As long as software has been produced, there have been efforts to strive for quality in software products. In order to understand quality in software products, researchers have built models of software quality that rely on metrics in an attempt to provide a quantitative view of software quality. The aim of these models is to provide software producers with the capability to define and evaluate metrics related to quality and use these metrics to improve the quality of the software they produce over time. These models can be quite cumbersome to implement as they require effort and resources to define and evaluate metrics from software projects. This dissertation aims to build an understanding of quality in software engineering by investigating those concepts core to the field. The basic concepts of the field are described, including quality, metrics and software engineering processes. Three software quality models and four approaches to using metrics to gain insight into quality are discussed with an aim to understanding the apparent strengths and weaknesses of each. This dissertation proposes a new approach to using metrics to gain insight into software quality. An equation, called the Product Quality Indicator, is proposed and critically assessed, which uses a combination of metrics based on requirements, tests and defects, to provide some insight into quality. Furthermore, a software product, called Metaversion, which relies on the Subversion Software Configuration Management system is presented. This software, which is a reference implementation of the proposed approach, aims to allow for the automatic collection and evaluation of the Product Quality Indicator. A case study is discussed where the Metaversion system is used and the results of the evaluation of the Product Quality Indicator are compared with the quality of the software as perceived by the testers responsible for testing the software. / Dissertation (MSc)--University of Pretoria, 2013. / gm2014 / Computer Science / unrestricted

This thesis focuses on the concept of quality in higher education, more particularly quality of the degree project. The overarching issue is whether an assessment of the quality of a degree project can be used for evaluating the quality of the entire programme where it forms a part. The subject is partly initiated by the design of the quality evaluation system in Sweden introduced in 2011, in which a quality indicator function of the degree projects is vital. The notion of quality in degree projects is analyzed through three perspectives – as articulated in the research literature, as stated in the policy documents and curriculum documents regarding a Swedish engineering programme, and as experienced by the actors – examiners and supervisors – of this same programme. If the three perspectives testify with reasonably equal meaning to the concept of quality, an indicator function of degree projects can be considered appropriate. Different methods have been combined. The policy documents are investigated by a qualitative and quantitative textual analysis, while the perceptions of the examiners and supervisors are explored by in-depth interviews. Results are interpreted by using an arena concept proposed by Lindensjö & Lundgren, and an analysis system suggested by Bernstein. The results show that quality of a degree project is an ambiguous notion, and that different aspects of quality are reflected in the three perspectives. The conclusion is that assuming a quality indicator function of a degree project is problematic and not self-evident. In a formal sense, the degree project course is clearly separated from other modules of the programme, i.e. it is strongly classified. At the same time it is weakly framed and the actors feel near-total freedom in implementing it. Conceivable consequences of the evaluation system used in Sweden since 2011 are also discussed. Uniformity in the design of the degree project course can be expected, as well as undervaluation of the conditions for the programme and the teaching processes of it.

京都大学 / 新制・課程博士 / 博士(社会健康医学) / 甲第23384号 / 社医博第117号 / 新制||社医||11(附属図書館) / 京都大学大学院医学研究科社会健康医学系専攻 / (主査)教授 佐藤 俊哉, 教授 滝田 順子, 教授 万代 昌紀 / 学位規則第4条第1項該当 / Doctor of Public Health / Kyoto University / DFAM

