Vietnamese Ethnicity Research Articles

How We Feel: COVID-19 Pandemic Experiences Among Intergenerational Cambodian, Laotian, and Vietnamese Americans in San Francisco

The COVID-19 pandemic has exacerbated many social determinants of health and barriers to health care for Southeast Asian Americans. The objective of this study is to understand the impact of the COVID-19 pandemic on Southeast Asian American communities’ health care utilization and need for support. This cross-sectional study administered surveys and conducted focus groups with 78 participants (>= 14 years) across generations and Cambodian, Laotian, and Vietnamese ethnicity in partnership with the Southeast Asian Development Center in San Francisco, California between July and September 2021. We identified two themes in health care utilization: barriers to health care and fear of anti-Asian violence; two themes in COVID-19 prevention: utilization of COVID-19 services and COVID-19 safety precautions; and two themes in the role of community and community centers: intergenerational community and crucial services provided by community centers. Despite the challenges posed by the duality of the COVID-19 pandemic and fear of anti-Asian violence, Southeast Asian Americans persisted with resilience to seek health services with intergenerational support and the guidance of community centers. This highlights the significance of community-oriented health among Southeast Asian Americans and the value of community-led health interventions in advancing health for a historically underserved population.

Factors associated with hepatitis B knowledge among people of Vietnamese ethnicity in Australia

ABSTRACT Despite high hepatitis B (HBV) prevalence among people of Vietnamese ethnicity in Australia and elsewhere, there is limited research on levels of HBV knowledge and factors associated with such knowledge. The aim of this study was to examine HBV knowledge and associated demographic and attitudinal factors among people of Vietnamese ethnicity in Australia. People of Vietnamese ethnicity (n = 966) were recruited through community events and social media groups to complete online surveys measuring HBV knowledge, attitudes towards HBV, levels of mistrust in Western medicine, and demographic characteristics. Findings of this study indicate that levels of knowledge are mixed, with gaps in knowledge related to transmission and treatment of the virus. Those with greater knowledge of HBV tended to be older, have higher levels of formal education, have been tested for HBV, and know someone living with HBV. Those with lower levels of knowledge tended to have more negative attitudes towards the virus and greater levels of mistrust in Western medicine. Given that health literacy is connected to effective communication from health providers, we suggest that there is a need for the development of health promotion and education resources targeted at people of Vietnamese ethnicity and translated into Vietnamese. We propose that such resources be developed in consultation with Vietnamese communities and health providers to ensure that they are culturally appropriate and sensitive to people of Vietnamese ethnicity living in Australia.

Food Insecurity, Financial Hardship, and Mental Health Among Multiple Asian American Ethnic Groups: Findings from the 2020 COVID-19 Household Impact Survey.

Background:The COVID-19 pandemic has adversely impacted the financial and mental well-being of U.S. adults, however, Asian American (AA)-specific data are lacking, particularly disaggregated by AA ethnicity. Our objective was to evaluate food insecurity (FI), financial hardship, and mental health among disaggregated AA ethnic groups during the COVID-19 pandemic.Methods:We used data from the COVID-19 Household Impact Survey, a sample of 10,760 U.S. adults weighted to reflect the U.S. population (weighted n: 418,209,893). AA ethnic categories were based on self-report (n=312, 5.1%; weighted n: 21,143,079) and provided as follows: Chinese American, South Asian, Filipino+Vietnamese, and Japanese+Korean. We estimated the prevalence of FI and financial hardship across AA ethnic categories. We estimated the demographic determinants of FI, including financial hardship, among AA adults using multivariable Poisson regression. We calculated the prevalence of mental health symptoms among food-insecure AA adults, as well as among AA adults experiencing both FI and financial hardship.Results:Overall, the prevalence of FI and financial hardship among AA adults was highest among Filipino+Vietnamese adults (52.9–24.5%) and lowest among Japanese+Korean adults (13.9–8.6%). Determinants of FI among AA adults included Filipino+Vietnamese ethnicity (adjusted prevalence ratios [aPR]: 2.81, 95% confidence interval [CI]: 1.49–5.29), being widowed/divorced/separated (aPR: 3.14, 95% CI: 1.37–7.23), high school graduate only (aPR: 3.46, 95% CI: 1.96–6.11), having low income <$30,000 (aPR: 2.54, 95% CI: 1.27–5.06), and living in rural areas (aPR: 7.65, 95% CI: 1.17–50.14). Eighty-one percent and 63% of AA adults with anxiety and hopelessness at least 3–7 days/week, respectively, were food insecure and experiencing financial hardship.Conclusion:Disparities exist in FI and financial hardship among AA adults, particularly Filipino+Vietnamese adults, and are associated with increased self-reporting of feelings of anxiety and hopelessness.

