Stress inoculation during adolescence attenuates social stress-induced increase in ethanol intake in adult male mice

Social stress exposure heightens the risk of substance abuse disorder development, especially when endured during adolescence, influencing long-term mental health. This study investigates early-life stress's potential to confer resilience against later-life stressors. To investigate this hypothesis, we examined the impact of a single social defeat (SD) incident during adolescent mice's lives on subsequent voluntary ethanol consumption following repeated adult social stress exposure. Half of the adolescent mice experienced SD at postnatal day 28. Three weeks later (postnatal day 49), defeated groups encountered four confrontations with aggressive residents every 72 h, while control groups were exposed to non-resident exploration. A day after the last SD, defeated mice were classified as resilient or susceptible based on their response to a social interaction test (SIT), a model for depressive behavior. To assess ethanol consumption during young adulthood, researchers used the 'drinking in the dark' and oral ethanol self-administration paradigms. Stress inoculation (IS) slightly increased resilient animals in the SIT. In mice without IS exposure during adolescence, susceptible defeated mice displayed higher ethanol consumption and motivation than control and resilient mice. IS in adolescence effectively counteracted this effect, as IS-SD groups, whether resilient or susceptible, showed no increase in ethanol intake. These groups also exhibited similar motivation to control, measured by the progressive ratio. Notably, elevated IL-6 levels seen in SD-S mice were absent in IS-exposed mice. Additionally, IS-exposed groups had lower prefrontal cortex IL-6 and CX3CL1 levels. These findings support the hypothesis that IS, induced by moderate-intensity stress during adolescence, can enhance resilience to more severe stressors in adulthood.

Exploring homecare leaders' risk perception and the link to resilience and adaptive capacity: a multiple case study

BACKGROUND

Home-based healthcare is considered crucial for the sustainability of healthcare systems worldwide. In the homecare context, however, adverse events may occur due to error-prone medication management processes and prevalent healthcare-associated infections, falls, and pressure ulcers. When dealing with risks in any form, it is fundamental for leaders to build a shared situational awareness of what is going on and what is at stake to achieve a good outcome. The overall aim of this study was to gain empirical knowledge of leaders' risk perception and adaptive capacity in homecare services.

METHODS

The study applied a multiple case study research design. We investigated risk perception, leadership, sensemaking, and decision-making in the homecare services context in three Norwegian municipalities. Twenty-three leaders were interviewed. The data material was analyzed using thematic analysis and interpreted in a resilience perspective of work-as-imagined versus work-as-done.

RESULTS

There is an increased demand on homecare services and workers' struggle to meet society's high expectations regarding homecare's responsibilities. The leaders find themselves trying to maneuver in these pressing conditions in alignment with the perceived risks. The themes emerging from analyzed data were: 'Risk and quality are conceptualized as integral to professional work', 'Perceiving and assessing risk imply discussing and consulting each other- no one can do it alone' and 'Leaders keep calm and look beyond the budget and quality measures by maneuvering within and around the system'. Different perspectives on patients' well-being revealed that the leaders have a large responsibility for organizing the healthcare soundly and adequately for each home-dwelling patient. Although the leaders did not use the term risk, discussing concerns and consulting each other was a profound part of the homecare leaders' sense of professionalism.

CONCLUSIONS

The leaders' construction of a risk picture is based on using multiple signals, such as measurable vital signs and patients' verbal and nonverbal expressions of their experience of health status. The findings imply a need for more research on how national guidelines and quality measures can be implemented better in a resilience perspective, where adaptive capacity to better align work-as-imagined and work-as-done is crucial for high quality homecare service provision.

Psychosocial correlates of flourishing in the late lifespan

BACKGROUND

Flourishing is a primary dimension of psychological well-being that contributes massively to the development of an active, purposeful, and respectful life, full of meaning, values, and personal interests that nurture social ties.

AIMS

This study primarily intended to examine the contribution of satisfaction with family relations, resilience, metacognitive efficiency, and crystallized intelligence in predicting a flourishing measure in cognitively healthy older adults. Moreover, the impact of gender was investigated on flourishing, satisfaction with family ties, resilience, and metacognitive efficiency.

METHODS

One hundred and eighty 65-94-year-old community dwellers were recruited in Sardinia (Italy). Participants self-rated their flourishing, satisfaction with their family connections, psychological hardness (i.e., a dimension of resilience), and cognitive function, whereas global cognitive efficiency and vocabulary were assessed through two internationally validated objective tests.

RESULTS

A hierarchical regression analysis revealed that 30% of the variance in the flourishing condition was explained by satisfaction with family ties, resilience, and metacognitive efficiency. In addition, males exhibited higher flourishing and satisfaction with family ties than females, and the former group also reported being more autonomous and acting proactively to influence its destiny.

CONCLUSION

Emotional support and rewarding relations with family members, the ability to face stressful events, and a good perception of one's cognitive efficiency play a crucial role in promoting flourishing in late adulthood.

Effect of parenting style on the emotional and behavioral problems among Chinese adolescents: the mediating effect of resilience

BACKGROUND

Although previous studies have found that parenting style significantly predicts emotional and behavioral problems (EBPs) among Chinese adolescents, the mechanism between different parenting styles and EBPs requires in-depth investigation. In our study, we aimed to investigate the mediating effect of resilience, a positive psychological characteristic, between parenting style and EBPs among Chinese adolescents.

METHODS

In this cross-sectional study, we used a multistage stratified cluster random sampling method to collect data in Shenyang, Liaoning Province from November to December 2019. Self-developed questionnaires were distributed to 1028 adolescents aged 10-18. Finally, the study consisted of 895 participants. The bootstrap method was used to investigate the role of resilience as a mediator in the relationship between different parenting styles and EBPs from a positive psychology perspective.

RESULTS

The mean score of EBPs was 12.71 (SD = 5.77). After controlling for variables such as gender, age, left-behind children, family type and family income, resilience partially played a mediating role in the associations of paternal rejection (a × b = 0.051 BCa95%CI:0.023,0.080), maternal rejection (a × b = 0.055 BCa95%CI: 0.024, 0.086), paternal emotional warmth (a × b = -0.139 BCa95%CI: -0.182, -0.099) and maternal emotional warmth (a × b = -0.140 BCa95%CI: -0.182, -0.102), with EBPs. The effect sizes were11.28%, 11.51%, 40.76%, and 38.78%, respectively.

CONCLUSIONS

Resilience could partially mediate the relationship between parenting style and EBPs, highlighting that parents should adopt a positive parenting style and that resilience improvement could be effective in reducing EBPs among Chinese adolescents.

Perturbation and resilience of the gut microbiome up to 3 months after β-lactams exposure in healthy volunteers suggest an important role of microbial β-lactamases

BACKGROUND

Antibiotics notoriously perturb the gut microbiota. We treated healthy volunteers either with cefotaxime or ceftriaxone for 3 days, and collected in each subject 12 faecal samples up to day 90. Using untargeted and targeted phenotypic and genotypic approaches, we studied the changes in the bacterial, phage and fungal components of the microbiota as well as the metabolome and the β-lactamase activity of the stools. This allowed assessing their degrees of perturbation and resilience.

RESULTS

While only two subjects had detectable concentrations of antibiotics in their faeces, suggesting important antibiotic degradation in the gut, the intravenous treatment perturbed very significantly the bacterial and phage microbiota, as well as the composition of the metabolome. In contrast, treatment impact was relatively low on the fungal microbiota. At the end of the surveillance period, we found evidence of resilience across the gut system since most components returned to a state like the initial one, even if the structure of the bacterial microbiota changed and the dynamics of the different components over time were rarely correlated. The observed richness of the antibiotic resistance genes repertoire was significantly reduced up to day 30, while a significant increase in the relative abundance of β-lactamase encoding genes was observed up to day 10, consistent with a concomitant increase in the β-lactamase activity of the microbiota. The level of β-lactamase activity at baseline was positively associated with the resilience of the metabolome content of the stools.

CONCLUSIONS

In healthy adults, antibiotics perturb many components of the microbiota, which return close to the baseline state within 30 days. These data suggest an important role of endogenous β-lactamase-producing anaerobes in protecting the functions of the microbiota by de-activating the antibiotics reaching the colon. Video Abstract.

Effects of Resilience and Emotion Regulation on Perceptions of Positive and Negative Life Changes in Cancer Survivors: A Longitudinal Study

BACKGROUND

While many studies have investigated the sociodemographic, clinical, and psychosocial factors associated with perceived positive change after cancer, longitudinal work examining how emotion regulation, and resilience impact perceptions of life change among newly diagnosed cancer survivors is lacking.

PURPOSE

This study examined the prevalence of perceived positive and negative life changes following cancer and explored the role of emotion regulation and resilience on perceived change over 6 months.

METHODS

Data from 534 recent survivors of breast, prostate, or colorectal cancer (Mage = 59.3, 36.5% male) collected at baseline (Time 1) and 6-month follow-up (Time 2) were analyzed. Multivariate linear regressions were estimated separately to examine if resilience or emotion regulation were associated with perceived change at Time 2 after controlling for relevant sociodemographic and psychosocial measures.

RESULTS

At both time points, greater than 90% of participants reported at least one perceived positive change while fewer than a third reported a negative change. Indices of emotion regulation and resilience were positively related to perceived positive change at both time points and negatively related to perceived negative change at Time 1. Emotion regulation but not resilience was negatively associated with perceived negative change at Time 2.

