Tesi sul tema "Cale development and validation"

Background: Undiagnosed chronic obstructive pulmonary disease (COPD) and asthma remain prevalent health issues. The current global and Canadian prevalence reported for obstructive lung disease do not reflect the true prevalence since undiagnosed cases remain missed and uncounted. Spirometry testing is viewed as the current gold standard for diagnosing obstructive lung disease. However, barriers associated with inaccessibility and underuse have contributed to undiagnosed lung disease. While guidelines advise against spirometry for asymptomatic persons, active case-finding for persons at-risk and those presenting with symptoms has been recommended. Given early treatment and management has the potential to improve health-related quality of life and reduce the progression of lung decline, identifying undiagnosed lung disease is critical to preventing adverse health outcomes. To date, this marks the first study to incorporate both obstructive lung diseases into a single-case finding instrument. Objective: To develop and validate a case-finding questionnaire to identify undiagnosed COPD and asthma in community-dwelling adults, and to prospectively evaluate reliability and predictive performance. Methods: This study uses data obtained from the Undiagnosed Chronic Obstructive Pulmonary Disease and Asthma Population (UCAP) study from June 2017 to March 2020. Eligible participants were >18 years, had a history of chronic respiratory symptoms, and had no previous physician diagnosis of obstructive lung disease. Presence of obstructive lung disease was confirmed with spirometry. Multinomial logistic regression and recursive partitioning were used to develop a case-finding questionnaire. Predictors available from six questionnaires completed during spirometry visit. Diagnostic accuracy of the models was used to evaluate performance. Risk score externally validated in a cohort of participants recruited between October 2020 and January 2021 at study sites open during the COVID-19 pandemic. Results: Derivation cohort included 1615 participants, with 136 ultimately diagnosed with asthma and 195 diagnosed with COPD. A 13-item questionnaire was developed using logistic regression: age, pack-years of cigarette smoking, wheeze, cough, sleep, chest tightness, level of tiredness, physical activity limitation, occupational exposure, primary or second-hand smoke exposure, frequency of chest attacks, and salbutamol medication. Internal validation showed an area under the curve (AUC) of 0.79 (0.70-0.90) for COPD and 0.64 (0.45-0.80) for asthma. At a predicted probability of greater than or equal to 6%, specificity was 17% for no OLD, sensitivity was 91% for asthma, and sensitivity was 96% for COPD. External cohort included 74 subjects, with 8 diagnosed with COPD and 6 diagnosed with asthma. The AUC for COPD was 0.89 (95% CI: 0.62-0.90) and AUC was 0.65 (95% CI: 0.63-0.72) for asthma. Sensitivity was 100% for both asthma and COPD, specificity was 13%, and positive predictive value was 23%. Conclusion: The 13-item case-finding questionnaire was shown to be reliable and with modest predictive ability in identifying COPD and asthma. Prospective evaluation with the UCAP study is still ongoing to recruit a larger sample to re-evaluate predictive performance.

Background: Root Cause Analysis (RCA) is a method of investigating adverse events (AEs). The purpose of RCA is to improve quality of care and patient safety through a retrospective, structured investigative process of an incident, resulting in recommendations to prevent the recurrence of medical errors. Aim: The aim of the study was to develop and validate a prototype questionnaire to establish whether the RCA model and processes employed at the research setting were perceived by the users to be acceptable, thorough and credible in terms of internationally established criteria. Methods: This is a validation study comprising four phases to meet the study objectives: 1) the development of a prototype questionnaire guided by a literature review; 2) assessing the validity of the content of the questionnaire by and numerical evaluation of the face validity thereof; 3) assessing the qualitative face validity cognitive interviews; and 4) reliability by test-retest. Results: Content validity assessment in Phase 2 resulted in removal of 1/36 (2.77%) question items and amendment of 7/36 (19.44%), resulting in 35 for the revised questionnaire. Analysis of data from the cognitive interviews resulted in amendment of 20/35 (57.14%) question items but no removal. Reliability of the final questionnaire achieved the predetermined ≥0.7 level of agreement. Conclusion: The questionnaire achieved a high content validity index and face validity was enhanced by cognitive interviews by providing qualitative data. The inter-rater coefficient indicated a high level of reliability. The tool was designed for a local private healthcare sector and this may limit its use.

Recent theoretical approaches, such the Psychology of Working perspective (Blustein, 2006; Duffy, Blustein, Diemer, & Autin, 2016), have emphasized social stratification and social justice, and quantitative assessments of these constructs are needed. The current study examines the development and initial validation of the Work and Human Needs Inventory (WAHNI), which assesses the extent to which individuals’ work meets several human needs: survival, power, autonomy, social connection, and purpose. Items were constructed and refined using content analysis of relevant constructs, expert analysis, and a pilot study. Exploratory factor analysis on a sample of 338 working adults revealed five factors: Provision, Purpose, Power, Autonomy, and Connection. Confirmatory factor analyses on a separate sample of 203 working adults supported this factor structure. Scale intercorrelations with the Differential Status Identity Scale (Brown et al., 2002), the MacArthur Scale of Subjective Social Status (Adler, Epel, Castellazzo, & Ickovicks, 2000), and the Meaning in Life Questionnaire (Steger, Frazier, Oishi, & Kaler, 2006) provided validity evidence. Research and practical implications for the WAHNI are discussed.

Thesis (MScPhysio (Interdisciplinary Health Sciences))--Stellenbosch University, 2008.
Introduction In clinical physiotherapy, there is a growing importance for the accuracy and reliability of assessment and outcome measures. The purpose of this study is to develop a valid outcome measure for orthopaedic trauma inpatients. Item generation was done by conducting a systematic review of published functional outcome measures and patients' interview. Item reduction was conducted by using a panel of physiotherapists and patients. Objectives The overall study objectives were: 1) To determine if a functional outcome measurement scale for trauma inpatients exists and has been published; 2) To generate functional items for the construction of a new outcome measurement tool for trauma inpatients; 3) To construct a new outcome measurement tool for trauma inpatients and assess elements of validity and reliability (face and content validity, response to change, internal consistency and floor and ceiling effects) of the new developed outcome measure. Methodology Convenience sampling was applied to collect data from 35 trauma inpatients in trauma wards at Rashid Hospital in Dubai, UAE. 88% of the trauma inpatients were male (total sample n= 100), mean age =34.75, and the standard deviation = 14.46. 21 functional activity items were generated from the collated results of the patient interviews. Internal consistency reliability, responsiveness and floor and ceiling effect were assessed. Data analysis was conducted using Statistica Version 7. Results The final number of functional activity items included in the newly developed Functional Scale outcome measure was 29 activity items relevant for trauma inpatients. A Cronbach's alpha ranged between 0.76 and 0.97. The lowest alpha result was for the 'ADL' activities at follow-up (0.76). The highest alpha result was for 'out of bed' activity at admission and discharge (0.97). The response to change of the Functional Scale for trauma inpatients over time results illustrates that there was a significant difference in the mean scores over three administrations of 'Bed', 'Out of bed' and 'ADL' activity items of Functional Scale for trauma inpatients (p=O.OOOO). In general, there was no significant floor and ceiling effects at admission or discharge for 'bed', 'out of bed' and 'ADL' activities, except there was a floor effect noted at discharge for 'bed' activities and 'ADL' activities, and a ceiling effect noted at admission for 'out of bed activities' only. Discussion and Conclusion The newly developed Functional Scale outcome measurement for trauma inpatients has been shown to be internally consistent and appears to be valid with respect to response to change in this sample of trauma inpatients. The results of this study thus suggest that the Functional Scale for trauma inpatients may be an appropriate tool when the goal is the assessment of change in disability functions in trauma inpatients, although further psychometric testing may be required.

Background: Patient empowerment is viewed as a priority by policy makers, patients and practitioners worldwide. Although there are a number of measures available, none have been developed specifically for patients in the UK with long-term conditions. It is the aim of this study to report the development and preliminary validation of an empowerment instrument for patients with long-term conditions in primary care.Methods: The study involved three methods. Firstly, a systematic review was conducted to identify existing empowerment instruments, and to describe, compare and appraise their content and quality. The results supported the need for a new instrument. Item content of existing instruments helped support development of the new instrument. Secondly, empowerment was explored in patients with long-term conditions and primary care practitioners using qualitative methods, to explore its meaning and the factors that support or hinder empowerment. This led to the development of a conceptual model to support instrument development. Thirdly, a new instrument for measuring empowerment in patients with long-term conditions in primary care was developed. A cross-sectional survey of patients was conducted to collect preliminary data on acceptability, reliability and validity, using pre-specified hypotheses based on existing theoretical and empirical work. Results: Nine instruments meeting review inclusion criteria were identified. Only one instrument was developed to measure empowerment in long-term conditions in the context of primary care, and that was judged to be insufficient in terms of content and purpose. Five dimensions (‘identity’, ‘knowledge and understanding’, ‘personal control’, personal decision-making’, and ‘enabling other patients’) of empowerment were identified through published literature and the qualitative work and incorporated into a preliminary version of the new instrument. A postal survey achieved 197 responses (response rate 33%). Almost half of the sample reported circulatory, diabetic or musculoskeletal conditions. Exploratory factor analysis suggested a three factor solution (‘identity’, ‘knowledge and understanding’ and ‘enabling’). Two dimensions of empowerment (‘identity’ and ‘enabling’) and total empowerment showed acceptable levels of internal consistency. The measure showed relationships with external measures (including quality of chronic illness care, self-efficacy and educational qualifications) that were generally supportive of its construct validity.Conclusion: Initial analyses suggest that the new measure meets basic psychometric criteria and has potential for the measurement of patient empowerment in long-term conditions in primary care. The scale may have a role in research on quality of care for long-term conditions, and could function as a patient-reported outcome measure. However, further validation is required before more extensive use of the measure.

Thesis (MA)--Stellenbosch University, 1999.
ENGLISH ABSTRACT: There is no standardised instrument available in South Africa to measure patient satisfaction with antenatal care. The measurement of patient satisfaction is especially important after the implementation of a free antenatal care service in the South African health system. The purpose of this study was to develop and validate an appropriate scale to measure patient satisfaction. Several methods to measure patient satisfaction are described in the literature. A questionnaire was developed for the Tygerberg Hospital patients. This questionnaire was tested in 200 antenatal patients through a structured interview. The importance of cross-cultural research is emphasised in the validation of the measuring instrument. Factor analysis was used to validate the instrument. This showed that a single factor accounted for most of the total variance. All the items had to do with the process of antenatal care. The findings of this survey showed the following: • One cannot use overseas measuring instruments without adjusting for cross-cultural differences. • The patient satisfaction score is negatively skewed with a high mean. • Social desirability response sets may play an important role in these questionnaires. • There is a statistically significant difference in patient satisfaction with antenatal care between the different antenatal clinics, even after controlling for socio-demographic differences. • That the satisfaction score is a reflection of the service rendered to the patient and not of the socio-demographic differences. This research identified the difficulties of developing a standardised instrument to measure patient satisfaction with antenatal care and opens the way for future research into patient satisfaction with medical services.
AFRIKAANSE OPSOMMING: Daar is geen gestandaardiseerde meetinstrument om pasiente se tevredenheid met voorgeboortesorg in Suid Afrika te bepaal nie. Die noodsaaklikheid van die bepaling van tevredenheid met voorgeboortesorg het nou belangriker geword nadat 'n stelsel van gratis voorgeboortesorg in Suid-Afrika gei"mplementeer is. Die doel van hierdie navorsing was om 'n skaal te ontwikkel om pasiente se tevredenheid met voorgeboortesorg te bepaal en om die geldigheid van hierdie meetinstrument plaaslik te toets. In die literatuur is daar verskeie metodes om pasiente se tevredenheid te bepaal. 'n Vraelys is ontwikkel vir Tygerberg Hospitaal se voorgeboorte pasiente. Hierdie vraelys is getoets by 200 pasiente in die voorgeboorte klinieke in Tygerberg Hospitaal deur middel van 'n gestruktureerde onderhoud. In die geldigheidsbepaling van die meetinstrument 1s die belangrikheid van kruiskulturele navorsing beklemtoon. Faktoranalise is gebruik vir die bepaling van geldigheid. Met faktoranalise is aangetoon dat een onderliggende faktor, naamlik die voorgeboortesorgsisteem, pasiente se tevredenheid verklaar. Die bevindings in hierdie ondersoek het die volgende getoon: • Dat aile meetinstrumente nie summier transkultureel toegepas kan word nie . • Dat die tevredenheidsmeting van voorgeboortesorg 'n negatiewe skewe verspreiding het, met 'n hoe gemiddelde telling. • Sosiaal-aanvaarbare antwoorde speel waarskynlik 'n groat rol in hierdie vraelyste. • Dat daar 'n statistiese betekenisvolle verskil is in die tevredenheidsgraad van pasiente met voorgeboortesorg tussen sommige klinieke; selfs nadat gekontroleer is vir sosiodemografiese verskille tussen pasiente. • Dat die tevredenheidsmeting 'n weerspieeling is van die diens gelewer aan die pasient, en nie net 'n weerspieeling is van die pasient se sosio-demografiese verskille nie. Hierdie navorsmg identifiseer die probleme met die opstel van 'n gestandaardiseerde meetinstrument vir die bepaling van pasente se tevredenheid met voorgeboortesorg en baan die weg vir verdere navorsing oor pasiente se tevredenheid met mediese dienste.

