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BackgroundIdentifying factors associated with post-disaster youth substance use is a crucial element of developing evidence-based prevention and intervention efforts. Hurricane María struck Puerto Rico in September of 2017 and the wide-spread impact from this disaster, including exposure to trauma, displacement, and disrupted social supports had the potential to negatively impact levels of substance use among youth across the archipelago. However, post-disaster substance use remains under-investigated in this context. The current study sought to identify risk and protective factors associated with substance use among Puerto Rican youth in the aftermath of Hurricane Maria.MethodsCross-sectional, secondary data analyses were conducted using school-based survey data collected at all schools in Puerto Rico between February 1 and June 29, 2018 (5-9 months after Hurricane María). Social supports, substance use, and trauma symptoms were assessed. An ordinal regression analysis was conducted to identify student factors associated with greater likelihood of post-disaster substance use.ResultsA total of 36,485 participants (50.7% female, grades 7-12), were included in an ordinal regression analysis that compared the likelihood of respondents endorsing high, low, or no substance use after Hurricane María based on reported adult social support, counselor/teacher social support, peer social support, ptsd symptomatology, and gender. Findings showed that, when compared to students that endorsed low or no substance use, those who reported having adult social support demonstrated a 58% reduction in odds (OR = 0.42, 95% CI: 0.34-0.53) of reporting high substance use after Hurricane María, while students who reported having teacher/counselor social support demonstrated a 21% reduction in odds (OR = 0.79, 95% CI: 0.69-0.89) of reporting high substance use. Additionally, those that reported having peer social support demonstrated a 31% increase in odds (OR = 1.31, 95% CI: 1.10 to 1.58) of reporting higher substance use, compared to those that reported low or no substance use.ConclusionsWhile social support was generally protective, prevention efforts to build positive family and community connections may be indicated. Evidence-based school screenings of substance use and trauma may help direct intervention to those most at risk for co-occurring issues.

Black men are disproportionately affected by firearm assaults in the United States, and these disparities are rooted in structural and social inequities. The objective of this scoping review of research was to identify risk and protective factors for firearm assault injuries among Black men at all levels of the social-ecological framework. The search was conducted in 2021. The initial search generated 1,122 articles. Studies were eligible if they (a) included an analysis of modifiable risk or protective factors for firearm assaults among Black men; (b) reported an estimate of correlation, association, or effect between risk or protective factors and firearm assault injuries, firearm violence, and/or firearm homicides; and (c) were published peer-reviewed articles. In all, 19 articles were identified for review. Risk factors identified at each ecological level include the following: (1) Individual: firearm possession/weapon use and criminal legal system interaction; (2) Relationships: gang membership and exposure to other people who have experienced a firearm assault; (3) Community: indicators for socioeconomic status and racial residential segregation; and (4) Societal: historical racist policy. Individual-level substance use had mixed results. Few (26%) studies examined protective factors at any ecological level, but community-level factors like neighborhood tree cover were identified. Future research needs to examine risk and protective factors at the societal level and multiple ecological levels simultaneously leading to more effective multi-level interventions that will guide policy formation. A greater diversity of study designs, research methods, and theoretical frameworks is needed to better understand factors associated with firearm assault among Black men.

Studies in the literature mainly focus on understanding the risk factors for suicide, giving little relevance to protective variables. This study aimed at exploring the specific contribution of protective variables (resilience, coping and psychological well-being) in hospitalized suicide attempt (SA) makers. We recruited 50 inpatients who made a SA before admission and 50 inpatients with no history of SA matched for DSM-5 diagnosis, gender and age. Protective variables were evaluated with: Brief COPE questionnaire, Dispositional Resilience Scale (DRS-15), Psychological Well-Being Scale (PWB-18). Psychopathological features and symptom severity were assessed with: Global Assessment of Functioning Scale (GAF), Rapid Dimensional Assessment Scale (SVARAD), Brief Psychiatric Rating Scale (BPRS), Clinical Global Impressions (CGI), Hamilton Depression Rating Scale (HDRS17). The DRS-15 total score was significantly lower in SA makers. SA makers displayed significantly lower scores on the Engagement and Cognitive Restructuring subscales of the Brief COPE. On the PWB-18, the Self-Acceptance subscale score was lower in SA makers. The small sample size suggests the need for caution in interpreting the results. Matching was carried out by excluding diagnoses of personality disorders. Patients hospitalized following a SA are more often diagnosed with personality disorders, have deficit areas concerning resilience and coping, and lower psychological well-being compared to patients without a SA. When approaching a patient who has committed a SA, it may be useful to evaluate protective variables as well as risk factors, and encourage the development of adaptive coping mechanisms and positive self-evaluation through more dynamic therapeutic paths. • Research on suicide have focused mainly on risk factors. • Risk factors are weak and inaccurate predictors of new suicide attempts. • Is necessary to carry out a comprehensive evaluation of protective factors for suicide. • Resilience, coping e psychological well-being are deficit areas of patients who attempt suicide. • Adaptive coping mechanisms and positive self-evaluation must be strengthened. [ABSTRACT FROM AUTHOR]

This study aimed to explore the experiences of peer interactions among LGBTQA+ young people in Australia. 22 verbatim transcriptions from semi-structured interviews with LGBTQA+ young Australians aged 16–24 were analyzed using Reflexive Thematic Analysis. Four themes were developed; (1) Online safety and anonymity facilitate identity exploration, (2) the risks and benefits of online support, (3) the risks and benefits of in-person peer support, and (4) gender and sexuality diverse experiences of peer support differ. These findings illuminate that both online and in-person peer support play an important role in the lives of young LGBTQA+ Australians with our findings indicating that rather than an either-or approach, online and in-person peer support predominately follows a sequential pattern in the development of their identity and sense of acceptance and belonging. Whilst the anonymity of online spaces acts as a catalyst for exploration of gender identity and sexuality, once assured of their identity, in person peer support allows LGBTQA+ young people to feel more connected to others in real life. These findings provide a strong rationale for future research into the differences between subgroups of the LGBTQA+ community and for policies and interventions to increase the safety of online and accessible offline community spaces. [ABSTRACT FROM AUTHOR]

Introduction: Numerous early-life risk factors are thought to significantly contribute to the development of psychological problems in toddlerhood. However, these factors have seldom been investigated concomitantly and longitudinally, and few studies include both mothers and fathers. This study examines the longitudinal impact of early environmental, parental, and child-specific risk factors on children's internalizing and externalizing symptomatology at age 4. Methods: Families were recruited from a perinatal center at birth and completed self-report questionnaires at birth, 4 weeks postpartum, 6 months postpartum, and annually thereafter. The final population-based sample consisted of n = 560 mothers (and fathers) who gave birth after June 2015, with children who turned 4 years old before March 31, 2021. The primary outcomes, children's internalizing and externalizing symptomatology at age 4, were measured using the Strengthsand Difficulties Questionnaire. Linear mixed effect models were used to estimate growth curves for predictors between 4 weeks and 4 years postpartum, which were subsequently entered into multivariable linear regressions to predict internalizing and externalizing symptomatology at age 4. Results: The study identified several key risk factors: environmental (lack of social support, lower parental education, male sex), parental (poor parental mental health, increased parenting stress, parental sleep difficulties) and child-specific (children's low physical health, children's reduced sleep quality, temperament). Discussion: The findings underscore that most identified risk factors are related to children's temperament, mental and physical health of parents, their experienced stress, and families' social support networks. These insights highlight the importance of targeted interventions focusing on improving parental mental health, reducing stress, and enhancing social support to mitigate early-life psychological problems in children. [ABSTRACT FROM AUTHOR]

Objective: To compare the differences in clinical-related factors between patients with type 2 diabetes (T2DM) and those without diabetic retinopathy (DR) and to explore the risk factors or protective factors affecting DR in T2DM patients. Methods: We performed a retrospective analysis of 380 patients with type 2 diabetes admitted to Handan Central Hospital from June 2023 to May 2024. Clinical data collected included baseline characteristics, hematological tests, metabolic indicators, and information on diabetic complications and comorbidities. Results: Our findings identified intervention, neck vascular disease, bilateral lower limb venous thrombosis, high creatinine, high glomerular filtration rate, high chloride, high fasting C-peptide, and high lactate dehydrogenase as risk factors for DR. In contrast, High 2-hour postprandial C-peptide is a protective factor for diabetic retinopathy. A logistic regression model was constructed using stepwise regression to predict DR occurrence, achieving an accuracy of 0.80 and an AUC of 0.83. [ABSTRACT FROM AUTHOR]

