A presente dissertação é uma reflexão sobre como o sociólogo pernambucano Gilberto Freyre (1900-1987) construiu o conceito de região Nordeste através de práticas culturais de herança escrava africana, dentro do que o autor chama de miscigenação equilibrada. Utilizou-se um corpus de quatro obras: Nordeste (1937), Manifesto regionalista (1952), Região e tradição (1968b) e Casa-grande &senzala (2006). Para isso, através de uma metodologia interpretativa, buscou-se analisar as influências das correntes deterministas da Europa do século XIX em intelectuais brasileiros que antecederam Freyre nas discussões raciais do Brasil. Eles são Franklin Távora, Silvio Romero e Raimundo Nina Rodrigues. Da mesma forma, tentou-se compreender os alcances das ideias do professor alemão Franz Boas no sociólogo. Empregou-se também a metodologia empírica de análise histórico documental, por meio de seleção de documentos históricos referentes ao Movimento Regionalista Nordestino e aos quatro Congressos Afro-Brasileiros do Nordeste. Os respectivos documentos foram encontrados nas Fundações Gilberto Freyre e Joaquim Nabuco, na cidade de Recife, em Pernambuco. Esta pesquisa abarca conceitos como região, regionalismo, cultura e raça, e, por isso, procuraram-se aportes teóricos em cientistas sociais, antropólogos, históricos e críticos literários. Dentre eles, apontam-se Pierre Bourdieu (2003), Norbert Elias (1994), Franz Boas (2005), Durval Muniz de Albuquerque Júnior (2011), José Aderaldo Castelo (1961), Neoraldo Pontes de Azevêdo (1984), Lilia Moritz Schwarcz (1993), Renato Ortiz (1985), Roberto Ventura (1991), entre outros. / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, CAPES. / This research analyzes how Brazilian Sociologist Gilberto Freyre(1900-1987) defines the concept of Brazilian Northeast through cultural practices of the African slave inheritage, considering a concept he created, balanced miscegenation. The research corpus consists in four publications: Nordeste (1937), Manifesto regionalista (1952),Região e tradição (1968b) and Casa-grande & senzala (2006). By applying hermeneutic methodology, the influences of deterministic currents of the nineteenth century in Europe are compared to the productions of Brazilian intellectuals, which led Freyre to focus on racial discussions in Brazil. These intellectuals are Franklin Távora, Silvio Romero and Raimundo Nina Rodrigues. Similarly the scope of the German teacher Franz Boas are considered as influences for Freyre’s productions. The empirical methodology of documentary historical analysis is also applied, by selecting historical documents related to the Regionalist Movement of Brazilian Northeast and the four African-Brazilian Northeast Congresses. The relevant documents were found in the Gilberto Freyre and Joaquim Nabuco foundations, in Recife – Pernambuco, Brazil. This research includes concepts such as region, regionalism, culture and race, and therefore uses theoretical contributions from Social Scientists, Anthropologists, Historians and Literary Critics. Amongthem are Pierre Bourdieu (2003), Norbert Elias (1994), Franz Boas (2005), Durval Muniz de Albuquerque Júnior (2011), José Aderaldo Castelo (1961), Neoraldo Pontes de Azevêdo (1984), Lilia Moritz Schwarcz (1993), Renato Ortiz (1985), Roberto Ventura (1991), and others.

In an effort to bridge the gap between public health practice and academia, the Health Resources and Services Administration (HRSA)-funded Tennessee Public Health Training Center (LIFEPATH) has supported establishment of an Academic Health Department (AHD) involving the East Tennessee State University (ETSU) College of Public Health (COPH) and the Sullivan County Regional Health Department (SCRHD). The SCRHD identified a need to increase internal capacity to conduct ongoing community health assessments and community-oriented practice. Similarly, the COPH recognized the need to expand field-based public health practice opportunities for students. Personnel from SCRHD, LIFEPATH, and COPH developed a formal AHD memorandum of understanding during the summer of 2012, launching the program in fall 2012. The COPH/SCRHD model addresses financial barriers experienced by other AHDs by competitively awarding the Coordinator position to a Doctor of Public Health (DrPH) student from the COPH, demonstrating investment in the model by the COPH. The DrPH student gains valuable leadership experience through project management, coordination of the local health council, and day-to-day facilitation of undergraduate and master's student interns. SCRHD benefits from formally trained graduate-level interns dedicated to long-term work within the community. This AHD offers a unique opportunity for doctoral-level students to develop practical leadership skills in a functioning health department, while enhancing the capacity of SCRHD and COPH to serve their community and stakeholders.

