Comparison of weighting methods used in multicriteria decision analysis frameworks in healthcare with focus on low- and middle-income countries

Criteria weighting is a key element of multicriteria decision analysis that is becoming extensively used in healthcare decision-making. In our narrative review we describe the advantages and disadvantages of various weighting methods.An assessment of the eight identified primary criteria weighting methods was compiled on domains including their resource requirements, and potential for bias.In general, we found more complex methods to have less potential for bias; however, resource intensity and general participant burden is greater for these methods.The selection of the most appropriate method depends on the decision-making context. The simple multiattribute rating technique (SMART) method combined with swing-weighting technique and the analytic hierarchy process methods may be the most feasible approaches for low- and middle-income countries

The role of collective narcissism in populist attitudes and the collapse of democracy in Hungary

What are the psychological processes responsible for the recent spread of populist political systems and movements? All political systems essentially reflect the mental representations of their populations, and collective narcissism has recently emerged as a contributing factor in the rise of populism. This article presents two studies examining the role of collective narcissism in predicting populist attitudes and voting intentions in Hungary. Hungary offers a particularly important case study of state-sponsored populism and illiberalism in Europe, as this country has gone furthest in undermining democratic principles and practices within the EU. To establish the pervasive role of collective narcissism we first review the historical evidence, survey research, and narrative analyses of Hungarian political representations. We then present two empirical studies where we predicted and found that collective narcissism was a significant predictor of negative attitudes toward the EU (Study 1), conservatism, and support for the ruling populist party (Studies 1 and 2). Collective narcissism predicted these variables independently from other factors, such as in-group positivity or perceived relative deprivation. However, once conservatism was controlled for the effects of collective narcissism faded out in some cases. The results nevertheless indicate that collective narcissism plays important role in promoting populist politics. The implications of these findings for understanding the psychological appeal of populism and illiberalism are discussed

EQ-5D in Central and Eastern Europe : 2000-2015

Objective: Cost per quality-adjusted life year data are required for reimbursement decisions in many Central and Eastern European (CEE) countries. EQ-5D is by far the most commonly used instrument to generate utility values in CEE. This study aims to systematically review the literature on EQ-5D from eight CEE countries. Methods: An electronic database search was performed up to July 1, 2015 to identify original EQ-5D studies from the countries of interest. We analysed the use of EQ-5D with respect to clinical areas, methodological rigor, population norms and value sets. Results: We identified 143 studies providing 152 country-specific results with a total sample size of 81,619: Austria (n=11), Bulgaria (n=6), Czech Republic (n=18), Hungary (n=47), Poland (n=51), Romania (n=2), Slovakia (n=3) and Slovenia (n=14). Cardiovascular (20%), neurologic (16%), musculoskeletal (15%) and endocrine/nutritional/metabolic diseases (14%) were the most frequently studied clinical areas. Overall 112 (78%) of the studies reported EQ VAS results and 86 (60%) EQ-5D index scores, of which 27 (31%) did not specify the applied tariff. Hungary, Poland and Slovenia have population norms. Poland and Slovenia also have a national value set. Conclusions: Increasing use of EQ-5D is observed throughout CEE. The spread of health technology assessment activities in countries seems to be reflected in the number of EQ-5D studies. However, improvement in informed use and methodological quality of reporting is needed. In jurisdictions where no national value set is available, in order to ensure comparability we recommend to apply the most frequently used UK tariff. Regional collaboration between CEE countries should be strengthened

Evaluation of some Achillea L. accessions based on morphological, cytological and chemical characteristics

Taxonomical evaluation of six taxa of the Achillea aggregate was carried out to determine their potential for breeding and cultivation. We used complex morphological, cytological and chemical aspects of characterisation. Three taxa of tetraploid genom and high chamazulene contents (33-40% ess.oil) proved to be A. collina Becker. A strain of wild origin had also high -bisabolol content and high oil level, comparable with the selected cultivars. A population was identified as new chemotype of A. pannonica Scheele with typical morphological and cytological traits, a wide sesquiterpene spectrum but lacking of 1.8 cineole and -pinene. We found a mixed population which consisted of both A. collina and A. pannonica plants. A tetraploid, azuleneless taxon could be concluded as A. pratensis Saukel and Langer not described before in Hungary. The diverse performance of the populations calls the attention to the significance of controlled plant raw in phytopharmaceutical products

