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PubMed2004

Prevalence of chlamydial and gonorrheal infections among females in a juvenile detention facility, Honolulu, Hawaii.

Limited studies have shown high rates of gonorrheal and chlamydial infections among incarcerated adolescents, however, this population has not been routinely targeted for sexually transmitted disease (STD) screening. This study was done to ascertain the feasibility of screening females for STDs at a juvenile detention facility in Honolulu, Hawaii, and to determine the prevalence of chlamydial and gonorrheal infections in this population. Between January 2000 and December 2001, pelvic examination-based STD screening was offered to all female detainees, on selected dates. Specimens from multiple anatomical sites were cultured for Neisseria gonorrhoeae. Endocervical swabs were tested for Chlamydia trachomatis using a DNA probe (GenProbe). One-hundred one of 204 (50%) eligible females were screened. Fourteen of 101 (13.9%) females were screen positive for chlamydial infection, while six of 101 (5.9%) were culture positive for infection with N. gonorrhoeae. Three females were co-infected with both organisms. The high STD rates justify the institution of a routine screening program for this high risk and previously underserved group.

Adolescent↗
PubMed2002

Organ donation in Hawaii: impact of the final rule.

BACKGROUND: In an effort to increase organ donation, the Department of Health and Human Services issued the Final Rule in 1998. The Health Care Financing Administration (HCFA) later required hospitals to notify organ procurement organizations (OPO) of all deaths and imminent deaths in order to remain eligible for Medicare and Medicaid reimbursement. We set out to determine the impact of the Final Rule on organ donation in Hawaii. METHODS: Medical records of all deaths between January 1999 and December 2000 at 17 acute-care hospitals were reviewed to determine the number of medically suitable, potential organ donors. RESULTS: Of 9427 deaths, 144 were potential organ donors. In 1999, before the Final Rule, 60 of 75 (80%) potential donors were identified and 40 (53%) were referred to the OPO. In 2000, after the Final Rule, the identification rate was 83% and the referral rate was 70%. CONCLUSIONS: Although, the Final Rule increased the referral rate slightly, medical centres must continue to improve their identification of potential donors and prompt referral. This is not only to comply with the Final Rule, but ultimately to increase organ donation to meet the needs of the ever-expanding list of patients waiting for organs.

Hawaii↗
PubMed2005

Adolescent alcohol use and suicide indicators among adolescents in Hawaii.

Research on suicide has focused on gender, age, ethnicity, and psychiatric profiles. However, few studies have examined alcohol use and its relationship to suicide among Native Hawaiians and other Asian American/Pacific Islanders. This study analyzes data from the 1997 and 1999 Hawaii Youth Risk Behavior Survey to examine whether alcohol problems increase the risk for suicide indicators (as evidenced by responses to questions asking whether an individual has considered, planned, attempted, or required treatment for a suicide attempt). Drinking pattern was the best predictor for all suicide indicators. School and community-based programs can help to increase an adolescent's knowledge about the consequences of alcohol use and prevention of suicide.

Adolescent↗
PubMed1980

Associations between cancer incidence and alcohol/cigarette consumption among five ethnic groups in Hawaii.

The average annual age-adjusted incidence rates of cancer for 15 sites were determined for 10 ethnic-sex groups in Hawaii. Consumption rates for cigarettes, beer, wine and hard liquor were also determined for the same 10 groups based on personal interview of a sample of 9920 individuals. Covariance analysis was used to adjust each exposure variable for the other three, and the cancer incidence rates were then linearly regressed on these covariance-adjusted consumption rates. Statistically significant regression coefficients were found for cancer of the tongue/mouth, pharynx, larynx, pancreas, lung, kidney and bladder regressed on cigarette consumption. Eight cancer sites, including tongue/mouth, pharynx, larynx, oesophagus, stomach, pancreas, lung and kidney, had significant positive regression coefficients for beer consumption which could not be explained by outlying values on the scattergram. Significant associations were also suggested between wine consumption and pharyngeal cancer and between hard-liquor consumption and pharyngeal, laryngeal and possibly brain cancer. No association was found between beer consumption and colorectal cancer. Multiple regression analysis with sex, cigarettes and alcoholic beverage as independent variables consistently found sex to be least important in determining cancer risk. This study supports the hypothesis that beer consumption may play a role in cancer risk for several sites. It is suggested that future studies of alcoholic beverages and cancer should examine not only types of alcoholic beverages, but individual brands of each type in an attempt to identify cancer risk due to carcinogens in only certain brands.

