Longitudinal leisure-time physical activity profiles throughout adulthood and related characteristics: a 36-year follow-up study of the older Finnish Twin Cohort.

BACKGROUND: Personalized interventions aiming to increase physical activity in individuals are effective. However, from a public health perspective, it would be important to stimulate physical activity in larger groups of people who share the vulnerability to be physically inactive throughout adulthood. To find these high-risk groups, we identified 36-year leisure-time physical activity profiles from young adulthood to late midlife in females and males. Moreover, we uncovered which anthropometric-, demographic-, lifestyle-, and health-related characteristics were associated with these physical activity profiles. METHODS: We included 2,778 females and 1,938 males from the population-based older Finnish Twin Cohort Study, who responded to health and behavior surveys at the mean ages of 24, 30, 40 and 60. Latent profile analysis was used to identify longitudinal leisure-time physical activity profiles. RESULTS: We found five longitudinal leisure-time physical activity profiles for both females and males. Females' profiles were: 1) Low increasing moderate (29%), 2) Moderate stable (23%), 3) Very low increasing low (20%), 4) Low stable (20%) and 5) High increasing high (9%). Males' profiles were: 1) Low increasing moderate (29%), 2) Low stable very low (26%), 3) Moderate decreasing low (21%), 4) High fluctuating high (17%) and 5) Very low stable (8%). In both females and males, lower leisure-time physical activity profiles were associated with lower education, higher body mass index, smoking, poorer perceived health, higher sedentary time, high blood pressure, and a higher risk for type 2 diabetes. Furthermore, lower leisure-time physical activity was linked to a higher risk of depression in females. CONCLUSIONS: We found several longitudinal leisure-time physical activity profiles with unique changes in both sexes. Fewer profiles in females than in males remained or became low physically active during the 36-year follow-up. We observed that lower education, higher body mass index, and more smoking already in young adulthood were associated with low leisure-time physical activity profiles. However, the fact that several longitudinal profiles demonstrated a change in their physical activity behavior over time implies the potential for public health interventions to improve leisure-time physical activity levels.

The association of adolescent fitness with cardiometabolic diseases in late adulthood: A 45-year longitudinal study.

OBJECTIVES: The aim of this study was to examine the associations of adolescent cardiorespiratory fitness (CRF), muscular fitness (MF), and speed-agility fitness (SA) with middle-aged cardiometabolic disease risk and explore sex differences. METHODS: This 45-year prospective cohort study examined the associations between objectively measured fitness at adolescence (12-19 years) and physician-ascertained diabetes mellitus, elevated blood pressure (BP), and coronary heart disease reported either in early (37-44 years) or late (57-64 years) middle age, and self-measurement of waist circumference (WC) in late middle age. Fitness measurements for healthy adolescents in baseline included CRF (1.5 km [girls] and 2 km [boys] run), MF (standing broad jump, sit-ups, pull-ups [boys], and flexed-arm hang [girls]), and SA (50 m dash and 4 × 10 m shuttle run). Logistic regression and general linear models were adjusted for baseline age, sex, and body mass index (BMI), involving data from baseline and at least one follow-up measurement (N up to 1358, 47% males). RESULTS: Adolescent CRF was inversely, and regardless of adiposity, associated with middle age accumulated burden of cardiometabolic conditions in the whole sample (N = 562, ß = -0.10, 95% confidence intervals [CI] [-0.18, -0.03], p = 0.006), and elevated BP in females (N = 256, OR = 0.71, 95% CI [0.51, 0.91]). Overall, we observed stronger associations in females than in males. An inverse association of adolescent MF and SA with middle-aged WC was observed, but it did not show as consistent associations as with CRF. CONCLUSIONS: In this study, adolescent fitness, particularly CRF, was inversely associated with the burden of cardiometabolic conditions up to 45 years. Promotion of fitness in youth may be beneficial in preventing adulthood cardiometabolic diseases.

Development of the Psychotherapist Character Virtues (PCV) Interview.

