Laryngotracheal Recurrent Papillomatosis: A Case Study and Survey of Surgical and Systemic Management.

This case report presents a 72-year-old man with longstanding recurrent respiratory papillomatosis (RRP). He has undergone multiple procedures for the condition, including an apparent urgent surgical airway followed by tracheoplasty repair. Modern management of complicated RRP should include both local debulking and systemic approaches. Systemic bevacizumab (Avastin) has shown some initial success as an effective treatment option, in addition to other medications such as pembrolizumab. Other future care strategies may include an HPV vaccination and other adjuvants; vaccination has been reported to have the possibility of drastically reducing the incidence of RRP.

Frecuencia de consultas al médico en población adulta en España, antes y después de la restricción de acceso a los inmigrantes indocumentados / Frequency of medical consultations in the adult population in Spain, before and after the restriction of access to undocumented immigrants

OBJETIVO: Estudiar la frecuencia de consultas médicas en las poblaciones autóctona e inmigrante en España, antes y después de una medida del Gobierno del 2012 que restringió el uso de servicios sanitarios públicos a los inmigrantes indocumentados. MATERIAL Y MÉTODOS: Los datos proceden de las Encuestas Europeas de Salud en España de 2009 y 2014. Se han analizado las consultas al médico de familia y al especialista en autóctonos e inmigrantes de 18 a 64 años. Se calcularon los incrementos porcentuales en la frecuencia de personas que consultaron en 2014 respecto a 2009 y, en cada año, la razón de porcentaje (RP) de consultas en inmigrantes frente autóctonos, con intervalos de confianza del 95% (IC del 95%). RESULTADOS: La frecuencia de consultas se incrementó en 2014 respecto a 2009, a excepción de la consulta al médico de familia en mujeres autóctonas. Los incrementos más altos se produjeron en las consultas al médico especialista en inmigrantes (39,9%) y en autóctonos (21,6%), y en las consultas al médico de familia en mujeres inmigrantes. Tras ajustar por edad y variables socioeconómicas e indicadoras de necesidad de asistencia, en ambos años no se observaron diferencias significativas entre inmigrantes y autóctonos en los 2 tipos consultas. CONCLUSIONES: En España no se redujo la frecuencia de consultas médicas al médico de familia ni al especialista entre 2009 y 2014 en la población inmigrante

OBJECTIVE: To study the frequency of medical consultations in autochthonous and immigrant populations in Spain, before and after a government measure of 2012 that restricted the use of public health services to undocumented immigrants. MATERIAL AND METHODS: The data were taken from the European Health Surveys in Spain in 2009 and 2014. An analysis was made of the consultations with the family doctor and the consultations with the medical specialist in autochthonous and immigrant populations from 18 to 64 years. Percentage increases were calculated in the frequency of people who consulted in 2014 with respect to 2009, and, in each year, the percentage ratio (PR) of consultation in immigrants with respect autochthonous, with 95% confidence intervals (95% CI). RESULTS: The frequency of consultations increased in 2014 compared to 2009, with the exception of family doctor's consultation with the autochthonous women. The highest increases occurred in visits to medical specialists in immigrants (39.9%), in autochthonous (21.6%), and in visits by the family doctor to immigrant women. After adjusting for age and socioeconomic variables and indicators of need for assistance, there were no significant differences in both years between immigrants and autochthonous in the 2 types of consultations. CONCLUSIONS: The frequency of consultations to the family doctor or medical specialist did not decrease in Spain between 2009 and 2014 in the immigrant population

[Frequency of medical consultations in the adult population in Spain, before and after the restriction of access to undocumented immigrants]. / Frecuencia de consultas al médico en población adulta en España, antes y después de la restricción de acceso a los inmigrantes indocumentados.

OBJECTIVE: To study the frequency of medical consultations in autochthonous and immigrant populations in Spain, before and after a government measure of 2012 that restricted the use of public health services to undocumented immigrants. MATERIAL AND METHODS: The data were taken from the European Health Surveys in Spain in 2009 and 2014. An analysis was made of the consultations with the family doctor and the consultations with the medical specialist in autochthonous and immigrant populations from 18 to 64 years. Percentage increases were calculated in the frequency of people who consulted in 2014 with respect to 2009, and, in each year, the percentage ratio (PR) of consultation in immigrants with respect autochthonous, with 95% confidence intervals (95% CI). RESULTS: The frequency of consultations increased in 2014 compared to 2009, with the exception of family doctor's consultation with the autochthonous women. The highest increases occurred in visits to medical specialists in immigrants (39.9%), in autochthonous (21.6%), and in visits by the family doctor to immigrant women. After adjusting for age and socioeconomic variables and indicators of need for assistance, there were no significant differences in both years between immigrants and autochthonous in the 2types of consultations. CONCLUSIONS: The frequency of consultations to the family doctor or medical specialist did not decrease in Spain between 2009 and 2014 in the immigrant population.

