Home Unit Research Articles

Robotic Expert System for Energy Management in Distributed Grid Ecosystem

A robotic expert system (RES) for energy management (EM) in community-based micro-grids is developed using a fuzzy computational scheme. Within the micro-grid multi-dimensional space, embedded algorithms for residential homes, sectors and central controller units are introduced to perform EM in a collaborative manner. Demand response and load shedding are carried out within the community micro-grid to ascertain the behavioral responses based on changes in power demand levels. Various tests are carried out with an observable low error margin. It was observed that the system reduced the total power demand on the micro-grid by 20% of the total distributed power. Micro-grid RES, neuro-fuzzy control (NFC), and support vector regression (SVR) evaluations are compared considering the home units at 40kW of the generated capacity. The results gave a 35.79%, 31.58% and 32.63% energy demand, respectively. Consequently, RES provides a grid look-ahead prediction, annotated-self healing, and stability restoration.

Fall related injuries in elderly patients in a tertiary care centre in Beirut, Lebanon.

Context:Falls cause significant morbidity and mortality, constituting 38.9% of trauma visits to the emergency department (ED) in Lebanon. Elderly have increased risk of falls due to co-morbidities. Injury-related deaths are most common in developing countries, and few studies have examined falls internationally.Aims:Describe characteristics, injury patterns, and outcomes of elderly treated for fall injuries at a tertiary care center in Lebanon.Settings and Design:Retrospective observational chart review of elderly presenting after a fall to the ED.Subjects and Methods:Retrospective observational study of elderly (≥65 years) patients who presented to the ED at a tertiary care center in Lebanon with the chief complaint of “fall” over a 6-year period.Statistical Analysis Used:Descriptive analysis.Results:Two hundred and thirty-five patients were included; mean age was 78.1 (±7.2) years with female predominance (60.5%). Falls occurred at home (99.2%) and from ground level (96.4%). Patients presented by private transport (85.8%). The initial impact was to the head in 31.2% of patients with 47.8% on antiplatelet/anticoagulation therapy. Imaging includes extremity X-ray (46.6%) and head/cervical spine computed tomography (39.5%). Dispositions included home (58.9%), regular floor (23.3%), operating room (7.9%), and intensive care unit (5.9%). Pelvic/hip repair was the most common surgical procedure. Most injuries were nonlife-threatening. Overall mortality was 2%.Conclusions:Falls have a high impact on the elderly population in Lebanon, with most occurring at home, resulting in pelvic/hip injuries and a mortality of 2%. There is a need to implement multifaceted fall prevention programs to mitigate such injuries and improve patient safety and outcomes.

Adaptation, modification, and psychometric assessment of a Norwegian version of the Basel extent of rationing of nursing care for nursing homes instrument (BERNCA-NH)

BackgroundTo our knowledge, no instrument has been developed and tested for measuring unfinished care in Norwegian nursing home settings. The Basel Extent of Rationing of Nursing Care for Nursing Homes instrument (BERNCA-NH) was developed and validated in Switzerland to measure the extent of implicit rationing of nursing care in nursing homes. The BERNCA-NH comprises a list of nursing care activities in which a care worker reports the frequency to which activities were left unfinished over the last 7 working days as a result of lack of time. The aim of this study was to adapt and modify a Norwegian version of the BERNCA-NH intended for all care workers, and assess the instruments’ psychometric properties in a Norwegian nursing home setting.MethodsThe BERNCA-NH was translated into Norwegian and modified to fit the Norwegian setting with inputs from individual cognitive interviews with informants from the target population. The instrument was then tested in a web-based survey with a final sample of 931 care workers in 162 nursing home units in different parts of Norway. The psychometric evaluation included score distribution, response completeness and confirmatory factor analysis (CFA) of a hypothesised factor structure and evaluation of internal consistency. Hypothesised relation to other variables was assessed through correlations between the subscale scores and three global ratings.ResultsThe Norwegian version of BERNCA-NH comprised four subscales labelled: routine care, ‘when required’ care, documentation and psychosocial care. All subscales demonstrated good internal consistency. The CFA supported the four-factor structure with fit statistics indicating a robust model. There were moderate to strong bivariate associations between the BERNCA-NH subscales and the three global ratings. Three items which were not relevant for all care workers were not included in the subscales and treated as single items.ConclusionsThis study found good psychometric properties of the Norwegian version BERNCA-NH, assessed in a sample of care workers in Norwegian nursing homes. The results indicate that the instrument can be used to measure unfinished care in similar settings.

