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Zaira Khalid,1 Hasina Momotaz,2 Farren Briggs,3 Kristin A Cassidy,1,2 Naomi S Chaytor,4 Robert T Fraser,5 Mary R Janevic,6 Barbara Jobst,7 Erica K Johnson,8 Peter Scal,9 Tanya M Spruill,10 Betsy K Wilson,2 Martha Sajatovic1,2 1Department of Psychiatry, Case Western Reserve University School of Medicine, University Hospitals Cleveland Medical Center , Cleveland, OH, USA; 2Department of Neurology, Case Western Reserve University School of Medicine, Neurological and Behavioral Outcomes Center, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; 3Department of Population Health and Quantitative Science, School of Medicine, Case Western Reserve University, Cleveland, OH, USA; 4Department of Medical Education and Clinical Sciences, Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA; 5Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA; 6Center for Managing Chronic Disease, University of Michigan School of Public Health, Ann Arbor, MI, USA; 7Department of Neurology, Geisel School of Medicine at Dartmouth, Dartmouth College, Lebanon, NH, USA; 8Health Promotion Research Center, University of Washington, Seattle, WA, USA; 9Department of Pediatrics and Adolescent Health, University of Minnesota, Minneapolis, MN, USA; 10Department of Population Health, NYU School of Medicine, New York, NY, USACorrespondence: Martha SajatovicPrevention Research Center, Case Western Reserve University School of Medicine, University Hospitals Cleveland Medical Center, 10524 Euclid Avenue, Cleveland, OH 44106, USATel +1 216 844-2808Fax +1 216 844-2742Email Martha.sajatovic@uhhospitals.orgAim: There are limited data on psychological outcomes in older people with epilepsy (PWE). This analysis, from a large pooled dataset of clinical studies from the Managing Epilepsy Well (MEW) Network, examined clinical variables including depressive symptom severity, quality of life and epilepsy self-management competency among older (age 55+) vs younger (

Objective: The purpose of this analysis was to explore adolescent and adult women's interest in public health messaging around bladder health and perceptions of its usefulness. Materials and Methods: Directed content analysis of focus group data from the Study of Habits, Attitudes, Realities, and Experiences, which explored adolescent and adult women's experiences, perceptions, beliefs, knowledge, and behaviors related to bladder health across the life course. This article reports an analysis of the "Public Health Messaging" code, which included participants' desire or need for information about bladder health and recommendations for appropriate priority audiences. Results: Forty-four focus groups were conducted with 360 participants organized into six age groups (11-93 years). There was consensus across age groups that more information about the bladder is wanted and needed throughout the life course, as there is currently a lack of reliable educational resources. Information on bladder health was seen as useful and important because it enables people to anticipate negative changes in bladder health and act to prevent these. Several priority audiences were identified based on their risk of developing symptoms, but participants also saw value in educating the general public regardless of risk status. They also recommended education for parents and teachers who are in positions to control bathroom access. Conclusions: Results indicate a uniform desire for information on women's bladder health and a need for more research to develop individual prevention strategies and public health messaging for women of all ages, as well as guidance for organizations with a role in supporting bladder health.

BackgroundLower urinary tract symptoms (LUTS) are common in children and adolescents. Non-invasive tests evaluating bladder function are generally preferred over invasive tests, yet few studies have explored the range of normative values for these tests in healthy, asymptomatic children.ObjectiveTo define normative reference ranges for non-invasive tests of bladder function in healthy, asymptomatic girls and adolescents.Study designA comprehensive search strategy was performed in seven electronic databases through October 2019. English-language studies reporting data on voiding frequency, voided and postvoid residual volumes (PVR) and uroflowmetry results in healthy, asymptomatic girls (mean age ≥ 5 years) were included. Two independent reviewers performed study review, data extraction, and quality assessment. Overall mean estimates and 95% confidence intervals for each bladder function parameter were calculated using random effects models, and 95% normative reference values were estimated.ResultsTen studies met eligibility criteria for the meta-analysis (n = 2143 girls, age range: 3-18). Mean estimates of maximum voided volume and PVR were 233.4 ml (95% CI 204.3-262.6; n = 1 study) and 8.6 ml (95% CI 4.8-12.4; n = 2 studies) respectively. Pooled mean estimates for uroflowmetry parameters were: 21.5 ml/s (95% CI 20.5-2.5) for maximum flow rate (n = 6 studies), 12.5 ml/s (95% CI 11.2-13.8) for mean flow rate (n = 6 studies), 6.8 s (95% CI 4.4-9.3) for time to maximum flow (n = 3 studies), 15.7 s (95% CI 13.0-18.5) for flow time (n = 3 studies), and 198.7 ml (95% CI 154.2-234.2) for voided volume (n = 9 studies). No studies reported estimates of voiding frequency. Between-study heterogeneity was high (89.0-99.6%).ConclusionsAlthough we were able to calculate pooled mean estimates for several parameters, the small number of included studies and the wide age ranges of participants preclude generalization of reference values to all healthy girls. Further research is needed to determine normative reference values within specific age groups.

