Rural Locales Research Articles

Amenity Migration Revisited

AbstractThe dismantling of government research throughout rural North America has altered the ways environmental scientists understand their ties to rural places like northwest British Columbia. As growing numbers of researchers have leveraged their professional mobility to move to small mountain towns and other rural locales—a process known as “amenity migration”—many have increasingly described their role in these transformations through idioms of personal commitment and individual expertise. At times, these articulations have overshadowed other migratory strategies enacted in response to the neoliberalization of resource extraction and environmental governance in the region, including those of First Nations technicians and blue collar workers in extractive industries. The kinds of jobs that draw experts to live and work in places like northwest British Columbia have shifted away from full‐time government positions into consulting and contract work. In the process, researchers’ growing tendency to present their movements as intentional processes has obscured the ways neoliberal reform redistributes compulsion and choice among residents of the new rural north.

Second homes in the city and the country: a reappraisal of vacation homes in the twenty-first century

In the United States and across Europe, research on second—and multiple—homeownership for vacation and leisure use has traditionally analysed the in-migration of urban residents into rural locales. Indeed, this line of inquiry has been warranted for many years because of the high concentration of urban dwellers who have sought second homes in natural amenity-rich rural destinations. However, drawing on interviews with 61 second homeowners who purchased property for vacation or leisure use, this paper unravels an empirical puzzle. While second homeownership has often been found to be an urban-to-rural phenomenon, this analysis uncovers a preponderance of second homeowners who purchase secondary residences in urban locales, as well as suburbanites who purchase secondary residences in either rural or urban destinations. To makes sense of these findings, I suggest that empirical and theoretical attention to second homeownership requires a twenty-first century reappraisal to account for both the heterogeneity of second homeownership as well as the larger socio-economic conditions under which it materialises.

Variability in Dietary Quality of School Lunches Meeting National School Lunch Program Standards by Socioeconomic Status and Rurality (P04-191-19)

ObjectivesRecent research suggests the possibility for significant variability in nutrient content and dietary quality (DQ) of school lunches, even when meeting National School Lunch Program (NSLP) nutrition standards. The purpose of this study was to determine whether there were differences in nutrient content and DQ by socioeconomic status (SES) and rurality, among middle school lunch menus meeting NSLP standards. MethodsAll 283 Kansas school districts were stratified into high and low SES groups (< 50% or > 50% of students received free/reduced-price lunch). Forty-five menus from low and from high SES strata (N = 90) were obtained from websites of randomly selected school districts for the same time period (first six weeks of school). Included menus were also stratified for analyses by rurality, determined by National Center for Education Statistics locales. Thirty days of each menu were portioned per NSLP standards for the middle school age group and per standardized assumptions across all menus. Portioned menus were analyzed for macro- and micro-nutrient content using ESHA Food Processor. Daily DQ scores were calculated using the Healthy Eating Index (HEI) 2015. Two-way ANOVA was used to determine differences in nutrient content and DQ by SES and rurality, with Bonferroni correction for multiple comparisons. Effect size was calculated using Cohen’s d. ResultsEighty-five menus were included in final analyses. There were significant differences between high SES vs. low SES menus for added sugar (‒0.4 g or ‒80%, Cohen’s d = 0.78, P < 0.001) and calcium (5.3 mg or 1%, d = ‒0.22, P = 0.001) favoring high SES menus, and sodium (54.1 mg or 48%, d = ‒0.66, P = 0.001) favoring low SES menus. There were no significant differences in nutrient content between city, suburban, town, or rural locales (ps > 0.05). HEI scores did not differ by SES or rurality (ps > 0.05), with mean score and standard deviation of 62.0 ± 4.0 across all schools. ConclusionsThere were few differences in nutrient content and DQ with minimal clinical significance when comparing middle school lunch menus in Kansas by SES and rurality. Efforts to improve school lunch DQ should focus on all school foodservice operations, not specifically low SES or rural, although these schools may have other foodservice needs outside the scope of this study. Funding SourcesNone.

