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PubMedDate not supplied

A case management protocol: reducing unnecessary Medicare admissions in Florida.

The Florida Medicare quality improvement organization implemented a case management project with 20 acute care hospitals to reduce unnecessary Medicare admissions. The project called for hospitals to implement a protocol to assign patients to observation or inpatient admission status. Results of the project showed a 67% reduction in the denial rate for the participating facilities. This relative reduction in denial rates was nearly 3 times greater for the participating facilities as compared to the control facilities. The protocol can easily be adopted by hospitals.

Case Management↗
PubMed2006

Influence of particle size distribution on inhalation doses to workers in the Florida phosphate industry.

Previous studies have indicated that inhalation exposures to TENORM aerosols are potentially a major contributor to the annual total effective dose to workers in the Florida phosphate industry. Further research was deemed necessary to characterize the particle size distribution of these aerosols containing various radionuclides of the U decay series. In the present study, individualized assessments of worker committed effective doses are reported in which detailed information is used on the particle size distribution, particle density, particle shape, and radioactivity concentrations from sampled aerosols at 6 different phosphate facilities and at various worker areas within these facilities. Inhalation dose assessments are calculated using the ICRP 66 human respiratory tract model as implemented within the LUDEP and IMBA computer codes. Under the least conservative assumptions of radionuclide-specific lung solubility, the annual total effective doses are shown to be 0.31+/-0.12, 0.27+/-0.07, and 0.22+/-0.02 mSv at granulator, storage, and shipping areas, respectively, and thus all annual doses are below the annual limits to the members of the general public (1 mSv y). In contrast, the most conservative assumptions of lung solubility by radionuclide yield annual total effective doses of 2.24+/-2.53 mSv at granulator areas, 1.26+/-1.19 mSv at storage areas, and 0.56+/-0.36 mSv at shipping areas. In this later case, some 44%, 31%, and 15% of individual dose assessments yield worker doses above the annual dose limit. The study thus demonstrates the importance of facility- and area-specific particle solubility data in dose assessments for regulatory compliance and for making decisions regarding worker respiratory protection.

Aerosols↗
PubMed2006

Risk and protective factors for psychopathology among older versus younger adults after the 2004 Florida hurricanes.

OBJECTIVE: Previous research demonstrates increased resiliency to psychopathology after disasters among older adults. However, little is known about differences in age-based risk and protective factors for postdisaster mental illness. METHOD: The authors used random-digit dialing methodology to survey 1,130 older adults (60+ years) and 413 younger adults residing in Florida counties directly affected by the 2004 hurricanes. Assessed risk and protective factors included demographics, social support, displacement, incurred dollar losses, perceived positive outcomes, and self-rated health status. Outcome variables included symptom counts of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-defined posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and generalized anxiety disorder (GAD). RESULTS: Older adults reported fewer symptoms of PTSD, MDD, and GAD. Explanatory risk variables accounted for large proportions of variance, but differed in meaningful ways across age groups. CONCLUSION: Although older adults are less symptomatic, their psychologic reactions appear more closely connected to economic consequences of disasters.

Adult↗
PubMed2006

Cancer incidence in Florida professional firefighters, 1981 to 1999.

OBJECTIVE: The objective of this study was to examine the cancer risk associated with firefighting. METHODS: Standardized incidence ratio analysis (SIR) was used to determine the relative cancer risk for firefighters as compared with the Florida general population. RESULTS: Among 34,796 male (413,022 person-years) and 2,017 female (18,843 person-years) firefighters, 970 male and 52 female cases of cancer were identified. Male firefighters had significantly increased incidence rates of bladder (SIR = 1.29; 95% confidence interval = 1.01-1.62), testicular (1.60; 1.20-2.09), and thyroid cancers (1.77; 1.08-2.73). Female firefighters had significantly increased incidence rates of overall cancer (1.63; 1.22-2.14), cervical (5.24; 2.93-8.65), and thyroid cancer (3.97; 1.45-8.65) and Hodgkin disease (6.25; 1.26-18.26). CONCLUSIONS: Firefighting may be associated with an increased risk of selected site-specific cancers in males and females, including an overall increased cancer risk in female firefighters.

