Guided by Self‐Determination and associated theories, we examined whether adolescent (, M , 52% female) competence (academic engagement and achievement) were supported by relationships at school and school fit. Aspects of relationships and school fit that were measured included adolescents’ perceptions of each context as promoting autonomy, relatedness and competence. Within a latent‐variable structural equation model, direct and indirect path estimates, standard errors and confidence intervals were produced using maximum likelihood and bootstrapping. Results supported the hypothesized model. As predicted, school fit partially mediated the association between teacher–student relationships and engagement, but fully mediated the association between peer relationships and engagement. Engagement fully mediated the path from school fit to achievement. The use of SEM and bootstrapping are encouraged as the combination of these techniques can increase power to detect direct and indirect effects, and can be a better choice for data that do not conform to normal theory assumptions. Overall, these techniques allowed for more firm conclusions about the importance of a hierarchy of multidimensional contextual experiences for adolescent competence.

Interventions that aim to facilitate shared decision making reduce antibiotic prescribing in primary care in the short term. Effects on longer-term rates of prescribing are uncertain and more evidence is needed to determine how any sustained reduction in antibiotic prescribing affects hospital admission, pneumonia and death.

BackgroundTerminally ill people experience a variety of symptoms in the last hours and days of life, including delirium, agitation, anxiety, terminal restlessness, dyspnoea, pain, vomiting, and psychological and physical distress. In the terminal phase of life, these symptoms may become refractory, and unable to be controlled by supportive and palliative therapies specifically targeted to these symptoms. Palliative sedation therapy is one potential solution to providing relief from these refractory symptoms. Sedation in terminally ill people is intended to provide relief from refractory symptoms that are not controlled by other methods. Sedative drugs such as benzodiazepines are titrated to achieve the desired level of sedation; the level of sedation can be easily maintained and the effect is reversible. ObjectivesTo assess the evidence for the benefit of palliative pharmacological sedation on quality of life, survival, and specific refractory symptoms in terminally ill adults during their last few days of life. Search methodsWe searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2014, Issue 11), MEDLINE (1946 to November 2014, and EMBASE (1974 to December 2014), using search terms representing the sedative drug names and classes, disease stage, and study designs. Selection criteriaWe included randomised controlled trials (RCTs), quasi-RCTs, non-RCTs, and observational studies (e.g. before-and-after, interruptedtime-series) with quantitative outcomes. We excluded studies with only qualitative outcomes or that had no comparison (i.e. no control group or no within-group comparison) (e.g. single arm case series). Data collection and analysisTwo review authors independently screened titles and abstracts of citations, and full text of potentially eligible studies. Two review authors independently carried out data extraction using standard data extraction forms. A third review author acted as arbiter for both stages. We carried out no meta-analyses due to insufficient data for pooling on any outcome; therefore, we reported outcomes narratively.

Poor expectations of recovery, posttraumatic stress symptoms and passive coping emerged as the most consistent prognostic factors of chronic neck pain and/or disability after a whiplash injury. Anxiety, travel anxiety, depression, personality, precollision distress, general psychological distress, and avoidance behavior were not associated with chronic whiplash problems.

Theory suggests that rejection sensitivity, a social cognitive processing style characterised by anxious and angry expectations of rejection, develops from experiences of rejection or acceptance by others. The purpose of this study of 417 children and early adolescents (age 9 to 13) was to examine how relationship experiences are directly and interactively associated with their rejection sensitivity. In a multivariate analysis, there was an association of rejection by parents and by peers with rejection sensitivity, with a stronger association between peer rejection and sensitivity than between parent rejection and sensitivity. Regarding interactive effects, peer rejection was found to have a strong association with rejection sensitivity among participants with low or high parent acceptance, and among those with high friendship satisfaction. Yet, there was evidence of a stronger association between peer rejection and rejection sensitivity among those with low parent acceptance or high friendship quality. This was because rejection sensitivity was highest when peer rejection was high and parent acceptance was low, and sensitivity was lowest when peer rejection was low and friendship quality was high. Findings show how young people's relationships in different domains uniquely co-vary with rejection sensitivity and interact in accounting for angry and anxious expectations of rejection by others.

Perceiving that one is rejected is an important correlate of emotional maladjustment. Yet, self‐perceptions can substantially differ from classmate‐reports of who is rejected. In this study, discrepancies between self‐ and classmate‐reports of rejection were identified in 359 Australian adolescents (age 10–12 years). As expected, adolescents who overestimated rejection reported more rejection sensitivity and felt more victimized by their peers, but were not seen by peers as more victimized. Adolescents who underestimated rejection identified themselves as high in overt aggression, and their peers identified them as high in overt and relational aggression and low in prosocial behavior. Yet, underestimators' feelings of friendship satisfaction did not seem to suffer and they reported low rejection sensitivity. Results suggest that interventions to promote adolescent health should explicitly recognize the different needs of those who do and do not seem to perceive their high rejection, as well as adolescents who overestimate their rejection.

Although many interventions for child externalizing behavior report promising outcomes for families, high attrition prior to program completion remains a problem. Many programs report dropout rates of 50% or higher. In this trial we sought to reduce attrition and improve outcomes by augmenting a well-known evidence-based intervention, Parent-Child Interaction Therapy (PCIT), with a 3-session individual motivational enhancement component. Participants were 192 Australian caregivers (91.7% female; M = 34.4 years) and their children (33.3% female; M = 4.4 years). Families (51% referred from child welfare or health services for risk of maltreatment) were assigned to PCIT or a supported waitlist, with families assigned to PCIT receiving either standard PCIT (S/PCIT) or motivation-enhanced PCIT (M/PCIT), depending on their time of entry to the study. Waitlist families received phone calls every week for 12 weeks. Parents in M/PCIT reported more readiness to change their behavior from preassessment to after the motivation sessions. Also, parents who reported high, rather than low, motivation at preassessment did have a lower attrition rate, and there was some evidence that enhancing motivation was protective of premature attrition to the extent that caregivers achieved a high degree of change in motivation. Yet comparison of attrition rates and survival analyses revealed no difference between M/PCIT and S/PCIT in retention rate. Finally, there were greater reductions in externalizing and internalizing child behavior problems and parental stress among families in S/PCIT and M/PCIT compared with waitlist, and there was generally no significant difference between the two treatment conditions.

Mothers' distress is a correlate of their children's elevated behaviour problems and symptoms. Parenting practices have been shown to mediate these associations, but few studies have observed parenting or focused on parents at risk of child abuse. In this study of 269 high‐risk mothers and their young children (M = 4.2 years), structural equation modelling was used to test associations between mothers' distress and child externalizing and internalizing symptoms. Associations were expected to be partly indirect via mothers' observed low sensitivity, and child gender was expected to moderate associations. Also, mothers' child abuse risk was examined as a unique correlate of sensitivity and children's symptoms, and a moderator of associations of distress with sensitivity and symptoms. Associations showed a pattern of gender‐moderated mediation with the link between mothers' distress and internalizing mostly direct for boys, and equally direct and indirect via sensitivity for girls. The association of mothers' distress with externalizing was mostly direct for boys and girls. Mothers' child abuse risk was not uniquely associated with sensitivity or symptoms and did not moderate any associations. There were no differences in model paths between mothers referred from child welfare/mental health compared with other sources or self‐referred. Copyright © 2013 John Wiley & Sons, Ltd.