The Youth Collaborative Mental Health Survey: A Community-Based Participatory Research Approach Using Constructivism With Majority Hispanic Youth

Youth today face novel mental health challenges compared to youth of previous generations. Youth voice in research is necessary to better understand and alleviate this national youth mental health crisis, but current U.S. nationally representative datasets on youth mental health lack youth voice in their survey designs. The academic team collaborated with 19 high school students to design a comprehensive youth mental health survey called the Youth Collaborative Mental Health Survey (YCMHS). The youth co-investigators represented the diversity of San Antonio, Texas, and were majority Hispanic. The constructivism pedagogy in education, which empowers youth voice in the learning process, was utilized to facilitate the youth-led creation of the YCMHS. During eight 2-hour meetings, the youth co-investigators designed the YCMHS with 20 domains and 195 questions. The YCMHS embraced respondent flexibility and voice and included 42 conditional response questions and 29 free-text response questions. The youth co-investigators led the survey administration at five schools during the 2020–2021 school year. The youth-led research design also strengthened collaboration between community and school partners. Takeaways from the academic team include the importance of being flexible and patient and advocating for the youth collaborators. Takeaways from the youth co-investigators include the importance of being open-minded, asking honest questions related to youth mental health, and being persistent. Future work will strengthen the scientific rigor of the YCMHS and highlight preliminary survey results

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Micro-learning, Digital Badges and Micro-credentials: Definitions, Affordances and Design Considerations for application in Higher Education Institutions.

While Higher Education Institutes have traditionally viewed awards as a result of ECTS (European Credit Transfer System) credit accumulation, in recent years the recognition of smaller parcels of learning has become popular. Micro-credentials and digital badges are a relatively new concept and lend themselves to a wide variety of educational knowledge, skills and competence achievement, furthermore, they could help certify the outcomes of small, tailored learning experiences. While they are usually regarded as distinct from ECTS credits, some universities have also formalized a connection between the two. They can be used in a variety of settings and offer a flexible and reliable means of capturing continuous professional development. This article considers the development of micro-credentials examining their potential and scope while proposing a distinction between the former and digital badges. The article presents several design models for micro-credentials and digital badges including examples of use in practice toward measurable and achievable learning outcomes. Examining the scope and path to realizing micro-credentials, taking into consideration the European Commission’s recommendations on micro-credentials, this article aims to inform best practice for micro-credential design and digital badge design

Developing and maintaining leadership, resilience and sustainability in interprofessional collaboration

Interprofessional collaboration has grown significantly in health care organisations, becoming a critical part of the way in which health and social care is delivered. It is now seen as an essential part of effective health care delivery. Health professionals can be assigned to designated teams due to the increasing complexity of health care delivery, or more commonly a number of professionals with different expertise work together in collaborations which can be configured over some distance (Thistlethwaite, Dunston, & Yassine in Journal of Interprofessional Care 32:745–751, 2019).N/