Time Of Transition Research Articles

Assessing barriers and facilitators to transition in sickle cell disease care prior to implementation of a formalized program.

Over 95% of children with sickle cell disease (SCD) survive into adulthood in the United States. However, early mortality remains a problem, especially in persons between the ages of 18 and 35. One possible explanation for the increased mortality rate in young adults is difficulties in engaging in care during the transition from a heavily contiguous pediatric healthcare model to a more self-reliant adult healthcare model. The goal of this study was to identify potential facilitators and barriers to a successful transfer in care from the pediatric to adult SCD program before the formation of a formal transition program. This is a retrospective cohort study of transition outcomes for 472 individuals with SCD (all genotypes) treated at the University of Alabama at Birmingham (UAB) sickle cell clinic (aged 18-24). The primary outcome was whether the patient continued care in (any) adult SCD program (defined as being seen at least once in an adult hematology/SCD clinic). One hundred eighty-eight (45%) transition age patients successfully transferred to adult care. Facilitators to successful transfer in care included being treated at the same hospital for both pediatric and adult programs, having the genotype HbSS, and/or receiving an SCD-modifying therapy at the time of transition (hydroxyurea and/or red cell transfusion therapy). Of primary interest, many of the patients who failed to transition to an adult clinic were lost to follow-up prior to 15years of age. Importantly, these patients who had previously been labeled as "transition failures," were lost to follow-up long before the transition age. Early engagement is needed for this population.

Pilot longitudinal kidney transplant transition program promotes peer connections and transition readiness.

Adolescents who have received a kidney transplant are at high risk of graft rejection and transplant-related comorbidities around the time of transition from pediatric to adult care. While there has been a progress in tracking transition readiness, further work is needed to prepare adolescents for healthcare transitions. We describe a longitudinal cohort-based transition curriculum designed to prepare kidney transplant recipients for adult transplant care. Adolescent kidney transplant recipients aged 17 and older participated in the pilot cohort of the 2-year transition curriculum. Session topics included communication with the healthcare team, insurance, job skills, reflective practice, reproductive health, medications, and adult clinic introduction. Surveys were given to obtain narrative feedback, assess participant self-management behavior, and track curriculum knowledge. Each participant attended an average of two sessions, with 18 out of 30 eligible adolescents participating in at least one session. After transitioning to a virtual platform, there was increased attendance of participants who live greater than 150 miles from the transplant center. Adolescents highlighted the value of the program's group structure to relate to and learn from other participants. The pilot transition program successfully provided adolescent kidney transplant recipients the opportunity to learn alongside their peers and gain interdisciplinary knowledge to prepare for healthcare transition. The program converted to a virtual platform during the COVID-19 pandemic, with increased accessibility for participants who live further from the transplant center. Group-based programming for adolescents should be enhanced to further prepare them for transitions to adult medicine.

Tempo de transição alimentar e método de alimentação na alta hospitalar de prematuros com displasia broncopulmonar

ABSTRACT Purpose To compare the time of food transition and the form of oral feeding at hospital discharge, between premature newborns diagnosed with bronchopulmonary dysplasia and premature newborns without the diagnosis. Methods Cross-sectional, retrospective study based on data collection from medical records. Data were collected from 78 newborns, in a reference maternity hospital, in which the sample was stratified into two groups according to the presence or absence of the diagnosis of bronchopulmonary dysplasia. The time of food transition and the feeding method at hospital discharge were analyzed for both groups. Results There was a significant difference in the time of food transition and in the feeding method at hospital discharge between the groups. Preterm newborns with bronchopulmonary dysplasia had an average of 18.03 (± 5.5) transition days and left using a bottle. Conclusion The group with bronchopulmonary dysplasia required a longer time of food transition and fewer ( of its ) infants had exclusive breastfeeding compared to the group without the diagnosis.

