A Review of Climate-Driven Threats to Recreational Water Users in Hawaii.

In Hawaii, impacts from climate change, such as sea-level rise and flooding, increased hurricanes and wildfires, and warmer temperatures, intersect with aging infrastructure, toxicities from the built environment, and pathogens to threaten the health of recreational ocean users via reduced water quality, severe weather and flooding, environmental degradation, and food systems impacts. An examination of climate-driven threats to water safety is a pertinent review of threats to coastal residents globally.

A randomized controlled trial of a proactive analgesic protocol demonstrates reduced opioid use among hospitalized adults with inflammatory bowel disease.

Most hospitalized patients with inflammatory bowel disease (IBD) experience pain. Despite the known risks associated with opioids in IBD including risk for misuse, overdose, infection, readmission, and even death, opioid use is more prevalent in IBD than any other chronic gastrointestinal condition. Most hospitalized IBD patients receive opioids; however, opioids have not been shown to improve pain during hospitalization.

Incident Cases of Sexually Transmitted Infections among Users of Pre-Exposure Prophylaxis for HIV Prevention in Honolulu, Hawai'i.

Emtricitabine/tenofovir disoproxil fumarate [FTC-TDF] is a daily oral medication taken by HIV-negative individuals for pre-exposure prophylaxis (PrEP) to prevent human immunodeficiency virus (HIV) infection. A higher incidence of sexually transmitted infections (STIs) among PrEP users has been reported compared to STI incidence before PrEP use. Asymptomatic incident STI rates were investigated among 78 patients presenting for PrEP in Honolulu, Hawai'i, from April 2018 to May 2019.

Calculating maximum morphine equivalent daily dose from prescription directions for use in the electronic health record: a case report.

To demonstrate a process of calculating the maximum potential morphine milligram equivalent daily dose (MEDD) based on the prescription Sig for use in quality improvement initiatives. To calculate an opioid prescription's maximum potential Sig-MEDD, we developed SQL code to determine a prescription's maximum units/day using discrete field data and text-parsing in the prescription instructions. We validated the derived units/day calculation using 3000 Sigs, then compared the Sig-MEDD calculation against the Epic-MEDD calculator.