Purpose Almost half of people diagnosed with cancer are working age. Survivors have increased risk of unemployment, but little is known about long-term work retention. This systematic review and meta-analysis assessed work retention and associated factors in long-term cancer survivors. Methods We searched Medline/Pubmed, Embase, PsychINFO, and CINAHL for studies published 01/01/2000-08/01/2019 reporting work retention in adult cancer survivors ≥ 2 years post-diagnosis. Survivors had to be in paid work at diagnosis. Pooled prevalence of long-term work retention was estimated. Factors associated with work retention from multivariate analysis were synthesized. Results Twenty-nine articles, reporting 21 studies/datasets including 14,207 cancer survivors, were eligible. Work retention was assessed 2-14 years post-diagnosis. Fourteen studies were cross-sectional, five were prospective, and two contained both crosssectional and prospective elements. No studies were scored as high quality. The pooled estimate of prevalence of long-term work retention in cancer survivors working at diagnosis was 0.73 (95%CI 0.69-0.77). The proportion working at 2-2.9 years was 0.72; at 3-3.9 years 0.80; at 4-4.9 years 0.75; at 5-5.9 years 0.74; and 6+ years 0.65. Pooled estimates did not differ by cancer site, geographical area, or study design. Seven studies assessed prognostic factors for work retention: older age, receiving chemotherapy, negative health outcomes, and lack of work adjustments were associated with not working. Conclusion Almost three-quarters of long-term cancer survivors working at diagnosis retain work. Implications for Cancer Survivors These findings are pertinent for guidelines on cancer survivorship care. Professionals could focus support on survivors most likely to have poor long-term work outcomes.

Purpose This study explored employer's perspectives on (1) their experience of good practice related to workers diagnosed with cancer and their return to work (RTW), and (2) their perceived needs necessary to achieve good practice as reported by employers from nine separate countries. Methods Twenty-five semi-structured interviews were held in eight European countries and Israel with two to three employers typically including HR managers or line managers from both profit and non-profit organisations of different sizes and sectors. Interviews were recorded and transcribed verbatim. A grounded theory/thematic analysis approach was completed. Results Employers' experience with RTW assistance for workers with cancer appears to be a dynamic process. Results indicate that good practice includes six phases: (1) reacting to disclosure, (2) collecting information, (3) decision-making related to initial actions, (4) remaining in touch, (5) decision-making on RTW, and (6) follow-up. The exact details of the process are shaped by country, employer type, and worker characteristics; however, there was consistency related to the need for (1) structured procedures, (2) collaboration, (3) communication skills training, (4) information on cancer, and (5) financial resources for realizing RTW support measures. Conclusions Notwithstanding variations at country, employer, and worker levels, the employers from all nine countries reported that good practice regarding RTW assistance in workers with a history of cancer consists of the six phases above. Employers indicate that they would benefit from shared collaboration and resources that support good practice for this human resource matter. Implications for cancer survivors Further research and development based on the six phases of employer support as a framework for a tool or strategy to support workers with a history of cancer across countries and organisations is warranted.

Return to work (RTW) following treatment can be problematic for cancer survivors. Although some people affected by cancer are able to continue working, a significant proportion of these survivors end up unemployed, retire early or change jobs more often than those without a diagnosis of cancer (1). One of the reasons for not returning to work is the lack of understanding and support from employers and supervisors (2). Currently, it is not clear what factors are likely to influence the employer's management of employees recovering from cancer. This article reports the outcome from a review of published literature on factors related to the current employer management of employed cancer survivors. Method: The conducted in-depth review (scientific literature from 1980 to 2016) used the National Institute for Health and Care Excellence evidence based systematic review guidelines (3). Articles were identified using PubMed, Google Scholar, Web of Science, Science Direct, Embase, PsychInfo and Cochrane Central Register of Controlled Trials. Inclusion criteria were: 1) original empirical articles; 2) data on supervisors and/or employers of return to work after a cancer diagnosis; 3) data on supervisors and/or employers from the employer and/or employee perspective; 4) articles focusing on adult cancer patients; 5) written in English; and 6) where access to full article was available. Results were synthesized according to the Resource Dependence Institutional Cooperation Model (RDIC) model (4).

No abstract

Physical forces acting on particles explain how physical systems change over time. Evolutionary forces acting on populations of genomes explain change in the genetic structure of populations across generations. The dynamics of human development - i.e., learning, or change in psychological systems, are not yet understood. This is a step in that direction.

No abstract

No abstract

In the summer of 2010, Romania undertook a process of hospital decentralisation as part of the reform in the healthcare sector. The national newsprint media covered the process thoroughly. This paper is a study of how key stakeholders' views, attitudes, beliefs and attitudes towards decentralisation are represented in print media. 106 articles, published between June and September 2010, retrieved from the online databases of six leading national dailies were analysed. A mixed methodology was used in the data analysis stage. The qualitative data exploration identified five voices belonging to stakeholders involved directly or indirectly in the process: the representatives of central government, the local authorities (district and local councils, municipal mayors), health professionals (managers and physicians in hospitals), the media (journalists, analysts) and finally voices from civil society, professional associations and advocacy groups. These were the main actors negotiating the subjective meanings of the decentralisation process. An imbalance between these key actors were observed in the frequency, content and tone of the messages delivered in media during the four months. Central government and the local authorities were the most active voices, but the respective discourses differed significantly. An analysis of the accounts identified three main themes: the financial problem (hospitals liabilities and future spending), human resource in hospitals (the impact of decentralisation upon it) and the political character of the decentralisation.