Children In Florida Research Articles

Effectiveness of palivizumab prophylaxis in infants and children in Florida

Palivizumab effectiveness data on respiratory syncytial virus (RSV) infections are limited to trial settings and vary considerably between selected high-risk populations. This study aimed to evaluate effectiveness in a community-based sample. We conducted a cohort study of children with ≥ 3 months Florida Medicaid fee-for-service eligibility between 1998 and 2004 who also had matching birth certificates. Children entered the cohort at the beginning of the RSV season, after a minimum of 60 days in ambulatory care, and were followed until the earliest of the following: season end, second birthday, loss of eligibility, hospitalization, or death. Study endpoint was the first RSV-related hospitalization. To evaluate the presence of confounding, a second endpoint, hospitalizations for pneumonia or bronchiolitis secondary to specified bacterial or viral pathogens other than RSV, was used. Palivizumab exposure defined as first use (day 1-30 of first dose), subsequent use (days 1-30 of each subsequent dose), and former use (days 31-60 after any dose if delays or no readministration occurred) was compared with non-use with a Cox regression model, adjusting for confounders. Hazard ratios (HRs) for RSV hospitalizations were 0.89 (95%CI, 0.71-1.12), 0.56 (95%CI, 0.46-0.69), and 0.71 (95%CI, 0.51-0.97) for first, subsequent, and former use, respectively. HRs for hospitalization because of non-RSV infections were 1.31 (95%CI, 1.04-1.65), 1.03 (95%CI, 0.86-1.23), and 1.05 (95%CI, 0.78-1.41), indicating residual confounding for first but not for subsequent and former use. In this community-based study, palivizumab was associated with a reduction in severe RSV infections of a magnitude comparable to the lower clinical trial efficacy estimates. Protection appears to extend beyond the currently recommended monthly dosing schedule.

Interpreting Children's Constructions of Their Ethnicity

Drawing upon post-structural and post-colonial theories, this study is an investigation into the ways in which five classes of first-grade children (six and seven year olds) in Florida and Hawaii talked about their ethnicities in a video pen pal project. The qualitative methods utilized in this research were participant observation, interviews, and videotaping. The resulting analysis notes that the children in the five different schools talked about their ethnicities differently (ethnicity only, hyphenated ethnic-national identity, or national identity only). Four themes emerge from the analysis related to multicultural education, real-life racism, national identity, and shifting subjectivities. Emphasized in the analysis and interpretation is the importance of situating children's talk about ethnicity within local contexts, acknowledging the multiple and fluid nature of individual subjectivities, and recognizing their location within ideological discourses.

Respiratory Syncytial Virus Seasonality in Southeast Florida

Southeast Florida generally experiences longer seasonal epidemics of respiratory syncytial virus (RSV) than other parts of the country. In this report, the primary objective was to more accurately define the onset, peak, and duration of the RSV season in Southeast Florida. The results obtained for this region were also compared with those reported for the state and for the nation. Seasonal patterns for RSV in Southeast Florida were analyzed based on the total number of RSV tests performed, number of positive tests, and percent of positive tests in children presenting with bronchiolitis to 3 emergency departments from January 2003 through December 2006. RSV was detected by rapid diagnostic testing and considered to be present at epidemic levels when at least 10% of performed tests were positive during a given month. During the entire 12 months of 2003 and 2006, RSV was detected above epidemic levels. The RSV-detection test positivity rate was less than 10% in only 6 months of 48 total months of observation, but during the months that were below epidemic threshold, RSV was still frequently identified. RSV activity increased during July, peaked during October, and waned during the spring months. These findings were nearly identical to those recently reported in other studies, confirming that RSV circulated at epidemic levels in Southeast Florida during most of the 4-year observation period and remained a significant cause of respiratory disease and hospitalization throughout the year. Strategies for RSV prophylaxis in at-risk children in South Florida should consider results of local RSV test detection.

Factors Influencing Complementary and Alternative Medicine Use in a Multisite Pediatric Oncology Practice

Complementary and alternative medicine (CAM) use in children is common although estimates of prevalence vary widely. We studied CAM use in our multisite pediatric oncology practice and evaluated factors influencing CAM use. We conducted an anonymous cross-sectional survey of 274 parents of children treated at the combined Nemours oncology practice in Florida and Delaware. Prevalence of CAM use was determined and binary logistic regression was used to evaluate factors related to CAM use in children. The prevalence of CAM use among children and parents was 24.5% and 66.7%, respectively. Intensity of parent's use of CAM and geographic region were significantly associated with CAM use in children. The odds of CAM use in children increased with increasing use among parents. When parents used 6 or more therapies children were 33 times more likely to use CAM compared with those whose parents did not use CAM (odds ratio=33.3; 95% confidence interval, 10.4-106.2, P<0.01). Children in Florida were more likely to use CAM compared with children in Delaware (odds ratio=3.0; 95% confidence interval, 1.6-5.8, P<0.01). These results indicate that children's use of CAM is significantly related to the intensity of parent's use regardless of parent's race, sex, education, household income, or child's sex or age. Clinicians should consider parental use and intensity of CAM use. Assessing CAM use should include classifications established by the National Center for CAM and a standard format for inquiring about CAM use should be developed.

