The effectiveness of an online short-format Recovery College model: a co-learning model to support mental health.

BACKGROUND: Our societies are facing mental health challenges, which have been compounded by the Covid-19. This event led people to isolate themselves and to stop seeking the help they needed. In response to this situation, the Health and Recovery Learning Center, applying the Recovery College (RC) model, modified its training program to a shorter online format. This study examines the effectiveness of a single RC training course delivered in a shortened online format to a diverse population at risk of mental health deterioration in the context of Covid-19. METHODS: This quasi-experimental study used a one-group pretest-posttest design with repeated measures. Three hundred and fifteen (n = 315) learners agreed to take part in the study and completed questionnaires on wellbeing, anxiety, resilience, self-management, empowerment and stigmatizing attitudes and behaviors. RESULTS: Analyses of variance using a linear mixed models revealed that attending a RC training course had, over time, a statistically significant effect on wellbeing (p = 0.004), anxiety (p < 0.001), self-esteem/self-efficacy (p = 0.005), disclosure/help-seeking (p < 0.001) and a slight effect on resilience (p = 0.019) and optimism/control over the future (p = 0.01). CONCLUSIONS: This study is the first to measure participation in a single online short-format RC training course, with a diversity of learners and a large sample. These results support the hypothesis that an online short-format training course can reduce psychological distress and increase self-efficacy and help-seeking. TRIAL REGISTRATION: This study was previously approved by two certified ethics committees: Comité d'éthique de la recherche du CIUSSS EMTL, which acted as the committee responsible for the multicenter study, reference number MP-12-2021-2421, and Comité d'éthique avec les êtres humains de l'UQTR, reference number CER-20-270-07.01.

EEG as a potential ground truth for the assessment of cognitive state in software development activities: A multimodal imaging study.

Cognitive human error and recent cognitive taxonomy on human error causes of software defects support the intuitive idea that, for instance, mental overload, attention slips, and working memory overload are important human causes for software bugs. In this paper, we approach the EEG as a reliable surrogate to MRI-based reference of the programmer's cognitive state to be used in situations where heavy imaging techniques are infeasible. The idea is to use EEG biomarkers to validate other less intrusive physiological measures, that can be easily recorded by wearable devices and useful in the assessment of the developer's cognitive state during software development tasks. Herein, our EEG study, with the support of fMRI, presents an extensive and systematic analysis by inspecting metrics and extracting relevant information about the most robust features, best EEG channels and the best hemodynamic time delay in the context of software development tasks. From the EEG-fMRI similarity analysis performed, we found significant correlations between a subset of EEG features and the Insula region of the brain, which has been reported as a region highly related to high cognitive tasks, such as software development tasks. We concluded that despite a clear inter-subject variability of the best EEG features and hemodynamic time delay used, the most robust and predominant EEG features, across all the subjects, are related to the Hjorth parameter Activity and Total Power features, from the EEG channels F4, FC4 and C4, and considering in most of the cases a hemodynamic time delay of 4 seconds used on the hemodynamic response function. These findings should be taken into account in future EEG-fMRI studies in the context of software debugging.

Learner Experience of an Online Co-Learning Model to Support Mental Health during the COVID-19 Pandemic: A Qualitative Study.

The COVID-19 pandemic has had a negative impact on the mental health of the population such as increased levels of anxiety, psychological distress, isolation, etc. Access to mental health services has been limited due to the "overflow" of demands. The Recovery College (RC) model, an education-based approach, has addressed this challenge and provided online well-being and mental health courses to at-risk populations. The RC model proposes a co-learning space in an adult education program where learners from diverse backgrounds collectively learn and empower themselves to better address psychological well-being and mental health issues. The aim of this study was to document the experience of learners who participated in online RC courses during the COVID-19 pandemic and the perceived impact of these courses on their mental health. A qualitative interpretative descriptive study design was employed, and Miles and Huberman's stepwise content analysis method was used to mine the data for themes. Fourteen structured online interviews were conducted with a sample representative of the diversity of learners. Five categories of themes emerged: (1) updating and validating your mental health knowledge, (2) taking care of yourself and your mental health, (3) improving and modifying your behaviors and practices, (4) changing how you look at yourself and others, and (5) interacting and connecting with others. Results suggest that online RC courses can be an effective strategy for supporting individual self-regulation and empowerment, breaking social isolation, and reducing the effects of stress in times of social confinement measures and limited access to care.

How Reliable Are Ultra-Short-Term HRV Measurements during Cognitively Demanding Tasks?