Identifying the long-term care beneficiaries: differences between risk factors of nursing homes and community-based services admissions.

The Portuguese long-term care sector is classified into home and community-based services (HCBS) and three nursing home (NH) units: convalescence, medium term and rehabilitation, and long term and maintenance. To identify the main factors of admission into each care setting and explore to what extent these populations are different. 14,140 patients from NH and 6844 from HCBS were included from all over the country. A logistic regression was estimated to identify determinants of admission into NH care, using sociodemographic characteristics, medical conditions and dependence levels at admission as independent variables, and region of care, referral entity and placement process as control variables. Then, ordered logistic regression was used to identify the contribution of the above factors in each specific NH unit. Being female, not being married, not having family/neighbour support, being literate, having mental illness, being cognitively or physically impaired are the main predictors of being admitted into a NH. Within the NH units, placements of the large majority of patients were accurately predicted, based on the available variables. However, for around half of the patients referred to long-term care units, the model expected placements into medium-term units, while for those admitted into short-stay units, the model returned that 29% could have benefited from being admitted into a medium-term care unit. Patients' accurate placement is a highly complex and challenging process, demanding more variables than the ones available for the model here presented. Our work confirms the need to collect other type of variables to improve the placement decision process.

How do numbers of births in England and Wales vary by time of day, day of the week and place of birth? An analysis using linked administrative data

BackgroundClinical policies have aimed at increase the proportion of births occurring during working hours on weekdays in the belief that this facilitates staffing and is safer for mothers and babies. Our recent analyses of hospital births have shown that that planned caesareans are concentrated into weekday mornings. In contrast, spontaneous births after spontaneous onset of labour are more likely in the hours after midnight, peaking from 4-6am. Births after induced labours are more likely in the hours around midnight.
 Main AimTo compare the timing of births of births at home and elsewhere with timing in NHS hospitals.
 MethodData from civil registration of births from 2005 to 2014 in England and Wales were linked to data recorded when newborn babies are notified to the NHS. Data about babies born in NHS maternity units were further linked to hospital data for England and for Wales. Data were analysed in the secure facilities of the Office for National Statistics’ Secure Research Service. Analysis was by place of birth recorded at birth registration.
 ResultsNumbers of singleton births in freestanding midwifery units and at home were highest from midnight to 7am, peaking from 4am-6am. Births on non-hospital sites followed a similar pattern with a flatter peak from 4am-8am, but peaks in non-maternity hospitals tended to occur during mornings. Births in military hospitals had a sharp peak at 8am and births in private hospitals had a peak in the morning and then again in early and late afternoon.
 ConclusionConclusion The small numbers of births in hospitals without maternity units or ‘elsewhere’ are unlikely to have occurred there intentionally, but the latter, along with home and midwifery unit births were more common at night. This has implications for staffing. A newly funded project will explore relative safety.

ORGANIZATIONAL CHARACTERISTICS OF HIGHLY PERSON-CENTERED UNITS IN SWEDISH NURSING HOME

The movement from an institutional model of care towards a person-centred care as the gold standard of practice is now guiding the provision of care services in nursing homes around the world. The organizational context of care has been described as a determining factor for the extent to which staff can offer person-centred care. However, few studies have empirically investigated which factors that defines nursing home units as being person-centred. Providing information about organizational characteristics would therefor provide insight into an organizational context with capacity to enhance a person-centred care. Thus, the aim was to explore factors of nursing homes with high vs. low person-centred care with focus on organizational variables. The study was based on a cross-sectional national survey, and data on 4831 residents, 3605 staff, and facility variables were collected in 2014. Descriptive statistics and regression modelling were used to analyze the data. The preliminary results showed that characteristics of highly person-centred units were; dementia specific units and units with fewer number of beds. No significant differences were seen between private and public nursing homes in terms of degree of person-centred care. Person-centred units was characterized by managers supporting staff to provide individualized care based on the resident’s needs, as well as staff receiving supervision of a reg. nurse in the direct care. These findings can be seen as facilitators ’ for person-centred care, suggesting several contextual and organizational elements of significance for enhancing person-centred practice.

Burnout in UK care home staff and its effect on staff turnover: MARQUE English national care home longitudinal survey.

