The perceived impact of the National Health Service on personalised nutrition service delivery among the UK public

Personalised nutrition (PN) has the potential to reduce disease risk and optimise health and performance. Although previous research has shown good acceptance of the concept of PN in the UK, preferences regarding the delivery of a PN service (e.g. online v. face-to-face) are not fully understood. It is anticipated that the presence of a free at point of delivery healthcare system, the National Health Service (NHS), in the UK may have an impact on end-user preferences for deliverances. To determine this, supplementary analysis of qualitative data obtained from focus group discussions on PN service delivery, collected as part of the Food4Me project in the UK and Ireland, was undertaken. Irish data provided comparative analysis of a healthcare system that is not provided free of charge at the point of delivery to the entire population. Analyses were conducted using the 'framework approach' described by Rabiee (Focus-group interview and data analysis. Proc Nutr Soc 63, 655-660). There was a preference for services to be led by the government and delivered face-to-face, which was perceived to increase trust and transparency, and add value. Both countries associated paying for nutritional advice with increased commitment and motivation to follow guidelines. Contrary to Ireland, however, and despite the perceived benefit of paying, UK discussants still expected PN services to be delivered free of charge by the NHS. Consideration of this unique challenge of free healthcare that is embedded in the NHS culture will be crucial when introducing PN to the UK.

Modelling requirements of supplier selection for benchmarking service provision

Supplier selection has a great impact on supply chain management. The quality of supplier selection also affects profitability of organisations which work in the supply chain. As suppliers can provide variety of services and customers demand higher quality of service provision, the organisation is facing challenges for making the right choice of supplier for the right needs. The existing methods for supplier selection, such as data envelopment analysis (DEA) and analytical hierarchy process (AHP) can automatically perform selection of competitive suppliers and further decide winning supplier(s). However, these methods are not capable of determining the right selection criteria which should be derived from the business strategy. An ontology model described in this paper integrates the strengths of DEA and AHP with new mechanisms which ensure the right supplier to be selected by the right criteria for the right customer's needs.

The evolution of strategy: thinking war from antiquity to the present

Latin had no word for "strategy", but the East Romans, whom we call the Byzantines, did. This book tracks the evolution of the concept of warfare being subjected to higher political aims from Antiquity to the Present, using Greek, Latin, French, Spanish, Italian, English and German sources. It tracks the rise, fall, and resurrection of the belief in the Roman and later the medieval and early modern world that warfare was only legitimate if it pursued the higher goal of a just peace, which in the 19th century gave way to a blinkered concentration on military victory as only war aim. It explains why one school of thought, from Antiquity to the present, emphasised eternal principles of warfare, while others emphasised, in Clausewitz's term, the "changing character of war". It tracks ideas from land warfare to naval warfare to air power and nuclear thinking, but it also stresses great leaps and discontinuities in thinking about strategy. It covers asymmetric wars both from the point of view of the weaker power seeking to overthrow a stronger power, and from the stronger power dealing with insurgents and other numerically inferior forces. It concludes with a commentary of the long-known problems of bureaucratic politics, non-centralised command and inter-service rivalry, which since the 16th century or earlier has created obstacles to coherent strategy making.

Identifying likely successful users of virtual reality systems

This paper suggests a method for identifying individuals who are most suited to using virtual reality (VR) systems. The aim is to help both an individual or employer to decide where that individual's skills and abilities would be best deployed. By considering a potential user's competence and temperament, a graphical representation is introduced that may then be used to crudely delineate a high-aptitude participant against those with lesser capabilities. By introducing standard tests for competence and a standard classifier for temperament, and by further weighting each measure with respect to the technology currently available and the application, a detailed representation of the effectiveness of different users is developed.

