Cultural humility development in adults serving as mentors for youth: A qualitative evidence synthesis.

This qualitative review synthesizes evidence regarding how cultural humility (i.e., critical self-reflection, challenging inequity) may be influenced by the experience of serving as a mentor in a youth program. A systematic search identified 35 qualitative studies with findings that address this question. Thematic synthesis of extracted data identified the following six themes, all but one of which pertains to ways in which serving as a mentor appeared to have enhanced the cultural humility of the adults involved: (1) humanizing others: awareness of experiential differences, (2) reflecting inward on one's own identity, biases, and opportunities, (3) connecting with others, (4) recognizing environmental influences on human development, (5) envisioning contributions to community change, and (6) counterevidence: deficit-oriented attributions. Findings indicate that mentor cultural humility development primarily entailed individual and interpersonal awareness with relatively less evidence of increased awareness of and action to change inequality. The identified themes provide promising directions for future research as well as potentially useful avenues for incorporating consideration of cultural humility more intentionally in the development and evaluation of mentoring programs for youth.

Deep Learning Body Region Classification of MRI and CT Examinations.

This study demonstrates the high performance of deep learning in identification of body regions covering the entire human body from magnetic resonance (MR) and computed tomography (CT) axial images across diverse acquisition protocols and modality manufacturers. Pixel-based analysis of anatomy contained in image sets can provide accurate anatomic labeling. For this purpose, a convolutional neural network (CNN)-based classifier was developed to identify body regions in CT and MRI studies. Seventeen CT (18 MRI) body regions covering the entire human body were defined for the classification task. Three retrospective datasets were built for the AI model training, validation, and testing, with a balanced distribution of studies per body region. The test datasets originated from a different healthcare network than the train and validation datasets. Sensitivity and specificity of the classifier was evaluated for patient age, patient sex, institution, scanner manufacturer, contrast, slice thickness, MRI sequence, and CT kernel. The data included a retrospective cohort of 2891 anonymized CT cases (training, 1804 studies; validation, 602 studies; test, 485 studies) and 3339 anonymized MRI cases (training, 1911 studies; validation, 636 studies; test, 792 studies). Twenty-seven institutions from primary care hospitals, community hospitals, and imaging centers contributed to the test datasets. The data included cases of all sexes in equal proportions and subjects aged from 18 years old to + 90 years old. Image-level weighted sensitivity of 92.5% (92.1-92.8) for CT and 92.3% (92.0-92.5) for MRI and weighted specificity of 99.4% (99.4-99.5) for CT and 99.2% (99.1-99.2) for MRI were achieved. Deep learning models can classify CT and MR images by body region including lower and upper extremities with high accuracy.

Are adults influenced by the experience of mentoring youth? A scoping review.

AIMS: A relatively large body of research exists on the effectiveness of mentoring programs directed at youth and numerous syntheses of this literature have proven useful for advancing both research and practice. Less studied, but also important is the potential for adults serving in the role of mentor to young persons to be influenced by this experience. A scoping review was conducted with the aim of identifying and critically assessing major trends in the methods and findings in this literature. METHODS: Included sources were empirical studies reporting findings that address potential influences on adults (18+) serving as mentors to youth (<18) in formal programs designed for this purpose. The initial search resulted in 3155 records and 96 were included in the review. RESULTS: Approximately half of the studies (58%) focused on younger adults (ages 18-22 years old, e.g., college students) serving as mentors; only a small minority of studies focused on adults over 35 years old (10%). Most studies were qualitative (n = 54). Studies with a quantitative component (n = 18 quantitative only; n = 24 mixed methods) exhibited a significant risk of bias for inferring effects on mentors due to limitations in study design (e.g., lack of comparison group). Studies most often addressed potential outcomes for mentors in academic/career (55%) and social (45%) domains, when findings suggested possible effects on mentors, they were nearly universally in a positive direction. CONCLUSION: Existing research, although consistent with the potential for adults to benefit from the experience of mentoring youth, has insufficient rigor and representativeness to adequately address this question. Future research should utilize more rigorous quantitative designs and samples with greater representativeness of the different stages of adult development.

Pathways by which case managers' match support influences youth mentoring outcomes: Testing the systemic model of youth mentoring.

