The mediating effect of positive expectations in the relationship between social support and post-traumatic stress disorder symptoms among parents of children with acute lymphoblastic leukemia.

PURPOSE: Parents of children with cancer are exposed to risks of developing post-traumatic stress disorder (PTSD) symptoms, but few studies have explored PTSD symptoms of Chinese parents of children with acute lymphoblastic leukemia (ALL). Our study aimed to examine the association between social support and PTSD symptoms and to examine the mediating effect of positive expectations in this relationship among parents of children with ALL. METHODS: A cross-sectional study was conducted of consecutive parents of children with ALL in the Shengjing Hospital of China Medical University. A total of 177 parents eligible for this study completed questionnaires on PTSD symptoms, perceived social support, optimism and general self-efficacy anonymously. Asymptotic and resampling strategies were used to examine how positive expectations mediated the association between perceived social support and PTSD symptoms. RESULTS: Mean score of PTSD symptoms was 37.64 ± 14.44; 29.4% of the sample scored 44 and above, 19.8% scored 50 and above. After adjusting for covariates, perceived social support was negatively associated with the total score of PTSD symptoms (ß = -0.209, p < 0.01). Positive expectations were found to mediate the relationship between perceived social support and PTSD symptoms, especially for the symptoms of avoidance and hyperarousal. CONCLUSIONS: Optimism and general self-efficacy fully mediated the association between perceived social support and PTSD symptoms. Therefore, social support and positive expectations should be included in PTSD preventions and treatments targeting Chinese parents of children with ALL.

Parent-child attachment mediates the association between parental conflict perceptions and suicide intention: a cross-sectional survey among middle school students in China.

Introduction: Adolescent suicide is a prevalent issue globally, with various factors contributing to this phenomenon. This study aimed to investigate these factors and their interrelationships to better understand the causes of adolescent suicide and provide evidence for its prevention. Methods: This study conducted among middle school students in Liaoning Province, China, from April to May 2016, A cross-sectional survey was administered to 1,028 students aged 10-19, using instruments such as the Behavior Questionnaire-Revised (SBQ-R), Children's Perception of Interparental Conflict Scale (CPIC), and revised version of Inventory of Parent Attachment (IPPA-R). Result: Binary logistic regression analysis revealed that adolescents aged 15-19, adolescents with strong perceptions of parental conflict were at high risk of suicide intention. Adolescents living in rural areas, adolescents with high mother-child attachment, adolescents with high father-child attachment were at low risk of suicide intention. Furthermore, parent-child attachment played a mediating role between two dimensions of parental conflict perception (resolved situations and response effect) and suicide intention. Discussion: The study concludes that adolescents living in urban areas, older adolescents, adolescents with a high level of parental conflict intensity, and those with low levels of parent-child attachment are at high risk of suicide intention. parent-child attachment played a mediating role between two dimensions of parental conflict perception (resolved situations and response effect) and suicide intention. Interventions aimed at reducing family conflicts and improving parent-child relationships are recommended to decrease the incidence of adolescent suicide.

Effect of parenting style on the emotional and behavioral problems among Chinese adolescents: the mediating effect of resilience.

BACKGROUND: Although previous studies have found that parenting style significantly predicts emotional and behavioral problems (EBPs) among Chinese adolescents, the mechanism between different parenting styles and EBPs requires in-depth investigation. In our study, we aimed to investigate the mediating effect of resilience, a positive psychological characteristic, between parenting style and EBPs among Chinese adolescents. METHODS: In this cross-sectional study, we used a multistage stratified cluster random sampling method to collect data in Shenyang, Liaoning Province from November to December 2019. Self-developed questionnaires were distributed to 1028 adolescents aged 10-18. Finally, the study consisted of 895 participants. The bootstrap method was used to investigate the role of resilience as a mediator in the relationship between different parenting styles and EBPs from a positive psychology perspective. RESULTS: The mean score of EBPs was 12.71 (SD = 5.77). After controlling for variables such as gender, age, left-behind children, family type and family income, resilience partially played a mediating role in the associations of paternal rejection (a × b = 0.051 BCa95%CI:0.023,0.080), maternal rejection (a × b = 0.055 BCa95%CI: 0.024, 0.086), paternal emotional warmth (a × b = -0.139 BCa95%CI: -0.182, -0.099) and maternal emotional warmth (a × b = -0.140 BCa95%CI: -0.182, -0.102), with EBPs. The effect sizes were11.28%, 11.51%, 40.76%, and 38.78%, respectively. CONCLUSIONS: Resilience could partially mediate the relationship between parenting style and EBPs, highlighting that parents should adopt a positive parenting style and that resilience improvement could be effective in reducing EBPs among Chinese adolescents.

