Increasing Transcultural Competence in Clinical Psychologists Through a Web-Based Training: Study Protocol for a Randomized Controlled Trial

Background In mental health care, the number of patients with diverse cultural backgrounds is growing. Nevertheless, evaluated training programs for transcultural competence are missing. Barriers for engaging in transcultural therapy can be identified in patients as well as in therapists. Besides language barriers, clinical psychologists report insecurities, for example, fear of additional expenses when involving a language mediator, ethical concerns such as power imbalances, or fear of lack of knowledge or incorrect handling when working with patients from other cultures. Divergent values and concepts of disease, prejudices, and stereotyping are also among the issues discussed as barriers to optimal psychotherapy care. The planned study aims to empower clinical psychologists to handle both their own as well as patients’ barriers through a web-based training on transcultural competence. Methods The training includes 6 modules, which are unlocked weekly. A total of N = 174 clinical psychologists are randomly assigned to two groups: the training group (TG) works through the complete training over 6 weeks, which includes a variety of practical exercises and self-refections. In addition, participants receive weekly written feedback from a trained psychologist. The waitlist control group (WL) completes the training after the end of the waiting period (2 months after the end of the TG’s training). The primary outcome is transcultural competence. Secondary outcomes consist of experiences in treating people from other cultures (number of patients, satisfaction and experience of competence in treatment, etc.). Data will be collected before and after the training as well as 2 and 6 months after the end of the training. Discussion This randomized controlled trial tests the efficacy of and satisfaction with a web-based training on transcultural competence for German-speaking clinical psychologists. If validated successfully, the training can represent a time- and place-flexible training opportunity that could be integrated into the continuing education of clinical psychologists in the long term. Trial registration DRKS00031105. Registered on 21 February 2023

Resilience trinity: safeguarding ecosystem functioning and services across three different time horizons and decision contexts

Ensuring ecosystem resilience is an intuitive approach to safeguard the functioning of ecosystems and hence the future provisioning of ecosystem services (ES). However, resilience is a multi‐faceted concept that is difficult to operationalize. Focusing on resilience mechanisms, such as diversity, network architectures or adaptive capacity, has recently been suggested as means to operationalize resilience. Still, the focus on mechanisms is not specific enough. We suggest a conceptual framework, resilience trinity, to facilitate management based on resilience mechanisms in three distinctive decision contexts and time‐horizons: 1) reactive, when there is an imminent threat to ES resilience and a high pressure to act, 2) adjustive, when the threat is known in general but there is still time to adapt management and 3) provident, when time horizons are very long and the nature of the threats is uncertain, leading to a low willingness to act. Resilience has different interpretations and implications at these different time horizons, which also prevail in different disciplines. Social ecology, ecology and engineering are often implicitly focussing on provident, adjustive or reactive resilience, respectively, but these different notions of resilience and their corresponding social, ecological and economic tradeoffs need to be reconciled. Otherwise, we keep risking unintended consequences of reactive actions, or shying away from provident action because of uncertainties that cannot be reduced. The suggested trinity of time horizons and their decision contexts could help ensuring that longer‐term management actions are not missed while urgent threats to ES are given priority

DBRepo: a Semantic Digital Repository for Relational Databases

Data curation is a complex, multi-faceted task. While dedicated data stewards are starting to take care of these activities in close collaboration with researchers for many types of (usually file-based) data in many institutions, this is rarely yet the case for data held in relational databases. Beyond large-scale infrastructures hosting e.g. climate or genome data, researchers usually have to create, build and maintain their database, care about security patches, and feed data into it in order to use it in their research. Data curation, if at all, usually happens after a project is finished, when data may be exported for digital preservation into file repository systems. We present DBRepo, a semantic digital repository for relational databases in a private cloud setting designed to (1) host research data stored in relational databases right from the beginning of a research project, (2) provide separation of concerns, allowing the researchers to focus on the domain aspects of the data and their work while bringing in experts to handle classic data management tasks, (3) improve findability, accessibility and reusability by offering semantic mapping of metadata attributes, and (4) focus on reproducibility in dynamically evolving data by supporting versioning and precise identification/cite-ability for arbitrary subsets of data.&nbsp

