Evaluation of an integrated system for classification, assessment and comparison of services for long-term care in Europe: the eDESDE-LTC study

Background: The harmonization of European health systems brings with it a need for tools to allow the standardized collection of information about medical care. A common coding system and standards for the description of services are needed to allow local data to be incorporated into evidence-informed policy, and to permit equity and mobility to be assessed. The aim of this project has been to design such a classification and a related tool for the coding of services for Long Term Care (DESDE-LTC), based on the European Service Mapping Schedule (ESMS). Methods: The development of DESDE-LTC followed an iterative process using nominal groups in 6 European countries. 54 researchers and stakeholders in health and social services contributed to this process. In order to classify services, we use the minimal organization unit or “Basic Stable Input of Care” (BSIC), coded by its principal function or “Main Type of Care” (MTC). The evaluation of the tool included an analysis of feasibility, consistency, ontology, inter-rater reliability, Boolean Factor Analysis, and a preliminary impact analysis (screening, scoping and appraisal). Results: DESDE-LTC includes an alpha-numerical coding system, a glossary and an assessment instrument for mapping and counting LTC. It shows high feasibility, consistency, inter-rater reliability and face, content and construct validity. DESDE-LTC is ontologically consistent. It is regarded by experts as useful and relevant for evidence-informed decision making. Conclusion: DESDE-LTC contributes to establishing a common terminology, taxonomy and coding of LTC services in a European context, and a standard procedure for data collection and international comparison.

Natural additives and agricultural wastes in biopolymer formulations for food packaging

The main directions in food packaging research are targeted toward improvements in food quality and food safety. For this purpose, food packaging providing longer product shelf-life, as well as the monitoring of safety and quality based upon international standards, is desirable. New active packaging strategies represent a key area of development in new multifunctional materials where the use of natural additives and/or agricultural wastes is getting increasing interest. The development of new materials, and particularly innovative biopolymer formulations, can help to address these requirements and also with other packaging functions such as: food protection and preservation, marketing and smart communication to consumers. The use of biocomposites for active food packaging is one of the most studied approaches in the last years on materials in contact with food. Applications of these innovative biocomposites could help to provide new food packaging materials with improved mechanical, barrier, antioxidant, and antimicrobial properties. From the food industry standpoint, concerns such as the safety and risk associated with these new additives, migration properties and possible human ingestion and regulations need to be considered. The latest innovations in the use of these innovative formulations to obtain biocomposites are reported in this review. Legislative issues related to the use of natural additives and agricultural wastes in food packaging systems are also discussed.