Personal Identity Changes of Female Cancer Survivors in Southern Appalachia

Navigating personal identity changes through the cancer journey can be challenging, especially for women in a culture that places emphasis on traditional gender roles and values close-knit families. Drawing on a story circule approach, this study examined the intersecting identities of female cancer survivors in southern Appalachia. Stories of 29 female Appalachian cancer survivors from Northeast Tennessee and Southwest Virginia were collected via a mixed methods approach in either a day-long story circule (N-26) or an in-depth interview (N=3). Transcripts from both phases were audio-recorded and transcribed verbatim; NVivo 8.0 facilitated qualitative content analysis of the data. Inductive analysis revealed that women in this study appeared in struggle with (1) maintaining place in the family, (2) mothering, and (3) navigating physical changes. Ideas of family versus self appeared to overlap and intertwine with how women in Appalachia navigate personal identify changes through the cancer journey

Navigating Family Cancer Communication: Communication Strategies of Female Cancer Survivors in Central Appalachia

In a multiphasic study, the stories of 29 female Appalachian cancer survivors were collected through either a day-long modified story circle event (n=26) or an in-depth interview (n=3). Qualitative content analysis was used to identify emergent themes in the data. The analysis revealed 5 types of family cancer communication including both pre-diagnosis and postdiagnosis cancer communication strategie

Omnibus Survivorship Narratives: Multiple Morbidities Among Female Cancer Survivors in South Central Appalachia

This study examines the illness narratives of female cancer survivors living in Southern Central Appalachia. Stories of 29 female Appalachian cancer survivors from northeastern Tennessee and southwcstmn Virginia were collected via a mixed methods approach in either a day-long story circle (n=26) or an in-depth interview (n=3), Qualitative content analysis was used to guide an inductive analysis of the tTanscript\u3c;, What emerged was that as participants survived cancer, they also survived other health conditions, their intorsccting stories yielding an omnibus survivorship narrative

Local Implementation of Cancer Control Activities in Rural Appalachia, 2006

Underserved communities with high cancer rates often are not involved in implementing state cancer control activities locally. An East Tennessee State University research team formed 2 Appalachian Community Cancer Research Review Work Groups, 1 in northeast Tennessee and 1 in southwest Virginia. During 4 sessions, the research team presented regional cancer data to the work groups. Work group participants explored research from a lay perspective and identified possible reasons for cancer disparities in central Appalachia. The fifth session was a community dissemination activity in which work group participants engaged in cancer education and action by presenting the research to their local communities in unique ways. During a sixth session, both work groups discussed these interventions and further attempted to answer the question, "What makes the experience of cancer unique in Appalachia?" This article describes the key steps of this community-based participatory research process

Culturally Tailored Cancer Communication, Education, and Research: The Highways and Back Roads of Appalachia

We have varying experiences with Appalachia, yet we all agree that there is a unique relationship between Appalachians and cancer. Two of us are nurses who have worked with various communities. Two of us grew up here; 1 watched several of her relatives battle cancer in their Appalachian homes. All of us are scholars who want to talk with practitioners and researchers who are developing culturally tailored cancer control interventions. This goal to have a dialogue emerged after we had a series of discussions about cancer in Appalachia, discussions resulting in our developing a list of cultural traits that seem to be related to this region’s high cancer morbidity and morality (Table). For example, in one of our previous publications we describe the association between the traditional Appalachian oral culture and the cancer experience, finding that cancer stories appeared to pass from 1 generation to the next (1). In turn, these stories seem to affect some community members\u27 willingness to be screened. Our essay\u27s purpose is not to justify the elements presented in the Table. Rather, we write to consider the following: What are the advantages and disadvantages of making generalizations about a culture that has already been marginalized by overgeneralizations

Mothered, Mothering & Motherizing in Illness Narratives: What Women Cancer Survivors in Southern Central Appalachia Reveal About Mothering-Disruption

Informed by a mothering-disruption framework, our study examines the illness narratives of women cancer survivors living in Southern Central Appalachia. We collected the stories of twenty-nine women cancer survivors from northeast Tennessee and southwest Virginia using a multi-phasic qualitative design. Phase I consisted of women cancer survivors participating in a day-long story circle (n=26). Phase II consisted of women cancer survivors who were unable to attend the story circle ; this sample sub-set participated in in-depth interviews (n=3) designed to capture their illness narratives. Participants\u27 illness narratives revealed the presence of: (1) mothering-disruption whereby cancer adversely impacted the mothering role ; and (2) mothering-connection , whereby the cancer experience motivatedmother-survivors. Participants\u27 illness narratives reflected thatthe role of mother was the preeminent role for mother-survivor and whenever there was oppositional tension between the roles of mother and survivor , the women-survivors seemed to linguistically relocate away from the survivor role and toward the mothering role. As a result , women-survivors seemingly rejected medicalization of their identities by emphasizing their mothering responsibilities , something we term motherizing

