Made available in DSpace on 2016-06-02T19:06:01Z (GMT). No. of bitstreams: 1 4801.pdf: 4117819 bytes, checksum: b4df67024157ee1a2c79256315a97e7d (MD5) Previous issue date: 2012-11-13 / Universidade Federal de Sao Carlos / Software development techniques continually evolve in order to improve development and maintenance processes in addition to lower costs and higher quality. The goal of MDD is to reduce the semantic distance between a problem and its solution specification. Therefore MDD focuses on high-level abstraction modeling and successive model transformations, until finally, generate code. Studies assert that model-driven development can be significantly more efficient than traditional source code-driven software development and still reduce the possibility of occurrence of several problems during the software life-cycle. Likewise, Web engineering can also be benefited by MDD adoption, especially when supported by approaches that facilitate MDD use. Web development is usually agile with frequent releases, these approaches must be flexible to adapt to this context. However, generally, the approaches proposed by the academic community have complex processes which involve many different model definitions, programming languages, plug-ins and IDEs. These features contradict the practices adopted by Web developers. This paper presents the MWDA (Model-Driven Web Applications) approach that provides a simple process to support model-driven web development. This approach does not depend on tools, technologies or plug-ins and encourage combination with other forms of reuse and development processes. Furthermore, the Ruby- MDWA was developed with Ruby language and Ruby on Rails framework support, in order to create Web applications with MDWA assistance. This tool provides a set of textual models and defines M2M and M2C transformation tools, maintaining the requirements traceability since its specification to its construction and further maintenance. In order to show the use of the approach and tool, it was performed a real study case with a software company, from São Carlos SP, where a project management system was developed. In parallel, two experiments were conducted with undergraduate students in Computer Science and Computer Engineering and a Masters in Computer Science, to evaluate the gains and limitations of the Ruby-MDWA tool. / As técnicas de desenvolvimento de software evoluem continuamente com a finalidade de melhorar processos de construção e manutenção de software, além de obter ganhos em tempo, custo e qualidade. O objetivo do MDD é reduzir a distância semântica entre um problema e a especificação de sua solução. Para isso, MDD tem enfoque na modelagem de alto nível de abstração e em sucessivos refinamentos dos modelos construídos em artefatos mais detalhados, até enfim, gerar código. Há afirmações de que o desenvolvimento orientado a modelos pode ser significativamente mais eficiente que o desenvolvimento tradicional guiado por código fonte, além de reduzir a possibilidade de ocorrência de uma série de problemas durante o ciclo de vida do software. Da mesma forma, a engenharia de aplicações Web também pode ser beneficiada pela adoção de MDD, em especial com o apoio de abordagens que facilitem sua utilização. Como o desenvolvimento de aplicações Web comumente é ágil e com publicações freqüentes, essas abordagens devem ser flexíveis para que se adaptem a esse contexto. Entretanto, em geral, as abordagens propostas pela comunidade acadêmica apresentam processos complexos que envolvem diversos modelos, linguagens de programação, plug-ins e ambientes de programação. Essas características contrariam as práticas aprovadas pelos desenvolvedores Web. Esta dissertação apresenta a abordagem MDWA (Model-Driven Web Applications) que fornece um processo simples para desenvolvimento de software Web com apoio de MDD. A abordagem não depende de ferramentas, tecnologias ou plug-ins e estimula a combinação com outras formas de reuso e processos de desenvolvimento. Além disso, foi construída uma ferramenta, denominada Ruby-MDWA, baseada na linguagem Ruby e no framework Ruby on Rails destinada à criação de aplicações Web com auxílio da abordagem MDWA. Essa ferramenta fornece um conjunto de quatro modelos textuais e define transformadores M2M e M2C, que mantém a rastreabilidade de um requisito desde sua especificação até sua construção e posterior manutenção. Para mostrar o uso da abordagem e da ferramenta, foi realizado um estudo de caso real em conjunto com uma empresa de software de São Carlos SP, onde um sistema de gerenciamento de projetos foi desenvolvido. De forma paralela, foram conduzidos dois experimentos com alunos de graduação em Bacharelado em Ciência da Computação e Engenharia de Computação e mestrado em computação da UFSCar, visando avaliar os ganhos e as limitações da ferramenta Ruby-MDWA.

