Vertical distribution of microplastics in the Western Pacific Warm Pool: In situ results comparison of different sampling method.

Marine microplastics (MPs) are recognized as a growing severe environmental concern. The vertical distribution pattern of MPs in the ocean is still elusive. Meanwhile, different sampling methods have been deployed in previous studies, resulting in difficulties in compiling data. In this study, for the first time, we explored ocean interior MP pollution in the Western Pacific Warm Pool simultaneously using both a CTD (Conductivity-temperature-depth) sampler and a large-volume in-situ filtration system. At the same sampling station, the average abundance of microplastics in the water column obtained by the two sampling methods was 0.37 ± 0.44 n/m3 (in-situ filtration) and 115.12 ± 64.13 n/m3 (CTD), respectively, which showed significant differences. Both methods found that the main chemical composition and shape of MPs were PET and fiber. Ocean current was identified as the dominant factor that impacted the horizontal distribution of MPs in the study area. The abundance of MPs in the surface layer was 5.4-703.8 times higher than that of the water column. The similar physical and chemical properties of MPs in the surface water and water column indicated that MPs in the water column originate from the sustained release from the surface layer.

Lymphatic filariasis in soldiers exposed in INDOPACOM.

Some military organizations in the U.S. Indo-Pacific Command (INDOPACOM) give returning soldiers presumptive treatment for filariasis. As there have been few clinical cases in recent decades, the historical basis for this chemotherapy was reviewed. During the Second World War, U.S. Marines stationed on Polynesian islands such as Tonga, Samoa, and Fiji experienced clinical lymphatic filariasis. Although thousands of both U.S. and Australian soldiers served in New Guinea, few, if any, cases of lymphatic filariasis were ascribed to Melanesia. While the French Army reported dozens of cases of filariasis among its service members during the 1950s Vietnam conflict, the U.S. military experienced only a few cases among the nearly 2 million service members who served in Vietnam in the 1960s. Australian soldiers deployed to Timor Leste in the 21st century showed rare seroconversions to filaria but no clinical disease. Following mass drug administration to eliminate lymphatic filaria in the INDOPACOM region, exposure in deployed soldiers rarely occurs and preventive chemotherapy should cease.

The burden of headache disorders in the adult population of Mongolia: estimates, and a health-care needs assessment, from a cross-sectional population-based study.

BACKGROUND: Having previously shown headache disorders to be prevalent in Mongolia, here we elaborate on headache as a public-health concern in this country, reporting symptom burden and headache-attributed impaired participation at individual and societal levels, and conducting a health-care needs assessment. METHODS: The study followed the standardized methodology developed by the Global Campaign against Headache, generating a representative general-population sample through multi-level randomized cluster sampling. Participants aged 18-65 years were interviewed at unannounced household visits by interviewers administering the HARDSHIP questionnaire. Symptom burden was established through questions on frequency, duration and intensity of headache, with proportion of time in ictal state calculated from frequency and duration. Individual impaired participation was established through the HALT questionnaire, enquiring into lost time from paid and household work and from leisure activities. Symptom burden and impaired participation yesterday were also assessed in those reporting headache yesterday. Population-level estimates were derived by factoring in prevalence. RESULTS: The total sample included 2,043 participants. Those reporting any headache in the last year (n = 1,351) spent, on average, 9.7% of all their time with headache, losing 1.3 workdays and 2.4 household days/3 months. These losses were considerably higher among those with probable medication-overuse headache (37.5%, 3.5 workdays, 6.7 household days) or other headache on ≥ 15 days/month (H15+) (21.9%, 2.4 workdays, 5.1 household days). At population-level (including those with and without headache), 6.2-7.4% of all time was spent with headache, 3.1% with H15+; 0.8 workdays and 1.4 household days/person/3 months were lost to headache, 0.3 workdays and 0.6 household days to migraine (the biggest contributor of all headache types). Our needs assessment estimated that one third (33.2%) of the adult population of Mongolia have headache (mostly migraine or H15+) likely to benefit from health care. CONCLUSION: This first population-based study on headache burden in Mongolia shows high levels of individual and societal burden, with H15 + the cause of greater burden at population level than migraine and TTH combined. Migraine, however, has the biggest impact on the nation's productivity. From a purely economic perspective, Mongolia, with limited health resources, would probably be best served by focusing on mitigating migraine-attributed burden.

