Performance of long-term care systems in Europe. ENEPRI Policy Brief No. 13, December 2012

The evaluation of long-term care (LTC) systems carried out in Work Package 7 of the ANCIEN project shows which performance criteria are important and – based on the available information – how European countries score on those criteria. This paper summarises the results and discusses the policy implications. An overall evaluation was carried out for four representative countries: Germany, the Netherlands, Spain and Poland. Of the four countries, the Dutch system has the highest scores on quality of life of LTC users, quality of care and equity of the LTC system, and it performs the secondbest after Poland in terms of the total burden of care (consisting of the financial burden and the burden of informal caregiving). The German system has somewhat lower scores than the Dutch on all four dimensions. The Polish system excels in having a low total burden of care, but it scores the lowest on quality of care and equity. The Spanish system has few extreme scores. Some important lessons are the following. The performance of a LTC system is a complex concept where many dimensions have to be included. Specifically, the impact of informal caregiving on the caregivers and on society should not be forgotten. The role of the state in funding and organising LTC versus individual responsibilities is one of the most important differences among countries. Choices concerning private funding and the role of informal care have a large effect not only on the public expenditures but also on the fairness of the system. International research into the relative preferences for the different performance criteria could produce a sound basis for the weights used in the overall evaluation.

DISTRIBUTION OF Cr, Pb, Cu, Cd AND Zn IN SEDIMENTS OF THE DOBCZYCE DAM RESERVOIR (SOUTHERN POLAND)

Sediments play a fundamental role in the behaviour of contaminants in aquatic systems. Various processes in sediments, eg adsorption-desorption, oxidation-reduction, ion exchange or biological activities, can cause accumulation or release of metals and anions from the bottom of reservoirs, and have been recently studied in Polish waters [1-3]. Sediment samples from layer A: (1 divided by 6 cm depth in direct contact with bottom water); layer B: (7 divided by 12 cm depth moderate contact); and layer C: (12+ cm depth, in theory an inactive layer) were collected in September 2007 from six sites representing different types of hydrological conditions along the Dobczyce Reservoir (Fig. l). Water depths at the sampling points varied from 3.5 to 21 m. We have focused on studying the distribution and accumulation of several heavy metals (Cr, Pb, Cd, Cu and Zn) in the sediments. The surface, bottom and pore water (extracted from sediments by centrifugation) samples were also collected. Possible relationships between the heavy-metal distribution in sediments and the sediment characteristics (mineralogy, organic matter) as well as the Fe, Mn and Ca content of sediments, have been studied. The 02 concentrations in water samples were also measured. The heavy metals in sediments ranged from 19.0 to 226.3 mg/kg of dry mass (ppm). The results show considerable variations in heavy-metal concentrations between the 6 stations, but not in the individual layers (A, B, C). These variations are related to the mineralogy and chemical composition of the sediments and their pore waters.

Stable isotope evidence for 1500 years of human diet at the city of York, UK

We present here the results of a large-scale diachronic palaeodietary (carbon and nitrogen isotopic measurements of bone collagen) study of humans and animals from a single site, the city of York (U.K.) dating from the Roman period to the early 19th century The human sample comprises 313 burials from the cemeteries of Trentholme Drive and Blossom Street (Roman), Belle Vue House (Anglo-Saxon), Fishergate (High and Later Medieval), and All Saints, Pavement (Later and Post-Medieval). In addition, 145 samples of mammal, fish and bird bone from the sites of Tanner Row and Fishergate were analyzed. The isotope data suggest dietary variation between all archaeological periods, although the most significant change was the introduction of significant quantities of marine foods in the Medieval periods. These are first evident in the diet of a small group of individuals from the High Medieval cemetery at Fishergate, although they were consumed almost universally in the following periods. The human isotope values are also remarkable due to unusually elevated delta N-15 ratios that are not sufficiently explained by the comparably small enrichment in C-13 that accompanies them. We discuss the possible reasons behind this and the archaeological significance of the data set.