Abstract Background To increase understanding of the healthcare transition (HCT) process for young people living with Juvenile Idopathic Arthritis (JIA) by examining: 1) the extent to which youth report discussing HCT topics with their rheumatologist and 2) the association between youth perceptions of autonomy support from their rheumatologist and HCT discussions. Methods Data are from an online survey of youth in the United States with rheumatologic conditions (n= 134). HCT discussion was measured by 4 questions from the National Survey of Children with Special Health Care Needs. Youth perception of autonomy support was measured using a validated 6-item scale. Results One third of the youth (33.7%) reported talking to their rheumatologist about transferring to adult medicine. Less than half (40.8%) of respondents talked with their rheumatologist about adult healthcare needs, and less than a quarter (22.0%) discussed acquiring health insurance as an adult. Nearly two-thirds of respondents (62.7%) reported that their rheumatologist usually/always encourages self-care responsibility. Multivariate analyses revealed significant associations between rheumatologist support for youth autonomy and HCT counseling. Conclusion The low frequency of HCT counseling reported indicates a continuing need to increase awareness among rheumatologist in the USA. The strong associations between rheumatologist’s support for youth autonomy and HCT counseling suggest that developmentally “in-tune” providers may deliver the best guidance about transition planning for youth living with arthritis.

Abstract Objective: The COVID-19 pandemic presented a challenge to established seed grant funding mechanisms aimed at fostering collaboration in child health research between investigators at the University of Minnesota (UMN) and Children’s Hospitals and Clinics of Minnesota (Children’s MN). We created a “rapid response,” small grant program to catalyze collaborations in child health COVID-19 research. In this paper, we describe the projects funded by this mechanism and metrics of their success. Methods: Using seed funds from the UMN Clinical and Translational Science Institute, the UMN Medical School Department of Pediatrics, and the Children’s Minnesota Research Institute, a rapid response request for applications (RFAs) was issued based on the stipulations that the proposal had to: 1) consist of a clear, synergistic partnership between co-PIs from the academic and community settings; and 2) that the proposal addressed an area of knowledge deficit relevant to child health engendered by the COVID-19 pandemic. Results: Grant applications submitted in response to this RFA segregated into three categories: family fragility and disruption exacerbated by COVID-19; knowledge gaps about COVID-19 disease in children; and optimizing pediatric care in the setting of COVID-19 pandemic restrictions. A series of virtual workshops presented research results to the pediatric community. Several manuscripts and extramural funding awards underscored the success of the program. Conclusions: A “rapid response” seed funding mechanism enabled nascent academic-community research partnerships during the COVID-19 pandemic. In the context of the rapidly evolving landscape of COVID-19, flexible seed grant programs can be useful in addressing unmet needs in pediatric health.

We assessed the extent to which parents of children with autism spectrum disorder report that they are engaged in shared decision making. We measured the association between shared decision making and (a) satisfaction with care, (b) perceived guidance regarding controversial issues in autism spectrum disorder, and (c) perceived assistance navigating the multitude of treatment options. Surveys assessing primary medical care and decision-making processes were developed on the basis of the U.S. Department of Health and Human Service's Consumer Assessment of Healthcare Providers and Systems survey. In May 2009, after pilot testing, we sent surveys to 203 parents of children from ages 3 to 18 with International Classification of Diseases-9 and parent-confirmed autism spectrum disorder diagnoses. The response rate was 64%. Controlling for key demographic variables, parents of children with autism spectrum disorder reporting higher levels of shared decision making reported significantly greater satisfaction with the overall quality of their child's health care (p [less than or equal to] 0.0001). Parents reporting higher levels of shared decision making were also significantly more likely to report receiving guidance on the many treatment options (p = 0.0002) and controversial issues related to autism spectrum disorder (p = 0.0322). In this study, shared decision making was associated with higher parent satisfaction and improved guidance regarding treatments and controversial issues within primary care for children with autism spectrum disorder.

