Striving for ALOHA with ALOHA

Inequity and disparities in health and health care have long been experienced by indigenous, colonized, enslaved peoples, waves of emigrants, and many minority communities. The COVID-19 pandemic laid bare these inequities to the rest of the country and, in many parts of the country, seriously disrupted medical education and care delivery. Using core values and shared missions that are grounded in Native Hawaiian values, the University of Hawaii John A. Burns School of Medicine (JABSOM) faculty, staff, students and leaders, together with our health system and community partners worked together to blunt the negative impact of COVID on our communities and medical education. Dr. Buenconsejo-Lum will describe some examples of how operationalizing core Native Hawaiian values helped move the needle toward achieving JABSOM’s vision of Attaining Lasting Optimal Health for All (ALOHA)

Minimum dissolved oxygen tolerance of four different sizes of milkfish

Four size groups of milkfish were tested, 4-18 g, 20-34 g, 35-95 g and 200-300 g. A number of fish from each group were placed separately in identical 1.2 m2 wooden tanks containing seawater filled up to 30 cm depth. The aggregate weight of fish per size group was approximately 1 kg. The fish were held for 72 h, fed with lab-lab and provided with continuous aeration to allow recovery from stress during transport and handling. After the recovery period, aeration was stopped and 200 g of the fine rice bran was spread over the water in each tank creating a film of bran particles on the water surface. This was designed to speed up depletion of dissolved oxygen considering the combined effects of the screening-off of sunlight, the reduction of air-water interface and the breakdown of the bran particles. It is probable that stress on milkfish in brackishwater ponds could start when oxygen level drops to about 1.4 ppm. A further decrease to 0.04 ppm could produce a total kill of all specimens above 4 grams with marketable size and bigger size fish dying first

Dances of Hostility and Friendship: Embodied Histories of Group Relations in the Agusanen Manobo Spirit-Possession (Yana-an) Ritual

This paper explores the complex, aesthetic embodiment of a particular history of group relations. It investigates how the form or materiality of ritual séance-constituted by dance, music, speech, and acts-reflects changes in the political economy. The paper deals with Agusanen Manobo séance (yana-an) as a channel for embodying the Agusan Manobo's rich cultural imagination of "others." Agusan Manobos are indigenous people,most of whom are now Christians and who live in middle Agusan Valley. Their "imaginary others" are distant outsiders with whom the Manobos owe some kind of affinity because of a more or less shared historical experience based upon concrete social exchange practices.The paper examines two kinds of social relations: (1) Manobos vis-à-vis other indigenous peoples, and (2) Manobos vis-à-vis the Visayan speaking settlers. It demonstrates that the nature of the first social relation is symmetrical or egalitarian. This contrasts with the second, which is asymmetrical. The paper shows that Agusan Manobo yana-an makes reflexive, visceral statements about these social relations, enabling ritual participants to define their social identity and reconstrue the newer asymmetrical Manobo-Visayan relations back to its original equalizing one

Secondary organic aerosol yields from the oxidation of benzyl alcohol

Recent inventory-based analysis suggests that emissions of volatile chemical products in urban areas are competitive with those from the transportation sector. Understanding the potential for secondary organic aerosol formation from these volatile chemical products is therefore critical to predicting levels of aerosol and for formulating policy to reduce aerosol exposure. Experimental and computationally simulated environmental chamber data provide an understanding of aerosol yield and chemistry under relevant urban conditions (5–200 ppb NO and 291–312 K) and give insight into the effect of volatile chemical products on the production of secondary organic aerosol. Benzyl alcohol, one of these volatile chemical products, is found to have a large secondary organic aerosol formation potential. At NO concentrations of ∼ 80 ppb and 291 K, secondary organic aerosol mass yields for benzyl alcohol can reach 1

Micronesian Migrants in Hawaii: Health Issues and Culturally Appropriate, Community-Based Solutions

More than 20,000 Micronesians have migrated to Guam, Hawaii, or the Commonwealth of the Northern Mariana Islands. Of these migrants, more than 8,000 now live in Hawaii. Factors in their home islands driving the recent emigration include the limited economic resources and struggling health care systems. Education systems in Micronesia are inadequate, and there are few job opportunities. The rates of infectious diseases remain high while at the same time, the epidemiologic transition in health has led to an explosion of non-communicable diseases. In Hawaii, the impact of the Micronesians emigration has been significant with most health and education expenses un-reimbursed. The health care costs alone are substantial as many Micronesians travel to Guam or Hawaii for medical treatment unavailable in their home islands. At the same time, Micronesians have difficulty accessing and navigating the health care system. While governmental, private, and academic programs already provide innovative and communitybased services to the Micronesian population, more work remains to be done. Not only are additional services, tailored to the culture and needs of Micronesian migrants, needed but a keener awareness and understanding of the issues surrounding Hawaii’s migrant population must be promoted among all public health stakeholders to ensure that the priority necessary to successfully address these challenges is recognized

A Socio-Ecological Framework for Cancer Control in the Pacific: A Community Case Study of the US Affiliated Pacific Island Jurisdictions 1997–2017

The United States Affiliated Pacific Island Jurisdictions (USAPIJ) are politically associated to the United States (US) as US Territories (Guam, American Samoa), a US Commonwealth (Commonwealth of the Northern Mariana Islands), and as sovereign nations linked to the US through Compacts of Free Association [Federated States of Micronesia (FSM), Republic of the Marshall Islands (RMI), Republic of Palau (ROP)]. Cervical cancer incidence in the RMI is the highest in the world, mammography services are not available in the FSM and only Guam has on-island oncology services. Cancer risk factors such as obesity, tobacco, and Hepatitis B are prevalent. Twelve years of nuclear testing in the RMI adds to the cancer burden. A community-based, multi-national coalition with multi-system external partners the Pacific Regional Cancer Control Partnership (PRCP) was developed to address cancer prevention and control in the USAPIJ. Through the PRCP, local cancer coalitions, a regional cancer registry, 12 years of regional cancer control plans, and cancer prevention programs and research has been implemented.Methods: The PRCP is the subject of this community case study. The PRCP is analyzed through a socio-ecological theoretical framework to contextualize its typology, building blocks, and management. The respective roles and work of each partner and organization will be described and aligned with the levels of the socio-ecological framework.Results: The USAPIJs evolved a community-focused internal and external regional cancer prevention and control network over 20 years. The function and structure of the PRCP fits within a socio-ecological framework for cancer control. An adaptive management strategy has been used within the PRCP to manage its multi-national, multi-level, and multi-system partners.Conclusion: The PRCP has been able to advance cancer prevention and control programs with a community-centric model that functions in a multi-national, multi-cultural, low-resource, geographically dispersed environment over the last 20 years. The PRCP operates with a structure and management style that is consistent with a socio-ecological framework for cancer control. This case study provides a blueprint for the PRCP organizational structure and a mechanism for its function. The PRCP concept, a community-centric model for cancer control in multi-national resource-limited environments, may be scaled to other global environments