CONCLUSIONS

Findings suggest that cancer survivors who are less resilient and struggle with emotion regulation are more susceptible to perceptions of fewer positive and greater negative life changes after cancer. As such, psychosocial interventions should be developed to promote resilience and emotional regulation in cancer survivors.

Mediating roles of sleep quality and resilience in the relationships between chronotypes and mental health symptoms

Sleep and mental health are intrinsically intertwined, but not every individual with problems sleeping develops a mental health disorder. This study examined the association among chronotypes, resilience, sleep quality and mental health symptoms amongst otherwise healthy individuals. Two hundred adults (Mage = 27.75 ± 5.11, 68% female) with no previous diagnosis of mental illness were recruited and filled in a set of questionnaires measuring chronotypes, sleep quality, depression and anxiety symptoms. The findings from the path analysis showed that the morning type had a statistically significant direct effect on a range of sleep quality indices. These included better subjective sleep quality, shortened sleep latency, and fewer daytime dysfunctions, as well as a higher level of resilience. However, it did not significantly affect depression and anxiety symptoms. In addition, the morning type had statistically significant indirect effects on a higher level of resilience and fewer depression and anxiety symptoms through the mediating effect of sleep quality indices. Findings from this study support that morning type is associated with better resilience and psychological health, which is mediated through better sleep quality.

Discussion: Harnessing microbiome-mediated adaptations in insect pollinators to mitigate climate change impact on crop pollination

Insect pollinators, vital for agriculture and biodiversity, face escalating threats from climate change. We argue and explore the pivotal role of the microbiomes in shaping adaptations of insect pollinator resilience amid climate-induced challenges (climate change and habitat alteration). Examining diverse taxonomic groups, we unravel the interplay between insect physiology, microbiomes, and adaptive mechanisms. Climate-driven alterations in microbiomes impact insect health, behavior, and plant interactions, posing significant effects on agricultural ecosystems. We propose harnessing microbiome-mediated adaptations as a strategic approach to mitigate climate change impacts on crop pollination. Insights into insect-pollinator microbiomes offer transformative avenues for sustainable agriculture, including probiotic interventions (use of EM PROBIOTIC) and microbiome engineering (such as engineering gut bacteria) to induce immune responses and enhanced pollination services. Integrating microbiome insights into conservation practices elucidates strategies for preserving pollinator habitats, optimizing agricultural landscapes, and developing policies to safeguard pollinator health in the face of environmental changes. Finally, we stress interdisciplinary collaboration and the urgency of understanding pollinator microbiome dynamics under climate change in future research.

Compounding effects of stress on diet, physical activity, and wellbeing among African American parents: a qualitative study to inform the LEADS health promotion trial

The purpose of the study was to conduct in-depth qualitative interviews to understand the lived experiences of African American parents of overweight adolescents who had previously participated in a family-based weight loss program and to utilize these insights to inform the essential elements of the LEADS trial, an integrated resilience stress management and health promotion intervention. Participants (N = 30) were African American parents and/or caregivers (96.7% female; Mage = 49.73, SD = 10.88; MBMI = 37.63, SD = 8.21) of adolescents with overweight and/or obesity. Interviews were transcribed and coded using inductive and deductive approaches for themes by two independent coders. Inter-rater reliability was acceptable (r = 0.70-0.80) and discrepancies were resolved to 100% agreement. Prominent stress themes included caregiver responsibilities, work, interpersonal family conflict, and physical and emotional consequences of chronic stress. Participants also noted decreases in physical activity and poor food choices due to stress. Coping mechanisms included prayer/meditation, church social support, and talking with family/partner. Results highlight the importance of mitigating stress among African American parents through stress management and cultural/familial resilience approaches to increase the likelihood of engagement in behavioral strategies in health promotion programs. Future studies should assess the utility of incorporating stress management components and health promotion techniques to improve health outcomes among African American families.

Alexithymia and negative emotions among nursing students: a moderated mediation model

Nursing students, who comprise a high percentage of China's college students, experience many psychological problems; however, few studies explored the mechanisms underlying these problems. This cross-sectional study explored the relationships and mechanisms of depression, anxiety, stress, and narrative disorders in senior nursing students. Questionnaires were administered to 380 senior nursing students in Hubei Province using the Sociodemographic Questionnaire, Toronto Alexithymia-20 Scale, Perceived Social Support Scale, 10-Item Connor-Davidson Resilience Scale, and Depression-Anxiety-Stress Scale. After controlling for sociodemographic variables, Hayes' PROCESS macros were used to test how psychological resilience moderates the relationships among narrative disorders, negative affect, and perceived social support. Bootstrap confidence intervals tested for indirect effects. Correlation analyses revealed that alexithymia was correlated significantly positively with depression-anxiety-stress (r = 0.57, 0.56, and 0.58, resp.) and significantly negatively with perceived social support (r = 0-0.46). Psychological resilience was correlated significantly negatively with alexithymia (r=-0.39) and depression-anxiety-stress (r=-0.31, -0.30, and-0.32, resp.) but significantly positively with perceived social support(r = 0.50). Perceived social support was correlated significantly negatively with depression-anxiety-stress (r=-0.33, -0.34, and - 0.42 resp.). Stress was correlated significantly positively with anxiety and depression (r = 0.81 and 0.77, resp.). Psychological resilience was a partial mediator between depression and dysphoria (β=-0.08, p < 0.05). Dysphoria directly predicted anxiety (β = 0.31) and stress (β = 0.37); moreover,alexithymia predicted depression not only directly but also through the mediating effect of psychological resilience. Therefore, educators and clinical administrators must promote and recognise negative emotions among nursing students to help ensure the nursing workforce's stability.

Association of β-globin polymorphisms and tolerance to haemonchosis in ewes and lambs of different sheep breeds

Gastrointestinal nematodes (GIN), especially Haemonchus contortus, represent a significant challenge for sheep production. Given the global concern about GIN anthelmintic resistance, alternative control methods able to reduce the dependence on these drugs are highly advisable. Since previous studies have shown that sheep carrying the Hb-A allele of β-globin are more resistant to H. contortus, this study aimed to investigate the relationship between the different haplotypes (Hb-AA, Hb-AB and Hb-BB) and phenotypes in Santa Inês (SI), Texel (TX) and White Dorper (DO) breeds infected with H. contortus. Blood samples were collected from 180 ewes and 123 lambs of the three breeds for DNA extraction followed by qPCR using a hydrolysis probe to identify the β-globin haplotypes. Phenotypic data, including fecal egg count (FEC), packed cell volume (PCV), FAMACHA score and body condition score for ewes and lambs, as well as weight gain for lambs, were collected. The genotypic frequencies of β-globin for ewes and lambs were, respectively: 21.7% and 21.4% Hb-AA, 50% and 50% Hb-AB and 28.3% and 28.6% Hb-BB in SI; 0% and 0% Hb-AA, 18.6% and 9.4% Hb-AB and 81.4% and 90.6% Hb-BB in TX; and 0% and 0% Hb-AA, 13.1% and 0% Hb-AB and 86.9% and 100% Hb-BB in DO. In ewes, mean PCV differed (p<0.05) between the three haplotypes, with higher PCV in Hb-AA animals, followed by Hb-AB and Hb-BB. When considering each breed separately, SI Hb-AA ewes presented higher PCV (p<0.05), highlighting that even in a breed already considered resistant, animals with Hb-AA haplotype showed superior performance. Lambs with the Hb-AA haplotype exhibited a higher (p<0.05) mean PCV compared to those with Hb-AB and Hb-BB. The same pattern was found in SI when analyzing each breed separately. No significant association was found between β-globin haplotypes and FEC, FAMACHA score, body condition score, or weight gain. Nevertheless, given that anemia is the major clinical sign of haemonchosis, our findings on PCV reinforce that sheep carrying the Hb-A allele of β-globin are more tolerant to haemonchosis. This study may support the development of a valuable tool, targeting genetic selection for GIN control, reducing the dependence on anthelmintics and boosting sheep production worldwide.

Practical strategies to achieve resilient health systems: results from a scoping review

BACKGROUND

This paper presents the results of a systematic review to identify practical strategies to create the institutions, skills, values, and norms that will improve health systems resilience.

METHODS

A PRISMA 2020 compliant systematic review identified peer-reviewed and gray literature on practical strategies to make health systems more resilient. Investigators screened 970 papers to identify 65 English language papers published since 2015.

RESULTS

Practical strategies focus efforts on system changes to improve a health system's resilience components of collective knowing, collective thinking, and collaborative doing. The most helpful studies identified potential lead organizations to serve as the stewards of resilience improvement, and these were commonly in national and local departments of public health. Papers on practical strategies suggested possible measurement tools to benchmark resilience components in efforts to focus on performance improvement and ways to sustain their use. Essential Public Health Function (EPHF) measurement and improvement tools are well-aligned to the resilience agenda. The field of health systems resilience lacks empirical trials linking resilience improvement interventions to outcomes.

CONCLUSIONS

The rigorous assessment of practical strategies to improve resilience based on cycles of measurement should be a high priority.

Resilience in patients and family caregivers living with congenital disorders of glycosylation (CDG): a quantitative study using the brief resilience coping scale (BRCS)

BACKGROUND

Patients and family caregivers living with Congenital Disorders of Glycosylation (CDG) experience a heavy burden, which can impact their resiliency and quality of life. The study's purpose was to measure the resilience levels of patients and family caregivers living with CDG using the brief resilience coping scale.

