Prevalence of Seasonal Influenza Vaccination in Chronic Obstructive Pulmonary Disease (COPD) Patients in the Balearic Islands (Spain) and Its Effect on COPD Exacerbations: A Population-Based Retrospective Cohort Study.

To determine the prevalence of influenza vaccination in chronic obstructive pulmonary disease (COPD) patients and its effect on COPD exacerbations, we conducted a retrospective population-based cohort study analyzing real-life data. We included all registered COPD patients ≥40 years old using respiratory medication during the study period (2012-2013). Influenza vaccination during the 2012/2013 campaign was the parameter studied. Moderate and severe exacerbations during 2013 were the dependent outcome variables. Logistic regression adjusting for age, gender, concomitant asthma diagnosis, COPD severity, smoking status, number of moderate and severe exacerbations the previous year, and comorbidities was performed, and 59.6% of the patients received seasonal influenza vaccination. The percentage of patients with exacerbations was higher among those vaccinated. Influenza vaccination had a statistically significantly negative (non-protective) crude effect favoring the risk of severe exacerbations: OR: 1.20 (95% CI; 1.05-1.37). This association diminished and lost statistical significance after adjustment: aOR: 0.93 (95% CI; 0.74-1.18). The protective effect in the analysis restricted to the epidemic period was not significant: aOR: 0.82 (95% CI; 0.58-1.16). We concluded that prevalence of influenza vaccination was suboptimal. In contrast with most of the available evidence, our results did not support a protective effect of influenza vaccination on the risk of admission for COPD exacerbation.

El arte de respirar: inspirando juntos / The Art of Breathing: Getting Inspiration

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Impact of Resistance Therapy on Motor Function in Children with Cerebral Palsy: A Systematic Review and Meta-Analysis.

Cerebral palsy is one of the main causes of disability in childhood. Resistance therapy shows benefits in increasing strength and gait in these patients, but its impact on motor function is not yet clear. The objective was to analyze the impact of resistance therapy on the improvement in the motor function using a review and meta-analysis. A comprehensive literature research was conducted in Medline (PubMed), Institute for Scientific Information (ISI) Web of Knowledge, and Physiotherapy Evidence Database (PEDro) in relation to clinical trials in which resistance therapy was used and motor function was assessed. Twelve controlled clinical trials and three non-controlled clinical trials (only one intervention arm) studies were identified. In terms of pre-post difference, the overall intra-group effect was in favor of resistance therapy intervention: standardized mean difference (SMD) = 0.37, 95% confidence interval (CI) = 0.21 to 0.52, p < 0.001 (random-effects model), with moderate heterogeneity (I2 = 59.82%). SMDs were also positive by restricting to each of the analyzed scales: SMD = 0.37, 1.33, 0.10, and 0.36 for Gross Motor Function Measure (GMFM), Lateral Step Up (LSU), Time Up and Go (TUG), and Mobility Questionnaire (MobQue) scales, respectively. Regarding the difference between groups, the results showed a high heterogeneity (I2 < 99%), with the mean difference (MD) also favorable for the GMFM scale: MD = 1.73, 95% CI = 0.81 to 2.64, p < 0.001 (random-effects model). Our results support a positive impact of resistance therapy on motor function. Further studies should delve into the clinical relevance of these results.

The impact of muscle relaxation techniques on the quality of life of cancer patients, as measured by the FACT-G questionnaire.

