Mediation, Moderation, and Conditional Process Analysis: Concepts, Computations, and Some Common Confusions

Body Satisfaction, Exercise Dependence, and White Matter Microstructure in Young Adults

BACKGROUND

Self-body satisfaction is considered a psychological factor for exercise dependence (EXD). However, the potential neuropsychological mechanisms underlying this association remain unclear.

PURPOSE

To investigate the role of white matter microstructure in the association between body satisfaction and EXD.

STUDY TYPE

Prospective.

POPULATION

One hundred eight regular exercisers (age 22.11 ± 2.62 years; 58 female).

FIELD STRENGTH/SEQUENCE

3.0 Tesla; diffusion-weighted echo planar imaging with 30 directions.

ASSESSMENT

The Body Shape Satisfaction (BSS) and Exercise Dependence Scale (EDS); whole-brain tract-based spatial statistics (TBSS) and correlational tractography analyses; average fractional anisotropy (FA) and quantitative anisotropy (QA) values of obtained tracts.

STATISTICAL TESTS

The whole-brain regression model, mediation analysis, and simple slope analysis. P values <0.05 were defined as statistically significant.

RESULTS

The BSS and EDS scores were 37.33 ± 6.32 and 68.22 ± 13.88, respectively. TBSS showed negative correlations between EDS and FA values in the bilateral corticospinal tract (CST, r = -0.41), right cingulum (r = -0.41), and left superior thalamic radiation (STR, r = -0.50). Correlational tractography showed negative associations between EDS and QA values of the left inferior frontal occipital fasciculus (r = -0.35), STR (r = -0.42), CST (r = -0.31), and right cingulum (r = -0.28). The FA values, rather than QA values, mediated the BSS-EDS association (indirect effects = 0.30). The BSS was significantly associated with the EDS score at both low (β = 1.02) and high (β = 0.43) levels of FA value, while the association was significant only at the high level of QA value (β = 1.26).

DATA CONCLUSION

EXD was correlated with white matter in frontal-subcortical and sensorimotor networks, and these tracts mediated the body satisfaction-EXD association. White matter microstructure could be a promising neural signature for understanding the underlying neuropsychological mechanisms of EXD.

LEVEL OF EVIDENCE

2 TECHNICAL EFFICACY: Stage 1.

Impact of the five-pattern personality traits of traditional Chinese medicine on workplace violence and depression among nurses

BACKGROUND

Depression seriously damage the health of nurses. It is not conducive to the provision of medical services and hospital management. Meanwhile, nurses are a highly vulnerable group to workplace violence (WPV), increasing the risk of depression. Nurses with different personalities may have various views and feelings towards WPV, and their impact on depression may also vary. This study aims to reveal the impact of the five-pattern personality traits of traditional Chinese medicine (TCM) on WPV and depression among nurses, providing a new perspective for managers to implement psychological interventions.

METHODS

A cross-sectional study was conducted. 2,788 valid questionnaires nationwide were collected based on Wenjuanxing from June to July 2024. We used Patient Health Questionnaire Depression Scale-9 item, The five- pattern Personality Traits of TCM Scale, and Workplace Violence Scale. We used latent class analysis, structural equation modeling, and simple slope analysis to analyze depression classes, mediating effects, and moderation effects, respectively.

RESULTS

Depression is classified into three types: "Good mental health group" (34.2%), "Moderate depression group" (23.0%), and "Severe depression group" (42.8%). "Taiyang", "Shaoyang", and "Balance of Yin-Yang" personalities alleviate nurses' feelings of WPV, thereby reducing the impact of WPV on depression. The values of mediating effect are -0.402, -0.393, and -0.426, respectively (P < 0.05). "Taiyin" personality exacerbate nurses' perception of WPV, thereby increasing the impact of WPV on depression. The value of mediating effect is 0.418 (P < 0.05). "Taiyang" and "Shaoyang" personalities reduce the impact of WPV on depression of nurses, and the effect become more significant as the scores increase. The values of moderating effect are 0.033 and -0.0563 respectively (P < 0.05). "Taiyin" and "Shaoyin" personalities increase the impact of WPV on depression, and the effect become more significant as the scores increase. The values of moderating effect are -0.0444 and -0.0220 respectively (P < 0.05).

CONCLUSIONS

The prevalence of depression and WPV among Chinese nurses is serious. Excellent personality effectively improve the relationship between WPV and depression. Nursing managers should arrange suitable positions for nurses based on their different personality traits. At the same time, it is necessary to actively cultivate excellent personality traits in nurses to reduce the frequency of WPV and improve their mental health.

Internalized Transnegativity, Self-Warmth, Self-Coldness, and Eating Disorder Symptomatology Among Transgender and Nonbinary Adults

Eating disorders (EDs) are highly prevalent among transgender and nonbinary (TNB) adults, and internalized transnegativity is a key risk factor for ED symptomatology. Although extant literature has established that self-compassion protects against EDs among the cisgender population, research among TNB adults is nascent. The current study sought to identify whether internalized transnegativity and components of self-compassion (i.e., self-warmth and self-coldness) were independently associated with ED symptomatology, and whether the components of self-compassion moderated the relation between internalized transnegativity and ED symptomatology. An international sample of 127 TNB adults aged between 18 and 69 years (M = 32.24, SD = 11.12) completed the Transgender Identity Survey, the Self-Compassion Scale, and the Screen for Disordered Eating via an online survey. Simple linear regression models were run, followed by moderation analyses. Internalized transnegativity and self-coldness were associated with ED symptomatology, but self-warmth was not. Self-warmth and self-coldness did not moderate the relation between internalized transnegativity and ED symptomatology. The results highlight that self-coldness and, to a lesser extent, internalized transnegativity account for a significant portion of the variance in ED symptomatology among TNB adults. Although these effect sizes were small, they have important clinical implications. Future research should take alternative analytical approaches to examine how self-warmth, self-coldness, and internalized transnegativity are related to ED symptomatology among TNB adults.

How traditional cultural load affects tourists' purchasing intention of tourist souvenirs

Based on the previous studies on the impact of traditional culture on tourists' purchasing intentions, this study aims to further explore the mechanism and boundary conditions regarding the traditional cultural load in tourist souvenir packaging. Through seven simulated experiments (N = 3203), the impact of different degrees of traditional cultural load on tourists' purchasing intentions has been examined, with value perception, cultural identity, and purchase purpose, advancing the research in the field of traditional culture and tourism marketing. The findings provide insights for managers in the industry of tourism and souvenir marketing for their package design.

The mediating effect of job burnout on the relationship between practice environment and workplace deviance behavior of nurses in China: a cross-sectional study

BACKGROUND

Faced with a shortage of nurses in China, the factors affecting the stability of the nursing workforce require urgent attention. The workplace deviance behavior of nurses is considered an important behavior in clinical practice, which will bring negative effects and affect the development of nurse team. However, no research has been done to examine the associations among workplace deviance behavior of nurses, practice environment and job burnout. Thus, this study aimed to determine the influence of practice environment on nurses' workplace deviance behavior and confirm the mediating role of job burnout.

METHODS

This study was designed as a multicentre cross-sectional study, and recruited 598 nurses in China to complete a survey of the general information questionnaire, Scale of Workplace Deviance Behavior of Nurses, Practice Environment Scale, and Maslach Burnout Inventory General Survey. The model was examined using descriptive analysis, Pearson's correlation analysis, and the PROCESS Macro in SPSS 26.0.

RESULTS

The results of the correlation analysis demonstrated a significant relationship between the practice environment and work deviance behavior of nurses, as well as a negative relationship between job burnout and these two factors. Moreover, the relationship between practice environment and work deviance behavior among nurses was partially mediated by job burnout.

CONCLUSION

A healthy practice environment and a decrease in job burnout could directly lower the work deviant behavior of nurses. Hospital managers must actively endeavor to improve the practice environment for nurses by fostering a just, fair, and supportive practice environment and by keeping lines of communication open and strong with the nursing staff. Furthermore, managers can also reduce nurses' work deviance behavior by lower their job burnout.

Political Orientation and Attitudes Toward Sexual Harassment: The Moderating Role of Gender

Sexual harassment (SH) refers to unwelcome behavior that creates a hostile, intimidating, or offensive environment. This behavior can manifest through physical, verbal, or nonverbal actions. The present study analyzes the relationship between political orientation (left-wing, center, and right-wing) and attitudes toward SH with a focus on the moderating role of gender. We examined two types of attitudes: SH myth acceptance, and rejection of sexist remarks, specifically piropos. SH myths are widely held but false beliefs that serve to deny and justify male-perpetrated harassment of women. Piropos are a form of harassment prevalent in Spain, where strangers make unsolicited comments about a woman's appearance in public spaces. Data were collected at a Spanish university, and multiple regression analyses were performed (N = 303). Participants with left-wing political orientation showed significantly lower SH myth acceptance compared to both right-wing (β = .80, p < .001) and center-oriented participants (β = .51, p < .01). Similarly, left-wing participants showed significantly higher rejection of piropos compared to right-wing (β = -1.26, p < .001) and center-oriented participants (β = -.80, p < .01). Furthermore, the interaction between political orientation and gender revealed that men with right-wing political orientation showed higher SH myth acceptance (β = -.51, p < .05) and lower rejection of piropos (β = .96, p < .05) compared to women of the same political orientation.