OBJECTIVE: To develop an interview-based rating method for assessing therapists' beneficial character traits and evaluate its reliability and validity. METHOD: The semi-structured Psychotherapist Character Virtues (PCV) interview and evaluation method, based on Erik Erikson's and Heinz Kohut's writings on 16 virtues or abilities and achievements of an adult self, was administered to 68 psychodynamic and solution-focused therapists. Inter-rater reliability was assessed based on 20 videorecorded interviews, rated by two evaluators. In a mixed-methods design, validity was investigated against (i) therapist's questionnaire-based self-reported professional and personal background characteristics and (ii) a qualitative content analysis of emotional atmosphere in the interview. RESULTS: Interrater reliability for individual 16 virtues was acceptable (median correlation .72). From individual virtues, three principal components (Creative Will, Empathy, and Love/Care) emerged with good/excellent internal consistency (component determinacies .95, .85, and .90, respectively) and criterion validity with self-reported professional and personal characteristics. Cluster analysis of therapists' component scores yielded six different therapist character profiles. In qualitative analysis, character profiles meaningfully differed in their impact on the interview's emotional atmosphere. CONCLUSION: PCV appears promising for evaluating therapists' character virtues, posited to undergird therapists' sensitive attunement and responsiveness. Further research is needed on PCV's predictive validity for therapeutic relationships and outcomes.

Literacy skills seem to fuel literacy enjoyment, rather than vice versa.

Children who like to read and write tend to be better at it. This association is typically interpreted as enjoyment impacting engagement in literacy activities, which boosts literacy skills. We fitted direction-of-causation models to partial data of 3690 Finnish twins aged 12. Literacy skills were rated by the twins' teachers and literacy enjoyment by the twins themselves. A bivariate twin model showed substantial genetic influences on literacy skills (70%) and literacy enjoyment (35%). In both skills and enjoyment, shared-environmental influences explained about 20% in each. The best-fitting direction-of-causation model showed that skills impacted enjoyment, while the influence in the other direction was zero. The genetic influences on skills influenced enjoyment, likely via the skills→enjoyment path. This indicates an active gene-environment correlation: children with an aptitude for good literacy skills are more likely to enjoy reading and seek out literacy activities. To a lesser extent, it was also the shared-environmental influences on children's skills that propagated to influence children's literacy enjoyment. Environmental influences that foster children's literacy skills (e.g., families and schools), also foster children's love for reading and writing. These findings underline the importance of nurturing children's literacy skills. HIGHLIGHTS: It's known that how much children enjoy reading and writing and how good they are at it correlates ∼0.30, but causality remains unknown. We tested the direction of causation in 3690 twins aged 12. Literacy skills impacted literacy enjoyment, but not the other way around. Genetics influence children's literacy skills and how much they like and choose to read and write, indicating genetic niche picking.

Perceived motor competence in early childhood predicts perceived and actual motor competence in middle childhood.

The study aims were to (1) identify perceived motor competence (PMC) and actual motor competence (AMC) profiles in children at two time points (early and middle childhood) 3 years apart, (2) explore transitions between the profiles from T1 to T2, and (3) investigate how PMC-AMC profiles at T1 differ in their mean values for AMC and PMC variables at T2. PMC was assessed by the pictorial scale of Perceived Movement Skill Competence for young children (PMSC). At T1, AMC was measured with Test of Gross Motor Development-third version (TGMD-3), and at T2, a shortened TGMD-3 was used. To identify the PMC-AMC profiles using latent profile analysis, the Mplus statistical package (version 8.7) was used. For aim 3, the Bolck-Croon-Hagenaars (BCH) method was used. There were 480 children (mean age 6.26 years, 51.9% boys) at T1, 647 children (mean age 8.76 years, 48.8% boys) at T2 (some children were too young to have the PMC assessment at T1), and 292 at both time points. For aim 1, three profiles were identified at each time point for each gender. Boys had two realistic profiles with medium and low levels of PMC-AMC, and an overestimation profile. Girls had a medium realistic profile, an overestimation, and an underestimation profile. The PMC-AMC profile in early childhood predicted the PMC-AMC profile (aim 2) and AMC and PMC variables (aim 3) in middle childhood, especially if a child had low PMC in early childhood. Children with low PMC in early childhood are at risk of low PMC and less AMC development in middle childhood.

A scalable school-based intervention to increase early adolescents' motor competence and health-related fitness.

