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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.

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.

Many seabirds show sexual differences in different aspects of their trophic ecology. The Imperial Cormorant (Leucocarbo atriceps) presents sexual size dimorphism, with males being larger and heavier than females. They show sexual differences in feeding behaviour, but no studies have yet comprehensively quantified the sexual segregation in the use of food resources. Diet composition through the analysis of stomach content samples and isotopic niches of female and male individuals were assessed during the incubation and chick rearing stage of 2019 at Islas Blancas (44°46′S, 65°38′W) and Punta León (43°04′S, 64°29′W), Argentina. A total of 117 stomach content samples and 80 whole blood samples were analysed. The sexes differed significantly in their overall prey composition. Females consumed mostly benthic prey in all cases, while males consumed demersal, pelagic or benthic prey depending on the breeding stage and colony. Males presented a lower diet diversity and consumed larger prey items than females in all stages. The isotopic niche of females and males differed in position and/or amplitude, presenting variations in the axes, in agreement with the results based on conventional diet analysis. Females and males exhibited trophic resource partitioning, although patterns of segregation varied depending on the stages of the breeding cycle and the location of the colony. These patterns show the differential role of the sexes in marine food webs, and may expose females and males to different environmental and anthropogenic pressures.

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.

We assessed differences in diet composition between Imperial Cormorants (Phalacrocorax atriceps) breeding at Isla Arce and Isla Vernaci Este, Golfo San Jorge, Argentina. Both colonies are located within the Patagonia Austral marine park, and commercial trawl fisheries operate in adjacent waters, thus knowledge of their food requirement is fundamental to assess potential conflicts and monitor interactions. We obtained stomach samples from 63 adult Imperial Cormorants during the chick-rearing period in 2014: 32 at Isla Arce and 31 at Isla Vemaci Este. We recorded 27 and 30 prey taxa in stomach samples at Isla Arce and Isla Vernaci Este, respectively, and at least 21 were common to both islands. Significant differences in diet composition in terms of importance by mass were found between young and old chick stages at Isla Arce but not at Isla Vernaci Este. Rock cod (Patagonotothen spp.) were dominant at Isla Vernaci Este during both chick stages (75.7% and 86.5%, respectively). At Isla Arce, rock cod, Argentine anchovy (Engraulis anchoita), and Argentine hake (Merluccius hubbsi) contributed similarly to their diet (26-33%) during the young chick stage, whereas Argentine anchovy dominated during the old chick stage (76.6%). Diet composition in terms of importance by mass was significantly different between colonies. Imperial Cormorant consumed benthic, demersal, and pelagic prey, confirming plasticity in feeding habits, but their contribution differed depending on the site and chick stage. Our results suggest that diet assessments and monitoring the potential interaction between Imperial Cormorant and fisheries should not be based on information from a single breeding stage or location, but requires the analysis of diet composition throughout the breeding cycle with a representative sampling of the 17 colonies within the marine park. Received 18 October. Accepted 19 April 2017.

