Promoting mental wellbeing in pregnant women living in Pakistan with the Safe Motherhood-Accessible Resilience Training (SM-ART) intervention: a randomized controlled trial.

BACKGROUND: The negative impact of adverse perinatal mental health extends beyond the mother and child; therefore, it is essential to make an early intervention for the management of mental illness during pregnancy. Resilience-building interventions are demonstrated to reduce depression and anxiety among expectant mothers, yet research in this field is limited. This study aims to examine the effect of the 'Safe Motherhood-Accessible Resilience Training (SM-ART)' on resilience, marital adjustment, depression, and pregnancy-related anxiety in a sample of pregnant women in Karachi, Pakistan. METHOD: In this single-blinded block randomized controlled study, 200 pregnant women were recruited and randomly assigned to either an intervention or a control group using computer-generated randomization and opaque sealed envelopes. The intervention group received the SM-ART intervention consisting of six, weekly sessions ranging from 60 to 90 min. Outcomes (Resilience, depression, pregnancy-related anxiety and marital harmony) were assessed through validated instruments at baseline and after six weeks of both intervention and control groups. RESULTS: The results revealed a significant increase in mean resilience scores (Difference:6.91, Effect size: 0.48, p-value < 0.05) and a decrease in depressive symptoms (Difference: -2.12, Effect size: 0.21, p-value < 0.05) in the intervention group compared to the control group. However, no significant change was observed in anxiety and marital adjustment scores. CONCLUSION: The SM-ART intervention has the potential to boost resilience scores and decrease depressive symptoms in pregnant women and offers a promising intervention to improve maternal psychological health. TRIAL REGISTRATION: NCT04694261, Date of first trial registration: 05/01/2021.

Systems modelling as an approach for eliciting the mechanisms for hip fracture recovery among older adults in a participatory stakeholder engagement setting.

Introduction: Due to an aging population, the rising prevalence and incidence of hip fractures and the associated health and economic burden present a challenge to healthcare systems worldwide. Studies have shown that a complex interplay of physiological, psychological, and social factors often affects the recovery trajectories of older adults with hip fractures, often complicating the recovery process. Methods: This research aims to actively engage stakeholders (including doctors, physiotherapists, hip fracture patients, and caregivers) using the systems modeling methodology of Group Model Building (GMB) to elicit the factors that promote or inhibit hip fracture recovery, incorporating a feedback perspective to inform system-wide interventions. Hip fracture stakeholder engagement was facilitated through the Group Model Building approach in a two-half-day workshop of 25 stakeholders. This approach combined different techniques to develop a comprehensive qualitative whole-system view model of the factors that promote or inhibit hip fracture recovery. Results: A conceptual, qualitative model of the dynamics of hip fracture recovery was developed that draws on stakeholders' personal experiences through a moderated interaction. Stakeholders identified four domains (i.e., expectation formation, rehabilitation, affordability/availability, and resilience building) that play a significant role in the hip fracture recovery journey.. Discussion: The insight that recovery of loss of function due to hip fracture is attributed to (a) the recognition of a gap between pre-fracture physical function and current physical function; and (b) the marshaling of psychological resilience to respond promptly to a physical functional loss via uptake of rehabilitation services is supported by findings and has several policy implications.

Smallholders' resilience-building adaptation and its influencing factors in rainfed agricultural areas in China: based on random forest model.

In recent years, extreme events and risks have increased under the background of global warming, which influenced agricultural production significantly. Adaptation has been considered as a key pathway to enhancing smallholders' climate resilience. We selected a total of 903 smallholders using the multi-stage random sampling technique in rainfed areas in China, and then collected the survey data through the structured questionnaire and focus group discussion. Three resilience-building adaptation indices (RBAS-A, RBAS-D and RBAS-I) were constructed by the entropy method, whose mean values were 0.378, 0.336, and 0.602, respectively. Furtherly, the random forest model was used to explore influencing factors of climate-resilient adaptation strategies. The results revealed that education level of household head, family size, farmland size, access to information by mass media and kith and kin, perception of temperature change in summer and winter, and perception of crop yield change were the significant factors influencing smallholders' alteration strategies. Meanwhile, age and education level of household heads, off-farm income, farmland size, mass media, and perception of winter temperature changes had significant effects on the diversification strategies. Moreover, demographic characteristics, socioeconomic characteristics, information access and climate change perceptions, and impacts had significant impacts on intensification strategies. Importantly, we found that there was a certain threshold for the impact of several factors on the constructed composite indices. And the impacts of the perceptions of temperature on alteration and intensification strategies showed a V-shape. Finally, we proposed targeted suggestions for improving smallholders' climate-resilient adaptation in the rainfed agricultural areas in China.

