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PubMed1997

Santa Fe provider network goes unchallenged by the DOJ.

After careful consideration of possible anticompetitive harm and payer reaction, the Department of Justice has chosen not to challenge as unlawful a provider-controlled, nonexclusive physician network in Santa Fe, New Mexico, even though the network will include 70 percent of the area's pediatricians. Reasons for the DOJ's decision include evidence of substantial risk sharing by the physician members, an arrangement by the network to provide a different compensation system for non-member participating physicians, and the pediatricians' promise that they will participate in the network on a nonexclusive basis. In addition, the member pediatricians will be a small minority of the primary care physicians whose compensation will be paid out of one fixed revenue pool. The DOJ's decision thus signals support for a provider network model for smaller communities.

Antitrust Laws↗

PubMedDate not supplied

Organizational development of a university-based interdisciplinary health promotion project.

PURPOSE: To analyze the organizational development and implementation of an interdisciplinary health promotion project at the University of New Mexico. The effort involved three academic units in a 3-year externally funded project to institutionalize health promotion curricula in the respective schools and to develop a wellness-oriented service for students, faculty, and staff. METHODS: The open systems theory was used as a framework to analyze the organizational and role issues that emerged from the data collected through interviews, staff surveys, and document review. The analysis is summarized by five thematic questions: (1) How did the project's vision affect its development? (2) How was leadership enacted, and with what effect? (3) What were the organizational issues for the staff? (4) What were the interdisciplinary dilemmas? (5) What was instituted or changed as a result of the project? RESULTS: The analysis uncovered a series of interpersonal and organizational dilemmas involving the nature of the organizational environment, the character of interdisciplinary work, leadership, boundaries of group membership, and the structuring of a unified vision. CONCLUSIONS: Future projects should consider the strength and stability of the boundary spanners, the resource context, and the role of a unified vision for new and organizationally linked units as key issues in facilitating and sustaining change.

Health Plan Implementation↗

PubMed2006

Demographic correlates of paternity confidence and pregnancy outcomes among Albuquerque men.

We examine the demographic correlates of paternity confidence, or men's assessment of the likelihood that they are the genetic father of a particular child. Evolutionary theory predicts that men will provide less parental investment for putative genetic offspring who are unlikely to be their actual offspring, but confidence of paternity has not been as extensively examined as its importance would merit. Using self-reported data on paternity confidence in 3,360 pregnancies reported by men living in Albuquerque, New Mexico, we find that low paternity confidence is more common among unmarried couples and for unplanned pregnancies. We also find that men are more likely not to state paternity confidence (i.e., they refuse to answer the question) if a pregnancy is unplanned. We additionally examine the pregnancy outcomes associated with confidence of paternity. We find that low paternity confidence pregnancies are significantly more likely to be aborted, and pregnancies for which paternity confidence is unstated are more likely to be aborted or to miscarry. Both abortion and miscarriage are associated with unmarried couples, with unplanned pregnancies, and with couples who have fewer children together.

Abortion, Induced↗

PubMed2003

Clerical frames for nursing practice: missionary nurses at Rehoboth.

This paper presents a discourse analysis of publications of the Christian Reformed Church regarding its Rehoboth Mission near Gallup, New Mexico, among the Navajo. All issues of The Banner, Acts of Synod of the Christian Reformed Church, the Rehoboth Hospital Bulletin, and the Annual Report of the Rehoboth Mission from 1880 to the present were reviewed for references to health-care at Rehoboth from 1903 to 1943. Four religiously framed discourses were identified: discourses justifying provision of health-care at the mission, discourses of the Navajos as immature and potentially dangerous, needing to be civilized, discourses of cleanliness, and discourses of calling. This paper adds to a growing body of knowledge about religious frames within which nurses have practiced in North America.

History of Nursing↗

PubMed1992

Chronic neurodegenerative disease associated with HTLV-II infection.