Understanding the Impacts of Aggregate Production on Agriculture and Identifying Mitigating Strategies

Across Ontario, aggregate extraction provides economic stimulus for many rural locales, but these operations significantly alter the landscapes upon which they occur and are often considered a nuisance to adjacent land owners. Especially in Southern Ontario, these operations frequently occur on agricultural land or within close proximity to productive farmland. Given the potentially disruptive nature of aggregate extraction, it is important to understand their impacts on nearby farms so that measures to mitigate these impacts can be developed and implemented. Thus, research is needed that understands the social, economic, environmental and land use impacts of aggregate operations to help ensure that adjacent agricultural operations prosper. This research therefore seeks to identify the farm operator’s perspective on impacts on crop and livestock production, along with corresponding best practices that can be utilized to mitigate these impacts. Additionally, this project will involve a jurisdictional scan to identify social, economic, environmental and land use impacts, as well as quantitative and qualitative research intended to identify impacts on agriculture (such as dust, noise and water) and promising practices that aggregate operators and municipal planners could use to limit these impacts. The goal is to see these best practices implemented early in the planning process to avoid conflict and negative impacts on agricultural production from future aggregate operations. The project is supported by a three-year research grant from OMAFRA.

“Mistakes Can be Beautiful”: Creative Engagement in Arts Integration for Early Adolescent Learners

AbstractIn this study we explored students’ perspectives and experiences engaging in an arts integration learning model during middle school through a pluralistic lens of creative engagement in learning. The sample included N = 86 students in Grades 6–7 attending schools in fringe rural and urban locales from small and mid‐sized cities in the Pacific Northwest. We used a grounded theory approach to explore how creative engagement takes shape for the early adolescent learner. Our conceptual framework integrated intrapsychological (inward) processes with interpsychological (outward) exchange in the social environment of an arts integrated classroom. Schools involved in the study were part of a larger mixed‐methods research investigation and received intensive support for school‐wide arts integration development. We found that students valued opportunities in arts integration for (a) choice, (b) the expression of their unique interpretations, (c) taking risks and making mistakes, (d) recognizing and applying their Studio Habits of Mind, and (e) enhancement of motivation and engagement in learning. The need for competency, belonging, and autonomy were important conditions of the learning environment and the need for meaning‐making was paramount in the process of creative engagement.

06 FOCUSING ON THE FUTURE: REDUCING BARRIERS AND IMPROVING ACCESS TO IBD SPECIALTY CARE

Inflammatory Bowel Disease (IBD) is a chronic, immune-mediated disease that affects approximately two million North Americans. Canada has the highest age-adjusted incidence and prevalence rates of IBD globally. Given its cumulative prevalence, the IBD clinical burden in North America continues to grow. Limitations in accessing specialty healthcare services is not a new issue facing patients and healthcare providers. Despite this persistent problem, no research elucidating the patient perspective using qualitative approaches to compare and contrast the patient experience across diverse geographic regions has been conducted. The aim of the current study was to elicit a qualitative stream of data to better understand phenomena related to access to healthcare for Canadians living with IBD from a patient-centered perspective. IBD patients (≥18 years of age) were recruited from gastroenterology clinics and communities through IBD specialists and Crohn’s & Colitis Canada. Patients were recruited from both urban and rural locales to ensure adequate representation from geographically diverse regions. Focus groups provided a powerful and more naturalistic tool through which a focused understanding of the patient experience was derived. Co-facilitated by a researcher and a patient research partner, the focus groups were held in Nova Scotia, New Brunswick, Quebec, Ontario, Manitoba, Saskatchewan, Alberta, and British Columbia. Patient demographics were collected to contextualize observed themes. Themes were distilled through qualitative thematic analysis using Atlas.ti software to ascertain congruence or discordance of patient experiences. Eastern Canadian focus groups have been completed, with recruitment underway for the Western Canadian focus groups. A total of 20 participants were recruited as of October 2018. The majority of participants were male (11/20, 55%) and were from urban/suburban regions (10/20, 50%). The mean age of participants was 44 years of age (SD=12 years, range=24 to 67 years). Preliminary analyses show that the main patient-identified barriers to accessing IBD care fall into the following categories: 1) Lack of multidisciplinary care (including psycho-social support), 2) Diagnostic delay, and 3) Inability to effectively receive and provide communication with healthcare providers. Solutions identified by patients included: 1) Integration of more holistic care into the clinical practice, 2) Readily accessible psychiatric and nutritional support, 3) Increased patient advocacy, and 4) Continuity and liaison through provision of a healthcare navigator resource. Healthcare access for IBD patients is complex. It is important to not only have a robust understanding of the healthcare system structure and processes but also the significant impact these factors have on patients. Access improvement research can be best tackled through patient-centered exploration of themes related to access to care.