The purpose of this study was to identify what high school principals indicate are effective strategies and interventions to reduce chronic student absenteeism. Research has shown chronic student absenteeism is highest among high school students (Stronge and Associates, 2019; U.S. Department of Education, n.d.), and effects may include low academic achievement, possible high school dropout, and poor outcomes in adulthood (Elias, 2019; Ready, 2010; Stronge and Associates, 2019; Virginia Department of Education [VDOE], n.d.). Chronic student absenteeism is one measure of school performance in Virginia and therefore, a responsibility of the school principal to monitor, maintain, or improve (VDOE, n.d). This study sought to answer the following research questions: 1. What strategies and interventions do high school principals indicate they utilize and implement to reduce chronic student absenteeism? 2. What are the perceptions of high school principals regarding the effectiveness of strategies and interventions they utilized and implemented in order to reduce chronic student absenteeism? This study included a survey of 8 Virginia high school principals whose school experienced a reduced rate of chronic absenteeism between 2016-2017, 2017-2018, and 2018- 2019. The Virginia Department of Education (VDOE) reported chronic absenteeism as a measure of school accountability beginning in 2016. Additionally, this study included semi-structured interviews with 3 of the high school principals. The survey and interview questions aimed to determine various strategies and interventions high school principals implement to reduce chronic student absenteeism, along with the effectiveness of each. Principals in this study reported communication, involving school stakeholders, creating a positive school culture, and utilizing accountability practices as means to reduce chronic student absenteeism. Principals perceived communication and engaging instruction to be effective strategies or interventions utilized in order to reduce chronic student absenteeism, while data collection and management were considered to be least effective. The study suggests principals could engage in those practices perceived as effective in reducing chronic student absenteeism, but also school divisions could provide job embedded professional development to enhance the knowledge and skills of principals related to the topic. / Doctor of Education / The purpose of this study was to identify what high school principals indicate are effective strategies and interventions to reduce chronic student absenteeism. This study also explored how effective principals perceived each strategy or intervention was in regard to reducing chronic student absenteeism. The study included Virginia high school principals whose school experienced a reduced rate of chronic student absenteeism between 2016-2017, 2017- 2018, and 2018-2019. Principals participated in a survey and individual interview; the survey and interview instruments were designed by the researcher (see Appendix G and Appendix H). The study results indicated high school principals are utilizing communication as a strategy or intervention to reduce chronic student absenteeism. Additionally, principals also reported involving various school stakeholders, creating a positive school culture, and utilizing accountability practices in order to reduce chronic student absenteeism. Principals perceived communication and engaging instruction to be effective strategies or interventions, while data collection and management was perceived to be least effective. Future actions could include principals' continued efforts to engage families in practices to reduce chronic absenteeism. Principals could also monitor and support teacher instruction for student engagement. Additional implications and future research to decrease chronic student absenteeism are shared.

Chronic absenteeism is a growing concern nationwide. Millions of students are absent from school, with the number summing to one month's worth of absences per student per year. As a result of Every Student Succeed Act (ESSA), many states have included chronic absenteeism as part of their school quality indicator. For the 2018-2019 school year, attendance was included in standards of accreditation. Reducing chronic absenteeism has long been a goal for many public principals at each grade level nationwide. The purpose of this study was to identify what interventions and strategies principals were implementing to decrease chronic absenteeism. This study further identified principals' perceptions of the interventions and strategies with the greatest and least effect on decreasing chronic absenteeism. A qualitative research design was used with semi-structured interviews to determine principals' perceptions of interventions and strategies to decrease chronic absenteeism. Participants were principals from secondary schools in one urban school district, located in the Southeastern region of Virginia. Findings from the research revealed that principals in this district are implementing interventions and strategies that include: positive behavioral interventions and supports, parent contacts, community partnerships, district supports, and professional development to decrease chronic absenteeism. The findings also suggested that interventions and strategies that help build relationships between the school, students, and parents are being most effective in decreasing chronic absenteeism in this district. Implications for continued decrease in chronic absenteeism at all level of practice are recommended and suggestions for future research / Doctor of Education / The purpose of this study was to identify what interventions and strategies principals were implementing to decrease chronic absenteeism. This study further identified principals' perceptions of the interventions and strategies with the greatest and least effect on decreasing chronic absenteeism. The study included principals from secondary schools in one urban school district, located in the Southeastern region of Virginia. Principals were interviewed using interview questions designed by the researcher (see Appendix E). The research findings identified principals are implementing positive behavior interventions and supports in their schools to decrease chronic absenteeism. They are also implementing parent contacts, community partnerships, district supports, and professional development. The interventions and strategies principals find most effective in decreasing chronic absenteeism are interventions and strategies that help build relationships with students and parents. Future interventions and strategies should include additional efforts to contact parents, an increase in staff to make home visits and students being able to recover or buy back time lost from school due to absenteeism. Implications for practice in the continued decrease of chronic absenteeism are recommended, as well as suggestions for future research.