Evaluation of left ventricular dysfunction by three-dimensional speckle-tracking echocardiography and bioinformatics analysis of circulating exosomal miRNA in obese patients.

BACKGROUND: Obesity is an independent risk factor for cardiovascular disease and affects the human population. This study aimed to evaluate left ventricular (LV) dysfunction in obese patients with three-dimensional speckle-tracking echocardiography (3D-STE) and investigate the possible related mechanisms at the exosomal miRNA level. METHODS: In total, 43 participants (16 obese patients and 27 healthy volunteers) were enrolled. All subjects underwent full conventional echocardiography as well as 3D-STE. Characterization and high-throughput sequencing for the isolated circulating exosomes and the differentially expressed miRNAs (DEMs) were screened for target gene prediction and enrichment analysis. RESULTS: Obese patients had significantly lower global longitudinal strain (GLS) (-20.80%±3.10% vs. -14.77%±2.05%, P < 0.001), global circumferential strain (GCS) (-31.63%±3.89% vs. -25.35%±5.66%, P = 0.001), global radial strain (GRS) (43.21%±4.89% vs. 33.38%±3.47%, P < 0.001), and indexed LV end-diastolic volume (LVEDV) [38.07mL/m2 (27.82mL/m2-9.57mL/m2) vs. 24.79mL/m2 (21.97mL/m2-30.73mL/m2), P = 0.002] than healthy controls. GLS (ρ = 0.610, P < 0.001), GCS (ρ = 0.424, P = 0.005), and GRS (ρ = -0.656, P < 0.001) indicated a moderate relationship with body mass index (BMI). In obese patients, 33 exosomal miRNAs were up-regulated and 26 exosomal miRNAs were down-regulated when compared to healthy controls (P < 0.05). These DEMs possibly contribute to obesity-associated LV dysfunction through the PI3K-Akt signaling pathway. Important miRNAs, including miR-101-3p, miR-140-3p, and miR-99a-5p, have clinical utility in predicting early obesity-related myocardial injury. CONCLUSIONS: The global strain obtained from 3D-STE can sensitively detect the decrease in LV myocardial function in obese patients. Key miRNAs and pathways provide a new theoretical basis and targets of action for studying obesity-induced LV dysfunction. TRIAL REGISTRATION: In accordance with the World Health Organization (WHO) definition of a clinical trial, this study does not include human health-related interventions. This study was carried out at the General Hospital of Ningxia Medical University after obtaining institutional ethical approval (KYLL-2022-0556) and written informed consent from all participants.

Trace analysis of food by surface-enhanced Raman spectroscopy combined with molecular imprinting technology: Principle, application, challenges, and prospects.

Surface-enhanced Raman spectroscopy (SERS) is a rapid detection method with high sensitivity and simple pretreatment, but can be affected by interference from matrix components. By incorporating molecularly imprinted polymers (MIPs) that recognize specific targets, MIP-SERS sensors effectively overcome the interference of complex matrices and offer improved stability and sensitivity. This review provides a comprehensive understanding of the applications of MIP-SERS sensors for the detection of trace toxic substances in food. The underlying mechanism and development of SERS technology and the principle and classification of MIPs technology are discussed. Furthermore, the types of MIP-SERS sensors are introduced, with their advantages and disadvantages systematically illustrated. Recent advances in MIP-SERS technology for the detection of mycotoxins, additives, prohibited dyes, pesticides, veterinary drug residues, and other hazardous substances in food are highlighted. Finally, this review discusses the challenges associated with MIP-SERS technology and proposes future development prospects.

Unintentional injury and its associated factors among left-behind children: a cross-sectional study.