Provider diversity in the English NHS: a study of recent developments in four local health economies

Objectives: The overall objective of the research was to assess the impact of provider diversity on quality and innovation in the English NHS. The aims were to map the extent of diverse provider activity, identify the differences in performance between Third Sector Organisations (TSOs), for-profit private enterprises, and incumbent organisations within the NHS, and the factors that affect the entry and growth of new private and TSOs. Methods: Case studies of four Local Health Economies (LHEs). Data included: semi-structured interviews with 48 managerial and clinical staff from NHS organizations and providers from the private and Third Sector; some documentary evidence; a focus group with service users; and routine data from the Care Quality Commission and Companies House. Data collection was mainly between November 2008 and November 2009. Results: Involvement of diverse providers in the NHS is limited. Commissioners’ local strategies influence degrees of diversity. Barriers to the entry for TSOs include lack of economies of scale in the bidding process. Private providers have greater concern to improve patient pathways and patient experience, whereas TSOs deliver quality improvements by using a more holistic approach and a greater degree of community involvement. Entry of new providers drives NHS Trusts to respond by making improvements. Information sharing diminishes as competition intensifies. Conclusions: There is scope to increase the participation of diverse providers in the NHS, but care must be taken not to damage public accountability, overall productivity, equity and NHS providers (especially acute hospitals, which are likely to remain in the NHS) in the process.

A framework of brand value in B2B markets: the contributing role of functional and emotional components

The creation of value is admittedly a critical task for marketers regardless of industry. This paper focuses on a type of value that has traditionally been perceived as irrelevant to industrial markets and argues that brand value facilitates the progression from goods and services value to relationship value. To address the limited amount of research on B2B branding from the suppliers' point of view, we complement insights gained from a literature review with ten exploratory interviews with B2B supplier managers, and develop a framework of brand value applicable to industrial markets. This identifies both the functional (i.e., quality, technology, capacity, infrastructure, after sales service, capabilities, reliability, innovation) and emotional qualities (i.e., risk reduction, reassurance, trust) important for the development of industrial brand equity. Situational (e.g. nature of the purchase) and environmental factors (e.g. the economic situation) affecting suppliers' perceptions of the importance of brand in a B2B context and the role of functional versus emotional brand qualities are discussed. The value of the brand as a driver for the development of business to business relationships is also highlighted. The framework provides a basis for B2B practitioners to build their brands in such a way as to make a functional as well as an emotional connection with buyers that is more likely to lead to a supplier–buyer relationship.

The price of space: the convergence of value in use and value in exchange

This paper discusses concepts of value from the point of view of the user of the space and the counter view of the provider of the same. Land and property are factors of production. The value of the land flows from the use to which it is put, and that in turn, is dependent upon the demand (and supply) for the product or service that is produced/provided from that space. If there is a high demand for the product (at a fixed level of supply), the price will increase and the economic rent for the land/property will increase accordingly. This is the underlying paradigm of Ricardian rent theory where the supply of land is fixed and a single good is produced. In such a case the rent of land is wholly an economic rent. Economic theory generally distinguishes between two kinds of price, price of production or “value in use” (as determined by the labour theory of value), and market price or “value in exchange” (as determined by supply and demand). It is based on a coherent and consistent theory of value and price. Effectively the distinction is between what space is ‘worth’ to an individual and that space’s price of exchange in the market place. In a perfect market where any individual has access to the same information as all others in the market, price and worth should coincide. However in a market where access to information is not uniform, and where different uses compete for the same space, it is more likely that the two figures will diverge. This paper argues that the traditional reliance of valuers to use methods of comparison to determine “price” has led to an artificial divergence of “value in use” and “value in exchange”, but now such comparison are becoming more difficult due to the diversity of lettings in the market place, there will be a requirement to return to fundamentals and pay heed to the thought process of the user in assessing the worth of the space to be let.

Infotainment across access devices: the perceptual impact of multimedia QoS

The introduction of multimedia on pervasive and mobile communication devices raises a number of perceptual quality issues. However, limited work has been done examining the 3-way interaction between use of equipment, user perceptual quality and quality of service. Our work measures user perceptual quality with the quality of perception (QoP) metrics which comprises levels of informational transfer (objective) and user satisfaction (subjective) when users are presented with multimedia video clips at three different frame rates, using four different display devices. Finally, our results will show that variation in frame-rate does not impact a user’s level of information assimilation (IA), however, does impact a users’ perception of multimedia video ‘quality’.

