SAS - D.S.A.P. Poniente de Almería

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  • Publication
    [Pulse oximetry: Role in the COVID-19 patient at home].
    (2021-04-20) Serrano-Cumplido, A; Trillo Calvo, E; García Matarín, L; Del Río Herrero, A; Gamir Ruiz, F J; Molina Escribano, F; Velilla Zancada, S
    COVID-19 behaves like a heterogeneous disease. Some patients may develop dyspnea-free hypoxemia during its evolution (silent hypoxemia). Pulse oximetry plays a crucial role in detecting hypoxemia in these patients, especially when they remain at home. Patients with SpO2 levels ≤ 92% or desaturations ≥ 3% after exercise test require hospital admission. Progressive saturation declines reaching SpO2 levels
  • Publication
    Patients' Experiences and Communication with Teledermatology versus Face-to-Face Dermatology.
    (2022-09-21) Leal-Costa, Cesar; Lopez-Villegas, Antonio; Perez-Heredia, Mercedes; Baena-Lopez, Miguel Angel; Hernandez-Montoya, Carlos Javier; Lopez-Liria, Remedios
    (1) Background: Teledermatology (TD) has exponentially grown since the onset of COVID-19, as the Face-to-Face Dermatology (F-F/D) modality changed within Public Health Systems. Although studies have been conducted on health results, we did not find any that analyzed the experiences of individuals who received care through TD. Therefore, the main objective of the study was to analyze the experiences of dermatology patients and the communication with health personnel. (2) Methods: A multicenter, controlled, randomized, non-blinded clinical trial was designed. Data were collected during the six months of follow-up. Four-hundred and fifty patients participated in the present study, who were assigned to two different groups: TD and F-F/D. The sociodemographic and clinical characteristics of the participants were collected. The ‘Generic Short Patient Experiences Questionnaire’ (GS-PEQ) was used to assess patients’ experiences, and the Healthcare Communication Questionnaire (HCCQ) was used to measure the communication of patients with healthcare professionals. (3) Results: After six months of follow-up, 450 patients completed the study (TD = 225; F-F/D = 225) of which 53.3% were women, with an average age of 52.16 (SD = 19.97). The main reasons for the consultations were skin lesions (51.56%) located on the head and neck (46.8%), followed by the legs (20.7%). According to the GS-PEQ, TD users indicated having a greater confidence in the professional skills of the doctors (p
  • Publication
    Comparative Analysis of Quality of Life of Patients with Dermatological Problems: Teledermatology Versus Face-to-Face Dermatology.
    (2022-10-30) Lopez-Liria, Remedios; Lopez-Villegas, Antonio; Valverde-Martinez, Maria Angeles; Perez-Heredia, Mercedes; Vega-Ramirez, Francisco Antonio; Peiro, Salvador; Leal-Costa, Cesar
    The health-related quality of life (HRQoL) of the patients cared for with teledermatology (TD) services was analyzed as compared with face-to-face dermatology (F-F/D) at the hospital. This study was a controlled, non-blinded, intra-level, and multicenter randomized clinical trial, with a 6-month follow-up. A total of 450 patients were randomly assigned to two different groups. The Spanish version of the generic EuroQol-5-dimensions-5-Levels (EQ-5D-5L) questionnaire and the specific Skindex-29 questionnaire were used at 0 and 6 months. The number of primary care visits (2.24 TD; 1.68 F-F/D) and number of hospital visits (0.01 TD; 1.48 F-F/D) were statistically significant. It was observed that from month 0 onwards, the users included in the F-F/D group self-perceived a lower HRQoL than the users included in the TD group (Skindex-29 total: p ≤ 0.00; EQ-5D-5L VAS = p ≤ 0.00; EQ-5D-5L utilities = p ≤ 0.00). At the end of the study, the patients included in the F-F/D group still obtained lower scores in their perception of HRQoL, as compared to those included in the other type of follow-up (Skindex-29 total: p ≤ 0.00; EQ-5D-5L VAS = p ≤ 0.00; EQ-5D-5L utilities = p ≤ 0.00). TD was an effective diagnosis and follow-up tool. At the end of the study period, the HRQoL of the patients in both groups was significantly higher as compared to their baseline levels. Additionally, both the general and specific HRQoL perceived by the TD patients was higher than the F-F/D group from the start of the study.
