Control, Process Facilitation, and Requirements Change in Offshore Requirements Analysis: The Provider Perspective

Process, technology, and project factors have been increasingly driving organizations to offshore early software development phases, such as requirements analysis. This emerging trend necessitates greater control and process facilitation between client and vendor sites. The effectiveness of control and facilitation has, however, not been examined within the context of requirements analysis and change. In this study, we examine the role of control and facilitation in managing changing requirements and on success of requirements gathering in the Indian offshore software development environment. Firms found that control by client-site coordinators had a positive impact on requirements analysis success while vender site-coordinators did not have similar influence. Process facilitation by client site-coordinators affected requirements phase success indirectly through control. The study concludes with recommendations for research and practice

Primary obstructive megaureter with ureteric calculi in a child

Congenital megaureter is an important differential diagnosis among the known causes of hydroureteronephrosis in children. Obstructive megaureter is usually due to a narrowed and aperistaltic prevesical portion of the ureter. The congenital megaureter is usually asymptomatic in children. Association of an obstructive megaureter with ureteric calculi, however, is a rare phenomenon in the pediatric age group. Calculi if present are usually secondary to stasis and asymptomatic, presenting usually at adulthood or adolescence. A differential diagnosis of obstructive megaureter should be kept in mind in a child who presents with symptoms such as hematuria, pain, and obstructive nephropathy, especially when there are an associated calculi in the ureter. We present a case of a 4-year-old child whose chief complaint was hematuria and on further investigation was found to have unilateral obstructive megaureter with secondary ureteric calculi on an intravenous urogram

Preperitoneal bladder augmentation: Feasibility and results

Introduction: Bladder augmentation is an important part of pediatric reconstructive urology. This study was conducted to assess the feasibility and results of our technique of preperitoneal bladder augmentation. Materials and Methods: Thirty-three children underwent preperitoneal bladder augmentation for small inelastic bladders who had failed medical management or needed undiversion. The underlying diagnosis included neurogenic bladder, valve bladder, bladder exstrophy, non-neurogenic neurogenic, ectopic ureters, and urogenital sinus. The operative procedure involved placing the entire augmentation in the preperitoneal or subcutaneous space after bivalving the native bladder. The augment segment of the bowel with its pedicle was brought into the preperitoneal space through a small opening in the parietal peritoneum. A Mitrofanoff port was also provided where needed. Results: Preperitoneal augmentation provided an adequately compliant, good volume bladder except in children with bladder exstrophy or previous abdominal surgery. There was a good cystometric recovery, with resolution of hydronephrosis and incontinence. Vesicoureteral reflux resolved in 24 of 26 units. In the 13 children who were uremic preoperatively, there was a significant decrease in serum creatinine levels, although 9 children continued to have supra-normal serum creatinine. Surgical complications seen were within expectations. There was no incidence of intraperitoneal leak, which is the main projected benefit of this procedure over the traditional “intraperitoneal” method of augmentation. Conclusions: The preperitoneal augmentation provides an adequate, safe, and low-pressure reservoir of urine except in cases of bladder exstrophy and previous abdominal surgery

Twelve-month observational study of children with cancer in 41 countries during the COVID-19 pandemic

Childhood cancer is a leading cause of death. It is unclear whether the COVID-19 pandemic has impacted childhood cancer mortality. In this study, we aimed to establish all-cause mortality rates for childhood cancers during the COVID-19 pandemic and determine the factors associated with mortality