Forty-six subjects received primary medical care within an autism-specific medical home intervention (www.autismmedicalhome.com) and 157 controls received standard primary medical care. Subjects and controls had autism spectrum disorder diagnoses. Thirty-four subjects (74%) and 62 controls (40%) completed pre and post surveys. Controlling for pre-survey medical home status, subjects had 250% greater odds of receipt of a medical home at the study end compared to controls (p = 0.021). Compared to controls, subjects receiving the intervention reported significantly more satisfaction (p = 0.0004), greater shared decision making (p = 0.0005) and fewer unmet needs (p = 0.067). However, subjects reported no change in family stress (p = 0.204).

Introduction This mixed-method study (a) describes challenges to providing sexual health services to youth with mobility impairments from the perspective of health care providers and experts and (b) describes and compares sexual health–related experiences of youth with mobility impairments. Method Secondary data analysis of My Path, a study focused on the transition to adulthood for youth with mobility impairments. Using an exploratory sequential design, qualitative data ( n = 10) were analyzed using systematic content analysis followed by quantitative analysis of survey data ( N = 337). Results Challenges included not talking about sex, managing sexual development, adaptation and instruction, parent roles, and safety. Survey data showed that youth with mobility impairments are diverse in their experiences with sexual behavior and sources of sexual health information. Although connected with primary care providers, few received information about sexual health. Discussion Interventions to improve youths' well-being should include comprehensive care and education that promotes and supports healthy sexual development. [ABSTRACT FROM AUTHOR]

Copyright of Tecnologia em Metalurgia, Materiais e Mineração is the property of Associacao Brasileira de Metalurgia e Materiais and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose We tested relationships between patient-centered communication (PCC), relatedness to health care providers, and autonomy around health care management among youth with and without mobility limitations (MLs) and examined whether the relationship between PCC and autonomy was mediated by how connected youth feel to their health care providers. Methods Stratified multiple regression models were used to examine predicted associations for youth with and without MLs. Results PCC was significantly associated with relatedness to health care providers and autonomy for managing health care among youth with and without MLs. After controlling for covariates, evidence of mediation was observed among youth without MLs but not for youth with MLs. Conclusions For youth without MLs, mediation suggests that youth's connection to their health care provider contributes to higher levels of health-related autonomy. For youth with MLs, independent of feeling connected to health care providers, more frequent PCC resulted in higher levels of health-related autonomy. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this study was to examine the likelihood of discussing health-related behaviors with health care providers (HCPs), comparing youth with and without mobility limitations (MLs). Methods Analyses were conducted using baseline data from the MyPath study. Adolescents and young adults between the ages of 16 and 24 years completed a survey about their health care and health-related experiences. Analyses assessed the relationship between mobility status and discussing health-related behaviors with an HCP. Secondary analyses examined the extent to which adolescents and young adults' engagement in these behaviors was associated with these discussions. Results Overall, we found low rates of discussions about the following topics: substance use, sexual and reproductive health, healthy eating, weight, and physical activity. Adolescents and young adults with MLs were less likely to report discussing substance use and sexual and reproductive health, but were more likely to discuss healthy eating, weight, and physical activity than peers without MLs. Those adolescents and young adults who reported substance use had higher odds of discussing this topic and those who reported having sexual intercourse had higher odds of discussing sexual and reproductive health. Conclusions Results suggest mobility status and a young person's engagement in health risk and promoting behaviors are associated with the likelihood of discussing these behaviors with an HCP. It is important that HCPs view adolescents and young adults with MLs as needing the same counseling and guidance about health-related behaviors as any young person presenting him/herself for treatment. [ABSTRACT FROM AUTHOR]

Purpose Focusing on youth with juvenile arthritis (JA), this study investigates eHealth interventions as a means to develop services to improve the health of youth with chronic conditions. Internet use and preferences for Internet-based interventions were compared among youth with high and low psychosocial quality of life (PS-QL) scores. Methods Youth with JA (n = 134; high PS-QL, n = 67; low PS-QL, n = 67) completed the MyRheum online survey, which assessed physical functioning, psychosocial health, Internet usage, and amount of time spent using social networking Web sites. Youth indicated their choice, interest, and preferences in using a Web site for youth with JA. The t tests, chi-squared tests, and Fisher exact tests were used to assess significance between high and low PS-QL groups. Results Youth with lower PS-QL reported greater intrusiveness of their condition across life's activities than did youth with higher PS-QL. Low PS-QL was associated with spending more than 1 hour per day using social networking sites and having used the Internet to find information on various health and substance use topics. Youth with lower PS-QL expressed more interest in messaging others, online forums, building personal profiles, and networking with other teens than did youth with higher PS-QL. Both those with high and low PS-QL preferred online to in-person support groups. Conclusions Many youth with JA report low PS-QL and identify interest in Internet-based supportive interventions. The next generation of eHealth interventions for youth with JA, and possibly other chronic conditions, may better address their needs by recognizing the diversity of experiences and tailoring intervention strategies accordingly. [ABSTRACT FROM AUTHOR]

