Estrategia de regularización de actividades mineras en los cantones San Lorenzo y Eloy Alfaro, como alternativa a mejorar las condiciones de vida, salud y ambiente de las poblaciones de influencia directa

Formular estrategias para el control ambiental de actividades mineras metálicas en los cantones San Lorenzo y Eloy Alfaro.La actividad minera informal e ilegal en la provincia Esmeraldas, especialmente en los cantones San Lorenzo y Eloy Alfaro ha causado problemas sociales y ambientales, debido a la generación de pasivos ambientales y la falta de prácticas técnicas. Por esta razón es necesario la regularización y control ambiental de todas las actividades mineras que se desarrollan en el sector. Este proyecto de titulación pretende complementar los estudios sociales y ambientales que se han desarrollado en la provincia Esmeraldas, con el objetivo principal de formular estrategias para el control ambiental de actividades mineras metálicas en los cantones San Lorenzo y Eloy Alfaro. Para la recopilación de datos el método aplicado fue la encuesta o ficha de levantamiento de información, con el fin de identificar los frentes de explotación minera y caracterizar de las prácticas mineras y para los impactos ambientales se aplicó el método de Conesa simplificado mediante la matriz de importancia, para cada uno de los métodos de explotación de minerales identificados en el área de estudio, además se realizó un análisis estadístico socioambiental para definir las dependencias de la labor minera y finalmente se realizó el análisis FODA para la generación de las diferentes estrategias. Se identificó 63 frentes de explotación en los dos cantones, de los cuales en cantón San Lorenzo presenta una mayoría de actividad con 47 casos y 16 para el cantón Eloy Alfaro. Se encontraron dos métodos de explotación conocidos como método Hidráulico y método de explotación por terrazas. Al realizar el análisis mediante la matriz de importancia se pudo identificar que, en el método de dragado, la principal afectación recae sobre el recurso hídrico y los ecosistemas acuáticos al no poseer ningún sistema de sedimentación. Del mismo modo en el método por terrazas se puedo identificar afectación sobre el recurso edáfico y paisaje, ya que no se realiza la etapa de reconformación del área después de ser intervenida. Para concluir las propuestas se generaron a través de los resultados obtenidos del análisis FODA, del cruce entre las variables DO, DA y FA. De lo cual se generaron diferentes programas, capacitación, sistemas de gestión en los proyectos de explotación, recuperación de áreas afectadas por la actividad

Effectiveness of a mental health stepped-care programme for healthcare workers with psychological distress in crisis settings: a multicentre randomised controlled trial

The dataset that supports the findings of this study are available upon reasonable request at the Universidad Autónoma de Madrid data repository, e‐cienciaDatos in https://doi.org/10.21950/HN1HNOArtículo escrito por un elevado número de autores, solo se referencian el que aparece en primer lugar, el nombre del grupo de colaboración, si le hubiere, y los autores pertenecientes a la UAMEvidence-based mental health interventions to support healthcare workers (HCWs) in crisis settings are scarce. Objective To evaluate the capacity of a mental health intervention in reducing anxiety and depression symptoms in HCWs, relative to enhanced care as usual (eCAU), amidst the COVID-19 pandemic. Methods We conducted an analyst-blind, parallel, multicentre, randomised controlled trial. We recruited HCWs with psychological distress from Madrid and Catalonia (Spain). The intervention arm received a stepped-care programme consisting of two WHO-developed interventions adapted for HCWs: Doing What Matters in Times of Stress (DWM) and Problem Management Plus (PM+). Each intervention lasted 5 weeks and was delivered remotely by non-specialist mental health providers. HCWs reporting psychological distress after DWM completion were invited to continue to PM+. The primary endpoint was self-reported anxiety/depression symptoms (Patient Health Questionnaire-Anxiety and Depression Scale) at week 21. Findings Between 3 November 2021 and 31 March 2022, 115 participants were randomised to stepped care and 117 to eCAU (86% women, mean age 37.5). The intervention showed a greater decrease in anxiety/depression symptoms compared with eCAU at the primary endpoint (baseline-adjusted difference 4.4, 95% CI 2.1 to 6.7; standardised effect size 0.8, 95% CI 0.4 to 1.2). No serious adverse events occurred. Conclusions Brief stepped-care psychological interventions reduce anxiety and depression during a period of stress among HCWs. Clinical implications Our results can inform policies and actions to protect the mental health of HCWs during major health crises and are potentially rapidly replicable in other settings where workers are affected by global emergenciesThe RESPOND project was funded by the European Commission under Horizon 2020 - the Framework Programme for Research and Innovation (2014– 2020) (grant number: 101016127). The work of RM was funded by the State Plan for Scientific and Technical Research and Innovation 2021–2023 of the Spanish Agencia Estatal de Investigación (FJC2021-047610-I), the Acción Estratégica en Salud programme of the Instituto de Salud Carlos III (CD22/00061), and the Centro de Investigación Biomédica en Red (CB/07/09/0013). The work of MF-N was funded by the Acción Estratégica en Salud programme of the Instituto de Salud Carlos III (CD20/00036

