Adaptation and validation study of the Indonesian version of the Global Psychotrauma Screen in an undergraduate student population.

BACKGROUND: The high incidence of potentially traumatic events (PTEs) in Indonesia warrants early identification of those with probable trauma-related disorders in order to tailor prevention and intervention for trauma-related symptoms. OBJECTIVES: This study aims to adapt and validate a novel brief transdiagnostic screener, the Global Psychotrauma Screen (GPS), in Indonesian undergraduate students. METHODS: An online survey was administered among Indonesian undergraduate students (N = 322). Exploratory factor analysis, reliability analyses, clinical validity analyses, and correlational analyses were performed to evaluate the construct validity, reliability, clinical validity, and convergent-divergent validity of the Indonesian GPS. Hierarchical multiple regression was conducted to assess the relationship between risk factors and trauma-related symptoms. The relationship between four categories of trauma-related symptom severity and social/work functioning was measured using Analysis of Covariance. RESULTS: Exploratory factor analysis yielded a single-factor solution. The Indonesian GPS demonstrated good internal consistency, test-retest correlation, and absolute agreement, indicating good reliability. The Indonesian GPS also had an acceptable area under the curve, sensitivity, and specificity for a probable diagnosis of Post-Traumatic Stress Disorder (PTSD), Complex-PTSD (CPTSD), depression, and generalized anxiety disorder (GAD). We also established evidence for the convergent and divergent validity of GPS. The GPS risk factors (low psychological resilience, other stressful events, history of mental illness, and low social support) contributed to predicting trauma-related symptoms after controlling for gender, age, employment status, and faculty background. Additionally, in comparison to participants from the mild and low categories of GPS symptoms scores, participants from the severe and moderate category reported impaired lowered social/work functioning. CONCLUSION: The current findings indicate that the Indonesian GPS is a valid and reliable transdiagnostic trauma screener for Indonesian undergraduate students. This first comprehensive validation of the GPS in Indonesia calls for more research in Lower-middle Income Countries (LMICs) as a way towards prevention and early intervention for trauma-related symptoms.

Validation of the Indonesian resilience evaluation scale in an undergraduate student population.

BACKGROUND: Psychological resilience is an important factor in coping with Potentially Traumatic Events (PTEs) and might mitigate the development of trauma-related disorders. Due to the high risk of natural disasters, criminal activity, and transportation accidents among the Indonesian population, it is critical to assess psychological resilience as a protective factor. This study aimed to validate the Resilience Evaluation Scale (RES) in Indonesian undergraduate students. METHODS: We recruited 327 students (78% female, the mean age is 19.61 (SD = 1.24)) between March and June 2020 using convenience sampling, 256 (78.28%) of whom completed the RES twice with an interval of 2 weeks for test-retest reliability purposes. Parallel Analysis and Exploratory Factor Analysis were performed to examine the construct validity of the RES. The internal consistency and the test-retest reliability were assessed using Cronbach Alpha, Pearson Correlations, and Interclass Correlation Coefficients (ICC). Convergent and divergent validity were examined using Pearson Correlations. RESULTS: EFA analysis yielded a two-factor structure for the final eight-item Indonesian version of RES, which reflected two underlying constructs of resilience: self-confidence and self-efficacy. The Indonesian version of RES demonstrated good internal consistency (α = 0.74-0.82) and test-retest reliability (r = 0.68-0.78; ICC = 0.67-0.78). The result showed that the RES total and subscale scores positively correlated with all criterion variables (resilience, self-efficacy, self-esteem, level of global functioning, and adaptive coping strategy; r = 0.27-0.73). RES total and subscale scores negatively correlated with opposite constructs (PTSD, depression, social/work impairment, and maladaptive coping strategy; r = - 0.27- -0.46). CONCLUSIONS: The current study showed that the Indonesian RES is a valid and reliable measurement of psychological resilience in Indonesian undergraduate students. The final 8-item Indonesian RES, a freely available resilience instrument, is recommended for future studies and public mental health initiatives in the Indonesian population.

Assessing psychological resilience: translation and validation of the Chinese version of the resilience evaluation scale (RES).

