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There are meaningful cancer-related disparities in the Appalachian region of the U.S. To address these disparities, the Appalachia Community Cancer Network (ACCN), a collaboration of investigators and community partners in five states (Kentucky, Ohio, Pennsylvania, Virginia, and West Virginia), is involved in increasing cancer education and awareness, conducting community-based participatory research (CBPR), and creating mentorship and training opportunities. The primary objective of this paper is to describe cancer-related disparities in the Appalachian region of the U.S. as an example of the disparities experienced by underserved, predominantly white, rural populations, and to describe ACCN activities designed to intervene regarding these disparities. An ACCN overview/history and the diverse activities of ACCN-participating states are presented in an effort to suggest potential useful strategies for working to reduce health-related disparities in underserved white populations. Strengths that have emerged from the ACCN approach (e.g., innovative collaborations, long-standing established networks) and remaining challenges (e.g., difficulties with continually changing communities, scarce resources) are described. Important recommendations that have emerged from the ACCN are also presented, including the value of allowing communities to lead CBPR efforts. Characteristics of the community-based work of the ACCN provide a framework for reducing health-related disparities in Appalachia and in other underserved white and rural populations. [ABSTRACT FROM AUTHOR]

The article discusses the barriers faced by families of infants with neonatal abstinence syndrome (NAS) in participating to research in rural Appalachian region in the U.S. and some recommendations to address them. Other topics include how opioid use during pregnancy increases risk of NAS in newborn infants, and the Appalachian states like West Virginia, Tennessee, and Alabama.

The article describes the development and implementation of a model to guide entry-level doctor of physical therapy (PT) students about their roles across the spectrum of opioid use disorder (OUD), across the lifespan, and across specialties within PT practice. Topics mentioned include the impact of the OUD epidemic on West Virginia, the 2019 workshop of The Role of Nonpharmacological Approaches to Pain Management, and implementation of the model for rural community education.

Since beginning operations in Central Appalachia, coal producers have economically exploited residents and exposed them to severe health risks associated with pollution. Despite causing these problems, the industry enjoys vigorous popular support. Drawing on nine months of immersive ethnography in "Shale County," this article examines why many Appalachians endorse the coal industry despite its negative externalities. I find that Appalachia's subordinate relationship to the rest of the nation plays a profound role in conditioning the region's pro-industry, anti-environmental views. Many Appalachians feel like the federal government neglects them, and like urban America, devalues them. Drawing upon Antonio Gramsci's theory of hegemony, I show how the coal industry capitalizes upon these feelings by promoting coal heritage —a carefully curated cultural construction that emphasizes selective aspects of Appalachian history while erasing those that challenge its domination. Coal heritage, I show, conveys environmentalism as an attack on Appalachians' right to economic opportunity, their role in the national division of labor, and their moral worth. It frames industry representatives, on the other hand, as guardians of regional interests and values. [ABSTRACT FROM AUTHOR]

The purpose of this article was to examine the average distance traveled to access an abortion procedure, rates of return for the procedure, and whether or not those living in rural zip codes were less likely to return for the abortion compared with residents in urban zip codes, in the context of a 48-hour in-person mandatory waiting period in Tennessee. Findings indicated that over 12 percent of patients who attended the in-person counseling session did not return for the procedure. Moreover, abortion patients in this study traveled an average of 50.53 miles to access abortion care, which is notably higher than the estimated national average of 11.00 miles. Rural residents were significantly more likely than urban residents to have to travel farther to access abortion services. However, neither geographic location nor distance traveled were predictive of returning to the clinic for the second appointment to obtain the abortion, suggesting that patients who did return were able to overcome any geographic disparities. Given the policy mandate that requires a minimum of two in-person clinic visits to obtain the abortion, patients who are traveling farther must still use more resources for two trips, which is a burden to them that is not experienced by more urban residents who are located in closer proximity to abortion providers. The article concludes with a discussion of the implications of the findings for social work practice and policy. [ABSTRACT FROM AUTHOR]

Rural schools face unique challenges that affect student academic success or failure. Youths served in rural settings experience barriers to learning that negatively influence their achievement and developmental outcomes. To improve outcomes for rural youths, it is important for schools to understand overall school experiences so that schoolwide interventions may be put in place to combat identified risks. In this study, descriptive statistics were used to examine rural middle school youths' perceptions of their overall school experiences, and a logistic regression explored how these experiences influence their academic achievement. Data were collected from 3,296 middle school youths in six Appalachian counties as part of a communitywide needs assessment. Examination of rural youths' school experiences revealed well-developed peer relationships and high perceptions of parental involvement. Authors identified evident needs in relation to student perceptions of support for diversity and limited school connectedness. Results from logistic regression analyses showed that academic motivation and peer relationships were positively and significantly related to academic achievement. The article concludes with a discussion of the findings' implications for social work practice in rural schools. [ABSTRACT FROM AUTHOR]