Apolipoprotein E Isoform-specific changes related to stress and trauma exposure

Post-Traumatic Stress Disorder (PTSD) is a highly prevalent mental health disorder. Due to the high level of variability in susceptibility and severity, PTSD therapies are still insufficient. In addition to environmental exposures, genetic risks play a prominent role and one such factor is apolipoprotein E. The protein (apoE) is functionally involved in cholesterol transport and metabolism and exists as 3 major isoforms in humans: E2, E3, and E4. To model the role of apolipoprotein E isoform in stress-related changes in behavior and cognition, female and male mice (3–5 months of age) expressing E2, E3, or E4 were used. Mice were either placed into control groups or exposed to chronic variable stress (CVS), which has been shown to induce PTSD-like behavioral and neuroendocrine changes. E2 mice showed a unique response to CVS compared to E3 and E4 mice that included impaired spatial learning and memory, increased adrenal gland weight, and no increase in glucocorticoid receptor protein levels (normalized to apoE levels). In addition, the cholesterol metabolite 7-ketocholesterol was elevated in the cortex after CVS in E3 and E4, but not E2 female mice. E2 confers unique changes in behavioral, cognitive, and biomarker profiles after stress exposure and identify 7-ketocholesterol as a possible novel biomarker of the traumatic stress response. We further explored the relationship between E2 and PTSD in an understudied population by genotyping 102 patients of Cambodian and Vietnamese ethnicity. E2 carriers demonstrated a higher odds ratio of having a PTSD diagnosis compared to E3/E3 carriers, supporting that the E2 genotype is associated with PTSD diagnosis after trauma exposure in this population.

Abstract PO-267: Demographic and psychosocial predictors of regular chronic hepatitis B monitoring among Asian Americans

Abstract Background: Asian Americans are 8-13 times more likely to develop liver cancer caused by chronic hepatitis B (CHB) and experience a 60% higher death rate than non-Hispanic whites. Doctor visitation for CHB monitoring every six months is effective to prevent liver cancer. Methods: This study utilized the baseline data from an ongoing randomized controlled clinical trial aimed at improving long-term adherence to CHB monitoring and treatment. The goal was to examine the association of sociodemographic and psychosocial factors with having a doctor's visit for their CHB in the past 12-months. Eligible Asian American CHB patients were recruited from the Greater Philadelphia Area and New York City. Multivariable logistic regression was conducted to test the associations. Results: The analysis sample consists of 240 participants, among which 74% did not have a college degree, 46% had lower than $20,000 annual household income, 72% had limited English proficiency. Multivariable logistic regression showed that a higher hepatitis B (HBV) knowledge score (OR = 1.24, p &amp;lt; 0.01) and having a regular physician (OR = 3.45, p &amp;lt; .05) were significantly associated with a higher chance of having visited a doctor in the past 6 months for their CHB management. Having health insurance (OR = 4.63, p &amp;lt; .05), a higher knowledge score (OR = 1.29, p &amp;lt; .01), and a higher CHB management motivation score (OR = 1.12, p &amp;lt; .001) were associated with a higher chance of having blood work done in the past 6 months; Vietnamese ethnicity (vs Chinese) and having a college degree (vs not) were associated with a lower chance of testing. Conclusion: Our study found that both sociodemographic and psychosocial factors had significant impacts on CHB management, suggesting that addressing barriers to health care and improving CHB patients' psychosocial status would be effective intervention strategies to promote CHB management and liver cancer prevention among vulnerable Asian Americans with CHB. Citation Format: Lin Zhu, Wenyue Lu, Sarit Golub, Yin Tan, Ming-Chin Yeh, Minhhuyen T Nguyen, Elizabeth Handorf, Grace X. Ma. Demographic and psychosocial predictors of regular chronic hepatitis B monitoring among Asian Americans [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-267.

