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Background: The objective of the study was to reveal through pragmatic MCDA (EVIDEM) the contribution of a broad range of criteria to the value of the orphan drug lenvatinib for radioiodine refractory differentiated thyroid cancer (RR-DTC) in country-specific contexts.Methods: The study was designed to enable comprehensive appraisal (12 quantitative, 7 qualitative criteria) in the current disease context (watchful waiting, sorafenib) of France, Italy and Spain. Data on the value of lenvatinib was collected from diverse stakeholders during country-specific panels and included: criteria weights (individual and social values); performance scores (judgments on evidence-collected through MCDA systematic review); qualitative impacts of contextual criteria; and verbal and written insights structured by criteria. The value contribution of each criterion was calculated and uncertainty explored.Results: Comparative effectiveness, Quality of evidence (Spain and Italy) and Disease severity (France) received the greatest weights. Four criteria contributed most to the value of lenvatinib, reflecting its superior Comparative effectiveness (16-22% of value), the severity of RR-DTC (16-22%), significant unmet needs (14-21%) and robust evidence (14-20%). Contributions varied by comparator, country and individuals, highlighting the importance of context and consultation. Results were reproducible at the group level. Impacts of contextual criteria varied across countries reflecting different health systems and cultural backgrounds. The MCDA process promoted sharing stakeholders' knowledge on lenvatinib and insights on context.Conclusions: The value of lenvatinib was consistently positive across diverse therapeutic contexts. MCDA identified the aspects contributing most to value, revealed rich contextual insights, and helped participants express and explicitly tackle ethical trade-offs inherent to balanced appraisal and decisionmaking. [ABSTRACT FROM AUTHOR]

The current situation of economic crisis in which one finds immersed Spain, with a rate of unemployment that concerns 26,02 per cent of the active population, takes as one of the principal effects an exponential increase of the mortgage executions consequence of the non-payment of the mortgage quotas --many of them contracted during the real-estate bubble-- with the consequent loss of the habitual housing. In this context, both the current government and the previous one they have adopted diverse normative initiatives orientated to relieving the situation of special vulnerability in which certain mortgagers are, modifying for it partially the procedure of mortgage execution, increasing the quantity of the salary inembargable when the execution must continue as ordinary execution on other goods of the debtor different from the mortgaged auctioned building, promoting the renegotation of the debt, the dation in payment in certain suppositions, the moderation of the interests of delay, the adhesion of the Banking to the Code of Good Practices, the suspension of the launch of the housing for two years; and the creation of a social Fund of housing, between other measures. Opposite to such an action consumers' associations or associations are not absent in defense of the mortgagers, or certain parliamentary groups that request a total reform of the Mortgage Law, and of the Law of Civil Prosecution, and claim as necessary measure the dation in payment with retroactive effect and the suspension of the mortgage executions. The present study is going to centre on the analysis of the position of the mortgager since the credit or mortgage lending signs up to the moment of mortgage execution and loss of the housing consequence of the not paid of the mortgage quota. For it we will study the existing regulation to determine if it proceeds or not a partial reform of the same one or, more wide or ambitious, likewise, we will emphasize the doctrine and resolutions polemic provoked from the judgment of the Provincial Hearing of Navarre, section 2.ª, of December 17, 2010 and later resolutions with the same orientation or with argumentation in the opposite direction. In any case, any of the measures that we consider, they will to be adopted, it is done thinking not only about the current mortgagers, but also about the futures, like, likewise, bearing in mind the current moment of restructuring of the bank Spanish system, as the existence of third parties fruit of the mortgage qualifications. [ABSTRACT FROM AUTHOR]

This article presents the results of three independent studies on the development and psychometric properties of the method of evaluating the performance of employees of Public Administration of the Principality of Asturias. Study 1 describes the development and selection of competencies to be assessed. For each of the three major dimensions of job performance, five competencies were identified that should be evaluated. Study 2 describes how we developed behaviorally-anchored rating scales for measuring competencies of task performance, contextual performance, and organizational performance. Study 3 examined reliability, construct validity and concurrent validity of performance appraisals. The results showed high reliability coefficients for both the dimensions and the overall performance assessment. An exploratory principal component analysis indicated the presence of two factors in which loaded (a) the evaluations of the immediate superiors and (b) external objective criteria, respectively. A confirmatory factor analysis showed that performance can be represented by a hierarchical model. Finally, external criteria and the ratings of managers showed to be correlated. The implications of the findings are commented on in the discussion. [ABSTRACT FROM AUTHOR]