Pacific health dialog最新文献

{"title":"Digital health and Universal Health Coverage: Opportunities and policy considerations for low- and middle-income Pacific Island countries and territories","authors":"Adam T. Craig, Kristen Beek, Myron Anthony Godinho, Sameera Ansari, J. Jonnagaddala, N. Asgari-Jirhandeh, Christine Linhart, John Hall, S. Liaw","doi":"10.24135/pacifichealth.v6i.64","DOIUrl":"https://doi.org/10.24135/pacifichealth.v6i.64","url":null,"abstract":"Introduction: Providing affordable, accessible, quality health services is critical to attaining Universal Health Coverage (UHC). Despite this, progress in many Pacific Island countries and territories could be faster. Digital health is an advancement in information communication technology that is anticipated to change health care delivery. \u0000Methods:  A systematic review of the literature and 5-years of Pacific Heads of Health, Pacific Health Ministers, and WHO’s (Western Pacific) Regional Committee meeting reports was conducted. In addition, an umbrella review of the literature pertaining to digital health's use to address health systems challenges in low-and middle-income countries was undertaken and key-informant interviews with policymakers, digital health managers, technical advisors, development specialists, and donors were held. Data was thematically analysed using an inductive approach. Finally, a series of consultations were held with Pacific Health Information Network members to test findings and refine recommendations. \u0000Results/Discussion: Four broad UHC-related challenges and associated priority digital health responses were identified. The challenges identified were a need to: (i) build systems for the collection and timely exchange of health data to support clinical management and health system planning; (ii) address barriers to accessing quality health care services (particularly in rural areas); (iii) improve mechanisms for communication between health staff and functions of the health system, and (iv) address workforce training and essential skills development. Priority digital health responses identified include electronic health and patient information systems, telehealth, digital stock and supply chain management systems, technology-supported collection and linkage of population data, digitally enabled health worker-to health-worker communication and digital clinical decision-making. \u0000Conclusion: While digital health can enhance health system function through accelerated access to and exchange of information, it does not replace fundamental health systems components such as a sufficient skilled health workforce, supply chains, health reporting, financing, or governance. Where adopted appropriately, digital health offers opportunities to improve the efficiency and effectiveness of established health enterprises and improve access to equitable and quality health care.","PeriodicalId":82251,"journal":{"name":"Pacific health dialog","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82287315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased Reports of Depression in Hawaiʻi during the first wave of COVID-19","authors":"Katherine Aumer, Michael Erickson, Eli Tsukayama","doi":"10.24135/pacifichealth.v6i.61","DOIUrl":"https://doi.org/10.24135/pacifichealth.v6i.61","url":null,"abstract":"Introduction: Reports of mental health issues increased nationally in the USA during the COVID-19 pandemic, often attributed to the effects of quarantine, isolation, and restriction of travel. Given that Hawaiʻi State’s population is unique in its largely ethnic minority population, geographic isolation, and economic dependence on tourism, it is important to document if similar mental health outcomes have occurred during the beginning of the COVID-19 pandemic. \u0000Methods: This study compares Hawaiʻi’s rates of depression using data from the National Center for Health Statistics collected in 2020 and the Hawaiʻi Behavioral Risk Factor Surveillance System collected in 2016. \u0000Results: Hawaiʻi’s rate of depression, like the rest of the nation, increased significantly during the first wave. A chi-square test of independence was conducted, and the results were significant, χ2 (1, n = 20,261.42) = 582.48, p < .001. Before COVID-19, typical rates of depression were at 11.03%, 95% CI [10.51%, 11.55%]. During the COVID-19 pandemic, reports of depression increased to 24.23%, 95% CI [23.16%, 25.31%]. \u0000Conclusion: Depressive symptoms doubled during the early stages of the pandemic in Hawaiʻi. Evidence-based strategies should be developed now to help prevent future possible mental health related issues that are attributable to pandemic related safety protocols.","PeriodicalId":82251,"journal":{"name":"Pacific health dialog","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82129474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstracts of Pasifika Medical Association Conference 2022","authors":"A. Ekeroma","doi":"10.26635/phd2022.153","DOIUrl":"https://doi.org/10.26635/phd2022.153","url":null,"abstract":"\u0000\u0000\u0000The annual Pasifika Medical Association (PMA) Conference was held at the Te Papa Museum, Wellington from the 4th to the 6th of September 2022. The Pasifika Medical Association celebrated 26 years of successful navigation and the conference with a theme of ‘Reconnect, Reflect, Reframe and Reenergise’ was attended by about 500 participants. Most were Pacific health workers from across the Pacific Islands, New Zealand and Australia. Abstracts from the Conference are published here.