"It Is Scary, but Then I Just Do It Anyway": Children's Experiences and Concerns about Risk and Challenge during Loose Parts Play.

Children's risky play opportunities depend on supervising adults' attitudes and the play environment. The possibilities to engage in risk-taking outdoor play for children have seriously decreased over the last few decades, due to safety concerns and adults' preoccupation with protection. In response to this shift, research has increasingly focused on influencing factors on professional attitudes toward risk-taking in children's play. However, children's perspective on risky play is underrepresented in the recent literature. This study generates awareness of children's risky play preferences and interests to help professional caretakers hone their facilitating role. We explored children's notions of risk and challenge in play during a loose parts intervention stimulating risky play and facilitated by after-school childcare practitioners. A thematic analysis examined observations, informal conversations, and roundtable talks with children about their risky play experiences. Children describe their risk-taking in play as experimental and daring. The findings report on children's general views on risky play, their play experiences with loose parts, their real-life risky play experiences, and their opinions on the role of practitioners. By relating the results to risky play research and self-determination theory, this study offers insight into children's innate needs. Taking risks on their own terms gives children a sense of self-confidence and mastery, and forces them into new relationships with other children and guiding adults. Consequently, children fulfill the three universal needs of self-determination theory: autonomy, competence, and relatedness.

Research Priorities for Health Care Chaplaincy in The Netherlands: A Delphi Study Among Dutch Chaplains.

The aim of this study was to identify research priorities for health care chaplaincy in The Netherlands according to practicing chaplains and chaplaincy leaders. To this end, a two-round Delphi study was conducted. The first round in which participants were asked to list at least three research priorities was completed by 249 respondents. Through content analysis, the resulting 811 priorities were merged into 54 research topics in 10 domains. In the second round, 179 respondents ranked these topics on a Likert scale from 1 to 5 (low priority-high priority) from the perspective of the patient/client, the organization, and the profession. Based on the mean score of each topic, five research priorities were identified: (a) to investigate the effect of chaplain care according to the patient/client; (b) to determine the patients'/clients' need(s) for chaplaincy; (c) to investigate the effect of chaplain care on the patient/client; (d) to identify possibilities for chaplaincy practice in outpatient care; and (e) to investigate how to develop a stronger profile for chaplaincy in The Netherlands. These priorities resonate with research on this topic from other countries and indicate directions for future research efforts to improve chaplaincy care.

Taking stock of self-control: a meta-analysis of how trait self-control relates to a wide range of behaviors.

Given assertions of the theoretical, empirical, and practical importance of self-control, this meta-analytic study sought to review evidence concerning the relationship between dispositional self-control and behavior. The authors provide a brief overview over prominent theories of self-control, identifying implicit assumptions surrounding the effects of self-control that warrant empirical testing. They report the results of a meta-analysis of 102 studies (total N = 32,648) investigating the behavioral effects of self-control using the Self-Control Scale, the Barratt Impulsiveness Scale, and the Low Self-Control Scale. A small to medium positive effect of self-control on behavior was found for the three scales. Only the Self-Control Scale allowed for a fine-grained analysis of conceptual moderators of the self-control behavior relation. Specifically, self-control (measured by the Self-Control Scale) related similarly to the performance of desired behaviors and the inhibition of undesired behaviors, but its effects varied dramatically across life domains (e.g., achievement, adjustment). In addition, the associations between self-control and behavior were significantly stronger for automatic (as compared to controlled) behavior and for imagined (as compared to actual) behavior.

Late-onset PTSD in unaccompanied refugee minors: exploring the predictive utility of depression and anxiety symptoms.

Following resettlement in Western countries, unaccompanied refugee minors (URM) are at risk of developing posttraumatic stress disorder (PTSD). It is unclear to what extent PTSD in this group may become manifest at later stages following resettlement and which factors are associated with late onset. We examined data from URM collected 1 (T1) and 2 years (T2) following resettlement for differences between groups with no PTSD, PTSD at T1, and late-onset PTSD (at T2 only) using multinomial regression and path analysis. Of the children and adolescents (ages 12-18) completing both assessments (N = 554), 223 (40%) met criteria for PTSD at T1, and 88 (16%) endorsed late-onset PTSD. Late-onset PTSD was associated with traumatic event exposure, older age, and low education. In the late-onset PTSD group, the predictive effects of traumatic event exposure on symptom severity at T2 were fully mediated by depression and anxiety symptoms at T1. These results suggest that late-onset PTSD is a clinically relevant problem among URM that may be heralded by early depression and anxiety symptoms.

