Standardized framework for assessing soil quality at antimony smelting site by considering microbial-induced resilience and heavy metal contamination.

Antimony smelting activities damage the soil and vegetation surroundings while generating economic value. However, no standardized methods are available to diagnose the extent of soil degradation at antimony smelting sites. This study developed a standardized framework for assessing soil quality by considering microbial-induced resilience and heavy metal contamination at Xikuangshan antimony smelting site. The soil resilience index (SRI) and soil contamination index (SCI) were calculated by Minimum Data Set and geo-accumulation model, respectively. After standardized by a multi-criteria quantitative procedure of modified Nemerow's pollution index (NPI), the integrated assessment of soil quality index (SQI), which is the minimum of SRINPI and SCINPI, was achieved. The results showed that Sb and As were the prominent metal(loid) pollutants, and significant correlations between SQI and SRI indicated that the poor soil quality was mainly caused by the low level of soil resilience. The primary limiting factors of SRI were Fungi in high and middle contaminated areas, and Skermanella in low contaminated area, suggesting that the weak soil resilience was caused by low specific microbial abundances. Microbial regulation and phytoremediation are greatly required to improve the soil quality at antimony smelting sites from the perspectives of pollution control and resilience improvement. This study improves our understanding of ecological effects of antimony smelting sites and provides a theoretical basis for ecological restoration and sustainable development of mining areas.

Academic resilience of nursing students during COVID-19: An analysis using machine learning methods.

AIM: This cross-sectional study investigates the factors that contribute to academic resilience among nursing students during COVID-19 pandemic. DESIGN: A cross-sectional study. METHODS: A survey was conducted in a general hospital between November and December 2022. The Nursing Student Academic Resilience Inventory (NSARI) model was used to assess the academic resilience of 96 nursing students. The Boruta method was then used to identify the core factors influencing overall academic resilience, and rough set analysis was used to analyse the behavioural patterns associated with these factors. RESULTS: Attributes were categorised into three importance levels. Three statistically significant attributes were identified ("I earn my patient's trust by making suitable communication," "I receive support from my instructors," and "I try to endure academic hardship") based on comparison with shadow attributes. The rough set analysis showed nine main behavioural patterns. Random forest, support vector machines, and backpropagation artificial neural networks were used to test the performance of the model, with accuracies ranging from 73.0% to 76.9%. CONCLUSION: Our results provide possible strategies for improving academic resilience and competence of nursing students.

Epistemic Trust: a Keyword for Contemporary Clinical Practice and Psychopathology.

The increasing integration of eclectic knowledge from fields not directly related to clinical psychology is coherent with a current tendency to employ alternative ideas to investigate psychopathology in the light of a more phenomenological perspective. The concept of epistemic trust may provide the gateway to alternative causal models for personality psychopathology that links poor mentalizing environment to a more general lack of social support. People who have been denied the ability to trust the information circulating in their more proximate environment may showcase a remarkable disadvantage in terms of social adjustment that relate to early insecure attachment experiences. Research assumes that patients who have been suffering an epistemic deficient environment in infancy could be trapped into a vicious cycle of suffering, loneliness and inability to seek or accept help. Although most contributes cited in this brief article deal with epistemic trust as potential tool for social learning from a theoretical point of view, the recent introduction of systematic measures of epistemic trust as a dimensional personality variable outlines a likely future increase in the use of new questionnaires and protocols for clinical assessment and treatment monitoring expressively focused on epistemic trust. The benefits of adopting such a holistic etiological paradigm in personality pathology are outlined, as proposed by the many works that advocate a more equitable clinical practice that assume individual development in the context of an unequal social world, that is believed to determine the child's evolutionary trajectory from the very first stages of life. In the same vein, the importance of fostering an authentic relationship of trust between patient and therapist as a fundamental element of the therapeutic alliance, as well as a driving force for salutogenesis at the community level, is vividly highlighted.

Resilience and Burden Related to Clinical Assistance: a Clinical Psychological Study.

