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BackgroundExergaming is associated with positive health benefits; however, little is known about what motivates young people to exergame. ObjectiveThis study aimed to develop a new Reasons to Exergame (RTEX) scale and describe its psychometric properties (Study 1) including test-retest reliability (Study 2). We also examined the test-retest reliability of self-report exergaming behavior measures (Study 2). MethodsWe identified scale items in consultation with experts. In Study 1, we conducted an Exploratory Factor Analysis of RTEX and examined how the factors identified relate to exergaming frequency and intensity in a population-based sample of 272 young adults. In Study 2, we examined the test-retest reliability of RTEX factors and self-report measures of past-week exergaming frequency and intensity among 147 college students. ResultsWe identified four factors in RTEX: exergaming for fitness, exergaming for enjoyment, preferring exergaming over other gaming options, and choosing exergaming over competing interests (eg, sports). Test-retest reliability of RTEX factors (ICC 0.7-0.8) and self-report exergaming frequency (ICC 0.4-0.9) was adequate. Exergaming for fitness and enjoyment were positively associated with the frequency of exergaming with friends and family, and with exergaming intensity. Preferring exergaming over other gaming options and choosing exergaming over competing interests (eg, sports) were not related to exergaming behavior. ConclusionsRTEX is a psychometrically sound scale with four factors that measure reasons to exergame. Replication of these findings is needed in larger, more diverse samples.

Introduction: This meta-analysis examined the association between dimensional and categorical conceptualizations of attachment styles and suicidal thoughts and behaviors (STBs). Methods: Random-effects meta-analysis was conducted to examine the associations between categorical secure attachment, categorical insecure attachment, and insecure attachment dimensions and STBs. Methodological moderators were also explored. This protocol was registered in PROSPERO (CRD42020152604). Results: Systematic search for articles published by December 2020 returned 58 eligible studies and 159 cross-sectional effects. Secure attachment was inversely associated with suicidal thoughts and not associated with suicide attempts. All categorical insecure attachment styles were positively associated with suicidal thoughts. Only fearful and preoccupied attachment were associated with risk for suicide attempts. Dimensional attachment anxiety was more strongly associated with suicidal thoughts and attempts than dimensional attachment avoidance. Discussion: Overall, attachment styles characterized by high attachment anxiety were associated with greatest vulnerability to STBs. Longitudinal studies are needed to better understand the association between attachment insecurity and STBs. [ABSTRACT FROM AUTHOR]

Brooding rumination is an intrapersonal emotion regulation strategy associated with negative interpersonal consequences. Resting respiratory sinus arrhythmia (RSA), a psychophysiological marker of self-regulatory capacity, may buffer the association between maladaptive emotion regulation and negative interpersonal behaviors. The current work examines the moderating effect of RSA on the association between brooding rumination and different negative interpersonal consequences. Across three convenience samples, individuals with lower RSA showed a stronger association between brooding rumination and more negative interpersonal behaviors as well as less perception of received instrumental social support (Study 1; n = 154), higher levels of interviewer-rated interpersonal stress (Study 2; n = 42) and a stronger indirect association between brooding rumination and depressive symptoms via daily interpersonal stress (Study 3; n = 222). These findings highlight the negative interpersonal consequences of brooding rumination, particularly among individuals with lower RSA. [ABSTRACT FROM AUTHOR]

Introduction: Robin sequence (RS) is a leading cause of obstructive sleep apnea (OSA) in newborns. Most studies have focused on understanding anatomic factors leading to OSA and changes in apnea–hypopnea index (AHI) on polysomnography (PSG) beyond the neonatal period. This study aims to define age-related OSA features between patients with RS, without RS and healthy controls using PSG-based analyses of respiratory arousal responses and gas-exchange parameters. Design: Retrospective comparison of PSG features in a total of 48 children encompassing three groups: (a) infants with RS (n = 24, <1-year old), (b) non-RS older children (1-2 years old) with severe OSA (obstructive AHI (OAHI) of ≥10 events; n = 12), and (c) control infants and children (0-2 years old) without sleep apnea (OAHI ≤1.5/h, n = 12). We examined OSA sleep-stage specific and position-specific indexes, and the relationship between OSA severity and respiratory arousal indexes (OAHI/respiratory arousal indexes). Results: OSA sleep-stage specific indexes (rapid eye movement [REM] vs non-REM[NREM]) as well as position-specific indexes (supine vs nonsupine) were similar in individuals with and without RS. Relative to the non-RS groups, infants with RS have more sustained hypoxemia (time with SpO2 < 90%) and reduced arousal responses to OSA demonstrated by higher OAHI/respiratory arousal indexes. OAHI/respiratory arousal indexes significantly correlated with the severity of hypoxemia in infants with RS. Conclusion: Infants with RS and OSA show reduced arousal responses to apneic events, which correlates with higher hypoxemia severity. OAHI/respiratory arousal indexes in RS may identify high-risk individuals with upper airway obstruction and reduced arousal protective responses. [ABSTRACT FROM AUTHOR]

