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PubMed1991

Needlestick injuries and hepatitis B immunization in Florida paramedics: a statewide survey.

STUDY OBJECTIVES: To determine the incidence of needlestick injury among paramedics working in Florida during 1987, to describe the circumstances surrounding such injuries, and to assess the hepatitis B vaccination status of this group. DESIGN: Survey of a systematic random sample of paramedics using a self-administered questionnaire. SETTING: Florida. TYPE OF PARTICIPANTS: Paramedics. MAIN RESULTS: A completed questionnaire was returned by 300 of 500 paramedics (60%) who received the mailed questionnaire. Sixty-nine paramedics (23%) reported a total of 110 needlestick injuries. More than one third of injuries occurred in conjunction with recapping needles. Almost 62% of reported injuries could have been prevented had proper needle disposal technique been used. Sixty-two percent of paramedics reported having had at least one dose of the hepatitis B vaccine. Sixty-five percent of the unvaccinated paramedics said they would take the hepatitis B vaccine if it was offered free. CONCLUSION: The majority of needlestick injuries among paramedics in Florida could be prevented with proper needle disposal. Offering the hepatitis B vaccine at no charge to paramedics in Florida could increase the vaccination rate substantially.

Adult↗

PubMed2003

Hookworms of feral cats in Florida.

Thirty feral cats (Felis catus) from Alachua county (northern Florida) and 30 from Palm Beach county (southern Florida) were examined for hookworms. Two species, Ancylostoma tubaeforme and Ancylostoma braziliense, were identified. Forty-five cats (75%) were infected with A. tubaeforme, with a mean intensity of 48 hookworms per cat. Twenty cats (33%) were infected with A. braziliense, with a mean intensity of 28 worms per cat. The prevalence of A. tubaeforme was greater than that of A. braziliense in Alachua (P=0.002) and Palm Beach (P=0.004) counties. The intensity of A. tubaeforme infections was higher in Palm Beach county than Alachua county (P=0.013). The intensities of A. tubaeforme and A. braziliense were positively correlated (increased together) in Palm Beach county (P=0.011). These hookworms have also been identified in bobcats (Felis rufus), gray foxes (Urocyon cinereoargenteus), and red foxes (Vulpes vulpes) in Florida. The prevalence of A. tubaeforme was significantly greater in feral cats than those reported in bobcats (P<0.001). The prevalence of A. braziliense was significantly greater in feral cats than in those reported in gray foxes (P=0.008). The hookworm that infects Florida panthers and bobcats, A. pluridentatum, was not found.

Ancylostoma↗

PubMed2006

Florida's weakened motorcycle helmet law: effects on death rates in motorcycle crashes.

OBJECTIVES: Effective July 1, 2000, Florida's universal helmet law was amended to exclude riders ages 21 and older with insurance coverage providing at least 10,000 US dollars in medical benefits for injuries sustained in a motorcycle crash. Observed helmet use in Florida was reported to have declined from nearly 100% in 1998, before the law change, to 53% after. This study examined the effects of the law change on the likelihood of death, given involvement in a motorcycle crash. METHODS: Rates of motorcyclist deaths per crash involvement in Florida for 2001-2002 (after the law change) were compared with those for 1998-1999 (before the law change). Before/after death rate ratios (95% CIs) were examined, and logistic regression models estimated the effect of the helmet law change on the odds of death in a crash, while controlling for rider gender, age, and seating position, and number of vehicles. RESULTS: The motorcyclist death rate increased significantly after the law change, from 30.8 to 38.8 deaths per 1,000 crash involvements. Motorcyclist death rates increased for single- and multiple-vehicle crashes, for male and female operators, and for riders of all ages including those younger than 21. After controlling for gender and age, the likelihood of death given involvement in a motorcycle crash was 25% higher than expected after the law change. It is estimated that 117 motorcyclist deaths could have been avoided during 2001-2002 if Florida's universal helmet law had remained in place. CONCLUSIONS: This study provides evidence of the life-saving benefits of universal helmet laws. The results also suggest that age-specific helmet laws are not effective in protecting the youngest drivers. This is not surprising, as these laws are largely unenforceable.

Accidents, Traffic↗

PubMed1989

An examination of loneliness among elderly Canadian seasonal residents in Florida.

