Uma abordagem sócio-técnica à avaliação de turismo sustentável

Não obstante o pico de interesse que rodeia a temática de Turismo Sustentável, a implementação efetiva de práticas de sustentabilidade dentro do setor permanece escassa. A avaliação da performance surge como uma solução viável para esta problemática. Todavia, até ao momento, não existe nenhum modelo universalmente reconhecido para este efeito. Vários autores apresentaram propostas de modelos de avaliação para o Turismo Sustentável, mas estes ainda apresentam limitações, em particular no que diz respeito aos métodos de identificação e ponderação dos critérios. Como tal, o propósito deste estudo centra-se na criação de um modelo de avaliação de Turismo Sustentável através da aplicação conjunta de mapas cognitivos e do Integral de Choquet. A implementação da abordagem proposta envolveu duas sessões de trabalho com um painel de especialistas, assim como uma última sessão com um representante da Confederação do Turismo Português, visando a validação dos resultados e algumas recomendações. Os resultados obtidos com a aplicação prática do sistema desenvolvido demonstram que o seu cariz construtivista e orientado para o processo foi útil na criação de um ranking das regiões turísticas portuguesas, de acordo com o seu grau de sustentabilidade. Adicionalmente, foram evidenciados novos detalhes acerca das alternativas em estudo, através da identificação e da análise das relações causais entre os critérios de avaliação.Despite the increasing interest in sustainable tourism, the actual implementation of sustainability practices within the tourism sector remains sporadic. Performance evaluation has emerged as a viable solution for this problem, but no universal sustainable tourism assessment model has yet been developed for this purpose. Various authors have proposed different approaches, but these still exhibit limitations, especially regarding criteria selection and weighting. This study sought to create an assessment system for sustainable tourism by combining cognitive mapping techniques and the Choquet integral, providing a rational, transparent foundation for the selection and weighting of evaluation criteria. The development of the proposed assessment system involved group meetings with a panel of experts on the topic, as well as a final validation session with a senior representative of the Portuguese Tourism Confederation. The results of a practical application of the system developed show that its process-oriented nature facilitates the ranking of tourism regions according to their degree of sustainability. In addition, new insights into the sustainability of the studied destinations can be obtained through an analysis of the cause-and-effect relationships between evaluation criteria. The advantages and limitations of the proposed system are also discussed

Guidance on the integrated assessment of complex health technologies: the INTEGRATE-HTA model