Background: The Resilience Evaluation Scale (RES) is a novel and freely available measure of psychological resilience (factored into self-confidence and self-efficacy). To date, psychometric properties were evaluated in Dutch and American samples, but not yet in a Chinese sample. Objective: We aimed to validate the RES in a Chinese sample by examining its factor structure, reliability, and construct validity. Methods: The RES was translated into Chinese following a cross-cultural translation and adaptation procedure. Self-report questionnaires including the RES, exposure to potentially traumatic events (PTE's), the PTSD checklist for DSM-5 (PCL-5), and scales for conceptually related constructs of psychological resilience were then administered via an online survey. Results: In total, 484 Chinese adults (females, 66.9%; age: 27.33 ± 6.86 years) participated. Parallel analysis results suggested a one-factor structure for the Chinese RES. The Chinese RES demonstrated good internal consistency (Cronbach's alpha = 0.88). Construct validity was demonstrated through significant associations with hypothesised related constructs and through a relation with lower levels of PTSD among the PTE-exposed subsample (n = 116) via the mediating role of avoidant coping strategies, i.e. behavioural disengagement and self-blame. Conclusion: Our results suggest that the RES is a reliable and valid assessment of psychological resilience to use in Chinese, in addition to its Dutch and English versions. The RES could potentially be adopted to measure psychological resilience in cross-cultural contexts.

Antecedentes: La Escala de Evaluación de la Resiliencia (RES en su sigla en inglés) es una medida nueva y disponible de forma gratuita de la resiliencia psicológica (conformada por los factores de autoconfianza y autoeficacia). A la fecha, las propiedades psicométricas fueron evaluadas en muestras danesas y americanas, pero no en una muestra china todavía.Objetivo: Buscamos validar la RES en una muestra china evaluando su estructura factorial, confiabilidad, y validez de constructo.Métodos: La RES fue traducida al chino siguiendo un procedimiento de traducción y adaptación intercultural. Se administraron en una encuesta en línea los cuestionarios de autoinforme incluyendo la RES, exposición a eventos potencialmente traumáticos (PTE's en su sigla en inglés), y la lista de chequeo del TEPT para el DSM-5 (PCL-5 en su sigla en inglés), y las escalas de constructos conceptualmente relacionados a la resiliencia psicológica.Resultados: En total, participaron 484 adultos chinos (mujeres, 66.9%; edad: 27.33 ± 6.86 años). Los resultados de los análisis paralelos sugirieron una estructura de un factor para la RES china. La RES china demostró una buena consistencia interna (alfa de Cronbach = 0.88). La validez de constructo fue demostrada a través de asociaciones significativas con los constructos hipotéticamente relacionades y a través de una relación con niveles más bajo de TEPT en la sub-muestra expuesta a PTEs (n = 116) por medio del rol mediador de los mecanismos de afrontamiento evitativos, es decir, desconexión conductual y autoculpa.Conclusión: Nuestros resultados sugieren que la RES es una evaluación fiable y valida de resiliencia psicológica para usar en chino, en adición a sus versiones danesa e inglesa. La RES podría potencialmente ser adaptada para medir la resiliencia psicológica en contextos interculturales.

Innate Immune Training of Human Macrophages by Cathelicidin Analogs.

Trained innate immunity can be induced in human macrophages by microbial ligands, but it is unknown if exposure to endogenous alarmins such as cathelicidins can have similar effects. Previously, we demonstrated sustained protection against infection by the chicken cathelicidin-2 analog DCATH-2. Thus, we assessed the capacity of cathelicidins to induce trained immunity. PMA-differentiated THP-1 (dTHP1) cells were trained with cathelicidin analogs for 24 hours and restimulated after a 3-day rest period. DCATH-2 training of dTHP-1 cells amplified their proinflammatory cytokine response when restimulated with TLR2/4 agonists. Trained cells displayed a biased cellular metabolism towards mTOR-dependent aerobic glycolysis and long-chain fatty acid accumulation and augmented microbicidal activity. DCATH-2-induced trained immunity was inhibited by histone acetylase inhibitors, suggesting epigenetic regulation, and depended on caveolae/lipid raft-mediated uptake, MAPK p38 and purinergic signaling. To our knowledge, this is the first report of trained immunity by host defense peptides.

Detecting Interval Distant Metastases With 18F-FDG PET/CT After Neoadjuvant Chemoradiotherapy for Locally Advanced Esophageal Cancer.

