Belief in a just world and fair behavior among clinical nurses: a moderated mediation model of empathy and observer justice sensitivity.

BACKGROUND: Exploration of the relationship between nursing staffs' justice in belief world and fair behavior is important to promote equity and access to health services in health organizations, as well as to enhance the quality of care. In order to further dissect the influencing factors of fair behavior among clinical nurses, the current study aims to investigate how belief in a just world influences the fair behavior among nurses. Based on the belief in a just world theory, the empathy-altruism theory and the protective-protective model, the current study aimed to provide a deeper understanding of the effect of belief in a just world on fair behavior by investigating the mediating role of empathy and the moderating role of observer justice sensitivity. METHOD: This was a cross-sectional study. 571 registered clinical nurses were included from five hospitals in Fuzhou through a convenience sampling method. Measurements included Chinese translations of belief in a just world scale, empathy scale, observer justice sensitivity scale, fair behavior scale. SPSS 22.0 was used to describe descriptive statistics and the variables' Pearson correlation coefficient. SPSS PROCESS macro Model 4 and model 14 were used to examine the mediation and the moderation between the relationship of belief in a just world and fairness behavior. RESULT: The results shower that fairness behavior was positively correlated with one's belief in a just world (r = 0.26, p < 0.01); (2)empathy mediated the relationship between belief in a just world and fair behavior. The mediation model explains 20.83%; (3) Observer justice sensitivity moderated the relationship between empathy and fair behavior. CONCLUSIONS: Belief in a just world, empathy, and observer justice sensitivity were motivations for nurses' fair behavior. Nursing administrators should focus on cultivating nurses' belief in a just world, their empathy abilities, and positive qualities of justice sensitivity to enhance fair behavior in a healthcare setting.

Exploring Relations Between Unique Patient Characteristics and Virtual Reality Immersion Level on Anxiety and Pain in Patients Undergoing Venipuncture: Secondary Analysis of a Randomized Control Trial.

BACKGROUND: Virtual reality (VR) is a well-researched digital intervention that has been used for managing acute pain and anxiety in pediatric patients undergoing various medical procedures. This study focuses on investigating the role of unique patient characteristics and VR immersion level on the effectiveness of VR for managing pediatric pain and anxiety during venipuncture. OBJECTIVE: The purpose of this study is to determine how specific patient characteristics and level of immersion during a VR intervention impact anxiety and pain levels for pediatric patients undergoing venipuncture procedures. METHODS: This study is a secondary data analysis of 2 combined, previously published randomized control trials on 252 pediatric patients aged 10-21 years observed at Children's Hospital Los Angeles from April 12, 2017, to July 24, 2019. One randomized clinical trial was conducted in 3 clinical environments examining peripheral intravenous catheter placement (radiology and an infusion center) and blood draw (phlebotomy). Conditional process analysis was used to conduct moderation and mediation analyses to assess the impact of immersion level during the VR intervention. RESULTS: Significant moderation was found between the level of immersion and anxiety sensitivity when predicting postprocedural anxiety (P=.01). Patients exhibiting the highest anxiety sensitivity within the standard of care yielded a 1.9 (95% CI 0.9-2.8; P<.001)-point elevation in postprocedural anxiety relative to individuals with high immersion levels. No other significant factors were found to mediate or moderate the effect of immersion on either postprocedural anxiety or pain. CONCLUSIONS: VR is most effective for patients with higher anxiety sensitivity who report feeling highly immersed. Age, location of the procedure, and gender of the patient were not found to significantly impact VR's success in managing levels of postprocedural pain or anxiety, suggesting that immersive VR may be a beneficial intervention for a broad pediatric population. TRIAL REGISTRATION: ClinicalTrials.gov NCT04268901; https://clinicaltrials.gov/study/NCT04268901.

Mind over chronic pain: A meta-analysis of cognitive restructuring in chronically ill adults.