\u0000\u0000\u0000","PeriodicalId":82251,"journal":{"name":"Pacific health dialog","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47657963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining case complexity among Pasifika with autism/Takiwātanga in Aotearoa New Zealand: a national cross-sectional study","authors":"T. Ruhe, Betty Kolose-Pulefolau, S. Foliaki, N. Bowden, R. Richards, J. Kokaua","doi":"10.26635/phd.2024.144","DOIUrl":"https://doi.org/10.26635/phd.2024.144","url":null,"abstract":"Introduction: Autism is a lifelong neurodevelopmental condition that is estimated to impact 1 in 44 children. In Aotearoa New Zealand, the rate of autism among Pasifika children and young people (38.6 per 10,000 people) is substantively lower than other ethnic groups (67.5 for European and 47.2 for Māori); however, the complexities associated with Autism diagnosis in Pasifika is unknown. \u0000Aim: We compared rates of Autism and co-occurring diagnoses of conditions as a proxy for Autism case complexity between Pasifika and NMNP young people (aged 0-24 years) in Aotearoa New Zealand. \u0000Methods: This national, cross-sectional study was undertaken using data from a national database; the Integrated Data Infrastructure (IDI). Three separate indicators were created to reflect different types of complexity for someone with autism: Asperger’s syndrome (identifies those with lower complexity with fewer demands on support services); intellectual disability (higher needs/greater complexity); ORS funding (higher needs/greater complexity). \u0000Findings: In this present study, Pasifika in Aotearoa New Zealand had much lower autism identification rates in comparison to Non-Māori Non-Pasifika (NMNP) (53.3 per 10,000 vs 83 per 10,000). After adjusting for socioeconomic differences, Pasifika had significantly lower odds (Odds Ratio (OR) = 0.47) of having an Asperger’s syndrome diagnosis.  However, Pasifika had significantly higher odds of having an intellectual disability (OR = 2.23) and being Ongoing Resources Scheme funded (OR = 2.18). \u0000Conclusions: Using this method within the IDI, Pasifika children in Aotearoa continue to have lower rates of Autism diagnosis; however, they are more likely to have a higher complexity of autism diagnosis.","PeriodicalId":82251,"journal":{"name":"Pacific health dialog","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46505592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Traditional kava use and body sway: A pilot investigation","authors":"S. Aporosa, K. Hébert-Losier, Harvey Aughton","doi":"10.26635/phd.2022.146","DOIUrl":"https://doi.org/10.26635/phd.2022.146","url":null,"abstract":"Introduction The (traditionally influenced) consumption of kava (Piper methysticum) has been associated with increased body sway, raising concerns about fall risk. However, studies typically utilise pill-styled kava extracts with a lack of understanding regarding experienced naturalistic kava drinkers. This pilot study investigated the effects of naturalistic kava consumption over a six-hour period on postural control. Methods Six experienced male kava drinkers consumed 100ml of kava every 10 minutes over six hours in a culturally responsive setting. Postural control was examined at three time points (Pre, Mid, and Post) using a 30-seconds eyes-closed feet-together postural balance test conducted on a 3D force plate. Centre of pressure path length, average velocity, and area of the 95th percentile ellipse data were extracted and compared between time points using a one-way repeated measures ANOVA. Findings There were no significant differences in the centre of pressure parameters. Based on the Pre and Post differences for path length and average velocity logged values, this study would require 19 participants to achieve an 80% power and 5% significance level. Discussion Irrespective of limited sample size, our preliminary results do not support that kava consumption negatively affects postural control, findings that appear to be corroborated by a recent neuroscience study. The perceived risks of naturalistic kava consumption with regards to falls may be overstated. Further study on the physiological implications of kava consumption in naturalistic settings is needed to quantify the actual risks. \u0000Highlights• Kava is a culturally significant drink for Pacific people• Anecdotal reports describe impaired balance following high traditional use volumes• Postural control was tested during and following kava use in a pilot study• Contrary to hypothesis, results do not show