This work begins by describing a general theory of value which embraces many of the commonly used valuation techniques that have been developed by economists (the time tradeoff, the standard gamble and willingness to pay). These techniques share the common characteristic that each expresses value in terms of a sacrifice that people are prepared to make in order to achieve the benefit being valued. Here, those benefits comprise improvements in health. In the time tradeoff, the sacrifice used to express the value people would attach to an improvement in health, is the amount of time they would give up to obtain it. Hitherto this technique has usually asked people to accept a premature death as the payment for better health. In the standard gamble, the most commonly used sacrifice that people are asked to make is a risk of death in exchange for better health. With 'willingness to pay', people are asked to value health in terms of the amount of money they would exchange for better health. Empirical evidence is produced from three major studies, involving 4739 respondents. These studies confirm that two health valuation techniques (the standard gamble and the time tradeoff) do indeed appear to be more closely related to each other than to other valuation methods, not based within the economic theory. Further work establishes the validity of an adaptation of the time tradeoff technique to overcome some of the principal disadvantages of the method as it has usually been applied hitherto. This adaptation asks people to value health by giving up time during much shorter and more immediate time intervals.

A broad research foundation exists on Lean management in the manufacturing context. Furthermore, the implementation of Lean in product development is discussed by an increasing number of publications. Yet, little documentation of the specific application in product development testing has been published. This master thesis provides insights into the specific environment of product development testing and the application of Lean methods.   Utilizing a systematic literature research, the beginning of this work elaborates principles of case study research, the context of testing as part of product development and the Lean management framework. The findings are synthesized into a priori construct for the case research. Main pillar for this construct is the value stream mapping method. It combines the analysis of the current state, the development of the future state and a strategy for the implementation of improvements.   Central part of this thesis is the in-depth case study of a global operating manufacturing company in the off-highway machinery market. Three product development testing sites were visited by the author in order to apply the previously defined case study framework. Through cross case analysis common process characteristics of the current state are derived. From a micro level perspective the relations within and across the testing process are shown.   Needs, values, wastes, interruptions and other process parameters are systematically analyzed; improvements are elaborated and prioritized to develop a common future state for the testing process. A partial takt time driven test process could be developed. To visualize the process task boards were introduced and the value stream map was digitalized and connected to a management information system. The systematic understanding of information needs is a major part of the future state. A possible implementation strategy is presented in this thesis.

Thesis (Ph.D)--Management, Georgia Institute of Technology, 2008.
Committee Chair: Malhotra, Naresh; Committee Member: Feldman, Jack; Committee Member: Jayaraman, Sundaresan; Committee Member: Ulgado, Francis; Committee Member: Wong, Nancy.

Despite much scepticism and problems for its adoption, the Model-Driven Development (MDD) is being used and improved to provide many inherent benefits for industry. One of its greatest benefits is the ability to handle the complexity of software development by raising the abstraction level. Models are expressed using concepts that are not related to a specific implementation technology (e.g. Unified Modelling Language -UML, Object Constraint Language -OCL, Action Language for Foundational UML -ALF), which means that the models can be easier to specify, maintain and document. As in Model-Driven Engineering (MDE), the primary artefacts are the conceptual models, efforts are focused on their creation, testing and evolution at different levels of abstraction through transformations because if a conceptual schema has defects, these are passed on to the following stages, including coding. Thus, one of the challenges for researchers and developers in Model-Driven Development is being able to identify defects early on, at the conceptual schema level, as this helps reduce development costs and improve software quality. Over the last decade, little research work has been performed in this area. Some of the causes of this are the high theoretical complexity of testing conceptual schemas and the lack of adequate software support. This research area thus admits new methods and techniques, facing challenges such as generation of test cases using information external to the conceptual schemas (i.e. requirements), the measurement of possible automation, selection and prioritization of test cases, the need for an efficient support tool using standard semantics, the opportune feedback to support the software quality assurance process and facilitate making decisions based on the analysis and interpretation of the results. The aim of this thesis is to mitigate some of the problems that affect conceptual schema validation by providing a novel testing-based validation framework based on Model-Driven Development. The use of MDD improves abstraction, automation and reuse, which allows us to alleviate the complexity of our validation framework. Furthermore, by leveraging MDD techniques (such as metamodeling, model transformations, and models at runtime), our framework supports four phases of the testing process: test design, test case generation, test case execution and the evaluation of the results. In order to provide software support for our proposal, we developed the CoSTest ALF-based testing environment. To ensure that CoSTest offers the necessary functionality, we first identified a set of functional requirements. Then, after these requirements were identified, we defined the architecture and testing environment of the validation framework, and finally we implemented the architecture in the Eclipse context. CoSTest has been developed to test several properties on the executable model, such as syntactic correctness (i.e. all the elements in the model conform to the syntax of the language in which it is described), consistency between the structural and behavioural parts (its integrity constraints) and completeness (i.e. all possible changes on the system state can be performed through the execution of the operations defined in the executable model). For defective models, the CoSTest report returns a meaningful feedback that helps locate and repair any defects detected.
A pesar del escepticismo y dificultades en su adopción, el Desarrollo Orientado por Modelos (MDD, por sus siglas en inglés) está siendo usado y mejorado para proveer muchos beneficios inherentes a la industria. Uno de sus mayores beneficios es la capacidad de manejar la complejidad del desarrollo de software elevando el nivel de abstracción. Los modelos se expresan utilizando conceptos que no están relacionados con una tecnología de implementación específica (por ejemplo, Lenguaje de Modelado Unificado -UML, Lenguaje de Restricción de Objetos -OCL, Lenguaje de Acción para el Foundational UML - ALF), lo que significa que los modelos pueden ser más fáciles de especificar, mantener y documentar. Debido a que en una Ingeniería dirigida por modelos (MDE), los artefactos primarios son los modelos conceptuales, los esfuerzos se centran en su creación, prueba y evolución a diferentes niveles de abstracción a través de transformaciones, porque si un esquema conceptual tiene defectos, éstos se pasan a las siguientes etapas, incluida la codificación. Por lo tanto, uno de los retos para los investigadores y desarrolladores in MDD es poder identificar los defectos temprano, a nivel de esquemas conceptuales, ya que esto ayudaría a reducir los costos de desarrollo y mejorar la calidad del software. Durante la última década, pocos trabajos de investigación se han realizado en esta área. Algunas de las causas de esta realidad son la alta complejidad teórica de probar esquemas conceptuales y la falta de soporte de software adecuado. Por lo tanto, este área de investigación admite nuevos métodos y técnicas, enfrentando retos como la generación de casos de prueba utilizando información externa a los esquemas conceptuales (es decir, los requisitos), la medición de una posible automatización, selección y priorización de casos de prueba, la necesidad de una herramienta de soporte eficiente que utilice una semántica estándar, la retroalimentación oportuna para apoyar el proceso de aseguramiento de la calidad del software y facilitar la toma de decisiones basadas en el análisis y la interpretación de los resultados. El objetivo de esta tesis es mitigar algunos de los problemas que afectan la validación de los esquemas conceptuales, proporcionando un nuevo marco de validación basado en pruebas que fue construido usando un desarrollo dirigido por modelos. El uso de MDD permite un aumento en la abstracción, automatización y reutilización que nos permite aliviar la complejidad de nuestro marco de validación. Además, al aprovechar las técnicas MDD (como el metamodelado, las transformaciones de modelos y los modelos en tiempo de ejecución), nuestro marco soporta cuatro fases del proceso de prueba: diseño de pruebas, generación de casos de prueba, ejecución de casos de prueba y la evaluación de los resultados. Con el fin de proporcionar soporte de software para nuestra propuesta, hemos desarrollado CoSTest, un entorno de pruebas basado en el lenguaje ALF. Para asegurar que CoSTest ofrece la funcionalidad necesaria, primero identificamos un conjunto de requisitos funcionales. Luego, después de identificar estos requisitos, definimos la arquitectura y el ambiente de pruebas de nuestro marco de validación y, finalmente, implementamos la arquitectura en el contexto de Eclipse. CoSTest ha sido desarrollado para probar varias propiedades sobre el modelo ejecutable como la corrección sintáctica (es decir, todos los elementos del modelo se ajustan a la sintaxis del lenguaje en el que se describe), consistencia entre la parte estructural y el comportamiento (sus restricciones de integridad) y completitud (es decir, todos los cambios posibles en el estado del sistema se pueden realizar a través de la ejecución de las operaciones definidas en el modelo ejecutable). Para los modelos defectuosos, el informe de CoSTest devuelve una retroalimentación significativa que ayuda a localizar y reparar los defectos detec
A pesar de l'escepticisme i les dificultats en la seua adopció, el Desenvolupament Orientat per Models (MDD, segons les sigles en anglès) està sent usat i millorat per tal de proveir molts beneficis potencials inherents a l' indústria. Un dels majors beneficis és la capacitat de manejar la complexitat del desenvolupament del programari elevant el nivell d'abstracció. Els models s'expressen mitjançant conceptes que no estan relacionats amb una tecnologia d'implementació específica (per exemple, el Llenguatge de Modelat Unificat - UML, Llenguatge de Restricció d'Objectes -OCL, Llenguatge d'Acció per al Foundational UML - ALF), el que significa que els models poder ser més fàcils d'especificar, mantindre i documentar. A causa de que en una Enginyeria dirigida per models (MDE), els artefactes primaris són els models conceptuals, els esforços es centren en la seua creació, prova i evolució a diferents nivells d'abstracció mitjançant transformacions, perquè si un esquema conceptual té defectes, aquestos es passen a les següents etapes, inclosa la codificació. Per tant, un del reptes per als investigadors i desenvolupadors en MDD és poder identificar els defectes des del principi, a nivell de esquemes conceptuals, perquè açò ajudaria a reduir els costos de desenvolupament i millora de la qualitat del programari. Durant l'última dècada, pocs treballs d'investigació s'han fet en aquesta àrea. Algunes de les causes d'aquesta realitat són l'alta complexitat teòrica de provar esquemes conceptuals i la falta de suport de programari adequat. Per tant, aquesta àrea d'investigació admet nous mètodes i tècniques, enfrontant reptes com la generació de casos de prova mitjançant informació externa als esquemes conceptuals (es a dir, requisits), la medició de una possible automatització, selecció i priorització de casos de prova, la necessitat de una ferramenta de suport rentable que utilitze una semàntica estàndard, la retroalimentació oportuna per suportar el procés d'assegurament de la qualitat del programari i la facilitat per a prendre decisions basades en l'anàlisi i la interpretació dels resultats. En aquesta tesi intentem mitigar alguns dels problemes que afecten a la validació dels esquemes conceptuals, proporcionant un nou marc de validació basat en proves que va ser construït mitjançant un desenvolupament dirigit per models. L'ús de MDD permet un augment en l'abstracció, automatització i reutilització que ens permet alleujar la complexitat del nostre marc de validació. A més a més, al aprofitar les tècniques MDD (com el metamodelat, les transformacions de models i els models en temps d'execució), el nostre marc suporta quatre fases del procés de prova: disseny, generació i execució de casos de prova, així com l'avaluació de resultats del procés de prova. Amb la finalitat de proporcionar suport de programari per a la nostra proposta, hem desenvolupat un entorn de proves basat en el llenguatge ALF que s'anomena CoSTest. Per tal d'assegurar que CoSTest ofereix la funcionalitat necessària, identifiquem un conjunt de requisits funcionals abans de desenvolupar la ferramenta. Després d'identificar aquestos requisits, definim l'arquitectura i l'ambient de proves del nostre marc de validació, i finalment, implementem l'arquitectura en el context Eclipse. CoSTest ha sigut desenvolupat per provar diverses propietats sobre el model executable com la correcció sintàctica (és a dir, tots els elements del model s'ajusten a la sintaxi del llenguatge en el que es descriu), consistència antre la part estructural i el comportament (les seues restriccions d'integritat) i completitud (és a dir, tots els canvis possibles en l'estat del sistema es poden realitzar mitjançant l'execució de les operacions definides en el model executable). Per als models defectuosos, l'informe de CoSTest retorna una retroalimentació significativa que ajuda a localitzar i reparar els defectes dete
Granda Juca, MF. (2017). Testing-Based Conceptual Schema Validation in a Model-Driven Environment [Tesis doctoral no publicada]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/89091
TESIS

