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BackgroundMethodological limitations affect a significant number of oncology and haematology trials, raising concerns about the applicability of their results. For example, a suboptimal control arm or limited access to best care upon progression may skew the trial results toward a benefit in the experimental arm. Beyond the fact that such limitations do not prevent drugs reaching the market, other assessment tools, such as those developed by professional societies-ESMO-MCBS and ASCO Value Framework-do not integrate these important shortcomings.MethodsWe propose creating a novel framework with the scope of assessing registration cancer clinical trials in haematology and oncology (randomized or single arm)-that is trials leading to a marketing authorization. The main steps of the methods are (1) assembling a scientific board; (2) defining the scope, goal and methods through pre-specified, pre-registered and protocolized methodology; (3) preregistration of the protocol; (4) conducting a scoping review of limitations and biases affecting oncology trials and assessing existing scores or methods; (5) developing a list of features to be included and assessed within the framework; (6) assessing each feature through a questionnaire sent to highly cited haematologists and oncologists involved in clinical trials; and (7) finalizing the first version of framework.ResultsNot applicable.ConclusionsOur proposal emerged in response to the lack of consideration for key limitations in current trial assessments. The goal is to create a framework specifically designed to assess single trials leading to marketing authorization in the field of oncology and haematogy.

Helping acts, however well intended and beneficial, sometimes involve immoral means or immoral helpers. Here, we explore whether help recipients consider moral evaluations in their appraisals of gratitude, a possibility that has been neglected by existing accounts of gratitude. Participants felt less grateful and more uneasy when offered immoral help (Study 1, N = 150), and when offered morally neutral help by an immoral helper (Study 2, N = 172). In response to immoral help or helpers, participants were less likely to accept the help and less willing to strengthen their relationship with the helper even when they accepted it. Study 3 (N = 276) showed that recipients who felt grateful when offered immoral help were perceived as less likable, less moral, and less suitable as close relationship partners than those who felt uneasy by observers. Our results demonstrate that gratitude is morally sensitive and suggest this might be socially adaptive.

Emails are an essential medium of communication. Their management is an organizational, security, legal and financial issue for all organizations. The interdepartmental digital archiving Vitam Programme, which develops a digital archives management system on behalf of the French government, could not help but wonder about the acquisition, preservation and access to the documents and data contained in email archives. In 2013, it carried out a proof of concept on email archiving, at a time when few archive services in France had embarked on the acquisition of this type of document. Ten years later, the French landscape in terms of digital recordkeeping has changed significantly. In practice, some archives have put in place strategies for archiving email, and tools have been made available to assist in their effort. This article looks at the transition from theory to practice of a more operational acquisition of this type of archive in a French context. [ABSTRACT FROM AUTHOR]

Many agree that the more we feel that we can handle a given situation, the less afraid we are. But why? Is the situation no longer dangerous or is fear a response to more than danger? Here I analyze situations in which one reacts in cold blood to danger and argue that the formal object of fear is not the dangerous, but the unsafe. The unsafe indicates not only how the world is, but also how it can be handled. Safety, and its negative counterpart, are characterized by their duality, both evaluative (is the snake dangerous?) and agentive (is it under control?). [ABSTRACT FROM AUTHOR]

This study aims to compare how lecturers, also being different English as a lingua franca (ELF) users use various vague expressions in academic lectures in a Chinese English‐medium instruction (EMI) university. The study adopts the framework of appraisal grounded in systemic functional linguistic theory to classify all vague expressions according to intensity, amount, and categorisation. It is found that vagueness in relation to amount with no gradable features was used most frequently in the 12 academic lectures of the study, followed by those related to no‐scaled categorisation and upscaled intensity. The use of vague expressions is further examined from an academic ELF perspective. We discover that native‐speaker lecturers may use more vague expressions concerning amount whereas ELF lecturers may prefer those concerning intensity. Finally, we suggest some pedagogical implications of using vagueness in ELF communication for delivering academic lectures in the EMI university context. [ABSTRACT FROM AUTHOR]

When recalling autobiographical events, people not only retrieve event details but also the feelings they experienced. The current study examined whether people are able to consistently recall the intensity of past feelings associated with two consequential and negatively valenced events, i.e. the 9/11 attack (N = 769) and the COVID-19 pandemic (N = 726). By comparing experienced and recalled intensities of negative feelings, we discovered that people systematically recall a higher intensity of negative feelings than initially reported – overestimating the intensity of past negative emotional experiences. The COVID-19 dataset also revealed that individuals who experienced greater improvement in emotional well-being displayed smaller biases in recalling their feelings. Across both datasets, the intensity of remembered feelings was correlated with initial feelings and current feelings, but the impact of the current feelings was stronger in the COVID-19 dataset than in the 9/11 dataset. Our results demonstrate that when recalling negative autobiographical events, people tend to overestimate the intensity of prior negative emotional experiences with their degree of bias influenced by current feelings and well-being. [ABSTRACT FROM AUTHOR]

Teacher evaluation and teachers' professional learning are too often confined to separate areas of research and professional practice. Rather than approach evaluation and enquiry as distinct or irreconcilable, this paper applies the ideas of Stenhouse to explore new possibilities for the reappropriation of mandated appraisal in ways that support teachers' professional growth. Illustrative case studies of laboratory schools in the United States and England are used to examine the interaction of local and lateral forms of professional accountability with external and hierarchical regulatory frameworks. The article reports the design and enactment of change in two schools (a US kindergarten through twelfth grade school and a UK high school) connected through the International Association of Laboratory Schools (IALS) that purposively redesigned appraisal over a three‐year period to build capacity for collaborative curriculum enquiry. Attention is afforded to the space for manoeuvre between advisory and mandatory guidance, and the challenges to relational trust and collective responsibility posed by performance‐based accountability systems. The findings provide new insights into how teacher‐led collaborative enquiry (curricular co‐design) can address the unintended consequences of test‐based accountability and rubrics‐based observation as principal drivers of educational improvement. [ABSTRACT FROM AUTHOR]

