Issues arising when crossing a border to give birth: an exploratory study on the French-Belgian border.

BACKGROUND: Anecdotal evidence suggests that many organised initiatives for cross-border collaboration in healthcare in border regions originate from the need for women to give birth close to home. Despite this, there is remarkably little research on these practices and the specific modes of collaboration between providers and experiences and needs of these women. In this paper we describe the experiences of French women who choose to give birth in Belgium. STUDY DESIGN: We conducted semi-structured interviews with 14 key informants and captured the experiences of 14 French mothers using a 40-item questionnaire. RESULTS: The chief motivations for French mothers to cross the border to deliver a baby in Belgium were geographical proximity as well as perceived better quality of care. Several procedural differences between France and Belgium were highlighted as possibly affecting the quality of follow-up care, including the absence, in some cases, of a contact person in France, and communication problems between providers. CONCLUSION: There is a tension between the testimony of patients who are clearly satisfied and evidence of problems in communication and weak collaboration between providers on either side of this cross border collaboration. This paradox requires more research efforts to generate clear evidence of the added value of these cross-border collaborations for patients

Usefulness and engagement with a guided workbook intervention (WorkPlan) to support work related goals among cancer survivors

Background: Returning to work after cancer is associated with improved physical and psychological functioning, but managing this return can be a challenging process. A workbook based intervention (WorkPlan) was developed to support return-to-work among cancer survivors. The aim of this study was to explore how participants using the workbook engaged with the intervention and utilised the content of the intervention in their plan to return-to-work. Methods: As part of a feasibility randomised controlled trial, 23 participants from the intervention group were interviewed 4-weeks post intervention. Interviews focussed on intervention delivery and data was analysed using Framework analysis. Results: Participants revealed a sense of empowerment and changes in their outlook as they transitioned from patient to employee, citing the act of writing as a medium for creating their own return-to-work narrative. Participants found the generation of a return-to-work plan useful for identifying potential problems and solutions, which also served as a tool for aiding discussion with the employer on return-to-work. Additionally, participants reported feeling less uncertain and anxious about returning to work. Timing of the intervention in coordination with ongoing cancer treatments was crucial to perceived effectiveness; participants identified the sole or final treatment as the ideal time to receive the intervention. Conclusions: The self-guided workbook supports people diagnosed with cancer to build their communication and planning skills to successfully manage their return-to-work. Further research could examine how writing plays a role in this process

How do social security schemes and labor market policies support the return-to-work of cancer survivors? A review article

Objective: About 40% of new cancer diagnoses are detected among working age individuals. Cancer diagnosis and treatment have high impact on the work ability of workers and represent a real challenge for the healthcare and social security systems but also for employers and the labour market. This review aims at investigating the legal frameworks set up in EU Member States that support the retention and integration of workers with disability. Furthermore, we look at these initiatives or measures to see whether they fit the specific needs of workers with cancer. Methods: We searched the PubMed database combining 4 key words: cancer, labour market, labour law and disability insurance or disability benefits. A total of 1.185 articles were found of which 10 were used for this review. In addition, grey literature, reports from the European Commission, the OECD and the WHO were searched and included in the material used for this review. Results: Few peer reviewed articles discuss the impact of labor market law on the (re)integration of cancer survivors. Most measures and initiatives support workers with chronic diseases but present important limits when considering workers with cancer. Collaboration and coordination among health providers, social workers and employment decision makers is the mostly required and effective. Conclusion: More research efforts should be made to systematically assess the impact of labor market and employment measures and initiatives on the (re)integration of workers with chronic diseases, with specific attention for workers with cancer. Legal frameworks need to be rethought for a better balance between productivity and equity, inclusion and social justice.SCOPUS: re.jinfo:eu-repo/semantics/publishe

The EMPCAN study: protocol of a population-based cohort study on the evolution of the socio-economic position of workers with cancer

