Dwelling within political violence: Palestinian women's narratives of home, mental health, and resilience

Political violence is increasingly played out within everyday civilian environments, particularly family homes. Yet, within the literature on political violence and mental health, the role of threats to home remains under-explored. Using focus group data from 32 Palestinian women, this paper explores the implications of violations to the home within political violence. Threats to the privacy, control, and constancy of the family home - key dimensions of ontological security (Giddens, 1990) emerged as central themes in women's narratives. Surveillance, home invasions, and actual or threatened destruction of women's home environments provoked fear, anxiety, grief, humiliation, and helplessness, particularly as women struggled to protect their children. Women also described how they mobilized the home for economic, familial and cultural survival. Study findings illuminate the impact of threats to intimate environments on the well-being of women and their families living with chronic political violence, and underscore the importance of attention to violations of place and home in research on civilian experiences of and responses to political violence.

Resilience to affective disorders: a comparative validation of two resilience scales

BACKGROUND

Resilience to affective disorders in rehabilitating patients or in individuals with a severe disability is of special research interest. However, there is no gold standard for measuring resilience. We aimed to test the accuracy of the Dutch translation of the Brief Resilience Scale (BRSnl) and of the Resilience Scale (RSnl) in recognizing rehabilitating patients without anxiety and depression, and to determine the reliability and construct validity of both scales.

METHODS

A within-subjects longitudinal study with six assessments, each one week apart. Forty residents of a nursing home rehabilitating unit were interviewed to assess resilience (BRSnl and RSnl), optimism and pessimism (LOT-R), depression and anxiety (HADS), positive and negative affect (PANAS), and pain (VAS).

RESULTS

Receiver operating characteristic analyses for recognizing the absence of depression and anxiety (HADS-score≤7) revealed better accuracy (P=0.038) for the BRSnl (AUC=0.84; p<0.0001) than for the RSnl (AUC=0.68; P=0.017). The scales correlated moderately at baseline (rs=0.35; p=0.026), and at four-week follow-up (rs=0.50; p=0.004). The RSnl was positively associated with positive outcomes (optimism and positive affect), and the BRSnl positively with positive outcomes, and negatively with negative outcomes (pessimism, anxiety and negative affect). The RSnl showed a better four-week test-retest reliability (ICC, 0.94; 95% CI, 0.87 to 0.97) than the BRSnl (0.66; 95% CI, 0.29 to.83).

LIMITATIONS

Short study duration, a relatively small sample.

CONCLUSION

The BRSnl showed better performance in detecting people without depression and anxiety than the RSnl, and performed better on construct validity.

Understanding the economic impacts of disruptions in water service

Over the past decade, there has been much attention focused on community readiness for catastrophic emergency events, such as major natural disasters or terrorist attacks. However, though the economic costs associated with experiencing such an event are high, the probability of such events occurring is quite low. At the same time, less catastrophic events that temporarily disrupt essential services to local areas, such as water and electricity, are quite common. However, there is little research that documents residents' actual economic costs when their water service is disrupted. In this paper, we contribute to the growing literature assigning economic value to residential water service by documenting the economic costs residents report from routine, small-scale water disruptions through focus groups and in-person interviews. We find that residential impacts ranged from over $1400 in savings (from working more hours than usual and eating out less than usual) to a cost of over $1000, with an overall average of $93.96. These costs, particularly when multiplied over a substantial population, become quite significant and demonstrate the importance of studying the economic costs of such events.

Wellness within illness: happiness in schizophrenia

Schizophrenia is typically a chronic disorder and among the most severe forms of serious mental illnesses in terms of adverse impact on quality of life. Yet, there have been suggestions that some people with schizophrenia can experience an overall sense of happiness in their lives. We investigated happiness among 72 outpatients with non-remitted chronic schizophrenia with a mean duration of illness of 24.4 years, and 64 healthy comparison subjects (HCs). Despite continued treatment with antipsychotic medications, the individuals with schizophrenia manifested a mild to moderate level of psychopathology. People with schizophrenia reported lower mean levels of happiness than HCs, but there was substantial heterogeneity within the schizophrenia group. Level of happiness in persons with schizophrenia was significantly correlated with higher mental health-related quality of life, and several positive psychosocial factors (lower perceived stress, and higher levels of resilience, optimism, and personal mastery). However, level of happiness was not related to sociodemographic characteristics, duration of illness, severity of positive or negative symptoms, physical function, medical comorbidity, or cognitive functioning. Except for an absence of an association with resilience, the pattern of correlations of happiness with other variables seen among HCs was similar to that in individuals with schizophrenia. Although happiness may be harder to achieve in the context of a serious mental illness, it nonetheless appears to be a viable treatment goal in schizophrenia. Psychotherapies targeting positive coping factors such as resilience, optimism, and personal mastery warrant further investigation.

The stress-inducible actin-interacting protein DRR1 shapes social behavior

Understanding the molecular mechanisms by which stress is translated into changes in complex behavior may help to identify novel treatment strategies for stress-associated psychiatric disorders. The tumor suppressor gene down-regulated in renal cell carcinoma 1 (DRR1) was recently characterized as a new molecular link between stress, synaptic efficacy and behavioral performance, most likely through its ability to modulate actin dynamics. The lateral septum is one of the brain regions prominently involved in the stress response. This brain region features high DRR1 expression in adult mice, even under basal conditions. We therefore aimed to characterize and dissect the functional role of septal DRR1 in modulating complex behavior. DRR1 protein expression was shown to be expressed in both neurons and astrocytes of the lateral septum of adult mice. Septal DRR1 mRNA expression increased after acute defeat stress and glucocorticoid receptor activation. To mimic the stress-induced DRR1 increase in the lateral septum of mice, we performed adenovirus-mediated region-specific overexpression of DRR1 and characterized the behavior of these mice. Overexpression of DRR1 in the septal region increased sociability, but did not change cognitive, anxiety-like or anhedonic behavior. The observed changes in social behavior did not involve alterations of the expression of vasopressin or oxytocin receptors, the canonical social neuropeptidergic circuits of the lateral septum. In summary, our data suggest that the stress-induced increase of DRR1 expression in the lateral septum could be a protective mechanism to buffer or counterbalance negative consequences of stress exposure on social behavior.

Foster care and healing from complex childhood trauma

Children enter foster care with many forms of adversity and trauma beyond maltreatment that impact their short- and long-term physical, mental, and developmental health and their adaptation to their new care environment. Applying an understanding of the impact of toxic stress on the developing brain and body allows the health care provider to understand findings in this vulnerable population. Complex trauma alters immune response, neurodevelopment, and the genome, resulting in predictable and significant cognitive, behavioral, and physical consequences. Pediatric care of children in foster care must be trauma informed to meet their medical, mental health, and developmental needs.

Resistance and resilience responses of a range of soil eukaryote and bacterial taxa to fungicide application

The application of plant protection products has the potential to significantly affect soil microbial community structure and function. However, the extent to which soil microbial communities from different trophic levels exhibit resistance and resilience to such compounds remains poorly understood. The resistance and resilience responses of a range of microbial communities (bacteria, fungi, archaea, pseudomonads, and nematodes) to different concentrations of the strobilurin fungicide, azoxystrobin were studied. A significant concentration-dependent decrease, and subsequent recovery in soil dehydrogenase activity was recorded, but no significant impact on total microbial biomass was observed. Impacts on specific microbial communities were studied using small subunit (SSU) rRNA terminal restriction fragment length polymorphism (T-RFLP) profiling using soil DNA and RNA. The application of azoxystrobin significantly affected fungal and nematode community structure and diversity but had no impact on other communities. Community impacts were more pronounced in the RNA-derived T-RFLP profiles than in the DNA-derived profiles. qPCR confirmed that azoxystrobin application significantly reduced fungal, but not bacterial, SSU rRNA gene copy number. Azoxystrobin application reduced the prevalence of ascomycete fungi, but increased the relative abundance of zygomycetes. Azoxystrobin amendment also reduced the relative abundance of nematodes in the order Enoplia, but stimulated a large increase in the relative abundance of nematodes from the order Araeolaimida.

