West Palm Beach Research Articles

Incorporating the effect of urbanization in measuring climate adaptive capacity

Measuring the ability of a community to face climatic changes, or its adaptive capacity, is necessary in order to plan and guide development as the global climate continues to warm. One factor that has not been thoroughly addressed by previous attempts at measuring adaptive capacity is urbanization. This study looks to measure adaptive capacity in relation to urbanization, as many areas of the world are undergoing this rapid transition. An indicator system was created with land-use sensitive measures and applied to three different land use projection scenarios (A, BAU, and B − high, medium, and low growth, respectively) to 2030 and 2050 for two case study areas, Tamsui, Taiwan and West Palm Beach, USA. In Tamsui, the adaptive capacity decreased in all scenarios, but most dramatically for the high growth scenario. The low growth scenario decreased more slowly through each time slice. For West Palm Beach, the high growth scenario had the highest score in 2030, but declined in 2050. The medium growth Scenario BAU, also had a higher adaptive capacity score in 2030 than in 2050. The low growth Scenario B had a score that improved less dramatically but continued to rise through 2050. Scenario A would be ideal for short term gains, but its benefits would plateau in the long term. Scenario B, with conservation measures and more restricted growth would be the most ideal alternative. This study shows that urbanization has short term socioeconomic gains, but long term environmental consequences. The results also successfully incorporates the effect of land use change into an adaptive capacity indicator system, and can be applied in other localities expecting significant increases in urbanization.

Preface to COAST 2016 innovators' workshop on personalized and precision orthodontic therapy.

A second focused workshop explored how to transfer novel findings into clinical orthodontic practice. Participants met in West Palm Beach (Florida, USA), on 9-11 September 2016 for the Consortium for Orthodontic Advances in Science and Technology 2016 Innovators' Workshop (COAST). Approximately 65 registered attendees considered and discussed information from 27 to 34 speakers, 8 to 15 poster presenters and four lunch-hour focus group leaders. The innovators' workshops were organized according to five themed sessions. The aims of the discussion sessions were to identify the following: i) the strength and impact of the evidenced-based discoveries, ii) required steps to enable further development and iii) required steps to translate these new discoveries into orthodontic practice. The role of gene-environment interactions that underlie complex craniofacial traits was the focus of several sessions. It was agreed that diverse approaches are called for, such as (i) large-scale collaborative efforts for future genetic studies of complex traits; (ii) deep genome sequencing to address the issues of isolated mutations; (iii) quantifying epigenetic-environmental variables in diverse areas myofascial pain, alveolar remodelling and mandibular growth. Common needs identified from the themed sessions were multiscale/multispecies modelling and experimentation using controlled and quantified mechanics and translation of the findings in bone biology between species. Panel discussions led to the consensus that a consortium approach to establish standards for intra-oral scanning and 3D imaging should be initiated. Current and emerging technologies still require supported research to translate new findings from the laboratory to orthodontic practice.

Does a Doctorate of Nursing Practice Make a Difference in Patient Care?

Does a Doctorate of Nursing Practice Make a Difference in Patient Care?

Negative Biopsies with Rising Prostate-Specific Antigen. What to Do?

Introduction: Prostate-specific antigen (PSA) is the main tool of detection for prostate cancer (PCa). However, PSA has limited specificity and sensitivity in determining the presence of PCa, leading to unnecessary biopsies and the diagnosis of potentially indolent PCa. The aim of this article is to review the tools available to urologists in the clinical situation of rising PSA with prior negative biopsies. Evidence synthesis: The need for prostate biopsy is based on PSA level and/or a suspicious digital rectal examination. Ultrasound-guided biopsy is the current gold standard. The incidence of PCa detected by saturation repeat biopsy is 30–43%. Prostate health indes, prostate cancer antigen 3, and 4Kscore are available second-line tests to distinguish between malignant and benign prostate conditions, reducing the number of unnecessary biopsies. Molecular testing including ConfirmMDx (MDxHealth, Irvine, California, USA) and The Prostate Core Mitomic Test™ (PCMT) (MDNA Life Sciences, West Palm Beach, Florida, USA) are tissue tests for men with prior negative biopsy. Multiparametric magnetic resonance imaging (mpMRI) is used for lesion identification and subsequently for biopsy or treatment. In the setting of suspected PCa, the use of prostate mpMRI has shown to have a negative predictive value for clinically significant PCa of 80–96%. Conclusions: Approximately 70% of patients undergoing prostate examination will have a negative result following analysis of the biopsy sample. This negative diagnosis leads to the common clinical challenge of determining when and if a repeat biopsy should be performed. New blood, urine, tissue, and imaging tools are now available to guide this decision.

