Mediating role of social support in dysphoria,despondency,and quality of life in patients undergoing maintenance hemodialysis

BACKGROUND Dysphoria and despondency are prevalent psychological issues in patients undergoing Maintenance Hemodialysis(MHD)that significantly affect their quality of life(QOL).High levels of social support can significantly improve the physical and mental well-being of patients undergoing MHD.Currently,there is limited research on how social support mediates the relationship between dysphoria,despondency,and overall QOL in patients undergoing MHD.It is imperative to investigate this mediating effect to mitigate dysphoria and despondency in patients undergoing MHD,ultimately enhancing their overall QOL.AIM To investigate the mediating role of social support in relationships between dysphoria,despondency,and QOL among patients undergoing MHD.METHODS Participants comprised 289 patients undergoing MHD,who were selected using a random sampling approach.The Social Support Rating Scale,Self-Rating Anxiety Scale,Self-Rating Depression Scale,and QOL Scale were administered.Correlation analysis was performed to examine the associations between social support,dysphoria,despondency,and QOL in patients undergoing MHD.To assess the mediating impact of social support on dysphoria,despondency,and QOL in patients undergoing MHD,a bootstrap method was applied.RESULTS Significant correlations among social support,dysphoria,despondency,and quality in patients undergoing MHD were observed(all P<0.01).Dysphoria and despondency negatively correlated with social support and QOL(P<0.01).Dysphoria and despondency had negative predictive impacts on the QOL of patients undergoing MHD(P<0.05).The direct effect of dysphoria on QOL was statistically significant(P<0.05).Social support mediated the relationship between dysphoria and QOL,and this mediating effect was significant(P<0.05).Similarly,the direct effect of despondency on QOL was significant(P<0.05).Moreover,social support played a mediating role between despondency and QOL,with a significant mediating effect(P<0.05).CONCLUSION These findings suggest that social support plays a significant mediating role in the relationship between dysphoria,despondency,and QOL in patients undergoing MHD.

Resilience provides mediating effect of resilience between fear of progression and sleep quality in patients with hematological malignancies

BACKGROUND Hematological tumors are common malignant tumors,with high morbidity and mortality rates.Most patients with hematological malignancies develop sleep disorders that seriously affect their life and health because of acute onset of disease,rapid progression,high recurrence rates,complex treatment methods,and treatment costs.AIM To explore the mediating effect of resilience on fear of disease progression and sleep quality in patients with hematological malignancies.METHODS A cross-sectional analysis of 100 patients with hematological malignancies,treated in the First Affiliated Hospital of Jinzhou Medical University between August 2022 and August 2023,was conducted.Patients were assessed using a general data survey,a simplified scale for the fear of progression(FoP)of disease,a resilience scale,and the Pittsburgh Sleep Quality Index.Statistical analysis was conducted to determine the relationship between various patient characteristics and FoP,resilience,and sleep quality.Spearman’s correlation analysis was used to examine the correlations between mental resilience,FoP,and sleep quality.RESULTS The total FoP score mean value in patients with hematological malignancies was 38.09±5.16;the total resilience score mean value was 40.73±7.04;and the Pittsburgh Sleep Quality Index score mean value was 10.72±1.90.FoP,resilience,and sleep quality of the patients were associated with family per capita monthly income and patient education level(P<0.05).Spearman correlation analysis revealed that FoP was negatively correlated with resilience and sleep quality scores(r=-0.560,-0.537,P<0.01),respectively,and resilience was significantly associated with sleep quality scores(r=0.688,P<0.01).Mediation analysis showed that the mediating effect of resilience between FoP and sleep quality in patients with hematological malignancies was-0.100 and accounted for 50.51%of the total effect.This indicated that FoP directly and indirectly affected sleep quality through the mesomeric effect of resilience.CONCLUSION Resilience is an intermediary variable between FoP and sleep quality in patients with hematological malignancies.Medical staff should evaluate and follow-up FoP and resilience to implement measures to improve sleep quality.

