Reliability and clinical utility of a Portuguese version of the Abnormal Involuntary Movements Scale (AIMS) for tardive dyskinesia in Brazilian patients

The objective of the present study was to evaluate the reliability and clinical utility of a Portuguese version of the Abnormal Involuntary Movements Scale (AIMS). Videotaped interviews with 16 psychiatric inpatients treated with antipsychotic drugs for at least 5 years were evaluated. Reliability was assessed by the intraclass correlation coefficient (ICC) between three raters, two with and one without clinical training in psychopathology. Clinical utility was assessed by the difference between the scores of patients with (N = 11) and without (N = 5) tardive dyskinesia (TD). Patients with TD exhibited a higher severity of global evaluation by the AIMS (sum of scores: 4.2 ± 0.9 vs 0.4 ± 0.2; score on item 8: 2.3 ± 0.3 vs 0.4 ± 0.2, TD vs controls). The ICC for the global evaluation was fair between the two skilled raters (0.58-0.62) and poor between these raters and the rater without clinical experience (0.05-0.29). Thus, we concluded that the Portuguese version of the AIMS shows an acceptable inter-rater reliability, but only between clinically skilled raters, and that it is clinically useful.

The reliability of the Brazilian version of the Composite International Diagnostic Interview (CIDI 2.1)

The objective of the present study was to determine the reliability of the Brazilian version of the Composite International Diagnostic Interview 2.1 (CIDI 2.1) in clinical psychiatry. The CIDI 2.1 was translated into Portuguese using WHO guidelines and reliability was studied using the inter-rater reliability method. The study sample consisted of 186 subjects from psychiatric hospitals and clinics, primary care centers and community services. The interviewers consisted of a group of 13 lay and three non-lay interviewers submitted to the CIDI training. The average interview time was 2 h and 30 min. General reliability ranged from kappa 0.50 to 1. For lifetime diagnoses the reliability ranged from kappa 0.77 (Bipolar Affective Disorder) to 1 (Substance-Related Disorder, Alcohol-Related Disorder, Eating Disorders). Previous year reliability ranged from kappa 0.66 (Obsessive-Compulsive Disorder) to 1 (Dissociative Disorders, Maniac Disorders, Eating Disorders). The poorest reliability rate was found for Mild Depressive Episode (kappa = 0.50) during the previous year. Training proved to be a fundamental factor for maintaining good reliability. Technical knowledge of the questionnaire compensated for the lack of psychiatric knowledge of the lay personnel. Inter-rater reliability was good to excellent for persons in psychiatric practice.

Translation into Brazilian Portuguese, cultural adaptation and evaluation of the reliability of the Disabilities of the Arm, Shoulder and Hand Questionnaire

The objective of the present study was to translate, adapt and validate a Brazilian Portuguese version of the Disabilities of the Arm, Shoulder and Hand (DASH) Questionnaire. The study was carried out in two steps. The first was to translate the DASH into Portuguese and to perform cultural adaptation and the second involved the determination of the reliability and validity of the DASH for the Brazilian population. For this purpose, 65 rheumatoid arthritis patients of either sex (according to the classification criteria of the American College of Rheumatology), ranging in age from 18 to 60 years and presenting no other diseases involving the upper limbs, were interviewed. The patients were selected consecutively at the rheumatology outpatient clinic of UNIFESP. The following results were obtained: in the first step (translation and cultural adaptation), all patients answered the questions. In the second step, Spearman's correlation coefficients for interobserver evaluation ranged from 0.762 to 0.995, values considered to be highly reliable. In addition, intraclass correlation coefficients ranged from 0.97 to 0.99, also highly reliable values. Spearman's correlation coefficients and the intraclass correlation coefficients obtained during intra-observer evaluation ranged from 0.731 to 0.937 and from 0.90 to 0.96, respectively, being highly reliable values. The Ritchie Index showed a weak correlation with Brazilian DASH scores, while the visual analog scale of pain showed a good correlation with DASH score. We conclude that the Portuguese version of the DASH is a reliable instrument.

