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Insecticide tolerance of Culex nigripalpus in Florida.

Larval susceptibility tests of Culex nigripalpus populations from various areas of Florida have shown resistance to several organophosphorus insecticides since 1984. Although the degree of resistance is low (2 to 7 times), it can be termed tolerance and appears to be the greatest for fenthion, followed by temephos, naled and malathion. It is suggested that pesticide runoff from lawns, golf courses and agricultural and urban areas may play a role in developing resistance in Florida mosquito populations.

Animals↗

Cardiac transplantation: University of South Florida--Tampa General Hospital experience.

Cardiac transplantation has evolved from an experimental procedure to an accepted mode of therapy that prolongs life in patients with severe heart failure. The University of South Florida-Tampa General Hospital began performing cardiac transplantation for the treatment of end-stage cardiac disease in June 1985. Since then 42 heart transplantations have been performed and 30 patients are alive and well. The one-year actuarial survival is 78.73% and the two-year actuarial survival is 72.15%. Multiple complications have been encountered most notably rejection and infection. The recent approval of the USF/TGH program as a Medicare funded cardiac transplantation center is expected to greatly expand the number of potential recipients and will provide the residents of Florida, and the Southeastern United States, with an additional health care resource.

Adult↗

The importance of autumn rainfall and sentinel flock location to understanding the epidemiology of St. Louis encephalitis virus in Indian River County, Florida.

Culex nigripalpus adults were collected from sentinel chickens at 4 sites in Indian River Co. (IRC), Florida. Chickens located in well drained, open habitats attracted fewer Cx. nigripalpus than did those located in a moist, forested area, but the number of mosquitoes collected in the open habitats increased significantly with heavy autumn rainfall. All St. Louis encephalitis virus (SLE) seroconversions (11/674) during a 7-year period were from chickens located in open, well drained habitats. A comparison of monthly rainfall during years of known SLE activity in IRC with the 22-year average showed that virus activity was significantly associated with years in which rainfall was unusually low in either September or October. Sentinel chickens in areas with large vector populations may not be the most reliable indicators of local SLE activity and autumn rainfall in September and October may influence yearly SLE patterns in southern Florida.

Animals↗

Autogeny in Culex salinarius from Texas, Florida and New Jersey.

Autogeny was studied in Culex salinarius from College Station, Texas; Vero Beach, Florida; and Edison and Dennisville, New Jersey. Autogenous egg development varied from 14% in the Florida colony to 23 and 27%, respectively, in colonies from Texas and New Jersey. The mean number of eggs per autogenous female ranged from 13.5 to 23.7. As in other autogenous mosquitoes, the expression of autogeny was dependent on larval and adult diets. Mating did not influence autogeny as it does in some mosquitoes. Autogeny in Cx. salinarius was obligate at warm temperatures, but females denied a bloodmeal appeared to undergo facultative autogeny at colder temperatures.

Animal Nutritional Physiological Phenomena↗

Legal incompetents' need for guardians in Florida.

This study assesses the alleged need for guardians in Florida. A survey of the state's 74 public receiving facilities, community mental health centers, and clinics; 30 private receiving facilities; 11 Aging and Adult district offices; Developmental Services institutional and residential placements; and six state mental hospitals revealed that 11,147 persons in Florida reportedly need a legal guardian. The limitations, implications, and possible policy responses to this alleged need are discussed.

Community Mental Health Services↗

Therapeutic drug-use review for the Florida Medicaid program.

A program is described in which drug-use review information was provided to prescribers and dispensing pharmacies for the purpose of reducing morbidity related to inappropriate drug therapy. In the Florida Medicaid program, computer-generated medical history profiles were used to identify patients at risk for drug-induced illnesses. Health-care providers were then notified of potential problems with patients' drug regimens and asked for a response. Patient profiles were monitored for changes, and follow-up letters were sent to the health-care providers as warranted. During a nine-month period in 1982-83, drug therapy was changed in 54% of cases after providers were notified of problems. Florida's Medicaid drug-use review program was effective in identifying inappropriate drug therapy that can lead to increased morbidity and higher health-care costs.

Computers↗

Mortality among workers in the Florida phosphate industry. I. Industry-wide cause-specific mortality patterns.

