Design and Implementation of a Method Base Management System for a Situational CASE Environment

Situational method engineering focuses on configuration of system development methods (SDMs) tuned to the situation of a project at hand. Situational methods are assembled from parts of existing SDMs, so called method fragments, that are selected to match the project situation. The complex task of selecting appropriate method fragments and assembling them into a method requires effective automated support. The paper describes the architecture of a tool prototype offering such support. We present the structure of its central repository, a method base containing method fragments. The functions to store, select and assemble these method fragments are offered by a stratified method base management system tool component, which is described as wel

Appropriate Delivery of Advice and Guidance on Method Adaptation

One can find enough evidence in the IS development (ISD) literature supporting the significance of method adaptation for the realization of an effective ISD. Method adaptation involves a decision making process through which the agent(s) modifies the project situation, including the method and the project context, at hand. This paper aims at exploring how a better delivery of guidance and advice (decision support) on method adaptation, i.e. the degree of which the decision support to be provided is employed successfully, can be achieved. To do this we study several stages in which a set of advice and guidance with some decision support tools on method adaptation realized in a large-scale IT department. Each stage is distinguished with respect to the underlying discourses proposed in the decision support literature and elaborated in terms of the method used, the involved parties concerning method adaptation, and the means used in a ten-year timeline in the department. This study shows that agility of the method used, the degree of sharedness of the meaning of method adaptation held by involved parties, the decision support approach (top-down, bottom-up, or middle-out approaches reflecting the degree of dominations of involved parties) to method adaptation, and the combination of human- and technology-driven guidance are essential to an appropriate delivery of decision support for method adaptation

On the Adaptation of an Agile Information Systems Development Method

Little specific research has been conducted to date on the adaptation of agile information systems development (ISD) methods. This article presents the work practice in dealing with the adaptation of such a method in the ISD department of one of the leading financial institutes in Europe. Two forms of method adaptation, static adaptation and dynamic adaptation, are introduced and discussed in detail. We provide some insights plus an instrument that the ISD department studied uses to deal with the dynamic method adaptation. To enhance our understanding of the observed practice, we take into account two complementary perspectives: the engineering perspective and the socio-organizational perspective. Practical and theoretical implications of this study are discussed.Keywords: agile method; information systems development; method adaptation; method engineerin

Sourcing Decision-Making: Elicitating Consultancy Knowledge Using Policy Capturing

Many organizations are currently deciding whether to insource or outsource their IS function or parts thereof, but are unsure as to what kind of organizational structure to arrange for sourcing and where to locate the sourced activities. To assist in this matter, several IT consultancy firms are providing sourcing consultancy to their clients, resulting in a large body of practical knowledge that is stored in the experience of consultants. Systematic scientific knowledge is largely based upon qualitative case studies. This paper presents the results of a Policy Capturing study that attempts to quantify the sourcing advice practice. 29 management consultants with experience in sourcing advice were presented with examples of situations in which a sourcing advice was to be given. Using Factor Analysis and Multilevel Regression the researchers obtained insight into how variables such as costs, flexibility, time-to-market and quality influence decisions with regard to both sourcing location as well as sourcing relationship. The Research method that was used proved to be useful in the explicitation of knowledge of consultants but needs further refinement

Optimization of trauma care: A two-tiered inhospital trauma team response system

Background: To improve utilization of resources and reduce overtriage, two-tiered trauma team activation (TTA) system was implemented. The system activates a complete or selective trauma team (CTT, STT). Activation is based on the mechanism of injury (MOI), prehospital vital signs and injuries. Objectives: The objective was to evaluate the feasibility, effectiveness and safety of the implementation of a two-tiered system and whether the triage is done according to the TTA criteria. Methods: A prospective observational study was performed at the emergency department (ED) of a Level I trauma center. Data were collected on TTA criteria, patient demographics, MOI, prehospital vital signs, imaging modalities and blood gas analysis in the ED and inhospital data. Results: In 3 months, 186 patients were presented to the trauma resuscitation room. Thirty-four patients were excluded, 152 patients were included for analysis. Median age was 48 years (range 193), 64 were males. In 73, the CTT was activated, in 27 the STT, the STT was upgraded three times. Seventy-nine patients had to be admitted, the median length of stay was 5 days (range 162). Thirty-eight patients needed Intensive Care Unit (ICU) admission; the median ICU stay was 3 days (range 133). Three patients died in the resuscitation room, in total, nine patients died. Overtriage was 29 and undertriage 7. No significant difference was found for mortality, duration of hospital admission or ICU admission across the four groups (correct activation STT, undertriage, overtriage, and correct activation CTT). Conclusions: This TTA system identifies those patients in need of a CTT adequately with an undertriage percentage of 7, indicative of improved care for the severely injured and a more appropriate use of resources. With this model, the overtriage is set to an acceptable percentage of 29

Tissue Stromal Vascular Fraction Improves Early Scar Healing:A Prospective Randomized Multicenter Clinical Trial

Background Wound healing and scar formation depends on a plethora of factors. Given the impact of abnormal scar formation, interventions aimed to improve scar formation would be most advantageous. The tissue stromal vascular fraction (tSVF) of adipose tissue is composed of a heterogenous mixture of cells embedded in extracellular matrix. It contains growth factors and cytokines involved in wound-healing processes, eg, parenchymal proliferation, inflammation, angiogenesis, and matrix remodeling.Objectives The aim of this study was to investigate the hypothesis that tSVF reduces postsurgical scar formation.Methods This prospective, double-blind, placebo-controlled, randomized trial was conducted between 2016 and 2020. Forty mammoplasty patients were enrolled and followed for 1 year. At the end of the mammoplasty procedure, all patients received tSVF in the lateral 5 cm of the horizontal scar of 1 breast and a placebo injection in the contralateral breast to serve as an intrapatient control. Primary outcome was scar quality measure by the Patient and Observer Scar Assessment Scale (POSAS). Secondary outcomes were obtained from photographic evaluation and histologic analysis of scar tissue samples.Results Thirty-four of 40 patients completed follow-up. At 6 months postoperation, injection of tSVF had significantly improved postoperative scar appearance as assessed by the POSAS questionnaire. No difference was observed at 12 months postoperation. No improvement was seen based on the evaluation of photographs and histologic analysis of postoperative scars between both groups.Conclusions Injection of tSVF resulted in improved wound healing and reduced scar formation at 6 months postoperation, without any noticeable advantageous effects seen at 12 months.</p