Memphis Tennessee Research Articles

Social Justice and Community-Based Rehabilitation Counseling

This invited article reports and reflects upon the proceedings of a presentation at the NRCA Symposium on Social Justice held on in Memphis Tennessee in 2019. The author posits that a proper understanding of social justice opens the door for a new, international vision for rehabilitation counseling in the context of community. The model reinterprets rehabilitation counseling as social justice counseling within the framework of community-based rehabilitation as currently defined within the established matrix and guidelines. This model augments our understanding of rehabilitation counseling role and function with an emerging practice in advocacy/empowerment. The construct of empowerment is operationalized for development in practice across community settings. The author reflects upon lessons learned in advancing this model of practice in the Asia/Pacific region. In a call for collaborative next steps, he concludes that the way to an empowered international identity for rehabilitation counseling is through an activist, inclusive, international community of practice that advocates for our role as agents of social justice.

The struggle for the future of public housing in Memphis, Tennessee: Reflections on HUD's choice neighborhoods planning program

This paper critically examines the Choice Neighborhoods Planning Initiative that was carried out in the Vance Avenue Neighborhood in Memphis Tennessee (USA). It tells the story of the involvements of a coalition of 25 neighborhood organizations in partnership with the City and Regional Planning (CRP) Department at the University of Memphis – called the Vance Avenue Collaborative (VAC) – in the CN Planning Initiative. Launched in 2011 with significant community support, the CN Planning Initiative ended in 2013 with a resident-led oppositional planning effort that challenged the institutional plan.The VAC story explores some of the pitfalls that might arise in institutionally-created spaces for citizen participation, by revealing the broad range of tactics used by public officials to marginalize democratic citizen participation. Based on the issues that emerged during the CN Planning Initiative, the VAC created alternative strategies to respond to those generated through institutional planning. These counter-strategies, framed in Advocacy Planning and Action Research approaches were able to secure some important achievements along the way and might be useful for communities within publicly sponsored urban revitalization efforts.

Pediatric News

Pediatric News

A Lobectomy by Any Other Name

A Lobectomy by Any Other Name

Artere Urbane: Tre Diversi Esperimenti Nelle Citta Americane (Urban Freeway Decisions: Different Outcomes and Explanations in Three American Cities)

Using three case studies, Syracuse New York, Memphis Tennessee and, Interstate 105 in Los Angeles, I trace the changing regulatory environment for decision-making on interstate highway construction within inner cities in the United States. Syracuse saw construction before the evolution of a modern environmental, historical, transportation and housing law; in Memphis the freeway was stopped by citizen actions resulting in judicial interpretations of federal highway law; and the Los Angeles resolution was molded by a consent decree entered after a law suit brought by a new public interest law firm.

Salivary Cortisol Levels in Students Challenged with a Testing Stressor

The objective was twofold. The focus of the study was primarily to determine if the stress of a particularly difficult exam could cause students to lose the normal diurnal variation seen in human cortisol levels and secondarily, to validate the use of a competitive enzyme immunoassay for salivary cortisol. Physical therapy students enrolled in Research Design were asked to participate in the study by collecting baseline evening and morning salivary cortisols during what was regarded as a relatively stress free time in the Fall of 2009. The following spring, the same students were asked for samples the evening before and morning of their first Kinesiology test, traditionally a stressful time. Method validation was accomplished using instrumentation owned by the Medical Laboratory Science (MLS) Program and analysis was performed by MLS faculty and a second year MLS student. Participants were enrolled in the College of Health Sciences at the University of Tennessee in Memphis. Sample collection and testing was performed in the student laboratory of the Medical Laboratory Science Program. Physical therapy students in their first year of a three-year entry level doctorate program, DPT. This group of students did not lose their diurnal variation of cortisol. However, an unexpected finding was noted: the students' salivary cortisol specimen collected in the morning of the fall semester was significantly higher than the salivary cortisol specimen collected the morning of the test in the spring semester (p = .019). Method validation was successful demonstrating a strong correlation ( r = 0.915) when compared to the reference laboratory. Cortisol diurnal variation was not lost in the study participants, but further studies should be performed due to the low percentage of students completing the study and the lack of demographic diversity. Even though the method validation in the student laboratory setting demonstrates that it is indeed possible to obtain the same excellent correlation as is seen in a clinical setting, the student laboratory is not CLIA certified, so assays can be performed for research use only.

