IntroductionGeriatric oncology (GO) is a discipline that focuses on the management of elderly patients with cancer. The Spanish Society of Medical Oncology (SEOM) created a Working group dedicated to geriatric oncology in February 2016.ObjectivesThe main goal of this study was to describe the current situation in Spain regarding the management of elderly cancer patients through an online survey of medical oncologists.MethodsA descriptive survey was sent to several hospitals by means of the SEOM website. A personal e-mail was also sent to SEOM members.ResultsBetween March 2016 and April 2017, 154 answers were collected. Only 74 centers (48%) had a geriatrics department and a mere 21 (14%) medical oncology departments had a person dedicated to GO. The vast majority (n = 135; 88%) had the perception that the number of elderly patients with cancer seen in clinical practice had increased. Eighteen (12%) oncologists had specific protocols and geriatric scales were used at 55 (31%) centers. Almost all (92%) claimed to apply special management practices using specific tools. There was agreement that GO afforded certain potential advantages. Finally, 99% of the oncologists surveyed believed it and that training in GO had to be improved.ConclusionsFrom the nationwide survey promoted by the Spanish Geriatric Oncology Working Group on behalf of SEOM, we conclude that there is currently no defined care structure for elderly cancer patients. There is an increasing perception of the need for training in GO. This survey reflects a reality in which specific needs are perceived.
Surgical site infection (SSI) is a major infectious complication that increases mortality, morbidity, and healthcare costs. There are scores attempting to classify patients for calculating SSI risk. Our objectives were to validate the Australian Clinical Risk Index (ACRI) in a European population after cardiac surgery, comparing it against the National Nosocomial Infections Surveillance-derived risk index (NNIS) and analyzing the predictive power of ACRI for SSI in valvular patients. All the patients that who underwent cardiac surgery in a tertiary university hospital between 2011 and 2015 were analyzed. The patients were divided into valvular and coronary groups, excluding mixed patients. The ACRI score was validated in both groups and its ability to predict SSI was compared to the NNIS risk index. We analyzed 1,657 procedures. In the valvular patient group (n: 1119), a correlation between the ACRI score and SSI development (p < 0.05) was found; there was no such correlation with the NNIS index. The area under the receiver-operating characteristic curve (AUC) was 0.64 (confidence interval [CI] 95%, 0.5-0.7) for ACRI and 0.62 (95% CI, 0.5-0.7) for NNIS. In the coronary group (n: 281), there was a correlation between ACRI and SSI but no between NNIS and SSI. The ACRI AUC was 0.70 (95% CI, 0.5-0.8) and the NNIS AUC was 0.60 (95% CI, 0.4-0.7). The ACRI score has insufficient predictive power, although it predicts SSI development better than the NNIS index, fundamentally in coronary artery bypass grafting (CABG). Further studies analyzing determining factors are needed.
Riesgos psicosociales en personal de asistencia de una clínica de tercer nivel de la ciudad de Cartagena de Indias en 2016Risks in a third level care team clinic of Cartagena de Indias city in 2016 ResumenObjetivo. determinar los riesgos psicosociales del personal asistencial de una clínica privada de tercer nivel de la ciudad de Cartagena de Indias. Método. se realizó un estudio descriptivo de corte transversal, la población objeto de estudio fue de cincuenta y siete trabajadores del área asistencial, se utilizó la batería de instrumentos para la evaluación de factores de riesgo psicosocial diseñada por el Ministerio de la Protección Social de Colombia. Resultados. el promedio de edad es de 34.2 años, 52% pertenece al nivel educativo técnico, con un predominio del género femenino. El estado civil predominante con un 46% es soltero, 44% viven en estrato 2. La mayoría (74%) de los trabajadores considera que su jefe brinda siempre o casi la posibilidad de tener contacto con él. Siempre tienen buena relación y apoyo de sus compañeros, 61% considera que no tienen control sobre el tiempo y cantidad de trabajo que realizan. El pago del salario no es puntual y los trabajadores tienen muy pocas posibilidades de ascenso y además sienten que la empresa muy pocas veces se preocupa por su bienestar. La prevalencia de nivel más alto de riesgo correspondió a un 76% por exceso de carga laboral, por alta exigencia de esfuerzo mental un 75% y está relacionado con el poco control sobre el trabajo en un 57%. Los trabajadores se exponen a jornadas laborales extensas, poco tiempo de descanso, cansancio y falta de sueño por jornadas nocturnas, escasa interacción con la familia y el contacto constante con situaciones de extremo sufrimiento y dolor. AbstractObjective. to determine the psychosocial risks of care personnel in a private third-level clinic in the city of Cartagena de Indias. Method. a cross-sectional descriptive study was carried out, the study population consisted of fifty-seven workers in the health care area, a battery of instruments was used for the evaluation of psychosocial risk factors designed by the Ministry of Social Protection of Colombia. Results. the average age is 34.2 years, 52% belongs to the technical education level, with a predominance of the female gender. The predominant civil status with 46% is single, 44% live in stratum 2. The majority (74%) of the workers consider that their boss always provides or almost the possibility of having contact with him. Always have good relationship and support from their peers, 61% feel they have no control over the time and amount of work they do. The payment of the salary is not punctual and the workers have very little possibility of promotion and also feel that the company very rarely worries about their well-being. The prevalence of the highest level of risk corresponded to 76% due to an excess of workload, due to a high mental stress requirement of 75% and related to poor control over work by 57%. Workers are exposed to long hours of work, little rest time, tire...
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