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Resumen El objetivo de este estudio consistió en explicar en qué medida la resiliencia y las estrategias de afrontamiento influyeron en la salud mental positiva de jóvenes mexicanos universitarios que vivieron la pandemia de COVID-19. La muestra se conformó por 1042 universitarios mexicanos de 18 a 24 años de edad (M = 20.5 DS = 1.9). El 78.4 % son mujeres (817). Se aplicaron en formato online los instrumentos: Mental Health Continuum-Short Form, Escala de Resiliencia, Escala de Afrontamiento y Escala de miedo al COVID-19. Se obtuvo un modelo con índices de bondad de ajuste satisfactorios (X 2 = 532.913, df = 114, X 2 /df = 4.6, SRMR = .053, RMSEA = .059, CFI = .927, p = .001), en el cual la resiliencia y el afrontamiento funcional son factores importantes que influyen en SMP, por lo que son variables que deben considerarse en los programas de intervención psicológica para la promoción de la salud de los jóvenes universitarios.
Abstract The objective of this study was to explain to what extent resilience and coping strategies influenced the positive mental health of young Mexican university students who have experienced the COVID-19 pandemic. The sample was made up of 1.042 Mexican university students between 18 and 24 years of age (M = 20.5 SD = 1.9). 78.4% are women (817). The instruments: Mental Health Continuum-Short Form, Resilience Scale, Coping Scale and Fear of COVID-19 Scale were applied in online format. A model was obtained with satisfactory goodness-of-fit indices (X2 = 532.913, df = 114), resilience and functional coping are important factors that influence SMP, so they are variables that should be considered in psychological intervention programs to promote the health of university students.
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El objetivo del presente estudio fue determinar la influencia del bienestar espiritual en la gratitud, el perdón y la resiliencia en estudiantes universitarios de la ciudad de Lima. Se utilizó un diseño explicativo con variables latentes. La muestra estuvo conformada por 957 estudiantes universitarios (29.5 % varones y 70.5 % mujeres, de 13 universidades (públicas 22.36 % y privadas 77.64 %) de Lima Metropolitana. Se utilizaron la Escala de Bienestar Espiritual (SWBS), la Escala de Disposición al Perdón (TFS), la Escala de Gratitud (EG) y la Escala Breve de Resiliencia (EBR). Entre los hallazgos se encontró que el modelo estimado con el método DWLS permite señalar que el bienestar espiritual tiene efectos directos sobre el perdón, la gratitud y la resiliencia. A su vez, la covarianza entre perdón y gratitud fue .090 (p > .05), entre perdón y resiliencia de .236 (p < .01), y entre gratitud y resiliencia fue igual a .122 (p < .01). Se discuten las implicancias de los resultados.
O objetivo deste estudo foi determinar a influência do bem-estar espiritual na gratidão, perdão e resiliência em estudantes universitários da cidade de Lima. Foi utilizado um desenho explicativo com variáveis latentes. A amostra foi composta por 957 estudantes universitários (29,5 % homens e 70,5 % mulheres) de 13 universidades (22,36 % públicas e 77,64 % privadas) de Lima Metropolitana. Foram utilizadas a Escala de Bem-Estar Espiritual (SWBS), a Escala de Disposição ao Perdão (TFS), a Escala de Gratidão (EG) e a Escala Breve de Resiliência (EBR). Entre os achados, encontrou-se que o modelo estimado com o método DWLS permite indicar que o bem-estar espiritual tem efeitos diretos sobre o perdão, gratidão e resiliência. Por sua vez, a covariância entre perdão e gratidão foi de .090 (p > .05), entre perdão e resiliência de .236 (p < .01) e entre gratidão e resiliência foi igual a .122 (p < .01). As implicações dos resultados foram discutidas.
This study aimed to determine the influence of spiritual well-being on gratitude, forgiveness, and resilience in university students in the city of Lima. An explanatory design with latent variables was used. The sample consisted of 957 university students (29.5 % men and 70.5 % women from 13 universities (22.36% public and 77.64 % private)), from Metropolitan Lima. The Spiritual Wellbeing Scale (SWBS), the Trait Forgivingness Scale (TFS), the Gratitude Scale (GS), and the Brief Resilience Scale (BRS) were used. Among the findings, it was found that the model estimated with the DWLS method allows us to point out that spiritual well-being directly affects forgiveness, gratitude, and resilience. In turn, the covariance between forgiveness and gratitude was .090 (p > .05), the covariance between forgiveness and resilience was .236 (p < .01), and the covariance between gratitude and resilience was equal to .122 (p < .01). The implications of the results have been discussed.