ABSTRACT Our attention is constantly drawn by messages that propose to us what should (not) be done in a specific place. According to the Evaluative Model of Normative Appeals (EMNA), we perceive them through a process (normative appraisal) that is structured in three dimensions, and assesses the degree to which the proposal (a) comes from an institution that ensures compliance, (b) avoids physical or psychological damage, and (c) affords the performance of the main intended action. We review the theoretical underpinnings related to these three dimensions, create a scale to measure them (Normative Appraisal Scale, NAS), and validate it in two studies. Specifically, 2376 citizens in eight countries completed the NAS regarding the norms of paying taxes and not drinking on the street (Study 1), and 1544 subway users completed it regarding two transport norms (Study 2). The analyses supported the three‐dimensional structure of the NAS. Furthermore, the NAS increased the prediction when included along with other predictors: sociological variables; social axioms and values (Study 1); and descriptive norm, injunctive norm, personal control, and formal sanction (Study 2). We suggest that the NAS is useful to assess the actual perception of specific normative appeals and anticipate their effectiveness in influencing peoples’ decisions. [ABSTRACT FROM AUTHOR]

This article combines linguistic analysis and data mining methods to explore variations in speakers' evaluative meaning-making in conflict talks. It focuses on conflict style construction through evaluative language, specifically how disputants advance attitudes. The corpus consists of 230 minutes of family mediation talks involving 12 divorcing spouses. The research draws from the Appraisal framework to analyse evaluative meaning-making at a discourse semantics level, capturing both explicit and implicit attitudes, as well as the scaling and dialogic framing of attitudes. Data exploration uses clustering algorithms via RStudio to identify variations in disputants' discursive behaviour. The findings uncover three conflict styles based on disputants' preference for attitude advancement formulations, with varying degrees of assertiveness and forcefulness. This study's contributions include a holistic treatment of evaluative meaning-making, the marriage of digital tools to nuanced linguistic annotation, and a novel interpretation for conflict style. The findings offer fresh insights into disputants' discursive self-presentation in confrontational exchanges. [ABSTRACT FROM AUTHOR]

This article outlines the initial psychometric evidence for the emotionally focused therapy skills rubric (EFTSR). The EFTSR is designed to assess clinician's emotionally focused therapy (EFT) skill proficiency, identify how EFT skills are used within the basic movements of EFT, and evaluate a clinician's ability to use the EFT attachment injury resolution model. The EFTSR content validity was confirmed with two overall content validity indexes of.86 and.87. There was substantial item-level internal consistency reliability, with α scores ranging from.70 to.99 for both videos. Item-total correlations were higher than.20 for most items demonstrating substantial interrater reliability. Thus, results indicate initial support for using the EFTSR as theoretically based instrument designed to assess counselors' ability to execute the skills of the EFT model. [ABSTRACT FROM AUTHOR]

Communal coping theorists have advanced our understanding of stress management in relationships. We add to that work by exploring the content of messages that people exchange when they talk about how they coped with stress. We collected data from 39 online forums and analyzed 446 posts in which people described how they coped with sexual health stress. Results indicated the presence of five types of coping (individual coping, parallelism, communal coping, refused communal coping, reluctant communal coping), distinguished by posters' descriptions of emotions, communication, and relationships in each category. Our findings indicate the need to consider valence in the study of communal coping. [ABSTRACT FROM AUTHOR]

Stance-taking in academic writing is now a well-established topic of interest in English language research, with explorations across a range of theoretical frameworks including metadiscourse and systemic functional linguistics (SFL). This includes studies investigating second language (L2) stance-taking, particularly those comparing stance features deployed by L1 and L2 English writers. However, studies investigating stance-taking using the APPRAISAL framework for evaluative discursive language across L1 and L2 production are relatively rare. Incorporating the APPRAISAL framework into research on stance-taking enhances our comprehension of evaluative language in academic writing, especially when it comes to cross-linguistic contexts. It also provides useful advantages for language assessment and instruction. In this learner corpus-assisted discourse study, APPRAISAL was used to determine how L1 English speakers and L2 English learners from L1 Vietnamese backgrounds expressed attitudes through their written texts. We also investigate the relationship between use of APPRAISAL resources and expert raters’ perceptions of written stance via a stance rubric. Findings show L2 English students are more explicit in argumentative writing than L1 English writers, despite fewer APPRAISAL choices in L2 texts. Besides, while high-rated texts were associated with more judgemental evaluation and invocation, more personal feelings were expressed in low-rated texts. These findings have implications for the instruction of L2 writers in conveying attitudinal meanings in text, as well as for raters tasked with assessing L2 academic essays for stance. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 pandemic has affected nearly every facet of life, constituting a "new normal" and prompting an ongoing collective psychological crisis. People's ways of coping with the pandemic and corresponding wellbeing are of particular research interest; however, these constructs have largely been examined using deductive quantitative approaches, deficit-based lenses, and mononational samples. Methods: The current mixed-methods study used inductive-sequential (QUAL, QUAN) approaches to explore positive coping strategies (approach coping style and COVID-related connection appraisal) and well-being (loneliness, distress, and happiness) across individuals from the United States, Japan, and Mexico. Qualitative data were gathered from N = 141 U.S., Japanese, and Mexican adults to examine how people perceived connection during the pandemic. Results: Qualitative analyses illuminated common themes in which people appraised the pandemic as an opportunity for connection and strengthened interpersonal relationships. Quantitative measures, including a newly-developed questionnaire on COVID-related connection appraisal, were then administered to a separate sample of N = 302 adults in the U.S, Japan, and Mexico to assess associations among approach coping style, COVID-related connection appraisal, and well-being outcomes (loneliness, distress, happiness). Quantitative analyses found significant associations among approach coping style, COVID-related connection appraisal, and all well-being outcomes. Of note, these associations did not differ by country. COVID-related connection appraisal mediated the relationship between approach coping style and two well-being outcomes (loneliness and happiness). Discussion: Findings point to approach coping style and connection appraisal as pathways for resilience and growth in the face of global suffering. [ABSTRACT FROM AUTHOR]

Suffering and misfortunes of other people are often portrayed in the media. Recipients react to these portrayals with different emotions. This article elucidates and clarifies schadenfreude (pleasure at the misfortune of others) and sympathy (feeling concern or sorrow over another person's distress) in media experiences. A thorough literature review provides in-depth insights into the formation of affective dispositions and schadenfreude from various psychological perspectives. This conceptual analysis leads to the "Model of Individual and Social Appraisals of Misfortunes of Others" (MISAM) which first reveals the determining intrapersonal factors within the emotional experience of schadenfreude and sympathy. Second, it discloses the social component vital for understanding the construction and regulation of these emotions. The model combines individual and social appraisal processes and identifies the factors involved in the elicitation and regulation of schadenfreude and sympathy in the media reception of misfortunes. With the aim of integrating different perspectives, we incorporated Affective Disposition Theory and recent work from social psychology and used an appraisal framework. The MISAM opens the path for further investigation of schadenfreude and sympathy in media reception, beyond entertainment experiences. [ABSTRACT FROM AUTHOR]

