Assistive technology and learning disabilities: today's realities and tomorrow's promises

Many forms of technology, both "high" and "low," can help individuals with learning disabilities capitalize on their strengths and bypass, or compensate for, their disabilities. This article surveys the current status of assistive technology for this population and reflects on future promises and potential problems. In addition, a model is presented for conceptualizing assistive technology in terms of the types of barriers it helps persons with disabilities to surmount. Several current technologies are described and the research supporting their effectiveness reviewed: word processing, computer-based instruction in reading and other academic areas, interactive videodisc interventions for math, and technologies for daily life. In conclusion, three themes related to the future success of assistive technology applications are discussed: equity of access to technology; ease of technology, use; and emergent technologies, such as virtual reality.     

Blastomycosis in northeast Tennessee

STUDY OBJECTIVES: To study the epidemiologic and clinical features of blastomycosis in northeast Tennessee. DESIGN: Retrospective review of blastomycosis cases in the region from 1980 through 1995. SETTING: Hospitals located in the Tri-Cities region of northeast Tennessee. PATIENTS: Seventy-two patients with confirmed blastomycosis infection. INTERVENTIONS: None. RESULTS: During the 1980 to 1995 study period, we documented 72 cases of blastomycosis. The mean age was 52 years (range, 13 to 86 years), most were male (69.4%), and nine were immunocompromised. A possible environmental exposure was noted for 28 patients. Pulmonary involvement represented the most common site of infection (61 cases), but multiorgan involvement was common (17 cases). Most patients with pulmonary blastomycosis (66%) presented with a chronic illness, and radiologic findings usually revealed local consolidation or a mass-like lesion. Nine patients developed ARDS with an associated mortality rate of 89%, compared with a 10% mortality for non-ARDS pulmonary cases. Antifungal treatment regimens varied widely, with amphotericin B often used for sicker patients. An epidemiologic evaluation revealed that the mean yearly incidence rate for blastomycosis quadrupled between 1980 and 1987 (0.31 cases/ 100,000 population) and 1988 to 1995 (1.23 cases/100,000 population) (p=0.00001). Most new blastomycosis cases in the 1988 to 1995 period occurred in three counties in the region where significant new construction projects have been underway. CONCLUSION: Blastomycosis is endemic in northeast Tennessee and the number of cases is increasing, coinciding with major new construction in the region. Clinicians in the area must be alert to this condition.     

Assessing dental manpower needs in Tennessee

Using a formula developed by the State of Kentucky and the best data available for the State of Tennessee, it is estimated that this state currently has a slight oversupply of dentists, but that by the turn of the century this will have become a shortage. There is no reason to doubt these estimates except that for confidence in them we will need state-specific data on the supply of dental manpower, the need for dental care, and the demand for dental care. Following the recommendations of the Institute of Medicine and others, the College of Dentistry has initiated the Dental Manpower Project to develop and maintain a database which will allow Tennessee to forecast and monitor trends in the supply of dental personnel and factors affecting need and demand. Hopefully, such an activity will help us avoid mistakes like those made 25 to 30 years ago which resulted in the education of too many dentists nationwide (and in this state) and an unfortunate breach between practitioners and dental education.     

Tuberculosis in Shelby County and Tennessee correctional facilities

A case is presented which highlights the problems encountered when using an implant-stabilised overdenture in an edentulous upper jaw, opposed by a natural dentition.     

Design and Evaluation of Experimental Bridges in Tennessee

This paper describes the design and evaluates the adequacy of the moment connection of an experimental two-span highway bridge designed by the Tennessee Department of Transportation. The Massman Drive Bridge is an experimental design that unifies the construction economy of simple span bridges and the structural economy of continuous span bridges. The experimental connection, consisting of cover plates and kicker wedge plates, is used to connect the two adjoining girders over the center pier. As a result, the bridge is designed to function as a continuous bridge during the deck pour and behave compositely with the reinforced concrete deck under the live load. After completing a moment comparison analysis, it is concluded that the Massman Drive Bridge indeed acts as continuous over the pier as it was designed.     

Assistive devices used by home-based elderly persons with arthritis

OBJECTIVE: This article examines assistive device use by home-based elderly persons with arthritis. METHOD: Sixty-six persons were interviewed for the State University of New York at Buffalo (University at Buffalo) Rehabilitation Engineering Research Center Consumer Assessment Study, which sought information on need for and current use of assistive devices. Subjects were assigned to a moderate or a severe arthritis group according to the impact of arthritis on their activities. RESULTS: Subjects in the severe arthritis group had more chronic diseases, a higher level of pain, and a lower level of independence in self-care activities than subjects in the moderate arthritis group. Similarities between the groups included relatively poor health, high rate of medication use, depression, use of a high number of assistive devices (about 10 per person), and an expressed need for additional devices, such as reachers, magnifiers, grab bars, jar openers, and hearing aids. Generally, there was a high rate of satisfaction with the assistive devices used. Most subjects missed being able to participate in at least one activity; most of these activities were active and many related to leisure time. CONCLUSION: Findings also revealed that subjects had inadequate information on assistive devices, which suggests the importance of more occupational therapy involvement with elderly persons in selecting devices.     

