Therapist self-compassion and compassion fatigue: the mediating role of resilience / Autocompasión del terapeuta y fatiga de la compasión: el papel mediador de la resiliencia

Las exigencias impuestas a los profesionales que trabajan con problemas psicológicos pueden resultar en un riesgo de agotamiento (Yang & Hayes, 2020). El objetivo de este estudio fue analizar el posible papel de la resiliencia como variable mediadora en la relación entre autocompasión y fatiga por compasión, burnout y satisfacción por compasión. Se utilizó un diseño de estudio descriptivo transversal. En el estudio participaron sesenta y cinco psicólogos clínicos (50 mujeres y 15 hombres) con edades comprendidas entre 23 y 71 años (M = 33.8, SD = 10.8). Los terapeutas completaron la Escala de Autocompasión, la Escala de Resiliencia de 14 ítems y la Escala de Calidad de Vida Profesional. Se probaron modelos de mediación simples separados para examinar en qué medida cada una de las variables de la escala de Resiliencia atenuó la relación entre Autocompasión y Calidad de Vida Profesional. Se realizaron modelos seriales de mediadores múltiples para explorar si las variables de resiliencia actuaban interactivamente como mediadores en la asociación entre la autocompasión y la calidad de vida profesional. Los análisis de mediación simples mostraron que la competencia personal fue un mediador parcial significativo en la relación entre la autocompasión y la satisfacción por la compasión y el agotamiento. La competencia personal y la aceptación de uno mismo y de la vida no fueron mediadores significativos de la relación entre la autocompasión y el estrés traumático secundario.(AU)

The demands placed on professionals working with psychologi-cal problems can result in a risk of burnout (Yang & Hayes, 2020). The ob-jective of this study was to analyze the possible role of resilience as a medi-ator variable in the relationship between self-compassion and compassion fatigue, burnout, and compassion satisfaction. A descriptive cross-sectional study design was used. Sixty-five clinical psychologists (50 women and 15 men) aged between 23 and 71 years (M= 33.8, SD= 10.8) participated in the study. The therapists completed the Self-Compassion Scale, the 14-Item Resilience Scale, and the Professional Quality of Life Scale. Separate simple mediation models were tested to examine the extent to which each of the Resilience scale variables attenuated the relationship between Self-compassion and Professional Quality of Life. Serial multiple mediator models were performed to explore whether Resilience variables acted in-teractively as mediators in the association between Self-compassion and Professional Quality of Life. Simple mediation analyses showed that Per-sonal Competence was a significant partial mediator in the relationship be-tween Self-Compassion and Compassion Satisfaction and Burnout. Per-sonal Competence and Acceptance of Self and Life were not significant mediators of the relationship between Self-Compassion and Secondary Traumatic Stress.(AU)

Supragingival microbiota, cytokines, and proteins in individuals with different trajectories in experimental gingivitis.

Background: Gingivitis in response to biofilm formation may exhibit different trajectories. The purposes of the present study were to characterize the composition of the supragingival microbiota and salivary cytokine and protein levels in healthy individuals with different gingivitis patterns, to test the hypothesis that manifestations of gingivitis associate with specific profiles in terms of supragingival microbiota, salivary cytokines, and proteins. Methods: Forty orally and systemically healthy individuals refrained from all oral hygiene procedures for a period of 14 days, followed by a resolution period of 14 days with regular oral care. Supragingival plaque level and bleeding on probing (BOP) were recorded, and supragingival plaque as well as saliva samples were collected at baseline, day 14, and day 28. Based on change in BOP% from baseline to day 14, rapid (n = 15), moderate (n = 10), and slow (n = 15) responders were identified. Supragingival microbiota composition, salivary cytokine, and protein levels were compared between groups at baseline, day 14, and day 28. Results: A significantly higher baseline abundance of Capnocytophaga, Eikenella, and Campylobacter species were recorded in rapid responders, whereas a significantly higher baseline abundance of Streptococcus species were detected in slow responders. Slow responders expressed a high degree of resilience, with minimal difference in microbial composition at baseline and after 14 days of resolution (day 28). On the contrary, significant differences in relative abundance of members of the core microbiota, Streptococcus, Actinomyces, and Rothia species, was noted in baseline samples versus day 28 samples in rapid responders. Comparable baseline cytokine and protein levels were recorded in all groups. Conclusion: Supragingival microbiota composition, but not saliva cytokine and protein profiles, seems to influence the extent of the inflammatory response during development of gingivitis in systemically healthy individuals.

