Enterprise Risk Management: Review, Critique, and Research Directions

© 2014 Elsevier Ltd. Many regulators, rating agencies, executives and academics have advocated a new approach to risk management: Enterprise Risk Management (ERM). ERM proposes the integrated management of all the risks an organization faces, which inherently requires alignment of risk management with corporate governance and strategy. Academic research on ERM is still in its infancy, with articles largely in accounting and finance journals but rarely in management journals. We argue that ERM offers an important new research domain for management scholars. A critical review of ERM research allows us to identify limitations and gaps that management scholars are best equipped to address. This paper not only identifies how management scholars can contribute to ERM research, but also points out why ERM research (and practice) needs management research for its development

Chapter 11: Poetry, Prose and Piaget

As a second generation ADAPT staff member, the first to add an essay to this series, it properly falls to me to extend the reflections of my colleagues. Before doing so, let me outline my relationship to the ADAPT Program. Piagetian theory attracted me for several reasons; most of them are alluded to elsewhere in this book. I had first become aware of Piaget\u27s work about ten years ago when participating in a teacher training project, but had not worked out its implications for college teaching very fully. So I was curious when I heard of the ADAPT Program and kept in touch with Professor Narveson of my department as it developed. I had no more than occasional contact with the founding seminar, made but small contribution to the formation of the Workshop, and had no close contact with the first year\u27s activity. But my interest in the project and in the Program\u27s development made me a logical choice for inclusion when it became clear that professional demands on the staff would require recruitment of new faculty. So, after a summer of study (subsidized to the equivalent of one course), I joined the ADAPT staff in English and have taught in the program for two years. I should be clear that I am not a psychologist, that my report is based on the experience of an amateur. Hard assessment must come, and is coming, from others competent to develop and assess the data. Further, I make no claims of magical success. The invention of learning cycles is hard work, their outcome is not always predictable nor their success assured. Students frequently resist the demands such exercises make upon them, especially when those exercises are not part of their regular educational experience. (One advantage of the ADAPT Program is that its students come to expect such exercises as normal.) Further, intellectual growth is a long term process, one which seems to follow circuitous routes, often by fits and starts. But I believe my experience validates, and the evaluations (elsewhere in this book) support, the claim that the program has beneficial effects on students. Personally I have found the frustrations of my own teaching are diminished when I have a theoretical base on which to build a coherent set of classroom procedures. It is a relief to know how to plan what exercises might work with students and how to examine my procedures in the face of failure. I feel pedagogically vital without feeling I have resorted to suspicious fads or to hit-or-miss tricks. My colleagues have covered that territory pretty well. What I should like to do is to explore some understandings we have gained in further experience over the last several years

Disparities in Hospital Services Utilization Among Patients with Mental Health Issues: A Statewide Example Examining Insurance Status and Race Factors from 1999-2010

There exist many disconnects between the mental and general health care sectors. However, a goal of the Affordable Care Act (ACA) of 2010 is to change this by improving insurance access and the intersection of mental and general health care. As insurance status intersects with race, the present study examines how race, insurance status, and hospital mental health services utilization differ across groups within the state of New Jersey. The present study aims to determine trends in hospital mental health care utilization by insurance status and race from 1999 to 2010. The rate of self-pay for mental health disorders in the Black population was significantly higher than the rate for Whites and Asians during this period. However, though Asian mental health utilization increased the most over the 11-year period, the Asian population had the slowest growth in self-pay rates. ANOVA tests demonstrated significant differences in the rate of self-pay mental health cases between race groups (

Are methodological quality and completeness of reporting associated with citation-based measures of publication impact? A secondary analysis of a systematic review of dementia biomarker studies

Objective: To determine whether methodological and reporting quality are associated with surrogate measures of publication impact in the field of dementia biomarker studies. Methods: We assessed dementia biomarker studies included in a previous systematic review in terms of methodological and reporting quality using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) and Standards for Reporting of Diagnostic Accuracy (STARD), respectively. We extracted additional study and journal-related data from each publication to account for factors shown to be associated with impact in previous research. We explored associations between potential determinants and measures of publication impact in univariable and stepwise multivariable linear regression analyses. Outcome measures: We aimed to collect data on four measures of publication impact: two traditional measures—average number of citations per year and 5-year impact factor of the publishing journal and two alternative measures—the Altmetric Attention Score and counts of electronic downloads. Results: The systematic review included 142 studies. Due to limited data, Altmetric Attention Scores and electronic downloads were excluded from the analysis, leaving traditional metrics as the only analysed outcome measures. We found no relationship between QUADAS and traditional metrics. Citation rates were independently associated with 5-year journal impact factor (β=0.42; p<0.001), journal subject area (β=0.39; p<0.001), number of years since publication (β=-0.29; p<0.001) and STARD (β=0.13; p<0.05). Independent determinants of 5-year journal impact factor were citation rates (β=0.45; p<0.001), statement on conflict of interest (β=0.22; p<0.01) and baseline sample size (β=0.15; p<0.05). Conclusions: Citation rates and 5-year journal impact factor appear to measure different dimensions of impact. Citation rates were weakly associated with completeness of reporting, while neither traditional metric was related to methodological rigour. Our results suggest that high publication usage and journal outlet is not a guarantee of quality and readers should critically appraise all papers regardless of presumed impact

Boosting BCG with recombinant modified vaccinia ankara expressing antigen 85A: Different boosting intervals and implications for efficacy trials