Alcohol Drinking↗
PubMed1981

Nutrient intakes in relation to cancer incidence in Hawaii.

A representative sample of 4657 adults greater than or equal to 45 years of age from the 5 main ethnic groups in Hawaii (Caucasians, Japanese, Chinese, Filipinos and Hawaiians) were interviewed during 1977-1979 regarding their diets. Quantitative food-consumption histories were obtained, from which average daily intakes of fat (saturated, unsaturated, cholesterol, meat, dairy, fish, animal, vegetable and total), protein (animal, meat, fish, dairy and total), carbohydrate, and vitamins A and C (including supplements) were calculated using food-consumption data from standard sources. Multiple regression analysis, with sex as a controlled variable, was used to assess the statistical relationship between these ethnic-sex-specific intakes and corresponding population-based cancer incidence rates of 15 selected sites for which nutrient components are suspected to be either causal or protective. Based on pre-set criteria for establishing important relationships, significant positive associations were found for 6 of the cancer sites: breast cancer with fat (saturated, unsaturated, animal, total) and protein (animal), corpus-uteri cancer with the same components as breast cancer, prostate cancer with fat (saturated, animal) and protein (animal, total), stomach cancer with fat (fish only) and protein (fish only), lung cancer with cholesterol, and laryngeal cancer with cholesterol. Breast and corpus-uteri cancers also showed significant negative associations with carbohydrate intake. The implications of these findings for future research are discussed.

Aged↗
PubMed1982

Stage-specific breast-cancer incidence rates by age among Japanese and Caucasian women in Hawaii, 1960-1979.

We have analysed the age- and stage-specific breast-cancer incidence rates of Japanese and Caucasian women in Hawaii for a 20-year period. A comparison of the 1192 Japanese and 1531 Caucasian patients by stage at diagnosis showed that Japanese women were likely to have breast cancer diagnosed at an earlier stage than Caucasian women, but this difference was statistically significant only after the menopause (ages 55+). We further found that for age 50-74, the age-specific ratios of Caucasian to Japanese incidence rates were least for in situ breast cancer, and successively greater for localized, regional and distant breast cancer. We interpreted this latter finding to be an indication that postmenopausal breast cancers in Japanese women have slower average growth rates than in Caucasian women. Such slower growth rates may explain the better breast-cancer survival among Japanese women after allowing for differences in stage, tumour size, histology, or treatment.

Adult↗
PubMed2004

Cord blood units collected at a remote site: a collaborative endeavor to collect umbilical cord blood through the Hawaii Cord Blood Bank and store the units at the Puget Sound Blood Center.

BACKGROUND: Umbilical cord blood is a useful source of hematopoietic stem cells, especially because compared to equivalent HLA-matched stem cells from unrelated adult donors. A network of community collection sites targeted at particular ethnic groups and serviced by a central processing and storage facility can maximize the genetic diversity of banked cord blood units (CBUs) in a cost-effective fashion. STUDY DESIGN AND METHODS: The present study compared CBUs collected near the Puget Sound Blood Center in Seattle, WA, with those collected in Honolulu, HI, and processed in Seattle. Evaluated variables include collection volume, total nucleated cell count, cellular viability, CD34+ cell count, clonogenic activity, and donor race for a total of 1646 CBUs received from July 1998 through November 2002. RESULTS: CBUs from the two sites did not differ with regard to volume or total nucleated cells. Those from Hawaii had significantly longer transit times (p < 0.001) and lower whole cord blood cell viability. However, the numbers of CFU and viable CD34+ cells were not affected by remote collection. CBUs screened from Seattle were largely from Caucasian donors, whereas over 85 percent of those from Honolulu were from donors of Asian-Pacific Islander or mixed ethnicity. CONCLUSION: These studies demonstrate the feasibility of long-distance umbilical cord blood banking. Arrangements such as those described here could be used to help target cost-effective collection from minority populations and increase the HLA and ethnic diversity for CBUs.

Asian People↗
PubMed2000

Clinical-pathological comparison of clinical prostate cancer between Japanese Americans in Hawaii and Japanese living in Japan.

