T4 tumors, R1 resections, and/or intraoperative perforation of the tumor or bowel wall are main features of low rectal cancers, causing inferior oncologic outcomes for tumors in this area. If surgery is optimized, preventing intraoperative perforation and involvement of the circumferential resection margin, the prognosis for cancers of the lower rectum seems not to be inherently different from that for tumors at higher levels. In that case, the level of the tumor or the type of resection will not be indicators for selecting patients for radiotherapy.
Introduction Increased attention is being paid to the longterm health and well-being of people living with a history of cancer. Of particular concern is cancer's effect on productivity and work ability, which in turn is important for persons' financial situation, life satisfaction, and social relationships. We explored the extent to which Norwegian cancer survivors stay affiliated to working life compared to the cancer-free population, and quantified cancer-associated earning declines. Methods and results Logistic regression models were estimated to explore the impact of cancer on employment using register data covering the entire Norwegian population in 2001, 567,000 men and 549,300 women 40-59 years old, of whom 34,000 were diagnosed with cancer. These analyses revealed that a cancer diagnosis was strongly associated with not being employed. Log-linear regression models were used to estimate the effect of cancer on labor earnings in 2001 for those employed. Cancer was associated with a 12% decline in earnings overall. Leukemia, lymphomas, lung, brain, bone, colorectal, and head-andneck cancer resulted in the largest reductions in employment and earnings. Earning declines were strongly associated with educational level. In addition, linear regression models were used to estimate differentials in earnings before and after cancer. These results accorded well with those from crosssectional models. Conclusion and implications for cancer survivors Cancer survivors are less likely to be employed than the cancer-free population, and undertake modifications in their employment, e.g. reduce work-hours or hold lower-wage jobs, which result in reduced earnings. A social class gradient is present and must be addressed to accommodate appropriate intervention from welfare societies.
Research on the correspondence between retirement intentions and subsequent behaviour is scarce. We aimed to explore possible associations between retirement intentions and behaviour, using five-year high-quality quantitative panel data on Norwegian senior workers. Retirement intentions operate at different levels of firmness: (a) considerations; (b) preferences; and (c) decisions. Compared to work continuation considerations, a targeted age for retirement improved predictive power whether the target was preferred or decided, and particularly so if the target (i.e. the preferred or decided age of retirement), corresponded with a normative retirement age. Because more workers are able to state a preferred age of retiring than a decision about when to retire, preferences may be better proxies for retirement behaviour than decisions, when the issue is planning for policies. The correspondence between intentions and behaviour varies primarily by health, education and type of work. Older workers with poor health, and workers with low education, often retire earlier than they prefer. Blue-collar workers often retire earlier than they had decided. These findings illustrate the possible effect of labour market resources, not only for senior workers' labour market participation, but also for their opportunities to work up to the age they prefer or had decided. Even for white-collar workers and those in good health, constraints seem to apply when they wish to retire late.
Aim: In order to improve patient outcomes and minimize health care costs, many Western countries are attempting to reduce the length of stay in hospitals by transferring responsibilities from specialist care to primary care. In Norway, the Coordination Reform was implemented in 2012 to enhance this development. As a result, the number of patients discharged to the municipal health care services has increased significantly. We investigate the extent to which nurses in nursing homes and home care services feel equipped to provide adequate care for patients discharged from hospitals after the reform.Data: Altogether, 1,938 nurses representing around 80% of Norwegian municipalities assessed their experiences of this reform.Results: An increase in the number of poorly functioning patients discharged to the municipality services was reported. Regardless of place of work, concerns were raised about limited resources in terms of personnel, equipment and competence, as well as an increase in hospital readmission rates. Negative reports on care provision for recently discharged patients came most frequently from nurses in municipalities which generally had low incomes, diverted limited resources to the health care sector and relied heavily on home-based care.Conclusion: Insufficient transfer of resources to the home care services may have hampered the ability to fulfil the Coordination Reform’s intentions of providing safe care to patients in their own homes as an alternative to prolonged hospital stays. Due to a marked increase in reported hospital readmissions, it is not obvious that shorter lengths of stays have reduced overall health care costs.
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