Although human T-cell leukemia virus (HTLV) type I is known to cause a number of diseases, there has been no convincing evidence of pathological changes after infection with the related virus, HTLV-II. We have found an endemic focus of HTLV-II infection among members of an American Indian population in New Mexico, USA. We set out to determine the pathological consequences of HTLV-II infection in this population and identified two sisters (aged 59 and 46 years) with a disease superficially resembling the myeloneuropathy induced by HTLV-I. These women had a syndrome similar to the olivopontocerebellar atrophy variant of multiple system atrophy, and HTLV-II infection was confirmed by western blot and the polymerase chain reaction. Thus, HTLV-II may, like HTLV-I, cause a progressive neurodegenerative disease.

Ataxia↗

PubMed1996

Pharmacist-patient relationships: authoritarian, participatory, or default?

The purpose of this study was to investigate the nature of pharmacist-patient relationships in New Mexico community pharmacies. A total of 344 pharmacy personnel-patient interactions were observed. Pharmacists interacted with only 57% of patients who were picking up their prescriptions. Pharmacists used an extensive participatory style with only 13% of the patients who they interacted with. Pharmacists were significantly more likely to use a participatory style with older patients and with patients who were picking up refill prescriptions. The average length of pharmacist-patient encounters was just less than 2 min (114s). Pharmacist-patient interactions were significantly longer if: (1) pharmacists used more of a participatory approach with patients and (2) pharmacists gave more drug information to patients.

Adolescent↗

PubMed2001

Differences in nonfatal suicide behaviors among Mexican and European American middle school children.

This report describes ethnic and gender differences in suicide ideation among two large samples of middle school students in New Mexico (n = 2,140) and Texas (n = 1,302). Students completed a self-administered questionnaire on suicide ideation and psychosocial risk factors. Mexican Americans in both samples reported significantly higher prevalence of suicide ideation than did their European American counterparts. Mexican Americans were 1.8 times more likely to have high suicide ideation than European Americans. The suicide ideation risk for Mexican Americans remained unchanged in both samples after adjusting for gender, age, family structure, depression, low social support, and self-esteem. This study indicates that ethnicity plays an important role in suicidal ideation, but the mechanism remains unclear.

Adolescent↗

PubMed1992

Colonic diverticular disease in patients 40 years old or younger.

Diverticular disease in patients 40 years of age or younger has been described as rare but virulent. Previous studies, based on age, on diverticular disease are often confusing because of inexact definitions of the disease status. With these criticisms in mind, the authors studied 322 clinical records on patients admitted with a diagnosis of colonic diverticulosis or diverticulitis to the University of New Mexico Hospital and the Lovelace Medical Center. Of these patients, 285 had documented evidence of colonic diverticula with only 6 per cent of these being 40 years of age or younger. The criteria for acute diverticulitis were met by 86 patients, 17 of whom were 40 years of age or younger. The younger group had disproportionately more men, particularly Hispanics. The authors conclude that acute diverticulitis is more common in the young than suggested by previous reports, but the behavior of the disease is not distinctive.

Acute Disease↗

PubMed1989

Fusarium mycotoxins from peanuts suspected as a cause of sandhill crane mortality.

An estimated 9,500 sandhill cranes (Grus canadensis) died in Gaines County, Texas and Roosevelt County, New Mexico between 1982 and 1987. The predominant clinical sign observed in sick cranes was their inability to hold their heads erect, both while standing and flying. Multiple muscle hemorrhages and submandibular edema were the most common lesions seen at necropsy. Mycotoxins produced by Fusarium sp. growing during cold, wet weather on peanuts left in the field after harvest, the predominant foods of the dead cranes at the time of these mortality events, were identified as the most likely cause of this mortality. Rendering moldy peanuts inaccessible to the cranes by conventional tillage resulted in reduced crane mortality in these areas.

Animals↗

PubMed2001

Toward the conceptualization and measurement of caregiver burden among Pueblo Indian family caregivers.

PURPOSE: The purpose of this study was to evaluate burden experienced by a group of American Indian primary family caregivers and to determine if caregiver burden is a multi-dimensional concept. DESIGN AND METHODS: This analysis is based on the results of a survey questionnaire administered to 169 Pueblo primary family caregivers in New Mexico. RESULTS: Analysis of the items composing the Caregiver Burden scale indicated that caregiver burden is multidimensional and consists of several types of burden. Caregiver burden, as identified in this sample, is composed of four dimensions: role conflict, negative feelings, lack of caregiver efficacy, and guilt. Investigations of caregiver burden should consider the multidimensionality of this experience and evaluate burden accordingly. IMPLICATIONS: By identifying the specific type of burden that a caregiver experiences, interventions can be targeted more accurately to support family caregiving.