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Background: With increasing healthcare service utilization and the introduction of costly therapies, healthcare organizations are pressured to deliver cost-effective services within constrained budgets. Rising costs and the need for efficient healthcare delivery are major concerns for governments, insurers, and health plans. Objectives: It aims to understand the impact of these intangible assets on creating value and organizational resilience in healthcare, informing better practices and strategies for VBHC implementation. Methods: An applied research approach using the Work Breakdown Structure (WBS) methodology was adopted. The research was divided into seven interconnected Work Packages (WPs), each designed to investigate different aspects of the integration between VBHC and intangible assets, with a focus on enhancing organizational resilience through innovative health processes. Key methodologies included literature reviews and qualitative analyses, employing Open Innovation and Design Thinking. Results: The study revealed a dynamic interplay between VBHC, organizational resilience, and intangible assets. It showed that managerial effectiveness is influenced by direct patient outcomes and elements like intellectual capital and organizational reputation. Data integration from various Work Packages provided new insights into how intangible assets underpin VBHC strategies, proposing novel management approaches. Findings highlight the essential role of intangible assets in enhancing service delivery and fostering sustainable healthcare practices. Discussion: The study highlights a significant oversight in the integration of intangible assets within healthcare organizations, despite their crucial role in optimizing VBHC. It supports literature emphasizing the importance of intellectual capital and organizational culture in enhancing healthcare management efficiency and resilience. A paradigm shift in VBHC to include these assets is needed for building a more adaptable and sustainable healthcare system. This integration can lead to better clinical outcomes, patient satisfaction, and overall healthcare efficiency, aligning more closely with VBHC goals. Conclusion: Recognizing and effectively managing intangible assets are paramount for the successful implementation of VBHC and enhanced organizational resilience. Strategic integration of these assets into healthcare management practices can significantly improve patient outcomes and create a more sustainable, patient-centered, and resilient healthcare system. Future studies should develop methodologies for robust measurement and integration of these assets to fully realize the potential of VBHC.
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Modern livestock production systems are characterized by a greater focus on intensification, involving managing larger numbers of animals to achieve higher productive efficiency and animal health and welfare within herds. Therefore, animal breeding programs need to be strategically designed to select animals that can effectively enhance production performance and animal welfare across a range of environmental conditions. Thus, this review summarizes the main methodologies used for assessing the levels of genotype-by-environment interaction (G × E) in cattle populations. In addition, we explored the importance of integrating genomic and phenotypic information to quantify and account for G × E in breeding programs. An overview of the structure of cattle breeding programs is provided to give insights into the potential outcomes and challenges faced when considering G × E to optimize genetic gains in breeding programs. The role of nutrigenomics and its impact on gene expression related to metabolism in cattle are also discussed, along with an examination of current research findings and their potential implications for future research and practical applications. Out of the 116 studies examined, 60 and 56 focused on beef and dairy cattle, respectively. A total of 83.62% of these studies reported genetic correlations across environmental gradients below 0.80, indicating the presence of G × E. For beef cattle, 69.33%, 24%, 2.67%, 2.67%, and 1.33% of the studies evaluated growth, reproduction, carcass and meat quality, survival, and feed efficiency traits, respectively. By contrast, G × E research in dairy cattle populations predominantly focused on milk yield and milk composition (79.36% of the studies), followed by reproduction and fertility (19.05%), and survival (1.59%) traits. The importance of G × E becomes particularly evident when considering complex traits such as heat tolerance, disease resistance, reproductive performance, and feed efficiency, as highlighted in this review. Genomic models provide a valuable avenue for studying these traits in greater depth, allowing for the identification of candidate genes and metabolic pathways associated with animal fitness, adaptation, and environmental efficiency. Nutrigenetics and nutrigenomics are emerging fields that require extensive investigation to maximize our understanding of gene-nutrient interactions. By studying various transcription factors, we can potentially improve animal metabolism, improving performance, health, and quality of products such as meat and milk.
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La investigación tiene como objetivo describir la resiliencia de los estudiantes de odontología, los factores asociados y las consecuencias en sus respectivas actividades académicas. Se realizó una investigación y recopilación de información bibliográfica especializada, en revistas indexadas de repositorios internacionales como Elsevier, PubMed Scielo, entre otras, con artículos publicados desde el 2019 hasta el 2023. La literatura ha demostrado que la resiliencia carece de una definición unánime, y su significado varía según las disciplinas que la estudian. Sin embargo, todas las definiciones hacen referencia a la capacidad de enfrentar adversidades y obtener resultados positivos. La resiliencia en estudiantes de odontología es crucial para equilibrar el crecimiento académico, la calidad del cuidado al paciente y el bienestar personal, lo que conduce a una experiencia educativa más exitosa y satisfactoria en esta profesión. También es importante resaltar que las instituciones educativas son el lugar ideal para promover la resiliencia.
