Differences in metabolic biomarkers in people with schizophrenia who are of Mexican descent compared to non-Hispanic whites.

Metabolic dysfunction is highly prevalent and contributes to premature mortality among people with schizophrenia (PwS), especially in Hispanic/Latino/a/x/e PwS, compared to non-Hispanic White (NHW) PwS. This study evaluated the relative contributions of Mexican descent and schizophrenia diagnosis to metabolic biomarker levels. This cross-sectional study included 115 PwS and 102 non-psychiatric comparison (NC) participants - English-speakers aged 26-66 years, 27% Mexican descent, and 52% women across both groups. Assessments included evaluations of BMI, psychopathology, and fasting metabolic biomarkers. We used ANOVA analyses to compare metabolic outcomes between diagnostic and ethnic subgroups, linear regression models to examine associations between Mexican descent and metabolic outcomes, and Spearman's correlations to examine relationships between metabolic outcomes and illness-related variables in PwS. Mexican PwS had higher hemoglobin A1c levels, insulin resistance, and body mass index than NHW PwS. Mexican descent was associated with higher hemoglobin A1c levels, insulin resistance, body mass index, and leptin levels, controlling for age, sex, depression, education, and smoking. Among Mexican PwS, worse negative symptoms were associated with greater insulin resistance. These findings support the possibility of ethnicity-based differences in metabolic dysregulation, though further investigation is warranted to create targeted health interventions for Hispanic PwS.

Barriers and facilitators to retention in care and treatment adherence among racially/ethnically diverse women with HIV in South Florida: a qualitative study.

Women, particularly those from racial/ethnic minority groups, experience disparities in HIV care and treatment, and in achieving viral suppression. This study identified barriers and facilitators influencing retention in HIV care and treatment adherence among women belonging to racial/ethnic minority groups. We conducted semi-structured interviews with 74 African American, Hispanic/Latina and Haitian cisgender women receiving care from the Ryan White HIV/AIDS Program in Miami-Dade County, Florida in 2019. Data were analyzed using a thematic analysis approach. The most salient barriers faced by women were competing life priorities, mental health and substance use issues, medication-related concerns and treatment burden, negative experiences with HIV care services, transportation and parking issues and stigma and discrimination. Important facilitators identified by women included taking personal responsibility for health, social support, and patient-friendly and supportive HIV care services. Our findings suggest that HIV care could be enhanced for this population by understanding the non-HIV needs of the women in care, provide more flexible and relevant services in response to the totality of these needs, and simplify and expand access to care and supportive services.

Clients' Perspectives on Patient-Centeredness: a Qualitative Study with Low-Income Minority Women Receiving HIV Care in South Florida.

Low-income, minority women living with HIV often experience multiple barriers in care that contribute to suboptimal care outcomes. Medical case managers (MCM) and medical providers are key players involved in care coordination and aid women along the HIV care continuum. The objective of this study was to identify current and potential patient-centered practices that facilitate adherence to medication and retention in care, from the perspective of racially and ethnically diverse women living with HIV. We implemented a qualitative study using semi-structured interviews with 75 African American, Hispanic/Latina, and Haitian women who were enrolled in the Ryan White HIV/AIDS Program in South Florida in 2019. We organized domains of exploration using a patient-centered care framework to identify practices in which providers acknowledged, respected, and responded to clients' preferences, needs, and values. Interviews were analyzed using consensual thematic analysis approach. Findings reflect women valued MCMs who were proactive and directive in care, provided motivation, and aided with navigation of shame, fear, and stigma. Women valued medical providers who upheld simple educational communication. Moreover, women reported that providers who reviewed medical results with clients, incorporated questions about families, and inquired about multiple physical and clinical needs beyond HIV created opportunities for women to feel respected, valued, and in turn, enhanced their involvement in their care. Findings identify specific interpersonal practices that can enhance the ability to better meet the needs of diverse groups of women, specifically those from racial/ethnic minority groups who face multiple sociocultural barriers while in care.