INTRODUCTION: Patients with cancer frequently suffer from emotional distress, characterized by psychological symptoms such as anxiety or depression. The presence of psychological symptoms combined with the complex nature of oncology processes can negatively impact patients' quality of life. We aimed to determine the impact of a relaxation protocol on improving quality of life in a sample of oncological patients treated in the Spanish National Public Health System. MATERIALS AND METHODS: We conducted a multicenter interventional study without a control group. In total, 272 patients with different oncologic pathologies and showing symptoms of anxiety were recruited from 10 Spanish public hospitals. The intervention comprised abbreviated progressive muscle relaxation training, according to Bernstein and Borkovec. This was followed by weekly telephone calls to each patient over a 1-month period. We collected sociodemographic variables related to the disease process, including information about mental health and the intervention. Patients' quality of life was assessed using the Functional Assessment of Cancer Therapy-General (FACT-G) questionnaire. Bivariate and univariate analyses were performed, along with an analysis of multiple correspondences to identify subgroups of patients with similar variations on the FACT-G. RESULTS: Patients showed statistically significant improvements on the FACT-G overall score (W = 16806; p<0.001), with an initial mean score of 55.33±10.42 and a final mean score of 64.49±7.70. We also found significant improvements for all subscales: emotional wellbeing (W = 13118; p<0.001), functional wellbeing (W = 16155.5; p<0.001), physical wellbeing (W = 8885.5; p<0.001), and social and family context (W = -1840; p = 0.037). CONCLUSIONS: Patients with cancer who learned and practiced abbreviated progressive muscle relaxation experienced improvement in their perceived quality of life as measured by the FACT-G. Our findings support a previous assumption that complementary techniques (including relaxation techniques) are effective in improving the quality of life of patients with cancer.

Validation of the Spanish Version of the ICECAP-O for Nursing Home Residents with Dementia.

BACKGROUND: Measurement of health-related quality of life (HRQoL) is important for a chronic disease, such as dementia, which impairs the quality of life of affected patients in addition to their length of life. This is important in the context of economic evaluations when interventions do not (only) affect HRQoL and these other factors also affect overall quality of life. OBJECTIVE: To validate the Spanish translation of the ICECAP-O's capability to measure Health-related quality of life in elderly with dementia who live in nursing homes. METHOD: Cross-sectional study. For 217 residents living in 8 Spanish nursing homes, questionnaires were completed by nursing professionals serving as proxy respondents. We analyzed the internal consistency and other psychometric properties. We investigated the convergent validity of the ICECAP-O with other HRQoL instruments, the EQ-5D extended with a cognitive dimension (EQ-5D+C), the Alzheimer's Disease Related Quality of Life (ADRQL) measures, and the Barthel Index measure of activities of daily living (ADL). RESULTS: The ICECAP-O presents satisfactory internal consistency (alpha 0.820). The factorial analysis indicated a structure of five principal dimensions that explain 66.57% of the total variance. Convergent validity between the ICECAP-O, EQ-5D+C, ADRQL, and Barthel Index scores was moderate to good (with correlations of 0.62, 0.61, and 0.68, respectively), but differed between dimensions of the instruments. Discriminant validity was confirmed by finding differences in ICECAP-O scores between subgroups based on ADL scores (0.70 low, 0.59 medium, and 0.39 high level care), dementia severity (0.72 mild, 0.63 medium, and 0.50 severe), and ages (0.59 below 75 years and 0.84 above 75 years). CONCLUSIONS: This study presented the first use of a Spanish version of the ICECAP-O. The results indicate that the ICECAP-O appears to be a reliable Health-related quality of life measurement instrument showing good convergent and discriminant validity for people with dementia.

Prevalencia de genotipos del virus del papiloma humano de alto riesgo no vacunables dentro del programa de Detección Precoz de Cáncer de Cérvix en Cantabria / Prevalence of non-vaccinable high risk genotypes of human papillomavirus in the Early Detection of Cervical Cancer Program in Cantabria

