Mediation Role Research Articles

Patient-pharmacist relationship dynamics: a mediation analysis of patient characteristics and reported outcomes.

While previous research underscores the independent effect of the pharmacist-patient relationship on patient outcomes, it did not delve further into the patient-pharmacist relationship dynamics and their effects on reported outcomes. Therefore, this study aimed to assess whether patient-pharmacist relationship aspects mediate the association between patient personal and health characteristics, on the one hand, and adherence to medication and quality of life, on the other hand (QOL). An online cross-sectional study was conducted between April 11 and 27, 2023. It enrolled 865 adults from all Lebanese governorates and used validated scales to measure the various concepts. The mean age was 32.52 ± 14.56 years, and 68.8% were female. Also, 79.3% reported having no chronic disease, and 57.7% indicated that getting nonprescription medications was the main reason for visiting a community pharmacy. The average routine intake of medications per day was 0.87 ± 1.78. Our key findings reveal a compelling association between worse health status and both increased medication non-adherence and reduced QOL. Sociodemographic factors were found to be correlated with QOL. Despite the considerable impact of demographic factors on patient expectations, our study challenges the expected mediation role of the pharmacist-patient relationship and counseling time on medication adherence. Nevertheless, patient expectations partially mediated the relationship between sociodemographic characteristics and QOL. This study sheds light on the intricate dynamics between patient characteristics, health status, medication adherence, and QOL within the context of the patient-pharmacist relationships.

Different parenting styles and rural Children’s mental Health: The mediational role of mental resilience

The baseline data from the China Education Panel Survey (CEPS) 2014–2015 was employed to construct linear regression models and structural equation models, which were used to investigate the effects of different parenting styles on the mental health of rural left-behind children. The study found that parenting behaviors and parenting attitudes in two different modes, intergenerational parenting and parental parenting, both have an impact on the mental health of rural left-behind children, with no significant difference between the two. Nevertheless, the quality of the relationship between children and their mothers has a considerable impact on their mental health. Secondly, parenting behavior exerts a direct and indirect influence on the mental health mechanism of these children, the direct effect is considerably more pronounced than the indirect effect; the impact of parenting attitudes on the mental health of left-behind children is contingent upon the mediating variable of mental resilience. In order to mitigate the adverse effects of parental absence on the mental health of left-behind children, it is imperative that families enhance their parenting attitudes, reinforce parent–child communication, and cultivate a nurturing family environment. Schools must implement human-centered education, enhance the professionalism of teachers, and extend greater care and support to left-behind children. Furthermore, the state and the government must prioritize the development of the rural economy and strive to narrow the urban–rural disparity.

Mediation Roles of Organizational Commitment and Teamwork on Strategic Management Practices and Public Organizations' Performance: Theoretical Framework

Mediation Roles of Organizational Commitment and Teamwork on Strategic Management Practices and Public Organizations' Performance: Theoretical Framework

S149 - Perceived Stigma on the Emotional Wellbeing Among Latinx With Substance Use Disorders: The Mediated Roles of Self-Stigma and Self-Efficacy

S149 - Perceived Stigma on the Emotional Wellbeing Among Latinx With Substance Use Disorders: The Mediated Roles of Self-Stigma and Self-Efficacy

The mediation model of social status on the link between parental attachment, aggressive behavior, and psychological well-being: Evidence from two studies in Vietnamese adolescents and young adults.

Little is known about how insecure attachment affects aggressive behavior and well-being among Vietnamese youth. Using structural equation modeling, we investigate the mediating role of subjective social status (SSS) on the paths from insecure attachment to overt aggressive behavior (OAB) and psychological well-being (PW) in a sample of 1753 Vietnamese adolescents (Mage = 16.136, SD = 0.784) and test whether the results will be replicated in another sample of 601 Vietnamese young adults (Mage = 19.93, SD = 1.35). Participants complete a survey comprising demographic information, attachment styles, SSS, OAB, and PW questionnaires. Our main findings include: (a) anxious attachment positively related to OAB in both samples, (b) anxious attachment was only negatively associated with adolescents' PW, (c) avoidant attachment was positively correlated to OAB in adolescents but negatively correlated in young adults, and (d) avoidant attachment was negatively related to PW in both samples. In addition, (e) in adolescents, the mediation role of SSS was significant in all paths, but (f) SSS only mediated the link from avoidant attachment to PW of young adults. The present study suggests that aggressive behavior might not be associated with social status or attachment in the same way in adolescents compared to young adult Vietnamese samples.

