Total Indirect Effect Research Articles

Global brands or local heroes? A comparative study of Egyptian consumer perceptions and behaviors in the fashion and apparel industry

PurposeThe paper examined the impact of brand-identity expressiveness and perceived brand value that was neglected in prior literature, in addition to perceived brand quality and prestige, on behavioral intention. Research also tests if certain consumer values moderate this relationship.Design/methodology/approachMall-interception technique was used. Also, partial least square-structural equation modelling (PLS-SEM) was used to analyze data and test research hypotheses.FindingsResults indicate that perceived brand globalness (PBG) and perceived brand localness (PBL) are significantly positively associated with perceived quality and prestige. Besides, the inclusion of brand-identity expressiveness and perceived brand value was supported. PBL showed a greater association with brand identity expressiveness compared to PBG, different from previous findings. Furthermore, the total indirect effect of PBG on behavioral intentions was significant through the routes of perceived quality and prestige, compared to a weak and non-significant effect for PBL through the quality route.Originality/valueThis study proposes a comprehensive model testing additional pathways through which global and local brands can boost their preferences.

The association between chronotype and wages at mid-age

Sleep has been shown to affect economic outcomes, including wages. The mechanisms by which sleep affects wages remain unclear. We examine the relationship between chronotype – morning larks, evening owls – and wages at mid-age. We propose a novel model relating chronotype to wages in consideration of human, social, and health capital constructs. Empirically, we explore the effects of chronotype mediated through life course choices, such as work experience, trust, and health behaviour. The data come from the 46-year-old follow-up study of the Northern Finland Birth Cohort (1966) and from registers of the Finnish Tax Administration. We find evening chronotype to have a significant indirect negative effect on wages, which occurs through accumulating less work experience and through poor health outcomes. The effect is largest for male workers, with a total indirect effect on average wages of − 4%. We also provide evidence that chronotype has a long-term association with wages between 29 and 50 years of age. We conclude that evening-type workers are less suited to typical working hours and accumulate less human, social and health capital which in turn negatively affects their wages. Our findings are of great socio-economic importance because evening chronotypes make up a significant part of the population.

Psychosocial and financial well-being mediated the effects of COVID-19 distress on suicidality: a serial mediation model among Hong Kong young adults.

The COVID-19 pandemic has brought significant distress on not only the physical health but also mental health of individuals. The present study investigated the direct and indirect effects from COVID-19 distress to suicidality via psychosocial and financial well-being among young people. This cross-sectional survey recruited 1472 Hong Kong young people via random sampling in 2021. The respondents completed a phone survey on COVID-19 distress, the four-item Patient Health Questionnaire and items on social well-being, financial well-being, and suicidality. Structural equation modeling (SEM) was conducted to examine the direct and indirect effects of COVID-19 distress on suicidality via psychosocial and financial well-being. The direct effect of COVID-19 distress on suicidality was not significant (β = 0.022, 95% CI -0.097-0.156). The total indirect effect from COVID-19 distress to suicidality was significant and positive (αβγ = 0.150, 95% CI = 0.085-0.245) and accounted for 87% of the total effect (B = 0.172, 95% CI = 0.043-0.341). There were significant specific indirect effects via social well-being and psychological distress, and financial well-being and psychological distress. The present findings support different pathways from COVID-19 distress to suicidality via functioning in different domains among young people in Hong Kong. Measures are needed to ameliorate the impact on their social and financial well-being to reduce their psychological distress and suicidality.

Counseling services leading to desistance by way of a change in certainty perceptions and cognitive agency beliefs.