A retrospective cohort mortality study was conducted on 17,601 white and 4,722 nonwhite male workers in the Florida phosphate mining and chemical processing industry. Concerns about potential risks from naturally-occurring sources of ionizing radiation and anecdotal reports of lung cancer among workers prompted this investigation. Historical follow-up was conducted for the years 1949 to 1978. In comparison with U.S. rates, small excess of mortality rates of lung cancer were observed for white (standardized mortality ratio [SMR] equals 1.22) and nonwhite workers (SMR = 1.24); however, these excesses disappeared when contrasts were made with prevailing rates in Florida. Emphysema mortality was also slightly elevated in comparison with U.S. rates; the SMRs were 1.48 and 1.73 for white and nonwhite workers, respectively. Neither disease was related to overall length of employment. Detailed analyses of mortality in relation to work assignments are presented in the companion article.

Adult↗

Effects of organochlorine residues on eggshell thickness, reproduction, and population status of brown pelicans (Pelecanus occidentalis) in South Carolina and Florida, 1969--76.

Shells of brown pelican (Pelecanus occidentalis) eggs collected in South Carolina from 1969 through 1975 and in Florida during 1969, 1970, and 1974 were significantly thinner (P greater than 0.05) than eggshells collected before 1947. Thickness of South Carolina eggshells increased in 1975, and mean thickness of eggshells collected in Florida during 1974 was greater than that of eggshells collected during 1969 and 1970, primarily in Gulf Coast colonies. Residues of 13 organochlorines were found in eggs and tissues of pelicans found dead during 1974 and 1975, although residues in brains of these specimens were not high enough to cause death. Residues of organochlorines, except PCBs, declined through 1975. PCBs increased in eggs from Atlantic Coast colonies. Reproductive success and population status of brown pelicans in South Carolina have improved markedly since authors began their studies in 1969. Good reproductive success was reported in 3 of 5 years from 1973 through 1977.

Animals↗

Characteristics of recipients in Florida's long-term program of insulin distribution.

Since 1935 the State health agency has provided insulin to medically indigent diabetics in Florida. During 1980, data were collected on 9,429 recipients regarding their age, race, sex, height, weight, and type and dosage of insulin. The mean age was 55 years; 47 percent were white and 52 percent were black. Seventy-two percent of the recipients were females and 28 percent were males. The utilization rate was much greater for blacks than for whites in all age-sex groups. Seventy-two percent of the estimated number of insulin-requiring black females used insulin supplied by the health agency, compared with 9 percent of insulin-requiring white females in the State. For black males, the proportion was 37 percent and for the white males, it was 5 percent. Obesity was defined as a Body Mass Index (BMI) of greater than 25 for females and greater than 27 for males. The mean BMIs were 30.9 for females and 27.7 for males. In all age groups, women were more obese than men, and blacks were more obese than whites except for the oldest age group, those 65 and older. The mean total daily dosage of insulin was 46 units, and 95 percent of recipients used NPH or Lente insulin. Insulin dosage per kilogram of body weight showed some decrease as weight increased. The authors concluded that the Florida program reaches a significant proportion of its target population.

Adult↗

Organochlorine residues in eggs of loggerhead and green sea turtles nesting at Merritt Island, Florida--July and August 1976.

Eggs from nine clutches of loggerhead turtles (Caretta caretta) and two clutches of green turtles (Chelonia mydas) were collected as they were laid on Merritt Island, Florida. Eggs were incubated, frozen, and analyzed for organochlorines. Levels of DDE and PCB, the major contaminants, averaged less than 0.08 ppm in loggerhead eggs and were even lower in green turtle eggs. These concentrations are far below levels thought to be potentially harmful. Loggerhead eggs were frozen after 43-52 days incubation; both DDE and PCB declined significantly during this interval. Authors estimate that DDE averaged about 0.2 ppm in loggerhead eggs when they were laid. DDE levels in eggs of both turtle species were less than levels in eggs of crocodiles (Crocodylus acutus) from Everglades National Park and in eggs of 13 species of aquatic birds nesting on Merritt Island. The remarkably low residues in the turtle eggs probably indicate that, when not nesting, the turtles live and feed in areas remote from Florida.

Animals↗

Determinants of nursing home costs in Florida: policy implications and support in national research findings.