Neighborhood disadvantage is associated with working memory and hippocampal volumes among older adults

It is not well understood how neighborhood disadvantage is associated with specific domains of cognitive function and underlying brain health within older adults. Thus, the objective was to examine associations between neighborhood disadvantage, brain health, and cognitive performance, and examine whether associations were more pronounced among women. The study included 136 older adults who underwent cognitive testing and MRI. Neighborhood disadvantage was characterized using the Area Deprivation Index (ADI). Descriptive statistics, bivariate correlations, and multiple regressions were run. Multiple regressions, adjusted for age, sex, education, and depression, showed that higher ADI state rankings (greater disadvantage) were associated with poorer working memory performance (p < .01) and lower hippocampal volumes (p < .01), but not total, frontal, and white matter lesion volumes, nor visual and verbal memory performance. There were no significant sex interactions. Findings suggest that greater neighborhood disadvantage may play a role in working memory and underlying brain structure.

From need to action: decoding the role of motivation in adherence to home-based cardiac rehabilitation exercise in chronic heart failure patients

BACKGROUND

Adherence to home-based cardiac rehabilitation exercise remains suboptimal, and motivation may be the intrinsic driving force. This study aimed to explore the role of exercise regulatory motivation in mediating the relationship between psychological needs and exercise adherence among chronic heart failure patients, and to develop a mechanism model.

METHODS

This study adopted an explanatory sequential mixed-methods design. A hypothesized model of adherence behavior was developed. A survey was used to test the theory-driven model. A semi-structured interview delved deeper into chronic heart failure patients' experiences with HBCR exercise, identifying reasons behind significant mediation effects and refining the mechanism model.

RESULTS

A total of 248 eligible chronic heart failure patients participated in the quantitative study. Exercise regulatory motivation partially mediated the relationship between psychological needs and exercise adherence. In the qualitative study, 18 chronic heart failure patients from the quantitative sample were purposefully selected. Five sub-themes emerged from the textual data, which were distilled into two overarching themes: "Specific Functions of Pathway Variables" and "Reasons for Mediation Path Significance." Integrating the qualitative and quantitative results, it was found that satisfying patients' psychological needs for exercise activates regulatory motivation, which in turn triggers sustained exercise behavior. As motivation becomes increasingly internalized, patients are able to set clear goals and maintain or adjust their home-based cardiac rehabilitation exercise over the long term.

CONCLUSION

From a health psychology perspective, this study is the first to reveal the role of exercise regulatory motivation in linking psychological needs and exercise adherence among chronic heart failure patients, ultimately developing a mechanism model.

CLINICAL TRIAL NUMBER

Not applicable.

Impact of diabetes on the progression of Alzheimer's disease via trajectories of amyloid-tau-neurodegeneration (ATN) biomarkers

BACKGROUND

Alzheimer's disease (AD) is characterized by the accumulation of abnormal proteins, such as β-amyloid and tau, in the brain, which precedes cognitive impairment. Although diabetes mellitus (DM) is a well-established risk factor for AD, few studies have investigated how the presence of DM affects the sequential pathogenesis of AD, specifically within the amyloid-tau-neurodegeneration (ATN) and cognition framework.

OBJECTIVES

This study aims to investigate the trajectories of ATN biomarkers in relation to the presence of DM in the preclinical and prodromal stages of AD.

DESIGN

Participants with normal cognition (CN) or mild cognitive impairment (MCI) at baseline were included. Subjects were followed for 12-192 months, with neuroimaging and cognitive assessments conducted at every 12 or 24 months.

SETTING

This study utilized data from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database.

PARTICIPANTS

A total of 603 participants aged 55-90 years were included, comprising 284 CN (25 with DM, 259 without DM) and 319 MCI (39 with DM, 280 without DM) individuals.

MEASUREMENTS

ATN biomarkers were identified using florbetapir positron emission tomography (PET), flortaucipir PET, and magnetic resonance imaging (MRI), respectively. Cognition was assessed using the Clinical Dementia Rating-Sum of Boxes (CDR-SB) and Mini-Mental State Examination (MMSE). Moderation analysis was conducted to investigate the effect of DM on the association between ATN biomarkers of AD.

RESULTS

Elevated amyloid standardized uptake value ratios (SUVRs) were associated with increased tau levels in the hippocampus, and this association was significantly enhanced by the presence of DM in MCI participants (p = 0.021). DM also strengthened the association between increased tau SUVR levels and neurodegeneration (indicated by decreased entorhinal cortical volumes; p = 0.005) in those with MCI. Furthermore, DM enhanced the association of decreased entorhinal (p = 0.012) and middle temporal cortex (p = 0.031) volumes with increased (worsened) CDR-SB scores in MCI participants. However, DM did not predict significant longitudinal changes in ATN pathology or cognitive decline in CN participants.

CONCLUSIONS

Our study suggests that DM may increase the risk of AD by accelerating each step of the A-T-N cascade in the prodromal stage of AD, underscoring the importance of DM management in preventing the MCI conversion to AD.

The moderating effect of cardiometabolic factors on the association between hepatic and intrapancreatic fat

OBJECTIVE

Previous studies have investigated the association between hepatic fat and intrapancreatic fat deposition (IPFD); however, results have been inconclusive. The presence of cardiometabolic factors in certain subpopulations could explain this discrepancy. The aim of the present study was to use moderation analyses to determine the conditions under which hepatic fat is associated with IPFD.

METHODS

All participants underwent 3T abdominal magnetic resonance imaging (MRI) and spectroscopy. Hepatic fat and IPFD were manually quantified by independent raters. Moderation analyses were performed with adjustment for sex and ethnicity.

RESULTS

There were 367 participants included. Adjusted analyses of the overall cohort revealed that age, glycated hemoglobin (HbA1c), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides were significant moderators (p < 0.05) of the association between hepatic fat and IPFD. Ranges of significance included age < 61 years, HbA1c < 45 mmol/mol, LDL-C < 157 mg/dL, HDL-C > 36 mg/dL, and triglycerides < 203 mg/dL.

CONCLUSIONS

The association between hepatic fat and IPFD is generally present in young and middle-aged adults with good cardiometabolic health, whereas the link between the two fat depots becomes uncoupled in older adults or individuals with cardiometabolic risk factors.

Do gendered racial microaggressions influence the relationship between body appreciation and Black emerging adult women's condom use behaviors?

Background: Sexual protective behaviors, such as consistent condom use and intention, are important preventative measures against the transmission of HIV/AIDS and sexually transmitted infections. Current sexual health research has yet to explore the interaction between contextual factors, such as gendered racial microaggressions, and the role of personal factors (i.e., body appreciation) on Black women's sexual risk and protective behaviors in the United States. Guided by objectification theory, we hypothesized that sexually objectifying gendered racial microaggressions moderated the body appreciation and condom use behaviors relationship. Participants: The current study consisted of 114 Black emerging adult women in the southern United States. Results: Results showed significant interactions between the frequency of sexually objectifying gendered racial microaggressions and body appreciation on consistent condom use and condom use intention. Conclusion: Overall, these findings suggested the need for sexual health researchers and interventionists to further explore the influence of gendered racial microaggressions and body appreciation on condom use behaviors.

Mediating role of gut microbiota on Baduanjin for cognitive function in community-dwelling older adults with mild cognitive impairment: a study protocol for a cluster randomised controlled trial

INTRODUCTION

The gut microbiome plays an important role in maintaining both cognitive and physical functions in older adults, and gut dysbiosis is an important pathophysiological mechanism of mild cognitive impairment (MCI) in older adults. As a typical traditional Chinese mind-body exercise, regular Baduanjin training has been shown to improve cognitive function and modulate the gut microbiome in community-dwelling older adults. However, the potential role of the gut microbiome in the benefits of Baduanjin on cognitive function remains unclear. The aim of this study is to investigate the mediating effect of gut microbiome between regular Baduanjin training and improvement in cognitive function in community-dwelling older adults with MCI.

METHODS AND ANALYSIS

This is a two-arm, randomised, parallel-controlled, single-blinded trial. Four residential communities (clusters) with a total of 64 eligible participants (16 participants in each residential community) will be randomised 1:1 to either the 24-week Baduanjin exercise intervention group (60 min per session, four sessions per week) or the no specific exercise intervention control group. Global cognitive function and the subdimensions of cognition including executive function, visuospatial function, language function and memory function will be assessed using the Montreal Cognitive Assessment Scale, Trail Making Test, Auditory Verbal Learning Test, Boston Naming Test-30 and Clock-Drawing Test, while the gut microbiome and its metabolomics will be detected using 16S rRNA and ultra-high-performance liquid chromatography-tandem mass spectrometry at baseline and at the end of 24-week intervention. The intervention effect of Baduanjin exercise and mediating role of gut microbiota will be analysed using linear mixed models and the bootstrapping method in the Hayes process.