OBJECTIVE: This meta-analysis synthesizes research on the impact of cognitive restructuring on chronic pain intensity, aiming to integrate diverse methodologies and findings while evaluating potential moderators. METHODS: Following PRISMA guidelines, we systematically searched multiple databases (PubMed, Web of Science, JSTOR, Sage, Social Science Research Network, PsycArticles, ScienceDirect, and Education Resources Information Center) until July 2023. Studies involving adults (≥18 years) diagnosed with chronic conditions who underwent cognitive restructuring to reduce chronic pain intensity, were included. Eligible studies compared this intervention with a control group. We excluded studies incorporating cognitive restructuring within broader interventions, lacking statistical data, or not written in English. Study quality was assessed using the Cochrane Risk of Bias tool (RoB 2). RESULTS: After reviewing 18,312 studies, we selected 11 studies published between 1991 and 2022, involving 693 participants with chronic conditions. A significant large overall effect size was found (d = 0.94, 95% CI 0.48 to 1.40). Moderation analyses revealed significant differences based on sex and study quality, with effects less pronounced among females and more substantial in higher-quality studies. CONCLUSION: Despite limitations such as statistical instability due to a small number of studies in certain moderator categories and methodological variability, this meta-analysis highlights the robust effects of cognitive restructuring on chronic pain intensity. The findings are valuable for guiding power calculations and future research expectations. Clinically, these results support the significant effect of cognitive restructuring in both individual and group settings, regardless of age, particularly when facilitated by teams that include psychologists.

Moderation Effects of Streetscape Perceptions on the Associations Between Accessibility, Land Use Mix, and Bike-Sharing Use: Cross-Sectional Study.

Background: Cycling is known to be beneficial for human health. Studies have suggested significant associations of physical activity with macroscale built environments and streetscapes. However, whether good streetscapes can amplify the benefits of a favorable built environment on physical activity remains unknown. Objective: This study examines whether streetscape perceptions can modify the associations between accessibility, land use mix, and bike-sharing use. Methods: This cross-sectional study used data from 18,019,266 bike-sharing orders during weekends in Shanghai, China. A 500 × 500 m grid was selected as the analysis unit to allocate data. Bike-sharing use was defined as the number of bike-sharing origins. Street view images and a human-machine adversarial scoring framework were combined to evaluate lively, safety, and wealthy perceptions. Negative binomial regression was developed to examine the independent effects of the three perceptual factors in both the univariate model and fully adjusted model, controlling for population density, average building height, distance to nearest transit, number of bus stations, number of points of interest, distance to the nearest park, and distance to the central business district. The moderation effect was then investigated through the interaction term between streetscape perception and accessibility and land use mix, based on the fully adjusted model. We also tested whether the findings of streetscape moderation effects are robust when examinations are performed at different geographic scales, using a small-sample statistics approach and different operationalizations of land use mix and accessibility. Results: High levels of lively, safety, and wealthy perceptions were correlated with more bike-sharing activities. There were negative effects for the interactions between the land use Herfindahl-Hirschman index with the lively perception (ß=-0.63; P=.01) and safety perception (ß=-0.52; P=.001). The interaction between the lively perception and road intersection density was positively associated with the number of bike-sharing uses (ß=0.43; P=.08). Among these, the lively perception showed the greatest independent effect (ß=1.29; P<.001), followed by the safety perception (ß=1.22; P=.001) and wealthy perception (ß=0.72; P=.001). The findings were robust in the three sensitivity analyses. Conclusions: A safer and livelier streetscape can enhance the benefits of land use mix in promoting bike-sharing use, with a safer streetscape also intensifying the effect of accessibility. Interventions focused on streetscape perceptions can encourage cycling behavior and enhance the benefits of accessibility and land use mix. This study also contributes to the literature on potential moderators of built environment healthy behavior associations from the perspective of microscale environmental perceptions.

Effectiveness of public health spending: Investigating the moderating role of governance using partial least squares structural equation modelling (PLS-SEM).

BACKGROUND: The link between public health spending (PHS) and population health outcomes (PHO) has been extensively studied. However, in sub-Saharan Africa (SSA), the moderating effects of governance in this relationship are little known. Furthermore, studies have focused on mortality as the main health outcome. This study contributes to this literature by investigating the moderating role of governance in the relationship by simultaneously assessing three dimensions of governance (corruption control, government effectiveness and voice accountability) using disability-adjusted life years (DALYs) as a measure of outcomes. METHODS: The study applies the two-stage moderation approach using partial least squares structural equation modelling (PLS-SEM) to panel data from 43 SSA nations from 2013 to 2019. The study also uses domestic general government health expenditure (DGGHE) as an independent variable and disability-adjusted life years (DALY) as the dependent variable in this relationship. RESULTS: The analysis reveals that DGGHE affects DALY negatively and that governance improves the effect of DGGHE on DALY, with bigger improvements among countries with worse governance. CONCLUSION: These findings provide evidence that good governance is crucial to the effectiveness of PHS in SSA nations. Sub-Saharan Africa (SSA) countries should improve governance to improve population health.

