Patients' perceptions and experiences of transitions in diabetes care: a longitudinal qualitative study

Objective To examine patients' perceptions and experiences over time of the devolvement of diabetes care/reviews from secondary to primary health-care settings. Design Repeat in-depth interviews with 20 patients over 4 years. Participants and setting Twenty type 2 diabetes patients recruited from primary- and secondary-care settings across Lothian, Scotland. Results Patients' views about their current diabetes care were informed by their previous service contact. The devolvement of diabetes care/reviews to general practice was presented as a 'mixed blessing'. Patients gained reassurance from their perception that receiving practice-based care/reviews signified that their diabetes was well-controlled. However, they also expressed resentment that, by achieving good control, they received what they saw as inferior care and/or less-frequent reviews to others with poorer control. While patients tended to regard GPs as having adequate expertise to conduct their practice-based reviews, they were more ambivalent about nurses taking on this role. Opportunities to receive holistic care in general practice were not always realized due to patients seeing health-care professionals for diabetes management to whom they would not normally present for other health issues. Conclusions It is important to educate patients about their care pathways, and to reassure them that frequency of reviews depends more on clinical need than location of care and that similar care guidelines are followed in hospital clinics and general practice. A patients' history of service contact may need to be taken into account in future studies of service satisfaction.

Product-service systems revisited

There is a growing interest around the potential value of service-led competitive strategies to UK based manufacturers. A Product Service-System (PSS) is one form of such a strategy and is based on integrated combination of products and services. This concept also embraces environmental sustainability. This paper aims to summarise the state-of-the-art of PSS research by presenting a review of literature currently available on this topic. The literature search is described and the major outcomes of the study are presented. On this basis, this paper defines the PSS concept, reports on its origin and features.

Will you tolerate this? The impact of affective commitment on complaint intention and postrecovery behavior

Successful complaint management primarily depends on customers' willingness to voice their complaints and on companies' ability to adequately deal with these complaints. This article investigates the impact of one relationship characteristic in the complaint management process: affective commitment. Based on two studies, the authors investigate whether affective commitment moderates the impact of complaint barriers on complaint intention (a) and whether it moderates the link between complaint satisfaction and purchase behavior after the complaint (b). Results show that affectively committed customers exhibit higher complaint intention irrespective of the level of complaint barriers. Furthermore, affectively committed customers display little change in their postrecovery behavior, even after a service failure followed by an unsatisfactory recovery attempt. It seems that these customers are tolerant and want to help the provider improve their business. Affective commitment seems to amplify willingness to help the company by means of voicing dissatisfaction despite considerable efforts in doing so. Moreover, affective commitment buffers the negative effects of service failures on postrecovery behavior. Findings have important implications for managers. They highlight the necessity to measure customers' affective commitment. Based on that, tailored complaint systems can be designed, which help in achieving a more effective allocation of resources for customer recovery.

The role of the sales employee in securing customer satisfaction

Purpose: Previous research has emphasized the pivotal role that salespeople play in customer satisfaction. In this regard, the relationship between salespeople's attitudes, skills, and characteristics, and customer satisfaction remains an area of interest. The paper aims to make three contributions: first, it seeks to examine the impact of salespeople's satisfaction, adaptive selling, and dominance on customer satisfaction. Second, this research aims to use dyadic data, which is a better test of the relationships between constructs since it avoids common method variance. Finally, in contrast to previous research, it aims to test all of the customers of salespeople rather than customers selected by salespeople. Design/methodology/approach: The study employs multilevel analysis to examine the relationship between salespeople's satisfaction with the firm on customer satisfaction, using a dyadic, matched business-to-business sample of a large European financial service provider that comprises 188 customers and 18 employees. Findings: The paper finds that customers' evaluation of service quality, product quality, and value influence customer satisfaction. The analysis at the selling firm's employee level shows that adaptive selling and employee satisfaction positively impact customer satisfaction, while dominance is negatively related to customer satisfaction. Practical implications: Research shows that customer-focus is a key driver in the success of service companies. Customer satisfaction is regarded as a prerequisite for establishing long-term, profitable relations between company and customer, and customer contact employees are key to nurturing this relationship. The role of salespeople's attitudes, skills, and characteristics in the customer satisfaction process are highlighted in this paper. Originality/value: The use of dyadic, multilevel studies to assess the nature of the relationship between employees and customers is, to date, surprisingly limited. The paper examines the link between employee attitudes, skills, and characteristics, and customer satisfaction in a business-to-business setting in the financial service sector, differentiating between customer- and employee-level drivers of business customer satisfaction.