In an attempt to determine the role of environmental factors in the etiology of prostate cancer, we compared the clinical-pathological findings of prostate cancer among Japanese Americans in Hawaii and Japanese living in Japan. Our study showed that prostate cancer in Japanese living in Japan is more advanced than in Japanese Americans. The findings indicate that screening for prostate cancer in Japan is far behind that in the USA. The difference in level of cancer screening also precluded our attempt to analyse environmental factors contributing to prostate cancer progression in the two groups. The variation in method of clinical detection of prostate cancer between the USA and Japan is also likely to contribute to the apparent difference in the incidence of the disease.

Aged↗
PubMed2000

Epidemiology of holoprosencephaly in Hawaii, 1986-97.

Holoprosencephaly is a birth defect affecting the medial structures of the brain and face. This investigation examined the epidemiology of holoprosencephaly in Hawaii between 1986 and 1997, using data obtained from a birth defects registry, and compared the results with those of other population-based studies. Twenty-five cases were identified, producing a prevalence of 1.09 per 10,000 livebirths. There were 17 (68.0%) livebirths, two (8.0%) fetal deaths and six (24.0%) elective terminations. Ten (58.8%) of the livebirths died before the age of 1 year. Seven (28.0%) had a known chromosomal abnormality, most often trisomy 13. Prevalence rates were higher for maternal age > 39 years, maternal race/ethnicity of Far East Asian or Filipino, females and residence in Maui County. The small number of cases limited the statistical significance of the study. However, this report confirms many of the findings from the previous studies and adds new findings, particularly the higher prevalence among Far East Asians and Filipinos.

Adult↗
PubMed2003

Epidemiology of intestinal malrotation, Hawaii, 1986-99.

Malrotation of the intestines occurs as a result of failure of normal intestinal rotation and fixation during early pregnancy. This study examined the epidemiology of malrotation in Hawaii during 1986-99, using data from a population-based birth defects registry. There were 81 cases of malrotation, resulting in a rate of 2.86 per 10 000 live births and fetal deaths. The first-year mortality rate was 15.8%. Other major birth defects were reported for 93.8% of the cases. The malrotation rate during 1993-99 was significantly higher than the rate during 1986-92 (rate ratio [RR] 1.42, 95% confidence interval [CI] 1.04, 1.90). The malrotation rate was inversely proportional to maternal age (P = 0.028). Compared with whites, the malrotation rate was significantly higher among Far East Asians (RR 1.95, 95% CI 1.12, 3.17), Pacific Islanders (RR 2.41, 95% CI 1.63, 3.44) and Filipinos (RR 1.82, 95% CI 1.02, 3.01). Malrotation rates did not differ significantly by sex (RR 0.98, 95% CI 0.70, 1.34) or plurality (RR 1.86, 95% CI 0.38, 5.44) but were significantly higher among livebirths with birthweight < 3000 g (RR 3.90, 95% CI 2.83, 5.24). With no other population-based studies of malrotation found in the literature, this study adds to the knowledge of the epidemiology of malrotation.

Adult↗
PubMed1999

Melanoma in Kauai, Hawaii, 1981-1990: the significance of in situ melanoma and the incidence trend.

BACKGROUND: The incidence of melanoma has often been portrayed as reaching 'epidemic' proportions. The reality of such an epidemic is, however, not clearly established due to the methods of data collection and interpretation. The population-based incidence data and incidence trend of melanoma from the Island of Kauai, Hawaii provide an illustration of this 'epidemic'. METHODS: We used medical records housed at the dermatology clinic and pathology laboratory in Kauai to: identify residents of Kauai who had their first melanoma during the years 1981-1990; and to measure the 10-year population-based incidence of melanoma. RESULTS: In Caucasians: A total of 53 Caucasian residents (29 men and 24 women), were identified with an initial episode of melanoma (MM) during the 10-year period. The average annual standardized incidence rate per 100,000 Kauai Caucasian residents was 36. Whereas the incidence of in-situ MM increased during the 10-year period, the incidence of invasive MM did not. The average patient age was 55 years. The trunk and the limbs were the most common anatomic sites of MM. In men, one third of MM occur on the back. In women, one third develop on the leg/thigh. Three patients (6%) had metastasis and eventually died of MM. Thirteen patients (25%) had other skin cancers such as basal cell carcinoma and squamous cell carcinoma at some time. In Filipinos, Japanese and Hawaiians: Three Filipinos (all women), two Japanese (one man and one woman) and one Hawaiian (man) had melanoma. The standardized incidence rates, to the U.S.A. Caucasian population, were 3.1, 0.8 and 2.1 per 100,000 residents, respectively. CONCLUSIONS: The melanoma incidence in Kauai is one of the highest rates documented in the U.S.A. However, a decreased incidence of invasive melanoma during the 10-year period was unexpected. The finding of nonmelanoma skin cancer in these patients supports a common etiology among these skin cancers.

