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Introduction: Resilience is the dynamic adaptive process of maintaining or recovering mental health from stressors, such as trauma, challenging life circumstances, critical transitions, or physical illnesses. Resilience after adversity can be fostered through protective factors and the implementation of interventions that promote resilience. Hence, it is essential to investigate both protective and vulnerable factors to reduce the negative effects of unfavorable life events and increase resilience through positive risk-response interventions. Objective: To assess the effect of previous adversity, protecting factors, and resilience-promoting interventions to possess resilience after adversity in a global context. Methods: The study included English language articles sourced from PubMed, Embase, Scopus, Web of Sciences, the Cochrane Database of Systematic Reviews, Scopus, and Google Scholar published before 15 April 2024. These articles reported the effect of adversity, protecting factors, and/or resilience-promoting interventions to possess resilience after adversity in a global context without a population age limitation. The quality of the included studies was assessed using the Assessment of Multiple Systematic Reviews. A weighted inverse-variance random-effects model was applied to find the pooled estimates. The subgroup analysis, heterogeneity, publication bias, and sensitivity analysis were also assessed. Results: A total of 44 articles (n = 556,920 participants) were included in this umbrella review. From the random-effects model analysis, the pooled effect of adversity on the development of resilience was 0.25 (p < 0.001). The pooled effects of adversity-protective factors and resilience-promoting interventions after adversity were 0.31 (p < 0.001) and 0.42 (p < 0.001), respectively. The pooled effects of specific adversity protective factors were 0.26, 0.09, 0.05, 0.34, 0.23, and 0.43 for the availability of support, cognitive ability, community cohesion, positive self-perception, religious involvement, and self-regulation, respectively. The pooled effects of specific resilience-promoting interventions were 0.30, 0.21, 0.51, and 0.52 for cognitive behavior therapy (CBT) interventions, mindfulness-based interventions, mixed interventions, and resilience-promoting interventions, respectively. Conclusion: The findings of this umbrella review revealed that people who experienced early adversity can develop resilience later in life. The study highlights the need to consider adversity protective factors, such as availability of support (family, friends, and school), cognitive ability, community cohesion, positive self-perception, religious involvement, and self-regulation, and resilience-promoting interventions, including CBT interventions, mindfulness-based interventions, and mixed interventions, to enhance resilience promotion programs.
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Background: Coronavirus disease 2019 caused significant negative damage to the health status of populations and health systems globally. In Uganda, our previous study revealed that the strict Public Health and Social measures (PHSMs) and the closure of Entebbe Regional Referral Hospital (ERRH) led to missed healthcare access among the citizens in the Entebbe municipality. Limited studies, however, exist on the impact of the response measures on the local health systems. This study aims to explore the impacts of these measures on the local health service provision from the views of health facilities in Entebbe. Methods: We used a thematic framework method, grounded by the health systems resilience framework consisting of five components: (1) health service delivery; (2) medical products and technology; (3) health workforce; (4) public health functions; and (5) governance and financing. Key informant interviews with eight representatives from four private hospitals and four health centers were conducted from September to October 2022. Results: Fifteen themes and 25 subthemes were identified. With the closure of the ERRH and the strict PHSMs, the citizens faced various difficulties in accessing the needed health services. The facilities received an overwhelming number of patients and faced various challenges, such as a lack of medicine, healthcare workers, facility capacity, and no means to transfer patients. Nevertheless, the facilities made efforts to maintain the required services. Moreover, mobilizing vertical and horizontal actors through a flexible network, from the district health office to community health volunteers, helped to coordinate the medicines, transportation for both patients and healthcare workers, conduct patient tracking, etc. Conclusion: Our study suggested the importance of an integrated system of public health and health service delivery systems, the formalization of a vertical cooperative mechanism, and the introduction of public health insurance for strengthening resilient health systems. These insights may benefit other sub-Saharan cities.
