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Introduction Since antiemetics have become more effective, it seems plausible that patients nowadays expect less emesis than in the past. To gain a deeper understanding of the patients’ caring needs during emetogenic chemotherapy used today, the aim was to describe patients’ experiences of chemotherapy-induced emesis and how it afects quality of life, daily life, and work. Further, to describe views of the signifcance of their treatment expectations and the communication with the health care personnel when undergoing chemotherapy for cancer. Methods Fifteen patients (median age 62 years, n=1 man and n=14 women, with breast (n=13) or colorectal (n=2) cancer), undergoing adjuvantor neo-adjuvant highly or moderately emetogenic chemotherapy were interviewed individually. The data were then analyzed using inductive thematic analysis. Results Three themes described the patients’ experiences: ”The whole life gets affected, or goes on as usual”, covering descriptions of how some patients experienced the emesis to limit their everyday lives, while others experienced no emesis at all or had found ways to manage it; ”Information is important for creating expectations, but experiences even more”, i.e., the patients expressed that they wanted all the information they could get about possible adverse efects from the treatment, even though they believed previous experiences to be more important than information for creating expectations about treatment outcomes. Overall, the participants described satisfaction with their antiemetic treatment; and ”Meet me as I am”, including the participants expressed being seen as a unique person to be the of utterly importance. It creates trust in the health care personnel and a feeling of safety and security in the situation. Conclusions These findings underline the importance of person-centered care ands upport in creating positive treatment expectations. Future research is welcomed regarding potential antiemetic efects of positive communication, strengthening positive treatment expectations during emetogenic chemotherapy

Introduction Since patients ask for acupuncture for cancer-therapy induced side-effects, and pre-existing expectations, i.e. beliefs, in a treatment may modify outcomes, the aim of this study was to investigate the use of acupuncture, interest, and belief in acupuncture effects among patients undergoing cancer therapy. Methods The study participants (n=457 of 507, 90% responded) cross-sectionally during radiotherapy answered a questionnaire regarding their use of, interest and belief in acupuncture treatment. Results Of the patients (mean age 65 years, 48% men, 37% had breast cancer, 32% prostate cancer), four (1%) patients used acupuncture during cancer therapy, while 368 (83%) expressed an interest in receiving acupuncture and (63%) believed acupuncture to be effective for at least one of 17 requested symptoms, most commonly pain (56% of the patients) and muscle tension(40%). They believed acupuncture to be effective for mean value 3 of 17 requested symptoms. Women (p<0.001), and patients 41-65 years (p<0.001), expressed a stronger belief in acupuncture effects than others. Conclusions Men and older patients expressed weaker beliefs in acupuncture effects than others, indicating the importance of collecting expectancy data in future acupuncture efficacy studies. The high interest and beliefs in acupuncture indicate that acupuncture should be available for side effects where acupuncture has proven effects. Older men might need more encouragement on positive expected outcomes of the acupuncture treatment than others.

Introduction Supporting cancer survivors in practicing evidence-based self-care has a central place in the rehabilitation plan to reduce side-efects of cancer treatment. However, knowledge is needed on the implementation of self-care practice among patients in routine radiotherapy care. Are there diferences in characteristics between self-care practitioners and non-practicing patients? Methods A study questionnaire including self-care and symptoms was delivered to 507 eligible patients undergoing radiotherapy at radiotherapy clinics in Sweden. The questions about self-care practice were responded by n=439 (51% women, 49% men) with breast (38%), prostate (33%), or other cancer (29%) types. Results Of the responding patients, 43% (n=189) practiced some form of self-care. The 332 self-reported descriptions of self-care were categorized into 14 self-care strategies of which six were practiced by more than 10 patients: physical activity (n=113), increased recovery (n=69), healthy eating (n=66), distraction (n=24), skincare (n=20), and self-medication (n=12). The most common indicators for self-care practice were fatigue (experienced by 72 %), general wellbeing (poor general wellbeing experienced by10%), psychological symptoms (worrying experienced by 44% and feeling sad by 42%), nausea (experienced by 34%), vomiting (experienced by 12%), and improving physical condition. Of the patients reporting experience of the above symptoms, 42%, 46%, 48%, 41%, 53%, and 47% practiced selfcare. Older age, relative risk (RR) 2.62, 95% confdence interval (CI) 1.6-4.28 and lower education i.e., elementary and secondary school, RR 1.75,CI 1.00-3.03 and RR 1.46, CI 1.16-1.85 were independently related with increased likelihood of being non-practitioners. Conclusions Roughly 40% of patients undergoing radiotherapy in a routine care setting practiced self-care. The most common indicator was fatigue, and the most common self-care strategy was physical activity. Half of symptomatic patients are non-practitioners who might beneft from evidenced based self-care. Among them, older and those with lower education might need more support in selfcare than others.