B. H. Roberts: A Life in the Public ArenaFrank J. Cannon: Saint, Senator, Scoundrel

B. H. Roberts: A Life in the Public ArenaFrank J. Cannon: Saint, Senator, Scoundrel

Perspectives on Adsorption. What else? A personal view

In this Perspectives paper I reviewed my work on the adsorption area starting with section 1- Looking back…and the reading of the old book of C.L. Mantell in 1969 and my doctoral work in Nancy where I learned fixed-bed processes and mechanistic models. Then I mention the creation of my research group at the U. Porto and the organization of four NATO Advanced Study Institute bringing top researchers in the area as well as the origin of the International Adsorption Society and the Fundamentals of Adsorption conferences. In Section 2, I focus on lessons learned mentioning what is important to understand batch isothermal adsorption (adsorption equilibrium isotherm, operating line, LDF kinetic model) and fixed-bed processes, namely the concept of compressive and dispersive concentration waves resulting from De Vault equation (1943). Going from batch to continuous processes is illustrated with the case of Simulated Moving Bed (SMB) technology. In Section 3 I suggest a roadmap for the development of adsorption processes and sorption-enhanced reaction processes (SERP) combining experiments and process simulation, with reference to the importance of IAST theory in predicting multicomponent adsorption equilibrium, shaping and 3D printing of materials and the contribution of molecular simulation both for the screening of adsorbents and prediction of adsorption isotherms and transport properties. Finally in section 4, I discuss some challenges and opportunities related with difficult separations and the relevant choice of materials and processes together. I believe that in this time of transition from fossil energy to renewables many existing technologies will find a place in future biorefineries. Some references are made to CCUS and Power to Gas processes as an example of SERP. Finally, I address the importance in the future of hybrid modeling involving not only mechanistic aspects but incorporating data-driven modeling with tools from AI and machine learning and application of adsorption in different field as perfume engineering.

The Second-Generation Polish Émigrés in Istanbul as Transcultural Agents in the Ottoman Modernising Reforms in the Late 19th and Early 20th Centuries

This paper examines the transcultural agency of selected representatives of the second generation of Polish political émigrés to the Ottoman Empire at the turn of the 20th century: chemist, hygiene specialist and general Karol Bonkowski Pasha (1841–1905); general and state dignitary Władysław Czaykowski/Muzaffer Pasha (1843–1907); general and diplomat Hasan Enver Pasha (1857–1929) as well as diplomat, journalist and member of parliament Alfred Bieliński/Ahmed Rüstem Bey (1862–1934). Most of them were born and raised in the multi-ethnic empire, made careers in various fields and often reached the highest positions in the Ottoman state apparatus. They often played the role of transcultural intermediaries during the political and social transformations of the Ottoman Empire in the 19th and 20th centuries. This paper focuses on their involvement in the late Ottoman public sphere by elucidating their place in Ottoman society at the time of transition that characterised the period in question. By tracing the trajectory of these figures’ identity entanglements, it examines their attitudes towards attachment to the Ottoman Empire and Poland. It underscores the importance of the Ottoman capital – Istanbul – as a contact zone in this process. It sheds light on various spheres of transcultural agency of these second-generation Polish émigrés in the late Ottoman state and society.

On libraries, databases and the advancement of knowledge in the field of language history

Recalling her past conversations with G.K. Venediktov, a leading specialist in 19th-century standard Bulgarian, the author reflects on the correlation between the methodology of linguistic research and its outcomes. The recollections pertain mainly to the Moscow stage of the author's life (1981–1992). It was a time of transition from the Soviet to the post-Soviet era in Russian history, when computers were just entering researchers’ daily routine, and when one had to sign up in advance to get access for a certain short time slot to one of the institute’s computers. Back then, there was a state monopoly on copying technology, scholars wrote their papers by hand or on typewriters, and then copied the final drafts on the office computer, using first 5.25-inch and later 3.5-inch floppy disks, and the text editor Chi-Writer for MS-DOS with encoding for Cyrillic KOI-8. Researchers spent a large portion of their time reading in libraries and checking data in index card collections, handwritten by several generations of scholars. The academic Institute of Slavic and Balkan Studies was first located in a two-story mansion, built in 1860 in 30a Trubnikovskii Pereulok and after 1990 it moved to the building of the Academy of Sciences on 32а Leninskii Prospekt. The advent of the Internet, e-mail, cell phones, digital cameras, and the national corpora of the Slavic languages was not far off, which, together with the mass employment of personal computers, was to lead later to a revolution in the methodology of philological research that no one yet foresaw.

