Lucy Kean DM FRCOG

• Consultant Obstetrician Subspecialist in Maternal and
• Fetal Medicine, University Hospitals, City Campus,
• Nottingham

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H a w aii Business 20 (Ju n e 1975): 22- R e p o r t on the e f f o r t s of the new ly a p p o in the d p a r t - H a w a i ia n d i r e c t o r of th e H a w aiian H o m e Lands p r o g ra m to r e v i t a l i z e t h a t s t a t e a g e n c y and the p ro b le m s she f a c e s in th is i m p l e m e n ta t io n. Som e s u b je c t iv e r e f l e c t i o n s on the p e rs o n a lity of th e H a w aiian s. S uggests t h a t th e H a w a iia n fa m ily s t r u c t u r e, which m e t th e e m o tio n a l n e e d s of c h ild r e n and n o u ris h e d and m a in ta in e d th is s e t in to childhood, c r e a t e d a p e o p le with g r e a t "in n e r f r e e d o m of s p irit. The origin of H a w aii land t i t l e s and of th e r ig h ts of n a ti v e t e n a n t s. D isc u sse s leg a l and t r a d i ti o n a l c i r c u m s t a n c e s lea d in g t o the d e v e lo p m e n t of p r iv a t e land t i t l e s and its c o r o lla r y, the rig h ts of n a ti v e t e n a n t s. A f t e r D a m ie n: his fa m o u s le p r o s a riu m is dying of su c c e s s. O b s e rv e s t h a t w hile it is no lo n g e r m ed ic a lly n e c e s s a ry fo r lep ro sy p a t i e n t s to be is o la the d a t K a la u p a p a, on the island of M olokai, its r e s id e n ts p r e f e r t o r e m a in the r. H a w a iia n a c t i v i s t, B e rn a rd P u n ik a ia, a r e s i d e n t, d iscusses the lives of the p a t i e n t s and the i r f u tu r. P ro v id e s e x the n s iv e d e ta i l a b o u t th e w orkings of the C ity of R e f u g e in K ona on the Island of H aw aii. An o s the o lo g ic a l a n a ly sis of s ix the e n H a w aiian b u ria ls fro m M aui, H a w a iia n Islands. E v a lu a the s p r e - c o n t a c t s k e le t a l m a t e r i a l e x c a v a t e d n e a r P a ia, Maui, in 1970. C o n s is ts of fo u r m a le s, e ig h t f e m a le s and fo u r c h ild re n who ra n g e d in a g e fro m one and a h a lf y e a r s to o v e r f i f t y y e a rs. N a t u r a l H isto ry 63 C i t e s he a v y se a s and s ilt fro m o v e r g r a z e d hillsides fo r th e d e s tr u c ti o n of the s e fishponds. D isc u sse s re a s o n s for th e a b a n d o n m e n t of P a la a u as a th riv in g, p r o d u c tiv e a r e a. C o m p a r a t iv e t r e a t m e n t of e p e n the t i c and p a ra g o g ic vow els in English loan words in J a p a n e s e and H a w a iia n. S ug g e sts a s im ila rity b e tw e e n H a w a iia n and J a p a n e s e in th e vow els c h o s e n by th o s e la n g u a g e s t o "open" sy lla b le s which a r e clo se d in English. A c c o u n t of the n u m e ro u s s e p a r a t e O ahu kingdom s fro m th e m ig r a to r y p e rio d t o the l a t e e i g h t e e n t h c e n tu r y. L ists n o ta b le e v e n ts, su c c e s s io n s, and w a rs o c c u rr in g u n d e r v a rio u s c h ie fs. S u m m a ry of the K a m e h a m e h a line th ro u g h Includes b irth and d e a th d a t e s and o the r c o m m e n ta r y. J P S 38 (Ju n e 1929): 105- A nalysis of th is le g e n d as t r a n s l a t e d by f o lk lo ris t A b ra h a m F o r n a n d e r s u g g e sts t h a t it is a c tu a ll y a p a r t of the a n c ie n t h isto ry of R a i a t e a and T a h iti. S u g g e sts th e e f f e c t i v e n e s s of H a w a iia n g e n e a lo g ie s as ta b l e s of m e a s u r e m e n t fo r H a w aiian p r e h is to r y. D e s c rib e s the P una, H e m a, N a n a, and Pili a n c e s t r a l f a m ily lines begun by alii who led e x p e d itio n s to H a w aii. Using d a t a fro m g e n e a lo g ie s, the a u th o r p ro d u c e d a f r a m e w o r k of c h a r a c t e r s upon which th e h isto ry of the p e rio d c a n b e c o n s t r u c t e d. In the r v ie w with e th n o b o t a n is t R a c h a e l M ahuiki of Honolulu re g a rd in g u sa g e of p la n ts fo r m e d ic in a l p u rposes. Educa O f f e r s in sig h t in to H a w a iia n c u lt u r a l a t t i t u d e s to w a rd w om en th ro u g h a re v ie w of H a w a iia n le g e n d s. A u th o r c o n c lu d e s t h a t the ro le and fu n c tio n of w om en in a n c i e n t H a w a iia n s o c ie ty was t h a t of s tr e n g th, dig n ity, and f o rc e fu ln e s s. P r o c e e d in g s of th e T w e n ty - th ir d Annual M e e tin g of the L a k e Mohonk C o n f e r e n c. P O P 42 S k e tc h e s the o r g a n iz a tio n of H a w a iia n g o v e r n m e n ta l p r o c e s s and c h a n g e s in it. C a t a lo g u e of the o f f i c e r s and s tu d e n t s of the Mission se m in a ry. L a h a in a, L ist of 134 s tu d e n t s, including f o r m e r p l a c e of r e s id e n c e, a tt e n d in g L a h a in a lu n a S e m in a ry in S e p t e m b e r 1843. C ritical in tr o d u c tio n and an a n n o t a t e d b ib lio g ra p h y of th e l i t e r a t u r e r e l a ti n g to th e H a w a iia n la n g u a g e by S a m u e l E l b e r t. An e a rly H a w a iia n g r a m m a r, s u p p le m e n the d by a m o d ern in tr o d u c tio n which e v a lu a the s it and o the r g r a m m a r s. I n the r v ie w s with tw o p a r t - H a w a i ia n Waikiki b e a c h b o y s a b o u t the i r w ork and view s of t o u r is ts. In K o h a la K e ia, c o ll e c t e d e x p re s s io n s of a c o m m u n ity, pp. G e n e r a l discussion of the H a w a iia n t r a i l s y s the m and its fu n c tio n. Includes a m ap of t r a i ls in th e L a p a k a h i d i s t r i c t on th e w e s the r n p a r t of th e island of H aw aii. In N eal P a la fo x and A nne W a rre n, E d ito rs, C r o s s - c u l tu r a l c a rin g; a handbook fo r h e a lth c a r e p ro fe s s io n s in H a w aii, pp. B rief o u tlin e of the a n c ie n t H a w a iia n social s y s the m, follow ed by a c o m p a ris o n of p a s t and p r e s e n t H a w a iia n s o c ie ty. C i t e s n u t r itio n a l and e p id e m io lo g ic a l p ro b le m s of m o d e r n - d a y H a w aiian s as well as th e i m p o r ta n c e of o h a n a, or f a m ily, t o p e rso n s of H a w aiian a n c e s t r y. T r a c e s the m o d e rn rev iv a l of i n t e r e s t and p rid e in being a H a w aiian. R e m a r k s on the Sandw ich Islands; the i r s itu a tio n, c li m a t e; d is e a s e s, and the i r s u ita b le n e s s as a r e s o r t fo r individuals a f f e c t e d with or p re d is p o s e d to p u lm o n a ry d ise a s e s. I n v e s tig a tio n of 188 skulls in the Bishop M useum re v e a ls t h a t t e e t h of a n c ie n t H a w aiian s w e r e of such e x c e l l e n t s t r u c t u r e and d e v e lo p m e n t t h a t few c a r i e s e x is the d, e s p e c ia lly to the a g e of fo rty. A g e n e a lo g y t r a c e s six c h ild re n and d e s c e n d a n ts of A heong and his w ife, th e f o r m e r N a u k a n a H iikiau of H uelo, Maui. Includes a re v ie w o f o the r E u ro p e a n c lo th in g and u n ifo rm s the King was known to h a v e worn. A r t i s t i c i n t e r p r e t a t i o n of the 1817 w a t e r c o lo r s and draw in g s of H a w aiian c h ie f e s s e s. Includes h is t o r ic a l a c c o u n t s of th e a r t i s t, Ludovik C h o ris, and his s u b je c ts. S ug g e sts t h a t p e tro g ly p h s and s c u lp tu r e w e r e n o t fully a p p r e c i a t e d in the W est u n til th e a d v e n t of t w e n t i e t h c e n tu r y a b s tr a c t io n i s m. The a p p lic a tio n of fo rm and r e d a c tio n c ri t ic is m H a w aiian l i t e r a t u r. S ug g e sts t h a t a d a p ti v e t r a n s l