Assessing Interest in a Peer Support Person for Patients Experiencing Early Pregnancy Loss: Results from a National Survey.

Introduction: The use of a peer support person as an intervention for early pregnancy loss (EPL) is not well studied. In addition, limited literature exists regarding the type of support patients need when experiencing EPL. The objective of this study is to quantify interest in a peer EPL support person intervention, to assess the types of support desired following EPL, and to investigate if there is an association between self-compassion or resilience and coping ability post-EPL. Methods: We conducted a cross-sectional, web-based survey with 110 individuals who experienced EPL in the past 2 years. Questions explored interest in a peer EPL support person and different types of support, as well as perceived self-compassion and resilience. Analyses of variance were used to test if interest in the peer support intervention and in different types of support varied by demographics, while linear regression modeling was used to test the relationship between self-compassion, resilience, and coping ability. Results: Nearly all participants (98.2%, n = 108) were interested in peer support. The majority (31.8%, n = 35) of participants prioritized informational and educational support at the time of their EPL and in the months following. There was a positive relationship between self-compassion scores and ability to cope with EPL (p = 0.2) and between resilience scores and coping ability (p < 0.05). Conclusions: Almost all participants were interested in a peer support person for coping with EPL. Given the types of support participants identified in this study, a peer support person may provide emotional and informational support as well as resilience training.

Resilience among organ donation coordinators: a Canadian mixed-methods study.

Background: Organ and Tissue Donation Coordinators (OTDCs) are key to the success of deceased organ donation processes. However, reduced resilience can leave them susceptible to the incidence of work-related issues and decrease the quality of the care provided. Therefore, this study aimed to examine the extent of resilience and influencing aspects among OTDCs in Canada. Methods: Mixed-method (QUAN-qual) explanatory sequential design. Quantitative data was collected using an online cross-sectional survey approach with demographic data and the validated scales and analyzed using descriptive and inferential statistics. Qualitative data was collected using a descriptive approach with a semi-structured interview guide and analyzed using content analysis. Results: One hundred twenty participants responded to the survey, and 39 participants were interviewed. Most participants from the survey were female (82%), registered nurses (97%) and on average 42 years old. The quantitative data revealed that OTDCs had a high level of perceived compassion satisfaction (ProQOL-CS = 36.3) but a resilience score (CD-RISC = 28.5) lower than other groups of healthcare professionals. OTDCs with over a year of experience in the role were more likely to have higher levels of resilience. The qualitative data identified that participants saw resilience as crucial for their work-related well-being. Although coping strategies were identified as a key factor that enhance resilience, many OTDCs reported difficulty in developing healthy coping strategies, and that the use of unhealthy mechanisms (e.g., alcohol and smoking) can result in negative physical consequences (e.g., weight gain) and reduced resilience levels. Conclusion: Participants reported using a series of coping and protective strategies to help build resilience, but also difficulty in developing healthy mechanisms. The lack of healthy coping strategies were seen as contributing to negative work-related issues (e.g., burnout). Our findings are being used to develop tailored interventions to improve resilience and healthy coping strategies among organ donor coordinators in Canada.

PTSD prevalence and factors in intern nursing students after COVID-19 full liberalization in China: a cross-sectional study.

Objective: This study aimed to assess the prevalence of post-traumatic stress disorder (PTSD) and its influencing factors among intern nursing students after the full liberalization of the COVID-19 prevention and control policy in China. Methods: Participants completed the online survey from January 14 to January 19, 2023. A demographic questionnaire, COVID-19 and internship-related questionnaire, the Fear of COVID-19 scale, the Primary Care PTSD Screen, and the Connor-Davidson Resilience Scale were used to conduct the online survey. Results: Of 438 participants, 88.4% tested positive for COVID-19 in the last 6 months. The prevalence of fear, resilience, and PTSD was 16.9, 15.5, and 11.2%, respectively. Direct care of COVID patients in hospital (OR = 2.084, 95%CI 1.034 ~ 4.202), the experience of occupational exposure (OR = 2.856, 95%CI 1.436 ~ 5.681), working with an experienced team (OR = 2.120, 95%CI 1.070 ~ 4.198), and fear COVID-19 (OR = 8.269, 95%CI 4.150 ~ 16.479) were significantly and positively associated with PTSD in nursing internship students. Conclusion: After COVID-19 full liberalization in China, intern nursing students still experienced pandemic-related mental distress, which can bring PTSD. Adequate support and counseling should be provided, as needed, to intern nursing students who are about to enter the workforce and have experienced severe PTSD symptoms related to COVID-19. Our findings indicated that should understand the importance of screening, formulate intervention strategies and preventive measures to address psychosocial problems, and provide coping skills training to intern nursing students.

