The examination of health disparities among people within Appalachian counties compared to people living in other counties is needed to find ways to strategically target improvements in community health in the United States of America (USA). Methods: A telephone survey of a random sample of adults living in households within communities of all counties of the state of Virginia (VA) in the USA was conducted. Findings: Health status was poorer among those in communities within Appalachian counties in VA and health insurance did not make a difference. Health perception was significantly worse in residents within communities in Appalachian counties compared to non-Appalachian community residents (30.5 vs. 17.4% rated their health status as poor/fair), and was worse even among those with no chronic diseases. Within communities in Appalachian counties, black residents report significantly better health perception than do white residents. Conclusion: Residents living in communities in Appalachian counties in VA are not receiving adequate health care, even among those with health insurance. More research with a larger ethnic minority sample is needed to investigate the racial/ethnic disparities in self-reported health and health care utilization within communities.

An evidence-based treatment for adolescent cannabis users, Adolescent Community Reinforcement Approach with Assertive Continuing Care, was implemented in a rural county and small city in the USA. A total of 147 adolescents, ages 12-18, were enrolled and assessed at baseline and three time points: 3, 6, and 12 months using the Global Appraisal of Individual Needs and related measures. Program effectiveness was confirmed. The treatment was equally effective for youth from the city versus the county. More than two-thirds (68.7%) of the adolescents reported quitting use of cannabis by 12 months. The days of cannabis use in the last 90 days decreased significantly from the first follow-up, controlling for age (p value < .01), and shows consistent decline until the end of the treatment. In addition to reduction in substance use, the average number of days missing school and expelled from school decreased significantly from baseline to the end of the treatment.

A lack of intensive community-based treatment and support in lieu of hospitalization accounted for a significant portion of variance in actions to initiate involuntary commitment. Comprehensive community services and supports for individuals experiencing mental health crises may reduce the rate of involuntary hospitalization. There is a need to enrich intensive community mental health services and supports and to evaluate the impact of these enhancements on the frequency of involuntary mental health interventions.

Objective-This study was conducted to evaluate a computer-imaging program called HAAIR (Help with Adjustment to Alopecia by Image Recovery) that was developed to provide educational support and reduce distress in women with hair loss following chemotherapy.Methods-Forty-five women who had been diagnosed with cancer and anticipated alopecia following treatment were randomly assigned to either the Computer Imagining Intervention group (IG) or Standardized Care group (SCG). Patients in the IG used a computer imaging program that created the patient's image on a screen to simulate baldness and use of wigs while patients in the SCG were directed to a resource room at the Cancer Center established for women with chemotherapy-related alopecia. Assessment data using the Brief Symptom Inventory, Importance of Hair Questionnaire, and the Brief Cope were completed at baseline (T1), before chemotherapy and hair loss, following hair loss (T2), and 3 months follow-up (T3).Results-All women were able to successfully use the touch screen computerized imaging program and reported that using the computer was a positive, helpful experience, thus establishing acceptability and usability. Women in both the IG and the SCG group showed significantly lower Hair Loss Distress scores at T2 after hair loss than at T1 with T3 distress scores increasing in the SCG and decreasing in the IG. Those with avoidance coping reported more distress.Conclusions-This evaluation demonstrates that the HAAIR program is a patient-endorsed educational and supportive complement to care for women facing chemotherapy-related alopecia.

Mood and weight concerns may relate to postpartum smoking, and racial differences in these concerns may be important in developing interventions to prevent postpartum relapse. We compared differences in the smoking patterns, mood, and weight concerns of Black and White women who quit smoking during pregnancy (N=174). In univariate comparisons, there were no consistent differences in nicotine dependence, smoking history, or motivation to remain abstinent postpartum. Moreover, although there were univariate differences in negative affect, smoking for weight control, and eating disinhibition, after controlling for differences in income and educational background between Black and White women, these differences in mood and weight concerns were no longer significant. In our sample of pregnant women who had quit smoking, Black and White women did not differ in mood and weight concerns, two potentially modifiable variables that may affect smoking postpartum relapse.

Introducción: la cirugía bariátrica no beneficia a todos los pacientes. Identificar a los pacientes gravemente obesos que tendrán éxito después de la cirugía bariátrica sigue siendo un reto para el equipo transdiciplinario. El objetivo de este estudio retrospectivo fue analizar factores dietéticos preoperatorios que pudieran predecir una pérdida de peso exitosa después de la cirugía bariátrica.Métodos: el estudio retrospectivo incluyó a pacientes sometidos a una cirugía de bypass gástrico laparoscópico en Y de Roux como procedimiento para obesidad severa (n = 84). Datos demográficos del paciente, comorbilidades, factores dietéticos y los resultados de pérdida de peso se extrajeron de la historia clínica electrónica.Resultados: la diabetes mellitus tipo 2 (DM2) se asoció con una pérdida subóptima de peso después de una cirugía de bypass gástrico laparoscópicoen Y de Roux.Conclusiones: aunque la cirugía bariátrica sigue siendo el tratamiento más efectivo para los pacientes con obesidad severa, es fundamental desarrollar estrategias para mejorar y mantener la pérdida de peso, especialmente en pacientes con DM2. Evaluar las características dietéticas de los candidatos a cirugía bariátrica es crucial.

Virginia's CSBs provide a range of outpatient mental health services that are designed to enable individuals to remain in their community. The availability of community-based mental health services was correlated with lower rates of inpatient hospitalization for mental illness. More research, however, is needed to establish causality and to determine which services are most effective at reducing the need for inpatient care.