Keller's systemic model of youth mentoring posits there are multiple pathways through which all stakeholders in the youth mentoring process, including the program staff who support the match (or case managers), influence youth outcomes. This study examines case managers' direct and indirect contributions to match outcomes and tests how transitive interactions facilitate a theorized sequence of mentoring interactions to effect greater closeness and length, specifically in nontargeted mentoring programs. A structural equations model of case manager contributions to match outcomes was tested using data from 758 mentor-mentee matches, supported by 73 case managers across seven mentoring agencies. Results reveal direct effects of mentor-reported match support quality on match length and indirect influences on match length through increasing youth-centeredness, goal-focused orientation, and closeness. The findings confirm the presence of multiple pathways of influence, including indirect effects on outcomes via transitive interactions in match support that scaffold youth-centeredness and goal-focused interactions in the match. Findings also suggest supervisors' evaluations of case managers may provide little information about how match support influences the nature of mentor-mentee interactions.

Identifying predictors of psychological well-being among volunteer mentors in Big Brothers Big Sisters.

Big Brothers Big Sisters (BBBS) facilitates mentoring relationships between youth and volunteer mentors. Although research has examined outcomes for youth in BBBS, relatively less investigation has been undertaken for volunteer outcomes. This study explored factors associated with changes in psychological well-being among BBBS volunteer mentors. Participants included 593 mentors (Mage = 31) surveyed at study baseline and 15-month follow-up. A classification and regression decision tree approach was used to predict residualized change in psychological well-being from study baseline with match length included as the first split variable, and demographic, individual, and relationship variables included as candidate predictors. Analyses indicated that mentors with longer relationships (>4.5 months) reported more positive change in psychological well-being compared with mentors with shorter relationships. Perceived quality of program supervision was a further predictor within both groups of volunteers. Findings suggest that longer relationships and greater program support may contribute to mentor well-being.

Mechanisms of Influence on Youth Substance Use for a Social-Emotional and Character Development Program: A Theory-Based Approach.

Background: The Theory of Triadic Influence (TTI) provides a comprehensive framework for understanding adolescent substance use. Objectives: We examined mechanisms by which a TTI-guided social-emotional and character development program, Positive Action (PA), influences adolescent substance use. Study data come from the PA-Chicago, longitudinal matched-pairs cluster-randomized control trial. A diverse, dynamic cohort of approximately 1,200 students from 14 low-performing schools were assessed at eight points of time, between grades 3-8, across a six-year period. Students completed scales related to substance use, self-control, deviant peer affiliation, and school attachment, adapted from the Risk Behavior Survey, Social-Emotional and Character Development Scale, Conventional Friends Scale, and People in My Life Scale. After testing the overall effect of PA on substance use, we used latent growth modeling to assess whether effects on each outcome were mediated by longitudinal changes in three composite measures aligning with the TTIs three streams. Results: Students in PA schools reported fewer experiences with drinking, getting drunk, and overall substance use. In the multiple mediator models, significant indirect effects of PA on substance use via changes in self-control were evident. Conclusions/Importance: Findings are consistent with theory and past research suggesting the influence of self-control on youth substance use. Future studies should include implementation in different settings and additional theory-based measures.Trial RegistrationThis trial is registered at ClinicalTrials.gov NCT01025674.

Mentoring in the Time of COVID-19: An Analysis of Online Focus Groups with Mentors to Youth.

This study explored the experiences of mentors to youth during the early months of the COVID-19 pandemic. The study aims were to examine (1) the role of the pandemic on mentor-mentee interactions and relationships and (2) the ways in which mentors could be supported during the health crisis to better meet youth needs. Six online focus groups were conducted with 39 mentors. Mentor participants included 26 females and 11 males (two did not disclose gender), and 51% identified as white. Any mentor currently in a mentoring relationship, regardless of type, was eligible. Using Facebook groups, moderators posted questions and prompts, and mentor participants responded using textual comments. The text from each group was recorded, extracted, and coded and analyzed using thematic analysis. As mentors transitioned to a primarily online format, text and video chat became the most common communication methods. Mentees' access to technology and privacy were the biggest challenges faced. Mentor concerns for their mentees varied, including mental health, school, family finances, and access to instrumental support and food. Mentor help involved routinely connecting with mentees and providing academic support. Mentors requested ideas and resources for connecting with mentees and an online mentor support group. During the early weeks of the pandemic, mentors continued to engage with mentees, offering valuable support during a confusing and scary time. Mentoring programs can broaden their approach, intentionally integrating online connecting in an effort to provide safe, appropriate, and continued support to both mentors and mentees.