Variability of phenolic compounds of four aromatic Lamiaceae species in consequence of different water supply

The reactions of lemon balm, marjoram, peppermint, thyme were investigated and compared in a pot experiment, adjusting 70% and 40% of soil water capacity (SWC). Biomass, total phenolic content (TPC), rosmarinic acid content (RA) and antioxidant capacity (FRAP, DPPH) of both the shoots and roots were measured. As an universal phenomenon the water stress (40% SWC) decreased the total biomass production of all species drastically. The highest increase was observed in the shoot mass of peppermint and lemon balm (decreased from 52.6 g·plant–1 to 11.3 g·plant–1 and from 236.8 g·plant–1 to 58 g·plant–1, respectively). The reaction of marjoram was much more moderate. The accumulation level of TPC was accelerated in the aboveground parts of the studied species, universally. The reactions in the roots were less characteristic. The largest increase of TPC was measured in the shoots of lemon balm (from 359.015 mg GAE· g–1 d.w. up to 412.44 GAE·g–1 d.w.). The reaction of marjoram was the less characteristic in this respect, as well. The parallel changes of biomass and TPC level might allow the total phenolic content to function as an adequate marker in predicting the lack of appropriate water supply. RA content showed species characteristics. Thyme, marjoram and peppermint reacted by a significant elevation (by 23–127%) of the RA content to the lack of water. The highest proportions were accumulated in shoots of the stressed thyme plants (3.45% d.w.)

Effect of irrigation on the production and volatile compounds of sweet basil cultivars (Ocimum basilicum L.)

Introduction: Irrigation plays an important role in the cultivation of medicinal plants. There is a lack of information on intraspecific variability of reactions to the effect of drought. Objective: The aim of the current study was to test the effect of irrigation on four sweet basil (Ocimum basilicum L.) cultivars (‘Genovese’, ‘Kasia’, ‘Keskenylevelű’, ‘Wala’). Methods: In an open field experiment irrigated and non-irrigated treatments were set. Plants were harvested in full flowering stage. Before the harvest, the stomatal conductance and chlorophyll content were measured. The production-related parameters were recorded. In the plant material the glandular hair density, essential oil content and composition (GC-MS) and volatile composition (SPME-GC-MS) were identified. Results: Stomatal conductance of the irrigated plants was 2.5–4.5 times higher than in the non-irrigated ones. The chlorophyll content showed only slight changes. The irrigation had a positive effect on the production. The leaf to stem ratio was not modified by the watering. Irrigation negatively influenced the glandular hair density and the EO content, however it increased the EO yield by 40–129%, depending on the cultivar. Significant compositional changes were registered only in the EO of cultivar ‘Kasia’ for linalool, 1,8-cineole and tau-cadinole ratios

Osteoporotic fractures may impair life as much as the complications of diabetes

RATIONALE, AIMS, AND OBJECTIVES: To compare the effect of osteoporotic fractures and complications of diabetes mellitus on quality of life (QoL). METHOD: A cross-sectional study was performed in 840 patients with osteoporosis and in 943 patients with diabetes in Hungary to estimate the effect of osteoporotic fractures and microvascular and macrovascular complications of diabetes on QoL using the EQ-5D questionnaire. Ordinary least-squares regression was performed for the analysis to control for age and gender. RESULTS: The effects of certain of osteoporotic fractures and diabetes complications were similar in size measured by the EQ-5D. Patients with hip fractures and compressions of the vertebrae suffered more than 0.2 drop in their QoL, which is comparable in size to the most severe complications of diabetes, such as vision loss and amputations. CONCLUSIONS: The use of mortality and premature mortality as the traditional measures of disease burden in public health policy making means that diseases which strongly affect QoL but less survival might not get the necessary priority. This is especially the case in low-income and middle-income countries where studies on QoL are scarce. Our comparative analysis, which showed that osteoporotic fractures reduce QoL as much as major complications of diabetes, highlights the need for comprehensive disease burden assessment, including losses in functionality and QoL, to support decision making