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Cialis trial uk /shin. For example, in this study of 873 patients using two different dosing courses of the same prescription, patients taking highest dose (60mg) were 1.2 times as likely to have adverse events as those taking the lowest (40mg). Again, with most of these study participants receiving more than one dosing regimen, it is not clear whether the same effect applies. Other similar studies showed comparable outcomes between dosing rates (i.e. 40mg/day and 60mg/day). Overall, the studies that I have managed only show a small benefit, and I would not base any type of treatment decision around them. Dosing too high and causing intolerable side-effects, or dosing too low and causing problems from nausea, dizziness, restlessness, abdominal pain and, possibly, headache, even during a dose that is beneficial to the patient's condition, such as for refractory pain, are never recommended. Q. Do you feel that or a colleague you are aware of is being over- or under-treated for their symptoms? It is sometimes difficult to find a doctor for whom you would like to see. Is it necessary tell doctors the risks and benefits of different Cialis 10 Pills 50mg $70 - $7 Per pill treatments? For example, what has your experience been with clinicians who advocate using an anticonvulsant drug in order to manage a condition and do not appear to understand both the risks and benefits of drug? A. There can be a number of reasons why clinician may believe that a patient with severe epilepsy should take a particular medication regardless of the potential for side-effects (or lack of them) and/or for whom alternative treatment options are not available. It may be a clinician's intuition that medication is appropriate, but they are not experts in the field and therefore are not aware of a patient's characteristics, personality or buy cialis online safe clinical context. Perhaps they do not want to 'mess up' the patient's life. Clinicians who are comfortable with making difficult treatment decisions sometimes are also not aware of the risks or potential for harm. They may be unsure how to evaluate the risk of taking a medication before making decisions, but when dealing with this decision they tend to rely on data-based medicine rather than personal experience. For many doctors though it is not the decision and prescription that is important, it whether the medication is actually making patient's symptoms improve. Q. I am currently doing my endocrinology residency. A lot of my students believe that the hormone-replacement therapy (HRT) available at the moment causes breast cancer, but that is not the case. Can you explain Gold max female viagra buy why HRT does not cause breast cancer? A. Many of the studies on which these recommendations are based on the effects of hormone replacement therapy to treat women with pre-existing breast cancer. However, the body of evidence to support the conclusion that HRT does not increase the risk of breast cancer is now very strong. For example, most studies that examined cancer outcomes in women taking HRT found that they were not linked to breast cancer, and those that did find a link Sildenafil basics 100 mg kaufen tended to have more severe cancers.

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“It allowed customers to build a digital wish list, to discover product information and to check availability. What we’ve learnt through the trial is that customers want access to the detailed information they can get online, but they also want to come in store to touch and feel the products.”

“As technology professionals, we need to work beyond the walls of the traditional IT department and become part of wider business planning decisions, so that the importance of digital transformation is articulated and understood.”

 mark.samuels@gmail.com mark@samuelsmedia.co.uk

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First up this week are a couple of articles I had published in The Sunday Times for a Raconteur supplement on cloud computing. The first article – on disruptive business models – highlights how the cloud has reached a tipping point, as buying IT on demand has moved to the core of technology provision with organisations using it to transform their operations.

The features quotes a range of independent experts and CxOs who are using the cloud as a platform for change. One of these individuals is Alex Hamilton, co-founder and chief executive of Radiant Law, an innovative and high-tech commercial contracts firm that uses the cloud to communicate and collaborate with staff and clients:

“We’re continually looking for better ways to serve the needs of our clients. The cloud provides the base layer that allows us to run our firm effectively, but it also allows us to experiment. The future of our business is tightly linked to the cloud.”

The supplement also included an article on the top five unusual for the cloud, from keeping animals fed and happy to bringing the written word to life. Independent publisher Faber & Faber is using cloud platform Box to manage incoming manuscripts from draft to final approval. Jim Lindsay, integration specialist at Faber & Faber, says the system is helping the firm embrace the digital world:

“Content is central to what we do and cloud computing makes content easily accessible for all staff, no matter where they are located in the world.”

Moving to the cloud involves a careful consideration of information security. Yet another article by me for ZDNet this week suggests most businesses are badly prepared when it comes to dealing with cyber attacks. Despite almost constant warnings about security threats, most companies rate their cyber resilience as low, even though they spend a huge chunk of their IT budgets on security.

Focusing on risk management is crucial, says Colin Lees at BT Business, whose main aim is to ensure potential points of entry are locked down. People policies are also important and he says BT has a range of plans and procedures for key areas, including building security, system access, and worker behaviour, in terms of education and training:

“The key to success is risk management, with an appropriate level of spend. You have to be prepared to invest. When I speak to other CIOs in other sectors, I sometimes find there’s less investment in security than at BT. Being so network-oriented means it’s a crucial area of IT spend for us.”