  • Publication
    Improving Humanization Skills through Simulation-Based Computers Using Simulated Nursing Video Consultations.
    (2021-12-26) Jiménez-Rodríguez, Diana; Pérez-Heredia, Mercedes; Molero Jurado, María Del Mar; Pérez-Fuentes, María Del Carmen; Arrogante, Oscar
    During the COVID-19 confinement, we converted our clinical simulation sessions into simulated video consultations. This study aims to evaluate the effects of virtual simulation-based training on developing and cultivating humanization competencies in undergraduate nursing students. A quasi-experimental study was conducted with 60 undergraduate nursing students. A validated questionnaire was used to evaluate the acquisition of humanization competencies (self-efficacy, sociability, affection, emotional understanding, and optimism). The development of humanization competencies in this group composed of undergraduate nursing students was evaluated using virtual simulation-based training, comparing the levels obtained in these competencies at baseline (pre-test) and after the virtual simulation experience (post-test). After the virtual simulation sessions, students improved their levels in humanization total score and the emotional understanding and self-efficacy competencies, obtaining large effects sizes in all of them (rB = 0.508, rB = 0.713, and rB = 0.505 respectively). This virtual simulation modality enables training in the humanization of care with the collaboration of standardized patients in the form of simulated nursing video consultations and the performance of high-fidelity simulation sessions that comply with the requirements of best practices. Therefore, this methodology could be considered as another choice for virtual simulation. Additionally, this virtual modality could be a way to humanize virtual simulation.
  • Publication
    A Preliminary Randomized Clinical Trial on the Effect of Cervicothoracic Manipulation Plus Supervised Exercises vs a Home Exercise Program for the Treatment of Shoulder Impingement
    (Elsevier inc, 2017-06-01) Vinuesa-Montoya, Sergio; Encarnacion Aguilar-Ferrandiz, Maria; Mataran-Penarrocha, Guillermo A.; Fernandez-Sanchez, Manuel; Maria Fernandez-Espinar, Elena; Maria Castro-Sanchez, Adelaida; [Vinuesa-Montoya, Sergio] ZBS Roquetas Mar, Andalusian Hlth Serv, Physiotherapy Serv, Almeria, Andalucia, Spain; [Encarnacion Aguilar-Ferrandiz, Maria] Univ Granada, Dept Phys Therapy, Granada, Andalucia, Spain; [Mataran-Penarrocha, Guillermo A.] Primary Heath Care, Andalusian Hlth Serv, Granada, Andalucia, Spain; [Fernandez-Sanchez, Manuel] Univ Almeria, Dept Nursing Phys Therapy & Med, Almeria, Andalucia, Spain; [Maria Castro-Sanchez, Adelaida] Univ Almeria, Dept Nursing Phys Therapy & Med, Almeria, Andalucia, Spain; [Maria Fernandez-Espinar, Elena] Hosp Poniente, Physiotherapy Serv, Almeria, Andalucia, Spain
    Objective: The purpose of this study was to investigate changes in pain, disability, and range of movement after cervicothoracic manipulation plus exercise therapy in individuals with unilateral shoulder impingement syndrome.Methods: Forty-one patients (30 men, 11 women; aged 47 +/- 9) diagnosed with unilateral shoulder impingement syndrome attended 10 sessions for 5 weeks (2 sessions/wk). Eligible patients were randomly allocated to 2 study groups: cervicothoracic manipulation plus exercise therapy (n = 21) or home exercise program (n = 20). The outcomes measures included the visual analog scale (VAS); the Disabilities of the Arm, Shoulder, and Hand score; Shoulder Disability Questionnaire; subacromial impingement syndrome (Hawkins-Kennedy Test and Neer Test); and shoulder active range of motion (movements of flexion, extension, rotation, adduction, and abduction). Assessments were applied at baseline and 24 hours after completing 5 weeks of related interventions.Results: After 5 weeks of treatment significant between-group differences were observed in the Disabilities of the Arm, Shoulder, and Hand score (P = .012); however, no statistically significant differences were achieved for Shoulder Disability Questionnaire (P = .061) and pain intensity (P = .859). Both groups improved with regard to disability and clinical tests for detecting subacromial impingement syndrome.Conclusions: This clinical trial suggests that cervicothoracic manipulative treatment with mobilization plus exercise therapy may improve intensity of pain and range of motion compared with the home exercise group alone; the home exercise group had significant changes for flexion, extension, adduction, and abduction, but not for external and internal rotation movement in patients with shoulder impingement.
