Methodological Note: On Using Personal Digital Assistants (PDAs) for Survey Administration in the Study of Youth Development

Applied developmental scientists face the challenge of identifying research methods that enable the efficient collection of data from youth of diverse social backgrounds (e.g., ethnic. racial, religious, economic) and varying levels cognitive-linguistic and attentional skills. In addition, because access to youth during school time is often limited by educators’ desire to preserve instructional time, finding methodologies to collect data from youth that are highly efficient, and also those that are feasible in less structured settings, are needed. This article outlines some of the benefits and limitations of using a voice-enhanced survey delivered on a personal digital assistants (PDA) as a method of gathering data from diverse youth in both, in and out-of-school contexts

Qualitative and Quantitative Assessments of Thriving and Contribution in Early Adolescence: Findings from the 4-H Study of Positive Youth Development

Research and practice in youth development converge in an interest in positive development, or thriving. They converge also in seeking to promote among youth an orientation to act in support of their own and others’ well-being through contributions to self, family, and community. Based on the results of both qualitative (open and axial coding of parents’ and students’ answers to several open-ended questions) and quantitative analyses of data from Wave 2 (Sixth Grade; 2003-2004) of the 4-H Study of Positive Youth Development (PYD), we found that adolescents and parents define a thriving youth in different ways and, as well, that the groups differ in the salience of contribution as part of their respective conceptions of thriving. We discuss the implications for research and practice of the two generational groups’ contrasting views of thriving and contribution

Qualitative and Quantitative Assessments of Thriving and Contribution in Early Adolescence: Findings from the 4-H Study of Positive Youth Development

Research and practice in youth development converge in an interest in positive development, or thriving. They converge also in seeking to promote among youth an orientation to act in support of their own and others’ well-being through contributions to self, family, and community. Based on the results of both qualitative (open and axial coding of parents’ and students’ answers to several open-ended questions) and quantitative analyses of data from Wave 2 (Sixth Grade; 2003-2004) of the 4-H Study of Positive Youth Development (PYD), we found that adolescents and parents define a thriving youth in different ways and, as well, that the groups differ in the salience of contribution as part of their respective conceptions of thriving. We discuss the implications for research and practice of the two generational groups’ contrasting views of thriving and contribution

Strengthening human potential for great love -compassion through elaborative development

Split conceptions of humanity reflect commitment to a part of humanity, and may be instantiated by war, genocide, racism, and nationalism, or even ordinary love and compassion. The embeddedness of all living entities makes them open systems that are integrally fused. Thus, commitment to a part will arguably compromise the healthy functioning of the whole. This dissertation attempted to begin to elucidate the dynamic developmental processes involved in commitment to the whole of humanity, as instantiated by Great Love-Compassion (GLC), i.e., the wish for all to have freedom and joy and for all to be relieved of their pain and suffering. Following in the social-behavioral science tradition of scholarship about mending split conceptions of humanity, a nonrecursive structural model hypothesized relationships among adaptive developmental regulations, elaborative development, and GLC. The present study aimed to validate the hypothesized relationship between elaborative status (ES) and GLC at a single time point. Quantitative and qualitative data from the John Templeton Foundation sponsored study of The Role of Spiritual Development in Growth of Purpose, Generosity, and Psychological Health in Adolescence were used to: (1) derive measures of ES and GLC via multi-step expert rater validation; (2) assess quantitatively the link between ES and GLC within 58 ethnically and religiously diverse high school-age youth (N = 30; 33.3% males) and college-age youth (N = 28; 50% males); and (3) obtain illustrative information about the manifestation of ES and GLC within 2 on-diagonal and 2 off-diagonal cases of ES-GLC relations. Expert rater validation yielded 33 psychometrically useful items indicative of ES (α = .65) and 17 items indicative of GLC (α = .86). Quantitative and qualitative findings provided evidence of the expected covariation between ES and GLC. The two off-diagonal cases helped elucidate the quantitative findings. To address the limitations of this study, future research should use a mixed method approach to measuring ES and GLC, dimensionalize measurement of elaborative and decremental status, employ longitudinal data, and increase the size and representativeness of the sample. Despite these limitations, this dissertation illustrates the possibility of conducting research on the concepts of adaptive development and commitment to the whole of humanity

Methodological Note: On Using Personal Digital Assistants (PDAs) for Survey Administration in the Study of Youth Development

Applied developmental scientists face the challenge of identifying research methods that enable the efficient collection of data from youth of diverse social backgrounds (e.g., ethnic. racial, religious, economic) and varying levels cognitive-linguistic and attentional skills. In addition, because access to youth during school time is often limited by educators’ desire to preserve instructional time, finding methodologies to collect data from youth that are highly efficient, and also those that are feasible in less structured settings, are needed. This article outlines some of the benefits and limitations of using a voice enhanced survey delivered on a personal digital assistants (PDA) as a method of gathering data from diverse youth in both, in and out-of school contexts

Methodological Note: On Using Personal Digital Assistants (PDAs) for Survey Administration in the Study of Youth Development

Applied developmental scientists face the challenge of identifying research methods that enable the efficient collection of data from youth of diverse social backgrounds (e.g., ethnic. racial, religious, economic) and varying levels cognitive-linguistic and attentional skills. In addition, because access to youth during school time is often limited by educators’ desire to preserve instructional time, finding methodologies to collect data from youth that are highly efficient, and also those that are feasible in less structured settings, are needed. This article outlines some of the benefits and limitations of using a voice enhanced survey delivered on a personal digital assistants (PDA) as a method of gathering data from diverse youth in both, in and out-of school contexts

