Patient safety and communication: A new assessment for doctors trained in countries where language differs from that of the host country: Results of a pilot using a domain-based assessment

Objective

Global migration of healthcare workers places responsibility on employers to comply with legal employment rights whilst ensuring patient safety remains the central goal. We describe the pilot of a communication assessment designed for doctors who trained and communicated with patients and colleagues in a different language from that of the host country. It is unique in assessing clinical communication without assessing knowledge.

A 14-station OSCE was developed using a domain-based marking scheme, covering professional communication and English language skills (speaking, listening, reading and writing) in routine, acute and emotionally challenging contexts, with patients, carers and healthcare teams. Candidates (n = 43), non-UK trained volunteers applying to the UK Foundation Programme, were provided with relevant station information prior to the exam.

The criteria for passing the test included achieving the pass score and passing 10 or more of the 14 stations. Of the 43 candidates, nine failed on the station criteria. Two failed the pass score and also the station criteria. The Cronbach's alpha coefficient was 0.866.

This pilot tested ‘proof of concept’ of a new domain-based communication assessment for non-UK trained doctors.

The test would enable employers and regulators to verify communication competence and safety in clinical contexts, independent of clinical knowledge, for doctors who trained in a language different from that of the host country.

Conceptual Analysis of Web 2.0 Technology Use to Enhance Parent–School Relationships

Parent–school relationships contribute significantly to the quality of students’ education. The Internet, in turn, has started to influence individuals’ way social communication and most school boards in Ontario now use the Internet to communicate with parents, which helps build parent–school relationships. This project comprised a conceptual analysis of how the Internet enhances parent–school relationships to support Ontario school board administrators seeking to implement such technology. The study’s literature review identified the links between Web 2.0 technology, parent–school relationships, and effective parent engagement. A conceptual framework of the features of Web 2.0 tools that promote social interaction was developed and used to analyze websites of three Ontario school boards. The analysis revealed that school board websites used static features such as email, newsletters, and announcements for communication and did not provide access to parents for providing feedback through Web 2.0 features such as instant messaging. General recommendations were made so that school board administrators have the opportunity to implement changes in their school community with feasible modifications. Overall, Web 2.0-based technologies such as interactive communication tools and social media hold the most promise for enhancing parent–school relationships because they can help not only overcome barriers of time and distance, but also improve the parents’ desire to be engaged in children’s education experiences.

Online Anonymity and the Kantian Publicity Principle: Can the Internet Solve the Paradox of Tyranny?

Immanuel Kant’s publicity maxim states that other-regarding actions are wrong if their maxim is not compatible with their being made public. This has the effect of forbidding dissent or rebellion against tyranny, since rebels cannot make their intentions and plans public. However, new internet technologies offer public speech from behind the “shield” of anonymity, allowing dissent to be public but preventing reprisals from tyrants. This thesis examines not only this possibility, but the value of internet-based discursive spaces for politics, their viability as a mode for political communication, and their implications for Classical and Enlightenment approaches to politics and intellectual virtue. Anonymous internet communications favour logos-based reasoning and discourse, which, in the liberal-democratic tradition, is preferable to phronesis and its attendant elitism and chauvinism. These technologies can open new vistas for liberal-democratic politics.

Communication, développement et appropriation des médias émergents en Afrique francophone subsaharienne : approche critique

