Sociology Commons^™

Changes In Perceptions Of First Responders After Witnessing A Drug Overdose: Individual And Contextual Variations Among People Who Use Opioids In West Virginia, Kathleen L. Egan, Kelly Gurka, Alexandria Macmadu, Herb Linn

Journal of Appalachian Health

Introduction: Success of opioid overdose interventions involving first responders is dependent on the comfort level that bystanders have with first responders and their willingness to call for assistance. Positive or negative experiences with first responders following witnessing an overdose may influence a person’s willingness to call a first responder for assistance in the future.

Purpose: The objective of this study was to examine changes in bystanders’ perceptions of first responders following witnessing an overdose attended by emergency medical services or a law enforcement official. It specifically explored perception changes among a sample of individuals residing in Appalachia who use prescription …

Disparities In Mortality Between Appalachian And Non-Appalachian Regions Of Kentucky, Sonali S. Salunkhe, Sahal Alzahrani, Beatrice Ugiliweneza

Journal of Appalachian Health

Introduction: In the opioid epidemic, the U.S. faces a significant public health crisis, with some areas of the country, such as rural and Appalachian regions, suffering more than others. The differential regional impact of the crisis in Kentucky—a state with both non-metropolitan/metropolitan and Appalachian/Non-Appalachian statuses—has not yet been documented despite such knowledge being essential to the success of overdose prevention efforts.

Purpose: This study compares all-cause, drug- and opioid-related mortality between counties in different regions of Kentucky: Appalachian non-metropolitan, Appalachian metropolitan, non-Appalachian non-metropolitan, and non-Appalachian metropolitan.

Methods: Age-adjusted mortality data from the Centers for Disease Control and Prevention’s Wide-ranging Online …

Assessing And Addressing The Determinants Of Appalachian Population Health: A Scoping Review, David L. Driscoll, Hannah O'Donnell, Maitri Patel, David C. Cattell-Gordon

Journal of Appalachian Health

Introduction: Residents of Appalachia experience elevated rates of morbidity and mortality compared to national averages, and these disparities are associated with inequitable exposures to various determinants of population health. Social and environmental determinants of health are a useful lens through which to develop and evaluate programs to mitigate regional health disparities.

Methods: This 2023 scoping review was conducted of studies linking determinants of Appalachian health with leading causes of regional mortality and morbidity. The search strategy employed a keyword search that included geographic terms for the Appalachian Region and the primary adverse health outcomes in that region. Studies meeting the …

High-Risk Individuals And Naloxone Use: Implications For Thn Programs In Rural Appalachian Communities, Victor Garcia, Lisa Mccann, Erick Lauber, Christian Vaccaro, Melissa Swauger, Alex Daniel Heckert

Journal of Appalachian Health

Introduction: Take-home naloxone (THN) is being made available across rural Appalachia to curb opioid overdose fatalities. Despite this initiative, some opioid users do not possess naloxone, and if they do, do not administer it to others.

Purpose: Research findings on risk factors that contribute to opioid overdose are presented. These factors, identified in a sample of 16 overdose cases, are (1) early onset age of opioid use; (2) progressive opioid use; (3) a transition from pain medication to heroin and fentanyl; (4) fears of being arrested at a naloxone intervention if first responders are contacted, and (5) limited knowledge of …

Review Of: Coal, Cages, Crisis: The Rise Of The Prison Economy In Central Appalachia, Ted Olson Phd

Journal of Appalachian Health

Ted Olson, PhD, is a professor of both Appalachian Studies and Bluegrass, Old-Time and Roots Music Studies at East Tennessee State University. In this piece, he reviews Professor Judah Schept's Coal, Cages, Crisis: The Rise of the Prison Economy in Central Appalachia and discusses the impacts of incarceration on the health of Appalachia and on its residents more broadly.

Reimagining A Caregiver-Friendly Society, Jodi L. Southerland

Journal of Appalachian Health

Demographic aging is accelerating in the Appalachian Region, resulting in a growing proportion of caregivers living in areas that lack services to support their needs. Strategies are urgently needed in Appalachia to address deficiencies in the region’s long-term supports and services for older adults and their caregivers. Strengthening equitable access to care and community supports for family caregivers is a policy priority for state and community leaders in Appalachia.