Assessing the influence of working hours on general health by migrant status and family structure: the case of Ecuadorian-, Colombian-, and Spanish-born workers in Spain.

OBJECTIVES: The purpose of this study was to analyze the relationship between working hours (WHs) and the likelihood of poor self-reported general health (SRGH) in the first data wave from a cohort of immigrant and native workers in Spain. STUDY DESIGN: Cross-sectional analyses from a prospective cohort study. METHODS: Data were drawn from the first wave of the Platform of Longitudinal Studies on Immigrant Families. The selected sample was composed of 217 immigrant workers and 89 native-born workers. We explored differences by immigrant status and family structure, assessing prevalences and Poisson regression models; an additional analysis explored statistically optimized work hour cut points. RESULTS: Highest prevalence of poor SRGH (72.7%) was reported by immigrant, single-parent workers working >40 WH/week. Immigrant single-parent families were more likely to report poor SRGH for three WH categories: ≤20 WH/week (prevalence ratio [PR] = 3.3, 95% confidence interval [CI] 1.6-7.2), >30-≤40 WH/week (PR = 2.8, 95% CI 1.3-6.4), and >40 WH/week (PR = 4.2, 95% CI 1.8-10.1). In two-parent families, immigrants working standard hours (i.e. >30-≤40) and native-born workers in the highest and lowest categories of WHs (i.e. ≤20 and >40) had similar PRs for poor SRGH compared with native-born workers working standard hours. Findings suggested that native-born workers residing in two-parent families were able to work more than 10 h longer per week than immigrant workers before reporting equivalent prevalences of poor SRGH. CONCLUSIONS: Differences in the association of WHs and poor SRGH among immigrants in Spain seem to be explained by family structure, which suggests that the influence of WHs on health differentially affects vulnerable groups, such as immigrant workers residing in single-parent families.

Work ability, psychosocial hazards and work experience in prison environments.

BACKGROUND: Work ability is predicted by age- and work-related psychosocial hazards; however, its association with work experience has not been studied. Work ability has not been studied in prison environments as well. AIMS: To describe work ability and its associates among prison workers. METHODS: A cross-sectional study was carried out in two prisons in Spain, one large and one medium prison, randomly selected from 17 in total. Prison workers were randomly administered a voluntary anonymous questionnaire to measure work ability [Work Ability Index (WAI)], work-related psychosocial hazards (Spanish version of COPSOQ), sociodemographic, lifestyle and work-related variables. RESULTS: Four hundred and forty-one workers (54%) participated. Results confirmed that older and more experienced workers (analysis of variance analysis) and workers in large prisons (t-student) presented significantly lower WAI scores. Quantitative and emotional demands, family work conflict, low work control, low autonomy, low social support from colleagues and stress had negative significant associations with WAI. Age, which highly correlated with work experience (Spearman's r = 0.85), had significant association with WAI (beta = -0.62). In the stepwise linear regression, the association between age and WAI lost statistical significance after controlling for work experience, which maintained significant correlation with WAI (beta = -0.37). CONCLUSIONS: The apparent association between age and WAI was confounded by work experience. Interventions to improve work ability among prison workers may benefit from results of this study to focus their efforts on the risk groups in such a psychologically demanding work environment rarely examined in previous research.

Heterogeneous trend in smoking prevalence by sex and age group following the implementation of a national smoke-free law.

