bluuebunny/crossref_metadata_2025 huggingface dataset:
Value of nonenhanced CT combined with laboratory examinations in the diagnosis of acute suppurative cholecystitis treated with percutaneous cholecystostomy: a retrospective study
Authors: Chen Bai-Qing , Xie Feng , Chen Guo-Dong , Li Xue , Mao Xue , Jia Bao
Published: March 2022

Purposes

In this study, we aimed to identify the distribution of presenting laboratory and nonenhanced computed tomography (CT) imaging features within 48 h before percutaneous cholecystostomy (PC) and create a model to appropriately guide the diagnosis of acute suppurative cholecystitis (ASC).

Methods

The study population included 204 acute cholecystitis patients who underwent PC. Based on the timing of the last laboratory and CT examinations before PC, the patients were divided into two groups: within 48 h before PC (Group 1, n = 138) and over 48 h before PC (Group 2, n = 63). The clinical features of the ASC patients in the two groups were compared. A multivariable model for the diagnosis of ASC in the patients in Group 1 was developed.

Results

Thirty-nine patients in Group 1 had ASC (28.3%). Gallbladder stones, common bile duct stones, gallbladder wall thickness > 2.85 mm, and neutrophil granulocytes > 82.55% were confirmed to be independent risk factors for ASC. The receiver operating characteristic curve of the recurrence prediction model verified its accuracy (area under the curve: 0.803). Compared with the ASC patients in Group 2, the ASC patients in Group 1 had a higher proportion of pericholecystic exudation or fluid (P = 0.013) and thicker gallbladder walls (P = 0.033).

Conclusions

Using nonenhanced CT imaging features and cutoffs for neutrophil granulocytes, we were able to identify a simple algorithm to discriminate ASC. The degree of local inflammation of the gallbladder in ASC patients progressively increases over time, and these changes can be observed on nonenhanced CT images. However, the symptoms of abdominal pain are of little help in estimating the disease duration in elderly patients.
Synergistic association between underweight and type 2 diabetes on the development of laryngeal cancer: a national population-based retrospective cohort study
Authors: Lee Oh. Hyeong , Park Yong-Moon , Ko Seung-Hyun , Lee Kyuna , Kim Yeonji , Han Kyungdo , Cho Jung-Hae
Published: March 2022

Background

Although cigarette smoking is the most significant risk factor for laryngeal cancer, other risk factors might also be associated with the development of laryngeal cancer. We investigated whether underweight and type 2 diabetes are associated with laryngeal cancer in a Korean population.

Methods

A total of 9,957,059 participants (≥20 years) without prior history of cancer who underwent a National Health Insurance Service health checkup in 2009 were followed up until December 31, 2018. Newly diagnosed laryngeal cancer was identified using claim data, and underweight was defined as body mass index (BMI) < 18.5 kg/m2. A Cox proportional-hazards models with multivariable adjustment were used to estimate hazard ratios (HRs) and corresponding 95% confidence intervals (95% CIs).

Results

During the median follow-up period of 8.3 years, 3504 cases of laryngeal cancer occurred. Underweight was associated with increased risk of laryngeal cancer after adjusting for potential confounders (HR: 1.43, 95% CI: 1.22–1.69) compared to those who were not underweight. Underweight and type 2 diabetes were synergistically associated with higher risk of laryngeal cancer (HR: 2.33, 95% CI: 1.54–3.51), compared to those without either condition. This relationship was stronger in those with an age < 65 years (HR: 3.33, 95% CI: 1.88–5.87) and alcohol consumption (HR: 2.72, 95% CI: 1.64–4.53).

Conclusions

These results suggest that underweight may be a significant risk factor for laryngeal cancer and that underweight and type 2 diabetes might synergistically increase the risk of laryngeal cancer.
Optical coherence tomography analysis of anterior segment parameters before and after laser peripheral iridotomy in primary angle-closure suspects by using CASIA2
Authors: Chen Xiaoxiao , Wang Xiaolei , Tang Yizhen , Sun Xinghuai , Chen Yuhong
Published: March 2022

Background

Laser peripheral iridotomy (LPI) is effective in primary angle-closure suspects (PACS); however, predictors for anterior segment alterations after LPI are limited. We aimed to evaluate the anterior segment biometric parameters before and after LPI in PACS using the recently developed, CASIA 2 device of anterior segment optical coherence tomography (AS-OCT).

Methods

We performed LPI in 52 PACS. Anterior segment parameters, including anterior chamber depth (ACD), anterior chamber width (ACW), anterior chamber volume (ACV), iris curvature (ICURVE), iridotrabecular contact (ITC), lens vault (LV), lens thickness (LT), radius of the lens, angle opening distance (AOD), angle recess area (ARA), trabecular iris space area (TISA), and trabecular iris angle (TIA) at different distances (i.e., 500 μm from the sclera spur), were evaluated before and after LPI using CASIA 2.