06 FOCUSING ON THE FUTURE: REDUCING BARRIERS AND IMPROVING ACCESS TO IBD SPECIALTY CARE

Inflammatory Bowel Disease (IBD) is a chronic, immune-mediated disease that affects approximately two million North Americans. Canada has the highest age-adjusted incidence and prevalence rates of IBD globally. Given its cumulative prevalence, the IBD clinical burden in North America continues to grow. Limitations in accessing specialty healthcare services is not a new issue facing patients and healthcare providers. Despite this persistent problem, no research elucidating the patient perspective using qualitative approaches to compare and contrast the patient experience across diverse geographic regions has been conducted. The aim of the current study was to elicit a qualitative stream of data to better understand phenomena related to access to healthcare for Canadians living with IBD from a patient-centered perspective. IBD patients (≥18 years of age) were recruited from gastroenterology clinics and communities through IBD specialists and Crohn’s & Colitis Canada. Patients were recruited from both urban and rural locales to ensure adequate representation from geographically diverse regions. Focus groups provided a powerful and more naturalistic tool through which a focused understanding of the patient experience was derived. Co-facilitated by a researcher and a patient research partner, the focus groups were held in Nova Scotia, New Brunswick, Quebec, Ontario, Manitoba, Saskatchewan, Alberta, and British Columbia. Patient demographics were collected to contextualize observed themes. Themes were distilled through qualitative thematic analysis using Atlas.ti software to ascertain congruence or discordance of patient experiences. Eastern Canadian focus groups have been completed, with recruitment underway for the Western Canadian focus groups. A total of 20 participants were recruited as of October 2018. The majority of participants were male (11/20, 55%) and were from urban/suburban regions (10/20, 50%). The mean age of participants was 44 years of age (SD=12 years, range=24 to 67 years). Preliminary analyses show that the main patient-identified barriers to accessing IBD care fall into the following categories: 1) Lack of multidisciplinary care (including psycho-social support), 2) Diagnostic delay, and 3) Inability to effectively receive and provide communication with healthcare providers. Solutions identified by patients included: 1) Integration of more holistic care into the clinical practice, 2) Readily accessible psychiatric and nutritional support, 3) Increased patient advocacy, and 4) Continuity and liaison through provision of a healthcare navigator resource. Healthcare access for IBD patients is complex. It is important to not only have a robust understanding of the healthcare system structure and processes but also the significant impact these factors have on patients. Access improvement research can be best tackled through patient-centered exploration of themes related to access to care.

