Managing the Risk of IT Outsourcing

While it can bring several benefits, IT outsourcing entails some risks. As it is the case in other types of investments or business ventures, the risk associated to an IT outsourcing project must be evaluated and managed. This paper proposes a framework for the management of IT outsourcing risk, and assesses the usefulness of the framework using data gathered about two cases of system development outsourcing. After providing a conceptual definition of risk and of risk exposure, the paper presents the proposed risk management framework. The two cases are then described along with the evaluation of the level of risk exposure of each, and the risk management mechanisms that were included in the contracts. The results of the study suggest that by charting the various items that contribute to risk exposure, and by specifically applying the appropriate mechanisms that can target the elements with the higher levels of risk exposure, outsourcing risk can be adequately managed. L'impartition des services informatiques, même si elle peut entrainer de nombreux bénéfices, implique un risque. Comme tout type d'investissement, ce risque doit être évalué et géré. Cet article propose un cadre d'analyse pour le risque d'impartition des services informatiques, et évalue ce cadre à l'aide d'une étude de cas. Ce cas présente deux décisions d'impartition de services informatiques, dans le domaine de l'assurance. Le niveau de risque de chaque décision est évalué et les mécanismes permettant de gérer ce risque sont présentés. Les résultats montrent que, en détaillant les facteurs de risque et les événenents correspondants, il est possible de cibler les éléments les plus risqués et de réduire le risque à un niveau acceptable.Outsourcing of IS, IS risk management, agency theory, transaction cost economics, case study, Sous-traitance des systèmes informatiques, gestion du risque des systèmes informatiques, théorie de l'agance, économie des coûts de transaction, étude de cas

Perceptions of portuguese family health care teams regarding the expansion of nurses’ scope of practice = Perceções de equipas de saúde familiar portuguesas sobre o alargamento do campo de exercício da enfermagem

Theoretical framework: Expanding primary health care nurses’ scope of practice is a strategy that has been used in various health systems to good advantage. Its feasibility depends on the health professionals’ consensus as to its suitability. Objectives: To find out the perceptions of Portuguese family health care teams regarding the expansion of primary care nurses’ scope of practice. Methodology: Focus groups. Results: The team perception is that citizen expectations, the shortage of nurses and the need for specific training are the main issues to be faced. The teams discussed various roles that the nursing profession could take on in Primary Health Care (PHC) via a work reorganisation included in the regulatory framework. Conclusion: The assignment of wider clinical roles to PHC nurses is not unanimously approved of, since it is perceived by some doctors and nurses as inappropriate and unfair. Some health care teams expressed their willingness to take part in this option, due to its potential contribution to improving the response to care needs not currently being met. Enquadramento: O alargamento do campo de exercício do enfermeiro de cuidados primários tem constituído uma estratégia utilizada em diversos sistemas de saúde com ganhos conhecidos. A sua exequibilidade depende do consenso dos profissionais de saúde sobre a sua adequação. Objetivos: Conhecer as perceções de equipas de saúde familiar portuguesas sobre o alargamento do campo de exercício do enfermeiro de cuidados primários. Metodologia: Grupos focais. Resultados: Na perceção das equipas, as expetativas dos cidadãos, a escassez de enfermeiros e a necessidade de formação específica são os principais problemas a enfrentar. As equipas discutiram vários papéis que a profissão de enfermagem poderia assumir em Cuidados de Saúde Primários (CSP), mediante uma reorganização do trabalho, enquadrada normativamente. Conclusão: A atribuição de papéis clínicos mais vastos ao enfermeiro de CSP não reúne unanimidade, por ser percebida, por alguns médicos e enfermeiros, como desajustada e iníqua. Algumas equipas de saúde manifestaram disponibilidade para aderir a esta opção, face ao seu potencial contributo para melhorar a resposta a necessidades assistenciais atualmente não satisfeitas.publishersversionpublishe

Health workforce metrics pre- and post-2015: A stimulus to public policy and planning

© 2017 The Author(s). Background: Evidence-based health workforce policies are essential to ensure the provision of high-quality health services and to support the attainment of universal health coverage (UHC). This paper describes the main characteristics of available health workforce data for 74 of the 75 countries identified under the 'Countdown to 2015' initiative as accounting for more than 95% of the world's maternal, newborn and child deaths. It also discusses best practices in the development of health workforce metrics post-2015. Methods: Using available health workforce data from the Global Health Workforce Statistics database from the Global Health Observatory, we generated descriptive statistics to explore the current status, recent trends in the number of skilled health professionals (SHPs: physicians, nurses, midwives) per 10 000 population, and future requirements to achieve adequate levels of health care in the 74 countries. A rapid literature review was conducted to obtain an overview of the types of methods and the types of data sources used in human resources for health (HRH) studies. Results: There are large intercountry and interregional differences in the density of SHPs to progress towards UHC in Countdown countries: a median of 10.2 per 10 000 population with range 1.6 to 142 per 10 000. Substantial efforts have been made in some countries to increase the availability of SHPs as shown by a positive average exponential growth rate (AEGR) in SHPs in 51% of Countdown countries for which there are data. Many of these countries will require large investments to achieve levels of workforce availability commensurate with UHC and the health-related sustainable development goals (SDGs). The availability, quality and comparability of global health workforce metrics remain limited. Most published workforce studies are descriptive, but more sophisticated needs-based workforce planning methods are being developed. Conclusions: There is a need for high-quality, comprehensive, interoperable sources of HRH data to support all policies towards UHC and the health-related SDGs. The recent WHO-led initiative of supporting countries in the development of National Health Workforce Accounts is a very promising move towards purposive health workforce metrics post-2015. Such data will allow more countries to apply the latest methods for health workforce planning