The Relationship between Parental Stress and Child Conformity:The Mediating Role of Resilience

Background:In today’s society,parental stress has become a prevalent and significant issue,impacting not only parents’mental health but also potentially profoundly affecting children’s growth and education.This topic has garnered continuous attention from scholars.The present study aims to delve into the relationship between parental stress and children’s behavior,particularly focusing on children’s conformity and discipline development during crucial stages.This study aims to explore the relationship between parental stress,child conformity,and resilience,and further examines the mediating role of resilience in the relationship between parental stress and child conformity.Methods:We used three scales:the Parental Stress Scale,the Child Conformity Scale,and the Resilience Scale,to survey 890 elementary school students(aged 6–12)and their parents in the Beijing-Tianjin-Hebei region of China.We employed SPSS 26.0 software for data analysis,conducting descriptive statistics,correlation analysis,and mediation effect tests sequentially.In the mediation effect tests,we utilized structural equation modeling(SEM)and regression analysis to examine the mediation effects,ensuring the accuracy and scientific nature of our analysis.Results:Through descriptive statistics,correlation analysis,regression models,and mediation effect tests,we found that parental stress significantly negatively predicts child conformity,while resilience shows a significant positive prediction.Further mediation analysis indicates that resilience plays a partial mediating role between parental stress and child conformity,with the mediation effect accounting for 36.67%.Conclusion:These findings highlight the importance of the family environment on child behavior and provide valuable insights and recommendations for family education practices in the Beijing-Tianjin-Hebei region.Therefore,we suggest future research should further explore the complex relationships among parental stress,child conformity,and resilience,and examine regional differences to better promote children’s overall development.

The Relationship between Overparenting and Adolescent Anxiety:The Mediating Role of Cognitive Avoidance

Background:Adolescent anxiety has a significant impact on physical and mental health,and overparenting is recognized as one of the major factors affecting adolescent anxiety.The objective of this study was to investigate the relationship between overparenting and adolescent anxiety,while also examining the mediating role of cognitive avoidance.Methods:Data were collected through a cross-sectional survey with 1931 valid responses using the Overparenting Scale,the Cognitive Avoidance Scale,and the Anxiety Self-Rating Scale.A structural equation modelling approach was used to test the mediating role of cognitive avoidance between overparenting and adolescent anxiety and to reveal the underlying mechanisms.The significance of the mediating effect was assessed based on maximum likelihood estimation.Differences in the mediating role of cognitive avoidance in the male and female samples were comparatively analyzed in the mediation effect analysis.Results:The study’s findings reveal a significant positive correlation between overparenting and adolescent anxiety(p<0.01),between overparenting and cognitive avoidance(p<0.01),and between cognitive avoidance and adolescent anxiety(p<0.01).Cognitive avoidance mediated the relationship between overparenting and adolescent anxiety.Overparenting can not only directly predict adolescent anxiety but also indirectly predict it through the mediating role of cognitive avoidance.Conclusion:This study validates the direct effect of overparenting on adolescent anxiety and reveals the mechanism of cognitive avoidance as a mediator.

The Influence of Academic Self-Efficacy on Learning Engagement in Online Education in China:The Mediating Role of Effort

The shift towards online intelligent learning has become the norm in education and is now a fundamental part of modern educational activities.However,this new model can influence students’learning behavior and lead to changes in their approach to learning.Based on online intelligent learning,we investigated how the academic self-efficacy of nursing students affects their engagement with learning and explored the role of academic attribution as a mediator.Five hundred fifty-three nursing college students from Hebei and Hunan provinces in China participated in the online questionnaire.The results revealed that effort plays a mediating role in the relationship between academic self-efficacy and learning engagement.

Association of education with cholelithiasis and mediating effects of cardiometabolic factors:A Mendelian randomization study

BACKGROUND Education,cognition,and intelligence are associated with cholelithiasis occurrence,yet which one has a prominent effect on cholelithiasis and which cardiometabolic risk factors mediate the causal relationship remain unelucidated.AIM To explore the causal associations between education,cognition,and intelligence and cholelithiasis,and the cardiometabolic risk factors that mediate the associations.METHODS Applying genome-wide association study summary statistics of primarily European individuals,we utilized two-sample multivariable Mendelian randomization to estimate the independent effects of education,intelligence,and cognition on cholelithiasis and cholecystitis(FinnGen study,37041 and 11632 patients,respectively;n=486484 participants)and performed two-step Mendelian randomization to evaluate 21 potential mediators and their mediating effects on the relationships between each exposure and cholelithiasis.RESULTS Inverse variance weighted Mendelian randomization results from the FinnGen consortium showed that genetically higher education,cognition,or intelligence were not independently associated with cholelithiasis and cholecystitis;when adjusted for cholelithiasis,higher education still presented an inverse effect on cholecystitis[odds ratio:0.292(95%CI:0.171-0.501)],which could not be induced by cognition or intelligence.Five out of 21 cardiometabolic risk factors were perceived as mediators of the association between education and cholelithiasis,including body mass index(20.84%),body fat percentage(40.3%),waist circumference(44.4%),waist-to-hip ratio(32.9%),and time spent watching television(41.6%),while time spent watching television was also a mediator from cognition(20.4%)and intelligence to cholelithiasis(28.4%).All results were robust to sensitivity analyses.CONCLUSION Education,cognition,and intelligence all play crucial roles in the development of cholelithiasis,and several cardiometabolic mediators have been identified for prevention of cholelithiasis due to defects in each exposure.

