PREDIRCAM eHealth platform for individualized telemedical assistance for lifestyle modification in the treatment of obesity, diabetes, and cardiometabolic risk prevention: a pilot study (PREDIRCAM 1)

Background: Healthy diet and regular physical activity are powerful tools in reducing diabetes and cardiometabolic risk. Various international scientific and health organizations have advocated the use of new technologies to solve these problems. The PREDIRCAM project explores the contribution that a technological system could offer for the continuous monitoring of lifestyle habits and individualized treatment of obesity as well as cardiometabolic risk prevention. Methods: PREDIRCAM is a technological platform for patients and professionals designed to improve the effectiveness of lifestyle behavior modifications through the intensive use of the latest information and communication technologies. The platform consists of a web-based application providing communication interface with monitoring devices of physiological variables, application for monitoring dietary intake, ad hoc electronic medical records, different communication channels, and an intelligent notification system. A 2-week feasibility study was conducted in 15 volunteers to assess the viability of the platform. Results: The website received 244 visits (average time/session: 17 min 45 s). A total of 435 dietary intakes were recorded (average time for each intake registration, 4 min 42 s ± 2 min 30 s), 59 exercises were recorded in 20 heart rate monitor downloads, 43 topics were discussed through a forum, and 11 of the 15 volunteers expressed a favorable opinion toward the platform. Food intake recording was reported as the most laborious task. Ten of the volunteers considered long-term use of the platform to be feasible. Conclusions: The PREDIRCAM platform is technically ready for clinical evaluation. Training is required to use the platform and, in particular, for registration of dietary food intake.

Case study on mobile applications UX: effect of the usage of a crosss-platform development framework

Cross-platform development frameworks for mobile applications promise important advantages in cost cuttings and easy maintenance, posing as a very good option for organizations interested in the design of mobile applications for several platforms. Given that platform conventions are especially important for the User eXperience (UX) of mobile applications, the usage of framework where the same code defines the behavior of the app in different platforms could have negative impact in the UX. The objetive of this study is comparing the cross-platform and the native approach for being able to determine if the selected development approach has any impact on the users in terms of UX. To be able to set a base line under this subject, study on cross-platform frameworks was performed to select the most appropriate one from a UX point of view. In order to achieve the objectives of this work, two development teams have developed two versions of the same application; one using framework that generates Android and iOS versions automatically, and another team developing native versions of the same application. The alternative versions for each platform have been evaluated with 37 users with a combination of a laboratory usability test and a longitudinal study. The results show that differences are minimal in the Android version, but in iOS, even if a reasonable good UX can be obtained with the usage of this framework by an UX-conscious design team, a higher level of UX can be obtained directly developing in native code.

Doubling the width of the platform of the San Pedro bridge in Spain

The San Pedro Bridge has six spans and is 750 m (2460 ft) long, 88 m (290 ft) high, 12 m (39 ft) wide, and curved with a radius of 700 m (2300 ft). It was built in 1993 using the cantilever method. Its super - structure is a prestressed concrete box girder with main spans of 150 m (490 ft). In 2008 and 2009, the width of the platform was enlarged to 23 m (75 ft) using five movable sets of scaffolding. The bridge remained open to traffic during construction. The original platform was widened 6 m (20 ft) on each side by connecting a new lightweight concrete cantilever to the original upper slab. These cantilevers were supported by steelstruts. The tie into the upper slab was made with new transverse post-tensioned tendons. The original superstructure was strengthened to resist the additional dead load of the expansion and live loads of the extra traffic. An additional new central web and a composite concrete-steel section were constructed and connected to the concrete box and central web using vertical high-strength post-tensioning bars. Also, external post-tensioning cables were implemented. It was also necessary to strengthen the connection of the original concrete box section to the piers. Detailed calculations were performed to evaluate the load distribution transmitted to the piers by the webs and by the original inclined concrete walls of the box girder. Finally, a detailed second-order-analysis of the complete structure was made to guarantee the resistance of the piers compared with actual loads

Visual Servoing for the Robotenis System: a Strategy for a 3 DOF Parallel Robot to Hit a Ping-Pong Ball