Purpose of the Study: The purpose of this study was to explore how older women in rural Appalachia with gynecological cancer construct and interpret their experience with cancer. Design and Methods: Grounded in social constructionist theory, semistructured in-depth interviews were conducted with 20 women, aged 51–82, who had been treated for gynecological cancer. Transcripts were analyzed using the constant comparative method. Results: Although women narrated their experience along a common trajectory from symptoms to diagnosis to treatment, four distinct patterns of posttreatment perceptions were described: (a) positive: women believed they were cancer survivors, (b) cautious: women saw themselves as survivors but not risk free, (c) distanced: women viewed themselves as cured and equated survivor with victim, and (d) resigned: women refused more treatment. All of the women acknowledged an inner strength in how they experienced cancer, requiring a more nuanced framework for understanding how negative and positive feelings coexist with faith in a higher power and the capacity to endure a devastating threat to life and health. Implications: The findings expand the concept of survivor identity, suggesting that the women’s perception that they had met life’s challenges with fortitude and inner strength may have more resonance in later life than the concept of survivorship. Family members and medical and public health professionals need to support older women’s individual response to cancer recovery and acknowledge their complicated reactions to a cancer diagnosis and prognosis. [ABSTRACT FROM PUBLISHER]

Completion of the Human Papillomavirus ( HPV) vaccine series is a national priority. This study not only identified correlates of intent to complete the vaccine series and actual series completion, but also tested the efficacy of a DVD intervention to promote series completion. Women's beliefs that all 3 doses reduced cancer risk predicted intent and completion. Intention predicted completion, as did the belief that having a friend accompany the woman would promote completion. Beyond these effects, women assigned to the intervention were 2.44 times more likely than women in the usual care group to complete the series. Thus, in controlled analyses, a theory-grounded DVD intervention successfully promoted HPV series completion in a community setting. This method of intervention has high translational potential. [ABSTRACT FROM AUTHOR]

A response by François Furstenberg to a letter to the editor about his article "The Significance of the Trans-Appalachian Frontier in Atlantic History" in the June 2008 issue is presented.

A letter to the editor is presented in response to the article "The Significance of the Trans-Appalachian Frontier in Atlantic History," by François Furstenberg in the June 2008 issue.

Spatial genetic structure in white-tailed deer (Odocoileus virginianus) has been examined at regional scales, but genetic markers with the resolution to detect fine-scale patterns have appeared only recently. We used a panel of microsatellite DNA markers, radiotelemetry data, and visual observations of marked deer to study fine-scale social and genetic structure in a high-density population of white-tailed deer (12-20 deer/km²). We collected genetic data on 229 adult females, 102 of which were assigned to 28 social groups. Our results were consistent with the conceptual model of white-tailed deer social structure, where philopatric females form social groups composed of related individuals. Within-group relatedness values approached the expected value for 1st cousins (R = 0.103, SE = 0.033), but individuals among groups (R = -0.014, SE = 0.003) and overall (R = -0.009, SE = 0.003) were unrelated. Fixation indices revealed a significant departure from equilibrium values among social groups (FST = 0.076, SE = 0.007) and an excess of heterozygotes within groups (FIS = -0.050, SE = 0.018), consistent with theoretical expectations for mammal populations characterized by female philopatry and a polygynous mating system. Analyses of spatial autocorrelation indicated genetic structuring occurred at a very fine spatial scale, where pairs of adult females within 1 km were genetically nonindependent. The occurrence of fine-scale genetic and social structure has implications for the ecology and management of white-tailed deer, including habitat use and resource competition, offspring sex allocation theories, disease transmission, and the consideration of social behaviors in management. [ABSTRACT FROM AUTHOR]

This article argues for the historical importance in American history of the area between the Appalachian Mountains and the Mississippi River. The author describes how the region was hotly contested by British, French, Spanish, American and Native Americans between roughly 1754 and 1815. He believes the several wars engulfing the region during that time period, the Seven Years War, the American Revolution, the Indian Wars and the War of 1812, should be seen a single continuous conflict. Whether the area would become part of the United States was not a foregone conclusion.

Describes how life tables for trees offer birth and death rates for each age class or size class in a population. Differences in life-history patterns in reference to selective forces and mechanisms; Consideration of the annual survival and reproduction rates of trees; Shape of the mortality curve; Analyzation of the age distributions for Appalachian second-growth forest; Evidence for declining mortality with size for small individual trees.

A letter to the editor is presented in response to the article "The Overlooked Terrestrial Impacts of Mountaintop Mining" by James Wickham and colleagues from 2013.

The article reports on the development of an inter-active web-based decision support system which aims to assist the analysis of harvesting costs and productivity of roundwood operations in Appalachian Region.