Built for movement: Neighborhoods and adolescent physical activity behaviors, and the moderating role of socioeconomic position and gender.

This study examined whether the built environment was associated with physical activity among adolescents in Oslo, Norway, and the role of socioeconomic position and gender as potential moderators of this association. We used data from 897 adolescents who participated in the TACKLE cross-sectional study conducted in 2020. Built environment features (recreational facilities, parks, forest, public transport, traffic calming devices, and schools) were assessed objectively using Geographical Information Systems. Physical activity data included device-measured moderate-to-vigorous physical activity, total physical activity, and self-reported active transportation to school. Using general linear models and logistic regression, we found that most built environment features were unrelated to the participants' device-measured physical activity. Longer distances to school and to traffic calming devices were associated with decreased likelihood of participants reporting active transportation to school. Our moderated regression analysis showed that adolescents with low socioeconomic backgrounds seemed less affected by longer distances to school compared with their high socioeconomic counterparts. Furthermore, boys appeared to be more sensitive to traffic safety relative to girls. Implementing traffic calming devices may enhance active transportation to school and improve traffic safety for Norwegian adolescents.

The Mediation/Moderation Effects of Gut Microbiota on Sleep Quality and Primary Liver Cancer: A Mendelian Randomization and Case-Control Study.

Background: Primary liver cancer (PLC) is a fatal malignancy, sleep quality and gut microbiota were shown to be associated with PLC. However, the mechanism of how sleep quality affects PLC is unclear. This study aims to investigate the mediation/moderation effects of gut microbiota on sleep quality and the occurrence of PLC. Methods: The causality of sleep quality and the occurrence of PLC was detected through the Mendelian randomization (MR) analysis based on the data including 305,359 individuals (Finland Database) and 456,348 participants (UK Biobank). The primary method used for MR analysis was inverse-variance weighted analysis. Gut microbiota' mediation/moderation effects were uncovered in the case-control study including 254 patients with PLC and 193 people with benign liver diseases through the mediation/moderation effect analyses. People's sleep quality was evaluated through the Pittsburgh sleep quality index (PSQI). Results: Poor sleep quality could lead to PLC through the MR analysis (P = 0.026). The case-control study uncovered that Actinobacteria had mediation effects on the relationship between PSQI score, self-sleep quality, and the occurrence of PLC (P = 0.048, P = 0.046). Actinobacteria and Bifidobacterium could inhibit the development of PLC caused by short night sleep duration (P = 0.021, P = 0.022). Erysipelotrichales could weaken the influence of daytime dysfunction on PLC (P = 0.033). Roseburia modulated the contribution of nocturnal insomnia and poor sleep quality to PLC (P = 0.009, P = 0.017). Conclusion: Poor sleep quality was associated with PLC. Gut microbiota' mediation/moderation effects on poor sleep quality and the occurrence of PLC prompted an insightful idea for the prevention of PLC.

Polycystic ovarian syndrome elevates the distress of sexual pain in Iranian women with infertility.

BACKGROUND: Sexual dysfunction may lead to sexual distress in women with infertility, while polycystic ovarian syndrome (PCOS) may escalate this distress. This study aimed to investigate the role of PCOS in the relationship between sexual dysfunction and sexual distress in Iranian women with infertility. METHODS: The Female Sexual Function Index (FSFI), Female Sexual Distress Scale-Revised (FSDS-R), and Depression and Anxiety modules of the DASS-21 were cross-sectionally investigated in 190 women with infertility (103 women with PCOS and 87 women without PCOS). RESULTS: There were negative correlations between sexual function domains and sexual distress (P < .001) in the total sample. Moderation analysis revealed that higher levels of impaired desire, arousal, and pain elevated sexual distress in the PCOS group. After adjusting for depression and anxiety, only the association between sexual pain and sexual distress was moderated by PCOS condition (P = .008). CONCLUSIONS: The findings suggest that impaired sexual function is associated with increased levels of sexual distress in infertile female patients. Importantly, comorbid PCOS renders patients susceptible to sexual distress where sexual pain is increased. Further research may shed light on the physiological, psychological, and relational aspects of sexual pain and associated distress in infertile female patients with comorbid PCOS.

