Hawai''i journal of health & social welfare最新文献_第3页

How COVID-19 Impacted Colonoscopy Utilization and Colorectal Cancer Detection in Hawai'i in 2020. COVID-19 如何影响 2020 年夏威夷的结肠镜检查使用率和结肠直肠癌检测率。

Hawai''i journal of health & social welfare Pub Date : 2024-07-01 DOI: 10.62547/TZCD4005

Ankur Jain, Shilpa Jain, Ian Pagano

{"title":"How COVID-19 Impacted Colonoscopy Utilization and Colorectal Cancer Detection in Hawai'i in 2020.","authors":"Ankur Jain, Shilpa Jain, Ian Pagano","doi":"10.62547/TZCD4005","DOIUrl":"10.62547/TZCD4005","url":null,"abstract":"The Coronavirus Disease of 2019 (COVID-19) pandemic had a profound impact on colorectal cancer (CRC) screening and diagnostic testing. During the initial months of the pandemic, there was a sharp decline in colonoscopies performed as many areas were on lockdown and elective procedures could not be performed. In later months, even when routine procedures started being scheduled again, some patients became fearful of contracting COVID during colonoscopy or lost their health insurance, leading to further delays in CRC diagnosis by colonoscopy. Previous studies have reported the dramatic decrease in colonoscopy rates and CRC detection at various institutions across the country, but no previous study has been performed to determine rates of colorectal screening by colonoscopy in Hawai'i where the demographics of CRC differ. The team investigated the pandemic's impact on colonoscopy services and colorectal neoplasia detection at several large outpatient endoscopy centers in Hawai'i and also classified new CRC cases by patient demographics of age, sex, and ethnicity. There were fewer colonoscopies performed in these endoscopy centers in 2020 than in 2019 and a disproportionate decrease in CRC cases diagnosed. Elderly males as well as Native Hawaiians/Pacific Islanders were most impacted by this decrease in CRC detection. It is possible there will be an increase in later stage presentation of CRC and eventual CRC related mortality among these patients.","PeriodicalId":36659,"journal":{"name":"Hawai''i journal of health & social welfare","volume":"83 7","pages":"200-203"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11224954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141555556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Patient Interview-Based Needs Assessment and Evaluation of Experiences with Periviable Pregnancies. 以患者访谈为基础的需求评估和围产期妊娠经验评价。

Hawai''i journal of health & social welfare Pub Date : 2024-06-01 DOI: 10.62547/XATQ5707

Michelle A Nakatsuka, Keahi Peters, Ingrid Chern, Kandie George, Men Jean Lee, Kelly S Yamasato

{"title":"A Patient Interview-Based Needs Assessment and Evaluation of Experiences with Periviable Pregnancies.","authors":"Michelle A Nakatsuka, Keahi Peters, Ingrid Chern, Kandie George, Men Jean Lee, Kelly S Yamasato","doi":"10.62547/XATQ5707","DOIUrl":"10.62547/XATQ5707","url":null,"abstract":"Given the complex ethical and emotional nature of births during the periviable period for both health care providers and families, this investigation sought to identify strategies for improved counseling of pregnant patients facing preterm birth at the cusp of viability at a tertiary care center in Hawai'i. As part of a larger quality improvement project on periviability counseling, 10 patients were interviewed during either individual or small focus groups using a progression of hypothetical scenarios. Interviews were analyzed independently by 3 investigators to identify themes of patient experience and potential areas for improvement when counseling patients who are carrying periviable pregnancies. Several common themes emerged from the interviews. Patients expressed the desire for more information throughout the process delivered in a jargon-free manner with unified messaging from the medical teams, and emotional support. These findings add to a limited body of literature which addresses patient perceptions of interactions with health care providers in the face of uncertainty, particularly in a Pacific Islander population. The authors recommend increasing provider training and developing a more structured process to counsel pregnant women facing periviable pregnancy loss to improve the patient experience.","PeriodicalId":36659,"journal":{"name":"Hawai''i journal of health & social welfare","volume":"83 6","pages":"162-167"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11161210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141296847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Describing the Medical Needs of Hawai'i's Houseless Population During COVID at Free Student Run Outpatient Clinics (Hawai'i HOME Project). 描述夏威夷无房人口在 COVID 期间在学生开办的免费门诊诊所的医疗需求（夏威夷 HOME 项目）。

Hawai''i journal of health & social welfare Pub Date : 2024-06-01 DOI: 10.62547/ZSAJ9907

Brendan K Seto, Dylan S Singh, Jason C Seto, Hussein B Said, Nick B Liu, Jill Omori, Teresa Schiff-Elfalan

