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BackgroundMeasurement of health-related quality of life (HRQoL) is important for a chronic disease, such as dementia, which impairs the quality of life of affected patients in addition to their length of life. This is important in the context of economic evaluations when interventions do not (only) affect HRQoL and these other factors also affect overall quality of life.ObjectiveTo validate the Spanish translation of the ICECAP-O’s capability to measure Health-related quality of life in elderly with dementia who live in nursing homes.MethodCross-sectional study. For 217 residents living in 8 Spanish nursing homes, questionnaires were completed by nursing professionals serving as proxy respondents. We analyzed the internal consistency and other psychometric properties. We investigated the convergent validity of the ICECAP-O with other HRQoL instruments, the EQ-5D extended with a cognitive dimension (EQ-5D+C), the Alzheimer’s Disease Related Quality of Life (ADRQL) measures, and the Barthel Index measure of activities of daily living (ADL).ResultsThe ICECAP-O presents satisfactory internal consistency (alpha 0.820). The factorial analysis indicated a structure of five principal dimensions that explain 66.57% of the total variance. Convergent validity between the ICECAP-O, EQ-5D+C, ADRQL, and Barthel Index scores was moderate to good (with correlations of 0.62, 0.61, and 0.68, respectively), but differed between dimensions of the instruments. Discriminant validity was confirmed by finding differences in ICECAP-O scores between subgroups based on ADL scores (0.70 low, 0.59 medium, and 0.39 high level care), dementia severity (0.72 mild, 0.63 medium, and 0.50 severe), and ages (0.59 below 75 years and 0.84 above 75 years).ConclusionsThis study presented the first use of a Spanish version of the ICECAP-O. The results indicate that the ICECAP-O appears to be a reliable Health-related quality of life measurement instrument showing good convergent and discriminant validity for people with dementia.

Background and AimThe use of venous catheters is a widespread practice, especially in oncological and oncohematological units. The objective of this study was to evaluate the complications associated with peripherally inserted central catheters (PICCs) in a cohort of patients.Materials and MethodsIn this retrospective cohort study, we included all patient carrying PICCs (n = 603) inserted at our institute between October 2010 and December 2013. The main variables collected were medical diagnosis, catheter care, location, duration of catheterization, reasons for catheter removal, complications, and nursing care. Complications were classified as infection, thrombosis, phlebitis, migration, edema, and/or ecchymosis.ResultsAll patients were treated according to the same “nursing care” protocol. The incidence rate of complications was two cases per 1000 days of catheter duration. The most relevant complications were infection and thrombosis, both with an incidence of 0.17 cases per 1000 days of the total catheterization period. The total average duration of catheterization was 170 days [SD 6.06]. Additionally to “end of treatment” (48.42%) and “exitus”, (22.53%) the most frequent cause of removal was migration (displacement towards the exterior) of the catheter (5.80%).ConclusionsPICCs are safe devices that allow the administration of long-term treatment and preserve the integrity of the venous system of the patient. Proper care of the catheter is very important to improve the quality life of patients with oncologic and hematologic conditions. Therefore, correct training of professionals and patients as well as following the latest scientific recommendations are particularly relevant.

Food losses and waste (FLW) tend to be referred to in terms of mass, occasionally in economic terms, disregarding the nutritional-cost nexus of such losses. This work aims to estimate the nutritional food losses and waste (NFLW) of the Spanish agri-food system in terms of energy, macronutrients, fibre, and vitamins and minerals along the entire supply chain. Nutritional food losses (NFL) occurring prior to the distribution level, and nutritional food waste (NFW) at the retail and consumption stages, are distinguished, and 48 representative food commodities and 32 nutrients are characterised. To provide insight into the extent of these values, the results are compared to the equivalent recommended daily intake. Moreover, the NFLW for an average Spanish citizen is compared to that for other representative diets: Mediterranean, lacto-ovo-vegetarian, and vegan, in addition to the Spanish recommended guidelines. Finally, a Nutritional Cost Footprint (NCF) indicator combining nutritional and economic variables is proposed to define recovery strategies. The results suggest that 1016 kcal, 70.7 g proteins, 22 g dietary fibre, 975 mcg vitamin A, 117 mg vitamin C and 332 mg calcium daily per capita are embedded within Spanish FLW. Agricultural production accounts for 40% of NFLW, and fruits and vegetables are the categories with the largest potential for nutritional and economic food wastage mitigation. Results from this paper provide NFLW data and analysis to strengthen and simplify the decision-making process of FLW management strategies.