Venous leg ulceration has a high recurrence rate. Patients with healed or frequently recurring venous ulceration are required to perform self-care behaviours to prevent recurrence or promote healing, but many find these difficult to perform. Bandura’s self-efficacy theory is a widely used and robust behaviour change model and underpins many interventions designed to promote self-care in a variety of chronic conditions. By identifying areas where patients may experience difficulty in performing self-care, interventions can be developed to strengthen their self-efficacy beliefs in performing these activities successfully. There are currently a variety of self-efficacy scales available to measure self-efficacy in a variety of conditions; but not a disease-specific scale for use with venous ulcer patients. The aim of this study, therefore, was to develop a disease-specific, patient-focused self-efficacy scale for patients with healed venous leg ulceration. Phase 1 consisted of a qualitative design and used focus group methodology to generate an item pool for potential inclusion into the scale from the patients’ perspective. In phase 2, factor analysis using equamax orthogonal rotation methods was used to reduce the items from 60 to 30, resulting in 5 major domains: general self-care; daily self-care tasks; normal living; developing expertise and avoiding trauma. Preliminary reliability studies indicated that the developed scale, VeLUSET© has good internal consistency, with an overall Cronbach alpha of .929 and a strong test-re-test reliability. Furthermore, correlation with the General Self-Efficacy Scale demonstrated a strong positive relationship between the two scales. These results indicate that the VeLUSET©, although still in the early validation stages, is a reliable instrument to measure venous leg ulcer patients’ self-efficacy in performing self-care tasks within clinical practice. The development of this disease-specific tool has now filled a gap in the research on managing patients with healed venous leg ulceration.

Primary care services are becoming increasingly important for older people with multi-morbidity and multiple medications. Despite the increasing demand for measuring quality of geriatric pharmacotherapy for patients with polypharmacy, few studies on the development and validation of quality indicators (QIs) have been conducted. The overall aim of the research described in this thesis was to develop a set of QIs for medicine use in geriatric pharmacotherapy in Japan and validate QIs in terms of their measurement properties. A 4-step process for the development of QIs was employed. The first step was to determine the elements of quality for community pharmacy services. The second step was to prepare a preliminary set of QIs based on guidelines about geriatric care. The preliminary set comprised 143 QIs. The third step was to use the RAND/UCLA appropriateness method to assess face and content validity of 143 QIs. A total of 134 QIs were judged as valid by the expert panel. The final step involved a pilot study to evaluate the measurement properties of the 121 of 134 QIs developed the third step. Specifically, a 6-month observational study was conducted to evaluate applicability, improvement potential and sensitivity to change. For this study, a web application was developed by our research team. After an observational study, in-depth semi-structured interviews were conducted to evaluate acceptability and implementation issues. As a result, 17 QIs met all measurement properties. The QI set developed in this research can be used to identify patients who may benefit from further assessment of their medication regimen. Future studies should assess the impact of an increase in quality improvement processes as measured by QIs on patient clinical, humanistic and economic outcomes, at different levels within healthcare systems.

Aim The thesis set out to examine validations of three observational pain assessment tools and establish nurses’ expectations of them and the factors that might influence them within intensive care unit (ICU) settings. Background The guidelines to pain assessment specific to ICU patients have been of great interest to health professionals over the last 20 years. Pain assessment remains a challenge for most ICU patients due to the difficulty of assessing pain with any precision. Evidence suggests that the Behavioural Pain Scale (BPS) and Critical- Care Pain Observation Tool (CPOT) have demonstrated sound psychometric properties. A review of the relevant literature highlighted the fact that no such studies have yet been conducted with a similar homogenous group in Asia. The Wong-Baker Face Pain Rating Scale (FPRS) is currently widely used for nonverbally communicating patients (NVCPs) with pain in ICU settings, and is even recommended for use with children. Valid assessment tools are required for effective pain assessment in ICU settings, particularly in patients who are experiencing communication difficulties. Design An embedded mixed methods design was employed to: 1) translate Chinese versions of BPS and CPOT, 2) test their validity and reliability of in comparison with FPRS, and 3) establish the nurses’ expectations about the three study scales when undertaking pain assessment by using semi-structured focus group interviews. Methods This thesis initially reviews the literature available to select the most appropriate scales for assessing pain in critically-ill NVCPs. The selected scales were then translated into a Traditional-Chinese version using established procedures for the Taiwanese context. Evaluations of the three pain scales were gathered using quantitative measures of pain scores in NVCPs experiencing painless/painful interventions. These were further compared with a few focus groups to establish the feasibility and utility of the three pain scales. The psychometric properties of the pain scales were assessed for reliability by using internal consistency and inter-rater agreement) and for validity by using content validity, concurrent validity, discriminant validity, and responsiveness. The validity was evaluated using ANOVA to compare the changes between the different procedures. The significance level was set at 0.05. As for the analysis of the qualitative data, this study typically follows the path of aggregating the words into themes of information and presenting the diversity of ideas gathered during the data collection. Results For the 2068 observations in 237 patients, there were no statistical differences between the characteristics of the BPS, CPOT, and FPRS groups. Validity was demonstrated by changes from baseline in the scores of the three groups, which were significantly higher during suction (p < 0.001). In regard to the result for the criterion validity, both BPS and CPOT had moderate positive correlations with FPRS. The internal consistency was excellent; the Cronbach’s α was 0.700 for BPS and 0.821 for CPOT when all items were included. The majority of nurses preferred to use BPS to assess pain in their clinical practice. When the nurses were asked how long they needed and how easy they found it to complete the assessments using these tools, they all agreed that each patient assessments were easier and took the least time when they used FRPS. However, the nurses considered that the most effective pain reaction during nociceptive procedures had been assessed by using BPS. Even though all of the participant nurses stated that CPOT provides a detailed item-description about pain behaviour, it also provided the biggest obstacle to use because of its ambiguous indicators. Conclusions BPS, CPOT and FRPS provide potentially useful measurement scales for assessing pain in ICU NVCPs. However, judging from the inconsistencies between the nurses’ replies, the results could reflect a conflict between the need to use a validated measure of pain for NVCPs on the one hand and managing a heavy workload in the ICU on the other. This study opens up an avenue for investigating further the link between the underlying conceptions of pain behaviour and the effectiveness of pain assessments in NVCPs when using an objective pain measurement.

Direct-care workers can provide an array of service types to children, adolescents, and their families in behavioral health treatment. They may also work in a variety of settings (e.g., group homes, inpatient units/hospitals, residential treatment, treatment foster care, day treatment, in-home treatment, etc.). Direct-care workers typically are involved in the supervision of youth and in the implementation of a treatment plan developed by the youth’s treatment team. For youth who are lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) and are receiving behavioral health services, such workers form a critical part of their therapeutic experience. However, little is known about these workers’ competencies related to working with LGBTQ youth. This study begins to fill that gap by developing and testing a measure that assessed LGBTQ cultural competencies related to behavioral health practice with youth and a measure that was relevant to the roles and responsibilities of direct-care (e.g., paraprofessional, front-line) workers. In order for direct-care workers to use LGBTQ cultural competency in their practice, more understanding is needed about their current level of LGBTQ-related cultural competency. The LGBTQ Youth Cultural Competency scale (abbreviated as LGBTQY-CC) provides a means to measure those competencies. An exploratory factor analysis found that the new scale consists of one primary factor which represents knowledge, attitudes, skill, and awareness of LGBTQ cultural competency. Cronbach’s alpha, correlations with other measures for concurrent validity, and correlation with a measure of social desirability all resulted in evidence that the LGBTQY-CC has good validity. Analyses examined how the new measure was related to constructs associated with training and competency in direct-care workers. Multiple regression analyses showed that higher levels of LGBTQ cultural competency (as measured by the LGBTQY-CC) were significantly related to age (younger), political ideology (more liberal), more social contact with LGBTQ individuals, and degree of religious belief about LGBTQ being a sin. A model including these factors explained 60% of the variance in LGBTQY-CC scores. The LGBTQY-CC was created with the long-term goal of creating training interventions for direct-care workers to improve their practice with LGBTQ youth. The measure could be used to assess training participants’ knowledge, attitudes, skills, and awareness and to evaluate the effectiveness of varying types and styles of training programs. Federal and state regulatory bodies have begun to require service providers to identify how they will address disparities faced by LGBTQ individuals, so service providers need to demonstrate how they are improving access to and quality of care for LGBTQ individuals. Therefore, the LGBTQY-CC may provide a means to gather data on efforts made by service providers to improve their behavioral health workforce’s capacity to serve LGBTQ youth.

