Goal-oriented Approach Research Articles

Misure di benessere dei territori e programmazione strategica: il livello comunale

The paper concerns the application of the indicators defined under the Istat’s projects to measure the Equitable and Sustainable Well-being (the BES projects) to the strategic planning of Italian Municipalities. To this end, the BES indicators are categorized according to the public accounting classification, so to enhance their relevance and usefulness in supporting policy-making and evaluation at local level. Recently, a governmental reform introduced for the first time in Italy a standard classification of the municipal budgets: according to the new rules, the municipalit’s budget planning is now going to follow a goal-oriented approach, to identify the strategic objectives to pursue through the administrative action. To better address local needs, a socio-economic analysis must support the strategic planning in order to set the goals and fix the targets. A standard set of indicators may suitably complete the harmonized budget and planning brought about by the reform. The BES indicators can provide the required information to decision-makers and they can inform both policy makers and citizens about the economic, social and environmental state of the local context. The BES indicators can also support the monitoring and benchmarking of the local well-being, as they are comparable in space and time. In addition, as the BES framework relies on a participatory process with the civil society and the stakeholders, the BES indicators, impartial, reliable and transparent, can be properly used for local policies’ planning and evaluation.

Surgical Updates in the Treatment of Pelvic Organ Prolapse.

Pelvic organ prolapse affects approximately 8% of women, and the demand for pelvic organ prolapse surgery is expected to increase by nearly 50% over the next 40 years. The surgical techniques used to correct pelvic organ prolapse have evolved over the last 10 years, with multiple well-designed studies addressing the risks, outcomes, reoperation rates, and optimal surgical approaches. Here we review the most recent evidence on the route of access, concomitant procedures, and synthetic materials for augmenting the repair. Ultimately, this review highlights that there is no optimal method for correcting pelvic organ prolapse and that the risks, benefits, and approaches should be discussed in a patient-centered, goal-oriented approach to decision-making.

Mending the patchwork of requirements from multiple standards using participative goal modelling: a case in the food industry

An increasing number of concurrent standards and regulations is being imposed on organizations operating in various domains. From healthcare to automotive to food, demands from national legislation, directives of each target market, and edicts from specific clients are creating a patchwork of requirements for compliance and audit. Managing these disconnected frameworks involves considerable overhead, duplications, and conflicts. But integrating and harmonizing these requirements needs the collaboration of varied stakeholders, with different trainings and backgrounds, capable of translating the impacts of the various norms in the different sectors of the organization. We propose a participative goal-oriented approach, consisting of four steps, to assist in this process. It brings together the requirements from the various regulations, the organizational goals, and measurement indicators. We describe its use in a company operating in the food industry, one of the most regulated in the world, where audits are very frequent, to integrate ISO 22000, IFS Food, and BRC Global Standards. Our findings show that an effective integration of the multiple regulations was possible and that the resulting goal diagrams are an effective tool for communicating with various stakeholders, such as employees, clients, auditors, consultants, and representatives of industry initiatives.

An Efficiency-Based Approach to Determining Potential Cost Savings and Profit Targets for Health Insurers: The Case of Obamacare Health Insurance CO-OPs

This research analyzes the performance of the health insurance consumer-operated and -oriented plan (CO-OPs), examines their medical services and operating efficiency, proposes an efficiency-based goal-oriented approach for cost reductions, profit targets, premium changes, and government subsidies, and provides an important guide for improvement potentials for both the CO-OP health insurance model and other health insurers. The CO-OPs are not satisfactory in the medical services efficiency, and they are much less efficient compared with other insurers. Potential cost reductions are significant using various (conservative) efficiency goals. Most CO-OPs suffer underwriting losses, as do many other insurers; a few CO-OPs are much more operating efficient than other insurers, but all CO-OPs need significant improvement of financial performance relative to benchmark insurers. Incorporating potential cost reductions, many CO-OPs would barely require any “premium changes and government subsidies,” and they are even capable of paying back the federal loans. With both potential cost reductions and premium increases, more CO-OPs would not need any help from the government but survive on their own. This research informs public debates and all stakeholders (including management, consumers, regulators, policymakers) of improvement potentials to be considered for related decision making besides other factors including the political environment and government policies.

The influence of contextual factors on patient involvement during follow-up consultations after colorectal cancer surgery: a case study.

