Cross-modal credibility modelling for EEG-based multimodal emotion recognition.

Objective.The study of emotion recognition through electroencephalography (EEG) has garnered significant attention recently. Integrating EEG with other peripheral physiological signals may greatly enhance performance in emotion recognition. Nonetheless, existing approaches still suffer from two predominant challenges: modality heterogeneity, stemming from the diverse mechanisms across modalities, and fusion credibility, which arises when one or multiple modalities fail to provide highly credible signals.Approach.In this paper, we introduce a novel multimodal physiological signal fusion model that incorporates both intra-inter modality reconstruction and sequential pattern consistency, thereby ensuring a computable and credible EEG-based multimodal emotion recognition. For the modality heterogeneity issue, we first implement a local self-attention transformer to obtain intra-modal features for each respective modality. Subsequently, we devise a pairwise cross-attention transformer to reveal the inter-modal correlations among different modalities, thereby rendering different modalities compatible and diminishing the heterogeneity concern. For the fusion credibility issue, we introduce the concept of sequential pattern consistency to measure whether different modalities evolve in a consistent way. Specifically, we propose to measure the varying trends of different modalities, and compute the inter-modality consistency scores to ascertain fusion credibility.Main results.We conduct extensive experiments on two benchmarked datasets (DEAP and MAHNOB-HCI) with the subject-dependent paradigm. For the DEAP dataset, our method improves the accuracy by 4.58%, and the F1 score by 0.63%, compared to the state-of-the-art baseline. Similarly, for the MAHNOB-HCI dataset, our method improves the accuracy by 3.97%, and the F1 score by 4.21%. In addition, we gain much insight into the proposed framework through significance test, ablation experiments, confusion matrices and hyperparameter analysis. Consequently, we demonstrate the effectiveness of the proposed credibility modelling through statistical analysis and carefully designed experiments.Significance.All experimental results demonstrate the effectiveness of our proposed architecture and indicate that credibility modelling is essential for multimodal emotion recognition.

Pharmacological validation of an attention bias test for conventional broiler chickens.

Fear and anxiety are considered concerns for animal welfare as they are associated with negative affective states. This study aimed to pharmacologically validate an attention bias test (ABT) for broiler chickens (Gallus gallus domesticus) as a cognitive bias test to determine anxiety. Two-hundred-and-four male Ross 708 broiler chickens were arbitrarily allocated to either the anxiogenic or control treatment at 25 days of age (n = 102/treatment). Birds from the anxiogenic group were administered with 2.5 mg of ß-CCM (ß-carboline-3-carboxylic acid-N-methylamide [FG 7142]) per kg of body weight through an intraperitoneal injection (0.1 ml/100 g of body weight). Birds from the control group were administered with 9 mg of a saline solution per kg of body weight. During ABT, birds were tested in groups of three (n = 34 groups of three birds/treatment) with commercial feed and mealworms as positive stimuli and a conspecific alarm call as a negative stimulus. Control birds were 45 s faster to begin feeding than anxiogenic birds. Birds from the control group vocalized 40 s later and stepped 57 s later than birds from the anxiogenic group. The occurrence of vigilance behaviors did not differ between treatments. This study was successful in pharmacologically validating an attention bias test for fast-growing broiler chickens, testing three birds simultaneously. Our findings showed that latencies to begin feeding, first vocalization, and first step were valid measures to quantify anxiety.

A mobile app to challenge obsessional beliefs in adolescents: a protocol of a two-armed, parallel randomized controlled trial.

BACKGROUND: Adolescence is a crucial stage for the development of OCD symptoms that, in most cases, persist into adulthood. This requires designing preventive strategies tailored to this population. Therefore, we aim to describe the study protocol that will be used to examine the effectiveness of a mobile health application to challenge obsessional beliefs in adolescents. METHODS: A two-armed randomized controlled trial will be conducted on an adolescent sample from the general population. The experimental group will use the intervention module (GGOC-AD) of a mobile app on the GGtude platform for 14 days whereas the control group will use a non-active module (GGN-AD) of said app. Primary outcome measures will be obsessional beliefs and obsessive-compulsive symptoms, and secondary measures will be self-esteem and emotional symptoms. Three assessment points will be conducted at baseline, post-intervention, and one-month follow-up. A linear multiple regression model with an intention to treat approach will be used. The expected total sample size will be 55 participants. DISCUSSION: We expect that the intervention group will show a reduction in obsessional beliefs and OCD-symptoms at post and follow-up in comparison with the control group. Additionally, we expect that the app will improve participants' self-esteem. This study could provide an accessible mobile health tool to prevent OCD-related symptoms in adolescents. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT06033391 . Registered September 4, 2023.