The Ninth Myth Of Appalachia, Randolph Wykoff

Journal of Appalachian Health

Many stereotypes afflict our much-maligned region, and the Jonesborough­­–Washington County History Museum displays eight of these "myths of Appalachia." Here, our Editor-in-Chief suggests a ninth—that the people of Appalachia "do not care" about their health—and argues that regional health disparities result not from apathy but from a confluence of socioeconomic factors.

The Last Of Us In Therapy: How Mind-Controlling Fungi And Gut Bacteria Affect Your Mental Health, Anastasia Lyon

Journal of Pharmacology & Nutritional Sciences

The "psilocybiome" represents the mutually beneficial relationship between ourselves, our bacteria, and psychedelic drugs. This short review briefly discusses the benefits and limitations surrounding the potential for psychedelic therapy to synergize with gut bacteria to help regulate and maintain proper balance in the immune system, diet, and stress levels. Psychedelic therapy is a novel treatment strategy that has the potential to improve patient mental health, and, by identifying the types of gut bacteria present in patients, it can aid in personalizing medicine by determining how well their "psilocybiome" may respond.

Reviewer Acknowledgments, Randy Wykoff Md, Mph & Tm, Rachel E. Dixon Mphil

Journal of Appalachian Health

As we reach our fifth year, we are particularly thankful for the contributions of our peer reviewers. The knowledge, expertise, and guidance offered by the people listed below have ensured that we can continue to share timely research to effect health and well-being across Appalachia.

We Welcome Findings From Further Afield, Randy Wykoff Md, Mph & Tm, Rachel E. Dixon Mphil

Journal of Appalachian Health

For the past five years, the Journal of Appalachian Health has published timely, high-quality research from within Appalachia. We also welcome submissions from those working outside of Appalachia who produce quality research of direct relevance to our region.

Adult Asthma Associated With Roadway Density And Housing In Rural Appalachia: The Mountain Air Project (Map)., W Jay Christian, John Flunker, Beverly May, Susan Westneat, Wayne T Sanderson, Nancy Schoenberg, Steven R Browning

UK CARES Faculty Publications

BACKGROUND: Appalachian Kentucky is a rural area with a high prevalence of asthma among adults. The relative contribution of environmental exposures in the etiology of adult asthma in these populations has been understudied.

OBJECTIVE: This manuscript describes the aims, study design, methods, and characteristics of participants for the Mountain Air Project (MAP), and focuses on associations between small area environmental exposures, including roadways and mining operations, and lifetime and current asthma in adults.

METHODS: A cohort of residents, aged 21 and older, in two Kentucky counties, was enrolled in a community-based, cross-sectional study. Stratified cluster sampling was used to select …

Connections Network: Harnessing The Collective Influence Of Grassroots Leaders To Address Health-Related Problems In Hawkins And Hancock County, Tn, Dr. Jodi L. Southerland, Teresa Buttry, Connie Johnson, Sheldon Livesay, Lisa Nichols, Priscilla Rogers

Journal of Appalachian Health

In March 2021, grassroots leaders in two counties in northeast Tennessee formed a new network called Connections. Leaders are working to strengthen the capacity of the network and member organizations by promoting partnerships as vital to address effectively rural social determinants of health. Connections provides network members with capacity-building tools and resources, including two funding opportunities, to achieve their missions and sustain impact. Network members are also aligning around common goals to address the socioeconomic conditions affecting health outcomes. Connections will utilize findings from network activities and collaborations to identify synergies that can accelerate improvements in community health and …

Evaluating The Association Between Depressive Symptoms And Glycemic Control Among Residents Of Rural Appalachia, Brittany L. Smalls, Adebola Adegboyega, Ellen Combs, Eli W. Travis, Felipe De La Barra, Lovoria B. Williams, Nancy Schoenberg

Journal of Appalachian Health

Introduction: Type 2 diabetes mellitus (T2DM) is associated with a range of co-morbid physical and psychological conditions, including depression. Yet there is a dearth of evidence regarding the prevalence of depression among those in Appalachia living with T2DM; this gap persists despite the higher regional prevalence of T2DM and challenging social determinants of health.

