Modeling Pathways of Character Development across the First Three Decades of Life: An Application of Integrative Data Analysis Techniques to Understanding the Development of Hopeful Future Expectations.

There were two purposes of the present research: first, to add to scholarship about a key character virtue, hopeful future expectations; and second, to demonstrate a recent innovation in longitudinal methodology that may be especially useful in enhancing the understanding of the developmental course of hopeful future expectations and other character virtues that have been the focus of recent scholarship in youth development. Burgeoning interest in character development has led to a proliferation of short-term, longitudinal studies on character. These data sets are sometimes limited in their ability to model character development trajectories due to low power or relatively brief time spans assessed. However, the integrative data analysis approach allows researchers to pool raw data across studies in order to fit one model to an aggregated data set. The purpose of this article is to demonstrate the promises and challenges of this new tool for modeling character development. We used data from four studies evaluating youth character strengths in different settings to fit latent growth curve models of hopeful future expectations from participants aged 7 through 26 years. We describe the analytic strategy for pooling the data and modeling the growth curves. Implications for future research are discussed in regard to the advantages of integrative data analysis. Finally, we discuss issues researchers should consider when applying these techniques in their own work.

Understanding entrepreneurial intent in late adolescence: the role of intentional self-regulation and innovation.

Entrepreneurship represents a form of adaptive developmental regulation through which both entrepreneurs and their ecologies benefit. We describe entrepreneurship from the perspective of relational developmental systems theory, and examine the joint role of personal attributes, contextual attributes, and characteristics of person-context relationships in predicting entrepreneurial intent in a sample 3,461 college students enrolled in colleges and universities in the United States (60 % female; 61 % European American). Specifically, we tested whether personal characteristics (i.e., gender, intentional self-regulation skills, innovation orientation) and contextual factors (i.e., entrepreneurial parents) predicted college students' intentions to pursue an entrepreneurial career. Our findings suggest that self-regulation, innovation orientation, and having entrepreneurial role models (i.e., parents) predict entrepreneurial intent. Limitations and future directions for the study of youth entrepreneurship are discussed.

Ketamine-assisted psychotherapy treatment of chronic pain and comorbid depression: a pilot study of two approaches.

Chronic pain and depression diagnoses are skyrocketing. There is an urgent need for more effective treatments. Ketamine was recently established to alleviate pain and depression, but many gaps remain in the scientific literature. This paper reports the findings of an observational preliminary study that explored the efficacy of ketamine-assisted psychotherapy (KAPT) for chronic pain/major depressive disorder (MDD) comorbidity. Researchers evaluated two KAPT approaches to determine optimal route of administration/dose. Ten individuals diagnosed with a chronic pain disorder and MDD receiving KAPT were recruited: five individuals pursuing the psychedelic approach (high doses administered intramuscularly 24 h before therapy) and five individuals pursuing the psycholytic approach (low doses administered sublingually via oral lozenges during therapy). To evaluate differences between altered states of consciousness each approach induces, participants completed the Mystical Experience Questionnaire (MEQ30) after their first (T-1), third (T-2) and sixth/final (T-3) treatment sessions. Primary outcomes were change in Beck Depression Inventory (BDI) scores and Brief Pain Inventory (BPI) Short Form scores from baseline (T0) to (T-1)-(T-3). Secondary outcomes were changes in Generalized Anxiety Disorder (GAD-7) Scale scores and Post-Traumatic Stress Disorder Checklist (PCL-5) scores at each timepoint. Statistically significant differences between each approach were not observed, but the small sample's limited statistical power makes changes seen worth noting. All participants' symptoms declined throughout treatment. Psychedelic treatment participants saw a larger, more consistent decrease. Researchers conclude that KAPT may be effective for treating chronic pain/MDD comorbidity, anxiety and Post-Traumatic Stress Disorder (PTSD). Findings imply that the psychedelic approach may be more effective. This pilot study serves as a basis for more extensive research that will inform how clinicians administer treatment to optimize outcomes.

The relationship between adolescents' news media use and civic engagement: the indirect effect of interpersonal communication with parents.