ETHICS AND DISSEMINATION

This study conforms to Declaration of Helsinki principles and relevant ethical guidelines. Ethical approval has been obtained from the Ethics Committee of the Shanghai University of Medicine and Health Sciences (approval number: 2023-GZR-011). Written informed consent will be obtained from all participants. Results will be disseminated to relevant groups in peer-reviewed journal(s), and at relevant international or national scientific conferences. Key findings will also be shared with social media, healthcare providers, participants or community-dwelling older adults to support access for non-research audiences.

TRIAL REGISTRATION NUMBER

ChiCTR2300078147.

Prevention of frailty in relation with social out-of-home activities in older adults: results from the Survey of Health, Ageing, and Retirement in Europe

Out-of-home mobility and social participation have been identified as resources to postpone frailty. We aim to examine the mediating role and specific contribution of social out-of-home activities in frailty prevention. Data from the Survey of Health, Ageing, and Retirement in Europe (SHARE) waves six (w6), seven (w7), and eight (w8) were used. Frailty was measured with the SHARE version of the Edmonton Frail Scale (EFS) with frailty states fit, pre-fail and frail. First, a mediation model with 13,456 fit participants aged ≥ 50 years in w6 was specified with social network size, loneliness (UCLA 3-Item Loneliness Scale), and lack of motivation (EURO-D) as predictors and number of performed social out-of-home activities in w7 as mediator variable on EFS-scores in w8. Age, education, gender, cohabitation, widowhood, urban environment, and country served as covariates. Second, we investigated the association of increasing social out-of-home activities from w6 to w7 with change in EFS-score from w6 to w8 using a linear mixed model with 17,439 participants in all frailty states. Direct effects of loneliness (w6) and lack of motivation (w6) on EFS-scores (w8) were partially mediated by social out-of-home activities (loneliness ß = 0.005; 95% CI = 0.003-0.008) and (lack of motivation ß = 0.014; 95% CI = 0.009-0.019). The linear mixed model revealed a significant effect of increasing social out-of-home activities (w6-w7) on reduction of EFS-scores (w8) (ß = - 0.21; 95% CI = - 0.29-0.04; p < 0.001). Social out-of-home activities appear to play a crucial role in frailty prevention, which could be used for future interventions.

Turnover intention among healthcare workers in Shenzhen, China: the mediating effect of job satisfaction and work engagement

BACKGROUND

To ensure workforce stability in China's healthcare system and maintain high-quality care, it is essential to comprehensively understand the interplay of factors contributing to turnover intention of healthcare workers. This study aims to examine the associations between potential factors and turnover intention in healthcare workers and explore the mediating effect of job satisfaction and work engagement in the association between them.

METHODS

In this cross-sectional study, a random sample of 1060 healthcare workers working in 98 public medical institutions were recruited to rate their turnover intention in 2018 in Shenzhen, China. Information on socio-demographic characteristics, job-related factors, turnover intention, job satisfaction, work engagement, work stress and doctor-patient relationship of participants were collected. Pearson's chi-squared tests and binary logistic regression analyses were performed to explore the association between these factor and turnover intention. Mediation analysis was used to explore the roles of potential mediators and moderators.

RESULTS

The results showed that age (OR: 0.35, 95%CI: 0.16 to 0.72), tenure (OR: 0.98, 95%CI: 0.96 to 0.99), administrative positions (OR: 0.33, 95%CI: 0.16 to 0.63), and night shift frequency (OR: 1.84, 95%CI: 1.26 to 2.67) were significantly associated with turnover intention. We identified the mediating effect of job satisfaction and work engagement in the relationship between administrative positions and turnover intention, while the suppressing effect in the relationship between professional titles and turnover intention. Additionally, we found that monthly income plays a moderating role in the relationship between work engagement and turnover intention, and in the association between professional titles and turnover intention.

CONCLUSIONS

Greater job satisfaction and engagement, along with reasonable remuneration, were found to be associated with lower turnover intention among healthcare workers. Employers should proactively monitor the dynamic interactions among these factors and then develop more tailored interventions in order to alleviate the ongoing loss of healthcare workers.

The mediating effect of digital literacy and self-regulation on the relationship between emotional intelligence and academic stress among university students: a cross-sectional study

BACKGROUND

Academic stress is a prevalent issue affecting students' well-being and academic achievement in today's challenging educational environment. Furthermore, combining digital literacy and self-regulation enhances emotional intelligence, creating a holistic "digitally regulated emotional intelligence" strategy to reduce academic stress effectively. This study emphasizes the significance of developing these abilities in educational settings to prepare students for success in a complex and technology-driven world.

AIM

To assess emotional intelligence and academic stress among healthcare students and investigate the mediating role of students' digital literacy and self-regulation.

METHODS

A cross-sectional study was conducted to examine correlations and describe quantitative data. Data on two hundred forty students were collected from Fatima College of Health Sciences in the 2023-24 academic year. Pearson's correlation coefficient was applied to assess the associations between variables, and univariate linear regression was employed to investigate the connections between emotional intelligence and pertinent variables. The Hayes Process Model 4 macro was used to study how students' digital literacy and self-regulation mediate the relationship between emotional intelligence and academic stress.

RESULTS

Emotional intelligence, digital literacy, and self-regulation were high. Furthermore, the academic stress level was moderate. The mediation analysis revealed that the direct effect of emotional intelligence on academic stress in the presence of the mediators was significant (t = 3.830, p < 0.001). Hence, digital literacy partially mediated the relationship between emotional intelligence and academic stress. On the other hand, self-regulation had no mediation effect on the relationship above.

CONCLUSION

The study noted significant connections between study attributes, mainly showing the substantial relationship between emotional intelligence and academic stress. Higher emotional intelligence did not consistently reduce stress levels for moderately stressed students, suggesting that other factors may influence their stress levels. Furthermore, digital literacy mediated between emotional intelligence and academic stress, implying that proficient use of online resources could help reduce stress in students with advanced digital skills. Finally, self-regulation did not act as a mediator in the relationship between emotional intelligence and academic stress.

The Impact of Parental Depressive, Anxiety, and Stress Symptoms on Adolescents' Mental Health and Quality of Life: The Moderating Role of Parental Rejection

Background/Objectives: Parental internalizing issues, particularly maternal mental health, can significantly influence adolescents' mental health by altering parenting behaviors and roles. This study explores the role of parental rejection in moderating the relationship between parental depressive, anxiety, and stress symptoms and adolescents' mental health and quality of life. Methods: One hundred thirty eight mothers (mean age: 47.96, SD = 5.06 years) and 68 fathers (mean age: 51.07, SD = 5.53 years) of adolescents aged 12-18 completed measures on mental health, parental rejection, and adolescent well-being. Results: Maternal rejection was found to moderate the relationship between maternal anxiety symptoms and adolescents' quality of life, as well as between maternal anxiety symptoms and adolescents' mental health problems. Paternal rejection moderated the relationship between paternal stress symptoms and adolescents' mental health. However, parental rejection did not moderate the relationship between parental depression and adolescents' quality of life or mental health. Conclusions: These findings highlight the distinct roles of maternal and paternal rejection in adolescent development and suggest that parental mental health, particularly anxiety and stress, has a significant impact on adolescent well-being. Future studies should consider the influence of both parents and focus on longitudinal effects. These results emphasize the need for interventions addressing parental rejection to improve adolescent outcomes.

How hand-made affects consumers' perceived nutritional quality of organic food

This study analyzed the impact of handmade in depth on consumers' perceived nutritional quality of organic food through three experiments. Experiment 1 found that handmade significantly enhanced consumers' positive perceptions of nutritional quality of organic food. Experiment 2 revealed the mediating role of handicraft cultural identity between handmade and perceived nutritional quality. Experiment 3 further explored the moderating role of perceived authenticity on the impact of handmade. We found that these factors above significantly enhanced the positive effect of handmade on perceived nutritional quality. The findings suggest that handmade directly affected consumers' perceived nutritional quality of organic food, which could be further strengthened through the mediating effect of handcraft cultural identity and the moderating effect of perceived authenticity. These findings provide important guidance for organic food manufacturers and marketers on marketing strategy-making that can help better meet consumer demand for high-quality organic food.

Mediating Effect of Illness Perception on the Relationship Between Perceived Family Function and Sleep Quality Among Patients With Atrial Fibrillation

AIMS

To evaluate the sleep quality of patients with atrial fibrillation and its influencing factors, and explore whether illness perception mediates the relationship between family function and sleep quality.

DESIGN

Cross-sectional survey conducted from November 2020 to November 2021.