Purpose: This study aimed to provide greater detail about the relationships between T2DM and depressive symptoms in adults living in Appalachia Kentucky.

Methods: The present study was a cross-sectional analysis of baseline data derived from an ongoing study of Appalachia Kentucky adults living with T2DM. Outcome …

The Conditions Of Oregon's Latinx Farmworkers, Kevin Alejandrez

Theses and Dissertations--Sociology

The goal of this three-paper dissertation is to better understand inequalities that Latinx farmworkers endure and the ways through which these inequalities can be addressed. As such, this dissertation examines pertinent inequalities Latinx farmworkers experience in the United States, their responses to resulting hardships, and the effects that crises such as the Covid-19 pandemic have in both exacerbating hardship and expanding opportunities to challenge inequitable systems in place. This is done through an intersectional analysis of a multi-year ethnographic study conducted in Oregon’s Willamette Valley.

First, paper one, titled, “Subordinate Adaptation: Intragroup Hierarchies Among Blueberry Pickers,” explores the ways in …

Let's Not Do Anything Drastic: Processes Of Reproducing Rural Marginalization In Education Policy Decision-Making, Julia M. Miller

Theses and Dissertations--Sociology

At a school board meeting in micropolitan Athens County, parents of children attending the district’s smallest elementary school, Chauncey Elementary, packed in to defend the school against consolidation. They made calls for a levy to cover the impending budget shortfall and offered to reduce their classrooms by half if other schools would also bear some of the costs. They spent their holiday season defending their school, a source of vibrancy in the small town, from being closed. In the meeting, someone advocating for alternatives to closure suggested cutting administrator positions. The board response, according to one parent-leader? “Let’s not do …

Sugar And Spice: Sex, Money, And Social Media, Rachel Elizabeth Davis

Theses and Dissertations--Sociology

Interest in transactional sex, or the provision of a sexual relationship in exchange for gifts and/or money, has increased in recent years among researchers, nongovernmental organizations, and law enforcement officials as increasing numbers of women self-identify as hypergamous, indicating their interest in forming heterosexual partnerships with men of higher status. Hypergamous women may identify as sugar babies, spoiled girlfriends, or high-value women. A sugar baby is a woman providing romantic companionship to an older man, known as a sugar daddy, in exchange for money and/or gifts. A spoiled girlfriend is a woman whose partner provides her with money and/or gifts …

Factors Associated With Successful Military-To-Civilian Transition Among Special Forces Veterans, Edward Richter

Theses and Dissertations--Social Work

The purpose of this study was to explore the military-to-civilian transitional experience in a sample of Special Forces veterans. Acknowledging challenges in accessing the veteran population, most existing research on the military-to-civilian transition consolidates military occupations into a single sample. This method fails to address the intricacies that may exist within individual military occupations, especially that of U.S. Army Special Forces soldiers. Special Forces qualified soldiers represent the largest portion of all U.S. Military Special Operations Forces and are responsible for the majority of all Special Operations activities, yet their experience in transitioning out of the Army is largely unknown. …

The Basil Technique: Bias Adaptive Statistical Inference Learning Agents For Learning From Human Feedback, Jonathan Indigo Watson

Theses and Dissertations--Computer Science

We introduce a novel approach for learning behaviors using human-provided feedback that is subject to systematic bias. Our method, known as BASIL, models the feedback signal as a combination of a heuristic evaluation of an action's utility and a probabilistically-drawn bias value, characterized by unknown parameters. We present both the general framework for our technique and specific algorithms for biases drawn from a normal distribution. We evaluate our approach across various environments and tasks, comparing it to interactive and non-interactive machine learning methods, including deep learning techniques, using human trainers and a synthetic oracle with feedback distorted to varying degrees. …

