A Risk Management Perspective of ASPs

Application service providers (ASPs) provide access to application software over wide area networks and have been viewed as a means of making the benefits of outsourcing available to small businesses. However, many enterprise ASPs get the majority of their revenue from very large businesses while many vertical niche ASPs get their revenue from small businesses. We analyze this seeming anomaly from a risk management perspective. ASPs present a greater risk management problem to would-be customers than traditional outsourcing. We analyze the nature of the risk differences and then propose a model of how would-be customers process those risks. In our model, prospects first assess whether they can tolerate the worst case scenario and if they are able to do due diligence on the likely outcome. They consider benefits only if one of the previous assertions is true. The worst case scenario for enterprise applications is truly dire and only technologically sophisticated businesses are better able to identify the true risk profile. For vertical niche ASPs the worst case scenario is relatively mild, but economies of scale make the benefits relatively more appealing to small businesses

Managing Security Service Providers: Issues in Outsourcing Security

The issue of trust and risk in outsourced relationships was extended beyond traditional outsourcing models with the introduction of Application Service Providers (ASPs). As ASPs evolve, Managed Security Service Providers (MSSPs) have emerged as external providers of security for firms facing increasing information assurance threats. This research-in-progress paper develops a conceptual model of MSSP adoption; it investigates variables that affect the adoption and management of the relationship (trust, risk, reputation and relationships with vendors)

Archimedean Survival Processes

Archimedean copulas are popular in the world of multivariate modelling as a result of their breadth, tractability, and flexibility. A. J. McNeil and J. Ne\v{s}lehov\'a (2009) showed that the class of Archimedean copulas coincides with the class of multivariate $\ell_1$-norm symmetric distributions. Building upon their results, we introduce a class of multivariate Markov processes that we call `Archimedean survival processes' (ASPs). An ASP is defined over a finite time interval, is equivalent in law to a multivariate gamma process, and its terminal value has an Archimedean survival copula. There exists a bijection from the class of ASPs to the class of Archimedean copulas. We provide various characterisations of ASPs, and a generalisation

Implementation and impact of pediatric antimicrobial stewardship programs: a systematic scoping review.

Background: Antibiotics are the most common medicines prescribed to children in hospitals and the community, with a high proportion of potentially inappropriate use. Antibiotic misuse increases the risk of toxicity, raises healthcare costs, and selection of resistance. The primary aim of this systematic review is to summarize the current state of evidence of the implementation and outcomes of pediatric antimicrobial stewardship programs (ASPs) globally. Methods: MEDLINE, Embase and Cochrane Library databases were systematically searched to identify studies reporting on ASP in children aged 0-18 years and conducted in outpatient or in-hospital settings. Three investigators independently reviewed identified articles for inclusion and extracted relevant data. Results: Of the 41,916 studies screened, 113 were eligible for inclusion in this study. Most of the studies originated in the USA (52.2%), while a minority were conducted in Europe (24.7%) or Asia (17.7%). Seventy-four (65.5%) studies used a before-and-after design, and sixteen (14.1%) were randomized trials. The majority (81.4%) described in-hospital ASPs with half of interventions in mixed pediatric wards and ten (8.8%) in emergency departments. Only sixteen (14.1%) studies focused on the costs of ASPs. Almost all the studies (79.6%) showed a significant reduction in inappropriate prescriptions. Compliance after ASP implementation increased. Sixteen of the included studies quantified cost savings related to the intervention with most of the decreases due to lower rates of drug administration. Seven studies showed an increased susceptibility of the bacteria analysed with a decrease in extended spectrum beta-lactamase producers E. coli and K. pneumoniae; a reduction in the rate of P. aeruginosa carbapenem resistance subsequent to an observed reduction in the rate of antimicrobial days of therapy; and, in two studies set in outpatient setting, an increase in erythromycin-sensitive S. pyogenes following a reduction in the use of macrolides. Conclusions: Pediatric ASPs have a significant impact on the reduction of targeted and empiric antibiotic use, healthcare costs, and antimicrobial resistance in both inpatient and outpatient settings. Pediatric ASPs are now widely implemented in the USA, but considerable further adaptation is required to facilitate their uptake in Europe, Asia, Latin America and Africa

The Use of Hosted Enterprise Applications by SMEs: A User Perspective

This paper seeks to deepen our understanding of the engagement of small to medium-sized enterprises (SMEs) in hosted enterprise applications (high complexity e-business applications) in the UK by investigating the relevance of organisational and technical factors through conducting interviews with SME users of hosted applications. The emergence and development of the application service provider (ASP) sector has attracted much interest and highly optimistic forecasts for revenues. Of particular interest in this paper is the emergence of service offerings targeted specifically at SMEs. The paper starts by considering information technology (IT) adoption by SMEs in general before reviewing the provision of hosted enterprise applications in the US and UK. The empirical data collected from SME users of hosted enterprise applications is then analysed in order to produce the key findings and conclusions. From an SME user perspective the key findings to emerge from the study include: i) confirmation that ICT infrastructure was no longer a barrier to adoption, ii) the pragmatic approach taken to security issues, iii) the use of both multiple information systems (hosted and resident) and service providers, iv) the attractiveness of the rental cost model and v) the intention to continue or extend their use of hosted applications within the enterprise. The early promise of the ASP sector appears not to have been generally realised for SMEs in the UK. This study explores the experience of early adopters of this new IT related innovation and identifies some significant business gains experienced by SME users. It also highlights the opportunity for gaining competitive advantage by using hosted enterprise applications to reduce costs. There are very few empirical studies of hosted applications which take a deliberately SME user perspective and this paper make an important contribution in this emerging field