To identify the contextual factors that influence individual patient involvement during colorectal cancer surgical follow-up consultations. The healthcare system is subject to the requirement and expectation of greater involvement of patients and relatives. Increased patient involvement requires the development and implementation of new communication initiatives. Research shows that it is also necessary to consider the contextual circumstances surrounding patient involvement in specific situations. Case study of a single Danish outpatient clinic, which allows the issues and circumstances involved in an everyday situation to be captured. 12 nonparticipative observations of outpatient visits and, subsequently, seven in-depth patient interviews. Content analysis based on a dialogical, interactive framework, which underpinned the identification of current contextual factors. The results showed five contextual factors that seemed to have an impact on patient involvement. The first, 'Two dimensions of patient involvement: treatment-oriented and person-oriented' highlighted a dual interpretation of patient involvement in the consultation situation. The two dimensions seemed to be influenced by four additional factors: 'Doctors leading the agenda', 'Traditional health professional roles', 'Unclear responsibilities' and 'Guidance primarily focused on treatment'. The results showed how patient involvement in clinical practice could be understood as a two-way movement, in which patients are invited to participate in clinical practice, while health professionals are invited to participate in the patients' lives. The movement will change from situation to situation and is influenced by several contextual factors. The results can help doctors and nurses to navigate using a goal-oriented approach towards patient involvement. The study makes visible the need for research-based development of the independent role of the nursing profession in cancer care follow-up, with a view to enhanced patient-centred care.

THE EFFECTIVENESS OF IMPLEMENTING INFORMATION AND COMMUNICATION TECHNOLOGY ON STUDENT ACADEMIC SERVICES (A Case Study in Bandung Institute of Technology for the 2015-2016 Period)

The implementation of Information and Communication Technology (ICT) in higher education institutions plays an important role in realizing the competitive advantage, especially in the realization of the three pillars of higher education. In order for the implementation of ICT in higher education institutions to be effective, adequate support from infrastructure, human resources, and leader and organizational commitment is needed. The research focuses on and aims to describe the effectiveness of ICT implementation in student academic services, covering ICT policies and programs, ICT implementation strategies, ICT implementation, and the effectiveness of ICT implementation in student academic services. In addition, it attempts to formulate a hypothetical model of ICT implementation in student academic services. The research adopted the analytical-descriptive method through qualitative approach. Data were collected through interviews, observations, and documentary analysis. Afterwards, the data were analyzed through data reduction, data display, inference drawing, and verification. The research took place in Bandung Institute of Technology. The findings show that: The ICT policies and programs are based on the implementation of the three pillars of higher education (education, research, and community service); the strategies give emphasis on coordination patterns; ICT implementation in academic services is realized through e-learning (online, blended learning, video conference), academic information system, and digital library; the effectiveness of the ICT implementation is analyzed based on the realization of the program at the level of unit (decision-focused approach), performance achievement (goal-oriented approach), and student satisfaction (user-oriented approach) in terms of tangibles, reliability, responsiveness, assurance, and empathy. It is recommended that ICT implementation in academic services should be able to realize the competitive advantage of the implementation of the three pillars of higher education, which is in accordance with the institution’s vision, missions, and strategic goals, supported by the availability of infrastructure, human resources, funds, managerial and organizational commitment, and periodical evaluation and monitoring.

The Students' Viewpoint on Quality of Educational Services in Iran.

Background:Recently, focusing on higher education quality has got increasingly critical. The novel managerial attitudes have defined the customer-demanded quality. Based on this, recognizing the receivers’ perception of the quality of the services offered and evaluating the quality of the service is considered of the basic measures taken in order to develop quality promotion programs. Therefore, this is a qualitative research conducted for students’ viewpoint on quality of educational services.Material and Methods:This qualitative study has been performed by the phenomenological method. The samples have been selected based on goal-oriented approach. In this qualitative research, the required data have been collected in two phases (90 individual interviews and 30 focus group discussions) at Mazandaran University of Medical Sciences during which the participants have conveyed their experiences and expectations encountering the educational quality topic. All the interviews have been recorded and implemented. The interviews analysis has been carried out simultaneously with the implementation and using theme analysis by Smith method.Results:According to the findings regarding the definition of quality, the students have emphasized two important aspects including “educational services standards by the teacher “and “the students’ satisfaction”. Thus the final education quality resulted from the students’ experiences and perception is this way: “Presenting the students educational services in class and out of class compatible with the educational services standards so that it results in the students’ satisfaction”. When a person views her/him-self rightful as a customer, whatever seems necessary to them appears like a requirement. Then regarding paying attention and reflecting on the customers’ perceived needs, it is possible to determine their expectations limit to some extent.Conclusion:Therefore, designing educational quality standards in order to evaluate the teachers’ function without taking the stakeholders’ perspective into account is not practical. This research-extracted finding can present the stakeholders’ perspective encountering the educational quality.