Rapid and simple comparison of messenger RNA levels using real-time PCR

Real-time polymerase chain reaction (PCR) constitutes a significant improvement over traditional end-point PCR, as it allows the quantification of starting amounts of nucleic acid templates, in real-time. However, quantification requires validation through numerous internal controls and standard curves. We describe in this paper a simple protocol which uses real-time PCR to compare mRNA levels of a gene of interest between different experimental conditions. Comparative real-time PCR can be a relatively low-cost method and does not require sequence-specific fluorescent reporters. Moreover, several genes from a set of experiments can be assessed in a single run. Thus, in addition to providing a comparative profile for the expression of a gene of interest, this method can also provide information regarding the relative abundance of different mRNA species

Design of a 3D printer head for additive manufacturing of sugar glass for tissue engineering applications

Additive manufacturing is now considered as a new paradigm that is foreseen to improve progress in many fields. The field of tissue engineering has been facing the need for tissue vascularization when producing thick tissues. The use of sugar glass as a fugitive ink to produce vascular networks through rapid casting may offer the key to vascularization of thick tissues produced by tissue engineering. Here, a 3D printer head capable of producing complex structures out of sugar glass is presented. This printer head uses a motorized heated syringe fitted with a custom made nozzle. The printer head was adapted to be mounted on a commercially available 3D printer. A mathematical model was derived to predict the diameter of the filaments based on the printer head feed rate and extrusion rate. Using a 1 mm diameter nozzle, the printer accurately produced filaments ranging from 0.3 mm to 3.2 mm in diameter. One of the main advantages of this manufacturing method is the self-supporting behaviour of sugar glass that allows the production of long, horizontal, curved, as well as overhanging filaments needed to produce complex vascular networks. Finally, to establish a proof of concept, polydimethylsiloxane was used as the gel matrix during the rapid casting to produce various “vascularized” constructs that were successfully perfused, which suggests that this new fabrication method can be used in a number of tissue engineering applications, including the vascularization of thick tissues

m7824 msb0011359c a bifunctional fusion protein targeting pd l1 and tgf β in patients with post platinum esophageal adenocarcinoma eac preliminary results from a phase i cohort

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Author correction : a global database for metacommunity ecology, integrating species, traits, environment and space

Correction to: Scientific Data https://doi.org/10.1038/s41597-019-0344-7, published online 08 January 202

Author correction : a global database for metacommunity ecology, integrating species, traits, environment and space

Correction to: Scientific Data https://doi.org/10.1038/s41597-019-0344-7, published online 08 January 202

Measuring Inequalities in the Distribution of Health Workers: The case of Tanzania.

The overall human resource shortages and the distributional inequalities in the health workforce in many developing countries are well acknowledged. However, little has been done to measure the degree of inequality systematically. Moreover, few attempts have been made to analyse the implications of using alternative measures of health care needs in the measurement of health workforce distributional inequalities. Most studies have implicitly relied on population levels as the only criterion for measuring health care needs. This paper attempts to achieve two objectives. First, it describes and measures health worker distributional inequalities in Tanzania on a per capita basis; second, it suggests and applies additional health care needs indicators in the measurement of distributional inequalities. We plotted Lorenz and concentration curves to illustrate graphically the distribution of the total health workforce and the cadre-specific (skill mix) distributions. Alternative indicators of health care needs were illustrated by concentration curves. Inequalities were measured by calculating Gini and concentration indices.\ud There are significant inequalities in the distribution of health workers per capita. Overall, the population quintile with the fewest health workers per capita accounts for only 8% of all health workers, while the quintile with the most health workers accounts for 46%. Inequality is perceptible across both urban and rural districts. Skill mix inequalities are also large. Districts with a small share of the health workforce (relative to their population levels have an even smaller share of highly trained medical personnel. A small share of highly trained personnel is compensated by a larger share of clinical officers (a middle-level cadre) but not by a larger share of untrained health workers. Clinical officers are relatively equally distributed. Distributional inequalities tend to be more pronounced when under-five deaths are used as an indicator of health care needs. Conversely, if health care needs are measured by HIV prevalence, the distributional inequalities appear to decline. The measure of inequality in the distribution of the health workforce may depend strongly on the underlying measure of health care needs. In cases of a non-uniform distribution of health care needs across geographical areas, other measures of health care needs than population levels may have to be developed in order to ensure a more meaningful measurement of distributional inequalities of the health workforce