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PubMed2001

Substance abuse and dependence in a public hospital: Hawaii.

UNLABELLED: A pilot study of the prevalence of substance abuse disorders was completed on the only open unit of the only state psychiatric hospital in Hawaii to address the following questions: 1) What were the substances of abuse and dependence in this population? 2) What was the pattern of abuse and/or dependence in this sample? 3) How did these patterns compare to the patterns observed in the published literature? 4) What was the predominant Stage of Change of these patients? 5) Was the staff perception that these patients were in denial an accurate perception? METHODOLOGY: All patients admitted to the unit between 1st June and 31st August 1999 comprised the sample, N = 35. Each patient was assigned diagnoses based upon the DSM-IV criteria and level of change was assessed. RESULTS: The demographic characteristics of the sample follow: 60% were ages 20-39, 89% were male; 92% were currently single, 71% had an education of high school or college, and 66% had a diagnosis of schizophrenia or schizoaffective disorder. The racial composition reflected the diversity of Hawaii. Although 20% of the sample had no substance abuse problem, 66% of the remaining patients were multiply dependent upon alcohol, cannabis, crystal methamphetamine, or cocaine with 48% of these patients in the Precontemplative Stage of Change (denial). The patterns of multiple substances of abuse and dependence were higher than in the reported literature. Further studies are needed.

Adult↗
PubMed2001

Hepatitis C, diagnosis and management: a survey of practicing physicians in Hawaii.

We surveyed 652 Hawaii physicians who diagnosed hepatitis C (HCV) since 1997. Less than 20% of licensed physicians have diagnosed HCV and initial estimates suggest there are 12,000 to 18,000 undiagnosed HCV cases in Hawaii. Treatment is concentrated among twelve physicians and aggressive case finding may overwhelm present resources. More primary care physicians need to participate in the detection and management of HCV.

Adult↗
PubMed2001

The Kulia Program: psychiatric rehabilitation in Hawaii.

The Kulia Program was a culturally oriented, psychiatric rehabilitation program. It was developed in the only in-patient psychiatric hospital serving the 2 million multi-ethnic residents of the island state of Hawaii. From 1992-1999 the Kulia program was implemented on the only open, 36-bed unit of the Hawaii State Hospital with the mission of facilitating the reintegration of the chronically mentally ill into the community by encouraged its patients "to strive for the highest." Of the 238 patients discharged between 1992 and 1999 only 7% were re-hospitalized. Comparisons with other four treatment units during this period were not appropriate because of the difference in patient populations. These units provided long-term institutionalization of the criminally mentally ill, the behaviorally disoriented, mentally retarded and/or traumatically brain injured, and the behaviorally disoriented demented elderly. Their lengths of stay varied from 8 years to over 20 years in the hospital during this time period.

Chronic Disease↗
PubMed2002

Six years and counting: the NIH-funded Clinical Research Center of Hawaii.

The CRC was developed in 1995 to make Hawaii a site of innovative, progressive research. Since then, the numbers of researchers and publications supported by the CRC have increased. In the next several years, the CRC will expand further into Hawaii's research community and apply for GCRC status, a strategy that will attract even more resources and investigators to JABSOM.

Academic Medical Centers↗
PubMed2003

Cancer screening among Vietnamese in Hawaii.

OBJECTIVES: To determine the extent of utilization of cancer screening services by Vietnamese in Hawaii, who had sought medical care from 1996 through 2000. METHODS: A chart review of 952 adult Vietnamese patients was performed. RESULTS: Of all eligible women, 52% and 26% had Papanicolaou test and mammogram, respectively. Among men age 45 and over, 8.4% had prostate-specific antigen test and 3.4% had digital rectal exam. Flexible sigmoidoscopy and colonoscopy were not utilized by patients. CONCLUSIONS: This is the first study to examine the use of cancer screening tests by Vietnamese immigrants in Hawaii. Our findings of lower utilization rates in cancer screening by both male and female strongly support efforts to educate and promote preventive health for this population.

Adult↗
PubMedDate not supplied

A prospective comparison of prostate cancer at autopsy and as a clinical event: the Hawaii Japanese experience.