<b>Background. </b> Although antipsychotic medications are primarily intended to treat schizophrenia and psychotic symptoms in adults, they are commonly administered to nursing home residents as pharmacotherapy for "off-label" indications such as disruptive behaviour. However, clinical trials have demonstrated limited efficacy and serious side-effects of antipsychotics among the elderly. As previous studies have reported inappropriate use in several countries, their use in nursing home residents ought to be monitored to detect and reduce inappropriate administration. <br /><br /> <b>Objectives. </b> The aim of this study was a) to determine and compare prevalence rates of antipsychotic use in Ontario and Swiss nursing homes, b) to identify determinants of antipsychotics use in these two countries, by means of a cross-sectional design, and c) to investigate the impact of antipsychotic use on behaviours over time in Ontario and Swiss residents, by means of a longitudinal design. <br /><br /> <b>Methods. </b> This study involved secondary data analysis of 1932 residents from 24 nursing homes in the province of Ontario in Canada and 1536 residents from 4 nursing homes in a German-speaking canton in Switzerland. Residents were assessed with the Minimum Data Set (MDS) tool. Resident characteristics and prevalence rates were compared internationally with the chi-square test. Demographic and clinical determinants of antipsychotic use, as well as behavioural change associated with antipsychotics, were analyzed using logistic regression. <br /><br /> <b>Results. </b> Although Ontario nursing home residents had an overall heavier-care profile than Swiss residents, antipsychotics were administered to 25% of the Ontario residents compared to 29. 5% of the Swiss residents. The adjusted rate among residents without appropriate conditions was also lower in Ontario (14%) than in Switzerland (24. 5%). Apart from schizophrenia, bipolar disorder and cognitive impairment, antipsychotic use was determined by a different range of characteristics in these two countries. Antipsychotic use was not predictive of behavioural improvement. <br /><br /> <b>Conclusion. </b> The high adjusted rates of antipsychotic use in Ontario and Swiss nursing home residents, as well as the presence of "inappropriate indications" and "facility" as determinants of their use, raise concerns about the appropriateness of their administration in both countries. Their lack of effectiveness to improve behaviours also questions their use as long-term treatment for behaviour disturbances. Changes in practice patterns and implementation of policies are warranted to reduce inappropriate prescribing practices to enhance the quality of care provided to residents in nursing homes.

RESUMO A úlcera de pressão é uma complicação comum em pacientes críticos hospitalizados, tornando-se um problema sério para os mesmos e a prevenção deste tipo de complicações um desafio para a assistência de enfermagem. Este estudo tem como objetivos caracterizar a produção do conhecimento sobre a úlcera de pressão em pacientes críticos hospitalizados, publicados no período de 1994 a 1998 em periódicos nacionais e internacionais, identificar os fatores de risco para úlceras de pressão, analisar definições e características associadas à essas e analisar as publicações com base nas categorias temáticas das diretrizes da AHCPR. A análise foi feita segundo as categorias temáticas das diretrizes para previsão e prevenção de úlceras de pressão da Agência Americana para o Cuidado, Política e Pesquisa em Saúde. Foram identificadas as definições, características e fatores de risco para o desenvolvimento de úlceras de pressão que estavam relacionados ao paciente, à estrutura da instituição e ao processo de cuidar. Encontramos na amostra uma hegemonia de autores americanos, enfermeiros com mestrado ou médicos, que atuavam em hospitais. A maior parte dos trabalhos foi a úlcera de pressão como indicador da qualidade do cuidado. Os resultados da análise apontam que a adoção de protocolos sistematizados referentes ao processo e estrutura do cuidar, desenvolvidos a partir de pesquisa são eficazes para a prevenção da úlcera, evidenciando pela redução dos índices ou da incidência. / Pressure ulcer are common complication and serious problem in hospitalized critical patients. The prevention has become a challenge for nursing. The goals of this study were: to decribe the characteristics of knowledge production about pressure ulcer from 1994 to 1998 in national and international publications; the identification of the risk factors; analizing the articles based on recommendations of AHCPR and definitions ans characteristics related to them. The analyse was done using a method proposed by GANONG in one sample of 47 articles, considering the same recommendations for prediction and prevention of pressure ulcer of AHCPR. Definitions, characteristics and risk factors for the pressure ulcer development related to a patient were identified, as well as the ones related to the structure of the institution and to the care process. It was found in the sample, a hegemony from American authors, nurses and physicians, who had worked in the hospitals. The main approach of those articles were pressure ulcer as an quality indicator. The results showed that the use of protocols, related to the process and to the care structure, which were develop from the research, are efficient to the pressure ulcer prevention.