{"title":"Describing the Medical Needs of Hawai'i's Houseless Population During COVID at Free Student Run Outpatient Clinics (Hawai'i HOME Project).","authors":"Brendan K Seto, Dylan S Singh, Jason C Seto, Hussein B Said, Nick B Liu, Jill Omori, Teresa Schiff-Elfalan","doi":"10.62547/ZSAJ9907","DOIUrl":"10.62547/ZSAJ9907","url":null,"abstract":"Hawai'i experiences some of the highest rates of houselessness per capita in the country. COVID-19 has exacerbated these disparities and made it difficult for these individuals to seek medical care. Hawai'i's Houseless Outreach in Medical Education (HOME) clinic is the largest student run free clinic in the state, which provides medical services to this patient population. This article reports the demographics, medical needs, and services provided to patients of Hawai'i's HOME clinic during the era of COVID-19. From September 2020 to 2021, the HOME clinic saw 1198 unique visits with 526 distinct patients. The most common chief complaints included wound care (42.4%), pain (26.9%), and skin complaints (15.7%). A large portion of the population suffered from comorbidities including elevated blood pressure (66%), a formal reported history of hypertension (30.6%), diabetes (11.6%), and psychiatric concerns including schizophrenia (5.2%) and generalized anxiety (5.1%). Additionally, a large portion of patients (57.2%) were substance users including 17.8% of patients endorsing use of alcohol, 48.5% tobacco and 12.5% marijuana. The most common services provided were dispensation of medication (58.7%), wound cleaning/dressing changes (30.7%), and alcohol or other drug cessation counseling (25.2%). This study emphasizes that the houseless are a diverse population with complex, evolving medical needs and a high prevalence of chronic diseases and comorbidities.","PeriodicalId":36659,"journal":{"name":"Hawai''i journal of health & social welfare","volume":"83 6","pages":"158-161"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11161211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141296848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Public Health Communication to Build Equity: 10 Best Practice Pandemic Insights and Examples from Hawai'i. 建立公平的公共卫生传播：夏威夷大流行病的 10 个最佳实践启示和范例》（Public Health Communication to Build Equity: 10 Best Practice Pandemic Insights and Examples from Hawai'i.

Hawai''i journal of health & social welfare Pub Date : 2024-06-01 DOI: 10.62547/HHZJ2325

Tetine Sentell, Julia Finn, N Kuuleimomi Tolentino, Kim Ku'ulei Birnie, Michael M Phillips

引用次数: 0

Impact of a Fast Pass on Emergency Department Wait Times for Oncology Patients with Febrile Neutropenia. 快速通道对肿瘤科发热性中性粒细胞减少症患者急诊科候诊时间的影响。

Hawai''i journal of health & social welfare Pub Date : 2024-06-01 DOI: 10.62547/BCON7342

Gisele Ige, Pamela Adena, So Yung Choi

{"title":"Impact of a Fast Pass on Emergency Department Wait Times for Oncology Patients with Febrile Neutropenia.","authors":"Gisele Ige, Pamela Adena, So Yung Choi","doi":"10.62547/BCON7342","DOIUrl":"10.62547/BCON7342","url":null,"abstract":"This pilot study examined differences in wait times for oncology patients who presented to the emergency department, with or without a Fast Pass, for febrile neutropenia (FN). Inadequate circulating neutrophils create a health risk for FN patients. An increased number of patients are receiving chemotherapy in an outpatient setting and may experience delays when seeking treatment in the emergency department. These delays in treatment may be due to overcrowding, patients who require life-saving medical interventions, and inconsistencies in recognizing febrile neutropenia, where fever may be the only presenting sign. The purpose of this study was to measure the impact on wait times, increasing possible risk of bacterial or viral exposure in the emergency department waiting room, for patients with a potential diagnosis of FN who presented their \"Fast Pass\" from the hospital cancer center's program upon arrival. Electronic medical records were reviewed over a period of 21 months, comparing wait times in the ED for oncology patients with potential FN before and after implementation of the Fast Pass program at an urban medical center in Hawai'i. Of the 1300 oncology patient chart reviews conducted, 6 patients met the study-defined inclusion criteria pre-Fast Pass and 10 met the study-defined inclusion criteria post-Fast Pass. Influence of the use of a Fast Pass on patient wait times was tested using a multivariate regression adjusted for ED patient volume. There were no differences in overall wait times pre- and post-Fast Pass.","PeriodicalId":36659,"journal":{"name":"Hawai''i journal of health & social welfare","volume":"83 6","pages":"152-157"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11161209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141296849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Historical Inequities in Medical Education - Commitment to Opportunity, Diversity, and Equity at the University of Hawai'i School of Medicine. 医学教育历史上的不平等--夏威夷大学医学院对机会、多样性和平等的承诺。

Hawai''i journal of health & social welfare Pub Date : 2024-05-01 DOI: 10.62547/HLHV7741