Reliability and validity of a Portuguese version of the Young Mania Rating Scale

The reliability and validity of a Portuguese version of the Young Mania Rating Scale were evaluated. The original scale was translated into and adapted to Portuguese by the authors. Definitions of clinical manifestations, a semi-structured anchored interview and more explicit rating criteria were added to the scale. Fifty-five adult subjects, aged 18 to 60 years, with a diagnosis of Current Manic Episode according to DSM-III-R criteria were assessed using the Young Mania Rating Scale as well as the Brief Psychiatric Rating Scale in two sessions held at intervals from 7 to 10 days. Good reliability ratings were obtained, with intra-class correlation coefficient of 0.97 for total scores, and levels of agreement above 0.80 (P < 0.001) for all individual items. Internal consistency analysis resulted in an alpha = 0.67 for the scale as a whole, and an alpha = 0.72 for each standardized item (P < 0.001). For the concurrent validity, a correlation of 0.78 was obtained by the Pearson coefficient between the total scores of the Young Mania Rating Scale and Brief Psychiatric Rating Scale. The results are similar to those reported for the English version, indicating that the Portuguese version of the scale constitutes a reliable and valid instrument for the assessment of manic patients.

The validity and 4-year test-retest reliability of the Brazilian version of the Eating Attitudes Test-26

In a cross-sectional study conducted four years ago to assess the validity of the Brazilian version of the Eating Attitudes Test-26 (EAT-26) for the identification of abnormal eating behaviors in a population of young females in Southern Brazil, 56 women presented abnormal eating behavior as indicated by the EAT-26 and the Edinburgh Bulimic Investigation Test. They were each matched for age and neighborhood to two normal controls (N = 112) and were re-assessed four years later with the two screening questionnaires plus the Composite International Diagnostic Interview (CIDI). The EAT results were then compared to diagnoses originating from the CIDI. To evaluate the temporal stability of the two screening questionnaires, a test-retest design was applied to estimate kappa coefficients for individual items. Given the prevalence of eating disorders of 6.2%, the CIDI psychiatry interview was applied to 161 women. Of these, 0.6% exhibited anorexia nervosa and 5.6%, bulimia nervosa (10 positive cases). The validity coefficients of the EAT were: 40% sensitivity, 84% specificity, and 14% positive predictive value. Cronbach's coefficient was 0.75. For each EAT item, the kappa index was not higher than 0.344 and the correlation coefficient was lower than 0.488. We conclude that the EAT-26 exhibited low validity coefficients for sensitivity and positive predictive value, and showed a poor temporal stability. It is reasonable to assume that these results were not influenced by the low prevalence of eating disorders in the community. Thus, the results cast doubts on the ability of the EAT-26 test to identify cases of abnormal eating behaviors in this population.

How computer programmers work : understanding software development in practise

Hur arbetar en framgångsrik programmerare? Uppgifterna att programmera datorspel och att programmera industriella, säkerhetskritiska system verkar tämligen olika. Genom en noggrann empirisk undersökning jämför och kontrasterar avhandlingen dessa två former av programmering och visar att programmering innefattar mer än teknisk förmåga. Med utgångspunkt i hermeneutisk och retorisk teori och med hjälp av både kulturvetenskap och datavetenskap visar avhandlingen att programmerarnas tradition och värderingar är grundläggande för deras arbete, och att båda sorter av programmering kan uppfattas och analyseras genom klassisk texttolkningstradition. Dessutom kan datorprogram betraktas och analyseras med hjälp av klassiska teorier om talproduktion i praktiken - program ses då i detta sammanhang som ett slags yttranden. Allt som allt förespråkar avhandlingen en återkomst till vetenskapens grunder, vilka innebär en ständig och oupphörlig cyklisk rörelse mellan att erfara och att förstå. Detta står i kontrast till en reduktionistisk syn på vetenskapen, som skiljer skarpt mellan subjektivt och objektivt, och på så sätt utgår från möjligheten att uppnå fullständigt vetande. Ofullständigt vetande är tolkandets och hermeneutikens domän. Syftet med avhandlingen är att med hjälp av exempel demonstrera programmeringens kulturella, hermeneutiska och retoriska natur.