The purpose of this study was to determine whether receiving counseling services reduced future offending in a group of seriously delinquent youths through a process of chaining. In this process, a youth's perceived certainty of punishment and an increase in their cognitive agency or control mediated the services-offending relationship. The main hypothesis was that where perceptions of certainty preceded cognitive agency beliefs (perceived certainty → cognitive agency), the (target) pathway would be significant, and where cognitive agency beliefs preceded perceptions of certainty (cognitive agency → perceived certainty), the (comparison) pathway would be nonsignificant. The difference between the target and comparison pathways was also predicted to be significant. This study modeled change in 1,354 (1,170 boys, 184 girls) justice-involved youths from the Pathways to Desistance study. The number of counseling services accessed by a participant within 6 months of the baseline (Wave 1) interview served as the independent variable, and self-reported offending 12-18 months later (Wave 4) served as the dependent variable. Perceived certainty of punishment and cognitive agency were cross-lagged at Waves 2 and 3 and served as mediators. Consistent with the research hypothesis, results showed that the total indirect effect from services to delinquency through perceived certainty and cognitive agency was significant, the total indirect effect from services to cognitive agency to perceived certainty was nonsignificant, and the difference between the two effects was significant. The results of this study suggest that turning points do not have to be major life events to bring about desistance and that chaining in which perceptions of certainty precede cognitive agency beliefs may play a vital role in the change process. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Interactive music therapy for chronic pain management in people with advanced cancer: A mechanistic study.

e24119 Background: Chronic pain is one of the most feared symptoms in people with cancer. Although music therapy is frequently used for pain management in cancer care, there is a lack of knowledge of underlying mechanisms. Yet, it is well accepted that knowledge of mediators is essential for optimization of psychosocial treatment interventions. We conducted a multi-site randomized controlled trial to examine mediators hypothesized to account for the pain-reducing effects of interactive music therapy (IMT) in adults with advanced cancer. Methods: This study included adults with advanced cancer (stage III/IV) who had moderate to severe chronic pain caused by 1) locally advanced cancer that had extended to other organs/soft tissue or was impinging on/eroding the bone, 2) bone metastasis, or 3) soft tissue metastasis. We excluded adults with primary central nervous system (CNS) tumor, CNS metastatic disease, or hematologic malignancies. We randomized 92 participants to 6 individual IMT ( n = 45) or social attention control (SAC) ( n = 47) sessions. The mediators (anxiety, mood, pain-related self-efficacy and emotional support) and pain outcomes (pain intensity and pain interference) were measured at baseline, week 4, and week 6 using self-report measures. We included treatment expectancy, music reward, and adult playfulness as moderators. Follow-up interviews were conducted to examine congruence between the hypothesized mediation model and participants’ explanations of how IMT impacted their pain experience. Our target sample size was 100 to achieve 80% power to detect a medium effect at α = 0.05 and 28% attrition. We used ITT analyses and the mediation model per Preacher and Hayes to estimate the total and specific indirect effects of each hypothesized mediator individually. Interview transcripts were analyzed using thematic analysis. Results: Participants were 56±12 years old. Most were female (72%), white (44%) or Black (39%), and had stage IV cancer (75%). The most common types of cancer were breast (46%) and lung (13%). Self-efficacy was found to be a significant mediator for the effect of IMT on pain intensity (indirect effect ab = 0.79, 95% CI 0.01 to 1.82) and pain interference (indirect effect ab = 1.16, 95% CI 0.02 to 2.51), while anxiety, mood, and perceived support were not. The quantitative results were supported by the qualitative findings. None of the proposed moderators were found to be significant. However, we found that the mediating effect of pain-related self-efficacy on pain intensity and pain interference was significantly moderated by baseline pain interference. Conclusions: This study suggests that the impact of music therapy on chronic pain management is mediated through self-efficacy. This knowledge can help further optimize music therapy interventions for chronic pain management in people with advanced cancer by capitalizing on teaching music-based self-management techniques. Clinical trial information: NCT03432247 .

Exploring Perceptions of the Adoption of Prefabricated Construction Technology in Pakistan Using the Technology Acceptance Model

Prefabricated construction is being pursued globally as a critically important sustainable construction technology. Prefabricated construction technology (PCT) provides opportunities to effectively manage construction waste and offers venues to address the poor productivity and lackluster performance of construction projects, which are often expected to miss their budget and schedule constraints. Despite the significant benefits inherent in the adoption of PCT, research has shown an unimpressive exploitation of this technology in the building sector. A modified version of the popular technology acceptance model (TAM) was used to understand Pakistan’s building construction industry stakeholder’s acceptance of PCT and the factors that influence its usage. Data were collected from 250 building construction experts in the industry to test the hypotheses derived from the proposed model. Data analysis using covariance-based structural equation modeling revealed that construction industry stakeholders’ perceptions of perceived ease-of-use, perceived usefulness, trust, and satisfaction all strongly influenced PCT acceptance behavior. Moreover, results also confirmed the total direct and indirect effects of the perceived usefulness and perceived ease-of-use of behavioral intention toward using PCT, with trust and user satisfaction as mediators. The results of this research are expected to serve as a guide for the construction industry stakeholders to effectively plan, strategize, encourage, and increase the adoption of PCT to achieve sustainable construction outcomes in the building construction sector.