BACKGROUND: The pituitary gland is an important endocrine organ in the body. Certain diseases can cause damage to the pituitary gland, such as pituitary adenoma and abnormal hormone secretion. Pituitary stem cells, due to their self-renewal and multi-directional differentiation potential, are expected to become a new therapeutic approach for repairing damaged pituitary glands. OBJECTIVE: To isolate and culture pituitary stem cells using the suspension cell ball culture method and identify their proliferation and differentiation ability. METHODS: Pituitary stem cells were isolated and cultured from the pituitary gland of newborn New Zealand white rabbits using the suspension cell ball culture method, and their morphological characteristics were observed. Immunofluorescence cytochemistry was used to detect the expression of pituitary stem cell markers SOX2 and Nestin. EdU labeling method was utilized to detect the proliferative ability of pituitary stem cells. After adherent and induced differentiation, the hormone levels in the culture medium were detected by ELISA. RESULTS AND CONCLUSION: Pituitary stem cell spheres could be successfully isolated by the suspension cell ball culture method, with strong proliferative ability. Positive expression of stem cell-specific markers SOX2 and Nestin was found in the cultured cells. After induction and differentiation, adrenocorticotropic hormone, thyroid hormone, growth hormone, luteinizing hormone, follicle-stimulating hormone, and prolactin levels significantly increased in the medium (P < 0.001), with strong differentiation ability. [ABSTRACT FROM AUTHOR]

This study aimed to examine the responses of early childhood education and care (ECEC) teachers to childrenʼs externalizing problems related to the teachersʼ cognition, ECEC methods, and years of childcare experience of teachers. Data from questionnaire-based responses from 628 ECEC teachers were analyzed. The appraisal of responsibility was positively associated with a variety of responses, including inappropriate ones. Meanwhile, inferences about the ECEC environment were negatively associated with inappropriate responses and positively associated with a range of other responses. Teacher-directed tendency in ECEC methods displayed a direct positive association with inappropriate responses, though it also demonstrated a positive association with diverse responses. However, child-centered tendencies were positively associated with a variety of responses, excluding inappropriate ones. Compared with ECEC methods, the association between years of childcare experience and the cognition of and response to externalizing problems was relatively low. These findings indicate that ECEC teachers respond to externalizing problems in various ways, including a few inappropriate responses. Furthermore, the responses varied according to cognition and methods of the teachers. [Research Impact] This study identifies multiple factors influencing ECEC teachersʼ responses to childrenʼs externalizing problems. The findings highlight the importance of inferring the causal factors of ECEC-related externalizing behaviors and reducing teacher-directed tendencies to prevent inappropriate responses. Addressing these issues is crucial, and the findings are expected to serve as reference for the development of support systems for ECEC teachers. [ABSTRACT FROM AUTHOR]

Background: People who were disabled from working reported substantially worse depression in recent research [1] despite adjustment for demographic covariates, cognitive-appraisal processes, and COVID-specific stressors, thus motivating the present work. Objective: This study sought to "drill down" to understand employment-group differences (employed, retired, unemployed, disabled) in cognitive factors, and how these factors played into paths to depression during COVID early in the pandemic and depression trajectories over 15.5 months of follow-up. Methods: This longitudinal cohort study (n = 771) included chronically ill and general-population samples in the United States, characterized into the same depression-trajectory groups as the earlier study [1]. The Quality-of-Life Appraisal Profilev2 Short-Form assessed cognitive-appraisal processes. COVID-specific scales assessed hardship, worry, and social support. Chi-square, Analysis of Variance, classification and regression tree, and random effects modeling investigated factors associated with reported depression over time specifically by employment group, rather than in the whole sample which was the focus of the earlier study. Results: Disabled participants were disproportionately represented in the stably depressed trajectory group, reporting more hardship and worry, and lower social support than employed and retired participants (p < 0.0001). They were more likely to focus on health goals, problem goals, and emphasizing the negative (p < 0.001). They had different paths and cut-points to depression than employed/unemployed/retired participants. Even mild endorsement of emphasizing the negative and recent changes predicted higher depression. COVID-specific stressors and cognitive-appraisal processes were less implicated in depression among disabled participants compared to others. Conclusions: Disabled participants were at greater risk of stable depression during the COVID pandemic. Small increases in emphasizing the negative were a path to worse depression, and disabled participants' depression may be less reactive to external circumstances or ways of thinking. [ABSTRACT FROM AUTHOR]

This study aimed to explore how facilitators of group dynamic and structured leadership courses cope with difficult situations during the course, and to relate their coping strategies to general individual characteristics and situation-specific appraisals. The study group consisted of facilitators of two of the most widespread leadership courses in Sweden: 110 facilitators of the course Understanding Group and Leader (UGL) and 111 facilitators of Developmental leadership (DL). A web-based questionnaire included descriptions of two difficult interpersonal course situations and questions on personality, general leadership style as well as situation-specific appraisal and coping. Three coping strategies were identified (factor analyses): Focus on course structure, Focus on psychological safety and Focus on own reflection. These factors were positively correlated. Weak associations were observed between the coping strategies and personality and general leadership style. Situation-specific appraisals covaried more strongly with the coping strategies. The findings suggest that reflection based on these coping strategies can lead to increased self-awareness and self-confidence on part of the facilitator. The findings may also help leadership course facilitators to cope more effectively, which in turn creates trust in the group that they are leading. The study contributes to the understanding of a limited research area; how leadership course facilitators cope with difficult course situations. The results provide guidance on how to cope more effectively. Practical implications include aspects to focus on in the training of leadership course facilitators. [ABSTRACT FROM AUTHOR]

As an intercultural modern art form, web-based ink and wash cartoons are significant tools to communicate cultural identities in the Chinese context because of their entertaining form, thought-provoking content, and profound cultural connotation. Against this background, the present study investigates the multimodal appraisal systems of 96 web-based ink and wash cartoons, focusing on attitudinal meanings and explicating how the attitudinal resources contribute to the communication of Chinese cultural identities. The analysis of 96 web-based ink and wash cartoons shows that the cultural identities of the Chinese dream, Confucianism, collectivism, and optimism are communicated through the interplay between visual and verbal semiotic resources. The analytical results reveal a series of generic features of the web-based ink and wash cartoons that contribute to the promotion of cultural identities, including the popular theme, minimalist style, positive attitude prosody, and the use of culture-specific metaphor and ideation. These features underpin the strategies for promoting Chinese cultural identities and the shift in national branding policy. The study hopes to provide clues for government, social institutions, and individuals to promote cultural identities effectively through social media. [ABSTRACT FROM AUTHOR]