Melanoma: is hair the root of the problem?

View the pubcast on this paper at http://www.scivee.tv/node/29174

Abstract B113: Regional differences in barriers to breast cancer screening among low-income African American women in Nashville, Chattanooga, and Memphis Tennessee

Abstract Background: African American women are more likely to have advanced breast cancer at the time of diagnosis and experience worse outcomes than Caucasian women. National surveys have shown that African American women obtain less breast cancer screening than Caucasian women. However, the degree to which psychosocial and economic barriers contribute to racial differences in breast cancer screening remains unclear. Objectives: The purpose of this study was to examine regional predictors of breast cancer screening among African American women residing in Nashville, Chattanooga, and Memphis. In addition to regional predictors of breast cancer screening, obstacles to screening were also examined. The aim of this study was to incorporate this information into programs aimed at improving breast cancer screening rates at the three Tennessee cities. Methods: As part of the Meharry Community Networks Program (CNP) needs assessment, a community survey was administered to assess demographic characteristics, breast cancer screening practices, health care access and utilization, and lifestyle behaviors of low-income African American women. Participants were recruited from predominantly African American communities in Nashville, Chattanooga, and Memphis. Only women 40 years and older were included in this study. The final sample size was 286. Results: The screening rates for mammograms within the past two years among African American women, 40 years and older in Nashville, Chattanooga, and Memphis were 65%, 67% and 62% respectively. There were no regional differences in the screening rates. The predictors of mammograms in the three regions included having made at least one medical visit in the past year, annual household income, employment status, and health insurance status. Although geographically, there were similar predictors of breast cancer screening, there were differences in barriers to screening among the three cities. For example, Memphis participants were more likely to report transportation issues and child/elderly care as obstacles to screening compared to participants in Nashville and Chattanooga (p<.05). In addition, Nashville and Memphis were more likely to report fear of a positive cancer diagnosis than Chattanooga (p<.05). Discussion: Understanding regional similarities and differences in breast cancer screening behaviors among African American women is important for addressing psychosocial and economic barriers that may contribute to low screening rates. Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):B113.

Substance Users Get Creative to Fool Drug Tests

Substance Users Get Creative to Fool Drug Tests

Welcome to the Journal for the Practicing Orthopaedic Surgeon

Andrew H. Crenshaw, Jr, M.D., is Editor-in-Chief of Current Orthopaedic Practice. He is Associate Professor in the University of Tennessee–Campbell Clinic Department of Orthopaedic Surgery, Memphis Tennessee.

The Treatment of Hypertension in the Elderly

Following a hypertension symposium in San Francisco in September 2007, an expert panel was convened to discuss the treatment of hypertension in the elderly. Based on recent data, new recommendations may be indicated. The session was moderated by Marvin Moser, MD, Clinical Professor of Medicine at Yale University, New Haven, CT. Participants were William Cushman, MD, Professor of Preventive Medicine and Medicine at the University of Tennessee in Memphis, and Michael Ziegler, MD, Professor of Medicine, University of California at San Diego. The discussion was supported by Novartis Pharmaceuticals and Merck & Company, and each author received an honorarium from Novartis Pharmaceuticals and Merck & Company for time and effort spent participating in the discussion and reviewing the transcript for intellectual content before publication. The authors maintained full control of the discussion and the resulting content of this article.

Control of Blood Pressure: Does It Matter Which Agent You Use?