Results

Eyes of PACS after LPI had a greater ACV, AOD, ARA, TISA, and TIA, and a lower ITC and ICURVE (all p < 0.001) than those before LPI. On a 360° scan, the anterior chamber angle in the superior quadrant increased the most after the LPI. A higher baseline LT was significantly associated with a greater postoperative increase in AOD 500, ARA 500, TISA 500, and TIA 500 (p = 0.001, p = 0.010, p = 0.004, and p < 0.001, respectively).

Conclusions

We found that LPI widens the anterior chamber angle in the PACS, especially, in the superior quadrant around the iridotomy hole. Eyes with a thicker lens are more likely to experience angle opening because of the LPI.
Global pattern of trends in incidence, mortality, and mortality-to-incidence ratio rates related to liver cancer, 1990–2019: a longitudinal analysis based on the global burden of disease study
Authors: Amini Maedeh , Looha Mehdi Azizmohammad , Zarean Elaheh , Pourhoseingholi Mohamad Amin
Published: March 2022

Background

Liver cancer (LC) is considered as one of the most dominant malignant tumors which ranked 4thand 6thin terms of global mortality and incidence, respectively. This work aimed to investigate the global temporal trends in LC mortality-to-incidence ratio (MIR) and its components, with a particular focus on examining long-term effect of human development index (HDI) on these metrics in a 30-year follow-up.

Methods

The age-standardized LC incidence and mortality data were derived from the global burden of disease (GBD) study 2019. We first leveraged joinpoint piecewise linear regression analysis to ascertain time trends in LC incidence, mortality, and MIR complement [1-MIR] and the average annual percentage change (AAPC) of the rates over the period 1990–2019. Then, the association between the metrics and HDI was explored through longitudinal multilevel models (LMMs).

Results

The incidence rates paralleled the mortality rates worldwide and they had similar significant monotonic decrementing trends with AAPC values of − 1.10% (95% confidence interval (CI): − 1.40, − 0.90%) and − 1.40% (− 1.50, − 1.30%), respectively from 1990 to 2019. The [1-MIR] rates were around 0 and showed an increasing pattern from 1.70 to 8.10 per 100,000 people (AAPC, 4.90%) at the same period of time. Results from the LMMs displayed that the majority of the variation lies at the country level accounted for about 88% of the total variance. Moreover, our analysis supported that the HDI was negatively associated with either incidence or mortality over time (p < 0.05).

Conclusions

Our findings highlighted that the global long-term temporal trends of LC incidence and mortality decreased slightly during 1990–2019 which may reflect improved therapeutic strategies and public health interventions. Besides, the low rates of [1-MIR] revealed the five-year relative survival rate was poor implying LC is diagnosed late in its development. Thereby, the policymakers’ focus must be on early screening and detection of liver cancer.
The perceived effects of COVID-19 pandemic on female genital mutilation/cutting and child or forced marriages in Kenya, Uganda, Ethiopia and Senegal
Authors: Esho Tammary , Matanda Dennis J. , Abuya Timothy , Abebe Sintayehu , Hailu Yeshitila , Camara Khaltoume , Mouhammed Bachir , Kapsandui Tonny , Kamanzi Lilian , Wabwire Andrew , Kagurusi Patrick , Nankanja Maureen , Gitimu Anne , Kawai David , Kogada John , Ondigo Millicent , Osur Joachim
Published: March 2022

Background

The effects of COVID-19 on harmful traditional practices such Female Genital Mutilation/Cutting (FGM/C) and Child or Forced Marriages (CFM) have not been well documented. We examined respondents’ perceptions on how the COVID-19 pandemic has affected FGM/C and CFM in Kenya, Uganda, Senegal, and Ethiopia.

Methods

A cross-sectional study design with a mixed methods approach was used. Data collection on participants’ perceptions on the effects of COVID-19 on FGM/C and CFM took place between October-December 2020. Household surveys targeting women and men aged 15–49 years in Kenya (n = 312), Uganda (n = 278), Ethiopia (n = 251), and Senegal (n = 208) were conducted. Thirty-eight key informant interviews with programme implementers and policymakers were carried out in Kenya (n = 17), Uganda (n = 9), Ethiopia (n = 8), and Senegal (n = 4).

Results

In Kenya, the COVID-19 pandemic has contributed to the increase in both FGM/C and CFM cases. Minimal increase of FGM/C cases was reported in Uganda and a significant increase in CFM cases. In Ethiopia, the COVID-19 pandemic had a limited perceived effect on changes in FGM/C and CFM. In Senegal, there were minimal perceived effects of COVID-19 on the number of FGM/C and CFM cases. The pandemic negatively affected implementation of interventions by the justice and legal system, the health system, and civil societies.

Conclusions

The pandemic has had varied perceived effects on FGM/C and CFM across the four countries. Generally, the pandemic has negatively affected implementation of interventions by the various sectors that are responsible for preventing and responding to FGM/C and CFM. This calls for innovative approaches in intervening in the various communities to ensure that women and girls at risk of FGM/C and CFM or in need of services are reached during the pandemic. Evidence on how effective alternative approaches such as the use of call centres, radio talk shows and the use of local champions as part of risk communication in preventing and responding to FGM/C and CFM amid COVID-19 is urgently required.
The classification of coronal deformity based on preoperative global coronal malalignment for adult spinal deformity is questionable
Authors: Zhang Jiandang , Yu Yang , Gao Shangju , Hai Yong , Wu Bing , Su Xiaojing , Wang Zheng
Published: March 2022

Study design

Retrospective case–control radiographic study.