OBJECTIVE: Given the limited evidence available about the effects of clean indoor air laws on smoking behaviour in the general population, the impact of national smoke-free workplace, bar and restaurant legislation, implemented on 1 January 2006, on smoking prevalence in Spain was assessed in this study. METHODS: Population-based trend analysis using estimates for 27 periods from the beginning of 2000 to the end of 2008-three periods per year. To calculate the period per cent change in smoking prevalence, the permutation test for joinpoint regression to detect significant changes was used. RESULTS: In men and women aged 15-24 years, the prevalence of smoking declined between the first period in 2000 and the third period in 2008, whereas in women aged 45-64 years, it increased by 1.7% per period. A declining trend was detected up to the first period in 2006 in men and women aged 25-44 years and in men aged 45-64 years, but between the beginning of 2006 and the end of 2008 the prevalence of smoking increased by 1.2%, 0.7% and 2.0% per period in men aged 25-44 years, in women aged 25-44 years and in men aged 45-64 years, respectively. CONCLUSIONS: 3 years after a national smoke-free law was implemented, the trend in smoking prevalence in some population groups was unchanged; however, in others, the declining trend of previous years was reversed. The similarity of these findings to those observed in other countries suggests that clean indoor air laws, although effective in reducing exposure to second-hand smoke, may not achieve the secondary objective of reducing the prevalence of smoking in the population.

Segmental hemangiomas of the upper airway.

OBJECTIVES/HYPOTHESIS: To characterize the anatomic distribution of segmental hemangiomas of the larynx and to describe indications for treatment modalities. STUDY DESIGN: Retrospective chart review. METHODS: We performed a retrospective chart review of patients with cutaneous hemangiomas at a tertiary care center over a 4-year period. Only patients with upper airway hemangiomas were studied. We reviewed the anatomic distribution of hemangiomas within the upper airway and the treatment course of each patient. RESULTS: Of 1,226 patients with cutaneous hemangiomas, 108 (9%) were segmental in distribution. There were 56 patients (52%) who had a V3 distribution pattern, and 16 patients (29%) with upper airway involvement. All of these patients had associated V3 or mandibular segmental hemangiomas. As with the cutaneous manifestation, the distribution of hemangioma within the upper airway was segmental. This included the following anatomic sites: oral cavity, oropharynx, hypopharynx, intrinsic structures of the larynx, and subglottis. Many of these patients had diffuse mucosal involvement, including tracheal involvement. A total of 13 out of 16 patients underwent medical intervention, and seven also required surgical intervention. Medical management included systemic (12 patients) and intralesional (two patients) steroids. One patient received chemotherapy prior to referral. Surgical treatment included tracheostomy (four patients prior to referral) and laser ablation of subglottic involvement (total of four patients). CONCLUSIONS: A high percentage of patients with V3 cutaneous hemangiomas (29%) will manifest with upper airway involvement, the distribution of which is segmental. Treatment should take this diffuse pattern of involvement into consideration.

Staged surgical management of hypopharyngeal traction diverticulum.

A 50-year-old woman who had undergone cervical spine fixation 6 years earlier presented with dysphagia, regurgitation of undigested food, halitosis, and weight loss. Operative examination demonstrated a hypopharyngeal diverticulum with spinal hardware visible in a defect in the mucosa. She underwent an open cervical approach to removal of the hardware. Endoscopic staple diverticulotomy as described by Scher and Richtsmeier was performed 8 weeks later in the ambulatory surgical setting. After a period of enteral feeding via a nasogastric tube in the initial postoperative period, she was able to resume oral nutrition in the interim between the surgical procedures. After the second procedure, she was able to resume a normal diet immediately and she experienced minimal symptoms. It is established that traction diverticulum is appropriately treated by removing the inciting anatomic factor(s). We propose that staged surgical management begin with the removal of the nidus followed by marsupialization of the diverticulum pouch. Standard staple diverticulotomy is a viable option for the second stage. This technique allows the patient to minimize the length of, or avoid, the second hospitalization for diverticulum management.

Impact of cumulative area-based adverse socioeconomic environment on body mass index and overweight.

OBJECTIVE: Although the relationship between area socioeconomic environment and obesity is known, previous research has measured area socioeconomic environment at only one point in time. This study evaluates the relationship of cumulative area-based adverse socioeconomic environment with body mass index (BMI) and overweight. DESIGN: Cross-sectional study. SETTING: Spain. PARTICIPANTS: 17 917 subjects in 2001. MAIN OUTCOME MEASURE: Information from 1980, 1990 and 2000 was used for the percentage of the population with low educational achievement, gross domestic product per capita (GDPpc), and Gini coefficient to estimate BMI and prevalence of overweight by the number of times each province had an adverse exposure to each of these measures of socioeconomic environment. RESULTS: After adjusting for individual variables and sports facilities in the area, the difference in BMI in residents of provinces with the highest percentage of population with low educational achievement in 1980, 1990 and 2000, compared with residents of provinces with no history of adverse socioeconomic environment based on this indicator, was 0.61 kg/m(2), whereas the prevalence of overweight was 1.46 times higher. Similar results were obtained for residents of provinces with cumulative low GDPpc versus residents of provinces that had never had low GDPpc. Neither BMI nor overweight were associated with cumulative income inequality based on the Gini coefficient. CONCLUSION: Cumulative adverse socioeconomic environment based on indicators of educational level or wealth, but not of income inequality, is positively associated with BMI and overweight. This association is not explained by individual characteristics or by the availability of sports facilities.