The effect of premium changes on SCHIP enrollment duration.

To examine the impact of premium changes in Florida's State Children's Health Insurance Program (SCHIP) on enrollment duration. Administrative records, containing enrollment and demographic data, were used to identify 173,330 enrollment spells for 153,768 children in Florida's SCHIP from July 2002 through June 2004. Health care claims data were used to classify the children's health status. Accelerated failure time models were used to examine the immediate and longer term effects on enrollment length of a temporary premium increase of $15 to $20 per family per month (PFPM) for children in families with income between 101-150 percent of the federal poverty level (FPL) and a permanent premium increase of $15 to $20 PFPM for children in families with 151-200 percent FPL. Health status and sociodemographic variables were included as covariates. Transfers to other public health insurance programs were taken into account. Enrollment lengths decreased significantly immediately following the premium increases, with a greater percentage decrease among lower income children (61 percent) than higher income children (55 percent). Enrollment lengths partially recovered in the longer term for both the temporary and permanent changes. Those with significant acute or chronic health conditions had longer enrollment lengths and were less sensitive to premium changes than healthy children. An increase in the PFPM premium amount had differential effects across income categories and health status levels. Enrollment lengths remained shortened after the premium increase was rescinded for lower income families, suggesting that it may be difficult to reverse the impacts of even a short-term premium increase.

Trends in Avoidable Hospitalizations for Children in Florida from 1992 to 2003

This article examines trends in avoidable hospitalizations to determine whether improved access following post-1997 Balanced Budget Act expansions in public health insurance programs resulted in a decreased rate among affected populations, particularly children of ages 0-19 years. Florida inpatient discharge data sets from 1992 to 2003 were compiled in order to analyze trends using descriptive and linear regression methods. The rate of avoidable hospitalizations for children was subsequently compared to that of adults (ages 20-64 years) to assess relative changes. The rate declined significantly for black and other nonwhite children. Based on age, the declines were concentrated in the subgroups for ages 0-1 year, 5-9 years, and 10-14 years. In contrast, the rate for adults, with the exception of nonwhite and black populations, increased. The decline in the overall rate of avoidable hospitalizations for children indicates that increased expenditures related to the expansions were at least partially offset. However, the trend could not be directly attributed to the Balanced Budget Act.

Factors Associated With Not Having a Personal Health Care Provider for Children in Florida

National recommendations by the American Academy of Pediatrics and the National Association of Pediatric Nurse Practitioners promote that all children obtain quality primary care through a consistent medical provider who can better assess, diagnose, and monitor a child's health. The purpose of this article was to identify characteristics of children in Florida without a personal health care provider. Florida data (N = 2116) from the 2003 National Survey of Children's Health were analyzed by using bivariate and multivariate methods. The dependent, or outcome, variable was a personal health care provider, defined in the National Survey of Children's Health as a personal doctor or nurse. In Florida, 20.1% of children (0-17 years of age) do not have a personal health care provider compared with 16.7% in the United States. Children at greatest risk are those without health insurance. Other significant risk factors include family poverty up to 100% of federal poverty level, poverty level 100% to 199%, poverty level unknown, poverty level 200% to 399%, children aged 5 to 12 years, children aged 13 to 17 years, and Hispanic ethnicity. All the factors in the Florida model were also significant in the national model. Lack of a personal health care provider is driven by larger community issues of health insurance, socioeconomic status, and ethnicity, including race, on a national level. To achieve the goal of a personal health care provider for children, a multifaceted approach needs to be considered. Knowing which children are without a personal health care provider provides valuable information for state policy-makers, program planners, and evaluators.