Sleep Problems in Preschoolers With Autism Spectrum Disorder Are Associated With Sensory Sensitivities and Thalamocortical Overconnectivity.

BACKGROUND: Projections between the thalamus and sensory cortices are established early in development and play an important role in regulating sleep as well as in relaying sensory information to the cortex. Atypical thalamocortical functional connectivity frequently observed in children with autism spectrum disorder (ASD) might therefore be linked to sensory and sleep problems common in ASD. METHODS: Here, we investigated the relationship between auditory-thalamic functional connectivity measured during natural sleep functional magnetic resonance imaging, sleep problems, and sound sensitivities in 70 toddlers and preschoolers (1.5-5 years old) with ASD compared with a matched group of 46 typically developing children. RESULTS: In children with ASD, sleep problems and sensory sensitivities were positively correlated, and increased sleep latency was associated with overconnectivity between the thalamus and auditory cortex in a subsample with high-quality magnetic resonance imaging data (n = 29). In addition, auditory cortex blood oxygen level-dependent signal amplitude was elevated in children with ASD, potentially reflecting reduced sensory gating or a lack of auditory habituation during natural sleep. CONCLUSIONS: These findings indicate that atypical thalamocortical functional connectivity can be detected early in development and may play a crucial role in sleep problems and sensory sensitivities in ASD.

Examining Barriers to Medication Adherence and Retention in Care among Women Living with HIV in the Face of Homelessness and Unstable Housing.

Despite advances in biomedical treatments, women living with HIV (WLH) who experience homelessness and housing instability suffer suboptimal HIV outcomes, even when linked to treatment. The purpose of this study was to explore experiences of housing instability among WLH and to understand its role in their ability to adhere to antiretroviral medication and remain retained in care. Sixteen women who were linked to Ryan White Program HIV care in South Florida participated in in-depth interviews. The findings focus around four larger themes: difficulty storing medication, privacy- and stigma-related issues, inconsistent access to medication and health care disruptions, and competing and unmet physical and mental health needs. Findings underscore the importance of strategies that are responsive to the disruption of routines and are sensitive to privacy issues in shared dwelling spaces; the proactive inquiry of behavioral and environmental considerations when prescribing antiretroviral medication; and the identification and treatment of comorbid conditions. This study provides evidence for strategies to facilitate self-management and improve modifiable system realities to augment larger-level policy and funding shifts that are critically needed to end the epidemic among vulnerable populations living with HIV.

HIV Care Access During the COVID-19 Pandemic as Perceived by Racial/Ethnic Minority Groups Served by the Ryan White Program, Miami-Dade County, Florida.

The Ryan White Program (RWP) in Miami-Dade County, Florida made several modifications to keep HIV care accessible during the COVID-19 Pandemic, including expanding telehealth services, increasing access to HIV medications, and waiving required lab tests for service recertification. We assessed ease of access to medical providers, medical case managers, and antiretroviral medications during the COVID-19 Pandemic among 298 Non-Hispanic Black, Hispanic, and Haitian people with HIV (PWH) served by the RWP Part A, Miami-Dade County, Florida using a telephone-administered survey between October 2020 and January 2021. Overall, most clients reported similar or better access compared to before the Pandemic. Use of videocalls to communicate with HIV medical providers varied by race/ethnicity: Hispanics (49.6%), Non-Hispanic Blacks (37.7%), and Haitian clients (16.0%). Results suggest the modifications helped maintain access to care during an unprecedented health crisis. Permanently adopting many of these modifications should be considered to continue to facilitate access to care.

Anthropogenic debris in Kelp Gull and other seabird nests in northern Patagonia, Argentina.