BACKGROUND: The literature consistently highlights the significant burden faced by healthcare professionals, often describing caregivers as "invisible patients." Resilience is a critical factor in their well-being and quality of life. This study aimed to examine the presence of variables such as resilience and burden in caregivers, along with factors like age, gender, education, and work commitment, to understand the correlations among these independent and clinical variables. METHODS: The sample consisted of 126 carers aged 18-30 years old (M: 26.15; SD: 3.21) with a 77.8% of the sample being female. The variables included the socio-demographic (age, sex, education, hours/days of speech per week and years of service) and clinical status, therefore burden (time dependence, development, physical, social and emotional burden) and resilience (self-perception, planned future, social competence, structured style, family cohesion and social resources). RESULTS: Regarding the correlational analyses involving socio-demographic variables and resilience, only a few significant correlations were found. However, significant positive correlations were identified between socio-demographic variables and burden, specifically with age, hours and days of work per week, and years of service. Conversely, education showed a significant negative correlation with burden, highlighting its protective role. Significant correlations between resilience and burden variables were generally positive, except for self-perception and developmental burden. Multivariate linear regression analyses revealed numerous dependencies, with predictors such as age, sex, education, hours/days of work per week, and years of service influencing the dependent variables related to burden and resilience. CONCLUSIONS: This study examined fundamental socio-demographic, occupational, and psychological variables in the lives of caregivers. It highlights not only the presence of factors that negatively impact caregivers' quality of life but also important relationships between personal variables, resilience, and burden risk. Therefore, it is crucial to consider the findings of this study, along with existing literature, to design interventions aimed at reducing burdens and improving the quality of life for caregivers.

"No one will come and help me make my life": Ecological-transactional model approach to resilience among people with a history of childhood adversity.

Resilience refers to the ability to employ a collection of protective factors to return to or maintain positive mental health following an experience of disadvantage or adversity. Understanding why some children do well despite early adverse experiences is crucial because it can inform more effective policies and programs that help more children reach their full potential. This study aimed to explore and explain the development of resilience within an ecological-transactional framework. A qualitative case study approach was used recruiting participants with history of childhood adversity: six patients with a diagnosis of first-episode psychosis from the main referral psychiatric hospital in Kenya and eight healthy controls from a neighbouring community in Nairobi. The findings indicate that children and their contexts mutually influenced each other. Using the systemic perspective of the ecological-transactional model, our participants identified the home environment (microsystem) as an important enabler of trauma to children. Available social support at both the micro-and exosystem levels, including good caregiver-child relationships, acted as buffers to alleviate the negative influence of adversity, leading to successful adaptation. Our study highlights the significant impact of adversities during childhood and adolescence. In addition, it emphasizes the influence of multiple contexts, supporting the need for appropriate interventions at each level to mitigate the negative consequences.

Resilience, compassion fatigue, moral distress and moral injury of nurses.

Background: Compassion fatigue, moral distress, and moral injury are interconnected phenomena that have a detrimental impact on the delivery of nursing care. Nurses possess the inherent resilience necessary to effectively handle these three adverse occurrences. Aim: To determine the mediating impact of resilience on compassion fatigue, moral distress, and moral injury among nurses in Saudi Arabia. Design: The final product was a structural equation model (SEM) generated using a quantitative correlation cross-sectional design, and we followed the STROBE guidelines for this study. Methods: The study involved a sample of 511 staff nurses, who were selected using consecutive sampling. The study was conducted in three government hospitals in Saudi Arabia. Ethical considerations: This study received approval from Ethics Committee under approval number H-2021-151 on March 5, 2021. The survey's description and consent statements were clearly presented on Google survey forms in both English and Arabic. Results: Results showed that resilience negatively influenced moral distress, while compassion fatigue and moral injury had a positive influence. Likewise, compassion fatigue had a direct, positive effect on moral distress and moral injury, and moral distress had a direct, positive effect on moral injury. Analyses also showed that resilience had positive, indirect effects on moral injury through the mediation of both compassion fatigue and moral distress. Similarly, compassion fatigue had a positive, indirect effect on moral injury through the mediation of moral distress. Conclusion: Because resilience enables nurses to adapt, it helps them overcome obstacles in their career and professional lives. Resilience is frequently cited by nurses as a protective quality. Moral injury, compassion fatigue, and moral distress can negatively impact the health of nurses. Implications for the profession and/or patient care: Nurse leaders should develop programs and initiate efforts to improve nurses' resilience as an important protective trait against compassion fatigue, moral distress, and moral injury. Patient or Public Contribution: There was no public or patient participation in this study.

