A dyadic trust perspective of key account relationship development in the UK mortgage industry

The main purpose of this study is to examine how a dyadic trust perspective can support effective development of key account relationships. The need for Key Account Management in the UK Mortgage Industry is investigated, factors for effective key account relationship management are identified and a trust/Mortgage Lender and Intermediary perspective of Key Account relationship effectiveness is analysed. The results of this study have been achieved through a mixed methods research strategy and these have been discussed in relation to Key Account Management and Trust theory. This study responds to concerns about the lack of research in this area, challenging and building on existing Key Account Management theory, integrating trust theory and applying this to a new context. A survey instrument to assess the effectiveness of Key Account relationships has been devised and can be applied to different contexts. Results show that demonstrations of trustworthiness leads to better key account performance but there is not a strong association of perceptions of higher trust with performance. Mortgage Lenders and Intermediaries have different perspectives of key account effectiveness and Mortgage Lenders lead the way in Key Account Management initiatives but there is evidence of various degrees of interdependence and willingness to achieve mutual gains. Key account relationships are not locked in to integrated Key Account Management programmes and exit from these relationships is quite easy. An important aspect of this research in the context of the UK Mortgage Industry has been the perceived positive role of the Key Account individual and that of different types of trust throughout relationship development, compensating for the perceived negative role of organisational culture aspects that may influence those involved in key account development within and between organisations. The contribution of this research is to show the relevance of Key Account Management as a business model providing market conditions are appropriate for Key Account Management development and that it is based on mutual learning and a format that suits the orientation of supplier and buyer, their own organisational design and culture and resources available as well as the environment in which they operate. This research suggests that fully integrated Key Account Management is not a realistic expectation and dependence on a few suppliers or customers as Key Account Management theory suggests, is not sensible. This study contributes to KAM practice in that it shows it is the management of trustworthiness rather than trying to manage trust that leads to a satisfactory Key Account relationship format for both supplier and buyer in the UK Mortgage Industry. This does currently rely heavily on the `intrapreneurial' skills of key individuals. In understanding how trustworthiness is demonstrated (through concern and benevolence, expertise, communication, intrapreneurial skills, commitment, organisational culture and KAM organisation) leads to more appropriate actions and behaviours to facilitate a relationship that works best for particular seller and buyer organisations given the particular circumstances. Organisations need to work on improving trust that is placed in the institution by for example developing effective marketing communications effort internally as well as externally and knowledge based trust, relating in particular to the exchange of confidential and strategic information. The identified factors for key account effectiveness presented in the survey can serve as useful guidelines for managing key accounts as they also demonstrate signals of trustworthiness. These factors can be used specifically to add to the limited range of performance criteria of key accounts currently adopted by the industry. Further research is suggested that may consider a key account manager or client's disposition towards trust, an examination of perceptions of supply chain t..

A dyadic trust perspective of key account relationship development in the UK mortgage industry

The main purpose of this study is to examine how a dyadic trust perspective can support effective development of key account relationships. The need for Key Account Management in the UK Mortgage Industry is investigated, factors for effective key account relationship management are identified and a trust/Mortgage Lender and Intermediary perspective of Key Account relationship effectiveness is analysed. The results of this study have been achieved through a mixed methods research strategy and these have been discussed in relation to Key Account Management and Trust theory. This study responds to concerns about the lack of research in this area, challenging and building on existing Key Account Management theory, integrating trust theory and applying this to a new context. A survey instrument to assess the effectiveness of Key Account relationships has been devised and can be applied to different contexts. Results show that demonstrations of trustworthiness leads to better key account performance but there is not a strong association of perceptions of higher trust with performance. Mortgage Lenders and Intermediaries have different perspectives of key account effectiveness and Mortgage Lenders lead the way in Key Account Management initiatives but there is evidence of various degrees of interdependence and willingness to achieve mutual gains. Key account relationships are not locked in to integrated Key Account Management programmes and exit from these relationships is quite easy. An important aspect of this research in the context of the UK Mortgage Industry has been the perceived positive role of the Key Account individual and that of different types of trust throughout relationship development, compensating for the perceived negative role of organisational culture aspects that may influence those involved in key account development within and between organisations. The contribution of this research is to show the relevance of Key Account Management as a business model providing market conditions are appropriate for Key Account Management development and that it is based on mutual learning and a format that suits the orientation of supplier and buyer, their own organisational design and culture and resources available as well as the environment in which they operate. This research suggests that fully integrated Key Account Management is not a realistic expectation and dependence on a few suppliers or customers as Key Account Management theory suggests, is not sensible. This study contributes to KAM practice in that it shows it is the management of trustworthiness rather than trying to manage trust that leads to a satisfactory Key Account relationship format for both supplier and buyer in the UK Mortgage Industry. This does currently rely heavily on the `intrapreneurial' skills of key individuals. In understanding how trustworthiness is demonstrated (through concern and benevolence, expertise, communication, intrapreneurial skills, commitment, organisational culture and KAM organisation) leads to more appropriate actions and behaviours to facilitate a relationship that works best for particular seller and buyer organisations given the particular circumstances. Organisations need to work on improving trust that is placed in the institution by for example developing effective marketing communications effort internally as well as externally and knowledge based trust, relating in particular to the exchange of confidential and strategic information. The identified factors for key account effectiveness presented in the survey can serve as useful guidelines for managing key accounts as they also demonstrate signals of trustworthiness. These factors can be used specifically to add to the limited range of performance criteria of key accounts currently adopted by the industry. Further research is suggested that may consider a key account manager or client's disposition towards trust, an examination of perceptions of supply chain t...EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Laser Remote Sensing From ISS: CATS Cloud and Aerosol Level 2 Data Products (Heritage Edition)

