{"doi":"10.1111/jan.70225","title":"The Right Framework, The Right Questions: Advancing Resilience Through a Multi‐Level Framework","abstract":"This section on the Society to Cells Resilience Framework emerges at a pivotal moment. First, decades of nursing science have illuminated a crucial truth: focusing on individuals alone is necessary but not sufficient. Each person is shaped by the intersecting forces of family, community and societal context. Second, as science and expertise face growing attacks worldwide, demonstrating the power of strong theoretical foundations becomes essential–when we establish the right framework, we unlock the right questions and unleash our most impactful science. We have used the framework to undergird our own work. Dr. Gill's work examines when and how traumatic brain injuries (TBIs) (including those from assaultive trauma) impact the health and well-being of military personnel, veterans, and emergency department patients. Her research reveals why some individuals thrive after trauma and some do not. Her work has shown that cumulative trauma and TBIs can impact individuals as they age, leading to compromises in neuronal functioning and cognition—but the striking finding is that while a subset is vulnerable, most are not; they are able to overcome these risks without developing any long-term consequences. However, one-fifth to one-third experience a cascade of health problems after multiple TBIs and traumatic events—cardiovascular disease, post-traumatic stress disorder (PTSD), depression, substance abuse—that compromises their resilience to future challenges, including biological aging. By studying cohorts with similar experiences, but differential outcomes, she identifies both protective and vulnerability factors. Her recent work has connected increased central inflammation—measured through cytokine activities within neuronally derived exosomes—to brain inflammation on positron emission tomography (PET), neuronal degradation, and overall reductions in health and well-being. These findings reveal that the brain has a tipping point in resilience that varies based on an individual's lifetime experiences and highlights the need for promoting brain health on all levels. Her future studies will integrate biomarkers of brain health into practical tools that help individuals understand their resilience and work with patients and their families to promote resilience to brain injury. Dr. Gill has also published a series of papers demonstrating how social determinants of health impact biological recovery from traumatic events and injuries. Her work has consistently shown that sex and gender fundamentally shape health responses to stress and trauma. This goes beyond simply noting gender differences—instead its understanding the individual as an embedded person, shaped by all aspects of their environment, and developing biological adaptations that enhance flexibility in responding to future stressors—a hallmark of resilience. This honours each person's complete experience rather than simply categorising them as different from a dominant norm. ‘Cellular resistance’ captures this phenomenon—across cell types, complex processes including epigenetic modifications create these flexible personalised responses. Dr. Szanton's work has focused on building resilience across multiple levels—from individuals to entire communities. First, she co-developed the CAPABLE programme, which restores function to older adults living with disability. The programme works by focusing on older adults' strengths and goals and providing physical changes to the home with support from an Occupational Therapist, a Nurse, and a Handyworker. Over four months, the occupational therapist and nurse help older adults problem-solve around their personal goals with particular attention to reducing difficulty with vital daily tasks such as bathing and dressing. This focus on daily function is critical—it determines whether older adults can age independently in their communities or require institutional care. CAPABLE has been validated through multiple clinical trials in diverse settings","journal":"Journal of Advanced Nursing","year":2025,"id":574990,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9551,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":375754,"name":"Jessica Gill","orcid":"0000-0002-3689-7441","position":1,"is_corresponding":false},{"id":438124,"name":"Sarah L. Szanton","orcid":"0000-0001-5418-4982","position":0,"is_corresponding":true}],"reference_count":5,"raw_metadata":null,"created_at":"2026-07-19T02:57:44.572630Z","pmid":"40955779","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}