The Influence Of Technology Orientation On Performance Is Mediated By Innovation In MSMES Results From Melinjo Processing In Menes Banten

This study analyzes the role of mediation of innovation in the influence of, technological orientation on the performance of MSMEs melinjo in the village of Menes Pandeglang, Banten. This research uses quantitative methods and statistical analysis tools in the form of smartpls 4.0. This study used a sampling technique in the form of accidental sampling as many as 90 entrepreneurs who processed melinjo. The results of this study found that there was an mediating of innovation on influence of technology orientation on performance of MSMEs melinjo in the village of Menes Pandeglang, Banten. Other results explain that the no influence of technology orientation on performance in direct effect. This research focuses on the role of performance of MSMEs processed melinjo. In addition, the focus of this research is on the village of Menes, which is one of the villages in Pandegelang, Banten. The novelty in this study is that apart from the object of research, it is also a research model that has never been studied before.

The mediation role of hope in the relationship of resilience with depression, anxiety, and stress in caregivers of children and adolescents with cancer

This study aimed to determine the mediation role of hope in the relationship of resilience with depression, anxiety, and stress in caregivers of children and adolescents with cancer. This cross-sectional study was conducted on 200 caregivers of children and adolescents with cancer. Adult Hope Scale, Connor-Davidson Resilience Scale, and Depression, Anxiety and Stress (DAS) scales were used for data collection. The mediator and moderator model was tested using the SPSS macro PROCESS (Model 4, and 5). The mediator model (model 4) indicated that DAS significantly correlated with resilience (β = − 0.54, t-value = − 5.01, p < 0.001), and hope (β = − 0.84, t-value = − 3.45, p = 0.0007). Hope mediated the relationship between resilience and DAS among caregivers of children and adolescents with cancer (Effect = − 0.18, SE = 0.06, 95% CI − 0.33 to − 0.06). The mediator and moderator model (model 5) showed that female caregivers had a stronger correlation between resilience and DAS when compared to their male counterparts (β = − 0.56, t-value = − 3.90, p-value = 0.0001); also, hope mediated the relationship between resilience and DAS among caregivers of children and adolescents with cancer (Effect = − 0.20, SE = 0.08, 95% CI − 0.37 to − 0.04). In conclusion, hope was a mediator, and female caregivers were a moderator in the relationship of resilience with depression, anxiety, and stress, and its promotion might be effective among caregivers of children and adolescents with cancer. It seems that resilience, female caregivers, and hope may provide good protection against depression, anxiety, and stress in caregivers of cancer patients.

Genetic evidence for the causal impact of insomnia on gastrointestinal diseases and the mediating effects of adiposity traits.

Insomnia has been implicated in gastrointestinal diseases (GIs), but the causal effect between insomnia and GIs and underlying mechanisms remain unknown. By using the released summary-level data, we conducted a two-step Mendelian randomization (MR) analysis to examine the relationship between insomnia and four GIs and estimate the mediating role of candidate mediators. The first step was to investigate the causal association between insomnia and GIs using univariable MR analysis. The second step was to estimate the mediation proportion of selected mediators in these associations using multivariable MR analysis. Subsequently, results from different datasets were combined using the fixed-effect meta-analysis. Univariable MR analysis provided strong evidence for the causal effects of insomnia on four GIs after Bonferroni correction for multiple comparisons, including peptic ulcer disease (PUD) (odds ratio [OR]=1.15, 95% interval confidence [CI]=1.10-1.20, P=1.83×10-9), gastroesophageal reflux (GORD) (OR=1.19, 95% CI=1.16-1.22, P=5.95×10-42), irritable bowel syndrome (IBS) (OR=1.18, 95% CI=1.15-1.22, P=8.69×10-25), and inflammatory bowel disease (IBD) (OR=1.09, 95% CI=1.03-1.05, P=3.46×10-3). In the mediation analysis, body mass index (BMI) and waist-to-hip ratio (WHR) were selected as mediators in the association between insomnia and PUD (BMI: mediation proportion [95% CI]: 13.61% [7.64%-20.70%]; WHR: 8.74% [5.50%-12.44%]) and GORD (BMI: 11.82% [5.94%-18.74%]; WHR: 7.68% [4.73%-11.12%]). Our findings suggest that genetically instrumented insomnia has causal effects on PUD, GORD, IBS, and IBD, respectively. Adiposity traits partially mediated the associations between insomnia and GIs. Further clinical studies are warranted to evaluate the protective effect of insomnia treatment on GIs.