Ultra-short-term HRV features assess minor autonomous nervous system variations such as variations resulting from cognitive stress peaks during demanding tasks. Several studies compare ultra-short-term and short-term HRV measurements to investigate their reliability. However, existing experiments are conducted in low cognitively demanding environments. In this paper, we propose to evaluate these measurements' reliability under cognitively demanding tasks using a near real-life setting. For this purpose, we selected 31 HRV features, extracted from data collected from 21 programmers performing code comprehension, and compared them across 18 different time frames, ranging from 3 min to 10 s. Statistical significance and correlation tests were performed between the features extracted using the larger window (3 min) and the same features extracted with the other 17 time frames. We paired these analyses with Bland-Altman plots to inspect how the extraction window size affects the HRV features. The main results show 13 features that presented at least 50% correlation when using 60-second windows. The HF and mNN features achieved around 50% correlation using a 30-second window. The 30-second window was the smallest time frame considered to have reliable measurements. Furthermore, the mNN feature proved to be quite robust to the shortening of the time resolution.

EPIC: Annotated epileptic EEG independent components for artifact reduction.

Scalp electroencephalogram is a non-invasive multi-channel biosignal that records the brain's electrical activity. It is highly susceptible to noise that might overshadow important data. Independent component analysis is one of the most used artifact removal methods. Independent component analysis separates data into different components, although it can not automatically reject the noisy ones. Therefore, experts are needed to decide which components must be removed before reconstructing the data. To automate this method, researchers have developed classifiers to identify noisy components. However, to build these classifiers, they need annotated data. Manually classifying independent components is a time-consuming task. Furthermore, few labelled data are publicly available. This paper presents a source of annotated electroencephalogram independent components acquired from patients with epilepsy (EPIC Dataset). This dataset contains 77,426 independent components obtained from approximately 613 hours of electroencephalogram, visually inspected by two experts, which was already successfully utilised to develop independent component classifiers.

Assessing Changes in Anxiety, Empowerment, Stigma and Wellbeing in Participants Attending an Online-Based Recovery College in Quebec During the Covid-19 Pandemic: A Pre-Experimental Study.

Objectives: The present study aims to evaluate the effect of an online Recovery College (RC) program implemented in Quebec (Canada) during the COVID-19 pandemic. From October 2020 to June 2021, 27 training groups were conducted with a total of 362 attendees. Methods: Outcome was evaluated using a single group repeated measure design, assessing participants prior the training (T0), after the training (T1) and at follow up (T2). 107 learners of the Quebec RC program attended three two-hour sessions agreed to participate to the research. Results: Overall findings show at T1 a small but statistically significant reduction of anxiety and increase in empowerment, and below threshold reduction of stigmatizing attitudes and increase of wellbeing. Conversely, the medium-term changes at follow up were non-significant for all the outcome dimension except for anxiety. Conclusion: Findings suggest that the RC online program can be considered as a potential effective strategy to support self-regulation and empowerment of individuals and to reduce anxiety in the context of crisis for the general population.

Software Bug Detection Causes a Shift From Bottom-Up to Top-Down Effective Connectivity Involving the Insula Within the Error-Monitoring Network.

The neural correlates of software programming skills have been the target of an increasing number of studies in the past few years. Those studies focused on error-monitoring during software code inspection. Others have studied task-related cognitive load as measured by distinct neurophysiological measures. Most studies addressed only syntax errors (shallow level of code monitoring). However, a recent functional MRI (fMRI) study suggested a pivotal role of the insula during error-monitoring when challenging deep-level analysis of code inspection was required. This raised the hypothesis that the insula is causally involved in deep error-monitoring. To confirm this hypothesis, we carried out a new fMRI study where participants performed a deep source-code comprehension task that included error-monitoring to detect bugs in the code. The generality of our paradigm was enhanced by comparison with a variety of tasks related to text reading and bugless source-code understanding. Healthy adult programmers (N = 21) participated in this 3T fMRI experiment. The activation maps evoked by error-related events confirmed significant activations in the insula [p(Bonferroni) < 0.05]. Importantly, a posterior-to-anterior causality shift was observed concerning the role of the insula: in the absence of error, causal directions were mainly bottom-up, whereas, in their presence, the strong causal top-down effects from frontal regions, in particular, the anterior cingulate cortex was observed.

Ensemble Deep Neural Network for Automatic Classification of EEG Independent Components.

OBJECTIVE: Independent component analysis (ICA) is commonly used to remove noisy artifacts from multi-channel scalp electroencephalogram (EEG) signals. ICA decomposes EEG into different independent components (ICs) and then, experts remove the noisy ones. This process is highly time-consuming and experts are not always available. To surpass this drawback, research is going on to develop models to automatically conduct IC classification. Current state-of-the-art models use power spectrum densities (PSDs) and topoplots to classify ICs. The performance of these methods may be limited by disregarding the IC time-series that would contribute to fully simulate the visual inspection performed by experts. METHODS: We present a novel ensemble deep neural network that combines time-series, PSDs, and topoplots to classify ICs. Moreover, we study the ability to use our model in transfer learning approaches. RESULTS: Experimental results showed that using time-series improves IC classification. Results also indicated that transfer learning obtained higher performance than simply training a new model from scratch. CONCLUSION: Researchers should develop IC classifiers using the three sources of information. Moreover, transfer learning approaches should be considered when producing new deep learning models. SIGNIFICANCE: This work improves IC classification, enhancing the automatic removal of EEG artifacts. Additionally, since labelled ICs are generally not publicly available, the possibility of using our model in transfer learning studies may motivate other researchers to develop their own classifiers.

