scholarly journals A qualitative study on pharmacy policies toward over-the-counter syringe sales in a rural epicenter of US drug-related epidemics

2022 ◽  
Vol 19 (1) ◽  
Author(s):  
Monica Fadanelli ◽  
Hannah L. F. Cooper ◽  
Patricia R. Freeman ◽  
April M. Ballard ◽  
Umed Ibragimov ◽  
...  
Keyword(s):  
Rural Areas ◽  
People Who Inject Drugs ◽  
Constructivist Grounded Theory ◽  
Structured Interviews ◽  
Over The Counter ◽  
Eastern Kentucky ◽  
Medical Need ◽  
Immunodeficiency Virus ◽  
Related Harm ◽  
Health Districts

Abstract Background Expanding access to sterile syringes in rural areas is vital, as injection-related epidemics expand beyond metropolitan areas globally. While pharmacies have potential to be an easily accessible source of sterile syringes, research in cities has identified moral, legal and ethical barriers that preclude over-the-counter (OTC) sales to people who inject drugs (PWID). The current study builds on prior urban-based research by elucidating (1) pharmacy OTC policies and (2) pharmacists’ rationale for, and barriers and facilitators to, OTC syringe sales in a US rural area hard hit by drug-related epidemics. Methods We conducted 14 semi-structured interviews with pharmacists recruited from two Eastern Kentucky health districts. Interview domains included experiences with, and attitudes toward, selling OTC syringes to PWID. Constructivist grounded theory methods were used to analyze verbatim transcripts. Results Most pharmacists operated “restrictive OTC” pharmacies (n = 8), where patients were required to have a prescription or proof of medical need to purchase a syringe. The remainder (n = 6) operated “open OTC” pharmacies, which allowed OTC syringe sales to most patients. Both groups believed their pharmacy policies protected their community and pharmacy from further drug-related harm, but diverging policies emerged because of stigma toward PWID, perceptions of Kentucky law, and belief OTC syringe sales were harmful rather than protective to the community. Conclusion Our results suggest that restrictive OTC pharmacy policies are rooted in stigmatizing views of PWID. Anti-stigma education about substance use disorder (SUD), human immunodeficiency virus (HIV), and Hepatitis C (HCV) is likely needed to truly shift restrictive pharmacy policy.

scholarly journals Loneliness Among the Elderly in Rural Contexts: A Mixed-Method Study Protocol

2021 ◽  
Vol 20 ◽  
pp. 160940692199686
Author(s):  
Borja Rivero Jiménez ◽  
David Conde-Caballero ◽  
Lorenzo Mariano Juárez
Keyword(s):  
Data Collection ◽  
Mixed Method ◽  
Rural Areas ◽  
Population Group ◽  
The Elderly ◽  
Interaction Patterns ◽  
Structured Interviews ◽  
Strict Adherence ◽  
Data Collection And Analysis ◽  
Technological Tools

Loneliness among the elderly has become a pressing issue in Western societies. In the Spanish context, the problem of the so-called “empty” Spain disproportionately affects this population group—elderly individuals living in rural areas with low population density, and therefore at higher risk of social exclusion and isolation. We introduce here a mixed-method, quantitative-qualitative research protocol, triangulated with technological tools, designed to improve both data acquisition and subsequent data analysis and interpretation. This study will take place in a rural locality in the Extremadura region (Spain), chosen according to a particular socio-demographic profile. The De Jong Gierveld Loneliness Scale will be used on a cohort of 80 people over 65 years old. Within this cohort, a smaller sample of 20–30 individuals will be selected for semi-structured interviews about their beliefs and experiences of loneliness. Finally, data gathered from technological tools (smartbands, Bluetooth sensors) will allow us to monitor social interactions and to map daily loneliness/interaction patterns. Data will be triangulated by analyzing and comparing the empirical material gathered through these different methods and tools. Strict adherence to ethical standards for data protection and handling will be essential through data collection and analysis. As well as providing insights into the phenomenon of loneliness in old age, the use of different methods and tools for data collection will provide the basis for an epistemological reflection on the scope and limits of each one of these methods.