Stage and cancer-specific mortality differ within specific Asian ethnic groups for upper tract urothelial carcinoma: North American population-based study.

To examine the effect of specific Asian ethnic subgroups on stage at presentation and cancer-specific mortality in non-metastatic upper tract urothelial carcinoma among North American upper tract urothelial carcinoma Asian patients treated with radical nephroureterectomy. We relied on the Surveillance, Epidemiology and End Results database, from 2004 to 2016. Kaplan-Meier plots and multivariable Cox regression models predicting cancer-specific mortality were used. Of 584 upper tract urothelial carcinoma patients, 173 (29.6%) were Chinese versus 130 (22.3%) Japanese versus 68 (11.6%) Korean versus 64 (11.0%) Filipino versus 40 (6.8%) Vietnamese versus 109 (18.7%) other. Vietnamese and Chinese patients showed the highest rates of T4 N0 M0 and/or T1-4 N1-2 M0 (25.0% and 18.5%, respectively), relative to other Asian ethnic subgroups. In Kaplan-Meier plots, Vietnamese patients showed the highest cancer-specific mortality rate. In multivariable models, Vietnamese ethnicity also independently predicted higher cancer-specific mortality (hazard ratio 2.15, P=0.02 and hazard ratio 1.96, P=0.03), relative to Japanese and Chinese patients. All other Asian ethnic subgroups showed similar cancer-specific mortality patterns. Vietnamese and Chinese patients are at a stage disadvantage at upper tract urothelial carcinoma diagnosis, relative to all other Asian ethnicities. After adjustment for stage, only Vietnamese patients showed a survival disadvantage relative to all other Asian ethnic subgroups. As a result, it appears that Vietnamese patients not only present at a higher upper tract urothelial carcinoma stage, but additionally appear to harbor upper tract urothelial carcinoma that progresses at a faster rate than in other Asian ethnic subgroups.

Establishment of a Vietnamese ethnicity induced pluripotent stem cell line (VRISGi001-A) from umbilical cord blood hematopoietic stem cells under a feeder-free system

We have established the original footprint-free Vietnamese human induced pluripotent stem cell line, VRISGi001-A, from cord-blood derived CD34 + hematopoietic stem cells (HSCs) of a 35 year old healthy woman under cGMP-compliant process. For the hiPSC induction, three Sendai virus vectors carrying four reprogramming factors including c-MYC, SOX2, KLF4, and OCT3/4 were delivered into CD34+ HSCs. The VRISGi001-A cell line expresses the majority of the pluripotent markers and differentiate in vitro into derivatives of three germ layers. The availability of Vietnamese hiPSC line could contribute to the improvement of inadequate genetic diversity in the currently available hiPSC lines.

The Three-Tiered World of the Tay People in Vietnam through the Performance of Then Rituals

The Tay people represent an ethnic minority in the mountainous north of Vietnam. As do Shaman rituals in all regions, the Shaman of the Tay people in Vietnam exhibit uniqueness in their languages and accommodation of their society’s world view through their ‘Then’ rituals. The Then rituals require an integration of many artistically positioned and framed elements, including language (poetry, vows, chanting, the dialogue in the ritual), music (singing, accompaniment), and dance. This paper investigates The Art of Speaking of the Tay Shaman, through their Then rituals, which include use of language to describe the imaginary journey of the Shaman into the three- tiered world (Muong fa - Heaven region (Thien phu); Muong Din - Mountain region (Nhac phu); Muong Nam - Water region (combination of Thuy phu and Dia phu) to describe dealings with deities and demons, and to describe the phenomenon of possession. The methodic framework of the paper thus includes discussions of in the comparison between the concept of the three-storey world in the Then ritual of the Tay people with the concept of Tam Tu phu in the Len dong ceremony of the Kinh in Vietnam. Thereby, it clearly shows the concept of Tay people of the universe, the world of gods, demons, the existence of the soul and the body, and theexistence of human soul after death. The study contributes to Linguistics and Anthropology in that it observes and describes the world views of a Northern Vietnamese ethnicity, and their negotiation with spirituality, through languages of both a spiritualistic medium and society.

