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Visual and auditory signs of patient functioning have long been used for clinical diagnosis, treatment selection, and prognosis. Direct measurement and quantification of these signals can aim to improve the consistency, sensitivity, and scalability of clinical assessment. Currently, we investigate if machine learning-based computer vision (CV), semantic, and acoustic analysis can capture clinical features from free speech responses to a brief interview 1 month post-trauma that accurately classify major depressive disorder (MDD) and posttraumatic stress disorder (PTSD).
N = 81 patients admitted to an emergency department (ED) of a Level-1 Trauma Unit following a life-threatening traumatic event participated in an open-ended qualitative interview with a para-professional about their experience 1 month following admission. A deep neural network was utilized to extract facial features of emotion and their intensity, movement parameters, speech prosody, and natural language content. These features were utilized as inputs to classify PTSD and MDD cross-sectionally.
Both video- and audio-based markers contributed to good discriminatory classification accuracy. The algorithm discriminates PTSD status at 1 month after ED admission with an AUC of 0.90 (weighted average precision = 0.83, recall = 0.84, and f1-score = 0.83) as well as depression status at 1 month after ED admission with an AUC of 0.86 (weighted average precision = 0.83, recall = 0.82, and f1-score = 0.82).
Direct clinical observation during post-trauma free speech using deep learning identifies digital markers that can be utilized to classify MDD and PTSD status.
We investigate economic resilience of UK regions before, during and after the 2007/8 global financial crisis. We date business cycle turning points in real output, employment and productivity to assess the resilience dimensions of resistance, recovery and renewal and rank the economic resilience of regions in a resilience scorecard. Our empirical results reveal that the business cycle in productivity has not returned to its pre-recession peak level for Yorkshire and the Humber and the employment level has not recovered in Scotland. The resilience scorecard ranks the South East as the most resilient region with Northern Ireland the least resilient.
Although early-life adversity can undermine healthy development, children growing up in harsh environments may develop intact, or even enhanced, skills for solving problems in high-adversity contexts (i.e., “hidden talents”). Here we situate the hidden talents model within a larger interdisciplinary framework. Summarizing theory and research on hidden talents, we propose that stress-adapted skills represent a form of adaptive intelligence that enables individuals to function within the constraints of harsh, unpredictable environments. We discuss the alignment of the hidden talents model with current knowledge about human brain development following early adversity; examine potential applications of this perspective to multiple sectors concerned with youth from harsh environments, including education, social services, and juvenile justice; and compare the hidden talents model with contemporary developmental resilience models. We conclude that the hidden talents approach offers exciting new directions for research on developmental adaptations to childhood adversity, with translational implications for leveraging stress-adapted skills to more effectively tailor education, jobs, and interventions to fit the needs and potentials of individuals from a diverse range of life circumstances. This approach affords a well-rounded view of people who live with adversity that avoids stigma and communicates a novel, distinctive, and strength-based message.
This study aims at investigating the influencing factors on hospital resilience. For this purpose, a systematic review of the literature was conducted. Six databases, including Web of Science, Scopus, SAGE, EBSCO, Google Scholar, and PubMed were searched for articles published between 2000 and 2018. Sixteen studies were selected based on inclusion/exclusion criteria. Content analysis revealed 22 influencing factors were included in a framework with 2 dimensions: (1) phases of the hospital resilience process (preparation, response, and recovery/growth) and (2) the key components of the hospital (staff, infrastructure, management, and logistics). Considering the factors that emerged from this research, suggestions were made to improve hospital resilience. The results of this research will enable a hospital manager to develop better plans for hospital preparedness, as well as perform more effectively before, during, and after disasters.
Chapter 8 presents ‘cultivating inner qualities’ (CIQ) an initiative case study for developing ethical relations in Chinese schools. In the light of the emergent shift from ‘teaching to test’ to ‘educating whole human beings’, the CIQ project has been launched in primary and secondary schools within the different economic development regions in China, targeting especially marginalised children who suffer from severe social and emotional deprivation and exclusion. The core of CIQ practice is centred on developing ethical relations in schools, including time and space within the curriculum to enrich social emotional experiences, developing relational competencies, fostering trust and caring relationships and encouraging mutual respect and mutual support amongst teachers and students. In addition, CIQ is an innovative approach to school management, and to home–school collaboration. Research into CIQ suggests that these core ethical education practices are key to cultivating students’ holistic inner qualities, such as a greater awareness of interconnection between oneself and others; better and more positive interpersonal relationships; a stronger sense of responsibility for each other’s learning; healthier emotional states; and more relational resilience when facing challenges.