An examination of moderator effects in the four-stage loyalty model

Oliver’s 1997 four-stage loyalty model proposes that loyalty consists of belief, affect, intention, and action. Although this loyalty model has recently been subject to empirical examination, the issue of moderator variables has been largely neglected. This article fills that void by analyzing the moderating effects of selected personal and situational characteristics, using a sample of 888 customers of a large do-it-yourself retailer. The results of multi-group causal analysis suggest that these moderators exert an influence on the development of the different stages of the loyalty sequence. Specifically, age, income, education and expertise, price orientation, critical incident recovery, and loyalty card membership are found to be important moderators of the links in the four-stage loyalty model. Limitations of the study are outlined, and implications for both research and managerial practice are discussed.

Internal branding: an enabler of employees' brand-supporting behaviours

Purpose – The purpose of this paper is to understand the internal branding process from the employees' perspective; it will empirically assess the relationship between internal branding and employees' delivery of the brand promise as well as the relationships among their brand identification, brand commitment and brand loyalty. Design/methodology/approach – On a census basis, a quantitative survey is carried out with 699 customer-interface employees from five major hotels. Findings – Internal branding is found to have a positive impact on attitudinal and behavioural aspects of employees in their delivery of the brand promise. As employees' brand commitment does not have a statistically significant relationship with employees' brand performance, it is not regarded as a mediator in the link between internal branding and employees' brand performance. Furthermore, the study shows that brand identification is a driver of brand commitment, which precedes brand loyalty of employees. Practical implications – A number of significant managerial implications are drawn from this study, for example using both internal communication and training to influence employees' brand-supporting attitudes and behaviours. Still, it should be noted that the effect of internal branding on the behaviours could be dependent on the extent to which it could effectively influence their brand attitudes. Originality/value – The results provide valuable insights from the key internal audience's perspectives into an internal branding process to ensure the delivery of the brand promise. It empirically shows the relationship between internal branding and the behavioural outcome as well as the meditational effects of employees' brand identification, commitment and loyalty.

The relationship between transformational leadership and customer-orientated boundary-spanning behaviours:examining the role of compassion

Customer-oriented boundary-spanning behaviours (COBSBs) are critical to the success of service organisations. Transformational leadership, with its emphasis on the social elements of the leader-subordinate dyad, is a likely antecedent to COBSBs. Similarly, the interpersonal nature of services suggests leader compassion could have a significant effect on the saliency of the relationship between transformational leadership and COBSBs. This paper reports on a study of the moderating effect of leader compassion on the relationship between transformational leadership and COBSBs (service delivery behaviours, internal influence and external representation). Transformational leadership and compassion both have significant and positive influences on COBSBs. However, compassion plays no moderating role. These findings are discussed and avenues for further research are proposed.

Unified model for performance analysis of IEEE 802.11 ad hoc networks in unsaturated conditions

IEEE 802.11 standard has achieved huge success in the past decade and is still under development to provide higher physical data rate and better quality of service (QoS). An important problem for the development and optimization of IEEE 802.11 networks is the modeling of the MAC layer channel access protocol. Although there are already many theoretic analysis for the 802.11 MAC protocol in the literature, most of the models focus on the saturated traffic and assume infinite buffer at the MAC layer. In this paper we develop a unified analytical model for IEEE 802.11 MAC protocol in ad hoc networks. The impacts of channel access parameters, traffic rate and buffer size at the MAC layer are modeled with the assistance of a generalized Markov chain and an M/G/1/K queue model. The performance of throughput, packet delivery delay and dropping probability can be achieved. Extensive simulations show the analytical model is highly accurate. From the analytical model it is shown that for practical buffer configuration (e.g. buffer size larger than one), we can maximize the total throughput and reduce the packet blocking probability (due to limited buffer size) and the average queuing delay to zero by effectively controlling the offered load. The average MAC layer service delay as well as its standard deviation, is also much lower than that in saturated conditions and has an upper bound. It is also observed that the optimal load is very close to the maximum achievable throughput regardless of the number of stations or buffer size. Moreover, the model is scalable for performance analysis of 802.11e in unsaturated conditions and 802.11 ad hoc networks with heterogenous traffic flows. © 2012 KSI.