Comparison of the reliability of multifocal visual evoked cortical potentials generated by pattern reversal and pattern pulse stimulation

This study compared the effectiveness of the multifocal visual evoked cortical potentials (mfVEP) elicited by pattern pulse stimulation with that of pattern reversal in producing reliable responses (signal-to-noise ratio >1.359). Participants were 14 healthy subjects. Visual stimulation was obtained using a 60-sector dartboard display consisting of 6 concentric rings presented in either pulse or reversal mode. Each sector, consisting of 16 checks at 99% Michelson contrast and 80 cd/m² mean luminance, was controlled by a binary m-sequence in the time domain. The signal-to-noise ratio was generally larger in the pattern reversal than in the pattern pulse mode. The number of reliable responses was similar in the central sectors for the two stimulation modes. At the periphery, pattern reversal showed a larger number of reliable responses. Pattern pulse stimuli performed similarly to pattern reversal stimuli to generate reliable waveforms in R1 and R2. The advantage of using both protocols to study mfVEP responses is their complementarity: in some patients, reliable waveforms in specific sectors may be obtained with only one of the two methods. The joint analysis of pattern reversal and pattern pulse stimuli increased the rate of reliability for central sectors by 7.14% in R1, 5.35% in R2, 4.76% in R3, 3.57% in R4, 2.97% in R5, and 1.78% in R6. From R1 to R4 the reliability to generate mfVEPs was above 70% when using both protocols. Thus, for a very high reliability and thorough examination of visual performance, it is recommended to use both stimulation protocols.

Reliability and validity of heart rate variability threshold assessment during an incremental shuttle-walk test in middle-aged and older adults

Studies on the assessment of heart rate variability threshold (HRVT) during walking are scarce. We determined the reliability and validity of HRVT assessment during the incremental shuttle walk test (ISWT) in healthy subjects. Thirty-one participants aged 57 ± 9 years (17 females) performed 3 ISWTs. During the 1st and 2nd ISWTs, instantaneous heart rate variability was calculated every 30 s and HRVT was measured. Walking velocity at HRVT in these tests (WV-HRVT1 and WV-HRVT2) was registered. During the 3rd ISWT, physiological responses were assessed. The ventilatory equivalents were used to determine ventilatory threshold (VT) and the WV at VT (WV-VT) was recorded. The difference between WV-HRVT1 and WV-HRVT2 was not statistically significant (median and interquartile range = 4.8; 4.8 to 5.4 vs4.8; 4.2 to 5.4 km/h); the correlation between WV-HRVT1 and WV-HRVT2 was significant (r = 0.84); the intraclass correlation coefficient was high (0.92; 0.82 to 0.96), and the agreement was acceptable (-0.08 km/h; -0.92 to 0.87). The difference between WV-VT and WV-HRVT2 was not statistically significant (4.8; 4.8 to 5.4 vs 4.8; 4.2 to 5.4 km/h) and the agreement was acceptable (0.04 km/h; -1.28 to 1.36). HRVT assessment during walking is a reliable measure and permits the estimation of VT in adults. We suggest the use of the ISWT for the assessment of exercise capacity in middle-aged and older adults.

Software business expansion through distribution channel : Case M-Files - Denmark