Housing instability is associated with numerous poor child outcomes in domains such as behavioral and emotional problems. The impacts of housing instability on child outcomes are typically investigated in the context of sociodemographic risk; however, exploring the role of protective factors (e.g., family routines, parental warmth) in these contexts allows for a more thorough understanding of the effect of housing instability and how potential negative outcomes might be mitigated. The present study further explored the relation between early housing instability and child behavioral and emotional outcomes in middle childhood in addition to the potential moderating role of family routines and parental warmth in early childhood. Longitudinal data of 4,898 families from the Future of Families and Child Wellbeing Study were used to explore these associations. Using structural equation modeling, the present analyses indicated that when controlling for key sociodemographic covariates, housing instability in early childhood was not related to child outcomes at age 9. Greater parental warmth at age 5 was significantly associated with lower levels of behavioral and emotional problems at age 9. Categorical models using the product indicator approach indicated that greater parental warmth attenuates the relation between moving one to two times and later child behavioral problems. Parental warmth emerged as a significant promotive factor for later child emotional problems. Further implications are discussed below. [ABSTRACT FROM AUTHOR]

Exposure to war is linked to negative mental health outcomes. Self-compassion and emotional intelligence may foster post-war adjustment processes differently depending on the time since the event happened. This study examines post-traumatic stress symptoms (PTSS) in civilians exposed to the 2020 Nagorno-Karabakh war shortly after and 6 months post-conflict, while investigating self-compassion and emotional intelligence's protective role. War-exposed civilians self-reported on PTSS, self-compassion, and trait emotional intelligence at two phases. Results showed greater PTSS shortly after war relative to 6 months later. Lower self-compassion scores were related to more PTSS at the first phase, whereas lower emotional intelligence was associated with more symptoms 6 months later. These data show how war-exposed Armenians coped, highlighting individual characteristics' effects, and suggest varying resource utilization during post-war adjustment. Specifically, self-compassion may be a protective factor shortly after war, whereas emotional intelligence may protect individuals against having adverse health outcomes later on. [ABSTRACT FROM AUTHOR]

Adverse childhood experiences (ACEs) may result in long-term mental health complications, including post-traumatic stress disorder (PTSD). ACEs are known to be more frequent among military personnel, despite their need to maintain their mental health to accomplish their missions. Self-compassion, or treating oneself with kindness and understanding, can mitigate the psychological effects of adversity but is also affected by adversity. This cross-sectional study aimed to identify the complex relationships between ACEs, self-compassion, and PTSD symptoms among 752 new recruits of the Japan Air Self-Defense Force, of whom 537 with ACEs completed the PTSD Checklist for DSM-5. Hierarchical multiple regression analysis was used to examine the independent effect of self-compassion, measured using the Self-Compassion Scale, on PTSD symptoms. Mediation effect analysis with self-compassion as a mediator was conducted on the relationship between ACEs and PTSD symptoms. We confirmed high levels of ACEs among our participants compared to a healthy population of a previous study, and approximately 6% presented PTSD symptoms above a threshold. Self-compassion was significantly negatively associated with PTSD symptoms (β = −.22, 95% confidence interval [CI], −.34 to −.11). Mediation effect analysis revealed that self-compassion partially mediated the relationship between ACEs and PTSD symptoms, explaining 6.9% of this effect, and ACEs were negatively associated with self-compassion (β = −.13, 95% CI, −.22 to −.04). These findings suggested that self-compassion is a protective factor against PTSD symptoms, whereas ACEs can decrease self-compassion. Further research should explore educational interventions to enhance self-compassion among individuals with ACEs to mitigate PTSD symptoms. • We confirmed a relationship between ACEs, PTSD symptoms, and self-compassion. • Approximately 6% of the JASDF recruits presented PTSD symptoms above the threshold. • Self-compassion showed protective effects against PTSD symptoms induced by ACEs. • PTSD symptoms were partially explained by reduced self-compassion due to ACEs. [ABSTRACT FROM AUTHOR]

Objective: This study's purpose was to determine if COVID-related stress predicted suicide risk among college students and if this risk was attenuated by higher levels of social and psychological resources. Participants: The sample included 65,142 college students who participated in the National College Health Assessment survey in Spring 2021. Methods: SPSS PROCESS was used to test the association between COVID-related stress and suicide risk while controlling for demographic covariates and to determine the potential stress-buffering roles of social connectedness, resiliency, and psychological well-being. Results: Higher levels of COVID-related stress predicted increased suicide risk yet this risk was attenuated when social connectedness, resiliency, and psychological flourishing were greater. Conclusions: Findings indicate that efforts to increase social connectedness, resiliency, and psychological flourishing could help reduce the risk of college students' suicidality under conditions of high COVID-related stress. [ABSTRACT FROM AUTHOR]

Aims: To describe how workplace violence (WPV) is experienced by nurses in hospitals and community services and identify protective and risk factors. Methods: An online cross‐sectional national study was conducted from January to April 2021 in Italy. Hospitals and community services were involved in the study. The survey combined the adapted and validated Italian version of the Violence in Emergency Nursing and Triage (VENT) questionnaire, which explores the episodes of WPV experienced during the previous 12 months, the Practice Environment Scale of the Nursing Work Index (PES‐NWI) and some additional questions about staffing levels extracted from a previous RN4CAST study. Nurses working in all clinical settings and community services were invited to participate in the survey. Descriptive and inferential statistics were used for data analysis. We adhered to the STROBE reporting guidelines. Results: A total of 6079 nurses completed the survey, 32.4% (n = 1969) had experienced WPV in the previous 12 months, and 46% (n = 920) reported WPV only in the previous week. The most significant protective factors were nurses' age, patients' use of illegal substances, attitude of individual nurses and considering effective the organization's procedures for preventing and managing episodes of violence. The most significant risk factors included workload, recognizing violence as an inevitable part of the job, patients' cultural aspects and patients' agitated behaviour. The frequency of WPV was significantly higher in certain areas, such as the emergency department and in mental health wards. Conclusion: Workplace violence (WPV) against nurses is a very frequent and concerning issue, especially in hospitals and community services. Based on our findings, integrated and multimodal programmes for prevention and management of WPV are recommended. More attention and resources need to be allocated to reduce WPV by improving the quality of nurses' workplace environment and implementing violence‐free policies for hospitals. Implications for the Profession and/or Patient Care: Impact: Workplace verbal and physical violence is a widespread phenomenon, both in hospital and community settings, and even during COVID‐19 pandemic. This problem is exacerbated by the lack of effective reporting systems, fear of retaliation and the tendency to consider violence as an inevitable part of the job.The characteristics of professionals, patients, work environment and organizational factors are involved in the spread of workplace violence, determining its multifactorial nature. Integrated and multimodal programmes to prevent and manage of workplace violence are probably the only way to effectively counteract workplace violence against nurses.Healthcare policymakers, managers of hospital and community services need to proactively prevent and effectively manage and monitor episodes of violence. Nurses need to feel protected and safeguarded against any form of verbal or physical violence, to provide high‐quality care in a totally safe environment. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Background: Aboriginal and Torres Strait Islander young people experience markedly higher suicide mortality than non-Indigenous youth in Australia, yet there is little evidence of effective preventative strategies. Many are misaligned to the needs of First Nations young people due to a lack of consideration of protective factors such as community and cultural connection. Objective: To date no research has examined whether increasing cultural connectedness may reduce Aboriginal and Torres Strait Islander youth suicidality. The current study outlines the development, implementation, and pilot evaluation of Project Yarn Circle, a school-based suicide prevention initiative utilising cultural education and connection. Method: Project Yarn Circle was piloted by an Indigenous owned and managed youth mental health organisation, delivering 5 weekly sessions to 276 young people at 9 schools in Southeast Queensland, Australia, between 2019 and 2023. Sessions connected students to cultural knowledge and practices (stories, painting, dance, Indigenous languages) with Elders and local cultural knowledge facilitators. Results: Pre- and post-program evaluation questionnaires completed 6–8 weeks apart found that participants had significantly lower suicidal ideation (GHQ-18-SS), pre 7.16, post 6.61, p =.043 higher positive ideation/reasons for living (PANSI-PI) pre 22.44, post 23.60, p =.009, and higher self-esteem (RSES) pre 16.55, post 23.60, p =.005. Analyses of cultural connectedness items co-designed for this evaluation study and validated using Exploratory Factor Analysis found that students demonstrated greater cultural identity clarity, peer cultural competence, strength from culture, salience of cultural continuity and sense of belonging. Conclusions: These findings provide new evidence towards utilising cultural connectedness as an intervention mechanism in Indigenous youth suicide prevention. KEY POINTS: What is already known about this topic: Aboriginal and Torres Strait Islander youth suicide rates are persistently higher than for other young people, with little evidence of effective suicide prevention strategies. Interventions often are misaligned to the different risk and protective factors experienced by First Nations young people. Connection to culture is promoted as a unique protective factor to reduce suicide risk for First Nations young people. What this topic adds: To our knowledge this is the first published cultural engagement intervention to report significant improvement in Aboriginal and Torres Strait Islander youth suicidality, providing an example of the development and delivery of a new program approach. This is the first study to explore increases in connection to culture in conjunction with lowered suicidal ideation and higher reasons for living. The findings suggest that connection to culture can be used as a therapeutic mechanism to reduce suicidality. [ABSTRACT FROM AUTHOR]