A gamified app for supporting undergraduate students' mental health: A feasibility and usability study.

Resilience, a person's mental ability to deal with challenging situations adaptively, is an important life skill. Supporting students in building psychological resilience and coping during crises (with the COVID-19 pandemic being a prime example) is crucial. Very few mobile applications (apps) for mental health explicitly report behavioral change techniques. Moreover, only a handful of the apps that support resilience are gamified, or use smartphone sensors readily available in modern smartphones for health self-management, or were designed for use by a nonclinical population. This study describes the design of a prototype for a gamified, theory-based mobile app that utilizes the Internet of Things to provide personalized data and enhance undergraduate students' resilience. A total of 74 participants evaluated the prototype and completed an online questionnaire during the COVID-19 lockdowns. The questionnaire included questions examining the design's feasibility for supporting resilience and questions on the System Usability Scale evaluating its usability. Regarding the evaluation of the prototype on improving psychological resilience, positive responses (M = 3.76 out of 5, SD = 0.82) were received for all functions (goal setting for studying, socializing and physical exercise, progress monitoring using sensors or self-reporting, reflection, motivational badges). The System Usability Scale returned an evaluation score of 72.9, indicating a satisfactory degree of usability. The resilience app is a promising proof of concept. Combining Internet of Things capabilities with active user interaction while incorporating behavior change techniques in a gamified environment was well accepted by students. Implications for the design of gamified environments for well-being are drawn. Future research will empirically validate its design using quasi-experimental methods.

Peer-Presented Versus Mental Health Service Provider-Presented Mental Health Outreach Programs for University Students: Randomized Controlled Trial.

BACKGROUND: University students are reporting concerning levels of mental health distress and challenges. University mental health service provider initiatives have been shown to be effective in supporting students' mental health, but these services are often resource-intensive. Consequently, new approaches to service delivery, such as web-based and peer support initiatives, have emerged as cost-effective and efficient approaches to support university students. However, these approaches have not been sufficiently evaluated for effectiveness or acceptability in university student populations. OBJECTIVE: Thus, the overarching goal of this study was to evaluate a mental health service provider-presented versus peer-presented web-based mental health resilience-building video outreach program against a wait-list comparison group. METHODS: Participants were 217 undergraduate students (mean age 20.44, SD 1.98 years; 171/217, 78.8% women) who were randomly assigned to one of the intervention groups (mental health service provider-presented: 69/217, 31.8%; peer-presented: 73/217, 33.6%) or the wait-list comparison group (75/217, 34.6%). Participants in the intervention groups were asked to watch 3 brief skill-building videos addressing strategies for building mental health resilience, whereas the comparison group was wait-listed. The mental health service provider-presented and peer-presented video series were identical in content, with presenters using a script to ensure consistency across delivery methods, but the videos differed in that they were either presented by mental health service providers or university students (peers). All participants were asked to complete web-based self-report measures of stress, coping self-efficacy, social support, social connectedness, mindfulness, and quality of life at baseline (time 1), 6 weeks later (time 2, after the intervention), and 1-month follow-up (time 3). RESULTS: Results from a series of 2-way ANOVAs found no significant differences in outcomes among any of the 3 groups. Surprisingly, a main effect of time revealed that all students improved on several well-being outcomes. In addition, results for program satisfaction revealed that both the mental health service provider-presented and peer-presented programs were rated very highly and at comparable levels. CONCLUSIONS: Thus, findings suggest that a web-based mental health resilience-building video outreach program may be acceptable for university students regardless of it being mental health service provider-presented or peer-presented. Furthermore, the overall increases in well-being across groups, which coincided with the onset and early weeks of the COVID-19 pandemic, suggest an unexpected pattern of response among university students to the early period of the pandemic. Limitations and barriers as well as research implications are discussed. TRIAL REGISTRATION: ClinicalTrials.gov NCT05454592; https://clinicaltrials.gov/ct2/show/NCT05454592.