Impact of drought stress on vitamin C and anthocyanin content in cultivated lettuces (Lactuca sativa L.) and wild relatives (Lactuca spp.).

Introduction: Lettuce production and quality could be seriously affected by the increasingly limited water resources. Methods: The effect of drought on the content of two antioxidant compounds, vitamin C and anthocyanins, in five cultivated lettuces and two wild relatives was assessed for 2 years. Results and discusion: In leaf samples, Lactuca wild species generally had a higher content of total vitamin C than the cultivated lettuces. In contrast, the commercial varieties usually contained more total anthocyanins than the wild species. Total vitamin C decreased with the drought stress in all accessions, commercial varieties, and lettuce wild relatives, with this tendency being consistent and reproducible across the 2 years. These differences were significant in the case of the green commercial varieties 'Winter Crop' (in 2020/2021) and 'Dolomiti G12' (in 2021/2022) and very significant in the red commercial variety 'Red Sails' (in 2020/2021). However, the only group in which the effect of drought was either significant or very significant in both years was the wild species, Lactuca homblei and Lactuca dregeana, and in the latter also in both tissues (leaf and stem) analyzed. Water stress resulted in an increase of the total anthocyanin content in the leaves from all the accessions, both red commercial varieties and wild relatives, in both years. The most significant enrichment and the only one being either significant or very significant in both years was observed in one of the wild relatives assayed (L. homblei). Stems (L. dregeana) contained more anthocyanins than leaves under control conditions, and it was exactly the opposite under drought. Changes in anthocyanins in the two tissues in response to drought stress were in opposite directions, increasing in leaves and decreasing in stems. This could suggest a translocation of anthocyanins as a first quick mechanism to cope with a severe lack of water. In conclusion, anthocyanins (unlike vitamin C) could play a role in the mechanisms deployed by the plant to tolerate drought stress. The wild species with a robust significant enrichment in anthocyanins as a response to drought (L. homblei) is a promising plant material to breed more resilient lettuces.

Structural white matter properties and cognitive resilience to tau pathology.

INTRODUCTION: We assessed whether macro- and/or micro-structural white matter properties are associated with cognitive resilience to Alzheimer's disease pathology years prior to clinical onset. METHODS: We examined whether global efficiency, an indicator of communication efficiency in brain networks, and diffusion measurements within the limbic network and default mode network moderate the association between amyloid-ß/tau pathology and cognitive decline. We also investigated whether demographic and health/risk factors are associated with white matter properties. RESULTS: Higher global efficiency of the limbic network, as well as free-water corrected diffusion measures within the tracts of both networks, attenuated the impact of tau pathology on memory decline. Education, age, sex, white matter hyperintensities, and vascular risk factors were associated with white matter properties of both networks. DISCUSSION: White matter can influence cognitive resilience against tau pathology, and promoting education and vascular health may enhance optimal white matter properties. HIGHLIGHTS: Aß and tau were associated with longitudinal memory change over ∼7.5 years. White matter properties attenuated the impact of tau pathology on memory change. Health/risk factors were associated with white matter properties.

Family farming in climate change: Strategies for resilient and sustainable food systems.

Family farming plays a pivotal role in ensuring household food security and bolstering the resilience of food systems against climate change. Traditional agricultural practices are evolving into context-specific, climate-resilient systems such as family farming, homestead gardening, and urban agriculture. This study examines the ways in which family farming can foster climate-resilient food systems amidst climate vulnerabilities. A systematic literature review spanning the past 22 years was undertaken to develop a conceptual framework. From this review, 37 pertinent documents were identified, leading to the creation of a context-specific, climate-resilient food system framework. The research posits that family farming facilitates easy access to food and nutrition by capitalizing on family-sourced land, labor, and capital, and by securing access to technology and markets. Each facet of family farming is intricately linked with sustainability principles. Local adaptation strategies employed by climate-vulnerable households can diminish their vulnerability and augment their adaptive, absorptive, and transformative capacities, enabling them to establish a climate-resilient food system. The research further reveals that farming families employ a myriad of strategies to fortify their food systems. These include crop diversification, adjusting planting times, cultivating high-value crops and fish, planting fruit trees, rearing poultry and livestock, and leveraging their land, labor, and resources-including their homesteads-to access food and nutrition. This study endorses the climate-resilient family farming framework and offers multiple metrics for assessing the resilience of family farming in developing countries.