BACKGROUND: Unintentional injuries among children and adolescents are a major public health problem worldwide. These injuries not only have negative effects on children's physiology and psychology, but also bring huge economic losses and social burdens to families and society. Unintentional injuries are the leading cause of disability and death among Chinese adolescents, and left-behind children (LBC) are more prone to experience unintentional injury. The purpose of this study was to evaluate the type and incidence of unintentional injury among Chinese children and adolescents and explore the influences of personal and environmental factors by comparing the differences between LBC and not left-behind children (NLBC). METHODS: This cross-sectional study was conducted in January and February 2019. Additionally, 2786 children and adolescents from 10 to 19 years old in Liaoning Province in China were collected in the form of self-filled questionnaires, including Unintentional Injury Investigation, Unintentional Injury Perception Questionnaire, Multidimensional Subhealth Questionnaire of Adolescent (MSQA), Negative life events, "My Class" questionnaire and Bullying/victim Questionnaire. Multiple logistic regression analysis was used to explore the factors associated with unintentional injury among children and adolescents. Binary logistic regression analysis was used to explore the factors affecting unintentional injuries between LBC and NLBC. RESULTS: The top three unintentional injuries were falling injuries (29.7%), sprains (27.2%) and burns and scalds (20.3%) in our study population. The incidence of unintentional injuries in LBC was higher than that in NLBC. Burn and scalds, cutting injury and animal bites in LBC were higher than those in NLBC. The results show that junior high school students (odds ratio (OR) = 1.296, CI = 1.066-1.574) were more likely to report multiple unintentional injuries than primary school students. Girls (OR = 1.252, CI = 1.042-1.504) had higher odds of reporting multiple unintentional injuries. The odds of multiple injuries in children and adolescents with low levels of unintentional injury perception were higher than those in children and adolescents with high levels of unintentional injury perception (OR = 1.321, C = 1.013-1.568). Children and adolescents with a higher levels of mental health symptoms (OR = 1.442, CI = 1.193-1.744) had higher odds of reporting multiple unintentional injuries. Compared with teenagers who had never experienced negative life events, teenagers who had experienced negative life events many times (OR = 2.724, CI = 2.121-3.499) were more likely to suffer unintentional injuries many times. Low-level discipline and order (OR = 1.277, CI = 1.036-1.574) had higher odds of reporting multiple unintentional injuries. In-school adolescents who were bullied were more likely to report being injured multiple times than their counterparts who were not bullied (OR = 2.340, CI = 1.925-2.845). Low levels of unintentional injury perception, experienced negative life events and bullying had greater impacts on LBC than on NLBC. CONCLUSION: The survey found that the incidence of at least one unintentional injury was 64.8%. School level, sex, unintentional injury perception, subhealth, negative life events, discipline and order and bullying were associated with incidents of unintentional injury. Compared with NLBC, LBC had a higher incidence of unintentional injury, and special attention should be given to this group.

Mindfulness for mediating the relationship between self-control and alexithymia among Chinese medical students: A structural equation modeling analysis.

Backgrounds: Medical students are prone to experience alexithymia due to academic work overload, which could increase the prevalence of mental illness such as anxiety and depression. The purpose of our study was to estimate the levels of alexithymia and to explore the relationships between alexithymia, self-control, and mindfulness among medical students. Materials and methods: From March 18th, 2021 to April 9th, 2021, a cross-sectional study with stratified sampling was carried out in China Medical University, Liaoning Province, China. A total of 1,013 medical students participated in this study. The questionnaires pertaining to the Toronto Alexithymia Scale (TAS-26), the Five Facet Mindfulness Questionnaire (FFMQ), and the Self-control Scale (SCS) were used to assess the levels of alexithymia, mindfulness and self-control. We used Hierarchical Multiple Regression (HMR) and structural equation modeling to explore the mediating role of mindfulness between self-control and alexithymia. Results: The mean score of alexithymia in medical students was 69.39 ± 9.9. After controlling for confounders, males were more likely to experience alexithymia. Self-control, acting with awareness, describing, and observing in mindfulness were negatively associated with alexithymia (P < 0.01). Mindfulness mediated the relationship between self-control and alexithymia (a*b = -0.06, BCa 95% CI: -0.09 to -0.031, Percentile 95% CI: -0.089 to -0.031). Conclusion: Chinese medical students experienced high levels of alexithymia. Self-control could directly attenuate alexithymia for medical students and indirectly affect alexithymia through the mediating path of mindfulness. Initiatives for self-control ability enhancement should be provided to medical students to combat alexithymia. And interventions on mindfulness training should be developed to prevent from alexithymia and promote their mental health.

