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At least 1,189 records · Page 66Linked to original sources
PubMed2001

Prevalence of tooth loss and dental service use in older Mexican Americans.

OBJECTIVES: To describe the prevalence of tooth loss, to examine risk factors for having fewer teeth or no teeth, and to describe the use of dental services in an older Mexican-American population. DESIGN: Data from the baseline phase of the Hispanic Established Population for the Epidemiological Study of the Elderly survey conducted from 1993 to 1994, a cross-sectional survey of older Mexican Americans. SETTING: Five southwestern states: Texas, California, Arizona, New Mexico, and Colorado. PARTICIPANTS: 3,050 noninstitutionalized Mexican Americans age 65 to 99. RESULTS: Twenty-seven percent of the sample was completely edentulous and 22% reported visiting or speaking with a dental care professional in the preceding year. Logistic regression analyses showed that being older or being female was significantly associated with tooth loss, adjusting for education, income, smoking status, and diabetes mellitus. Current smokers (odds ratio (OR) = 1.69; 95% CI = 1.31-2.20) and diabetics (OR = 1.53; 95% CI = 1.27-1.84) were more at risk for tooth loss, as were persons of lower socioeconomic status. CONCLUSIONS: The prevalence of tooth loss and use of dental services in this population of older Mexican Americans is lower than what has been previously found among older people in the general population.

Age Distribution↗
PubMed2001

Ethnicity and physician-older patient communication about alternative therapies.

OBJECTIVES: The purpose of this study was to describe ethnic differences in physician-patient communication about alternative therapies, using a data set comprised of audiotapes and transcripts of primary care medical visits. METHODS: The data set was collected during 1995 at the family practice and general medicine clinics at the University of New Mexico Health Sciences Center, Albuquerque, NM. Twenty-seven (27) resident physicians and 205 of their Hispanic and non-Hispanic white patients age 50 and over participated. RESULTS: Almost 18 percent of patients reported using one or more alternative therapies during the preceding month. Herbal medicine was the most widely used therapy. Eighty-three percent (83%) of patients who reported using an alternative therapy in the previous month did not tell their physicians. Physicians asked one or more questions about alternative therapies during only 3.4% of encounters. Only 2% of patients asked their physicians one or more questions about alternative therapies. There were no ethnic differences in physician-older patient communication about alternative therapies. DISCUSSION: Physician-patient communication could be improved to enhance physician understanding of the spectrum of interventions patients pursue to improve their health.

Adult↗
PubMed1982

Medical students' attitudes toward basic sciences: influence of a primary care curriculum.

The emerging popularity of family medicine and primary care among medical students with an attendant pressure for clinical relevance in pre-clinical coursework and early clinical exposure has raised questions in the minds of many academicians about the students' perceived value of basic sciences in such an educational environment. A comparison was made of attitudes toward the basic sciences between students in two, concurrent, pre-clinical medical school curricula at the University of New Mexico School of Medicine. The conventional curriculum offers a teacher-centered, 2-year curriculum of basic sciences taught predominantly by basic scientists in a lecture format. The experimental curriculum entitled the Primary Care Curriculum (PCC), offers a student-centered, 2-year curriculum in which pertinent basic and clinical science learning is derive primarily from common, primary care, patient problems, discussed in small group tutorials. There are no formal lectures. Half the tutors are primary care clinicians, half basic scientists. Attitude scales were administered in two successive classes of students in both curricula at the beginning of the first and second terms of the first year. Increased cynicism toward the curriculum and its relevance to future practice was observed among conventional, but not among PCC students. This findings lends supports to the hypothesis that modification in educational methods in general and relevant, primary care experience in particular can favourably influence students' attitudes toward basic sciences.

Attitude of Health Personnel↗
PubMed1987

Occult breast cancer: prevalence and radiographic detectability.

