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Educational collaboration and innovation. The nurse-midwifery and family nurse practitioner programs at the University of New Mexico.

The University of New Mexico College of Nursing Nurse-Midwifery and Family Nurse Practitioner programs are successfully implementing an educational program founded on a shared vision and core. The curriculum design and methods of implementation facilitate study by students distant from the College, clinical learning experiences in rural areas, and dual preparation. Shared application of faculty resources results in availing students of a variety of expertise and cost-effectiveness.

Curriculum↗

Breast cancer among Hispanics, American Indians and non-Hispanic whites in New Mexico.

Variation in breast cancer occurrence among women in New Mexico's three major ethnic groups has not previously been assessed. The address the descriptive epidemiology of breast cancer in New Mexico Hispanics, American Indians, and non-Hispanic whites, we calculated incidence rates from population-based registry data covering 1969-1987 and mortality data collected from 1958 to 1987. Breast cancer incidence and mortality rates for New Mexico's non-Hispanic white women were comparable to those for white women nationwide. In contrast, American Indian women had extremely low incidence and mortality rates for breast cancer; rates for Hispanics were intermediate, but well below those for non-Hispanic white women throughout the study period. Pronounced temporal trends in breast cancer occurrence were evident among Hispanic women, with the incidence rate increasing by 56% over the 19 years of available data and the mortality rate increasing by nearly 100% over 30 years. Age-specific incidence and mortality rates increased at all ages for successive birth cohorts of Hispanic women. For non-Hispanic whites, increasing incidence and mortality rates were also observed, but the increments were much smaller, approximately 15% for incidence and 30% for mortality. Our data show substantial ethnic differences in breast cancer incidence and mortality in New Mexico, suggesting the need for aetiological investigations to assist in controlling this disease.

Adult↗

Stroke risk factor knowledge in Hispanic and non-Hispanic white women in New Mexico: implications for targeted prevention strategies.

Hispanic women in New Mexico have recently experienced an increase in age-adjusted mortality compared with non-Hispanic white women. Since patients' knowledge of stroke risk factors may affect risk factor control, the present study was undertaken to characterize stroke risk factor understanding in Hispanic and non-Hispanic white women in New Mexico. We administered a stroke risk factor knowledge survey to 215 women hospitalized in Albuquerque, New Mexico. Patients were classified by each of three dichotomous groupings: stroke or nonstroke diagnosis; Hispanic or non-Hispanic white ethnicity; history of cardiovascular risk factors. The frequency of specific item responses was determined for each patient grouping. Two-way analysis of variance was used to determine whether composite knowledge score differed among patient groups. Stress was the attribute most commonly thought to be a risk factor for stroke. Although no ethnic differences were found on composite knowledge score, Hispanic women were significantly less likely to report hypertension as a stroke risk factor than non-Hispanic white women. We suggest that stroke risk factor understanding in Hispanic and non-Hispanic white women in New Mexico is inadequate. Insufficient understanding of the consequences of hypertension, including stroke, may diminish the degree of hypertension control that patients achieve. Further study of the relationship between stroke risk factor understanding and health behavior could enhance prevention efforts.

Aged↗

Outbreak of Salmonellosis associated with beef jerky--New Mexico, 1995.

In February 1995, the New Mexico Department of Health (NMDOH) was notified of cases of salmonellosis in two persons who had eaten beef jerky. An investigation by the New Mexico Environment Department determined that these cases were associated with beef jerky processed at a local plant. An investigation by NMDOH identified 91 additional cases. This report summarizes the investigation of this outbreak.

Adolescent↗

Alcohol and suicide death among American Indians of New Mexico: 1980-1998.

The relationship between alcohol use prior to suicide was explored among American Indian decedents in New Mexico for the years 1980 through 1998. The suicide data were collected from New Mexico Vital Statistics and toxicology reports from the New Mexico Office of the Medical Investigator and matched on a case-by-case basis. Detailed analyses were undertaken for all cases of resident New Mexico Indians from the Navajo, Pueblo, and Apache cultures. Alcohol was detected in 69% of all suicides of American Indians with some variance by major tribal cultural groups (range = 62.1% to 84.4%). This is higher than in suicides among the overall New Mexico population (44.3%). The mean blood alcohol concentration (BAC) of the drinking Indian decedents at suicide was 0.198 (+/- SD of .088). Mean BACs were high for both males (0.199) and females (0.180) who had been drinking. Over 90% of the Indian decedents who had been drinking had BACs greater than the legal intoxication level of 0.08. The Navajo had the lowest percentage of cases that were alcohol involved, and their mean BAC was lower than the other two cultural groups. Alcohol use for completed suicides also varied somewhat by age, sex, method of suicide, and place of occurrence, but very little by whether the decedent was an on or off reservation resident. Analyses indicated that alcohol use prior to suicide was significantly more associated with male suicides than for females, and it was negatively correlated for those who died by overdose and also those using other drugs at suicide. Otherwise, alcohol use did not significantly differentiate American Indian suicides by age, use of firearms, hanging, use of other methods, or residence, for the presence of alcohol was a factor very commonly associated with all of these variables. Heavy alcohol consumption is, therefore, an important factor in over two thirds of all completed suicides among the Indians of New Mexico.

Adolescent↗

Injury mortality in New Mexico's American Indians, Hispanics, and non-Hispanic whites, 1958 to 1982.