Associations of Minority Stressors, Alcohol Use Disorder, Resilience, and HIV Testing Self-Efficacy Among Community-Based Black Men Who Have Sex with Men in a Southern U.S. City: A Causal Mediation and Moderation Analysis.

Background: Black men who have sex with men (BMSM) face multiple minority stressors (e.g., homophobia, racism, and presumed HIV status) that may indirectly erode their confidence in pursuing HIV testing uptake through exacerbating alcohol use disorder (AUD). Objectives: Using cross-sectional data from 203 community-based BMSM (71.4% as homosexual with a mean age of 26 years) living in a Southern US city, we conducted a causal mediation and moderation analysis to investigate in/direct pathways linking minority stressors, AUD risk, and self-efficacy of HIV testing, including how resilience may moderate these associations. Results: Our mediation analysis revealed that AUD risk accounted for 32.1% of the total effect of internalized homonegativity (ßtotal effect = -0.424; SE=0.071; p<0.001), 28.6% of the total effect of experienced homophobia (ßtotal effect = -0.684; SE=0.122; p<0.001), and 15.3% of the total effect of perceived HIV stigma (ßtotal effect = -0.361; SE=0.164; p<0.05) on HIV testing self-efficacy. Resilience significantly moderated the associations of experienced homophobia (ß = -0.049; SE=0.011; p<0.001), internalized homonegativity (ß = -0.065; SE=0.027; p<0.01), and perceived HIV stigma (ß = -0.034; SE=0.013; p<0.05) with AUD risk. Resilience also significantly moderated the associations of experienced homophobia (ß = -0.073; SE=0.021; p<0.01), internalized homonegativity (ß = -0.082; SE=0.012; p<0.001), perceived HIV stigma (ß = -0.037; SE=0.039; p<0.05), and AUD risk (ß = -0.021; SE=0.015; p<0.05) with HIV testing self-efficacy. Conclusions: Our study provides important implications in identifying multilevel sources for building resilience among BMSM to buffer the effects of minority stress on AUD risk and improve HIV testing outcomes.

The mediating role of loneliness between psychological resilience and health-related quality of life among patients with nasopharyngeal carcinoma: a cross-sectional study using structural equation modeling.

BACKGROUND: Cancer patients' health-related quality of life (HRQoL) has always been a hot discussion spot. Loneliness and psychological resilience are considered to be significant psychosocial factors impacting the HRQoL of the cancer population. However, there is a lack of studies on the interrelationship among loneliness, resilience, and HRQoL in patients with nasopharyngeal carcinoma (NPC). This study aims to explore the relationship between resilience and HRQoL among NPC patients and to recognize the potential mediating role of loneliness in this relationship. METHODS: A cross-sectional study was performed in this study. A convenience sampling method was conducted to recruit participants. A total of 155 patients with nasopharyngeal carcinoma were required to complete the socio-demographic questionnaire, the Cancer Loneliness Scale (CLS), the 10-item Connor-Davidson Resilience Scale (CD-RISC-10), and the European Organization for Research and Treatment of Quality of Life Questionnaire C-30 (EORTC QLQ-C30) from April 2022 to August 2022 in a tertiary grade A hospital in Guangzhou, China. The multiple linear regression analysis was used to identify influencing factors, and structural equation modeling with the bootstrap method was performed to test the mediating role of loneliness. This study complied with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. RESULTS: HRQoL was at a median level among NPC patients, with a mean score of 64.19 (24.38) on the Global health status/quality of life (GHS/QoL) scale. Monthly household income (B = 4.973, P < 0.001), cancer stage (B=-4.342, P = 0.004), psychological resilience (B = 0.914, P < 0.001), and loneliness (B =-1.083, P < 0.001) were independent factors related to HRQoL, explaining 36.7% of the variance of HRQoL. Psychological resilience exerted its direct negative impact on loneliness (ß = -0.199, BC95%CI = -0.318/-0.089), and it also had a both direct and indirect positive impact on HRQoL (ß = 0.653, BC95%CI = 0.423/0.912; ß = 0.142, BC95%CI = 0.046/0.296). Loneliness exerted a partially mediating impact on the relationship between psychological resilience and HRQoL. CONCLUSIONS: NPC patients with higher monthly household, early stages of cancer, higher resilience, and lower loneliness show a better HRQoL. Resilience has an indirect positive impact on HRQoL by influencing loneliness in NPC patients. It is suggested that healthcare staff should strive to enhancing resilience and reducing loneliness as new strategies to promote NPC patients' HRQoL further.

