The dominant position of esports game publishers is a fundamental difference between the systemic governance of esports and traditional sports. There are no such equivalent organizations in traditional sports. As for-profit corporations, the publishers develop and market the electronic games as their commercial products and thus, possess exclusive property rights. Publishers control the virtual sporting environment and the rules of the game. In conventional sports, by contrast, non-profit associations administer their sports with the core task of developing the sport by regulations, playing rules, and licensing. There are, however, esports associations which resemble traditional leagues and national governing bodies. Given this, we explore how esports associations pursue legitimacy. This study is empirically motivated by the recent emergence of two esports associations in the insightful case of Germany and examines the pursuit of legitimacy by the World Esports Association (WESA) and the eSport-Bund Deutschland e.V. (ESBD). The study is based on a content analysis of 55 documents and nine interviews with relevant stakeholders. The findings show that the esports associations rely on conformance and manipulation strategies by transferring existing structures from traditional sports to esports. The most effective practices are lobbying for social and public acceptance of esports and creating supportive networks for esports development. While publishers possess an undisputed and taken-for-granted legitimacy based on their product property rights, esports associations struggle for recognition and acceptance. They may still have a long way to go, given that established associations in conventional sports have a history for decades. Yet, esports associations need to accept publisher dominance. Thus, they can only claim partial legitimacy within the esports ecosystem by targeting segments of stakeholders. Management, policy and theoretical implications of this key insight are finally presented.

Physical and psychological effects of playing computer games cannot be ignored. Electronic games are considered to be an influential factor in growth, personality development, and positive sociability of children, and game duration has been associated with increased aggression, reduced mental health, and higher BMI. The aim of the present study was to explore the relationship between electronic gaming and health, social relationships, and physical activity among males aged 16-18 years in Saudi Arabia. An online survey designed by the authors containing 60 items and divided into 5 sections was used during one school semester. The sample was selected randomly from 30 high schools; 90 students were selected from each school, with 30 chosen from each of grades 9, 10, and 11. Respondents were 194 male students, aged 17.23 ± 1.52 years. The questionnaire was presented to six experts to assess validity, with Cronbach\'s α established at 0.87. Results showed that playing electronic games had a negative relation with health, social relationships, and physical activity among males. The most negative significant was the correlation between electronic games and physical activity (r = -.49), followed by that with social relationships (r = -.42) and BMI (r = -.31) . The lowest result was for health (r = .20). More empirical investigations are needed to explore deeper effects of electronic gaming on various groups in Saudi society, including the general population, employees, and different categories of school and university students.

BACKGROUND: Researchers and therapists have increasingly turned to digital games for new forms of treatments and interventions for people suffering from a variety of mental health issues. Yet, the depiction of mental illness within digital games typically promotes stigmatized versions of those with mental health concerns. Recently, more games have attempted to implement more realistic and respectful depictions of mental health conditions.
OBJECTIVE: This paper presents an exploratory analysis of a contemporary game that has the potential to change the way researchers, practitioners, and game designers approach topics of mental health within the context of gaming.
METHODS: A case study of Hellblade: Senua\'s Sacrifice was conducted using frame analysis to show how key design choices for this game present the potential for new ways of approaching games and mental health.
RESULTS: A case study of Hellblade\'s development shows how research-informed collaborative design with mental health practitioners, scientists, and individuals with mental health problems can lead to a realistic depiction of mental illness in games. Furthermore, the use of frame analysis demonstrates how to harness narrative, mechanics, and technology to create embodied experiences of mental health, which has the potential to promote empathetic understanding.
CONCLUSIONS: This paper highlights an exemplary case of collaborative commercial game design for entertainment purposes in relation to mental health. Understanding the success of Hellblade\'s depiction of psychosis can improve serious games research and design. Further research must continue to provide deeper analysis of not only games that depict mental illness, but also the design process behind them.

Adolescents spend a substantial and increasing amount of time using digital media (smartphones, computers, social media, gaming, Internet), but existing studies do not agree on whether time spent on digital media is associated with lower psychological well-being (including happiness, general well-being, and indicators of low well-being such as depression, suicidal ideation, and suicide attempts). Across three large surveys of adolescents in two countries (n = 221,096), light users (<1 h a day) of digital media reported substantially higher psychological well-being than heavy users (5+ hours a day). Datasets initially presented as supporting opposite conclusions produced similar effect sizes when analyzed using the same strategy. Heavy users (vs. light) of digital media were 48% to 171% more likely to be unhappy, to be in low in well-being, or to have suicide risk factors such as depression, suicidal ideation, or past suicide attempts. Heavy users (vs. light) were twice as likely to report having attempted suicide. Light users (rather than non- or moderate users) were highest in well-being, and for most digital media use the largest drop in well-being occurred between moderate use and heavy use. The limitations of using percent variance explained as a gauge of practical impact are discussed.

BACKGROUND: Video and hobby gaming are immensely popular among adults; however, associations between gaming and health have primarily been investigated in children and adolescents. Furthermore, most research has focused on electronic gaming, despite traditional hobby gaming gaining prominence.
OBJECTIVE: To determine whether the number of platforms used, platform preference, and gaming time are associated with obesity, physical activity, sedentary behavior, and cardiovascular risk factors in an adult gaming population.
METHODS: We conducted a cross-sectional analysis using data obtained from 292 participants who attended a large Midwestern gaming convention. We collected data using a computer-based questionnaire that comprised questions on gaming behavior, demographics, physical activity (using the International Physical Activity Questionnaire), and health characteristics. In addition, we used multivariable-adjusted linear and logistic regression to model health outcomes as a function of the number of platforms used, platform preference, and weekday and weekend gaming time quartile.
RESULTS: After adjusting for covariates, we observed a significant linear trend for increasing odds of being obese and higher weekend sitting time by the number of platforms used (P=.03 for both). The platform preference and weekend gaming time quartile exhibited significant associations with odds of meeting physical activity recommendations (P=.047 and P=.03, respectively). In addition, we observed higher odds of being obese among those reporting that they sat most or all of the time while gaming [odds ratio (OR) 2.69 (95% CI 1.14-6.31) and OR 2.71 (95% CI 1.06-6.93), respectively].
CONCLUSIONS: In adult gamers, the number of platforms used, which platforms they prefer to play on, and the amount of time spent gaming on weekends could have significant implications for their odds of being obese and meeting physical activity recommendations.

This investigation explored the contribution of extracurricular sport and screen time viewing (television viewing and electronic gaming) to personality trait stability and change during childhood. Two independent samples of 3,956 young children (age 6) and 3,862 older children (age 10) were taken from the Longitudinal Study of Australian Children. Parent-reported child sport participation, screen time, and personality traits were measured at baseline and again 24 months later. Young children who were more active recorded more of a decrease in introversion, less of a decrease in persistence, and less of an increase in reactivity, than those who were less active. Older children who were more active recorded less of an increase in introversion and more of an increase in persistence than those who were less active. In addition, young children who continued participation in extracurricular sport had greater intra-individual stability of personality for introversion. These finding suggest that an active lifestyle might help to facilitate desirable personality trait stability and change during childhood.