Background: Suicide is among the leading cause of death in adolescence and suicidal ideation is its most critical precursor. Suicidal ideation being a complex phenomenon involving multiple factors, this study aimed to use network analysis to depict the interplay of risk and protective factors for suicidal ideation. Methods: An online survey was conducted with 614 Saudi adolescents (mean age = 16.16, SD = 1.88, range = 12–18, 61% female). Participants completed instruments to assess suicidal ideation, bullying victimization and perpetration, psychache, family cohesion and adaptability, positive parenting, and multidimensional social support. A psychological network analysis was estimated to determine the most central risk and protective factors for suicidal ideation. Results: As per strength and expected influence centrality, the risk factors that were central were psychache and bullying victimization, and the central protective factors were family cohesion and support from significant other. The network analysis showed that other factors directly connected with suicidal ideation were bullying perpetration, family adaptability, positive parenting, support from family, and support from friends. Conclusion: This network study highlights the importance of addressing both risk and protective factors in an attempt to deal with suicidal ideation. The findings suggest that interventions targeting psychological pain, bullying, and family bonds may be crucial in the treatment and prevention of suicidal ideation among adolescents. [ABSTRACT FROM AUTHOR]

Purpose: Intimate partner violence is a global public health problem that mainly affects women rather than men. It has been associated with negative physical and mental health outcomes, including experiences of revictimization. This systematic review describes the risk and protective factors associated with revictimization in female victims of intimate partner violence. Methods: We searched for articles published between 1995 and 2024 in the Scopus, Web of Science, and PsycINFO databases. In total, 925 studies that met the inclusion criteria were reviewed, of which 38 were evaluated as eligible, and 12 were finally included in the review. Results: Among the risk factors were mental health problems, some demographic characteristics of the victims, previous experiences of violence, and coping and attachment styles. Economic independence, empowerment, and restraining orders were protective factors. Conclusions: Based on the results, we present some practical implications for health and public policy as well as recommendations for directing future research into revictimization. [ABSTRACT FROM AUTHOR]

Purpose: Combat deployment increases exposure to potentially traumatic events. Perceived social support (PSS) may promote health and recovery from combat trauma. This systematic review and meta-analysis aimed to synthesize studies investigating the level of PSS and associated factors among (ex-)military personnel who served in the Iraq/Afghanistan conflicts. Methods: Five electronic databases were searched in August 2023 and searches were restricted to the beginning of the Iraq/Afghanistan conflicts in 2001. The search was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A quality assessment was carried out, and a meta-analysis and narrative synthesis were performed. Results: In total, 35 papers consisting of 19,073 participants were included. Of these, 31 studies were conducted in the United States (US) and 23 were cross-sectional. The pooled mean PSS score was 54.40 (95% CI: 51.78 to 57.01). Samples with probable post-traumatic stress disorder had a lower mean PSS score (44.40, 95% CI: 39.10 to 49.70). Approximately half of the included studies (n = 19) investigated mental health in relation to PSS, whilst only four explored physical health. The most frequently reported risk factors for low PSS included post-traumatic stress disorder, depression and anxiety, whilst post-traumatic growth and unit support were protective factors. Conclusion: Higher levels of PSS were generally associated with more positive psychosocial and mental health-related outcomes following deployment. PSS should be targeted in psychosocial interventions and education programmes. Future research should investigate PSS in (ex-)military personnel across other countries and cultures, based on the lack of studies that focused on PSS in countries outside of the US. [ABSTRACT FROM AUTHOR]

Background: School engagement is a positive, malleable aspect of youth functioning that may be influenced by familial factors. Both risk and protective factors may affect youth's school engagement. Objective: Utilizing an intergenerational transmission of risk framework, the current study examined how maternal factors (i.e., maternal psychopathology, maternal trauma history, maternal education) and youth factors (i.e., social support) relate to school engagement. Methods: Participants were 117 youth of color aged 8–13 years (Mage = 9.96, SD = 1.40), 51% female, 89% Black or African American and their female primary caregivers; all families had experienced adversity. Using a single-group, cross-sectional design, hierarchical linear regression models examined direct and interactive effects. The first block included maternal psychopathology (i.e., anxiety or depression), maternal trauma history, maternal education, and child social support. The second block added the interaction between maternal psychopathology and child social support. Results: Results revealed a direct, positive relation between child social support and school engagement. Social support also moderated the association between maternal anxiety and school engagement; for individuals with extremely low social support, higher maternal anxiety was related to lower school engagement. Conclusions: Results illustrate the value of an intergenerational approach to exploring how maternal factors have implications for youth functioning. Findings also highlight the importance of social support among families of color exposed to adversity. Limitations include the cross-sectional design; thus, future research would benefit from longitudinal examination of maternal and child factors related to school engagement to assess temporal and directional effects. [ABSTRACT FROM AUTHOR]

The aim of this study is to identify both protective and risk factors that serve as predictors of bullying victimisation among Indonesian children. This study uses data from the Children's Worlds survey in Indonesia on 10- and 12-year-old children (N = 14,576; 49.35% boys; 47.05% 10-year-olds) who reported whether they had been bullied at home or in school in the past month. Data were analysed using binary logistic regression. Five bullying victimisation indicators (at home and at school) were employed as dependent variables, namely being hit by siblings, being called unkind names by siblings, being hit by other children in school, being called unkind names by other children in school and being left out by other children in the class. There were also five groups of independent variables: sociodemographic variables; three groups of perception variables about family, friends and school, which are measured through an agreement scale; and reported fights among children at school, measured through a frequency scale. Among the factors that increase the probability of the different types of bullying victimisation are not getting along well with friends, fights between children at school and frequent arguments between children in the class. In contrast to the other four bullying victimisation indicators, the likelihood of boys being left out by other children in the class is much lower than for girls. A negative school climate increases the odds of children being victimised at school. These results are of interest to parents, teachers and policymakers who seek to develop actions to decrease the likelihood of bullying incidents and to protect children from being victimised. [ABSTRACT FROM AUTHOR]

This paper delves into the experiences and protective factors contributing to integration of highly skilled African immigrants (HSAIs) into the Quebec labour market. Despite the Canadian government's considerable efforts to attract and retain skilled immigrants to promote its economic prosperity, challenges persist for these individuals as they navigate the complexities of the Canadian labour market. While most of the existing studies have focused on these challenges, this paper centers on the key protective factors for the success of HSAIs in Quebec. Drawing on in-depth semi-structured interviews (n = 16) with HSALs, this paper uncovers the multifaceted landscape of labour market integration for HSAIs. The findings reveal that, although a majority of participants encounter barriers preventing them from fully utilizing their skills, education, and experience, they often overcome these barriers by leveraging protective factors such as being in high-demand job sectors, receiving familial support, benefiting from social networks, possessing bilingual proficiency, and engaging in mentorship programmes. This paper highlights the urgent need for evidence-based policies to ensure employment opportunities commensurate with the academic qualifications and professional skills for highly skilled immigrants in Canada, particularly HSAIs. These policies should not only recognize protective factors but also prioritize building resilience and addressing systemic labour market barriers. [ABSTRACT FROM AUTHOR]