Using data from the 4-H Study of Positive Youth Development, a longitudinal study involving U.S. adolescents, multi-group structural equation modeling (SEM) was used to evaluate whether news media use is predictive of a set of civic indicators (civic duty, civic efficacy, neighborhood social connection, and civic participation) for youth in Grades 8, 9, and 10, via an indirect effect of interpersonal communication about politics with parents. The proposed model had a good fit within each grade. News media use was predictive of interpersonal communication with parents and in turn, interpersonal communication was predictive of civic duty, civic efficacy, neighborhood social connection, and civic participation. The cross-group comparison of the structural model suggests that the predictive qualities of news media use and interpersonal communication are comparable across grades. The role of media use and interpersonal communication in fostering civic development and socialization as well as implications for future research are discussed.

The role of ecological assets in positive and problematic developmental trajectories.

Two theoretical perspectives have been proposed to describe, explain, and intervene in adolescent development - prevention science and positive youth development (PYD). An integrative model bridging these two perspectives posits that it is important to assess the extent to which the same, similar, or complementary mechanisms may be responsible for preventing problem behavior and promoting PYD. Therefore, using data from the 4-H Study of PYD, the present study examines the role of assets in the family, school, and neighborhood in differentiating trajectories of goal-optimization and delinquency in a sample of 626 youth (50.9% female) from Grades 5 to 11. The results indicated that collective activity in the family best predicted membership for the five goal-optimization trajectories while school-based assets differentiated the four delinquency trajectories that were identified. The findings suggest that multidimensional approaches may be most effective to promote PYD and prevent problem behaviors.

The COVID-19 cannabis health study: Results from an epidemiologic assessment of adults who use cannabis for medicinal reasons in the United States.

Background: Clinical indications for medicinal cannabis include chronic conditions; thus users (MCUs) are at an increased risk of morbidity and mortality resulting from SARS-CoV-2 infection (COVID-19). The study aimed to provide data on cannabis use and self-reported behavioral changes among MCUs with preexisting chronic conditions in response to the pandemic.Methods: An internet-based questionnaire was administered to adults ≥18 who self-reported medicinal cannabis use within the past year. Data are from respondents between March 21 and April 23, 2020; response rate was 83.3%. Health conditions and cannabis frequency, route, and patterns of use were assessed via the COVID-19 Cannabis Health Questionnaire (Vidot et al. 2020).Results: Participants (N = 1202) were predominantly non-Hispanic white (82.5%) and 52.0% male (mean age 47.2 years). Mental health (76.7%), pain (43.7%), cardiometabolic (32.9%), respiratory (16.8%), and autoimmune (12.2%) conditions were most reported. Those with mental health conditions reported increased medicinal cannabis use by 91% since COVID-19 was declared a pandemic compared to those with no mental health conditions (adjusted odds ratio: 1.91, 95% CI: 1.38-2.65). 6.8% reported suspected COVID-19 symptoms. Two percent (2.1%) have been tested for COVID-19 with only 1 positive test result. Some MCUs (16%) changed their route of cannabis administration, switching to nonsmoking forms.Conclusions: The majority of MCUs reported at least one preexisting chronic health condition. Over half report fear of COVID-19 diagnosis and giving the virus to someone else; yet only some switched from smoking to nonsmoking forms of cannabis. Clinicians may consider asking about cannabis use among their patients, particularly those with chronic health conditions.

Racial And Ethnic Inequities In Children's Neighborhoods: Evidence From The New Child Opportunity Index 2.0.

Neighborhoods influence children's health, so it is important to have measures of children's neighborhood environments. Using the Child Opportunity Index 2.0, a composite metric of the neighborhood conditions that children experience today across the US, we present new evidence of vast geographic and racial/ethnic inequities in neighborhood conditions in the 100 largest metropolitan areas in the US. Child Opportunity Scores range from 20 in Fresno, California, to 83 in Madison, Wisconsin. However, more than 90 percent of the variation in neighborhood opportunity happens within metropolitan areas. In 35 percent of these areas the Child Opportunity Gap (the difference between Child Opportunity Scores in very low- and very high-opportunity neighborhoods) is higher than across the entire national neighborhood distribution. Nationally, the Child Opportunity Score for White children (73) is much higher than for Black (24) and Hispanic (33) children. To improve children's health and well-being, the health sector must move beyond a focus on treating disease or modifying individual behavior to a broader focus on neighborhood conditions. This will require the health sector to both implement place-based interventions and collaborate with other sectors such as housing to execute mobility-based interventions.