a t i o n is a u se fu l c o m p l e m e n t, to o the r c r i t i c a l m e th o d s - such as m o tif a n a ly sis, sym bolism s tu d ie s and c o m p a r a t i v e f o lk lo re - f o r th e u n d e rs ta n d in g of H a w aiian l i t e r a t u r. In the rv ie w with s c u lp to r who t r a n s l a t e s a s tro n g id e n t if i c a t io n with his H a w aiian h e r i t a g e in to his works. E x a m in e s the b a s ic e l e m e n t s of the hula as th e y r e l a t e to t r a d i ti o n a l H a w aiian c u lt u r. S u g g e sts t h a t hula c o n c e n t r a t e s and h e ig h the n s a c o n scio u sn e ss of bodily g e s tu r e s with la n g u a g. They o f f e r b a c k g ro u n d and i n t e r p r e t a t i o n s of the c u r r e n t upsu rg e of i n t e r e s t in H a w a iia n a. The island w orld of the P a c if ic: Being th e p e rso n a l n a r r a t i v e and r e s u lts of t r a v e l th ro u g h the Sandw ich or H a w aiian Islands, and o the r p a r t s of P o ly n e sia. D esig n ed to u p d a the e a r l i e r a c c o u n t s of m is s io n a r y /h is to r ia n s Sheldon, D ibble, a nd W illiam Ellis, th is f ir s th a n d c o m m e n ta r y o f f e r s a s y m p a the ti c p o r tr a y a l o f H a w a iia n s during the t r a n s it io n fro m old to new ways. P r e n a t a l diagnosis: an e x p lo r a to r y a t t i t u d i n a l study of w o m e n a t t e n d i n g the ru ra l O ahu f a m ily planning p r o je c t c lin ic s. Study of 122 c li e n ts, including 27 p a r t - H a w a i ia n w om en, a t the Ewa B each, K a n e o h e, and W aipahu c lin ic s. R e v e a ls f a v o r a b le a t t i t u d e s to w a rd s p r e n a t a l diagnosis, b u t w hich a r e c lo u d e d by p e rso n a l u n c e r t a i n t y a b o u t und e rg o in g t r e a t m e n t. W ithin the sound of the s e w aves, the s to ry of th e kings of H aw aii Island, c o n ta in in g a full a c c o u n t of the d e a th of C a p t a in C ook, t o g e the r with the H a w a iia n a d v e n tu r e s of G e o rg e V ancouver and sundry o the r m a r in e r s. N a r r a t i v e of the lives of e ig h t fa m o u s alii aim o k u, or kings, of th e island of H aw aii. Includes f a c s im ile s of M ahele Book pag e s and Land C o m m issio n a w a rd s. D e s c rip tio n of the d o c u m e n ts issued by the H a w aiian g o v e rn m e n t and an a ly sis of the i r s ig n if ic a n c e in the h isto ry of th e H a w aiian land s y s the m. A h isto ry and c r i t ic is m of p o litic a l spe ak in g in th e H a w aiian K ingdom, 1874-1891. A d u lte r y and f o r n i f i c a t i o n as used in th e H a w aiian and T a h itia n Bibles. English tr a n s la t io n s of the v e rs e s de a lin g with a d u lte r y and f o r n ic a tio n in th e H a w aiian a nd T a h itia n P r o t e s t a n t Bibles re v e a ls c o m p a r a t i v e d e v e lo p m e n t of the s e t e r m s. S t a t i s t i c s in d ic a the t h a t H a w aiian s p a r t H a w aiian s, and Filipinos w e r e l e a s t in c lin e d to suicide. Honolulu: E th n ic R e s o u r c e C e n t e r fo r th e P a c if i c, U n iv e rs ity of H aw aii, 1975. The a u th o r r e c o u n t s m e m o r ie s and s to r i e s of h er H a w aiian h e r i t a g e as h a n d e d down by h e r g r a n d p a r e n ts. A ngle O r t h o C o m p a r e s m e a s u r e m e n ts fro m e ig h t e e n m a le and t w e n t y - f i v e f e m a le skulls fro m the Bishop M useum with s tu d ie s using sim ila r m e th o d s on o the r r a c ia l groups. Tells of th e r e g a r d he ld fo r s a c r e d s to n e s and s to r ie d p la c e s in th e f a b r i c of e v e ry d a y life. R a c ia l a s p e c t s of leprosy and r e c e n t the r a p e u t i c a d v a n c e s. O f 271 new c a s e s d iag n o se d in H aw aii during the period 1945-1955, slightly under h a lf w e r e H a w a iia n or p a r t - H a w a i ia n and o n e - f o u r th w e r e i m m ig r a n t Filipinos. A c c o u n t of the f u n e r a l H a w a iia n d e l e g a t e to C o n g re ss. The q u e e n who w e ig h e d a ton; C a p t a in K o tz e b u e, 1825, pays his r e s p e c ts to Q ueen N a m a h a n a. L a c k in g n u m e r a ls, all c a lc u la t io n s w e re p e r f o r m e d by c o u n tin g th in g s out. O re g o n H is to r ic a l Q u a r the r ly Survey of H a w aiian s who s a ile d to O re g o n during the l a t e e ig h t e e n t h and e a rly n i n e t e e n t h c e n t u r i e s. N o the s t h a t f e w t r a c e s of th is im m ig r a tio n in O re g o n re m a in e d by the end of the n i n e t e e n t h c e n tu r y. Includes so m e a c c o u n ts of the a c t i v i t i e s of H a w aiian b e a c h b o y s during th e 1930s. C o m p a r a t iv e study of the s im i la r i t ie s in s t r u c t u r e and sym bolism of H a w a iia n and H e b re w p o e tr y. C i t e s h e r e f f o r t s in s e tt in g up an e s t a t e t o b e n e f i t H a w aiian s th ro u g h th e m e a n s of the K a m e h a m e h a Schools. P r o g ra m study and e v a lu a tio n of th e D e p a r t m e n t of H a w aiian H o m e Lands. F i r s t p a r t of a stu d y, m a n d a t e d by the 1969 S t a t e L e g is la tu r e, to f o r m u l a t e plans for th e m o d e r n iz a tio n of th e D e p a r t m e n t of H a w aiian H om e Lands. This s t a t e a g e n c y a t t e m p t s to p ro v id e public lands fo r th o s e of H a w aiian blood. C o m p ila tio n of l e t t e r s of c o n d o le n c e and res o lu tio n s o f f e r e d a f t e r the d e a th of M iriam C le g h o rn on F e b r u a r y 2, 1887. Includes t h i r ty - s e v e n N a M ele K an ik a u, or c h a n ts of m o u rn in g, and an a c c o u n t of th e f u n e r a l c e re m o n ie s. S ug g e sts t h a t th is c a v e in the Kau d i s t r i c t had only se aso n a l use for s w e e t p o t a t o c u lt iv a t io n, h a r v e s tin g of m a m a k i fo r k a p a m a n u f a c t u r e, and c o lle c tio n of fre s h w a t e r f o r t r a n s p o r t a t i o n to a rid c o a s tlin e s e t t l e m e n t s. L e t t e r s fro m the Sandw ich Islands w r i t t e n for th e S a c r a m e n t o Union by M ark Tw ain. C o lle c tio n of t w e n t y - f i v e l e t t e r s w r i t t e n by C le m e n s while in H aw aii as a n e w s p a p e r c o r r e s p o n d e n t during th e spring and s u m m e r of 1866. G r e a t d e ta il is g iven t o the f u n e r a l of P rin c e s s V ic to ria K a m a m a lu K a a h u m a n u. The C h r i s t i a n i z a t i o n of H aw aii v iew ed as a social m o v e m e n t. A rg u e s t h a t long is o la tio n and opp ressio n u n d e r the kapu s y s the m p rim e d H a w aiian s for the c u l t u r a l u p h e a v a l of th e e a rly n i n e t e e n t h c e n tu r y and a c c e p t a n c e and t o l e r a t i o n of new c o n d itio n s. An a r c h a e o lo g i c a l survey of th e s e a w a rd p o rtio n of H onokohau #1 a nd # 2, N o r th K ona, H a w aii Island. E v a lu a tio n of the a rc h a e o lo g i c a l s ig n if ic a n c e of an a r e a which was im p o r ta n t in e a rly days b e c a u s e of its f a c i l i t i e s fo r c a n o e s and its m any fishponds. In L ife in H aw aii: an a u to b io g r a p h ic s k e tc h of m ission lif e and la b o rs (1835-1881), pp. A u th o r a t t e m p t s to c h a r a c t e r i z e H a w a iia n s on th e basis of his fir s th a n d im p re ssio n s of som e g e n e r a l p e rs o n a l t r a i t s. A nnals of th e A m e ric a n A c a d e m y of P o litic a l and Social S c ie n c e (July 1901): 917. P h o to g ra p h s of an e a rly Waikiki se a pond and an i n t e r i o r fishpond a r e also included.