Purpose The aim of the present study was to investigate relationships between sense of coherence, emotion-focused coping, problem-focused coping, coping efficiency, and mental quality of life (QoL) in patients with chronic illness. A model based on Lazarus' and Folkman's stress and coping theory tested the specific hypothesis: Sense of coherence has a direct and indirect effect on mental QoL mediated by emotion-focused coping, problem-focused coping, and coping efficiency in serial adjusted for age, gender, educational level, comorbidity, and economic status. Methods The study used a cross-sectional and correlational design. Patients (n = 292) with chronic diseases (chronic heart failure, end-stage renal disease, multiple sclerosis, stroke, and Parkinson) completed three questionnaires and provided back-ground data. Data were collected in 2012, and a serial multiple mediator model was tested using PROCESS macro for SPSS. Results The test of the conceptual model confirmed the hypothesis. There was a significant direct and indirect effect of sense of coherence on mental QoL through the three mediators. The model explained 39% of the variance in mental QoL. Conclusions Self-perceived effective coping strategies are the most important mediating factors between sense of coherence and QoL in patients with chronic illness, which supports Lazarus' and Folkman's stress and coping theory.

Background People with dementia and informal carers often access formal care late in the process of dementia. The barriers and facilitators to service use from the perspectives of different stakeholders involved are not well understood. Thus, we aimed to explore the barriers and facilitators of access to and utilisation of formal care from the perspectives of people with dementia, their informal carers and health and social care professionals. Method Focus groups with people with dementia, informal carers and professionals were conducted in eight European countries. Recruitment targeted people with dementia, informal carers with experience of formal care and professionals involved in providing (access to) formal care. Qualitative content analysis using open coding was used on a national level. Cross-national synthesis was based on the translated national reports. Results Overall, 55 focus groups with 261 participants were conducted, involving 51 people with dementia, 96 informal carers and 114 professionals. Sixteen categories describing barriers and facilitators were identified, referring to three global themes: Aspects related to 1) individuals involved, 2) the system or 3) overarching aspects. The attitudes and beliefs of people with dementia and their carers may have a major impact, and they often serve as barriers. Formal care was perceived as a threat to the individual independence of people with dementia and was thus avoided as long as possible. A healthcare professional serving as a constant key contact person could be an essential facilitator to overcome these barriers. Contact should be initiated proactively, as early as possible, and a trusting and consistent relationship needs to be established. Beyond that, the findings largely confirm former research and show that barriers to accessing and using formal care still exist across Europe despite a number of national and European initiatives. Conclusion Further investigations are needed to elaborate how the concept of a key contact person could be integrated with existing case management approaches and how the independence and autonomy of people with dementia can be strengthened when formal care needs to be accessed and used. These may be meaningful facilitators regarding enhanced access to formal care for people with dementia and their families.

