ADRs to any drugs more than the use of PIMs might be associated with functional decline in elderly hospitalized patients, but because the power of this study was too limited to definitively exclude a direct relationship between PIMs and functional decline, this merits further investigation.

No abstract

Objective: We aimed to investigate the association of the clinical variables of the metabolic syndrome (MS) and psychological parameters on health-related quality of life (HRQL) in obesity. In particular, our aim was to investigate the relative impact of physical symptoms, somatic diseases and psychological distress on both the physical and the mental domains of HRQL. Design: Cross-sectional study. Subjects: A cohort of 1822 obese outpatients seeking treatment in medical centers. Measurements: HRQL was measured by the standardized summary scores for physical (PCS) and mental (MCS) components of the Short Form 36 Health Survey (SF-36). Patients were grouped according to tertiles of PCS and MCS. Metabolic and psychological profiles of PCS and MCS tertiles were compared by discriminant analysis. Results: The profile of metabolic and psychological variables was tertile-specific in 62.4 and 68.3% of patients in the lowest and highest tertiles of PCS, respectively, while concordance was low in the mid-tertile (32.8%). Concordance was very high in the lowest (74.4%) and in the highest (75.5%) tertiles of MCS, and was fair in the mid-tertile (53.2%). The main correlates of PCS were obesity-specific and general psychological well-being, BMI, body uneasiness, binge eating, gender and psychiatric distress. Only hypertension and hyperglycemia qualified as correlates among the components of MS. The components of MS did not define MCS. Conclusions: Psychological well-being is the most important correlate of HRQL in obesity, both in the physical and in the mental domains, whereas the features of MS correlate only to some extent with the physical domain of HRQL.

consecutively enrolled in the QUOVADIS study, an observational multicenter study of obese treatment-seeking outpatients. The construct validity of the SF-36 was assessed by main component analysis. Age-, gender-, and educationadjusted general linear models were used to investigate the relationship between BMI and SF-36 domains or factors identified by main component analysis. Results: BMI was significantly associated with poor healthrelated quality of life in all eight SF-36 domains, and the strongest association was observed with physical activity. Main components analysis generated a six-factor solution explaining 59% of the observed variance. BMI was strongly associated with factors based on the loading of items regarding the physical activity domain and factors based on role-physical and role-emotional items or general health and bodily pain items. In contrast, mental health-, vitality-, and social functioning-based factors were not related to BMI. Discussion: In obese treatment-seeking outpatients, the clustering of SF-36 items in main components is not significantly different from the domain-based approach generally used, thus confirming the robustness of such a generic questionnaire in this specific condition. However, the peculiar clustering of some SF-36 items and their relationship with BMI suggest that the health-related quality of life profile of subjects belonging to that population may be better described with alternative aggregations of the SF-36 items or with disease-tailored questionnaires.

No abstract

Objective: To assess whether the number of daily administrations of individual drugs, as a measure of regimen complexity, contributes to the profi le of an elderly patient who adheres poorly to the prescribed therapy. Population: Six hundred ninety patients over 64 years who were consecutively admitted to 11 acute medical care and three long term/rehabilitation wards in Italy. Main outcome measure: Self-reported adherence to drugs taken at home before admission was measured by a single question assessment for each listed drug supplemented with a latter question about the circumstances of the missed administration. For cognitively impaired patients the question was put to patients' relatives or caregivers. Methods: A structured multidimensional assessment was performed to identify nonadherence and its potential correlates. Correlates of nonadherence were identifi ed by multivariable logistic regression. Results: We recorded 44 cases (6.4%) of nonadherence to at least one drug. Being assisted by foreign caregivers (OR 2.17; 95% CI 1.02-4.63) and the use of at least one multiple daily dosing drug (OR 2.99; 95% CI 1.24-7.17) were signifi cant independent correlates of medication nonadherence, while age, selected indexes of frailty and the cumulative number of prescribed drugs were not. Conclusion: Regimen complexity and type of assistance are independent correlates of medication nonadherence.

Food waste is one of the most important issues taken into account by the European Union due to its negative environmental, economic and social impacts. The treatment of food waste through recycling processes represents a solution for food waste minimisation. Concerning, in particular, the retail sector, it is necessary to define strategies for retail-oriented sustainable food waste management. The aim of this study is to compare the potential environmental impacts related to five scenarios (landfill, incineration, composting, anaerobic digestion and bioconversion through insects) for the disposal/treatment of food waste produced by a mass retail company operating in Messina (Italy) through the application of the Life Cycle Assessment method, in order to find the best treatment solution. Results based on the treatment of a functional unit of 1 tonne of food waste show that the bioconversion scenario represents the most preferable solution considering all of the impact categories analysed through the CML 2 baseline 2000 method, except for Global Warming, for which higher environmental performances are connected to the anaerobic digestion scenario. The incineration and the bioconversion scenarios show the highest environmental benefits when the production of alternative energy sources and valuable materials is evaluated through the inclusion of the avoided productions in the analysis.

Abstract\ud Purpose Social life cycle assessment (S-LCA) method lacks\ud of standard and code of practice. The aim of the study is to\ud classify the wide variety of contributions on S-LCA for tracking\ud the development of different themes and for defining and\ud classifying the main approaches in a systematic and reproducible\ud way.\ud Methods The research addressed to study a collection of 51\ud articles published between January 2006 and November 2014\ud using statistical criteria. We used automatic text analysis\ud (ATA) tools related to lexicon analysis to identify keywords\ud useful in tracing the main topics covered in articles published\ud in different periods. We conducted principal component analysis\ud (PCA) to classify the different approaches in the literature\ud and to outline the orientations of the various research groups.\ud Results and discussion The results from lexicon analysis\ud showed a rapid succession of different topics covered in\ud the analyzed period. This alternation is strongly affected by\ud the introduction of UNEP/Society of Environmental\ud Toxicology and Chemistry (SETAC) S-LCA guidelines\ud and methodological sheets. PCA analysis enabled to synthesize\ud the information related to the numerous\ud approaches. Results did not show a clear division into\ud groups which indicates the absence of a dominant position\ud on the subject in the literature.\ud Conclusions This study attempted to map the state of art in SLCA\ud integrating literature review with multivariate statistical\ud techniques. The analysis showed a highly fragmented field.\ud These results confirm the existence of a variety of approaches\ud that in part have already been identified by literature reviews\ud on S-LCA. Alignment with the results in the literature confirms\ud ATA to be a suitable instrument for the realization of\ud reviews. Moreover, being systematic and reproducible allows\ud ATA to be applied repeatedly, expanding the number of articles\ud and topics analyzed