Risk factors associated with 1-year mortality after osteoporotic hip fracture in Hawai'i: higher mortality risk among Native Hawaiians and other Pacific Islanders.

Unlabelled: We studied factors affecting osteoporotic hip fracture mortality in Hawai'i, a region with unique geography and racial composition. Men, older adults, higher ASA score, lower BMI, and NHPI race were associated with higher mortality. This is the first study demonstrating increased mortality risk after hip fracture in NHPI patients.

The Memory Assessment Scale: A Population-based Cognitive Impairment Screening Instrument.

This study re-examined the Memory Assessment Scale (MAS), a brief memory test developed in Hawai'i in 1987, to assess whether it remains a valid and reliable cognitive impairment screening tool in Hawai'i. Patients suspected of having neurocognitive dysfunction were divided into 2 groups (those with and without mild cognitive impairment) based on their results on a battery of neuropsychological tests. No differences in MAS scores were found between patients with and without mild cognitive impairment.

Prevalence of invalid ImPACT baseline test results among high school athletes with invalidity and sandbagging indices.

The comparison of baseline neuropsychological test results with post-concussion neuropsychological test results is a common practice to assess the aftermath of a sport-related concussion. The effectiveness of this approach is compromised when invalid baseline test performances occur. The present study was designed to assess the prevalence of invalid baseline test results of high school athletes, using the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT).

Hepatopancreaticobiliary Surgical Outcomes at a Community Hospital.

There is a national trend towards regionalizing complex hepatopancreaticobiliary (HPB) surgeries to high-volume institutions. Due to geographic and socioeconomic constraints, however, many patients in the United States continue to undergo HPB surgery at local community hospitals. This study evaluated complex HPB surgeries performed by a single surgeon at a low-volume community hospital from May 2007 to June 2021.

Nontuberculous mycobacterial skin and soft tissue infection in Hawai'i.

Background: Hawai'i has the highest nontuberculous mycobacterial (NTM) lung infection prevalence in the United States. Limited data regarding skin and soft tissue infections (SSTI) due to NTM in Hawai'i exists. This study describes patient demographics, clinical courses of infection, treatment patterns, and clinical outcomes of NTM SSTIs in Hawai'i.

Osteoporosis treatment rates after hip fracture 2011-2019 in Hawaii: Undertreatment of men after hip fractures.

Objectives: To investigate trends of osteoporosis treatment rates, and factors affecting osteoporosis treatment after hip fracture admission within a single health care system in Hawaii.

Methods: A retrospective chart review was conducted of patients aged 50 years or older and hospitalized for hip fractures between January 1, 2011 and December 31, 2019 at Hawaii Pacific Health, a large health care system in Hawaii. We collected data on basic demographics and osteoporosis medication prescription from electronic medical records.

The NEW Keiki Program Reduces BMI z-scores Among Overweight and Obese Children and BMI Among Their Adult Caregivers in Hawai'i.

The high prevalence of childhood obesity highlights the need for effective weight management interventions. This study evaluated a family-based weight management program (Nutrition+Exercise+Weight Management; NEW Keiki) in overweight and obese children and their adult caregivers. Data were collected on overweight (body mass index, BMI = 85th-94th percentile) and obese (BMI > 95th percentile) children (n = 75, 5-14 years) and their adult caregivers (n = 104).

The Importance of Echocardiogram during the Second Week of Illness in Children with Kawasaki Disease.

Objective: To determine the timing of peak coronary artery dilation and the characteristics of patients who present with new-onset coronary artery dilation during the acute phase of Kawasaki disease with an initial normal echocardiogram.

Study Design: This retrospective study analyzed 231 children hospitalized for Kawasaki disease in Hawai'i over a period of 7 years. Clinical and echocardiographic data were collected to calculate the timing of peak z score, and study subjects were compared based on the timing of coronary dilation.

Patterns of health care utilization of gout patients in Hawai'i-high rates of emergency department utilization as compared to rheumatoid arthritis.

Recent and comprehensive research of gout in the Pacific region and Hawai'i is significantly lacking. This study was conducted to improve the understanding of the healthcare utilization of gout patients within a single health care system in Hawai'i. The objective was to examine gout inpatient, outpatient and emergency department care within a single health care system in Hawai'i.

Invalid Baseline Testing with ImPACT: Does Sandbagging Occur with High School Athletes?

The aim of this large-scale research was to determine the frequency of valid, invalid, and sandbagging results in ImPACT baseline testing of high school athletes. This retrospective study identified valid, invalid (identified by five embedded Invalidity Indicators), and sandbagging (identified by three "red flags") results in the ImPACT baseline test scores of 6,346 high school athletes. In addition, the ImPACT postconcussion scores of 266 athletes who sustained a concussion during the school year were evaluated to compare the baseline-to-postconcussion changes of valid versus a combined group of invalid and sandbagging scorers.

Cost and Risk Analysis of Lifelong Penicillin Allergy.

Patients labeled as being penicillin-allergic require the use of alternative antibiotics. The objective of this study was to estimate the lifetime antibiotic costs of patients labeled as being penicillin allergic prior to age 10 compared with those who were not penicillin allergic and to compare antibiotic utilization between these 2 groups with regard to risks of adverse effects. Using the low end of the antibiotic cost range, penicillin-allergic patients had a mean lifetime antibiotic cost of $8171 per patient, compared with $6278 for non-penicillin-allergic patients, a difference of $1893.

Replacing Liquid Antibiotics With Cheaper Pill Equivalents: An Opportunity for Substantial Savings.

