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Errázuriz A, Passi Solar A, Beltrán R, Paz C, Evans C, De la Parra G. Psychometric properties of the Spanish version of the Clinical Outcomes in Routine Evaluation Outcome Measure (CORE-OM) in Chile. Psychother Res 2024:1-13. [PMID: 38781596 DOI: 10.1080/10503307.2024.2356195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 05/09/2024] [Indexed: 05/25/2024] Open
Abstract
OBJECTIVE To examine the psychometric properties of the Spanish version of the 34-item Clinical Outcomes in Routine Evaluation-Outcome Measure questionnaire (CORE-OM). METHOD Psychometric exploration was conducted in two samples: non-clinical (n = 706) and clinical (n = 420) participants. The non-clinical sample comprised a subgroup of community members (n = 308) and students (n = 398). The clinical sample consisted of self-reported patients (n = 209) and outpatients (n = 211). The analysis included both internal and test-retest reliability, convergent validity, and principal component analysis. A reliable change index and clinical cut-off scores were established for assessing clinically significant change. RESULTS The Spanish CORE-OM demonstrated good internal consistency and test-retest reliability, along with satisfactory convergent validity against the 45-item Outcome Questionnaire (OQ-45.2). There were strong differentiations between the clinical and non-clinical samples and the four sample subsets. The outpatient group reported the highest scores, while the community group exhibited the lowest scores. There were no marked gender effects. All observed patterns aligned closely with the established Spanish referential data. CONCLUSION Our findings provide support for the utilization of the Spanish CORE-OM as a measure for tracking psychotherapeutic progress in the context of Chile.
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Affiliation(s)
- Antonia Errázuriz
- Department of Psychiatry, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile
- Millennium Institute for Research on Depression and Personality-MIDAP, Santiago, Chile
| | - Alvaro Passi Solar
- Department of Public Health, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Rodrigo Beltrán
- Department of Psychology, Universidad de Chile, Santiago, Chile
| | - Clara Paz
- Grupo de Investigación Bienestar, Salud y Sociedad, Escuela de Psicología y Educación, Universidad de Las Américas, Quito, Ecuador
| | - Chris Evans
- Grupo de Investigación Bienestar, Salud y Sociedad, Escuela de Psicología y Educación, Universidad de Las Américas, Quito, Ecuador
- Department of Psychology, The University of Roehampton, London, UK
| | - Guillermo De la Parra
- Department of Psychiatry, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile
- Millennium Institute for Research on Depression and Personality-MIDAP, Santiago, Chile
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Fernández-Alvarez J, Molinari G, Kilcullen R, Delgadillo J, Drill R, Errázuriz P, Falkenstrom F, Firth N, O'Shea A, Paz C, Youn SJ, Castonguay LG. The Importance of Conducting Practice-oriented Research with Underserved Populations. Adm Policy Ment Health 2024; 51:358-375. [PMID: 38157130 DOI: 10.1007/s10488-023-01337-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2023] [Indexed: 01/03/2024]
Abstract
There has been a growing emphasis on dissemination of empirically supported treatments. Dissemination, however, should not be restricted to treatment. It can and, in the spirit of the scientific-practitioner model, should also involve research. Because it focuses on the investigation of clinical routine as it takes place in local settings and because it can involve the collaboration of several stakeholders, practice-oriented research (POR) can be viewed as an optimal research method to be disseminated. POR has the potential of addressing particularly relevant gaps of knowledge and action when implemented in regions of the world that have limited resources for or experiences with empirical research, and/or in clinical settings that are serving clinical populations who are not typically receiving optimal mental care services - specifically, individuals in rural and inner cities that have limited economic and social resources. The establishment and maintenance of POR in such regions and/or settings, however, come with specific obstacles and challenges. Integrating the experiences acquired from research conducted in various continents (Africa, Europe, Latin America, and North America), the goal of this paper is to describe some of these challenges, strategies that have been implemented to address them, as well as new possible directions to facilitate the creation and growth of POR. It also describes how these challenges and ways to deal with them can provide helpful lessons for already existing POR infrastructures.
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Affiliation(s)
| | - Guadalupe Molinari
- International University of Valencia, Valencia, Spain
- Aiglé Valencia, Valencia, Spain
| | - Ryan Kilcullen
- Department of Psychology, The Pennsylvania State University, Pennsylvania, USA
| | - Jaime Delgadillo
- Clinical and Applied Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, UK
| | - Rebecca Drill
- Department of Psychiatry, Cambridge Health Alliance, Cambridge, USA
| | - Paula Errázuriz
- Pontificia Universidad Católica de Chile, Santiago de Chile, Chile
- Millennium Institute for Research on Depression and Personality, Chile, PsiConecta, Chile
| | | | - Nick Firth
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Amber O'Shea
- Department of Educational Psychology, Counseling, and Special Education, The Pennsylvania State University, Pennsylvania, USA
| | - Clara Paz
- Universidad de Las Américas, Ciudad de México, Ecuador
| | - Soo Jeong Youn
- Reliant Medical Group, OptumCare, Harvard Medical School, Worcester, MA, USA
| | - Louis G Castonguay
- Department of Psychology, The Pennsylvania State University, Pennsylvania, USA
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Izquierdo-Condoy JS, Sánchez Abadiano LE, Sánchez W, Rodríguez I, De La Cruz Matías K, Paz C, Ortiz-Prado E. Exploring healthcare barriers and satisfaction levels among deaf individuals in Ecuador: A video-based survey approach. Disabil Health J 2024:101622. [PMID: 38580501 DOI: 10.1016/j.dhjo.2024.101622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 03/15/2024] [Accepted: 03/27/2024] [Indexed: 04/07/2024]
Abstract
BACKGROUND Approximately 80% of Deaf individuals live in low- and middle-income countries, where health systems often overlook their specific needs. This communication gap can result in misdiagnosis and inappropriate treatment, impacting their overall satisfaction with healthcare services. OBJECTIVES This study aims to uncover barriers to healthcare access and preferences among the Deaf population in Ecuador, and the role of communication barriers in shaping satisfaction levels with healthcare services. METHODS The study gathered data from 386 participants through online surveys, focusing on demographic characteristics, healthcare experiences, communication methods, and levels of satisfaction. Descriptive statistics and association analyses were employed to analyze the data. RESULTS The study reveals that nearly all participants possessed an officially recognized disability (95.9%) and 53.9% reported hereditary deafness. Ecuadorian sign language was predominant (60.9%). Communication barriers were evident, with 65.0% having trouble understanding medical instructions, and 66.6% identifying a deficiency of tools for Deaf individuals in healthcare settings. Satisfaction levels were associated with the presence of interpreters during medical care, with 46.6% expressing a preference for interpreters over other communication methods. Additionally, private healthcare facilities were perceived as providing better services, despite being less frequently accessed (38.9%). Dissatisfaction was evident, particularly in aspects of communication and physician courtesy. CONCLUSIONS This study underscores the importance of tailoring healthcare services to address the unique needs of the Deaf population. Communication barriers emerged as a central obstacle, necessitating the inclusion of sign language interpreters and improvement of resources. The study's implications extend to healthcare equity in developing nations, emphasizing the significance of patient-centered care and inclusive healthcare practices.
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Affiliation(s)
| | | | - Wilson Sánchez
- Facultad de Ciencias Médicas, Universidad Central del Ecuador, Quito, 170136, Ecuador
| | - Ivonne Rodríguez
- Facultad de Ciencias Médicas, Universidad Central del Ecuador, Quito, 170136, Ecuador
| | | | - Clara Paz
- Grupo de Investigación Bienestar, Salud y Sociedad, Universidad de las Américas, Quito, 170137, Ecuador
| | - Esteban Ortiz-Prado
- One Health Research Group, Universidad de las Américas, Quito, 170137, Ecuador.
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Rivadulla C, Pardo-Vazquez JL, de Labra C, Aguilar J, Suarez E, Paz C, Álvarez-Dolado M, Cudeiro J. Transcranial static magnetic stimulation reduces seizures in a mouse model of Dravet syndrome. Exp Neurol 2023; 370:114581. [PMID: 37884190 DOI: 10.1016/j.expneurol.2023.114581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 10/03/2023] [Accepted: 10/21/2023] [Indexed: 10/28/2023]
Abstract
Dravet syndrome is a rare form of severe genetic epilepsy characterized by recurrent and long-lasting seizures. It appears around the first year of life, with a quick evolution toward an increase in the frequency of the seizures, accompanied by a delay in motor and cognitive development, and does not respond well to antiepileptic medication. Most patients carry a mutation in the gene SCN1A encoding the α subunit of the voltage-gated sodium channel Nav1.1, resulting in hyperexcitability of neural circuits and seizure onset. In this work, we applied transcranial static magnetic stimulation (tSMS), a non-invasive, safe, easy-to-use and affordable neuromodulatory tool that reduces neural excitability in a mouse model of Dravet syndrome. We demonstrate that tSMS dramatically reduced the number of crises. Furthermore, crises recorded in the presence of the tSMS were shorter and less intense than in the sham condition. Since tSMS has demonstrated its efficacy at reducing cortical excitability in humans without showing unwanted side effects, in an attempt to anticipate a possible use of tSMS for Dravet Syndrome patients, we performed a numerical simulation in which the magnetic field generated by the magnet was modeled to estimate the magnetic field intensity reached in the cerebral cortex, which could help to design stimulation strategies in these patients. Our results provide a proof of concept for nonpharmacological treatment of Dravet syndrome, which opens the door to the design of new protocols for treatment.
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Affiliation(s)
- C Rivadulla
- Universidade da Coruña, NEUROcom, Centro Interdisciplinar de Química e Bioloxía (CICA), Rúa as Carballeiras, A Coruña 15071, Spain; Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas. As Xubias, A Coruña 15006, Spain; Universidade da Coruña, NEUROcom, Facultade de Ciencias da Saúde, Campus de Oza, A Coruña, Spain.
| | - J L Pardo-Vazquez
- Universidade da Coruña, NEUROcom, Centro Interdisciplinar de Química e Bioloxía (CICA), Rúa as Carballeiras, A Coruña 15071, Spain; Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas. As Xubias, A Coruña 15006, Spain; Universidade da Coruña, NEUROcom, Facultade de Ciencias da Saúde, Campus de Oza, A Coruña, Spain
| | - C de Labra
- Universidade da Coruña, NEUROcom, Centro Interdisciplinar de Química e Bioloxía (CICA), Rúa as Carballeiras, A Coruña 15071, Spain; Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas. As Xubias, A Coruña 15006, Spain; Universidade da Coruña, NEUROcom, Facultade de Enfermería e Podoloxía, Campus de Esteiro, Ferrol, Spain
| | - J Aguilar
- Laboratorio de Neurofisiología Experimental, y Circuitos Neuronales Hospital Nacional de Parapléjicos, Servicio de Salud de Castilla-La Mancha, Toledo, Spain
| | - E Suarez
- School of Industrial Engineering, University of Vigo, Campus Universitario Lagoas-Marcosende, Vigo 36310, Spain
| | - C Paz
- School of Industrial Engineering, University of Vigo, Campus Universitario Lagoas-Marcosende, Vigo 36310, Spain
| | - M Álvarez-Dolado
- Laboratorio de Terapia Celular en Neuropatologías, Centro Andaluz de Biología Molecular y Medicina Regenerativa (CABIMER), Spain
| | - J Cudeiro
- Universidade da Coruña, NEUROcom, Centro Interdisciplinar de Química e Bioloxía (CICA), Rúa as Carballeiras, A Coruña 15071, Spain; Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas. As Xubias, A Coruña 15006, Spain; Universidade da Coruña, NEUROcom, Facultade de Ciencias da Saúde, Campus de Oza, A Coruña, Spain; Centro de Estimulación Cerebral de Galicia, Enique Mariñas 32, 15009, A Coruña, Spain
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Paz C, Glassey A, Frick AG, Kimple RE, Kimple RJ. Pathway Analysis of Transcriptional Alterations in the Salivary Gland Following Radiation Exposure. Int J Radiat Oncol Biol Phys 2023; 117:e254-e255. [PMID: 37784983 DOI: 10.1016/j.ijrobp.2023.06.1200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Radiation-induced xerostomia (RIX) is the subjective condition of dry mouth caused by radiation therapy to the head and neck and a result of hyposalivation and altered sialochemistry. Our long-term goal is to develop novel approaches to improve salivary function after radiation therapy. To better understand the molecular alterations induced by radiation in the salivary glands, we performed transcriptional profiling aimed at describing acute and long-term alterations in the murine salivary glands induced by radiation to better design effective regenerative therapies. MATERIALS/METHODS The submandibular gland (SMG) of male C57Bl/6 mice received 15 Gy in a single fraction using a small animal image-guided irradiator. The mice were followed for 90 days. Saliva was collected at baseline and 7, 60 and 90 days after radiation. Salivary glands were collected for histology 3, 7, 60, and 90 days after radiation. The tissues were analyzed using a multiplex analysis platform processed with the murine whole transcriptome panel to investigate changes in gene expression over time. Using the multiplex analysis platform software, 96 regions of interest corresponding to acini, ducts, and granular convoluted tubules (GCTs) were delineated and gene expression was assessed separately in each area. To confirm the identified alterations, SMG tissue was histologically evaluated for fibrosis (masons tri-chrome), mucin (alcian blue), and amylase (α-amylase). Alterations in the immune microenvironment (CD19, CD3, and F4/80) and salivary gland stem cells (MIST1, SCA, Sox2, and c-Kit) were assessed by immunohistochemistry. RESULTS Radiation resulted in a significant decrease in salivary production compared to nonirradiated controls (p-value = 0.03). The analysis of the transcriptional pathway identified early alterations in cell communication, DNA damage, and the immune response. Protein metabolism and extracellular matrix remodeling were up-regulated at later time points. Histological evaluation of tissues showed an increase in glandular structure disorganization over time, with a decrease in the size and distribution of the acinar compartments throughout the gland (mean area stained: No RT = 25.81% vs 90d RT = 19.98%, p-value = 0.005). There was an increase in periductal fibrosis within the tissue after 60 days compared to controls. Acutely, there was an increase in the expression of MIST1 and macrophages (mean area stained: No RT = 14.8% vs 7d RT = 18.76%, p-value = 0.0004) within the SMG that had resolved by the 60- and 90-day time points. CONCLUSION The results implicate macrophage alterations in radiation-induced salivary gland damage and provide valuable mechanistic insight guiding potential approaches to intervene in RIX. We are pursuing cell therapy-based approaches to prevent and repair damage caused by radiation in order to improve the lives of our patients.