Kathleen Kihmm Connolly, Winona Lee, Vanessa Freitas, Lee Ellen Buenconsejo-Lum

{"title":"Historical Inequities in Medical Education - Commitment to Opportunity, Diversity, and Equity at the University of Hawai'i School of Medicine.","authors":"Kathleen Kihmm Connolly, Winona Lee, Vanessa Freitas, Lee Ellen Buenconsejo-Lum","doi":"10.62547/HLHV7741","DOIUrl":"10.62547/HLHV7741","url":null,"abstract":"Medical education in the US has contributed to institutionalized racism through historically exclusionary practices, which has led to health disparities and inequities in health care today. The 1910 Flexner report, which favored schools with greater resources, led to the closure of nearly half of medical schools in the Us, which were mostly small schools located in rural communities that served economically disadvantaged, ethnic minority, and female populations. Closing these schools ultimately limited the availability of physicians willing to serve disadvantaged and minority populations in impoverished and underserved communities. In order to transform medical education to be more equitable, medical schools must be proactive in opportunity, diversity, and equity efforts. This not only includes efforts in admissions and faculty hiring, but also curricula related to social and health disparities, interracial interactions between students and faculty, and service learning activities that engage and work with marginalized communities. The University of Hawai'i John A. Burns School of Medicine has a longstanding commitment to diversity, which is integral to the school's mission. Providing opportunities to underserved populations has been a priority since establishment of the school. As one of the most diverse univeristies in the US, the school of medicine continues to focus on opportunity, diversity, and equity priorities in both its strategic planning and overall mission.","PeriodicalId":36659,"journal":{"name":"Hawai''i journal of health & social welfare","volume":"83 5","pages":"138-143"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11070778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140877592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

'Tausi Feagaiga: A Project to Train Caregivers and Empower the American Samoan Community. Tausi Feagaiga：培训护理人员和增强美属萨摩亚社区能力的项目。

Hawai''i journal of health & social welfare Pub Date : 2024-05-01 DOI: 10.62547/CNOI4613

Ritabelle Fernandes, Nancy E Allen

{"title":"'Tausi Feagaiga: A Project to Train Caregivers and Empower the American Samoan Community.","authors":"Ritabelle Fernandes, Nancy E Allen","doi":"10.62547/CNOI4613","DOIUrl":"10.62547/CNOI4613","url":null,"abstract":"The 'Tausi Feagaiga (Covenant Keeper) project was a partnership to support the traditional values of tausi matua (caring for one's elders). The partners included a non-governmental organization (Pacific Youth and Community Development), a faith-based organization (Roman Catholic Diocese of Samoa-Pago Pago), and an institute of higher education (University of Hawai'i John A. Burns School of Medicine). The project was created to address the lack of community-based health care such as home health or hospice, and families needing to work outside the home. A culturally based caregiving curriculum was developed to educate caregivers and improve their knowledge and skills. Using a train-the-trainer model, 125 caregivers were trained in family caregiving from 2016-2020. Training was conducted through an intensive workshop followed by practicum at Hope House, the Catholic Diocese home for the aged. Participants who expressed a willingness and competency were mentored to be trainers to continue the 'Tausi Feagaiga project. The mean self-rated confidence in caregiving improved significantly from 3.17 ± 1.02 (mean SD) pre workshop to 3.53 ± 0.71 post workshop (P = .001). Competence in geriatric syndromes was improved from 18.04 ± 4.27 to 21.31 ± 4.30 after attending the workshop (P < .001) and the feedback was extremely positive. Technical assistance was provided to obtain funding through American Samoa Medicaid State Agency to improve the existing infrastructure of Hope House, obtain much needed supplies, and increase ability to hire the participants. 'Tausi Feagaiga positively impacted the lives of the residents of Hope House, the course participants, the elders in the community, and those who care for them.","PeriodicalId":36659,"journal":{"name":"Hawai''i journal of health & social welfare","volume":"83 5","pages":"132-137"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11070779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140877591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Native Hawaiian and Pacific Islander Youth Substance Use Prevention in Rural Hawai'i. 夏威夷农村地区夏威夷原住民和太平洋岛民青少年药物使用预防。

Hawai''i journal of health & social welfare Pub Date : 2024-05-01 DOI: 10.62547/DUAS8087

Sarah Momilani Marshall, Sophia Lau

引用次数: 0

Understanding Hawaiian Identity and Well-being to Improve Mental Health Outcomes for Hawaiian Young Adults. 了解夏威夷人的身份和福祉，改善夏威夷年轻成年人的心理健康结果。

Hawai''i journal of health & social welfare Pub Date : 2024-05-01 DOI: 10.62547/HHGI9020

Catherine Jara, Ngoc Phan

引用次数: 0

Leukocytoclastic Vasculitis Localized to the Uterine Cervix. 子宫颈局部白细胞胞浆细胞性血管炎

Hawai''i journal of health & social welfare Pub Date : 2024-03-01

Jose G Roble, Sarah E Ligon, Kelly L Langan

引用次数: 0