Major depressive disorder (MDD) is a mood disorder majorly responsible for disability and mortality worldwide. With a lifetime prevalence of 15-20%, it is the main cause of functional impairment in Western societies as well as the fourth most debilitating illness in the world. Although the pathophysiology of MDD is not yet fully understood, some evidence that suggest the presence of a neuroanatomical deficiency have given rise to the theory of a specific imbalance in the monoamine neurotransmitters noradrenaline (NA) and/or serotonin (5-HT) levels in the brain. Overall, the various classes of antidepressant agents that have been developed to increase monoamine levels on the basis of this proposal have been successful. However, facts relating to prevalent escalation in the illness and recurring episodes of depression point towards a need to enhance clinical treatment. Most conventional antidepressants such as selective serotonin reuptake inhibitors (SSRI) and selective serotonin and noradrenaline inhibitors (SNRI) pose problems in symptomatic improvement. These include therapeutic lag, safety and tolerability issues, making more than 30% patients with MDD unable to reach adequate relief. In this respect, the action mechanism has moved beyond conventional SSRI and lead to the introduction of vilazodone, a novel antidepressant with an additional 5-HT1A partial agonist profile argued to be of potential benefit for a greater efficacy, faster onset of action and better tolerability. Using secondary data, this project aimed to evaluate the role of vilazodone as a SPARI-drug in the overall clinical treatment of MDD as well as its potential in addressing some of the most common obstacles in antidepressant treatment. Study results proved vilazodone’s efficacy to be superior to placebo. Patients across all studies showed significant improvement in depressive symptoms measured in MADRS and HAMD17. Vilazodone was also shown to be generally safe and tolerable but was not positively distinguished from placebo with regards to adverse effects. An overall, meaningful improvement in depressive symptoms was demonstrated in vilazodone, which reinforces its merit as an important treatment option for patients with MDD.

Objective. Major depressive disorder (MDD) is a common condition following treatment in the Intensive Care Unit (ICU). Long-term data on MDD in chronically critically ill (CCI) patients are scarce. Hence, the primary aim of the present study was to investigate the frequency and predictors of MDD after intensive care of CCI patients. Materials and Methods. In a prospective cohort study, patients with long-term mechanical ventilation requirements () were assessed with respect to a diagnosis of MDD, using the Structured Clinical Interview for DSM-IV, three and six months after the transfer from acute ICU to post-acute ICU. Sociodemographic, psychological, and clinical risk factors with values ≤ 0.1 were identified in a univariate logistic regression analysis and entered in a multivariable logistic regression model. A mediator analysis was run using the bootstrapping method, testing the mediating effect of perceived helplessness during the ICU stay, between the recalled traumatic experience from the ICU and a post-ICU MDD. Results. 17.6% () of the patients showed a full- or subsyndromal MDD. Perceived helplessness, recalled experiences of a traumatic event from the ICU, symptoms of acute stress disorder, and the diagnosis of posttraumatic stress disorder (PTSD) after ICU could be identified as significant predictors of MDD. In a mediator analysis, perceived helplessness could be proved as a mediator. Conclusions. Every fifth CCI patient suffers from MDD up to six months after being discharged from ICU. Particularly, perceived helplessness during the ICU stay seems to mainly affect the long-term evolvement of MDD. CCI patients with symptoms of acute stress disorder/PTSD should also be screened for MDD.

Directive 2007/47/EC of the European Parliament amending Medical Device Directive (MDD) provides medical device manufacturers with a compliance framework. However, the effects of the amendments to the MDD on competition in the U.S. medical device software industry are unknown. This study examined the impact of this directive on the competitiveness of U.S. medical device software companies, the safety and efficacy of medical device software, employee training, and recruitment. The conceptual framework for this study included 3 dimensions of medical device regulations: safety, performance, and reliability. The overall research design was a concurrent mixed method study using both quantitative and qualitative techniques. The qualitative techniques involved case studies of 5 purposively selected companies. Data collection involved both surveys and interviews. The sample consisted of 56 employees within medical device firms with markets around the European regions. Qualitative data analysis consisted of descriptive thematic analysis along the study questions and hypotheses and summative evaluation. Quantitative data analysis included descriptive statistics and correlation to test the 4 hypotheses. The results suggested that the MDD has realigned medical device software manufacturing practices, and US medical device companies have gained global competitiveness in improving product safety and increasing sales revenue. Key recommendations to medical device manufacturers include adopting MDD 93/42/EEC, using model-based approaches, and being comprehensive in model use. Adopting the MDD will provide positive social change to patients, as human safety improves with better product quality while companies experience fewer product recalls.