Prostate cancer was diagnosed in life among 274 of 8006 (3.6%) members of a cohort of Japanese men in Hawaii between 1965 and 1990. Only 55 (20%) of the 274 diagnosed cases died with prostate cancer, and they accounted for only 2% of the 2893 deaths that occurred among the men during this period. None of the 61 men whose tumor was found incidentally to a transurethral resection died as a result of this cancer, while it was the cause of death of 9 of 106 (8%) men with clinical cancer localized to the prostate. Forty-six of the 107 (43%) men with more extensive disease at the time of diagnosis died from prostate cancer. Step sectioning of the prostate identified prostate cancer in 80 of 293 (27%) autopsied Hawaii Japanese men who died after 50 years of age, reaching a frequency of 63% (10 of 16) among men over 80 years of age. The volume of 48 (60%) of these cancers was less than 150 mm3. These small tumors would probably not have been discovered in a screening program. Tumors larger than 1000 mm3 would probably be discovered using modern diagnostic procedures but were found in only 13 (4.4%) of the autopsied men. It is likely that a screening program to detect and treat such large, unsuspected tumors in this population would have had little impact upon the already low proportion of deaths due to prostate cancer among these Japanese men.

Aged↗
PubMed1955

Wild-rodent-flea control in rural areas of an enzootic plague region in Hawaii; a preliminary investigation of methods.

Preliminary field tests were carried out to develop methods for controlling fleas on wild rodents in the enzootic plague region of the Island of Hawaii. Among several designs, a metal hood-type DDT bait-box was developed which was simple in design, low in cost, easy to transport to and maintain in the field, protected the insecticide from the elements, and attracted all species of field rats inhabiting a gulch in the Hamakua District. These rats-Rattus rattus (and its subspecies), R. norvegicus, and R. hawaiiensis-readily fed in the DDT bait-boxes and were dusted with 10% DDT powder (in pyrophyllite) on contacting hanging cloth sacks, containing the insecticide, when entering and leaving the bait-boxes. The results indicate that a reduction of the plague-vector fleas, Xenopsylla cheopis and X. vexabilis hawaiiensis, may be obtained both on rats and within their burrows and nests, by the use of DDT bait-boxes. It is suggested that the use of such bait-boxes for wild-rodent-flea control may constitute a valuable method in the prevention of epizootics of plague in the Hamakua District, Hawaii.

Animals↗
PubMed2003

Descriptive epidemiological analysis of diving accidents in Hawaii from 1983 to 2001.

The Hyperbaric Treatment Center (HTC) at the University of Hawaii, has evaluated and treated over 1100 divers for dysbaric disease from 1983 to 2001. We describe some epidemiological parameters and compare trends between local residents and tourist divers in this article. Data obtained from this review were analyzed for age, gender, type of injury and resident status. While trends in Hawaii have mirrored national figures, we did determine that there were some significant differences between resident and tourist divers' patterns of injury over this period of time.

Age Distribution↗
PubMed2003

HIV and women in Hawaii: risk and protective factors in HIV/AIDS prevention.

Using semi-structured interviews with adults living with or at-risk for HIV and interviews and focus groups with key informants, the present study examined risk for HIV transmission among women living in Hawaii. Key research findings suggest that women in Hawaii are at risk for HIV infection primarily through sexual contact with their male sex partners, including bisexual and injection drug using (IDU) men. A significant factor in women's HIV risk is sex and gender role dynamics in the context of their relationships with men. Recommendations support primary prevention services for HIV-positive men who have sex with men and women, and IDU men who also have sex or share needles with women. Collaborative efforts between health care professionals and HIV/AIDS agencies to integrate gender-specific and culturally appropriate HIV prevention interventions are recommended.

Female↗
PubMed2003

Nursing workforce supply data trends in Hawaii.

Surveys of the nursing workforce in Hawaii over the last six years point to an increasing shortage of nurses. Data trends reveal a nursing workforce that is older than the rest of the U.S. with more ethnic and gender diversity. Strategies are needed to ensure adequate numbers and levels of nurses to meet the health care needs of the people of Hawaii.

Age Distribution↗
PubMed2003

Calcium intake of Asian and Caucasian adolescents in Hawaii.