Adolescent↗
PubMed2005

Florida's multifaceted response for increases in syphilis among MSM: the Miami-Ft. Lauderdale initiative.

After many years of declining rates, it became apparent in 1999 that syphilis cases were on the rise in Florida. Data analysis identified that the outbreak was predominately contained in Miami and Ft. Lauderdale and among men who have sex with men. An in-depth investigation was undertaken to identify the risk factors, the best way to attack the outbreak, and how to build sustainability into implemented strategies. After thorough review of the data and extensive dialogue with local public health and community participants, the Bureau of STD Prevention & Control developed initiatives that focused public awareness through print, radio, and television media resources; expanded access to men's health services; and enhanced education/training for public and private health care providers, STD program field staff, and community representatives. This initiative has resulted in unprecedented community involvement in syphilis control efforts.

Adult↗
PubMed2007

Patterns in prenatal syphilis screening among Florida Medicaid enrollees.

OBJECTIVE: The objective of this study was to assess the rate of prenatal syphilis screening and compliance with clinical guidelines on the receipt of early and repeat screening in a Medicaid population before and after implementation of the National Plan to Eliminate Syphilis. STUDY DESIGN: Rates of office- and clinic-based prenatal syphilis screening among pregnant women with Medicaid-covered deliveries in Florida in fiscal years (FYs) 1995 and 2000 are analyzed using Medicaid claims data. RESULTS: The proportions of women receiving any, early, and repeat prenatal syphilis screening increased sharply between FY 1995 and FY 2000 but remain well below recommended levels. Screening is highly correlated with timing of prenatal care and Medicaid enrollment duration. CONCLUSIONS: Further efforts to improve screening rates will need to both increase the proportion of women who receive timely prenatal care and ensure that providers comply with guidelines to provide syphilis screening as a component of prenatal care for all women.

Adolescent↗
PubMed2005

A division of labour with role specialization in group-hunting bottlenose dolphins (Tursiops truncatus) off Cedar Key, Florida.

Individual role specialization during group hunting is extremely rare in mammals. Observations on two groups of bottlenose dolphins (Tursiops truncatus) in Cedar Key, Florida revealed distinctive behavioural roles during group feeding. In each group, one individual was consistently the 'driver', herding the fishes in a circle toward the remaining 'barrier' dolphins. Aerial fish-capture rates differed between groups, as well as between the driver and barrier dolphins, in one group but not in the other. These differences between the two groups may reflect differences in group stability or in prey school size.

Animals↗
PubMed1998

Classification of new phytoplasmas associated with diseases of strawberry in Florida, based on analysis of 16S rRNA and ribosomal protein gene operon sequences.

Strawberry plants exhibiting symptoms of stunting and abnormally small leaves were observed in production fields in central Florida, USA. Since the symptoms were suggestive of phytoplasma infection, plants were assayed for presence of phytoplasma by PCR amplification of 16S rDNA and ribosomal protein (rp) gene sequences. Amplification of phytoplasma-specific DNA sequences by PCR indicated infection of the diseased strawberry plants by phytoplasmas. RFLP analyses of amplified 16S rDNA revealed that the plants were infected by two mutually distinct phytoplasmas that differed from strawberry green petal phytoplasma (group 16Srl-C). Both phytoplasmas were members of 16S rRNA gene group I (16Srl). Based on RFLP analysis of amplified 16S rDNA and rp gene sequences, one was classified in group 16Srl subgroup I and new rp subgroup 16Srl-l(rp); its 16S rRNA-rp subgroup was designated 16Srl-K(rr-rp). The second phytoplasma represented a previously undescribed subgroup, designated K, in 16S rRNA group I but belonged to rp subgroup 16Srl-J(rp); this phytoplasma's 16S rRNA-rp subgroup was designated 16Srl-J(rr-rp). Results of RFLP analyses agreed with putative restriction site maps based on nucleotide sequences determined for the amplified 16S rDNAs and rp gene operon DNAs. Further evidence indicated that the 16Srl-K(rr-rp) strawberry phytoplasma, Mexican periwinkle virescence phytoplasma and stolbur phytoplasma shared sequence homologies that enabled amplification of DNA from all three by PCR using primers previously designed as stolbur-specific.