Security engineering methods - in-depth analysis

Providing security to complex information system development is challenging because of complex network and ubiquitous system. Traditional mechanisms address security concerns during development or design phases that may lead to various loopholes or over-constrained system. The field of security engineering has emerged whereby security requirements are gathered along with other requirements during the initial phase of software development. However, dealing with security concerns during the initial phases of development is challenging because of design and code unavailability. The paper first represents the proposals for security requirements engineering based on different approaches such as use case approach, goal-oriented approach, and process-oriented approach. These methodologies are evaluated along various parameters such as security engineering activities covered, application domain and others. The in-depth analysis ends with a recent proposal for security engineering and list of unresolved issues that needs consideration. The outcome of the paper can be exploited to drive further research.

A GOAL-ORIENTED APPROACH TO THE PERFORMANCE ASSESSMENT OF RESEARCH TEAMS

The current growth of scientific knowledge has intensified the problem of research performance assessment. However, there is still a lack of the unified assessment methodology, largely due to the changing nature of modern science. At present, knowledge is increasingly generated by collective actors - research teams, rather than by individual scientists. These collective actors constitute a complex self-developing and evolutionary system, making its evaluation rather problematic. By using a goal-oriented approach, this paper seeks to identify specific characteristics of various research team types and suggests a qualitative criterion against which their research performance can be measured. It is shown that a research team forms and evolves around a goal that is shared by all its members; this common goal defines both structural-managerial characteristics of such a collective actor and qualitative attributes of attained research objectives. The obtained results - research team models and the qualitative criterion of their performance - can be used as a platform for further research into the cross-cultural, ethical, and economic dimensions of research teams, as well as for assessing research performance of actual teams.

Assessing the Infusion of Sustainability Principles into University Curricula

Abstract The current paper presents the assessment of the infusion of sustainability principles into university curricula at two Jordanian universities. The peer review process of revising the curricula infusing sustainability principles is also discussed. The research methodology involved quantitative methods to assess the revised courses. The results revealed the following: the most relevant ESD themes in the revised curricula were “human connections to the physical and natural world”, and “ethics/values”. The most relevant ESD topics were: “sustainable production/consumption” and “health promotion”. The most infused ESD pillars (competencies) were: “learning to know” and “learning to do”. The most relevant ESD principles were: “practiced locally” and “responds through applied learning”. The findings offered a rich scenario of the strategies applied by the university professors in revising the curricula, providing evidence of a mental attitude to adopt ESD strategies, as well as a goal-oriented approach in curriculum planning. The paper also discusses the implications of the study results for syllabus revision and development, as well as the refinement of the teaching methods that focus on infusing sustainability into university curricula.

The Goal Behind the Action

Human activity is almost always intentional, be it in a physical context or as part of an interaction with a computer system. By understanding why user-generated events are happening and what purposes they serve, a system can offer a significantly improved and more engaging experience. However, goals cannot be easily captured. Analyzing user actions such as clicks and purchases can reveal patterns and behaviors, but understanding the goals behind these actions is a different and challenging issue. Our work presents a unified, multidisciplinary viewpoint for goal management that covers many different cases where goals can be used and techniques with which they can be exploited. Our purpose is to provide a common reference point to the concepts and challenging tasks that need to be formally defined when someone wants to approach a data analysis problem from a goal-oriented point of view. This work also serves as a springboard to discuss several open challenges and opportunities for goal-oriented approaches in data management, analysis, and sharing systems and applications.

A Discriminant Parameter Determining Technique in Variational Multiscale Method for Stokes Equations

A Goal-Oriented and Model-Constrained Optimization (GOMCO) approach was proposed as a discriminant technique for the Variational Geomano Method (VGM) in the coefficient determinations of variational multiscale Unresolved-Scale (URS) model in steady Stokes equations. Numerical implementations using both linear and nonlinear models were performed with both the GOMCO and VGM. Numerical results show that the coefficients determined by the GOMCO are scale-invariant, while they are scale-variant by the VGM. The GOMCO technique is found to be more appropriate for coefficient determinations in steady Stokes equations, as the VGM is sensitive to the computing procedures. Moreover, the GOMCO could provide reliable coefficients for the URS model.