A panel was convened to discuss the question, "Is blood pressure lowering the sole determinant of outcome, or do specific drugs make a difference?" The panel was moderated by Marvin Moser, MD, Clinical Professor of Medicine at the Yale University School of Medicine, New Haven, CT. Panelists included Norman Kaplan, MD, Clinical Professor of Medicine at the University of Texas Southwestern Medical Center at Dallas, TX, and William Cushman, MD, Professor of Medicine at the University of Tennessee in Memphis, TN. The discussion was supported by Boehringer Ingelheim, and each author received an honorarium from Boehringer Ingelheim for time and effort spent participating in the discussion or reviewing the transcript for intellectual content before publication. The authors maintained full control of the discussion and the resulting content of this article.

A doctor in the house

I became chairman of the pathology department at Vanderbilt the second time the dean asked (Fig. 1). Here is the story of how that came about. In 1962, after serving in the Army, I joined Bill Shelly in surgical pathology at Johns Hopkins at a salary of $12,000 a year. We had a wonderful time using the first double-headed microscopes for sign-out. The house staff was superb, and many have gone on to outstanding careers. In January 1968, I signed on at the University of Tennessee in Memphis to run surgical pathology, but that position was not meant to be. Not long after I got there, I became very ill with hepatitis and was flown directly to Johns Hopkins for treatment. Then, the chairman who had hired me was fired and was contemplating legal action against the State of Tennessee, the governor, and the University. Then, Stan Eversole in Mountain View, CA, offered me a position in private practice, and I accepted. The night I left Memphis was the night that Martin Luther King, Jr, was assassinated, and the riots followed me as I drove across the country. Each city I passed through was torn by riots the day after I left it. It was like being followed by a slow-burning fire. Shortly after I began private practice, two residents from the University of Tennessee joined me. Things went well, but after a couple of years I discovered that private practice didn’t suit me. The two residents had left, and I found I missed the daily involvement with them. In 1971, Dr John Shapiro at Vanderbilt offered me a position to run surgical pathology, so I returned to Tennessee. Before I got there,

Hypertension, Renal Disease, and Cardiovascular Outcomes

During the meeting of the American Society of Hypertension in San Francisco, CA on May 17, 2005, a roundtable was convened to discuss the relationship between hypertension, renal disease, and cardiovascular outcomes. Dr. Marvin Moser, Clinical Professor at Yale University School of Medicine, New Haven, CT, chaired the session. Dr. Jan Basile, Professor of Medicine at the Ralph Johnson VA Medical Center and the Medical University of South Carolina in Charleston, SC and Dr. William Cushman, Professor of Preventive Medicine and Medicine at the University of Tennessee in Memphis, TN participated in the discussion.

‘Memphis Tennessee’ in Borstendorf: boundaries set and transcended in East German television entertainment

‘Memphis Tennessee’ in Borstendorf: boundaries set and transcended in East German television entertainment

Observations on the use of sirolimus and tacrolimus in high-risk renal transplant recipients

Sirolimus is the first of a group of mammalian target of rapamycin inhibitors to be introduced for clinical use in the United States. At the University of Tennessee in Memphis, we have evolved strategies for the use of sirolimus in kidney transplant recipients; which utilize the drug as a primary immunosuppressant and exploit its potential for preserving renal function. Conversions from the calcineurins to sirolimusbased immunosuppression established the efficacy of calcineurin-free immunosuppressants in selected high-risk patients. The conversion experience stimulated the design of protocols for primary use of sirolimus. Posttransplant use of sirolimus was associated with low incidence of rejection whether sirolimus was used with low-dose Prograf or in calcineurin-free protocols. Primary use with full-dose Prograf was associated with a high incidence of calcineurin-related nephrotoxicity and was abandoned in our program. Hematologic and lipid side effects were manageable, as was an observed increase in wound-healing problems and lymphocele formation. Continuous modifications of the sirolimus protocols to increase our benefit-to-risk ratio are ongoing and indicate a continued role for the drug in posttransplant immune suppression.