Baseline composition of the supragingival microbiota might predict different gingivitis trajectories.Microbial resilience after gingivitis might augment oral homeostasis in individuals with a slow gingivitis trajectory.

Evaluation of an Embedded Health Psychologist Intervention for Obstetric Patients With Adverse Childhood Experiences.

BACKGROUND: Screening for adverse childhood experiences (ACEs) and resilience in pregnancy is a promising practice for mitigating ACEs-related health complications. Yet, the best follow-up for pregnant patients with high ACEs and/or low resilience has not been established. OBJECTIVE: This study evaluates referrals to and participation in an embedded health psychologist (EHP) intervention for pregnant patients with ACEs and/or low resilience. MATERIALS AND METHODS: Patients in 3 Kaiser Permanente Northern California medical centers with ACEs who had also received resilience screening during standard prenatal care and who were participating in an EHP intervention were included (N = 910). The authors used multivariable logistic regression to examine whether ACEs (0, 1-2, 3+) and resilience (high vs low) were associated with referrals to and participation in EHP intervention. They also evaluated the impact of EHP intervention through clinician (N = 53) and patient (N = 51) surveys. RESULTS: Patients with 3+ vs 0 ACEs were more likely to receive an EHP referral (adjusted odds ratio [aOR] = 2.89, 95% confidence interval [CI]: 1.93-4.33) and were more likely to participate in EHP intervention (aOR = 2.85, 95% CI: 1.87-4.36). Those with low vs high resilience were also more likely to receive an EHP referral (aOR = 1.86, 95% CI: 1.32-2.62) and participate in EHP (aOR = 1.71, 95% CI: 1.19-2.44). When ACEs and resilience were combined, those with high ACEs and low resilience had the greatest odds of referrals and participation. Patients and clinicians reported positive experiences with EHP intervention. CONCLUSION: Patients with higher ACEs and lower resilience scores were more likely to be referred to and participate in EHP intervention, suggesting that at-risk patients can be successfully linked with a health psychologist when accessible within obstetric care.

The predictive role of resilience and the ethical climate of hospital in the fatigue of surgical technologists working in operating rooms.

BACKGROUND: Fatigue in surgical technologists is of paramount importance and is known as a priority because it can be regarded as a threat to the nurse's health and patient's safety. The fatigue level of healthcare workers can be affected by some factors, while the role of part of these factors is less known. This study aimed to determine the predictive role of resilience and the hospital ethical climate in the fatigue of surgical technologists working in operating rooms (ORs). METHODS: This is a cross-sectional study conducted on 217 surgical technologists working in ORs of hospitals affiliated with Shiraz University of Medical Sciences. Data were collected using Connor-Davidson's Resilience scale, Olson's Hospital Ethical Climate Survey, and the Multidimensional Fatigue Inventory, and then analyzed using Pearson's correlation coefficient and multiple regression analysis. RESULTS: 87.1% and 12.9% of surgical technologists reported low and high fatigue, respectively. All fatigue subscales had significant and negative relationships with resilience (p < 0.05). Moreover, the relationship between fatigue and ethical climate was significant (p = 0.02). The multiple linear regression model showed the predictive role of resilience in fatigue (ß=-0.29, P < 0.001). According to the model, 10% of the change of fatigue was related to resilience and ethical climate. CONCLUSION: The present study demonstrated the relationship between resilience and ethical climate with fatigue. Moreover, resilience was a predictor of the surgical technologists' fatigue, so that their fatigue decreased with increasing resilience. However, future studies are recommended to determine other factors influencing fatigue in surgical technologists.

