Quality of life and death anxiety among caregivers of patients with advanced cancer: the mediating effect of trait anxious personality and the moderating effect of social support.

PURPOSE: To explore the mediating role of trait anxious personality in the association between quality of life (QoL) and death anxiety (DA), as well as to test the moderating effect of social support in the mediation model. METHODS: The Death Anxiety Scale, Quality of Life Scale, State-Trait Anxiety Scale, and Social Support Rating Scale were used to measure 588 family caregivers of advanced cancer patients. We then constructed a moderated mediation model. RESULTS: The presence of QoL was negatively associated with DA (ß = - 0.67, p < 0.01). Trait anxious personality partially mediated the relationship between QoL and DA (indirect effect ß = - 0.08, p < 0.01). Social support moderated both the antecedent and subsequent segments of the mediating paths of "QoL → trait anxious personality → DA" and the direct relationship between QoL and DA. Among caregivers with a low level of social support, the mediating effect coefficient of trait anxious personality was higher at 0.25 (95% confidence interval (CI): 0.059-0.182), in contrast to caregivers with a high level of social support, where the mediating effect coefficient of trait anxious personality was 0.11 (95% CI: 0.029-0.072). CONCLUSION: QoL is directly associated with an increased risk of DA and indirectly related to DA by increasing the risk of trait anxious personality among caregivers. Social support can moderate the mediating effect of trait anxious personality and the relationship between QoL and DA. The intervention strategy for preventing DA among caregivers who have encountered QoL reduction should focus on reducing trait anxious personality and social support.

How and when does proactive personality predict career adaptability? A study of the moderated mediation model.

In the present study, we explored the relationship between proactive personality and career adaptability to construct a cross-level moderated mediation model based on the conservation of resources (COR) theory. By conducting a time-lagged study involving three data collection points from 587 employees across 104 teams in China, we examined how and when proactive personality predicts employees' career adaptability using strengths use as a mediator and managerial coaching as boundary conditions. The results revealed that proactive personality predicted strengths use, which, in turn, influenced career adaptability, with managerial coaching moderating the indirect relationship between proactive personality and career adaptability. Consequently, our findings suggest that, in contexts where managerial coaching lacks guidance, facilitation, and inspiration, a proactive personality encourages employees to leverage their strengths, subsequently enhancing their career adaptability. Finally, we discuss the theoretical and practical implications of our findings, address limitations, and propose directions for future research.

The relationship between the psychological resilience and post-traumatic growth of college students during the COVID-19 pandemic: a model of conditioned processes mediated by negative emotions and moderated by deliberate rumination.

BACKGROUND: The mental health of university students during the COVID-19 pandemic has attracted the attention of researchers. For the present study researchers constructed a mediation model to explore the relationship between psychological resilience and post-traumatic growth, the mediating role of negative emotions and the moderating role of deliberate rumination in students. METHODS: The Psychological Resilience Scale, Posttraumatic Growth Inventory, Depression-Anxiety-Stress Scale (DASS-21) and Event Related Rumination Inventory were used in a survey of 881 college students. The data were analyzed using SPSS 26.0 and the PROCESS plugin (version 3.3). RESULTS: (1) Psychological resilience is positively related with post-traumatic growth. Deliberate rumination is positively related to psychological resilience, posttraumatic growth, and negative emotions. Psychological resilience, post-traumatic growth and negative emotions are negatively related. (2) Negative emotions mediated the relationship between psychological resilience and post-traumatic growth. (3) Deliberate rumination plays a moderating role in psychological resilience affecting negative emotions. Deliberate rumination plays a moderating role in the extent to which psychological resilience influences PTG through negative emotions. CONCLUSIONS: Psychological resilience affects post-traumatic growth directly and also indirectly through negative emotions. With the increase of mental resilience, the level of negative emotion tended to decrease. When individuals are experiencing negative emotions, high levels of active rumination are more likely to promote post-traumatic growth. This study helps to explore the factors affecting the mental health of college students during the epidemic, thus providing guidance for appropriate mental health interventions.