In response to the growing need for trauma-informed teaching, more teacher education programs are incorporating trauma-informed content to prepare preservice teachers for their future classrooms. For this study, we examined student coursework and clinical experiences related to student trauma and trauma-informed teaching with a group of preservice teachers (N = 25). A thematic analysis of written reflections and interviews revealed deficit-based ideologies connected to student trauma with minimal attention directed at student strengths and resilience. Preservice teachers viewed student trauma in relation to behavioral issues, as circumstances that teachers have to deal with, and as a result of family and community deficiencies. A few students recognized trauma in relation to resilience by viewing schools and teachers as a protective factor. Informal stories shared by cooperating teachers appeared to feed these deficit views, as well as some course-related materials and projects. Recommendations for teacher educators are discussed. [ABSTRACT FROM AUTHOR]

Prostate cancer (PCa) is the second most common malignancy affecting men globally. Recent advances in metabolomics have highlighted significant alterations in specific amino acid (AA) metabolism linked to PCa, indicating their potential utility in diagnosis and therapy. However, no direct causal association between serum AA levels and PCa risk has been established. A total of 35 patients with PCa and 30 individuals with benign prostatic hyperplasia (BPH) were recruited for this study. Targeted metabolomic analysis was performed using ultra-high-performance liquid chromatography-tandem mass spectrometry on serum samples. Two-sample Mendelian randomization (MR) was applied to explore potential causal links between serum AA levels and PCa risk, including mediator effects using dual-phase MR and assessing reverse causality through reverse MR. Results Targeted metabolomic profiling identified six amino acids—glutamate (Glu), Ser, histidine (His), arginine (Arg), aspartic acid (Asp), and glycine (Gly)—that showed significant area under the ROC curve in differentiating between BPH and PCa cases. Notably, Glu demonstrated an inverse association with PCa risk, distinct from the other AAs identified. However, definitive evidence supporting a causal relationship between low Glu levels and increased PCa risk was not observed. Our results suggest a protective role of Glu against PCa development, which may have implications for disease prognosis. Increasing dietary Glu intake may present a potential preventive or therapeutic approach for PCa. [ABSTRACT FROM AUTHOR]

Risk and protective factors for psychiatric illnesses are linked to distinct structural and functional changes in the brain. Further, the prevalence of these factors varies across sexes and genders, yet the distinct and joint effects of sex and gender in this context have not been extensively characterized. This suggests that risk and protective factors may map onto the brain and uniquely influence individuals across sexes and genders. Here, we review how specific risk (childhood maltreatment, the COVID-19 pandemic, experiences of racism), and protective factors (social support and psychological resilience) distinctly influence the brain across sexes and genders. We also discuss the role of sex and gender in the compounding effects of risk factors and in the interdependent influences of risk and protective factors. As such, we call on researchers to consider sex and gender when researching risk and protective factors for psychiatric illnesses, and we provide concrete recommendations on how to account for them in future research. Considering protective factors alongside risk factors in research and acknowledging sex and gender differences will enable us to establish sex- and gender-specific brain-behavior relationships. This will subsequently inform the development of targeted prevention and intervention strategies for psychiatric illnesses, which have been lacking. To achieve sex and gender equality in mental health, acknowledging and researching potential differences will lead to a better understanding of men and women, males and females, and the factors that make them more vulnerable or resilient to psychopathology. Plain English summary: Exposure to different environments and distinct lived experiences for individuals across the sexes and genders have unique effects on mental wellbeing, brain structure, and function. These differences in outcomes arise from interdependent effects of biology and socio-culture and can be challenging to separate. This review describes sex- and gender-specific effects of negative and positive environmental experiences, known as risk and protective factors. Specifically, we review current sex- and gender-specific findings for childhood maltreatment, the COVID-19 pandemic, experiences of racism, social support, and resilience. Risk and protective factors, and sex and gender have bidirectional influences, and our review outlines their dynamic, interconnected and intersectional nature. Including sex and gender as a variable of interest will enable us to capture specific effects that may have previously gone undetected. More broadly, implementing the outlined considerations will lead to more inclusive and representative research that can deliver robust findings and meaningfully propel the field forward. Highlights: Unique effects of sex and gender on brain and behavior necessitate the investigation of these factors as a variable of interest in research. Protective factors should be considered alongside risk factors for a more holistic understanding of mental wellbeing. Investigating sex and gender influences will help detect findings that would have otherwise been overlooked. Risk factors, protective factors, sex, and gender all have bidirectional influences on each other. [ABSTRACT FROM AUTHOR]

ABSTRACT Aim Design Data Sources Review Methods Results Conclusions Impact Reporting Method No Patient or Public Contribution To examine current evidence on health‐related quality of life and its associated factors in women with metastatic breast cancer over the past 10 years.An integrative review.We conducted a comprehensive search across five databases: CINAHL, EMBASE, MEDLINE, PsycINFO, and Web of Science, for studies published between January 2013 and June 2023.Following the integrative review guideline, we screened full‐text papers based on the inclusion and exclusion criteria. The quality of the studies was assessed using the Joanna Briggs Institute's appraisal checklist, and the data were extracted and synthesised.Of 7316 articles, 25 studies met the inclusion criteria. Most of the participants were non‐Hispanic white women from the United States or Europe. Various instruments were used to assess health‐related quality of life. The key factors included sociodemographic and clinical characteristics, physical symptoms and function, disease stability and progression, and psychological attributes. Although targeted agents and immunotherapy are common therapies today, data on their side effects and health‐related quality of life remain limited. Literature gaps included a lack of racially diverse samples, an absence of data on protective factors, and limited insights into symptom experience with novel therapies.Physical and psychological symptoms were still the major influencing factors. Clinicians should prioritise symptom management in women. Future research is needed to increase racial diversity in the study and explore novel agents related to symptoms and protective factors that may improve health‐related quality of life.Women with metastatic breast cancer experience compromised health‐related quality of life. Understanding which factors influence their quality of life, particularly those on novel therapies is critical for providing high‐quality, individualised care and developing targeted interventions to improve their well‐being.PRISMA.This integrative review does not need patient or public contribution. [ABSTRACT FROM AUTHOR]

The benign dermatological hair condition Alopecia Areata (AA) is known to impair Quality of Life (QoL), especially mental and social health, due to the accompanying visible appearance changes. Previous studies have identified demographic, clinical, social, and psychological variables related to QoL. Yet, the novelty of this study lies in examining how QoL differences in AA relate to (combinations of) these variables. The aim of the current study is to identify and characterize subgroups of AA persons with less or more QoL impairment by means of (combinations of) demographic, clinical, psychological, and social factors, including both potential risk (perceived stigmatization, avoidant coping, physical identity definition) and protective factors (disclosure, social support, emotion-focused coping and non-physical identity definition). An online questionnaire was filled out by 322 persons with AA, including the Dermatology Life Quality Index (DLQI) as QoL measure, Perceived Stigmatization Questionnaire (FSQ), brief COPE, Social Support Survey, a newly developed identity-definition measure, clinical characteristics, and demographics. Classification and Regression Tree (CART) analysis identified subgroups based on QoL outcome. Lowest QoL impairment was found in persons with low feelings of being flawed combined with low secretiveness. Low QoL impairment was also found in persons feeling flawed combined with low avoidant coping, low sensitivity to others’ opinions and older age. QoL impairment was intermediate in persons perceiving more social support in those with a younger age, and defining identity less on physical appearance in those sensitive to others’ opinions. Highest QoL impairment was characterized by feeling flawed combined with an avoidant coping style. Current findings provide indications for the identification of risk and protective profiles for QoL impairment and which factors to address in interventions to improve QoL in AA. [ABSTRACT FROM AUTHOR]

