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PubMed1989

Parasites that attack stable fly and house fly (Diptera: Muscidae) puparia during the winter on dairies in northwestern Florida.

Throughout the winter and early spring months, stable fly, Stomoxys calcitrans (L.), and house fly, Musca domestica L., puparia were collected from silage, hay, and manure from six dairies in northwestern Florida and evaluated for parasitism. Of the puparia producing flies or parasites, 23% of the stable flies and 46% of the house flies were parasitized. The predominant parasite observed attacking muscoid flies (76% for stable flies and 58% for house flies) was Spalangia cameroni Perkins. Muscidifurax sp. was recovered from 11 and 36% of the stable fly and house fly pupae, respectively. Other parasite species encountered were Spalangia endius Walker and S. nigroaenea Curtis. Significantly more parasitized fly pupae were collected from silage than from hay residues or manure. Winter and early spring parasite populations in northwestern Florida appear to be present as long as viable fly pupae are available to support the developing parasites.

Animals↗
PubMed1995

Parasitism of Aedes aegypti and Ae. albopictus (Diptera: Culicidae) by Ascogregarina spp. (Apicomplexa: Lecudinidae) in Florida.

Aedes aegypti (L.) and Ae. albopictus (Skuse) from 40 sites in 17 counties of Florida were surveyed for gregarine parasites during the spring and autumn of 1993 and in July 1994. Larvae collected from containers (mainly tires) were dissected to determine the number of gregarine trophozoites present. Ascogregarina spp. were found at 70% of the sites and occurred as frequently in Ae. aegypti populations as in Ae. albopictus. Within sites, parasite distributions were highly variable and aggregated in host populations. Parasite loads ranged from 1 to 486 trophozoites per host. Mean parasite load was significantly higher in Ae. aegypti larvae (52.5 per host) than in Ae. albopictus (33.5 per host). Parasite prevalence was significantly higher in Ae. aegypti populations that were not sympatric with Ae. albopictus compared with allopatric Ae. albopictus or sympatric populations of either species. In sympatric populations, Ae. aegypti tended to have equal or higher parasite prevalence than the cohabiting Ae. albopictus. Ascogregarina taiwanensis (Lien & Levine) prevalence in Ae. albopictus was significantly higher in areas where these hosts have been present for at least 3 yr. These data contribute to the hypothesis that parasite-mediated competition may be a factor in the apparent displacement of Ae. aegypti by Ae. albopictus in Florida.

Aedes↗
PubMed1999

Blood feeding and oviposition by Culex nigripalpus (Diptera: Culicidae) before, during, and after a widespread St. Louis encephalitis virus epidemic in Florida.

A widespread epidemic of St. Louis encephalitis (SLE) virus was reported from central Florida from late July through December 1990 with 226 clinical cases and 11 deaths in humans. The abundance of blood-fed and gravid Culex nigripalpus Theobald females, the vector of SLE in Florida, was monitored at a resting site in Indian River County, FL, for the 3 yr before the epidemic, the epidemic year, and for 1 yr following the epidemic. Each study year was divided into four 3-mo periods that depict the subtropical SLE transmission cycle; a January-March maintenance phase, an April-June amplification phase, a July-September early transmission phase, and an October-December late transmission phase. The abundance of blood-fed and gravid females was significantly greater during the amplification, early transmission, and late transmission phases of the 1990 SLE epidemic when compared with the 3 pre-epidemic years. Throughout the study, Cx. nigripalpus blood feeding and oviposition was driven by epic (> 50 mm) rainfall events. The abundance of gravid females decreased, whereas the number of blood-fed females increased following heavy rainfalls. Epizootic and epidemic transmission of SLE to sentinel chickens and humans in Indian River County was greatest immediately following heavy rainfalls that synchronized Cx. nigripalpus oviposition and blood feeding.

Animals↗
PubMed1999

Aedes albopictus (Diptera: Culicidae): an experimental and natural host of Dirofilaria immitis (Filarioidea: Onchocercidae) in Florida, U.S.A.