Effects of Cash and Counseling on Personal Care and Well‐Being

To examine how a new model of consumer-directed care changes the way that consumers with disabilities meet their personal care needs and, in turn, affects their well-being. Eligible Medicaid beneficiaries in Arkansas, Florida, and New Jersey volunteered to participate in the demonstration and were randomly assigned to receive an allowance and direct their own Medicaid supportive services as Cash and Counseling consumers (the treatment group) or to rely on Medicaid services as usual (the control group). The demonstration included elderly and non-elderly adults in all three states and children in Florida. Telephone interviews administered 9 months after random assignment. Outcomes for the treatment and control group were compared, using regression analysis to control for consumers' baseline characteristics. Treatment group members were more likely to receive paid care, had greater satisfaction with their care, and had fewer unmet needs than control group members in nearly every state and age group. However, among the elderly in Florida, Cash and Counseling had little effect on these outcomes because so few treatment group members actually received the allowance. Within each state and age group, consumers were not more susceptible to adverse health outcomes or injuries under Cash and Counseling. Cash and Counseling substantially improves the lives of Medicaid beneficiaries of all ages if consumers actually receive the allowance that the program offers.

The research design and methodological issues for the Cash and Counseling Evaluation.

To provide an overview of the design, research questions, data sources, and methods used to evaluate the Cash and Counseling Demonstration and resolution of analytic concerns that arose. The methodology was designed to provide statistically rigorous estimates while presenting the findings in a manner easily accessible to a broad, non-technical audience. Eligible Medicaid beneficiaries in Arkansas, Florida, and New Jersey who volunteered to participate in the demonstration were randomly assigned to receive an allowance and direct their own Medicaid supportive services as Cash and Counseling consumers (the treatment group) or to rely on Medicaid services as usual (the control group). The demonstration included elderly and non-elderly adults in all three states and children in Florida. Both age groups in Arkansas and New Jersey and the elderly adults group in Florida primarily included individuals with physical disabilities. In Florida, the children and non-elderly adults primarily included individuals with developmental disabilities. The intervention was conducted from 1999 through 2003. Data included baseline and 9-month follow-up surveys of consumers, surveys of the primary informal caregiver and the primary paid worker for sample members, program data, interviews with program staff, and Medicaid and Medicare claims data. Descriptive data analyses were conducted on program participation, program implementation, and the experiences of hired workers. Program impacts on consumers, caregivers, and costs were estimated using an intent-to-treat-approach, comparing the regression-adjusted means of outcomes for the full treatment and control groups. A broad set of control variables from the baseline interview and prior Medicaid claims data controlled for possible preexisting differences. Ordinal scale responses were converted to binary outcome indicators for high and for low values for ease of presentation and interpretation of effects. Two-tailed statistical tests of the estimated effects were conducted at the .05 level. Separate estimates were provided for each state and for each age group. Sensitivity tests were conducted of the robustness of estimates to outliers (for continuous outcome measures) and to proxy use. PRINCIPAL FINDINGS/CONCLUSION: The experimental design, high survey response rates, and available sample sizes led to valid, unbiased estimates of program impacts, with adequate power to detect moderate-size impacts on most outcomes for the key age subgroups examined. For certain survey-based outcome measures related to satisfaction with paid care, the sample had to be restricted to those who received care and those without proxy respondents who were also hired workers. Sensitivity tests suggest that these necessary restrictions were unlikely to have led to over statement of favorable program effects on these outcome measures. The high proportions of sample members with proxy respondents reflect the frailty of the sample members. Similar rates for treatment and control groups cases with proxy respondents suggest the high use of proxy respondents has not biased the estimated program effects on survey measures.

Short Term Involuntary Psychiatric Examination of Children in Florida

This study describes the use of emergency mental health services by children over a 4-year period. Analysis of a statewide database revealed 51,861 or 15% of all involuntary examinations were conducted on children. These youth were on average a little over 14 years of age and law enforcement officials initiated the majority of examinations. The majority of examinations were initiated due to the children demonstrating harmful behaviors to themselves or others. One-fifth of the children (21%) experienced more than one examination over the 4-year period. Areas of future research on this topic are discussed. The implications of the nature of examinations and patterns of repeated examinations are discussed.