Backgroundstaff burnout and turnover lead to care home residents receiving poorer quality care. Burnout is thought to cause turnover, but this has never been investigated. We know little about which care home staffs are burnt out.Aimsto explore burnout’s relationship with staff turnover and prevalence and predictors of burnout.Methodwe calculated the relationship between Maslach Burnout Inventory scores and future staff turnover (12-month number of staff leaving/number employed). We explored staff, resident and care home predictors of burnout, measured as emotional exhaustion (EE), depersonalisation (DP) and personal accomplishment (PA).Resultstwo-thousand sixty-two care staff in 97 care home units participated. Median yearly staff turnover was 22.7%, interquartile range (IQR) 14.0–37.7%. Care staff recorded low median burnout (median EE: 14, IQR: 7–22; DP: 1, IQR: 0–5; PA 42, IQR: 36–45). We found no association between staff burnout and turnover rate. Younger staff age was associated with higher burnout (EE coefficient − 0.09; 95% confidence interval (CI): −0.13, −0.05; DP −0.02; 95% CI: −0.04, −0.01; PA 0.05; 95% CI: 0.02, 0.08). Speaking English as a second language predicted higher EE (1.59; 95% CI: 0.32, 2.85), males had higher DP (0.02; 95% CI: 0.01, 0.04) and staff working only night shifts lower PA (−2.08; 95% CI: −4.05, −1.30).Conclusionswe found no association between care homes staff burnout level and staff turnover rates. It is a myth that burnout levels are high. Interventions for burnout could focus on at-risk groups. Future studies could consider turnover at an individual level.

Challenging the ethnic pyramid: Golden rules and organisational measures towards a more inclusive work environment.

To contribute to knowledge of how healthcare managers can promote connection and ethnic equality among staff in multicultural organisations. The increase in migrant care workers often leads to deskilling, discrimination, communication difficulties and harsh working conditions. A constructivist grounded theory approach was used to examine the work experiences of healthcare workers in a strategically selected nursing home unit with minority and majority workers well balanced across positions. Three golden rules were identified: (a) take responsibility for the quality of care in the unit, (b) should engage in all aspects of the care work within scope of practice and (c) collaborate and help each other. Organisational measures supporting these norms were also identified. It is possible, by means of golden rules and organisational measures, to foster connection and cooperation among nursing home staff and to promote an inclusive work environment where the workers' skills and competences are recognized across educational and migration backgrounds. Healthcare managers can contribute to challenge the ethnic pyramid often identified in multicultural institutions by implementing diversity-sensitive measures. This may increase the quality of care and the well-being of residents.

Eficacia y seguridad de la infusión subcutánea de furosemida en domicilio para el manejo de la insuficiencia cardiaca

La Insuficiencia cardiaca es una patología muy prevalente, siendo una de las principales causas de morbi-mortalidad en países desarrollados. Su tratamiento se basa, entre otros fármacos, en la administración de diuréticos para mejorar la sintomatología del paciente. Sin embargo, en muchas ocasiones, la falta de mejoría con el tratamiento oral supone la necesidad de ingreso hospitalario para la administración por vía intravenosa.Presentamos dos casos de pacientes ingresados a cargo de la Unidad de Hospitalización a Domicilio que presentaban insuficiencia cardiaca refractaria a pesar de tratamiento con diuréticos por vía oral. Se inició infusión de furosemida subcutánea en ambos. En el primer caso, presentó mejoría de la sintomatología con resolución del cuadro. En el segundo, al tratarse de un paciente en situación terminal, se produce una mejoría de la clínica pero, debido a su situación, se decidió no completar el tratamiento.