Development of a transition program for pediatric patients with renal disease

BackgroundThe transition from pediatric to adult health care is challenging for patients with renal disease and inadequate transition can lead to increased disease-related morbidity. We developed a structured health care transition (HCT) program that includes a joint two-step transition clinic; the first step is the pediatric clinic and second step is the adult clinic. MethodsQuality improvement methodology was utilized to establish an interdisciplinary transition team and conduct a needs assessment. Lack of a standardized HCT program was identified as a primary barrier to HCT. We utilized transition team and other stakeholder input to implement a transition program that included a joint pediatric/adult two-step transition clinic. Various other components were developed, including a transition policy and patient and provider feedback surveys. A pilot group of patients with kidney disease participated in the program. Results27 patients completed the “first step” and 22 patients completed the “second step” of the transition clinic. Median age at the time of transition was 20 years, with kidney transplant (41 %) as the major diagnosis. All patients (100 %) received the transition policy and reported that the transition team worked with them to gain skills to manage their health and plan for the future. Pediatric and adult nephrologists reported feeling satisfied (100 %) with the transition program. ConclusionA structured transition program was established utilizing expertise of a dedicated transition team and was well received by participants. This program is a critical first step in addressing the gap in standardized care for transition for pediatric patients with kidney disease.

Primjenom otpadne drvne biomase i Miscanthusa do održivog sektora termoenergetike u vremenu energetske tranzicije / Sustainable Energy Sector Using Waste Woody Biomass and Miscanthus in the Energy Transition

The thermal energy sector is very important at this time of global energy transition. From the aspect of stable energy independence, this is especially important in countries whose energy system is based on fossil fuels, especially coal. This is why decarbonisation of the energy sector is necessary, with a partial and gradual substitution of coal with renewable fuels. However, the use of these fuels is not always possible in existing plants. This refers to the establishment of energy, economic and environmentally acceptable proportion of the co-firing of these fuels, i.e. a mixture of coal and renewable fuels. The success of the establishment of this process is a function of several variables, the dominant of which are the aggregate properties of the fuel, basic and their mixtures, including the ash properties of those fuels. With the motive of contributing to a more successful implementation of the energy transition in the thermal energy sector, and with the aim of obtaining new scientific knowledge about the characteristics of the combustion of lignite and brown coal with different renewable fuels, laboratory research was carried out. In particular, different mixtures of lignite and brown coal, waste woody biomass and Miscanthus as a fast-growing energy crop were subjected to co-firing with variable process conditions. In addition to changing the composition of fuel mixtures, the test regimes included a significant change in process temperature (1250-1450 °C) and the primary measure of staged air supply to the furnace. In these combustion conditions, the emission of undesirable and harmful components into the environment, the efficiency of combustion, and the tendency of the ash from the fuel mixture to possible soiling of the heating surfaces in the furnace were evaluated - an analysis of the characteristics of the ash samples from the reaction zone and samples of the slag and ash to the furnace. Here, in both cases of co-firing, lignite and brown coal with different types of biomass, it was shown that in real conditions it is possible to establish a sustainable primary energy conversion process from fuel with a low unburnt carbon content in the slag (unburnt carbon content, UBC<1%) as well as low CO emission, below 350 mg/mn 3. At the same time, the NOx emission is below 320 mg/mn 3 during the co-firing of lignite mixtures at 1250 °C, and in the case of brown coal mixtures below 740 mg/mn 3 at 1450 °C. In both cases, the net CO2 emission decreases in proportion to the proportion of biomass in the mixture, while the SO2 emission is still high, at a level of up to 2500 mg/mn 3 for lignite mixtures and up to 6400 mg/mn 3 for brown coal mixtures. None of the treated types of biomass, up to the level of applicable content in the mixture with lignite and brown coal, does not worsen the progress of the process from the aspect of possible slagging/fouling heating surfaces in the boiler.

���������� ������ί ����Ѳ� ��Ѳ����ί ������ֲ� ����� �������: ²� ò�������� ������������ �� ����������������� ��������� ����������

The article examines the views of domestic and foreign scientists on the peculiarities of the development of the modern world political process, the development of the global information space and technologies, the specifics of the social, economic and political conditions of the development of the modern world community that influenced the nature and peculiarities of the conduct of modern wars; analyzed the attempt to transition to force principles in relations between states, which was the beginning of the crisis of the European security system; formulated a vision of the concept of hybrid war through the prism of Ukrainian-Russian relations, as a kind of reference point in conflicts of a new type, state-legal mechanisms for ensuring the national security of Ukraine, justified the understanding of the essence of hybrid war as a new form of global confrontation in international relations, where hybrid war has become a new as a means of conducting an armed struggle at the beginning of the 21st century ? as the desire of one country to impose its political will on another through a complex of measures of a political, economic, informational and actually military nature ? without declaring war in accordance with the norms of international law; the main components of a hybrid war are characterized, with the help of which simultaneous influence on the opponent is carried out in various directions, where the determining components are informational, ideological, psychological, economic, political, diplomatic, military, technological, resource, energy; approaches are systematized understanding of the confrontation between Ukraine and the Russian Federation after 1991, namely the establishment of specific mass psychological attitudes, which at the time of transition of the conflict to the phase of large-scale armed aggression, were used to weaken Ukrainian statehood. An analysis was carried out to determine the location of the hybrid war as a prerequisite for the armed aggression of the Russian Federation against Ukraine. So, hybrid war is a new type of conflict that will be constantly encountered in the world in the last decades practice, therefore the world community must learn to adequately respond to such challenges and learn to effectively confront these threats.