Child dental caries (i.e., cavities) are a major preventable health problem in most high-income countries. The aim of this study was to compare the extent of inequalities in child dental caries across four high-income countries alongside their child oral health policies. Coordinated analyses of data were conducted across four prospective population-based birth cohorts (Australia, n = 4085, born 2004; Québec, Canada, n = 1253, born 1997; Rotterdam, the Netherlands, n = 6690, born 2002; Southeast Sweden, n = 7445, born 1997), which enabled a high degree of harmonization. Risk ratios (adjusted) and slope indexes of inequality were estimated to quantify social gradients in child dental caries according to maternal education and household income. Children in the least advantaged quintile for income were at greater risk of caries, compared to the most advantaged quintile: Australia: AdjRR = 1.18, 95%CI = 1.04–1.34; Québec: AdjRR = 1.69, 95%CI = 1.36–2.10; Rotterdam: AdjRR = 1.67, 95%CI = 1.36–2.04; Southeast Sweden: AdjRR = 1.37, 95%CI = 1.10–1.71). There was a higher risk of caries for children of mothers with the lowest level of education, compared to the highest: Australia: AdjRR = 1.18, 95%CI = 1.01–1.38; Southeast Sweden: AdjRR = 2.31, 95%CI = 1.81–2.96; Rotterdam: AdjRR = 1.98, 95%CI = 1.71–2.30; Québec: AdjRR = 1.16, 95%CI = 0.98–1.37. The extent of inequalities varied in line with jurisdictional policies for provision of child oral health services and preventive public health measures. Clear gradients of social inequalities in child dental caries are evident in high-income countries. Policy related mechanisms may contribute to the differences in the extent of these inequalities. Lesser gradients in settings with combinations of universal dental coverage and/or fluoridation suggest these provisions may ameliorate inequalities through additional benefits for socio-economically disadvantaged groups of children. [ABSTRACT FROM AUTHOR]

Objective: Robust evidence exists for the health-enhancing benefits of social support in adults. Inflammatory processes are thought to be an important mechanism linking social support and health risk. Less is known about the relation between social support and chronic inflammation during childhood and adolescence, or when the association emerges during the lifespan. Method: Data from the population-representative 1999 Quebec Child and Adolescent Health and Social (QCAHS) survey were analyzed. Youth aged 9, 13, and 16 years (N = 3613) and their parents answered questions about social support. A subsample (n = 2186) completed a fasting blood draw that was assayed for C-reactive protein (CRP). Findings: Higher social support was significantly associated with lower hs-CRPlog, after controlling for age, sex, body mass index (BMI Z-score), medication use, puberty, ethnoracial status (French-Canadian), smoking, household income, and parental education (F = 25.88, p = <.001, Total R2adj = 10.2%). The association was largely similar for boys and girls, and strengthened with age. Conclusion: Greater social support was linked to lower chronic low-grade inflammation in a large sample of children and adolescents. Effect sizes were small and consistent with prior findings in the adult literature. Importantly, these findings provide evidence that the relation between social support and inflammation emerges early in the lifespan. Future work should consider broader, more encompassing conceptualizations of social support, the role of social media, and prospective trajectories of social support and inflammatory markers. [ABSTRACT FROM AUTHOR]

