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At least 613 records · Page 34Linked to original sources
PubMed2005

Ethnic differences in trends and determinants of cigarette smoking in Hawaii.

BACKGROUND: The prevalence of smoking continues to be higher in some ethnic groups than in others, despite the overall decrease of smoking during the last 30 years. The goal of this project was to investigate the trends and predictors of cigarette smoking among a population of Caucasians, Japanese, Chinese, Filipino, and Native Hawaiians. METHODS: We combined data from 19 earlier studies conducted in Hawaii between 1975 and 2001. After excluding 1,885 individuals without smoking data, 158,629 subjects (40.0% Japanese, 30.3% Caucasian, 14.3% Hawaiian, 8.1% Filipino, 3.0% Chinese) were included in the analysis. The prevalence of current smoking and past smoking was estimated for 5-year periods by sex and ethnicity and age-adjusted to the state's population. We calculated odds ratios and 95% confidence intervals by using polytomous logistic regression to explore determinants of smoking, while controlling for clustering by study. RESULTS: Men were more likely to smoke than women throughout the study period, but they experienced a greater decline in smoking until 1994. We observed a small increase in smoking prevalence thereafter. Native Hawaiians reported the highest smoking prevalence, Japanese the lowest, and Caucasians intermediate levels. Graduate level education had the strongest inverse association with current and past smoking. Older age at interview, being married, and a higher body weight were related to lower smoking prevalence. CONCLUSIONS: Our data suggest a modest reversal in the declining smoking prevalence during the late 1990s. The persistent ethnic differences require new approaches that reach those groups who remain at high risk for adverse health effects from smoking.

Adult↗
PubMed2005

Descriptive epidemiology of congenital hydrocephaly in Hawaii, 1986--2000.

Using data from a birth defects registry, this study examined the epidemiology of hydrocephaly in Hawaii during 1986--2000. There were 294 cases of hydrocephaly, resulting in a rate of 10.4 per 10,000 live births. The hydrocephaly rate was lower with increased maternal age and female sex and higher with lower birth weight, lower gestational age, and multiple gestation pregnancy.

Adolescent↗
PubMed2005

Adherence to oral hypoglycemic agents in Hawaii.

INTRODUCTION: Adherence to oral hypoglycemic agents is essential to reducing the poor health outcomes of populations at high risk for developing diabetes and its chronic complications. The goal of this study was to identify characteristics of patients in Hawaii least likely to adhere to oral hypoglycemic agents. METHODS: This retrospective administrative data analysis included prescription refill claims for oral hypoglycemic agents from January 1, 1999, through June 30, 2003 (n = 20,685). Multivariate logistic regression analysis was used to examine the relationship between adherence and patient characteristics. RESULTS: Adherence was found to be strongly associated with age and ethnicity. Relative to the age subset 55 to 64 years, adherence increased as age increased, reaching a peak at age 74 (odds ratio [OR] 1.1; 95% confidence interval [CI], 1.0-1.20). Past the age of 85, adherence declined (OR 0.90; 95% CI, 0.82-0.98). Relative to white patients, the odds ratio of adherence was highest for Japanese patients (OR 1.20; 95% CI, 1.0-1.30) and lowest for Filipino patients (OR 0.78; 95% CI, 0.68-0.90). Gender was not associated with adherence. CONCLUSION: Differences in adherence to oral hypoglycemic agents were found to be related to ethnicity and age. Adherence was found to be lowest in younger patients and Filipino patients. This is a significant finding considering that younger diabetic patients have been shown to have the poorest glycemic control and worst health outcomes. Although the literature on adherence to oral hypoglycemic agents and health outcomes in Filipino patients is limited, studies support an increased risk for developing diabetes in this group. This information can be used to target younger patients and Filipino patients to improve their adherence to oral hypoglycemic agents.

Age Factors↗
PubMed2005

Depression and antidepressant use among people living with HIV in Hawaii: focus on Native Hawaiians.

Depression, including antidepressant use, has not been widely studied in the HIV-positive population or at all in HIV-positive Native Hawaiians. Of 1016 clients in Hawaii's HIV Seropositivity and Medical Management Program in 2001-2002, 300 (30%) reported having depression and half reported taking antidepressants. Native Hawaiians had the lowest depression rates of any group. Antidepressant use did not vary by race/ethnicity.

Adult↗
PubMed2005

Two decades of HIV/AIDS in Hawaii: contrast with national trends.

This paper describes the HIV/AIDS epidemic in Hawaii. Data indicate gradual but steady changes in characteristics of infected populations. Most significant are increases in cases among Asian Pacific Islanders, women, heterosexuals and younger age groups. Early harm reduction measures and low incidence among injection drug users relative to other parts of the U.S. may have played a significant role in containing the epidemic.

Acquired Immunodeficiency Syndrome↗
PubMed1977

Are infantile periarteritis nodosa with coronary artery involvement and fatal mucocutaneous lymph node syndrome the same? Comparison of 20 patients from North America with patients from Hawaii and Japan.