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To effectively protect against the increasingly pervasive effects of climate change, countries and cities around the world are tasked with formulating and implementing climate actions that effectively respond to the challenges ahead. However, choosing the optimal climate actions is complex, since it is necessary to consider many external impacts as early on as the planning phase. Our novel methodology uncovers and integrates into first-of-its-kind decision support framework the identified climate actions of 443 European cities (from 32 countries) and the city structure-related features that influence the basic success of strategy creation into a first-of-its-kind decision support framework. Depending on their budget, population density, development and energy consumption portfolio, the results highlight that the analyzed European cities need to adopt a different way of thinking. The research results lay the foundation for the decision support of evidence-based climate action planning and contribute towards strengthening the role of cities worldwide in the fight against climate change in the future.
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Climate change has a significant impact on human health, leading to increased mortality and morbidity worldwide, including in India. To address this issue, countries must work on developing health systems that can effectively respond, manage, recover, and adapt to climate-related shocks and stresses. Strengthening the health system's resilience requires focusing on essential building blocks, such as leadership, health information systems, the health workforce, essential medical products and technologies, service delivery, and health financing. India, as a key player in this global effort, has undertaken many initiatives in each of the health system building blocks. However, there is a pressing need for India to strengthen its planning processes, ensure adequate financial resources, and develop a robust data system to make its health system resilient to climate change and low carbon emissions.
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Multi-objective Urban Green Space (UGS) design is essential for optimizing limited resources amid diverse urban development challenges. This study introduces a new design support tool that overcomes the data-intensive and expert-reliant limitations faced by urban designers. The tool integrates stormwater management analysis within the Rhinoceros + Grasshopper platform, offering three key features: (1) quantifying stormwater volume in the 3D model, (2) estimating the space required for stormwater management in UGS, and (3) providing options for stormwater management facilities for UGS design. Across the five scenarios, the tool effectively demonstrated (1) the identification that dispersed UGS layouts collect more stormwater than aggregated ones with the same total area; (2) the consideration of the impact of weather changes on passive stormwater collection; and (3) the provision of recommendations on facility areas and locations to enhance collaborative urban and landscape design, better addressing stormwater management needs. This design support tool empowers urban designers to create more sustainable and resilient urban landscapes by addressing stormwater management challenges effectively in UGS design.
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BACKGROUND: Staff in health systems everywhere have exhibited flexibility and a capacity for improvisations during, and in response to, the COVID-19 pandemic. Looking to other examples of such resilient behaviours outside of those induced by the pandemic is instructive for those involved with researching or understanding change, or making health systems improvements. METHODS: Here, we synthesise and then assess the value of eight case studies of in situ resilient performance from Canada, Sweden, Japan, Belgium, the United Kingdom, Norway, the United States and Brazil. The cases are divided into four categories: responsiveness to a crisis; adaptiveness over time; local adoption in accommodating to a top down, national policy change; and the consequential outcomes of an intervention. RESULTS: The cases illuminate the resourcefulness of translational and social researchers in examining such behaviours and practices. More than that, they also foreground the ingenuity and adaptive capacity of staff on-the-ground who continually anticipate, respond and adapt to make systems work and provide continuous care in the face of many challenges, including resource deficiencies, policy misalignments, and new technologies, policies and procedures that need to be integrated into local workflows. Front line clinicians make care systems work, pre-empting issues and sorting out problems before they occur or as they arise. CONCLUSIONS: A key lesson amongst a range of findings is that, rather than focusing on shiny new tools of change (checklists, frameworks, policy mandates), it is much more insightful and satisfying to deeply apprehend care at the sharp end, where clinicians deliver care to patients, understanding how everyday work is executed. This, rather than the Health Ministry, the Boardroom, or the Management Consultant's office, is where and how change is being enabled, and where street level actors solve problems, thwart issues in advance, and constantly avoid pitfalls.