Medicine, emotience, and reason.

Medicine is faced with a number of intractable modern challenges that can be understood in terms of hyper-intellectualization; a compassion crisis, burnout, dehumanization, and lost meaning. These challenges have roots in medical philosophy and indeed general Western philosophy by way of the historic exclusion of human emotion from human reason. The resolution of these medical challenges first requires a novel philosophic schema of human knowledge and reason that incorporates the balanced interaction of human intellect and human emotion. This schema of necessity requires a novel extension of dual-process theory into epistemology in terms of both intellect and emotion each generating a distinct natural kind of knowledge independent of the other as well as how these two forms of mental process together construct human reason. Such a novel philosophic schema is here proposed. This scheme is then applied to the practice of medicine with examples of practical applications with the goal of reformulating medical practice in a more knowledgable, balanced, and healthy way. This schema's expanded epistemology becomes the philosophic foundation for more fully incorporating the humanities in medicine.

Physiological data for affective computing in HRI with anthropomorphic service robots: the AFFECT-HRI data set.

In human-human and human-robot interaction, the counterpart influences the human's affective state. Contrary to humans, robots inherently cannot respond empathically, meaning non-beneficial affective reactions cannot be mitigated. Thus, to create a responsible and empathetic human-robot interaction (HRI), involving anthropomorphic service robots, the effect of robot behavior on human affect in HRI must be understood. To contribute to this understanding, we provide the new comprehensive data set AFFECT-HRI, including, for the first time, physiological data labeled with human affect (i.e., emotions and mood) gathered from a conducted HRI study. Within the study, 146 participants interacted with an anthropomorphic service robot in a realistic and complex retail scenario. The participants' questionnaire ratings regarding affect, demographics, and socio-technical ratings are provided in the data set. Five different conditions (i.e., neutral, transparency, liability, moral, and immoral) were considered during the study, eliciting different affective reactions and allowing interdisciplinary investigations (e.g., computer science, law, and psychology). Each condition includes three scenes: a consultation regarding products, a request for sensitive personal information, and a handover.

The effects of prefrontal tDCS and hf-tRNS on the processing of positive and negative emotions evoked by video clips in first- and third-person.

The causal role of the cerebral hemispheres in positive and negative emotion processing remains uncertain. The Right Hemisphere Hypothesis proposes right hemispheric superiority for all emotions, while the Valence Hypothesis suggests the left/right hemisphere's primary involvement in positive/negative emotions, respectively. To address this, emotional video clips were presented during dorsolateral prefrontal cortex (DLPFC) electrical stimulation, incorporating a comparison of tDCS and high frequency tRNS stimulation techniques and manipulating perspective-taking (first-person vs third-person Point of View, POV). Four stimulation conditions were applied while participants were asked to rate emotional video valence: anodal/cathodal tDCS to the left/right DLPFC, reverse configuration (anodal/cathodal on the right/left DLPFC), bilateral hf-tRNS, and sham (control condition). Results revealed significant interactions between stimulation setup, emotional valence, and POV, implicating the DLPFC in emotions and perspective-taking. The right hemisphere played a crucial role in both positive and negative valence, supporting the Right Hemisphere Hypothesis. However, the complex interactions between the brain hemispheres and valence also supported the Valence Hypothesis. Both stimulation techniques (tDCS and tRNS) significantly modulated results. These findings support both hypotheses regarding hemispheric involvement in emotions, underscore the utility of video stimuli, and emphasize the importance of perspective-taking in this field, which is often overlooked.

Vibrotactile enhancement of musical engagement.