  • Publication
    Description of clinical pathological concordance and patient satisfaction in minor surgery in a Primary Care centre
    (Ediciones doyma s a, 2017-02-01) Ramirez Arriola, Maria Gabriela; Hunt Mohamed, Naima; Abad Vivas-Perez, Juan Jose; Bretones Alcaraz, Juan Jose; Garcia Torrecillas, Juan Manuel; Huber, Evelyn; [Ramirez Arriola, Maria Gabriela] Med Familiar & Comunitaria, Dist Almeria, Almeria, Spain; [Hunt Mohamed, Naima] Med Familiar & Comunitaria, Dist Poniente, Almeria, Spain; [Abad Vivas-Perez, Juan Jose] Ctr Salud, Med Familia, Almeria Ctr, Almeria, Spain; [Bretones Alcaraz, Juan Jose] Ctr Salud, Med Familia, Almeria Ctr, Almeria, Spain; [Garcia Torrecillas, Juan Manuel] Hosp Torrecardenas, Med Familia, Almeria, Spain; [Huber, Evelyn] Ctr Salud, Almeria Ctr, Pediat, Almeria, Spain
    Aim: To describe the minor surgery (MS) characteristics in a Primary Care (PC) centre, and to evaluate the clinical pathological concordance and patient satisfaction.Design: Descriptive and retrospective study.Setting: Primary Care, urban health care centre, Almeria, Spain.Participants: The population were the patients belonging to urban Primary Health Care centre, referred by their family physicians or paediatricians for the performing of MS during year 2013, and who consented to the intervention. A sample of 223 patients was obtained.Main measurements: Variables analysed were: sex, age, locations of the lesions, type of intervention, clinical diagnosis, histopathology diagnosis, complications, and patient satisfaction. The data were extracted from the medical history, the histopathology reports, and by using a satisfaction questionnaire completed by post or telephone by the patients.Results: The population consisted of 53.8% males, and had a mean age of 51.12 years (SD 19.02). The location of the most intervened lesions was in the head (35.4%). Electro-surgery was the most used procedure (62.8%), with only 16.9% of the lesions being biopsied, of which the most frequent was fibroids (32.3%). The clinical pathological concordance was > 80% and the Kappa index was 0.783 (P 80% and the Kappa index was 0.783 (P
  • Publication
    Efficacy of Physiotherapy Treatment in Primary Dysmenorrhea: A Systematic Review and Meta-Analysis.
    (2021-07-23) López-Liria, Remedios; Torres-Álamo, Lucía; Vega-Ramírez, Francisco A; García-Luengo, Amelia V; Aguilar-Parra, José M; Trigueros-Ramos, Rubén; Rocamora-Pérez, Patricia
    Primary dysmenorrhea (PD) refers to painful cramps before and/or during menstruation. There is a need for emphasis on alternative methods of conservative treatment, so as to reduce the dependence on drugs for alleviating the symptoms. The aim was to find out the effectiveness of some physiotherapy techniques in the treatment of PD. A systematic review and meta-analysis was conducted according to PRISMA standards. The descriptors were "dysmenorrhea", "physical the-rapy", "physiotherapy", and "manual therapy". The search was performed in five databases: Scopus, PubMed, PEDro, Web of Science, and Medline, in February 2021. The inclusion criteria were randomized controlled trials over the last six years. Articles not related to the treatment of PD or using pharmacology as the main treatment were excluded. Nine articles met the objectives and criteria, with a total of 692 participants. The most used scale to measure pain was the VAS (visual analogue scale). The main techniques were isometric exercises, massage therapy, yoga, electrotherapy, connective tissue manipulation, stretching, kinesio tape, progressive relaxation exercises and aerobic dance. Meta-analysis shows benefits of physiotherapy treatment for pain relief compared with no intervention or placebo (MD: -1.13, 95% CI: -1.61 to -0.64, I2: 88%). The current low-quality evidence suggests that physiotherapy may provide a clinically significant reduction in menstrual pain intensity. Given the overall health benefits of physiotherapy and the low risk of side effects reported, women may consider using it, either alone or in conjunction with other therapeutic modalities.