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Affiliation(s)
- C Paz
- University of Wisconsin, Madison, WI
| | - A Glassey
- University of Wisconsin - Madison, Madison, WI
| | - A G Frick
- University of Wisconsin, Madison, WI
| | | | - R J Kimple
- Department of Human Oncology, University of Wisconsin, Madison, WI
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Pérez-Villa A, Echeverría-Garcés G, Ramos-Medina MJ, Prathap L, Martínez-López M, Ramírez-Sánchez D, García-Cárdenas JM, Armendáriz-Castillo I, Guerrero S, Paz C, López-Cortés A. Integrated multi-omics analysis reveals the molecular interplay between circadian clocks and cancer pathogenesis. Sci Rep 2023; 13:14198. [PMID: 37648722 PMCID: PMC10469199 DOI: 10.1038/s41598-023-39401-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 07/25/2023] [Indexed: 09/01/2023] Open
Abstract
Circadian rhythms (CRs) are fundamental biological processes that significantly impact human well-being. Disruption of these rhythms can trigger insufficient neurocognitive development, insomnia, mental disorders, cardiovascular diseases, metabolic dysfunctions, and cancer. The field of chronobiology has increased our understanding of how rhythm disturbances contribute to cancer pathogenesis, and how circadian timing influences the efficacy of cancer treatments. As the circadian clock steadily gains recognition as an emerging factor in tumorigenesis, a thorough and comprehensive multi-omics analysis of CR genes/proteins has never been performed. To shed light on this, we performed, for the first time, an integrated data analysis encompassing genomic/transcriptomic alterations across 32 cancer types (n = 10,918 tumors) taken from the PanCancer Atlas, unfavorable prognostic protein analysis, protein-protein interactomics, and shortest distance score pathways to cancer hallmark phenotypes. This data mining strategy allowed us to unravel 31 essential CR-related proteins involved in the signaling crossroad between circadian rhythms and cancer. In the context of drugging the clock, we identified pharmacogenomic clinical annotations and drugs currently in late phase clinical trials that could be considered as potential cancer therapeutic strategies. These findings highlight the diverse roles of CR-related genes/proteins in the realm of cancer research and therapy.
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Affiliation(s)
- Andy Pérez-Villa
- Cancer Research Group (CRG), Faculty of Medicine, Universidad de Las Américas, Quito, Ecuador
- Programa de Investigación en Salud Global, Facultad de Ciencias de la Salud, Universidad Internacional SEK, Quito, Ecuador
- Latin American Network for the Implementation and Validation of Clinical Pharmacogenomics Guidelines (RELIVAF-CYTED), Santiago, Chile
| | - Gabriela Echeverría-Garcés
- Latin American Network for the Implementation and Validation of Clinical Pharmacogenomics Guidelines (RELIVAF-CYTED), Santiago, Chile
- Centro de Referencia Nacional de Genómica, Secuenciación y Bioinformática, Instituto Nacional de Investigación en Salud Pública "Leopoldo Izquieta Pérez", Quito, Ecuador
| | - María José Ramos-Medina
- German Cancer Research Center (DKFZ), Faculty of Biosciences, Heidelberg University, Heidelberg, Germany
| | - Lavanya Prathap
- Department of Anatomy, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences, Chennai, India
| | - Mayra Martínez-López
- Cancer Research Group (CRG), Faculty of Medicine, Universidad de Las Américas, Quito, Ecuador
| | - David Ramírez-Sánchez
- Cancer Research Group (CRG), Faculty of Medicine, Universidad de Las Américas, Quito, Ecuador
| | - Jennyfer M García-Cárdenas
- Latin American Network for the Implementation and Validation of Clinical Pharmacogenomics Guidelines (RELIVAF-CYTED), Santiago, Chile
- Laboratorio de Ciencia de Datos Biomédicos, Escuela de Medicina, Facultad de Ciencias Médicas de la Salud y de la Vida, Universidad Internacional del Ecuador, Quito, Ecuador
- Facultade de Ciencias, Universidade da Coruña, A Coruña, Spain
| | - Isaac Armendáriz-Castillo
- Programa de Investigación en Salud Global, Facultad de Ciencias de la Salud, Universidad Internacional SEK, Quito, Ecuador
- Latin American Network for the Implementation and Validation of Clinical Pharmacogenomics Guidelines (RELIVAF-CYTED), Santiago, Chile
- Laboratorio de Ciencia de Datos Biomédicos, Escuela de Medicina, Facultad de Ciencias Médicas de la Salud y de la Vida, Universidad Internacional del Ecuador, Quito, Ecuador
- Centro de Investigación para la Salud en América Latina (CISeAL), Pontificia Universidad Católica del Ecuador, Quito, Ecuador
| | - Santiago Guerrero
- Latin American Network for the Implementation and Validation of Clinical Pharmacogenomics Guidelines (RELIVAF-CYTED), Santiago, Chile
- Laboratorio de Ciencia de Datos Biomédicos, Escuela de Medicina, Facultad de Ciencias Médicas de la Salud y de la Vida, Universidad Internacional del Ecuador, Quito, Ecuador
| | - Clara Paz
- Grupo de Investigación Bienestar, Salud y Sociedad, Universidad de Las Américas, Quito, Ecuador
| | - Andrés López-Cortés
- Cancer Research Group (CRG), Faculty of Medicine, Universidad de Las Américas, Quito, Ecuador.
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Paz C, Suárez E, Cabarcos A, Pinto SIS. Numerical Study of a Thrombus Migration Risk in Aneurysm After Coil Embolization in Patient Cases: FSI Modelling. Cardiovasc Eng Technol 2023; 14:544-559. [PMID: 37468797 PMCID: PMC10465652 DOI: 10.1007/s13239-023-00672-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 07/03/2023] [Indexed: 07/21/2023]
Abstract
PURPOSE There are still many challenges for modelling a thrombus migration process in aneurysms. The main novelty of the present research lies in the modelling of aneurysm clot migration process in a realistic cerebral aneurysm, and the analysis of forces suffered by clots inside an aneurysm, through transient FSI simulations. METHODS The blood flow has been modelled using a Womersley velocity profile, and following the Carreau viscosity model. Hyperelastic Ogden model has been used for clot and isotropic linear elastic model for the artery walls. The FSI coupled model was implemented in ANSYS® software. The hemodynamic forces suffered by the clot have been quantified using eight different clot sizes and positions inside a real aneurysm. RESULTS The obtained results have shown that it is almost impossible for clots adjacent to aneurysm walls, to leave the aneurysm. Nevertheless, in clots positioned in the centre of the aneurysm, there is a real risk of clot migration. The risk of migration of a typical post-coiling intervention clot in an aneurysm, in contact with the wall and occupying a significant percentage of its volume is very low in the case studied, even in the presence of abnormally intense events, associated with sneezes or impacts. CONCLUSIONS The proposed methodology allows evaluating the clot migration risk, vital for evaluating the progress after endovascular interventions, it is a step forward in the personalized medicine, patient follow-up, and helping the medical team deciding the optimal treatment.
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Affiliation(s)
- C. Paz
- CINTECX, Universidade de Vigo, Campus As Lagoas-Marcosende, 36310 Vigo, Spain
| | - E. Suárez
- CINTECX, Universidade de Vigo, Campus As Lagoas-Marcosende, 36310 Vigo, Spain
| | - A. Cabarcos
- CINTECX, Universidade de Vigo, Campus As Lagoas-Marcosende, 36310 Vigo, Spain
| | - S. I. S. Pinto
- Engineering Faculty of University of Porto, Institute of Science and Innovation in Mechanical and Industrial Engineering (LAETA-INEGI), Rua Dr. Roberto Frias, 4200-465 Porto, Portugal
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Unda-López A, Paz C, Hidalgo-Andrade P, Hermosa-Bosano C. Variations of work engagement and psychological distress based on three working modalities during the COVID-19 pandemic. Front Public Health 2023; 11:1191314. [PMID: 37388160 PMCID: PMC10300637 DOI: 10.3389/fpubh.2023.1191314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 05/26/2023] [Indexed: 07/01/2023] Open
Abstract
With the onset of the COVID-19 pandemic, the rapid spread of the SARS-CoV-2 virus became a global health threat affecting people's mental and physical health, as well as working conditions and modalities. The reorganization of the work environment also affected work engagement and psychological distress levels. This manuscript assesses how work engagement and distress vary according to gender and age across three working modalities. We used a voluntary response sampling strategy to collect data on psychological distress and work engagement between August 2021 and January 2022. Results are from 542 people working in Ecuador during the COVID-19 pandemic. Overall, participants experienced psychological distress; women and younger participants presented higher psychological distress. Regarding engagement, the sample showed average levels of total engagement, average levels of vigor, and high levels of dedication and absorption. Men presented higher levels of total work engagement and vigor. Psychological distress was significantly and negatively correlated with total work engagement scores and its three factors. There were no differences in work engagement according to the different modalities. However, teleworkers reported significantly higher levels of psychological distress than hybrid workers. Findings are discussed considering ideas for decision-makers to explore the benefits of flexible working practices.
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Affiliation(s)
| | - Clara Paz
- Escuela de Psicología y Educación, Universidad de Las Américas, Quito, Ecuador
| | - Paula Hidalgo-Andrade
- Escuela de Psicología y Educación, Universidad de Las Américas, Quito, Ecuador
- Universidad Latina de Costa Rica, San José, Costa Rica
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Valdiviezo-Oña J, Montesano A, Evans C, Paz C. Fostering practice-based evidence through routine outcome monitoring in a university psychotherapy service for common mental health problems: a protocol for a naturalistic, observational study. BMJ Open 2023; 13:e071875. [PMID: 37225267 DOI: 10.1136/bmjopen-2023-071875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
INTRODUCTION Data-informed psychotherapy and routine outcome monitoring are growing as referents in psychotherapy research and practice. In Ecuador, standardised web-based routine outcome monitoring systems have not been used yet, precluding data-driven clinical decisions and service management. Hence, this project aims at fostering and disseminating practice-based evidence in psychotherapy in Ecuador by implementing a web-based routine outcome monitoring system in a university psychotherapy service. METHODS AND ANALYSES This is a protocol for an observational naturalistic longitudinal study. Progress and outcomes of treatment in the Centro de Psicología Aplicada of the Universidad de Las Américas in Quito, Ecuador will be examined. Participants will be adolescents and adults (≥11 years) seeking treatment, as well as therapists and trainees working at the centre between October 2022 and September 2025. Clients' progress will be monitored by a range of key variables: psychological distress, ambivalence to change, family functioning, therapeutic alliance and life satisfaction. Sociodemographic information and satisfaction with treatment data will be collected before and at the end of treatment, respectively. Also, semi-structured interviews to explore therapists' and trainees' perceptions, expectations and experiences will be conducted. We will analyse first contact data, psychometrics of the measures, reliable and clinically significant change, outcome predictors as well as trajectories of changes. Moreover, we will conduct a framework analysis for the interviews. ETHICS AND DISSEMINATION The protocol for this study was approved by the Human Research Ethics Committee of the Pontificia Universidad Católica del Ecuador (#PV-10-2022). The results will be disseminated in peer-reviewed scientific articles, at conferences and in workshops. TRIAL REGISTRATION NUMBER NCT05343741.
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Affiliation(s)
- Jorge Valdiviezo-Oña
- Escuela de Psicología y Educación, Universidad de Las Américas, Quito, Ecuador
- Departamento de Psicología, Sociología y Trabajo Social, Universitat de Lleida, Lleida, Spain
| | - Adrián Montesano
- Faculty of Psychology and Educational Sciences, Universitat Oberta de Catalunya, Barcelona, Spain
| | - Chris Evans
- Escuela de Psicología y Educación, Universidad de Las Américas, Quito, Ecuador
- School of Psychology, University of Roehampton, London, UK
| | - Clara Paz
- Escuela de Psicología y Educación, Universidad de Las Américas, Quito, Ecuador
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Vásconez-González J, Fernandez-Naranjo R, Izquierdo-Condoy JS, Delgado-Moreira K, Cordovez S, Tello-De-la-Torre A, Paz C, Castillo D, Izquierdo-Condoy N, Carrington SJ, Ortiz-Prado E. Comparative analysis of long-term self-reported COVID-19 symptoms among pregnant women. J Infect Public Health 2023; 16:430-440. [PMID: 36736066 PMCID: PMC9851727 DOI: 10.1016/j.jiph.2023.01.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 01/03/2023] [Accepted: 01/16/2023] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND The negative effects of COVID-19 infections during pregnancy have been amply described, however, the persistent sequels of this infection have not been explored so far. OBJECTIVE The aim of this study was to describe persisting symptoms after COVID-19 infection in pregnant and non-pregnant women in Ecuador. METHODS A cross-sectional analysis based on an online, self-reporting questionnaire was conducted in Ecuador from April to July 2022. Participants were invited by social media, radio, and TV to voluntarily participate in our study. A total of 457 surveys were included in this study. We compared risk factor variables and long-term persisting symptoms of pregnant and non-pregnant women in Ecuador. RESULTS Overall, 247 (54.1 %) responders claimed to have long-term symptoms after SARS-CoV-2 infection. Most of these symptoms were reported by non-pregnant women (94.0 %). The most common Long-COVID symptoms in pregnant women were fatigue (10.6 %), hair loss (9.6 %), and difficulty concentrating (6.2 %). We found that pregnant women who smoked had a higher risk of suffering fatigue. CONCLUSIONS The most frequent Long-COVID symptoms in pregnant women were fatigue, hair loss, and difficulty concentrating. Apparently, the patterns of presentation of long-term sequelae of SARS-CoV-2 infection in pregnant women do not differ significantly from reports available from studies in the general population.
