Limits of the Southern Ocean

The knowledge about processes concerning perception and understanding is of paramount importance for designing means of communication like maps and charts. This is especially the case, if one does not want to lose sight of the map-user and if map-design is to be orientated along the map-users needs and preferences in order to improve the cartographic product's usability. A scientific approach to visualization can help to achieve useable results. The insights achieved by such an approach can lead to modes of visualization that are superior to those, which have seemingly proved their value in praxis - so-called "bestpractices" -, concerning their utility and efficiency. This thesis shows this by using the example of visualizing the limits of bodies of waters in the Southern Ocean. After making some introductorily remarks on the chosen mode of problem-solution in chapter one, which simultaneously illustrate the flow of work while working on the problem, in chapter two the relevant information concerning the drawing of limits in the Southern Ocean is outlined. Chapter 3 builds the theoretical framework, which is a multidisciplinary approach to representation. This theoretical framework is based on "How Maps Work" by the American Cartographer MacEachren (1995/2004). His "scientific approach to visualization" is amended and adjusted by the knowledge gained from recent findings of the social sciences where necessary. So, the approach suggested in this thesis represents a synergy of psychology, sociology, semiotics, linguistics, communication theory and cartography. It follows the tradition of interdisciplinary research getting over the boundaries of a single scientific subject. The achieved holistic approach can help to improve the usability of cartographic products. It illustrates on the one hand those processes taking place while perceiving and recognizing cartographic information - so-called bottom-up-processes. On the other hand it illuminates the processes which happen during understanding this information in so-called top-down-processes. Bottom-up- and top-down-processes are interdependent and inseparably interrelated and therefore cannot be understood without each other. Regarding aspects of usability the approach suggested in this thesis strongly focuses on the map-user. This is the reason why the phenomenon of communication gains more weight than in MacEachren's map-centered approach. Because of this, in chapter 4 a holistic approach to communication is developed. This approach makes clear that only the map-user can evaluate the usability of a cartographic product. Only if he can extract the information relevant for him from the cartographical product, it is really useable. The concept of communication is well suited to conceive that. In case of the visualization of limits of bodies of water in the Southern Ocean, which is not complex enough to illustrate all results of the theoretical considerations, it is suggested to visualize the limits with red lines. This suggestion deviates from the commonly used mode of visualization. So, this thesis shows how theory is able to ameliorate praxis. Chapter 5 leads back to the task of fixing limits of the bodies of water in the area of concern. A convention by the International Hydrographic Organization (IHO) states that those limits should be drawn by using meridians, parallels, rhumb lines and bathymetric data. Based on the available bathymetric data both a representation and a process model are calculated, which should support the drawing of the limits. The quality of both models, which depends on the quality of the bathymetric data at hand, leads to the decision that the representation model is better suited to support the drawing of limits.

Reference list of sources used for two experimental data files dataBSRN and dataMixed

Increasing amounts of data is collected in most areas of research and application. The degree to which this data can be accessed, analyzed, and retrieved, is a decisive in obtaining progress in fields such as scientific research or industrial production. We present a novel methodology supporting content-based retrieval and exploratory search in repositories of multivariate research data. In particular, our methods are able to describe two-dimensional functional dependencies in research data, e.g. the relationship between ination and unemployment in economics. Our basic idea is to use feature vectors based on the goodness-of-fit of a set of regression models to describe the data mathematically. We denote this approach Regressional Features and use it for content-based search and, since our approach motivates an intuitive definition of interestingness, for exploring the most interesting data. We apply our method on considerable real-world research datasets, showing the usefulness of our approach for user-centered access to research data in a Digital Library system.

Adapting a speech into sign language translation system to a new domain

This paper presents a methodology for adapting an advanced communication system for deaf people in a new domain. This methodology is a user-centered design approach consisting of four main steps: requirement analysis, parallel corpus generation, technology adaptation to the new domain, and finally, system evaluation. In this paper, the new considered domain has been the dialogues in a hotel reception. With this methodology, it was possible to develop the system in a few months, obtaining very good performance: good speech recognition and translation rates (around 90%) with small processing times.

Context-awareness in task automation services by distributed event processing

Everybody has to coordinate several tasks everyday, usually in a manual manner. Recently, the concept of Task Automation Services has been introduced to automate and personalize the task coordination problem. Several user centered platforms and applications have arisen in the last years, that let their users configure their very own automations based on third party services. In this paper, we propose a new system architecture for Task Automation Services in a heterogeneous mobile, smart devices, and cloud services environment. Our architecture is based on the novel idea to employ distributed Complex Event Processing to implement innovative mixed execution profiles. The major advantage of the approach is its ability to incorporate context-awareness and real-time coordination in Task Automation Services.