This article describes a new visual servo control and strategies that are used to carry out dynamic tasks by the Robotenis platform. This platform is basically a parallel robot that is equipped with an acquisition and processing system of visual information, its main feature is that it has a completely open architecture control, and planned in order to design, implement, test and compare control strategies and algorithms (visual and actuated joint controllers). Following sections describe a new visual control strategy specially designed to track and intercept objects in 3D space. The results are compared with a controller shown in previous woks, where the end effector of the robot keeps a constant distance from the tracked object. In this work, the controller is specially designed in order to allow changes in the tracking reference. Changes in the tracking reference can be used to grip an object that is under movement, or as in this case, hitting a hanging Ping-Pong ball. Lyapunov stability is taken into account in the controller design.

Migration to an a on-line laboatory in mechanical engineering. The case of a cam-follower design practice.

The European Higher Education Area (EHEA) has leaded to a change in the way the subjects are taught. One of the more important aspects of the EHEA is to support the autonomous study of the students. Taking into account this new approach, the virtual laboratory of the subject Mechanisms of the Aeronautical studies at the Technical University of Madrid is being migrated to an on-line scheme. This virtual laboratory consist on two practices: the design of cam-follower mechanisms and the design of trains of gears. Both practices are software applications that, in the current situation, need to be installed on each computer and the students carry out the practice at the computer classroom of the school under the supervision of a teacher. During this year the design of cam-follower mechanisms practice has been moved to a web application using Java and the Google Development Toolkit. In this practice the students has to design and study the running of a cam to perform a specific displacement diagram with a selected follower taking into account that the mechanism must be able to work properly at high speed regime. The practice has maintained its objectives in the new platform but to take advantage of the new methodology and try to avoid the inconveniences that the previous version had shown. Once the new practice has been ready, a pilot study has been carried out to compare both approaches: on-line and in-lab. This paper shows the adaptation of the cam and follower practice to an on-line methodology. Both practices are described and the changes that has been done to the initial one are shown. They are compared and the weak and strong points of each one are analyzed. Finally we explain the pilot study carried out, the students impression and the results obtained.

Migration to an a on.line laboratory in mechanical engineering. The case of a cam follower design practice.

The European Higher Education Area (EHEA) has leaded to a change in the way the subjects are taught. One of the more important aspects of the EHEA is to support the autonomous study of the students. Taking into account this new approach, the virtual laboratory of the subject Mechanisms of the Aeronautical studies at the Technical University of Madrid is being migrated to an on-line scheme. This virtual laboratory consist on two practices: the design of cam-follower mechanisms and the design of trains of gears. Both practices are software applications that, in the current situation, need to be installed on each computer and the students carry out the practice at the computer classroom of the school under the supervision of a teacher. During this year the design of cam-follower mechanisms practice has been moved to a web application using Java and the Google Development Toolkit. In this practice the students has to design and study the running of a cam to perform a specific displacement diagram with a selected follower taking into account that the mechanism must be able to work properly at high speed regime. The practice has maintained its objectives in the new platform but to take advantage of the new methodology and try to avoid the inconveniences that the previous version had shown. Once the new practice has been ready, a pilot study has been carried out to compare both approaches: on-line and in-lab. This paper shows the adaptation of the cam and follower practice to an on-line methodology. Both practices are described and the changes that has been done to the initial one are shown. They are compared and the weak and strong points of each one are analyzed. Finally we explain the pilot study carried out, the students impression and the results obtained.

Boron dilution benchmark using COBAYA3/FLICA4 coupled codes within the NURISP European Project

Within the subproject 3 of the NURISP project three neutron kinetic codes have been implemented into the NURESIM platform. For all three codes (CRONOS2, COBAYA3 and DYN3D) the coupling with the thermal hydraulic code FLICA4 was accomplished using the features of the NURESIM platform. This paper contains the results obtained with COBAYA3/FLICA4 coupled codes for the PWR boron dilution benchmark defined within the sub project 3 of the NURISP project. Results are provided for all the scenarios.

A platform for real-time control education with LEGO MINDSTORMS.