Females of an Aedes albopictus (Skuse) colony from southeastern Florida, U.S.A., ingested low (22.9 +/- 3.2 mg/Female) and high (243.2 +/- 37.6 mf/Female) numbers of microfilariae from a dog infected with Dirofilaria immitis (Leidy). High mortality of females occurred during the first 4 d after infection regardless of the number of microfilariae ingested; daily mortality was almost negligible during 5-15 d after infection. Percentage of survival 15 d after infection was higher (63%) in females that ingested low numbers of microfilariae than those (15%) that ingested high numbers of microfilariae. The development of most of the D. immitis larvae was arrested in late L1 stage with some of the L1 stage larvae becoming melanized intracellularly in the Malpighian tubule cells of Ae. albopictus. Fifteen days after infection, development of D. immitis to the infective L3 stage occurred in only 10.9% of the surviving F1 and F2 Ae. albopictus that ingested low numbers of microfilariae, but in 94% of Anopheles quadrimaculatus Say ingesting similar numbers of microfilariae, as a control. Females of Ae. albopictus ingesting high numbers of microfilariae had more surviving females with L3 than those ingesting low numbers of microfilariae. The number of L3 larvae in the Malpighian tubules, hemocoel, head capsule and proboscis ranged from 1 to 37 per female, indicating the potential of Ae. albopictus to transmit D. immitis. Development of D. immitis larvae was not affected by co-infection with Ascogregarina taiwanensis (Lien & Levine), although both parasites infect the Malpighian tubules, the first intracellularly and the second extracellularly. After one generation of selection, a strain of Ae. albopictus susceptible to D. immitis developed 2.5 times more L3 than the parent strain. These results show that a small portion of the natural population of Ae. albopictus is susceptible to infection with D. immitis and that susceptibility may be increased rapidly by selection. The presence of developing Dirofilaria sp. larvae in the Malpighian tubules of field-caught females indicated that Ae. albopictus may be infected naturally with D. immitis in Florida.

Aedes↗
PubMed1989

Multiple sclerosis in Key West, Florida.

In 1984, a press release by a Miami, Florida, neurologist described a possible cluster of persons with multiple sclerosis in Key West, Florida. The authors examined the cluster using prevalence rates, which are recognized as having a latitudinal gradient for multiple sclerosis, being generally high at high latitudes and low at low latitudes. Case ascertainment showed 32 definite or probable cases among residents of the study area (latitude, 24.5 degrees N) on September 1, 1985, a prevalence rate of 70.1/100,000 population--14 times the rate estimated for this latitude by modeling techniques based on US and international data, 7-44 times the rate for areas at similar latitudes (Mexico City, Mexico; Hawaii; New Orleans, Louisiana; and Charles County, South Carolina), and 2.5 times the expected rate for all US latitudes below 37 degrees N. This finding could not be explained by changes in diagnostic criteria, case ascertainment bias, immigration of people from high-risk areas, an unusual population structure, a large percentage of related cases, or better survival. Prevalent cases (n = 22) were more likely than general population controls (n = 76), matched by sex and 10-year age group, to have: lived longer in Key West, been a nurse, ever owned a Siamese cat, had detectable antibody titers to coxsackievirus A2 and poliovirus 2, and ever visited a local military base (Fleming Key). Key West has an unusually high prevalence of multiple sclerosis that may be related to these risk factors.

Adult↗
PubMed1992

Quality of care in residential homes: a comparison between Israel and Florida.

This paper reports on two studies of the quality of care in long-term care institutions for the elderly, one in Israel and one in Florida, which used the tracer methodology developed by the JDC-Brookdale Institute of Gerontology for examining quality of care in such institutions. A tracer is a well-defined and frequently occurring problem which has a known treatment. Tracers from the medical, nursing and psychosocial areas of care were used in the studies. Data were collected by multidisciplinary teams of medical and paramedical personnel who examined and interviewed elderly residents, interviewed staff members, conducted observations, and reviewed records. Differences inherent in the two study groups--such as in cultural norms and organizational systems--were taken into consideration, and the instruments were adjusted accordingly. The tracer method proved to be a feasible method for assessing quality of care in both locales. Findings regarding 12 tracers show that for units previously assessed as either good or poor/mediocre by surveyors, good units consistently scored higher than poor/mediocre units in quality of care. Florida scored higher for quality of care in the medical area, and Israel in the nursing and psychosocial areas.

Aged↗
PubMedDate not supplied

A complex alloantigen system in Florida sandhill cranes, Grus canadensis pratensis: evidence for the major histocompatibility (B) system.

The B blood group system constitutes the major histocompatibility complex (Mhc) in birds. The Mhc is a cluster of genes largely devoted to the processing and presentation of antigen. The Mhc is highly polymorphic in many species and, thus, useful in the evaluation of genetic diversity for fitness traits within populations of a variety of animals. Correlations found between particular Mhc haplotypes and resistance to certain diseases emphasize the importance of understanding the functional significance of diversity of the Mhc, particularly in species threatened with extinction. As part of studies focused on genetic diversity in wild birds, serological techniques were used to define a highly polymorphic alloantigen system in seven families of Florida sandhill cranes (Grus canadensis pratensis). The results of analyses with antisera produced within the crane families and with chicken Mhc antigen-specific reagents revealed a single major alloantigen system that is likely the Mhc of the Florida sandhill crane. Preliminary experiments indicate that these crane alloantisera will provide a means of defining the Mhc in other species of cranes.

ABO Blood-Group System↗
PubMedDate not supplied

Trial marriage: Florida's experience in consolidating HIV/AIDS, STD, and TB programs.