The Moderating and Mediating Role of Responsive Parenting Behavior in Explaining the Link between Intimate Partner Violence and Posttraumatic Stress Symptoms in Young Children.

Responsive parenting serves an influential role in explaining the link between children's exposure to intimate partner violence (IPV) and children's mental health impairment, but how this occurs is not well elucidated. In some cases, researchers examine parenting as a mediator to explain how IPV leads to maladaptive outcomes (i.e., IPV negatively impacts one's capacity for responsive parenting, which in turn impacts children), whereas others examine moderation in which either the absence of responsive parenting exacerbates adverse outcomes or increased responsive parenting buffers risk. Mediation addresses theoretical questions about how or why IPV leads to maladaptive outcomes, whereas moderation addresses who might be most impacted. However, responsive parenting has rarely, if ever, been tested as both a mediator and moderator of the link between IPV and posttraumatic stress symptoms (PTSS) within the same sample. The current study examined the mediating and moderating role of responsive parenting on physical IPV exposure and child PTSS in a longitudinal sample of 391 children ages 3 to 5 years (M = 4.74, SD = 0.89). Self-report measures of physical IPV exposure, parenting practices, and PTSS were completed by mothers. We found that responsive parenting significantly moderated and mediated the association between physical IPV exposure and child PTSS over time. Studies that include tests of both moderation and mediation are critical for advancing mechanistic insight into the role of parenting in the etiology of mental health impairment in children exposed to IPV.

Use of natural environments is associated with reduced inequalities in child mental wellbeing: A cross-sectional analysis using global positioning system (GPS) data.

Exposure to natural environments may benefit child mental wellbeing whilst offering a lever to reduce health inequalities. However, understanding of these relationships is limited by evidence from indirect measures of exposure. We objectively measured children's direct use of natural environments-and use in low or high physical activity (PA) states-and associated this with their mental wellbeing. We then examined moderation by sex and household income. Using global positioning system and accelerometry data from children (n = 640), we measured mean daily time in natural environments ('total use'), which we stratified by PA level as 'passive use' (sedentary and light PA) and 'active use' (moderate and vigorous PA). Logistic regression associated exposures with dichotomised Strengths and Difficulties Questionnaire outcomes (internalising difficulties; externalising difficulties; prosocial behaviour), with interactions to examine moderation. A 10-minute increase in total use was associated with 10.5 % lower risk of abnormal internalising outcomes (OR: 0.895; 95 % CI 0.809, 0.990), and 13.2 % lower risk of abnormal externalising outcomes (OR: 0.868; 95 % CI 0.776, 0.990). This suggests that âˆ¼ 60 min of daily total use was associated with 50 % lower risk of abnormal internalising and externalising outcomes. The relative effects of passive and active use were equal, but their associations were moderated by income independently for specific outcomes. For externalising outcomes, the risk of abnormal scores in lower-income children reduced as passive use increased (P = 0.027) but remained constant for higher-income children. For prosocial outcomes, the likelihood of normal scores increased with active use in lower-income children, but not higher-income children (P = 0.005). Sex did not moderate these associations. The findings suggest that targeted interventions supporting disadvantaged children to use natural environments could help address inequalities in mental wellbeing. Further, the moderated associations with types of use suggest the equigenic effects of natural environments may operate through multiple pathways.

The Mediating and Moderating Role of Social-Emotional Skills in the Relationship between Sports Participation and Test Anxiety.

PURPOSE: Test anxiety is a prevalent issue among adolescents, prompting a need for effective coping mechanisms. Participation in sports, which is gaining recognition for its crucial role in alleviating test anxiety, may be effective due to its association with social-emotional skills. Moreover, students with diverse levels of social-emotional skills not only experience enjoyment in sports differently but also perceive test anxiety uniquely, leading to varying interpretations of the relationships between them. Due to the lack of direct evidence, therefore, this study aimed to explore the intricate relationships among sports participation, test anxiety, and social-emotional skills. METHODS: Utilizing OECD data from 61,010 participants across 10 locations, all variable measurements were collected through the Survey on Social and Emotional Skills (SSES). RESULTS: The results indicated that social-emotional skills mediated and moderated the relationship between sports participation and test anxiety. However, only lower- and medium-level social-emotional skills significantly weakened the negative correlation between sports participation and test anxiety. CONCLUSION: Social-emotional skills serve a dual function in the relationship between sports participation and test anxiety. Not only do they elucidate why sports participation can alleviate test anxiety, but they also act as regulators, moderating the extent of this alleviation. These findings provide valuable insights for educational interventions, underscoring the importance of sports participation and the cultivation of social-emotional skills in mitigating test anxiety.

