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At least 883 records · Page 49Linked to original sources
PubMed2005

Student-developed problem-based learning cases: preparing for rural healthcare practice.

INTRODUCTION: The need for health professionals is acute throughout rural communities worldwide. The Rural Health Interdisciplinary Program (RHIP) successfully trains health professional students for practice in rural USA. Student-developed problem-based learning (PBL) cases are a central feature of the RHIP and an important educational focus of learning. METHODS: This retrospective study was designed to describe 222 PBL cases developed by health professional students in the RHIP. The analysis focused on the extent to which student-developed cases reflect demographics and health conditions of rural New Mexico, as well as how successfully cases reflect rural interdisciplinary healthcare issues and practices. RESULTS: The PBL cases do reflect rural New Mexico in terms of population demographics, certain health problems and complexity of health issues. The cases appear to address interdisciplinary, rural clinical concerns. However, the cases are less effective at raising issues related to public health, financial, legal and ethical issues, and other non-medical health topics. CONCLUSIONS: In order to strengthen attention to non-medical issues, PBL groups should have broad interdisciplinary membership, special case development training, and faculty encouragement to address a wide variety of health-related topics. Student-developed PBL cases appear to be an interesting way for health professional students to learn about rural healthcare issues and could be used in a variety of different educational settings.

Female↗
PubMed2005

Student-developed problem-based learning cases: preparing for rural healthcare practice.

INTRODUCTION: The need for health professionals is acute throughout rural communities worldwide. The Rural Health Interdisciplinary Program (RHIP) successfully trains health professional students for practice in rural USA. Student-developed problem-based learning (PBL) cases are a central feature of the RHIP and an important educational focus of learning. METHODS: This retrospective study was designed to describe 222 PBL cases developed by health professional students in the RHIP. The analysis focused on the extent to which student-developed cases reflect demographics and health conditions of rural New Mexico, as well as how successfully cases reflect rural interdisciplinary healthcare issues and practices. RESULTS: The PBL cases do reflect rural New Mexico in terms of population demographics, certain health problems and complexity of health issues. The cases appear address interdisciplinary, rural clinical concerns. However, the cases are less effective at raising issues related to public health, financial, legal and ethical issues, and other non-medical health topics. CONCLUSIONS: In order to strengthen attention to non-medical issues, PBL groups should have broad interdisciplinary membership, special case development training, and faculty encouragement to address a wide variety of health-related topics. Student-developed PBL cases appear to be an interesting way for health professional students to learn about rural healthcare issues and could be used in a variety different educational settings.

Adolescent↗
PubMed1976

A social systems model of hospital utilization.

A social systems model for the health services system serving the state of New Mexico is presented. Utilization of short-term general hospitals is viewed as a function of sociodemographic characteristics of the population and of the supply of health manpower and facilities available to that population. The model includes a network specifying the causal relationships hypothesized as existing among a set of social, demographic, and economic variables known to be related to the supply of health manpower and facilities and to their utilization. Inclusion of feedback into the model as well as lagged values of physician supply variables permits examination of the dynamic behavior of the social system over time. A method for deriving the reduced form of the structural model is presented along with the reduced-form equations. These equations provide valuable information for policy decisions regarding the likely consequences of changes in the structure of the population and in the supply of health manpower and facilities. The structural and reduced-form equations have been used to predict the consequences for one New Mexico county of state and federal policies that would affect the organization and delivery of health services.

Age Factors↗
PubMed1980

Gallbladder cancer in Hispanic New Mexicans: I. General population, 1957-1977.

Many studies report unusually high rates of gallbladder cancer among all American Indians and among Hispanic Americans in the Southwest and California. It has been suggested that there is a strong genetic component to the development of this cancer in American Indians and that the high rates among Hispanics are a result of genetic admixture with Indian groups. In this paper, we review the epidemiologic characteristics of gallbladder cancer in New Mexico's Hispanic population. We discuss the genetic study of the residents of the Abiquiu area of Rio Arriba County in northern New Mexico where the incidence of gallbladder cancer in white residents is significantly higher than that in any other county of the state. The Abiquiu population has a high degree of Indian ancestry, is genetically isolated, and shows close inbreeding. This combination has produced elevated frequencies of the allele or alleles predisposing to gallbladder cancer. Two familial aggregations of this disease, the first such aggregations to be reported, appear among these people.