The radiographic detectability of occult breast cancer has been difficult to determine. A prospective study of breast disease was carried out that involved the performance of subcutaneous mastectomies in 519 consecutive cases of traumatic or initially unexplained death in New Mexico. Routine mammograms and radiographs of 1-cm specimens were obtained. At least 18 biopsies were performed in each subject. Carcinoma was identified in ten subjects; one subject had metastatic carcinoma from the lung, and two subjects had bilateral breast cancer, for a total of 11 breast cancers identified with microscopic examination. Two of the cancers were seen on whole-breast mammograms, and six were seen on radiographs of thin-section specimens. Four of the 11 breast cancers were apparent only on histologic study of breast tissue that was not suggestive of malignancy. No cancer was found in subjects under the age of 39 years. Five carcinomas were found in the 40-69-year age group; six were found in the 70-year and over age group. No correlation was noted between the radiographic Wolfe parenchymal patterns and the prevalence of breast cancer.

Adolescent↗
PubMed2005

Patient knowledge improves glycemic control: is it time to go back to the classroom?

BACKGROUND: Over the last two decades, pharmaceutical intervention for the treatment of type 2 diabetes has expanded. Studies over this same time demonstrated the benefits of tight glycemic control. Unfortunately, despite the availability of novel therapies, glycemic control remains problematic. Nonpharmacologic interventions need to be explored, including patient empowerment. Improving patient knowledge of diabetes may ultimately improve glycemic control. To test this hypothesis, we compared patients' diabetes knowledge with their glycemic control. METHODS: The Michigan Diabetes Knowledge Test, designed by the University of Michigan, was administered to patients with type 2 diabetes at three University of New Mexico primary care clinics. Patient records were reviewed. The most recent hemoglobin A1c (HbA1c) value was recorded. The data were analyzed using linear regression analysis. RESULTS: Seventy-seven patients completed surveys and had HbA1c values available. Only questions 1 to 14 of the 23-question survey were used because they pertained specifically to type 2 diabetes. HbA1c was inversely correlated with the number of questions answered correctly on the test (r = -.337, p < .003). Using "all subsets" regression, a correct response to questions 1, 3, and 9 specifically correlated with a lower HbA1c (p < .0001). CONCLUSIONS: These results demonstrate that an inverse linear relationship exists between performance on this diabetes test and HbA1c values. Improvement in patient knowledge of diabetes and the importance of treatment may indeed improve glycemic control and ultimately decrease complications. Studies aimed at empowering patients with disease knowledge may help control the ramifications of the growing diabetes epidemic.

Blood Glucose Self-Monitoring↗
PubMed1977

Reduction in mortality from coronary heart disease in men residing at high altitude.

In New Mexico, where inhabited areas vary from 914 to over 2135 m above sea level, we compared age-adjusted mortality rates for arteriosclerotic heart disease for white men and women for the years 1957-1970 in five sets of counties, grouped by altitude in 305-m (1000-foot) increments. The results show a serial decline in mortality from the lowest to the highest altitude for males but not for females. Mortality rates for males residing in the county groups higher than 1220 m in order of ascending altitude were 98, 90, 86 and 72 per cent of that for the county group below 1220-m altitude (P less than 0.0001). The results do not appear to be explained by artifacts in ascertainment, variations in ethnicity or urbanization. A possible explanation of the trend is that adjustment to residence at high altitude is incomplete and daily activities therefore represent greater exercise than when undertaken at lower altitudes.

Acclimatization↗
PubMed2001

Physician gender and hormone replacement therapy discussion.