The research aims to describe the resilience of dental students, the associated factors and the consequences in their respective academic activities. A research and compilation of specialised bibliographic information was carried out, in journals indexed in international repositories such as Elsevier, PubMed Scielo, among others, with articles published from 2019 to 2023. The literature has shown that resilience lacks a unanimous definition, and its meaning varies according to the disciplines that study it. However, all definitions refer to the ability to cope with adversity and achieve positive outcomes. Resilience in dental students is crucial to balancing academic growth, quality patient care and personal well-being, leading to a more successful and satisfying educational experience in this profession. It is also important to note that educational institutions are the ideal place to foster resilience.
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Individuals considered resilient can overcome adversity, achieving normal physical and psychological development, while those deemed vulnerable may not. Adversity promotes structural and functional alterations in the medial prefrontal cortex (mPFC) and hippocampus. Moreover, activity-dependent synaptic plasticity is intricately linked to neuronal shaping resulting from experiences. We hypothesize that this plasticity plays a crucial role in resilience processes. However, there is a notable absence of studies investigating this plasticity and behavioral changes following social adversity at different life stages. Consequently, we evaluated the impact of social adversity during early postnatal development (maternal separation [MS]), adulthood (social defeat [SD]), and a combined exposure (MS + SD) on behavioral outcomes (anxiety, motivation, anhedonia, and social interaction). We also examined cFos expression induced by social interaction in mPFC and hippocampus of adult male rats. Behavioral analyses revealed that SD-induced anhedonia, whereas MS + SD increased social interaction and mitigated SD-induced anhedonia. cFos evaluation showed that social interaction heightened plasticity in the prelimbic (PrL) and infralimbic (IL) cortices, dentate gyrus (DG), CA3, and CA1. Social interaction-associated plasticity was compromised in IL and PrL cortices of the MS and SD groups. Interestingly, social interaction-induced plasticity was restored in the MS + SD group. Furthermore, plasticity was impaired in DG by all social stressors, and in CA3 was impaired by SD. Our findings suggest in male rats (i) two adverse social experiences during development foster resilience; (ii) activity-dependent plasticity in the mPFC is a foundation for resilience to social adversity; (iii) plasticity in DG is highly susceptible to social adversity.
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Privação Materna , Plasticidade Neuronal , Córtex Pré-Frontal , Resiliência Psicológica , Animais , Plasticidade Neuronal/fisiologia , Masculino , Ratos , Anedonia/fisiologia , Interação Social , Derrota Social , Hipocampo , Estresse Psicológico/fisiopatologia , Estresse Psicológico/psicologia , Ratos Wistar , Comportamento Animal/fisiologia , Comportamento Social , Ansiedade/fisiopatologiaRESUMO
The soil seed bank (SSB) is one of the key mechanisms that ensure the perpetuity of forests, but how will it behave in the scenarios projected for the future climate? Faced with this main question, still little explored in seasonal tropical forests, this study evaluated the germination, ecological attributes, and functional traits of the SSB in a seasonal forest in the Atlantic Forest. Forty-eight composite samples of the SSB were collected from 12 plots, distributed across four treatments, each with 12 replicates. The samples were placed in two climate-controlled greenhouses, establishing two environments of controlled climatic conditions, both with two levels of water, as follows: Cur: current scenario without water restriction; Cur_WR: current scenario with water restriction; RCP8.5: future scenario without water restriction; RCP8.5_WR: future scenario with water restriction. The germinants were identified, and their ecological attributes and functional traits were obtained. Leaf area and biomass production, differences in abundance, richness, and diversity were evaluated, along with analysis of variance to assess the interaction between water levels and scenarios. All ecological attributes and functional traits evaluated drastically decreased in the future projection with water restriction, with this restriction being the main component influencing this response. The increased temperature in the future scenario significantly raised water consumption compared to the current scenario. However, persistent water restrictions in the future could undermine the resilience of seasonal forests, hindering seed germination in the soil. Richness and abundance were also adversely affected by water scarcity in the future scenario, revealing a low tolerance to the projected prolonged drought. These changes found in the results could alter the overall structure of seasonal forests in the future, as well as result in the loss of the regeneration potential of the SSB due to decreased seed viability and increased seedling mortality.