Activities of Daily Living↗

PubMed1987

Helminth remains from prehistoric Indian coprolites on the Colorado Plateau.

Examination of coprolites excavated from archaeological sites in the Americas demonstrates excellent preservation of helminth eggs and, in some cases, larvae. To gain an understanding of helminth parasitism in prehistory on the Colorado Plateau of Arizona, New Mexico, and Utah, 319 coprolites from 5 archaeological sites were analyzed. Helminth eggs and larvae were recovered after the coprolites were rehydrated, screened, and sedimented. At a sixth site, soils excavated from 5 rooms used as latrine areas were processed with palynological techniques. The results indicate that all but 1 of the prehistoric populations examined were infected with intestinal worms. The helminths implicated are Enterobius vermicularis, Trichuris trichiura, cf. Ascaris lumbricoides, cf. Trichostrongylus sp., cf. Strongyloides sp., taeniid cestodes, and hymenolepidid cestodes. The study suggests that prehistoric hunter-gatherer peoples carried fewer helminth parasites than agriculturalists. At 1 site, it appears that increased helminth parasitism preceded abandonment of the village.

Animals↗

PubMed1995

Asthma in Jemez Pueblo schoolchildren.

Asthma, a major chronic health problem of children, has received little investigation in Native Americans. We conducted a survey of asthma in children of Jemez Pueblo, Jemez, New Mexico, in response to concerns of the community and health care providers about the frequency of asthma. In collaboration with Jemez Pueblo, we developed a standardized questionnaire and administered it to parents of 318 children aged 3 to 13 years. Parents reported that 12.3% had been diagnosed as having asthma or reactive airway disease by a physician or other health care practitioner. Asthma was reported as still active at the time of the interview for 55% of those subjects. The study showed that asthma was not uncommon among the Jemez Pueblo children and, in fact, was more common than in recent nationwide surveys.

Adolescent↗

PubMed1979

Blood pressure survey on the Navajo Indian reservation.

The authors conducted blood pressure screening on the Navajo Indian reservation in northeastern Arizona and northwestern New Mexico. Six hundred forty Navajos over 19 years of age were surveyed at various sites. The mean systolic and diastolic blood pressures in Navajo men and women did not show as great increases with age as those seen among white and black Americans. Navajos also had generally lower blood pressures and lower prevalence of hypertension than white and black Americans. The authors were unable to demonstrate any association between degree of acculturation and blood pressure, but they did find that obesity in both men and women and alcohol use in men were associated with a higher prevalence of elevated pressure in the Navajos.

Adult↗

PubMed1984

Alternatives in the collection and analysis of food frequency interview data.

In addition to frequency of consumption, a food frequency questionnaire may assess amount consumed, often by using food models, and the stability of diet. A food frequency interview directed at preformed vitamin A and beta-carotene was administered to 130 cases and 309 controls in an ongoing population-based case-control study of lung cancer in New Mexico. The questionnaire measured frequency, amount, and stability of consumption for 55 food items. Different combinations of responses to these three types of questions were used to calculate indices of total vitamin A consumption. The index based on frequency alone had the lowest value and increased significantly when amount was combined with frequency. Consideration of past consumption had relatively little effect on absolute and relative estimates of intake. Spearman rank order correlations between index pairs were high. These results suggest that the use of frequency alone is appropriate when the objective of data collection is to establish subjects' relative intake of specific nutrients.

Adult↗

PubMed1996

Validity of self-reported criminal offences and traffic violations in screening of driving-while-intoxicated offenders.