Association between frailty and meaning in life of older adults in nursing home: the mediating effect of psychological resilience.

Background: Meaning in life is a crucial aspect of psychological well-being, often overlooked despite its clinical significance. This warrants further investigation, especially regarding its relationship with frailty and psychological resilience. Objective: This study aims to assess the status and relevance of frailty, psychological resilience, and meaning in life among older adults in Chinese nursing homes. Additionally, it explores the mediating role of psychological resilience between frailty and meaning in life, providing insights to improve the meaning in life for older adults in nursing homes. Methods: Between August 2022 and November 2022, 302 older adults in Chinese nursing homes were selected using convenience sampling. The study utilized the Socio-demographic Characteristics Questionnaire, Tilburg Frailty Indicator, Connor-Davidson Resilience Scale, and the Source of Meaning Scale for Older Adults. A face-to-face questionnaire survey was conducted, and SPSS 27.0 was employed for analyzing correlations between frailty, psychological resilience, and meaning in life. The mediating effect of psychological resilience was assessed using Model 4 in the Process plug-in. Results: Older adults in nursing homes exhibited a frailty total score of 4.00 (2.00, 5.00), with a prevalence of 28.5%. Psychological resilience scored 66.00 (51.75, 76.00), and meaning in life scored 149.00 (132.00, 158.25). Frailty showed a negative correlation with both meaning in life and psychological resilience, while meaning in life demonstrated a positive correlation with psychological resilience. Psychological resilience exhibited a partial mediating effect, accounting for 51.04% of the total effect between frailty and meaning in life. Conclusion: Frailty incidence is high among older adults in nursing homes, with psychological resilience at a general level and meaning in life in the upper middle level. Psychological resilience plays a crucial role as a partial mediator between frailty and meaning in life. Timely assessment of frailty, targeted interventions, and improvements in psychological resilience are essential for enhancing the meaning in life and promoting successful aging.

NEET and resilient: The lived experiences of a sample of South African emerging adults.

There is scant understanding of what supports African emerging adults who are not in employment, education or training (i.e., NEET) to show resilience to NEET-related challenges. This article narrows that gap by reporting an iterative phenomenological study with nine African emerging adults (mean age: 23.44; 66% female) who were NEET for the 18-month duration of the study and living in a resource-constrained community in South Africa. We interviewed each young person three times (June 2021; December 2021; June 2022). A reflexive thematic analysis of these interview transcripts showed that being NEET is a multifaceted challenge. Supported by a mix of personal, relational and environmental resources, young people managed this challenge by resisting or recuperating from destructive coping mechanisms and believing in a successful future self. These findings point to the importance of young people and their social ecologies (families, peers, service providers and policymakers) recognising and enacting their co-responsibility for resilience to the compound challenges of being NEET.

Psychological resilience in the relationship between family function and illness uncertainty among family members of trauma patients in the intensive care unit.

BACKGROUND: Severe trauma accounts for a main factor inducing mortality for individuals aged < 45 years in China, which requires admission to intensive care unit (ICU) to receive comprehensive treatment. Family members of patients with unanticipated and life-threatening trauma during their ICU stays often experience psychosocial distress due to illness uncertainty. Previous research has shown that family function and psychological resilience are associated with illness uncertainty, respectively. However, little is known about the current situation and interacting mechanism between family function, psychological resilience, and illness uncertainty of family members for ICU trauma patients. Therefore, this study focused on exploring the current situation and relationships between these three factors in family members for ICU trauma patients. METHODS: The convenience sampling approach was adopted in the present cross-sectional survey, which involved 230 family members for ICU trauma patients from 34 hospitals in Chongqing, China. Related data were extracted with self-reporting questionnaires, which included sociodemographic characteristic questionnaire, the Family Adaptability, Partnership, Growth, Affection and Resolve Scale (APGAR), the 10-item Connor-Davidson Resilience Scale (10-CD-RISC) and the Mishel's Illness Uncertainty Scale for Family Members (MUIS-FM). Pearson correlation analysis was conducted to examine the correlations between various variables. Additionally, a structural equation model was adopted to assess the mediating effect of psychological resilience on family function and illness uncertainty. RESULTS: According to our results, family members for ICU trauma patients experienced high illness uncertainty with moderate family dysfunction and low psychological resilience. Family function directly affected illness uncertainty and indirectly affected illness uncertainty through psychological resilience in family members of ICU trauma patients. CONCLUSIONS: Family function and psychological resilience are the protective factors for reducing illness uncertainty. Healthcare providers should take effective measures, including family-functioning improvement and resilience-focused interventions, for alleviating illness uncertainty in family members of ICU trauma patients.

