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Attitudes of Florida Academic Physicians toward the Florida Medical Association.

An Ad Hoc Committee on Academic Physicians was given the charge in 1992 of studying Florida academic physician's participation in the Florida Medical Association. It was postulated that academic physicians may participate less in organized medicine than community physicians and, therefore, may be a group that should be selectively targeted during membership campaigns. Data was obtained from the American Medical Association Masterfiles about Florida academic and community physician membership in the FMA and AMA. Academic physicians at the four academic medical centers in Florida were surveyed about their attitudes toward organized medicine, especially the Florida Medical Association. Unlike any other state in the Federation, more academic physicians than community physicians were members of the state society (46.9% v 43.5%) p < 0.05, which was accounted for mainly women academic physicians. There were substantial differences across the academic medical centers with the University of Florida at Gainesville and Jacksonville being overrepresented, the University of South Florida having average membership, and the University of Miami being underrepresented. Florida academic and community physician membership in the AMA was 34.6% and 38.5% respectively, which was consistent with national trends. Academic physicians at the University of Florida campuses rated their relationship and communication with the FMA as being better than academic physicians at the University of South Florida and Miami. Academic physicians at all four medical centers rated membership dues as being too high relative to the benefits derived, but there was indirect evidence to suggest that this was an apparent and not real barrier. Also, academic physicians thought that the FMA represented community physicians more effectively than academic physicians. The state of Florida is unique in that more academic physicians than community physicians are members of the state medical society. The differences by academic medical centers may be accounted for by variations in leadership at the different medical centers. Decreasing the membership dues for academic physicians probably will not have a significant effect on membership of academic physicians. The FMA should direct efforts at informing academic physicians about how the FMA is representing their interest in forums such as governmental and other regulatory agencies, and third party payers like the insurance industry.

Academic Medical Centers↗

Florida Hospital Medical Center, Orlando, Florida. Profile.

In 1908, a 20 bed hospital known as Florida Sanitarium began serving the small farming community of Orlando primarily through traditional "rest cures" in a quiet, wooded environment. By contrast in 1985, the 1,071 bed Florida Hospital is a technologically advanced, full service medical center offering specialized surgical and diagnostic services to a greatly expanded Central Florida population. Owned and operated by the Seventh-Day Adventist Church, Florida Hospital Medical Center is today the fourth largest employer in the Orlando area, supporting a staff of some 700 physicians, 1,600 nurses and 2,400 technical, administrative and medical support personnel. Florida Hospital is located on a sprawling campus in Orlando, with the adjacent "West Campus" containing a free standing ambulatory care center and a professional office building with physician's offices and a family health center. Additionally, two satellite hospitals (Florida Hospital/Altamonte with 220 beds and Florida Hospital/Apopka with 50 beds), are located approximately 20 minutes away. A 56-bed Center for Psychiatry on the Orlando campus was completed last year, and a regional cancer center is currently under construction adjacent to Florida Hospital/Altamonte.

Florida↗

Hematologic effects of cytauxzoonosis in Florida panthers and Texas cougars in Florida.

Cytauxzoon felis is a long-recognized hemoparasite of free-ranging Florida panthers (Puma concolor coryi), but its prevalence and effect on the population has not been assessed. Red blood cell indices and white blood cell counts were compared between infected and noninfected Florida panthers and Texas cougars (Puma concolor stanleyana) from 1983-1997 in Florida (USA). The prevalence of cytauxzoonosis for both populations was 39% (11/28) for Texas cougars, 35% for Florida panthers (22/63) and 36% overall. Thirteen hematologic parameters were compared between C. felis positive and negative panthers and cougars. Florida panthers had significantly lower mean cell hemoglobin count (MCHC) and higher white blood cell (WBC), neutrophil, monocyte and eosinophil counts (P < or = 0.05) than Texas cougars. Infected Florida panthers had significantly lower mean cell hemoglobin (MCH) and monocyte counts and higher neutrophil and eosinophil counts than infected Texas cougars. Although statistically significant differences were measured for hematologic parameters in C. felis positive panthers and cougars, biologically significant differences were not likely because values were generally within expected reference ranges for healthy animals. Cytauxzoonosis does not appear to have a negative effect on the hematologic parameters of chronically infected panthers and cougars. Potential transient changes during initial infection were not evaluated.