  • Publication
    Migration-associated malaria from Africa in southern Spain.
    (2021-05-07) Pousibet-Puerto, Joaquín; Lozano-Serrano, Ana Belén; Soriano-Pérez, Manuel Jesús; Vázquez-Villegas, José; Giménez-López, María José; Cabeza-Barrera, María Isabel; Cuenca-Gómez, José Ángel; Palanca-Giménez, Matilde; Luzón-García, María Pilar; Castillo-Fernández, Nerea; Cabezas-Fernández, María Teresa; Salas-Coronas, Joaquín
    The western area of the province of Almeria, sited in southern Spain, has one of the highest immigrant population rates in Spain, mainly dedicated to agricultural work. In recent years, there has been a significant increase in the number of cases of imported malaria associated with migrants from countries belonging to sub-Saharan Africa. The objective of our study is to describe the epidemiological, clinical and analytical characteristics of malaria patients treated in a specialized tropical unit, paying special attention to the differences between VFR and non-VFR migrants and also to the peculiarities of microscopic malaria cases compared to submicroscopic ones. Retrospective observational study of migrants over 14 years of age with imported malaria treated from October 2004 to May 2019. Characteristics of VFR and non-VFR migrants were compared. Malaria cases were divided into microscopic malaria (MM) and submicroscopic malaria (SMM). SMM was defined as the presence of a positive malaria PCR test together with a negative direct microscopic examination and a negative rapid diagnostic test (RDT). Microscopic malaria was defined as the presence of a positive RDT and/or a positive smear examination. Three hundred thirty-six cases of malaria were diagnosed, 329 in sub-Saharan immigrants. Of these, 78.1% were VFR migrants, in whom MM predominated (85.2% of cases). In non-VFR migrants, SMM represented 72.2% of the cases. Overall, 239 (72.6%) patients presented MM and 90 (27.4%) SMM. Fever was the most frequent clinical manifestation (64.4%), mainly in the MM group (MM: 81.1% vs SMM: 20.0%; p  Imported malaria in our area is closely related to sub-Saharan migration. VFR migrants are the main risk group, highlighting the need for actions aimed at improving disease prevention measures. On the other hand, almost a third of the cases are due to SMM. This fact could justify its systematic screening, at least for those travelers at greater risk.
  • Publication
    [Clinical and epidemiological profile of COVID-19 infected residents in medicalized social health institutions and their evolution during the pandemic].
    (2021-01-28) Aguilar-Martín, Ignacio; Ferra-Murcia, Sergio; Quesada-Yáñez, Enriqueta; Sandoval-Codoni, Javier
  • Publication
    Consensus on Criteria for Good Practices in Video Consultation: A Delphi Study.
    (2020-07-27) Jiménez-Rodríguez, Diana; Ruiz-Salvador, Diego; Rodríguez Salvador, María Del Mar; Pérez-Heredia, Mercedes; Muñoz Ronda, Francisco José; Arrogante, Oscar
    The use of telemedicine has greatly increased, largely derived from the COVID-19 pandemic, which has created the need for a guide aimed towards the adequate management of a modality of health care: the video consultation. A Delphi study composed of three rounds was conducted with 16 experts in holding video consultations and managing non-technical skills from different specialties and nationalities to conceive a consensus on the criteria needed for properly managing video consultations by healthcare professionals. The consensus criteria were defined by three dimensions (preparation of video consultation, video consultation process, and post-video consultation) and their corresponding items. Excellent consensus data was obtained; therefore, use is recommended by any healthcare professional who is going to utilize a video consultation, in order to manage it effectively.
  • Publication
    Increase in Video Consultations During the COVID-19 Pandemic: Healthcare Professionals' Perceptions about Their Implementation and Adequate Management.
