SAS - D.S.A.P. Guadalquivir

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Effectiveness of a multicomponent intervention to reduce social isolation and loneliness in community-dwelling elders: A randomized clinical trial.
(2022-06-24) Hernández-Ascanio, José; Perula-de Torres, Luis Ángel; Rich-Ruiz, Manuel; González-Santos, Josefa; Mielgo-Ayuso, Juan; González-Bernal, Jerónimo; ASyS Study Collaborative Group
To assess the effect of a multicomponent intervention on reducing social isolation and loneliness and improving the quality of life in community-dwelling older adults. A cluster-randomized controlled clinical trial. A total of 56 older adults participated in the control group and 63 older adults in the experimental group. The intervention consisted of 6 home-based face-to-face sessions, intercalated with 5 telephone calls and was conducted by nursing students and volunteer staff with experience in the subject. The study was conducted between April 2018 and December 2019. In terms of statistical analysis, several procedures were carried out: a statistical analysis per protocol and intention to treat, considering isolation, loneliness and quality of life as endpoints; a comparison of paired means, to analyse the behaviour of the outcome variables at baseline and the end of the study; and finally, a binary logistic regression analysis, considering social support as a dependent variable. The study results do not show the effectiveness of the modified CARELINK programme, analysed as a whole, on the decrease in social isolation or loneliness or the improvement in HRQL. However, a detailed analysis of the behaviour of some of the variables during the study indicates some results that deserve to be commented on. Comparing the mean confidential support scores between the experimental and control group at the initial and final stages shows significant differences in the analysis by protocol, and close to statistical significance in the analysis by intention to treat. Comparing the paired means obtained in the experimental group, an improvement in emotional loneliness scores was found. Finally, the variables associated with the social support of the subjects at the end of the follow-up period were as follows: having people who help them and mobility. Although the results obtained do not allow us to affirm that the intervention programme is effective, these same results point to improved confidential support and emotional loneliness in older adults participating in the intervention. Having people to help them and a greater degree of mobility are factors favouring the decrease in social isolation. This study suggested that modified CARELINK, a multicomponent intervention performed by trained volunteers, could improve confidential support in community-dwelling older adults. It also reports the importance of considering the level of mobility and support networks as determinants of the improvement caused by the intervention.
A Mediterranean-Diet-Based Nutritional Intervention for Children with Prediabetes in a Rural Town: A Pilot Randomized Controlled Trial.
(2022-09-01) Blancas-Sánchez, Isabel María; Del Rosal Jurado, María; Aparicio-Martínez, Pilar; Quintana Navarro, Gracia; Vaquero-Abellan, Manuel; Castro Jiménez, Rafael A; Fonseca Pozo, Francisco Javier
Prediabetes is a pathological condition in which the blood glucose concentration is higher than normal concentrations but lower than those considered necessary for a type 2 diabetes mellitus diagnosis. Various authors have indicated that the Mediterranean Diet is one of the dietary patterns with the most healthy outcomes, reducing high levels of HbA1c, triglycerides, BMI, and other anthropometric parameters. The main objective of this study was to determine the efficacy of the nutritional intervention for children with prediabetes, including the effectiveness of this nutritional education regarding anthropometric parameters. A randomized pilot trial with two groups, an experimental group (EG) and a control group (CG), using intervention in dietary habits with nutritional reinforcement was carried out on 29 children with prediabetes from a rural area. The nutritional intervention was analyzed through astrophotometric and glycemic measurements and validated surveys. Results: The results indicated improvement in eating habits, adherence to the Mediterranean diet, anthropometric measurements, mainly body mass index and perimeters, and analytical parameters, with a significant decrease in glycated hemoglobin in the EG compared to the CG (p
Impact of Activity-Oriented Propioceptive Antiedema Therapy on the Health-Related Quality of Life of Women with Upper-Limb Lymphedema Secondary to Breast Cancer-A Randomized Clinical Trial.