Explaining the link between violence perpetration, victimization and drug use.

This study examined relationships between illegal and legal drug use and violence perpetration and victimization as well as possible mediators of these relationships. Subjects were continuation high school students followed prospectively over 5 years. Results indicated that illegal drug use predicted violence and victimization 5 years later and that earlier victimization was also associated with later illegal drug use. A measure intending to tap a psychopharmacological effects system, consistent with its definition in [Goldstein, P. J. (1985). The drugs/violence nexus: A tripartite conceptual framework. Journal of Drug Issues, 15(4), 493-506] tripartite model, was found to mediate the relationships between illegal drug use and victimization and violence. Results suggest that violence and victimization prevention efforts may benefit by addressing the psychopharmacological effects of adolescent illegal drug use.

Assessing the prevalence of autoimmune, endocrine, gynecologic, and psychiatric comorbidities in an ethnically diverse cohort of female fibromyalgia patients: does the time from hysterectomy provide a clue?

BACKGROUND: This retrospective chart review investigated differences in the prevalence of medical comorbidity between women with fibromyalgia (FM) (n=219) and a control group women with chronic pain (CP) without FM (n=116). The specific aims were to compare the prevalence of autoimmune, psychiatric, endocrine, gynecologic pathology, the relationship between timing of gynecologic surgery, and pain onset. We additionally sought to compare the number of comorbidities in an ethnically diverse cohort. METHODS: This was a retrospective chart review of patients seen in FM or CP clinics at an academic medical center in 2009-2010. RESULTS: Logistic regression modeling found that gynecologic, endocrine, and autoimmune diagnoses were independently associated with a diagnosis of FM. Detailed analyses showed that thyroid disease (P<0.01) and gynecologic surgery (P<0.05) were significantly more common in FM. Women with FM were more likely to have multiple autoimmune, endocrine, gynecologic, or psychiatric pathologies. A relationship was observed between the timing of gynecologic surgery and pain onset in FM, with more surgeries observed in the years just prior to pain onset or in the year after pain onset. A similar pattern was not found in the control group. CONCLUSION: This study demonstrates that autoimmune, endocrine, and gynecologic pathologies occur more commonly in women with FM than in those with CP, which is consistent with findings in less ethnically diverse samples. Moreover, a relationship was found between timing of pain onset and gynecologic surgery. A larger prospective study of the relationship between gynecologic surgery and pain onset in FM is warranted.

Divorce and eating behaviors: a 5-day within-subject study of preadolescent obesity risk.

BACKGROUND: Obesity rates have more than doubled among children and have tripled among adolescents since the 1980s, and currently more than one third of children and adolescents are overweight or obese. Parental divorce is a time of family upheaval, yet little is known about the family processes that link family structure and obesity. METHODS: The current study gathered a 5-day eating behavior questionnaire from 37 preadolescents (mean=10.26 years; standard deviation=1.32; 32.4% female) and one parent to explore whether marital status was linked to obesity risk behaviors (i.e., high consumption of sugar-sweetened beverages (SSBs), low consumption of produce, skipping breakfast, and eating dinners away from the home) and whether family context (e.g., parent time spent with child, parental acceptance, and family routines) mediated that link. RESULTS: Results showed that preadolescents in divorced families consumed more SSBs than preadolescents in married families, and there was a trend for less-frequent breakfast consumption among preadolescents in the divorced families. Of the three family context variables, only family routines explained the link between family structure and obesity risk. CONCLUSIONS: This study highlights the importance of family processes during divorce to understand the etiology and prevalence of child and adolescent obesity.

Prior cigarette smoking initiation predicting current alcohol use: evidence for a gateway drug effect among California adolescents from eleven ethnic groups.