Many jurisdictions in the USA, Canada and some European countries use diagnostic methods to assess substance abuse problems of driving-while-intoxicated (DWI) offenders, to address the concern that, during DWI screening, offenders may not give accurate information on their criminal history and traffic violations to avoid referral to treatment. This study was designed to validate self-reported data, to assess the need for DWI agencies to access court records, and to obtain an offence profile for this population. DWI offenders (n = 274, mostly first-time) were randomly selected from those who attended the Lovelace Comprehensive Screening Program (LCSP). The self-reported data were compared with records retrieved from the Metropolitan Court in Albuquerque, New Mexico, USA. Three-quarters of the offenders had had at least one offence or traffic violation before this DWI arrest. Sixty-five per cent of the offenders with court records underreported their records. The high percentage of false self-reporting for a primarily first-time offender population indicates the need to use court records to verify self-reported data. For multiple offenders, who have a much higher rate of criminal offences and traffic violations, checking self-reported data against court records becomes more important. In addition, a questionnaire based on offence information could be used to obtain a more complete history of those offences.

Accidents, Traffic↗

PubMed2003

Family history, Hispanic ethnicity, and prostate cancer risk.

Family history is known to be a prostate cancer (CaP) risk factor for non-Hispanic Whites (NHWs) and African Americans, but little data are available on the risk for Hispanics (Hs). This population-based case-control study used mailed surveys to assess the effects of ethnicity and family history of CaP on CaP risk in Hs and NHWs. Cases (N = 351) were those identified by the New Mexico Tumor Registry as having been newly diagnosed with CaP from October 1, 1994 to October 31, 1995. Controls (N = 618) were randomly selected and frequency-matched to cases by ethnicity and 5-year age groups. Multivariate analyses were conducted using conditional logistic regression. After controlling for age, education, and income in the models, positive family history increased risk for both Hispanics (H) (OR 2.7, 95% CI 1.5-4.7) and non-Hispanic Whites (NHW) (OR 2.0, 95% CI 1.3-3.1), suggesting that having a family history of CaP is a risk factor for both ethnic groups.

Aged↗

PubMed1999

Health indicators and intimate partner violence among women who are members of a managed care organization.

BACKGROUND: There have been no population-based studies estimating the prevalence of intimate partner violence (IPV) in an insured population. There is also little information on how well routinely collected health status information predicts IPV risk. Many women now obtain health care from providers who are members of a managed care organization (MCO). To justify efforts to routinely screen for IPV, it is essential to know the prevalence of IPV in this growing population and to identify correlates of IPV among female MCO members. METHODS: A telephone survey with questions on health status, behavioral risk factors, preventive services use, and the Conflict Tactics Scale was completed by 2,415 female members of a New Mexico MCO. RESULTS: Overall, 13.5% of respondents reported experiencing major verbal aggression and 6.7% reported experiencing physical aggression. Younger age, degree of sadness, and inability to handle stress, and a perception of a poorer general health status were significantly associated with major verbal aggression. Race/ethnicity, degree of sadness, and average number of drinks consumed at one sitting were significantly associated with physical aggression. CONCLUSIONS: There is a low but important annual prevalence of IPV among female members of a MCO that occurs across all variables studied. This information is needed to develop appropriate screening protocols and interventions in this population.

Adult↗

PubMedDate not supplied

Participant satisfaction with a culturally appropriate diabetes education program: the Native American Diabetes Project.

PURPOSE: The purpose of this paper is to report on participant satisfaction with the Native American Diabetes Project diabetes education program. METHODS: A questionnaire was designed to measure satisfaction among participants in the diabetes education program, which consisted of five sessions designed according to the Transtheoretical Model of Change and Social Action Theory with input from community members. Eight pueblo communities participated in the program. Sessions were taught by community mentors in three sites in New Mexico. One site taught sessions in a one-on-one format, and two sites taught sessions in a group format. RESULTS: The results showed that participant satisfaction did not vary based on session delivery type or by session site. Overall, participants responded positively to sessions designed according to Social Action Theory and with cultural competency. Retention rates for the sessions were 81% for group sessions and 91% for one-one-one sessions. CONCLUSIONS: Using a strong theoretical framework and community input to design diabetes education sessions may be important factors in participant satisfaction and retention in diabetes lifestyle education sessions.

Diabetes Mellitus↗