METHODS

We conducted an observational, cross-sectional study with 23 patients and 151 family caregivers living with CDG. Descriptive analyses were performed to characterize patients with CDG and family caregivers' samples. Additionally, we assessed correlations between resilience and specific variables (e.g., age, academic degree, time until diagnosis) and examined resilience differences between groups (e.g., sex, marital status, occupation, professional and social support).

RESULTS

GNE myopathy was the most prevalent CDG among patients, while in family caregivers was PMM2-CDG. Both samples showed medium levels of resilience coping scores. Individuals with GNE myopathy had significantly higher scores of resilience compared to patients with other CDG. Resilience was positively correlated with educational degree in patients with CDG. Family caregivers had marginally significant higher scores of resilience coping if they received any kind of professional support or had contact with other families or people with the same or similar disease, compared with unsupported individuals.

CONCLUSIONS

Despite the inherited difficulties of living with a life-threatening disease like CDG, patients and family caregivers showed medium resilient coping levels. Resilience scores changed significantly considering the CDG genotype, individual's academic degree and professional and social support. These exploratory findings can empower the healthcare system and private institutions by promoting the development of targeted interventions to enhance individuals` coping skills and improve the overall well-being and mental health of the CDG community.

Supporting social emotional learning and wellbeing of displaced adolescents from the middle east: a pilot evaluation of the 'forward with peers' intervention

BACKGROUND

A growing literature points to the critical role schools can play in promoting improved psychosocial wellbeing and resilience among first- and second-generation Arab immigrant and refugee adolescents, but few evaluations have examined the effectiveness of culturally adapted, school-based interventions.

METHODS

We conducted a pilot evaluation of a culturally adapted social and emotional learning and life skills program, Forward with Peers (FwP), and examined its potential effectiveness for this population. FwP was evaluated across three high schools in the Detroit Metropolitan Area. Within each school, one Arabic class was randomly assigned to receive FwP programming and another served as a control. The pilot evaluation sought to examine changes in several mental health and psychosocial outcomes of interest.

FINDINGS

Improvements in overall perceived social support (P = 0.045) and perceived social support from someone special in one's life (0.042) were statistically significant in the treatment as compared to the control group. Comparative improvements were also marginally significant for resilience (P = 0.095) and perceived social support from family (P = 0.074).

CONCLUSIONS

Findings highlight the potential of FwP and support the growing interest in establishing efficacy of school-based, culturally appropriate SEL programming to improve psychosocial wellbeing among Arab refugee and immigrant adolescents. FwP's demonstrated improvements in resilience and social support have the potential to prevent mental health disorders and bolster coping mechanisms to minimize adverse consequences in this vulnerable population. Employing a strengths-based approach, FwP offers an alternative intervention to traditional treatment-oriented supports for the proliferation of mental health disorders within this vulnerable population.

Resilient responses to stressful events among chiropractic students: A cross-sectional survey

OBJECTIVE

Resilient students may better navigate the challenges of chiropractic training. This study explored the relationships between response to stressful experiences, perceived stress, and quality of life among students at 1 US chiropractic college campus.

METHODS

A cross-sectional survey was conducted with 873 students. The anonymous online questionnaire included demographics, quality of life, perceived stress, and the Response to Stressful Events Scale (RSES). Hierarchical multiple regression analyses assessed for significant relationships among variables.

RESULTS

A sample of 221 students (60% female) completed the survey (25% response rate). Male respondents reported greater psychological health. Participants reporting high quality of life exhibited higher resiliency on the RSES flat score and many RSES domains. Respondents who rated greater psychological health and social relationships exhibited greater spiritual resiliency. Respondents reporting higher psychological health and lower levels of perceived stress exhibited higher self-efficacy resilience. Psychological health was the most important predictor for RSES flat score and domains, except for spiritual resilience, for which social relationships were most important. Male gender was predictive of 3 RSES domains: meaning making, active coping, and cognitive flexibility.

CONCLUSION

More resilient responses to stressful events were reported by male chiropractic students and those who reported greater psychological health, higher quality of life, or lower perceived stress. Female students and those experiencing psychological challenges or lower quality of life might consider resilience training to increase the use of protective coping strategies. These findings may permit academic institutions to identify students at highest risk and employ interventions to prevent program withdrawal.

Behavioural traits related with resilience or vulnerability to the development of cocaine-induced conditioned place preference after exposure of female mice to vicarious social defeat

Exposure to stress induced by intermittent repeated social defeat (IRSD) increases vulnerability to the development of cocaine-induced conditioned place preference (CPP) among male mice; however, some defeated mice are resilient to these effects of stress. In the present study we evaluated the effects of vicarious IRSD (VIRSD) in female mice and explored behavioural traits that are potentially predictive of resilience. C57BL/6 female mice (n = 28) were exposed to VIRSD, which consisted of the animals witnessing a short experience of social defeat by a male mouse on postnatal day (PND) 47, 50, 53 and 56. The control group (n = 10) was not exposed to stress. Blood samples were collected on PND 47 and 56 for corticosterone and interleukin-6 determinations. On PND 57-58, female mice performed several behavioural tests (elevated plus maze, hole-board, object recognition, social interaction, TST and splash tests). Three weeks later, the effects of cocaine (1.5 mg/kg) on the CPP paradigm were assessed. VIRSD decreased corticosterone levels (on PND 56), increased interleukin-6 levels, enhanced novelty-seeking, improved recognition memory and induced anxiety- and depression-like symptoms. Control and VIRSD female mice did not acquire CPP, although some stressed individuals with certain behavioural traits - including a high novelty-seeking profile or the development of depression-like behaviour in the splash test shortly after VIRSD - acquired cocaine CPP. Our results confirm that some behavioural traits of female mice are associated with vulnerability or resilience to the long-term effects of social stress on cocaine reward, as previously observed in males.

Resilience strengthening in youth with a chronic medical condition: a randomized controlled feasibility trial of a combined app and coaching program

Youth with a chronic medical condition (CMC) are often affected by comorbid mental disorders. Resilience-strengthening interventions can protect youth's mental health, yet evidence-based programs remain scarce. To address this lack, this study aimed to evaluate the feasibility of a dual approach combining app-based resilience training and cognitive behavioral group coaching. Fifty-one youths with CMC treated at a German university children's hospital aged 12-16 years were recruited. They were randomly assigned to a combined app game and coaching intervention or sole app gameplay. At pre-, post-intervention, and at a 2-month follow-up resilience, automatic negative thoughts and an app and coaching evaluation were assessed. Feasibility was defined as a recruitment rate of 70%, an 85% adherence rate for the REThink game, and 70% participation in both coaching sessions. Feasibility criteria were reached for coaching participation but not for recruitment or app adherence. While both the REThink game app and coaching intervention had high acceptance rates among youth with CMC, participants receiving additional coaching sessions showed higher satisfaction and adherence rates. Participants preferred remote to in-person meetings. The findings support a combination of a gamification app approach with online group coaching. Group coaching can improve adherence while online options increase accessibility. Future research should focus on testing in diverse participant samples, language, and age-adapted updates of the REThink game app. These findings provide guidance for increasing adherence in future intervention studies in youth with CMC cohorts.

Positive and adverse childhood experiences and mental health outcomes of children

OBJECTIVE

Researchers and policymakers have identified adverse childhood experiences (ACEs) like abuse, neglect, and household dysfunction as a contributing factor to poor mental health outcomes for children. Positive childhood experiences (PCEs) like open family communication styles, having the ability to live and play in a safe, stable, and protective environment, having constructive opportunities for social engagement, and receiving mentorship from adults have been found to improve the mental health of children.

PURPOSE

This paper explores the role of ACEs and PCEs on the mental health outcomes of children.

METHOD

A sample of 22,628 children ages 6-17 from the National Survey of Children's Health (2017-2020) was used to explore the relationship between PCEs and ACEs and the mental health of children. Logistic regression analysis is used to model the effect of PCEs and ACEs on the odds of child mental health diagnoses.

RESULTS

Findings indicate that with each additional ACE, there was a significant increase in the odds of reporting a MH condition (OR = 1.25, 95 % CI 1.09-1.43). Conversely, with each additional PCE, there is a significant decrease in the odds or reporting a MH condition (OR = 0.76, 95 % CI 0.68-0.84). There was also evidence that PCEs moderate the relationship between ACEs and reports of mental health conditions. When counts of ACEs are low, PCEs provide a protective effect on reports of mental health. But when the count of ACEs are high, children with higher numbers of PCEs have similar reports of mental health conditions.

SUMMARY

This study provides information about the moderating effect of PCEs on the relationship between ACEs and child mental health diagnosis with the goal of informing policies and interventions focused on ameliorating the growing crisis of children's negative mental health and well-being. WHAT IS KNOWN?: Adverse childhood events (ACEs) like abuse, neglect and household dysfunction are known to negatively impact the mental health and well-being of children. Positive childhood experiences (PCEs), on the other hand, can positively influence the mental health and well-being of children. WHAT DOES THIS ARTICLE ADD?: This study examines the association between adverse and positive childhood experiences to understand how they impact the mental health outcomes of children ages 6-17. Findings indicate that when ACEs are lower, the impact of PCEs are positive, but when ACEs are higher, PCEs do not make much difference in reports of mental health problems.