Positive effects of parent-child group emotional regulation and resilience training on nonsuicidal self-injury behavior in adolescents: a quasi-experimental study.

Background: Nonsuicidal self-injury (NSSI) among adolescents is a growing global concern. However, effective interventions for treating NSSI are limited. Method: A 36-week quasi-experimental study design of parent-child group resilience training (intervention group) for adolescents aged 12-17 years was used and compared with treatment-as-usual (control group). The primary endpoint was the frequency of NSSI assessed with the Ottawa Self-Injury Inventory (OSI), and the secondary endpoints were the levels of depression, hope, resilience, and family adaptability and cohesion as assessed by the 24-item Hamilton depression rating scale (HAMD-24), Herth Hope Scale (HHS), Connor-Davidson Resilience Scale (CD-RISC), and Family Adaptability and Cohesion Evaluation Scale, second edition (FACES-II-CV), respectively. Result: A total of 118 participants completed the trial. Both groups showed a significant reduction in NSSI frequency after 12, 24, and 36 weeks of intervention (p< 0.05), although the intervention group did not differ significantly from the control group. After 12, 24, and 36 weeks of intervention, the CD-RISC, HHS, HAMD-24, and FACES-II-CV scores in the intervention and control groups improved over baseline (p< 0.05). Furthermore, the intervention group had higher scores on the CD-RISC, HHS, and FACES-II-CV and lower scores on the HAMD-24 than the control group after 12, 24, and 36 weeks of intervention (p  < 0.05). Conclusion: Parent-child group emotional regulation and resilience training showed promise as treatment options for NSSI among adolescents, leading to increased hope, resilience, and improved family dynamics among NSSI teens. Moreover, NSSI frequency significantly decreased in the intervention group compared to baseline.

Impact of social support on the resilience of youth: mediating effects of coping styles.

Background: Chinese youth are at high risk for depression with a significantly higher detection rate of depression risk than other age groups, which brings about a huge challenge to the mental health work of universities. Developing supportive resources that promote resilience against adverse environmental influences in high-risk groups is quite more urgent than medical treatment for firm diagnoses of mental issues that have developed into depression in the current background. Methods: A total of 665 university students in China completed self-reported questionnaires measuring psychological resilience, social support, and coping styles. The structural equation model testing on the goodness of fit of the theoretical framework was first performed. Descriptive statistics and Pearson's correlation analysis among social support, resilience, and coping styles were then conducted. At last, we tested the mediating role of coping styles. Results: Social support has a significant positive effect on the psychological resilience of the youth. Mixed coping and immature coping styles have significant negative impacts on both social support and resilience, while mature coping styles have a significant positive effect on social support and resilience. Mature and immature coping styles mediate the association between social support and resilience in youth. Conclusion: Based on stress theory, this study explores mechanisms that facilitate the development of resilience in young people with regard to social support and coping styles. The current research depicts an interventional perspective of building a social support network that guides the youth to adopt mature coping styles to enhance their resilience and facilitate their mental health.

Hair dehydroepiandrosterone sulfate as biomarker of employees' well-being? A longitudinal investigation of support, resilience, and work engagement during COVID-19 pandemic.