Validación de un marco abierto accesible de tercera generación para la integración nativa de productos de apoyo en tecnologías de la información y la comunicación

Las personas con discapacidad a menudo se encuentran con problemas de acceso a las Tecnologías de la Información y la Comunicación (TIC), debido a diseños y desarrollos que no tienen en cuenta sus diferencias funcionales, y en consecuencia se encuentran en riesgo de exclusión social. Cada vez es más común encontrar productos de apoyo que permitan utilizar diferentes tecnologías (ordenadores, Internet, dispositivos móviles), pero muchos de ellos no se encuentran integrados debido a que funcionan esencialmente modificando la plataforma donde están instalados, siendo soluciones de acceso de segunda generación. Más allá del desarrollo de los productos de apoyo, que sin duda ha evolucionado positivamente en los últimos años, cabe resaltar que existe una falta de herramientas y de aproximación holística que ayuden a los desarrolladores y diseñadores hacer las TIC accesibles. Esta tesis doctoral pretende validar la hipótesis de que una metodología holística de desarrollo de aplicaciones y productos de apoyo TIC, llamada Marco Abierto Accesible, facilita el desarrollo y la integración de modo nativo de la accesibilidad en las aplicaciones y productos apoyo, independientemente de la tecnología utilizada, dando lugar a soluciones de acceso de tercera generación que permitan mejorar la utilización de dichas aplicaciones por parte de personas con discapacidad. Este trabajo se ha desarrollado en el marco del proyecto AEGIS (del inglés, open Accessibility Everywhere: Groundwork, Infrastructure, Standards), que fue parcialmente financiado por la Comisión Europea (CE) bajo el VII Programa Marco y tuvo una duración de cuatro años. La metodología para el diseño, desarrollo y validación seguida en esta tesis es una adaptación de dos metodologías de diseño existentes (el Diseño Centrado en el Usuario y el Diseño Orientado a Metas), la implementación del Marco Abierto Accesible y el uso de diferentes técnicas de validación. Además se ha desarrollado un marco metodológico de entrenamiento para minimizar el efecto que tiene la curva de aprendizaje cuando los usuarios prueban por primera vez las soluciones desarrolladas. En esta tesis se presenta el Marco Abierto Accesible aplicado a las TIC en las tres áreas en las que se desarrolla este trabajo: ordenadores, Internet y dispositivos móviles, partiendo de las necesidades y problemas que tienen los usuarios con discapacidad en el uso de las TIC. Diferentes instanciaciones del Marco Abierto Accesible se definen en las tres áreas TIC mencionadas anteriormente y se describen varios ejemplos de sus implementaciones particulares. Los resultados de las evaluaciones de las implementaciones particulares con usuarios finales y expertos, una vez discutidos y contrastados con las hipótesis, sirven para probar la validez del Marco Abierto Accesible para la integración nativa de productos de apoyo en Tecnologías de la Información y la Comunicación. Finalmente, se presentan las líneas de investigación y trabajo futuro en el área de la accesibilidad en las TIC. ABSTRACT People with disabilities often encounter problems of access to Information and Communications Technology (ICT), due to design and developments that do not take into account their functional differences and therefore put them at risk of social exclusion. It is increasingly common to find assistive products that allow to use different technologies (computers, Internet, mobile devices), but many of them are not well integrated because they work essentially modifying the platform where they are installed, beeing the second-generation access solutions. Beyond the assistive product development, which has certainly evolved positively in recent years, it is notable that there is a lack of tools and holistic approach to help developers and designers make accessible ICT. This doctoral thesis aims to validate the hypothesis that a holistic approach to application development and assistive ICT products, called Open Accessibility Framework, facilitates the development and integration of native accessible applications and assistive products, regardless of the technology used, resulting in third-generation access solutions that improve the use of such applications by people with disabilities. This work was developed under the AEGIS project (open Accessibility Everywhere: Groundwork, Infrastructure, Standards), which was partially funded by the European Commission (EC) under the Seventh Framework Programme and lasted four years. The methodology for the design, development and validation followed in this thesis is an adaptation of two existing design methodologies (User Centered Design and Goal Oriented Design), the implementation of the Open Accessibility Framework and the usage of different validation techniques. A training methodological framework ha also been developed to minimize the effect of the learning curve when users first try the solutions developed. This thesis presents the Open Accessibility Framework applied to ICT in three areas in which this work is developed: computers, Internet and mobile devices, based on the needs and problems of the disabled users in the use of ICT. Different instantiations of the Open Accessibility Framework are defined in the three aforementioned ICT areas and various examples of its particular implementations are described. The results of the evaluations of the particular implementations which have been carried with end users and experts, once discussed and contrasted with the hypotheses, have been used to test the validity of the Open Accessibility Framework for the native integration of assistive products in Information and Communications Technology. Finally, the future research lines and future work in the area of ICT accessibility are presented.

A technological framework based on automatic messaging for improving adherence of diabetic patients

