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This chapter explores how identity formation in Appalachia is impacted by globalized processes. Residents of the region are often understood as inhabiting space belated which ignores the ways that global processes of extraction, exploitation, colonialism, and national politics come to impact the region and its inhabitants. Rooted in narratives of time, death, and belonging, personal identity formation in Appalachia is as rich and complex, while often unseen, as the region is itself. By understanding the way selective hegemonies and colonial narratives have impacted the region, we can begin to explore how these same concepts have begun to impact personal development.

This chapter provides theoretical conceptualizations to (1) better understand the phenomenon of rural gentrification and (2) the links between rural gentrification and regional tourism development, using a case study in south central Appalachia.

This ethnographic study relies on the results of a series of interviews and instances of participant observation.

Affluent newcomers often implement development projects through the injection of private capital into public-seeming projects like community-based organizations (CBOs). These projects offer partial solutions to the problem of failing local economies. However, they also have the potential to reinforce class structures and push narrowly perceived development processes.

A critical evaluation of rural gentrification may be useful to CBOs and local governments leading development projects in rural areas.

The phenomenon of rural gentrification warrants critical examination of current development agendas being proposed or implemented.

The purpose of this paper is to determine if rural firms can utilize technology to communicate with their customers, compete for business, reduce costs, and improve operations to maintain competitive advantage.

Businesses in the service area were anonymously surveyed to identify the perceived needs and benefits the firms had concerning digital technology. The various business sectors such as manufacturing, retail, construction, wholesale, financial services, healthcare, and food services were juxtaposed with there data to see if there were any correlations between the needs and perception of the categories of business and size of the businesses. The total number of respondents was 309, from five counties in three contiguous states located in Appalachia.

This study revealed answers to the following research questions: what percentage of annual business revenue is spent to improve technology? Does the business use computers and does it vary by industry and size? Is technological information important to business and does it vary by industry and size? What methods do businesses utilize to contact their customers and do they vary by size? Can technology reduce costs in business? Does new technology help business stay competitive?

This study focused on five counties in Appalachia and its findings may not necessarily be applied to other populations. Future research could focus on underrepresented categories of business such as wholesale firms. In addition, the definition of technology needs to be consistent from business to business. Furthermore, the specific software applications used by firms, the training and their return on investment could be evaluated via the firm's classification, size, ownership, location, and number of employees.

Firms in Appalachia need to be encouraged to invest their hard‐earned profits in technology. These investments must be aligned with their business plans to provide cost‐saving, efficiency, and/or customer‐relationship benefits. Furthermore, state and country governments should promote technological advances, infrastructure development, and technological literacy. While this study focused on businesses in Appalachia, its implications and impact are far reaching. In this time of recession, unemployment, and financial hardships, the use of electronic technology may be a stimulus for job creation and competitiveness. Digital technologies have enabled firms of any size and at any location to improve their marketing, communications, and business operations to reach customers and improve efficiencies. Investments in electronic technologies could enable them to not only reach new customers, but also be competitive with their larger, urban counterparts.

This paper provides both theoretical and empirical data to increase the body of knowledge about small business practices in Appalachia. In addition, it cites the importance of technology for competitiveness.

In 2017, racial minorities made up 18.6% of the population in Appalachia compared to 39.3% of the United States population. Of this 18.6%, Black/African Americans represent the largest minority group, at 9.7% (Pollard & Jacobs, 2019). This chapter focuses on the positionality and experiences of Black women educators teaching critical perspectives at the intersection of race, gender, and class in rural Appalachia. Using Black feminist thought (Collins, 1986, 2000), a coautoethnography is used to highlight the authors' teaching experiences as Black women educators from non-Appalachian areas. Themes and recommendations identified across the authors' experiences are presented.

The nexus where law, social movements, and organizations meet demands further explication. This research adds to our understandings of these dynamics by examining the case of the central Appalachian anti-strip mining movement. After developing a social network technique to analyze over thirty years of newspapers, we find a period of reduced movement activity following the passage of the Surface Mining Control and Reclamation Act of 1977. Conversely, we observe a reinvigoration of the movement following the passage of the Clean Air Amendments of 1990 and the perverse incentives they created for mountaintop removal mining. Finally, we see that joint participation in lawsuits is a primary tie that binds these groups together.

