Hawai''i journal of health & social welfare最新文献

This retrospective study assesses the prevalence of otolaryngology (OTO) disease in houseless patients on O'ahu based on data from the Houseless Outreach and Medical Education (HOME) clinics, a medical student-run, primary health care service. It is important to note that this data represents only a snapshot in time of the OTO diseases present in this population. Records were examined from September 3, 2020 to September 30, 2021. Patients with at least 1 OTO disease were included in this study. A total of 597 patient records were reviewed; a total of 58 patients were included in this study. The most common OTO diagnoses in this sample were facial trauma (n = 12, 21%), dental caries (n = 7, 12%), cerumen impaction (n = 6, 10%), viral upper respiratory infection (n = 5, 9%), otitis media (n = 4, 7%), and allergic conjunctivitis (n = 3, 5%). Roughly 10% of patients seen in HOME clinics between September 2020 and September 2021 were seen for OTO disease.

There is an estimated shortage of 46 000 to 90 000 physicians in the US, especially in rural areas. Physicians working in rural areas often maintain a larger scope of practice compared to their urban counterparts. This scope may include performing procedures which may require additional training, and lack of that training may limit rural physicians' capability to perform procedures. Physicians practicing in rural areas of Hawai'i were surveyed about their scope of practice regarding procedures and the perceived hindrances in performing procedures. Physicians identified as rural practitioners and rural physicians attending local conferences were asked to participate. Forty-seven (out of 301) rural Hawai'i physicians participated in the survey, of which 89% reported performing procedures. The most common procedures performed included suture removal, incision and drainage, wound care, and suturing. Of the 47 respondents, a total of 28 physicians or 60% reported wishing to perform procedures but not doing so. The procedures physicians would like to perform included gynecological (36%), casting (21%) and wound care (14%). Barriers to performing procedures included lack of time (51%), inadequate training (37%), out of practice (22%), and poor reimbursement (17%). While most rural physicians in this study perform procedures, many would like to perform more. Lack of training and support are significant barriers to increasing scope of procedures performed. Medical schools, residencies, and continuing education programs should consider expanding training in these areas, especially for those planning to practice or currently practicing in rural areas.

Antimicrobial-resistant pathogens, or "superbugs," cause more than 35 000 deaths and more than 2.8 million antibiotic-resistant infections in the US each year. Worldwide, antimicrobial resistance (AMR) has claimed at least 700 000 lives per year, including 230 000 from multi-drug resistant (MDR) tuberculosis. AMR-related deaths are projected to increase to 10 million by the year 2050. The use of biocides, improper prescribing of antibiotics for viral infections, prolonged hospital stays, and other issues contribute to AMR. The purpose of this study was to determine whether the COVID-19 pandemic has had an impact on the rates of AMR globally. While it is still early for the results of research studies, 4 articles indicated an increase, 2 found a decrease, and 2 had mixed results. It is possible that this pandemic may be contributing to an increase of medication-resistant infections.

Breast cancer disproportionately impacts Native Hawaiian and Pacific Islander communities in Hawai'i, as exemplified by high breast cancer prevalence and mortality rates. Breast cancer disparities are linked to socio-cultural determinants of health, signifying the importance of culturally-based interventions. This paper systematically reviewed breast cancer studies conducted in Hawai'i. The literature search yielded 813 published studies, with a final total of 13 peer-reviewed studies that met this paper's inclusion criteria. All but 1 study incorporated cultural components. By evaluating key intervention components and assessing the quality of each study, the research team aimed to analyze the importance of cultural values in health interventions. Family and spirituality in coping with a cancer diagnosis were key themes in patients' lived experiences. Other culturally-based components in these studies included community-engaged research and cultural training for health professionals. The collective findings suggest that breast cancer health interventions that incorporate cultural strengths, values, and worldviews may play a central role in reducing the overall breast cancer burden among these communities. The present review advocates for future research to take a more culturally-based strategy in addressing breast cancer health disparities among Native Hawaiian and Pacific Islanders in Hawai'i.

Rates of electronic nicotine delivery systems (ENDS) use are exponentially increasing in youth and young adults within the United States, including Asian American, Native Hawaiian, and Pacific Islander (AANHPI) youth in Hawai'i. Disproportionately high ENDS use rates for AANHPI youth point to the need to understand the empirical literature in this area. A systematic literature review is a prerequisite for programs effectively curbing AANHPI youths' elevated use of ENDS. This systematic literature review examines empirical studies published between 2010-2020 on ENDS and their use as it applies to AANHPI youth. A total of 11 articles were identified using specific inclusionary and exclusionary criteria in a literature search. Studies described individual and interpersonal correlates to ENDS use. Notably, there were no published ENDS intervention studies detailed to AANHPI youth. Implications of these studies for prevention and social welfare interventions are discussed.