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Radon-222 and progeny measurements in "typical" East Tennessee residences.

Modified Wrenn chambers for continuous monitoring of 222Rn, featuring several improvements including a computer-assisted electronics package, have been developed at the Oak Ridge National Laboratory. A field test of these instruments was conducted by placing them in the homes of staff members. Field testing was conducted in seven houses for periods ranging from 4 to 18 days. During this testing period, the 222Rn concentration in these houses was monitored continuously. Radon-222 concentrations in the basements of three of the seven houses were in excess of 100 Bq/m3 almost continuously. One residence had instantaneous concentrations approaching 1000 Bq/m3. Samples of soil and building materials from these residences indicated that 226Ra concentrations were in the normal range (40 Bq/kg). Radon progeny measurements were made in five of these houses on a "typical" day. Results obtained were as follows: for basements, a geometric mean of 0.016 WL (geometric S.D. of 2.9); for upper floors a geometric mean of 0.014 WL (geometric S.D. of 2.9). This paper summarizes the results obtained in the field test.

Air Pollutants, Radioactive↗

Geographic clustering of obesity, diabetes, and hypertension in Nashville, Tennessee.

To better understand how neighborhood environments contribute to health outcomes by encouraging or discouraging healthy lifestyles, we studied the clustering of health outcomes, health behaviors, and environmental characteristics in Nashville, Tenn. Data from 2 large telephone surveys (N = 7606) were geocoded and linked to the long-form census data at the census-tract level. Cluster analysis was used to create 12 scales that measured neighborhood characteristics using census variables. A geographic information system was used to map patterns of health, health behavior, and neighborhood characteristics at the census-tract level. Pearson correlations across the 129 census tracts were in the 0.20 to 0.60 range and provided evidence for spatial clustering of health outcomes, health behaviors, and neighborhood characteristics.

Black or African American↗

Clinical efficacy of temporal artery biopsy in Nashville, Tennessee.

A retrospective study of temporal artery biopsies done over one decade in four Nashville hospitals yielded 412 procedures on 394 patients. Diagnosis was obtained in 17%, and the procedure was helpful in 21% of patients. Only two complications were recorded. There was no correlation between length of biopsy specimen and diagnostic yield. The Nashville experience with temporal artery biopsy is probably representative. Some refinement of procedure application appears necessary.

Adult↗

Emergence of community-associated methicillin-resistant Staphylococcus aureus at a Memphis, Tennessee Children's Hospital.

BACKGROUND: An epidemiologic investigation was performed because of a perceived increase in infections caused by community-associated methicillin-resistant Staphylococcus aureus (MRSA) among children in the greater Memphis area. METHODS: We reviewed medical records of 289 children evaluated from January 2000 to June 2002 at a children's hospital. Clinical criteria were applied to classify MRSA isolates as community-associated (n=51) or health care-associated (n=138). The relatedness of 33 archived S. aureus isolates was evaluated using pulsed field gel electrophoresis (PFGE) of Sma I-digested genomic DNA; a common pulsed field type was defined as > or = 80 % similarity based on Dice coefficients. PFGE profiles were compared with those in a national database of MRSA isolates. RESULTS: During the first 18 study months, 46 of 122 MRSA isolates (38%) were community-associated; this proportion increased to 106 of 167 isolates (63%) during the last 12 study months (P <.0001). Community-associated isolates were recovered from normally sterile sites as frequently as were health care-associated isolates (16% versus 13%). PFGE revealed that 15 of 16 community-associated isolates shared a common pulsed field type (USA300) observed in community-associated MRSA infections elsewhere in the United States and characterized by staphylococcal cassette chromosome mec type IV, clindamycin susceptibility and erythromycin resistance mediated by an msr A-encoded macrolide efflux pump. CONCLUSIONS: Community-associated MRSA has emerged as a potentially invasive pathogen among children in the greater Memphis area, and this phenomenon is not explained by spread of nosocomial strains into the community.

Child↗

Racial differences in child safety restraint use in Tennessee.

OBJECTIVES: To evaluate the appropriate use of child safety restraints (CSR) in black and white children. DESIGN: Cross sectional, observational study of drivers of children age 0-10 years involving an on-site vehicle and CSR inspection and brief driver interview. RESULTS: Data were obtained on 244 white and 204 black children; results were stratified by race due to effect modification of race on driver restraint use and CSR use. Twenty four percent of black and 13% of white child passengers aged 4-10 years were completely unrestrained (p=0.003). Of the 168 black and 220 white child passengers aged 0-10 years who were restrained, 64% of black and 58% of white children had inappropriate restraint use. Appropriate CSR use was significantly lower in 4-8 year old passengers compared with appropriately restrained children aged <4 years and 9-10 years (p<0.0001 for both black and white child passengers). CONCLUSIONS: Black child passengers and all child passengers aged 4-8 years are at increased risk of being inappropriately restrained. Educational efforts should address specific barriers to booster seat use in these populations.

Automobile Driving↗