Interdisciplinary public health solutions are vital for an effective coronavirus disease 2019 (COVID-19) response and recovery. However, there is often a lack of awareness and understanding of the environmental health workforce connections and capabilities. In the United States, this is a foundational function of health departments and is the second largest public health workforce. The primary role is to protect the public from exposures to environmental hazards, disasters, and disease outbreaks. More specifically, this includes addressing risks relating to sanitation, drinking water, food safety, vector control, and mass gatherings. This profession is also recognized in the Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019. Despite this, the profession is often not considered an essential service. Rapid integration into COVID-19 activities can easily occur as most are government employees and experienced working in complex and stressful situations. This role, for example, could include working with leaders, businesses, workplaces, and churches to safely reopen, and inspections to inform, educate, and empower employers, employees, and the public on safe actions. There is now the legislative support, evidence and a window of opportunity to truly enable interdisciplinary public health solutions by mobilizing the environmental health workforce to support COVID-19 response, recovery, and resilience activities.
The coronavirus disease 2019 (COVID-19) pandemic and associated lockdown could be considered a ‘perfect storm’ for increases in emotional distress. Such increases can only be identified by studies that use data collected before and during the pandemic. Longitudinal data are also needed to examine (1) the roles of previous distress and stressors in emotional distress during the pandemic and (2) how COVID-19-related stressors and coping strategies are associated with emotional distress when pre-pandemic distress is accounted for.
Data came from a cohort study (N = 768). Emotional distress (perceived stress, internalizing symptoms, and anger), COVID-19-related stressors, and coping strategies were measured during the pandemic/lockdown when participants were aged 22. Previous distress and stressors were measured before COVID-19 (at age 20).
On average, participants showed increased levels of perceived stress and anger (but not internalizing symptoms) during the pandemic compared to before. Pre-COVID-19 emotional distress was the strongest predictor of during-pandemic emotional distress, followed by during-pandemic economic and psychosocial stressors (e.g. lifestyle and economic disruptions) and hopelessness, and pre-pandemic social stressors (e.g. bullying victimization and stressful life events). Most health risks to self or loved ones due to COVID-19 were not uniquely associated with emotional distress in final models. Coping strategies associated with reduced distress included keeping a daily routine, physical activity, and positive reappraisal/reframing.
In our community sample, pre-pandemic distress, secondary consequences of the pandemic (e.g. lifestyle and economic disruptions), and pre-pandemic social stressors were more consistently associated with young adults' emotional distress than COVID-19-related health risk exposures.
The rehabilitation of essential services infrastructure following hostilities, whether during a conflict or post-conflict, is a complex undertaking. This is made more complicated in protracted conflicts due to the continuing cycle of damage and expedient repair amid changing demands. The rehabilitation paradigm that was developed for the successful post-World War II rehabilitation of Germany and Japan has been less successful since. There are a myriad of conflicting interests that impede its application, yet the issue consistently comes down to a lack of systems-level understanding of the current situation on the ground and a lack of alignment between what is delivered and the actual local need. This article proposes a novel conceptual framework to address this, affording a greater “system of systems” understanding of the local essential services and how they can be restored to reflect the changed needs of the local population that has itself been changed by the conflict. The recommendations draw on heuristic practice and commercially available tools to provide a practicable approach to restoring infrastructure function in order to enable essential services that are resilient to temporary returns to violence and support the overall rehabilitation of the affected community.
Unit cohesion may protect service member mental health by mitigating effects of combat exposure; however, questions remain about the origins of potential stress-buffering effects. We examined buffering effects associated with two forms of unit cohesion (peer-oriented horizontal cohesion and subordinate-leader vertical cohesion) defined as either individual-level or aggregated unit-level variables.
