Mental health and resilience quotient of patients in primary care units during the widespread COVID-19 pandemic in Thailand: a cross-sectional study

BACKGROUND

The coronavirus disease 2019 pandemic impacted both the physical and mental health of individuals. The resilience quotient (RQ) is an important factor that decreases mental health problems. This study aimed to explore mental health problems and RQ in patients who visit Primary Care Units (PCU).

METHODS

A cross-sectional study was conducted on participants aged 18 to 60 years who visited the PCU of Songklanagarind Hospital from May 1, 2022, to June 31, 2022. Participants completed a self-administered questionnaire on baseline characteristics and the Primary Care Assessment, Personal Resource Questionnaire, satisfaction with life scale, Thai RQ, PHQ-9, and GAD-7, and the results were analyzed by descriptive, logistic regression, and Spearman's rank correlation.

RESULTS

Among the 216 participants, 72.2% were female, and the median age was 39 (24,51) years old. Most of them had normal RQ levels (61.1%). Of these, 4.2% and 12.1% exhibited moderate to high levels of depression and anxiety, respectively. This study found that sex (OOR 1.93; 95% CI 1.01-3.74), age (OOR 1.03; 95% CI 1.01-1.06), moderate and high social support levels (OOR 9.51; 95% CI 3.36-28.85), and a high life satisfaction level (OOR 4.67; 95%CI 1.75-13.25) were associated with RQ. Moreover, the results showed that ≥ 3 times visiting PCU (β 1.73; 95% CI 0.39-3.08), BMI (β 0.13; 95% CI 0.04-0.23) and experiencing stressful events (β 2.34; 95% CI 1.32-3.36) were positively associated with depression. Finally, experiencing stressful events (OR 4.1; 95% CI 1.09-15.47) significantly affected anxiety, however, moderate and high life satisfaction levels acted as a protective factor against anxiety (OR 0.19; 95% CI 0.07-0.54 and OR 0.03; 95% CI 0.01-0.16, respectively).

CONCLUSION

Although there were a few patients with moderate to severe levels of depression and anxiety, most of them had normal RQ levels. However, there were some patients with low RQ levels which correlated to a high risk of psychiatric diseases such as depression and anxiety. Healthcare providers should focus on interventions that enhance resilience in both proactive and defensive strategies to reduce negative mental problems during these formidable times.

Regulation and resilience: Panarchy analysis in forest socio-ecosystem of Northeast National Forest Region, China

This paper examines the socio-ecological resilience within China's Northeast National Forest Region (NNFR), focusing on the implications of climate change for forest management and carbon sequestration. It offers a critical assessment of the Natural Forest Protection Program (NFPP) and the associated logging ban policy, recognizing their pivotal contributions to forest conservation but also identifying the shortcomings of a one-size-fits-all approach. Integrating panarchy theory, the study proposes sustainable management practices that align ecological dynamics with societal needs, emphasizing nature-based solutions. The overarching aim is to bolster the long-term resilience and enhance the carbon sequestration potential of the NNFR's forests. It aims to inform global environmental strategy with lessons from the NNFR, advocating for integrated approaches that ensure both ecological sustainability and community prosperity. This approach seeks to provide a comprehensive and effective strategy for addressing environmental challenges, ensuring both ecological integrity and community well-being.

Azerbaijani adaptation of the WHO-5 wellbeing index: investigating its relationship with psychological distress, resilience, and life satisfaction

BACKGROUND

The WHO-5 Wellbeing Index is a widely used tool for assessing psychological well-being. Despite its global application, its adaptation and validation for the Azerbaijani population had not been previously explored. This study aims to fill this gap by adapting the WHO-5 Wellbeing Index for Azerbaijani adults and examining its relationship with psychological distress, resilience, and life satisfaction.

METHODS

A sample of 875 Azerbaijani adults aged 18 to 89 (mean age = 29.13, SD = 10.98) participated in this study. The adaptation process included confirmatory factor analysis to test the original 5-item structure of the index in the Azerbaijani context. Additionally, item response theory analysis was employed to evaluate the discriminative values of the items. Reliability was assessed through various methods, including Cronbach's alpha, McDonald's omega, and Guttmann's lambda.

RESULTS

Confirmatory factor analysis supported the original 5-item structure of the WHO-5 Wellbeing Index for the Azerbaijani sample, demonstrating alignment with the index's original version. All items showed acceptable discriminative values in item response theory analysis. The index also exhibited sufficient reliability, as evidenced by Cronbach's alpha, McDonald's omega, and Guttmann's lambda. Correlation and network analyses indicated significant associations of the WHO-5 Wellbeing Index with psychological distress, resilience, and life satisfaction. Specifically, the index was negatively correlated with depression, anxiety, and stress, and positively correlated with resilience and life satisfaction.

CONCLUSION

The findings suggest that the WHO-5 Wellbeing Index is a valid and reliable tool for assessing psychological well-being in the Azerbaijani population. Its significant associations with psychological distress, resilience, and life satisfaction further affirm its utility in this cultural context.

Physician resilience and perceived quality of care among medical doctors with training in psychosomatic medicine during the COVID-19 pandemic: a quantitative and qualitative analysis

BACKGROUND

At an individual level, physician resilience protects against burnout and against its known negative effects on individual physicians, patient safety, and quality of care. However, it remains uncertain whether physician resilience also correlates with maintaining a high level of healthcare quality during crises such as a pandemic. This study aimed to investigate whether higher resilience among physicians, who had received training in resilience-related competences in the past, would be associated with higher quality of care delivered during the COVID-19 pandemic.

METHODS

This study enrolled physicians working in family medicine, psychiatry, internal medicine, and other medical specialties, who had obtained at least one of three consecutive diplomas in psychosomatic medicine in the past. Participants completed a quantitative and qualitative anonymous online survey. Resilience was measured using the Connor-Davidson Resilience Scale, and healthcare quality was assessed through single-item quality indicators, including perceived quality of care, professional autonomy, adequate time for patient care, and job satisfaction.

RESULTS

The study included 229 physicians (70 males/159 females) with additional training in psychosomatic medicine, working in family medicine (42.5%), psychiatry (28.1%), internal medicine (7.0%), or other medical specialties (22.4%). Participants represented four intensity levels of training background (level 1 to level 4: 9.2%, 32.3%, 46.3%, and 12.2% of participants). Training background in psychosomatic medicine was positively associated with resilience (B = 0.08, SE = 0.04, p <.05). Resilience and training background independently predicted perceived quality of care, even after controlling for variables such as own health concerns, involvement in the treatment of COVID-19 patients, financial strain, percentage of working hours spent on patient care, age, and gender (resilience: B = 0.33, SE = 0.12, p <.01; training background: B = 0.17, SE = 0.07, p <.05). Both resilience and training background predicted job satisfaction (resilience: B = 0.42, SE = 0.12, p <.001; training background: B = 0.18, SE = 0.07, p <.05), while resilience alone predicted professional autonomy (B = 0.27, SE = 0.12, p <.05). In response to an open question about their resources, resilient physicians more frequently reported applying conscious resilient skills/emotion regulation (p <.05) and personal coping strategies (p <.01) compared to less resilient medical doctors.

CONCLUSION

Physician resilience appears to play a significant role in the perceived quality of patient care, professional autonomy, and job satisfaction during healthcare crises.

The effect of green infrastructure on resilience performance in combined sewer systems under climate change

Climate change is currently reshaping precipitation patterns, intensifying extremes, and altering runoff dynamics. Particularly susceptible to these impacts are combined sewer systems (CSS), which convey both stormwater and wastewater and can lead to combined sewer overflow (CSO) discharges during heavy rainfall. Green infrastructure (GI) can help mitigate these discharges and enhance system resilience under historical conditions; however, the quantification of its effect on resilience in a future climate remains unknown in the literature. This study employs a modified Global Resilience Analysis (GRA) framework for continuous simulation to quantify the impact of climate change on CSS resilience, particularly CSOs. The study assesses the efficacy of GI interventions (green roofs, permeable pavements, and bioretention cells) under diverse future rainfall scenarios based on EURO-CORDEX regional climate models (2085-2099) and three Representative Concentration Pathways (2.6, 4.5, 8.5 W/m2). The findings underscore a general decline in resilience indices across the future rainfall scenarios considered. Notably, the total yearly CSO discharge volume increases by a range of 145 % to 256 % in response to different rainfall scenarios. While GI proves effective in increasing resilience, it falls short of offsetting the impacts of climate change. Among the GI options assessed, green roofs routed to pervious areas exhibit the highest adaptive capacity, ranging from 9 % to 22 % at a system level, followed by permeable pavements with an adaptation capacity between 7 and 13 %. By linking the effects of future rainfall scenarios on CSO performance, this study contributes to understanding GI's potential as a strategic tool for enhancing urban resilience.

Microbial composition, functionality, and stress resilience or susceptibility: unraveling sex-specific patterns

BACKGROUND

Following exposure to traumatic stress, women are twice as likely as men to develop mood disorders. Yet, individual responses to such stress vary, with some people developing stress-induced psychopathologies while others exhibit resilience. The factors influencing sex-related disparities in affective disorders as well as variations in resilience remain unclear; however, emerging evidence suggests differences in the gut microbiota play a role. In this study, using the single prolonged stress (SPS) model of post-traumatic stress disorder, we investigated pre- and post-existing differences in microbial composition, functionality, and metabolites that affect stress susceptibility or resilience in each sex.