Objective

To identify main effects of preoperative pattern and global coronal malalignment (GCM) on postoperative coronal imbalance in degenerative lumbar scoliosis (DLS) patients and evaluate the rationality of the classification of coronal deformity based on preoperative GCM.

Summary of background data

A classification of coronal deformity based on preoperative GCM (20 mm set as the threshold of coronal imbalance) has been proposed recently, but whether it is practical is unclear.

Methods

One hundred twelve DLS patients treated with posterior instrumented fusion were reviewed. Coronal measurements included GCM and major Cobb angle. Based on relationship between C7 PL and major curve, preoperative patterns were classified into: Pattern 1(concave pattern), C7 PL shifted to the concave side of major curve; Pattern 2(convex pattern), C7 PL shifted to the convex side of major curve. Patients were separated into 4 groups (3 types): Type 0–1: GCM < 20 mm plus Pattern 1; Type 0–2: GCM < 20 mm plus Pattern 2; Type 1: GCM > 20 mm plus Pattern 1; Type 2: GCM > 20 mm plus Pattern 2. After comparison within patterns or among 4 groups, further factorial analysis was performed.

Results

Significant differences regarding postoperative GCM or coronal imbalance/balance ratio existed among 4 groups (F = 6.219, p = 0.001; x2 = 22.506, p < 0.001, respectively), despite no significant difference in intra-pattern 1(concave pattern) or intra-pattern 2(convex pattern) groups. Two-way analysis of variance showed preoperative pattern exhibited significant effect on postoperative GCM or imbalance/balance ratio (F(1,108) = 14.286, p < 0.001; F(1,108) = 30.514, p < 0.001, respectively) while neither preoperative GCM alone nor interaction of preoperative GCM with pattern did.

Conclusion

In DLS patients, it’s the preoperative pattern other than GCM that had main effects on postoperative coronal imbalance. Classification of coronal deformity based on preoperative GCM is questionable.

Level of evidence

3
The impact of a novel medication scanner on administration errors in the hospital setting: a before and after feasibility study
Authors: Tolley Clare L. , Watson Neil W. , Heed Andrew , Einbeck Jochen , Medows Suzanne , Wood Linda , Campbell Layla , Slight Sarah P.
Published: March 2022

Objective

The medication administration process is complex and consequently prone to errors. Closed Loop Medication Administration solutions aim to improve patient safety. We assessed the impact of a novel medication scanning device (MedEye) on the rate of medication administration errors in a large UK Hospital.

Methods

We performed a feasibility before and after study on one ward at a tertiary-care teaching hospital that used a commercial electronic prescribing and medication administration system. We conducted direct observations of nursing drug administration rounds before and after the MedEye implementation. We calculated the rate and type (‘timing’, ‘omission’ or ‘other’ error) of medication administration errors (MAEs) before and after the MedEye implementation.

Results

We observed a total of 1069 administrations before and 432 after the MedEye intervention was implemented. Data suggested that MedEye could support a reduction in MAEs. After adjusting for heterogeneity, we detected a decreasing effect of MedEye on overall errors (p = 0.0753). Non-timing errors (‘omission’ and ‘other’ errors) reduced from 51 (4.77%) to 11 (2.55%), a reduction of 46.5%, which had borderline significance at the 5% level, although this was lost after adjusting for confounders.

Conclusions

This pilot study detected a decreasing effect of MedEye on overall errors and a reduction in non-timing error rates that was clinically important as such errors are more likely to be associated with harm. Further research is needed to investigate the impact on a larger sample of medications.
Patient safety culture in Iranian teaching hospitals: baseline assessment, opportunities for improvement and benchmarking
Authors: Kakemam Edris , Albelbeisi Ahmed Hassan , Davoodabadi Samane , Ghafari Masoud , Dehghandar Zahra , Raeissi Pouran
Published: March 2022

Background

Patient safety culture is an essential factor in determining the ability of hospitals to treat and reduce patient risks. Healthcare professionals, especially nurses, play an important role in patient safety because they are responsible for direct and ongoing patient care. Few studies in Iran examine the patient safety culture in Iranian teaching hospitals, particularly from the perspective of nursing staff. This research assessed patient safety culture in teaching hospitals in Iran from the nurses’ point of view and compared the outcomes with similar regional and global studies. Furthermore, the study identified the factors influencing patient safety culture and its association with outcomes.

Methods

A cross-sectional study was accomplished in thirty-two teaching hospitals in five provinces of Iran. A total of 2295 nurses were chosen through convenience sampling. Collection data were done using the Hospital Survey of Patient Safety Culture (HOPSC) from October 2018 and September 2019. We analyzed the data using descriptive statistics, independent sample t-test, one-way ANOVA, and multiple linear regression analysis.