The Relationship between Mental Health Literacy and Subjective Well-Being of Young and Middle-Aged Residents: Perceived the Mediating Role of Social Support and Its Urban-Rural Differences

This study investigates mental health literacy among young and middle-aged urban and rural residents and the differences in mental health literacy,perceived social support and subjective well-being.From January to February 2022,620 participants(320 rural and 300 urban residents)from three provinces of China were selected by con-venience sampling.A general data questionnaire,mental health literacy scale,perceived social support scale and subjective well-being scale were administered.The mental health literacy scores of urban residents were 3.34±0.57 and those of rural residents were 2.73±0.79.The results of multiple regression analysis showed that the mental health literacy scores of rural residents were more significant than those of urban residents in terms of sex and age,while urban residents’mental health literacy scores were more significant than those of rural resi-dents in terms of monthly income.Mental health literacy,perceived social support and subjective well-being of young and middle-aged urban and rural residents were all positively correlated(P<0.01).While the level of mental health literacy is better among urban residents than rural residents,perceived social support plays a partial mediating role between mental health literacy and subjective well-being of both urban and rural residents,and should be the focus of researchers seeking to improve the level of well-being of residents.

Mediating effect of mindfulness level on the relationship between marital quality and postpartum depression among primiparas

BACKGROUND Postpartum depression refers to a depressive episode or depressive symptoms up to 12 mo after delivery.Trait mindfulness has presented a protective factor for postpartum depressive symptoms and proved efficient in improving relationship satisfaction among couples.AIM To investigate the correlations among mindfulness,marital quality,anxiety,and depression in a large city in western China during the post-corona virus infectious disease-2019 era and determine whether trait mindfulness mediates the relationship between marital quality and postpartum anxiety and depression among primiparas.METHODS A cross-sectional study was conducted.The self-administered questionnaire was submitted online through smartphones.The levels of mindfulness,anxiety,depression,and marital quality were respectively investigated by the mindful attention awareness scale(MAAS),the self-rating anxiety scale(SAS),the selfrating depression scale(SDS),and the marriage perception scale(MPS)in these enrolled Han and Tujia primiparas.RESULTS No statistical significance was observed in the prevalence of postpartum anxiety and depression,nor scores of MAAS and MPS-Total in different regions or ethnicities(P>0.05).However,MPSMarital interaction(P<0.05),MPS-Family relationship(MPS-FR)(P<0.01),and MPS-Marital conflict(MPS-MC)(P<0.01)scores of urban primiparas were higher than those of rural primiparas.The MPS-MC score of Han primiparas was higher than that of Tujia primiparas(P<0.05).Negative correlations were observed between MAAS and SAS(r=-0.457,P<0.01),and MAAS and SDS(r=-0.439,P<0.01).SAS has revealed a highly positive correlation with SDS(r=0.720,P<0.01)and a weak negative correlation with MPS(r=-0.200,P<0.05).Besides,a weak negative correlation was observed between MAAS and MPS-MC(r=-0.184,P<0.05),and a weak positive correlation was noticed between SAS and MPS-MC(r=-0.225,P<0.01).Mediation analysis demonstrated a full mediation effect of mindfulness level on the relationship between MPS-FR and postpartum anxiety(P<0.05,95%CI:-0.384 to 0.033),MPS-MC and postpartum anxiety(P<0.01,95%CI:0.027-0.193),MPS-FR and postpartum depression(P<0.05,95%CI:-0.365 to 0.031),and MPS-MC and postpartum depression(P<0.01,95%CI:0.022-0.206).CONCLUSION Mindfulness demonstrates negative correlations with marital conflict,postpartum anxiety and depression,and it may have cross-ethnic and trans-regional characteristics.Although the mindfulness levels have revealed no significant mediating effect between the total score of marital quality and postpartum depression in this study,it demonstrates a full mediation effect on the relationships between family relationships,marital conflict,and postpartum anxiety and depression.

