Good dying in the elderly: What have we learned in the last ten years?

El buen morir es un fenómeno que se construye desde múltiples perspectivas de los actores involucrados en la atención del adulto mayor. El objetivo de este trabajo fue llevar a cabo una revisión temática con análisis cualitativo del contenido 50 artículos relacionados con el buen morir en el adulto mayor, publicados en los últimos 10 años. Se encontró que el buen morir carece de una definición universal y está configurada por elementos que varían según el actor involucrado, las variables sociodemográficas y los aspectos culturales. Visibilizar los elementos más relevantes de lo que configura el buen morir permite ampliar su comprensión, con el objetivo de mejorar la atención en el fin de vida del adulto mayor.Q1The good dying is a phenomenon that is constructed from multiple perspectives of the actors involved in the care of the elderly. The aim of this work was to carry out a narrative review with qualitative analysis of the content of 50 articles related to good dying in the elderly published in the last 10 years. It was found that good dying lacks a universal definition and is configured by elements that vary according to the actor involved, sociodemographic variables, and cultural aspects. Making visible the most relevant elements of what makes the good dying allows us to broaden its understanding, with the aim of improving end-of-life care for the elderly.https://scienti.minciencias.gov.co/cvlac/visualizador/generarCurriculoCv.do?cod_rh=0001796584Revista Nacional - IndexadaS

Moral anguish and medical education : thematic review to make a growing problem visible

La angustia moral (AM) es un fenómeno descrito en el personal de salud, que poco a poco va ganando interés por estar involucrado en la cotidianidad de la toma de decisiones clínicas. El objetivo del artículo fue estructurar una visión general del concepto. Se realizó una revisión temática con análisis cualitativo del contenido de 40 artículos relacionados con el tema y obtenidos de la base datos Pubmed. Así, se obtuvo que la AM es un fenómeno multicausal del cual no se tiene aún un modelo concreto que permita entenderla e interpretarla, por lo que, a ciencia cierta, no se conoce su frecuencia, su intensidad o el alcance de su impacto. La AM es un fenómeno sin un cuerpo teórico, por lo que se hace necesario diseñar herramientas interdisciplinares que permitan su comprensión y abordaje. Palabras clave: angustia moral; final de vida; cuidados paliativos; educación médica.Moral Distress (MD) is a phenomenon described amongst healthcare personnel, that's been gathering interest little by little due to its involvement in the daily dynamics of clinical decision making. The current work's objective was to structure an overview of the MD concept. A narrative review was made with a qualitative analysis of 40 article's content related with the topic and obtained from the PubMed database. MD is a polycausal phenomenon that still lacks a concrete model with which to understand and interpret it which is why its frequency, intensity or the scope of its impact is unknown. MD is a phenomenon that lacks a complete theoretical background that would allow us to understand it fully, which is why it's necessary to design interdisciplinary tools that'd allow a full comprehension and approach. Keywords moral distress; palliative care; end of life; education; medical; undergraduate.https://orcid.org/0000-0002-9132-0557https://scholar.google.com/citations?user=SH-SFzMAAAAJ&hl=eshttps://scienti.minciencias.gov.co/cvlac/visualizador/generarCurriculoCv.do?cod_rh=0000274801&lang=esRevista Nacional - Indexad

