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PubMed2003

Uncertainties in modeling secondary organic aerosols: three-dimensional modeling studies in Nashville/western Tennessee.

The formation of secondary organic aerosols (SOA) is simulated for the Nashville/western Tennessee domain using three recent SOA modules incorporated into the three-dimensional air quality model, CMAQ. The Odum/Griffin et al. and CMU/STI modules represent SOA absorptive partitioning into a mixture of primary and secondary particulate organic compounds (OC), with some differences in the formulation of the absorption process and the selection of SOA species and their precursors. Empirical representations based on measured laboratory SOA yields are used for condensable organic products in both these modules. The AEC module simulates SOA absorption into organic and aqueous particulate phases, and a representation based on an explicit gas-phase mechanism is used in the AEC module. Predicted SOA concentrations can vary by a factor of 10 or more. In general, the gas-phase mechanistic approach predicts a higher yield of SOA than those based on laboratory yields. There exist some differences in the two empirical modules despite their similar basis on experimental data. All three modules predict a dominance of SOA of biogenic origin as compared to SOA of anthropogenic origin. The causes for differences among the three SOA modules include the representation of terpenes, the mechanistic versus empirical representation of SOA-forming reactions, the identities of SOA, and the parameters used in the gas/particle partitioning calculations. Two sensitivity studies show that formation of water-soluble SOA and temperature dependence may be areas of key uncertainties affecting current models.

Aerosols↗
PubMedDate not supplied

Biotic diversity of Natchez Trace State Forest, western Tennessee.

We carried out a multiple-scale assessment of biotic resources within Natchez Trace State Forest (NTSF) in western Tennessee, focusing on the relation between biotic communities and seven previously developed ecological land types (ELT, based on topography and soils). We wanted to test the functional ability of ELTs for biodiversity stewardship. Woody and herbaceous flora as well as herpetofauna and avifauna communities had substantial differences between upland and lowland forests. However, none of the faunal communities distinguished among upland ELTs. In addition, herbaceous taxa also failed to distinguish upland ELTs. The results suggest the present use of ELTs at NTSF will not be a helpful guide to land stewardship focusing on biodiversity. The disturbance history of the Forest and the mobility of animals are given as potential explanations for a poor relationship between abiotic ELTs and the resident biota.

Animals↗
PubMedDate not supplied

Possible sources of sick building syndrome in a Tennessee middle school.

Sick Building Syndrome has been reported with increasing frequency during recent years. Buildings that have sustained water damage harbor various molds, some of which may be toxic. Students and staff at Central Middle School in Murfreesboro, Tennessee, reported symptoms similar to those associated with Sick Building Syndrome. Upon investigation, investigators noted that a black fungal growth occurred throughout the building on wet cellulose ceiling tiles. Fungal growth of this type is consistent with the genus Stachybotrys. Stachybotrys spores contain macrocyclic trichothecenes, which may cause harm when inhaled or ingested. Bulk sampling of the black mold was initiated, and the samples were cultured in a moist chamber. Testing of the samples confirmed the presence of Stachybotrys spp., a finding that implies that air sampling procedures should ensue. Professional remediation of this potentially hazardous fungal contaminant is therefore recommended.

Adolescent↗
PubMedDate not supplied

Acute respiratory illness in families exposed to nitrogen dioxide ambient air pollution in Chattanooga, Tennessee.

The incidence of acute respiratory illness in families in Chattanooga, Tennessee was studied in 1972 and 1973 to determine if residents of a formerly high nitrogen dioxide exposure community continued to experience a high incidence of illness after ambient air concentrations of the pollutant had been reduced substantially. Illness data were collected by telephone at 2-wk intervals and illness rates per 100 person weeks of observation were contrasted with air pollution concentrations measured no more than 3.2 km from the home. Data were contrasted by communities designated as high, intermediate, or low pollution exposure. In 1972, higher rates of respiratory illness continued to occur in the designated high pollution area. These were associated with current higher short-term concentrations of nitrogen dioxide even though the long-term mean concentrations of the pollutant were little higher than those in the low pollution area. It was not possible to attribute the excesses in illness to specific pollutants or to specific exposure periods. However, reduction of the illness rate in 1973 associated with a strike at the primary source industry that curtailed nitrogen dioxide pollution in the high exposure community suggested that the short-term exposure may be more important than long-term exposure.

Adolescent↗
PubMed1975

Lead levels in human deciduous teeth in Tennessee.

