1 4599 83 NATURE AND NURTURE OF HUMAN PAIN. HUMANS ARE VERY DIFFERENT WHEN IT COMES TO PAIN. SOME GET PAINFUL PIERCINGS AND TATTOOS; OTHERS CAN NOT STAND EVEN A FLU SHOT. INTERINDIVIDUAL VARIABILITY IS ONE OF THE MAIN CHARACTERISTICS OF HUMAN PAIN ON EVERY LEVEL INCLUDING THE PROCESSING OF NOCICEPTIVE IMPULSES AT THE PERIPHERY, MODIFICATION OF PAIN SIGNAL IN THE CENTRAL NERVOUS SYSTEM, PERCEPTION OF PAIN, AND RESPONSE TO ANALGESIC STRATEGIES. AS FOR MANY OTHER COMPLEX BEHAVIORS, THE SOURCES OF THIS VARIABILITY COME FROM BOTH NURTURE (ENVIRONMENT) AND NATURE (GENES). HERE, I WILL DISCUSS HOW THESE FACTORS CONTRIBUTE TO HUMAN PAIN SEPARATELY AND VIA INTERPLAY AND HOW EPIGENETIC MECHANISMS ADD TO THE COMPLEXITY OF THEIR EFFECTS. 2013 2 2521 24 EPIGENETICS AND THE INTERNATIONAL CLASSIFICATION OF FUNCTIONING, DISABILITY AND HEALTH MODEL: BRIDGING NATURE, NURTURE, AND PATIENT-CENTERED POPULATION HEALTH. EPIGENETIC PROCESSES ENABLE ENVIRONMENTAL INPUTS SUCH AS DIET, EXERCISE, AND HEALTH BEHAVIORS TO REVERSIBLY TAG DNA WITH CHEMICAL "MARKS" THAT INCREASE OR DECREASE THE EXPRESSION OF AN INDIVIDUAL'S GENETIC TEMPLATE. OVER TIME, EPIGENETIC ADAPTATIONS ENABLE THE EFFECTS OF HEALTHY OR UNHEALTHY STRESSES TO BECOME STABLY EXPRESSED IN THE TISSUE OF AN ORGANISM, WITH IMPORTANT CONSEQUENCES FOR HEALTH AND DISEASE. NEW RESEARCH INDICATES THAT SEEMINGLY NON-BIOLOGICAL FACTORS SUCH AS SOCIAL STRESS, POVERTY, AND CHILDHOOD HARDSHIP INITIATE EPIGENETIC ADAPTATIONS IN GENE PATHWAYS THAT GOVERN INFLAMMATION AND IMMUNITY, TWO OF THE GREATEST CONTRIBUTORS TO CHRONIC DISEASES SUCH AS DIABETES AND OBESITY. EPIGENETIC PROCESSES THEREFORE PROVIDE A BIOLOGICAL BRIDGE BETWEEN THE GENOME-AN INDIVIDUAL'S GENETIC INHERITANCE-AND THE SOCIAL DETERMINANTS OF HEALTH-THE CONDITIONS IN WHICH THEY ARE BORN, GROW, LIVE, WORK, AND AGE. THIS PERSPECTIVE PAPER ARGUES THAT PHYSICAL THERAPY CLINICIANS, RESEARCHERS, AND EDUCATORS CAN USE THE THEORETICAL FRAMEWORK PROVIDED BY THE INTERNATIONAL CLASSIFICATION OF FUNCTIONING, DISABILITY, AND HEALTH (ICF MODEL) TO HARMONIZE NEW DISCOVERIES FROM BOTH PUBLIC HEALTH RESEARCH AND MEDICALLY FOCUSED GENOMIC RESEARCH. THE ICF MODEL LIKEWISE CAPTURES THE ESSENTIAL ROLE PLAYED BY PHYSICAL ACTIVITY AND EXERCISE, WHICH INITIATE POWERFUL AND WIDESPREAD EPIGENETIC ADAPTATIONS THAT PROMOTE HEALTH AND FUNCTIONING. IN THIS PROPOSED FRAMEWORK, EPIGENETIC PROCESSES TRANSDUCE THE EFFECTS OF THE SOCIAL DETERMINANTS OF HEALTH AND BEHAVIORS SUCH AS EXERCISE INTO STABLE BIOLOGICAL ADAPTATIONS THAT AFFECT AN INDIVIDUAL'S DAILY ACTIVITIES AND THEIR PARTICIPATION IN SOCIAL ROLES. BY HARMONIZING "NATURE" AND "NURTURE," PHYSICAL THERAPISTS CAN APPROACH PATIENT CARE WITH A MORE INTEGRATED PERSPECTIVE, CAPITALIZING ON NOVEL DISCOVERIES IN PRECISION MEDICINE, REHABILITATION SCIENCE, AND IN POPULATION-LEVEL RESEARCH. AS THE EXPERTS IN PHYSICAL ACTIVITY AND EXERCISE, PHYSICAL THERAPISTS ARE IDEALLY POSITIONED TO DRIVE PROGRESS IN THE NEW ERA OF PATIENT-CENTERED POPULATION HEALTH CARE. 2022 3 5465 25 RESILIENCE TO STRESS: LESSONS FROM RODENTS ABOUT NATURE VERSUS NURTURE. INDIVIDUAL DIFFERENCES IN HUMAN TEMPERAMENT INFLUENCE HOW WE RESPOND TO STRESS AND CAN CONFER VULNERABILITY (OR RESILIENCE) TO EMOTIONAL DISORDERS. FOR EXAMPLE, HIGH LEVELS OF BEHAVIORAL INHIBITION IN CHILDREN PREDICT INCREASED RISK OF MOOD AND ANXIETY DISORDERS IN LATER LIFE. THE BIOLOGICAL UNDERPINNINGS OF TEMPERAMENT ARE UNKNOWN, ALTHOUGH IMPROVED UNDERSTANDING CAN OFFER INSIGHT INTO THE PATHOGENESIS OF EMOTIONAL DISORDERS. OUR LABORATORY HAS USED A RAT MODEL OF TEMPERAMENTAL DIFFERENCES TO STUDY NEURODEVELOPMENTAL FACTORS THAT LEAD TO A HIGHLY INHIBITED, STRESS VULNERABLE PHENOTYPE. SELECTIVE BREEDING FOR HIGH VERSUS LOW BEHAVIORAL RESPONSE TO NOVELTY CREATED TWO RAT