Adolescent↗
PubMed1976

Serum lipoproteins and coronary heart disease in a population study of Hawaii Japanese men.

To ascertain the frequency of defined hyperlipoproteinemia and to investigate the relation between lipoprotein fractions and coronary heart disease, we measured serum lipoprotein cholesterol levels in a population-based sample of Hawaii Japanese men 50 to 72 years old. Type II hyperlipoproteinemia was present in 3 per cent of 1859 men, and Type IV in 26 per cent. Relative risks for coronary heart disease, based on 264 prevalence cases, were found to be 1.8, 1.8 and 0.46, between the upper and lower quartiles of total, beta, and alpha cholesterol, respectively. We found no significant relation between triglyceride and coronary heart disease. The inverse relation of alpha cholesterol of prevalence of coronary heart disease was independent of beta cholesterol, obesity, and other factors. The data suggest the need for further evaluation of the protective effect of the alpha lipoprotein fraction on the development of coronary heart disease.

Aged↗
PubMed1977

Coffee, alcohol and risk of coronary heart disease among Japanese men living in Hawaii.

We examined the relation of coffee and alcohol consumption to the risk of coronary heart disease during a six-year period in a cohort of 7705 Japanese men living in Hawaii. The analysis was based on 294 new cases of coronary heart disease. There was a positive association between coffee intake and risk, but it became statistically insignificant when cigarette smoking was taken into account. There was a strong negative association between moderate alcohol consumption (up to 60 ml per day), mainly from beer, and the risk of nonfatal myocardial infarction and death from coronary heart disease. This association remained significant in multivariate analysis, taking into account smoking and other risk factors. The correlation of alcohol consumption with the level of alpha cholesterol (positive) and beta cholesterol (negative) may partly account for the observed negative association between alcohol and coronary heart disease.

Aged↗
PubMed1991

Helicobacter pylori infection and gastric carcinoma among Japanese Americans in Hawaii.

BACKGROUND: Helicobacter pylori are gram-negative spiral bacteria that are associated with chronic gastritis, a known precursor of gastric carcinoma. Persons at high risk for gastric carcinoma have been shown to have a high prevalence of H. pylori infection. METHODS: We studied the relation of H. pylori infection and gastric carcinoma in a cohort of Japanese American men living in Hawaii. The 5908 men were enrolled and examined from 1967 to 1970. By 1989, 109 cases of pathologically confirmed gastric carcinoma had been identified. The store serum of each patient with gastric carcinoma and of each matched control subject were tested for the presence of serum IgG antibody to H. pylori. RESULTS: Ninety-four percent of the men with gastric carcinoma and 76 percent of the matched control subjects had a positive test for H. pylori antibodies, for an odds ratio of 6.0 (95 percent confidence interval, 2.1 to 17.3). As the level of antibody to H. pylori increased, there was a progressive increase in the risk of gastric carcinoma (P for trend = 0.0009). The association was strong even for men in whom the diagnosis was made 10 or more years after the serum sample was obtained (odds ratio, 10.5; 95 percent confidence interval, 2.5 to 44.8). CONCLUSIONS: Infection with H. pylori is strongly associated with an increased risk of gastric carcinoma. However, most persons infected with H. pylori will never have gastric carcinoma. Therefore, other factors that increase the risk of gastric carcinoma among persons infected with H. pylori need to be identified.

Antibodies, Bacterial↗
PubMed2001

A randomized trial of the Hawaii SunSmart program's impact on outdoor recreation staff.