Deciduous teeth were analyzed by atomic absorption spectroscopy for lead content to ascertain the extent of lead exposure in certain areas in Tennessee. The data were analyzed to clarify the relationships between tooth lead content and race, sex, age, tooth type, economic status, and place of residence. Results indicated that blacks had slightly higher lead concentrations than whites; however, the age and sex of the person or the type of tooth analyzed had little effect upon the lead content. The major factors were shown to be economic status and, indirectly, place of residence.

Black or African American↗
PubMed2004

Outdoor/Indoor/Personal ozone exposures of children in Nashville, Tennessee.

An ozone (O3) exposure study was conducted in Nashville, TN, using passive O3 samplers to measure six weekly outdoor, indoor, and personal O3 exposure estimates for a group of 10- to 12-yr-old elementary school children. Thirty-six children from two Nashville area communities (Inglewood and Hendersonville) participated in the O3 sampling program, and 99 children provided additional time-activity information by telephone interview. By design, this study coincided with the 1994 Nashville/Middle Tennessee Ozone Study conducted by the Southern Oxidants Study, which provided enhanced continuous ambient O3 monitoring across the Nashville area. Passive sampling estimated weekly average outdoor O3 concentrations from 0.011 to 0.O30 ppm in the urban Inglewood community and from 0.015 to 0.042 ppm in suburban Hendersonville. The maximum 1- and 8-hr ambient concentrations encountered at the Hendersonville continuous monitor exceeded the levels of the 1- and 8-hr metrics for the O3 National Ambient Air Quality Standard. Weekly average personal O3 exposures ranged from 0.0013 to 0.0064 ppm (7-31% of outdoor levels). Personal O3 exposures reflected the proportional amount of time spent in indoor and outdoor environments. Air-conditioned homes displayed very low indoor O3 concentrations, and homes using open windows and fans for ventilation displayed much higher concentrations.

Air Pollutants↗
PubMed2004

Tennessee's Novice Driver Safety Project: a program to increase parental involvement.

Graduated licensing has been implemented in many U.S. states to reduce teenage driver crash involvement. The goal is to introduce teenagers gradually to driving before allowing full, unrestricted licensure. Tennessee, one of the states that introduced graduated licensing, implemented a program to influence both driving by teenagers during the learner stage and restrictions imposed by parents after licensure. In addition to a standard welcome letter, booklets and reminder cards were mailed to parents of teenagers who had just obtained their learner's permits. The booklets and cards were designed to assist parents in becoming more actively involved in their children's driving experiences. The effects of three different approaches (welcome letter only, letter plus booklet, and letter plus booklet plus reminder cards) on parental involvement, teenage crashes, and teenage citations were assessed based on telephone interviews with parents. Although the parents said the booklets and reminder cards were helpful and should continue to be sent to other parents, there were no discernible effects on teenage practice driving and reported parental involvement during the learner stage. Nor was there any measurable influence on restrictions imposed by parents after licensure. It is unknown whether the standard welcome letter affected parental involvement, but overall supervised driving exceeded the state requirements by a substantial margin.

Accidents, Traffic↗
PubMed2000

Use of polymerase chain reaction to diagnose the fifth reported US case of autochthonous transmission of Trypanosoma cruzi, in Tennessee, 1998.

In July 1998, the mother of an 18-month-old boy in rural Tennessee found a triatomine bug in his crib, which she saved because it resembled a bug shown on a television program about insects that prey on mammals. The gut contents of the Triatoma sanguisuga were found, by light microscopy and polymerase chain reaction (PCR), to be infected with Trypanosoma cruzi; PCR products hybridized with T. cruzi-specific oligonucleotide probes. Whole-blood specimens obtained from the child in July and August were negative by buffy-coat examination and hemoculture but positive by PCR and DNA hybridization, suggesting that he had low-level parasitemia. Specimens obtained after treatment with benznidazole were negative. He did not develop anti-T. cruzi antibody; 19 relatives and neighbors also were seronegative. Two of 3 raccoons trapped in the vicinity had positive hemocultures for T. cruzi. The child's case of T. cruzi infection-the fifth reported US autochthonous case-would have been missed without his mother's attentiveness and the availability of sensitive molecular techniques.

Animals↗
PubMed2001

Clones of Streptococcus pneumoniae isolated from nasopharyngeal carriage and invasive disease in young children in central Tennessee.