Obsessive-compulsive symptoms and personal disposition, family coherence and school environment in Chinese adolescents: a resilience approach

BACKGROUND

Risk factors of adolescents with obsessive-compulsive symptoms (OC) have been extensively examined, but protective resilience factors have not been explored, particularly in Chinese adolescents.

AIM

This study aimed to investigate the association of resilience factors with the occurrence of OC and its symptoms in Chinese adolescents.

METHOD

This study consisted of two phases. The first phase used a cross-sectional design involving a stratified clustered non-clinical sample of 3185 secondary school students. A clinical interview procedure was then employed to diagnose OC in students who had a Leyton Obsessional Inventory 'yes' score of ≥15. The second phase used a case-control study design to analyse the relationship between resilience factors and OC in a matched sample of 288 adolescents with diagnosed OC relative to 246 healthy adolescents.

RESULTS

Low personal disposition scores in self-fulfilment, flexibility and self-esteem, and low peer relation scores in the school environment were associated with a higher probability of having OC. Canonical correlation analysis indicated that OC symptoms were significantly associated with personal dispositions, poor peer relationships and maladaptive social life, but not to family coherence.

LIMITATIONS

The study is not prospective in nature, so the causal relationship between OC occurrence and resilience factors cannot be confirmed. Second, the use of self-report instruments in personal disposition, family coherence, and school environment may be a source of error.

CONCLUSIONS

Resilience factors at both the personal disposition and school environment levels are important predictors of OC symptoms and caseness. Future studies using prospective designs are needed to confirm these relationships.

The heritability of mental health and wellbeing defined using COMPAS-W, a new composite measure of wellbeing

Mental health is not simply the absence of mental illness; rather it is a distinct entity representing wellness. Models of wellbeing have been proposed that emphasize components of subjective wellbeing, psychological wellbeing, or a combination of both. A new 26-item scale of wellbeing (COMPAS-W) was developed in a cohort of 1669 healthy adult twins (18-61 years). The scale was derived using factor analysis of multiple scales of complementary constructs and confirmed using tests of reliability and convergent validity. Bivariate genetic modeling confirmed its heritability. From an original 89 items we identified six independent subcomponents that contributed to wellbeing. The COMPAS-W scale and its subcomponents showed construct validity against psychological and physical health behaviors, high internal consistency (average r=0.71, Wellbeing r=0.84), and 12-month test-retest reliability (average r=0.62, Wellbeing r=0.82). There was a moderate contribution of genetics to total Wellbeing (heritability h(2)=48%) and its subcomponents: Composure (h(2)=24%), Own-worth (h(2)=42%), Mastery (h(2)=40%), Positivity (h(2)=42%), Achievement (h(2)=32%) and Satisfaction (h(2)=43%). Multivariate genetic modeling indicated genetic variance was correlated across the scales, suggesting common genetic factors contributed to Wellbeing and its subcomponents. The COMPAS-W scale provides a validated indicator of wellbeing and offers a new tool to quantify mental health.

Physical and psychiatric recovery from burns

Burn injuries pose complex biopsychosocial challenges to recovery and improved comprehensive care. The physical and emotional sequelae of burns differ, depending on burn severity, individual resilience, and stage of development when they occur. Most burn survivors are resilient and recover, whereas some are more vulnerable and have complicated outcomes. Physical rehabilitation is affected by orthopedic, neurologic, and metabolic complications and disabilities. Psychiatric recovery is affected by pain, mental disorders, substance abuse, and burn stigmatization. Individual resilience, social supports, and educational or occupational achievements affect outcomes.

Stress in utero alters neonatal stress-induced regulation of the synaptic plasticity proteins Arc and Egr1 in a sex-specific manner

The present study in juvenile rats investigated a "two-hit model" to test the impact of prenatal stress exposure ("first hit") on the regulation of the synaptic plasticity immediate early genes Arc and Egr1 in response to a second neonatal stressor ("second hit") in a sex-specific manner. Three stress-exposed animal groups were compared at the age of 21 days in relation to unstressed controls (CON): preS animals were exposed to various unpredictable stressors during the last gestational trimester; postS animals were exposed to 45 min restraint stress at postnatal day 21, pre/postS animals were exposed to a combination of pre- and postnatal stress as described for the two previous groups. The postS and pre/postS groups were killed 2 h after exposure to the postnatal stressor, males and females were separately analyzed. In line with our hypothesis we detected sex-specific stress sensitivity for both analyzed proteins. Males did not show any significant changes in Arc expression irrespective of the stress condition. In contrast, females, which had been pre-exposed to prenatal stress, displayed an "amplified" Arc upregulation in response to postnatal stress (pre/postS group) compared to unstressed controls, which may reflect a "sensitization" effect of prenatal stress. For Egr1, the females did not show any stress-induced regulation irrespective of the stress condition, whereas in males, which were pre-exposed to prenatal stress, we observed a "protective" effect of prenatal stress on postnatal stress-induced downregulation of Egr1 expression (pre/postS group), which may indicate that prenatal stress exposure may induce "resilience".

Geriatric rehabilitation and resilience from a cultural perspective

Resiliency is a key aspect to aging successfully. Promoting healthy lifestyles, strong social bonds, enhancements to one's environment, accessibility to quality care and rehabilitation are critical in a positive aging experience. Issues of personal, social, medical, and rehabilitative care are addressed in the context of resiliency from a cultural perspective. Various research studies explore resiliency through the progression of aging within changing environments, medical needs, and social conditions. Findings suggest that a strong connection to culture, accessibility to medical attention, and comprehensive assessment of a patient's background can effectively improve the rehabilitation for an aging individual. This article addresses aspects of caregiving that are essential in raising cultural sensitivity and resiliency, discussing three case studies (i.e. fall risk; stroke; congestive heart failure) in the geriatric patient. Resiliency in culture and rehabilitation has a connection needed to advance the quality of care and quality of life for an aging patient population.

Benthic primary production in an upwelling-influenced coral reef, Colombian Caribbean

In Tayrona National Natural Park (Colombian Caribbean), abiotic factors such as light intensity, water temperature, and nutrient availability are subjected to high temporal variability due to seasonal coastal upwelling. These factors are the major drivers controlling coral reef primary production as one of the key ecosystem services. This offers the opportunity to assess the effects of abiotic factors on reef productivity. We therefore quantified primary net (Pn ) and gross production (Pg ) of the dominant local primary producers (scleractinian corals, macroalgae, algal turfs, crustose coralline algae, and microphytobenthos) at a water current/wave-exposed and-sheltered site in an exemplary bay of Tayrona National Natural Park. A series of short-term incubations was conducted to quantify O2 fluxes of the different primary producers during non-upwelling and the upwelling event 2011/2012, and generalized linear models were used to analyze group-specific O2 production, their contribution to benthic O2 fluxes, and total daily benthic O2 production. At the organism level, scleractinian corals showed highest Pn and Pg rates during non-upwelling (16 and 19 mmol O2 m(-2) specimen area h(-1)), and corals and algal turfs dominated the primary production during upwelling (12 and 19 mmol O2 m(-2) specimen area h(-1), respectively). At the ecosystem level, corals contributed most to total Pn and Pg during non-upwelling, while during upwelling, corals contributed most to Pn and Pg only at the exposed site and macroalgae at the sheltered site, respectively. Despite the significant spatial and temporal differences in individual productivity of the investigated groups and their different contribution to reef productivity, differences for daily ecosystem productivity were only present for Pg at exposed with higher O2 fluxes during non-upwelling compared to upwelling. Our findings therefore indicate that total benthic primary productivity of local autotrophic reef communities is relatively stable despite the pronounced fluctuations of environmental key parameters. This may result in higher resilience against anthropogenic disturbances and climate change and Tayrona National Natural Park should therefore be considered as a conservation priority area.