IntroductionObjectiveMethodResultsConclusionEach year, over 700,000 people die by suicide worldwide, and far more attempt and are impacted by the outcome. Agriculture is one of the most dangerous industries in which to work; it is also exposed to a lot of external stressors, such as climatic conditions, market forces (both input and output) and government regulation, as well as internal such as employment and of staff, multiple skills required and isolation. These stressors contribute to the higher rate of farm suicide cases. While there is growing evidence of the protective circumstances (factors) that protect against suicide and suicidality, more needs to be done in the agricultural sector.To review global literature and consolidate the current knowledge regarding protective factors against suicide and suicidality in agricultural communities and elucidate the implications of these findings.A systematic scoping review following the Preferred Reporting Items for Systematic Scoping Reviews (PRISMA-Sc). A range of databases was searched for the terms “suicide*” or “suicidal behavior”, “suicide attempt”, or “suicidal ideation”, or “suicidality”, and “farm*” or ‘agricultural worker*’ or ‘rancher*’ and ‘protective factors’ or protect”. Paper included had to be peer reviewed in English, include people living, working in or with agriculture or lived in an agricultural area.Fourteen studies met the study criteria, predominately (72%) from the United States of America and Australia. Four (29%) articles discussed individual coping mechanisms and self-reliance as protective factors against suicide and suicidality, while six (43%) described the influence of social support and perceived sense of belonging on suicide risk. Five (36%) papers examined the association between health-promoting and suicide-prevention initiatives as protective factors in agricultural communities.There is limited, however, growing literature about protective factors for the prevention of suicide in agriculture; however, it is skewed to high-income countries. This review demonstrates a link between the development of individual coping skills as a protective factor against suicide in agricultural communities, with a primary focus on farming occupations within this setting. Social support was found to help reduce suicide risk by increasing a sense of belonging. These need to be exploited to drive down suicide rates. [ABSTRACT FROM AUTHOR]

This study investigates the relationship between risk and protective factors and suicidal ideation among teachers, a group often overlooked in suicide prevention efforts. Using the diathesis-stress model as a partial framework, the research explores how depression and anxiety, as risk factors, and emotional intelligence, resilience, and positive thoughts, as protective factors, influence suicidal ideation. A cross-sectional design was employed, involving 1,270 Spanish teachers (median age: 46, 70.2% female). Key measures included the Positive and Negative Suicidal Ideation scale (PANSI), the Brief Emotional Intelligence Scale (BEIS-10), the Brief Resilient Coping Scale (BRCS) for resilience, and the General Health Questionnaire (GHQ-12) for depression and anxiety. A network approach was used to examine the relationships between these variables. Results showed that depression had a stronger relationship with negative ideation than anxiety, while emotional intelligence and positive thoughts acted as protective factors. Positive ideation was negatively associated with depression and anxiety, and positively linked to emotional intelligence and resilience. Emotional intelligence emerged as the most critical protective factor. These findings provide valuable evidence to inform the development of emotional management and resilience-building programs aimed at enhancing teachers' mental health and performance, which could also indirectly benefit students. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Adverse childhood experiences (ACEs) are associated with mental health problems, but many children who experience ACEs do not develop such difficulties. A warm and supportive adult presence in childhood is associated with a lower likelihood of developing mental health problems after exposure to ACEs. However, it is unclear whether this association is causal, as previous research has not accounted for genetic and environmental confounding.We used the twin‐difference design to strengthen causal inference about whether a warm and supportive adult presence protects children exposed to ACEs from mental health problems. Participants were from the Environmental Risk (E‐Risk) Longitudinal Twin Study, a UK population‐representative birth cohort of 2,232 same‐sex twins. ACEs were measured prospectively from ages 5 to 12. Maternal warmth was assessed at ages 5 and 10 through maternal speech samples. Adult support was assessed through child reports at age 12. Mental health problems were assessed through interviews at age 12 with parents and teachers and participants at age 18.Among children exposed to ACEs, those who experienced greater maternal warmth and adult support had lower levels of mental health problems at ages 12 and 18. In monozygotic twin‐difference analyses, the protective effects of maternal warmth and adult support on mental health were attenuated by 70% for maternal warmth and 81% for adult support, compared to phenotypic analyses. Twins who experienced greater maternal warmth and adult support had minimal or no difference in mental health compared to their co‐twins, concordant for ACE exposure.The apparent protective effect of a warm, supportive adult against mental health problems following ACEs is largely explained by genetic and environmental confounding. This suggests that interventions which boost maternal warmth and adult support should be supplemented by components addressing wider family environments and heritable vulnerabilities in children exposed to adversity, to improve mental health. [ABSTRACT FROM AUTHOR]

There is growing awareness and empirical support for targeting strengths and resilience when providing services to youth and families who have been impacted by adverse childhood experiences (ACE) and trauma. The purpose of this article is to highlight strengths-based, resilience-enhancing (SBRE) clinical applications that can be incorporated into ACE-informed therapeutic services. Twenty treatment components are described and organized into six main categories that chronicle the course of therapy: Relationship Development, Stabilization, Engagement, Assessment, Intervention, and Prevention. SBRE services assist youth in adaptively coping with life adversity, and acquiring the knowledge, skills, and strengths for leading psychologically healthy, resilient lives. It is hoped this article will stimulate interest from both clinicians and researchers regarding the SBRE model, which is being introduced here for the first time. [ABSTRACT FROM AUTHOR]

AbstractThe unprecedented events on October 7th in Israel, characterized by little actual and perceived control over the sources of the stress, have affected virtually every household in Israel, either due to the economic and social consequences of the ensuing war or experiencing the loss of relatives and friends. The current study examined the association between traumatic loss of close friends/relatives and resilience during the initial stages of the Iron-Swords war and explored the moderating role of coping strategies for this link. Data were collected from 286 participants (age range 19-82) who completed online scales assessing loss, resilience, and coping strategies during the first weeks of the Iron-Swords war. Results demonstrated a negative association between emotion-focused coping and resilience, as well as a positive association between problem-focused coping and resilience. Moreover, coping strategies moderated the loss-resilience link, which was significant only for individuals reporting low levels of both problem-focused and emotion-focused coping. Our findings support the claim that relying on at least one dominant coping strategy (i.e., problem-focused coping/emotional-focused coping/both) is efficient to reserve resilience levels at times of adversity. The findings of the current study, based on data collected in the first weeks of the Iron-Swords war, highlight the value of different coping styles in preserving individual resilience as a protective factor against stress during adversity. [ABSTRACT FROM AUTHOR]

ABSTRACT In this study, the attachment and resilience levels of 60‐ to 72‐month‐old Turkish girls and boys were examined in terms of certain demographic characteristics, and the predictive role of attachment on resilience was investigated while controlling for these characteristics. The study was structured as a descriptive study within the scope of quantitative research methods of the survey model. Participants consisted of 361 children and 73 teachers. We collected the data for the study administering the Incomplete Stories with Doll Family Scale to each child for approximately 20 min by the researcher and having teachers complete the Preschool Period Resilience Scale. Independent samples t‐tests, one‐way analysis of variance (ANOVA) and multiple regression analysis were applied. In the study, the least observed attachment style in children was negative, followed by secure, with avoidance the most prevalent. While the child's gender, parental education level and socio‐economic status explained 14% of resilience, it was determined that the attachment variable explained 57.9% of the variance in resilience when common independent variables were controlled. The results of the study highlight the significance of the impact of attachment styles on the resilience of young children. [ABSTRACT FROM AUTHOR]

Background: Intestinal infectious diseases (IIDs) can impact the growth and development of children and weaken adults. This study aimed to establish a spatial panel model to analyze the relationship between factors such as population, economy and health resources, and the incidence of common IIDs. The objective was to provide a scientific basis for the formulation diseases prevention measures. Methods: Data on monthly reported cases of IIDs in each district and county of Zhejiang Province were collected from 2011 to 2021. The spatial distribution trend was plotted, and nine factors related to population, economy and health resources were selected for analysis. A spatial panel model was developed to identify statistically significant spatial patterns of influencing factors (P < 0.05). Results: The results revealed that each type of IIDs exhibited a certain level of clustering. Each IIDs had a significant radiation effect, HEV (b = 0.28, P < 0.05), bacillary dysentery (b = 0.38, P < 0.05), typhoid (b = 0.36, P < 0.05), other infectious diarrheas (OIDs) (b = 0.28, P < 0.05) and hand, foot and mouth disease (HFMD) (b = 0.39, P < 0.05), indicating that regions with high morbidity rates spread to neighboring areas. Among the population characteristics, density of population acted as a protective factor for bacillary dysentery (b=-1.81, P < 0.05), sex ratio acted as a protective factor for HFMD (b=-0.07, P < 0.05), and aging rate increased the risk of OIDs (b = 2.39, P < 0.05). Urbanization ratio posed a hazard factor for bacillary dysentery (b = 5.17, P < 0.05) and OIDs (b = 0.64, P < 0.05) while serving as a protective factor for typhoid (b=-1.61, P < 0.05) and HFMD (b=-0.39, P < 0.05). Per capita GDP was a risk factor for typhoid (b = 0.54, P < 0.05), but acted as a protective factor for OIDs (b=-0.45, P < 0.05) and HFMD (b=-0.27, P < 0.05). Additionally, the subsistence allowances ratio was a risk factor for HEV (b = 0.24, P < 0.05). Conclusion: The incidence of IIDs in Zhejiang Province exhibited a certain degree of clustering, with major hotspots identified in Hangzhou, Shaoxing, and Jinhua. It would be essential to consider the spillover effects from neighboring regions and implement targeted measures to enhance disease prevention based on regional development. [ABSTRACT FROM AUTHOR]

