147. Chlamydia and Gonorrhea Prevalence and Treatment in Detained Youths in Hawaii: A follow up Study on Strategies for Improvement

Purpose: Adolescents acquire Chlamydia trachomatis with rates in 15-19 y/o females more than 4.8x the adult population and males 2.5x higher. There is growing recognition of the health consequences of untreated sexually transmitted infections (STI) especially for women in juvenile or correctional facilities. The previous study was a retrospective analysis conducted at the only juvenile detention facility in the state of Hawaii from 2014-2017. It revealed high prevalence of STIs, Chlamydia (CT) and Gonorrhea (GC), in both males and females with fewer than half the documented infections being treated prior to discharge, indicating a need for routine and timely testing to allow treatment of those infected as opposed to a presumptive STI treatment. The purpose of this study is to look at the prevalence rate of CT and GC after implementing routine testing and to assess treatment rate upon timely result receipt. Methods: This retrospective analysis was conducted at the only juvenile detention facility in the State of Hawaii from June 1, 2020-May 31, 2021. It documented the prevalence rate of CT and GC after implementing routine testing upon detention. It also looked at the timeliness of treatment and treatment rates as the time frame marked the first year of implementing routine CT and GC urine screen upon detention and sending the screen tests at a commercial lab for timely results. This time frame is unprecedented in the era of the coronavirus pandemic. This study was approved by Hawai‘i DOH Institutional Review Board. Results: Of the 218 admissions, 187 were tested (85%). 14 refused and 17 were under the state's age of consent (15%) prohibiting routine sample collection and testing as ordered by the facility. Of the 187 tests, 75(35%) were females, 143(65%) were males. CT was prevalent in 25% of females and 7% of males. GC was found in 13% of females and 3% of the males. CT-positive tests of females sent to commercial lab were treated timely 80% of the time vs. 60% for the CT-positive tests sent to the state lab. For CT-positive tests of males and GC-positive tests of females and males, the commercial and state labs showed the same timeliness of treatment. Rates of untreated females with CT was 12%, untreated males 25%;untreated females with GC was 11%, all males with GC were treated. The average result time receipt of tests sent to commercial lab was 6 days vs.2 weeks with the state lab. Conclusions: Prevalence rate of CT and GC remained consistently higher in females than males despite females making up only a third of the census. Timely treatment rate was remarkable for tests sent to commercial lab decreasing the number of untreated youths. This avoided presumptive CT and GC treatment, further leaving out the potential for antibiotic resistance, a continuous and growing concern prompting the updates in the CDC STD treatment guidelines in 2021. Sources of Support: None.

COVID-19 Information Seeking Behaviors of University of Hawai'i at Manoa Undergraduates: Information Channels, Sources, and Consumption

This study explored how undergraduate students at the University of Hawai'i at Manoa sought and consumed information about the virus that causes COVID-19. This study also examined student perceptions of the severity of and their susceptibility to the virus and their main concerns about it. Four hundred fifty-six students completed online surveys between October and early December of 2020 and 2021. Students reported low to moderate levels of information seeking across four domains: (1) knowledge about COVID-19 and its symptoms;(2) preventing the spread of the virus;(3) the current state of the pandemic in Hawai'i;and (4) the likely future of the pandemic in Hawai'i. Overall, websites, television, and Instagram were the top 3 channels used by students to seek information for these domains. Students reported primarily paying attention to information from government and news organizations as sources. However, students' preferred channels and sources varied with the type of information they sought. Students also reported believing that COVID-19 is severe and that they are susceptible to being infected with it. The more time students reported seeking information, the greater their perceptions of COVID-19's severity across all domains. Students' primary concerns about COVID-19 centered on state regulations/policies, vaccines, tourism/travel, the economy, and pandemic/post-pandemic life. These findings can help public health practitioners in Hawai'i determine how best to reach an undergraduate student population with information related to COVID-19. ©Copyright 2023 by University Health Partners of Hawai'i (UHP Hawai'i).