Effects of Asian immigrants’ group membership in the association between perceived racial discrimination and psychological well-being: the interplay of immigrants’ generational status, age, and ethnic subgroup

ABSTRACTUsing data from the National Latino and Asian American Study (NLAAS) (2002–2003) of 2,059 Asian immigrants, the given study explores the effects of perceived racial discrimination on participants’ psychological well-being. Asian immigrants’ group membership factors – immigrants’ generational status, age, and ethnic subgroup – were tested for possible moderating effects through two sets of regression analyses. Results indicated that immigrants’ generational status was not a significant moderating factor. However, young adults (ages 18–24) and Vietnamese ethnicity showed the most vulnerability when they experienced racial discrimination. Findings from the current study provide a number of important implications for policy and social work practice.

McLeod syndrome: Five new pedigrees with novel mutations

ObjectiveTo present five new McLeod Syndrome (MLS) pedigrees with novel XK gene mutations, review the literature of this disorder, and discuss the typical and atypical clinical features noted with these new mutations. MethodsThis is a multi-center retrospective review of five MLS cases with novel gene mutations. Genotypic and phenotypic information has been obtained from each center. ResultsFive novel mutations are reported in this Case series. New clinical findings include prolonged asymptomatic elevated creatine kinase (CK) levels, vocal tics, presence of obstructive sleep apnea (OSA), and one patient of Vietnamese ethnicity. ConclusionsWe expand on the clinical and genetic spectrum of MLS demonstrating the clinical variability of MLS.

Diarrheal knowledge and preventative behaviors among the caregivers of children under 5 years of age on the Tonle Sap Lake, Cambodia.

PurposeAlthough Cambodia has made significant progress toward lowering the under-five mortality rate since 2000, diarrhea still accounts for 6% of the total number of these deaths. A vast majority of these deaths is preventable. In this study, we sought to examine diarrheal knowledge and preventative behaviors of caregivers of children under the age of 5 years, to determine caregiver factors associated with knowledge and behavior scores.Patients and methodsThis was a cross-sectional household-level study conducted in two floating villages on the Tonle Sap Lake, Cambodia between January and February 2014. Caregivers of children under 5 years of age in the villages of Steung Trov and Moat Khla were asked 31 true or false questions to assess their knowledge of diarrhea. They also filled out a questionnaire to assess diarrhea preventative behaviors (DPBs). Comparison of mean scores to categorical caregiver variables was performed using one-way ANOVA analysis. Spearman’s rank correlation was applied to identify the relationship between the knowledge and preventative behavior scores and independent quantitative variables.ResultsA total of 101 caregivers of 161 children under 5 years of age were interviewed. The majority of them (85.1%) was classified as having good knowledge and scored >80% on the assessment. Those with Khmer ethnicity (mean=28.10) scored significantly higher than those with Vietnamese ethnicity (mean 26.00; p=0.004). Older age was correlated with higher knowledge scores (ρ=0.2260; p=0.023) and DPB scores (ρ=0.2320; p=0.019). Significant differences were found between the DPB score and ethnicity, educational background, and wealth (p<0.01).ConclusionAlthough the majority of caregivers had high diarrheal knowledge scores, preventative behaviors for diarrhea as assessed by this study were poor among almost all study participants. Vietnamese, wealthier, older, and more educated participants had better prevention scores. Future interventions in this remote region may benefit from these data as a guide to determine which specific preventative behaviors should be targeted.

