Assessing a Business Software Application using Strategic IT Alignment Factors: A New Way for IS Evaluation?

The alignment between the business strategy of an organization and its related information technology (IT) strategy, infrastructure and processes remains important for both research and practice. Prior studies have shown that effective strategic IT alignment (SITA) leads to effective business value. When measuring the SITA, these studies focused on the overall information system (IS) of an organization. However, it would be useful for practitioners to evaluate, not only a global alignment, but also the alignment of a specific business software application, which could lead to business value as well. Previous investigations in the IS evaluation field, such as studies related to the Information Systems Success Model (ISSM), do not include strategic alignment factors. In this contribution, we address the issue of how to evaluate a business software application using SITA factors. To identify SITA factors, we selected a set of scientific papers and documents from practitioners related to strategic alignment and we used them as input for a coding process. We followed the thematic analysis method for coding and we obtained a hierarchical structure of SITA factors. From this structure, and based on the Strategic Alignment Model (SAM), we built an emergent alignment model that clarifies relations between a business software application and first the organization’s strategies (business and IT), second the organizational structure, and third the processes and operations of the IT department. The model reveals that all relations, except those between business strategy, organizational structure and business operations, are appropriate for evaluating the strategic alignment of a business software application

Molekulare Veränderungen beim Pankreaskarzinom

Zusammenfassung: Grundlagen: Das Pankreaskarzinom hat eine infauste Prognose. Die Ursachen für das aggressive Tumorwachstum und die frühe Metastasierung sind nur unzureichend bekannt. Mit Hilfe von modernen molekularbiologischen Untersuchungstechniken ist es in den vergangenen Jahren gelungen, einen Einblick in die Pathophysiologie dieser Erkrankung zu gewinnen. Methodik: Im Rahmen dieser Übersicht wird die pathogenetische Bedeutung von Wachstumsfaktor-Rezeptoren (EGFR, c-erbB-2, c-erbB-3), Wachstumsfaktoren (EGF, TGF-α, Amphiregulin, Betacellulin, TGF-βs, FGFs) sowie von Genmutationen (p53, K-ras) und Adhäsionsmolekülen beim humanen Pankreaskarzinom dargestellt. Ergebnisse: In einer signifikanten Anzahl der Pankreaskarzinome sind Wachstumsfaktorrezeptoren (EGFR, c-erbB-2, c-erbB-3), Wachstumsfaktoren (EGF, TGF-α, Amphiregulin, Betacellulin, TGF-βs, FGFs) und Adhäsionsmoleküle (ICAM-1, ELAM-1) überexprimiert sowie Genmutationen (p53, K-ras) vorhanden. Allerdings sind nicht alle diese molekularen Veränderungen mit einem schnelleren Tumorwachstum und einer schlechteren Prognose nach Tumorresektion vergesellschaftet. Schlußfolgerungen: Molekulare Störungen in Pankreaskarzinomzellen tragen zum malignen Phänotyp bei. Diese Veränderungen erklären, warum die Pankreaskarzinomzellen schnell proliferieren und nur eine geringe Ansprechbarkeit auf adjuvante onkologische Behandlungen zeige

Frequency of medical students' language expressing implicit uncertainty in simulated handovers

OBJECTIVES: The aim of this study was to investigate the number and type of implicit expressions of uncertainty by medical students during simulated patient handovers. METHODS: Eighty-seven volunteer medical students, a convenience sample collected on a first-come, first-served basis, participated in simulated handovers. They each worked with three simulated patients who presented with different chief complaints and personal conditions. The handovers were video recorded and transcribed. A framework of implicit expressions of uncertainty was used to identify and count modifiers that attenuate or strengthen medical information using MAXQDA lexical search. We analysed the findings with respect to the patients' contexts. RESULTS: Implicit uncertainty expressions which attenuate or strengthen information occurred in almost equal frequency, 1879 (55%) versus 1505 (45%). Attenuators were found most frequently in the category 'Questionable', 1041 (55.4%), strengtheners in the category 'Focused', 1031 (68.5%). Most attenuators and strengtheners were found in the handover of two patients with challenging personal conditions ('angry man', 434 (23.1%) versus 323 (21.5%); 'unfocused woman', 354 (19.4%) versus 322 (21.4%)) and one patient with abnormal laboratory findings ('elevated creatinine', 379 (20.2%) versus 285 (18.9%)). CONCLUSIONS: Medical students use a variety of implicit expressions of uncertainty in simulated handovers. These findings provide an opportunity for medical educators to design communication courses that raise students' awareness for content-dependent implicit expressions of uncertainty and provide strategies to communicate uncertainty explicitly

Effects of contour propagation and background corrections in different MRI flow software packages