A set of software development tools for building real-time control systems on a simple robotics platform is described in the paper. The tools are being used in a real-time systems course as a basis for student projects. The development platform is a low-cost PC running GNU/Linux, and the target system is LEGO MINDSTORMS NXT, thus keeping the cost of the laboratory low. Real-time control software is developed using a mixed paradigm. Functional code for control algorithms is automatically generated in C from Simulink models. This code is then integrated into a concurrent, real-time software architecture based on a set of components written in Ada. This approach enables the students to take advantage of the high-level, model-oriented features that Simulink oers for designing control algorithms, and the comprehensive support for concurrency and real-time constructs provided by Ada.

Hardware-software integration platform for a WSN testbed based on cookies nodes

In this work a complete hardware-software support platform for a WSN testbed focused on developing wireless sensor applications in a simple and intuitive way is presented, as an alternative of commercial-motes-based testbeds that can be found in the state of the art. The main target of this hardware-software platform is to provide the highest abstraction level on the management of WSNs but in the simplest way in order to achieve a fast profiling mechanism for reliable prototyping based on the Cookies platform as well as helping users to develop, test and validate Cookie-Based WSN applications.

CookieLibs: An Intuitive Software Platform For Controlling Cookies Wireless Sensor Nodes

In this work a complete set of libraries for developing wireless sensor applications in a simple and intuitive way is presented, in contraposition to the most spread application abstraction-level mechanisms based on operating systems. The main target of this software platform, named CookieLibs, is to provide the highest abstraction level on the management of WSNs but in the simplest way for those users who are not familiar with software design, in order to achieve a fast profiling mechanism for reliable prototyping based on the Cookies platform.

Design and evaluation of an educational platform for implementing and testing bilateral control algorithms

This paper describes the design and evaluation of a new platform created in order to improve the learning experience of bilateral control algorithms in teleoperation. This experimental platform, developed at Universidad Politécnica de Madrid, is used by the students of the Master on Automation and Robotics in the practices of the subject called “Telerobotics and Teleoperation”. The main objective is to easily implement different control architectures in the developed platform and evaluate them under different conditions to better understand the main advantages and drawbacks of each control scheme. So, the student’s tasks are focused on adjusting the control parameters of the predefined controllers and designing new ones to analyze the changes in the behavior of the whole system. A description of the subject, main topics and the platform constructed are detailed in the paper. Furthermore, the methodology followed in the practices and the bilateral control algorithms are presented. Finally, the results obtained in the experiments with students are also shown.

The european project NURISP for nuclear reactor simulation

The NURISP project aims at developing the European NURESIM reference simulation platform [1] for nuclear reactor. A first version of NURESIM was delivered in 2008. 22 organizations from 14 European countries contribute to the further development of this platform. NURISP also includes a User’s Group (UG) whose members are not NURISP partners and come from the industrial nuclear sector or European and non-European R&D labs. Users can benefit from the use of the NURESIM platform, methods, results and modules and they provide concrete input and feedback on the use of these elements.

Evaluation and implementation of a hybrid cross-platform application combining mobile web-technologies and native device functions