    (2020-07-15) Jiménez-Rodríguez, Diana; Santillán García, Azucena; Montoro Robles, Jesús; Rodríguez Salvador, María Del Mar; Muñoz Ronda, Francisco José; Arrogante, Oscar
    In response to the COVID-19 pandemic, health care modalities such as video consultations have been rapidly developed to provide safe health care and to minimize the risk of spread. The purpose of our study is to explore Spanish healthcare professionals' perceptions about the implementation of video consultations. Based on the testimonies of 53 professionals, different categories emerged related to the four identified themes: benefits of video consultations (for professionals, patients, and the health system, and compared to phone calls), negative aspects (inherent to new technologies and the risk of a perceived distancing from the professional), difficulties associated with the implementation of video consultations (technological difficulties, lack of technical skills and refusal to use video consultation among professionals and patients), and the need for training (technological, nontechnical, and social-emotional skills, and adaptation of technical skills). Additionally, the interviewees indicated that this new modality of health care may be extended to a broader variety of patients and clinical settings. Therefore, since video consultations are becoming more widespread, it would be advisable for health policies and systems to support this modality of health care, promoting their implementation and guaranteeing their operability, equal access and quality.
  • Publication
    Treatment of Dysphagia in Parkinson's Disease: A Systematic Review.
    (2020-06-09) López-Liria, Remedios; Parra-Egeda, Jennifer; Vega-Ramírez, Francisco A; Aguilar-Parra, José Manuel; Trigueros-Ramos, Rubén; Morales-Gázquez, María José; Rocamora-Pérez, Patricia
    The incidence of oropharyngeal dysphagia in Parkinson's disease (PD) is very high. It is necessary to search for effective therapies that could prevent pneumonia. Previous results should be interpreted cautiously as there is a lack of evidence to support the use of compensatory or rehabilitative approaches to dysphagia. We reviewed the scientific literature to describe the treatments of dysphagia in PD. A systematic review was performed in PubMed, Scopus, Elsevier, and Medline according to PRISMA standards in 2018. The articles that did not mention dysphagia secondary to PD or used surgical treatment were excluded. Eleven articles met the criteria with information from 402 patients. The review relates to different protocols, such as training in expiratory muscle strength, postural techniques, oral motor exercises, video-assisted swallowing therapy, surface electrical stimulation, thermal stimulation, touch, compensatory interventions, training regime for swallowing, neuromuscular electrical stimulation, Lee Silverman voice treatment, swallow maneuver, airway protection, and postural compensation maneuvers. This review identifies the rationing interventions in each trial, if they are efficient and equitable. Several rehabilitative therapies have been successful. An improvement was seen in the degenerative function (coordination, speed, and volume), quality of life, and social relationships of people with PD. Further investigations concerning the clinical applicability of these therapies based on well-designed randomized controlled studies are needed. Larger patient populations need to be recruited to evaluate the effectiveness, long-term effects, and new treatment techniques.
  • Publication
    Evaluation of the Effectiveness of a Nursing/Physiotherapy Program in Chronic Patients.
    (2019-06-25) López-Liria, Remedios; Vega-Ramírez, Francisco Antonio; Aguilar-Parra, José Manuel; Padilla-Góngora, David; Trigueros-Ramos, Rubén; Rocamora-Pérez, Patricia
    This study aimed to evaluate the functional impact of a shared intervention model by the mobile physiotherapy and rehabilitation team (MPRT) and primary care case management nurses (PCCMNs) on chronic patients. This was a prospective, observational study involving 1086 patients (mean age, 80 years; 63.7% females) in the province of Almeria, which was conducted between 2004 and 2018. Most of the registered diseases included cerebrovascular and neurological diseases (56.7%), osteoarticular diseases (45.3%), diabetes mellitus (25.7%), cardiovascular diseases (25.5%), and chronic respiratory diseases. The study included a home care intervention by the MPRT and PCCMNs and included the following main outcome measures: age, sex, main caregiver, disabling process (ICD-9), type and number of inclusion categories for chronic disease, initial and final Barthel index (BI), treatment or intervention on the patient (techniques), objectives, and number of sessions. The main techniques used were kinesiotherapy (44.6%) and caregiver training (23%), along with technical aid. An equation predicting the patients' final BI, according to the initial BI, was constructed using multiple linear regression modelling. A marked improvement in functional capacity was found after an average of 10 physiotherapy sessions. A lower patient age was correlated with a higher functional capacity, both initial and final BI, as well as a greater number of sessions.