Analysis of Variance↗

Cancer among Hispanic women in South Florida: an 18-year assessment: a report from the Florida Cancer Data System.

BACKGROUND: The Hispanic population now represents the majority of residents in Miami-Dade County, Florida. The authors present cancer incidence and mortality data for South Florida's Hispanic women for the period 1990-1998 and compare these data to previously reported data from 1981-1989. Cancer incidence, risk, and mortality data should reflect current population distribution, lifestyle, and environmental risk factors so that cancer prevention and control activities are informed optimally. METHODS: The study population consisted of all women with malignant disease during 1981-1998 from Miami-Dade County found in the Florida Cancer Data System data base; patients were divided into 2 9-year periods for analysis. Age-standardized incidence and mortality rates were computed for common disease sites; rates for Hispanic women were compared with the rates for non-Hispanic white (NHW) women as standardized rate ratios (SRR) with 95% confidence intervals (95%CIs). Incidence and mortality trends were analyzed using linear regression. RESULTS: Over 70,000 cancer incidents were analyzed. The overall decreased cancer risk for Hispanic women (SRR, 0.65; 95%CI, 0.64-0.67), compared with NHW women, remained essentially constant over the two study periods. Cancer incidence increased similarly for the two racial-ethnic groups. The incidence of lung carcinoma increased in both groups, becoming the second most common disease site for NHW women and the third most common disease site for Hispanic women. CONCLUSIONS: The decreased relative cancer risk for Hispanic women in South Florida has remained stable over the past 18 years. Lung carcinoma is increasing among women in both racial-ethnic groups.

Adult↗

Metal and metalloid concentrations in the eggs of threatened Florida scrub-jays in suburban habitat from south-central Florida.

Monitoring and assessing changes in contaminants in urban and suburban environments is essential to assessing ecosystem well-being in human-influenced landscapes. We analyzed metal and metalloid levels in the eggs of the threatened Florida scrub-jay (Aphelocoma coerulescens), an extremely sedentary and modestly long-lived passerine bird that is federally threatened and endemic only in Florida. Eggs that failed to hatch were collected in a suburban environment to compare with the long-term study of this species at the Archbold Biological Station, located 8 km south in a more rural part of south-central Florida. Florida scrub-jays remain in a permanent territory in scrub oak habitat where they feed mainly on insects and acorns, but in suburban habitats human-provided foods comprise 30% of their diet. From the data previously collected at Archbold, and their low position on the food chain, we expected levels of contaminants to be comparatively low and remain relatively constant over time. Except for the low mercury value, all means were within the range of mean values reported for a wide range of non-passerine species (including those at higher tropic levels), are lower than concentrations associated with abnormalities in birds, and are lower than those previously reported for scrub-jays from Archbold Biological Station. A significant increase in selenium occurred from 1996 to 2001, but did not appear associated with changes in human density.

Animals↗

Metal concentrations in the eggs of endangered Florida scrub-jays from central Florida.

We analyzed metal levels in the eggs of the endangered Florida scrub-jay (Aphelocoma coerulescens), an extremely sedentary and modestly long-lived passerine bird. Eggs were obtained as part of the long-term study of this species at the Archbold Biological Station, located in south central Florida. Following a brief and usually short dispersal, Florida scrub-jays remain in a permanent territory in their scrub oak habitat, where they feed mainly on insects and acorns. As they are low on the food chain and sedentary, we expected levels of contaminants to be comparatively low and to reflect the local environment. No significant yearly differences existed for any metal between eggs collected in 1997 (n = 11) and 1998 (n = 5). Arithmetic mean metal concentrations (whole egg, dry weight) were low for arsenic (34 ppb), cadmium (25 ppb), mercury (74 ppb), and lead (66 ppb), intermediate for chromium (226 ppb), and higher for selenium (1,470 ppb) and manganese (2,230 ppb). Except for the low mercury value, all these means were within the range of mean values reported for a wide range of nonpasserine species, including those at high trophic levels, but are lower than concentrations associated with abnormalities in birds. The three essential elements (chromium, selenium, and manganese) were approximately normally distributed, whereas arsenic, cadmium, lead, and mercury were highly skewed (arithmetic mean much higher than geometric mean).