Personality Traits and Family SES Moderate the Relationship between Media Multitasking and Reasoning Performance.

The prevalence of media multitasking has raised concerns regarding its potential impact on cognitive abilities. Despite increasing attention given to this topic, there remains no consensus on how media multitasking is related to cognitive performance. This study aims to shed light on this issue by examining whether and how personality traits and family socioeconomic status (SES) moderate the relationship between media multitasking and reasoning performance. To this end, a large sample of university students (n = 777) completed a battery of measures, including the Raven's Advanced Progressive Matrices, the Media Multitasking Inventory, the Big Five Inventory, the Barratt Impulsiveness Scale, the Grit Scale, and the Family SES Questionnaire. Results revealed a negative correlation between media multitasking and reasoning performance. However, this relationship was substantially moderated by conscientiousness, extraversion, openness, and family SES. Specifically, media multitasking was more detrimental to reasoning performance among individuals with lower levels of conscientiousness, extraversion, openness, and family SES, whereas it was less detrimental to counterparts with higher levels of these personality traits and family SES. The proposed moderation model, for the first time, not only offers novel insights into the theoretical accounts regarding how media multitasking relates to cognitive abilities, but also identifies the protective factors that may buffer the negative impacts of media multitasking.

Road congestion and air pollution -Analysis of spatial and temporal congestion effects.

Urban traffic congestion has resulted in several adverse outcomes, including reduced traffic efficiency, increased noise pollution, and heightened exhaust emissions. It has also emerged as a significant indicator of urban health concerns. This article primarily delves into an examination of the pollution stemming from congestion. To accomplish this, the study focuses on two specific aspects of congestion measurement: long-term spatial constraints (limited travel routes) and short-term time delays (time wasted due to congestion). Expanding on this, the article explores the potential solutions to mitigate pollution effects through measures such as optimizing space utilization through public transportation systems like subways and strategically scheduling travel during holidays. These considerations are incorporated within the article's scope. Additionally, in order to address endogeneity concerns, the research conducts instrumental variable effectiveness tests from both temporal and spatial perspectives. The outcomes highlight the degradation of air quality and the increase in total traffic congestion in both the long and short term, while also indicating the presence of genuine methods to alleviate these issues. Consequently, effective collaborative efforts for prevention and control are imperative to combat environmental and traffic pollution. Moreover, optimizing sustainable urban development plans to enhance land utilization plays a pivotal role in minimizing the external costs associated with long-distance commuting.

The contribution of school climate, socioeconomic status, ethnocultural affiliation, and school level to language arts scores: A multilevel moderated mediation model.

Evidence suggests that schools can promote academic success and higher grades by reducing the negative effect of socioeconomic disadvantage through the mediation of a positive climate. However, a critical question largely remains unanswered: Does the mediation of positive school climate on the link between socioeconomic background and academic achievement remain similar for all schools in all cultures and among all ethnic groups? Using a nationally representative database with school climate and language arts test scores of primary and secondary Hebrew and Arabic language schools in Israel (N = 1188), we examined the contribution of both internal (i.e., school climate and grade level) and external (i.e., ethnocultural and socioeconomic backgrounds) influences on schools' language arts test scores. Using multilevel analyses, findings indicated that the magnitude of the mediation of positive school climate, as manifested by a greater sense of security and decreased school violence, in the link between socioeconomic status and test scores was significant only for elementary schools educating Arabic language minority populations and not for nonminority elementary Hebrew language schools. However, this was not the case for secondary schools, where evidence of higher test scores in schools with positive school climate did not emerge. Despite the many socioeconomic obstacles that ethnocultural minority students face, these results indicate that schools prioritizing a positive climate can increase academic opportunities and level the playing field for students from vulnerable cultures and backgrounds. School professionals are encouraged to invest resources that improve school climate to support underprivileged students' prosperity, especially in schools educating students from minoritized backgrounds, where more significant contributions likely exist. Implications for educational policy and future research are discussed.