METHODS

Male and female Sprague-Dawley rats were randomly assigned to control or SPS groups. Two weeks following SPS, the animals were exposed to a battery of behavioral tests and decapitated a day later. Based on their anxiety index, they were further categorized as SPS-resilient (SPS-R) or SPS-susceptible (SPS-S). On the day of dissection, cecum, and selected brain tissues were isolated. Stool samples were collected before and after SPS, whereas urine samples were taken before and 30 min into the SPS.

RESULTS

Before SPS exposure, the sympathoadrenal axis exhibited alterations within male subgroups only. Expression of tight junction protein claudin-5 was lower in brain of SPS-S males, but higher in SPS-R females following SPS. Across the study, alpha diversity remained consistently lower in males compared to females. Beta diversity revealed distinct separations between male and female susceptible groups before SPS, with this separation becoming evident in the resilient groups following SPS. At the genus level, Lactobacillus, Lachnospiraceae_Incertae_Sedis, and Barnesiella exhibited sex-specific alterations, displaying opposing abundances in each sex. Additionally, sex-specific changes were observed in microbial predictive functionality and targeted functional modules both before and after SPS. Alterations in the microbial short-chain fatty acids (SCFAs), were also observed, with major and minor SCFAs being lower in SPS-susceptible males whereas branched-chain SCFAs being higher in SPS-susceptible females.

CONCLUSION

This study highlights distinct pre- and post-trauma differences in microbial composition, functionality, and metabolites, associated with stress resilience in male and female rats. The findings underscore the importance of developing sex-specific therapeutic strategies to effectively address stress-related disorders. Highlights SPS model induces divergent anxiety and social behavioral responses to traumatic stress in both male and female rodents. SPS-resilient females displayed less anxiety-like behavior and initiated more interactions towards a juvenile rat than SPS-resilient males. Sex-specific pre-existing and SPS-induced differences in the gut microbial composition and predictive functionality were observed in susceptible and resilient rats. SPS-resilient males displayed elevated cecal acetate levels, whereas SPS-susceptible females exhibited heightened branched-chain SCFAs.

Hydrogeological assessment of a major spring discharging from a calcarenitic aquifer with implications on resilience to climate change

Groundwater is a vital source of freshwater, serving ecological, environmental, and societal needs. In regions with springs as a predominant source, such as the Northern Apennines (Italy), resilience of these springs to climate-induced recharge changes is crucial for water supply and ecosystem preservation. In this study, Nadìa Spring in the Northern Apennines is examined through an unprecedented array of multidisciplinary analyses to understand its resilience and unique characteristics. The Nadìa Spring's exceptional response, characterized by a sustained base flow even in the face of drought, is attributed to a combination of factors including a substantial groundwater reservoir, a complex network of faults/fractures, slope instabilities, and karst dissolution. The investigation reveals a dual porosity system in the aquifer, consisting of fast-flow conduits and a diffuse fracture network. While fast-flow conduits contribute to rapid responses during high-flow conditions, the diffuse system becomes predominant during low-flow periods. This dual porosity structure helps the spring maintain a consistent base flow in the face of climate-induced recharge fluctuations. The study shows that Nadìa Spring exhibits remarkable resilience to year-to-year variations in recharge, as evidenced by stable minimum discharge values. While the spring has undergone a decline in discharge over the past century due to long-term climate change, it is becoming more resilient over interdecadal timescales due to transition to a diffuse drainage system that mitigates the impact of reduced recharge. The availability of a century-long spring discharge monitoring was a crucial piece of information for understanding the spring's discharge response and drawing conclusions about its long-term resilience to recharge fluctuations. Continuing long-term monitoring and research in the future will be essential to validate and expand upon these findings in the context of changing climatic conditions. This research serves as a model for assessing strategic groundwater discharge points in geological settings similar to the Northern Apennines.

A Well-Being Well-Check for Neurosurgery: Evidence-Based Suggestions for Our Specialty Based on a Systematic Review

BACKGROUND

The path through neurosurgery is rigorous. Many neurosurgeons may experience burnout, depression, or suicide throughout training and practice. We review the literature to help foster a culture of awareness and self-care and arm trainees with coping skills to reduce burnout and, thus, suicidality during all phases of their medical careers.

METHODS

A systematic search was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using 4 databases. 7 studies were included.

RESULTS

Overlying themes of interventions were to increase balance, mindfulness, and physical fitness. The most common interventions included in programs were educational and physical activity. We suggest a comprehensive wellness program emphasizing interventions from 4 wellness dimensions-physical, spiritual, mental, and emotional.

CONCLUSIONS

Many neurosurgeons experience burnout, leading to a lack of satisfaction and early retirement; this necessitates a discipline-wide acknowledgment of endemic burnout among neurosurgeons. Systemic changes are needed to refine the training process and prioritize physician well-being- this cannot be left to chance.

Paying attention to attention: a program evaluation of faculty-delivered mindfulness-based attention training to optimize wellness and professionalism in medical students

BACKGROUND

As physician distress rises, medical schools must provide programs to counter such distress at the earliest stages of training. Mindfulness training (MT) is one intervention that can alleviate stress during medical school. However, framing MT around wellness alone misses the opportunity to connect core cognitive and psychological capacities strengthened by MT to professional goals and skill acquisition inherent to successful medical training. Here, we highlight how the attentional components of MT align with students' goals of becoming attending physicians while promoting academic, psychological, and interpersonal flourishing. MT courses that focus on strengthening attentional capacities can intuitively link academic and professional development with wellness, appealing to a wide array of students.

METHODS

We iteratively recontextualized an existing short-form mindfulness training program for high-stress pre-professionals, known as Mindfulness Based Attention Training (MBAT), to the medical school context (MBAT-Rx). MBAT-Rx was offered by physician trainers to first-year medical students at Warren Alpert Medical School of Brown University as a tool for improving study habits and focus in addition to the development of both self-care and patient care strategies. MBAT-Rx consists of weekly, two-hour sessions over four weeks, with 10-15 min of daily mindfulness practice between sessions. At the end of the four weeks, students submitted voluntary program evaluation responses detailing their experience of the program.

RESULTS

Optional program evaluation responses (n = 67) highlight that students found the program to be useful for their academic success and ability to pay attention, their interpersonal relationships, and their psychological health. By framing MT as an opportunity to boost core attentional capacities and connecting this to professional and academic goals in addition to wellness, MBAT-Rx appealed to a wide variety of students.

CONCLUSIONS

Our ongoing work suggests that framing MT as both a professional development and wellness promotion tool, taught by physicians themselves, and structured around students' time demands, may be a successful model for medical schools looking to increase the impact of their mindfulness offerings. Such programs are needed to equip medical students to navigate the demands of a challenging healthcare training landscape.

Identifying, categorising, and mapping actors involved in resilience in healthcare: a qualitative stakeholder analysis

BACKGROUND

Resilience in healthcare is the capacity to adapt to challenges and changes to maintain high-quality care across system levels. While healthcare system stakeholders such as patients, informal carers, healthcare professionals and service managers have all come to be acknowledged as important co-creators of resilient healthcare, our knowledge and understanding of who, how, and in which contexts different stakeholders come to facilitate and support resilience is still lacking. This study addresses gaps in the research by conducting a stakeholder analysis to identify and categorise the stakeholders that are key to facilitating and sustaining resilience in healthcare, and to investigate stakeholder relationships relevant for the enactment of resilient healthcare systems.

METHODS

The stakeholder analysis was conducted using a sample of 19 empirical research projects. A narrative summary was written for 14 of the projects, based on publicly available material. In addition, 16 individual interviews were undertaken with researchers from the same sample of 19 projects. The 16 interview transcripts and 14 narratives made up the data material of the study. Application of stakeholder analysis methods was done in three steps: a) identification of stakeholders; b) differentiation and categorisation of stakeholders using an interest/influence grid; and c) investigation and mapping of stakeholder relationships using an actor-linkage matrix.

RESULTS

Identified stakeholders were Patients, Family Carers, Healthcare Professionals, Ward/Unit Managers, Service or Case Managers, Regulatory Investigators, Policy Makers, and Other Service Providers. All identified stakeholders were categorised as either 'Subjects', 'Players', or 'Context Setters' according to their level of interest in and influence on resilient healthcare. Stakeholder relationships were mapped according to the degree and type of contact between the various groups of stakeholders involved in facilitating resilient healthcare, ranging from 'Not linked' to 'Fully linked'.

CONCLUSION

Family carers and healthcare professionals were found to be the most active groups of stakeholders in the enactment of healthcare system resilience. Patients, managers, and policy makers also contribute to resilience to various degrees. Relationships between stakeholder groups are largely characterised by communication and coordination, in addition to formal collaborations where diverse actors work together to achieve common goals.

Light and temperature controls of aquatic plant photosynthesis downstream of a hydropower plant and the effect of plant removal

Many rivers worldwide are regulated, and the altered hydrology can lead to mass development of aquatic plants. Plant invasions are often seen as a nuisance for human activities leading to costly remedial actions with uncertain implications for aquatic biodiversity and ecosystem functioning. Mechanical harvesting is often used to remove aquatic plants and knowledge of plant growth rate could improve management decisions. Here, we used a simple light-temperature theoretical model to make a priori prediction of aquatic plant photosynthesis. These predictions were assessed through an open-channel diel change in O2 mass balance approach. A Michaelis-Menten type model was fitted to observed gross primary production (GPP) standardised at 10 °C using a temperature dependence from thermodynamic theory of enzyme kinetics. The model explained 87 % of the variability in GPP of a submerged aquatic plant (Juncus bulbosus L.) throughout an annual cycle in the River Otra, Norway. The annual net plant production was about 2.4 (1.0-3.8) times the standing biomass of J. bulbosus. This suggests a high continuous mass loss due to hydraulic stress and natural mechanical breakage of stems, as the biomass of J. bulbosus remained relatively constant throughout the year. J. bulbosus was predicted to be resilient to mechanical harvesting with photosynthetic capacity recovered within two years following 50-85 % plant removal. The predicted recovery was confirmed through a field experiment where 72 % of J. bulbosus biomass was mechanically removed. We emphasise the value of using a theoretical approach, like metabolic theory, over statistical models where a posteriori results are not always easy to interpret. Finally, the ability to predict ecosystem resilience of aquatic photosynthesis in response to varying management scenarios offers a valuable tool for estimating aquatic ecosystem services, such as carbon regulation. This tool can benefit the EU Biodiversity Strategy and UN Sustainable Development Goals.