A model of resilience and meaning after military deployment: personal resources in making sense of war and peacekeeping experiences.

The aim of the present study was to examine whether the specific personal resources of self-esteem, optimism and perceived control, combined in the latent variable called 'resilience', were associated with cognitive processing of war-zone experiences. Data were collected by questionnaires from a sample of 1.561 veterans who had participated in various war or peacekeeping operations. Structural equation modelling was performed to assess the expected relationships between the observed and latent variables. The construct of resilience was well-defined and proved to be strongly associated with both construals of meaning, comprehensibility versus personal significance, after military deployment. According to our model, higher resilience predicted less distrust in others and the world, more personal growth and less intrusions and avoidance after military deployment.

Schizophrenia and 1957 pandemic of influenza: meta-analysis.

Maternal influenza during pregnancy is a controversial risk factor for schizophrenia in the child. We conducted a meta-analysis to examine whether birth during the 9-month period after the pandemic of 1957 was a risk factor for schizophrenia. Studies that compared the risk of schizophrenia among subjects born after the pandemic with that among those born in corresponding time periods in surrounding years were divided into those conducted in the United States, Europe, or Australia (type A studies, n = 8) and those from Japan, where the epidemic came in 2 waves (type B studies, n = 3). Other studies examined the risk among subjects born to mothers who were pregnant during the pandemic and reported having had influenza (type C studies, n = 2). Relative risks (RRs) were extracted or calculated for each month and/or trimester of possible exposure by 2 independent authors. All analyses were performed using a fixed-effects model. The weighted results of the type A studies did not indicate a significantly increased risk of schizophrenia among children exposed during any trimester or month of prenatal life. Not a single study found a significant first- or second-trimester effect. The mean weighted RR for subjects who were in their first, second, or third trimester of prenatal life during the pandemic (8 effect sizes) was 0.91 (95% confidence interval [CI]: 0.85-0.98), 1.00 (95% CI: 0.93-1.07), and 1.05 (95% CI: 0.98-1.12), respectively. The pooled results of the type B and type C studies were also negative. Given high infection rates during the pandemic (about 50%), these results do not support the maternal influenza hypothesis.

Brain volume abnormalities in major depressive disorder: a meta-analysis of magnetic resonance imaging studies.

OBJECTIVE: So far, there have been no attempts to integrate the growing number of all brain volumetric magnetic resonance imaging studies in depression. In this comprehensive meta-analysis the magnitude and extent of brain volume differences between 2,418 patients with major depressive disorder and 1,974 healthy individuals from 64 studies was determined. METHODS: A systematic research was conducted for volumetric magnetic resonance imaging studies of patients with major depressive disorder in relation to healthy control subjects. Studies had to report sufficient data for computation of effect sizes. For each study, the Cohen's d was calculated. All analyses were performed using the random effects model. Additionally, meta-regression analyses were done to explore the effects of potential sources of heterogeneity. RESULTS: Patients showed large volume reductions in frontal regions, especially in the anterior cingulate and orbitofrontal cortex with smaller reductions in the prefrontal cortex. The hippocampus, the putamen and caudate nucleus showed moderate volume reductions. CONCLUSIONS: This is the first comprehensive meta-analysis in major depressive disorder demonstrating structural brain abnormalities, particularly in those brain areas that are involved in emotion processing and stress-regulation.

Relations among peritraumatic dissociation and posttraumatic stress: a critical review.

This paper critically reviews the empirical literature addressing the relationship of peritraumatic dissociation to posttraumatic stress. PSYCHLIT and MEDLINE literature searches were conducted to identify relevant studies. The list of articles generated was supplemented by a review of their bibliographies, which resulted in a total of 53 empirical studies. These studies were classified according to the type of potentially traumatizing event investigated and discussed. In the majority of studies, evidence was found for a positive association between peritraumatic dissociation and posttraumatic stress. However, research in this area is limited by several methodological differences and shortcomings with respect to study design, sample characteristics, measurement instruments, and control for moderating or mediating variables. In addition, research is also limited by conceptual problems and the lack of specific time parameters for the occurrence of peritraumatic dissociation. The literature is evaluated according to these methodological differences or shortcomings, and directions for future research are provided.

The Odor Awareness Scale: a new scale for measuring positive and negative odor awareness.