Resilience of breadfruit agro-ecosystems in Hawai'i during the COVID-19 pandemic.

Background: The COVID-19 pandemic is interrupting domestic and global food supply chains resulting in reduced access to healthy diverse diets. Hawai'i has been described as a model social-ecological system and it has been suggested that indigenous agro-ecosystems have the potential to be highly productive and resilient under changing land-use and climate change disturbance. However, little research has yet been conducted exploring the disruption and resilience of agro-ecosystems in Hawai'i caused by the COVID-19 pandemic. The breadfruit tree (Artocarpus altilis; Moraceae) is a signature, multi-purpose-tree of the complex perennial agro-ecosystems systems in Oceania. Methods: This case study explores the ways in which the breadfruit agro-ecosystems of Hawai'i have shown resilience during the COVID-19 pandemic. Results: Our study suggests that breadfruit has increased its value as a subsistence crop during the COVID-19 pandemic, even in a developed economy like Hawai'i, and that resilience of Hawaiian breadfruit agroe-cosystems during a crisis can be supported through cooperatives and food-hubs. Supplementary Information: The online version contains supplementary material available at 10.1186/s43170-022-00125-3.

Evaluation of roost culling as a management strategy for reducing invasive rose-ringed parakeet (Psittacula krameri) populations.

Rose-ringed parakeets (Psittacula krameri) are one of the most widespread invasive avian species worldwide. This species was introduced to the island of Kaua'i, Hawai'i, USA, in the 1960s. The rapidly increasing population has caused substantial economic losses in the agricultural and tourism industries. We evaluated the efficacy of a roost culling program conducted by an independent contractor from March 2020 to March 2021. We estimated island-wide minimum abundance was 10,512 parakeets in January 2020 and 7,372 in April 2021. Over 30 nights of culling at four roost sites, approximately 6,030 parakeets were removed via air rifles with 4,415 (73%) confirmed via carcasses retrieval. An estimated average of 45 parakeets were removed per hour of shooter effort. The proportion of adult females removed in 2020 was 1.9 × greater when culled outside of the estimated nesting season. Of the four roosts where culling occurred, the parakeets fully abandoned three and partially abandoned one site. Of the three fully abandoned roosts, an estimated average of 29.6% of birds were culled prior to roost abandonment. The roost culling effort was conducted during the COVID-19 pandemic, when tourist numbers and foot traffic were greatly reduced. It is unknown how public perception of roost culling in public areas may impact future efforts. Findings suggest roost culling can be utilized for management of nonnative rose-ringed parakeet populations when roost size is small enough and staff size large enough to cull entire roosts in no greater than two consecutive nights (e.g., if two shooters are available for three hours per night, roost culling should only be attempted on a roost with ≤ 540 rose-ringed parakeets). Supplementary Information: The online version contains supplementary material available at 10.1007/s10530-022-02984-3.

Fostering Faculty Innovation: Colleges Strive Individually and Collectively to Provide Resources, Leeway for Faculty

As the world takes two steps forward toward normalcy, typically followed by a step backward into pandemic mode, the truism that faculty success leads to student success probably has never been more resonant. To achieve professional success, faculty need a culture--along with a budget--to try out new, innovative ideas. Both at the individual campus or district level, as well as statewide, community colleges are working to make these sorts of initiatives happen.

Racial Disparities in Patient-Provider Communication During Telehealth Visits Versus Face-to-face Visits Among Asian and Native Hawaiian and Other Pacific Islander Patients With Cancer: Cross-sectional Analysis.