Ethnic Platforms and the Failure of Techno-Futurity

This article analyzes a novel yet fleeting configuration of ethnicity, the ethnic platform. Through ethnographic fieldwork of a diasporic Vietnamese entrepreneurial organization, this article explains why this attempt to create economic potential through Vietnamese ethnicity eventually failed. The ethnic platform was organized around two regimes of futurity. On the one hand, the ethnic platform was founded on a hope for a transcendent Vietnamese ethnicity that organized future as potential and forward momentum. This future potential, however, stood at odds with the future present of a refugee subjectivity that shaped the ethnic formation of many of these diasporic entrepreneurs. Hence, the ethnic platform was situated at the disjuncture between incommensurate ethnic temporalities. Despite the ethnic platform’s short-lived existence, this article underscores the importance of failure as an ethno-temporal critique through which we come to see the struggles and limits of techno-capitalism.

NRG1 fusion in a French cohort of invasive mucinous lung adenocarcinoma.

Invasive mucinous lung adenocarcinoma (IMA) is a rare subtype of lung adenocarcinoma with no effective treatment option in advanced disease. KRAS mutations occur in 28–87% of the cases. NRG1 fusions were recently discovered in KRAS‐negative IMA cases and otherwise negative for known driver oncogenes and could represent an attractive therapeutic target. Published data suggest that NRG1 fusions occur essentially in nonsmoking Asian women. From an IMA cohort of 25 French patients of known ethnicity, driver oncogenes EGFR, KRAS, BRAF, ERBB2 mutations, and ALK and ROS1 rearrangements presence were analyzed. In the IMA samples remaining negative for these driver oncogenes, an NRG1 rearrangement detection was performed by FISH. A driver oncogene was identified in 14/25 IMA, namely 12 KRAS mutations (48%), one ROS1 rearrangement (4%), and one ALK rearrangement (4%). The detection of NRG1 rearrangement by FISH was conducted in the 11 pan‐negative IMA. One sample was NRG1 FISH‐positive and 100% of the tumor nuclei analyzed were positive. This NRG1‐positive patient was a 61‐year‐old nonsmoking woman of Vietnamese ethnicity and was the sole patient of Asian ethnicity of the cohort. She died 6 months after the diagnosis with a pulmonary multifocal disease. NRG1 FISH detection should be considered in patients with IMA pan‐negative for known driver oncogenes. These results might suggest that NRG1 fusion is more frequent in IMA from Asian patient. Larger studies are needed.

Using Cognitive Testing to Develop Items for Surveying Asian American Cancer Patients and Their Caregivers as a Pathway to Culturally Competent Care.

We report the results from cognitive interviews with Asian American patients and their caregivers. We interviewed seven caregivers and six patients who were all bilingual Asian Americans. The main goal of the cognitive interviews was to test a survey instrument developed for a study about perspectives of Asian American patients with advanced cancer who are facing decisions around end-of-life care. We were particularly interested to see whether items commonly used in White and Black populations are culturally meaningful and equivalent in Asian populations, primarily those of Chinese and Vietnamese ethnicity. Our exploration shows that understanding respondents' language proficiency, degree of acculturation, and cultural context of receiving, processing, and communicating information about medical care can help design questions that are appropriate for Asian American patients and caregivers, and therefore can help researchers obtain quality data about the care Asian American cancer patients receive.

Prevalence and Risk Factors of Type 2 Diabetes in Older Vietnam-Born Australians

Vietnamese immigrants in Australia represent the second largest Vietnamese community in developed countries, following the United States. However, limited information is available about prevalence of type 2 diabetes (T2D) and the relative roles of socio-demographic characteristics, lifestyle factors, and Vietnamese ethnicity per se in this population. This study investigated the prevalence of T2D and its risk factors in older Vietnam-born Australians, in comparison to native-born Australians. The study used baseline questionnaire data from 787 Vietnam- and 196,866 Australia-born individuals (≥45years), who participated in the 45 and Up Study, which is Australia's largest population-based cohort study. Country of birth specific prevalence of T2D and its risk factors were age-standardised to the 2006 Australian population (≥45years). Multivariable logistic regression models were built for each group to assess the relationship between T2D and socio-demographic characteristics, family history of diabetes, lifestyle factors and health status. Compared to Australia-born counterparts, Vietnam-born individuals had significantly (p<0.001) higher age-standardised prevalence of T2D (14.7 vs 7.4%) and significantly (p<0.001) lower levels of vegetable consumption (≥5 serves/day, 19.4 vs 33.5%), physical activity (≥5 sessions/week, 68.7 vs 78.5%) and overweight and obesity (body mass index ≥25kg/m(2), 21.5 vs 62.7%). The increased risk of T2D associated with a family history of diabetes for Vietnam-born people [adjusted odds ratio (OR) 7.14, 95% CI 4.15-12.28] was almost double that for Australia-born people (OR 3.77, 95% CI 3.63-3.90). The patterns of association between T2D and other factors were similar between the two groups. The findings suggest a genetic predisposition to T2D in people of Vietnamese ethnicity. Reducing lifestyle risk factors for diabetes and better management of diabetes are priorities for Vietnam-born populations.