Layered vulnerability and researchers' responsibilities: learning from research involving Kenyan adolescents living with perinatal HIV infection

BACKGROUND

Carefully planned research is critical to developing policies and interventions that counter physical, psychological and social challenges faced by young people living with HIV/AIDS, without increasing burdens. Such studies, however, must navigate a 'vulnerability paradox', since including potentially vulnerable groups also risks unintentionally worsening their situation. Through embedded social science research, linked to a cohort study involving Adolescents Living with HIV/AIDS (ALH) in Kenya, we develop an account of researchers' responsibilities towards young people, incorporating concepts of vulnerability, resilience, and agency as 'interacting layers'.

METHODS

Using a qualitative, iterative approach across three linked data collection phases including interviews, group discussions, observations and a participatory workshop, we explored stakeholders' perspectives on vulnerability and resilience of young people living with HIV/AIDS, in relation to home and community, school, health care and health research participation. A total of 62 policy, provider, research, and community-based stakeholders were involved, including 27 ALH participating in a longitudinal cohort study. Data analysis drew on a Framework Analysis approach; ethical analysis adapts Luna's layered account of vulnerability.

RESULTS

ALH experienced forms of vulnerability and resilience in their daily lives in which socioeconomic context, institutional policies, organisational systems and interpersonal relations were key, interrelated influences. Anticipated and experienced forms of stigma and discrimination in schools, health clinics and communities were linked to actions undermining ART adherence, worsening physical and mental health, and poor educational outcomes, indicating cascading forms of vulnerability, resulting in worsened vulnerabilities. Positive inputs within and across sectors could build resilience, improve outcomes, and support positive research experiences.

CONCLUSIONS

The most serious forms of vulnerability faced by ALH in the cohort study were related to structural, inter-sectoral influences, unrelated to study participation and underscored by constraints to their agency. Vulnerabilities, including cascading forms, were potentially responsive to policy-based and interpersonal actions. Stakeholder engagement supported cohort design and implementation, building privacy, stakeholder understanding, interpersonal relations and ancillary care policies. Structural forms of vulnerability underscore researchers' responsibilities to work within multi-sectoral partnerships to plan and implement studies involving ALH, share findings in a timely way and contribute to policies addressing known causes of vulnerabilities.

The effect of personalized mobile health (mHealth) in cardiac rehabilitation for discharged elderly patients after acute myocardial infarction on their inner strength and resilience

INTRODUCTION

Given the importance of promoting self-care and quality of life for discharged elderly patients after acute Myocardial Infarction(MI), It is necessitated we conduct interventions to promote these items. This study was conducted to determine the effect of mHealth-Cardiac rehabilitation (CR) on the inner Strength and resilience of elderly patients with MI after discharge from the hospital.

METHODS

The present study was a randomized controlled trial that was conducted on 56 Elderly patients with myocardial infarction were discharged from the heart departments. In the intervention group after the patient's discharge, the patients were contacted twice a week for one month and the necessary training and support were given online. To gather data, the Mini-Mental State Examination (MMSE), the demographic and clinical characteristics questionnaire, the inner strength scale (ISS), and the Connor-Davidson Resilience Scale (CD-RISC) were completed pre- and post-intervention. The data analysis was done by SPSS16.

RESULTS

This study showed the mean resilience and inner strength scores before and after the intervention in the control group had no statistically significant difference(P˃0.05). There was a significant increase in the mean resilience and inner strength scores in the intervention group after the intervention (P ≤ 0.001).

CONCLUSION

The results of this study showed that mHealth as a kind of telenursing nursing has a significant effect on both variables of inner strength and resilience of post-discharge elderly patients after acute myocardial infarction. This means that using mHealth for these patients could increase the inner strength and resilience of the elderly discharged after myocardial infarction. Therefore, through using this method, elderly patients' self-care ability and quality of life could be increased.

Fostering resilience and well-being in emerging adults with adverse childhood experiences: study protocol for a randomized controlled trial to evaluate the FACE self-help app

BACKGROUND

Adverse childhood experiences (ACE) are linked to an increased risk of psychological disorders and lower psychosocial functioning throughout life. This study aims to evaluate the FACE self-help app, designed to promote resilience and well-being in emerging adults with a history of ACE. The app is based on cognitive-behavioural principles and consists of two thematic components: (1) self- and emotion regulation (SER) and (2) social skills and biases in social information processing (SSIP).

METHODS

The efficacy of the app will be tested through a single-centre, two-arm randomized controlled trial, comparing an active intervention group against a waiting list control group. The active group is divided into two subgroups, in which the two components are delivered in a different order to investigate differential effects in a crossover design. Up to 250 emerging adults aged 18 to 25 years with a history of ACE from a general population cohort study will be recruited. The primary objective is to test the efficacy of the app in improving resilience (primary outcome) and well-being (co-primary outcome) compared to a waiting list control group and to examine the stability of these effects. The secondary objectives include testing the efficacy of the app in improving the secondary outcomes, i.e., self-efficacy in managing emotions, problem solving, fear of evaluation, social avoidance, and self-esteem; examining the differential effects of the two components; and assessing the effect of the app on real-life data on resilience, affective states, distress in social interactions and coping strategies. Furthermore, the study will investigate potential moderators (e.g. ACE severity) and mediators of intervention outcomes (e.g. self-efficacy in managing emotions).

DISCUSSION

The results will provide insights into the efficacy of the self-help intervention as well as mediators and moderators of outcomes. Furthermore, results will extend the existing knowledge by testing the differential effects of the SER and SSIP component on the outcomes. Findings can inform improvements to the FACE app and the development of other interventions for this target group and assess its potential as a scalable, low-threshold intervention to support emerging adults with a history of ACE in their transition to adulthood.

TRIAL REGISTRATION NUMBER

NCT05824182.

Moderating effect of work fatigue on the association between resilience and posttraumatic stress symptoms: a cross-sectional multi-country study among pharmacists during the COVID-19 pandemic

INTRODUCTION

In the context of the COVID-19 pandemic, pharmacists, despite their vital contributions, have faced significant challenges that have impacted their mental well-being, potentially leading to the development of Post-Traumatic Stress symptoms (PTSS). The aim of this study was to investigate the role of work-related fatigue as a potential moderator in the relationship between pharmacists' resilience and their likelihood of experiencing PTSS during the COVID-19 pandemic.

METHODS

A cross-sectional survey was conducted online in eight countries from January to December 2021, including Brazil, Lebanon, Nigeria, Pakistan, Poland, Serbia, and Tunisia. The mediation analysis was conducted using PROCESS MACRO (an SPSS add-on) v3.4 model 1, taking work fatigue as a moderator in the association between resilience and PTSS.

RESULTS

A total of 442 pharmacists were enrolled in this study (mean age = 33.91 ± 10.36 years) with 59.5% of them being females. The results were adjusted over country, gender, working in contact with COVID-19, working patients, working mandatory hours, working voluntary hours, age, household crowding index and number of months engaged in COVID-19. The interactions resilience by physical (Beta = 0.02; p = .029), mental (Beta = 0.02; p = .040) and emotional (Beta = 0.03; p = .008) work fatigue were significantly associated with PTSS; for pharmacists with low to moderate levels of physical (Beta = - 0.33; p < .001 and Beta = - 0.21; p = .001), mental (Beta = - 0.29; p < .001 and Beta = - 0.18; p = .006) and emotional (Beta = - 0.31; p < .001 and Beta = - 0.17; p = .008) work fatigue, higher resilience was significantly related to lower PTSS levels. However, for pharmacists with high levels of physical/mental/emotional work fatigue, the association between resilience and PTSS became non-significant.

CONCLUSION

This study highlights the complex relationship between work-related fatigue, resilience, and PTSS in pharmacists. It emphasizes the need to address work-related fatigue for pharmacists' psychological well-being during crises, offering insights for tailored support and interventions.

Impact of community-based employment on Aboriginal and Torres Strait Islander wellbeing, aspirations, and resilience

BACKGROUND

This study evaluated a research project that provided employment in an Aboriginal and Torres Strait Islander community-based setting and supported participants to identify and achieve their goals and aspirations. The evaluation examined changes in personal, relationship, community and cultural strengths and resources and explored empowerment and resilience, in terms of promoting wellbeing.

METHODS

Ten Aboriginal people employed as life coaches and peer researchers participated in semi-structured interviews and also completed the Aboriginal Resilience and Recovery Questionnaire at the beginning of their employment and 6-months after employment. Interviews with the 10 participants explored changes in their wellbeing, relationships, resilience, opportunity to lead, aspirations, goal setting skills, connection to culture and community, and empowerment.

RESULTS

Participants personal strengths, and cultural and community strengths, sub-scale scores showed improvements across the 6-month period, however these changes were not statistically significant. Using reflexive thematic analysis, we generated five themes including Aspirations; Personal capabilities; Constraints to wellbeing; Community engagement and cultural connection; and Employment facilitators. Overall, participants identified that despite the challenges of their work and the additional challenges posed by the COVID-19 lockdowns, they were able to develop their skills to set and achieve goals. They reported feeling empowered and proud of their work, and engaged more frequently with their communities and culture.