Major depressive disorder (MDD) is a mood disorder majorly responsible for disability and mortality worldwide. With a lifetime prevalence of 15-20%, it is the main cause of functional impairment in Western societies as well as the fourth most debilitating illness in the world. Although the pathophysiology of MDD is not yet fully understood, some evidence that suggest the presence of a neuroanatomical deficiency have given rise to the theory of a specific imbalance in the monoamine neurotransmitters noradrenaline (NA) and/or serotonin (5-HT) levels in the brain. Overall, the various classes of antidepressant agents that have been developed to increase monoamine levels on the basis of this proposal have been successful. However, facts relating to prevalent escalation in the illness and recurring episodes of depression point towards a need to enhance clinical treatment. Most conventional antidepressants such as selective serotonin reuptake inhibitors (SSRI) and selective serotonin and noradrenaline inhibitors (SNRI) pose problems in symptomatic improvement. These include therapeutic lag, safety and tolerability issues, making more than 30% patients with MDD unable to reach adequate relief. In this respect, the action mechanism has moved beyond conventional SSRI and lead to the introduction of vilazodone, a novel antidepressant with an additional 5-HT1A partial agonist profile argued to be of potential benefit for a greater efficacy, faster onset of action and better tolerability. Using secondary data, this project aimed to evaluate the role of vilazodone as a SPARI-drug in the overall clinical treatment of MDD as well as its potential in addressing some of the most common obstacles in antidepressant treatment. Study results proved vilazodone’s efficacy to be superior to placebo. Patients across all studies showed significant improvement in depressive symptoms measured in MADRS and HAMD17. Vilazodone was also shown to be generally safe and tolerable but was not positively distinguished from placebo with regards to adverse effects. An overall, meaningful improvement in depressive symptoms was demonstrated in vilazodone, which reinforces its merit as an important treatment option for patients with MDD.

No description available.

Hoy en día, la complejidad de los sistemas software y la gran relevancia que han adquirido los requisitos no funcionales son retos que han de abordarse durante el proceso de desarrollo software. En los últimos años, estas propiedades han provocado un gran incremento en el tiempo y el personal necesario para llevar a cabo los procesos de desarrollo y mantenimiento del software. Por ello, existe un gran interés en mejorar dichos procesos. Esta tesis presenta un nuevo enfoque de desarrollo para sistemas software complejos. Dicho enfoque, llamado PRISMA, da soporte a estos nuevos retos y permite satisfacer la elevada competitividad del mercado. El enfoque PRISMA se ha materializado en un marco de trabajo formado por un modelo, un lenguaje, una metodología y un prototipo de herramienta CASE (Computer-Aided Software Engineering). El modelo de PRISMA combina dos aproximaciones para definir arquitecturas software: el Desarrollo de Software Basado en Componentes (DSBC) y el Desarrollo de Software Orientado a Aspectos (DSOA). Las principales aportaciones del modelo es la manera en la que integra ambas aproximaciones para obtener sus ventajas y su lenguaje formal. PRISMA tiene en cuenta los requisitos no funcionales desde las primeras etapas del ciclo de vida software y mejora su reutilización y el mantenimiento. Todo ello gracias a la descomposición que realiza de los sistemas software utilizando dos conceptos diferentes: aspectos y elementos arquitectónicos (componentes y conectores). PRISMA proporciona un Lenguaje de Descripción de Arquitecturas Orientado a Aspectos (LDAOA) formal para la especificación de arquitecturas software orientadas a aspectos. El LDAOA de PRISMA es independiente de cualquier tecnología y está basado en lenguajes formales para evitar la ambigüedad y poder aplicar técnicas de generación automática de código. La metodología de PRISMA apuesta por el desarrollo de software siguiendo el Paradigma de la Prototipación Automática mediante la aplicación del e / Pérez Benedí, J. (2006). Prisma: aspect-oriented software architectures [Tesis doctoral]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/1928