As part of a larger study focusing on different facets of the lives of 2,731 older Canadians who seasonally reside in Florida, we investigated primarily the extent of family and friendship contacts and the loneliness expressed by these older Canadians. The data were collected using a questionnaire that was distributed and returned by mail. The sample was taken from the subscription list of a newspaper in Florida that was a subsidiary of a large Canadian newspaper. The results show a population that was relatively young, married, in generally good health, and with rather extensive contacts with family and friends while residing in Florida. Nevertheless, more than a fifth indicated they were at least somewhat lonely. Results, using discriminate function analysis, showed that those more lonely were younger, female, less educated, not married, in poorer physical health, had fewer Florida friends, and had more children who lived near them in Canada, but fewer children who lived near them in the United States. Implications of the results are discussed.

Age Factors↗

PubMed2003

Reinventing long-term care: the effect of policy changes on trends in nursing home reimbursement and resident characteristics--Florida, 1989-1997.

PURPOSE: This study investigated how changes in Medicare and Medicaid policies affected skilled nursing facility (SNF) revenue streams and resident characteristics in Florida during the 1990s. DESIGN AND METHODS: We used a series of ordinary least squares (OLS) regression models to analyze state-provided administrative data and Online Survey Certification and Reporting (OSCAR) data for all Florida SNFs. RESULTS: We found that Florida SNFs responded differently to the growing gap in reimbursement between Medicaid and other payers, depending on their profit status. As the reimbursement gap grew, for-profit SNFs maximized their revenues by admitting fewer Medicaid paying residents, whereas nonprofit facilities increased their percentage of Medicaid admissions. IMPLICATIONS: Changes in patterns of reimbursement altered the composition of Florida SNF residents in terms of age, physical status, length of stay, and place of discharge.

Aged↗

PubMed2003

The nursing home problem in Florida.

The nursing home problem in Florida was characterized as a debate over quality of care and the rapid increase of lawsuits against nursing homes that led to a decline in the availability of affordable liability insurance. The staff for Florida's Task Force on Availability and Affordability of Long-Term Care analyzed lawsuit and quality-of-care data from one county in Florida and quality-of-care data statewide to understand the relationship between the two sides of the argument. Analyses showed support for both positions and a middle-ground policy position was achieved. The subsequent nursing home reform legislation and implications for the future of long-term care in Florida are discussed.

Assisted Living Facilities↗

PubMed1996

Deaths related to Hurricane Andrew in Florida and Louisiana, 1992.

BACKGROUND: Information about circumstances leading to disaster-related deaths helps emergency response coordinators and other public health officials respond to the needs of disaster victims and develop policies for reducing the mortality and morbidity of future disasters. In this paper, we describe the decedent population, circumstances of death, and population-based mortality rates related to Hurricane Andrew, and propose recommendations for evaluating and reducing the public health impact of natural disasters. METHODS: To ascertain the number and circumstances of deaths attributed to Hurricane Andrew in Florida and Louisiana, we contacted medical examiners in 11 Florida counties and coroners in 36 Louisiana parishes. RESULTS: In Florida medical examiners attributed 44 deaths to the hurricane. The mortality rate for directly-related deaths was 4.4 per 1 000 000 population and that for indirectly-related deaths was 8.5 per 1 000 000 population. In Louisiana, coroners attributed 11 resident deaths to the hurricane. Mortality rates were 0.6 per 1000 000 population for deaths directly related to the storm and 2.8 for deaths indirectly related to the storm. Six additional deaths occurred among non-residents who drowned in international waters in the Gulf of Mexico. In both Florida and Louisiana, mortality rates generally increased with age and were higher among whites and males. CONCLUSIONS: In addition to encouraging people to follow existing recommendations, we recommend emphasizing safe driving practices during evacuation and clean-up, equipping shelters with basic medical needs for the population served, and modifying zoning and housing legislation. We also recommend developing and using a standard definition for disaster-related deaths, and using population-based statistics to describe the public health effectiveness of policies intended to reduce disaster-related mortality.

Adolescent↗

PubMed1999

Avian serology in a St. Louis encephalitis epicenter before, during, and after a widespread epidemic in south Florida, USA.