CONCLUSIONS

The study outcomes evidence the role of employment in an Aboriginal and Torres Strait Islander community-based project in strengthening wellbeing, enhancing resilience, and supporting participants to advance their personal goals and aspirations. These findings reinforce the importance of supporting the aspirations and employment of Aboriginal and Torres Strait Islander Peoples through employment.

Testing for synergistic effects of natural and anthropogenic disturbance on ecological communities at a landscape scale

Context

Anthropogenic and natural disturbances may interact synergistically, magnifying their individual effects on biodiversity. However, few studies have measured responses of ecological communities to multiple stressors at landscape scales.

Objectives

We use a long-term dataset to test for synergistic effects of anthropogenic and natural disturbance on plant community diversity and composition in a large protected area.

Methods

We quantified changes in plant communities over two decades in 98 plots in Waterton Lakes National Park, Canada. Fifty-three plots burned in a wildfire in the interim. We modeled the effects of wildfire, proximity to trails or roads, and their interaction on changes in species richness, community composition, relative abundance of disturbance-associated species, and colonization by exotic species.

Results

Interactions between wildfire and proximity to roads and trails affected all metrics except species richness. Only one interaction was synergistic: the relative abundance of disturbance-associated species following wildfire was magnified closer to recreational corridors. The other community metrics showed unexpected patterns. For example, plots with no exotic species in the baseline survey that burned in the wildfire were more likely to gain exotic species than unburned plots only when they were distant from recreational corridors.

Conclusions

Our study demonstrates interactive effects of natural and anthropogenic disturbance at landscape scales within a protected area. Plant community response to wildfire was influenced by proximity to recreational corridors, sometimes in surprising ways. As the frequency and severity of anthropogenic and natural disturbances both continue to rise, documenting the prevalence and magnitude of interactions between them is key to predicting long-term effects and designing mitigation strategies.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10980-024-01844-w.

Flexible emotional regulation typology: associations with PTSD symptomology and trait resilience

BACKGROUND

Multiple factors influence posttraumatic stress disorder (PTSD) risk in trauma exposed individuals. An established association exists between trait resilience and decreased PTSD distress and between emotion regulation (ER) ability/flexibility and trait resilience. Typologies in ER ability/flexibility, associated with trait resilience and PTSD experience, could explain the difference in risk. This study aimed to explore the relationship between ER ability, ER flexibility, context sensitivity, resilience, and PTSD.

METHODS

Data from N = 563 trauma exposed UK residents was used in a latent profile analysis (LPA) and membership in the resultant profiles was explored in a logistic regression of sociodemographics, resilience, and PTSD symptomology.

RESULTS

Analysis showed 2 latent profiles (High Flexibility, Low Flexibility) typified by emotion regulation ability and context sensitivity. Members of the Low Flexibility profile were more likely to be younger, male, endorsing less trait resilience, and experiencing negative cognition/mood and hyperarousal PTSD symptomology.

CONCLUSIONS

Difficulties in ER ability and flexibility could be improved with targeted learning in a therapeutic or home setting, potentially increasing trait resilience after trauma exposure and reducing PTSD distress.

"You cannot just stop life for just that": a qualitative study on children's experiences on refugee journey to Sweden

Children with refugee backgrounds are often exposed to violence and other adverse experiences with well-known detrimental consequences on mental health. However, the current group of approximately 40 million child refugees is heterogeneous, stressing the importance of first-person perspectives in understanding children's unique experiences and needs related to the migration process. Identifying contextual factors promoting health and resilience is also essential. For instance, the roles children play as active agents in constructing their own lives and adapting to different environments are poorly described in contemporary research on child refugees and their mental health. To address these knowledge gaps, we conducted qualitative interviews with a reflexive thematic analysis with eighteen children with refugee backgrounds in Sweden. This resulted in two main themes: Longing for a good life that cannot be taken for granted and Challenged agency and changing rights. The narratives indicate that children, although exposed to different challenges in different migration phases and based on gender and asylum status, have experiences of ordinary childhood with a desire for a good life with prospects. The results also show that children execute active and adaptable agency that is impacted by various factors. Reaching the full age appears to be a confusing and ambivalent transition due to changes in rights. The results pinpoint several possibilities to address factors that pose a risk to health and restrictions of rights among child refugees.

Enduring education and employment: Examining motivation and mechanisms of psychological resilience

Resilience, the ability to bounce back from difficult events, is critical for an individual to negotiate stressors and adversity. Despite being widely studied, little is known about the processes involved in the development of resilience. The goal of the studies are to investigate the relationship between motivation orientation, emotional intelligence, cognitive appraisals, and psychological resilience. Two studies, using self-report questionnaires were conducted with employed young adults also enrolled in post-secondary studies (pre- and during the pandemic) to test the tenability of our proposed models. Study 1 and Study 2 showed that emotional intelligence and challenge appraisals were mediators of autonomous motivation and resilience. Study 2 revealed statistically significant differences in mean scores of autonomous motivation and emotional intelligence between non-pandemic students and pandemic students. Based on the findings, it is suggested that autonomous motivation, emotional intelligence, and challenge appraisals are important aptitudes for the development of resilience. Furthermore, findings suggest that social isolation caused by the pandemic may have affected levels of emotional intelligence. Ultimately, the research expands the literature on both self-determination theory and resilience by offering a unique multiple mediation model for predicting the development of resilience within the employed undergraduate population.

The effect of social support, diabetes management self-efficacy, and diabetes distress on resilience among patients with type 2 diabetes: a moderated mediation analysis

BACKGROUND

Diabetes can result in distress. Improving Resilience is important in managing these conditions. It is also important to consider the mediating role of diabetes management self-efficacy (DMSE) between diabetes distress (DD) and Resilience. Likewise, understanding how social support (SS) buffers the impact of diabetes distress on Resilience is equally important.

METHODS

The present study used a cross-sectional design and included 403 participants diagnosed with type 2 diabetes (T2D). The study was conducted in the south of Iran. The participants were selected through convenience sampling from July 2022 to January 2023. Self-reported questionnaires, namely the Diabetes Distress Scale (DDS), Diabetes Management Self-Efficacy Scale (DMSE), Perceived Social Support Scale (PSSS), and Resilience Scale, were used for data collection in the present study. Structural equation modelling was used for moderated mediation analysis.

RESULTS

The results of the Pearson correlation analysis were indicative of a significant negative correlation (p < 0.01) between diabetes distress and diabetes management self-efficacy (r = - 0.607), social support (r = - 0.417), and Resilience (r = - 0.552). The findings further revealed that diabetes management self-efficacy had fully mediated the correlation between diabetes distress and Resilience. Moreover, the results indicated that social support had a moderating role in the DD-resilience link.

CONCLUSIONS

The present study's findings offer a new theoretical framework for T2DM that can benefit intervention designers. The results further suggest that promoting diabetes management self-efficacy can be an effective strategy to enhance Resilience and decrease diabetes distress. Also, nurses and other healthcare providers must pay close attention to support resources to improve the patients' Resilience and evaluate the distress associated with diabetes.

Effectiveness, working mechanisms, and implementation of youth-initiated mentoring for juvenile delinquents: a multiple-methods study protocol

BACKGROUND

The societal costs associated with juvenile delinquency and reoffending are high, emphasising the need for effective prevention strategies. A promising approach is Youth-Initiated Mentoring (YIM). In YIM, professionals support youths in selecting a non-parental adult from within their social network as their mentor. However, until now, little (quasi-)experimental research has been conducted on YIM in the field of juvenile delinquency. We will examine the effectiveness, working mechanisms, and implementation of YIM as a selective prevention strategy for juvenile delinquents.

METHODS

This multiple-methods study consists of a quasi-experimental trial and a qualitative study. In the quasi-experimental trial, we aim to include 300 juvenile offenders referred to Halt, a Dutch juvenile justice system organisation which offers youths a diversion program. In the Netherlands, all juvenile offenders between 12 and 18 years old are referred to Halt, where they must complete the Halt intervention. Youths will be non-randomly assigned to region-matched non-YIM-trained and YIM-trained Halt professionals implementing Care as Usual (CAU, i.e., the Halt intervention) or CAU plus YIM, respectively. Despite non-random allocation, this approach may yield comparable conditions regarding (1) the characteristics of professionals delivering the intervention and (2) case type and severity. Youth and caregiver(s) self-report data will be collected at pre-and post-test and a 6-month follow-up and complemented with official Halt records data. Multilevel analyses will test whether youths following CAU plus YIM show a stronger increase in resilience factors and a stronger decline in the need for formal support and delinquency than youths following CAU. In the qualitative study, we will organise focus group interviews with YIM-trained professionals to explore boosters and barriers experienced by professionals during the implementation of YIM.

DISCUSSION

The proposed study will help identify the effectiveness of YIM in strengthening resilience factors and possibly decreasing juvenile delinquency. In addition, it may offer insights into how and for whom YIM works. Finally, this study can help strengthen the implementation of YIM in the future.

TRIAL REGISTRATION

ClinicalTrials.Gov (# NCT05555472). Registered 7 September 2022. https://www.

CLINICALTRIALS

gov/ct2/show/NCT05555472?cond=Youth+Initiated+Mentoring&draw=2&rank=1 .

Care burden and resilience in parents of children with special needs and chronic diseases

AIM

Comparison of care burden and resilience levels in parents of children with special needs and chronic diseases.