Personalised model generated risk predictions that incorporate several risk factors may motivate people to increase sun protection. The aim of the thesis is to evaluate and build the quality of the evidence for melanoma risk prediction models, contribute to knowledge of melanoma risk factors for inclusion in risk prediction models, and evaluate their effectiveness as preventive tools inclinical practice. Chapter 1 presents an overview of the epidemiology and role of melanoma risk prediction models in prevention. Chapter 2 presents the results of a systematic review of melanoma risk prediction models. The systematic review identified 28 melanoma risk prediction models. However, there was limited reporting of model development and performance measures, and few studies were externally validated or prospectively evaluated in clinical settings. Chapter 3 evaluates occupational sun exposure and melanoma risk to improve understanding of whether this risk factor should be considered for inclusion in risk prediction models by use of two population based case control studies. There was no association between occupational sun exposure and melanoma risk overall or according to anatomical site. Chapters 4 and 5 presents the development and validation of two melanoma risk prediction models, one using self assessed risk factors and the other using clinicallyassessed risk factors. Chapter 6 presents the results of a pragmatic randomised controlled trial, in which 272 Australian general practice patients were randomly allocated to receive (1) real time personalised model generated risk predictions based on self assessed risk factors and tailored prevention advice, or (2) generic prevention advice. There were no statistically significant differences between intervention and control patients in sun protection practices (p=0.13). However average risk patients in the intervention group appeared to show greater sun protection at 6 weeks (mean difference=0.23, on a scale of 1 to 5; 95% confidence interval: 0.01 to 0.45; p=0.04). This thesis adds high quality evidence relevant to the prevention of me lanoma from the development and validation of model generated risk predictions to their implementation and efficacy in clinical practice and is likely to have an impact on preventative care in Australia and internationally.

Background: Patient evaluation of primary health care (PHC) as a recognised means of obtaining important information for quality improvement can be enhanced with the availability and use of acceptable, reliable and valid questionnaires. This research reports the development and validation of the patients' evaluation scale (PES) for assessment of the quality of primary health care in Nigeria. Methods: Mixed methods design was used to develop and validate items, response scale and domains in the Patients' Evaluation Scale. Items were derived from literature review and content analysis of interviews with patients. Face and content validity were established with primary health care experts and patients while quantitative pilots were conducted to determine questionnaire's acceptability across groups and appropriate response format. The conduct of a large multi-centre psychometric validation survey was used to determine the internal structure (exploratory factor analysis), reliability (internal consistency), construct, criterion and discriminative validities (Pearson's correlation coefficient, structural equation modelling using regression equation method) and acceptability (scale and item response pattern) of the questionnaire. The discriminatory properties were assessed by questionnaire's ability to differentiate population groups' scores in line with 'a priori' hypotheses. Results: The development resulted in the long and shortened forms of PES containing 27 and 18-items respectively. Both showed good indices for validity and acceptability among various population groups in Nigeria. PES-SF resulted from the deletion of items in PES that didn't meet recommended Eigen value < 1, factor loading < 0.5, item-total, item-domain correlation < 0.4 and item-item correlation within domains of < 0.2. PES-SF has Cronbach's alpha of 0.87 for entire questionnaire and 0.78, 0.79 and 0.81 respectively for the three domains (codenamed 'facility', 'organisation', and 'health care'). The three components solution from the Scree plot explained 56.6% of the total variance of perceived quality. Items correlated significantly higher with domain identified through factor analysis than with other domains. In line with 'a priori' hypothesis, scale and domains scores of PES-SF could differentiate population groups based on patients' clinical and socio-demographic characteristics. PES-SF scores also showed significant correlation with patient general satisfaction and likelihood of returning or recommending others to the PHC centres. Conclusion: The patient evaluation scale designed for exit assessment of patients' experiences with PHC in Nigeria shows good measurement properties. It will be useful to clinicians, researchers and policy makers for patient-focused quality improvement activities in Nigeria. Further research will involve translation to major Nigerian languages and to assess PES validity against observed quality criteria.

L’objectif de cette thèse était de conceptualiser un modèle des compétences politiques adapté au contexte organisationnel français. A partir d’une réflexion interculturelle entre les modes de fonctionnement organisationnel français et américain, le Political Skill Inventory (PSI) développé par Ferris, Treadway, Kolodinsky, Hochwarter, Kacmar, Douglas & Frink (2005) a été étendu aux niveaux positionnel et idéologique de la théorie psychosociale de Doise (1982), à la dimension formelle des organisations (Mintzberg, 1983) et à l’analyse stratégique de Crozier et Friedberg (1977). Quatre études ont permis de développer une structure factorielle à quatre dimensions (accès à la connaissance formelle, influence interpersonnelle, intuition des relations stratégiques, propension à l’apprentissage) et de montrer la validité initiale de l’échelle de mesure: le French Political Skill Inventory (FPSI). Nous avons montré que la structure factorielle du FPSI n’est pas maintenue en contexte organisationnel américain. Le modèle antécédents dispositionnels/aptitudes personnelles de Ferris, Treadway, Perrewé, Brouer, Douglas & Lux (2007) a révélé une bonne adéquation à notre modèle. Suite au constat que les hommes ont déclaré des scores de FPSI significativement plus élevés que les femmes, nous avons montré que les différences sexuées observées sont dues à des variations de l’identité de genre et non au sexe biologique. En particulier, les profils androgynes ont rapporté des scores de FPSI significativement plus élevés que les profils féminins et indifférenciés
The aim of this thesis was to conceptualize a model of political skill adapted to the French organizational context. Based on an intercultural reflection between the modes of French and American organizational functioning, the Political Skill Inventory (PSI) developed by Ferris, Treadway, Kolodinsky, Hochwarter, Kacmar, Douglas, & Frink (2005) has been extended to positional and ideological levels from Doise’s psychosocial theory (1982), to the formal dimension of organizations (Mintzberg, 1983) and to the strategic analysis of Crozier and Friedberg (1977). Four studies have led to the development of a four-factor structure (access to formal knowledge, interpersonal influence, intuition of strategic relationships, propensity for learning) and gave evidence of the initial validity of the scale of measurement: the French Political Skill Inventory (FPSI). We have shown that the factor structure of the FPSI is not maintained in the American organizational context. The dispositional and personal ability antecedents of political skill from Ferris, Treadway, Perrewé, Brouer, Douglas & Lux (2007) revealed a good fit to our model. Following the finding that men reported significantly higher FPSI scores than women, we showed that the gender differences observed are due to variations in gender identity and not in biological sex. In particular, androgynous profiles reported significantly higher FPSI scores than female and undifferentiated profiles

El sistema de fangs activats és el tractament biològic més àmpliament utilitzat arreu del món per la depuració d'aigües residuals. El seu funcionament depèn de la correcta operació tant del reactor biològic com del decantador secundari. Quan la fase de sedimentació no es realitza correctament, la biomassa no decantada s'escapa amb l'efluent causant un impacte sobre el medi receptor. Els problemes de separació de sòlids, són actualment una de les principals causes d'ineficiència en l'operació dels sistemes de fangs activats arreu del món. Inclouen: bulking filamentós, bulking viscós, escumes biològiques, creixement dispers, flòcul pin-point i desnitrificació incontrolada. L'origen dels problemes de separació generalment es troba en un desequilibri entre les principals comunitats de microorganismes implicades en la sedimentació de la biomassa: els bacteris formadors de flòcul i els bacteris filamentosos. Degut a aquest origen microbiològic, la seva identificació i control no és una tasca fàcil pels caps de planta.
Els Sistemes de Suport a la Presa de Decisions basats en el coneixement (KBDSS) són un grup d'eines informàtiques caracteritzades per la seva capacitat de representar coneixement heurístic i tractar grans quantitats de dades. L'objectiu de la present tesi és el desenvolupament i validació d'un KBDSS específicament dissenyat per donar suport als caps de planta en el control dels problemes de separació de sòlids d'orígen microbiològic en els sistemes de fangs activats. Per aconseguir aquest objectiu principal, el KBDSS ha de presentar les següents característiques: (1) la implementació del sistema ha de ser viable i realista per garantir el seu correcte funcionament; (2) el raonament del sistema ha de ser dinàmic i evolutiu per adaptar-se a les necessitats del domini al qual es vol aplicar i (3) el raonament del sistema ha de ser intel·ligent.
En primer lloc, a fi de garantir la viabilitat del sistema, s'ha realitzat un estudi a petita escala (Catalunya) que ha permès determinar tant les variables més utilitzades per a la diagnosi i monitorització dels problemes i els mètodes de control més viables, com la detecció de les principals limitacions que el sistema hauria de resoldre.
Els resultats d'anteriors aplicacions han demostrat que la principal limitació en el desenvolupament de KBDSSs és l'estructura de la base de coneixement (KB), on es representa tot el coneixement adquirit sobre el domini, juntament amb els processos de raonament a seguir. En el nostre cas, tenint en compte la dinàmica del domini, aquestes limitacions es podrien veure incrementades si aquest disseny no fos òptim. En aquest sentit, s'ha proposat el Domino Model com a eina per dissenyar conceptualment el sistema.
Finalment, segons el darrer objectiu referent al seguiment d'un raonament intel·ligent, l'ús d'un Sistema Expert (basat en coneixement expert) i l'ús d'un Sistema de Raonament Basat en Casos (basat en l'experiència) han estat integrats com els principals sistemes intel·ligents encarregats de dur a terme el raonament del KBDSS. Als capítols 5 i 6 respectivament, es presenten el desenvolupament del Sistema Expert dinàmic (ES) i del Sistema de Raonament Basat en Casos temporal, anomenat Sistema de Raonament Basat en Episodis (EBRS). A continuació, al capítol 7, es presenten detalls de la implementació del sistema global (KBDSS) en l'entorn G2. Seguidament, al capítol 8, es mostren els resultats obtinguts durant els 11 mesos de validació del sistema, on aspectes com la precisió, capacitat i utilitat del sistema han estat validats tant experimentalment (prèviament a la implementació) com a partir de la seva implementació real a l'EDAR de Girona. Finalment, al capítol 9 s'enumeren les principals conclusions derivades de la present tesi.
The activated sludge system is the most widely used technology for biological wastewater treatment in the world. Its successful performance relies on the correct operation of both the bioreactor and the secondary settler. When settleability deteriorates, the inefficient separation of biomass can affect the quality of the activated sludge effluent, implying on most occasions an impact on the receiving ecosystem. These kind of undesired situations, known as activated sludge solids separation problems, are one of the main causes of inefficiency in activated sludge systems. They include: filamentous bulking, non-filamentous bulking, biological foaming, dispersed growth, pin-point floc and rising sludge. The origin of solids separation problems is (except from rising sludge) an imbalance between the different microbiological communities responsible for the biomass settleability: the floc-forming bacteria and the filamentous bacteria. Due to this microbiological origin, their identification and control is a tough task for plant operators.
Knowledge-Based Decision Support Systems (KBDSS) are a group of tools from the Artificial Intelligence domain characterized by their capability to represent heuristic knowledge and to work with large amounts of data. The main objective of the present thesis is to develop and validate a KBDSS specially designed to support plant operators to handle solids separation problems of microbiological origin occurring in activated sludge systems. In order to achieve this objective, the developed KBDSS must accomplish with the following characteristics: (1) the implementation of the system must be viable and realistic in order to ensure its proper operation; (2) the reasoning process followed by the system must be dynamic and evolutive in order to match the necessities of the domain and (3) the reasoning must be also intelligent,.
First of all, in order to guarantee the feasibility of the system, a thorough study, at a local scale (Catalonia) has contributed to the determination of the most common parameters generally used to diagnose, monitor and control these problems as well as to the detection of the existing limitations that the suggested KBDSS should overcome.
The results obtained from past applications of KBDSS has demonstrated that the main bottleneck in developing KBDSS is the structure of the knowledge base (KB), where all the knowledge acquired from the domain is represented, together with the necessary reasoning processes. In our approach, the additional complexity and the corresponding necessities imposed by the dynamic nature of the domain exacerbate the limitations in developing a feasible system. In this case, a previous conceptualisation phase was considered in which a conceptual design of the system was set up. The Domino Model was suggested as a tool to conceptually design the system.
Finally, in order to efficiently fulfill its main tasks, the last main objective or characteristic that the KBDSS must accomplish is the use of intelligent reasoning. In our approach, an Expert system (based on expert knowledge) and a Case-Based Reasoning System (based on experiential knowledge) have been and integrated as the main intelligent tools to carry out the goals of the KBDSS. In chapter 5 the development of the dynamic ES is presented. In chapter 6, a new temporal approach for classical CBRS is depicted, the Episode-Based Reasoning System (EBRS). Next, in chapter 7 some details of the KBDSS implementation in the G2 environment are presented. After that, in chapter 8 the results obtained during the 11 months of validation are depicted, including the results regarding the accuracy, adequacy, usefulness and usability of the system, which have been validated both experimentally (before the implementation) and as a result of the system's implementation in the Girona WWTP. Finally, in chapter 9, the main conclusions derived from the present thesis are enumerated.