En todo el mundo se ha observado un crecimiento exponencial en la incidencia de enfermedades crónicas como la hipertensión y enfermedades cardiovasculares y respiratorias, así como la diabetes mellitus, que causa un número de muertes cada vez mayor en todo el mundo (Beaglehole et al., 2008). En concreto, la prevalencia de diabetes mellitus (DM) está aumentando de manera considerable en todas las edades y representa un serio problema de salud mundial. La diabetes fue la responsable directa de 1,5 millones de muertes en 2012 y 89 millones de años de vida ajustados por discapacidad (AVAD) (OMS, 2014). Uno de los principales dilemas que suelen asociarse a la gestión de EC es la adherencia de los pacientes a los tratamientos, que representa un aspecto multifactorial que necesita asistencia en lo relativo a: educación, autogestión, interacción entre los pacientes y cuidadores y compromiso de los pacientes. Medir la adherencia del tratamiento es complicado y, aunque se ha hablado ampliamente de ello, aún no hay soluciones “de oro” (Reviews, 2002). El compromiso de los pacientes, a través de la participación, colaboración, negociación y a veces del compromiso firme, aumentan las oportunidades para una terapia óptima en la que los pacientes se responsabilizan de su parte en la ecuación de adherencia. Comprometer e involucrar a los pacientes diabéticos en las decisiones de su tratamiento, junto con expertos profesionales, puede ayudar a favorecer un enfoque centrado en el paciente hacia la atención a la diabetes (Martin et al., 2005). La motivación y atribución de poder de los pacientes son quizás los dos factores interventores más relevantes que afectan directamente a la autogestión de la atención a la diabetes. Se ha demostrado que estos dos factores desempeñan un papel fundamental en la adherencia a la prescripción, así como en el fomento exitoso de un estilo de vida sana y otros cambios de conducta (Heneghan et al., 2013). Un plan de educación personalizada es indispensable para proporcionarle al paciente las herramientas adecuadas que necesita para la autogestión efectiva de la enfermedad (El-Gayar et al. 2013). La comunicación efectiva es fundamental para proporcionar una atención centrada en el paciente puesto que influye en las conductas y actitudes hacia un problema de salud ((Frampton et al. 2008). En este sentido, la interactividad, la frecuencia, la temporalización y la adaptación de los mensajes de texto pueden promover la adherencia a un régimen de medicación. Como consecuencia, adaptar los mensajes de texto a los pacientes puede resultar ser una manera de hacer que las sugerencias y la información sean más relevantes y efectivas (Nundy et al. 2013). En este contexto, las tecnologías móviles en el ámbito de la salud (mHealth) están desempeñando un papel importante al conectar con pacientes para mejorar la adherencia a medicamentos recetados (Krishna et al., 2009). La adaptación de los mensajes de texto específicos de diabetes sigue siendo un área de oportunidad para mejorar la adherencia a la medicación y ofrecer motivación a adultos con diabetes. Sin embargo, se necesita más investigación para entender totalmente su eficacia. Los consejos de texto personalizados han demostrado causar un impacto positivo en la atribución de poder a los pacientes, su autogestión y su adherencia a la prescripción (Gatwood et al., 2014). mHealth se puede utilizar para ofrecer programas de asistencia de autogestión a los pacientes con diabetes y, al mismo tiempo, superar las dificultades técnicas y financieras que supone el tratamiento de la diabetes (Free at al., 2013). El objetivo principal de este trabajo de investigación es demostrar que un marco tecnológico basado en las teorías de cambios de conducta, aplicado al campo de la mHealth, permite una mejora de la adherencia al tratamiento en pacientes diabéticos. Como método de definición de una solución tecnológica, se han adoptado un conjunto de diferentes técnicas de conducta validadas denominado marco de compromiso de retroacción conductual (EBF, por sus siglas en inglés) para formular los mensajes, guiar el contenido y evaluar los resultados. Los estudios incorporan elementos del modelo transteórico (TTM, por sus siglas en inglés), la teoría de la fijación de objetivos (GST, por sus siglas en inglés) y los principios de comunicación sanitaria persuasiva y eficaz. Como concepto general, el modelo TTM ayuda a los pacientes a progresar a su próxima fase de conducta a través de mensajes de texto motivados específicos y permite que el médico identifique la fase actual y adapte sus estrategias individualmente. Además, se adoptan las directrices del TTM para fijar objetivos personalizados a un nivel apropiado a la fase de cambio del paciente. La GST encierra normas que van a ponerse en práctica para promover la intervención educativa y objetivos de pérdida de peso. Finalmente, los principios de comunicación sanitaria persuasiva y eficaz aplicados a la aparición de los mensajes se han puesto en marcha para aumentar la efectividad. El EBF tiene como objetivo ayudar a los pacientes a mejorar su adherencia a la prescripción y encaminarlos a una mejora general en la autogestión de la diabetes mediante mensajes de texto personalizados denominados mensajes de retroacción automáticos (AFM, por sus siglas en inglés). Después de una primera revisión del perfil, consistente en identificar características significativas del paciente basadas en las necesidades de tratamiento, actitudes y conductas de atención sanitaria, el sistema elige los AFM personalizados, los aprueba el médico y al final se transfieren a la interfaz del paciente. Durante el tratamiento, el usuario recopila los datos en dispositivos de monitorización de pacientes (PMD, por sus siglas en inglés) de una serie de dispositivos médicos y registros manuales. Los registros consisten en la toma de medicación, dieta y actividad física y tareas de aprendizaje y control de la medida del metabolismo. El compromiso general del paciente se comprueba al estimar el uso del sistema y la adherencia del tratamiento y el estado de los objetivos del paciente a corto y largo plazo. El módulo de análisis conductual, que consiste en una serie de reglas y ecuaciones, calcula la conducta del paciente. Tras lograr el análisis conductual, el módulo de gestión de AFM actualiza la lista de AFM y la configuración de los envíos. Las actualizaciones incluyen el número, el tipo y la frecuencia de mensajes. Los AFM los revisa periódicamente el médico que también participa en el perfeccionamiento del tratamiento, adaptado a la fase transteórica actual. Los AFM se segmentan en distintas categorías y niveles y los pacientes pueden ajustar la entrega del mensaje de acuerdo con sus necesidades personales. El EBF se ha puesto en marcha integrado dentro del sistema METABO, diseñado para facilitar al paciente diabético que controle sus condiciones relevantes de una manera menos intrusiva. El dispositivo del paciente se vincula en una plataforma móvil, mientras que una interfaz de panel médico permite que los profesionales controlen la evolución del tratamiento. Herramientas específicas posibilitan que los profesionales comprueben la adherencia del paciente y actualicen la gestión de envíos de AFM. El EBF fue probado en un proyecto piloto controlado de manera aleatoria. El principal objetivo era examinar la viabilidad y aceptación del sistema. Los objetivos secundarios eran también la evaluación de la eficacia del sistema en lo referente a la mejora de la adherencia, el control glucémico y la calidad de vida. Se reclutaron participantes de cuatro centros clínicos distintos en Europa. La evaluación del punto de referencia incluía datos demográficos, estado de la diabetes, información del perfil, conocimiento de la diabetes en general, uso de las plataformas TIC, opinión y experiencia con dispositivos electrónicos y adopción de buenas prácticas con la diabetes. La aceptación y eficacia de los criterios de evaluación se aplicaron para valorar el funcionamiento del marco tecnológico. El principal objetivo era la valoración de la eficacia del sistema en lo referente a la mejora de la adherencia. En las pruebas participaron 54 pacientes. 