Animals↗

Benzodiazepines in Miami-Dade County, Florida driving under the influence (DUI) cases (1995-1998) with emphasis on Rohypnol: GC-MS confirmation, patterns of use, psychomotor impairment, and results of Florida legislation.

Benzodiazepines are central nervous system depressant drugs often detected in biological samples from driving under the influence (DUI) offenders. They are associated with marked psychomotor impairment and represent up to 20% of all Miami-Dade County, Florida DUI urine samples analyzed in our laboratory annually. Flunitrazepam emerged in the mid-1990s as an illegal drug in the U.S. that was predominantly abused recreationally and associated with sexual assaults. Immunoassays for benzodiazepines do not discriminate between different benzodiazepines, and certain metabolites, such as 7-aminoflunitrazepam, react poorly with immunoassay reagents. A simple and sensitive method for the detection and quantitation of major benzodiazepines and metabolites by gas chromatography with mass selective detection is presented. This method was used to confirm benzodiazepines in general and flunitrazepam in particular. Data collected over a three-and-a-half-year period are summarized. Whereas flunitrazepam was present in up to 10% of DUI cases in 1995 and 1996 and had fast become the most frequently encountered benzodiazepine in Miami-Dade County DUI-related urine samples, a dramatic drop in case numbers followed the legal reclassification of the drug as a Schedule I substance in Florida in February 1997. Flunitrazepam was often used alone or in combination with cannabis and cocaine. A recent rise in clonazepam cases coincides with the decrease in flunitrazepam confirmation and may indicate a new trend in the abuse of benzodiazepines in South Florida.

Benzodiazepines↗

Lung cancer in Florida. Risks associated with residence in the central Florida phosphate mining region.

A case-control study that included 25,398 cases of lung cancer among Florida residents, first diagnosed in 1981-1983, was conducted to determine if residence in the central Florida phosphate mining region was associated with an increased risk of lung cancer. A twofold increase in lung cancer risk was observed among male nonsmokers who lived in the study area. Risks were elevated for all major lung cancer cell types, with the highest risks observed for small cell carcinoma of the lung. Among cigarette smokers, a slight, but not statistically significant, additional increase in risk was associated with residence in the study area. Among women, no significant elevations in risk were observed for persons who lived in the study area. The greatest increase in risk among women was for small cell carcinomas, but the elevations were not statistically significant.

Adenocarcinoma↗

Can Florida become the first state in the United States to take heart disease out of first place? The Maryland versus Florida challenge.

The high morbidity and mortality from acute myocardial infarctions (AMI) prompted Dr. Raymond Bahr to challenge the author as to whether Maryland or Florida could be the safest state in which to have an AMI. He extended this competition spirit to a second debate as to which state would first take heart disease out of first place as the cause of death. Such a goal appeared laudable. But is it? Would AIDS, tuberculosis, or widespread cancer be a better way to die? Thinking not, Florida cardiologists established a goal to become the safest state, with the nation's largest percent of physiologically active centenarians, who would eventually die peacefully, even if due to a heart attack.

Cardiovascular Diseases↗

Seed dispersal by the Florida box turtle (Terrapene carolina bauri) in pine rockland forests of the lower Florida Keys, United States.