Schools are key settings for the promotion of students' physical activity, fitness, and motor competence. The purpose of our study was to investigate the efficacy of a 5-month-long intervention program that aimed to increase students' motor competence and health-related fitness during school days. We conducted a quasi-experimental study with 325 Finnish Grade 5 (Mage = 11.26, SD = 0.33) students from five schools. Two schools were allocated to the intervention group and three schools to the control group. The intervention consisted of three components: (a) weekly 20 min session during regular PE lessons, (b) weekly 20 min session during recess, and (c) daily 5-minute-long classroom activity breaks. All activities were designed to systematically develop different elements of motor competence and fitness. The following assessments were conducted at baseline and 5-months: cardiorespiratory fitness levels were measured by 20-meter shuttle run test, muscular fitness by curl-up and push-up tests, and motor competence by 5-leaps and throwing-catching combination tests. We analyzed the data using a multi-group latent change score modeling. Results showed that students in the intervention group developed significantly better in 20-meter shuttle run test (ß = 0.269, p = 0.000, 95% CI [0.141, 0.397]; +5.0 laps), push-up (ß = 0.442, p = 0.000, 95% CI [0.267, 0.617]; +6.5 repetitions), curl-up (ß = 0.353, p = 0.001, 95% CI [0.154, 0.552]; +7.8 repetitions), and throwing-catching combination tests (ß = 0.195, p = 0.019, 95% CI [0.033, 0.356]; +1.1 repetitions) than students in the control group. The intervention program appeared to be feasible and effective in increasing students' cardiorespiratory fitness, muscular fitness, and object control skills. This indicates that guided school-based physical activity programs can be influential in promoting physical fitness and motor competence among early adolescent students.

Associations between student-athletes' self-esteem and career adaptability across the high school years.

The key challenges in sustainable elite sports concern young athletes´ holistic development. Consequently, preparation for dual careers has been recommended to enhance athletes' well-being and equip them for life after sports. The aim of this study was to examine the developmental associations between self-esteem and career adaptability among adolescent athletes across the high school years and investigate the role of gender in these developmental trajectories. A total of 391 student-athletes were followed up four times from the beginning of high school (T1) to its end (T4) using the Dual-Career Form of the Career Adapt-Abilities Scale and the Self-Esteem Questionnaire. The results indicated that individual differences in student-athletes' self-esteem and career adaptability were relatively stable across the high school years and were thus modeled via the between-persons factors capturing differences between individuals across time. The results further showed that the overall levels of self-esteem and career adaptability were positively associated. Males showed higher overall levels of career adaptability and self-esteem than females. This study suggests that it is important to facilitate youth athletes' self-regulation resources by involving them in vocational developmental tasks. Further, gender differences should be considered when supporting student-athletes' development.

Leisure-time physical activity from adolescence to late middle age and its associations with the COVID-19 pandemic: A 45-year follow-up.

We aimed to investigate the association of self-reported leisure-time physical activity (LTPA) over a 45-years from adolescence to late middle age mediated by LTPA in early middle age. We also explored whether LTPA in adolescence and early middle age was associated with change in LTPA during the COVID-19 pandemic. We constructed a path model employing questionnaire data from three LTPA measurements (1976, 2001, 2021) including duplicated assessment for pre- and during COVID-19 in 2021. The direct and indirect associations between LTPA in adolescence, early middle and late middle age were investigated, as well as the impact of previous LTPA on change in late middle age LTPA due to the pandemic. The number of participants per assessment was: n = 2083; n = 1468 (71% of the original); n = 878 (42%) and n = 867 (42%), respectively. However, the number varied depending on the path examined. LTPA in adolescence was associated with LTPA in late middle age, although the association was not strong. LTPA decreased significantly during the pandemic. Earlier LTPA was associated with change in LTPA between before and during COVID-19 among males. This study is the first to demonstrate an association between adolescent and late middle age LTPA. However, the association across the 45-years was low.

Passing the test of motherhood? Self-esteem development and birth experience in the transition to motherhood: A longitudinal mixed methods study in Finland.