Mediating role of physical activity in the relationship between psychological distress and intimate relationships among stroke patients

BACKGROUND Stroke patients often experience psychological distress,which can impact their intimate relationships with spouses,subsequently influencing their treatment and recovery.Physical activity is considered a key rehabilitation method for stroke patients.This paper aims to analyze whether psychological distress affects intimate relationship between spouses through physical activity.AIM To explore the mediating effect of physical activity between psychological distress and intimate relationship in stroke patients.METHODS A total of 256 stroke patients who underwent treatment at the First People’s Hospital of Shangqiu between July 2021 and July 2022 were enrolled in this study.The participants completed questionnaires,including the Kessler Psychological Distress Scale(K10),the Quality of Relationship Index(QRI),International Physical Activity Questionnaire,and a general information questionnaire.Data analysis were performed using SPSS 23.0.The Harman test was employed to detect common method deviations,and Spearman correlation was used for correlation analysis.The mediating effect was assessed using Process 3.4.1,with significance testing of the regression coefficients conducted using the bias-corrected percentile Bootstrap method(5000 iterations,95%confidence interval).Statistical significance was set at P<0.05.RESULTS The results showed that patients scored an average of 21.61±6.44 points on the K10,32.40±6.19 points on the QRI;the median physical activity level according to the International Physical Activity Questionnaire was 1861(566,2846)MET·min/w.The level of physical activity(the physical activity intensity of the patients reflected by the Interna-tional Physical Activity Questionnaire-Long Form scale)negatively correlated with psychological distress and intimacy(P<0.05),and positively correlated with each other(P<0.05),with the correlation stronger at lower physical activity levels compared to higher ones.The mediating effect of physical activity between psychological distress and intimate relationship was calculated to be 40.23%.Bootstrap analysis further validated the results.The mediating effect of psychological distress on intimate relationships through physical activity level was-0.284,with a confidence interval of-0.409 to-0.163,excluding 0,confirming a significant mediating effect of psychological distress on intimate relationships.CONCLUSION Physical activity significantly affects relationship between psychological distress and intimate relationships among stroke patients.Addressing the role of physical activity may have implications for improving patient outcomes and rehabilitation strategies.

The Relationship between Rural Left-Behind Children’s Physical Activity and Hope:The Mediating Effects of Perceived Social Support

It has been confirmed in previous studies that there is a positive correlation between physical activity and hope.In this study,rural left-behind children in China was taken as the participants to investigate the impact of physical activity on hope in rural left-behind children and examine the mediating role of perceived social support in the relationship between physical activity and hope.797 valid copies of the questionnaire were collected from China.Pearson correlation coefficient was employed to analyze the relationship between physical activity and hope;SEM and Bootstrap were used to test the mediating effect of perceived social support.The results show that physical activity can not only directly and positively predict the level of hope in rural leftbehind children but can also predict the level of hope through perceived social support;perceived social support plays a mediating role in the relationship between physical activity and hope.These results highlight the necessity to pay more attention to the physical activity of left-behind children and the possibility to improve the level of hope by increasing their physical activity;at the same time,the acquisition of more material,emotional and psychological support from teachers and guardians is more conducive to improving the sense of hope in left-behind children.These findings can deepen the understanding of the sense of hope in left-behind children,and provide new methods for and enlightenments on improving the level of hope in left-behind children.

China’s Foreign Aid,Recipient Countries’Economic Growth,and the Mediating Effect of Aid in Infrastructure

Based on the panel data of China’s foreign aid in 2003-2014 from AidData,this paper empirically investigates the relationship between China’s foreign aid and economic growth in recipient countries.Using the principal component analysis(PCA),the authors propose a variable,i.e.the infrastructure index,to measure the effects of aid on the economic growth of recipient countries.This study shows that aid from China has significantly improved the level of economic growth in recipient countries,which provides a new evidence of China’s aid effectiveness.Through analysis of the ways by which aid in infrastructure induces economic growth,the authors conclude that the improvement of local infrastructure accounts for 55.30%of the aggregate economic growth effect of China’s aid to recipient countries.

