Multisectoral perspectives toward a sustainable energy transition in Puerto Rico: Implications for the post-2017 Atlantic Hurricane Season.

Puerto Rico experienced the most prolonged power outage in US history after two hurricanes hit the Archipelago in September 2017. Hurricane Irma left over one million people without electricity, and Hurricane Maria left Puerto Rico in a total blackout when it hit. The damages to 80 percent of the electrical grid opened the possibility to the Puerto Rico Electric Power Authority to explore options beyond merely reconstructing and keeping the grid centralized. Prior to these events, an active public discussion on how to transform the electrical system had been occurring regarding a new energy policy passed in 2014 that created Puerto Rico's first Energy Commission and concerning the first Integrated Resource Plan approved in 2016. OBJECTIVE: This study aimed to examine stakeholders' visions, values, perceived barriers, and opportunities for a sustainable energy transition before the 2017 Atlantic Hurricane Season and how the stakeholders' perspectives have been manifesting during post-disaster efforts. DESIGN: This study examined working documents generated by an Energy Stakeholders Forum (ESF) and semistructured interviews with key stakeholders in the energy decision-making arena. SETTING: The data analyzed in this study were collected for 2 years (2015-2016) before Hurricanes Irma and Maria hit Puerto Rico. The ESF had a series of meetings to generate multisectoral dialog and pursue more public participation in energy policy and planning processes. The semistructured interviews were conducted as part of an NSF-Critical Resilient Infrastructure Systems and Processes project investigating stakeholders' perspectives on the electrical system. PARTICIPANTS: Thirty-one stakeholders participated in face-to-face semistructured interviews using purposive and snowball sampling. The ESF's meetings not only gathered up to 60 key stakeholders but also were open to the public. RESULTS: This study suggests that stakeholders' perspectives were consistent with the prerequisites for a transition to renewable energy before the 2017 Atlantic Hurricane Season. However, even though the conditions of vision and values were present, there was also predisaster inertia from nontechnical barriers preventing the sustainable transition that still prevails in post-disaster Puerto Rico. CONCLUSION: This paper provides an empirical reflection that ponders Puerto Rico's post-disaster scenario through predisaster stakeholders' perspectives. Emergency management professionals should reflect on why understanding predisaster conditions is critical in order to promote recovery efforts that meet the long-term needs of society and support sustainable development for future generations. The analysis may also reinforce planning for disaster recovery via governance approaches that consider stakeholders' perspectives before disasters strike.

Efficacy of tobacco dependence treatment in the context of a "smoke-free grounds" worksite policy: a case study.

BACKGROUND: Smoking restrictions provide opportunities to modify smoking behavior. A large insurance company implemented a smoke-free grounds policy at two of their office complexes in January, 2000. METHODS: This cohort study evaluated the impact of the smoke-free grounds policy on abstinence among 128 employees who participated in a tobacco dependence treatment program. RESULTS: The overall quit rate at 6 months was 44.5%. The larger complex showed a trend for higher quit rates compared to the smaller complex (46.5 vs. 28.6%). Post-ban participants had higher quit rates than pre-ban participants (52.4 vs. 43.0%). The probability of abstinence at 6 months follow-up was higher for post-ban compared to pre-ban participants (P = 0.03). Post-ban participants were 80% less likely to relapse than pre-ban participants. Non-quitters decreased their consumption by 6.6 cigarettes/day (39.1% decrease). CONCLUSIONS: A "smoke-free grounds" policy encourages abstinence and may play a significant role in harm reduction among continuing tobacco users.

Evaluating risk communication about fish consumption advisories: efficacy of a brochure versus a classroom lesson in Spanish and English.

Presentation format can influence the way target audiences understand risk-related information. Brochures or fish fact sheets are the methods traditionally used by state agencies to inform the public about fish consumption advisories and the risks from consuming fish. This study examines the efficacy of presenting information about the risks from consuming contaminated fish and shellfish in two different formats: a brochure and classroom presentation. The two instruments were developed and tested in Spanish and English, reflecting the local ethnic composition in the Newark Bay Complex. The instruments were tested on women of child-bearing age at the Women, Infants, and Children Center in Elizabeth, New Jersey. Detailed diagrams were used in both presentations, including contaminated fish species, fish preparation methods, and food chain bioaccumulation and transmission to the fetus. There were few language-related differences in the efficacy of the classroom lesson, and the main ideas were understood by both groups. Where there were significant differences in understanding about the risks from consuming fish or crabs from the contaminated waters of Newark Bay, in all cases the women exposed to the classroom lesson had a better understanding than those who read the brochure. Ninety-six percent of the women who heard the lesson understood that it was unsafe to eat fish from the port, compared to 72% of those reading the brochure. Both formats succeeded in imparting information to most women about the area under advisories, the fish species under advisories, and transmission of toxins to the fetus. Information on fish preparation was recalled less clearly, partly because women were asked to relate methods to reduce the risk from consuming fish from 11 presented, and most recalled only two or three of the list. The advantages and disadvantages of conducting short classes to women of child-bearing age are discussed.

A pilot study of telephone-based smoking cessation intervention in asbestos workers.

Smoking markedly increases the risk of asbestos-related lung cancer. We conducted a randomized pilot trial of a telephone-based smoking cessation intervention in asbestos workers. Fifty-nine smokers were assigned to either a control or telephone-based smoking cessation treatment group and were followed-up at 6 months. Intent-to-treat analysis revealed a 16.7% quit rate at 6 months for the intervention group compared to 6.9% for the control group (P = 0.25). Treatment-received quit-rates were 33% for the intervention group and 6.9% for the control group (P = 0.05). The intervention group was twice as likely to use smoking cessation medicines and progressed further along the stage of change continuum compared with the control group. Incorporating telephone-based smoking cessation treatment into medical screening activities for asbestos workers is feasible and the intervention is effective in increasing quit rates at 6 months.