To determine whether nasopharyngeal carriage isolates of Streptococcus pneumoniae are of the same genetic background as isolates that caused invasive disease in one community, IS1167 and boxA genotypes were obtained for 182 pneumococcal isolates from children living in central Tennessee. The isolates represented 70 combined IS1167-boxA genotypes. The genotypic diversity of the invasive isolates was significantly less than that of the total population (P=.003). Most of the carriage isolates belonged to genotypes unique to carriage, whereas most of the invasive isolates belonged to genotypes common to carriage and disease (P=.02). Monte Carlo simulations showed a greater number of genotypes unique to carriage than can be explained by chance (P<.05 in all cases). Two genotypes were identified by multilocus sequence typing as members of globally disseminated clones, and one such genotype that was strictly carriage in this sample caused disease in other studies. Thus, clones can have different propensities for carriage and invasion.

Bacterial Capsules↗
PubMed2005

Prevalence of reovirus-specific antibodies in young children in Nashville, Tennessee.

Although reovirus infections are thought to be common in adults, there have been few assessments of the seroprevalence of reovirus in young children. We developed an indirect enzyme-linked immunosorbent assay to measure levels of total antireovirus immunoglobulin A, G, and M in serum specimens collected from otherwise healthy infants and children (1 month to 5 years of age) in Nashville, Tennessee. Of the 272 serum specimens evaluated, 64 (23.5%) tested positive for reovirus-specific antibodies. We observed an age-dependent increase in reovirus-specific antibodies in children 1 year of age and older, peaking at 50.0% in children 5-6 years of age. These findings suggest that reovirus infections are common during early childhood.

Age Distribution↗
PubMed2005

Detection of very high-level penicillin-resistant variants of the Tennessee (23 F)-4 clone via single and serial transformations with four serotype 19 A international pneumococcal clones.

In the United States, penicillin-resistant variants of the Tennessee (Tenn) (23 F)-4 clone account for a substantial proportion of the very-high-level penicillin-resistant (MIC 8 microg/ml) infections in the 7-valent pneumococcal protein conjugate vaccine (PCV 7) era. Serotype 19 A strains account for an increasing proportion of penicillin-nonsusceptible Streptococcus pneumoniae infections. Sequential transformations of the Tenn (23 F)-4 clone (penicillin MIC 0.1 microg/ml) were performed with four penicillin-nonsusceptible serotype 19 A international clones (penicillin MIC): S. Africa (19 A)-7 (0.5 microg/ml), Hungary (19 A)-6 (2 microg/ml), Slovakia (19 A)-11 (8 microg/ml), and South Africa (19 A)-13 (8 microg/ml). Fifty-two transformants were characterized by MICs, serogroup-specific PCR, pbp PCR restriction profile and sequence, psp A PCR restriction profile, and erm/mef PCR. A subset was analyzed with multilocus sequence typing (MLST) and pulsed-field gel electrophoresis. Serotype 23 F transformants with penicillin MIC >or= 8 microg/ml were detected through a single transformation with the Hungary (19 A)-6 clone or serial transformations using two to three different clones. Forty-four percent (14/32) of the transformants incorporated >or=1 new MLST allele. Using encapsulated donors, very-high-level penicillin resistant variants of the Tenn (23 F)-4 clone were detected. In addition to detecting stepwise increases in penicillin MIC, a 12-fold increase in penicillin MIC was achieved through a single transformation. This large increase in MIC may explain why this clone is commonly associated with very-high-level resistance in natural populations. Recombination within the MLST housekeeping genes was commonly detected in the transformants that had acquired penicillin resistance.

Alleles↗
PubMed1997

The value and use of the Qualified Medicare Beneficiary Program: early evidence from Tennessee.

The Qualified Medicare Beneficiary (QMB) Program eliminated the out-of-pocket costs of obtaining health care services under the Medicare program for some low-income beneficiaries who were previously ineligible for Medicaid. The program is underused, and little is known about its effects. The article describes the QMB Program and compares program beneficiaries with others whose out-of-pocket payments are covered by Medicaid. Using Medicare claims data covering QMBs in Tennessee, we found that the program financed a relatively high rate of use of Medicare services and saved low-income Medicare beneficiaries hundreds of dollars per month in out-of-pocket costs. Social workers can promote the program and increase the use of its covered services appropriately, thereby by maximizing its potential benefits to low-income people.

Cost-Benefit Analysis↗
PubMed1984

Seroepidemiology of hepatitis B in Tennessee prisoners.

A prevalence serosurvey was performed on an 11.7% sample of the 6,503 adult male inmates in Tennessee prisons. On the basis of the sample, 0.9% of the prisoners possessed hepatitis B surface antigen, and 29.5% had one or more serum markers for hepatitis B virus (HBV). Thirty-two possible risk factors were analyzed for association with possession of HBV serum markers. The significant risk factors for possession of HBV markers in this population were found to be age, intravenous drug use while not incarcerated, intravenous drug use while incarcerated, race, education, military service history, and duration of prior and current imprisonments, in that order of importance. Given the modest contribution of incarceration to overall risk, mass immunization of prisoners against HBV seems unwarranted. Prisoners with unusually long sentences or who use intravenous drugs in prison are subgroups at particularly high risk. The logistic model can be used to target a serological screening and immunization program.