Worst-case multi-objective error estimation and adaptivity

This paper introduces a new computational methodology for determining a-posteriori multi-objective error estimates for finite-element approximations, and for constructing corresponding (quasi-)optimal adaptive refinements of finite-element spaces. As opposed to the classical goal-oriented approaches, which consider only a single objective functional, the presented methodology applies to general closed convex subsets of the dual space and constructs a worst-case error estimate of the finite-element approximation error. This worst-case multi-objective error estimate conforms to a dual-weighted residual, in which the dual solution is associated with an approximate supporting functional of the objective set at the approximation error. We regard both standard approximation errors and data-incompatibility errors associated with incompatibility of boundary data with the trace of the finite-element space. Numerical experiments are presented to demonstrate the efficacy of applying the proposed worst-case multi-objective error estimate in adaptive refinement procedures.

How do males recover from eating disorders? An interview study

ObjectivesThe aim of the current study is to investigate what males experience as helpful in their recovery process from eating disorders (ED).MethodsQualitative in-depth interviews within a phenomenological approach, and using...

A goal-oriented, ontology-based methodology to support the design of AAL environments

One of the most critical issues in Ambient Assisted Living (AAL) is the design of systems that can evolve to meet the requirements of individuals as their needs and health conditions change. Although much work has been done on home and building automation systems for AAL, often referred to as assistive domotics, there is in fact still a substantial lack of solutions capable to support system designers in the early stage of development of such assistive systems. To this aim, the work contributes to the research on design of assistive domotic systems by presenting an ontology-driven methodology aimed to guide the development process. The novel contributions of the paper include the goal-oriented approach of the methodology, which involves the elicitation and analysis of AAL requirements and their formal representation in an ontology, where high-level goals are described in terms of subgoals and tasks, that are then linked to corresponding measures and devices. Moreover, logic-based reasoning enables more advanced functionalities useful at design time. We present a validation of the methodology showing typical use cases both related to the development from scratch of a domotic system with assistive capabilities starting from a set of high-level user requirements and the redesign of existing implementations according to changed requirements.

SERP-test: a taxonomy for supporting industry–academia communication

This paper presents the construction and evaluation of SERP-test, a taxonomy aimed to improve communication between researchers and practitioners in the area of software testing. SERP-test can be utilized for direct communication in industry academia collaborations. It may also facilitate indirect communication between practitioners adopting software engineering research and researchers who are striving for industry relevance. SERP-test was constructed through a systematic and goal-oriented approach which included literature reviews and interviews with practitioners and researchers. SERP-test was evaluated through an online survey and by utilizing it in an industry–academia collaboration project. SERP-test comprises four facets along which both research contributions and practical challenges may be classified: Intervention, Scope, Effect target and Context constraints. This paper explains the available categories for each of these facets (i.e., their definitions and rationales) and presents examples of categorized entities. Several tasks may benefit from SERP-test, such as formulating research goals from a problem perspective, describing practical challenges in a researchable fashion, analyzing primary studies in a literature review, or identifying relevant points of comparison and generalization of research.

The Labor Market: Challenges and Development Trends

Background/Objectives: In current context, typical problems for CIS countries are associated with imbalance between supply and demand of national labor markets. Formation, development of forms of employment will reduce unemployment rate. Methods/Statistical Analysis: The article concerns with the theoretic-methodological problems of labor market formation in countries with market economies at different levels of their advancement. The author reveals features, development trends and labor market formation issues in the context of general and regional aspects from the standpoint of system-structural, program-oriented and goal-oriented approach. The article presents also comparative analysis of dynamics of employment and labor market key parameters in the CIS countries. Special attention is paid to the condition of the labor market in Uzbekistan. Findings: It is argued that the labor market both in the country and at the regional level is a complex integrated system with a large number of business entities and intermediaries, the diversity of the occurring socio-economic processes, ambiguity of current tasks, the exceptionally large volume of information, constantly increasing number of links between market participants as well as their probabilistic nature. Solving the problems of imbalances between supply and demand in the labor market is possible through the implementation of the strategic partnership between the state, employers and institutions of professional education system. It is shown that the analysis of employment dynamics and the labor market, as well as their structural characteristics, should be considered in the context of the diversity of forward and backward linkages with the key macroeconomic and demographic processes. The proposed measures will promote further the formation of conditions for sustainable functioning of national labor markets in the CIS countries that in future will contribute to the growth of living standards. Application/Improvements: Results can be used in development of national programs aimed at reduction of unemployment and the labor market development.