Intra-household gender disparity: effects on climate change adaptation in Arsi Negele district, Ethiopia.

Women empowerment in agriculture influences adaptation capacity to climate change impacts. Women are disempowered in rural households. This affects household's adaptive capacity to climate change negatively. Household survey, focus group discussion, key informant interview and workshop were used to track stakeholders' opinions on gender disparity in agriculture and policy issues. The objective of the study was to assess the gender parity index in agriculture, resource governance patterns and how these impact the capacity to climate change adaptation. The results show wives were imparity with their husbands. The parity gap on ownership, access to, and decision-making power over agricultural equipment was as wide as 59% and this affects women's adaptation capacity to climate change impacts. Indeed, 94% of the coupled households have got their land by redistribution and inheritance land acquisition forms by which both forms of acquiring land favored the husband. Half of the respondent households acknowledged that they have already acquired certification for their farmlands. However, the certification was mostly given by the names of husbands and in few cases by both. Certification of farmlands by the name of a wife and a husband has built confidence on ownership and manage their farmlands. This has helped a household to better adapt climate change impacts. Gender disparity in agricultural productive resources combined with policy and cultural distortions could exacerbate household's vulnerability to the impacts of climate change. This indicates the need for gender mainstreaming in climate change policy reforms and formulation so as to empower women and build their adaptive capacity.

Building community resilience in a context of climate change: The role of social capital.

Social capital is considered important for resilience across social levels, including communities, yet insights are scattered across disciplines. This meta-synthesis of 187 studies examines conceptual and empirical understandings of how social capital relates to resilience, identifying implications for community resilience and climate change practice. Different conceptualisations are highlighted, yet also limited focus on underlying dimensions of social capital and proactive types of resilience for engaging with the complex climate change challenge. Empirical insights show that structural and socio-cultural aspects of social capital, multiple other factors and formal actors are all important for shaping the role of social capital for guiding resilience outcomes. Thus, finding ways to work with these different elements is important. Greater attention on how and why outcomes emerge, interactions between factors, approaches of formal actors and different socio-cultural dimensions will advance understandings about how to nurture social capital for resilience in the context of climate change.

Resilience building among Chinese family caregivers of older people with Parkinson's disease in Shanghai.

Despite a rapid increase in people with Parkinson's disease (PD) in China, studies focusing on caregiver burden remain scarce. Challenges faced by caregivers in other Asian societies are also underexplored in the PD-related research field. To addresses this gap, this study drew on the theory of resilience and examined the caregiving experiences of Chinese family caregivers for older people with PD. We conducted participant observation and semi-structured interviews with 15 family caregivers of older people with PD in Shanghai in 2018. We used thematic analysis to identify key patterns of stressors and factors affecting the capacity of caregivers to address burdens. Our analysis shows that stressors faced by Chinese PD caregivers included physical limitations, psychological and emotional problems, reduction in social connections, financial burden and lack of information and knowledge. Three levels of factors-personal, social and structural-played different roles in resilience among Chinese PD caregivers. However, resilience was unevenly developed among PD caregivers across gender, kinship, residential status and generation. Our study provides novel empirical evidence about the burden on Chinese PD caregivers. It can inform policymakers and social workers as they develop a holistic understanding of promoting resilience building in this rapidly growing group. Our study also enriches cross-cultural knowledge about factors contributing to caregivers' resilience building in Asian societies.

From the Cyclone Idai disaster to the COVID-19 pandemic: An account of inadvertent social capital enhancement in Eastern Chimanimani, Zimbabwe.