Resilience, Self-Efficacy, and Symptoms of Anxiety and Depression in Older Adults during COVID-19 Confinement

OBJECTIVE

This study examined the relationship between resilience, self-efficacy, anxiety, and depression to test whether self-efficacy affected anxiety and depression and compared how the participants in different age groups experienced anxiety, as well as the differences in anxiety between employed and unemployed participants.

METHOD

A cross sectional web-based survey study that included adults aged 60 years or older living in Puerto Rico was performed during April and May 2020.

RESULTS

A total of 299 older adults completed the online questionnaire (14% men, 83.6% women). Of the total sample, 25.4% reported having moderate to severe symptoms of anxiety, while 20.8% reported having moderate to severe symptoms of depression. Our path analysis model suggested that while self-efficacy did not directly affect anxiety, it had an impact on resilience, thereby reducing anxiety symptoms. The participants who were 71 years old or older had lower anxiety levels than their younger counterparts did. We also confirmed that work might serve as a protective factor against anxiety.

CONCLUSION

Our findings underscore the importance of resilience, self-efficacy, and working later in life to promote well-being and successful aging.

Climate Change Adaptation Methods for Public Health Prevention in Australia: an Integrative Review

PURPOSE OF REVIEW

Climate change poses a serious threat to human health and well-being. Australia is not immune to the public health impacts and continues to be underprepared, putting the population health at risk. However, there is a dearth in knowledge about how the Australian public health system will address the impacts of climate change.

RECENT FINDINGS

This integrative review synthesises tools, frameworks, and guidance material suitable for climate change adaptation from a preventive public health perspective. The literature search was conducted in electronic databases MEDLINE, PubMed, CINAHL, and Web of Science. Of 4507 articles identified, 19 articles met the inclusion criteria that focused on operational methods in public health and excluded the clinical context and reactive disaster response approaches. This review revealed that Australia is ill-prepared to manage climate change adverse health impacts due to ineffective adaptation strategies. The review highlights that Australia urgently requires effective adaptation strategies such as undertaking a National Adaptation Plan process and an improved understanding in managing complex health risks. Taking this action will strengthen the public health system and build health resilience especially for vulnerable populations. These findings will help understand and develop of the necessary adaptive strategies in Australia.

Interested to start a venture but worried about the future: Investigating the role of resilience in fear of career uncertainty and entrepreneurial intention

Entrepreneurship is inherently characterised by immense uncertainty. Thereby, fear becomes an obvious experience and poses a significant threat to entrepreneurial intention (EI). This study aimed to extend this understanding by exploring how specific fears, such as fear of career uncertainty and fear of perceived inability, affect EI and how resilience impacts these fears and their interaction with EI. This study tested a mediation model on a sample of young university students in Bangladesh (n = 553), using a two-phase survey (before and after the COVID-19 pandemic) and applying the partial least squares - structural equation model in Smart PLS 4. The findings indicated that fear of career uncertainty had a significant negative influence, and resilience had a significant positive influence on EI. Additionally, resilience reduced both fear of career uncertainty and fear of perceived inability and, transformed fear of career uncertainty into a positive driver toward EI. In contrast to the extant evidence that suggested fear as a threat to EI, this study indicated that not all forms of fear are detrimental to EI and that experience of fear can be mitigated. This study suggested that resilient students can overcome fear concerning their careers and focus on establishing new ventures.

Duration of the psychosis prodrome and its relationship to duration of untreated psychosis across all 12 DSM-IV psychotic diagnoses: Evidence for a trans-diagnostic process associated with resilience

While duration of the psychosis prodrome (DPP) attracts attention in relation to the developmental trajectory of psychotic illness and service models, fundamental issues endure in the context of dimensional-spectrum models of psychosis. Among 205 epidemiologically representative subjects in the Cavan-Monaghan First Episode Psychosis Study, DPP was systematically quantified and compared, for the first time, across all 12 DSM-IV psychotic diagnoses. DPP was also compared with duration of untreated psychosis (DUP) and each was then analysed in relation to premorbid features across three age ranges: <12, 12-15 and 16-18 years. For each diagnosis, medians for both DPP and DUP were shorter than means, indicating common right-skewed distributions. Rank orders for both DPP and DUP were longest for schizophrenia, intermediate for other schizophrenia-spectrum psychoses, psychotic depression and psychotic disorder not otherwise specified, and shortest for brief psychotic disorder, bipolar disorder and substance-induced psychotic disorder, though with overlapping right-skewed distributions. DPP was longer than DUP for all diagnoses except substance-induced psychotic disorder. Across functional psychotic diagnoses, longer DPP was predicted by higher premorbid intelligence and better premorbid adjustment during age 16-18 years. These findings indicate that, trans-diagnostically, DPP and DUP share right-skewed continuities, in accordance with a dimensional-spectrum model of psychotic illness, and may reflect a unitary process that has been dichotomized at a subjective threshold along its trajectory. Better premorbid functioning during age 16-18 years appears to confer resilience by delaying progression to overt psychotic symptoms and may constitute a particular target period for psychosocial interventions.

A systematic review of studies on resilience and risk and protective factors for health among refugee children in Nordic countries

The Nordic welfare model is often used as an example for the promotion of health and wellbeing, even in vulnerable groups of children, such as refugees. Nonetheless, there are no published reviews on resilience and/or risk and protective factors for physical and mental health among refugee children living in Nordic countries. In this systematic review, we identified 5181 studies on the topic, screened titles, and abstracts, viewed 632, and finally included 26 studies. These studies described 18 samples with a total of 34,080 individuals ranging in ages 0-18 years. Overall, the studies were of good quality. Nearly all studies assessed adversity. Six studies reported physical health outcomes and all studies mental health outcomes, most often post-traumatic stress disorder and anxiety. None explicitly studied resilience. While we found that age and sex are the most frequently studied  risk- and protective factors, findings are inconclusive, since the direction of the associations was different in the different studies. This systematic review indicates that there is still a need for well-designed and -powered studies using clear definitions of key study concepts to examine health outcomes and resilience among refugee children in Nordic countries.

Harnessing the Humanities to Foster Staff Resilience: An Annual Arts and Humanities Rounds at a Children's Hospital

Working in healthcare can be fulfilling, meaningful, and sometimes exhausting. Creative endeavors may be one way to foster personal resilience in healthcare providers. In this article, we describe an annual arts and humanities program, the Ludwig Rounds, developed at a large academic children's hospital. The event encourages staff to reflect on resilience by sharing their creative work and how it had an impact on their clinical careers. The multidisciplinary forum also allows staff to connect and learn about each other. We discuss the development of the program, its format and logistics, and lessons learned over the past 15 years.

Self-driven solutions and resilience adapted by people with drug-resistant tuberculosis and their caregivers in Bengaluru and Hyderabad, India: a qualitative study

Background

One-fifth of people with drug-resistance tuberculosis (DR-TB) who were initiated on newer shorter treatment regimen (with injection) had unfavourable treatment outcomes in India as on 2020. Evidence on self-driven solutions and resilience adapted by people with DR-TB (PwDR-TB) towards their multi-dimensional disease and treatment challenges are scarce globally, which we aimed to understand.

Methods

In this qualitative study using positive deviance framework, we conducted semi-structured in-depth interviews among consenting adult PwDR-TB (7 women, 13 men) who completed shorter treatment regimen (including injections) with maximum treatment adherence. The study was conducted in the southern districts of Bengaluru and Hyderabad, India between June 2020 and December 2022. Caregivers (14 women, 6 men) and health providers (8 men, 2 women) of PwDR-TB were also interviewed. Interviews were conducted in local language (Kannada, Tamil, Telugu, Urdu and Hindi) and inquired about practices, behaviours, experiences, perceptions and attributes which enabled maximum adherence and resilience of PwDR-TB. Interviews were audio recorded, transcribed, and translated to English and coded for thematic analysis using inductive approach.

Findings

Distinctive themes explanatory of the self-driven solutions and resilience exhibited by PwDR-TB and their caregivers were identified: (i) Self-adaptation towards the biological consequences of drugs, by personalised nutritional and adjuvant practices, which helped to improve drug ingestion and therapeutic effects. Also home remedies and self-plans for ameliorating injection pain. (ii) Perceptual adaptation towards drugs aversion and fatigue, by their mind diversion practices, routinisation and normalisation of drug intake process. and constant reinforcement and re-interpretation of bodily signs of disease recovery (iii) Family caregivers intense and participatory care for PwDR-TB, by aiding their essential life activities and ensuring survival, learning and fulfilling special nutritional needs and goal oriented actions to aid drug intake (iv) Health care providers care, marked by swift and timely risk mitigation of side-effects and crisis response (v) Acquired self-efficacy of PwDR-TB, by their decisive family concerns resulting in attitudinal change. Also being sensitised on the detrimental consequences of disease and being motivated through positive examples.

Interpretation

Synthesised findings on self-driven solutions and resilience towards the multi-dimensional DR-TB challenges provides opportunity for developing and testing new interventions for its effectiveness in DR-TB care settings globally. Designing and testing personalised cognitive interventions for PwDR-TB: to inculcate attitudinal change and self-efficacy towards medication, developing cognitive reinforcements to address the perception burden of treatment, skill building and mainstreaming the role of family caregivers as therapeutic partners of PwDR-TB, curating self-adaptive behaviours and practices of PwDR-TB to normalise their drug consumptions experiences could be the way forward in building resilience towards DR-TB.

Funding

United States Agency for International Development (USAID) through Karnataka Health Promotion Trust (KHPT), Bengaluru, India.

