Enhancing Depression Screening and Treatment for Latinxs Residing in the U.S.

Introduction: In the U.S., Latinxs with Spanish as their preferred language encounter two prominent structural barriers impacting access to treatment for major depressive disorder (MDD). The first is that MDD symptoms commonly go undetected in Latinxs with Spanish compared to English as their preferred language. This might be perhaps because commonly used MDD screeners lack somatic symptom survey items culturally specific in how MDD may present among Latinxs with Spanish as their preferred language. The second structural barrier is that treatment access and completion rates are lower in Spanish-speaking than English-speaking Latinxs, perhaps due to treatments lacking the structure and approaches favored by Spanish-speakers. Purpose: This study had two aims (1) Examining whether the sensitivity and specificity of the Patient Health Questionnaire (PHQ-9) could be enhanced by including a modified version of the Brief Symptom Inventiory-18 (BSI-18) somatic items; and (2) better understanding preferences for MDD treatment across linguistic groups. Together, these aims can potentially improve the recognition and treatment of depression in a largely underserved population. Design and Method: Participants were 50 Latinx adults who completed online self-report measures and a virtual MDD structured diagnostic and qualitative interview about their preferences for MDD treatment. Analytic Approach: Chi-square analyses were used to determine similarities in PHQ-9 responses between the Spanish and English-speaking subsamples. The area under the curve analyses (AUC) helped determine the cut-off in which the PHQ-9 best detected MDD in Spanish-speaking and English-speaking Latinxs and whether sensitivity and specificity improved when the somatic items were added to the screener. Thematic analyses summarized depression treatment preferences. Results: English-speaking participants endorsed more symptoms of MDD than Spanish-speaking Latinxs. Regardless of language preference, Latinx participants met diagnostic criteria for MDD according to the MDD MINI more often than on the PHQ-9 alone. The cut-off points for the PHQ-9, according to the AUC analyses, were substantially lower than the recommended cut-off. Adding the modified somatic items of the BSI-18 to the PHQ-9 did not increase the sensitivity and specificity of the PHQ-9. Qualitative interviews juxtapose differences in the description of depression based on language groups. Spanish- speakers focused on relational ways depression impacts a sense of community connectedness. English-speakers focused on debilitating individual experiences. Both language groups endorsed preferences for therapists versed in cultural considerations. Preferences for treatment placed counseling above medication and in-person above telehealth. Conclusions: Adding the modified somatic items of the BSI-18 to the PHQ-9 did not increase the sensitivity and specificity of the PHQ-9. Future work should investigate whether adding relationship quality questions should be included in depression screeners

Perceptions of Help-Seeking Likelihood for Depression: Examining the Relative Predictive Value of Ethnicity and Barriers to Care

Latinx and non-Latinx White adults 18 years of age and older experience depression at proportional rates. However, Latinxs seek specialized care for depression at lower rates than non-Latinx Whites, suggesting these groups experience barriers in accessing care differently. This study sought to test the theoretical steps of help-seeking as informed by the Gaining Access and Treatment Equity model (GATE model; Bridges, 2018). According to the GATE model, successful help-seeking means navigating a series of barriers: sequentially, these are perceived need, attitudinal barriers, and structural barriers. Participants (N = 987) were either Latinx (n = 437) or non-Latinx White (n = 550) undergraduate students enrolled in general psychology courses. Participants were randomized to read one of eight vignettes describing a woman with depression and were asked to rate how likely the character would be to seek mental health services. The character’s perceived need for services, attitudinal barriers, and structural barriers for seeking specialized care were manipulated. High perceived need versus low perceived need was hypothesized to better predict help-seeking. Low attitudinal versus high attitudinal barriers was hypothesized to better predict help-seeking. Low external versus high attitudinal barriers was hypothesized to better predict help-seeking. Hypotheses were tested using independent sample t-tests. The three hypotheses were supported. Logistic regression revealed structural barriers served as the strongest predictor for likelihood of seeking care. Structural barriers moderated the relationship between perceived need and perceived likelihood of seeking care, such that help-seeking was more likely to occur when structural barriers were low and perceived need was high. The same moderation effect was true for attitudinal barriers, such that perceived help-seeking was more likely in the context of low attitudinal barriers when perceived need was high. Participants’ ethnicity did not moderate the relationship between perceived need and perceived likelihood of seeking care. This work highlights the importance of addressing structural barriers to reduce disparities in accessing treatment for depression

Enhancing Depression Screening and Treatment for Latinxs Residing in the U.S.