AIMS: To investigate women's childbirth experiences and their relation to self-esteem development in the postpartum year. DESIGN: A mixed methods study. METHODS: Women (N = 125) completed survey questionnaires regarding their self-esteem and childbirth experiences at three time points in 2020-2021: third trimester of pregnancy (T1), 4-8 weeks postpartum (T2) and 1 year postpartum (T3). The survey results were analysed using qualitative thematic and quantitative path analyses with latent change factors. The open-ended answers of the women who demonstrated a change in self-esteem between T2 and T3 were then compared. The STROBE checklist was used as the reporting guideline. RESULTS: The quantitatively measured childbirth experiences predicted statistically significantly and positively the changes in self-esteem in the following year. The women described their childbirth stories through three main themes: childbirth as a lived experience, childbirth as a relational event and childbirth as a medical event. On the basis of the thematic analysis, we propose that the relationship between childbirth experience and self-esteem development might only hold for women with extremely positive or negative childbirth experiences. There were mixed results for those women who had mixed experiences, indicating that other factors probably contributed to the changes in self-esteem. CONCLUSION: Childbirth is a pivotal event that may have lasting effects on the mother's self-esteem after childbirth. Especially women with traumatic experiences deserve attention because they are at risk of the most negative consequences. IMPACT: Perinatal services and policy makers must recognize the importance of childbirth experiences in women's well-being and improve their practices. Different cultural models of childbirth should be recognized and supported to facilitate good experiences and prevent traumatic ones. PATIENT OR PUBLIC CONTRIBUTION: Service users recruited in Finnish Child Health Centers responded to surveys that were used as data for this study.

The role of self-esteem on fear of childbirth and birth experience.

OBJECTIVE: Fear of childbirth (FOC), also referred to as tokophobia, can have detrimental consequences for a woman's well-being during pregnancy and for their subjective birth experience. However, it is unknown what role self-esteem plays in the relationship between FOC and the experience of childbirth. This study investigates the relation between FOC and the birth experience, and the role of self-esteem in that relation. METHODS: We studied 125 nulliparous and parous Finnish women from their third trimester of pregnancy to 4-8 weeks postpartum. Path analysis with MLR estimation was conducted using MPlus to predict the childbirth experience according to prior self-esteem and fear of childbirth as well as their interaction. Also, age and parity were included as predictors of the birth experience, as well as their interactions with self-esteem. FOC was measured with the Wijma Delivery Expectancy/Experience Questionnaire - version A (W-DEQ-A), self-esteem with the Rosenberg Self-Esteem Scale (RSES), and birthing experience with the Delivery Satisfaction Scale (DSS). RESULTS: We found that self-esteem moderated the association between fear of childbirth and the subjective birth experience: the lower the self-esteem, the stronger the negative connection between FOC and the birth experience; and, reversely, the higher the self-esteem, the weaker the connection between FOC and the birth experience. CONCLUSIONS: The results highlight intra-group differences between fearful women and contribute to theory formation. They can be used in clinical practice and when planning interventions to reduce negative birth experiences.

Dampness and student-reported social climate: two multilevel mediation models.

BACKGROUND: Little previous research has analysed the relationship between schools' indoor air problems and schools' social climate. In this study, we analysed a) whether observed mould and dampness in a school building relates to students' perceptions of school climate (i.e. teacher-student relationships and class spirit) and b) whether reported subjective indoor air quality (IAQ) at the school level mediates this relationship. METHODS: The data analysed was created by merging two nationwide data sets: survey data from students, including information on subjective IAQ (N = 25,101 students), and data from schools, including information on mould and dampness in school buildings (N = 222). The data was analysed using multilevel mediational models. RESULTS: After the background variables were adjusted, schools' observed mould and dampness was not significantly related to neither student-perceived teacher-student relationships nor class spirit. However, our mediational models showed that there were significant indirect effects from schools' observed mould and dampness to outcome variables via school-level subjective IAQ: a) in schools with mould and dampness, students reported significantly poorer subjective IAQ (standardised ß = 0.34, p < 0.001) than in schools without; b) the worse the subjective IAQ at school level, the worse the student-reported teacher-student relationships (ß = 0.31, p = 0.001) and class spirit (ß = 0.25, p = 0.006). CONCLUSIONS: Problems in a school's indoor environment may impair the school's social climate to the degree that such problems decrease the school's perceived IAQ.