The Odor Awareness Scale (OAS) is a questionnaire designed to assess individual differences in awareness of odors in the environment. The theory that odor awareness can be distinguished in awareness of negative (to be avoided) odors and positive (to be approached) odors was tested using confirmatory factor analysis (CFA) on the 34-item questionnaire after completion by 525 respondents. CFA (after deletion of 2 items) showed good fit of the 2-factor theory, resulting in a positive awareness subscale (11 items, Cronbach's alpha = .77) and a negative awareness subscale (21 items, Cronbach's alpha = .80). Furthermore, reports of sickness from environmental odors were correlated with the negative odor awareness factor, not the positive odor awareness factor. Respondents scoring high on the overall sum score of the OAS showed significantly better olfactory performance on an odor perception test battery than respondents with a low score. These results suggest a causal relation between awareness of potentially negative odors, olfactory performance and experiencing health effects from environmental odor exposure, that warrants further investigation.

Relations among peritraumatic dissociation and posttraumatic stress: a meta-analysis.

A meta-analysis was performed on the empirical literature which addressed the relationship of peritraumatic dissociation to posttraumatic stress (PTS). Extensive literature searches were conducted to identify as many relevant studies as possible, and revealed 59 independent eligible studies. All studies were coded using a detailed code sheet that included effect measures, variables that indicated the methodological quality of the studies, and substantial variables that might theoretically affect the relationship between peritraumatic dissociation and PTS. A significant positive relation between peritraumatic dissociation and PTS was found. Differences in the methodological rigor between studies - time elapsed since peritraumatic dissociation, design, sample type, and study type - significantly and sufficiently explained the variability in effect sizes between studies. Theoretical variables did not explain such variability. Although results underline earlier findings, due to designs of the reviewed studies no conclusions could be drawn as to causal relations between peritraumatic dissociation and PTS.

Functional status in 5 to 7-year-old children with Down syndrome in relation to motor ability and performance mental ability.

PURPOSE: To examine the contribution of motor ability and 'performance' mental ability on functional skills in children with Down syndrome (DS). METHOD: A structural equation modelling approach was used to test the relation between motor ability, performance mental ability and functional status. Functional status was assessed with the Pediatric Evaluation Disability Inventory (PEDI), motor ability with the Movement Assessment Battery for Children (M-ABC), and performance mental ability was assessed with the Gross-Form Board (GFB). Sixty-five children with DS, selected by the Dutch Down Syndrome Foundation, were asked to participate in the study. Data were analysed with the programme AMOS using the Bollen-Stine bootstrap method. Chi2 and NFI index were used as goodness-of-fit indices. RESULTS: The fit of the model was good (chi2 4 = 1.35, p = 0.85; and NFI = 0.99). 'Functional status' explained 70% of the variance in the model. Standardized regression weights indicated that motor ability was a far better predictor of functional status of children with DS than performance mental ability (0.96 vs. 0.17). CONCLUSIONS: Limitations in functional activities of 5 to 7-year-old children with Down syndrome seem to be more related to the level of motor ability than to the level of performance mental ability.

Modeling individual and physical environmental factors with adolescent physical activity.

BACKGROUND: Recent calls have been made to consider both environmental factors and individual-level factors in the explanation of physical activity (PA). The present study tested a conceptual model that integrated past PA, relevant environmental-level and individual-level factors and their associations with adolescent PA, using the tenets of the Theory of Planned Behavior (TPB). METHODS: Data were gathered in an adolescent sample (n=221; 60% girls) using questionnaires. PA was assessed in May 2003 and November 2003. Theory of Planned Behavior cognitions regarding PA and the environmental factors under study were assessed in November 2003. Confirmatory factor analyses and path analyses were performed using AMOS software. RESULTS: The initial structural model did not provide an acceptable fit to the data. Including a direct path from past PA to current PA significantly improved model fit to an acceptable fit. Including a direct path from past PA to environmental perceptions did not significantly improve model fit. Including a direct path from the environmental variables to current PA did not significantly improve model fit. Current PA was most strongly influenced by past PA, while environmental aesthetics and distance to PA opportunities were indirectly related to adolescents' intention to be physically active. Significant standardized path coefficients ranged from 0.14 to 0.34 and explained 17% variance in current PA. CONCLUSIONS: Combining past PA, Theory of Planned Behavior cognitions, and environmental factors increased our understanding of their relative influences on adolescent PA. Implications for future research on physical activity are discussed.