Introduction: In the U.S., Latinxs with Spanish as their preferred language encounter two prominent structural barriers impacting access to treatment for major depressive disorder (MDD). The first is that MDD symptoms commonly go undetected in Latinxs with Spanish compared to English as their preferred language. This might be perhaps because commonly used MDD screeners lack somatic symptom survey items culturally specific in how MDD may present among Latinxs with Spanish as their preferred language. The second structural barrier is that treatment access and completion rates are lower in Spanish-speaking than English-speaking Latinxs, perhaps due to treatments lacking the structure and approaches favored by Spanish-speakers. Purpose: This study had two aims (1) Examining whether the sensitivity and specificity of the Patient Health Questionnaire (PHQ-9) could be enhanced by including a modified version of the Brief Symptom Inventiory-18 (BSI-18) somatic items; and (2) better understanding preferences for MDD treatment across linguistic groups. Together, these aims can potentially improve the recognition and treatment of depression in a largely underserved population. Design and Method: Participants were 50 Latinx adults who completed online self-report measures and a virtual MDD structured diagnostic and qualitative interview about their preferences for MDD treatment. Analytic Approach: Chi-square analyses were used to determine similarities in PHQ-9 responses between the Spanish and English-speaking subsamples. The area under the curve analyses (AUC) helped determine the cut-off in which the PHQ-9 best detected MDD in Spanish-speaking and English-speaking Latinxs and whether sensitivity and specificity improved when the somatic items were added to the screener. Thematic analyses summarized depression treatment preferences. Results: English-speaking participants endorsed more symptoms of MDD than Spanish-speaking Latinxs. Regardless of language preference, Latinx participants met diagnostic criteria for MDD according to the MDD MINI more often than on the PHQ-9 alone. The cut-off points for the PHQ-9, according to the AUC analyses, were substantially lower than the recommended cut-off. Adding the modified somatic items of the BSI-18 to the PHQ-9 did not increase the sensitivity and specificity of the PHQ-9. Qualitative interviews juxtapose differences in the description of depression based on language groups. Spanish- speakers focused on relational ways depression impacts a sense of community connectedness. English-speakers focused on debilitating individual experiences. Both language groups endorsed preferences for therapists versed in cultural considerations. Preferences for treatment placed counseling above medication and in-person above telehealth. Conclusions: Adding the modified somatic items of the BSI-18 to the PHQ-9 did not increase the sensitivity and specificity of the PHQ-9. Future work should investigate whether adding relationship quality questions should be included in depression screeners

Standefer v. State: The Creation of the Criminal Defendant\u27s Diminished Right to a Trial by a Fair and Impartial Jury.

In Texas, the right of an accused to have an impartial jury is firmly grounded in the voir dire process, the definitive goal of which is to empanel a fair and impartial jury. The right to a fair and impartial jury is bolstered by the voir dire examination. There have been large discrepancies over the types of questions which can be asked during the voir dire process. The court’s attempt to simplify the process of differentiating between proper and improper voir dire questions has “muddied the issue” for court participants and has resulted in the deprivation of a criminal defendant’s Sixth Amendment right to a fair and impartial jury. Much of the confusion has been over commitment questions and when such questions are proper. The standard adopted in Standefer v. State presents a threat to a fair and impartial jury because, in deciding which types of commitment questions are proper, the Texas Court of Criminal Appeals appears to be limiting the right to use a peremptory challenge. It is apparent the Texas Court of Criminal Appeals had good intentions when it adopted Standefer and later when it modified the test in Barajas v. State. The court attempted to simplify the process of determining when a question improperly commits a prospective juror to a particular verdict. When the court in Standefer required proper commitment questions to lead to valid challenges for cause, it ignored one of the most important purposes of voir dire — examination so litigants can intelligently exercise both challenges for cause and peremptory challenges. Furthermore, Barajas’s failure to provide litigants with guidance as to whether a question is too factually detailed or overly broad, transforming voir dire into an impossible guessing game which further denies criminal defendants of their right to a fair and impartial jury

Standefer v. State: The Creation of the Criminal Defendant\u27s Diminished Right to a Trial by a Fair and Impartial Jury.