  • Publication
    Chronic hepatitis B genotype E in African migrants: response to nucleos(t)ide treatment in real clinical practice.
    (2018-11-14) Cuenca-Gómez, José Ángel; Lozano-Serrano, Ana Belén; Cabezas-Fernández, María Teresa; Soriano-Pérez, Manuel Jesús; Vázquez-Villegas, José; Estévez-Escobar, Matías; Cabeza-Barrera, Isabel; Salas-Coronas, Joaquín
    Hepatitis B virus (HBV) genotype E is a poorly studied genotype that almost exclusively occurs in African people. It seems to harbour intrinsic potential oncogenic activity and virological characteristics of immune scape but a paucity of information is available on clinical and virological characteristic of HBV genotype E-infected patients as well as on the efficacy of anti-HBV drugs for such patients. The increasing flow of migrants from high endemic HBV sub-Saharan Africa, where genotype E is the predominant one, to Western countries makes improving such knowledge critical in order to deliver proper medical care. Prospective observational study of naïve patients of sub-Saharan origin treated for chronic HBV genotype E infection at a Tropical Medicine clinic sited in Spain from February 2004 to January 2018. The aim of the study was to describe the response of chronic HBV genotype E infection to nucleos(t)ide analogues (NA), entecavir or tenofovir, in real clinical practice. During the study period, 2209 sub-Saharan patients were assisted at our Tropical Medicine Unit and 609 (27.6%) had chronic HBV (CHB) infection. Genotype information was available for 55 naïve patients initiating treatment with NA (entecavir or tenofovir), 43 (84.3%) of them being genotype E, although 15 were excluded because they did not meet study inclusion criteria. Thus, a total of 28 CHB genotype E patients were included and followed for 24 months at least. Twenty-one patients were in HBeAg-negative chronic hepatitis phase and 7 patients in HBeAg-positive chronic hepatitis phase. After one year of treatment, among those with good adherence, 89.4% (17/19) of the HBeAg-negative patients and 80% of the HBeAg-positive ones had undetectable viral loads. Response rates reached 100% in both groups after 15-18 months of follow-up. Out of the 7 HBeAg-positive patients, 6 (85.7%) presented HBeAg loss in a median time of 31.8 months. Neither serious adverse effects nor hepatocarcinoma cases happened during the study period. HBV genotype may influence disease progression and antiviral response. Our study provides precious information on the efficacy and safety of NA treatment for CHB genotype E infection, a fairly unknown genotype with and increasing epidemiological impact.
  • Publication
    Predictive risk model for the diagnosis of diabetes mellitus type 2 in a follow-up study 15 years on: PRODI2 Study.
    (2019) Moreno, Luisa M; Vergara, Jesús; Alarcón, Raquel
    The prevalence and mortality related to diabetes mellitus type 2 (DM2) have increased consistently for decades. Identifying adults at high risk of diabetes incidence is important for the execution of intervention. The participants in the PRODI2 study (n=273), who come from the southeast of Spain and did not have diabetes at the start of the study, were followed for 15 years (1999-2014), and their risk parameters were measured, from which a predictive model was obtained which indicates the level of influence of each factor in the development of DM2. The expected risk of diabetes was calculated by binary logistic regression. Those participants whose father has suffered an acute myocardial infarction are 3.9 times more likely to develop DM2 (confidence interval 95%: 1.498, 10.339); those with at least one parent who has a history of diabetes are 2.7 times more at risk (confidence interval 95%: 1.224, 6.101); the risk of being diabetic was 1.13 times higher for every extra unit on the waist-hip ratio (confidence interval 95%: 1.073, 1.195), and for the hip perimeter an OR of 0.93 was obtained (confidence interval 95%: 0.876, 0.982). Statistically significant differences were observed in all cases (P This study shows that the risk of being diabetic rises in patients whose father has suffered an acute myocardial infarction, in those whose mother or father is diabetic and in patients with a high waist perimeter.
