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Consumer confusion is an often discussed, but seldom investigated, construct central to marketing. This study aims to conceptualize consumer confusion as an intellectual emotion with cognitive and emotional components, and examine it in the context of qualified health claims and conflicting marketplace information.

A between-subjects experimental design is used to test the hypotheses.

Structural equation modeling suggests that weak science discussions and conflicting information on dietary supplements evoke consumer confusion. Confusion, in turn, impacts scientific certainty perceptions, product quality and firm credibility. Incorporating confusion measures in theoretical models significantly increases the amount of variance explained in consumer perceptions. Implications are offered for businesses, consumer behaviorists and public policymakers.

It is hard to think about many of marketing’s focal issues (e.g. trademark theory, disclosures and warnings, advertising deception, search and shopping behavior) without using the term confusion. While confusion is central to discussions of these domains, it has evaded focused attention and study. Indeed, no previous research in marketing has directly addressed the experience of consumer confusion per se. The current research fills a gap in the marketing literature by explicitly defining the construct of confusion and offering a measurement approach that is easily adapted to many business/consumer interactions. Furthermore, the authors demonstrate the role of confusion in the context of qualified health claims by showing how conflicting information between health claims, qualifiers and external information can create confusion, and in turn, lead to negative consumer perceptions.

One shift in the retail landscape is the workload transfer from the retailer to the consumer. This study aims to explore consumer perceived effort and the consequences of this workload transfer.

Two scenario-based experiments were conducted. Partial least squares modeling was implemented on the experimental survey data to explore how different dimensions of effort (i.e. mental, physical and emotional) and surface acting contribute to perceptions of effort and value.

Surface acting increases consumer effort perceptions. Consumers’ value perceptions decline as perceived effort increases. Effort perceptions attenuate when consumers have a choice. The paper also brings attention to the shortcomings in the current conceptualization of surface acting and perceived effort, and reconceptualizes effort as a formative construct.

This paper cautions marketers about the potential negative implications of shadow work. Service marketers should provide a choice between face-to-face (F2F) and self-service technologies whenever possible. In addition, marketers should develop and implement strategies for reducing consumer surface acting.

This study includes an extended conceptualization and new operationalization of consumer surface acting, revised thinking about measuring consumer effort and a unique approach to accounting for effort perceptions of traditional F2F service vs SST.

Off-label drug prescribing by healthcare providers is a growing practice. Yet, the US Food and Drug Administration bans the marketing of drugs for off-label uses. In recent years, legal challenges by the pharmaceutical industry have chipped away government restrictions on off-label drug promotion. Although the changing legal landscape has been discussed, this paper aims to examine how key stakeholders and policy-makers might interact to provide a more transparent marketing environment for off-label drug discussions in the patient–provider relationship.

Drawing on a variety of sources, the authors assess the current marketing landscape of off-label drugs and some of the issues that challenge the healthcare provider–patient relationship. The authors then examine opportunities to improve the off-label promotion environment and the relevant decision-making theories that key stakeholders need to consider when formulating marketing efforts and policies.

The authors suggest that fewer restrictions on truthful, non-misleading off-label drug promotion provide an opportunity to improve drug knowledge and, importantly, healthcare provider and consumer decision-making. Key stakeholders should consider, among other solutions, criteria for defining truthful information on off-label drugs, alternative methods of approval of off-label uses and ubiquitous icons to identify off-label prescribing to all stakeholders.

Rather than rehash the legal landscape of off-label drug promotion, this paper focuses on how the healthcare provider–patient relationship is impacted and how stakeholders can improve information flow in this changing environment.

This paper aims to examine country-of-origin (COO) effects from the theoretical angle of extended self and “otherness”. Traditional COO perspectives view COO as an important quality-related, informational cue used to form product evaluations, develop preferences and make purchase decisions.

An experiment was conducted with the COO of a fresh milk product manipulated to examine these predictions. Data were collected from four samples, Americans living in the USA, Americans living in China, Chinese living in China and Chinese living in the USA.

