A study involving unobtrusive observations of salespeople's behaviors in sales settings surfaces a novel insight: a salesperson's selling effectiveness with a customer may be enhanced by the way the ...salesperson interacts with secondary entities, such as objects and people outside the core salesperson–customer dyad. Based on this insight and social interest theory, this research introduces the construct of secondary selling. It refers to a salesperson interacting with secondary entities in a manner that indicates to a focal customer that the salesperson values these entities. The pattern of results from four follow-on studies using multiple methods and data sources indicates that, in general, secondary selling reduces a focal customer's reactance to a salesperson's recommendations, which leads to higher sales revenue and customer satisfaction. Customers with high persuasion knowledge (compared with customers with lower persuasion knowledge) are more favorably influenced by secondary selling involving company property but less favorably influenced by secondary selling involving nonfocal customers. In addition to reducing a focal customer's reactance to sales recommendations, secondary selling also helps primary selling (targeted at a focal customer) reduce the customer's reactance to a greater extent. Overall, the results provide evidence of the pervasive and influential role of secondary selling in boosting sales revenue and customer satisfaction in sales exchanges.
Purpose
The purpose of this paper is to conceptualize the notion of thin crossing points from a social network perspective and to outline the concrete networking strategies that enable salespeople to ...foster mutually valuable resource exchange (i.e. to thin crossing points) across a selling ecosystem.
Design/methodology/approach
The authors integrate extant theoretical perspectives to advance a conceptual framework of sales-related networking across three key actors in a selling ecosystem: intraorganizational selling actors and actors in customers and external partner organizations.
Findings
Thin crossing points are defined as figurative transaction points at the boundary between organizations or organizational subunits at which actors engage in mutually valuable resource exchange in the process of value cocreation. To thin crossing points with key ecosystem actors, salespeople must adapt networking strategies considering the time and trust constraints inherent in a network relationship. Such constraints inform the most advantageous network centralities (degree, eigenvector and betweenness) and actions to impact key network properties (tie strength, contact diversity) that enable salespeople to efficiently develop social capital and thus to optimally thin crossing points across a selling ecosystem.
Originality/value
To the best of the authors’ knowledge, this study is the first social network-based exploration of salespeople’s role in thinning crossing points with key ecosystem actors. It advances a novel conceptual framework of sales-related networking strategies that foster social capital development and optimally thin crossing points across a selling ecosystem.
Background. Early antiretroviral therapy (ART) limits proviral reservoirs, a goal for human immunodeficiency virus type 1 (HIV-1) remission strategies. Whether this is an immediate or long-term ...effect of virologic suppression (VS) in perinatal infection is unknown. Methods. We quantified HIV-1 DNA longitudinally for up to 14 years in peripheral blood mononuclear cells (PBMCs) among 61 perinatally HIV-1–infected youths in the Pediatric HIV/AIDS Cohort Study who achieved VS at different ages. Participants in group 1 (n = 13) were <1 year of age and in group 2 (n = 48) from 1 through 5 years of age at VS. Piecewise linear mixed-effects regression models assessed the effect of age at VS on HIV-1 DNA trajectories during VS. Results. In the first 2 years following VS, HIV-1 DNA levels decreased by −0.25 (95% confidence interval CI, −.36 to −.13) log10 copies/million PBMCs per year and was faster with early VS by age 1 year compared with after age 1 (−0.50 and −0.15 log10 copies/million PBMCs per year, respectively). Between years 2 and 14 from VS, HIV-1 DNA decayed by −0.05 (95% CI, −.06 to −.03) log10 copies/million PBMCs per year and was no longer significantly different between groups. The estimated mean half-life of HIV-1 DNA from VS was 15.9 years and was shorter for group 1 compared to group 2 at 5.9 years and 18.8 years, respectively (P = .09). Adjusting for CD4 cell counts had no effect on decay estimates. Conclusions. Early effective, long-term ART initiated from infancy leads to decay of HIV-1–infected cells to exceedingly low concentrations desired for HIV-1 remission strategies.