PURPOSE: Patients with esophageal cancer can develop distant metastases between the start of neoadjuvant chemoradiotherapy (nCRT) and planned surgery (ie, interval distant metastases). 18F-FDG PET/CT restaging after nCRT detects interval distant metastases in ~8% of patients. This study aimed to identify patients for whom 18F-FDG PET/CT restaging after nCRT could be omitted using an existing prediction model predicting for interval distant metastases or by using clinical stage groups. PATIENTS AND METHODS: Patients with locally advanced esophageal cancer who underwent baseline and restaging 18F-FDG PET/CT, nCRT, and were planned for esophagectomy between 2017 and 2021 were eligible for inclusion in this retrospective study. The primary outcome was the existing model's external performance (ie, discrimination and calibration) for predicting interval distant metastases. The existing model predictors included tumor length, cN status, squamous cell carcinoma histology, and baseline SUVmax. The secondary outcome determined the clinical stage groups (AJCC/UICC eighth edition) for adenocarcinoma and squamous cell carcinoma for which the incidence of interval distant metastases was <10%. RESULTS: In total, 127 patients were included, of whom 17 patients developed interval distant metastases (13%; 95% confidence interval [CI], 8%-21%) and 9 patients were deemed to have false-positive lesions on 18F-FDG PET/CT (7%; 95% CI, 2%-11%). Applying the existing model to this cohort yielded a discriminatory c-statistic of 0.56 (95% CI, 0.40-0.72). The calibration of the existing model was poor (ie, mostly underestimating the actual risk). The incidence of true-positive versus false-positive interval distant metastases for patients with clinical stage II disease was 5% versus 0%; clinical stage III, 14% versus 8%; and clinical stage IVa, 22% versus 9%. CONCLUSIONS: The existing prediction model cannot reliably identify patients at risk for developing interval distant metastases after nCRT for esophageal cancer. Omission of 18F-FDG PET/CT restaging after nCRT could be considered in patients with clinical stage II esophageal cancer.

E-health applications in the field of traumatic stress.

E-health offers great potential in the field of traumatic stress to deliver training, assessment, prevention, and treatment of adverse outcomes after trauma worldwide. In order to encourage research on E-health applications in the field of traumatic stress, this current special issue of the European Journal of Psychotraumatology presents a series of papers divided into three emergent topics: I) development of digital interventions, II) the use of digital interventions to foster self-management and deliver therapy, and III) digital methods to improve prediction, assessment, and monitoring of post-trauma outcomes. These studies show acceptance of the tools by various end-user groups and improvements of current research and clinical practices, but also areas for improvement regarding the development process and making even better use of technological capabilities of E-Health. We propose three general themes to accelerate the quality of e-Health interventions and studies in this area in the coming years: optimizing user engagement and adherence, conducting more (innovative) research, and increasing implementation and dissemination activities. This issue appears in the midst of the COVID-19 pandemic. It is exactly at times like these that we need effective online interventions and we see an enormous increase in the use of e-Health. We hope this issue will contribute to help those affected and to serve the community worldwide.

La salud electrónica (E-salud) ofrece un gran potencial en el campo del estrés traumático para brindar capacitación, evaluación, prevención y tratamiento de resultados adversos luego de un trauma en todo el mundo. Con el fin de fomentar la investigación sobre aplicaciones de E-salud en el campo del estrés traumático, este número especial de la Revista Europea de Psicotraumatología presenta una serie de artículos divididos en tres temas emergentes: I) desarrollo de intervenciones digitales, II) el uso de intervenciones digitales para fomentar la autogestión y administrar terapia, y III) métodos digitales para mejorar la predicción, evaluación y monitoreo de resultados posteriores a un trauma. Estos estudios muestran aceptación de las herramientas por parte de varios grupos de usuarios finales y mejoras en la investigación actual y prácticas clínicas, pero también áreas para mejorar el proceso de desarrollo y hacer un mejor uso aún de las posibilidades tecnológicas de E-salud. Proponemos tres temas generales para acelerar la calidad de las intervenciones y estudios de E-salud en esta área en los próximos años: optimizar el compromiso y la adherencia del usuario, conducir más investigaciones (innovadoras) y aumentar las actividades de implementación y diseminación. Esta publicación aparece en medio de la pandemia de COVID-19. Es exactamente en tiempos como este que necesitamos intervenciones efectivas en línea y vemos un enorme aumento en el uso de E-salud. Esperamos que esta publicación contribuya a ayudar a los afectados y servir a la comunidad en todo el mundo.

Sexual function and pelvic floor activity in women: the role of traumatic events and PTSD symptoms.

