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This research investigated complementary and alternative medicine (CAM) use by Hawaii cancer patients. Thirty-six percent of patients used CAM, most commonly religious/spiritual therapy and herbal treatments. CAM use was linked with younger age, female gender, Catholic religion, and more education. More research is needed to inform decision-making.
The international code of ethics of psychiatry, the Declaration of Hawaii was in the main the achievement of Clarence Blomquist. There were several prerequisites for the success of this work. 1. The unique profile of the education of Clarence Blomquist, combining training to be a specialist in psychiatry with a doctor's degree in practical philosophy. 2. An outstanding competence in analyzing complicated issues and in putting thoughts into words. 3. The courage to challenge the Hippocratic ethics and adapt the principles of ethics to modern health care. 4. A scholarship at the Institute of Society, Ethics and the Life Sciences, Hastings-on-Hudson, New York, where he could test his ideas in an intellectual interdisciplinary atmosphere. 5. Support from the late Professor Leo Eitinger, Norway and Professor Gerdt Wretmark, Sweden, who together with Clarence Blomquist constituted a task force on ethics of the World Psychiatric Association. 6. A continuous backing-up by Dr Denis Leigh, the then secretary general of the World Psychiatric Association. Denis Leigh was convinced that a code of ethics was the only means to reconcile the various member countries on issues of misuse of psychiatry and, in addition, would raise the quality of psychiatric care throughout the world.
Decomposition studies were conducted at two sites on the Island of Oahu, Hawaii, to compare patterns of decomposition and arthropod invasion in intertidal and adjacent terrestrial habitats. The animal model used was the domestic pig. One site was on Coconut Island in Kaneohe Bay on the northeast side of Oahu, and the second was conducted in an anchialine pool located at Barber's Point Naval Air Station on the southwest shore of Oahu. At both sites, the terrestrial animal decomposed in a manner similar to what has been observed in previous studies in terrestrial habitats on the island of Oahu. Rate of biomass depletion was slower in both intertidal studies, and decomposition was primarily due to tide and wave activity and bacterial decomposition. No permanent colonization of carcasses by insects was seen for the intertidal carcass at Coconut Island. At the anchialine pool at Barber's Point Naval Air Station, Diptera larvae were responsible for biomass removal until the carcass was reduced below the water line and, from that point on, bacterial action was the means of decomposition. Marine and terrestrial scavengers were present at both sites although their impact on decomposition was negligible. Five stages of decomposition were recognized for the intertidal sites: fresh, buoyant/floating, deterioration/disintegration, buoyant remains, and scattered skeletal.
Decomposition studies were conducted to determine differences in rates and patterns of decomposition of carcasses hanging and exposed on the surface of the soil. These studies were conducted between 17 October and 17 December 1997 inside of Diamond Head Crater on the island of Oahu, Hawaii. The animal model was the domestic pig. Sus scrofa. The rate of biomass removal from the hanging carcass was significantly slower than that observed for the control carcass during the bloat and decay stages of decomposition. Internal temperatures for the control carcass were elevated above the ambient air temperatures during the earlier stages of decomposition (bloated and decay), while those recorded for the hanging carcass approximated the ambient air temperatures. There was a greater diversity of arthropod species recorded and numbers of individuals observed were higher for the control carcass. A significant site of arthropod activity was observed on the surface of the soil immediately under the hanging carcass and this became the primary site of arthropod activity as decomposition progressed.
PURPOSE. This study examines ethnic-specific differences in associations of inadequate use of prenatal care with poor birthweight outcomes to determine whether ethnic specific improvements in the use of prenatal care in a rural district could potentially reduce infant morbidity or mortality there. METHODS. Data from 1988 to 1990 birth certificates of the state of Hawaii were used to study Filipino, Hawaiian and Japanese births. Stratified multivariate logistic regression analyses of the association of inadequate use of prenatal care visits with low birthweight were performed for each group adjusting for potentially confounding sociodemographic risk characteristics. SUMMARY OF IMPORTANT FINDINGS. Results indicate that the adjusted odds of low birthweight for the Hawaiians in the rural district with inadequate amounts of prenatal care visits were higher than for those with adequate visits (OR 2.1; CI 1.4, 3.1) and those relative odds were higher than for Hawaiians in the rest of the state (OR 1.2; CI 1.1, 1.5). Births to Japanese women in the area had a similar pattern (OR 2.3, CI 0.97, 5.6; rest of state OR 1.2, CI 0.98, 1.5), but the ratios were not statistically significant. Births to Filipino women did not have the same pattern (OR 0.73, CI 0.34, 1.6; rest of state OR 1.4, CI 1.2, 1.6). MAJOR CONCLUSIONS. There is substantial heterogeneity in the associations of inadequate care use with poor birthweight outcomes in different groups of Asian Pacific women and in different locations in which they settle. RELEVANCE TO ASIAN AND PACIFIC ISLANDER AMERICAN POPULATIONS. Communities need to determine the associations of poor birth outcomes with poor prenatal care usage of Asian Pacific women to determine whether ethnic specific improvements in prenatal care could potentially improve such outcomes in their areas. KEY WORDS. pregnancy, health services research, outcome and process assessment (health care), regression analysis (logistic models), low birth weight, patient compliance.