Background With the expansion of an aging population and the rise in the prevalence of chronic conditions, medicine use has increasingly become prevalent, with global annual costs over 1.2 trillion dollars. If used appropriately, medicines are powerful weapons which can relieve debilitating symptoms, cure diseases, prevent morbidity and mortality and improve patient health outcomes. However, medicines are often used inappropriately. The inappropriate use of medicines can have significant adverse consequences. Additionally, irrespective of the appropriateness of medicine use, there is often inherent burden associated with long term multiple medicine taking, which may impact on post treatment Health-Related Quality of Life (HRQoL) outcomes. For patients, requiring long term medicines, there is often associated psychological and physical difficulties, socioeconomic challenges, and sometimes social exclusion. The inherent burden along with inappropriate use of medicine place patients at greater risk of experiencing significant clinical, economic and humanistic burden. Research has shown that medicine-focused and patient-centered services also known as ‘Pharmaceutical care (PC)’ have been effective in improving medication related clinical outcomes and saving medicine related health care expenditure. The economic and clinical benefits of PC services have been well demonstrated. However, despite the increasing number of studies evaluating the impact of PC on humanistic outcomes over the last 30 years, results are often mixed and conflicting. The complete picture of the benefit of PC services in improving humanistic outcomes remains unclear to date. The following section describes two potential reasons for this. First, in contrast to economic and clinical outcomes which have well-established measures to evaluate and quantify these outcomes, there is no medicine-related standard measure to evaluate humanistic outcomes specific to PC services. Second, apart from biological manifestations of medicines (e.g. side effects), the social, psychological and functional burden of taking medicines has not been well explored in peer-reviewed literature. However, measurement of clinical or economic outcomes are not enough to understand the entire spectrum of medicine related impact on a patient’s health. Thus, this third humanistic construct is necessary to compliment clinical and economic outcomes, and to understand the entire spectrum of medicine related health outcomes. In addition to providing insights into the burden of medicine on health and well-being, such a measure may facilitate evaluation of humanistic outcomes of practice and research. Aims and objectives The overall aim of this thesis was to develop and validate a medicine-specific quality of life measure intended to (i) Assess the burden of medicine on functioning and well-being (ii) Evaluate the benefit of pharmaceutical care interventions on medicine specific quality of life outcomes. The specific objectives of this thesis were to: (1) Explore the physical, social, psychological determinants of medicine impact on patient’s health, and well-being. (2) Determine the sensitivity of domains of HRQoL measures to PC interventions. (3) Investigate the gap in the HRQoL measures used in PC studies. Methods The development and validation of the proposed measure was undertaken in three phases. Phase I involved two stages. The first stage involved an in-depth understanding of the impact of medication burden and the development of a theoretical and conceptual framework. This was achieved through meta-synthesis of qualitative studies (Chapter Three) and provided a foundation for item generation. In the second stage, the need for a new measure was established based on evidence generated from a meta-analysis of the impact of PC on HRQoL outcomes and a content analysis of HQRQoL measures used in PC studies (Chapters Four and Five). Phase II involved generating an item bank, developing and refining of a pool of items, and determining the response format. Phase III involved psychometric evaluation of the tool (Chapter Six). To evaluate psychometric properties of MRB-QoL, consumers aged 18 and older, living with chronic medical conditions and on multiple medicines completed the MRB-QoL survey. The instrument was psychometrically tested for reliability and validity. Exploratory Factor Analysis (EFA) was used to determine factor structure underlying the MRB-QoL items. Additionally, objective measurements of medication burden such as Medication Regimen Complexity Index (MRCI), Drug BurdenI (DBI), and a disease burden -Charlson’s Comorbidity Index (CCI) were used for testing construct validity (e.g convergent, discriminant, known groups) of MRB-QoL. Finally, the applicability of MRB-QoL as a measure of medication related quality of life outcome was tested through an exploratory cross-sectional study (Chapter Seven). Association between domains of MRB-QoL and medical condition related factors (i.e number of comorbidities, CCI), medication related factors (i.e number of medicines, DBI, MRCI), and demographic factors was explored using simple linear regression and then multiple linear regression analyses. Results A meta-synthesis of Medication-Related Burden (MRB) and Patient’s Lived Experience with Medicine (PLEM) in Chapter Three provided new insights into MRB which had not been previously reported in the literature, prior to the commencement of this thesis. It uncovered consumers’ experience of taking medicines and the burden they encounter in their day-to-day life. It generated evidence that MRB has a negative impact on patient’s health and wellbeing, beliefs and behavior towards medicine and that it is a potential risk for Drug Related Problems (DRPs). The review also highlighted clinical implications of the findings, emphasizing the need and importance of considering MRB during pharmacotherapeutic decision making, to meet a patient’s medication related needs and improve medication therapy outcomes. Chapter Four presents a systematic review and meta-analysis of 48 studies and identified that PC had significant improvement in at least one domain of HRQoL in 18 of 32 studies which used a generic measure and 16 of 32 studies which used a disease specific measure. It showed the sensitivity of some domains of HRQoL measures to PC interventions, such as general health (Standardized mean difference/SMD 0.36; 95% CI= 0.12, 0.59), social functioning (SMD 0.59; 95% CI= 0.14, 1.04) and physical functioning (SMD 0.30; 95% CI= 0.11, 0.48) of the Short Form 36 items health survey (SF-36). The review did not demonstrate a significant impact of PC on HRQoL when heart failure-specific (SMD -0.17; 95% CI= -0.43, 0.09), asthma-specific (SMD 0.17; 95% CI= -0.03, 0.36), and chronic obstructive pulmonary disease-specific (SMD -0.09; 95% CI= -0.37, 0.19) measures of HRQoL were used. Emphasizing the lack of sensitivity of evaluated measures, this review reported that existing HRQoL measures are insufficient to reflect the complete picture of the benefit of PC interventions in improving HRQoL outcomes. A systematic review and content analysis in Chapter Five followed, identifying 1019 items from 10 generic and 27 disease specific measures of HRQoL used in 117 PC studies published between 1990 and 2015. This review indicated a paucity of items pertaining specifically to medicines, with only 34 of 1019 items related to medicine. It revealed that measures of HRQoL used in PC studies provided a very limited coverage of items related to the burden of medicine taking, therefore, had limited potential for use as a sole humanistic measure in evaluating PC interventions. The next part of this thesis discussed the development and psychometric testing of MRB-QoL tool. After undergoing item reduction using Exploratory Factor Analysis (EFA), MRB-QoL items were reduced from 76 items to 31-items, with a 5 factor solution explaining 72% of the total variance. The five factors were interpreted as: Routine and regimen complexity (11 items), Psychological burden (6 items), Functional and role limitation (7 items), Therapeutic relationship (3 items), and Social burden (4 items). All factors showed good internal consistency reliability (Cronbach’s alpha ranging from 0.87 to 0.95). Discriminant validity was demonstrated via the tool’s correlations with MRCI (r -0.16 to 0.05), DBI (r 0.12 to 0.28), and CCI (r -0.23 to -0.15). Patients on polypharmacy, multiple morbidity, and DBI>0 had higher scores of MRB-QoL indicating evidence for known group validity. In a cross-sectional study conducted applying MRB-QoL as an outcome measure, exposure to medicines with anticholinergic and sedative effects (DBI>0) was the only medicine related factor significantly associated with multiple domains of MRB-QoL. In a multivariate linear regression analysis, an increase in DBI was significantly associated with a decrease in psychological (β -0.15, p<0.001) and functional well-being (β -1.79, p<0.001) whereas both polypharmacy and MRCI were not associated with any of the MRB-QoL domains. Overall, this study provided preliminary evidence for potential factors associated with MRB-QoL outcomes. Future longitudinal studies are proposed to better understand predictors of MRB-QoL, with then the potential for this tool to be utilized as a robust measure in clinical intervention studies as an appropriate humanistic measure of the impact of PC services. Conclusions Prior to the commencement of this thesis, the sensitivity and specificity of HRQoL measures to PC interventions was unknown. Specifically, no systematic body of work had been conducted to provide an in-depth insight into the magnitude of PC interventions on HRQoL, the extent of sensitivity of the domains of HRQoL to PC interventions, nor whether the items of HRQoL pertained specifically to medicines. Additionally, comprehensive investigation into Medication-Related Burden (MRB) had not been attempted. The body of work presented in this thesis uncovered the gap in the literature regarding evidence pertaining to the impact of PC on HRQoL outcomes, and the sensitivity of measures of HRQoL to PC interventions. This thesis has demonstrated that existing HRQoL measures have limited use as sole humanistic measures for evaluation of PC interventions, they do not have focus on the burden imposed by medicines. Thus, the judicious selection of HRQoL measures for evaluation of PC interventions is crucial from research, practice and policy perspectives. This includes consideration of the proximity of the content of HRQoL measure to PC services, and their sensitivity to capture changes in quality of life attributed to the burden of medicine. This thesis has also demonstrated a wholistic and profound understanding of MRB i.e. the physical, social, psychological and financial burden of medicine use on patient’s health and well-being (Chapter Three, Figure 4). MRB has been conceptualized as the difference between the observed and theoretically expected post treatment HRQoL (Figure 3). The overall work presented in this thesis resulted in the development and validation of MRB-QoL, which is the first comprehensive measure of the burden of medicine use on functioning and well-being. With good initial psychometric properties (i.e. internal consistency reliability, construct, known groups, discriminant and convergent validity), MRB-QoL is a promising patient self-reported measure of physical, social and psychological burden of medicine use. It is a tool that has the potential to be applied in research pertaining to the evaluation of medication focused interventions. In clinical practice, it may aid screening of patients at high risk of experiencing medication related burden. Identification of high risk patients and detection of the particular burden encountered, is an opportunity for health care providers to make an informed decision about ongoing therapies for patients. In the future, with further psychometric testing of MRB-QoL along with good uptake in clinical practice and research, MRB-QoL has the potential to inform patient care and thereby help minimize the burden of medicine taking on health and well-being of patients