Cette thèse porte sur l’appropriation de l’Internet et du multimédias dans la population universitaire d’Afrique francophone, en l’an 2001. Elle couvre six pays : le Bénin, le Burkina Faso, le Cameroun, la Côte d’Ivoire, le Mali et le Togo. La recherche porte sur le recensement des centres de recherche démographique en Afrique francophone subsaharienne et sur une enquête auprès des universités de Yaoundé II et de Douala au Cameroun. La problématique de l’accès et de l’usage est centrale dans notre démarche. Elle est traduite dans la question de recherche suivante : « Dans un contexte dominé par les représentations des NTIC comme symboles de modernité et facteurs d’intégration à l’économie mondiale, quelles sont les modalités d’appropriation de ces technologies par les universitaires des institutions de l’enseignement et de la recherche en Afrique considérées dans cette étude ? » Pour aborder le matériel empirique, nous avons opté pour deux approches théoriques : les théories du développement en lien avec les (nouveaux) médias et la sociologie des innovations techniques. Enracinées dans la pensée des Lumières, complétée et affinée par les approches évolutionnistes inspirées de Spencer, le fonctionnalisme d’inspiration parsonienne et l’économie politique axée sur la pensée de W. W. Rostow, les théories du développement ont largement mis à contribution les théories de la communication pour atteindre leur objet. Alors que la crise de la modernité occidentale menace de délégitimer ces paradigmes, les technologies émergentes leur donnent une nouvelle naissance : dans la continuité de la pensée d’Auguste Comte, le développement est désormais pensé en termes d’intégration à un nouveau type de société, la société de l’information. Cette nouvelle promesse eschatologique et cette foi dans la technique comme facteur d’intégration à la société et à l’économie en réseau habitent tous les projets menés sur le continent, que ce soit le NEPAD, le Fond de solidarité numérique, le projet d’ordinateur à 100$ pour les enfants démunis ou le projet panafricain de desserte satellitaire, le RASCOM. Le deuxième volet de notre cadre de référence théorique est axé sur la sociologie des innovations techniques. Nous mobilisons la sociopolitique des usages de Vedel et Vitalis pour ramener la raison critique dans le débat sur le développement du continent africain, dans l’optique de montrer que la prérogative politique assumée par les États a encore sa place, si l’on veut que les ressources numériques servent à satisfaire les demandes sociales et non les seules demandes solvables essentiellement localisées dans les centres urbains. En refusant le déterminisme technique si courant dans la pensée sur le développement, nous voulons montrer que le devenir de la technique n’est pas inscrit dans son essence, comme une ombre portée, mais que l’action des humains, notamment l’action politique, peut infléchir la trajectoire des innovations techniques dans l’optique de servir les aspirations des citoyens. Sur le plan méthodologique, la démarche combine les méthodes quantitatives et les méthodes qualitatives. Les premières nous permettront de mesurer la présence d’Internet et du multimédia dans l’environnement des répondants. Les secondes nous aideront à saisir les représentations développées par les usagers au contact de ces outils. Dans la perspective socioconstructiviste, ces discours sont constitutifs des technologies, dans la mesure où ils sont autant de modalités d’appropriation, de construction sociale de l’usage. Ultimement, l’intégration du langage technique propre aux outils multimédias dans le langage quotidien des usagers traduit le dernier stade de cette appropriation. À travers cette recherche, il est apparu que les usagers sont peu nombreux à utiliser les technologies audiovisuelles dans le contexte professionnel. Quand à l’Internet et aux outils multimédias, leur présence et leurs usages restent limités, l’accès physique n’étant pas encore garanti à tous les répondants de l’étude. Internet suscite de grandes espérances, mais reste, là aussi, largement inaccessible en contexte professionnel, la majorité des usagers se rabattant sur les lieux publics comme les cybercafés pour pallier l’insuffisance des ressources au sein de leurs institutions d’appartenance. Quant aux représentations, elles restent encore largement tributaires des discours politiques et institutionnels dominants, selon lesquels l’avenir sera numérique ou ne sera pas. La thèse va cependant au-delà de ces données pour dessiner la carte numérique actuelle du continent, en intégrant dans la nouvelle donne technologique la montée fulgurante de la téléphonie cellulaire mobile. Il nous est apparu que l’Internet, dont la diffusion sur le continent a été plus que modeste, pourrait largement profiter de l’émergence sur le continent de la culture mobile, que favorise notamment la convergence entre les mini-portables et la téléphonie mobile.

Les procédés scripturaux des salons de clavardage (en français, en anglais et en espagnol) chez les adolescents et les adultes