Cancer incidence among Hispanic children in the United States

To directly compare cancer incidence among Hispanic children and non-Hispanic white children in California and Florida, two states in the United States of America that include nearly one in three Hispanic children in the country. Cross-sectional data for 1988 through 1998 pertaining to all incident pediatric cancer cases (age < 15 years) with race/ethnicity coded as either Hispanic or non-Hispanic white came from the Florida Cancer Data System database and the California Cancer Registry database. The results were expressed as age-standardized incidence rates, standardized to the world standard million population. Hispanic rates and non-Hispanic white rates were compared using standardized incidence ratios (SIRs) with 95% confidence intervals (95% CIs.). The SIR for all cancers for Hispanic children compared to non-Hispanic white children was 1.02 (95% CI: 0.99, 1.05). For selected tumor types, SIRs indicated higher incidences among Hispanic children for leukemia (SIR = 1.26; 95% CI: 1.19, 1.34), Hodgkin's lymphoma (SIR = 1.29; 95% CI: 1.08, 1.54), and germ cell tumors (SIR = 1.62; 95% CI: 1.34, 1.96). There were lower incidences for the Hispanic children for central nervous system tumors (SIR = 0.72; 95% CI: 0.66, 0.78) and for sympathetic nervous system tumors (SIR = 0.76; 95% CI: 0.66, 0.87). In terms of interstate differences, the incidence of lymphoma, central nervous system tumors, sympathetic nervous system tumors, and malignant bone tumors was highest among Hispanic youth in Florida; the incidence of hepatic tumors was highest among Hispanic youth in California. While the overall cancer incidence rate among Hispanic children was similar to that for non-Hispanic white children, significant differences for specific tumor types were identified. Since Hispanic ethnicity may be a confounder for other cancer risk factors (e.g., familial, socioeconomic, or environmental), it is recommended that future research into Hispanic pediatric cancer risk investigate these risk factors.

Using Surveillance Data to Develop and Disseminate Local Childhood Lead Poisoning Screening Recommendations: Miami—Dade County’s Experience

Before 1999, few children in Florida's Miami-Dade County were being screened for lead poisoning. To improve screening rates, the county's department of health developed screening recommendations and a screening tool using surveillance and census data and disseminated these materials to primary care providers. Each year, recommendations have been reviewed to assess their sensitivity, and revised recommendations have been disseminated to health care providers. The percentage of children 6 years or younger screened in Florida who reside in Miami-Dade County increased from 4.1% in 1998 to 20.3% in 2002. Analysis and dissemination of blood lead surveillance data not only guide development of screening recommendations but also educate health care providers regarding the importance of childhood screening.

Refractive error study in children: results from La Florida, Chile

PURPOSE: To assess the prevalence of refractive errors and vision impairment in school-age children in a suburban area (La Florida) of Santiago, Chile. METHODS: Random selection of geographically defined clusters was used to identify a representative sample of children 5 to 15 years of age. Children in the 26 selected clusters were enumerated through a door-to-door survey and invited to report to a community health clinic for examination. Visual acuity measurements, cycloplegic retinoscopy, cycloplegic autorefraction, ocular motility evaluation, and examination of the external eye, anterior segment, media, and fundus were done from April through August 1998. Independent replicate examinations of all children with reduced vision and a sample of those with normal vision were done for quality assurance monitoring in six clusters. RESULTS: A total of 6,998 children from 3,830 households were enumerated, and 5,303 children (75.8%) were examined. The prevalence of uncorrected, presenting, and best visual acuity 0.50 (20/40) or worse in at least one eye was 15.8%, 14.7%, and 7.4%, respectively; 3.3% had best visual acuity 0.50 or worse in both eyes. Refractive error was the cause in 56.3% of the 1,285 eyes with reduced vision, amblyopia in 6.5%, other causes in 4.3%, with unexplained causes in the remaining 32.9%. Myopia −0.50 diopter or less in either eye was present in 3.4% of 5-year-old children, increasing to 19.4% in males and 14.7% in females by age 15. Over this same age range, hyperopia 2.00 diopters or greater decreased from 22.7% to 7.1% in males and from 26.3% to 8.9% in females. Females had a significantly higher risk of hyperopia than males. CONCLUSIONS: Refractive error, associated primarily with myopia, is a major cause of reduced vision in school-age children in La Florida. More than 7% of children could benefit from the provision of proper spectacles. Efforts are needed to make existing programs that provide free spectacles for school children more effective. Further studies are needed to determine whether the upward trend in myopia continues far beyond 15 years of age.

Cluster of five children with acute encephalopathy associated with cat-scratch disease in South Florida

Between August 12 and September 27, 1994, five children in South Florida were hospitalized at a single hospital because of encephalopathy, presenting as status epilepticus, associated with cat-scratch disease (CSD). Diagnoses were confirmed by using an indirect fluorescent antibody test to detect antibody to Bartonella henselae, the causative agent of CSD. These cases represent the first cluster of CSD encephalopathy cases to be recognized in the United States. The patients lived within 7 miles of each other and all reported contact with pet or stray cats before developing regional lymphadenopathy and encephalopathy. All recovered fully. A high proportion of 124 cats from the local area were seropositive (62%) or bacteremic (22%). This study suggests that B. henselae can be associated with geographically focal clusters of CSD encephalitis and should be considered in the evaluation of children with acute encephalopathy.