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Affiliation(s)
- Jorge Vásconez-González
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, 170137 Quito, Ecuador,Pontificia Universidad Católica del Ecuador, Tecnologias PUCE-TEC, Quito 170143, Ecuador
| | - Raul Fernandez-Naranjo
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, 170137 Quito, Ecuador
| | - Juan S. Izquierdo-Condoy
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, 170137 Quito, Ecuador,Health Management and Research Area, Universidad Internacional Iberoamericana, Arecibo 00613, Puerto Rico
| | - Karen Delgado-Moreira
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, 170137 Quito, Ecuador
| | - Simone Cordovez
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, 170137 Quito, Ecuador
| | - Andrea Tello-De-la-Torre
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, 170137 Quito, Ecuador
| | - Clara Paz
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, 170137 Quito, Ecuador
| | - Diana Castillo
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, 170137 Quito, Ecuador
| | | | - Sarah J. Carrington
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, 170137 Quito, Ecuador
| | - Esteban Ortiz-Prado
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, 170137 Quito, Ecuador.
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11
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Hidalgo-Andrade P, Hermosa-Bosano C, Paz C. Opportunities and Challenges for Psychological Research Amid the COVID-19 Pandemic: Lessons Learned from a Group of Early-Career Researchers in Quito, Ecuador. Trends in Psychol 2023. [PMCID: PMC9946699 DOI: 10.1007/s43076-023-00272-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
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12
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Evans C, Carlyle JA, Paz C. Rigorous idiography: Exploring subjective and idiographic data with rigorous methods-The method of derangements. Front Psychol 2023; 13:1007685. [PMID: 36710731 PMCID: PMC9879009 DOI: 10.3389/fpsyg.2022.1007685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 11/22/2022] [Indexed: 01/13/2023] Open
Abstract
Psychological research often seeks general rules applying across individuals, an aim that is in tension with examining that which is unique to any individual. There are general statistical regularities across individuals' subjective self-report which enable much psychology and psychotherapy research to combine data from self-report questionnaire responses with statistical and psychometric methods to create a fundamental part of Cronbach and Meehl's foundational nomological networks of validity. However, these methods only apply when most participants answer the same questions on measures creating nomothetic data and this has led to a neglect of idiographic data. This paper reviews a method of analysis of idiographic data, of "rigorous idiography": the method of derangements. This is a remarkably simple statistical test of whether purely idiographic data convey reliable information. We show how the method appeared to become stuck in a bibliometric backwater but we expand on its potential for research and practise and hope it will be taken up and used correctly and more widely.
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Affiliation(s)
- Chris Evans
- Escuela de Psicología y Educación, Universidad de Las Américas, Quito, Ecuador,School of Psychology, University of Roehampton, London, United Kingdom,*Correspondence: Chris Evans,
| | | | - Clara Paz
- Escuela de Psicología y Educación, Universidad de Las Américas, Quito, Ecuador
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13
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Valdiviezo-Oña J, Granja E, Cuadros-López A, Valdivieso-Meza G, Evans C, Paz C. Practice-based research with psychologists-in-training: presentation of a supervision model and use of routine outcome monitoring ( Investigación basada en la práctica con psicólogos en formación: presentación de un modelo de supervisión y uso de la monitorización rutinaria de resultados). Studies in Psychology 2022. [DOI: 10.1080/02109395.2022.2132749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
| | - Eduardo Granja
- School of Psychology and Education, Universidad de Las Américas, Ecuador
- Centre for Applied Psychology, Universidad de Las Américas, Ecuador
| | | | - Grace Valdivieso-Meza
- School of Psychology and Education, Universidad de Las Américas, Ecuador
- Centre for Applied Psychology, Universidad de Las Américas, Ecuador
| | - Chris Evans
- School of Psychology and Education, Universidad de Las Américas, Ecuador
| | - Clara Paz
- School of Psychology and Education, Universidad de Las Américas, Ecuador
- Centre for Applied Psychology, Universidad de Las Américas, Ecuador
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14
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Izquierdo-Condoy JS, Fernandez-Naranjo R, Vasconez-González E, Cordovez S, Tello-De-la-Torre A, Paz C, Delgado-Moreira K, Carrington S, Viscor G, Ortiz-Prado E. Long COVID at Different Altitudes: A Countrywide Epidemiological Analysis. Int J Environ Res Public Health 2022; 19:ijerph192214673. [PMID: 36429392 PMCID: PMC9690364 DOI: 10.3390/ijerph192214673] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 10/24/2022] [Accepted: 10/26/2022] [Indexed: 05/12/2023]
Abstract
BACKGROUND Several reports from around the world have reported that some patients who have recovered from COVID-19 have experienced a range of persistent or new clinical symptoms after a SARS-CoV-2 infection. These symptoms can last from weeks to months, impacting everyday functioning to a significant number of patients. METHODS A cross-sectional analysis based on an online, self-reporting questionnaire was conducted in Ecuador from April to July 2022. Participants were invited by social media, radio, and TV to voluntarily participate in our study. A total of 2103 surveys were included in this study. We compared socio-demographic variables and long-term persisting symptoms at low (<2500 m) and high altitude (>2500 m). RESULTS Overall, 1100 (52.3%) responders claimed to have Long-COVID symptoms after SARS-CoV-2 infection. Most of these were reported by women (64.0%); the most affected group was young adults between 21 to 40 years (68.5%), and most long-haulers were mestizos (91.6%). We found that high altitude residents were more likely to report persisting symptoms (71.7%) versus those living at lower altitudes (29.3%). The most common symptoms were fatigue or tiredness (8.4%), hair loss (5.1%) and difficulty concentrating (5.0%). The highest proportion of symptoms was observed in the group that received less than 2 doses. CONCLUSIONS This is the first study describing post-COVID symptoms' persistence in low and high-altitude residents. Our findings demonstrate that women, especially those aging between 21-40, are more likely to describe Long-COVID. We also found that living at a high altitude was associated with higher reports of mood changes, tachycardia, decreased libido, insomnia, and palpitations compared to lowlanders. Finally, we found a greater risk to report Long-COVID symptoms among women, those with previous comorbidities and those who had a severer acute SARS-CoV-2 infection.
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Affiliation(s)
- Juan S. Izquierdo-Condoy
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito 170137, Ecuador
- Health Management and Research Area, Department of Health Sciences, Universidad Internacional Iberoamericana, Arecibo, PR 00613, USA
| | - Raul Fernandez-Naranjo
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito 170137, Ecuador
| | - Eduardo Vasconez-González
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito 170137, Ecuador
| | - Simone Cordovez
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito 170137, Ecuador
| | - Andrea Tello-De-la-Torre
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito 170137, Ecuador
| | - Clara Paz
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito 170137, Ecuador
| | - Karen Delgado-Moreira
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito 170137, Ecuador
| | - Sarah Carrington
- Lugar, Medio y Sociedad Research Group, School of Economics, Universidad de Las Américas, Quito 170124, Ecuador
| | - Ginés Viscor
- Departament de Biologia Cel·lular, Fisiologia i Immunologia, Universitat de Barcelona, 08028 Barcelona, Spain
| | - Esteban Ortiz-Prado
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito 170137, Ecuador
- Correspondence: ; Tel.: +593-995-760-693
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15
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Mascialino G, Cañadas V, Valdiviezo-Oña J, Rodríguez-Lorenzana A, Arango-Lasprilla JC, Paz C. Self-concept 6 months after traumatic brain injury and its relationship with emotional functioning. Front Psychol 2022; 13:995436. [DOI: 10.3389/fpsyg.2022.995436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 10/14/2022] [Indexed: 11/06/2022] Open
Abstract
This is an observational exploratory study assessing self-concept and its association with depression, anxiety, satisfaction with life, and quality of life 6 months after experiencing a traumatic brain injury. Participants were 33 patients who suffered a traumatic brain injury 6 months before the assessment. The measures used in this study were the Repertory Grid Technique, Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Satisfaction With Life Scale, and the Quality of Life after Brain Injury. We calculated Euclidean distances to assess differences in pre-and post-injury self-perception, as well as the proportion of opposed pole construct rating and polarization to understand how they are associated with the scores of the other offered measures. We found that the distance between the present and ideal self, as well as the distance between the present self and the self before the lesion showed moderate positive correlations with depression, and negative correlations with satisfaction with life and quality of life. Also, for the present and self before the lesion, the proportion of opposed pole ratings was correlated with depression symptoms, quality, and satisfaction with life, while for the present self and the ideal self this proportion was correlated with all the measures. The proportion of polarization of the present self and the total polarization was negatively correlated with symptom measures. The repertory grid might facilitate a greater understanding of self-concept after traumatic brain injury. This information could be used to guide treatments that address the emotions related to distances observed in the perception of the self.
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16
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Vinueza-Cabezas A, Osejo-Taco G, Unda-López A, Paz C, Hidalgo-Andrade P. A Comparison of Working Conditions and Workers' Perceptions among On-Site, Telework, and Hybrid Workers in Ecuador during the COVID-19 Pandemic. Int J Environ Res Public Health 2022; 19:14337. [PMID: 36361220 PMCID: PMC9657088 DOI: 10.3390/ijerph192114337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 10/16/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
The COVID-19 pandemic has forced many companies to adopt different work modalities to ensure their operation during this period. In this study, we described and compared working conditions and perceptions among face-to-face workers, teleworkers, and hybrid workers in Ecuador. A cross-sectional study was conducted with a sample of 542 participants, using a self-report survey to assess sociodemographic data, working conditions, and workers' perceptions. Variables were described and then compared by the Chi-square test, ANOVA, and the Kruskal-Wallis test. The results indicated a higher proportion of on-site workers without higher education and in the public sector compared to the other modalities. At the same time, there was evidence of increased perceived productivity. People in the hybrid modality tended to have more than one job, earning a higher monthly salary, perceiving a decrease in productivity, an increase in daily working hours, and a lower capacity for time management. In addition, most teleworkers reported fair working conditions, a dedicated workspace, and easy adaptation to this work mode. This study builds a more in-depth understanding of how workers perceived their working conditions among work modalities for organizational decision-making because the evolution of the COVID-19 pandemic is modifying the ways of working permanently.
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Affiliation(s)
| | - Gabriel Osejo-Taco
- Escuela de Psicología y Educación, Universidad de Las Américas, Quito 170124, Ecuador
| | - Alejandro Unda-López
- Escuela de Psicología y Educación, Universidad de Las Américas, Quito 170124, Ecuador
| | - Clara Paz
- Escuela de Psicología y Educación, Universidad de Las Américas, Quito 170124, Ecuador
| | - Paula Hidalgo-Andrade
- Escuela de Psicología y Educación, Universidad de Las Américas, Quito 170124, Ecuador
- Universidad Latina de Costa Rica, San José 11501, Costa Rica
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17
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Medina JC, Paz C, Salla M, Aguilera M, Montesano A, Compañ V, Feixas G. The effect of two cognitive therapies on subjective wellbeing of individuals with depression: results from a randomised controlled trial. J Ment Health 2022; 32:655-661. [PMID: 36062848 DOI: 10.1080/09638237.2022.2118682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
BACKGROUND Despite the burden associated to depression, current standards of care are still limited in scope and effectiveness. In addition, therapy outcomes have frequently focused solely on symptoms, leaving patients' wellbeing relatively unaddressed. AIMS The objective of this study was to test whether two cognitive therapies increased subjective wellbeing in a sample of adults diagnosed with a depressive disorder, additionally assessing the relationship between this growth and decreases in both depression severity and psychological distress. METHODS Data from 116 participants from a randomised controlled trial comparing the efficacy of cognitive behavioural therapy and dilemma-focused therapy were analysed. Multilevel linear models were employed, together with correlational analyses. RESULTS Results showed that both interventions significantly improved wellbeing with moderate to large effect sizes, while no significant differences were found between treatments. In turn, the increase in wellbeing was significantly associated to improvements in depression severity and psychological distress. CONCLUSIONS This study sheds light on the complex relationship between happiness and depression, supporting their conceptualisation as related yet independent human experiences, and strengthening subjective wellbeing as a useful outcome for psychological research. Psychotherapy is presented as an effective intervention to enhance wellbeing, even among individuals with severe depressive symptoms.