Glioma-Stem-Cell-Derived Exosomes Remodeled Glioma-Associated Macrophage via NEAT1/miR-125a/STAT3 Pathway.

Glioblastoma (GBM), as the most common primary brain tumor, usually results in an extremely poor prognosis, in which glioma stem cells (GSCs) and their immunosuppressive microenvironment prominently intervene in the resistance to radiotherapy and chemotherapy that directly leads to tumor recurrence and shortened survival time. The specific mechanism through which exosomes generated from GSCs support the creation of an immunosuppressive microenvironment remains unknown, while it is acknowledged to be engaged in intercellular communication and the regulation of the glioma immunosuppressive microenvironment. The elevated expression of LncRNA-NEAT1 was found in glioma cells after radiotherapy, chemotherapy, and DNA damage stimulation, and NEAT1 could promote the malignant biological activities of GSCs. Emerging evidence suggests that lncRNAs may reply to external stimuli or DNA damage by playing a role in modulating different aspects of tumor biology. Our study demonstrated a promotive role of the carried NEAT1 by GSC-derived exosomes in the polarization of M2-like macrophages. Further experiments demonstrated the mediative role of miR-125a and its target gene STAT3 in NEAT1-induced polarization of M2-like macrophages that promote glioma progression. Our findings elucidate the mechanism by which GSCs influence the polarization of M2-like macrophages through exosomes, which may contribute to the formation of immunosuppressive microenvironments. Taken together, our study reveals the miR-125a-STAT3 pathway through which exosomal NEAT1 from treatment-resistant GSCs contributes to M2-like macrophage polarization, indicating the potential of exosomal NEAT1 for treating glioma.

Effects of resilience, social support, and academic self-efficacy, on mental health among Peruvian university students during the pandemic: the mediating role of digital inclusion.

Mental health of university students has been impacted during the pandemic, highlighting the importance of understanding its psychosocial determinants. Nevertheless, there has been limited exploration into whether the digital inclusion conditions for remote education could mediate the effects that variables such as resilience, social support, and academic self-efficacy may have on mental health. Considering the above, there is evidence that shows a consistent relationship between resilience, social support and academic self-efficacy on mental health, to the extent that these are psychological variables. On the other hand, digital inclusion, which comprehends a contextual variable, not a psychological one, related to ICT access opportunities and mainly focused on the quality of Internet access, should be analyzed in a differential manner. This study seeks to analyze the effect of resilience, social support and academic self-efficacy, on the mental health of a group of Peruvian university students; in addition, it seeks to analyze the mediating role of digital inclusion. A cross-sectional study was conducted with 3,147 undergraduate students from a private university in Lima, Perú. From August to October 2020, data were collected online through questionnaire, this include The Depression, Anxiety and Stress Scale 21 (DASS-21), The 10-item version of the Connor-Davidson Resilience Scale (CD-RISC10), The Multidimensional Scale of Perceived Social Support (EMASP), The Perceived Self-Efficacy Specific for Academic Situations Scale (EAPESA) and to measure digital inclusion, the Perceived Quality of Internet Access reported by the students. The levels of participants' anxiety, depression and stress were described using frequency and percentage. Pearson Correlation test was used to measure the correlation between the variables and a Path analysis was conducted. Finally, The PROCESS macro for SPSS (Model 4) was applied to examine the mediating effect of the model controlling gender variable. The results revealed significant levels of extremely severe symptoms of anxiety (36.8%), depression (33.4%) and stress (18.1%) among the participants. A path analysis, which indicated that resilience (β = -0.346), social support (β = -0.189), academic self-efficacy (β = -0.060) and digital inclusion (β = -0.089) had significant impact on students' General Distress. In addition, digital inclusion plays a partial mediation role with low but significant effect size in the relationship between resilience, social support and self-efficacy with mental health. Mental health of university students during the pandemic shows alarming levels of general or emotional distress. The findings indicate that resilience, social support and self-efficacy protect college students' mental health by reducing general distress. However, the study shows that when there is a digital divide around internet quality the impact of these factors is affected.