Results

The results demonstrated the overall percentage of positive response rate for the HOPSC tool (36.4%). The average percentage of positive responses among all dimensions ranged from 27.1% in “Staffing” to 53.8% in “Teamwork across Hospital Units”. Benchmarking analysis shows that Iranian hospitals are equal or better performance than the benchmark on several composites compared to regional and global findings. The results of multiple linear regression analysis showed that the age, gender, total years of experience in nursing, work area or unit, work hours, and size of the hospital were significant predictors of the perceptions patient safety culture of nurses (p <  0.05).

Conclusions

This is one of few studies that examine nurses’ perceptions of patient safety culture in public hospitals in Iran. Although the results of the present study showed that the results of Iran were at or better than the many composites in Jordan, Turkey, KSA, and the Philippines. The findings confirmed that all 12 dimensions can be considered as areas requiring improvement, and these results demonstrated that there was a severe shortage in patient safety culture among the included hospitals.
An electronic patient-reported outcome created based on my needs is worth using: an explorative qualitative study investigating young people’s opinions for a health assessment tool
Authors: Lostelius Petra V. , Mattebo Magdalena , Söderlund Anne , Revenäs Åsa , Thors Adolfsson Eva
Published: March 2022

Background

Young people in different healthcare settings are positive about using electronic patient-reported outcomes (ePROs), which are meant to increase the effectiveness and safety of interventions from the patient’s perspective. Sweden offers free healthcare to young people aged 12–25 years at 275 youth health clinics (YHCs), whose goals are to strengthen young people and promote sexual, physical, and mental health. YHCs need effective ways to identify the overall picture of young people’s health and health-related problems. To our knowledge, there is no ePRO for YHCs that provides an overview of young people’s health from several health perspectives. The aim of this study was to explore young people’s view on content and design of an ePRO to provide an overview of their health and health related problems when visiting a YHC, and their opinion on what healthcare needs to consider when using the ePRO. This was an explorative qualitative study. The participants were included from five YHCs, in different socioeconomic areas in central Sweden. Fifteen participants were included: 10 girls, three boys, and two non-binary participants with an age range of 16–22 years. Data were collected using a semi-structured interview guide and individual interviews, and inductive content analysis was performed.

Results

One main theme, “ePRO created based on my needs is worth using” and two sub-themes, “Appealing content and design” and “Trusting healthcare”, emerged. The participants wanted that an ePRO should include overall questions about mental-, physical-, and sexual health and social support. Participants also believed the ePRO must disclose the risks of self-harm or suicide. The participants noted the importance of emotional and digital security when using the ePRO and having a confidential conversation with a healthcare provider. To share health information means to trust to gain health.

Conclusions

The study participants' views on content and design can form the basis for designing an ePRO for young people. Their thoughts on safety and treatment in healthcare can be considered in the development process. This study is the starting point for developing an ePRO for young people at YHCs.
"Good Farming–Clear Thinking–Right Living": Midwestern Farm Newspapers, Social Reform, and Rural Readers in the Early Twentieth Century
Authors: Fry John J.
Published: March 2022

Between 1895 and 1920 technological, economic, demographic, and cultural changes transformed American rural life. This article argues that historians should not take agricultural newspapers as is and assume that they expressed the farmer’s point of view. Because most of the publishers and editors of farm newspapers lived in cities and were influenced by progressive reformers, farm newspapers often reflected urban reform ideas. At the same time, farm newspapers provided space for opposing viewpoints by publishing letters to the editor. The coverage of agricultural education and rural school consolidation in four midwestern farm newspapers provides an illustrative case study of this interaction. While publishers and editors promoted reformers’ recommendations, many farmers did not agree with or follow their advice. As a result, farm newspapers are better seen not as expressing the ideas of farmers, but providing a forum for reformers and farmers to debate proposed changes to country life.
Dead Beef and Live Soldiers: Lyndon Johnson, Keith Holyoake, and U.S.-New Zealand Relations in the 1960s
Authors: Sarantakes Nicholas Evan
Published: March 2022

The focus of this article is the "friendship" between Lyndon Johnson, president of the United States, and Keith Holyoake, prime minister of New Zealand, and how it influenced the diplomatic relationship their two countries had with one another. Johnson and Holyoake were the masters of their political systems and dominated the political life of their countries in the 1960s. With similar rural backgrounds and professions, they understood one another and treated the foreign policy of their two countries as a series of political deals. Johnson’s most important concern was garnering support for the United States’ initiative in Vietnam, while Holyoake wanted to make sure that New Zealand had access to American markets for its agricultural exports.
From La Tijera to San Luis: Farm and Faith on the Rio Puerco
Authors: Diggle Susan E. , Hieb Louis A.
Published: March 2022