Audit data show that despite the existence of guidelines to prevent transmission of infections in hemodialysis units erectile dysfunction pumps cost buy generic extra super avana 260mg online, their implementation remains suboptimal erectile dysfunction causes prostate buy extra super avana 260mg low cost, leading to a large preventable burden of infections that not only adversely impacts clinical outcomes zantac causes erectile dysfunction discount extra super avana 260mg line, but imposes large costs on the health care system erectile dysfunction meme generic extra super avana 260 mg otc. Experience from public health interventions shows that interventions Kidney International Supplements (2018) 8 best male erectile dysfunction pills order extra super avana 260mg with amex, 91Р165 Follow-up and testing of patients who were treated in the center and those subsequently transferred or discharged may be warranted erectile dysfunction drugs and high blood pressure purchase extra super avana 260 mg otc. Conduct a thorough root cause analysis of the infection and address infection control lapses. Perform rigorous assessments of staff infection control practices to identify lapses. This should minimally include assessments of hand hygiene and glove change practices; injectable medication preparation, handling, and administration; and environmental cleaning and disinfection practices. Consider hiring a consultant with infection prevention expertise to provide recommendations for improvement of practices and work flow and/or to help implement actions to address identified lapses. If transmission within the center is suspected or confirmed, inform all patients of this. Patients should also be made aware of steps being taken to assess and improve practices. In contrast, making systemwide changes, such as imposition of regulations and creating an environment that discourages unhealthy behavior, is likely to have greater impact. Recommendation of uniform validated measures such as those used by the National Healthcare Safety Network are critical for comparisons and to facilitate interventions. Other systemwide changes that are likely to have a beneficial impact on infection prevention and control practices include increasing staff-topatient ratios and instituting staff training and education requirements. Physical infrastructure changes to facilities might also be beneficialСfor example, establishing minimum space requirements between treatment stations, creating walls around individual treatment stations to establish separate rooms instead of large open spaces, and using walls to separate clean and dirty processes. Such possibilities should be explored, along with Table 6 Strategies to support adherence to infection control recommendations in hemodialysis centers It is important for the designers of dialysis units to create an environment that makes infection control procedures easy to implement. Adequate handwashing facilities must be provided, and the machines and shared space should make it easy for staff to visualize individual treatment stations. The unit should ensure that there is sufficient time between shifts for effective decontamination of the exterior of the machine and other shared surfaces. The unit should locate supplies of gloves at enough strategic points to ensure that staff has no difficulty obtaining gloves in an emergency. There are indications from the literature that the rate of failure to implement hygienic precautions increases with understaffing. Dialysis units that are changing staff-to-patient ratios, or introducing a cohort of new staff, should review the implications on infection control procedures and educational requirements. Resource problems should be handled by carrying out a risk assessment and developing local procedures. For example, if blood is suspected to have penetrated the pressure-monitoring system of a machine but the unit has no on-site technical support and no spare machines, an extra transducer protector can be inserted between the blood line and the contaminated system so that the dialysis can continue until a technician can attend to the problem. This may take the form of a welldefined cubicle or room, but there is usually no material boundary separating dialysis stations from each other or from the shared areas of the dialysis unit. A "potentially contaminated" surface is any item of equipment at the dialysis station that could have been contaminated with blood, or fluid containing blood, since it was last disinfected, even if there is no visual evidence of contamination. Education A program of continuing education covering the mechanisms and prevention of crossinfection should be established for staff caring for hemodialysis patients. Staff should demonstrate infection control competency for the tasks they are assigned. Appropriate information on infection control should also be given to nonclinical staff, patients, caregivers, and visitors. Patients should be encouraged to speak up when they observe an infection control practice that is concerning to them. Hand hygiene Staff should wash their hands with soap or an antiseptic hand-wash and water, before and after contact with a patient or any equipment at the dialysis station. An alcohol-based hand rub may be used instead when their hands are not visibly contaminated. In addition to hand washing, staff should wear disposable gloves when caring for a patient or touching any potentially contaminated surfaces at the dialysis station. Patients should also clean their hands with soap and water, or use an alcohol-based hand rub or sanitizer, when arriving at and leaving the dialysis station. Injection safety Medication preparation should be done in a designated clean area. All vials should be entered with a new needle and a new syringe, which should be discarded at point of use. Medications should be administered aseptically, after wearing a disposable glove and disinfecting the injection port with an antiseptic. All single-dose vials must be discarded and multidose vials, if used, should not be stored or handled in the immediate patient care area. Equipment management (for management of the dialysis machine, see Table 4) Single-use items required in the dialysis process should be disposed of after use on 1 patient. Blood pressure cuffs should be dedicated to a single patient or made from a light-colored, wipe-clean fabric. Medications provided in multiple-use vials, and those requiring dilution using a multiple-use diluent vial, should be prepared in a dedicated central area and taken separately to each patient. Items that have been taken to the dialysis station should not be returned to the preparation area. After each session, all potentially contaminated surfaces at the dialysis station should be wiped clean with a low-level disinfectant if not visibly contaminated. Surfaces that are visibly contaminated with blood or fluid should be disinfected with a commercially available tuberculocidal germicide or a solution containing at least 500 p. Waste and specimen management Needles should be disposed of in closed, unbreakable containers, which should not be overfilled. A "no-touch" technique should be used to drop the needle into the container, as it is likely to have a contaminated surface. If this is difficult due to the design of the container, staff should complete patient care before disposing of needles. All blood and other biologic specimen handling should occur away from dedicated clean areas, medications, and clean supplies. The used extracorporeal circuit should be sealed as effectively as possible before transporting it from the dialysis station in a fluid-tight waste bag or leak-proof container for disposal. If it is necessary to drain the circuit to comply with local regulatory requirements, or to remove any components for reprocessing, this should be done in a dedicated area away from the treatment and preparation areas. As such, regulatory and accrediting agencies should issue and/or incorporate recommendations to favor compliance with basic infection control practices in dialysis units, and efforts to make the desired infection control behavior the simplest or most logical approach to care processes should be pursued (Table 6). Table 7 provides a summary of important hygienic precautions for hemodialysis center staff to follow. Despite such strong data, adherence to recommended practices remains suboptimal, often due to misconceptions of the dialysis staff. On the basis of their observational results, which included high compliance with glove use (93%) in contrast to poor hand hygiene compliance (36%), Arenas et al. These data support the need for improved training and education to address knowledge gaps, as well as other initiatives focused on optimizing adherence to recommended infection control practices (Table 7). As mentioned above, implementation is more likely when guidelines are accompanied by changes in regulations. Research recommendations Further observation studies should be conducted to ascertain features of facilities that do not have incident cases. These studies should ideally evaluate costs, patient perceptions, and complications associated with isolation. These studies should ensure the physical separation of either the center or room, or separation by treatment shift; these programs should have strict isolation strategies in place that include staff. In particular, we need innovative, effective strategies to improve infection control, and it is still important to