This study presents the Swedish standard version of the Copenhagen Psychosocial Questionnaire, COPSOQ III, and investigates its reliability and validity at individual and workplace levels with the aim of establishing benchmarks for the psychosocial work environment. Cross-sectional data from (1) a random sample of employees in Sweden aged 25–65 years (N = 2847) and (2) a convenience sample of non-managerial employees at 51 workplaces (N = 1818) were analysed. Internal consistency reliability was evaluated as well as the effects of sex, work sector and blue/white-collar work. Population benchmarks and mean scores for major occupational groups were computed based on weighted data. ICC(1) and ICC(2) estimates were computed to evaluate aggregation to the workplace level and Pearson inter-correlations to evaluate construct validity at individual and aggregated levels. The reliability and scale characteristics were satisfactory, with few exceptions, at both individual and workplace levels. The strength and direction of correlations supported the construct validity of the dimensions and the amount of variance explained by workplace justified aggregation to the workplace level. The present study thus supports the use of COPSOQ III for measurement at the workplace level and presents benchmarks for risk management as well as for research purposes.

[...]too much mechanical force can lead to musculoskeletal injury,1 too frequent activity can lead to fatigue2 and too prolonged standing can lead to varicose veins.3 Similarly, too little force can lead to bone and muscle loss, too infrequent moderate/vigorous physical activity can lead to cardiorespiratory deconditioning and too little standing or walking can lead to impaired cardiometabolic health.4 The ‘just right’ paradigm, the ‘Goldilocks Principle’ Therefore, we argue that the benefits of physical activity, both at work and leisure, can only be seen when the various aspects of physical activity are ‘just right.’ Like planning an exercise programme for different athletes from different sports, so too designing health-promoting work should take account of individual worker capacities, work requirements and constraints, as well as non-work activities. [...]work should be designed with consideration to workers’ whole-of-life 24/7/52 physical activity. [...]male workers who often perform strenuous tasks have an 80% increased risk of ischaemic heart disease mortality compared with workers who seldom/never perform strenuous work tasks (even after adjusting for a range of potential confounders).7 Likewise, a high occupational physical workload is related to an increased risk of back pain.8 The physical activity in their work is not ‘just right’ and this exacerbates the socioeconomic health gap.

Objectives In spite of preventive efforts, organizations and employees face several challenges related to working life and occupational health, such as a substantial prevalence of musculoskeletal disorders, social inequality in health and physical capacity, multi-morbidity, an obesity epidemic and an aging workforce. We argue that a new approach to occupational ergonomics and health is required, going beyond prevention of harm caused by work. We propose the \"Goldilocks Principle\" for how productive work can be designed to promote health and physical capacity. Methods Physical (in)activity profoundly influences health and physical capacity, with effects depending on the extent and temporal structure of the (in)activity. Like the porridge, chair and bed that needed to be \"just right\" for Goldilocks in the The Three Bears fairytale, physical activity during productive work needs to be \"just right\" for promoting rather than deteriorating health and capacity. In many jobs, physical activity is, however, either too much/high/frequent or too little/low/infrequent to give positive biomechanical and cardiometabolic stimuli. Results This paper presents the rationale, concept, development, application and prospects of the Goldilocks Principle for how productive work can be designed to promote health and physical capacity. Conclusions We envision a great potential to promote health and physical capacity by designing productive work according to the Goldilocks Principle, thus leading to benefits with respect to the current challenges related to working life and occupational health for society, organizations and employees.

Food insecurity (FI) is one of the major causes of malnutrition and is associated with a range of negative health outcomes in low and middle-income countries. The burden of FI in southern Africa is unknown, although FI continues to be a major public health problem across sub-Saharan Africa as a whole. Therefore, this review sought to identify empirical studies that related FI to health outcomes among adults in southern Africa. Altogether, 14 publications using diverse measures of FI were reviewed. The majority of the studies measured FI using modified versions of the United States Department of Agriculture Household Food Security Survey Module. A wide range in prevalence and severity of FI was reported (18–91%), depending on the measurement tool and population under investigation. Furthermore, FI was mostly associated with hypertension, diabetes, anxiety, depression and increased risk of human immunodeficiency virus (HIV) acquisition. Based on the findings, future research is needed, especially in countries with as yet no empirical studies on the subject, to identify and standardize measures of FI suitable for the southern African context and to inform public health policies and appropriate interventions aiming to alleviate FI and potentially improve health outcomes in the region.