METHODS

A total of 191 participants validly completed the Pittsburgh Sleep Quality Index, the Family APGAR Index and the Brief Illness Perception Questionnaire. Data were analysed using descriptive statistics, independent samples t-tests, one-way ANOVA, Pearson correlation analysis and multiple linear regression analysis. Bootstrapping was used to detect the mediating role of illness perception.

RESULTS

Patients with atrial fibrillation reported poor sleep quality, good family function and a moderate level of illness perception. The better the family function, the lower the level of illness perception and the better sleep quality in patients with atrial fibrillation. Patients with commercial medical insurance had lower levels of sleep quality relative to self-financed patients. EHRA III and EHRA IV patients had worse sleep quality than EHRA II patients. Illness perception played a significant mediating role in the relationship between family function and sleep quality.

CONCLUSIONS

Patients with atrial fibrillation have poorer sleep quality, and the type of medical insurance and EHRA score are independent indicators related to their sleep quality. Future health education and interventions need to focus on strengthening and improving the emotional support of family members in order to improve family function and reduce illness perception, thereby improving sleep quality of patients with atrial fibrillation.

IMPACT

This study provides further evidence that nurses need to enhance their awareness and provide ongoing education to better identify patients with AF who have family dysfunction and perceived high levels of illness threat perceptions, as these factors negatively impact sleep quality.

REPORTING METHOD

This study was reported in strict compliance with the strengthening the reporting of observational studies in epidemiology (STROBE) guideline.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Prenatal exposure to neonicotinoid insecticides, fetal endocrine hormones and birth size: Findings from SMBCS

BACKGROUND

Neonicotinoid insecticides (NNIs) were reported to be endocrine disruptors and cause adverse health effects in human. However, epidemiological evidence about the effect of prenatal NNIs exposure on birth outcome and hormones remains limited.

OBJECTIVES

This study aimed to explore the effects of prenatal NNIs exposure on neonatal birth size and endocrine hormones, and assess the potential mediating role of hormones.

METHODS

The study included 860 mother-child pairs from the Sheyang Mini Birth Cohort Study. 12 parent NNIs (p-NNIs) and 6 metabolites of NNIs (m-NNIs) were measured in maternal urine samples collected on their delivery days, and 5 thyroid hormones and 2 sex hormones were analyzed in cord serum. The concentrations of p-NNIs and its specific metabolite(s) were summed to characterize the role of each class of NNIs. Generalized linear model and weighted quantile sum regression were used to examine the impact of prenatal NNIs exposure on birth size and endocrine hormones, and potential mediating roles of hormones were further explored using mediation analysis.

RESULTS

Higher detection frequencies of m-NNIs were observed than those in p-NNIs. A decrease in neonatal head circumference for gestation age z-score was associated with a 10-fold increase in 5-OH-IMI (β = -0.15, 95 %CI: -0.26, -0.03), ∑DIN (β = -0.22, 95 %CI: -0.40, -0.03), ∑IMI (β = -0.20, 95 %CI: -0.35, -0.06) and ∑NNIs (β = -0.23, 95 %CI: -0.42, -0.04). ∑IMI and ∑DIN were the major contributors to the significantly negative mixture effect and no sex-specific effect was observed. Negative associations were observed between ∑DIN and TT3 (β = -0.013, 95 %CI: -0.025, -0.002), ∑IMI and T (β = -0.035, 95 %CI: -0.065, -0.004), respectively. Furthermore, TT3 and T demonstrated 6.7 % and 6.1 % mediating effects on the negative association of prenatal ∑DIN and ∑IMI exposure with head circumference.

CONCLUSIONS

Our findings suggested the potential endocrine disruptive properties of NNIs and their impacts on head circumference. Endocrine hormones may partly mediate these associations.

Depression and suicidal ideation among Black individuals in Canada: mediating role of traumatic life events and moderating role of racial microaggressions and internalized racism

PURPOSE

Although suicidal ideation (SI) is a serious concern in Canada, its prevalence and related factors among Black individuals are poorly documented. Using data from the Mental Health of Black Communities in Canada project (BeCoMHeal), this study aimed to assess the prevalence of SI in Black individuals aged 15-40 years old in Canada, the mediating role of traumatic life events in the association between depression and SI, and the moderating role of racial microaggressions and internalized racism.

METHODS

Eight hundred and sixty participants aged between 15 and 40 years (Mage =24.96, SD = 6.29) completed the online questionnaire assessing sociodemographic data, depression symptoms, traumatic life events, racial microaggressions, internalized racism, and SI.

RESULTS

Findings showed that 25.7% of the participants reported having experienced SI (26.5% women, 22.7% men, 𝛘2 = 1.08, p = .299). The moderated-mediation model revealed that traumatic life events fully mediated the association between depression and SI (B = 0.12, p = .004; 95% CI, [0.04, 0.20]) and that racial microaggressions (B = - 0.03, p = .042; 95% CI [-0.07, - 0.00]) and internalized racism (B = 0.06, p = .006; 95% CI [0.02, 0.10]) moderated this relationship.

CONCLUSION

These findings underscore the importance of addressing racial microaggressions and internalized racism in therapy contexts among Black individuals to mitigate the potential negative impacts on their mental health. They also emphasize the need to develop effective, culturally sensitive, and racially adapted suicide prevention and intervention programs for Black communities in Canada.

Personality and sleep quality among nursing interns: Traditional Chinese medicine constitution as a mediator and sedentary time as a moderator

Aims

This study investigated whether the relationship between neuroticism and sleep quality in nursing interns is mediated by traditional Chinese medicine (TCM) constitution. In addition, the study examined whether sedentary behaviour affects this mediating model.

Background

The importance of sleep quality for nursing interns cannot be overstated. Previous studies have demonstrated that neuroticism negatively affects sleep quality. However, little is known about the path of the relationship between neuroticism and sleep quality among nursing interns.

Design

A cross-sectional study was conducted in Central and South China.

Methods

A total of 630 nursing interns participated in this study. Neuroticism, TCM constitution, sleep quality, and sedentary behaviour were measured using reliable and valid questionnaires. Data were analysed using the PROCESS macro in SPSS.

Results

Neuroticism significantly predicted the Pittsburgh Sleep Quality Index (PSQI; β = 0.144, P < 0.001). Neuroticism exerted a significant indirect effect on the PSQI through gentleness and damp heat constitution (β = 0.265, 95 % CI [0.214, 0.315]). In addition, sedentary time moderated this mediation model. Sedentary time marginally moderated the direct pathway from neuroticism to the PSQI (B = -0.025, 95 % CI [-0.046, -0.004]) and the pathway from neuroticism to the damp heat constitution (B = 0.175, 95 % CI [0.021, 0.329]) in the nursing interns.

Conclusion

TCM constitution mediates the relationship between neuroticism and sleep quality. Given the moderating effect of sedentary behaviour, targeting sedentary behaviour can be an effective approach to improve the sleep quality of nursing interns.

Information-Seeking and Risk Perception to Explain Infection-Prevention Behaviors: Conditional Analysis on Trust in Media and Government as Moderator

Purpose

This study aims to explore how the relationship between information-seeking and infection-prevention behaviors through risk perception changes according to the level of trust in the media and government.

Methods

The study is a secondary data analysis of data from a cross-sectional national survey of 700 adults living in the community, representing different age groups, genders, and geographic regions. A validated questionnaire was used to assess information-seeking behaviors, trust in media and government, and risk perception to explain infection-prevention behaviors in response to the COVID-19 pandemic. A conditional analysis was conducted using SPSS and PROCESS macro (Model 7) to identify the effect of moderated mediation.

Results

The participants were fairly balanced by gender and age group. Most participants learned about COVID-19 through major broadcasts and television (56.7%) followed by internet media (21.7%). Information-seeking and risk perception together explained 17% of the variance in infection-prevention behaviors (F=63.95, p<0.01). The standardized indirect effect (β=0.04, BootCI 0.02, 0.06) was significant at 95% CI. The moderated mediation index (M=-0.04, CI -0.05, -0.01) indicates that trust in media and government influences the effect of information-seeking on risk perception and infection-prevention behavior even after controlling for age and gender.

Conclusion

Information-seeking behaviors affect infection-prevention behaviors directly and indirectly through risk perception. Trust in media and government modulates this relationship, emphasizing the importance of establishing trust to promote effective risk communication and long-term public compliance with infection-prevention practices. Health authorities should focus on building trust through transparent risk communication and integrating diverse media perspectives. Further research is needed to explore the psychological and social mechanisms underlying trust in media and government through qualitative, cross-cultural comparisons.

Can the sports apps using play an intervening role in the process of college students' exercise motivation affecting mental health by exercise adherence?

