The FOODRUS index: Assessing suitability for effective food loss and waste prevention management under an integral perspective.

The impact of food loss and waste (FLW) generation on food supply chains' (FSC) sustainability represents a challenge embodied in the Sustainable Development Goal (SDG) 12.3. This problem requires a methodology to measure such an impact in a rigorous, holistic, and standardized way that can be applied to any FSC. This paper aims to develop and validate a single index to assess the readiness of FSCs to implement FLW prevention strategies and measure their impact: the so-called FOODRUS index. The co-creation methodology followed incorporates experts and FSC stakeholders feedback. The index has been validated in 3 FSCs: The Slovak pilot scored 74.35%, the Spanish pilot reached 68.79%, and the Danish pilot was rated 61.14%. Its calculation, eased by the FOODRUS index self-assessment tool (described in the Appendix), allows quick diagnosis of the FSC capability to implement FLW prevention strategies considering both the knowledge provided by experts and the experience of the FSC stakeholders that participated in its co-creation process. In this way the FSC can assess its FLW prevention performance at a strategic and management level, with the aim of improving its sustainability impact.

Thin film multiferroic nanocomposites by ion implantation.

Thin film multiferroic nanocomposites might enable a range of potentially disruptive integrated magnetoelectric devices for information storage, spintronics, microwave telecommunications, and magnetic sensing. With this aim, we have investigated ion implantation of magnetic species into ferroelectric single crystal targets as a radically novel approach to prepare film nanoparticulate magnetic-metal ferroelectric-oxide composites. These materials are an alternative to multiferroic oxide epitaxial columnar nanostructures that are under intensive research, but whose magnetoelectric response is far from expectations. Here, we unambiguously demonstrate the preparation of such a thin film multiferroic nanocomposite of Co and BaTiO3 by ion implantation of a high dose of the magnetic species, followed by rapid thermal processing under tailored conditions. Results thus constitute a proof of concept for the feasibility of obtaining the materials by this alternative approach. Ion implantation is a standard technique for the microelectronic industry in combination with well-established patterning procedures.

Puntos de vista de pacientes, ciudadanos, profesionales y directivos sobre cómo llevar a la práctica una atención sanitaria centrada en el paciente / How to achieve patient-centered healthcare: patients’, citizens’, health professionals’ Asesores. Universidad Miguel Hernández. Elche. Alicante. España

Objetivo: Analizar qué entienden por "humanización" profesionales y directivos sanitarios y líderes de asociaciones ciudadanas y de pacientes. Material y método: Investigación cualitativa. Participaron: 20 representantes de asociaciones de pacientes o ciudadanas, 2 presidentes de colegios profesionales, 18 profesionales de Servicios de Atención e Información al Paciente, 41 directivos de centros sanitarios (hospitales y atención primaria). Los temas abordados fueron: ¿qué es humanizar la atención sanitaria? ¿Cómo hacer para mejorar la calidad de la atención personal a los pacientes (atención más digna y humana)? ¿En qué ha cambiado el perfil de los pacientes? ¿Qué nuevas demandas están planteando los pacientes? ¿Qué derechos y deberes del paciente deben desarrollarse en el futuro? Resultados: Comunicación, empatía, trato personalizado, calidad técnica, comodidad y una buena gestión de los recursos definen el concepto de humanización. Formación, información al paciente, medios y mejoras en infraestructuras constituyen ejes para mejorar la calidad de la atención. Actualmente, el paciente demanda mayor información (que contrasta), nuevas prestaciones y no respeta igual el criterio médico. Se hace necesario insistir en: información, libre elección, trato respetuoso, equidad, segunda opinión, atención urgente, participación en toma de decisiones, deber de respeto hacia los profesionales y colaborar en la sostenibilidad. Conclusiones: Se deben impulsar acciones que favorezcan la autonomía del paciente y una mayor accesibilidad de los recursos sanitarios. El marco para el desarrollo y el cumplimiento de los derechos del paciente y el respeto a sus valores como persona requiere también de su compromiso para hacer un uso responsable de los recursos

