Thesis--University of Turku, Finland, 2001. / Added t.p. with thesis statement inserted. Includes bibliographical references.

Thesis (Ph. D.)--Rand Graduate School, 1995. / At head of title: Dissertation. "RGSD-126." Includes bibliographical references (p. 264-267).

Thesis (M.S.)--University of Michigan, 1995.

Thesis (M.S.)--University of Michigan, 1995.

Thesis--University of Turku, Finland, 2001. / Added t.p. with thesis statement inserted. Includes bibliographical references.

Thesis (Ph. D.)--University of Washington, 2006. / Vita. Includes bibliographical references (leaves 64-71).

Estudo de caso Ãnico com o objetivo geral de avaliar a estrutura, o processo e o resultado da atenÃÃo em diabetes no Centro Integrado de Diabetes e HipertensÃo de Barbalha-CearÃ. Da amostra constaram 108 prontuÃrios de saÃde de usuÃrios com diabetes mellitus tipo 2 e nove profissionais envolvidos na atenÃÃo em diabetes. A coleta de dados desenvolveu-se no perÃodo de julho a dezembro de 2011 utilizando-se de trÃs fontes de evidÃncias: prontuÃrios de saÃde, mapas e observaÃÃo direta. Para anÃlise adotou-se AvaliaÃÃo de Cuidados em SaÃde proposta por Donabedian (1980). Em relaÃÃo à caracterizaÃÃo dos usuÃrios, segundo se constatou ,85,2% eram do sexo feminino, mediana de idade de 67 anos, tempo de tratamento com mediana de 8 anos, 97,7% tinham hipertensÃo arterial, 91,6% estavam em acompanhamento com endocrinologista, 46,3% em uso de antidiabÃtico oral associado a anti-hipertensivo e insulina, 24,1% de aspirina e 23,1% de estatinas. Quanto ao componente estrutura, a estrutura fÃsica contraria em parte o preconizado pela AgÃncia Nacional de VigilÃncia SanitÃria, portanto, inadequada para atender plenamente as necessidades dos usuÃrios e dos profissionais. No tocante aos recursos materiais, medicamentos e insumos, suprem as necessidades quanto Ãs quantidades existentes. No referente ao componente processo, as consultas de enfermagem nÃo sÃo baseadas na metodologia da assistÃncia, as mÃdicas sÃo centradas na relaÃÃo queixa-conduta e as de nutriÃÃo na prescriÃÃo do plano e educaÃÃo alimentar. OrientaÃÃes quanto à alimentaÃÃo foram ofertadas aos usuÃrios pelo enfermeiro e mÃdico, com Ãnfase na restriÃÃo do sal, do aÃÃcar, das gorduras e na diminuiÃÃo dos carboidratos, enquanto os nutricionistas abordaram aspectos dos grupos alimentares, suas substituiÃÃes e regularidade dos horÃrios das refeiÃÃes. Apenas o endocrinologista orientou sobre atividade fÃsica. Quanto Ãs orientaÃÃes sobre medicamentos, o enfermeiro foi o principal responsÃvel. Evidenciaram-se lacunas no inerente à oferta de orientaÃÃes educativas grupais pelos profissionais de saÃde aos usuÃrios. O exame dos pÃs dos usuÃrios nÃo fazia parte do atendimento do endocrinologista e do enfermeiro. O auxiliar e o tÃcnico de enfermagem realizavam a verificaÃÃo da glicemia capilar, da pressÃo arterial, do peso corporal e da altura. Enquanto o recepcionista e o auxiliar de serviÃos gerais desempenharam parte das suas competÃncias tÃcnicas, o auxiliar e o tÃcnico de enfermagem apresentaram o maior nÃmero de registros nos prontuÃrios, seguidos pelo mÃdico. Embora o registro das consultas de nutriÃÃo tenha se revelado incipiente e as de enfermagem nÃo tenham atingido a totalidade dos prontuÃrios, o registro da aferiÃÃo da pressÃo arterial, da glicemia capilar e o do peso à prÃtica estabelecida na rotina do centro. Jà o registro da altura e do Ãndice de massa corpÃrea foi incipiente, enquanto o da circunferÃncia abdominal foi inexistente. No tocante ao exame do pà e do olho, os percentuais de registro foram baixos no perÃodo investigado. Segundo constatado, o registro de exames laboratoriais nÃo alcanÃou a totalidade dos prontuÃrios investigados, mas o registro de orientaÃÃes acerca da alimentaÃÃo e atividade fÃsica obteve percentuais expressivos no perÃodo estudado. Houve lacunas de registros quanto a estratÃgias educativas grupais referentes ao tratamento medicamentoso e nÃo medicamentoso. Quanto ao componente resultado, constatou-se no ano de 2007 que o serviÃo atendeu a exigÃncia do indicador LDL colesterol < 100mg/dl, em 2008 cumpriu o determinado para os indicadores hemoglobina A1c > 9%, A1c < 7% e o LDL < 100mg/dl. Contudo, no ano de 2009, o Ãnico indicador alcanÃado foi o LDL < 100 mg/dl. Diante dos resultados encontrados e compreendendo a avaliÃÃo em saÃde como instrumento para tomada de decisÃo, ressalta-se a importÃncia da atenÃÃo do gestor municipal, coordenaÃÃo e profissionais em reestruturar o referido centro em face das fragilidades constatadas. / This is a single case study that aimed to assess the structure, the process and the outcome of diabetes care in the Integrated Center for Diabetes and Hypertension of Barbalha-CE, Brazil. The sample consisted of 108 medical records of patients with diabetes mellitus type 2 and nine professionals involved in diabetes care. Data collection was carried out from July to December 2011, using three sources of evidence: medical records, maps and direct observation. For the analysis, we used the Health Care Evaluation proposed by Donabedian (1980). Regarding the characterization of users, we verified that 85.2% were female, median age of 67 years, with median treatment time of 8 years, 97.7% had hypertension, 91.6% were in endocrinology follow-up, 46.3% were using oral antidiabetic associated with antihypertensive and insulin, 24.1% aspirin and 23.1% statins. Regarding the component structure, the physical structure partly contradicts the recommendations of the National Agency for Sanitary Vigilance, therefore inadequate to fully meet the needs of users and professionals. As for the material resources, medicines and supplies, they met the needs concerning the existing quantities. Regarding the component process, we verified that nursing consultations are not based on the assistance methodology; medical consultations are centered on the complaint-behavior relationship; and nutrition consultations in the plan prescription and nutrition education. Guidelines on eating were offered to the users by nurses and doctors, focusing on restriction of salt, sugar, fat and carbohydrates decrease, while nutritionists approached aspects of the food groups, their replacements and regularity of mealtimes. Only the endocrinologist advised about physical activity. Regarding the guidelines on medication, nurses were the main responsible. We identified gaps inherent to the offer of group educational guidelines to users by health professionals. The foot examination was not part of the assistance of endocrinologists and nurses. The nurse assistants and technicians performed the verification of blood glucose, blood pressure, body weight and height. The receptionist and general services assistant played part of their technical skills, while the nurse assistants and technicians presented the highest number of medical records, followed by doctors. Although the register of nutrition consultations has proved incipient and the nursing consultations have not fully reached the records, the register of blood pressure, blood glucose and weight measurements are established practices in the daily routine of the center. The register of height and body mass index was incipient, while waist circumference was nonexistent. Regarding the foot and eye examination, the registration rates were low in the investigated period. We found that the register of laboratory tests did not reach all the records investigated, but the register of guidelines on diet and physical activity presented significant percentage during the study period. There were gaps in records on the group educational strategies concerning the medical and non-medical treatment. Regarding the component outcome, we verified that in 2007 the service has met the requirement of the indicator LDL cholesterol < 100mg/dl, in 2008 it has met the specific indicators for A1c hemoglobin > 9%, A1c < 7% and LDL < 100 mg/dl. However, in 2009, the only indicator achieved was LDL < 100 mg/dl. Considering the results found and understanding the health services evaluation as a tool for decision-making, we highlight the importance of the attention of the city manager, coordination and professionals in order to restructure the center in study, given the weaknesses noted.