Cortisol response to an experimental stress paradigm prospectively predicts long-term distress and resilience trajectories in response to active police service

Heterogeneity in glucocorticoid response to experimental stress conditions has shown to differentiate individuals with healthy from maladaptive real-life stress responses in a number of distinct domains. However, it is not known if this heterogeneity influences the risk for developing stress related disorders or if it is a biological consequence of the stress response itself. Determining if glucocorticoid response to stress induction prospectively predicts psychological vulnerability to significant real life stressors can adjudicate this issue. To test this relationship, salivary cortisol as well as catecholamine responses to a laboratory stressor during academy training were examined as predictors of empirically identified distress trajectories through the subsequent 4 years of active duty among urban police officers routinely exposed to potentially traumatic events and routine life stressors (N = 234). During training, officers were exposed to a video vignette of police officers exposed to real-life trauma. Changes in salivary 3-methoxy-4-hydroxyphenylglycol (MHPG) and cortisol in response to this video challenge were examined as predictors of trajectory membership while controlling for age, gender, and baseline neuroendocrine levels. Officers who followed trajectories of resilience and recovery over 4 years mounted significant increases in cortisol in response to the experimental stressor, while those following a trajectory of chronic increasing distress had no significant cortisol change in response to the challenge. MHPG responses were not associated with distress trajectories. Cortisol response prospectively differentiated trajectories of distress response suggesting that a blunted cortisol response to a laboratory stressor is a risk factor for later vulnerability to distress following significant life stressors.

Adverse life events and delinquent behavior among Kenyan adolescents: a cross-sectional study on the protective role of parental monitoring, religiosity, and self-esteem

BACKGROUND

Past research provides strong evidence that adverse life events heighten the risk of delinquent behavior among adolescents. Urban informal (slum) settlements in sub-Saharan Africa are marked by extreme adversity. However, the prevalence and consequences of adverse life events as well as protective factors that can mitigate the effects of exposure to these events in slum settlements is largely understudied. We examine two research questions. First, are adverse life events experienced at the individual and household level associated with a higher likelihood of delinquent behavior among adolescents living in two slums in Nairobi, Kenya? Second, are parental monitoring, religiosity, and self-esteem protective against delinquency in a context of high adversity?

METHODS

We used cross-sectional data from 3,064 males and females aged 12-19 years who participated in the Transitions to Adulthood Study. We examined the extent to which a composite index of adverse life events was associated with delinquent behavior (measured using a composite index derived from nine items). We also examined the direct and moderating effects of three protective factors: parental monitoring, religiosity, and self-esteem.

RESULTS

Fifty-four percent of adolescents reported at least one adverse life event, while 18% reported three or more adverse events. For both males and females, adversity was positively and significantly associated with delinquency in bivariate and multivariate models. Negative associations were observed between the protective factors and delinquency. Significant adverse events × protective factor interaction terms were observed for parental monitoring (females and males), religiosity (males), and self-esteem (females).

CONCLUSIONS

Similar to research in high income countries, adverse life events are associated with an increased likelihood of delinquent behavior among adolescents living in urban slums in Kenya, a low-income country. However, parental monitoring, religiosity, and self-esteem may moderate the effect of adversity on delinquent behavior and pinpoint possible avenues to develop interventions to reduce delinquency in resource-poor settings in low and middle income countries.

Serotonin and stress coping

Coping is the necessary outcome of any stressful situation and the major determinant of stress resilience. Coping strategies can be divided into two broad categories, based on the presence (active) or absence (passive) of attempts to act upon the stressor. The role of brain serotonin (5-hydroxytryptamine, 5-HT) in coping behavior that is emerging from studies in animals and humans is the subject of this article. We have focused attention on studies that consider the coping behavior exhibited when the individual is faced with a new stressful experience. Coping styles characterize different species with different evolutionary histories, from fishes to mammals, and evidence shows that serotonin transmission in the central nervous system, with differences in transporter, receptor types and hormone or neurotransmitter influences is critical in determining coping behavior. Moreover, a major role of environmental challenges throughout the lifespan affects brain systems that control coping outcomes through 5-HT transmission. In particular early experiences, for their long-term effects in adulthood, and social experiences throughout the life span, for the effects on serotonin functioning, received attention in preclinical research because of their parallelism in humans and animals. Based on growing evidence pointing to a medial prefrontal cortex-amygdala system in mediating adaptive and maladaptive stress responses, we propose a brain circuit in which serotonin neurons in the dorsal raphe depending on the CRF (corticotropin releasing factor) regulatory action engage a prefrontal cortical-amygdala pathway through 5-HT1A receptors, GABA and Glutamate to moderate coping behavior.

Active coping toward predatory stress is associated with lower corticosterone and progesterone plasma levels and decreased methylation in the medial amygdala vasopressin system

An active coping style displayed under stress - which involves proactive investigatory responses toward environmental threats - has been associated with reduced vulnerability to psychiatric illness. However, the neurobiological determinants of coping styles are not well understood. When rats are exposed to a naturalistic stressor (cat fur) in a group, some individuals in the group show robust active investigation of the stimulus while others show a passive response involving retreat, immobility and close aggregation with conspecifics. Here we explored endocrine and epigenetic correlates of these contrasting coping styles. Male Wistar rats (n=48) were exposed to cat fur in groups of 4 and the passive and active responders were identified and assessed for endocrine and epigenetic differences. Three days after the final cat fur exposure, active responders had substantially lower plasma levels of corticosterone and progesterone than passive responders. Plasma and testicular testosterone levels did not differ between active and passive responders. Active responders had markedly less methylation of the AVP CGCG promoter region located at base 4970 in the posterodorsal region of the medial amygdala but did not differ in the methylation status of the CCGG sequence located at base 2243. This is in agreement with prior research suggesting that AVP and progesterone act in opposition within the medial amygdala to modulate stress-related behaviors. The present study reports striking endocrine and epigenetic differences between active and passive responders, providing insight into potential systems involved in the manifestation of differing coping styles.

Understanding resilience in industrial symbiosis networks: insights from network analysis

Industrial symbiotic networks are based on the principles of ecological systems where waste equals food, to develop synergistic networks. For example, industrial symbiosis (IS) at Kalundborg, Denmark, creates an exchange network of waste, water, and energy among companies based on contractual dependency. Since most of the industrial symbiotic networks are based on ad-hoc opportunities rather than strategic planning, gaining insight into disruptive scenarios is pivotal for understanding the balance of resilience and sustainability and developing heuristics for designing resilient IS networks. The present work focuses on understanding resilience as an emergent property of an IS network via a network-based approach with application to the Kalundborg Industrial Symbiosis (KIS). Results from network metrics and simulated disruptive scenarios reveal Asnaes power plant as the most critical node in the system. We also observe a decrease in the vulnerability of nodes and reduction in single points of failure in the system, suggesting an increase in the overall resilience of the KIS system from 1960 to 2010. Based on our findings, we recommend design strategies, such as increasing diversity, redundancy, and multi-functionality to ensure flexibility and plasticity, to develop resilient and sustainable industrial symbiotic networks.

Neonatal experience interacts with adult social stress to alter acute and chronic Theiler's virus infection

Previous research has shown that neonatal handling has prolonged protective effects associated with stress resilience and aging, yet little is known about its effect on stress-induced modulation of infectious disease. We have previously demonstrated that social disruption stress exacerbates the acute and chronic phases of the disease when applied prior to Theiler's virus infection (PRE-SDR) whereas it attenuates disease severity when applied concurrently with infection (CON-SDR). Here, we asked whether neonatal handling would protect adult mice from the detrimental effects of PRE-SDR and attenuate the protective effects of CON-SDR on Theiler's virus infection. As expected, handling alone decreased IL-6 and corticosterone levels, protected the non-stressed adult mice from motor impairment throughout infection and reduced antibodies to myelin components (PLP, MBP) during the autoimmune phase of disease. In contrast, neonatal handling X PRE/CON-SDR elevated IL-6 and reduced corticosterone as well as increased motor impairment during the acute phase of the infection. Neonatal handling X PRE/CON-SDR continued to exacerbate motor impairment during the chronic phase, whereas only neonatal handling X PRE-SDR increased in antibodies to PLP, MOG, MBP and TMEV. Together, these results imply that while handling reduced the severity of later Theiler's virus infection in non-stressed mice, brief handling may not be protective when paired with later social stress.