overcome barriers to identification and treatment of all infected patients. Future research should devise innovative approaches that accurately measure infection control processes at a reasonable cost. In addition, measurement of hepaticvein wedge-pressure gradient is useful when deciding whether single kidney transplantation or simultaneous liver-kidney transplantation should be proposed. Absence of varices on endoscopy and portal pressure gradient < 10 mm Hg suggests that cirrhosis is compensated. In patients with compensated cirrhosis without portal hypertension, isolated kidney transplantation is recommended. Other factors such as candidate sensitization and patient preference can be also considered for choosing the timing of treatment. The scarcity of donor organs for transplantation results in long waiting times for kidney transplantation. Longer time on hemodialysis and on wait-list may be an independent risk factor for graft loss and mortality after transplantation. For these reasons kidney transplantation with expanded criteria donors has become a necessity. Indeed, cyclosporine, tacrolimus, sirolimus, and everolimus are metabolized in the liver by the cytochrome P450. As such, the Work Group suggests that the Hepatitis Drug Interactions website from the University of Liverpool. The most common presentation is proteinuria with or without microhematuria, or nephrotic syndrome. In the case of urine protein-to-creatinine ratio > 1 g/g or 24-hour urine protein (protein excretion rate) greater than 1 g on 2 or more occasions, a graft biopsy is indicated. Pathological examination should include immunofluorescence and electron microscopy. In the absence of an identified etiology (currently <10% of mixed cryoglobulinemia), cryoglobulinemic vasculitis is defined as essential or idiopathic. Thus, some patients might be spared from immunosuppression in the presence of severe chronic lesions when there is no extrarenal indication for immunosuppression. Glomeruli may show prominent hypercellularity as a result of infiltration of glomerular capillaries by mononuclear and polymorphonuclear leucocytes. Glomeruli frequently show accentuation of lobulation of the tuft architecture with a combination of increased matrix and mesangial cells, capillary endothelial swelling, splitting of capillary basement membrane, and accumulation of eosinophilic material representing precipitated immune complexes or cryoglobulins. The glomerular basement membrane often shows double contours, which are caused by the interposition of monocytes between the basement membrane and the endothelium. Both subendothelial and mesangial immune complexes can be identified by electron microscopy 138 typically without a distinctive substructure. On light microscopy, the characteristic finding is a diffuse and uniform thickening of the glomerular basement membrane without mesangial or endothelial proliferation. Diffuse subepithelial immune deposits can be identified by electron microscopy, and immunofluorescence shows diffuse and granular deposits of IgG, IgA, and C3. At the end of antiviral therapy, the summary estimate of the mean decrease in proteinuria was 2. Serum creatinine was not significantly decreased with antiviral treatment; however, stabilization of serum creatinine was achieved. One report emphasized the spontaneous remission of glomerular lesions; this cannot be excluded in a few cases. First, the impact of antiviral therapy on the longterm outcomes of kidney disease remains uncertain. The development of kidney disease among patients with mixed cryoglobulinemia has particular importance because kidney involvement confers a poor prognosis to such Kidney International Supplements (2018) 8, 91Р165 patients. Extrarenal features of mixed cryoglobulinemia include neuropathy, hepatomegaly, sicca syndrome, and central nervous system and gut involvement. Although extrarenal signs of mixed cryoglobulinemia vasculitis usually precede the kidney manifestations, often by years, in 29% of cases, kidney and extrarenal involvement are concurrent. Acute nephritic and nephrotic syndrome can be a presenting feature in 25% and 20% of patients, respectively. Arterial hypertension is frequent (affecting >50% of patients at the time of diagnosis) and is often resistant to antihypertensive drugs; the severity of hypertension often mirrors the severity of kidney disease. In addition, antiproteinuric agents such as angiotensin-converting enzyme inhibitors/angiotensin receptor blockers should be given. Cyclophosphamide has been selected to improve kidney disease by reducing stimulation of B lymphocytes and cryoglobulin synthesis; steroid pulses have been given to treat glomerular inflammation, and plasma exchange has been employed to remove circulating cryoglobulins from the plasma and consequently to reduce the deposition of immune complexes to the kidneys. Potential regimens include rituximab (375 mg/m2 weekly for 4 weeks) with or without corticosteroids (see below), or cyclophosphamide (2 mg/kg/d for 2­4 months) plus methylprednisolone pulses 0. Until a few years ago, combined therapy with corticosteroids and immunosuppressive agents-for example, treatment using sequentially cyclophosphamide and azathioprine-has been used while awaiting the response, if any, to antiviral therapy. In one retrospective study, the clinical outcome of 105 patients with essential mixed cryoglobulinemia vasculitis and renal involvement was evaluated throughout a median follow-up of 72 months since kidney biopsy. About 80% of patients underwent treatment with oral or pulse intravenous steroids and/or cytotoxic agents, whereas 67% were treated with plasma exchange. Despite this aggressive treatment, patient survival was 49% at 10 years after kidney biopsy, and only 14% of patients had long-term remission of kidney disease. However, it is clear that we need larger and controlled studies to confirm these results. Frequent relapses may occur after rituximab when B cells re-emerge in the peripheral blood; in addition, repeated rituximab infusions may expose patients to opportunistic infections. Safety and efficacy of rituximab was evaluated over a long-term follow-up (mean: 72. Re-induction with rituximab was carried out in 9 patients who relapsed after a mean of 31. In addition, complete remission of pre-treatment active manifestations was observed in all cases of purpuric lesions and non-healing vasculitic ulcers, and in 80% of the peripheral neuropathies. However, these complications were mostly observed in patients under multiple immunosuppressive agents. For example, what is the optimal timing and dosing of periodic rituximab infusions for relapsers? Severe infections after rituximab therapy frequently occur in patients who are older than 50 years, have kidney disease, and report concomitant use of high-dose corticosteroids.

Time Points of Measurement: pretest erectile dysfunction over 70 order 260mg extra super avana free shipping, post-test erectile dysfunction 50 buy extra super avana 260mg line, follow-up Intellectual Assessment Standard Progressive Matrices (Raven erectile dysfunction natural treatment options buy extra super avana 260 mg with amex, 1960); nonverbal and culture-fair test of general intellectual ability; used to determine eligibility for inclusion in study erectile dysfunction pink guy buy 260 mg extra super avana free shipping. Time Points of Measurement: pretest Results the increments of sexual abuse knowledge remained stable for 2 months erectile dysfunction treatment online buy discount extra super avana 260mg. In contrast erectile dysfunction humor discount extra super avana 260mg fast delivery, control participants consistently performed at lower levels and remained naive with regard to sexual abuse issues. Clinical significance: authors point out that although the intervention group significantly outperformed those in the control group, the clinical significance of their participating is less promising. Yet, the percentage of students reaching the 80% competency criterion increased from 5% at pretest to 34% at post-test for the intervention, and only from 8. About 50% of the intervention group showed a 6-point increase on their knowledge of selfprotection skills at post-test, whereas only 14. However, a number of participants in intervention group did not reach the 80% criterion. Study Quality Fear Assessment Thermometer Scale - significant main effect for time; significant differences between post-test and follow-up and between pretest and follow-up, with lower level at the follow-up assessment (p<. This indicated that lower level of fear was displayed at the 2month follow-up for both groups. Age and intellectual abilities were not associated with side effects of the program at various time points. Measures Results between program completers and dropouts Study Quality Author/s: Singer Title: Evaluation of a Self-protection Group for Clients Living in a Residential Group Home Population and Setting Location: Group home, residential Study Eligibility Criteria: People with learning disabilities who lived in a residential group home, were referred for skills training by their home manager, Participation was voluntary Population Type: Learning Disabled/Mentally retarded Population Characteristics: Age: Ranged 27-70 years Sex: 3 women, 4 men Females = 43% Males=57% Education: Not Reported Race/Ethnicity: Not Reported Sexually Active: Not Reported Victimization: Direct Assessments. Clients were interviewed individually by the trainers