On the Prevalence and Causes of Oncologist Burnout

Abstract

The author(s) indicated no potential conflicts of interest. REFERENCES 1. Moll AC, Dommering CJ, Bosscha MI, et al: Risk factors for the incidence of second cancers in survivors of retinoblastoma with a family history. J Clin Oncol 30:3028, 2012 2. Rushlow D, Piovesan B, Zhang K, et al: Detection of mosaic RB1 mutations in families with retinoblastoma. Hum Mutat 30:842-851, 2009 3. Sippel KC, Fraioli RE, Smith GD, et al: Frequency of somatic and germ-line mosaicism in retinoblastoma: Implications for genetic counseling. Am J Hum Genet 62:610-619, 1998 4. Kleinerman RA, Yu CL, Little MP, et al: Variation of second cancer risk by family history of retinoblastoma among long-term survivors. J Clin Oncol 30:950-957, 2012 Abbreviation: RR, relative risk. Correspondence www.jco.org

Physiologically-based pharmacokinetic and pharmacodynamic models for gemcitabine and birinapant in pancreatic cancer xenografts

“…The estimated hepatic intrinsic clearance was 105 ml/h, and accounting for the hepatic blood flow of 135 ml/h, the apparent clearance calculated from QH·CLintQH+CLint is about 60 ml/h. If converted to a 75 kg human using allometric scaling with a coefficient factor of 0.75, the estimated clearance would be about 24 L/h, which matches the reported value from human studies [28]. The estimated partition coefficients values ( K p ) for most tissues are large (10–200), except for brain (<2), consistent with the characteristic of extensive tissue distribution for this drug class.…”

“…Plasma and pancreatic tumor concentrations of birinapant were comparable, whereas gemcitabine concentrations were about 10-fold lower in tumors compared to plasma. In clinical trials, the plasma concentrations of birinapant attained were 100–1000 ng/ml [28], whereas gemcitabine plasma concentrations were found to exceed 10 μg/ml [32–34]. Therefore, the selected doses and the developed PK models have clinical relevance for drug exposures.…”

“…A clinical study found that gemcitabine increased the efflux rate of birinapant from fast-distribution tissues to plasma (parameter k 31 in a compartmental model) by 30%, possibly because of reduced OATP1B3-mediated tissue uptake [28]. The impact of gemcitabine on birinapant PK was considered as minor, and PK interactions were not considered here, because the final PK model structures for combined birinapant and gemcitabine were the same as for the single agents [28], and birinapant exhibited high concentrations in most tissues. Finally, the strategy here to translate the network model from in vitro to in vivo is empirical and specific to these two drugs.…”

Nuevas tendencias en psicología y salud: Teoría, Investigación y Práctica Profesional

“…Muchas son las causas que pueden llevar al médico a desarrollar el Síndrome de desgaste profesional (sdp), que van desde la carga horaria, carga asistencial, nuevas tecnologías, poca remuneración económica, falta de tiempo libre, problemas personales, familiares y con el grupo, poco apoyo institucional, etcétera. Pero también, las consecuencias del mismo pueden ser graves para el médico, el paciente y las instituciones, ya que se ha demostrado que existe una relación directa entre el sdp y la mala praxis, consumo de drogas y de antidepresivos por parte del personal sanitario; asimismo, disminución en el rendimiento laboral, deseos de abandono de la profesión e inclusive intentos suicidas, entre otros (Blanchar, Rodríguez, & Colombat 2012;Blanchar et al, 2010;Mark & Smith, 2012;Ramírez & Graham, 1996;Ramos, Tung, & Hallak, 2007;Shanafelt, 2013;Shanafelt et al, 2010;Shanafelt & Dyrbye, 2012;Shanafelt et al, 2013).…”

Only One Burnout Estimator Is Consistently Associated with Health Care Providers’ Perceptions of Job Demand and Resource Problems

“…The concern over which of the five estimators to use is important because the prevalence of "high" burnout depends on which estimator is used. Some investigators argue strongly that some of the five estimators overestimate the prevalence of "high" burnout (Blanchard, Rodrigues, & Colombat, 2012;Kleijweg et al, 2013). Others argue that restricting the estimator of "high" burnout to the occurrence of "Burnout Syndrome" alone (the joint prevalence of "high" emotional exhaustion and depersonalization and "low" sense of personal accomplishment) underestimates it (Campbell et al, 2011;Shanafelt, Dyrbye, & West, 2013).…”