We reviewed available clinical and pathologic autopsy material from 20 patients with infantile periarteritis nodosa with coronary artery involvement (IPN) from the continental United States, two Hawaiian patients with fatal mucocutaneous lymph node syndrome (MCLS; Kawasaki disease), and three patients with classical periarteritis nodosa (CPN). Comparison of the findings in patients with IPN and in patients with MCLS from Hawaii to material from patients with fatal MCLS from Japan showed no definite clinical reason to distinguish IPN from MCLS; neither gross nor microscopic features of the vascular lesions nor their pattern of distribution appears to warrant separation of IPN from fatal MCLS. CPN differs, both clinically and pathologically, from IPN/MCLS, and may well have a different etiology.

Adult↗
PubMed2003

Early childhood caries among Hawaii public school children, 1989 vs. 1999.

Utilizing a standardized oral health assessment tool, public school children ages 5 through 9 were evaluated Statewide in 1989 and 1999. In both samples, it was demonstrated that Asian & Pacific Islander children (as a group), by contrast with Caucasian, African Amercan or Hispanic children, suffered from disproportionately high rates of dental caries, were more likely to have unmet treatment needs and less likely to utilize dental sealants. Significant variance among oral health/ oral disease indicators was found among ethnic and regional groups and all Hawaii cohorts were found to have poorer oral health indicators by contrast with U.S. national findings. Data was not found to follow any particular pattern with regards to urban vs. rural settings. This report shows the value of considering a variety of oral health indicators in evaluating the health of a community. More research needs to be done in evaluating the influence of socioeconomic status and cultural beliefs and practices on the oral health of young children in Hawai'i.

Black or African American↗
PubMed2005

Rates of selected birth defects in relation to folic acid fortification, Hawaii, 1986-2002.

Because of studies suggesting that folic acid use reduces risk of various birth defects, the Unites States fortified enriched cereal grains with folic acid in 1998. To determine whether this fortification reduced rates for birth defects in Hawaii, rates were calculated before and after fortification. Of the 19 birth defects categories studied, the rates for 16 were lower after fortification.

Congenital Abnormalities↗
PubMed1991

Sports medicine in Hawaii: care of the high school athlete in Oahu's public schools.

A recent study by the National Athletic Trainers Association indicated that injuries occur more often during practice than during games in high school athletics. Results of the 3-year study indicated that 60% of basketball injuries occurred in boys and young men during practice and 59% occurred in women. About 2/3 of the estimated 120,000 injuries suffered by prep wrestlers each year happen during practice. The study found that an average of 331,865 high school football players (1/3 of the million who play football each year) were sidelined by an injury at least once. With these statistics in mind, our study looks at the approach to the management of injury in the public schools that make up the Oahu Inter-scholastic Association (OIA) in the state of Hawaii. The estimated number of student athletes that participate in organized athletics in the OIA is 7,960 and the number of coaches is 1,189.

Adolescent↗
PubMed1991

Hereditary anemias in Hawaii. 1987.

The differential diagnosis of microcytic anemias in Hawaii presents special problems because of the hereditary anemias prevalent in its large Asian subpopulations. Both the alpha- and beta-thalassemias are important because of morbidity and mortality. Heterozygous carriers for either type mimic iron deficiency, which may lead to inappropriate work-up or treatment. The thalassemias and hemoglobin (Hb) variants are all benign in heterozygotes, but if a couple are both heterozygous for the same or for incompatible variants, their children have 25% risk of inheriting a serious anemia. These can be prevented by detecting the heterozygotes, and by offering genetic counseling and fetal testing to couples at risk of having severely affected children. Early detection is also possible by the screening of newborns. Fetal diagnosis, or early detection and treatment, can greatly reduce the consequences of these anemias. Screening and prevention will cost far less than the cost of care for affected patients.

Anemia↗
PubMed1991

Birth of the first 100 babies in Hawaii after conception in-vitro: experience at the Pacific In-Vitro Fertilization Institute.

This paper reports on the first 100 infants delivered consecutively the result of 63 pregnancies after conception in-vitro at the Pacific In-Vitro Fertilization (IVF) Institute. These pregnancies were established prior to the introduction of embryo-cryopreservation into the program. Ninety-seven percent (97%) of singleton pregnancies delivered after 36 weeks; only 5/31 (16%) required tocolytic therapy. The overall multiple gestation rate was 51%, higher than in many other IVF centers. Maternal complications and neonatal morbidity were associated primarily with these multiple gestations. Forty-one percent (41%) delivered in less than 36 weeks, and tocolytics were administered in 22/27 (81%) of twin and 5/5 (100%) of triplet gestations. Neonatal morbidity was noted in 39 infants (33 from multiple gestations); 28 neonates were admitted to the intensive care unit (27 from multiple gestations). Nine births had or developed minor abnormalities (hernias, pyloric stenosis). One case of Trisomy 21, and one infant death at 11 months occurred in the group. The caesarean section rate for all IVF deliveries was 65%. It is concluded that IVF is clearly established in Hawaii for infertility refractory to other methods of treatment. The risk associated with IVF stem from the possibility of multiple gestations, not whether the pregnancy was initiated in-vitro. In the future, embryo cryopreservation may help to reduce the risk of multiple pregnancy.