STRAINS THAT EXHIBIT DRAMATIC BEHAVIOR DIFFERENCES OVER MULTIPLE DOMAINS RELEVANT TO EMOTIONAL DISORDERS. LOW NOVELTY RESPONDER (BLR) RATS EXHIBIT HIGH LEVELS OF BEHAVIORAL INHIBITION, PASSIVE STRESS COPING, ANHEDONIA, DECREASED SOCIABILITY AND VULNERABILITY TO CHRONIC STRESS COMPARED TO HIGH NOVELTY RESPONDERS (BHRS). ON THE OTHER HAND, BHRS EXHIBIT HIGH LEVELS OF BEHAVIORAL DIS-INHIBITION, ACTIVE COPING, AND AGGRESSION. THIS REVIEW ARTICLE SUMMARIZES OUR WORK WITH THE BHR/BLR MODEL SHOWING THE DEVELOPMENTAL EMERGENCE OF THE BHR/BLR PHENOTYPES, THE ROLE THE ENVIRONMENT PLAYS IN SHAPING IT, AND THE INVOLVEMENT OF EPIGENETIC PROCESSES SUCH AS DNA METHYLATION THAT MEDIATE DIFFERENCES IN EMOTIONALITY AND STRESS REACTIVITY. 2022 4 4600 27 NATURE OR NURTURE: LET FOOD BE YOUR EPIGENETIC MEDICINE IN CHRONIC INFLAMMATORY DISORDERS. NUMEROUS CLINICAL, PHYSIOPATHOLOGICAL AND EPIDEMIOLOGICAL STUDIES HAVE UNDERLINED THE DETRIMENTAL OR BENEFICIAL ROLE OF NUTRITIONAL FACTORS IN COMPLEX INFLAMMATION RELATED DISORDERS SUCH AS ALLERGY, ASTHMA, OBESITY, TYPE 2 DIABETES, CARDIOVASCULAR DISEASE, RHEUMATOID ARTHRITIS AND CANCER. TODAY, NUTRITIONAL RESEARCH HAS SHIFTED FROM ALLEVIATING NUTRIENT DEFICIENCIES TO CHRONIC DISEASE PREVENTION. IT IS KNOWN THAT LIFESTYLE, ENVIRONMENTAL CONDITIONS AND NUTRITIONAL COMPOUNDS INFLUENCE GENE EXPRESSION. GENE EXPRESSION STATES ARE SET BY TRANSCRIPTIONAL ACTIVATORS AND REPRESSORS AND ARE OFTEN LOCKED IN BY CELL-HERITABLE CHROMATIN STATES. ONLY RECENTLY, IT HAS BEEN OBSERVED THAT THE ENVIRONMENTAL CONDITIONS AND DAILY DIET CAN AFFECT TRANSGENERATIONAL GENE EXPRESSION VIA "REVERSIBLE" HERITABLE EPIGENETIC MECHANISMS. EPIGENETIC CHANGES IN DNA METHYLATION PATTERNS AT CPG SITES (EPIMUTATIONS) OR CORRUPT CHROMATIN STATES OF KEY INFLAMMATORY GENES AND NONCODING RNAS, RECENTLY EMERGED AS MAJOR GOVERNING FACTORS IN CANCER, CHRONIC INFLAMMATORY AND METABOLIC DISORDERS. RECIPROCALLY, INFLAMMATION, METABOLIC STRESS AND DIET COMPOSITION CAN ALSO CHANGE ACTIVITIES OF THE EPIGENETIC MACHINERY AND INDIRECTLY OR DIRECTLY CHANGE CHROMATIN MARKS. THIS HAS RECENTLY LAUNCHED RE-EXPLORATION OF ANTI-INFLAMMATORY BIOACTIVE FOOD COMPONENTS FOR CHARACTERIZATION OF THEIR EFFECTS ON EPIGENOME MODIFYING ENZYMATIC ACTIVITIES (ACETYLATION, METHYLATION, PHOSPHORYLATION, RIBOSYLATION, OXIDATION, UBIQUITINATION, SUMOYLATION). THIS MAY ALLOW TO IMPROVE HEALTHY AGING BY REVERSING DISEASE PRONE EPIMUTATIONS INVOLVED IN CHRONIC INFLAMMATORY AND METABOLIC DISORDERS. 2010 5 1913 30 ENVIRONMENTAL AND GENETIC CONTRIBUTIONS TO DIABETES. DIABETES MELLITUS (DM) IS A HETEROGENEOUS GROUP OF DISORDERS CHARACTERIZED BY PERSISTENT HYPERGLYCEMIA. ITS TWO MOST COMMON FORMS ARE TYPE 1 DIABETES (T1D) AND TYPE 2 DIABETES (T2D), FOR WHICH GENETIC AND ENVIRONMENTAL RISK FACTORS ACT IN SYNERGY. BECAUSE IT OCCURS IN CHILDREN AND INVOLVES INFECTIOUS, AUTOIMMUNE OR TOXIC DESTRUCTION OF THE INSULIN-SECRETING PANCREATIC BETA-CELLS, TYPE 1 DIABETES HAS BEEN CALLED JUVENILE OR INSULIN-DEFICIENT DIABETES. IN TYPE 2, PATIENTS CAN STILL SECRETE SOME INSULIN BUT ITS EFFECTIVENESS MAY BE ATTENUATED BY 'INSULIN RESISTANCE.' THERE IS ALSO A GROUP OF RARE FORMS OF DIABETES IN THE YOUNG WHICH ARE INHERITED AS MONOGENETIC DISEASES. WHETHER ONE CALLS THE UNDERLYING PROCESS 'GENES VS. ENVIRONMENT' OR 'NATURE VS NURTURE', DIABETES OCCURS AT THE INTERFACE OF THE TWO DOMAINS. TOGETHER WITH OUR GENETIC BACKGROUND WE ARE BORN TABULA RASA-A BLANK SLATE UPON WHICH THE STORY OF LIFE, WITH ALL ITS ENVIRONMENTAL INPUTS WILL BE WRITTEN. THERE IS ONE PROVISO: THE INFLUENCE OF EPIGENETIC INHERITANCE MUST ALSO BE CONSIDERED. THUS, IN THE CREATION OF DATABASES THAT INCLUDE "BIG DATA" ORIGINATING FROM GENOMIC AS WELL AS EXPOSOME (DEFINED AS: THE TOTALITY OF ENVIRONMENTAL EXPOSURE