Association of maternal pre-pregnancy body mass index with resilience and prosociality of the offspring aged 6-7 years old: a population-based cohort study in Japan

The association between maternal pre-pregnancy obesity and child behavior problems has been widely researched, leaving a gap in understanding the positive aspects of children's mental health. The present study aimed to investigate the association between maternal pre-pregnancy body mass index (BMI) and resilience and prosociality among 6-7 year-old children in Japan. A retrospective cohort study was conducted using data from the Adachi Child Health Impact of Living Difficulty (A-CHILD) study, a population-based study in 2017 and 2019 including all first-grade students in public schools in Adachi, Tokyo, Japan (n = 7328, response rate = 84.7%). Resilience and prosociality were measured by the Children's Resilient Coping Scale and the Strength and Difficulties Questionnaire, respectively. Maternal pre-pregnancy weight and height were reported based on the Mother and Child Health Handbook, and BMI was categorized as underweight (BMI < 18.5), normal weight (BMI 18.5-24.9), overweight (BMI 25.0-29.9), and obesity (BMI ≥ 30). Linear regression models were employed to control for covariates. Maternal pre-pregnancy obesity was found to be negatively associated with child resilience (coefficient: - 3.29; 95% CI - 6.42--0.15), while maternal underweight was negatively associated with child prosociality (coefficient: - 0.12; 95% CI - 0.24--0.005) compared to mothers of pre-pregnancy normal BMI. Perinatal factors, such as gestational weight gain, gestational age, and birth weight, did not mediate the association. Our findings suggest that maternal pre-pregnancy obesity is linked to decreased resilience and maternal underweight is linked to decreased prosociality in children aged 6-7 years. Maintaining an appropriate BMI range before pregnancy may be crucial for enhancing resilience and prosociality of offspring.

Effects of interventions for enhancing resilience in cancer patients: A systematic review and network meta-analysis

BACKGROUND

Various interventions appear to enhance cancer patients' resilience. However, the best intervention options are still unknown. This systematic review and network meta-analysis aimed to examine the impact of different interventions on resilience and identify the most effective interventions.

METHODS

Nine major English and Chinese databases were systematically retrieved for randomized controlled trials (RCTs) published from inception to 13 November 2023. The outcome was resilience. The analysis was conducted using Software Review Manager 5.4, R 4.2.3, and STATA 14.0.

RESULTS

The network meta-analysis included 32 RCTs and evaluated 12 interventions. Regarding effectiveness, compared to routine care, the relative effect sizes of attention and interpretation therapy, cyclic adjustment training, cognitive intervention, expressive therapy, positive psychological intervention, social support intervention, and work-environment therapy had statistically significant enhancing resilience, with the SMD (95%CI) of 1.42 (0.75, 2.07), 1.97 (0.76, 3.18), 1.26 (0.76, 1.77), 0.93 (0.08, 1.78), 1.02 (0.55, 1.50), 1.01 (0.48, 1.56), 1.65 (0.94, 2.37), respectively. Considering the rank probability, statistical power, and efficacy, the most effective interventions for improving resilience were attention and interpretation therapy, cognitive intervention, and positive psychological intervention. With the limited quantity of RCTs, the effectiveness of cyclic adjustment training and work-environment therapy still needs to be explored.

CONCLUSIONS

Attention and interpretation therapy was the first best choice for boosting resilience out of the 12 interventions. Cognitive intervention and positive psychological intervention were also better choices for improving cancer patients' resilience. Due to the low quality and quantity of included RCTs, the need for multi-center, higher-quality trials with larger samples should be carried out.

PROSPERO ID

CRD42023434223. The study did not receive funding support.

The effect of sleep problems on core self-evaluations in undergraduate nursing students and the role of emotion regulation and resilience: A cross-sectional study

BACKGROUND

Nursing students are prone to sleep problems that affect their core self-evaluations. However, little attention has been paid to the specific roles of emotion regulation (including cognitive reappraisal and expressive suppression) and resilience in this process.

OBJECTIVES

This study aimed to explore 1) the direct effect of sleep problems on core self-evaluations among nursing students; 2) the chain-mediating effect of cognitive reappraisal and resilience on the relationship between sleep problems and core self-evaluations; 3) the moderating effect of expressive suppression on the direct relationship between sleep problems and core self-evaluations; and 4) the moderating effect of expressive suppression on the indirect relationship between sleep problems affecting core self-evaluations through resilience.

METHODS

A total of 345 nursing students completed a survey conducted between September and October 2022. Data was analyzed using descriptive analysis, Fisher exact test, Kruskal-Wallis H test, Spearman correlation analysis, and hierarchical regression analysis. Additionally, the SPSS PROCESS V4.0 plug-in was used to verify the moderated chain-mediating effect.

RESULTS

Sleep problems directly affected core self-evaluations among nursing students. Cognitive reappraisal and resilience played a partial chain-mediating role in the relationship between sleep problems and core self-evaluations, with expressive suppression having a direct moderating effect.

CONCLUSIONS

Opportunities exist for enhancing the core self-evaluations of nursing students by addressing their sleep problems, promoting cognitive reappraisal strategies, and increasing resilience. Additionally, encouraging expressive suppression can mitigate the negative impact of sleep problems on nursing students' core self-evaluations.

Analysis of genetic diversity in patients with major psychiatric disorders versus healthy controls: A molecular-genetic study of 1698 subjects genotyped for 100 candidate genes (549 SNPs)

BACKGROUND

This study analyzed the extent to which irregularities in genetic diversity separate psychiatric patients from healthy controls.

METHODS

Genetic diversity was quantified through multidimensional "gene vectors" assembled from 4 to 8 polymorphic SNPs located within each of 100 candidate genes. The number of different genotypic patterns observed per gene was called the gene's "diversity index".

RESULTS

The diversity indices were found to be only weakly correlated with their constituent number of SNPs (20.5 % explained variance), thus suggesting that genetic diversity is an intrinsic gene property that has evolved over the course of evolution. Significant deviations from "normal" diversity values were found for (1) major depression; (2) Alzheimer's disease; and (3) schizoaffective disorders. Almost one third of the genes were correlated with each other, with correlations ranging from 0.0303 to 0.7245. The central finding of this study was the discovery of "singular genes" characterized by distinctive genotypic patterns that appeared exclusively in patients but not in healthy controls. Neural Nets yielded nonlinear classifiers that correctly identified up to 90 % of patients. Overlaps between diagnostic subgroups on the genotype level suggested that (1) diagnoses-crossing vulnerabilities are likely involved in the pathogenesis of major psychiatric disorders; (2) clinically defined diagnoses may not constitute etiological entities.

CONCLUSION

Detailed analyses of the variation of genotypic patterns in genes along with the correlation between genes lead to nonlinear classifiers that enable very robust separation between psychiatric patients and healthy controls on the genotype level.

Cognitive Functioning and Psychosocial Outcomes in Adults with Complex Congenital Heart Disease: A Cross-sectional Pilot Study

Adults with complex congenital heart disease (CHD) are at risk for cognitive dysfunction. However, associations between cognitive dysfunction and psychosocial outcomes are poorly defined. Between June and November 2022, we prospectively recruited 39 adults with complex CHD who completed a computerized cognitive assessment (Cogstate) and validated psychosocial scales measuring psychological distress, health-related quality of life (HRQOL), and resilience. Participants had a mean age of 36.4 ± 11.2 years. Over half (62%) were women, most (79%) had complex biventricular CHD, and 21% had Fontan physiology. Prevalence of cognitive dysfunction was greatest in the domains of attention (29%), working memory (25%), and psychomotor speed (21%). Adjusting for age and sex, Pearson partial correlations between Cogstate z-scores and self-reported cognitive problems were small. Participants who lived in the most disadvantaged areas and those with a below-average annual household income had lower global cognitive z-scores (p = 0.02 and p = 0.03, respectively). Two-thirds (64%) reported elevated symptoms of depression, anxiety, and/or stress. Small correlations were observed between psychological distress and cognitive performance. Greater resilience was associated with lower psychological distress (r ≥ -0.5, p < 0.001) and higher HRQOL (r = 0.33, p = 0.02). Our findings demonstrate that adults with complex CHD have a high risk of cognitive dysfunction, though may not recognize or report their cognitive challenges. Lower socioeconomic status may be an indicator for those at risk of poorer cognitive functioning. Psychological distress is common though may not be a strong correlate of performance-based cognitive functioning. Formal cognitive evaluation in this patient population is essential. Optimizing resilience may be a protective strategy to minimize psychological distress and bolster HRQOL.

"HIV has taught us that you can survive anything": findings from auto-ethnographic video diaries exploring resilience among people living with HIV during the Covid pandemic in five countries

This study aimed to elucidate the intrinsic and extrinsic resilience resources among people living with HIV (PLWH) during the Covid pandemic. Autoethnographic video diaries from 29 PLWH from Argentina, UK, Philippines, Zimbabwe, and Trinidad and Tobago were included. Data were thematically analysed and validated with community partners and a video was co-produced. PLWH displayed a readiness to adopt healthy behaviours and engage in optimistic and constructive thinking about the future. Hobbies and daily activities, supportive relationships with peers living with HIV, family and friends, opportunities to mobilise and contribute to their communities in meaningful ways, supportive healthcare providers and reliable access to antiretroviral treatment helped foster psychological resilience among PLWH. The extrinsic resilience resources also supported positive physical health outcomes among PLWH through improved medication adherence.