As mentioned in my last update, I’ll be writing more skills-based articles for The Register in coming weeks. My next article will focus on the role of the CDO. If you have an angle or an idea, drop me a line. I’m also always keen to hear from CIOs and independent experts who have an opinion or responsibility for areas of Europe beyond the UK. Just drop me a line if you’d like to get involved at mark.samuels@gmail.com or mark@samuelsmedia.co.uk.

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Analysts expect virtual reality (VR) to be one of the key trends of 2016, with big vendors set to launch an array of related technologies. The consumer market for VR is evolving quickly, but how will such devices be used in the business?

My latest piece for ZDNet explores the trend. Late last year, mapping specialist Ordnance Survey (OS) created a 10km by 10km recreation of Ben Nevis, Britain’s highest mountain. OS has now released a VR tour of the mountain scape for Oculus Rift and Google Cardboard.

David Haynes, software developer and VR expert at OS, says the firm’s experimental work shows how other businesses could use the technology. He says potential beneficiaries are organisations with transferable information:

“I’m fairly confident that VR has lots of potential applications. We’ve already talked to some of our partners about use cases, such as helping businesses to view a location virtually before a physical site visit. We’re still at the start of the journey but the possibilities are endless.”

My first article for The Register, also published this week, analyses the impact of new technology on the role of the CIO. It suggests that technology leadership, which is normally a demanding role, has become something else in today’s world. Modern CIOs must not only maintain day-to-day IT operations but also manage the heightened expectations of a tech-savvy user base.

There is good news. It’s the fact that most businesses, despite the ability to source technology on-demand through access to things like CRM delivered as a service, still recognise the importance of strong IT leadership:

Research from the Tech Partnership and Experian suggests there will be more, not fewer, specialist technology roles with growth likely the greatest amongst IT directors – 37.5 per cent growth between 2015 and 2025. 

Great CIOs, then, will always be in demand all over the globe. One such IT leader is Johan Kestens, managing director and CIO at ING Belgium. I spoke to the experienced IT director for Computer Weekly this week, who is approaching the end of his second year at the bank and is keen to help the business make the most of innovation.

To help deliver on his transformative aim of a new style of banking, Kestens is keen to modernise the firm’s application and infrastructure portfolio. Innovation is crucial, said Kestens, pointing to his bank’s continued efforts in wearable technology. The aim, he says, is to be as digital as possible – and that requires access to great talent:

“The power of imagination is crucial. Increasingly, the world is beginning to understand that engineers are like artists – there are engineers that make a difference and we all want access to those people.”

I’ll be writing more skills-based articles for The Register in coming weeks. If you have an angle or an idea, drop me a line. As in the case of Johan Kestens at ING, I’m always keen to hear from CIOs and independent experts who have an opinion or responsibility for areas of Europe beyond the UK. Just drop me a line if you’d like to get involved at mark.samuels@gmail.com or mark@samuelsmedia.co.uk.

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Modern IT leaders are under siege. CIOs are expected to keep systems up and running, while also keeping track of fast-changing business demands and the technologies that can help improve organisational effectiveness. My latest feature for Computer Weekly analyses the ways in which CIOs can develop an IT strategy that delivers real change and lasting business benefits in the digital age:

Former CIO turned digital advisor Ian Cox says in the article that disruption usually happens in industries that have not seen any major change in business models, products and services for prolonged periods. One approach that some CIOs have taken is to develop a digital strategy that is separate to the firm’s overall approach to IT. But Cox is adamant than no separation should exist:

“What every organisation needs is a single business strategy, and the CIO should take part to provoke debate and extend capabilities. The modern CIO should be a person who knows what’s coming in terms of IT and the startup community.”

CIOs, then, need to be creative. But say that someone in your firm comes up with a great idea – is your first thought to keep the intellectual property confined within the enterprise firewall, or would you rather share those ideas with external partners, peers, and even competitors?

Some experts believe the closed nature of how most organisations deal with innovation means business and society at large are missing out on benefits that could inspire growth. My latest feature for ZDNet suggests that one way to encourage a more open approach to creativity is through horizontal innovation, which involves the systematic transfer of knowledge and technology from one sector to another.