Mechanisms Influencing Learning Gains Under Information Security: Structural Equation Modeling with Mediating Effect

With the expanding enrollments in higher education,the quality of col-lege education and the learning gains of students have attracted much attention.It is important to study the influencing factors and mechanisms of individual stu-dents’acquisition of learning gains to improve the quality of talent cultivation in colleges.However,in the context of information security,the original data of learning situation surveys in various universities involve the security of educa-tional evaluation data and daily privacy of teachers and students.To protect the original data,data feature mining and correlation analyses were performed at the model level.This study selected 12,181 pieces of data from X University,which participated in the Chinese College Student Survey(CCSS)from 2018 to 2021.A confirmatory factor analysis was conducted and a structural equation modeling was conducted using AMOS 24.0.Through hypothesis testing,this study explored the mechanisms that influence learning gains from the per-spectives of student involvement,teacher involvement,and school support.The results indicated that the quality of student involvement has an important mediat-ing effect on learning gains and that a supportive campus environment has the greatest influence on learning gains.Establishing positive emotional communica-tions between teachers and students is a more direct and effective method than improving the teaching level to improve the quality of student involvement.This study discusses the implications of these results on the research and practice of connotative development in higher education.

Influence of resilience on depression among nurses in clean operating departments:The mediating effect of life satisfaction

BACKGROUND A clean operating room is an important part of surgical and critical treatment in hospitals.The workload is substantial,the pace is rapid,and the working environment is intense;therefore,nurses who work in clean operating rooms are constantly challenged,which can lead to anxiety,depression,and other mental health issues.Life satisfaction and resilience are important factors that ensure mental health.Therefore,exploring the mediating role of life satisfaction in the influence of resilience on depression among nurses in clean operating rooms can help improve nursing services and teamwork.AIM To explore the mediating effect of satisfaction on the influence of resilience on depression among nurses in a clean operating department.METHODS From April to November 2022,196 nurses from the Department of Clean Operating at Harbin Medical University Cancer Hospital participated in this study.Participants were selected using convenience sampling.Participants’gender,age,marital status,position,length of service,personal monthly income,daily working hours,employment status,and professional title were collected,and the Connor-Davidson resilience scale,satisfaction with life scale,and selfrating depression scale were used to evaluate resilience,life satisfaction,and depression.The researchers conducted professional training in advance,introduced the research methods to the participants before the investigation,and explained the study’s significance and purpose.Surveys were distributed and collected on-site.Each questionnaire took 30 min to complete.RESULTS The average scores for life satisfaction,resilience,and depression were 3.13(±0.28),4.09(±0.78),and 56.21(±8.70),respectively.The correlation between resilience and depression was negative(r=-0.829,P<0.01).Life satisfaction was positively related to resilience(r=0.855,P<0.01)and negatively related to depression(r=-0.778,P<0.01).The relationship between resilience and depression was partially mediated by life satisfaction.The value of the mediating effect was-6.853(26.68%of the total effect).CONCLUSION Life satisfaction partially mediates the link between resilience and depression among nurses in clean operating departments.

The impact of nurses’organizational commitment on their perceptions of the work environment:Strong mediating effect of the psychological contract

Objective:The objective is to assess the direct and indirect effects of nurses’organizational commitment(OC)on their work environment perceptions(WEP)and the role of the psychological contr act(PC).Methods:A cross‑sectional quantitative study of 3047 registered nurses in four Chinese hospitals was conducted.The Essentials of Magnetism II(Chinese version),OC,and PC scales were used in the study,and the structural equation modeling was used to assess the connections among variables.Results:The results showed that OC was positively correlated with WEP(r=0.561,P<0.001),and PC was negatively correlated with the WEP(r=−0.717,P<0.001),and OC(r=−0.739,P<0.001).Nurses’PC played a strong mediating role between OC and WEP,accounting for 87.64%of the total effect.Besides,PC played an important role in creating a healthy work environment.Conclusions:The exploration of the relationships among WEP,PC,and OC provides new insights for hospital managers to build a better work environment for nurses,which is conducive to maintaining a stable nurse team and providing high‑quality nursing services for patients.

