South Florida Research Articles

Spanish-Speaking Latinas with Pelvic Floor Disorders: Understanding the Misunderstood.

Challenges to providing care to Spanish-speaking Latinas with pelvic floor disorders (PFDs) are well studied. Limited data exist on patient and provider perspectives on the unique challenges in providing language-discordant care. Our study was aimed at highlighting these challenges and providing evidence-based recommendations on how to optimize the care of these women. Both Spanish-speaking patients with PFDs and non-Spanish speaking providers at the University of South Florida were recruited for this study. Interviews were conducted by a single bilingual interviewer. Topics included providers' experiences, specifically barriers, when caring for Spanish-speaking Latinas, and patients' experiences, focusing on differences between Spanish and non-Spanish speaking providers, while receiving care for PFDs. All interviews were analyzed using grounded theory qualitative methods. Thirteen interviews were conducted, 7 Spanish-speaking Latinas with PFDs and 6 non-Spanish-speaking urogynecology providers. Qualitative analysis yielded three major themes noted by both patients and providers: cultural stigma, barriers influencing care, and behavioral adaptations to language discordance. Concepts identified from these themes included: generational shame and embarrassment, aversion to treatment, interpreter use barriers, lack of resources, accommodation between patient and provider, and time constraints. Culturally competent recommendations were made based on study findings and review of the literature to improve care of Spanish-speaking Latinas. This study highlights common themes experienced by both patients and their non-Spanish-speaking providers caring for Spanish-speaking Latinas. The study provides recommendations and implementable strategies that can improve care and help providers to build a stronger therapeutic relationship with Spanish-speaking Latinas.

Temporal Dynamics of Two Genetically Diverse Downy Mildew Mitochondrial Clades on Cucumber Cultivars in South Carolina and Florida

Downy mildew (DM, Pseudoperonospora cubensis) is an important disease that can significantly reduce yield of field-grown cucumbers in the US. Cucumber cultivars with resistance to DM were widely grown for >30 years. However, resistance broke down in 2004 resulting in severe DM epidemics. Large plot trials were conducted to characterize pathogen virulence and population dynamics on DM tolerant cultivars Peacemaker and Expedition and susceptible SMR-58 in Charleston, SC and Fort Pierce, FL in 2016 and 2017. Rapid DM development on SMR-58 was observed at both locations in 2016 and 2017. Disease progress on Expedition and Peacemaker were slow as compared to SMR-58 in Fort Pierce, FL in 2016. Very low to no DM was observed on Peacemaker or Expedition in Charleston in 2016. In 2017, all cultivars were affected in Charleston, but only SMR-58 had severe DM (95-100%) in Fort Pierce. Pathogen population analysis using DM specific mitochondrial clade (MC1 and MC2) markers showed differences between the P. cubensis populations across location and years on the cucumber cultivars. Both MC1 and MC2 were detected in cucumber plots in SC and FL. The most prevalent DM mitochondrial clade in SC during June 2016 was MC1 primarily on SMR-58 (95-100%). However, in July 2016 that population shifted towards MC2 (45-77%). This suggested that the DM populations can change relatively quickly when suitable environment favors. Mixed populations of MC1 and MC2 continued to be observed in following year in Charleston, SC in 2017. In Fort Pierce, FL a complete shift was observed from MC2 in 2016 to MC1 in 2017. Since both MCs are present in the southeastern United States either at the same time or possibly different times during the production year, cultivars with combined resistance to P. cubensis populations will be needed to reduce reliance on fungicides to manage DM.