Este Proyecto de Fin de Carrera presenta un prototipo de aplicación móvil híbrida multi-plataforma para Android y iOS. Las aplicaciones móviles híbridas son una combinación de aplicaciones web móviles y aplicaciones móviles nativas. Se desarrollan parcialmente con tecnologías web y pueden acceder a la capa nativa y sensores del teléfono. Para el usuario se presentan como aplicaciones nativas, ya que se pueden descargar de las tiendas de aplicaciones y son instaladas en el dispositivo. El prototipo consiste en la migración del módulo de noticias financieras de las aplicaciones actuales para móviles de una compañía bancaria reimplementándolo como aplicación híbrida utilizando uno de los entornos de desarrollo disponibles en el mercado para este propósito. El desarrollo de aplicaciones híbridas puede ahorrar tiempo y dinero cuando se pretende alcanzar más de una plataforma móvil. El objetivo es la evaluación de las ventajas e inconvenientes que ofrece el desarrollo de aplicaciones híbridas en términos de reducción de costes, tiempo de desarrollo y resultado final de la aplicación. El proyecto consta de varias fases. Durante la primera fase se realiza un estudio sobre las aplicaciones híbridas que podemos encontrar hoy en día en el mercado utilizando los ejemplos de linkedIn, Facebook y Financial times. Se hace hincapié en las tecnologías utilizadas, uso de la red móvil y problemas encontrados. Posteriormente se realiza una comparación de distintos entornos de desarrollo multi-plataforma para aplicaciones híbridas en términos de la estrategia utilizada, plataformas soportadas, lenguajes de programación, acceso a capacidades nativas de los dispositivos y licencias de uso. Esta primera fase da como resultado la elección del entorno de desarrollo más adecuado a las exigencias del proyecto, que es PhoneGap, y continua con un análisis más detallado de dicho entorno en cuanto a su arquitectura, características y componentes. La siguiente fase comienza con un estudio de las aplicaciones actuales de la compañía para extraer el código fuente necesario y adaptarlo a la arquitectura que tendrá la aplicación. Para la realización del prototipo se hace uso de la característica que ofrece PhoneGap para acceder a la capa nativa del dispositivo, esto es, el uso de plugins. Se diseña y desarrolla un plugin que permite acceder a la capa nativa para cada plataforma. Una vez desarrollado el prototipo para la plataforma Android, se migra y adapta para la plataforma iOS. Por último se hace una evaluación de los prototipos en cuanto a su facilidad y tiempo de desarrollo, rendimiento, funcionalidad y apariencia de la interfaz de usuario. ABSTRACT. This bachelor's thesis presents a prototype of a hybrid cross-platform mobile application for Android and iOS. Hybrid mobile applications are a combination of mobile web and mobile native applications. They are built partially with web technologies and they can also access native features and sensors of the device. For a user, they look like native applications as they are downloaded from the application stores and installed on the device. This prototype consists of the migration of the financial news module of current mobile applications from a financial bank reimplementing them as a hybrid application using one of the frameworks available in the market for that purpose. Development of applications on a hybrid way can help reducing costs and effort when targeting more than one platform. The target of the project is the evaluation of the advantages and disadvantages that hybrid development can offer in terms of reducing costs and efforts and the final result of the application. The project starts with an analysis of successfully released hybrid applications using the examples of linkedIn, Facebook and Financial Times, emphasizing the different used technologies, the transmitted network data and the encountered problems during the development. This analysis is followed by a comparison of most popular hybrid crossplatform development frameworks in terms of the different approaches, supported platforms, programming languages, access to native features and license. This first stage has the outcome of finding the development framework that best fits to the requirements of the project, that is PhoneGap, and continues with a deeper analysis of its architecture, features and components. Next stage analyzes current company's applications to extract the needed source code and adapt it to the architecture of the prototype. For the realization of the application, the feature that PhoneGap offers to access the native layer of the device is used. This feature is called plugin. A custom plugin is designed and developed to access the native layer of each targeted platform. Once the prototype is finished for Android, it is migrated and adapted to the iOS platform. As a final conclusion the prototypes are evaluated in terms of ease and time of development, performance, functionality and look and feel.

