid illness or health condition; and lower limb training or pregnancy. We will record medical history, demographic details, pain, quality of life, psychomotor movement awareness and knee temperature. We will assess hip abductor and quadriceps weakness, patellar hypermobility and hypomobility, foot posture and lower limb biarticular muscle tightness. The primary analytic approach will be descriptive. We shall present numbers and percentages of participants who meet the criteria for membership of (1) each of the subgroups, (2) none of the subgroups and (3) multiple subgroups. Exact (binomial) 95% CIs for these percentages will also be presented. Ethics and dissemination This study has been approved by National Research Ethics Service (NRES) Committee North West—Greater Manchester North (11/NW/0814) and University of Central Lancashire (UCLan) Built, Sport, Health (BuSH) Ethics Committee (BuSH 025). An abstract has been accepted for the third International Patellofemoral Pain Research Retreat, Vancouver, September 2013

All plug-in electric vehicles are not the same: Predictors of preference for a plug-in hybrid versus a battery-electric vehicle

This study analyzes data from a survey of drivers (n = 1080) administered in late 2013 to assess factors that influence potential car buyers to consider two different types of plug-in electric vehicles (PEVs) in the United States: plug-in hybrid electric vehicles (PHEVs) and battery electric vehicles (BEVs). The results indicate distinct profiles of respondents preferring PHEVs, which have a gasoline backup engine, versus battery BEVs, which rely solely on a battery for power. Respondents interested in selecting a PHEV consider it more for its economic benefits, such as reduced gasoline and maintenance expenditures. Respondents preferring a BEV are drawn to its environmental and technological appeal. The absence of range anxiety for PHEV is a major factor influencing potential PEV buyers

A high fat diet increases mitochondrial fatty acid oxidation and uncoupling to decrease efficiency in rat heart

Elevated levels of cardiac mitochondrial uncoupling protein 3 (UCP3) and decreased cardiac efficiency (hydraulic power/oxygen consumption) with abnormal cardiac function occur in obese, diabetic mice. To determine whether cardiac mitochondrial uncoupling occurs in non-genetic obesity, we fed rats a high fat diet (55% kcal from fat) or standard laboratory chow (7% kcal from fat) for 3 weeks, after which we measured cardiac function in vivo using cine MRI, efficiency in isolated working hearts and respiration rates and ADP/O ratios in isolated interfibrillar mitochondria; also, measured were medium chain acyl-CoA dehydrogenase (MCAD) and citrate synthase activities plus uncoupling protein 3 (UCP3), mitochondrial thioesterase 1 (MTE-1), adenine nucleotide translocase (ANT) and ATP synthase protein levels. We found that in vivo cardiac function was the same for all rats, yet oxygen consumption was 19% higher in high fat-fed rat hearts, therefore, efficiency was 21% lower than in controls. We found that mitochondrial fatty acid oxidation rates were 25% higher, and MCAD activity was 23% higher, in hearts from rats fed the high fat diet when compared with controls. Mitochondria from high fat-fed rat hearts had lower ADP/O ratios than controls, indicating increased respiratory uncoupling, which was ameliorated by GDP, a UCP3 inhibitor. Mitochondrial UCP3 and MTE-1 levels were both increased by 20% in high fat-fed rat hearts when compared with controls, with no significant change in ATP synthase or ANT levels, or citrate synthase activity. We conclude that increased cardiac oxygen utilisation, and thereby decreased cardiac efficiency, occurs in non-genetic obesity, which is associated with increased mitochondrial uncoupling due to elevated UCP3 and MTE-1 levels

Diabetic cardiomyopathy

Diabetic cardiomyopathy is a distinct primary disease process, independent of coronary artery disease, which leads to heart failure in diabetic patients. Epidemiological and clinical trial data have confirmed the greater incidence and prevalence of heart failure in diabetes. Novel echocardiographic and MR (magnetic resonance) techniques have enabled a more accurate means of phenotyping diabetic cardiomyopathy. Experimental models of diabetes have provided a range of novel molecular targets for this condition, but none have been substantiated in humans. Similarly, although ultrastructural pathology of the microvessels and cardiomyocytes is well described in animal models, studies in humans are small and limited to light microscopy. With regard to treatment, recent data with thiazoledinediones has generated much controversy in terms of the cardiac safety of both these and other drugs currently in use and under development. Clinical trials are urgently required to establish the efficacy of currently available agents for heart failure, as well as novel therapies in patients specifically with diabetic cardiomyopathy

Total ankle replacement: Medium-term results in 200 Scandinavian total ankle replacements

We describe the medium-term results of a prospective study of 200 total ankle replacements at a single-centre using the Scandinavian Total Ankle Replacement. A total of 24 ankles (12%) have been revised, 20 by fusion and four by further replacement and 27 patients (33 ankles) have died. All the surviving patients were seen at a minimum of five years after operation. The five-year survival was 93.3% (95% confidence interval (CI) 89.8 to 96.8) and the ten-year survival 80.3% (95% CI 71.0 to 89.6). Anterior subluxation of the talus, often seen on the lateral radiograph in osteoarthritic ankles, was corrected and, in most instances, the anatomical alignment was restored by total ankle replacement. The orientation of the tibial component, as seen on the lateral radiograph, also affects the position of the talus and if not correct can hold the talus in an abnormal anterior position. Subtalar arthritis may continue to progress after total ankle replacement. Our results are similar to those published previously

Service Quality in Leisure, Events, Tourism and Sport

Service quality is at the forefront of how the leisure, events, tourism and sport (LETS) sectors operate. This updated and enhanced new edition addresses key points and principles of managing service quality across the industry sector. It identifies and analyses the requirements of managing service quality in an industry with distinctive features and challenges, and is illustrated throughout with case-studies which draw on a range of contexts and organizations. Considering the underpinning theory of service quality, it informs the reader of the practical application of service quality management tools and techniques in the leisure and tourism industry

Service Quality in Leisure, Events, Tourism and Sport

Service quality is at the forefront of how the leisure, events, tourism and sport (LETS) sectors operate. This updated and enhanced new edition addresses key points and principles of managing service quality across the industry sector. It identifies and analyses the requirements of managing service quality in an industry with distinctive features and challenges, and is illustrated throughout with case-studies which draw on a range of contexts and organizations. Considering the underpinning theory of service quality, it informs the reader of the practical application of service quality management tools and techniques in the leisure and tourism industry