The continuous increase in college students' use of the Internet and their mental health problems caused by a sedentary lifestyle, lack of exercise, and obesity have gradually attracted researchers' attention. There is still more work to be done to understand "how" and "under what circumstances" exercise motivation effects mental health, despite the fact that many of these studies have demonstrated that it has a significant impact on it. Four hundred forty-three college students in China were selected to participate in this study in order to explore the impact of exercise motivation on mental health. The mediating role of exercise adherence and the moderating role of sports apps using in this relationship. The results show that exercise motivation has a significant positive impact on college students' mental health; exercise adherence partially mediates the relationship between exercise motivation and mental health; and the relationship between exercise motivation and exercise adherence is moderated by sports apps using. Specifically, the relationship between exercise motivation and exercise adherence is stronger for college students with high sports apps using. This study is based on the Internet using to promote physical exercise to college students, thereby alleviating their psychological problems caused by a sedentary lifestyle, lack of exercise, and obesity in the Internet era. New ideas are also provided for intervention in college students' mental health.

Estimation of mediators in the associations between campus green spaces and students' anxiety: a case study in Nanjing

Introduction

Although a number of scholars have examined the theoretical pathways between green space (GS) and mental health, few have focused on how campus greenness affects the mental health of Chinese youth.

Methods

Herein, two objective indicators, campus and individual 300-m normalized vegetation index (NDVI) data, were used as independent variables. A questionnaire was used to collect the self-rated anxiety level of students on campuses in Nanjing. Then, we chose "subjective perception of campus GS", "physical activity", "social cohesion", "nature relatedness" and "usage pattern" as mediating variables to explore the pathways between the campus greenery and college student' anxiety level through correlation analysis, linear regression, and mediation effect test.

Results

Results showed the campus-wide NDVI and individual students' 300-m range NDVI had significant negative correlations with anxiety (p = 0.045, p = 0.023). Campus perception, nature relatedness and the frequency of using GS are the pathways through which campus GSs influence student anxiety.

Discussion

Our findings emphasised the importance of subjective perceptions of greenspaces, which provided a direction that can be deepened in future research.

Sociocultural determinants of children's oral health among immigrants in Canada

OBJECTIVE

A conceptual model was designed and tested to predict immigrant children's oral health in Canada by examining parental acculturation and perceived social support (PSS) using structural equation modelling.

METHODS

A convenience sample of first-generation immigrant parents and their children aged 2-12 years were recruited by multilingual community workers in Edmonton, Canada. Parents completed a validated questionnaire on demographics, child's oral health (OH) behaviours, parental acculturation and PSS. Dental examinations determined children's dental caries rate using DMFT/dmft index. Structural equation modelling (SEM) was used to analyse the data.

RESULTS

A total of 336 families participated in this study. The average parental acculturation level was 10.46 with a maximum of 15, and the average PSS was 63.27 with a maximum of 75. SEM showed that 77% of the variance of DMFT/dmft scores in children was explained by parental PSS, acculturation level, immigration-related variables, socioeconomic variables and children's OH behaviours. The direct effect of parental PSS was associated with a significantly reduced rate of dental caries (β = -.076, p-value = .008) and lower sugar consumption (β = -.17, p-value = .04). While the mediation effect of parental acculturation on PSS was associated with positive OH behaviours of children (e.g., toothbrushing frequency and dental care utilization), the indirect effect was negatively associated with caries rate (β = .77, p-value = .00).

CONCLUSIONS

The direct effect of Parental Perceived Stress Scale (PSS) was associated with more favourable oral health behaviours and a lower prevalence of dental caries, while the mediation effect of acculturation was linked to a higher prevalence of dental caries.

Positive maternal mental health during pregnancy and psychiatric problems in children from early childhood to late childhood

Negative maternal mental health during pregnancy increases the risk of psychiatric problems in children, but research on the potential benefits of positive maternal mental health during pregnancy is scarce. We investigated associations between positive maternal mental health composite score, based on reports of maternal positive affect, curiosity, and social support during pregnancy, and children's psychiatric problems (Child Behavior Checklist) at ages 1.9-5.9 and 7.1-12.1 years among 2636 mother-child dyads of the Prediction and Prevention of Preeclampsia and Intrauterine Growth Restriction study. For each standard deviation higher positive maternal mental health score during pregnancy, total psychiatric problems were 1.37 (95% confidence interval (CI) -1.79,-0.95) t-scores lower in early childhood and 1.75 (95% CI -2.24,-1.26) t-scores lower in late childhood. These associations were independent of covariates and of negative maternal mental health. Total psychiatric problems remained stably lower from early childhood to late childhood in children of mothers with higher positive mental health during pregnancy, whereas they increased in children of mothers with lower positive mental health. Positive maternal mental health in child's late childhood partially mediated the effects of positive maternal mental health during pregnancy on children's psychiatric problems. Supporting positive maternal mental health may benefit mothers and children.

Integrating work and sleep to understand work-life balance among healthcare professionals: A conservation of resources perspective

Healthcare professionals sacrifice their sleep for increased patient care. However, this could be detrimental to their selves and the quality of healthcare service. This study used the Conservation of Resources Theory (COR) to examine the integration between the workaholic tendency of healthcare professionals and their daily sleep deprivation to determine the extent of their self-balance. The researchers used a time-lag design to measure the workaholic tendency of healthcare professionals (Total = 422 of 282 doctors and 140 nurses), observed their sleep patterns over one working week, and obtained their ratings of self-life balance. This study revealed that the relationship between workaholism and sleep deprivation and the relation between sleep deprivation and work-self balance was significant for doctors only. However, the mediating role of daily sleep deprivation between workaholism and self-balance was non-significant. This study offers some practical implications by highlighting the positive role of work and the negative role of daily sleep deprivation in maintaining self-balance for healthcare professionals.

Driving factors of residential demand response for the integration of variable renewable power

The large-scale integration of renewable power poses great challenges to grid stability. Among flexible resources, demand response (DR) stands out for its advantages in cost and efficiency. To identify key factors influencing DR, this study adopted the modified theory of planned behavior (TPB) to establish the conceptual model. Social norms were included as a front-end variable, and institutional factors and electricity consumption habits served as moderating variables. The model was subsequently tested and modified using the structural equation modelling (SEM). Results indicated that social norms can exert a substantial indirect effect on DR behavior. However, due to the deficiency of such norms, the formation of the positive attitude towards DR was hindered, resulting in a low standard coefficient of 0.16. Moreover, the influence of subjective norm on response intention was rejected due to limited perceived external pressure. Perceived behavior control exhibited the most significant direct influence on response intention (0.76). Additionally, the positive effects of situational factors and personal habits on the conversion from response intention to behavior were supported. Based on these findings, several policy suggestions including enhancing publicity and incentive policies were proposed.

The mediating role of individual evaluation, anxiety, and depression in the association between leisure activity and cognitive function among Chinese older adults

The purpose of this research was to investigate the association between leisure activity and cognitive function in Chinese older adults, and to explore the mediating role of individual evaluation, anxiety and depression. Using cross-sectional data from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS), Pearson correlation analyses were employed to examine the relationships among various indicators. A multiple mediation model was constructed to investigate the mediating pathways through which leisure activities impact cognitive function in elderly individuals. Leisure activities, individual evaluation, anxiety, and depression were significantly correlated with cognitive function (p < 0.01). Leisure activities not only directly positively impacted cognitive function in elderly individuals (effect = 0.3780; 95% CI = [0.3459, 0.4101]), but also exerted indirect effects through five pathways. Individual evaluation, anxiety, depression, they plays a mediating role in the association between leisure activity and cognitive function in older adults in China. Leisure activities can positively impact cognitive function in elderly individuals by enhancing individual evaluation and subsequently reducing anxiety and depression.

Adolescent-Mother Attachment and Dyadic Affective Processes: Predictors of Internalizing and Externalizing Symptoms

Given that adolescence is a critical period for socioemotional development, marked by shifting dynamics in the parent-child relationship, parent-adolescent dyadic regulation may serve as a key mechanism linking the quality of the parent-adolescent relationship to adolescent mental health. The current study investigated two dyadic regulatory processes during mother-adolescent conflictual interactions as interpersonal mechanisms underlying the link between adolescent-mother attachment security and adolescents' internalizing and externalizing symptoms: (a) mutual engagement in positive affect (i.e., dyadic positivity) and (b) mutual engagement in re-coordination following relational mismatches (i.e., dyadic repair). Eighty-six adolescents (Mage = 13.3 years, SD = 0.6, 37% girls) and their mothers participated. Path models revealed that attachment security was associated with greater engagement in dyadic positivity and repair. Moreover, the indirect effect of attachment security on adolescents' symptoms (i.e., internalizing symptoms at age 13 and externalizing symptoms at age 14) was significant via dyadic positivity, but not dyadic repair. Dyadic positivity during mother-adolescent conflictual interactions may be one interpersonal process that underlies the link between a secure child-mother attachment and mental health during adolescence.