METHODS

This study, designed with a cross-sectional and relationship-seeking design, was conducted in a Training and Research Hospital in Turkey. Data was obtained from parents of children with special needs (n = 102) and chronic diseases (n = 102) who presented to the outpatient clinic for routine follow-up between October 2022 and February 2023. The consecutive sampling method was used while choosing the sample. The "Descriptive Characteristics Questionnaire," "Zarit Caregiver Burden Scale (ZCB)," and "Resilience Scale for Adults (RSA)" were used to collect data. Data were evaluated using the SPSS 22.0 statistical program.

RESULTS

The burden of care in parents differed significantly between the two groups (p < 0.001), the majority of parents of children with chronic diseases (PCCD) had a mild/moderate care burden, and the majority of parents of children with special needs (PCSN) had a moderate/severe level of care. The care burden scores and total resilience scores were found to be higher in the PCSN group, and the care burden scores and total resilience scores were found to be lower in the PCCD group (p < 0.001).

CONCLUSION

This research determined that PCSN showed more care burden and less resilience than PCCD. In this context, it is recommended to regularly monitor the resilience, caregiver burden, and quality of life of caregivers of children with special needs and conduct preventive and strengthening programs.

A latent profile analysis of resilience and their relation to differences in sleep quality in patients with lung cancer

PURPOSE

Sleep problems are a significant issue in patients with lung cancer, and resilience is a closely related factor. However, few studies have identified subgroups of resilience and their relationship with sleep quality. This study aimed to investigate whether there are different profiles of resilience in patients with lung cancer, to determine the sociodemographic characteristics of each subgroup, and to determine the relationship between resilience and sleep quality in different subgroups.

METHODS

A total of 303 patients with lung cancer from four tertiary hospitals in China completed the General Sociodemographic sheet, the Connor-Davidson Resilience Scale, and the Pittsburgh Sleep Quality Index. Latent profile analysis was applied to explore the latent profiles of resilience. Multivariate logistic regression was used to analyze the sociodemographic variables in each profile, and ANOVA was used to explore the relationships between resilience profiles and sleep quality.

RESULTS

The following three latent profiles were identified: the "high-resilience group" (30.2%), the "moderate-resilience group" (46.0%), and the "low-resilience group" (23.8%). Gender, place of residence, and average monthly household income significantly influenced the distribution of resilience in patients with lung cancer.

CONCLUSION

The resilience patterns of patients with lung cancer varied. It is suggested that health care providers screen out various types of patients with multiple levels of resilience and pay more attention to female, rural, and poor patients. Additionally, individual differences in resilience may provide an actionable means for addressing sleep problems.

'A system that is struggling': understanding health protection resilience in England during the COVID-19 pandemic through the experiences of local health protection responders

BACKGROUND

Local health protection systems play a crucial role in infectious disease prevention and control and were critical to COVID-19 pandemic responses. Despite this vital function, few studies have explored the lived experience of health protection responders managing COVID-19. We provide new insights by examining how COVID-19 shaped infectious disease prevention and control in local health protection systems in England.

METHODS

Semi-structured interviews were conducted with twenty local health protection responders from three contrasting local authority areas, and Public Health England (PHE) health protection teams, in England between June 2021 - March 2022. Participants were from: PHE health protection teams (n=6); local authority public health teams (n=5); local authority Public Protection Services (n=7); and local authority commissioned Infection Prevention and Control Teams (n=2). Data were analysed using reflexive thematic analysis.

RESULTS

First, participants acknowledged the pandemic caused an unprecedented workload and disruption to local health protection service delivery. There was not enough capacity within existing local health protection systems to manage the increased workload. PHE health protection teams therefore transferred some COVID-19 related health protection tasks to other staff, mainly those employed by local authorities. Second, health protection responders highlighted how COVID-19 drew attention to the weaknesses in local health protection systems already stressed by reduced funding in the years leading up to the pandemic. Injecting money into the COVID-19 response did not completely overcome former losses in specialist health protection workforce. Third, health protection responders described how pandemic management raised the profile of public health, especially infectious disease prevention and control. Managing COVID-19 strengthened collaborative working, resulting in enhanced capacity of local health protection systems at the time.

CONCLUSION

The COVID-19 pandemic challenged the public health preparedness of all countries. Health protection responders in this study also expressed many challenges. There was insufficient resilience in these local health protection systems and an inability to scale up the specialist health protection workforce, as required in a pandemic situation. The UK needs to learn from the pandemic experience by acknowledging and addressing the challenges faced by local health protection responders so that it can more effectively respond to future threats.

Resilience and burnout of healthcare workers during the early COVID-19 pandemic

INTRODUCTION

The COVID-19 pandemic has led to significantly more healthcare workers (HCWs) experiencing burnout than previously. This burnout is strongly associated with low resilience. Addressing organisational stresses and the introduction of resilience training will help to reduce the proportion of HCWs experiencing this phenomenon.

AIMS

The aim of this study was to assess the impact of the biopsychosocial changes and challenges associated with the COVID-19 pandemic on the healthcare workforce, exploring, specifically, the impact on and relationship between HCWs' resilience and burnout.

METHODS

An electronic opt-in survey was distributed to HCWs through hospital and professional association communications emails and websites, as well as social media. The survey consisted of demographic questions, the Oldenburg Burnout Inventory to assess burnout, Brief Resilience Scale to assess general resilience, and 10-item Connor-Davidson Resilience Scale to assess resilience during the pandemic. Univariate and multivariate analysis was undertaken to examine the relationship between these factors.

RESULTS

A total of 1370 HCWs completed the questionnaire, with 802 (58.5%) having burnout, 348 (25.4%) having low general resilience and 390 (28.5%) having low COVID resilience. Burnout was significantly associated with being public sector workers, low general resilience and low COVID resilience. Resilience training was found to be protective for burnout.

CONCLUSION

The introduction of resilience training in the workplace is a fundamental tool that will significantly benefit HCWs when working under challenging conditions.

Validation of an eight-item resilience scale for inpatients with spinal cord injuries in a rehabilitation hospital: exploratory factor analyses and item response theory

PURPOSE

People with spinal cord injury (PwSCI) can experience life changes, including impacts on their physical and mental health. PwSCI often report less life satisfaction and lower subjective well-being than peers without SCI. These challenges and adversities increase the demand on them to be more resilient. Healthcare providers need quick and valid instruments to assess adult patients' resilience in clinical settings. We aimed to validate the factor validity and discrimination ability of a resilience scale, CD-RISC-10, for clinical usage in adults with SCI during hospitalization.

MATERIALS AND METHODS

93 adults with SCI responded to the self-reported survey, including CD-RISC-10, the Patient Health Questionnaire-9 Scale (PHQ-9), the Satisfaction with Life Scale (SWLS), and the Intrinsic Spirituality Scale. We conducted descriptive statistics, exploratory factor analysis (EFA), and item response theory (IRT).

RESULTS

Two items were deleted from CD-RISC-10 after EFA, forming CD-RISC-8. The item discriminations of the remaining eight items from the unconstrained IRT model ranged from a high of 3.071 to a relatively low 1.433. CD-RISC-8 is significantly related to PHQ-9 and SWLS.

CONCLUSIONS

The factor validity of the CD-RISC-8 was improved. Significantly, the CD-RISC-8 has excellent potential for clinical usage due to its discriminant ability between low and intermediate resilience.

Resilience resources for mental health among people living with HIV: a mixed-method systematic review

People living with HIV (PLWH) experience a disproportionate burden of mental health problems compared to people living without HIV. This systematic review aims to depict the spectrum of resilience resources that may promote the mental health of PLWH at the individual, interpersonal, organisational, community and policy levels. A systematic literature search was conducted in PsycINFO, Scopus, Medline and advanced Google Scholar. The quality of included studies was assessed using the Mixed Methods Appraisal Tool (MMAT). Of the 591 studies identified, fourteen were included representing a total of 5,142 PLWH from China, Ghana, Nepal, Spain, Tanzania and the USA. Resilience resources were identified at the individual level (self-efficacy, self-esteem, acceptance, hope, optimism, religiosity/spirituality, belief in fate, mindfulness, strength and self-responsibility); interpersonal level (social support and parental monitoring); and community level (attending HIV clinic support groups and access to healthcare). All quantitative studies were cross-sectional, limiting inferences about causation or directionality. Future research should focus on resilience resources at the organisational and policy levels and incorporate longitudinal designs.

Examining resilience among child protection professionals during COVID-19: A global comparison across 57 countries

BACKGROUND

The COVID-19 pandemic led to numerous challenges for child protection professionals (CPPs). However, limited research has investigated the interwoven concepts of coping, resilience, and mental distress among CPPs during COVID-19 on a global scale.

OBJECTIVES

This study aimed to explore CPPs' practice, resilience, and mental distress during COVID-19, the relationship between their resilience and mental distress, the global stability of the Multi-System Model of Resilience (MSMR), and how CPPs' resilience varied according to the Human Development Index (HDI).

METHODS

Data were collected from 420 CPPs in 57 countries across five continents between July and September 2021. Participants completed an online questionnaire on demographics, resilience, mental distress, coping, and perceptions of child protection during the pandemic in their native languages. The analyses compared the countries grouped according to HDI using means comparisons, correlations, and multiple linear regressions. A two-path analysis was also performed to identify variables associated with behavioral resilience engagement and mental distress.

RESULTS

The findings indicated that CPPs' perceptions of COVID-19's impact on child maltreatment varied in correlation with their country's HDI. There were also significant HDI-based differences regarding the perceived opportunity to engage in resilient behavior and its helpfulness. Years of professional experience, internal resilience, and external resilience were shown to be significant predictors of mental distress among CPPs during the pandemic, and resilience mediated how years of experience predicted mental distress.