Longitudinal survey data from US Army soldiers who deployed to Afghanistan in 2012 were analyzed using mixed-effects regression. Models evaluated individual- and unit-level interaction effects of combat exposure and cohesion during deployment on symptoms of post-traumatic stress disorder (PTSD), depression, and suicidal ideation reported at 3 months post-deployment (model n's = 6684 to 6826). Given the small effective sample size (k = 89), the significance of unit-level interactions was evaluated at a 90% confidence level.
At the individual-level, buffering effects of horizontal cohesion were found for PTSD symptoms [B = −0.11, 95% CI (−0.18 to −0.04), p < 0.01] and depressive symptoms [B = −0.06, 95% CI (−0.10 to −0.01), p < 0.05]; while a buffering effect of vertical cohesion was observed for PTSD symptoms only [B = −0.03, 95% CI (−0.06 to −0.0001), p < 0.05]. At the unit-level, buffering effects of horizontal (but not vertical) cohesion were observed for PTSD symptoms [B = −0.91, 90% CI (−1.70 to −0.11), p = 0.06], depressive symptoms [B = −0.83, 90% CI (−1.24 to −0.41), p < 0.01], and suicidal ideation [B = −0.32, 90% CI (−0.62 to −0.01), p = 0.08].
Policies and interventions that enhance horizontal cohesion may protect combat-exposed units against post-deployment mental health problems. Efforts to support individual soldiers who report low levels of horizontal or vertical cohesion may also yield mental health benefits.
In this chapter, you will gain an understanding of resilience in teachers and teaching, coping strategies for sustaining a teaching career, being mindful as a teacher, your wellbeing and ability to flourish and the meaning of a growth mindset.
The COVID-19 global crisis is reshaping Canadian society in unexpected and profound ways. The significantly higher morbidity and mortality risks by age suggest that this is largely a “gero-pandemic,” which has thrust the field of aging onto center stage. This editorial emphasizes that vulnerable older adults are also those most affected by COVID-19 in terms of infection risk, negative health effects, and the potential deleterious outcomes on a range of social, psychological, and economic contexts – from ageism to social isolation. We also contend that the pathogenic analysis of this pandemic needs to be balanced with a salutogenic approach that examines the positive adaptation of people, systems and society, termed COVID-19 resilience. This begs the question: how and why do some older adults and communities adapt and thrive better than others? This examination will lead to the identification and response to research and data gaps, challenges, and innovative opportunities as we plan for a future in which COVID-19 has become another endemic infection in the growing list of emerging and re-emerging pathogens.
Chapter 5 draws on the survey data to show how private standards are implemented in the field. It introduces three avenues through which standards may address different definitions of sustainability: to drive sustainable intensification, to shift time horizons backward, or to act as payments for social and ecosystem services. It then evaluates standards’ success by evaluating a range of production practices in each category. It shows that particularly industry-friendly standards encourage farmers to intensify their production, with moderate success, but that simultaneous decreases in input use are rarer. Improvements in practices that encourage farmers to make short-term investments for longer-term gains in terms of health or farm resilience can be observed, but often depend on outside financial support. Finally, the chapter finds very few improvements in practices that constitute long-term opportunity costs, for two reasons: one, over time many standards have lowered the stringency of their requirements for high-opportunity-cost practices such as the maintenance of permanent shade cover. Two, even when rules are binding (e.g., minimum wage laws), they are not always followed.
Psychological resilience – positive psychological adaptation in the context of adversity – is defined and measured in multiple ways across disciplines. However, little is known about whether definitions capture the same underlying construct and/or share similar correlates. This study examined the congruence of different resilience measures and associations with sociodemographic factors and body mass index (BMI), a key health indicator.
In a cross-sectional sample of 1429 African American adults exposed to child maltreatment, we derived four resilience measures: a self-report scale assessing resiliency (perceived trait resilience); a binary variable defining resilience as low depression and posttraumatic stress (absence of distress); a binary variable defining resilience as low distress and high positive affect (absence of distress plus positive functioning); and a continuous variable reflecting individuals' deviation from distress levels predicted by maltreatment severity (relative resilience). Associations between resilience measures, sociodemographic factors, and BMI were assessed using correlations and regressions.