"Alexithymia, Cognitive Distortion and internet Addiction: Moderating Role of Emotional Intelligence"

Excessive engagement in online activities, also known as Internet addiction can have detrimental impacts on the mental, social, and physical well-being of individuals. This research work aims to contribute to the existing body of knowledge on internet addiction and alexithymia to provide insights that may inform the development of targeted interventions to support university students at risk of internet addiction. With emotional intelligence as the moderator and cognitive distortion as the mediator, the study investigated the effect of alexithymia on internet addiction. The approach of this cross-sectional design allowed researchers to investigate intricate interactions among several elements influencing internet addiction among university students in northern Indian areas. For data collection, the study created a thorough English 53-item questionnaire. Initially, 600 surveys were distributed, and 508 useable surveys were used. All the study hypotheses have received adequate support from empirical evidence, thus offering significant insights. This study supported a direct positive correlation between alexithymia and internet addiction. Also, the findings revealed a positive relationship between alexithymia and cognitive distortions which further leads to internet addiction. Moreover, moderation results show that emotional intelligence acts as a significant moderator in this relationship between alexithymia and internet addiction. The study has added a unique antecedent of cognitive distortion of internet addiction, which is currently under-researched in previous works. This research adds to the knowledge of alexithymia as not only a personality characteristic but also a variable that should be taken into account regarding constituent processes of the regulation of emotions.

The Influence of Parents' Educational Expectations on Children's Development: The Chain Mediation Role of Educational Anxiety and Parental Involvement

In the social context of the "Educational Involution", the educational expectations of parents have a potential influence on the development of children. High parental educational expectations create parental anxiety, which in turn results in a rise in parental involvement and eventually promotes the growth and progress of children. The current study administered an electronic questionnaire to 891 parents of young children in four provinces of China. The questionnaire included the Parental Educational Expectations Scale, the Educational Anxiety Scale, the Parental Involvement Scale, and the Child Development Scale. This study used SPSS 27.0 for statistical data analysis and the SPSS macro program PROCESS to explore the mediation role. We found that (1) educational anxiety plays a mediating role between parental educational expectations and child development; (2) parental involvement has a mediating effect between parental educational expectations and child development; and (3) educational anxiety and parental involvement play a chain mediating role between parental educational expectations and child development. In conclusion, parental educational expectations appear to contribute to child development, and this effect may be mediated individually and sequentially by educational anxiety and parental involvement.

The mediation effects of COVID-19-related traumatic stress symptoms and mentalization on the relationship between perceived stress and psychological well-being in healthcare workers transitioning to a post-pandemic world

BACKGROUND

In context of COVID-19 as a collective trauma and the intense involvement of healthcare workers (HCWs) in the pandemic, perceived stress continues to have a tremendous impact on their psychological well-being. However, few studies have attempted to delineate the underlying mechanisms. This study examined whether COVID-19-related traumatic stress symptoms and mentalization act as mediators.

METHODS

A sample of HCWs (N = 2610) from 22 hospitals in Beijing, China participated in this cross-sectional investigation. Data on their perceived stress, psychological well-being, the impact of event, and reflective function during the COVID-19 pandemic were collected using self-report questionnaires. Different mediating models were tested.

RESULTS

COVID-19-related stress symptoms and mentalization independently mediate the association between perceived stress and psychological well-being. These two mediators also compose a serial mediation model. In particular, higher perceived stress inhibits the psychological well-being of HCWs through increased severity of traumatic stress symptoms, which in turn is associated with hypomentalizing.

CONCLUSION

These findings shed light on the mechanisms underlying the relationship between perceived stress and psychological well-being in HCWs. We strongly recommend incorporating a mentalization framework with trauma-informed practice in prevention and intervention work with this population during this and future healthcare crisis.

Compassion, stress and coping strategies in family caregivers of patients with heart failure

The requirements of caring for individuals with diseases with excess care burden like heart failure (HF) comprise a source of stress for the caregiver. This situation affects the health of caregivers and may cause a reduction in their level of compassion. However, compassion is associated with psychological benefits and coping strategies like positive mood in caregivers. The aim of this study was to investigate the correlations between compassion, coping strategies and stress levels of family members caring for individuals with HF. We found that the dysfunctional coping strategies were determined to play a partial mediating role in the relationship between caregiver compassion levels and stress levels. Caregivers with higher compassion levels reported lower stress levels. This situation may be linked to their use of relatively fewer dysfunctional coping strategies. Findings help to examine the correlations between compassion, coping strategies and stress levels of family members caring for individuals with HF.

Leader's ethical behavior: A precursor to employees' well-being through emotions management

Contemporary research in leadership demonstrates that the ethical behaviors of leaders are vital to enhancing employee well-being. Despite this, research is scant on the connection between leaders' ethical practices and the well-being of their employees via employee emotions. Relying on affective events theory, this study, directly and indirectly, examined the relationships between leaders' ethical behaviors and employees' well-being (via employee emotions). Furthermore, it investigated employee core self-evaluations as a substitute for the ethical behaviors of leaders that mitigate the influence of leaders' ethical behaviors. A sample of 398 faculties from 20 public universities in Pakistan was chosen using the simple random sampling approach, and then SPSS Process Macro was applied to the sample. Study results indicate that leaders' ethical behaviors facilitate employees to manage their emotions, and effective management of emotions improves their well-being. The research also revealed that employees' core self-evaluation swapped with the ethical behaviors of leaders. The theoretical model, therefore, confirms the significance of EBOL as a strategic resource and employees' CSE as an interpersonal resource, which accentuates one another to manage employees' emotions and promote their well-being. The study offers practical management ramifications and adds to our understanding of EBOL, employee emotions, and well-being.

The effects of psychological capital, work engagement and job autonomy on job performance in platform flexible employees

The performance of platform flexible employees is a core element that contributes to the rapid growth of the sharing economy platform. It is crucial to explore strategies to improve employees' performance with the growing competition among these platforms. Only a handful of research evidence has been found evaluating platform flexible employees' psychological capital and work engagement to improve their performance. In order to remedy the gap, we draw on self-determination theory to develop a moderated mediation model, which examines how psychological capital affects platform flexible employees' job performance. We employed hierarchical regression analysis to test the theoretical model and carried out two rounds of surveys, resulting in 474 valid paired questionnaires. The questionnaire assessed the psychological capital, work engagement, job performance, and job autonomy of flexible platform employees. The results indicate that work engagement plays a mediating role between psychological capital affects platform flexible employees' job performance. Moreover, job autonomy moderates the mediating effect. The findings not only contribute to the literature on employees' psychological capital and job performance, but also broaden the research scope of self-determination theory, and provide new ideas for improving the job performance of platform flexible employees.

How psychological ownership over nutritional products affects purchase intentions of high-pressure working groups

This study aims to investigate the influence of psychological ownership of nutritional products on the purchase intention of high-pressure working groups, as well as the underlying mechanisms and boundary conditions of this influence. This study aims to investigate the impact of psychological ownership of nutritional products on the purchase intention of high-pressure working groups, as well as the underlying mechanisms and boundary conditions of this influence. The research contributes through the use of variance analysis, mediation models, and moderation models on data from adult participants over the age of 18, across three experiments. Experiment 1, conducted on the Credamo platform, randomly recruited 285 participants, with 148 males (51.9%) and 137 females (48.1%), and the results indicated a direct impact of psychological ownership on purchase intention. Building upon this, Experiment 2, which also utilized the Credamo platform and recruited 280 participants consisting of 136 males (48.6%) and 144 females (51.4%), further revealed the mediating role of perceived value. Experiment 3, with 265 participants randomly recruited on the Credamo platform, including 131 males (49.4%) and 134 females (50.6%), identified the moderating effect of nutritional awareness. The theoretical contribution of this study lies primarily in its in-depth exploration of the impact of psychological ownership of nutritional products. By integrating the factors of perceived value and nutritional awareness, it provides a systematic explanation for better understanding the purchase intentions of high-pressure working groups. Additionally, this study offers valuable strategies for merchants to enhance the purchase intentions of high-pressure living groups.

Coping styles and the developmental trajectories of anxiety symptoms in children during transition into early adolescence

The study investigated how active and avoidant coping styles predicted the trajectory membership of anxiety symptoms during the transition into early adolescence. A total of 321 Chinese children aged 9 to 10 years were recruited from a primary school in mainland China. Self-reported trait anxiety, coping styles and anxiety symptoms were assessed at baseline. After 6 months, self-reported anxiety symptoms were measured at three follow-up assessments with an interval of 6 months. Latent class growth modelling revealed high (18.7%) and low (81.3%) trajectories of anxiety symptoms in children during the transition into early adolescence. After controlling for trait anxiety, depression and sex, high active coping style predicted the trajectory of high anxiety symptoms, which was not moderated by trait anxiety. Before controlling for these covariates, the relation between active coping style and anxiety symptoms was in the opposite direction. A high avoidant coping style showed a trend to predict the trajectory of high anxiety symptoms only for children with low trait anxiety. These findings add a developmental context to the relationships of active and avoidant coping styles to anxiety symptoms and suggest that trait anxiety may moderate these relationships.

Relationship between benefit finding and volunteer motivation among nursing students: The mediating role of perceived social support

BACKGROUND

Volunteer motivation is essential to advancing community service, education, and career development of nursing students. However, few studies have been conducted on nursing students' volunteer motivation.

