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While most accounts see worshippers of Saturn as indigenous Africans or rural peasants, this chapter argues that stele-dedicants used stelae to articulate positions for themselves within the frameworks of the wider empire. Unlike earlier stelae, which worked to imagine stele-dedicants as a horizontal community of equals, stelae dedicated from the first century BCE onward became billboards that asserted the prestige of dedicants in the deeply localized but also vertically structured world of the Roman Empire. This can be seen in the adoption of new anthropocentric iconographies that adapt a koine of imagery, the composition of stelae, and new titles for worshippers like sacerdos that are borrowed from a civic sphere.
West Virginia is a rural state with high rates of type 2 diabetes (T2DM) and prediabetes. The Diabetes Prevention and Management (DPM) program was a health coach (HC)-led, 12-month community-based lifestyle intervention.
Objective:
The study examined the impact of the DPM program on changes in glycosylated hemoglobin (A1C) and weight over twelve months among rural adults with diabetes and prediabetes. Program feasibility and acceptability were also explored.
Methods:
An explanatory sequential quantitative and qualitative one-group study design was used to gain insight into the pre- and 12-month changes to health behavior and clinical outcomes. Trained HCs delivered the educational sessions and provided weekly health coaching feedback. Assessments included demographics, clinical, anthropometric, and qualitative focus groups. Participants included 94 obese adults with diabetes (63%) and prediabetes (37%). Twenty-two participated in three focus groups.
Results:
Average attendance was 13.7 ± 6.1 out of 22 sessions. Mean weight loss was 4.4 ± 11.5 lbs at twelve months and clinical improvement in A1C (0.4%) was noted among T2DM adults. Program retention (82%) was higher among older participants and those with poor glycemic control. While all participants connected to a trained HC, only 72% had regular weekly health coaching. Participants reported overall acceptability and satisfaction with the program and limited barriers to program engagement.
Conclusion:
Our findings suggest that it is feasible to implement an HC-led DPM program in rural communities and improve A1C in T2DM adults. Trained HCs have the potential to be integrated with healthcare teams in rural regions of the United States.
Group-based identities are an important basis of political competition. Politicians consciously appeal to specific social groups, and these group-based appeals often improve the evaluation of parties and candidates. Studying place-based appeals, we advance the understanding of this strategy by distinguishing between dominant and subordinate social groups. Using two survey experiments in Germany and England, we show that group appeals improve candidate evaluation among subordinate (rural) voters. By contrast, appeals to the dominant (urban) group trigger a negative reaction. While urban citizens’ weaker local identities and lower place-based resentment partly explain this asymmetry, they mainly dislike group-based appeals because of their antagonistic nature. If the same policies are framed as benefiting urban and rural dwellers alike, candidate evaluation improves. Thus, people on the dominant side of a group divide reject a framing of politics as antagonistically structured by this divide, even if they identify with the dominant group.
There has been a decline in the rural population of India from nearly 82% to about 65% over the past six decades. The National Mental Health Survey of India (2015–2016) reported a lower prevalence of mental disorders in rural areas compared with urban ones. Mental health services in the country are skewed towards the urban areas, and more families are pushed below the poverty line while getting treatment for a member with mental illness. India has expanded its District Mental Health Programme over the past two decades, and it now covers nearly all the districts in the country. Despite that, significant numbers of people with mental disorders, ranging from 70–90%, do not receive adequate treatment. This paper discusses the rural–urban divide in the mental health services, examining the problem and need, and the initiatives taken by the government of India in this direction.
Rural communities. Rural families. Both face challenges and opportunities for viability and security. The Rural Families Speak Project has been studying rural families with low incomes for over twenty years, listening to the voices of families and sharing their stories of challenges as well as resiliency with policymakers and community educators. Select findings of this rich body of work focused on four domains – food insecurity, economic security, health, and family well-being – and are shared in this chapter along with implications and recommendations for community outreach and education. In particular, the roles that Extension can play in serving rural communities and families are presented. This chapter illustrates the translational linkage between research and Extension work highlighting the importance of integrating research and practice.