Proactive Condition Assessment and Rehabilitation Program Saves A Critical 48-Inch Pccp Force Main in West Palm Beach

Proactive Condition Assessment and Rehabilitation Program Saves A Critical 48-Inch Pccp Force Main in West Palm Beach

Integration of a Clinical Pharmacist into an Interdisciplinary Palliative Care Outpatient Clinic

The primary objective of this quality improvement (QI) project was to determine if the Interdisciplinary Palliative Care Outpatient Clinic (IPCOC) at the West Palm Beach Veterans Affairs Medical Center offered improved symptom assessment and palliative care treatment outcomes. Secondary objectives were to identify, classify, and resolve medication problems and calculate the number of pharmacist recommendations accepted by prescribing providers. An IPCOC was created by selecting disciplines for a core group including a nurse practitioner, clinical pharmacist, social worker, chaplain, and physician. Consult referrals were recruited by providing educational sessions. The patient assessments were completed using the Edmonton Symptom Assessment System: (revised version; ESAS-R). The clinical pharmacist classified and resolved drug-related problems. The pharmacy resident telephoned veterans for completion of the "Patient Assessment: Overall Satisfaction with Outpatient Palliative Care Clinic." Seventeen consults were received, 6 patients were excluded, and 11 were seen in clinic. One (9%) of 11 patients met the outcomes measure of system assessment documentation in the past year. At completion, 11 (100%) of 11 patients met the outcomes data measure. The Patient Satisfaction Assessment revealed veterans strongly agree to recommend the IPCOC. The clinical pharmacist identified 20 drug-related problems, made 16 recommendations, had a 93.7% implementation rate, and facilitated implementation of medication changes. This QI project demonstrates that an IPCOC improved symptom assessment and palliative care outcomes in addition to resolution of medication prescribing issues in veterans with advanced cancer by integration of a clinical pharmacist into the core team.

West Palm Beach Waterworks: A Unique Blend of Old and New

Steeped in history yet offering the latest technologies and sustainable features, West Palm Beach Waterworks is proud of its past and what it offers its customers, today and into the future.

Combining genetic and distributional approaches to sourcing introduced species: a case study on the Nile monitor (Varanus niloticus) in Florida

Three separate breeding populations of the Nile monitor (Varanus niloticus) have been identified in Florida, USA, located in Cape Coral, West Palm Beach and Homestead Air Reserve Base. This large, predatory lizard could have negative effects on Florida's native wildlife. Here, we infer the source of the introduced populations using genetic and statistical approaches, as well as estimate the potential non-native distribution of V. niloticus in North America. We collected genetic data from 25 Florida individuals as well as utilized genetic datasets from reference individuals spanning the full native distribution throughout sub-Saharan Africa. Using occurrence data from the inferred source population and the full species range, we built ecological niche models (ENMs) and projected them onto North America to determine regions with suitable climate. Our results indicated that the introduced populations resulted from three separate introduction events, and all originated from the southern coastal region of West Africa. The ENM built from the West African source population predicted only the southernmost portions of North America to be suitable. Conversely, the model derived from the full species’ range predicted suitable climates across a large portion of the United States. This information can be used to focus management and eradication efforts.

Insights into the Introduction History and Population Genetic Dynamics of the Nile Monitor (Varanus niloticus) in Florida.

Invasive species are widely recognized as important drivers of the ongoing biodiversity crisis. The US state of Florida is especially susceptible to the proliferation of invasive reptiles, and nonnative lizards currently outnumber native lizard species. At present, there are 3 documented breeding populations of the Nile monitor (Varanus niloticus) in different regions of Southern Florida, and these populations are considered potential dangers to threatened, fossorial endemics, such as burrowing owls, American crocodiles, and gopher tortoises. Nevertheless, at present, both the introduction histories of these populations and the degree to which they are connected by gene flow are not known. To address these issues, we genotyped V. niloticus from Cape Coral, Homestead Air Reserve Base, and West Palm Beach at 17 microsatellite loci and conducted a variety of analyses to assess both intrapopulation genetic diversity, the degree of gene flow between populations, and the most likely introduction scenario. The results of our analyses demonstrate that all 3 populations have limited genetic diversity (mean number of effective alleles across loci in all 3 populations ~ 2.00) and are highly differentiated from one another (G ST = 0.268; G″ST = 0.628). Our results also suggest that these populations resulted from independent introduction events that occurred within the past few decades. Consequently, we advise that wildlife managers focus management efforts on containment of existing populations and intensification of monitoring efforts on potential migration corridors.