Gordon Attenborough, head of sectors at the IET, says business leaders in all sectors must understand the importance of horizontal innovation. He says good examples of idea sharing can be seen in the healthcare and aerospace industries. Other technologists should use their awareness to solve some of the greatest conundrums in business:

“There are solutions to your challenges already out there, irrespective of the discipline. Those challenges cover the broad span of B2B and B2C issues – we just need to makes sure that cross-sector conversations take place. Horizontal innovation is a low cost way to create business solutions that can have a very big impact.”

Elsewhere, I’ve just put the finishing touch to an article on cloud computing for a Raconteur supplement in The Sunday Times, and I’m just completing an article for The Register on the evolving nature of the IT leadership role.

As ever, I’m always keen to hear from people who want to contribute to IT, business and leadership features, so just drop me a line if you’d like to get involved at mark.samuels@gmail.com or mark@samuelsmedia.co.uk. It’s always good to hear from independent experts who have a new take on strategy and innovation, particularly when it comes to leading-edge technology.

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The Friday Update 2: Priority setting for the New Year – from the Internet of Things to the power of personal branding

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A couple of weeks into 2016 and priority setting continues apace. I’ve just written a piece for ZDNet, which suggests that CIOs can expect to hear a lot more about the Internet of Things (IoT) in 2016. The trend is right at the peak of Gartner’s hype cycle for emerging technologies and IT leaders will have to help the business make sense of connected devices. The experts in the article – including Colin Lees, CIO at BT Business – suggest the role for IT leaders is to help their executives get beneath the hype and understand potential use cases:

“If you’re a business leader who’s focused on revenues and margins, you’re not going to be overly concerned with something that isn’t going to affect the business for at least five years. The IoT is struggling from being too intangible. Nothing happens in the world without a business case. But once you’ve got one, you can get moving.”

I spoke to Colin at length for Computer Weekly just before Christmas, where he outlined his achievements in regards to organisational transformation. Lees’ aim for the next 12 to 24 months is to help BT Business build on the platform and services the firm has developed. His other objective is to continue his journey towards being a more externally focused CIO, including offering best practice advice to some of his peers:

“I’ve taken the things I’ve learnt during the past two years and I’m using those as case studies. I’ve got major CIOs of blue-chip companies coming in to see about their IT estates, regarding how they deal with information and security. What I’m finding is that, when I speak to peers, we have a lot to talk about. When you’ve been there, done it and got the scars on your back, it helps to create very good conversations.”

I’ll be speaking to other CxOs about their business and IT priorities during the coming months, so if you’re a senior executive that wants to be profiled – or you just have something to say – drop me a line. I’m always keen to chat with interesting people. As I mentioned last time, I’ve got a few editorial projects on the go at the moment. I’m having a look at virtual reality in the business, so if you’ve got an opinion on VR, let me know at mark.samuels@gmail.com or mark@samuelsmedia.co.uk.

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I’ve had a few things published by ZDNet recently. I put together a weekly article on the views of IT and business leaders – some profile a single individual, others poll a series of CIOs, others are more opinion-focused. One of the recent articles covered CIO priorities for 2016. The article seemed to gain quite a lot of traction on social media, probably as it provides some sort of short hand for the kinds of things IT leaders should be focusing on through this year:

CIOs have many competing demands on their time, so it’s important that they focus on the big issues that really matter. ZDNet explores the research, speaks to the experts and discovers the five priority areas for CIOs through 2016. Here’s what CIOs will have on their to-do list this year, from finding the right talent to taking time out to focus on the next big thing.

The above article features comments from a series of IT leaders, including esure CIO Mark Foulsham. Mark knows his specialist field inside and out. I spoke to him a few times during the past 12-or-so months, including a profile feature for Computer Weekly about his plans for IT at the insurance firm. He provides an interesting take on transformation, particularly around new areas of innovation, such as mobility and the use of hackathons:

Mark Foulsham, group CIO at insurance firm esure, is overseeing an IT transformation plan that he hopes will help future-proof the business for the fast-evolving nature of modern business technology. The programme – which involves operating platforms, computing appliances, virtualisation and the cloud – is just the latest project for experienced IT leader Foulsham.

I’m currently working on a piece for The Register about the movement of business people into the IT profession. There’s a view that more outsiders from a non-techie background are coming in. The article will look at whether this is true overall, or whether it’s only true for certain fields or vertical sectors. I’m happy to hear your views – contact me at mark.samuels@gmail.com or mark@samuelsmedia.co.uk. As ever, I’m always looking for CIO and business leader comment for a range of features. Again, just drop me a line if you’d like to get involved.

Five ways CIOs can improve how colleagues think of tech

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How can IT leaders overcome entrenched views of technology and create the type of communication that boosts the perception of the IT department within the company? Here’s my analysis for silicon.com:

Technology is still often seen by other business executives as a service, rather than a business essential. At the same time, ever-increasing consumerisation means workers across the organisation now have clear views on how they think internal IT should operate. silicon.com spoke to five IT leaders to get their take on how CIOs can help change perceptions.