After a three-year experiment in consolidating services, the Florida Department of Health has again separated programs for the prevention and control of HIV/AIDS, sexually transmitted diseases (STDs), and tuberculosis. The authors report that while there were some clear advantages to consolidating services, especially programs dealing with HIV and other STDs, the individual programs suffered in some important ways. The authors describe Florida's effort to preserve the positive programmatic and administrative aspects of the consolidated approach and to apply the lessons learned.

Acquired Immunodeficiency Syndrome↗
PubMed2006

TENORM aerosols in the Florida phosphate industry--assessment of lung fluid solubility and annual effective dose to workers.

Inhalation exposure to workers in the Florida phosphate industry due to TENORM aerosols has not been adequately addressed owing to lack of aerosol information. One of the more critical factors is the absorption rate of inhaled radionuclides into blood. In this study, this parameter was characterised using an in vitro dissolution test. The solubility data and other aerosol information were then used for individualised dose assessments at six different Florida phosphate facilities. The solubility data support the selections of ICRP Publication 66 Type M for uranium and lead isotopes and Type S for thorium isotopes. Total annual effective doses are 0.34 +/- 0.12 mSv at granulator areas, 0.30 +/- 0.10 mSv at storage areas and 0.23 +/- 0.02 mSv at shipping areas. These findings are considerably lower than originally postulated in previous studies where no site-specific information on particle size and lung fluid solubility had been available.

Aerosols↗
PubMedDate not supplied

Fighting the silent epidemic: the Florida Brain and Spinal Cord Injury Program.

This article describes a statewide model program that provides a range of services for individuals with traumatic brain injury in Florida. The article answers questions regarding the organization, delivery, and financing of a system that includes surveillance data, case management, health services, a network of contractors, and a Medicaid waiver. With an annual budget of more than 15 million US dollars, the primary source of financing is a trust fund established through state statute with revenues from fines levied for driving while intoxicated. Lessons from Florida that will be useful to states as they respond to Olmstead and develop Medicaid waivers include (a) how a data registry laid the foundation for a service delivery system, (b) how early and aggressive case management has the potential for Medicaid savings, and (c) how a statewide system, critical mass of patients, and standards for providers can improve the quality of services for persons with traumatic brain injury.

Brain Injuries↗
PubMed2005

Founding a new College of Medicine at Florida State University.

In 2000, the Florida State University (FSU) College of Medicine was founded, becoming the first new allopathic medical school in the United States in over 20 years. The new medical school was to use community-based clinical training for the education of its students, create a technology-rich environment, and address primary care health needs of Florida's citizens, especially the elderly, rural, minorities, and underserved. The challenges faced during the creation of the new school, including accreditation and a leadership change, as well as accomplishments are described here. The new school admits a diverse student body made possible through its extensive outreach programs, fosters a humane learning environment through creation of student learning communities, has a distributed clinical training model-with clinical campuses in Orlando, Pensacola, Sarasota and Tallahassee, and with 70% of training occurring in ambulatory settings-and utilizes 21st-century information technology. The curriculum focuses on patient-centered clinical training, using the biopsychosocial model of patient care throughout the entire medical curriculum, promotes primary care and geriatrics medicine through longitudinal community experiences, relies on a hybrid curriculum for delivery of the first two years of medical education with half of class sessions occurring in small groups and on a continuum of clinical skills development throughout the first three years, and uses an interdisciplinary departmental model for faculty, which greatly facilitates delivery of an integrated curriculum. The first class was admitted in 2001 and graduated in May 2005. In February 2005, the FSU College of Medicine received full accreditation from the Liaison Committee on Medical Education.

Curriculum↗
PubMed2002

Enacting litigious environments: litigation and Florida's nursing homes.

This article examines how different for-profit nursing home facilities with varying levels of lawsuit risk responded to the litigious environment existing in Florida during 1999. Specifically, this article considers the question: How do nursing home staffs differ in their views of litigation risks and their reactions to those perceived risks? To answer this question, this study examined selected Florida facilities from a large, multinational, for-profit long-term-care chain.

Attitude of Health Personnel↗
PubMedDate not supplied

Uncompensated care provided by emergency physicians in Florida emergency departments.

Uncompensated emergency department (ED) visits can negatively affect patients, clinicians, and hospitals, particularly as overcrowding occurs. Florida provides a unique market to analyze uncompensated ED care due to the high percent of for-profit hospitals, which typically provide significantly less uncompensated care, coupled with the older population that is more likely to be insured through Medicare. A survey of 188 Florida hospital emergency physician groups was conducted to estimate the level of uncompensated care provided by each ED physician group in 1998. The response rate was 44 percent (eighty-three ED physician groups). All ED physician groups provided substantial uncompensated care regardless of hospital ownership type. Uncompensated care averaged 46.8 percent and ranged from 25.8 to 79.4 percent. A model was developed to predict the amount of uncompensated care using ED volume and payer mix. A rise in the percent of self-pay patients causes a disproportionate increase in uncompensated care, such that EDs with high levels of self-pay visits have markedly higher uncompensated care rates. The results suggest the need for a uniform reporting method of ED physician uncompensated care cost.