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COVID-19 , Atenção à Saúde , SARS-CoV-2 , Humanos , COVID-19/epidemiologia , Atenção à Saúde/organização & administração , Pandemias , Política de SaúdeRESUMO
Spinal muscular atrophy (SMA) is a rare, genetic neurodegenerative disorder caused by insufficient production of survival motor neuron (SMN) protein. Diminished SMN protein levels lead to motor neuron loss, causing muscle atrophy and weakness that impairs daily functioning and reduces quality of life. SMN upregulators offer clinical improvements and increased survival in SMA patients, although significant unmet needs remain. Myostatin, a TGF-ß superfamily signaling molecule that binds to the activin II receptor, negatively regulates muscle growth; myostatin inhibition is a promising therapeutic strategy for enhancing muscle. Combining myostatin inhibition with SMN upregulation, a comprehensive therapeutic strategy targeting the whole motor unit, offers promise in SMA. Taldefgrobep alfa is a novel, fully human recombinant protein that selectively binds to myostatin and competitively inhibits other ligands that signal through the activin II receptor. Given a robust scientific and clinical rationale and the favorable safety profile of taldefgrobep in patients with neuromuscular disease, the RESILIENT phase 3, randomized, placebo-controlled trial is investigating taldefgrobep as an adjunct to SMN upregulators in SMA (NCT05337553). This manuscript reviews the role of myostatin in muscle, explores the preclinical and clinical development of taldefgrobep and introduces the phase 3 RESILIENT trial of taldefgrobep in SMA.
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Atrofia Muscular Espinal , Miostatina , Humanos , Miostatina/metabolismo , Miostatina/antagonistas & inibidores , Atrofia Muscular Espinal/metabolismo , Atrofia Muscular Espinal/tratamento farmacológico , Atrofia Muscular Espinal/genética , Ensaios Clínicos Fase III como Assunto , Receptores de Activinas Tipo II/metabolismo , Receptores de Activinas Tipo II/uso terapêutico , Animais , Proteínas Recombinantes/uso terapêuticoRESUMO
The advancement of soft bioelectronics hinges critically on the electromechanical properties of hydrogels. Despite ongoing research into diverse material and structural strategies to enhance these properties, producing hydrogels that are simultaneously tough, resilient, and highly conductive for long-term, dynamic physiological monitoring remains a formidable challenge. Here, a strategy utilizing scalable layered heterogeneous hydrogel fibers (LHHFs) is introduced that enables synergistic electromechanical modulation of hydrogels. High toughness (1.4 MJ m-3) and resilience (over 92% recovery from 200% strain) of LHHFs are achieved through a damage-free toughening mechanism that involves dense long-chain entanglements and reversible strain-induced crystallization of sodium polyacrylate. The unique symmetrical layered structure of LHHFs, featuring distinct electrical and mechanical functional layers, facilitates the mixing of multi-walled carbon nanotubes to significantly enhance electrical conductivity (192.7 S m-1) without compromising toughness and resilience. Furthermore, high-performance LHHF capacitive iontronic strain/pressure sensors and epidermal electrodes are developed, capable of accurately and stably capturing biomechanical and bioelectrical signals from the human body under long-term, dynamic conditions. The LHHF offers a promising route for developing hydrogels with uniquely integrated electromechanical attributes, advancing practical wearable healthcare applications.
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Resilient mounts are essential for anti-vibration and shock absorption applications, making accurate predictions of their static and dynamic behaviors critical for effective design and mechanical performance. This study investigates static and dynamic characteristics of resilient mounts to predict their effects. Tension, compression, and shear tests were performed under quasi-static loading conditions to obtain stress-strain cycle curves. This study includes a review of the Yeoh hyperelastic model, which consists of three parameters, and discusses the calibration of these parameters to describe the hyperelastic material behavior. The parameters were validated through numerical analysis by comparing them with experimental results from quasi-static tests on the resilient mount. The dynamic behavior was further analyzed using modal analysis and frequency response simulations under various preload conditions. Results show that increasing preload significantly shifts the transmissibility curves and resonance peaks to lower frequencies. This study offers valuable insights into static and dynamic characteristics of resilient mounts, contributing to the design and optimization of vibration isolation systems for naval applications.