(2022-03-28) Muñoz-Alcaraz, María Nieves; Pérula-de Torres, Luis A; Jiménez-Vílchez, Antonio José; Rodríguez-Fernández, Paula; Olmo-Carmona, María Victoria; Muñoz-García, María Teresa; Jorge-Gutiérrez, Presentación; Serrano-Merino, Jesús; Romero-Rodríguez, Esperanza; Rodríguez-Elena, Lorena; Refusta-Ainaga, Raquel; Lahoz-Sánchez, María Pilar; Miró-Palacios, Belén; Medrano-Cid, Mayra; Magallón-Botaya, Rosa; Santamaría-Peláez, Mirian; Mínguez-Mínguez, Luis A; González-Bernal, Jerónimo J
Alterations derived from lymphedema in the upper-limb secondary to breast cancer-related lymphedema (BCRL) decrease the health-related quality of life (HRQoL), but there is limited evidence of the impact of the different interventions on it. The aim of this research was to compare the effect of conventional treatment with another treatment based on Activity-Oriented Antiedema Proprioceptive Therapy (TAPA) on HRQoL in women diagnosed with BCRL. A prospective clinical study was designed with two parallel arms. The study population consisted of women diagnosed with BCRL in stage I and II, belonging to different institutions in Córdoba and Aragon, Spain. Sociodemographic and HRQoL-related variables, pain, tightness, heaviness and functionality were obtained before and after treatments. 51 women participated in the study, 25 received the conventional treatment and 26 the TAPA, with a mean age of 59.24 ± 9.55 years. HRQoL was significantly related to upper-limb function and pain on the participants' affected side. In addition, covariance analysis (ANCOVA) showed that the TAPA treatment interfered less in the performance of activities of daily life and produced significant improvements in the social dimension of HRQoL. the non-use of compressive elements in the rehabilitative treatment of the BCRL that is proposed with TAPA improves aspects such as self-image and participation in social and recreational activities.
Retinal and Choroidal Effects of Continuous Positive Airway Pressure as Treatment for Sleep Apnea: Results at 12 Months.
(2022-10-03) Naranjo-Bonilla, Pedro; Giménez-Gómez, Rafael; Muñoz-Villanueva, María Del Carmen; Jurado-Gámez, Bernabé
To determine the impacts of continuous positive airway pressure (CPAP) treatment on retinal and choroidal thickness measurement in individuals with obstructive sleep apnea (OSA). Participants were 28 patients with OSA treated with CPAP who were enrolled immediately after diagnosis and graded according to the apnea hypopnea index (AHI) determined in an overnight polysomnography. Inclusion criteria were a new diagnosis of OSA and an indication for CPAP. Participants underwent a full ophthalmologic examination including standard automated perimetry (SAP) and optical coherence tomography (OCT) at the levels peripapillary, macular, and choroidal before CPAP onset, and after three and twelve months of CPAP. The data compared before and after treatment were intraocular pressure, SAP, and the thicknesses peripapillary retinal nerve fiber layer (pRNFL), total retinal (TR), retinal ganglion cell layer (RGCL), inner plexiform layer (IPL), photoreceptor layer (PL), and choroidal. After 3 months of CPAP, we observed thickening of the pRNFL (in 5/6 subfields) (p 12 months of CPAP avoids retinal thinning and normalizes choroidal thickness in OSA patients.
Conditions for Feasibility of a Multicomponent Intervention to Reduce Social Isolation and Loneliness in Noninstitutionalized Older Adults.
(2022-06-14) Hernández-Ascanio, Jose; Ventura-Puertos, Pedro Emilio; Rich-Ruiz, Manuel; Cantón-Habas, Vanesa; Roldán-Villalobos, Ana María; Pérula-de Torres, Luis Ángel
To identify the factors conditioning the feasibility of an intervention to reduce social isolation and loneliness in noninstitutionalized older adults from the perspective of the intervention agents. A Dimensional Grounded Theory study conducted from December 2019 to January 2020. Twelve participants were recruited from an experimental study developed in a health district of a southern Spanish city. Data were collected through focus group meetings, individual interviews, biograms, anecdote notebooks, and the field diaries of two participants not included in the other techniques. Transcripts were analyzed using thematic analysis. Findings were divided into three themes: (a) the elderly between the walls of loneliness, economic difficulties, losses, and the past; (b) intervention agents/volunteers between the walls of inexperience in the management of psychological/emotional processes, lack of moral authority, and difficulty in planning results adapted to the (elderly) person; and (c) intervention between the walls of (interest in) company and assistance at home, lack of involvement ("waiting for you to save them"), and withdrawal/"abandonment". A profile of the specialized intervention agent, professionalized (or at least a mentored agent), with both technical and relational competencies; a clear understanding of the purposes of the intervention (empowerment, as opposed to having company or being helped with household chores) and the commitment to active participation by the elder; or adequate management of the completion of the intervention (flexibility, attachment management) are some of the main factors contributing to the feasibility of these approaches. The findings have potential implications in the field of primary healthcare because primary and community healthcare services can implement corrections to the proposed intervention and ensure its effectiveness under feasible conditions. The nurse is shown as the most appropriate profile to conduct this intervention, although more research is needed to analyze the feasibility of this type of intervention in the daily practice of community nurses.
