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Background: Adolescent depression can severely interfere with age-appropriate and lifetime development and functionality. Physical functioning in daily life (as a means of individual support) as well as social support from family and friends have been shown to enhance adolescent resilience against depression. By applying a multisystemic model of resilience, this study investigates how these resources reciprocally influence each other and how they interact with depression over time.Methods: Longitudinal data (three assessments over three years) from the Resilient Youth in Stressed Environments project was analyzed using panel network analysis to investigate short- and long-term uni- and bidirectional effects. The sample consisted of N = 500 adolescents from Canada (mean age = 18.49, SD = 3.01, 56.40% young women) at the first assessment.Results: Depression seemed to fluctuate, while the resources showed significant stability over the course of the study. Perceived family and friend support were not significantly influenced by depression while they had significantly negative temporal effects on depression. Only physical functioning showed a negative feedback loop, notably with somatic symptoms of depression. Family and friend support shared a reinforcing feedback loop, while physical functioning was not related to either type of support.Limitations: Future studies should address the low average of depressive symptomatology and subjective, global measures of social support.Conclusions: The resources show potential time-dependent effects: symptom-specific resources need to be applied in the short-term, while a pool of multisystemic resilience resources seems necessary over the long-term to increase the resilience to depression among adolescents. [ABSTRACT FROM AUTHOR]

• Elevated Allostatic Load Index determines worse physical performance states in older adults. • Distributions of Allostatic Load Averages do not differ significantly among the cities evaluated. • Total and Indirect Mediation Effects between Allostatic Load and the variables of age, socioeconomic and chronic conditions on physical performance scores were evidenced. This study aimed to evaluate the association between Allostatic Load (AL) and physical performance scores in older adults from four cities in North and South America. In this cross-sectional study, data from 1101 volunteers from three countries (Canada, Brazil, and Colombia) from the International Mobility in Aging Study (IMIAS) were used to evaluate the association between AL index and Short Physical Performance Battery (SPPB) scores. Three multiple linear regression models adjusted by age, Socioeconomic Status (SES), chronic conditions, depression symptoms, and Leganés Cognitive Test (LCT) were developed to estimate the independent association between SPPB and AL. Mediation analysis with 2012 LA data and covariates was performed to access the total, direct, and indirect effects of mediation on SPPB scores from 2016. AL and SPPB were inversely associated, with older adults with high allostatic load scoring lower on SPPB (β: -0.234, Std: 0.033, p-value: <0.001). Indirect effects were evidenced between age, SES and chronic conditions with AL and SPPB scores. Chronic conditions also had a total effect on SPPB scores and were also mediated by AL. However, indirect effects of depressive symptoms and LCT on SPPB scores mediated by AL were not observed. Findings from this study support that increased AL index determines worse physical performance states after full adjustments. AL has a mediator role between the number of chronic diseases, depressive symptoms, cognitive status and physical performance. Socioeconomic status also influenced physical scores mediated by the AL index. [ABSTRACT FROM AUTHOR]

Pulmonary endarterectomy (PEA) surgery is the main curative treatment for chronic thromboembolic pulmonary hypertension (CTEPH). Despite the importance of quality of life (QoL), it is under-reported in clinical studies done on CTEPH. The present study aims to prospectively investigate health-related QoL, determined by the 36-item Short Form Health Survey (SF-36) and the EQ-5D-5L form, in a CTEPH cohort. Consent was obtained from surgical candidates who were referred to the Toronto CTEPH program. QoL forms were collected at baseline, and the 3-month follow-up visit and clinical data were retrospectively reviewed (Table 1). 32 subjects (15 men, 17 women; age range, 22-74y) were studied from 59 surgical cases from April 2021- June 2022. EQ-5D-5L health states were directly converted into country-specific utility index values using a Canada-specific value set. SF-36 questions were categorized into 8 domains and scored on a 0-100 scale. Responses at the two time points were compared using a paired t-test analysis with p values less than 0.05 considered statistically significant. SF-36 analysis showed a significant improvement in 5 of the 8 domains, most substantially in physical functioning and vitality (Fig. 1A). Significant improvements were also observed in the physical component summary score but not in the mental component summary score (Fig. 1B). EQ-5D-5L results demonstrated a significant increase in the mean visual analogue scale (VAS) score, a self-reported numerical indicator of patient health, from 55.66±22.10 at baseline to 68.81±18.24 at post-op (Fig. 1C). The significant improvement in the mean utility index score from 0.69±0.20 to 0.80±0.12 further supported the VAS score findings (Fig. 1D). Given that pulmonary hypertension can lead to physical activity restrictions that would necessitate lifestyle changes, these post-treatment improvements in patients' QoL demonstrate the importance and success of PEA. [ABSTRACT FROM AUTHOR]