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Floor impact noise is a significant social concern to secure a quiescent living space for multi-story building residents in South Korea. The floating floor, consisting of a concrete structure on resilient pads, is a specifically designed system to minimize noise transmission. This floating structure employs polymeric pads as the resilient materials. In this study, we investigated the utilization of helically shaped machining scraps as a resilient material for an alternative approach to floor noise reduction. The dynamic elastic modulus and loss factor of the scrap pads were measured using the vibration test method. The scrap pads exhibited a low dynamic elastic modulus and a high loss factor compared to the polymeric pads. Heavyweight impact sound experiments in an actual building were conducted to evaluate the noise reduction performance. The proposed pads showed excellent performance on the reduction in the structure-borne vibration of the concrete slab and resulting sound generation. The analytical model was used to simulate the response of the floating floor structure, enabling a parametric study to examine the effects of the resilient layer viscoelastic properties. Both experimental and analytical evidence confirmed that the proposed scrap pads contribute to the development of sustainable solutions for the minimization of floor impact noise.
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BACKGROUND: Despite years of attention, avoiding medication-related harm remains a global challenge. Nursing homes provide essential health care for frail older individuals, who often experience multiple chronic diseases and polypharmacy, increasing their risk of medication errors. Evidence of effective interventions to improve medication safety in these settings is inconclusive. Focusing on patient safety culture is a potential key to intervention development as it forms the foundation for overall patient safety and is associated with medication errors. OBJECTIVE: This study aims to develop an intervention to improve medication safety for nursing home residents through a cocreative process guided by integrated knowledge translation and experience-based codesign. METHODS: This study used a cocreative process guided by integrated knowledge translation and experience-based co-design principles. Evidence on patient safety culture was used as an inspirational source for exploration of medication safety. Data collection involved semistructured focus groups to generate experiential knowledge (stage 1) to inform intervention design in a multidisciplinary workshop (stage 2). Research validation engaging different types of research expertise and municipal managerial representatives in finalizing the intervention design was essential. Acceptance of the final intervention for evaluation was aimed for through contextualization focused on partnership with a municipal advisory board. An abductive, rapid qualitative analytical approach to data analysis was chosen using elements from analyzing in the present, addressing the time-dependent, context-bound aspects of the cocreative process. RESULTS: Experiential knowledge was represented by three main themes: (1) closed systems and gaps between functions, (2) resource interpretation and untapped potential, and (3) community of medication safety and surveillance. The main themes informed the design of preliminary intervention components in a multidisciplinary workshop. An intervention design process focused on research validation in addition to contextualization resulted in the Safe Medication in Nursing Home Residents (SAME) intervention covering (1) campaign material visualizing key roles and responsibilities regarding medication for nursing home residents and (2) "Medication safety reflexive spaces" focused on social and health care assistants. CONCLUSIONS: The cocreative process successfully resulted in the multifaceted SAME intervention, grounded in lived experiences shared by some of the most important (but often underrepresented in research) stakeholders: frontline health care professionals and representatives of nursing home residents. This study brought attention toward closed systems related to functions in medication management and surveillance, not only informing the SAME intervention design but as opportunities for further exploration in future research. Evaluation of the intervention is an important next step. Overall, this study represents an important contribution to the complex field of medication safety. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/43538.