Pathways to healthy ageing in Vanuatu: a qualitative evaluation of national policy priorities.

Background: The Pacific Island country of Vanuatu is at the early stages of demographic ageing. The government is yet to develop a strategic approach to optimize the health and wellbeing of older indigenous Vanuatu residents (ni-Vanuatu). Methods: Using policy mapping and semi-structured interviews with 42 ni-Vanuatu, this research aimed to explore the current policy context surrounding ageing in Vanuatu and the priorities of older adults to inform preliminary steps to develop a national response to healthy ageing. Analyses were grounded in the World Health Organization's Regional Action Plan on Healthy Ageing in the Western Pacific. Findings: While the national policy context exhibited an indirect commitment to creating an environment conducive to healthy ageing, explicit policy commitments and monitoring indicators were lacking. Older persons reported numerous obstacles to healthy ageing, including financial insecurity, physical and psychological barriers to participation, and lack of community support. Interpretation: Findings highlighted the need for policymakers and stakeholders to focus preliminary strategic efforts on select components of the Regional Action Plan: evidence generation, advocacy/awareness, financing, community engagement and coordination, and family-centred empowerment. To ensure acceptability and sustainability, it is vital that these leverage existing strengths of traditional community values and the prevailing role of faith and religion in the lives of older ni-Vanuatu. Funding: This project was funded and supported by the World Health Organization (WHO) Regional Office for the Western Pacific (WPRO). Outcomes reflect the deliberations of authors and research partners.

A call for multi-agency collaboration in the Pacific Island countries' mental health - The World Federation for Mental Health viewpoint.

OBJECTIVE: To introduce the World Federation for Mental Health (WFMH) viewpoint on the Pacific Island countries' mental health capacity building. CONCLUSION: Multi-agency collaboration guided by a nuanced understanding of the local context can enable a public health model of mental health service delivery in the Pacific Island countries.

Increasing Oncology Nurse Cultural Knowledge, Sensitivity, and Humility in Caring for the Native Hawai'ian and Pacific Islander Population.

Stress affects people's physiologic and mental well-being. Compounded stress from natural disasters, intergenerational trauma, stigma, and mistrust of the dominant society may lead to illness and potential oncologic disorde.

A new species of Bivesiculoides (Digenea: Bivesiculidae) infecting atherinid fishes of the Great Barrier Reef, Queensland, Australia.

We describe a new species of Bivesiculidae, Bivesiculoides maiae n. sp., from Hypoatherina tropicalis (Whitley) (Atherinidae) collected from off Heron Island (southern Great Barrier Reef, Queensland, Australia). Bivesiculoides maiae n. sp. is morphologically consistent with Bivesiculoides Yamaguti, 1938 in the entirely pre-testicular position of its uterus, and the possession of caeca and vitelline fields that extend posteriorly to level with the anterior extremity of the testis. The new species is morphologically distinct from the six known Bivesiculoides species in body size and shape, and shape of the pharynx and testis. Bivesiculoides maiae n. sp. is genetically distinct from the only other sequenced Bivesiculoides species, Bivesiculoides fusiformis Cribb, Bray & Barker, 1994, with which it occurs sympatrically at Heron Island. A review of related species allows two systematic recombinations. In view of the pre-testicular position of its uterus, we recombine Bivesicula hepsetiae Manter, 1947 as Bivesiculoides hepsetiae (Manter, 1947) n. comb. In view of its obtriangular body shape, round pharynx, strongly elongated testis, and the position of its ovary opposite the testis, we recombine Bivesiculoides triangularis Machida & Kuramochi, 2000 as Treptodemoides triangularis (Machida & Kuramochi, 2000) n. comb. Host-specificity of species of Bivesiculoides and their geographic distributions are discussed.

