Hawaii Medical Journal Articles For 1995
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Item Medicaid recipients and psychiatric treatment.(1995-01) Chun, W KItem Bone mineral content in Hawaiian, Asian, and Filipino children.(1995-01) Nowack, M K; Brizzolara, S; Lally, D AOs calcis bone mineral content (BMC) was measured by single photon absorptiometry in 86 children, ages 6 to 13 years from Hawaiian, Oriental, Caucasian, and Filipino ethnic groups. Pearson correlations indicated significant positive correlations between BMC and age, height, and weight. However, there were no significant differences in age, height or weight between ethnic groups. ANOVA revealed a significant effect of ethnic group on BMC with the Hawaiian group having a significantly higher BMC than the Asian or Caucasian groups. When age, height and weight were controlled for, ANCOVA still showed a significant effect of ethnicity on BMC. The current findings suggest that ethnic differences can develop early in life.Item Organizational response to adolescent HIV risk.(1995-01) Mueller, C; Mann, E; Bidwell, R; Liebow, E; Lovely, R; McGrady, G; Vera, MUsing semi-structured interviews, the present study examined organizational responses to adolescent HIV risk in an urban Honolulu community. All 23 health, social service, and educational organizations studied have been impacted by HIV. However, the overall organizational response has been compartmentalized and limited. Recommendations concerning improved organizational responses are provided.Item Transjugular intrahepatic portosystemic shunt (TIPS): treatment of esophageal variceal bleeding.(1995-01) Lau, L D; Wong, L L; Tsai, N C; Kon, K N; Wong, L MManagement of esophageal variceal bleeding continues to be a difficult problem for the practicing physician. TIPS is an interventional radiologic procedure that involves creating a channel within the liver between the portal vein and the systemic circulation using an expandable metallic stent. Ten patients underwent TIPS at St Francis Medical Center and the technical success rate was 100%. Complications have been minimal. One patient has died from progressive hepatic failure and carcinoma, and 1 patient underwent liver transplantation. The remaining 8 patients have a patent TIPS in place and have not rebled.Item Characteristics of long-term mentally ill patients: policy implications.(1995-02) Anders, R LThis study examined the records of all psychiatric patients who were hospitalized over one year in a public sector institution. The 88 patients primarily were men, hospitalized under a penal code, Hawaiian or other ethnic minority, and unmarried. Over 74% were hospitalized under a penal code. The State is moving toward a capitated managed care environment for the seriously and persistently mentally ill. With the majority of the patients who are hospitalized under a penal code, changes in the public policy concerning their care is needed. If no changes are made, all of the existing hospital beds potentially could be filled with forensic patients.Item Adequacy of a pre-participation examination form: a study of Hawaii physicians.(1995-02) Buxton, B P; Ho, K W; Nichols, A W; McCarthy, M R; Hiller, W DMany states currently require a medical screening prior to participation in organized sports. The purpose of this study was to examine the adequacy of the existing pre-participation examination form in Hawaii. One hundred forty-eight physicians who perform school health/pre-participation physical examinations were surveyed. The results indirectly suggest that these physicians agreed that the form should be modified and improved (p, .001).Item Prevalence of systemic lupus erythematosus in Hawaii: is there a difference between ethnic groups?(1995-02) Maskarinec, G; Katz, A RThis population-based study in Hawaii collected cases of systemic lupus erythematosus from medical facilities and a patient support group. A total of 454 cases was found and the prevalence was estimated at 41.8 per 100,000 population for 1989. The prevalence odds ratio for all non-Caucasians compared to Caucasians was 1.2 (0.9-1.5), for Japanese 1.3 (1.0-1.7), for Filipinos 1.5 (1.1-2.0), for Chinese 2.4 (1.7-3.4), and for Hawaiians 0.8 (0.6-1.1). Mortality rates were 3 times higher for non-Caucasians than for Caucasians in 1985 to 1989. Despite the observed differences, it remains unclear whether individuals with Asian or Pacific Islander ancestry are at higher risk for systemic lupus erythematosus. The variation in prevalence rates may be a result of differences in access to medical care and in survival.Item Trends in workers compensation costs in a hotel-operating company over a six-year period.