In Texas, the right of an accused to have an impartial jury is firmly grounded in the voir dire process, the definitive goal of which is to empanel a fair and impartial jury. The right to a fair and impartial jury is bolstered by the voir dire examination. There have been large discrepancies over the types of questions which can be asked during the voir dire process. The court’s attempt to simplify the process of differentiating between proper and improper voir dire questions has “muddied the issue” for court participants and has resulted in the deprivation of a criminal defendant’s Sixth Amendment right to a fair and impartial jury. Much of the confusion has been over commitment questions and when such questions are proper. The standard adopted in Standefer v. State presents a threat to a fair and impartial jury because, in deciding which types of commitment questions are proper, the Texas Court of Criminal Appeals appears to be limiting the right to use a peremptory challenge. It is apparent the Texas Court of Criminal Appeals had good intentions when it adopted Standefer and later when it modified the test in Barajas v. State. The court attempted to simplify the process of determining when a question improperly commits a prospective juror to a particular verdict. When the court in Standefer required proper commitment questions to lead to valid challenges for cause, it ignored one of the most important purposes of voir dire — examination so litigants can intelligently exercise both challenges for cause and peremptory challenges. Furthermore, Barajas’s failure to provide litigants with guidance as to whether a question is too factually detailed or overly broad, transforming voir dire into an impossible guessing game which further denies criminal defendants of their right to a fair and impartial jury

Papel Protagónico en el Centro Escolar El Hular del municipio de El Tuma – La Dalia, en acciones de mitigación y adaptación ante el cambio climático, durante el II semestre del 2011

El presente estudio resume el papel protagónico del centro escolar el Hular del municipio El Tuma la Dalia, durante el segundo semestre del año 2011,el cual fue generado producto de investigación dirigida a fuentes primarias, con el propósito de conocer y evaluar que acciones de adaptación y mitigación se implementan en los centros educativos, particularmente en el centro escolar El Hular, para enfrentar la crisis de cambio climático que afecta irreversiblemente al planeta donde la comunidad educativa no está exenta de ella. Herramienta que servirá también al Ministerio de Educación como un indicador para evaluar el grado de cumplimiento de la temática de cambio climático descrita en los programas de educación y bajo que metodología se están desarrollando. Según encuestas aplicadas a estudiantes, entrevistas a docentes señalan que la falta de conocimientos teóricos y prácticos en la temáticas ambiental, que poseen docentes y alumnos, limitan su capacidad de comprender la magnitud del problema, donde se promueve algunas acciones como la reforestación, el uso racional del agua, el ahorro de la energía, depositar los desechos sólidos en sacos que ubican los estudiantes, sanjeos a la orilla del centro para que no se destruya la infraestructura y limpieza de cada aula y el centro por parte de los estudiantes en conjuntos con los docente

Violencia, bienestar económico y población: México 1998-2016

La presente investigación se plantea el objetivo de analizar el fenómeno de la violencia en México en dos vertientes: primero a la luz de las cifras publicadas por el INEGI en donde se señala que la cifra de homicidios en 2017 alcanzó la cifra récord de 31,174 y segundo mediante la prueba hipótesis a través de un modelo panel que afirma que la violencia está asociada a la violencia misma y a factores de bienestar económico y demográfico. El estudio rechaza la hipótesis nula para tres grupos de entidades federativas: las que concentran cerca del 50% de las variables estudiadas; las que muestran una tendencia hacia la disminución y las que destacan por el número de homicidios creciente por cada cien mil habitantes entre 1998 y 2016. Al final concluimos que la violencia tiene un carácter estructural, difícil de abatir en el corto plazo