Method 1. Become the champion for innovation - Comic Relief CIO Marcus East says perception has long been a challenge for IT functions and departments. It’s a challenge that has increased in recent years, with employees eager to understand why they cannot do things in the office that they can do at home with consumer IT.

“Arguments about the need for corporate security used to be enough to stop non-compliant users in their tracks, but that approach won’t work anymore. IT leaders need to address this issue and become the champions for people’s use of technology in their organisations, rather than trying to resist innovation,” says East.

To read the rest of the article, please click here.

Five ways CIOs can innovate for the business

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Getting creative in troubled economic times can be tough. So, how can CIOs prove the value of innovation? My feature for silicon.com investigates:

In the present climate, it can be hard for CIOs to shape the type of opportunities that will provide new benefits to the business. So silicon.com has canvassed the views of a group of IT experts for their suggestions. They have come up with five key ways that CIOs can continue to create new opportunities for the business.

Idea 1. Develop new partnerships and ideas - Asos.com director of IT Dan West says CIOs need to carve out opportunities to start innovating. West is leading the transformation of his IT team, so the skills of the department are designed to meet wider business objectives and to help develop creative ideas.

“That might include partnerships with universities and start-ups, or through the creation of internal events that are developed to inspire innovation,” he says. One such example is the Hackathon, a trial event created by West and his IT team to generate new business ideas.

For the rest of the feature, please click here.

Creativity is only significant if it does not entail excessive risk

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Your working life should be a continual learning process, from your first day of employment to your inevitable promotion to the top table.

Any employee who makes the mistake of thinking they know everything is bound to fail. A good worker listens, talks and learns – and the same methods for success exist across every sector and individual business.

Take technology journalism, where novice business reporters are traditionally given the storage beat. It is a dry, technical area but any reporter who proves their worth in storage is likely to flourish at the front line of IT innovation and implementation.

The moral, I guess, is you need to do the right ground work. And the same principle holds true in the real – rather than reported – world of business technology, where CIOs are expected to put years of technical experience into practice for the benefit of the business.

Once at the top, it is easy to become sidetracked by ephemeral talk of alignment and agility – and to forget that lasting success is all about policy and process. A true technology leader recognises that the governance helping maintain day-to-day IT will not be forsaken for the more exciting areas of implementation and innovation.

The winter edition of CIO Connect magazine (from which this editorial is taken) shows that successful technology chiefs find a balance between creativity and risk-taking.

When it comes to how the CIO should develop novel techniques for intractable challenges, Marks & Spencer’s director of IT and logistics Darrell Stein says he only gets excited about business cases, sales and costs.

Change attempts are set by a business agenda, an approach echoed by Paul Forester – IT director at fashion retailer Monsoon Accessorize – who is looking to create an IT planning function to focus on innovation.

Creativity, it turns out, is only significant if it does not entail excessive risk. And that propensity for the business to cope with risk relies on the well-learned basics of policy and process.

With strong governance, CIOs are much more likely to see projects succeed. Like storage, governance has a reputation for being dry and staid. But it involves a learning process that must not be forgotten.

Tom Herbich, now director of business applications and information governance at Deutsche Bank, has spent three decades honing a unique and effective approach to compliance. In a special feature on the finance industry, Herbich offers advice which is true for CIOs across all sectors.

“You must implement solid business controls,” he concludes. “You need to know how to manage and you need to understand what is really important.” As ever, experience will see you right.

Dark side of the cloud

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A quick update to my article list for silicon.com – an article explaining why the shift to cloud computing may take longer than CIOs think. Along with the familiar barriers to cloud adoption, such as security and vendor lock-in, there are a number of less obvious challenges giving some CIOs pause for thought:

Listen to the vendors and on-demand computing is presented as an unstoppable force that is set to change technology provision quickly and irrevocably.

Check the research and that representation certainly appears credible, with analyst house IDC estimating that companies spend £10.7bn a year on cloud IT services worldwide and that the market will be worth £27bn by 2013. But while the numbers might sound impressive, IT leaders wishing to transfer services to the cloud face significant challenges.

Executives rapidly discover a dark side to the cloud, where concepts of on-demand technology are confused, trust is constrained and understanding is limited. “I find the whole debate about cloud as interesting as the debate about service-oriented architecture,” says Stuart Curley, chief technology architect at the Royal Mail. “It doesn’t keep me awake at night but it does send me to sleep.”

For the rest of the feature, click here.