BACKGROUND: Traumatic sexual experiences can negatively affect sexual functioning and increase pelvic floor activity in women, especially when post-traumatic stress disorder (PTSD) is developed. However, little is known about the effect of other types of interpersonal and non-interpersonal, traumatic experiences on sexual function and pelvic floor overactivity. OBJECTIVE: The aim of this study was to examine the effects of lifetime traumatic experiences and subsequent PTSD symptoms on sexual function and pelvic floor activity and to investigate whether the effects differ for interpersonal and non-interpersonal trauma. METHODS: Women (N=82) with obesity and a history of infertility, participating in a follow-up study of an RCT investigating a lifestyle intervention programme, completed questionnaires on lifetime exposure to traumatic events (LEC-5), PTSD symptoms (PC-PTSD-5), sexual function (MFSQ) and pelvic floor activity (AOPFS-SV). RESULTS: A large majority of women (85%) reported exposure to at least one traumatic event during their lifetime. Sexual function and pelvic floor activity did not differ between women who experienced non-interpersonal or interpersonal (including sexual) trauma and those who did not experience traumatic events during their lifetime. Women who had developed PTSD symptoms, however, did have higher pelvic floor activity, but sexual function was not affected. Women with a positive screen for PTSD had the highest pelvic floor activity score, and individual PTSD symptoms nightmares and hypervigilance were associated with significantly higher pelvic floor activity scores. CONCLUSION: Trauma exposure is associated with pelvic floor overactivity in women with a positive screen for PTSD, such that pelvic floor overactivity is more severe with greater PTSD severity. These findings suggest that the development of PTSD after interpersonal trauma is pivotal in this association. Sexual function was unrelated to trauma exposure and pelvic floor function, perhaps related to the fact that the interpersonal trauma events reported in this study were mainly non-sexual.

Antecedentes: Las experiencias sexuales traumáticas pueden comprometer negativamente el funcionamiento sexual e incrementar la actividad del piso pélvico en mujeres, especialmente cuando se desarrolla un trastorno de estrés postraumático (TEPT). Sin embargo, se sabe poco sobre los efectos de otros tipos de experiencias traumáticas, interpersonales y no interpersonales, en la función sexual y la hiperactividad del piso pélvico.Objetivo: El propósito de este estudio fue evaluar los efectos de las experiencias traumáticas a lo largo de la vida, con síntomas del TEPT subsecuentes, en la función sexual y la actividad del piso pélvico e investigar si los efectos difieren entre trauma interpersonal y no interpersonal.Métodos: Un grupo (N=82) de mujeres con obesidad y antecedente de infertilidad que estaba participando de un estudio clínico longitudinal aleatorizado (RCT) sobre un programa de intervención sobre estilos de vida, respondió un cuestionario sobre exposición a eventos traumáticos a lo largo de la vida (LEC-5, por sus siglas en inglés), síntomas del TEPT (PC-PTSD-5, por sus siglas en inglés), función sexual (MFSQ, por sus siglas en inglés) y actividad del piso pélvico (AOPFS-SV, por sus siglas en inglés).Resultados: Una gran mayoría de las mujeres (85%) reportó exposición a al menos un evento traumático a lo largo de la vida. No hubo diferencia de la función sexual y la actividad del piso pélvico entre las mujeres que experimentaron trauma no interpersonal, entre las mujeres que experimentaron trauma interpersonal (incluyendo el sexual), y entre aquellas que no experimentaron eventos traumáticos a lo largo de su vida. Sin embargo, en las mujeres que desarrollaron síntomas del TEPT se encontró mayor actividad del piso pélvico, pero sin comprometer la función sexual. Las mujeres con un puntaje significativo para el TEPT presentaban los puntajes más altos en actividad del piso pélvico, y síntomas puntuales del TEPT como pesadillas e hipervigilancia se asociaron a puntajes de actividad del piso pélvico más altas.Conclusión: La exposición a trauma se asocia con hiperactividad del piso pélvico en mujeres con puntajes significativos para el TEPT, y tal hiperactividad del piso pélvico es más severa a mayor severidad del TEPT. Estos hallazgos sugieren que el desarrollo del TEPT luego del trauma interpersonal es un aspecto clave en esta asociación. La función sexual no estaba relacionada con la exposición al trauma o a la función del piso pélvico, quizá relacionado al hecho que los eventos reportados como eventos traumáticos interpersonales eran principalmente no sexuales.

Cooperation of N-Heterocyclic Carbenes on a Gold Surface.

Atomically precise tailoring of interface structures is crucial for developing functional materials. We demonstrate an N-heterocyclic carbene (NHC) based molecular tool, which modifies the structure of a gold surface with atomic accuracy by the formation of gold nanorods. After adsorption on the gold surface, individual surface atoms are pulled out by the NHCs, generating single-atom surface defects and mobile NHC-Au species. Atomistic calculations reveal that these molecular "ballbots" can act as assembling tools to dislocate individual surface atoms. The predicted functionality of these carbene-based complexes is confirmed by scanning tunneling microscopy measurements. Cooperative operation of these NHC-Au species induces a step-wise formation of gold nanorods. Consequently, the surface is re-structured by a zipper-type mechanism. Our work presents a foundation to utilize molecular-based nanotools to design surface structures.