Aggressive behaviors and associated factors in Chinese left-behind adolescents: a cross-sectional study.

BACKGROUND: To examine whether the levels of aggressive behaviors and other individual and contextual variables differ between left-behind adolescents (LBA) and not left-behind adolescents (NLBA) and explore associations between aggression and other constructs among them. METHODS: A cross-sectional study was conducted and 4530 school adolescents aged 9-18 years in north and south of China were randomly selected. The levels of aggressive behavior, personality and family and classroom environment were compared between LBA and NLBA and also the associated factors of aggression. RESULTS: The total scores of aggressive behaviors were 6.33 ± 6.35 (Mean ± SD) in LBA and 5.78 ± 6.16 (Mean ± SD) in NLBA. Multiple linear regression models revealed that neuroticism and psychoticism were positively associated with aggressive behaviors for LBA with similar results of NLBA. Cohesion was negatively associated with aggressive behaviors, and conflict and achievement had positive effects in NLBA. Organization had a negative effect in LBA. Uncertainty and dissatisfaction had positive effects on aggression both in LBA and NLBA. CONCLUSION: This study found a slightly higher level of aggressive behaviors in LBA comparing with NLBA. Personality was the mainly associated factor of aggression, but class-based interventions were more practical for aggressive behaviors in Chinese LBA.

The Effects of Safety Climate on Psychosocial Factors: An Empirical Study in Healthcare Workplaces.

ABSTRACT: How to develop a better patient safety culture has been an important goal for healthcare organizations, but the effects of safety culture on psychosocial factors, such as emotional exhaustion and stress, have not been fully addressed. This study aimed to reconfigure important dimensions affecting safety culture and examine the associations between safety culture and psychosocial factors (emotional exhaustion and work-life balance). The partial least squaring technique was used to analyze the data, showing that job satisfaction (ß = 0.320, P < 0.001), working conditions (ß = 0.307, P < 0.001), and perception of management (ß = 0.282, P < 0.001) positively affected the safety climate. The safety climate and work-life balance could reduce the occurrence of emotional exhaustion, whereas a high-stress environment would cause a higher level of emotional exhaustion. Given these findings, hospitals should endeavor to help employees feel safe and not threatened, reduce stress, and advise them to maintain a good work-life balance.

Prenatal anxiety and the associated factors among Chinese pregnant women during the COVID-19 pandemic--a smartphone questionnaire survey study.

BACKGROUNDS: The uncertainty of the pandemic of Coronavirus Disease 2019 (COVID-19) brought about tremendous psychological harm for pregnant women, causing their high rates of prenatal anxiety. The impacts of COVID-19 pandemic and symptoms of pregnant status are highly linked with prenatal anxiety. Whereas, self-efficacy and support from family and friends could attenuate the development of prenatal anxiety. Thus, the purpose of the study is to evaluate the prevalence of prenatal anxiety and its influence factors among pregnant women during the pandemic of COVID-19 in Shenyang, China. METHODS: A cross-sectional study with face-to-face interview between April 24, 2020 and May 3, 2020 during the COVID-19 pandemic was applied among pregnant women in Shenyang Women's and Children's Hospital. Chi-square tests were calculated to determine the differences in prenatal anxiety among categorical variables. Multivariable logistic regression was employed to investigate the risk factors of prenatal anxiety. RESULTS: The percentage of prenatal anxiety (GAD-7 score ≥ 7) among pregnant women during the pandemic of COVID-19 was 34/304 (11.18%). Logistic regression indicated that vomiting (OR 4.454, 95% CI 1.113-17.821) and feeling susceptible to SARS-CoV-2 infection (OR 2.966, 95% CI 1.151-7.642) increased the odds of prenatal anxiety. Satisfaction with medical care (OR 0.303, 95% CI 0.113-0.813) and self-efficacy (OR 0.253, 95% CI 0.100-0.639) decreased the odds of prenatal anxiety. High monthly income (OR 0.246, 95% CI 0.078 ~ 0.780) reduced the chances of suffering from prenatal anxiety. CONCLUSION: The pregnant women in China exerted a higher prevalence of prenatal anxiety during the COVID-19 pandemic than that without COVID-19 pandemic. Effective management on symptoms of pregnant status should be delivered to relieve prenatal anxiety for the pregnant women. Furthermore, interventions on self-efficacy enhancement and high-quality medical prenatal care should be provided to prevent from the susceptibility of SARS-CoV-2 infection and reduce prenatal anxiety.