Challenges in assessments of health technologies In recent years there have been major advances in the development of health technology assessment (HTA). However, HTA still has certain limitations when assessing technologies which are complex, i.e. consist of several interacting components, target different groups or organizational levels, have multiple and variable outcomes, and/or permit a certain degree of flexibility or tailoring (Craig et al., 2008), fi are context-dependent - current HTA usually focusses on the technology, not on the system within which it is used, fi perform differently depending on the way they are implemented, fi have different effects on different individuals. Furthermore, HTA usually assesses and appraises aspects side-by-side, while decision-making needs an integrated perspective on the value of a technology. In the EU-funded INTEGRATE-HTA project, we developed concepts and methods to deal with these challenges, which are described in six guidances. Because of the interactions, an integrated assessment needs to start from the beginning of the assessment. This guidance provides a systematic five-step-process for an integrated assessment of complex technologies (the INTEGRATE-HTA Model). Purpose and scope of the guidance The aim of the INTEGRATE-HTA project is to provide concepts and methods that enable a patient-centred, comprehensive, and integrated assessment of complex health technologies. The purpose of this guidance is to structure the overall HTA-process. The INTEGRATE-HTA Model outlines an integrated scoping process, a coordinated application of assessment methods for different aspects and an integrated and structured decision-making process. It is intended for HTA agencies, HTA researchers and those engaged in the evaluation of complex health technologies. As it links the assessment to the decision-making process, it also addresses HTA commissioners and other stakeholders using or planning HTAs. While all technologies are arguably complex, some are more complex than others. Applying this guidance might lead to a more thorough and therefore more time-consuming process. Depending on the degree of complexity, one might choose to follow the whole process as described in this guidance, or only focus on certain steps. The guidance provides an operational definition to assess the complexity of technologies which can be used to identify specific aspects that will need more attention than others. What the guidance does not provide is a post-hoc solution for assessments that have already been completed. | 6 Development of the guidance The INTEGRATE-HTA Model presented in this guidance was developed based on a systematic literature search on approaches for integration, on the experiences of traditional HTAs, as well as on the other methodological guidances developed in the INTEGRATE-HTA project. It was tested in a case study on palliative care and iteratively revised during the practical application. The guidance was again revised after internal and external peer-review. Application of this guidance For a comprehensive integrated assessment of a complex technology, we developed a five-step process, the INTEGRATE-HTA model. In Step 1, the HTA objective and the technology are defined with the support from a panel of stakeholders. An initial logic model is developed in Step 2. The initial logic model provides a structured overview of the technology, the context, implementation issues, and relevant patient groups. It then frames the assessment of the effectiveness, as well as economic, ethical, legal, and socio-cultural aspects in Step 3. In Step 4, a graphical overview of the assessment results, structured by the logic model, is provided. Step 5 is a structured decision-making process informed by the HTA (and is thus not formally part of the HTA, but follows it). fi Step 1: In step 1, the technology under assessment and the objective of the HTA are defined. Especially for complex technologies, such as palliative care, the definition of the technology alone is a challenge that must not be underestimated. It is recommended to do this based on a tentative literature review and with the support of stakeholder advisory panels (SAPs) which should comprise clinical experts, academics, patients, possibly their relatives and/or other caretakers, and the public. The setting of an objective considering all relevant aspects of complexity and structured by assessment criteria is important. The assessment criteria will usually reflect values of the stakeholders as well as the input from the theoretical, methodological and empirical literature. fi Step 2: In step 2, an initial logic model is developed (see Guidance on the use of logic models in health technology assessments of complex interventions). The model provides a structured overview on participants, interventions, comparators, and outcomes. Parallel to this, groups of patients that are distinguished by different preferences and treatment moderators (see Guidance for the assessment of treatment moderation and patients’ preferences) are identified. Specific context and implementation issues are also identified as part of the initial logic model (see Guidance for the Assessment of Context and Implementation in Health Technology Assessments (HTA) and Systematic Reviews of Complex Interventions). The product of this step is the logic model as a graphical representation of all aspects and their interactions that are relevant for the assessment of the complex technology. fi Step 3: In step 3, the logic model serves as a conceptual framework that guides the evidence assessment. Depending on the specific aspect (e.g. effectiveness, economic, ethical, socio-cultural, or legal aspects) different methods are available for the assessment (see Guidance for assessing effectiveness, economic aspects, ethical aspects, socio-cultural aspects and legal aspects in complex technologies). The outputs of step 3 are evidence reports and standardized evidence summaries for each assessment aspect (e.g. report on economics, report on ethical aspects, etc.). fi Step 4: In step 4, the assessment results of step 3 are structured using the logic model developed in step 2. Whereas the initial logic model in step 2 specifies what evidence is relevant, the extended logic model to assist decision-making in step 4 visualizes the assessment results as well as the interaction with respect to the HTA objectives. It also allows for the consideration of different scenarios depending on the variation in context, implementation and patient characteristics. 7 | fi Step 5: Step 5 involves a structured decision-making process and is not an integral part of the HTA in the narrow sense. Decision-making can be supported by applying quantitative e.g. MCDA- (Multi-criteria decision analysis) or qualitative decision support tools. Flexibility in the application of these tools by the decision committee is crucial, taking different decision settings and evidence needs into consideration. Conclusions In current HTA, different aspects are usually assessed and presented independent of each other. Context, implementation issues and patient characteristics are rarely considered. The INTEGRATE-HTA Model enables a coordinated assessment of all these aspects and addresses their interdependencies. The perspective of stakeholders such as patients and professionals with their values and preferences is integrated in the INTEGRATE-HTA Model to obtain HTA results that are meaningful for all relevant stakeholders. Finally, health policy makers obtain an integrated perspective of the assessment results to achieve fair and legitimate conclusions at the end of the HTA process. The application of the model will usually require more time and resources than traditional HTA. An initial assessment of the degree and the character of complexity of a technology might be helpful to decide whether or not the whole process or only specific elements will be applied

Z-Numbers-Based Approach to Hotel Service Quality Assessment

In this study, we are analyzing the possibility of using Z-numbers for measuring the service quality and decision-making for quality improvement in the hotel industry. Techniques used for these purposes are based on consumer evalu- ations - expectations and perceptions. As a rule, these evaluations are expressed in crisp numbers (Likert scale) or fuzzy estimates. However, descriptions of the respondent opinions based on crisp or fuzzy numbers formalism not in all cases are relevant. The existing methods do not take into account the degree of con- fidence of respondents in their assessments. A fuzzy approach better describes the uncertainties associated with human perceptions and expectations. Linguis- tic values are more acceptable than crisp numbers. To consider the subjective natures of both service quality estimates and confidence degree in them, the two- component Z-numbers Z = (A, B) were used. Z-numbers express more adequately the opinion of consumers. The proposed and computationally efficient approach (Z-SERVQUAL, Z-IPA) allows to determine the quality of services and iden- tify the factors that required improvement and the areas for further development. The suggested method was applied to evaluate the service quality in small and medium-sized hotels in Turkey and Azerbaijan, illustrated by the example