Blood and serum from 3,915 wild and domestic birds (2,590 resident, 139 migrant, and 1,186 captive), representing 56 species collected in central Florida from 1989 through 1997, were analyzed for evidence of St. Louis encephalitis (SLE) virus transmission. All sera were tested for SLE hemagglutination inhibition (HI) antibody. Selected sera and bloods were tested for SLE neutralizing (NT) antibody and virus. The reproductive success of resident birds was highest from 1990-1992 and lowest from 1994-1997. Transmission of SLE to resident birds, especially mourning doves (Zenaida macroura), peaked during the summer of 1990, a year during which a widespread SLE epidemic was recorded in central Florida. The SLE antibody-positive resident birds 1st appeared during September of the epidemic year. Some SLE, HI antibody-positive resident birds were captured throughout 1991, but only 5% were yearlings, compared with 36% in 1990. By 1993, wild resident birds expressing HI and NT antibodies to SLE had nearly disappeared. None of the migrant birds tested were SLE-positive. Sentinel chickens maintained in Indian River County during the epidemic year seroconverted to SLE starting in early July with peak seroconversion rates in August, September, and October. High (> or = 50%) SLE seroconversion rates in sentinel chickens preceded those in wild birds by 10 wk and preceded peak human SLE transmission by at least 8 wk. Major SLE epidemics in south Florida depend on abundant wild bird populations, especially during the amplification phase of the transmission cycle. We propose that hard winter freezes along the temperature-subtropical climatic zone interface in central Florida, at approximately 27 degrees 30' North Latitude, opens foraging and nesting habitats for ground-feeding birds, resulting in high reproductive success and an abundance of seronegative individuals that rapidly amplify the SLE later in the year.

Animals↗

PubMedDate not supplied

Cyclosporiasis associated with imported raspberries, Florida, 1996.

OBJECTIVES: Until 1995, infection with Cyclospora cayetanenis, a parasite that causes gastroenteritis, was diagnosed in the US primarily in overseas travelers; its modes of transmission were largely unknown. In 1995, 45 cases of cyclosporiasis were diagnosed in Florida residents who had no history of recent foreign travel, but an investigation could not pinpoint a source for the parasite. In 1996, a North American outbreak of cyclosporiasis resulted in more than 1400 cases, 180 of them in Florida. The authors investigated the 1996 Florida outbreak to identify the vehicle of transmission. METHODS: The authors conducted a matched case-control study in which each of 86 laboratory-confirmed sporadic cases was matched with up to four controls. They also investigated nine clusters of cases associated with common meals and attempted to trace implicated foods to their countries of origin. RESULTS: In the case control study, eating raspberries was strongly associated with cyclosporiasis (matched odds ratio = 31.9; 95% confidence interval [CI] 7.4, 138.2). In the cluster investigation, raspberries were the only food common to all nine clusters of cases; a summary analysis showed a strong association between consumption of raspberries and confirmed or probable cyclosporiasis (risk ratio = 17.6; 95% CI 1.9, 188.8). Guatemala was the sole country of origin for raspberries served at six of nine events. CONCLUSIONS: Guatemalan raspberries were the vehicle for the 1996 Florida cyclosporiasis outbreak. Cyclospora is a foodborne pathogen that may play a growing role in the etiology of enteric disease in this country as food markets become increasingly international.

Adult↗

PubMed1996

The need for pediatric-specific triage criteria: results from the Florida Trauma Triage Study.

OBJECTIVE: The objective of the Florida Trauma Triage Study was to assess the performance of state-adopted field triage criteria. The study addressed three specific age groups: pediatric (age < 15 years), adult (age 15-54 years), and geriatric (age 55+ years). Since 1990, Florida has used a uniform set of eight triage criteria, known as the trauma scorecard, for triaging adult trauma patients to state-approved trauma centers. However, only five of the criteria are recommended for use with pediatric patients. This article presents the findings regarding the performance of the scorecard when applied to a pediatric population. DESIGN: We used state trauma registry data linked to state hospital discharge data in a retrospective analysis of trauma patients transported by prehospital providers to any acute care hospital within nine selected Florida counties between July 1, 1991, and December 31, 1991. We used cross-table and logistic regression analysis to determine the ability of triage criteria to correctly identify patients who were retrospectively defined as major trauma. We applied the field criteria to physiologic and anatomy/mechanism of injury data contained in the trauma registry to "score" the patient as major or minor trauma. To make our retrospective determination of major or minor trauma we used the protocols developed by an expert medical panel as described by E. J. MacKenzie et al. (1990). MAIN OUTCOME MEASURES: We calculated sensitivity, specificity, and the corresponding over- and undertriage rates by comparing patient classifications (major or minor trauma) produced by the triage criteria and the retrospective algorithm. We used logistic regression to identify which triage criteria were statistically significant in predicting major trauma. RESULTS: Pediatric cases accounted for 9.2% of the total study population, 6.0% of all hospitalized cases, and 6.8% of all trauma deaths. Of the 1505 pediatric cases available for analysis, the triage criteria classified 269 cases as expected major trauma and 1236 cases as expected minor trauma. The retrospective algorithm classified 78 cases as expected major trauma and 1427 cases as expected minor trauma. The resulting specificity is 84.8% (15.2% overtriage), and the sensitivity is 66.7% (33.3% undertriage). Logistic regression indicated that, of the eight state-adopted field triage criteria, only the Glasgow coma score, ejection from vehicle, and penetrating injuries have a statistically significant impact on predicting major trauma in pediatric patients. CONCLUSIONS: Although the state-adopted trauma scorecard, applied to a pediatric population, produced acceptable overtriage, it did not produce acceptable undertriage. However, our undertriage rate is comparable to the results of other published studies on pediatric trauma. As a result of the Florida Trauma Triage Study, a new pediatric triage instrument was developed. It is currently being field-tested.