26 fueron asignados al grupo de intervención y equipados con tecnología móvil donde estaba instalado el EBF: 14 pacientes tenían T1DM y 12 tenían T2DM. El grupo de control estaba compuesto por 25 pa cientes que fueron tratados con atención estándar, sin el empleo del EBF. La intervención profesional tanto de los grupos de control como de intervención corrió a cargo de 24 cuidadores, entre los que incluían diabetólogos, nutricionistas y enfermeras. Para evaluar la aceptabilidad del sistema y analizar la satisfacción de los usuarios, a través de LimeSurvey, se creó una encuesta multilingüe tanto para los pacientes como para los profesionales. Los resultados también se recopilaron de los archivos de registro generados en los PMD, el panel médico profesional y las entradas de la base de datos. Los mensajes enviados hacia y desde el EBF y los archivos de registro del sistema y los servicios de comunicación se grabaron durante las cinco semanas del estudio. Se entregaron un total de 2795 mensajes, lo que supuso una media de 107,50 mensajes por paciente. Como se muestra, los mensajes disminuyen con el tiempo, indicando una mejora global de la adherencia al plan de tratamiento. Como se esperaba, los pacientes con T1DM recibieron más consejos a corto plazo, en relación a su estado. Del mismo modo, al ser el centro de T2DM en cambios de estilo de vida sostenible a largo plazo, los pacientes con T2DM recibieron más consejos de recomendación, en cuanto a dietas y actividad física. También se ha llevado a cabo una comparación de la adherencia e índices de uso para pacientes con T1DM y T2DM, entre la primera y la segunda mitad de la prueba. Se han observado resultados favorables para el uso. En lo relativo a la adherencia, los resultados denotaron una mejora general en cada dimensión del plan de tratamiento, como la nutrición y las mediciones de inserción de glucosa en la sangre. Se han llevado a cabo más estudios acerca del cambio a nivel educativo antes y después de la prueba, medidos tanto para grupos de control como de intervención. Los resultados indicaron que el grupo de intervención había mejorado su nivel de conocimientos mientras que el grupo de control mostró una leve disminución. El análisis de correlación entre el nivel de adherencia y las AFM ha mostrado una mejora en la adherencia de uso para los pacientes que recibieron los mensajes de tipo alertas, y unos resultados no significativos aunque positivos relacionados con la adherencia tanto al tratamiento que al uso correlacionado con los recordatorios. Por otra parte, los AFM parecían ayudar a los pacientes que no tomaban suficientemente en serio su tratamiento en el principio y que sí estaban dispuestos a responder a los mensajes recibidos. Aun así, los pacientes que recibieron demasiadas advertencias, comenzaron a considerar el envío de mensajes un poco estresante. El trabajo de investigación llevado a cabo al desarrollar este proyecto ofrece respuestas a las cuatro hipótesis de investigación que fueron la motivación para el trabajo. • Hipótesis 1 : es posible definir una serie de criterios para medir la adherencia en pacientes diabéticos. • Hipótesis 2: es posible diseñar un marco tecnológico basado en los criterios y teorías de cambio de conducta mencionados con anterioridad para hacer que los pacientes diabéticos se comprometan a controlar su enfermedad y adherirse a planes de atención. • Hipótesis 3: es posible poner en marcha el marco tecnológico en el sector de la salud móvil. • Hipótesis 4: es posible utilizar el marco tecnológico como solución de salud móvil en un contexto real y tener efectos positivos en lo referente a indicadores de control de diabetes. La verificación de cada hipótesis permite ofrecer respuesta a la hipótesis principal: La hipótesis principal es: es posible mejorar la adherencia diabética a través de un marco tecnológico mHealth basado en teorías de cambio de conducta. El trabajo llevado a cabo para responder estas preguntas se explica en este trabajo de investigación. El marco fue desarrollado y puesto en práctica en el Proyecto METABO. METABO es un Proyecto I+D, cofinanciado por la Comisión Europea (METABO 2008) que integra infraestructura móvil para ayudar al control, gestión y tratamiento de los pacientes con diabetes mellitus de tipo 1 (T1DM) y los que padecen diabetes mellitus de tipo 2 (T2DM). ABSTRACT Worldwide there is an exponential growth in the incidence of Chronic Diseases (CDs), such as: hypertension, cardiovascular and respiratory diseases, as well as diabetes mellitus, leading to rising numbers of deaths worldwide (Beaglehole et al. 2008). In particular, the prevalence of diabetes mellitus (DM) is largely increasing among all ages and constitutes a major worldwide health problem. Diabetes was directly responsible for 1,5 million deaths in 2012 and 89 million Disability-adjusted life year (DALYs) (WHO 2014). One of the key dilemmas often associated to CD management is the patients’ adherence to treatments, representing a multi-factorial aspect that requires support in terms of: education, self-management, interaction between patients and caregivers, and patients’ engagement. Measuring adherence is complex and, even if widely discussed, there are still no “gold” standards ((Giardini et al. 2015), (Costa et al. 2015). Patient’s engagement, through participation, collaboration, negotiation, and sometimes compromise, enhance opportunities for optimal therapy in which patients take responsibility for their part of the adherence equation. Engaging and involving diabetic patients in treatment decisions, along with professional expertise, can help foster a patient-centered approach to diabetes care (Martin et al. 2005). Patients’ motivation and empowerment are perhaps the two most relevant intervening factors that directly affect self-management of diabetes care. It has been demonstrated that these two factors play an essential role in prescription adherence, as well as for the successful encouragement of a healthy life-style and other behavioural changes (Heneghan et al. 2013). A personalised education plan is indispensable in order to provide the patient with the appropriate tools needed for the effective self-management of the disease (El-Gayar et al. 2013). Effective communication is at the core of providing patient-centred care since it influences behaviours and attitudes towards a health problem (Frampton et al. 2008). In this regard, interactivity, frequency, timing, and tailoring of text messages may promote adherence to a medication regimen. As a consequence, tailoring text messages to patients can constitute a way of making suggestions and information more relevant and effective (Nundy et al. 2013). In this context, mobile health technologies (mHealth) are playing significant roles in improving adherence to prescribed medications (Krishna et al. 2009). The tailoring of diabetes-specific text messages remains an area of opportunity to improve medication adherence and provide motivation to adults with diabetes but further research is needed to fully understand their effectiveness. Personalized text advices have proven to produce a positive impact on patients’ empowerment, self-management, and adherence to prescriptions (Gatwood et al. 2014). mHealth can be used for offering self-management support programs to diabetes patients and at the same time surmounting the technical and financial difficulties involved in