Abstract Background: Over 100 million people in the United States (U.S.) have diagnosed diabetes or pre-diabetes. People with this condition are at an increased risk of Peripheral Arterial Disease (PAD). There is a high prevalence of people with risk factors of diabetes especially in the rural Central Appalachia region. People with diabetes are at a higher risk of developing atherosclerosis, which is the most common cause of PAD. Although about 20–30% of 12 million people affected with PAD in the U.S. have diabetes, little is known about diabetes in PAD patients in Central Appalachia. Therefore, this study aimed to examine the risk factors of diabetes in patients with PAD within the Central Appalachian region. Methods: The study population consisted of patients with PAD with medical comorbidities of Cardiovascular disease (CVD). All patients were admitted to a large health system in Central Appalachia between 2008 and 2018. 13,455 index cases were extracted from the Electronic Medical Records (EMR) using the ICD-9 and ICD-10 codes. With diabetes as the outcome variable under study, the risk factors included Myocardial Infarction (MI) history, hypertension, smoking status and hypercholesterolemia. Socio-demographic variables considered in the study included gender, age, ethnicity and marital status and the covariates were Body Mass Index (BMI), Low density lipoproteins (LDL), High density lipoproteins (HDL), Total Cholesterol, and Triglycerides (TG). Multivariable logistic regression was performed to examine potential risk factors of diabetes in PAD patients. Results: The results showed that BMI {OR =1.056 (CI: 1.039, 1.073)}, HDL {OR =0.980 (CI: 0.965, 0.995)}, TG {OR=1.003 (CI: 1.001, 1.005)}, MI history {OR= 1.375 (CI: 1.111, 1.703)}, hypertension {OR=2.822 (CI: 1.804, 4.415)} and smoking {OR =0.802(CI: 0.641, 1.003)} were significant for diabetes in known PAD. To control for potential confounders, Stratification was used. Among males and females with PAD, diabetes was associated with last BMI, MI, hypertension and TG. HDL seemed to be negatively associated with hypertension and female diabetics while smoking seemed to be negatively associated in males. Upon stratification with hypertension, diabetes in PAD patients was significant with BMI, TG, MI history and HDL. After stratification with MI, diabetes in PAD female patients was associated with BMI, and previous MI history. On the other hand, patients without MI had an elevated TG level and an increased risk of hypertension. Conclusion: CVD risk factors are strongly associated with PAD comorbidities, which are worsened in the presence of diabetes. We suggest that hospitals and health care systems should strongly control for the risk factors of diabetes and adopt a multi-risk-factor approach for improving health outcomes for PAD patients.

This study explores how the context of an event can be reconstructed in order to change an event's meaning and how the recontextualization can influence perceptions of a community. The artifact examined is a documentary film produced by Appalshop, Stranger with a Camera directed by Elizabeth Barret.Chapter One includes an introduction to Stranger with a Camera, and work by scholars related to the study of documentary film. The research focus guiding the analysis is an examination of how Barret reconstructs the context of a murder in Jeremiah, Kentucky in order to alter the event's significance and meaning, and how her reconstruction may influence dominant social perceptions of a community.Chapter Two describes the method to be used in the analysis, cluster analysis developed by Kenneth Burke. The process of cluster analysis entails: 1) identifying the key terms in the rhetoric, 2) charting the terms that cluster around the key terms, 3) discovering emergent patterns in the clusters, and 4) naming the motive, or situation, based on the meanings of the key terms.Chapter Three is a cluster analysis of Stranger with a Camera. Key terms found in this analysis are "picture," "camera," "shooting," "media," "poverty," and "social action."Chapter Four contains conclusions pertaining to the analysis of the rhetorical artifact, conclusions for cluster analysis as a rhetorical methodology, and future considerations for academic scholarship. / Department of Communication Studies

Thesis (Ph. D.)--University of Wisconsin, 1966. / Typescript. Vita. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

Thesis (D. Min.)--Liberty Baptist Theological Seminary, 1999. / Includes bibliographical references.

Thesis (Ph. D.)--West Virginia University, 2007. / Title from document title page. Document formatted into pages; contains vii, 221 p. : maps. Includes abstract. Includes bibliographical references (p. 180-208).