Wet chemical polishing for industrial type PERC solar cells

Industrial PERC cell process flows typically apply the polishing of the rear side after texturing as well as the edge isolation after POCl3 diffusion. In this paper, we present a novel single step polishing process which we apply post double sided texturing and diffusion in order to remove the rear emitter and to reduce the rear surface roughness. One challenge is to minimize the etch back of the front side emitter during rear side polishing due to the reactive gas phase of the polishing process. By optimizing the polishing process, we are able to limit the increase of the emitter sheet resistance below 5 Ω/sq. However, the wet cleaning post polishing contributes an additional 20 Ω/sq emitter sheet resistance increase which is subject to further optimization. We compensate the emitter sheet resistance increase due to wet cleaning by applying a 45 Ω/sq POCl3 diffusion instead of a 60 Ω/sq diffusion. The resulting PERC solar cells with polished rear surface post texture and diffusion show conversion efficiencies up to 19.6% which is comparable to the reference PERC cells which apply a rear protection layer instead of a polishing process.German Federal Ministry for the Environment, Nature Conservation and Nuclear Safety/0325296Heraeus Precious MetalsRenaSingulus TechnologiesSolar Worl

Associations between sleep problems and posttraumatic stress symptoms, social functioning, and quality of life in refugees with posttraumatic stress disorder

Many patients with posttraumatic stress disorder (PTSD) suffer from sleep problems, leading to impairments in social functioning and quality of life. Refugees are at high risk for sleep problems due to stressful life circumstances and a high PTSD prevalence. However, limited data on the frequency of sleep problems in refugees with diagnosed PTSD exist. This study examined the frequency of sleep problems in refugees with PTSD and their associations with symptoms of PTSD. Additionally, we investigated the contribution of sleep problems to social functioning and quality of life. Participants (N = 70) were refugees from different countries of origin currently living in Germany. All participants met the criteria for PTSD and completed measures of PTSD symptom severity, subjective sleep problems, social impairment, and quality of life. There was a very high frequency of sleep problems in the sample (100%), and sleep problems were significantly associated with both clinician-rated, r = .47, and self-rated, r = .30, PTSD symptom severity after controlling for overlapping items. Contrary to expectations, sleep problems did not predict social impairment, d = 0.16, nor quality of life, d = 0.13, beyond the effect of other PTSD symptoms. The findings highlight the widespread frequency of sleep problems among refugees. Future studies should assess the causal nature of the association between sleep problems and measures of psychosocial functioning in more detail and examine its dynamic change over time

A multi-environmental tracer study to determine groundwater residence times and recharge in a structurally complex multi-aquifer system

Despite being the main drinking water resource for over 5 million people, the water balance of the Eastern Mountain Aquifer system on the western side of the Dead Sea is poorly understood. The regional aquifer consists of fractured and karstified limestone - aquifers of Cretaceous age, and it can be separated into a Cenomanian aquifer (upper aquifer) and Albian aquifer (lower aquifer). Both aquifers are exposed along the mountain ridge around Jerusalem, which is the main recharge area. From here, the recharged groundwater flows in a highly karstified aquifer system towards the east and discharges in springs in the lower Jordan Valley and Dead Sea region. We investigated the Eastern Mountain Aquifer system for groundwater flow, groundwater age and potential mixtures, and groundwater recharge. We combined 36Cl ∕ Cl, tritium, and the anthropogenic gases SF6, CFC-12 (chlorofluorocarbon) and CFC-11, while using CFC-113 as "dating" tracers to estimate the young water components inside the Eastern Mountain Aquifer system. By application of lumped parameter models, we verified young groundwater components from the last 10 to 30 years and an admixture of a groundwater component older than about 70 years. Concentrations of nitrate, simazine (pesticide), acesulfame K (ACE-K; artificial sweetener) and naproxen (NAP; drug) in the groundwater were further indications of infiltration during the last 30 years. The combination of multiple environmental tracers and lumped parameter modelling helped to understand the groundwater age distribution and to estimate recharge despite scarce data in this very complex hydrogeological setting. Our groundwater recharge rates support groundwater management of this politically difficult area and can be used to inform and calibrate ongoing groundwater flow models.This research has been supported by the Helmholtz Association (grant no. VH-VI527), the Federal Ministry of Education and Research (BMBF; grant no. 02WM0848) and the BMBF-MOST(grant no. YSEP111)