Requirements Engineering (RE) is a crucial part of any product management and product development activity, and as such deficiencies in the RE process may have severe consequences. There are reports from industry that point towards inadequate requirements being one of the leading sources for project failure. Software Process Improvement (SPI) is generally seen as the main tool to address process deficiencies in general and within RE. Assessments lead to establishing plans for improvements that are subsequently implemented and evaluated, and then the SPI cycle starts again, in an optimal case being incremental and continuous. Most well known SPI frameworks, e.g. CMM, CMMI, SPICE and QIP, are based on these general principles. There are however several factors that can have a negative impact on SPI efforts in general, and in the case of SPI targeted at RE in particular. Time and cost are two fundamental factors that can effectively “raise the bar” for SPI efforts being initiated at all. This is the particular case for Small and Medium sized Enterprises (SMEs) with limited resources, and a limited ability to wait for the return on their investment. Other issues include commitment and involvement in the SPI work by the ones affected by the changes, coverage of the RE area in SPI frameworks, and the ability to focus improvements to areas where they are needed the most. The research presented in this thesis is based on actual needs identified in industry, and all of the proposed solutions have also been validated in industry to address issues of applicability and usability. In general, the goal of the research is to “lower the bar”, i.e. enabling SMEs to initiate and perform SPI activities. It is accomplished through the presentation and validation of two assessment methods that targets RE, one aimed at both fast and low-cost benchmarking of current practices, and the other designed to produce tangible improvement proposals that can be used as input to an improvement activity, i.e. producing a relatively accurate assessment but taking limited time and resources into account. Further, to offer a structured way in which SMEs can focus their SPI efforts, a framework is introduced that can be used to package improvement proposals with regards to their relative priority taking dependencies into account. This enables SMEs to choose what to do first based on their needs, as well as a way to control time to return on their investment by controlling the size of the undertaking. As a result of industry validation of the assessment method and packaging framework, several improvement proposals were identified and prioritized/packaged. As a part of a process improvement effort (based on an improvement proposal package) an RE model was developed that was appropriate for SMEs faced with a market-driven product centered development situation. The model, called Requirements Abstraction Model (RAM), addresses the structuring and specification of requirements. The main feature of the model is that it not only offers a structured way in which requirements can be specified, but it also takes a requirement’s abstraction level into account, using abstraction for the work-up instead of putting all requirements in one repository independent of abstraction level. The RAM was developed to support primarily the product management effort, recognizing that RE from this perspective is not project initiated but rather project initiating. The model assists product managers to take requirements on varying abstraction levels and refining them to the point of being good-enough to offer decision support for management, and at the same time being good-enough for project initiation. The main contribution of the thesis is to present SMEs with “tools” that help them commit to and perform SPI activities. Moreover, the thesis introduces the RAM model that was developed based on needs identified in industry, and subsequently piloted in industry to assure usability.

