BACKGROUND AND OBJECTIVES:Latino-white disparities in age at autism spectrum disorder (ASD) diagnosis may be modified by primary care pediatrician (PCP) practices and beliefs. The objectives of this study were to assess ASD and developmental screening practices, attitudes toward ASD identification in Latino children, and barriers to ASD identification for Latino children, in a sample of 267 California PCPs.METHODS:In mail-based PCP survey, we assessed rates of bilingual general developmental and ASD screening, perceptions of parent ASD knowledge in Latino and white families, reports of difficulty assessing for ASDs in Latino and white children, and perceptions of barriers to early ASD identification for Latinos.RESULTS:Although 81% of PCPs offered some form of developmental screening, 29% of PCPs offered Spanish ASD screening per American Academy of Pediatrics guidelines, and only 10% offered both Spanish general developmental and Spanish ASD screening per American Academy of Pediatrics guidelines. Most PCPs thought that Latino (English and Spanish primary family language) parents were less knowledgeable about ASDs than white parents. PCPs had more difficulty assessing ASD risk for Latino children with Spanish primary family language than for white children, even when the PCP conducted recommended ASD screening or had >25% Latino patients. The most frequent barrier to ASD identification in Latinos was access to developmental specialists.CONCLUSIONS:Multiple factors in the primary care setting may contribute to delayed ASD identification for Latinos. Promoting language-appropriate screening, disseminating culturally appropriate ASD materials to Latino families, improving the specialist workforce, and providing PCP support in screening and referral of Latino children may be important ways to reduce racial and ethnic differences in care.
Latinos report higher rates of depression and anxiety than US whites but are less likely to receive care. Transmedia storytelling interventions accessible on the Internet via smartphones, tablets, and computers hold promise for reducing reluctance to explore or get help for symptoms because they are private, convenient, and can reach large numbers of people, including Latinas with mental health needs.
Latinos in the U.S. are almost twice as likely to progress to End Stage Renal disease (ESRD) compared to non-Latino whites. Patients with ESRD on dialysis experience high morbidity, pre-mature mortality and receive intensive procedures at the end of life (EOL). This study explores intensive procedure preferences at the EOL in older Latino adults.
Pasos Hacia La Salud: a randomized controlled trial of an internet-delivered physical activity intervention for Latinas
- The international journal of behavioral nutrition and physical activity
- Published about 4 years ago
Internet access has grown markedly in Latinos during the past decade. However, there have been no Internet-based physical activity interventions designed for Latinos, despite large disparities in lifestyle-related conditions, such as obesity and diabetes, particularly in Latina women. The current study tested the efficacy of a 6-month culturally adapted, individually tailored, Spanish-language Internet-based physical activity intervention.
Historically occurring throughout the southeastern United States, the Florida panther is now restricted to less than 5% of its historic range in one breeding population located in southern Florida. Using radio-telemetry data from 87 prime-aged (≥3 years old) adult panthers (35 males and 52 females) during the period 2004 through 2013 (28,720 radio-locations), we analyzed the characteristics of the occupied area and used those attributes in a random forest model to develop a predictive distribution map for resident breeding panthers in southern Florida. Using 10-fold cross validation, the model was 87.5 % accurate in predicting presence or absence of panthers in the 16,678 km2 study area. Analysis of variable importance indicated that the amount of forests and forest edge, hydrology, and human population density were the most important factors determining presence or absence of panthers. Sensitivity analysis showed that the presence of human populations, roads, and agriculture (other than pasture) had strong negative effects on the probability of panther presence. Forest cover and forest edge had strong positive effects. The median model-predicted probability of presence for panther home ranges was 0.81 (0.82 for females and 0.74 for males). The model identified 5579 km2 of suitable breeding habitat remaining in southern Florida; 1399 km2 (25%) of this habitat is in non-protected private ownership. Because there is less panther habitat remaining than previously thought, we recommend that all remaining breeding habitat in south Florida should be maintained, and the current panther range should be expanded into south-central Florida. This model should be useful for evaluating the impacts of future development projects, in prioritizing areas for panther conservation, and in evaluating the potential impacts of sea-level rise and changes in hydrology.
Modeling of groundwater levels in a portion of the low-lying coastal Arch Creek basin in northern Miami-Dade County in Southeast Florida USA, which is subject to repetitive flooding, reveals that rain-induced short-term water table rises can be viewed as a primary driver of flooding events under current conditions. Areas below 0.9m North American Vertical Datum (NAVD) elevation are particularly vulnerable and areas below 1.5m NAVD are vulnerable to exceptionally large rainfall events. Long-term water table rise is evident in the groundwater data, and the rate appears to be consistent with local rates of sea level rise. Linear extrapolation of long-term observed groundwater levels to 2060 suggest roughly a doubling of the number of days when groundwater levels exceed 0.9m NAVD and a threefold increase in the number of days when levels exceed 1.5m NAVD. Projected sea level rise of 0.61m by 2060 together with increased rainfall lead to a model prediction of frequent groundwater-related flooding in areas<0.9m NAVD. However, current simulations do not consider the range of rainfall events that have led to water table elevations>1.5m NAVD and widespread flooding of the area in the past. Tidal fluctuations in the water table are predicted to be more pronounced within 600m of a tidally influenced water control structure that is hydrodynamically connected to Biscayne Bay. The inland influence of tidal fluctuations appears to increase with increased sea level, but the principal driver of high groundwater levels under the 2060 scenario conditions remains groundwater recharge due to rainfall events.
We evaluated correlates of gunshot wound (GSW) injuries in Miami-Dade County, Florida. Firearm-related injury has previously been linked to socio- and geo-demographic indicators such as occupation, income, neighborhood and race in other metropolitan areas, but remains understudied in Miami.
Abstract The purpose of this study was to examine the results of implementing a rapid counselor-based HIV testing program in community pharmacies. A prospective cross-sectional study was conducted on a convenience sample of clients at five community pharmacies in New York City (NYC). In 294 days of pharmacy testing, 2805 clients were eligible to receive testing, and 2030 individuals agreed to test. The average age was 33±15 years, 41% were male, 59% were Hispanic, 77% had been previously tested for HIV, and 34% were uninsured. HIV incidence was 0.3%, median CD4 cell count was 622.0, and the average age of the newly diagnosed positives was 36.0±13.9 years. Participants were satisfied with a counselor-based rapid HIV testing program in community-based pharmacies.
To investigate differences in severe maternal morbidity between Hispanic mothers and three major Hispanic subgroups compared with non-Hispanic white mothers and the extent to which differences in delivery hospitals may contribute to excess morbidity among Hispanic mothers.
This study examined the third-grade outcomes of 11,902 low-income Latino children who experienced public school pre-K or child care via subsidies (center-based care) at age 4 in Miami-Dade County, Florida. Regression and propensity score analyses revealed that children who experienced public school pre-K earned higher scores on standardized assessments of math and reading in third grade and had higher grade point averages than those who attended center-based care 4 years earlier. The sustained associations between public school pre-K (vs. center-based care) and third-grade outcomes were mediated by children’s kindergarten entry preacademic and social-behavioral skills, and among English-language learners, English proficiency. Implications for investing in early childhood programs to assist with the school readiness of young Latino children in poverty are discussed.