Investigating the effects of chlorogenic acid on novel object recognition memory impairment, hyperlocomotion, and prefrontal BDNF expression in a sub-chronic ketamine-induced schizophrenia-like rat mo

Each year in the United States, an estimated 1.2 million youth with chronic health conditions or functional limitations reach adulthood and must transition from pediatric to adult health care. Historically, many of these individuals did not survive into adulthood. Due to medical advancements, today most children with conditions such as spina bifida, cerebral palsy, rare genetic disorders, and bleeding disorders are expected to live well into adulthood, . Transition requires more than just a transfer of medical responsibility or location. It includes early preparation, comprehensive planning, and collaboration among patients, families, and both pediatric and adult healthcare providers. Yet numerous barriers persist that limit independence, including a shortage of adult providers with expertise, disruptions related to insurance changes, reduced access to community resources, and constraints on caregiver participation, which can be affected by caregivers' own health, , , , . In practice, this means a young adult may wait months for an appointment with an adult subspecialist unfamiliar with their condition, lose Medicaid or waiver-funded services at a fixed age cutoff, travel to an unfamiliar health system without reliable transportation, or depend on a parent whose own health limits their ability to attend visits, , . The young people themselves face significant barriers in this transition, as do their caregivers and the health systems that serve them. Addressing these barriers is critical to a successful transition and long-term health outcomes for this growing population. Although the value of a structured transition process is well recognized, significant gaps remain in understanding and meeting the unique needs of this population. Transition is often framed as an adolescent milestone, but the changes and challenges it introduces extend across the lifespan: individuals with medical complexity and their families continue to confront decisions about health care, post-secondary education, employment, independent living, participation in day programs, and long-term planning well into adulthood , , . Many challenges, including aging caregivers and future planning, intensify over time rather than resolving after transfer to adult care., , . Layering medical transition onto these demands often amplifies family anxiety and fear and can contribute to worsening health outcomes, . Compounding this, a persistent lack of communication and coordination among key stakeholders, such as hospitals, specialty clinics, pediatricians, school systems, and community agencies, further exacerbates stress during an already demanding time and undermines efforts to streamline care and support families, , . As a result, many individuals with childhood-onset conditions remain in pediatric care well beyond the typical transfer age, and the timing of transfer varies widely from patient to patient rather than following a fixed age. The absence of standardized metrics of a successful transition further complicates efforts to measure and improve outcomes, , , . Importantly, most transition support is delivered at the individual level, leaving few opportunities for families to connect with peers, access community resources, or learn from adults who have already navigated this path. These shared, largely psychosocial needs are rarely addressed at the community level. To address these gaps, which span the adult care workforce, the health system, and the families and youth navigating transition, the University of Alabama at Birmingham established the Staging Transition for Every Patient (STEP) Program.. Through an interdisciplinary team and a dedicated primary care clinic, STEP develops individualized care plans, coordinates specialist referrals, and supports patients and families as they move into an adult model of care, with an emphasis on independence, decision-making support, reduced caregiver burden, and personal growth, . Recognizing that transition needs extend beyond a single clinic visit, the STEP team partnered with community organizations, caregivers, and individuals with lived experience to develop an annual health care transition conference. This manuscript describes the conference and summarizes two years of attendee feedback (2024 and 2025), identifying valued content, persistent gaps, and elements transferable to other institutions seeking to strengthen transitional care for individuals with medical complexity.