Exploring the supply-side of IT outsourcing: evaluating the emerging role of application service providers

The paper explores the supply-side of IT outsourcing by focusing upon the emerging role of application service providers (ASPs). It traces the transition from first wave IT outsourcing in the 1960s, to business-centric outsourcing in the 1980s and 90s to application outsourcing in the 21st century. Drawing from empirical research on a taxonomy of ASPs, the paper explores how application outsourcing is currently changing the nature of the outsourcing contract and relationship between client and supplier. This will have significant implications for traditional outsourcing and ERP vendors in the software and computing services industry, in addition to presenting new opportunities to SMEs with little history or experience of outsourcing.     

Self-improving process control for molecular beam epitaxy

This paper addresses manufacturing research involving advances in material process control. The research objective has been to develop intelligent, self-directed and self-improving control systems which enablein situ (real-time) control path generation based on both product (material behaviour) and processing (control agent) feedback. A product-process control philosophy which emphasises product quality is described together with a generic architecture for representing product and process knowledge.Specific details are presented involving the development and application of a self-directed and self-improving material processing system for molecular beam epitaxy of gallium arsenide wafers. Special emphasis is given to the development of a neural model for self-improving control as well as future research directions.     

Effect of set-up error on the dose across the junction of matching cranial-spinal fields in the treatment of medulloblastoma

PURPOSE: The effect of systematic and stochastic setup error on the dose delivered to the gap region for the three field radiation treatment of medulloblastoma is studied. The consequences of such setup error is discussed. METHODS AND MATERIALS: The treatment of medulloblastoma is typically a 3 field technique, in which two lateral cranial fields are matched with a spine field. The x-ray dose delivered to the region between the matched fields depends upon the gap size. The choice of the gap width between the cranial and spinal fields is controversial. It is currently a compromise between minimizing the risk of dose hot spots to the spine, and the associated clinical complications, as well as the magnitude of cold spots (underdosing) across the gap, with the associated risk of disease recurrence. In this paper, we examine the effect of gap width with a moving junction, referred to as "field feathering", on the dose across the field junction for a 6MV photon beam. In addition, we have studied 129 portal films and 40 simulation films to assess the accuracy and precision of patient setup during treatment with a plan involving feathered fields. Selected landmarks observable on both portal and simulation films were identified and the variation in the distances to the field edges measured. The distribution of patient setup error was convoluted with the beam profiles for a 6MV linac. These convoluted field edges were used obtain dose profiles across the gap region as a function of gap separation. The consequences for therapy are discussed. In addition, analysis of patient setup error on an alternative treatment involving beam modifiers to broaden the beam penumbra is discussed. RESULTS: The magnitude of the spatial stochastic and systematic setup error was determined to be approximately three and two millimeters respectively. The dosimetric consequences of patient setup error lead to over and under dosing in the spinal gap region for the three field technique. The degree of under or over dose depends on the nature and magnitude of the patient setup error. CONCLUSIONS: The effect of patient setup error can lead to significant dosimetric errors in the dose to the gap region depending on the magnitude of the setup errors. The effective over and under dose can be compensated by the use beams modifiers such as a beam spoiler or vibrating jaws.     

Extent and severity of periodontal destruction based on partial clinical assessments

OBJECTIVES: To evaluate the postoperative analgesic efficacy, side effects and acceptance by patients and nurses of intravenous "patient-controlled analgesia" (PCA) with morphine, metamizole and buprenorphine. MATERIAL AND METHODS: In this randomized double blind prospective study of 150 patients in three groups receiving morphine (group A), metamizole (group B) or buprenorphine (group C), the patients had undergone low abdominal surgery with the same anesthetic protocol. Pain was recorded during the first 48 h after surgery on an orally-communicated scale of none or slight = 0, moderate = 1 and severe = 2. Upon the first report of moderate pain, patients were administered an intravenous bolus containing 5 mg morphine, 1 g metamizole or 0.15 mg buprenorphine. A perfusion pump was then connected and set with one bolus of 1.2 mg morphine, one of 333 mg metamizole or one of 0.04 buprenorphine. The maximum dose allowed in 24 h was 40 mg morphine, 8 g metamizole or 1.2 mg buprenorphine. The minimum interval between doses was 30 min for all three groups. Side effects reported were respiratory depression, sedation, nausea, vomiting, pruritus, perspiration and pain upon administration. Patients and nurses were asked to evaluate the system when the pump was disconnected and the results were then analyzed statistically. RESULTS: The analgesic effect was satisfactory in all three groups, with no significant differences among them. The percentages of patients reaching the maximum allowed dose on the first day were 2% with morphine, 18% (p < 0.05) with metamizole and 8% with buprenorphine. No respiratory depression was observed. Sedation was greater with morphine and buprenorphine than with metamizole (p = 0.0001). Pruritus was also greater with morphine and buprenorphine than with metamizole (p = 0.02) and pain upon infusion was greater with metamizole (p = 0.0002). CONCLUSIONS: Intravenous postoperative PCA was effective with all three drugs studied. Patient and nurse acceptance was good and side effects were few in the three groups. The lower rate of side effects for metamizole makes it the drug of choice.     