Evaluation of risk prediction scores for adults hospitalized with COVID-19 in a highly-vaccinated population, Aotearoa New Zealand 2022.

Objectives: COVID-19 severity prediction scores need further validation due to evolving COVID-19 illness. We evaluated existing COVID-19 risk prediction scores in Aotearoa New Zealand, including for Maori and Pacific peoples who have been inequitably affected by COVID-19. Methods: We conducted a multicenter retrospective cohort study in adults hospitalized with COVID-19 from January to May 2022, including all Maori and Pacific patients, and every second non-Maori, non-Pacific (NMNP) patient to achieve equal analytic power by ethnic grouping. We assessed the accuracy of existing severity scores (4C Mortality, CURB-65, PRIEST, and VACO) to predict death in the hospital or within 28 days. Results: Of 2319 patients, 582 (25.1%) identified as Maori, 914 (39.4%) as Pacific, and 862 (37.2%) as NMNP. There were 146 (6.3%, 95% confidence interval 5.4-7.4%) deaths, with a predicted probability of death higher than observed mortality for VACO (10.4%), modified PRIEST (15.1%) and 4C mortality (15.5%) scores, but lower for CURB-65 (4.5%). C-statistics (95% CI) of severity scores were: 4C mortality: Maori 0.82 (0.75, 0.88), Pacific 0.87 (0.83, 0.90), NMNP 0.90 (0.86, 0.93); CURB-65: Maori 0.83 (0.69, 0.92), Pacific 0.87 (0.82, 0.91), NMNP 0.86 (0.80, 0.91); modified PRIEST: Maori 0.85 (0.79, 0.90), Pacific 0.81 (0.76, 0.86), NMNP 0.83 (0.78, 0.87); and VACO: Maori 0.79 (0.75, 0.83), Pacific 0.71 (0.58, 0.82), NMNP 0.78 (0.73, 0.83). Conclusions: Following re-calibration, existing risk prediction scores accurately predicted mortality.

Antimicrobial susceptibility profiles of invasive bacterial infections among children from low- and middle-income countries in the Western Pacific Region (WPRO) - a systematic review and meta-analysis.

Background: Antimicrobial resistance increasingly impacts paediatric mortality, particularly in resource-constrained settings. We aimed to evaluate the susceptibility profiles of bacteria causing infections in children from the Western Pacific region. Methods: We conducted a systematic review and meta-analysis of bacteria responsible for common infections in children. We included studies published from January 2011 to December 2023 (PROSPERO CRD42021248722). Pooled susceptibilities were evaluated against empiric antibiotics recommended to treat common clinical syndromes. Findings: Fifty-one papers met inclusion criteria, incorporating 18,330 bacterial isolates. Of available published data, only six countries from the region were represented. Escherichia coli revealed a pooled susceptibility to ampicillin of 17% (95% CI 12-23%, n = 3292), gentamicin 63% (95% CI 59-67%, n = 3956), and third-generation cephalosporins 59% (95% CI 49-69%, n = 3585). Susceptibility of Klebsiella spp. to gentamicin was 71% (95% CI 61-80%, n = 2323), third-generation cephalosporins 35% (95% CI 22-49%, n = 2076), and carbapenems 89% (95% CI 78-97%, n = 2080). Pooled susceptibility of Staphylococcus aureus to flucloxacillin was 72% (95% CI 58-83%, n = 1666), and susceptibility of Streptococcus pneumoniae meningitis isolates to ampicillin was 26% (95% CI 11-44%, n = 375), and 63% (95% CI 40-84%, n = 246) to third-generation cephalosporins. Interpretation: The burden of antimicrobial resistance among bacteria responsible for common infections in children across the Western Pacific region is significant, and the currently recommended World Health Organization antibiotics to treat these infections may be inefficacious. Strategies to improve the availability of high-quality data to understand the burden of antimicrobial resistance in the region are necessary. Funding: The study was supported by an Australian GovernmentNational Health and Medical Research Council Investigator Grant. This research was funded in part by the Wellcome Trust [220211/Z/20/Z]. For the purpose of Open Access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission.