DISP-17. OUTCOMES, CLINICAL AND MOLECULAR CHARACTERISTICS OF HISPANIC PATIENTS WITH IDH WILDTYPE GLIOBLASTOMA

Abstract BACKGROUND Knowledge about outcomes in Hispanic patients with gliomas is scant and mainly derived from tumor registries. IDH wild-type glioblastomas (GBM) are the most common and aggressive malignant primary brain tumor. Hispanics account for 19% of US population, reaching 29% in Florida and 65% in Miami-Dade County. As a reference center for GBM serving the community of South Florida we provide care for many Hispanic patients. Herein, we aim to describe the clinical and molecular features, including RNA seq analysis of Hispanic vs non-Hispanic patients with IDH wild-type GBM. METHODS Retrospective study of adult patients with diagnosis of IDH Wild-type Glioblastoma, who had NGS testing, treated at University of Miami. RESULTS 179 patients were included, 63 (35%) were Hispanic. 41 (65%) of Hispanic patients were males as compared to 65 (56%) of the non-Hispanics. Median age at diagnosis was 54 years (45-67) for the Hispanic vs 62 (54-72) years for non-Hispanic, p=.002. With a median follow up of 17 months (CI 95% 14-19), median overall survival for Hispanic patients was 22 months (18-25) and 23 months (18-28) for non-Hispanics, p=.99. 42 (23%) patients were enrolled in clinical trials, of whom 21 (50%) were Hispanic, meaning 33% of Hispanic patients enrolled. The molecular characteristics from these patients by next-generation sequencing, including RNA seq, are being analyzed. CONCLUSIONS In our series of IDH wild-type Glioblastomas, Hispanic patients were significantly younger at diagnosis compared to non-Hispanic patients, but there were no differences in overall survival. 33% of Hispanic patients were enrolled in clinical trials. As the latest growing ethnic group in the USA, major efforts have to be made to better understand the disease characteristics and outcomes of this particular population. To our knowledge this will be the first report of the molecular characteristics by NGS from Hispanic patients with GBM.

Collective Action, Climate Change Adaptation, and Green Job Creation in South Florida

ABSTRACT The study draws from the bonding and bridging effects to investigate (1) collaboration for green job creation, (2) climate change adaptation for green job creation, and (3) increases in green job creation among local governments. It uses survey data from South Florida cities and employs one-way ANOVA, crosstabs, and chi-squares tests in analyzing the data. The findings show that the bonding effect, rather than the bridging effect, contributes to collaboration for green jobs that also address climate change challenges in South Florida. The study contributes to the literature on creating a collective green economy in response to climate change challenges.

Fusarium oxysporum f. sp. apii Race 4 Threatening Celery Production in South Florida.

Fusarium wilt, caused by Fusarium oxysporum f. sp. apii (Foa), is a vascular disease affecting celery. This soilborne pathogen is classified into four distinct pathogenic races: 1, 2, 3, and 4. Notably, race 4 emerges as the most virulent, representing the latest evolutionary development of this pathogen, which was first reported in 2013 in California. In 2022, celery plants in South Florida exhibited typical Fusarium wilt symptoms, with the disease reaching a 100% incidence and causing yield losses ranging from 20 to 100%. Given the significance of celery as a vegetable crop and the severity of this outbreak, the primary objective of this study was to identify and characterize the causal agent of Fusarium wilt in South Florida. The second goal aimed to test the pathogenicity and virulence of the Fusarium isolates from Florida on celery and parsley plants. Using race-specific primers and dual-loci phylogenetic analyses, the isolates surveyed in this study were identified as Foa race 4. Pathogenicity assays in the greenhouse showed that the Foa race 4 isolate from celery induced disease not only on the two celery cultivars (Duda 30 and Duda 71) but also on two commonly cultivated parsley varieties (curly and Italian). Our study also revealed that the Foa race 4 significantly (P < 0.05) affected plant health attributes in all cultivars, including plant height, total plant weight, and root weight. Interestingly, the pathogen exhibited higher (P < 0.0001) virulence on parsley than celery based on vascular discoloration. These findings strongly indicate the urgency of comprehending and managing Fusarium wilt on celery and related crops. Furthermore, the ability of Foa race 4 to affect different plant species highlights a potential threat to agricultural production, emphasizing the need for proactive measures to mitigate the impact of this virulent pathogen.

High Prevalence of Sarcocystis in a Collapsed Black Rat (Rattus rattus) Population from the Florida Keys.