diabetes treatment (Free et al. 2013). The main objective of this research work is to demonstrate that a technological framework, based on behavioural change theories, applied to mHealth domain, allows improving adherence treatment in diabetic patients. The framework, named Engagement Behavioural Feedback Framework (EBF), is built on top of validated behavioural techniques to frame messages, guide the definition of contents and assess outcomes: elements from the Transtheoretical Model (TTM), the Goal-Setting Theory (GST), Effective Health Communication (EHC) guidelines and Principles of Persuasive Technology (PPT) were incorporated. The TTM helps patients to progress to a next behavioural stage, through specific motivated text messages, and allow clinician’s identifying the current stage and tailor its strategies individually. Moreover, TTM guidelines are adopted to set customised goals at a level appropriate to the patient’s stage of change. The GST was used to build rules to be applied for enhancing educational intervention and weight loss objectives. Finally, the EHC guidelines and the PPT were applied to increase the effectiveness of messages. The EBF aims to support patients on improving their prescription adherence and persuade them towards a general improvement in diabetes self-management, by means of personalised text messages, named Automatic Feedback Messages (AFM). After a first profile screening, consisting in identifying meaningful patient characteristics based on treatment needs, attitudes and health care behaviours, customised AFMs are selected by the system, approved by the professional, and finally transferred into the patient interface. During the treatment, the user collects the data into a Patient Monitoring Device (PMD) from a set of medical devices and from manual inputs. Inputs consist in medication intake, diet and physical activity, metabolic measurement monitoring and learning tasks. Patient general engagement is checked by estimating the usage of the system and the adherence of treatment and patient goals status in the short and the long term period. The Behavioural Analysis Module, consisting in a set of rules and equations, calculates the patient’s behaviour. After behavioural analysis is accomplished, the AFM library and the dispatch setting are updated by the AFM Manager module. Updates include the number, the type and the frequency of messages. The AFMs are periodically supervised by the professional who also participates to the refinement of the treatment, adapted to the current transtheoretical stage. The AFMs are segmented in different categories and levels and patients can adjust message delivery in accordance with their personal needs. The EBF was integrated to the METABO system, designed to facilitate diabetic patients in managing their disease in a less intrusive approach. Patient device corresponds in a mobile platform, while a medical panel interface allows professionals to monitoring the treatment evolution. Specific tools allow professional to check patient adherence and to update the AFMs dispatch management. The EBF was tested in a randomised controlled pilot. The main objective was to examine the feasibility and acceptance of the system. Secondary objectives were also the assessment of the effectiveness of system in terms of adherence improvement, glycaemic control, and quality of life. Participants were recruited from four different clinical centres in Europe. The baseline assessment included demographics, diabetes status, profile information, knowledge about diabetes in general, usage of ICT platforms, opinion and experience about electronic devices and adoption of good practices with diabetes. Acceptance and the effectiveness evaluation criteria were applied to evaluate the performance of the technological framework. The main objective was the assessment of the effectiveness of system in terms of adherence improvement. Fifty-four patients participated on the trials. Twenty-six patients were assigned in the intervention group and equipped with mobile where the EBF was installed: 14 patients were T1DM and 12 were T2DM. The control group was composed of 25 patients that were treated through a standard care, without the usage of the EBF. Professional’s intervention for both intervention and control groups was carried out by 24 care providers, including endocrinologists, nutritionists, and nurses. In order to evaluate the system acceptability and analyse the users’ satisfaction, an online multi-language survey, using LimeSurvey, was produced for both patients and professionals. Results were also collected from the log-files generated in the PMDs, the professional medical panel and the entries of the data base. The messages sent to and from the EBF and the log-files of the system and communication services were recorded over 5 weeks of the study. A total of 2795 messages were submitted, representing an average of 107,50 messages per patient. As demonstrated, messages decrease over time indicating an overall improvement of the care plan’s adherence. As expected, T1DM patients were more loaded with short-term advices, in accordance with their condition. Similarly, being the focus of T2DM on long-term sustainable lifestyle changes, T2DM received more reminders advices, as for diet and physical activity. Favourable outcomes were observed for treatment and usage adherences of the intervention group: for both the adherence indices, results denoted a general improvement on each care plan’s dimension, such as on nutrition and blood glucose input measurements. Further studies were conducted on the change on educational level before and after the trial, measured for both control and intervention groups. The outcomes indicated the intervention group has improved its level of knowledge, while the control group denoted a low decrease. The correlation analysis between the level of adherences and the AFMs showed an improvement in usage adherence for patients who received warnings message, while non-significantly yet even positive indicators related to both treatment and usage adherence correlated with the Reminders. Moreover, the AFMs seemed to help those patients who did not take their treatment seriously enough in the beginning and who were willing to respond to the messages they received. Even though, patients who received too many Warnings, started to consider the message dispatch to be a bit stressful. The research work carried out in developing this research work provides responses to the four research hypothesis that were the motivation for the work: •Hypothesis 1: It is possible to define a set of criteria to measure adherence in diabetic patients. •Hypothesis 2: It is possible to design a technological framework, based on the aforementioned criteria and behavioural change theories, to engage diabetic patients in managing their disease and adhere to care plans. •Hypothesis 3: It is possible to implement the technological framework in the mobile health domain. •Hypothesis 4: It is possible to use the technological framework as a mobile health solution in a real context and have positive effects in terms of diabetes management indicators. The verification of each hypothesis allowed us to provide a response to the main hypothesis: The Main Hypothesis is: It is possible to improve diabetic adherence through a mHealth technological framework based on behavioural change theories. The work carried out to answer these questions is explained in this research work. The framework was developed and applied in the METABO project. METABO is an R&D project, co-funded by the European Commission (METABO 2008) that integrates mobile infrastructure for supporting the monitoring, management, and treatment of type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) patients.