Burden of cardiovascular disease among the Western Pacific region and its association with human resources for health, 1990-2021: a systematic analysis of the Global Burden of Disease Study 2021.

Background: A comprehensive profile of cardiovascular disease (CVD) burden and human resources for health (HRH) distribution in the WHO Western Pacific region has yet to be presented. Studies on the relationship between HRH and CVD in this region are limited. We aimed to describe CVD trends and HRH density in the Western Pacific region and explore the association of HRH with CVD burden. Methods: Estimates of CVD deaths and disability-adjusted life years (DALYs) were obtained from the Global Burden of Disease Study (GBD) 2021, and the annual density of HRH was retrieved from GBD 2019. We presented trends in CVD burden and HRH density across 31 Western Pacific countries. Spearman rank correlation analysis and generalized linear models were used to examine associations between CVD burden and HRH density. Findings: In 2021, CVD caused six million deaths and 125 million DALYs in the Western Pacific region, accounting for 39.4% and 22.5% of all-cause deaths and DALYs. From 1990 to 2021, the number of CVD deaths and DALYs increased by 94.9% and 57.3% in this region, whereas the age-standardized rate of CVD deaths and DALYs declined in all countries. In 2021, stroke and ischemic heart disease were the leading causes in the Western Pacific region, and a 32-year increase in CVD burden was primarily driven by aortic aneurysm, lower extremity peripheral arterial disease, endocarditis, and atrial fibrillation and flutter. In 2019, there was an approximately 20-fold difference in HRH density across 31 countries from the lowest in Papua New Guinea to the highest in Australia. HRH density was negatively related to the age-standardized rate of CVD deaths (r s  = -0.74) and DALYs (r s  = -0.73), especially strong associations between CVD burden and the density of dentistry personnel, aides & emergency medical workers, and medical laboratory technicians. Interpretation: CVD remains a pressing public health issue in the Western Pacific region where noticeable shortages in health workers exist. The negative associations between CVD burden and HRH density suggest that health workers, especially dentistry personnel, aides & emergency medical staff, and medical laboratory technicians merit more investment to reduce the CVD burden. Funding: National Natural Science Foundation of China (82073573 to ZZ; 82273654 to YS).

Tracking sero-molecular trends of swine brucellosis in Hawai'i and the central Pacific.

Introduction: Brucellosis is a zoonotic disease of mammals caused by bacterial species of the Brucella genus. The reservoir for disease is typically mammals, with species of Brucella found infecting amphibians, bats, and marine mammals. Brucella spp. can pass directly to humans through contact with infected animals or their products. Brucella spp. can cause chronic debilitating infections in mammals, including humans, and is associated with spontaneous abortions in infected animals, causing reduced fecundity. In Hawai'i, terrestrial species that could harbor Brucella spp. include swine, cattle, horses, and axis deer among others. The numerous feral swine in Hawai'i are known to carry Brucella suis, with evidence supporting infections in cattle. Brucella suis also poses infection risk to humans, dogs, and potentially horses across the state. Methods: In this study, 3,274 feral swine serum samples collected from 5 of the 8 main islands over a 15-year span were analyzed for exposure to B. suis. Of the 558 watersheds in the state, 77 were sampled as part of this effort. Spatial analysis was used to identify watersheds of concern. MLVA and whole genome SNP analysis was used for molecular epidemiological analysis. Results: Statewide seropositivity rates were triple that of feral swine found in the conterminous United States. Smoothed positivity rates were highest on Maui, followed by O'ahu, and the island of Hawai'i. Island-by-island analysis found high brucellosis positivity levels associated with specific watersheds and agricultural areas. Local spatial autocorrelation identified hot spots on O'ahu and Hawai'i. MLVA analysis of available B. suis from Hawai'i found molecular epidemiological connections with B. suis found in French Polynesia and the mainland US while differing from those in Tonga, Western Polynesia. Strains from Hawai'i are phylogenetically closest to strains from the United States. MLVA and SNP analysis found B. suis strains from Hawai'i fell into the genetic group that contains biovar 1 B. suis. Discussion: This work identified islands and watersheds of high brucellosis seropositivity in feral swine of Hawai'i, highlighting the magnitude of the zoonotic risk. Introduction of strains in recent history is unlikely due to modern animal trade and disease control practices. Genomic analysis of strains in Hawai'i and the Pacific area can provide hidden historical and local clues to brucellosis epidemiology in the state.