Mediating roles of activities of daily living and depression on the relationship between sleep quality and health-related quality of life.

This study aimed to explore the mediating effects of ADL and depression on the relationship between sleep quality and HRQOL among older people in rural China, while also exploring the moderating impact of loneliness. The study gathered data from a household survey conducted among 1587 Chinese rural older adults (mean age = 73.63 years). The collected data was analyzed using SPSS version 23.0 software (IBM, New York, USA) and the PROCESS macro version 4.0 program. The findings indicated a significant correlation between sleep quality, ADL, depression, loneliness and HRQOL. ADL and depression exhibited a chain mediation effect on the relationship between sleep quality and HRQOL. Notably, the association between sleep quality and HRQOL was entirely mediated by ADL and depression. Additionally, loneliness acted as a moderator in the relationship between ADL and HRQOL. The findings of this study suggest that interventions focusing on sleep quality should prioritize strategies for enhancing older adults' ADL and depression as integral components of promoting older adults' HRQOL.

High-dimensional mediation analysis for continuous outcome with confounders using overlap weighting method in observational epigenetic study.

BACKGROUND: Mediation analysis is a powerful tool to identify factors mediating the causal pathway of exposure to health outcomes. Mediation analysis has been extended to study a large number of potential mediators in high-dimensional data settings. The presence of confounding in observational studies is inevitable. Hence, it's an essential part of high-dimensional mediation analysis (HDMA) to adjust for the potential confounders. Although the propensity score (PS) related method such as propensity score regression adjustment (PSR) and inverse probability weighting (IPW) has been proposed to tackle this problem, the characteristics with extreme propensity score distribution of the PS-based method would result in the biased estimation. METHODS: In this article, we integrated the overlapping weighting (OW) technique into HDMA workflow and proposed a concise and powerful high-dimensional mediation analysis procedure consisting of OW confounding adjustment, sure independence screening (SIS), de-biased Lasso penalization, and joint-significance testing underlying the mixture null distribution. We compared the proposed method with the existing method consisting of PS-based confounding adjustment, SIS, minimax concave penalty (MCP) variable selection, and classical joint-significance testing. RESULTS: Simulation studies demonstrate the proposed procedure has the best performance in mediator selection and estimation. The proposed procedure yielded the highest true positive rate, acceptable false discovery proportion level, and lower mean square error. In the empirical study based on the GSE117859 dataset in the Gene Expression Omnibus database using the proposed method, we found that smoking history may lead to the estimated natural killer (NK) cell level reduction through the mediation effect of some methylation markers, mainly including methylation sites cg13917614 in CNP gene and cg16893868 in LILRA2 gene. CONCLUSIONS: The proposed method has higher power, sufficient false discovery rate control, and precise mediation effect estimation. Meanwhile, it is feasible to be implemented with the presence of confounders. Hence, our method is worth considering in HDMA studies.

The relationship between fear of cancer recurrence and death anxiety among Chinese cancer patients: the serial mediation model.

AIMS: This study aims to investigate the association between fear of cancer recurrence (FCR) and death anxiety (DA) among Chinese cancer patients, while considering the mediating effects of experiential avoidance (EA) and meaning in life (MIL). METHODS: From February to June 2023, convenience sampling was used to select newly diagnosed cancer patients in a tertiary Cancer Hospital in Chinese Hunan Province as the survey objects. A total of 436 cancer patients completed the Fear of Cancer Recurrence Inventory, the Meaning in Life Questionnaire, the Acceptance and Action Questionnaire-II, and the Templer's death anxiety scale. Descriptive analysis and Pearson correlation analysis were conducted using SPSS 28.0 software. Serial mediation analysis was performed by Hayes' PROCESS macro. RESULTS: Gender, age, educational level, marital status, residence, occupation, per capita monthly household income, tumor type, and cancer stage were controlled in the model. The results revealed that fear of cancer recurrence had a significant direct effect on death anxiety (Effect = 0.075, 95% CI: 0.064 to 0.087). Additionally, three indirect pathways were identified: (1) through experiential avoidance (Effect = 0.037, 95% CI: 0.026 to 0.049), (2) through meaning in life (Effect = 0.022, 95% CI: 0.014 to 0.031), and (3) through the serial mediators involving meaning in life and experiential avoidance (Effect = 0.016, 95% CI: 0.010 to 0.023). The total indirect effect of the three mediation paths was 63.56%. CONCLUSION: Fear of cancer recurrence is a significant psychological distress experienced by cancer patients, which not only directly contributes to death anxiety but also may triggers changes, such as experiential avoidance and meaning in life. Ultimately, this comprehensive psychological distress leads to death anxiety.

