Life satisfaction and peace of mind among dentists: a cross-sectional study.

OBJECTIVES: This study sought to identify the factors associated with the life satisfaction and peace of mind (PoM) of dentists not in full-time clinical training. MATERIALS AND METHODS: Cross-sectional questionnaires were distributed to dentists in Taiwan to collect their life satisfaction, PoM, sociodemographic data, and dental career-related characteristics. Life satisfaction was measured using a 5-item Satisfaction with Life Scale. PoM was measured using a 7-item Peace of Mind Scale. Descriptive statistics and multiple linear regression models were estimated to explore potential associations between the two scales and the examined factors. RESULTS: A total of 1196 dentists (45.6% female; mean age = 44.12) completed the questionnaires. The response rate of completed questionnaires from email invitations was 32.9%. On multivariable analysis, life satisfaction and PoM were associated with age (b = 0.008 in both), better perceived health (b = 0.262 and 0.308, respectively), family interaction (b = 0.264 and 0.207, respectively), and friend relationships (b = 0.076 and 0.091, respectively). Being married (b = 0.191), being specialized (b = 0.127), working in private practice, and spending 10 to 39 h per week with patients (b = 0.101 to 0.162) were associated with a higher level of life satisfaction but not PoM. CONCLUSIONS: Specialists working in private practice without working overtime were associated with better life satisfaction. However, the dentists' health and relationships with family were more related to their subjective well-being than their professional achievements. CLINICAL RELEVANCE: Our findings can help policymakers increase awareness of the well-being of general dentists and those in academia or hospitals to promote their mental health.

"Seems Like There Is No Stopping Point at All Whatsoever": A Mixed-Methods Analysis of Public Health Workforce Perception on COVID-19 Pandemic Management and Future Needs.

OBJECTIVE: The COVID-19 pandemic, caused by a highly contagious novel virus called SARS-CoV-2, has led to significant global morbidity and mortality, with disproportionate burden among frontline workers. While the current empirical body of evidence highlights reported depression, burnout, moral injury, compassion fatigue, and post-traumatic stress among healthcare workers, similar assessment among the public health workforce is limited. Given work-related pressure of rapid pandemic management strategies, risk of exposure, potential fatigue, etc., understanding the caregiver burden of the public health workforce is critical. Methods: This study used a convergent parallel mixed-methods design. Participants were recruited using a mix of both convenience and snowball sampling. All data were collected virtually and kept anonymous. All statistical analyses were conducted using SPSS version 28, and all qualitative results were thematically analyzed using the grounded theory approach. Results: Among the study participants, nearly 65% reported that their personal lives were impacted due to providing COVID-19 related services. Furthermore, a majority (88%) reported poor sleep health, including low daytime wakefulness, while 24% reported serious psychological distress. Qualitative analysis demonstrated several emergent themes, with central themes indicative of the need for paradigm shift in capacity building for public health emergency preparedness that integrates caregiver support. Conclusions: Results highlight the importance of addressing the caregiver burden experienced by public health and related workforces during public health emergencies.

Holistic Evaluation of Language Models.

Language models (LMs) like GPT-3, PaLM, and ChatGPT are the foundation for almost all major language technologies, but their capabilities, limitations, and risks are not well understood. We present Holistic Evaluation of Language Models (HELM) to improve the transparency of LMs. LMs can serve many purposes and their behavior should satisfy many desiderata. To navigate the vast space of potential scenarios and metrics, we taxonomize the space and select representative subsets. We evaluate models on 16 core scenarios and 7 metrics, exposing important trade-offs. We supplement our core evaluation with seven targeted evaluations to deeply analyze specific aspects (including world knowledge, reasoning, regurgitation of copyrighted content, and generation of disinformation). We benchmark 30 LMs, from OpenAI, Microsoft, Google, Meta, Cohere, AI21 Labs, and others. Prior to HELM, models were evaluated on just 17.9% of the core HELM scenarios, with some prominent models not sharing a single scenario in common. We improve this to 96.0%: all 30 models are now benchmarked under the same standardized conditions. Our evaluation surfaces 25 top-level findings. For full transparency, we release all raw model prompts and completions publicly. HELM is a living benchmark for the community, continuously updated with new scenarios, metrics, and models https://crfm.stanford.edu/helm/latest/.

Change of home visit frequency by public health nurses predicts emergency escorts for psychiatric patients living in the community: A retrospective medical record review.