We collected and screened black rats (Rattus rattus) in Key Largo, Florida, USA, to determine the potential role of disease or parasites in the collapse of the local population. Rats appeared healthy, but 94% (n=15/16) tested positive for Sarcocystis sp. The partial 18S rRNA gene sequence was 98.7-99.7% similar to a strain of Sarcocystis zuoi that is now considered a strain of the newly described Sarcocystis kani within the larger S. zuoi species complex that contains numerous new species. These Sarcocystis spp. use Asian snakes as definitive hosts and rodents, shrews, or tree shrews as intermediate hosts. Pythons are the definitive host for several Sarcocystis spp. in Asia, including a related parasite (Sarcocystis singaporensis) that has been used as a biologic control agent for Rattus spp. in southeast Asia. It is probable that increasing numbers of invasive Burmese pythons (Python bivittatus) in the Florida Keys are contributing to the spread of this parasite in addition to imposing predation pressure on both rodents and native snakes. As such, further surveillance and molecular and morphologic characterization of parasites from rodents and snakes in south Florida should be prioritized.

Assessment of Landscape‐Scale Fluxes of Carbon Dioxide and Methane in Subtropical Coastal Wetlands of South Florida

AbstractCoastal wetlands play a significant role in the storage of “blue carbon,” indicating their importance in the carbon biogeochemistry in the coastal zone and in global climate change mitigation strategies. We present airborne eddy covariance observations of CO2 and CH4 fluxes collected in southern Florida as part of the NASA BlueFlux mission during April 2022, October 2022, February 2023, and April 2023. The flux data generated from this mission consists of over 100 flight hours and more than 6,000 km of horizontal distance over coastal saline and freshwater wetlands. We find that the spatial and temporal heterogeneity in CO2 and CH4 exchange is primarily influenced by season, vegetation type, ecosystem productivity, and soil inundation. The largest CO2 uptake fluxes of more than 20 μmol m−2 s−1 were observed over mangroves during all deployments and over swamp forests during flights in April. The greatest CH4 effluxes of more than 250 nmol m−2 s−1 were measured at the end of the wet season in October 2022 over freshwater marshes and swamp shrublands. Although the combined Everglades National Park and Big Cypress National Preserve region was a net sink for carbon, CH4 emissions reduced the ecosystem carbon uptake capacity (net CO2 exchange rates) by 11%–91%. Average total net carbon exchange rates during the flight periods were −4 to −0.2 g CO2‐eq m−2 d−1. Our results highlight the importance of preserving mangrove forests and point to potential avenues of further research for greenhouse gas mitigation strategies.

Space-Based Mapping of Pre- and Post-Hurricane Mangrove Canopy Heights Using Machine Learning with Multi-Sensor Observations

Coastal mangrove forests provide numerous ecosystem services, which can be disrupted by natural disturbances, mainly hurricanes. Canopy height (CH) is a key parameter for estimating carbon storage. Airborne Light Detection and Ranging (LiDAR) is widely viewed as the most accurate method for estimating CH but data are often limited in spatial coverage and are not readily available for rapid impact assessment after hurricane events. Hence, we evaluated the use of systematically acquired space-based Synthetic Aperture Radar (SAR) and optical observations with airborne LiDAR to predict CH across expansive mangrove areas in South Florida that were severely impacted by Category 3 Hurricane Irma in 2017. We used pre- and post-Irma LiDAR-derived canopy height models (CHMs) to train Random Forest regression models that used features of Sentinel-1 SAR time series, Landsat-8 optical, and classified mangrove maps. We evaluated (1) spatial transfer learning to predict regional CH for both time periods and (2) temporal transfer learning coupled with species-specific error correction models to predict post-Irma CH using models trained by pre-Irma data. Model performance of SAR and optical data differed with time period and across height classes. For spatial transfer, SAR data models achieved higher accuracy than optical models for post-Irma, while the opposite was the case for the pre-Irma period. For temporal transfer, SAR models were more accurate for tall trees (&gt;10 m) but optical models were more accurate for short trees. By fusing data of both sensors, spatial and temporal transfer learning achieved the root mean square errors (RMSEs) of 1.9 m and 1.7 m, respectively, for absolute CH. Predicted CH losses were comparable with LiDAR-derived reference values across height and species classes. Spatial and temporal transfer learning techniques applied to readily available spaceborne satellite data can enable conservation managers to assess the impacts of disturbances on regional coastal ecosystems efficiently and within a practical timeframe after a disturbance event.