In children, the mechanisms implicated in deterioration of glucose homeostasis versus reversion to normal glucose tolerance (NGT) remain uncertain. We aimed to describe the natural history of dysglycemia from childhood to late adolescence and to identify its early determinants. We used baseline (8–10 years, n = 630), 1st follow‐up (10–12 years, n = 564) and 2nd follow‐up (15–17 years, n = 377) data from the QUALITY cohort of White Canadian children with parental obesity. Children underwent a 2‐h oral glucose tolerance test at each cycle with plasma glucose and insulin measured at 0/30/60/90/120 min. American Diabetes Association criteria defined dysglycemia (impaired fasting glucose, impaired glucose tolerance or type 2 diabetes). Longitudinal patterns of insulin sensitivity and beta‐cell function were estimated using generalized additive mixed models. Model averaging identified biological, sociodemographic and lifestyle‐related determinants of dysglycemia. Of the children NGT at baseline, 66 (21%) developed dysglycemia without reverting to NGT. Among children with dysglycemia at baseline, 24 (73%) reverted to NGT. In children with dysglycemia at 1st follow‐up, 18 (53%) later reverted to NGT. Among biological, sociodemographic and lifestyle determinants at 8–10 years, only fasting and 2‐h glucose were associated with developing dysglycemia (odds ratio [95% CI] per 1 mmol/L increase: 4.50 [1.06; 19.02] and 1.74 [1.11; 2.73], respectively). Beta‐cell function decreased by 40% in children with overweight or obesity. In conclusion, up to 75% of children with dysglycemia reverted to NGT during puberty. Children with higher fasting and 2‐h glucose were at higher risk for progression to dysglycemia, while no demographic/lifestyle determinants were identified. [ABSTRACT FROM AUTHOR]

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.socscimed.2006.03.019 Byline: Jennifer J. McGrath (a), Karen A. Matthews (b), Sonya S. Brady (c) Keywords: Socioeconomic status; Blood pressure; Cardiovascular; Adolescent; Youth; Neighborhood; USA Abstract: Socioeconomic status (SES) disparities are linked to increased cardiovascular disease risk. Although typically considered an individual or family indicator, SES alternatively can be derived from neighborhood characteristics. Previous research has found both family and neighborhood SES predict laboratory blood pressure responses in youth. The question remains as to whether this SES gradient predicts blood pressure during daily living situations. We evaluated individual versus neighborhood SES and race as predictors of ambulatory blood pressure and heart rate. Participants were recruited from two schools in Pittsburgh, diverse in terms of both race and SES. Adolescents' (N=212, 14.5 years, 50% black) cardiovascular responses were measured at school and home. Individual (parent education, household income) and neighborhood SES indices (derived from 78 census tracts: percentage with high school degree or less, percentage below poverty) were assessed. A neighborhood index of race based on the proportion of blacks in the census tract was also derived as a counterpart to individuals' race. Multi-level modeling indicated neighborhood income predicted systolic blood pressure. Individual race predicted diastolic blood pressure. Individual income and education, and neighborhood race each predicted heart rate. These results have important public health implications as they suggest individual and neighborhood SES and race are linked to cardiovascular risk disparities as early as adolescence. Author Affiliation: (a) Concordia University Montreal, QC, Canada (b) University of Pittsburgh, USA (c) University of California, San Francisco, USA

Objective: This study aimed to examine social gradients in ADHD during late childhood (age 9–11 years) using absolute and relative relationships with socioeconomic status exposure (household income, maternal education) during early childhood (<5 years) in seven cohorts from six industrialised countries (UK, Australia, Canada, The Netherlands, USA, Sweden). Methods: Secondary analyses were conducted for each birth cohort. Risk ratios, pooled risk estimates, and absolute inequality, measured by the Slope Index of Inequality (SII), were estimated to quantify social gradients in ADHD during late childhood by household income and maternal education measured during early childhood. Estimates were adjusted for child sex, mother age at birth, mother ethnicity, and multiple births. Findings: All cohorts demonstrated social gradients by household income and maternal education in early childhood, except for maternal education in Quebec. Pooled risk estimates, relating to 44,925 children, yielded expected gradients (income: low 1.83(CI 1.38,2.41), middle 1.42(1.13,1.79), high (reference); maternal education: low 2.13(1.39,3.25), middle 1.42(1.13,1.79)). Estimates of absolute inequality using SII showed that the largest differences in ADHD prevalence between the highest and lowest levels of maternal education were observed in Australia (4% lower) and Sweden (3% lower); for household income, the largest differences were observed in Quebec (6% lower) and Canada (all provinces: 5% lower). Conclusion: Findings indicate that children in families with high household income or maternal education are less likely to have ADHD at age 9–11. Absolute inequality, in combination with relative inequality, provides a more complete account of the socioeconomic status and ADHD relationship in different high-income countries. While the study design precludes causal inference, the linear relation between early childhood social circumstances and later ADHD suggests a potential role for policies that promote high levels of education, especially among women, and adequate levels of household income over children's early years in reducing risk of later ADHD. [ABSTRACT FROM AUTHOR]