Моделирование тепловых процессов в многослойном логическом наноэлементе, состоящем из нанопроводов NbN, расположенных в различных функциональных слоях и разделенных слоем диэлектрика Al-=SUB=-2-=/SUB=-O-=SUB=-3-=/SUB=-

A simulation of the temperature distribution in a three-layer functional nanoelement consisting of NbN nanowires separated by layers of Al2O3 has been performed. A nanowire with a built-in area of normal metal is located in the middle layer of the device. The simulation is performed for all three wires included in the device. A constant current of ~0.9 from the Ic was passed through each of the wires. The time of transition of the upper nanowire to the normal state as a result of heating is estimated, taking into account its gradual warming up and the dependence of Ic on temperature.

Труд медицинских работников в США: социальный аспект

The shortage of medical personnel is becoming a heavy burden on modern healthcare systems around the world. All countries, without exception, turned out to be vulnerable, regardless of the level of income and available forms of medical care. This study addresses the issue of staffing at the time of transition to a new technological level of the healthcare system in the United States. The paper shows that at the present stage in the country there is a need for fundamental changes in the personnel policy in the medical field. The challenges caused by the COVID‑19 pandemic not only exposed all the vulnerabilities of the national health system, but also opened up opportunities considering the lessons learned to rethink the long-term vision of solving the workforce problems directly related to the use of new technologies. Based on the analysis of statistical data and sociological research, the author identified the latest trends of overcoming barriers in the field of training and retraining of personnel in the context of the transition to digital medicine. Overexertion among medical personnel associated with increased workload has exacerbated the problem of their professional burnout. The mass protests of physicians necessitated the development of new approaches to the labor protection of employees in the medical field. Solution of such important social problems will require a long time and financial costs and is possible only through the joint efforts of the state and the entire community as a whole.

Мотив болезни в романе Бориса Пастернака „Доктор Живаго”

The motif of illness and recovery lies at the core of the worldview of the protagonist of Boris Pasternak’s novel Doctor Zhivago. The novel refers to the motif of illness firstly because of the protagonist’s trade and the realities of the post-revolutionary and civil war years, which were accompanied (or followed) by typhus epidemics. Secondly, the motif of illness is inextricably linked with the time of major historic transitions, and as such with the prevalent feeling of violation of physical and psychological harmony of the universe. The article distinguishes and analyses a number of themes and motifs which are interwoven with the motif of illness, such as creativity, the release of unconscious impulses, liminal states, dreamstates, and the figure of the window. All these themes and motifs were outlined in Pasternak’s poems and later found their continuation and development in the novel Doctor Zhivago.

Automatic dock-to-dock control system for surface vessels using bumpless transfer

This paper proposes and demonstrates an automatic steering system designed for passenger ferries with dock-to-dock capabilities. The method consists of a modular control architecture and bumpless transfer transition strategies that enable the implementation of different independent controllers for different vessel operational phases. The method is expressed as a state machine and divides the ferry operations into three different phases, undocking, transit, and docking. The proposed modular architecture allows the use of well-proven vessel control methods such as dynamic positioning for navigating within the marine harbor environment, and a speed- and course controller for transit between the different docks. Bumpless transfer is achieved by resetting the integrator of the receiving controller, to avoid discontinuities in the control action. Specifically, the output of two controllers are constrained to be equal at the time of transition, and the integrator state value required by the receiving controller is solved. The proposed method has been demonstrated in several simulations, taking the vessel from one dock to another in a satisfactory manner.