This chapter explores the perspectives of rural librarians about the information behaviors of children with special needs (CSN) and services available for the disenfranchised population in the Southern and Central Appalachian (SCA) region.

Qualitative feedback is collected from 31 SCA rural librarians via phone interviews and a web-based survey about: (1) The most important information needs/wants of the CSN in the SCA rural libraries; (2) The most important information resources and services that the CSN seek/use in the SCA rural libraries; (3) Extent of perceived need for effective library services for the CSN in rural areas; (4) Ways that the SCA rural libraries can improve to better serve the CSN in their local communities.

Content analysis of the data generated quantitative representation of response counts for specific themes that resulted in practical user-centered suggestions for positive change in delivering effective library services for the CSN in the SCA region.

Research significance lies in its first-time effort to understand the information needs and information uses of the CSN in the SCA rural library environments from the perspective of a rural librarian immersed in an American society that perceives a parochial regional work setting. This research presents data that challenges notions stereotyping and marginalizing of the “South” in its documentation of positive and meaningful efforts that rural librarians suggest should be made to improve the conditions experienced by the CSN in this region.

The purpose of this paper is to describe standardized clinical process of care and quality performance metrics at Roane Medical Center (RMC) and compare data from 2005 to 2015.

Information was extracted from a nationwide sample of short-term acute care hospitals using the Hospital Quality Alliance (HQA) database, evaluating multiple parameters measured at RMC. HQA data from RMC were matched against state and national benchmarks; findings were also compared with similar reports from the same facility in 2005.

Information collected by HQA expanded substantially in ten years and queried different parameters over time, thus exact comparisons between 2005 and 2015 cannot be easily calculated. Nevertheless, analysis of process of care data for 2015 placed RMC at or above state- and national-average performance in 64.9 percent (24 of 37) and 56.5 percent (26 of 46) categories, respectively. RMC registered superior process of care scores in heart failure care, pneumonia care, thrombus prevention and care, as well as stroke care. While RMC continues to perform favorably against state and national reference groups, the differences between RMC vs state and RMC vs national averages using current reporting metrics were both statistically smaller in 2015 compared to 2005 (p<0.05).

Perhaps the most significant interval health event for the RMC service area since 2005 was a coal ash spill at the nearby Tennessee Valley Authority facility in December 2008. Although reports on environmental and health effects following one of the largest domestic industrial toxin releases reached a number of important conclusions, the consequences for RMC in terms of potential added clinical burden on emergency services and impact on chronic health conditions have not been specifically studied. This could explain data reported on emergency department services at RMC but additional research will be needed to establish causality.

While tracking of care processes at all US hospitals will be facilitated by refinements in HQA tools, longitudinal evaluations for any specific unit will be more meaningful if the assessment instrument undergoes limited change over time.

Appalachia remains one of several regions in the USA often identified as medically underserved. Hospitals here have confronted the challenge of diminished reimbursement, high expenses, limited staffing and other financial hardships in a variety of ways. Since the last published report on RMC, a particularly severe global recession has placed additional stress on organizations offering crucial health services in the region.

As a follow-up study to track potential changes which have been registered in the decade 2005-2015, this is the first report to provide original, longitudinal analysis on RMC, an institution operating in a rural and underserved area.

This chapter presents a gap analysis of the perspectives of small businesses and rural librarians in Tennessee in order to develop an implementation blueprint of a public library small business toolkit, a resource that the state’s rural public libraries can create for small businesses in the future.

The chapter reports on select comparison data sets collected via two exploratory online surveys with small businesses and rural public librarians, respectively, in an externally funded planning grant awarded by the Institute of Museum and Library Services’ National Leadership Grants for Libraries (Research category) to the School of Information Sciences at the University of Tennessee.

Findings from the gap analysis of the perspectives of small businesses and rural librarians provide similarities and differences between the two stakeholder groups in terms of

• existing assistance needs of small businesses,

• information-related challenges small businesses experience,

• desired public library use, and

• information-related components of a public library small business toolkit.

existing assistance needs of small businesses,

information-related challenges small businesses experience,

desired public library use, and

information-related components of a public library small business toolkit.

The study is a unique example of action research based on varied levels of participation in rural research and action, learning through collaboration, community inquiry into everyday experiences and potential impact, use of mixed methods, and the situated nature of applications and concrete outcomes. It serves as a pilot case experience and prototype assessment test bed to expand strategies for the entire Appalachian region and other rural environments in the future.