Voting participation in grassroots elections and rural residents’ subjective well‐being in China: The mediation roles of social class and fairness

Voting participation in grassroots elections and rural residents’ subjective well‐being in China: The mediation roles of social class and fairness

The effect of physical exercise on social adaptability in Chinese middle school students: The mediating role of social anxiety.

The purpose of this study was to explore the effect of physical exercise on the social adaptability of middle school students and further analyze the mediating role of social anxiety. A total of 1056 middle school students from 6 middle schools in Sichuan, China, voluntarily participated in the survey. The Physical Activity Rating Scale (PARS-3), Social Anxiety Subscale of the Self-Consciousness Scale, and Social Adaptability Scale were used in this study. The data obtained in this study were processed by SPSS 19.0 and Process 3.0. The results showed that physical exercise could positively predict social adaptability (b = 0.08, P < .05), and social anxiety played a mediation role between physical exercise and social adaptability (indirect effect = 0.11, 95% confidence interval = 0.066-0.150). Some practical implications have been discussed on the physical exercise intervention for promoting social adaptability in middle school students.

The Mediator Role of Depression, Stress and Anxiety in the Relationship between Childhood Trauma Experiences and Psychological Vulnerability

The Mediator Role of Depression, Stress and Anxiety in the Relationship between Childhood Trauma Experiences and Psychological Vulnerability

Intermediaries, mediators and digital advertising’s tensions

ABSTRACT We argue that Latour’s distinction between ‘intermediaries’ and ‘mediators’ captures important facets of tensions in market encounters and in the co-creation of ‘supply’ and ‘demand’ within digital advertising. Drawing upon 110 interviews with 87 practitioners, participation in sector meetings and training courses, and McGowan’s ‘autoethnographic’ experiences, we explore the different forms tensions take in the two main configurations of digital advertising: (1) the ‘open marketplace,’ which is the site of much effort to turn mediators into intermediaries; and (2) ‘walled gardens,’ which increasingly are unequivocally mediators, and which are ‘de-agencing’ advertising’s human practitioners in specific ways (e.g. by making human-guided targeting less attractive and more difficult). De-agencing interacts with current initiatives, especially Apple’s, that partially ‘de-individualize’ advertising’s audiences and reinforce walled gardens’ mediator roles.

Artificial sweeteners and risk of incident cardiovascular disease and mortality: evidence from UK Biobank

BackgroundArtificial sweeteners are widely popular worldwide as substitutes for sugar or caloric sweeteners, but there are still several important unknowns and controversies regarding their associations with cardiovascular disease (CVD). We aimed to extensively assess the association and subgroup variability between artificial sweeteners and CVD and CVD mortality in the UK Biobank cohort, and further investigate the modification effects of genetic susceptibility and the mediation role of type 2 diabetes mellitus (T2DM).MethodsThis study included 133,285 participants in the UK Biobank who were free of CVD and diabetes at recruitment. Artificial sweetener intake was obtained from repeated 24-hour diet recalls. Cox proportional hazard models were used to estimate HRs. Genetic predisposition was estimated using the polygenic risk score (PRS). Furthermore, time-dependent mediation was performed.ResultsIn our study, artificial sweetener intake (each teaspoon increase) was significantly associated with an increased risk of incident overall CVD (HR1.012, 95%CI: 1.008,1.017), coronary artery disease (CAD) (HR: 1.018, 95%CI: 1.001,1.035), peripheral arterial disease (PAD) (HR: 1.035, 95%CI: 1.010,1.061), and marginally significantly associated with heart failure (HF) risk (HR: 1.018, 95%CI: 0.999,1.038). In stratified analyses, non-whites were at greater risk of incident overall CVD from artificial sweetener. People with no obesity (BMI < 30 kg/m2) also tended to be at greater risk of incident CVD from artificial sweetener, although the obesity interaction is not significant. Meanwhile, the CVD risk associated with artificial sweeteners is independent of genetic susceptibility, and no significant interaction exists between genetic susceptibility and artificial sweeteners in terms of either additive or multiplicative effects. Furthermore, our study revealed that the relationship between artificial sweetener intake and overall CVD is significantly mediated, in large part, by prior T2DM (proportion of indirect effect: 70.0%). In specific CVD subtypes (CAD, PAD, and HF), the proportion of indirect effects ranges from 68.2 to 79.9%.ConclusionsOur findings suggest significant or marginally significant associations between artificial sweeteners and CVD and its subtypes (CAD, PAD, and HF). The associations are independent of genetic predisposition and are mediated primarily by T2DM. Therefore, the large-scale application of artificial sweeteners should be prudent, and the responses of individuals with different characteristics to artificial sweeteners should be better characterized to guide consumers’ artificial sweeteners consumption behavior.