John N. Whitaker, MD

John N. Whitaker, MD, Chairman of the Neurology Department at the University of Alabama at Birmingham (UAB) died on August 29, 2001 at age 60. John was born in Memphis, Tennessee, and graduated magna cum laude from Hendrix College. In 1965, he earned his medical degree from the University of Tennessee College of Medicine. Following a medicine internship, he obtained neurology training at the Albert Einstein College of Medicine and then served as a Clinical Associate in the Medical Neurology Branch at NIH under the tutelage of Dr. W. King Engel. After a short tenure on the Neurology Faculty at the University of Minnesota, he joined the Neurology Department at the University of Tennessee in Memphis and was soon named Chairman of that Department. In 1985, he came to UAB, where he served as Chairman of the Neurology Department until his untimely death. John N. Whitaker When John came to UAB, it was clear that he had extraordinary administrative skills and leadership abilities. He built what is now a preeminent neurology program, nationally …

Memphis Tennessee Garrison: the remarkable story of a black Appalachian woman

As an Appalachian African-American woman, Memphis Tennessee Garrison belonged to a category of persons who have been triply ignored by historians. The daughter of former slaves, she moved to Gary, West Virginia, at the age of eight and died at the age of 98 in Huntington, West Virginia. The coalfields of McDowell county were among the richest seams in the nation and Gary, home of U.S. Steel, was one of the largest mines in the country. As Garrison makes clear, the backbone of that workforce - those who laid the railroad tracks, manned the coke ovens, and dug the coal - were black miners. These miners and their families created communities that became the centers of the struggle for unions, better education, and expanded civil rights and Memphis Tennessee Garrison, an innovative teacher, administrative worker at U.S. Steel, and vice-president of the National Board of the NAACP at the height of the civil rights struggle (1963-66) was at the center of all of these struggles. In many ways, this oral history, based on interview transcripts, is the untold and multidimensional story of African-American life in a West Virginia company town, as seen through the eyes of a remarkable woman.

Will women accept randomization in a clinical trial of hormonal contraceptives?

Despite the clear scientific merit of randomized clinical trials questions remain regarding whether this study design is sufficiently used in pharmacologic research involving hormonal contraceptives as well as whether women will accept random assignment in such a clinical trial. To evaluate these questions the authors performed a systematic review of published literature in three peer-reviewed journals to assess the study design participant assignment and the type of hormonal contraceptive used. In addition the authors undertook a review of the recruitment experience of a randomized clinical trial of hormonal contraceptives called the Contraceptive Hormone Assessment of Risk Markers study (CHARM). All articles involving the use of hormonal contraceptives in humans were reviewed. The majority of articles (62%) could be classified as observational in study design with the cohort study being the most commonly used type. Furthermore only 18% of studies used random assignment and it was rare (4.8%) to find a clinical trial that randomized participants to groups that used different types of hormonal contraceptive delivery systems (i.e. oral vs. parenteral delivery). During recruitment for the CHARM study 2079 women were contacted by telephone 472 (23%) attended a screening visit and 125 (5%) were considered eligible and were randomly assigned to 1 of 2 different hormonal contraceptive delivery systems (the levonorgestrel implant or an oral contraceptive). The recruitment experience in CHARM was similar to that of other clinical trials in the Memphis Tennessee area. The authors infer that the randomized clinical trial study design is being underused in hormonal contraceptive research even though it seems that women are willing to participate in a randomized clinical trial and to accept randomization to different types of hormonal contraceptive delivery systems. (authors)

Family planning decisions after prenatal detection of fetal abnormalities

Our purpose was to assess the family planning decisions made by women found to be carrying fetuses with chromosome abnormalities or neural tube defects. We studied the family planning decisions of 132 women carrying fetuses with chromosome abnormalities (n = 91) or neural tube defects (n = 41) with regard to prenatal diagnosis, pregnancy management decision, patient's gravidity, and maternal and gestational age. Twenty women (17 carrying fetuses with chromosome abnormalities and 3 with fetal neural tube defects) elected permanent sterilization after completion of the affected pregnancy. Only maternal age and fetal chromosome abnormalities were associated with a decision to obtain permanent sterilization. Most women carrying fetuses with chromosome abnormalities or neural tube defects will not choose permanent sterilization after completion of the pregnancy. Delaying such decisions until resolution of grief and depression is now facilitated by the availability of safe, reliable, and relatively long-term reversible contraceptive agents.