Introduction: Building on the motivational process of the job demands-resources (JD-R) theory, in the current research we investigated the longitudinal association between supervisor support/resilience as job/personal resources, work engagement (WE) and hair dehydroepiandrosterone sulfate, or DHEA(S), as a possible biomarker of employees' well-being. Methods: In the context of the COVID-19 pandemic, 122 workers completed two self-report questionnaires (i.e., psychological data): the former at Time 1 (T1) and the latter three months afterwards, at Time 2 (T2). Participants also collected a strand of hair (i.e., biological data) at T2. Results: Results from path analysis showed that both SS and resilience at T1 were positively related to WE at T2, which, in its turn, was positively related to hair DHEA(S) at T2. Both SS and resilience at T1 had a positive indirect effect on hair DHEA(S) at T2 through WE at T2, which fully mediated the association between job/personal resources and hair DHEA(S). Discussion: Overall, results are consistent with the motivational process of the JD-R. Furthermore, this study provides preliminary evidence for the role of hair DHEA(S) as a biomarker of WE, a type of work-related subjective well-being that plays a central role in the motivational process of the JD-R, leading to favorable personal and organizational outcomes. Finally, the article outlines practical implications for organizations and professionals to foster WE within the workplace.

Children and adolescents weathering the storm: Resilience in the presence of bullying victimization, harassment, and pandemic lockdown in northern Norway.

Resilience is a concept of growing interest because it can systematically inform prevention measures and psychosocial interventions for children and adolescents. The aim of this study was to explore resilience factors among young people who are victims of bullying and harassment (age 9 to 16 years old). In 2021 the burden of the pandemic lockdown became an additional adversity. The study used a repeated cross-sectional design. Two datasets with a total of 2,211 participants from 2017 (N = 972) and 2021 (N = 1,239) were included. The strengths and difficulties questionnaire (SDQ) was applied to define the resilient and non-resilient groups, and the quality-of-life questionnaire (KINDL) was used to map resilience factors. A total of 227 participants reported that they were being bullied, and 604 participants reported harassments from their peers. We used correlation and regression analyses to identify which factors predicted the highest resistance to the negative effects of bullying and harassment. The results were that 77.2% of the participants stayed resilient when facing these maladjustments, but this dropped to 61.7% during the pandemic. The most important resilience factors before the pandemic were the school environment, emotional well-being, and good relations with their friends. The impact of these predictors changed during the pandemic. Emotional well-being increased in strength, school environment was reduced, and friends did not predict resilience anymore. The effect sizes were generally large to medium. As it is common to experience adversity at some stage in life, it is vital for families, schools, social and healthcare workers to be aware of the factors associated with resilience. The results of this study may contribute towards an evidence base for developing plans to increase the capacity of resilience among young people.

Effects of metacognitions, self-compassion, and difficulties in emotion regulation on psychological resilience in oncology nurses.

PURPOSE: Providing care to individuals with cancer requires oncology nurses to have superior skills related to physical care and adaptation to the changing healthcare system, as well as witnessing and supporting the psychosocial difficulties experienced by patients and families in this process. It requires oncology nurses to be psychologically resilient. Therefore, it is crucial to determine the factors affecting the psychological resilience of oncology nurses. This study aimed to determine the effect of self-compassion, metacognitions, and difficulties in emotion regulation on psychological resilience in oncology nurses. METHODS: This is a cross-sectional correlational study. The study was conducted with 121 oncology nurses providing active oncologic care and who volunteered to participate. The Difficulties in Emotion Regulation Scale-Short Form, the Self-Compassion Scale, and the Metacognitions Questionnaire-30 were used to collect data. Data were analyzed using descriptive statistics, Pearson correlation coefficient, and multiple linear regression analysis. RESULTS: The regression model established to determine the effect of self-compassion, metacognitions, and difficulties in emotion regulation on psychological resilience was statistically significant (F(3,117) = 24.086 p < 0.001) and explained 36.6% of the change in resilience. Among the independent variables, only self-compassion had a significant contribution to the model (p = 0.001). According to the model, 1-unit change in self-compassion caused 0.571-unit change in psychological resilience. CONCLUSION: Self-compassion, metacognitions, and difficulties in emotion regulation were significantly related to psychological resilience, but only self-compassion significantly affected psychological resilience.

Three years into the pandemic: Insights of the COVID-19 impacts on food security and nutrition in low and middle-income countries.