Changes in Body Mass Index and Incident Mild Cognitive Impairment Among African American Older Adults

BACKGROUND

Previous research suggests a decline in body mass index (BMI) among older adults is associated with negative health outcomes, including mild cognitive impairment (MCI) and incident dementia. However, no studies have examined the effects of education or developing MCI on BMI trajectories over time. The purpose of this investigation was to characterize trajectories of change in BMI among older adults who develop MCI.

METHODS

Participants were from the Minority Aging Research Study (MARS), a longitudinal cohort study of cognitive decline and Alzheimer's disease in older African Americans living in the greater Chicago, Illinois, area. The study included annual clinical evaluations of cognitive status, as well as measurements of height and weight for BMI calculation. Older African American participants without cognitive impairment at baseline were included in the present analysis (N = 436, 78% women, mean baseline age = 72 [SD = 5.7], mean education = 15 [SD = 3.5]).

RESULTS

In piecewise linear mixed-effects models that included a random intercept and 2 random slopes, BMI declined over time (B = -0.20, SE = 0.02, p < .001), with a faster decline after MCI diagnosis (additional decline, B = -0.15, SE = 0.06, p = .019). Older age was associated with lower baseline BMI (B = -0.19, SE = 0.05, p < .001), as was higher education (B = -0.34, SE = 0.09, p < .001). Further, higher education was associated with a slower decline in BMI before MCI (B = 0.02, SE = 0.006, p = .001), but a faster decline after MCI (B = -0.06, SE = 0.022, p = .003).

CONCLUSIONS

These results suggest an accelerated decline in BMI following an MCI diagnosis, with higher education related to an even faster BMI decline.

Physical activity as a promoter of stress resilience: An analysis of behavioral effects and brain connectivity with cytochrome c-oxidase activity in adult male Wistar rats

Physical activity (PA) is very beneficial for physical and mental health. This study aims to examine the resilience-inducting effect of PA in adult male Wistar rats exposed to unpredictable chronic mild stress (UCMS). Furthermore, we analyzed the influence of PA on behavioral tasks and functional brain connectivity with cytochrome c oxidase technique. The cytochrome c oxidase (CCO) is a mitochondrial enzyme involved in oxidative phosphorylation and ATP generation. For this analysis, we included five groups: Basal (n = 10, to determine the basal level of brain activity), Behav (n = 15, subjected exclusively to behavioral tests), PA (n = 10, exposed to physical activity), UCMS (n = 15, subjected to a stress protocol) and PA + UCMS (n = 15, exposed to PA prior to stress). The UCMS protocol consisted of randomly presenting several different stressors over four consecutive weeks. We evaluated several behaviors of the Behav, UCMS, and PA + UCMS groups. This assessment includes the hedonic responses using the sucrose consumption task, unconditioned anxiety with the zero maze, and coping strategies assessed with the cat odor test. The UCMS group showed an anhedonia profile and increased anxiety compared with the other groups. Although in the exposure to cat odor test, the PA + UCMS remained for the same time in the cat odor compartment as the other groups, it did not approach the odor, showing that it detected the risk. This response is more adaptive than the responses of the UCMS and Behav groups. An exploratory analysis of the cerebral connections showed an increase in CCO activity in the UCMS group compared to the other groups. This overactivity was reduced in dorsal Cornu Ammonis 3(dCA3) by prior PA. In this region, PA + UCMS showed similar activity as the groups not subjected to chronic stress. Therefore, PA can prevent the harmful effects of chronic stress on dCA3.

Reactivity of Health-Related Quality of Life to Perceived Stress: The Buffering Role of Psychosocial Resources in a Longitudinal Study of Adults with and Without HIV

People with HIV now have increased longevity; however, their health-related quality of life (HRQoL) still lags significantly compared to people without HIV. Perceived stress negatively impacts HRQoL, whereas psychosocial resources are linked to better HRQoL. This longitudinal analysis aims to explore the buffering role of psychosocial resources on the relationship between HRQoL and perceived stress. Participants (N = 240) included 142 persons with HIV (PwH) and 98 without HIV, M(SD) = 50.9(8.1) years. Multilevel models over four study years examined longitudinal relationships between HRQoL (outcome) and perceived stress (predictor) and potential moderation by psychosocial resources (personal mastery, social support, and resilience) by HIV serostatus. Among PwH only, personal mastery (p = 0.001), social support (p = 0.015), and resilience (p = 0.029) were associated with an attenuated effect of perceived stress (less negative slopes) for physical HRQoL over time. Bolstering personal mastery, social support, and resilience may have relevance for improving physical well-being among PwH.

Scoping review on trauma and recovery in youth after natural disasters: what Europe can learn from natural disasters around the world

In the last decade, Europe has seen a rise in natural disasters. Due to climate change, an increase of such events is predicted for the future. While natural disasters have been a rare phenomenon in Europe so far, other regions of the world, such as Central and North America or Southeast Asia, have regularly been affected by Hurricanes and Tsunamis. The aim of the current study is to synthesize the literature on child development in immediate stress, prolonged reactions, trauma, and recovery after natural disasters with a special focus on trajectories of (mal-)adaptation. In a literature search using PubMed, Psychinfo and EBSCOhost, 15 studies reporting about 11 independent samples, including 11,519 participants aged 3-18 years, were identified. All studies identified resilience, recovery, and chronic trajectories. There was also evidence for delayed or relapsing trajectories. The proportions of participants within each trajectory varied across studies, but the more favorable trajectories such as resilient or recovering trajectory were the most prevalent. The results suggested a more dynamic development within the first 12 months post-disaster. Female gender, a higher trauma exposure, more life events, less social support, and negative coping emerged as risk factors. Based on the results, a stepped care approach seems useful for the treatment of victims of natural disasters. This may support victims in their recovery and strengthen their resilience. As mental health responses to disasters vary, a coordinated screening process is necessary, to plan interventions and to detect delayed or chronic trauma responses and initiate effective interventions.

A 2-year mental health follow-up study subsequent to COVID-19

The COVID-19 pandemic has profoundly impacted the mental health and education of college students. This study examined the interrelationships among loneliness, resilience, and COVID-19 fear among college students in Northern Michigan, a region of the United States severely affected by the pandemic. Data were collected from two student cohorts (n = 258), with half surveyed in early 2022 and the other half in mid-2022, two years after pandemic's onset. The Omicron wave peaked in Michigan in January 2022, but by June 2022, cases, hospitalizations, and deaths had significantly declined. Students completed measures of loneliness, resilience, learning difficulty, and psychological symptoms. Key findings are: 1) Participants' fear, loneliness, and academic difficulty decreased over time, reflecting fluctuations in acute situational and emotional states; 2) Unexpectedly, resilience declined from early to mid-2022, suggesting its diminishing protective role under prolonged, pandemic-induced stress; 3) Despite improvements, students continued reporting high academic difficulties. Loneliness, heightened fear, and dampened happiness together contributed to greater academic difficulties; 4) Pre-existing sex differences equalized two years after the pandemic's onset. While modest improvements were noted, enduring academic and mental health impacts signal a need for continued support.

Care stressors and perceived stress among family caregivers of Chinese older adults with disabilities: The mediation effect of resilience

OBJECTIVES

Guided by the Stress Process Model, this study examined the mediating effect of resilience on the relationship between care stressors and perceived caregiving stress.

METHODS

Data were based on 234 older adults with disabilities and their caregivers from 6 urban districts and 6 rural counties from Jinan, China. Descriptive analysis, analysis of variance, ordinary least squares regression, and mediation analysis were performed.

RESULTS

Perceived stress among family caregivers of Chinese older adults with disabilities was affected by the physical and mental health of both themselves and the care recipients, as well as care intensity and financial difficulties. Resilience played a partial mediating role in the associations among three stressors (i.e. older adults' disability levels, number of chronic diseases, and caregivers' self-reported mental) and perceived caregiving stress.

CONCLUSIONS

Enhanced resilience aids caregivers' adaptation to their roles, suggesting the need for societal, spiritual, emotional, and behavioral resilience training.

Examining resilience and burnout in parents of children with chronic disease

AIM

The study determines the relationship between resilience and burnout in parents of children with chronic diseases and the influencing factors.

METHOD

The study was conducted with a descriptive design. The study population consisted of the parents of children with any chronic illness who applied to the pediatric outpatient clinics of a state hospital located in a province in the northeast of Turkey. The study sample consisted of 207 parents who came to the hospital between October 2020 and June 2022, who met the criteria, and agreed to participate. "Descriptive Information Form," "Family Resilience Scale (FRS)," and "Burnout Inventory (BI)" were employed to collect data. The data were analyzed using the SPSS for Windows 22 package program.

RESULTS

37.2% of the parents participating in the study were in the age group of 30-39 years, 52.2% were female, 93.2% had no other children with chronic diseases, 20.3% were diagnosed with asthma, and the duration of the diagnosis was between 1 and 4 years in 44.4%. The participants scored 130.64 ± 25.73 points in the Family Resilience Scale and 36.16 ± 7.78 points in the overall Burnout Inventory.

CONCLUSION

It was determined that parents' resilience was high and their burnout was moderate. Burnout decreases as resilience increases in parents of children with chronic diseases.

PRACTICE IMPLICATIONS

To strengthen family resilience and reduce parental burnout, nurses should support and provide holistic care to parents with chronically ill children.

