An Analysis of the Notion of Need for the Representation of Public Services

Many Public Administrations structure their services around the notion of users’ need. However, there is a gap between private, subjectively perceived needs (self-attributed) and needs that are attributed by PA to citizens (heteroattributed). Because of the gap, citizens’ needs are often only partially satisfied by PAs services. This gap is in part due to the fact that the meaning of the word “need” is ambiguous and full of antinomic nuances. The purpose of this paper is to formulate a definition of “need” suitable for citizens’ needs management with respect to PA’s services offering, and to provide an accurate ontological analysis of the notion of “need” and the network of concepts that relate to it

Needs and intentionality

A thorough understanding of what needs are is fundamental for design- ing well-behaved information systems for many social applications and in partic- ular for public services. Talking about needs pervades indeed the jargon of Public Administrations when motivating their service offering. In this paper, we propose an ontological analysis of needs, aiming at a principled disentangling of the differ- ent uses of the term. We leverage philosophical tradition on intentionality, for its rich understanding of mental entities, we compare it with the well-established BDI (Belief-Desire-Intention) tradition in knowledge representation, and we propose a formalisation of needs within the foundational ontology DOLCE. Throughout the paper, we motivate our analysis focusing on needs in public services

Association of kidney disease measures with risk of renal function worsening in patients with type 1 diabetes

Background: Albuminuria has been classically considered a marker of kidney damage progression in diabetic patients and it is routinely assessed to monitor kidney function. However, the role of a mild GFR reduction on the development of stage 653 CKD has been less explored in type 1 diabetes mellitus (T1DM) patients. Aim of the present study was to evaluate the prognostic role of kidney disease measures, namely albuminuria and reduced GFR, on the development of stage 653 CKD in a large cohort of patients affected by T1DM. Methods: A total of 4284 patients affected by T1DM followed-up at 76 diabetes centers participating to the Italian Association of Clinical Diabetologists (Associazione Medici Diabetologi, AMD) initiative constitutes the study population. Urinary albumin excretion (ACR) and estimated GFR (eGFR) were retrieved and analyzed. The incidence of stage 653 CKD (eGFR < 60 mL/min/1.73 m2) or eGFR reduction > 30% from baseline was evaluated. Results: The mean estimated GFR was 98 \ub1 17 mL/min/1.73m2 and the proportion of patients with albuminuria was 15.3% (n = 654) at baseline. About 8% (n = 337) of patients developed one of the two renal endpoints during the 4-year follow-up period. Age, albuminuria (micro or macro) and baseline eGFR < 90 ml/min/m2 were independent risk factors for stage 653 CKD and renal function worsening. When compared to patients with eGFR > 90 ml/min/1.73m2 and normoalbuminuria, those with albuminuria at baseline had a 1.69 greater risk of reaching stage 3 CKD, while patients with mild eGFR reduction (i.e. eGFR between 90 and 60 mL/min/1.73 m2) show a 3.81 greater risk that rose to 8.24 for those patients with albuminuria and mild eGFR reduction at baseline. Conclusions: Albuminuria and eGFR reduction represent independent risk factors for incident stage 653 CKD in T1DM patients. The simultaneous occurrence of reduced eGFR and albuminuria have a synergistic effect on renal function worsening