GW190425, GW190521 and GW190814: Three candidate mergers of primordial black holes from the QCD epoch

The two recent gravitational-wave events GW190425 and GW190814 from the third observing run of LIGO/Virgo have both a companion which is unexpected if originated from a neutron star or a stellar black hole, with masses [ 1 . 6 − 2 . 5 ] M ⊙ and [ 2 . 5 − 2 . 7 ] M ⊙ and merging rates 46 0 − 360 + 1050 and 7 − 6 + 16 events/yr/Gpc 3 respectively, at 90% confidence level. Moreover, the recent event GW190521 has black hole components with masses 67 and 91 M ⊙ , and therefore lies in the so-called pair-instability mass gap, where there should not be direct formation of stellar black holes. The possibility that all of these compact objects are Primordial Black Holes (PBHs) is investigated. The known thermal history of the Universe predicts that PBH formation is boosted at the time of the QCD transition, inducing a peak in their distribution at this particular mass scale, and a bump around 30 − 50 M ⊙ . We find that the merging rates inferred from GW190425, GW190521 and GW190814 are consistent with PBH binaries formed by capture in dense halos in the matter era or in the early universe. At the same time, the rate of black hole mergers around 30 M ⊙ and of sub-solar PBH mergers do not exceed the LIGO/Virgo limits. Such PBHs could explain a significant fraction, or even the totality of the Dark Matter, but they must be sufficiently strongly clustered in order to be consistent with current astrophysical limits.

Simple and active magnetic-field stabilization for cold atom experiments.

Cold atom experiments usually need a controllable and low-noise bias magnetic field to provide a quantization axis. Most labs need home-made stabilization of the field according to the actual setup, as commercially available power supply cannot directly satisfy their requirements. Here, by measuring the field fluctuations and active feedback modulating current supply of the applied magnetic field, we successfully demonstrate a field of 10.58G with a stability to the level of 2.8 × 10-7 in a duration of 5min. The root mean square noise is reduced to 0.05 mG, compared to the noise of 1.3 mG without stabilization. The coherence time of the magnetic-field sensitive transition between the rubidium ground states F=1,mF=-1 and 1,0, as measured by Rabi oscillation, is extended to 19.2ms from the unstabilized value of 1.3ms. This result is long enough for most experiments on quantum simulation and precision measurement. As our system has no passive magnetic shielding and additional compensation coils, it is highly simple and compact to provide the stable magnetic field and would be adapted to various applications with cold atoms.

Designing Business Continuity Plan for It Organizations: A Systematic Literature Review and Meta-Analysis

With the recent pandemic due to COVID-19 and several other uncertain events (due to human error or natural disaster), designing and implementation of Business Continuity Plan (BCP) has become a vital part of any organization. The organizations must prepare in advance and identify all possible uncertain events which may cause hindrance in their services. They must also access the consequences due to such events, which helps them devise such a plan that their operations do not pause even in such a disaster. This research explores the possibilities and finds a standard set of steps that must be taken care of while designing, testing, and implementing BCP. In this research paper, a systematic literature review has been performed on a previous research paper in the area of Business Continuity Plan to explore various options that an organization may adopt during a disaster. The studies were of moderate quality and had a low chance of being skewed by publishing prejudice. Subgroup analyses were not possible due to the heterogeneity of outcome tests, follow-up durations, and research forms. The new research should be used to help create and evaluate executive training strategies that facilitate long-term adaptive coping with PSP and reduce PTSIs. The aim of this systematic review and metanalysis is to assess PSP coping effects over time. The number of patients born with congenital heart disease need to be monitored for the rest of their lives. Discontinuity of treatment, on the other hand, is a well-known issue that tends to be worsening at the time of transition to adulthood.

Accelerating simulated annealing of glassy materials with data assimilation

The ultra-long relaxation time of glass transition makes it difficult to construct atomic models of amorphous materials by conventional methods. We propose a novel method for building such atomic models using data assimilation method by simulated annealing with an accurately computed interatomic potential augmented by penalty from experimental data. The advantage of this method is that not only can it reproduce experimental data as the structure refinement methods like reverse Monte Carlo but also obtain the reasonable structure in terms of interatomic potential energy. In addition, thanks to the interatomic potential, we do not need high Q range diffraction data, which is necessary to take into account the short-range order. Persistent homology analysis shows that the amorphous ice obtained by the new method is indeed more ordered at intermediate range.