Factors Affecting on Access to Formal Credit of Households in the Mekong Delta, Vietnam

This paper investigates the factors affecting the access of rural households to formal credit in the Mekong Delta (MD), Vietnam. Poverty levels in the Mekong Delta have reduced significantly over the last decades, but in the rural areas they remain significant. If it is assumed that access to credit is a vehicle for poverty alleviation, it is necessary to assess how households decide on borrowing. This paper identifies the determinants of the decision to borrow and of the amount that is borrowed. Data used in this paper was obtained from a survey of 279 rural households, conducted between May and October 2009. The results of the Heckman Selection Model indicate that education, Vietnamese ethnicity, location, and the marital status of household’s head affect the probability to ask for credit and the size of loan obtained.

Ficolin-2 Levels and FCN2 Haplotypes Influence Hepatitis B Infection Outcome in Vietnamese Patients

Human Ficolin-2 (L-ficolins) encoded by FCN2 gene is a soluble serum protein that plays an important role in innate immunity and is mainly expressed in the liver. Ficolin-2 serum levels and FCN2 single nucleotide polymorphisms were associated to several infectious diseases. We initially screened the complete FCN2 gene in 48 healthy individuals of Vietnamese ethnicity. We genotyped a Vietnamese cohort comprising of 423 clinically classified hepatitis B virus patients and 303 controls for functional single nucleotide polymorphisms in the promoter region (-986G>A, -602G>A, -4A>G) and in exon 8 (+6424G>T) by real-time PCR and investigated the contribution of FCN2 genotypes and haplotypes to serum Ficolin-2 levels, viral load and liver enzyme levels. Haplotypes differed significantly between patients and controls (P = 0.002) and the haplotype AGGG was found frequently in controls in comparison to patients with hepatitis B virus and hepatocellular carcinoma (P = 0.0002 and P<0.0001) conferring a protective effect. Ficolin-2 levels differed significantly between patients and controls (p<0.0001). Patients with acute hepatitis B had higher serum Ficolin-2 levels compared to other patient groups and controls.The viral load was observed to be significantly distributed among the haplotypes (P = 0.04) and the AAAG haplotype contributed to higher Ficolin-2 levels and to viral load. Four novel single nucleotide polymorphisms in introns (-941G>T, -310G>A, +2363G>A, +4882G>A) and one synonymous mutation in exon 8 (+6485G>T) was observed. Strong linkage was found between the variant -986G>A and -4A>G. The very first study on Vietnamese cohort associates both Ficolin-2 serum levels and FCN2 haplotypes to hepatitis B virus infection and subsequent disease progression.

Association between limited English proficiency and understanding prescription labels among five ethnic groups in California