An evaluation of the development of IT in a college of nursing and midwifery

This paper presents the findings of a case study of the development of IT in a College of Nursing and Midwifery. Data were collected by means of postal questionnaires, interviews, focus groups, direct observations and documentary evidence. The findings suggest that the majority of staff used some form of IT on a regular basis, but only 50% of students used college-based IT facilities. The main use of IT was for administrative and productive purposes and there was little evidence of IT in teaching/learning methods. Training offered to staff was poorly attended and training offered to students did not meet what they perceived as their needs. Although most staff used IT there was still evidence of resistance and stress related to IT use. The use of IT in the study college was driven by tactical considerations rather than as a part of an explicit strategy.     

Analysing four types of IT sourcing decisions in the context of scale, client/supplier interdependency and risk mitigation

The main thrust of the article is to distinguish between four types of IT sourcing decision: total outsourcing; multiple-supplier sourcing; joint venture/strategic alliance sourcing; and insourcing. To illustrate each type, detailed case histories are used that analyse the reasons why specific IT sourcing decisions were adopted. Here, we consider total outsourcing at the London Stock Exchange; multiple-supplier sourcing at ICI plc; joint venture project sourcing at CRESTCo Ltd; and insourcing at the Royal Bank of Scotland. The trend towards outsourcing is increasing in all industrial and commercial sectors. However, client organizations need to become more aware of some of the pitfalls, particularly in respect of large-scale outsourcing deals to single or multiple suppliers. This is because the move to IT outsourcing engenders the need to develop new capabilities and skills to manage complex commercial contracts. We therefore conclude that, while many IT outsourcing contracts followed rationalization, cost-cutting and disappointing results from in-house IT provision, short-termism and current uncertainties over market, business and political conditions pose problems for many organizations in deciding future outsourcing arrangements.     

Increased socioeconomic differences in mortality in eight Spanish provinces

In Spain, the study of socioeconomic differences in mortality has been limited by the fact that death certificates often do not include complete information on occupation. In this study, we chose those geographic areas with the highest quality information on occupation of the deceased in order to study socioeconomic differences in mortality from various causes of death. We used information from the death certificates of males who died between 30 and 64 years of age in eight Spanish provinces to compare mortality from the leading causes of death in professionals and managers (group I) and in manual laborers (group II) in 1980-82 and 1988-90. In each period the standardized mortality ratios (SMRs) were higher in group II, except for ischaemic heart disease during the first period, and cancer of the colon and rectum in both, although in the latter case the differences were not statistically significant. The ratio between the SMR from all causes in group II and group I was 1.27 in 1980-82, and 1.72 in 1988-90; for cancer of the colon and rectum the ratio went from 0.98 to 0.84, and for ischaemic heart disease, from 0.80 to 1.31. Except for cancer of the colon and rectum, which resulted in higher mortality in occupational group I, the excess mortality in occupational group II increased between the first and second period. The relation between socioeconomic level and mortality for ischaemic heart disease was reversed, a phenomenon similar to that which took place in the 1960s and 1970s in the developed countries.(ABSTRACT TRUNCATED AT 250 WORDS)     

4/spl times/10 GHz mode-locked multiple-wavelength fiber laser

We demonstrate a four-wavelength 10-GHz mode-locked erbium-doped fiber laser, with wavelength spacings of 3.5-5 nm. Nearly transform-limited Gaussian pulses of 11- to 14-ps duration are measured and all wavelengths are synchronous.     

Hybrid photonic analog-to-digital conversion using superconducting electronics

A hybrid analog-to-digital converter is described that uses photonic waveform sampling coupled with superconducting electronics for quantization and conversion to a binary format. The architecture scheme exploits extremely low clock jitter, amplitude stability, and a picosecond sampling aperture from the photonic system and magnetic flux quantization and high-speed digital logic in the superconducting system. The operational speed of the conversion is primarily limited by the maximum speed of the superconducting logic elements.