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Rebecca L Hagedorn, Melissa D Olfert
In order to investigate the impact of food insecurity on college students in a highly health disparate region we (1) assessed the prevalence of food insecurity among young adults at a large, rural university in Appalachia, and (2) investigated the relationship between food insecurity and behavioral characteristics including academic performance, coping strategies, and money expenditure. A cross-sectional design was used to capture a representative sample of young adults attending a large, central Appalachian university in Fall 2016...
March 16, 2018: Nutrients
Melissa Ventura Marra, Sowmyanarayanan V Thuppal, Elizabeth J Johnson, Regan L Bailey
Proactive nutrition screening is an effective public health strategy for identifying and targeting individuals who could benefit from making dietary improvements for primary and secondary prevention of disease. The Dietary Screening Tool (DST) was developed and validated to assess nutritional risk among rural older adults. The purpose of this study was to evaluate the utility and validity of the DST to identify nutritional risk in middle-aged adults. This cross-sectional study in middle-aged adults (45-64 year olds, n = 87) who reside in Appalachia, examined nutritional status using an online health survey, biochemical measures, anthropometry, and three representative 24-h dietary recalls...
March 12, 2018: Nutrients
Julianna M Nemeth, Tiffany L Thomson, Bo Lu, Juan Peng, Valdis Krebs, Nathan J Doogan, Amy K Ferketich, Douglas M Post, Christopher R Browning, Electra D Paskett, Mary E Wewers
INTRODUCTION: The social-contextual model of tobacco control and the potential mechanisms of the maintenance or cessation of smoking behavior among disadvantaged women, including rural residents, have yet to be comprehensively studied. The purpose of this study was to determine the association between selected individual, interpersonal, workplace, and neighborhood characteristics and smoking status among women in Appalachia, a US region whose residents experience a disproportionate prevalence of tobacco-related health disparities...
March 2018: Rural and Remote Health
Roberto Cardarelli, Mary Horsley, Lisa Ray, Nancy Maggard, Jennifer Schilling, Sarah Weatherford, Fran Feltner, Kayla Gilliam
This exploratory study aimed to address the effectiveness of a lay-health worker (LHW) model in addressing social needs and readmissions of high-risk patients admitted in a rural community hospital. A quasi-experimental study design assessed implementation of a LHW model for assisting high-risk patients with their post-discharge social needs. Outcome measures included 30-day hospital readmissions rates during a 4-month baseline period compared with a 6-month post-implementation period. The LHW intervention involved assessment and development of a personalized social needs plan for enrolled patients (e...
February 21, 2018: Health Education Research
Linda Nguyen, Laura R Lander, Kevin E O'Grady, Patrick J Marshalek, Adrienne Schmidt, Audra K Kelly, Hendrée E Jones
BACKGROUND AND OBJECTIVES: Rising concerns regarding diversion and misuse of mono-buprenorphine for treatment of pregnant women with opioid use disorders have sparked interest in the use of buprenorphine + naloxone to reduce misuse and diversion rates. Examined the relationship of prenatal buprenorphine + naloxone exposure to neonatal outcomes. METHODS: This is a retrospective chart review of 26 mother infant dyads in comprehensive medication-assisted treatment with buprenorphine + naloxone during pregnancy...
March 2018: American Journal on Addictions
Elizabeth A Beverly, Marilyn D Ritholz, Linda A Wray, Ching-Ju Chiu, Emmy Suhl
Purpose: Food and eating convey memories and feelings and serve important functions in creating and maintaining relationships. Given the increasing rate of diabetes in the United States, research understanding the meaning of food may shed light on how patients negotiate everyday food choices while managing type 2 diabetes. The purpose of this qualitative study was to explore the meaning of food among adults with type 2 diabetes living in Northern Appalachia. Methods: In-depth, face-to-face interviews were conducted with type 2 diabetes patients...
February 2018: Diabetes Spectrum: a Publication of the American Diabetes Association
Emma C Potter, Katherine R Allen, Karen A Roberto
Researchers consider older women in rural Appalachia to have low levels of agency and high levels of fatalism regarding decision making about cancer treatment. Using the life course perspective, we examined older women's agency with information seeking about gynecological cancer. Semistructured interviews with 20 White women living in central Appalachia revealed four trajectories: Surrendering Control, Accepting Death, Self-Care, and Advocacy, each with its own forms of agency. Some women experienced personal transformation, increased self-efficacy, and a passion for community empowerment...