Music, Beer and Performativity in New Local Leisure Spaces: Case Study of a Yorkshire Dales Market Town

Pubs and popular music share long-standing connections, both through commodified entertainment practices and ones which cultivate a sense of belonging. In this article we consider how new spaces for drink and music related leisure form sites of community, distinction and resistance in a Yorkshire Dales market town. Pubs in urban areas have long contributed to the vitality of more diffuse music scenes, but instances of pub-based scenes in rural areas have been rare and disconnected. However, the conjunction of reduced demand for retail space and an emergent do-it-yourself culture has brought about the transformation of redundant retail outlets as independently-run leisure spaces in both urban and rural locales, including a growing number of micropubs. Foregrounding the role of individual agency and the significance of locally-negotiated meanings, we examine how Habermasian communicative leisure is performed at recently-opened micropubs which stage live music. Through observational analysis and semi-structured interviews we examine how these performative spaces foster a sense of belonging and how this is enhanced through activities including music quizzes, trips to music festivals and amateur music-making. We consider how locally negotiated trading and exchange practices constitute resistance to corporate capitalism and the extent to which this community’s preferences for real-ale and less-mainstream musical styles also serve as markers of distinction in a Bourdieusian sense.

If You Are Poor, It is Better to be Rural

Part of a larger research project involving the study of mathematics achievement of middle and high school students in Tennessee, this report analyzes said achievement in terms of school locale and the percentage of disadvantaged (pdisadv) students enrolled in the school. Schools were designated as Rural, Large Central City, and Other Nonrural. Socioeconomic Status (SES) was determined by the percentage of students receiving federally subsidized free and reduced lunch. Schools were then placed into one of three economic categories: Low to moderate pdisadv (less than 50 percent of students receiving free or reduced lunch), High pdisadv (50-74.99 percent), or Highest (75 percent or greater). The findings involving SES and achievement were as expected, the higher the percentage of disadvantage, the lower the achievement. Interesting results involving locale as well as the intersection between locale and SES were also discovered. If a student is poor, the data suggests, it is better, in terms of mathematics achievement, to be rural. The possibility exists that close-knit, economically disadvantaged rural locales offer a sense of community not found in other economically disadvantaged locales which enables rural students to achieve at a higher level mathematically than their nonrural peers.

When the Marae Moves into the City: Being Māori in Urban Palmerston North

Through processes of colonization, many indigenous peoples have become absorbed into settler societies and new ways of existing within urban environments. Settler society economic, legal, and social structures have facilitated this absorption by recasting indigenous selves in ways that reflect the cultural values of settler populations. Urban enclaves populated and textured by indigenous groups such as Māori (indigenous people of New Zealand) can be approached as sites of existential resistance to the imposition of colonial ways of seeing and understanding the self. In maintaining everyday social practices and ways–of–being that traverse rural and urban locales, Māori preserve and reproduce cultural selves in ways that make aspects of cityscapes more homely for Māori ways–of–being. This article brings issues of place and being to the fore by investigating Māori reassemblage of cultural selves within a low SES urban environment as an ongoing resistance to colonial absorption.

Growth and Persistence of Place-Based Mortality in the United States: The Rural Mortality Penalty.

To examine 47 years of US urban and rural mortality trends at the county level, controlling for effects of education, income, poverty, and race. We obtained (1) Centers for Disease Control and Prevention WONDER (Wide-ranging ONline Data for Epidemiologic Research) data (1970-2016) on 104 million deaths; (2) US Census data on education, poverty, and race; and (3) Bureau of Economic Analysis data on income. We calculated ordinary least square regression models, including interaction models, for each year. We graphed standardized parameter estimates for 47 years. Rural-urban mortality disparities increased from the mid-1980s through 2016. We found education, race, and rurality to be strong predictors; we found strong interactions between percentage poverty and percentage rural, indicating that the largest penalty was in high-poverty, rural counties. The rural-urban mortality disparity was persistent, growing, and large when compared to other place-based disparities. The penalty had evolved into a high-poverty, rural penalty that rivaled the effects of education and exceeded the effects of race by 2016. Public Health Implications. Targeting public health programs that focus on high-poverty, rural locales is a promising strategy for addressing disparities in mortality.

