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At least 217 records · Page 12Linked to original sources
PubMed1993

Prevalence of Leptospira antibodies in white-tailed deer, Cades Cove, Great Smoky Mountains National Park, Tennessee, USA.

We conducted a study of the population dynamics, movement, and diseases of white-tailed deer (Odocoileus virginianus) in Cades Cove, Great Smoky Mountains National Park, Tennessee (USA) from 1980 to 1984. During the study 590 blood samples were collected from 518 deer, with some deer recaptured one or two times. The estimated percent of the herd sampled each year ranged from 8% to 28%. We also collected serum samples from 56 cattle pastured in Cades Cove. Deer and cattle sera were tested using the microagglutination test for the presence of antibody to the following serovars of Leptospira: pomona, hardjo, grippotyphosa, icterohemorrhagiae, and canicola. One hundred and six deer (21%) were seropositive for only one of the serovars. We found that 57 (11%) of the deer had antibodies to serovar hardjo, 33 (6%) were positive for antibodies to serovar pomona, 15 (3%) were positive for antibodies to serovar icterohemorrhagiae, and one deer had antibodies to serovar canicola. Age class and sex of deer were associated with antibody presence. Adult (> or = 1.5 yr) male deer were more likely to have antibodies than the other age class and sex groups (P = 0.001). In recaptured deer, similar titers were found in samples from one deer taken 807 days apart. Titer declined below the screening dilution level (1:250) after 37 days in one deer.

Age Factors↗
PubMed1995

State perspectives on health care reform: Oregon, Hawaii, Tennessee, and Rhode Island.

The general consensus among States which have had their section 1115 demonstration projects approved is that there is no one best way to implement State health care reform. The Health Care Financing Administration (HCFA), however, wished to discern how States were accomplishing the task of implementing the demonstrations, and solicited responses from State representatives whose section 1115 demonstration waivers had been approved. The resulting article gives an overview of this implementation process from four State perspectives. Written by representatives from Oregon, Hawaii, Tennessee, and Rhode Island, the ideas presented here are indicative of the complex undertaking of State health care reform.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1999

TennCare: Tennessee's answer to runaway Medicaid costs.

TennCare was implemented in Tennessee on January 1, 1994, as the state's replacement program for Medicaid. Created through a demonstration waiver under Section 1115(a) of the Social Security Act, TennCare is unlike any other state Medicaid program in the nation because it includes coverage of uninsured and uninsurable Tennesseans. By contracting with managed care organizations (MCOs) to administer the Medicaid benefit package to TennCare enrollees, the state virtually privatized the program and dramatically shifted the state's responsibility from one of total administration to an oversight function only. Amid provider lawsuits, MCO contract controversy, and general chaos surrounding the new program, the implementation of TennCare created one of the most significant health care events in the state's history. This article provides an overview of the TennCare program and its impact on enrollees, providers, and the state budget.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1999

Fatal privet (Ligustrum amurease) toxicosis in Tennessee cows.

Five of 24 cows pastured in a 40-acre field in east Tennessee died after they consumed leaves from a privet (Ligustrum amurease) hedge. Clinical findings included ataxia, recumbency with an inability to stand, depression, greenish nasal discharge, cessation of rumination, normal body temperature, and increased heart and respiratory rates. Differential diagnoses included grass tetany, nitrate toxicosis, and plant toxicosis. Privet toxicosis was confirmed by finding privet in ruminal contents, by the presence of a large quantity of privet in the field, by observing places where this privet had been eaten by the cows, by the immediate cessation of the problem when the cows were removed from the field, and by observing no recurrent problems after the privet was destroyed with a herbicide and the cows were returned to the field.

Animals↗
PubMed2000

Nontreatment variables affecting return-to-work in Tennessee-based employees with complaints of low back pain.