Fearlessness as an Underlying Mechanism Leading to Conduct Problems: Testing the Intermediate Effects of Parenting, Anxiety, and callous-unemotional Traits.

This study investigates whether the longitudinal association between fearlessness and conduct problems (CP) is mediated by warm and harsh parenting, parent-child conflict, anxiety, and callous-unemotional (CU) traits. The constructs under investigation were assessed at five different time points, spanning a period of eight years. A multi-informant approach was followed, collecting data from parents and teachers (N = 2,121; 47% girls). The structural equation model pointed to both direct and indirect pathways between fearlessness and CP. Specifically, findings suggested that Time 1 fearlessness (age 3-5 years) increased the likelihood of Time 2 (age 4-6 years) harsh parenting and Time 3 (age 5-7 years) parent-child conflict. Further, fearlessness was positively associated with Time 4 (age 8-10) callous-unemotional traits and Time 5 (age 11-13) CP. The total indirect effect from fearlessness to CP through these variables was significant, although the specific indirect effect from fearlessness to CU traits to CP accounted for most of the variance. Warm parenting and anxiety did not mediate the association between fearlessness and CP. In addition to the identified pathways connecting fearlessness to CP, findings pointed to the existence of multiple developmental pathways to future CP, as well as gender differences in longitudinal associations.

A serial mediation model of social media addiction and college students’ academic engagement: the role of sleep quality and fatigue

BackgroundIt has been documented that social media addiction (SMA) has a detrimental effect on college students’ academic engagement. However, the mechanisms underlying this association are not well understood. This study aimed to determine the serial mediation effects of sleep quality and fatigue on the relationship between SMA and academic engagement among college students.MethodsA cross-sectional survey was conducted with 2661 college students (43.3% males, mean age = 19.97 years). The participants completed the Bergen Social Media Addiction Scale, the Utrecht Student Work Engagement Scale for Students, the Pittsburgh Sleep Quality Index, and the Fatigue Assessment Scale. The serial mediation effects were examined using Model 6 in the Hayes’ PROCESS macro for SPSS.ResultsThe results showed that SMA among college students had a direct negative relationship with their academic engagement (Effect = − 0.051, 95% CI: −0.087 to − 0.015). In addition, sleep quality and fatigue mediated the relationship between SMA and academic engagement both independent and serially, with the independent mediation effect of sleep quality being − 0.031 (95% CI: −0.048 to − 0.016), the independent mediation effect of fatigue being − 0.109 (95% CI: −0.133 to − 0.088), and the serial mediation effect of sleep quality and fatigue being − 0.080 (95% CI: −0.095 to − 0.066). The total indirect effect of the three mediation paths was 80.9%.ConclusionsDecreased academic engagement caused by SMA can be aggravated by poor sleep quality and fatigue. Strengthening supervision and intervention in social media use among college students, supplemented by attention to psychosomatic health, including sleep quality and fatigue could promote their engagement in academic work.

Association of adverse childhood experiences and depression among medical students: the role of family functioning and insomnia.