The Choquet and Sugeno Integrals as Measures of Total Effectiveness of Medicines

Abstract. The concepts of the Choquet and Sugeno integrals, based on a fuzzy measure, can be adopted as useful tools in estimation of the total effectiveness of a drug when appreciating its positive influence on a collection of symptoms typical of a considered diagnosis. The expected effectiveness of the medicine is evaluated by a physician as a verbal expression for each distinct symptom. By converting the words at first to fuzzy sets and then numbers we can regard the effectiveness structures as measures in the Choquet and Sugeno problem formulations. After comparing the quantities of total effectiveness among medicines, expressed as the values of the Choquet or Sugeno integrals, we accomplish the selection of the most efficacious drug

Collected Papers (on Neutrosophic Theory and Applications), Volume VII

This seventh volume of Collected Papers includes 70 papers comprising 974 pages on (theoretic and applied) neutrosophics, written between 2013-2021 by the author alone or in collaboration with the following 122 co-authors from 22 countries: Mohamed Abdel-Basset, Abdel-Nasser Hussian, C. Alexander, Mumtaz Ali, Yaman Akbulut, Amir Abdullah, Amira S. Ashour, Assia Bakali, Kousik Bhattacharya, Kainat Bibi, R. N. Boyd, Ümit Budak, Lulu Cai, Cenap Özel, Chang Su Kim, Victor Christianto, Chunlai Du, Chunxin Bo, Rituparna Chutia, Cu Nguyen Giap, Dao The Son, Vinayak Devvrat, Arindam Dey, Partha Pratim Dey, Fahad Alsharari, Feng Yongfei, S. Ganesan, Shivam Ghildiyal, Bibhas C. Giri, Masooma Raza Hashmi, Ahmed Refaat Hawas, Hoang Viet Long, Le Hoang Son, Hongbo Wang, Hongnian Yu, Mihaiela Iliescu, Saeid Jafari, Temitope Gbolahan Jaiyeola, Naeem Jan, R. Jeevitha, Jun Ye, Anup Khan, Madad Khan, Salma Khan, Ilanthenral Kandasamy, W.B. Vasantha Kandasamy, Darjan Karabašević, Kifayat Ullah, Kishore Kumar P.K., Sujit Kumar De, Prasun Kumar Nayak, Malayalan Lathamaheswari, Luong Thi Hong Lan, Anam Luqman, Luu Quoc Dat, Tahir Mahmood, Hafsa M. Malik, Nivetha Martin, Mai Mohamed, Parimala Mani, Mingcong Deng, Mohammed A. Al Shumrani, Mohammad Hamidi, Mohamed Talea, Kalyan Mondal, Muhammad Akram, Muhammad Gulistan, Farshid Mofidnakhaei, Muhammad Shoaib, Muhammad Riaz, Karthika Muthusamy, Nabeela Ishfaq, Deivanayagampillai Nagarajan, Sumera Naz, Nguyen Dinh Hoa, Nguyen Tho Thong, Nguyen Xuan Thao, Noor ul Amin, Dragan Pamučar, Gabrijela Popović, S. Krishna Prabha, Surapati Pramanik, Priya R, Qiaoyan Li, Yaser Saber, Said Broumi, Saima Anis, Saleem Abdullah, Ganeshsree Selvachandran, Abdulkadir Sengür, Seyed Ahmad Edalatpanah, Shahbaz Ali, Shahzaib Ashraf, Shouzhen Zeng, Shio Gai Quek, Shuangwu Zhu, Shumaiza, Sidra Sayed, Sohail Iqbal, Songtao Shao, Sundas Shahzadi, Dragiša Stanujkić, Željko Stević, Udhayakumar Ramalingam, Zunaira Rashid, Hossein Rashmanlou, Rajkumar Verma, Luige Vlădăreanu, Victor Vlădăreanu, Desmond Jun Yi Tey, Selçuk Topal, Naveed Yaqoob, Yanhui Guo, Yee Fei Gan, Yingcang Ma, Young Bae Jun, Yuping Lai, Hafiz Abdul Wahab, Wei Yang, Xiaohong Zhang, Edmundas Kazimieras Zavadskas, Lemnaouar Zedam

Safety and Reliability - Safe Societies in a Changing World

The contributions cover a wide range of methodologies and application areas for safety and reliability that contribute to safe societies in a changing world. These methodologies and applications include: - foundations of risk and reliability assessment and management - mathematical methods in reliability and safety - risk assessment - risk management - system reliability - uncertainty analysis - digitalization and big data - prognostics and system health management - occupational safety - accident and incident modeling - maintenance modeling and applications - simulation for safety and reliability analysis - dynamic risk and barrier management - organizational factors and safety culture - human factors and human reliability - resilience engineering - structural reliability - natural hazards - security - economic analysis in risk managemen