Resumo O banco de sementes do solo (SSB) é um dos principais mecanismos que garantem a perpetuidade das florestas, mas como ele se comportará nos cenários projetados para o clima futuro? Diante dessa questão principal, ainda pouco explorada em florestas tropicais sazonais, este estudo avaliou a germinação, atributos ecológicos e traços funcionais do SSB em uma floresta sazonal na Mata Atlântica. Quarenta e oito amostras compostas do SSB foram coletadas de 12 parcelas, distribuídas em quatro tratamentos, cada uma com 12 réplicas. As amostras foram colocadas em duas estufas com controle climático, estabelecendo dois ambientes de condições climáticas controladas, ambos com dois níveis de água, conforme segue: Cur: cenário atual sem restrição hídrica; Cur_WR: cenário atual com restrição hídrica; RCP8.5: cenário futuro sem restrição hídrica; RCP8.5_WR: cenário futuro com restrição hídrica. Os germinantes foram identificados e seus atributos ecológicos e traços funcionais foram obtidos. Área foliar e produção de biomassa, diferenças na abundância, riqueza e diversidade foram avaliadas, juntamente com análise de variância para avaliar a interação entre níveis de água e cenários. Todos os atributos ecológicos e traços funcionais avaliados diminuíram drasticamente na projeção futura com restrição hídrica, sendo essa restrição o principal componente influenciando essa resposta. O aumento da temperatura no cenário futuro elevou significativamente o consumo de água em comparação com o cenário atual. No entanto, a restrição hídrica persistente no futuro pode comprometer a resiliência das florestas sazonais, dificultando a germinação de sementes no solo. Riqueza e abundância também foram adversamente afetadas pela escassez de água no cenário futuro, revelando uma baixa tolerância à seca prolongada projetada. Essas mudanças encontradas nos resultados podem alterar a estrutura geral das florestas sazonais no futuro, além de resultar na perda do potencial de regeneração do SSB devido à diminuição da viabilidade das sementes e ao aumento da mortalidade das plântulas.
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Mudança Climática , Florestas , Estações do Ano , Banco de Sementes , Água , Água/análise , Germinação , Brasil , Sementes/crescimento & desenvolvimento , Árvores/crescimento & desenvolvimentoRESUMO
BACKGROUND: Studies evaluating the effects of natural disasters on cancer outcomes are scarce, especially among USA ethnic minority groups, and none have focused on the effects of concurrent natural disasters and the COVID-19 pandemic. The goal of this secondary data analysis is to explore the impact of concurrent exposure to COVID-19 and earthquakes on psychological distress and symptom burden among Puerto Rican cancer survivors. METHODS: This secondary data analysis (n = 101) was part of a longitudinal case-control cohort study (n = 402) aimed at describing unmet psychological needs among Puerto Rican cancer patients and non-cancer subjects previously exposed to Hurricane María in 2017. The research team pooled data from participants (cancer survivors and non-cancer group) from their baseline assessments and from follow-up assessments conducted during January-July 2020 (earthquake and the lockdown period). A descriptive, paired t-test, non-parametric mean rank test, and two-sided Pearson correlation analyses were performed. RESULTS: Psychological distress and cancer symptom burden diminished over time. Resilience was significantly correlated with all the psychological and symptom burden variables during both pre- and post-earthquake and COVID-19 assessment periods. CONCLUSIONS: The results support the role of resilience, social support, and post-traumatic growth as potential protective factors preventing psychological distress and diminishing cancer symptom burden among cancer survivors exposed to natural disasters and the COVID-19 pandemic.
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Ansiedade , COVID-19 , Sobreviventes de Câncer , Depressão , Hispânico ou Latino , Desastres Naturais , Transtornos de Estresse Pós-Traumáticos , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ansiedade/epidemiologia , Ansiedade/psicologia , Sobreviventes de Câncer/psicologia , Estudos de Casos e Controles , COVID-19/psicologia , COVID-19/epidemiologia , Tempestades Ciclônicas , Depressão/epidemiologia , Depressão/psicologia , Terremotos , Hispânico ou Latino/psicologia , Estudos Longitudinais , Angústia Psicológica , Porto Rico/epidemiologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Estresse Psicológico/psicologia , Carga de SintomasRESUMO
Background: There are limited data on the effectiveness of differentiated service delivery (DSD) for HIV care during sociopolitical turmoil. We assessed outcomes with a DSD model of care that includes patient choice between community-based antiretroviral therapy (ART) centres, home-based ART dispensing, or facility-based care at GHESKIO clinic during a period of severe civil unrest in Port-au-Prince, Haiti. Methods: This retrospective analysis included data on patients with at least one HIV visit at GHESKIO between May 1, 2019, and December 31, 2021. Multivariable logistic regression models were used to assess predictors of attending ≥1 community visit during the study period, and failure to attend timely visits. HIV-1 RNA test results were reported among patients who had been ART for ≥3 months at last visit. Findings: Of the 18,625 patients included in the analysis, 9659 (51.9%) attended at least one community visit. The proportion of community visits ranged from 0.3% (2019) to 44.1% (2021). Predictors of ≥1 community visit included male sex (aOR: 1.13; 95% CI: 1.06, 1.20), secondary education (aOR: 1.07; 95% CI: 1.01, 1.14), income > $USD 1.00/day (aOR: 1.24; 95% CI: 1.14, 1.35), longer duration on ART (aOR: 1.08 per additional year; 95% CI: 1.07, 1.09), and residence in Carrefour/Gressier (p < 0.0001 in comparisons with all other zones). Younger age and shorter time on ART were associated with late visits and loss to follow-up. Among 12,586 patients with an on-time final visit who had been on ART for ≥3 months, 11,131 (88.4%) received a viral load test and 9639 (86.6%) had HIV-1 RNA < 1000 copies/mL. Interpretation: The socio-political situation in Haiti has presented extraordinary challenges to the health care system, but retention and viral suppression rates remain high with a model of community-based HIV care. Additional interventions are needed to improve outcomes for younger patients, and those with shorter time on ART. Funding: No funding.