Background: Improper or insufficient treatment of mental health illness harms individuals, families, and society. When psychiatric treatment shifts from a hospital-based to a community-based health care system, risk management is essential to the provision of effective care. Objective: We examine whether an upgrade in home visit frequency of psychiatric patients as identified by public health nurses can predict the subsequent need for emergency escort services for medical treatment. Design: A 2-year retrospective medical record review. Settings: A district of New Taipei City in Taiwan. Participants: A total of 425 patients with a diagnosed mental health illness cared for through home visits by public health nurses from January 2018 to December 2019. Methods: We accessed the Ministry of Health and Welfare's psychiatric care management information system to identify a set of medical records, and analyzed these records using chi-square and regression analyses. Results: The analyses indicated that the groups experiencing the greatest need for emergency escort services were: male, 35-49 years old, with a senior high school level of education, without a disability identification card, with a schizophrenia diagnosis, and had been reported by the nurse as having progressed to a serious level. Nurses' increased frequency of home visits (an indicator that the patient's overall condition was worsening) and nurses' reports of increased severity of problems were significant predictors of the need for emergency escort services. Conclusions: The nurses' adjustment of visit frequency based on the results of the visit assessment predicts the need for emergency escort services for mental patients. The findings support not only the professional roles and functions of public health nurses, but also the importance of strengthening psychiatric health community support services.

The cognition, information behaviors, and preventive behaviors of Taiwanese people facing COVID-19.

This study investigated the cognition, information behaviors and preventive behaviors of Taiwanese citizens in the face of the COVID-19 pandemic. An online survey was administered and 610 valid responses were collected. The relationships between demographic variables and optimistic bias, social trust, information credibility, personal protective measures, avoidance of human contact, and immune system strengthening were examined. Results showed that optimistic bias existed, but there was no significant correlation between optimistic bias and personal protective measures. Laypersons had high trust in the government, but also optimistic bias. Gender was the most important predictor; with occupation and region of residence also interacting with different preventive behaviors. People in Taiwan may be overly optimistic in facing the epidemic; relevant information should be properly disclosed to help reduce this bias. Social trust in the government seems to be an important successful factor in the fight against COVID-19 in Taiwan.

Gray-Scale and Power Doppler Ultrasound Findings Predictive of Cubital Tunnel Syndrome Severity.

BACKGROUND: The use of ultrasound in the diagnosis of cubital tunnel syndrome (CuTS) is an attractive alternative to electrodiagnostic (EDX) studies, but its utility is binary with poor severity correlation. We hypothesize that increasing ulnar nerve cross-sectional area (CSA) and power Doppler measurement of intraneural vascularity may predict the extent of disease. METHODS: We identified 20 elbows from patients with a history of CuTS and 20 elbows in 10 asymptomatic controls. Electrodiagnosis was performed for symptomatic patients. Gray-scale ultrasound and power Doppler ultrasound were performed to measure CSA and intraneural vascularity in all participants. Functional measures, Boston Carpal Tunnel Questionnaire (BCTQ), and Patient-Reported Outcomes Measurement Information System surveys were also completed. RESULTS: A strong positive correlation was found between CSA and motor nerve conduction velocity (MNCV) decrease between elbow and forearm, which increased when BCTQ >2 was used as a screening criterion. Increased CSA also demonstrated a high positive predictive value (PPV) in predicting MNCV changes, but poor ability to predict axonal loss. In contrast, power Doppler ultrasound demonstrated 100% PPV and 94% negative predictive value (NPV) in predicting severe CuTS (defined as compound motor action potential [CMAP] amplitude <6 mV and electromyography [EMG] findings). CONCLUSIONS: Cross-sectional area is a sensitive method for identifying changes in MNCV and amplitude but does not stratify disease severity, as defined by diminished CMAP amplitude and/or evidence of denervation on EMG. The presence of increased intraneural vascularity is relatively sensitive but highly specific for axonal loss. The combination of nerve CSA, BCTQ screening, and power Doppler ultrasound may provide an alternative means for CuTS assessment.

Early Expression of MMP-9 Predicts Recovery of Tibialis Anterior after Sciatic Nerve Crush Injury.