Resilience trinity: safeguarding ecosystem functioning and services across three different time horizons and decision contexts

Ensuring ecosystem resilience is an intuitive approach to safeguard the functioning of ecosystems and hence the future provisioning of ecosystem services (ES). However, resilience is a multi-faceted concept that is difficult to operationalize. Focusing on resilience mechanisms, such as diversity, network architectures or adaptive capacity, has recently been suggested as means to operationalize resilience. Still, the focus on mechanisms is not specific enough. We suggest a conceptual framework, resilience trinity, to facilitate management based on resilience mechanisms in three distinctive decision contexts and time-horizons: i) reactive, when there is an imminent threat to ES resilience and a high pressure to act, ii) adjustive, when the threat is known in general but there is still time to adapt management, and iii) provident, when time horizons are very long and the nature of the threats is uncertain, leading to a low willingness to act. Resilience has different interpretations and implications at these different time horizons, which also prevail in different disciplines. Social ecology, ecology, and engineering are often implicitly focussing on provident, adjustive, or reactive resilience, respectively, but these different notions and of resilience and their corresponding social, ecological, and economic trade-offs need to be reconciled. Otherwise, we keep risking unintended consequences of reactive actions, or shying away from provident action because of uncertainties that cannot be reduced. The suggested trinity of time horizons and their decision contexts could help ensuring that longer-term management actions are not missed while urgent threats to ES are given priority

Cortical Plasticity Induced by Transcranial Magnetic Stimulation during Wakefulness Affects Electroencephalogram Activity during Sleep

BACKGROUND:Sleep electroencephalogram (EEG) brain oscillations in the low-frequency range show local signs of homeostatic regulation after learning. Such increases and decreases of slow wave activity are limited to the cortical regions involved in specific task performance during wakefulness. Here, we test the hypothesis that reorganization of motor cortex produced by long-term potentiation (LTP) affects EEG activity of this brain area during subsequent sleep. METHODOLOGY/PRINCIPAL FINDINGS:By pairing median nerve stimulation with transcranial magnetic stimulation over the contralateral motor cortex, one can potentiate the motor output, which is presumed to reflect plasticity of the neural circuitry. This paired associative stimulation increases M1 cortical excitability at interstimulus intervals of 25 ms. We compared the scalp distribution of sleep EEG power following paired associative stimulation at 25 ms to that following a control paradigm with 50 ms intervals. It is shown that the experimental manipulation by paired associative stimulation at 25 ms induces a 48% increase in amplitude of motor evoked potentials. This LTP-like potentiation, induced during waking, affects delta and theta EEG power in both REM and non-REM sleep, measured during the following night. Slow-wave activity increases in some frontal and prefrontal derivations and decreases at sites neighboring and contralateral to the stimulated motor cortex. The magnitude of increased amplitudes of motor evoked potentials by the paired associative stimulation at 25 ms predicts enhancements of slow-wave activity in prefrontal regions. CONCLUSIONS/SIGNIFICANCE:An LTP-like paradigm, presumably inducing increased synaptic strength, leads to changes in local sleep regulation, as indexed by EEG slow-wave activity. Enhancement and depression of slow-wave activity are interpreted in terms of a simultaneous activation of both excitatory and inhibitory circuits consequent to the paired associative stimulation at 25 ms