Does Serum Uric Acid Mediate Relation between Healthy Lifestyle and Components of Metabolic Syndrome?

A healthy lifestyle is related to metabolic syndrome (MetS), but the mechanism is not fully understood. This study aimed to examine the association of components of MetS with lifestyle in a Chinese population and potential mediation role of serum uric acid (SUA) in the association between lifestyle behaviors and risk of components of MetS. Data were derived from a baseline survey of the Shaanxi urban cohort in the Regional Ethnic Cohort Study in northwest China. The relationship between components of MetS, healthy lifestyle score (HLS), and SUA was investigated by logistic or linear regression. A counterfactual-based mediation analysis was performed to ascertain whether and to what extent SUA mediated the total effect of HLS on components of MetS. Compared to those with 1 or less low-risk lifestyle factors, participants with 4-5 factors had 43.6% lower risk of impaired glucose tolerance (OR = 0.564; 95%CI: 0.408~0.778), 60.8% reduction in risk of high blood pressure (OR = 0.392; 95%CI: 0.321~0.478), 69.4% reduction in risk of hypertriglyceridemia (OR = 0.306; 95%CI: 0.252~0.372), and 47.3% lower risk of low levels of HDL cholesterol (OR = 0.527; 95%CI: 0.434~0.641). SUA mediated 2.95% (95%CI: 1.81~6.16%) of the total effect of HLS on impaired glucose tolerance, 14.68% (95%CI: 12.04~18.85%) on high blood pressure, 17.29% (95%CI: 15.01~20.5%) on hypertriglyceridemia, and 12.83% (95%CI: 10.22~17.48%) on low levels of HDL cholesterol. Increased HLS tends to reduce risk of components of MetS partly by decreasing the SUA level, which could be an important mechanism by which lifestyle influences MetS.

The relationship between performance goal orientation and bedtime procrastination: the mediation roles of academic stress and self-control

The relationship between performance goal orientation and bedtime procrastination: the mediation roles of academic stress and self-control

Associations amongst dynamic knee stiffness during gait, quadriceps stiffness, and the incidence of knee osteoarthritis over 24 months: a cohort study with a mediation analysis