The impact of childhood trauma on depression: does resilience matter? Population-based results from the Study of Health in Pomerania

OBJECTIVE

Data suggests that traumatic experiences at early age contribute to the onset of major depressive disorder (MDD) in later life. This study aims at investigating the influence of dispositional resilience on this relationship.

METHODS

Two thousand and forty-six subjects aged 29-89 (SD=13.9) from a community based sample who were free of MDD during the last 12 months prior to data collection were diagnosed for Lifetime diagnosis of MDD by the Munich-Composite International Diagnostic Interview (M-CIDI) according to DSM-IV criteria. Childhood maltreatment (CM) and resilience were assessed with the Childhood Trauma Questionnaire (CTQ) and the Resilience-Scale (RS-25).

RESULTS

Both CM (OR=1.03, 95% CI [1.02, 1.04], P<.000) and resilience (OR=0.98, 95% CI [0.98, 0.99], P<.000) were associated with MDD later in life. The detrimental effects of low resilience on MDD were not only especially prominent in subjects with a history of CM (OR=3.18, 95% CI [1.84, 5.50], P<.000), but also effective in subjects without CM (OR=2.62, 95% CI [1.41, 4.88], P=.002).

CONCLUSIONS

The findings support the clinical assumption that resilient subjects may be partly protected against the detrimental long-term effects of child abuse and neglect.

Resilience Scale-25 Spanish version: validation and assessment in eating disorders

OBJECTIVES

To validate into Spanish the Wagnild and Young Resilience Scale - 25 (RS-25), assess and compare the scores on the scale among women from the general population, eating disorder (ED) patients and recovered ED patients.

METHOD

This is a cross-sectional study. ED participants were invited to participate by their respective therapists. The sample from the general population was gathered via an open online survey. Participants (N general population=279; N ED patients=124; and N recovered ED patients=45) completed the RS-25, the World Health Organization Quality of Life Scale-BREF and the Hospital Anxiety and Depression Scale. Mean age of participants ranged from 28.87 to 30.42years old. Statistical analysis included a multi-group confirmatory factor analysis and ANOVA.

RESULTS

The two-factor model of the RS-25 produced excellent fit indexes. Measurement invariance across samples was generally supported. The ANOVA found statistically significant differences in the RS-25 mean scores between the ED patients (Mean=103.13, SD=31.32) and the recovered ED participants (Mean=138.42, SD=22.26) and between the ED patients and the general population participants (Mean=136.63, SD=19.56).

DISCUSSION

The Spanish version of the RS-25 is a psychometrically sound measurement tool in samples of ED patients. Resilience is lower in people diagnosed with ED than in recovered individuals and the general population.

Do Higher Levels of Resilience Buffer the Deleterious Impact of Chronic Illness on Disability in Later Life?

PURPOSE OF THE STUDY

In examining the ability of resilience, or the ability to navigate adversity in a manner that protects well-being, to buffer the impact of chronic disease onset on disability in later life, the authors tested 2 hypotheses: (a) People with greater levels of resilience will have lower levels of disability and (b) resilience will moderate the association between the onset of a new chronic condition and subsequent disability.

DESIGN AND METHODS

This study used a sample of 10,753 Americans between the ages of 51 and 98, derived from 3 waves of the Health and Retirement Study (2006-2010). Ordinary least squares regression was used to estimate the impact of resilience on changes in disability (measured as difficulty with activities of daily living [ADLs] and instrumental activities of daily living [IADLs]) over a 2-year period using a simplified resilience score.

RESULTS

Resilience protects against increases in ADL and IADL limitations that are often associated with aging. Resilience mitigates a considerable amount of the deleterious consequences related to the onset of chronic illness and subsequent disability.

IMPLICATIONS

Our results support our hypotheses and are consistent with claims that high levels of resilience can protect against the negative impact of disability in later life.

Health-related self-perceptions over time and provider-based Complementary and Alternative Medicine (CAM) use in people with inflammatory bowel disease or arthritis. Complement Ther Med. 2014;22:701-709. [PMID: 25146075 DOI: 10.1016/j.ctim.2014.07.003]

OBJECTIVES

To prospectively investigate how health-related self-perceptions are associated with use of provider-based CAM in two chronic inflammatory diseases, arthritis and inflammatory bowel disease (IBD).

DESIGN AND SETTING

A prospective online survey was administered to convenience samples of individuals with arthritis or inflammatory bowel disease, and a follow-up survey completed 6 months later. Participants were recruited via online ads, through national organizations, and support groups.

MAIN OUTCOME MEASURES

Surveys included measures of demographics, use of provider-delivered CAM, disease-related factors, self-perceptions of having a healthy lifestyle and being able to handle stress, and trait resilience.

RESULTS

325 people (170 with arthritis and 155 with IBD) completed the initial and follow-up surveys. Rates of CAM use were 43.2% and 45.9% for the arthritis and IBD groups, respectively. T-tests revealed significant differences on healthy lifestyle self-perceptions and trait resilience for both illness groups. Differences in self-perceptions about handling stress were only significant in the IBD group. Multivariate logistic regression controlling for demographics and health-related variables revealed that seeing oneself as having a healthy lifestyle predicted CAM use in both illness groups. Being resilient predicted CAM use only in the IBD group, and self-perceptions about handling stress predicted CAM use only in the arthritis group.

CONCLUSIONS

This study provides insights into how health-related self-perceptions are prospectively linked to provider-based CAM use in patients with chronic inflammatory disease. This information is important for both health-care practitioners and researchers as it has implications for maximizing the health-promoting aspects of CAM use and understanding CAM adherence.

Stress biology and aging mechanisms: toward understanding the deep connection between adaptation to stress and longevity

The rate of biological aging is modulated in part by genes interacting with stressor exposures. Basic research has shown that exposure to short-term stress can strengthen cellular responses to stress ("hormetic stress"). Hormetic stress promotes longevity in part through enhanced activity of molecular chaperones and other defense mechanisms. In contrast, prolonged exposure to stress can overwhelm compensatory responses ("toxic stress") and shorten lifespan. One key question is whether the stressors that are well understood in basic models of aging can help us understand psychological stressors and human health. The psychological stress response promotes regulatory changes important in aging (e.g., increases in stress hormones, inflammation, oxidative stress, insulin). The negative effects of severe stress are well documented in humans. Potential positive effects of acute stress (stress resistance) are less studied, especially at the cellular level. Can stress resistance slow the rate of aging in humans, as it does in model organisms? If so, how can we promote stress resistance in humans? We urge a new research agenda embracing the continuum from cellular stress to psychological stress, using basic and human research in tandem. This will require interdisciplinary novel approaches that hold much promise for understanding and intervening in human chronic disease.

The effects of coral bleaching on settlement preferences and growth of juvenile butterflyfishes

Coral bleaching and associated mortality is an increasingly prominent threat to coral reef ecosystems. Although the effects of bleaching-induced coral mortality on reef fishes have been well demonstrated, corals can remain bleached for several weeks prior to recovery or death and little is known about how bleaching affects resident fishes during this time period. This study compared growth rates of two species of juvenile butterflyfishes (Chaetodon aureofasciatus and Chaetodon lunulatus) that were restricted to feeding upon either bleached or healthy coral tissue of Acropora spathulata or Pocillopora damicornis. Coral condition (bleached vs. unbleached) had no significant effects on changes in total length or weight over a 23-day period. Likewise, in a habitat choice experiment, juvenile butterflyfishes did not discriminate between healthy and bleached corals, but actively avoided using recently dead colonies. These results indicate that juvenile coral-feeding fishes are relatively robust to short term effects of bleaching events, provided that the corals do recover.