DNA Primers↗
PubMed1992

The nucleotide sequence of tomato mottle virus, a new geminivirus isolated from tomatoes in Florida.

A new geminivirus, tomato mottle virus (TMoV), affecting tomato production in Florida has been cloned and sequenced. Sequence analysis of the cloned replicative forms of TMoV revealed four potential coding regions for the A component [2601 nucleotides (nt)] and two for the B component (2541 nt). Comparisons of the nucleotide sequence of the TMoV genome with those of other whitefly-transmitted geminiviruses indicate that TMoV is a typical bipartite geminivirus of the New World and is closely related to but distinct from abutilon mosaic virus.

Base Sequence↗
PubMed2006

Examining the CDCynergy Event Assessment Tool: an investigation of the anthrax crisis in Boca Raton, Florida.

This paper examines the dependability of the Event Assessment Tool over time. The latter is part of a CD-ROM--Emergency Risk Communication CDCynergy--distributed primarily to public information officers in the United States by the Centers for Disease Control and Prevention. The Event Assessment Tool is designed to aid emergency professionals in identifying the magnitude of a crisis event and to suggest appropriate actions to confront such a situation. Applied twice during the 2001 anthrax bioterrorism crisis in Boca Raton, Florida, the tool functioned in a binary manner by first indicating a moderate crisis level (on 4 October) and then four days later (on 8 October) a highly intense crisis, suggesting that it is time sensitive. This anthrax event provides an opportunity for crisis and disaster managers to understand the dynamic nature of crises. Rapid changes during these types of events suggest that any metric used to predict intensity must account for this variability. Additional limitations and implications of the tool are discussed.

Anthrax↗
PubMedDate not supplied

Maternal bacterial vaginosis and fetal/infant mortality in eight Florida counties, 1999 to 2000.

This study determined the prevalence of maternal bacterial vaginosis (BV) in fetal/infant mortality cases and factors associated with BV. A retrospective descriptive study was utilized. Data were obtained from review of vital statistics and medical records of 176 women experiencing fetal/infant deaths in eight Florida counties, 1999 to 2000. Non-White mothers accounted for 68.96% of deaths (chi square = 10.119, df = 4, p = 0.038), although the population of the eight counties was 64% White. Of 121 non-White mothers (68.8%) with infections, 37 (30.6%) had BV. Most fetal/infant deaths (39.7%) occurred 20-23 weeks' gestation and at birthweights <500 g, as did most cases of BV (46%). Women with BV were more likely to be non-White (OR 2.756, 95% CI 1.075, 7.066), single (OR 2.090, 95% CI 1.081, 7.246), <24 years old (t = 3.172, p = 0.002), and have <12 years of education (t = 2.56, p = 0.011). Findings support early screening and treatment for BV in women with these risk factors or a history of prior fetal/infant loss or preterm/low-birthweight infant. Factors contributing to racial disparity in BV and fetal/infant mortality need further exploration.

Adolescent↗
PubMed2006

Multiscale patterns of movement in fragmented landscapes and consequences on demography of the snail kite in Florida.