Environmental and social framework to protect marine bivalves under extreme weather events.

Rising ocean temperatures, a consequence of anthropogenic climate change, are increasing the frequency, intensity, and magnitude of extreme marine heatwaves (MHWs). These persistent anomalous warming events can have severe ecological and socioeconomic impacts, threatening ecologically and economically vital organisms such as bivalves and the ecosystems they support. Developing robust environmental and social frameworks to enhance the resilience and adaptability of bivalve aquaculture is critical to ensuring the sustainability of this crucial food source. This review synthesizes the current understanding of the physiological and ecological impacts of MHWs on commercially important bivalve species farmed globally. We propose an integrated risk assessment framework that encompasses environmental monitoring, farm-level preparedness planning, and community-level social support systems to safeguard bivalve aquaculture. Specifically, we examine heatwave prediction models, local mitigation strategies, and social programs that could mitigate the impacts on bivalve farms and vulnerable coastal communities economically dependent on this fishery. At the farm level, adaptation strategies such as selective breeding for heat-tolerant strains, optimized site selection, and adjustments to culture practices can improve survival outcomes during MHWs. Robust disease surveillance and management programs are essential for early detection and rapid response. Furthermore, we highlight the importance of stakeholder engagement, knowledge exchange, and collaborative governance in developing context-specific, inclusive, and equitable safeguard systems. Proactive measures, such as advanced forecasting tools like the California Current Marine Heat Wave Tracker developed by NOAA's Southwest Fisheries Science Center, enable preemptive action before losses occur. Coordinated preparation and response, underpinned by continuous monitoring and adaptive management, promise to protect these climate-vulnerable food systems and coastal communities. However, sustained research, innovation, and cross-sector collaboration are imperative to navigate the challenges posed by our rapidly changing oceans.

A Literature Review on Holistic Well-Being and Dopamine Fasting: An Integrated Approach.

Popularly known as dopaminergic detox or dopamine fasting, it is a concept that aims at reducing dependence on instant satisfaction gratification and overstimulation to attain mental clarity, lessen anxiety, and be able to enjoy everyday events again. Digital detox has been a part of the dopamine fasting concept for several years now. However, some critics argue that this notion has no scientific proof behind it and may fail to deal with the problem of dopamine dysregulation. Some intense types of dopamine fasting which include extreme isolation or strict dieting can result in damage to mental health as well as physical fitness. The objective of the article is to understand what dopamine fasting means and see the literature and evidence available on the topic. Indexes like PubMed, Scopus, OVID, Embase, and Google Scholar were searched using the keywords to understand the existing knowledge about dopamine fasting. The literature review was then written to incorporate the understanding in a way that can be implemented practically. Recent studies have shown that individuals who engage in dopamine-fasting-like ideologies may experience reduced impulsive behaviors, increased focus on tasks, and reduced overwhelm. However, extreme forms of dopamine fasting can lead to feelings of loneliness, anxiety, and malnutrition, which can have detrimental effects on mental and physical health. Hence, the effects of dopamine fasting can vary greatly among individuals, and there is no one-size-fits-all approach. It is essential to consider individual needs and preferences when incorporating dopamine fasting into one's lifestyle and explore alternative practices that align with the principles of dopamine fasting. Understanding and respecting these differences is crucial in determining the most suitable strategies for maintaining a balanced dopamine response and overall psychological health. The benefits of dopamine fasting can be tremendous if done correctly but it depends on every individual to find the correct way and in the modern day, the practices can become tough to implement.