Resilience measures were weakly-to-moderately correlated (0.27–0.69), though similarly patterned across sociodemographic factors. Women showed higher relative resilience, but lower perceived trait resilience than men. Only measures incorporating positive affect or resiliency perceptions were associated with BMI: individuals classified as resilient by absence of distress plus positive functioning had lower BMI than non-resilient (β = −2.10, p = 0.026), as did those with higher perceived trait resilience (β = −0.63, p = 0.046).
Relatively low congruence between resilience measures suggests studies will yield divergent findings about predictors, prevalence, and consequences of resilience. Efforts to clearly define resilience are needed to better understand resilience and inform intervention and prevention efforts.
As the systems that people depend on are increasingly strained by the coronavirus disease–2019 (COVID-19) outbreak, public health impacts are manifesting in different ways beyond morbidity and mortality for elderly populations. Loneliness is already a chief public health concern that is being made worse by COVID-19. Agencies should recognize the prevalence of loneliness among elderly populations and the impacts that their interventions have on loneliness. This letter describes several ways that loneliness can be addressed to build resilience for elderly populations as part of the public health response to COVID-19.
Governments across the world increasingly rely on non-state agents for managing even the most sensitive tasks that range from running critical infrastructures to protecting citizens. While private agents frequently underperform, governments as principals tend nonetheless not to enforce delegation contracts. Why? We suggest the mechanism of institutional resilience. A preexisting set of rules shapes non-enforcement through the combination of (i) its structural misfit with the delegation contract and (ii) asymmetric interdependence that favors the agent over time. To demonstrate the plausibility of our argument, we trace the political process behind Europe’s largest military transport aircraft, the A400M. Governments delegated the development and production of this complex program to a private firm, Airbus. They layered a ‘commercial approach’ onto traditionally state-run defense industries. Yet, resilience caused these new formal rules to fail and eventually disarmed principals. Our mechanism constitutes an innovative approach by theorizing an alternative path toward dynamic continuity.
Quantifying robustness of farm animals is essential before it can be implemented in breeding and management strategies. A generic modelling and data analysis procedure was developed to quantify the feed intake response of growing pigs to perturbations in terms of resistance and resilience. The objective of this study was to apply this procedure to quantify these traits in 155 pigs from an experiment where they received diets with or without cereals contaminated with the mycotoxin deoxynivalenol (DON). The experimental pigs were divided equally in a control group and three DON-challenged groups. Pigs in each of the challenged groups received a diet contaminated with DON for 7 days early on (from 113 to 119 days of age), later on (from 134 to 140 days of age) or in both periods of the experiment. Results showed that the target feed intake trajectory of each pig could be estimated independently of the challenge. The procedure also estimated relatively accurately the times when DON was given to each challenged group. Results of the quantification of the feed intake response indicated that age and previous exposure to DON have an effect on the resilience capacity of the animals. The correlation between resistance and resilience traits was modest, indicating that these are different elements of robustness. The feed intake analysis procedure proved its capacity to detect and quantify the response of animals to perturbations, and the resulting response traits can potentially be used in breeding strategies.
The general understanding of the ‘vulnerability–stress model’ of mental disorders neglects the modifying impact of resilience-increasing factors such as coping ability.
Probing a conceptual framework integrating both adverse events and coping factors in an extended ‘vulnerability–stress–coping model’ of mental disorders, the effects of functional neuropeptide S receptor gene (NPSR1) variation (G), early adversity (E) and coping factors (C) on anxiety were addressed in a three-dimensional G × E × C model.
In two independent samples of healthy probands (discovery: n = 1403; replication: n = 630), the interaction of NPSR1 rs324981, childhood trauma (Childhood Trauma Questionnaire, CTQ) and general self-efficacy as a measure of coping ability (General Self-Efficacy Scale, GSE) on trait anxiety (State-Trait Anxiety Inventory) was investigated via hierarchical multiple regression analyses.