Background: Velocity-encoded magnetic resonance imaging (VENC-MRI) is a commonly used technique in cardiac examinations. This technique utilizes the phase shift properties of protons moving along a magnetic field gradient. VENC-MRI offers a unique way of measuring the severity of valve regurgitation by directly quantifying the regurgitation flow volume. Purpose: To compare flow analysis results of different software programs and to assess the effect of background correction in sample patient cases. Material and Methods: A phantom was built out of Polymethyl methacrylate (PMMA) which provides tubes of different diameters. These tubes can be connected to an external water circuit to generate a water flow inside the tubes. Expected absolute flow quantities inside the tubes were determined from preset tube- and flow-parameters. Different flow conditions were measured with a VENC-MRI sequence and the images evaluated using different software packages. In a second step six randomly selected patients showing different degrees of aortic insufficiency were evaluated in clinical terms. Results: The contour propagation algorithms used in the software packages performed differently even on static phantom geometry. In terms of clinical evaluation the software packages performed similarly. Enabling background correction or leaving out manual correction of propagated contours changed results for severity of aortic insufficiency. Conclusion: Turning on background correction and manual correction of propagated contours in MRI flow volume measurements is strongly recommended

Use of Learning Media by Undergraduate Medical Students in Pharmacology: A Prospective Cohort Study

The ubiquity of the internet and computer-based technologies has an increasing impact on higher education and the way students access information for learning. Moreover, there is a paucity of information about the quantitative and qualitative use of learning media by the current student generation. In this study we systematically analyzed the use of digital and non-digital learning resources by undergraduate medical students. Daily online surveys and semi-structured interviews were conducted with a cohort of 338 third year medical students enrolled in a general pharmacology course. Our data demonstrate a predominant use of digital over non-digital learning resources (69 +/- 7% vs. 31 +/- 7%;p 300 pages) (10.6 +/- 3.3%),internet search (7.9 +/- 1.6%) and e-learning cases (7.6 +/- 3.0%). When comparing learning media use of teaching vs. pre-exam self-study periods, textbooks were used significantly less during self-study (-55%;p < 0.01), while exam questions (+334%;p < 0.01) and e-learning cases (+176%;p < 0.01) were utilized more. Taken together, our study revealed a high prevalence and acceptance of digital learning resources by undergraduate medical students, in particular mobile applications

Von Sick of ... zu Sick with ... zu Walk with ...: Die narrative Anerkennung individuellen Leidens und Lebens in der Medizin(ausbildung)

Every individual has its unique reasons for seeing a doctor. It follows that, in order to find the appropriate remedy for each case, doctors need to pay particular attention in their endeavour to understand the individual problem. Easy to say, but hard if not impossible to achieve: Not often having the time for long personal conversations, doctors are nevertheless expected to understand the positions and perspectives, the desires and priorities, the troubles and sufferings of others in order to provide them the exact help they need and / or want. This is a professional challenge that should be addressed appropriately in the course of medical education. Confronted with the otherness of the individual other, and therefore with the impossibility of a 100% accurate understanding of each other, doctors need the mindset to acknowledge individual problems as individual problems as well as the attitude to side with their patients against these problems nevertheless. In other words: doctors need to think in narrative dimensions. This paper wants to discuss the potentials, limits and risks of respective elements in medical education around two case studies developed at TUM Medical School

How is modern bedside teaching structured? A video analysis of learning content, social and spatial structures

BACKGROUND: Bedside teaching (BST) is an essential and traditional clinical teaching format. It has been subject to various impediments and has transformed over time. Besides a decrease in bedside time, there has also been a didactic diversification. In order to use time at the bedside effectively and understand the current design of BST, we here offer an evidence-based insight into how BST is practiced. This may serve as a basis for a refinement of its didactic design. METHODS: In the current study, we investigate the interrelationships between learning content and the social as well as spatial structures of BST. To this end, we have empirically analysed almost 80 hours of video material from a total of 36 BST sessions with good interrater reliability. RESULTS: BST lasted on average 125 min, most of which was spent in plenary and less than a third of the time at the patient’s bedside. History taking was primarily practiced at the bedside while case presentations, clinical reasoning and theoretical knowledge were largely taught away from the patient. Clinical examination took place to a similar extent in the patient’s room and in the theory room. CONCLUSIONS: Even though the filmed BSTs are not purely “bedside”, the teaching format investigated here is a typical example of undergraduate medical education. In order to maximize the teaching time available, a suitable learning space should be provided in addition to the bedside. Moreover, the clinical examination should be revised in its general sequence prior to the BST, and conscious decisions should be made regarding the social structure so as to optimize the potential of small groups and plenary sessions