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Depression is a disabling and highly prevalent psychiatric illness. Multiple studies have linked glutamatergic dysfunction with the pathophysiology of depression, but the exact alterations in the glutamatergic system that contribute to depressive-like behaviors are not fully understood. Recent evidence suggests that a decreased level in neuronal glutamate transporter (EAAT3), known to control glutamate levels and limit the activation of glutamate receptors at synaptic sites, may contribute to the manifestation of a depressive phenotype. Here, we tested the possibility that increased EAAT3 expression at excitatory synapses could reduce the susceptibility of mice to develop depressive-like behaviors when challenged to a 5-week unpredictable chronic mild stress (UCMS) protocol. Mice overexpressing EAAT3 in the forebrain (EAAT3glo/CMKII) and control littermates (EAAT3glo) were assessed for depressive-like behaviors and long-term memory performance after being subjected to UCMS conditions. We found that, after UCMS, EAAT3glo/CMKII mice did not exhibit depressive-like behaviors or memory alterations observed in control mice. Moreover, we found that EAAT3glo/CMKII mice did not show alterations in phasic dopamine release in the nucleus accumbens neither in long-term synaptic plasticity in the CA1 region of the hippocampus after UCMS, as observed in control littermates. Altogether these results suggest that forebrain EAAT3 overexpression may be related to a resilient phenotype, both at behavioral and functional level, to the deleterious effect of chronic stress, highlighting the importance of neuronal EAAT3 in the pathophysiology of depressive-like behaviors.
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Objective: Residents of Puerto Rico have recently experienced multiple adverse events, including hurricanes, earthquakes, and political unrest. Such adversity is associated with worse mental and physical health. Psychological resilience and effective coping may mitigate these relations by fostering positive health behaviors, like consuming a high-quality diet and being physically active. However, empirical evidence for these relationships is limited. Methods: We assessed psychological resilience, resilient coping, and health behaviors among two groups of adults in Puerto Rico, before and during the pandemic, in 2019-2023 (total N = 1,342). Resilience and resilient coping were assessed using the Brief Resilience Scale and Brief Resilient Coping Scale. Diet quality was defined by the Alternate Healthy Eating Index from a food frequency questionnaire. We collected data on sleep, physical activity, alcohol intake, and tobacco use using validated questionnaires. Results: Adjusting for confounders, higher resilience z-scores were associated with being in the highest category of diet quality [OR: 1.25, 95 % CI: 1.04, 1.50]; getting 7-8 h of sleep per night [OR: 1.15, 95 % CI: 1.02,1.30]; and reporting moderate or heavy physical activity (vs. light or sedentary) [OR: 1.17, 95 % CI: 1.02,1.34]. The same patterns were observed for higher resilient coping z-scores, and for categorical measures of resilience and resilient coping. These relationships were stronger among participants interviewed during (vs. before) the COVID-19 pandemic, suggesting that resilience and resilient coping may be particularly relevant during an ongoing stressor. Conclusion: Identifying supportive strategies to cultivate resilience and effective coping mechanisms may contribute to healthier behaviors, particularly in a vulnerable population.
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We explore the implications of the concept of territorio cuerpo-tierra for conducting research on women's resilience to trauma and post-COVID-19 pandemic recovery in El Salvador, Central America. Cuerpo-territorio forces a reconceptualization of women's realities as bound to the embodiment of the geo-politics of gender, body, and land as territories, and thus, their realities as bound to the histories and temporality of those as territories. Through a series of despartares decoloniales (decolonial awakenings), we postulate that resilience research reproduces narrowly defined understanding of women's realities and responses to both the symbolic and physical conditions and adversities of their lives.