The usefulness of the Spanish version of the STOP-Bang questionnaire for screening for moderate or severe sleep apnea syndrome in primary care.
(2022-09-09) Muñoz-Gómez, Rafaela; Navarrete-Martínez, Esther; Serrano-Merino, Jesús; Silva-Gil, Fátima; Roldán-Villalobos, Ana; Martín-Rioboó, Enrique; Ruiz-Moruno, Javier; Romero-Rodríguez, Esperanza; Gonzalez-Lama, Jesus; Vaquero-Abellán, Manuel; Perula-de-Torres, Luis Angel
Sleep apnea-hypopnea syndrome (OSA) is a highly prevalent disease and has been related to cardiovascular diseases and occupational and traffic accidents. Currently, it is estimated that there is a significant underdiagnosis of OSA, mainly due to the difficulty accessing the tests for that purpose. To determine the usefulness of the Spanish version of the STOP-Bang questionnaire (SBQ) for screening for moderate or severe OSA in the adult population attending primary care. A descriptive observational multicenter study was conducted. Through an opportunistic search, (patients over 18 years old), were recruited in seven primary care centers. The SBQ was applied to them and home respiratory polygraphy (HRP) was subsequently performed to confirm the diagnosis of OSA. The criterion validity of the SBQ was analyzed, comparing the score obtained by the SBQ with the apnea-hypopnea index (AHI) obtained by RP, establishing the diagnosis of OSA for an AHI>5. The reliability of the questionnaire was evaluated. A total of 255 subjects, 54.1% men, with a mean age of 54.76 ± 10 years, were recruited in the study. The results showed that 61.57% (95% Confidence Interval: 55.57-67.57) of the subjects presented OSA, presenting 22.75% (17.57-57.92) a mild OSA (530) (11.54-20.62). The Kuder and Richardson coefficient was 0.623 (0.335-0.788) and Cohen's Kappa coefficient was 0.871 (0.520-1.00; p 15) the SBQ obtained an ROC curve of 0.769 (0.704-0.833) that with an optimal cutoff of 3, achieved a sensitivity of 84.85% (77.28-92.42) and a specificity of 55.10% (44.74-65.46). The SBQ is very effective for detecting moderate/severe OSA. Its psychometric properties are similar to those obtained in studies on other populations. Because of its ease of use, the SBQ is a very useful tool for primary health care professionals.
Influence of clinical and psychological variables upon the oral health-related quality of life in patients with temporomandibular disorders
(Medicina oral s l, 2017-11-01) Blanco-Aguilera, Antonio; Blanco-Aguilera, Elena; Serrano-del-Rosal, Rafael; Biedma-Velazquez, Lourdes; Rodriguez-Torronteras, Alejandro; Segura-Saint-Gerons, Rafael; Blanco-Hungria, Antonio; [Blanco-Aguilera, Antonio] Univ Cordoba, Dept Med, Maimonides Inst Biomed Res Cordoba, Cordoba, Spain; [Blanco-Hungria, Antonio] Univ Cordoba, Dept Med, Maimonides Inst Biomed Res Cordoba, Cordoba, Spain; [Blanco-Aguilera, Elena] Univ Santiago de Compostela, Oral Med Surg & Implantol, Santiago, Spain; [Serrano-del-Rosal, Rafael] Spanish Natl Res Council IESA CSIC, Inst Adv Social Studies, Madrid, Spain; [Biedma-Velazquez, Lourdes] Spanish Natl Res Council IESA CSIC, Inst Adv Social Studies, Madrid, Spain; [Rodriguez-Torronteras, Alejandro] Andalusian Healthcare Serv, Andalucia, Spain; [Segura-Saint-Gerons, Rafael] Univ Cordoba, Dept Med & Surg Specialties, Cordoba, Spain
Background: To analyze the association between the OHIP-14 and the different subtypes making up the clinical and psychological axis obtained using the RDC/TMD.Material and Methods: 407 patients treated at the TMD unit of the Andalusian Healthcare Service were administered the Spanish version of the Research Diagnostic Criteria for Temporomandibular Disorders questionnaire (RDC/TMD), together with the Oral Health Impact Profile questionnaire (OHIP-14). The degree of association between the patients' score in the OHIP-14 and the clinical and biopsychosocial variables was analyzed through bivariate and multivariate analyses, specifically through linear regression.Results: 89.4% of the treated patients were women, while 10.6% were men, with an average age of 42.08 +/- 14.9 years. The mean score and standard deviation for the OHIP-14 was 20.57 +/- 10.73. A significant association (p