Psychometric validation of the Arabic multiple sclerosis resiliency scale: Uncovering resilience factors in Lebanese MS patients for clinical and research advancements

Background

Multiple sclerosis (MS) is an autoimmune demyelinating disease that involves the central nervous system (CNS). Individuals with Multiple Sclerosis (MS) may experience difficulty adapting to their diagnosis as the unpredictable nature of the disease can be challenging to cope with.

Methods

The purpose of this study is twofold. First, we have culturally adapted and analyzed the Arabic version of the Multiple Sclerosis Resiliency Scale (MSRS) psychometric properties. Second, we aimed to explore resilience in a sample of Lebanese patients with MS in the face of the chronic disease and financial hardship that Lebanon is going through to evaluate their strengths and struggles. The sample consisted of 306 participants aged between 18 and 79 diagnosed with MS for at least one year.

Results

After examining criterion validity, construct validity, internal consistency, and test-retest reliability, the Arabic version of the MSRS exhibited good psychometric properties. The study also revealed that resilience increases with age and lower disability scores. Additionally, individuals with higher resilience levels displayed lower levels of depression. The research revealed that MS patients have high resilience, mainly relying on cognitive and emotional strategies, social support from family and friends, MS peer support, and spirituality.

Conclusion

These findings highlight the importance of emotional coping strategies and social support in building resilience among MS patients.

Farmers´ sense of the biological impact of extreme heat and seasonality on Swedish high-yielding dairy cows - A mixed methods approach

Supporting dairy farmers in becoming resilient towards extreme weather requires a broad understanding of the experiences and perceived risks associated with these events from those who undergo them. We used a mixed methods approach to explore national trends of biological consequences on dairy cow udder health and fertility, combined with in-depth farmer conversations around extreme weather events, focusing on heat. The aim is to provide a comprehensive picture of how dairy farmer perceptions, priorities and decision-making are related to the season and extreme weather to identify preventive pathways that can reduce biological costs of heat stress on Swedish dairy cattle during summer. Data collected monthly at cow and farm level between 2016-2019 as part of the Swedish milk and disease recording system confirm seasonal trends and show increased somatic cell counts (SCC) and negatively impacted fertility during summers. In addition, transcriptions of 18 interviews with dairy farmers across the country and seasonal variations of SCC and fertility were thematically analysed. The results suggest that farmers have a broad definition of extreme weather and are aware of the negative impacts. Yet handling of extreme weather events can mainly be classified as reactive. Nevertheless, there are long-term effects on the farm economy, health and herd dynamics. Swedish dairy farmers are currently showing resilience, albeit a fragile one. The capability to ensure sufficient feed production in extreme weather is critical for farm self-perceived resilience. However, acknowledging the long-term biological costs related to fertility, currently not perceived by farmers, has the potential to support proactive planning and improve farm resilience and profitability.

Association of adverse and positive childhood experiences with health-related quality of life in adolescents

OBJECTIVES

To investigate the independent impacts of adverse childhood experiences (ACEs) and positive childhood experiences (PCEs) on the health-related quality of life (HRQOL) of Chinese adolescents, and to explore the potential moderating role of PCEs in the association between ACEs and HRQOL.

STUDY DESIGN

This was a cross-sectional study.

METHODS

We surveyed 6982 students aged 11-20 in Guangzhou, China, from November to December 2021. Adolescents self-reported their ACEs, PCEs, and HRQOL by the Childhood Trauma Questionnaire Short Form, the Adverse Childhood Experiences-International Questionnaire, the Benevolent Childhood Experiences Scale, and the Paediatric Quality of Life Inventory Version 4.0, respectively. Multivariable linear regressions were performed to examine the associations between ACEs, PCEs, and HRQOL controlled for adolescents' age, gender, single-child status, boarding school attendance, primary caregivers, as well as parental age and occupational status. Likelihood-ratio tests were further applied to explore the moderating role of PCEs.

RESULTS

In the models that considered both ACEs and PCEs, ACEs were significantly associated with lower HRQOL scores in all dimensions, summary scales, and total scale (β = -13.88, 95% confidence interval [CI]: -14.82, -12.94 for total scale). Conversely, exposure to an above-average number of PCEs was associated with higher HRQOL scores in all measured aspects (β = 7.20, 95%CI: 6.57, 7.84 for total scale). PCEs significantly moderated the association between ACEs and all HRQOL dimensions, summary scales, and total scale, except school functioning.

CONCLUSION

ACEs and PCEs exert independent and opposite impacts on adolescents' HRQOL. PCEs could mitigate the negative impacts of ACEs. Enhancing resilience, like PCEs, may contribute to improving the HRQOL among adolescents who have exposed to ACEs.

Childhood emotional abuse and depression among Chinese adolescent sample: A mediating and moderating dual role model of rumination and resilience

BACKGROUND

Childhood emotional abuse (CEA) has been identified as a distal risk factor for later depression in adolescents. However, the underlying psychological mechanisms between CEA and adolescent depression are still poorly understood.

OBJECTIVES

This study aimed to explore the roles of rumination and resilience played in the association between CEA and depression among Chinese adolescents.

PARTICIPANTS AND SETTING

The sample included 919 students (52.56 % boys) with an average age of 13.47 years from a central province in China.

METHODS

Participants completed multiple measurements of CEA, rumination, resilience, and depression. Multivariate path analysis was applied to examine the relations among these variables.

RESULTS

Results showed (a) CEA was significantly positively related to adolescent depression; (b) Rumination partially mediated the relationship between CEA and depression and moderated the relationship between resilience and depression; (c) Resilience partially mediated the relationship between CEA and depression and moderated the relationship between rumination and depression.

CONCLUSIONS

The results revealed that both rumination and resilience played not only mediating but also moderating roles in the relationship between CEA and depression among Chinese adolescent sample, suggesting that the indirect effects of CEA on depression via resilience and rumination are dependent on each other. Hence, these findings deepened the understanding of the psychological mechanisms between CEA and depression and had several practical implications.

The Phenotype of a Bone Marrow Transplant Nurse: Survival of the Fittest

There is a need for proficient nursing practice in specialized critical care settings, such as a pediatric Bone Marrow Transplant (BMT) Unit. The staffing crisis continues to be problematic for areas around the country. Nursing tenure has been positively correlated with improving patient outcomes and confidence in giving care, so efforts must be made to retain pediatric BMT nurses. The purpose of this study was to investigate factors of resilience and how it pertains to the retention of pediatric BMT nurses through (1) Understanding current BMT nursing turnover and trend why nurses are leaving; (2) Measure resilience throughout BMT nursing cohort, covering all tenure of nurses; and (3) Interview senior nurses within the cohort to identify themes relating to retention and resilience using grounded theory methodology. This research was carried out in the Bone Marrow Transplant (BMT) Unit at Cincinnati Children's Hospital Medical Center (CCHMC). The study spanned from 2014 to 2019, during which researchers gathered extensive data to evaluate the turnover risk among BMT nurses. A detailed follow-up was conducted in 2019 to further assess this risk. To measure resilience levels, a group of 115 nurses in the unit completed the Connor Davidson Resilience Scale (CD-RISC). Additionally, in-depth interviews were conducted with 9 senior nurses in the cohort, continuing until theoretical saturation was reached, ensuring a comprehensive understanding of the factors influencing nurse turnover in the unit. Researchers looked retrospectively at nursing turnover from 2014 to 2019. Investigators determined the risk of new nurses leaving was between 22 and 24 months (HR 0.025). Further, follow-up was conducted for data points between 2019-present time, which showed a drastic change in the hazard rate curvature. However, the risk remained relatively the same at 22 to 24 months (HR 0.03). There was no statistical significance found between CD-RISC results and age (P = .465), gender (P = .725), working experience (P = .15), or education (P = .14). Through a constant comparative process, several themes were identified as positive, negative, and ambiguous contributions to the retention of nurses. The risk of nurses leaving after 2 years decreases significantly; therefore, we determined that a nurse with a commitment to pediatric BMT occurs with 2 years' experience. Although our initial hypothesis was that senior nurses had greater resilience than less tenured nurses, there was no statistical significance as the effect of resilience is small. However, we identified several additional factors pertinent to the pediatric BMT field which may be associated with nursing retention.

Through the looking glass: qualitative study of critical care clinicians engaging in humanities

PURPOSE

Critical care medicine is facing an epidemic of burnout and consequent attrition. Interventions are needed to re-establish the medical field as a place of professional growth, resilience, and personal well-being. Humanities facilitate creation, reflection, and meaning-making, holding the promise of personal and community transformation. This study aimed to explore how clinicians engage with a humanities program, and what role and impact do the humanities play in their individual and collective journey.

METHODS

This is a qualitative study employing a phenomenological approach. Participants were faculty and trainees who participated in the program. Data consisted of (a) 60-h observations of humanities evenings, (b) more than 200 humanities artifacts brought by participants, and (c) 15 in-depth participant interviews. Data were analyzed inductively and reflectively by a team of researchers.

RESULTS

Participants were motivated to engage with the humanities curriculum because of past experiences with art, identifying a desire to re-explore their creativity to make meaning from their clinical experiences and a wish to socialize with and understand their colleagues through a different lens. The evenings facilitated self-expression, and inspired and empowered participants to create art pieces and re-engage with art in their daily lives. More importantly, they found a community where they could be vulnerable and supported, where shared experiences were discussed, emotions were validated, and relationships were deepened between colleagues.