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Introduction: Empathy is a complex and multidimensional attribute. Attempts have been made to explain empathic behavior based on other variables. Empirical evidence shows that empathy could be the product of the influence of several factors. One of these factors could be resilience. There is still no developed theory and consistent empirical evidence demonstrating that empathy depends on resilience. Objective: The aim of this study is to determine if resilience can predict empathic behavior. Methodology: This study is non-experimental and ex post facto with a cross-sectional design. Variables. Dependent: Empathy; Independent: Resilience. Population: Medical students belonging to the Faculty of Health Sciences of the Universidad Autónoma de Santa Ana (UNASA), Santa Ana, El Salvador (N=579). The sample (n=465) consisted of students (both sexes). Convenience sampling. Jefferson Scale of Empathy for Healthcare Professionals, student version (JSE-HPS). Trait Resilience Scale (EEA). A Structural Equation Modelling (SEM) model was used. Additionally, the Comparative Fit Index (CFI) (>0.95), Tucker-Lewis Index (TLI) (>0.95), Root Mean Square Error of Approximation (RMSEA) (<0.08), and Standardized Root Mean Square (SRMR) (<0.08), Confirmatory Factor Analysis (CFA) were employed. The significance level employed was α < 0.05. Results: All these results show that both measurement models (empathy and resilience) are adequately represented and are suitable for the structural model. Discussion: Individual resilience is a variable that can predict empathic behavior in medical students belonging to a Faculty of Health Sciences. The results constitute indirect empirical evidence that it is possible to define empathy as a dependent variable and resilience as an independent variable.
Introducción: La empatía es un atributo complejo y multidimensional. Se han realizado intentos para explicar el comportamiento empático basado en otras variables. La evidencia empírica muestra que la empatía podría ser el producto de la influencia de varios factores. Uno de estos factores podría ser la resiliencia. Aún no existe una teoría desarrollada y evidencia empírica consistente que demuestre que la empatía depende de la resiliencia. Objetivo: El objetivo de este estudio es determinar si la resiliencia puede predecir el comportamiento empático. Metodología: Este estudio es no experimental y ex post facto con un diseño transversal. Variables. Dependiente: Empatía; Independiente: Resiliencia. Población: Estudiantes de medicina pertenecientes a la Facultad de Ciencias de la Salud de la Universidad Autónoma de Santa Ana (UNASA), Santa Ana, El Salvador (N=579). La muestra (n=465) consistió en estudiantes (ambos sexos). Muestreo por conveniencia. Escala de Empatía de Jefferson para Profesionales de la Salud, versión estudiantil (JSE-HPS). Escala de Resiliencia de Rasgo (EEA). Se utilizó un modelo de Modelado de Ecuaciones Estructurales (SEM). Además, se emplearon el Índice de Ajuste Comparativo (CFI) (>0.95), Índice de Tucker-Lewis (TLI) (>0.95), Error Cuadrático Medio de Aproximación (RMSEA) (<0.08) y Error Cuadrático Medio Estandarizado (SRMR) (<0.08), Análisis Factorial Confirmatorio (CFA). El nivel de significancia empleado fue α < 0.05. Resultados: Estos resultados muestran que ambos modelos de medición (empatía y resiliencia) están adecuadamente representados y son adecuados para el modelo estructural. Discusión: Los resultados constituyen evidencia empírica indirecta de que es posible definir la empatía como una variable dependiente y la resiliencia como una variable independiente.
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Globally, transgender women (TW) face a high burden of the HIV epidemic. In Peru, HIV prevalence among TW rises at age 25, indicating a need to understand HIV vulnerability as adolescents reach adulthood. The life course of TW is often marked by abuse, discrimination and poverty fueled by transphobic stigma. Approaches to the HIV epidemic among TW and adolescents emphasize problem behaviors such as unprotected sex and substance. However, there has been a call for HIV research and interventions to understand and leverage community strengths. This qualitative study utilized a transgender-oriented, strength-based, intersectional and feminist approach to understand the strengths and protective health behaviors among 17 transgender adolescents and young women (TAYW) age 16-24 in Lima, Peru. Most participants re-located to Lima from the Amazon due to familial rejection, and engaged in obligatory sex work. TAYW demonstrated self-knowledge, motivation for education, efforts to secure employment, strong community networks, legal advocacy, avoiding problem substance use, HIV knowledge and condom use. However, strengths were impeded by multi-level barriers such as familial physical abuse, educational discrimination, and sexual assault which led to increased HIV vulnerability. We created a conceptual model of the "cycle" of HIV to describe the limits of personal responsibility within a vulnerable community denied access to family, education, employment and human rights. We recommend researchers, clinicians and public health workers follow the lead of TAYW at the frontlines of the HIV epidemic, and support beloved communities and enabling environments which may permit protective behaviors to mitigate HIV vulnerability.