The COVID-19 pandemic triggered a global crisis with unanticipated and diverse consequences. Moreover, the pandemic has considerably impacted food dynamics in low- and middle-income countries (LMICs), where food systems have already been challenged. These countries also have the highest share of the world's malnourished and food insecure. Therefore, this paper aims to analyze the pandemic's impact on food security dimensions (availability, accessibility, utilization, and stability), with a special emphasis on LMICs. According to the results, the pandemic immediately impacted food security by limiting food production and availability. It also had an indirect impact when lockdowns and other confinement measures (e.g., social distancing, movement restrictions) made it more difficult for individuals to access food and maintain a healthy, balanced diet (cf. food utilization). Indeed, with rising unemployment and poverty, access to food has been the most critically undermined aspect of food security. At the utilization level, COVID-19 adversely influences the nutritional state of both individuals and countries, leading to an increase in all forms of malnutrition. Finally, the impact of COVID-19 on the stability dimension is dependent on the length of the pandemic as well as the effectiveness with which recovery plans are followed to ensure universal vaccine availability, among other factors. As a result, including agricultural and food systems in recovery strategies is crucial to mitigating the pandemic's long-term effects on food security.

Latent profiles of academic resilience in undergraduate nursing students and their association with resilience and self-efficacy.

AIM: This study aimed to investigate the heterogeneity of academic resilience among nursing students using latent profile analysis and its associated influencing factors. BACKGROUND: Nursing students experience higher levels of stress compared to their peers in other professions, and the cultivation of academic resilience plays a pivotal role in their ability to effectively cope with this stress. Academic resilience not only facilitates success in the face of academic adversity but also contributes to the promotion of mental well-being among nursing students. However, the current research on the academic resilience of nursing students has predominantly focused on a scale-centered total score approach, disregarding individual variability, and hindering the development to inform personalized interventions for enhancing academic resilience. DESIGN: A cross-sectional study. METHODS: A convenience sampling method was used to collect a total of 644 nursing students from two medical schools in Guangzhou City. The participants were recruited through an online survey conducted from January to March 2023. The questionnaires consisted of a general information form, the Chinese version of the Academic Resilience Scale-30 (C-ARS-30), the 10-item Connor Davidson Resilience Scale (CD-RISC-10), and the General Self-Efficacy Scale (GSES). Latent profile analysis was used to identify distinct categories of academic resilience among nursing students, and influencing factors were examined through ordinal logistic regression analysis. RESULTS: The academic resilience levels of nursing students can be divided into three potential categories: 'low academic resilience' (13.0%), 'moderate academic resilience' (70.0%), and 'high academic resilience' (17.0%). Level of grade, GPA, self-reported physical health level, resilience and self-efficacy were significantly influenced the different categories of academic resilience of nursing students (P<0.05). CONCLUSIONS: The majority of undergraduate nursing students were placed in the moderate academic resilience group, however, educational institutions should pay special attention to nursing students demonstrating low levels. Regular assessments of academic resilience are recommended, and personalized interventions should be tailored to address specific academic resilience characteristics across different grades of nursing students. Strategies aimed at enhancing academic resilience among nursing students may include improvements in GPA performance, attention to physical health, and the reinforcement of resilience and self-efficacy.

Complications and Surgeon Health: Resources for individuals and institutions.

The emotional impact of surgical complications on urologists is a significant yet historically under-addressed issue. Traditionally, surgeons have been expected to cope with complications and their psychological effects in silence, perpetuating a culture of perfectionism and 'silent suffering.' This has left many unprepared to handle the emotional toll of adverse events during their training and early careers. Recognizing the gap in structured education on this matter, there is a growing movement to openly address and educate on the emotional consequences of surgical complications. This article underscores the importance of such educational initiatives in the mid-career phase, proposing strategies to promote surgeon health, and psychological safety. It advocates for utilizing Morbidity and Mortality conferences as platforms for peer support, learning from 'near miss' events, and encourages at least annual department-wide discussions to raise awareness and normalize the emotional challenges faced by surgeons. Furthermore, it highlights the role of formal peer support programs, acceptance and commitment therapy, and resilience training as vital tools for promoting surgeon well-being. Resources from various organizations, including the American Urological Association and the American Medical Association, are now available to facilitate these critical conversations. By integrating these resources and encouraging a culture of openness and support, the article suggests that the surgical community can better manage the inevitable emotional ramifications of complications, thereby fostering resilience and reducing burnout among surgeons.

Latent class analysis of psychological resilience and influencing factors in patients with rheumatoid arthritis: a cross-sectional survey.