FROM CONCEPTION TO DEATH), A BROAD PERSPECTIVE IS CRUCIAL AS THESE FACTORS ACT IN CONCERT IN SUCH CHRONIC ILLNESSES AS DIABETES THAT, FOR EXAMPLE, ARE LIKELY TO REQUIRE ADOPTION OF AN APPROPRIATE LIFESTYLE CHANGE. ALSO, IT IS BECOMING INCREASINGLY EVIDENT THAT EPIGENETIC FACTORS CAN MODULATE THE INTERPLAY BETWEEN GENES AND ENVIRONMENT. CONSEQUENTLY, THROUGHOUT THE LIFE OF AN INDIVIDUAL NATURE AND NURTURE INTERACT IN A COMPLEX MANNER IN THE DEVELOPMENT OF DIABETES. THIS REVIEW ADDRESSES THE QUESTION OF THE CONTRIBUTION OF GENE AND ENVIRONMENT AND THEIR INTERACTIONS IN THE DEVELOPMENT OF DIABETES. 2019 6 4338 22 MICROVASCULAR BARRIER PROTECTION BY MICRORNA-183 VIA FOXO1 REPRESSION: A PATHWAY DISTURBED IN NEUROPATHY AND COMPLEX REGIONAL PAIN SYNDROME. BLOOD NERVE BARRIER DISRUPTION AND EDEMA ARE COMMON IN NEUROPATHIC PAIN AS WELL AS IN COMPLEX REGIONAL PAIN SYNDROME (CRPS). MICRORNAS (MIRNA) ARE EPIGENETIC MULTITARGET SWITCHES CONTROLLING NEURONAL AND NON-NEURONAL CELLS IN PAIN. THE MIR-183 COMPLEX ATTENUATES HYPEREXCITABILITY IN NOCICEPTORS, BUT ADDITIONAL NON-NEURONAL EFFECTS VIA TRANSCRIPTION FACTORS COULD CONTRIBUTE AS WELL. THIS STUDY EXPLORED EXOSOMAL MIR-183 IN CRPS AND MURINE NEUROPATHY, ITS EFFECT ON THE MICROVASCULAR BARRIER VIA TRANSCRIPTION FACTOR FOXO1 AND TIGHT JUNCTION PROTEIN CLAUDIN-5, AND ITS ANTIHYPERALGESIC POTENTIAL. SCIATIC MIR-183 DECREASED AFTER CCI. SUBSTITUTION WITH PERINEURAL MIR-183 MIMIC ATTENUATED MECHANICAL HYPERSENSITIVITY AND RESTORED BLOOD NERVE BARRIER FUNCTION. IN VITRO, SERUM FROM CCI MICE UND CRPS PATIENTS WEAKENED THE MICROVASCULAR BARRIER OF MURINE CEREBELLAR ENDOTHELIAL CELLS, INCREASED ACTIVE FOXO1 AND REDUCED CLAUDIN-5, CONCOMITANT WITH A LACK OF EXOSOMAL MIR-183 IN CRPS PATIENTS. CELLULAR STRESS ALSO COMPROMISED THE MICROVASCULAR BARRIER WHICH WAS RESCUED EITHER BY MIR-183 MIMIC VIA FOXO1 REPRESSION OR BY PRIOR SILENCING OF FOXO1. PERSPECTIVE: LOW MIR-183 LEADING TO BARRIER IMPAIRMENT VIA FOXO1 AND SUBSEQUENT CLAUDIN-5 SUPPRESSION IS A NEW ASPECT IN THE PATHOPHYSIOLOGY OF CRPS AND NEUROPATHIC PAIN. THIS PATHWAY MIGHT HELP UNTANGLE THE WIDE SYMPTOMATIC RANGE OF CRPS AND NURTURE FURTHER RESEARCH INTO MIRNA MIMICS OR FOXO1 INHIBITORS. 2022 7 5466 32 RESILIENCE: SAFETY IN THE AFTERMATH OF TRAUMATIC STRESSOR EXPERIENCES. THE RELATIONSHIP BETWEEN ADVERSE EXPERIENCES AND THE EMERGENCE OF PATHOLOGY HAS OFTEN FOCUSED ON CHARACTERISTICS OF THE STRESSOR OR OF THE INDIVIDUAL (STRESSOR APPRAISALS, COPING STRATEGIES). THESE FEATURES ARE THOUGHT TO INFLUENCE MULTIPLE BIOLOGICAL PROCESSES THAT FAVOR THE DEVELOPMENT OF MENTAL AND PHYSICAL ILLNESSES. LESS OFTEN HAS ATTENTION FOCUSED ON THE AFTERMATH OF TRAUMATIC EXPERIENCES, AND THE IMPORTANCE OF SAFETY AND REASSURANCE THAT IS NECESSARY FOR LONGER-TERM WELL-BEING. IN SOME CASES (E.G., POST-TRAUMATIC STRESS DISORDER) THIS MAY BE REFLECTED BY A FAILURE OF FEAR EXTINCTION, WHEREAS IN OTHER INSTANCES (E.G., HISTORICAL TRAUMA), THE UNCERTAINTY ABOUT THE FUTURE MIGHT FOSTER CONTINUED ANXIETY. IN ESSENCE, THE QUESTION BECOMES ONE OF HOW INDIVIDUALS ATTAIN FEELINGS OF SAFETY WHEN IT IS FULLY UNDERSTOOD THAT THE WORLD IS NOT NECESSARILY A SAFE PLACE, UNCERTAINTIES ABOUND, AND FEELINGS OF AGENCY ARE OFTEN ILLUSORY. WE CONSIDER HOW INDIVIDUALS ACQUIRE RESILIENCE IN THE AFTERMATH OF TRAUMATIC AND CHRONIC STRESSORS. IN THIS RESPECT, WE REVIEW CHARACTERISTICS OF STRESSORS THAT MAY TRIGGER PARTICULAR BIOLOGICAL AND BEHAVIORAL COPING RESPONSES, AS WELL AS FACTORS THAT UNDERMINE THEIR EFFICACY. TO THIS END, WE EXPLORE STRESSOR DYNAMICS AND SOCIAL PROCESSES THAT FOSTER RESILIENCE IN RESPONSE TO SPECIFIC TRAUMATIC, CHRONIC, AND UNCONTROLLABLE STRESSOR CONTEXTS (INTIMATE PARTNER ABUSE; REFUGEE MIGRATION; COLLECTIVE HISTORICAL TRAUMA). WE POINT TO RESILIENCE FACTORS THAT MAY COMPRISE NEUROBIOLOGICAL CHANGES, SUCH AS THOSE RELATED TO VARIOUS STRESSOR-PROVOKED HORMONES, NEUROTROPHINS, INFLAMMATORY IMMUNE, MICROBIAL, AND EPIGENETIC PROCESSES. THESE BEHAVIORAL AND BIOLOGICAL STRESS RESPONSES MAY INFLUENCE, AND BE INFLUENCED BY, FEELINGS OF SAFETY THAT COME ABOUT THROUGH RELATIONSHIPS WITH OTHERS, SPIRITUAL AND PLACE-BASED CONNECTIONS. 