We assessed differences in diet composition between Imperial Cormorants (Phalacrocorax atriceps) breeding at Isla Arce and Isla Vernaci Este, Golfo San Jorge, Argentina. Both colonies are located within the Patagonia Austral marine park, and commercial trawl fisheries operate in adjacent waters, thus knowledge of their food requirement is fundamental to assess potential conflicts and monitor interactions. We obtained stomach samples from 63 adult Imperial Cormorants during the chick-rearing period in 2014: 32 at Isla Arce and 31 at Isla Vemaci Este. We recorded 27 and 30 prey taxa in stomach samples at Isla Arce and Isla Vernaci Este, respectively, and at least 21 were common to both islands. Significant differences in diet composition in terms of importance by mass were found between young and old chick stages at Isla Arce but not at Isla Vernaci Este. Rock cod (Patagonotothen spp.) were dominant at Isla Vernaci Este during both chick stages (75.7% and 86.5%, respectively). At Isla Arce, rock cod, Argentine anchovy (Engraulis anchoita), and Argentine hake (Merluccius hubbsi) contributed similarly to their diet (26-33%) during the young chick stage, whereas Argentine anchovy dominated during the old chick stage (76.6%). Diet composition in terms of importance by mass was significantly different between colonies. Imperial Cormorant consumed benthic, demersal, and pelagic prey, confirming plasticity in feeding habits, but their contribution differed depending on the site and chick stage. Our results suggest that diet assessments and monitoring the potential interaction between Imperial Cormorant and fisheries should not be based on information from a single breeding stage or location, but requires the analysis of diet composition throughout the breeding cycle with a representative sampling of the 17 colonies within the marine park. Received 18 October. Accepted 19 April 2017. Key words: Argentina, diet, Golfo San Jorge, Phalacrocorax atriceps, seabirds, site differences. Evaluamos las diferencias en la composicion de la dieta entre Phalacrocorax atriceps que se reproducen en Isla Arce e Isla Vernaci Este, Golfo San Jorge. Argentina. Ambas colonias estan ubicadas dentro del parque marino Patagonia Austral y pesquerias comerciales de arrastre operan en aguas adyacentes, por lo que el conocimiento de sus requerimientos alimentarios es fundamental para evaluar potenciales conflictos y monitorear interacciones. Obtuvimos contenidos estomacales de 63 Phalacrocorax atriceps adultos durante el periodo de crianza de pichones en 2014: 32 en Isla Arce y 31 en Isla Vernaci Este. Registramos 27 y 30 items presa en los contenidos estomacales de Isla Arce e Isla Vernaci Este, respectivamente, y al menos 21 fueron comunes a ambas islas. Se encontraron diferencias significativas en la composicion de la dieta en terminos de importancia en peso entre las etapas de pichones temprana y tardia en Isla Arce pero no en Isla Vemaci Este. Patagonotothen spp. fueron dominantes en Isla Vemaci Este durante las dos etapas de pichones (75.7% y 86.5%, respectivamente). En Isla Arce, Patagonotothen spp., Engraulis anchoita y Merluccius hubbsi contribuyeron de manera similar a su dieta (26-33%) durante la etapa de pichones temprana, mientras que Engraulis anchoita domino durante la etapa de pichones tardia (76.6%). La composicion de la dicta en terminos de importancia en peso fue significativamente diferente entre las colonias. Phalacrocorax atriceps consumio presas bentonicas, demersales y pelagicas, confirmando la plasticidad en sus habitos alimenticios, pero su contribucion difirio dependiendo del sitio y la etapa de pichones. Nuestros resultados sugieren que la evaluacion de la dieta y el monitoreo de la interaccion potencial entre Phalacrocorax atriceps y las pesquerias no deberian basarse en informacion de una sola etapa o sitio de reproduccion, sino que requieren del analisis de la composicion de la dieta a lo largo del ciclo reproductivo en una muestra representativa de las 17 colonias ubicadas dentro del parque marino. Palabras clave: Argentina, aves marinas, dieta, diferencias entre sitios, Golfo San Jorge, Phalacrocorax atriceps.

Several studies have applied induced regurgitations to characterize the diet of cormorants, but none have presented quantitative information indicating complete stomach contents were obtained. Our goal was to test the value of induced regurgitations for the assessment and monitoring of Imperial Cormorant (Phalacrocorax atriceps) diet. Stomach samples were obtained from male and female breeding adults bringing food back to the colony during the chick rearing stage (n = 22) at Isla Arce, Argentina. Samples were obtained through induced regurgitation, and immediately afterward each individual was flushed with sea water. The diet of the Imperial Cormorant consisted of at least 23 prey taxa, mostly fish complemented by crustaceans, cephalopods and polychaetes. However, only Argentine anchovy (Engraulis anchoita) and rockcods (Patagonotothen spp.) showed a significant contribution by mass (70.7% and 25.3%, respectively). Analysis of similarity indicated that prey composition between samples obtained by induced regurgitation and those obtained by combining regurgitation followed by stomach flushing were similar in both the numerical frequency of all prey taxa recorded and the contribution by mass of the main prey. Our results show that induced regurgitation provides complete stomach contents, and thus validates the use of this technique for quantifying Imperial Cormorant diet composition.