UNLABELLED: Disability and health care-related costs continue to rise as a result of work-related low back injury. Our investigation examined treatment-independent variables that influenced return-to-work outcome in a sample of workers employed in Northeast Tennessee. METHODS: The review collected 11 variables from two different outpatient physical therapy clinics utilizing a balanced quota sampling design. The patients were enrolled if the documented complaint was low back pain and was an employment-related injury. The patients were grouped according to whether or not they returned to full-time pre-injury work. Twenty-five patients were enrolled in the positive outcome group, those who returned to full-time pre-injury work. Twenty-two patients who did not achieve this goal were enrolled in a separate group. RESULTS: Return-to-work for these patients was not dependent upon age, gender, insurer, number of physical therapy treatments attended, or previously reported low back injury. Those who returned to work had (1) a higher percentage of patients working full-time at their pre-injury position during the rehabilitation process (28% vs. 0%); (2) a higher compliance with the treatment schedule (97% vs. 93%); (3) a lower cancellation rate (0.5 vs. 2.4); (4) a shorter interval in days between reporting the injury and initiation of physical therapy rehabilitation (27 vs. 58); and (5) a lower percentage of previous surgeries resulting from low back injuries (12% vs. 36%), than those who did not. A relationship was also demonstrated between previous surgery and the interval prior to beginning treatments (P < or = 0.0001). However, no relationship was observed between previous surgery and compliance, or between the interval prior to beginning treatments and compliance. DISCUSSION: These results document two variables representing independent factors affecting return-to-work in this population. The first was previous injury influencing the current injury, as documented by both previous surgery and the interval between the current injury and beginning of treatments. The second was compliance with the treatment schedule for the current injury. The psychosocioeconomic aspects of these results are discussed.

Adult↗
PubMed2000

Chrysomya rufifacies (Macquart) (Diptera: Calliphoridae) established in the vicinity of Knoxville, Tennessee, USA.

The hairy maggot blow fly, Chrsomya rufifacies (Macquart) (Diptera: Calliphoridae) was collected in large numbers as both adults and immatures in the Knoxville, Tennessee, area during 1998 and is likely established there. The distribution of this species in the Old World, isothermal data, and its collection from mid-Michigan during 1998 suggest that it will eventually occupy most of the U.S. The forensic importance of C. rufifacies makes it probable that it will factor into an increasing number of medicolegal cases, but the expanding distribution of this species decreases its utility as a geographic indicator when postmortem movement of decedents is suspected.

Animals↗
PubMed2000

Treatment of elderly women with urge incontinence in middle tennessee: a single institution practice-based study.

INTRODUCTION AND OBJECTIVES: Urinary urge incontinence (UUI) is a major factor in reducing quality of life in elderly women. The treatment of UUI in the elderly population is complicated by comorbidities, polypharmacy, cost, and side effects. The purpose of this study was to examine our practice pattern in Middle Tennessee for the treatment of elderly women with UUI. METHODS: We retrospectively reviewed the medical records of all women over age 65 seen at our institution between January 1, 1998 and September 1, 1999 with an initial complaint of pure UUI. Diagnosis was based on history and physical examination by a single urologist (JJF). Initial treatment in all patients was medication as well as timed and double voids. Medication chosen was based on cost factors, co-morbidities, current medications, and outcome from previous treatment. RESULTS: Of 53 women ranging in age from 65-87 years of age (avg. 74.7) included in this study, 6/53 (11.3%) had a previous CVA, and 2/53 (3.7%) had grade I-II cystoceles. Initial pharmacologic treatment included anticholinergic medication in 47 patients (88.6%), and either imipramine or topical estrogen alone in the remaining 11.4%. Of the anticholinergics, hyoscyamine time capsules were used in 29, tolterodine in 7, standard oxybutynin in 5, oxybutynin XL in 1, and a combination with imipramine in 5. Thirty-four of the 53 total patients (64.1%) discontinued their medications because of no improvement 14 (41.1%), dry mouth 9 (26.4%), other side effects 9 (26.4%), cost 1, and other reasons in the remaining 2 patients. Only 17 patients (32%) stated they were doing well on their initial medications; 11 of those (64.7%) were taking hyoscyamine time capsules. Upon subjective failure, 22/36 patients (61.1%) had their medications changed, while 14/36 (38.8%) pursued behavioral therapy without additional medications. Urodynamic studies were done in 12 patients who failed empiric medical treatment (22.6%). CONCLUSIONS: Only 32% of elderly women treated medically for UUI were satisfied and continued therapy in this patient population. One-fourth of elderly women failed empiric medical management of UUI due to lack of efficacy, and one-third due to intolerable side effects. In this practice, hyoscyamine was continued more often than any other anticholinergic because of reasonable cost, efficacy, and side effect profile.

Aged↗
PubMed2000

The effect of managed care penetration on hospital staffing in Tennessee, 1991--1995.

The author analyzed secondary data from Tennessee hospitals (1991-1995) to determine what effect, if any, managed health care plans had on hospital staffing. The results of the study, which incorporated multiple regression analysis, revealed an increase in the number of administrative hospital employees on average, with additional interesting effects on the skill-mix of nursing staff. The author believes that, overall, the increase in the number of registered nurses, together with the decrease in the number of licensed practical nurses, does not confirm notions that managed care would lead to a decrease in hospital skill-mix. Since a higher nursing skill-mix is associated with a lower inpatient mortality, managed care may contribute to an improvement in outcomes' quality of hospitals.