The purpose of this study was to assess calcium intake of Asian and Caucasian adolescents in Hawaii, food and beverage sources of calcium, and key factors influencing calcium intake. Data were gathered in a cross-sectional survey of 51 adolescents and included two 24-hour recalls per person. Mean calcium intakes were below the U.S. Dietary Reference Intake's Adequate Intake level for calcium; still, they were higher than nationally reported calcium intakes of this age group. Although ethnic differences in dietary calcium intake were not seen between the Asian and Caucasian/Other group, the sample size may not be large enough to demonstrate a difference. Asians in Hawaii consumed more calcium than in previous studies. Caucasian/Other group consumed more non-fat milk than the Asian adolescent group. The Caucasian/Other group and the higher socio-economic group consumed more calcium from dietary supplements than Asians and the lower-socioeconomic group. A higher calcium intake was found on the weekday in comparison with the weekend (Sunday), which was largely due to calcium intake from school meals.

Adolescent↗
PubMed1992

Rabid bat diagnosed in Hawaii.

Since 1966, the Hawaii State Government has been conducting Fluorescent Rabies Antibody (FRA) testing on animal brains as part of a statewide rabies-surveillance program. On April 3, 1991, the Department of Health (DoH) laboratory diagnosed the first case of rabies detected in the State. A large brown bat, Eptesicus fuscus fuscus, captured in a transport container that had just been off-loaded from a ship at Honolulu harbor, was caught. It's brain was examined and showed typical fluorescent staining patterns for rabies virus. The USPHS Centers For Disease Control (CDC) rabies laboratory confirmed the diagnosis 2 days later. The successful interception of this rabid animal was the result of close cooperation between the private sector (Sea Land Service, Hawaiian Stevedores) and the Hawaii State Government Departments of Health and of Agriculture.

Animals↗
PubMed2004

Physicians and complementary-alternative medicine: training, attitudes, and practices in Hawaii.

INTRODUCTION: There were only few studies addressing the physicians' training, attitudes, and utilization of complementary and alternative medicine (CAM) therapies, compared to the well-documented escalating use of CAM among consumers. Patients who use CAM, however often do not disclose their utilization to their physicians. This study thus surveyed knowledge, attitudes, and practices of complementary and alternative medicine among physicians on the island of Oahu in Hawaii. The Hawaii Medical Service Association (HMSA) provided physicians' names and contact information. METHOD: This is a descriptive study with a questionnaire that was mailed to all physicians on the list. A total of 299 physicians responded to this survey. Response rate was 17.45%. RESULTS: Physicians reported having moderate acknowledge in acupuncture, massage, prayer/spiritualty chiropractic, hypnosis and meditation. They recognized the value of these treatments and refer their patients to have these treatments. On the other hand, homeopathy naturopathy, electromagnetic therapies, therapeutic/healing touch, and nutriceuticals were consistently rated as having no role in conventional medicine, strongly opposed to in practice, or would not refer patients to. Respondents felt CAM could be most effective for pain, musculoskeletal, psychological conditions and smoking cessation. DISCUSSIONS: Results indicated that the respondents had knowledge about prayer/spirituality, massage, chiropractic, meditation, hypnosis, and acupuncture, and also rated them as playing a role in conventional medicine, and would refer or have referred patients to. When they had little knowledge about naturopathy, electromagnetic therapies, nutriceuticals, and homeopathy, they rated these therapies as having no role in conventional medicine, and were strongly opposed to in practice or would not refer patients to. Respondents reported the least know abut the Aryurveda and Native American medicine. However, there was no significant correlation between negative attitude and practice patterns. Similarly therapeutic touch and chiropractic were perceived as therapies, but no role in conventional medicine although the respondents reported having some knowledge of these therapies. Thus, knowledge may not be necessarily associated with negative attitudes and practice patterns.

Attitude of Health Personnel↗
PubMed2004

The effect of migration on cancer incidence among Japanese in Hawaii.

OBJECTIVES: This analysis compared cancer incidence trends among Japanese in Japan, and Japanese and Caucasians in Hawaii, between 1960 and 1997, and estimated the impact of migration on the incidence of different cancers. METHODS: Incidence information was obtained from 8 volumes of Cancer Incidence in Five Continents. The migration effect was estimated from the areas under the incidence curves as the ratio of the geographic and the ethnic difference in cumulative cancer incidence. RESULTS: Among the 5 more common cancers, the migrant effect was strongest for colon and stomach cancers, prostate and breast cancers were affected to a lesser degree, and lung cancer risk differed little between Japanese in Japan and Hawaii. Migration led to lower risk of stomach, esophageal, pancreatic, liver, and cervical cancers, but to higher rates for all other cancers. The large variation in time for migrants to adopt the host population's cancer risk suggests that risk factors have organ-specific effects, or operate at different times in life. Although the available incidence rates are limited by under-reporting and early detection efforts, mortality rates confirm the significant differences in cancer risk. CONCLUSIONS: The persistent difference in cancer incidence several generations after migration supports the idea that living in the host country is not, alone, sufficient to modify cancer risk for all cancer sites to the level of the host population. Although the migration effect can be partially explained by known etiologic factors, a large proportion of the changing risk remains unexplained.