(1995-03) Kelley, C R; Mark, C RA large Honolulu-based hotel-operating company reviewed its workers compensation costs over the last 6 years. Data retrieved from the company's computerized data base is used to describe trends in injury incidence rate, average cost per claim, average medical cost per claim, and medical expenses as a percentage of total costs. Factors that might have influenced these parameters include company reorganization, employee training and safety programs, changes in the economy, company morale, aggressive case management, and the quality of the adjusting services hired. Cause-and-effect relationships, although suggested, cannot be proven. The data is presented, in this year of imminent workers compensation legislative reform, to increase the available factual data base on which rational and efficacious reform proposals can be developed.Item Pre-participation examination: a new form for Hawaii.(1995-03) Nichols, A W; Buxton, B P; Ho, K WA recent study examining the adequacy of the existing pre-participation physical examination (PPE) form in the State of Hawaii suggested that the form be modified and expanded. The standards for a comprehensive PPE indicate that the screening should include an extensive medical history, assessment of height, weight, blood pressure, pulses, vision, cardiopulmonary (heart, and lungs), maturation, skin, abdominal, genitalia, and musculoskeletal function. Pursuant to the recommendation of this recent study and the accepted standards of the American Academy of Family Physicians, American Academy of Pediatrics, American Medical Society for Sports Medicine, American Orthopedic Society for Sports Medicine, and the American Osteopathic Academy of Sports Medicine, the PPE form utilized by the Hawaii High School Athletic Association has been drastically modified. The new form includes an expanded medical history, a maturational assessment (Tanner Stage), a complete musculoskeletal examination, and a participation clearance and recommendation.Item The role of genetics in (continuing) medical education in Hawaii.(1995-03) Powell, B; Hsia, Y EItem Epinephrine for anaphylaxis.(1995-03) Frazier, C AItem Wonder what Hippocrates would say?(1995-03) Wong, S CItem Ethical issues--physicians and managed care.(1995-04) Wallach, S JItem Have physicians abdicated their role?(1995-04) Moser, S SItem Medical decisions at the end-of-life: lessons from America.(1995-04) Tan, S YBioethical issues that deal with medical decisions at the end of life are as interesting as they are contentious. Daily, we confront questions of health care rationing, medical futility, euthanasia, or the use of advanced directives and ethics committees. There is present-day mainstream thinking on these bioethical themes and more important, under-emphasized and controversial aspects of dying in America.Item Psychiatric assessment of the suicidal terminally ill.(1995-04) Burnell, G MTerminally ill patients who refuse life-supporting treatments and express a wish to die are often viewed in the same light as suicidal patients who are medically well. Terminally ill patients who are depressed should be treated with antidepressants, but if the wish to die persists, it should be respected.Item Age-based rationing of health care.(1995-04) Blanchette, P LThe U.S. has focused attention on the rising costs of health care coincident with the increasing age of the population. Arguments have been made to overtly ration care to older persons; however, general acceptance of the need to ration scarce resources, whether or not such a policy is actually formalized, can lead to covert rationing. Some overt rationing has already occurred, some of the data put forth to justify that rationing needs to be challenged, and ethical principles need to be applied to provide appropriate and perhaps less costly care.Item The new Hawaii Comfort Care Only-Do Not Resuscitate law.(1995-04) Gifford, G CThe new Hawaii law creating the Comfort Care Only-Do Not Resuscitate order allows terminally ill patients to be treated by ambulance personnel for comfort and pain control, and to not be resuscitated when they are near death.Item Toward an exit visa--regulating health care decision-making.(1995-04) Pietsch, J HItem Consent for children as organ donors.(1995-04) Williams, R WThe use of children as organ donors has been a source of legal and ethical concern since transplantation became generally available.