Gateway drug theory provides a useful framework for understanding drug use among adolescent populations. Studies have reported a gateway effect of cigarette smoking on alcohol use among adolescents; but there is a lack of knowledge regarding ethnic differences in this effect. Using data from a cross-sectional survey in California, 11,239 subjects (46.3% male) from 31 high schools with at least 25% of total enrollment of Asian and at least 200 students with Asian ancestry entered the analysis. Among them, 6016 were ninth graders (mean age=14.3, S.D.=0.49) and 5223 were twelfth graders (mean age=17.3, S.D.=0.54). After controlling for seven variables, the risk ratio of last 30-day alcohol use among prior smoking initiators vs. noninitiators was 5.82 for non-Hispanic Whites, 4.25 for Blacks, 8.37 for Asian Indians, 3.99 for Chinese, 3.45 for Filipinos, 3.48 for Japanese, 5.41 for Koreans, 7.57 for Vietnamese, 4.02 for Mexicans, 2.64 for South/Central Americans, and 5.95 for adolescents with multiethnic background. Comparison of the 11 ethnic groups indicated that adolescents from different ethnic groups but with similar cultural background had a similar risk level; such pattern existed after controlling for acculturation, parents' monitoring, and school performance. The risk ratio did not differ by gender and grade. There is an association between prior cigarette smoking initiation and current alcohol use among adolescents from different ethnic backgrounds, including those of multiethnicity, which supports the generalizability of gateway drug effect of cigarette smoking on alcohol use. Studies should be conducted to investigate factors attributable to the ethnic variations of this association.

Prediction of violence perpetration among high-risk youth.

OBJECTIVES: To prospectively examine demographic background, personality, perceived environment, and behavior as violence perpetration predictors in emerging adulthood among high-risk adolescents using problem-behavior theory as a conceptual perspective. METHODS: Self-report questionnaires were administered 5 years apart to 676 participants. RESULTS: Hard drug use, belief that hurting another's property while drunk was acceptable, and high-risk group self-identification predicted later violence perpetration independent of baseline violence perpetration. CONCLUSIONS: Consistent with problem-behavior theory, personality, perceived environment, and behavior variables, beyond baseline violent behavior, predict risk for future violence perpetration in emerging adulthood, whereas demographic background may exert indirect effects.

Cardiac arrests in schools: assessing use of automated external defibrillators (AED) on school campuses.

BACKGROUND: Sudden cardiac arrest in schools are infrequent, but emotionally charged events. The purpose of our study was to: (1) describe characteristics and outcomes of school cardiac arrests; and (2) assess the feasibility of conducting school bystander interviews to describe the events surrounding cardiac arrests, assess AED availability and use, and identify barriers to AED use. METHODS: We performed a telephone survey of bystanders to cardiac arrests occurring in K-12 schools in communities participating in the Cardiac Arrest Registry to Enhance Survival (CARES) database and a local cardiac arrest database. The study period was from 8/2005 to 8/2011 and continued in one community through 2011. Utstein style descriptive data and outcomes were collected. A structured telephone interview of a bystander or administrative personnel was conducted for each cardiac arrest event. We collected a descriptive event summary, including provision of bystander CPR, presence of an AED and information regarding AED deployment, training, and use and perceived barriers to AED use. Descriptive data are reported. RESULTS: During the study period there were 30,603 cardiac arrests identified at study communities, of which 47 (0.15%) events were at K-12 schools. Of these, 21 (45.7%) were at high schools, a minority (16, 34.0%) were children (

Improving treadmill performance in patients with lumbar stenosis: evaluation of a custom angle load reduction device.