Few studies have explored the mechanisms linking adverse childhood experiences (ACEs) to depression in medical students. This study aimed to investigate the relationship between ACEs and depression through the serial mediation effect of family functioning and insomnia. A cross-sectional survey was conducted with 368 medical students from university in Chengdu in 2021. The participants were asked to complete four self-report questionnaires, including ACEs scale, the family APGAR index, the ISI and PHQ-9. Singe and serial mediation analyses were conducted using structural equation modeling by Mplus 8.3. ACEs had a significant direct effect on depression (β = 0.438, p < 0.001) and through three significantly indirect pathways: (1) through family functioning (β = 0.026, 95% CI: 0.007-0.060), accounting for 5.9% of the total effect; (2) through insomnia (β = 0.103, 95% CI: 0.011-0.187), accounting for 23.5% of the total effect; and (3) through the serial mediators involving in family functioning and insomnia (β = 0.038, 95% CI: 0.015-0.078), accounting for 8.7% of the total effect. The total indirect effect was 38.1%. This cross-sectional study prevented us from establishing causality. This study highlights the role of family functioning and insomnia as serial mediators of the relationship between ACEs and depression. Findings help to elucidate the mechanism that underlines the pathway between ACEs and depression in medical students. These findings may indicate developing measures to strengthen family functioning and improve insomnia aiming to reduce depression in medical students with ACEs.

Processes of change in preventing alcohol-exposed pregnancy: Replication of a mediation analysis.

Further test mechanisms of the CHOICES intervention by replicating analyses of the experiential and behavioral processes of change (POC) for alcohol and for contraception as mediators of the intervention for reducing risk of alcohol-exposed pregnancy (AEP) using data from a more recent trial, CHOICES Plus (CP). As in the prior study, replication models examined indirect paths from intervention to experiential POC for alcohol at 3 months, to behavioral POC at 9 months, to risky drinking and risk of AEP at 9 months and experiential POC for contraception at 3 months, to behavioral POC at 9 months, and to ineffective contraception and risk of AEP at 9 months. To test the temporal relationship, additional models examined the indirect path from behavioral POC for alcohol and POC for contraception at 3 months, to the experiential POC at 9 months, and to risk of AEP at 9 months. A final model tested the mediation of experiential and behavioral POC assessed at 3 months. There was an indirect effect of the intervention on risky drinking (total indirect effect = -.13, 95% confidence interval [CI] [-.32, -.02]) but not AEP via the alcohol POC. There was an indirect effect of the intervention on ineffective contraception (total indirect effect = -.27, 95% CI [-.55, -.07]) and AEP (total indirect effect = -.22, 95% CI [-.46, -.06]) via the contraception POC. This study completely replicated the prior indirect effects of the CHOICES intervention on the targeted risk behaviors through the experiential and behavioral POC for each behavior. Findings support the utility of the POC for informing health behavior change interventions. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Mediating effect of anxiety and depression between family function and hope in patients receiving maintenance hemodialysis: a cross-sectional study

ObjectivesThis study aimed to explore the levels of hope in patients receiving maintenance hemodialysis (MHD), and whether anxiety and depression mediate the relationship between family function and hope.MethodsThe family APGAR index, hospital anxiety and depression scale, and Herth hope index were recorded using the self-reported questionnaires completed by 227 MHD patients.ResultsThe family function can directly predict hope, positively predict hope through depression (β = 0.052, p = 0.001), and positively predict hope through the chain mediating of anxiety and depression (β = 0.087, p = 0.001), according to chain mediation analysis. The total effect size was 28.31%. The total indirect effect value was 0.139, and the total effect value was 0.491.ConclusionsOur findings suggest that family function had a direct impact on MHD patients’ hope, and that lowering anxiety and depression can help to feel more hopeful.

Trust in the approval process of medicines mediates the effect of an educational intervention on the pain relief induced by a generic analgesic

BackgroundGeneric medicines have been associated with less efficacy compared to originator products. Educational videos explaining generic medicines can have a positive effect on perceptions of generic drugs and their pain-relieving effect.The central aim of the current study was to examine whether trust in the governmental approval process of medicines mediates the effect of educational video interventions on the pain-relieving effect induced by a generic medicine and whether trust can be built by improving individuals’ understanding of generic medication. MethodsThis is a secondary analysis of a randomized controlled trial where participants with frequent tension headaches were randomly assigned to either watching a video explaining generic drugs (n = 69) or a video informing about headaches (control group: n = 34). After watching the video, participants took an originator and a generic pain analgesic in a randomized order to treat their next two consecutive headaches. Pain severity was measured before and 1 h after taking the medicine. ResultsA multiple serial mediator model showed that improving individuals' understanding of generic medicines is associated with increased trust in medicines. Both factors together, understanding and trust, significantly mediated the effect of the video education about generic drugs on the generic's pain-relieving effect (total indirect effect: coefficient: 0.20, 95% CI: 0.42, −0.0001). ConclusionResults of this study show that improving individuals’ understanding of generic medication and trust in the process of approving medicines should be considered as important mechanisms of future educational interventions about generic medicines.