Latin Transgender and Gender-Diverse Individuals’ Perceptions of Well-Being During the COVID-19 Pandemic

Latin transgender and gender-diverse (LTGGD) individuals experienced the public health measures mandated during the COVID-19 pandemic in unique ways. Intersecting ethnic and gender-identifying frameworks contributes to differing access, support, and well-being observations. The aim of this study was to examine emerging adult LTGGD individuals’ perceptions of their health and well-being experiences during the COVID-19 pandemic in South Florida. Interviews were conducted with nine self-identifying LTGGD individuals. Using a thematic analysis, a total of three major themes were identified as shaping the participants’ experiences and perceptions of health during COVID-19, including (a) healthcare interactions, (b) challenges, and (c) opportunities. Some of the participants were mixed in their perceptions of their well-being during the COVID-19 pandemic; negative concerns included the inability to access general and transgender/gender-diverse specific health services. However, others note that they were happy that the pandemic allowed them to avoid contexts where they regularly experienced microaggressions due to their identities. Additionally, various participants were able to use this time of isolation to identify providers with greater knowledge about LTGGD health needs. These findings highlight the importance of providing culturally competent and humility-centered skills to healthcare providers and others supporting the LTGGD population’s well-being.

First Detection of Pseudocerradoa paullula Causing Aroid Leaf Rust on Swiss Cheese Plant (Monstera deliciosa) in Virginia.

Monstera deliciosa Liebm. (Araceae) is a monocotyledonous plant that is native to tropical forests of southern Mexico to Panama. It is widely grown as an ornamental in the United States because of its easy maintenance and attractive, fenestrate leaves. On May 10th, 2024, at a nursery and garden center in Henrico County, Virginia, four M. deliciosa plants in 3.8 L containers were observed with necrotic spots surrounded by a yellow halo on the leaves (Fig. 1A). Uredinia were present in the center of the lesions with dense, reddish-brown sporulation mostly on the abaxial surface of the leaves (Fig. 1B). Urediniospores with pedicels were golden brown in color, globose, echinulate, with two opposite germ pores, averaging (28) 25.2 x 25 (23) µm (n = 40) in size and a wall thickness of 1.5 to 2 µm (n = 40) (Fig. 1F - K). Telia were not present. The host, symptoms, and urediniospore size was comparable to reports of Pseudocerradoa paullula (Syd. & P. Syd.) M. Ebinghaus & Dianese from South Carolina (22.9 to 27.9 μm), Florida (24 to 31 μm), and Japan (24.8 to 29.3 μm) (Ebinghaus et al. 2022; Sakamoto et al. 2023; Urbina et al. 2023; Yang et al. 2023). Urediniospores from the infected plants were collected with a sterile needle and DNA was extracted using a Qiagen DNeasy PowerLyzer Microbial Kit (Germantown, MD) according to the manufacturer's instructions. PCR and sequencing of the small ribosomal subunit (SSU) and large ribosomal subunit (LSU) gene regions was performed with primer sets NS1/Rust18SR and LRust1R/LR3 (Beenken et al. 2012; Vilgalys and Hester 1990). The resulting 1,630bp and 638 bp sequence fragments of the SSU and LSU loci from strain GS24-AE50 were deposited into the NCBI Genbank database under accessions PQ059898 and PQ059897, respectively. A pairwise alignment of the SSU gene shared 1,363/1,366 (99%) nucleotides with the P. paullula voucher (ON887197) from Florida. A Genbank nBLAST analysis of the LSU gene shared 636/638 (99%), 636/638 (99%), and 592/600 (99%) nucleotides with vouchers from M. deliciosa from South Carolina (OQ746460), Florida (ON887197) and Japan (OK509070) (Sakamoto et al. 20222; Urbina et al. 2023; Yang et al. 2023). Koch's postulates were fulfilled by spraying four, healthy, non-wounded M. deliciosa plants to run-off with a urediniospore suspension (1 x 106 spores/ml distilled water, 20 ml per plant) that was collected from the original infected plants. An additional four, healthy control plants were sprayed with distilled water only. After 6 weeks in a greenhouse at 22 ± 2°C with ≥85% relative humidity under an 8-h photoperiod, uredinia in the center of lesions identical to those on the original symptomatic plants developed on 12 out of 20 leaves from the inoculated plants, while all the leaves from the control plants remained asymptomatic (Fig.1C - E). Urediniospores collected from the inoculated plants were morphologically identical to the urediniospores from the original infected plants with 100% LSU sequence homology to accession PQ059897. Globally, P. paullula has been reported from Australia, China, Japan, Malaysia, the Philippines, and the United States, where the pathogen was detected at the port of Los Angeles in 2014, Florida in 2019, and South Carolina in 2023 (Sakamoto et al. 2023; Shaw et al. 1991; Urbina et al. 2023; Yang et al. 2023). Although the pathogen is not known to be established in Virginia, the recent surge of reports suggests that the pathogen's distribution is expanding. The impact of aroid leaf rust on M. deliciosa production is unclear, but it has the potential to reduce the aesthetic and commercial value of plants under favorable conditions.