Among 234 US youths with perinatal human immunodeficiency virus, 75% had antiretroviral resistance, substantially higher than that of the reference laboratory overall (36%–44%). Resistance to newer ...antiretrovirals and to all antiretrovirals in a class was uncommon. The only factor independently associated with future resistance was a higher peak viral load.
Objectives
HIV‐infected children may be at risk for premature cardiovascular disease. We compared levels of biomarkers of vascular dysfunction in HIV‐infected children (with and without ...hyperlipidaemia) with those in HIV‐exposed, uninfected (HEU) children enrolled in the Pediatric HIV/AIDS Cohort Study (PHACS), and determined factors associated with these biomarkers.
Methods
A prospective cohort study was carried out. Biomarkers of inflammation C‐reactive protein (CRP), interleukin‐6 (IL‐6) and monocyte chemoattractant protein‐1 (MCP1), coagulant dysfunction (fibrinogen and P‐selectin), endothelial dysfunction soluble intracellular cell adhesion molecule‐1 (sICAM), soluble vascular cell adhesion molecule‐1 (sVCAM) and E‐selectin, and metabolic dysfunction (adiponectin) were measured in 226 HIV‐infected and 140 HEU children. Anthropometry, body composition, lipids, glucose, insulin, HIV disease severity, and antiretroviral therapy were recorded.
Results
The median ages of the children were 12.3 years in the HIV‐infected group and 10.1 years in the HEU group. Body mass index (BMI) z‐scores, waist and hip circumferences, and percentage body fat were lower in the HIV‐infected children. Total and non‐high‐density lipoprotein (HDL) cholesterol and triglycerides were higher in HIV‐infected children. HIV‐infected children also had higher MCP‐1, fibrinogen, sICAM and sVCAM levels. In multivariable analyses in the HIV‐infected children alone, BMI z‐score was associated with higher CRP and fibrinogen, but lower MCP‐1 and sVCAM. Unfavourable lipid profiles were positively associated with IL‐6, MCP‐1, fibrinogen, and P‐ and E‐selectin, whereas increased HIV viral load was associated with markers of inflammation (MCP‐1 and CRP) and endothelial dysfunction (sICAM and sVCAM).
Conclusions
HIV‐infected children have higher levels of biomarkers of vascular dysfunction than do HEU children. Risk factors associated with higher biomarkers include unfavourable lipid levels and active HIV replication.
Objectives
Dyslipidaemia is common in perinatally HIV‐infected (PHIV) youth receiving protease inhibitors (PIs). Few studies have evaluated longitudinal lipid changes in PHIV youth after switch to ...newer PIs.
Methods
We compared longitudinal changes in fasting lipids total cholesterol (TC), triglycerides (TG), low‐density lipoprotein cholesterol (LDL‐C), high‐density lipoprotein cholesterol (HDL‐C), and TC:HDL‐C ratio in PHIV youth enrolled in the Pediatric HIV/AIDS Cohort Study (PHACS) Adolescent Master Protocol (AMP) study who switched to atazanavir/ritonavir (ATV/r)‐ or darunavir/ritonavir (DRV/r)‐based antiretroviral therapy (ART) from an older PI‐based ART and those remaining on an older PI. Generalized estimating equation models were fitted to assess the association of a switch to ATV/r‐ or DRV/r‐based ART with the rate of change in lipids, adjusted for potential confounders.
Results
From 2007 to 2014, 47 PHIV children/adolescents switched to ATV/r or DRV/r, while 120 remained on an older PI primarily lopinavir/r (72%) and nelfinavir (24%). Baseline age ranged from 7 to 21 years. After adjustment for age, Tanner stage, race/ethnicity, and HIV RNA level, a switch to ATV/r or DRV/r was associated with a more rapid annual rate of decline in the ratio of TC:HDL‐C. (β = −0.12; P = 0.039) than remaining on an older PI. On average, TC declined by 4.57 mg/dL/year (P = 0.057) more in the switch group. A switch to ATV/r or DRV/r was not associated with the rate of HDL‐C, LDL‐C, or TG change.
Conclusions
A switch to ATV/r or DRV/r may result in more rapid reduction in TC and the TC:HDL‐C ratio in PHIV youth, potentially impacting long‐term cardiovascular disease risk.
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