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BACKGROUND AND AIMS: The increase in the proportion of elderly people and a consequent increase in the demand for care have caused healthcare systems to become overloaded. This paper describes the use of Home Care Quality Indicators (HCQIs), derived from the Minimum Data Set for Home Care, for monitoring quality of care. Research questions were, 'Do HCQI scores vary between home care organizations in different countries?' and 'Are one or more country-specific sites consistently scoring better on most or all HCQIs'? METHODS: a cross-sectional observational study of 65+ randomly selected clients of home care organizations in urban areas in 11 European countries who had been receiving home care for at least two weeks. Data were collected with the MDS-HC. The scoring of 16 prevalent quality indicators for home care, adjusted for population differences, was calculated with baseline data. RESULTS: Population size at baseline was 4,007 clients. Among home care clients in Europe, 'rehabilitation potential in Activities of Daily Living and no therapies' (average 75.9%) and 'inadequate pain control' were the most common quality problems. The prevalence between populations studied in various countries varied substantially. No country-specific site consistently scored worst or best. CONCLUSIONS: HCQIs derived from the MDS-HC detect variance in quality scores between home care in the 11 partner countries. The highest prevalence of unwanted outcomes were most often found in the Czech Republic, Italy and Germany. Although further research is necessary, we believe that HCQIs may be of great value for quality improvement in home care. [ABSTRACT FROM AUTHOR]

Background: Gastroesophageal reflux disease (GERD) occurs when stomach acid frequently backs up (or refluxes) into the gullet (or esophagus), and it has serious consequences for the quality of life. Usually this is felt as heartburn. Because severely mentally retarded people usually do not utter complaints of heartburn, it requires a high index of suspicion to discover possible GERD. Therefore it is relevant for care professionals such as nurses to have knowledge of those with a higher risk of GERD and of the possible manifestations of GERD.Methods: Using a predefined search method, electronic databases were searched for studies relating the presence of symptoms to the presence of GERD. Relevant data were extracted and the methodological quality of the studies assessed. The results of the included studies were synthesized and conclusions about the level of evidence were drawn.Results: Nineteen studies were found relating symptoms to the presence of GERD. Only four were of good methodological quality. The studies were very diverse concerning the studied population, the study method, and the kind of symptoms examined. This makes it difficult to synthesize the results of the studies. There is evidence that patients with cerebral palsy, patients using anticonvulsive drugs, and those with an IQ lower than 35 more frequently have GERD. There is also evidence that vomiting, rumination and hematemesis are associated with a higher risk of the presence of GERD, whereas there is no clear scientific evidence that particular behavior symptoms are indicative for GERD.Conclusion: The possible manifestations of GERD are many and varied. A guideline will be made for care professionals to aid systematic observation of possible manifestations of GERD. [ABSTRACT FROM AUTHOR]

Coral reefs are both exceptionally biodiverse and threatened by climate change and other human activities. Here, we review population genomic processes in coral reef taxa and their importance for understanding responses to global change. Many taxa on coral reefs are characterized by weak genetic drift, extensive gene flow, and strong selection from complex biotic and abiotic environments, which together present a fascinating test of microevolutionary theory. Selection, gene flow, and hybridization have played and will continue to play an important role in the adaptation or extinction of coral reef taxa in the face of rapid environmental change, but research remains exceptionally limited compared to the urgent needs. Critical areas for future investigation include understanding evolutionary potential and the mechanisms of local adaptation, developing historical baselines, and building greater research capacity in the countries where most reef diversity is concentrated.

Background: As academic workload seems to be increasing, many studies examined factors that contribute to the mental workload of academics. Age-related differences in work motives and intellectual ability may lead to differences in experienced workload and in the way employees experience work features. This study aims to obtain a better understanding of age differences in sources of mental workload. 33 academics from one faculty discussed causes of workload during focus group interviews, stratified by age., Findings: Among our participants, the influence of ageing seems most evident in employees' actions and reactions, while the causes of workload mentioned seemed largely similar. These individual reactions to workload may also be driven by differences in tenure. Most positively assessed work characteristics were: interaction with colleagues and students and autonomy. Aspects most often indicated as increasing the workload, were organisational aspects as obstacles for 'getting the best out of people' and the feeling that overtime seems unavoidable. Many employees indicated to feel stretched between the 'greediness' of the organisation and their own high working standards, and many fear to be assigned even less time for research if they do not meet the rigorous output criteria. Moreover, despite great efforts on their part, promotion opportunities seem limited. A more pronounced role for the supervisor seems appreciated by employees of all ages, although the specific interpretation varied between individuals and career stages., Conclusions: To preserve good working conditions and quality of work, it seems important to scrutinize the output requirements and tenure-based needs for employee supervision.