Abstract: Introduction: The objective of this study was to identify challenges that teens experience while living with juvenile arthritis (JA) from the perspective of youth and young adults with JA. Method: Focus group interviews were conducted with youth (aged 14-21 years) and young adults (aged 22-29 years) with JA using a semi-structured interview protocol that included questions about the challenges adolescents experience while living with arthritis. Results: Challenges of living with JA were identified in the areas of (a) health care, (b) relationships, (c) school, (d) physical, and (e) individual. However, distinct perspectives emerged between youth and young adult participants. For youth, challenges were situated in present time and focused heavily on interpersonal situations. Alternatively, young adults reported challenges that illuminated their experiences of movement from adolescence into young adulthood (e.g., independently managing their JA and disclosure to dating partners). Discussion: Findings from this study display complex and multifaceted experiences that teens face while living with arthritis. Experiences associated with arthritis were not limited to being described as health care–related challenges; rather, arthritis permeates multiple contexts in adolescents'' lives. [Copyright &y& Elsevier]

Copyright of Tecnologia em Metalurgia, Materiais e Mineração is the property of Associacao Brasileira de Metalurgia e Materiais and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To examine the effect of the transition to adulthood on financial and non-financial barriers to care in youth with asthma. Study design: With National Health Interview Survey data from 2000 to 2005, we examined delays and unmet needs because of financial and non-financial barriers, evaluating the effect of adolescent (age, 12-17 years; n = 1539) versus young adult age (age, 18-24 years; N = 833), controlling for insurance, usual source of care, and sociodemographic characteristics. We also simulated the effects of providing public insurance to uninsured patients and a usual source of care to patients without one. Results: More young adults than adolescents encountered financial barriers resulting in delays (18.6% versus 8%, P < .05) and unmet needs (26.6% versus 11.4%, P < .05), although delays caused by non-financial barriers were similar (17.3% versus 14.9%, P = not significant). In logistic models young adults were more likely than adolescents to report delays (odds ratio [OR], 1.45; 95% CI, 1.02-2.08) and unmet needs (OR, 1.8; 95% CI, 1.29-2.52) caused by financial barriers. Conclusions: Delays and unmet needs for care caused by financial reasons are significantly higher for young adults than they are for adolescents with asthma. [Copyright &y& Elsevier]

Since the US Surgeon General's conference on health care transitions in 1989, transition from pediatric to adult-oriented health care for youth with chronic conditions continues to develop as an important issue among youth, parents, and health professionals. Key professional organizations, public agencies, and disease-specific organizations have promoted research on transition and the development of transition services. Although there is evidence of the advancement of the science and practice of transition in the context of subspecialty medical care, the same may not be true for transition in the context of primary care practice. Little has been written about the role of the primary care provider in facilitating transition, and little is published in the medical literature about how transition occurs in primary care settings. [ABSTRACT FROM AUTHOR]