Background: The purpose of this study was to assess the expression of molecular markers and epineural blood flow after differing degrees of nerve injury to identify potential tools to predict nerve recovery in a rat sciatic nerve model. Methods: A total of 72 rats were divided into nine groups. Each group was subjected to one of three crush injuries, created by applying one of three vascular clamps for 30 seconds. Vascularity was assessed with laser Doppler flowmetry before and after crush, and at nonsurvival surgery. Nonsurvival surgeries were performed 6 hours, 2 weeks, or 6 weeks later with nerve conduction studies and muscle strength testing. Expression of matrix metalloproteinase 9 (MMP-9) and matrix metalloproteinase 2 (MMP-2) in each nerve was quantified using with enzyme linked immunosorbent analysis. Results: Persistent hyperemia was noted in the zone of injury compared with baseline at 2 weeks and 6 weeks in the groups that displayed incomplete recovery. Expression of MMP-9 at 6 hours increased with increasing severity of crush and was inversely related to tibialis anterior muscle force recovery. The ratio of MMP-9:MMP-2 expression correlated well with recovery of compound nerve action potential amplitude at 6 weeks. Conclusions: Resolution of nerve hyperemia may correlate with nerve recovery from trauma, but early measures of nerve blood flow after injury are not prognostic of recovery. Ratio of MMP-9:MMP-2 expression 6 hours after injury correlates with recovery of compound nerve action potential at 6 weeks, while MMP-9 expression alone predicts tibialis anterior recovery. These findings together suggest that increased MMP-9 expression is a potentially useful marker of more severe nerve injury.

Life Satisfaction of US-trained Dental Specialists in Taiwan.

OBJECTIVE: A large number of residents in US advanced specialty education programmes are foreign-trained dentists. When faced with the career dilemma of applying for US residency training, foreign-trained dentists may wonder whether it is worth proceeding along that path. In addiditon, studies capturing benefits from receiving US residency training are rare. Therefore, this study compared the life satisfaction amongst 3 dentist groups in Taiwan (ie, US-trained specialists, Taiwan-trained specialists, and general dentists). METHODS: Cross-sectional surveys were distributed to dentists currently residing in Taiwan. Participants were surveyed about demographic information, career-related information, and life satisfaction. Life satisfaction was measured with a structured Satisfaction With Life Scale (SWLS). Nonparametric bivariate analyses and multivariable adjusted generalised linear model (GLM) were used to examine the differences between mean SWLS scores and examined variables. We included 134 US-trained specialists, 134 Taiwan-trained specialists, and 134 general dentists matched for age, sex, and marital status. RESULTS: With the mean age of 51.4 ± 10.8 years old, specialists had significantly higher mean life satisfaction scores than general dentists. US-trained specialists had significantly higher mean life satisfaction scores than Taiwan-trained specialists when health and family relationships were not considered. Career-rated factors (eg, spending more clinical hours with patients, having more expenses related to continuing education, publishing more peer-reviewed articles, and being a frequent speaker) were not associated with better life satisfaction. CONCLUSIONS: US-trained specialists were more likely to be satisfied with their lives than Taiwan-trained specialists and general dentists. However, health and social relationships contribute more to dentists' life satisfaction than do career-rated factors.

Clinical and behavior characteristics of individuals who used ketamine.

This study aims to depict and compare clinical characteristics and risk behavior among groups of individuals using ketamine, polydrugs or smoking cigarette. A total of 185 drug-using participants and 49 smokers participated in this study. A cross-sectional interview was used to collect information on demographics, drug- and sex-related behaviors, HIV serostatus, lower urinary tract symptoms (LUTS), behavioral dispositions. N-back memory test was used to measure short-term memory. Result shows that 10 participants (5.41%) were HIV positive and 14 (7.57%) having LUTS. Individuals with ketamine and polydrugs use have significantly worse drug-related problem than cigarette smokers. Compared to cigarette smokers and ketamine users, individuals with polydrug users scored significantly higher on impulsivity measures. Cigarette smokers performed significantly better than the other two groups on the memory tests. A few patients had been infected with HIV and diagnosed with LUTS. Findings support that memory on short term recalls of patients with ketamine use might be impaired. Study findings warrants the necessarily of further study on influences of using ketamine.

Parents' right strategy on preventing youngsters' recent suicidal ideation: a 13-year prospective cohort study.