The Influence of Space Layout, Technology and Teaching Approach on Student Learning: An Architectural Technology Perspective

Some would argue that there is a need for the traditional lecture format to be rethought in favour of a more active approach. However, this must form part of a bipartite strategy, considered in conjunction with the layout of any new space to facilitate alternative learning and teaching methods. With this in mind, this paper begins to examine the impact of the learning environment on the student learning experience, specifically focusing on students studying on the Architectural Technology and Management programme at Ulster University. The aim of this study is two-fold: to increase understanding of the impact of learning space layout, by taking a student centered approach; and to gain an appreciation of how technology can impact upon the learning space. The study forms part of a wider project being undertaken at Ulster University known as the Learning Landscape Transition Project, exploring the relationship between learning, teaching and space layout. Data collection was both qualitative and quantitative, with use of a case study supported by a questionnaire based on attitudinal scaling. A focus group was also used to further analyse the key trends resulting from the questionnaire. The initial results suggest that the learning environment, and the technology within it, can not only play an important part in the overall learning experience of the student, but also assist with preparation for the working environment to be experienced in professional life.

“This beer is off!”:building a dialogue game for servitization

Purpose: Development and evaluation of a prototype dialogue game for servitization is reported. Design/methodology/approach: This paper reports the design of the iServe game, from user centered design, through implementation using the Unity games engine to evaluation, a process which took 270 researcher hours. Findings: No relationship was found between either age or gaming experience and usability. Participants who identified themselves as non-experts in servitization recognized the potential of the game to teach servitization concepts to other novice learners. Originality/value: The potential of business games for education and executive development has been recognized but factors, including high development cost, inhibit their uptake. Games engines offer a potential solution.