Early Spanish colonists in regions of northern New Mexico and southern Colorado sought locations where irrigation works could be constructed to make new settlements possible. Between 1867 and 1872 four Hispanic villages, based on an economy of irrigation, agriculture, and livestock grazing, were established in the middle Rio Puerco valley, northwest of Albuquerque, New Mexico. Within a decade, overgrazing in the larger Rio Puerco watershed initiated a process of erosion and entrenchment of the Rio Puerco that eventually led to the abandonment of three of the villages. The surviving village of San Luis has kept its sense of community alive despite environmental losses that brought an end to agriculture and severely limited the possibilities for raising livestock. San Luis’s institutions of agriculture once provided its unique connection to place. The community now survives on faith, as it once survived on agriculture, and draws spiritual, if not actual sustenance from the land it hopes someday to reclaim.
Rural Banks and Czech Nationalism in Bohemia, 1848–1914
Authors: Albrecht Catherine
Published: March 2022

Rural credit in the Bohemian crown lands of the Habsburg monarchy became available on a wide scale only after the abolition of serfdom in 1848. Although organized to serve municipal interests, savings banks and Schulze-Delitzsch credit cooperatives initially provided rural credit, primarily in the form of mortgage loans. Such local financial institutions embraced a social mission of aiding the poor and promoting small producers, while seeking to encourage economic modernization and Czech national revival. Strengthening the economic position of small agricultural producers fit in with both the socioeconomic and national motives of local financial institutions in the 1860s and 1870s. With the agricultural depression of the 1880s, however, agrarian leaders criticized credit cooperatives and savings banks for promoting urban interests over those of their rural customers, and new financial institutions, particularly Raiffeisen-type cooperatives, were founded in the 1890s and 1900s to better meet the credit needs of small farmers. These new cooperatives contributed to the growing political and economic integration of the peasantry into the Czech national life.
Forging His Own Path: William Jasper Spillman and Progressive Era Breeding and Genetics
Authors: Carlson Laurie
Published: March 2022

William Jasper Spillman (1863-1931) developed wheat hybrids at Washington State Agricultural College in 1899 and was the first to explain Mendelian theories to an agricultural audience. He moved to the USDA in Washington, DC, where he pioneered the field of farm management and helped establish cooperative programs that evolved into the Agricultural Extension Service. Spillman, an iconoclast of sorts, straddled the rural world of empirical thinking as well as the world of professional science. He remained linked to his Missouri roots by participating in the National Grange his entire adult life, while he also was a member of the American Academy of Science and received an honorary doctorate for his pioneering work in genetics. The plant genetics work he participated in was largely responsible for agricultural over-production and ultimately the depopulation of rural America by the 1930s. He sought to resolve the situation with his plans for a national agricultural allotment program, which eventually became the foundation for federal farm programs. His books, "The Law of Diminishing Returns (1924)" and "Balancing the Farm Output: A Statement of the Present Deplorable Conditions of Farming, its Causes and Suggested Remedies (1927)", helped shape agricultural policies for decades.
A World without Chocolate: Grocery Purchases at Some Upper Canadian Country Stores, 1808-1861
Authors: McCalla Douglas
Published: March 2022

Based on account books, a frequently overlooked type of source, this is a study of grocery purchases made by sample customers from some country stores in Upper Canada (Ontario), in selected years between 1808 and 1861. Although literary sources suggest otherwise, no one bought chocolate; but many people bought tea, tobacco, sugar, and salt, evidently at standard levels for contemporary British society. As time went by, a growing range of products appear among purchases, notably many drugs and medications. The evidence is also read for indications of what families made for themselves. Their choices, visible in everyday routine purchases, have implications for some of the main stories about material life, consumption, and market relationships in early settlement society. It is difficult, for example, to picture rural isolation from a capitalist world if ordinary farm families regularly purchased goods imported from the far side of the globe.
“Quite an Experiment”: A Mining Company’s Attempt to Promote Agriculture on Michigan’s Upper Peninsula, 1895–1915
Authors: Reynolds Terry S.
Published: March 2022

Between 1895 and 1915 Cleveland-Cliffs, one of America’s leading iron mining companies, became deeply involved in promoting agricultural development on Michigan’s rugged Upper Peninsula. Its two-decade-long attempt to identify appropriate plants and farming practices and thus to extend the agricultural frontier into this region was ambitious. It included an experimental garden, a greenhouse and nursery, an attempt to produce fertilizer locally, two major experimental/demonstration farms, and a number of other agricultural initiatives not usually associated with mining companies. This article reviews why Cleveland-Cliffs became deeply involved in promoting agriculture, the nature of its programs, why its activities were more comprehensive and longer lasting that those of most other companies (mostly timber and railroad) who attempted to promote agriculture in the Great Lakes cutover region, and why the attempt ultimately failed.
Furniture Exempt from Seizure: African-American Farm Families and Their Property in Texas, 1880s–1930s
Authors: Reid Debra A.
Published: March 2022

The real and personal property that African-American farm families accumulated between the 1880s and the 1930s can tell a lot about the political consciousness of the disfranchised at the height of African-American landownership. Farm women and their families invested their limited financial and labor resources into household equipment and furnishings, knick-knacks and personal adornment, land, and homes. They used the legal system to secure their property and convey it to heirs even as unscrupulous landlords conspired against them. But purchasing land could limit a family’s mobility, disrupt kinship networks, and constrain their ability to purchase other products of the modern consumer age, most notably automobiles. Irrefutably, the white middle class defined consumer culture and the characteristics of modernization in the rural South, not the black farm families, but rural African Americans still had to feed, clothe, and house their families. Their choices became the object of analysis and ridicule by reformers during the early twentieth century. By the 1930s the small homes that once housed aspiring families became the symbols of poverty even as rural reformers and the Progressive farmers they served celebrated a rural aesthetic that advocated recycling and thrifty management.
“Mightier than Missiles”: The Rhetoric of Civil Defense for Rural American Families, 1950–1970
Authors: Barker-Devine Jenny
Published: March 2022