Dyadic effects of financial toxicity and social support on the fear of cancer recurrence in breast cancer patients and caregivers: an actor-partner interdependence mediation model.

PURPOSE: In this study, the actor-partner interdependence mediation model (APIMeM) was applied to breast cancer patients and their caregivers to assess the factors that affect the fear of cancer recurrence. In particular, the purpose of this study was to evaluate the mediating effect of social support on financial toxicity and the fear of cancer recurrence, providing an effective basis for developing plans to reduce the level of fear of cancer recurrence. METHODS: This study employed a cross-sectional design, and 405 dyads of breast cancer patients and their caregivers were enrolled. Financial toxicity, social support, and fear of cancer recurrence were assessed by computing comprehensive scores for financial toxicity based on patient-reported outcome measures, the Social Support Rating Scale, and the Fear of Cancer Recurrence Inventory Short Form, respectively. The data were analysed using SPSS 24.0 and AMOS 23.0. RESULTS: The results showed that the fear of cancer recurrence of breast cancer patients and their caregivers was significantly related to dyadic financial toxicity and social support. In addition, the financial toxicity of breast cancer patients and their caregivers had significant actor effects and partner effects on the fear of cancer recurrence through dyadic social support. CONCLUSIONS: The financial toxicity of breast cancer patients and their caregivers could produce actor and partner effects on the fear of cancer recurrence through the mediation of social support, which provided empirical support for improving reducing the level of fear of cancer recurrence among patients and caregivers at the dyadic level.

Regional brain structure mediates the association between sleep quality and intellectual abilities: the moderating role of socioeconomic status.

This study aims to reveal the association between sleep quality and crystallized intelligence (Gc), fluid intelligence (Gf), and the underlying brain structural basis. Using the data from the Human Connectome Project (N = 1087), we performed mediation analysis to explore whether regional brain structure related to sleep quality mediate the association between sleep quality and intellectual abilities, and further examined whether socioeconomic status (i.e., income and education level) moderate the mediation effect. Results showed that poorer sleep quality was associated with lower Gc rather than Gf, and worse sleep quality was associated with smaller volume and surface area in temporal lobe, including inferior temporal gyrus and middle temporal gyrus. Notably, temporal lobe structures mediated the association between sleep quality and Gc rather than Gf. Furthermore, socioeconomic status (i.e., income and education level) moderated the mediating effect, showing low socioeconomic status has a more significant mediating effect with stronger association between sleep quality and Gc as well as stronger association between temporal lobe structure and Gc in low socioeconomic status group. These findings suggest that individuals with higher socioeconomic status are less susceptible to the effect of sleep quality on Gc.

The Effect of Corporate Social Responsibility on Workplace Safety: The Significance of Employees' Moral Identity.

Corporate social responsibility (CSR) has gained significant attention from researchers and practitioners due to its potential impact on employee attitudes and behaviors. This study investigates the influence of CSR on employee safety behavior, examining the mediating effects of job stress and organizational identification, as well as the moderating role of moral identity. We conducted a three-wave time-lagged survey among 236 South Korean employees. Participants were recruited through a research company using stratified random sampling. Data were collected at three time points, each separated by a 4-5-week interval. Structural equation modeling (SEM) was used to test the hypothesized relationships. The findings support all of the hypothesized relationships. CSR was positively related to safety behavior and negatively related to job stress. Job stress was negatively related to organizational identification, which in turn was positively related to safety behavior. The sequential mediation of job stress and organizational identification was significant. Moral identity moderated the relationship between CSR and job stress, such that the negative effect of CSR on job stress was stronger for employees with a high moral identity. This study contributes to the CSR literature by examining the impact of CSR on safety behavior and the underlying mechanisms and boundary conditions of this relationship. The findings suggest that organizations can promote employee safety behavior by implementing CSR initiatives, which can reduce job stress and enhance organizational identification. Organizations should also consider the role of employees' moral identity when designing and communicating CSR initiatives.