Adolescent↗
PubMed1989

Urbs in rure: human immunodeficiency virus infection in rural Tennessee.

Although the AIDS Commentaries published over the past 18 months have focused on clinical questions relevant to all practicing infectious diseases physicians, they have emphasized clinical information gathered from the large epicenters of the epidemic. We need to remember that clinicians dealing with HIV-infected patients outside metropolitan areas may face problems that are unique. For example, fighting the stigma of AIDS in a low-prevalence population may be as important an issue as treating pneumocystic pneumonia. In this AIDS Commentary, Drs. Abraham Verghese, Steven L. Berk, and Felix Sarubbi of the Veterans Administration Medical Center, East Tennessee State University and describe their experiences in such an environment, discuss some of the problems they've faced, and offer suggestions about what physicians and health officers need to do to prepare for the inevitable spread of AIDS to rural communities.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Ticks (Acari: Ixodidae) infesting medium-sized wild mammals in southwestern Tennessee.

Seven species of ixodid ticks (n = 2,661) were found on medium-sized wild mammals (n = 295) during a 13-mo study in Shelby County, Tennessee. The seven tick species collected were Dermacentor variabilis (Say), Amblyomma americanum (L.), Rhipicephalus sanguineus (Latreille), Ixodes texanus (Banks), I. cookei (Packard), I. scapularis (Say), and Haemaphysalis leporispalustris (Packard). The raccoon had the greatest tick species diversity in all of the aforementioned ticks except H. leporispalustris and R. sanguineus. The raccoon and opossum accounted for 96.9% of the ticks collected and were the most commonly captured medium-sized mammals. The only tick collected in high enough numbers for statistical analysis was D. variabilis. Mammal species and habitat type were the most important factors affecting the mean number of adult D. variabilis per mammal. The mean number of D. variabilis adults carried by raccoons was significantly higher than opossums. Whether a habitat occurred within Memphis city limits or outside city limits also affected the number of adult D. variabilis on mammals. The interaction between habitat, mammal, and whether inside or outside the city limits was near statistical significance. It is suggested that there is biological significance; within city limits, medium-sized wild mammals are forced into wooded areas where there is a subsequent increase in tick populations in these habitat patches.

Animals↗
PubMed1992

So-called accidental firearm fatalities in children and teenagers in Tennessee, 1961-1988.

Tennessee State medical examiner reports of firearm fatalities classified as accidents involving victims aged 19 year or less from 1961 through 1988, were reviewed to evaluate circumstantial and contributing factors. A total of 225 were analyzed. The peak age for victims was 17 years, and there were more than five times more male than female victims. In Shelby County (Memphis), the racial distribution of fatalities was approximately that of the general population. Playing with a gun was the most frequent circumstance. The person responsible for pulling the trigger was equally likely to be a friend, a family member, or the victim. Head or neck were injured in most cases. The urban mortality rate was nearly twice that of the rural rate. More than half of the deaths in urban counties occurred indoors and involved handguns, whereas in rural counties only a third were due to handguns and the location was more often outdoors. Deaths in rural counties showed a seasonal variation that corresponded with the hunting season; by contrast, a peak in early summer was noted in the urban deaths. Defective guns or guns unsafe in design caused several deaths. (Semiautomatic pistols, which can be fired after unloading the ammunition magazine, are conspicuous examples of guns unsafe in design.) An important observation of this study is that medical examiners vary considerably in their classification of accidental manner, particularly when children are involved. Furthermore, medical examiner reports need to include much more information than is currently recorded if they are to be useful in guiding public policy to reduce firearm injuries.

Accidents↗
PubMed1997

Proactive changes in nursing work force development in Tennessee.

Problems to be addressed by the CIC grant have been identified and defined, and a coalition has been formalized to address nursing work force development in Tennessee. The THCN, composed of consumers, nursing educators, policy makers, healthcare providers, and representatives of professional organizations and regulatory boards, is enthusiastically tackling the implementation phase of the project. These members are demonstrating open communication, teamwork, and interdependent decision making. Results are being achieved through persuasion, negotiation, seeking input from others, showing political sensitivity, and a willingness to share rewards and recognition.

Cooperative Behavior↗