2020 8 6577 18 TREATMENT STRATEGIES FOR COMPLEX BEHAVIORAL INSOMNIA IN CHILDREN WITH NEURODEVELOPMENTAL DISORDERS. PURPOSE OF REVIEW: THIS REVIEW DESCRIBES RECENT RESEARCH IN PEDIATRIC BEHAVIORAL INSOMNIAS IN NEURODEVELOPMENTAL DISORDERS AND THEIR TREATMENT. RECENT FINDINGS: INSOMNIA IN CHILDREN WITH AUTISM SPECTRUM DISORDER (ASD) AND OTHER NEURODEVELOPMENTAL DISORDERS (NDDS) IS TYPICALLY COMPLEX, CHRONIC, AND DIFFICULT TO ADEQUATELY CONTROL. ABNORMALITIES IN GENETIC AND/OR EPIGENETIC REGULATION OF SLEEP/WAKEFULNESS AND ITS TIMING PREDISPOSE PATIENTS WITH NDD TO INSOMNIA, ALTHOUGH POOR SLEEP HYGIENE, MALADAPTIVE ASSOCIATIONS, AND LIMIT-SETTING ARE LIKELY TO CONTRIBUTE. PARENTS ARE AGENTS FOR CHANGE IN PROBLEMATIC SLEEP BEHAVIORS IN PATIENTS WITH NDD. WE REVIEW THE BENEFITS OF BEHAVIORAL THERAPIES AND MELATONIN TO TREAT SLEEP PROBLEMS IN CHILDREN WITH NDD. PROBLEMATIC SLEEP IS SO PREVALENT IN SOME NEURODEVELOPMENTAL SYNDROMES (RETT, ANGELMAN, WILLIAMS, AND SMITH-MAGENIS) THAT IT IS PART OF THEIR DIAGNOSTIC CRITERIA. SUMMARY: CHILDREN AND ADOLESCENTS WITH NEUROLOGICAL DISORDERS FREQUENTLY HAVE COMPLEX SLEEP DISORDERS THAT REQUIRE TREATMENT. UNDERSTANDING THE BASIC PATHOLOGY AND TREATMENT STRATEGIES PROVIDES AN OPPORTUNITY TO IMPROVE WELL BEING AND QUALITY OF LIFE IN THOSE AFFECTED BY NDD AND THEIR FAMILIES. 2013 9 5457 22 RESEARCH AND THE PROMOTION OF CHILD HEALTH: A POSITION PAPER OF THE EUROPEAN SOCIETY FOR PEDIATRIC GASTROENTEROLOGY, HEPATOLOGY, AND NUTRITION. CHILDREN COMPRISE ONE-FIFTH OF EUROPE'S POPULATION. PROMOTING CHILD HEALTH AND DEVELOPMENT IS OF KEY IMPORTANCE FOR SOCIETY AND ITS FUTURE. THIS POSITION PAPER HIGHLIGHTS OPPORTUNITIES OF INVESTING IN GASTROINTESTINAL, LIVER, AND NUTRITIONAL RESEARCH TO PROMOTE CHILD HEALTH AND DELINEATES PRIORITIES FOR RESEARCH. INVESTING IN CHILD HEALTH PLAYS A KEY ROLE IN THE PROMOTION OF POPULATION HEALTH, WELL-BEING, AND DISEASE PREVENTION LIFELONG, WITH LARGE HEALTH ECONOMIC BENEFITS. MAJOR OPPORTUNITIES FOR IMPROVING KNOWLEDGE AND TRANSLATIONAL APPLICATION ARISE FROM RECENT SCIENTIFIC AND TECHNOLOGICAL DEVELOPMENTS, FOR EXAMPLE, THE LONG-TERM IMPACT OF EARLY ENVIRONMENTAL CUES INTERACTING WITH GENES. PERSONALISED APPROACHES TO THERAPY AND PREVENTION SHOULD BE ENHANCED. DECIPHERING THE MICROBIOME AND ITS EFFECTS ON FUNCTIONS CAN HELP IN PROMOTING LONG-TERM HEALTH. EPIGENETIC RESEARCH CAN HELP TO UNDERSTAND HOW EARLY ENVIRONMENTAL FACTORS INFLUENCE LATER GASTROINTESTINAL AND HEPATIC HEALTH AND DISEASE. A LINKED NUTRITION AND PHYSICAL ACTIVITY STRATEGY CAN PROMOTE HEALTH AND PREVENT NUTRITIONAL DEFICIENCIES, INACTIVITY, AND CHRONIC NONCOMMUNICABLE DISEASES, SUCH AS DIABETES, TO ENSURE OPTIMAL HEALTH AND COGNITION. SPECIAL ATTENTION SHOULD BE DEVOTED TO POPULATIONS WITH LOW SOCIOECONOMIC STATUS, MIGRANT BACKGROUND, AND ETHNIC MINORITIES, AND TO CRITICAL LIFE PERIODS, INCLUDING PREGNANCY, LACTATION, INFANCY, AND CHILDHOOD. IMPROVED UNDERSTANDING OF OPTIMAL NUTRITION AND ON MAINTAINING GUT AND LIVER HOMEOSTASIS THROUGHOUT CHILDHOOD WILL HELP PREVENT CHRONIC DISEASES IN LATER LIFE. 2014 10 4592 23 NATURAL ENVIRONMENTS, NATURE RELATEDNESS AND THE ECOLOGICAL THEATER: CONNECTING SATELLITES AND SEQUENCING TO SHINRIN-YOKU. RECENT ADVANCES IN RESEARCH CONCERNING THE PUBLIC HEALTH VALUE OF NATURAL ENVIRONMENTS HAVE BEEN REMARKABLE. THE GROWING INTEREST IN THIS TOPIC (OFTEN HOUSED UNDER TERMS SUCH