The interplay of psychological resilience and adolescent mobile phone addiction in Henan province, China: insights from latent class analysis.

Background: The aim of this study was to classify distinct subgroups of adolescents based on the severity levels of their mobile phone addiction and to investigate how these groups differed in terms of their psychosocial characteristics. We surveyed a total of 2,230 adolescents using three different questionnaires to assess the severity of their mobile phone addiction, stress, anxiety, depression, psychological resilience, and personality. Latent class analysis was employed to identify the subgroups, and we utilized Receiver Operating Characteristic (ROC) curves and multinomial logistic regression for statistical analysis. All data analyses were conducted using SPSS 26.0 and Mplus 8.5. Methods: We classified the subjects into subgroups based on their mobile phone addiction severity, and the results revealed a clear pattern with a three-class model based on the likelihood level of mobile phone addiction (p < 0.05). We examined common trends in psychosocial traits such as age, grade at school, parental education level, anxiety levels, and resilience. ROC analysis of sensitivity versus 1-specificity for various mobile phone addiction index (MPAI) scores yielded an area under the curve (AUC) of 0.893 (95% CI, 0.879 to 0.905, p < 0.001). We also determined diagnostic value indices for potential cutoff points ranging from 8 to 40. The optimal cutoff value for MPAI was found to be >14, which corresponded to the maximum Youden index (Youden index = 0.751). Results: The latent classification process in this research confirmed the existence of three distinct mobile phone user groups. We also examined the psychosocial characteristics that varied in relation to the severity levels of addiction. Conclusion: This study provides valuable insights into the categorization of adolescents based on the severity of mobile phone addiction and sheds light on the psychosocial characteristics associated with different addiction levels. These findings are expected to enhance our understanding of mobile phone addiction traits and stimulate further research in this area.

Psychological Resilience among Orang Asli Youths in Selangor during COVID-19 and Its Associated Factors.

Background: Coronavirus disease (COVID-19) has affected everyone and stress-related mental health issues affect young people more than other groups, including marginalised populations. As a result of this pandemic, society is being urged to examine indigenous psychological resilience, especially among Orang Asli (OA) communities in Malaysia. Hence, this study aims to identify factors associated with psychological resilience among OA youths of Kampung Orang Asli (KOA) in Gombak during the COVID-19 pandemic. Method: A cross-sectional study comprising OA communities was conducted between January 2022 and September 2022 in the Gombak District, Selangor. A self-administered online questionnaire using Google Forms and a self-administered printed questionnaire was used to collect data from youths aged 18 years old-24 years old. The Malay version of Conner-Davidson Resilience Scale-25 (CD-RISC-25) was used to assess psychological resilience. Data analysis was performed using SPSS version 28.0, and multiple linear regression analyses were conducted to evaluate the associated factors and their significance level. Result: A total of 158 participants were involved in this study. The mean score for psychological resilience was estimated at 69.28 (SD = 14.52). The social relationships domain recorded the highest mean score for quality of life (71.54, SD = 13.72). Meanwhile, the total mean score for self-esteem fell into the high-level category (35.77, SD = 4.94), and the domain of relationship and family dynamics under family environment scored the highest mean score of 18.83 (SD = 2.89). Psychological resilience was associated with youths of KOA Batu 12 (ß = -14.274, P < 0.05), KOA Ulu Batu (ß = -17.789, P < 0.05), less than four siblings (ß = -6.495, P < 0.05), owner of residential property (ß = -7.543, P < 0.05), high self-esteem (ß = 0.612, P < 0.05) and good relationship and family dynamic (ß = 1.391, P < 0.05). Conclusion: Developing interventions aimed at psychological resilience determinants may assist OA youths in coping with future threats.

Connor Davidson resilience scores, perceived organizational support and workplace violence among emergency nurses.