Passenger safety and comfort are important aspects in the process of vehicle development. The world is heading towards developing the safest possible vehicle on the road. Using vehicle motion control functions is one of the ways to enhance vehicle stability. These motion control functions need to be developed in an energy optimised way. By complementing some of the development process with virtual models, both the development time and cost could be minimised. Hence, a sustainable way of control function development could be achieved. In order to verify, validate and calibrate vehicle motion control functions, an accurate model of the virtual vehicle is required. Hence, a research question on how good the virtual model needs to be for the purpose has been addressed. This report suggests a framework in order to determine the capabilities of a virtual vehicle.In this report, a comparison study has been carried out by exciting the real car and virtual model of a Volvo XC90 with a focus of covering the six degrees of freedom (Yaw, pitch, roll, longitudinal, lateral and vertical). A semi automated framework that possesses the capability of automating the testing in a virtual platform has been established. From the test results, the virtual vehicle capabilities were determined. Further, in the second part of the report, an example use case has been considered by taking two calibration sets of Electronic stability control (ESC) system in order to verify the previously established framework.The analysis includes various levels of plant and controller complexity such as Model-in-loop, Software-in-loop and Hardware-in-loop and on two different road surfaces, low friction and high friction. From the observations, the virtual models considered correlates well for the purpose of verification and validation. However, for the purpose of calibration, the models need to be fine-tuned in the virtual platform. Furthermore, the correlation on low friction road surface could be improved by simulating the tests using an advanced tyre model. Overall, this study helps in choosing the correct complexity of various subsystems in a vehicle for the purpose of verification, validation and calibration of vehicle motion control functions.
Passagerarsäkerhet och komfort är viktiga aspekter i utvecklingen av ett fordon. Världen är på väg mot att utveckla säkraste möjliga fordon på vägen. Användning av fordonetse rörelsekontrollfunktioner är ett av sätten att förbättra fordonets stabilitet. Dessa rörelsekontrollfunktioner måste utvecklas på ett energioptimerat sätt. Genom att komplettera en del av utvecklingsprocessen med virtuella modeller kan både utvecklingstid och kostnad minimeras. Därför kan ett hållbart sätt att utveckla funktionerna för kontrollfunktioner uppnås. För att verifiera, validera och kalibrera fordonets rörelsekontrollfunktioner krävs en detaljerad modell av ett virtuellt fordon. Därför har en forskningsfråga om hur bra den virtuella modellen måste vara för ändamålet behandlats. Denna rapport föreslår ett ramverk för att bestämma funktionerna hos virtuella fordon.I denna rapport har en jämförelsestudie genomförts genom att excitera den verkliga bilen och den virtuella modellen av en Volvo XC90 med fokus på att täcka de sex frihetsgraderna (gir, nick, roll, längs, lateral, vertikal). Ett semi-automatiserat ramverk som har förmågan att automatisera testningen i en virtuell plattform har skapats. Från testresultaten bestämdes de virtuella fordonsfunktionerna. Vidare har i den andra delen av rapporten ett exempel på användningsfall beaktats genom att man tar två kalibreringsuppsättningar av ESC-system (Electronic Stability Control) för att verifiera det tidigare etablerade ramverket.Analysen innefattar olika nivåer av modell- och styrenhetskomplexitet såsom Model-in-loop, Software-in-loop och Hardware-in-loop och på två olika vägytor, låg friktion och hög friktion. Enligt observationerna är de virtuella modellerna väl korrelerade för verifiering och validering. För kalibreringen måste dock modellerna finjusteras på den virtuella plattformen. Dessutom kunde korrelationen på lågfriktionsvägytan förbättras genom att simulera testerna med hjälp av en avancerad däckmodell. Sammantaget hjälper den här studien att välja rätt komplexitet hos olika delsystem i ett fordon för verifiering, validering och kalibrering av fordonets rörelsekontrollfunktioner.

Contexte : L'évolution des pratiques en alcoologie, suivant le modèle des soins centrés sur la patient, permet de revisiter le concept de rémission pour une meilleure prise en compte du point de vue du patient, participant de façon prépondérante dans la définition de ses objectifs thérapeutiques et dans leur évaluation. Pourtant, peu de ces critères subjectifs de l’évaluation du devenir des patients ont véritablement inclus le patient dans leur développement. Jusqu'à récemment, les instruments mesurant la qualité de vie les plus utilisés en alcoologie étaient génériques, constitués d'items générés par les experts et s'appuyant sur la littérature existante, mais n'ayant pas impliqué de patient dans leur développement, c’est-à-dire dans la génération des items. Méthodes : nous avons réalisé une revue systématique de la littérature recensant les essais thérapeutiques randomisés testant une intervention chez les patients alcoolodépendants, et mesurant son efficacité sur la qualité de vie. Nous avons répertorié les dimensions explorées dans les instruments existants. Il a été montré que ces instruments n'exploraient pas de façon optimale l’impact de l’alcoolodépendance sur la qualité de vie. Sur ce constat, nous avons développé conformément aux recommandations de la Food and Drug Administration (FDA) sur le développement des « Patients-Reported Outcomes » une échelle spécifique au trouble d'usage d'alcool, à partir du vécu rapporté par les patients. Nous avons utilisé la méthode des groupes focus, réalisés en parallèle en France et en Grande-Bretagne auprès de 38 patients présentant un trouble d’usage d’alcool. Ces groupes ont pu générer un pool d’items, testés secondairement par des entretiens cognitifs individuels auprès de 31 patients, aboutissant à l’échelle finale « Alcohol Quality of life Scale » (AQoLS). Nous avons ensuite validé l’échelle AQoLS sur un échantillon de 285 patients français présentant un trouble d’usage d’alcool, recrutés dans des centres sélectionnés de façon aléatoire en France. Résultats : L’échelle développée comporte 34 items, répartis selon 7 dimensions : les relations sociales, les activités, les conditions de vie, s’occuper de soi, les émotions négatives, le sommeil et la perte de contrôle. L’analyse de l’échelle a pu confirmer 6 de ces sept dimensions, avec une répartition légèrement différente des items. La dimension « s’occuper de soi » a disparu au profit d’une nouvelle dimension, l’estime de soi. Les dimensions de contrôle et d’estime de soi sont novatrices dans un instrument de qualité de vie liée à la santé, chez l’adulte. L’échelle a montré de bonnes propriétés psychométriques, avec une bonne consistance interne (Cronbach = 0.96), et une corrélation modérée mais significative avec certains sous-scores de la SF-36 et l’EQ-5D. Un travail complémentaire qualitatif a pu illustrer les liens entre les différents domaines impactés, et notamment la proximité de perception dans les propos des patients, entre l’estime de soi, la perte de contrôle et les troubles cognitifs. Conclusion : L’évolution vers un modèle des soins centrés sur le patient permet d’envisager une conception différente de la rémission et de construire et valider une mesure de la qualité de vie se rapprochant des préoccupations des patients, l’échelle AQoLS. Deux dimensions novatrices ont été rattachées à ce concept : la perte de contrôle du point de vue du patient, et l’estime de soi
Context : The evolution of practices in alcohol use disorder field, following the model of patient-centered care, lets revisit the concept of remission for a better consideration of the patient's point of view, participating predominantly in the definition of therapeutic objectives and in their assessment. Yet few of these subjective criteria of the evaluation of patient outcomes have actually included the patient in their development. Until recently, quality of life instruments the most used among patients with alcohol use disorder were generic ones, and their development and particularly generation of items did not involve patients, but rather experts and were based on existing literature. Methods : we conducted a systematic literature review identifying randomized clinical trials testing an intervention in alcohol-dependent patients, and measuring its effectiveness on quality of life. We have listed the dimensions explored in the existing instruments. It has been shown that these instruments did not optimally explore the impact of alcohol dependence on quality of life in this population. On this, we have developed a scale specific for patients with alcohol use disorder, following the recommendations of the Food and Drug Administration (FDA) on the development of "Patient-Reported Outcomes", namely involving patients extensively. We used the method of focus groups conducted in parallel in France and Great Britain with 38 patients with alcohol use disorder. These groups allowed the generation of a pool of items, secondarily tested by individual cognitive interviews with 31 patients, resulting in the final scale "Alcohol Quality of Life Scale" (AQoLS). We then validated the AQoLS scale on a sample of 285 French patients with alcoho use disorder, recruited from randomly selected centers in France. Results: The scale has 34 items developed, distributed in seven dimensions: social relationships, activities, living conditions, looking after self, negative emotions, sleep and loss of control. The validation study confirmed six of the seven dimensions, with a slightly different distribution of the items. The "looking after self" dimension disappeared in favor of a new dimension of self-esteem. Control and self-esteem dimensions are innovative in a health-related quality of life instrument in adults. The scale showed good psychometric properties, with good internal consistency (Cronbach = 0.96), and a moderate correlation with sub-scores of the SF-36 and EQ-5D. A qualitative complementary work could illustrate the links between the different affected areas, including the proximity in patients’ perception between self-esteem, loss of control and cognitive impairment. Conclusion : The move towards a model of patient-centered care allows considering a different approach of remission and to build and validate a measure of health-related quality of life close to the concerns of patients with a alcohol use disorder, AQoLS scale. Two innovative dimensions were attached to this concept: loss of control from the patient's perspective, and self-esteem

Abstract There is a great interest by practitioners and academics to consider patents as a strategic and organizational concern aiming to bring economic and competitive advantage, in addition to its legal value. To this end, patent management has a critical importance for enterprises operations, and successful firms are also known by their well-structured management process and organizational structure for patenting. However, there is a demand for a holistic, valid and practical measurement instruments to monitor patent management and assess firm patent portfolios. To fill this gap, the current study develops and validates patent management measurement scales at the firm level. To this purpose, a four-step (i.e. specify domain of the construct, item generation, scale purification, and scale finalization) widely recognized and structured scale development and validation procedure towards developing psychometrically sound measures is adopted. The first two steps focus on the development of measurement scales within a defined scope of investigation. To this end, an in-depth literature review supported by a qualitative analysis through interview with experts is carried out. These analyses allowed conceptualizing the theoretical background of the constructs under investigation, which leads us to develop a theoretical framework of patent management with core processes and supporting dimensions and associated activities and organizational aspects. Then, the pool of measurement items for each activities and organizational aspects are generated. In the third and fourth steps, we carried out exploratory factor analysis (EFA) and a confirmatory factor analysis (CFA) to purify and validate, respectively, the measurement items using two samples of primary data collected through an online survey sent to firms located in Southern and Northern European countries (the EFA) and Central European countries (the CFA). The results of EFA and CFA yield some changes to the initial framework and the measurement items. More particularly, the study demonstrates that patent management is composed of five core processes (i.e. patent generation, freedom to operate, patent portfolio management, patent exploitation and enforcement, and patent intelligence) and two supporting dimensions (patent strategy and organization for patenting). For each core process and supporting dimension, the underlying factor structure with the associated measurement items are finalized after removing some items based on established criteria for item retention. Reliability and validity are also assessed to further support the soundness of the measurement scales. This study has both theoretical and practical implications. For academics, the study extends existing research by offering an up-to-date and comprehensive conceptualization of firm patent management activities, thereby enriching patent management body of literature. Moreover, it offers researchers a basis to test hypotheses about the relationships among processes and dimensions of patent management, and firms output attributes (e.g. performance) using real data collected from firms. In addition, the scales developed in this study for each core process and supporting dimension can also be used separately to suit specific research needs and examine a particular aspect of patent management. For managers, the study offers a comprehensive framework that can be used as an assessment tool to evaluate firm patent management. Moreover, the measurement of the current level of patent management can be used as a basis for managers and entrepreneurs to adopt a proactive attitude towards patent management.
Sommario Considerare i brevetti come un aspetto strategico-organizzativo che mira a portare un vantaggio economico e competitivo, in aggiunta al suo valore legale, sta diventando una pratica sempre più consolidata tra professionisti e accademici. In tal senso, la gestione dei brevetti ha un'importanza fondamentale per le imprese, tanto che le aziende di successo sono altrettanto note per la struttura organizzativa ed i loro efficaci processi di gestione dei brevetti. Tuttavia, vi è una richiesta di strumenti di misura olistici, validi e pratici per gestire i brevetti e valutare portafogli brevetti delle aziende. Per colmare questa lacuna, tale lavoro di tesi sviluppa e convalida delle scale di misura con riferimento al processo di gestione brevettuale a livello aziendale. A questo scopo, è stata adottata un’ampiamente conosciuta procedura di sviluppo e validazione di scale di misura strutturata in quattro fasi (i.e. specificare il dominio del costrutto, generare gli item, purificare le scale e finalizzare le scale). Le prime due fasi si concentrano sulla definizione dell’ambito di indagine e sullo sviluppo di scale di misura in questo ambito. A tal fine, è stata effettuata una revisione approfondita della letteratura supportata da un'analisi qualitativa attraverso delle interviste con esperti. Queste analisi hanno permesso di concettualizzare il background teorico dei costrutti oggetto di indagine, il che ha portato a sviluppare un framework di gestione dei brevetti composto da processi core e dimensioni di supporto, al cui interno sono state definite le rispettive attività e gli aspetti organizzativi. Quindi, è stato generato l’insieme di item di misura per ciascuna attività e aspetto organizzativo. Nella terza e quarta fase, sono state effettuate un'analisi fattoriale esplorativa e un'analisi fattoriale confermativa per purificare e validare, rispettivamente, gli item di misura utilizzando due campioni di dati primari raccolti attraverso un sondaggio online inviato alle aziende situate in Paesi dell'Europa meridionale e settentrionale (analisi esplorativa) e paesi dell'Europa centrale (analisi confermativa). I risultati di tali analisi hanno portato ad alcune modifiche al framework iniziale e agli item di misura. Più in particolare, lo studio dimostra che la gestione dei brevetti è composta da cinque processi fondamentali (i.e. generazione di brevetti, freedom to operate, gestione del portafoglio brevetti, sfruttamento e enforcement dei brevetti e intelligence sui brevetti) e due dimensioni di supporto (strategia dei brevetti e organizzazione per la brevettazione). Per ciascun processo principale e dimensione di supporto, sono stati definiti attività e fattori organizzativi (i cosiddetti “fattori”), con i relativi item di misura, dopo aver rimosso alcuni item in base a precisi criteri stabiliti in precedenza. Al fine di supportare ulteriormente la solidità delle scale di misurazione, sono state valutate l'affidabilità e la validità delle scale di misura con appositi test statistici. Questo studio ha implicazioni sia teoriche che pratiche. Dal punto di vista accademico, lo studio estende la ricerca esistente offrendo una concettualizzazione completa e aggiornata delle attività di gestione dei brevetti a livello aziendale, arricchendo in tal modo la letteratura sulla gestione dei brevetti. Inoltre, offre ai ricercatori una base per testare le ipotesi sulle relazioni tra i processi e le dimensioni della gestione dei brevetti e le caratteristiche di output delle imprese (e.g. prestazioni) utilizzando dati reali raccolti dalle aziende. Inoltre, le scale sviluppate in questo studio per ciascun processo core e dimensione di supporto possono anche essere utilizzate separatamente per soddisfare esigenze di ricerca specifiche ed esaminare un aspetto particolare della gestione dei brevetti. Per i manager, lo studio offre un quadro completo sulla gestione brevettuale che può essere utilizzato come strumento di valutazione per analizzare la gestione dei brevetti. Inoltre, la misura dell'attuale livello di gestione dei brevetti può essere utilizzata come base per manager e imprenditori per adottare un atteggiamento proattivo nella gestione brevettuale.