OBJECTIVES

To investigate the relationship between social support benefit finding and volunteer motivation among nursing students and the role of social support in these relationships.

METHOD

This study adopted a descriptive cross-sectional design. A total of 2166 nursing students were recruited from eighteen medical schools in Henan Province, China. Participants completed a sociodemographic questionnaire, the Social Support Scale, the Benefit Finding Scale, and the Volunteer Motivation Scale online between March and May 2022. Correlation and mediation analyses were used to explore the mediating role of social support in the relationships among social support, benefit finding, and volunteer motivation.

RESULTS

A total of 2166 valid questionnaires were collected in this study. Benefit finding positively affected volunteer motivation (β = 0.422, p < 0.01), and perceived social support positively affected volunteer motivation (β = 0.407, p < 0.01). Perceived social support played a mediating role between benefit finding and volunteer motivation (β = 0.112, 95 % confidence interval 0.076, 0.148).

CONCLUSIONS

The study provides evidence on the mechanisms of action between benefit finding and volunteer motivation among nursing students. Professionals in schools and voluntary organizations should prioritize guiding nursing students to explore the motivations behind volunteering while also fostering a supportive environment for student volunteers in nursing.

Systemic inflammation in midlife is associated with late-life functional limitations

Systemic inflammation generally coexists with functional limitations that seriously affect quality of life. This study aimed to investigate the association between systemic inflammation in midlife and the risk of functional limitations in late-life. A total of 10,044 participants with an average age of 53.9 ± 5.7 years at baseline were included in a cohort study. At the last follow-up, the prevalence of impaired activities of daily living (ADLs), instrumental activities of daily living (IADLs), and lower extremity function (LEF) was 14.7%, 21.6%, and 50.3%, respectively. The values of four inflammatory biomarkers were used to calculate the inflammation composite score. Compared with the participants in the lowest quartile of the inflammation composite score (Q1), those in the highest quartile (Q4) exhibited an odds ratio (OR) of 1.589 and a 95% confidence interval (CI) of 1.335-1.892 for impaired ADLs, an OR of 1.426 and a 95% CI of 1.228-1.657 for impaired IADLs, and an OR of 1.728 and a 95% CI of 1.526-1.957 for impaired LEF. The association between systemic inflammation and functional limitations was partly mediated by cardiac and brain function. The present study provides evidence that systemic inflammation in midlife is associated with a higher risk of late-life functional limitations. Protecting vital organ functions in midlife may have a positive impact on reducing the risk of future functional limitations.Trial registration: www.clinicaltrials.gov ; Unique identifier: NCT00005131.

The impact of social isolation on smartphone addiction among college students: the multiple mediating effects of loneliness and COVID-19 anxiety

Background

The widespread use of smartphones has significantly increased smartphone addiction among college students, especially during the COVID-19 pandemic. Since the COVID-19 outbreak, university campuses in mainland China have strictly followed the Chinese government's strict quarantine policy, including closed campus management, prohibitions against gatherings, and social distancing, increasing student loneliness and anxiety and thus increasing the risk of smartphone addiction. Extant Studies have revealed that social isolation is a prominent predictor of smartphone addiction but have failed to systematically explore the complex relationship between social isolation and smartphone addiction in the context of COVID-19; therefore, the underlying mechanisms of these factors in the post-pandemic era are unclear.

Objective

This study is the first attempt to consider loneliness, COVID-19 anxiety and social isolation as a whole and to clarify the underlying mechanisms of social isolation and smartphone addiction by constructing a multiple mediating model.

Method

This study included students enrolled at eight higher education institutions in Conghua District (Guangzhou city). Quota proportional sampling was adopted, 900 self-report questionnaires were distributed through the WeChat groups of these universities from December 10 to December 15, 2022, and 868 valid questionnaires (620 females, 248 males) were ultimately obtained.

Results

The direct effect of social isolation on smartphone addiction was significant, and loneliness and COVID-19 anxiety mediated the association between social isolation and smartphone addiction in both parallel and sequential ways. Moreover, a reverse mediation model with COVID-19 anxiety as the first mediator and loneliness as the second mediator was found.

Conclusion

College students who experience social isolation are at greater risk for smartphone addiction, and the core factor leading to their smartphone addiction is the subjective psychological state triggered by campus isolation and social distancing, such as loneliness and anxiety. These risky behaviors of people should receive extra attention, and psychological factors such as loneliness and COVID-19 anxiety should be considered in future therapies aimed at reducing addiction.

The Effect of Psychological Flexibility on Well-Being during the COVID-19 Pandemic: The Multiple Mediation Role of Mindfulness and Coping

The COVID-19 pandemic involved a complex set of stressors affecting the health and well-being of the population. The understanding of the psychological processes that influence well-being in response to the pandemic and their interrelation is vital. A promising process in understanding the emotional impacts of these stressors is psychological flexibility. This study investigated the effect of psychological flexibility on well-being, both directly and indirectly, via mindfulness and coping strategies. A total of 334 Portuguese adults participated in this cross-sectional study. Participants were asked to complete an online questionnaire, including measures of psychological flexibility, well-being, mindfulness, and coping strategies. A multiple mediation model studied whether there are conditional indirect effects of mindfulness and coping strategies on well-being. The results showed statistically significant correlations between psychological flexibility, well-being, mindfulness, and coping strategies. Furthermore, we found that mindfulness and coping strategies partly mediate the relationship between psychological flexibility and well-being. Understanding the processes through which psychological flexibility influences well-being in a stressful context is important in comprehending the processes involved in an emotional reaction to a pandemic-like societal event. Mindfulness and coping are shown to be important processes to consider in understanding this phenomenon and designing future responses.

English language learning anxiety and academic burnout in Chinese freshmen: a chain mediating approach

Background

The university stage is critical for cultivating and enhancing students' practical English proficiency, encompassing listening, speaking, reading, writing, and translation skills. Losing interest in English studies at this stage not only hampers the development of practical English competence but also has a negative impact on future employment and personal growth.

Aims

This study aimed to explore to how English language learning anxiety (ELLA) affects academic burnout (AB) of freshman in China and explores the role of academic peer support (APS) and academic self-efficacy (ASE) in the relationship between the two.

Methods

The study involved 1,355 college students who completed English Language Learning Anxiety Scale, the English Academic burnout Scale, Academic Peer Relationship Scale, the Academic Self-efficacy Scale.

Results

AB was significantly impacted by ELLA. ELLA and AB were mediated by ASE. Another factor that acted as a mediator between ELLA and AB was APS. ELLA and AB were mediated by a chain reaction involving ASE and APS.

Conclusion

The chain mediation model validated in this study, providing valuable insights into the effects of freshmen's ELLA on AB in China, as well as practical insights into the prevention and intervention of ELLA and AB in other current college students.

Indirect effects of emotion regulation in the relationship between pain and cannabis use in adults 18-64 years

INTRODUCTION

Individuals with chronic pain often receive prescription opioid medication, and they may use cannabis to treat pain as well, although the risks of cannabis-opioid co-use are significant. This study aimed to investigate whether two transdiagnostic factors, emotion regulation and distress tolerance, had significant indirect effects in the relationship between pain and cannabis use in adults with chronic pain and an opioid prescription.

METHODS

Participants (n = 450; mean age = 38.6 ± 11.09) were recruited using Qualtrics panel service and were 75 % female and 79 % White, non-Hispanic. Participants completed a 30-minute self-report survey capturing three-month cannabis use, the Difficulties in Emotional Regulation Scale (DERS), and the Distress Tolerance Scale (DTS). The Graded Pain Scale (GCPS) assessed pain severity/intensity and disability. Analyses used the SPSS PROCESS macro, with both single (i.e., one transdiagnostic factor) and parallel indirect effects (i.e., both the DERS and DTS) examined.

RESULTS

There were statistically significant indirect effects for both the DERS and DTS in the relationship between pain intensity or disability and three-month cannabis use in single factor models. In the parallel indirect effect model, only the DERS was statistically significant (intensity indirect effect coefficient = 0.0195 % confidence interval [95 %CI] = 0.0065, 0.390; disability indirect effect coefficient = 0.0147, 95 %CI = 0.0055, 0.0274).

CONCLUSIONS

When examining parallel indirect effects, only emotional regulation and not distress tolerance mediated the relationship between chronic pain and cannabis use among those with an opioid prescription. Clinically, interventions aimed at improving emotional regulation in individuals with chronic pain can help limit cannabis and opioid co-use.

Cell phone addiction and sleep disturbance among medical students in Jiangsu Province, China: the mediating role of psychological resilience and the moderating role of gender

Background

Cell phone addiction presents a widespread and severe physical and mental health concern, now recognized as a global public health issue. Among medical college students, the issue of poor sleep quality has become particularly prevalent. This study aimed to investigate the relationship between cell phone addiction and sleep disturbance in a population of medical college students, exploring the potential mediating role of psychological resilience and the moderating impact of gender.