Cultural and social barriers to hope in gastrointestinal cancer patients.

Background: Hope is correlated with quality of life and overall survivorship among patients with cancer. We aimed to identify sociodemographic and clinical determinants of hope among patients with gastrointestinal (GI) cancer. Methods: Patients with GI cancer seen in radiation oncology between 10/2022 and 6/2023 were surveyed with the Adult Hope Scale (AHS) questionnaire, which assesses hope based on goal-setting and goal-striving beliefs. Linear regression and Pearson's/Spearman's correlation coefficients were used to evaluate associations between AHS scores and demographic or disease variables. Results: One-hundred and forty-five (71.1% response rate) patients were included in the analysis. Most (75%) patients were symptomatic from disease, and Asian American and Pacific Islander (AAPI) patients accounted for 30.3% of our cohort. Identifying as AAPI or needing an interpreter for clinic visits was significantly associated with lower AHS scores, and more AAPI patients required interpreter assistance compared to non-AAPI patients (P=0.04). Being divorced, unemployed, or female was also linked to less hope. No other differences in hope were found. Conclusions: Sociodemographic rather than prognostic clinical factors were predictive of hope among patients with GI cancer. Interventions to contextualize psychosocial risk factors have the potential to improve quality of life and oncologic outcomes.

Potential impacts of climate change on cephalopods in a highly productive region (Northwest Pacific): Habitat suitability and management.

Cephalopods occupy a mid-trophic level in marine ecosystems and are vital both ecologically and as fishery resources. However, under the pressure of climate change and fishing, the sustainability of cephalopod resources requires reasonable management. This study aims to study climate change and fishing impacts on the common economic cephalopod species habitats using species distribution models. We take the northwest Pacific Ocean region as an example, which stands out as a significant region for cephalopod production around the world. Results found that the habitats of cephalopods are moving to higher latitudes or deeper waters (Bohai Sea, mid-bottom Yellow Sea, and the Okinawa Trough waters) under climate change. Additionally, these regions are currently under lower fishing pressure, which suggests that species migration might mitigate the effects of warming and fishing. This study provides the large-scale assessment of the distribution range of cephalopods affected by climate change coping with fishing pressure in the northwest Pacific Ocean. By identifying climate refuges and key fishing grounds, we underscore the importance of this information for managing cephalopod resources in the context of climate adaptation and sustainable fishing practices.

Oceanographical-driven dispersal and environmental variation explain genetic structure in an upwelling coastal ecosystem.

The seascape comprises multiple environmental variables that interact with species biology to determine patterns of spatial genetic variation. The environment imposes spatially variable selective forces together with homogenizing and diverging drivers that facilitate or restrict dispersal, which is a complex, time-dependent process. Understanding how the seascape influences spatial patterns of genetic variation remains elusive, particularly in coastal upwelling systems. Here, we combine genome-wide SNP data, Lagrangian larval dispersal simulated over a hydrodynamic model, and ocean environmental information to quantify the relative contribution of ocean circulation and environmental heterogeneity as drivers of the spatial genetic structure of two congeneric intertidal limpets, Scurria scurra and S. araucana, along the central coast of Chile. We find that a genetic break observed in both limpet species coincides with a break in connectivity shown by the Lagrangian dispersal, suggesting that mean ocean circulation is an important seascape feature, in particular for S. scurra. For S. araucana, environmental variation appears as a better predictor of genetic structure than ocean circulation. Overall, our study shows broad patterns of seascape forcing on genetic diversity and contributes to our understanding of the complex ecological and evolutionary interactions along coastal upwelling systems.

Creating a mental health talanoa to promote a collaborative approach to wellbeing across Pacific peoples.