Tooth loss, body mass index and cognitive function among middle-aged and older adults in China: Does gender matter?

BackgroundPrevious studies have shown a longitudinal association between tooth loss and cognitive function. Body mass index (BMI) is an essential applicable indicator of health status screening. However, the underlying mechanism among these factors remains unclear. This study aimed to determine the mediating role of BMI in the tooth loss-cognition relationship by gender among Chinese middle-aged and older adults. MethodsThis is a prospective and cohort study. We used three waves of follow-up data (2011, 2013, and 2015) from the China Health and Retirement Longitudinal Survey, including 10,013 participants aged 45 years or above. Cognitive function was evaluated by Telephone Interview of Cognitive Status, words recall, and figure drawing. The cross-lagged panel model was applied to test the hypothesized model. ResultsTooth loss is associated with higher BMI and lower level of cognitive function. We found significant total effects (B = −0.017, P = 0.008), direct effect (B = −0.015, P = 0.022) and indirect effects (B = −0.002, P = 0.010) of tooth loss on cognition mediated through BMI only among middle-aged and older men. For middle-aged and older women, the total effect (B = −0.010, P = 0.125) and direct effect (B = −0.007, P = 0.249) were no more significant. ConclusionsThe longitudinal association between tooth loss and cognition was primarily indirect through BMI among middle-aged Chinese males but not women. Public health authorities should remind middle-aged and older males with tooth loss and high BMI to participate in timely medical checkups for improving cognition.

Fatty liver mediates the association of hyperuricemia with prediabetes and diabetes: a weighting-based mediation analysis.

Fatty liver, obesity, and dyslipidemia are associated with prediabetes or diabetes risk, and hyperuricemia co-exists. The present study evaluated the role of multiple mediators, namely, fatty liver, body mass index (BMI), and dyslipidemia, in the association between hyperuricemia and diabetes status. Baseline data from the ongoing Fuqing cohort (5,336 participants) were analyzed to investigate the association of hyperuricemia with diabetes status using a multinomial logistic regression model. Furthermore, causal mediation analysis with the weighting-based approach was performed to estimate hyperuricemia's total natural direct effect (tnde), total natural indirect effect (tnie), and total effect (te) on prediabetes and diabetes risk, mediating jointly via fatty liver, BMI, and dyslipidemia. In multinomial analysis without considering mediators' effects, hyperuricemia was associated with a higher risk of prediabetes only (odds ratio: 1.25; 95% CI: 1.09-1.43; p < 0.001). When fatty liver, BMI, and dyslipidemia were considered as multiple mediators in the association, hyperuricemia was linked to both prediabetes [tnde: 1.11, 95% CI: 1.04-1.11; tnie: 1.07, 95% CI: 1.05-1.09; and overall proportion mediated (pm): 42%, 95% CI: 27%-73%] and diabetes risk (tnde: 0.96, 95% CI: 0.82-1.14; tnie: 1.25, 95% CI: 1.18-1.33; and pm: 100%, 95% CI: 57%-361%). Hyperuricemia showed significant tnde, te, and tnie, mediated by fatty liver jointly with dyslipidemia (pm = 17%) or BMI (pm = 35%), on prediabetes risk. Hyperuricemia could increase prediabetes or diabetes risk, partially mediated by fatty liver, BMI, and dyslipidemia. Fatty liver is the crucial mediator in the association between hyperuricemia and prediabetes.