Background: Alzheimer’s disease (AD) is a type of Dementia and a neurodegenerative disease that is characterized by the gradual degrading of both memory and cognitive functions. According to the World Health Organization (WHO), the prevalence of AD is increasing globally. Currently, AD is the sixth leading cause of mortality in the United States. As the ageing population increases in the United States, it is possible that AD will move up the ladder in the top cause of mortality. Although the prevalence of AD in most urban parts of developed nations such as the United States is widely known, little is known about the prevalence and early diagnosis of the disease among the rural populations. According to a study by the Centers for Disease Control and Prevention (CDC), on deaths from AD between 1999 and 2014, most mortality are concentrated in the rural counties of the Appalachian region of the United States, where the mortality rate has increased by an alarming 75%. Our study focuses on the Northeast Tennessee region, which is a prominent part of the Appalachian region. We examine the prevalence of Alzheimer’s disease in the Northeast Tennessee region compared to other parts of the state of Tennessee. We sought to understand whether there is a likely association between the disease and the rural counties in the Northeast Tennessee region. Methods: We performed a cross-sectional study that computes and compares between the Prevalence Odds Ratio (POR) of the 2013 to 2015 Centers for Medicare and Medicaid Services Public Use Files data on rural versus urban counties in the Northeast Tennessee region followed by the Northeast Tennessee counties versus other counties in Tennessee. In addition, we collected primary data from 44 experts and professionals working in AD-related fields within the Northeast Tennessee region using an online survey that captures the perceived observation of the experts and professionals about the increasing prevalence of AD over the last five years. Results: Findings show that the rural counties within the Northeast Tennessee region had 18.3% (POR: 1.183, C.I: 1.113-1.258), 4.7% (POR: 1.047, C.I: 0.982-1.117), and 19% (POR: 1.190, C.I: 1.121-1.264) increased odds of prevalence of AD compared to the urban counties within the region in 2013, 2014, and 2015, respectively. Similarly, the Northeast Tennessee region as a whole, had increased odds of 22.7% (POR: 1.227, C.I: 1.203-1.250), 22.5% (POR: 1.225, C.I: 1.202-1.249), and 21.2% (POR: 1.212, C.I: 1.189-1.235) of AD compared to all other counties in Tennessee during the same periods. Conclusions: Statistical analysis and findings from experts and professionals working with patients with AD in the Northeast Tennessee region show that there are more cases of AD in the Northeast Tennessee region compared to the last five years. We suggest early screening strategies for possible decrease in the morbidity and mortality rates in Northeast Tennessee region.

Objectives: Women with substance use disorders often experience unique challenges to obtaining contraception and adhering to user-dependent methods. As a result, this at-risk population of women tends to have higher than average rates of unintended pregnancy. The objective of this study was to describe contraceptive use, pregnancy intentions, and adequacy of access to reproductive healthcare among women receiving opioid agonist therapy in northeast Tennessee. Methods: A cross-sectional survey was piloted among female patients aged 18 to 55 years from two opioid agonist therapy clinics. Descriptive analyses were conducted using logistic regression to evaluate the statistical significance of bivariate associations. Results: Of 91 participants, 84% reported having health insurance, with 70% perceiving having adequate access to health care. More than half had a history of unwanted pregnancy (53%), among whom few (23.1%) reported the consistent use of contraception at time of conception. Although most desired to avoid pregnancy (90%), only 59% of women reported the current use of regular contraception. Most of those not using regular contraception believed that they were not at risk for pregnancy (54.3%). Conclusions: Although most participants reported adequate access to health care and a desire to avoid pregnancy, few reported the consistent use of regular contraception. Furthermore, misperceptions regarding pregnancy risk were common among participants. Research is needed to identify barriers to contraceptive acceptance and causes of pregnancy risk misperceptions in this population of women at increased risk of unintended pregnancy.

E-cigarette use among youth in the United States (U.S.) continues to increase. In the rural Northeast Tennessee, where prevalence of tobacco use is higher than national and state averages, there is no literature on e-cigarette use to inform policies and programs. This study aimed to estimate the prevalence of e-cigarette use and examine association of e-cigarette use with two tobacco products among school-going adolescents. Data from 894 participants of a school-based survey conducted in 2016 in Northeast Tennessee were analyzed. Descriptive statistics and logistic regression analyses were conducted to estimate the prevalence and delineate the associations between e-cigarette use and other tobacco products. Approximately 11% of the participants currently used e-cigarettes, and 35% had ever used e-cigarettes. About 6% of the participants were current users of both e-cigarettes and cigarettes; 4% were current users of e-cigarettes and smokeless tobacco; 3% were current users of all three products, and 15% had ever tried all three products. More than one-half of current e-cigarette users (52%) also smoked cigarettes. Adjusting for covariates, current e-cigarette use was positively associated with cigarette smoking [Odds Ratio (OR) 27.32, 95% confidence interval (CI) 14.4–51.7] and smokeless tobacco use [OR 7.92, 95% CI 3.8–16.5]. E-cigarette use was more common among the high school students than cigarette and smokeless tobacco use, and a significant proportion of users either smoked cigarettes, used smokeless tobacco, or both. Thus, there is a critical need for preventive policies and programs to address dual and poly-use of these products.