We assemble a property-level panel of appraiser-reported attributes associated with 4.6 million loan applications from 2013 to 2017 to test whether attributes were consistently reported. Appraisers have an incentive to misreport property attributes to justify higher appraised values to ensure that associated mortgage loans are approved. We focus on property transactions with multiple sets of attributes reported by the same appraiser within four quarters and find evidence consistent with an intent to inflate valuations through attribute misreporting. We find that strategic misreporting of attributes is prevalent across markets, and that highly leveraged borrowers whose appraisals had inconsistently reported attributes were 9.8 percent more likely to become seriously delinquent in their loan payments. [ABSTRACT FROM AUTHOR]

Under the assumption that appraisal entails selection of records to be archives in line with the concept of values in archives and what each society values, this article investigates the situation of appraisal in the Thai public sector, where records are not always readily transferred from government agencies to the National Archives of Thailand. The research attempts to identify gaps and seeks to conceive a suitable appraisal system through documentary research (e.g., legislation, manuals, policies and related literature), interviews, and public hearings. The data collected for this research, which was conducted along with dissemination of knowledge on archival appraisal as advocacy for archival appraisal in Thailand, suggest that there is a need to combine records and archives values with existing values in society to make public organization executives and policy makers drive archives into the public agenda. More importantly, it is necessary to build communities and networks that support archival appraisal among information professionals and records creators and across related areas of expertise, such as digital curators and IT specialists. [ABSTRACT FROM AUTHOR]

Museums are multimodal environments where semiotic resources including objects, space, sound, light, movement, language and the body converge. Our case study of a Taiwanese ceramics exhibition draws on the concept of 'affective affordances', meaning the socially and contextually informed ways that semiotic resources invite felt and embodied responses. We use this concept to investigate the ways in which texts and space co-construct affective meanings. We discuss texts and space as physical entities within the affective exhibition, each possessing intrinsic properties which can potentially stimulate certain embodied responses from visitors. Specifically, the case study addresses two questions: (1) how written texts within an exhibition interact with space to afford affective meaning potential; and (2) how museum visitors as active participants respond to space and text as affective stimuli. The study adopts a novel composite theoretical framework that combines spatial discourse analysis using the Binding framework, linguistic analysis using the Appraisal framework, and walking interviews. Our analysis provides rich empirical evidence of how space and written texts interact to create a felt sense of place for visitors. [ABSTRACT FROM AUTHOR]

The introduction of autonomous vehicles (AVs) has the potential to drastically change society, planning, design, and development strategies. This study uses the PRISMA protocol to carry out a systematic literature review, focusing on the backcasting method as an analytic tool. By examining. 21 studies published between 2003 and 2024, this paper highlights the phases of backcasting: visioning, policy packaging, and appraisal, and identifies critical factors necessary for the successful integration of AVs. Visioning for future driverless cities includes high-quality urban areas, active mobility, and innovative developments. Policies and Packaging suggested a focus on restricting vehicular access, transit-oriented development, and encouraging public transportation. Appraisal reveals skepticism about the positive impacts of AVs, urging policies that limit access to urban areas and promote sustainable modes of transportation. The main contribution of this study lies in its comprehensive application of backcasting to AV implementation, offering a structured approach to envisioning future urban scenarios, formulating supportive policies, and evaluating their impact. This analysis provides a solid foundation for future research, urging us to explore the intersection between AVs, citizen participation, and environmental sustainability to achieve more efficient and sustainable cities. [ABSTRACT FROM AUTHOR]

The purpose of the present study was to assess whether the recognition of tennis players' affective state associated with their nonverbal behavior would be influenced by (a) the importance of the situation, (b) the point outcome, and (c) the tennis expertise of the observer. Two hundred sixty-nine participants (Mage = 30.51 years; 116 female; 79 tennis club members) watched video excerpts showing the nonverbal behavior of amateur tennis players during competitive matches immediately after the end of a rally and were asked to estimate whether the player had just won or lost the point. Results indicate that the recognition rates were higher for situations closer to the end of a game, closer to the end of a set, and with a tighter score during a game. Moreover, recognition rates were higher for lost than for won points, while the tennis expertise of participants had no influence on the recognition rates. [ABSTRACT FROM AUTHOR]

Guided by transactional stress theory, this study aimed to explore elite U.K. soccer coaches' perceived stressors, the situational properties, appraisals, and coping during the COVID-19 pandemic. This study also aimed to explore any variation in stress experiences across football league standards A total of 13 professional first-team male U.K. association football coaches between 38 and 59 years of age (M = 43.00, SD = 6.94) participated in telephone (n = 5) or online (n = 8) semistructured interviews. Informed by the philosophical position of critical realism, Braun et al.'s six-phase approach to thematic analysis was used to generate competitive, organizational, and personal stressor themes. Deductive thematic analysis generated themes reflective of all situational properties of stressors identified by Lazarus and Folkman and an array of appraisal and coping strategies. Future research and recommendations for supporting coach performance and well-being post-COVID-19 pandemic are offered. [ABSTRACT FROM AUTHOR]

Abstract Background With the increased use of patient-reported outcomes measures (PROMs) to assess spine surgery outcomes, it is important to understand how patients interpret their health changes over time. The measurement of cognitive-appraisal processes enables the quantification of how individuals think about quality of life (QOL). This study examined how appraisal processes were associated with patients’ views of their role in managing their health—patient activation. Methods This longitudinal cohort study from August 2019 to January 2022 included 222 adults undergoing spine surgery for cervical (n = 107) and/or lumbar (n = 148) pathology at an academic medical center. PROMs assessed disability (Neck Disability Index for cervical or Oswestry Disability Index for lumbar) and mental health (PROMIS-29 v2.0), cognitive-appraisal processes (QOLAPv2-SF), and patient activation (Patient Activation Measure). ANOVA models were used to examine the relationships between QOL and cognitive appraisal processes before and after surgery, overall and stratified by patient-activation stage. Effect sizes facilitated interpretation. Results There were significant improvements in pain-related disability and mental health following surgery. Cognitive appraisal processes explained substantial amounts of variance, particularly with changes in mental health (45% before surgery, 75% at three months, and 63%, at 12-months after surgery). With respect to physical disability, less disability was associated with a lesser focus on negative aspects of QOL. Appraisal explained the most variance before surgery for high-activation patients. At 12-months post-surgery, however, appraisal explained the most variance for the low-activation patients. Appraisal explained similar amounts of variance in mental health at baseline and three-months post-surgery for all activation groups, but substantially more variance in the low-activation group at 12-months post-surgery. There were differences in the direction of appraisal-outcome associations by activation group in selected appraisal items/domains. Conclusions Cognitive-appraisal processes demonstrate a significant relationship with QOL among spine surgery patients. These processes explain substantial variance in pain-related disability and mental health, especially among those high in activation before surgery and those low in activation at 12-months post-surgery. Our findings suggest that patients’ ways of thinking about their health may be effective targets of motivational coaching, to help them become more engaged over the recovery trajectory.