Ethnocentrism and place identity in the consumption of local products.

Research on the consumption of local products is essential to promote sustainability, boost local economies, and preserve cultural identity. Although a positive relationship has been demonstrated between attitude towards local products and consumption determinants, the role of the former as a mediator has not been sufficiently explored. This study examines how the attitude towards local products mediates between consumer ethnocentrism and consumption intention, as well as between place identity and consumption intention. A total of 1325 wine and cheese consumers in the Canary Islands were surveyed using a moderated mediation model, applying PLS-SEM. The results indicate that attitude towards local products mediates the aforementioned relationships but does not moderate them according to the type of local product. Consequently, marketing strategies should focus on the emotional and cultural connection that consumers establish with local products, highlighting their value in terms of identity and belonging.

Emotional sociology applied: predictive influence of affective neuroscience personality traits on Chinese preschool teachers' performance and wellbeing.

Background: The interplay between teaching engagement and performance has garnered attention in both theoretical and empirical research, primarily due to its influence on student academic achievement, teacher well-being, and the realization of institutional goals. This is especially pertinent in the realm of preschool education, where the scope of learning extends beyond academic content to encompass the broader socialization of children. Drawing from Affective Neuroscience research, this study investigates the role of affective tendencies as mediators in the relationship between work engagement and job performance. Objective: The primary aim of this research is to examine a chain mediation model that hypothesizes the predictive role of teacher engagement. This model posits the intermediary influence of four basic emotions-CARING, SEEKING, ANGER, and FEAR-followed by the mediating effect of job satisfaction on teacher job performance. Method: The study utilized a sample of 842 Chinese preschool teachers. Data were collected through an online questionnaire, employing a time-lagged design. The analysis was conducted using Model 80 of the PROCESS Macros. Results: The findings reveal that both positive and negative emotions significantly predict teachers' job satisfaction. However, job satisfaction does not influence job performance. The analysis confirmed the direct and total effects of teacher engagement, as well as the indirect effects, particularly through the positive emotion of Caring. Implications: The results are instrumental in informing and refining interventions designed to enhance teacher engagement and performance, underscoring the importance of emotional factors in the educational environment.

Dyadic coping, resilience, and quality of life in young and middle-aged couples after gynecologic cancer: An actor-partner interdependence mediation model.

PURPOSE: To examine the effects of dyadic coping on quality of life (QoL) and the mediating role of resilience in these effects among young and middle-aged couples after gynecologic cancer (GC). METHODS: A cross-sectional study was conducted between July 2022 and June 2023 from one tertiary hospital in Wuhan, China. 240 pairs of young and middle-aged GC couples were recruited. The demographic and clinical characteristics questionnaire, the Dyadic Coping Inventory, the 10-item Connor-Davidson Resilience Scale, and the 12-item Short-Form Health Survey were used to collect data. The process of dyadic analysis was based on the actor-partner interdependence mediation model. RESULTS: GC patients' dyadic coping had an actor effect on both their own physical and mental QoL, while spouses' dyadic coping only exerted an actor effect on their own mental QoL. The mediating effects of resilience on the relationship between dyadic coping and QoL were identified in dyads. Moreover, spouses' dyadic coping could indirectly influence patients' QoL through their own and patients' resilience. CONCLUSION: The findings confirm the dyadic relationships between dyadic coping, resilience, and QoL among young and middle-aged couples facing GC. These results suggest that it is necessary to develop couple-based interventions to improve dyadic coping and resilience, thus enhancing the QoL of both members.

The dyadic associations among self-efficacy, dyadic coping, and health-related quality of life between high-risk pregnant women and spouses: a cross-sectional study.