Spectroelectrochemical operando method for monitoring a phenothiazine electrografting process on amide functionalized C-nanodots/Au hybrid electrodes

Phenothiazine derivatives are extensively explored dye molecules, which present interesting electrochemical and optical properties. In recent years, the possibility of transforming some phenothiazines in their aryl diazonium salt derivatives has been proved, what allows them to be electrochemically reduced and electrografted onto conductive surfaces. This is a smart way to modify these surfaces and enable them with specific functionalities. In order to better comprehend the electrografting process and consequently have a higher control of it, in this work we have carried out an exhaustive study by operando UV–Vis spectroelectrochemistry of the electrografting of a phenothiazine aryl diazonium salt onto amide carbon nanodots. As a model of phenothiazine dye we have chosen Azure A. The electrografting onto carbon nanodots has been stablished by comparison with the results obtained on bare gold electrodes in this novel study. The presence of carbon dots improves the reversibility of the electrochemical process as derived from the results obtained by operando UV–Vis spectroelectrochemistry. In addition, to asses that the electrochemical process studied corresponds to the electrografting, the results have been compared to those obtained for the simple Azure A adsorption. This study shows the advantages of obtaining simultaneously the electrochemical and the spectroscopic evolution of an electron-transfer process in a single experiment, in a particular electrochemical reaction. This work could be the starting point for the study of the electrografting on other nanomaterialsFunding from the Spanish Ministerio de Ciencia, Innovación y Universidades (project: CTQ2017-84309-C2-1-R) and Comunidad Autónoma de Madrid (NANOAVANSENS Program) is acknowledged. IMDEA Nanociencia acknowledges support from the 'Severo Ochoa' Programme for Centres of Excellence in R&D (Ministerio de Ciencia, Innovación y Universidades, Grant SEV-2016-0686

Mindfulness-Based Social Cognition Training (SocialMind) for People With Psychosis: A Feasibility Trial

Introduction: Difficulties in social functioning are common among people with psychosis. Negative symptoms such as blunted affect or social withdrawal are often linked to these difficulties and worsen real-life outcomes. One important dimension associated with social functioning is social cognition, which refers to the psychological processes that are necessary to perceive, encode, store, retrieve, and regulate social information. Mindfulness-based interventions for people with psychosis are safe and effective in improving anxiety and depressive symptoms; however, no mindfulness-based interventions addressing social cognition have yet been developed.Method: A pilot, single-arm, nonrandomized, noncontrolled feasibility trial is proposed. The main objectives are to assess the tolerability of mindfulness-based social cognition training (SocialMind) and to test the feasibility of a further randomized controlled trial.Results: A final sample of 25 outpatients with schizophrenia spectrum disorders was included. Attrition rate was lower than usual for this population, and most participants completed the training. No adverse effects were identified in terms of hospitalizations, emergency room visits, dissociative and psychotic symptoms, or state of anxiety during the sessions.Conclusion: This is the first implementation of SocialMind, which is the first mindfulness-based social cognition training. It is well tolerated by participants with schizophrenia spectrum disorders, and a further randomized controlled trial is proposed for people who have suffered their first episode of psychosis within the past 5 years.Clinical Trial Registration:www.ClinicalTrials.gov, identifier NCT03434405