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Affiliation(s)
- Joan C Medina
- Department of Clinical Psychology and Psychobiology, Universitat de Barcelona, Barcelona, Spain.,Faculty of Psychology and Education Sciences, Universitat Oberta de Catalunya, Barcelona, Spain
| | - Clara Paz
- School of Psychology, Universidad de Las Américas, Quito, Ecuador
| | - Marta Salla
- Department of Clinical Psychology and Psychobiology, Universitat de Barcelona, Barcelona, Spain.,Institute of Neurosciences, Universitat de Barcelona, Barcelona, Spain
| | - Mari Aguilera
- Institute of Neurosciences, Universitat de Barcelona, Barcelona, Spain.,Department of Cognition, Development and Educational Psychology, Universitat de Barcelona, Barcelona, Spain
| | - Adrián Montesano
- Faculty of Psychology and Education Sciences, Universitat Oberta de Catalunya, Barcelona, Spain
| | - Victoria Compañ
- Department of Clinical Psychology and Psychobiology, Universitat de Barcelona, Barcelona, Spain
| | - Guillem Feixas
- Department of Clinical Psychology and Psychobiology, Universitat de Barcelona, Barcelona, Spain.,Institute of Neurosciences, Universitat de Barcelona, Barcelona, Spain
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18
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Fernández O, Espinosa HD, Krause M, Altimir C, Mantilla C, Paz C, Lozano AG, Argumedo D, De La Cerda C, Juan S, Fernández S, Lancho MP, Fernández-Álvarez J. Personal experience of Latin American therapists on their clinical practice during the COVID-19 pandemic ( Experiencia personal de terapeutas latinoamericanos sobre su práctica clínica durante la pandemia por COVID-19). Studies in Psychology 2022. [DOI: 10.1080/02109395.2022.2133456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Affiliation(s)
| | | | | | | | | | - Clara Paz
- Universidad de las Américas, Ecuador
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19
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Medina JC, Paz C, García-Mieres H, Niño-Robles N, Herrera JE, Feixas G, Montesano A. Efficacy of psychological interventions for young adults with mild-to-moderate depressive symptoms: A meta-analysis. J Psychiatr Res 2022; 152:366-374. [PMID: 35793580 DOI: 10.1016/j.jpsychires.2022.06.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 05/26/2022] [Accepted: 06/10/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND Psychological interventions are commonly used to treat mild-to-moderate depression, but their efficacy in young adults has not been exhaustively addressed. This meta-analysis aims to establish it in comparison to no treatment, wait-list, usual treatment, passive interventions, and other bona-fide treatments. METHODS The search was conducted in Scopus, MEDLINE, PsycINFO, ClinicalTrials.gov, the ISRCTN Registry, Cochrane CENTRAL, Clarivate BIOSIS Previews and the METAPSY database, retrieving studies from the start of records to April 2020. Eligibility criteria included samples of 16-30 years experiencing mild-to-moderate depressive symptoms and participating in randomized controlled trials (RCTs), non-RCTs, or pre-post studies measuring depressive symptomatology and featuring psychological treatments. RESULTS Up to 45 studies met criteria, consisting of 3,947 participants, assessed using the Quality Assessment Tool for Quantitative Studies and their results meta-analyzed assuming random effects. Psychological interventions proved to be efficacious in RCTs compared to no treatment (g = -0.68; 95% CI = -0.87, -0.48) and wait-list (g = -1.04; 95% CI = -1.25, -0.82), while depressive symptoms also improved in pre-post studies (g = -0.99; 95% CI = -1.32, -0.66). However, intervention efficacy was similar to usual care, passive, and bona-fide comparators. The heterogeneity found, a likely reporting bias and the low quality of most studies must be considered when interpreting these results. CONCLUSIONS Psychological treatments are efficacious to reduce depressive symptoms in young adults, but comparable to other interventions in the mild-to-moderate range. Moderators like depression severity or therapist involvement significantly influenced their efficacy, with results encouraging clinicians to adopt flexible and personalized approaches.
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Affiliation(s)
- J C Medina
- Department of Psychology and Education Sciences, Universitat Oberta de Catalunya, Barcelona, Spain; Department of Clinical Psychology and Psychobiology, Universitat de Barcelona, Barcelona, Spain.
| | - C Paz
- School of Psychology, Universidad de Las Américas, Quito, Ecuador
| | - H García-Mieres
- Etiopathogenesis and Treatment of Severe Mental Disorders (MERITT), Teaching, Research & Innovation Unit, Institut de Recerca Sant Joan de Déu, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; Centro Investigación Biomédica en Red Salud Mental (CIBERSAM), Madrid, Spain
| | - N Niño-Robles
- Department of Clinical Psychology and Psychobiology, Universitat de Barcelona, Barcelona, Spain
| | - J E Herrera
- School of Psychology, Universidad de Las Américas, Quito, Ecuador
| | - G Feixas
- Department of Clinical Psychology and Psychobiology, Universitat de Barcelona, Barcelona, Spain; Institute of Neurosciences, Universitat de Barcelona, Barcelona, Spain
| | - A Montesano
- Department of Psychology and Education Sciences, Universitat Oberta de Catalunya, Barcelona, Spain
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Salla M, Aguilera M, Paz C, Moya-Higueras J, Feixas G. The effects of Cumulative Trauma and Cognitive Rigidity on the Severity of Depressive Disorder: Preliminary Results. Eur Psychiatry 2022. [PMCID: PMC9568045 DOI: 10.1192/j.eurpsy.2022.1416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction The long-lasting effects of trauma on mental health and the cumulative effect during the lifetime is one of the great interest in research and applied psychology. However, the effect of cumulative trauma in combination with cognitive biases, such as cognitive rigidity (“all-or-nothing” thinking pattern), on the severity of depression has not been tested yet. Objectives The aim of this study was to analyse these variables, while considering for differential gender effects on a sample of patients with the diagnosis of depressive disorder. Methods A total sample of 177 patients (137 women) were assessed using the Cumulative Trauma Scale. Cognitive rigidity was measured with the Repertory Grid Technique and severity of depressive symptoms with the Beck Depression Inventory. Results indicated that high levels of cognitive rigidity and high frequency of perceived negative cumulative trauma predicted depressive symptoms; while high frequency of perceived positive trauma did not predict depressive symptoms. Moreover, gender did not explain variability of depression, and its interaction with frequency of perceived trauma was not significant. Conclusions Overall, traumatic cumulative trauma frequency and its negative appraisal are key to the understanding the severity of depression but also cognitive rigidity seemed to be a relevant factor to consider. Thus, these results highlight the need to focus on traumatic and cognitive aspects to increase the efficacy of psychological interventions in depression. Disclosure No significant relationships.
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Aguilera M, Paz C, Salla M, Feixas G. Personal construct therapy vs. cognitive behavioural therapy in the treatment of depression in women with fibromyalgia: a multicentre randomized controlled trial with a 6-month follow-up. Eur Psychiatry 2022. [PMCID: PMC9567482 DOI: 10.1192/j.eurpsy.2022.660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Depressive symptoms are common in patients with Fibromyalgia (FM), a chronic and disabling pain syndrome. Psychological interventions are mostly focused in negative thinking and behavioural activation. However, several studies suggest that personal identity is also affected by FM. Objectives We aimed to examine the effects of Personal Construct Therapy (PCT), an idiographic approach that emphasizes identity features and interpersonal construal, on depressive symptoms in women with FM. Methods In the context of a multicentre parallel randomized trial (Trial Registry: NCT02711020), 106 women with FM and presenting depressive symptoms were randomized either to either Cognitive Behavioural Therapy (CBT; n = 55), taken as a gold standard comparison, or PCT (n = 51). In total, 69 patients completed the treatment and the six-month follow-up assessment (CBT = 32 and PCT = 37). Both treatments were applied on case formulation premises. Results Linear mixed-effects models were performed to compare depressive symptoms between treatment conditions. Anxiety and pain measures were treated as secondary outcomes. Participants in both conditions significantly reduced their levels of depression and anxiety as well as the impact of FM but no significant between treatment differences were found. Analysis of clinically significant change for depressive symptoms and pain was also similar between both conditions. Conclusions PCT resulted equally effective in the treatment of depressive symptoms in women with FM when compared with CBT, both offered in a modular format. Thus, PCT with tis focus on identity issues can be considered as an alternative treatment for these patients. Disclosure No significant relationships.
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Grau A, Evans C, Medina J, Paz C. Levels of intervention and support for newly presenting clients with eating disorders. Eur Psychiatry 2022. [PMCID: PMC9567841 DOI: 10.1192/j.eurpsy.2022.1483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Introduction Clients with Eating Disorders may be treated as inpatients (IP), day hospital (DH) or community patients (Ambu). The ITAMITED study is following to treatment termination (or end of October 2025) all new clients with EDs presenting between November 2017 and October 2020 to eight centres in Spain. Objectives To describe to what extent initial care levels (IP, DH, Ambu) are associated with gender, age, social relationships, ED diagnosis Body Mass Index (BMI) and baseline medication. Methods The study is exploratory/descriptive, practice-based evidence (PBE). Consecutive new clients were approached for participation. Inclusion criteria were a diagnosis of an ED and opting in to treatment. Results The only variables not showing a statistically significant relationship with level were gender (no relationship), diagnosis of bulimia and use of prescribed psychostimulant medication (which was rare). OP care was associated with older age which did not discriminate between DH and IP. Similarly, being in a relationship was associated with OP care but didn’t differentiate between DH and OP. Relationships with ED diagnosis other than AN type I were complex but significant. Relationships with AN type I, BMI and being on antipsychotics, antidepressants, anxiolytics, mood stabilisers and a catch-all category of all other medication all showed an ordered relationship IP > DH > Ambu. The most powerful relationships were with BMI and diagnosis of AN type I. ![]()
Conclusions
Initial level of care is associated with many factors and strongly with many of them. This will complicate the analyses of trajectories of change but reflects the heterogeneity of this client group. Disclosure
I am Clinical Director of ITA but analyses are prespecified. Evans, Medina and Paz are not remunerated by ITA nor related to ITA or any of its employees they would counter any pressure on analyses or reporting that might arise from my position.
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Evans C, Paz C, Medina J, Grau A. Self-report questionnaires in eating disorders: do we need to be careful interpreting self-report in conditions with self-perception issues? Eur Psychiatry 2022. [PMCID: PMC9567620 DOI: 10.1192/j.eurpsy.2022.1486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction A major revolution in psychiatry since the late 20th and early 21st Century has sought to put the individual client at the heart of intervention, promoting shared decision making. Increasing use of patient reported outcome measures (PROMs) to evaluate interventions and even steer therapies (“power assisted steering for psychotherapy”, Evans 2012) appears congruent with this. But is caution needed interpreting PROMS where self-perception distortions form a core part of the client’s problem? Eating disorders are a paradigmatic test. Objectives To see if PROM scores at initial presentation at services for ED seemed congruent with help-seeking. We report CORE-Outcome scores here. Methods Inclusion criteria were a diagnosis of an ED and opting in to treatment. Consecutive new clients at all the centres were approached for participation. Scores distributions were analysed to see if numbers of low scores, “non-clinical range” scores seemed congruent with help-seeking. Results 18% of the participants who completed the CORE-OM at baseline had a score below the Clinically Significant Change (CSC) cutting point. Though the rate was higher in participants with an Anorexia type I diagnosis (22.6%) than those with other ED diagnoses (15.8%): in the expected direction, the difference was narrowly non-significant (chi-squared = 3.5, d.f. = 1, p = .06). Scores did relate to treatment level. ![]()
Conclusions The predicted elevated rate of non-clinical baseline scores in the AN1 group was narrowly non-significant but the rate of 18% non-clinical scores in a help-seeking population raises a cautionary message about interpretation of change from initially low scores. Disclosure I am one of the three trustees of CORE System Trust which holds the copyright on the CORE measures used in this study but the measures are all provided under a Creative Commons licence so I receive no remuneration from this.
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Aguilera M, Paz C, Salla M, Compañ V, Medina JC, Medeiros-Ferreira L, Feixas G. Cognitive-Behavioral and Personal Construct Therapies for Depression in Women with Fibromyalgia: A Randomized Controlled Trial. Int J Clin Health Psychol 2022; 22:100296. [PMID: 35281770 PMCID: PMC8873601 DOI: 10.1016/j.ijchp.2022.100296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 12/21/2021] [Indexed: 11/25/2022] Open
Abstract
Background/Objective Method Results Conclusions
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Paz C, Blitzer G, Glassey A, Giri J, Pennati A, Ganz O, Schreiber S, Nickel K, Kelm-Nelson C, Vanessa C, Pohlman R, Glazer T, Lunga T, Robbins D, Mattison R, Varghese T, Thibeault S, Pulia N, Gallipeau J, Kimple R. Treatment of Radiation-Induced Xerostomia with INF-g Pre-Licensed Mesenchymal Stromal Cells (MSCs). Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2021.12.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Paz C, Abiuso T, Adana-Díaz L, Rodríguez-Lorenzana A, Jaramillo-Vivanco T, Ortiz-Prado E, Páez Monge I, Mascialino G. Psychological Distress in the Galapagos Islands During the COVID-19 Pandemic. Int J Public Health 2022; 67:1604366. [PMID: 35341066 PMCID: PMC8948121 DOI: 10.3389/ijph.2022.1604366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 02/07/2022] [Indexed: 11/14/2022] Open
Abstract
Objectives: to explore the emotional impact of the COVID-19 pandemic in the Galapagos Islands. Methods: an online survey of 369 participants, conducted on October of 2020, was used to assess levels of depression, anxiety, and stress, as well as specific behavioral and emotional reactions to the pandemic. Results: the prevalence of anxiety was 4% and depression 3.65%. Perceived stress level was higher, with 52% of the sample reporting moderate amounts. Women had higher levels of depression and perceived stress. Financial distress, interpersonal conflicts, feelings of isolation and fear of contagion of COVID-19 were all associated with higher levels of anxiety, depression, and stress. Conclusion: prevalence of anxiety and depression is lower in the Galápagos Islands during the pandemic compared to other regions, while stress levels are more significant and may warrant intervention. Despite being low, anxiety and depression were associated with potentially problematic behaviors and emotional reactions.
