¿Cuál es la actitud de los médicos hacia el actual modelo de atención primaria?

ObjetivoDeterminar cómo es la actitud de los médicos hacia el actual modelo de atención primaria de salud y estimar su relación con variables de tipo sociodemográfico y/o laboral.DiseñoEstudio multicéntrico, transversal.EmplazamientoCentros de salud del Área II de la Región de Murcia.ParticipantesTotalidad de médicos generales, de familia y pediatras de los centros de salud mencionados (54 en total).Mediciones principalesComo instrumento de evaluación se utiliza la «Escala de actitudes hacia los contenidos de atención primaria de salud», de Ballesteros et al. Esta escala proporciona una puntuación total, así como una puntuación específica para cada una de las 7 dimensiones que la componen.ResultadosEn general, la actitud de los médicos es favorable (4,1 puntos de media sobre 5). En la dimensión «Inclusión de los profesionales del segundo nivel en atención primaria» es donde hemos encontrado una actitud menos favorable, siendo los médicos de familia los que se muestran más de acuerdo. En cuanto a las demás variables asociadas, los profesionales que trabajan en centros periféricos y en situación de interinidad muestran una actitud más positiva hacia el actual modelo.ConclusionesEl conocimiento de las actitudes de los profesionales, así como de las variables relacionadas, puede servir de base para diseñar posibles estrategias de intervención dirigidas a la mejora de la calidad asistencial en atención primaria y para una evolución positiva de los profesionales que prestan sus servicios.ObjectivesTo determine the attitude of doctors towards the current model of primary care and to calculate its relationship with social and demographic and/or work variables.DesignMulti-centre cross-sectional study.SettingHealth centres in Area II of the Murcia region.ParticipantsAll general practitioners, family doctors and paediatricians in the health centres mentioned (54 in all).Main measurementsThe «Scale of attitudes towards the contents of primary health care» by Ballesteros et al. was used as the tool of evaluation. This scale provides both a total score and a specific score for each of its 7 dimensions.ResultsIn general, doctors´ attitudes were favourable (4.1 points average out of 5). We found a less favourable attitude in the dimension «Inclusion of second-level professionals in primary care», with family doctors most in agreement. The professionals working in centres on the periphery and those without tenure had a more positive attitude towards the current model, for the remaining variables.ConclusionsUnderstanding professionals´ attitudes and the variables related to them may serve as a basis for designing intervention strategies aimed at improving the quality of primary care and for the positive evolution of professionals working in PC

RELACIÓN ENTRE SOMNOLENCIA Y TURNOS DE TRABAJO EN UNA MUESTRA DE POLICÍA LOCAL.

Background: Excesive daytime sleepiness is a frequent in our socirty and a public health problem due to it association with work and traffic accidents. The aim of the present study is to evaluate the relationship between daytime somnolence, as measured by the ESS and shift-work in a sample of local policemen. Results: Our results show that policemen in permanent shift and morning shift present higher scores in daytime sleepiness. Besides, in this study 36,5% of the sample suffered a job accident, and in 9% of this sample, the accidents were associated to fatigue.Fundamento: La somnolencia diurna excesiva es un síntoma frecuente en nuestra sociedad y un importante problema de salud publica debido a su asociación con los accidentes laborales y de tráfico. El objetivo del presente estudio es establecer la relación entre somnolencia diurna medida con el ESS y los diferentes turnos de trabajo, en una muestra de policía local. Resultados: Indican que los agentes que se encuentran en el turno fijo y de mañana presentan mayores puntuaciones en somnolencia diurna. También se establece en este estudio que un 36,5% de la muestra padecieron un accidente laboral y que de ellos un 9% establecen que fueron debidos a la fatiga

The MLH1 c.1852_1853delinsGC (p.K618A) Variant in Colorectal Cancer:Genetic Association Study in 18,723 Individuals

Colorectal cancer is one of the most frequent neoplasms and an important cause of mortality in the developed world. Mendelian syndromes account for about 5% of the total burden of CRC, being Lynch syndrome and familial adenomatous polyposis the most common forms. Lynch syndrome tumors develop mainly as a consequence of defective DNA mismatch repair associated with germline mutations in MLH1, MSH2, MSH6 and PMS2. A significant proportion of variants identified by screening these genes correspond to missense or noncoding changes without a clear pathogenic consequence, and they are designated as "variants of uncertain significance", being the c.1852_1853delinsGC (p.K618A) variant in the MLH1 gene a clear example. The implication of this variant as a low-penetrance risk variant for CRC was assessed in the present study by performing a case-control study within a large cohort from the COGENT consortium-COST Action BM1206 including 18,723 individuals (8,055 colorectal cancer cases and 10,668 controls) and a case-only genotype-phenotype correlation with several clinical and pathological characteristics restricted to the Epicolon cohort. Our results showed no involvement of this variant as a low-penetrance variant for colorectal cancer genetic susceptibility and no association with any clinical and pathological characteristics including family history for this neoplasm or Lynch syndrome

Vertical and lateral workplace bullying in nursing: development of the hospital aggressive behaviour scale.

Healthcare staff is one of the professional groups that suffers the highest exposure to sources of occupational stress such as hostility from coworkers and superiors. In order to contribute to the assessment of bullying behaviors in the healthcare sector and to obtain a brief and manageable instrument for the assessment of this psychosocial risk, we developed the Hospital Aggressive Behaviour Scale-version Co-workers-Superiors (HABS-CS). By means of thorough qualitative analysis, an initial pool of 166 items was obtained, which were reviewed according to precise criteria until concluding with a total of 57 items, which were administered to a sample of 1,484 healthcare professionals from 11 public hospitals. The analyses concluded with the selection of 17 items distributed in two subscales. The internal 5-factor structure is the result of exploratory and confirmatory factor analysis conducted in two samples. Both the resulting questionnaire and the factors identified present adequate psychometric properties: high-internal consistency (Cronbach's α of .86) and adequate criterion validity, analyzed by means of significant correlations between the HABS-CS and job satisfaction, burnout components, and psychological well-being. This instrument may be of great utility for the assessment and prevention of psychosocial risks