February 16, 2018: Journal of Women & Aging
Sadie P Hutson, Caroline K Darlington, Joanne M Hall, R Eric Heidel, Susan Gaskins
The Appalachian South is disproportionately affected by HIV/AIDS. Partly due to the negative connotation that this disease carries in religiously conservative areas, HIV-related stigma remains a critical barrier to HIV care in the South. However, spirituality is a well-documented, effective coping mechanism among persons living with HIV/AIDS (PLWH). The purpose of this study was to examine the relationship between HIV-related stigma and spiritual well-being among a sample of PLWH (n = 216) in Appalachian counties of Tennessee and Alabama using the HIV Stigma Scale and the Spiritual Well-being Scale...
February 15, 2018: Issues in Mental Health Nursing
Joy L Hart, Kandi L Walker, Clara G Sears, Lindsay K Tompkins, Alexander S Lee, Delvon T Mattingly, Allison Groom, Robyn Landry, Aida L Giachello, Thomas J Payne, Anshula Kesh, Allison Siu, Courteney Smith, Rose M Robertson
INTRODUCTION: In Appalachia, youth tobacco-use rates remain higher than the U.S. national average. Past research has indicated that several factors are related to high rates of tobacco use among Appalachian youth (e.g. low socioeconomic status, rural lifestyles). Of the Appalachian states, Kentucky has one of the highest rates of youth tobacco use. The aim of this study was to explore views of tobacco among Kentucky youth living in Appalachian counties. METHODS: In Fall 2014 - Spring 2015, focus group interviews were conducted with middle and high school students (N=109) in Appalachian counties in Kentucky...
January 2018: Tobacco Prevention & Cessation
Joanne Hall, Sadie P Hutson, Frankie West
As part of a mixed methods study determining end-of-life and advanced care planning needs in southern Appalachia, a narrative analysis was done of stories told in interviews of 8 selected participants using transcript data. Narratives were fraught with contradiction and paradox. Tensions were evident about living in Appalachia, the Bible Belt, and an area wherein distances are long and community rejection can occur as news travels quickly. The primary finding was that stigma, from several sources, and shrinking circles of social support for people living with HIV/AIDS, all of whom were in treatment, combined to create a sense of solitariness...
January 1, 2018: American Journal of Hospice & Palliative Care
Ann L Coker, Huong T Luu, Heather M Bush
PURPOSE: The purpose was to determine whether Appalachian residence alone or in combination with violence was linked to poorer quality of life (QOL). METHODS: Women recently diagnosed and included in either the Kentucky or North Carolina Cancer Registries were interviewed by phone between 2009 and 2015 (n = 3320; mean age = 56.74). Response rates were similar by state (40.1 in Kentucky and 40.9% in North Carolina). Appalachian (N = 990) versus non-Appalachian residents (N = 2330) were hypothesized to have poorer QOL defined as (a) lower Functional Assessment of Cancer Therapy-General (FACT-G) scores and (b) more symptoms of depression, stress, or comorbid physical conditions...
January 27, 2018: Quality of Life Research
Kenneth B Plants, Toni Marie Rudisill, Motao Zhu
Purpose: Research has shown that Appalachia has a higher traffic fatality rate than the non-Appalachian United States. This study compared traffic fatality rates in West Virginia to the rest of the United States. Methods: Fatality Analysis Reporting System and Census data from 2008-2012 were used to calculate traffic fatality rates. Poisson regression was used to model rate ratios stratified by age, sex, rurality, and transportation type, as well as rate ratios per licensed driver, vehicles registered and miles travelled...
March 2017: West Virginia Medical Journal
Rebecca S Linger
Objective. To create and implement a class in ethnopharmacology that would educate student pharmacists on folk medicine, including home remedies and native plants that are used as alternative medicinal sources; active components of medicinal plants including toxicity issues and the mechanism of action of beneficial compounds, such as catechins and other flavonoids; and nutraceuticals and poisonous plants. Methods. In this three-credit hour class, herbal remedies are investigated from the standpoints of medical efficacy, potential toxicities and drug interactions with prescribed medications...
December 2017: American Journal of Pharmaceutical Education
Anthony J Timpano, Carl E Zipper, David J Soucek, Stephen H Schoenholtz
Salinization of freshwaters by human activities is of growing concern globally. Consequences of salt pollution include adverse effects to aquatic biodiversity, ecosystem function, human health, and ecosystem services. In headwater streams of the temperate forests of eastern USA, elevated specific conductance (SC), a surrogate measurement for the major dissolved ions composing salinity, has been linked to decreased diversity of aquatic insects. However, such linkages have typically been based on limited numbers of SC measurements that do not quantify intra-annual variation...