Voices from high achieving Black students allow the conversation to move from a deficit way of thinking to an asset-based perspective leading to greater opportunities for academic success. Through the lens of resilience theory and also through examining protective factors, this qualitative study employs an interpretative approach, enabling participants to articulate their individual experiences. Aligned with the theory of human motivation, the findings highlight the significance of Black teachers, race representation and socioeconomic background, as potential catalysts for inspiring students to leverage protective factors such as (a) locus of control, (b) parental support, (c) teacher relationships, (d) peer interactions, and (e) community and church support. By amplifying students' voices, the study contributes to existing literature, offering valuable insights into the lived experiences of Black students. These insights not only enrich academic discourse but provide practical implications for education leaders and policymakers based on the experiences of high achieving graduates. [ABSTRACT FROM AUTHOR]

This study investigated whether sleep-specific (e.g. chronotype) and traditional (e.g. resilience) protective factors were associated with reduced shift work disorder (SWD) risk and explored their role as moderators in the relationship between SWD risk and health. Shift workers (n = 126) participated in a cross-sectional study evaluating SWD risk (i.e. low vs. high; SWD-screening Questionnaire), mental health (Patient Health Questionnaire-9; Generalized Anxiety Disorder Questionnaire-7), physical health (Subjective Health Complaints Inventory), sleep (Pittsburgh Sleep Quality Index; Insomnia Severity Index; Epworth Sleepiness Scale), and protective factors (Resilience Scale; Social Provisions Scale; Survey of Perceived Organizational Support; Short Impulsive Behavior Scale; Circadian Type Inventory; reduced-Morningness-Eveningness Questionnaire). Logistic regressions revealed lower sleep languidity was associated with reduced odds (OR = 0.88 [0.79,0.96]) for having high SWD risk. Multiple regression analyses showed in shift workers with high social support or morningness, having high SWD risk was not associated with increased depression symptoms, or insomnia severity and poor sleep quality, respectively. Finally, in those with high or medium levels of perceived organizational support, high SWD risk was not associated with increased gastrointestinal and allergy complaints. Longitudinal research with larger samples is needed to confirm the moderating role of protective factors in the relationship between SWD risk and health. [ABSTRACT FROM AUTHOR]

Background International studies have revealed that numerous challenges (e.g. job demands) and opportunities (e.g. job resources as protective factors) affect the well-being of healthcare workers. Aims Building on the job demands–resources theory, we explored how job-related demands and the role of inclusive leadership as a job resource influenced the well-being of junior doctors during the coronavirus disease 2019 (COVID-19) pandemic. Methods A cross-sectional web survey was conducted in July 2022 for 82 junior doctors who had experienced the 3-year COVID-19 pandemic. The survey captured their perceived physical, psychological and COVID-19-related job demands and the inclusive leadership behaviours exhibited by their clinical unit supervisors as job resources. Data were also collected on junior doctors' experiences of burnout, compassion satisfaction and occupational commitment as variables of job outcomes. Hierarchical linear regression analysis was applied to explore the relationships between the variables. Results Physical and COVID-19-related job demands were associated with increased burnout among junior doctors. Inclusive leadership as a job resource was associated with junior doctors' reduced burnout and increased compassion satisfaction and buffered the negative effects of psychological demands on their compassion satisfaction. Only COVID-19-related job demands were associated with junior doctors' occupational commitment. Conclusions Our study highlights the critical effects of COVID-19-related job demands on junior doctors' burnout and occupational commitment. Inclusive leadership behaviours exhibited by clinical unit supervisors are a valuable job resource, which can be incorporated as one of the competencies training for medical staff. [ABSTRACT FROM AUTHOR]

Community lay leaders are critical in connecting professional services and general populations in communities. However, limited studies have explored the potential protective factors for psychological health among this group of people. In addition, based on the complex nature of spiritual health, the inconsistent findings of previous studies also suggested that different domains of spiritual health may shape psychological health differently in different contexts and among different socio-demographic groups. Therefore, we assessed the psychological health of Hong Kong community lay leaders after COVID-19 and examined the effects of different domains of spiritual health on psychological distress after controlling for age and gender. Cross-sectional data from 234 Hong Kong community lay leaders aged 18 to 84 were analyzed using structural equation modeling. The results showed that most Hong Kong community lay leaders reported moderate anxiety. In addition, personal and communal (one domain) and transcendental domains of spiritual health were negatively associated with depression, anxiety, and stress, and the environmental domain of spiritual health was positively associated with depression, anxiety, and stress. These findings imply the importance of considering both the positive and negative effects of spiritual health on psychological distress. [ABSTRACT FROM AUTHOR]

Objective: Individuals affected by cancer have an elevated risk of experiencing suicidal crises. Aligning established suicide theories with social‐cognitive theories, perceived control and related constructs emerge as potential protective factors for suicidal thoughts and behaviors in cancer patients. As perceived control is potentially modifiable, it holds great potential for prevention and intervention efforts. We aimed to comprehensively synthesize the evidence on perceived control and its link with suicidal thoughts and behaviors in cancer patients. Methods: The search term and procedures were registered in PROSPERO (CRD42023391048). We systematically searched the databases PubMed/MEDLINE, CINAHL, PsycInfo, Web‐of‐Science Core Collection, Cochrane Library, adding a grey literature search. In addition to the narrative review, pooled effect sizes, moderation and subgroup analysis were calculated. Results: The systematic search yielded 1986 original reports of which 36 were included in the systematic review and 25 in the meta‐analysis. Demoralization, help‐/hopelessness, and self‐efficacy were the most commonly studied facets of control, showing a relatively large, pooled correlation with suicidal ideation overall (r = 0.45, [95% CI = 0.38–0.52], Q = 346.15, p < 0.01, I2 = 91.2%) and across operationalisations (demoralisation: r = 52; hopelessness: r = 45; self‐efficacy: r = 0.40). Moderation analyses revealed no effect of cancer stages; but more directly cancer‐associated variables (demoralisation, hopelessness) were more closely related to suicidal ideation (QM = 5.40, p = 0.02) than general self‐efficacy. Conclusion: The findings underscore the pivotal role of perceived control in shaping severe distress in cancer patients. More studies are needed examining perceived control in a narrower sense. [ABSTRACT FROM AUTHOR]

Learning Objective: After participating in this CME activity, the psychiatrist should be better able to: * Explain current understanding of how religiosity, spirituality, and meaning-making (R/S/M) affect patients with psychiatric diagnoses. Introduction: R/S/M generally protect against suicidality and suicide. Thus far, reviews on the topic have largely been descriptive, and there are no meta-analyses focused on psychiatric patients. This study systematically evaluates all empirical evidence on R/S/M's potential influences on suicidality for psychiatric patients and recent suicide attempters. Methods: A systematic PROSPERO preregistered search following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol was performed in MEDLINE and PsycInfo. Quantitative studies until 31 December 2022 on R/S/M and suicidality in psychiatric populations and recent suicide attempters were selected; psychological autopsy studies were excluded. Results: The search identified 4,374 studies for screening. This resulted in 108 eligible studies for the systematic review and 75 studies for the meta-analysis, including 231 effect sizes (ES) and 17,561 subjects. Research focused mainly on the emotional, moral, and ritual aspects of R/S/M. Most research was cross-sectional; repeated R/S/M assessments were rarely reported. A combined significant and negative ES (Fisher Z = -0.13, p = .006, equivalent to Cohen's d = -0.26) was found for all good- and fair-quality studies. Conclusion: Overall, R/S/M was associated with lowering suicidality. Maladaptive-distressing dimensions of R/S/M correlated with higher rates of suicidality (e.g., religious struggles). The explanatory value was limited by the predominantly cross-sectional nature of ESs. [ABSTRACT FROM AUTHOR]