Impact of CPAP therapy on health-related quality of life in elderly patients with apnoea-hypopnea syndrome: a systematic review of randomised clinical trials
(European respiratory soc journals ltd, 2017-01-01) Serrano Merino, Jesus; Perula de Torres, Luis A.; Munoz Gomez, Rafaela; Roldan Villalobos, Ana; Feu Collado, M. Nuria; Ruiz-Moral, Roger; Jurado-Gamez, Bernabe; Collaborative Grp CVCPAP Study; [Serrano Merino, Jesus] Univ Hosp Reina Sofia, Resp Dept, Sleep Unit, Cordoba, Spain; [Feu Collado, M. Nuria] Univ Hosp Reina Sofia, Resp Dept, Sleep Unit, Cordoba, Spain; [Jurado-Gamez, Bernabe] Univ Hosp Reina Sofia, Resp Dept, Sleep Unit, Cordoba, Spain; [Serrano Merino, Jesus] Univ Cordoba, Hosp Univ Reina Sofia, IMIBIC, Cordoba, Spain; [Perula de Torres, Luis A.] Univ Cordoba, Hosp Univ Reina Sofia, IMIBIC, Cordoba, Spain; [Roldan Villalobos, Ana] Univ Cordoba, Hosp Univ Reina Sofia, IMIBIC, Cordoba, Spain; [Ruiz-Moral, Roger] Univ Cordoba, Hosp Univ Reina Sofia, IMIBIC, Cordoba, Spain; [Jurado-Gamez, Bernabe] Univ Cordoba, Hosp Univ Reina Sofia, IMIBIC, Cordoba, Spain; [Perula de Torres, Luis A.] Hlth Dist Cordoba & Guadalquivir, Unidad Docente Med Familiar & Comunitaria, Cordoba, Spain; [Roldan Villalobos, Ana] Hlth Dist Cordoba & Guadalquivir, Unidad Docente Med Familiar & Comunitaria, Cordoba, Spain; [Munoz Gomez, Rafaela] Hlth Dist Cordoba & Guadalquivir, UGC Sect Sur, Cordoba, Spain; [Ruiz-Moral, Roger] Univ Francisco Vitoria, Fac Med, Madrid, Spain; [Jurado-Gamez, Bernabe] Univ Cordoba, Fac Med, Cordoba, Spain; Public Andalusian Foundation of Process and Health
Measuring the quality of motivational interviewing in primary health care encounters: The development and validation of the motivational interviewing assessment scale (MIAS)
(Taylor & francis ltd, 2016-01-01) Campinez Navarro, Manuel; Perula de Torres, Luis Angel; Bosch Fontcuberta, Josep M.; Barragan Brun, Nieves; Arbonies Ortiz, Juan Carlos; Novo Rodriguez, Jesus Manuel; Boveda Fontan, Julia; Martin Alvarez, Remedios; Prados Castillejo, Jose Antonio; Rivas Doutreleau, Gabriela Renee; Domingo Pena, Carmen; Castro Moreno, Jaime Jesus; Romero Rodriguez, Esperanza Maria; [Campinez Navarro, Manuel] CAP Vallcarca, Barcelona, Spain; [Barragan Brun, Nieves] CAP Vallcarca, Barcelona, Spain; [Martin Alvarez, Remedios] CAP Vallcarca, Barcelona, Spain; [Perula de Torres, Luis Angel] Univ Cordoba, Hosp Univ Reina Sofia, Unidad Docente Med Familiar & Comunitaria Cordoba, Dist Sanitario Cordoba & Guadalquivir,IMIBIC, Avda Menendez Pidal S-N, Cordoba, Spain; [Bosch Fontcuberta, Josep M.] Inst Catala Salut, Area Basica Salud Encants Maragall, Barcelona, Spain; [Arbonies Ortiz, Juan Carlos] Ctr Salud Beraun Errenteria, Donostia San Sebastian, Spain; [Novo Rodriguez, Jesus Manuel] Ctr Saude A Milagrosa, Lugo, Spain; [Boveda Fontan, Julia] EAP Colmeiro, Vigo, Spain; [Prados Castillejo, Jose Antonio] Ctr Salud Lucano, Serv Andaluz Salud, Cordoba, Spain; [Rivas Doutreleau, Gabriela Renee] Univ Basque Country, San Sebastian, Spain; [Domingo Pena, Carmen] Univ Basque Country, San Sebastian, Spain; [Castro Moreno, Jaime Jesus] UGC La Carlota, Serv Andaluz Salud, Cordoba, Spain; [Romero Rodriguez, Esperanza Maria] UGC Occidente, Serv Andaluz Salud, Cordoba, Spain; Spanish Society of Family Physicians (semFYC); Health Council of the Andalusian Government
