Purpose The main purpose of this article is to assess the nutritional and economic efficiency of food loss and waste (FLW) along the supply of 13 food categories included in the Spanish food basket by means of the definition of a new method which combines two indexes. MethodsThe Nutrient Rich Foods index and the economic food loss and waste (EFLW) index were combined by means of linear programming to obtain the Nutritional Cost Footprint (NCF) indicator under a life cycle perspective. The functional unit used was the daily supply of food for a Spanish citizen in year 2015. Results and discussionResults showed that vegetables and cereals were the food categories most affected by the inefficiencies in the food supply chain under a nutritional perspective, being agricultural production and household consumption the main stages in which the nutritional content of food is lost or wasted. Moreover, according to the NCF index, vegetables represented 27% of total nutritional-economic wastage throughout the entire Spanish agri-food chain. They are followed by fruits, which add up to 19%. Hence, specific food waste management strategies should be established for these specific products and supply stages. Finally, the sensitivity analysis performed highlighted that results were mostly independent from the importance attributed to either nutritional or economic variables. ConclusionsThe methodology described in this study proposes an indicator quantifying the nutritional-economic cost of different food categories in the Spanish food basket. This NCF indicator makes it possible to define reduction strategies to promote the use of food waste fractions for waste-to-energy valorization approaches or the extraction of different types of pharmacological, chemical or cosmetic compounds.

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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.

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There is a growing debate surrounding the contradiction between an unremitting increase in the use of resources and the search for environmental sustainability. Therefore, the concept of sustainable degrowth is emerging aiming to introduce in our societies new social values and new policies, capable of satisfying human requirements whilst reducing environmental impacts and consumption of resources. In this framework, circular economy strategies for food production and food loss and waste management systems, following the Sustainable Development Goals agenda, are being developed based on a search for circularity, but without setting limits to the continual increase in environmental impacts and resource use. This work presents a methodology for determining the percentage of degrowth needed in any food supply chain, by analyzing four scenarios in a life cycle assessment approach over time between 2020 and 2040. Results for the Spanish case study suggested a degrowth need of 26.8% in 2015 and 58.9% in 2040 in order to achieve compliance with the Paris Agreement targets, highlighting the reduction of meat and fish and seafood consumption as the most useful path.

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.

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