Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “TENNESSEE”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 37 records · Page 2Linked to original sources
PubMed2003

Substance abuse treatment effectiveness of publicly funded clients in Tennessee.

The Tennessee Outcomes for Alcohol and Drug Services (TOADS) in collaboration with the Bureau of Alcohol and Drug Abuse Services at the Tennessee Department of Health evaluated the effectiveness of publicly funded substance abuse treatment programs in Tennessee by collecting and analyzing data from clients treated between 1998 and 2000. Using a structured questionnaire, TOADS staff conducted telephone interviews with clients 6 months after their admission to treatment facilities. The sample populations for these follow-up interviews ranged from 1,150 to 1,350 clients over the 3 years, and each year, post-treatment abstinence rates were around 60%, which suggests that treatment in Tennessee has been successful in reducing substance abuse. In addition, the follow-up interview data suggest that treatment also helped drastically reduce both unemployment and arrests among clients. These findings in Tennessee are comparable to treatment outcomes in other states. In addition to the positive effects that treatment has on clients, treatment is also cost-effective for state budgets since treatment reduces many of the burdens substance abuse places on the criminal justice system, the healthcare system, and other state-supported services.

Adolescent↗
PubMed1997

The fleas (Siphonaptera) of Tennessee.

Thirty-three species of fleas are recorded from the state of Tennessee. New state records are reported for two species, the pulicid fleas Euhoplopsyllus glacialis affinis and Pulex simulans. Two species of fleas with catholic feeding habits appear to be especially widespread and abundant in Tennessee. These are the pulicid Ctenocephalides felis which parasitizes cats, dogs, humans, opossums, and other medium to large sized mammals, and the hystrichopsyllid Ctenophthalmus pseudagyrtes which is associated with several species of small mammals, particularly shrews, moles, voles, and native mice. For a southeastern state, Tennessee has a relatively rich flea fauna. The figure of 33 flea species recorded here for Tennessee is higher than documented figures for other southeastern states (17 species for Alabama, 19 for Florida, 20 for Georgia, 12 for Mississippi, 18 for North Carolina, 19 for South Carolina). This is largely because several species with boreal origins inhabit the higher elevations characteristic of the Appalachian Mountains in the eastern part of the state. Although plague is not enzootic as far east as Tennessee, and murine typhus is rare of absent, suitable flea vectors inhabit the state and one abundant flea species, C. felis, is a pest because it feeds on companion animals and humans.

Animals↗
PubMed1997

New use of anticonvulsant medications among children enrolled in the Tennessee Medicaid Program.

OBJECTIVE: To describe the new use of anticonvulsant medications among children enrolled in the Tennessee Medicaid program. DESIGN: A retrospective cohort study. PATIENTS: New users of anticonvulsant medications in 1992 were identified from the 206,098 children (aged 0-18 years) enrolled continuously for 12 months in the Aid to Families With Dependent Children program or foster care program of Tennessee Medicaid. MAIN OUTCOME MEASURES: New users were categorized according to the diagnosis codes of health care encounters occurring 90 days before to 90 days after the first anticonvulsant prescription was filled as having diagnoses consistent with (1) epilepsy or convulsions, (2) neonatal seizures, (3) central nervous system disease, (4) no epilepsy diagnoses but diagnoses for which anticonvulsants might appropriately be used (jaundice, headaches, or psychiatric disorders), or (5) no diagnoses for which an anticonvulsant might appropriately be used. The children in each group were described according to sociodemographic variables, with logistic regression used to analyze variations in the subsequent filling of anticonvulsant prescriptions. RESULTS: Of 647 children continuously enrolled in the Tennessee Medicaid program who were new anticonvulsant users in 1992, 58% had at least 1 health care encounter coded as epilepsy or convulsions, 2% had a diagnosis of neonatal seizures, 8% had central nervous system diagnoses, 16% had specific nonepilepsy diagnoses (jaundice, headache, or psychiatric diagnoses), and 16% had no diagnoses for which anticonvulsants might appropriately be prescribed. For children with epilepsy diagnoses, white race (P = .002) and undergoing tests (P < .001) were independent predictors of a child filling 6 or more prescriptions in the year following the first prescription CONCLUSIONS: A large proportion of new users of anticonvulsants among children enrolled in the Tennessee Medicaid program received these medications for indications other than epilepsy. For children with epilepsy diagnoses, there was considerable variation in the subsequent filling of prescriptions. Further analysis of these variations in practice will allow for the development of policies that will maximize benefit for children who need anticonvulsant therapy, while diminishing unnecessary exposure to potentially toxic drugs for children who do not.