BackgroundDecreased strength and increased stiffness of the quadriceps have been associated with a higher risk of developing knee osteoarthritis (OA) in elders. Dynamic joint stiffness (DJS) represents collective resistance from active and passive knee structures for dynamic knee motions. Elevated sagittal knee DJS has been associated with worsening of cartilage loss in knee OA patients. Altered quadriceps properties may affect DJS, which could be a mediator for associations between quadriceps properties and knee OA. Hence, this study aimed to examine whether DJS and quadriceps properties would be associated with the development of clinical knee OA over 24 months, and to explore the mediation role of DJS in associations between quadriceps properties and knee OA.MethodsThis was a prospective cohort study with 162 healthy community-dwelling elders. Gait analysis was conducted to compute DJS during the loading response phase. Quadriceps strength and stiffness were evaluated using a Cybex dynamometer and shear-wave ultrasound elastography, respectively. Knee OA was defined based on clinical criteria 24 months later. Logistic regression with generalized estimating equations was used to examine the association between quadriceps properties and DJS and incident knee OA. Mediation analysis was performed to explore the mediation role of DJS in associations between quadriceps properties and the incidence of knee OA.ResultsA total of 125 participants (65.6 ± 4.0 years, 58.4% females) completed the 24-month follow-up, with 36 out of 250 knees identified as clinical knee OA. Higher DJS (OR = 1.86, 95%CI: 1.33–2.62), lower quadriceps strength (1.85, 1.05–3.23), and greater quadriceps stiffness (1.56, 1.10–2.21) were significantly associated with a higher risk of clinical knee OA. Mediation analysis showed that the DJS was not a significant mediator for the associations between quadriceps properties and knee OA.ConclusionsHigher sagittal knee dynamic joint stiffness, lower quadriceps strength, and greater quadriceps stiffness are potential risk factors for developing clinical knee OA in asymptomatic elders. Associations between quadriceps properties and knee OA may not be mediated by dynamic joint stiffness. Interventions for reducing increased passive properties of the quadriceps and knee joint stiffness may be beneficial for maintaining healthy knees in the aging population.

Workplace small talk and task performance: the chain mediation role of relational energy and positive affect

Purpose Small talk, often regarded as a superficial interaction unrelated to work, is a pervasive and inescapable aspect of daily life and professional settings. In China, where the notion of guanxi – the cultivation of strategic relationships – is deeply valued, workplace small talk (WST) is a strategic tool used by employees to strengthen their interpersonal networks. This study aims to investigate the positive impact of WST on task performance within the Chinese workplace and explores the mechanisms underpinning this relationship. Design/methodology/approach This study adopted a time-lagged research design to test its hypotheses using data from 516 employees across various Chinese firms. Findings This study revealed that WST exerts both direct and indirect positive effects on task performance. It boosts task performance indirectly via two mediators: relational energy and positive affect. This study also delineated a chain mediation model wherein WST sequentially elevates task performance by first enhancing relational energy and then fostering positive affect. Originality/value Counter to the prevailing focus on the negative repercussions of WST, this study sheds light on its beneficial outcomes, proposing novel pathways connecting WST to task performance. These insights contribute to both academic discourse and the development of practical management strategies.

Coupled changes between ruminating thoughts and resting-state brain networks during the transition into adulthood.

Perseverative negative thoughts, known as rumination, might arise from emotional challenges and preclude mental health when transitioning into adulthood. Due to its multifaceted nature, rumination can take several ruminative response styles, that diverge in manifestations, severity, and mental health outcomes. Still, prospective ruminative phenotypes remain elusive insofar. Longitudinal study designs are ideal for stratifying ruminative response styles, especially with resting-state functional MRI whose setup naturally elicits people's ruminative traits. Here, we considered self-rated questionnaires on rumination and psychopathology, along with resting-state functional MRI data in 595 individuals assessed at age 18 and 22 from the IMAGEN cohort. We conducted independent component analysis to characterize eight single static resting-state functional networks in each subject and session and furthermore conducted a dynamic analysis, tackling the time variations of functional networks during the entire scanning time. We then investigated their longitudinal mediation role between changes in three ruminative response styles (reflective pondering, brooding, and depressive rumination) and changes in internalizing and co-morbid externalizing symptoms. Four static and two dynamic networks longitudinally differentiated these ruminative styles and showed complemental sensitivity to internalizing and co-morbid externalizing symptoms. Among these networks, the right frontoparietal network covaried with all ruminative styles but did not play any mediation role towards psychopathology. The default mode, the salience, and the limbic networks prospectively stratified these ruminative styles, suggesting that maladaptive ruminative styles are associated with altered corticolimbic function. For static measures, only the salience network played a longitudinal causal role between brooding rumination and internalizing symptoms. Dynamic measures highlighted the default-mode mediation role between the other ruminative styles and co-morbid externalizing symptoms. In conclusion, we identified the ruminative styles' psychometric and neural outcome specificities, supporting their translation into applied research on young adult mental healthcare.