Since the first robotic surgical intervention was performed in 1985 using a PUMA industrial manipulator, development in the field of surgical robotics has been relatively fast paced, despite the tremendous costs involved in developing new robotic interventional devices. This is due to the clear advantages to augmented a clinicians skill and dexterity with the precision and reliability of computer controlled motion. A natural extension of robotic surgical intervention is the integration of image guided interventions, which give the promise of reduced trauma, procedure time and inaccuracies. Despite magnetic resonance imaging (MRI) being one of the most effective imaging modalities for visualizing soft tissue structures within the body, MRI guided surgical robotics has been frustrated by the high magnetic field in the MRI image space and the extreme sensitivity to electromagnetic interference. The primary contributions of this dissertation relate to enabling the use of direct, live MR imaging to guide and assist interventional procedures. These are the two focus areas: creation both of an integrated MRI-guided development platform and of a stereotactic neural intervention system. The integrated series of modules of the development platform represent a significant advancement in the practice of creating MRI guided mechatronic devices, as well as an understanding of design requirements for creating actuated devices to operate within a diagnostic MRI. This knowledge was gained through a systematic approach to understanding, isolating, characterizing, and circumventing difficulties associated with developing MRI-guided interventional systems. These contributions have been validated on the levels of the individual modules, the total development system, and several deployed interventional devices. An overview of this work is presented with a summary of contributions and lessons learned along the way.

This thesis describes bioanalytical methods for drug determination in biological matrixes, with drugs in focus used against diseases largely affecting low-income countries. Solid-phase extraction is used for sample cleanup, and processed samples are analyzed by liquid chromatography. Developed bioanalytical methods are validated according to international guidelines. Eflornithine (DFMO) is a chiral drug, used for treating human African trypanosomiasis. A bioanalytical method for determination of DFMO enantiomers in plasma is presented. The enantiomers are detected by evaporative light-scattering detection. The method has been applied to determination of D-DFMO and L-DFMO in rats, after intravenous and oral administration of racemic DFMO. It is concluded that DFMO exhibits enantioselective absorption, with the more potent enantiomer L-DFMO being less favored. Sulfadoxine (SD) and sulfamethoxazole (SM) are sulfa-drugs used for malaria and pneumonia respectively. Two methods are described for simultaneous determination of SD and SM in capillary blood sampled on filter paper. The former method allows direct injection of extracts from dried blood spots (DBS), while for the latter method solid-phase extraction is added. Pre-analytical factors contributing to measurement uncertainty is also discussed, and it is concluded that it is of high importance that homogeneity in type of sampling paper and sampling volume is assured. Piperaquine (PQ) is an antimalarial, increasingly used in artemisinin combination therapy. A method for determination of piperaquine in DBS is presented. By using a monolithic LC column, a very short LC analysis of two minutes per sample is achieved. A method for simultaneous determination of three antiretroviral drugs i.e. lamivudine (3TC), zidovudine (AZT) and nevirapine (NVP), in DBS samples is described. The method is applied to drug determination in two subjects after receiving standard antiretroviral treatment. Conclusion is that the method is suitable for determination of 3TC and NVP, and to some extent for AZT.

Educators in a low socioeconomic urban school district have been concerned with the quality of professional development (PD) training provided by the district. This issue affects students, parents, and teachers. Guided by the educational philosophy of inquiry and community, which hold that empowering teachers with validated PD could improve teacher pedagogy and perhaps academic outcomes, this project study examined (a) what benefits a standardized professional development content validation program for the 21st century can provide and, (b) what standardized professional development content validation for the 21st century looks like. A sequential exploratory mixed-methods design was used on a purposive sample of 8 teachers, who participated in semistructured, open-ended interviews. A quantitative questionnaire collected perceptions of teachers at the school. Interview data were analyzed via an inductive analysis approach, and survey data were analyzed via descriptive statistics. The findings of this sequential mixed methods research revealed that the content of PD activities often lacked structured validation for teachers to master important skills in their content area, new skills were undiscovered, and their pedagogy was underdeveloped. The outcome was a 3-day workshop designed to provide PD content validation for educators in 1 district in Washington State. Positive social change implications include teachers who can engage students in an informed, confident, professional manner, and increased teacher satisfaction at the research site as well as in other rural schools. Implementing this workshop will provide useful knowledge for policymakers, educators, and other researchers who are looking for a clearer definition of PD content for the 21st century.

This series of studies was carried in order to develop and validate the Alzheimer’s Questionnaire (AQ). The underlying rationale for the creation of the AQ was to provide clinicians with a brief and easy-to-use informant-based assessment of symptoms associated with Alzheimer’s disease (AD). Initial studies of the AQ found that it has both high sensitivity and high specificity for differentiating individuals with AD and its prodrome, amnestic mild cognitive impairment (MCI). The AQ’s accuracy in identifying MCI was explored further in an additional study which sought to determine which items on the AQ were best predicted the presence of MCI. Four items were strongly associated with MCI which were: repetition of statements and/or questions [OR = 13.20 (3.02, 57.66)]; trouble knowing the day, date, month, year, and time [OR = 17.97 (2.63, 122.77)]; difficulty managing finances [OR = 11.60 (2.10, 63.99)]; and decreased sense of direction [OR = 5.84(1.09, 31.30)]. Concurrent validity was established through another study which found that the AQ correlated moderately with the MMSE (r = -0.56) and MoCA (r = -0.46) while a strong correlation (r = 0.79) was found with the Clinical Dementia Rating Sum of Boxes (CDR-SOB). Additional work found that the AQ correlated well with formal neuropsychological measures of episodic memory and executive function. Longitudinal analyses found that was AQ was a significant predictor of clinically meaningful decline as measured by the changes in CDR Global Score (OR = 1.20, 95% CI: 1.09, 1.32; p < 0.001). In addition, AQ identified clinically meaningful change among MCI cases at a greater rate(24%) than the MMSE (17%). This series of studies demonstrates that the AQ is an accurate instrument that correlates well with known measures of MCI and AD.

Summary Objective To develop a psychometrically sound self-report questionnaire, the Vocal Fatigue Index (VFI), to help identify individuals with vocal fatigue (VF) and characterize their complaints. Study Design Descriptive research—scale development. Methods Four laryngologists and six speech-language pathologists specialized in voice created a beta version of the VFI (version 1), an index of 21 statements they considered to reflect VF. Two hundred patients presenting to two different clinics completed the VFI-1. Two items from VFI-1 were excluded because of poor item-to-total correlations. The final VFI of 19 items (version 2), completed by 105 patients with voice complaints and 70 vocally healthy individuals, was assessed for its psychometric properties. Results Test-retest reliability for the final VFI was generally strong, as was sensitivity and specificity using the classification table under logistic regression for correctly distinguishing individuals with and without VF. Moreover, factor analysis indicated that VF may be characterized by three factors: (1) factor 1, related to tiredness of voice and voice avoidance, (2) factor 2, related to physical discomfort associated with voicing, and (3) factor 3, related to improvement of symptoms with rest. Conclusion The VFI is a standardized tool that can identify individuals with probable VF with good reliability, validity, sensitivity, and specificity.

Educators in a low socioeconomic urban school district have been concerned with the quality of professional development (PD) training provided by the district. This issue affects students, parents, and teachers. Guided by the educational philosophy of inquiry and community, which hold that empowering teachers with validated PD could improve teacher pedagogy and perhaps academic outcomes, this project study examined (a) what benefits a standardized professional development content validation program for the 21st century can provide and, (b) what standardized professional development content validation for the 21st century looks like. A sequential exploratory mixed-methods design was used on a purposive sample of 8 teachers, who participated in semistructured, open-ended interviews. A quantitative questionnaire collected perceptions of teachers at the school. Interview data were analyzed via an inductive analysis approach, and survey data were analyzed via descriptive statistics. The findings of this sequential mixed methods research revealed that the content of PD activities often lacked structured validation for teachers to master important skills in their content area, new skills were undiscovered, and their pedagogy was underdeveloped. The outcome was a 3-day workshop designed to provide PD content validation for educators in 1 district in Washington State. Positive social change implications include teachers who can engage students in an informed, confident, professional manner, and increased teacher satisfaction at the research site as well as in other rural schools. Implementing this workshop will provide useful knowledge for policymakers, educators, and other researchers who are looking for a clearer definition of PD content for the 21st century.