AS GREEN AND/OR BLUE SPACE) HAS BEEN OCCURRING IN PARALLEL WITH THE MICROBIOME REVOLUTION AND AN INCREASED USE OF REMOTE SENSING TECHNOLOGY IN PUBLIC HEALTH. IN THE CONTEXT OF BIODIVERSITY LOSS, RAPID URBANIZATION, AND ALARMING RATES OF GLOBAL NON-COMMUNICABLE DISEASES (MANY ASSOCIATED WITH CHRONIC, LOW-GRADE INFLAMMATION), DISCUSSIONS OF NATURAL VIS-A-VIS BUILT ENVIRONMENTS ARE NOT MERELY FODDER FOR INTELLECTUAL CURIOSITY. HERE, WE ARGUE FOR INCREASED INTERDISCIPLINARY COLLABORATION WITH THE AIM OF BETTER UNDERSTANDING THE MECHANISMS-INCLUDING AEROBIOLOGICAL AND EPIGENETIC-THAT MIGHT HELP EXPLAIN SOME OF THE NOTED POSITIVE HEALTH OUTCOMES. IT IS OUR CONTENTION THAT SOME OF THESE MECHANISMS ARE RELATED TO ECODIVERSITY (I.E., THE SUM OF BIODIVERSITY AND GEODIVERSITY, INCLUDING BIOTIC AND ABIOTIC CONSTITUENTS). WE ALSO ENCOURAGE RESEARCHERS TO MORE CLOSELY EXAMINE INDIVIDUAL NATURE RELATEDNESS AND HOW IT MIGHT INFLUENCE MANY OUTCOMES THAT ARE AT THE INTERFACE OF LIFESTYLE HABITS AND CONTACT WITH ECODIVERSITY. 2016 11 704 25 BUILDING RESILIENCE AGAINST THE SEQUELAE OF ADVERSE CHILDHOOD EXPERIENCES: RISE UP, CHANGE YOUR LIFE, AND REFORM HEALTH CARE. A REFORMED APPROACH TO HEALTH CARE TACKLES HEALTH AT ITS ROOTS. ADVERSE CHILDHOOD EXPERIENCES (ACES) IN THOSE EXPOSED TO THEM MAY CONTRIBUTE SIGNIFICANTLY TO THE ROOT CAUSES OF MANY DISEASES OF LIFESTYLE. ACES ARE TRAUMATIC EXPERIENCES, SUCH AS PHYSICAL AND EMOTIONAL ABUSE AND EXPOSURE TO RISKY FAMILY ENVIRONMENTS. IN 1998, A GROUND-BREAKING STUDY FOUND THAT NEARLY 70% OF AMERICANS EXPERIENCE AT LEAST 1 ACE IN THEIR LIFETIME, AND GRADED EXPOSURE IS ASSOCIATED WITH THE PRESENCE OF MENTAL HEALTH DISORDERS, HEART DISEASE, CANCER, AND OTHER CHRONIC DISEASES. OVER THE PAST 20 YEARS, EVIDENCE HAS DEMONSTRATED FURTHER DISEASE RISK, OUTCOMES, AND EPIGENETIC UNDERPINNINGS IN CHILDREN AND ADULTS WITH ACES. BUILDING RESILIENCE-THE CAPACITY TO ADAPT IN HEALTHY WAYS TO TRAUMATIC EXPERIENCES-THROUGH LIFESTYLE MODIFICATION OFFERS POTENTIAL TO COMBAT THE NEGATIVE HEALTH EFFECTS ASSOCIATED WITH ACES. EMERGING RESEARCH DEMONSTRATES RESILIENCE IS CULTIVATED THROUGH INDIVIDUAL SKILLS (EMOTIONAL INTELLIGENCE, COPING, AND FOSTERING HEALTHY LIFESTYLE CHOICES), AND NURTURING SUPPORTIVE RELATIONSHIPS. BEING MINDFUL OF THE IMPACT AND PREVALENCE OF ACES AND DIVERSITY OF INDIVIDUALS' EXPERIENCES IN SOCIETY WILL HELP BUILD RESILIENCE AND COMBAT THE ROOT CAUSE OF CHRONIC DISEASE. THIS REVIEW AIMS TO CULTIVATE THAT AWARENESS AND WILL DISCUSS 3 OBJECTIVES: TO DISCUSS THE EFFECTS AND HYPOTHESIZED PATHOPHYSIOLOGICAL UNDERPINNINGS OF TRAUMATIC EXPERIENCES IN CHILDHOOD ON HEALTH AND WELLBEING THROUGHOUT LIFE, TO PRESENT WAYS WE CAN PROMOTE RESILIENCE IN OUR DAILY LIVES AND PATIENT ENCOUNTERS, AND TO DEMONSTRATE HOW ADVOCACY FOR THE REDUCTION OF ACES AND PROMOTION OF RESILIENT, TRAUMA-INFORMED ENVIRONMENTS ARE FUNDAMENTAL TO HEALTH CARE REFORM. 2019 12 4067 21 MATERNAL AND PEDIATRIC HEALTH AND DISEASE: INTEGRATING BIOPSYCHOSOCIAL MODELS AND EPIGENETICS. THE CONCEPTS OF ALLOSTASIS (STABILITY THROUGH ADAPTATION) AND ACCUMULATED LIFE STRESS (MCEWEN'S ALLOSTATIC LOAD) AIM TO UNDERSTAND CHILDHOOD AND ADULT OUTCOMES. CHRONIC MALNUTRITION, CHANGES IN SOCIAL CONDITION, AND ADVERSE EARLY-LIFE EXPERIENCES MAY PROGRAM PHENOTYPES AND CONTRIBUTE TO LONG-LASTING DISEASE RISK. HOWEVER, INTEGRATION OF LIFE COURSE APPROACHES, SOCIAL AND ECONOMIC CONTEXTS, AND COMPARISON AMONG DIFFERENT BIOPSYCHOSOCIAL MODELS HAS NOT GENERALLY BEEN EXPLORED. THIS REVIEW CRITICALLY EXAMINES THE LITERATURE AND EVALUATES RECENT INSIGHTS INTO HOW ENVIRONMENTAL STRESS CAN ALTER LIFELONG HYPOTHALAMIC-PITUITARY-ADRENAL AXIS AND IMMUNE SYSTEM RESPONSIVENESS AND INDUCE METABOLIC AND NEURODEVELOPMENTAL MALADAPTATION. MODELS OF BIOPSYCHOSOCIAL