OBJETIVO: Estimar la prevalencia de infección por genotipos del virus del papiloma humano (VPH) de alto riesgo no vacunables. DISEÑO: Estudio descriptivo transversal. Emplazamiento: Siete centros de salud de Cantabria seleccionados aleatoriamente. PARTICIPANTES: Se incluyó a todas las mujeres con una citología vaginal valorable (n = 3.359) entre 2010-2011. MEDICIONES PRINCIPALES: Se recogieron diagnóstico citológico, resultado de PCR y método anticonceptivo. Los resultados de las citologías se clasificaron con el sistema Bethesda. Para la tipificación de VPH según el riesgo oncogénico se utilizó la clasificación de Muñoz et al. Se estimaron proporciones y odds ratio (OR) con sus correspondientes intervalos de confianza al 95% (IC95%). RESULTADOS: La prevalencia de infección por VPH fue del 2,71% (IC95%: 2,15-3,27). La prevalencia de genotipos de VPH de alto riesgo oncogénico fue del 2,26%; (IC95%: 1,75-2,78). El genotipo más frecuente fue el 16 (28,89%). Más de la mitad de las mujeres fueron positivas para algún genotipo de alto riesgo no vacunable: 51 (18,89%) o 58 (13,33%) o 68 (12,22%) o 31 (11,11%). En el 23,33% de las mujeres coexistieron al menos 2 genotipos de alto riesgo no vacunables. Las mujeres más jóvenes (≤ 30 años) tuvieron 2 veces más riesgo de infección por cualquier VPH: OR 2,01; (IC95%: 1,02-3,96); y 2 veces más probabilidad de usar anticonceptivos hormonales frente al preservativo: OR 2,09; (IC95%: 1,64-2,67). CONCLUSIONES: Atendiendo al alto porcentaje de VPH de alto riesgo oncogénico no vacunable, habría que replantear la estrategia de prevención en la población, que podría tener una falsa sensación de protección

OBJECTIVE: To assess the persistence of treatment with monthly risedronate and know the reasons of persistence and nontherapeutic persistence and the profile of the non-persistent patients. Desing: Observational, postmarketin and prospective study. LOCATION: Primary care, traumatology, rheumatology, gynecology and geriatrics of Catalonia. PARTICIPANTS: Women with osteoporosis treated with monthly risedronate that previously had abandoned weekly bisphosphonate therapy. MAIN MEASUREMENTS: Percentage of patients on persistent monthly risedronate year of their prescription, reasons for persistent and non persistent and profile of non persistent patients in relation to biodemographic data, clinical data and risk factors for fracture. RESULTS: 289 evaluable patients with a mean age of 68.3. At 12 months of initiation with monthly risedronate, 58.1% of patients remained on treatment. Most frequent reasons for leaving: fear of having side effects and belief that the disease is typical of the age. Reasons remarkable persistence: comfort/ease and dosage. Significant differences were observed between persistent and non-persistent patients relative to: employment status, number of concomitant therapy and height; however the results of possible associated factors must be contextualized within the study characteristics and the difference in size does not seem clinically relevant. CONCLUSIONS: The administration of therapeutic patterns more comfortable as monthly risedronate in osteoporosis, could facilitate persistence in patients improving the effectiveness of the drug. However in that persistence can also influence biodemographic and clinical variables and diverse of various kinds

[Prevalence of non-vaccinable high risk genotypes of human papillomavirus in the Early Detection of Cervical Cancer Program in Cantabria]. / Prevalencia de genotipos del virus del papiloma humano de alto riesgo no vacunables dentro del programa de Detección Precoz de Cáncer de Cérvix en Cantabria.

OBJECTIVE: To estimate the prevalence of infection with non-vaccinable high risk genotypes of human papillomavirus (HPV). DESIGN: Cross-sectional study. LOCATION: Seven randomly selected health centres in Cantabria (Northern Spain). PARTICIPANTS: All women with an evaluable vaginal smear (n=3,359) between 2010 and 2011. MAIN MEASURES: The variables collected were cytological diagnosis, PCR results, and family planning method. The vaginal smear results were classified with the Bethesda system. The classification by Muñoz et al. was used for typing as oncogenic risk HPV. Proportions and odds ratio (OR) were estimated with corresponding confidence intervals at 95% (95% CI). RESULTS: The prevalence of HPV infection was 2.71% (95% CI: 2.15 to 3.27). The prevalence of high oncogenic risk HPV genotypes was 2.26%; (95% CI: 1.75 to 2.78). The most frequent genotype was 16 (28.89%). More than half of the women were positive for one of the non-vaccinable high risk genotypes: 51 (18.89%) and 58 (13.33%) and 68 (12.22%) or 31 (11.11%). At least two non-vaccinable high-risk genotypes co-existed in 23.33% of women. Younger women (≤30 years) had twice the risk of any HPV infection: OR 2.01 (95% CI: 1.02 to 3.96); and were twice as likely to use condoms compared to hormonal contraceptives, OR 2.09 (95% CI: 1.64 to 2.67). CONCLUSIONS: According to the high percentage of non-vaccinable high oncogenic risk HPV types, there should be a re-think of the prevention strategy in the population, who may have a false sense of protection.