Zimbabwe suffered a devastating meteorological disaster when Cyclone Idai affected the southeast part of the country in March 2019. Barely a year after the cyclonic event, the coronavirus disease 2019 (COVID-19) pandemic emerged, leading to the declaration of a nationwide lockdown that paralysed socio-economic systems. This article examines how social capital was autonomously cultivated and eventually utilised by the Cyclone Idai disaster survivors in Eastern Chimanimani to face the fresh socio-economic challenges of the COVID-19 pandemic. In this article, a qualitative method embedded in a case study design was used. Data was collected using 30 purposively selected key respondents who interacted with victim communities from March to July 2020. A thematic content analysis approach was applied to obtain opinion patterns and subsequent inferences. The study results revealed a lack of immediate external disaster intervention during the Cyclone Idai disaster in Chimanimani. Accordingly, a strong sense of collective action developed between victim communities, thus enabling them to perform hasty operations meant to salvage lives and property. The enhanced social capital helped the Cyclone Idai victims to face the new COVID-19 lockdown challenges. This article recommends pro-active and well-coordinated government and private sector disaster response strategies supporting local area initiatives to minimise loss of lives and property during disaster situations.

Challenges and Resilience-Building: A Narrative Inquiry Study on a Mid-Career Chinese EFL Teacher.

With a high rate of attrition and burnout of teachers as a global concern, teacher resilience has become a trendy topic in the research of their professional development as one of the pillars of positive psychology (positive character traits). However, the literature reveals that little research has been done on the mid-career teachers in the Chinese context, especially on how resilience may be nurtured, sustained, or eroded over time. Focusing on a mid-career EFL female teacher (the author) in China as a case study, this longitudinal self-reflective study employs a narrative inquiry to investigate the challenges that the experienced teacher was encountered with and to depict her trajectories of resilience-building by fleshing out the interaction between challenges, resources, and coping strategies in her three different scenarios. "Hard data," such as teaching journals, reflective field notes, and messages with students were collected and analyzed inductively by using thematic analysis, and "soft data," like memory was also referred to. The findings unfolded challenges confronting the experienced teacher peculiar to the Chinese context and charted a detailed bumpy journey of resilience building in three phases, accompanied by her growing emotional, intellectual, and psychological capacities. Implications are drawn out for teacher resilience building, school leaders, and policymakers.

Population Preparedness for Disasters and Extreme Weather Events as a Predictor of Building a Resilient Society: The Slovak Republic.

The current increase and severity of the natural disasters whose effects on the public health are likely to be even more extreme and complex, requires enhancing and developing the disaster preparedness on the population level. In order to be able to do so, it is inevitable and determinative to know the factors that affect people's preparedness on the population level. Therefore, the objective of this article is to present the results from assessing the factors related to the population preparedness for the disasters on a sample of citizens living from the Slovak Republic. Our research is based on the exploration of the questionnaire survey' results aimed at investigating the preparedness and preventive proactive behaviour of the population against the disasters. The search for the initiators of such a behaviour and assessment of the influence of various aspects (e.g., the respondents' experience with disasters, their vulnerability to disasters, the risk awareness, the perception of the disaster risks in the changing environment, etc.) on the respondents' behaviour against disasters is the main part of the article and is supported by the statistical analysis. The results of the survey suggest that the disaster risk awareness and overall disaster preparedness level is rather poor and the population is inactive. The proactive behaviour of the respondents against the disasters is partially affected by some of their personality and socio-economic characteristics, especially the younger respondents currently incline more to adopting the protective measures. In addition, other aspects, e.g., the negative experience with the disasters in the past influence the preparedness. However, the impacts must have been relatively serious for the proactive behaviour to be influenced. The influences of other aspects as well as the possible methods for improving the disaster preparedness and the possibilities of increasing the resilience of the population as a whole are also discussed in this article.

A unitary caring science resilience-building model: Unifying the human caring theory and research-informed psychology and neuroscience evidence.