BACKGROUND: Skin cancer is the most common form of cancer in the United States and one of the most preventable. Prevention programs for children at outdoor recreation sites may influence not only the youth, but the staff, or caregivers, as well. By teaching children about sun protection, staff may also change their sun protection behaviors. OBJECTIVE: We report on the impact of a childhood skin cancer prevention program (SunSmart) on staff at outdoor recreation sites where a child-focused intervention was conducted. METHODS: The intervention included staff training, on-site activities delivered by staff, distribution of sunscreen, and the promotion of sun-safe environments. It was hypothesized that by teaching children about sun protection, staff would change their sun protection behaviors. A randomized trial at 14 recreation sites (n = 176 staff) in Hawaii tested the efficacy of education only, and education plus environmental changes, compared with a control condition. RESULTS: Results showed significant positive changes in knowledge, sun protection habits, norms, and sun protection policies. The education plus environment group was not superior to education alone. CONCLUSION: Changes in staff behavior and attitudes are important for their own health, as positive role models, and for the dissemination of skin cancer control programs.

Adolescent↗
PubMed1994

Multiple origins of a spider radiation in Hawaii.

The Hawaiian Islands are renowned for some of the most spectacular species radiations in the world. Most of these radiations have been attributed to single colonization events, although the evidence supporting monophyletic origins is often poorly resolved and/or ambiguous. Without a concrete understanding of the origins of species radiations, it is impossible to understand the phylogenetic pattern of species proliferation or the spectrum of morphological, ecological, and behavioral modifications attributable to a single colonist. In this study we examined the species radiation of the spider genus Tetragnatha in Hawaii. Unlike their mainland congeners, the Hawaiian Tetragnatha are extremely diverse in morphology, ecology, and behavior. We tested whether this diversity arose from a single or multiple colonization events. We coupled morphological (37 characters) and molecular (sequence from the 12S ribosomal subunit of mitochondrial DNA) approaches to assess the phylogenetic position of the Hawaiian Tetragnatha relative to continental congeners and to examine evidence for monophyly. We provide evidence that the Hawaiian Tetragnatha emanate from multiple origins. At least two independent species radiations, the "spiny-leg" clade and the web-building species Tetragnatha stelarobusta and Tetragnatha acuta, have arisen from one or more founder events. Two additional natural colonizations have resulted in the establishment of non-speciose lineages, as represented by Tetragnatha hawaiensis and Doryonychus raptor.

Animals↗
PubMed1986

Anthropometric indicators of breast cancer risk in postmenopausal women in Hawaii.

As part of a case-control study of breast cancer in Hawaii, self-reported data on height, weight at various ages, breast size, shoe size, and triceps skinfold thickness were collected from 138 Japanese postmenopausal cases, 134 Caucasian postmenopausal cases, 154 Japanese neighborhood controls, and 142 Caucasian neighborhood controls. In a multiple covariance analysis, cases of both ethnic groups were slightly heavier (at all ages) and more obese (based on a weight-corrected-for-height index) than were controls, although none of the differences was statistically significant. Among the Japanese only, cases were also taller, had a greater body surface area (computed from the height and weight data), and had a larger shoe size than did the controls. The latter finding was statistically significant (p less than 0.05). Odds ratios were computed by multiple logistic regression analysis and revealed no additional relationships; however, there were suggested dose-response gradients for height, weight at age 20, and body surface area in the Japanese women and for breast size in the Caucasian women. A further analysis of risks based on changes in relative body weight between young adult life (age 20) and current age was also negative. Overall, these findings offer only weak support for an association between weight or obesity and breast cancer risk and suggest that anthropometric indices are at best very indirect indicators of true etiologic factors for breast cancer.

Adult↗
PubMedDate not supplied

Age at first pregnancy in relation to age at menarche and year of birth in Caucasian, Japanese, Chinese and part-Hawaiian women living in Hawaii.

A multiple regression analysis was undertaken to examine the relationship between age at first pregnancy and recollected age at menarche and sociological variables in Caucasian, Japanese, Chinese and part-Hawaiian parous women living in Hawaii. The analysis was conducted using the medical history records of 1198 Caucasian, 1770 Japanese, 453 Chinese and 578 part-Hawaiian women. Age at first pregnancy varied significantly among ethnic groups. Initial results showed an apparent heterogeneity among ethnic groups in the effect of age at menarche on age at first pregnancy. Once appropriate controls for the linear and non-linear effects of year of birth were made, the effects of age at menarche on age at first pregnancy no longer varied significantly among ethnic groups. The observed secular trends in age at first pregnancy have varied widely among the four ethnic groups studied and appear unrelated to genetic background.

Adult↗