Resilience and Speed of Recovery after Critical Illness

Length of stay in the critical care setting is a topic of concern for both patients and the health care system. However, the subject of psychological influences on recovery time after critical illness is a one that little to no research has been conducted. This extensive literature review aims to look specifically at the relationship between resilience and speed of recovery after critical illness and research that has been done on this subject matter. Within this review lies an extensive review of literature, in-depth definitions of resilience, factors affecting length of stay in the intensive care units, a theoretical framework with which to build upon, along with recommendations to advanced practice nurses for further research on this subject matter. It also includes a tool which measures resilience developed by Wagnild and Young

Resilience of dynamical systems

Stability is among the most important concepts in dynamical systems. Local stability is well-studied, whereas determining how "globally stable" a nonlinear system is very challenging. Over the last few decades, many different ideas have been developed to address this issue, primarily driven by concrete applications. In particular, several disciplines suggested a web of concepts under the headline "resilience". Unfortunately, there are many different variants and explanations of resilience, and often the definitions are left relatively vague, sometimes even deliberately. Yet, to allow for a structural development of a mathematical theory of resilience that can be used across different areas, one has to ensure precise starting definitions and provide a mathematical comparison of different resilience measures. In this work, we provide a systematic review of the most relevant indicators of resilience in the context of continuous dynamical systems, grouped according to their mathematical features. The indicators are also generalized to be applicable to any attractor. These steps are important to ensure a more reliable, quantitatively comparable and reproducible study of resilience in dynamical systems. Furthermore, we also develop a new concept of resilience against certain non-autonomous perturbations to demonstrate, how one can naturally extend our framework. All the indicators are finally compared via the analysis of a classic scalar model from population dynamics to show that direct quantitative application-based comparisons are an immediate consequence of a detailed mathematical analysis.Comment: 54 pages, 18 figure

Resilience in Caregivers of Partners With Young Onset Dementia: A Concept Analysis

Introduction: Over 200,000 Americans diagnosed with young onset dementia (YOD), dementia diagnosed prior to age 65, are cared for by family members. This can be costly to caregivers’physical and psychological health. Some adapt well to the caregiver role and are said to be resilient. Aim/Question: This paper builds on current understanding of the concept of resilience and applies this to caregivers of partners diagnosed with YOD. Method: Concept analysis. Results: Resilient caregivers exhibit attributes including determination, flexibility, positive thinking, self-efficacy, resourcefulness, social support and spirituality. Discussion: YOD affects caregiver’s health. Much research has been done on interventions for dementia caregivers. These interventions do not necessarily meet the needs of YOD caregivers as they do not account for dynamics in the family. By recognizing what is resiliency in YOD caregivers, interventions can be developed that focus on characteristics that build these attributes. Implications for Practice: Understanding the concept of resilience related to caregiving for a partner diagnosed with YOD allows for future development, measurement, and evaluation of nursing interventions. Nursing staff are in a strategic position to provide effective interventions to enhance resilience among caregivers of YOD

Resilience trinity: safeguarding ecosystem functioning and services across three different time horizons and decision contexts

Ensuring ecosystem resilience is an intuitive approach to safeguard the functioning of ecosystems and hence the future provisioning of ecosystem services (ES). However, resilience is a multi‐faceted concept that is difficult to operationalize. Focusing on resilience mechanisms, such as diversity, network architectures or adaptive capacity, has recently been suggested as means to operationalize resilience. Still, the focus on mechanisms is not specific enough. We suggest a conceptual framework, resilience trinity, to facilitate management based on resilience mechanisms in three distinctive decision contexts and time‐horizons: 1) reactive, when there is an imminent threat to ES resilience and a high pressure to act, 2) adjustive, when the threat is known in general but there is still time to adapt management and 3) provident, when time horizons are very long and the nature of the threats is uncertain, leading to a low willingness to act. Resilience has different interpretations and implications at these different time horizons, which also prevail in different disciplines. Social ecology, ecology and engineering are often implicitly focussing on provident, adjustive or reactive resilience, respectively, but these different notions of resilience and their corresponding social, ecological and economic tradeoffs need to be reconciled. Otherwise, we keep risking unintended consequences of reactive actions, or shying away from provident action because of uncertainties that cannot be reduced. The suggested trinity of time horizons and their decision contexts could help ensuring that longer‐term management actions are not missed while urgent threats to ES are given priority

An integrative quantifier of multistability in complex systems based on ecological resilience

Acknowledgements This work was supported by the German Federal Ministry of Education and Research (BMBF) via the Young Investigators Group CoSy-CC2 (grant no. 01LN1306A). C.M. acknowledges the support of Bedartha Goswami, Jobst Heitzig and Tim Kittel.Peer reviewedPublisher PD

Exploring Resilience Models in a Sample of Combat-Exposed Military Service Members and Veterans: A Comparison and Commentary