Sound is sensed by the ear but can also be felt on the skin, by means of vibrotactile stimulation. Only little research has addressed perceptual implications of vibrotactile stimulation in the realm of music. Here, we studied which perceptual dimensions of music listening are affected by vibrotactile stimulation and whether the spatial segregation of vibrations improves vibrotactile stimulation. Forty-one listeners were presented with vibrotactile stimuli via a chair's surfaces (left and right arm rests, back rest, seat) in addition to music presented over headphones. Vibrations for each surface were derived from individual tracks of the music (multi condition) or conjointly by a mono-rendering, in addition to incongruent and headphones-only conditions. Listeners evaluated unknown music from popular genres according to valence, arousal, groove, the feeling of being part of a live performance, the feeling of being part of the music, and liking. Results indicated that the multi- and mono vibration conditions robustly enhanced the nature of the musical experience compared to listening via headphones alone. Vibrotactile enhancement was strong in the latent dimension of 'musical engagement', encompassing the sense of being a part of the music, arousal, and groove. These findings highlight the potential of vibrotactile cues for creating intensive musical experiences.

A serial mediating effect of perceived family support on psychological well-being.

Family has a significant impact on individual mental health. Based on social support theory, family system theory and the Mental Health Continuum Short Form (MHC-SF), this research constructed a model of the pathway of perceived family support on psychological well-being and the results empirically clarified that perceived family support has a significant positive relationship with emotional well-being, social well-being, and psychological well-being (P < 0.001). Emotional well-being positively influences social well-being and psychological well-being (P < 0.001). Social well-being positively affects psychological well-being (P < 0.001). There were direct mediating effects of emotional well-being (13.45%), direct mediating effects of social well-being (32.82%) and a serial mediating effect (28.07%) between perceived family support and psychological well-being (P < 0.001).

Mind to move: Differences in running biomechanics between sensing and intuition shod runners.

Delving into the complexities of embodied cognition unveils the intertwined influence of mind, body, and environment. The connection of physical activity with cognition sparks a hypothesis linking motion and personality traits. Hence, this study explored whether personality traits could be linked to biomechanical variables characterizing running forms. To do so, 80 runners completed three randomized 50-m running-trials at 3.3, 4.2, and 5m/s during which their running biomechanics [ground contact time (tc), flight time (tf), duty factor (DF), step frequency (SF), leg stiffness (kleg), maximal vertical ground reaction force (Fmax), and maximal leg compression of the spring during stance (ΔL)] was evaluated. In addition, participants' personality traits were assessed through the Myers-Briggs Type Indicator (MBTI) test. The MBTI classifies personality traits into one of two possible categories along four axes: extraversion-introversion; sensing-intuition; thinking-feeling; and judging-perceiving. This exploratory study offers compelling evidence that personality traits, specifically sensing and intuition, are associated with distinct running biomechanics. Individuals classified as sensing demonstrated a more grounded running style characterized by prolonged tc, shorter tf, higher DF, and greater ΔL compared to intuition individuals (p≤0.02). Conversely, intuition runners exhibited a more dynamic and elastic running style with a shorter tc and higher kleg than their sensing counterparts (p≤0.02). Post-hoc tests revealed a significant difference in tc between intuition and sensing runners at all speeds (p≤0.02). According to the definition of each category provided by the MBTI, sensing individuals tend to focus on concrete facts and physical realities while intuition individuals emphasize abstract concepts and patterns of information. These results suggest that runners with sensing and intuition personality traits differ in their ability to use their lower limb structures as springs. Intuition runners appeared to rely more in the stretch-shortening cycle to energetically optimize their running style while sensing runners seemed to optimize running economy by promoting more forward progression than vertical oscillations. This study underscores the intriguing interplay between personality traits of individuals and their preferred movement patterns.

Liking music with and without sadness: Testing the direct effect hypothesis of pleasurable negative emotion.