Dynamics of a dynamic interrelationship: Exploring whether bidirectional learning behaviors-achievement relations differ across student-teacher relationship profiles.

Children who engage more in classroom instruction tend to also have higher levels of academic achievement relative to their peers who engage less. Although research has clearly established an association between such learning behaviors and academic achievement, the directionality of this relationship, and the possibility of bidirectional relations, remain unclear. It is possible that this lack of clarity stems from the fact that interrelationships between achievement and learning behaviors may differ across student-teacher relationship contexts. We evaluated this possibility using a large nationally representative sample of kindergarten to third grade students (N = 2010) from the Early Childhood Longitudinal Study-Kindergarten Cohort of 2011. Using latent profile moderation analyses, we identified three profiles of student-teacher relationships across kindergarten through third grade students: (a) Close (68%), (b) Conflictual (16%), and (c) Uninvolved (16%). Our follow-up models identified bidirectional relations that differed across these profiles, indicating more robust bidirectional learning behavior-achievement interrelationships in the Close profile and more unidirectional achievement to learning behavior relations in the Conflictual and Uninvolved profiles. These findings illustrate how differences in environmental contexts impact the relationship between students' learning behaviors and their achievement. Future studies should consider contextual influences when investigating children's academic growth processes and developing interventions.

Social transition, socioeconomic status and self-rated health in China: evidence from a national cross-sectional survey (CGSS).

Background: Social transition is one of the multi-level mechanisms that influence health disparities. However, it has received less attention as one of the non-traditional social determinants of health. A few studies have examined China's social transition and its impact on health inequality in self-rated health (SRH). Therefore, this study explores the impact of China's market-oriented reforms-social transition and socioeconomic status (SES)-on residents' SRH. Methods: Using the cross-sectional data from the Chinese General Social Survey (CGSS) in 2017, we analyzed the effects of social transition and SES on the SRH of Chinese residents using the RIF (Recentered influence function) method. The RIF decomposition method investigated health differences among different populations and their determinants. Results: Social transition and SES have significant positive effects on the SRH of Chinese residents. The correlation between SES and the SRH of Chinese residents is moderated by social transition, implying that social transition can weaken the correlation between SES and the SRH of Chinese residents. The impacts of SES and social transition on SRH vary across populations. Conclusion: Promoting social transition and favoring disadvantaged groups with more resources are urgently needed to promote equitable health outcomes.

Adherence to Dietary Behavior Recommendations Moderates the Effect Between Time Since Metabolic and Bariatric Surgery and Percentage Total Weight Loss.

PURPOSE: Metabolic and bariatric surgery (MBS) is the gold standard in treating severe obesity. Previous research implies that different psychological and behavior-related factors might be critical for MBS' sustained success. Yet adherence to dietary behavior recommendations and its impact on weight development is rarely examined. This study investigated the relationship between adherence to dietary behavior recommendations and the percentage of total weight loss (%TWL) after MBS. MATERIALS AND METHODS: This study is a cohort study (acquisition in Germany). N = 485 patients after MBS, being in grade III of obesity (body mass index (BMI) ≥ 40 kg/m2) pre-MBS, were included. Participants answered a standardized assessment on the relevant constructs, including adherence to dietary behavior recommendations, depression symptoms, weight, diet, and MBS characteristics. RESULTS: BMI pre-MBS, type of MBS, age, regularity of physical activity, and depression symptoms were identified as significant covariates of %TWL and adherence. Within 6 months after MBS, adherence seems to peak, F(5,352) = 12.35, p < .001. Adherence and time since MBS predict %TWL. A higher adherence (moderator) is related to a higher %TWL, R2 = 52.65%, F(13,344) = 31.54, p < .001. CONCLUSION: After MBS, adherence to dietary behavior recommendations seems crucial for maximizing its success. Implications for the optimization of MBS' success in aftercare management arise. In particular, behavior modification interventions should be routinely implemented.

Cerebrospinal fluid mesencephalic astrocyte-derived neurotrophic factor: A moderating effect on sleep time and cognitive function.