BACKGROUND: Suicide remains the second leading cause of death among youths. Family-related factors are considered important determinants of children's suicidal ideation, whereas their short-/long-term influence is seldom quantified. AIMS: We aim to confirm the simultaneous/lagged effects of family-related factors on the occurrence of recent suicidal ideation from childhood to young adulthood (aged from 10 to 22 years old). METHOD: Data were derived from a longitudinal prospective cohort study. Participants included 2065 students who were followed up for 13 years. Generalized estimating equations were used to clarify the influential effects of family-related factors on suicidal ideation during the past month. RESULTS: The peak of the rate of recent suicidal ideation arrived during junior high school years. Family interaction, family support, family involvement, and parental punishment had simultaneous effects on recent suicidal ideation. Family involvement, parental conflict, and psychological control had lagged and lasting effects on suicidal ideation. Notably, the lasting protective effects of family involvement were more obvious than simultaneous effects. CONCLUSIONS: Providing parents with sustained support and education to improve their "positive parenting literacy" can help with their children's mental health development. This is especially the case during COVID-19 quarantine periods when families spend the most time together at home.

COVID-19 stigma associates with burnout among healthcare providers: Evidence from Taiwanese physicians and nurses.

BACKGROUND/PURPOSE: During pandemics like SARS-CoV-2, healthcare providers' well-being and morale are in particular at stake. Burnout may substantially hinder the well-being and morale of healthcare providers, challenging our efforts at disease containment. This study investigated the relationship between perceived COVID-19 stigma and burnout symptoms among physicians and nurses. We further aimed to identify potential factors that may moderate this relationship, including profession, clinical contact with COVID-19 patients, and prior experience with 2003 SARS-CoV-1. METHODS: We used a web-based, structured survey from March 12th to 29th, 2020 to collect cross-sectional, self-reported data. Participants were provided with a link to the survey which took them on average 5-8 minutes. Survey consisted of demographic characteristics, clinical experiences, perceived COVID-19 related stigma, and burnout symptoms. Linear regression with bootstrapping techniques was adopted to test the relations between stigma and burnout, as well as other potential moderators, while adjusting for demographic and clinical factors. RESULTS: Of the 1421 consented respondents, 357 identified as physicians while 1064 identified as nurses. Participants reported some levels of stigma, and noticeable burnout symptoms. Burnout symptoms were positively correlated with COVID-19 stigma, profession, and currently care for confirmed/suspected COVID-19 patients. The interaction between stigma and profession (Stigma × Nurses) but no other interaction terms reached the significance level, suggesting that the slope for nurses was flatter than the slope for physicians. CONCLUSION: The study results suggest that COVID-19 stigma may contribute to burnout among physicians and nurses, and this relation may not vary across clinical roles and experiences but profession.

Preventing Re-Emergence of COVID-19: A National Survey of Public Risk Perceptions and Behavioural Intentions Concerning Travel Plan Among Taiwanese.

Background: The objectives of this study were to investigate risk perceptions and travel intention among the general public in Taiwan during the COVID-19 outbreak. Methods: This study used a cross-sectional online survey to collect data. The questionnaire was disseminated via the social media platform (LINE and Facebook) to the general public. Results: A total of 3,237 complete responses were received, of whom 5.8% (95% CI 5.1-6.7) of the participants reported intent to travel to overseas countries with an apparent community spread and 5.5% (95% CI 4.7-6.3) reported intent to travel to other overseas countries in the next 1 month. A relatively higher proportion (46.5%; 95% CI 44.7-48.2) reported intention for domestic travelling. Participants who viewed travelling to only be risky for older adults or those with medical conditions (OR = 2.19; 95% CI 1.38-3.47) and who perceived that one will not get infected if one takes recommended precautionary measures (OR = 3.12; 95% CI 1.85-5.27) reported higher travelling intention to overseas countries with an apparent community spread. Conclusions: Overall, the findings suggest that risk perceptions were depicted as a strong influence of travel intentions.

MRI contributes to accurate and early diagnosis of non-radiographic HLA-B27 negative axial spondyloarthritis.