Adolescent↗
PubMed1997

Robertsonian chromosomal rearrangements in the short-tailed shrew, Blarina carolinensis, in western Tennessee.

We report significant heterozygosity for numerous Robertsonian translocations in the southern short-tailed shrew (Blarina carolinensis) in western Tennessee. Eight Robertsonian rearrangements were documented using G-banding techniques that explain the variability in diploid numbers from 46 throughout most of the range of the species to 34-40 in western Tennessee. These fusions resulted in the loss of telomere sequences and were not associated with nucleolar organizer regions. When heterozygocity is considered, the lowest diploid number possibly present would be 30. Four localities with distances of over 180 km apart were sampled, and 80-90% of the collected animals were heterozygous for at least one rearrangement. No putative parental type was found in western Tennessee. Heterozygosity for the same rearrangements was found in these different localities, and no monobrachial fusions were noted. Thus, this is a very wide hybrid zone with rare or absent parental types in the areas sampled or is an evolutionary stage preceding establishment of Robertsonian races. Selective forces, if any, were minimal, as evidenced by the wide area of polymorphism, significant heterozygosity, and the fact that the Robertsonian translocations were in Hardy-Weinberg equilibrium. The origin of such extensive polymorphism in western Tennessee is discussed, especially in light of putative effects of the New Madrid seismic activity. Similarities and differences are noted between the Blarina model and the well-documented variation in the European common shrew (Sorex araneus) and Mus musculus groups.

Animals↗
PubMed1981

The Tennessee child restraint law in its third year.

Observations of child travel were made in Knoxville and Nashville, Tennessee, and Lexington and Louisville, Kentucky about two and one-half years after the Tennessee child restraint law went into force. Use of child restraints anchored by seat belts increased in Tennessee from 8 per cent prior to the law to 29 per cent, compared to a change from 11 to 14 per cent in Kentucky, which does not have a child restraint law. Travel in arms, a hazardous practice permitted by the law, was at the same level in Tennessee and Kentucky as prior to passage of the law.

Automobiles↗
PubMed1995

Comments on "Cancer Mortality near Oak Ridge, Tennessee".

A recent article by Joseph Mangano concluded that changes in cancer mortality near Oak Ridge (Anderson County) in Tennessee over a 40-year period (1950-1989) suggest an increase in cancer deaths linked to radiation contamination. These conclusions are not supported by available, representative data. In his analysis, Mangano selected for comparison two three-year periods (1950-1952 and 1987-1989) that are not representative of the entire 40 years. An analysis by decade of the 42-year period from 1950 to 1991, using U.S. mortality rates from the National Center for Health Statistics and Tennessee mortality rates from the NCHS and the Tennessee Health Department, shows that the relation between expected and actual cancer deaths for the white population of Anderson County does not differ from that for the State of Tennessee. In addition, changes in methods of reporting death statistics during the 40-year period invalidate any attempt to compare current cause-specific mortality data (such as cancer deaths) with data from the 1950s. Relevant comparisons that can be made for the period 1970-1991 again show that cancer deaths for whites in Anderson County have been statistically equivalent to the expected rates.

Adult↗
PubMed1997

A unified health ministry in central Tennessee: eleven years of successful partnership.