Liquid antibiotics are often substantially more expensive than their pill counterparts, representing an opportunity for substantial cost reductions. Children can be taught to swallow pills at about age 6 years. The objective of this study was to calculate the potential cost saved by replacing liquid antibiotics with cheaper pill equivalents for pediatric patients for the antibiotic prescriptions written by a health care system.

Incidence and Risk of Concussions in Youth Athletes: Comparisons of Age, Sex, Concussion History, Sport, and Football Position.

Objective: This study was designed to determine concussion incidence, risk, and relative risk among middle and high school athletes participating in various sports.

Method: Data were retrospectively obtained from 10,334 athletes of 12 different sports in Hawaii. In addition to determining the overall concussion incidence, comparisons of incidence, risk, and relative risk were made according to age, sex, concussion history, sport, and football position.

Effects of repetitive subconcussive head trauma on the neuropsychological test performance of high school athletes: A comparison of high, moderate, and low contact sports.

The aim of this study was to examine the neuropsychological test results of non-concussed high school athletes playing at three different levels of contact sports. Based on the concussion risk data of 12 different sports, a High Contact group (n=2819; wrestling/martial arts, cheerleading, track and field, football), a Moderate Contact group (n=2323; softball, basketball, soccer), and a Low Contact group (n=1580; baseball, volleyball, water polo, tennis, cross-country) were formed and compared in terms of their scores on the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT). The results revealed that the High Contact group obtained small but statistically poorer performances in ImPACT Visual Memory, Visual Motor Speed, Impulse Control, and Total Symptom scores compared to the Moderate and Low Contact groups.

Computerized neuropsychological test performance of youth football players at different positions: A comparison of high and low contact players.

The aim of this study was to examine the effects of head impact frequency on the neuropsychological test results of football players who participate in different positions on the team. Based on the biomechanical measures of head impact frequency reported in high school football, a High Contact group (n = 480) consisting of offensive and defensive linemen was compared with a Low Contact group (n = 640) comprised of receivers and defensive backs. The results revealed that the High Contact group obtained poorer performances on the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) on three Composite scores (Verbal Memory, Visual Motor Speed, Impulse Control) and the Total Symptom score compared to the Low Contact group.

Recovery of Left Ventricular Function After Percutaneous Coronary Intervention Compared to Coronary Artery Bypass Grafting in Patients with Multi-Vessel Coronary Disease and Left Ventricular Dysfunction.

Recovery of left ventricular (LV) function after revascularization has been described for coronary artery bypass grafting (CABG); however, LV recovery after percutaneous coronary intervention (PCI), and how it compares to CABG has not been well described in the literature. The aim of this single center retrospective study was to evaluate LV recovery in patients with severely reduced LV function undergoing PCI compared to those undergoing CABG. Patients with LV ejection fraction (LVEF) < 40% and multivessel coronary artery disease (CAD) undergoing revascularization with either CABG (n=16) or PCI (n=176), and with 12 months of follow up data were included in the study.

Complementary and alternative medicine practices, traditional healing practices, and cultural competency in pediatric oncology in Hawai' i.

Objective: Hawai'i is an ethnically diverse island state with a high rate of both traditional healing (TH) and complementary and alternative medicine (CAM) use. The aim of this project was to assess TH and CAM use within the pediatric oncology population in Honolulu and improve the delivery of culturally competent care.

Methods: A 9-item survey was distributed to all pediatric oncology patients at Kapi'olani Medical Center for Women and Children for 3 months.

Comparison of neuropsychological test scores of high school athletes in high and low contact sports: A replication study.

This replication study re-examined the neuropsychological effects of participation in high and low contact youth sports. Modeled after a recently published investigation, two contact sport groups of participants ages 12 to 18 were formed based on the rate of concussion in their respective sport, with the assumption that more head impacts and neuropsychological effects occur in high contact sports that have a greater number of reported concussions as compared with low contact sports. The preseason baseline ImPACT neuropsychological test scores and symptom scores of non-concussed youth athletes in a High Contact Sport (football, n = 139) and a Low Contact Sport (basketball, baseball, soccer, wrestling, volleyball, paddling, and cheerleading, n = 57) were compared.

Two-year Test-Retest Reliability of ImPACT in High School Athletes.

This research evaluated the 2-year test-retest reliability of the Immediate Postconcussion Assessment and Cognitive Testing (ImPACT) neuropsychological battery, and clarified the need for biennial updated baseline testing of high school athletes. This study compared the baseline test scores of 212 non-concussed athletes that were obtained in Grade 9 and again 2 years later when they were in Grade 11. Regression-based methods indicated that 4 of the 5 ImPACT scores were stable over 2 years, as they fell within the 80% and 95% confidence intervals (CIs).

Ethnicity, traditional healing practices, and attitudes towards complementary medicine of a pediatric oncology population receiving healing touch in Hawaii.

Objective: Cultural competence among healthcare providers is becoming increasingly important. Hawai'i is an ethnically diverse island state that has a high rate of traditional and complementary medicine use. We previously reported on the feasibility of delivering Healing Touch (HT) to pediatric oncology patients, and its impact on pain, distress and fatigue.

Neuropsychological test performance of Hawai'i high school athletes: updated Hawai'i immediate post-concussion assessment and cognitive testing data.

The present study reviewed the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) baseline test scores of 247 high school athletes ages 13 to 18 from a private school in Hawai'i. The aim of the research was to update a prior exploratory investigation conducted in 2008 that compared the test scores of Hawai'i public high school athletes with the normative data provided by the ImPACT publishers. The results of this study provide assurance that the present ImPACT scores of the Hawai'i high school athletes are similar to the general ImPACT norms.