L’un des aspects les plus percutants des avancées de la technologie des quinze dernières années a trait à la communication médiée par ordinateur : clavardage, messagerie instantanée, courrier électronique, forums de discussion, blogues, sites de réseautage social, etc. En plus d’avoir eu un impact significatif sur la société contemporaine, ces outils de communication ont largement modifié les pratiques d’écriture. Notre objet d’étude est le clavardage en groupe qui offre la possibilité aux scripteurs de communiquer simultanément entre eux. Cet outil de communication présente deux caractéristiques importantes aux plans discursif et communicationnel. Premièrement, on admet de façon générale que le clavardage est une forme de communication hybride : le code utilisé est l’écrit, mais les échanges de messages entrent dans une structure de dialogue qui rappelle l’oral. Deuxièmement, le caractère spontané du clavardage impose la rapidité, tant pour l’encodage que pour le décodage des messages. Dans le cadre d’une étude comparative réalisée sur les pratiques scripturales des clavardeurs francophones (Tatossian et Dagenais 2008), nous avons établi quatre catégories générales pour rendre compte de toutes les variantes scripturales de notre corpus : procédés abréviatifs, substitutions de graphèmes, neutralisations en finale absolue et procédés expressifs. Nous voulons maintenant tester la solidité de notre typologie pour des langues dont le degré de correspondance phonético-graphique diffère. En vertu de l’hypothèse de la profondeur de l’orthographe (orthographic depth hypothesis [ODH]; Katz et Frost 1992) selon laquelle un système orthographique transparent (comme l’italien, l’espagnol ou le serbo-croate) transpose les phonèmes directement dans l’orthographe, nous vérifierons si nos résultats pour le français peuvent être généralisés à des langues dont l’orthographe est dite « transparente » (l’espagnol) comparativement à des langues dont l’orthographe est dite « opaque » (le français et l’anglais). Pour chacune des langues, nous avons voulu répondre à deux question, soit : 1. De quelle manière peut-on classifier les usages scripturaux attestés ? 2. Ces usages graphiques sont-ils les mêmes chez les adolescents et les adultes aux plans qualitatif et quantitatif ? Les phénomènes scripturaux du clavardage impliquent également l’identité générationnelle. L’adolescence est une période caractérisée par la quête d’identité. L’étude de Sebba (2003) sur l’anglais démontre qu’il existe un rapport entre le « détournement de l’orthographe » et la construction identitaire chez les adolescents (par ex. les graffitis, la CMO). De plus, dans ces espaces communicationnels, nous assistons à la formation de communautés d’usagers fondée sur des intérêts communs (Crystal 2006), comme l’est la communauté des adolescents. Pour la collecte des corpus, nous recourrons à des échanges effectués au moyen du protocole Internet Relay Chat (IRC). Aux fins de notre étude, nous délimitons dans chacune des langues deux sous-corpus sociolinguistiquement distincts : le premier constitué à partir de forums de clavardage destinés aux adolescents, le second à partir de forums pour adultes. Pour chacune des langues, nous avons analysé 4 520 énoncés extraits de divers canaux IRC pour adolescents et pour adultes. Nous dressons d’abord un inventaire quantifié des différents phénomènes scripturaux recensés et procédons ensuite à la comparaison des résultats.

