Hawaii medical journal
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Hawaii medical journal · Nov 2011
Recommendations for medical training: a Native Hawaiian patient perspective.
Culturally competent health care providers are needed to eliminate healthcare disparities. In the State of Hawai'i, Native Hawaiians suffer some of the worst health disparities. Prior to implementing a cultural competency curriculum to address these disparities, the John A. Burns School of Medicine's Department of Native Hawaiian Health Cultural Competency Curriculum Development team asked Native Hawaiian patients about their experiences and recommendations. ⋯ The emphasis participants placed on the need for cultural competency training of physicians supports the need to address the role of culture in medical education. Although most of the issues raised are not unique to Hawai'i, participants' recommendations to teach students about the host culture and traditional healing practices identify important themes not usually found in medical school curricula.
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Hawaii medical journal · Nov 2011
Towards cultural competency in end-of-life communication training.
To meet the needs of a more diverse population, a culturally sensitive approach to end-of-life communication is critical. This paper describes a unique communication workshop that introduces future physicians to the delivery of culturally responsive care for patients in palliative and end-of-life treatment. ⋯ Post workshop student evaluations reveal an overwhelmingly favorable response to the curriculum, with high scores for overall quality of the workshop, practical value, and appropriateness for level of training. This workshop meets the goal for all graduating medical students to engage in culturally competent palliative and end of life patient care.
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Hawaii medical journal · Jul 2011
Hawai'i's Opportunity for Active Living Advancement (HO'ĀLA): addressing childhood obesity through safe routes to school.
Increasing active transportation to and from school may reduce childhood obesity rates in Hawai'i. A community partnership was formed to address this issue in Hawai'i's Opportunity for Active Living Advancement (HO'ĀLA), a quasi-experimental study of active transportation in Hawai'i County. The purpose of this study was to determine baseline rates for active transportation rates to and from school and to track changes related to macro-level (statewide) policy, locally-based Safe Routes to School (SRTS) programs and bicycle and pedestrian planning initiatives expected to improve the safety, comfort and ease of walking and bicycling to and from school. ⋯ The majority of children were driven to and from school by their parents. With the influence of HO'ĀLA staff members, two intervention schools were obligated SRTS project funding from the state, schools were identified as key areas in the pedestrian master plan, and one intervention school was slated for a bike plan priority project. As the SRTS programs are implemented in the next phase of the project, post-test data will be collected to ascertain if changes in active transportation rates occur.
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Hawaii medical journal · Apr 2011
Case ReportsGastric volvulus, Borchardt's Triad, and Endoscopy: A Rare Twist.
The authors describe a case of gastric volvulus, which is a rare cause of gastric outlet obstruction. An 85-year-old man presented with nausea, vomiting, and epigastric pain. Admission abdominal radiograph demonstrated a grossly distended stomach with air-fluid levels. ⋯ Endoscopy revealed a fluid-filled, tortuous stomach with a paraesophageal hernia, and the operator was unable to locate or pass the scope through the pylorus. Traditionally Borchardt's triad is believed to be diagnostic for acute gastric volvulus and consists of unproductive retching, epigastric pain and distention, and the inability to pass a nasogastric tube. The authors propose that the following features on endoscopy are highly suggestive of the most common type of volvulus (organoaxial): tortuous stomach, paraesophageal hernia, and inability to locate or pass the scope through the pylorus.