Negative emotion evoked in listeners of music can produce intense pleasure, but we do not fully understand why. The present study addressed the question by asking participants (n = 50) to self-select a piece of sadness-evoking music that was loved. The key part of the study asked participants to imagine that the felt sadness could be removed. Overall participants reported performing the task successfully. They also indicated that the removal of the sadness reduced their liking of the music, and 82% of participants reported that the evoked sadness also adds to the enjoyment of the music. The study provided evidence for a "Direct effect hypothesis", which draws on the multicomponent model of emotion, where a component of the negative emotion is experienced as positive during music (and other aesthetic) experiences. Earlier evidence of a mediator, such as 'being moved', as the source of enjoyment was reinterpreted in light of the new findings. Instead, the present study applied a semantic overlap explanation, arguing that sadness primes emotions that share meaning with sadness, such as being-moved. The priming occurs if the overlap in meaning is sufficient. The degree of semantic overlap was defined empirically. The present study therefore suggests that mediator-based explanations need to be treated with caution both as a finding of the study, and because of analytic limitations in earlier research that are discussed in the paper.

Climate change beliefs, emotions and pro-environmental behaviors among adults: The role of core personality traits and the time perspective.

Climate change and its consequences are recognized as one of the most important challenges to the functioning of the Earth's ecosystem and humanity. However, the response to the threat posed by the climate crisis still seems inadequate. The question of which psychological factors cause people to engage (or not) in pro-environmental behavior remains without a comprehensive answer. The aim of this study is to establish the links between the cognitive (level of knowledge about climate change and degree of belief in climate myths), emotional (various climate emotions, especially climate anxiety) and behavioral aspects of attitudes towards the climate crisis and their determinants in the form of the Big Five personality domains and time perspectives. The stated hypotheses were verified by analyzing data collected in an online survey of 333 adults using knowledge tests and self-report methods, including psychological questionnaires (Climate Change Anxiety Scale by Clayton and Karazsia, Big Five Inventory-short version by Schupp and Gerlitz, and Zimbardo Time Perspective Inventory by Zimbardo and Boyd), and measurement scales developed for this study (Climate myth belief scale, Climate emotion scale, and Inventories of current and planned pro-environmental activities). The results of stepwise regression analysis demonstrate the importance of the core personality traits and the dominant temporal perspective as determinants of belief in climate change myths, climate anxiety, as well as actual and planned pro-environmental behavior.

Single point motion kinematics convey emotional signals in children and adults.

This study investigates whether humans recognize different emotions conveyed only by the kinematics of a single moving geometrical shape and how this competence unfolds during development, from childhood to adulthood. To this aim, animations in which a shape moved according to happy, fearful, or neutral cartoons were shown, in a forced-choice paradigm, to 7- and 10-year-old children and adults. Accuracy and response times were recorded, and the movement of the mouse while the participants selected a response was tracked. Results showed that 10-year-old children and adults recognize happiness and fear when conveyed solely by different kinematics, with an advantage for fearful stimuli. Fearful stimuli were also accurately identified at 7-year-olds, together with neutral stimuli, while, at this age, the accuracy for happiness was not significantly different than chance. Overall, results demonstrates that emotions can be identified by a single point motion alone during both childhood and adulthood. Moreover, motion contributes in various measures to the comprehension of emotions, with fear recognized earlier in development and more readily even later on, when all emotions are accurately labeled.

Increased anger and stress and heightened connectivity between IFG and vmPFC in victims during social interaction.

Self-identification as a victim of violence may lead to increased negative emotions and stress and thus, may change both structure and function of the underlying neural network(s). In a trans-diagnostic sample of individuals who identified themselves as victims of violence and a matched control group with no prior exposure to violence, we employed a social exclusion paradigm, the Cyberball task, to stimulate the re-experience of stress. Participants were partially excluded in the ball-tossing game without prior knowledge. We analyzed group differences in brain activity and functional connectivity during exclusion versus inclusion in exclusion-related regions. The victim group showed increased anger and stress levels during all conditions. Activation patterns during the task did not differ between groups but an enhanced functional connectivity between the IFG and the right vmPFC distinguished victims from controls during exclusion. This effect was driven by aberrant connectivity in victims during inclusion rather than exclusion, indicating that victimization affects emotional responses and inclusion-related brain connectivity rather than exclusion-related brain activity or connectivity. Victims may respond differently to the social context itself. Enhanced negative emotions and connectivity deviations during social inclusion may depict altered social processing and may thus affect social interactions.