Risk and resilience profiles and their transition pathways in the ABCD Study.

The transition from childhood to adolescence presents elevated risks for the onset of psychopathology in youth. Given the multilayered nature of development, the present study leverages the longitudinal, population-based Adolescent Brain Cognitive Development Study to derive ecologically informed risk/resilience profiles based on multilevel influences (e.g., neighborhood and family socioeconomic resources, parenting, school characteristics) and their transition pathways and examine their associations with psychopathology. Latent profile analysis characterized risk/resilience profiles at each time point (i.e., baseline, Year-1, Year-2); latent transition analysis estimated the most likely transition pathway for each individual. Analysis of covariance was used to examine associations between profile membership at baseline (i.e., ages 9-11) and psychopathology, both concurrently and at Year-2 follow-up. Further, we examined the associations between profile transition pathways and Year-2 psychopathology. Four distinct profiles emerged across time - High-SES High-Protective, High-SES Low-Protective, Low-SES High-Family-Risk, and Low-SES High-Protective. Despite reasonably high stability, significant transition over time among profiles was detected. Profile membership at baseline significantly correlated with concurrent psychopathology and predicted psychopathology 2 years later. Additionally, profile transition pathways significantly predicted Year-2 psychopathology, exemplifying equifinality and multifinality. Characterizing and tracing shifts in ecologically informed risk/resilience influences, our findings have the potential to inform more precise intervention efforts in youth.

Relationships Between Family Resilience, Individual Resilience, and Quality of Life in Patients with Head and Neck Cancer: A Cross-Sectional Study.

BACKGROUND: Patients with head and neck cancer (HNC) have to cope with a multitude of treatment-related adverse effects that impact their quality of life (QoL) post-treatment completion. The presence of family resilience could potentially foster individual resilience and might contribute to patients' QoL. However, this interconnection has not been confirmed. OBJECTIVE: To explore the relationships between family resilience, individual resilience, and QoL in patients with HNC and to determine whether individual resilience in HNC patients functions as a mediator between family resilience and QoL. METHODS: From September 2022 to June 2023, a cross-sectional survey was conducted among 185 patients with HNC recruited through convenience sampling from a tertiary care hospital in Jiangsu Province, China. Self-report measures of family resilience, individual resilience, and QoL were assessed. Relationships were examined by Pearson's correlations. Structural equation models were used to assess whether individual resilience played a mediating role between family resilience and QoL. RESULTS: There were significant positive correlations between QoL and both family resilience (r = 0.43, P < .01) and individual resilience (r = 0.59, P < .01). Moreover, family resilience had an indirect influence on QoL through its effect on individual resilience (ß = 0.319, 95% CI: 0.336-0.815). CONCLUSION: Family resilience emerges as a significant positive factor capable of enhancing QoL for patients with HNC by bolstering their resilience. To mitigate the detrimental effects of inadequate individual resilience on QoL of patients with HNC, it is advised to implement interventions focused on enhancing family resilience. CHINA CLINICAL TRIALS REGISTRY NUMBER: ChiCTR2300067612.

The post-Cartesian dilemma: Reuniting the mind and body through psychoneuroimmunology.

While today, it might seem absurd to hear anyone claim that stress does not alter all aspects of the human experience, including behavioral, cognitive, affective, and physiological processes. Dr. Janice Kiecolt-Glaser started her career at a time when stress was primarily considered a neuroendocrine response with cardiovascular repercussions. She was part of a small group of innovative scientists who began to push the boundaries of stress research - many contemporary immunologists and virologist disputed their early results in 1980s and 90s - and, yet, they persevered by connecting psychological stress to altered immune function via stress-related neuroendocrine changes. As a clinical psychologist, she focused mainly on human research studies to advance the field of psychoneuroimmunology throughout her career. Her research demonstrates how adversity and psychosocial aspects of human experience alter physiological functioning, primarily immune, and health or, in other words, the embodiment of our lived experiences. This short review is a contextualized synthesis of Dr. Kiecolt-Glaser's key contributions to the fields of psychoneuroimmunology and health psychology and her influence on my present day thinking and research approaches, as well as potential steps forward in our post-pandemic world.