Perspectives on advance directives among German intensive care physicians in leading positions

Six years after introduction of a law for advance directives (AD) in 2009, AD are still discussed controversially. For the first time in Germany, this study investigates intensive care physicians' perspectives on implementation of AD, and corresponding experience of ethical issues. A standardized questionnaire was sent to German hospitals with > 300 beds and anesthesiologist-led intensive care units. The questionnaire was based on results of a previous qualitative study and was intended to be answered by one leading intensive care physician per hospital. N = 222/299 (74.2 % response) physicians answered the survey. Despite a number of reported problems regarding the implementation of AD, 70.6 % (n = 154/218) rated AD generally as helpful. 86.5 % (n = 185/214) would prefer a more goal-oriented approach to an intervention-oriented approach to formulate AD. Furthermore 95.9 % (n = 207/216) plead for qualified professional counseling for intensive care topics in AD. Acceptance for interventions that equal termination of treatment can be perceived. Terminal extubation in correspondence with the patient's will is done in 79.4 % (n = 173/218) of hospitals, however 54.8 % (n = 113/206) of the physicians experience terminal extubations as burdening. Supporting concepts and measures will be necessary in order to prepare valid AD and to effectively improve implementation in intensive care practice.

The challenging interplay between rheumatoid arthritis, ageing and comorbidities

BackgroundThe incidence of rheumatoid arthritis (RA) is expected to increase over the next 10 years in the European Union because of the increasing proportion of elderly people. As both RA and ageing are associated with emerging comorbidities such as cardiovascular disease, malignancies and osteoporosis, these factors will have a profound effect on the management of RA. In addition, both increasing age and comorbidities may independently alter commonly used RA-specific outcome measures.DiscussionAge-related decline in immune cell functions (immunosenescence), such as a decrease in T-cell function, may contribute to the development of RA, as well as comorbidity. The chronic immune stimulation that occurs in RA may also lead to premature ageing and comorbidity. The interplay between RA, ageing and (emerging) comorbidities is interesting but complex. Cardiovascular disease, lung disease, malignancies, bone and muscle wasting and neuropsychiatric disease all occur more frequently in RA patients as compared to the general population. It is unclear how RA should be managed in ‘today’s world of multiple comorbidities’. Evidence that treatment of RA improves comorbidities is currently lacking, although some promising indirect observations are available. On the other hand, there is limited evidence that medication regularly prescribed for comorbidities, such as statins, might improve RA disease activity. Both ageing and comorbidity have an independent effect on commonly used outcome measures in the RA field, such as the Health Assessment Questionnaire (HAQ) and the clinical disease activity index (CDAI). Prospective studies, that also account for the presence of comorbidity in (elderly) RA patients are therefore urgently needed. To address gaps in knowledge, future research should focus on the complex interdependencies between RA, ageing and comorbidity. In addition, these findings should be integrated into daily clinical practice by developing and testing integrated and coordinated health care services. Adaptation of management recommendations is likely required.SummaryThe elderly RA patient who also deals with (emerging) comorbidities presents a unique challenge to treating clinicians. A paradigm shift from disease-centered to goal-oriented approach is needed to develop adequate health care services for these patients.

A qualitative interpretation of challenges associated with helping patients with multiple chronic diseases identify their goals.

BackgroundPatients with multiple chronic diseases are usually treated according to disease-specific guidelines, with outcome measurements focusing mostly on biomedical indicators (e.g. blood sugar levels or lung function). However, for multimorbidity, a goal-oriented approach focusing on the goals defined by the individual patient, may be more suitable. Despite the clear theoretical and conceptual advantages of including patient-defined goals in clinical decision-making for multimorbidity, it is not clear how patients define their goals and which aspects play a role in the process of defining them.ObjectiveTo explore goal-setting in patients with multimorbidity.DesignQualitative analysis of interviews with 19 patients diagnosed with chronic obstructive pulmonary disease and comorbidities.ResultsPatients do not naturally present their goals. Their goals are difficult to elicit, even when different interviewing techniques are used. Four underlying hypotheses which may explain this finding were identified from the interviews: (1) patients cannot identify with the concept of goal-setting; (2) goal-setting is reduced due to acceptation; (3) actual stressors predominate over personal goal-setting; and (4) patients may consider personal goals as selfish.ConclusionsOur findings advocate for specific attention to provider skills and strategies that help patients identify their personal goals. The hypotheses on why patients may struggle with defining goals may be useful to prompt patients in this process and support the development of a clinical method for goal-oriented care.