Dealing with the consequences of war: resources of formerly recruited and non-recruited youth in northern Uganda

PURPOSE

This article explores resources that help formerly recruited young people in dealing with war-related adversity and subsequent challenges, hence fostering their resilience.

METHODS

Self-reports on pertinent resources were collected from 1,008 northern Ugandan youth, of whom 330 had formerly been recruited by the Lord's Resistance Army. Based on the conceptual framework developed by the Psychosocial Working Group, the reported resources were thematically clustered and quantitatively analyzed.

RESULTS

This study identified a range of human, social, and cultural resources, with little difference between groups. Religious beliefs, social support, and mental health resources were most frequently reported by former child soldiers.

CONCLUSIONS

These results reveal a multitude of resources and suggest that it is important to build on these resources in interventions that aim to support former child soldiers in the aftermath of armed conflict.

Recovery trends of Scrobicularia plana populations after restoration measures, affected by extreme climate events

The Mondego estuary (Portugal) went through different ecological scenarios over the last decades. An eutrophication process led to a decline in the ecosystem quality. The ensuing restoration plan resulted into a gradual ecological recovery, which was impaired by the occurrence of successive extreme climate events that affected dynamics and productivity of key species. In this study we assess the response of the bivalve Scrobicularia plana to the impacts of these events in a recovery scenario, by comparing populations in two different intertidal habitats: a seagrass bed and a sandflat area. As a general tendency, S. plana, which was negatively affected by eutrophication, responded positively to restoration. However, the occurrence of extreme climate events seemed to affect recruitment success, biomass and production, impairing the recovery process. In the seagrass bed, S. plana maintained a stable and structured population, while in the sandflat area recovery clearly reverted into a decline, mainly concerning biomass and production values. This sequence of multiple stressors might have reduced S. plana resilience to further impacts and therefore, understanding the behavior of biological populations following restoration initiatives requires acknowledgement that some changes may not be easily reversible.

Predictors of Positive Outcomes in Offspring of Depressed Parents and Non-depressed Parents Across 20 Years

Understanding differences in factors leading to positive outcomes in high-risk and low-risk offspring has important implications for preventive interventions. We identified variables predicting positive outcomes in a cohort of 235 offspring from 76 families in which one, both, or neither parent had major depressive disorder. Positive outcomes were termed resilient in offspring of depressed parents, and competent in offspring of non-depressed parents, and defined by two separate criteria: absence of psychiatric diagnosis and consistently high functioning at 2, 10, and 20 years follow-up. In offspring of depressed parents, easier temperament and higher self-esteem were associated with greater odds of resilient outcome defined by absence of diagnosis. Lower maternal overprotection, greater offspring self-esteem, and higher IQ were associated with greater odds of resilient outcome defined by consistently high functioning. Multivariate analysis indicated that resilient outcome defined by absence of diagnosis was best predicted by offspring self-esteem; resilient outcome defined by functioning was best predicted by maternal overprotection and self-esteem. Among offspring of non-depressed parents, greater family cohesion, easier temperament and higher self-esteem were associated with greater odds of offspring competent outcome defined by absence of diagnosis. Higher maternal affection and greater offspring self-esteem were associated with greater odds of competent outcome, defined by consistently high functioning. Multivariate analysis for each criterion indicated that competent outcome was best predicted by offspring self-esteem. As the most robust predictor of positive outcomes in offspring of depressed and non-depressed parents, self-esteem is an important target for youth preventive interventions.

The impact of social support on psychological distress for U.S. Afghanistan/Iraq era veterans with PTSD and other psychiatric diagnoses

This study aimed to examine the degree to which posttraumatic stress disorder (PTSD) affects the relationship between social support and psychological distress for U.S. Afghanistan/Iraq era veterans with and without co-occurring psychiatric disorders. Veterans (N=1825) were administered self-report questionnaires and a structured diagnostic interview as part of a multi-site study of post-deployment mental health through the Department of Veterans Affairs (VA) Mid-Atlantic Mental Illness Research, Education and Clinical Center (MIRECC). Main and interaction effects models assessed the association between psychological distress and social support for three comparisons conditions (Controls vs. PTSD-only, non-PTSD, and PTSD plus co-morbid diagnoses). Having PTSD was a critical factor in attenuating the strength of this association, more so than other diagnoses. Furthermore, those with PTSD plus co-morbid diagnoses did not demonstrate significantly larger attenuation in that association compared to the PTSD-only group, indicating that psychiatric comorbidity may be less important in considering the role of social support in PTSD. By understanding this relationship, new avenues for engaging and enhancing treatment outcomes related to social support for veterans of this cohort may be identified. Additional longitudinal research could help evaluate the effect of PTSD symptom clusters, social support type, and trauma exposure type on these relationships.

"That land means everything to us as Anishinaabe….": Environmental dispossession and resilience on the North Shore of Lake Superior

This article shares results of a community-based (CBR) study that qualitatively examined the perceived health impacts of environmental dispossession among Elders in two Anishinaabe communities in Ontario, Canada. Through in-depth interviews, Elders (n=46) recounted changes in health and well-being, specifically that related to reduced access to traditional foods and decreased capacity to participate in, and share knowledge of, land-based practices. Elders discussed the ways in which they have remained resilient to these changes in their ways of living. With a greater purpose of proposing solutions that will improve contemporary patterns of Indigenous health, this research underscores the importance of engaging theoretically in concepts of environmental dispossession and resilience.

Enzymatic functional stability of Zn-contaminated field-collected soils: an ecotoxicological perspective

Functional stability (FS) is an ecosystem attribute that is increasingly promoted in soil health assessment. However, FS is currently assessed comparatively, and it is therefore impossible to generate toxicity parameters. Additionally, the FS scores in the literature do not consider site and contamination history within the score. To address these issues, three new FS scores adapted to an ecotoxicological context and based on the Relative Soil Stability Index (RSSI) method were developed. The aim of the study was then to determine the FS score(s) that best describe the toxicity of metal-contaminated field-collected soils. Twenty pairs of Zn-contaminated soils (contaminated and reference soils) were collected on the field, and their enzymatic FS (arylsulfatase, protease, phosphatase and urease) and metal fractions (total and bioavailable) were analyzed. New RSSI-based and existing FS scores were calculated for each enzyme and correlated to the Zn fractions. One of the new RSSI-based scores was well correlated with the bioavailable labile Zn concentration for the arylsulfatase, phosphatase and urease (coefficients of regression higher than 0.50). Furthermore, this FS score was not affected by the soil organic matter and depended little on other soil properties. Other FS scores were correlated to labile Zn for only one enzyme, which varied according to the score. The new RSSI-based score thus better attributed Zn toxicity to field-collected soils than other FS scores.

Resilient parenting of children at developmental risk across middle childhood

This paper focuses on factors that might influence positive parenting during middle childhood when a parent faces formidable challenges defined herein as "resilient parenting." Data were obtained from 162 families at child age 5 and 8 years. Using an adapted ABCX model, we examined three risk domains (child developmental delay, child ADHD/ODD diagnosis, and low family income) and three protective factors (mother's education, health, and optimism). The outcome of interest was positive parenting as coded from mother-child interactions. We hypothesized that each of the risk factors would predict poorer parenting and that higher levels of each protective factor would buffer the risk-parenting relationship. Positive parenting scores decreased across levels of increasing risk. Maternal optimism appeared to be a protective factor for resilient parenting concurrently at age 5 and predictively to age 8, as well as a predictor of positive change in parenting from age 5 to age 8, above and beyond level of risk. Maternal education and health were not significantly protective for positive parenting. Limitations, future directions, and implications for intervention are discussed.

Resilience buffers the impact of traumatic events on the development of PTSD symptoms in firefighters

BACKGROUND

Resilience is considered to be a powerful protective factor in buffering the detrimental impact of traumatic stress on the development of posttraumatic stress disorder (PTSD). However, there is a striking lack of research concerning the development of a model of resilience, especially one including both risk and protective factors. The aim of this study was to investigate the possible mediators and moderators influencing the relationship between traumatic stress and PTSD using a moderated mediation analysis.