Enhanced mitochondrial activity reshapes a gut microbiota profile that delays NASH progression

[EN] Background and Aims: Recent studies suggest that mitochondrial dysfunction promotes progression to NASH by aggravating the gut-liver status. However, the underlying mechanism remains unclear. Herein, we hypothesized that enhanced mitochondrial activity might reshape a specific microbiota signature that, when transferred to germ-free (GF) mice, could delay NASH progression. Approach and Results: Wild-type and methylation-controlled J protein knockout (MCJ-KO) mice were fed for 6 weeks with either control or a choline-deficient, L-amino acid–defined, high-fat diet (CDA-HFD). One mouse of each group acted as a donor of cecal microbiota to GF mice, who also underwent the CDA-HFD model for 3 weeks. Hepatic injury, intestinal barrier, gut microbiome, and the associated fecal metabolome were then studied. Following 6 weeks of CDA-HFD, the absence of methylation-controlled J protein, an inhibitor of mitochondrial complex I activity, reduced hepatic injury and improved gut-liver axis in an aggressive NASH dietary model. This effect was transferred to GF mice through cecal microbiota transplantation. We suggest that the specific microbiota profile of MCJ-KO, characterized by an increase in the fecal relative abundance of Dorea and Oscillospira genera and a reduction in AF12, Allboaculum, and [Ruminococcus], exerted protective actions through enhancing short-chain fatty acids, nicotinamide adenine dinucleotide (NAD+) metabolism, and sirtuin activity, subsequently increasing fatty acid oxidation in GF mice. Importantly, we identified Dorea genus as one of the main modulators of this microbiota-dependent protective phenotype. Conclusions: Overall, we provide evidence for the relevance of mitochondria–microbiota interplay during NASH and that targeting it could be a valuable therapeutic approach.S

Beyond effectiveness in eHealth trials: Process evaluation of a stepped-care programme to support healthcare workers with psychological distress (RESPOND-HCWs)

Objectives: This study presents the process evaluation of an effective stepped-care programme of eHealth interventions (Doing What Matters in Times of Stress [DWM] and Problem Management Plus [PM+]) for healthcare workers (HCWs) with psychological distress (RESPOND-HCWs trial) conducted in Spain. The aim is to analyse the context in which the programme was delivered, assess key implementation outcomes and explore mechanisms of action. Methods: We used mixed methods. Quantitative data came from routine randomised control trial monitoring and structured observation, and qualitative data were collected using semi-structured, in-depth interviews with trial participants (n = 12) and decision-makers (n = 7) and a focus group discussion with intervention providers (n = 7). We conducted a descriptive analysis of quantitative data using R software and a thematic analysis of qualitative data using NVivo. Results: Context analysis revealed implementation barriers, including unrealistic expectations of participants about the programme and mental health-related stigma. The flexibility of interventions and the opportunity for mental health actions were enabling factors. Implementation outcomes showed that the trial was feasible, appropriate and timely, and that the intervention was delivered with minimal protocol deviations and good acceptance among participants. Mechanisms of action included confidence in the positive effect of the intervention, a good therapeutic relationship and specific intervention components. Conclusions: These results supplement the outcome evaluation and can help inform large-scale implementation in similar settings. Specific recommendations include increasing mental health awareness and reducing stigma in the implementation setting, including a short orientation session and ensuring flexibility in schedules and peer support. Trial registration number: NCT04980326