We assessed differences in diet composition between Imperial Cormorants (Phalacrocorax atriceps) breeding at Isla Arce and Isla Vernaci Este, Golfo San Jorge, Argentina. Both colonies are located within the Patagonia Austral marine park, and commercial trawl fisheries operate in adjacent waters, thus knowledge of their food requirement is fundamental to assess potential conflicts and monitor interactions. We obtained stomach samples from 63 adult Imperial Cormorants during the chick-rearing period in 2014: 32 at Isla Arce and 31 at Isla Vernaci Este. We recorded 27 and 30 prey taxa in stomach samples at Isla Arce and Isla Vernaci Este, respectively, and at least 21 were common to both islands. Significant differences in diet composition in terms of importance by mass were found between young and old chick stages at Isla Arce but not at Isla Vernaci Este. Rock cod (Patagonotothen spp.) were dominant at Isla Vernaci Este during both chick stages (75.7% and 86.5%, respectively). At Isla Arce, rock cod, Argentine anchovy (Engraulis anchoita), and Argentine hake (Merluccius hubbsi) contributed similarly to their diet (26–33%) during the young chick stage, whereas Argentine anchovy dominated during the old chick stage (76.6%). Diet composition in terms of importance by mass was significantly different between colonies. Imperial Cormorant consumed benthic, demersal, and pelagic prey, confirming plasticity in feeding habits, but their contribution differed depending on the site and chick stage. Our results suggest that diet assessments and monitoring the potential interaction between Imperial Cormorant and fisheries should not be based on information from a single breeding stage or location, but requires the analysis of diet composition throughout the breeding cycle with a representative sampling of the 17 colonies within the marine park.

Autism spectrum disorders (ASDs) are diagnosed exclusively on behavioral criteria, however, there is a broad consensus that autism is a disorder of brain development. Although not a diagnostic feature, substantial evidence demonstrates that emotion dysregulation (ED) is associated with autism. However, little is known about the brain patterns accompanying the emergence of early ED in children with ASDs in the first years of life. The brain salience network (SN) is critically implicated in detecting and orienting to relevant internal and external stimuli, and is a key player in affective and empathic processing underlying emotion regulation. The present study aims (a) to advance our understanding of ED emergence in ASDs and its role in core autism symptoms, and (b) to identify SN connectivity patterns supporting emotional processing in toddlers with first symptoms of ASDs. Toddlers and preschoolers with an ASD diagnosis and typically developing (TD) children were drawn from an ongoing study of early brain markers of ASDs. The Full Cohort included 49 children with ASDs and 37 age-matched TD children with complete behavioral data; the Imaging Cohort included 25 children with ASDs and 23 TD children with complete MRI (both cohorts ages 1.5 to 4 years). Children completed 2 visits: a developmental assessment and an MRI scan session during natural nocturnal sleep. Results revealed that children in the ASD group displayed more ED behaviors compared to TD children, and higher ED was linked to deficits in socialization skills. Whole-brain seed-based and ROI-ROI functional connectivity analyses were performed for the SN, with seed ROIs in the right and left anterior insula (rAI, lAI) and dorsal anterior cingulate cortex. Direct between-group comparisons revealed greater connectivity within the SN, especially between the rAI and lAI, and weaker connectivity between the SN and frontal regions in children with ASDs. There were no significant associations between emotional reactivity indices and SN connectivity patterns. Findings provide insight into early onset of ED in toddlers and preschoolers with ASDs, and have substantial implications for developing more targeted interventions. Moreover, atypical SN connectivity patterns point to evidence of network dysfunction at the time when autism symptomology first emerges.

  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.