RESUMEN: A nivel mundial, las mujeres transgénero (MT) enfrentan una alta carga de la epidemia del VIH. En Perú, la prevalencia del VIH entre las MT aumenta a los 25 años, lo que indica la necesidad de comprender la vulnerabilidad al VIH a medida que las adolescentes llegan a la edad adulta. El curso de vida de las MT suele estar marcado por el abuso, la discriminación y la pobreza por culpa del estigma transfóbico. Los enfoques sobre la epidemia del VIH entre las MT y los adolescentes enfatizan conductas problemáticas como el sexo sin protección o el uso de sustancias. Sin embargo, existe un llamado a realizar investigaciones e intervenciones sobre el VIH para comprender y aprovechar las fortalezas de la comunidad. Este estudio cualitativo utilizó un enfoque feminista, interseccional, basado en fortalezas y orientado a las personas transgénero para comprender las fortalezas y los comportamientos protectores de la salud entre 17 adolescentes y mujeres jóvenes transgénero de 16 a 24 años en Lima, Perú. La mayoría de las participantes migraron a Lima desde la Amazonía debido al rechazo familiar y se dedicaron al trabajo sexual obligatorio. Las adolescentes y mujeres jóvenes transgénero demostraron autoconocimiento, motivación para la educación, esfuerzos para conseguir empleo, redes comunitarias sólidas, defensa legal, evitar el uso problemático de sustancias, conocimiento sobre el VIH y uso de condones. Sin embargo, las fortalezas se vieron obstaculizadas por barreras de múltiples niveles, como el abuso físico familiar, la discriminación educativa y la agresión sexual, que llevaron a una mayor vulnerabilidad al VIH. Desarrollamos un modelo conceptual del "ciclo" del VIH para describir los límites de la responsabilidad personal dentro de una comunidad vulnerable a la que se le niega el acceso a la familia, la educación, el empleo y los derechos humanos. Recomendamos que los investigadores, médicos y trabajadores de la salud pública sigan el ejemplo de adolescentes y mujeres jóvenes transgénero en la primera línea de la epidemia del VIH y apoyen a comunidades queridas y entornos propicios que puedan permitir conductas protectoras para mitigar la vulnerabilidad al VIH.
Assuntos
Infecções por HIV , Pesquisa Qualitativa , Pessoas Transgênero , Humanos , Pessoas Transgênero/psicologia , Pessoas Transgênero/estatística & dados numéricos , Peru/epidemiologia , Adolescente , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Infecções por HIV/psicologia , Adulto Jovem , Masculino , Estigma Social , Conhecimentos, Atitudes e Prática em Saúde , Populações Vulneráveis , Comportamento Sexual/psicologia , Assunção de Riscos , Sexo sem Proteção/estatística & dados numéricos , Sexo sem Proteção/psicologia , Trabalho SexualRESUMO
Achieving more sustainable adaptation to social-environmental change demands the transformation of the narratives that provide the rationale for risk governance. These narratives often reflect long-standing beliefs about social and political relationships, ascribe actions and responsibilities, and specify solutions to risk. When such solutions are implemented through material investments in landscapes, these narratives become embedded in physical infrastructure with long legacies. Dominant narratives can mask a range of divergent problem framings. By masking alternatives, narratives can contribute to the persistence of unsustainable governance trajectories. Decision-support tools have begun to represent narratives as drivers of system dynamics; making narratives visible can reveal opportunities for more sustainable governance. We present the results of the project "The Dynamics of Multi-Scalar Adaptation in the Megalopolis", a dynamic, exploratory model of socio-hydrological risks in Mexico City that was designed to both endogenize and simultaneously challenge the dominant narratives that characterize water-risk governance in the city. Qualitative data characterize dominant narratives at city and borough scales. An agent-based model, informed by multicriteria decision analysis and coupled with hydrological, urbanization, and climatic model inputs, permitted the development of exploratory governance scenarios designed to challenge dominant narratives. Scenarios revealed how dominant narratives may contribute to the persistence of vulnerability "hotspots" in the city, despite stated goals of equity and vulnerability alleviation. Participatory workshops with representatives of the city government illustrate how making such narratives visible through exploratory modeling can lead to a questioning of prior assumptions and causal relations, recognition of a need for intersectoral collaboration, and insights into potential management strategies.