Factor Structure and Measurement Invariance of the Cultural Attitudes Toward Healthcare and Mental Illness Questionnaire Among Latino Sexual Minority Men

Mental health disparities among Latino sexual minority men (LSMM) are exacerbated by un(der)treated mental health needs. This study sought to establish the factor structure of the Cultural Attitudes Toward Healthcare and Mental Illness Questionnaire (CAHMIQ) and examine measurement invariance across nativity (born in vs. outside the continental U.S.). Participants included 290 LSMM in South Florida. Confirmatory factor analysis examined the factor structure of CAHMIQ and measurement invariance examined equivalence across LSMM born outside (51.4%) and inside (48.3%) the continental U.S. The second-order factor model showed an acceptable fit (CFI/RMSEA = .91/.03) and consisted of first-ordered factors representing manifest indicators of causes and supports for mental health. Measurement invariance results suggest that the CAHMIQ performs equivalently across nativity groups (∆χ2(18) = 16.941, p = .5272). The CAHMIQ may be used among both nativity groups to understand attitudes toward healthcare and mental illness and inform LSMMs’ engagement in mental health treatment.

Research and program grants will support health equity

The philanthropic arm of health insurance company Humana Inc. has announced a series of grants devoted to advancing health equity, with several of the funded initiatives focused on mental health. The Humana Foundation on Oct. 16 announced investments totaling $15.2 million for research and programmatic initiatives emphasizing emotional health and community connection. Among the funded research projects, investigators at Indiana University's Bloomington campus will use grant support to examine connection between school staff and marginalized students for suicide prevention, while researchers at the University of South Florida will test a nutrition education intervention for low‐income older adults with behavioral health conditions. Program grantees include Junior Achievement of Kentuckiana, which plans to establish a youth mental health center in Kentucky, and Spring Branch Community Health Center in Texas, which intends to open a mental health center at a high school with a large proportion of students struggling with mental health issues. Older adults and school‐age children have been priority populations in the foundation's overall giving mission. “This commitment from the Humana Foundation offers a major investment in creating practical tools that will have wide application in reconnecting older adults to social and community networks,” said Tom Kamber, executive director of grant recipient agency Older Adults Technology Services, which will use its grant to educate communities on the difficulties many seniors have in combating social isolation.

Profitability and Cost Estimates for Producing Tropical Hibiscus in South Florida

Tropical hibiscus (Hibiscus rosa-sinensis) is a bushy evergreen shrub or small tree native to the temperate regions of Asia and an economically significant crop in Florida. According to the 2017 Census of Agriculture, the market value of the ornamental industry in Miami-Dade County was $697 million, and approximately 25% of the production was in hibiscus. Demand for the cultivation of plants with minimal pesticides is rising due to concerns about potential adverse environmental and health effects. Integrated pest management, or IPM, is an alternative to conventional pesticide application. A broad-based approach, it integrates both chemical and non-chemical practices for sustainable control of pests. To help growers and other stakeholders determine the best approach to changing demands for pesticide management, this publication estimates the costs and returns of producing tropical hibiscus on an established nursery in south Florida using both traditional and IPM methods.