Abstractions to support dynamic adaptation of communication frameworks for user-centric communication

The convergence of data, audio and video on IP networks is changing the way individuals, groups and organizations communicate. This diversity of communication media presents opportunities for creating synergistic collaborative communications. This form of collaborative communication is however not without its challenges. The increasing number of communication service providers coupled with a combinatorial mix of offered services, varying Quality-of-Service and oscillating pricing of services increases the complexity for the user to manage and maintain ‘always best’ priced or performance services. Consumers have to manually manage and adapt their communication in line with differences in services across devices, networks and media while ensuring that the usage remain consistent with their intended goals. This dissertation proposes a novel user-centric approach to address this problem. The proposed approach aims to reduce the aforementioned complexity to the user by (1) providing high-level abstractions and a policy based methodology for automated selection of the communication services guided by high-level user policies and (2) providing services through the seamless integration of multiple communication service providers and providing an extensible framework to support the integration of multiple communication service providers. The approach was implemented in the Communication Virtual Machine (CVM), a model-driven technology for realizing communication applications. The CVM includes the Network Communication Broker, the layer responsible for providing a network-independent API to the upper layers of CVM. The initial prototype for the NCB supported only a single communication framework which limited the number, quality and types of services available. Experimental evaluation of the approach show the additional overhead of the approach is minimal compared to the individual communication services frameworks. Additionally the automated approach proposed out performed the individual communication services frameworks for cross framework switching.

A experiência do usuário idoso no design de jogo digital para a reabilitação neural de pacientes com quadro de acidente vascular cerebral (AVC)

Stroke is nowadays one of the main causes of death in Brazil and worldwide. During the rehabilitation process, patients undergo physioterapic exercises based on repetition, which may cause them to feel little progress is being made. Focusing on themes from the areas of Human-Computer Interaction and Motor Imagery, the present work describes the development of a digital game concept aimed at motor rehabilitation to the neural rehabilitation of patients who have suffered a stroke in a playful and engaging way. The research hypothesizes that an interactive digital game based on Motor Imagery contributes to patients' raised commitment in the stroke sequel rehabilitation process. The research process entailed the investigation of 10 subjects who live with sequels caused by stroke - it was further established that subjects were over 60 years old. Using as foundation an initial survey regarding target-users' specificities, where an investigation on subjectrelated aspects was carried out through Focus Group (n=9) and Contextual Analysis (n=3), having as subjects elderly individuals, a list with the necessary requirements for the conceptualization of a digital game was fleshed out. The initial survey also enabled the establishment of preliminary interactions for the formulation of game prototypes. At first, low-resolution prototypes were used, with two distinct interaction models for the game - one with a direct approach to the Motor Imagery concept, and another using a narrative with characters and scene settings. The goal was to verify participants' receptivity regarding the addition of playful activities into game dynamics. Prototypes were analyzed while being used by five patients, through the Cooperative Evaluation technique. The tests indicated a preference for option with elements in a playful narrative. Based on these results high fidelity prototypes were created, where concepts close to the game's final version were elaborated. The High Fidelity prototype was also evaluated with four patients through the Cooperative Evaluation technique. It was concluded that elderly individuals and patients were receptive to the idea of a digital game for the rehabilitation from sequels caused by stroke; that, for the success of devices aimed at these cohorts, their contexts, needs and expectations must be respected above all; and that user-centered design is an essential approach in that regard.

Market-oriented new product development of health promoting foods for the ageing population

Major factors influencing food development and food marketing strategies in global market places at present can be attributable to the changing age structure of the population. The significant shifts in global age structure will inevitably lead to the number of people aged 60 reaching an all-time high of one billion by the year 2020. The rapidly growing population of ageing people globally represents a large, neglected and very much under-developed category within the Food Industry. The primary focus of this study was the integration of knowledge creation techniques at early NPD stages, for the development of market-oriented new health promoting foods for the ageing population. The methodology of this study was centered on an exploratory sequential mixed methods strategy. Stage one of the study involved in-depth semi-structured interviews with 16 Stakeholders to facilitate the need identification stage of the NPD process. The main outputs identified were the need for: the fortification of foods for a preventative nutrition approach, the development of foods that targeted age-related conditions such as cognitive, heart, gut and bone health, the integration of ageing compensatory packaging adaptations and the creation of marketing messages with an active lifestyle message. Stage two consisted of a market-oriented computer assisted NPD technique, a user centered design interaction (UCD) to integrate consumers as co-creators throughout the idea generation stage of the NPD process. The most important product attributes identified in this stage included: products targeted at brain and cognitive health, liquid based beverages, easy to use packaging with environmentally friendly elements, simplistic marketing with a clear focus on health not age and realistic health claims constructed with consumer friendly terminology. Finally, Stage three used an abbreviated means-end chain (MEC) analysis to complete the concept development stage of the NPD process. This stage identified commercial information that could be used by food firms for the development of positioning and communication strategies. Equally, the information generated could be of high strategic importance to governments, policy makers, health professionals and medical professionals. The values and goals listed in this stage included: better overall health, active lifestyle, optimum nutrition and wellbeing feelings. Overall, this research illustrated that knowledge creation techniques can assist firms in the development of market-oriented health promoting foods for the ageing population.