The second part of Volume Two starts with passages relating to the Black Death which ravaged the population in 1349. Knighton’s Chronicle records a series of facts about the impact of the plague. The Ordinance of Labourers, recorded in a Close Roll of 1349, states the new regulations governing the employment of rural and urban workers. These were aimed at curbing the increased power of workers now that many had died in the plague. The situation is seen from the perspective of the upper classes who needed servants but who did not wish to pay the higher wages demanded.
This study aimed to understand rural–urban differences in the uptake of COVID-19 vaccinations during the peak period of the national vaccination roll-out in Aotearoa New Zealand (NZ). Using a linked national dataset of health service users aged 12+ years and COVID-19 immunization records, age-standardized rates of vaccination uptake were calculated at fortnightly intervals, between June and December 2021, by rurality, ethnicity, and region. Rate ratios were calculated for each rurality category with the most urban areas (U1) used as the reference. Overall, rural vaccination rates lagged behind urban rates, despite early rapid rural uptake. By December 2021, a rural–urban gradient developed, with age-standardized coverage for R3 areas (most rural) at 77%, R2 81%, R1 83%, U2 85%, and U1 (most urban) 89%. Age-based assessments illustrate the rural–urban vaccination uptake gap was widest for those aged 12–44 years, with older people (65+) having broadly consistent levels of uptake regardless of rurality. Variations from national trends are observable by ethnicity. Early in the roll-out, Indigenous Māori residing in R3 areas had a higher uptake than Māori in U1, and Pacific peoples in R1 had a higher uptake than those in U1. The extent of differences in rural–urban vaccine uptake also varied by region.
How can we make the transition to a net-zero-carbon economy a political divide pitting conservatives versus liberals and those living in urban cores versus rural communites?
It is already well-understood that patients requiring multiple hospital visits deal with several barriers. This paper considers a new methodology for determining the barrier that travel can cause, applying it to the mixed rural-city population of South-West Wales, calculating the travel burden for patients accessing radiotherapy. Travel burden could factor into conversations around optimisation of appointments and the impact of changes to treatment pathways.
Methods:
Patient-specific travel data were calculated using Google Maps, for 1516 patients attending South-West Wales Cancer Centre for radiotherapy, modelled for 5-fraction and 15-fraction regimes.
Results:
28% of patients travelled for longer than 60 minutes. Moving to a 5-fraction treatment regime saves 20 one-way trips to the hospital, resulting in an average time saving of 15.9 hours for those travelling by car and 39.3 hours for those travelling by public transport. On average, this reduces carbon dioxide emissions by 91 kg per patient.
Conclusions:
Implementation of a 5-fraction treatment regime has significantly reduced the travel burden for some patients receiving radiotherapy, as well as emissions related to travel. However, access to radiotherapy services in South-West Wales varies, with certain regions facing substantial travel burdens. Further research exploring other potential options to reduce travel burden is needed.
Mental illness stigma is universally prevalent and a significant barrier to achieving global mental health goals. Mental illness stigma in Bangladesh has gained little attention despite its widespread impact on seeking mental health care in rural and urban areas. This study aimed to investigate mental illness stigma and the associated factors in rural and urban areas of Bangladesh.
Methods
The study areas were divided into several clusters from which 325 participants (≥18 years) were recruited with systematic random sampling. The Bangla version of the Days’ Mental Illness Stigma Scale was used to collect data. Independent-samples t-test, ANOVA, and multiple regression were performed.
Results
Results suggest that gender, age, geographical location, socioeconomic status, and occupation significantly differed across subscales of stigma. Age, gender, seeking treatment of mental illness, having knowledge on mental health, and socioeconomic status were predictive factors of mental illness stigma. The results also showed a high treatment gap in both rural and urban areas.