CONCLUSIONS

Humanities may impact resilience and personal and community well-being by facilitating reflection and meaning-making of challenging clinical work and building bonds between colleagues.

Cognitive trajectories in longitudinally trained 3xTg-AD mice

Preclinical studies in Alzheimer's disease (AD) often rely on cognitively naïve animal models in cross-sectional designs that can fail to reflect the cognitive exposures across the lifespan and heterogeneous neurobehavioral features observed in humans. To determine whether longitudinal cognitive training may affect cognitive capacities in a well-characterized AD mouse model, 3xTg and wild-type mice (n = 20) were exposed daily to a training variant of the Go-No-Go (GNG) operant task from 3 to 9 months old. At 3, 6, and 9 months, performance on a testing variant of the GNG task and anxiety-like behaviors were measured, while long-term recognition memory was also assessed at 9 months. In general, GNG training improved performance with increasing age across genotypes. At 3 months old, 3xTg mice showed slight deficits in inhibitory control that were accompanied by minor improvements in signal detection and decreased anxiety-like behavior, but these differences did not persist at 6 and 9 months old. At 9 months old, 3xTg mice displayed minor deficits in signal detection, and long-term recognition memory capacity was comparable with wild-type subjects. Our findings indicate that longitudinal cognitive training can render 3xTg mice with cognitive capacities that are on par with their wild-type counterparts, potentially reflecting functional compensation in subjects harboring AD genetic mutations.

Farm forests, seasonal hunger, and biomass poverty: Evidence of induced intensification from panel data in the Ethiopian Highlands

Seasonal hunger is the most common food insecurity experience for millions of small dryland farmers. This study tests the relationships between food insecurity, farm forests, and biomass poverty using a longitudinal dataset from the Amhara region of Ethiopia. These data form part of the Ethiopia Socioeconomic Survey, which collected panel data over three survey rounds from 530 households between 2011 and 2016. This dataset represents a collection of unique socioeconomic, wellbeing, and micro-land use measures, including farm forests. Hierarchical mixed effect regression models assessed the relationship between food insecurity and farm forests as well as the conditional effects of biomass poverty among the poorest farmers and women-headed households. Over a six-year study period, farmers reported increased stress from smaller land holdings, higher prices, and climate-related shocks. A clear trend towards spontaneous dispersed afforestation is observed by both researchers and satellite remote sensing. Model results indicate, dedicating approximately 10% of farm area to forest reduces months of food insecurity by half. The greatest reductions in food insecurity from farm forests are reported by ultra-poor and crop residue-burning households, suggesting that biomass poverty may be a major constraint to resilient food security on these farms. This research provides novel quantitative evidence of induced intensification and food security impacts of farm management preserving and building stores of biomass value as green assets. The results reported here have important implications for nature-based solutions as a major strategy to achieve sustainable development in some contexts.

The association between psychological resilience and hair cortisol concentration in adults: A systematic review and meta-analysis

BACKGROUND

Resilience measures are typically based on subjective self-assessment, which is prone to bias. Objective biological/physiological measures of resilience are therefore needed. Hair cortisol concentration is a particularly promising candidate as a biomarker for resilience.

METHODS

We conducted a meta-analytic review from inception to April 2023 in PubMed, EMBASE, Cochrane Library, and Psych Info databases. All data were analyzed using a random-effects model.

RESULTS

Eight studies were identified that included a total of 1,064 adults. The random effects model demonstrated that resilience and hair cortisol concentration were inversely correlated (r = -0.18, 95% confidence interval [CI] = -0.27 to -0.09) with substantial heterogeneity (I2 = 54.2%, p = 0.03). The inverse association was stronger in those who were age 40 years or younger compared to those who were over 40 years. The correlation coefficients between psychological resilience and hair cortisol concentration among adults assessed by different resilience measures were r = -0.29 (95% CI = -0.49 to -0.08) for the CD-RISC-10; r = -0.21 (95% CI = -0.31 to -0.11) for the CDRISC- 25, and r = -0.08 (95% CI = -0.22 to 0.06) for the BRS. Six of eight studies examined the connection between resilience and perceived stress, where the weighted mean correlation coefficient was r = -0.45 (95% CI = -0.56 to -0.33), with considerable heterogeneity (I2 = 76.2%, p = 0.001).

CONCLUSIONS

There is a negative association between psychological resilience and hair cortisol concentration based on these eight studies. Additional research, particularly prospective studies, is needed to determine whether hair cortisol concentration can be used as a biomarker for psychological resilience.

How does physical activity improve adolescent resilience? Serial indirect effects via self-efficacy and basic psychological needs

Background

Resilience is vital for improving mental health and well-being during adolescence, which is an important yet vulnerable period. Previous research has indicated that physical activity enhances individual resilience. However, limited studies have examined underlying psychological mechanisms between them. The current study aimed to investigate the effect of physical activity on adolescent resilience via self-efficacy and basic psychological needs.

Methods

A cross-sectional survey was conducted with 1,732 high school students aged 16 to 20 years old (mean age: 16.51 ± 0.77 years), with nearly equal number of boys (47.63%) and girls (52.37%). They each completed the Physical Exercise Questionnaire, Basic Psychological Needs in Exercise Scale, General Self-Efficacy Scale, and Resilience Scale, respectively. A serial indirect model was constructed to examine how physical activity influences resilience.

Results

Structural equation model analysis revealed that physical activity significantly and directly predicted resilience. When self-efficacy and basic psychological needs were included in the model, both direct and indirect effects were observed. Specifically, the positive relationship between physical activity and resilience was partially mediated by self-efficacy and basic psychological needs. In addition, basic psychological needs and self-efficacy were found to serially mediate the direct relathonship between physical activity and resilience.

Conclusions

The present study provides novel theoretical insights into sports psychology by establishing a link between basic psychological needs and self-efficacy. The findings have implications for school administrators and physical education instructors in designing targeted interventions to promote adolescent resilience. These interventions may involve creating supportive environment conductive to fulfilling students' basic psychological needs, implementing strategies to enhance self-efficacy beliefs, and providing opportunities for skill development and mastery experiences in sports and physical activities.

Necessary condition analysis of organisational capabilities for a resilient service operation in the hotel industry in Ghana

Resilience in service operation is essential for minimising service failures. Based on a necessity logic, this study sought to examine whether innovation, transparency, flexibility, collaboration and agility are necessary antecedents of resilience in service operations of hotels, and to determine the minimum level of each capability required for optimal level of resilience. A survey of managers of Star-rated hotels in the Greater Accra region of Ghana was conducted. The conditions (agility, transparency, innovation, collaboration and flexibility) and outcome (resilience) variables were operationalised and modelled as necessary determinants of service resilience. Structured questionnaires were administered, from which 167 validated responses was analysed with necessary condition analysis (NCA) package in R. NCA explores necessity relationships both 'in kind' and 'in degree' to identify underlying capabilities and the corresponding levels that must be developed and sustained. The study found innovation, transparency, collaboration, flexibility, and agility to be necessary determinants of service resilience. However, from lower to medium levels of resilience (30%-80%), transparency, collaboration, flexibility, and agility are identified as bottlenecks. Innovation becomes important when higher resilience goals are sought. From a managerial standpoint, this study provides insight into critical antecedents of resilience within service operations. In addition, the study sheds light on the degree of resource allocation appropriate for different levels of firm resilience.

An integrative decision-making framework to guide policies on regulating ChatGPT usage

Generative artificial intelligence has created a moment in history where human beings have begin to closely interact with artificial intelligence (AI) tools, putting policymakers in a position to restrict or legislate such tools. One particular example of such a tool is ChatGPT which is the first and world's most popular multipurpose generative AI tool. This study aims to put forward a policy-making framework of generative artificial intelligence based on the risk, reward, and resilience framework. A systematic search was conducted, by using carefully chosen keywords, excluding non-English content, conference articles, book chapters, and editorials. Published research were filtered based on their relevance to ChatGPT ethics, yielding a total of 41 articles. Key elements surrounding ChatGPT concerns and motivations were systematically deduced and classified under the risk, reward, and resilience categories to serve as ingredients for the proposed decision-making framework. The decision-making process and rules were developed as a primer to help policymakers navigate decision-making conundrums. Then, the framework was practically tailored towards some of the concerns surrounding ChatGPT in the context of higher education. In the case of the interconnection between risk and reward, the findings show that providing students with access to ChatGPT presents an opportunity for increased efficiency in tasks such as text summarization and workload reduction. However, this exposes them to risks such as plagiarism and cheating. Similarly, pursuing certain opportunities such as accessing vast amounts of information, can lead to rewards, but it also introduces risks like misinformation and copyright issues. Likewise, focusing on specific capabilities of ChatGPT, such as developing tools to detect plagiarism and misinformation, may enhance resilience in some areas (e.g., academic integrity). However, it may also create vulnerabilities in other domains, such as the digital divide, educational equity, and job losses. Furthermore, the finding indicates second-order effects of legislation regarding ChatGPT which have implications both positively and negatively. One potential effect is a decrease in rewards due to the limitations imposed by the legislation, which may hinder individuals from fully capitalizing on the opportunities provided by ChatGPT. Hence, the risk, reward, and resilience framework provides a comprehensive and flexible decision-making model that allows policymakers and in this use case, higher education institutions to navigate the complexities and trade-offs associated with ChatGPT, which have theoretical and practical implications for the future.