AIM: Health-related quality of life(HRQoL) is essential for high-risk pregnant women and their spouses. This study aimed to explore the dyadic associations (including actor and partner effects) among self-efficacy, dyadic coping, and HRQoL of high-risk pregnant women and their spouses and examine the mediating effect of dyadic coping. METHODS: This cross-sectional study recruited participants from two Grade A tertiary hospitals in China from October 2022 to September 2023. A questionnaire including the Chinese version of the General Self-Efficacy Scale, Dyadic Coping Inventory, and 12 Short Form Health Survey Scales was used for the survey. The actor-partner interdependence mediation model was constructed to test dyadic associations and mediating effects. RESULTS: In the actor effects, self-efficacy was positively associated with dyadic coping and HRQoL (P < 0.05). Regarding partner effects, pregnant women's self-efficacy was positively associated with spouses' dyadic coping and physical health (P < 0.05). Dyadic coping partially mediated the relationship between self-efficacy and HRQoL for both groups(P < 0.05). CONCLUSION: The HRQoL of high-risk pregnant women and their spouses requires urgent attention. Enhancing self-efficacy and dyadic coping in these couples is related to their improved physical and mental health. Healthcare professionals should consider interactions between couples and include them together in perinatal care. Intervention programs for couples or families based on existing positive psychology and dyadic interventions may work together to improve the HRQoL of couples.

Resilience, Burnout and Mental Health in Nurses: A Latent Mediation Model.

Background/Objectives: The burnout syndrome in nurses has been related to the development of mental health problems. On the contrary, resilience is related to adequately coping with stressful situations and better mental health. The objective was to analyze the relationship between resilience and mental health problems in nurses and estimate the proportion mediated by burnout in the association. Methods: In 2021, a total of 1165 Spanish nurses were selected through a stratified random sampling method. Participants anonymously filled in the Resilience Scale (RS-14), the Maslach Burnout Inventory Survey, and the General Health Questionnaire. To test the hypothesis proposed and explain the mediating effect of burnout empirically, structural equation modeling (SEM) was applied. A latent mediation model was computed. Results: Resilience was negatively related to burnout and mental health problems. The direct relationship between burnout and the latent health variable was positive. In addition, in view of the total effect of resilience on mental health problems and the magnitude of the indirect effect, we stated that the proportion of this effect mediated by burnout ranged from 0.486 to 0.870. Conclusions: This study reveals that fostering resilience in nurses directly and indirectly reduces burnout and improves their mental health. The implementation of resilience programs and supportive institutional policies is recommended to improve working conditions and the quality of patient care.

The Relationship Between Intimate Partner Violence, Depression, Alcohol Abuse in Black and Hispanic Women.

The relationship between intimate partner violence (IPV), depression, and risky alcohol use is complex and multi-dimensional. Depression has been documented as a common consequence of experiencing IPV, where depressed individuals might turn to substances like alcohol as a coping mechanism. Thus, assessing the indirect effect of depression in the relationship between IPV and alcohol abuse in African American and Hispanic women is warranted. Cross-sectional data was collected from 152 African American and Hispanic women living in Miami, Florida. Descriptive statistics, correlation analysis, and Hayes' direct and indirect mediation analyses were conducted. A total of 77% reported IPV. The mean age was 42.84 (SD = 10.69). About 57% of participants identified as African American, and 62% identified as Hispanic/Latino. On average, participant depression scores (8.6, SD = 5.7) showed mild-to-moderate severity, and the average alcohol abuse score was 15.5 (±8.9), suggesting risky alcohol use. IPV was directly associated with alcohol abuse (ß = .50, 95% CI [.18, .82]; [R2 = .059, F(1, 150) = 9.37, p < .001), and with depression (ß = .48, 95% CI [.27, .69]; [R2 = .119, F(1, 150) = 20.43, p < .001). Depression modified the effect of IPV on alcohol abuse by about 19% (ß = .56, 95% CI [.33, .80]; [R2 = .185, F(2, 149) = 16.87, p < .0026). Results of this study suggest that depression is an important component to be considered when addressing alcohol abuse among women with experiences of IPV. This study highlights the importance of assessing women who report IPV for depressive symptoms when treating alcohol use disorders.