before the intervention work began. Clients had over the last year been subjected to verbal, physical, and emotional abuse by previous staff members who had left. Criminal History: Not Reported Session 3: Saying Yes and No clearly Methods/Setting of Data Collection: Home manager was asked to complete the Indirect Assessments. Time Points of Data Collection: Pre-test: Before intervention (exactly when not reported) Post-test: last session of the intervention Study Design and Sample Study Design: Pre-post design Author-reported: Not Reported Intervention Group Type(s): 7 adults with learning disabilities who were referred for skills training by their home manager Comparison Group Type(s): Not Applicable Sampling Frame Size: Not Reported Baseline Sample Size (and Participation Rate): N=7 Post-test and Follow-up Sample Sizes (and Participation Rates): 6/7 = 86% Intervention Setting: Group home, residential Year: 1996 Article Number: 074 Duration: Six sessions, between 1 and 1 Ѕ hours held on a weekly basis. It has been suggested that assertive behavior can avoid patronizing, insulting and abusive behaviors from others (Winchurst et al, 1992). Curriculum was designed in a way that allowed clients to learn and retain information through more active games and role-plays. Delivery Mode: Mixture of information-giving, group exercises, active games and role play. All residents were able to communicate verbally, at least to some extent, five using full sentences and two using a few single words in communication. Four were perceived as being quite articulate, three as being more passive and quiet. Two could not read at all, three could read a limited number of words, and two could read full sentences. Study Design and Sample Intervention - using voice and body language Session 4: Developing self-esteem - differences between people - self-descriptions - what I enjoy doing - what I do well Session 5: Good and bad touches - what they are in different contexts (places and people) Session 6: Role Plays - being bullied (verbally and physically) - being touched by strangers - being touched by someone you know the role plays were always demonstrated by the facilitators. Session 7: Application of skills - role playing with a stranger Program Implementer: Group was facilitated by two people, the author and an Assistant Psychologist, both of whom were women and members of a Community Learning Disability Team Culturally Specific: Not Reported Assessment of Exposure: Not Reported Intervention Retention Rate: 6/7 = 86% Other: G-28 this document is a research report submitted to the U. Measures Knowledge: Not Reported Time Points of Measurement: Attitudes: Not Reported Time Points of Measurement: Victimization: Not Reported Time Points of Measurement: Perpetration: Not Reported Time Points of Measurement: Other Measures: - Indirect Assessments of abilities and appropriateness of behavior in social situations. Time Points of Measurement: pre-test and post-test Results Primary Measures: Knowledge: Attitudes: Victimization: Perpetration: Other Measures: Study Quality Quality Score: Total: 36/85 (42%) Description: 23/25 (92%) Design: 13/60 (22%) Major Strengths: Study: Examined population that had a history of victimization. The residents varied quite substantially in their ability to give verbal responses and in their level of assertiveness. For less verbal clients more emphasis was placed on non-verbal responses such as pushing hands away or moving away physically. They also found that verbally less able clients initially used more able clients as role models and copied their behaviors in different role play situations. The mean ratings of clients on the individual items of levels of assertiveness in social situations indicates that apart from assertiveness with people in authority all changes were positive in the direction of more appropriate assertiveness responses. Shifts were also noted in other areas such as verbal/nonverbal behavior (particularly eye contact, posture, appropriate distance from others in conversation and pitch of voice) and in social behavior. All group members, except for one, were rated as giving more appropriate responses in social situations after the group sessions (social interaction/assertiveness skill). Reading and writing skills: findings not reported Informal feedback from the manager and other members of the staff included the observations that clients appeared Direct measure G-29 this document is a research report submitted to the U. Measures - In the last session, clients were asked to role-play the scenarios that were introduced and practiced over the previous six sessions with a person they had never met before. The last session was used as a direct measure of what had been learned in the group. Clients were asked to repeat some of the exercises (body awareness; saying yes and no) and to do all the role plays with a new member of the Community Learning Disability Team (another Assistant Psychologist). Results more confident, expressed their needs more clearly and generally conveyed a more positive attitude. Direct assessment: all six participants performed confidently and responded appropriately in the exercises as well as in the role plays. Attendance/Treatment Completion: All clients attended at least 6 sessions except one person who dropped out after the 5th session. Title: Teaching Refusal Skills To Sexually Active Adolescents Primary Reviewer: Joyce Secondary Reviewer: Anita Population and Setting Location: Not reported Study Eligibility Criteria: Not reported Population Type: Deaf; developmentally delayed Population Characteristics: Age: client A: 14-yrs old Client B: 16-yrs old Sex: Female Study Design and Sample Study Design: pre-post Year: 1990 Article Number: 075 Tertiary: Shannon Intervention Setting: Unclear Duration: Not reported Theory/Model: Skills acquisition approach to teaching decision-making, problem solving skills, and interpersonal communication skills (Blythe, Gilchrist, & Schinke, 1981; Franzini, Siderman, & Dexter, 1988; Gilchrist & Schinke, 1983; Libby & Carlson, 1973; Schinke, Gilchrist, & Small, 1979). Delivery Mode: Role-play Curriculum/Content: Each girl described situations that resulted in unwanted intercourse. The who, what, when and where were used to develop role-plays vignettes for each girl. Each session began with a role-play followed by a review of previously learned refusals skills components, training in refusal skills, and additional role play assessment. Refusal skills training followed the format of rationale, modeling, behavioral rehearsal, feedback, and reinforcement (Eisler & Frederiksen, 1980; Kelley, 1982). No information on who assisted with other training Culturally Specific: Not reported Author-reported: Not reported Intervention Group Type(s): N=2; One lived in a residential school setting for the deaf; other lived in residential treatment center for developmentally delayed. Comparison Group Type(s): N/A Sampling Frame Size: Not reported Education: Not reported Race/Ethnicity: Not reported Sexually Active: Both girls were sexually active (client A had been repeatedly suspended from school because of sexual intimacy with male residents and client B had a "history of precocious sexual behavior") Victimization: Not reported Criminal History: Not reported Other. Each expressed interest in learning skills that might help them avoid unwanted sexual intimacy. Baseline Sample Size (and Participation Rate): N=2 Post-test and Follow-up Sample Sizes (and Participation Rates): 100% Time Points of Data Collection: Post-test: 2 weeks following the completion of refusals skills training Follow-up: one-year after training (phone calls) Methods/Setting of Data Collection: Unclear New role plays and different confederates were used during the follow-up assessments. Population and Setting Study Design and Sample Intervention Assessment of Exposure: only 2 clients so staff were aware of their presence Intervention Retention Rate: 100% Other: G-32 this document is a research report submitted to the U. Measures Knowledge: Female psychology graduate students rated videotaped role-plays randomly selected at the conclusion of training each skill; 9-point Likert scale. Client A had significant differences between baseline and post-treatment performance ratings for both refusal effectiveness (p<=. Differences were also found for skillfulness measures obtained at baseline and after the addition of each of the other skill components. Attitudes: Victimization: Perpetration: Other Measures: Follow-up (one-year after training): telephone contact with residential staff serving as informants indicated decreased sexual activity for each girl, as noted by patient incidence reports. Attendance/Treatment Completion: Other: Study Quality Major Strengths: Study: - role-plays scored by two observers - treatment designed for each client individually Article: Major Weaknesses: Study: Authors comments: - small sample; limits generalizability - difficulty in obtaining valid data on sexual behavior Article: G-33 this document is a research report submitted to the U. Title: An Eight Year Follow-up of Three Social Skills Training Studies; Teaching social skills to mentally retarded adults: Follow-up results from three studies; Teaching Social/Sexual Skills to Mentally Retarded Adults Primary Reviewer: Jennifer Secondary Reviewer: Anita Tertiary: Shannon Population and Setting Location: Two coeducational wards for moderately and mildly retarded adults Study Eligibility