Discrimination, racism, and class bias affects the accessibility of resources available to African American males who are exoffenders. The purpose of this phenomenological study was to explore the lived experiences of African American, male exoffenders' ability to access resources postincarceration. Guided by Bell and Freeman's critical race theory, a purposeful sample of 6 African American, male exoffenders were recruited from 2 reentry programs in the Northeast United States. A semistructured interview approach was employed to examine the life history, details of experience, and reflection on the meaning of the lived experience from the participants. The modified Stevick, Colaizzi, and Keen method of analysis was used to analyze the interview data. Seven themes emerged that included the stigma of a criminal record, lack of resources, good family support, the importance of employment, accountability, responsibility, lack of education, and the environment that can impact the success or failure of an exoffender's reentry. Policymakers in the criminal justice system can change the current policy that underestimates the extent to which the Violent Crime Control and Law Enforcement Act of 1994 has affected the resources that African American, male exoffenders need to reintegrate into society. The positive social change implication is that service providers can use the results of this study to better serve the needs of African American, male exoffenders as they transition from prison into society.

Clearing of trees from the so-called caatinga woodland that characterizes the vegetation of the semi-arid region of northeast Brazil offers possibilities for increasing forage production. This research analyzed the first-year effects of clearing caatinga on dry season forage for goats and sheep. In addition, factors affecting litter decomposition on cleared and uncleared caatinga were assessed to evaluate the viability of deferring grazing of forages during the wet season for use later in the dry season. Removing the trees resulted in a sixfold increase in production of herbaceous vegetation, however, 88 percent of the increased yield on the cleared areas was in the form of stems from herbaceous vegetation. Seventy-two percent of the stems were unpalatable to goats and sheep because of the massive size of those stems. Leaf litter from trees was an important component of the diets of goats and sheep during the dry season and clearing reduced production of this forage threefold. Clearing resulted in increased decomposition of leaf litter. Changes in microclimate played only a minor role in this difference. The reduction in the amount of leaf litter from trees relative to litter from herbs had the greatest effect on decomposition rates of dry season forage because tree litter decomposed less rapidly than did herbaceous litter. The slow decomposition of leaf litter during the dry season suggests that deferment. of cleared or uncleared caatinga for use as forage in the latter part of the dry season is feasible. An analysis of the diets of esophageally fistulated goats and sheep indicated that clearing may be a viable alternative for improving the amount and the in vitro dry matter digestibility of the forage consumed during the dry season the first-year post-treatment. These increases were attributed to an absolute greater abundance of preferred herbaceous forages (i.e., foliage and leaf litter) and to the persistent green foliage on coppicing woody plants. Dietary nitrogen appeared to limit intake, and clearing did not improve availability of this nutrient to sheep and goats at the higher levels of grazing pressure applied in this study. Other ecosystem considerations such as watershed protection and long-term community stability must also be considered in decisions to remove the tree canopy of the caatinga.

Northeast Brazil is a region characterized by economic poverty and human misery. Poor ecological conditions contribute to the nature of the dilemma, but another factor in the apparent cultural stagnation of the Northeast, may be the persistence of values and social practices traditionally aligned with the colonial sugar plantation system. Thus, this thesis represents an examination of the continuity of a given pattern, the man/patron relationship. This pattern is a contemporary parallel to the master/slave relationship which was the key to understanding of the social system of the colonial period. An historical overview reveals the nature of the traditional system, which proceeded to decline in the late nineteenth century. A review of present day conditions of the rural worker in the Northeast indicates numerous aspects of the colonial system which remain almost as they were. This review is followed by several case studies which particularly reveal various manifestations of the man/patron pattern in contemporary situations other than those associated with the remaining sugar industry. The information presented in the case studies was collected in 1968-69 when the author was living in Recife on a Fulbright-Hays grant. The case studies do not represent conclusive documentation but, rather, provocative evidence that certain aspects of the traditional social system, namely the man/patron pattern, persist in a con­temporary society which is no longer solely dependent on nor dominated by the production of sugar. Furthermore, the thesis implies that the continuity of traditional cultural patterns may, in fact, obstruct efforts of economic and social development.

Preparted by the First Tennessee-Virginia Development District in 1978, this tourism map denotes points of interest along the I-81 corridor of Northeast Tennessee and Southwest Virginia. With I-81 constructed just 19 years earlier, this helped open the region up to many new travelers. This maps highlights some of the historic areas to visit, many of which still serve as area attractions today. These include Roan Mountain State park, Tipton-Haynes Farm and Davy Crockett's Birthplace. Also of note is the spelling of Jonesboro, which later reverted back to the original spelling of the town as Jonesborough. Physical copy resides in the Government Information, Law and Maps Department of East Tennessee State University’s Sherrod Library. / https://dc.etsu.edu/rare-maps/1006/thumbnail.jpg

Published in 1983 by the U.S. Geological Survey, this map denotes land use and land cover in the northeast Tennesee/Johnson City area for the years 1975-83. Base map from U.S. Geologic Survey, 1966. The legend along the right edge denotes different types of land use and coverage using a numeric code. Additional details on how the map was compiled can by found on the lower right corner. The North Carolina portion of this map was prepared in cooperation with the North Carolina Department of Natural Resources and Community Development. Physical copy resides in the Government Information, Law and Maps Department of East Tennessee State University’s Sherrod Library. Scale - 1: 250,000. / https://dc.etsu.edu/rare-maps/1044/thumbnail.jpg