Satisfacción Laboral y Apoyo Social en trabajadores de un hospital de tercer nivel / Job satisfaction and perceived social support among workers from a tertiary hospital

OBJETIVO: Realizar una evaluación del grado de satisfacción laboral y de apoyo social percibido en profesionales del Hospital Universitario Marqués de Valdecilla (HUMV). Trabajadores y método: Estudio transversal, descriptivo y analítico, en respondedores a un cuestionario con variables sociodemográficas, de la escala de satisfacción laboral de Warr, Cook y Wall (1979), y de la escala de valoración del apoyo social percibido de House y Wells (1978), ambas validadas por el INSHT. El cuestionario se puso a disposición de todos los profesionales, la respuesta fue voluntaria y se preservó el anonimato. RESULTADOS: Respondieron 676 trabajadores, 14,6% de la plantilla. La satisfacción general percibida fue en grado neutro. Se encontró diferencia por ámbito laboral (p = 0,005), edad (p = 0,01) y estado civil (p = 0,01). Los factores mejor apreciados fueron la relación con compañeros, supervisor directo, responsabilidad asignada, variedad de tareas, estabilidad en el empleo y horario. Especialmente insatisfactorias resultaron salario, atención a sugerencias, posibilidades de promoción y modo de gestión de la organización. Se observó mayor satisfacción con la tarea a realizar en facultativos, DUE y técnicos de laboratorio (TL), y menor en auxiliares de enfermería y celadores (p < 0,00005). Por edad fue menor en el grupo de 31-40 años (p = 0,05). Las satisfacción con las condiciones en que desarrollan su tarea fue asimismo mayor en facultativos, DUE y TL que en auxiliares de enfermería y celadores (p < 0,00005); y por ámbito laboral mayor en consultas, plantas y bloque quirúrgico que en servicios centrales, UCIs y Urgencias (p = 0,004). La satisfacción con las personas de la organización se asoció al ámbito laboral (p < 0,00005), profesión (p = 0,001) y edad (p = 0,005). El apoyo instrumental en el trabajo se correlacionó con la satisfacción con el superior jerárquico (r=0,77; p < 0,00005) y con las relaciones con la Dirección (r=0,70; p < 0,00005). El sanitario percibió mayor apoyo instrumental que el no sanitario (p = 0,01) y por lugar de trabajo fue menor la percepción en servicios centrales (p < 0,00005). El apoyo emocional en el trabajo mostró fuerte correlación con la satisfacción con el superior jerárquico (r=0,75; p < 0,00005) y relaciones con la Dirección (r=0,69; p < 0,00005). De segundo orden fue la correlación con la satisfacción con compañeros, el reconocimiento y el uso de la capacidad profesional. Se observó fuerte correlación entre la satisfacción con las condiciones de trabajo y la satisfacción con la tarea realizada (r=0,84; p < 0,00005). Así mismo, se encontró fuerte correlación entre la satisfacción general, con la tarea, con las condiciones de trabajo, con las personas y con el apoyo emocional e instrumental en el trabajo. El análisis multivariante mostró una relación independiente entre la satisfacción laboral general y el apoyo en el trabajo emocional (p = 0,0001; OR: 1,16-1,61) e instrumental (p = 0,0018, OR: 1,15-1,97). CONCLUSIONES: La satisfacción general es en promedio de grado neutro, si bien hay diferencia por ámbito laboral, edad y estado civil. Los tres factores mejor valorados fueron compañeros, responsabilidad asignada y estabilidad en el empleo. Los tres peores salario, atención a sugerencias y modo de gestión de la organización. El apoyo en el trabajo emocional e instrumental fueron las variables independientes asociadas al grado de satisfacción laboral. Deben potenciarse estos aspectos y mejorar los factores de satisfacción peor valorados