A Scoping Review of the Use of Social and Behavioral Change in Acute Care Antimicrobial Stewardship Initiatives.

Purpose: Antimicrobial stewardship (AS) initiatives are implemented with a goal of reducing antimicrobial resistance. It is unknown exactly how many acute care AS initiatives have since been based on social and behavioral theory. The purpose of this scoping review is to provide an updated review of theory-informed acute care AS initiatives in the published literature, including how social and behavioral theories have been used in the described interventions. Methods: PubMed, EMBASE, CINAHL, PsycINFO, and ProQuest Dissertations were searched using a combination of AS, acute care, and social and behavioral theory search terms from April 2011 to November 2019. Using both an initial review of titles and abstracts and a second review of full text, a total of 4 articles were identified after a review of 2014 records. Each article was coded using a guide that abstracted details of study methods, the AS intervention, and use of theory based on a validated theory coding scheme. Results: The interventions included combinations of decision-making tools, provider education, and prospective audit and feedback. Two studies included an evaluation of the described initiative, with findings indicating improvement in antimicrobial use. All interventions utilized theory in developing AS interventions. However, gaps were evident in the use of theory in the evaluations, including inconsistent measurement of theory constructs and lack of testing of the theory. Conclusion: AS interventions are frequently published; however, theory-based acute care AS interventions are not commonly described. More consistent and comprehensive utilization of social and behavioral theories may enhance effectiveness of AS programs.

The roles of Centrin 2 and Dynein Light Chain 8a in apical secretory organelles discharge of Toxoplasma gondii.

To efficiently enter host cells, apicomplexan parasites such as Toxoplasma gondii rely on an apical complex composed of tubulin-based structures as well as two sets of secretory organelles named micronemes and rhoptries. The trafficking and docking of these organelles to the apical pole of the parasite is crucial for the discharge of their contents. Here, we describe two proteins typically associated with microtubules, Centrin 2 (CEN2) and Dynein Light Chain 8a (DLC8a), that are required for efficient host cell invasion. CEN2 localizes to four different compartments, and remarkably, conditional depletion of the protein occurs in stepwise manner, sequentially depleting the protein pools from each location. This phenomenon allowed us to discern the essential function of the apical pool of CEN2 for microneme secretion, motility, invasion and egress. DLC8a localizes to the conoid, and its depletion also perturbs microneme exocytosis in addition to the apical docking of the rhoptry organelles, causing a severe defect in host cell invasion. Phenotypic characterization of CEN2 and DLC8a indicates that while both proteins participate in microneme secretion, they likely act at different steps along the cascade of events leading to organelle exocytosis.

Biogenesis and secretion of micronemes in Toxoplasma gondii.

One of the hallmarks of the parasitic phylum of Apicomplexa is the presence of highly specialised, apical secretory organelles, called the micronemes and rhoptries that play critical roles in ensuring survival and dissemination. Upon exocytosis, the micronemes release adhesin complexes, perforins, and proteases that are crucially implicated in egress from infected cells, gliding motility, migration across biological barriers, and host cell invasion. Recent studies on Toxoplasma gondii and Plasmodium species have shed more light on the signalling events and the machinery that trigger microneme secretion. Intracellular cyclic nucleotides, calcium level, and phosphatidic acid act as key mediators of microneme exocytosis, and several downstream effectors have been identified. Here, we review the key steps of microneme biogenesis and exocytosis, summarising the still fractal knowledge at the molecular level regarding the fusion event with the parasite plasma membrane.

Improving understanding of how mentoring works: Measuring multiple intervention processes.