that kava negatively affects postural control","PeriodicalId":82251,"journal":{"name":"Pacific health dialog","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43282141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thoracic spinal cord compression & aortic thrombosis; an unusual presentation of seminoma","authors":"Jonathan Johns, Poasa Cama, A. Sharma, David Adern","doi":"10.26635/phd.2022.151","DOIUrl":"https://doi.org/10.26635/phd.2022.151","url":null,"abstract":"Testicular cancers are particularly treatable neoplasms, with five-year survival over 95%.1 An increasing proportion of testicular tumours are seminomas, at the expense of non-seminomas, and the age at time of presentation is also increasing.2 Seminomas are particularly likely to present with localised disease, approximately 80% present with disease limited to the testicle, and less than 5% spread beyond the retroperitoneal nodes at presentation.1","PeriodicalId":82251,"journal":{"name":"Pacific health dialog","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47252266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between diabetes-related symptoms, glycemic control, and health-related quality of life in adult Samoans","authors":"Anna C. Rivara, A. Pomer, A. Wetzel, S. Viali, T. Naseri, M. Reupena, E. Kershaw, S. McGarvey, N. Hawley","doi":"10.26635/phd.2022.142","DOIUrl":"https://doi.org/10.26635/phd.2022.142","url":null,"abstract":"Aim \u0000The prevalence of Type 2 diabetes in Samoa has increased substantially over the last 30 years. Identifying common symptoms in those living with diabetes may be instrumental in directing those at risk to seek early evaluation, diagnosis, and treatment. Additionally, identifying associations between diabetes experiences and health-related quality of life is useful for understanding the lived experience of having diabetes in this setting. Here we present the first description of diabetes-related symptoms in an adult cohort of Samoans with diabetes and prediabetes and describe associations between symptom presence and sex, glycemic control (HbA1c ≥ 8.0%), and health-related quality of life (HRQL). We also assessed whether reported symptoms were independently associated, when adjusting for other factors, with increased odds of having diabetes. \u0000METHODS \u0000Analyses were conducted on n = 123 adult Samoan participants selectively sampled from the observational cohort Soifua Manuia study, and who were living with either prediabetes or diabetes. Participants completed a series of anthropometric, biochemical, and questionnaire measures including the Revised Diabetes Symptoms Checklist (DSC-R) questionnaire between 2017-2019. Differences in symptom presence by sex, diabetes status (prediabetes vs. diabetes), glycemic control (HbA1c < or ≥ 8.0%), and HRQL were assessed using Independent Sample T-tests, Mann Whitney U tests and Chi-square tests of association. Multivariate logistic regression was used to assess which symptoms, when controlling for other factors, were associated with increased odds of having diabetes. \u0000RESULTS \u0000In a small sample of adult Samoans, we observed high symptom burdens among those with prediabetes and diabetes, and sex differences in the reported impact of diabetes symptoms on health-related quality of life. We identified three specific symptoms – frequent urination, difficulty thinking clearly, and chest/heart pains – that may be useful indicators of diabetes in this setting. \u0000DISCUSSION \u0000A high prevalence of symptoms was observed among those with prediabetes and among those with diabetes. It is recommended that individuals experiencing any of the measured symptoms seek early evaluation and engage in diabetes self-care behaviors to prevent diabetes-related complications and/or progression to diabetes among those in the early stages of the disease.","PeriodicalId":82251,"journal":{"name":"Pacific health dialog","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48197022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impacts of religious faith on the mental wellbeing of young, multi-ethnic Pacific women in Aotearoa","authors":"Therese Lautua, J. Tiatia","doi":"10.26635/phd.2022.143","DOIUrl":"https://doi.org/10.26635/phd.2022.143","url":null,"abstract":"Aim: By employing a multi-faceted approach in the disciplines of Theology and Pacific Studies; three key areas of investigation were examined and included: how young Pacific women perceived images of God and faith; how it impacted upon their mental resilience and their responses to mundane and significant life events; and their personal constructs of mental wellbeing. \u0000Method: Qualitative group interviews (talanoa) were conducted with participants aged between 17-24 years old; identified with multiple ethnicities, with at least one being Pacific; identified as Roman Catholic, with varying degrees of faith practice; and were based in Auckland, Aotearoa. The Praxis Model methodology was employed throughout the research process and speaks to the interdisciplinary nature of