OBJECTIVE: To evaluate the perception of satisfaction and perceived social support in the workplace among staff of University Hospital Marqués de Valdecilla. Workers and methodology: Descriptive and analytical, cross-sectional study among responders who selfcompleted a questionnaire about sociodemographic variables, and about the items from the questionnaires specifically developed by Warr, Cook y Wall (1979) 'Job satisfaction: Overall Job Satisfaction Scale' and House y Wells (1978) 'Social support', both validated by the INHT. Questionnaire was available for all workers, the response was voluntary and anonymity was preserved. RESULTS: 676 workers completed the questionnaire, 14.6% out of the whole staff. Perceived overall Job Satisfaction was neutral. Statistically significant diffferences were found according to occupational area (p = 0.005), age (p = 0.01) and civil status (p = 0.01). The best valorated elements were the relationship with workmates, direct supervisor, assigned responsibility, taks variety, job security and timetable. Salary, feedback to suggestions, promotion possibilities, and the way of organization management were specially unsatisfactory. A higher satisfaction regarding tasks to perform was observed among doctors, nursery and laboratory staff; and a lower satifastion was observed among nursery assistants and porters (p < 0.00005). According to age, satisfaction was lower among 31-40 years old (p = 0.05). Regarding the work conditions in which such tasks are performed, a higher satisfaction was also observed among doctors, nursery and laboratory staff in contrast to nursery assistants and porters (p < 0.00005). In relation to work setting, satisfaction was higher in consulting rooms, hospitalization floors, and surgery area with respect to central offices, ICUs and Emergency (p = 0.004). Satisfaction with people at organization was associated to work setting (p < 0.00005), occupation (job tittle) (p = 0.001) and age (p = 0.005). Instrumental support at work showed a strong correlation in relation to satisfaction with the superior hierarchical level supervisor (r=0.77; p < 0.00005) and relationship with executive management (r=0.70; p < 0.00005). Healthcare staff perceived a higher instrumental support than Non-Healthcare staff (p = 0.01). Instrumental support was lower in central offices (p < 0.00005). Emotional support at work showed also a strong correlation in relation to satisfaction with the superior hierarchical level supervisor (r=0.75; p < 0.00005) and relationship with executive management (r=0.69; p < 0.00005). Less strong correlations were found in relation to satisfaction with workmates, recognition and use of proffessional capacitation. A strong correlation was observed between work conditions and satisfaction regarding tasks to perform (r=0.84; p < 0.00005). Likewise, strong correlations were found between overall Job Satisfaction, satisfaction regarding tasks to perform, work conditions, workmates, and emotional and instrumental support at work. Multivariable analysis showed an independent association between overall Job Satisfaction and emotional (p = 0.0001; OR: 1.16-1.61) and instrumental support (p = 0.0018, OR: 1.15-1.97). CONCLUSIONS: Overall Job Satisfaction was on average neutral, but there were differences according to occupational area, age and civil status. The three best valorated elements were relationship with workmates, assigned responsibility, and job security. The three worse valorated ones were salary, feedback to suggestions, and the way of organization management. Intrumental and emotional support were independent variables associated with job satisfaction. These aspects must be strengthened whereas worse valorated elements must be improved

Exposiciones laborales y riesgo de cáncer esofágico según tipos histológicos: un estudio de casos y controles en el este de España / Occupational exposures and risk of oesophageal cancer by histological type: A case-control study in eastern Spain