Introduction Epilepsy has been reported by the CDC to have a prevalence of 1.2% in the United States, which accounts for roughly 3.4 million adults in 2015. Nearly 1 million of those adults are aged 55 or older.1 Epilepsy is more likely to develop in older adults because risk factors for epilepsy are more common as people age including stroke/cardiovascular disease, neurodegenerative disorders, brain tumor and long-term sequelae of alcohol abuse.2 As our population ages, there will be even more older people with epilepsy. A common comorbidity in epilepsy is depression. While the prevalence of depression in patients with epilepsy varies in literature, it is estimated to be between 15% and 37%.3 The significance of depressive symptoms on quality of life has been shown to be greater than that of short-term seizure control.4 For older people, balancing epilepsy treatment in conjunction with other health problems can present with great difficulty. Many antiepileptic's also have side effects such as bone loss, dizziness and greater risk for falls, which can make someone more likely to fall and become injured.5 This analysis, from a large pooled dataset of multiple epilepsy treatment studies, examined presence and symptom severity of depression in older adults (age > 55) with epilepsy in comparison to younger adults (age <55) with epilepsy. Methods Analysis was completed using baseline data and clinical variables from 9 studies of the Managing Epilepsy Well (MEW) Network integrated research database (MEW DB). Patients were divided into two groups; age 18-55 and age greater than or equal to 55. A total of 935 adults participated, out of which 161 (17.2 %) were of age 55 or greater and 774 adults younger than 55 (82.8 %). Other demographics included were gender, race, marital status, highest education level and annual income. Standardized rating scales included Quality of Life in Epilepsy (QOLIE-10) and Patient Health Questionnaire (PHQ-9) for depressive symptoms. The QOLIE-10 scoring was harmonized to accommodate slightly different versions of this scale within the integrated dataset. Results The mean age for older patients was 61.5 vs. 34.4 for younger patients. Approximately 60% of patients in both groups were females. Among older patients 109 (76.2%) were white, 24 (16.8%) African Americans, and 4 (3.1%) Hispanic. Majority of these patients (78.6%) had a college education and 53.4% were either married or co-habiting. Demographics of the under 55 group were largely similar. Mean PHQ-9 score was 8.5 in older patients vs. 9.5 in younger patients (p= 0.07). Amongst older patients, those with moderate-severe depression defined as PHQ-9 > 10 had an average of 7 seizures in 30 days, compared to those with scores <10 with an average of 2.7 seizures in 30 days (p=0.447). QOLIE-10 scores followed a similar pattern in that severe depression (PHQ 9 >10) in both younger and older groups was associated with worse QOL (p=<0.001). Conclusions Depression is common in people with epilepsy across the lifespan. Depression is more common in those with poorly controlled epilepsy, and more severe depressive symptoms are associated with poorer quality of life. However, we did not find that these findings were different in older vs. younger patients. Methodological limitations such as the clinical trials' data source and relatively young age of the sample overall could have biased findings. Future analyses need to sample more elderly people with epilepsy including the "old-old" and those with more extensive medical comorbidity. This research was funded by: This study was supported in part by CDC grants U48DP001930 (CWRU), U48DP005030 (CWRU) U48DP005008 (NYU), 148DP005013 (WA), and 1U48DP005018 (Geisel School of Medicine at Dartmouth) under the Health Promotion and Disease Prevention Research Centers Program. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: To examine self-reported use and correlates of complementary and alternative medicine (CAM) in adolescents with juvenile arthritis (JA). Methods: One hundred thirty-four adolescents with JA completed an online survey of their use of, interest in, and discussions about CAM. The PedsQL 4.0 SF15 assessed quality of life. Results: The majority (72%) of youth reported using ≥1 CAM modality. Use did not differ by sex, age, race, or geographic location. The most commonly used CAM modalities were yoga (45%) and meditation, relaxation, or guided imagery (40%). Low psychosocial quality of life was associated with massage and meditation, relaxation, or guided imagery use (p < .05). Only 46% of youth reported discussing CAM with a health care provider. Nonusers were most interested in learning more about massage (79%) and yoga (57%). Conclusions: Youth with JA reported high use of CAM, but few discussed CAM with health care providers. Findings suggest practitioners should engage adolescents in discussions about CAM. [Copyright &y& Elsevier]