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Erros de Medicação , Casas de Saúde , Segurança do Paciente , Humanos , Erros de Medicação/prevenção & controle , Grupos Focais , Gestão da Segurança , Idoso , Masculino , FemininoRESUMO
Land degradation (LD) is driven by many factors resulting from the intricate interplay between natural and socio-economic systems, which adds dynamism and complexity to this phenomenon. The study highlights LD as a source of social vulnerability in the Baragan Plain (Romania), often called the "granary of Europe" due to its century-long history of industrial crop production. We explore the community's perceptions of vulnerability due to LD and the community-based solutions to sustainable transformations through governance using a community-based causal-effect analysis (CBCEA). CBCEA is a participatory approach that uses systems thinking, engages key informants, and generates qualitative causal-effect diagrams to illustrate the system structure. Two workshops with local key informants revealed their views on the direct and indirect causes and effects of LD, strategies they proposed to reduce the community's vulnerability, and the conditions for making the agricultural land decision-making integrative, inclusive, adaptive, and participatory (IIAP). IIAP decision-making was considered a key to transformative governance. Key informants identified "Windbreaks construction" and "(Resilient) Irrigation system" as two effective, context-specific measures to address the causes and effects of LD. We advise caution when implementing the "Irrigation system" measure, as it may risk constraining the system to an undesirable state, commonly referred to as a "trap".
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A type 1 diabetes (T1D) transition clinic in Sydney, Australia, provides age specific care for young adults (aged 16-25 years) and for adults (aged 21 years and above), and has reported improved clinical outcomes post transition to adult care over a 21-year period. This study investigated the contribution of digital technology to long-term resilient capacity of the clinic. Clinic observations and interviews with eight providers and 17 young adults were conducted. Using a framework to analyze resilient capacity in healthcare, seven strong themes emerged from the data: Leadership, Involvement, Communication, Coordination, Risk Awareness, Competence and Alignment with three themes, Structure, Learning and Facilitators also supported. Patient service adaptations included offering out of hours appointment times and telehealth to accommodate young adults' availability. This study provides evidence for the important role that digital technologies contribute to a system of care with capacity for resilience. Our findings contribute to the understanding of the factors needed to support young adults with T1D and may be valuable to inform models of care for young adults living with other chronic health conditions.
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The current study aims to characterise the complementary feeding practice and identify locally available climate-resilient crops that can be used for complementary feeding among agro-pastoralists in Ethiopia. A phenomenological study in Benna-Tsemay district, comprising focused group discussions, key informant interviews, and household observations, was conducted. A pretested guide was used to capture information regarding types of complementary food, lists of food items, and ingredients included in their complementary formulation. A thematic analysis for emerging points of discussion was carried out. Three major themes, including infant and young child feeding practices, food items included in complementary food, and their consumption frequencies, as well as the incorporation of climate-resilient crops into complementary foods as coping mechanisms, emerged. Breastfeeding was common and regarded as essential. Gruel and porridge from grains, roots, and tubers were regular parts of complementary foods in the study area. Moringa and sorghum were dominantly identified as climate-resilient crops regularly grown and used in complementary foods. Growing these crops was regarded as a coping strategy for drought and seasonal constraints. The district is one of the most drought-prone areas in Ethiopia, compromising the quality of complementary food. Unlike the World Health Organization recommendation, the grains, roots, and tubers-based diet formed the basis of complementary food lacking flesh foods, eggs, pulses, and other fruits and vegetables. Thus, it is recommended to improve complementary food quality through value-addition using locally accessible crops.
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Produtos Agrícolas , Fenômenos Fisiológicos da Nutrição do Lactente , Etiópia , Humanos , Lactente , Feminino , Alimentos Infantis , Pesquisa Qualitativa , Masculino , Adulto , Aleitamento Materno , Clima , Dieta , Pré-EscolarRESUMO
With the emergence of Industry 5.0 and an increasing focus on human-centric approaches in manufacturing, the analysis of workers in production systems has gathered significant interest among researchers and practitioners. Previous studies have explored the impact of various aspects, such as skills, fatigue, and circadian rhythms, on human performance. However, the cumulative effect of these aspects as disturbances on work performance has yet to be fully elucidated. This study introduces an approach using the Functional Resonance Analysis Method (FRAM) to investigate the impact of multiple disturbances on workers' performance. Furthermore, this approach explored how the resilience-related skill aspects of workers affect their performance under multiple disturbances. A case study on engine test and repair processes was conducted, employing qualitative data collection and semi-quantitative simulation studies examining the impact of combined disturbances across 4,094 scenarios. The results show that a larger number of compounded variabilities expressed in Common Performance Conditions (CPCs) made it significantly challenging to recover work performance, and CPCs with particularly critical effects were identified. In addition, the FRAM model of skilled workers was shown to sustain higher performance across more scenarios. The approach of this study has demonstrated its ability to provide insights for effectively and safely managing production systems while considering complex disturbances.
