Coping Strategies Utilized by Middle-Aged and Older Latino Caregivers of Loved Ones with Alzheimer's Disease and Related Dementia.

We aimed to explore the coping strategies utilized by Latino caregivers of people with Alzheimer's disease or related dementia (ADRD). We conducted 16 semi-structured interviews with Latinos family caregivers. The interviews explored the caregivers' experiences utilizing coping strategies. Coping strategies were identified based on a direct content analysis of the interviews. Participants were 50 to 75 years old, majority female, and from Mexico. The most common coping strategies adopted were: rationalization, social interactions, physical activity, and leisure activities. Other strategies used included avoidance, keeping busy, self-care, and spirituality or faith. Strategies such as using social interactions and spirituality and faith may be rooted in Latino cultural values such as familismo and fatalismo. The possible origin from cultural values might make some of the coping strategies more prevalent or effective in Latinos. Effective interventions aiming to reduce stress in Latino caregivers should prioritize culturally relevant problem-focused coping strategies.

A new species of Microkayla (Anura: Craugastoridae: Holoadeninae) from Department La Paz, Bolivia.

We describe a new species of direct-developing frog of the genus Microkayla from the Cordillera Real of the Bolivian Andes, in the Department of La Paz. The new species, Microkayla huayna sp. nov., is closely related to M. teqta and can be distinguished from other species of the genus by its brown dorsal skin and the presence of a large dark brown vocal sac in males. This is the second species of Microkayla known from the Zongo Valley, and the ninth in the Cordillera Real, contributing to a total of 22 described species in Bolivia. Given its small distribution range, we recommend to considering it as Vulnerable according to IUCN criteria.

Detection of Biased Rating of Medical Students by Standardized Patients: Opportunity for Improvement.

OBJECTIVES: To assess the inter-rater reliability of standardized patients (SPs) as they assess the clinical skills of medical students and to detect possible rating bias in SPs. METHODS: The ratings received by 6 students examined in 4 clinical stations by 13 SPs were examined. Each SP contributed at least 3 and at most 10 pairwise ratings, with an average of approximately 5 ratings per SP. The standard Cohen' kappa statistic was calculated and the distribution of scores among SPs was compared via both ANOVA the Kruskal-Wallis H test (one-way ANOVA by ranks). Furthermore, the number of discrepancies between pairwise raters (showing either "positive" or "negative" bias in the rating) were analyzed using ANOVA and a χ2 goodness-of-fit test. RESULTS: The conventional method, which compared the statistics of kappa scores of the raters (including the prevalence-adjusted-bias adjusted kappa scores) did not reject the null hypothesis, that the raters (SPs) are similar. However, the analysis of the distribution of the discrepancies among the raters revealed that the differences between raters cannot be attributed to chance, particularly when a distinction was made between their overall "positive" and "negative" bias. A strong (p<0.001) "negative" bias was detected, and the SPs responsible for this bias have been identified. CONCLUSIONS: The statistical method suggested here, which takes into account explicitly the "positive" and the "negative" bias of the raters, is more sensitive than the conventional method (Cohens' kappa). Since the outliers (the biased SPs) affect the fairness of the grading of the medical students, it is important to detect any statistically-significant bias in the rating and to adjust correspondingly the SP's assessment.