1. Habitat loss and fragmentation are major factors affecting vertebrate populations. A major effect of these habitat alterations is that they reduce movement of organisms. Despite the accepted importance of movement in driving the dynamics of many natural populations, movement of vertebrates in fragmented landscapes have seldom been estimated with robust statistical methods. 2. We estimated movement probabilities of snail kites Rosthramus sociabilis within the remaining wetlands in Florida. Using both radio-telemetry and banding information, we used a multistate modelling approach to estimate transition probabilities at two temporal scales (month; year) and multiple spatial scales. We examined kite movement among wetlands altered by three different levels of fragmentation: among wetlands separated by small physical barriers (e.g. road); among wetlands separated by moderate amount of matrix (< 5 km); and among wetlands separated by extensive matrix areas (> 15 km). 3. Kites moved extensively among contiguous wetlands (movement probability 0.29 per month), but significantly less among isolated wetlands (movement probability 0.10 per month). 4. Kites showed high levels of annual site fidelity to most isolated wetlands (probability ranged from 0.72 to 0.95 per year). 5. We tested the effects of patch size and interpatch distance on movement. Our modelling indicated an effect of both distance and patch size on juveniles' movement (but not adult) when examining movements among fragments. 6. Only a small proportion of kites escaped a regional drought by moving to refugia (wetlands less affected by drought). Many individuals died after the drought. During drought adult survival dropped by 16% while juvenile survival dropped by 86% (possibly because juveniles were less likely to reach refugia). 7. We hypothesize that fragmentation may decrease kite's resistance to drought by restricting exploratory behaviour.

Animals↗
PubMed2006

Geographical variation in antibiotic resistance profiles of Escherichia coli isolated from swine, poultry, beef and dairy cattle farm water retention ponds in Florida.

AIMS: The aim of this study was to assess geographical variation in multiple antibiotic resistance (MAR) profiles of livestock Escherichia coli as well as to evaluate the ability of MAR profiles to differentiate sources of faecal pollution. METHODS AND RESULTS: More than 2000 E. coli isolates were collected from water retention ponds and manure of swine, poultry, beef and dairy farms in south, central and north Florida, and analysed for MAR using nine antibiotics. There were significant differences in antibiotic resistance of E. coli by season and livestock type for more than one antibiotic, but regional differences were significant only for ampicillin. Over the three regions, discriminant analysis using MAR profiles correctly classified 27% of swine, 49% of poultry, 56% of beef and 51% of dairy isolates. CONCLUSIONS: Regional variations in MAR combined with moderate discrimination success suggest that MAR profiles of E. coli may only be marginally successful in identifying sources of faecal pollution. SIGNIFICANCE AND IMPACT OF THE STUDY: This study demonstrates the existence of regional and seasonal differences in MAR profiles as well as the limited ability of MAR profiles to discriminate among livestock sources.

Agriculture↗
PubMed2006

Carbohydrate storage in five resprouting Florida scrub plants across a fire chronosequence.

Most research analyzing nonstructural carbohydrate (NSC) concentrations on resprouter species in fire-controlled ecosystems has concentrated on how NSC concentrations recover immediately after fire. However, we know little of the effect of long periods without fire on NSC concentrations. In order to assess the effect of different periods of time-since-fire on resprouter species, we studied carbohydrate concentrations (total [NSC], soluble sugars [SS] and nonsoluble sugars [NSS]) in five resprouting species with contrasting trends of abundance across a chronosequence of time-since-fire (0.5-40 yr) in Florida. Carbohydrate concentrations were highest in species with specialized reserve organs. [SS] was mainly explained by factors related to plant size, whereas time-since-fire was the main factor explaining [NSS]. Changes in [NSS] and [NSC] were correlated with the time-since-fire abundance patterns. Variation in [NSS] carbohydrates can be related to the structural development of vegetation, with only those species capable of accessing full light able to accumulate carbohydrates, whereas subordinate plants show reductions in the [NSS] carbohydrate fractions. In areas with long intervals between fires, this carbohydrate reduction could affect subsequent postfire resprouting vigour, although this remains to be confirmed.

Asteraceae↗
PubMed2006

Effectiveness of a regional corridor in connecting two Florida black bear populations.

Corridors may mitigate the adverse effects of habitat fragmentation by restoring or maintaining connectivity between disjunct populations. The efficacy of corridors for large carnivores, however has rarely been evaluated objectively. We used noninvasive sampling, microsatellite analysis, and population assignment tests to evaluate the effectiveness of a regional corridor in connecting two Florida black bear (Ursus americanus floridanus) populations (Osceola and Ocala). Bear movement was predominantly unidirectional, with a limited mixing of individuals from the two populations in one area of the corridor We also documented bears in Osceola that were genetically assigned to Ocala and bears in Osceola that may be offspring from an Osceola-Ocala mating. Our results indicate that the Osceola-Ocala corridor is functional and provides a conduit for gene flow between these populations. Human development, however may hinder the use of the Osceola-Ocala corridor by bears. The noninvasive sampling and genetic methods we used provide a means of evaluating corridor effectiveness that can help identify linkages necessary for maintaining metapopulation structure and population viability.

