Objective: While everyone-including front-line clinicians-should strive to prevent the maltreatment and other severe stresses experienced by many children and adults in everyday life, psychiatrists and other health professionals also need to consider how best to support, throughout the lifespan, those people affected by severe adversity. The first step in achieving this is a clear understanding of the definitions and concepts in the rapidly growing study of resilience. Our paper reviews the definitions of resilience and the range of factors understood as contributing to it, and considers some of the implications for clinical care and public health. Clinical Implications• Effective clinical care and public health work to develop resilience require partnerships across health and nonhealth sectors.• Psychiatrists and other mental health professionals should collaborate with policy-makers in developing policies and interventions to bolster resilience.• Clinical and public health interventions each have a role in improving the chances of resilience among children and adults affected by severe adversity. Interventions across the lifespan include support for parents of infants, early childhood intervention programs, school-based interventions, workplace and unemployment programs, and activity programs for older adults.• Clinical implications include renewed emphasis on the value of a clinician taking a good history, a strong therapeutic alliance, and the reinforcement of attitudes and behaviours known to facilitate resilient outcomes. Limitations• There is a lack of consensus regarding an operational definition of resilience, although investigators have recently commented that the limitation is less significant than it appears, as most definitions use similar domains as evidence of resilience.• The clinical relevance is not so far established for measures of resilience, though their experimental use will likely assist rapid growth in understanding the effectiveness of protective interventions.• Given the multidisciplinary study of resilience, a literature search based on MEDLINE and PsycINFO may restrict the findings although it is likely to give access to major ideas.

Quarantined workers experienced stigma, fear, and frustration. We highlight the need for clear and easily accessible information on dealing with infectious diseases. Practical advice on coping and stress management techniques for health care workers are needed in preparation for potential future outbreaks of infectious diseases.

Objectives: To determine the prevalence of physical abuse during late pregnancy and to investigate how abused and nonabused pregnant women differ in demographic characteristics, health habits, psychologic distress and attitudes about fetal health. Design: Survey of women attending for prenatal health care or admitted to hospital for delivery. The information was obtained on one occasion from self-report questionnaires, completed with the option of anonymity. Settings: Community-based prenatal clinic, private obstetricians' offices in a large city, private family physicians' offices in a large city, family physicians' offices in a small town, and a university teaching hospital. Patients: English-speaking women at 20 weeks' or more gestation attending or admitted consecutively.Interventions: Three self-report questionnaires: the General Health Questionnaire (GHQ), the Fetal Health Locus of Control (FHLC) and the study questionnaire. Results: Thirteen women (2.4%) refused to participate in the survey. Of the 548 women who completed the questionnaires 36 (6.6%) reported physical abuse during the current pregnancy and 60 (10.9%) before it. There were no significant differences in rates of abuse between settings. Of the women abused during the pregnancy 23 (63.9%) reported increased abuse during the pregnancy, and 28 (77.8%) remained with the abuser. Twenty-four pregnant women (66.7%) received medical treatment for abuse, but only 1, (2.8%) told her prenatal care provider of the abuse. Factor analysis revealed three factors associated with physical abuse in pregnancy: "social instability" (comprising low age, unmarried status, lower level of education, unemployment and unplanned pregnancy), "unhealthy lifestyle" (comprising poor diet, alcohol use, illicit drug use and emotional problems) and "physical health problems" (comprising health problems and prescription drug use). The GHQ scores showed that the abused women were significantly more emotionally distressed than the nonabused women (p < 0.001). The FHLC scores showed that the abused women believed they had little "intemal control" over the health of their fetuses and that "chance" played the most important role in the outcome of their pregnancy (p < 0.001). Conclusions: Abused pregnant patients are a frequently undetected high-risk group. Prenatal care should include a routine screening question about domestic violence, and identified patients should be appropriately counselled and referred.