Anorexia nervosa and the size-weight illusion: No evidence of impaired visual-haptic object integration.

Body image disorders in anorexia nervosa (AN) patients and recovered AN (RAN) patients have been suggested to stem from aberrant integration of sensory information. Previous research by Case et al. (2012) used the size-weight illusion (SWI) to study multisensory integration in AN. Their results showed a diminished SWI in AN patients, which they interpreted as evidence of decreased integration of visual and proprioceptive information. However, their method did not distinguish between visual and haptic size information, which was presented concurrently while making weight judgements. Therefore, the reported effect might be attributed to integrating visual, haptic size cues, or a combination of both processes with proprioceptive input. Here, we use the SWI to investigate the integration of visual and haptic object-related sensory information in a sample of AN patients (n = 30), RAN patients (n = 29) and healthy controls (HC) (n = 29). We aimed to distinguish the contribution of visual and haptic object size by including separate visual and haptic SWI conditions. In addition to explicit measures, we included grip force measurements to assess implicit expectations about object weight. We further analysed the correlation between the SWI and a visual body size estimation (VSE) task. In contrast to Case et al. (2012), we found no evidence of differential SWI experience between groups. All participants reported a stronger visual SWI compared to haptic SWI. Grip force rate (but not peak) showed evidence of motor adaptation for the larger object in the visual condition. Furthermore, there was no correlation between the VSE and SWI, indicating no relation between perceived object weight and body size estimation. These results do not support the hypothesised impairment of visual-haptic object related integration in AN.

A Unidirectional Surface-Anchored N-Heterocyclic Carbene Rotor.

A molecular rotor based on N-heterocyclic carbenes (NHCs) has been rationally designed following theoretical predictions, experimentally realized, and characterized. Utilizing the structural tunability of NHCs, a computational screening protocol was first applied to identify NHCs with asymmetric rotational potentials on a surface as a prerequisite for unidirectional molecular rotors. Suitable candidates were then synthesized and studied using scanning tunneling microscopy/spectroscopy (STM/STS), analytical theoretical models, and molecular dynamics simulations. For our best NHC rotor featuring a mesityl N substituent on one side and a chiral naphthylethyl substituent on the other, unidirectional rotation is driven by inelastic tunneling of electrons from the NHC to the STM tip. While electrons preferentially tunnel through the mesityl N substituent, the chiral naphthylethyl substituent controls the directionality. Such NHC-based surface rotors open up new possibilities for the design and construction of functionalized molecular systems with high catalytic applicability and superior stability compared with other classes of molecular rotors.

Screening for consequences of trauma - an update on the global collaboration on traumatic stress.

This letter provides an update on the activities of "The Global Collaboration on Traumatic Stress" (GC-TS) as first described by Schnyder et al. in 2017. It presents in further detail the projects of the first theme, in particular the development of and initial data on the Global Psychotrauma Screen (GPS), a brief instrument designed to screen for the wide range of potential outcomes of trauma. English language data and ongoing studies in several languages provide a first indication that the GPS is a feasible, reliable and valid tool, a tool that may be very useful in the current pandemic of the coronavirus disease 2019 (COVID-19). Further multi-language and cross-cultural validation is needed. Since the start of the GC-TS, new themes have been introduced to focus on in the coming years: a) Forcibly displaced persons, b) Global prevalence of stress and trauma related disorders, c) Socio-emotional development across cultures, and d) Collaborating to make traumatic stress research data "FAIR". The most recent theme added is that of Global crises, currently focusing on COVID-19-related projects.

Help in hand after traumatic events: a randomized controlled trial in health care professionals on the efficacy, usability, and user satisfaction of a self-help app to reduce trauma-related symptoms.