Proteome characterization in various biological fluids of Trypanosoma brucei gambiense-infected subjects

Human African trypanosomiasis (HAT) is a neglected tropical disease that is endemic in sub-Saharan Africa. Control of the disease has been recently improved by better screening and treatment strategies, and the disease is on the WHO list of possible elimination. However, some physiopathological aspects of the disease transmission and progression remain unclear. We propose a new proteomic approach to identify new targets and thus possible new biomarkers of the disease. We also focused our attention on fluids classically associated with HAT (serum and cerebrospinal fluid (CSF)) and on the more easily accessible biological fluids urine and saliva.Liquid chromatography–tandem mass spectrometry (LC-MS/MS) established the proteomic profile of patients with early and late stage disease. The serum, CSF, urine and saliva of 3 uninfected controls, 3 early stage patients and 4 late stage patients were analyzed.Among proteins identified, in CSF, urine and saliva, respectively, 37, 8 and 24 proteins were differentially expressed and showed particular interest with regards to their function. The most promising proteins (Neogenin, Neuroserpin, secretogranin 2 in CSF; moesin in urine and intelectin 2 in saliva) were quantified by enzyme-linked immunosorbent assay in a confirmatory cohort of 14 uninfected controls, 23 patients with early stage disease and 43 patients with late stage disease. The potential of two proteins, neuroserpin and moesin, with the latter present in urine, were further characterized.Our results showed the potential of proteomic analysis to discover new biomarkers and provide the basis of the establishment of a new proteomic catalogue applied to HAT-infected subjects and controls. SignificanceSleeping sickness, also called Human African Trypanosomiasis (HAT), is a parasitic infection caused by a parasitic protozoan, Trypanosoma brucei gambiense or T. b. rhodesiense which are transmitted via an infected tsetse fly: Glossina. For both, the haemolymphatic stage (or first stage) signs and symptoms are intermittent fever, lymphadenopathy, hepatosplenomegaly, headaches, pruritus, and for T. b. rhodesiense infection a chancre is often formed at the bite site. Meningoencephalitic stage (or second stage) occurs when parasites invade the CNS, it is characterised by neurological signs and symptoms such as altered gait, tremors, neuropathy, somnolence which can lead to coma and death if untreated. first stage of the disease is characterizing by fevers, headaches, itchiness, and joint pains and progressive lethargy corresponding to the second stage with confusion, poor coordination, numbness and trouble sleeping. Actually, diagnosing HAT requires specialized expertise and significant resources such as well-equipped health centers and qualified staff. Such resources are lacking in many endemic areas that are often in rural locales, so many individuals with HAT die before the diagnosis is established. In this study, we analysed by mass spectrometry the entire proteome of serum, CSF, urine and saliva samples from infected and non-infected Angolan individuals to define new biomarkers of the disease. This work of proteomics analysis is a preliminary stage to the characterization of the whole proteome, of these 4 biological fluids, of HAT patients. We have identified 69 new biomarkers. Five of them have been thoroughly investigated by ELISA quantification. Neuroserpine and Moesin are respectively promising new biomarkers in CSF and urine’s patient for a better diagnosis.

A closer look at rickets and vitamin D deficiency in Manitoba: The tip of the iceberg.

Vitamin D deficiency rickets remains a problem in Canada. Our primary objective was to determine the annual incidence of rickets and/or early vitamin D deficiency in Manitoba. Secondarily, we investigated if there was an increase in the annual incidence. A retrospective chart review was undertaken to identify cases in our catchment area from 2003 to 2015. Data sources included endocrine and hospital charts and radiology reports. Early vitamin D deficiency was determined by review of all 25(OH)D tests from 2011 to 2015. Values less than 30 nmol/L with an elevated bone marker prompted a chart review in children under 7 years. We identified 46 cases of rickets and 68 with early vitamin D deficiency. For Manitoba, the annual incidence of rickets was 8.2 cases per 100,000 in infants, and 1.6 per 100,000 in children aged 1 to 7 years. Those with early vitamin D deficiency had annual incidences of 2.7 per 100,000 infants and 9.9 per 100,000 Manitoban children. No temporal trends were noted for either. For both disorders, most cases were from northern or rural locales; about 50% were of self-declared Indigenous or Inuit heritage, and the majority (>75%) of children were from families with high material deprivation using area-based socioeconomic measures. Despite several decades of preventative efforts, the incidence of rickets was comparable to previous Canadian reports, particularly in infants. Greater education across the lifespan and engagement with communities and public health agencies will be needed to reduce the high incidence of this preventable disease.