本研究旨在探討「健康、性格、習慣量表(HPH)」的臨床效度。HPH最初是由柯永河教授(民84)編製，後來廣泛使用在國內臨床場域中。發展至今已有中上程度的信效度支持，但過去較缺乏臨床上區辨與構念效度的研究，因此本研究旨在探討HPH區辨不同疾患的能力，以及以臨床疾患為受試時量尺之構念效度。 本研究回顧國內外類似測驗─MMPI、KMHQ、MCMI─的發展軌跡，並參照前人作法來進行HPH的臨床區辨效度研究。初步以臨床場域中常見的精神分裂症、重鬱症、低落型情感疾患、焦慮疾患，共257名患者為受試。先以共變數分析(ANCOVA)探討控制人口與臨床變項後，不同疾患組別在HPH的A、B、D類量尺的影響。再進一步使用羅吉斯迴歸(logistic regression)探討哪些量尺及其組合可以區辨兩兩疾患間的差異。最後，本研究也進行HPH的探索性因素分析(exploratory factor analysis)，以檢驗其臨床上的因素結構。 本研究發現，精神分裂症(A1)、躁症傾向(A2)、憂鬱自殺類(A3、B4、A4)、心理功能與健康(D1、D3、D4、D5、D6)量尺在共變數分析上的差異情形與假設大致相符，後續討論分析也支持強迫症(B5)量尺效度。羅吉斯迴歸中，A1、A3、B4、B5能在兩兩疾患間區辨有顯著預測力。其中A1能在精神分裂症與其他三組疾患的兩兩區辨中預測，A3能在重鬱症與另外兩組(精神分裂症、焦慮症)的兩兩區辨中預測，B4能在低落型情感與精神分裂症的兩兩區辨中預測，B5能在強迫症與其他疾患間的兩兩區辨中預測。但是在重鬱症與低落型情感疾患間，以及低落型情感與焦慮疾患間，沒有量尺能在兩者的區辨中有顯著預測力。而各兩兩疾患間整體區辨效果有中至高度的關聯性，分類正確率也多有七成以上，顯示HPH量表在臨床上的區辨效度獲得支持。 構念效度部分，A、D類量尺因素結構與當初編製的每個量尺構念相近，B類量尺構念雖與原量尺略有不同，但仍不違背原量尺編製架構，因此構念效度亦獲得支持。不過各量尺仍有值得編修之處，討論一節中針對結果提出HPH後續編修之建議。 最後，本研究也將此結果之臨床實務應用於討論一節中詳述，以供後續研究與實務者參考。 / The purpose of this study is to examine the clinical validity of the Health, Personality, and Habit Test (HPH). The HPH was developed by Dr. Yung-Ho Ko in 1995, and has been widely used in clinical settings. The HPH has demonstrated appropriate reliability and validity, but little research has been done on its differential and construct validity in the clinical settings. Therefore, the aim of this study is to explore the HPH’s ability to differentiate between disorders and its construct validity in clinical context. This research reviewed the developments of similar tests, such as MMPI, KMHQ, and MCMI, and examined validity of the HPH with the same methods. Subjects were 257 patients who suffered from common disorders in clinical settings, including schizophrenia, major depression, dysthymia, and anxiety disorders. ANCOVA was first used to explore whether different disorders have an effect on category A, B, and D scales after controlling demographic and clinical variables. Next, logistic regression was used to clarify which scales and combinations can differentiate between two of four disorders. Finally, exploratory factor analysis was conducted to examine the structure of HPH in clinical setting. The results of ANCOVA showed that the differences of schizophrenia scale (A1), manic scale (A2), depression/suicide scales (A3, B4, & A4), obsessive-compulsive disorder (OCD) scale (B5), and psychological function and health scales (D1, D3, D4, D5, D6) were partly consistent with assumptions, supporting the differential validity of HPH. The results of logistic regression analysis also supported the validity of A1, A3, B4, and B5 scales. More specifically, A1 was able to differentiate schizophrenia from any other three disorders, A3 was able to differentiate MDD from schizophrenia and anxiety disorders, B4 was able to differentiate dysthymia from schizophrenia, and B5 was able to differentiate OCD from other disorders. However, none of the scales was able to differentiate MDD from dysthymia, nor were they able to differentiate dysthymia from anxiety disorders. Moreover, each of the logistic regression functions showed moderate to high correlations, and most of them achieved high overall hit rates (above 70%), providing support for the clinical differential validity of the HPH. As for construct validity, these factors in category A and D scales were essentially similar to original scales. Similarly, factors in category B scales were compatible to original scales though difference was found. In sum, these results lent support to the construct validity of the HPH in the clinical settings. However, refining of the scales is needed and suggestions are discussed. Finally, the practical uses of the findings were also discussed.