Background: Motivational interviewing (MI) is a collaborative, goal-oriented method to help patients change behaviour. Tools that are often used to measure MI are the motivational interviewing skills code' (MISC), the motivational interviewing treatment integrity' (MITI) and the behaviour change counselling index' (BECCI). The first two instruments have not been designed to be used in primary healthcare (PHC) settings. The BECCI actually is time-consuming. The motivational interviewing assessment scale (MIAS, 'EVEM' in Spanish) was developed to measure MI in PHC encounters as an alternative to the previous instruments.Objectives: To validate MIAS as an instrument to assess the quality of MI in PHC settings.Methods: (a) Development: Sixteen experts in MI participated in the design, face and consensus validity, using a Delphi-type methodology. (b) Validation: Setting: 27 PHC centres located in Spain. Subjects: four experts in MI tested its psychometric properties with 332 video recordings coming from the Dislip-EM study (consultations provided by 37 practitioners). Measurements: dimensionality, internal consistency, reliability (intra-class correlation coefficient-ICC), sensitivity to change and convergent validity with the BECCI scale.Results: A 14-item scale was obtained after the validation process. Factor analysis: two factors explained 76.6% of the total variance. Internal consistency, alpha=0.99. Reliability: intra-rater ICC=0.96; inter-rater ICC=0.97. Sensitivity to change: means before and after training were 23.63 versus 38.57 (P
Efficiency in nursing prescription in Andalusia. A step back in the health system after annulment by Royal Decree
(Ediciones doyma s a, 2018-05-01) Ruiz Sanchez, Juan Jose; Ruiz Calzado, Rocio; Romero Sanchez, Marcos; [Ruiz Sanchez, Juan Jose] UGC Palma del Rio, Consultorio Penaflor, Cordoba, Spain; [Ruiz Calzado, Rocio] Hosp Univ Reina Sofia, Enfermeria Quirofano, Cordoba, Spain; [Romero Sanchez, Marcos] Complejo Hosp Virgen de las Nieves, UGC Digest, Granada, Spain
Objectives: To analyse the efficiency of nurse prescription of the health products inherent to their care work, in Andalusia, Spain, between the years 2009-2015. To also analyse the discussions by the Medical Colleges Organisation and the Ministry of Health, Social Services and Equality, before the draft bill on nurse prescription and their outcome.Design: Scoping review.Data source: Main bibliographic databases of Latin-American, Spanish, and foreign languages were reviewed, including, Fundacion Index, Doyma, and Medline Library. Google Scholar was also used with the same search terms, adding to limit the search the term "Andalusia": "prescription nurse" AND "efficiency" OR "Andalusia". Another search was conducted in the grey literature using the same criteria in the Andalusian Health Service (SAS) web site. It was complemented with an interview with the care director of the SAS.Data extraction: A total of 617 articles were found, of which 20 were selected. In the grey literature, 52 documents were found, of which 4 were used.Results: Few studies were found on the efficiency in nurse prescription in Andalusia, although they are as strong as the data provided by the Andalusian Health Care Directorate on the health products inherent in their profession. After modification of Royal Decree 954/2015, and under pressure from the Medical Colleges Organisation, it leaves the competence of prescription nurse exclusively to the medical indication, who diagnoses and prescribes and eliminates it without argument scientifically endorsed.Conclusions: We corroborate the incorporation of efficiency in the Health System through the nurse prescription, and the rupture with the Royal Decree 954/2015. The allegations of the Medical Colleges Organisation are without argument. (C) 2017 Elsevier Espana, S.L.U.
Comparison of the Effectiveness of an Abbreviated Program versus a Standard Program in Mindfulness, Self-Compassion and Self-Perceived Empathy in Tutors and Resident Intern Specialists of Family and Community Medicine and Nursing in Spain.