Conceptualizing Asexual Identities, Miranda L. Bejda

Theses and Dissertations--Family Sciences

In current literature, there is little congruence on an inclusive definition of human asexuality. This study explored individuals’ self-identification with asexuality as well as their conceptualization of that identity via thematic analysis. Using a Qualtrics XM survey, 374 individuals (18+ years old) answer questions regarding their experience as a person identifying themselves as asexual. Identity label authenticity, perceived impact of compulsory heterosexuality and heteronormativity on participants' current identity within the asexual spectrum, and prescribed heteronormative ideals were correlated. Thematic analysis revealed themes such as confusion about identity membership, feeling abnormal, the burden of living in a heteronormative society, and identity …

Exploring The Distinction Between Support And Enabling In Families With Substance Use Disorder, Krystal N. King

Theses and Dissertations--Family Sciences

Substance use disorders (SUD) are a pervasive public health problem facing families in the United States. Although families are frequently urged to support loved ones who have SUD and cautioned against enabling them, there is a dearth of literature that distinguishes between supporting and enabling. Through qualitative interviews, this phenomenological study examined the experiences of eight parents with adult children with SUD who were currently in recovery. Five themes emerged from the data including: (a) living in despair, (b) addiction and recovery knowledge, (c) support group philosophy, (d) coping with addiction, and (e) differentiation. The results from this study suggest …

Assessing 4-H And Its Circle Of Courage In A Psychiatric Residential Treatment Facility: A Case Study, Elizabeth Steering

Theses and Dissertations--Family Sciences

This 4-H case study takes place in a psychiatric residential treatment facility (PRTF) in Kentucky. The PRTF provides clinical services to youth that are not able to be safely maintained in their homes due to having demonstrated unsafe or harmful behaviors. Youth admitted to the PRTF stay for an average of three to six months while they receive intensive therapeutic and psychiatric care as well as medical treatment and public schooling. The current case study incorporates programming from 4-H, which is the youth development program of the Cooperative Extension System (CES) and the National Institute of Food and Agriculture (NIFA), …

Foster Caregiving: How Interactions With The Child Welfare Agency Impact Foster Parent Satisfaction, Recruitment, And Retention, Ethan Engelhardt

Theses and Dissertations--Social Work

Professionals of the child welfare system in Kentucky have continuously worked to retain and recruit new foster parents for the foster care system. Foster parents are uniquely placed in a surrogate caring position for children removed from their homes for reasons of abuse or neglect. Foster parents accept this role and step in to provide a safe and loving household for many children. There are more than 9,000 children placed in Out of Home Care (OOHC) on any given day in Kentucky, leaving many children in need of a loving and supportive household. Foster parents hang in the balance between …

An Exploration Of Service Needs And Preferences Of Dementia Caregivers In Kentucky, Heehyul Moon, Sunshine Rote, Allison Kacmar, Amy Kostelic, Bari Lewis

Family Sciences Faculty Publications

As Americans live longer, the prevalence of Alzheimer’s disease and related dementias will increase. Caregivers are critical to the care and life quality of people with dementia. Yet, dementia caregivers are at increased risk for health issues, social isolation, and financial challenges. To help educators with the University of Kentucky Cooperative Extension Service work with their local Alzheimer’s Association and the University of Louisville to better support dementia families, we explored caregiver needs and service utilization using an online survey. Our findings highlighted the need for counseling/support, care management skills, resource education, self-care strategies, and legal services. Extension Service Educators …

Evaluating Social Support And T2d Risk Factors Among Members Of Rural-Dwelling Grandparent-Headed Households, Brittany L. Smalls, Abebola Adegboyega, Kelly Nb Palmer, Jennifer Hatcher

Journal of Appalachian Health

Purpose: This study examines the associations of social support and type 2 diabetes (T2D) risk factors among members of rural-dwelling, grandparent-headed households (GHH).

Methods: Prospective data were collected from rural-dwelling members of GHH with no known diagnosis of T2D. Data collected on family characteristics, T2D clinical risk factors, and social support were assessed.