Mit dem Wandel des Internets zu einer universellen Softwareplattform sind die Möglichkeiten und Fähigkeiten von Webanwendungen zwar rasant gestiegen. Gleichzeitig gestaltet sich ihre Entwicklung jedoch zunehmend aufwändig und komplex, was dem Wunsch nach immer kürzeren Entwicklungszyklen für möglichst situative, bedarfsgerechte Lösungen entgegensteht. Bestehende Ansätze aus Forschung und Technik, insbesondere im Umfeld der serviceorientierten Architekturen und Mashups, werden diesen Problemen bislang nicht ausreichend gerecht. Deshalb werden in dieser Dissertation neue Konzepte für die modellgetriebene Entwicklung und Bereitstellung von Webanwendungen vorgestellt. Die zugrunde liegende Idee besteht darin, das Paradigma der Serviceorientierung auf die Präsentationsebene zu erweitern. So sollen erstmals – neben Daten- und Geschäftslogik – auch Teile der Anwendungsoberfläche in Form wiederverwendbarer Komponenten über Dienste bereitgestellt werden. Anwendungen sollen somit über alle Anwendungsebenen hinweg nach einheitlichen Prinzipien „komponiert“ werden können. Den ersten Schwerpunkt der Arbeit bilden die entsprechenden universellen Modellierungskonzepte für Komponenten und Kompositionen. Sie erlauben u. a. die plattformunabhängige Beschreibung von Anwendungen als Komposition der o. g. Komponenten. Durch die Abstraktion und entsprechende Autorenwerkzeuge wird die Entwicklung so auch für Domänenexperten bzw. Nicht-Programmierer möglich. Der zweite Schwerpunkt liegt auf dem kontextadaptiven Integrationsprozess von Komponenten und der zugehörigen, serviceorientierten Referenzarchitektur. Sie ermöglichen die dynamische Suche, Bindung und Konfiguration von Komponenten, d. h. auf Basis der o. g. Abstraktionen können genau die Anwendungskomponenten geladen und ausgeführt werden, die für den vorliegenden Nutzer-, Nutzungs- und Endgerätekontext am geeignetsten sind. Der dritte Schwerpunkt adressiert die Kontextadaptivität der kompositen Anwendungen in Form von Konzepten zur aspektorientierten Definition von adaptivem Verhalten im Modell und dessen Umsetzung zur Laufzeit. In Abhängigkeit von Kontextänderungen können so Rekonfigurationen von Komponenten, ihr Austausch oder Veränderungen an der Komposition, z.B. am Layout oder dem Datenfluss, automatisch durchgesetzt werden. Alle vorgestellten Konzepte wurden durch prototypische Implementierungen praktisch untermauert. Anhand diverser Anwendungsbeispiele konnten ihre Validität und Praktikabilität – von der Modellierung im Autorenwerkzeug bis zur Ausführung und dynamischen Anpassung – nachgewiesen werden. Die vorliegende Dissertation liefert folglich eine Antwort auf die Frage, wie zukünftige Web- bzw. Mashup-Anwendungen zeit- und kostengünstig entwickelt sowie zuverlässig und performant ausgeführt werden können. Die geschaffenen Konzepte bilden gleichermaßen die Grundlage für eine Vielzahl an Folgearbeiten.

Requirements Engineering (ER) has an important role in Software Engineering for being an early stage of the software development process. ER serves as the basis for implementation of other activities, contributing decisively to the quality of the final software product. Requirements Elicitation process is among the main concerns of ER. It involves the recognition and description of customer needs, in such a way that it is possible to reflect the business accurately and consistent. Moreover, in general, most problems that occur during the process of software development are caused by failures in the early stages. In this context, emerging approaches such as Model-Driven Developement (MDD) and Business Process Modeling (MPN). Such approaches seek to understand and describe business processes and enable a closer look of the domain. As well, especially when backed by support tools, using approaches such as MDD and MPN can contribute to improving the quality of the requirements and the requirements Elicitation process. This work presents ModelER approach, which seeks to promote improvements in Requirements Elicitation process, through the use of concepts and practices of the MDD and the MPN for identifying software requirements. / A Engenharia de Requisitos (ER) possui um importante papel na Engenharia de Software pelo fato de compreender uma fase inicial do processo de desenvolvimento de software. Ela serve de base para a realização das demais atividades, contribuindo decisivamente para a qualidade do produto de software final. O processo de Elicitação de Requisitos está entre as principais preocupações da ER. Ele envolve o reconhecimento e a descrição das necessidades dos clientes, de tal forma que seja possível refletir o negócio de forma precisa e coerente. Além disso, de maneira geral, a maior parte dos problemas que ocorrem durante o processo de desenvolvimento de software é causada por falhas nas fases iniciais. Diante desse contexto, surgem abordagens tais como o Desenvolvimento Orientado por Modelos (Model-Driven Developement MDD) e a Modelagem de Processos de Negócio (Business Process Modeling MPN1). Tais abordagens tanto buscam compreender e descrever os processos de negócio, quanto permitem uma visão mais próxima do domínio. Assim, sobretudo quando apoiadas por ferramentas de suporte, o uso de abordagens como MDD e MPN pode contribuir para a melhoria da qualidade dos requisitos e do processo de Elicitação de Requisitos. Este trabalho apresenta a abordagem ModelER, a qual busca promover melhorias no processo de Elicitação de Requisitos, através da utilização de conceitos e práticas do MDD e da MPN para identificação de requisitos de software.