Objective: To compare demographic and functional characteristics of elderly users and non-users of home care services in urban Nova Scotia (n = 533) and Newfoundland (n = 449) using a cross sectional study design.

Results: More Nova Scotians (24%) than Newfoundlanders (11%) received home care services. In both provinces, most ADL-dependent people do not receive home care services, and most home care users are not ADL dependent. In Newfoundland, home care users were more likely to be ADL dependent and to have dementia; this was not the case in Nova Scotia. In Nova Scotia being over age 85 without a supporter in the same residence, not being married, and having an IADL limitation significantly increased the likelihood of home care use. IADL impaired subjects in Newfoundland were also more likely to receive home care.

Conclusions: If home care is to substitute for institutional care, existing home care programs must be prepared to adapt to a new type of user.

The authors conducted a systematic review of studies examining correlations between assessments of function obtained using self-report and those obtained using performance-based measures for community-dwelling older adults.

The digestive gland of Pecten maximus consists, as in other lamellibranchs, of numerous blindending tubules which communicate with the stomach by partially ciliated main ducts and non ciliated secondary ducts. The non-ciliated cells of the main ducts are characterized by a well developed brush border constituted by high and dense microvilli and a strong pinocytotic activity. Ciliated and non ciliated cells have a very similar fine structure. The digestive tubules have a large lumen and contain digestive cells at different stages of absorption, digestion and excretion, one part of the tubules being functional while the other is disintegrating. The dark crypts contain the flagellated secretory cells, characterized by a well developed granular endoplasmic reticulum, and the young immature cells which may replace both the secretory and digestive cells. The numerous lipid droplets occurring in the digestive duct cells and in the digestive cells reveal the lipid storage function of the digestive gland. Several enzyme activities involved in digestion have been localized in the digestive gland. High amylase activity and cellulase and lysozyme activities have been found in the ducts and in the tubules, whereas no proteolytic activity could be detected histochemically. Some intracellular peptidases and glycosidases have been localized in the cells of the digestive gland, especially in the brush-border cells of the ducts and in the functional part of the tubules. High alkaline and acid phosphatase activities are displayed by the duct brush-border cells and the digestive and secretory cells. These results show the main role of the digestive gland, both in extracellular digestion (secretion of the digestive enzymes) and in absorption and intracellular digestion and provide information on the respective functions of the different cells within these processes.