Existing studies investigating the integration of technology using the framework of technological pedagogical content knowledge (TPACK) have frequently relied on self-reported data analyzed through qualitative or quantitative methods focusing on TPACK regardless of their contexts. Targeting this need to better understand how teachers’ individual factors influence their TPACK development, the current study uses reflective writing assignments from 45 international English teachers participating in a global online course (GOC) on educational technology in the classroom to identify how details related to classroom, school, and/or national context influence TPACK gained from an activity involving Google Docs. Further drawing on a systemic functional approach using the APPRAISAL system to examine how teachers use evaluative language to successfully demonstrate TPACK through reflective writing, our qualitative discourse analysis reveals that participants often used positive and negative evaluation of their own and student behavior (JUDGEMENT) and, more rarely, emotions (AFFECT) to describe changes in TPACK shaped by new understandings of specific uses of technology in classroom contexts. Findings also show that participants often mentioned details related to their classroom actions and practices yet rarely provided contextual details related to school, community, or national/societal factors in these assignments. By utilizing qualitative analysis of reflective writing to capture how in-service teachers develop TPACK shaped by their individual contexts, this study provides avenues for understanding TPACK through professional development materials rather than teachers’ self-reports while suggesting methods useful for both global online course design and future studies operationalizing context as part of the TPACK framework.

Nature or the physical environment is strategically presented as a compelling attraction to persuade tourists to visit a country, including Indonesia. While previous studies investigated tourism promotion from persuasive devices like metaphors and adjectives, this study takes a different trajectory by investigating the language of attitudes, identified explicitly from the Graduation, in tourism promotion discourse. This study built a specific corpus compiled from articles promoting nature on the official website of Indonesian tourism (OWIT). Using Sketch Engine and Wmatrix5, this study aims to identify 1) the types of nature offered on the Indonesian tourism promotion website, 2) quantification and its grammatical realization used in the promotion, and 3) attitudes amplified from the graduation strategy. Findings reveal that Indonesian tourism is promoted mainly by its topography, flora and fauna, nature-based activity, and weather and climate. Graduation is realized through diverse grammatical realizations, such as the specific and non-specific numerals and infused amounts, in order to quantify nature’s values/ numbers, extent, and mass/ presence. The concordance study indicates that upscaling quantification emphasizes Indonesia’s natural beauty and richness, while downscaling quantification promotes the endangered species in Indonesia’s national parks. From an ecological lens, the Graduation is employed to amplify readers’ Appreciation of the country’s valuation and composition. Quantification has also been proven to be a productive persuasive device in tourism promotion that functions to materialize and commodify nature. Notwithstanding the corpus size, this study contributes to tourism promotion discourse and ecolinguistics studies.

Introduction: Professional classical musicians operate within a highly demanding environment, which includes organizational, social, and emotional demands. When not effectively coped with, these demands may cause stress and negatively impact well-being. This qualitative study explored the perceived stress and well-being experiences of professional classical musicians through a transactional theory of stress. The study employed a double hermeneutic interpretation of the lived experiences of the perceived demands faced, stress appraisals made, resources used, and the influence on well-being. Methods: Six professional classical musicians were purposefully selected for participation. Semi-structured interviews were conducted and participants reflected on two events: one they perceived as a positive experience and one that was negative. Transcripts were analyzed using Interpretative Phenomenological Analysis and Group Experiential Themes emerged. Results: Three Group Experiential Themes were identified: (a) Performance Demands; (b) Organizational Demands; and, (c) Relationship Demands. Participants predominantly appraised demands as a threat. A small number of demands were appraised as a challenge or benefit, and the fewest demands were appraised as causing harm or loss. Participants' appraisals were informed by underlying properties of stress appraisal such as self and other comparison, and preparation. Participants often relied on personal resources as opposed to available workplace resources. They perceived well-being to relate to stress appraisals with participants experiencing acute and long-term outcomes. Discussion: This study offers insight into the lived experience of the occupational stress process within professional classical musicians. The findings demonstrate that organizational interventions targeted at continuing professional development and social support are appropriate to help musicians cope more effectively with demands. [ABSTRACT FROM AUTHOR]

The convergence of researchers in the fields of flourishing, moral psychology, and social-emotional studies has reached a stage where developing a theory that connects emotional regulation and flourishing is meaningful. This theoretical investigation aims to uncover insights from the research of Magda B. Arnold, renowned for her theory of emotions, and lesser-known for her notion of the self-ideal, regarding the relationship between emotional regulation and flourishing. Our initial hypothesis posits that Arnold's concept of self-ideal provides a framework for understanding how to foster emotional regulation in individuals by directing it toward constructive life objectives. To achieve this, we explore the current state of emotional regulation and flourishing and the relationship between these concepts; we consider the interconnectedness of emotion and self-ideal within Arnold's theory and analyze its potential to serve as a foundation for building a theory relating flourishing and emotional regulation. We find in Arnold's theory substantial ideas about the relationship between emotional regulation, flourishing, and self-ideal, as well as emerging empirical research relating to these themes. We conclude that Arnold's research can serve as a catalyst for developing psychological intervention models that enhance emotional regulation and promote a flourishing life. [ABSTRACT FROM AUTHOR]