OBJECTIVE: Promoting holistic health and wellbeing is a shared conversation, or talanoa, requiring collaboration between individuals, their families and wider communities. This paper will explore various community-based initiatives privileging Pacific epistemologies and ontologies that promote and provide accessible resources improving mental health literacies. METHOD: Three specific initiatives are discussed in this paper; Mental Health Talanoa (MHT), Open Worksheet and Wellbeing Talanoa. These provide a platform to understand practical ways to support Pacific peoples in various contexts. RESULTS: The MHT project offers a nuanced understanding of symptomatology related to common mental disorders amongst Pacific peoples, a nuanced understanding of the barriers and enablers to health literacies and help seeking behaviour, and a series of infographics, including the Pacific Mental Health Lexicons (PIMHL). The Open Worksheet is a dynamic tool underpinned by a dialogical and relationally driven way to understanding individual and familial narratives. The Wellbeing Talanoa supports a communally orientated opportunity to enhance a sense of connection to self and others whilst therapeutically reviewing social and welfare needs and solutions. CONCLUSION: Developing and implemented Pacific approaches that are grounded in Pacific values and practices can lead to enhanced help seeking behaviour, engagement, service retention and provision.

Multiple environmental gradients shape the functional structure of macrobenthic communities across the Pacific Arctic shelf.

The Pacific Arctic shelf is undergoing significant environmental changes that are expected to impact the functioning of Arctic benthic ecosystem. By utilizing trait-based methods, we can better understand the effects of environmental changes on the functional structure of macrobenthic communities, offering a more detailed interpretation that complements traditional biodiversity assessments based on community structure. Using Biological Trait Analysis (BTA), we investigated shifts in the functional composition of macrobenthic communities across the subarctic to Arctic regions of the Pacific Arctic shelf, examining how these communities are responding to various environmental gradients. The study analyzed data from 14 environmental variables and 355 taxa, using 13 functional traits coded with 51 modalities collected from 78 boxcore stations. Multivariate statistics, including fuzzy correspondence analysis (FCA) and RLQ/fourth-corner combined analysis, were utilized. We find that the northern Bering Sea (NB) and southeastern Chukchi Sea (SEC) shelves exhibit shared functional similarities (e.g., small, chitinous skeletons, gregarious behavior, and low body flexibility) and significant regional differences from other subregions. The analysis revealed that sediment characteristics and sea ice cover influenced macrobenthic trait composition. The ongoing retreat of sea ice is expected to lead to rapid functional shifts in the Pacific Arctic shelves, potentially causing the migration of smaller, deposit-feeding, shorter-lived taxa to the Arctic seas. This could result in structural transformation in Arctic communities characterized by greater longevity, suspension-feeding, and larger size. These findings can inform future polar environmental management and help develop adaptive management strategies.

Description and Phylogenetic Position of a New Genus and Species of Deep-Water Alpheid Shrimp Associated with Glass Sponges off New Caledonia (Decapoda: Caridea).

Batellopsis paula gen. et sp. nov., a new hexactinellid-associated alpheid shrimp, is described based on a single specimen collected at a depth of 477-503 m north of Île des Pins, New Caledonia. Batellopsis gen. nov. is part of a clade of four genera all containing hexactinellid-associated species, for which a molecular phylogeny is presented. The evolution of several morphological characters, including orbital teeth, a bulgefossa system on the fingers of the first pereiopod chela, and groups of microserrulate setae on the second pereiopod chela, is discussed in light of phylogenetic results.

Prevalence and Pattern of Ear Disease Among Primary School Students in Samoa: Preliminary Results from ENT Clinic Outreach to Urban, Rural and Remote Settings.