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Affiliation(s)
- Clara Paz
- Escuela de Psicología y Educación, Universidad de Las Américas, Quito, Ecuador
| | | | - Lila Adana-Díaz
- Escuela de Psicología y Educación, Universidad de Las Américas, Quito, Ecuador
| | | | | | | | - Ignacia Páez Monge
- National Department of Mental Health, Ministry of Public Health (Ecuador), Quito, Ecuador
| | - Guido Mascialino
- Escuela de Psicología y Educación, Universidad de Las Américas, Quito, Ecuador
- *Correspondence: Guido Mascialino,
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Paz C, Hermosa-Bosano C, Hidalgo-Andrade P, García-Manglano J, Sábada Chalezquer C, López-Madrigal C, Serrano C. Self-Esteem, Happiness, and Flourishing in Times of COVID-19: A Study During the Lockdown Period in Ecuador. Int J Public Health 2022; 67:1604418. [PMID: 35283717 PMCID: PMC8916225 DOI: 10.3389/ijph.2022.1604418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 02/03/2022] [Indexed: 11/13/2022] Open
Abstract
Objective: Several studies have investigated the negative toll the pandemic has had on people’s mental health. However, there is limited research on the pandemic’s effect on positive mental health variables. This article reports on the levels of self-esteem and well-being (flourishing and happiness) in a sample of adults living in Ecuador and their relationships with the characteristics of their personal situation and the effects of the COVID-19 pandemic had on their personal lives.Methods: A total of 766 adults completed an anonymous online survey between March and August 2020.Results: Participants reported average scores in the flourishing scale, the majority considered themselves to be happy or very happy people, and more than half presented high levels of self-esteem. Age, education, socioeconomic status, time spent using mobile phones and on hobbies, among others, explained self-esteem, happiness, and flourishing.Conclusion: The relationships between sociodemographic and situational variables of confinement during the pandemic are discussed, as well as the possible predictors of happiness, flourishing, and self-esteem.
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Affiliation(s)
- Clara Paz
- School of Psychology and Education, Universidad de Las Américas, Quito, Ecuador
| | | | - Paula Hidalgo-Andrade
- School of Psychology and Education, Universidad de Las Américas, Quito, Ecuador
- *Correspondence: Paula Hidalgo-Andrade,
| | | | | | | | - Cecilia Serrano
- Department of Sociology, Università Cattolica di Milano, Milano, Italy
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Ortiz-Prado E, Simbaña-Rivera K, Duta D, Ochoa I, Izquierdo-Condoy JS, Vasconez E, Carrasco K, Calvopiña M, Viscor G, Paz C. Optimism and Health Self-Perception-Related Differences in Indigenous Kiwchas of Ecuador at Low and High Altitude: A Cross-Sectional Analysis. High Alt Med Biol 2022; 23:26-36. [PMID: 35020475 DOI: 10.1089/ham.2021.0046] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Ortiz-Prado, Esteban, Katherine Simbaña-Rivera, Diego Duta, Israel Ochoa, Juan S. Izquierdo-Condoy, Eduardo Vasconez, Kathia Carrasco, Manuel Calvopiña, Ginés Viscor, and Clara Paz. Optimism and health self-perception-related differences in indigenous Kiwchas of Ecuador at low and high altitude: a cross-sectional analysis. High Alt Med Biol 00:000-000, 2021. Background: Living at high altitude causes adaptive responses at every physiological and molecular level within the human body. Emotional and psychological short- or long-term consequences, including mood changes, higher mental overload, and depression prevalence, as well as increased risk to commit suicide have been reported among highlanders. The objective of this report is to explore the differences in self-reported dispositional optimism and health perception among sex-, age-, and genotype-controlled indigenous Kiwcha natives living at two different altitudes. Methods: A cross-sectional analysis of the comparison of means of subscales and summary scores of the 36-item short-form health survey (SF-36) self-reported questionnaire and the Life Orientation Test-Revised was conducted among 219 adults Kiwchas living at low (230 m) and high altitude (3,800 m) in Ecuador. Results: High-altitude dwellers presented lower scores in all the studied dimensions of SF-36 and the total score. Differences were found for the role limitation sphere due to vitality (p = 0.005), mental health (p = 0.002), and social functioning (p = 0.005). In all the cases, participants living at low altitudes scored higher than those living at high altitudes. Lowland women were more optimistic than their high-altitude counterparts. Conclusions: We observe that populations located at high altitudes have more unfavorable self-reported health states. Although our results depict the existence of significant differences in the health status of indigenous peoples living at different altitudes, further studies are needed to explain in depth the sociodemographic and/or environmental factors that might underlie these differences.
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Affiliation(s)
- Esteban Ortiz-Prado
- One Health Research Group, Faculty of Medicine, Universidad De Las Americas, Quito, Ecuador
| | - Katherine Simbaña-Rivera
- One Health Research Group, Faculty of Medicine, Universidad De Las Americas, Quito, Ecuador.,Physiology Section, Department of Cell Biology, Physiology and Immunology, Faculty of Biology, Universitat de Barcelona, Barcelona, Spain
| | - Diego Duta
- Family Medicine Department, Limoncocha Community Health Unit, Limoncocha, Ecuador
| | - Israel Ochoa
- Family Medicine Department, Oyacachi Community Health Unit, Oyacachi, Ecuador
| | | | - Eduardo Vasconez
- One Health Research Group, Faculty of Medicine, Universidad De Las Americas, Quito, Ecuador
| | - Kathia Carrasco
- One Health Research Group, Faculty of Medicine, Universidad De Las Americas, Quito, Ecuador
| | - Manuel Calvopiña
- One Health Research Group, Faculty of Medicine, Universidad De Las Americas, Quito, Ecuador
| | - Ginés Viscor
- Physiology Section, Department of Cell Biology, Physiology and Immunology, Faculty of Biology, Universitat de Barcelona, Barcelona, Spain
| | - Clara Paz
- One Health Research Group, Faculty of Medicine, Universidad De Las Americas, Quito, Ecuador
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Paz C, Osejo-Taco G, Evans C. Trajectories of success and/or distress: protocol for an observational cohort study investigating changing psychological distress among emerging Ecuadorian adults over a year. BMJ Open 2021; 11:e056361. [PMID: 34930747 PMCID: PMC8689188 DOI: 10.1136/bmjopen-2021-056361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Emerging adulthood is a period of instability with changes in personal relationships and often a series of job changes before life trajectories clarify and more lasting decisions are possible. These changes often produce distress, and they might explain why most of the symptoms that impact the individual's mental health throughout their lives appear at this stage, although full-blown disorders are often only diagnosed subsequently. The objective of this study is to analyse the intraindividual changes in psychological distress and health-related quality of life in both student and non-student emerging adults over 1 year. Between-individual differences in variability will be analysed and life events will be recorded to identify possible associations. METHODS AND ANALYSIS Participants will be emerging adults (18-29 years of age) students and non-students. The primary outcome will be psychological distress measured using the Clinical Outcomes in Routine Evaluation-Outcome Measure and the secondary outcome will be health-related quality of life measured by the EuroQol five-dimension-three-level. Sociodemographic and life events will be recorded. Information will be collected using an online survey.Analyses, described in a data analysis plan with the registration, will check the psychometric properties of the measures, describe the distribution of scores on the outcome measures, their relationship to group and other demographic variables and how they change over the seven assessment points across a year and explore any relationship between scores and life events. ETHICS AND DISSEMINATION This study received ethical approval by the Comité de Ética y Bioética (Ethics and Bioethics Committee) of the Universidad de Las Américas, Quito-Ecuador (2020-0807). Results will be published in peer-reviewed journals and presented at relevant meetings. Brief reports of these publications will be disseminated using social media to reach the community and private or public organisations interested in emerging adults. TRIAL REGISTRATION NUMBER NCT04596345.
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Affiliation(s)
- Clara Paz
- Escuela de Psicología y Educación, Universidad de Las Américas, Quito, Ecuador
| | - Gabriel Osejo-Taco
- Escuela de Psicología y Educación, Universidad de Las Américas, Quito, Ecuador
| | - Chris Evans
- Escuela de Psicología y Educación, Universidad de Las Américas, Quito, Ecuador
- Department of Psychology, The University of Sheffield, Sheffield, UK
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Montesano A, Medina JC, Paz C, García-Mieres H, Niño-Robles N, García-Grau E, Crespillo JC, García-Gutiérrez A, Alabèrnia-Segura M, Feixas G. Does virtual reality increase the efficacy of psychotherapy for young adults with mild-to-moderate depression? A study protocol for a multicenter randomized clinical trial. Trials 2021; 22:916. [PMID: 34903251 PMCID: PMC8666832 DOI: 10.1186/s13063-021-05809-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 11/08/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The improvement of psychological treatments for depression in young adults is a pressing issue highlighted in the literature. Its relevance is determined not only because young adults are underrepresented in research, but also to prevent chronic severe mental health disorders later in life. Engagement is considered a key factor for a good therapeutic outcome, especially among young patients. In this sense, virtual reality could be particularly suited to engage young adults in the therapy process. This project aims to improve the psychological treatment of mild-to-moderate depression in young adults by testing out the efficacy of virtual reality-enhanced personal construct therapy (PCT-VR), as compared to personal construct therapy alone (PCT) and to the reference standard cognitive behavioral therapy (CBT). In contrast to CBT, PCT neither educates patients about depression nor gives them directions on the changes to be made in their dysfunctional behaviors or cognitions. Rather, PCT explores the coherence (or conflicts) of thoughts and behaviors with respect to the person's sense of identity and focuses on meaning-making processes. METHODS The efficacy of this innovative intervention (PCT-VR) will be compared to PCT and to CBT in a randomized clinical trial. The study includes an appraisal of therapists' adherence and independent assessments to preserve internal validity. The Beck Depression Inventory-II is the primary outcome measure for calculating both statistical and clinical significance, but other outcomes will also be assessed (e.g., functioning, well-being, anxiety, stress) at pre- and post-therapy and at 6-month follow-up. The trial will be conducted in a naturalistic context, mostly at the usual health care center of each patient. A sample of 225 participants is targeted to reach enough statistical power to accomplish the goals of the study. DISCUSSION We expect that providing evidence for PCT-VR will widen the repertoire of evidence-based technology-based psychotherapeutic interventions for young adults and contribute to the prevention of deteriorating courses of the disorder. TRIAL REGISTRATION ClinicalTrials.gov NCT04321525 . Registered on 18 February 2020.
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Affiliation(s)
- Adrián Montesano
- School of Psychology and Educational Sciences, Open University of Catalonia, Barcelona, Spain
| | - Joan C. Medina
- School of Psychology and Educational Sciences, Open University of Catalonia, Barcelona, Spain
| | - Clara Paz
- School of Psychology and Education, Universidad de Las Américas, Quito, Ecuador
| | - Helena García-Mieres
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
- Centro de Investigación Biomédica en Red Salud Mental, Madrid, Spain
| | - Noelia Niño-Robles
- Department of Clinical Psychology and Psychobiology, Universitat de Barcelona, Barcelona, Spain
| | - Eugeni García-Grau
- Department of Clinical Psychology and Psychobiology, Universitat de Barcelona, Barcelona, Spain
| | - Josep Cañete Crespillo
- Department of Mental Health, Consorci Sanitari del Maresme, Hospital de Mataró, Mataró, Spain
| | | | - Miquel Alabèrnia-Segura
- Department of Clinical Psychology and Psychobiology, Universitat de Barcelona, Barcelona, Spain
| | - Guillem Feixas
- Department of Clinical Psychology and Psychobiology, The Institute of Neurosciences, Universitat de Barcelona, Barcelona, Spain
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Hidalgo-Andrade P, Paz C, Hermosa-Bosano C, García-Manglano J, Sádaba-Chalezquer C, López-Madrigal C, Serrano C, Fernández-Zapico A. Psychological Factors, Leisure Activities, and Satisfaction during the COVID-19 Pandemic: A Cross-Sectional Study in Eleven Spanish-Speaking Countries. Int J Environ Res Public Health 2021; 18:ijerph182111104. [PMID: 34769625 PMCID: PMC8582710 DOI: 10.3390/ijerph182111104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 10/04/2021] [Accepted: 10/07/2021] [Indexed: 11/22/2022]
Abstract
The COVID-19 pandemic has affected the lives of millions of people worldwide. This study aimed to analyze the effects of several psychological factors (self-esteem, self-control, and emotional stability) over lifestyle-related variables (time spent on leisure activities) and the levels of satisfaction (family, friends, work, and leisure satisfaction) experienced during the COVID-19 outbreak. Data for this article were retrieved as part of a cross-sectional international study conducted in eleven Spanish-speaking countries between March and September 2020. The analyses were conducted using the responses of 9500 persons (65.95% women, 34.05% men). Structural equation modeling was used to test the direct and indirect effects of the psychological variables on satisfaction variables mediated by the time engaged in leisure activities. Our model indicated that psychological factors significantly predicted the amount of time spent in leisure activities and satisfaction. Overall, results indicate that self-esteem is a relevant psychological factor to consider in the development of psychological interventions directed at promoting healthy lifestyles. Nevertheless, further research is needed to validate the direction of the associations found in this study.