A model to develop a platform for personalised health applications

Antecedentes Europa vive una situación insostenible. Desde el 2008 se han reducido los recursos de los gobiernos a raíz de la crisis económica. El continente Europeo envejece con ritmo constante al punto que se prevé que en 2050 habrá sólo dos trabajadores por jubilado [54]. A esta situación se le añade el aumento de la incidencia de las enfermedades crónicas, relacionadas con el envejecimiento, cuyo coste puede alcanzar el 7% del PIB de un país [51]. Es necesario un cambio de paradigma. Una nueva manera de cuidar de la salud de las personas: sustentable, eficaz y preventiva más que curativa. Algunos estudios abogan por el cuidado personalizado de la salud (pHealth). En este modelo las prácticas médicas son adaptadas e individualizadas al paciente, desde la detección de los factores de riesgo hasta la personalización de los tratamientos basada en la respuesta del individuo [81]. El cuidado personalizado de la salud está asociado a menudo al uso de las tecnologías de la información y comunicación (TICs) que, con su desarrollo exponencial, ofrecen oportunidades interesantes para la mejora de la salud. El cambio de paradigma hacia el pHealth está lentamente ocurriendo, tanto en el ámbito de la investigación como en la industria, pero todavía no de manera significativa. Existen todavía muchas barreras relacionadas a la economía, a la política y la cultura. También existen barreras puramente tecnológicas, como la falta de sistemas de información interoperables [199]. A pesar de que los aspectos de interoperabilidad están evolucionando, todavía hace falta un diseño de referencia especialmente direccionado a la implementación y el despliegue en gran escala de sistemas basados en pHealth. La presente Tesis representa un intento de organizar la disciplina de la aplicación de las TICs al cuidado personalizado de la salud en un modelo de referencia, que permita la creación de plataformas de desarrollo de software para simplificar tareas comunes de desarrollo en este dominio. Preguntas de investigación RQ1 >Es posible definir un modelo, basado en técnicas de ingeniería del software, que represente el dominio del cuidado personalizado de la salud de una forma abstracta y representativa? RQ2 >Es posible construir una plataforma de desarrollo basada en este modelo? RQ3 >Esta plataforma ayuda a los desarrolladores a crear sistemas pHealth complejos e integrados? Métodos Para la descripción del modelo se adoptó el estándar ISO/IEC/IEEE 42010por ser lo suficientemente general y abstracto para el amplio enfoque de esta tesis [25]. El modelo está definido en varias partes: un modelo conceptual, expresado a través de mapas conceptuales que representan las partes interesadas (stakeholders), los artefactos y la información compartida; y escenarios y casos de uso para la descripción de sus funcionalidades. El modelo fue desarrollado de acuerdo a la información obtenida del análisis de la literatura, incluyendo 7 informes industriales y científicos, 9 estándares, 10 artículos en conferencias, 37 artículos en revistas, 25 páginas web y 5 libros. Basándose en el modelo se definieron los requisitos para la creación de la plataforma de desarrollo, enriquecidos por otros requisitos recolectados a través de una encuesta realizada a 11 ingenieros con experiencia en la rama. Para el desarrollo de la plataforma, se adoptó la metodología de integración continua [74] que permitió ejecutar tests automáticos en un servidor y también desplegar aplicaciones en una página web. En cuanto a la metodología utilizada para la validación se adoptó un marco para la formulación de teorías en la ingeniería del software [181]. Esto requiere el desarrollo de modelos y proposiciones que han de ser validados dentro de un ámbito de investigación definido, y que sirvan para guiar al investigador en la búsqueda de la evidencia necesaria para justificarla. La validación del modelo fue desarrollada mediante una encuesta online en tres rondas con un número creciente de invitados. El cuestionario fue enviado a 134 contactos y distribuido en algunos canales públicos como listas de correo y redes sociales. El objetivo era evaluar la legibilidad del modelo, su nivel de cobertura del dominio y su potencial utilidad en el diseño de sistemas derivados. El cuestionario incluía preguntas cuantitativas de tipo Likert y campos para recolección de comentarios. La plataforma de desarrollo fue validada en dos etapas. En la primera etapa se utilizó la plataforma en un experimento a pequeña escala, que consistió en una sesión de entrenamiento de 12 horas en la que 4 desarrolladores tuvieron que desarrollar algunos casos de uso y reunirse en un grupo focal para discutir su uso. La segunda etapa se realizó durante los tests de un proyecto en gran escala llamado HeartCycle [160]. En este proyecto un equipo de diseñadores y programadores desarrollaron tres aplicaciones en el campo de las enfermedades cardio-vasculares. Una de estas aplicaciones fue testeada en un ensayo clínico con pacientes reales. Al analizar el proyecto, el equipo de desarrollo se reunió en un grupo focal para identificar las ventajas y desventajas de la plataforma y su utilidad. Resultados Por lo que concierne el modelo que describe el dominio del pHealth, la parte conceptual incluye una descripción de los roles principales y las preocupaciones