scholarly journals Homeless on Main Street: Using Photovoice to Highlight Older Adults Among the Hidden Homeless

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 728-728
Author(s):  
H Shellae Versey
Keyword(s):  
Older Adults ◽  
Rural Areas ◽  
Meaning Making ◽  
Small Towns ◽  
Photo Elicitation ◽  
Service Agency ◽  
Structured Interviews ◽  
Community Based Interventions ◽  
Community Based ◽  
Formerly Homeless

Abstract Homelessness is a reality for a growing number of Americans living in small towns and rural areas. However, unlike in cities, housing instability may be less visible. Using a photo-elicitation method (i.e., Photovoice), this study explores the meaning of place and obscured visibility to currently and formerly homeless older adults living in a small town in central Connecticut. Participants (N = 27) were recruited from a local service agency, given cameras and asked to photograph areas around town that were meaningful to them. Photographs were developed and followed by in-person, semi-structured interviews with participants in which photos and experiences during the project were discussed. Primary themes included belonging, generativity, social isolation, and place-making as meaning-making. The study culminated in a community photography exhibition in which photographs from the project were displayed in public spaces around town. Implications for community-based interventions to reach homeless groups in rural areas are discussed. Part of a symposium sponsored by the Qualitative Research Interest Group.

scholarly journals Homegarden agroecosystems managed by Salar people on Qinghai-Tibet Plateau

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Mingjing Zhu ◽  
Binsheng Luo ◽  
Ben La ◽  
Ruijie Chen ◽  
Fenggui Liu ◽  
...  
Keyword(s):  
Plant Species ◽  
Rural Areas ◽  
Production Systems ◽  
Farming Systems ◽  
Field Investigation ◽  
Tibet Plateau ◽  
Ecosystem Functions ◽  
Structured Interviews ◽  
Services Research ◽  
Qinghai Tibet Plateau

Abstract Background Salar is a Turkic-speaking Islamic ethnic group in China living mainly in Xunhua Salar Autonomous County (Xunhua or Xunhua County), Qinghai-Tibet Plateau. Salar people are skilled in horticulture and their homegarden (HG) management. They are regarded as the first people on the Qinghai-Tibet Plateau to practice horticulture, especially manage their HGs, traditional farming systems, and supplementary food production systems. Traditional knowledge of Salar people associated with their HGs always contributes significantly to the local livelihood, food security, ornamental value, and biodiversity conservation. The cultivation of different plants in HGs for self-sufficiency has a long tradition in China’s rural areas, especially in some mountainous areas. However, Salar traditional HGs have not been described. The present paper aims to report the features of Salar HGs mostly based on agrobiodiversity and its ecosystem services. Methods The methods used in this work included semi-structured interviews and participatory observation. A total of 60 households in three townships, 9 villages were surveyed. There are 4–12 family members in each household, aged from 20 to 86 years old. The homestead size is between 200 and 1200 m2. Plant species cultivated in Salar HGs were identified according to Flora of China. Based on a comprehensive survey of Salar HGs and related to background data, we identified and characterized the most important services and functions provided by Salar HGs. Results According to primary production systems, there are 4 different types of Salar HGs, including ornamental focus, product focus, dual-purpose and multi-purpose. In total, 108 (excluding weeds and bonsai) plant species were recorded in Salar HGs, within 43 plant families. The most important and frequently used plants are Rosa chinensis, Armeniaca vulgar, Prunus salicina, and Ziziphus jujuba. About 4 to 32 plant species were recorded in each homegarden. We found that the Salar HGs, as a typical agroecosyste, prossess multiple servcices and functions that directly benefit households according to the field investigation. Conclusion This paper reveals the floristic diversity of Salar HGs. It presents useful information in the homegarden agroecosystem of Salar people, such as HG types and species diversity in Salar HGs. Ecosystem functions and services research suggested that the Salar HG agroecosystem provides agroecosystem services mainly related to supply and culture services. Salar HGs are important as food supplement resources, aesthetics symbol, and cultural spaces.