METHODS

Study participants included 552 Korean firefighters from four large cities. The subjects completed a series of self-report measures including the Life Event Checklist, the Perceived Stress Scale, the Occupational Stress Scale, the Impact of Event Scale-Revised, and the Connor-Davidson Resilience Scale.

RESULTS

Traumatic stress had both a direct and an indirect, via perceived stress, impact on the development of PTSD symptoms. Additionally, the mediation of the association between traumatic stress and PTSD symptoms via perceived stress was moderated by individual resilience. In particular, under the same level of traumatic stress, firefighters with high levels of resilience (scores ≥75, upper 25th percentile or ≥90, upper 10th percentile) were protected from both the direct and indirect impacts of traumatic stress relative to those with lower levels of individual resilience.

CONCLUSIONS

The current findings provide a comprehensive picture of individuals who should be considered at high risk for the development of PTSD symptoms following traumatic stress and identify the factors that should be targeted by efforts to prevent PTSD.

Factors related to academic success among nursing students: a descriptive correlational research study

BACKGROUND

The current rise in employment is improving forecasts for the future supply of registered nurses; however sizeable shortages are still projected. With the intention of improving academic success in nursing students, related factors need to be better understood.

OBJECTIVES

The purpose of the correlational study was to describe the relationship between emotional intelligence, psychological empowerment, resilience, spiritual well-being, and academic success in undergraduate and graduate nursing students.

DESIGN/SETTING

A descriptive correlational design was utilized. The study was set in a private Catholic university.

PARTICIPANTS

There were 124 participants. There were 59% undergraduate and 41% graduate students.

METHODS

Background data, in addition to the Spreitzer Psychological Empowerment Scale, the Wagnild and Young Resilience Scale, and the Spiritual Well-Being Scale and the Mayer-Salovey-Caruso Emotional Intelligence Test, was collected from students who met study criteria.

RESULTS

In a combined sample, academic success was correlated with overall spiritual well-being, empowerment and resilience. Although academic success was not correlated with overall emotional intelligence, it was correlated with the emotional intelligence branch four (managing emotions) score. When undergraduate and graduate students were considered separately, only one correlation was found to be significantly related to academic success in the undergraduate sample, namely, emotional intelligence branch one (perceiving emotions). When examining the data from just graduate level nurses, significant relationships were found between total emotional intelligence with academic success, resilience with academic success, and psychological empowerment with academic success.

CONCLUSION

The significant relationship between psychological empowerment, resilience, spiritual well-being and academic success in this study supports the statements in the literature that these concepts may play an important role in persistence through the challenges of nursing education. Research is needed to examine if strategies to enhance empowerment, resilience, and spiritual well-being can increase academic success in a test-retest design.

Understanding resilience in armed conflict: social resources and mental health of children in Burundi

Little is known about the role of cognitive social capital among war-affected youth in low- and middle-income countries. We examined the longitudinal association between cognitive social capital and mental health (depression and posttraumatic stress disorder (PTSD) symptoms), functioning, and received social support of children in Burundi. Data were obtained from face-to-face interviews with 176 children over three measurement occasions over the span of 4-months. Cognitive social capital measured the degree to which children believed their community was trustworthy and cohesive. Mental health measures included the Depression Self-Rating Scale (DSRS) (Birleson, 1981), the Child Posttraumatic Symptom Scale (Foa et al., 2001), and a locally constructed scale of functional impairment. Children reported received social support by listing whether they received different types of social support from self-selected key individuals. Cross-lagged path analytic modeling evaluated relationships between cognitive social capital, symptoms and received support separately over baseline (T1), 6-week follow-up (T2), and 4-month follow-up (T3). Each concept was treated and analyzed as a continuous score using manifest indicators. Significant associations between study variables were unidirectional. Cognitive social capital was associated with decreased depression between T1 and T2 (B = -.22, p < .001) and T2 and T3 (β = -.25, p < .001), and with functional impairment between T1 and T2 (β = -.15, p = .005) and T2 and T3 (β = -.14, p = .005); no association was found for PTSD symptoms at either time point. Cognitive social capital was associated with increased social support between T1 and T2 (β = .16, p = .002) and T2 and T3 (β = .16, p = .002). In this longitudinal study, cognitive social capital was related to a declining trajectory of children's mental health problems and increases in social support. Interventions that improve community relations in war-affected communities may alter the trajectories of resource loss and gain with conflict-affected children.

Maintenance of dominance status is necessary for resistance to social defeat stress in Syrian hamsters

Resilience is an active process that involves a discrete set of neural substrates and cellular mechanisms and enables individuals to avoid some of the negative consequences of extreme stress. We have previously shown that dominant individuals show less stress-induced changes in behavior compared to subordinates using a conditioned defeat model in male Syrian hamsters (Mesocricetus auratus). To rule out pre-existing differences between dominants and subordinates, we examined whether 14 days of dominance experience is required to reduce the conditioned defeat response and whether the development of conditioned defeat resistance correlates with defeat-induced neural activation in select brain regions. We paired hamsters in daily 5-min aggressive encounters for 1, 7, or 14 days and then exposed animals to 3, 5-min social defeat episodes. The next day animals received conditioned defeat testing which involved a 5-min social interaction test with a non-aggressive intruder. In separate animals brains were collected after social defeat for c-Fos immunohistochemistry. We found that 14-day dominants showed a decreased conditioned defeat response compared to 14-day subordinates and controls, while 1-day and 7-day dominants did not differ from their subordinate counterparts. Also, the duration of dominance relationship was associated with distinct patterns of defeat-induced neural activation such that only 14-day dominants showed elevated c-Fos immunoreactivity in the ventral medial prefrontal cortex, medial amygdala, and lateral portions of the ventral medial hypothalamus. Our data suggest that resistance to social stress develops during the maintenance of dominance relationships and is associated with experience-dependent neural plasticity in select brain regions.

Systematic review of universal school-based resilience interventions targeting adolescent tobacco, alcohol or illicit drug use: review protocol

INTRODUCTION

Tobacco, alcohol and illicit drug use contribute significantly to global rates of morbidity and mortality. Despite evidence suggesting interventions designed to increase adolescent resilience may represent a means of reducing adolescent substance use, and schools providing a key opportunity to implement such interventions, existing systematic reviews assessing the effectiveness of school-based interventions targeting adolescent substance use have not examined this potential.

METHODS AND ANALYSIS

The aim of the systematic review is to determine whether universal interventions focused on enhancing the resilience of adolescents are effective in reducing adolescent substance use. Eligible studies will: include participants 5-18 years of age; report tobacco use, alcohol consumption or illicit drug use as outcomes; and implement a school-based intervention designed to promote internal (eg, self-esteem) and external (eg, school connectedness) resilience factors. Eligible study designs include randomised controlled trials, cluster randomised controlled trials, staggered enrolment trials, stepped wedged trials, quasi-randomised trials, quasi-experimental trials, time series/interrupted time-series trials, preference trials, regression discontinuity trials and natural experiment studies with a parallel control group. A search strategy including criteria for participants, study design, outcome, setting and intervention will be implemented in various electronic databases and information sources. Two reviewers will independently screen studies to assess eligibility, as well as extract data from, and assess risk of bias of included studies. A third reviewer will resolve any discrepancies. Attempts will be made to quantify trial effects by meta-analysis. Binary outcomes will be pooled and effect size reported using ORs. For continuous data, effect size of trials will be reported using a mean difference where trial outcomes report the same outcome using a consistent measure, or standardised mean difference where trials report a comparable measure. Otherwise, trial outcomes will be described narratively.

DISSEMINATION

Review findings will be disseminated via peer-reviewed journals and conferences.