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A plethora of studies have uncovered numerous important genes with agricultural significance in staple crops. However, when it comes to orphan crops like minor millet, genomic research lags significantly behind that of major crops. This situation has promoted a focus on exploring research opportunities in minor millets, particularly in finger millet, using cutting-edge methods. Finger millet, a coarse cereal known for its exceptional nutritional content and ability to withstand environmental stresses represents a promising climate-smart and nutritional crop in the battle against escalating environmental challenges. The existing traditional improvement programs for finger millet are insufficient to address global hunger effectively. The lack of utilization of high-throughput platforms, genome editing, haplotype breeding, and advanced breeding approaches hinders the systematic multi-omics studies on finger millet, which are essential for pinpointing crucial genes related to agronomically important and various stress responses. The growing environmental uncertainties have widened the gap between the anticipated and real progress in crop improvement. To overcome these challenges a combination of cutting-edge multi-omics techniques such as high-throughput sequencing, speed breeding, mutational breeding, haplotype-based breeding, genomic selection, high-throughput phenotyping, pangenomics, genome editing, and more along with integration of deep learning and artificial intelligence technologies are essential to accelerate research efforts in finger millet. The scarcity of multi-omics approaches in finger millet leaves breeders with limited modern tools for crop enhancement. Therefore, leveraging datasets from previous studies could prove effective in implementing the necessary multi-omics interventions to enrich the genetic resource in finger millet.
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Eleusine , Genômica , Melhoramento Vegetal , Melhoramento Vegetal/métodos , Eleusine/genética , Genômica/métodos , Edição de Genes/métodos , Produtos Agrícolas/genética , Genoma de Planta , Biotecnologia , MultiômicaRESUMO
Wildfire governance requires addressing driving physical, biological and socio-economic processes, by promoting the development of fire-resistant and resilient landscapes. These landscapes can best be achieved by strategies that integrate fuel management for direct prevention with allied socio-economic activities, through the collaboration of stakeholders with different and sometimes conflicting interests. This work aims to address the need for new approaches supporting the participatory process of collective decision-making, helping stakeholders explore land management strategies for landscape fire resilience. We present and discuss a methodology combining agent-based modelling with a role-playing game. It was tested in a valley of the Italian Alps, involving 23 local stakeholders in forest and pasture management in three game sessions. Evaluation was based on observation of game sessions, collection of feedback via immediate post-session debriefing and questionnaires, and long-term (multi-year) assessment carried out through semi-structured interviews. We found the methodology valuable for facilitating discussion among different stakeholders, who were able to identify context-related challenges (land fragmentation and land abandonment, stakeholders' limited collaboration, controversial drives of European funding) and possible strategies for producing a fire-resilient landscape (community management forms of pastoralists activities for maintaining land cover diversity). The approach also triggered a positive process for longer-term change. By analysing the outcomes, we are able to identify four key recommendations for future work using serious gaming for sustainable landscapes: 1) aim for an even composition of session groups, 2) consider the multiple levels of organisation in the area, 3) use the allocation of game roles to disrupt power dynamics, and 4) seek to involve the broadest stakeholder spectrum in developing the game itself.
