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Older people living in nursing homes have complex care needs and frequently need specialists’ advice and support that can be challenging to deliver in a rural setting. The aim of this paper is to describe a model of integrated care in a rural area supported by a nurse case manager.

A real-world evidence study of people living in Ribes de Freser nursing home, was conducted between specific timeframes in 2019 and 2022, comparing the casemix and outcomes of a traditional care model with the integrated interdisciplinary model.

The integrated care model led to a significant reduction in transfers to the emergency department, hospitalisations, outpatient medical visits and a reduction in the number of medicines. In addition, the number of residents receiving end-of-life care at the nursing home showed a substantial increase.

This case study contributes valuable evidence supporting the implementation of an integrated model of nurse case manager support in nursing homes, particularly in the rural contexts, where access to specialist medical staff may be limited. The findings highlight the potential benefits of person-centred integrated care for older adults, addressing their complex needs and improving end-of-life care in nursing home settings.

The purpose of this study is to evaluate whether the perceptions of cleanliness and organization of the point of sale, hygiene and training of those who serve the public (service) and healthiness of the products, constitute a base for the perception of the quality of food sold in the street. Studies about development of street food trade have gained relevance in academic debate because of its social and economic significance. Usually, aspects related to sanitary issues are presented, and the factors that influence consumer perception regarding quality of food consumed are less explored. This was the focus of this work. The relationships among possible predecessors – attendance, cleanliness, organization and healthiness – were tested, all acting together, influencing the variable perception of product quality. Competitive models were tested because of theoretical divergences regarding the relationship between quality and healthiness, not yet totally clear in the literature.

A quantitative survey was carried out in the city of Diadema (SP, Brazil), getting 603 respondents, with data and theoretical models analyzed by structural equation modeling.

Results indicated that organization variable is not significant regarding perception of product quality, while attendance and healthiness directly affect this perception. On the other hand, cleanliness influences perceived healthiness and this, in turn, reinforces perception of product quality.

The focus of street food traders should be on clerk cleanliness and politeness (characteristics related to the service) that end up influencing the perception that the consumer develops regarding healthiness (characteristic related to product quality).

Usually research studies on this theme include only aspects related to sanitary and safety issues, and those which focus on consumer perception of food quality cover conventional outlets such as bars and restaurants. There are few ones performed as in this study that analyze street food consumer behavior regarding his/her perception of quality, cleanliness, care received, among others.

This study aims to propose and evaluate the progress in the basic-pixel (a strategy to generate continuous trajectories that fill out the entire surface) algorithm towards performance gain. The objective is also to investigate the operational efficiency and effectiveness of an enhanced version compared with conventional strategies.

For the first objective, the proposed methodology is to apply the improvements proposed in the basic-pixel strategy, test it on three demonstrative parts and statistically evaluate the performance using the distance trajectory criterion. For the second objective, the enhanced-pixel strategy is compared with conventional strategies in terms of trajectory distance, build time and the number of arcs starts and stops (operational efficiency) and targeting the nominal geometry of a part (operational effectiveness).

The results showed that the improvements proposed to the basic-pixel strategy could generate continuous trajectories with shorter distances and comparable building times (operational efficiency). Regarding operational effectiveness, the parts built by the enhanced-pixel strategy presented lower dimensional deviation than the other strategies studied. Therefore, the enhanced-pixel strategy appears to be a good candidate for building more complex printable parts and delivering operational efficiency and effectiveness.

This paper presents an evolution of the basic-pixel strategy (a space-filling strategy) with the introduction of new elements in the algorithm and proves the improvement of the strategy’s performance with this. An interesting comparison is also presented in terms of operational efficiency and effectiveness between the enhanced-pixel strategy and conventional strategies.