Minimum effective release rate (MERR) of three antifoulants was examined at Snug harbor, Hawaii using a dynamic diffusion system. Among the three antifoulants tested TBTCI was found to be effective in preventing the settlement of Hydroides elegans and Crisea sp at 0.5 microg cm(-2) d(-1) flux rate. At a maximum flux rate of 10 microg cm(-2) d(-1) of 2-furyl-n-pentyl ketone larval settlement of both the test species were 32-36% reduced. More or less similar effect was seen at 10 microg cm(-2) d(-1) of coumaric acid. Non-toxic antifoulants, 2-furyl-n-pentyl ketone and coumaric acid exhibit specific activity against target species. MERR obtainedfor the three antifoulants is discussed.
Other than atrial fibrillation-flutter, the majority of supraventricular tachyarrhythmias involve either a macro-re-entry circuit utilizing an atrioventricular (AV) accessory pathway or a micro-re-entry circuit inside or around the AV node. The traditional form of therapy has been medical, with suppression by antiarrhythmic agents, most of which carry a heavy side-effect profile. The established alternative for medical therapy has been surgery, with open-chest excisional ablation of the accessory pathway or cryo-modification of the AV node. Even though, as opposed to medical therapy, surgery promises cure, it requires thoracotomy and cardiopulmonary bypass with significant associated morbidity and even mortality, as well as high cost. Ten years ago, the technique of "fulguration" was first introduced, which involved the delivery of an electrical charge through specialized catheters. Our first experience with this technique was reported in this Journal. Unfortunately, despite being a much better tolerated curative procedure involving a very brief hospitalization, the use of high-energy direct current (DC) shocks is associated with a low but significant incidence of serious complications including cardiac perforation, hypotension, coronary artery spasm, and late occurrence of ventricular fibrillation. Concerns about these potential complications have markedly limited the application of the catheter technique. In the past 2 years, adoption of radio-frequency (RF) current as the energy source has allowed the ablation to be performed in a very efficacious and much safer fashion. We would like to report the first experience with this technique in Hawaii.
Sebaceous gland carcinomas of the eyelids are rare neoplasms accounting for less than 1% of all eyelid tumors. They usually mimic chalazia and undergo repeated curettage before a definitive diagnosis is made. Although they are relatively slow-growing tumors, they behave in an aggressive manner, frequently metastasizing to regional lymph nodes. Approximately 50% of the patients who develop metastasis to lymph nodes of the neck will survive five years. A case report and the review of similar cases in Hawaii in the past 10 years demonstrates the need for early detection and treatment of sebaceous adenocarcinoma of the eyelids.
The first kidney transplant in Hawaii was performed in August 1969. In the following 25 years, more than 433 kidney transplants were performed. The most common etiology leading to transplantation was chronic glomerulonephritis. Patient and graft survivals after a kidney transplant have progressively improved, particularly after the introduction of cyclosporine in 1984. The overall one-year patient and graft survival rates now are 96% and 85%, respectively; these results exceed the national averages.
The first liver transplant performed in Hawaii was on May 17, 1993 in a patient with end-stage liver disease caused by autoimmune hepatitis. Liver transplantation is a well-accepted treatment for end-stage liver disease with a 1-year patient survival of 80% to 85%. Early recognition of the appropriate candidate by primary care physicians and prompt referral to a liver transplant center are essential for optimal results. The indications, contraindications, organ procurement and allocation, complications, and results of liver transplantation are described. Finally, several controversial areas will be introduced, including liver transplant for alcoholic cirrhosis and hepatitis B, and use of transjugular intrahepatic portosystemic shunts (TIPS).
Technetium-99m (99mTc) sestamibi (MIBI) was first used as a parathyroid imaging agent in Hawaii in 1991. The purpose of this study was to determine the sensitivity and positive predictive value of the MIBI scan in detecting abnormal parathyroid glands. A retrospective, multi-center study from 1992-1994 involving 33 patients in four hospitals showed the overall sensitivity of the MIBI scan for detecting hyperparathyroid disease was 90%. The positive predictive value was 93%. It was more sensitive in detecting adenomas (95%) than hyperplasia (45%). In conclusion, the MIBI scan can be helpful in detecting abnormal parathyroid glands and may be most useful prior to reoperations for persistent and recurrent hyperparathyroidism.
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