Effectiveness and implementation of an online intervention (MINDxYOU) for reducing stress and promote mental health among healthcare workers in Spain : a study protocol for a stepped-wedge cluster randomized trial

The World Health Organization has formally recognized that healthcare professionals are at risk of developing mental health problems; finding ways to reduce their stress is mandatory to improve both their quality of life and, indirectly, their job performance. In recent years, particularly since the COVID-19 pandemic outbreak, there has been a proliferation of online interventions with promising results. The purpose of the present study is twofold: to test the effectiveness of an online, self-guided intervention, MINDxYOU, to reduce the stress levels of healthcare workers; and to conduct an implementation study of this intervention. Additionally, an economic evaluation of the intervention will be conducted. The current study has a hybrid effectiveness-implementation type 2 design. A stepped wedge cluster randomized trial design will be used, with a cohort of 180 healthcare workers recruited in two Spanish provinces (Malaga and Zaragoza). The recruitment stage will commence in October 2022. Frontline health workers who provide direct care to people in a hospital, primary care center, or nursing home setting in both regions will participate. The effectiveness of the intervention will be studied, with perceived stress as the main outcome (Perceived Stress Scale), while other psychopathological symptoms and process variables (e.g., mindfulness, compassion, resilience, and psychological flexibility) will be also assessed as secondary outcomes. The implementation study will include analysis of feasibility, acceptability, adoption, appropriateness, fidelity, penetration, and sustainability. The incremental costs and benefits, in terms of quality-adjusted life years, will be examined by means of cost-utility and cost-effectiveness analyses. MINDxYOU is designed to reduce healthcare workers' stress levels through the practice of mindfulness, acceptance, and compassion, with a special focus on how to apply these skills to healthy habits and considering the particular stressors that these professionals face on a daily basis. The present study will show how implementation studies are useful for establishing the framework in which to address barriers to and promote facilitators for acceptability, appropriateness, adoption, feasibility, fidelity, penetration, and sustainability of online interventions. The ultimate goal is to reduce the research-to-practice gap. This study was registered in ClinicalTrials.gov on 29/06/2022; registration number: NCT05436717

Gran Telescopio Canarias observations of an overdense region of Lyman α emitters at z = 6.5

We present the results of our search near the end of the Reionization Epoch for faint galaxies. This has been done using very deep OSIRIS images obtained at the Gran Telescopio Canarias (GTC). Our observations focus around two close, massive Lyman α emitters (LAEs) at redshift 6.5, discovered in the SXDS field within a large-scale overdense region. The total GTC observing time in three medium band filters (F883w35, F913w25 and F941w33) is over 34 h covering 7.0 × 8.5 arcmin2 (or ∼30 000 Mpc3 at z = 6.5). In addition to the two spectroscopically confirmed LAEs in the field, we have identified 45 other LAE candidates. The preliminary luminosity function derived from our observations, assuming a spectroscopic confirmation success rate of 2/3 as in previous surveys, suggests this area is about 2 times denser than the general field galaxy population at z = 6.5. If confirmed spectroscopically, our results will imply the discovery of one of the earliest protoclusters in the Universe, which will evolve to resemble the most massive galaxy clusters today

(el caso del Macizo de Caroig)

Se estudian los regímenes selvícolas más adecuados para la utilización energética y maderable de las masas de pino carrasco (Pinus halepensis) del Macizo del Caroig, partiendo de los datos de un inventario LIDAR y de una revision bibliográfica amplia sobre la especie. Se proporcionan datos sobre los sistemas de aprovechamiento más adecuados, sus rendimientos y costes estimados para los distintos tipos de masas forestales inventariadas, se estudia la influencia de esos tratamientos sobre el riesgo de incendios forestales y se recomiendan prácticas para reducir su incidencia y gravedad a través de selvicultura preventiva e infraestructuras de defensa optimizadas mediante algoritmos basados en lógica fuzzy. Se proporcionan también datos sobre transformación energética y características de los combustibles