The purpose of this study was to find out how a software company can successfully expand business to the Danish software market through distribution channel. The study was commissioned by a Finnish software company and it was conducted using a qualitative research method by analyzing external and internal business environment, and interviewing Danish ICT organizations and M-Files personnel. Interviews were semi-structured interviews, which were designed to collect comprehensive information on the existing ICT and software market in Denmark. The research used three external and internal analyzing frameworks; PEST analysis (market level), Porter´s Five Force analysis (industry level competition) and SWOT analysis (company level). Distribution channels theory was a base to understand why and what kind of distribution channels the case company uses, and what kind of channels target markets companies’ uses. Channel strategy and design were integrated to the industry level analysis. The empirical findings revealed that Denmark has very business friendly ICT environment. Several organizations have ranked Denmark´s information and communication technology as the best in the world. Denmark’s ICT and software market are relatively small, compared to many other countries in Europe. Danish software market is centralized. Largest software clusters are in the largest cities; Copenhagen, Aarhus, Odense and Aalborg. From these clusters, software companies can most likely find suitable resellers. The following growing trends are clearly seen in the software market: mobile and wireless applications, outsourcing, security solutions, cloud computing, social business solutions and e-business solutions. When expanding software business to the Danish market, it is important to take into account these trends. In Denmark distribution channels varies depending on the product or service. For many, a natural distribution channel is a local partner or internet. In the public sector solutions are purchased through a public procurement process. In the private sector the buying process is more straight forwarded. Danish companies are buying software from reliable suppliers. This means that they usually buy software direct from big software vendors or local partners. Some customers prefer to use professional consulting companies. These consulting companies can strongly influence on the selection of the supplier and products, and in this light, consulting companies can be important partners for software companies. Even though the competition is fierce in ECM and DMS solutions, Danish market offers opportunities for foreign companies. Penetration to the Danish market through reseller channel requires advanced solutions and objective selection criteria for channel partners. Based on the findings, Danish companies are interested in advanced and efficient software solutions. Interest towards M-Files solutions was clearly seen and the company has excellent opportunity to expand business to the Danish market through reseller channel. Since the research explored the Danish ICT and software market, the results of the study may offer valuable information also to the other software companies which are expanding their business to the Danish market.

Development of an Ecology-Oriented Software-Defined Networking Framework

ICT contributed to about 0.83 GtCO2 emissions where the 37% comes from the telecoms infrastructures. At the same time, the increasing cost of energy has been hindering the industry in providing more affordable services for the users. One of the sources of these problems is said to be the rigidity of the current network infrastructures which limits innovations in the network. SDN (Software Defined Network) has emerged as one of the prominent solutions with its idea of abstraction, visibility, and programmability in the network. Nevertheless, there are still significant efforts needed to actually utilize it to create a more energy and environmentally friendly network. In this paper, we suggested and developed a platform for developing ecology-related SDN applications. The main approach we take in realizing this goal is by maximizing the abstractions provided by OpenFlow and to expose RESTful interfaces to modules which enable energy saving in the network. While OpenFlow is made to be the standard for SDN protocol, there are still some mechanisms not defined in its specification such as settings related to Quality of Service (QoS). To solve this, we created REST interfaces for setting of QoS in the switches which can maximize network utilization. We also created a module for minimizing the required network resources in delivering packets across the network. This is achieved by utilizing redundant links when it is needed, but disabling them when the load in the network decreases. The usage of multi paths in a network is also evaluated for its benefit in terms of transfer rate improvement and energy savings. Hopefully, the developed framework can be beneficial for developers in creating applications for supporting environmentally friendly network infrastructures.

Electromagnetic and thermal design of a multilevel converter with high power density and reliability

Electric energy demand has been growing constantly as the global population increases. To avoid electric energy shortage, renewable energy sources and energy conservation are emphasized all over the world. The role of power electronics in energy saving and development of renewable energy systems is significant. Power electronics is applied in wind, solar, fuel cell, and micro turbine energy systems for the energy conversion and control. The use of power electronics introduces an energy saving potential in such applications as motors, lighting, home appliances, and consumer electronics. Despite the advantages of power converters, their penetration into the market requires that they have a set of characteristics such as high reliability and power density, cost effectiveness, and low weight, which are dictated by the emerging applications. In association with the increasing requirements, the design of the power converter is becoming more complicated, and thus, a multidisciplinary approach to the modelling of the converter is required. In this doctoral dissertation, methods and models are developed for the design of a multilevel power converter and the analysis of the related electromagnetic, thermal, and reliability issues. The focus is on the design of the main circuit. The electromagnetic model of the laminated busbar system and the IGBT modules is established with the aim of minimizing the stray inductance of the commutation loops that degrade the converter power capability. The circular busbar system is proposed to achieve equal current sharing among parallel-connected devices and implemented in the non-destructive test set-up. In addition to the electromagnetic model, a thermal model of the laminated busbar system is developed based on a lumped parameter thermal model. The temperature and temperature-dependent power losses of the busbars are estimated by the proposed algorithm. The Joule losses produced by non-sinusoidal currents flowing through the busbars in the converter are estimated taking into account the skin and proximity effects, which have a strong influence on the AC resistance of the busbars. The lifetime estimation algorithm was implemented to investigate the influence of the cooling solution on the reliability of the IGBT modules. As efficient cooling solutions have a low thermal inertia, they cause excessive temperature cycling of the IGBTs. Thus, a reliability analysis is required when selecting the cooling solutions for a particular application. The control of the cooling solution based on the use of a heat flux sensor is proposed to reduce the amplitude of the temperature cycles. The developed methods and models are verified experimentally by a laboratory prototype.