Characterization of 17 novel microsatellite loci in the Nile monitor (Varanus niloticus) via 454 pyrosequencing

We used 454 pyrosequencing to characterize 17 novel microsatellite loci from the Nile monitor (Varanus niloticus), using samples from an invasive population in the US state of Florida. These markers were screened for variation in 40 individuals from the City of Cape Coral. Observed heterozygosity ranged from 0.18 to 0.73 (mean ± SE = 0.46 ± 0.06) and the number of alleles per locus ranged from 1 to 4 (mean ± SE = 2.5 ± 0.2). Preliminary genotyping of samples from populations in West Palm Beach and Homestead revealed two loci (Mon6andMon15) that are monomorphic in Cape Coral, but polymorphic in these other two populations. We found no statistical departures from Hardy-Weinberg equilibrium or evidence of null alleles. However, there was statistical evidence for genotypic disequilibrium betweenMon1-Mon14andMon3-Mon8. BLASTn searches of NCBI’s nr/nt database identified four microsatellites containing 454 fragments that exhibit substantial sequence similarity to loci in other reptilian genomes, suggesting these markers should be prioritized by researchers interested in cross-amplification in other varanids. The resources we have developed will enable investigations of the population genetic dynamics of invasive Nile monitors in Florida and may facilitate studies within this species native range.

Eye-spy wealth: cultural capital and ‘knowing luxury’ in the identification of and engagement with the superrich

Drawing upon a wider ethnographic study of superrich lifestyle mobilities, I reflect upon my experiences of working as an assistant within a yacht brokerage during a superyacht sales show in West Palm Beach, Florida. Specifically, I examine the role of dress and appearance in guiding (and at times misguiding) my identification of potential superrich clients during the yacht show. In turn I outline the four-step process utilized by yacht brokers both to qualify the wealth status of a potential client and to successfully engage with legitimate clients. In doing so, I reflect upon some of the constraints of conducting an empirical study of the superrich, including the need to demonstrate sufficient cultural capital of luxury leisure practices and material goods.

Appreciating migration flows for health/social services planning: A case study of older adults leaving from New York to Florida

This paper utilizes the 2009/2010/2011 American Community Survey to examine spatial patterns of later-life relocation from the state of New York into Florida. Given that the first-wave of the Baby Boom generation reached the retirement age of 65 years in January 2011 and many more will continue to do so, examining the mobility/subsequent residential choices of this group is a worthwhile undertaking. This research paper is also a noteworthy contribution because it offers an interdisciplinary study of spatial statistics and population geography. Exploratory spatial analysis and multinomial regressions suggest older adults from New York leave select origins, such as Capital District, Mid-Hudson, and Lower Hudson. In addition, these older adults select preferred destinations in Florida, such as Fort Myers, Fort Pierce–Stuart, and West Palm Beach. This finding can inform planners, policy analysts, and social workers about how to best address issues related to health and community services since not all older adult migrants seeking coastal and recreational areas in Florida maintain greater wealth and better health.

Application of inverse path distance weighting for high-density spatial mapping of coastal water quality patterns

One of the primary goals of coastal water quality monitoring is to characterize spatial variation. Generally, this monitoring takes place at a limited number of fixed sampling points. The alternative sampling methodology explored in this paper involves high-density sampling from an on-board flow-through water analysis system (Dataflow). Dataflow (West Palm Beach, FL, USA) has the potential to provide better spatial resolution of water quality features because it generates many closely spaced (<10 m) measurements. Regardless of the measurement technique, parameter values at unsampled locations must be interpolated from nearby measurement points in order to generate a comprehensive picture of spatial variations. Standard Euclidean interpolations in coastal settings tend to yield inaccurate results because they extend through barriers in the landscape such as peninsulas, islands, and submerged banks. We recently developed a method for non-Euclidean interpolation by inverse path distance weighting (IPDW) in order to account for these barriers. The algorithms were implemented as part of an R package and made available from R repositories. The combination of IPDW with Dataflow provided more accurate estimates of salinity patterning relative to Euclidean inverse distance weighting (IDW). IPDW was notably more accurate than IDW in the presence of intense spatial gradients.