Developing virtues requires attending to the affective and cognitive components of virtue. The former component implies cultivating apt emotional responses to specific situations. The cognitive part requires the (meta) virtue of phronesis. In dealing with "Phronesis in educating emotions," this article attends to the nature of emotions and phronesis as its role in cultivating good action habits and virtuous emotional habits. It understands emotion regulation as one of the functions of phronesis. In the broader sense, phronesis includes elements other than deliberation, such as dialectics and rhetoric, which can be helpful to induce a certain suspicion or to persuade somewhat since our affectivity is susceptible to persuasion (i.e. Aristotle's political dominion of emotions). As a topic in the intersection of moral psychology and moral philosophy, we get valuable insights into a psychologist's work, Magda Arnold's (1903–2002) emotion theory. Her understanding of emotion elicitation elucidates the relation between phronesis and emotions. The article focuses on one of the central elements of emotion elicitation, the appraisal. This piece can make the education of emotions for virtue development more understandable. At first glance, our initial appraisal may be hasty and inaccurate, leading to emotional reactions. However, with careful reflection, we can correct and improve upon our initial appraisal and subsequent emotions. If our initial assessment was flawed, this second, more thoughtful evaluation can be enhanced through phronesis. Due to the appraisal's spontaneity, cultivating educated emotions requires values' teaching, learning, and thus, appraising good things. With the development of virtues, intuitive estimates become adequate, so emotional responses are more attuned to diverse situations. [ABSTRACT FROM AUTHOR]

Background: With the increased use of patient-reported outcomes measures (PROMs) to assess spine surgery outcomes, it is important to understand how patients interpret their health changes over time. The measurement of cognitive-appraisal processes enables the quantification of how individuals think about quality of life (QOL). This study examined how appraisal processes were associated with patients' views of their role in managing their health—patient activation. Methods: This longitudinal cohort study from August 2019 to January 2022 included 222 adults undergoing spine surgery for cervical (n = 107) and/or lumbar (n = 148) pathology at an academic medical center. PROMs assessed disability (Neck Disability Index for cervical or Oswestry Disability Index for lumbar) and mental health (PROMIS-29 v2.0), cognitive-appraisal processes (QOLAPv2-SF), and patient activation (Patient Activation Measure). ANOVA models were used to examine the relationships between QOL and cognitive appraisal processes before and after surgery, overall and stratified by patient-activation stage. Effect sizes facilitated interpretation. Results: There were significant improvements in pain-related disability and mental health following surgery. Cognitive appraisal processes explained substantial amounts of variance, particularly with changes in mental health (45% before surgery, 75% at three months, and 63%, at 12-months after surgery). With respect to physical disability, less disability was associated with a lesser focus on negative aspects of QOL. Appraisal explained the most variance before surgery for high-activation patients. At 12-months post-surgery, however, appraisal explained the most variance for the low-activation patients. Appraisal explained similar amounts of variance in mental health at baseline and three-months post-surgery for all activation groups, but substantially more variance in the low-activation group at 12-months post-surgery. There were differences in the direction of appraisal-outcome associations by activation group in selected appraisal items/domains. Conclusions: Cognitive-appraisal processes demonstrate a significant relationship with QOL among spine surgery patients. These processes explain substantial variance in pain-related disability and mental health, especially among those high in activation before surgery and those low in activation at 12-months post-surgery. Our findings suggest that patients' ways of thinking about their health may be effective targets of motivational coaching, to help them become more engaged over the recovery trajectory. [ABSTRACT FROM AUTHOR]

This preliminary online study investigated the short-term effects of self-distancing, worry, and distraction on anxiety and worry-related appraisals among individuals high in worry. N = 104 community members high in trait worry were randomly assigned to think about a personally identified worry-provoking situation using self-distancing (SC), worry (WC), or distraction (DC). Participants rated their anxiety (Visual Analogue Scale for Anxiety) and appraisals of the situation (Perceived Probability, Coping, and Cost Questions) at post-task and one-day follow-up. Mixed factorial ANOVAs revealed an increase in anxiety within the WC (d =.475) and no difference in anxiety within the SC (d =.010) from pre- to post-task. There was no difference in anxiety within the DC (p =.177). Participants within the SC reported a decrease in the perceived cost associated with their identified situation from pre- to post-task (d =.424), which was maintained at one-day follow-up (d =.034). Participants reported an increase in perceived ability to cope from post-task to one-day follow-up (d =.236), and from pre-task to one-day follow-up (d =.338), regardless of condition. Self-distancing may prevent increases in anxiety and catastrophizing while reflecting on a feared situation. [ABSTRACT FROM AUTHOR]

This work aims to examine the identities communicated prior to and during a role-playing game (RPG) for individuals with acquired brain injury (ABI). Appraisal, an analysis tool of Systemic Functional Linguistics (SFL), that allows one to examine the interpersonal metafunction, was applied to interview and RPG group treatment conversations. This allowed for the investigation of the evaluative language of five individuals with ABI. The analysis revealed that individuals were capable of using various resources of appraisal to communicate their identities and did so differently across contexts. SFL, specifically the analysis of appraisal, is a useful resource for examining the communication and negotiation of identity after ABI. This has implications for interventions that support and facilitate positive identity negotiation and thus, enhanced rehabilitation outcomes. [ABSTRACT FROM AUTHOR]

Existing studies investigating the integration of technology using the framework of technological pedagogical content knowledge (TPACK) have frequently relied on self-reported data analyzed through qualitative or quantitative methods focusing on TPACK regardless of their contexts. Targeting this need to better understand how teachers' individual factors influence their TPACK development, the current study uses reflective writing assignments from 45 international English teachers participating in a global online course (GOC) on educational technology in the classroom to identify how details related to classroom, school, and/or national context influence TPACK gained from an activity involving Google Docs. Further drawing on a systemic functional approach using the APPRAISAL system to examine how teachers use evaluative language to successfully demonstrate TPACK through reflective writing, our qualitative discourse analysis reveals that participants often used positive and negative evaluation of their own and student behavior (JUDGEMENT) and, more rarely, emotions (AFFECT) to describe changes in TPACK shaped by new understandings of specific uses of technology in classroom contexts. Findings also show that participants often mentioned details related to their classroom actions and practices yet rarely provided contextual details related to school, community, or national/societal factors in these assignments. By utilizing qualitative analysis of reflective writing to capture how in-service teachers develop TPACK shaped by their individual contexts, this study provides avenues for understanding TPACK through professional development materials rather than teachers' self-reports while suggesting methods useful for both global online course design and future studies operationalizing context as part of the TPACK framework. [ABSTRACT FROM AUTHOR]