Conclusion
This study supports that mental illness stigma is prevalent in Bangladesh, requiring coordinated efforts. Results can inform the development of contextually tailored mental health strategies to reduce stigma and contribute to the promotion of mental health of individuals and communities across Bangladesh.
This chapter delves into the challenges and rewards of working in remote areas of countries such as Australia and small Pacific nations. Teaching strategies are presented to assist in maintaining a positive learning environment in remote and small Pacific-nation classrooms. The importance of the relationships among and between parents, students, teachers and other community members is explored, along with practical suggestions for making the most of the available resources. This chapter explores strategies for making the most of available resources and the invaluable professional experience of working in these areas.
This scoping review aimed to explore international evidence on the impact of Food Policy Groups (FPGs) on local food systems, in urban and rural regions of high-income countries. Peer-reviewed and grey literature were searched to identify thirty-one documents published between 2002 and 2022 providing evidence on the impact of FPGs. Activities spanned domains including increasing food equity (e.g. strengthening school meals programmes); increasing knowledge and/or demand for healthy food (e.g. food literacy programmes with children and adults); increasing food access (e.g. enhancing local food procurement); environmental sustainability (e.g. promoting low-waste food items on café menus); economic development (e.g. ensuring local businesses are not outperformed by large food distributors); and increasing food system resiliency (e.g. establishment of local produce schemes). Most FPGs reported conducting activities that positively influenced multiple food system domains and reported activities in urban areas, and to a lesser extent in rural areas. Our study highlighted a range of qualitative and quantitative evaluation strategies used to measure FPGs’ impact on local food systems. Our recommendations focus on regular and systematic evaluation and research surrounding the impact of FPG activities, to build the evidence base of their impact. Ideally, evaluation would utilise comprehensive and established tools. We recommend exploring the establishment of FPGs across more regions of high-income countries, particularly rural areas, and forming partnerships between FPGs, local government and universities to maximise implementation and evaluation of activities.
Physical activity and social interaction among rural older adults are important, particularly during the COVID-19 pandemic when restrictions on physical gatherings were placed. The purpose of this qualitative study was to gain a deeper understanding of rural older adults’ experience with physical activity and social interaction during the COVID-19 pandemic. An interpretative phenomenological approach was used to explore the experience of 10 older adults, 67–82 years of age, from rural communities throughout Saskatchewan. Findings revealed that many rural older adults acknowledged the health benefits of physical and social activities and experienced loneliness when COVID-19 restrictions were placed, even when living with a partner. For some, the restrictions placed on physical and social activity provided a welcome break from daily responsibilities. Rural communities, often at a disadvantage, were also perceived by participants as being protected against COVID-19. The resilience demonstrated among rural participants to persevere and adapt to their changing environment during the pandemic was evident in the findings.
Early modern Europe was predominantly rural and agriculture was the most common form of production. Yet women’s contribution to agricultural work is relatively neglected in studies of women’s work and remains an area of discussion and disagreement among historians. This chapter sets out to tackle misconceptions around women’s agricultural work. It does so first by critically examining the main areas for debate; secondly by offering a survey of women’s work in different parts of Europe; and finally through two detailed case studies (of Norway and south-west England). The case studies not only highlight women’s contribution to agricultural work in detail but also suggest a range of research approaches to uncovering women’s work. We find that women’s work in agriculture was often substantial and was varied and adaptable. For instance, in coastal Norway and some mountainous regions women did the majority of agricultural work because men were absent working elsewhere; in eastern Europe women’s labour was as important as men’s; in south-west England women contributed about a third of labour required in agriculture; while in some economies, such as central Spain in the eighteenth-century, women were largely absent from agricultural work because they could earn more from rural textile production.