Middle Tennessee Medical Center (MTMC) is a not-for-profit community hospital located in Murfreesboro, Tennessee. Eleven years ago, a large investor-owned hospital company presented the institution's board of trustees with a purchase offer. As an alternative, two church-related institutions in Nashville--Baptist Hospital and Saint Thomas Hospital, which is part of the Daughters of Charity National Health System--presented the board of trustees with a plan whereby a new not-for-profit holding company sponsored jointly by Baptist Hospital and Saint Thomas Hospital would become the corporate member of Middle Tennessee Medical Center. Funds contributed by Baptist and Saint Thomas Hospitals would be infused into the Christy-Houston Foundation, a not-for-profit entity devoted to identifying and serving community needs in Murfreesboro and the surrounding area. Their proposal was accepted, and the two church-related institutions became partners in jointly sponsoring and governing an important not-for-profit healthcare institution in central Tennessee. In 1996, The Lewin Group, a healthcare consulting firm based in Fairfax, Virginia, was commissioned by Baptist Hospital, Saint Thomas Hospital, and Daughters of Charity National Health System to conduct a retrospective assessment of the progress of this jointly sponsored ministry in relation to the original vision and goals. Historical and operational data were analyzed, and interviews were conducted with 24 people who were directly involved in conceiving, developing, or implementing this ministry. This article summarizes the principal findings and conclusions of this ten-year assessment.

Catchment Area, Health↗
PubMed2002

Management of elevated blood lead in Tennessee's children: questions a physician might ask.

OBJECTIVES: To present the most commonly asked questions health care providers have about the management of a child with elevated blood lead, and the answers based on current guidelines. METHODS: Questions answered in this paper were selected based on recall of three years' experience as a statewide physician lead consultant in Alabama and Tennessee. RESULTS: 20 questions are presented, along with relevant Tennessee resources for obtaining more information and medical consultation. CONCLUSIONS: Tennessee's Childhood Lead Poisoning Prevention Program has the resources to assist health care providers with any child who presents with lead poisoning. No Tennessee health care provider should lack the knowledge to manage any lead poisoned child.

Case Management↗
PubMed2004

Cremation weights in east Tennessee.

In spite of increasing number of cremations in the U.S., little is known about weights of cremated remains. This research was undertaken in order to add to the limited literature on cremains weights and to explore variation. Weights of cremated remains were obtained from the East Tennessee Crematorium. The sample consists of 151 males and 155 females. Age, sex, and race were obtained for each individual. Males are about 1000 g heavier than females. Both sexes lose weight with age, but females lose weight at about twice the rate of males. East Tennessee cremation weights were compared with those from Florida reported by Warren and Maples, and those from Southern California reported by Sonek. East Tennessee results were also compared with an earlier study on ash weight of anatomical human skeletons carried out by Trotter and Hixon. East Tennessee cremations weigh about 500 g more than the samples from Florida and California, and about the same as the earlier anatomical samples. We hypothesize that variation reflects variation in body weight and activity. This variation must be taken into account when cremation weights are at issue.

Adolescent↗
PubMed1982

Tennessee antigen: the predictive value of preoperative and postoperative assays in large-bowel cancer.

Twenty-nine of 31 patients bearing resectable colorectal cancers had elevated levels of serum Tennessee antigen in comparison with only eight of 31 patients for carcinoembryonic antigen. This high detection rate is, however, of limited value since the level of serum Tennessee antigen is not specific for the presence of malignancy. There appeared to be no relationship between the level of preoperative serum Tennessee antigen and subsequent prognosis. Furthermore, in only nine of 31 patients did the serum Tennessee antigen level fall after removal of all macroscopic cancer. There also appeared to be no relationship between the level of serum TennaGen at three months after resection and subsequent prognosis. These findings are in contrast to estimations of serum carcinoembryonic antigen.

Antigens, Neoplasm↗
PubMed1982

Tennessee antigen: its value in the monitoring of patients with colorectal cancer.

Serial estimations of serum Tennessee antigen have been performed at regular three-month intervals on 35 patients with colorectal cancer who had undergone resection of all macroscopically obvious tumor but who were considered to be at high risk of developing subsequent metastases. The results were interpreted by a panel of surgeons in order to assess the clinical relevance of using serum Tennessee antigen for monitoring of patients. The serial estimation of serum Tennessee antigen was found to be very variable, difficult to interpret, and clinically unreliable as an accurate marker for the development of recurrent cancer in this group of patients. There are unacceptably high false-positive and false-negative diagnostic rates for serum Tennessee antigen estimations in comparison with serial estimations of carcinoembryonic antigen.