scholarly journals Immigrant entrepreneurs in rural England – An examination of the socio- cultural barriers facing migrant small businesses in Lincolnshire

2020 ◽  
Vol 35 (7) ◽  
pp. 676-694
Author(s):  
Dieu Hack-Polay ◽  
Justice Tenna Ogbaburu ◽  
Mahfuzur Rahman ◽  
Ali B Mahmoud
Keyword(s):  
Rural Areas ◽  
Small Businesses ◽  
Cultural Barriers ◽  
Entrepreneurial Success ◽  
Structured Interviews ◽  
Language Differences ◽  
Institutional Embeddedness ◽  
Immigrant Entrepreneurs ◽  
Relational Embeddedness ◽  
Rural England

A growing body of literature recognises the crucial role played by immigrant entrepreneurs. However, certain socio-cultural barriers adversely affect their businesses in rural areas. Thus, this article examines the socio-cultural barriers facing immigrant entrepreneurs in Lincolnshire. Eleven semi-structured interviews were held with businesses owned by immigrants from diverse ethnic backgrounds. The findings identified migrant ethnocentrism, stereotypes, cultural differences and language differences as key socio-cultural barriers adversely affecting immigrant businesses in Lincolnshire. The research found that immigrant enterprises experienced growth issues, not just owing to the size of the market but also due to issues of embeddedness in the socio-economic nomenclature. The study found mixed embeddedness to be key to immigrant entrepreneurial success. This involves immigrant adaptation to develop relational embeddedness with the hosts, involvement with its social, structural and institutional frameworks. The study contributes to our understanding of the role of social, relational, structural and institutional embeddedness in steering fertile approaches to immigrant entrepreneurship in rural England which has been under-researched.

Psychotropic drug use in Northern Ireland 1966–80: prescribing trends, inter- and intra-regional comparisons and relationship to demographic and socioeconomic variables

1982 ◽  
Vol 12 (4) ◽  
pp. 819-833 ◽  
Author(s):  
David J. King ◽  
Kathryn Griffiths ◽  
Phillip M. Reilly ◽  
J. Desmond Merrett
Keyword(s):  
Northern Ireland ◽  
Psychotropic Drug ◽  
Rural Areas ◽  
Adult Population ◽  
Regional Analysis ◽  
Socioeconomic Variables ◽  
Rate Of Increase ◽  
Prescribing Trends ◽  
Regional Comparisons ◽  
Health Districts

SynopsisA study of psychotropic drug prescribing, derived from the computerized pricing data in Northern Ireland from 1966, showed that the use of these drugs reached a peak in 1975, when about 12·5% of the adult population were estimated to have been receiving them, and declined in the following 5 years. Benzodioazepines accounted for three-quarters of all psychotropic drugs prescribed in 1980. Benzodiazepine tranquillizer prescribing was consistently 20–30% higher than in the rest of the United Kindom, in contrast to hypnotic and antidepressant prescribing which has been consistently lower. The rate of increase in benzodiazepine tranquillizer prescribing was greater than in other European countries, but the level remains lower than in Iceland and Denmark. The influence of a number of demographic and socioeconomic variables was studied in an intra-regional analysis of the 1978 data for the 17 health districts in the province, using multivariate and multiple regression statistics. The prescribing of benzodiazepine hypnotics was almost entirely accounted for by the proportion of elderly (over 65 years) and women aged 45–59 years; neuroleptic prescribing was largely a function of factors associated with rural areas (overcrowding and unemployment) and the proportion of elderly; but neither tranquillizer, antidepressant, barbiturate hypnotic nor psychostimulant prescribing were satisfactorily explained by these variables.