STRESS OVERLAP BUT MAY CONSIDER DIFFERENT CONDITIONS. CONCEPTS INCLUDE ALLOSTASIS, WHICH INCORPORATES HORMONAL RESPONSES TO PREDICTABLE ENVIRONMENTAL CHANGES, AND GERONIMUS'S "WEATHERING," WHICH AIMS TO EXPLAIN HOW SOCIALLY STRUCTURED, REPEATED STRESS CAN ACCUMULATE AND INCREASE DISEASE VULNERABILITY. WEATHERING EMPHASIZES ROLES OF INTERNALIZED/INTERPERSONAL RACISM IN OUTCOMES DISPARITIES. FOR MEXICAN IMMIGRANTS AND MEXICAN AMERICANS, THE "ACCULTURATION" FRAMEWORK HAS PROVEN ESPECIALLY USEFUL TO EXPLORE DISPARITIES, INCLUDING PRETERM BIRTH AND NEUROPSYCHIATRIC RISKS IN CHILDHOOD. COMPLEXITIES OF STRESS ASSESSMENTS AND RECENT RESEARCH INTO EPIGENETIC MECHANISMS MEDIATING EFFECTS OF PHYSICAL, NUTRITIONAL, PSYCHOLOGICAL, AND SOCIAL STRESS ARE REVIEWED. 2016 13 6483 24 TOXIC STRESS, EPIGENETICS AND CHILD DEVELOPMENT. OBJECTIVES: TO DESCRIBE THE CONCEPT OF TOXIC STRESS, PRESENT THE BASICS OF EPIGENETICS AND DISCUSS THEIR RELATIONSHIP WITH CHILD DEVELOPMENT. DATA SOURCE: NARRATIVE LITERATURE REVIEW THROUGH A SEARCH IN THE SCIELO, LILACS, MEDLINE DATABASES USING THE TERMS ADVERSE CHILDHOOD EXPERIENCE OR EARLY LIFE STRESS, EPIGENOMIC OR EPIGENETIC, CHILD DEVELOPMENT OR INFANT DEVELOPMENT. DATA SYNTHESIS: CONTINUING STRESS RESPONSE, KNOWN AS TOXIC STRESS, CAN OCCUR WHEN A CHILD EXPERIENCES INTENSE, FREQUENT, AND/OR PROLONGED ADVERSITY-SUCH AS PHYSICAL OR EMOTIONAL ABUSE, CHRONIC NEGLECT, FOR EXAMPLE-WITHOUT ADEQUATE ADULT SUPPORT. THIS TOXIC STRESS CAN HAVE HARMFUL EFFECTS ON LEARNING, BEHAVIOR, AND HEALTH THROUGHOUT LIFE. EPIGENETICS, AN EMERGING SCIENTIFIC RESEARCH AREA?, SHOWS HOW ENVIRONMENTAL INFLUENCES AFFECT GENE EXPRESSIONS AND EXPLAINS HOW EARLY EXPERIENCES CAN IMPACT THROUGHOUT LIFE. CONCLUSIONS: TOXIC STRESS CAUSES CHANGES IN THE HUMAN BODY RESPONSE SYSTEMS THAT CAN BE EXPLAINED IN PART BY EPIGENETIC CHANGES, WHICH CAN BE TEMPORARY OR LONG-LASTING. PEDIATRICIANS MUST BE AWARE OF THESE MECHANISMS AND THEIR CONSEQUENCES, SEEKING TO PREVENT THEM AND THUS PROMOTE THE HEALTH, WELL-BEING, AND QUALITY OF LIFE OF CHILDREN, CONTRIBUTING TO THEIR FULL DEVELOPMENT. 2022 14 4080 10 MATERNAL LIFESTYLE INTERVENTIONS: TARGETING PRECONCEPTION HEALTH. ABOUT ONE-THIRD OF WOMEN OF REPRODUCTIVE AGE ARE OBESE, PREDISPOSING BOTH MOTHER AND BABY TO UNFAVOURABLE PREGNANCY OUTCOMES AND INITIATING AN INTERGENERATIONAL CYCLE OF CHRONIC METABOLIC DISORDERS. HERE WE SUMMARISE RECENT RESEARCH ON THE INFLUENCE OF MATERNAL METABOLIC HEALTH ON OFFSPRING SUSCEPTIBILITY TO FUTURE CARDIOMETABOLIC DISEASES. CURRENT PRIMARY LIFESTYLE APPROACHES (I.E., DIET AND EXERCISE INTERVENTIONS) TO HALT THE SUCCESSION OF INHERITED AND EPIGENETIC METABOLIC ABNORMALITIES HAVE MET WITH LIMITED SUCCESS DUE TO LATE IMPLEMENTATION, POOR ADHERENCE, AND/OR GENERIC GUIDELINES. IN OUR OPINION, SUCH INTERVENTIONS MUST COMMENCE PRIOR TO CONCEPTION TO IMPROVE BOTH MATERNAL AND CHILD HEALTH OUTCOMES, WITH NEW APPROACHES URGENTLY NEEDED TO INCREASE ADHERENCE TO PRIMARY LIFESTYLE CHANGES AMONG REPRODUCTIVE-AGE WOMEN. 2020 15 2518 25 EPIGENETICS AND THE EMBODIMENT OF RACE: DEVELOPMENTAL ORIGINS OF US RACIAL DISPARITIES IN CARDIOVASCULAR HEALTH. THE RELATIVE CONTRIBUTION OF GENETIC AND ENVIRONMENTAL INFLUENCES TO THE US BLACK-WHITE DISPARITY IN CARDIOVASCULAR DISEASE (CVD) IS HOTLY DEBATED WITHIN THE PUBLIC HEALTH, ANTHROPOLOGY, AND MEDICAL COMMUNITIES. IN THIS ARTICLE, WE REVIEW EVIDENCE FOR DEVELOPMENTAL AND EPIGENETIC PATHWAYS LINKING EARLY LIFE ENVIRONMENTS WITH CVD, AND CRITICALLY EVALUATE THEIR POSSIBLE ROLE IN THE ORIGINS OF THESE RACIAL HEALTH DISPARITIES. AFRICAN AMERICANS NOT ONLY SUFFER FROM A DISPROPORTIONATE BURDEN OF CVD RELATIVE TO WHITES, BUT ALSO HAVE HIGHER RATES OF THE PERINATAL HEALTH DISPARITIES NOW KNOWN TO BE THE ANTECEDENTS OF THESE CONDITIONS. THERE