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Background The International Classification of Diseases (ICD) is the standard diagnostic tool for classifying and coding diseases and injuries. The Abbreviated Injury Scale (AIS) is the most widely used injury severity scoring system. Although manual coding is considered the gold standard, it is sometimes unavailable or impractical. There have been many prior attempts to develop programs for the automated conversion of ICD rubrics into AIS codes. Objective To convert ICD, Ninth Revision, Clinical Modification (ICD-9-CM) codes into AIS 2005 (update 2008) codes via a derived map using a two-step process and, subsequently, to compare Injury Severity Score (ISS) resulting from said conversion with manually coded ISS values. Methods A cross-sectional retrospective study was designed in which medical records at the Hospital Universitario Marqués de Valdecilla of Cantabria (HUMV) and the Complejo Hospitalario of Navarra (CHN), both in Spain, were reviewed. Coding of injuries using AIS 2005 (update 2008) version was done manually by a certified AIS specialist and ISS values were calculated. ICD-9-CM codes were automatically converted into ISS values by another certified AIS specialist in a two-step process. ISS scores obtained from manual coding were compared to those obtained through this conversion process. Results The comparison of obtained through conversion versus manual ISS resulted in 396 concordant pairs (70.2%); the analysis of values according to ISS categories (ISS<9, ISS 9–15, ISS 16–24, ISS>24) showed 493 concordant pairs (87.4%). Regarding the criterion of “major trauma” patient (i.e., ISS> 15), 538 matching pairs (95.2%) were obtained. The conversion process resulted in underestimation of ISS in 112 cases (19.9%) and conversion was not possible in 136 cases (19%) for different reasons. Conclusions The process used in this study has proven to be a useful tool for selecting patients who meet the ISS>15 criterion for “major trauma”. Further research is needed to improve the conversion process.

Background: High-fidelity simulation is being considered as a suitable environment for imparting the skills needed to deal with end-of-life (EOL) situations. The objective was to evaluate an EOL simulation project that introduced communication skills to nursing students who had not yet begun their training in real healthcare environments. Methods: A sequential approach was used. The “questionnaire for the evaluation of the end-of-life project” was employed. Results: A total of 130 students participated. Increasing the time spent in high-fidelity simulation significantly favored the exploration of feelings and fears regarding EOL (t = −2.37, p = 0.019), encouraged dialogue (t = −2.23, p = 0.028) and increased the acquisition of communication skills (t = −2.32, p = 0.022). Conclusions: High-fidelity simulation promotes communication skills related to EOL in novice nursing students.

Purpose The objective of this systematic review was to determine the characteristics of the interventions conducted by nurses that attempt to improve the health related quality of life (HRQoL) of people over 18 years of age with chronic diseases. Methods This systematic review with meta-analysis summarizes 24 studies, conducted in 10 countries, that evaluated HRQoL through the Short-Form Health Survey (SF). Five databases were accessed to find the available studies from December 31 st , 2000 to May 22 sd , 2017. Selected studies were coded according to the characteristics of the sample and the intervention. A model of random effects was adopted for the overall estimation and to explain the heterogeneity. Results Twenty-four studies were included in the systematic review and meta-analysis providing a sample of 4324 chronic patients aged 63.4 years. Among the 8 subscales and two summary measures that comprise the SF-36, only an overall significant effect size (ES) index was found in the Mental Health Component summary score (ES = 0.14; 95% CI:0.03 − 0.26; I 2 = 44.6, p = 0.042) and the Mental Health subscale. This improvement on HRQoL was associated to interventions on “Case Management” and “Treatments and Procedures”, which were based on a theory, were of shorter duration, and had a follow-up period. Conclusions Interventions targeting people with chronic diseases resulted in a slight increase in the HRQoL that was not always significant, which suggests that there is a need for their continuous improvement.