End-of-Life Care Received by Physicians Compared With Nonphysicians

The idea that physicians as patients choose less-aggressive care at the end of life for themselves is an often-cited rationale to advocate for less technology-laden end-of-life care. To assess end-of-life care received by physicians compared with nonphysicians in a system with universal health care. In this population-level decedent cohort study of data from April 1, 2004, through March 31, 2015 (fiscal years 2004-2014), in Ontario, Canada, 2507 physicians were matched approximately 1:3 to 7513 nonphysicians (ie, individuals who never were registered as a physician with the College of Physicians and Surgeons of Ontario) according to age, sex, income quintile, and location of residence. The primary outcome was location of death. Other outcomes included measures of health care use in the last 6 months of life. Differences were assessed using Poisson regression with robust error variances, adjusting for the Charlson Comorbidity Index. In total, 2516 physicians and 954 836 nonphysicians died between April 1, 2004, and March 31, 2015, in Ontario; 2247 physicians (89.3%) and 474 182 nonphysicians (49.7%) were men. The median (interquartile range) age at death was 82 (74-87) years for the physicians and 80 (68-87) years for the nonphysicians. After matching, data for 2507 physicians and 7513 nonphysicians were analyzed. For physicians, the risk of death at home was no different from that for nonphysicians (42.8% vs 39.0%; adjusted relative risk [aRR], 1.04; 95% CI, 0.99-1.09), but the risk of death in an intensive care unit was increased (11.9% vs 10.0%; aRR, 1.22; 95% CI, 1.08-1.39). In the prior 6 months, physicians had a decreased risk of an emergency department visit (73.0% vs 78.4%; aRR, 0.96; 95% CI, 0.94-0.98) but increased risks of an intensive care unit admission (20.8% vs 19.1%; aRR, 1.14; 95% CI, 1.05-1.24) and of receipt of palliative care services (52.9% vs 47.4%; aRR, 1.18; 95% CI, 1.13-1.23). Among a subgroup of 457 physicians and 1347 nonphysicians with cancer, the risk of death at home or intensive care unit was increased (37.6% vs 28.6%; aRR, 1.30; 95% CI, 1.13-1.50), as was the risk of receiving chemotherapy in the last 6 months of life. There was no difference overall for physicians compared with nonphysicians in terms of the likelihood of dying at home; physicians were more likely to die in an intensive care unit and to receive chemotherapy, but also to receive palliative care services. These findings suggest that physicians do not consistently opt for less-aggressive care but instead receive end-of-life care that includes both intensive and palliative care. These findings inform a more nuanced perspective of what physicians may perceive to be optimal care at the end of life.

Wind speed forecasting by subspace and nuclear norm optimization based algorithms

In this paper, we study properties of two wind speed forecasting schemes from mid-to-short term wind velocity measurements. The measurements are assumed to be collected over time intervals shorter than the ones previously studied by the authors. Two application examples illustrate the properties of these schemes. In the first example, historical data originating from five meteorological stations are considered. This example demonstrates that the first scheme outperforms persistence and artificial neural network (ANN) predictors by a large margin for all step sizes considered. This result enlarges domain of application of the first forecasting scheme from multi-step-ahead only to one and multi-step-ahead and from long-term observations only to long and mid-term observations. A local wildly fluctuating dense data set obtained from a renewable energy research home unit is studied in the second example to check the performance of the first scheme under non-standard operating conditions. The second scheme is a compressive subspace algorithm developed recently for innovation models.The second scheme complements the first scheme in that it uses short-term observations and outperforms the multi-step-ahead persistence and the ANN predictors.

PREDICTING DAYTIME MANIFESTATIONS OF CHALLENGING BEHAVIOURS IN ADVANCED STAGES OF DEMENTIA USING PRE-DAYTIME ACCELEROMETRY: POST-HOC ANALYSIS OF THE DZNE ROSTOCK INSIDEDEM STUDY

Behavioral disturbances such as night-day shift, agitation and aggression occur frequently in advanced stages of Alzheimer's disease and other dementias, and are summarized as “challenging behaviors” (CB). Previous studies have used actimetry to detect some of these characteristic behavioural changes. It has also been shown that accelerometric motion features allow detection of agitation levels among people in mild to moderate stages of dementia. The InsideDem study aimed to develop a computerized expert system to support assessment of CB and intervention selection. By extension, a post-hoc exploratory analysis was done to explore the potential of predicting the occurrence of CB using accelerometric motion scores (AMS) from late hours and night time of a preceding day, and early hours of a concurrent day. The study involved 4 weeks of real-time observation of daytime naturally occurring activities of 17 residents with moderate to very severe dementia (Global Deterioration Scale score of >3), in two nursing homes units. Behaviour of a subsample of 8 participants was also recorded by videotaping. Accelerometers were mounted on the participants’ wrist and ankle which measured their motion features. CB measures were obtained either in real-time by trained observers using both the DCM and a basic annotation scheme in unit-1, or from video recordings using only the basic annotation scheme in unit-2. Hierarchical Linear Mixed Models controlling for age, gender and nursing home unit, were applied to ascertain if the AMS from time windows: 6pm-10pm, 10pm-6am and 6am-8am, robustly predicts the occurrence (frequency or duration) of daytime CB (Figure 1). AMS significantly predicted the daily sum of frequency of CB across units for time frames 6pm-10pm (ß=1.50, p<0.05) and 6am-8am (ß=1.48, p<0.05). Furthermore, significant differences were found for daily sum of frequency of CB between gender (Figure 2) and unit (Figure 3). Lastly, age was also significantly correlated with daily sum of frequency of CB (r=0.23, p<0.001).