Correlation and pathways of behavioral activation systems mediating physical activity level and depressive symptoms among college students

BACKGROUND Depression is a common mental disorder among college students.The main symptoms include being persistent low mood,sad emotional experiences,lack of pleasure,listlessness,and impaired cognitive function accompanied by tendencies of self-harm and suicide.AIM To clarify the pathways and effects of the behavioral activation system between physical activity and depressive symptoms in college students with depressive symptoms.METHODS This cross-sectional research screened 3047 college students.Of these,472 had depressive symptoms,with a depression detection rate of 15.49%.Furthermore,442 college students with depressive symptoms were analyzed.A one-way analysis of variance and Pearson’s correlation,linear regression,and structural equation modeling analyses were used to explore the correlations and pathways of the interactions between the variables.RESULTS Depressive symptoms were significantly negatively correlated with physical activity(r=-0.175,P<0.001),the behavioral activation system(r=-0.197,P<0.001),and drive(r=-0.113,P=0.017).Furthermore,it was negatively correlated with fun-seeking(FS)(r=-0.055,P=0.251);however,it was not significant.Physical activity was significantly positively correlated with reward responsiveness(RR)(r=0.141,P=0.003)and drive(r=0.124,P=0.009)and not significantly positively correlated with FS(r=0.090,P=0.058).The mediating effect of RR between physical activity and depressive symptoms was significant[B=-0.025,95%confidence interval(95%CI):-0.051 to-0.008,P=0.001].The direct and total effects of physical activity on depressive symptoms and were significant(B=-0.150,95%CI:-0.233 to-0.073,P<0.001;B=-0.175,95%CI:-0.260 to-0.099,P<0.001),respectively.CONCLUSION As physical activity levels increased,depression scores among college students decreased.The mediating effect of RR between physical activity and depressive symptoms was significant.Therefore,colleges and universities should encourage college students with depression to increase their physical activity and improve their behavioral activation system.Particular attention should be paid to RR,which may reduce the prevalence of depressive symptoms.

The Mediating Effect of Social Media on the Relationship Between Travel Preference and Tourist Behavior of Local Tourists in Davao City

This paper aims to determine the mediating effect of social media on the relationship between travel behavior and tourist preference.This paper utilized the mediation analysis design to determine whether social media significantly affects the independent and dependent variables.For the statistical tools,the proponents of the study utilized descriptive statistics,Sobel’s test,mean and standard deviation.Also,the proponents of the study utilized data from questionnaires gathered through an online google form.Most of the respondents are single females,college-level,and use Facebook most of the time.Therefore,this is the social media platform that the majority utilize.It has been revealed in the study the three sets of correlated variables:Travel behavior vs.tourist behavior,travel preference vs.social media,and social media vs.tourist behavior,have a strong positive linear relationship between the two quantitative variables.Thus,the study proponents concluded that there is an indirect effect between the travel preference and tourist behavior of local tourists in Davao City via social media.Lastly,the study’s findings reveal the fundamentals of how visitors make decisions,which are essential for enhancing the competitive advantages of cultural destinations.Significant findings from the study are beneficial to the growth of cultural tourism in Davao City.

Mediating effect of self-efficacy in relationship between emotional intelligence and clinical communication competency of nurses

Objective:This study investigates the emotional intelligence(EI),self-efficacy,and clinical communication ability of clinical nurses to explore the correlation among these three variables,and verify the mediating effect of self-efficacy on relationship between EI and communication skills.Methods:A total of 865 nurses were recruited and investigated using Wong and Law's Emotional Intelligence Scale,General Self-Efficacy Scale,and nurse clinical communication scale.Results:The scores for EI and self-efficacy of nurses were 14.23±2.61 and 25.36±5.67,respectively,which were lower than the international norm(p<0.01).The score for clinical communication ability of nurses was 4.14±0.53.The clinical communication competency of nurses was positively correlated with EI and general self-efficacy.Furthermore,selfefficacy played an intermediary role between EI and clinical communication commitment.Conclusion:Nursing administrators can improve the clinical communication ability of nurses by enhancing their self-efficacy and EI.