Job dissatisfaction and need for recovery are associated with voluntary turnover, absenteeism and diminished health. In the light of encouraging working longer, this study investigated whether the relationships between various work characteristics and job dissatisfaction and need for recovery are dependent on age. Cross-sectional questionnaire data from 591 university employees were divided into four age groups: < 36, 36-44, 45-54 and ≥ 55 years. Multivariate regression analyses were used, including interaction variables to detect a moderating effect of age group. Limited age group effects were found: only the association of Feedback with job dissatisfaction and Task variety with need for recovery were influenced by age group. The salience of specific work characteristics within the age groups varied: for job dissatisfaction, Task variety ( < 55) and Changes in tasks ( ≥ 55) were most important. For need for recovery, this applied to Autonomy ( < 36) and Workload ( ≥ 45). To encourage working longer, age-specific measures could be considered, in addition to individual measures, to respond to individual needs., Practitioner Summary: Demographic changes increase the importance to stimulate working longer. Using questionnaire data, we investigated the relationship between work characteristics, job dissatisfaction and need for recovery in four age groups. Although the moderating effect of age group was rather limited, the salience of specific work characteristics within the age groups varied.

Objectives: To investigate differences in associations between sick leave and aspects of health, psychosocial workload, family life and work-family interference between four age groups (<36, 36-45, 46-55 and 55+ years)., Design: A cross-sectional study; a questionnaire was sent to the home addresses of all employees of a university., Setting: A Dutch university., Participants: 1843 employees returned the questionnaire (net response: 49.1%). The age distribution was as follows: <36: 32%; 36-45: 26%; 46-55: 27% and 55+: 12%., Primary Outcomes: Frequent sick leave (FSL, ≥3 times in the past 12 months) and prolonged sick leave (PSL, >2 weeks in total in the past 12 months). Differences between the age groups in independent variables and outcomes were investigated. Logistic regression analysis was used to calculate associations between various variables and the sick leave outcomes. Interaction terms were included to detect differences between the age groups., Results: Age differences were found for many work- and family-related characteristics but not in the mean scores for health-related aspects. Presence of chronic disease was reported more frequently with increasing age. The 55+ age group had almost two times less chance of FSL, but 1.6 times more chance of PSL than the <36 age group. Age moderates the associations between career opportunities, partner's contribution in domestic tasks and sex, and FSL. Job security and pay, support from supervisor, challenging work and being breadwinner have different associations with PSL. However, life events in private lives and perceived health complaints are important in all age groups. FSL and PSL have some determinants in common, but there are differences between the outcomes as well., Conclusions: Age should be treated as a variable of interest instead of a control variable. Employers and occupational physicians need to be aware that each phase in life has specific difficulties that can lead to FSL and PSL.

Purpose: To investigate (a) differences in work characteristics and (b) determinants of job satisfaction among employees in different age groups., Methods: A cross-sectional questionnaire was filled in by 1,112 university employees, classified into four age groups. (a) Work characteristics were analysed with ANOVA while adjusting for sex and job classification. (b) Job satisfaction was regressed against job demands and job resources adapted from the Job Demands-Resources model., Results: Statistically significant differences concerning work characteristics between age groups are present, but rather small. Regression analyses revealed that negative association of the job demands workload and conflicts at work with job satisfaction faded by adding job resources. Job resources were most correlated with more job satisfaction, especially more skill discretion and more relations with colleagues., Conclusions: Skill discretion and relations with colleagues are major determinants of job satisfaction. However, attention should also be given to conflicts at work, support from supervisor and opportunities for further education, because the mean scores of these work characteristics were disappointing in almost all age groups. The latter two characteristics were found to be associated significantly to job satisfaction in older workers.

Objectives: To describe and calculate Home Care Quality Indicators from data of the European Aged in Home Care (ADHOC) project. With due regard for risk factors, home care agencies at country level have been compared with each other on quality of care., Methods: The indicators of Home Care quality of care (HCQIs) are calculated based on methods that have been developed in the US and Canada. The values of these QIs are risk adjusted on the basis of odds ratios of covariates resulting from logistic regression analysis on the ADHOC sample. To enhance the comparison of QIs between countries we have used the method of percentile thresholds and QI aggregate sum measure related to those., Results: Risk adjusted values of 22 Home Care Quality Indicators differed considerably between home care agencies in the eleven European countries that participated in ADHOC. The QI aggregate showed which countries probably had the best home care and which had the worst., Conclusions: There are quality indicators available, derived from data of the Resident Assessment Instrument for Home Care, with which quality of care between home care agencies in and across nations can be adequately compared. Examples of this type of indicator are: social isolation, inadequate pain control, failure to improve in impaired locomotion in the home.