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Taxonomic recognition of Solidago lancifolia (Torrey & A. Gray) Chapman and diagnostic characters used for identification have vacillated among floras and treatments. Fieldwork greatly expanded the specimen base in US herbaria, extended the known range in Tennessee, and identified new occurrences in North Carolina and Virginia. A morphometric analysis of herbarium specimens identified qualitative and quantitative characters unambiguously diagnostic for S. lancifolia. These included the presence of glands on the phyllaries; long, wide-diameter rhizomes; thick stems; and a long pappus on disk florets. Using these characters, an analysis of herbarium specimens corrected widespread misidentifications and showed that S. lancifolia is strictly endemic to a 12-county region encompassing the high elevations (> 1,400 m) in the mountains of southwestern Virginia, northwestern North Carolina, and northeastern Tennessee. Based on the narrow geographic range and small population sizes, prior uncertainty of the taxonomic validity and geographic range of S. lancifolia has been resolved. Consequently, for North Carolina and Virginia, the recommendation is for an upgrade in the conservation status to “Endangered” with a state rank of “S1.” Moreover, the narrow geographic range and small number of populations are consistent with a global rank of “G2” and consideration as a federal Species of Concern.

Objectives: This study examined the relation of multiple aspects of the home food environment to dietary intake and body weight among overweight and obese children in southern Appalachia. Methods: The study used baseline data from a cluster-randomized controlled trial, Parent-Led Activity and Nutrition for Healthy Living, evaluating a parent-mediated approach to treating child overweight and obesity in the primary care setting in southern Appalachia. Sixty-seven children ages 5 to 11 years were recruited from four primary care clinics. Multiple linear regression was used to estimate the relation between multiple aspects of the home food environment to dietary intake (fruit and vegetable intake, fat and sweets intake), and standardized body mass index (zBMI), adjusted for baseline family characteristics (education, smoking status during the past month, BMI) and child characteristics (sex, age, Medicaid/TennCare). Results: Findings showed greater parental restriction and pressure in feeding were associated with greater fruit and vegetable intake in children (β = 0.33, β = 0.30, respectively; both P < 0.05). The availability of chips and sweets in a child’s home and parental inappropriate modeling of eating were associated with an increased risk for consumption of fats and sweets by children (β = 0.47, β = 0.54, respectively; both P < 0.01). Parental monitoring of the child’s eating was associated with a reduced risk for fat and sweets intake (β = −0.24; P < 0.01). Finally, parental responsibility for feeding the child was associated with lower zBMI (β = −0.20; P < 0.05). Conclusions: The home food environment, including food availability and parenting behaviors, was associated with overweight and obese children’s dietary intake and weight. This study adds to evidence suggesting that programs aimed at improving overweight and obese children’s eating patterns may target both aspects of the physical home environment and parental behaviors surrounding eating.

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Objective: The prevalence of childhood overweight and obesity in southern Appalachia is among the highest in the United States (US). Primary care providers are in a unique position to address the problem; however, little is known about attitudes and practices in these settings. Methods: A 61-item healthcare provider questionnaire assessing current practices, attitudes, perceived barriers, and skill levels in managing childhood overweight and obesity was distributed to physicians in four primary care clinics. Questionnaires were obtained from 36 physicians. Results: Physicians' practices to address childhood overweight and obesity were limited, despite the fact that most physicians shared the attitude that childhood overweight and obesity need attention. While 71% of physicians reported talking about eating and physical activity habits with parents of overweight or obese children, only 19% reported giving these parents the tools they needed to make changes. Approximately 42% determined the parents' readiness to make small changes for their overweight or obese children. Physicians' self-perceived skill level in managing childhood overweight and obesity was found to be a key factor for childhood overweight- and obesity- related practices. Conclusion: Primary care physicians in southern Appalachia currently play a limited role in the prevention or intervention of childhood overweight and obesity. Training physicians to improve their skills in managing childhood overweight and obesity may lead to an improvement in practice.