Resilience is the psychological capability to recover from difficulties quickly. Healthcare professionals are especially vulnerable to job-related stress and burnout. Unitary Caring Science is the framework for Watson's Human Caring Theory, providing a philosophy of practice in healthcare. With the high rates of clinician burnout and psychological issues, it will be significant to unify the human caring theory with research-informed psychological and neuroscience evidence to develop clinicians' resilience-building strategies. The purpose of this article is to introduce a Unitary Caring Science Resilience Model and explain the science behind the core strategies based on Unitary Caring Science philosophy and the psychological and neuroscience research. This model includes six strategies: Embracing loving-kindness for self and others; Nurturing interpersonal and intersubjective connections/relations; Deepening a creative use of self and sense of belonging; Balancing self-learning, self-awareness, and an evolved self-consciousness; Valuing forgiveness and releasing negativity; Inspiring and maintaining faith-hope. The caring-theory guided resilience-building strategies are proven to alleviate the depletion of clinicians' energy and emotions. Healthcare practices are challenging but rewarding. Clinicians can be emotionally, psychologically, and physically exhausted if they always consider themselves 'giving' and 'doing' institutional tasks without a sense of purpose or fulfillment. The practice can be rewarding if it becomes more aligned with clinicians' value to serve humanity. Through the unitary caring science resilience strategies, clinicians can build resilience as an antidote to clinician burnout and depletion.

Exploring the contribution of social capital in building resilience for climate change effects in peri-urban areas, Dar es Salaam, Tanzania.

This article aims to contribute to the literature on the quest for resilient cities by focusing on the climate change resilience building discourse in peri-urban areas, and specifically by exploring the role of social capital-an under-researched topic. The article examines bonding social capital and bridging social capital, with a focus on how they can potentially contribute to, or inhibit, the socio-ecological system resilience building processes in the context of climate change reality in peri-urban areas. Theoretically, the author draws on the existing social capital and resilience related literatures; empirically, the article presents findings from a study conducted in the peri-urban areas of Pugu and Kazimzumbwi forest reserves on the outskirts of Dar es Salaam city in Tanzania. The study deployed a household survey and key informant interviews. It found that both bonding and bridging social capital were strong in the research area, suggesting the feasibility of building resilience to climate change effects. Examples are given of a number of resilience building interventions that were established through synergies between social capital actors and local communities, although some doubt is cast over the sustainability of these initiatives. Overall, both theoretical and empirical evidence suggests the importance of including a focus on social capital in exploring the building of climate change resilience pathways in peri-urban areas, and especially in the context of the global south.

Vulnerabilidade socioambiental, redução de riscos de desastres e construção da resiliência: lições do terremoto no Haiti e das chuvas fortes na Região Serrana, Brasil / Socio-environmental vulnerability, disaster risk-reduction and resilience-building: lessons from the earthquake in Haiti and torrential rains in the mountain range close to Rio de Janeiro in Brazil

Dados sobre desastres no mundo apontam para uma maior gravidade nos países com menores níveis de desenvolvimento econômico e social. Neste contexto, políticas de redução de riscos de desastres e construção da resiliência constituem prioridades na agenda do desenvolvimento sustentável, estando entre os temas eleitos para a Rio+20. O objetivo deste artigo é, através de uma contribuição de natureza conceitual e dos exemplos de desastres em países com níveis de desenvolvimento diferentes, o terremoto do Haiti e as chuvas fortes na Região Serrana (Rio de Janeiro, Brasil), demonstrar como a vulnerabilidade socioambiental cria condições para os desastres, ao mesmo tempo em que limita as estratégias para prevenção e mitigação. Ao final são apontados alguns dos desafios que a redução de riscos de desastres e a construção da resiliência exigem em contextos de vulnerabilidade socioambiental, o que inclui mudanças nos padrões de desenvolvimento social, econômico e ambiental orientados para a sustentabilidade ecológica e a justiça social como pilares do desenvolvimento sustentável.

Data on disasters around the world reveal greater seriousness in countries with lower social and economic development levels. In this context, disaster risk-reduction and resilience-building policies are priorities in the sustainable development agenda, featuring among the topics selected for the Rio+20 Summit. By means of a contribution of a conceptual nature and from examples of disasters in countries with different development levels, namely the Haiti earthquake and the torrential rains in the mountain range close to Rio de Janeiro in Brazil, the scope of this article is to demonstrate how socio-environmental vulnerability creates conditions for disasters, while at the same time limiting strategies for their prevention and mitigation. Lastly, some of the measures that disaster risk reduction and resilience-building demand in a socio-environmental vulnerability context are highlighted. These involve changes in the current patterns of social, economic and environmental development geared toward ecological sustainability and social justice as pillars of sustainable development.