Re-implementation of a pharmacist-managed metabolic syndrome clinic in an outpatient mental health clinic setting

Introduction: Second-generation antipsychotics (SGA) are often prescribed prior to first-generation antipsychotics (FGA) for mental health disorders by reason of proposed improved tolerability. Patients on SGA are not always appropriately screened for metabolic parameters in the clinical setting. A metabolic clinic was previously established for a limited time period at the West Palm Beach Veterans Affairs Medical Center (WPB VAMC) with beneficial outcomes. Re-implementation expanded the clinic to assess the impact when patients were referred from outpatient mental health and primary care providers. The objectives of this quality improvement initiative were to evaluate pharmacologic and nonpharmacologic interventions and compare the patient load preexpansion and postexpansion of the metabolic clinic. Methods: Patients receiving SGA at the WPB VAMC who met the criteria for metabolic syndrome were referred to the metabolic clinic. Preclinic data variables collected include demographics, social history, SGA, and assessment for presence of hypertension, diabetes, or dyslipidemia. Pharmacologic and nonpharmacologic intervention variables were collected throughout clinic involvement. The patient load post clinic expansion was reported. Results: Of the 17 patients evaluated, 88.2% had hypertension, 94.1% had dyslipidemia, and 88.2% had diabetes mellitus. The average number of components of metabolic syndrome was 3.7 out of 5 possible components. Most patients were taking risperidone (47.1%). An average of 1.5 medication interventions were made per patient. Only 28 patients were referred during reimplementation phase. Discussion: Metabolic syndrome commonly occurs in patients receiving SGA. Appropriately trained clinical pharmacists can help fill a gap in care by providing the recommended monitoring criteria and interventions for patients taking SGA.

Fisher Earns Distinguished STEM Educator Award: Volunteering with IEEE helps balance life [Pipelining: Attractive Programs for Women

During Engineers Week (Eweek), The Engineers' Council presented its annual Distinguished STEM Educator Award to highlight the most outstanding contributor helping raise awareness about technological literacy and interest in an engineering career. This year's winner, awarded in West Palm Beach, Florida, in February, was IEEE Member Dusty Fisher.

Validated age, growth and maturity of the bonnethead Sphyrna tiburo in the western North Atlantic Ocean.

The age, growth and maturity of bonnetheads Sphyrna tiburo inhabiting the estuarine and coastal waters of the western North Atlantic Ocean (WNA) from Onslow Bay, North Carolina, south to West Palm Beach, Florida, were examined. Vertebrae were collected and aged from 329 females and 217 males ranging in size from 262 to 1043 mm and 245 to 825 mm fork length, LF , respectively. Sex-specific von Bertalanffy growth curves were fitted to length-at-age data. Female von Bertalanffy parameters were L∞ = 1036 mm LF , k = 0·18, t0 = -1·64 and L0 = 272 mm LF . Males reached a smaller theoretical asymptotic length and had a higher growth coefficient (L∞ = 782 mm LF , k = 0·29, t0 = -1·43 and L0 = 266 mm LF ). Maximum observed age was 17·9 years for females and 16·0 years for males. Annual deposition of growth increments was verified by marginal increment analysis and validated for age classes 2·5+ to 10·5+ years through recapture of 13 oxytetracycline-injected specimens at liberty in the wild for 1-4 years. Length (LF50 ) and age (A50 ) at 50% maturity were 819 mm and 6·7 years for females, and 618 mm and 3·9 years for males. Both female and male S. tiburo in the WNA had a significantly higher maximum observed age, LF50 , A50 and L∞ , and a significantly lower k and estimated L0 than evident in the Gulf of Mexico (GOM). These significant differences in life-history parameters, as well as evidence from tagging and genetic studies, suggest that S. tiburo in the WNA and GOM should be considered separate stocks.

Reducing Smoking Risks While Honoring Residents' Choices

Reducing Smoking Risks While Honoring Residents' Choices

One to One honors pharmacists, student pharmacists for exceptional counseling

One to One honors pharmacists, student pharmacists for exceptional counseling

One to One honors pharmacists, student pharmacists for exceptional counseling

The One to One Patient Counseling Recognition Program, now in its 11th year, acknowledges the inspiring efforts of 20 pharmacists and five student pharmacists committed to providing outstanding patient care. Pharmacy Today and Student Pharmacist honor these individuals for going to great lengths to keep their patients and their communities well.

Beyond Superwomen: Justice for Black Women Too

On June 18, 2007, Tommy Poindexter coaxed a woman out of her apartment in West Palm Beach, Florida by telling her that her car had a flat. Then he and nine other young blackmen forced her back into her home in the Dunbar Village public housing community, where they not only robbed her but engaged in three hours of rape, beatings, and torture. The female victim, a Haitian immigrant, was raped vaginally, orally, and anally, sometimes with bottles or a firearm, while they beat her twelve-year-old son in another room. In an effort to cover up their crimes, they told both the woman and her son to clean off and then forced the mother and son to have sex with each other. Finally, the assailants poured alcohol into the woman’s anus, ammonia on both her and her son’s eyes, stuffed a bar of soap into the woman’s vagina, and tried to light the mother and child on fire as they lay naked in a bathtub.