A Systematic Review and Meta-analysis of Telephone-Based Therapy Targeting Depressive Symptoms Among Low-Income People Living with HIV.

People living with human immunodeficiency virus (PLWH) has been reported to have a high prevalence of depressive symptoms. Low-income populations account for a large proportion of PLWH, hence indicating a high level of depressive symptoms in low-income PLWH. Telephone-based therapy has been shown to be effective for treating PLWH's depressive symptoms, but its effects among low-income PLWH remain unclear. The purpose of this meta-analysis was to evaluate the effects of telephone-based therapy targeting depressive symptoms among low-income PLWH. Six databases (PubMed, EMBASE, Web of Science, China National Knowledge Infrastructure, VIP Database and Wanfang Data) were searched until May 2020 using search terms related to telephone-based therapy, depressive symptoms, and PLWH. Eight studies were included in the meta-analysis. Both postintervention effects (primary outcome) and long-term effects (secondary outcome) were evaluated using a random effects model. The meta-analysis revealed a small to moderate effect size (g = - 0.29, 95% CI - 0.51, - 0.06) on reducing depressive symptom scores (Z = 2.51, p = 0.01) in telephone-based intervention group compared with the control group at postintervention. However, there was no statistically significant long-term effects (Z = 0.77, p = 0.44) at follow-up. For postintervention effects, calculation of the I2 index indicated moderate heterogeneity (I2 = 50%); sensitivity analysis and subgroup analysis were performed to explore the source of heterogeneity. Ethnic group was classified into minority and majority which refers to most of the population were ethnic minority and majority respectively. Between-group differences were found across ethnic groups. The results suggested that there was a slightly stronger effect of telephone-based therapy in low-income PLWH than among PLWH in general, but its long-term effect requires future investigation. The effects of the intervention were better among the ethnic majority subgroups of low-income PLWH. Treatment format and intervention duration might also influence the intervention effects. However, the overall quality of evidence was low and directly impacted on the interpretation of our results, suggesting that more high-quality random controlled trial (RCT)/longitudinal studies with less selection and detection bias, less inconsistency and less indirectness are needed when applying telephone-based therapy to low-income PLWH with depressive symptoms in further studies.

RESUMEN: Se ha informado de que las personas con el virus de la inmunodeficiencia humana (PLWH) tienen un alto riesgo de síntomas depresivos, y las personas de bajos ingresos ocupan una gran proporción de PLWH. El objetivo de este análisis es evaluar los efectos de la terapia telefónica para los síntomas depresivos en personas con PLWH de bajos ingresos. Se realizaron búsquedas en seis bases de datos hasta mayo de 2020, incluidos ocho estudios. En comparación con el grupo de control, el análisis reveló que en el grupo de intervención telefónica contaba con un efecto pequeño a moderado (g = -0.29, IC 95% -0.51, -0.06) en la reducción de las puntuaciones de síntomas depresivos (Z = 2.51, p = 0.01). Sin embargo, no hubo efectos estadísticamente significativos a largo plazo (Z = 0.77, p = 0.44) en el seguimiento. Se encontraron diferencias entre grupos desde los grupos étnicos. Los resultados mostraron que el efecto de la terapia telefónica era levemente más fuerte que el de PLWH general en las PLWH de bajos ingresos, pero la evidencia general de baja calidad impactó en la interpretación de nuestros resultados.

Multilevel analysis of personality, family, and classroom influences on emotional and behavioral problems among Chinese adolescent students.