Antigens, Neoplasm↗
PubMedDate not supplied

The Tennessee study of class size in the early school grades.

The Tennessee class size project is a three-phase study designed to determine the effect of smaller class size in the earliest grades on short-term and long-term pupil performance. The first phase of this project, termed Project STAR (for Student-Teacher Achievement Ratio), was begun in 1985, when Lamar Alexander was governor of Tennessee. Governor Alexander, who later served as secretary of education in the cabinet of President George Bush, had made education a top priority for his second term. The legislature and the educational community of Tennessee were mindful of a promising study of the benefits of small class size carried out in nearby Indiana, but were also aware of the costs associated with additional classrooms and teachers. Wishing to obtain data on the effectiveness of reduced class size before committing additional funds, the Tennessee legislature authorized this four-year study in which results obtained in kindergarten, first, second, and third grade classrooms of 13 to 17 pupils were compared with those obtained in classrooms of 22 to 25 pupils and in classrooms of this larger size where the teacher was assisted by a paid aide. Both standardized and curriculum-based tests were used to assess and compare the performance of some 6,500 pupils in about 330 classrooms at approximately 80 schools in the areas of reading, mathematics, and basic study skills. After four years, it was clear that smaller classes did produce substantial improvement in early learning and cognitive studies and that the effect of small class size on the achievement of minority children was initially about double that observed for majority children, but in later years, it was about the same. The second phase of the project, called the Lasting Benefits Study, was begun in 1989 to determine whether these perceived benefits persisted. Observations made as a part of this phase confirmed that the children who were originally enrolled in smaller classes continued to perform better than their grade-mates (whose school experience had begun in larger classes) when they were returned to regular-sized classes in later grades. Under the third phase, Project Challenge, the 17 economically poorest school districts were given small classes in kindergarten, first, second, and third grades. These districts improved their end-of-year standing in rank among the 139 districts from well below average to above average in reading and mathematics.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed2006

Report of the Tennessee Task Force on Screening Newborn Infants for Critical Congenital Heart Disease.

A member of the Tennessee state legislature recently proposed a bill that would mandate all newborn infants to undergo pulse oximetry screening for the purpose of identifying those with critical structural heart disease before discharge home. The Tennessee Task Force on Screening Newborn Infants for Critical Congenital Heart Defects was convened on September 29, 2005. This group reviewed the current medical literature on this topic, as well as data obtained from the Tennessee Department of Health, and debated the merits and potential detriments of a statewide screening program. The estimated incidence of critical congenital heart disease is 170 in 100,000 live births, and of those, 60 in 100,000 infants have ductal-dependent left-sided obstructive lesions with the potential of presentation by shock or death if the diagnosis is missed. Of the latter group, the diagnosis is missed in approximately 9 in 100,000 by fetal ultrasound assessment and discharge examination and might be identified by a screening program. Identification of the missed diagnosis in these infants before discharge could spare many of them death or neurologic sequelae. Four major studies using pulse oximetry screening were analyzed, and when data were restricted to critical left-sided obstructive lesions, sensitivity values of 0% to 50% and false-positive rates of between 0.01% and 12% were found in asymptomatic populations. Because of this variability and other considerations, a meaningful cost/benefit analysis could not be performed. It was the consensus of the task force to provide a recommendation to the legislature that mandatory screening not be implemented at this time. In addition, we determined that a very large, prospective, perhaps multistate study is needed to define the sensitivity and false-positive rates of lower-limb pulse oximetry screening in the asymptomatic newborn population and that there needs to be continued partnering between the medical community, parents, and local, state, and national governments in decisions regarding mandated medical care.

Advisory Committees↗
PubMed1995

Immunization coverage among infants enrolled in the Tennessee Medicaid program.