The different shades of innovation emergence in smart service systems: the case of Italian cluster for aerospace technology

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Orlando Troisi ◽  
Anna Visvizi ◽  
Mara Grimaldi
Keyword(s):  
New Technologies ◽  
Service Systems ◽  
Constructivist Grounded Theory ◽  
Structured Interviews ◽  
Social Rules ◽  
Content Type ◽  
Novel Technologies ◽  
Aerospace Technology ◽  
Smart Service ◽  
Relational Strategies

Purpose The purpose of this paper is to explore the emergence of innovation in smart service systems to conceptualize how actor’s relationships through technology-enabled interactions can give birth to novel technologies, processes, strategies and value. The objectives of the study are: to detect the different enablers that activate innovation in smart service systems; and to explore how these can lead dynamically to the emergence of different innovation patterns. Design/methodology/approach The empirical research adopts an approach based on constructivist grounded theory, performed through observation and semi-structured interviews to investigate the development of innovation in the Italian CTNA (Italian acronym of National Cluster for Aerospace Technology). Findings The identification and re-elaboration of the novelties that emerged from the analysis of the Cluster allow the elaboration of a diagram that classifies five different shades of innovation, introduced through some related theoretical propositions: technological; process; business model and data-driven; social and eco-sustainable; and practice-based. Originality/value The paper embraces a synthesis view that detects the enabling structural and systems dimensions for innovation (the “what”) and the way in which these can be combined to create new technologies, resources, values and social rules (the “how” dimension). The classification of five different kinds of innovation can contribute to enrich extant research on value co-creation and innovation and can shed light on how given technologies and relational strategies can produce varied innovation outcomes according to the diverse stakeholders engaged.

scholarly journals Hepatitis C Virus Treatment Access Among Human Immunodeficiency Virus and Hepatitis C Virus (HCV)-Coinfected People Who Inject Drugs in Guangzhou, China: Implications for HCV Treatment Expansion

2016 ◽  
Vol 3 (2) ◽  
Author(s):  
Carissa E. Chu ◽  
Feng Wu ◽  
Xi He ◽  
Kali Zhou ◽  
Yu Cheng ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Social Workers ◽  
People Who Inject Drugs ◽  
Hiv Treatment ◽  
Direct Acting Antivirals ◽  
Hcv Treatment ◽  
Treatment Access ◽  
Immunodeficiency Virus ◽  
Direct Acting

Abstract Background.  Hepatitis C virus (HCV) treatment access among human immunodeficiency virus (HIV)/HCV-coinfected people who inject drugs is poor, despite a high burden of disease in this population. Understanding barriers and facilitators to HCV treatment uptake is critical to the implementation of new direct-acting antivirals. Methods.  We conducted in-depth interviews with patients, physicians, and social workers at an HIV treatment facility and methadone maintenance treatment centers in Guangzhou, China to identify barriers and facilitators to HCV treatment. We included patients who were in various stages of HCV treatment and those who were not treated. We used standard qualitative methods and organized data into themes. Results.  Interview data from 29 patients, 8 physicians, and 3 social workers were analyzed. Facilitators and barriers were organized according to a modified Consolidated Framework for Implementation Research schematic. Facilitators included patient trust in physicians, hope for a cure, peer networks, and social support. Barriers included ongoing drug use, low HCV disease knowledge, fragmented reimbursement systems, HIV exceptionalism, and stigma. Conclusions.  Expanding existing harm reduction programs, HIV treatment programs, and social services may facilitate scale-up of direct-acting antivirals globally. Improving integration of ancillary social and mental health services within existing HIV care systems may facilitate HCV treatment access.

Rural Neighborhood Walkability: Implications for Assessment

2015 ◽  
Vol 12 (s1) ◽  
pp. S40-S45 ◽  
Author(s):  
Michelle C. Kegler ◽  
Iris Alcantara ◽  
Regine Haardörfer ◽  
Alexandra Gemma ◽  
Denise Ballard ◽  
...  
Keyword(s):  
Physical Activity ◽  
Rural Communities ◽  
Rural Areas ◽  
Walking Distance ◽  
Activity Levels ◽  
Structured Interviews ◽  
Physically Active ◽  
Neighborhood Walkability ◽  
Bodies Of Water ◽  
Active Adults