Bed Occupancy↗
PubMed1992

Human psittacosis linked to a bird distributor in Mississippi--Massachusetts and Tennessee, 1992.

During April-May 1992, CDC was notified of a possible outbreak of psittacosis involving members of two families in Massachusetts and Tennessee who had recently purchased birds as pets. In the subsequent investigation of this problem, human psittacosis was defined as a fourfold rise in complement-fixing antibody titer to > or = 32 or a single titer of > or = 32 in a patient with fever and/or respiratory symptoms. This report summarizes the investigation of this problem.

Adult↗
PubMed2004

Trichinellosis associated with bear meat--New York and Tennessee, 2003.

Trichinellosis is a parasitic infection caused by tissue-dwelling Trichinella roundworms and is associated traditionally with ingestion of pork from infected domestic swine. As a result of improvements in swine production, trichinellosis has declined steadily in the United States. However, infection also can result from eating the meat of wild animals. During 1997-2001, a total of 72 cases of trichinellosis (median: 12 cases annually; range: 11-23 cases) were reported to CDC; the majority of these infections were associated with eating wild game, predominantly bear. This report describes three cases of trichinellosis associated with eating undercooked bear meat reported from New York and Tennessee in 2003. To prevent trichinellosis, persons should cook meat, particularly wild game, to an internal temperature of 160 degrees F (71 degrees C).

Adult↗
PubMed2004

A power information user (PIU) model to promote information integration in Tennessee's public health community.

Observation and immersion in the user community are critical factors in designing and implementing informatics solutions; such practices ensure relevant interventions and promote user acceptance. Libraries can adapt these strategies to developing instruction and outreach. While needs assessment is typically a core facet of library instruction, sustained, iterative assessment underlying the development of user-centered instruction is key to integrating resource use into the workflow. This paper describes the Eskind Biomedical Library's (EBL's) recent work with the Tennessee public health community to articulate a training model centered around developing power information users (PIUs). PIUs are community-based individuals with an advanced understanding of information seeking and resource use and are committed to championing information integration. As model development was informed by observation of PIU workflow and information needs, it also allowed for informal testing of the applicability of assessment via domain immersion in library outreach. Though the number of PIUs involved in the project was small, evaluation indicated that the model was useful for promoting information use in PIU workgroups and that the concept of domain immersion was relevant to library-related projects. Moreover, EBL continues to employ principles of domain understanding inherent in the PIU model to develop further interventions for the public health community and library users.

Access to Information↗
PubMed2004

Literacy, medical care, and health status in Tennessee.

Based on the most recent information, Tennessee is facing an enormous problem with literacy and health outcomes. As a result, the healthcare industry is vulnerable because of patients' inability to understand and follow a plan of treatment. This in part has resulted in poor healthcare and increased costs in providing care. By implementing strategies such as those outlined in Table 1, strides can be made in improving the healthcare provided to Tennesseans and reducing costs associated.

Educational Status↗
PubMed2004

One year's experience with virtual reality preclinical laboratory simulation at the University of Tennessee.

Virtual reality-based preclinical simulation learning is a new teaching modality with significant potential. The University of Tennessee Health Science Center, College of Dentistry has completed its first year of student experience using 40 DentSim simulators, in conjunction with an 80-unit traditional simulation laboratory. This article describes this experience and relates both the positive and negative aspects as they impacted on the students, staff and school. The purpose of the article is to relay information pertinent to this new educational modality to other educational institutes interested in pursuing virtual reality dental simulation. The results of the first-year experience were encouraging, although certain areas proved problematic and frustrating for both students and staff.

Calibration↗
PubMed2005

Does carcass enrichment alter community structure of predaceous and parasitic arthropods? A second test of the arthropod saturation hypothesis at the Anthropology Research Facility in Knoxville, Tennessee.