Volume 2 of The Cambridge History of Global Migrations presents an authoritative overview of the various continuities and changes in migration and globalization from the 1800s to the present day. Despite revolutionary changes in communication technologies, the growing accessibility of long-distance travel, and globalization across major economies, the rise of nation-states empowered immigration regulation and bureaucratic capacities for enforcement that curtailed migration. One major theme worldwide across the post-1800 centuries was the differentiation between “skilled” and “unskilled” workers, often considered through a racialized lens; it emerged as the primary divide between greater rights of immigration and citizenship for the former, and confinement to temporary or unauthorized migrant status for the latter. Through thirty-one chapters, this volume further evaluates the long global history of migration; and it shows that despite the increased disciplinary systems, the primacy of migration remains and continues to shape political, economic, and social landscapes around the world.
This study employs a strengths-based approach to assess food access in remote Alaska during the COVID-19 pandemic, identifying both the negative consequences of the pandemic on store-bought and subsistence/traditional food access and compensatory strategies used.
Design:
As a part of a larger study on the impacts of COVID-19 on daily life remote Alaskan communities, study data presented here were collected through key informant interviews (KII) and state-wide online surveys from 21 September 2020 to 31 March 2021 among remote Alaska community members.
Setting:
This study was conducted with residents of remote communities in Alaska, defined as those off the road system. Remote communities often have small or no grocery stores and rely on subsistence or traditional sources of food.
Participants:
KII participants (n 36) were majority female (78 %) and Alaska Native (57 %). Survey participants (n 615) were also majority female, 25–54 years old and most had had some post-secondary education or training.
Results:
Survey and interview data revealed that the pandemic had significant negative impacts on store-bought food access in remote Alaskan communities. Individuals also shared that locally available and wild harvested foods acted as a buffer to some of the loss of access to these store-bought foods, with some people sharing that the harvesting of wild and traditional foods served as a coping strategy during times of pandemic-related stress.
Conclusions:
The results from this study demonstrate that the remoteness of some Alaskan communities has been both a source of vulnerability and protection in terms of food access.
There has recently been an increased interest in studying the language development of non-western languages. This is not new - it began in 1960’s and continued into the 1980’s and 1990’s. The current renewed interest is much welcomed, and will benefit from many of the experimental methods and theoretical insights developed over the past decades.
Multiple approaches – including observational and experimental – are necessary to articulate powerful theories of learning. Our field’s key questions, which rely on these varied methods, are still open. How do children perceive and produce language? What do they encounter in their linguistic input? What does the learner bring to the task of acquisition? Considerable progress has been made for the development of spoken English (especially by North American learners). Yet there is still a great deal to discover about how children in other populations proceed, especially populations in rural settings. To examine language learning in these populations, we need a multi-method approach. However, adapting and integrating methods, particularly experimental ones, to new settings can present immense challenges. In this paper, we discuss the opportunities and challenges facing researchers who aim to use a multimethodological approach in rural samples, and what the field of language acquisition can do to promote such work.
Rural areas tend to be inhabited by more older people and thus have a higher prevalence of dementia. Combined with lower population densities and more sparse geography, rural areas pose numerous barriers and costs relating to support and resource provision. This may leave people with dementia in rural places at a significant disadvantage, leading to a heavy reliance on informal support networks. The present study explores the personal experiences of people living with dementia and carers living in rural areas, seeking to discover both benefits and challenges, as well as recommendations within the literature for improving the lives of those affected by dementia in rural areas. A scoping review following the framework of Arksey and O'Malley identified 60 studies that describe or discuss the personal experience of dementia (either by the person with dementia or carer), in relation to living in rural or remote geographical areas. Four overarching themes were derived, namely the possible benefits of living in a rural community (supportive rural communities), sources of strength described by people affected by dementia in rural areas (managing and coping), detrimental aspects of living in a rural community (rural community challenges) and difficulties with dementia care services. Three further themes yielded recommendations for improving the experience of dementia in rural areas. This review highlights some potential opportunities related to living in rural areas for people living with dementia. These often come with parallel challenges, reflecting a delicate balance between being well-supported and being in crisis for those living in rural areas. Given the limited access to formal services, supporting people with dementia in rural areas requires input and innovation from the people, organisations and services local to those communities.