Objetivo. Explorar la relación entre ocupaciones y exposiciones laborales específi cas y cáncer esofágico según tipos histológicos.Métodos. Se llevó a cabo un estudio de casos y controles hospitalario multicéntrico en dos provincias del área mediterránea de España. Serecogió información laboral, sociodemográfi ca y sobre estilos de vida en 185 hombres pacientes recién diagnosticados de cáncer esofágico (147casos de células escamosas, 38 adenocarcinomas) y en 285 controles apareados por frecuencia. Se codifi có la ocupación según la Clasifi caciónNacional de Ocupaciones de 1994 (CNO-94). Se valoró la exposición laboral a una selección de agentes carcinogénicos utilizando la matrizempleo-exposición FINJEM. Se calcularon las odds ratios mediante modelos de regresión logística no condicional ajustando por edad, educacióny consumo de alcohol y tabaco.Resultados. Para la variedad de células escamosas, se encontraron asociaciones estadísticamente signifi cativas en camareros (OR 8,18,95%IC 1,98-33,75) y mineros, dinamiteros, picapedreros y tallistas (OR 10,78, 95%IC 1,24-93,7) en relación con otras ocupaciones. Para lavariedad de adenocarcinoma, se encontraron asociaciones estadísticamente signifi cativas en carpinteros (OR 9,69), producción animal y trabajadoresrelacionados (OR 5,61) y electricistas de construcción y relacionados (OR 8,26), aunque estas observaciones se basaban en un númerolimitado de casos. En cuanto a exposiciones específi cas, en el estudio se encontraron aumentos del riesgo signifi cativos para carcinomade células escamosas en relación con la exposición a radiaciones ionizantes, y para el adenocarcinoma para la exposición elevada a compuestossulfurosos volátiles (OR 3,12) y plomo (OR 5,30). Para todos los tipos histológicos de cancer esofágico, se encontró un riesgo signifi cativoy tres veces mayor en los expuestos a amianto, con tendencia estadísticamente signifi cativa (OR 3,46, 95% CI 0,99-12,10)(AU)

Conclusiones. Los datos sugieren que algunas exposiciones laborales pueden aumentar específi camente el riesgo de cáncer esofágico de célulasescamosas o adenocarcinoma, mientras que otras exposiciones como el amianto pueden aumentar el riesgo general de cáncer esofágico(AU)

Objective. To explore the relationship between occupations and specifi c occupational exposures and oesophageal cancer (OC) by histologicaltype.Methods. A multicentre hospital-based case–control study was conducted in two Mediterranean provinces of Spain. Occupational, sociodemographicand lifestyle information was collected from 185 newly diagnosed male oesophageal cancer patients (147 squamous cell, 38 adenocarcinoma)and 285 frequency matched controls. Occupation was coded according to the Spanish National Classifi cation of Occupations1994. Occupational exposure to a selection of carcinogenic substances was assessed by the FINJEM job exposure matrix. Odds ratios were calculatedby unconditional logistic regression adjusting for age, education, alcohol intake and cigarette smoking.Results. For the squamous cell variety, statistically signifi cant associations were found for waiters and bartenders (OR 8.18, 95% CI 1.98to 33.75) and miners, shotfi rers, stone cutters and carvers (OR 10.78, 95% CI 1.24 to 93.7) in relation to other occupations. For the adenocarcinomavariety, statistically signifi cant associations were observed for carpenters and joiners (OR 9.69), animal producers and related workers(OR 5.61) and building and related electricians (OR 8.26), although these observations were based on a low number of cases. Regardingspecifi c exposures, the study found a statistically signifi cant increased risk of squamous cell carcinoma for ionising radiation, and of adenocarcinomafor high exposure to volatile sulphur compounds (OR 3.12) and lead (OR 5.30). For all histological types of OC combined, a threefoldincrease in risk was found with a signifi cant trend for asbestos exposure (OR 3.46, 95% CI 0.99 to 12.10)(AU)

Conclusions. The data suggest that some occupational exposures may specifi cally increase the risk of oesophageal squamous cell carcinomaor adenocarcinoma, while other exposures such as asbestos may increase the overall risk of OC(AU)

[Perception of primary health care medical staff of their functions, and training and knowledge in occupational health]. / Percepción del personal médico de atención primaria de salud acerca de sus funciones, formación y conocimientos en materia de salud laboral.