Background: The improvements in cancer control led to an increase in the number of cancer survivors, notably, in the working age population (16–64 years). There is a strong need to assess and understand their reintegration on the labour market, which underlines and ensures their social integration and quality of life. The objectives of the EMPCAN study is therefore to measure the scale of return-to-work after cancer and to identify the determining factors, allowing for the implementation of an adequate socio-professional support. Methods: We requested data from the Belgian Cancer Registry and the Crossroad Bank for Social Security. We included all socially insured Belgian workers diagnosed between 2004 and 2011 with colorectal, breast, head &amp; neck, prostate, testis, lung and corpus uteri cancer. The end of (administrative) follow-up was 31st December 2012. We include demographic, health-related and work-related factors in the analysis and observed how these factors interplay to determine the working status. After having solved legal, ethical and technical issues for the coupling, we will perform survival analysis with competing risks using the Fine and Gray model; we will also perform a multistate model using transitions probabilities; and finally, a group-based modeling for longitudinal data using the ‘proc traj’ package in SAS. Discussion: The results of the EMPCAN study will allow the provision of an evidence-based support to professional reintegration policies. It will also bring some key features for the prediction of the cancer-related social security needs. Besides the raise of awareness among health professionals and policy makers, this study could lead to a better planning and organization of vocational rehabilitation programs. &nbsp;</p

The EMPCAN study: Protocol of a population-based cohort study on the evolution of the socio-economic position of workers with cancer

Background: The improvements in cancer control led to an increase in the number of cancer survivors, notably, in the working age population (16-64 years). There is a strong need to assess and understand their reintegration on the labour market, which underlines and ensures their social integration and quality of life. The objectives of the EMPCAN study is therefore to measure the scale of return-to-work after cancer and to identify the determining factors, allowing for the implementation of an adequate socio-professional support. Methods: We requested data from the Belgian Cancer Registry and the Crossroad Bank for Social Security. We included all socially insured Belgian workers diagnosed between 2004 and 2011 with colorectal, breast, head & neck, prostate, testis, lung and corpus uteri cancer. The end of (administrative) follow-up was 31st December 2012. We include demographic, health-related and work-related factors in the analysis and observed how these factors interplay to determine the working status. After having solved legal, ethical and technical issues for the coupling, we will perform survival analysis with competing risks using the Fine and Gray model; we will also perform a multistate model using transitions probabilities; and finally, a group-based modeling for longitudinal data using the 'proc traj' package in SAS. Discussion: The results of the EMPCAN study will allow the provision of an evidence-based support to professional reintegration policies. It will also bring some key features for the prediction of the cancer-related social security needs. Besides the raise of awareness among health professionals and policy makers, this study could lead to a better planning and organization of vocational rehabilitation programs.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Optitrain : a randomised controlled exercise trial for women with breast cancer undergoing chemotherapy.

BACKGROUND: Women with breast cancer undergoing chemotherapy suffer from a range of detrimental disease and treatment related side-effects. Exercise has shown to be able to counter some of these side-effects and improve physical function as well as quality of life. The primary aim of the study is to investigate and compare the effects of two different exercise regimens on the primary outcome cancer-related fatigue and the secondary outcomes muscle strength, function and structure, cardiovascular fitness, systemic inflammation, skeletal muscle gene activity, health related quality of life, pain, disease and treatment-related symptoms in women with breast cancer receiving chemotherapy. The second aim is to examine if any effects are sustained 1, 2, and 5 years following the completion of the intervention and to monitor return to work, recurrence and survival. The third aim of the study is to examine the effect of attendance and adherence rates on the effects of the exercise programme. METHODS: This study is a randomised controlled trial including 240 women with breast cancer receiving chemotherapy in Stockholm, Sweden. The participants are randomly allocated to either: group 1: Aerobic training, group 2: Combined resistance and aerobic training, or group 3: usual care (control group). During the 5-year follow-up period, participants in the exercise groups will receive a physical activity prescription. Measurements for endpoints will take place at baseline, after 16 weeks (end of intervention) as well as after 1, 2 and 5 years. DISCUSSION: This randomised controlled trial will generate substantial information regarding the effects of different types of exercise on the health of patients with breast cancer undergoing chemotherapy. We expect that dissemination of the knowledge gained from this study will contribute to developing effective long term strategies to improve the physical and psychosocial health of breast cancer survivors. TRIAL REGISTRATION: OptiTrain - Optimal Training Women with Breast Cancer (OptiTrain), NCT02522260 ; Registration: June 9, 2015, Last updated version Feb 29, 2016. Retrospectively registered