Prototipagem ágil centrada no utilizador : aplicações de second screen

Com o desenvolvimento das tecnologias da Comunicação, o ser humano tem alterado os seus hábitos de consumo televisivo. Neste contexto, destaca-se o uso de aplicações mobile designadas como Second Screen, as quais, entre outras possibilidades, permitem interagir com conteúdos adicionais aos que se encontram a ser transmitidos na televisão. Sendo este fenómeno relativamente recente, pretende-se compreender qual a abordagem a adotar no desenvolvimento de uma prototipagem ágil de aplicações Second Screen centradas no utilizador. De modo a compreender o respetivo processo, iniciou-se o estudo com um enquadramento teórico, que possibilitou a familiarização com as aplicações Second Screen e ferramentas de prototipagem ágil já existentes. Após o enquadramento teórico, procedeu-se à criação de dois mockups de aplicações Second Screen, que foram testados em Focus Groups. A partir dos dados obtidos, desenvolveram-se dois protótipos ágeis, os quais foram submetidos a uma última fase de testes (Experimentação por observação, Entrevista e Questionário de avaliação, respetivamente). Os participantes deste estudo foram os mesmos para ambas as fases de testes, constituindo um grupo de consumidores, um grupo de designers e um grupo de especialistas na área de prototipagem. Os resultados obtidos, a partir dos protótipos concebidos, comprovam a validade do processo realizado neste estudo, podendo este ser usado para desenvolver protótipos de aplicações mobile e Second Screen.

Psychosocial Risk Factors, Interventions, and Comorbidity in Patients with Non-Specific Low Back Pain in Primary Care: Need for Comprehensive and Patient-Centered Care

International audience

Product/Brand co-creation methodology crossing marketing, design thinking, creativity and management: ideas(r)evolution

This thesis introduce a new innovation methodology called IDEAS(R)EVOLUTION that was developed according to an on-going experimental research project started in 2007. This new approach to innovation has initial based on Design thinking for innovation theory and practice. The concept of design thinking for innovation has received much attention in recent years. This innovation approach has climbed from the design and designers knowledge field towards other knowledge areas, mainly business management and marketing. Human centered approach, radical collaboration, creativity and breakthrough thinking are the main founding principles of Design thinking that were adapted by those knowledge areas due to their assertively and fitness to the business context and market complexity evolution. Also Open innovation, User-centered innovation and later on Living Labs models emerge as answers to the market and consumers pressure and desire for new products, new services or new business models. Innovation became the principal business management focus and strategic orientation. All this changes had an impact also in the marketing theory. It is possible now to have better strategies, communications plans and continuous dialogue systems with the target audience, incorporating their insights and promoting them to the main dissemination ambassadors of our innovations in the market. Drawing upon data from five case studies, the empirical findings in this dissertation suggest that companies need to shift from Design thinking for innovation approach to an holistic, multidimensional and integrated innovation system. The innovation context it is complex, companies need deeper systems then the success formulas that “commercial “Design thinking for innovation “preaches”. They need to learn how to change their organization culture, how to empower their workforce and collaborators, how to incorporate external stakeholders in their innovation processes, hoe to measure and create key performance indicators throughout the innovation process to give them better decision making data, how to integrate meaning and purpose in their innovation philosophy. Finally they need to understand that the strategic innovation effort it is not a “one shot” story it is about creating a continuous flow of interaction and dialogue with their clients within a “value creation chain“ mindset; RESUMO: Metodologia de co-criação de um produto/marca cruzando Marketing, Design Thinking, Criativity and Management - IDEAS(R)EVOLUTION. Esta dissertação apresenta uma nova metodologia de inovação chamada IDEAS(R)EVOLUTION, que foi desenvolvida segundo um projecto de investigação experimental contínuo que teve o seu início em 2007. Esta nova abordagem baseou-se, inicialmente, na teoria e na práctica do Design thinking para a inovação. Actualmente o conceito do Design Thinking para a inovação “saiu” do dominio da area de conhecimento do Design e dos Designers, tendo despertado muito interesse noutras áreas como a Gestão e o Marketing. Uma abordagem centrada na Pessoa, a colaboração radical, a criatividade e o pensamento disruptivo são principios fundadores do movimento do Design thinking que têm sido adaptados por essas novas áreas de conhecimento devido assertividade e adaptabilidade ao contexto dos negócios e à evolução e complexidade do Mercado. Também os modelos de Inovação Aberta, a inovação centrada no utilizador e mais tarde os Living Labs, emergem como possiveis soluções para o Mercado e para a pressão e desejo dos consumidores para novos productos, serviços ou modelos de negócio. A inovação passou a ser o principal foco e orientação estratégica na Gestão. Todas estas mudanças também tiveram impacto na teoria do Marketing. Hoje é possivel criar melhores estratégias, planos de comunicação e sistemas continuos de diálogo com o público alvo, incorporando os seus insights e promovendo os consumidores como embaixadores na disseminação da inovação das empresas no Mercado Os resultados empiricos desta tese, construídos com a informação obtida nos cinco casos realizados, sugerem que as empresas precisam de se re-orientar do paradigma do Design thinking para a inovação, para um sistema de inovação mais holistico, multidimensional e integrado. O contexto da Inovação é complexo, por isso as empresas precisam de sistemas mais profundos e não apenas de “fórmulas comerciais” como o Design thinking para a inovação advoga. As Empresas precisam de aprender como mudar a sua cultura organizacional, como capacitar sua força de trabalho e colaboradores, como incorporar os públicos externos no processo de inovação, como medir o processo de inovação criando indicadores chave de performance e obter dados para um tomada de decisão mais informada, como integrar significado e propósito na sua filosofia de inovação. Por fim, precisam de perceber que uma estratégia de inovação não passa por ter “sucesso uma vez”, mas sim por criar um fluxo contínuo de interação e diálogo com os seus clientes com uma mentalidade de “cadeia de criação de valor”