Cancer and its impact on work among the self-employed: A need to bridge the knowledge gap.

Self-employment-the so-called flexible layer of the economy-has gained importance following the 2007-2008 global economic and financial crisis. In Europe, the self-employed now comprise on average 15% of workers [Eurostat, Labour market and Labour force survey (LFS) statistics, 2016]. Around one-third of self-employed people also provide jobs for others [European Commission, Fact Sheet. 2015 Employment and Social Developments in Europe Review: frequently asked questions, 2016]. Moreover, this group of workers adapts quickly to changing circumstances. In the UK, for instance, recent growth in self-employment is considered to have made an important contribution to labour market recovery [Hatfield, Self-employment in Europe. London, Institute of Public Policy Research, 2015]. Across the European Union self-employment is viewed as a key enabler of sustainable economic growth and, reflecting this, the Europe 2020 strategy encourages member states both to promote self-employment and to remove measures that discourage it [Library of the European Parliament, Self-employment and social security. Effects on innovation and economic growth, 2013].

Development and usability of a computer-tailored pedometer-based physical activity advice for breast cancer survivors.

This observational study aimed to adapt a computer-tailored step advice for the general population into a feasible advice for breast cancer survivors and to test its usability. First, several adaptations were made to the original design (adding cancer-related physical activity (PA) barriers and beliefs, and self-management strategies to improve survivors' personal control). Second, the adapted advice was evaluated in two phases: (1) a usability testing in healthy women (n = 3) and survivors (n = 6); and (2) a process evaluation during 3 weeks in breast cancer survivors (n = 8). Preliminary usability testing revealed no problems during logging-in; however, three survivors misinterpreted some questions. After refining the questionnaire and advice, survivors evaluated the advice as interesting, attractive to read, comprehensible and credible. Inactive survivors found the advice novel, but too long. The process evaluation indicated that the majority of the women (n = 5/8) reported increased steps. Monitoring step counts by using a pedometer was perceived as an important motivator to be more active. To conclude, this study provides initial support for the usability and acceptability of a computer-tailored pedometer-based PA advice for breast cancer survivors. After testing efficacy and effectiveness of this intervention, this tool can broaden the reach of PA promotion in breast cancer survivors.

What is the value of occupational therapy in return to work for breast cancer patients? A qualitative inquiry among experts.

An increasing number of patients are confronted with breast cancer (BC) and functional limitations after treatment. Occupational therapy (OT) is successful in return to work (RTW), but not yet available for BC patients. This paper explores experts' opinions on OT interventions for RTW in BC patients in the Belgian context. Primary data were topic-interviews with all heads of OT departments in Flemish University Hospitals (n = 5). Secondary data were four focus group interviews with care professionals in oncological rehabilitation (n = 41). All data were transcribed and thematic analysis was used. Integrated in multidisciplinary teamwork, OT interventions should have a holistic and client-centred approach, start early in the rehabilitation process, include workplace visits and contacts with relevant stakeholders, and use goal setting to start up tailor made rehabilitation, linking assessment of abilities and work. Occupational therapists are regarded as professionals who can effectively answer BC patients unmet needs regarding RTW due to their skill to bridge between care and workplace. According to the experts, OT interventions supporting RTW in BC patients are useful when integrated in regular healthcare. They agree on the components but organisational barriers should be removed, for example not providing reimbursement for including this type of support trough healthcare insurance.

Physical activity levels and supportive care needs for physical activity among breast cancer survivors with different psychosocial profiles: a cluster-analytical approach.

The transition from breast cancer patient to survivor is associated with many treatment-related and psychosocial factors, which can influence health behaviour and associated needs. First, this study aimed to identify clusters of treatment-related and psychosocial factors among breast cancer survivors. Second, clusters' physical activity levels and care needs for physical activity were evaluated. Breast cancer survivors (n= 440; 52 ± 8 years) (3 weeks to 6 months post treatment) completed self-reports on physical and psychological symptoms; illness representations; social support and coping; physical activity and care needs for physical activity. Analyses identified four clusters: (1) a low distress-active approach group; (2) a low distress-resigned approach group; (3) a high distress-active approach group; and (4) a high distress-emotional approach group. Physical activity levels were higher in the low distress groups than in the high distress-emotional approach group. However, women with low distress and an active approach reported equal care needs for physical activity than women with high distress and an emotional approach. These findings suggest that care needs for physical activity are unrelated to distress and actual physical activity levels. The results emphasise the importance of screening for needs and provide a framework supporting the referral of breast cancer survivors to tailored interventions.

Cycling to work: influence on indexes of health in untrained men and women in Flanders. Coronary heart disease and quality of life.

The purpose of this study was to examine if a 1-year lifestyle intervention study (cycling to work) has an influence on coronary heart disease (CHD) risk factors and health-related quality of life, in previously untrained healthy adults. Healthy, untrained men and women, who did not cycle to work, participated in an intervention study. Sixty-five subjects (intervention group: IG) were asked to cycle to work at least 3 times a week and 15 controls (CG) were asked not to change their living habits. All measurements were performed on 3 consecutive occasions, with 6 months in between. Physical performance, venous blood samples, blood pressure (BP), and the SF-36 Health Status Survey were assessed. Cycling characteristics and leisure-time physical activities were reported in a dairy. Total cholesterol (TC), LDL, TC/HDL and diastolic BP decreased and HDL increased significantly in the IG. TC and LDL decreased significantly in the CG. Vitality for the total group and physical functioning for women significantly changed over time between IG and CG in the first 6 months. These results show that cycling to work has a positive influence on CHD risk factors and is likely to improve the health-related quality of life in previously untrained healthy adults.

Atypical depression as a secondary symptom in chronic fatigue syndrome.

Chronic fatigue syndrome (CFS) has gained prominence since 1988 and a substantial amount of research has been done in this domain. However, it is still regarded as a controversial condition. Moreover, most of the symptoms of CFS itself are non-specific, occurring in many illnesses; some of the symptoms are also common in depression. Indeed, an area of continued controversy and debate involves the diagnostic overlap between CFS and psychiatric disorders. Through anecdotal evidence, atypical depression appears to be common in CFS. Recent developments in psychobiology underscore the role of the acute phase response and its associated sickness behavior in affective disorders. Thus, we hypothesize that atypical depression is sickness behavior rather than an affective disorder as shown by anecdotal evidence in CFS.

Influence of plasma preparations and donor red blood cells on the antioxidant capacity of blood from newborn babies: an in vitro study.

We investigated in an in vitro transfusion model the early effects of plasma preparations and donor red blood cells on the antioxidant capacity of the cord blood from babies. Addition of pasteurized plasma protein solution to plasma from babies decreased the peroxyl radical trapping capacity (p < 0.02). In contrast, fresh frozen plasma did not lower this capacity. Addition of adult donor red blood cells to the babies' red blood cells did not significantly decrease the glutathione-recycling capacity of the blood. On the basis of these in vitro results we hypothesize that the use of resuscitation fluids with low antioxidant capacity may temporarily decrease the ability of the baby to catabolize reactive oxygen species.