The Use of Hosted Enterprise Applications by SMEs: A Dual Market and User Perspective

YesThis deliberately dual perspective paper seeks to deepen our understanding of the engagement of SMEs in hosted enterprise applications in the UK. The emergence and development of the ASP sector has attracted much interest and highly optimistic forecasts for revenues. The paper starts by considering ICT adoption by SMEs in general before reviewing the provision of hosted enterprise applications in the US and UK (market perspective). The study is extended by qualitative empirical data collected by semi-structured interviews with SME users of hosted enterprise applications (user perspective) and subsequent analysis in order to develop the key findings and conclusions. From an SME user perspective the key findings to emerge from the study include: i) confirmation that ICT infrastructure was no longer a barrier to adoption, ii) the pragmatic approach taken to security issues, iii) the use of both multiple information systems and multiple service providers, iv) the financial attractiveness of the rental model and v) the intention to continue or extend the use of hosted applications. It also highlights the opportunity for gaining competitive advantage by using hosted enterprise applications to reduce costs. There are very few empirical studies of hosted applications which take deliberately market and SME user perspectives - this paper makes an important contribution in this emerging field

The Impact of After-School Programs That Promote Personal and Social Skills

The first of several reports to come from CASEL's major meta-analysisproject. Conducted in collaboration with Joseph Durlak of Loyola Universityand funded by the W.T. Grant Foundation, this first report describes thestrong positive effects after-school programs can have, and the conditionsneeded to realize these benefits

Multicenter Retrospective Risk Assessment of Esophageal Variceal Bleeding in Patients with Cirrhosis: An Acoustic Radiation Force Impulse Elastography-Based Prediction Model

BACKGROUND/AIMS: Acoustic radiation force impulse (ARFI) elastography predicts the presence of esophageal varices (EVs). We investigated whether an ARFI-based prediction model can assess EV bleeding (EVB) risk in patients with cirrhosis. METHODS: The records of 262 patients with cirrhosis who underwent ARFI elastography and endoscopic surveillance at two institutions in 2008 to 2013 were retrospectively reviewed, and ARFI-spleen diameter-to-platelet ratio scores (ASPS) were calculated. RESULTS: The median patient age (165 men, 97 women) was 56 years. The median ARFI velocity, spleen diameter, platelet count, and ASPS were 1.7 m/sec, 10.1 cm, 145×109/L, and 1.16, respectively. During the median 38-month follow-up, 61 patients experienced EVB. Among all patients (179 without EVs and 83 with EVs), the cutoff value that maximized the sum of the sensitivity (73.1%) and specificity (78.4%) (area under receiver operating characteristic curve [AUROC], 0.824) for predicting EVB was 2.60. The cumulative EVB incidence was significantly higher in patients with ASPS ≥2.60 than in those with ASPS <2.60 (p<0.001). Among patients with EVs (n=83), 49 had high-risk EVs (HEVs), and 22 had EVB. The cumulative EVB incidence was significantly higher in HEV patients than in low-risk EV patients (p=0.037). At an ASPS of 4.50 (sensitivity, 66.7%; specificity, 70.6%; AUROC, 0.691), the cumulative EVB incidence was significantly higher in patients with a high ASPS than in those with a low ASPS (p=0.045). A higher ASPS independently predicted EVB (hazard ratio, 4.072; p=0.047). CONCLUSIONS: ASPS can assess EVB risk in patients with cirrhosis. Prophylactic management should be considered for patients with HEVs and ASPS ≥4.50.ope

Finding Success in the Cauldron of Competition: The Effectiveness of Academic Support Programs

This article provides an in-depth analysis of our comprehensive study of the Pace Academic Support Program. Section II of the article discusses the purpose and design of ASPs generally, and Pace Law School\u27s program specifically. Section III describes the research design, methodology, and procedures used for this study. Section IV evaluates and analyzes the findings, with an in-depth analysis of the impact each service yields to ASP students, as well as the statistical significance of such benefits. Section V evaluates the importance of background criteria and the impact that such variables have on ASP participants and non-participants. Section V also discusses whether any of these background variables allow some students to derive a greater benefit from the program than other students participating in the same service. Section VI elaborates on the benefits of participation in an ASP, while Section VII elaborates on the impact of background variables on the performance of students