CONCLUSIONS

This study emphasized the importance of experience and internal resilience for CPPs' psychological well-being. It also provides empirical evidence to support the MSMR theory on a global scale. Additionally, it demonstrates how the perceived changes in child maltreatment during COVID-19 may be associated with regional HDI. Lastly, the opportunities CPPs had to engage in resilient behavior and how much this helped them was associated with regional HDI, but not in the way originally predicted. Study results also hold implications for how practice and policy may be altered to help CPPs cope better during times of crisis and generally.

Impact of fibre supplementation on microbiome and resilience in healthy participants: A randomized, placebo-controlled clinical trial

BACKGROUND AND AIMS

The gut microbiome exerts important roles in health, e.g., functions in metabolism and immunology. These functions are often exerted via short-chain fatty acid (SCFA) production by gut bacteria. Studies demonstrating causal relationships between interventions targeting the microbiome and clinical outcomes are limited. This study aimed to show a causal relationship between microbiome modulation through fibre intervention and health.

METHODS AND RESULTS

This randomized, double-blind, cross-over study included 65 healthy subjects, aged 45-70 years, with increased metabolic risk (i.e., body mass index [BMI] 25-30 kg/m2, low to moderate daily dietary fibre intake, <30g/day). Subjects took daily a fibre mixture of Acacia gum and carrot powder or placebo for 12 weeks, with an 8-week wash-out period. Faecal samples for measurement of SCFAs and microbiome analysis were collected every 4 weeks. Before and after each intervention period subjects underwent the mixed-meal PhenFlex challenge Test (PFT). Health effects were expressed as resilience to the stressors of the PFT and as fasting metabolic and inflammatory state. The fibre mixture exerted microbiome modulation, with an increase in β-diversity (p < 0.001). α-diversity was lower during fibre mixture intake compared to placebo after 4, 8 and 12 weeks (p = 0.002; p = 0.012; p = 0.031). There was no effect observed on faecal SCFA concentrations, nor on any of the primary clinical outcomes (Inflammatory resilience: p = 0.605, Metabolic resilience: p = 0.485).

CONCLUSION

Although the intervention exerted effects on gut microbiome composition, no effects on SCFA production, on resilience or fasting metabolic and inflammatory state were observed in this cohort. REGISTRATION NUMBER CLINICALTRIALS.GOV: NCT04829396.

Maintaining the working state of firefighters by utilizing self-concept clarity as a resource

The working state of firefighters is important for their own safety as well as that of the general public. The purpose of this study is to investigate the correlations between self-concept clarity, resilience, work engagement, and job burnout among firefighters, as well as the impacts of self-concept clarity and resilience as resources that can maintain their working state. Based on data from 2,156 firefighters, analysis showed that self-concept clarity was negatively associated with job burnout and positively associated with work engagement. The results also showed that self-concept clarity had a direct effect on job burnout and work engagement, and an indirect effect by improving the firefighters' resilience. Maintaining and improving their self-concept clarity and resilience promises to be an effective strategy for guaranteeing the working state of firefighters.

Religious Involvement and Allostatic Resilience: Findings from a Community Study of Black and White Americans

Wide inequities in stress and health have been documented between Black and White women and men in the United States. This study asks: How does religion factor into these inequities? We approach this open question from a biopsychosocial perspective, developing three hypotheses for the stress-coping effects of religiosity between groups. We then test our hypotheses with survey and biomarker data from the Nashville Stress and Health Study (2011-2014), a probability sample of Black and White women and men from Davidson County, Tennessee. We find that Black women score the highest on all indicators of religiosity, followed by Black men, White women, and White men. We also find that increased divine control and religious coping predict higher levels of resiliency biomarkers for Black women only and lower levels for White respondents, especially White men. We discuss how our findings inform broader population health inequities and outline several avenues for future research.

Global Indigenous gender concepts, gender-based violence and resilience: A scoping review

BACKGROUND & OBJECTIVE

The legacy of colonialism includes ongoing trauma and disruption of traditional teachings on relationality, which has contributed to Indigenous populations being disproportionately exposed to gender-based violence (GBV). GBV in Indigenous populations is explored to consider gender-specific findings and points of resilience in relational networks.

PARTICIPANTS & SETTING

Included articles sampled Indigenous groups in Canada, US, Mexico, Guatemala, and Israel. All participants self-identified as Indigenous, and were either GBV survivors or service providers working in GBV contexts.

METHODS

A scoping review was conducted in OVID Medline, Embase, APA Psycinfo, and Informit Indigenous Collection, using keywords for Indigenous peoples, gender concepts, and GBV. Articles were screened and extracted by two reviewers; a third reviewer resolved conflicts.

RESULTS

Our search yielded one mixed-method study and seven qualitative studies, all published since 2016. North American studies identified colonial, patriarchal disruptions (e.g. residential schools) to positive pre-contact gender norms (e.g. non-hierarchical roles) that contribute to emerging GBV. Studies conducted in Guatemala and Israel also described local patriarchal cultures contributing to GBV. Lack of understanding of the Two-Spirit identity (i.e. supra-binary gender identity used by Indigenous persons) led to harmful attitudes and stigma. Interpersonal support and return to traditional matriarchal practices were identified as key resilience processes.

CONCLUSIONS

There is limited literature on Indigenous gender concepts and GBV, particularly regarding GBV against males and Two-Spirit persons. Colonization-related violence and/or patriarchal gender norms were identified as precursors for GBV. Decolonization processes should be further explored to address GBV in Indigenous populations.

External vulnerability, local resilience, and urban-rural heterogeneity in the Marshall Islands

Popular media often positions the Marshall Islands as especially vulnerable to environmental shocks and shifts. This framing overlooks sources of vulnerability, local resilience, and within country differences. To better understand relationships between social, economic, and cultural shifts and vulnerability and resilience in the Marshall Islands, this study draws on interviews with internal migrants and members of government and civil society to investigate perceptions of vulnerability and resilience in outer islands and Majuro. Findings reveal sharp perceived differences. Participants largely tied vulnerability on outer islands to increasingly variable environmental conditions affecting natural resource-dependent livelihoods and vulnerability on Majuro to the cash economy. In both urban core and rural outer islands, participants linked vulnerability to interdependencies far beyond the Marshall Islands. By evaluating historical and external influences and spatial heterogeneity, this study supports a nuanced understanding of vulnerability and resilience within archipelagic countries critical to policy development.

A cross-sectional survey on the relationship between workplace psychological violence and empathy among Chinese nurses: the mediation role of resilience

BACKGROUND

Workplace violence is one of the most serious public health issues worldwide in healthcare occupations, nurse is a profession which faces the greatest risk of exposure to workplace violence among healthcare occupations.

OBJECTIVE

The present study aimed to explore the relationship between workplace psychological violence and empathy among Chinese nurses, and further examine the mediation role of resilience in this relationship.

METHOD

A cross-sectional survey was conducted among a convenience sample of clinical registered nurses in Xinjiang China from 29 September 2023 to 19 October 2023.The online questionnaire, contained the general information form, the Workplace Psychologically Violent Behaviors Instrument, the Jefferson Scale of Empathy-Healthcare Professionals Version, and the Connor-Davidson Resilience Scale, was used to collect data. The IBM SPSS statistics software version 22.0 was used to perform data analyses in forms of descriptive statistics, correlation analysis, and mediation analysis.

RESULT

This survey recruited a convenience sample of 1613 clinical registered nurses aged 22 to 55 years who come from diverse ethnicities and worked in different departments. A total of 534 nurse experienced psychological violent, which yielded a positive rate of 33.1% for psychological violent among nurses. Pearson analysis reported a negative correlation between psychological violences and empathy (r=-0.724, P < 0.01) as well as a negative correlation between psychological violences and resilience (r=-0.681, P < 0.01). Mediation analysis reported that resilience mediated the negative relationship between psychological violence and empathy, the mediation effect accounted for ab/(ab + c') = 23.40% of the total effect.

CONCLUSION

This study supported an inverse ralationship between psychological violence and empathy among Chinese nurses where resilience acted as a protective factor to mediated the negative impacts of psychological violences on empathy These results directed health policies and clinical interventions to equip nurses with resilience to copy with and recover from workplace psychological violence.

Emotional Resilience Predicts Preserved White Matter Microstructure Following Mild Traumatic Brain Injury

BACKGROUND

Adult patients with mild traumatic brain injury (mTBI) exhibit distinct phenotypes of emotional and cognitive functioning identified by latent profile analysis of clinical neuropsychological assessments. When discerned early after injury, these latent clinical profiles have been found to improve prediction of long-term outcomes from mTBI. The present study hypothesized that white matter (WM) microstructure is better preserved in an emotionally resilient mTBI phenotype compared with a neuropsychiatrically distressed mTBI phenotype.

METHODS

The present study used diffusion magnetic resonance imaging to investigate and compare WM microstructure in major association, projection, and commissural tracts between the two phenotypes and over time. Diffusion magnetic resonance images from 172 patients with mTBI were analyzed to compute individual diffusion tensor imaging maps at 2 weeks and 6 months after injury.

RESULTS

By comparing the diffusion tensor imaging parameters between the two phenotypes at global, regional, and voxel levels, emotionally resilient patients were shown to have higher axial diffusivity compared with neuropsychiatrically distressed patients early after mTBI. Longitudinal analysis revealed greater compromise of WM microstructure in neuropsychiatrically distressed patients, with greater decrease of global axial diffusivity and more widespread decrease of regional axial diffusivity during the first 6 months after injury compared with emotionally resilient patients.