Adolescent↗
PubMedDate not supplied

Persistence of high-risk sexual activity among homosexual men in an area of low incidence of the acquired immunodeficiency syndrome.

Before 1985 only five cases of the acquired immunodeficiency syndrome (AIDS) had been diagnosed in New Mexico, and there was no information regarding prevalence of antibody to the human immunodeficiency virus (HIV). Of 166 gay and bisexual men tested in 1985 in New Mexico, 20% were found to have antibody to HIV. Of 153 responding participants, 107 (70%) reported practicing receptive anal intercourse in the last 12 months, and only 13% of the 107 reported the regular use of condoms. High-risk sexual activity may have persisted in part because of underestimation of the local risk of acquiring HIV infection. Voluntary serologic testing and education of members of high-risk groups should be stressed in areas where the incidences of AIDS and of seropositivity to HIV are low but where high-risk sexual activity may still be prevalent.

Acquired Immunodeficiency Syndrome↗
PubMed2006

Web-based primary care referral program associated with reduced emergency department utilization.

BACKGROUND AND OBJECTIVES: Uninsured patients without a primary care home tend to use the emergency department (ED) for primary care. We examined whether an enhanced scheduling system for follow-up care from the University of New Mexico Hospital Emergency Department (UNMH-ED) that assigns patients to a family medicine home can decrease ED utilization. METHODS: The Community Access Program for Central New Mexico (CAP-NM) is a consortium of primary care safety net provider organizations. CAP-NM developed a HIPAA-compliant (Health Insurance Portability and Accountability Act), Web-based information system used by the UNMH-ED to refer uninsured, unassigned patients to family medicine practices ("homes") within the consortium. The Web site referral system operated 24 hours a day, 7 days a week; printed maps to clinic sites; and listed services offered. Analysis of quality assurance data compared (1) ED utilization outcomes of eligible patients referred by the CAP-NM Web site to a family medicine home to (2) outcomes of controls discharged from the ED in the usual manner. RESULTS: The 756 patients referred to family medicine homes through the CAP-NM Web site demonstrated a significant 31% reduction in subsequent ED visits compared to controls. This reduction was most evident among those who had infrequent ED use before institution of the program. CONCLUSIONS: Implementing an enhanced referral system to family medicine homes from the ED is associated with decreased subsequent ED utilization by uninsured patients.

Appointments and Schedules↗
PubMed2002

Effects of vaccination prior to transit and administration of florfenicol at time of arrival in a feedlot on the health of transported calves and detection of Mannheimia haemolytica in nasal secretions.

OBJECTIVE: To determine effects of vaccination prior to transit and prophylactic administration of florfenicol at time of arrival at a feedyard on health of cattle and colonization of the nasopharynx by Mannheimia haemolytica (MH). ANIMALS: 121 steers from Tennessee and 84 steers from New Mexico. PROCEDURE: Half of the steers were vaccinated before transport to a feedyard. Steers from Tennessee were vaccinated with MH bacterin-toxoid, and steers from New Mexico were vaccinated intranasally with modified-live leukotoxin-deficient MH. Half of the vaccinates and nonvaccinates were randomly selected to receive florfenicol on arrival at the feedyard. Steers were observed daily for respiratory tract disease (RTD). RESULTS: Administration of florfenicol at time of arrival reduced the incidence of RTD, delayed the interval before onset of RTD, and reduced the incidence of MH colonization of the nasopharynx for at least 4 days, but vaccination did not have any effect. Vaccination elicited an increase in serum antibody titers to MH. Administration of florfenicol at time of arrival reduced the development of serum antibody titers in intranasally vaccinated steers and both groups of nonvaccinated steers, but intranasal vaccination did not affect colonization by wild-type MH. CONCLUSIONS AND CLINICAL RELEVANCE: Administration of florfenicol at time of arrival decreased the incidence of MH organisms in the nasopharynx and delayed the onset of RTD. Prophylactic use of suitable antibiotics is likely to reduce the incidence of acute RTD in calves for several days after arrival at feedyards, which is the period when they are most susceptible to infectious organisms.