Understanding the Challenges of Reducing Cancer in Appalachia: Addressing a Place-Based Health Disparity Population

The Appalachian region of the United States has long been recognized for its poor economic and social indicators. Only during the past decade have multi-state data become more accessible to describe the regions’ poor health status and resulting outcomes. A recent community-based participatory study engaged rural Appalachians to describe “what makes Appalachia different?” from other geographic areas and cultural groups in the United States and identify those characteristics that influence the region’s health. This article summarizes the community interpretation of these findings

Divergent neural and endocrine responses in wild-caught and laboratory-bred Rattus norvegicus

Although rodents have represented the most intensely studied animals in neurobiological investigations for more than a century, few studies have systematically compared neural and endocrine differences between wild rodents in their natural habitats and laboratory strains raised in traditional laboratory environments. In the current study, male and female Rattus norvegicus rats were trapped in an urban setting and compared to weight-and sex-matched conspecifics living in standard laboratory housing conditions. Brains were extracted for neural assessments and fecal boli were collected for endocrine [corticosterone and dehydroepiandrosterone (DHEA)] assays. Additionally, given their role in immune and stress functions, spleen and adrenal weights were recorded. A separate set of wild rats was trapped at a dairy farm and held in captivity for one month prior to assessments; in these animals, brains were processed but no hormone data were available. The results indicated that wild-trapped rats exhibited 31% heavier brains, including higher densities of cerebellar neurons and glial cells in the bed nucleus of the stria terminalis. The wild rats also had approximately 300% greater spleen and adrenal weights, and more than a six-fold increase in corticosterone levels than observed in laboratory rats. Further research on neurobiological variables in wild vs. lab animals will inform the extensive neurobiological knowledge base derived from laboratory investigations using selectively bred rodents in laboratory environments, knowledge that will enhance the translational value of preclinical laboratory rodent studies

Compositional and Quantitative Insights Into Bacterial and Archaeal Communities of South Pacific Deep-Sea Sponges (Demospongiae and Hexactinellida)

In the present study, we profiled bacterial and archaeal communities from 13 phylogenetically diverse deep-sea sponge species (Demospongiae and Hexactinellida) from the South Pacific by 16S rRNA-gene amplicon sequencing. Additionally, the associated bacteria and archaea were quantified by real-time qPCR. Our results show that bacterial communities from the deep-sea sponges are mostly host-species specific similar to what has been observed for shallow-water demosponges. The archaeal deep-sea sponge community structures are different from the bacterial community structures in that they are almost completely dominated by a single family, which are the ammonia-oxidizing genera within the Nitrosopumilaceae. Remarkably, the archaeal communities are mostly specific to individual sponges (rather than sponge-species), and this observation applies to both hexactinellids and demosponges. Finally, archaeal 16s gene numbers, as detected by quantitative real-time PCR, were up to three orders of magnitude higher than in shallow-water sponges, highlighting the importance of the archaea for deep-sea sponges in general

Pragmatic randomised controlled trial to evaluate the effectiveness and cost effectiveness of a multi-component intervention to reduce substance use and risk-taking behaviour in adolescents involved in the criminal justice system: A trial protocol (RISKIT-CJS)

Background: Adolescence is a critical developmental stage when young people make lifestyle choices that have the potential to impact on their current and future health and social wellbeing. The relationship between substance use and criminal activity is complex but there is clear evidence that the prevalence of problematic substance use is far higher among adolescent offenders than the general adolescent population. Adolescent offenders are a marginalized and vulnerable population who are significantly more likely to experience health and social inequalities in later life than their non-offending peers. There is a paucity of evidence on effective interventions to address substance use and risk-taking behaviours in adolescent offender populations but it is clear that preventative or abstinence orientated interventions are not effective. RISKIT-CJS is an intervention developed in collaboration with young people taking account of the current best evidence. Feasibility and pilot studies have found the intervention addresses the needs of adolescents, is acceptable and has demonstrated potential in reducing substance use and risk-taking behavior. Methods: The study is a mixed method, two-armed, prospective, pragmatic randomized controlled trial with individual randomisation to either treatment as usual alone or the RISKIT-CJS intervention in addition to treatment as usual. Adolescents, aged 13 to 17 years inclusive, engaged with the criminal justice system who are identified as having problematic substance use are eligible to participate. The study will be conducted across three geographical areas; South and South East England, London and North East England between March 2017 and February 2019. Discussion: The study represents an ambitious programme of work to address an area of need for a marginalized and vulnerable population