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Affiliation(s)
- Paula Hidalgo-Andrade
- Escuela de Psicología, Universidad de Las Américas, Quito 170517, Ecuador; (P.H.-A.); (C.H.-B.)
| | - Clara Paz
- Escuela de Psicología, Universidad de Las Américas, Quito 170517, Ecuador; (P.H.-A.); (C.H.-B.)
- Correspondence:
| | - Carlos Hermosa-Bosano
- Escuela de Psicología, Universidad de Las Américas, Quito 170517, Ecuador; (P.H.-A.); (C.H.-B.)
| | - Javier García-Manglano
- Instituto Cultura y Sociedad, Universidad de Navarra, 31008 Pamplona, Spain; (J.G.-M.); (A.F.-Z.)
| | | | | | - Cecilia Serrano
- Departamento de Sociología, Universidad Católica de Milán, 20123 Milán, Italy;
| | - Aurelio Fernández-Zapico
- Instituto Cultura y Sociedad, Universidad de Navarra, 31008 Pamplona, Spain; (J.G.-M.); (A.F.-Z.)
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Hermosa-Bosano C, Hidalgo-Andrade P, Paz C. Geosocial Networking Apps Use Among Sexual Minority Men in Ecuador: An Exploratory Study. Arch Sex Behav 2021; 50:2995-3009. [PMID: 34117560 PMCID: PMC8563596 DOI: 10.1007/s10508-021-01921-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 01/04/2021] [Accepted: 01/15/2021] [Indexed: 06/04/2023]
Abstract
Geosocial networking applications (GSN apps) have become important socialization contexts for sexual minority men (SMM). Despite their popularity, there is limited research carried out in Latin American countries and no single previous study done in Ecuador. To fill this gap, this exploratory study described and analyzed the relationships between the sociodemographic characteristics of SMM using GSN apps, their sought and fulfilled expectations, profile shared and sought characteristics, and the evaluation of their experiences as users including their perceptions of support, and discrimination. We used an online recruited sample of 303 participants enrolled between November 2019 and January 2020. Most respondents used Grindr and reported spending up to 3 h per day using apps. Most common sought expectations were getting distracted, meeting new friends, and meeting people for sexual encounters. The least met expectation was meeting someone to build a romantic relationship with. When asked about their profiles, participants reported sharing mainly their age, photographs, and sexual role. Participants also prioritized these characteristics when looking at others' profiles. When asked about their experiences, most reported having been discriminated against, weight being the main reason for it. Some participants also indicated having received emotional support from other users. Correlation analyses indicated significant but weak relationships among the variables. Results indicated a positive correlation between time as an active GSN app user and higher experiences of discrimination. Likewise, higher number of used apps related positively with levels of received support. These results provide information that could inform future research in the country and the region regarding GSN apps use among SMM, socialization practices, and modern dating tools.
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Affiliation(s)
- Carlos Hermosa-Bosano
- School of Psychology, Universidad de Las Américas (UDLA), Redondel del Ciclista, Antigua Vía a Nayón, Campus UDLAPark, 170124, Quito, Ecuador.
| | - Paula Hidalgo-Andrade
- School of Psychology, Universidad de Las Américas (UDLA), Redondel del Ciclista, Antigua Vía a Nayón, Campus UDLAPark, 170124, Quito, Ecuador
| | - Clara Paz
- School of Psychology, Universidad de Las Américas (UDLA), Redondel del Ciclista, Antigua Vía a Nayón, Campus UDLAPark, 170124, Quito, Ecuador
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Hermosa-Bosano C, Paz C, Hidalgo-Andrade P, Aguayo-Romero R. Sexual Behaviors and HIV/STI Prevention Strategies Among Sexual Minority Men in Ecuador Who Use Geosocial Networking Apps. Arch Sex Behav 2021; 50:3011-3021. [PMID: 34585282 PMCID: PMC8563564 DOI: 10.1007/s10508-021-02093-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 06/15/2021] [Accepted: 06/24/2021] [Indexed: 06/13/2023]
Abstract
Around the world, geosocial networking apps have become widely popular among sexual minority men (SMM). This research analyzed the sexual behaviors and HIV and STI prevention strategies (HIV/STI testing, HIV/STI inquiry, and HIV/STI disclosure) of an online-recruited sample of 284 SMM living in Ecuador. Sexting and oral sex were the most common sexual behaviors among SMM in the sample. Most participants had low perceptions of HIV and STI risk; 85% reported being tested for HIV and 70% for STIs. Being older predicted higher odds of being tested for either HIV or STIs at least once. Being single also predicted HIV testing. Future interventions in the country should explore apps' utility as intervention tools to spread information about sexual health and HIV prevention strategies, such as condom use and event-driven PrEP. Apps can also facilitate connections to sexual health services, including programs for PrEP initiation and linkage to HIV treatment. They should also focus on promoting sexual harm reduction conversations among potential app-met sexual partners.
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Affiliation(s)
- Carlos Hermosa-Bosano
- School of Psychology, Universidad de Las Américas, Redondel del Ciclista, Antigua Vía a Nayón, Campus UDLAPark, Quito, 170124, Ecuador.
| | - Clara Paz
- School of Psychology, Universidad de Las Américas, Redondel del Ciclista, Antigua Vía a Nayón, Campus UDLAPark, Quito, 170124, Ecuador
| | - Paula Hidalgo-Andrade
- School of Psychology, Universidad de Las Américas, Redondel del Ciclista, Antigua Vía a Nayón, Campus UDLAPark, Quito, 170124, Ecuador
| | - Rodrigo Aguayo-Romero
- Brigham and Women's Hospital, Harvard Medical School, The Fenway Institute, Boston, MA, USA
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Evans C, Paz C, Mascialino G. " Infeliz" or " Triste": A Paradigm for Mixed Methods Exploration of Outcome Measures Adaptation Across Language Variants. Front Psychol 2021; 12:695893. [PMID: 34434145 PMCID: PMC8381247 DOI: 10.3389/fpsyg.2021.695893] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 07/07/2021] [Indexed: 11/13/2022] Open
Abstract
The literature on measure translation tends to hold, overtly or covertly, a questionable assumption about the possibility of exact translation and almost completely ignores issues of within language variation. Equally, psychometric methods used to assess cross-cultural validity after translation focus on large sample tests of cross-sectional measurement invariance. Such invariance is often not found and is of dubious pertinence to change/outcome measures usually used in psychotherapy research. We present a sequential process of three substudies using quantitative and qualitative procedures to explore whether an outcome measure needs to be changed when used across language variation. Qualitative data confirmed that an item was not ideal in the new context. However, quantitative exploration showed that, although statistically significant and affected by gender and item order, the impact of changing the item in the overall score was small, allowing retention of the existing Spanish translation. We argue that the myth of perfect translation and over-reliance on large-sample psychometric testing pursuing measurement invariance limit exploration of language effects. We recommend that these be used in the companion of user-based, sequential, mixed-method exploration to support the development of a richer field of understanding of outcomes and change self-report measures across languages and cultures and both across and within languages.
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Affiliation(s)
- Chris Evans
- Department of Psychology, The University of Sheffield, Sheffield, United Kingdom
| | - Clara Paz
- Escuela de Psicología, Universidad de Las Américas, Quito, Ecuador
| | - Guido Mascialino
- Escuela de Psicología, Universidad de Las Américas, Quito, Ecuador
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Hidalgo-Andrade P, Hermosa-Bosano C, Paz C. Teachers' Mental Health and Self-Reported Coping Strategies During the COVID-19 Pandemic in Ecuador: A Mixed-Methods Study. Psychol Res Behav Manag 2021; 14:933-944. [PMID: 34239334 PMCID: PMC8259946 DOI: 10.2147/prbm.s314844] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 06/03/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE This study assessed the psychological distress, life satisfaction, and perceived stress of Ecuadorian teachers who adopted online learning in response to the COVID-19 pandemic. It also aimed to qualitatively report the coping strategies used to maintain their mental health and well-being. METHODS A web-based cross-sectional survey was conducted from June to mid-August 2020. RESULTS In total, 394 teachers completed the questionnaire, and from those, 320 also completed an optional open-ended question included in the survey. More than half of the participants reported taking care of children under 11 years and/or adults over 65 years. At the time of the study, most of the participants were teaching in higher education settings. Age was significantly correlated with all the psychological variables, females presented higher levels of perceived stress, and teachers with home care responsibilities presented higher psychological distress as well as perceived stress. Teachers who had previous training and experience with online teaching presented lower levels of distress, perceived stress as well as higher levels of life satisfaction. The most used coping strategies included seeking social support, exercising, and engaging in leisure activities. CONCLUSION The results provide useful information to help develop initiatives that promote teacher well-being. Future studies should consider using a more diverse sample and dedicate attention to work-family conflicts as well as social and structural inequalities that may have a toll on teachers' mental health and performance.
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Affiliation(s)
| | | | - Clara Paz
- Escuela de Psicología, Universidad de Las Américas, Quito, Ecuador
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Paz C, Suárez E, Cabarcos A, Pinto SIS. FSI modeling on the effect of artery-aneurysm thickness and coil embolization in patient cases. Comput Methods Programs Biomed 2021; 206:106148. [PMID: 33992899 DOI: 10.1016/j.cmpb.2021.106148] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 04/26/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND AND OBJECTIVE The attainment of a methodology to simulate the hemodynamic in patient-specific cerebral vessels with aneurysms is still a challenge. The novelty of this work is focused on the effect of coil embolization in a realistic cerebral aneurysm, according to the vessel wall thickness and aneurysm thickness, through transient FSI simulations. METHODS The quality of the mesh for simulations was checked with a specific mesh convergence study; and the numerical methodology was validated using numerical research data of the literature. The model was implemented in ANSYS® software. The total deformation and equivalent stress evolution in the studied cases, before and after coil embolization, were compared. More than 20 different models were employed due to different arterial wall thickness and aneurysm wall thickness combinations. RESULTS The obtained results have showed that deformation and stress values are highly influenced with the sac thickness. The thinner sac aneurysm thickness is, the greater deformation and stress are. The results after coil embolization process have highlighted that considering typical values of arterial wall thickness and aneurysm thickness 0.3 mm and 0.15 mm respectively, a deformation reduction around 50% and a stress reduction around 70% can be achieved. CONCLUSIONS The proposed methodology is a step forward in the personalized medicine, quantifying the aneurysm rupture risk reduction, and helping the medical team in the preoperative planning, or to deciding the optimal treatment.
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Affiliation(s)
- C Paz
- CINTECX, University of Vigo, Campus Universitario Lagoas-Marcosende, Vigo 36310, España.
| | - E Suárez
- CINTECX, University of Vigo, Campus Universitario Lagoas-Marcosende, Vigo 36310, España.
| | - A Cabarcos
- CINTECX, University of Vigo, Campus Universitario Lagoas-Marcosende, Vigo 36310, España.
| | - S I S Pinto
- Engineering Faculty of University of Porto, Institute of Science and Innovation in Mechanical and Industrial Engineering (LAETA-INEGI), Rua Dr. Roberto Frias, Porto 4200-465, Portugal.
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Paz C, Hermosa-Bosano C, Evans C. What Happens When Individuals Answer Questionnaires in Two Different Languages. Front Psychol 2021; 12:688397. [PMID: 34248794 PMCID: PMC8260934 DOI: 10.3389/fpsyg.2021.688397] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 05/25/2021] [Indexed: 11/24/2022] Open
Abstract
The aim of the present study was to compare scores from the English and the Spanish versions of two well-known measures of psychological distress using a within-subject approach. This method involved bilingual participants completing both measures in four conditions. For two groups of people, measures were offered in the same language both times and for the other two groups, each language version was offered, the order differing between the groups. The measures were the Clinical Outcomes in Routine Evaluation-Outcome Measure and the Schwartz Outcome Scale-10, both originally created in English and then translated to Spanish. In total, 109 bilingual participants (69.7% women) completed the measures in two occasions and were randomly allocated to the four conditions (English-English, English-Spanish, Spanish-English and Spanish-Spanish). Linear mixed effects models were performed to provide a formal null hypothesis test of the effect of language, order of completion and their interaction for each measure. The results indicate that for the total score of the Clinical Outcomes in Routine Evaluation-Outcome Measure just language had a significant effect, but no significant effects were found for completion order or the language by order interaction. For the Schwartz Outcome Scale-10 scores, none of these effects were statistically significant. This method offers some clear advantages over the more prevalent psychometric methods of testing score comparability across measure translations.
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Affiliation(s)
- Clara Paz
- Escuela de Psicología, Universidad de Las Américas, Quito, Ecuador
| | | | - Chris Evans
- Department of Psychology, The University of Sheffield, Sheffield, United Kingdom
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Grau Touriño A, Feixas G, Medina JC, Paz C, Evans C. Effectiveness of integrated treatment for eating disorders in Spain: protocol for a multicentre, naturalistic, observational study. BMJ Open 2021; 11:e043152. [PMID: 34006027 PMCID: PMC7942235 DOI: 10.1136/bmjopen-2020-043152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Eating disorders (EDs) are complex pathologies which require equally complex treatment strategies. These strategies should be multidisciplinary, personalised interventions, performed in appropriate settings along a healthcare continuum from inpatient to community care. Personalisation, and the complexity of levels of care and interventions make evaluation of treatments difficult. The present study aims to measure the effectiveness of a complex treatment programme for EDs which includes hospitalisation, day hospital and outpatient settings. Our purpose is to assess the complete therapeutic process of each patient through all these levels of care, capturing the multiplicity of trajectories that a programme of these characteristics involves. METHODS AND ANALYSIS This protocol describes a multicentre, naturalistic, observational study. All patients starting between November 2017 and October 2020 in a healthcare network for EDs in Spain are being invited to participate. The first phase of intensive change monitoring to November 2020 is followed by lower intensity follow-up until October 2025. In the first phase progress of all participants is assessed every 3 weeks using specific measures for ED and the Clinical Outcomes Routine Evaluation system, a family of instruments specifically designed to measure change in psychotherapy. In the second phase data collection will happen quarterly. Both cross-sectional and longitudinal analyses will be conducted, with a special focus on patterns and predictors of change studied through multilevel linear models. ETHICS AND DISSEMINATION The study has been approved by the Research Bioethics Committee of the University of Barcelona (no. IRB00003099) and the ethical committee of ITA Mental Health, the organisation to which all participating centres belong. Dissemination will be in papers for peer-reviewed research journals and to clinicians working with ED. TRIAL REGISTRATION NUMBER NCT04127214.