(2021-04-20) Pérula-de Torres, Luis Ángel; Verdes-Montenegro-Atalaya, Juan Carlos; Melús-Palazón, Elena; García-de Vinuesa, Leonor; Valverde, Francisco Javier; Rodríguez, Luis Alberto; Lietor-Villajos, Norberto; Bartolomé-Moreno, Cruz; Moreno-Martos, Herminia; García-Campayo, Javier; González-Santos, Josefa; Rodríguez-Fernández, Paula; León-Del-Barco, Benito; Soto-Cámara, Raúl; González-Bernal, Jerónimo J; The Minduudd Collaborative Study Group,
Health professionals are among the most vulnerable to work stress and emotional exhaustion problems. These health professionals include tutors and resident intern specialists, due to the growing demand for the former and the high work overload of the latter. Mindfulness training programs can support these professionals during times of crisis, such as the current global pandemic caused by the coronavirus-19 disease. The objective of this study was to compare the effectiveness of an abbreviated Mindfulness-Based Stress Reduction (MBSR) and Mindful Self-Compassion (MSC) training program in relation to a standard training program on the levels of mindfulness, self-compassion, and self-perceived empathy in tutors and resident intern specialists of Family and Community Medicine and Nursing. A total of 112 professionals attached to six Spanish National Health System teaching units (TUs) participated in this randomized and controlled clinical trial. Experimental Group (GE) participants were included in the standard or abbreviated MBSR programs. The Five Facet Mindfulness Questionnaire (FFMQ), the Self-Compassion Scale short form (SCS-SF), and the Jefferson Scale of Physician Empathy (JSPE) were administered three times during the study: before, immediately after, and 3 months after the intervention. Adjusted covariance analysis (ANCOVA), using pretest scores as the covariate, showed a significant increase in mindfulness (F(2,91) = 3.271; p = 0.042; η2 = 0.067) and self-compassion (F(2,91) = 6.046; p = 0.003; η2 = 0.117) in the post-test visit, and in self-compassion (F(2,79) = 3.880; p = 0.025; η2 = 0.089) in the follow-up visit, attributable to the implementation of the standard training program. The standard MBSR and MSC training program improves levels of mindfulness and self-compassion, and promotes long-lasting effects in tutors and resident intern specialists. New studies are needed to demonstrate the effectiveness of abbreviated training programs.
Frequency and predictive validity of olfactory and taste dysfunction in patients with SARS-CoV-2 infection.
(2021-01-28) Pérula de Torres, Luis Ángel; González-Lama, Jesús; Jiménez García, Celia; Sánchez Montero, Rosa; Rider Garrido, Faustino; Ortega López, Yolanda; Pajares Conde, Diego; Ramírez Baena, Miguel; Párraga Martínez, Ignacio; Romero-Rodríguez, Esperanza; Grupo Colaborativo EPICOVID
Olfactory and taste dysfunction (OD, TD) have been considered symptoms of SARS-CoV-2 infection. However, its presence in certain populations, especially those with mild clinical symptoms, has not been clarified. The objective was to estimate the frequency of OD and TD, and its predictive validity in patients detected in Primary Care. A cross-sectional study was carried out in the Spanish National Health System. An epidemiological survey was administered to patients who were requested the PCR test for SARS-CoV-2. Odds ratio (OR) were estimated to measure the magnitude of the association between OD and TD and the existence of SARS-CoV-2 infection. The sensitivity, specificity, and positive and negative predictive values (PPV, NPV) of these symptoms in SARS-CoV-2 infection were calculated. Of 1,038 patients screened, 20.1% had SARS-CoV-2 infection. OD and DG were present in 64.4% (95% CI 56.0-72.1) and 56.2% (95% CI 47.9-64.2) of the subjects with infection, respectively. The OR for OD was 12.2 (95% CI 8.26-18.06) and for TD was 7.95 (95% CI 5.48-11.53). TD presented a sensitivity of 41.1% (95% CI 34.4-46.1), a specificity of 91.9% (95% CI 89.8-93.7), a PPV of 56.2% (95% CI48.0-64.2) and a NPV of 86.1% (95% CI 83.6-88.3), while the OD showed a sensitivity of 45.0% (95% CI 37.6-51.5), a specificity of 93.7% (95% CI 91.8-95.0), a PPV of 64.4% (95% CI 56.0-72.1) and a NPV of 87.1% (95% CI 84.7-89.2). More than half of the subjects with SARS-CoV-2 infection have OD or TD. The presence of OD or TD could be of diagnostic utility due to its ability to predict infection in more than half of the cases.
[Clinical and epidemiological characteristics of SARS-CoV-2 infections in family physicians: A case-control study].