Objectives: To assess the prevalence and pattern of ear disease among students attending primary school in urban, rural, and remote regions of Samoa in order to develop an evidence-based national school ear and hearing health program. Methods: Retrospective clinical data review of all primary school students seen by the Ear, Nose & Throat Clinic of Samoa during school-based outreach visits from March 2022 to April 2024. A purposefully designed spreadsheet was created to extract the following information from the clinical records: school location (urban, rural, remote), gender (male, female), age (years), age category (0-4, 5-9, 10-14, 15+ years), right ear diagnosis, left ear diagnosis. Data were entered into the SPSS statistical software package for descriptive statistical analysis and association tests of significance. Results: A total of 1491 primary school students were seen for ear health examinations (51.1% male, 48.9% female), with a mean age of 9.1 years (SD = 2.3). Five primary schools were included, representing urban (n = 865), rural (n = 258), and remote (n = 368) settings. Overall, 682 (45.7%) students had normal ear examination results for both ears, 237 (15.9%) had an ear pathology in 1 ear only, and 568 (38.1%) had ear pathology in both ears. Bilateral ear pathology was significantly higher among students who were in the 5 to 9 age group (P < .00001), female (P = .035), and from rural settings (P = .0001). The most common pathology was impacted cerumen (36.8%), followed by otitis media with effusion (7.5%). Overall prevalence of chronic suppurative otitis media (CSOM) was 2.6% (n = 39 students). Following the school visits, no further intervention was required for 1180 students (79%), mostly due to successful cerumen and foreign body removals for 468 students (31.4%). Conclusion: Impacted cerumen is a significant issue among Samoan school-aged students, and future school-based ear health programs should include staff members trained in cerumen removal. CSOM prevalence suggests an avoidable burden of disease that must be addressed.

Telehealth Utilization to Address Health Care Disparities Among Asian Americans, Native Hawaiians, and Pacific Islanders: A Scoping Review.

Research has reported health care disparities, including low rates of health care utilization, among racial and ethnic minority groups compared to Whites. Asian Americans, Native Hawaiians, and Pacific Islanders (AANHPIs) have experienced these disparities, attributed to various barriers such as limited access to linguistically and culturally concordant health care services. Telehealth may offer a viable mode of health service delivery for AANHPIs. The coronavirus disease of 2019 (COVID-19) pandemic sparked the adoption of technology for receiving health services. However, the literature on telehealth utilization before and during the COVID-19 pandemic among AANHPIs is limited. To address this gap, we conducted a scoping review of telehealth intervention empirical studies serving AANHPIs published between January 2010 and February 2024, using five databases. Twenty-four articles met our inclusion criteria, which required the use of a telehealth intervention program, provision of disaggregated AANHPIs, and targeting of physical and/or mental health outcomes. Our review revealed positive findings of telehealth interventions in helping AANHPIs access health care, with a primary focus on education and consultation for self-management. The review highlighted a range of technological platforms used in AANHPIs telehealth interventions, including web-based, mobile, and blended approaches. Additionally, the review emphasized the need for improved access to technology and reduction in digital exclusion. The findings affirm the usefulness and potential of telehealth interventions, providing implications for how health professionals can serve AANHPIs. Telehealth technology offers the ability for greater accessibility and individualization to address health care disparities in AANHPIs.

Anaerobic digestion of poultry manure to power a poultry farm in Ba: Pilot and techno-economic study.

Although poultry is the largest meat by volume produced in Fiji, there has not been any established study, nor application of the anaerobic digestion (AD) of poultry manure (PM) in the country. This paper aims to determine the techno-economic feasibility of the AD of PM to power a poultry farm in Fiji. A pilot scale study was first conducted with mono-digestion batches of poultry manure, and co-digestions with kitchen waste (KW) and newspaper waste (NPW). Solid state anaerobic digestion (SSAD) was employed in all the batches, and the key operational parameters of AD were studied, along with its influence on biogas production. The pilot study revealed that even slight changes in environmental temperature had the greatest effect on biogas production. The most resilient to the temperature changes were the co-digested feedstocks of KW. Yet, given a substantial AD period, the anaerobes in the mono-digesters were able to eventually acclimatize to the SSAD environment, and produce the overall highest biogas production. The pilot study results were then used to conduct a feasibility study of the full-scale design. The analysis showed that the SSAD system would generate 189.46 MWh of electricity annually, with a levelized cost of energy of FJ$0.17/KWh.