Background: Despite the fact that many people are affected by trauma and suffer from posttraumatic stress symptoms (PTSS) there is a lack of easy-accessible interventions to self-manage these symptoms. Mobile apps may deliver low-intensity self-help to reduce trauma-related symptoms and empower individuals following trauma, such as high-risk professionals who are regularly exposed to potentially traumatic events. In this randomized controlled trial, we examined the efficacy, and evaluated the usability and user satisfaction of the app 'SUPPORT Coach' as a self-help tool to reduce trauma-related symptoms. Methods: Health care professionals (e.g. nurses, physicians, paramedics and ambulance drivers) completed an online screening on PTSS (T0). They were randomized when at least one PTSS was reported, either to the intervention (1 month unlimited access to SUPPORT Coach) or control condition (no access to SUPPORT Coach). Self-reported PTSS, negative trauma-related cognitions, psychological resilience, and social support were assessed online at baseline (T1), post-condition (T2), and 1 month follow-up (T3). Results: Of the 1175 participants screened, 287 (24.4%) indicated at least one posttraumatic stress symptom and were randomized. The majority of intervention condition participants (83%, n = 103) used SUPPORT Coach; they were slightly to moderately satisfied with the app. There was no significant group difference in change in PTSS and social support after one-month app usage. However, the intervention condition showed a greater decline in negative trauma-related cognitions at T2 and T3, and a larger increase in psychological resilience at T3 than the control condition. Conclusions: SUPPORT Coach without guidance could potentially provide easy-accessible self-help to diminish negative trauma-related cognitions, and strengthen resilience in coping with adversities. However, since the attrition rate was substantially higher in the intervention than in control condition, our findings should be interpreted with caution and warrant replication.

Antecedentes: Pese al hecho de que muchas personas son afectadas por traumas y sufren de síntomas de estrés postraumático (PTSS por sus siglas en inglés) existe una carencia de intervenciones fácilmente accesibles para auto-manejar estos síntomas. Las aplicaciones móviles pueden entregar autoayuda de baja intensidad para reducir los síntomas relacionados con el trauma y empoderar individuos posterior a un trauma, tales como en profesionales de alto riesgo que están regularmente expuestos a eventos potencialmente traumáticos. En este ensayo controlado randomizado examinamos la eficacia, y evaluamos la usabilidad y satisfacción de la aplicación 'SUPPORT Coach' como una herramienta de autoayuda para reducir síntomas relacionados con el trauma.Métodos: Profesionales de atención en salud (como enfermeras, médicos, paramédicos y conductores de ambulancia) completaron un tamizaje online de PTSS (T0). Fueron randomizados cuando al menos un PTSS fue reportado, ya sea a la intervención (un mes de acceso ilimitado a SUPPORT Coach) o a control (sin acceso a la aplicación). Se evaluó el auto-reporte de PTSS, cogniciones negativas relacionadas al trauma, resiliencia psicológica y apoyo social basalmente (T1), post condición (T2) y un seguimiento al mes de la intervención (T3).Resultados: de los 1175 participantes tamizados, 287 (24.4%) indicaron al menos un síntoma de estrés postraumático y fueron randomizados. La mayoría de los participantes del grupo de la intervención usaron SUPPORT Coach (83% n=103), y se encontraron de leve a moderamente satisfechos con la aplicación. No hubo diferencia significativa entre los grupos en PTSS y en apoyo social después de un mes de haber utilizado la aplicación. Sin embargo, el grupo que recibió la intervención mostró una mayor declinación en cogniciones negativas relacionadas con el trauma en T2 y T3, y un mayor aumento de la resiliencia psicológica en T3 que en el grupo control.Conclusiones: El uso de SUPPORT Coach sin guía podría potencialmente proveer autoayuda fácilmente accesible para disminuir cogniciones negativas relacionadas con el trauma, y fortalecer la resiliencia al lidiar con adversidades. Sin embargo, dado que la tasa de deserción fue sustancialmente más alta en el grupo de intervención que en el de control, nuestros hallazgos debiesen ser interpretados con cautela y justifican replicación.

An Electron-Rich Cyclic (Alkyl)(Amino)Carbene on Au(111), Ag(111), and Cu(111) Surfaces.

The structural properties and binding motif of a strongly σ-electron-donating N-heterocyclic carbene have been investigated on different transition-metal surfaces. The examined cyclic (alkyl)(amino)carbene (CAAC) was found to be mobile on surfaces, and molecular islands with short-range order could be found at high coverage. A combination of scanning tunneling microscopy (STM), X-ray photoelectron spectroscopy (XPS), and density functional theory (DFT) calculations highlights how CAACs bind to the surface, which is of tremendous importance to gain an understanding of heterogeneous catalysts bearing CAACs as ligands.

Web-Based Peer Support Education Program for Health Care Professionals.