OBJECTIVES: To investigate the latent class of psychological resilience in patients with rheumatoid arthritis (RA) and examine the factors influencing various latent types. METHODS: A cross-sectional survey design was used in this study. A total of 480 patients with RA were enrolled from two tertiary care institutions in Chengdu, Sichuan Province, between May and November 2023, using the convenience sample approach. The General Information Questionnaire, CD-RISC-10, SSRS, ASES-8, and BRAF-MDQ were used to analyze the latent classes of psychological resilience in the respondents, and the factors influencing the latent classes were explored using one-way analysis of variance, analysis of variance, and multi-categorical logistic regression analysis. RESULTS: Overall, 423 valid questionnaires were returned, indicating an 88.13% effective return rate. A latent class analysis revealed that RA patients were divided into three classes of psychological resilience: low-level (20.3%), moderate-level (31.0%), and high-level (48.7%) psychological resilience. A multi-categorical logistic regression analysis found that social support, self-efficacy, weariness, age, work status, and somatic pain all significantly influenced psychological resilience in RA patients. CONCLUSION: Three classes of RA patients' psychological resilience were identified by this study, and these classes were strongly correlated with individual treatment components. It is crucial to take into account the psychological resiliency of female RA patients who do not have a job. In order to improve psychological resilience, healthcare staff should first increase their comprehension of treat-to-target. Furthermore, people with RA may become more psychologically resilient if they receive more social support. Key Points • Preliminary research found that psychological resilience in RA patients was associated with three latent classes. • In RA patients, psychological resilience was significantly influenced by self-efficacy, fatigue, age, work status, physical pain, and social support. • The fundamental goal of bolstering RA patients' psychological resilience is to reaffirm their place in the treatment process, for example, by improving patient compliance and achieving treat-to-target earlier.

The moderating role of psychological resilience in the relationship between fear of COVID-19 and psychological distress, in a cohort of rural and regional healthcare workers. During major lockdowns in Victoria, Australia 2020-2021.

The emergence of the COVID-19 pandemic resulted in substantial pressures for healthcare workers across the world. The association between fear of COVID-19 and psychological distress, and the role of psychological resilience have gained research interest. The current study aimed to investigate the cross-sectional association between fear of COVID-19 and psychological distress, in Australian rural/regional healthcare workers and determine whether resilience modifies this association. Most participants were nurses (38.0%), mean age was 44.9 years, and 80.5% were female (N = 1313). An adjusted logistic regression analysis showed that the highest tertile of the Fear of COVID-19 scale was associated with higher odds of moderate to severe symptoms of anxiety (OR = 3.72, 95% CI = 2.27, 6.11; p < 0.001) and depression (OR = 3.48, 95% CI = 2.30, 5.28; p < 0.001). Healthcare workers with high level of fear of COVID-19 and low level of resilience were much more likely to report moderate to severe symptoms of anxiety (OR = 12.27, 95% CI = 6.65-22.65, p < 0.001) and depression (OR = 12.21, 95% CI = 6.93-21.50, p < 0.001) when compared to healthcare workers with low level of fear of COVID-19 and high level of resilience. A cross-sectional design was used and therefore cause and effect between fear of COVID-19 and psychological distress cannot be inferred. Longitudinal research is needed to investigate the possible causal relationship. These findings highlight the potential mental health effects of fear of COVID-19 on HCWs and demonstrate the importance of resilience as a possible moderator of these effects.

Toward a critical theory of social-ecological resilience: Maize and cattle in Southern Province, Zambia.

Climate change threatens the lives and livelihoods of smallholder farmers throughout the global South. In order to address the challenges these farmers face, researchers and practitioners need reasonable theoretical models of how humans and the environment interact within social-ecological systems (SES). Social-ecological resilience theory has proved to be a popular model for understanding human environment relationships within SES; however, the theory lacks a sophisticated understanding of power, relying instead on outdated functionalist sociological approaches. We reconstruct social-ecological resilience theory through a case study of smallholder climate change adaptation in Southern Province, Zambia. Farmers in the region focus on cattle and maize production. Though the changing environment would seem to favor different crops and livestock, institutional (power) dynamics determine whether or not individuals have the capacity (or desire) to adapt. Our critical reconstruction provides researchers and practitioners with an improved social-ecological lens for understanding the causes and consequences of vulnerability and adaptation.

