Tennessee

The purpose of this study was to examine the relationship between health literacy and health-related quality of life (HRQOL) in a sample of English-speaking Tennesseans attending a university-based family medicine residency clinic. We measured the health literacy skills of patients (n = 249) using the Rapid Estimate of Adult Literacy in Medicine (REALM), dividing patients' scores into limited (< or = 8th-grade level) and adequate (> or = 9th-grade) literacy skill levels. We measured HRQOL using four items developed and validated by the Centers for Disease Control and Prevention (CDC). Scores on the REALM indicated that 28.5 percent of patients had limited and 71.5 percent had adequate health literacy skills. There was a significant correlation between patients' health literacy skills and self-reported general health (rho = 0.249, P < 0.01). Patients with limited health literacy skills had a higher median number of physically unhealthy days (P = 0.05) and activity li...

Determine the relative frequency with which guns in the home are used to injure or kill in self-defense, compared with the number of times these weapons are involved in an unintentional injury, suicide attempt, or criminal assault or homicide. We reviewed the police, medical examiner, emergency medical service, emergency department, and hospital records of all fatal and nonfatal shootings in three U.S. cities: Memphis, Tennessee; Seattle, Washington; and Galveston, Texas. During the study interval (12 months in Memphis, 18 months in Seattle, and Galveston) 626 shootings occurred in or around a residence. This total included 54 unintentional shootings, 118 attempted or completed suicides, and 438 assaults/homicides. Thirteen shootings were legally justifiable or an act of self-defense, including three that involved law enforcement officers acting in the line of duty. For every time a gun in the home was used in a self-defense or legally justifiable shooting, there were four unintentional shootings, seven criminal assaults or homicides, and 11 attempted or completed suicides. Guns kept in homes are more likely to be involved in a fatal or nonfatal accidental shooting, criminal assault, or suicide attempt than to be used to injure or kill in self-defense.

The aim of this study was to quantify and characterize bacterial contamination of radiologist workstations. Dictation microphones and computer mice at the most frequently used radiologist workstations from 2 inpatient and 2 outpatient reading rooms at 2 teaching hospitals in 2 states were sampled for bacteria. Reference toilet seat and doorknob sampling was performed in the 4 restrooms nearest those reading rooms. One microphone and one mouse in each reading room were sampled again after quick disinfection with an inexpensive, commercially available antiseptic pad. Sampling was performed using direct trypticase soy agar plating, with sampled areas uniformly approximating 50 cm(2). Colonies were quantified and additionally characterized after 24 hours using mannitol salt agar and MacConkey agar. All sampled radiologist computer workstation and restroom sites were contaminated with bacteria. Mean colony counts were 69.4 ± 38.7 (range, 15-123) for microphones, 46.1 ± 58.1 (range, 1-173) for mice, 10.5 ± 9.7 (range, 1-22) for toilet seats, and 14.8 ± 16.0 (range, 1-36) for restroom doorknobs. Of all workstation sites, 64.3% (9 of 14) grew Staphylococcus aureus, and 21.4% (3 of 14) grew enteric organisms. Overall microphone and mouse bacterial contamination was significantly higher than that of nearby restroom toilets and doorknobs (57.8 ± 49.0 vs 12.6 ± 12.5, P = .005). Microphone and mouse bacterial counts were nearly completely eliminated after brief antiseptic swabbing (from 76.9 ± 53.2 to 0.3 ± 0.7, P = .002). Bacterial contamination of microphones and computer mice at radiologist workstations is common, with colonization significantly greater than nearby restroom toilet seats and doorknobs. Simple, rapid, and inexpensive disinfection techniques nearly completely eradicate workstation bacterial contamination. The clinical implications of colonization merits further study.

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.

As health care providers, physical therapists are in an ideal position to address health promotion issues with their patients; yet, little is known about actual health promotion practice patterns or the confidence of physical therapists in engaging in such activities. The purposes of this study were: (1) to investigate perceptions of practice patterns in 4 focus areas of Healthy People 2010 (disability and secondary conditions by assessing psychological well-being, nutrition and overweight, physical activity and fitness, and tobacco use) and (2) to identify related self-efficacy and outcome expectations in California, New York, and Tennessee. A instrument was pilot tested and distributed in 2 waves to 3,500 randomly selected, licensed physical therapists from 3 states: California, New York, and Tennessee. Interviews were randomly conducted via telephone with 23 physical therapists in all 3 states until similar responses were identified in order to create the qualitative instrument, ...

Few empirical studies have explored the grieving process among different ethnic groups within the United States, and very little is known about how African Americans and Caucasians may differ in their experience of loss. The purpose of this study was to examine the African-American experience of grief, with particular emphasis on issues of identity change, interpersonal dimensions of the loss, and continuing attachments with the deceased. Participants were 1,581 bereaved college students (940 Caucasians and 641 African Americans) attending classes at a large southern university. Each participant completed the Inventory of Complicated Grief-Revised, the Continuing Bonds Scale, and questions regarding the circumstances surrounding his or her loss. Results revealed that African Americans experienced more frequent bereavement by homicide, maintenance of a stronger continuing bond with the deceased, greater grief for the loss of extended kin beyond the immediate family, and a sense of su...

Few empirical studies have explored the grieving process among different ethnic groups within the United States, and very little is known about how African Americans and Caucasians may differ in their experience of loss. The purpose of this study was to examine the African-American experience of grief, with particular emphasis on issues of identity change, interpersonal dimensions of the loss, and continuing attachments with the deceased. Participants were 1,581 bereaved college students (940 Caucasians and 641 African Americans) attending classes at a large southern university. Each participant completed the Inventory of Complicated Grief-Revised, the Continuing Bonds Scale, and questions regarding the circumstances surrounding his or her loss. Results revealed that African Americans experienced more frequent bereavement by homicide, maintenance of a stronger continuing bond with the deceased, greater grief for the loss of extended kin beyond the immediate family, and a sense of su...

Crash data are collected through police reports and integrated with road inventory data for further analysis. Integrated police reports and inventory data yield correlated multivariate data for roadway entities (e.g., segments or intersections). Analysis of such data reveals important relationships that can help focus on high-risk situations and coming up with safety countermeasures. To understand relationships between crash frequencies and associated variables, while taking full advantage of the available data, multivariate random-parameters models are appropriate since they can simultaneously consider the correlation among the specific crash types and account for unobserved heterogeneity. However, a key issue that arises with correlated multivariate data is the number of crash-free samples increases, as crash counts have many categories. In this paper, we describe a multivariate random-parameters zero-inflated negative binomial (MRZINB) regression model for jointly modeling crash ...

In summer 2012, the University of Tennessee Health Science Center College of Dentistry transitioned from a departmental clinical education model to a comprehensive care/group leader model. The aim of this study was to investigate the perspectives of the fourth-year class of dental students who, because the transition took place during their training, had experienced treating patients under both educational models. To achieve this objective, a questionnaire was designed to assess the students' opinions on the efficiency of their effort, availability of specialty faculty, stress, collaboration with classmates, and availability of exposure to different practice styles and techniques under the two systems. The students were also given an opportunity to provide open-ended feedback on the shortcomings and advantages of the systems. The Class of 2013 had 81 students, 55 of whom participated in the survey for a response rate of 67.9%. The majority (86%) of the respondents preferred the ...

Several studies have reported that older black and Latino adults have lower cognitive function test scores than older white adults, but few have comprehensively examined reasons for score differences. This study evaluates whether differences in health and socioeconomic indicators, including literacy level, can explain differences in cognitive function test scores between older black and white adults.