Assessing Effectiveness and Cost-Benefit of the Trinity Hospital Twin City Fit For Life Program for Weight Loss and Diabetes Prevention in a Rural Midwestern Town.

IntroductionObesity is a top public health priority in the United States. This article reports on the Fit For Life (FFL) health education program designed to address the determinants of obesity in rural settings and help participants lose weight.Purpose and ObjectivesWe evaluated the implementation of the original FFL program, a replication program, and a diabetes-focused program.Intervention ApproachThe original FFL program (2006 to 2012) was a 12-week session of classes meeting once weekly. Lecture topics included stress management, nutrition, healthy eating, reading food labels, fitness, disease prevention, and healthy aging. The replication program, conducted in 4 locations from 2012 to 2015, helped determine if the FFL program could be implemented on a larger scale, with outcomes similar to the original program. The longer, more-intensive FFL diabetes prevention program, conducted in 2016 and 2017, sought to reduce the number of rural adults at risk for diabetes.Evaluation MethodsWe evaluated FFL participation and outcome data from 2009 through first quarter 2017. We calculated rates of course participation and completion and measured changes in several health indicators. We constructed a linear regression model to examine the impact of health behaviors on weight loss and calculated program cost-effectiveness.ResultsFrom 2009 to 2017, FFL was delivered to over 1,200 people; 82% of participants completed the program. Completing participants lost an average of 2.7 kg or 3% of their total weight. Overall, 68% of participants said they exercised more per week at the end of the program than at the beginning. Estimated cost per kilogram lost for replication sites was between $73 and $101 for original FFL, in line with other programs. The more resource-intensive diabetes prevention program cost per kilogram lost was $151 to $171.Implications for Public Health PracticeWeight loss and lifestyle management are major ways to counteract obesity. Improving program options, especially in rural locales, should be a key policy priority. These programs should be considered for population-based expansion, perhaps by health departments or public–private health care consortiums.

Preferences for Attributes of Sacred Groves and Temples along an Urbanization Gradient in the National Capital Region of India

In India, sacred groves have been considered the forested abodes of one or multiple deities and are often managed by communal governance systems. As land development has progressed, the population surrounding these and other green spaces has changed, and responsibility for their protection has shifted to the bureaucracies that manage urban environments. The sacred grove now means different things to different people, and the value of its protection is increasingly difficult to characterize. In this context, we study individual preferences for sacred groves and non-forested temples along an urbanization gradient –defined by land use– in rural locales near the megacity of Delhi, informed by the theoretical perspective of Sanskritization. We use revealed and stated preference data that includes information on visits to forests and worship sites, weighting for relevant forest characteristics, and socio-demographic factors related to culture. Respondents generally place higher value on sacred groves than on non-sacred green space, but more urbanized and sanskritized individuals exhibit higher valuations for non-forested temples and conservation of urban green space. Taken together, these results suggest a potential increase in the perception of non-sacred and non-use forest value among urbanized respondents.

Multiple Correspondence Analysis of Pedestrian Crashes in Rural Illinois

During the five-year period between 2010 and 2014, there were 24,178 pedestrian crashes in Illinois. Approximately 4.39% of these pedestrian crashes occurred in rural areas; and approximately 40% of the crashes resulted in a severe injury or a fatality. Thus, pedestrian safety problems exist in rural locales, and the factors contributing to these problems need to be investigated. The goal of this study is to answer the question: “Which variable categories, when acting together, contribute more to the occurrence of pedestrian crashes in rural areas?” Crashes are random events stemming from the convergence of various factors. However, traditional statistical tools can only make pairwise comparisons of dependent and independent variables. Therefore, it is necessary to apply an analytical tool that can identify complex underlying structures in crash data and spot associations among variable categories that contribute to crash occurrence. The multiple correspondence analysis (MCA) method, which is used in this study, can do just that. According to the obtained results, categories of variables such as roadway functional class, the number of lanes, lighting conditions, weather conditions, traffic control devices, driver condition, and pedestrian condition were proved to contribute to pedestrian crashes in rural Illinois.