Savoring Belief, Resilience, and Meaning in Life as Pathways to Happiness: A Sequential Mediation Analysis among Taiwanese University Students.

In recent decades, scholarly interest has grown in the psychological components of happiness. Savoring belief, or the capacity to attend to, appreciate, and enhance the positive experiences in one's life, along with resilience and meaning in life, have emerged as significant predictors of enhanced happiness among diverse populations. This research examined the interrelationships among savoring belief, resilience, meaning in life, and happiness. A sample of 561 students from 75 universities in Taiwan, comprising 361 female and 200 male participants with an average age of 20.88 years, participated in an online survey. The study employed various instruments, including the Savoring Belief Inventory, the Subjective Happiness Scale, the Brief Resilience Scale, and the Meaning in Life Questionnaire. These instruments were translated into Traditional Chinese using a back-translation method and subsequently validated for accuracy by specialists in the field. Analysis of the data using Hayes' PROCESS Model 6 revealed several key insights: (1) savoring belief positively influenced happiness, resilience, and meaning in life with resilience further enhancing happiness and meaning in life; (2) resilience served as a significant mediator in the relationship between savoring belief and happiness; (3) meaning in life significantly mediated the relationship between savoring belief and happiness; (4) a sequential mediation model illustrated the mediating effects of resilience and meaning in life on the relationship between savoring belief and happiness. This study illustrates that, much like a garden requires water, sunlight, and care to flourish, our happiness is cultivated through enhancing our ability to savor the good moments, rebound from challenges, and find deep significance in our lives. We can significantly boost well-being by fostering these qualities-savoring belief, resilience, and a sense of meaning. These findings are particularly relevant for educators, highlighting the critical need to develop these traits in students to promote greater happiness and fulfillment in their lives. Discussions included theoretical implications, educational implications, and avenues for future research.

The effects of cyber-ostracism on college students' aggressive behavior: a moderated mediation model.

Purpose: This study used questionnaire survey to explore the influence of cyber-ostracism on the aggressive behavior of college students. Specifically, this study explored the mediation role of the basic psychological needs satisfaction, and explored the moderating role of self-integrity. Method: An online questionnaire was designed through a questionnaire website, which was linked and transferred to college students nationwide. 377 valid questionnaires were obtained after excluding invalid questionnaires. Results: Cyber-ostracism had a significant positive predictive effect on the basic psychological needs satisfaction; Basic psychological needs satisfaction play a mediation role between cyber-ostracism and aggression. Self-integrity moderates the association between basic psychological needs and aggression.

Influence of physical exercise on negative emotions in college students: chain mediating role of sleep quality and self-rated health.

Background: Negative emotions in college students are a significant factor affecting mental health, with suicide behaviors caused by negative emotions showing an annual increasing trend. Existing studies suggest that physical exercise is essential to alleviate negative feelings, yet the intrinsic mechanisms by which it affects negative emotions have not been fully revealed. Objective: Negative emotions in college students represent a significant issue affecting mental health. This study investigates the relationship between physical exercise and negative emotions among college students, incorporating sleep quality and self-rated health (SRH) as mediators to analyze the pathway mechanism of how physical exercise affects students' negative emotions. Methods: A cross-sectional study design was utilized, employing online questionnaires for investigation. The scales included the Physical Activity Rating Scale-3 (PARS-3), the Depression Anxiety Stress Scales-21 (DASS-21), the Pittsburgh Sleep Quality Index (PSQI), and the 12-Item Short Form Health Survey (SF-12), resulting in the collection of 30,475 valid questionnaires, with a validity rate of 91%. Chain mediation tests and Bootstrap methods were applied for effect analysis. Results: The proportions of university students engaged in low, medium, and high levels of physical exercise were 77.6, 13.1, and 9.3%, respectively. The proportions of students experiencing "very severe" levels of stress, anxiety, and depression were 4.5, 10.9, and 3.6%, respectively. Physical exercise was significantly positively correlated with self-rated health (r = 0.194, p < 0.01), significantly negatively correlated with sleep quality (r = -0.035, p < 0.01), and significantly negatively correlated with stress, anxiety, and depression (r = -0.03, p < 0.01; r = -0.058, p < 0.01; r = -0.055, p < 0.01). Sleep quality was significantly negatively correlated with self-rated health (r = -0.242, p < 0.01). Mediation effect testing indicated that sleep quality and self-rated health partially mediated the relationship between physical exercise and negative emotions, with total effect, total direct effect, and total indirect effect values of -1.702, -0.426, and - 1.277, respectively. Conclusion: College students primarily engage in low-intensity physical activity. Sleep quality and self-rated health mediate the impact of physical exercise on students' negative emotions. A certain level of physical activity can directly affect students' emotional states and indirectly influence their negative emotions via sleep and self-rated health. Regular engagement in physical activities primarily positively impacts emotional states by enhancing mood stability and overall emotional resilience.