On the accuracy of code complexity metrics: A neuroscience-based guideline for improvement.

Complexity is the key element of software quality. This article investigates the problem of measuring code complexity and discusses the results of a controlled experiment to compare different views and methods to measure code complexity. Participants (27 programmers) were asked to read and (try to) understand a set of programs, while the complexity of such programs is assessed through different methods and perspectives: (a) classic code complexity metrics such as McCabe and Halstead metrics, (b) cognitive complexity metrics based on scored code constructs, (c) cognitive complexity metrics from state-of-the-art tools such as SonarQube, (d) human-centered metrics relying on the direct assessment of programmers' behavioral features (e.g., reading time, and revisits) using eye tracking, and (e) cognitive load/mental effort assessed using electroencephalography (EEG). The human-centered perspective was complemented by the subjective evaluation of participants on the mental effort required to understand the programs using the NASA Task Load Index (TLX). Additionally, the evaluation of the code complexity is measured at both the program level and, whenever possible, at the very low level of code constructs/code regions, to identify the actual code elements and the code context that may trigger a complexity surge in the programmers' perception of code comprehension difficulty. The programmers' cognitive load measured using EEG was used as a reference to evaluate how the different metrics can express the (human) difficulty in comprehending the code. Extensive experimental results show that popular metrics such as V(g) and the complexity metric from SonarSource tools deviate considerably from the programmers' perception of code complexity and often do not show the expected monotonic behavior. The article summarizes the findings in a set of guidelines to improve existing code complexity metrics, particularly state-of-the-art metrics such as cognitive complexity from SonarSource tools.

Can EEG Be Adopted as a Neuroscience Reference for Assessing Software Programmers' Cognitive Load?

An emergent research area in software engineering and software reliability is the use of wearable biosensors to monitor the cognitive state of software developers during software development tasks. The goal is to gather physiologic manifestations that can be linked to error-prone scenarios related to programmers' cognitive states. In this paper we investigate whether electroencephalography (EEG) can be applied to accurately identify programmers' cognitive load associated with the comprehension of code with different complexity levels. Therefore, a controlled experiment involving 26 programmers was carried. We found that features related to Theta, Alpha, and Beta brain waves have the highest discriminative power, allowing the identification of code lines and demanding higher mental effort. The EEG results reveal evidence of mental effort saturation as code complexity increases. Conversely, the classic software complexity metrics do not accurately represent the mental effort involved in code comprehension. Finally, EEG is proposed as a reference, in particular, the combination of EEG with eye tracking information allows for an accurate identification of code lines that correspond to peaks of cognitive load, providing a reference to help in the future evaluation of the space and time accuracy of programmers' cognitive state monitored using wearable devices compatible with software development activities.

Externalizing behaviors and attachment disorganization in children of different-sex separated parents: The protective role of joint physical custody.

The aim of this study was to examine the relationship between externalizing behaviors and the quality of attachment representations in preschool children, and to determine if family type and custody arrangement had a moderating effect on this relationship. The participants were 33 girls and 31 boys (n = 64) aged between three and six years (M = 4.75; SD = 0.87 years) and their mothers. Among them, 36 came from "intact" families, 13 were living mainly with their mothers and 15 were in joint physical custody. Children's attachment representations were assessed with the Attachment Story Completion Task (Bretherton, Ridgeway & Cassidy, 1990). Mothers reported on their child's behavior problems using the Child Behavior Checklist (Achenbach & Rescorla, 2001) and on their alliance with the father using the Parenting Alliance Inventory (Abidin & Brunner, 1995). Although children's externalizing behaviors were found to be associated with the disorganization of their attachment representations, this relationship was significantly weaker and was non-significant for children in joint physical custody. Thus, the results of this pilot study suggest that joint custody may protect children of separated parents from the effects of attachment disorganization on externalizing behaviors.

Cybersecurity and medical devices: A practical guide for cardiac electrophysiologists.

Medical devices increasingly depend on software. While this expands the ability of devices to perform key therapeutic and diagnostic functions, reliance on software inevitably causes exposure to hazards of security vulnerabilities. This article uses a recent high-profile case example to outline a proactive approach to security awareness that incorporates a scientific, risk-based analysis of security concerns that supports ongoing discussions with patients about their medical devices.