Adolescent↗

PubMed2005

Disaster mental health training in Florida and the response to the 2004 hurricanes.

The need for mental health interventions in disasters has long been recognized. The Florida Center for Public Health Preparedness (FCPHP) has been providing disaster mental health training to employees of the Florida Department of Health and others since 2001. One of the training programs was Bioterrorism Trauma Intervention Specialist Training (BTIST), offered between May 2003 and January 2004. The FCPHP has also developed three distance learning courses, including one that provides advice to responders who are experiencing compassion fatigue. The BTIST curriculum prepares participants to provide mental health interventions during and following disasters. The four hurricanes that struck Florida in a 7-week period in 2004 created a great demand for mental health services. The FCPHP supported the Florida Department of Health response effort by providing a roster of BTIST trainees and hundreds of copies of the compassion fatigue audio CD. The FCPHP conducted a Web-based survey of the BTIST participants after the hurricanes. A large majority of respondents reported that the training had given them greater knowledge of disaster mental health, provided many disaster mental health skills, and the skills had been valuable in their professional and personal lives. Most of those who had actively responded to the hurricanes indicated that the training had given them confidence for their response and that they had used the acquired skills in their response efforts.

Attitude of Health Personnel↗

PubMedDate not supplied

Indicators of a healthy and sustainable community. The Central Florida experience.

The society, economy, and health and well-being of residents in the Central Florida region create a holistic perspective of a healthy community. This article discusses the important role health care organizations play in developing and creating healthy communities. It also discusses the responsibility health care providers in the Central Florida region have to the communities they serve using this broad-based approach to a healthy community. A history is presented showing how a local initiative to develop a healthier community led to the development of several healthy community indicators for the Central Florida region. The article delineates how the indicators reflect the health and long-term viability of the 7 counties comprising the Central Florida region. A number of public policy implications and the role of the region's health care system in furthering these indicators are presented for the broadly defined categories of crime, education, the local economy, and transporation.

Community Health Planning↗

PubMed2001

The Florida "truth" anti-tobacco media evaluation: design, first year results, and implications for planning future state media evaluations.

OBJECTIVES: To outline the design and present selected findings from the evaluation of a state counter-advertising, anti-tobacco media campaign. The appropriateness of the design for states developing media evaluations is discussed. DESIGN: Four cross sectional, telephone surveys of the 12--17 year old population were used to track and monitor advertising and campaign awareness, confirmed awareness, and receptivity. The Florida baseline and one year surveys were used with two parallel national surveys in a quasi-experimental design to assess attitude and smoking related behaviour change attributable to the campaign. MEASURES: Awareness was measured by self report, confirmed awareness by unaided description, and receptivity by self reports of how well advertisements were liked, talked to friends about, and made one think about whether or not to smoke. Eleven attitude and three smoking behaviour items for Florida (treatment) and a national (control) population were compared at baseline and after 12 months. RESULTS: Significant increases in ad specific awareness, confirmed, receptivity, and campaign awareness, and confirmed awareness were reached by the sixth week. They continued to rise through the first year. No attitude and only minor behaviour differences were noted between the treatment and comparison populations at baseline. By the end of the first year, Florida youth had stronger anti-tobacco attitudes and better behaviour patterns than the comparison population. CONCLUSIONS: The industry manipulation strategy used in the Florida campaign resulted in high rates of recall, significant changes in attitudes/beliefs, and reduced rates of smoking behaviour among youth.

Adolescent↗

PubMed2005

Body wiping behaviors associated with cutaneous lipids in hylid tree frogs of Florida.