Conocimientos y actitudes del personal de odontología sobre los riesgos biológicos por exposición laboral / Knowledge and attitudes of dental health-care personnel regarding occupational exposure to biohazards

Objetivo: Revisar los conocimientos y actitudes del personal de odontología sobre los riesgos biológicos por exposición laboral. Métodos: Se realizó una búsqueda bibliográfica utilizando las bases de datos MEDLINE, y CINHAL desde 1996 hasta el 2004 y cuyos criterios de inclusión fueron: Abstract disponibles. Idioma inglés / castellano. Revista disponible (on-line, bibliotecas, solicitud a los autores). Resultados: Diferentes estudios afirman que, aunque el riesgo por exposición laboral de adquirir los Virus de Inmunodeficiencia Human (VIH), Virus de la hepatitis B (VHB) o el Virus de la Hepatitis C (VHC) en la práctica odontológica es relativamente bajo, es una importante causa de preocupación para el personal odontológico, al no existir una vacuna contra el VIH y el VHC. También muestran que estos profesionales consideran que el riesgo de ser infectado por VHB es significativamente más alto que el riesgo de ser infectado con VIH, aunque la mayoría no han sido inmunizados contra VHB, y que el uso de barreras de protección ha aumentado. No se encontraron estudios sobre los conocimientos y actitudes de los odontólogos hacia el VHC por exposición laboral y sobre los riesgos de exposición ocupacional a otros tipos de enfermedades infecciosas como la varicela, la rubéola, el sarampión y la parotiditis. Conclusiones: Aunque el personal de odontología conoce los aspectos básicos de los riesgos biológicos al que están expuestos en su práctica diaria, aún son muchos los profesionales que desconocen aspectos específicos de estos riesgos. Esta falta de conocimientos sobre las infecciones por exposición laboral y sus formas de transmisión, generan miedos y mitos en los propios profesionales, así como actitudes y comportamientos erróneos hacia los pacientes infectados por VIH y VHB

Objective: To review the knowledge and attitudes of dental health-care personnel about occupational exposure to biological hazards. Methods: A literature search was conducted using the MEDLINE and CINHAL databases from 1996 to 2004, using all available abstracts in Spanish and English, and all available journals (online, libraries, requests made to authors). Results: Different studies confirm that, although the occupational risk of acquiring HIV, hepatitis B virus (HBV) or hepatitis C virus (HCV) infections in dental practice is relatively low, it is an important cause of concern for dental health-care personnel, there being no vaccine against HIV and HCV. These professionals also consider that the risk of being infected by HBV is significantly higher than the risk of being infected with HIV, although the majority have not been immunized against HBV, and that the use of the protection barriers has increased. No studies were found on the knowledge and attitudes of dental personnel towards occupational HCV infection or towards risk of occupational exposures to other infectious diseases such as varicella, rubella, measles and mumps. Conclusions: Although dental health-care personnel are aware of basic aspects of biological hazards to which they are exposed in their daily work, there are still many professionals who do not know specific aspects regarding these risks. This lack of knowledge about occupationally-acquired infections and their forms of transmission generates fear and myths among these professionals, as well as erroneous attitudes and behaviours towards HIV and HBV-infected patients

Multipotential differentiation of adipose tissue-derived stem cells.

Tissue engineering offers considerable promise in the repair or replacement of diseased and/or damaged tissues. The cellular component of this regenerative approach will play a key role in bringing these tissue engineered constructs from the laboratory bench to the clinical bedside. However, the ideal source of cells still remains unclear and may differ depending upon the application. Current research for many applications is focused on the use of adult stem cells. The properties of adult stem cells that make them well-suited for regenerative medicine are (1) ease of harvest for autologous transplantation, (2) high proliferation rates for ex vivo expansion and (3) multilineage differentiation capacity. This review will highlight the use of adipose tissue as a reservoir of adult stem cells and draw conclusions based upon comparisons with bone marrow stromal cells.