Investigation of EDFA power transients in circuit-switched and packet-switched optical networks

Erbium-doped fibre amplifiers (EDFA’s) are a key technology for the design of all optical communication systems and networks. The superiority of EDFAs lies in their negligible intermodulation distortion across high speed multichannel signals, low intrinsic losses, slow gain dynamics, and gain in a wide range of optical wavelengths. Due to long lifetime in excited states, EDFAs do not oppose the effect of cross-gain saturation. The time characteristics of the gain saturation and recovery effects are between a few hundred microseconds and 10 milliseconds. However, in wavelength division multiplexed (WDM) optical networks with EDFAs, the number of channels traversing an EDFA can change due to the faulty link of the network or the system reconfiguration. It has been found that, due to the variation in channel number in the EDFAs chain, the output system powers of surviving channels can change in a very short time. Thus, the power transient is one of the problems deteriorating system performance. In this thesis, the transient phenomenon in wavelength routed WDM optical networks with EDFA chains was investigated. The task was performed using different input signal powers for circuit switched networks. A simulator for the EDFA gain dynamicmodel was developed to compute the magnitude and speed of the power transients in the non-self-saturated EDFA both single and chained. The dynamic model of the self-saturated EDFAs chain and its simulator were also developed to compute the magnitude and speed of the power transients and the Optical signal-to-noise ratio (OSNR). We found that the OSNR transient magnitude and speed are a function of both the output power transient and the number of EDFAs in the chain. The OSNR value predicts the level of the quality of service in the related network. It was found that the power transients for both self-saturated and non-self-saturated EDFAs are close in magnitude in the case of gain saturated EDFAs networks. Moreover, the cross-gain saturation also degrades the performance of the packet switching networks due to varying traffic characteristics. The magnitude and the speed of output power transients increase along the EDFAs chain. An investigation was done on the asynchronous transfer mode (ATM) or the WDM Internet protocol (WDM-IP) traffic networks using different traffic patterns based on the Pareto and Poisson distribution. The simulator is used to examine the amount and speed of the power transients in Pareto and Poisson distributed traffic at different bit rates, with specific focus on 2.5 Gb/s. It was found from numerical and statistical analysis that the power swing increases if the time interval of theburst-ON/burst-OFF is long in the packet bursts. This is because the gain dynamics is fast during strong signal pulse or with long duration pulses, which is due to the stimulatedemission avalanche depletion of the excited ions. Thus, an increase in output power levelcould lead to error burst which affects the system performance.

The practical challenges of servitized manufacture

Servitization is now widely recognised as the process of creating value by adding services to products. Since this term was first coined in the late 1980s it has been studied by a range of authors who have specifically sought to understand the methods and mechanisms of service-led competitive strategies for manufacturers. This paper reports on the experiences of a large company as they have moved towards servitized manufacture. This has been based on an extensive series of interviews with key personnel. The results of the study and implications for research are all reported.

Market-awareness in service-based systems

Service-based systems are applications built by composing pre-existing services. During design time and according to the specifications, a set of services is selected. Both, service providers and consumers exist in a service market that is constantly changing. Service providers continuously change their quality of services (QoS), and service consumers can update their specifications according to what the market is offering. Therefore, during runtime, the services are periodically and manually checked to verify if they still satisfy the specifications. Unfortunately, humans are overwhelmed with the degree of changes exhibited by the service market. Consequently, verification of the compliance specification and execution of the corresponding adaptations when deviations are detected cannot be carried out in a manual fashion. In this work, we propose a framework to enable online awareness of changes in the service market in both consumers and providers by representing them as active software agents. At runtime, consumer agents concretize QoS specifications according to the available market knowledge. Services agents are collectively aware of themselves and of the consumers' requests. Moreover, they can create and maintain virtual organizations to react actively to demands that come from the market. In this paper we show preliminary results that allow us to conclude that the creation and adaptation of service-based systems can be carried out by a self-organized service market system. © 2012 IEEE.