Animals↗
PubMed1997

The distribution of Dermacentor hunteri and Anaplasma sp. in desert bighorn sheep (Ovis canadensis).

The ixodid tick Dermacentor hunteri has been collected intermittently this century, primarily from desert bighorn sheep (Ovis canadensis). Anaplasma spp. are intraerythrocytic rickettsial parasites of ungulates and are vectored in the western United States by ticks of the genus Dermacentor. We tested the hypotheses that D. hunteri would be found infesting all populations of desert bighorn, and that all infested populations would be seropositive for Anaplasma sp. Dermacentor hunteri was found on desert bighorn throughout their range in the Mojave and Sonoran deserts of the southwestern United States and northern Mexico, but not in any portion of the Chihuahuan desert of New Mexico and eastern Arizona or in Baja California Sur, Mexico. Using an indirect immunofluorescence antibody test (IIF), 8 populations of desert bighorn in California with D. hunteri were seropositive for Anaplasma sp. (n = 160). Four populations of desert bighorn with D. hunteri in Arizona (n = 69), 1 in Nevada (n = 22), and I in Utah (n = 14) with D. hunteri were seronegative. Six populations of desert bighorn were uninfested with D. hunteri and were also seronegative. Of these populations, 1 was in California (n = 19), 2 were in New Mexico (n = 33), 2 were in Utah (n = 30), and 1 was in Baja California Sur (n = 14). We found no support for either of our original hypotheses and concluded that both D. hunteri and Anaplasma sp. are limited in their distribution among desert bighorn. We also suggest a cautionary approach to translocations of desert bighorn given the high prevalence of ticks and the unknown effects of Anaplasma sp. on free-ranging bighorn.

Anaplasma↗
PubMedDate not supplied

Open the door whenever opportunity knocks.

The Community Environmental Health Program/Community Outreach and Education Program (CEHP/COEP) New Mexico Center for Environmental Health Sciences has learned that listening and responding to opportunities that arise in local communities can be a more effective means of reaching health care providers, lay health workers, and community members than structured plans of action. While specific opportunities that have occurred in New Mexico may be unique, they are presented here with the hope that they might suggest new strategies to the reader and help to identify parallel opportunities in other communities. The paper is organized around three major opportunities to which CEHP/COEP has responded: (1) the need for more informed health care in communities with unique and complex environmental and occupational exposures due to their proximity to National Laboratories; (2) the need for resources on environmental health within local provider networks and issue-specific groups; and (3) the need for community environmental health projects within the College of Nursing. CEHP/COEP's responses, observations, and lessons learned through these experiences are discussed. In the end, the major lesson is that the ability to respond to opportunities requires flexibility and creativity; by sticking doggedly to plans, valuable-and sometimes more profitable and productive-opportunities may be missed.

Attitude of Health Personnel↗
PubMedDate not supplied

Student and resident education and rural practice in the Southwest Indian Health Service: a physician survey.

BACKGROUND AND OBJECTIVES: The Indian Health Service (IHS) is an educational rotation site for numerous medical students and residents. These IHS rotations may be an important factor in recruitment and retention of physicians to the IHS. We describe the combined number of student/resident rotations in the Southwest IHS and their influence on recruitment and retention. We also analyze factors related to choice of rural practice in the IHS. METHODS: We conducted a survey of clinical directors and IHS physicians in Arizona and New Mexico. RESULTS: Twenty (87%) clinical director surveys and 289 (66%) physician surveys were returned. More than 400 students/residents participate in rotations annually in the IHS in Arizona and New Mexico. Eighty-four percent of clinical directors feel that educational programs are important to recruitment. Forty-five percent of current IHS physicians participated in IHS rotations as students or residents, and 87% feel that rotating influenced their decision to join the IHS. Eighty percent of IHS physicians who teach feel that working with students and residents improves their job satisfaction. Seventy-five percent of respondents practice in rural areas. Rural medical student and resident rotations are associated with subsequent rural practice. CONCLUSIONS: Many medical students and residents rotate in the Southwest IHS. Clinical directors state that these rotations are helpful to recruitment, and IHS physicians who rotated feel it was important in their decision to join the IHS. IHS clinicians feel that teaching improves job satisfaction.