de los participantes, un modelo de los artefactos TIC que se usan comúnmente y un modelo para representar los datos típicos que son necesarios formalizar e intercambiar entre sistemas basados en pHealth. El modelo funcional incluye un conjunto de 18 escenarios, repartidos en: punto de vista de la persona asistida, punto de vista del cuidador, punto de vista del desarrollador, punto de vista de los proveedores de tecnologías y punto de vista de las autoridades; y un conjunto de 52 casos de uso repartidos en 6 categorías: actividades de la persona asistida, reacciones del sistema, actividades del cuidador, \engagement" del usuario, actividades del desarrollador y actividades de despliegue. Como resultado del cuestionario de validación del modelo, un total de 65 personas revisó el modelo proporcionando su nivel de acuerdo con las dimensiones evaluadas y un total de 248 comentarios sobre cómo mejorar el modelo. Los conocimientos de los participantes variaban desde la ingeniería del software (70%) hasta las especialidades médicas (15%), con declarado interés en eHealth (24%), mHealth (16%), Ambient Assisted Living (21%), medicina personalizada (5%), sistemas basados en pHealth (15%), informática médica (10%) e ingeniería biomédica (8%) con una media de 7.25_4.99 años de experiencia en estas áreas. Los resultados de la encuesta muestran que los expertos contactados consideran el modelo fácil de leer (media de 1.89_0.79 siendo 1 el valor más favorable y 5 el peor), suficientemente abstracto (1.99_0.88) y formal (2.13_0.77), con una cobertura suficiente del dominio (2.26_0.95), útil para describir el dominio (2.02_0.7) y para generar sistemas más específicos (2_0.75). Los expertos también reportan un interés parcial en utilizar el modelo en su trabajo (2.48_0.91). Gracias a sus comentarios, el modelo fue mejorado y enriquecido con conceptos que faltaban, aunque no se pudo demonstrar su mejora en las dimensiones evaluadas, dada la composición diferente de personas en las tres rondas de evaluación. Desde el modelo, se generó una plataforma de desarrollo llamada \pHealth Patient Platform (pHPP)". La plataforma desarrollada incluye librerías, herramientas de programación y desarrollo, un tutorial y una aplicación de ejemplo. Se definieron cuatro módulos principales de la arquitectura: el Data Collection Engine, que permite abstraer las fuentes de datos como sensores o servicios externos, mapeando los datos a bases de datos u ontologías, y permitiendo interacción basada en eventos; el GUI Engine, que abstrae la interfaz de usuario en un modelo de interacción basado en mensajes; y el Rule Engine, que proporciona a los desarrolladores un medio simple para programar la lógica de la aplicación en forma de reglas \if-then". Después de que la plataforma pHPP fue utilizada durante 5 años en el proyecto HeartCycle, 5 desarrolladores fueron reunidos en un grupo de discusión para analizar y evaluar la plataforma. De estas evaluaciones se concluye que la plataforma fue diseñada para encajar las necesidades de los ingenieros que trabajan en la rama, permitiendo la separación de problemas entre las distintas especialidades, y simplificando algunas tareas de desarrollo como el manejo de datos y la interacción asíncrona. A pesar de ello, se encontraron algunos defectos a causa de la inmadurez de algunas tecnologías empleadas, y la ausencia de algunas herramientas específicas para el dominio como el procesado de datos o algunos protocolos de comunicación relacionados con la salud. Dentro del proyecto HeartCycle la plataforma fue utilizada para el desarrollo de la aplicación \Guided Exercise", un sistema TIC para la rehabilitación de pacientes que han sufrido un infarto del miocardio. El sistema fue testeado en un ensayo clínico randomizado en el cual a 55 pacientes se les dio el sistema para su uso por 21 semanas. De los resultados técnicos del ensayo se puede concluir que, a pesar de algunos errores menores prontamente corregidos durante el estudio, la plataforma es estable y fiable. Conclusiones La investigación llevada a cabo en esta Tesis y los resultados obtenidos proporcionan las respuestas a las tres preguntas de investigación que motivaron este trabajo: RQ1 Se ha desarrollado un modelo para representar el dominio de los sistemas personalizados de salud. La evaluación hecha por los expertos de la rama concluye que el modelo representa el dominio con precisión y con un balance apropiado entre abstracción y detalle. RQ2 Se ha desarrollado, con éxito, una plataforma de desarrollo basada en el modelo. RQ3 Se ha demostrado que la plataforma es capaz de ayudar a los desarrolladores en la creación de software pHealth complejos. Las ventajas de la plataforma han sido demostradas en el ámbito de un proyecto de gran escala, aunque el enfoque genérico adoptado indica que la plataforma podría ofrecer beneficios también en otros contextos. Los resultados de estas evaluaciones ofrecen indicios de que, ambos, el modelo y la plataforma serán buenos candidatos para poderse convertir en una referencia para futuros desarrollos de sistemas pHealth. ABSTRACT Background Europe is living in an unsustainable situation. The economic crisis has been reducing governments' economic resources since 2008 and threatening social and health systems, while the proportion of older people in the European population continues to increase so that it is foreseen