Development of the Individual and Environmental Resilience Model among children, adolescents and young adults using the empirical evidence: An integrative systematic review.

To create a new conceptual model of resilience based on evidence, this integrative systematic review aims to identify the evidence-based protective factors related to resilience among children, adolescents and young adults at-risk of several exposures. An Integrative Systematic review was conducted by using systematic principles according to PRISMA statement. Searching strategy was conducted through MEDLINE, CINAHL, Web of Science (ISI) and PsycINFO during July 2021(1991-2021). Keywords were related to resilience, self-esteem, hardiness, ego-resilience, risk factors, vulnerability, protective factors, ecological model and theoretical model. Those statiscally significant protective factors found in individual studies conducted with young populations (from 7 to 24 years old) exposed to violence, trauma or socio-economic instability were included in the qualitative synthesis. Of 15,235 peer-reviewed articles initially identified, 93 articles were screened and met the inclusion criteria; finally, 31 articles were included for the quality synthesis. More than 60 protective factors were found. They were classified in 10 different domains and two dimensions of resilience (Individual skills and Environmental), developing a new model of resilience: The Individual and Environmental Resilience Model (IERM). The Environmental dimension includes the domains: Family, School, Peers, Cultural and Community and The Individual skills dimension: Biological, Behaviour, Communications, Cognitive and Emotional domains. These domains and their specific protective factors have been set up as protective factors that significantly buffer negative outcomes in the face of adverse events. Compared with other models currently available, the new IERM model is potentially a more comprehensive approach that may facilitate the development of effective interventions to promote resilience in children, adolescents and young adults.

Home-based exercise programs in patients with chronic kidney disease: A systematic review and META-analysis.

BACKGROUND: Intradialysis exercise programs in renal patients result in improved functional capacity, muscle strength, symptoms of depression, and health-related quality of life. Home-based exercise programs are an alternative to overcome logistical and human resource problems. However, the implementation of these programs is not an easy task and there is a lack of knowledge regarding the benefits associated with home-based exercise programs. AIM: To determine whether home-based exercise programs improve functional capacity, health-related quality of life, muscle strength, and symptoms of depression among patients with stage III-V chronic kidney disease. METHODS: A systematic review and meta-analyses following PRISMA guidelines were utilized. Relevant articles were collected and independently assessed for their inclusion eligibility. Effects of home-based exercise were summarized by the standardized mean differences and represented by forest plots (Review Manager 5.4). RESULTS: Eight studies were included, none of which reported any adverse effects. The intervention was usually aerobic, 76% of these programs lasted 3-6 months, and exercise adherence was 60-87.5%. Four studies measured health-related quality of life and found significant improvements in several subscales. Regarding functional capacity, five studies used the six-minute walking test (44.9 meters; 95% CI [30.45, 59.30]; p ≤ .001), three studies used the sit-to-stand-to-sit test (-0.45 seconds; 95% CI [-0.46, -0.26]; p ≤ .001), and two studies used the timed up-and-go test (-0.76 seconds; 95% CI [-1.38, -0.15]; p ≤ .001) and the handgrip strength test (1.16 kg; 95% CI [-2.88, 5.20]; p ≤ .001). LINKING EVIDENCE TO ACTION: Home-based exercise programs are beneficial to renal patients. These interventions are safe and effective to improve health-related quality of life and functional capacity and reduce symptoms of depression among patients with chronic kidney disease.