BACKGROUND: Workplace violence can threaten the physical and mental health of emergency nurses, increasing their mobility and burnout rates. However, little research has focused on how to mitigate the negative effects of workplace violence. OBJECTIVES: To investigate the relationships among resilience scores, perceived organizational support, and workplace violence and to explore the mediating role of perceived organizational support in the relationship between resilience scores and workplace violence among emergency nurses. RESEARCH DESIGN: A quantitative, cross-sectional study. METHODS: From June to July 2023, 466 valid questionnaires were collected via the WeChat app Credamo Seeing Numbers. Participants were assessed using the Connor-Davidson Resilience Scale, the Perceived Organizational Support Scale, and the Fear of Future Violence at Work Scale. ETHICAL CONSIDERATION: The study was approved by the Ethics Committee of Hunan Normal University (No. 2023-389). FINDINGS: The Connor-Davidson resilience scores of emergency nurses were negatively associated with workplace violence and positively associated with emergency nurses' perceived organizational support. Emergency nurses' perceived organizational support was negatively associated with workplace violence. Perceived organizational support moderated the relationship between Connor-Davidson resilience scores and workplace violence among emergency nurses to some extent. DISCUSSION: High levels of Connor-Davidson resilience scores can mitigate the negative effects of workplace violence. Perceived organizational support can increase with increasing levels of Connor-Davidson resilience scores. When nurses face workplace violence, support from the organization can, on the one hand, reduce the negative impacts of stress and, on the other hand, elicit positive emotions. CONCLUSION: To mitigate the effects of workplace violence on emergency nurses, interventions aimed at both internal and external organizational conditions must be developed to establish a supportive environment that can increase emergency nurses' Connor-Davidson resilience scores and sense of perceived organizational support, and decrease workplace violence.

Enhanced resilience in urban stormwater management through model predictive control and optimal layout schemes under extreme rainfall events.

Optimizing the layout of urban stormwater management systems is an effective method for mitigating the risk of urban flooding under extreme storms. However, traditional approaches that consider only economic costs or annual runoff control rates cannot dynamically respond to the uncertainties of extreme weather, making it difficult to completely avoid large accumulations of water and flooding in a short period. This study proposes an integrated method combining system layout optimization and Model Predictive Control(MPC)to enhance the system's resilience and effectiveness in flood control. An optimization framework was initially built to identify optimal system layouts, balancing annual average life cycle cost (AALCC) and resilience index. The MPC was then applied to the optimal layout selected using the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) method, aiming to alleviate inundation cost-effectively. The adaptability of MPC to varying sets of control horizons and its efficacy in managing the hydrograph and flood dynamics of urban drainage system were examined. Conducted in Yubei, Chongqing, this study revealed patterns in optimal layout fronts among various extreme design rainfalls, showing that peak position rate and return period significantly influence system resilience. The contribution of MPC to the optimal system layout was particularly notable, resulting in improved instantaneous and overall flood mitigation. The application of MPC increased the resilience index by an average of 0.0485 and offered cost savings of 0.0514 million yuan in AALCC. Besides, our findings highlighted the importance of selecting an optimal set of control horizons for MPC, which could reduce maximum flood depth from 0.43m to 0.19m and decrease conduit peak flow by up to 14% at a flood-prone downstream location.

Applying Kumpfer's resilience framework to understand the social adaptation process of the trailing parents in China.

BACKGROUND: Trailing parents, a distinct group emerging from China's rapid social change and urbanization, are experiencing migration in old age, posing challenges for their social adaptation. Existing research has mainly focused on the hardships faced by this group, but few studies have focused on how they cope with change and achieve some degree of successful social adaptation. This study aimed to understand the coping and social adaptation process of trailing parents in China. METHODS: This study used a qualitative research approach. A total of 24 trailing parents were invited to participate in a semi-structured interview and share their experiences and efforts to cope with the many challenges. Kumpfer's resilience framework was used as the theoretical framework for the study design, data collection, and data analysis. RESULTS: This study identified several intra-family and community stressors that trailing parents may face when moving to a new environment and uncovered five key resilience characteristics that may be triggered or fostered in the presence of these stressors, including physical fitness, psychological stability, open-mindedness, learning ability, and nurturing hobbies. Individuals with resilience traits have been observed to engage in positive cognitive processing and transform the new environment. Consistent with Kumpfer's resilience framework, this study revealed the dynamics of the stressors faced by trailing parents in the new environments, the role of resilience characteristics, and the critical influence of social support in shaping the interplay between the individual and the environment that enabled them to adapt positively. CONCLUSIONS: This study highlights the importance of fostering resilience traits and leveraging positive coping mechanisms to facilitate a smoother adaptation process for trailing parents. Meanwhile, there is an urgent need to focus on creating opportunities that strengthen their social support networks.