Objectives. To investigate the safety and immunogenicity of boosting BCG with modified vaccinia Ankara expressing antigen 85A (MVA85A), shortly after BCG vaccination, and to compare this first with the immunogenicity of BCG vaccination alone and second with a previous clinical trial where MVA85A was administered more than 10 years after BCG vaccination. Design. There are two clinical trials reported here: a Phase I observational trial with MVA85A; and a Phase IV observational trial with BCG. These clinical trials were all conducted in the UK in healthy, HIV negative, BCG naı¨ve adults. Subjects were vaccinated with BCG alone; or BCG and then subsequently boosted with MVA85A four weeks later (short interval). The outcome measures, safety and immunogenicity, were monitored for six months. The immunogenicity results from this short interval BCG prime–MVA85A boost trial were compared first with the BCG alone trial and second with a previous clinical trial where MVA85A vaccination was administered many years after vaccination with BCG. Results. MVA85A was safe and highly immunogenic when administered to subjects who had recently received BCG vaccination. When the short interval trial data presented here were compared with the previous long interval trial data, there were no significant differences in the magnitude of immune responses generated when MVA85A was administered shortly after, or many years after BCG vaccination. Conclusions. The clinical trial data presented here provides further evidence of the ability of MVA85A to boost BCG primed immune responses. This boosting potential is not influenced by the time interval between prior BCG vaccination and boosting with MVA85A. These findings have important implications for the design of efficacy trials with MVA85A. Boosting BCG induced anti-mycobacterial immunity in either infancy or adolescence are both potential applications for this vaccine, given the immunological data presented here. Trial Registration. ClinicalTrials.Oxford University was the sponsor for all the clinical trials reported here

Meningitis in an Irish community

A series of 26 cases of meningitis occurring in one year in a defined area is presented. The clinical features, and complications are reviewed. Neisseria meningitidis occurred twice as commonly as Haemophilus influenzae, suggesting that the pattern of infection differs from that reported in England and Wales. An incidence of 4·6/100,000 for N. meningitidis is reported exceeding rates of infection in previous UK “epidemics”

A New Vaccine for Tuberculosis: The Challenges of Development and Deployment.

Tuberculosis (TB) is one of the world's leading causes of death due to infection and efforts to control TB would be substantially aided by the availability of an improved TB vaccine. There are currently nine new TB vaccines in clinical development, and the first efficacy trials are due to commence in 2009. There are many complex ethical issues which arise at all stages of TB vaccine development, from the need to conduct trials in developing countries to informed consent and the process of ethical review. While it is important that these issues are discussed, it may also be timely to consider the challenges which may arise if a vaccine in clinical development proves to be highly effective. We examine a number of scenarios where decisions on the deployment of a new TB vaccine may impact on the rights and liberty of the individual

Identification of major factors influencing ELISpot-based monitoring of cellular responses to antigens from mycobacterium tuberculosis

A number of different interferon-c ELISpot protocols are in use in laboratories studying antigen-specific immune responses. It is therefore unclear how results from different assays compare, and what factors most significantly influence assay outcome. One such difference is that some laboratories use a short in vitro stimulation period of cells before they are transferred to the ELISpot plate; this is commonly done in the case of frozen cells, in order to enhance assay sensitivity. Other differences that may be significant include antibody coating of plates, the use of media with or without serum, the serum source and the number of cells added to the wells. The aim of this paper was to identify which components of the different ELISpot protocols influenced assay sensitivity and inter-laboratory variation. Four laboratories provided protocols for quantifying numbers of interferon-c spot forming cells in human peripheral blood mononuclear cells stimulated with Mycobacterium tuberculosis derived antigens. The differences in the protocols were compared directly. We found that several sources of variation in assay protocols can be eliminated, for example by avoiding serum supplementation and using AIM-V serum free medium. In addition, the number of cells added to ELISpot wells should also be standardised. Importantly, delays in peripheral blood mononuclear cell processing before stimulation had a marked effect on the number of detectable spot forming cells; processing delay thus should be minimised as well as standardised. Finally, a pre-stimulation culture period improved the sensitivity of the assay, however this effect may be both antigen and donor dependent. In conclusion, small differences in ELISpot protocols in routine use can affect the results obtained and care should be given to conditions selected for use in a given study. A pre-stimulation step may improve the sensitivity of the assay, particularly when cells have been previously frozen

Risk Allocation Across the Enterprise: Evidence From the Insurance Industry

Financial researchers initially regarded hedging activities as a means to reduce total firm risk, which often is defined in terms of cash flow volatility. More recently, researchers have focused on the strategic allocation of risk. Direct tests of risk allocation have been problematic, however, because hedging data are rarely available and, when available, are specific only to a single operation of the firm, such as bank lending. In this study, we exploit unique data from the insurance industry that allows us to observe hedging proxies for both investment and insurance underwriting risks and test the risk allocation hypothesis developed in the finance literature. We also conduct separate examinations of life-health and property-casualty insurers, which reveal differences in the risks and hedging activities of these two types of insurers

Mucosal delivery of tuberculosis vaccines: a review of current approaches and challenges.

Introduction: Tuberculosis (TB) remains a major health threat and it is now clear that the current vaccine, BCG, is unable to arrest the global TB epidemic. A new vaccine is needed to either replace or boost BCG so that a better level of protection could be achieved. The route of entry of Mycobacterium tuberculosis, the causative organism, is via inhalation making TB primarily a respiratory disease. There is therefore good reason to hypothesize that a mucosally delivered vaccine against TB could be more effective than one delivered via the systemic route.Areas covered: This review summarizes the progress that has been made in the area of TB mucosal vaccines in the last few years. It highlights some of the strengths and shortcomings of the published evidence and aims to discuss immunological and practical considerations in the development of mucosal vaccines.Expert opinion: There is a growing body of evidence that the mucosal approach to vaccination against TB is feasible and should be pursued. However, further key studies are necessary to both improve our understanding of the protective immune mechanisms operating in the mucosa and the technical aspects of aerosolized delivery, before such a vaccine could become a feasible, deployable strategy