OBJECTIVES: To evaluate the perception of primary health care medical staff (PHCMS) have on their functions in occupational risk prevention (ORP), as well as their knowledge and skills on the subject of occupational health (OH). DESIGN: Descriptive cross-sectional study. SETTING: Health Department 20 of Alicante province, Spain. PARTICIPANTS: All PHCMS (N=104), with a participation of 80% (N=83). PRIMARY MEASUREMENTS: The participants self-completed a questionnaire specifically developed for the study. Sixteen questions were established and covered functions in ORP and skills for developing them, as well as the amount and usefulness of training received on the subject of OH. RESULTS: The PHCMS did not perceive that they had functions as regards ORP (median [Me], 2; interquartile range [IR], 1-3). To a greater extent they considered themselves capable of identifying whether an illness seen in their clinic was of work origin or not (Me, 3; IR, 3-4). Training in OH as a medical student and in their medical internship (MIR) was identified as of minor importance (55.4% and 60%, respectively, of those surveyed scored a value of 1 in the questionnaire). The PHCMS obviously considered that better training in OH would help them in their daily professional activity. High scores were obtained for this (response options greater than or equal to 4) in more than 70% of the interviewees. CONCLUSIONS: Training in OH must be encouraged so that PHCMS are seen to be health personnel with functions in ORP and are able to acquire the necessary knowledge and skills in OH for their routine medical practice.

Percepción del personal médico de atención primaria de salud acerca de sus funciones, formación y conocimientos en materia de salud laboral / Perception of primary health care medical staff of their functions, and training and knowledge in occupational health

Objetivos. Evaluar la percepción que el profesional médico de atención primaria de salud (PMAPS) tiene sobre sus funciones en prevención de riesgos laborales (PRL), así como sus conocimientos y habilidades en materia de salud laboral (SL). Diseño. Estudio descriptivo, transversal. Emplazamiento. Departamento de Salud 20 de la provincia de Alicante. Participantes. Todos los PMAPS (n = 104), con una participación del 80% (n = 83). Mediciones principales. Los participantes autocumplimentaron un cuestionario específicamente desarrollado para el estudio. Se establecieron 16 cuestiones que abarcaban funciones en PRL y capacitación para desarrollarlas, así como cantidad y utilidad de formación recibidas en materia de SL. Resultados. El PMAPS no percibe que tenga funciones en materia de PRL (mediana [Me], 2; rango intercuartílico [RI], 1-3). En mayor medida se consideró capacitado para identificar el origen laboral o no de una enfermedad atendida en su consulta (Me, 3; RI, 3-4). La formación en SL durante la licenciatura de medicina junto con la vía MIR se han identificado como las de menor cuantía (el 55,4 y el 60% de los entrevistados puntuaron en el valor 1 del cuestionario). EL PMAPS claramente ha considerado que una mayor formación en SL le ayudaría en su actividad diaria profesional; se obtuvieron puntuaciones de tipo alto (opciones de respuesta mayores o iguales a 4) en más del 70% de los entrevistados. Conclusiones. Es necesario que se fomente la formación en SL para que el PMAPS se sienta parte integrante del personal sanitario con funciones en PRL y pueda adquirir los conocimientos y habilidades necesarios en materia de SL para su práctica médica habitual

Objectives. To evaluate the perception of primary health care medical staff (PHCMS) have on their functions in occupational risk prevention (ORP), as well as their knowledge and skills on the subject of occupational health (OH). Design. Descriptive cross-sectional study. Setting. Health Department 20 of Alicante province, Spain. Participants. All PHCMS (N=104), with a participation of 80% (N=83). Primary Measurements. The participants self-completed a questionnaire specifically developed for the study. Sixteen questions were established and covered functions in ORP and skills for developing them, as well as the amount and usefulness of training received on the subject of OH. Results. The PHCMS did not perceive that they had functions as regards ORP (median [Me], 2; interquartile range [IR], 1-3). To a greater extent they considered themselves capable of identifying whether an illness seen in their clinic was of work origin or not (Me, 3; IR, 3-4). Training in OH as a medical student and in their medical internship (MIR) was identified as of minor importance (55.4% and 60%, respectively, of those surveyed scored a value of 1 in the questionnaire). The PHCMS obviously considered that better training in OH would help them in their daily professional activity. High scores were obtained for this (response options greater than or equal to 4) in more than 70% of the interviewees. Conclusions. Training in OH must be encouraged so that PHCMS are seen to be health personnel with functions in ORP and are able to acquire the necessary knowledge and skills in OH for their routine medical practice