Knowledge Building in Landscape Architecture

The objective of this study was to develop an internet-based seminar framework applicable for landscape architecture education. This process was accompanied by various aims. The basic expectation was to keep the main characteristics of landscape architecture education also in the online format. On top of that, four further objectives were anticipated: (1) training of competences for virtual team work, (2) fostering intercultural competence, (3) creation of equal opportunities for education through internet-based open access and (4) synergy effects and learning processes across institutional boundaries. This work started with the hypothesis that these four expected advantages would compensate for additional organisational efforts caused by the online delivery of the seminars and thus lead to a sustainable integration of this new learning mode into landscape architecture curricula. This rationale was followed by a presentation of four areas of knowledge to which the seminar development was directly related (1) landscape architecture as a subject and its pedagogy, (2) general learning theories, (3) developments in the ICT sector and (4) wider societal driving forces such as global citizenship and the increase of open educational resources. The research design took the shape of a pedagogical action research cycle. This approach was constructive: The author herself is teaching international landscape architecture students so that the model could directly be applied in practice. Seven online seminars were implemented in the period from 2008 to 2013 and this experience represents the core of this study. The seminars were conducted with varying themes while its pedagogy, organisation and the technological tools remained widely identical. The research design is further based on three levels of observation: (1) the seminar design on the basis of theory and methods from the learning sciences, in particular educational constructivism, (2) the seminar evaluation and (3) the evaluation of the seminars’ long term impact. The seminar model itself basically consists of four elements: (1) the taxonomy of learning objectives, (2) ICT tools and their application and pedagogy, (3) process models and (4) the case study framework. The seminar framework was followed by the presentation of the evaluation findings. The major findings of this study can be summed up as follows: Implementing online seminars across educational and national boundaries was possible both in term of organisation and technology. In particular, a high level of cultural diversity among the seminar participants has definitively been achieved. However, there were also obvious obstacles. These were primarily competing study commitments and incompatible schedules among the students attending from different academic programmes, partly even in different time zones. Both factors had negative impact on the individual and working group performances. With respect to the technical framework it can be concluded that the majority of the participants were able to use the tools either directly without any problem or after overcoming some smaller problems. Also the seminar wiki was intensively used for completing the seminar assignments. However, too less truly collaborative text production was observed which could be improved by changing the requirements for the collaborative task. Two different process models have been applied for guiding the collaboration of the small groups and both were in general successful. However, it needs to be said that even if the students were able to follow the collaborative task and to co-construct and compare case studies, most of them were not able to synthesize the knowledge they had compiled. This means that the area of consideration often remained on the level of the case and further reflections, generalisations and critique were largely missing. This shows that the seminar model needs to find better ways for triggering knowledge building and critical reflection. It was also suggested to have a more differentiated group building strategy in future seminars. A comparison of pre- and post seminar concept maps showed that an increase of factual and conceptual knowledge on the individual level was widely recognizable. Also the evaluation of the case studies (the major seminar output) revealed that the students have undergone developments of both the factual and the conceptual knowledge domain. Also their self-assessment with respect to individual learning development showed that the highest consensus was achieved in the field of subject-specific knowledge. The participants were much more doubtful with regard to the progress of generic competences such as analysis, communication and organisation. However, 50% of the participants confirmed that they perceived individual development on all competence areas the survey had asked for. Have the additional four targets been met? Concerning the competences for working in a virtual team it can be concluded that the vast majority was able to use the internet-based tools and to work with them in a target-oriented way. However, there were obvious differences regarding the intensity and activity of participation, both because of external and personal factors. A very positive aspect is the achievement of a high cultural diversity supporting the participants’ intercultural competence. Learning from group members was obviously a success factor for the working groups. Regarding the possibilities for better accessibility of educational opportunities it became clear that a significant number of participants were not able to go abroad during their studies because of financial or personal reasons. They confirmed that the online seminar was to some extent a compensation for not having been abroad for studying. Inter-institutional learning and synergy was achieved in so far that many teachers from different countries contributed with individual lectures. However, those teachers hardly ever followed more than one session. Therefore, the learning effect remained largely within the seminar learning group. Looking back at the research design it can be said that the pedagogical action research cycle was an appropriate and valuable approach allowing for strong interaction between theory and practice. However, some more external evaluation from peers in particular regarding the participants’ products would have been valuable.

Teaching Intercultural Communication in Foreign Language Education through Video Conferencing

Since 1980s, Western linguists and specialists on second language acquisition have emphasized the importance of enhancing students’ intercultural communication competence in foreign language education. At the same time, the demand for intercultural communicative competence increased along with the advances of communication technology with its increasingly global reach and the process of globalization itself.In the field of distance language education, these changes have resulted in a shift of focus from the production and distribution of learning materials towards communication and learning as a social process, facilitated by various internet-based platforms. The current focus on learners interacting and communicating synchronously trough videoconferencing is known as the fourth generation of distance language education. Despite the fact that teaching of Chinese as a foreign language (CFL) faces the same or even greater challenges as teaching other languages, the intercultural communication perspective is still quite a new trend in CFL and its implementation and evaluation are still under development. Moreover, the advocates of the new trends in CFL have so far focused almost exclusively on classroom-based courses, neglecting the distance mode of CFL and leaving it as an open field for others to explore. In this under-researched context, Dalarna University (Sweden), where I currently work, started to provide web-based courses of the Chinese language in 2007. Since 2010, the Chinese language courses have been available only in the distance form, using the same teaching materials as the previous campus-based courses. The textbooks used in both settings basically followed the functional nationalism approach. However, in order to catch up with the main trend of foreign-language education, we felt a need to implement the cross-cultural dimension into the distance courses as well. Therefore in 2010, a pilot study has been carried out to explore opportunities and challenges for implementing a cross-cultural perspective into existing courses and evaluating the effectiveness of this implementation based on the feedback of the students and on the experience of the teacher/researcher.