Key drivers of frontline employee generation of ideas for customer service improvement

Anchored in the service-dominant logic and service innovation literature, this study investigates the drivers of employee generation of ideas for service improvement (GISI). Employee GISI focuses on customer needs and providing the exact service wanted by customers. GISI should enhance competitive advantage and organizational success (cf. Berry et al. 2006; Wang and Netemeyer 2004). Despite its importance, there is little research on the idea generation stage of the service development process (Chai, Zhang, and Tan 2005). This study contributes to the service field by providing the first empirical evaluation of the drivers of GISI. It also investigates a new explanatory determinant of reading of customer needs, namely, perceived organizational support (POS), and an outcome of POS, in the form of emotional exhaustion. Results show that the major driver of GISI is reading of customer needs by employees followed by affective organizational commitment and job satisfaction. This research provides several new and important insights for service management practice by suggesting that special care should be put into selecting and recruiting employees who have the ability to read customer needs. Additionally, organizations should invest in creating work environments that encourage and reward the flow of ideas for service improvement

A randomised controlled trial of positive memory training for the treatment of depression within schizophrenia

Abstract Background: Depression is highly prevalent within individuals diagnosed with schizophrenia, and is associated with an increased risk of suicide. There are no current evidence based treatments for low mood within this group. The specific targeting of co-morbid conditions within complex mental health problems lends itself to the development of short-term structured interventions which are relatively easy to disseminate within health services. A brief cognitive intervention based on a competitive memory theory of depression, is being evaluated in terms of its effectiveness in reducing depression within this group. Methods/Design: This is a single blind, intention-to-treat, multi-site, randomized controlled trial comparing Positive Memory Training plus Treatment as Usual with Treatment as Usual alone. Participants will be recruited from two NHS Trusts in Southern England. In order to be eligible, participants must have a DSM-V diagnosis of schizophrenia or schizo-affective disorder and exhibit at least a mild level of depression. Following baseline assessment eligible participants will be randomly allocated to either the Positive Memory Training plus Treatment as Usual group or the Treatment as Usual group. Outcome will be assessed at the end of treatment (3-months) and at 6-month and 9-month post randomization by assessors blind to group allocation. The primary outcome will be levels of depression and secondary outcomes will be severity of psychotic symptoms and cost-effectiveness. Semi-structured interviews will be conducted with all participants who are allocated to the treatment group so as to explore the acceptability of the intervention. Discussion: Cognitive behaviour therapy is recommended for individuals diagnosed with schizophrenia. However, the number of sessions and length of training required to deliver this intervention has caused a limit in availability. The current trial will evaluate a short-term structured protocol which targets a co-morbid condition often considered of primary importance by service users. If successful the intervention will be an important addition to current initiatives aimed at increasing access to psychological therapies for people diagnosed with severe mental health problems. Trial registration: Current Controlled Trials. ISRCTN99485756. Registered 13 March 2014.

Resources, staff beliefs and organizational culture: factors in the use of information and communication technology for adults with intellectual disabilities

Background  Access to, and the use of, information and communication technology (ICT) is increasingly becoming a vital component of mainstream life. First-order (e.g. time and money) and second-order factors (e.g. beliefs of staff members) affect the use of ICT in different contexts. It is timely to investigate what these factors may be in the context of service provision for adults with intellectual disabilities given the role ICT could play in facilitating communication and access to information and opportunities as suggested in Valuing People. Method  Taking a qualitative approach, nine day service sites within one organization were visited over a period of 6 months to observe ICT-related practice and seek the views of staff members working with adults with intellectual disabilities. All day services were equipped with modern ICT equipment including computers, digital cameras, Internet connections and related peripherals. Results  Staff members reported time, training and budget as significant first-order factors. Organizational culture and beliefs about the suitability of technology for older or less able service users were the striking second-order factors mentioned. Despite similar levels of equipment, support and training, ICT use had developed in very different ways across sites. Conclusion  The provision of ICT equipment and training is not sufficient to ensure their use; the beliefs of staff members and organizational culture of sites play a substantial role in how ICT is used with and by service users. Activity theory provides a useful framework for considering how first- and second-order factors are related. Staff members need to be given clear information about the broader purpose of activities in day services, especially in relation to the lifelong learning agenda, in order to see the relevance and usefulness of ICT resources for all service users.