Objectives: Military sexual trauma (MST) is a prevalent issue among actively serving members and Veterans, and is associated with adverse health outcomes including mental disorders. This study sought to identify correlates and protective factors for the development of mental disorders among Canadian MST survivors. Methods: We analyzed data from participants of the longitudinal 2018 Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey (CAFVMHS) who experienced MST (rounded n = 455; 9.6%). A semi-structured diagnostic interview assessed MST and mental disorders in accordance with DSM-IV criteria. Multivariable logistic regressions examined associations between sample characteristics (2002 and 2018) and psychosocial factors (at baseline [i.e., 2002] and 2018) and any mental disorder since 2002. Analyses were run among the full subsample of MST survivors and additionally stratified by sex, when possible. Results: Among MST survivors, 66.5% had a mental disorder since 2002. Among the total sample, those who were officers (odds ratio [OR] = 0.58) or on active duty (OR = 0.52) had reduced odds of any mental disorder since 2002. In addition, less frequent use of avoidance coping in 2002 and 2018 (adjusted odds ratio [AOR]: 0.86, 0.64), more frequent use of active coping in 2018 (AOR = 0.64), less frequent use of self-medication coping in 2018 (AOR = 0.79), greater perceived social support in 2018 (AOR = 0.94), and reduced work stress across various domains in 2018 (AOR: 0.67–0.87) were associated with reduced odds of any mental disorder since 2002. Some variability emerged according to sex (e.g., types of work stress or coping emerging as protective). Conclusions: Results highlight certain sample characteristics and psychosocial factors that illustrated a protective relationship with mental disorders among MST survivors. Findings may inform targeted intervention strategies that could help mitigate adverse mental health impacts of MST. Plain Language Summary: Sexual trauma in the military is an important issue and negatively impacts the mental health of actively-serving members and veterans. Using data that represents the Canadian Armed Forces from 2002, and follow-up data from 2018, we examined factors that may help improve mental health in those who have experienced military sexual trauma. Nearly two-thirds of survivors of military sexual trauma had a mental health condition since 2002. Factors identified that may help improve mental health in military sexual trauma survivors included: less use of avoidance and self-medication coping, more use of active coping, increased social support, and reduced work stress. These results may help guide important treatment targets to improve mental health for survivors of military sexual trauma. [ABSTRACT FROM AUTHOR]

Objective: This study was designed to assess the relationship between mental health service utilization and heavy episodic drinking (HED) after controlling for demographic and student-level variables. Participants: A national sample of college undergraduate respondents to the 2017–2018 Healthy Minds Study survey (n = 67,427). Methods: Hierarchical logistic regression entering all variables on a single step. Subsequent logistic regression was used to assess interactions between mental health service variables and select demographic and student level variables. Results: Twenty-two demographic and student-level variables were associated with current HED (9 protective and 11 risk factors). Current mental health therapy was associated with a lower risk of current HED while mental health medication use in the past 12 months (but not currently) was associated with a higher risk of HED. Conclusions: Findings provide guidance to college/university community professionals given the responsibility of designing and implementing programs for mitigation of alcohol misuse on their campus. [ABSTRACT FROM AUTHOR]

Purpose: To identify risk and protective factors associated with physician performance in practice; to use this information to create a risk assessment scale; and, to test use of the risk assessment scale with a new population of assessed physicians. Design: Physician assessments that were completed by community-based physicians between March 2016 and February 2022 (n=2708) were gathered to determine what professional characteristics and practice context factors were associated with poor peer practice assessment (PPA). The predictive capacity of the resulting model was then tested against a new sample of physician assessments completed between March 2022 and February 2023 (n=320). Results: N=2401 physicians were eligible for inclusion in a logistic regression analysis, which resulted in an empirical model containing 11 variables that was able to account for 21.6% of the variance in the likelihood of receiving a poor PPA generated by the College of Physicians and Surgeons of British Columbia. The resulting model, when tested against 320 new cases, was able to predict good versus poor PPA performance with a sensitivity of 0.79 and specificity of 0.75. Not having undertaken peer review (OR=1.47) created a risk like that arising from a full decade passing since completion of medical school (OR=1.50). Conclusion: In addition to being the largest known study of its type, this work builds on similar studies by demonstrating the capacity to use regulator-mandated peer review to empirically identify physicians who are at risk of substandard performance using factors that are safe from claims of violating Human Rights Codes; that emphasize modifiable aspects of practice; and that can be readily updated to account for change over time. [ABSTRACT FROM AUTHOR]

Background: The "LIfestyle for BRAin health" (LIBRA) index was recently updated with three new modifiable factors: hearing impairment, social contact, and sleep (LIBRA2), but has not yet been validated. Objective: Comparison of the performance of both LIBRA versions in predicting dementia risk. Methods: Longitudinal data from the English Longitudinal Study of Ageing (ELSA) and the Maastricht Aging Study (MAAS) were used. The weighted LIBRA (11/12 factors available) and LIBRA2 (14/15 factors available) scores were calculated, with higher scores representing an unhealthier lifestyle. Dementia diagnoses were based on self- or informant reported physician diagnosis, an informant-based cognitive screening tool, registry data or test data. Cox-proportional hazards regression was used to investigate the association between LIBRA(2) scores and dementia risk. Model fit and predictive accuracy were determined using the Akaike information criterion and Harrell's C index. Results: Over an average follow-up of 8.3 years in ELSA and 17.9 years in MAAS, 346 (4.6%) and 120 (8.5%) individuals developed dementia, respectively. In ELSA, a one-point increase in LIBRA2 was associated with an 8% (1.06–1.11) higher dementia risk (LIBRA: 13%, 1.09–1.16). In MAAS, a one-point increase in LIBRA2 was associated with a 6% (1.01–1.12) higher dementia risk (LIBRA: 8%, 0.99–1.16). In ELSA, LIBRA (Harrell's C = 0.68) and LIBRA2 (Harrell's C = 0.67) performed similarly. In MAAS, LIBRA2 (Harrell's C = 0.62) performed better compared to LIBRA (Harrell's C = 0.52) Conclusions: LIBRA2 is a better model for identifying individuals at increased dementia risk and for public health initiatives aimed at dementia risk reduction. [ABSTRACT FROM AUTHOR]

Justice‐involved adolescents (JIA) are at higher risk for opioid misuse (OM) and opioid‐related overdose than nonoffending adolescents. Untreated OM can lead to severe consequences (e.g., trauma), which may be harsher for female JIA. Therefore, examining risk and protective factors, such as parental supervision, is essential to identify factors that may impact OM. The current study used a statewide, cross‐sectional dataset including 79,960 JIA from the Florida Department of Juvenile Justice. Stratified logistic regression analyses were conducted. Results indicated that JIA who experienced sporadic or inadequate supervision had 2.14 and 3.54 higher odds, respectively, of misusing opioids compared to JIA who experienced consistent supervision. Female JIA who experienced sporadic or inadequate supervision had 2.23 and 3.70 higher odds, respectively, of misusing opioids. Results suggest parental supervision is an important protective factor that should be considered in developing prevention and treatment efforts that serve JIA who misuse opioids, especially females. [ABSTRACT FROM AUTHOR]

Although numerous predictors of sexual violence (SV) have been identified, there is a need to further explore protective factors and examine the nature and strength of associations between predictors and SV outcomes using a hierarchical predictive model. Cross-sectional data from the My World Survey Post-Second Level (2019) in Ireland were used. The sample contained 8, 288 post-secondary students, 69% female, aged 18 to 25 years (M = 20.25, SD = 1.85). Univariate and multivariate binary logistic regression analyses were conducted to identify correlates of two SV outcomes (i.e., forced/pressured to have sex and being touched in a sexual manner without consent) across societal, community, relationship, and individual levels. Approximately 25% of females and 10% of males reported being forced/pressured to have sex, whereas 55% of females and 23% of males reported being touched in a sexual manner without consent. Key predictors of SV in multivariate analyses included being female and experiencing violence in a romantic relationship, whereas discrimination, living on campus or in rented accommodation (compared with living at home) were also significant predictors of both SV outcomes. Parental conflict, sexual initiation, depressive symptoms, older age, and an avoidant coping style significantly predicted being forced/pressured to have sex, whereas being bullied and engaging in problem drinking were unique predictors of being touched sexually without consent. Findings highlight the importance of considering salient risk and protective factors at the individual, relationship, community and societal level to predict SV and effectively guide the delivery of interventions and support services for post-secondary students affected by SV. [ABSTRACT FROM AUTHOR]