Evolution over Time of Ventilatory Management and Outcome of Patients with Neurologic Disease∗

OBJECTIVES: To describe the changes in ventilator management over time in patients with neurologic disease at ICU admission and to estimate factors associated with 28-day hospital mortality. DESIGN: Secondary analysis of three prospective, observational, multicenter studies. SETTING: Cohort studies conducted in 2004, 2010, and 2016. PATIENTS: Adult patients who received mechanical ventilation for more than 12 hours. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Among the 20,929 patients enrolled, we included 4,152 (20%) mechanically ventilated patients due to different neurologic diseases. Hemorrhagic stroke and brain trauma were the most common pathologies associated with the need for mechanical ventilation. Although volume-cycled ventilation remained the preferred ventilation mode, there was a significant (p < 0.001) increment in the use of pressure support ventilation. The proportion of patients receiving a protective lung ventilation strategy was increased over time: 47% in 2004, 63% in 2010, and 65% in 2016 (p < 0.001), as well as the duration of protective ventilation strategies: 406 days per 1,000 mechanical ventilation days in 2004, 523 days per 1,000 mechanical ventilation days in 2010, and 585 days per 1,000 mechanical ventilation days in 2016 (p < 0.001). There were no differences in the length of stay in the ICU, mortality in the ICU, and mortality in hospital from 2004 to 2016. Independent risk factors for 28-day mortality were age greater than 75 years, Simplified Acute Physiology Score II greater than 50, the occurrence of organ dysfunction within first 48 hours after brain injury, and specific neurologic diseases such as hemorrhagic stroke, ischemic stroke, and brain trauma. CONCLUSIONS: More lung-protective ventilatory strategies have been implemented over years in neurologic patients with no effect on pulmonary complications or on survival. We found several prognostic factors on mortality such as advanced age, the severity of the disease, organ dysfunctions, and the etiology of neurologic disease

Analysis of Outcomes in Ischemic vs Nonischemic Cardiomyopathy in Patients With Atrial Fibrillation A Report From the GARFIELD-AF Registry

IMPORTANCE Congestive heart failure (CHF) is commonly associated with nonvalvular atrial fibrillation (AF), and their combination may affect treatment strategies and outcomes

Outcomes in Newly Diagnosed Atrial Fibrillation and History of Acute Coronary Syndromes: Insights from GARFIELD-AF

BACKGROUND: Many patients with atrial fibrillation have concomitant coronary artery disease with or without acute coronary syndromes and are in need of additional antithrombotic therapy. There are few data on the long-term clinical outcome of atrial fibrillation patients with a history of acute coronary syndrome. This is a 2-year study of atrial fibrillation patients with or without a history of acute coronary syndromes

Geoeconomic variations in epidemiology, ventilation management, and outcomes in invasively ventilated intensive care unit patients without acute respiratory distress syndrome: a pooled analysis of four observational studies

Background: Geoeconomic variations in epidemiology, the practice of ventilation, and outcome in invasively ventilated intensive care unit (ICU) patients without acute respiratory distress syndrome (ARDS) remain unexplored. In this analysis we aim to address these gaps using individual patient data of four large observational studies. Methods: In this pooled analysis we harmonised individual patient data from the ERICC, LUNG SAFE, PRoVENT, and PRoVENT-iMiC prospective observational studies, which were conducted from June, 2011, to December, 2018, in 534 ICUs in 54 countries. We used the 2016 World Bank classification to define two geoeconomic regions: middle-income countries (MICs) and high-income countries (HICs). ARDS was defined according to the Berlin criteria. Descriptive statistics were used to compare patients in MICs versus HICs. The primary outcome was the use of low tidal volume ventilation (LTVV) for the first 3 days of mechanical ventilation. Secondary outcomes were key ventilation parameters (tidal volume size, positive end-expiratory pressure, fraction of inspired oxygen, peak pressure, plateau pressure, driving pressure, and respiratory rate), patient characteristics, the risk for and actual development of acute respiratory distress syndrome after the first day of ventilation, duration of ventilation, ICU length of stay, and ICU mortality. Findings: Of the 7608 patients included in the original studies, this analysis included 3852 patients without ARDS, of whom 2345 were from MICs and 1507 were from HICs. Patients in MICs were younger, shorter and with a slightly lower body-mass index, more often had diabetes and active cancer, but less often chronic obstructive pulmonary disease and heart failure than patients from HICs. Sequential organ failure assessment scores were similar in MICs and HICs. Use of LTVV in MICs and HICs was comparable (42·4% vs 44·2%; absolute difference -1·69 [-9·58 to 6·11] p=0·67; data available in 3174 [82%] of 3852 patients). The median applied positive end expiratory pressure was lower in MICs than in HICs (5 [IQR 5-8] vs 6 [5-8] cm H2O; p=0·0011). ICU mortality was higher in MICs than in HICs (30·5% vs 19·9%; p=0·0004; adjusted effect 16·41% [95% CI 9·52-23·52]; p<0·0001) and was inversely associated with gross domestic product (adjusted odds ratio for a US$10 000 increase per capita 0·80 [95% CI 0·75-0·86]; p<0·0001). Interpretation: Despite similar disease severity and ventilation management, ICU mortality in patients without ARDS is higher in MICs than in HICs, with a strong association with country-level economic status