Tobacco Control as an LGBTQ+ Issue: Knowledge, Attitudes, and Recommendations from LGBTQ+ Community Leaders

Tobacco companies use price discounts, including coupons and rebates, to market their products. Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) communities are targeted by these marketing strategies, contributing to inequitably high tobacco use. Some localities have adopted policies restricting tobacco price discounts; for successful implementation, community buy-in is crucial. From July–October 2018, Equality California staff conducted semi-structured interviews with seven participants in Los Angeles, CA. Themes included familiarity with tobacco price discounts, their perceived impact on tobacco use in LGBTQ+ communities, and attitudes toward potential policy restrictions. Interview notes were analyzed using a deductive approach to qualitative analysis. Awareness of tobacco price discounts varied; some interviewees were familiar, while others expressed surprise at their ubiquity. Price discounts were seen to disproportionately impact LGBTQ+ individuals, especially those who additionally identify with other vulnerable groups, including young people and communities of color. Support for policy restrictions was unanimous; however, interviewees expressed concern over political opposition and emphasized a need for culturally competent outreach to LGBTQ+ communities. Community organizations are essential in mobilizing support for policy reform. Understanding the perceptions and recommendations of community leaders provides tools for policy action, likely improving outcomes to reduce LGBTQ+ tobacco use through restricting tobacco price discounts.

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The First Decade of Effort: Progress Toward a Hospital Information System at the UCLA Hospital, Los Angeles, California

Methods of Information in Medicine ◽

10.1055/s-0038-1636003 ◽

1970 ◽

Vol 09 (02) ◽

pp. 75-80

Author(s):

B. G. Lamson ◽

W. S. Russell ◽

J. Fullmore ◽

W. E. Nix

Keyword(s):

Los Angeles ◽

Medical Record ◽

Communication Systems ◽

The United States ◽

Computer Applications ◽

Record Management ◽

Successful Implementation ◽

Accounting System ◽

Accrual Accounting ◽

Medical Specialties

Total information and communication systems within hospitals have been designed, but successful complete implementation, to date, has not been achieved. Limited applications with both patient medical data, notably in the clinical laboratories, and in the hospital accounting offices have been numerous. Although total programs are not yet a reality, it is apparent that the computer will serve ultimately many communication requirements, both medical and financial, within the hospital.Sound hospital management requires that costs of all component operations be known in order that value judgments concerning worth and efficiency may be made. Accrual accounting systems which match revenue and expense over the same time period are a prerequisite. Cash and modified cash hospital accounting cannot provide current reliable data for sound decision making.Costs of hospital operations cannot be evaluated unless related to the characteristics of the patient service load. Average per diem costs mean little except when large similar populations of patients are being compared. A modern hospital accrual accounting system should be able to provide information concerning the costs of caring for specific diseases in patients with known age and sex and disease severity characteristics. Without information of this type, it will not be possible to objectively evaluate alternative systems of financing and organizing patient care.Medical record management offers the promise of prospective use of patient disease information in the planning and scheduling of facilities. The prose content of medical record summaries, such as diagnostic statements in tissue pathology, radiology, and admission and discharge diagnoses, may be susceptible to non-coded, full prose input into computer controlled diagnostic files. Thesauri in the several medical specialties will be necessary for this achievement.There is little immediate prospect for complete hospital communication systems that can be made available as a package to any hospital without substantial local alteration. Pilot projects in teaching centers should be viewed for the time being as opportunities to define objectives, evaluate feasibility, and determine degree of risk and expense.A brief survey of applications in the United States which have been successfully implemented or which appear suitable for successful implementation is recorded.Eleven general principles which have been associated with successful implementation of computer applications within the UCLA Hospital are enumerated.

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Professional perspectives on providing recovery-oriented services in Taiwan: a qualitative study

BMC Psychiatry ◽

10.1186/s12888-021-03152-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yen-Ching Chang ◽

Ling-Hui Chang ◽

Su-Ting Hsu ◽

Meng-Wen Huang

Keyword(s):