Hormone replacement therapy (HRT) is a major issue confronting millions of women today, and general internal medicine and family practice physicians are an important source of information and counseling on this issue. Previous studies have suggested that HRT discussion and prescribing are more frequent with female than with male physicians, but others have suggested age and practice setting may be the reason for observed differences. We attempted to determine if physician gender influenced HRT discussion frequency between physicians and their patients using cross-sectional, secondary analysis of data collected at general internal medicine and family practice clinics at the University of New Mexico Health Sciences Center. Twenty-seven family practice and internal medicine resident physicians (15 female, 12 male) participated. There were 127 female patients age 45 and older. Audio-taped observations of patient-physician visits collected during 1995 for a study on patient-physician communication and patient satisfaction were used. There was less frequent discussion with female than male physicians (OR = 0.42, p = 0.0014). HRT was discussed during 51 visits. Patients initiated HRT discussion in 39.2% of visits in which it was discussed. Patients with diabetes were less likely to discuss HRT (OR = 0.25, p = 0.0122). Increasing year of physician residency was associated with decreased discussion of HRT (OR = 0.51, p < 0.0001). In this health sciences center, with physicians similar in age and training, male physicians discussed HRT significantly more often than did female physicians.

Age Factors↗
PubMed2006

Pragmatic help seeking: How sexual and gender minority groups access mental health care in a rural state.

OBJECTIVE: This qualitative study examined how lesbian, gay, bisexual, and transgender (LGBT) people in rural areas of the poor and multiethnic state of New Mexico access secular (professional and lay) and sacred (indigenous and Christian) mental health care resources. METHODS: In-depth, semistructured interviews were used to document the help-seeking processes of 38 rural LGBT people. RESULTS: Obtaining assistance was complicated by the ideal of self-reliance and the view of mental illness as a sign of weakness. Financial considerations and a lack of and community-based LGBT social networks also exerted substantial influence on help seeking. Many LGBT people would strategically remain silent about their sexuality or gender status and rely on their family ties to access the range of secular and sacred resources that are most commonly available in medically underserved rural communities. CONCLUSIONS: Although persons from sexual and gender minority groups often experience positive outcomes as a result of help seeking, some LGBT people remain vulnerable to anti-LGBT sentiments that persist within secular and sacred sectors of rural health care systems.

Bisexuality↗
PubMed2001

Weight loss attempts and attitudes toward body size, eating, and physical activity in American Indian children: relationship to weight status and gender.

OBJECTIVE: This study examined dieting, weight perceptions, and self-efficacy to eat healthy foods and engage in physical activity and their relationships to weight status and gender among American Indian elementary schoolchildren. RESEARCH METHODS AND PROCEDURES: Data for this study were collected as part of the baseline examination for the Pathways study. Participants were 1441 second- through third-grade American Indian children in 41 schools representing seven tribes in Arizona, New Mexico, and South Dakota who filled out a questionnaire and had heights and weights taken. RESULTS: Forty-two percent of the children were overweight or obese. No differences were found between overweight/obese and normal weight children for healthy food intentions or self-efficacy. Heavier children (especially those with body mass index > 95th percentile) were more likely to have tried to lose weight or were currently trying to lose weight. No gender differences were found. Normal weight children chose a slightly heavier body size as most healthy compared with overweight/obese children. DISCUSSION: The results indicate that children are concerned about their weight and that weight modification efforts are common among overweight American Indian children. School, community, and family-based programs are needed to help young people adopt lifelong healthful eating and physical activity practices.

Arizona↗
PubMed1999

Using feedback letters to influence the use of antiulcer agents in a Medicaid program.