During the Cold War, physical and cultural distance from major metropolitan areas did not preclude farm and rural families from taking part in civil defense preparations. In the early 1950s the evacuation of civilian populations from urban areas and military targets served as the basis for federal and state civil defense programs. By the late 1950s and early 1960s, however, as the dangers of fallout shaped the public discourse, rural areas were no longer considered safe from an attack. Throughout this period, the Federal Civil Defense Administration (FCDA), in conjunction with the USDA and State Cooperative Extension Services, launched campaigns to educate farmers on their roles as providers of food and as budding atomic scientists. The rhetoric of these programs reinforced the notion that rural Americans contributed not only food and raw materials to the American economy, but also served as the moral backbone of a democratic nation. Such language placed farmers and rural residents on the front lines of the Cold War.
Consumer Choice, Agency, and New Directions in Rural History
Authors: Blanke David
Published: March 2022

According to critics, history resides at an intellectual crossroads. They charge that scholars rely too heavily on ill-defined concepts-like agency-and under-appreciate the determination force of the capitalist consumer economy. This essay appraises the key themes, methods, questions, and conclusions contained within recent US history. While consumer agency looms large in many works, consumer studies also explore the influence of structural economics, material goods, and institutions that shaped consumer behavior. Moreover, distinct periodization is important in recognizing and understanding the shifting contours of American consumption. This article appraises how recent scholarship in rural consumer culture relates to these broad categories and what this reveals about rural history in general. In the end, this paper probes the central challenge posed to historians by the notions of consumer choice and agency.
Beyond the Monolith of Modernity: New Trends in Immigrant and Ethnic Rural History
Authors: Loewen Royden
Published: March 2022

This article suggests that the idea of "modernization," the uni-linear transition from peasantry to commercial agriculture, has shaped much of the writing of rural immigrant communities during the twentieth century. It also suggests that the history of immigrant and ethnic farm communities has begun to take a different tack during the last decade. This change reflects trends in the broader historiography of settlement society, including a shift from social history to cultural history. Modernity is no longer seen as an unrelenting force, natural and dominant in character. Rather postmodernity’s concern with fragmentation and asymmetry, and the linguistic turn with its fixation on cultural invention and created mythology, seemed evident. Regional, national, and international-based studies alike reflect this new research agenda, and this article highlights seven books in particular. Three, focusing on settler society and rural culture in regional, national, and transnational variations, describe modernity in particular; they see the very idea of change, once seen as inevitable and inexorable, as constructed, invented, and contrived. Three others are local studies of specific ethnic rural groups in which the immigrant or ethnic farm community stands at a cross current to a commercializing countryside, contesting and subverting the very intentions of the agents of the market economy and state interests. The final book is the author’s own recent work in comparative history, Diaspora in the Countryside: Two Mennonite Communities and Mid-Twentieth Century Rural Disjuncture. The two central words "diaspora" and "disjuncture" suggests that these communities, one located in Canada and the other in the United States, responded to economic changes through a diversity of lifeworlds, including farm commercialization, urbanization, and a conservative recreation of an old order agraria. These Mennonites created a set of contradictory mythologies and master narratives that sought to bring teleological sense, social order, and meaning to inchoate and fragmented cultures. The seven books thus acknowledge quotidian complexity, ethnic variation, and national and regional difference. They are representative of what appears to be a wider trend in the academy of North American rural history.
The Proliferation of Agricultural Schools: A Practical Education in Greece (1922–1932)
Authors: Kritikos George
Published: March 2022

This study analyzes the proliferation of agricultural schools in Greece from 1922 to 1932 from a social, economic, and cultural perspective. It examines the role of the Greek vernacular language—demotic—and vernacular education as tools for national and social integration. It investigates the links between the establishment of agricultural schools, the teaching of demotic in elementary school, and the integration in the labor market not only of thousands of unemployed Greek citizens, but also of approximately 1.2 million Asia Minor refugees who fled to Greece after 1922. The article examines whether limiting the Greek vernacular language to primary schools, with the continuation of both the dominant classical model of education and the use of "purist" (katharevousa) Greek in secondary education, created the prerequisites for upward mobility through education or reproduced the existing social and financial inequalities in Greek society.
The Far-from-Dry Debates: Dry Farming on the Canadian Prairies and the American Great Plains
Authors: Russell Peter A.
Published: March 2022