Prenatal maternal mental health and resilience in the United Kingdom during the SARS-CoV-2 pandemic: a cross- national comparison.

Introduction: Prenatal mental health problems are associated with morbidity for the pregnant person, and their infants are at long-term risk for poor health outcomes. We aim to explore how the SARS-CoV-2 pandemic affected the mental health of pregnant people in the United Kingdom (UK), and to further identify resilience factors which may have contributed to varying mental health outcomes. We also aim to examine the quality of antenatal care provided during the pandemic in the UK and to identify potential inadequacies to enhance preparedness for future events. Methods: During June-November 2020, we recruited 3666 individuals in the UK for the EPPOCH pregnancy cohort (Maternal mental health during the COVID-19 pandemic: Effect of the Pandemic on Pregnancy Outcomes and Childhood Health). Participants were assessed for depression, anxiety, anger and pregnancy-related anxiety using validated scales. Additionally, physical activity, social support, individualized support and personal coping ability of the respondents were assessed as potential resilience factors. Results: Participants reported high levels of depression (57.05%), anxiety (58.04%) and anger (58.05%). Higher levels of social and individualized support and personal coping ability were associated with lower mental health challenges. Additionally, pregnant individuals in the UK experienced higher depression during the pandemic than that reported in Canada. Finally, qualitative analysis revealed that restrictions for partners and support persons during medical appointments as well as poor public health communication led to increased mental health adversities and hindered ability to make medical decisions. Discussion: This study revealed increased mental health challenges among pregnant individuals in the UK during the SARS-CoV-2 pandemic. These results highlight the need for reassessing the mental health support measures available to pregnant people in the UK, both during times of crisis and in general.

How does family resilience develop among stroke survivors and their caregivers? A mixed-method study using a chain mediating model.

Background: Walsh's family resilience theory indicated that families could foster resilient outcomes among their members when they are facing changes or crises. However, little is known about family resilience among Chinese stroke survivors and their caregivers. Objectives: To explore the direct and indirect relationships between the family resilience of stroke survivors, perceived social support, self-perceived burden, self-efficacy, and the burden on their principal caregivers, and to examine the journey of adapting to family resilience among stroke survivors. Design: An explanatory sequential mixed-method study. Methods: A quantitative assessment of perceived social support, self-perceived burden, self-efficacy, and family resilience was conducted among a cohort of stroke survivors. For a deeper understanding of the family resilience formation process, semi-structured, in-depth interviews were undertaken with a purposefully selected subset of participants, consisting of 15 stroke survivors and their principal caregivers who met the study criteria. Data analysis encompassed descriptive statistics, mediation models, and content analysis to integrate and interpret both quantitative and qualitative data. Results: In a comprehensive hospital in Guangdong Province, China, 379 participants-229 men (60.4%) and 150 women (39.6%)-completed a cross-sectional questionnaire survey. The quantitative phase revealed significant statistical differences (p < 0.05) in total family resilience scores among stroke survivors related to various factors, such as age, marital status, educational level, occupational status, average monthly income per capita, first-time onset, and types of stroke. Self-perceived burden and self-efficacy partially mediate the relationship between perceived social support and family resilience, contributing to a sequential chain-mediated effect. During the qualitative phase, in-depth interviews revealed a progressive trajectory from the initial shock of diagnosis through the ongoing presence of stress and challenges to the ultimate development of family resilience and an adaptive perspective toward the future. Conclusions: Exploring the factors influencing family resilience in stroke survivors could assist healthcare professionals developing interventions to enhance family resilience and lessen the burden on principal caregivers from individual, family, and social perspectives.

Dysfunctional eating attitudes and behaviors among French elite athletes: the impact of psychological characteristics and the sporting calendar.