Results found that COO effects were stronger when consumers felt greater animosity toward the foreign country, were more ethnocentric and were less acculturated (i.e. conceptualized as a less expanded self). Additionally, negative product events were interpreted in light of self, in that reactions to an adverse act were stronger when “others” committed the act. American consumers living abroad were more heavily influenced by COO effects, and evidence suggests that this effect occurred because these Americans had a less expanded self than their Chinese counterparts.

This study provides a unique angle which leads to a deeper understanding of COO effects which augments the traditional match hypothesis. Specifically, COO effects are stronger, the smaller one’s extended self (greater animosity and ethnocentrism, less acculturation), and that wrongdoings are interpreted in light of self (i.e. reaction to an adverse act is stronger when “others” commit the act). Few studies to date have focused on these factors as layers of armor that consumers use to protect their self and extended self-image in a cross-cultural context.

Examines the mature market, defined as consumers age 50 years or older, and reviews 33 segmentation methods for the mature market and identifies five key segmentation criteria: discretionary income, health, activity level, discretionary time, and response to others. Integrates methods devised by other researchers and provides marketers with a step‐by‐step, actionable segmentation method based on these five criteria. Offers implications for managers.

In 2010, the National Mediation Board (NMB) decided to base Railway Labor Act representation election outcomes on a simple majority of those voting, rather than on the majority of all eligible voters, as had been required earlier. This was widely expected to make it easier for unions to win rights to recognition in the railway and airline industries. We demonstrate that investors expected that this change would favor unions, just as they earlier had expected rule changes that made voting easier (in 2002 and 2007) to be favorable to unions, affecting stock prices of railway and airline corporations. After the 2010 change in election procedure, between 77% and 91% of all eligible employees returned ballots in NMB elections, demonstrating that a significant portion of nonvoters were not opposed to union representation, but simply were unwilling or were unable to vote. We conclude that the current voting process is fairer than the old one. However, it has not resulted in a tide of union success in these representation elections. Apparently scholars, the parties themselves, and investors all over-estimated the practical consequences of changing NMB representation election procedures.

The purpose of this paper is to compare the evidence from a range of reviews concerned with the links between human resource management (HRM) and performance. The aim of the paper is to review this diverse literature, and to derive human resource (HR) implications for healthcare researchers, policy makers and managers.

Recent reviews of the human resource management and performance literature are examined, in addition to the inclusion of a previously unpublished review. Their methods, HRM focus, findings and recommendations are contrasted in order to produce this review.

The paper finds that relationships have been found between a range of HRM practices, policies systems and performance. Despite being an important concern for HR professionals, there is little research exploring the link between HRM and performance in the health sector.

The paper sees that recent studies have found HRM practices to be associated with patient outcomes such as mortality, yet they yield little information regarding the processes through which HRM affects individual performance and its consequent impact on patient care. The use of approaches that seek to gain an understanding of workers' interpretations of their experience, i.e. the psychological process through which HRM can affect individual performance, may shed some light on how these processes work in practice.

The paper shows that increasing autonomy for healthcare organisations in the UK, i.e. Foundation Trusts, may offer increased opportunity for locally tailored HR systems and practices.

The paper presents findings drawn from a review of previous research on a subject of increasing relevance to HR researchers and practitioners in healthcare organisations. The paper indicates alternative approaches to research and practice in light of extant research.

This paper addresses access to formal health care among Cape Verdean immigrants in the Netherlands, and their transnational health‐seeking process in other European countries. Three barriers hindering Cape Verdeans' access to care have been identified: lack of information about the health services available, problems in the relationship with health providers and difficulties in dealing with the conditionality of help. These problems are deeply intertwined, and relate to two sets of factors. At the macro‐level these include the organisational and structural characteristics of the Dutch health care system. At the micro‐level, the problems concern the mismatch between users' and providers' expectations of health care provision.Despite the barriers encountered, Cape Verdeans strive to benefit from good health. The informants in this study employ two sorts of strategy to access good health care. On the one hand, they try to adapt their help‐seeking behaviour to the model prevalent in the Netherlands. On the other, they resort to transnational health care use in other European countries, including Portugal and France. These strategies prove Cape Verdeans' resilience in finding the care that is most appropriate to their needs.