How the Plants for Joints multidisciplinary lifestyle intervention achieved its effects: a mixed methods process evaluation.

BACKGROUND: Plants for Joints (PFJ) is a multidisciplinary intervention centered around a whole-food plant-based diet, physical activity, and sleep and stress management. The PFJ intervention successfully improved disease activity and symptoms in people with rheumatoid arthritis (RA) or osteoarthritis (OA), respectively, and metabolic health. To investigate how these effects were achieved a mixed methods process evaluation was conducted to understand the context, implementation, and mechanism of impact of the PFJ intervention. Also, the relationship between degree of implementation and lifestyle changes was explored. METHODS: Quantitative and qualitative data were collected across the evaluation domains context (i.e. reach), implementation (i.e. recruitment and delivery), and mechanism of impact (i.e. responsiveness) of both the participants and coaches (incl. dietitians, sport coaches) according to the UK MRC guidelines for process evaluations. Data was collected from the participants via focus groups and questionnaires after the intervention, and interviews with coaches. Qualitative data were analyzed thematically, and quantitative data were assessed with descriptive statistics and linear regression analyses. Degree of implementation was quantified using a theory-driven implementation index score composed of different process evaluation constructs. RESULTS: Of the 155 participants who participated in the PFJ intervention, 106 (68%) took part in the questionnaire and 34 (22%) attended a focus group. Participants felt the intervention was complete, coherent, and would recommend the intervention to others (mean score 9.2 (SD 1.4) out of 10). Participants felt heard and empowered to take control of their lifestyle and health outcomes. Components perceived as most useful were self-monitoring, social support, practical and theoretical information, and (individual) guidance by the multidisciplinary team. Participants perceived the intervention as feasible, and many indicated it effectively improved their health outcomes. In an explorative analysis there was no significant difference in healthy lifestyle changes across implementation index score groups. CONCLUSION: This process evaluation offers important insights into why the PFJ intervention works and how the intervention can be optimized for future implementation. Results indicating the intervention's high satisfaction, feasibility, and perceived effectiveness, further support the use of plant-based lifestyle interventions as an additional treatment option for patients with RA, OA, or other chronic diseases. TRIAL REGISTRATION: International Clinical Trial Registry Platform numbers: NL7800, NL7801, and NL7802, all registered 17-06-2019.

Effects of green tea and roasted green tea on human responses.

Our objective was to elucidate the effects of tea consumption on refreshment and stress reduction/recovery through examining the multiple associations among factors such as various physiological responses and task performance. Participants included 20 healthy young men who performed a mental arithmetic task while 11 physiological responses were measured. The experiments were conducted twice under different beverage consumption conditions on separate days. The mental arithmetic task was executed six times in 1 day; participants ingested hot water, green tea, or roasted green tea (hojicha) before each task. Several subjective assessments: subjective fatigue, stress, mental workload, and flow were evaluated after each task. The R-R intervals, heart rate variability spectral components, the Poincaré plot indices (SD1 and SD2) and plethysmogram amplitude tended to decrease during task periods compared to resting periods. Tissue blood volume/flow (TBV, TBF) and near-infrared spectroscopy responses (NIRS) were lower in the tea condition than in the hot water condition. By scrutinizing various indicators, we found that aromatic stimulation of Japanese tea beverages has the potential to induce positive effects, enhance mental task performance, promote refreshment, and alleviate feelings of fatigue. These positive effects were observed even in small quantities and within a short duration, mirroring responses observed in daily consumption.

Application of trauma-focused cognitive behavioral therapy among children and adolescents with childhood household dysfunction. / 创伤聚焦的认知行为疗法在童年家庭功能障碍儿童和青少年中的应用.

Childhood household dysfunction (CHD) is a common adverse childhood experience, which brings the heavy physical and mental afflictions to children and adolescents. Trauma-focused cognitive behavioral therapy (TF-CBT) is an evidence-based psychotherapy that helps children and adolescents who have experienced childhood trauma with traumatic memories. It aims to enhance the coping abilities of CHD children and adolescents, thereby improving the negative effects caused by trauma and effectively reducing psychological burden. TF-CBT can effectively improve post-traumatic stress disorder, emotional and behavioral problems, and family function in children and adolescents with CHD. It is recommended to conduct high-quality original research in the future, develop targeted TF-CBT intervention plans based on potential predictive factors, adopt a combination of online and offline methods, and construct TF-CBT interventions suitable for the Chinese CHD population to meet the mental health service needs of CHD children and adolescents.

