Purpose – The purpose of this paper is to explore, illustrate, and conceptualize how sustainability service is performed and the role it plays in the promotion of sustainable consumption. Design/methodology/approach – Theoretically, this paper takes a practice theory approach, conceptualizing the provision of sustainability service as a set of complex, socio-material, and performative practices. Methodologically, this paper draws on an ethnographic study of a retail chain – W-Store – and its sustainability service. Interviews with management and focus group interviews with shop assistants and consumers, as well as observations made in-store, make up the material analysed. Findings – The provision of sustainability service is accomplished in this case via three service practices; arranging green shopping trails, answering sustainability questions, and promoting sustainability to green consumers in-store. The analysis shows that the retailing of sustainable products is not simply a matter of including sustainability products in the range and instructing shop assistants to promote them. Sustainability service – as enacted at W-Store – was dependent on the successful combination and configuration of human competence (service staff) and IT and organizational artefacts. There also needed to be congruence between consumers and their images and between retailers and the version of sustainability they were enacting. Finally, the provision of sustainability service required an investigative and adaptive organization capable of keeping up as well as developing vis-á-vis changing sustainability discourses and issues. However, once the necessary conditions had been met, sustainability service worked towards promoting sustainable consumption by making green shopping possible, educating consumers on sustainability issues, and motivating them via positive feedback and dialogue. Originality/value – Underscores the importance of investigating sustainability service and offers both a conceptual approach to and an analysis of this particular type of retail service work.

ObjectivesTo test the hypothesis that implementing a patient-initiated system of care could improve clinical outcome in rheumatoid arthritis (RA) using disease activity guided management.MethodsAn 18-month controlled blinded end point two-centre study with 131 patients with RA randomised to intervention (n=64) or control (n=67). The intervention group participants were guaranteed appointments to a rheumatologist within 10 working days if they subjectively experienced a flare in disease activity. The control group participants were booked in advance according to guidelines. Independent assessments were performed in the two groups at 0, 3, 6, 12 and 18 months. Outcome measures included: Disease Activity Score 28 (DAS28), a Visual Analogue Scale (satisfaction with care, confidence in care), number of appointments with a rheumatologist.ResultsDAS28 decreased. Median satisfaction and confidence in care were >90 mm on Visual Analog Scale. Median number of appointments was 3. There were no significant differences between the groups among these outcomes. Visits in the intervention group more often resulted in change of treatment than in the control group (p<0.001).ConclusionsPatient-initiated care was neither better nor inferior to traditional care in terms of outcomes analysed. Patient-initiated appointments can safely be used in everyday outpatient care of RA to empower the patient, if disease activity guided management is applied. Further research should investigate if this intervention can target a subgroup of patients and hence also result in released resources.

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