Peace in crisis: notions, agreement and implementation

Paz en crisis es un proyecto editorial con el que se cierra un programa de investi gación de años atrás y en el que se condensan distintas aproximaciones sobre la paz; en esta oportunidad, bajo la lupa o noción de crisis. Los aportes se encuentran agrupados en 4 tomos, 44 capítulos y 6 bloques temáticos en donde 87 autores ofrecen perspectivas multidisciplinares y multidimensionales, pluralidad meto dológica y variedad en las maneras de hacer investigación y con estilos de escritura diferenciados. Los tomos, en su conjunto, presentan reflexiones diversas sobre las antiguas, múltiples y nuevas conflictividades (tanto armadas como no armadas), así como de los diferentes actores (heredados, emergentes y transformados), en el escenario de lo que ha venido refiriéndose por algunos especialistas como una situación de posacuerdo bélico en Colombia. Este primer tomo, titulado Nociones, acuerdo e implementación (compuesto por trece capítulos y un epílogo), analiza la situación actual de la paz, la democra cia, la seguridad y el ejercicio de los derechos en Colombia, demostrando que lejos de las aspiraciones de estabilización y avance contenidas en los acuerdos, es una renovada y multimodal conflictividad la que define el contexto nacional. En este tomo se apunta a debatir nociones conceptuales y aproximaciones a proble máticas particulares, que resultan relevantes en el marco contextual de crisis que atraviesa la implementación de los acuerdos de paz alcanzados en La Habana. La polarización originada en todos los escenarios de la vida política y social del país como consecuencia del apoyo o rechazo al proceso de paz y sus mecanismos de implementación, ha puesto de manifiesto una profunda crisis de los consensos necesarios, ya no solo para la puesta en marcha de lo acordado en el proceso de paz, sino también de los fundamentos de cohesión que deben hacerse presentes en la elaboración de cualquier proyecto de construcción social amplio, incluyente y sostenible.Peace in crisis is an editorial project that closes a research program gation from years ago and in which different approaches are condensed on the peace; on this occasion, under the magnifying glass or notion of crisis. The contributions are found grouped in 4 volumes, 44 chapters and 6 thematic blocks where 87 authors offer multidisciplinary and multidimensional perspectives, meta plurality dology and variety in the ways of doing research and writing styles differentiated. The volumes, as a whole, present diverse reflections on the ancient, multiple and new conflicts (both armed and unarmed), as well as the different actors (inherited, emerging and transformed), on the stage of what has been referred to by some specialists as a situation of post-war agreement in Colombia. This first volume, entitled Notions, agreement and implementation (composed or thirteen chapters and an epilogue), analyzes the current situation of peace, democracy cia, security and the exercise of rights in Colombia, demonstrating that far from the aspirations of stabilization and progress contained in the agreements, it is a renewed and multimodal conflictivity that defines the national context. In This volume aims to debate conceptual notions and approaches to problems. particular themes, which are relevant in the contextual framework of crisis that is going through the implementation of the peace agreements reached in Havana. The polarization originating in all scenarios of the country's political and social life as a consequence of the support or rejection of the peace process and its mechanisms of implementation, has revealed a deep crisis of consensus necessary, not only for the implementation of what was agreed in the process of peace, but also of the foundations of cohesion that must be present in the development of any broad, inclusive and social construction project sustainable peace, but also of the foundations of cohesion that must be present in the development of any broad, inclusive and social construction project sustainable.Bogot

Delayed colorectal cancer care during covid-19 pandemic (decor-19). Global perspective from an international survey

Background The widespread nature of coronavirus disease 2019 (COVID-19) has been unprecedented. We sought to analyze its global impact with a survey on colorectal cancer (CRC) care during the pandemic. Methods The impact of COVID-19 on preoperative assessment, elective surgery, and postoperative management of CRC patients was explored by a 35-item survey, which was distributed worldwide to members of surgical societies with an interest in CRC care. Respondents were divided into two comparator groups: 1) ‘delay’ group: CRC care affected by the pandemic; 2) ‘no delay’ group: unaltered CRC practice. Results A total of 1,051 respondents from 84 countries completed the survey. No substantial differences in demographics were found between the ‘delay’ (745, 70.9%) and ‘no delay’ (306, 29.1%) groups. Suspension of multidisciplinary team meetings, staff members quarantined or relocated to COVID-19 units, units fully dedicated to COVID-19 care, personal protective equipment not readily available were factors significantly associated to delays in endoscopy, radiology, surgery, histopathology and prolonged chemoradiation therapy-to-surgery intervals. In the ‘delay’ group, 48.9% of respondents reported a change in the initial surgical plan and 26.3% reported a shift from elective to urgent operations. Recovery of CRC care was associated with the status of the outbreak. Practicing in COVID-free units, no change in operative slots and staff members not relocated to COVID-19 units were statistically associated with unaltered CRC care in the ‘no delay’ group, while the geographical distribution was not. Conclusions Global changes in diagnostic and therapeutic CRC practices were evident. Changes were associated with differences in health-care delivery systems, hospital’s preparedness, resources availability, and local COVID-19 prevalence rather than geographical factors. Strategic planning is required to optimize CRC care