Os frutos da pinheira possuem limitações para sua distribuição a mercados distantes, por causa do rápido amadurecimento, que os torna muito macios, de difícil manuseio sem a ocorrência de danos e de conservação extremamente reduzida. O objetivo deste trabalho foi avaliar a influência do filme de policloreto de vinila (PVC), associado às temperaturas de refrigeração, na conservação pós-colheita da pinha. Os frutos foram selecionados, lavados, sanitizados e acondicionados em bandejas de isopor, com, ou sem, envolvimento de película de policloreto de vinila, e conservados a 12 e 25 ºC. Foram avaliados: cor da casca, firmeza, perda de matéria fresca, sólidos solúveis, acidez titulável, açúcares totais e amido. Os frutos conservados a 12 ºC, com policloreto de vinila, mantiveram a coloração verde da casca até o 18º dia, apresentaram menor perda de massa de matéria fresca e firmeza da casca e menor teor de sólidos solúveis e acidez titulável, em relação aos frutos armazenados a 25 ºC. A utilização da embalagem, associada à temperatura de 12 ºC, permite um período seguro de 18 dias de conservação, com adequada manutenção dos atributos físicos e químicos. Os frutos armazenados a 25 ºC conservaram-se por seis dias. A película de PVC, associada ao armazenamento de 12 ºC, pode ser utilizada para atrasar o amadurecimento dos frutos por 18 dias, mantendo sua qualidade. Os frutos que permaneceram armazenados, por seis dias, a 25 ºC com, ou sem, PVC, não apresentaram características físicas e químicas desejáveis.Sweetsop fruits show limitations to the distribution to distant markets due to their fast ripening, which turns them very soft and difficult to handle without the occurrence of damage, with their conservation extremely reduced. This study was carried out to evaluate the influence of the polyvinyl chloride associated to cooling temperatures in the post-harvest conservation of the sweetsop. The fruits were selected, washed, sanitized and stored in polystyrene trays with or without polyvinyl chloride and stored at 12 ºC and 25 ºC. The following characteristics were evaluated: color rind, firmness, fresh matter loss, soluble solids, titrable acidity, total sugars and starch. The fruits stored at 12 ºC with polyvinyl chloride kept the green coloration of the rind up to the 18th day, showing lower loss of fresh matter and rind firmness as well as lower content of the soluble solids and titrable acidity in relation to the fruits stored at 25 ºC. The use of the package associated to the temperature of 12 ºC allowed a safe period of 18 days under storage with appropriate maintenance of the physiochemical attributes. The fruits stored for 6 days at 25 ºC, with or without PVC, did not show desirable physicochemical characteristics.

Best practices have not yet been established in the interprofessional education (IPE) literature to guide the ideal dose and duration of IPE experiences across the curriculum. As such, the content, structure, and delivery format of IPE offerings vary significantly across institutions. The University of Minnesota had the rare opportunity to evaluate learner-perceived collaborative competency outcomes due to the transition of its centrally offered introductory IPE course. Data were collected consistently, longitudinally, and for a high volume of learners and professions across two IPE course models applied within the same academic institution. Retrospective analysis of pre-post interprofessional collaborative competency scores collected for over 5,000 learners from 17 health profession degree programs demonstrated nearly identical self-reported competency attainment for both a 12- and 4-hour introductory IPE offering, assessed using the ICCAS tool over the course of 5-year format transition. If student-reported competency attainment is the same following an introductory IPE experience regardless of the dosage, then academic IPE programs may be better positioned by decreasing their introductory emphasis and instead focus their resources on exploring innovative workplace-based and competency-based IPE strategies in line with contemporary recommendations. Further studies are needed to explore the implications of and next steps in this line of research.

Objective: To assess depressive symptom outcomes in a pooled sample of epilepsy self-management randomized controlled trials (RCTs) from the Managing Epilepsy Well (MEW) Network integrated research database (MEW DB)., Methods: Five prospective RCTs involving 453 adults with epilepsy compared self-management intervention (n = 232) versus treatment as usual or wait-list control outcomes (n = 221). Depression was assessed with the nine-item Patient Health Questionnaire. Other variables included age, gender, race, ethnicity, education, income, marital status, seizure frequency, and quality of life. Follow-up assessments were collapsed into a visit 2 and a visit 3; these were conducted postbaseline., Results: Mean age was 43.5 years (SD = 12.6), nearly two-thirds were women, and nearly one-third were African American. Baseline sample characteristics were mostly similar in the self-management intervention group versus controls. At follow-up, the self-management group had a significantly greater reduction in depression compared to controls at visit 2 (P < .0001) and visit 3 (P = .0002). Quality of life also significantly improved in the self-management group at visit 2 (P = .001) and visit 3 (P = .005)., Significance: Aggregate MEW DB analysis of five RCTs found depressive symptom severity and quality of life significantly improved in individuals randomized to self-management intervention versus controls. Evidence-based epilepsy self-management programs should be made more broadly available in neurology practices., (Wiley Periodicals, Inc. © 2019 International League Against Epilepsy.)

Over the last 5 decades, health-care advances have yielded quantum improvements in the life expectancy of individuals with congenital genitourinary conditions (CGCs), leading to a crisis of care. Many individuals with CGC enter adulthood unprepared to manage their condition. Pediatric CGC specialists lack training to manage adulthood-related health-care issues, whereas adult genitourinary specialists lack training within the context of CGCs. To address these challenges, the National Institutes of Diabetes and Digestive and Kidney Diseases convened individuals with CGCs and experts from a variety of fields to identify research needs to improve transitional urology care. This paper outlines identified research needs., (Copyright © 2017 Elsevier Inc. All rights reserved.)