Methods

A random cluster sampling method was employed to survey 5,048 students from four medical colleges in Jiangsu Province, China, utilizing the Mobile Phone Addiction Index (MPAI), Connor-Davidson Resilience Scale (CD-RISC), and Pittsburgh Sleep Quality Index (PSQI) for data collection. Statistical analyses were conducted using SPSS 26.0 and the PROCESS macro version 4.1. To assess mediation, Model 4 of the PROCESS macro was utilized, while Model 15 was employed to investigate the moderating effect of gender.

Results

The results revealed a significant positive correlation between cell phone addiction and sleep disturbance, with psychological resilience found to partially mediate this relationship. Moreover, gender was observed to significantly moderate the impact of cell phone addiction on sleep disturbance. Specifically, bootstrap analysis indicated a significant interaction between cell phone addiction and gender (Coeff. = -0.0215, P< 0.001), with a stronger relationship found in males (simple slope = 0.0616, t = 16.66, P< 0.001) compared to females (simple slope = 0.0401, t = 9.51, P< 0.001).

Conclusion

Ultimately, psychological resilience was identified as a partial mediator between cell phone addiction and sleep disturbance in medical students from Jiangsu Province, with gender playing a significant moderating role in this association.

The Relationship Between Stressful Life Events and Depressive Symptoms in College Students: mediation by Parenting Style and Gender's Moderating Effect

Aim

Stressful life events have a significant impact on the mental health of college students. Depression, as a prevalent psychological issue, has garnered attention in the field of college student mental health and is closely linked to it. Additionally, parenting style is identified as an important factor influencing the development of college students' mental health. Therefore, this study aims to explore the relationship between these three factors.

Methods

A total of 8079 first-year college students from two medical universities in Shandong Province, China were surveyed. The Beck Depression Inventory was utilized to evaluate depressive symptoms among the college students, while the Adolescent Self-rating Life Events Checklist and the Egna Minnen Beträfande Uppfostran were employed to gather data. Subsequently, the SPSS macro program PROCESS was utilized to analyze both the mediating and moderating effects. All statistical analyses were conducted using SPSS 26.0.

Results

The study found a detection rate of 6.3% for depressive symptoms among college students. The correlation analysis of this study showed that the stressful life events of college students were significantly positively correlated with depressive symptoms (r=0.261, p< 0.01). Each dimension of parenting style was associated with depressive symptoms in different degrees and directions. At the same time, parenting styles of all sizes play a partial mediating role between stressful life events and depressive symptoms in college students, gender plays a crucial regulatory role in this mediation.

Conclusion

Stressful life events experienced by college students have a significant impact on their mental health. Early intervention through positive parenting styles from parents may prove to be beneficial in promoting the development of good mental health among college students.

Effects of perceived stress on turnover intention of female healthcare staff: a serial multiple mediation model

BACKGROUND

Healthcare staff in China, especially females, work in a high-pressure, high-load, and high-risk environment, which affects the physical and mental health, the efficiency and quality of work, and increases turnover intention. The present study investigated the relationship between perceived stress and turnover intention in female healthcare staff, and the effects of future-oriented coping and work-family balance on this relationship.

METHODS

Four hundred thirty-five female medical workers were recruited to perform a perceived stress scale, future-oriented coping inventory, work-family balance scale and turnover intention scale. Meanwhile, serial multiple mediation analysis was performed using PROCESS.

RESULTS

1) Perceived stress positively predicted the level of turnover intention in female healthcare staff; 2) Preventive coping and proactive coping showed mediation effects on the relationship between perceived stress and turnover intention, and preventive coping positively related to proactive coping; 3) The work-family balance also showed mediation effects on the relationship between perceived stress and turnover intention; 4) Preventive coping, proactive coping and work-family balance showed a serial multiple mediation on the relationship between perceived stress and turnover intention in female healthcare workers.

CONCLUSIONS

Perceived stress affects the level of turnover intention in female healthcare staff through preventive coping, proactive coping, and work-family balance. In addition, the sequential model of future-oriented coping was validated among female healthcare staff.

Association between abusive supervision and nurses' withholding voice about patient safety: the roles of impression management motivation and speak up-related climate

BACKGROUND

Abusive supervision by the nurse manager significantly influences nurses' withholding voice about patient safety. The role of impression management motivation and speak up-related climate is crucial in understanding their connection. This study aimed to explore the relationship between abusive supervision, impression management motivation, speak up-related climate, and withholding voice about patient safety.

METHODS

This cross-sectional study employed a convenience sampling method to recruit 419 clinical nurses from Taizhou Hospital, Zhejiang Province, China, between 1 November 2022 and 31 January 2023. The study adhered to the STROBE checklist. Abusive supervision and impression management motivation were assessed using the Chinese versions of the Abusive Supervision Scale and the Impression Management Motivation Scale, respectively. Withholding voice about patient safety and speak up-related climate were identified using the Chinese version of the Speaking Up about Patient Safety Questionnaire.

RESULTS

Nurse leaders' abusive supervision (β=0.40, p<0.01) and nurses' impression management motivation (β=0.10, p<0.01) significantly and positively influenced nurses' withholding voice about patient safety. We introduced impression management motivation as a mediating variable, and the effect of abusive supervision on nurses' withholding voice decreased (β from 0.40 to 0.38, p< 0.01). Nurses' speak up-related climate played a moderating role between abusive supervision and impression management motivation (β= 0.24, p<0.05).

CONCLUSIONS

Abusive supervision by nursing leaders can result in nurses withholding voice about patient safety out of self-protective impression management motives. This phenomenon inhibits nurses' subjective initiative and undermines their proactive involvement in improving patient safety, and hinders the cultivation of a culture encouraging full participation in patient safety, which should warrant significant attention.

Effect of weight loss on knee joint synovitis over 48 months and mediation by subcutaneous fat around the knee: data from the Osteoarthritis Initiative

BACKGROUND

Obesity influences the development of osteoarthritis via low-grade inflammation. Progression of local inflammation (= synovitis) increased with weight gain in overweight and obese women compared to stable weight. Synovitis could be associated with subcutaneous fat (SCF) around the knee. Purpose of the study was to investigate the effect of weight loss on synovitis progression and to assess whether SCF around the knee mediates the relationship between weight loss and synovitis progression.

METHODS

We included 234 overweight and obese participants (body mass index [BMI] ≥ 25 kg/m2) from the Osteoarthritis Initiative (OAI) with > 10% weight loss (n = 117) or stable overweight (< ± 3% change, n = 117) over 48 months matched for age and sex. In magnetic resonance imaging (MRI) at baseline and 48 months, effusion-synovitis and Hoffa-synovitis using the MRI Osteoarthritis Knee Score (MOAKS) and average joint-adjacent SCF (ajSCF) were assessed. Odds-ratios (ORs) for synovitis progression over 48 months (≥ 1 score increase) were calculated in logistic regression models adjusting for age, sex, baseline BMI, Physical Activity Scale for the Elderly (PASE), and baseline SCF measurements. Mediation of the effect of weight loss on synovitis progression by local SCF change was assessed.

RESULTS

Odds for effusion-synovitis progression decreased with weight loss and ajSCF decrease (odds ratio [OR] = 0.61 and 0.56 per standard deviation [SD] change, 95% confidence interval [CI] 0.44, 0.83 and 0.40, 0.79, p = 0.002 and 0.001, respectively), whereas odds for Hoffa-synovitis progression increased with weight loss and ajSCF decrease (OR = 1.47 and 1.48, CI 1.05, 2.04 and 1.02, 2.13, p = 0.024 and 0.038, respectively). AjSCF decrease mediated 39% of the effect of weight loss on effusion-synovitis progression.

CONCLUSIONS

Effusion-synovitis progression was slowed by weight loss and decrease in local subcutaneous fat. Hoffa-synovitis characterized by fluid in the infrapatellar fat pad increased at the same time, suggesting a decreasing fat pad rather than active synovitis. Decrease in local subcutaneous fat partially mediated the systemic effect of weight loss on synovitis.

Relationship between affiliate stigma and family quality of life among parents of children with autism spectrum disorders: The mediating role of parenting self-efficacy

BACKGROUND

The parents of children with autism spectrum disorder (ASD) are under great pressure and experience discrimination in their daily lives, which affects their family quality of life (FQOL).

OBJECTIVE

METHODS: A total of 237 parents of children with ASD were recruited in a university-affiliated hospital in Guangzhou, China, from October 2020 to April 2021 by convenience sampling. The Affiliate Stigma Scale, Parenting Sense of Competence Scale and Beach Center Family Quality of Life Scale were employed for data collection.

RESULTS

The results showed that affiliate stigma negatively predicts total FQOL and the dimensions of FQOL through both a direct effect and an indirect effect through parenting self-efficacy.

CONCLUSIONS

The findings suggest that affiliate stigma is an important predictor of FQOL, and interventions to reduce affiliate stigma and strengthen parenting self-efficacy might be effective in improving FQOL in the parents of children with ASD.