Data Collection↗
PubMed1979

Serum concentrations of 25-hydroxyvitamin D in Florida children: effect of anticonvulsant drugs.

The mean serum concentration of 25-hydroxyvitamin D (25OHD), determined by nonchromatographic radioassay, was significantly lower (P less than .02) in Florida children with epilepsy treated with anticonvulsant drugs (34.4 +/- 11.3 [SD] ng/ml) than in normal subjects (40.9 +/- 14.3), despite exposure of both groups to sunlight throughout the year. In 12% of children treated with anticonvulsant drugs, the 25OHD level was below the lowest value recorded in the control group. The mean serum concentration of 25OHD in normal Philadelphia children (27.5 +/- 9.1 ng/ml) was significantly less than in either group of Florida subjects. Annual monitoring of calcium homeostasis and vitamin D status is indicated in Southern children receiving anticonvulsant drugs, but routine vitamin D supplementation of such patients is unnecessary.

Anticonvulsants↗
PubMed1987

Haemophilus ducreyi infection in south Florida: a rare disease on the rise?

Increased numbers of patients with genital ulcers sought medical attention in the Palm Beach County, Florida, Sexually Transmitted Disease clinics from Aug 1, 1982 to Aug 31, 1983. We established that a small proportion of subsequent cases of genital ulcers were caused by Haemophilus ducreyi, the etiologic agent associated with chancroid. We also set up a surveillance system to monitor this sexually transmitted infection, and have illuminated several recent cases of chancroid occurring in that area. This outbreak of chancroid suggest that clinicians practicing in south Florida consider chancroid (generally a rare disease in the United States) in their differential diagnoses of genital ulcers.

Adult↗
PubMed1990

Fatalities associated with Vibrio parahaemolyticus and Vibrio cholerae non-O1 infections in Florida (1981 to 1988).

Vibrio infections constitute a continuing source of morbidity and mortality in Florida. Seven fatal infections caused by Vibrio parahaemolyticus or V cholerae non-O1 were reported in Florida between 1981 and 1988. Review of those seven medical records and Vibrio case investigation forms showed that although all patients died of sepsis, gastrointestinal signs and symptoms characterized the early illness in four patients, whereas the other three initially had painful swelling and/or lesions of the lower extremities. All patients had preexisting chronic diseases. Five patients (71%) had eaten seafood during the week before oneset of illness, including four (57%) who had eaten raw oysters. To reduce the risk of acquiring Vibrio infections, raw or undercooked seafood should be eliminated from the diet, particularly by persons with underlying chronic diseases.

Aged↗
PubMed1995

Survey of clinical breast examinations and use of screening mammography in Florida.

This study examined data on usage of screening mammograms and clinical breast examination (CBE) by 1,339 Florida women interviewed during the 1991 Behavioral Risk Factor Surveillance Survey. Among women 20 to 40 years old, 87.3% reported a CBE within the past 3 years, exceeding the guidelines of the American Cancer Society. Among older women, 70.4% had a CBE within the past year as recommended. However, only a bare majority (50.5%) of those aged 50 or older had obtained a mammogram in the past year. Annual household income, but not educational level, was positively associated with adherence to mammography. Among those having mammograms, self-referred women were more educated, more affluent, and more likely to be white than were physician-referred women. Further efforts and resources must be directed toward education of physicians and the public on the value of regular mammography for all Florida women, especially for our elderly and economically disadvantaged.

Adult↗
PubMed1999

Determinants of the excessive rates of lung cancer in northeast Florida.

BACKGROUND: Age-adjusted rates of lung cancer among whites, but not blacks, in Duval County Jacksonville), Florida, have been among the highest of any metropolitan area of the United States for three decades. METHODS: We conducted a case-control study, interviewing 507 patients with lung cancer diagnosed from 1993 to 1996 and 1,007 control subjects, randomly selected from the county population. RESULTS: Cigarette smoking was the dominant cause of lung cancer (odds ratios, 59 among male current smokers; 30 among female current smokers). Both prevalence and intensity of smoking were excessive for whites but less for blacks when compared with national norms. Little association was found with residential patterns, indices of air quality, or occupation. Risk doubled with increased intake of dietary fat and with a family history of lung cancer. CONCLUSIONS: Life-style factors, especially smoking, but not environmental factors, appear responsible for the high rates of lung cancer in northeast Florida.

Adult↗