In both samples, trait anxiety differed as a function of NPSR1 genotype, CTQ and GSE score (discovery: β = 0.129, P = 3.938 × 10−8; replication: β = 0.102, P = 0.020). In A allele carriers, the relationship between childhood trauma and anxiety was moderated by general self-efficacy: higher self-efficacy and childhood trauma resulted in low anxiety scores, and lower self-efficacy and childhood trauma in higher anxiety levels. In turn, TT homozygotes displayed increased anxiety as a function of childhood adversity unaffected by general self-efficacy.
Functional NPSR1 variation and childhood trauma are suggested as prime moderators in the vulnerability–stress model of anxiety, further modified by the protective effect of self-efficacy. This G × E × C approach – introducing coping as an additional dimension further shaping a G × E risk constellation, thus suggesting a three-dimensional ‘vulnerability–stress–coping model’ of mental disorders – might inform targeted preventive or therapeutic interventions strengthening coping ability to promote resilient functioning.
A definition of resilience is the capacity to resist mental disorders despite exposure to stress. Little is known about its biological concomitants. In adults, biochemical and hormonal factors have been advocated. Smaller Corpus Callosum (CC) volume and lower Fractional Anisotropy (FA) have been observed in psychiatric and stress-related conditions. There is no Diffusion Tensor Imaging (DTI) study of resilience in adolescence, a critical lifetime period for neural and psychological maturation. We hypothesized that higher FA in the CC would characterize stress-resilient adolescents.
Three community groups were compared: resilient adolescents – with low risk of mental disorder despite high exposure to lifetime stress, adolescents at risk of mental disorder exposed to the same level of stress, and controls. Personality was assessed by NEO Five Factor Inventory (NEO-FFI) and cognitive function by a battery of tests. Voxelwise statistics of DTI values in CC were obtained using Tract-Based Spatial Statistic. Regional projections were identified by probabilistic tractography.
Higher FA values were detected in the anterior CC of resilient compared with both non-resilient and control adolescents. FA values varied according to resilience capacity. Regional changes in CC were in regions that project onto anterior cingulated and frontal cortex. Neuroticism and three other personality factors differentiated at risk adolescents from the other two groups.
High FA was detected in resilient adolescents in an anterior CC region projecting to frontal areas subserving cognitive resources. Psychiatric risk in adolescents was associated with personality characteristics. Resilience in adolescence may be a dimension embedding white matter features.
The effect of perceived-stress on students' health is dependent on their coping abilities. One of coping strategies for dealing with stress is resilience. The aim of this study is to examine perceived stress and its relation with resilience in undergraduate Nursing students
Methods & Materials
In this cross-sectional study, 309 under-graduate nursing students studying at Tehran University of Medical Sciences during the first semester of 2012-2013 were selected by stratified sampling. Data were collected using the Perceived stress scale and Connor-Davidson Resilience Scale (CD-RISC) questionnaires. The data was analyzed using descriptive and inferential statistics by SPSS-Verrsion14.
Findings revealed that about 100% (99.3%) students reported that perceived stress moderately or high. Regarding relation between perceived-stress and resilience There were statistically significant relationship between these two variables (P≤ 001/0, r=-0.38).
According the study findings nursing school can provide facilities and opportunities for students to learn stress management strategies such as increasing resilience ability during 4 years educational program.
Epimeleia and resilience are required elements in care practice, because there is in the mortality of the treated the provocation of a sense of temporariness of human life. This is work analyzes the notion of temporality of the life through the losses and changes throughout life.
To investigate human beings’ ability to absorb shocks and frustrations that occur throughout life and keep homeostasis, premised on the need for epimeleia in cognitive, spiritual and social spheres to strengthen resilience.
Interdisciplinary research in articles published in journals and works in the fields of Psychiatry, Psychology, Theology and Thanatology, as well as a literature review concerning the resolution of mourning through resilience.
Educational measures and care practices, highlighting the activities and actions that promote the ability to restore the holistic balance, evoke the rescue of the innate faculty of resilience in the patients.
It is important to research on the attention given to the recovery and maintenance of the resilience of those who undergo stress, live in unsafe conditions or seek the resolution of their mourning. Patients, family and caregivers are benefited by measures and practices that promote and maintain mental and psychological balance of all involved. Further research will be useful to develop the issue.