Objective. Misunderstanding of prescription labels results in adverse drug events and non-adherence. We assessed the effect of limited English and other factors on prescription understanding among five ethnic groups in a controlled analysis. Design. Subjects were respondents to California's 2007 Health Interview Survey who received a prescription in the past year. In separate logistic regressions, limited English's effect on self-reported prescription understanding – controlling for bilingual doctor, education level, medications for chronic conditions, disability, years in USA, citizenship and socio-demographics – was estimated for Mexicans, Central Americans, Chinese, Koreans, and Vietnamese. Results. Unweighted sample size was 48,968. Approximately 14% had limited English and 8% had difficulty in understanding prescriptions. In multivariate analysis, limited English increased odds of difficulty in understanding prescriptions by three times for Mexicans, Central Americans, and Koreans, and four times for Chinese; it was insignificant for Vietnamese. Generally, having a bilingual doctor reduced odds of difficulty while disability, low education, low income or recent immigration increased odds of difficulty. Effects varied according to the ethnic group. In controlled analysis, Chinese and Korean ethnicity increased odds of difficulty compared to Mexican or Central American ethnicity; Vietnamese ethnicity reduced odds of difficulty compared to others. Conclusions. Limited English blocked prescription understanding for all groups except Vietnamese. Translated prescription labels and interpreted in-person pharmacy consultations are indicated. Education and ethnicity affected prescription understanding; prescription instructions must be compatible with patients' educational level and culture. Bilingual/bicultural providers and interpreters can help bridge linguistic/cultural gaps but efforts should be made to ensure that they are truly culturally and linguistically concordant. Linguistic, cultural or educational needs should be noted in the patient's record or on the prescription to alert pharmacy staff. Sub-populations needing extra support include chronically ill, disabled, recent immigrants, low-income or rural inhabitants. Community outreach workers may provide an effective strategy for assisting these sub-populations with prescriptions.

Beyond neoclassical economics: Social process, agency and the maintenance of order in an Australian illicit drug marketplace

Background The dominant Australian approaches to understanding illicit drug marketplaces are surveillance and criminological research. These approaches rely on the elementary neoclassical economic model of the market which focuses primarily on supply and demand. In this paper, we draw on anthropological and sociological research to develop an alternative framework for understanding Australian illicit drug marketplaces that emphasises their constituent processes. Methods The paper draws on two years of ethnographic research among heroin user/sellers of Vietnamese ethnicity in an Australian heroin marketplace. Results Trade and barter were key modes of exchange in this marketplace. We identified active negotiation and bargaining over price on the basis of social relationships, with dealers and customers actively working to develop and maintain such ties. Dealers set price collectively and this was shaped by moral and cultural elements such as notions of a ‘fair’ price. Social processes and relations as well as shared cultural expectations helped to generate trust and maintain order in the marketplace. Conclusion Our ethnographic research suggests that the dominant Australian approaches to the study of illicit drug markets, with their reliance on the elementary neoclassical economic market model, ignore the social processes and social relations through which such sites are made and remade. Nor do they adequately capture the complex character of the subjects who act within these sites. If we are to expand our understanding of illicit drug markets and marketplaces in Australia, we must look beyond the conceptions offered by surveillance and criminological approaches.

Factors Associated with Ethnic Differences in Health Insurance Coverage and Type Among Asian Americans

This study examines the discrepancies in health insurance coverage and type across Asian American ethnic groups and the potential factors that may explain why these differences exist. Asian Americans are often considered as a homogeneous population and consequently, remain largely "invisible" in the current research literature. Recent data have highlighted discrepancies in the health insurance coverage between different Asian American ethnic groups-particularly the high uninsurance rates among Korean and Vietnamese Americans. For this study, the 2003 and 2005 California Health Interview Surveys were pooled to obtain a sample of 6,610 Asian American adults aged 18-64, including those of Chinese, Filipino, Japanese, South Asian, and Vietnamese ethnicity. Binomial and multinomial logistic regression models were used to examine the likelihood of current health coverage and insurance type (employer-based vs. private vs. public), respectively. The results showed that ethnic differences in uninsurance and insurance type were partially explained by socioeconomic and immigration-related characteristics-particularly for Vietnamese Americans and to a lesser extent, for Chinese and Korean Americans. There were also key differences in the extent to which specific ethnic groups purchased private insurance or relied on public programs (e.g., Medicaid) to offset the lack of employer-based coverage. This study reaffirms the tremendous heterogeneity in the Asian American population and the need for more targeted policy approaches. With the lack of adequate national data, more localized studies may help to improve our understanding of the health issues affecting specific Asian ethnic groups.