Propuesta de adaptación de un programa de salud laboral al programa de convergencia europea en educación / Adaptationof an occupational health academic program to the program of european convergence in higher education

La Declaración de Bolonia establece el compromiso de coordinación de las políticas educativas para conseguir la creación de un espacio europeo en educación superior. Entre sus objetivos figura establecer un sistema único de créditos, ECTS (European Credit Transfer System) por parte de las universidades europeas. La salud laboral es una materia impartida en diferentes diplomaturas y licenciaturas que también se ve afectada por este proceso. El objetivo de este trabajo fue realizar una propuesta de adaptación de un programa de salud laboral de acuerdo con las directrices ECTS. Se presenta el programa de salud laboral en la Diplomatura de Relaciones Laborales de la Universidad de Alicante adaptado al crédito europeo

The Bologna Declaration establishes a commitment to coordinate educational policies in order to create a European area in higher education. Among its objectives is the establishment of a uniform system of academic credits, the ECTS (European Credit Transfer System) by European universities. Occupational health is a subject taught in different degree programs that is also affected by this process. The aim of this study was to present a proposal for the adaptation of an existing occupational health program in accordance with the ECTS guidelines. The Labour Relations Diploma Program at the University of Alicante, adapted to the ECTS, is discussed

La divulgación de la salud en las publicaciones españolas: una aproximación sobre el interés de la población / No disponible

Introducción: En los últimos años se observa un incremento del interés sobre temas de salud en la población general española. El objetivo de este trabajo es describir la evolución y disponibilidad de la oferta editorial española de obras divulgativas sobre salud como un indicador del interés de la población hacia estos temas. Método: Estudio descriptivo transversal de las publicaciones divulgativas impresas sobre salud, usando como fuente de información la base de datos Ariadna que recoge los fondos de la Biblioteca Nacional de España. Resultados: De las 6.340 obras, 3.278 (51,7%) fueron divulgativas. Las de origen comercial representan el 87,5% y el 12.5%, las institucionales. Los temas más frecuentes fueron: alimentación (22,6%), adelgazamiento (13,3%), educación sanitaria (11,3%) y sexual (11,3%).Conclusiones: Existe una gran oferta de obras incrementada en los últimos años a expensas de editoriales comerciales. La producción institucional ha centrado su oferta en drogadicción, sida y tabaco/alcohol. Existe una discrepancia entre lo demandado por la población, sobre temas relacionados con la calidad de vida, y lo ofertado por las instituciones que se centran en factores de riesgo

Introduction: In the last years seem to be an increasing interest in the topics related to health in the overall population. The objective of this study is to describe the evolution and availability of the Spanish editorial about publications related to health as an indicator of the interest of the population to these topics. Method: A descriptive transverse study of all the printed publications about health using Ariadna Data base -it contains all the bibliographic catalogs from the Spanish National Library. Results: Of the 6.340 books, 51.7% were divulgative. Those of commercial origin represent 87.5% and 12.5% the institutional ones. The more frequent topics were nutrition (22.6%), weight loss (13.3%), health education (11.3%) and sexual issues 11.3%). Conclusions: At present exits a great offer that has been increased over the last years. The institutional production has focussed their offer in drug addiction, AIDS and tobacco/alcohol. A discrepancy exists among what is demanded by the population, specially on topics related with the quality of life, and what is offered by the institutions about risks factors

Vigilancia médica específica en trabajadores de una fábrica de amianto-cemento: descripción de resultados / Targeted medical surveillance of workers in an asbestoscement factory: Results

Objective: To describe asbestos-related respiratory disease in an asbestos-cement factory. Method: The study population was made up of workers at an asbestos cement plant in Alicante (Spain). The sources of information consisted of environmental measurements and the occupational and medical records of evaluations conducted at the Safety and Hygiene Centre. Results: There were 69 males (age range: 43 to 78 years), all whom were exposed to asbestos. 95% had worked more than 11 years in the company. There were 24 cases of asbestosis, 31 cases of asbestos-related pleural disease and 14 workers without pathology, associated with latency periods of 31, 35 and 28.5 years, respectively. In addition, 5 asbestos-related cancers (3 mesotheliomas and 2 lung cancers) were identified in the study sample. Conclusions: The frequency of health problems and the exposure conditions highlight the need for an active search for additional cases among other exposed workers in this population (AU)