Work-family conflict and job burn-out among Chinese doctors:the mediating role of coping styles

Background Burn-out among doctors threatens their own health, and that of their patients. To identify risk factors of the doctor burn-out is vital to improving their health and increasing the quality of healthcare services. This study aims to explore the relationship between work-family confict （WFC） and burn-out among Chinese doctors and the mediating role of coping styles in this relationship.Methods A cross-sectional survey was conducted in China, with a questionnaire packet which consisted of the Chinese Maslach Burnout Inventory （CMBI）, WFC Scale and the Simplifed Coping Style Questionnaire （SCSQ）. A total of 2530 doctors participated in the survey. Correlation analysis was performed to explore the relationship between CMBI, WFC and SCSQ scores. A linear regression model was set to determine the mediating role of coping styles on the relationship between WFC and burn-out.Results Doctors who had higher scores on work interfering with family confict, reported more emotional exhaustion （r=0.514, P〈0.001） and had a sense of accomplishment （r= 0.149, P〈0.001）. Simultaneously, family interfering with work （FIW） was positively associated with all dimensions of burn-out （r=0.213, 0.504, 0.088, respectively, P〈0.001）. Coping styles had partial, complete and even mediating effects on the relationship between WFC and burn-out among Chinese doctors.Conclusions WFC was correlated with burn-out, and coping style was a mediator in this relationship among Chinese doctors. Coping style was a positive resource against burn-out.

Mediating effect of interpersonal relations on negative emotions and dysmenorrhea in female adolescents

Background Good interpersonal relationships can improve the negative mood and, to a certain extent, may help relieve dysmenorrhea symptoms. However, there has been no study examining the role of interpersonal relationships in dysmenorrhea and how they may interact with negative emotions. Aims To investigate the connection between negative affect and dysmenorrhea, and the role of interpersonal relationships plays in this relationship. Methods The Cox Menstrual Symptom Scale (CMSS), short-form of Depression Anxiety Stress Scale, Interpersonal Comprehensive Diagnostic Scale and UCLA (University of California at Los Angeles) Loneliness Scale were applied to 855 adolescent nursing students to collect information on severity and frequency of dysmenorrheal symptoms, negative emotions (including depression, anxiety and stress), interpersonal problems and subjective experience of loneliness among them, and the relationship among these variables was examined. Results (1) Both the severity and frequency of dysmenorrhea were positively correlated with negative emotions, loneliness experience and interpersonal problems, while negatively correlated with age at menarche.(2) The negative emotions, romantic relationship and menarche age, but not loneliness and interpersonal problems, significantly contributed to both the severity and frequency of dysmenorrhea.(3) Mediation analysis revealed that the effects of loneliness and interpersonal problems on dysmenorrhea were totally mediated by negative emotions. Conclusions This investigation indicates that the relationship between interpersonal relationships and dysmenorrhea is mediated by negative emotions.

In vivo evidence of IGF-I–estrogen crosstalk in mediating the cortical bone response to mechanical strain

Although insulin-like growth factor-I （IGF-I） and estrogen signaling pathways have been shown to be involved in mediating the bone anabolic response to mechanical loading, it is not known whether these two signaling pathways crosstalk with each other in producing a skeletal response to mechanical loading. To test this, at 5 weeks of age, partial ovariectomy （pOVX） or a sham operation was performed on heterozygous IGF-I conditional knockout （H IGF-I KO） and control mice generated using a Cre-loxP approach. At 10 weeks of age, a 10 N axial load was applied on the right tibia of these mice for a period of 2 weeks and the left tibia was used as an internal non-non-loaded control. At the cortical site, partial estrogen loss reduced total volumetric bone mineral density （BMD） by 5% in control pOVX mice （P=0.05, one-way ANOVA）, but not in the H IGF-I KO pOVX mice. At the trabecular site, bone volume/total volume （BV/TV） was reduced by 5%-6% in both control pOVX （P〈0.05） and H IGF-I KO pOVX （P=0.05） mice. Two weeks of mechanical loading caused a 7 %-8% and an 11%-13% （P〈0.05 vs. non-loaded bones） increase in cortical BMD and cortical thickness （Ct.Th）, respectively, in the control sham, control pOVX and H IGF-I KO sham groups. By contrast, the magnitude of cortical BMD （4%, P=0.13） and Ct.Th （6%, P〈0.05） responses were reduced by 50% in the H IGF-I KO pOVX mice compared to the other three groups. The interaction between genotype and estrogen deficiency on the mechanical loading-induced cortical bone response was significant （P〈0.05） by two-way ANOVA. Two weeks of axial loading caused similar increases in trabecular BV/TV （13%-17%） and thickness （17%-23%） in all four groups of mice. In conclusion, partial loss of both estrogen and IGF-I significantly reduced cortical but not the trabecular bone response to mechanical loading, providing in vivo evidence of the above crosstalk in mediating the bone response to loading.