Mental Health Professionals ◽

Organizational Support ◽

Psychiatric Rehabilitation ◽

Successful Implementation ◽

Policy Changes ◽

Structured Interviews ◽

Team Collaboration ◽

Self Confidence ◽

Professional Perspectives ◽

Implementation Problems

Abstract Background The experiences of professionals in well-established recovery-oriented programs are valuable for professionals in similar practice settings. This study explored professionals’ experiences with providing recovery-oriented services in community psychiatric rehabilitation organizations. Methods Semi-structured interviews were conducted with 14 professionals from five recovery-oriented psychiatric rehabilitation organizations in Taiwan. The interviews were recorded and transcribed verbatim. Thematic analysis was used for the qualitative data analysis. Results The analyses documented three main themes with 13 subthemes. Recovery-oriented service implementation included seven subthemes: Enabling clients to set their own goals and make decisions, using a strengths-based approach, establishing partnerships with clients, improving individuals’ self-acceptance, encouraging community participation, seeking family, peer, and organizational support, and building team collaboration. Problems with implementing recovery-oriented services included limited policy and organizational support, a lack of understanding of recovery among professionals, stigma, clients’ lack of motivation or self-confidence in their own ability to achieve recovery, and passive or overprotective family members. Strategies to resolve implementation problems included policy changes and organizational support, improving the recovery competence and confidence of professionals, and family and public education. Conclusions To date, this is the first known study examining the perspectives of mental health professionals who have experience implementing recovery-oriented services in Asia. The participants identified family collaboration, anti-stigma efforts, and changes in policy and attitudes as critical to successful implementation and delivery of recovery-oriented services.

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Culturally competent, safe and equitable clinical care for Ma¯ori with bipolar disorder in New Zealand: The expert critique of Ma¯ori patients and Wha¯nau

Australian & New Zealand Journal of Psychiatry ◽

10.1177/00048674211031490 ◽

2021 ◽

pp. 000486742110314

Author(s):

Tracy Haitana ◽

Suzanne Pitama ◽

Donna Cormack ◽

Mau Te Rangimarie Clark ◽

Cameron Lacey

Keyword(s):

Bipolar Disorder ◽

New Zealand ◽

Cultural Competence ◽

Health System ◽

Clinical Care ◽

Clinical Work ◽

Culturally Competent ◽

Structured Interviews ◽

Clinical Culture ◽

Competence Framework

Objective: Research designed to increase knowledge about Māori with bipolar disorder is required to understand how health services support wellbeing and respond to identified levels of community need. This paper synthesises the expert critique of Māori patients with bipolar disorder and their whānau regarding the nuances of cultural competence and safety in clinical encounters with the health system. Methods: A qualitative Kaupapa Māori Research methodology was used. A total of 24 semi-structured interviews were completed with Māori patients with bipolar disorder and members of their whānau. Structural, descriptive and pattern coding was completed using an adapted cultural competence framework to organise and analyse the data. Results: Three themes were evident from participants’ critique of clinical components of the health system. Theme 1 established that the efficacy of clinical care for bipolar disorder was dependent on Māori patients and whānau having clear pathways through care, and being able to access timely, consistent care from clinically and culturally competent staff. Theme 2 identified the influence of clinical culture in bipolar disorder services, embedded into care settings, expressed by staff, affecting the safety of clinical care for Māori. Theme 3 focused on the need for bipolar disorder services to prioritise clinical work with whānau, equip staff with skills to facilitate engagement and tailor care with resources to enhance whānau as well as patient wellbeing. Conclusion: The standard of clinical care for Māori with bipolar disorder in New Zealand does not align with practice guidelines, Māori models of health or clinical frameworks designed to inform treatment and address systemic barriers to equity. Research also needs to explore the role of structural and organisational features of the health system on Māori patient and whānau experiences of care.

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Blended learning: Barriers and drawbacks for English language lecturers at Vietnamese universities

E-Learning and Digital Media ◽

10.1177/20427530211048235 ◽

2021 ◽

pp. 204275302110482

Author(s):

Thi Nguyet Le ◽

Bill Allen ◽

Nicola F Johnson

Keyword(s):

Blended Learning ◽

Teaching And Learning ◽

English Language ◽

English Language Teaching ◽

Successful Implementation ◽

Structured Interviews ◽

Policy And Practice ◽

Web Based ◽

Learning Barriers ◽

Teaching Time

Although blended learning (BL) has emerged as one of the most dominant delivery modes in higher education in the 21st century, there are notable barriers and drawbacks in using BL for English language teaching and learning in Vietnamese universities. This study reports on research into the use of BL, conducted through semi-structured interviews with 30 English as a Foreign Language (EFL) lecturers from 10 different universities across the two major cities of Vietnam. The findings revealed that EFL lecturers identified eight groups of barriers and four groups of drawbacks to the successful implementation of BL. The most significant barriers included: lack of infrastructure and technology, institutional policies and support; lack of knowledge, experience and investment in using BL; lack of technological competence and information technology (IT) skills and lack of teaching time to employ web-based technologies and online resources in classrooms. Meanwhile, the most crucial drawbacks were: lecturers’ workload, ineffective use of BL, time consumption and demotivation. The authors point to the underlying factors contributing to these barriers and drawbacks and make implications for how some of these can be effectively addressed through constructive changes to policy and practice.