BACKGROUND: The classroom environment plays a potentially important role in shaping the emotions and behavior of adolescents. However, few studies have focused on this factor. The aim of this study was to explore the association between the classroom environment and emotional and behavioral problems among Chinese adolescents while also considering personality-and family-related factors. METHODS: This cross-sectional study was conducted in November and December, 2009. A set of questionnaires, including the Strengths and Difficulties Questionnaire (SDQ), the Eysenck Personality Questionnaire (EPQ), the Family Environment Scale (FES), the Questionnaire on Teacher Interaction (QTI), and the Center for Epidemiological Studies- Depression Scale (CES-D), were distributed to participants. A total of 5,433 Chinese adolescent students (aged 9-18) and 244 classroom teachers in Liaoning Province were ultimately included in the study. Hierarchical linear modeling was used to explore the factors associated with emotional and behavioral problems. RESULTS: Multilevel analyses revealed that adolescent emotional and behavioral problems significantly varied among classrooms. Although personality and family characteristics exerted the greatest influence on adolescents' emotions and behavior at the individual-level, interactions between classroom teachers and students increasingly affected adolescents with respect to age at the class-level. A mild positive association was found between adolescents' mental health problems and the mental health of teachers. CONCLUSION: This study focused on the classroom environment in order to understand Chinese adolescent mental health problems, the findings of which highlight important implications for policymakers and educators. The results underscore the importance of establishing a comfortable classroom climate by improving teacher-student interactions and meeting specific needs at different school stages, thus promoting a climate of positive mental health among Chinese adolescents.

[Chemical constituents from Pteris dispar and their anti-tumor activity in vitro].

The dried whole plant of Pteris dispar were milled and extracted with 95% EtOH. The resulting dried extract was isolated by kinds of chromatographic column, including polyamide, Sephadex LH-20, preparative HPLC. As a result, ten diterpenes were isolated from the plant. By analyzing of ESI-MS and NMR spectroscopic data, the structures were established as geopyxin B(1), geopyxin E(2), ent-11α-hydroxy-18-acetoxykaur-16-ene(3), ent-14ß-hydroxy-18-acetoxykaur-16-ene(4), neolaxiflorin L(5), ent-3ß,19-dihydroxy-kaur-16-ene(6), ent-3ß-hydroxy-kaur-16-ene(7), 7ß,17-dihydroxy-16α-ent-kauran-19-oic acid 19-O-ß-D-glucopyranoside ester(8), crotonkinin C(9)and crotonkinin C(10). Compounds 1-10 were obtained from P. dispar for the first time. Compounds 1 and 2 showed moderate activities against Bel-7402 with IC50 values of 7.50 and 10.60 µmol•L⁻¹, and against HepG2 with IC50 values of 6.68,11.80 µmol•L⁻¹, respectively.

Quality of Life and Its Related Factors in Chinese Unemployed People: A Population-Based Cross-Sectional Study.

With the global economic crisis and industrial restructuring, the unemployed are suffering from job loss-related stress and loss of income, which is believed to impair their mental and physical health, while coping and self-efficacy could combat the adverse effects of unemployment on health. Thus, this study aims to describe quality of life (QOL) among unemployed Chinese people and explore the associated factors. A cross-sectional study was conducted by convenience sampling, composed of 1825 unemployed people, from January 2011 to September 2011. Questionnaires pertaining to demographic characteristics, the 36-item Short-Form Health Survey (SF-36), the abbreviated version of the Cope Inventory (Brief COPE) and self-efficacy scales were used to collect information from unemployed people in the eastern, central, and western regions of China. Hierarchical multiple regression analysis was performed to explore the related factors of QOL. A structural equation model (SEM) was used to test the relations among coping, self-efficacy, and QOL. Mental QOL was significantly lower than physical QOL in Chinese unemployed people. Coping had significant effects on both physical component summary (PCS) and mental component summary (MCS), while self-efficacy played the mediating role in the association between Coping and QOL. Unemployed Chinese people's mental QOL was disrupted more seriously than their physical QOL. An increase in coping could improve QOL by promoting better management of issues brought about by unemployment. In addition, self-efficacy has the ability to reduce the impact of unemployment on QOL, through the mediating path of coping on QOL. This study highlights the need of coping skills training and self-efficacy enhancement for better management of unemployment in order to improve QOL and well-being.

Perceived Organizational Support Impacts on the Associations of Work-Family Conflict or Family-Work Conflict with Depressive Symptoms among Chinese Doctors.