OBJECTIVE: The aim of this study was to evaluate a custom angle load reduction rolling walker to determine the relationship between flexion and load reduction on walking performance in patients with lumbar spinal stenosis.The hypothesis was that walking performance in patients with lumbar spinal stenosis would be significantly improved using the Oliver Static Measuring Apparatus device compared with unaided treadmill walking. DESIGN: Fifteen patients with symptomatic neurogenic intermittent claudication caused by lumbar spinal stenosis were recruited at a Veterans Affairs Medical Center. This study used a cross-sectional design with two random-order treadmill conditions: (1) spinal flexion and unloading and (2) level walking. Primary outcome measures included initiation time of first symptoms, total walking time, spinal flexion angle, and unloading force. Secondary measures included baseline pain, fatigue, and disability severity. RESULTS: The participants' initiation time of symptoms and total walking time were significantly greater with the use of the Oliver Static Measuring Apparatus compared with the unaided walking trial. The participants with increased baseline pain, fatigue, and disability severity had decreased walking performance for the unaided condition but not for the Oliver Static Measuring Apparatus condition. CONCLUSIONS: The results show that spinal flexion is important for pain reduction in lumbar spinal stenosis. The Oliver Static Measuring Apparatus device used in this study was shown to be effective and immediate in significantly increasing total walking time and prolonging the onset of neurogenic intermittent claudication symptoms while ambulating.

Transdermal buprenorphine controls central neuropathic pain.

A 53-year-old male with peripheral sensorimotor neuropathy suffered an intracerebral hemorrhage resulting in right hemiparesis and hemisensory loss. Three months later, he developed constant and burning pain within the entire right side of his body. He was diagnosed with central pain syndrome and treated with antiepileptics and tricyclic antidepressants. Minimal analgesia was achieved, which was limited by intractable sedation and drowsiness. Patient was then treated with oral opioids (morphine and hydrocodone with acetaminophen) in escalating doses that produced cognitive impairment. After an opioid rotation was attempted, by switching morphine to transdermal fentanyl, there was no pain reduction or improved quality of life. A trial of buprenorphine was initiated, by administering transdermal patches in escalating doses in weekly intervals. Patient's pain was eventually successfully controlled with buprenorphine patch 60 µg/h every 7 days. His self-reported Visual Analogue Scale pain scores decreased from an average of 8/10 to 2/10 or less. Patient's overall function and participation in home activities increased. Buprenorphine is a partial µ-receptor and a κ-δ receptor antagonist known to block NMDA receptors and reduce hyperalgesia secondary to central sensitization.(1) Buprenorphine is also a partial agonist at the opioid receptor-like (ORL-1) receptor, which is found to be analgesic and antinociceptive at the level of the spinal cord.(1,2) The difference in analgesic responses between buprenorphine and other opioids may be due to different receptor G protein interactions and/or selective activation of neuronal K(ATP) channels by buprenorphine.(3) Deficient opening of K(ATP) channels has been shown to mediate neuropathic pain(4); therefore, activation of these channels by buprenorphine may contribute to its analgesic effect in neuropathic pain states wherein other opioids fail. More recently, there have been two case reports in which patients with neuropathic pain of different central etiology were successfully treated with buprenorphine.(5) Despite advances in understanding the pathology related to central pain, effective treatment options are limited. Buprenorphine may be an analgesic option for central pain management when opioids fail to reduce hypersensitivity or when patients exhibit intolerable side effects to other medications.

Physical and relational aggression as predictors of drug use: gender differences among high school students.

The present study investigated the longitudinal relationships between physical and relational aggression and later drug use, as moderated by gender. Self-reported data were gathered from 2064 high school students at pretest and 1-year post-test to test the hypotheses that (1) males would engage in more physical aggression than females, whereas females would engage in more relational aggression than males; and (2) physical aggression would be a stronger drug use predictor for males and relational aggression a stronger predictor for females. Results indicated that males reported engaging in more physical aggression than females at baseline; however, females and males reported engaging in similar rates of relational aggression. After controlling for relational aggression, baseline drug use, and demographic variables, physical aggression at baseline was found to predict alcohol use 1-year later for males but not for females. After controlling for physical aggression, baseline drug use, and demographic variables, relational aggression was found to predict cigarette use and marijuana use for females but not for males. However, relational aggression was found to predict later alcohol and hard drug equally across gender. These findings suggest that both physical and relational aggression are predictive of subsequent drug use and have important implications for violence and drug use prevention intervention efforts.