Arizona↗
PubMed2004

Incidence of and risk factors for residual posterior capsule opacification after cataract surgery.

PURPOSE: To evaluate the incidence of and determine the risk factors for residual posterior capsule opacification (PCO). SETTING: University of New Mexico Health Sciences Center and the Veterans Administration Medical Center, Albuquerque, New Mexico, USA. METHODS: This study evaluated 194 uneventful cataract surgeries. Immature cataracts were graded for nuclear sclerosis (NS), posterior subcapsular cataract (PSC), and anterior cortical spokes on a 1 to 4 scale. Preoperative Snellen best corrected visual acuity was converted to the logMAR scale. The posterior capsule was examined after polishing and was classified as clear or as having residual opacity. Those with residual capsule opacity were evaluated 6 weeks postoperatively for the presence of visually significant PCO. RESULTS: The incidence of residual capsule opacity was 23% (44 eyes). Seven (54%) of 13 eyes with white mature cataract had residual capsule opacity. In contrast, 37 (20%) of 181 eyes with immature cataract had residual capsule opacity (P = .01). In eyes with immature cataract, the mean preoperative logMAR acuity was +1.14 +/- 0.60 (SD) in the residual capsule opacity group and +0.73 +/- 0.46 in the clear group (P<.001). In eyes with immature cataract, the adjusted odds ratio for each increasing grade of NS was 2.3 and of PSC, 1.8 (P = .002 and P<.001, respectively). Eleven percent (5 eyes) of residual capsule opacities resulted in visually significant PCO 6 weeks postoperatively. All 5 opacities were centrally located at surgery. CONCLUSIONS: Results indicate that aggressive polishing of peripheral or adherent residual capsule opacities is not advisable as only 5 eyes with central residual capsule opacities developed visually significant PCO.

Aged↗
PubMed1995

Distance education for nurse practitioners: a partial solution.

Health professionals who live and practice in rural areas have limited opportunities to further their education. In order to pursue advanced nursing degrees, nurses have to leave their communities. A collaborative distance education project involving the University of New Mexico College of Nursing, the Area Health Education Center, and Western New Mexico University has provided a partial solution to this problem. Six registered nurses living and practicing in a rural site are now receiving their Family Nurse Practitioner degrees via two-way audio/video teleconferencing equipment. Distance education can improve the numbers of primary care providers in rural areas; however, projects will require extensive planning and resources.

Education, Nursing, Graduate↗
PubMed2003

Use of herbal medicine by elderly Hispanic and non-Hispanic white patients.

STUDY OBJECTIVES: To determine the types and prevalence of herbal medicines used by Hispanic and non-Hispanic white individuals aged 65 years and older. Secondary objectives were to compare herbal medicine use according to ethnicity, sex, age, socioeconomic status, and education level, and to determine patients' beliefs about herbal medicines. Use of nonphysician health care providers such as acupuncturists and chiropractors also was assessed. METHODS: Data for a cross-sectional, interviewer-administered survey were collected at the University of New Mexico Senior Health Center, an ambulatory health care clinic, in Albuquerque, New Mexico, from February 1996-January 1997. To participate in the study, patients had to be at least 65 years of age, established patients at the clinic, and live independently in a community dwelling. They were excluded if they had dementia, lived in an institution, or belonged to any ethnic group other than Hispanic or non-Hispanic white. Ethnicity was determined by asking the patients in which ethnic group they identified themselves. RESULTS: A total of 186 patients were surveyed: 84 Hispanic (34 men, 50 women) and 102 non-Hispanic white (47 men, 55 women). Of the 186 patients, 91 (49%) admitted to having taken herbal medicines in the previous year. The most common were spearmint, chamomile, aloe vera, garlic, brook-mint, osha, lavender, ginger, ginseng, and camphor. Most of the patients who used herbal medicines were 65-74 years of age and took them primarily for health care maintenance or self-perceived problems. CONCLUSION: As approximately half of the elderly patients stated that they used herbal medicines, health care providers should be knowledgeable about herbal remedies and provide reliable information to their patients about them in a nonjudgmental manner.

Aged↗
PubMed2000

Talking about hysterectomy: the experiences of women from four cultural groups.