Body wiping behavior, integumentary secretions and rates of evaporative water loss (EWL) were examined in six species of Florida tree frogs (Anura: Hylidae). Additionally, morphology of the integument and dermal glands were compared among these and one other Florida tree frog (Hyla andersonii), an arid-adapted tree frog (Phyllomedusa hypochondrialis), and a highly aquatic frog (Rana utricularia). An extra-epidermal layer of lipid and mucus, presumably secreted from dermal granular glands, was detected on the skin of all Florida hylid frogs examined. Distinct body wiping behaviors were observed in the hylid frogs, but these were less complex than those described previously in phyllomedusine frogs, which occupy arid habitats, secrete lipids onto their skin, and are regarded as relatively 'waterproof'. Florida hylids occupy seasonally arid habitats and appear to have reduced rates of EWL. The suite of traits we observed in these frogs have been previously documented in a rhacophorid tree frog from seasonally arid regions of India and likely represent an evolutionary convergent response to periodic dehydration stress. The presence of lipids that are spread by simple wiping behaviors to form an extra-epidermal water barrier may represent an early stage of the more advanced adaptations described in more waterproof arboreal frogs.

Animals↗

PubMed2000

Frequency of Saint Louis encephalitis virus in humans from Florida, USA: 1990-1999.

Four general frequencies of human St. Louis encephalitis (SLE) virus (epidemic, focal, sporadic, and no transmission) occurred in Florida between 1990 and 1999. An epidemic with 226 clinical cases and 11 deaths was reported from 28 Florida counties between July 1990 and January 1991. During the autumn of 1993, a focal outbreak was reported from Lee (5 cases) and Collier (3) Counties in southwest Florida. During the autumn of 1997, sporadic transmission to nine humans was reported from five Florida counties (Brevard [1 case], Polk [3], Charlotte [1], Lee [2], and Palm Beach [2]). Human infection with SLE virus depends on a number of variables that drive virus transmission. These include vector, virus, and avian host abundance, and meteorological events, especially rainfall. We monitored the abundance and serological status of wild avian amplification hosts, virus isolations from Culex nigripalpus Theobald females, and SLE virus transmission to sentinel chickens during 1990, 1993, and 1997. The epidemic of 1990 was characterized by conditions that produced an unusual abundance of vector mosquitoes and avian amplification hosts early in the year. We propose that epidemics may result when a specific combination of biotic and abiotic conditions favor SLE virus minimum field infection rates that approach 1:1,000 in Cx. nigripalpus vectors.

Animals↗

PubMed2006

Orchid bees don't need orchids: evidence from the naturalization of an orchid bee in Florida.

Almost 200 species of orchid bees are the exclusive pollinators of nearly 700 specialized orchids in the neotropics. This well-known mutualism involves orchids, called perfume orchids, which produce species-specific blends of floral fragrances, and male orchid bees, which collect and use these fragrance compounds during their courtship. We report here the naturalization of an orchid bee, Euglossa viridissima, in southern Florida, USA, where perfume orchids are absent. Chemical analysis of the contents of the fragrance storage organs in the hind tibias of 59 male bees collected in Florida identified 55 fragrance compounds, including 27 known from the perfumes of nine species of E. viridissima's orchid mutualists in Mesoamerica. Aromatic leaves, such as basil, were found to be important surrogate sources of needed fragrance compounds in Florida. The bee's ability to live and become abundant in the absence of its orchid mutualists suggests that the orchid bee-perfume orchid mutualism may be facultative for the bees, even though it is obligatory for the orchids. This invasive bee visits and potentially pollinates the flowers of many plants in Florida, behavior that could promote the abundance of selected exotic and native species.

Animal Communication↗

PubMed1985

Rocky Mountain spotted fever acquired in Florida, 1973-83.

From 1973 to 1983, 49 Florida residents were reported with confirmed Rocky Mountain spotted fever (RMSF), 25 of whom were considered to have had Florida-acquired disease. Although there was no history of tick exposure for six of these 25 persons, all had contact with dogs or outdoor activities during the incubation period. The tick vectors of RMSF are widely distributed throughout Florida. We conclude that RMSF, although rare in Florida, can be acquired in the state.

Adolescent↗

PubMed2004

Confirming "truth": more evidence of a successful tobacco countermarketing campaign in Florida.

This study provides additional evidence that Florida's "truth" tobacco countermarketing campaign was successful in reducing smoking among Florida teens. Smoking rates were substantially lower among Florida teens between fall 2001 and spring 2002, whereas previous studies found that smoking rates were comparable before the launch of "truth." Florida teens had higher levels of "truth" campaign awareness and were more likely to agree with campaign-targeted beliefs; 2 of these beliefs were the only items associated with current smoking.

Adolescent↗