Background: Research on sport psychology suggests that athletes are at risk of developing dysfunctional eating attitudes and behaviors (DEAB), however the origins of these behaviors remain largely unexplored. The present study aims to identify factors (i.e., personality traits, anxiety levels, eating attitudes and behaviors, the internalization of sport thinness norms, and resilience) associated with the development of DEAB among female endurance athletes, in training and competition. Method: A longitudinal follow-up study was conducted among 14 elite female athletes who were tested daily, weekly, and quarterly over 12 months in 2022, for a total of 545 measures. Participants completed questionnaires assessing personality traits, anxiety levels, eating attitudes and behaviors, the internalization of sport thinness norms, and resilience. Descriptive statistics were calculated for all study data, and odds ratios were conducted to compare the variance of psychological factors and sporting factors depending on the level of DEAB and the sport period. Significance was set at p < 0.05. Results: Overall, 28% of our sample of athletes were identified with DEAB. Among those with DEAB, scores for agreeableness, anxiety, and competitive anxiety were significantly higher, while scores for resilience were significantly lower than those without DEAB. During the competitive season, scores for self-regulatory eating attitudes and the internalization of thinness norms were significantly higher than during the training period. Conclusion: Our results suggest a greater probability of DEAB among athletes who exhibit the trait of agreeableness, experience anxiety during competition, and lack resilience. The competitive season was also identified as a period conducive for developing DEAB compared with the training period. Based on these results our study suggests preventive measures that can be implemented with athletes displaying these traits, with a particular emphasis during the competitive phase.

Psychological resilience and intention to stay among nurses: the mediating role of perceived organizational support.

Background: This study aims to analyze the relationship between psychological resilience, perceived organizational support, and intention to stay among nurses. Additionally, it explores the mediating role of perceived organizational support in the relationship between psychological resilience and nurses' intention to stay. Methods: A cross-sectional survey was conducted between August and September 2023, involving 1,402 nurses from five Grade 3A hospitals in Guangdong. The survey utilized several instruments, including the General Information Questionnaire (GIQ), the Chinese version of the Connor-Davidson Resilience Scale (CD-RISC), the Chinese version of the Perceived Organizational Support Scale (POSS), and the Chinese version of the Intention to Stay Scale (ITSS). The obtained data were analyzed using descriptive statistics and Pearson's correlation coefficient, while the mediating effect of perceived organizational support was assessed using the PROCESS macro mediation model in SPSS. Results: The overall mean score for psychological resilience among nurses in the five Grade 3A hospitals in Guangdong was 60.54 ± 19.17, the overall mean score for perceived organizational support was 45.77 ± 11.49, and the mean score for intention to stay was 20.82 ± 4.65. The results of the statistical analysis revealed positive correlations between psychological resilience and intention to stay (r = 0.388, p < 0.01), between perceived organizational support and psychological resilience (r = 0.570, p < 0.01), and between perceived organizational support and intention to stay (r = 0.550, p < 0.01). Additionally, perceived organizational support was found to mediate the relationship between psychological resilience and intention to stay, with a mediation effect value of 0.067, accounting for 71.28% of the total effect. Conclusion: Psychological resilience of nursing staff directly impacts their intention to stay and indirectly influences their caring behaviors, with perceived organizational support serving as a key mediator in both relationships. Therefore, nursing managers should implement targeted interventions to enhance nurses' psychological resilience and perceived organizational support. Strengthening these factors can significantly increase nurses' intention to stay in their jobs, improve the quality of care, and contribute to building a strong and stable nursing workforce.

Spatio-temporal evolution of social-ecological system resilience in ethnic tourism destinations in mountainous areas and trend prediction: a case study in Wuling, China.

Mountainous ethnic tourism lands are important social-ecological system types. With tourism as the main disturbance factor, the theory of social-ecological system resilience provides a new way to realize the sustainable development of ethno-tourism in mountainous areas. This study divides the social-ecological system into social, economic, and ecological subsystems. It constructs an evaluation index system to assess the resilience of ethnic tourism destinations in mountainous areas, considering vulnerability and adaptability. We investigate 64 counties in the Wuling Mountain area and use set-pair analysis to assess the resilience index of the social-ecological system from 2000 to 2020 and reveal the temporal and spatial characteristics. Obstacle degree models and a genetic algorithm-back propagation neural network are utilized to determine the influencing factors and predict future development trends. The following results were obtained: (1) Temporally, the resilience index shows a steady upward trend, reaching a moderate level. The resilience of the social subsystem fluctuates and rises; the economic subsystem exhibits slow, fast, and slow growth rates with occasional abrupt changes; and the ecological subsystem demonstrates a stable, slightly increasing trend. (2) Spatially, the resilience index is high at the edges and low in the central area, exhibiting a concave distribution. Most counties have moderate or higher resilience. The social and ecological subsystems have low resilience in the south and high resilience in the north. The resilience of the economic subsystem is high at the edges and low in the central area. (3) On the distribution of major obstacle factors, the first two are similar at the county level, and the last three are significantly different. The similarity of the barrier factors is related to the degree of regional proximity of the county, and overall, the similarity is decreasing from north to south and from west to east in the distribution pattern within the area. and to a certain extent, it is affected by terrain and geomorphology. (4) The spatial distribution of the resilience index is similar in 2025 and 2030. The index decreases slightly and then increases annually, with a lower growth rate in the south than in the north. Lower values occur in the northern and southwestern parts, whereas higher values are observed around high-value areas. The region as a whole will develop in a coordinated and integrated manner in the future.

