Returning to work following curative chemotherapy: a qualitative study of return to work barriers and preferences for intervention

Purpose

This study aimed to explore barriers to return to work (RTW) and preferences for intervention and support for cancer patients treated with curative intent from the perspectives of cancer survivors and oncology health professionals.

Methods

Participants attended a focus group (N?=?24) or an individual interview (N?=?14). A topic guide and a semi-structured recorded interview format were used to gather data, which were later transcribed and analysed for global themes and subthemes.

Results

With regard to barriers, the global theme ‘work capacity’ captured an array of barriers encompassing financial pressure, preparedness for work, lack of confidence as well as other key physical, practical and psychosocial barriers. Participants expressed a preference for RTW models that focus on objective and structured assessment whilst allowing for flexibility to address individual needs.

Conclusions

Cancer survivors perceive multiple barriers when attempting to RTW. These barriers were perceived to impact upon work capacity, where ‘capacity’ was defined broadly to include practical, physical and psychosocial concerns. RTW is an important concern for cancer survivors and structured RTW interventions should be incorporated into the care of cancer survivors.     

Reducing one million child deaths from birth asphyxia – a survey of health systems gaps and priorities

Background  

Millions of child deaths and stillbirths are attributable to birth asphyxia, yet limited information is available to guide policy and practice, particularly at the community level. We surveyed selected policymakers, programme implementers and researchers to compile insights on policies, programmes, and research to reduce asphyxia-related deaths.     

Prevalence of HIV-associated ophthalmic disease among patients enrolling for antiretroviral treatment in India: A cross-sectional study

Background  

The ocular manifestations of HIV may lead to visual impairment or blindness. In India, patients typically initiate antiretroviral treatment (ART) with low CD4 cell counts when the risk of ocular complications may be high. The objective of this study was to determine the prevalence and types of HIV-associated ocular conditions in patients referred for ART in India.     

Damage accumulation and fatigue life of particle-abraded ceramics

PURPOSE: This investigation compared initial and fatigue strengths of particle-abraded ceramics to those of as-polished alumina and zirconia ceramics in crown-like layer structures. MATERIALS AND METHODS: Alumina or zirconia plates bonded to polycarbonate substrates were subjected to single-cycle and multi-cycle contact (fatigue) loading. Cementation surfaces of the ceramic were damaged by controlled particle abrasion, indentation with a sharp diamond at low load, or a blunt indenter at high load. The stresses needed to initiate radial fractures were evaluated. RESULTS: The strengths of specimens were lowered by fatigue loading. After the equivalent of 1 year of occlusal contacts, the strengths of undamaged specimens degraded to approximately half of their single-cycle values. In particle-abraded specimens, an additional 20% to 30% drop in strength occurred after several hundred load cycles. Particle abrasion damage was approximately equivalent to damage from sharp indentation at low load or blunt indentation at high load. CONCLUSION: Damage from particle abrasion, not necessarily immediately apparent, compromised the fatigue strength of zirconia and alumina ceramics in crown-like structures. In fatigue, small flaws introduced by particle abrasion can outweigh any countervailing strengthening effect from compression associated with surface damage or, in the case of zirconia, with phase transformation.     

Stillbirths: how can health systems deliver for mothers and babies?

The causes of stillbirths are inseparable from the causes of maternal and neonatal deaths. This report focuses on prevention of stillbirths by scale-up of care for mothers and babies at the health-system level, with consideration for effects and cost. In countries with high mortality rates, emergency obstetric care has the greatest effect on maternal and neonatal deaths, and on stillbirths. Syphilis detection and treatment is of moderate effect but of lower cost and is highly feasible. Advanced antenatal care, including induction for post-term pregnancies, and detection and management of hypertensive disease, fetal growth restriction, and gestational diabetes, will further reduce mortality, but at higher cost. These interventions are best packaged and provided through linked service delivery methods tailored to suit existing health-care systems. If 99% coverage is reached in 68 priority countries by 2015, up to 1·1 million (45%) third-trimester stillbirths, 201?000 (54%) maternal deaths, and 1·4 million (43%) neonatal deaths could be saved per year at an additional total cost of US$10·9 billion or $2·32 per person, which is in the range of $0·96-2·32 for other ingredients-based intervention packages with only recurrent costs.