Cloud computing adoption: Strategies for Sub-Saharan Africa SMEs for enhancing competitiveness

Small and medium-sized enterprises (SMEs) need to design and implement strategies for adopting new technologies as a competitive tool for maintaining their competitive advantage and cloud computing is at its peak. Since its emergence, there has been a surge in the adoption of cloud computing with research into its adoption primarily concentrated on bigger firms. However, a major characteristic of cloud computing is the anticipated possibilities it holds for SMEs. This paper primarily explores cloud computing adoption strategies for SMEs operating in Sub-Saharan Africa. Using a mixed method approach, a sample of 261 respondents and 11 SMEs was respectively used for the quantitative and qualitative stages of the research. The results reveal that, even though SMEs have their unique expectations for adopting cloud computing, they were of the consensus that elements of an adoption strategy should include adoption goals, a roadmap, and considerations. The paper makes specific recommendations to SMEs to develop adoption strategies that meet their specific needs if they expect cloud computing to play a stronger role to support more strategic initiatives to grow their businesses and improve customer experience

Steroids in kidney transplant patients

Any evaluation of steroids in kidney transplantation is hampered by individual variability in metabolism, the lack of clinically available steroid blood levels, and overall little attention to steroid exposure. Many feel that steroids were an essential part of chronic immunosuppression in past decades but may no longer be necessary in low-risk populations when our newer and more potent drugs are used. Potential differences in long-term outcome will be unapparent in short-term antibody induction studies in low-risk patients, particularly with low on steroid doses, as may have happened in the recent, well-done Astellas trial. In many studies, the evidence for the superiority of mycophenolate (MMF) and tacrolimus (TAC) was not as strong as the evidence for the benefit of steroids in the Canadian cyclosporine study. As the practice of steroid withdrawal has increased, we have not seen the improvement in long-term graft survival that many expected with our newer agents. Steroids have immunosuppressive effects even in doses that are low by historic standards, and side effects may not justify their abandonment