As a common mental disorder, depressive symptoms had been studied extensively all over the world. However, positive resources for combating depressive symptoms among Chinese doctors were rarely studied. Our study aimed to investigate the relationships between work-family conflict (WFC) and family-work conflict (FWC) with depressive symptoms among Chinese doctors. Meanwhile, the role of perceived organizational support (POS) in this association was explored at an organizational level. The investigation was conducted between March and April 2014. Questionnaires that measured WFC, FWC, depressive symptoms and POS were distributed to 1200 doctors in Shenyang, China. The final study subjects were 931 doctors (effective response rate: 77.6%). In all analyses, male and female doctors were analyzed separately because of possible gender differences. Hierarchical linear regression analyses were used to examine the moderating role of POS. Baron and Kenny's technique and asymptotic and resampling strategies were used to explore the mediating role of POS on the associations of WFC or FWC with depressive symptoms. WFC and FWC had positive relations with depressive symptoms among doctors. POS played a partial mediating role on the correlation of FWC with depressive symptoms among male doctors, and POS played a partial mediating role on the correlation of WFC with depressive symptoms among female doctors. POS had a positive moderating effect on the relationship between WFC and depressive symptoms among doctors. WFC and FWC could aggravate doctors' depressive symptoms, and POS, as an organizational resource, could fight against doctors' depressive symptoms. When POS functioned as a mediator, FWC had a negative effect on POS, which could increase male doctors' depressive symptoms, and WFC had a negative effect on POS, which could increase female doctors' depressive symptoms. In the meantime, POS, as a moderator, could enhance the effects of WFC on depressive symptoms.

The Effects of Being an Only Child, Family Cohesion, and Family Conflict on Behavioral Problems among Adolescents with Physically Ill Parents.

BACKGROUND: This study aimed to examine the parental physical illness' effect on behavioral problems among adolescents, and the effects of being an only child, family cohesion, and family conflict on behavioral problems among adolescents with physically ill parents in Liaoning province, China. METHODS: This cross-sectional study was performed in 2009. A questionnaire including two dimensions of the Family Environment Scale (family cohesion and family conflict), self-reported Strength and Difficulties Questionnaire (SDQ), and demographic factors was distributed to the subjects. RESULTS: Among the 5220 adolescents, 308 adolescents lived with physically ill parents. The adolescents with physically ill parents had more behavioral problems than adolescents with healthy parents. Among the girls who lived in families with physically ill parents, the SDQ score and the prevalence of SDQ syndromes were higher in the girls with siblings than the girls without siblings after adjusting for variables; the effect of family cohesion on SDQ was significant after adjusting for variables. CONCLUSION: Interventions targeting family cohesion may be effective to reduce behavioral problems of adolescents with physically ill parents.

The mediating role of psychological capital on the association between occupational stress and job burnout among bank employees in China.

Although job burnout is common among bank employees, few studies have explored positive resources for combating burnout in this population. This study aims to explore the relationship between occupational stress and job burnout among Chinese bank employees, and particularly the mediating role of psychological capital. A cross-sectional study was conducted in Liaoning, China, during June to August of 2013. A questionnaire that included the effort-reward imbalance scale, the Psychological Capital Questionnaire and the Maslach Burnout Inventory-General Survey, as well as demographic and working factors, was distributed to 1739 employees of state-owned banks. This yielded 1239 effective respondents (467 men, 772 women). Asymptotic and resampling strategies explored the mediating role of psychological capital in the relationship between occupational stress and job burnout. Both extrinsic effort and overcommitment were positively associated with emotional exhaustion and depersonalisation. Meanwhile, reward was negatively associated with emotional exhaustion and depersonalisation, but positively associated with personal accomplishment. There was a gender difference in the mediating role of Psychological capital on the occupational stress-job burnout. In male bank employees, Psychological capital mediated the relationships of extrinsic effort and reward with emotional exhaustion and depersonalization; in female bank employees, it partially mediated the relationships of extrinsic effort, reward and overcommitment with emotional exhaustion and depersonalisation, as well as the relationship between reward and personal accomplishment. Psychological capital was generally a mediator between occupational stress and job burnout among Chinese bank employees. Psychological capital may be a potential positive resource in reducing the negative effects of occupational stress on job burnout and relieving job burnout among bank employees, especially female bank employees.

Relationship between occupational stress and burnout among Chinese teachers: a cross-sectional survey in Liaoning, China.