The absence of dry farming techniques is the key element that many Canadian scholars use to explain the decade of delay in the agricultural development of the prairie region after the completion of the Canadian Pacific Railway in 1885. They have assumed that American farmers had developed an unproblematic set of techniques, the presence of which was essential before large-scale European settlement of the Prairies could begin. American historians of Great Plains agriculture present a far different picture of those American farmers. Dry farming in the United States did not designate an agreed-upon set of techniques, but a lively field of debate that remained unresolved for decades. Summer fallow comprised the essential practice on the driest Canadian Prairies for the conservation of moisture. Americans neither pioneered nor promoted it first; summer fallow only became general practice on the northern Great Plains after Canadian farmers had demonstrated how it could be practicably done. The flow of this agricultural innovation turns out to have been the opposite of what most Canadian scholars had assumed.
St. Louis and the Sharecroppers: Urban Connections to a Rural Protest
Authors: Stepenoff Bonnie
Published: March 2022

Scholars have paid a great deal of attention to the Sharecroppers’ Roadside Demonstration by evicted farmworkers, who camped out along rural highways in Missouri’s southeastern Bootheel in January 1939. This article differs from previous works by focusing on Fannie Cook and Marcus "Al" Murphy and their interactions with the sharecroppers. Cook, an affluent Jewish woman, and Murphy, an African-American member of the Communist Party, both participated in the St. Louis Committee for the Rehabilitation of the Sharecroppers. After state officials removed the demonstrators from the highways, Cook traveled to the Bootheel to observe conditions there and wrote a novel about what she saw. She also helped support the Sharecroppers’ Camp, or Cropperville, a privately funded refuge for displaced farmworkers. Murphy came to St. Louis in the mid-1930s to teach farmworkers how to organize. When the demonstrators went out onto the roadsides, he worked with labor organizations to collect and deliver supplies. Ultimately, the connections between these urban supporters and rural protesters were personal, not ideological, reminding us that history is not about abstractions, but people.
Thomas Minor’s World: Agrarian Life in Seventeenth-Century New England
Authors: Anderson Virginia Dejohn
Published: March 2022

For over thirty years (1653-1685), Thomas Minor kept a diary recording his activities as a farmer in Stonington, Connecticut. This article uses Minor’s diary, the only extant document of its kind for the seventeenth century, to reconstruct key features of the colonial New England agrarian experience. Arguing that work played as significant a role as religion in shaping early New Englanders’ lives, the article examines not only how farming contributed to the Minors’ economic prosperity and independence, but also how its physical demands and seasonal rhythms shaped Thomas Minor’s world-view more generally. Agriculture provided an important context for Minor’s relations with his wife and sons, with nature, and even with a sense of his own mortality. Minor emerges as someone less interested in calculating profit and loss on his farm than in accomplishing a hard day’s work as a steward of the land that he hoped would support his family for generations to come.
"Agricultural Statecraft" in the Cold War: A Case Study of Poland and the West from 1945 to 1957
Authors: Spaulding Robert Mark
Published: March 2022

This paper examines how the rise and fall of Polish agriculture affected the larger political and economic relationships among Poland and three key members of the western alliance--the United States, the United Kingdom, and the Federal Republic of Germany--in the first decade of the Cold War. This period is revealing precisely because the reversal of fortunes in the Polish agricultural economy required the Polish government and some western counterparts to maneuver through periods of both agricultural advantage and disadvantage. Agricultural strategies as means and ends motivated the Polish, British, West German, and American governments to actions that bent, stretched, and limited some well-established practices in Cold War relations across divided Europe. By explicating the political consequences of changing flows of agricultural exports and imports in one specific context, this essay serves as case study of the role of agriculture in the global context of the Cold War.
Breaking Sod or Breaking Even? Flax on the Northern Great Plains and Prairies, 1889–1930
Authors: MACFADYEN JOSHUA D.
Published: March 2022

A new thirst for paint and color in cities made extensive flax production profitable in the northern Great Plains and Prairies and contributed to the cultivation of the most fragile grassland ecosystems. The production of flax seed for linseed oil became an early spin-off of the Prairie wheat economy but, unlike wheat, flax vanished from old land after one or two rotations and reappeared in districts with the most new breaking. Officials explained the migrant crop as preparing native grasslands for cultivation or exhausting soil in old land, but farmers brought flax to their new breaking for other reasons. Producers would only put flax on any land when a range of economic and environmental conditions were in place. It was never sown without promise of adequately high prices or in the absence of affordable seed and other inputs. When price allowed, it usually appeared on new breaking because it could be planted later and transported further without upsetting the balance of other activities and without farmers learning many new techniques. Scientists discovered that diseased soil drove flax off old land, not soil exhaustion. Circumventing the disease was possible but costly, and farmers simply replaced flax with the next most lucrative commodity.
Telling Stories: Keeping Secrets
Authors: JENSEN JOAN M.
Published: March 2022

This article addresses the reticence of some farm women to share their experiences with historians and how that desire to keep secrets collides with the desire by scholars to tell the stories of these women. It argues that scholars must continue to struggle with the issue of which stories to tell publicly and which to keep private. The author discusses her own experience telling stories about rural women in the 1970s and the need to give voice to the heritage of rural women, especially of groups that have feared revealing their experiences. She offers examples of historians of rural women who have successfully worked with formerly silenced populations and urges historians to continue to tell stories about these lives, to reevaluate what has been already learned, to ask new questions, and to discuss which secrets need to be shared.
"So Long as I Can Read": Farm Women’s Reading Experiences in Depression-Era South Dakota
Authors: LINDELL LISA R.
Published: March 2022