The servitization of manufacturing:a review of literature and reflection on future challenges

Purpose – The purpose of this paper is to report the state-of-the-art of servitization by presenting a clinical review of literature currently available on the topic. The paper aims to define the servitization concept, report on its origin, features and drivers and give examples of its adoption along with future research challenges. Design/methodology/approach – In determining the scope of this study, the focus is on articles that are central and relevant to servitization within a wider manufacturing context. The methodology consists of identifying relevant publication databases, searching these using a wide range of key words and phrases associated with servitization, and then fully reviewing each article in turn. The key findings and their implications for research are all described. Findings – Servitization is the innovation of an organisation's capabilities and processes to shift from selling products to selling integrated products and services that deliver value in use. There are a diverse range of servitization examples in the literature. These tend to emphasize the potential to maintain revenue streams and improve profitability. Practical implications – Servitization does not represent a panacea for manufactures. However, it is a concept of significant potential value, providing routes for companies to move up the value chain and exploit higher value business activities. There is little work to date that can be used to help practitioners. Originality/value – This paper provides a useful review of servitization and a platform on which to base more in-depth research into the broader topic of service-led competitive strategy by drawing on the work from other related research communities.

Servitization of manufacture:exploring the deployment and skills of people critical to the delivery of advanced services

Purpose - This "research note" sets out to fuel the debate around the practices and technologies within operations that are critical to success with servitization. It presents a study of four companies which are delivering advanced services and reports on the organisation and skill-sets of people within these. Design/methodology/approach - This has been case-based research at four manufacturers leading in their delivery of services. Findings - It describes the desirable behaviour of people in the front-line of service delivery, identifies the supporting skill-sets, how these people are organised, and explains why all these factors are so important. Originality/value - This paper contributes to the understanding of the servitization process and, in particular, the implications to broader operations of the firm. © 2013 Emerald Group Publishing Limited. All rights reserved.

Service employee clusters in banking:exploring Ind's typology considering behaviour, commitment and attitude about leadership

Purpose: Ind suggests front line employees can be segmented according to their level of brand-supporting performance. His employee typology has not been empirically tested. The paper aims to explore front line employee performance in retail banking, and profile employee types. Design/methodology/approach: Attitudinal and demographic data from a sample of 404 front line service employees in a leading Irish bank informs a typology of service employees. Findings: Champions, Outsiders and Disruptors exist within retail banking. The authors provide an employee profile for each employee type. They found Champions amongst males, and older employees. The highest proportion of female employees surveyed were Outsiders. Disruptors were more likely to complain, and rated their performance lower than any other employee type. Contrary to extant literature, Disruptors were more likely to hold a permanent contract than other employee types. Originality/value: The authors augment the literature by providing insights about the profile of three employee types: Brand Champions, Outsiders and Disruptors. Moreover, the authors postulate the influence of leadership and commitment on each employee type. The cluster profiles raise important questions for hiring, training and rewarding front line banking employees. The authors also provide guidelines for managers to encourage Champions, and curtail Disruptors. © Emerald Group Publishing Limited.

The future of M-interaction

Many experts predicted that this, the first decade of the 21st century, will be the decade of mobile computing; although in recent years mobile technology has been one of the major growth areas in computing, the hype has thus far exceeded the reality (Urbaczewski, Valacich, & Jessup, 2003). Why is this? A recent international study of users of handheld devices suggests that there is a predominant perception that quality of service is low and that mobile applications are difficult to use; additionally, although users recognise the potential of emerging mobile technology, the study highlighted a general feeling that the technology is currently dominating rather than supporting users (Jarvenpaa, Lang, Takeda, & Tuunainen, 2003). Users are generally forgiving of physical limitations of mobile devices imposed by technological constraints; they are not, however, so forgiving of the interface to these devices (Sarker & Wells, 2003). Users can excuse restrictions on their use of mobile technology on the basis of level of technological advancement, but find it hard to accept impractical, illogical, or inconvenient interaction design.