Trends in the Management of Anterior Mitral Leaflet Regurgitation.

Importance: The overall prevalence of mitral valve replacement (MVR) or MV repair at the time of cardiac surgery in the setting of isolated anterior mitral leaflet degenerative pathologic status in the US population is unknown. Objective: To investigate the prevalence of MVR and MV repair using the Society of Thoracic Surgeons' Adult Cardiac Surgery Database. Design, Setting, and Participants: In a cross-sectional study, all patients diagnosed with isolated anterior mitral leaflet degenerative regurgitation who underwent either surgical MVR or MV repair between July 1, 2011, and June 30, 2022, were identified. Linear regression analysis was used to assess trends over time. Main Outcomes and Measures: Assessment of the trends in MV repair and MVR over time. Results: A total of 16 259 patients (9624 [59.2%] men) were identified, and the median age was 68 (IQR, 58-74) years. A total of 7214 patients (44.4%) had MVR, and 9045 (55.6%) had MV repair. There was a declining trend of MV repair from 58.0% in 2011 to 51.6% in 2022 (P = .05). The MVR group was older (median [IQR] age, 70 [62-77] vs 67 [58-74] years; P < .001) and had more comorbidities. A total of 85.1% of all patients underwent concomitant procedures. In 81.7% of MVR cases, no attempt at MV repair was made. The median (IQR) annual hospital volume was lower with MVR vs MV repair (2.50 [1.50-5.00] vs 4.00 [2.00-7.00]; P < .001). Conventional surgical approaches were most common (91.5%) but with a declining trend (P < .001). Minimally invasive approaches were used in 13.1% (robotic, 4.6%), and with an inclining trend from 5.0% in 2011 to 12.0% in 2022 (P < .001). Annuloplasty was performed in 88.8% of MV repair cases. Its use as a sole mean of MV repair decreased from 48.0% in 2011 to 13.9% in 2022 (P < .001). Repair maneuvers in addition to annuloplasty were neochordae (overall 40.1%, increasing from 22.5% in 2011 to 62.3% in 2022; P < .001), leaflet resection (overall 10.2%, decreasing from 13.1% in 2011 to 7.9% in 2022, P = .002), edge-to-edge MV repair (overall 5.3%, decreasing from 6.9% in 2011 to 4.5% in 2022; P = 0.04), and chordal transfer (overall 2.4%, decreasing from 2.7% in 2011 to 0.7% in 2022; P = .004). Conclusions and Relevance: In this cross-sectional study, MV repair was the preferred option for degenerative mitral valve disease but was only slightly more commonly performed than MVR for isolated anterior leaflet pathologic status. A large proportion of MVR was performed without an MV repair attempt, suggesting reluctance to repair this pathologic condition.

Identifying tripartite relationship among cortical thickness, neuroticism, and mood and anxiety disorders.

The number of young adults seeking help for emotional distress, subsyndromal-syndromal mood/anxiety symptoms, including those associated with neuroticism, is rising and can be an early manifestation of mood/anxiety disorders. Identification of gray matter (GM) thickness alterations and their relationship with neuroticism and mood/anxiety symptoms can aid in earlier diagnosis and prevention of risk for future mood and anxiety disorders. In a transdiagnostic sample of young adults (n = 252;177 females; age 21.7 ± 2), Hypothesis (H) 1:regularized regression followed by multiple regression examined relationships among GM cortical thickness and clinician-rated depression, anxiety, and mania/hypomania; H2:the neuroticism factor and its subfactors as measured by NEO Personality Inventory (NEO-PI-R) were tested as mediators. Analyses revealed positive relationships between left parsopercularis thickness and depression (B = 4.87, p = 0.002), anxiety (B = 4.68, p = 0.002), mania/hypomania (B = 6.08, p ≤ 0.001); negative relationships between left inferior temporal gyrus (ITG) thickness and depression (B = - 5.64, p ≤ 0.001), anxiety (B = - 6.77, p ≤ 0.001), mania/hypomania (B = - 6.47, p ≤ 0.001); and positive relationships between left isthmus cingulate thickness (B = 2.84, p = 0.011), and anxiety. NEO anger/hostility mediated the relationship between left ITG thickness and mania/hypomania; NEO vulnerability mediated the relationship between left ITG thickness and depression. Examining the interrelationships among cortical thickness, neuroticism and mood and anxiety symptoms enriches the potential for identifying markers conferring risk for mood and anxiety disorders and can provide targets for personalized intervention strategies for these disorders.