Um dos elementos para melhoria da qualidade dos serviços farmacêuticos clínicos é medir a qualidade do cuidado prestado e os indicadores podem ser usados nesta avaliação. O presente trabalho teve como objetivos identificar estudos sobre indicadores de qualidade para serviços farmacêuticos clínicos e desenvolver e validar um instrumento de indicadores para avaliação dos serviços de acompanhamento farmacoterapêutico prestados para pacientes ambulatoriais. Para tanto, uma busca abrangente da literatura foi conduzida nas bases de dados PubMed/Medline, Scopus, Lilacs e DOAJ por esses estudos. Os instrumentos apresentados pelos estudos foram avaliados em relação à qualidade das propriedades psicométricas. A seguir, foi desenvolvido um instrumento de indicadores-chave de desempenho. O grupo de pesquisa estabeleceu sete indicadores possíveis para avaliação de especialistas da área através de duas rodadas da técnica Delphi para validação de conteúdo. Ainda, farmacêuticos foram convidados a participar por meio de um questionário para validação de construto e confiabilidade do instrumento. A busca bibliográfica identificou 3.276 registros, dos quais 12 estudos completaram os critérios de inclusão. No geral, o maior número de estudos foi baseado em pesquisas para avaliar a satisfação dos pacientes e usou a revisão da literatura combinada com opinião de especialistas para o desenvolvimento do instrumento. Todos os estudos apresentaram algumas propriedades psicométricas do instrumento. A consistência interna e a validade de conteúdo foram os critérios mais relatados dos estudos, e nenhum deles apresentou o critério de estabilidade. Onze (68,8%) especialistas participaram da primeira rodada da técnica Delphi e nove (81,8%) especialistas completaram as 2 rodadas. Um novo indicador foi desenvolvido após a avaliação do painel de especialistas na primeira rodada. No geral, a validade de conteúdo e construto foi alcançada para o instrumento final. Os resultados desta tese apontam que os instrumentos dos estudos identificados na revisão sistemática apresentaram propriedades psicométricas, porém de forma incompleta ou não satisfatória. Ainda, um instrumento com seis indicadores foi desenvolvido e validado para o Serviço de Acompanhamento Farmacoterapêutico prestado para pacientes ambulatoriais. / One of the elements of quality improvement of medication management services is measuring the quality of care and key performance indicators (KPIs) can be used in this assessment. The study is aimed to identify quality indicators instruments in pharmaceutical care services and to develop and validate KPI instrument for medication management services provided for outpatients. For this, comprehensive literature search was performed in databases PubMed/Medline, Scopus, and Lilacs. The psychometric quality of the instruments was determined. In addition, a key performance indicators instrument was developed. A working group established 7 possible KPIs for assessment of the expert panel through an internet based 2-round Delphi approach. An internet questionnaire was developed for pharmacists in order to construct validity and reliability of the instrument. The literature search yielded 3,276 records, of which 12 studies satisfied the inclusion criteria. Overall, the greatest number of studies were based surveys to assess patients\' satisfaction and used literature review combined with expert\'s opinion for the instrument development. All studies presented some psychometrics properties of the instrument. Internal consistency and content validity were the most reported criteria of the studies and none of them presented stability. Eleven (68.8%) experts participated in the Delphi round 1 and nine (81.8%) experts completed the 2 Delphi rounds. A new KPI was develop after expert panel assessment in the first round. Overall, content and construct validity were reached for final instrument. The results of this thesis point out that instrument of the studies identified in the systematic review presented some psychometrics properties, but did not describe them satisfactorily. In addition, a set of six key performance indicators was developed and validated for medication management services provided for outpatients.

RESUMO A úlcera de pressão é uma complicação comum em pacientes críticos hospitalizados, tornando-se um problema sério para os mesmos e a prevenção deste tipo de complicações um desafio para a assistência de enfermagem. Este estudo tem como objetivos caracterizar a produção do conhecimento sobre a úlcera de pressão em pacientes críticos hospitalizados, publicados no período de 1994 a 1998 em periódicos nacionais e internacionais, identificar os fatores de risco para úlceras de pressão, analisar definições e características associadas à essas e analisar as publicações com base nas categorias temáticas das diretrizes da AHCPR. A análise foi feita segundo as categorias temáticas das diretrizes para previsão e prevenção de úlceras de pressão da Agência Americana para o Cuidado, Política e Pesquisa em Saúde. Foram identificadas as definições, características e fatores de risco para o desenvolvimento de úlceras de pressão que estavam relacionados ao paciente, à estrutura da instituição e ao processo de cuidar. Encontramos na amostra uma hegemonia de autores americanos, enfermeiros com mestrado ou médicos, que atuavam em hospitais. A maior parte dos trabalhos foi a úlcera de pressão como indicador da qualidade do cuidado. Os resultados da análise apontam que a adoção de protocolos sistematizados referentes ao processo e estrutura do cuidar, desenvolvidos a partir de pesquisa são eficazes para a prevenção da úlcera, evidenciando pela redução dos índices ou da incidência. / Pressure ulcer are common complication and serious problem in hospitalized critical patients. The prevention has become a challenge for nursing. The goals of this study were: to decribe the characteristics of knowledge production about pressure ulcer from 1994 to 1998 in national and international publications; the identification of the risk factors; analizing the articles based on recommendations of AHCPR and definitions ans characteristics related to them. The analyse was done using a method proposed by GANONG in one sample of 47 articles, considering the same recommendations for prediction and prevention of pressure ulcer of AHCPR. Definitions, characteristics and risk factors for the pressure ulcer development related to a patient were identified, as well as the ones related to the structure of the institution and to the care process. It was found in the sample, a hegemony from American authors, nurses and physicians, who had worked in the hospitals. The main approach of those articles were pressure ulcer as an quality indicator. The results showed that the use of protocols, related to the process and to the care structure, which were develop from the research, are efficient to the pressure ulcer prevention.