Adult↗
PubMed1991

Carettacola hawaiiensis n. sp. (Trematoda: Spirorchidae) from the green turtle, Chelonia mydas, in Hawaii.

Carettacola hawaiiensis n. sp. (Trematoda: Spirorchidae) is described from the hepatic vessels of the green turtle, Chelonia mydas (L.), in Hawaii. The new species differs from any previously described species of Carettacola in size, placement of vitellaria, and shape and placement of Laurer's canal. The genus Haemoxenicon Martin and Bamberger, 1952, becomes a synonym of Carettacola Manter and Larson, 1950. Haemoxenicon stunkardi Martin and Bamberger, 1952, is transferred to the genus Carettacola Manter and Larson, 1950, and becomes Carettacola stunkardi n. comb. An emended generic diagnosis for Carettacola is given along with a key to the species.

Animals↗
PubMed1991

Compliance with Hawaii's Workers' Compensation Law.

The late United States Supreme Court Justice Brandeis once stated: "Don't assume that the interests of employer and employee are necessarily hostile--that what is good for one is necessarily bad for the other. The opposite is more apt to be the case. While they have different interests, they are likely to suffer or prosper together". Working toward resolving the employee's physical and/or emotional problems will confer a benefit on both employer and employee. It has become apparent to me that the issues of concurrent care, consultations and treatment plans are of great concern to physicians in Hawaii. I have therefore chosen to discuss these areas in light of recent Labor and Industrial Relations Appeals Board decisions.

Hawaii↗
PubMed1991

The health status of working women in Hawaii.

The effect of work on women's health was examined in this study by comparing selected health indicators and specific chronic conditions among employed men, employed women and housewives. The study analyzed data from the Hawaii Health Surveillance Program. The study group was comprised of 56,203 subjects and represented a randomly stratified sample of the population interviewed during the period 1981-1986. Housewives as a group were older, less educated and reported the lowest family income compared to employed men or employed women. The prevalence of several specific chronic conditions were higher among housewives than in employed men and employed women. Multiple regression analysis tested the difference in several health indicators (chronic conditions, hospital episodes and restricted activity days) between employed men, employed women and housewives, controlled for sociodemographic variables. The health status of housewives was clearly worse than that of employed men and employed women by all health indicators; employed women had more hospital episodes than employed men. The results suggest that mostly healthy women are selected for the labor force. Among employed women, those in poor health and needing hospital services more frequently, are probably at high risk of dropping out of work. Our study projects the importance of promoting occupational good health for employed women during their working life.

Adult↗
PubMed1991

Occupational-health training at the University of Hawaii.

Occupational-health training at the University of Hawaii School of Public Health (UH-SPH) is a graduate-level program focusing on industrial hygiene; it also offers courses of interest to other health professionals, particularly physicians and nurses. The current training at the UH-SPH is designed primarily to prepare occupational-health practitioners at the master's degree level. The occupational-health program elective is considered to be an area of emphasis within a broader program of study in public health. The program offers special opportunities for occupational-health training and research in cross-cultural and international settings. Post-graduate and continuing-education occupational-health training in the community is also discussed.

Curriculum↗
PubMed1990

Epidemiology of ocean sports-related injuries in Hawaii: 'Akahele O Ke Kai'.

Before attempting to prevent ocean activity injuries, as well as to improve treatment strategies, more information is needed regarding the numbers of injuries that are geographic and activity specific and the identification of persons at risk for such injury. Data on 276 injuries that occurred during ocean sports activities on the islands of Oahu and Hawaii over a 10-month period are presented. The injuries were mainly related to swimming and board-surfing, although serious injuries were found for almost all types of sports activities. The majority of those injured were young adult men who were local residents. Over 10% of the injuries required hospitalization, including 4 fatalities due to drowning and 5 spinal cord injuries due to trauma or to SCUBA-related, decompression incidents. Our study identifies the need for determining an estimate of the number of persons engaging in ocean sports, establishes the need for a single reporting system for injuries, determines potential risk factors, and suggests targets for prevention.

Athletic Injuries↗
PubMed1990

Hawaii and the AIDS epidemic.

Hawaii has enacted legislation pertaining to the AIDS epidemic. This legislation pertains to such areas as HIV testing, informed consent for testing, confidentiality of HIV-related data, quality assurance standards for HIV testing, and requirements pertaining to insurance availability. Physicians in the State should be aware of these legal requirements, particularly as they may affect medical practice in the state.

Acquired Immunodeficiency Syndrome↗
PubMed1989

An analysis of hospital utilization in Hawaii.

The objective of this study was to identify and analyze trends in hospital utilization over the past decade in Hawaii. The findings indicate that hospital utilization has dropped significantly, though not steadily, between 1976 and 1984. This drop can be attributed to steadily shrinking lengths of stay and not to fewer admissions, the latter having, in fact, increased over the years.

Age Factors↗