OBJECTIVES: To determine immunization coverage of infants receiving Medicaid in Tennessee and to identify risk factors for failure to complete recommended vaccinations by 24 months of age. DESIGN: Retrospective cohort study. SUBJECTS: A total of 33,615 children born in one of three urban Tennessee counties from 1980 through 1989 who were enrolled in Medicaid throughout their first 24 months of life. MAIN OUTCOME MEASURES: Receipt of four diphtheria-tetanus-pertussis, three oral polio, and one measles-mumps-rubella vaccines by 24 months of age (up-to-date), as recorded in computerized county immunization records and Medicaid billing files. RESULTS: Overall, 45% of infants enrolled in Medicaid in the three urban counties completed the recommended vaccinations by 24 months. The proportion of infants up-to-date peaked at 50% for those born in 1982 and 1983, and decreased to 44% for those born in 1989. The only strong independent predictors of immunization completion were number of prior births for the mother, timing of the first immunization, and county of birth. The proportion up-to-date was 56% for first-born children compared with 27% for those whose mothers had at least three prior births; 55% for those whose first immunization was on time compared with 22% for those with a delay in the first immunization; and 63%, 52%, and 37% for infants born in the three respective counties. Maternal age, education, race, and marital status predicted immunization completeness only weakly or not at all. CONCLUSIONS: Of infants born in the three counties in the 1980s who were enrolled in the Tennessee Medicaid program, fewer than half completed their recommended childhood vaccinations by 24 months of age. The large differences in immunization levels between infants enrolled in the Medicaid program in the three counties, not accounted for by differences in demographics, suggest that factors related to the health care and vaccine delivery system have important effects on achieving adequate immunization of these infants.

Child, Preschool↗
PubMed2003

Beyond palisades: The nature and frequency of late prehistoric deliberate violent trauma in the Chickamauga reservoir of east Tennessee.

Based on the presence of palisades and an iconography suggesting a warrior elite, warfare is presumed to be endemic in the Late Mississippian period (AD 1200-1600) of the southeastern United States. Warfare is theorized to play a vital role in the cycling of chiefdoms. However, apart from a few exemplary cases that display double-digit frequencies, very little direct (i.e., skeletal) evidence of violent trauma has dovetailed with the archaeological presumptions of warfare. Eight sites from the Chickamauga Reservoir of east Tennessee were examined for skeletal evidence of deliberate violent trauma. Violent trauma was anticipated because these sites are in close proximity and consist of two adjacent, sociopolitically distinct, and temporally overlapping phases: Dallas (AD 1300-1600) and Mouse Creek (AD 1400-1600). In addition to small, round, nonlethal ectocranial blunt-force trauma (BFT) on the frontal and upper parietal bones, inflicted projectile points and scalping were identified. The low total trauma frequency in the Dallas sample (3.86%, n = 259) is consistent with emerging evidence from east and west Tennessee Late Mississippian data, but significantly different from Mouse Creek (8.06%, n = 273). The proportion of nonlethal cranial BFT in the collective Chickamauga sample is large and at odds with the Tennessee River Valley comparative literature. Based on other bioarchaeological literature, this pattern suggests intragroup violence, but not face-to-face ritual contests. It is better explained as interpersonal conflict resolution along codified lines. This is consistent with southeastern ethnohistoric data and may explain the more frequent cranial BFT in the less stratified Mouse Creek phase, which likely would not have had an overarching civil authority.

Anthropology, Physical↗
PubMed2006

Smoking rates among pregnant women in Tennessee, 1990-2001.

BACKGROUND: Pregnant smokers represent a major public health challenge. The objective of this study was to determine trends in smoking during pregnancy in Tennessee, a state with one of the highest smoking burdens in the nation, and to confirm characteristics of high-risk groups to target for smoking prevention. METHODS: Population-based cohort study of pregnant women in Tennessee who delivered live births from 1990-2001. Trends in smoking were determined by maternal age, race and insurance status using vital records and Medicaid data. Characteristics of women who smoked during pregnancy were described for 2001. RESULTS: Among 900,986 pregnant women in the cohort, there were statewide decreases in smoking rates during pregnancy; however, smoking among pregnant women younger than 25 years in Medicaid increased from 1996 to 2001: among whites from 31% to 34%, and among blacks from 6% to 9% (P values for trend shifts <0.0001). Characteristics of pregnant women who smoked during pregnancy included white race, Medicaid enrollment, nonurban residence, and less than a high school education. CONCLUSIONS: Smoking rates increased significantly among pregnant women <25 years enrolled in Medicaid between 1996 and 2001. Tennessee needs smoking cessation and prevention efforts that target young, low-income women with less than a high school education.