BACKGROUND: Sleeping late has been associated with cognitive impairment, and insufficient sleep can affect the secretion of feeding-related cytokines. Feeding-related cytokines may contribute to cognitive deficits resulting from delayed bedtime. Glial cell line-derived neurotrophic factor (GDNF) and mesencephalic astrocyte-derived neurotrophic factor (MANF), which are feeding-related neurotrophic factors, have been associated with improved cognitive function and neuroprotective abilities. Enhanced expression of GDNF and MANF is linked to increased energy expenditure and hyperphagia, respectively. AIMS: This study aimed to investigate the association between cerebrospinal fluid (CSF) GDNF, MANF, cognition, and sleep time and to explore the moderating effects of GDNF and MANF on cognitive impairment in individuals who sleep late. METHOD: This cross-sectional study included participants (mean age 31.76 ± 10.22 years) who were categorized as ≤23 o'clock sleepers (n = 66) and >23 o'clock sleepers (n = 125) based on sleep time. Cognition was assessed using Montreal Cognitive Assessment (MoCA), and GDNF and MANF levels in CSF were measured. RESULTS: MANF may play a moderating role in the relationship between sleep time and cognition (R2 = 0.06, ß = 0.59, p = 0.031). Age showed a negative correlation with MoCA scores (R2 = 0.08, ß = -0.18), while education exhibited a positive correlation (ß = 0.17, both p < 0.05). Only ≤23 o'clock sleepers exhibited a negative correlation between MANF levels and BMI (r = -0.35, p = 0.005). CONCLUSIONS: This study provides hitherto undocumented evidence of the potential protective effect of CSF MANF on cognitive impairment of late sleepers, which suggests that maintaining a regular sleep schedule may contribute to cognition and overall health, with MANF playing a role in this process.

Originalarbeiten / Original Articles. Die protektive Rolle von Selbstregulation für die gesundheitsbezogene Lebensqualität bei Jugendlichen mit einer chronisch körperlichen Erkrankung / The Protective Role of Self-Regulation for HRQOL of Adolescents with a Chronic Physical Health Condition.

The Protective Role of Self-Regulation for HRQOL of Adolescents with a Chronic Physical Health Condition A physical chronic condition comes with many challenges and negatively impacts the healthrelated quality of life (HRQOL) of those affected. Self-regulation plays an important role in successfully coping with the demands of a chronic condition. In line with a resource-oriented approach, this study aimed to investigate themoderating effect of self-regulation on the relationship between disease severity andHRQOL. For this, 498 adolescents with cystic fibrosis, juvenile idiopathic arthritis, or type-1 diabetes aged of 12-21 years (M= 15.43, SD= 2.07) were recruited through three patient registers. Subjective disease severity, self-regulation (Brief Self-Control- Scale), andHRQOL (DISABKIDSChronicGenericMeasure)were examined at two time points (T1 and T2, one year apart). Cross-sectional analysis showed significant effects of subjective disease severity and self-regulation on HRQOL. Prospective analysis, in which HRQOL at T1 was controlled for, revealed that disease severity only predicted emotion-related HRQOL at T2; selfregulation emerged as a predictor for HRQOL subscales independence, emotion, inclusion, exclusion, and treatment. A significantmoderation effect of self-regulation was found on the relationship between disease severity and HRQOL emotion. Our results highlight the positive impact of self-regulation on quality of life, specifically in the context of chronic conditions and represent a starting point for prevention and intervention approaches.

An exploratory analysis of moderating effects in a non-randomized, quasi-experimental evaluation of a college-based mental health literacy curriculum.

Objective: To assess possible moderating variables that influence the effectiveness of a college-based mental health literacy curriculum, Mental Health Awareness and Advocacy (MHAA). Participants: Students at a Western University in the United States (MHAA treatment group: N = 474; Comparison group: N = 575). Methods: Using a non-randomized, quasi-experimental design over six semesters (2017-2019), students in the treatment and control groups reported on key demographic factors, experiences with mental health, and their knowledge, self-efficacy, and behaviors related to mental health literacy in a pretest/post-test format. Linear mixed effects models were used to assess moderation. Results: MHAA curriculum's efficacy varied based on participants' current depression and anxiety levels, whether they had prior personal experience with a mental health concern, whether they had been diagnosed with a mental health concern, and whether they had experienced suicidal thoughts. Conclusions: Reducing anxiety and depression among students may increase the efficacy of the MHAA program.