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PubMed1992

Mental illness and help-seeking behavior among Mariel Cuban and Haitian refugees in south Florida.

Differences in psychopathology and use of the mental health system by recent refugee groups are explored in light of competing hypotheses stemming from theories of immigrant adaptation and minority mental health. Results show that would-be Haitian refugees arriving in South Florida during the early 1980s had relatively small needs for mental health care, but whatever needs they had were largely unattended by the health services system. Mariel Cubans had far greater needs that were mostly met satisfactorily by virtue of their familiarity with service facilities prior to departure and their incorporation into a favorable social environment. These contextual factors are added and compared with the individual-level predictor variables suggested by Andersen and others. The results' implications for theories of immigrant mental health and help-seeking and for the implementation of effective delivery programs are discussed.

Adolescent↗
PubMed2003

Quinacrine sterilization (QS) in a private practice in Daytona Beach, Florida: a preliminary report.

OBJECTIVES: To affirm that QS can be performed safely and effectively in a U.S. private office practice. METHODS: The U.S. FDA Modernization Act of 1997 Pharmacy Compounding Provisions made it possible for American physicians to begin offering QS to their patients. These provisions became effective November 21, 1998. This series was initiated in October 2000. The standard protocol recommended by the International Federation for Family Health (IFFH) is followed. Information on patients is recorded on forms suggested by IFFH to accomplish good post-marketing surveillance. The potential role of uterine septae in QS failures is of particular interest to this investigator. RESULTS: Seven cases have been completed. There have been no failures. Side effects have been minor. Women have been exceptionally happy with this method. The Florida Agency for Health Care Administration has examined QS and found it to be an acceptable off-label use of quinacrine. CONCLUSION: Preliminary results have been similar to those reported by QS researchers around the world.

Adult↗
PubMedDate not supplied

A survey of local anesthetic usage in pediatric patients by Florida dentists.

Local anesthetic toxicity in the child dental patient is a concern of the dental profession. A survey of 117 Florida dentists was conducted to determine their local anesthetic practices in treating children. Results indicated that a fifth of the respondents might use local anesthetic levels that could cause potential CNS toxicity in the smaller and younger children they treat. It is the responsibility of the dental profession to recognize the differences in treating this group of patients, and the serious consequences that might occur when maximum recommended levels of local anesthetic are exceeded.

Age Factors↗
PubMed2004

Homicide victim/offender relationship in Florida Medical Examiner District 8.

This study examined the correlations between victim/offender relationship and three variables: motive, weapon choice, and number of injuries inflicted. Empirical relationship and motive categories were used. The sample consisted of 57 intentional homicide cases from Florida Medical Examiner District 8 between the years 1992 and 1996. Relationships were divided into primary and secondary categories. Primary relationships included intimates, relatives, and friends; secondary relationships included acquaintances and strangers. Motives were classified as romantic dispute, argument/conflict, revenge, or felony type; weapons as firearm or contact; and number of injuries inflicted as single or multiple. A significant correlation was found between victim/offender relationship and homicide motive; however, the revenge and felony type motive categories did not differ. Unexpectedly, no correlation was found between victim/offender relationship and either weapon choice or number of injuries inflicted. Further study is needed of the interactions between homicide victim/offender relationship and motive, weapon selection, and number of injuries inflicted.

Adolescent↗
PubMed2004

The medical provision of hydration and nutrition: two very different outcomes in Victoria and Florida.

Decisions to withhold or withdraw medical hydration and nutrition are amongst the most difficult that confront patients and their families, medical and other health professionals all over the world. This article discusses two cases relating to lawful withdrawal and withholding of a percutaneous endoscopic gastrostomy tube (PEG) from incompetent patients with no hope of recovery. Victoria and Florida have statutory frameworks that provide for advance directives, however in both Gardner; Re BWV and Schindler v Schiavo; Re Schiavo the respective patients did not leave documented instructions. The article analyses the two cases and their outcomes from legal, medical and ethical perspectives.

Adult↗
PubMed1992

Positional asphyxiation in adults. A series of 30 cases from the Dade and Broward County Florida Medical Examiner Offices from 1982 to 1990.

Over a 9-year period, 30 cases of positional (or postural) asphyxia were identified in the Dade and Broward County (Florida) Medical Examiner Offices. The victims had an average age of 50.6 years with no significant sex or racial differences as compared with the general medical examiner population. Chronic alcoholism or acute alcohol intoxication was a significant risk factor in 75% of cases and these had an average postmortem ethanol concentration of 0.24 g%. Signs of mechanical asphyxiation (petechiae and/or combined lung weights greater than 900 g) were present in 93% of cases. Victims were commonly (43%) found in a restrictive position producing hyperflexion of the head and neck. Two deaths involved restraint vests ("poseys") in elderly, demented, wheel-chair-confined victims. Scene photographs of the undisturbed decedent are extremely helpful in confirming a suspicion of postional asphyxia.