A novel avenue to explore in the treatment of dementia

A novel avenue to explore in the treatment of dementia A collaborative project between the University of South Florida and The Healthy Aging Company is exploring how a new biological entity called ALF5755 could be a candidate drug for the treatment of dementia and Alzheimer’s disease. Aging is the major common risk factor for death from all adult diseases. Death rates increase logarithmically with advancing age for all diseases associated with aging, including heart disease, cancer, stroke, type 2 diabetes mellitus (T2DM), and Alzheimer’s disease. In this context, Alzheimer’s disease has emerged as a major health concern. Despite some improvement in the therapy, the overall prognosis of AD is still poor. With the current lack of treatments, any type of symptom alleviation will have a beneficial impact on the lives of patients and their caregivers.

Helicopter Emergency Medical Services (HEMS) Transportation Utilization for Acute Ischemic Strokes at a Community-Based Hospital in South Florida

Background: A comprehensive stroke center (CSC) servicing remote areas in South Florida became HEMS direct-from-field capable on October 15, 2020. This analysis reviews the utilization of this service and compares it to ground EMS (GEMS). Methods: This is a retrospective cohort study from October 15, 2020, to July 31, 2021, that collected HEMS adult stroke alert data and compared it to the prior year's summary GEMS stroke alert data. Using HEMS transportation logs, presenting stroke symptoms and prehospital assessment were abstracted, in addition to initial NIHSS, downgrade rate, stroke diagnosis percentage, treatment rate, and times. Results: The analysis included a total of 52 direct transport HEMS stroke alerts. Assessment tools utilized by HEMS included the Cincinnati stroke scale (4%) and the FAST-ED (37%); most cases (59%) did not document a stroke assessment tool. The median NIHSS was 10, with 37% presenting a score &lt;6. Cases were downgraded upon arrival in 27% and after CT imaging in 15% of cases. Significantly (p&lt;.001), more HEMS cases were diagnosed as stroke (69%) compared to GEMS (57%). Stroke treatment rates remained similar (HEMS=23%; GEMS=24%). Median door-to-needle times were significantly faster for HEMS (15 min) than GEMS (25 min) (p&lt;.05). Median door-to-puncture times were clinically faster for HEMS (61mins) than GEMS (66 mins). Conclusion: Prehospital triage could be improved to better detect the 77% of patients who are not eligible for acute stroke reperfusion treatments and may benefit from ground as opposed to air transportation. The current HEMS triage, although not consistently documented, appropriately selects stroke victims, but not necessarily those who need air transport to a higher care level. Patients arriving via HEMS receive similar access to stroke treatment and, if treated, significantly faster treatment times.

Funding Strategies used by Hispanic Churches in South Florida

The congregations in the United States need help with attendance. A decline in church membership results in a decrease in funds. This unfavorable effect on the institution's finances can affect the congregation's operations. This article seeks to assess and recommend a funding strategy for Hispanic Churches in South Florida. Correspondingly, Churches and other faith-based institutions require solid financial management to attain financial sustainment. Congregation administrators should focus on external and internal factors, financial planning, and developing and maintaining collaborations with external entities to grow their finances.

AEDEOMYIA SQUAMIPENNIS: A NEW GENUS AND SPECIES RECORD FOR COLLIER COUNTY, FLORIDA, USA

ABSTRACT On November 7, 2023, 3 female specimens of Aedeomyia squamipennis were captured in Collier County, Florida, for the first time during routine adult mosquito surveillance in Collier Seminole State Park. This species was first found in the USA in Miami-Dade County in 2016 and has since expanded into multiple counties throughout South Florida. The presence of Ad. squamipennis has implications for arbovirus transmission as it is a vector for the Venezuelan equine encephalitis virus group. The detection of this mosquito species also highlights the importance of a robust and consistent mosquito surveillance program.