Residential treatment for emotionally disturbed children & adolescents in Tennessee

In some cases the differential diagnosis of the torsion of the testicles may be difficult also for the experienced clinician. It is reported on a new method of the delimitation of the torsion of the testicles compared with inflammatory changes of the testicles and the epididymis. By means of the ultrasound-Doppler-method the blood supply of the vasa spermatica is registered. Missing Doppler-signals in the direct measurement above the spermatic cord in comparison to the collateral side are typical for a complete torsion of the testicles.     

Mapping of Landsat Satellite and Gravity Lineaments in West Tennessee

Earthquakes are a common occurrence in west Tennessee. Yet it is difficult to recognize related faults within the alluvial valley because of the unconsolidated sediments. Therefore, a synergetic approach to the analysis of lineament patterns was applied through the use of Landsat satellite and gravity anomaly data. Landsat satellite images were evaluated for lineament identification using different spectral bands, seasons, enhancement, and image interpretation techniques. Gravity trends were delineated on the gravity anomaly map of west Tennessee, and gravity lineaments were identified and mapped. The Landsat and gravity lineaments were quantitatively analyzed and compared by means of two‐dimensional histograms and rose diagrams. The results indicated that the primary direction of both Landsat and gravity lineaments was NE; N36‐63E for Landsat and N27‐72E for gravity. Weaker trends were found in N50‐55W for Landsat and N60‐70W for gravity. The NE trend of the lineaments corresponded to faults and was in accordance with reactivation of the Reelfoot rift near the Mississippi River. These results suggest that deeper features, maybe at the earthquake focal depth, probably extend to the land surface as Landsat detectable lineaments.     

Extrapulmonary tuberculosis in Tennessee: lessons from the last decade

Human immunodeficiency virus type-1 Tat protein is phosphorylated by protein kinase C in a calcium-, diacylglycerol-, and phosphatidylserine-dependent manner. Maximum phosphorylation is reached at a stoichiometry of between 0.45 and 0.5 mol of phosphate per mol of Tat. Several Tat peptides, containing serine at position 46, are the only ones which are phosphorylated at significant rates. Several other Tat peptides containing potential protein kinase C phosphorylation sites are not phosphorylated.     

Assessing the Benefits of Assistive Technologies for Activities and Participation.

Purpose: Assistive technologies (ATs) are a key component of the Environmental Factors domain of the World Health Organization's International Classification of Functioning, Disability and Health (ICF). This article defines the Environmental Factors of the ICF and describes how ATs can improve the functioning of individuals with disabilities in community environments. Emphasis is placed on the need for comprehensive assessment before selecting ATs, particularly of the individual's current goals, past experiences with the use of technologies and other supports, and predisposition to use the AT as well as alternative or additional supports. Method: Previous research identified correlates of successful AT use and other supports by persons with disabilities. Key studies are reviewed with a discussion of the implications of findings on the further development of the ICF. Conclusion: Effective use of ATs and other supports will be maximized by matching device and support features to users' goals, preferences, and environmental resources. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Roof Collapse, Magic Mart Store, Bolivar, Tennessee

This paper summarizes an investigation of the July 2, 1983, roof collapse of the Magic Mart store in Bolivar, Tennessee. The building was a onestory retail store of steel‐framed roof construction. The collapse occurred during a severe thunderstorm with intense rainfall. The investigation includes review of background information and eyewitness accounts of the collapse, review of design and construction documents, site investigation and sample collection, laboratory testing of samples of the collapse debris, and structural analyses. The initiating mode of failure was instability of one of the beam‐column connections of the roof framing, triggered by ponded roof water. The principal cause of the failure was inadequate buckling resistance of the unbraced and unstiffened beam‐column connections, due to major deviations in the construction from the design documents. Also contributing to the failure were ponding rain water caused by improper slope and drainage of the roof and the increased weight of roofing materials added during the 10‐year life of the building. The paper concludes with a summary of the results of a personal injury law suit resulting from the collapse, and with recommendations for improvement in design and construction practices based on the lessons learned from this failure.     

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.     

The role of managed care: the national and Tennessee experiences

The United States is the only developed country with no national health care policy. What exists is a national health insurance system. The problem with this system arises when paying for health care for the poor, who often require the most expensive type of care for acute or episodic ailments. Managed care, though not a panacea, has the potential of providing the organization to effectively control costs and change the existing health care paradigm from one of fee-for-service inpatient care to one of ambulatory care, home-based care, and physician office-based procedures. An example of a state-based initiative that has cut medical costs is Tennessee's TennCare. Under TennCare, approximately 1.2 million Tennesseans are covered, nearly 400,000 of whom were previously uninsured. Such programs, both state and national, must now look to including prevention and wellness care to effectively change the underlying epidemiology of illness among the poor.