  • Publication
    Newly Arrived African Migrants to Spain: Epidemiology and Burden of Disease.
    (2018) Salas-Coronas, Joaquín; Cabezas-Fernández, María Teresa; Lozano-Serrano, Ana Belén; Soriano-Pérez, Manuel Jesús; Vázquez-Villegas, José; Cuenca-Gómez, José Ángel
    The aim of this study is to describe the epidemiological profile, clinical characteristics, and microbiological findings in African immigrants newly arrived to Spain attended at a specialized reference unit from October 2004 to February 2017. A common protocol for the screening of imported and cosmopolitan diseases was designed to evaluate patients with ≤ 12 months of stay in Spain. A total of 523 patients were included in the study, 488 (93.3%) of sub-Saharan origin. A high number of helminthic infections were diagnosed in sub-Saharan patients, including geohelminthiasis (hookworms 14.3%; Trichuris trichiura 4.1%; Ascaris lumbricoides 3.1%), schistosomiasis (12.3%), strongyloidiasis (17.2%), and filariasis (8.4%). Thirty-five patients (7.2%) had malaria, most by Plasmodium falciparum. Among communicable diseases, 33.6% of sub-Saharans presented HBsAg positivity compared with 5.7% of North African patients (P = 0.001). Thirteen patients were diagnosed with active tuberculosis. Seventy percent of the sub-Saharans and 40% of the North Africans who were tested had a latent tuberculosis infection (LTI). Treatment of LTI was administered in selected cases (14%), achieving end of treatment in 80% of them. In light of these results, effective screening strategies, particularly within the sub-Saharan immigrant population, including potentially communicable diseases and certain potentially serious parasitic diseases (Strongyloides, Schistosoma), should be implemented. It is necessary to facilitate fully and free of charge access to the public health system to newly arrived immigrants, as well as to implement programs and actions aimed at favoring care and follow-up, especially for communicable diseases. Empirical treatment of some parasitic diseases could be a cost-effective action.
  • Publication
    Consensus on Criteria for Good Practices in Video Consultation: A Delphi Study
    (MDPI, 2020-07-27) Jiménez-Rodríguez, Diana; Ruiz-Salvador, Diego; Rodríguez Salvador, María del Mar; Pérez-Heredia, Mercedes; Muñoz Ronda, Francisco José; Arrogante, Oscar; [Jiménez-Rodríguez,D; Ruiz-Salvador,D] Department of Nursing, Physiotherapy and Medicine, University of Almeria, Almeria, Spain. [Ruiz-Salvador,D] Emergency Care Unit, Poniente Hospital Health Agency, El Ejido-Almeria, Spain. [Rodríguez Salvador,MM; Muñoz Ronda,FJ] Knowledge and Research Management Department, Primary Care District of Almeria, Almeria, Spain. [Pérez-Heredia,M] Research Management Department, Primary Care District Poniente of Almeria, El Ejido-Almeria, Spain. [Arrogante,O] University Centre of Health Sciences San Rafael, San Juan de Dios Foundation, Nebrija University, Madrid, Spain.
    The use of telemedicine has greatly increased, largely derived from the COVID-19 pandemic, which has created the need for a guide aimed towards the adequate management of a modality of health care: the video consultation. A Delphi study composed of three rounds was conducted with 16 experts in holding video consultations and managing non-technical skills from different specialties and nationalities to conceive a consensus on the criteria needed for properly managing video consultations by healthcare professionals. The consensus criteria were defined by three dimensions (preparation of video consultation, video consultation process, and post-video consultation) and their corresponding items. Excellent consensus data was obtained; therefore, use is recommended by any healthcare professional who is going to utilize a video consultation, in order to manage it effectively.