Animals↗
PubMed1986

Sun protection in well-child care: results of a survey of Florida pediatricians.

Chronic sun exposure has been linked to induction of skin cancers including melanoma and aging changes of the skin, has an adverse effect on certain diseases such as lupus erythematosus and is responsible for drug-induced phototoxic reactions. A majority of an individual's lifetime sun exposure may occur during childhood, and thus early photoprotection is desirable. We conducted a written survey of Florida pediatricians regarding their inclusion of sun protection information as part of routine well-child care. The results indicated that a majority of the pediatricians have awareness of the need for parent and patient education about sun-related issues, and most (65%) requested further information and educational materials. This study suggests that expanded educational efforts concerning sun-related health hazards and sun protection would be desirable for physicians involved in pediatric care, for parents, and for children.

Child↗
PubMedDate not supplied

Raising sun protection and early detection awareness among Florida high schoolers.

Changing adolescents' sun protection behaviors remains a challenge, and the need for effective interventions targeting this group is a priority, particularly in warmer climates where emphasis on appropriate sun protection remains a year-round concern. However, there has been little prospective research on the effect of school-based sun protection interventions, particularly on adolescents, especially teens aged 15 to 18. High school science students in Palm Beach County, Florida, received a seven-lesson sun protection and early detection curriculum preceded by pretests and followed with post-tests 6 months later. The main outcome measures were student knowledge and sun protection practices, including adherence to sunscreen recommendations. Of 344 students completing the baseline surveys, 184 students completed the postintervention questionnaire. Overall, there were significant improvements from baseline to follow-up for many of the knowledge questions. Greatest change scores were seen in the children's ability to correctly define the five rules of early detection of skin cancer (27-60%, p<0.001) with improved change scores by gender and race persisting after 6 months. No significant differences were found in reported use of sunscreen, hat wearing, or sunglasses, although there was a slight decrease in the reported use of always wearing sun protective clothing (p=0.03). In conclusion, in this study, a skin cancer prevention and detection curriculum integrated into high school biology, resulted in knowledge gains maintained at least 6 months after classroom teaching. For example, procedural knowledge (e.g., knowing ways to identify early malignant moles) obtained in this study improved in 6 months, and may lay the foundation for future behavioral change. Sun protection activities in the United States have met with many challenges and obstacles and thus, further work is needed to better understand what combination of knowledge-based information, activity-based education, school-wide changes, and community efforts, will create a long-term systemic improvement in sun protection habits in children.

Adolescent↗
PubMedDate not supplied

Exuviotrophic apostome ciliates from crustaceans of St. Andrew Bay, Florida, and a description of Gymnodinioides kozloffi n. sp.

Gymnodinioides kozloffi n. sp. is described from the eelgrass broken-back shrimp Hippolyte zostericola. The species is distinct from others in the apostome genus Gymnodinioides in that the trophont ciliature has a small group of kinetosomes located to the right of Kinety 9a, and Kinety 1 and 2 are divided. Other apostome morphologies are described from many decapod crustaceans from St. Andrew Bay, Florida, including Gymnodinioides inkystans, Hyalophysa chattoni, and variants of both H. chattoni and G. kozloffi. All of these apostome ciliates are exuviotrophic, found feeding on exuvial fluid within the exoskeleton of the host after ecdysis. The hosts surveyed for this study are the following: Callinectes sapidus, Eurypanopeus depressus, Hippolyte zostericola, Farfantepenaeus spp., Palaemonetes intermedius, Palaemon floridanus, Portunus spp., Tozeuma carolinense, and Sicyonia laevigata, which revealed a number of new host-apostome records.

Animals↗