Um dos elementos para melhoria da qualidade dos serviços farmacêuticos clínicos é medir a qualidade do cuidado prestado e os indicadores podem ser usados nesta avaliação. O presente trabalho teve como objetivos identificar estudos sobre indicadores de qualidade para serviços farmacêuticos clínicos e desenvolver e validar um instrumento de indicadores para avaliação dos serviços de acompanhamento farmacoterapêutico prestados para pacientes ambulatoriais. Para tanto, uma busca abrangente da literatura foi conduzida nas bases de dados PubMed/Medline, Scopus, Lilacs e DOAJ por esses estudos. Os instrumentos apresentados pelos estudos foram avaliados em relação à qualidade das propriedades psicométricas. A seguir, foi desenvolvido um instrumento de indicadores-chave de desempenho. O grupo de pesquisa estabeleceu sete indicadores possíveis para avaliação de especialistas da área através de duas rodadas da técnica Delphi para validação de conteúdo. Ainda, farmacêuticos foram convidados a participar por meio de um questionário para validação de construto e confiabilidade do instrumento. A busca bibliográfica identificou 3.276 registros, dos quais 12 estudos completaram os critérios de inclusão. No geral, o maior número de estudos foi baseado em pesquisas para avaliar a satisfação dos pacientes e usou a revisão da literatura combinada com opinião de especialistas para o desenvolvimento do instrumento. Todos os estudos apresentaram algumas propriedades psicométricas do instrumento. A consistência interna e a validade de conteúdo foram os critérios mais relatados dos estudos, e nenhum deles apresentou o critério de estabilidade. Onze (68,8%) especialistas participaram da primeira rodada da técnica Delphi e nove (81,8%) especialistas completaram as 2 rodadas. Um novo indicador foi desenvolvido após a avaliação do painel de especialistas na primeira rodada. No geral, a validade de conteúdo e construto foi alcançada para o instrumento final. Os resultados desta tese apontam que os instrumentos dos estudos identificados na revisão sistemática apresentaram propriedades psicométricas, porém de forma incompleta ou não satisfatória. Ainda, um instrumento com seis indicadores foi desenvolvido e validado para o Serviço de Acompanhamento Farmacoterapêutico prestado para pacientes ambulatoriais. / One of the elements of quality improvement of medication management services is measuring the quality of care and key performance indicators (KPIs) can be used in this assessment. The study is aimed to identify quality indicators instruments in pharmaceutical care services and to develop and validate KPI instrument for medication management services provided for outpatients. For this, comprehensive literature search was performed in databases PubMed/Medline, Scopus, and Lilacs. The psychometric quality of the instruments was determined. In addition, a key performance indicators instrument was developed. A working group established 7 possible KPIs for assessment of the expert panel through an internet based 2-round Delphi approach. An internet questionnaire was developed for pharmacists in order to construct validity and reliability of the instrument. The literature search yielded 3,276 records, of which 12 studies satisfied the inclusion criteria. Overall, the greatest number of studies were based surveys to assess patients\' satisfaction and used literature review combined with expert\'s opinion for the instrument development. All studies presented some psychometrics properties of the instrument. Internal consistency and content validity were the most reported criteria of the studies and none of them presented stability. Eleven (68.8%) experts participated in the Delphi round 1 and nine (81.8%) experts completed the 2 Delphi rounds. A new KPI was develop after expert panel assessment in the first round. Overall, content and construct validity were reached for final instrument. The results of this thesis point out that instrument of the studies identified in the systematic review presented some psychometrics properties, but did not describe them satisfactorily. In addition, a set of six key performance indicators was developed and validated for medication management services provided for outpatients.