IS EXTENSIVE EVIDENCE FOR A SOCIAL ORIGIN TO PREMATURITY AND LOW BIRTH WEIGHT IN AFRICAN AMERICANS, REFLECTING PATHWAYS SUCH AS THE EFFECTS OF DISCRIMINATION ON MATERNAL STRESS PHYSIOLOGY. IN LIGHT OF THE INVERSE RELATIONSHIP BETWEEN BIRTH WEIGHT AND ADULT CVD, THERE IS NOW A STRONG RATIONALE TO CONSIDER DEVELOPMENTAL AND EPIGENETIC MECHANISMS AS LINKS BETWEEN EARLY LIFE ENVIRONMENTAL FACTORS LIKE MATERNAL STRESS DURING PREGNANCY AND ADULT RACE-BASED HEALTH DISPARITIES IN DISEASES LIKE HYPERTENSION, DIABETES, STROKE, AND CORONARY HEART DISEASE. THE MODEL OUTLINED HERE BUILDS UPON SOCIAL CONSTRUCTIVIST PERSPECTIVES TO HIGHLIGHT AN IMPORTANT SET OF MECHANISMS BY WHICH SOCIAL INFLUENCES CAN BECOME EMBODIED, HAVING DURABLE AND EVEN TRANSGENERATIONAL INFLUENCES ON THE MOST PRESSING US HEALTH DISPARITIES. WE CONCLUDE THAT ENVIRONMENTALLY RESPONSIVE PHENOTYPIC PLASTICITY, IN COMBINATION WITH THE BETTER-STUDIED ACUTE AND CHRONIC EFFECTS OF SOCIAL-ENVIRONMENTAL EXPOSURES, PROVIDES A MORE PARSIMONIOUS EXPLANATION THAN GENETICS FOR THE PERSISTENCE OF CVD DISPARITIES BETWEEN MEMBERS OF SOCIALLY IMPOSED RACIAL CATEGORIES. 2009 16 3797 13 INTERNATIONAL BREAST CANCER AND NUTRITION: A MODEL FOR RESEARCH, TRAINING AND POLICY IN DIET, EPIGENETICS, AND CHRONIC DISEASE PREVENTION. THIS ARTICLE SUMMARIZES PRESENTATIONS FROM THE INTERNATIONAL BREAST CANCER AND NUTRITION WORKSHOP HELD DURING THE ASN SCIENTIFIC SESSIONS AND ANNUAL MEETING AT EXPERIMENTAL BIOLOGY 2014 IN SAN DIEGO, CA, ON 28 APRIL 2014. AN INTERNATIONAL COLLABORATION WAS DESCRIBED AMONG TEAMS FROM LOW-, MIDDLE-, AND HIGH-INCOME COUNTRIES ADDRESSING ENVIRONMENTAL FACTORS, ESPECIALLY DIET, AND EPIGENETIC INTERACTIONS THAT AFFECT THE RISK OF CHRONIC DISEASE. SPEAKERS ADDRESSED OPPORTUNITIES AND CHALLENGES INVOLVED IN THIS TYPE OF INTERNATIONAL COLLABORATION, ASSESSING DIET AND NUTRITIONAL STATUS ACROSS A WIDE RANGE OF CULTURES, AND RESEARCH TOOLS AND DISCOVERIES FROM THIS GROUP. 2014 17 1936 27 ENVIRONMENTAL RISK FACTORS OF TYPE 2 DIABETES-AN EXPOSOME APPROACH. TYPE 2 DIABETES IS ONE OF THE MAJOR CHRONIC DISEASES ACCOUNTING FOR A SUBSTANTIAL PROPORTION OF DISEASE BURDEN IN WESTERN COUNTRIES. THE MAJORITY OF THE BURDEN OF TYPE 2 DIABETES IS ATTRIBUTED TO ENVIRONMENTAL RISKS AND MODIFIABLE RISK FACTORS SUCH AS LIFESTYLE. THE ENVIRONMENT WE LIVE IN, AND CHANGES TO IT, CAN THUS CONTRIBUTE SUBSTANTIALLY TO THE PREVENTION OF TYPE 2 DIABETES AT A POPULATION LEVEL. THE 'EXPOSOME' REPRESENTS THE (MEASURABLE) TOTALITY OF ENVIRONMENTAL, I.E. NONGENETIC, DRIVERS OF HEALTH AND DISEASE. THE EXTERNAL EXPOSOME COMPRISES ASPECTS OF THE BUILT ENVIRONMENT, THE SOCIAL ENVIRONMENT, THE PHYSICO-CHEMICAL ENVIRONMENT AND THE LIFESTYLE/FOOD ENVIRONMENT. THE INTERNAL EXPOSOME COMPRISES MEASUREMENTS AT THE EPIGENETIC, TRANSCRIPT, PROTEOME, MICROBIOME OR METABOLOME LEVEL TO STUDY EITHER THE EXPOSURES DIRECTLY, THE IMPRINTS THESE EXPOSURES LEAVE IN THE BIOLOGICAL SYSTEM, THE POTENTIAL OF THE BODY TO COMBAT ENVIRONMENTAL INSULTS AND/OR THE BIOLOGY ITSELF. IN THIS REVIEW, WE DESCRIBE THE EVIDENCE FOR ENVIRONMENTAL RISK FACTORS OF TYPE 2 DIABETES, FOCUSING ON BOTH THE GENERAL EXTERNAL EXPOSOME AND IMPRINTS OF THIS ON THE INTERNAL EXPOSOME. STUDIES PROVIDED ESTABLISHED ASSOCIATIONS OF AIR POLLUTION, RESIDENTIAL NOISE AND AREA-LEVEL SOCIOECONOMIC DEPRIVATION WITH AN INCREASED RISK OF TYPE 2 DIABETES, WHILE NEIGHBOURHOOD WALKABILITY AND GREEN SPACE ARE CONSISTENTLY ASSOCIATED WITH A REDUCED RISK OF TYPE 2 DIABETES. THERE IS LITTLE OR INCONSISTENT EVIDENCE ON THE CONTRIBUTION OF THE FOOD ENVIRONMENT, OTHER ASPECTS OF THE SOCIAL ENVIRONMENT AND OUTDOOR TEMPERATURE. THESE ENVIRONMENTAL FACTORS ARE THOUGHT TO AFFECT TYPE 2 DIABETES RISK MAINLY THROUGH MECHANISMS INCORPORATING LIFESTYLE FACTORS SUCH AS PHYSICAL ACTIVITY OR DIET, THE MICROBIOME, INFLAMMATION OR CHRONIC STRESS. TO FURTHER ASSESS CAUSALITY OF THESE ASSOCIATIONS, FUTURE STUDIES SHOULD FOCUS ON INVESTIGATING THE LONGITUDINAL EFFECTS OF OUR ENVIRONMENT (AND CHANGES TO IT) IN RELATION TO TYPE 2 DIABETES RISK AND WHETHER THESE ASSOCIATIONS ARE EXPLAINED BY THESE PROPOSED MECHANISMS. 