The Cloud-Aerosol Transport System (CATS) instrument was developed at NASA's Goddard Space Flight Center (GSFC) and deployed to the International Space Station (ISS) on 10 January 2015. CATS is mounted on the Japanese Experiment Module's Exposed Facility (JEM_EF) and will provide near-continuous, altitude-resolved measurements of clouds and aerosols in the Earth's atmosphere. The CATS ISS orbit path provides a unique opportunity to capture the full diurnal cycle of cloud and aerosol development and transport, allowing for studies that are not possible with the lidar aboard the CALIPSO platform, which flies in the sun-synchronous A-Train orbit." " One of the primary science objectives of CATS is to continue the CALIPSO aerosol and cloud profile data record to provide continuity of lidar climate observations during the transition from CALIPSO to EarthCARE. To accomplish this, the CATS project at NASA's Goddard Space Flight Center (GSFC) and the CALIPSO project at NASA's Langley Research Center (LaRC) are closely collaborating to develop and deliver a full suite of CALIPSO-like level 2 data products that will be produced using the newly acquired CATS level 1B data whenever CATS is operating in science modes 1. The CALIPSO mission is now well into its ninth year of on-orbit operations, and has developed a robust set of mature and well-validated science algorithms to retrieve the spatial and optical properties of clouds and aerosols from multi-wavelength lidar backscatter signals. By leveraging both new and existing NASA technical resources, this joint effort by the CATS and CALIPSO teams will deliver validated lidar data sets to the user community at the earliest possible opportunity. The science community will have access to two sets of CATS Level 2 data products. The "Operational" data products will be produced by the GSFC CATS team utilizing the new instrument capabilities (e.g., multiple FOVs and 1064 nm depolarization), while the "Heritage" data products created using the existing CALIPSO algorithms and the CATS 532 nm channels and the total 1064 nm channel. " Below is the development of the CATS "Heritage" level 2 software and data along with some initial results with operational data.

The Role of Environment in the Mass-Metallicity Relation

Using a sample of 57,377 star-forming galaxies drawn from the Sloan Digital Sky Survey, we study the relationship between gas-phase oxygen abundance and environment in the local Universe. We find that there is a strong relationship between metallicity and environment such that more metal-rich galaxies favor regions of higher overdensity. Furthermore, this metallicity-density relation is comparable in strength to the color-density relation along the blue cloud. After removing the mean dependence of environment on color and luminosity, we find a significant residual trend between metallicity and environment that is largely driven by galaxies in high-density regions, such as groups and clusters. We discuss the potential source of this relationship between metallicity and local galaxy density in the context of feedback models, with special attention paid to quantifying the impact of environment on the scatter in the mass-metallicity relation. We find that environment is a non-negligible source of scatter in this fundamental relation, with > 15% of the measured scatter correlated with environment.Comment: Submitted to MNRA

Identifying amyloid pathology–related cerebrospinal fluid biomarkers for Alzheimer\u27s disease in a multicohort study

Introduction: The dynamic range of cerebrospinal fluid (CSF) amyloid β (Aβ1–42) measurement does not parallel to cognitive changes in Alzheimer\u27s disease (AD) and cognitively normal (CN) subjects across different studies. Therefore, identifying novel proteins to characterize symptomatic AD samples is important. Methods: Proteins were profiled using a multianalyte platform by Rules Based Medicine (MAP-RBM). Due to underlying heterogeneity and unbalanced sample size, we combined subjects (344 AD and 325 CN) from three cohorts: Alzheimer\u27s Disease Neuroimaging Initiative, Penn Center for Neurodegenerative Disease Research of the University of Pennsylvania, and Knight Alzheimer\u27s Disease Research Center at Washington University in St. Louis. We focused on samples whose cognitive and amyloid status was consistent. We performed linear regression (accounted for age, gender, number of apolipoprotein E (APOE) e4 alleles, and cohort variable) to identify amyloid-related proteins for symptomatic AD subjects in this largest ever CSF–based MAP-RBM study. ANOVA and Tukey\u27s test were used to evaluate if these proteins were related to cognitive impairment changes as measured by mini-mental state examination (MMSE). Results: Seven proteins were significantly associated with Aβ1–42 levels in the combined cohort (false discovery rate adjusted P \u3c .05), of which lipoprotein a (Lp(a)), prolactin (PRL), resistin, and vascular endothelial growth factor (VEGF) have consistent direction of associations across every individual cohort. VEGF was strongly associated with MMSE scores, followed by pancreatic polypeptide and immunoglobulin A (IgA), suggesting they may be related to staging of AD. Discussion: Lp(a), PRL, IgA, and tissue factor/thromboplastin have never been reported for AD diagnosis in previous individual CSF–based MAP-RBM studies. Although some of our reported analytes are related to AD pathophysiology, other\u27s roles in symptomatic AD samples worth further explorations