Objective: To analyze what health professionals, health managers, and the leaders of patient associations understand by "humanization". Material and method: We performed a qualitative study. Participants consisted of 20 representatives of patient or citizens' associations, two presidents of professional associations, 18 representatives of the patient advice and liaison service, 41 health managers (hospitals and primary care). The following questions were analyzed: What does humanizing health care mean? How can personalized patient care (making healthcare more dignified and human) be improved? How has the patient profile changed? What new demands are patients making? Which rights and responsibilities of the patient should be developed in the future? Results: The concept of humanization was defined as communication, empathy, personalized dealings between patients and staff, technical quality, comfort, and good resource management. The main factors for improving healthcare quality were training, patient information, resources, and improvements in infrastructure. Patients currently demand more information (which they check) and new services, and show less respect for medical criteria. The following factors should be stressed: information, free choice, respect, equity, second opinions, emergency care, and participation in decision making. Patients' duty to respect health professionals and collaborate in the sustainability of the system should also be emphasized. Conclusions: Actions encouraging patient autonomy and greater accessibility to health resources should be encouraged. The development of patients rights and respect for their values, and compliance with these elements, also requires responsible resource use by patients

Mejora de la calidad asistencial en la Comunidad Valenciana / Improvement in healthcare quality in the Autonomous Community of Extremadura

Desde el año 1988, en que la Generalitat Valenciana gestiona las prestaciones de asistencia sanitaria, han existido diferentes estructuras encaminadas a la mejora de la calidad asistencial que culminan con la creación de la actual Dirección General de Calidad y Atención al Paciente. El marco de referencia para la mejora de la calidad asistencial se recoge en el Plan de Calidad Total de la Asistencia Sanitaria, que propugna "la mejora continua como estrategia general, articulada alrededor de las necesidades y preferencias de los pacientes, basada en la participación de los profesionales y el trabajo en equipo, con el aprovechamiento óptimo de la información". En este marco, se insertan la constitución de un organismo acreditador independiente (INACEPS) y el Plan de Humanización de la Asistencia Sanitaria, con el que se pretende mejorar la atención e información al paciente, fomentando su participación activa, e incrementar la accesibilidad y la comodidad de las instalaciones (AU)

Multicenter, prospective, randomized, single-blind study comparing the efficacy and gastrointestinal complications of early jejunal feeding with early gastric feeding in critically ill patients.

OBJECTIVE: To compare the incidence of enteral nutrition-related gastrointestinal complications, the efficacy of diet administration, and the incidence of nosocomial pneumonia in patients fed in the stomach or in the jejunum. DESIGN: Prospective, randomized multicenter study. SETTING: Intensive care units (ICUs) in 11 teaching hospitals. PATIENTS: Critically ill patients who could receive early enteral nutrition more than 5 days. INTERVENTIONS: Enteral nutrition was started in the first 36 hrs after admission. One group was fed with a nasogastric tube (GEN group) and the other in the jejunum through a dual-lumen nasogastrojejunal tube (JEN group). MEASUREMENTS AND MAIN RESULTS: Gastrointestinal complications were previously defined. The efficacy of diet administration was calculated using the volume ratio (expressed as the ratio between administered and prescribed volumes). Nosocomial pneumonia was defined according the Centers for Disease Control and Prevention's definitions. One hundred ten patients were included (GEN: 51, JEN: 50). Both groups were comparable in age, gender, Acute Physiology and Chronic Health Evaluation II, and Multiple Organ Dysfunction Score. There were no differences in feeding duration, ICU length of stay, or mortality (43% vs. 38%). The JEN group had lesser gastrointestinal complications (57% vs. 24%, p <.001), mainly because of a lesser incidence of increased gastric residuals (49% vs. 2%, p <.001). Volume ratio was similar in both groups. A post hoc analysis showed that the JEN group had a higher volume ratio at day 7 than the GEN group (68% vs. 82%, p <.03) in patients from ICUs with previous experience in jejunal feeding. Both groups had a similar incidence of nosocomial pneumonia (40% vs. 32%). CONCLUSIONS: Gastrointestinal complications are less frequent in ICU patients fed in the jejunum. Nevertheless, it seems to be a necessary learning curve to achieve better results with a postpyloric access. Early enteral nutrition using a nasojejunal route seems not to be an efficacious measure to decrease nosocomial pneumonia in critically ill patients.