Abstract The workload of Verification and Validation (V&V) has increased constantly in the high technology industries. The changes in the business environment, with fast time-to-market and demands to decrease research and development costs, have increased the importance of efficient product creation process, including V&V. The significance of the V&V related know-how and testing is increasing in the high tech business environment. As a consequence, companies in the ICT sector have pressures for improving product development process and verification and validation activities. The main motive for this research arises from the fact that the research has been scarce on verification and validation from product development process perspective. This study approaches the above mentioned goal from four perspectives: current challenges and success factors, V&V maturity in different NPD phases, benchmarking automotive sector, and shifting the emphasis of NPD efforts. This dissertation is qualitative in nature and is based on interviewing experienced industrial managers, reflecting their views against scientific literature. The researcher has analysed the obtained material and made conclusions. The main implications of this doctoral dissertation can be concluded as a visible need to shift the emphasis of V&V activities to early NPD. These activities should be viewed and managed over the entire NPD process. There is a need for companies to understand the V&V maturity in different NPD phases and develop activities based on this understanding. Verification and validation activities must be seen as an integral element for successful NPD. Benchmarking other sectors may enable identifying development potential for NPD process. The automotive sector being a mature sector, has developed practices for successfully handling requirements during NPD. The role of V&V is different in different NPD phases. Set-based type V&V can provide required understanding during early product development. In addition, developing parallel technological alternatives and platforms during early NPD also support shifting the emphasis towards earlier development phases.

A reactive control system is a computer system reacting to certain stimuli emitted by its environment in order to maintain it in a desired state. Distributed reactive control systems are generally composed of several processes, running in parallel on one or more computers, communicating with one another to perform the required control task. By their very nature, distributed reactive control systems are hard to design. Their distributed nature and/or the communication scheme used can introduce subtle unforeseen behaviours. When dealing with critical applications, such as plane control systems, or traffic light control systems, those unintended behaviours can have disastrous consequences. It is therefore essential, for the designer, to ensure that this does not happen. For that purpose, rigorous and systematic techniques can (and should) be applied as early as possible in the development process. In that spirit, this work aims at providing the designer with the necessary tools in order to facilitate the development and validation of such distributed reactive control systems. In particular, we show how using a dedicated language called dSL (Distributed Supervision language) can be used to ease the development process. We also study how validations techniques such as model-checking and testing can be applied in this context.
Doctorat en Sciences
info:eu-repo/semantics/nonPublished

Thesis (M.S.)--Missouri University of Science and Technology, 2008.
Vita. The entire thesis text is included in file. Title from title screen of thesis/dissertation PDF file (viewed May 5, 2008) Includes bibliographical references (p. 21-22).

Organizational citizenship behaviors (OCBs) are the extra-role, voluntary behaviors performed by organization members for the benefit of the organization. These behaviors have been widely studied and several dimensions have been defined. However, the majority of the work on OCBs focuses on traditional organizations where all employees are collocated and can interact on a regular basis. With the changing workplace, employees can now work remotely or across different locations and still be expected to work together. Those employees who are not collocated may not feel the need to benefit the organization, but may feel connected to the team and therefore participate in virtual team citizenship behaviors (VTCBs).

This paper reviews the current OCB literature by defining OCBs, reviewing the empirical literature, and providing a critique of the current literature. Next, a framework for studying VTCBs is developed based on virtual team literature. I define and discuss the differences between VTCBs and OCBs. Next, I develop propositions for assessing construct validity using multiple validation approaches, including convergent, and divergent, and nomological validity. I then propose and conduct three interlocking studies to generate items for the scale (Study 1), to assess the dimensionality and psychometric properties of the scale and establish convergent and divergent validity (Study 2), and to test the proposed nomological model (Study 3). The results of each study and the implications of the studies are discussed.

Current evacuation models have been found to have limitations either in the scope of their simulation, or the size of the scenario that can be simulated. A model currently under development called EvacuatioNZ was produced to address some of these limitations. EvacuatioNZ is a coarse network model that simulates the occupant movement times as well as the human behaviour before and during the evacuation process. It incorporates the Monte Carlo approach in producing probability distributions of evacuation times. This model is designed to allow the expansion or modification of the program as more knowledge on human behaviour and occupant emergency movement is obtained, without the need to reproduce the entire model. The main aim of this research was to assist in the development of this evacuation model by carrying out validation processes that tested the model's components. This would allow the model to be used with reasonable confidence by designers and fire engineers. Individual component testing on the model has shown that the basic components of movement are working satisfactorily, and are producing results that are comparable to values produced by the Nelson and MacLennan flow equations. Tests using a combination of components have also been found to produce representative results, when similar assumptions are being used. However, more components, including the behavioural components, should be tested before this model can be used for design purposes. The current version of the program still has some limitations that need to be addressed in order to increase its functional value. Further research should also include the model validation using more calculation examples, as well as data from actual trial evacuations to validate the components of human behaviour in the model.

PONTIFÍCIA UNIVERSIDADE CATÓLICA DO RIO DE JANEIRO
A análise do perfil do investidor (API) ou Suitability é uma política de autorregulamentação implementada pela ANBIMA que tem como objetivo adequar à alocação de recursos de forma que estejam compatíveis ao perfil dos investidores. O objetivo principal desta pesquisa é desenvolver um questionário capaz de classificar os investidores das instituições financeiras considerando diversas características pessoais, principalmente a tolerância ao risco, tornando possível alinhar os interesses dos gerentes comerciais e de seus clientes. O instrumento foi elaborado seguindo as diretrizes estabelecidas pelo Código ANBIMA de Regulação e Melhores Práticas e adicionando uma escala elaborada por Grable e Joo (2010) com questões fundamentais capazes de medir a tolerância ao risco financeiro. A falta de um modelo padrão faz com que os profissionais financeiros desenvolvam e usem métodos simplificados geralmente limitados à simples conversações com os clientes sobre o nível de bem estar diante de diferentes cenários (GRABLE e LYTTON, 2001). Sendo assim, a contribuição deste trabalho foi à análise de possíveis falhas no processo atual e a busca por evidências de que a política de API poderia obter resultados mais significativos uma vez instituído um questionário padrão.
The present study has the objective of development and validation of a standard questionnaire applied to the Brazilian financial market which has the main objective to identify and classify clients. This instrument is part of the Now Your Client Policy that was implemented by Brazilian Financial and Capital Markets Association (ANBIMA), and could help institutions to advisory better their clients. The present article has the objective to develop and to verify the validity of a research instrument for the classification of investors according to their personal preferences and risk tolerance. In addition performing a suitability test allows the financial institutions to assess the investment objectives of the client, the client s financial ability to bear any related investment risks consistent with his investment objectives. The instrument was elaborated following the ANBIMA s regulations in addition to Financial Risk-Tolerance Scale developed by Grable and Joo in 2001. The lack of a standard model leads financial professionals to develop and use simplified methods, usually limited to simple conversations with clients about their level of well being in a variety of scenarios (GRABLE; LYTTON, 2001). Another contribution from this study is to show evidences that without a standard questionnaire is impossible to obtain accurate results among the different financial institutions.

Brand equity is an extensively researched subject associated with marketing performance measurement. Although brand equity is a significant source of competitive advantage online, previous conceptualisations and measures thereof overlook the unique characteristics of computer mediated environments that render consumers co-creators of brand value as opposed to passive recipients. Experience with interactive media such as the internet 1 has shown that simply replicating offline marketing effort online is not capitalising on the interactive opportunities offered by the internet. The internet's unique capabilities have significant implications for the development and management of brands and, by extension, to the translation of brand value into consumer based brand equity. By choosing to focus on e-tail brands, a multi-phased research programme was initiated to identify the facets of etail brand equity, and then develop and validate a scale for its measurement. Following well established procedures for scale development and validation in the social sciences (e.g., Churchill 1979; Gerbing and Anderson 1988), an exploratory stage was first undertaken in conjunction with a literature review to identify the facets of e-tail brand equity. This involved sixteen depth interviews with brand experts and two focus groups with consumers. Based on the results of this exploratory qualitative stage, e-tail brand equity was assumed to be three-faceted, the dimensions being emotional connection, online experience, and responsive service nature. An initial item pool was then developed to tap the aforementioned facets. In this thesis a lowercase "i" is used for the word "internet" (cf. Schwartz 2002). Next, quantitative data were collected by means of a web based consumer survey, administered to a sample of UK online shoppers, all of whom were registered users of a leading European online reward programme. After a series of iterative statistical analyses, including coefficient alpha, item-to-total correlations, exploratory and confirmatory factor analysis, the initial pool was reduced to a more tractable number of items. Items of fulfilment and trust failed to load on the hypothesised factors, responsive service nature and emotional connection respectively, but emerged as separate factors. Various tests of validity, reliability, and unidimensionality provided preliminary evidence of the stability of the resulting scale's psychometric properties, and suggested that e-tail brand equity is a second order construct with five independent but correlated dimensions: emotional connection, online experience, responsive service nature, trust, and fulfilment. The proposed e-tail brand equity scale is reflective of a paradigm shift precipitated by the internet and its related technologies. No longer is brand equity the outcome of "cultural engineering" branding, but is instead the result of a dialectical process between managers and consumers. The implications of this research are both theoretical and practical. The 12-item e-tail brand equity scale can potentially be used for a variety of applications in e-tailing, and can also serve as the basis for further empirical research in marketing.

Chrononutrition, or the circadian timing of food intake, has garnered attention as a topic of study due to its associations with health (e.g., weight gain); however, a valid assessment of chrononutrition in daily life has not yet been developed. The present study therefore aimed to develop and validate both a diary and questionnaire version of the Chrononutrition Profile which assess 6 components of chrononutrition that have been associated with poor health (breakfast skipping, night eating, eating window, evening latency, largest meal, and evening eating). The measure demonstrated preliminary evidence of test-retest reliability and convergent validity, though concurrent validity was not interpretable. Based on analyses, the final diary and questionnaire versions of the CP assess 5 components of chrononutrition: breakfast skipping, night eating, eating window, evening latency, and evening eating. This measure offers health care professionals, researchers, and stakeholders a cost-effective method of evaluating chrononutrition and identifying targets for health improvement.

The thesis paper will be covering the grounds of what, how and why a Universal Testing Machine is used, an alternative to the generic Universal Testing Machinedesigns and how it is built. The primary objective of this thesis work is to designand build a Universal Testing Machine which can handle a load up to 10kN forpolymer materials which is cost effective and modular. The operating system and electronic components are open-source leaving room for further development and compression test. The mechanical properties of material can be measured through tensile test. It gives the the characteristic of tensile strength, yield strength, modulus of elasticity, ductility, resilience, and toughness. The thesis paper covers the use of real timeimage processing for calculating and plotting of a stress strain curve. It also covers the implementation of open source code, using a MATLAB user interface to control, analyse and compile the results of tests done using the new machine. These results have been compared to values obtained from a standard Universal Testing machine and thus validated. As the machine is modular, the parts can be swapped with better components that fits the requirement, leaving the possibility for easy upgrades in the future.

A Magical Contagion and AIDS Scale was developed to address problems with existing Contagion and AIDS measures. Magical Contagion is an influence that exists after contact is terminated. It is comprised of Permanence, Holographic Effects, Moral Germ Conflation and Backward Action. Data from 280 undergraduates revealed low mean levels of Magical Contagion and AIDS. Contagion effects did not differ on demographic variables. Content validity, criterion-related validity, discriminate validity, and internal consistency were evaluated. Significant correlations were found between the Contagion Scale and Merging/Separation and Homophobia Scales. Negative correlations were found between the Contagion scale and the AIDS knowledge and social desirability scales. Alpha reliabilities were high (a > .93) for the Contagion scale and subscales. Factor analysis suggested the existence of a single factor and mixed support for three factors.

Thesis (M.S.) -- University of Maryland, College Park, 2008.
Thesis research directed by: Dept. of Psychology. Title from t.p. of PDF. Includes bibliographical references. Published by UMI Dissertation Services, Ann Arbor, Mich. Also available in paper.