Adolescent↗
PubMed1992

Rapid health needs assessment following hurricane Andrew--Florida and Louisiana, 1992.

Following the impact phase of Hurricane Andrew in Florida (August 24) and Louisiana (August 26) (Figure 1), the primary objectives of the public health response have been to address the health and medical needs of residents in the storm-damaged areas and to provide data for relief interventions and decision-making. This report presents the combined findings from rapid health needs assessment surveys conducted by state health departments with CDC assistance 3-10 days postimpact.

Disasters↗
PubMed2004

The spatial-temporal distribution of drought, wetting, and human cases of St. Louis encephalitis in southcentral Florida.

Using a dynamic hydrology model, we simulated land surface wetness conditions at 42 sites in 28 counties in southcentral Florida from 1990 to 1998 and compared these simulations with the incidence of human cases of St. Louis encephalitis (SLE) within these counties. Within counties, drought four months prior and wetting one-half month prior were significantly associated with human cases of SLE. Simulated land surface wetness conditions resolved transmission loci in both space and time, and May drought was significantly associated with the subsequent occurrence of human SLE cases. These findings are consistent with previous results associating simulated land surface wetness conditions with the transmission of SLE virus as measured in sentinel chickens, and support our working hypothesis that springtime drought facilitates SLE virus amplification in mosquito and wild bird populations.

Demography↗
PubMed2004

Use of HOS data in Florida.

The Medicare Health Outcomes Survey (HOS) is a longitudinal cohort study that assesses physical and mental functioning of Medicare enrollees in MCPs. Realizing the potential of HOS data to improve health care, the Florida Medicare Quality Improvement Organization (QIO) analyzed HOS scores and shared them with M+COs to assist in evaluating the efficacy of their disease management programs. The QIO also discusses additional uses for HOS data such as cross-linking with a patient satisfaction survey and sharing with health care organizations that collaborate with the QIO.

Aged↗
PubMed2004

Face-to-face approach proves successful for HIV/AIDS program in Florida.

In the past several years, Florida legislators have pinned their hopes on a cadre of DM vendors to bring health care costs under control in that state's Medicaid program. While most of these highly publicized efforts have failed to meet the lawmakers' expectations, the state's HIV/AIDS program has reportedly saved the state as much as dollar 52 million dollars over five years. That program, developed by the Los Angeles, CA-based AIDS Healthcare Foundation, relies on an in-person approach that developers contend is critical to bringing people into care.

Cost Savings↗
PubMed1992

Unpaid hospital bills: evidence from Florida.

Most of what we know about the population generating uncompensated care is inferred from data on the uninsured population. The use of insurance status as an indicator for potential charity patients is justifiable considering the lack of alternative information. This study directly examines uncompensated hospital care using a unique data set generated from a special survey conducted in Florida. A selection model estimated using these data explains who is likely to default on their bill and what amount will be left unpaid. The results provide a clearer picture of the uncompensated hospital care problem.

Adolescent↗
PubMed2005

Florida hospital saves 5.3 M dollars by adopting principles of lean manufacturing.

Florida hospital saves 5.3M dollars by adopting principles of lean manufacturing. Surgery cancellations have been slashed from 13% of cases to less than 3%, while emergency department admissions have increased by 20%. Those are just two of the results of a quality improvement project at Lee Memorial Health System in Fort Myers, FL, that focused on using the principles of lean manufacturing to improve patient flow in the five-hospital system

Cost Savings↗
PubMed1992

Invasion of cemeteries in Florida by Aedes albopictus.

Aedes albopictus has been found in 53 of the 67 Florida counties. The initial discoveries in 11 of these counties were made in cemeteries. At several locations, Ae. albopictus became well-established in cemeteries before appearing in nearby accumulations of waste tires. The recycling of plastic floral baskets may be aiding the spread of Ae. albopictus. Mosquitoes were commonly found in all types of flower-holding containers in cemeteries, except bronze vases. In the laboratory, most Aedes aegypti eggs laid in bronze vases hatched, but larvae subsequently died. The spread of Ae. albopictus in cemeteries seems to occur at the expense of Ae. aegypti populations. At one cemetery immature Ae. albopictus and Ae. aegypti were found in about 70% of the Aedes-positive containers at the start of a monitoring program. In subsequent collections from this site, Ae. albopictus was found in nearly all Aedes-positive containers, whereas there was a progressive decrease in containers with Ae. aegypti. This trend did not appear to be the result of any seasonal pattern because in a nearby cemetery where Ae. albopictus was absent, Ae. aegypti did not show a similar decline. Limiting flower-holding containers to those with drain holes or to bronze vases would greatly limit mosquito production.