Criteria: institutionalized adults with mild to moderate mental retardation; unit staff were asked to refer residents in need of social/sexual skills training Population Type: disabled adults Population Characteristics: Age: mean age: group one 26; group two 24 Sex: all females Education: Not reported Race/Ethnicity: Not reported Sexually Active: 5 subjects were identified by staff as frequently engaging in public sexual behavior that the staff deemed inappropriate Victimization: 4 subjects were described by staff as being "frequently exploited by males" 1 subject had complained on several occasions of being sexually harassed by male residents (as reported by staff) Criminal History: Not reported Other. Comparison Group Type(s): Not applicable Sampling Frame Size: Not reported Intervention Year: 1992; 1984; 1985 Article Number: 076, 077, 078 Setting: all games were played in a basement area of an institutional residence hall Duration: 12 games were played (no time frame reported) Theory/Model: Social/sexual skills training; game cards were developed based on 6 social skill component areas ­ compliments, social interaction, politeness, criticism, social confrontation, and questions/answers ­ that the researchers found to be applicable to social situations involving male-female sexual interactions Delivery Mode: card game played by 3 subjects and the facilitator Curriculum/Content: (Foxx, McMorrow, Schloss, 1983; Foxx, McMorrow, & Mennemeier, 1984) Subjects played a game using a modified table game (Sorry) and 48 game cards specially designed to elicit complex verbal responses. Baseline ­ During baseline players could move their game pieces on their turn regardless of whether they were correct in their response. They received no feedback, but the facilitator modeled a correct response on her turn. Social/sexual skills game ­ during training, movement of game pieces was contingent on correct responses. Players self-monitored their performance during the game and graphed it afterwards. Training was aimed at helping players verbally differentiate between public and private sexual behavior as well as make appropriate responses to boyfriends, acquaintances, or strangers. Population and Setting had no difficultly learning to play Study Design and Sample Game involved the use of modified table board game and specially designed game cards; responses were also videotaped behind one-way glass Setting ­ the generalization tests were conducted in a small lounge (3m x 3m) at the other end of the basement that was furnished with a table, chairs, plants, and pictures; both rooms contained one-way glass that permitted unobtrusive video taping; videotapes were transcribed Follow-up ­ different assessment rooms were used than were used during pre- and post-test assessments because of renovations to the facility Intervention opinions expressed were not judged in order to eliminate value judgements on the part of the scorers. Follow-up: the assessors were most likely different than the two that conducted the pre- and post-test assessments (1992 article indicates that only one assessor from original study was available, but which one is not specified) Culturally Specific: Not reported Assessment of Exposure: Not reported Intervention Retention Rate: Not reported Other: G-35 this document is a research report submitted to the U. Measures Knowledge: Not reported Time Points of Measurement: Attitudes: Not reported Time Points of Measurement: Victimization: Not reported Time Points of Measurement: Perpetration: Not reported Time Points of Measurement: Other Measures: Social Skills Training 8 game cards that depicted non-explicit sexual interactions or contained referents to sexual behavior were developed for each of the six component skills, thereby creating a 48-card deck. Each skill was further differentiated into four "actor" and "reactor" situational competencies, each of which required that players initiate interaction or respond to an interaction initiated by someone else. The cards were prearranged so that each player would be required to respond once to each card after 4 games. Responses in each component area were scored using rules and validated criteria from earlier research (Foxx, McMorrow, Schloss, 1983; Foxx, McMorrow, & Mennemeier, 1984) Also, young, unmarried mental health paraprofessionals were asked to respond to each situation. Their responses were used to further validate the criteria and to develop correct responses used by the facilitator during the game. Individualized performance criteria was established for each player based on their baseline performance (beginning at 30% above baseline mean, increased to 60%, and finally to 90% correct). Results Primary Measures: Original study (Post-test) Social/sexual skills game Group 1 averaged 40. At the end of the 12 training games, both groups were responding at the 75% correct level. In general, there was continued improvement as training progressed, in both "action" and "reaction" categories and tended to score higher in reactor situations. Subjects used their newly learned skills in both individual and group assessments. Post-test (as reported in Foxx & McMorrow, 1985) ­ all subjects maintained their levels of appropriate responding that were above pre-training in both the individual and group assessments ­ Four subjects showed some improvement from post-test to follow-up on the individual tests which 2 did so on the group assessment Number of words per response ­ 5 of the 6 subjects were above their pretest levels on the individual test. Study Quality Major Strengths: Study: Measures taken to ensure standardization: ­ Scoring criteria were developed by compiling and synthesizing the responses of non-retarded persons to each training situation ­ Scoring criteria accommodated individual levels of knowledge and attitudes regarding social/sexual behavior because they permitted a number of responses to be acceptable to any particular training situation ­ Validity of the criteria and trained skills was substantiated by the acceptable levels of reliability between the trained observer and four naive mental health professionals. Measures Time Points of Measurement: baseline and training Generalization test Consisted of 3 stories that together contained all of the 48 training situations. Each story depicted a fictitious woman in situations similar to those that the subjects might encounter and was constructed to permit the logical inclusion of variations of one-third of the training situations, i. The stories were read one at a time and the subjects were asked at specific points what they would do if they found themselves in the situation. Mean number of words per response ­ 3 of the 4 subjects were below their post-test levels and all were below their 6-month follow-up levels. An overview of the development of self-advocacy by mentally handicapped people and recommendation for the development of trainee committees. Teaching Social Skills to Mentally Retarded Adults: Followup Results from Three Studies. Teaching social/vocational skills to retarded adults using a modified table game: An analysis of generalization. Stacking the deck: Teaching social skills to retarded adults with a modified table game. Postponing Sexual Involvement Among Adolescents: An Alternative Approach to Prevention of Sexually Transmitted Diseases. Increased independent interpersonal decision-making skills of women with mental retardation in response to social-interpersonal situations involving abuse. Unpublished doctoral dissertation, Teachers College, Columbia University, New York. Effectiveness of a computer-based safety program for children with severe learning difficulties. Evaluation of a sexual abuse prevention program for female Chinese adolescents with mild mental retardation. Sexual Abuse: Special Considerations when Teaching Children Who Have Severe Learning Difficulties. Training and generalization of sexual abuse prevention skills for women with mental retardation. Evaluation of a self-protection group for clients living in a residential group home. Effective decision-making/problem-solving training with mothers who have mental retardation. Teaching learning disabled adolescents to think critically using a problem-solving schema. Teaching Personal Safety Skills for Potential Prevention of Sexual Abuse: A Comparison of Treatments. An Evaluation of Side Effects Associated with Participation in Child Sexual Abuse Prevention Program. Increase sample size* · to ensure sufficient statistical power · for more representative sample size * Mentioned multiple times by different authors. Follow-up · Incorporate multiple ongoing follow-up assessments at brief, intermediate, and long-term time intervals. Replication · There are individual studies on single programs with little follow-up work. Once identified, multi-site testing of the program and replication of the results are essential. Setting · Determine if intervention effective in other settings* · Test rape prevention education in other settings (beyond classroom). Victimization and prevention efforts · Future research is needed to continue to assess the mechanisms through which victimization experiences become linked so that this information can be incorporated into prevention programs. Behavioral measures · Assess behavioral change through self-reports of sexual coercion and harassment experienced. Future research could be strengthened by measures of behavioral commitment to positive changes in attitudes towards rape.