that in 2050 there will be only two workers per retiree [54]. To this situation it should be added the rise, strongly related to age, of chronic diseases the burden of which has been estimated to be up to the 7% of a country's gross domestic product [51]. There is a need for a paradigm shift, the need for a new way of caring for people's health, shifting the focus from curing conditions that have arisen to a sustainable and effective approach with the emphasis on prevention. Some advocate the adoption of personalised health care (pHealth), a model where medical practices are tailored to the patient's unique life, from the detection of risk factors to the customization of treatments based on each individual's response [81]. Personalised health is often associated to the use of Information and Communications Technology (ICT), that, with its exponential development, offers interesting opportunities for improving healthcare. The shift towards pHealth is slowly taking place, both in research and in industry, but the change is not significant yet. Many barriers still exist related to economy, politics and culture, while others are purely technological, like the lack of interoperable information systems [199]. Though interoperability aspects are evolving, there is still the need of a reference design, especially tackling implementation and large scale deployment of pHealth systems. This thesis contributes to organizing the subject of ICT systems for personalised health into a reference model that allows for the creation of software development platforms to ease common development issues in the domain. Research questions RQ1 Is it possible to define a model, based on software engineering techniques, for representing the personalised health domain in an abstract and representative way? RQ2 Is it possible to build a development platform based on this model? RQ3 Does the development platform help developers create complex integrated pHealth systems? Methods As method for describing the model, the ISO/IEC/IEEE 42010 framework [25] is adopted for its generality and high level of abstraction. The model is specified in different parts: a conceptual model, which makes use of concept maps, for representing stakeholders, artefacts and shared information, and in scenarios and use cases for the representation of the functionalities of pHealth systems. The model was derived from literature analysis, including 7 industrial and scientific reports, 9 electronic standards, 10 conference proceedings papers, 37 journal papers, 25 websites and 5 books. Based on the reference model, requirements were drawn for building the development platform enriched with a set of requirements gathered in a survey run among 11 experienced engineers. For developing the platform, the continuous integration methodology [74] was adopted which allowed to perform automatic tests on a server and also to deploy packaged releases on a web site. As a validation methodology, a theory building framework for SW engineering was adopted from [181]. The framework, chosen as a guide to find evidence for justifying the research questions, imposed the creation of theories based on models and propositions to be validated within a scope. The validation of the model was conducted as an on-line survey in three validation rounds, encompassing a growing number of participants. The survey was submitted to 134 experts of the field and on some public channels like relevant mailing lists and social networks. Its objective was to assess the model's readability, its level of coverage of the domain and its potential usefulness in the design of actual, derived systems. The questionnaires included quantitative Likert scale questions and free text inputs for comments. The development platform was validated in two scopes. As a small-scale experiment, the platform was used in a 12 hours training session where 4 developers had to perform an exercise consisting in developing a set of typical pHealth use cases At the end of the session, a focus group was held to identify benefits and drawbacks of the platform. The second validation was held as a test-case study in a large scale research project called HeartCycle the aim of which was to develop a closed-loop disease management system for heart failure and coronary heart disease patients [160]. During this project three applications were developed by a team of programmers and designers. One of these applications was tested in a clinical trial with actual patients. At the end of the project, the team was interviewed in a focus group to assess the role the platform had within the project. Results For what regards the model that describes the pHealth domain, its conceptual part includes a description of the main roles and concerns of pHealth stakeholders, a model of the ICT artefacts that are commonly adopted and a model representing the typical data that need to be formalized among pHealth systems. The functional model includes a set of 18 scenarios, divided into assisted person's view, caregiver's view, developer's view, technology and services providers' view and authority's view, and a set of 52 Use Cases grouped in 6 categories: assisted person's activities, system reactions, caregiver's activities, user engagement, developer's activities and deployer's activities. For what concerns the validation of the model, a total of 65 people