Implementing a novel strategy for interprofessional medication review using collegial mentoring and systematic clinical evaluation in nursing homes (COSMOS)

BackgroundMultimorbid patients in nursing homes are prescribed long lists of medication, often without sufficient clinical evaluations beforehand. This results in poor clinical effects of the prescribed medication and significant side-effects, especially in patients with impaired cognition. The aim of this paper is to describe the process, content and implementation of a clinical medication review encompassing clinical testing and collegial support to prescribers.MethodsThe implementation process of a novel approach to medication review in nursing homes was logged thoroughly by structured staff feedback. Staff experienced promotors and barriers to implementation also were collected. The study was part of a cluster randomized controlled trial, in which 36 long-term care units received the COSMOS intervention. Nurses and physicians randomized to the intervention group participated in educational programs, training in clinical evaluation of the patients, and interprofessional medication review with collegial mentoring.ResultsThe intervention group contained 297 patients from 36 nursing home units. There were 105 staff attendees for the education program. The units were served by 21 different physicians. Clinical medication reviews were performed in all units and all patients were assessed prior to the medication reviews. Of the 240 patients with a logged intervention process, 220 (92%) underwent a medication review. The intervention generated enthusiasm and improved communication among nursing staff and between nursing staff and physicians. The interprofessional discussions helped to facilitate difficult decisions pertaining to treatment levels. Reported barriers were lack of time, low engagement of all nursing staff and physicians, and ethical dilemmas.ConclusionsClinical medication reviews were implemented for almost all patients, and every patient was systematically assessed prior to the medication review. The physicians perceived collegial mentoring as an asset, learning from each other facilitated decision making in terms of difficult aspects of prescribing. Knowledge about barriers and promotors can improve implementation of similar interventions in other nursing homes.Trial registrationClinicaltrials.gov (NCT02238652). Registered July 7th 2014.

Staff perceptions of competence in a multicultural nursing home in Norway

Nursing homes throughout the Western world are seeing a steady increase in migrant workers. Although migrant staff members' multicultural background may be perceived and used by management as a resource in the workplace, studies indicate that the qualifications and competencies of these workers are often underestimated. Numerous studies have examined and theorized on the challenges related to workplace diversity and the deskilling of migrant workers. However, our knowledge of how competence may be conceptualized in inclusive ways in diverse staff groups remains scarce. This study examines minority and majority staff members' perceptions of competence in a strategically selected multicultural nursing home unit in Norway with 15–20 years of experience in recruiting and including minority staff members to various levels of the organization. We performed a thematic analysis of in-depth interviews with 22 healthcare providers and found that in this nursing home unit, contrary to what has often been found in other organizations, competence was not primarily discussed as a matter of educational level or background, skin complexion or whether staff members spoke the majority language with a foreign accent. Rather, a competent care worker was perceived as a) having good professional knowledge on how to care for nursing home residents (regardless of the worker's educational level), b) either having the ability to speak well or working hard to improve one's skills in the majority language, c) exhibiting ‘a genuine interest’ in working in a nursing home despite the relatively harsh working conditions, and d) having the ability to prioritize to ensure that all tasks and duties were completed on each shift. Staff members' perceptions of competence were hence interrelated with educational, racial, linguistic and social dimensions, but in unexpected and transgressing ways, paving the way to ethnic equality among staff.

Vertical monitoring of traffic-related air pollution (TRAP) in urban street canyons of Hong Kong

Rapid urbanization has significantly increased air pollution especially in urban regions with high traffic volumes. Existing methods for estimating traffic-related air pollution (TRAP) and TRAP-related health impacts are based on two-dimensional modelling. This paper describes a point-based methodology to monitor vertical pollutant concentrations in typical street canyons of Hong Kong. It explains the conceptual design, monitoring strategy and selection criteria for a limited number of receptor locations in street canyons to undertake field measurements for both outdoor exposure and indoor infiltration. It also expounds on the limitations and complications associated with field instrumentation and retention of participating home units. The empirical results were applied on the building infiltration efficiencies assessment. It is concluded that the cost-effective field methodology developed in this paper expects to strike a balance between exposure error and limited data locations. These findings will have important implications in future monitoring design of vertical TRAP exposure to support health studies.