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Affiliation(s)
| | - Guillem Feixas
- Department of Clinical Psychology and Psychobiology, Section of Personality, Evaluation and Psychological Treatment, Psychology Faculty, Universitat de Barcelona, Barcelona, Spain
- The Institute of Neurosciences, Universitat de Barcelona, Barcelona, Spain
| | - Joan Carles Medina
- Department of Clinical Psychology and Psychobiology, Universitat de Barcelona, Barcelona, Spain
- Faculty of Psychology and Education Sciences, Universitat Oberta de Catalunya, Barcelona, Spain
| | - Clara Paz
- School of Psychology, Universidad de Las Americas, Quito, Ecuador
| | - Chris Evans
- Department of Psychology, The University of Sheffield, Sheffield, UK
- Department of Psychology, University of Roehampton, London, UK
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Ortiz-Prado E, Simbaña-Rivera K, Barreno LG, Diaz AM, Barreto A, Moyano C, Arcos V, Vásconez-González E, Paz C, Simbaña-Guaycha F, Molestina-Luzuriaga M, Fernández-Naranjo R, Feijoo J, Henriquez-Trujillo AR, Adana L, López-Cortés A, Fletcher I, Lowe R. Epidemiological, socio-demographic and clinical features of the early phase of the COVID-19 epidemic in Ecuador. PLoS Negl Trop Dis 2021; 15:e0008958. [PMID: 33395425 PMCID: PMC7817051 DOI: 10.1371/journal.pntd.0008958] [Citation(s) in RCA: 70] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 01/20/2021] [Accepted: 11/05/2020] [Indexed: 01/15/2023] Open
Abstract
The SARS-CoV-2 virus has spread rapidly around the globe. Nevertheless, there is limited information describing the characteristics and outcomes of COVID-19 patients in Latin America. We conducted a cross-sectional analysis of 9,468 confirmed COVID-19 cases reported in Ecuador. We calculated overall incidence, mortality, case fatality rates, disability adjusted life years, attack and crude mortality rates, as well as relative risk and relative odds of death, adjusted for age, sex and presence of comorbidities. A total of 9,468 positive COVID-19 cases and 474 deaths were included in the analysis. Men accounted for 55.4% (n = 5, 247) of cases and women for 44.6% (n = 4, 221). We found the presence of comorbidities, being male and older than 65 years were important determinants of mortality. Coastal regions were most affected by COVID-19, with higher mortality rates than the highlands. Fatigue was reported in 53.2% of the patients, followed by headache (43%), dry cough (41.7%), ageusia (37.1%) and anosmia (36.1%). We present an analysis of the burden of COVID-19 in Ecuador. Our findings show that men are at higher risk of dying from COVID-19 than women, and risk increases with age and the presence of comorbidities. We also found that blue-collar workers and the unemployed are at greater risk of dying. These early observations offer clinical insights for the medical community to help improve patient care and for public health officials to strengthen Ecuador's response to the outbreak.
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Affiliation(s)
- Esteban Ortiz-Prado
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito, Ecuador
| | - Katherine Simbaña-Rivera
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito, Ecuador
| | - Lenin Gómez Barreno
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito, Ecuador
| | - Ana Maria Diaz
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito, Ecuador
| | - Alejandra Barreto
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito, Ecuador
| | - Carla Moyano
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito, Ecuador
| | - Vannesa Arcos
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito, Ecuador
| | | | - Clara Paz
- School of psychology, Universidad de Las Americas, Quito, Ecuador
| | | | | | - Raúl Fernández-Naranjo
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito, Ecuador
| | - Javier Feijoo
- Instituto de Física La Plata, Universidad Nacional de la Plata, La Plata, Argentina
| | | | - Lila Adana
- School of psychology, Universidad de Las Americas, Quito, Ecuador
| | - Andrés López-Cortés
- Centro de Investigación Genética y Genómica, Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador
- Red Latinoamericana de Implementación y Validación de Guías Clínicas Farmacogenómicas (RELIVAF-CYTED), Quito, Ecuador
| | - Isabel Fletcher
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Rachel Lowe
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
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Yacelga Ponce T, Zúñiga E, Paz C, Hidalgo-Andrade P. Supervision Model of Mental Health Telecare Volunteers During the Covid-19 Pandemic. Clin Neuropsychiatry 2020; 17:361-364. [PMID: 34909014 PMCID: PMC8662711 DOI: 10.36131/cnfioritieditore20200605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The COVID-19 outbreak is a pandemic that has strained significantly the capacity of many public and private health systems. To alleviate the burden, many students of health-related professions volunteered to offer their expertise to attend to the health needs of the public. This brief article aims to share a replicable supervision model that is currently in place to care for those volunteers in telecare mental health. The key aspects of this supervision model are the team composition, ongoing group supervision, formally structured supervision sessions, and the objective monitoring of members' well-being.
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Affiliation(s)
| | - Edgar Zúñiga
- School of Psychology, Universidad de Las Américas, Quito, Ecuador
| | - Clara Paz
- School of Psychology, Universidad de Las Américas, Quito, Ecuador
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Blitzer G, Paz C, Giri J, Pennati A, Ganz O, Schreiber S, Nickel K, Kelm-Nelson C, Vanessa C, Pohlman R, Varghese T, Glazer T, Mattison R, Pulia N, Gallipeau J, Kimple R. Salivary Gland Autotransplantation of Marrow Mesenchymal Stromal Cells for Treatment of Radiation-Induced Xerostomia - FDA IND Enabling Studies. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Paz C, Evans C, Valdiviezo-Oña J, Osejo-Taco G. Acceptability and Psychometric Properties of the Spanish Translation of the Schwartz Outcome Scale-10 (SOS-10-E) Outside the United States: A Replication and Extension in a Latin American Context. J Pers Assess 2020; 103:695-704. [PMID: 33006483 DOI: 10.1080/00223891.2020.1825963] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The Schwartz Outcome Scale-10 is a 10-item measure that has proven utility for assessing well-being and mental health and measuring change over time. Although there is a Spanish translation of the measure created in the United States for the Latino population, its acceptability and psychometric properties have not been studied in unilingual Spanish speakers, nor outside the United States. The aim of the present study is to explore these properties in larger samples, clinical and non-clinical, from Latin America adding convergent validity checking and exploration of effects of gender and age on scores. A qualitative study was conducted with 11 participants to test for dialect/language issues, then a psychometric exploration of data from 886 participants in a non-clinical sample and 172 in a clinical sample. The results showed good psychometric characteristics and suggest that the SOS-10-E can be used in Latin America. A cutoff of 42.51 differentiates clinical scores from non-clinical. Future studies are needed to explore sensitivity to change and check replication in other Spanish speaking populations.
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Affiliation(s)
- Clara Paz
- School of Psychology, Universidad de Las Américas, Quito, Ecuador
| | - Chris Evans
- Psychology Department, University of Sheffield, Sheffield, UK.,Department of Psychology, University of Roehampton, London, UK
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Paz C, Mascialino G, Adana-Díaz L, Rodríguez-Lorenzana A, Simbaña-Rivera K, Gómez-Barreno L, Troya M, Páez MI, Cárdenas J, Gerstner RM, Ortiz-Prado E. Anxiety and depression in patients with confirmed and suspected COVID-19 in Ecuador. Psychiatry Clin Neurosci 2020; 74:554-555. [PMID: 32609409 PMCID: PMC7361296 DOI: 10.1111/pcn.13106] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 06/23/2020] [Accepted: 06/24/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Clara Paz
- School of Psychology, Universidad de Las Américas, Quito, Ecuador
| | - Guido Mascialino
- School of Psychology, Universidad de Las Américas, Quito, Ecuador
| | - Lila Adana-Díaz
- School of Psychology, Universidad de Las Américas, Quito, Ecuador
| | | | - Katherine Simbaña-Rivera
- One Health Research Group, Faculty of Health Sciences, Universidad de Las Américas, Quito, Ecuador
| | - Lenin Gómez-Barreno
- One Health Research Group, Faculty of Health Sciences, Universidad de Las Américas, Quito, Ecuador
| | - Maritza Troya
- National Department of Mental Health from the Ministry of Public Health Ecuador, Quito, Ecuador
| | - María Ignacia Páez
- National Department of Mental Health from the Ministry of Public Health Ecuador, Quito, Ecuador
| | - Javier Cárdenas
- National Department of Mental Health from the Ministry of Public Health Ecuador, Quito, Ecuador
| | - Rebekka M Gerstner
- National Department of Mental Health from the Ministry of Public Health Ecuador, Quito, Ecuador.,Department of Psico-etichs, Pontificia Universidad Católica del Ecuador, sede PUCE Santo Domingo, Santo Domingo de los Tsachilas, Ecuador
| | - Esteban Ortiz-Prado
- One Health Research Group, Faculty of Health Sciences, Universidad de Las Américas, Quito, Ecuador
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Paz C, Mascialino G, Adana-Díaz L, Rodríguez-Lorenzana A, Simbaña-Rivera K, Gómez-Barreno L, Troya M, Paez MI, Cárdenas J, Gerstner RM, Ortiz-Prado E. Behavioral and sociodemographic predictors of anxiety and depression in patients under epidemiological surveillance for COVID-19 in Ecuador. PLoS One 2020; 15:e0240008. [PMID: 32997705 PMCID: PMC7526886 DOI: 10.1371/journal.pone.0240008] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 09/17/2020] [Indexed: 01/14/2023] Open
Abstract
Ecuador has been one of the most affected countries by the Corona Virus Disease 19 (COVID-19) pandemic, by April 2020 this country presented the highest rates of mortality in Latin America. The purpose of the present study was to identify behaviors during confinement and sociodemographic variables associated with the mental health status of confirmed or suspected COVID-19 patients who were part of the epidemiological surveillance program in Ecuador that included mandatory confinement and self-isolation. A cross-sectional study was performed from March 22th to April 18th, 2020 using an online survey. The survey collected socio-demographic information and severity of depressive symptoms using the Patient Health Questionnaire-9 and anxiety symptoms through the Generalized Anxiety Disorder-7. A total of 759 patients completed the questionnaire, 20.3% presented moderate to severe symptoms of depression and 22.5% moderate to severe symptoms of anxiety. Being a woman and from the Coastal region were risk factors. Exercising, maintaining daily routines, and keeping informed about the COVID-19 but limiting to an hour was associated with better mental health. Regression analysis indicated that the mentioned behaviors explained approximately 17% of the variance for depression sum scores and 11.8% of the variance for anxiety sum scores while controlling for gender and region. Understanding the association between sociodemographic variables and psychological states in patients with COVID-19 is relevant to tackle future public mental health problems and to implement health policies that are intended to palliate further psychiatric complications. Promotion of modifiable behaviors such as exercising, maintaining daily routines, and keeping informed about the COVID-19 but limiting to less than an hour is recommended.
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Affiliation(s)
- Clara Paz
- School of Psychology, Universidad de Las Américas, Quito, Ecuador
| | - Guido Mascialino
- School of Psychology, Universidad de Las Américas, Quito, Ecuador
| | - Lila Adana-Díaz
- School of Psychology, Universidad de Las Américas, Quito, Ecuador
| | | | - Katherine Simbaña-Rivera
- Faculty of Health Science, One Health Research Group, Universidad de Las Américas, Quito, Ecuador
| | - Lenin Gómez-Barreno
- Faculty of Health Science, One Health Research Group, Universidad de Las Américas, Quito, Ecuador
| | - Maritza Troya
- National Department of Mental Health, Ministry of Public Health in Ecuador, Quito, Ecuador
| | - María Ignacia Paez
- National Department of Mental Health, Ministry of Public Health in Ecuador, Quito, Ecuador
| | - Javier Cárdenas
- National Department of Mental Health, Ministry of Public Health in Ecuador, Quito, Ecuador
| | - Rebekka M. Gerstner
- Department of Sicoethics, Pontificia Universidad Católica del Ecuador, PUCE, Sede Santo Domingo, Quito, Ecuador
| | - Esteban Ortiz-Prado
- Faculty of Health Science, One Health Research Group, Universidad de Las Américas, Quito, Ecuador
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García-Mieres H, Montesano A, Villaplana A, Trujillo A, Salla M, Paz C, Ochoa S, Feixas G. Common and differential dimensions of personal identity between psychosis and depression: The relevance of gender and depressive mood. J Psychiatr Res 2020; 127:48-56. [PMID: 32480046 DOI: 10.1016/j.jpsychires.2020.05.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 04/15/2020] [Accepted: 05/18/2020] [Indexed: 12/14/2022]
Abstract
Disturbances in personal identity are recognized in psychosis and depression. However, it is unknown whether these disruptions share common processes across clinical groups, or whether there are unique alterations by group or between men and women within each clinical group. To advance on this question, we compared personal identity dimensions in psychosis and depression and investigated the effects of gender and depressive mood. This study assessed dimensions of personal identity using the repertory grid technique among 85 outpatients with psychosis, 85 outpatients with depressive disorders and 85 healthy controls who were matched by age. Data regarding depressive mood and general functioning was also collected. Results showed that self-discrepancies were higher in psychosis and depression than in controls, and were associated with depressive mood. Interpersonal dichotomous thinking was more prevalent in women in both clinical groups. Women with psychosis showed higher ideal-others discrepancy and had a more complex structure of personal identity than their male counterparts. To conclude, alterations in self-ideal and self-others discrepancies may be transdiagnostic dimensions related to depressive mood. Interpersonal dichotomous thinking may also be a common dimensional characteristic in psychosis and depression but more specific to women. Finally, critical views of others and a higher complexity of personal identity may be more specific to women than men with psychosis. Our results are consistent with other studies pointing to the need for person-focused treatments promoting the recovery of a full sense of personal identity, rather than just focusing on specific thoughts and feelings.
