Reducing Inequities among Children with Asthma in the Island of Puerto Rico: Experiences of a Community-Based, Trans-Sectoral Effort

2009 ◽  
Vol 20 (4A) ◽  
pp. 116-136 ◽  
Author(s):  
Marielena Lara ◽  
Gilberto Ramos Valencia ◽  
Jesús A. González Gavillán ◽  
Beatriz Morales Reyes ◽  
Carmen Arabía ◽  
...  
Author(s):  
Mark E. Keim ◽  
Laura A. Runnels ◽  
Alexander P. Lovallo ◽  
Margarita Pagan Medina ◽  
Eduardo Roman Rosa ◽  
...  

Abstract Objective: The efficacy is measured for a public health intervention related to community-based planning for population protection measures (PPMs; ie, shelter-in-place and evacuation). Design: This is a mixed (qualitative and quantitative) prospective study of intervention efficacy, measured in terms of usability related to effectiveness, efficiency, satisfaction, and degree of community engagement. Setting: Two municipalities in the Commonwealth of Puerto Rico are included. Participants: Community members consisting of individuals; traditional leaders; federal, territorial, and municipal emergency managers; municipal mayors; National Guard; territorial departments of education, health, housing, public works, and transportation; health care; police; Emergency Medical Services; faith-based organizations; nongovernmental organizations (NGOs); and the private sector. Intervention: The intervention included four community convenings: one for risk communication; two for plan-writing; and one tabletop exercise (TTX). This study analyzed data collected from the project work plan; participant rosters; participant surveys; workshop outputs; and focus group interviews. Main Outcome Measures: Efficacy was measured in terms of ISO 9241-11, an international standard for usability that includes effectiveness, efficiency, user satisfaction, and “freedom from risk” among users. Degree of engagement was considered an indicator of “freedom from risk,” measurable through workshop attendance. Results: Two separate communities drafted and exercised ~60-page-long population protection plans, each within 14.5 hours. Plan-writing workshops completed 100% of plan objectives and activities. Efficiency rates were nearly the same in both communities. Interviews and surveys indicated high degrees of community satisfaction. Engagement was consistent among community members and variable among governmental officials. Conclusions: Frontline communities have successfully demonstrated the ability to understand the environmental health hazards in their own community; rapidly write consensus-based plans for PPMs; participate in an objective-based TTX; and perform these activities in a bi-lingual setting. This intervention appears to be efficacious for public use in the rapid development of community-based PPMs.


1996 ◽  
Vol 25 (1) ◽  
pp. 61-111 ◽  
Author(s):  
Richard Cameron

ABSTRACTThe Functional Compensation Hypothesis (Hochberg 1986a, b) interprets frequent expression of pronominal subjects as compensation for frequent deletion of agreement marking on finite verbs in Puerto Rican Spanish (PRS). Specifically, this applies to 2sg.túwhere variably deleted word-final -smarks agreement. If the hypothesis is correct, finite verbs with agreement deleted in speech should co-occur more frequently with pronominal subjects than finite verbs with agreement intact. Likewise, social dialects which frequently delete agreement should show higher rates of pronominal expression than social dialects which less frequently delete agreement. These auxiliary hypotheses are tested across a socially stratified sample of 62 speakers from San Juan. Functional compensation does show stylistic and social patterning in the category of Specifictú, not in that of Non-specifictú. However, Non-specifictúis the key to frequency differences between -s-deleting PRS and -s-conserving Madrid; hence the Functional Compensation Hypothesis should be discarded. (Functionalism, compensation, null subject, analogy, Spanish, Puerto Rico)


Author(s):  
Elizabeth L. Andrade ◽  
Nicole D. Barrett ◽  
Mark C. Edberg ◽  
Matthew W. Seeger ◽  
Carlos Santos-Burgoa

Abstract Objective: This study aimed to examine factors that may have contributed to community disaster resilience following Hurricane Maria in Puerto Rico. Methods: In April 2018, qualitative interviews (n = 22) were conducted with stakeholders in 7 Puerto Rican municipalities (9% of total). Transcripts were deductively and inductively coded and analyzed to identify salient topics and themes, then examined according to strategic themes from the Federal Emergency Management Association’s (FEMA) Whole Community Approach. Results: Municipal preparedness efforts were coordinated, community-based, leveraged community assets, and prioritized vulnerable populations. Strategies included (1) multi-sectoral coordination and strategic personnel allocation; (2) neighborhood leader designation as support contacts; (3) leveraging of community leader expertise and social networks to protect vulnerable residents; (4) Censuses of at-risk groups, health professionals, and first responders; and (5) outreach for risk communication and locally tailored protective measures. In the context of collapsed telecommunications, communities implemented post-disaster strategies to facilitate communication with the Puerto Rican Government, between local first responders, and to keep residents informed, including the use of: (1) police radios; (2) vehicles with loudspeakers; (3) direct interpersonal communication; and (4) solar-powered Internet radio stations. Conclusions: Adaptive capacities and actions of Puerto Rican communities exemplify the importance of local solutions in disasters. Expanded research is recommended to better understand contributors to disaster resilience.


2013 ◽  
Vol 42 (3) ◽  
pp. 248-263
Author(s):  
David A. Fedele ◽  
Daphne Koinis-Mitchell ◽  
Sheryl Kopel ◽  
Debra Lobato ◽  
Elizabeth L. McQuaid

Author(s):  
Giovanni Martínez ◽  
Lili M. Sardiñas ◽  
Edna Acosta-Perez ◽  
Lizbeth Medina ◽  
Mirza Rivera ◽  
...  

1980 ◽  
Vol 29 (6) ◽  
pp. 1228-1240 ◽  
Author(s):  
Robert A. Hiatt ◽  
Luis A. Berrios-Duran ◽  
Barnett L. Cline ◽  
Wilda B. Knight ◽  
Ernesto Ruiz-Tiben

2002 ◽  
Vol 67 (4) ◽  
pp. 363-370 ◽  
Author(s):  
Peter J Winch ◽  
José G Rigau-Pérez ◽  
Gary G Clark ◽  
Mervin Ruiz-Pérez ◽  
Elli Leontsini ◽  
...  

Author(s):  
Claire Hepworth ◽  
Andrew Lilley ◽  
Lucy Gait ◽  
Neil Mingaud ◽  
Helen Hannigan ◽  
...  

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