Surgical management of uncontrolled focal epilepsy is most commonly carried out in young adults with good results, but there has been some doubt about the effectiveness of cortical resection in older individuals. We assessed the outcome of temporal lobectomy done after age 45 years in 20 patients with intractable epilepsy followed for more than 2 years after surgery. During a mean follow-up of 5 years, six patients (30%) were seizure-free following surgery and seven (35%) had greater than 90% reduction in seizure frequency. This compares with an outcome of 40% seizure-free and 44% with greater than 90% seizure reduction in 68 younger patients aged 17 to 45 years; the differences do not achieve statistical significance. The outcome was better for complex partial seizures than for secondarily generalized seizures. Complications were no greater than in the younger patients. The findings indicate that surgery is an effective treatment alternative for intractable temporal lobe epilepsy in older patients since two of three of these patients will obtain satisfactory seizure control.

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The purpose of this study is to explore the lived experiences of 16 Deaf Canadians ages 18-85 years in relation to their well-being. Quantitative measures were used as descriptors of well-being, and qualitative measures explored open-ended narratives. Results indicated that as a group, this sample was of normal cognition, moderately depressed, moderately anxious, and slightly satisfied with their lives. Thematic analysis yielded a rich understanding of the intersection of systems that surround the family of the Deaf individual. These included the medical, educational, employment, government, and societal systems, which are influential from the earliest years, often in negative, enduring ways. Overlaid on all of these systems is Canadian legislation which is meant to address human rights, language recognition, and disability access acts. Recommendations are offered to close the gap of policy and practice, which will ultimately better the lives of Deaf Canadians as well as our society at large. Public Significance StatementAs a cultural and linguistic minority, the perspectives of Deaf Canadians have not been included in studies of well-being. A Deaf psychologist led our research team, and we explored the lived experiences of Deaf Canadians through their own stories and mental health screening tools. Our findings indicate that many societal barriers negatively affect their lives, yet these individuals demonstrate remarkable resilience. From their narratives, we offer recommendations necessary to ensure equitable lives as Canadians.

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There has been an increase in the tendency to implement performance validity tests (PVTs) to detect possible malingering in patients during neuropsychological assessments. The Test of Memory Malingering (TOMM) is a well-validated PVT amongst hearing populations. A major gap in the literature is the use of the TOMM amongst culturally Deaf individuals who use American Sign Language (ASL). Performance within this population may differ for a few reasons. Firstly, the use of ASL interpreters may affect consistent instruction delivery and receptive comprehension. Secondly, there may be a difference in semantic categorization and retrieval using ASL signs rather than English words. This study recruited 30 (11 male, 19 female) culturally and linguistically Deaf adults aged 21-64 years (M = 45.9, SD = 12.2). Participants were screened for cognitive ability using non-verbal components of the Wechsler Abbreviated Scale of Intelligence, Second Edition (WASI-II) and using a cognitive screening tool, the Mini Mental State Examination: ASL Version (MMSE:ASL). We found that no participants scored lower than the cutoff score for Trial 2 or the Retention Trial on the TOMM. These results suggest that culturally Deaf individuals who use ASL are able to perform just as adequately on the TOMM as hearing individuals. The TOMM can be considered a valid measure to use with this group of individuals. VALIDITY OF TOMM WITH DEAF INDIVIDUALS 3 Thank you to Dr. Cathy Chovaz for opening my eyes and providing me with a deeper understanding of the Deaf world, as well as the importance of advocating for this group of individuals. For guiding me through the hardships of this project and ensuring the execution of

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