The relationship between young college students' recognition of national COVID-19 crisis governance capabilities and the improvement of national identity: the mediating role of online participation in public health critical events.

Background: Improving the young college students' national identity is crucial for ensuring social stability and fostering development during public health critical events such as COVID-19. Young college students' recognition of national COVID-19 crisis governance capabilities can influence their national identity, and online participation in public health criticalevents may serve as a crucial role in shaping this intricate relationship. To investigate this possibility, the present study established an intermediary model to examine the impact of online participation in public health critical events on young college students' recognition of national COVID-19 crisis governance capabilities and improvement of national identity. Methods: This cross-sectional survey study employed a convenience sampling method to investigate a total of 3041 young college students in China. The correlations between study variables were analyzed using Spearman's rank correlation. The mediation model was established using PROCESS Model 4 with 5000 bootstrap samples in SPSS. The bias-corrected bootstrap method provided statistical efficacy and identification interval estimation. Results: Young college students' recognition of national COVID-19 crisis governance capabilities (r=0.729, P<0.001) and online participation in public health critical events (r=0.609, P<0.001) were positively correlated with improvement of their national identity. The relationship between these two factors was partially mediated by online participation in public health critical events (Indirect effect estimate=0.196, P<0.001). Conclusion: Online participation in public health critical events played a mediating role in the association between college students' recognition of national COVID-19 crisis governance capabilities and the improvement of national identity. Our findings provide a novel intervention strategy for improving college students' national identity, which is to encourage their online participation in public health critical events.

Negative life events and suicidality among adolescents in Western China: the mediating effect of depressive symptoms and the moderating effect of self-esteem.

OBJECTIVE: To investigate the mediating role of depressive symptoms in the relationship between negative life events (NLEs) and suicidality, as well as to test the moderating effect of self-esteem in the mediation model. METHODS: A total of 3,003 adolescents from Han, Tibetan, and Yi ethnic groups living in Western China were included in this study. Utilizing the structural equation model, a mediation model and a moderated mediation model were constructed. RESULTS: The presence of NLEs was positively associated with suicidality (ß = 0.17, p < 0.001). Depressive symptoms partially mediated the relationship between NLEs and suicidality (indirect effect ß = 0.19, p < 0.001). Self-esteem moderated both the antecedent and subsequent segments of the mediating paths of "NLEs → depressive symptoms → suicidality" and the direct relationship between NLEs and suicidality. Among adolescents with a low level of self-esteem, the mediating effect coefficient of depressive symptoms was higher at 0.18 (95% confidence interval (CI): 0.14-0.23), in contrast to adolescents with a high level of self-esteem, where the mediating effect coefficient of depressive symptoms was 0.04 (95% CI: 0.02-0.07). CONCLUSION: NLEs are directly associated with an increased risk of suicidality and indirectly related to suicidality by increasing the risk of depressive symptoms among adolescents. Self-esteem can moderate the mediating effect of depressive symptoms and the relationship between NLEs and suicidality. The intervention strategy for preventing suicidality among adolescents who have experienced NLEs should focus on reducing depressive symptoms and improving self-esteem.