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Mexicans who migrate to the United States endure significant stressors related to the migration process and social and environmental conditions of life in the United States. Given that chronic stress exposure has been linked to the onset of health conditions, these ecological factors may expose them to increased risk for poor health. However, Mexicans have many positive health outcomes compared to those monitored nationally, making it crucial to understand possible sources of resilience in this population. Here, we investigate Mexicans' lay health knowledge in response to stress as a possible source of health-related resilience. Health knowledge is considered a central facet of practical and traditional knowledge as well as adaptive modes of intelligence and has a tangible impact on health. Using an ethnographically grounded community-based participatory research design informed by the theory of embodiment, our hybrid team of bilingual university and community-based researchers interviewed Mexican-origin residents (N = 30) living in rural southwestern Arizona about how they experienced and responded to stress and incorporated it into their etiological frameworks. Thematic analysis revealed that participants paid close attention to how stress presented itself in their bodies, which informed their understanding of its potentially harmful health impacts and motivated them to employ multiple stress reduction strategies. Our results highlight the breadth of Mexicans' lay health knowledge, thereby challenging dominant narratives about low rates of health literacy in this population. Findings can be harnessed to optimize potential health protective effects in home and community settings as well as to inform preventive and clinical interventions.
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Teachers' actions go beyond instruction, as their personal traits influence their teaching methods, problem-solving skills, and the quality of their relationships with students. Among these attributes, their prosocial competencies stand out for contributing to school, community, and social coexistence. Furthermore, the connection they have to resilience and self-efficacy promotes increased effectiveness in meeting the demands of an ever-more challenging work environment. This research aimed to analyze the effect of the relationship between self-efficacy and resilience on the prosocial behavior of Chilean elementary school teachers. The sample consisted of 1426 teachers (77.2% women) working in public and subsidized Chilean schools. Structural equation modeling (SEM) explored the relationships between self-efficacy, resilience, and prosocial behavior. The findings indicate that self-efficacy and resilience directly and positively affect the prosocial behavior of elementary school teachers. It is suggested that resilience, self-efficacy, and prosociality among teachers are promoted due to their synergistic effects and, consequently, the benefits for school children, especially those from vulnerable social contexts.
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Background: Resilience can mitigate the negative impact produced by the COVID-19 pandemic. Medical students endure significant academic stress, so adjusting to sudden changes can present greater mental health challenges. The aim is to identify the level and prevalence of resilience and to know what are the educational variables and is sleep quality associated with resilience. Methods: A cross-sectional study was conducted using an online questionnaire. The survey was elaborated in Google Forms and shared through social networks. The outcome was resilience, measured with the Connor Davidson Resilience Scale. Its association was assessed with sleep quality (measured with the Pittsburgh Sleep Quality Index), daytime sleepiness (measured with the Epworth Sleepiness Scale), and selected academic/sociodemographic variables. Generalized linear models were used to identify the association between the variables. Results: Of 1277 participants, 35.7% experienced high resilience. Poor sleep quality and sleepiness were present in 88.4% and 36.0% of students, respectively. High resilience was associated with good sleep quality (PR:1.56; 95%CI: 1.34 - 1.83; p-value<0.001), absent sleepiness (PR:1.59; 95%CI: 1.32-1.91; p-value<0.001), male sex (PR: 1.21; 95%CI: 1.05-1.39; p-value 0.006), working (PR:1.14), having family responsibilities (PR: 1.36; 95%CI: 1.09-1.70; p-value 0.005) and spending more than 6 hours studying (PR: 1.35; 95%CI: 1.17-1.54; p-value<0.001). Conclusion: 4 out of 10 students presented high levels of resilience. The development of resilience depended on multiple individual and sociodemographic factors. These findings are important to support universities in developing resilience-building measures and strategies that can be implemented to mitigate the adverse pandemic event.
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Purpose: To present the social network analysis-based approach used to create a new workspace layout for three hospital services as part of a campus expansion at a large tertiary care public hospital. Objective: To analyze the relationships among service members across four healthcare resilience abilities (monitor, anticipate, respond, and learn) and utilize network metrics to indicate the suitability of a shared workspace layout for the services. Background: The hospital expanded by 70%, providing space for relocating key services-the rapid response team, medical on-call team, and nursing supervision. Initial observations suggested a shared workspace layout based on anecdotal evidence. Method: Stakeholders have reached a consensus on a three-stage process to assess the suitability of a shared workspace layout for these services: first, collecting data on social interactions with a focus on resilience abilities; second, presenting layout alternatives based on sociograms; and third, evaluating these alternatives and devising a strategy for allocating personnel to shifts based on a resilience score derived from social network metrics. Case Study: The examination of social network metrics allowed identifying key individuals contributing to the overall resilience of the three services. Sociograms provided visual representations of how these individuals were spatially distributed within the shared layout. Discussion: The process was designed to shape a resilient layout and incorporated initial data, preferences, and constraints into layout proposals. Additionally, it utilized a resilience score from existing literature to formulate a strategy for staff allocation to shifts, ensuring consistent collective resilience ability across all shifts.