BACKGROUND: Nonradiographic axial spondyloarthropathies (nr-axSpA) are diagnosed by the absence of radiographic sacroiliitis and the presence of bone marrow edema (BME) on magnetic resonance imaging (MRI). According to the classification criteria of the international Assessment of Spondyloarthritis Society (ASAS), structural changes to sacroiliac joints (SIJs) on MRI cannot be used as criteria in the absence of BME. However, less than half the Asian patients with clinically active axSpA show BME. The incidence of human leukocyte antigen (HLA)-B27 is low in Asian populations, which makes it more difficult to identify nr-axSpA. We used MRI to evaluate the structural damage to SIJs in patients with nr-axSpA with and without BME with the aim of identifying the best methodology for accurate diagnosis, especially in populations with less common BME and HLA-B27. METHODS: One hundred three patients with inflammatory back pain were included in this prospective study. No patient's radiograph met the definition of positive modified New York criteria. BME and structural damage to SIJ including sclerosis and erosion were assessed independently on coronal and axial short-tau inversion recovery and T1-weighted spin echo MRI scans by two well-trained musculoskeletal radiologists using the Spondyloarthritis Research Consortium of Canada (SPARCC) score. Demographics of patients were collected. Disease characteristics and structural damage were analyzed in patients with and without BME on SIJ MRI. Receiver operating characteristic (ROC) curve analysis was used to assess the diagnostic performance of structural damage. RESULTS: All individuals in the cohort had at least one abnormal finding on SIJ MRI, including BME or structural damage; 36 of 103 patients had BME. We identified a significant positive correlation between SPARCC scores and severe erosion assessed by focal joint space widening (fJSW) (p = 0.001) in these 36 patients. Fifty-eight of the 103 enrolled patients fulfilled the ASAS criteria for nr-axSpA in the either absence or presence of BME. Of these 58 patients, 57 and 19 had erosions or fJSW, respectively, and the presence of BME was significantly correlated with fJSW (phi score of 0.319 and p = 0.015). We demonstrated a significant positive correlation between fJSW and either the presence or the severity of BME in patients with nr-axSpA who met the ASAS definition. There was a positive correlation between BME and fJSW across the whole study cohort (phi score of 0.389; p < 0.001). The area under the ROC curve (AUC) for fJSW on SIJ MRI was 0.736, p < 0.001. In both HLA-B27-positive and -negative groups, BME was more common in the presence of fJSW (phi scores of 0.370 and 0.377, p = 0.018 and 0.003, respectively) and SPARCC scores were higher in patients with fJSW (p < 0.001 and p = 0.005). We also identified a positive correlation between fJSW and BME in patients with nr-axSpA and normal serum levels of C-reactive protein (phi score of 0.362 and p = 0.001). CONCLUSION: Structural damage detected on SIJ MRI, sclerosis, erosions and fJSW may be present in patients without detectable inflammation on SIJ MRI. However, fJSW is significantly correlated with the severity of inflammation seen on SIJ MRI, which contributes to the accurate diagnosis of nr-axSpA, and it could be used as an alternative diagnostic test for nr-axSpA in the general population, especially for those who do not carry the HLA-B27 gene, Asian patients without BME, or patients with normal serum inflammatory biomarkers.

Mental health crisis in healthcare providers in the COVID-19 pandemic: a cross-sectional facility-based survey.

OBJECTIVES: During a pandemic, healthcare providers experience increased mental and physical burden. Burnout can lead to treatment errors, patient mortality, increased suicidal ideation and substance abuse as well as medical malpractice suits among medical staff. This study aimed to investigate the occurrence of burnout, acute stress disorder, anxiety disorder and depressive disorder among healthcare providers at the third month of the COVID-19 pandemic. DESIGN: A cross-sectional facility-based survey. SETTING: Hospitals around the country with different levels of care. PARTICIPANTS: A total of 1795 respondents, including 360 men and 1435 women who participated in the survey. PRIMARY OUTCOME MEASURES: Burnout was assessed using the Physician Work Life Study. A score of ≥3 implied burnout. RESULTS: Of the 1795 respondents, 723 (40.3%) reported burnout, and 669 (37.3%) cared for patients with COVID-19. Anxiety levels were mild in 185 (10.3%) respondents, moderate in 209 (11.6%) and severe in 1401 (78.1%). The mean Center for Epidemiologic Studies Depression Scale-10 score was 9.5±6.3, and 817 (45.5%) respondents were classified as having depression. Factors associated with burnout were working in acute and critical care (ACC) divisions (adjusted OR (aOR)=1.84, 95% CI 1.20 to 3.39, p=0.019), caring for patients with COVID-19 (aOR=3.90, 95% CI 1.14 to 13.37, p=0.031) and having depressive disorder (aOR=9.44, 95% CI 7.44 to 11.97, p<0.001). CONCLUSIONS: Physicians and nurses are vulnerable to burnout during a pandemic, especially those working in ACC divisions. Anxiety disorder, depressive disorder and care of patients with COVID-19 may be factors that influence the occurrence of burnout among healthcare providers.