participated in the online survey providing their level of agreement in all the assessed dimensions and a total of 248 comments on how to improve and complete the model. Participants' background spanned from engineering and software development (70%) to medical specialities (15%), with declared interest in the fields of eHealth (24%), mHealth (16%), Ambient Assisted Living (21%), Personalized Medicine (5%), Personal Health Systems (15%), Medical Informatics (10%) and Biomedical Engineering (8%) with an average of 7.25_4.99 years of experience in these fields. From the analysis of the answers it is possible to observe that the contacted experts considered the model easily readable (average of 1.89_0.79 being 1 the most favourable scoring and 5 the worst), sufficiently abstract (1.99_0.88) and formal (2.13_0.77) for its purpose, with a sufficient coverage of the domain (2.26_0.95), useful for describing the domain (2.02_0.7) and for generating more specific systems (2_0.75) and they reported a partial interest in using the model in their job (2.48_0.91). Thanks to their comments, the model was improved and enriched with concepts that were missing at the beginning, nonetheless it was not possible to prove an improvement among the iterations, due to the diversity of the participants in the three rounds. From the model, a development platform for the pHealth domain was generated called pHealth Patient Platform (pHPP). The platform includes a set of libraries, programming and deployment tools, a tutorial and a sample application. The main four modules of the architecture are: the Data Collection Engine, which allows abstracting sources of information like sensors or external services, mapping data to databases and ontologies, and allowing event-based interaction and filtering, the GUI Engine, which abstracts the user interface in a message-like interaction model, the Workow Engine, which allows programming the application's user interaction ows with graphical workows, and the Rule Engine, which gives developers a simple means for programming the application's logic in the form of \if-then" rules. After the 5 years experience of HeartCycle, partially programmed with pHPP, 5 developers were joined in a focus group to discuss the advantages and drawbacks of the platform. The view that emerged from the training course and the focus group was that the platform is well-suited to the needs of the engineers working in the field, it allowed the separation of concerns among the different specialities and it simplified some common development tasks like data management and asynchronous interaction. Nevertheless, some deficiencies were pointed out in terms of a lack of maturity of some technological choices, and for the absence of some domain-specific tools, e.g. for data processing or for health-related communication protocols. Within HeartCycle, the platform was used to develop part of the Guided Exercise system, a composition of ICT tools for the physical rehabilitation of patients who suffered from myocardial infarction. The system developed using the platform was tested in a randomized controlled clinical trial, in which 55 patients used the system for 21 weeks. The technical results of this trial showed that the system was stable and reliable. Some minor bugs were detected, but these were promptly corrected using the platform. This shows that the platform, as well as facilitating the development task, can be successfully used to produce reliable software. Conclusions The research work carried out in developing this thesis provides responses to the three three research questions that were the motivation for the work. RQ1 A model was developed representing the domain of personalised health systems, and the assessment of experts in the field was that it represents the domain accurately, with an appropriate balance between abstraction and detail. RQ2 A development platform based on the model was successfully developed. RQ3 The platform has been shown to assist developers create complex pHealth software. This was demonstrated within the scope of one large-scale project, but the generic approach adopted provides indications that it would offer benefits more widely. The results of these evaluations provide indications that both the model and the platform are good candidates for being a reference for future pHealth developments.

Diffusion of Eco-innovations: exploring the literature

In recent years, the importance of the management of eco-innovations has been growing, more in practice than in academia. However, although in the literature there are already some evidences focussed on management of eco-innovations, there is no comprehensive review on the knowledge base of diffusion of eco-innovations. This paper provides a current overview of the existing body of literature, identifying the most active scholars and relevant publications in this field, and deepening in the major disciplines and research streams. Results show that the theory of diffusion of innovations which provided the philosophical underpinnings of how innovations are diffused is not the main knowledge base to explain the diffusion of eco-innovations. Lead market hypothesis, sustainable transitions and the ecological modernization appear as the initial base of the cognitive platform that can contribute to the understanding of diffusion of eco-innovations.