Shika kahverengi yumurtacı tavuklarda yumurta ağırlığı üzerine iç ve dış kalite özelliklerinin doğrudan ve dolaylı katkılarının Path Katsayısı Analizi kullanılarak belirlenmesi

Path analysis procedure is a statistical procedure that can be applied to evaluate direct and indirect contributions of independent variables to the dependent variables for better understanding of the relationships between egg quality traits. One hundred and twenty (120) eggs, collected from Shika Brown layers, were used to evaluate the direct and indirect effects of internal and external egg quality parameters on egg weight of Shika Brown layers using Path analysis procedure. Data obtained on individual egg include the following; egg weight (EWT), egg length (ELT), egg width (EWD), shell thickness (STK), shell weight (SWT), albumen weight (AWT) and yolk weight (YWT). Correlation coefficient results show that EWT had a positively significant correlation (P&amp;lt;0.05) with ELT (0.715), EWD (0.758), SWT (0.460) and AWT (0.785). ELT had the greatest direct effect (0.360; P&amp;lt;0.05) on EWT followed by EWD (0.345; P&amp;lt;0.05) while the least of the direct effects on EWT (0.012; P&amp;lt;0.05) was from STK. However, the highest total indirect effect (0.487) on EGW was realised largely via EWD. Therefore, EWT of Shika Brown layer strain had a high positive relationship with ELT, EWD and AWT. The path coefficient analysis revealed that ELT, along with EWD contributed highest direct effect on the EWT. This information could be used in selection programme for the improvement of EWT of Shika Brown layer chickens.

Maternal metabolic syndrome in pregnancy and child development at age 5: exploring mediating mechanisms using cord blood markers

BackgroundThere is limited evidence on how the classification of maternal metabolic syndrome during pregnancy affects children’s developmental outcomes and the possible mediators of this association. This study uses a cohort sample of 12,644 to 13,832 mother–child pairs from the UK Born in Bradford Study to examine the associations between maternal metabolic syndrome classification (MetS) and child development outcomes at age 5, using cord blood markers as candidate mediators.MethodsMaternal cardiometabolic markers included diabetes, obesity, triglycerides, high-density lipoprotein cholesterol, blood pressure, hypertension, and fasting glucose during pregnancy. Cord blood markers of high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, leptin, and adiponectin were used as child mediators. Child outcomes included two starting school variables: British Picture Vocabulary Scale (BPVS) and the Letter Identification Assessment (LID), and five developmental milestone domains from a national UK framework: (1) communication and language (COM); (2) personal, social, and emotional (PSE); (3) physical development (PHY); (4) literacy (LIT); and (5) mathematics (MAT). Mediation models were used to examine the associations between the classification of maternal metabolic syndrome and child developmental milestones. Models were adjusted for potential maternal, socioeconomic, and child confounders such as maternal education, deprivation, and gestational age.ResultsIn mediation models, significant total effects were found for MetS associations with children’s development in the LIT domain at age 5. MetS predicted individual cord blood mediators of lower HDL and increased leptin levels in both adjusted and unadjusted models. Total indirect effects (effects of all mediators combined) for MetS on a child’s COM and PSE domain were significant, through all child cord blood mediators of LDL, HDL, triglycerides, adiponectin, and leptin for adjusted models.ConclusionsThe results support the hypothesis that maternal metabolic syndrome classification during pregnancy is associated with some child developmental outcomes at age 5. After adjusting for maternal, child, and environmental covariates, maternal metabolic syndrome classification during pregnancy was associated with children’s LIT domain through direct effects of maternal metabolic health and indirect effects of cord blood markers (total effects), and COM and PSE domains via changes only in a child’s cord blood markers (total indirect effects).

School-Day Physical Activity and Academic Achievement: Mediators Among US Elementary Students