Objetivo: Describir la patología neumológica relacionada en una muestra de trabajadores con antecedentes de exposición al amianto. Método: La población base está constituida por los trabajadores de una fábrica de fibrocementos en Alicante. Las fuentes de información han sido las mediciones ambientales y las historias clínico-laborales de los exámenes médicos realizados por el Gabinete de Seguridad e Higiene. Resultados: Hubo 69 varones (rango edad: 43-78), todos expuestos a amianto. El 95% ha trabajado más de 11 años en la empresa. Se han diagnosticado 24 casos de asbestosis, 31 de alteraciones pleurales y 14 sin patología relacionada, siendo el periodo de latencia de 31, 35 y 28,5 años. Asimismo, se constató la incidencia de 5 casos de cánceres relacionados con el amianto (3 mesoteliomas y 2 cánceres de pulmón) en la muestra estudiada. Conclusiones: La frecuencia de problemas de salud hallados y las condiciones de exposición permiten proponer la necesidad de medidas de búsqueda activa de casos en el resto de trabajadores que hayan estado expuestos (AU)

Paternal exposure to agricultural pesticides and cause specific fetal death.

AIMS: To study the association between fetal death and paternal agricultural occupation in areas and time periods with different levels of use of agricultural pesticides. METHODS: A total of 1 473 146 stillbirths and births occurring in Spain between 1995 and 1999 were analysed. RESULTS: The offspring of agricultural workers had the highest risk of fetal death from congenital anomalies in the southern and eastern area (where pesticide use is greatest) and the lowest risk in the rest of Spain. In both areas the offspring of agricultural workers had a similar excess risk of fetal death from the remaining causes of death. The relative risk of fetal death from congenital anomalies in infants conceived between April and September (the months of greater use of pesticides) in the southern and eastern area was 0.90 in manual workers and 1.62 in agricultural workers, compared to non-manual workers; in individuals who were conceived during the rest of the year, the relative risk was 0.87 and 0.85, respectively. In both periods the offspring of agricultural workers had an excess risk of fetal death from the remaining causes of death. CONCLUSIONS: Paternal agricultural work in the areas where pesticides are massively used increases the risk of fetal death from congenital anomalies. The risk is also increased for fetuses conceived during the time periods of maximum use of pesticides The higher risk of fetal death from the remaining causes of death in the offspring of agricultural workers seems unrelated to pesticide exposure.

Adult stem cell therapy for the heart.

The purpose of this review is to summarize current data leading to and arising from recent clinical application of cellular therapy for acute myocardial infarct (heart attack) and congestive heart failure. We specifically focus on use of adult stem cells and compare and contrast bone marrow and adipose tissue; two different sources from which stem cells can be harvested in substantial numbers with limited morbidity. Cellular therapy is the latest in a series of strategies applied in an effort to prevent or mitigate the progressive and otherwise irreversible loss of cardiac function that frequently follows a heart attack. Unlike surgical, pharmacologic, and gene transfer approaches, cellular therapy has the potential to restore cardiac function by providing cells capable of regenerating damaged myocardium and/or myocardial function. Skeletal muscle myoblast expansion and transfer allows delivery of cells with contractile function, albeit without any evidence of cardiomyogenesis or electrical coupling to remaining healthy myocardium. Delivery of endothelial progenitor cells (EPCs) which drive reperfusion of infarct zone tissues is also promising, although this mechanism is directed at halting ongoing degeneration rather than initiating a regenerative process. By contrast, demonstration of the ability of adult stem cells to undergo cardiomyocyte differentiation both in vitro and in vivo suggests a potential for regenerative medicine. This potential is being examined in early clinical studies.

Aplicación de los modelos de gestión de calidad total a los Servicios de Prevención de Riesgos Laborales / Application of total quality management models in Occupational Risks Prevention Services

Los Servicios de Prevención de Riesgos Laborales constituyen un sector muy adecuado para la aplicación de los modelos de gestión de calidad total. Conocer los componentes de la calidad, así como los métodos y modelos para aplicarla y evaluarla, permitirá mejorar la atención que se presta a los trabajadores y trabajadoras a la vez que facilitará un mejor clima laboral a los profesionales de estos servicios. Este artículo revisa los fundamentos en los que se basa la mejora de la calidad asistencial, discutiendo su aplicación a los Servicios de Prevención de Riesgos Laborales (AU)