Academic resilience in nusing students: a concept analysis.

BACKGROUND: Academic resilience is a crucial concept for nursing students to cope with academic challenges. Currently, there is significant variation in the description of the concept attributes of academic resilience among nursing students, which impedes the advancement of academic research. Therefore, it is essential to establish a clear definition of the concept of academic resilience for nursing students. PURPOSE: The purpose of this paper is to report the results of concept analysis of academic resilience of nursing students. METHODS: The Rodgers evolutionary concept analysis was employed to test the attributes, antecedents, consequences and related concepts of academic resilience of nursing students. Walker and Avant's method was utilized to construct a model case and provide empirical referents. RESULTS: The findings indicate that the attributes of nursing students' academic resilience include self-efficacy, self-regulation and recovery, and the antecedents include internal factors and external environmental factors. The consequences include adaptability, career maturity, adversity quotient level, probability of academic success, a sense of belonging to school and low levels of psychological distress. CONCLUSION: The systematic understanding of academic resilience among nursing students provides a pathway for nursing educators and students to enhance academic resilience, promote academic success, and establish a foundation for the training of more qualified nurses.

Interdependent water and power infrastructure model (IWPIM): A modeling approach for water and energy resource management in rural communities.

The importance of the dependencies between water and power systems is more acutely perceived when challenges emerge. As both energy and water supply are limited, efficient use is a must for any sustainable future, especially in rural areas. Although important, a modeling tool that can analyze water-energy systems interdependencies in rural systems, at the architectural level highlighting the physical interconnections and synergies of these systems, is still lacking. We present a multi-agent system model that captures the features of both systems, at the same levels of fidelity and resolution, with coordinated operations and contingency components represented. Unlike other models, ours captures architectural features of both systems and technical constraints of the systems' components, which is critical to capture physical intricacies of the interplay between systems components and shed light on the impacts of disruptions of either system on the other. This model, which includes multiple infrastructure components, shows the importance of a holistic understanding of the systems, for cooperation across systems physical boundaries and enhanced benefits at larger scales. This study looks to investigate water-power resource management in an irrigation system via the analysis of physical links and highlight strengths and vulnerabilities. The effects of water shortage, water re-allocation and load shedding are analyzed through scenarios designed to illustrate the utility of such a model. Results highlights the importance of inter-reservoir relationships for alleviating effects of disruption and unforeseen rise in energy demand. Water storage is also critical, helping to mitigate the impacts of water scarcity, and by extension, to keep the energy system unaffected. It can be a viable part of the solution to compensate for the negative impact of shortage for both resources.

Diagnosis of Brugada syndrome affects quality of life and psychological status.