Aedes↗
PubMedDate not supplied

Prevalence of noncavitated and cavitated carious lesions in 5-year-old head start schoolchildren in Alachua County, Florida.

PURPOSE: The diagnosis of early carious lesions is essential for nonsurgical management of dental caries. This report describes the prevalence of early noncavitated and cavitated carious lesions in the primary dentition of 5-year-old Head Start schoolchildren in Alachua, Fla. METHODS: As part of the Fluoride Varnish Study conducted at the University of Florida, modified caries diagnostic criteria-which differentiated caries lesion activity and severity-were developed for the primary teeth. Dental examinations were conducted on 221 children ages 5 years by 2 calibrated examiners. RESULTS: Overall, 86% of the children had experienced noncavitated or cavitated caries lesions in the primary dentition. Prevalence of cavitated dentinal lesions was 48%, and prevalence of active noncavitated enamel lesions was 71%. The mean number of active noncavitated enamel lesions (mean +/- SEM: 2.91 +/- 0.21) was slightly higher than the mean number of cavitated dentinal lesions (2.52 +/- 0.31). The mean number of restored surfaces was 1.24 (+/- 0.42), and only 8% of the children had 1 or more restored surfaces. Noncavitated lesions were most common on occlusal surfaces, especially in mandibular second molars. African-American children had a higher prevalence of noncavitated lesions (81%) than whites (69%) or others (33%; P<.0001). Prevalence of cavitated lesions was 49% for African Americans, 46% for whites, and 48% for others. CONCLUSIONS: This study shows that noncavitated enamel and cavitated dentinal lesions are common in this study population's primary dentition. There is a need for preventive measures and treatment of decay in these children living in low-income families.

Black or African American↗
PubMed2005

Abrupt biological response to hydrologic and land-use changes in Lake Apopka, Florida, USA.

Lake Apopka is a shallow, hypereutrophic lake in north-central Florida that experienced an abrupt shift in primary producer community structure (PPCS) in 1947. The PPCS shift was so abrupt anecdotal accounts report that dominant, submersed aquatic vegetation was uprooted by a hurricane in 1947 and replaced by phytoplankton within weeks. Here we propose two hypotheses to explain the sudden shift to phytoplankton. First, hydrologic modification of the drainage basin in the late 1800s lowered the lake level ca. 1.0 m, allowing the ecosystem to accommodate moderate, anthropogenic nutrient enrichment through enhanced production in the macrophyte community. Second, additional hydrologic changes and large-scale agricultural development of floodplain wetlands began in 1942 and altered the pattern and scale of phosphorus loading to the lake that triggered the rapid shift to phytoplankton dominance in 1947. Historic land-use changes and paleolimnological data on biological responses to nutrient loading support these hypotheses.

Agriculture↗
PubMed2005

Microbiological assessment of ambient waters and proposed water sources for restoration of a Florida wetland.

This study evaluated the microbial quality of reclaimed and storm water as proposed sources for restoration of a Florida wetland. Bacterial indicators, bacteriophages and waterborne pathogenic microorganisms (Cryptosporidium, Giardia and infectious enteric viruses) were analysed during a 1-year period in order to determine potential public health risks associated with exposure to the proposed water sources for restoration. Ambient waters within the wetland (four active water wells and four major lakes) were included in the study in order to determine the microbial water quality before restoration. Storm water and lakes had the highest level of microbial contamination. Much lower levels of microbial indicators and waterborne pathogens were found in reclaimed water and groundwater. Pathogen occurrence in groundwater was intermittent. Owing to the small percentage of source waters (3.3%) migrating to the water wells, ambient concentration of microbial constituents in surface and groundwater could dominate microbial risk. The results of this study indicate that, in the light of the uncertainties involved in computing average Cryptosporidium concentrations, additional characterization of the current ambient water quality should be ongoing prior to restoration.

Animals↗
PubMed2005

Human rabies--Florida, 2004.

Rabies is a viral infection of the central nervous system, usually contracted from the bite of an infected animal, and nearly always fatal without postexposure prophylaxis. In February 2004, a man aged 41 years died after a 4-day hospitalization in Broward County, Florida. A diagnosis of rabies was considered on the day before the patient's death; however, no antemortem samples were obtained for testing. In March 2004, postmortem samples of fixed brain material were sent to CDC, where laboratory testing confirmed a diagnosis of rabies, the 47th case of human rabies reported in the United States since 1990 (CDC, unpublished data, 2005). This report summarizes results of the subsequent investigation led by the Broward County Health Department and laboratory testing at CDC, which determined that the rabies virus was a canine variant present in Haiti, where the man had traveled and reportedly been bitten by a dog. Rabies should be considered in persons after a dog bite, especially if the bite occurs in a country where canine rabies is enzootic.

Adult↗