Background: Over 100 million people in the United States (U.S.) have diagnosed diabetes or pre-diabetes. People with this condition are at an increased risk of Peripheral Arterial Disease (PAD). There is a high prevalence of people with risk factors of diabetes especially in the rural Central Appalachia region. People with diabetes are at a higher risk of developing atherosclerosis, which is the most common cause of PAD. Although about 20–30% of 12 million people affected with PAD in the U.S. have diabetes, little is known about diabetes in PAD patients in Central Appalachia. Therefore, this study aimed to examine the risk factors of diabetes in patients with PAD within the Central Appalachian region. Methods: The study population consisted of patients with PAD with medical comorbidities of Cardiovascular disease (CVD). All patients were admitted to a large health system in Central Appalachia between 2008 and 2018. 13,455 index cases were extracted from the Electronic Medical Records (EMR) using the ICD-9 and ICD-10 codes. With diabetes as the outcome variable under study, the risk factors included Myocardial Infarction (MI) history, hypertension, smoking status and hypercholesterolemia. Socio-demographic variables considered in the study included gender, age, ethnicity and marital status and the covariates were Body Mass Index (BMI), Low density lipoproteins (LDL), High density lipoproteins (HDL), Total Cholesterol, and Triglycerides (TG). Multivariable logistic regression was performed to examine potential risk factors of diabetes in PAD patients. Results: The results showed that BMI {OR =1.056 (CI: 1.039, 1.073)}, HDL {OR =0.980 (CI: 0.965, 0.995)}, TG {OR=1.003 (CI: 1.001, 1.005)}, MI history {OR= 1.375 (CI: 1.111, 1.703)}, hypertension {OR=2.822 (CI: 1.804, 4.415)} and smoking {OR =0.802(CI: 0.641, 1.003)} were significant for diabetes in known PAD. To control for potential confounders, Stratification was used. Among males and females with PAD, diabetes was associated with last BMI, MI, hypertension and TG. HDL seemed to be negatively associated with hypertension and female diabetics while smoking seemed to be negatively associated in males. Upon stratification with hypertension, diabetes in PAD patients was significant with BMI, TG, MI history and HDL. After stratification with MI, diabetes in PAD female patients was associated with BMI, and previous MI history. On the other hand, patients without MI had an elevated TG level and an increased risk of hypertension. Conclusion: CVD risk factors are strongly associated with PAD comorbidities, which are worsened in the presence of diabetes. We suggest that hospitals and health care systems should strongly control for the risk factors of diabetes and adopt a multi-risk-factor approach for improving health outcomes for PAD patients.

First-generation college students from the Appalachian region may be at risk in terms of their successful transition from home to college and in their persistence to graduation. I investigated possible influences on the college experiences of a purposeful sample of 10 Walters State Community College students. Participants were of diverse ethnicity, included both genders, and ranged in age from 18 to 45 years. In-depth interviews were conducted to aid in a narrative study that explored their experiences and the obstacles they faced in the college environment. Many of the findings of this study concur with the review of the literature in that socioeconomic and generational status play a role in Appalachian students' college experience. This study, unlike the review of literature, found that the families of many first-generation students not only recognize the value of a college education, but also fully support the academic endeavors of their college students.

This study was conducted in an attempt to determine whether certain burial practices are unique to the people of Southern Appalachia. Eight individuals were interviewed, including a minister and a funeral director. As a result of the research, it was found that, although a strong sense of community and religion still prevails, making certain burial rituals distinctive to the people of Southern Appalachia, they are slowly eroding due to the growing presence of the modern American funeral industry. Qualitative research methods were used to analyze a segment of the Southern Appalachian population, with literature reviews of related material and in-depth interviews conducted with subjects in Grainger, Hamblen and Hancock Counties of East Tennessee.

National Forest timber management in the southern Appalachians is changing from traditional even-aged management and clearcutting to uneven-aged management and group selection silviculture. Group selection, with its small 1/2-to-2-acre patch cuts widely dispersed throughout a timber stand, has the potential to substantially increase timber harvesting costs over traditional clearcutting. This could exacerbate the below-cost timber sale issue. The objective of this study was to assess the impact of groups election silviculture on timber harvest productivity and cost in hardwood stands of the southern Appalachians. This was accomplished by collecting and analyzing field production and cost data from typical Appalachian loggers operating on group-selection timber sales. Three logging systems were chosen for the study: (1) cable yarder ,(skyline) system; (2) feller-buncher/cable skidder system; and (3) motor-manual chainsaw felling/cable skidding system. At least one full week of time-study production data was collected at each location. cost information was obtained from the cooperating loggers' records, as well as historic production and cost data from previous clearcut sales for comparison purposes. study results show that production was reduced and unit cost increased for all three logging systems when operating on group-selection timber sales as compared to clearcutting. unit cost per ton for the cable yarder system was $40.18, a 29 percent increase over their previous average clearcutting cost. The fellerbuncher/cable skidder system unit cost per ton was $14.79, a 19 percent increase over this system's average clearcutting cost. The chainsaw felling/cable skidder system cost of $16.15 per ton was 33 percent above their normal clearcutting cost. A large increase in delays and unproductive time as a result of specific group-selection timber sale characteristics appears to be the major cause of reduced logging productivity and increased costs. / Master of Science

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