Key summary points Aim This scoping review examined the effectiveness of intermediate care including transitional care interventions for middle-aged and older adults on function, healthcare utilisation, and costs. Findings While some studies report positive outcomes on hospital utilisation, the evidence is limited for their effectiveness on emergency department attendances, institutionalisation, function, and cost-effectiveness. Message Intermediate care including transitional care interventions were associated with reduced hospital stay but this finding was not universal. Electronic supplementary material The online version of this article (10.1007/s41999-020-00365-4) contains supplementary material, which is available to authorized users.

Patients with multimorbidity (defined as the co-occurrence of multiple chronic diseases) frequently experience fragmented care, which increases the risk of negative outcomes. A recently proposed Integrated Multimorbidity Care Model aims to overcome many issues related to fragmented care. In the context of Joint Action CHRODIS-PLUS, an implementation methodology was developed for the care model, which is being piloted in five sites. We aim to (1) explain the methodology used to implement the care model and (2) describe how the pilot sites have adapted and applied the proposed methodology. The model is being implemented in Spain (Andalusia and Aragon), Lithuania (Vilnius and Kaunas), and Italy (Rome). Local implementation working groups at each site adapted the model to local needs, goals, and resources using the same methodological steps: (1) Scope analysis; (2) situation analysis—“strengths, weaknesses, opportunities, threats” (SWOT) analysis; (3) development and improvement of implementation methodology; and (4) final development of an action plan. This common implementation strategy shows how care models can be adapted according to local and regional specificities. Analysis of the common key outcome indicators at the post-implementation phase will help to demonstrate the clinical effectiveness, as well as highlight any difficulties in adapting a common Integrated Multimorbidity Care Model in different countries and clinical settings.

Background Although there is growing utilisation of intermediate care to improve the health and well-being of older adults with complex care needs, there is no international agreement on how it is defined, limiting comparability between studies and reducing the ability to scale effective interventions. Aim To identify and define the characteristics of intermediate care models. Methods A scoping review, a modified two-round electronic Delphi study involving 27 multi-professional experts from 13 countries, and a virtual consensus meeting were conducted. Results Sixty-six records were included in the scoping review, which identified four main themes: transitions, components, benefits and interchangeability. These formed the basis of the first round of the Delphi survey. After Round 2, 16 statements were agreed, refined and collapsed further. Consensus was established for 10 statements addressing the definitions, purpose, target populations, approach to care and organisation of intermediate care models. Discussion There was agreement that intermediate care represents time-limited services which ensure continuity and quality of care, promote recovery, restore independence and confidence at the interface between home and acute services, with transitional care representing a subset of intermediate care. Models are best delivered by an interdisciplinary team within an integrated health and social care system where a single contact point optimises service access, communication and coordination. Conclusions This study identified key defining features of intermediate care to improve understanding and to support comparisons between models and studies evaluating them. More research is required to develop operational definitions for use in different healthcare systems.

A new and simple method has been developed for determining high molecular mass polycyclic aromatic hydrocarbons (PAHs) in refined olive pomace, and other vegetable oils from an initial sample of 0.25 g. The hydrocarbon fraction is isolated by solid-phase extraction (SPE) on silica gel using hexane as eluent. The fraction is evaporated to reduced volume and cleaned-up by SPE on an amino phase eluting with toluene. The evaporated residue, dissolved in acetonitrile, is analyzed by reversephase high-performance liquid chromatography with fluorescence detector using programmed excitation and emission wavelengths. The benzo(e)pyrene is determined together with other usual heavy PAHs. Interferences due to squalene and other hydrocarbons are minimized. Recoveries were greater than 80% and detection limits ranged from 0.01 to 0.2 µg kg −1 . The method was validated using certified oil samples and was applied to various vegetable oils.

A new sensitive and selective method has been developed for the quantification of the total coenzyme Q9 (CoQ9) and coenzyme Q10 (CoQ10) concentration in vegetable oil samples. The coenzyme Q fraction is isolated by solid-phase extraction (SPE) on amino phase eluting with a mixture of heptane:ethyl ether. The organic solvent is evaporated under nitrogen, and the residue is dissolved in a mixture of acetonitrile:tetrahydrofuran and finally is analyzed by reverse-phase high-performance liquid chromatography with a mass detector. The sensitivity of the method is based on the high efficient formation of the radical anions [M (-.)] of CoQ9 and CoQ10 by negative atmospheric pressure ionization. Interferences are minimized by using mass detection of the [M (-.)] ions ( m/ z = 797.5 for CoQ9 and m/ z = 862.5 for CoQ10) in selective reaction monitoring mode ( m/ z = 797.5 --> m/ z = 779.5 and m/ z = 862.5 --> m/ z = 847.5) using a triple-quadrupole mass spectrometer. The method was successfully applied to sunflower, soybean, and rapeseed oils, with a limit of quantification of 0.025 mg/kg for both compounds.