Distribution patterns of tau pathology in progressive supranuclear palsy

Progressive supranuclear palsy (PSP) is a 4R-tauopathy predominated by subcortical pathology in neurons, astrocytes, and oligodendroglia associated with various clinical phenotypes. In the present international study, we addressed the question of whether or not sequential distribution patterns can be recognized for PSP pathology. We evaluated heat maps and distribution patterns of neuronal, astroglial, and oligodendroglial tau pathologies and their combinations in different clinical subtypes of PSP in postmortem brains. W

Neuropathological and Genetic Correlates of Survival and Dementia Onset in Synucleinopathies: A Retrospective Analysis

Background Great heterogeneity exists in survival and the interval between onset of motor symptoms and dementia symptoms across synucleinopathies. We aimed to identify genetic and pathological markers that have the strongest association with these features of clinical heterogeneity in synucleinopathies. Methods In this retrospective study, we examined symptom onset, and genetic and neuropathological data from a cohort of patients with Lewy body disorders with autopsy-confirmed α synucleinopathy (as of Oct 1, 2015) who were previously included in other studies from five academic institutions in five cities in the USA. We used histopathology techniques and markers to assess the burden of tau neurofibrillary tangles, neuritic plaques, α-synuclein inclusions, and other pathological changes in cortical regions. These samples were graded on an ordinal scale and genotyped for variants associated with synucleinopathies. We assessed the interval from onset of motor symptoms to onset of dementia, and overall survival in groups with varying levels of comorbid Alzheimer\u27s disease pathology according to US National Institute on Aging–Alzheimer\u27s Association neuropathological criteria, and used multivariate regression to control for age at death and sex. Findings On the basis of data from 213 patients who had been followed up to autopsy and met inclusion criteria of Lewy body disorder with autopsy-confirmed α synucleinopathy, we identified 49 (23%) patients with no Alzheimer\u27s disease neuropathology, 56 (26%) with low-level Alzheimer\u27s disease neuropathology, 45 (21%) with intermediate-level Alzheimer\u27s disease neuropathology, and 63 (30%) with high-level Alzheimer\u27s disease neuropathology. As levels of Alzheimer\u27s disease neuropathology increased, cerebral α-synuclein scores were higher, and the interval between onset of motor and dementia symptoms and disease duration was shorter (p \u3c 0·0001 for all comparisons). Multivariate regression showed independent negative associations of cerebral tau neurofibrillary tangles score with the interval between onset of motor and dementia symptoms (β −4·0, 95% CI −5·5 to −2·6; p \u3c 0·0001; R 2 0·22, p \u3c 0·0001) and with survival (–2·0, −3·2 to −0·8; 0·003; 0·15, \u3c 0·0001) in models that included age at death, sex, cerebral neuritic plaque scores, cerebral α-synuclein scores, presence of cerebrovascular disease, MAPT haplotype, and APOE genotype as covariates. Interpretation Alzheimer\u27s disease neuropathology is common in synucleinopathies and confers a worse prognosis for each increasing level of neuropathological change. Cerebral neurofibrillary tangles burden, in addition to α-synuclein pathology and amyloid plaque pathology, are the strongest pathological predictors of a shorter interval between onset of motor and dementia symptoms and survival. Diagnostic criteria based on reliable biomarkers for Alzheimer\u27s disease neuropathology in synucleinopathies should help to identify the most appropriate patients for clinical trials of emerging therapies targeting tau, amyloid-β or α synuclein, and to stratify them by level of Alzheimer\u27s disease neuropathology

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Top-down Modulations in the Visual Form Pathway Revealed with Dynamic Causal Modeling

Perception entails interactions between activated brain visual areas and the records of previous sensations, allowing for processes like figure–ground segregation and object recognition. The aim of this study was to characterize top-down effects that originate in the visual cortex and that are involved in the generation and perception of form. We performed a functional magnetic resonance imaging experiment, where subjects viewed 3 groups of stimuli comprising oriented lines with different levels of recognizable high-order structure (none, collinearity, and meaning). Our results showed that recognizable stimuli cause larger activations in anterior visual and frontal areas. In contrast, when stimuli are random or unrecognizable, activations are greater in posterior visual areas, following a hierarchical organization where areas V1/V2 were less active with “collinearity” and the middle occipital cortex was less active with “meaning.” An effective connectivity analysis using dynamic causal modeling showed that high-order visual form engages higher visual areas that generate top-down signals, from multiple levels of the visual hierarchy. These results are consistent with a model in which if a stimulus has recognizable attributes, such as collinearity and meaning, the areas specialized for processing these attributes send top-down messages to the lower levels to facilitate more efficient encoding of visual form