Histologic and Functional Outcomes of Conduit Wrapping for Peripheral Nerve Repair: Early Results in a Rat Model.

BACKGROUND: The concept of utilizing a nerve conduit for augmentation of a primary nerve repair has been advocated as a method to prevent neural scarring and decrease adhesions. Despite clinical use, little is known about the effects of a nerve conduit wrapped around a primary repair. To better understand this, we investigated the histologic and functional effects of use of a nerve conduit wrapped around a rat sciatic nerve repair without tension. METHODS: Twenty Lewis' rats were divided into two groups of 10 rats each. In each group, unilateral sciatic nerve transection and repair were performed, with the opposite limb utilized as a matched control. In the first group, direct repair alone was performed; in the second group, this repair was augmented with a porcine submucosa conduit wrapped around the repair site. Sciatic functional index (SFI) was measured at 6 weeks with walking track analysis in both groups. Nonsurvival surgeries were then performed in all animals to harvest both the experimental and control nerves to measure histomorphometric parameters of recovery. Histomorphometric parameters assessed included total number of neurons, nerve fiber density, nerve fiber width, G-ratio, and percentage of debris. Unpaired t-test was used to compare outcomes between the two groups. RESULTS: All nerves healed uneventfully but compared with direct repair; conduit usage was associated with greater histologic debris, decreased axonal density, worse G-ratio, and worse SFI. No significant differences were found in total axon count or gastrocnemius weight. CONCLUSION: In the absence of segmental defects, conduit wrapping primary nerve repairs seem to be associated with worse functional and mixed histologic outcomes at 6 weeks, possibly due to debris from conduit resorption. While clinical implications are unclear, more basic science and clinical studies should be performed prior to widespread adoption of this practice.

Rare-Earth Elements as Natural Tracers for In Situ Remediation of Groundwater.

The utility of rare-earth elements (REEs) as natural geochemical tracers for the analysis of groundwater remediation was examined in several example permeable reactive barriers (PRBs). The PRBs utilize zero-valent iron and organic carbon plus limestone mixtures for contaminant treatment. Zero-valent iron removed REEs from groundwater to below detection levels (2-4 ng/L) and subsequent rebound of REE concentrations in regions down-gradient of the treatment zones was not observed. In addition, REE concentrations within and down-gradient of an organic carbon/limestone PRB were significantly reduced to <1% of influent levels. Thus, REEs are sensitive tracers for evaluating the interaction of groundwater with materials placed in the subsurface for contaminant remediation. Analysis of geochemical tracers for understanding in situ remediation becomes important in situations where down-gradient contaminant concentrations fail to decrease within expected timeframes. The field data indicated that increased solid-phase partitioning of REEs occurred with increasing pH and heavy REEs were preferentially removed compared to light REEs in ZVI systems. In the organic carbon PRB, unexpected negative europium anomalies were observed, revealing new information about redox conditions within the treatment zone. REE concentrations and shale-normalized profiles can be used as natural tracers to better understand in situ technologies for groundwater remediation.

Resilience as a mediator of interpersonal relationships and depressive symptoms amongst 10th to 12th grade students.

BACKGROUND: The aim of this study was to explore the associations among interpersonal relationships, resilience and depressive symptoms, and to examine if resilience is a mediator between interpersonal relationships and depressive symptoms in senior high school students. METHODS: Of 463 randomly selected participants from among 3,900 high school students, 450 (97.19%) consented to and completed a structured 4-part questionnaire consisting of demographic items, Inventory of Adolescent Resilience, Taiwan Relationship Inventory for Children and Adolescents, and Center for Epidemiologic Studies Depression Scale for Children. The associations between interpersonal relations and resilience and their associations with depressive symptoms were analyzed using MPlus 8.0 software for structural equation modeling. RESULTS: Results from structural equation modeling indicate that resilience and interpersonal relationships were negatively associated with students' depressive symptoms, and resilience partially mediated the associations between interpersonal relationships and depressive symptoms after controlling for demographics. CONCLUSION: Findings support that resilience and better interpersonal relationships are protective factors against depressive symptoms in adolescents. The positive association between the two protectors implies that interpersonal relationships might increase resilience and then alleviate depression amongst adolescents.