Uma abordagem comportamental para inserção de robôs em ambientes culturais

In this work, we propose methodologies and computer tools to insert robots in cultural environments. The basic idea is to have a robot in a real context (a cultural space) that can represent an user connected to the system through Internet (visitor avatar in the real space) and that the robot also have its representation in a Mixed Reality space (robot avatar in the virtual space). In this way, robot and avatar are not simply real and virtual objects. They play a more important role in the scenery, interfering in the process and taking decisions. In order to have this service running, we developed a module composed by a robot, communication tools and ways to provide integration of these with the virtual environment. As welI we implemented a set of behaviors with the purpose of controlling the robot in the real space. We studied available software and hardware tools for the robotics platform used in the experiments, as welI we developed test routines to determine their potentialities. Finally, we studied the behavior-based control model, we planned and implemented alI the necessary behaviors for the robot integration to the real and virtual cultural spaces. Several experiments were conducted, in order to validate the developed methodologies and tools

A internet como ferramenta de mediação no acervo artístico-cultural dos Palácios do Governo do Estado de São Paulo

This research focuses on methods and strategies for educational-based digital tools, aimed at the public school. Thus, we present possibilities, and the main actions of the national museum institutions in several online educational services that exemplify some forms of virtual mediation in order to verify the relevance of using these tools. The study discusses the need for museums to follow the advance of new technologies to engage and retain the public school, consisting of a highly connected generation with new technologies. It also brings a brief overview of the evolution of the museum in the Western world and presents the formation and nature of art collections that comprise the Artistic-Cultural Collection of the Governmental Palaces of the State of São Paulo, focusing on the management policy of each period, highlighting the educational program and the relationship with the website. As a practical exercise, the research presented suggests applying a form of mediation for the virtual site of Artistic-Cultural Collection of the Governmental Palaces to extend relations sector educational institution for the virtual context

Relações públicas e web 2.0: a manutenção do relacionamento entre artista e público pela internet

The objective of this study is a explanation about the action possibilities of the Public Relations professional as a manager of communication between the musical celebrity and his publics. For this purpose, a bibliographical research was made about Internet question like his history, the evolution of Web 2.0 and even about different kinds of virtualization, introducing with interactivity. Other researches was been made like social culture topics and even the studies of Public Relations actions in the artistic scene, acting like a manager of different publics relationships in the virtual contacts. A study case with the virtual communication tools employed in the career of Hugo e Tiago, one of the country artists in Brazil, is also in this studies. Otherwise, the study explains about the different ways of Public Relations actions, his upgrades along with the new communication tools and his new types of making relations with more and more different publics. Working with new strategies and keeping his objectives in the organization and public relationship, Public Relations brands a new vision to this type of communication professional, who becomes even more important in the actual organizations scenario

Research Blogging: Indexing and Registering the Change in Science 2.0

Increasing public interest in science information in a digital and 2.0 science era promotes a dramatically, rapid and deep change in science itself. The emergence and expansion of new technologies and internet-based tools is leading to new means to improve scientific methodology and communication, assessment, promotion and certification. It allows methods of acquisition, manipulation and storage, generating vast quantities of data that can further facilitate the research process. It also improves access to scientific results through information sharing and discussion. Content previously restricted only to specialists is now available to a wider audience. This context requires new management systems to make scientific knowledge more accessible and useable, including new measures to evaluate the reach of scientific information. The new science and research quality measures are strongly related to the new online technologies and services based in social media. Tools such as blogs, social bookmarks and online reference managers, Twitter and others offer alternative, transparent and more comprehensive information about the active interest, usage and reach of scientific publications. Another of these new filters is the Research Blogging platform, which was created in 2007 and now has over 1,230 active blogs, with over 26,960 entries posted about peer-reviewed research on subjects ranging from Anthropology to Zoology. This study takes a closer look at RB, in order to get insights into its contribution to the rapidly changing landscape of scientific communication.