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Affiliation(s)
- H García-Mieres
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, The Institute of Neurosciences, University of Barcelona, 08035, Barcelona, Spain; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain.
| | - A Montesano
- Department of Psychology and Educational Sciences, Open University of Catalonia, Barcelona, Spain
| | - A Villaplana
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
| | - A Trujillo
- Faculty of Psychology, Universidad El Bosque, Bogotá, Colombia
| | - M Salla
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, The Institute of Neurosciences, University of Barcelona, 08035, Barcelona, Spain
| | - C Paz
- Clara Paz: School of Psychology, Universidad de Las Américas, Quito, Ecuador
| | - S Ochoa
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; Mental Health Networking Biomedical Research Centre, CIBERSAM, Madrid, Spain
| | - G Feixas
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, The Institute of Neurosciences, University of Barcelona, 08035, Barcelona, Spain
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Evans C, Sabucedo P, Paz C. Supporting practice based evidence in the COVID-19 crisis: three researcher-practitioners’ stories. Counselling Psychology Quarterly 2020. [DOI: 10.1080/09515070.2020.1779661] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Chris Evans
- Psychology Department, University of Sheffield, Sheffield, UK & Department of Psychology, University of Roehampton, London, UK
| | - Pablo Sabucedo
- Ábaco Psicología, Vigo, Galicia, Spain & Department of Psychology, University of Roehampton, London, UK
| | - Clara Paz
- School of Psychology, Universidad de Las Americas, Quito, Ecuador
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Abstract
Objective: To conduct a scoping review of measure utilization in Latin America. We relate the findings to the needs of the region and give recommendations for measure usage in LA. Methods: Six electronic databases (PubMed, Web of Science, CINAHL, PsychInfo, SCOPUS, and SCIELO) were searched to identify peer-reviewed literature. In total, 207 studies using change and/or outcome measures were identified based on a priori inclusion criteria. Results: Production by country varied markedly; more than three quarters of the studies took place in just three of the 20 Latin American countries: Brazil, Chile, and Mexico. The most frequently used measures were the Outcome Questionnaire, Beck Depression Inventory-II, Hamilton Rating Scale, and Yale-Brown Obsessive-Compulsive Scale. The most common diagnosis was depression (n = 54). Conclusions: Outcome and change research in Latin America is growing rapidly but future efforts should focus more tightly on the needs of the region, as well as on forging collaborations with researchers from other regions. The use of change measures for serial assessment throughout interventions is recommended in view of its adaptability to highly diverse Latin American social realities. Dissemination of research findings and promotion of outcome and change measure use through implementation of public policy is recommended.
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Affiliation(s)
- Clara Paz
- School of Psychology, Universidad de Las Américas, Quito, Ecuador
| | - Guido Mascialino
- School of Psychology, Universidad de Las Américas, Quito, Ecuador
| | - Karen Proaño
- School of Psychology, Universidad de Las Américas, Quito, Ecuador
| | - Chris Evans
- The University of Sheffield, Western Bank, Sheffield, UK
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Paz C, Aguilera M, Salla M, Compañ V, Medina JC, Bados A, García-Grau E, Castel A, Cañete Crespillo J, Montesano A, Medeiros-Ferreira L, Feixas G. Personal Construct Therapy vs Cognitive Behavioral Therapy in the Treatment of Depression in Women with Fibromyalgia: Study Protocol for a Multicenter Randomized Controlled Trial. Neuropsychiatr Dis Treat 2020; 16:301-311. [PMID: 32021219 PMCID: PMC6987966 DOI: 10.2147/ndt.s235161] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 01/07/2020] [Indexed: 11/23/2022] Open
Abstract
Background: Fibromyalgia (FM) is a debilitating syndrome, more prevalent in women, which is aggravated by the presence of depressive symptoms. In the last decade, cognitive behavioral therapy (CBT) has demonstrated to reduce such depressive symptoms and pain in these patients, but there are still a considerable number of them who do not respond to interventions. The complexity of the disorder requires the consideration of the unique psychological characteristics of each patient to attain good outcomes. One approach that could accomplish this goal might be personal construct therapy (PCT), an idiographic approach that considers identity features and interpersonal meanings as their main target of intervention. Then, the aim of the study is to test the efficacy of PCT as compared to a well-established treatment in the reduction of depressive symptoms in women with fibromyalgia. METHODS AND ANALYSIS This is a multicenter randomized controlled trial. In each condition participants will attend up to eighteen 1-hr weekly therapy sessions and up to three 1-hr booster sessions during the following 3-5 months after the end of treatment. The depression subscale of the Hospital Anxiety and Depression Scale (HADS-D) will be the primary outcome measure and it will be assessed at baseline, at the end of therapy, and at 6-month follow-up. Other secondary measures will be applied following the same schedule. Participants will be 18- to 70-years-old women with a diagnosis of FM, presenting depressive symptoms evinced by scores above seven in depression items of the HADS-D. Intention-to-treat and complete case analyses will be performed for the main statistical tests. Linear mixed models will be used to analyze and to compare the treatment effects of both conditions. TRIAL REGISTRATION ClinicalTrials.gov: NCT02711020.
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Affiliation(s)
- Clara Paz
- School of Psychology, Universidad de Las Américas, Quito, Ecuador
| | - Mari Aguilera
- Department of Cognition, Development and Educational Psychology, Faculty of Psychology, Universitat de Barcelona, Barcelona, Spain
| | - Marta Salla
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, Universitat de Barcelona, Barcelona, Spain
| | - Victoria Compañ
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, Universitat de Barcelona, Barcelona, Spain
| | - Joan C Medina
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, Universitat de Barcelona, Barcelona, Spain
- The Institute of Neurosciences, Universitat de Barcelona, Barcelona, Spain
| | - Arturo Bados
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, Universitat de Barcelona, Barcelona, Spain
| | - Eugeni García-Grau
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, Universitat de Barcelona, Barcelona, Spain
| | - Antoni Castel
- Hospital Universitari de Tarragona Joan XXIII, Tarragona, Spain
| | | | - Adrián Montesano
- Faculty of Psychology and Educational Sciences, Universitat Oberta de Catalunya, Barcelona, Spain
| | | | - Guillem Feixas
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, Universitat de Barcelona, Barcelona, Spain
- The Institute of Neurosciences, Universitat de Barcelona, Barcelona, Spain
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Ortiz-Prado E, Mascialino G, Paz C, Rodriguez-Lorenzana A, Gómez-Barreno L, Simbaña-Rivera K, Diaz AM, Coral-Almeida M, Espinosa PS. A Nationwide Study of Incidence and Mortality Due to Traumatic Brain Injury in Ecuador (2004-2016). Neuroepidemiology 2019; 54:33-44. [PMID: 31461702 DOI: 10.1159/000502580] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 08/07/2019] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Traumatic brain injury (TBI) is a public health problem worldwide. Information regarding TBI from low- and middle-income countries is scarce. The objectives of this study are to determine the incidence, mortality and geodemographic distribution of TBI in Ecuador. METHODS A population-based analytical study from 2004 to 2016 was conducted in Ecuador. Men and women with a diagnosis of TBI from all ages (0-110 years) were included. Data was obtained from official hospital-discharges records and retrieved from the National Institute of Statistics and Census (INEC) Database. We analyzed data by region, province and canton with a monthly resolution. The incidence, mortality, case fatality rates and the risk of developing TBI within the population were calculated based on the last 13 years of available data. RESULTS A total of 124,576 hospital admissions and 5,264 deaths due to TBI were registered in Ecuador from 2004 to 2016. The overall TBI-related hospital admission rate was 70.68 per 100,000. The sex- and age-specific rate was 90.1 per 100,000 for men and 64.1 per 100,000 for women. Mestizos' population has the highest adjusted incidence rate of 195.6 per 100,000, followed by the indigenous with 61.4 per 100,000 and Afro-Americans with 14.2 per 100,000. The overall annual mortality rate during the study ranged from 2.11 to 3.35 per 100,000. Case fatality rates were significantly higher in older populations, becoming fatal in up to 27% of men >90 years/old and in 15% of women older than 90 years/old. CONCLUSION This is the first recorded epidemiological study of the socio-demographic distribution of TBI in Ecuador to date. The study found that young men were almost 4 times more likely to be hospitalized due to TBI than women of this age. Fatalities due to TBI were less likely to occur among younger age groups, increasing significantly among the elderly population. The national incidence rate of TBI has been decreasing since 2011, which coincides with the introduction of stricter alcohol regulation, suggesting that this measure might have played a role in this reduction.
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Affiliation(s)
- Esteban Ortiz-Prado
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, Quito, Ecuador, .,Programa de Biomedicina, Universitat de Barcelona, Barcelona, Spain,
| | - Guido Mascialino
- School of psychology, Universidad de Las Americas, Quito, Ecuador
| | - Clara Paz
- School of psychology, Universidad de Las Americas, Quito, Ecuador
| | | | - Lenin Gómez-Barreno
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, Quito, Ecuador
| | - Katherine Simbaña-Rivera
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, Quito, Ecuador
| | - Ana Maria Diaz
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, Quito, Ecuador
| | - Marco Coral-Almeida
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, Quito, Ecuador
| | - Patricio S Espinosa
- Chief of Neurology, Marcus Neuroscience Institute, Florida Atlantic University, Boca Raton, Florida, USA
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Feixas G, Paz C, García-Grau E, Montesano A, Medina JC, Bados A, Trujillo A, Ortíz E, Compañ V, Salla M, Aguilera M, Guasch V, Codina J, Winter DA. One-year follow-up of a randomized trial with a dilemma-focused intervention for depression: Exploring an alternative to problem-oriented strategies. PLoS One 2018; 13:e0208245. [PMID: 30543642 PMCID: PMC6292643 DOI: 10.1371/journal.pone.0208245] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 11/13/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Cognitive behavioural therapy (CBT) is aimed to counteract cognitions and behaviours that are considered as dysfunctional. The aim of the study is to test whether the inclusion of a non-counteractive approach (dilemma-focused intervention, DFI) in combination with CBT group therapy will yield better short- and long-term outcomes than an intervention conducted entirely using CBT. METHOD A total of 128 patients with depression and at least one cognitive conflict, of six health community centres in Barcelona, participated from November of 2011 to December of 2014 in seven weekly group CBT sessions and were then randomly allocated to either DFI or CBT (eight individual sessions each) by an independent researcher. Depressive symptoms were assessed with the Beck Depression Inventory-II at baseline, at the end of therapy and three- and twelve-month follow-ups. Therapists did not participate in any of the assessments nor in the randomisation of patients and evaluators were masked to group assignment. Both intention to treat and complete case analyses were performed using linear mixed models with random effects. FINDINGS According to intention-to-treat analysis (F2, 179 = 0.69) and complete case analysis (F2, 146 = 0.88), both conditions similarly reduced the severity of symptoms across posttreatment assessments. For the 77 participants (CBTgroup +CBTindividual = 40; CBTgroup+DFIindividual = 37) that completed allocated treatment and one-year follow-up assessment, response and remission rates were relative higher for the DFI condition, however no significant differences were found between treatment conditions. The relapse rates were similar between treatment conditions (CBTgroup +CBTindividual = 7/20; CBTgroup+DFIindividual = 8/22). INTERPRETATION Although using a counteractive approach across all the treatment sessions is quite effective, it does not seem to be necessary to produce significant improvement. DFI may be considered as an alternative, which could be included in a wider treatment for depression. TRIAL REGISTRATION ClinicalTrials.gov; ID: NCT01542957.
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Affiliation(s)
- Guillem Feixas
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
- The Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Clara Paz
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
- School of Psychology, Universidad de Las Américas, Quito, Ecuador
| | - Eugeni García-Grau
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
| | - Adrián Montesano
- Department of Psychology and Educational Sciences, Open University of Catalonia, Barcelona, Spain
| | - Joan C. Medina
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
- The Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Arturo Bados
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
| | - Adriana Trujillo
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
- Faculty of Psychology, El Bosque University, Bogotá, Colombia
| | - Eliana Ortíz
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
- Faculty of Psychology, Universidad Católica de Colombia, Bogotá, Colombia
| | - Victoria Compañ
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
| | - Marta Salla
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
| | - Mari Aguilera
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
| | - Víctor Guasch
- Mental Health Services, Fundació Sanitària Sant Pere Claver, Barcelona, Spain
| | - Jordi Codina
- Mental Health Services, Fundació Sanitària Sant Pere Claver, Barcelona, Spain
| | - David A. Winter
- Department of Psychology and Sport Sciences, University of Hertfordshire, Hatfield, United Kingdom
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