Actinopterygian and chondrichthyan ichthyoliths reveal enhanced cosmopolitanism in Late Triassic marine ecosystems

ABSTRACT The Late Triassic was a time of major evolutionary transition for marine vertebrates, with the emergence of important new clades and the expansion of durophagy. The diversity record of shallow marine vertebrates has been limited by poor preservation, and palaeogeographic ranges of common marine vertebrates is poorly constrained. Isolated ichthyoliths are an important resource for documenting taxonomic and ecological diversity in shallow marine environments and have a relatively high preservation potential. Here, we report the first Upper Triassic elasmobranchs, neopterygians and chondrosteans from Nevada, and contribute 14 new generic occurrences. The vertebrates represented in this survey include teeth of specialised durophages and piscivores, and a tentative reconstruction of the shallow marine ecosystem trophic niches based on dietary interpretations and known shelly macrofossils from this locality. The ichthyolith assemblage exhibited greater similarity to low-latitude Europe than high-latitude Canada localities, and the results of this study suggest that several taxa previously considered to be endemic to Europe may be cosmopolitan. The present study highlights the need for additional research in early Mesozoic ichthyoliths in order to establish diversity patterns, paleobiogeographic ranges, and timing of adaptive radiations among key groups of marine vertebrates in the Triassic Period in suboptimal preservation conditions.

Primary Care Provider Use and Depression Screening Among Transitioning Adolescents and Young Adults with Sickle Cell Disease

Background Sickle cell disease (SCD) is a red blood cell disorder that impacts approximately 100,000 Americans. Adolescents and young adults (AYAs) with SCD face many barriers to successful transition from pediatric to adult care, including high rates of being uninsured, limited access to adult hematology and primary care providers (PCPs), and high rates of depression. Compared to people with SCD in other age groups, AYAs also have more healthcare costs, hospital visits, and greater rates of mortality. In other chronically ill populations, PCP use and well-managed depression are associated with improved outcomes. However, little is known about the prevalence of PCP use and how PCP use relates to mental health care and acute care use in this population near their transition. Thus, the objective of this study was to describe PCP use among transitioning AYAs with SCD and determine if being seen by a PCP in the year prior to transition was associated with receipt of depression screening and care and with decreased acute care utilization. Methods This was a single-site, retrospective review of electronic medical records (EMR) of AYAs 18-21 years old with SCD (any genotype) at Nationwide Children's Hospital (NCH) who had their last pediatric hematology clinic visit between 2015-2019. Patients were excluded if they had ever received a bone marrow transplant or were incarcerated at the time of transition. Demographics, PCP use, depression screening using the validated patient health questionnaire-9 (PHQ-9), and acute care utilization (emergency room and/or hospitalization visits) during their last year of pediatric care were abstracted. Data were analyzed in SPSS. Pearson's correlations and chi-square tests were used to determine significant associations between target variables. Results The final sample (N=56) included 32 (57%) females with mean age of 20.52 (SD=1.27). Of these, 55 (98%) were African/African American/Black, 1 (2%) was Arab; 37 (66%) had Medicaid insurance, 18 (32%) had private or commercial insurance, and 1 (2%) had military insurance. Overall, 51 (91%) patients had a PCP listed in their EMR, 30 (59%) had their PCP through NCH and 7 (23%) of these 30 had visited their PCP at least once in the year prior to their transition. Of the 30 with NCH PCP's, having ≥1 PCP visit in the year prior to transition was significantly associated with completing the PHQ-9 (p<0.01) and receiving a referral to psychiatry or therapy (p<0.01) compared to not having had a PCP visit. Patients who saw an NCH PCP in their final year of pediatric care had a mean of 5 acute care visits (SD= 3) compared to 6 visits (SD=8) among those without a visit to their PCP in their final year, this difference was not significant (p=0.440). Discussion Our results suggest that many AYAs with SCD are not receiving primary care in the year prior to transition to adult care. We also identified that those with a PCP visit may be more likely to receive depression screening and referral for mental health care than those without a PCP visit. These findings suggest that PCPs may play a crucial role in depression diagnosis and management for transitioning AYAs with SCD, which is critical to address due to the impact that undiagnosed and/or untreated depression can have on transition and SCD outcomes. Thus, increasing access to PCPs who can provide essential preventive primary care and mental health screenings may have the potential to impact successful SCD transition. Our study was limited by its retrospective nature and small sample size and because PCP care that may have been provided outside of NCH setting could not be evaluated. Additional studies, with larger samples and across multiple centers, are warranted to better understand PCP use, depression diagnosis and management, and how visits with a PCP can augment and optimize management of SCD.