January 8, 2018: Water Research
George A Mensah, Richard S Cooper, Anna Maria Siega-Riz, Lisa A Cooper, Justin D Smith, C Hendricks Brown, John M Westfall, Elizabeth O Ofili, LeShawndra N Price, Sonia Arteaga, Melissa C Green Parker, Cheryl R Nelson, Bradley J Newsome, Nicole Redmond, Rebecca A Roper, Bettina M Beech, Jada L Brooks, Debra Furr-Holden, Samson Y Gebreab, Wayne H Giles, Regina Smith James, Tené T Lewis, Ali H Mokdad, Kari D Moore, Joseph E Ravenell, Al Richmond, Nancy E Schoenberg, Mario Sims, Gopal K Singh, Anne E Sumner, Roberto P Treviño, Karriem S Watson, M Larissa Avilés-Santa, Jared P Reis, Charlotte A Pratt, Michael M Engelgau, David C Goff, Eliseo J Pérez-Stable
Cardiovascular disparities remain pervasive in the United States. Unequal disease burden is evident among population groups based on sex, race, ethnicity, socioeconomic status, educational attainment, nativity, or geography. Despite the significant declines in cardiovascular disease mortality rates in all demographic groups during the last 50 years, large disparities remain by sex, race, ethnicity, and geography. Recent data from modeling studies, linked micromap plots, and small-area analyses also demonstrate prominent variation in cardiovascular disease mortality rates across states and counties, with an especially high disease burden in the southeastern United States and Appalachia...
January 19, 2018: Circulation Research
J Travis Donahoe, Andrea R Titus, Nancy L Fleischer
The Appalachian Region has among the highest rates of smoking and smoking-related illness in the United States. Strong smoke-free legislation could help protect nonsmoking residents from the harmful effects of secondhand smoke. However, there is a dearth of state, county, city, and subcounty smoke-free law coverage throughout Appalachia. As of July 2016, only 21% of Appalachian residents were covered by comprehensive smoke-free laws (i.e., 100% coverage for workplaces, restaurants, and bars). Only 46% of Appalachians lived in places with 100% smoke-free workplace laws, only 30% lived in places with 100% smoke-free restaurant laws, and only 29% lived in places with 100% smoke-free bar laws...
January 18, 2018: American Journal of Public Health
Kelsey Leonard Grabeel, Jennifer Russomanno, Sandy Oelschlegel, Emily Tester, Robert Eric Heidel
Objective: The research compared and contrasted hand-scoring and computerized methods of evaluating the grade level of patient education materials that are distributed at an academic medical center in east Tennessee and sought to determine if these materials adhered to the American Medical Association's (AMA's) recommended reading level of sixth grade. Methods: Librarians at an academic medical center located in the heart of Appalachian Tennessee initiated the assessment of 150 of the most used printed patient education materials...
January 2018: Journal of the Medical Library Association: JMLA
Danielle Hobdy, R Keith Huffaker, Beth Bailey
OBJECTIVES: Despite their growing prevalence, pelvic floor disorders (PFDs) remain undertreated and not well understood by patients, with treatment disparities noted in specific subgroups of women. The goal of the present study was to determine the basic understanding of PFDs of women in the southern Appalachian region of the United States, to determine factors that predict knowledge, and to explore the possible disparities in seeking access to care among women in this region who reported symptoms...
January 2018: Southern Medical Journal
Mary de Groot, Todd Doyle, Jennifer Averyt
High rates of type 2 diabetes (T2DM) and depression exist in rural Appalachia with limited access to psychotherapeutic treatment. No manualized cognitive behavioral therapy (CBT) treatment materials exist that are culturally tailored for individuals in this region with T2DM. We describe the development of the Program ACTIVE CBT intervention for use with adults with T2DM and depression by mental health providers in rural Appalachia. Qualitative and quantitative methods were used to test the feasibility and acceptability of Program ACTIVE...
August 2017: Journal of Cognitive Psychotherapy
Laura Helena McArthur, Lanae Ball, Ariel C Danek, Donald Holbert
OBJECTIVES: To measure prevalence and correlates of food insecurity among college students in Appalachia, compare food-insecure and food-secure students on correlates, and identify predictor variables. DESIGN: Cross-sectional, online questionnaire. SETTING: University in Appalachia. PARTICIPANTS: Nonprobability, random sample of 1,093 students (317 male [30.1%]; 723 females [68.4%]). MAIN OUTCOME MEASURES: Food insecurity, coping strategies, money expenditure, academic progress, and demographics...
December 12, 2017: Journal of Nutrition Education and Behavior
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