Anthropogenic debris is used as nesting material by many seabirds and may result in negative impacts. We assessed the frequency of occurrence of debris (>5 mm) in Kelp Gull (Larus dominicanus) nests at six locations along 2400 km of the Argentine coast, at different distances from urban centres, and in nests of other seven seabird species nesting syntopically. Frequencies in Kelp Gull nests were in general relatively low, ranging between 3.3 and 37.5%, and differed significantly among colonies. No relationship was found between frequency and distance to urban centres. Debris were recorded with frequencies of less than 19.2% in nests of Olrog's Gulls (L. atlanticus), Dolphin Gulls (L. scoresbii), Imperial Cormorants (Leucocarbo atriceps) and Magellanic Penguins (Spheniscus magellanicus), but not in nests of Neotropical Cormorants (Nannopterum brasilianus), Rock Shags (Leucocarbo magellanicus) and Southern Skuas (Catharacta antarctica). This information obtained along a wide coastal sector provides a baseline for future monitoring.

Improving Healthy Living in Residential Care Facilities: Feasibility, Acceptability, and Appropriateness of Implementing a Multicomponent Intervention for Diabetes Risk Reduction in Adults with Serious Mental Illnesses.

Persons with serious mental illnesses experience high rates of medical comorbidity, especially diabetes. This study examined initial implementation feasibility, acceptability, and appropriateness of a new 6-month Multicomponent Intervention for Diabetes risk reduction in Adults with Serious mental illnesses (MIDAS) among persons in residential care facilities (RCFs). We conducted a mixed-methods study using four types of quantitative and qualitative data sources (administrative data; structured facility-level observations; resident assessments including blood-based biomarkers, 24-h dietary recalls, and self-report physical activity; and focus groups/interviews with staff and participants), to assess evidence of and factors affecting intervention feasibility, acceptability, and appropriateness. It was feasible to provide a high percentage of MIDAS class sessions (mean 50 of 52 intended sessions delivered) and make nutrition-related RCF changes (substitutions for healthier food items and reduced portion sizes). Class attendance rates and positive feedback from residents and staff provided evidence of MIDAS acceptability and appropriateness for addressing identified health needs. The residents who attended ≥ 85% of the sessions had greater improvement in several desired outcomes compared to others. Implementing a fully integrated MIDAS model with more extensive changes to facilities and more fundamental health changes among residents was more challenging. While the study found evidence to support feasibility, acceptability, and appropriateness of individual MIDAS components, some challenges for full implementation and success in obtaining immediate health benefits were also apparent. The study results highlight the need for improving health among RCF populations and will inform MIDAS adaptations designed to improve intervention fit and effectiveness outcomes.

Externalizing Behaviors are Associated with Increased Parenting Stress in Caregivers of Young Children with Autism.

Parents of children diagnosed with autism spectrum disorder (ASD) report higher levels of stress than parents of typically developing children. Few studies have examined factors associated with parental stress in early childhood. Even fewer have investigated the simultaneous influence of sociodemographic, clinical, and developmental variables on parental stress. We examined factors associated with stress in parents of young children with ASD. Multiple regression models were used to test for associations between socioeconomic indices, developmental measures, and parental stress. Externalizing behaviors, communication, and socialization skills accounted for variance in parental stress, controlling for ASD diagnosis. Results highlight the importance of interventions aimed at reducing externalizing behaviors in young children as well as addressing stress in caregivers of children with ASD.

Resting state functional networks in 1-to-3-year-old typically developing children.

Brain functional networks undergo substantial development and refinement during the first years of life. Yet, the maturational pathways of functional network development remain poorly understood. Using resting-state fMRI data acquired during natural sleep from 24 typically developing toddlers, ages 1.5-3.5 years, we aimed to examine the large-scale resting-state functional networks and their relationship with age and developmental skills. Specifically, two network organization indices reflecting network connectivity and spatial variability were derived. Our results revealed that reduced spatial variability or increased network homogeneity in one of the default mode network components was associated with age, with older children displaying less spatially variable posterior DMN subcomponent, consistent with the notion of increased spatial and functional specialization. Further, greater network homogeneity in higher-order functional networks, including the posterior default mode, salience, and language networks, was associated with more advanced developmental skills measured with a standardized assessment of early learning, regardless of age. These results not only improve our understanding of brain functional network development during toddler years, but also inform the relationship between brain network organization and emerging cognitive and behavioral skills.