The adolescent emotional coping after an earthquake: a risk factor for suicidal ideation

The study aims to investigate the relationship of suicidal ideation with coping and resilience in a sample of adolescents who survived an earthquake. Three hundred forty-three adolescents who had experienced the L'Aquila earthquake were investigated for a screening distinguishing Suicidal Screen-Negative (SSN) from the Positive (SSP) subjects. Resilience Scale for Adolescents (READ) and Brief Cope were administered. Emotion-focused coping score was significantly higher in SSP subjects. In the SSN but not in the SSP sample the READ total score correlated with problem-focused total score. A positive correlation was seen between emotion-focused and problem-focused scores in both samples, with a higher coefficient in SSP sample. Externalising problems and maladaptive behaviours can arise in adolescents exposed to traumatic events. Attention should be paid in reducing risk factors and in the development of psychological abilities, improving the coping strategies that can protect from emotional despair and suicidal ideation.

Assessing the impact of human trampling on vegetation: a systematic review and meta-analysis of experimental evidence

Vegetation trampling resulting from recreation can adversely impact natural habitats, leading to the loss of vegetation and the degradation of plant communities. A considerable primary literature exists on this topic, therefore it is important to assess whether this accumulated evidence can be used to reach general conclusions concerning vegetation vulnerability to inform conservation management decisions. Experimental trampling studies on a global scale were retrieved using a systematic review methodology and synthesised using random effects meta-analysis. The relationships between vegetation recovery and each of initial vegetation resistance, trampling intensity, time for recovery, Raunkiaer life-form (perennating bud position), and habitat were tested using random effects multiple meta-regressions and subgroup analyses. The systematic search yielded 304 studies; of these, nine reported relevant randomized controlled experiments, providing 188 vegetation recovery effect sizes for analysis. The synthesis indicated there was significant heterogeneity in the impact of trampling on vegetation recovery. This was related to resistance and recovery time, and the interactions of these variables with Raunkiaer life-form, but was not strongly dependent on the intensity of the trampling experienced. The available evidence suggests that vegetation dominated by hemicryptophytes and geophytes recovers from trampling to a greater extent than vegetation dominated by other life-forms. Variation in effect within the chamaephyte, hemicryptophyte and geophyte life-form sub-groups was also explained by the initial resistance of vegetation to trampling, but not by trampling intensity. Intrinsic properties of plant communities appear to be the most important factors determining the response of vegetation to trampling disturbance. Specifically, the dominant Raunkiaer life-form of a plant community accounts for more variation in the resilience of communities to trampling than the intensity of the trampling experienced, suggesting that simple assessments based on this trait could guide decisions concerning sustainable access to natural areas. Methodological and reporting limitations must be overcome before more disparate types of evidence can be synthesised; this would enable more reliable extrapolation to non-study situations, and a more comprehensive understanding of how assessments of intrinsic plant traits can be used to underpin conservation management decisions concerning access.

Nurses' occupational health as a driver for curriculum change emphasising health promotion: an historical research study

BACKGROUND

Reasons stated for curriculum change in nursing education are usually shifts in knowledge, care delivery, roles, regulatory standards and population health needs. In New Zealand in the 1930s, a curriculum change was driven instead by the need to protect and promote nurses' health. Tuberculosis was an international occupational health risk among nurses. Mary Lambie, New Zealand's chief nurse, considered nursing a "hazardous profession". One remedy she instituted was curriculum change in the national nurse training programme to emphasise health promotion among nurses. Global nursing issues today also impact on nurses' health. Curriculum changes again address this by promoting self-care and resilience.

OBJECTIVE

To examine how international and national concern for nurses' occupational health drove a curriculum change in New Zealand nurse training in the 1930s.

DESIGN

Historical Research

METHODS

International occupational health reports (1930s), Lambie's annual reports (1932-1950), and questions and examiners' comments in a new state examination (1940s-1950s), were analysed to identify the reasons for and direction of the curriculum change. Findings were interpreted within international and national concerns and measures related to occupational health in nursing.

RESULTS

Lambie used the political leverage of international and national worry over tuberculosis as a nursing occupational health risk to protect nurses' health more generally. In 1933 she revised the first year of the three-year national nursing curriculum to emphasise personal hygiene and bacteriology related to cross-infection, and in 1938 introduced a State Preliminary Examination at the end of the first year of training to test this knowledge. Analysis of examinations, 1940s-1950s, confirms that the curriculum change driver was a concern to make nursing a less "hazardous profession".

CONCLUSION

Nurse educators today should be aware of the variety of factors that can lead to curriculum change in nursing. In addition, concern for nurses' health today demonstrates the continuing need for health promotion in nursing curricula.

Disentangling Sense of Coherence and Resilience in case of multiple traumas

BACKGROUND

Depressive and anxiety disorders (DAD) are a major public health problem. Trauma endured during childhood is known to increase the risk of DAD in adulthood. We investigate the hypothesis that Sense of Coherence (SOC) is a mediator between childhood trauma and depressive and anxious symptoms (DAD) in adulthood. We also explore the nature (personality trait or aptitude) of SOC and attempt to disentangle the concepts of resilience and SOC.

METHOD

Former hidden children (FHC), the Jewish youths who spent World War II in various hideaway shelters across Nazi-occupied Europe, were compared with a control group. In each group we measured the presence of multiple traumas, the resilience with the Resilience Scale for Adults, the DAD with the Hopkins Symptoms Checklist and the SOC with the SOC-13 self-report questionnaire. We tested a mediated moderation model with childhood Trauma as the predictor; Adulthood trauma as the moderator; SOC as the mediator; and DAD as the outcome variable.

RESULTS

Results were consistent with a sensitization model of DAD partially mediated by SOC. A first component of SOC was similar to an aptitude and another part of SOC was more similar to a personality trait.

LIMITATIONS

We are unable to differentiate if the sensitization process is a consequence of the nature of the trauma endured by FHC (long-standing exposure to extreme external events) or a consequence of the fact that this first trauma occurred during childhood.

CONCLUSION

Our results could account for the controversial debate regarding the life time stability of SOC.

Analysis of the resilience of team performance during a nuclear emergency response exercise

The current work presents results from a cognitive task analysis (CTA) of a nuclear disaster simulation. Audio-visual records were collected from an emergency room team composed of individuals from 26 different agencies as they responded to multiple scenarios in a simulated nuclear disaster. This simulation was part of a national emergency response training activity for a nuclear power plant located in a developing country. The objectives of this paper are to describe sources of resilience and brittleness in these activities, identify cues of potential improvements for future emergency simulations, and leveraging the resilience of the emergency response system in case of a real disaster. Multiple CTA techniques were used to gain a better understanding of the cognitive dimensions of the activity and to identify team coordination and crisis management patterns that emerged from the simulation exercises.

Surgical resilience: a review of resilience biomarkers and surgical recovery

BACKGROUND

Two distinct and large bodies of literature exist on resilience that are of potential interest for surgical outcomes. First is the literature on the impact of resilience on surgical recovery and wound-healing. Second is the literature on biomarkers for resilience, which largely focuses on neuropeptide Y (NPY), testosterone and dehydroepiandrosterone (DHEA). Despite this activity, there is a dearth of literature linking these two bodies of research by investigating biomarkers for surgical resilience and its impact on surgical recovery. This paper reviews both bodies of literature within the context of surgical recovery.

METHOD

Literature searches within Medline and Embase were conducted for studies and previous reviews of resilience biomarkers and for the impact of individual resilience on surgical recovery. Reference lists of the reviews were searched for additional papers. No systematic review is yet possible due to the novelty of the use of resilience biomarkers within a surgical context.

RESULTS

This is the first review to explore a potential link between resilience biomarkers and surgical recovery. There are a number of biomarkers that correlate with individual resilience levels and resilient individuals exhibit better recovery trajectories following surgery, suggesting a novel use of such biomarkers for the identification of "surgical resilience".

CONCLUSION

By identifying surgical resilience, there is potential for utilising these biomarkers as prognostic indicators of likely recovery trajectories from surgery, which in turn complement individualised peri-operative management.