Descriptive and econometric analysis of the major nonquality determinants of nursing home costs for Florida shows that mean costs, size, and occupancy rate increased between 1971 and 1976, that per diem costs and occupancy rate were inversely related, and that the per diem cost was lower in rural than in urban areas. Regression of the data shows that--next to inflation, as expressed by the Consumer Price Index--the occupancy rate accounts for most of the variation in per diem costs, followed by size, urban-rural location, and by type of control. The hypothetical "optimal," defined as lowest cost-size range, was calculated to be more than 350 beds. Recent research substantiates most of these findings. Medicaid Cost Reports from Florida's nursing homes were the source of the information analyzed; by 1976, the sixth year of the study, the data base covered nearly 9 of 10 licensed beds in the State. Some policy implications can be drawn from the analysis. Reductions in per diem costs could be achieved by higher occupancy rates, especially in the larger nursing homes, and a reduction in the rate of inflation would reduce the rate of increase in nursing home costs.

Costs and Cost Analysis↗

Cancer experience in Florida: a suggestion of lowered risk.

The state of Florida has the highest crude incidence rate of cancer in the United States. When age adjusted, however, this rate falls close to or below the national mean. The authors analyzed 14,369 new cancer cases for 1977 and noted a major difference in the proportion of digestive tract cancers. The possibility of a protective factor in Florida is suggested.

Adolescent↗

Medicaid costs of live births from unintended pregnancies in Florida.

The Florida Pregnancy Risk Assessment Monitoring System (PRAMS) survey, a population-based, random sample mail-telephone query of new mothers of live-born infants, includes questions about pregnancy timing and wantedness, sources of payment for care, other related topics, mother's risk behaviors, satisfaction with prenatal care, and the newborn's health. There were 2,059 completed responses in 1993. Results are weighted for factors affecting response rates to reflect all births. An estimated 13.8% (95% confidence interval 11.7, 15.9) of all Florida babies in 1993 were unwanted at conception, and 20.3% (16.5, 24.1) of those whose deliveries were paid for by Medicaid were unwanted. The Medicaid program currently pays for the prenatal, intrapartum, delivery and infant health care of an estimated 16,000 pregnancies and newborns each year that were unwanted at conception. The total annual cost is estimated at $401 million, or over 8% of all 1992-93 Medicaid costs.

Adolescent↗

Early management of acute myocardial ischemic events. Recommendations. Quality of Patient Care Committee, Florida Chapter, American College of Cardiology.

A Consensus Development Conference conducted by the Quality of Patient Care Committee, Florida Chapter, American College of Cardiology, for the Early Management of Acute Myocardial Ischemic Events in Florida was held August 26-28, 1994, at St. Joseph's Heart Institute, Tampa. Twenty recommendations were proposed to improve the management of patients with these conditions and to reduce mortality and long-term morbidity from coronary heart disease.

Florida↗

Mercury exposure in a residential community--Florida, 1994.

Residential exposure to elemental mercury typically involves small amounts (e.g., the approximately 0.3 mL in a thermometer). During August 1994, five children residing in a neighborhood in Palm Beach County, Florida, found 5 pints of elemental mercury in an abandoned van. During the ensuing 25 days, the children shared and played with the mercury outdoors, inside homes, and at local schools. On August 25, 1994, a parent notified local police and fire authorities that her children had brought mercury into the home. On the same day, 50 homes were immediately vacated and an assessment of environmental and health impacts was initiated by the State of Florida Department of Environmental Protection, the Health and Rehabilitative Services of the Palm Beach County Public Health Unit, and the U.S. Environmental Protection Agency. This report summarizes the investigation of this incident.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Physician issues and Florida health care reform.

Data are presented from a mail survey of Florida physicians one year after passage of the Florida Health Care Insurance and Reform Act. Respondents rated the importance of various issues and reported their perceptions of physician input, knowledge and support for health-care reform legislation. Issues considered important included tort reform, physician autonomy, consumer choice of providers, and freedom from insurance hassles along with reduced paperwork. Ratings were low for input and health-care reform support. Issues of importance to physicians were not addressed by previous legislation; therefore, they must take the lead in focusing new legislation in conjunction with their professional organizations.

Adult↗

Neurosurgical malpractice insurance survey. Florida 1993.

A survey of Florida neurosurgeons was conducted in April 1993 with a 68% response rate. One hundred twenty-three (81%) had malpractice insurance. Of the 29 (19%) without insurance, all but one practiced in South Florida. Cost was the major factor in dropping coverage. The cutoff appeared to be in excess of $100,000 per year for coverage for $250,000 per incident. Over 50% have considered early retirement. Those without coverage are limiting patient access. The number unable to afford minimal coverage is likely to increase; consequently patient access will continue to decline unless reforms allow coverage at a reasonable cost.

Costs and Cost Analysis↗