Abstract Many software-intensive products and systems on the market today reveal a poor level of usability despite the availability of knowledge about how to develop good usability, namely user-centred design. Improving the status of user-centred design has proved to be a challenge in product development. An effective step to start out on the road to such improvements is to carry out a current state analysis. Our research problem was to learn how to perform an effective current state analysis, i.e. an assessment, of user-centred design processes to provide a basis for improvement action. As the main part of our research, we carried out five experimental assessments in industrial settings during the years 2000 and 2001. The main result of the research is a novel assessment approach. The objective of the approach is to provide a basis for improvement of the performance of user-centred design in individual product development projects. The particular features of the approach are a new user-centred design process model, a three-dimensional process performance model and implementation of the assessment in the form of a workshop with extensive participation by the project members. The user-centred design process model is method-independent, and consists of six processes that are defined through outcomes. The performance of processes is assessed from the viewpoints of quantity, quality, and integration. Our theoretical examinations show that different assessment categories can be identified depending on the different foci and purposes of an assessment. Moreover, it may even be appropriate to have different assessment approaches for different categories. In the category of our focus and purpose, i.e. 'assessment of user-centred design processes for performance improvement', the focus of an assessment should be in the substance rather than in the management of UCD processes. An assessment approach should be regarded as an artefact and it should be subject to ongoing refinement. An assessment should be an intervention that provides both an effective training session and a meaningful experience to the participants. Clarity in both the concepts and the results seems to take precedence over having standard reference models. In addition, we created a preliminary theory of usability capability. It identifies three dimensions of usability capability: user-centred design infrastructure, performance of user-centred design in product development projects and usability in business strategy. We also propose some new assessment artefacts for other assessment categories and contrast our research experience with established research frameworks.

As more systems are becoming embedded hardware-based, challenges regarding software safety and considerable consequences of their failure arise. Various safety standards assure certain safety aspects of systems, addressing areas including testing. The safety standards chosen for this thesis are ISO/IEC/IEEE 29119-2 &amp; 3, IEC 61508-1 &amp; 3, ISO 13849-1 &amp; 2, and ISO/IEC/IEEE 12207:2017. This thesis tackles the problem of compliance with safety standards by utilising a lightweight assessment method, leading to recommendations for improving the test process of an industrial control system. A case study is performed on an automation company to achieve the objectives of this thesis. The method used for the qualitative data analysis results in recommendations regarding the compliance of the company's test process with selected safety standards. As the final step, the execution of a focus group research leads to the industrial evaluation of the recommendations and assessment results. The company's development process fully complies with 22% and fails to comply with 58% of the extracted requirements from the selected safety standards. Furthermore, the thesis results in recommendations for improving the test process of an industrial control system. As a result of performing the case study, a method for a lightweight assessment of the development process of industrial control systems is achieved. The generic method follows five steps, firstly tabulating the data to attain assessment criteria and items, used by the assessment step to get a compliance degree per requirement. The analysis step comes next to shed light on areas of strength and weakness, leading to recommendations. The final step evaluates and refines the recommendations according to the results of a focus group. Further development of the method used in this thesis can lead to a generic method for assessing development processes, concerning safety standards, using limited resources.  The results of this generic method can lead to recommendations for test process improvements of control systems via safety standards.