Students' school-level symptoms mediate the relationship between a school's observed moisture problems and students' subjective perceptions of indoor air quality.

Moisture damage can influence the subjective assessment of indoor air quality (subjective IAQ) in various ways. We studied whether the frequency of symptoms reported across students at school level mediates the relationship between observed mold and dampness in a school building and students' subjective IAQ. To answer this research question, we tested a multilevel path model. The analyzed data were created by merging two nationwide data sets: (a) survey data from students, including information on subjective IAQ (N = 24,786 students); (b) data from schools, including information on mold and dampness in a school building (N = 222). After the background variables were adjusted, schools' observed mold and dampness were directly and significantly related to poor subjective IAQ (standardized beta (ß)= 0.22, P = .002). In addition, in schools with mold and dampness, students reported significantly more symptoms (ß = 0.22, P = .023) than in schools without; the higher the prevalence of symptoms at school level, the worse the students' subjective IAQ (ß = 0.60, P < .001). This indirect path was significant (P = .023). In total, schools' observed mold and dampness and student-reported symptoms explained 52% of the between-school variance in subjective IAQ.

Life-course leisure-time physical activity trajectories in relation to health-related behaviors in adulthood: the Cardiovascular Risk in Young Finns study.

BACKGROUND: Evidence on whether leisure-time physical activity (LTPA) facilitates individuals' adoption of multiple healthy behaviors remains scarce. This study investigated the associations of diverse longitudinal LTPA trajectories from childhood to adulthood with diet, screen time, smoking, binge drinking, sleep difficulties, and sleep duration in adulthood. METHODS: Data were drawn from the Cardiovascular Risk in Young Finns Study. Participants were aged 9-18 years (N = 3553; 51% females) in 1980 and 33-49 years at the latest follow-up in 2011. The LTPA trajectories were identified using a latent profile analysis. Differences in self-reported health-related behaviors across the LTPA trajectories were studied separately for women and men by using the Bolck-Croon-Hagenaars approach. Models were adjusted for age, body mass index, education level, marital status, total energy intake and previous corresponding behaviors. RESULTS: Persistently active, persistently low-active, decreasingly and increasingly active trajectories were identified in both genders and an additional inactive trajectory for women. After adjusting the models with the above-mentioned covariates, the inactive women had an unhealthier diet than the women in the other trajectories (p <  0.01; effect size (ES) > 0.50). The low-active men followed an unhealthier diet than the persistently and increasingly active men (p <  0.01; ES > 0.50). Compared to their inactive and low-active peers, smoking frequency was lower in the increasingly active women and men (p <  0.01; ES > 0.20) and persistently active men (p <  0.05; ES > 0.20). The increasingly active men reported lower screen time than the low-active (p <  0.001; ES > 0.50) and persistently active (p <  0.05; ES > 0.20) men. The increasingly and persistently active women reported fewer sleep difficulties than the inactive (p <  0.001; ES > 0.80) and low-active (p <  0.05; ES > 0.50 and > 0.80, respectively) women. Sleep duration and binge drinking were not associated with the LTPA trajectories in either gender, nor were sleep difficulties in men and screen time in women. CONCLUSIONS: Not only persistently higher LTPA but also an increasing tendency to engage in LTPA after childhood/adolescence were associated with healthier diet and lower smoking frequency in both genders, having less sleep difficulties in women and lower screen time in increasingly active men. Inactivity and low activity were associated with the accumulation of several unhealthy behaviors in adulthood. Associations were stronger in women.

Leisure Reading (But Not Any Kind) and Reading Comprehension Support Each Other-A Longitudinal Study Across Grades 1 and 9.

This study examines associations between leisure reading and reading skills in data of 2,525 students followed from age 7 to 16. As a step further from traditional cross-lagged analysis, a random intercept cross-lagged panel model was used to identify within-person associations of leisure reading (books, magazines, newspapers, and digital reading), reading fluency, and reading comprehension. In Grades 1-3 poorer comprehension and fluency predicted less leisure reading. In later grades more frequent leisure reading, particularly of books, predicted better reading comprehension. Negative associations were found between digital reading and reading skills. The findings specify earlier findings of correlations between individuals by showing that reading comprehension improvement, in particular, is predicted by within-individual increases in book reading.