  • Publication
    Increase in Video Consultations During the COVID-19 Pandemic: Healthcare Professionals’ Perceptions about Their Implementation and Adequate Management
    (MDPI, 2020-07-15) Jiménez-Rodríguez, Diana; Santillán García, Azucena; Montoro Robles, Jesús; Rodríguez Salvador, María del Mar; Muñoz Ronda, Francisco José; Arrogante, Oscar; [Jiménez-Rodríguez,D] Department of Nursing, Physiotherapy and Medicine, University of Almeria, Almeria, Spain. [Santillán García,A] Department of Cardiology, Burgos University Hospital, Burgos, Spain. [Montoro Robles,J] Teaching Unit, Nursing Subcommittee, Primary Care District Poniente of Almeria, Almeria, Spain. [Rodríguez Salvador,MM; Muñoz Ronda,FJ] Knowledge and Research Management Department, Primary Care District of Almeria, Almeria, Spain. [Arrogante,O] University Centre of Health Sciences San Rafael, San Juan de Dios Foundation, Nebrija University, Madrid, Spain.
    In response to the COVID-19 pandemic, health care modalities such as video consultations have been rapidly developed to provide safe health care and to minimize the risk of spread. The purpose of our study is to explore Spanish healthcare professionals’ perceptions about the implementation of video consultations. Based on the testimonies of 53 professionals, different categories emerged related to the four identified themes: benefits of video consultations (for professionals, patients, and the health system, and compared to phone calls), negative aspects (inherent to new technologies and the risk of a perceived distancing from the professional), difficulties associated with the implementation of video consultations (technological difficulties, lack of technical skills and refusal to use video consultation among professionals and patients), and the need for training (technological, nontechnical, and social-emotional skills, and adaptation of technical skills). Additionally, the interviewees indicated that this new modality of health care may be extended to a broader variety of patients and clinical settings. Therefore, since video consultations are becoming more widespread, it would be advisable for health policies and systems to support this modality of health care, promoting their implementation and guaranteeing their operability, equal access and quality.
  • Publication
    Derivaciones en los centros de salud de Andalucía según el sexo de profesionales y pacientes: un análisis de género.
    (Ministerio de Sanidad y Consumo, 2014-05) Delgado, Ana; Saletti-Cuesta, Lorena; Sánchez-Cantalejo, Carmen; López-Hernández, Begoña; Guijosa-Campos, Pilar; Acosta-Ferrer, Margarita; Montoya-Vergel, Juana; Gil-Garrido, Natalia; [Delgado,A; Saletti-Cuesta,L; Sánchez-Cantalejo,C] Escuela Andaluza de Salud Pública. [López-Hernández,B; Guijosa-Campos,P] Distrito Sanitario Granada-Metropolitano. [Acosta-Ferrer,M] Distrito Sanitario Almería. [Montoya-Vergel,J] Distrito Sanitario Poniente de Almería. [Gil-Garrido,N] Centro de salud de Iznájar. Distrito Sanitario Córdoba Sur.
    BACKGROUND It has been identified differences of medical care practice in primary care related to physician's sex. Simultaneously, there are gender inequalities in the assignment of health resources. Both aspects give rise to an increasing growing interest in the management and provision of health services. OBJECTIVES To examine the differences in the referral practice made by female and male primary care physicians working in health centers in Andalusia, to consider whether there are disparities in referrals received by men and women, and to examine the interaction between patient's sex and physician's sex. METHODS Observational, cross-sectional, and multicenter study. POPULATION 4 health districts in Andalucía and their physicians. SAMPLE 382 physicians. MEASUREMENTS referral rate per visit (RV), referral rate per patient quota (RQ), patient's sex, physician: sex, age, postgraduate family medicine specialty, size of the patient quota by sex, mean number of patients/day by sex, mean age of the patient quota by sex, and proportion of men in the quota. Health center: urban / rural, size of the team, enrolled population, and postgraduate family medicine specialty's accreditation. SOURCES databases of health districts. PERIOD OF STUDY 2010. ANALYSIS Bivariate and multivariate multilevel analysis of the referral rate per visit with mixed Poisson model. RESULTS In 2010 382 physicians made 129,161 referrals to specialized care. The RQ was 23.47 and the RV was 4.92. The RQ in women and men was 27.23 and 19.78 for women physicians, being 27.37 and 19.51 for male physicians. The RV in women and men was 4.92 and 5.48 for women physicians, being 4.54 and 4.93 for male physicians. CONCLUSION There are no differences in referral according to physician's sex. However, there are signs that might indicate the existence of gender inequality, and women patient received less referrals. There are no physician-patient's sex interaction.