(2020-12-17) Párraga Martínez, Ignacio; Pérula de Torres, Luis Angel; González Lama, Jesús; Jiménez García, Celia; Sánchez Montero, Rosa; Rider Garrido, Faustino; en representación del Grupo EPICOVID
To identify the sociodemographic, clinical and epidemiological characteristics associated with the presence of infection by the SARS-CoV-2 virus in family physicians who carry out their work in Primary Care (PC) or in Hospital Emergencies. Observational analytical case-control study. SITE: Primary care. 969 Primare Care Physicians, Hospital Emergency physicians and other extrahospitalry centers that had PCR for the detection of the SARS-CoV-2. Of these, 133 participated as cases (PCR positive) and 836 as controls (PCR negative). No. Sociodemographic and work, contact with a COVID-19 patient, symptoms present during the process, first manifested symptom, previous chronic pathologies, and tobacco use. 13.7% (95% CI: 11.6-16.0) were cases infected with SARS-CoV-2. The most frequently declared symptoms by those infected were a feeling of fatigue/tiredness (69.2%; 95% CI: 60.9-77.4%), cough (56.4%; 95% CI: 47.6-65.2%) and headache (55.6%; 95% CI: 46.8-64.4%).Using logistic regression, the variables independently associated with SARS-CoV-2 virus infection in Family Physicians were: previous contact with a COVID-19 patient (OR: 2.3; 95% CI: 1.2-4.2), present fatigue / tiredness (OR: 2.2; 95% CI: 1.2-3.9), smell alteration (4.6; 95% CI: 1.7-12.5), taste alteration (OR: 32.0; 95% CI: 9.6-106.8), cough (OR: 3.0; 95% CI: 1.7-5.3) and fever (OR: 6.1; 95% CI: 3.2-11.4). Symptoms independently related to SARS-CoV-2 virus infection in Family Physicians were fatigue, fever, cough, and altered taste and smell. The presence of these symptoms could facilitate the diagnosis of suspected COVID-19 disease and the earlier selection of those that require confirmatory tests.
Mindfulness in primary care healthcare and teaching professionals and its relationship with stress at work: a multicentric cross-sectional study.
(2021-02-02) Magallón-Botaya, Rosa; Pérula-de Torres, Luis Angel; Verdes-Montenegro Atalaya, Juan Carlos; Pérula-Jiménez, Celia; Lietor-Villajos, Norberto; Bartolomé-Moreno, Cruz; Garcia-Campayo, Javier; Moreno-Martos, Herminia; Minduudd Collaborative Study Group
Work stress is a common problem among the health personnel of the Spanish National Health System. The objective of this paper is to assess the state of mindfulness among Spanish primary care providers and to evaluate its potential relationship with work stress and basic labor and sociodemographic characteristics. Cross-sectional, multi-centric study. Primary care nurses, teachers, teaching collaborators and residents assigned to six Spanish Family Medicine/Family and Community Care Departments were invited to participate (n = 475). A template was designed in Google Forms, including sociodemographic and work-related variables. The state of mindfulness was measured with the Five Facet Mindfulness Questionnaire (FFMQ), while work-related stress was measured using an ordinal scale ranging from 0 to 10 points. Descriptive and inferential statistical analyses were carried out, as well as bivariate and multivariate statistics. The mean age of participants was 40,14 ± 13.12 (range:23-65 years); 66.9% were women, 42.5% internal medicine residents, 29.3% family physicians, and 20.2% nurses. More than half (54.5%) knew about mindfulness, with 24.0% have received training on it, and 22.5% were usual practitioners. The average level of mindfulness was 127.18 ± 15.45 (range: 89-177). The average score of stress at work was 6.00 ± 2.44; 49.9% (range: 0-10). 49.9% of participants scored 7 or more on the stress at work scale. There was an inverse correlation between the levels of mindfulness (FFMQ total score) and work-related stress (Spearman's r = - 0.155, p = 0.003). Significant relationships between the mindfulness practice and the level of mindfulness (F = 29.80, p Levels of mindfulness in primary care health providers were in line with those levels observed in other groups of health professionals. Half of all of the primary care providers suffered from a high degree of stress. Although weak, inverse relationships were observed between levels of mindfulness and stress at work, with lower values of stress at work among those who practiced mindfulness. NCT03629457 .
[Ethical issues in primary care during the coronavirus (SARS-CoV-2) pandemic].