ABSTRACT Introduction/Purpose It is recommended that children get 60 min of moderate-to-vigorous physical activity (MVPA) daily. Previous research on MVPA’s effect on academic achievement (AA) is inconclusive, and few studies have investigated the relationship’s mediators. This study assessed whether cardiorespiratory fitness (CRF) and body mass index (BMI) mediate the school-based MVPA–AA relationship. Methods Grade 4 students (n = 4936) were recruited in 40 elementary schools from a large, diverse US public school district. Students wore accelerometers measuring school-day MVPA for 15 d across three semesters. Academic performance data were collected from grades 3 to 5, and CRF and BMI were measured in grades 4 and 5. Multilevel modeling assessed whether BMI and CRF were mediators in the cross-sectional and longitudinal MVPA–AA relationship. Stratified analyses assessed differences in mediation by sex. Results Cross-sectional analyses found that school-day MVPA had a significant positive indirect effect through higher CRF for various teacher-assigned course grades and English language arts standardized test scores (all P &lt; 0.001). Cross-sectional analyses found no significant mediation through BMI. Longitudinal analyses found that a 10-min increase in daily grade 4 school-day MVPA was associated with higher CRF with 0.16-, 0.09-, and 0.14-point increases in grade 5 math, reading, and writing grades, respectively (all P &lt; 0.001). Decreased grade 4 BMI mediated a 0.06-point increase and 0.05-point increase for grade 5 math and writing grades, respectively (both P &lt; 0.001). The total effect of school-day MVPA on AA was negative but negligible in practical terms. Stratified analyses found more evidence for positive indirect effects through CRF among females. Conclusions School-day MVPA can positively impact AA through increased CRF and (to a lesser extent) lowered BMI, but the effect is negligible. The negative total effects and positive indirect effects suggest that there are other unmeasured mediators. It remains important for schools to protect school-based physical activity given its health benefits.

Effects of sleep quality on suicide risk in COVID-19 patients: The chain mediating of anxiety and depressive symptoms

BackgroundAlthough current studies have identified sleep disorders as an independent risk factor for suicide, the relationship between sleep disorders and suicide risk has not been well established. This study explored whether anxiety and depressive symptoms are used as mediators to participate in the impact of sleep quality on suicide risk. MethodsThis is a cross-sectional study. We administered a psychological questionnaire to the participants, using a combination of self-assessment and psychiatrist assessment.Sleep quality, suicide risk, level of anxiety and depressive symptoms were assessed by PSQI, NGASR, SAS and SDS.The study subjects were 391 hospitalized COVID-19 patients from Wuhan hospitals. We used model 6 in the PROCESS (version 3.5) plug-in of SPSS software to conduct mediation test with sleep quality as the independent variable, suicide risk as the dependent variable, level of anxiety and depressive symptoms as intermediate variables. ResultsThe severity of anxiety and depressive symptoms and the risk of suicide in the sleep disorder group (63.15 ± 13.71, 59.85 ± 13.38, 6.52 ± 3.67) were higher than those in the non-sleep disorder group (49.83 ± 13.14, 44.87 ± 10.19, 2.87 ± 3.26) (P < 0.001). The mediation model works well, The total indirect effect was 0.22 (95%CI = [0.17, 0.28]), and the direct effect was 0.16 (95%CI = [0.08, 0.24]). LimitationsThis study used a self-assessment scale. ConclusionsAnxiety and depressive symptoms played a chain mediating role between sleep quality and suicide risk.

고령자의 사회경제적 지위가 건강상태에 미치는 영향

This study attempted to verify the sequential mediating effect of social activity participation and cognitive function in the effect of the socioeconomic status of the elderly on health status. The subjects of the analysis were 3,364 out of 4,405 valid samples of the 8th Korean Longitudinal Study of Aging, which removed missing values for the elderly aged 65 or older. For statistical analysis, PROCESS macro v.4.1 program model 6 and SPSS 25.0 program were used. As a result of verifying the significance of the sequential mediating effect of social activity participation and cognitive function, the total indirect effect of socioeconomic status on health status, the mediating effect of social activity participation in socioeconomic status, and the sequential mediating effect of socioeconomic status. As a result of this study, implications for finding a practical method that can prevent or improve the deterioration of the health status of the elderly were proposed.

Proanthocyanidin Structure-Activity Relationship Analysis by Path Analysis Model.

To fully explore the influence mechanism of interactions between different monomer units of proanthocyanidins (PAs) on biological activity, a path analysis model of the PA structure-activity relationship was proposed. This model subdivides the total correlation between each monomer unit and activity into direct and indirect effects by taking into account not only each monomer unit but also the correlation with its related monomer units. In addition, this method can determine the action mode of each monomer unit affecting the activity by comparing the direct and total indirect effects. Finally, the advantage of this model is demonstrated through an influence mechanism analysis of Rhodiola crenulata PA monomer units on antioxidant and anti-diabetes activities.