OBJECTIVE: To determine the impact of printed patient-specific feedback regarding potential misprescribing of antiulcer agents (AUAs). Measures of impact included improvements in patients' dispensing profiles, assessed according to predetermined criteria, and decreases in cost and quantity of AUAs dispensed. DESIGN: Controlled study. After evaluation for compliance with predetermined criteria, prescribers identified as having one or two patient profiles with potential errors were assigned alternatively to control or experimental groups. An intervention was mailed to the experimental group. SETTING: Outpatient setting in the New Mexico Medicaid population. PARTICIPANTS: Patients and prescribers identified as having potential misprescribing of AUAs. INTERVENTION: The intervention consisted of a cover letter describing the purpose of the drug utilization review program, an educational fact sheet regarding prescribing AUAs, patient profiles with potential misprescribing, and physician response forms. MEASUREMENTS AND MAIN RESULTS: There were greater improvements in dispensing to patients in the intervention group (chi2, p <.001). Significant odds ratios for the intervention group were 2.29 for AUAs discontinued, 1.98 for all improvements combined, 13.13 for improvement in listing of proper diagnosis for AUAs, and 2.84 for appropriate indication when prescribing the higher acute daily dosage. Using data from 3 months before and after the intervention, we found greater decreases in mean monthly costs (p =.044) and mean monthly quantity of AUAs dispensed (p =.049) in the intervention group. CONCLUSIONS: This intervention significantly decreased AUA dispensing to patients whose prescribers were mailed the patient-specific feedback intervention.

Anti-Ulcer Agents↗
PubMedDate not supplied

Multiple chemical sensitivity: a 1999 consensus.

Consensus criteria for the definition of multiple chemical sensitivity (MCS) were first identified in a 1989 multidisciplinary survey of 89 clinicians and researchers with extensive experience in, but widely differing views of, MCS. A decade later, their top 5 consensus criteria (i.e., defining MCS as [1] a chronic condition [2] with symptoms that recur reproducibly [3] in response to low levels of exposure [4] to multiple unrelated chemicals and [5] improve or resolve when incitants are removed) are still unrefuted in published literature. Along with a 6th criterion that we now propose adding (i.e., requiring that symptoms occur in multiple organ systems), these criteria are all commonly encompassed by research definitions of MCS. Nonetheless, their standardized use in clinical settings is still lacking, long overdue, and greatly needed--especially in light of government studies in the United States, United Kingdom, and Canada that revealed 2-4 times as many cases of chemical sensitivity among Gulf War veterans than undeployed controls. In addition, state health department surveys of civilians in New Mexico and California showed that 2-6%, respectively, already had been diagnosed with MCS and that 16% of the civilians reported an "unusual sensitivity" to common everyday chemicals. Given this high prevalence, as well as the 1994 consensus of the American Lung Association, American Medical Association, U.S. Environmental Protection Agency, and the U.S. Consumer Product Safety Commission that "complaints [of MCS] should not be dismissed as psychogenic, and a thorough workup is essential," we recommend that MCS be formally diagnosed--in addition to any other disorders that may be present--in all cases in which the 6 aforementioned consensus criteria are met and no single other organic disorder (e.g., mastocytosis) can account for all the signs and symptoms associated with chemical exposure. The millions of civilians and tens of thousands of Gulf War veterans who suffer from chemical sensitivity should not be kept waiting any longer for a standardized diagnosis while medical research continues to investigate the etiology of their signs and symptoms.

California↗
PubMed1977

Inactivation of polioviruses and coxsackieviruses in surface water.

Inactivation rates of polioviruses 1 and 3 and coxsackieviruses A-13 and B-1 were determined in situ in the Rio Grande in southern New Mexico, using membrane dialysis chambers. Inactivation of the viruses was exponential, and the rates of inactivation were apparently affected principally by the water temperature. Stability of the viruses in river water differed, with poliovirus 1 and coxsackie B-1 being most stable. Typically 1-log reductions of infectivity at water temperatures ranging between 23 and 27 degrees C required 25 h for poliovirus 1, 19 h for poliovirus 3, and 7 h for coxsackie virus A-13. At water temperatures of 4 to 8 degrees C, the log reduction times for poliovirus 1 and coxsackievirus B-1 were 46 and 58 h, respectively. Results obtained with labeled poliovirus 1 and coxsackievirus B-1 and with infectious ribonucleic acid indicate that inactivation was due to damage to viral ribonucleic acid. Virus-inactivation rates were also affected by heat sterilization of river water, indicating the presence of a heat-labile or volatile inactivating factor. The inactivating factor in Rio Grande water was apparently present at a constant concentration over a 1-year period.