Model-based testing of software systems : functionality and performance

Software is a key component in many of our devices and products that we use every day. Most customers demand not only that their devices should function as expected but also that the software should be of high quality, reliable, fault tolerant, efficient, etc. In short, it is not enough that a calculator gives the correct result of a calculation, we want the result instantly, in the right form, with minimal use of battery, etc. One of the key aspects for succeeding in today's industry is delivering high quality. In most software development projects, high-quality software is achieved by rigorous testing and good quality assurance practices. However, today, customers are asking for these high quality software products at an ever-increasing pace. This leaves the companies with less time for development. Software testing is an expensive activity, because it requires much manual work. Testing, debugging, and verification are estimated to consume 50 to 75 per cent of the total development cost of complex software projects. Further, the most expensive software defects are those which have to be fixed after the product is released. One of the main challenges in software development is reducing the associated cost and time of software testing without sacrificing the quality of the developed software. It is often not enough to only demonstrate that a piece of software is functioning correctly. Usually, many other aspects of the software, such as performance, security, scalability, usability, etc., need also to be verified. Testing these aspects of the software is traditionally referred to as nonfunctional testing. One of the major challenges with non-functional testing is that it is usually carried out at the end of the software development process when most of the functionality is implemented. This is due to the fact that non-functional aspects, such as performance or security, apply to the software as a whole. In this thesis, we study the use of model-based testing. We present approaches to automatically generate tests from behavioral models for solving some of these challenges. We show that model-based testing is not only applicable to functional testing but also to non-functional testing. In its simplest form, performance testing is performed by executing multiple test sequences at once while observing the software in terms of responsiveness and stability, rather than the output. The main contribution of the thesis is a coherent model-based testing approach for testing functional and performance related issues in software systems. We show how we go from system models, expressed in the Unified Modeling Language, to test cases and back to models again. The system requirements are traced throughout the entire testing process. Requirements traceability facilitates finding faults in the design and implementation of the software. In the research field of model-based testing, many new proposed approaches suffer from poor or the lack of tool support. Therefore, the second contribution of this thesis is proper tool support for the proposed approach that is integrated with leading industry tools. We o er independent tools, tools that are integrated with other industry leading tools, and complete tool-chains when necessary. Many model-based testing approaches proposed by the research community suffer from poor empirical validation in an industrial context. In order to demonstrate the applicability of our proposed approach, we apply our research to several systems, including industrial ones.

Empirical studies on software quality construction: Exploring human factors and organizational influences

Software quality has become an important research subject, not only in the Information and Communication Technology spheres, but also in other industries at large where software is applied. Software quality is not a happenstance; it is defined, planned and created into the software product throughout the Software Development Life Cycle. The research objective of this study is to investigate the roles of human and organizational factors that influence software quality construction. The study employs the Straussian grounded theory. The empirical data has been collected from 13 software companies, and the data includes 40 interviews. The results of the study suggest that tools, infrastructure and other resources have a positive impact on software quality, but human factors involved in the software development processes will determine the quality of the products developed. On the other hand, methods of development were found to bring little effect on software quality. The research suggests that software quality is an information-intensive process whereby organizational structures, mode of operation, and information flow within the company variably affect software quality. The results also suggest that software development managers influence the productivity of developers and the quality of the software products. Several challenges of software testing that affect software quality are also brought to light. The findings of this research are expected to benefit the academic community and software practitioners by providing an insight into the issues pertaining to software quality construction undertakings.