Asian People↗
PubMedDate not supplied

The health status of Vietnamese immigrants in Hawaii from chart records.

OBJECTIVES: We determined the most common diseases among adult Vietnamese men and women in Hawaii. METHODS: A chart review of 952 adult Vietnamese patients was conducted between January and February 2000. A data collection form with 39 categories of diagnosed chronic illnesses or problems was used. The study was conducted at a Vietnamese internist's private medical office in Honolulu, HI. RESULTS: Chart review revealed that the five most prevalent diagnostic conditions seen in Vietnamese men, from the highest to lowest frequency, were gastrointestinal disorders (39%), cutaneous conditions (31%), lower back pain (23%), headache (18%), and allergies (18%). In women, gastrointestinal disorders (38%), cutaneous conditions (34%), headache (32%), gynecologic conditions (30%), and arthritic diseases (24%) were most common. Gender, years of U.S. arrival, and types of occupation were significantly correlated with certain diseases (p< or =0.05). CONCLUSIONS: This is the first study to examine frequency of diseases diagnosed in an ambulatory care setting in a cohort of Vietnamese patients in Hawaii.

Adolescent↗
PubMed2005

A case control investigation of hepatitis C risk factors in Hawaii.

This case control investigation of hepatitis C risk factors in Hawaii showed that IV drug use, blood transfusion, tattoos, incarceration, acupuncture, prior dental or oral surgery, and HIV infection were associated with HCV Future public health efforts in Hawaii should focus on developing effective and appropriate community interventions targeting those with well-established risk factors for HCV

Adult↗
PubMed2006

Brief report: Leptospirosis after flooding of a university campus--Hawaii, 2004.

On November 19, 2004, the Hawaii Department of Health (HDOH) received a report that a University of Hawaii professor aged 56 years had been hospitalized with suspected leptospirosis after cleaning his flooded laboratory. On October 31, heavy rains had caused an adjacent stream to overflow its banks and flood the campus. Persons exposed to fresh water or mud contaminated by the urine of animals infected with the spirochete Leptospira interrogans can have systemic illness if the leptospires enter the body through broken skin or mucous membranes. This report describes the subsequent investigation by HDOH, assisted by CDC, which highlights the importance of maintaining clinical suspicion for leptospirosis after flooding in areas where the illness is endemic, even in well-developed urban settings.

Disasters↗
PubMed2006

Ethnic differences in hiv disease progression: a comparison of Asian/Pacific Islanders and Whites living in Hawaii.

OBJECTIVE: To characterize the association of demographic factors with the relative hazards (RH) of developing AIDS or death among HIV-infected individuals of Asian/Pacific Islander (API) ethnicity and Whites. DESIGN: Cohort study SETTING: Hawaii State Health Department database of HIV-infected individuals PATIENTS OR PARTICIPANTS: Hawaii Sero-Positivity and Medical Management (HSPAMM) program participants from January 1989 to November 2002 INTERVENTIONS: None MAIN OUTCOME MEASURES: Differences in the time to develop AIDS or death among HIV-infected individuals who reported being on highly active antiretroviral treatment (HAART) were examined by ethnicity, income, and CD4+ cell counts at HAART initiation by using Kaplan-Meier survival analysis and Cox proportional hazard analyses. RESULTS: The study was based on 516 HIV-infected individuals, who were primarily White (61.0%) and API (21.7%). Whites had a significantly higher CD4+ cell count (P<.01) and income (P<.01) than APIs at enrollment into HSPAMM. Lower income levels and CD4+ cell counts at HAART initiation were strongly associated with an increased RH of developing AIDS or dying. Despite having significantly lower incomes and CD4+ cell counts at enrollment, individuals of API ethnicity do not have an increased RH of developing the outcomes compared to Whites. CONCLUSION: Lower income and CD4+ cell counts at HAART initiation significantly increased the RH of developing AIDS or dying among HIV-infected individuals. Asian/Pacific Islander (API) ethnicity was not a predictor of developing AIDS or dying.

Adult↗