Micro-RNA profiles of pathology and resilience in posterior cingulate cortex of cognitively intact elders.

The posterior cingulate cortex (PCC) is a key hub of the default mode network underlying autobiographical memory retrieval, which falters early in the progression of Alzheimer's disease (AD). We recently performed RNA sequencing of post-mortem PCC tissue samples from 26 elderly Rush Religious Orders Study participants who came to autopsy with an ante-mortem diagnosis of no cognitive impairment but who collectively displayed a range of Braak I-IV neurofibrillary tangle stages. Notably, cognitively unimpaired subjects displaying high Braak stages may represent cognitive resilience to AD pathology. Transcriptomic data revealed elevated synaptic and ATP-related gene expression in Braak Stages III/IV compared with Stages I/II, suggesting these pathways may be related to PCC resilience. We also mined expression profiles for small non-coding micro-RNAs (miRNAs), which regulate mRNA stability and may represent an underexplored potential mechanism of resilience through the fine-tuning of gene expression within complex cellular networks. Twelve miRNAs were identified as differentially expressed between Braak Stages I/II and III/IV. However, the extent to which the levels of all identified miRNAs were associated with subject demographics, neuropsychological test performance and/or neuropathological diagnostic criteria within this cohort was not explored. Here, we report that a total of 667 miRNAs are significantly associated (rho > 0.38, P < 0.05) with subject variables. There were significant positive correlations between miRNA expression levels and age, perceptual orientation and perceptual speed. By contrast, higher miRNA levels correlated negatively with semantic and episodic memory. Higher expression of 15 miRNAs associated with lower Braak Stages I-II and 47 miRNAs were associated with higher Braak Stages III-IV, suggesting additional mechanistic influences of PCC miRNA expression with resilience. Pathway analysis showed enrichment for miRNAs operating in pathways related to lysine degradation and fatty acid synthesis and metabolism. Finally, we demonstrated that the 12 resilience-related miRNAs differentially expressed in Braak Stages I/II versus Braak Stages III/IV were predicted to regulate mRNAs related to amyloid processing, tau and inflammation. In summary, we demonstrate a dynamic state wherein differential PCC miRNA levels are associated with cognitive performance and post-mortem neuropathological AD diagnostic criteria in cognitively intact elders. We posit these relationships may inform miRNA transcriptional alterations within the PCC relevant to potential early protective (resilience) or pathogenic (pre-clinical or prodromal) responses to disease pathogenesis and thus may be therapeutic targets.

Investigating mortality salience as a potential causal influence and moderator of responses to laboratory pain.

Background: Because pain can have profound ramifications for quality of life and daily functioning, understanding nuances in the interplay of psychosocial experiences with pain perception is vital for effective pain management. In separate lines of research, pain resilience and mortality salience have emerged as potentially important psychological correlates of reduced pain severity and increased tolerance of pain. However, to date, there has been a paucity of research examining potentially interactive effects of these factors on pain perception. To address this gap, the present experiment investigated mortality salience as a causal influence on tolerance of laboratory pain and a moderator of associations between pain resilience and pain tolerance within a Chinese sample. Methods: Participants were healthy young Chinese adults (86 women, 84 men) who first completed a brief initial cold pressor test (CPT) followed by measures of demographics and pain resilience. Subsequently, participants randomly assigned to a mortality salience (MS) condition completed two open-ended essay questions in which they wrote about their death as well as a death anxiety scale while those randomly assigned to a control condition completed analogous tasks about watching television. Finally, all participants engaged in a delay task and a second CPT designed to measure post-manipulation pain tolerance and subjective pain intensity levels. Results: MS condition cohorts showed greater pain tolerance than controls on the post-manipulation CPT, though pain intensity levels did not differ between groups. Moderator analyses indicated that the relationship between the behavior perseverance facet of pain resilience and pain tolerance was significantly stronger among MS condition participants than controls. Conclusions: This experiment is the first to document potential causal effects of MS on pain tolerance and Ms as a moderator of the association between self-reported behavior perseverance and behavioral pain tolerance. Findings provide foundations for extensions within clinical pain samples.