BACKGROUND: Health care professionals can routinely face potential critical incidents in the workplace, which can cause high levels of occupational distress and mental health problems. Peer support, in which a trained colleague provides psychosocial support after a work-related critical incident, is an early intervention strategy to support health care professionals. This study describes the development and evaluation of an innovative new online program to educate peer supporters. METHODS: An interactive Web-based peer support education program (e-learning Peer Support) was developed to teach health care professionals the theory of peer support in preparation for face-to-face training (hybrid learning). User acceptance was determined with a 21-item online survey and technical user data. RESULTS: Forty-four health care professionals completed the e-learning Peer Support and the online evaluation survey. Participants were nurses (68.2%), physicians (18.2%), residents (6.8%), and staff (6.8%). The e-learning was well received and positively evaluated with regard to all studied indicators of acceptance, including perceived usefulness, ease of use, actual use, and effectivity. All participants would recommend the e-learning to future trainees. CONCLUSION: The e-learning is a valuable addition to the theoretical peer support training curriculum. Future steps include implementing the e-learning as a yearly continuing education meeting, as a clinical lecture, or as part of the standard curriculum for health care professionals in medical training. Developments like this e-learning may contribute to a standardized training method and, eventually, the implementation of peer support programs.

Mothers' emotions after pediatric burn injury: Longitudinal associations with posttraumatic stress and depressive symptoms 18 months postburn.

BACKGROUND: Various emotions are implicated in posttraumatic stress disorder (PTSD). Longitudinal studies examining temporal associations between emotions and posttraumatic stress may reveal who is at risk of chronic psychological problems. This study examined the longitudinal relationships of mothers' trauma-related emotions with posttraumatic stress and depressive symptoms after pediatric burn injury. METHODS: Data from two cohort studies were used (n = 296). Mothers reported the intensity of burn-related emotions within the first month (T1) and 12 months postburn (T2). The Impact of Event Scale (IES) and the Hospital and Anxiety Depression Scale (HADS-D; depression subscale) were administered at T1 and 18 months postburn (T3). RESULTS: Based on two exploratory factor analyses, emotion variables were combined into acute and long-term basic emotions (fear, sadness, horror, anger) and self-conscious emotions (guilt, shame). The path model showed a positive relationship between acute and long-term basic emotions. Higher long-term basic emotions were related to persistence of posttraumatic stress and depressive symptoms. Acute self-conscious emotions showed associations with posttraumatic stress and depressive symptoms at T1 and were longitudinally related to depressive, but not posttraumatic stress, symptoms. LIMITATIONS: The posttraumatic stress measure was not based on DSM-5 PTSD criteria and results require replication using these criteria. CONCLUSIONS: This study suggests that mothers' acute self-conscious and long-term basic emotions in relation to their child's burn injury are involved in the development of posttraumatic stress and depressive symptoms. Clinically, assessing and monitoring parents' early posttraumatic stress, depressive symptoms and burn-related emotions may be useful to identify parents at risk.

Development and Evaluation of the Dutch Clinician-Administered PTSD Scale for DSM-5 (CAPS-5).

Background: In 2013, the Clinician-Administered PTSD Scale, the golden standard to assess PTSD, was adapted to the DSM-5 (CAPS-5). Objective: This project aimed to develop a clinically relevant Dutch translation of the CAPS-5 and to investigate its psychometric properties. Method: We conducted a stepped translation including Delphi rounds with a crowd of 44 Dutch psychotrauma experts and five senior psychotrauma experts. Using partial crowd-translations, two professional translations and the official Dutch translation of the DSM-5, each senior expert aggregated one independent translation. Consensus was reached plenary. After back-translation, comparison with the original CAPS-5 and field testing, a last round with the senior experts resulted in the final version. After implementation clinicians conducted CAPS-5 interviews with 669 trauma-exposed individuals referred for specialized diagnostic assessment. Reliability of the Dutch CAPS-5 was investigated through internal consistency and interrater reliability analyses, and construct validity through confirmatory factor analysis (CFA). Results: CAPS-5 total severity score showed high internal consistency (α = .90) and interrater reliability (ICC = .98, 95% CI: .94-.99). CAPS-5 diagnosis showed modest interrater reliability (kappa = .59, 95% CI: .20-.98). CFA with alternative PTSD models revealed adequate support for the DSM-5 four-factor model, but a six-factor (Anhedonia) model fit the data best. Conclusions: The Dutch CAPS-5 is a carefully translated instrument with adequate psychometric properties. Current results add to the growing support for more refined (six and seven) factor models for DSM-5 PTSD indicating that the validity and clinical implications of these models should be objective of further research.