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Honolulu: U n iv e rs ity of H aw aii E th n ic S tu d ie s O ra l H isto ry P r o j e c t low testosterone causes erectile dysfunction purchase extra super avana 260 mg without a prescription, 1978. C o n s is ts of slig h tly e d it e d t r a n s c r i p ti o n s of i n the r v ie w s with nine individuals of H a w aiian a n c e s t r y, ran g in g in a g e fro m 65 t o 90, a b o u t the i r lives, c a r e e r s, and c u lt u r a l in v o lv e m e n t. T r a n s a c tio n s of th e R oyal H a w aiian A g r ic u ltu r a l S o c ie ty 2 (1854): 101-105. R e v ie w of c o m m o n ly held a t t i t u d e s of H a w aiian s to w a rd w orking on p la n t a ti o n s. Includes g e n e a lo g ie s of h e r s e lf, K a m e h a m e h a I, K e p o o k a lan i (her g r a n d f a th e r), Q ue e n E m m a, P r in c e s s R u th K e e lik o la n i, and K e k a u lik e, an e a rly king of H aw aii. R e p r in t of the r a r e 1897 p u b lic a tio n in which Q ueen L iliuokalani t r a n s l a t e d in to English an 1889 H a w a iia n la n g u a g e t e x t of th e K um ulipo or c r e a t i o n c h a n t, w hich had b e e n w r i t t e n by h e r b r o the r King K a la k a u a. This is e s s e n tia lly the g e n e a lo g y of the King with which he ju s tifie d h im s e lf as a d e s c e n d a n t of the a n c i e n t kings of H aw aii. A survey of the H a w aiian p e o p le to d a y and a s tu d y of the c h a r a c t e r i s t i c s of c h ild re n u n der c a r e of L iliuokalani T r u s t C hild W e lfa re D e p a r t m e n t. C o lle c tio n of d a t a p e r ta in in g t o the s o c ia l, p h y sic a l, and e c o n o m ic p ro b le m s of H a w a iia n s, with r e c o m m e n d a ti o n s fo r a s s is ta n c. London: O x fo rd C h a p t e r 4, "Folk p e o p le in an in d u s tr ia liz e d w orld," r e p r e s e n t s H a w aiian s as being c a u g h t b e tw e e n tw o c o n f lic tin g f o r c e s, one t o s u s ta in a c o m m u n a lly o r ie n t e d and m u tu a lly r e - e n f o r c in g way of life and th e o the r e n c o u ra g in g a c o m p e t i t i v e and in d iv id u a listic a p p ro a c h. Honolulu: K a m e h a m e h a Schools and the P o ly n e sia n Voyaging S o c ie ty, 1980. C la s sro o m r e s o u r c e guide p ro v id e s in tr o d u c tio n s t o m any t o p ic s a s s o c i a the d with a n c ie n t P o ly n e sia n c a n o e voyaging. T hese in clu d e m ig r a tio n, s e t t l e m e n t, n a v ig a tio n, r o u the s, sailing the c h n iq u e s, food, and fishing. New Z e a la n d A rc h a e o lo g ic a l A s s o c ia tio n N e w s l e t t e r 16 (Ju n e 1973): 55-65. D e s c rib e s and i l l u s t r a t e s with d e ta i le d draw in g s, p e tro g ly p h s a t four s ite s. D isc u sse s the a g e, s u b je c t m a t t e r, and s ig n if ic a n c e of th e p e tro g ly p h s. I n the rv ie w with film m a k e r G e o rg e T a h a r a a b o u t his c o lle c tin g H a w aiian legends and th e n d r a m a ti z in g and p r e s e rv in g th e m on film. The c o m p e t it io n, w hich was p r o m o t e d by B u ffalo K e a u la n a, u tiliz e d th e la r g e r, h e a v ie r s u rf b o a rd s w hich w e r e p o p u lar during the 1950s and 1960s. A m e ric a n P r e s e n t s r e s u lts, in t a b u l a r fo rm, of a psy c h o lo g ic al e x a m in a tio n given to 2,139 Island high school se n io rs. A s ia tic -H a w a iia n and C a u c a s ia n -H a w a iia n w e r e tw o of the s e v e n e th n i c c a t e g o r i e s lis the d. R e l a ti o n s of e c o n o m ic s t a t u s to " in the llig e n c e " and to the r a c ia l d e riv a tio n of high school se n io rs in H aw aii. C o m p a r a t iv e t e s t s c o re s, by in c o m e and r a c e (including A s i a ti c H a w aiian s and C a u c a s ia n -H a w a iia n s), a r e b a sed on t e s t s c o re s of 2,139 high school se niors. Study of t e s t s g iven 286 U n iv e rs ity of H aw aii s tu d e n ts, including p a r t - H a w a i ia n s, to d e t e r m i n e d i f f e r e n c e s in r e a c ti o n tim. M e n tio n s the pu rp o se s of the H ale N a u a o r g a n iz a tio n s fo u n d ed in 1830, 1886, and 1975, r e s p e c tiv e ly. Los A ngeles: K osm on A t t e m p t s t o a n a ly z e the p sy c h ic p o w e rs u tiliz e d by the a n c ie n t kah u n a s. S ug g e sts t h a t th e k a h u n a s use d sy m bolic w ords, such as unihipili, ha, la, and huli, t o p ass on the i r lo re to f u t u r e p rie s ts. A h i s t o r ic a l s it e study and e v a lu a tio n of N o rth H aw aii; with s p e c if ic r e f e r e n c e t o th e d i s t r i c t s of H a m a k u a, N o rth and South K ohala, N o rth and South Hilo, a nd Puna. D e s c rib e s 72 c a v e s, h e ia u s, w a t e r tu n n e ls, sh rin e s, t r a i l m a r k e rs, c a n o e p l a t f o r m s, p e tr o g ly p h s, and fishponds. C a t e g o r i z e s the s e s ite s, a c c o r d in g t o c r i t e r i a e s ta b lis h e d by the H aw aii S t a t e R e g i s the r of H is to ric S ite s, d epending on the i r i m p o r t a n c e, i n t e g r i t y, and n e e d for r e s t o r a t i o n and study. Honolulu: U n iv e rs ity P re s s N a r r a t i v e of the re v o lu tio n which o v e r t h r e w the H a w aiian M onarchy in 1893, th e a t t e m p t to r e s t o r e it by a c o u n the r - r e v o lu t io n in 1895, and th e e v e n tu a l a n n e x a tio n of the Islands by the U n ite d S t a t e s in 1898. P o r tr a y s the C a u c a s ia n r e v o lu tio n a r ie s who s e iz e d th e H a w aiian g o v e r n m e n t and the R o y a lis t f o r c e s who opposed the m. J o u rn a l of A s ia n - P a c if ic and World P e r s p e c t iv e s I (S um m er 1977): 47-50. A rg u e s t h a t H a w a iia n s w e r e n e it h e r a v e r s e t o c h a n g e nor he lp le ss v ic tim s of f o re ig n i n t e r v e n t io n, having a c a p a c i t y fo r a c c e p t in g a m b iv a l e n t c h a n g e and fo r co n scio u sly shaping it to w a rd social p ro g re s s. S ug g e sts t h a t c u r r e n t a c ti v is m, s tr e s s i n g v a lu e s and a c h ie v e m e n t s, m a k e s f o r m o re b e n e v o l e n t c h a n g. E n c y c lo p e d ia of Honolulu: H aw aii S t a t e A rc h iv e s M ic ro film, 1980. This b ro u g h t an end to the a n c ie n t H a w aiian relig io u s, s o c ia l, and g o v e r n m e n ta l s y s the m. N o the s so m e of the i m m e d i a t e re sp o n se and r e a c ti o n to this a c t. T r a c e s the h isto ry of th is c o r a l block c h u rc h in Honolulu fro m its c o n s tr u c ti o n in 1836-1842. C o m m e n t s on its p r im a rily H a w aiian c o n g r e g a t io n and its four H a w a iia n p a s to r s. R o y a l H a w aiian Band, a re g a l H isto ry of the R o y a l H a w a iia n Band e m p h a s iz e s its d e v e lo p m e n t and in flu e n c e during the y e a r s of B a n d m a s the r H e n ri B e rg e r. A m e ric a n J o u rn a l o f Sociology S u m m a r iz e s the h is to r y, f o rm s, and lif e s ty le s of C h in e s e - H a w a iia n fa m ilie s which b e g a n fo rm in g a f t e r 1852. The s t p e r f o r m a n c e of a s e l e c t e d group of p a r t H a w aiian s. T h e s e t e s t s w e r e the B inet, P o r the u s M aze, and H ealy P i c t u r e C o m p le tio n No. R a c i a l c o m p a r is o n s of a b ility in i m m e d i a the r e c a ll of lo g ic a l and non se n se m a t e r i a l. M issionary d e s c e n d a n t A l b e r t i n e L oom is r e c o u n t s th e s to r y of a widow of K a m e h a m e h a I, Kalakaua, who a s k e d m issio n a ry w ives t o m a k e a d re s s for h er. A r t ic l e a b o u t the d e v e lo p m e n t of H a w a iia n law s a g a in s t m u rd e r including e a r l i e r kapus. Includ es an a c c o u n