CONCLUSIONS

These results provide neuroimaging evidence of WM microstructural differences underpinning mTBI phenotypes identified from neuropsychological assessments and show differing longitudinal trajectories of these biological effects. These findings suggest that diffusion magnetic resonance imaging can provide short- and long-term imaging biomarkers of resilience.

Characterizing the spatio-temporal distribution, detection, and prediction of aerosol atmospheric rivers on a global scale

Aerosol Atmospheric Rivers (AARs) are elongated and narrow regions that carry high concentrations of aerosols (tiny particles suspended in the atmosphere) across large distances, exerting effects on both air quality and human health (Chakraborty et al., 2021, 2022). Monitoring and modeling these aerosols present distinct challenges due to their dynamic nature and complex interactions within the atmosphere. In this context, the present study detects and predicts the AARs using MERRA-2 reanalysis datasets with their seasonal climatology of key aerosol species, including Black Carbon (BC), Dust (DU), Organic Carbon (OC), Sea Salt (SS), and Sulphates (SU). The study employs an innovative Integrated Aerosol Transport (IAT) based AAR algorithm from 2015 to 2022. A total count of 44,020 BC AARs, 13,280 DU AARs, 21,599 OC AARs, 17,925 SS AARs, and 31,437 SU AARs were detected globally. The seasonal climatology of BC and OC AARs intensifies in areas such as the Amazon rainforest and Congo during AMJJAS (April-September) due to forest fires. Similarly, DU AARs are more frequent in regions near the Saharan desert, primarily around the equator during AMJJAS. SS AARs tend to predominate over the oceans, while SU AARs are predominantly found in the northern hemisphere, primarily due to higher anthropogenic emissions. Furthermore, convolutional autoencoder-based models were developed for key aerosol species, strengthening predictive accuracy by effectively capturing complex data relationships and delivering precise predictions for the last 5-time frames. During validation, the model evaluation parameters for image prediction such as the Structural Similarity Index ranged from 0.86 to 0.94, Peak Signal-to-Noise Ratio fluctuated between 1.14 and 42.25 dB, Root Mean Square Error varied from 2.39 to 296.4 mg/(m-sec), and Mean Square Error fell within the range of 1.55-17.22 mg/(m-sec). These collectively reflect image closeness, quality, dissimilarity, and accuracy in AAR prediction. This study demonstrates the effectiveness of advanced machine and deep learning models in predicting AARs, offering the potential for advanced forecasting and enhancing resilience in high-aerosol concentration regions.

Multilevel Resilience and HIV Virologic Suppression Among African American/Black Adults in the Southeastern United States

OBJECTIVE

To assess overall and by neighborhood risk environments whether multilevel resilience resources were associated with HIV virologic suppression among African American/Black adults in the Southeastern United States.

SETTING AND METHODS

This clinical cohort sub-study included 436 African American/Black participants enrolled in two parent HIV clinical cohorts. Resilience was assessed using the Multilevel Resilience Resource Measure (MRM) for African American/Black adults living with HIV, where endorsement of a MRM statement indicated agreement that a resilience resource helped a participant continue HIV care despite challenges or was present in a participant's neighborhood. Modified Poisson regression models estimated adjusted prevalence ratios (aPRs) for virologic suppression as a function of categorical MRM scores, controlling for demographic, clinical, and behavioral characteristics at or prior to sub-study enrollment. We assessed for effect measure modification (EMM) by neighborhood risk environments.

RESULTS

Compared to participants with lesser endorsement of multilevel resilience resources, aPRs for virologic suppression among those with greater or moderate endorsement were 1.03 (95% confidence interval: 0.96-1.11) and 1.03 (0.96-1.11), respectively. Regarding multilevel resilience resource endorsement, there was no strong evidence for EMM by levels of neighborhood risk environments.

CONCLUSIONS

Modest positive associations between higher multilevel resilience resource endorsement and virologic suppression were at times most compatible with the data. However, null findings were also compatible. There was no strong evidence for EMM concerning multilevel resilience resource endorsement, which could have been due to random error. Prospective studies assessing EMM by levels of the neighborhood risk environment with larger sample sizes are needed.

Minority stress and mental health in European transgender and gender diverse people: A systematic review of quantitative studies

The current study aimed at systematically reviewing evidence on the relationships between gender minority stress and mental health outcomes among European transgender and gender diverse (TGD) individuals. A systematic search was conducted in PsycINFO, PubMED, Scopus, and Google Scholar. It was based on Boolean operators to combine terms related to minority stress, TGD identities, and mental health. Thirty studies were identified as eligible. The results confirmed that gender minority stress factors are significantly related with mental health problems among European TGD individuals. Distal stressors were identified as strongly associated with poorer mental health, with gender-related discrimination emerging as the most documented risk factor. The significant role of proximal stressors was also highlighted, with some mediation analyses detecting an indirect effect on mental health. However, identity concealment appeared unrelated to mental health outcomes. Resilience-promoting factors buffering the impact of stressors were also identified, including self-esteem, pride, transitioning, and social support. Conversely, data on community connectedness as a source of resilience were inconclusive. The studies reviewed have several limitations, including lack of longitudinal designs, sampling bias, variability in measurement methods, and unaccounted ethnic variables. Research and clinical recommendations in this field are reported.

Threshold effect of ecosystem services in response to human activity in China's urban agglomeration: a perspective on quantifying ecological resilience

Ecological resilience reflects the role of human activity intensity (HMI) on regional ecosystem services (ESs), and resilience improvement is crucial for the high-quality development of urban agglomeration areas. However, a theoretical framework for ecological resilience needs to be developed based on ES thresholds under human activities. Based on the threshold index, we used threshold regression model to determine of the nonlinear dominant factors affecting ESs and to identify the priority areas for ecological restoration. The results suggest that (1) CS, HQ, and TES declined, while FP increased. The spatial distribution of each ES showed higher values in the central region and lower values in the surrounding areas. HMI showed a significant upward trend, with expanding high-HMI areas. There is a threshold effect in the relationship between HMI and ESs, leading to variations in their positive, non-monotonic, or non-linear interactions. (2) HMI positively and significantly affects ESs, especially at low threshold levels. The effect of HMI on ESs is negative in counties with higher threshold levels rather than in lower-level grids. (3) The critical area of artificial potential ecological restoration was 712 km2, primarily concentrated around urban; the critical area of natural restoration was 490 km2. Therefore, the threshold in the relationship between HMI and ESs should be given more attention. This study serves as a guide for picking out key regions for territorial ecological restoration.

Teaching a Canadian Experiential Course in Religion and Spirituality for Undergraduates in Addiction Counseling and Health Sciences: A Social Constructivist Framework

Religion and spirituality (RS) are integral to counseling and health but their incorporation into the curricula of these professions is still lacking. Limited literature is available on how to effectively teach such courses. This article presents a promising experiential, interactive model for an RS course designed for undergraduate students pursuing careers in addictions counseling, therapeutic recreation, and public health. An online course conducted during the COVID-19 pandemic adopted a social constructivist framework that encompassed four key components in its design and delivery: assessing prior knowledge, creating cognitive dissonance, applying new knowledge with feedback, reflecting on learning. Students' feedback in the course indicated their broadened understanding of the plurality of RS orientations and their acquisition of foundational skills with an increased confidence in bringing RS conversations into their practice. This article provides a conceptual and practical framework for educators to develop an RS course for a diverse representation of students and encourages further evaluation of the proposed model to assess its impact on learning outcomes.

Increased Stress Is Associated With Severe Pain and Decrements in Cognitive Function in Patients Receiving Chemotherapy

OBJECTIVES

Purposes were to identify subgroups of adult oncology patients (n = 1342) with distinct joint profiles of worst pain and cognitive function (CF) and evaluate for differences in demographic and clinical characteristics, as well as the severity of three distinct types of stress, resilience, and coping.

DATA SOURCES

Measures of pain and CF were evaluated six times over two cycles of chemotherapy. The other measures of demographic and clinical characteristics, stress, resilience, and coping were completed at enrollment (ie, prior to the second or third cycle of chemotherapy).

RESULTS

Using latent profile analysis, four distinct profiles were identified (ie, no pain + moderate CF [27.6%], moderate pain + high CF [22.4%] moderate pain and moderate CF [32.4%, both moderate], severe pain and low CF [17.5%, both severe]). Both moderate and both severe classes reported higher global, cancer-specific, and cumulative life stress, lower levels of resilience, and greater use of disengagement coping strategies. The Both severe class had higher occurrence rates for a number of adverse childhood experiences (ie, family violence in childhood, physical abuse at <16 years, forced sex at <16 years). Risk factors associated with membership in the two worst profiles included: being female, having a lower annual income, having a higher comorbidity burden, and having a poorer functional status.

CONCLUSION

Findings suggest that 72.4% of the patients reported pain scores in the moderate to severe range and 77.6% reported low to moderate levels of CF. Clinicians need to assess for both symptoms and various types of stress on a routine basis.

Examining the connection between water concerns, water anxiety, and resilience among Indigenous persons: A systematic scoping review

BACKGROUND & OBJECTIVE

Despite Canada's and the United States' acceptance of the United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP), achieving equitable water, sanitation and hygiene (WASH)-related services among Indigenous peoples remain at issue for the 2030 Sustainable Development Goals (SDGs). Water anxiety is a mental health burden threatening resilience, given cultural stewardship imperatives for water well-being.

PARTICIPANTS AND SETTINGS

Peer-reviewed literature documenting water anxiety/insecurity was explored in relation to resilience among Indigenous communities in Canada and the United States (including Hawaii and Alaska).