Background: The term resilience is applied in numerous ways in the mental health field, leading to different perspectives of what constitutes a resilient response and disparate findings regarding its prevalence following trauma. Objective: illustrate the impact of various definitions on our understanding and prevalence of resilience, we compared various resilience definitions (absence of PTSD, absence of current mental health diagnosis, absence of generalized psychological distress, and an alternative trauma load–resilience discrepancy model of the difference between actual and predicted distress given lifetime trauma exposure) within a combat-exposed military personnel and veteran sample. Method: In this combat-trauma exposed sample (N = 849), of which approximately half were treatment seeking, rates of resilience were determined across all models, the kappa statistic was used to determine the concordance and strength of association across models, and t-tests examined the models in relation to a self-reported resilience measure. Results: Prevalence rates were 43.7%, 30.7%, 87.4%, and 50.1% in each of the four models. Concordance analyses identified 25.7% (n = 218) considered resilient by all four models (kappa = .40, p \u3c .001). Correlations between models and self-reported resilience were strong, but did not fully overlap. Conclusions:The discussion highlights theoretical considerations regarding the impact of various definitions and methodologies on resilience classifications, links current findings to a systems-based perspective, and ends with suggestions for future research approaches on resilience

Economic Resilience A new concept for policy making? Bertelsmann Stiftung Inclusive Growth for Germany|11

The idea of “resilience” has in recent years gained a high level of popularity in the formulation of economic- policy objectives. Given the rapid sequence of serious crises, the rise of this concept is hardly surprising. If economic shocks are apparently unavoidable, then an economy’s ability to cope with them should be a subject of interest. However, the virtually inflationary use of the resilience concept has been accompanied by a lack of precision. In particular, there is often no clear understanding that alongside its static interpretation (retention of a system’s existing functions in the case of a crisis), crisis resilience also includes an adaptive dimension (adjustment to new surrounding conditions). Against this background, this article addresses the origin of the resilience concept, illustrates its various usages in different disciplines, and distinguishes it from other key words (“vulnerability,” “sustainability,” “stability”). On this basis, the resilience concept is given additional precision and defined in a manner useful for the economic- policy perspective. A central conclusion is that the concept of resilience can become a normative economic- policy principle if 1) it is not viewed narrowly as only a static concept; 2) it is linked to the societal objectives within the economy being studied; and 3) the interplay of different societal levels is taken into account

On Track? Ensuring the Resilience of the Great Lakes Compact

The Great Lakes hold about 20 percent of the world's available surface freshwater, and 84 percent of North America's surface freshwater. As a resource, the lakes and their tributaries are invaluable -- providing drinking water for 40 million people and serving as the region's economic and recreational lifeblood.Yet, the sheer vastness of the lakes belies a fragility that policy-makers, scientists and other experts have struggled to address for more than a century . With less than 1 percent of the waters of the Great Lakes renewed annually through rainfall and snowmelt, the lakes are vulnerable to misuse and depletion.Congress unanimously approved and President Bush signed the Great Lakes-St. Lawrence River Basin Water Resources Compact into law in October 2008. The eight-state water management pact is a first-of-its kind model for a consensus-based, basin-wide approach to decisions about how much and how far away Great Lakes water can be used. The eight Great Lakes governors who collectively wrote and unanimously endorsed the pact deliberately left it to the states to devise their own rules of implementation for in-state water use. Since the compact's adoption, the Great Lakes states have developed water use standards that are much improved from what existed before, though many lack proactive policies designed to protect and nurture water sustainability. Meanwhile, the Great Lakes-St. Lawrence River Basin Water Resources Council -- the body established by the compact to make decisions about water diversions outside the basin -- has not rendered binding rules for its review of diversion applications, leaving a void that may expose the pact to legal challenge and put Great Lakes water at risk.The compact will soon face its first regional test from Waukesha, Wis., a community eligible to apply to divert Great Lakes water beyond the basin because of its location within a county straddling the Great Lakes and Mississippi River divide. The compact allows for straddling communities and communities within straddling counties not currently using Great Lakes water to be granted an exception to its ban on diversions -- but only if the community can prove no reasonable alternative water source exists and that the water will be returned to the basin. Absent water-tight regional implementation rules, however, this precedent-setting application could reveal deficiencies in the application process that, if unaddressed, leave the compact vulnerable to legal challenges .Waukesha is only the first of a number of communities that may line up for Great Lakes water in the coming decades. We encourage the Great Lakes governors to consider not only the implications of reviewing the Waukesha application under current guidance, but how the decisions made during this review will inevitably shape the basis for future decisions. The first section of this report identifies a number of communities -- some similarly situated in straddling counties, others themselves straddling the border of the Great Lakes Basin -- that may face the need for an alternative water supply soon and could find requesting Great Lakes water a sensible prospect in the coming decade. The second component of the report seeks to take advantage of a narrowing window of opportunity to fix shortcomings in the Compact Council review process; a window that will shut with the arrival of the first diversion request on its doorstep. The report analyzes Compact Council implementation deficiencies which, if not addressed, leave the application review process vulnerable to legal challenges that could reshape parts of the compact