t of the f i r s t public e x e c u tio n in 1835 of tw o m en, K a m a n a w a and L o n o p u a k a u, who killed the i r w ives. In the r v ie w with M ililani A llen, a hula i n s t r u c t o r a t the H alau H ula O M ililani. A llen c o m m e n ts on h e r tra in in g, the a c h in g m e th o d s, and d i f f e r e n c e s b e tw e e n a n c ie n t and m o d e rn hula. In the r v ie w with E d w ard K eliia h o n u i K a w a n a n a k o a who m ig h t h a v e b e e n king to d a y if the H a w a iia n m o n a rc h y had survived. Includes g e n e a lo g ie s of th e K a w a n a n a k o a -K u h io fa m ily and th e K a la k a u a d y n a s ty. A c c o u n t of th e t r a v e l s of a H a w a iia n r e f e r r e d to as J a c k A t t o o fo c u s e s on his visit to B oston in A u g u st 1790. In: H a w aii, e d it e d by L e o n a rd L u e ra s, O v e rv ie w of so m e of the m o re n o ta b le a s p e c t s of e a rly H a w aiian life including the kapu s y s the m, gods, w a r f a r e, a r t w o r k, and hula. B rief in tr o d u c tio n to e a rly P o ly n e sia n n a v ig a tio n a l m e th o d s, fo l low ed by n o the s on the f i r s t i m m ig r a tio n to H aw aii b e tw e e n A. P ro v id e s an i n tr o d u c ti o n to th is t r a d i ti o n a l s p o rt th ro u g h a re v ie w of e ig h t e e n t h, n i n e t e e n t h, a nd e a rly t w e n t i e t h c e n tu r y l i t e r a r y a c c o u n ts. D e s c rib e s m o d ern s u rf b o a rd s, m e th o d s of riding, and th e p o p u la rity of su rfin g m e e ts. Old p u rp o se s and new ways: the ro le of v a lu e s in H a w aiian e d u c a tio n. Sug g e sts t h a t, w hile so m e a n c i e n t H a w a iia n ways m ay be a n a c h r o n is t i c, the p u rp o se s of the old c u l t u r e m ay n o t b e o u t d a t e d. A d v o c a the s b r o a d e n in g the public school c u r r ic u lu m to allow t im e - h o n o r e d H a w aiian c u lt u r a l v a lu e s to a s su m e a r e i n t e r p r e t e d ro le in b a s ic e d u c a tio n. M a u i- o f- a -T h o u s a n d - T ric k s: his O c e a n ic and B u lletin 198. D e f in itiv e s c h o la rly stu d y of the le g e n d s and tr a d i ti o n s a b o u t Maui, the p o pular P a c if ic Island c u l t u r e h e ro. Includes discussion of Maui the m e s t h ro u g h o u t the P a c if i c as w ell a s an an a ly sis of m y th v a ria n ts. I n the r n a t io n a l House Q u a r the r ly A n a ly z e s the c h a r a c t e r and b e h a v io r of th e dem igod Maui and th e s to r ie s a b o u t his tr i c k e r y. The m e n e h u n e of P o ly n e sia and o the r m y th ic a l l i t t l e pe o p le of O c e a n ia. C o m p a ris o n of the H a w a iia n m e n e h u n e t r a d i ti o n with b e lie fs a b o u t s im ila r w o n d e r-w o rk in g d w a rfs e ls e w h e r e in the P a c if ic. C o n c lu d e s t h a t the s e m y th ic a l p e o p le w e r e in v e n the d by s t o r y t e l l e r s. C o lle c tio n of p o p u lar e s sa y s r e t e l l the leg e n d s of the m e n e h u n e, M aui, and s e v e r a l o the r P o ly n e sia n folk h e ro e s. D e velops the m ajo r f e a t u r e s and r a n g e of the s e h e ro c y c le s c o m m o n to the P o lynesians. A d y n a m ic in O c e a n ic Maui m y th s; visual i llu s tr a tio n with r e f e r e n c e t o H a w a iia n lo c a l iz a ti o n. C o m m e n t a r y on the way in w hich H a w aiian s h a v e a d d e d visual ill u s tr a t i o n s t o m y th s a b o u t the le g e n d a ry Maui by id e n tify in g p la c e s with e i the r o b je c ts he used or c h a r a c t e r s h e a s s o c i a the d w ith. C r e a t i v e p r o c e s s e s in H a w aiian use of p la c e n a m e s in c h a n ts. D iscussion of the H a w a iia n pred ilec tio n fo r in c o r p o r a tin g highly d e s c r ip tiv e p la c e n a m e s in c h a n ts. S u g g e sts t h a t th is c r e a t i v e e n u m e r a tio n of n a m e s of p la c e s th e y r e g a r d as b e a u ti f u l or s ig n if ic a n t m ay r e s u lt fro m an a n im is tic a t t i t u d e to w a r d n a t u r. D is in t e g r a t io n and r e g e n e r a t io n, p h a n to m h itc h h ik e r le g e n d. R e v ie w of the e s s e n t ia l c h a r a c t e r i s t i c s of the a n c ie n t H a w aiian relig io n in clu d e s c o m m e n t a r y on i ts o ra l a r t and m ythology. The n a r r a t i v e s o u rc e of a H a w aiian p ro v e rb and r e l a t e d p ro b le m s. A u th o r finds a c t i v e i n t e r a c t i o n b e tw e e n p ro v e rb s and c h a n ts which a c c o m p a n y the m aking of s tr in g fig u re s. Honolulu: B rief re v ie w of s e v e r a l i m p o r t a n t law s and r e p o r t s which a f f e c t e d h o m e s the a d in g c o n c e p ts. Includes r e c o m m e n d a ti o n s fo r th e f u t u r e b a sed on p a s t p r a c t ic e s. F ir s th a n d d e s c r ip tio n of a w e e k s p e n t in H a n a le i with a H a w a iia n p a s to r and his c o n g re g a tio n. P e rso n a l r e f l e c t i o n s on the e d u c a t io n a l, s t r e n g t h s and w e a k n e s se s of H a w a iia n c le rg y. F o r e s e e s no H a w aiian w ord in c o m m o n English use in a hun d red y e a rs. B iography inclu d e s a d e ta i le d a c c o u n t of the d e a th of K a u m u a lii in Honolulu on May 26, 1824. S y m p a th e ti c discussion of the p ro b le m s f a c in g id e n tify in g and o b ta in in g m a h e le lands a v a ila b le to th e m. F o c u s e s on the in d iv id u ality of H a w a iia n p e rso n a l n a m e s, c itin g a c c i d e n t of b ir th, h is to r ic a l e v e n ts, c o n f e r r a l of f a v o rs, or d e p r e c a to r y i n t e n t as p r im a ry in flu e n c e s on n am ing. C o m m e n t a r y a b o u t King K a u m u a lii by W e ste rn c o n the m p o r a r ie s is fo llo w e d by s p e c u la tio n a b o u t his re la tio n s h ip with K a m e h a m e h a I. R e v ie w of th e a n c i e n t H a w a iia n f a m i li a r i ty with, and d e p e n d e n c y on, 200 s p e c ie s of woods. A n e c d o the s by the a u th o r who knew and w orked fo r L ot K a m e h a m e h a. In: P u n a stu d ie s: p r e lim in a r y r e s e a r c h in h u m a n e c o lo g y, 1971, e d ite d by B u r d e tt e E. Honolulu: D e p a r t m e n t of G e o g ra p h y and School of Public H e a lth, U n iv e rs ity of H aw aii, 1976. Sam pling of m o d e rn H a w a iia n o ral tr a d i ti o n s as p r e s e n t e d by a s t o r y t e l l e r who lives in K a la p a n a on the island of H aw aii. Includes th e follow ing s to r i e s in English: K a io o n i, H ina, Puu Loa, M anini, and K ahapuupuu. Story of the f i r s t d re s s sew n by m issio n a ry wives fo r K a la k u a, a widow of K a m e h a m e h a I. A r t i c l e c o n ta in s n u m e ro u s q u o ta tio n s fro m old m issio n a ry journals. P ro v id e s in tr o d u c to r y b a c k g ro u n d on the a n c ie n t H a w aiian s y s the m of land division a nd the g e n e r a l land p rin c ip le s in e f f e c t on v arious islands. A r t ic l e w r i t t e n in 1856 d e s c r ib e s the m a jo r f e a t u r e s of the e a rly H a w aiian s y s the m of land t e n u r. An a s s e s s m e n t of an in-school a n ti- d e lin q u e n c y in the r v e n t io n p r o g ra m. Study of 89 H a w a iia n and p a r t - H a w a i ia n s tu d e n t s a t a Honolulu i n t e r m e d i a t e school fro m 1969 to 1973 r e v e a ls e f f o r t s of th e p ro g ra m in r e d u c in g a c a d e m ic f a ilu r e and d e lin q u e n c y. Honolulu: D e s c rib e s, l o c a t e s, and m ap s 384 s ite s v is ite d in a 1930 su rv e y. Includes le g e n d a ry r e f e r e n c e s o b ta in e d fro m in f o r m a n ts and l i t e r a r y s o u rc e s.

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