Enterovirus↗
PubMed1990

Snoring in a Hispanic-American population. Risk factors and association with hypertension and other morbidity.

Snoring was investigated in a survey of respiratory disease in Hispanic-Americans of a New Mexico community. A population-based sample of 1222 adults was studied with questionnaires and measurements of height, weight, and blood pressure. The age-adjusted prevalence of regular loud snoring was 27.8% in men and 15.3% in women. Snoring prevalence increased with age and obesity in both men and women. Cigarette smoking was also associated with snoring, but chronic obstructive lung disease and alcohol consumption were not. Snorers more frequently had hypertension, ischemic heart disease, and excessive daytime sleepiness. In contrast to other studies, after adjustment for confounding factors, there was no effect of snoring on hypertension (odds ratio, 1.0; 95% confidence interval, 0.7 to 1.5), but an effect on myocardial infarction was still demonstrable (odds ratio, 1.8; 95% confidence interval, 0.9 to 3.6). The association of snoring with sleepiness suggests that respiratory disturbance of sleep related to upper airway obstruction, such as sleep apnea, occurs more frequently in snorers in this population.

Adult↗
PubMed2003

The influence of Hispanic ethnicity on long-term outcome in three alcohol-treatment modalities.

OBJECTIVE: Prior research has suggested that treatment-seeking Hispanic clients are not likely to affiliate with Alcoholics Anonymous (AA). It was hypothesized that AA 12-step facilitation therapy (TSF) would therefore be less effective than cognitive behavioral therapy (CBT) and motivational enhancement therapy (MET) for Hispanics, particularly for those with low acculturation. METHOD: Outcomes for non-Hispanic white (n = 105; 70% male) and Hispanic (n = 100; 80% male) clients at the New Mexico site within Project MATCH were analyzed for evidence of differential treatment response. A pretreatment measure of acculturation to non-Hispanic white culture was available for 80 of the Hispanic clients. RESULTS: Self-identified ethnicity mediated treatment response at distal follow-up, as measured by frequency and intensity of alcohol consumption (p < .02). Hispanics drank with more intensity than did non-Hispanic whites when assigned to TSF; non-Hispanic whites in TSF drank with less frequency than those in the combined CBT and MET conditions. The modest outcome advantage for TSF observed in Project MATCH appears to have been limited to non-Hispanic clients. Contrary to prediction, level of acculturation did not mediate treatment response at proximal (Months 1-6 after treatment) or distal follow-up (Months 7-12). CONCLUSIONS: Ethnic self-identification may interact with treatment outcomes in complex ways that are not directly associated with the factors tapped by commonly used measures of acculturation.

Adult↗
PubMed1976

The etiology and porotic hyperostosis among the prehistoric and historic Anasazi Indians of Southwestern United States.

Porotic hyperostosis was studied in 539 crania from maize-growing prehistoric and historic groups who occupied two dissimilar ecological zones of the Plateau country of Arizona and New Mexico--canyon bottoms and sage plain. Defined as abnormal localized sieve-like structural changes involving the hematopoietic areas of the cranium, it was found in 185 (34.3%) of these skulls. More frequent in children than in adults, it shows significant frequency differences between both children and adults of the two ecological zones. The two ecological zones differ in the availability of iron in the diet; the canyon inhabitants depended heavily on maize (which interferes with iron absorption) while the sage plain people consumed more iron-rich animal products. We hypothesize that an increased dependence on maize produced more iron deficiency anemia and resulted in more porotic hyperostosis. Maize is known to have permitted a food surplus which in turn allowed for increased Southwestern population growth in marginal areas like the canyon bottoms. Heavy dependency on a single food type with consequent hematologic problems may have been an important reason for the subsequent abandonment of the Anasazi region.

Adult↗
PubMed1982

Laboratory diagnosis in a large outbreak of type A botulism: confirmation of the value of coproexamination.

