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The process of transitioning from a pediatric to adult health models of care is a significant challenge associated with heightened morbidity and mortality, particularly for patients with medical complexity.

The aim of this study was to determine the concentration of Fe, Ni, Cu, Zn and Pb in scalp hair of leukaemia patients and healthy volunteers, using the optimised XRF method. Leukaemia hair samples were classifi ed corresponding to type, growth and age of the participants. The results showed that the studied trace elements (TEs) in both of leukaemia and control groups were positively skewed. In comparison with the control group, lower Fe, Cu, Zn and Pb and higher of Ni medians were found in all studied leukaemia patients. The median rank obtained by Mann-Whitney U-test revealed insignifi cant differences between the leukaemia patients subgroups and the controls. An exact probability (α < 0.05) associated with the U-test showed signifi cant differences between medians in leukaemia patients and controls groups for Pb (lymphatic/control, acute/control), Cu (lymphatic/control, chronic/control), Ni (lymphatic/control, chronic/control) and Fe (chronic/control). Very strong positive and negative correlations (r > 0.70) in the scalp hair of control group were observed between Ni/Fe-Ni, Cu/Fe-Cu, Zn/Fe-Zn, Pb/Fe-Pb, Cu/Ni-Zn/Ni, Cu/Ni-Pb/Ni, Zn/Ni-Pb/Ni, Zn/Fe-Zn/Cu, Pb/Ni-Ni and Ni/Fe-Pb/Ni, whereas only very strong positive ratios in the scalp hair of leukaemia patients group were observed between Ni/Fe-Ni, Cu/Fe-Cu, Zn/Fe-Zn and Pb/Fe-Pb, all correlations were signifi cant at p < 0.05. Other strong and signifi cant correlations were also observed in scalp hair of both groups. Signifi cant differences between grouping of studied TEs in all classifi ed leukaemia groups and controls were found using principal component analysis (PCA). The results of PCA confi rmed that the type and the growth of leukaemia factors were more important in element loading than the age factor.

Executive dysfunction is thought to be primary to autism. We examined differences in executive function between 20 adults with autism and learning disability and 23 individuals with learning disabilities outside the autistic spectrum. All participants were matched for chronological age and full-scale IQ, and were given a battery of tasks assessing fluency, planning, set-shifting, inhibition and working memory. Analyses of the individual tasks revealed very few significant differences between the two groups. However, analyses of composite scores derived for each executive domain revealed that the group with autism showed impaired performance on the working memory and planning tests. Together, these two measures were sufficient to classify participants into their diagnostic groups significantly better than would be expected by chance (75% of the autism group; 65% of the control group). Executive impairments were neither universal nor exclusive to the autism group, and we suggest that an alternative cognitive theory may better explain the cognitive profile we found. (Contains 2 tables and 1 note.)

Purpose: To assess perspectives of clinicians at an academic medical center regarding current practices, barriers and possible interventions in transitioning young adult patients to adult care.Methods: Electronic survey results from licensed independent providers in the Departments of Internal Medicine (n = 87) and Pediatrics (n = 49) were analyzed.Results: The majority of providers at our institution are unaware of and do not follow national transition guidelines. Seventy-seven percent of pediatricians provide the majority of preparation and support in transition care of young adults with complex medical conditions without involvement of other interprofessional team members. Ninety-six percent of internists report not receiving formal training related to transition care and only 44% are comfortable caring for young adults with medical complexity. Eighty-eight percent of pediatricians and internists support a standard transition process, yet significant gaps in this process exist.Conclusion: Despite the existence of national society-supported recommendations for transitions of care processes, lack of awareness among providers regarding national transition guidelines has led to uncertainty when it comes to managing the transition of young adult patients. There is lack of communication between pediatricians and internists, and internists are not as confident in caring for young adult patients. The scope of work of the interprofessional team is not utilized adequately. Providers agree on the importance of developing a standardized pediatric to adult transition process. These results help inform possible future interventions to improve care for this population. [ABSTRACT FROM AUTHOR]