BACKGROUND: Telehealth visits increase patients' access to care and are often rated as "just as good" as face-to-face visits by oncology patients. Telehealth visits have become increasingly more common in the care of patients with cancer since the advent of the COVID-19 pandemic. Asians and Pacific Islanders are two of the fastest growing racial groups in the United States, but there are few studies assessing patient satisfaction with telemedicine among these two racial groups. OBJECTIVE: Our objective was to compare satisfaction with communication during telehealth visits versus face-to-face visits among oncology patients, with a specific focus on Asian patients and Native Hawaiian and other Pacific Islander (NHOPI) patients. METHODS: We surveyed a racially diverse group of patients who were treated at community cancer centers in Hawaii and had recently experienced a face-to-face visit or telehealth visit. Questions for assessing satisfaction with patient-physician communication were adapted from a previously published study of cancer survivors. Variables that impact communication, including age, sex, household income, education level, and cancer type and stage, were captured. Multivariable logistic models for patient satisfaction were created, with adjustments for sociodemographic factors. RESULTS: Participants who attended a face-to-face visit reported higher levels of satisfaction in all communication measures than those reported by participants who underwent a telehealth encounter. The univariate analysis revealed lower levels of satisfaction during telehealth visits among Asian participants and NHOPI participants compared to those among White participants for all measures of communication (eg, when asked to what degree "[y]our physician listened carefully to you"). Asian patients and NHOPI patients were significantly less likely than White patients to strongly agree with the statement (P<.004 and P<.007, respectively). Racial differences in satisfaction with communication persisted in the multivariate analysis even after adjusting for sociodemographic factors. There were no significant racial differences in communication during face-to-face visits. CONCLUSIONS: Asian patients and NHOPI patients were significantly less content with patient-physician communication during telehealth visits when compared to White patients. This difference among racial groups was not seen in face-to-face visits. The observation that telehealth increases racial disparities in health care satisfaction should prompt further exploration.

RAGE against the Machine: Can Increasing Our Understanding of RAGE Help Us to Battle SARS-CoV-2 Infection in Pregnancy?

The receptor of advanced glycation end products (RAGE) is a receptor that is thought to be a key driver of inflammation in pregnancy, SARS-CoV-2, and also in the comorbidities that are known to aggravate these afflictions. In addition to this, vulnerable populations are particularly susceptible to the negative health outcomes when these afflictions are experienced in concert. RAGE binds a number of ligands produced by tissue damage and cellular stress, and its activation triggers the proinflammatory transcription factor Nuclear Factor Kappa B (NF-κB), with the subsequent generation of key proinflammatory cytokines. While this is important for fetal membrane weakening, RAGE is also activated at the end of pregnancy in the uterus, placenta, and cervix. The comorbidities of hypertension, cardiovascular disease, diabetes, and obesity are known to lead to poor pregnancy outcomes, and particularly in populations such as Native Hawaiians and Pacific Islanders. They have also been linked to RAGE activation when individuals are infected with SARS-CoV-2. Therefore, we propose that increasing our understanding of this receptor system will help us to understand how these various afflictions converge, how forms of RAGE could be used as a biomarker, and if its manipulation could be used to develop future therapeutic targets to help those at risk.

The Effects of COVID-19 Vaccine Mandates in Hawaii.

Having been affected by the highest increase in COVID-19 cases since the start of the pandemic, Honolulu and Maui counties in Hawaii implemented vaccine passport mandates for select industries in September 2021. However, the degree to which such mandates impacted COVID-19 mitigation efforts and economics remains poorly understood. Herein, we describe the effects of these mandates on changes in three areas using difference-in-difference regression models: (1) business foot traffic; (2) number of COVID-19 cases per 100,000 individuals, and (3) COVID-19 vaccination rates across counties affected or unaffected by the mandates. We observed that although businesses affected by mandates experienced a 6.7% decrease in foot traffic over the 14 weeks after the mandates were implemented, the number of COVID-19 cases decreased by 19.0%. Notably, the vaccination rate increased by 1.41% in counties that implemented mandates. In addition, towards the end of the studied period, the level of foot traffic at impacted businesses converged towards the level of that of non-impacted businesses. As such, the trade-off in temporary losses at businesses was met with significant gains in public health and safety.