This study examined media-framed investment fraud issues through critical discourse analysis (CDA) by Fairclough (1995). It analyzed the impact of context on text, employing van Dijk's (2009) theory of news discourse and van Leeuwen's (2008) framework for social actors (SAs) in investment fraud news, they were the affiliate (AF), the investor (IF), and the police (PL). Transitivity analysis (TA) was used to assess power relationships, while the appraisal system (AS) was used to identify SA’s attitudes. Framing served various purposes, enhancing salience in news contexts. In investment fraud news, the AF was portrayed as a target with immoral attitudes, the IF as un/fortunate behavers, and the PL as trustworthy sayers. The data obtained from Indonesian online media during the investment fraud reports were analyzed. The study utilized systemic functional linguistics (SFL) within CDA, integrating transitivity analysis for power relations and the appraisal system for attitude analysis of each social actor. The results demonstrated how the social actors shape the construction of social and economic values, influencing the public perceptions and beliefs of the business investment. [ABSTRACT FROM AUTHOR]

Research has extensively examined spousal caregiving in Alzheimer's disease (AD), but it remains unclear how people with AD help spousal caregivers. We aimed to describe emotional and practical support that people with AD and their spouses provide to each other and test the role their empathy plays in these support experiences. Seventy-two people with early-stage AD and their spousal caregivers independently reported empathy (personal distress, empathic concern, perspective taking) and the frequency and appraisal of support provision. Caregivers reported both partners' sociodemographic characteristics. People with early-stage AD and their spousal caregivers provided support to each other often. Caregivers provided more support but people with AD appraised support provision as more pleasant and less stressful. Lower personal distress in both partners and greater caregiver empathic concern were associated with more frequent caregiver support to people with AD. Greater empathic concern and perspective taking were associated with more pleasant appraisals of helping. Personal distress was positively associated with stress of helping. Findings describe support reciprocity in early-stage AD and debunk the myth of people with AD being only recipients of care. We identify risk and resilience in couples per empathy and inform the design of dyadic interventions to promote mutually beneficial relationships in AD. [ABSTRACT FROM AUTHOR]

Emotion elicitation using emotional film clips is one of the most common and ecologically valid methods in Affective Computing. However, selecting and validating appropriate materials that evoke a range of emotions is challenging. Here, we present EmoStim: A Database of Emotional Film Clips as a film library with rich and varied content. EmoStim is designed for researchers interested in studying emotions in relation to either discrete or componential models of emotion. To create the database, 139 film clips were selected from literature and then annotated by 638 participants through the CrowdFlower platform. We selected 99 film clips based on the distribution of subjective ratings that effectively distinguished between emotions defined by the discrete model. We show that the selected film clips reliably induce a range of specific emotions according to the discrete model. Further, we describe relationships between emotions, emotion organization in the componential space, and underlying dimensions representing emotional experience. The EmoStim database and participant annotations are freely available for research purposes. The database can be used to enrich our understanding of emotions further and serve as a guide to select or creating additional materials. [ABSTRACT FROM AUTHOR]

As social robots and other intelligent machines enter the home, artificial emotional intelligence (AEI) is taking center stage to address users’ desire for deeper, more meaningful human-machine interaction. To accomplish such efficacious interaction, the next-generation AEI needs comprehensive human emotion models for training. Unlike theory of emotion, which has been the historical focus in psychology, emotion models are a descriptive tool. In practice, the strongest models need robust coverage, which means defining the smallest core set of emotions from which all others can be derived. To achieve the desired coverage, we turn to word embeddings from natural language processing. Using unsupervised clustering techniques, our experiments show that with as few as 15 discrete emotion categories, we can provide maximum coverage across six major languages–Arabic, Chinese, English, French, Spanish, and Russian. In support of our findings, we also examine annotations from two large-scale emotion recognition datasets to assess the validity of existing emotion models compared to human perception at scale. Because robust, comprehensive emotion models are foundational for developing real-world affective computing applications, this work has broad implications in social robotics, human-machine interaction, mental healthcare, computational psychology, and entertainment. [ABSTRACT FROM AUTHOR]

Previous studies have solely focused on establishing Machine Learning (ML) models for automated detection of stress arousal. However, these studies do not recognize stress appraisal and presume stress is a negative mental state. Yet, stress can be classified according to its influence on individuals; the way people perceive a stressor determines whether the stress reaction is considered as eustress (positive stress) or distress (negative stress). Thus, this study aims to assess the potential of using an ML approach to determine stress appraisal and identify eustress and distress instances using physiological and behavioral features. The results indicate that distress leads to higher perceived stress arousal compared to eustress. An XGBoost model that combined physiological and behavioral features using a 30 second time window had 83.38% and 78.79% F1-scores for predicting eustress and distress, respectively. Gender-based models resulted in an average increase of 2-4% in eustress and distress prediction accuracy. Finally, a model to predict the simultaneous assessment of eustress and distress, distinguishing between pure eustress, pure distress, eustress-distress coexistence, and the absence of stress achieved a moderate F1-score of 65.12%. The results of this study lay the foundation for work management interventions to maximize eustress and minimize distress in the workplace. [ABSTRACT FROM AUTHOR]

The fight or flight phenomena is of evolutionary origin and responsible for the type of defensive behaviours enacted, when in the face of threat. This review attempts to draw the link between fear and aggression as motivational levers for fight or flight defensive behaviours. Furthermore, this review investigates whether human biological motion is modulated by the affective behaviours associated with the fight or flight phenomenon. It examines how threat informed emotion and motor systems have the potential to result in the modulation of empathetic appraisal. This is of interest to this systematic review, as empathetic modulation is crucial to prosocial drive, which has the potential to alleviate the perceived threat. Hence, this review investigates the role of affective computing in capturing the potential outcome of threat perception and associated empathetic responses. To gain a comprehensive understanding of the affective responses and biological motion evoked from threat scenarios, affective computing methods used to capture these neurophysiological and behavioural responses are discussed. A systematic review using Google Scholar and Web of Science was conducted as of 2023, and findings were supplemented by bibliographies of key articles. A total of 26 studies were analysed from initial web searches to explore the topics of empathy, threat perception, fight or flight, fear, aggression, and human motion. Relationships between affective behaviours (fear, aggression) and corresponding motor defensive behaviours (fight or flight) were examined within threat scenarios, and whether existing affective computing methods are effective in capturing these responses, identifying the varying consensus in the literature, challenges, and limitations of existing research. [ABSTRACT FROM AUTHOR]

Individual differences in preferences allow for integrative (win–win) solutions in negotiations. However, reaching an integrative solution is difficult as each party's preferences and limits are private and must be inferred. We hypothesized that teaching people to infer a generative model of how individuals appraise outcomes and express them as emotional expressions, i.e., an appraisal model, contributes to improving the capability of mental state inference and thus facilitates integrative solutions. In the present study, we compared participants’ performance in a 4-issue negotiation after training participants to infer appraisal model during three 2-issue negotiations with a visualized appraisal process and text feedback with the performance of those without inference learning. The results showed that training participants to infer appraisal model helped them better estimate their counterpart's preferences but did not lead them to negotiate more integrative solutions. [ABSTRACT FROM AUTHOR]