Greater functional connectivity between sensory networks is related to symptom severity in toddlers with autism spectrum disorder.

BACKGROUND: Symptoms of autism spectrum disorder (ASD) emerge in the first years of life. Yet, little is known about the organization and development of functional brain networks in ASD proximally to the symptom onset. Further, the relationship between brain network connectivity and emerging ASD symptoms and overall functioning in early childhood is not well understood. METHODS: Resting-state fMRI data were acquired during natural sleep from 24 young children with ASD and 23 typically developing (TD) children, aged 17-45 months. Intrinsic functional connectivity (iFC) within and between resting-state functional networks was derived with independent component analysis (ICA). RESULTS: Increased iFC between visual and sensorimotor networks was found in young children with ASD compared to TD participants. Within the ASD group, the degree of overconnectivity between visual and sensorimotor networks was associated with greater autism symptoms. Age-related weakening of the visual-auditory between-network connectivity was observed in the ASD but not the TD group. CONCLUSIONS: Taken together, these results provide evidence for disrupted functional network maturation and differentiation, particularly involving visual and sensorimotor networks, during the first years of life in ASD. The observed pattern of greater visual-sensorimotor between-network connectivity associated with poorer clinical outcomes suggests that disruptions in multisensory brain circuitry may play a critical role for early development of behavioral skills and autism symptomatology in young children with ASD.

Socioeconomic Factors Account for Variability in Language Skills in Preschoolers with Autism Spectrum Disorders.

OBJECTIVE: Although no longer required for a diagnosis, language delays are extremely common in children diagnosed with autism spectrum disorders (ASD). Factors associated with socioeconomic status (SES) have broad-reaching impact on language development in early childhood. Despite recent advances in characterizing autism in early childhood, the relationship between SES and language development in ASD has not received much attention. THE OBJECTIVE OF THIS STUDY WAS: to examine whether toddlers and preschoolers with ASD from low-resource families are more likely to experience language delays above and beyond those associated with autism itself. METHODS: Developmental and diagnostic assessments including the Mullen Scales of Early Learning, the Autism Diagnostic Observation Schedule, Second Edition, and the Vineland Adaptive Behavior Scales were obtained from 62 young children with ASD and 45 typically developing children aged 15 to 64 months. Sociodemographic information including household income, maternal education, and racial/ethnic identity was obtained from caregivers. Multiple regression models were used to test for associations between socioeconomic indices and language scores. RESULTS: Maternal education accounted for variability in expressive language (EL) and receptive language (RL), with lower SES indices associated with lower language skills, and more so in children with ASD. CONCLUSION: These results demonstrate that variability in EL and RL skills in young children with autism can be accounted for by socioeconomic variables. These findings highlight the necessity for targeted intervention and effective implementation strategies for children with ASD from low-resource households and communities and for policies designed to improve learning opportunities and access to services for these young children and their families.

Patterns of plastic ingestion in Kelp Gull (Larus dominicanus) populations breeding in northern Patagonia, Argentina.

Human waste is a global concern, and volumes are growing rapidly. For opportunistic species, like many birds, urban waste offers alternative food which in turn may lead to plastic ingestion with potential negative effects. We assessed the incidence of plastics and other marine debris in breeding Kelp Gull (Larus dominicanus) diet at nine colonies located along ~2400 km of coastline from southern Buenos Aires to southern Chubut, Argentina, using regurgitated pellets (n = 2355) and chick stomach content samples (n = 588). Plastics were recorded at all colonies, and incidence varied between 0.0 and 16.2% in adult pellets and 0.0-12.5% in chick stomach content samples, depending on the colony, breeding stage and year. Contrary to our expectation, incidence of debris including plastics in Kelp Gull diet was relatively low despite its opportunistic feeding habits and widespread use of refuse dumps, even at colonies located close (<10 km) to these anthropogenic food subsidies.