Results: Sixty-six grandparents and 72 grandchildren participated in the study. The average age and HbA1Cs were 59.4 years and 6.2% ± 1.4 for grandparents and 11.8 years and 4.9% ± 0.6 for grandchildren. Most grandparents were found to have prediabetes or undiagnosed diabetes. The number of people …

[Black] Teachers Resisting Damaged-Centered Research: Community Listening Exchanges As A Reciprocal Research Tool In A Gentrifying City, Thais Council, Shaeroya Earls, Shakale George, Rebecca Graham

Curriculum and Instruction Faculty Publications

Gentrification impacts many cities across the nation. Affordable housing task forces and legislation meant to address housing inequities are becoming more common, yet the authentic experiences of those affected are often unacknowledged. Absent from the discussion of gentrification are the voices of those deeply impacted, some who are at the center of the work to maintain communities: Black teachers, Black students, and Black families. In many school districts, teachers do not have the opportunity to address the systemic issues that impact their students and communities. Still, it is impossible to ignore the ways societal injustice seeps into the classroom. This …

Clinical Geography: A Commentary Response, Jessica M. Finlay, Graham D. Rowles

Graduate Center for Gerontology Faculty Publications

No abstract provided.

Ambiguous Appalachianness: A Linguistic And Perceptual Investigation Into Arc-Labeled Pennsylvania Counties, Crissandra J. George

Theses and Dissertations--Linguistics

The Appalachian Regional Commission (2022) designates 52 of Pennsylvania’s 67 counties as Appalachia, excluding only the southeast portion of the state. Matthew Ferrence, in Appalachia North, states that his "home is sometimes called Appalachia, sometimes Rust Belt, other times Midwest, even though very few who live there would accept any of those labels as correct" (xi). This ambiguous and fluid identity is due to the shaping, forming, and changing of Pennsylvania’s role within society from a founding colony to a thriving state with industry, unselfishly spoiling others, to the grounds of converging identities (Ferrence xi). This ambiguous identity makes …

Exploring The Relationship Between Place Attachment And Attitudes Toward Tourism Development In Powell County, Lindsay Vance

Theses and Dissertations--Community & Leadership Development

This study explores the relationship between Powell County, Kentucky residents’ place attachment, and the perceived sociocultural, environmental, and financial benefits of the future Warrior’s Path development. A survey consisting primarily of five-point Likert scale questions was shared with several local organizations to distribute to their members. The Pearson’s correlation coefficient and Chi-square test of independence tests were used to discover any correlation between place attachment and perceived sociocultural, environmental, and financial benefits of tourism development. The Pearson’s correlation coefficient (r=.465) determined a moderate positive correlation between place attachment and perceived sociocultural benefits of the Warrior’s Path and tourism development. Of …

Social And Biological Determinants Of Pregnancy-Related Mortality And Morbidity In A Rural, Underserved Population, Anna Hansen

Theses and Dissertations--Sociology

Cases of severe maternal morbidity (SMM) and pregnancy-related mortality (PRM) are increasing in the US. Research concerning SMM and PRM has neglected women in Central Appalachia; a largely rural, health-disparate population. The aims of this study are two-fold: (1) Examine patient-level and place-based predictors of SMM/PRM via hierarchical logistic regression modeling, and (2) Elucidate Appalachian healthcare patients’ and providers’ experiences with SMM/PRM, perceptions of contributing factors, and insights on points of intervention.

This study uses a mixed methods approach guided by the WHO’s conceptual framework for action on social determinants of health to identify determinants of SMM and PRM among …

An Examination Of Three Transitional Events In The Substance Misuse Trajectories Of Women With Criminal Legal System Involvement, Martha Tillson

Theses and Dissertations--Sociology

Research has consistently demonstrated that criminal legal system (CLS)-involved women are distinct from men in initiation and course of drug use, with important differences on biological, environmental, and sociocultural levels. Thus, the unique pathways and transitions into and out of drug use for women with CLS involvement are critical to consider from a research perspective, but also from a need to develop and support evidence-based, women-centered services in correctional contexts. This dissertation project uses a three-paper format to investigate three aims: (1) to understand CLS-involved women’s initiations to injection drug use and their experiences providing injection initiation assistance (IIA) to …