Effectiveness of a stepped-care programme of internet-based psychological interventions for healthcare workers with psychological distress: Study protocol for the RESPOND healthcare workers randomised controlled trial

The dataset that supports the findings of this study are archived in the Universidad Autónoma de Madrid data repository e‐cienciaDatos in https://doi.org/10.21950/HN1HNOBackground and aims: The coronavirus disease 2019 pandemic has challenged health services worldwide, with a worsening of healthcare workers’ mental health within initial pandemic hotspots. In early 2022, the Omicron variant is spreading rapidly around the world. This study explores the effectiveness and cost-effectiveness of a stepped-care programme of scalable, internet-based psychological interventions for distressed health workers on self-reported anxiety and depression symptoms. Methods: We present the study protocol for a multicentre (two sites), parallel-group (1:1 allocation ratio), analyst-blinded, superiority, randomised controlled trial. Healthcare workers with psychological distress will be allocated either to care as usual only or to care as usual plus a stepped-care programme that includes two scalable psychological interventions developed by the World Health Organization: A guided self-help stress management guide (Doing What Matters in Times of Stress) and a five-session cognitive behavioural intervention (Problem Management Plus). All participants will receive a single-session emotional support intervention, namely psychological first aid. We will include 212 participants. An intention-to-treat analysis using linear mixed models will be conducted to explore the programme's effect on anxiety and depression symptoms, as measured by the Patient Health Questionnaire – Anxiety and Depression Scale summary score at 21 weeks from baseline. Secondary outcomes include post-traumatic stress disorder symptoms, resilience, quality of life, cost impact and cost-effectiveness. Conclusions: This study is the first randomised trial that combines two World Health Organization psychological interventions tailored for health workers into one stepped-care programme. Results will inform occupational and mental health prevention, treatment, and recovery strategies. Registration details: ClinicalTrials.gov Identifier: NCT04980326The RESPOND project was funded under Horizon 2020 -the Framework Programme for Research and Innovation (2014– 2020) (grant number: 101016127), and the work of MF-N was supported by a postdoctoral fellowship of the ISCIII (CD20/ 00036

Effectiveness of a mental health stepped-care programme for healthcare workers with psychological distress in crisis settings: a multicentre randomised controlled trial

Background Evidence-based mental health interventions to support healthcare workers (HCWs) in crisis settings are scarce. Objective To evaluate the capacity of a mental health intervention in reducing anxiety and depression symptoms in HCWs, relative to enhanced care as usual (eCAU), amidst the COVID-19 pandemic. Methods We conducted an analyst-blind, parallel, multicentre, randomised controlled trial. We recruited HCWs with psychological distress from Madrid and Catalonia (Spain). The intervention arm received a stepped-care programme consisting of two WHO-developed interventions adapted for HCWs: Doing What Matters in Times of Stress (DWM) and Problem Management Plus (PM+). Each intervention lasted 5 weeks and was delivered remotely by non-specialist mental health providers. HCWs reporting psychological distress after DWM completion were invited to continue to PM+. The primary endpoint was self-reported anxiety/depression symptoms (Patient Health Questionnaire-Anxiety and Depression Scale) at week 21. Findings Between 3 November 2021 and 31 March 2022, 115 participants were randomised to stepped care and 117 to eCAU (86% women, mean age 37.5). The intervention showed a greater decrease in anxiety/depression symptoms compared with eCAU at the primary endpoint (baseline-adjusted difference 4.4, 95% CI 2.1 to 6.7; standardised effect size 0.8, 95% CI 0.4 to 1.2). No serious adverse events occurred. Conclusions Brief stepped-care psychological interventions reduce anxiety and depression during a period of stress among HCWs. Clinical implications Our results can inform policies and actions to protect the mental health of HCWs during major health crises and are potentially rapidly replicable in other settings where workers are affected by global emergencies