Validity of the Finnish version of the Parental Burnout Assessment (PBA).

The aim of the present study was to validate the Finnish version of the Parental Burnout Assessment (PBA) using data from 1,688 Finnish parents (91% mothers) living in Finland with at least one child living at home. Confirmatory factor analyses supported the theoretical four-factor structure of the PBA - emotional exhaustion in one's parental role, contrast with previous parental self, feelings of being fed up with one's parental role, and emotional distancing from one's children. Internal consistency for the total scale was excellent (Cronbach's alpha ≥ 0.90) and for the subscales from acceptable (alpha ≥ 0.70) to excellent. The results further demonstrated strict factorial invariance of PBA across genders and educational status groups. Finally, the PBA and its four subscales correlated as expected with the three criteria variables (depressive symptoms, sleep disruptions, and self-esteem), the latent factors of all three criteria variables being still clearly unique and separate constructions from parental burnout factors.

The role of resilience in student-athletes' sport and school burnout and dropout: A longitudinal person-oriented study.

Although it has been shown that student-athletes who pursue upper secondary school alongside with an athletic career may be prone to sport and school burnout, the concrete life changes resulting from burning out, such as dropping out of sport or school, have not been investigated. Moreover, it is unknown why some student-athletes do not burnout. The purpose of the present study was to examine whether there are different kinds of profiles-based on the level and development of sport and school burnout symptoms across upper secondary school-that can be identified among student-athletes and how resilience and the likelihood of dropping out from sport or school differ between the profiles. The sample consisted of 491 (49% females) Finnish student-athletes who filled in questionnaires four times during the three years of upper secondary school. The data were analyzed by using growth mixture modeling. Three burnout profiles were identified: (a) Average profile, (b) Increased burnout profile, and (c) Non-risk profile. The profiles differed significantly in terms of student-athletes' resilience and the likelihood of dropping out, as those in the Increased burnout group symptoms were less resilient and more likely to dropout from sport than those in the other two groups. Furthermore, those in the Non-risk profile were more resilient than athletes in the other two groups. The results can be used in teaching student-athletes resilience-related skills which can prevent them from burning out and dropping out from sport and school.

Objectively assessed vigorous physical activity and motor coordination are associated in 11-year old children.

This cross-sectional study examined the associations between gender, sports club (SC) participation, physical activity (PA), motor coordination (MQ) and object control skill (TC). 11 year-old children (n = 477) wore accelerometers during seven consecutive days for the analysis of moderate PA (MPA) and vigorous PA (VPA). To detect motor competence (MC), children's motor coordination was measured using the KTK (MQ), and object control skill with throw-and-catch task (TC). Sports club (SC) status was obtained by a questionnaire. Boys had higher levels of MPA (F = 50.45, P<0.001) and VPA (F = 11.13, P = 0.001), and were better in TC (F = 39.83, P < 0.001) than girls. SC participants outperformed non-participants in MPA (F = 5.45, P = 0.020) and VPA (F = 11.71, P = 0.001), MQ (F = 31.56, P < 0.001), and TC (F = 15.60, P < 0.001). Moreover, better TC was associated with higher MPA (ß = 0.88, t = 2.16, P = 0.031), and higher MQ was associated with higher VPA (ß = 0.21, t = 3.87, P < 0.001). The association between PA and MC was found showing that different intensities of PA were associated with different aspects of MC. SC participation may be one important factor promoting PA and MC in children. Therefore, all children, especially girls, should be encouraged to participate in various practices to ensure the development of adequate level of motor competence to be physically active.

Distinct trajectories of physical activity and related factors during the life course in the general population: a systematic review.

