Religion and spirituality may influence outcomes in cancer prevention and therapy and contribute to cancer disparities in deeply religious communities like the Appalachian region of the United States. Finding a method to bridge this division is essential to reduce cancer health disparities in this population. Religious beliefs may lead patients to seek less aggressive medical care, influence them to believe that the diagnosis of cancer is a mandate from God and cannot be managed by the healthcare system, ultimately compromising outcomes and contributing to disparities in healthcare in such communities. The significant role of religion and spirituality in decision making relevant to cancer care has been reinforced through clinical experience and conversations with Appalachian focus groups. The influence needs to be recognized, emphasized and handled appropriately by healthcare providers. Physicians in practice need to be able to relate to this dimension and work with local spiritual support systems to provide both a medical and spiritual prescription for the individual's journey through cancer care or prevention approaches.

Evidence is growing regarding the salutary relationships between spirituality and health, including alcohol problems, yet little is known about spirituality and health in the context thereof. Cross-sectional associations between forgiveness and health were examined among college student problematic drinkers (n = 126; = 60%; Mage = 22) in Southern Appalachia. Controlling for demographic variables (including religiosity), dimensions of forgiveness accounted for 7's33 percent of the variance in the health-related variables in a salutary fashion. Forgiveness of Self appears to be the most important dimension of forgiveness measured, yet the most difficult to develop.

Background: The southern Appalachian states show a high prevalence of smoking, with associated high rates of both heart disease and cancer, yet cultural differences raise questions concerning the applicability of the most frequently used model for smoking cessation, the transtheoretical model, for smokers from this region of the country. Objective: To identify, by examining the applicability of the transtheoretical model for southern Appalachian smokers, the percentage of individuals in each of the five stages of change, the use of the processes of change from the transtheoretical model, and the scores on recognized predictors of smoking cessation including the temptation to smoke, the perceived barriers to cessation, the pros and cons of smoking, and nicotine dependence. Methods: This population-based, descriptive, cross-sectional study used a random sample of 3,800 telephone numbers, which were called up to eight times. The 659 smokers or former smokers who agreed to participate were mailed a written questionnaire consisting of six well-established scales that measure constructs from the transtheoretical model. The final sample consisted of 357 usable questionnaires. Results: The distribution of smokers in northeastern Tennessee differed from national samples across the first three stages of change, with 56% in precontemplation, as compared with previous findings of 40% in national samples. The subjects' scores for the pros of smoking were similar across the stages of change in this sample, and although the scores for the cons differed significantly across the stages in the sample, post hoc analysis indicated that the only significant change occurred between precontemplation and contemplation. The scores for temptation to smoke did not differ significantly across the stages of change in this sample. Discussion: Smokers from Appalachian Tennessee differ from smokers in other parts of the United States, and these findings raise questions about the applicability of the transtheoretical model for this population.

Scale 1 inch = 6 leagues. Library of Congress facsimile No. 1a, which is based on the sixth out of ten issues (known as "states"). The original map was published in 1612, and the revisions comprising the sixth state are from 1624. The map includes ca. 200 names including Native American tribes, and is considered the first authoritative map of Virginia. / https://dc.etsu.edu/rare-maps/1122/thumbnail.jpg

Indicates locations of seventy one historic properties in east Tennessee. Drawn by Penelope Lane in 1984. Scale 1 in = 250000 ft. / https://dc.etsu.edu/rare-maps/1128/thumbnail.jpg

Hand drawn map indicating general locations associated with 28 authors. Includes a ahart below the map lists 60 authors with a representative publication for each. Copyright 1965, Whitehaven High School, Tommy D. Harris. No Scale Provided. / https://dc.etsu.edu/rare-maps/1129/thumbnail.jpg

Includes four hand drawn maps: a complete map of Tennessee, indicating dates and locations for 26 treaties with Native Americans from the 18th and 19th centuries, traced from W.R. Garrett and A.V. Goodpasture, History of Tennessee, Its People and Its Institutions (Nashville, 1900), pages 128-129; and a tripartite map of east, middle, and west Tennessee (traced from 1968 issue by AAA) indicating state lines, county lines, and locations of county seats. Drawn May 1968 by Katherine W. Ewing, Nashville. Copyright Katherine W. Ewing, 1973. / https://dc.etsu.edu/rare-maps/1131/thumbnail.jpg

Hand drawn and hand colored map tracing portions of a map in J.G.M. Ramsey, Annals of Tennessee (1853), with excerpts from John Donelson's log of the voyage to Cumberland Country. Indicates eleven points along the route, with respective dates and brief descriptions of highlights of the journey. Drawn July 1968 by Katherine W. Ewing, Nashville, Tennessee. Copyright 1972, Katherine W. Ewing. No scale provided. / https://dc.etsu.edu/rare-maps/1132/thumbnail.jpg

Indicates 414 events or locations of historic significance, and includes a legend summarizing their significance. For the Netherland Inn Association. Cartographer: H.T. Spoden. Illustrator: Bob Hensley. Copyright 1969 by H.T. and M.C. Spoden. Scale 1 in = 0.6 miles. / https://dc.etsu.edu/rare-maps/1134/thumbnail.jpg

Indicates state lines, county lines, and county seats. Eight original shires, established 1634, tinted yellow. Independent cities (not administered by a county government), with dates of incorporation as cities, tinted blue, with the exception of Hampton and Newport News which cover areas of Original Shires, Warwich (River) and Elizabeth City couties, now extinct. County origins taken from charts and county abstracts in first edition of "A Hornbook of Virginia History" (1949, Division of History of the Virginia Department of Conservation and Development, Richmond); the recent consolidation of areas to form new cities taken from 1965 edition of the Hornbook (publ. by the State Library, Richmond, under direction of Randolph W. Church, Virginia State Librarian). Drawn May 1968 by Katherine W. Ewing, Nashville, Tennessee. No scale provided. / https://dc.etsu.edu/rare-maps/1135/thumbnail.jpg