Rural community pharmacist willingness to dispense Suboxone® - A secret shopper investigation in South-Central Appalachia

Background Research on centenarians to date has focused on areas with a high population of centenarians. However, there is limited literature on centenarians’ perspectives about growing up on farms from the heartland of Appalachia in Eastern Tennessee. Purpose This qualitative descriptive study was designed to characterize the role of a farming childhood by exploring the viewpoints of community-dwelling centenarians who grew up on farms in south central Appalachia. Methods A qualitative descriptive design was used with a convenience sample ( n = 16). Cognitive status was determined with the Short Portable Mental Status Questionnaire. Demographic data were collected. Interviews were transcribed and analyzed with the Neuendorf method of content analysis. Results Main emerging themes were the farm, the family, and the environment. Conclusion The farm was at the center of these centenarians’ childhood, influencing their family, community relations, and social interactions, which provided lessons that they utilized throughout their long lives.

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The Protective Effects of Adolescent Motherhood in South Central Appalachia

Journal of Transcultural Nursing ◽

10.1177/1043659614524249 ◽

2014 ◽

Vol 26 (4) ◽

pp. 409-417 ◽

Cited By ~ 2

Author(s):

Elizabeth D. Dalton

Keyword(s):

Protective Effects ◽

Adolescent Motherhood ◽

South Central ◽

Central Appalachia

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Occurrence of potentially zoonotic and cephalosporin resistant enteric bacteria among shelter dogs in the Central and South-Central Appalachia

BMC Veterinary Research ◽

10.1186/s12917-021-03025-2 ◽

2021 ◽

Vol 17 (1) ◽

Author(s):

Ashutosh Verma ◽

Kimberly Carney ◽

Marina Taylor ◽

Kaitlyn Amsler ◽

Joey Morgan ◽

...

Keyword(s):

Public Health ◽

Bacterial Pathogens ◽

Enteric Bacteria ◽

Multidrug Resistant ◽

Fecal Samples ◽

Microdilution Method ◽

South Central ◽

Broth Microdilution Method ◽

Central Appalachia ◽

Shelter Dogs

Abstract Background Antimicrobial resistance and presence of zoonotic enteropathogens in shelter dogs pose a public health risk to shelter workers and potential adopters alike. In this study we investigated the prevalence of zoonotic bacterial pathogens and cephalosporin resistant (CefR) enteric bacteria in the feces of apparently healthy shelter dogs in the Cumberland Gap Region (CGR) in the US states of Kentucky, Tennessee and Virginia. Results Fecal samples of 59 dogs from 10 shelters in the CGR of Central and South-Central Appalachia were screened for the presence of Campylobacter jejuni, Clostridium perfringens, Salmonella and CefR enteric bacteria. C. jejuni, C. perfringens were detected by PCR based assays. Culture and PCR were used for Salmonella detection. Of 59 dogs, fecal samples from 14 (23.7%) and 8 (13.6%) dogs tested positive for cpa and hipO genes of C. perfringens and C. jejuni, respectively. Salmonella was not detected in any of the tested samples by PCR or culture. CefR enteric bacteria were isolated on MacConkey agar supplemented with ceftiofur followed by identification using MALDI-TOF. Fecal samples from 16 dogs (27.1%) yielded a total of 18 CefR enteric bacteria. Majority of CefR isolates (14/18, 77.8%) were E. coli followed by, one isolate each of Enterococcus hirae, Acinetobacter baumannii, Acinetobacter pittii, and Pseudomonas aeruginosa. CefR enteric bacteria were tested for resistance against 19- or 24-antibiotic panels using broth microdilution method. Seventeen (94.4%) CefR bacteria were resistant to more than one antimicrobial agent, and 14 (77.8%) displayed multidrug resistance (MDR). Conclusions This study shows that shelter dogs within the CGR not only carry zoonotic bacterial pathogens, but also shed multidrug resistant enteric bacteria in their feces that may pose public health risks.