Background: Chronic diseases have a negative impact on quality of life (QOL) and psychological health. There are limited related data regarding this topic in Brugada syndrome (BrS). We evaluated the effects of the diagnosis of BrS on health-related QOL and psychological status among patients and their relatives. Methods: Patients with BrS and their relatives underwent psychological evaluation at diagnosis (T0), 1 and 2 years after diagnosis (T1 and T2) using questionnaires on mental QOL, anxiety, depression, stress, post-traumatic stress, and resilience resources. Results: Sixty-one patients and 39 relatives were enrolled. Compared with controls, patients showed increased physical QOL (54.1 ± 6.5 vs. 50.1 ± 8.0, p = 0.014), reduced mental QOL (43.2 ± 11.8 vs. 49.6 ± 9.1, p = 0.018) and increased anxiety (9.9 ± 6.6 vs. 6.9 ± 7.7, p = 0.024) at T0; reduced resilience scores (3.69 ± 0.40 vs. 3.96 ± 0.55, p = 0.008) at T1; and reduced resilience (3.69 ± 0.35 vs. 3.96 ± 0.55, p = 0.019) and increased anxiety scores (16.4 ± 12.8 vs. 6.9 ± 7.7, p = 0.006) at T2. Relatives presented higher stress (17.63 ± 3.77 vs. 12.90 ± 6.0, p = 0.02) at T0 and higher anxiety scores at T0 (13.5 ± 7.6 vs. 6.9 ± 7.7, p < 0.001), T1 (12.0 ± 8.7 vs. 6.9 ± 7.7, p = 0.005), and T2 (16.4 ± 12.8 vs. 6.9 ± 7.7, p = 0.006) than controls. Female sex was significantly independently associated with worse mental QOL scores in patients at T0 (odds ratio = 0.10; 95% confidence interval = 0.05-0.94; p = 0.04). Conclusions: The diagnosis of BrS impairs the QOL and psychological status of patients and their relatives. Female sex is independently associated with worse mental QOL in patients at diagnosis.

"Something we must be proud of": An interview and document study of team improvisation in the Dutch convalescent plasma project group.

Background and Aims: The COVID-19 pandemic has revealed the importance of organizational resilience, the ability to effectively respond to a disruptive event before, during, and after it occurs. Team improvisation is an important component of organizational resilience as it describes characteristics of team skills and contextual qualities to create order from chaos. In Spring 2020, the Dutch national blood bank, began the convalescent plasma project (CCP). We aimed to study which elements of team improvisation in the CCP group were found and how lessons learned can contribute towards a non-crisis situation for blood establishments. Methods: Using Vera and Crossan's framework of improvisation, semi-structured interviews with eight members of the CCP group were conducted. This was simultaneous to performing a document analysis of 21 Intranet posts and seven internal reports. MAXDA 2020 was used to conduct deductive and inductive thematic analyses. Results: The CCP group showed strong characteristics of expertise and memory, teamwork quality, experimental culture, and real-time information and communication that enabled them to improvise in all aspects of the donation process. Improvisation examples included comprehensive communication methods to identify and obtain new donors, asking additional intake questions and collecting additional aliquots to store while waiting for an internal antibody test to be developed, and regulatory respondents allowing a flexible change control procedure to meet the pace of the crisis. Training was evident to a lesser degree. Conclusion: While improvisation impacted set routines and procedures, the safety and quality of the product were not affected. Regarding organizational resilience, our results showed that the CCP group "coped" well using elements of team improvisation. Blood establishments may consider introducing improvisational training and innovation teams throughout the organization for future preparedness and improving organizational resilience.

Family resilience in a social-ecological context - emotional difficulties and coping strategies.

Introduction: This research explored how crises such as the pandemic influence the family dynamic and the way that the parents and the children face new difficulties and challenges. The present study investigates children's and young people's emotional states, the dimensions of family resilience, and the types of coping strategies and parents' emotional states during the coronavirus pandemic. The final sample for the research was represented by 1,010 parents from Romania. Methods: The present scientific research is a transversal study with the scope to understand the emotional difficulties that parents and children/ young people face and the coping strategies that they adopt in a crisis, such as the time of the coronavirus pandemic. Results: Parents with maladaptive coping strategies are more affected by the pandemic. Also, the results indicate that there is a significant correlation between parental coping strategies and the children's emotional states, and the adaptability level. Therefore, the high scores on the subscales which measure maladaptive coping indicate high scores of the levels of depression, anxiety, and stress of the parents. Family resilience, through the dimension of 'communication and problem-solving in the family' has a moderation role in the relationship between parental depression and the maladaptive coping strategy of rumination. Family resilience through 'maintaining a positive attitude' has a moderation role in the relationship between catastrophizing and the teenagers' level of adaptability. Discussion: The results of the study pointed out the role and place of family resilience within the family system and how a period of crisis can affect this system.