Climate change (CC) is adversely affecting human health and will become far more dangerous in the future, if no substantial measures are taken. Young people in particular are taking an energetic stand for CC awareness. Some CC experts argue that medical doctors are especially well positioned to inform about the impact of CC on public health, as it is well established that they are among the most trusted members of society. However, medical doctors seem to be unsure of their role in addressing CC. This study aimed to investigate future doctors´, i.e., final year medical students´ (FYMS), attitudes towards CC and their personal role in CC education and health care. A questionnaire was developed to examine (1) the expected consequences of CC for FYMS, (2) their perceived individual responsibility, and their attitudes towards an additional (3) professional responsibility. To examine the climate-questionnaire’s component correlations, we ran a factor analysis using oblique (promax) rotation and conducted a one-way ANOVA with repeated measures to compare the mean scores of the factors. Data are presented as mean ± SD or percentage, as appropriate. n = 65 FYMS (response rate: 87%) were participating and all of them completed the questionnaire. Items of the factor professional responsibility showed the lowest level of agreement (47.2 ± 21.2), while the 2 other factors showed higher levels of agreement (expected consequences (75.6 ± 18.4), individual responsibility (75.1 ± 20.6). Future doctors at Heidelberg University Hospital are well-informed about the expected health consequences of CC. They recognize human contributions to CC and make personal decisions to mitigate the impact. However, the opinion that they have a professional responsibility as physicians to patients or society in regard to CC is weaker. Specific teaching could help to change the way future doctors see their role and responsibility in tackling CC.

Background: Emergency call-takers and dispatchers (ECDs) field emergency calls and dispatch the appropriate emergency services. Exposure to the callers’ traumatic experiences can lead to psychological stress and even to secondary traumatic stress (STS). In addition, previous studies suggest that ECDs may also suffer from posttraumatic stress disorder (PTSD), depression and anxiety disorders. Objectives: To investigate the prevalence of STS and to screen for PTSD, depression and anxiety disorders in ECDs. We further aimed to identify sociodemographic variables and attachment styles as possible risk factors for higher STS symptom load in ECDs. Methods: STS and PTSD regarding lifetime traumatic events, as well as depression and anxiety disorders, were investigated in N = 71 ECDs. Multiple regression analysis was performed to identify possible risk factors for higher STS symptom load. Results: The analysis determined a prevalence of 8.5% for moderate STS and 2.8% for severe STS. A total of 11.3% of the ECDs screened positive for PTSD, 15.5% for depression and 7.0% for anxiety disorders. A higher number of children and the absence of a secure attachment style were identified to be significantly associated with higher STS symptom load. Conclusions: STS resulting from exposure to traumatic emergency caller content is a common phenomenon among ECDs. Specific sociodemographic variables and the attachment style are significant risk factors of STS symptom load. ECDs should receive regular psychoeducational interventions and supervision to identify and mitigate mental distress at an early stage.

Background: Refugees have an increased risk of developing mental health problems. There are insufficient psychosocial care structures to meet the resulting need for support. Stabilizing and guided imagery techniques have shown promising results in increasing traumatized refugees’ emotional stabilization. If delivered via audio files, the techniques can be practiced autonomously and independent of time, space, and human resources or stable treatment settings. Objective: This study aimed to evaluate the self-practice of stabilizing and guided imagery techniques via digital audio files for traumatized refugees living in a reception and registration center in Germany. Methods: From May 2018 to February 2019, 42 traumatized refugees participated in our study. At T1, patients received digital audio files in English, French, Arabic, Farsi, Turkish, or Serbian for self-practice. Nine days later, at T2, a face-to-face interview was conducted. Two months after T2, a follow-up interview took place via telephone. Results: At T2, about half of the patients reported the daily practice of stabilizing and guided imagery techniques. At follow-up, the average frequency of practice was once weekly or more for those experiencing worse symptoms. No technical difficulties were reported. According to T2 and follow-up statements, the techniques helped the patients dealing with arousal, concentration, sleep, mood, thoughts, empowerment, and tension. The guided imagery technique “The Inner Safe Place” was the most popular. Self-practice was impeded by postmigratory distress factors, like overcrowded accommodations. Conclusions: The results show that self-practice of stabilizing and guided imagery techniques via digital audio files was helpful to and well accepted by the assessed refugees. Even though postmigratory distress factors hampered self-practice, “The Inner Safe Place” technique was particularly well received. Overall, the self-practiced audio-based stabilizing and guided imagery techniques showed promising results among the highly vulnerable group of newly arrived traumatized refugees.

Background: A number of correlates to adolescent substance use have been shown, yet their unique predictive influence is unclear. We investigated the incremental validity of demographics, family background, school variables, risk perception, parental alcohol attitudes, age of first alcohol use, peer group influence, and behavioral variables as they concurrently predicted last month alcohol use, binge drinking, and drunkenness experience frequency. Methods: Hierarchical multiple regression analyses in a sample of N = 743 adolescents (mean age = 15.01). Results: All predictors explained 26–40% of the total variance. Alcohol use was predicted by age, gender, having two working parents, academic family background, relationship to parents, relative risk perception, parental acceptance of alcohol use, age of first use, talking about positive aspects of alcohol, normality of alcohol use among peers, time spent with friends, and going out to clubs. Binge drinking was predicted by age, working parents, school problems, relative risk perception, parental alcohol acceptance, age of first use, talking about positive aspects of alcohol, time spent with friends, and going out to clubs. Drunkenness was predicted by age, relationship to parents, school problems, relative risk perception, age of first use, talking about positive aspects of alcohol, and going out to clubs. Conclusions: Researchers need to take the complexity of adolescent substance use into account when designing studies and interventions. Relative risk perception emerged as the strongest (positive) predictor, indicating that adolescents are able to rather accurately assess their own risk and risk awareness alone does not suffice to engage in protective behavior.

Background: International medical students are frequently confronted with intercultural, psychosocial, and language barriers and often receive lower marks in written, oral, and clinical-practical examinations than fellow local students. Training communication competence in procedural skills, such as blood sampling, is further challenge in this particular group of medical students. This pre-post comparative intervention study aimed to investigate the effects of training communication skills during the performance of procedural skills (taking blood samples from a silicone model) in international and local students as part of their clinical practical medical training.Methods: Study participants performed blood sampling on an arm prosthesis model (part-task trainer) before and after the communication skills training, focusing on accompanying communication with a simulation patient sitting next to the arm model. The pre- and post-evaluation video was assessed by two independent evaluators using a binary checklist, the Integrated Procedural Performance Instrument (IPPI) and global assessments of clinical professionalism in terms of procedural and communication performance. Linear models with mixed effects were used. Group differences regarding global competence levels were analysed with χ²-tests.Results: International medical students did not perform as well as their local counterparts in the pre- and post-examinations. Both groups improved their performance significantly, whereby the international students improved more than their local counterparts in terms of their communication performance, assessed via binary checklist. Clinical professionalism evaluated via global assessments of procedural and communication performance highlights the intervention’s impact insofar as no international student was assessed as clinically not competent after the training.Conclusions: Our results suggest that already a low-dose intervention can lead to improved communication skills in medical students performing procedural tasks and significantly increase their confidence in patient interaction.