Understanding the importance of therapeutic alliance during physiotherapy treatment for musculoskeletal pain in children: a scoping review.

Introduction: Musculoskeletal pain affecting children is common. Rehabilitation and treatment effectiveness can be influenced by multiple individual and contextual factors. The need for more rigorous evaluation of physiotherapy treatment for children's pain, identification of the role of specific techniques, and exploration of the influence of the therapeutic alliance is needed. This scoping review of research aimed to examine: (1) What are the perceptions of children, parents, and physiotherapists about the importance of therapeutic alliance during musculoskeletal pain treatment? (2) What are the key characteristics of therapeutic alliance during a child's musculoskeletal pain treatment from the perspectives of children, parents, and physiotherapists? and (3) What are the perceived impacts of therapeutic alliance (positive and negative) during a child's physiotherapy treatment for musculoskeletal pain? Methods: The scoping review, based on Arksey and O'Malley's framework and reporting was guided by PRISMA-ScR. The search strategy was based on three concept blocks: (1) Study population: Children (<18 years); (2) Medical condition: Any musculoskeletal pain (acute, chronic primary, chronic secondary); (3) Intervention: Qualitative exploration of experience of physiotherapy treatment delivered by a physiotherapist from the perspective of a child, parent, or physiotherapist. The search (no date limit) was conducted in February 2024 across Medline, AMED and CINAHL. Results: Following duplicate removal and assessment of eligibility of the initial 236 articles, nine articles were included; of these, only one specifically aimed to explore therapeutic alliance and it was the only paper to directly mention therapeutic alliance. All nine articles presented the child's experience. One overarching theme "Finding resilience within me through therapeutic alliance" and three main themes: "A trusted guide through the ups and the downs of rehabilitation"; "Having a route map"; and "Take me seriously but make it fun" were identified. Discussion: Therapeutic alliance was considered important by children, parents and physiotherapist and it influenced child and parent perceptions of physiotherapy and overall treatment outcomes. Physiotherapists can foster the children's resilience when experiencing musculoskeletal pain by providing disciplinary expertise, connecting and collaborating with the child by becoming their trusted guide, and co-creating a route map for rehabilitation by helping them to learn about their body, pain and recovery timeline.

Gender Minority Stress, Resilience, and Psychological Distress: The Role of Resilience Among Transgender and Gender Diverse Youth.

Purpose: Gender minority (GM) stress, resulting from distal (i.e., external) and proximal (i.e., internal) stigma-based stressors, is thought to drive mental health disparities among transgender and gender diverse (TGD) youth. We tested the gender minority stress and resilience (GMSR) model hypotheses that distal GM stress effects on mental health are partially mediated by proximal GM stress and moderated by GM-specific resilience (i.e., community connectedness, identity pride) among a U.S. national sample of TGD youth. Methods: As part of an HIV prevention study (NCT03185975), 159 TGD youth (ages 15-24) completed an online survey that included the GMSR measure, assessing distal and proximal GM stress and GM resilience, and the 18-item Brief Symptom Inventory, assessing past-7-day psychological distress. Three models linking GMSR constructs to psychological distress were tested using PROCESS v4.0: (1) simple partial mediation, (2) moderated partial mediation, and (3) serial partial mediation. Results: A direct effect of distal GM stress was observed in all models. An indirect effect through proximal GM stress alone was observed in model 1, but not models 2 or 3. In model 2, resilience did not moderate the effects of distal or proximal GM stress. In model 3, indirect effects were observed through proximal GM stress and GM resilience serially as well as GM resilience alone. Conclusion: Larger prospective studies are needed to confirm the role of GM resilience as a mediator, rather than moderator, of GM stress effects on mental health and a critical, rather than supplementary, target for mental health intervention among TGD youth.