To assess the initial success rate and its correlated factors on cardiopulmonary resuscitation (CPR) in emergency prehospital cardiac arrest patients. The clinical information of 429 patients with cardiac arrest who underwent prehospital CPR in the fourth hospital of Hebei Medical University from Jan 2020 to Apr 2022 were evaluated. The patients were divided into the successful group (ROSC, n = 25) and the unsuccessful group (non-ROSC, n = 404) according to whether the autonomous circulation (ROSC) was resumed. The univariate analysis was performed to evaluate the differences in age, the start time of CPR, the application of electric defibrillation, and other related data between the two groups. The multivariate analysis evaluated protective factors affecting CPR's success in prehospital cardiac arrest patients. Patients with cardiogenic causes had the highest success rate of cardiopulmonary resuscitation. The causes of traffic accidents and drowning account for a low proportion. Furthermore, the median CPR length was 25.0 min, alternating from 1.5 to 64 mi. The univariate analysis revealed that age, the start time of CPR, application of electric defibrillation, and adrenaline dosage were correlated with CPR attempts (p < 0.05). Multivariate logistic regression analysis showed that the age of patients with prehospital CA, the location of prehospital CA, etiology, bystander CPR, CPR start time, defibrillation start time, tracheal intubation time, type of rhythm before resuscitation, adrenaline dosage <5 mg, and adrenaline administration time were all the influencing factors of prehospital CPR success (p < 0.01). The factors affecting CPR's success rate in prehospital CA patients are complicated. Establishing a few procedures to diminish the incidence of these risk factors is crucial. [ABSTRACT FROM AUTHOR]

Background: Past research suggests that individuals with learning disabilities experience higher levels of emotional difficulties. Objective: The aim of the current study was to investigate the relationships between specific learning disabilities (SLDs) and learning-based stress symptoms (LBSSs). Further, this study examines whether dispositional mindfulness (DM) can be used as a moderating factor for these symptoms resulting from the same stressful learning experience. Methods: The sample consisted of 133 participants (73 male) aged 23–44 years (M = 34.41; SD = 9.69). In this sample, 56 reported that they have been officially diagnosed with a SLD. Participants completed an online survey comprising a demographics questionnaire, self-report SLD questionnaire, school learning-based stress symptoms, and five-facet mindfulness questionnaire (FFMQ-24). Results: Results revealed that participants with an SLD had higher levels of LBSSs compared to the general population. Furthermore, findings revealed that DM significantly predicts LBSS levels. Conclusions: The present study provides further evidence on the impact of learning experiences on stress symptoms among individuals with SLDs, and this phenomenon we have termed as "learning-based stress symptoms". Additionally, our findings introduce novel evidence that DM may influence the relationship between LBSSs and SLDs, suggesting that a high level of DM can serve as a protective factor against these learning-based stress symptoms. [ABSTRACT FROM AUTHOR]

The aims of the current systematic review are to provide an overview of the available evidence concerning the risk and protective factors for entering organized crime groups (OCGs), to explore which entry mechanisms for entering OCGs are distinguished in the literature, and to assess whether different sets of risk and protective factors could be identified for each of these entry mechanisms. To achieve these aims, a systematic literature search for qualitative, quantitative, and mixed method studies was performed up to 19 April 2021. To be included in the current review, studies had to be of empirical nature and published in either English or Dutch. ASReview was used to facilitate the inclusion process, a reference check of the included studies was performed, and all included studies in prior reviews on this topic were checked for inclusion. This process resulted in 51 included studies. Relevant study and sample characteristics, information on risk and protective factors, and indicated entry mechanisms were derived from the included studies. In line with earlier reviews, we find relatively strong evidence that being male, belonging to an ethnic minority group, committing certain crimes prior to entry at a young(er) age, committing multiple offenses without being specialized, and having a criminally involved family and/or friends are risk factors for entering OCGs. Entering OCGs occurs via four different entry mechanisms: active recruitment, soliciting for membership, growing into and self-setup. Based on the included studies, the risk and protective factors for entering OCGs that are associated with these different entry mechanisms into OCGs seem to overlap. Although the current review provides grounds to suggest that, in addition to a general set of risk and protective factors for entering OCGs, there might be different risk and protective factors associated with different entry mechanisms, longitudinal prospective studies are needed to substantiate this suggestion. [ABSTRACT FROM AUTHOR]

Islamist radicalization is a global phenomenon and is currently a major subject of concern. Our objective is to systematically review the literature for evidence exploring risk and protective factors for and against Islamist radicalization. The following databases PsycINFO, Web of Science, Embase, PubMed and Google Scholar (complementary research) were systematically searched for English and WISO for German papers. The results of the review lend support to the notion that accumulated risk factors in the absence of protective factors may accelerate the process of Islamist radicalization. Consensus is increasing in respect to the empirical evidence that there is neither a typical set of characteristics nor a specific personality profile those individuals who come to islamistically radicalize share. Despite this heterogeneity, the current review captures eight domains of risk and protective factors for Islamist radicalization. [ABSTRACT FROM AUTHOR]

Kinship care is provided by members of a child’s extended family or friend network when they can no longer live with their parents. This study explores risk and resilience in UK school environments for students in kinship care. Eight professionals experienced in working with students in kinship care and their schools took part in individual, semi-structured interviews. Interviews focussed on kinship students’ needs and how professionals perceive schools respond to those needs. Reflexive thematic analysis generated over-arching themes indicating that: children in kinship care have multiple needs and are looked after by kinship carers who find themselves “between a rock and a hard place”; in some schools kinship care is “under the radar”; other schools respond to kinship families with the attitude of “the apple doesn’t fall far from the tree”; and in some schools kinship care is “on the agenda”. A model is presented that integrates risk and protective factors within schools, generated from this study, with risk and protective factors for kinship students within families, identified by previous literature. Implications for educational psychology (EP) practice are presented, and further research needs discussed. [ABSTRACT FROM AUTHOR]

Age-related cognitive decline has become an increasingly relevant public health issue. However, risk and protective factors of cognitive decline have yet to be investigated prospectively taking into account genetic, lifestyle, physical and mental health factors. Population-based data from middle-aged (40 to 59 years; N = 2,764) and older individuals (60 to 80 years; N = 1,254) were drawn from a prospective community cohort study using the Tower of London (TOL) planning task. Assessments were repeated at a 5-year interval to investigate age-related changes in planning performance and to determine the impact of risk and protective factors. Planning performance improved in middle-aged, but declined in older participants over 5 years. SNPs affecting the dopamine system (COMT, DRD2) and APOE polymorphisms differentially predicted cognitive performance in older vs. middle-aged individuals. For older individuals, high alcohol consumption, antidepressant medication and living without a partner had additional negative predictive power on cognition. In contrast, undiagnosed hypertension, no obstructive lung disease, and fewer years of education predicted cognitive decline in the middle-aged group. The results inform screening for individuals particularly vulnerable to cognitive decline and interventions (e.g., focusing on lifestyle factors) to help maintain cognitive performance into old age. [ABSTRACT FROM AUTHOR]

The act of play has long been recognized as a fundamental aspect of human development. Playfulness, in turn, is considered a variable reflecting individual differences regarding the disposition to engage in play. To gain insight into playfulness's potential contribution to health and well-being, this paper will explore its role during times of extreme adversity, proposing a theoretical model to understand playfulness as a coping mechanism in such conditions. Our Playfulness as a Coping Strategy model suggests that playfulness comprises various dimensions that serve as intrinsic resources for navigating adversity. In this context, we refer to playfulness as a self-initiated state, whereby individuals reclaim their autonomy to enter a space that opposes or contradicts the extremely adverse condition they are in. The model frames the use of playfulness in extremely adverse conditions, and demonstrates the model with two case illustrations of videos from soldiers in war, both from Ukraine and Israel. By doing that, we shed light on how playfulness can be cultivated as a protective factor promoting psychological adaptation. Furthermore, we outline future directions for research on playfulness as a change factor (i.e., active ingredient) in the creative arts therapies and other interventions, paving the way for elucidating its role in fostering well-being and health. [ABSTRACT FROM AUTHOR]