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‘Ice’ flavoured e-cigarette use among young adults

Tobacco Control ◽

10.1136/tobaccocontrol-2020-056416 ◽

2021 ◽

pp. tobaccocontrol-2020-056416

Author(s):

Adam Leventhal ◽

Hongying Dai ◽

Jessica Barrington-Trimis ◽

Steve Sussman

Keyword(s):

Young Adults ◽

Los Angeles ◽

Tobacco Use ◽

Cross Sectional Study ◽

Cigarette Use ◽

Cross Sectional ◽

Web Based ◽

The Past ◽

Frequency Of Use ◽

Exposure Variable

Background‘Ice’ e-cigarette flavours—marketed as a combination of fruity/sweet and cooling flavours (eg, ‘blueberry ice’ or ‘melon ice’)—recently entered the US market. The prevalence and correlates of ice flavoured e-cigarette use in young adults are unknown.MethodsThis cross-sectional study of a Los Angeles, California, USA, cohort analysed data from the past 30-day e-cigarette (current) users (n=344; M (SD)=21.2 (0.4) years old) who completed web-based surveys from May–August 2020. The exposure variable was self-reported e-cigarette flavour used most often in the past month (menthol/mint, fruit/sweet or ice). Outcomes included self-reported combustible tobacco use, vaping dependence symptoms, frequency of use and device type used.ResultsAmong current e-cigarette users, 48.8% reported using ice flavours most often, 33.7% predominately used fruit/sweet and 17.4% used menthol/mint. Using primarily ice-flavour was associated with reporting more past-30-day vaping days (vs menthol/mint: b=4.4, 95% CI (1 to 7.7); vs fruit/sweet: b=3.6, 95% CI (0.8 to 6.4)) and more episodes per vaping day versus fruit/sweet users (b=2.4, 95% CI (0.5 to 4.3)). Ice-flavour users were less likely than menthol/mint users to use JUUL/cartridge-based rechargeable (OR=0.1, 95% CI (0.03 to 0.45)) and more likely than sweet/fruit users to use disposable non-cartridge (OR=3.9, 95% CI (2.1 to 7.4)) devices than refillable/rechargeable tank/pen or other devices. Ice users had greater odds of past 30-day combustible tobacco use versus menthol/mint users (OR=2.7, 95% CI (1.3 to 5.7)) and vaping dependence symptoms than versus sweet/fruit users (OR=2.6, 95% CI (1.5 to 4.4)).ConclusionYoung adult use of ice flavoured e-cigarettes may be common and positively associated with combustible tobacco use, nicotine vaping frequency and dependence and use of disposable e-cigarette devices. Further study of the prevalence, determinants and health effects of ice flavoured e-cigarette use is warranted.

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KEPEMIMPINAN LURAH DALAM PENGELOLAAN BANK SAMPAH DI KELURAHAN RAYA KECAMATAN SINGKEP BARAT KABUPATEN LINGGA PROVINSI KEPULAUAN RIAU

Jurnal Pemerintahan Dan Keamanan Publik (JP dan KP) ◽

10.33701/jpkp.v3i1.1943 ◽

2021 ◽

pp. 13-27

Author(s):

Agung Nurrahman ◽

Gatiningsih Gatiningsih ◽

Muhammad Tri Syaputra

Keyword(s):

Environmental Issues ◽

Research Data ◽

Community Leaders ◽

Structured Interviews ◽

Political Will ◽

Descriptive Research ◽

Qualitative Descriptive ◽

Waste Bank

This research focuses on how leadership has a major role in addressing environmental issues, especially through the garbage bank program as a form of case study. Furthermore, the problems that occur in the midst of society are often rely solely on political will or political desire to solve them. The research is to know and learn Lurah's (head of village) leadership in the management of waste banks specifically. This research is qualitative descriptive research. Data collection techniques through structured interviews, documentation and observations. Researchers conducted an analysis using leadership theory from Yukl, where the theory discusses leadership comprehensively. Researchers only focus on five parts of the concept that are considered relevant, namely: visionary, guidance, affiliative, democratic and communicative concepts. The results of this study based on these dimensions are good enough Lurah (head of village) leadership. But there are several things that are considered able to optimize the running of the program through the role of Lurah (Head of village) leadership, namely: first, involving active knots and community leaders such as MUI, academics to support scientific aspects, and professionals in the field of practical management. Keywords: Leadership, Head of Village, Environmental Issues, Waste Management, Waste Bank

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“It can’t happen to me”

Nordic Studies on Alcohol and Drugs ◽

10.1177/1455072517733597 ◽

2017 ◽

Vol 34 (5) ◽

pp. 385-399 ◽

Cited By ~ 3

Author(s):

Vendula Belackova ◽

Barbara Janikova ◽

Jaroslav Vacek ◽

Hana Fidesova ◽

Michal Miovsky

Keyword(s):