2022 18 29 23 A BIOPSYCHOSOCIAL OVERVIEW OF THE OPIOID CRISIS: CONSIDERING NUTRITION AND GASTROINTESTINAL HEALTH. THE OPIOID CRISIS HAS REACHED EPIDEMIC PROPORTIONS IN THE UNITED STATES WITH RISING OVERDOSE DEATH RATES. IDENTIFYING THE UNDERLYING FACTORS THAT CONTRIBUTE TO ADDICTION VULNERABILITY MAY LEAD TO MORE EFFECTIVE PREVENTION STRATEGIES. SUPPLY SIDE ENVIRONMENTAL FACTORS ARE A MAJOR CONTRIBUTING COMPONENT. PSYCHOSOCIAL FACTORS SUCH AS STRESS, TRAUMA, AND ADVERSE CHILDHOOD EXPERIENCES HAVE BEEN LINKED TO EMOTIONAL PAIN LEADING TO SELF-MEDICATION. GENETIC AND EPIGENETIC FACTORS ASSOCIATED WITH BRAIN REWARD PATHWAYS AND IMPULSIVITY ARE KNOWN PREDICTORS OF ADDICTION VULNERABILITY. THIS REVIEW ATTEMPTS TO PRESENT A BIOPSYCHOSOCIAL APPROACH THAT CONNECTS VARIOUS SOCIAL AND BIOLOGICAL THEORIES RELATED TO THE ADDICTION CRISIS. THE EMERGING ROLE OF NUTRITION THERAPY WITH AN EMPHASIS ON GASTROINTESTINAL HEALTH IN THE TREATMENT OF OPIOID USE DISORDER IS PRESENTED. THE BIOPSYCHOSOCIAL MODEL INTEGRATES CONCEPTS FROM SEVERAL DISCIPLINES, EMPHASIZING MULTICAUSALITY RATHER THAN A REDUCTIONIST APPROACH. POTENTIAL SOLUTIONS AT MULTIPLE LEVELS ARE PRESENTED, CONSIDERING INDIVIDUAL AS WELL AS POPULATION HEALTH. THIS SINGLE COHESIVE FRAMEWORK IS BASED ON THE INTERDEPENDENCY OF THE ENTIRE SYSTEM, IDENTIFYING RISK AND PROTECTIVE FACTORS THAT MAY INFLUENCE SUBSTANCE-SEEKING BEHAVIOR. NUTRITION SHOULD BE INCLUDED AS ONE FACET OF A MULTIDISCIPLINARY APPROACH TOWARD IMPROVED RECOVERY OUTCOMES. CROSS-DISCIPLINARY COLLABORATIVE EFFORTS, NEW IDEAS, AND FISCAL RESOURCES WILL BE CRITICAL TO ADDRESS THE EPIDEMIC. 2019 19 1 12 ON DECEMBER 5, 2017, THE NATIONAL ACADEMIES OF SCIENCES, ENGINEERING, AND MEDICINE HOSTED A PUBLIC WORKSHOP TITLED NUTRIGENOMICS AND THE FUTURE OF NUTRITION IN WASHINGTON, DC, TO REVIEW CURRENT KNOWLEDGE IN THE FIELD OF NUTRIGENOMICS AS IT RELATES TO NUTRITION. WORKSHOP PARTICIPANTS EXPLORED THE INFLUENCE OF GENETIC AND EPIGENETIC EXPRESSION ON NUTRITIONAL STATUS AND THE POTENTIAL IMPACT OF PERSONALIZED NUTRITION ON HEALTH MAINTENANCE AND CHRONIC DISEASE PREVENTION. THIS PUBLICATION SUMMARIZES THE PRESENTATIONS AND DISCUSSIONS FROM THE WORKSHOP. 2018 20 6626 22 UNDERSTANDING RESILIENCE. RESILIENCE IS THE ABILITY TO ADAPT SUCCESSFULLY IN THE FACE OF STRESS AND ADVERSITY. STRESSFUL LIFE EVENTS, TRAUMA, AND CHRONIC ADVERSITY CAN HAVE A SUBSTANTIAL IMPACT ON BRAIN FUNCTION AND STRUCTURE, AND CAN RESULT IN THE DEVELOPMENT OF POSTTRAUMATIC STRESS DISORDER (PTSD), DEPRESSION AND OTHER PSYCHIATRIC DISORDERS. HOWEVER, MOST INDIVIDUALS DO NOT DEVELOP SUCH ILLNESSES AFTER EXPERIENCING STRESSFUL LIFE EVENTS, AND ARE THUS THOUGHT TO BE RESILIENT. RESILIENCE AS SUCCESSFUL ADAPTATION RELIES ON EFFECTIVE RESPONSES TO ENVIRONMENTAL CHALLENGES AND ULTIMATE RESISTANCE TO THE DELETERIOUS EFFECTS OF STRESS, THEREFORE A GREATER UNDERSTANDING OF THE FACTORS THAT PROMOTE SUCH EFFECTS IS OF GREAT RELEVANCE. THIS REVIEW FOCUSES ON RECENT FINDINGS REGARDING GENETIC, EPIGENETIC, DEVELOPMENTAL, PSYCHOSOCIAL, AND NEUROCHEMICAL FACTORS THAT ARE CONSIDERED ESSENTIAL CONTRIBUTORS TO THE DEVELOPMENT OF RESILIENCE. NEURAL CIRCUITS AND PATHWAYS INVOLVED IN MEDIATING RESILIENCE ARE ALSO DISCUSSED. THE GROWING UNDERSTANDING OF RESILIENCE FACTORS WILL HOPEFULLY LEAD TO THE DEVELOPMENT OF NEW PHARMACOLOGICAL AND PSYCHOLOGICAL INTERVENTIONS FOR ENHANCING RESILIENCE AND MITIGATING THE UNTOWARD CONSEQUENCES. 2013