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Rural community pharmacist lowers barriers to care for locals

Pharmacy Today ◽

10.1016/j.ptdy.2020.10.054 ◽

2020 ◽

Vol 26 (11) ◽

pp. 38

Author(s):

Sonya Collins

Keyword(s):

Rural Community ◽

Community Pharmacist ◽

Barriers To Care

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Cleft Lip and/or Palate in Infants Prenatally Exposed to Opioids

The Cleft Palate-Craniofacial Journal ◽

10.1177/10556656211013687 ◽

2021 ◽

pp. 105566562110136

Author(s):

Kerry Proctor-Williams ◽

Brenda Louw

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Pharmacological Intervention ◽

Prenatally Exposed ◽

Odds Ratios ◽

South Central ◽

Central Appalachia ◽

Cohort Study Design ◽

Isolated Cleft Palate ◽

Opioid Withdrawal Syndrome

Objective: To determine the prevalence and odds ratios for cleft lip and/or palate (CL/P) among infants prenatally exposed to opioids with or without neonatal opioid withdrawal syndrome (NOWS). Design: This study represents an exploratory, retrospective cohort study design of newborn medical health records from 2011 to 2016. Setting: Records were drawn from a regional health system located in South Central Appalachia. Population and Study Sample: The original population yielded 3 cohorts of infants: (1) infants with opioid exposure (OE) but not requiring pharmacological intervention (OE; N = 168); (2) infants with NOWS requiring pharmacological intervention (N = 294); and (3) infants with no opioid exposure (NOE; N = 16 090), the primary comparison group. Main Outcome: Infants in the NOWS and OE groups showed significantly increased prevalence and odds ratios for CL/P when compared to those in the NOE group. Results: Prevalence rates per 1000 live births for infants with OE (35.71) and infants with NOWS (6.80) were significantly higher than those for infants with NOE (1.37). Comparison of infants with OE to the NOE group revealed significantly increased odds for CL/P, isolated cleft palate (CP), cleft lip (CL), and cleft lip and palate (CLP) (27.05, 41.81, 19.26, 19.37, respectively; all Ps < .008). The odds ratios for infants with NOWS compared to the NOE group were significantly higher for CL/P and CP (5.00 and 10.98, respectively; Ps < .03) but not for CL and CLP. Conclusion: The results provide additional evidence that prenatal OE should be considered among the critical environmental risk factors that can contribute to CL/P.

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Cultural, Institutional, And Economic Factors Inhibiting The Transition From Tobacco Cultivation To Alternative Forms Of Agriculture In South Central Appalachia

Journal of Business & Economics Research (JBER) ◽

10.19030/jber.v1i4.2994 ◽

2011 ◽

Vol 1 (4) ◽

Author(s):

Donald J. Shemwell

Keyword(s):

Learned Helplessness ◽

Community Sustainability ◽

Cultural Barrier ◽

Institutional Economic ◽

South Central ◽

Start Up ◽

Variable Nature ◽

Central Appalachia ◽

Economic Barriers ◽

Tobacco Cultivation

A series of preliminary investigations indicated the strong need for alternatives for tobacco farming. Progressive elements in the communities where the study took place often suggested that this particular economic development issue should be a leading or critical priority. Nevertheless, when the issue was put to communities at large in subsequent community sustainability studies, there was little enthusiasm among the populace for alternative agriculture initiatives. The study reported here involved interviews with thirteen tobacco growers, two intermediaries who have grown tobacco themselves and worked among the farmers for many years, and representatives of three entities that have demonstrated success in alternate methods. The results indicate that there are substantial institutional, economic, and psychological barriers to grower adaption. The most important institutional barriers are the concentration in retailing and the development of highly centralized buying offices. The most significant economic barriers are the high start-up costs and variable nature of returns. Finally, the most salient cultural barrier is a learned helplessness resulting from years of isolation from market forces and an under educated and aging populace in farm communities.

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