Seed dispersal by animals is one of the most important plant-animal mutualisms, but saurochory, the dispersal of seeds by reptiles, has received little attention. We investigated the role of the Florida box turtle (Terrapene carolina bauri) as a seed dispersal agent in pine rockland forests of the lower Florida Keys and examined the effect of turtle digestion on seed germination. We obtained seeds of 11 species with fleshy fruits and 2 species with non-fleshy fruits (a grass and legume) from the feces of 145 box turtles collected on Key Deer National Wildlife Refuge from 1999 to 2000. We planted the seeds of nine species and germination percentage (percentage of seeds that germinated during the experiment) varied from 10% to 80%. Comparative germination experiments were conducted with Thrinax morrissii, Serenoa repens, and Byrsonima lucida. We compared the germination percentage and germination rate (number of days from planting to seedling emergence) of seeds from three treatments (seeds recovered from feces, control seeds with pulp, and control seeds without pulp) and continued these experiments for up to 2 years. Passage through the box turtle digestive tract greatly enhanced the germination percentage and germination rate of S. repens, but decreased the germination percentage of B. lucida and T. morrissii, and decreased germination rate for T. morrissii. Subsequent destructive seed viability tests revealed that many ungerminated T. morrissii seeds remained viable, suggesting long-term seed dormancy may occur, even after passage through the turtle digestive system. In addition, the proportion of ungerminated seeds which remained viable was greater for seeds recovered from turtle feces than from control seeds with pulp. Furthermore, removal of fleshy pulp either manually or by the turtle digestive system may allow T. morrissii to escape insect predation.

Animals↗

Department of Community Dentistry, University of Florida College of Dentistry, Gainesville, Florida.

The oral health status of 454 children and 115 adults from a population of migrant and seasonal farmworkers in Florida was assessed. The prevalence of disease among the children was consistent with that reported for other black children of this age. The migrants had received more dental treatment than the children of seasonal farmworkers; however, the level of care for both groups was strikingly low. The results of this neglect were clearly reflected in the mouths of the adults, most of which were found to be in a very deteriorated state of dental health. A program to cope with these long unmet needs is unrealistic. Efforts should be made to eliminate pain and infection until the cycle of poverty can be broken.

Agriculture↗

Mosquitoes infected with West Nile virus in the Florida Keys, Monroe County, Florida, USA.

More than 30,000 mosquitoes in 22 species or species groups were collected from the Florida Keys, Monroe County, FL, USA, in dry ice-baited light and gravid traps. Dry ice-baited traps collected more mosquitoes than did gravid traps. West Nile virus was detected in pools of Anopheles atropos Dyar & Knab, Deinocerites cancer Theobald, and Ochlerotatus taeniorhynchus (Wiedemann).

Animals↗

Survey of container-breeding mosquitoes from the Florida Keys, Monroe County, Florida.

A survey of container-breeding mosquitoes was conducted on urban islands (Big Coppitt Key, Rockland Key, Key West, and Stock Island) and rural islands (Big Pine Key, Cudjoe Key, Little Torch Key, No Name Key, Ramrod Key, Saddlebunch Keys, Sugarloaf Key, and Summerland Key) within the Florida Keys. Five mosquito species were collected: Aedes aegypti, Culex nigripalpus, Cx. quinquefasciatus, Cx. salinarius, and Ochlerotatus taeniorhynchus. Plastic buckets, trash cans, and discarded plastic containers most commonly were found to be mosquito breeding sites. Many containers were used by more than 1 mosquito species. More containers holding water were found in the rural areas than in the urban areas. The percentage of wet containers with mosquitoes did not differ between the rural and urban areas.

Aedes↗

House dust mite allergy in Florida. Mite survey in households of mite-sensitive individuals in Tampa, Florida.

This study evaluated the prevalence of positive house dust mite skin tests in a population of atopic individuals and identified the mite species present in mattress and house dust samples in homes of the Tampa Bay area. Four hundred consecutive individuals were evaluated for respiratory complaints and skin tested with standardized extracts of Dermatophagoides pteronyssinus (Dp) and Dermatophagoides farinae (Df). Two hundred forty individuals (60%) had a positive skin test to the mite extracts. Dust samples were collected in 40 homes of mite-allergic individuals and analyzed by light microscopy. Mite species were found in 53 of the 60 dust samples (20 mattresses and 40 carpets). Mite numbers ranged from 110-6200 mites/g of mattress dust and from 120-5500 mites/g of carpet dust. Eleven different mite species were identified and Blomia tropicalis (Bt), not previously identified in the United States, was found in 30% of the samples. Dp and Df wee the predominant species. These observations suggest that house dust mite allergy is common in the Tampa Bay area and that the house dust mite fauna comprises several mite species besides Dp and Df. Prospective studies in progress are designed to confirm the role of different mite species in house dust mite allergy.

Air Pollutants↗