BACKGROUND: In recent years, researchers have begun applying a trajectory approach to identify homogeneous subgroups of physical activity (PA) in heterogeneous populations. This study systematically reviewed the articles identifying longitudinal PA trajectory classes and the related factors (e.g., determinants, predictors, and outcomes) in the general population during different life phases. METHODS: The included studies used finite mixture models for identifying trajectories of PA, exercise, or sport participation. Three electronic databases, PubMed (Medline), Web of Science, and CINAHL, were searched from the year 2000 to 13 February 2018. The study was conducted according to the PRISMA recommendations. RESULTS: Twenty-seven articles were included and organized into three age group: youngest (eleven articles), middle (eight articles), and oldest (eight articles). The youngest group consisted mainly of youth, the middle group of adults and the oldest group of late middle-aged and older adults. Most commonly, three or four trajectory classes were reported. Several trajectories describing a decline in PA were reported, especially in the youngest group, whereas trajectories of consistently increasing PA were observed in the middle and oldest group. While the proportion of persistently physically inactive individuals increased with age, the proportion was relatively high at all ages. Generally, male gender, being Caucasian, non-smoking, having low television viewing time, higher socioeconomic status, no chronic illnesses, and family support for PA were associated either with persistent or increasing PA. CONCLUSIONS: The reviewed articles identified various PA subgroups, indicating that finite mixture modeling can yield new information on the complexity of PA behavior compared to studying population mean PA level only. The studies also provided novel information how different factors relate to changes in PA during life course. The recognition of the PA subgroups and their determinants is important for the more precise targeting of PA promotion and PA interventions. TRIAL REGISTRATION: PROSPERO registration number: CRD42018088120 .

Psychometric properties of the Internet Gaming Disorder Test (IGDT-10) and problematic gaming behavior among Finnish vocational school students.

This study was conducted to investigate the psychometric properties of the Finnish version of the Internet Gaming Disorder Test (IGDT-10), identify the proportion displaying problematic gaming behavior (PGB) among Finnish vocational school students, and characterize the relationships between sociodemographic factors and gaming characteristics predicting PGB in this population. This cross-sectional study involving 773 students (mean age 17.5 years). Socio-demographic and gaming behavior characteristics were established using a web-based survey. A confirmatory factor analysis (CFA) showed that the IGDT-10 test has appropriate psychometric properties. The proportion of students exhibiting PGB based on the DSM-5 cut-off threshold was 1.3%. Regression analysis showed that male gender, preference for gaming on a personal computer, gaming time, poor self-perceived health status, and a preference for the solo and multiplayer online battle arenas (MOBA) game genres related positively to PGB scores. These findings demonstrate the appropriateness of the IGDT-10 test for the assessment of problematic gaming among adults, and support further research on PGB in Finland.

Predictors of Participation and Autonomy in People With Multiple Sclerosis.

IMPORTANCE: Because multiple sclerosis (MS) affects many life areas, it is important to know how participation and autonomy are associated with the perceived impact of MS on everyday life. OBJECTIVE: To investigate how perceived quality of life, disease impact, gender, and disease severity predict participation and autonomy in people with MS. DESIGN: Cross-sectional study in which structural equation modeling was used to evaluate relationships between measured variables. SETTINGS: Outpatient clinics in three areas and one inpatient rehabilitation center in Finland. PARTICIPANTS: Convenience sample of 194 people with MS. OUTCOMES AND MEASURES: Participants completed the Impact on Participation and Autonomy (IPA), the World Health Organization Quality of Life-Brief measure (WHOQOL-BREF), and the Multiple Sclerosis Impact Scale (MSIS-29). The Expanded Disability Status Scale (EDSS) was administered by a neurologist. RESULTS: The final model showed good fit to the data. All the goodness-of-fit indexes except χ² supported the model, χ²(30, N = 194) = 46.729, p < .026; comparative fit index = .983; Tucker-Lewis index = .969; root mean square error of approximation = .054; standardized root mean square residual = .039. Quality of life (WHOQOL-BREF) and the impact of multiple sclerosis (MSIS-29) were the main predictors of participation and autonomy. Disease severity influenced only the IPA Autonomy Indoors domain. Gender was not associated with participation and autonomy. CONCLUSION AND RELEVANCE: Experiences of participation and autonomy appear to be closely associated with perceived quality of life and impact of the disease. Findings support the importance of assessing participation and autonomy and planning interventions using this information. WHAT THIS ARTICLE ADDS: The IPA appears to be an appropriate measure for assessing participation and autonomy and planning occupational therapy interventions for people with MS. In particular, environmental factors affecting participation and autonomy should be considered when planning interventions to promote participation and autonomy.