"Being an informal caregiver - strengthening resources": mixed methods evaluation of a psychoeducational intervention supporting informal caregivers in palliative care.

BACKGROUND: Informal caregivers are key support for patients with progressive incurable diseases. However, their own needs often remain unmet. Therefore, we developed, manualised and implemented the intervention "Being an informal caregiver - strengthening resources" aiming to support and empower informal caregivers by addressing relevant information-related, physical, psychological and social needs. METHODS: In this pilot study, we evaluated the acceptance and experiences with this psychoeducational intervention. The study was conducted over two years (2019-2021). Informal caregivers were recruited from the University Medical Centre Hamburg-Eppendorf and the metropolitan region of Hamburg, Germany. The intervention was aimed at adult persons who identified themselves as an informal caregiver to an adult patient with a progressive incurable cancer and non-cancer disease. For the evaluation we used a mixed methods approach, combining a longitudinal questionnaire survey (pre-intervention, after each module, 3-months follow-up) and semi-structured interviews post-intervention. Quantitative data were analysed using descriptive statistics and a paired t-Test, interviews were analysed based on the qualitative content analysis according to Mayring. Results were triangulated using a convergent triangulation design. RESULTS: Of 31 informal caregivers who received the intervention, 25 returned the follow-up questionnaire and 20 informal caregivers were interviewed. Triangulated results showed a high satisfaction with the implementation of the intervention. Of a broad range of subjective benefits, gaining knowledge, self-awareness and self-efficacy were most apparent. Informal caregivers reported improved preparedness, awareness of own needs as well as confidence regarding handling own emotions and interacting with the ill person. However, implementing the learned skills into daily life can be challenging due to internal and external factors. Motivations and challenges for participating as well as potential for improvement were identified. CONCLUSIONS: This pilot study showed an overall positive evaluation and several subjective benefits of the psychoeducational intervention "Being an informal caregiver - strengthening resources". Further research is needed to measure the efficacy of this intervention on informal caregivers' outcomes. Therefore, a multicentre randomized prospective study is planned.

A systematic scoping review of group reflection in medical education.

BACKGROUND: Reviewing experiences and recognizing the impact of personal and professional views and emotions upon conduct shapes a physician's professional and personal development, molding their professional identity formation (PIF). Poor appreciation on the role of reflection, shortages in trained tutors and inadequate 'protected time' for reflections in packed medical curricula has hindered its integration into medical education. Group reflection could be a viable alternative to individual reflections; however, this nascent practice requires further study. METHODS: A Systematic Evidence Based Approach guided Systematic Scoping Review (SSR in SEBA) was adopted to guide and structure a review of group reflections in medical education. Independent searches of articles published between 1st January 2000 and 30th June 2022 in bibliographic and grey literature databases were carried out. Included articles were analysed separately using thematic and content analysis, and combined into categories and themes. The themes/categories created were compared with the tabulated summaries of included articles to create domains that framed the synthesis of the discussion. RESULTS: 1141 abstracts were reviewed, 193 full-text articles were appraised and 66 articles were included and the domains identified were theories; indications; types; structure; and benefits and challenges of group reflections. CONCLUSIONS: Scaffolded by current approaches to individual reflections and theories and inculcated with nuanced adaptations from other medical practices, this SSR in SEBA suggests that structured group reflections may fill current gaps in training. However, design and assessment of the evidence-based structuring of group reflections proposed here must be the focus of future study.