As part of the Ethnicity, Needs, and Decisions of Women (ENDOW) project, in-depth qualitative interviews and focus groups were conducted at four sites, Alabama, New Mexico, South Carolina, and Texas. In South Carolina and Alabama, African American and white women were interviewed. In Texas, African American, Caucasian, and Hispanic women were interviewed, and in New Mexico, focus groups with Caucasian, Hispanic, and Navajo women were conducted. The Texas site also conducted focus groups with lesbian women. Data were collected on women's experiences with and attitude toward menopause, hysterectomy, and hormone replacement therapy (HRT). Information also was gathered on women's concerns and what experiences they have had or expect to have with healthcare providers and what they perceive their friends', families', and sexual partners' attitudes are toward hysterectomy. Numerous commonalties of experience existed across racial and ethnic groups. Overall, the women who participated believed that doctors do not take the time to explain issues related to menopause, hysterectomy, and HRT. Most of the women who have had a hysterectomy were satisfied with the outcome of surgery, as painful symptoms were relieved. There are also several interesting differences among the groups. Decision-making patterns differed among the ethnic groups, as did experience with healthcare providers. Many women in the focus groups expressed mistrust of or negative opinions of healthcare providers. African Americans expressed mistrust of their motives for recommending surgery, as did several of the Caucasian, non-Hispanic women. Most of the Hispanic participants respected and trusted their providers. All groups said they would seek additional medical opinions if they could afford to do so.

Black or African American↗
PubMed1978

Prevalence of trachoma among Navajo Indian children.

Examination of some 6000 Navajo children in their schools in the Shiprock, New Mexico area between 1975 and 1977 yielded an overall prevalence of trachoma of 2.4%. The prevalence was highest for high schoolers (3.8%) and lowest for preschoolers (2.3%). These prevalences are lower than those found (6.0%) for Navajo schoolchildren in the Gallup, New Mexico area 8-9 yr previously.

Adolescent↗
PubMed2006

Flatland sound services design supports virtual medical training simulations.

This paper describes the evolution of the design of Flatland Sound Service (FSS), a sound system for virtual reality required to support Project TOUCH (Telehealth Outreach for Unified Community Health), a multi-year collaboration between the Schools of Medicine at the state Universities of Hawaii and of New Mexico. Two virtual sonic environments specific case scenarios, a neurological trauma (Toma) and a virtual kidney nephron (Nephron), were developed using integrated services provided by FSS. Flatland is an open source visualization and virtual reality application development tool created at the University of New Mexico.

Computer Simulation↗
PubMed1993

Marketing strategy determinants in rural hospitals.

Rural hospitals confront an inauspicious environment due to changes in patient reimbursement and medical practice. Facing a situation of declining revenues, marketing presents an option for rural hospitals to adapt to the growing constraints. This paper analyzes the determinants of marketing strategy emphasis in rural hospitals. The conceptual model adopted in this study predicts that prior performance and contextual variables explain marketing strategy emphasis. The relationships are examined in a case study of rural New Mexico hospitals. Results suggest that prior performance and several contextual variables explain variations in marketing strategy emphasis. In particular, higher gross patient revenues are associated with more emphasis on television and radio advertising. Furthermore, rural New Mexico hospitals with high numbers of licensed beds and medical staff members, or that are affiliated with a chain organization, place greater emphasis on market research and market planning. The implications for marketing practice in rural hospitals are discussed.

Advertising↗
PubMed1982

Malignant melanoma incidence at the Los Alamos National Laboratory.

In an analysis of melanoma incidence for 1969 to 1978 among 11 308 workers at the Los Alamos National Laboratory in New Mexico 6 cases were detected in the total cohort, in which 5.69 cases would be expected (standardised incidence ratio [SIR] = 105; 90% confidence interval [CI] = 51,198) on the basis of incidence rates for the State of New Mexico, specific for age, sex, and ethnic origin. Among the White non-Hispanic men, 3 cases were detected, whereas 4.4 would be expected. The associated SIR of 68 (90% CI = 23, 163) does not suggest excess melanoma incidence in this subcohort. A direct comparison with Statewide incidence rates gave similar results. These results do not agree with the threefold excess of malignant melanoma incidence found among White male employees at the Lawrence Livermore National Laboratory.

Adult↗