Limited acceptance of buprenorphine in recovery residences in South Florida: A secret shopper survey

BackgroundBuprenorphine is a first-line treatment for opioid use disorder (OUD), essential for reducing opioid overdose mortality and improving treatment retention. Despite federal policies that mandate the acceptance of buprenorphine in recovery residences, individuals in South Florida taking this medication often face significant barriers to admission. This study uses a secret shopper survey to examine whether federal policies regarding prescribed buprenorphine use are being violated in South Florida recovery residences. MethodsWe selected recovery residences in South Florida due to the region's high opioid overdose death rate and its prominence as a recovery hub. From a list of 141 Florida Association of Recovery Residences (FARR)-certified residences in Palm Beach, Broward, and Miami-Dade, we randomly surveyed 100 programs across all treatment levels (I-IV) using a standardized script. The primary outcome was whether residences accepted individuals taking buprenorphine, classified into three categories: (1) unconditional acceptance, where any person taking buprenorphine was accepted; (2) denial, where admission was refused for all individuals taking buprenorphine; and (3) conditional acceptance, where admission was granted under specific conditions. Secondary outcomes included requirements for conditional acceptance, such as dose limits or tapering policies. ResultsThe distribution of the 100 surveyed recovery residences was comparable to the 141 FARR-certified facilities: 67 % were in Palm Beach, 31 % in Broward, and 2 % in Miami-Dade. Most residences (55 %) were level II certified, followed by 26 % level IV, 14 % level I, and 5 % level III. Sixteen percent of residences permitted admission of individuals taking any buprenorphine dose, 31 % had conditional policies, and 53 % prohibited buprenorphine. The maximum acceptance across all counties and levels was 20 %. No significant differences were observed by county (p = 0.61) or facility level (p = 0.29). Of 31 residences with conditional policies, 25.8 % (n = 8) required a mandatory taper, 38.7 % (n = 12) allowed a maximum 8 mg daily dosage, 12.9 % (n = 4) had a maximum 12 mg daily dosage, 6.5 % (n = 2) had a maximum 16 mg daily dosage, 6.5 % (n = 2) required a provider letter, and 9.7 % (n = 3) did not provide further information. ConclusionsAccess to FARR-certified recovery residences is severely limited for individuals in South Florida taking buprenorphine. Urgent action is needed to improve access to evidence-based OUD treatments, address complexities influencing recovery residence policy and practice, and ensure appropriate allocation of public funds like State Opioid Response dollars.

Entrustable Professional Activities in Medical Education: SELECT Leadership, Values-Based Patient-Centered Care, Health Systems, and Scholarly Excellence

Entrustable Professional Activities (EPAs) represent a concept in medical education that has gained significant traction over the last few years, particularly in the context of competency-based medical education. An EPA refers to a specific task or responsibility that can be entrusted to a trainee once they have demonstrated the necessary competence. EPAs provide concrete tasks that a trainee should be able to complete at various stages of training in order to clarify expectations and responsibilities they should master. The University of South Florida Morsani College of Medicine (USFMCOM), Scholarly Excellence, Leadership Experiences, Collaborative Training (SELECT) MD program pairs a unique four-year longitudinal leadership program including the domains of leadership, values-based patient-centered care, health systems, and scholarly excellence with an innovative medical degree program. Students in the SELECT program spend the first two years on the campus in Tampa, Florida, and the clinical years on the regional campus in Allentown, Pennsylvania. These additional threads of curriculum call for a unique set of EPAs. A working group of faculty, students, and administrators within the college from both the main and regional campus developed EPAs for each of the above listed areas of focus within the curriculum. In this paper, the authors describe how Entrustable Professional Activities were developed at MCOM to assess the SELECT curriculum in the areas of leadership, values-based patient-centered care, health systems, and scholarly excellence.

Perceptions and tolerance of American crocodiles and their management by South Florida residents

Perceptions and tolerance of American crocodiles and their management by South Florida residents