Durch das Leben lernen

Web 2.0 und soziale Netzwerke gaben erste Impulse für neue Formen der Online-Lehre, welche die umfassende Vernetzung von Objekten und Nutzern im Internet nachhaltig einsetzen. Die Vielfältigkeit der unterschiedlichen Systeme erschwert aber deren ganzheitliche Nutzung in einem umfassenden Lernszenario, das den Anforderungen der modernen Informationsgesellschaft genügt. In diesem Beitrag wird eine auf dem Konnektivismus basierende Plattform für die Online-Lehre namens “Wiki-Learnia” präsentiert, welche alle wesentlichen Abschnitte des lebenslangen Lernens abbildet. Unter Einsatz zeitgemäßer Technologien werden nicht nur Nutzer untereinander verbunden, sondern auch Nutzer mit dedizierten Inhalten sowie ggf. zugehörigen Autoren und/oder Tutoren verknüpft. Für ersteres werden verschiedene Kommunikations-Werkzeuge des Web 2.0 (soziale Netzwerke, Chats, Foren etc.) eingesetzt. Letzteres fußt auf dem sogenannten “Learning-Hub”-Ansatz, welcher mit Hilfe von Web-3.0-Mechanismen insbesondere durch eine semantische Metasuchmaschine instrumentiert wird. Zum Aufzeigen der praktischen Relevanz des Ansatzes wird das mediengestützte Juniorstudium der Universität Rostock vorgestellt, ein Projekt, das Schüler der Abiturstufe aufs Studium vorbereitet. Anhand der speziellen Anforderungen dieses Vorhabens werden der enorme Funktionsumfang und die große Flexibilität von Wiki-Learnia demonstriert.

Learning through life

Web 2.0 und soziale Netzwerke gaben erste Impulse für neue Formen der Online-Lehre, welche die umfassende Vernetzung von Objekten und Nutzern im Internet nachhaltig einsetzen. Die Vielfältigkeit der unterschiedlichen Systeme erschwert aber deren ganzheitliche Nutzung in einem umfassenden Lernszenario, das den Anforderungen der modernen Informationsgesellschaft genügt. In diesem Beitrag wird eine auf dem Konnektivismus basierende Plattform für die Online-Lehre namens “Wiki-Learnia” präsentiert, welche alle wesentlichen Abschnitte des lebenslangen Lernens abbildet. Unter Einsatz zeitgemäßer Technologien werden nicht nur Nutzer untereinander verbunden, sondern auch Nutzer mit dedizierten Inhalten sowie ggf. zugehörigen Autoren und/oder Tutoren verknüpft. Für ersteres werden verschiedene Kommunikations-Werkzeuge des Web 2.0 (soziale Netzwerke, Chats, Foren etc.) eingesetzt. Letzteres fußt auf dem sogenannten “Learning-Hub”-Ansatz, welcher mit Hilfe von Web-3.0-Mechanismen insbesondere durch eine semantische Metasuchmaschine instrumentiert wird. Zum Aufzeigen der praktischen Relevanz des Ansatzes wird das mediengestützte Juniorstudium der Universität Rostock vorgestellt, ein Projekt, das Schüler der Abiturstufe aufs Studium vorbereitet. Anhand der speziellen Anforderungen dieses Vorhabens werden der enorme Funktionsumfang und die große Flexibilität von Wiki-Learnia demonstriert.

Advancing psychotherapy and evidence-based psychological interventions

Psychological models of mental disorders guide research into psychological and environmental factors that elicit and maintain mental disorders as well as interventions to reduce them. This paper addresses four areas. (1) Psychological models of mental disorders have become increasingly transdiagnostic, focusing on core cognitive endophenotypes of psychopathology from an integrative cognitive psychology perspective rather than offering explanations for unitary mental disorders. It is argued that psychological interventions for mental disorders will increasingly target specific cognitive dysfunctions rather than symptom-based mental disorders as a result. (2) Psychotherapy research still lacks a comprehensive conceptual framework that brings together the wide variety of findings, models and perspectives. Analysing the state-of-the-art in psychotherapy treatment research, “component analyses” aiming at an optimal identification of core ingredients and the mechanisms of change is highlighted as the core need towards improved efficacy and effectiveness of psychotherapy, and improved translation to routine care. (3) In order to provide more effective psychological interventions to children and adolescents, there is a need to develop new and/or improved psychotherapeutic interventions on the basis of developmental psychopathology research taking into account knowledge of mediators and moderators. Developmental neuroscience research might be instrumental to uncover associated aberrant brain processes in children and adolescents with mental health problems and to better examine mechanisms of their correction by means of psychotherapy and psychological interventions. (4) Psychotherapy research needs to broaden in terms of adoption of large-scale public health strategies and treatments that can be applied to more patients in a simpler and cost-effective way. Increased research on efficacy and moderators of Internet-based treatments and e-mental health tools (e.g. to support “real time” clinical decision-making to prevent treatment failure or relapse) might be one promising way forward.