Adult↗
PubMed1997

Genital Chlamydia trachomatis infection in pregnant adolescents in east Tennessee: a 7-year case-control study.

STUDY OBJECTIVE: To examine the prevalence, symptomatology, risk factors, and other infections associated with urogenital chlamydial infection in pregnant teenagers. DESIGN: Retrospective case-control study by medical record review. SETTING: Prenatal care clinic for adolescents at University of Tennessee Medical Center, Knoxville, Tennessee. PARTICIPANTS: Pregnant adolescents younger than 19 years of age who were diagnosed with chlamydial infection on the first prenatal visit from 1988 to 1994 were studied. Pregnant adolescents of similar age and socioeconomic background who came in the same day for the first prenatal visit, but were not infected, made up the control group. INTERVENTION: Routine prenatal questionnaires regarding personal and medical histories, and routine prenatal screening, including pelvic examination with Papanicolaou (PAP) smear and laboratory investigations for common genital infections and sexual transmitted disease (STDs), were obtained. MAIN OUTCOME MEASURES: Analyzed the prevalence of chlamydial infection and compared the infected group to the control group with regard to race, behavioral factors, symptoms, prenatal screening results, other concurrent genital infections, and histories of STDs. RESULTS: Of a total population of 596 pregnant teenagers, 67 (11.24%) were infected with Chlamydia trachomatis. In multivariate analysis, black race (odds ratio [OR] = 4.01; 95% confidence interval [CI] = 1.74-9.23; p = 0.001) and greater gestational age at first prenatal visit (OR = 1.11; 95% CI = 1.04-1.18; p = 0.001) were independently associated with chlamydial infection. Age, marital status, number of pregnancies, smoking, alcohol abuse, drug abuse, age at first intercourse, and multiple sex partners were not associated with the infection. Likewise, the symptom of vaginal discharge (a complaint of > 70% in each group), other genital co-infections (found > 50% in each group, mainly candidiasis and bacterial vaginosis), abnormal PAP smears (found > 60% in each group) and histories of STDs or previous chlamydial infection were not significantly different between case and control groups. Human papillomavirus infection, trichomonal infection, and dysplasia or atypia were found more often in patients infected with chlamydia, but were not statistically significant. CONCLUSION: Pregnant adolescents in east Tennessee were at risk for chlamydial infection as well as for other genital infections and abnormal PAP smears. Routine prenatal chlamydial screening is warranted because of a lack of specific symptoms.

Adolescent↗
PubMed2006

Pyrethroid insecticides and sediment toxicity in urban creeks from California and Tennessee.

Pyrethroid pesticides have replaced organophosphates for many urban applications, including structural pest control, landscape maintenance, and residential home and garden use. This study was intended to determine if pyrethroids are detectable and widespread in diverse urban systems and if concentrations are high enough to cause associated aquatic toxicity. Urban creeks in California and Tennessee were tested on up to four occasions for pesticide residues in sediments, and aquatic toxicity was determined by acute toxicity tests using the amphipod, Hyalella azteca. In California, 12 of the 15 creeks tested were toxic on at least one sampling occasion, and sediment pyrethroid concentrations were sufficient to explain the observed toxicity in most cases. The pyrethroid bifenthrin, due to its high concentrations and relative toxicity as compared to other pyrethroids, was likely responsible for the majority of the toxicity at most sites. Cypermethrin, cyfluthrin, deltamethrin, and lambda-cyhalothrin also contributed to toxicity at some locations. The source of cypermethrin and deltamethrin was probably almost entirely structural pest control by professional applicators. Bifenthrin, cyfluthrin, and lambda-cyhalothrin may have originated either from professional structural pest control or from lawn and garden care by homeowners. None of the sediments collected from the 12 Tennessee creeks were toxic, and pyrethroids were rarely detectable. Regional differences between Tennessee and California are possibly attributable to climate, differences in types of residential development, and pesticide use practices.

California↗