Lantana, or red sage (Lantana camara L., [Verbenaceae]), notorious weed and popular garden flower; some cases of poisoning in Florida

Lantana, or red sage (lantana camara, Verbenaceae) is an aromatic shrub with rough, opposite or whorled leaves and four-angled, prickly or smooth stems, showy heads of small flowers (usually pink-and-yellow changing to red-and-orange) and dark-blue or blackish fruits. Native from tropical America north to lower Texas and southern Georgia, the bird-distributed plant has become naturalized in the Caribbean area, the Pacific islands, Australia, New Zealand, South Africa and southern Asia. Hundreds of cultivars are grown as ornamentals in temperate climates. In warm regions, L. camara is a pest in farms, pastures and forests, providing breeding places for diseases, detrimental animals and insects, including the tsetse fly. Of 29 named races in Australia, 19 are toxic or gravely pestiferous. Active principles are the triterpenes lantadene A and B. Ingestion of 340-453 g of leaves causes liver and kidney damage, photosensitization, intestinal hemorrhage, paralysis of the gall bladder, and death in 1-4 days in horses, cattle and sheep (not goats). Ripe fruits are edible, but green, unripe fruits have caused illness and one known fatality in children in Florida. Leaves and roots are popular folk remedies. Stems are used as toothbrushes, and the leaves for polishing wood. Prickly races are grown as protective hedges around forest dwellings.

State and federal expenditures on medicaid eligible chronically ill children in rural Florida

This paper details public (State and Federal) expenditures for children's health care among Medicaid eligible chronically ill children resident in a rural setting. Of the cases. 78.5% had an expenditure in the study year with an average per capita total expenditure of $604. The mean total expenditure was considerably higher than the median total expenditure ($142), i.e. there was a relatively small proportion of high cost cases. Inpatient services accounted for 54.2% of total expenditures despite the fact that only 12% of the cases had been hospitalized. Wide variation in total expenditures, both within and among disease categories, was noted. By implication, while substantial savings might be realized from efforts directed at reducing health care costs for a small subset of the population, the identification of that subpopulation remains elusive.

Policy Support within a Target Group: The Case of School Desegregation

This study empirically tests three theoretical approaches to explaining specific support for a policy output among members of its target group. The utilitarian model posits support as a function of objective costs and benefits to the individual stemming directly from the policy. The attitudinal model relates specific support to diffuse predispositions rooted in socialization. The perceptual model holds that specific support derives from beliefs about the character of the political decision process by which the policy was formulated. Tests of these three approaches are based on survey data on specific support for school district desegregation plans among a large sample of black and white parents of public school children in Florida. In both subsamples, the utilitarian approach explained very little of the variance in support, but the attitudinal and perceptual models were corroborated. Implications of these findings are drawn for desegregation policy making and for public policy theory.

The Harris School Project-A Compensatory Program for Negro Migrant Children in Florida

Each year over 1,000,000 migratory agricultural workers come into Florida to harvest the winter fruit and vegetable crops. Of this group approximately 56 per cent are Negroes, 31 per cent are Spanish speaking Mexican-Americans or Puerto Ricans, 11 per cent are white, while 2 per cent come from other ethnic and national origins.1 Traditionally the children of these laborers have presented unique problems of assimilation in the schools, and until recently there has been scant opportunity for the migrant child in Florida to obtain a meaningful education. His family was constantly on the move and he was needed to contribute to the common weal; crew leaders and growers were willing to hire even young school-aged children. Moreover, the authorities in many areas were either unable or unwilling to enforce compulsory attendance laws. Even when the migrant child did attend the public school ihere was little there to entice him back. Ill-clothed, ill-fed, often in poor health, and invariably working below the grade level in which he was placed, the migrant child had little chance to experience academic success. He encountered a hostile world of middle-class learning

Aquatic and Marine Ecosystems

The new Florida 4-H Aquatic/Marine Ecosystems Leader’s Guide, is a part of the Environmental Education Framework, OUR NATURAL WORLD, This framework includes the basic premise that aquatic/marine environments are important in children’s lives, particularly to those children in Florida. The 4-H Aquatic/Marine Ecosystems program provides an opportunity for young people to practice a variety of life skills while learning subject matter.

Problems of Deprived and Wayward Children In Florida

Juvenile Court Judges JournalVolume 12, Issue 1 p. 9-10 Problems of Deprived and Wayward Children In Florida W. S. CRISWELL, W. S. CRISWELLSearch for more papers by this author W. S. CRISWELL, W. S. CRISWELLSearch for more papers by this author First published: March 1961 https://doi.org/10.1111/j.1755-6988.1961.tb00260.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume12, Issue1March 1961Pages 9-10 RelatedInformation