Antecedentes: En el año 2013 la Escala para el TEPT Aplicada por el Clínico, la prueba estándar para evaluar el TEPT, fue adaptada al DSM-5 (CAPS-5).Objetivo: Este proyecto apuntó a desarrollar una traducción holandesa clínicamente relevante de la Escala para el TEPT Aplicada por el Clínico adaptada al DSM-5 (CAPS-5) e investigar sus propiedades psicométricas.Método: Realizamos una traducción escalonada, incluyendo fases del método Delphi con un grupo de 44 expertos holandeses en psicotrauma y cinco expertos de larga trayectoria en psicotrauma. Utilizando traducciones en grupo parciales, dos traducciones profesionales y la traducción holandesa oficial del DSM-5, cada experto experimentado sumó una traducción independiente. Se alcanzó un conceso pleno. Después de traducciones inversas, comparación con el CAPS-5 original y ensayo de campo, una última fase con los expertos experimentados resultó en la versión definitiva. Tras la implementación, los clínicos realizaron entrevistas aplicando CAPS-5 a 669 individuos expuestos a trauma referidos por evaluación diagnóstica especializada. Se investigó la fiabilidad del CAPS-5 holandés a través de consistencia interna y análisis de confiabilidad, y se estableció su validez a través de análisis factorial de tipo confirmatorio.Resultados: El puntaje de severidad total del CAPS-5 mostró alta consistencia interna (α = .90) y confiabilidad (ICC = .98, 95% IC: .94 - .99). El diagnóstico de CAPS-5 mostró una modesta confiabilidad (kappa = .59, 95% CI: .20 - .98). El análisis factorial de tipo confirmatorio con modelos alternativos de TEPT reveló un respaldo adecuado para el modelo de 4 factores del DSM-5, pero un modelo de 6 factores (Anhedonia) se ajusta mejor a los datos.Conclusiones: El CAPS-5 holandés es un instrumento cuidadosamente traducido con adecuadas propiedades psicométricas. Nuestros resultados se suman al respaldo creciente para modelos de factores (seis y siete) más refinados para el TEPT según el DSM-5, indicando que la validez y las implicaciones clínicas de estos modelos deberían ser objeto de futuras investigaciones.

Elucidating the Binding Modes of N-Heterocyclic Carbenes on a Gold Surface.

Tuning the binding mode of N-heterocyclic carbenes on metal surfaces is crucial for the development of new functional materials. To understand the impact of alkyl side groups on the formation of NHC species at the Au(111) surface, we combined scanning tunneling microscopy, X-ray photoelectron spectroscopy, and density functional theory calculations. We reveal two significantly different binding modes depending on the alkyl chain length. In the case of a short alkyl substituent, an up-standing configuration with one Au adatom is preferred, whereas the longer alkyl groups result exclusively in NHC-Au-NHC complexes lying flat on the surface. Our study highlights how well-defined structural modifications of NHCs allow for controlling the local binding motif on surfaces, which is important to design designated catalytic sites at interfaces.

Chemistry of 4-[(4-bromophenyl)ethynyl]pyridine at metal surfaces studied by STM.

Molecular architectures (Kagome networks, coordinated/covalent dimers and branched coordination chains) via self-assembly, Ullmann reaction and pyridine coordination of 4-[(4-bromophenyl)ethynyl]pyridine are found to be sensitive to the underlying metallic surfaces. The molecular species were characterised on the surface by low-temperature scanning tunnelling microscopy (LT-STM) at sub-molecular level.

PTSD Coach around the world.

Posttraumatic stress disorder (PTSD) is a global public health problem. Unfortunately, many individuals with PTSD do not receive professional care due to a lack of available providers, stigma about mental illness, and other concerns. Technology-based interventions, including mobile phone applications (apps) may be a viable means of surmounting such barriers and reaching and helping those in need. Given this potential, in 2011 the U.S Veterans Affairs National Center for PTSD released PTSD Coach, a mobile app intended to provide psycho-education and self-management tools for trauma survivors with PTSD symptoms. Emerging research on PTSD Coach demonstrates high user satisfaction, feasibility, and improvement in PTSD symptoms and other psychosocial outcomes. A model of openly sharing the app's source code and content has resulted in versions being created by individuals in six other countries: Australia, Canada, The Netherlands, Germany, Sweden, and Denmark. These versions are described, highlighting their significant adaptations, enhancements, and expansions to the original PTSD Coach app as well as emerging research on them. It is clear that the sharing of app source code and content has benefited this emerging PTSD Coach community, as well as the populations they are targeting. Despite this success, challenges remain especially reaching trauma survivors in areas where few or no other mental health resources exist.