Mentoring Youth at High Risk: The Perspectives of Professional Mentors

Background

Youth mentoring programs rely largely on volunteers, but youth facing significant risks may be poor candidates for volunteer-based interventions. Full-time “professional” mentors in highly structured programs may be better suited to partner effectively with such youth and their families, but few studies examine professional mentoring interventions. Because of mentoring’s inherent flexibility, mentors’ role conceptualizations can profoundly influence the nature of their work. Serving as a professional mentor may have important implications for how mentors conceptualize and perform their role.

Objective

This qualitative study examined the role conceptions of professional mentors serving at-risk youth.

Methods

Semi-structured interviews with mentors were transcribed, coded, and subjected to thematic analysis.

Results

Mentors described the importance of “professionalism” in prioritizing mentoring, expending considerable effort, and performing difficult or unpleasant tasks. They reported that serving multiple children full-time enabled them to rapidly build expertise, that credibility and authority granted them because of their professional status facilitated their work across multiple key contexts, and that their expertise and long-term commitment facilitated the development of deep relationships. Mentors perceived their role as highly challenging but reported high self-efficacy. They described high multifaceted organizational support, a community for youth, and an individualized child focus.

Conclusions

A mentoring model delivered by experienced professional mentors may hold promise for working with youth at high risk. The role conceptualizations of mentors and the organizational culture within which mentors work may be important in helping youth succeed.     

Cannabidiol: Promise and Pitfalls

Over the past few years, increasing public and political pressure has supported legalization of medical marijuana. One of the main thrusts in this effort has related to the treatment of refractory epilepsy—especially in children with Dravet syndrome—using cannabidiol (CBD). Despite initiatives in numerous states to at least legalize possession of CBD oil for treating epilepsy, little published evidence is available to prove or disprove the efficacy and safety of CBD in patients with epilepsy. This review highlights some of the basic science theory behind the use of CBD, summarizes published data on clinical use of CBD for epilepsy, and highlights issues related to the use of currently available CBD products.Cannabidiol is the major nonpsychoactive component of Cannabis sativa. Over the centuries, a number of medicinal preparations derived from C. sativa have been employed for a variety of disorders, including gout, rheumatism, malaria, pain, and fever. These preparations were widely employed as analgesics by Western medical practitioners in the 19^th century (1). More recently, there is clinical evidence suggesting efficacy in HIV-associated neuropathic pain, as well as spasms associated with multiple sclerosis (1).     

Sequence Kernel Association Test for Survival Traits

Rare variant tests have been of great interest in testing genetic associations with diseases and disease‐related quantitative traits in recent years. Among these tests, the sequence kernel association test (SKAT) is an omnibus test for effects of rare genetic variants, in a linear or logistic regression framework. It is often described as a variance component test treating the genotypic effects as random. When the linear kernel is used, its test statistic can be expressed as a weighted sum of single‐marker score test statistics. In this paper, we extend the test to survival phenotypes in a Cox regression framework. Because of the anticonservative small‐sample performance of the score test in a Cox model, we substitute signed square‐root likelihood ratio statistics for the score statistics, and confirm that the small‐sample control of type I error is greatly improved. This test can also be applied in meta‐analysis. We show in our simulation studies that this test has superior statistical power except in a few specific scenarios, as compared to burden tests in a Cox model. We also present results in an application to time‐to‐obesity using genotypes from Framingham Heart Study SNP Health Association Resource.     

Cellular plasticity: A mechanism for homeostasis in the kidney

Cellular plasticity is a topical subject with interest spanning a wide range of fields from developmental biology to regenerative medicine. Even the nomenclature is a subject of debate, and the underlying mechanisms are still under investigation. On top of injury repair, cell plasticity is a constant physiological process in adult organisms and tissues, in response to homeostatic challenges. In this review we discuss two examples of plasticity for the maintenance of homeostasis in the renal system—namely the renin‐producing juxtaglomerular cells (JG cells) and cortical collecting duct (CCD) cells. JG cells show plasticity through recruitment mechanisms, answering the demand for an increase in renin production. In the CCD, cells appear to have the ability to transdifferentiate between principal and intercalated cells to help maintain the highly regulated solute transport levels of that segment. These two cases highlight the complexity of plasticity processes and the role they can play in the kidney.     

PEER umbrella systematic review of systematic reviews: Management of osteoarthritis in primary care

ObjectiveTo determine how many patients with chronic osteoarthritis pain respond to various non-surgical treatments.Data sourcesPubMed and the Cochrane Library.Study selection Published systematic reviews of randomized controlled trials (RCTs) that included meta-analysis of responder outcomes for at least 1 of the following interventions were included: acetaminophen, oral nonsteroidal anti-inflammatory drugs (NSAIDs), topical NSAIDs, serotonin-norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants, cannabinoids, counseling, exercise, platelet-rich plasma, viscosupplementation, glucosamine, chondroitin, intra-articular corticosteroids, rubefacients, or opioids.Synthesis In total, 235 systematic reviews were included. Owing to limited reporting of responder meta-analyses, a post hoc decision was made to evaluate individual RCTs with responder analysis within the included systematic reviews. New meta-analyses were performed where possible. A total of 155 RCTs were included. Interventions that led to more patients attaining meaningful pain relief compared with control included exercise (risk ratio [RR] of 2.36; 95% CI 1.79 to 3.12), intra-articular corticosteroids (RR = 1.74; 95% CI 1.15 to 2.62), SNRIs (RR = 1.53; 95% CI 1.25 to 1.87), oral NSAIDs (RR = 1.44; 95% CI 1.36 to 1.52), glucosamine (RR = 1.33; 95% CI 1.02 to 1.74), topical NSAIDs (RR = 1.27; 95% CI 1.16 to 1.38), chondroitin (RR = 1.26; 95% CI 1.13 to 1.41), viscosupplementation (RR = 1.22; 95% CI 1.12 to 1.33), and opioids (RR = 1.16; 95% CI 1.02 to 1.32). Preplanned subgroup analysis demonstrated no effect with glucosamine, chondroitin, or viscosupplementation in studies that were only publicly funded. When trials longer than 4 weeks were analyzed, the benefits of opioids were not statistically significant.ConclusionInterventions that provide meaningful relief for chronic osteoarthritis pain might include exercise, intra-articular corticosteroids, SNRIs, oral and topical NSAIDs, glucosamine, chondroitin, viscosupplementation, and opioids. However, funding of studies and length of treatment are important considerations in interpreting these data.     

Chemokine (C-X-C motif) ligand 1 (CXCL1) protein expression is increased in high-grade prostate cancer

Chemokines, including chemokine (C-X-C motif) ligand 1 (CXCL1), may enhance tumor epithelial-stromal interactions facilitating tumor growth and invasion. Studies have linked CXCL1 expression to gastric, colon and skin cancers, however, no study to date has been reported describing CXCL1 in human prostate tumors. Herein, we set out to describe the expression pattern of CXCL1 in human prostate tumors.