The objective is to develop and test dimensionality and validity of a new measure of five mentoring intervention processes drawn from emphases across prior mentoring efforts that might be the basis for effects: identification with the mentor, social and emotional support, teaching and education, and advocacy, and shared time and activity. Partial validation of value was drawn from moderation role in a meta-analysis of mentoring (Tolan, Henry, Lovegrove, Schoeny, & Nichols, 2014. J. Exp. Criminol., 10, 179-201). Data collected of candidate items completed by 740 mentors and 302 mentees (mean age = 16.59 years) were subjected to confirmatory factor analyses based on the five theorized dimensions. Scales derived from best-fitting solutions were examined for convergent validity in relation to other indicators of mentoring relationship qualities. A bifactor model with five specific factors was supported for adult mentor reports while a simplified single factor model fit youth reports. Correlations between derived scale scores and validity indicators of mentoring relationship qualities were consistent with expectations. Multiple activities that comprise mentoring can be identified in adult mentor reports but not youth reports. This scale provides a promising basis for testing how variation in emphasis during mentoring affects impact and help guide training emphases.

Predictors of mentoring relationship quality: Investigation from the perspectives of youth and parent participants in Big Brothers Big Sisters of Canada one-to-one mentoring programs.

AIMS: This study examined predictors of mentoring relationship quality (MRQ) as reported by youth and parents participating in Big Brothers Big Sisters (BBBS) of Canada one-to-one mentoring programs. METHODS: Mentoring program capacity and other external supports, youth personal and environmental risk, youth and parent attitudes and motives, and mentoring relationship processes and attributes were examined as predictors of MRQ at 18 months following youth referral to the program using data from a longitudinal study of the Canadian BBBS mentoring programs. RESULTS: For youth (n = 335), significant predictors of MRQ included: minimal difficulties pairing youth and mentors, perceptions of shared attributes with their mentor, mentor emotional engagement and support, and longer relationships. For parents (n = 356) higher MRQ was correlated with parent report of minimal difficulties pairing youth and mentors, a high-quality relationship with the youth's mentor, and longer relationships. CONCLUSION: Implications for program and policy development are discussed.

Do mentor support for ethnic-racial identity and mentee cultural mistrust matter for girls of color? A preliminary investigation.

[Correction Notice: An Erratum for this article was reported online in Cultural Diversity and Ethnic Minority Psychology on Jul 18 2019 (see record 2019-41300-001). In this article, all the authors were listed as being affiliated with DePaul University, but only Bernadette Sánchez is affiliated with DePaul University. The other authors were at the following affiliations while the work for the article was completed: Julia Pryce, School of Social Work, Loyola University Chicago; Naida Silverthorn, Institute for Health Research and Policy, University of Illinois at Chicago; Kelsey L. Deane, Department of Education and Social Work, University of Auckland; and David L. DuBois, Department of Community Health Sciences, University of Illinois at Chicago. All versions of this article have been corrected.] Objectives: The aim of this repeated-measures study was to examine the roles of cultural mistrust and perceived mentor support for ethnic-racial identity in a sample of girls of color. It was hypothesized that mentors' support for ethnic-racial identity measured at baseline would influence relationship quality, as well as the girls' ethnic identity and cultural mistrust, at the end of the intervention, adjusting for baseline measures. It was also hypothesized that girls' cultural mistrust toward Whites at baseline would be negatively associated with mentoring relationship quality at the end of the intervention. METHOD: Participants were 40 adolescent girls of color who were matched with racially-ethnically diverse women mentors in a community-based mentoring program. RESULTS: Mentor support for ethnic-racial identity as reported by youth significantly predicted relative increases in youth reports of relational but not instrumental satisfaction. Higher mentor support for ethnic-racial identity also significantly predicted increases in ethnic identity exploration, but only among girls with White mentors. Further, youth's reported greater cultural mistrust toward Whites was a significant predictor of decreased instrumental relationship satisfaction among girls with White mentors. CONCLUSIONS: Findings support the importance of further efforts to understand the roles of culturally relevant relationship processes and youth attitudes in mentoring interventions for girls of color. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

"Do mentor support for ethnic-racial identity and mentee cultural mistrust matter for girls of color? A preliminary investigation": Correction to Sánchez et al. (2019).