(2020-11-28) Beltran-Aroca, C M; González-Tirado, M; Girela-López, E
Public health emergencies, such as the current SARS-CoV-2 coronavirus pandemic, have led to tragic resource constraints that prevent lives from being saved. This has led to tensions in patient-centered care as the backbone of the system in normal conditions and the same care in emergencies originating in the COVID-19. In this review we address some of the healthcare, organizational and ethical problems that this scenario has caused in primary care such as: cancellation of programmed activities; scarce home care and follow-up of elderly, chronically ill and immobilized patients; shortage of PPE and the exposure to risk of healthcare professionals, and finally the problems associated with telemedicine and telephone attention to patients.
Medical and Legal Aspects of the Practice of Teledermatology in Spain.
(2020-10-06) Gómez Arias, P J; Abad Arenas, E; Arias Blanco, M C; Redondo Sánchez, J; Galán Gutiérrez, M; Vélez García-Nieto, A J
Teledermatology is now fully incorporated into our clinical practice. However, after reviewing current legislation on the ethical aspects of teledermatology (data confidentiality, quality of care, patient autonomy, and privacy) as well as insurance and professional responsibility, we observed that a specific regulatory framework is still lacking and related legal aspects are still at a preliminary stage of development. Safeguarding confidentiality and patient autonomy and ensuring secure storage and transfer of data are essential aspects of telemedicine. One of the main topics of debate has been the responsibilities of the physicians involved in the process, with the concept of designating a single responsible clinician emerging as a determining factor in the allocation of responsibility in this setting. A specific legal and regulatory framework must be put in place to ensure the safe practice of teledermatology for medical professionals and their patients.
[Alcohol use among Medical and Nursing students and Family and Community Medicine residents].
(2020-09-18) Romero-Rodríguez, Esperanza; Pérula de Torres, Luis Ángel; Fernández García, José Ángel; Camarelles Guillem, Francisco
[Degree of knowledge of the European Code against Cancer among university students, residents and health professionals of primary care].
(2019-10-28) Pérula de Torres, Luis Ángel; Romero Rodríguez, Esperanza; Moscosio Cuevas, José Ignacio; Jiménez García, Celia
Impact of a primary care training program on the prevention and management of unhealthy alcohol use: A quasi-experimental study.
(2019-05-23) Romero-Rodríguez, Esperanza; Pérula de Torres, Luis Ángel; Fernández García, José Ángel; Roldán Villalobos, Ana; Ruiz Moral, Roger; Parras Rejano, Juan Manuel
To assess the impact of a training program targeted to Primary Care (PC) professionalson the acquisition of communication skills, attitudes, and knowledge about the prevention and management of unhealthy alcohol use. A quasi-experimental, pre- and post-intervention study was performed in PC centers of Cordoba (Spain). Family doctors, residents and nurses participated in the study. The intervention was based on a motivational interviewing training program, which consisted in a workshop on learning skills, attitudes and knowledge about the alcohol management. PC providers were videotaped with a standardized patient in order to check the clinical and communication competencies acquired. A descriptive, bivariate and multivariate analysis was carried out (p  PC providers' communication skills and attitudes showed significant improvements in the variables studied (p  The present study reveals the impact of a training program targeted to PC professionals on communication skills, attitudes, and knowledge about the prevention and management of patients with unhealthy alcohol use. Training activities targeted to PC providers represent a valuable strategy to improve communication skills, attitudes and knowledge of these professionals in their clinical practice.
Serum Magnesium is associated with Carotid Atherosclerosis in patients with high cardiovascular risk (CORDIOPREV Study).
(2019-05-29) Rodríguez-Ortiz, M Encarnación; Gómez-Delgado, Francisco; Arenas de Larriva, Antonio P; Canalejo, Antonio; Gómez-Luna, Purificación; Herencia, Carmen; López-Moreno, Javier; Rodríguez, Mariano; López-Miranda, José; Almadén, Yolanda
This study aimed to ascertain whether there is an independent association between serum magnesium (Mg) and the Carotid Intima-Media Thickness (IMT-CC), a well-accepted atherosclerotic-biomarker surrogate of cardiovascular disease (CVD), in a population with high cardiovascular risk. Serum Mg and traditional atherosclerotic risk factors were recorded in 939 patients (mean age, 59.6 ± 0.3 years, 83.2% men) with coronary heart disease (CHD) enrolled in the CORDIOPREV trial. Serum Mg strongly associated with IMT-CC. Before adjusting for potential confounding factors, IMT-CC decreased by 0.111 ± 0.011 mm per mg/dl increase in serum Mg (p

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