Introduction. Previous research shows overweight children report poorer health-related quality of life (HRQoL), primarily in the areas of physical health and social functioning. These relations may be especially important to understand in rural populations characterized by poorer health behaviors and limited access to healthcare resources. Objective. The purpose of the current study was to investigate the relation between HRQoL (overall, physical, and social) and weight perception as well as actual weight status in middle school students residing in Southern Appalachia. Methods. 397 middle school students participating in Winning with Wellness, a school-based obesity prevention study, completed a written survey including the Pediatric Quality of Life Inventory. Results from a question on self-perceived weight were used to assign students to 1 of 4 weight-perception groups (underweight, healthy weight, overweight, or obese). Actual body mass index (BMI) percentile data collected by the schools was available for a subset of 152 students and used to classify students’ actual weight status according to Centers for Disease Control and Prevention guidelines. Results. Students who perceived them self to be overweight or obese reported significantly lower overall as well as lower physical and social HRQoL compared to students who perceived them self as a healthy weight. In the sub-sample with actual weight data, students whose actual weight status was obese reported significantly lower overall HRQoL than students whose weight status was in the healthy weight range. Conclusion. Our findings with students in Southern Appalachia are consistent with previous research documenting poorer HRQoL in overweight children and substantiate the need for more inclusive programs that target psychosocial well-being. The understanding of the role of weight perception in addition to actual weight may also inform future efforts at prevention and intervention.

Purpose Breastfeeding rates in Northeast Tennessee are much lower than national rates and the Healthy People 2020 targets. The purpose of this research was to develop and evaluate a high school breastfeeding education intervention. Methods Literature review and interviews with regional stakeholders informed development of an educational intervention for high school students aimed at increasing breastfeeding rates in this southern Appalachian region. An interactive educational game was developed based on the Theory of Planned Behavior (TPB) to provide age-appropriate information about breastfeeding. Health science classes from two regional high schools participated. Prior to the game, the students were given a 35-question pre-survey to assess knowledge, attitudes, subjective norms, perceived behavioral control, and intentions, the tenets of the TPB. Education was delivered during a single class session and included information about related health careers. A post-survey was given two weeks after the educational intervention and compared to the pre-test results using t-tests and Cohen’s d to assess changes in mean summary scores of measures of the TPB tenets. Results Surveys were completed by 107 students (75% female, 68% freshman/sophomores). Intention to breastfeed in the future significantly increased from 47.6% to 66.3% following the intervention. Measures of knowledge, attitudes, and perceptions of subjective norms related to breastfeeding were all significantly improved after the intervention. Levels of breastfeeding knowledge were low at baseline and demonstrated the largest improvement of all of the TPB tenets following the intervention (Cohen’s d = 1.6). Results were not found to vary significantly based on gender or grade level. Conclusion Breastfeeding education is not common in middle and high schools and published research evaluating the effects of breastfeeding education in schools is limited. While this study did not assess the impact of the intervention on breastfeeding rates, the changes observed suggest that an educational intervention based on the TPB may have the potential to increase the breastfeeding rates in the future. Limitations of the study include only having one session of education and a short follow-up period of only two weeks.

There are limited studies on bat activity in higher elevations in the Appalachian region. Levels of bat activity were compared in south central Appalachia at low (< 914.4 m) and high (> 1, 524 m) elevations in open, forest edge, and riparian habitats. Additionally, habitat suitability was modeled for a common species, big brown bat (Eptesicus fuscus). The study started May 27th 2019, and sites were monitored biweekly until October 2nd 2019. Six species and one genus were recorded during the study. Species from the Myotis genus were grouped together because of similar call characteristics. Results show that species were significantly more active in the lower elevations (F= 44.22, p

An analysis of information obtained from interviews with 660 older native inhabitants of the southern Appalachian region in the United States indicates that plant foods, especially cultivars and materials processed from them, and some wildcrafted plant foods as well, constituted the bulk of the folk materia medica in the 1920s and 1930s. Aside from their use for the treatment of common ailments, many plant foods were, and still are to a lesser extent, valued in the region for cleaning and building blood, cleaning the bowel, and as a source of vitamins and minerals. The dependence on plant foods and wildcrafted medicinal plants, however, appears to have diminished considerably in recent years.