Reports an error in "Do mentor support for ethnic-racial identity and mentee cultural mistrust matter for girls of color? A preliminary investigation" by Bernadette Sánchez, Julia Pryce, Naida Silverthorn, Kelsey L. Deane and David L. DuBois (Cultural Diversity and Ethnic Minority Psychology, Advanced Online Publication, Oct 01, 2018, np). In this article, all the authors were listed as being affiliated with DePaul University, but only Bernadette Sánchez is affiliated with DePaul University. The other authors were at the following affiliations while the work for the article was completed: Julia Pryce, School of Social Work, Loyola University Chicago; Naida Silverthorn, Institute for Health Research and Policy, University of Illinois at Chicago; Kelsey L. Deane, Department of Education and Social Work, University of Auckland; and David L. DuBois, Department of Community Health Sciences, University of Illinois at Chicago. All versions of this article have been corrected. (The following abstract of the original article appeared in record 2018-48484-001.) Objectives: The aim of this repeated-measures study was to examine the roles of cultural mistrust and perceived mentor support for ethnic-racial identity in a sample of girls of color. It was hypothesized that mentors' support for ethnic-racial identity measured at baseline would influence relationship quality, as well as the girls' ethnic identity and cultural mistrust, at the end of the intervention, adjusting for baseline measures. It was also hypothesized that girls' cultural mistrust toward Whites at baseline would be negatively associated with mentoring relationship quality at the end of the intervention. METHOD: Participants were 40 adolescent girls of color who were matched with racially-ethnically diverse women mentors in a community-based mentoring program. RESULTS: Mentor support for ethnic-racial identity as reported by youth significantly predicted relative increases in youth reports of relational but not instrumental satisfaction. Higher mentor support for ethnic-racial identity also significantly predicted increases in ethnic identity exploration, but only among girls with White mentors. Further, youth's reported greater cultural mistrust toward Whites was a significant predictor of decreased instrumental relationship satisfaction among girls with White mentors. CONCLUSIONS: Findings support the importance of further efforts to understand the roles of culturally relevant relationship processes and youth attitudes in mentoring interventions for girls of color. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Childhood Protective Factors and a Prevention Program Reduce Later Problem Behaviors.

Prior research has yet to elucidate how constellations of protective factors in childhood and prevention efforts simultaneously may influence youth involvement in problem behaviors across different points in development. The current study examines how latent classes of social and emotional learning (SEL) skills, parent-child relationships, and peer influences in third grade and receipt of an ongoing SEL intervention predict substance use and violence in fifth and eighth grade. The urban, predominantly low-income, sample (N = 1,169) was nested in 14 schools that were randomly assigned to the Positive Action program or business-as-usual. Membership in a latent class reflecting protective childhood factors predicted less substance use and violence in fifth grade; however, the SEL program predicted less substance use and violence in eighth grade. Findings generally support that SEL interventions can successfully target and boost developmentally appropriate positive behaviors and can prevail over initial risk factors with enough time and exposure.

Toxoplasma gondii acetyl-CoA synthetase is involved in fatty acid elongation (of long fatty acid chains) during tachyzoite life stages.

Apicomplexan parasites are pathogens responsible for major human diseases such as toxoplasmosis caused by Toxoplasma gondii and malaria caused by Plasmodium spp. Throughout their intracellular division cycle, the parasites require vast and specific amounts of lipids to divide and survive. This demand for lipids relies on a fine balance between de novo synthesized lipids and scavenged lipids from the host. Acetyl-CoA is a major and central precursor for many metabolic pathways, especially for lipid biosynthesis. T. gondii possesses a single cytosolic acetyl-CoA synthetase (TgACS). Its role in the parasite lipid synthesis is unclear. Here, we generated an inducible TgACS KO parasite line and confirmed the cytosolic localization of the protein. We conducted 13C-stable isotope labeling combined with mass spectrometry-based lipidomic analyses to unravel its putative role in the parasite lipid synthesis pathway. We show that its disruption has a minor effect on the global FA composition due to the metabolic changes induced to compensate for its loss. However, we could demonstrate that TgACS is involved in providing acetyl-CoA for the essential fatty elongation pathway to generate FAs used for membrane biogenesis. This work provides novel metabolic insight to decipher the complex lipid synthesis in T. gondii.

Apicoplast-Localized Lysophosphatidic Acid Precursor Assembly Is Required for Bulk Phospholipid Synthesis in Toxoplasma gondii and Relies on an Algal/Plant-Like Glycerol 3-Phosphate Acyltransferase.