The Emergence and Persistence of Queerness: Conversing Through Visual Culture Within a Generation

ABSTRACTIn this article, the authors explore the work of becoming queer within the Millennial generation. Collaborative in nature, their investigation turns to three key popular-culture texts of the 1990s—Will & Grace, Rent, and MTV’s Spring Break—that were central to their then-emerging sense of self. Staged as an intragenerational conversation, the authors look to create space to unpack the connections, anecdotal by design, between popular texts and changing ideas of queer identity and community. Since neither author grew up within the confines of a gay ghetto—Boystown of Chicago, the Castro of San Francisco, the East Village of New York City—where they may have encountered and been enamored by the avant-garde queer subcultures so often praised in queer scholarship (for important reasons), they turn instead to experiences with popular culture that opened up lessons in becoming gay, in rural and Midwestern locales where queerness operated and emerged differently.

Dampness problems in Tianjin dwellings: A cross-sectional study of associations with building characteristics and lifestyles

This study investigated the association of building characteristics and occupant behaviours with building dampness indicators. Data were from a cross-sectional study in urban Tianjin and rural Cangzhou, China, from 2013 to 2014. We studied two fundamental types of Chinese dwellings: bungalows typical of rural locales and apartments in low- and high-rise buildings typical of urban settings. Occupants of bungalows reported more dampness indicators than apartment dwellers. Risk factors for one or more dampness indicators included natural ventilation without fans, older dwellings and coal stove or Kang heating system (a brick bed installed in the bedroom for heating and sleeping). All these factors were typical of bungalows, which generally used older building technologies including non-insulated external walls, wooden frame windows, electric fans for cooling and no exhaust fan ventilation. Occupant behaviours that decreased the risk for dampness indicators included frequent window opening and daily cleaning, regardless of the type of dwelling. Indoor dampness was highly correlated with mouldy and humid odour, and paradoxically (although not a new finding) with the perception of air dryness.

Chronic Disease Self-Management Challenges among Rural Women Living with HIV/AIDS in Prakasam, Andhra Pradesh, India: A Qualitative Study.

Rural women living with HIV/AIDS (WLHA) in India experience challenges self-managing HIV/AIDS in their rural communities. The purpose of this qualitative study was to explore factors influencing their care and antiretroviral treatment (ART) adherence. Themes that emerged from the qualitative focus groups among WLHA (N = 24) in rural Prakasam, Andhra Pradesh, India, included: (1) coming to know about HIV and other health conditions, (2) experiences being on ART, (3) challenges maintaining a nutritious diet, (4) factors affecting health care access and quality, and (5) seeking support for a better future. Chronic disease self-management in rural locales is challenging, given the number of barriers which rural women experience on a daily basis. These findings suggest a need for individual- and structural-level supports that will aid in assisting rural WLHA to self-manage HIV/AIDS as a chronic illness.

Understanding the Effects of Rurality and Socioeconomic Status on College Attendance and Institutional Choice in the United States

This study seeks to update past studies of rural youth by examining college attendance and choice decisions for students who graduated from rural high schools, while also conducting an examination of how the effects of socioeconomic status manifest differently by locale. Logistic regression is used to study the postsecondary attendance and institutional choice for rural students. Data are taken from the Education Longitudinal Study of 2002 and the Integrated Postsecondary Education Data System. The results reveal clear differences in postsecondary attendance and initial institutional chose for youth from rural locales. Socioeconomic effects also differ for rural and non-rural youth.