The Effect of Surgeon Expertise on the Outcome of Patients with Adrenocortical Carcinoma

Complete surgical removal of adrenocortical carcinoma (ACC) represents the only chance of long-term cure. In this study, we compared the long-term outcomes of ACC patients depending on whether they had adrenal surgery performed in a high-volume (HVC) or in a low-volume (LVC) center. This retrospective study included 49 patients from the Croatian ACC Registry with the European Network for the Study of Adrenal Tumors (ENSAT) stage I–III ACC, of which 35 underwent surgery in a HVC whereas 14 of them were operated in one of the LVCs. Patients operated in the LVCs had a significantly higher rate of ACC recurrence (57.1% vs. 22.9%; p = 0.02). Accordingly, RFS was significantly longer in patients operated on in HVC (p = 0.04). The difference in RFS remained significant after controlling for age, gender, tumor size, Ki-67 index, Weiss score, and type of surgery (HR 4.55; 95% CI 1.16–17.88; p = 0.03). In addition, there is a tendency towards longer DSS in patients in the HVC group compared to those in the LVC group (p = 0.05). These results point to the centralization of adrenal surgery as a key prerequisite for improving the outcomes of ACC patients.

Quality of training in cervical cancer radical surgery: a survey from the European Network of Young Gynaecologic Oncologists (ENYGO)

BackgroundThe European Society of Gynaecological Oncology (ESGO) and partners are committed to improving the training for gynecologic oncology fellows. The aim of this survey was to assess the type and level of training in cervical cancer surgery and to investigate whether the Laparoscopic Approach to Cervical Cancer (LACC) trial results impacted training in radical surgery for gynecologic oncology fellows.MethodsIn June 2020, a 47-question electronic survey was shared with European Network of Young Gynaecologic Oncologists (ENYGO) members. Specialist fellows in obstetrics and gynecology, and gynecologic oncology, from high- and low-volume centers, who started training between January 1, 2017 and January 1, 2020 or started before January 1, 2017 but finished their training at least 6 months after the LACC trial publication (October 2018), were included.Results81 of 125 (64.8%) respondents were included. The median time from the start of the fellowship to completion of the survey was 28 months (range 6–48). 56 (69.1%) respondents were still fellows-in-training. 6 of 56 (10.7%) and 14 of 25 (56.0%) respondents who were still in training and completed the fellowship, respectively, performed ≥10 radical hysterectomies during their training. Fellows trained in an ESGO accredited center had a higher chance to perform sentinel lymph node biopsy (60.4% vs 30.3%; p=0.027). There was no difference in the mean number of radical hysterectomies performed by fellows during fellowship before and after the LACC trial publication (8±12.0 vs 7±8.4, respectively; p=0.46). A significant reduction in number of minimally invasive radical hysterectomies was noted when comparing the period before and after the LACC trial (38.5% vs 13.8%, respectively; p<0.001).ConclusionExposure to radical surgery for cervical cancer among gynecologic oncology fellows is low. Centralization of cervical cancer cases to high-volume centers may provide an increase in fellows’ exposure to radical procedures. The LACC trial publication was associated with a decrease in minimally invasive radical hysterectomies performed by fellows.

Las acreditaciones internacionales de los programas de ingeniería en tiempos de pandemia: perspectiva comparada entre España y México

En este trabajo se realiza una reflexión sobre las acreditaciones internacionales de programas educativos de ingeniería españoles y mexicanos, gestionadas por la Agencia Nacional de Evaluación de la Calidad y Acreditación (ANECA), en colaboración con el Instituto de Ingeniería de España (IIE) y el Consejo de Acreditación de la Enseñanza de Ingeniería (CACEI) de México, dentro del Programa de Sellos Internacionales de Calidad (SIC), desde sus inicios hasta el momento de la pandemia provocada por la COVID-19, en el contexto de la evaluación del Sello EUR-ACE® de ingeniería, creado por la agencia europea European Network for the Accreditation of Engineering Education (ENAEE). Los datos utilizados en este estudio fueron obtenidos directamente por ANECA. 234 programas educativos obtuvieron el Sello EUR-ACE® en el periodo analizado, distribuidos entre 35 universidades españolas y tres mexicanas, en los que se aplicó idéntico proceso de evaluación y criterios.

What about nurses’ competencies in Europe?−Translation process of the Nurse Professional Competence Scale into German within the European Network of Nursing Academies and its use

The link between the level of qualification described as competence of the nursing staff and the patient outcome is repeatedly indicated in patient’s safety studies. The Bologna process initiated in 1999 triggered a Europe-wide reform process in the field of education, leading to reforms in nursing education in Europe that promoted the academization of nursing in many countries. In this context, a shift from teaching to learning outcomes occurred which spurred the development of competence frameworks at the European, national and profession-specific level. Competence measurement instruments are important for improving nursing education as well as nursing practice. Studies using such instruments can point to the strength and limitations of the educational and of the health care system of the countries under study. The aim of this article is to describe the translation process of the English version of the Nurse Professional Competence (NPC) Scale to create a German version to be used within German-speaking countries within the European Network of Nursing Academies (ENNA). The background of translating the NPC Scale from English into German is a European research project initiated by ENNA in which 11 European Higher Education Institutes participated. The article proceeds by providing information about nursing work in Austria, Germany and Switzerland. By accounting for the nationally specific conditions of nursing education and by describing the translation process, the study points to the relevance of context specific conditions for measuring self-reported professional competences. Making transparent the translation process supports the applicability of this scale in other research projects.