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The present experiment evaluated whether dietary protein (P) or lipid (L) is preferred as an energy source by genetically improved farmed tilapia (GIFT) reared at high temperatures. A 60-day feeding trial was conducted at 28.3 °C and 33.3 °C, testing five diets with varying protein (34,36,38 %) and lipid (8,10,12 %) levels, viz., P38L8, P36L8, P34L8, P34L10, P34L12. Parameters assessed included growth, body composition, serum lipids, enzyme activities, fatty acid profiles, and PPAR-α mRNA expression. Results indicated that the fish fed optimum protein and highest lipid level (P34L12) showed significantly higher (P < 0.05) weight gain percent and thermal growth coefficient. Increasing dietary lipid content reduced whole-body lipid deposition and mobilised serum triglycerides and cholesterol at higher temperatures (HT). Hepatic malic enzyme activity decreased with rising temperature and lipid content, while lipoprotein lipase activity in muscle increased. The fatty acid composition altered substantially with the changes in rearing temperature and diets. Unsaturated fats were preferred as direct fuels for ß-oxidation, wherein the P34L12 groups preserved body (area %) EPA, DHA, and linolenic acid, especially at HT. The expression of PPAR-α, a lipolytic marker, was upregulated with increasing temperature and high dietary lipid content, peaking in P34L12 groups. The study concludes that high-lipid diets (12 %) are metabolically superior to high-protein diets for GIFT tilapia at elevated temperatures, optimising growth, enhancing metabolic efficiency, and maintaining essential fatty acid profiles under hyperthermal stress.
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The metro is susceptible to disruption risks and requires a system response capability to build resilience to manage disruptions. Achieving such resilient response state requires readiness in both the technology side, e.g., utilizing digital technologies (DTs) to monitor system components, and the human factors side, e.g., fostering positive human coping capabilities; however, these two sides are usually considered independently, without sufficient integration. This paper aims to develop and empirically test a model in which monitoring-enabled DTs, employees' reactions, and their positive capabilities are simultaneously considered in terms of their interplay and impact on system response capability. The results showed that while DTs for monitoring physical components enhanced perceived management commitment and fostered collective efficacy, DTs for monitoring human components increased psychological strain and inhibited improvisation capability, creating a "double-edged sword" effect on system response capability. Additionally, explicit management commitment buffered the adverse effect of DTs-induced psychological strain on individual improvisation.
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Sri Lanka, a tropical island, confronts climate-driven water scarcity and is of great concern to building climate-resilient water management to achieve UN SDGs 6 and 13. This study explores the dynamic interaction between surface water (SW) and groundwater (GW) in the dry zone of Sri Lanka, employing a multi-tracer of dual stable isotopes (18O and 2H) and chloride. Two basins, Mahakanadarawa (MK) basin with numerous village tanks and tank cascade systems (VTCSs/TCSs) and Kawudulla (KW) basin serving as a control with a lack of tanks, were selected in this study. Results show that the presence or absence of TCSs emerges as a pivotal factor influencing regional water dynamics. Water quality (TDS and Cl-) in natural waters between the two basins was significantly different (ANOVA: p < 0.05) in both seasons. Statistically uniform dissolved mineral content in tanks and shallow groundwater in the MK basin contrasted with significant regional deviation in the KW basin. ANOVA and Tukey tests showed significant seasonal differences (p < 0.05) in mean values of áº2H and áº18O compositions of shallow groundwater and tank water within the MK basin, while non-significance in the KW basin. Isotopic mass balance calculations revealed that tank water mixing in the shallow groundwater (fT: mixed Tank water mass fraction) ranged from 0.9 % to 77.8 % across the MK basin depending on the regional soil characteristics. Lack of tank-aquifer interconnection observed in the shallow soil in rock knob plain results in groundwater depletion while enhanced interconnections within alluvial sediment regions encourage stable and pollution-resistant shallow groundwater bodies. The consistency of the groundwater flow system in TCS regions throughout the year ensures a stable water supply, highlighting the vital synergy between TCSs and regional groundwaters in these arid regions. These results shed insights for policymakers and water managers to implement effective conservation strategies for rehabilitation and restoring these ancient VTCSs/TCSs.