Psychosis symptoms in nursing home residents with and without dementia-Cross-sectional analyses from the COSMOS study.

To investigate the characteristics of nursing home residents with psychosis and the association with potential underlying factors, such as pain, sleep disturbances, and antipsychotic medication. Five hundred forty-five residents with and without dementia from 67 Norwegian nursing home units were included in the cross-sectional analyses. Psychosis was the main outcome measure in our study; other outcome measures include quality of life (QoL), activities of daily living (ADL) function, cognitive function, pain, and antipsychotic medication. One hundred twelve residents had one or more symptoms of psychosis, and compared with residents without psychosis, they had lower QoL (p<0.001), ADL function (p=0.003), and cognitive functioning (p=0.001). Adjusted logistic regression analyses showed that psychosis was associated with the prevalence of pain (OR: 3.19; 95% CI, 1.94-5.24), sleep disturbances (OR: 4.51; 95% CI, 2.91-6.99), and total number of medication (OR: 1.10; 95% CI, 1.03-1.17). Residents with psychosis but without antipsychotic medication had better QoL (p=0.005) compared with residents receiving any antipsychotics. Psychosis in NH residents is associated with pain, sleep disturbances, and number of medications. Residents with psychosis have poor QoL, although better QoL was observed among those who did not use antipsychotic medication.

Music Interventions for Dementia and Depression in ELderly care (MIDDEL): protocol and statistical analysis plan for a multinational cluster-randomised trial

IntroductionIn older adults, dementia and depression are associated with individual distress and high societal costs. Music interventions such as group music therapy (GMT) and recreational choir singing (RCS) have shown...

Small parties and the federal structure of the Indian state

ABSTRACTPolitical parties have proliferated in India since the 1980s. A marked feature of the growth of parties has been the competitiveness of regional parties. Political entrepreneurs have broken away from established parties and formed separate parties that have competed at both state and national levels of the Indian political system. A few of the newly formed parties became strong competitors in their home units, sometimes leading state governments, demonstrating that they were large parties in their own region. A larger number of regional parties won representation in the Lok Sabha after 1989, but most of these newer parties, and some of the older ones, remained small. In the context of coalition politics many small parties were welcomed into national coalitions. Yet a lack of Assembly seats usually resulted in small parties being excluded from government at the state level. This article develops a typology that distinguishes small parties, active in national and state elections, from the larger regional parties and the hundreds of smaller parties registered with the Election Commission. The wider significance of the small parties is assessed in relation to party system change and the everyday conduct of politics.

Constructions of inclusion at two senior nursing home units in Sweden: immigrants’ perspectives

Purpose This study is an inductive exploration of factors that are relevant to the inclusion and integration of immigrant workers in a Swedish workplace. The purpose of this paper is to examine the experiences of immigrant employees with other organisational actors at two senior nursing units in Sweden. Design/methodology/approach Results are drawn from the analyses of interviews with six female and three male immigrant nursing assistants living permanently in Sweden. Findings Trustful relationships with other organisational actors, during both formal and informal interactions, are considered essential facilitating inclusion of these immigrant workers. Immigrant workers experienced inclusion when they achieved language competence (or felt supported in their attempts to do so) and bridged cultural differences. The results also highlight conditions for interactions and leadership as factors influencing inclusion. In addition, inclusion implied acculturation or awareness of the values of native-born citizens. Research limitations/implications The study suggests that immigrants’ relational dynamics with their colleagues are essential to inclusion, despite types of studies that focus mainly on the competences of leaders to manage diversity. Practical implications The results have implications for organisations’ development of a more democratic workplace with more inclusiveness and with satisfied employees. Originality/value The study gives voice to immigrant workers, which is rare in Swedish and international organisations that deal with the issue of immigrant integration in the workplace.

Correction: The course of neuropsychiatric symptoms in nursing home residents from admission to 30-month follow-up.

[This corrects the article DOI: 10.1371/journal.pone.0206147.].