Most apicomplexan parasites possess a non-photosynthetic plastid (the apicoplast), which harbors enzymes for a number of metabolic pathways, including a prokaryotic type II fatty acid synthesis (FASII) pathway. In Toxoplasma gondii, the causative agent of toxoplasmosis, the FASII pathway is essential for parasite growth and infectivity. However, little is known about the fate of fatty acids synthesized by FASII. In this study, we have investigated the function of a plant-like glycerol 3-phosphate acyltransferase (TgATS1) that localizes to the T. gondii apicoplast. Knock-down of TgATS1 resulted in significantly reduced incorporation of FASII-synthesized fatty acids into phosphatidic acid and downstream phospholipids and a severe defect in intracellular parasite replication and survival. Lipidomic analysis demonstrated that lipid precursors are made in, and exported from, the apicoplast for de novo biosynthesis of bulk phospholipids. This study reveals that the apicoplast-located FASII and ATS1, which are primarily used to generate plastid galactolipids in plants and algae, instead generate bulk phospholipids for membrane biogenesis in T. gondii.

Youth with chronic health problems: how do they fare in main-stream mentoring programs?

BACKGROUND: Youth with chronic physical health problems often experience social and emotional problems. We investigate the relationship between participation in the Big Brothers Big Sisters of Canada community-based mentoring programs (BBBS) and youth social and mood outcomes by youth health status. METHODS: Youth newly enrolled in BBBS were classified by health status (one or more chronic physical health problems without activity limitation, n = 191; one or more chronic physical health problems with activity limitation, n = 94; no chronic health problem or activity limitation, n = 536) and mentoring status (yes/no) at 18 month follow-up. Youth outcomes measured at follow-up were social anxiety, depressed mood, and peer self-esteem. RESULTS: Youth with chronic health problems and activity limitation were more likely to live with two biological parents, use mental health or social services, and have parents who reported difficulties with depressed mood, social anxiety, family functioning and neighbourhood problems. At 18 month follow-up, mentored youth in this health status group experienced fewer symptoms of social anxiety and higher peer self-esteem compared to non-mentored youth. Mentored youth with chronic health problems without activity limitation and mentored youth with no health problems or limitations did not show significant improvements in social anxiety and peer self-esteem. Regardless of their health status, mentored youth reported fewer symptoms of depressed mood than non-mentored youth. CONCLUSIONS: Youth with chronic health problems, particularly those with activity limitation as well, demonstrate a capacity to experience social and mood benefits associated with mentoring.

"I really wanted her to have a Big Sister": Caregiver perspectives on mentoring for early adolescent girls.

Formal youth mentoring programs tend to focus on the mentor-mentee dyad as the primary relationship cultivated and supported. The interests and preferences of the parent or caregiver in the mentoring relationship may receive little attention. In this study, semi-structured qualitative interviews were conducted with primary caregivers (N=20) of early adolescent girls participating in a Big Brothers Big Sisters community-based mentoring program to explore reasons why they wanted mentors for their daughters. Thematic analysis revealed that caregivers expected mentors to support their daughters as trusted companions, confidants, and conduits to opportunities and services. In addition, caregivers noted ways in which mentoring offered them respite and reinforced their parenting. The findings highlight the potential value of assessing caregiver perspectives and priorities so that program staff and mentors can partner more effectively with youth and families for successful mentoring experiences.

How Mentor Support Interacts With Mother and Teacher Support in Predicting Youth Academic Adjustment: An Investigation Among Youth Exposed to Big Brothers Big Sisters of Canada Programs.

This study examines three potential contributions (i.e., additive only, hierarchical compensatory, and hierarchical conditional) of mentor support to youth academic adjustment, taking into account interactions with support from mothers and teachers. We derived data from a larger study of the Big Brothers Big Sisters (BBBS) of Canada community mentoring program. The sample included 427 youth (average age 9.8 years; 64% girls, 56% White) who received one-to-one community-based mentoring for at least three months. We assessed perceptions of support from mothers and teachers before the match and assessed perceptions of support from mentors five times throughout the mentoring experience. Hierarchical linear regression analyses showed that mentor support predicted positive changes in youth academic adjustment (i.e., school attitude, academic self-efficacy, assistance seeking, and problem solving) mainly when mentees already reported high support from their mother. This finding clearly supports the conditional model and invites researchers to question the assumption that mentoring constitutes a corrective experience for young people (i.e., the compensatory model). BBBS agencies are strongly encouraged to involve parents in the mentoring process and to view them as experts, assets, and allies in their effort to meet the youth's needs.