In a second test of an arthropod saturation hypothesis, we analyzed if the on-campus Anthropology Research Facility (ARF) at the University of Tennessee, Knoxville, with its 20+ yr history of carcass enrichment, is comparable to non-enriched sites in community structure of predatory and parasitic arthropods that prey upon the sarcosaprophagous fauna. Over a 12-day period in June 1998, using pitfall traps and sweep nets, 10,065 predaceous, parasitic, and hematophagous (blood-feeding) arthropods were collected from freshly euthanized pigs (Sus scrofa L.) placed at ARF and at three surrounding sites various distances away (S2-S4). The community structure of these organisms was comparable in most paired-site tests with respect to species composition, colonization rates, and evenness of pitfall-trap abundances on a per carcass basis. Site differences were found in rarefaction tests of both sweep-net and pitfall-trap taxa and in tests of taxonomic evenness and ranked abundances of sweep-net samples. Despite these differences, no evidence was found that the predatory/parasitic fauna at ARF was impoverished with fewer but larger populations as a result of carcass enrichment. Comparison of the sarcosaprophagous and predatory/parasitic faunas revealed a tighter (and more predictable) linkage between carrion feeders (sarcosaprovores) and their carrion than between carrion feeders and their natural enemies (predators and parasitoids), leading us to conclude that ARF is more representative of surrounding sites with respect to the sarcosaprovore component than to the predatory/parasitic component within the larger carrion-arthropod community.

Animals↗
PubMed2005

Empowering factors for regular mammography screening in under-served populations: pilot survey results in Tennessee.

BACKGROUND: Mammography screening can reduce breast cancer burden, however it continues to be underutilized by low-income women even though their health insurance provides free mammograms. While a vast majority of eligible women in Tennessee do not receive the free mammograms available to them, 25% of women with comparable backgrounds do. OBJECTIVE: To describe the influences that may have led these women to adhere to mammography screening guidelines in order to develop a case-control study for further research. DESIGN: Healthcare workers conducted personal interviews on mammography knowledge, attitudes, and behaviors. SETTING: In-home. PARTICIPANTS: All were members of the Managed Care Organization Access MedPlus with incomes <200% above poverty. All were adherent to mammography guidelines per medical records. Fifty-eight respondents were Black, 27 were White, and all were at least 40 years old. RESULTS: Participants recognized breast cancer risk factors, warning signs, and the importance of early detection to survival. 75% reported a family history of any cancer type, 77% knew someone who had breast cancer, and 52% knew someone who had died from it. These women expressed that screening strongly reassured them. Willing to work with their doctors, they trust the health system's ability to treat breast cancer and are generally satisfied with their health care. CONCLUSIONS: Repeat regular mammography screening is positively associated with higher knowledge about risk factors, warning signs, screening, and treatment. Trust in the healthcare system, ability to work with physicians, and support by family and friends lead low-income, adhering women to be proactive in seeking mammography screenings.

Adult↗
PubMed2006

A survey of Spanish language services among L&D units in Southeast Tennessee and North Georgia.

Over the past few years, we have noticed in our obstetrics residency program at Erlanger Hospital in Chattanooga that Hispanic women delivered by our service have become the majority of patients in our care. While the Hispanic population in Tennessee made up only 2.2 percent of the total state population in 2000, certain regions have seen large increases in immigrant population and Latina women accounted for 30 percent of our deliveries at the Baroness Erlanger Campus in 2003. Specifically, the number of women who speak little-to-no English has risen dramatically, forcing the hospital and all employees to expand efforts to communicate with patients in Spanish.

Communication↗
PubMed2005

More than 56,000 children with disabilities in Tennessee.

Since 1990, Tennessee has been ranked among the states with a series of health and social difficulties. In addition, there are more than 56,000 children with disabilities in the state. In an effort to personalize these findings, the numbers of children with disabilities are presented by city, metropolitan area, county, and congressional districts. There are numerous difficulties associated with the delivery of dental care to these children with special needs. If all dentists were willing to help, however, each practitioner would need to care for twenty of these youngsters.

Adolescent↗
PubMedDate not supplied

Perioperative antimicrobial prophylaxis in middle Tennessee, 1989-1990.

The patterns of use of perioperative antimicrobial prophylaxis were assessed in a randomly selected sample of short-stay hospitals in middle Tennessee. Overall, 438 procedures (48%) were associated with antimicrobial prophylaxis. Prophylaxis was more common in hospitals with more than 400 beds than in smaller hospitals. Moreover, prophylactic antibiotics were given more often for procedures with a proven indication for prophylaxis than for those without a proven indication (60% vs. 41%, P less than .05); this relationship remained constant regardless of hospital size (common odds ratio, 2.09). However, prophylaxis for procedures with a proven indication was more likely to be given in teaching hospitals than in nonteaching hospitals (odds ratios, 5.41 vs. 1.94). The duration of prophylaxis was less than 2 days for 89% of procedures. A wide variety of agents were used. This study suggests that while improvements have been made over the past decade in decisions about the duration of prophylaxis, considerable variation remains in the selection of the procedures in which such treatment is administered and of the antimicrobial agents used.

Anti-Infective Agents↗