METHODS

A systematic scoping review was conducted using three databases (Medline, Sociological Abstracts and PsycINFO) and key words pertaining to Indigenous Peoples, Canada, U.S., and water. Two reviewers screened and extracted each article.

RESULTS

The search yielded six quantitative studies. Large diversity among Indigenous communities resulted in different water concerns tied to geographical locales, industry, and the health of water bodies. Environmental concerns, poor access to safe drinking water, and negative effects of water insecurity (water costs, food scarcity) was associated with water anxiety. Indigenous ecological knowledge, cultural continuity, water advocacy, and participatory community interventions was associated with resilience.

CONCLUSION

There is limited research exploring water anxiety and resilience among Indigenous communities. Particularly among women, water related health risks, concern for future generations, and cultural gender role expectations for water stewardship, contribute to water anxiety. An important next step is to recognize water anxiety as a mental health burden, and advance Indigenous-led research to not only optimally redress water inequities, but also the broader scope of its impact to ongoing trauma among Indigenous peoples.

The Role of Resilience in the Impact of Family Economic Adversity on Youth Emotional Distress over Time

Previous research has highlighted the enduring negative impact of family economic adversity on youth emotional well-being. However, the longitudinal mechanism underlying the link between economic adversity and emotional distress is less explored. The present study examined the longitudinal pathway of parent economic adversity, and parent and adolescent emotional distress at age 16, parental support at age 21, youth self-esteem and mastery at age 23, and adult emotional distress at age 27. Data came from the Family Transitions Project (N = 441, 57% female), a 30-year study of families from the rural Midwest. Structural equation models revealed that economic adversity exerted a long-term negative influence on adult emotional well-being through parent and adolescent emotional distress and youth self-esteem and mastery. Additionally, parental support was associated with adult emotional distress through youth self-esteem and mastery. The current study advances our understanding of youth emotional well-being by suggesting a longitudinal family process and resilience pathways from adolescence to early adulthood.

Belonging, endurance, and resistance: Black placemaking theory in primary care

Black-Americans continue to experience pervasive health disparities. Factors contributing to increased disease risk include a general mistrust of biomedical institutions among Black Americans. The purpose of this focus group study was to identify, among Black patients who regularly seek care from a primary provider, salient themes regarding barriers to 1) receiving quality primary care; and 2) adhering to medical recommendations. We examined transcripts of eight focus groups held remotely with 29 Black patients (aged 30-60 years) who had established primary care providers. Using grounded theory and an inductive thematic analysis of the transcripts, we identified three themes (belonging, endurance, and resistance) consistent with Black placemaking theory. Our findings suggest that reducing health disparities for Black Americans will require clinical initiatives that emphasize: 1) attention to social influences on health behavior and to features of medical institutions that mark them as White spaces (belonging); 2) recognition of, as well as sensitivity to, community awareness of the systemic and interpersonal barriers to health and safety that many Black adults endure; and 3) reframing avoidant (resistant) behaviors as protective strategies among Black patients. Examining primary care in this way-through the lens of Black placemaking theory-reveals how culturally meaningful approaches to harnessing the specialized knowledge and resilience that clearly exists among many Black communities can improve health care delivery.

Resilience of the Dutch HPV-based cervical screening programme during the COVID-19 pandemic

OBJECTIVES

Organisation of a screening programme influences programme resilience to a disruption as COVID-19. Due to COVID-19, the Dutch human papillomavirus-based cervical screening programme was temporarily suspended. Afterwards, multiple measures have been taken to catch-up participation. This study aimed to investigate programme resilience by examining the effect of COVID-19 and programme measures taken on participation in cervical screening.

STUDY DESIGN

Observational cohort study.

METHODS

Data from the national screening registry and Dutch nationwide pathology databank (Palga) were used on invitations and follow-up in 2018/2019 (pre-COVID) and 2020 (COVID). Sending invitations, reminders and self-sampling kits were suspended from March to July 2020. Main outcome measures include distribution of participant characteristics (age, region and screening history), participation rates by age and region, time between invitation and participation (i.e. response time) and self-sampling use per month.

RESULTS

Participation rate was significantly lower in 2020 (49.8%) compared to 2018/19 (56.8%, P < 0.001), in all ages and regions. Compared to 2018/19, participation rates decreased most in women invited from January to March 2020 (-6.7%, -9.1% and -10.4%, respectively). From August, participation rates started to recover (difference between -0.8% and -2.7%). Median response time was longer in February and March (2020: 143 and 173 days; 2018/19: 53 and 55 days) and comparable from July onwards (median difference 0-6 days). Self-sampling use was higher in 2020 (16.3%) compared to 2018/19 (7.6%).

CONCLUSIONS

The pandemic impacted participation rates in the Dutch cervical screening programme, especially of women invited before the programme pause. Implementation of self-sampling in national cervical screening programmes could increase participation rates and could serve as an alternative screening method in times of exceptional health care circumstances, such as a pandemic. Due to the well-organised programme and measures taken to catch-up participation, the impact of COVID-19 on the screening programme remained small.

Widowhood and bereavement in late life

Bereavement is a common and often challenging experience in late life. Evidence shows that while many older adults manage to adjust well and demonstrate resilience in response to the death of a close person, bereavement puts a substantial minority at risk of adverse mental and physical health impacts including mortality. Current research further indicates that 1) this is the case across different countries and cultures across the globe; 2) that the COVID-19 pandemic posed unprecedented challenges for coping with late-life bereavement; 3) that loneliness and social isolation among bereaved older adults tend to be prevalent and harmful, particularly under pandemic but also in nonpandemic circumstances; and, recently, 4) that bereavement may be a risk factor for cognitive decline in this population.

The effect of psychological resilience and spiritual well-being on the experience of hope in parents of children with cancer

PURPOSE

Hope in pediatric oncology guides parents as an inner guidance compass through their child's challenging journey toward cancer treatment. This study was designed to examine the effects of psychological resilience, spiritual well-being, and some child- and parent-related factors on parents' experience of hope while their child is undergoing cancer treatment.

DESIGN AND METHODS

This cross-sectional, correlational study was conducted between March and July 2022 in the pediatric oncology-hematology ward of a university hospital in Turkey. Parents of 120 children with cancer were included in the study. Data were collected using the child and parent questionnaire, Herth Hope Index, Connor-Davidson Resilience Short Form, and Spiritual Well-Being Scale. Correlation and multiple linear regression analysis were used to analyze the data. In addition, the content analysis method was used to analyze the open-ended structured questions. Ethical approval was obtained for the study.

RESULTS

In the study, 57.5% of the parents who participated were mothers. The mean age of the children was 9.46 ± 5.00 years. 30.8% of the children were diagnosed with Acute Lymphoblastic Leukemia, and the mean duration of treatment was 20.42 ± 13.75 months. According to multiple linear regression analysis, child gender (β = -0.16), number of children (β = -0.16), cancer diagnosis (β = -0.24), resilience (β =0.31), and parental spiritual well-being (β =0.40) were the determinant factors affecting parents' experiences of hope. All these predictors explained 55% of the change in parents' hope levels. In addition, two main themes (increasing and decreasing factors) were identified regarding parents' experiences of hope.

CONCLUSIONS

Insights from this study have the potential to shape interventions specifically designed to maintain parents' hope throughout their child's cancer treatment journey.

IMPLICATIONS FOR PRACTICE

This study may provide insights for the design of intervention programs in pediatric oncology hematology wards aimed at strengthening the hope and improving coping mechanisms of parents with children coping with cancer.

The trade-off between health system resiliency and efficiency: evidence from COVID-19 in European regions

The objective of this paper was to investigate the existence of a trade-off between health system resilience and the economic efficiency of the health system, using data for 173 regions in the European Union and the European Free Trade Association countries. Data Envelopment Analysis was used to measure the efficiency of regional health systems before the COVID-19 pandemic. Then, a spatial econometrics model was used to estimate whether this measure of efficiency, adjusted for several covariates, has a significant impact on regional health system resilience during the COVID-19 pandemic, measured by the number of COVID-19 deaths per hundred thousand inhabitants. The results show that COVID-19 death rates were significantly higher in regions with higher population density, higher share of employment in industry, and higher share of women in the population. Results also show that regions with higher values of the health system efficiency index in 2017 had significantly higher rates of COVID-19 deaths in 2020 and 2021, suggesting the existence of a trade-off between health system efficiency and health system resilience during the COVID-19 pandemic.

Exploring strengths, psychological functioning and youth victimization among American Indians and Alaska Natives in four southern states

BACKGROUND

Identifying factors that support healthy psychological functioning after experiencing violence or other adversities in youth can lead to better prevention and intervention efforts. This is particularly important among communities with disproportionately high rates of adversity resulting from legacies of social and political injustices, such as American Indian and Alaska Native populations.

METHODS

Data were pooled from four studies in the southern U.S. to examine a subsample of American Indian/Alaska Native participants (N = 147; mean age 28.54 years, SD = 16.3). Using the resilience portfolio model, we investigate the impact of three categories of psychosocial strengths (regulatory, meaning making, and interpersonal) on psychological functioning (subjective well-being and trauma symptoms), controlling for youth victimization, lifetime adversities, age, and gender.

RESULTS

In examining subjective well-being, the full model accounted for 52 % of the variance, with strengths explaining more variance than adversities (45 % vs 6 %). For trauma symptoms, the full model accounted for 28 % of the variance, with strengths and adversities accounting nearly equally for the variance (14 % and 13 %).

DISCUSSION

Psychological endurance and sense of purpose showed the most promise for bolstering subjective well-being while poly-strengths (having a diversity of multiple strengths) was most predictive of fewer trauma symptoms. Building psychosocial strengths offers promising strategies for prevention and intervention in Native nations and communities.