Background:Physical activity levels, including walking, are lower in the southern U.S., particularly in rural areas. This study investigated the concept of rural neighborhood walkability to aid in developing tools for assessing walkability and to identify intervention targets in rural communities.Methods:Semi-structured interviews were conducted with physically active adults (n = 29) in rural Georgia. Mean age of participants was 55.9 years; 66% were male, 76% were white, and 24% were African American. Participants drew maps of their neighborhoods and discussed the relevance of typical domains of walkability to their decisions to exercise. Comparative analyses were conducted to identify major themes.Results:The majority felt the concept of neighborhood was applicable and viewed their neighborhood as small geographically (less than 0.5 square miles). Sidewalks were not viewed as essential for neighborhood-based physical activity and typical destinations for walking were largely absent. Destinations within walking distance included neighbors’ homes and bodies of water. Views were mixed on whether shade, safety, dogs, and aesthetics affected decisions to exercise in their neighborhoods.Conclusions:Measures of neighborhood walkability in rural areas should acknowledge the small size of self-defined neighborhoods, that walking in rural areas is likely for leisure time exercise, and that some domains may not be relevant.

scholarly journals Over-the-Counter Drugs and Complementary Medications Use among Children in Southern Italy

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Claudia Pileggi ◽  
Valentina Mascaro ◽  
Aida Bianco ◽  
Maria Pavia
Keyword(s):  
Positive Attitude ◽  
Southern Italy ◽  
Sole Source ◽  
Structured Interviews ◽  
Cross Sectional Survey ◽  
Community Based ◽  
Cross Sectional ◽  
Over The Counter ◽  
Source Of Information

The use of nonprescription medicines (NPDs) for children illnesses without a doctor’s suggestion can lead to unnecessary medication use and is not free of risks. The aim of our study was to examine attitudes and practice of parents towards NPDs use for their children. We also investigated the conditions that may predict NPDs use. A cross-sectional survey was conducted on parents of children attending Community Based Pediatrician (CBP) consultation and data were collected through structured interviews. Positive attitude on NPDs use was reported by 71.4% of parents, and 61.5% of them had administered NPDs in the previous 6 months. Antipyretic drugs were the most frequently used medication class without the supervision of the CBP. A positive attitude towards NPDs was significantly more frequent in parents who did not use the CBP as the sole source of information about drugs. The study demonstrated a widespread use of NPDs in children in our context, supported by a substantial positive attitude towards their safety. However, considering potential harms related to some NPDs and the finding that most parents rely on CBP advice, role of CBP on appropriate use of NPDs by parents should be emphasized.

scholarly journals Health Insurance in Myanmar: The Views and Perception of Healthcare Consumers and Health System Informants on the Establishment of a Nationwide Health Insurance System

Risks ◽  
2018 ◽  
Vol 6 (3) ◽  
pp. 81
Author(s):  
Marjolein van Rooijen ◽  
Chaw-Yin Myint ◽  
Milena Pavlova ◽  
Wim Groot
Keyword(s):  
Health Insurance ◽  
Health System ◽  
Rural Areas ◽  
Social Protection ◽  
Vulnerable Groups ◽  
Health Insurance System ◽  
Structured Interviews ◽  
Insurance System ◽  
Supplementary Health Insurance ◽  
Insurance Model

(1) Background: Health insurance and social protection in Myanmar are negligible, which leaves many citizens at risk of financial hardship in case of a serious illness. The aim of this study is to explore the views of healthcare consumers and compare them to the views of key informants on the design and implementation of a nationwide health insurance system in Myanmar. (2) Method: Data were collected through nine focus group discussions with healthcare consumers and six semi-structured interviews with key health system informants. (3) Results: The consumers supported a mandatory basic health insurance and voluntary supplementary health insurance. Tax-based funding was suggested as an option that can help to enhance healthcare utilization among the poor and vulnerable groups. However, a fully tax-based funding was perceived to have limited chances of success given the low level of government resources available. Community-based insurance, where community members pool money in a healthcare fund, was seen as more appropriate for the rural areas. (4) Conclusion: This study suggests a healthcare financing mechanism based on a mixed insurance model for the creation of nationwide health insurance. Further inquiry into the feasibility of the vital aspects of the nationwide health insurance is needed.

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