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Health care professionals (HCPs) performing tracheostomies in patients with COVID-19 may be at increased risk of infection.To evaluate factors underlying HCPs' COVID-19 infection and determine whether tracheostomy providers report increased rates of infection.An anonymous international survey examining factors associated with COVID-19 infection was made available November 2020 through July 2021 to HCPs at a convenience sample of hospitals, universities, and professional organizations. Infections reported were compared between HCPs involved in tracheostomy on patients with COVID-19 and HCPs who were not involved.Of the 361 respondents (from 33 countries), 50% (n = 179) had performed tracheostomies on patients with COVID-19. Performing tracheostomies on patients with COVID-19 was not associated with increased infection in either univariable (P = .06) or multivariable analysis (odds ratio, 1.48; 95% CI, 0.90-2.46; P = .13). Working in a low- or middle-income country (LMIC) was associated with increased infection in both univariable (P.001) and multivariable analysis (odds ratio, 2.88; CI, 1.50-5.53; P = .001).Performing tracheostomy was not associated with COVID-19 infection, suggesting that tracheostomies can be safely performed in infected patients with appropriate precautions. However, HCPs in LMICs may face increased infection risk.

Gluten-free dieting entails lifestyle changes that burden families. This article uses data from content analysis of gluten-free Facebook pages and interviews to show how a gluten-free diet intensifies families’ gendered divisions of labor in the United States. Maintaining a child’s diet increases mothers’ physical, emotional, relational, and mental labor. It is argued that the gendered labor of diet management intersects with diet criticism to create a backlash rooted in gender stereotypes. Mothers face criticism for intensive, risk-averse mothering practices, yet are expected to parent intensively. Women’s visibility in connection to gluten-free diets contributes to backlash against the diet infused with negative stereotypes of women and mothers. This results in additional burdens on mothers of gluten-free children.

"Gluten free" exploded onto the American foodscape in recent years: as of January 2013, 30 percent of U.S. adults reported reducing or eliminating gluten in their diets. How do individuals participate in the expansion of gluten-free dieting, and what are the implications of that expansion? This article is based on 31 in-depth, semi-structured interviews conducted between May and October 2012 with gluten-free and -restricted persons. I identify three interrelated factors contributing to the expansion of gluten-free dieting among non-celiacs. Participants broaden the lay understanding of gluten-related disorders, undermine biomedical authority, and diagnose others. Such participant-driven change, termed self-ascriptive looping, is one factor in the diet's rapid popularization. I show how participants question the doctor-patient relationship and increase social contestability for other dieters. My findings challenge previous work on contested illness and suggest food intolerances may require a reconceptualization of contested illness experience.

Rural America has undergone dramatic changes in the last half century. Brown and Schafft (2011) survey these changes in Rural People and Communities in the Twentyfirst Century. The book synthesizes research on the social, economic, and political aspects of life in rural America. Intended for students, policy-makers, and academics, the book is an introduction to the many issues facing these communities today. The authors introduce their work with a compelling argument for the importance of rural communities. The rural population, comprising 17 % of the US population, is larger than ‘‘other important subgroups’’ like Hispanics (Brown and Schafft 2011:11). Moreover, most of the nation’s infrastructure and natural resources exist in rural areas. American society is deeply invested in a collective rural identity. The ‘‘rural mystique’’ idealizes rural life as ‘‘somehow more moral, virtuous, and simple’’ than urban life (10). A collective memory of idyllic life before urbanization means that many Americans want to preserve such communities, even if they never experience rural life firsthand. Rural People and Communities includes sections on rural places in urban society; rural communities, institutions and environments; rural populations; rural economy and socioeconomic well-being; and policy recommendations. Each chapter relates empirical data to macro-level changes and policy debates, and each spotlights diverse theories to interpret the data. This technique makes this book a ‘‘toolkit’’ that equips readers with a broad range of analytic frames. For example, ‘‘Understanding Community in Rural Society’’ compares perspectives of ‘‘community as a social system’’ and ‘‘community as a field of social interaction,’’ to show how they can be fruitfully combined for a robust understanding of community life (38–46). Particularly compelling were Chapters 9 (‘‘Farms, Farmers, and Farming’’) and 10 (‘‘Poverty’’). Poverty is often considered an urban problem. However, the magnitude and quality of poverty in rural areas differs greatly from urban environments. Rural areas suffer from deep, persistent poverty. Whereas urban families cycle in and out of economic instability, rural families experience fewer fluctuations. The rural poor are at high poverty risk but numerically few, rendering them largely invisible in national poverty programs. These policies, designed to alleviate urban problems, are unsatisfactory outside the city. For example, in addition to living far from basic services such as grocery stores or medical facilities, rural workers often face a long, costly commute. Transportation costs quickly make work ‘‘economically irrational’’ for those who cannot relocate to pricier urban markets. However, the nation’s largest anti-poverty program, Temporary Assistance for Needy Families, is ‘‘contingent on work effort... [and has] strict time limits’’ trapping the rural poor in employment costs that outstrip financial returns (199). Chapter 9 dispels myths of widespread agricultural labor in rural communities. Many Americans assume that agricultural and rural policies are synonymous, but this conflation is misguided. Shifts over the last 200 years have undermined agriculture as a ‘‘viable livelihood strategy’’ for many (Brown and Schafft 2011:183). Agricultural lands are increasingly under the control of fewer individuals. At the time of publication, only 7 % of rural Americans were involved in farming. Brown and Schafft (179) suggest that, rather than just examining agriculture, scholars focus on ‘‘food systems,’’ the ‘‘complex set of social, economic, and L. R. Moore (&) University of Kentucky, 211 Lafferty Hall, Lexington, KY 40506-0024, USA e-mail: LaurenRMoore@uky.edu

The Bore Drain Replacement Project (BDRP) in south-west Queensland provided government subsidies to land managers to convert water distribution systems from open earth bore drains to piped water systems, thereby addressing Great Artesian Basin (GAB) sustainability issues. To fully evaluate the benefits and costs of the project for land managers, both a financial benefit-cost analysis and a study of land managers' perceptions were conducted. The main benefit for land managers from bore drain replacement, was a substantial decrease in operating costs (mean decrease of 87%). Results of the financial benefit-cost analysis showed that the mean private benefit to total cost ratio (BP:CT) (0.86, at a real discount rate of 6%, over 10 years) was less than the break-even value of unity . The mean BP:CT (0.6) for land managers with less than 50% of bore drains on mulga (Acacia aneura F. Muell ex. Benth) land systems was also less than unity, while those land managers with bore drains predominately on mulga land systems had a mean BP:CT that only marginally exceeded unity (1.1). With a government subsidy (study mean 72%), the private benefits to private cost ratio (BP:CP), averaged across all land managers in the study, was 2.25. The break-even subsidy level for land managers was calculated as 17% of the total capital cost. Land managers perceived a number of important benefits from bore drain replacement that were not included in the financial benefit-cost analysis, due to difficulty quantifying values. These included benefits from changes in grazing management, increased time-savings and an improved quality of life. In general, there were no changes documented in animal productivity, native and feral animal populations, or carrying capacity in the 18 months since piping, although potential changes for the future were identified. Some land managers noted improvements to natural resource condition near bore drains after closure, while most expected little deterioration in natural resource condition near the new water points. Recommendations are made for ongoing funding support for bore drain replacement, including further monitoring and evaluation, with emphasis on conducting an economic public and private benefit-cost analysis. Land managers' capacity to pay, willingness to adopt change and public benefits of the project should be considered in cost sharing arrangements and determination of future government subsidy levels.