Rethinking the relationship between flood risk perception and flood management

Although flood risk perceptions and their concomitant motivations for behaviour have long been recognised as significant features of community resilience in the face of flooding events, there has, for some time now, been a poorly appreciated fissure in the accompanying literature. Specifically, rationalist and constructivist paradigms in the broader domain of risk perception provide different (though not always conflicting) contexts for interpreting evidence and developing theory. This contribution reviews the major constructs that have been applied to understanding flood risk perceptions and contextualises these within broader conceptual developments around risk perception theory and contemporary thinking around flood risk management. We argue that there is a need to re-examine and re-invigorate flood risk perception research, in a manner that is comprehensively underpinned by more constructivist thinking around flood risk management as well as by developments in broader risk perception research. We draw attention to an historical over-emphasis on the cognitive perceptions of those at risk to the detriment of a richer understanding of a wider range of flood risk perceptions such as those of policy-makers or of tax-payers who live outside flood affected areas as well as the linkages between these perspectives and protective measures such as state-supported flood insurance schemes. Conclusions challenge existing understandings of the relationship between risk perception and flood management, particularly where the latter relates to communication strategies and the extent to which those at risk from flooding feel responsible for taking protective actions.

Listening to Religious Music and Mental Health in Later Life

PURPOSE OF THE STUDY

Research has linked several aspects of religion--including service attendance, prayer, meditation, religious coping strategies, congregational support systems, and relations with God, among others--with positive mental health outcomes among older U.S. adults. This study examines a neglected dimension of religious life: listening to religious music.

DESIGN AND METHODS

Two waves of nationally representative data on older U.S. adults were analyzed (n = 1,024).

RESULTS

Findings suggest that the frequency of listening to religious music is associated with a decrease in death anxiety and increases in life satisfaction, self-esteem, and a sense of control across the 2 waves of data. In addition, the frequency of listening to gospel music (a specific type of religious music) is associated with a decrease in death anxiety and an increase in a sense of control. These associations are similar for blacks and whites, women and men, and low- and high-socioeconomic status individuals.

IMPLICATIONS

Religion is an important socioemotional resource that has been linked with desirable mental health outcomes among older U.S. adults. This study shows that listening to religious music may promote psychological well-being in later life. Given that religious music is available to most individuals--even those with health problems or physical limitations that might preclude participation in more formal aspects of religious life--it might be a valuable resource for promoting mental health later in the life course.

Serum neuropeptide Y in accident survivors with depression or posttraumatic stress disorder

Although neuropeptide Y (NPY) has received attention for its potential anti-depressive and anti-anxiety effect, evidence in humans has been limited. This study aimed to clarify the relationships between serum NPY and depressive disorders, and posttraumatic stress disorder (PTSD) in accident survivors. Depressive disorders and PTSD were diagnosed by structural interviews at 1-month follow-up, and serum NPY was measured at the first assessment and 1-month follow-up. Analysis of variance was used to investigate significance of the differences identified. Furthermore, resilience was measured by self-report questionnaires. Multiple linear regression analyses were used to examine the relationship between resilience and serum NPY. Three hundred accident survivors participated in the assessment at the first assessment, and 138 completed the assessment at 1-month follow-up. Twenty-six participants had major depressive disorder and 6 had minor depressive disorder. Nine participants had PTSD and 16 had partial PTSD. No relationship existed between serum NPY and depressive disorders, PTSD, and resilience. The results of cannot be compared with those of NPY in the central nervous system (CNS), but these findings might be due to the nature of depression and PTSD in accident survivors. Further studies are needed to examine the relationships between NPY in CNS and depression and PTSD.

Resilience characteristics mitigate tendency for harmful alcohol and illicit drug use in adults with a history of childhood abuse: a cross-sectional study of 2024 inner-city men and women

Resilience refers to abilities to cope adaptively with adversity or trauma. A common psychological sequella of childhood abuse or other traumatic experiences is substance use problems. There are, however, very limited data on relationships among resilience traits, childhood abuse, and alcohol or drug use problems. Hence, we aimed to examine associations between resilience characteristics and lifetime alcohol and illicit drug use in 2024 inner-city adults with high rates of childhood abuse and other trauma exposure. In this cross-sectional study, resilience was assessed with the Connor-Davidson Resilience Scale, childhood abuse with the Childhood Trauma Questionnaire, lifetime alcohol and illicit drug use with the Alcohol Use Disorder Identification Test and Drug Abuse Screening Test. Associations between resilience and substance use were examined with linear regression models, adjusting for trauma load, age, and sex. We found that resilience characteristics mitigated tendency for lifetime alcohol use problems both as a main effect (β = -0.11; p = 0.0014) and an interaction with severity of childhood abuse (β = -0.06; p = 0.0115) after trauma severity, age, and sex were controlled for. Similarly, resilience reduced lifetime illicit drug use both as a main effect (β = -0.03; p = 0.0008) and as an interaction with severity of childhood abuse (β = -0.01; p = 0.0256) after trauma load, age, and sex were adjusted for. Our findings add to a nascent body of literature suggesting that resilience characteristics mitigate risks not only for PTSD, major depression, and suicidality, but also for substance use problems in adults exposed to childhood abuse or other traumatic experiences.

Resilin: protein-based elastomeric biomaterials

Resilin is an elastomeric protein found in insect cuticles and is remarkable for its high strain, low stiffness, and high resilience. Since the first resilin sequence was identified in Drosophilia melanogaster (fruit fly), researchers have utilized molecular cloning techniques to construct resilin-based proteins for a number of different applications. In addition to exhibiting the superior mechanical properties of resilin, resilin-based proteins are autofluorescent, display self-assembly properties, and undergo phase transitions in response to temperature. These properties have potential application in designing biosensors or environmentally responsive materials for use in tissue engineering or drug delivery. Furthermore, the capability of resilin-based biomaterials has been expanded by designing proteins that include both resilin-based sequences and bioactive domains such as cell-adhesion or matrix metalloproteinase sequences. These new materials maintain the superior mechanical and physical properties of resilin and also have the added benefit of controlling cell response. Because the mechanical and biological properties can be tuned through protein engineering, a wide range of properties can be achieved for tissue engineering applications including muscles, vocal folds, cardiovascular tissues, and cartilage.

Resilience in families raising children with disabilities and behavior problems

The purpose of this study was to investigate the resilience displayed by families raising children with disabilities and behavior problems. The question is why do some families do well when others, exposed to similar stressors, struggle to keep their family life running? A stratified (by child age group) random sample of 538 families raising children with disabilities in Alberta, Canada took part. Participants completed the Family Life Survey, which incorporated measures of child behavior problems, social-ecological resources and family-level 'outcomes'. Families raising children with disabilities and behavior problems 'do well' under conditions of high social support and low financial hardship. In contrast, families with low levels of social support and high levels of financial hardship typically struggle, even when the number or intensity of child behavior problems is low. The study findings are consistent with the view that 'resilience' has more to do with the availability and accessibility of culturally relevant resources than with intrinsic, individual or family factors. With respect to family-level outcomes, strengthening social relationships and ameliorating financial hardship may be more important than behavior modification.

Multiple service use: the impact of consistency in service quality for vulnerable youth

Little is known about the way in which variations in service quality influence outcomes when youth are clients of more than one service system. This article reports on a study of 1,210 adolescents (aged 13-17 years), half were concurrent clients of two or more services and half were not involved in two or more services. Youth completed a self-report questionnaire administered by a trained interviewer. It was hypothesized that youth reporting two positive service experiences would report lower risks, higher resilience, and better outcomes than youth reporting inconsistent or two negative service experiences and that their resilience, risks, and outcomes would be similar to those of youth not involved in two or more services. MANCOVA was used to determine the relationship among service quality and resilience, risk, and outcomes with four covariates that assessed family and neighborhood environments, history of abuse and neglect, and chronic need. Results indicate that service quality had an effect on resilience, risks, and outcomes. These relationships were mediated quite strongly by the influence of the risks youth faced in their neighborhoods and to a lesser extent by the other three covariates. Of the three dependent variables, risk appeared to be the most consistently influenced by all the covariates, and it also differentiated service experience groups. Results point to the importance of services developing strategies to effectively address risks confronted by youth and also to ensure that when more than one service is involved with youth, consistency in service delivery is achieved.