the project. The theory of Intersectionality was utilized as the lens to view each research participants’ multi-layered self-identities. \u0000Findings: There were a total of 64 research participants. Out of the 64 participants, 82% (n=52), generally agreed that their image of God aided a positive state of mental wellbeing, five women were unsure and six stated, that it was something else in their faith practice which primarily supported their mental wellbeing. Part of the reason women felt their image of God offered hope for their future, derived from their belief in an afterlife beyond physical death, which they felt, reduced anxiety about their family members who had died or experienced sickness and trauma throughout their lives \u0000Conclusions: There is a need for more denomination-specific and culturally responsive foci around mental wellbeing, therefore recognising the unique experiences of faith traditions and the challenges faced, particularly, by multi-ethnic young Pacific women. \u0000Key words: Mental wellbeing, Pacific, Theology","PeriodicalId":82251,"journal":{"name":"Pacific health dialog","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44485924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of mental health and substance use-related conditions among Pasifika young people in Aotearoa New Zealand - a national cross-sectional study using the Integrated Data Infrastructure (IDI)","authors":"T. Ruhe, N. Bowden, Reremoana Theodore, Brittany Stanley-Wishart, S. Hetrick, H. Thabrew, M. Hobbs, L. Marek, J. Wiki, Joe Boden, J. Kokaua","doi":"10.26635/phd.2022.147","DOIUrl":"https://doi.org/10.26635/phd.2022.147","url":null,"abstract":"Introduction: Pasifika young people of Aotearoa New Zealand are known to experience higher rates of mental health and addiction conditions (especially anxiety and depression), compared with young non-Māori/non-Pasifika (NMNP). However, there is little information about how well these issues are identified by mental health services. \u0000Aim: We compared rates of diagnosis of common mental health and substance use-related conditions between Pasifika and NMNP young people (aged 10-24 years) and examined how these diagnoses varied with deprivation. \u0000Method: This national, cross-sectional study was undertaken using 2017/18 fiscal year data from a national database known as the Integrated Data Infrastructure. Specialist mental health service use, hospitalisations and pharmaceutical dispensing for any mental health condition, emotional condition (depression and/or anxiety), substance use-related conditions, and self-harm were examined. \u0000Results: A total of 982,305 young people (12.4%, Pasifika and 63.9%, NMNP) were identified. Compared with NMNP, Pasifika young people were significantly less likely to be diagnosed by specialist mental health services with any mental health condition (adjusted Risk Ratio (aRR) = 0.77, 95% CI = 0.75 to 0.78); any emotional condition (aRR= 0.44, 95% Confidence Interval (CI) = 0.43 to 0.45); or to be hospitalised for self-harm (aRR = 0.88, 95% CI = 0.82 to 0.94). However, they were significantly more likely than NMNP to be diagnosed with substance use-related conditions (aRR = 1.68, 95% CI = 1.63 to 1.74). Although the overall rate of mental health issues remained relatively stable across deprivation levels, emotional conditions were much less frequently diagnosed in those with greater deprivation. \u0000Discussion: Discrepancies between expected and identified rates of diagnoses of common mental health and substance use-related conditions might indicate different patterns of service access by Pasifika young people, or they may reflect the bias of an inequitable and less than culturally appropriate health system.","PeriodicalId":82251,"journal":{"name":"Pacific health dialog","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48414010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"On the vaccination threshold for Covid-19 in French Polynesia","authors":"G. Bisson, Roger Oyono","doi":"10.24135/pacifichealth.v5i.59","DOIUrl":"https://doi.org/10.24135/pacifichealth.v5i.59","url":null,"abstract":"High immunization rates are often sought to contain epidemics with target values typically 70% or greater. Our objective is to independently assess this value in the context of the 2020 Covid-19 pandemic in French Polynesia. To this extent, we develop a graph-based epidemic model tailored to this pandemic and compute the vaccination threshold required to prevent exponential spread of the communicable disease. Our results indicate that herd immunity increases drastically when a threshold percentage of vaccinated individuals is reached. Experimental data using our idealized model indicates that the threshold value is approximately 45%. We conclude that vaccination is much more effective at preventing pandemics than usually predicted.","PeriodicalId":82251,"journal":{"name":"Pacific health dialog","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88201180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}