During the Great Depression, with conditions grim, entertainment scarce, and educational opportunities limited, many South Dakota farm women relied on reading to fill emotional, social, and informational needs. To read to any degree, these rural women had to overcome multiple obstacles. Extensive reading (whether books, farm journals, or newspapers) was limited to those who had access to publications and could make time to read. The South Dakota Free Library Commission was valuable in circulating reading materials to the state’s rural population. In the 1930s the commission collaborated with the USDA ’ s Extension Service in a popular reading project geared toward South Dakota farm women. This "Reading in the Home" program greatly increased reading opportunities and motivations. Of particular interest to rural women were tales of pioneer life featuring strong protagonists.Through these stories, farm women found validation and encouragement to persevere. Reading also broadened horizons and challenged assumptions. For the depression-era farm woman, reading books and other materials provided recreation, instruction, and inspiration in a discouraging time.
Second Dialect Acquisition “in Real Time”: Two Longitudinal Case Studies from YouTube
Authors: Cheng Andrew
Published: March 2022

Longitudinal tracking of second dialect acquisition normally requires carefully planned data collection and years of patience. However, the rise of self-recorded public speech data on internet archives such as YouTube affords researchers with a novel way of tracking language change over time. This article presents two case studies of YouTube vloggers who have recorded their voices over the course of a decade (or longer) and have also relocated from different dialect regions of the United States to the West Coast. It reveals that, in addition to typical age-graded change such as a decrease in fundamental frequency over time, some vocalic aspects of their original dialects (Hawai‘i English and Inland North English) shifted to become more in line with Western American English, while others did not. The disparity between the vowels that changed and those that did not for each speaker are discussed through the lenses of social salience, gender and race, and the audience design of YouTube vlogs.
The Documentary Imaginary of Brotherhood and Unity: Nonfiction Film in Yugoslavia, 1945–51
Authors: Malitsky Joshua
Published: March 2022

This article explores how nonfiction film in postwar Yugoslavia (1945–51) expressed a fundamental ambivalence that negotiated a desire for and image of a unified nation-state (supranationalism) with that of one made up of multiple nations (nationalism). I argue that nonfiction film became a key vehicle for communicating the ideological principle of “brotherhood and unity” (“bratstvo i jedinstvo”), a slogan Yugoslav Communists used to articulate a solution to the challenges of a unified, multinational, and multiethnic Yugoslavia. This effort, I contend, emerged not simply through cinematic textuality but also through the social experiences people have with cinema: not just by seeing national bodies laboring and cooperating with other peoples but also by viewing them together in a presentational space, by experiencing a film program with overlapping and conflicting thematics, and by the industrial and institutional organization of nonfiction film itself. Mobilizing Peircean semiotics and Taylor's concept of the social imaginary, I argue that the documentary imagination of “brotherhood and unity” emerges from a combination of textual and extratextual factors, an interrelation of materiality and discursivity.
102 Association of Medicaid Expansion Under the Affordable Care Act with Access to Elective Spine Surgical Care
Authors: Greenberg Jacob K. , Brown Derek , Olsen Margaret , Ray Zack
Published: March 2022

INTRODUCTION:

The Affordable Care Act expanded Medicaid eligibility in many states, improving access to some forms of elective healthcare in the United States. Whether this effort increased access to elective spine surgical care is unknown.

METHODS:

We evaluated elective spine surgeries using state inpatient databases from 2011-2016 from 10 states that did and four states that did not expand Medicaid access in 2014. Patients aged 18-64 years undergoing elective spine surgery were included. We used a quasi-experimental difference-in-difference design to evaluate the impact of Medicaid expansion on hospital procedure volume and payer mix, independent of any time-dependent trends. Subgroup analyses were conducted that stratified results by cervical fusion, thoracolumbar fusion, and non-instrumented surgery.

RESULTS:

We identified 218,648 surgeries in 10 Medicaid expansion states and 118,693 in 4 non-expansion states. Expansion states showed an increase in overall and Medicaid but not privately insured volumes in 2014, compared to decreased or steady volumes in non-expansion states.These changes led to a 17% (95% CI 2%-35%) increase in mean hospital spine surgical volume, and a 23% (95% CI -0.3%-52%) increase in Medicaid volume associated with Medicaid expansion. Privately insured surgical volumes did not change significantly. The rise in Medicaid volumes led to a shift in payer mix, with the proportion of Medicaid patients rising by 6.1 percentage points (95% CI 4.0-8.1), and the proportion of private payers decreasing by 6.9 percentage points (95% CI 4.7-9.1). While the magnitude of the effects varied, these trends were similar across procedure subgroups.

CONCLUSION:

Medicaid expansion under the Affordable Care Act was associated with an economically and statistically significant increase in spine surgery volume and the proportion of patients with Medicaid insurance.