Coproexamination is a vital component of the laboratory evaluation of botulism and is an essential part of the investigation of suspected botulism cases. In April 1978, type A botulism developed in 34 persons who had eaten at a restaurant in a town in New Mexico. Pretreatment serum specimens, along with stool specimens for toxin assay and culture for Clostridium botulinum, were obtained. At least one specimen (serum or stool) was available for each patient. Of 30 serum specimens, 16 (53%) were toxin positive; seven (32%) of 22 stools were toxin positive; and C. botulinum type A was cultured from 19 (79%) of 24 stool specimens. Overall laboratory confirmation was available for 26 cases (76%). Serum and stool toxin detection was related both to the time elapsed between symptom onset and specimen collection and to the severity of illness, with shorter times and severe illness associated with higher rates of toxin detection. Recovery of C. botulinum type A did not vary appreciably according to these factors. In 18 cases, both serum and stool specimens were available; the proportion of suspected cases that could be laboratory-proven increased by 46% when patients' feces, and not just their sera, were subjected to botulism testing procedures.

Adolescent↗
PubMed2006

Environmental surveillance at Los Alamos: an independent reassessment of historical data.

Since 1971, a series of annual Environmental Surveillance ... reports have served as the official public record of Los Alamos National Laboratory's (LANL) environmental performance. In northern New Mexico, where past LANL emissions are a public health concern, there is public skepticism over the accuracy of information contained in these reports. To test the hypothesis that LANL Environmental Surveillance ... reports systematically understate past emissions, we compared the data on releases in LANL's own internal Occurrence Reports Collection (ORC) to the data reported to the public in the Environmental Surveillance ... reports. A data set of 89 environmental occurrences recorded in the ORC in the time period from 1971 through 1980 was assembled. We did not find a systematic pattern of quantitative underreporting of source terms. However, 17 of the 89 (19%) environmental occurrences recorded in the ORC were not reported to the public in the Environmental Surveillance ... reports. The observed discrepancies are discussed in terms of their relevance to public health concerns. Methodological caveats dictate restraint in applying these findings beyond the scope of the relative comparison performed here. Possible social origins for the rejected hypothesis are discussed. Areas for further consideration by the Centers for Disease Control's dose reconstruction study of LANL are identified.

Environmental Monitoring↗
PubMed2003

Adiposity and sex hormones in postmenopausal breast cancer survivors.

PURPOSE: Overweight and obese women with breast cancer have poorer survival compared with thinner women. One possible reason is that breast cancer survivors with higher degrees of adiposity have higher concentrations of tumor-promoting hormones. This study examined the association between adiposity and concentrations of estrogens, androgens, and sex hormone-binding globulin (SHBG) in a population-based sample of postmenopausal women with breast cancer. METHODS: We studied the associations between body mass index (BMI), body fat mass, and percent body fat, measured by dual-energy x-ray absorptiometry scan, waist circumference, and waist-to-hip circumference ratio, with concentrations of estrone, estradiol, testosterone, SHBG, dehydroepiandrosterone sulfate, free estradiol, and free testosterone in 505 postmenopausal women in western Washington and New Mexico with incident stage 0 to IIIA breast cancer. Blood and adiposity measurements were performed between 4 and 12 months after diagnosis. RESULTS: Obese women (BMI > or = 30) had 35% higher concentrations of estrone and 130% higher concentrations of estradiol compared with lighter-weight women (BMI < 22.0; P =.005 and.002, respectively). Similar associations were observed for body fat mass, percent body fat, and waist circumference. Testosterone concentrations also increased with increasing levels of adiposity (P =.0001). Concentrations of free estradiol and free testosterone were two to three times greater in overweight and obese women compared with lighter-weight women (P =.0001). CONCLUSION: These data provide information about potential hormonal explanations for the association between adiposity and breast cancer prognosis. These sex hormones may be useful biomarkers for weight loss intervention studies in women with breast cancer.

Absorptiometry, Photon↗