Psychology-oriented research extensively studied how affect influences human decision making. Particularly, the cognitive tuning assumption suggests that mood can serve to regulate between shallow and deliberative decisions – a more negative mood means higher deliberation. This work proposes a model that mimics the cognitive tuning assumption. To that end, the Collective Risk Dilemma (CRD) game For the Planet was designed and created, a process allowing for distinct levels of reasoning was defined and tested in that game, and mood was integrated to control the level of reasoning of such a process. Several distinct Artificial Intelligence (AI) profiles were created to verify that the developed model was able to dynamically change the level of reasoning and adjust the resulting AI behavior in our CRD game. Results revealed that the distinct AI profiles were influenced by their affective states and experienced circumstances, and that the emergent behaviors were consistent with the cognitive tuning assumption, thus demonstrating that we managed to construct an innovative and flexible model that can use mood to dynamically adjust the level of reasoning of an AI agent. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to explore polarization in the discourse of social media commentators over crimes of Revenge Porn. Revenge porn refers to "the nonconsensual sharing of intimate images" (Bond and Tyrrell 2021, 2166), videos, or other intimate material, which are weaponized against its victims. As with other crimes, revenge porn cases are highly discussed on social media, where users might (a) reproduce prejudice and stigma against victims or, contrarily, (b) resist victimblaming and shaming ideologies as a form of activism and call for empathy (Garcés-Conejos Blitvich and Bou-Franch 2019; Palomino-Manjón 2022). In light of this, this paper examines the discursive construction of the phenomenon of revenge porn and the evaluations proposed of victims and perpetrators on the social network YouTube with the aim of unveiling conflicting ideologies online. To this end, the present study analyzes a corpus of 14,000 comments (ca. 411,000 words) from four different YouTube videos tackling revenge porn cases. The paper adopts a Corpus-Assisted Discourse Studies (CADS) approach (Partington et al. 2013) and uses Sketch Engine to analyze the corpus. Additionally, a more detailed analysis of evaluative resources and linguistic patterns is carried out. Results show that polarized understandings of revenge porn abound in the corpus. Specifically, victim-blaming ideologies are discursively concealed, whereas traditional ideologies regarding sex are overtly encoded. Moreover, male users affiliate with newer constructions of masculinity and dissociate from the illegal actions attributed to perpetrators. Women/victims are generally derogated for not conforming to societal views of common-sensical sexual behavior or praised for their strength in standing social judgment. [ABSTRACT FROM AUTHOR]

This paper presents a systemic functional analysis of process types in academic texts in Spanish from the Appraisal Theory perspective in order to establish connections and observe the interaction of the experiential and interpersonal metafunctions and the systems of Transitivity and Attitude. Our purpose is to explore how student writers use process types to construe their specific disciplinary experience, how they inscribe attitudinal meanings in their texts, and how the Transitivity and Attitude systems interact in student choices in academic writing. We used student texts from the CLAE corpus (Ignatieva, Natalia & M. Cecilia Colombi (eds.). 2014. CLAE: El lenguaje académico en México y los Estados Unidos, un análisis sistémico funcional. Mexico: UNAM). The texts belong to two disciplines (literature and history) and to three text types, or genres, labeled in the university setting as essays, reviews, and question-answers. The methodology included a quantitative and qualitative analysis of 1) process type realizations, 2) expressions of Attitude, classified according to type (Affect, Judgment, Appreciation) and 3) interaction between the process types and Attitude types. This was followed by a comparative analysis between the disciplines and genres, detecting both the similarities and the differences. In addition, some patterns that combine process types and Attitude expressions were found. Such patterns could represent an important tool in the teaching of academic writing in Spanish. [ABSTRACT FROM AUTHOR]

L’objectif de cet article est d’analyser l’utilisation des adjectifs évaluatifs dans le cadre des recherches quantitatives et qualitatives fondées sur le corpus du discours juridictionnel français. Dans cette analyse, nous adopterons l’approche Appraisal (Martin & White 2005) qui s’intéresse aux marques linguistiques laissant entrevoir la présence subjective du sujet parlant dans le texte. Notre corpus comprend 100 arrêts de la Cour de cassation de 2018 à 2022 inclus. Nous utiliserons la plateforme AnaText pour l’analyse quantitative et ChatGPT pour l’analyse qualitative. Cette recherche nous permettra d’identifier les adjectifs évaluatifs les plus souvent utilisés par les juges et d’indiquer les cibles et la polarité de l’argumentation judiciaire.This article aims to analyse the use of evaluative adjectives in quantitative and qualitative research based on the corpus of French jurisdictional discourse. In this analysis, we adopt the Appraisal approach (Martin & White 2005), which focuses on linguistic marks that reveal the subjective presence of the speaker in the text. Our corpus comprises 100 judgments of the Court of Cassation from 2018 to 2022 inclusive. We use the AnaText platform for quantitative analysis and ChatGPT for qualitative analysis. This research allows us to identify the evaluative adjectives most often used by judges and to indicate the targets and polarity of judicial argumentation. [ABSTRACT FROM AUTHOR]

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Background: Real-world evidence (RWE) can reinforce clinical trial evidence in health technology assessment (HTA). Objectives: Review HTA bodies' (HTAbs) requirements for RWE, real uses, and acceptance across seven countries (Brazil, Canada, France, Germany, Italy, Spain, and the United Kingdom) and outline recommendations that may improve acceptance of RWE in efficacy/effectiveness assessments and appraisals processes. Methods: RWE requirements were summarized based on HTAbs' guidelines. Acceptance by HTAbs was evaluated based on industry experience and case studies. Results: As of June 2022, RWE methodological guidelines were in place in three of the seven countries. HTAbs typically requested analyses based on local data sources, but the preferred study design and data sources differed. HTAbs had individual submission, assessment, and appraisal processes; some allowed early meetings for the protocol and/or results validation, though few involved external experts or medical societies to provide input to assessment and appraisal. The extent of submission, assessment, and appraisal requirements did not necessarily reflect the degree of acceptance. Conclusion: All the countries reviewed face common challenges regarding the use of RWE. Our proposals address the need to facilitate collaboration and communication with industry and regulatory agencies and the need for specific guidelines describing RWE design and criteria of acceptance throughout the assessment and appraisal processes. [ABSTRACT FROM AUTHOR]