OBJECTIVES: Teaching has been reported to be one of the most stressful occupations in the world. Few studies have been conducted to explore the effects of occupational stress on burnout among teachers in developing countries. This study aimed to explore the relationship between occupational stress and burnout among teachers in primary and secondary schools in the Liaoning Province of China. METHODS: A questionnaire that assessed occupational stress comprised of Karasek's job content questionnaire (JCQ), Siegrist's effort-reward imbalance questionnaire (ERI), and burnout assessed by the Maslach Burnout Inventory-General Survey was distributed to 681 teachers in primary and secondary schools. A total of 559 effective respondents became our final study subjects. Hierarchical linear regression and logistic regression analyses were performed through the use of SPSS 17.0 to explore the association between occupational stress and burnout. RESULTS: A high level of emotional exhaustion was significantly associated with high extrinsic effort, high overcommitment, low skill discretion, and high job demand. A high level of cynicism was associated with low reward, low skill discretion, high overcommitment, and low supervisor support. The low level of professional efficacy was associated with low coworker support, low reward, low skill discretion, and high job demand. Compared to the JCQ, the ERI was more likely to explain the burnout of teachers in our study. CONCLUSIONS: Occupational stress proved to be associated with dimensions of burnout among Chinese teachers. It is important for administrators of primary and middle schools to note that strategies to decrease teachers' occupational stress seem to be crucial to enhance physical and mental health of teachers in China.

Factors related to burnout among Chinese female hospital nurses: cross-sectional survey in Liaoning Province of China.

AIM: To explore the factors associated with burnout among female hospital nurses in China. BACKGROUND: Burnout has been a major concern in the field of occupational health, and yet there has been little research exploring the factors related to burnout among Chinese nurses. Exploring the factors associated with burnout is important in improving nurses' health and the quality of health care services in China. METHODS: The study population consisted of 1845 female hospital nurses in the Liaoning Province of China. Burnout was measured using the Chinese version of the Maslach Burnout Inventory-General Survey; occupational stress was measured using the Chinese versions of the Job Content Questionnaire and Effort-Reward Imbalance Questionnaire. A general linear regression model was applied to analyse the factors associated with burnout. RESULTS: Mean scores (±SD) were 11.74 (7.14) for emotional exhaustion, 7.12 (5.67) for cynicism and 23.34 (9.60) for self-efficacy. Strong extrinsic effort was the most powerful predictor of emotional exhaustion and cynicism; strong psychological job demands were the most robust predictor of low self-efficacy. CONCLUSION: The findings suggest that occupational stress was strongly related to burnout among female hospital nurses in China. IMPLICATIONS FOR NURSING MANAGEMENT: Occupational stress was identified as the most robust predictor of burnout among Chinese female hospital nurses. Reducing burnout among nurses working in China may require health education, health promotion and occupational training programmes aimed at improving work situations and reducing occupational stress.

Agreement between parents and adolescents on emotional and behavioral problems and its associated factors among Chinese school adolescents: a cross-sectional study.

BACKGROUND: Most studies about informant agreements on adolescents' emotional and behavioral problems have been conducted in Western countries, but this subject has not been well researched in China. The aim of this study was to evaluate the pattern of parent-adolescent agreement on adolescents' problems and its associated factors among school-age adolescents in China. METHODS: This cross-sectional study was conducted in November and December of 2010. A questionnaire including the Child Behavior Checklist (CBCL), the Youth Self-Report (YSR), the Family Environment Scale (FES) and the characteristics of the child (age and gender), parents (parent-adolescent relationship and parental expectations) and family (family structure, negative life events) was distributed to our study population. A total of 2,199 Chinese adolescents (aged 11-18) from 15 public schools in Liaoning Province, who completed the questionnaire, became our final participants. Pearson's correlation coefficient was used to assess parent-adolescent agreement, and linear regression analysis was used to explore the associated factors of parent-adolescent discrepancies on emotional and behavioral problems. RESULTS: The parent-adolescent agreement on emotional and behavioral problems was high (mean r = 0.6). The scores of YSR were higher than those of CBCL. Factors that increased informant discrepancies on emotional and behavioral problems were boys, older age, the experience of negative life events, low levels of cohesion and organization, and high levels of conflict in the family. CONCLUSIONS: A high level of parent-adolescent agreement on emotional and behavioral problems was found. Adolescents reported more problems than their parents did. Family environment is an important factor to be considered when interpreting informant discrepancies on the mental health of Chinese adolescents.