Rapid Assessment ◽

Alcoholic Beverages ◽

Vulnerable Groups ◽

Lower Probability ◽

Drinking Patterns ◽

Structured Interviews ◽

Emergency Situations ◽

Response Method ◽

Alcohol Users ◽

The Impact

Background: In September 2012, a series of methanol poisonings occurred in the Czech Republic as a result of an influx of illicit alcohol into (predominantly) cheap alcoholic beverages on the retail market. The public authorities decided to prevent public health risks by prohibiting sales of liquors that contained more than 20% alcohol (> 20% liquor). The “partial” prohibition lasted for almost two weeks, but the poisonings still continued. This article assesses the impact of the methanol poisoning risks and the (partial) prohibition on alcohol drinking patterns, and describes the understanding of risks and their mitigation in vulnerable groups. Methods: The rapid assessment and response method (RAR) was used during the (partial) alcohol prohibition. Semi-structured interviews were conducted with respondents recruited for the study in alcohol-intake settings (e.g., bars and restaurants, street alcohol outlets) in six regions. In total, 107 alcohol users were interviewed, mostly with risky drinking patterns (69% scored ≥ 1 on the CAGE scale), and 53 alcohol retailers/staff members serving alcohol. Results: About one third of the alcohol users in the study (35%) drank > 20% liquors during the prohibition; a higher score on the CAGE scale was associated with a lower probability of drinking > 20% liquors during the period of the prohibition, probably because of the perception of being at high risk of poisoning. There was some increase in drinking liquors with an alcohol content less than 20%. Those who continued drinking > 20% liquors typically did so in the belief that some sources of these were safe. Conclusions: Public policies aimed at reducing the risk of methanol poisonings in emergency situations should adopt broader measures than those focusing on market control. These measures include increased access to brief interventions, addressing the strategies that alcohol consumers adopt to prevent risk, and, in general, helping consumers make informed choices to prevent further fatalities.

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Promoting Peer-to-Peer Ridesharing Services as Transit System Feeders

Transportation Research Record Journal of the Transportation Research Board ◽

10.3141/2650-09 ◽

2017 ◽

Vol 2650 (1) ◽

pp. 74-83 ◽

Cited By ~ 12

Author(s):

Neda Masoud ◽

Daisik Nam ◽

Jiangbo Yu ◽

R. Jayakrishnan

Keyword(s):

Los Angeles ◽

Travel Demand ◽

Decision Support Tool ◽

Peer To Peer ◽

Successful Implementation ◽

Modeling Framework ◽

Transit System ◽

Support Tool ◽

Demand Shifts ◽

Red Line

Peer-to-peer (P2P) ridesharing is a recently emerging travel alternative that can help accommodate the growth in urban travel demand and at the same time alleviate problems such as excessive vehicular emissions. Prior ridesharing projects suggest that the demand for ridesharing is usually shifted from transit, but its true benefits are realized when the demand shifts from single-occupancy vehicles. This study investigated the potential of shifting demand from private autos to transit by providing a general modeling framework that found routes for private vehicle users that were a combination of P2P ridesharing and transit. The Los Angeles Metro Red Line in California was considered for a case study because it has recently shown declining ridership trends. For successful implementation of a ridesharing system, strategically selecting locations for individuals to get on and off the rideshare vehicles is crucial, along with an appropriate pricing structure for the rides. The study conducted a parametric analysis of the application of real-time P2P ridesharing to feed the Los Angeles Metro Red Line with simulated demand. A mobile application with an innovative ride-matching algorithm was developed as a decision support tool that suggested transit-rideshare and rideshare routes.

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Administrative Work and Job Role Beliefs in Primary Care Physicians: An Analysis of Semi-Structured Interviews

SAGE Open ◽

10.1177/2158244019899092 ◽

2020 ◽

Vol 10 (1) ◽

pp. 215824401989909

Author(s):

Eric Apaydin

Keyword(s):

Primary Care ◽

Los Angeles ◽

Primary Care Physicians ◽

Theory Approach ◽

Structured Interviews ◽

Job Roles ◽

Face To Face ◽

Administrative Work ◽

Job Role ◽

The Relationship

Primary care physicians face increasing amounts of administrative work (e.g., entering notes into electronic health records, managing insurance issues, delivering test results, etc.) outside of face-to-face patient visits. The objective of this study is to qualitatively describe the experience that primary care physicians have with administrative work, with an emphasis on their beliefs about their job role. I conducted semi-structured interviews with 28 family physicians and internists in Chicago, Los Angeles, and Miami and qualitatively analyzed themes from interview transcripts using the grounded theory approach. Two major themes concerning the relationship between primary care physicians and administrative work were discovered: (a) Administrative work was not central to primary care physicians’ job role beliefs, and (b) “below license” work should be delegated to nonphysicians. Job roles should be considered in future efforts to reduce physician administrative work in primary care.

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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 ◽

10.3390/risks6030081 ◽

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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