New Mexico has extraordinarily high injury mortality rates. To better characterize the injury problem in New Mexico, we calculated proportionate injury mortality and age-adjusted and age-specific injury mortality rates for the state's 3 major ethnic groups--American Indians, Hispanics, and non-Hispanic whites. According to death certificate data collected from 1958 to 1982 and US population census figures, age-adjusted mortality rates for total external causes varied widely between the sexes and among the ethnic groups. Males in each ethnic group consistently had higher average annual age-adjusted external mortality rates than females. Injury mortality rates for American Indians of both sexes were 2 to 3 times higher than those for the other New Mexico ethnic groups. Motor vehicle crashes were the leading cause of death from injury for all 3 groups. Homicide accounted for twice the proportion of injury death in Hispanic compared with non-Hispanic white males (12.5% and 6.1%, respectively), while the proportion of males dying of suicide was highest in non-Hispanic whites. Deaths from excessive cold and exposure were leading causes of injury mortality for American Indians, but these causes were not among the leading causes of injury mortality for Hispanics or non-Hispanic whites. We conclude that the minority populations in New Mexico are at high risk for injury-related death and that the major causes of injury mortality vary substantially in the state's predominant ethnic populations.

Adolescent↗

Assessing continuing medical education needs in New Mexico.

In 1981 a decision was made by the University of New Mexico School of Medicine to create a new Office of Community Professional Education whose primary function was to create continuing medical education programs tailored to its constituency. To accomplish this, a needs assessment survey was distributed to a stratified random sample of members of the New Mexico Medical Society practicing throughout the state to determine preferred learning styles, locations of programs and times of year, as well as other determinants for attending such programs. The survey was received by 647 physicians and 469 returned them-a response rate of 72.4 percent. Conclusions reached as a result of the needs assessment will serve as a basis of policy formation for the delivery of continuing medical education at the University of New Mexico School of Medicine.

Education, Medical, Continuing↗

Increased occurrence of exfoliation in the male, Spanish American population of New Mexico.

Exfoliation syndrome was found to occur much more frequently in the male Spanish American population of New Mexico. This was based on a Veterans Administration Medical Center study in Albuquerque, New Mexico. The prevalence of exfoliation in the Spanish Americans was estimated to be from 3-6 percent and this is consistent with many other such studies performed in the United States and other countries. The Spanish American population is 5.8 times more likely to develop exfoliation than the non-Spanish American population of New Mexico. Exfoliation was found on such eye structures as the lens, iris, ciliary processes, posterior capsule, vitreous face, posterior corneal surface, and arterial chamber angle. Glaucoma capsulare was also studied and it was found that there was not a significant difference between the Spanish American and the non-Spanish American population for developing the condition. However, there was a strong association of glaucoma with the presence of exfoliation in both groups. Based on our results, patients with exfoliation are 22 times more likely to develop glaucoma than are their age-matched controls. Also, 40 percent of the exfoliation patients had glaucoma compared with only 5 percent of the age-matched controls (p less than .001). The patients with glaucoma capsulare were found to have a more medically resistant type of glaucoma, which was consistent with other reports of this condition. There are two theories we propose for the existence of exfoliation in the Spanish American population of New Mexico. The first is a geographic climatic theory that relates exfoliation to greater solar radiation levels due to a high overall altitude and sunny weather in New Mexico.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

New Mexico pharmacists' knowledge, attitudes, and beliefs toward prescribing oral emergency contraception.

OBJECTIVE: To describe New Mexico pharmacists' knowledge, attitudes, and beliefs toward the prescribing of oral emergency contraception (EC) in their practices. DESIGN: Cross-sectional study. SETTING: New Mexico in January through March 2004. POTENTIAL PARTICIPANTS: New Mexico pharmacists. INTERVENTIONS: Questionnaire containing 74 items. MAIN OUTCOME MEASURE(S): Mean scores were calculated for individual knowledge items, overall knowledge scores, and attitude/belief items. Knowledge and attitude/belief scores were compared across demographic variables using t tests, ANOVA, and chi-square analyses. RESULTS: Of 1392 deliverable questionnaires, 555 (40%) were returned and 523 (38%) were usable; 136 contained written comments. Pharmacists had overall knowledge scores of 71.2% +/- 11.3%. Pharmacists who had participated in a state-approved EC prescribing training program and had time in their practice setting to prescribe EC had significantly higher knowledge scores. Mean scores indicated that pharmacists have positive attitudes and beliefs toward prescribing EC. Overall, 40% of respondents indicated that they would like to become certified to prescribe EC. Pharmacists who agreed that they would like to be certified to prescribe EC were significantly more likely to be male, non-Hispanic, non-Christian, to have liberal or moderate political views, and to indicate that they had employer/manager approval, time, and privacy in their practice setting to prescribe EC. CONCLUSION: New Mexico pharmacists have positive attitudes/beliefs toward EC prescribing; however, their knowledge in this area is average. Although religious, moral, and political views influence pharmacists' willingness to prescribe EC, factors such as education and practice environment must be addressed if more pharmacists are to accept this EC prescriptive authority.

Contraception, Postcoital↗

Altitude and ischemic heart disease in tricultural New Mexico: an example of confounding.

The relationship of male white ischemic heart disease (IHD) death rates to altitude falls to negligible levels when New Mexico populations are separated into Hispanic and Anglo. Low rates of IHD mortality characterize Hispanic males in New Mexico regardless of altitude. In comparison, New Mexico Anglo males have rates near the US average. The variable showing the most consistent positive relationship with altitude is per cent Hispanic. Mortimer et al. (N Engl J Med 296:581--587, 1977) reported a reduction in coronary heart disease mortality in New Mexico white males with an increase in altitude. The current authors claim that this is an example of confounding. They find that the relationship between IHD mortality and altitude is largely due to the intervening variable, per cent Hispanic. Ethnicity demands major attention in epidemiologic studies in tricultural New Mexico.

Altitude↗

Infectious disease survey of gemsbok in New Mexico.

Exotic wildlife can introduce new diseases or act as reservoirs of endemic diseases. On White Sands Missile Range, New Mexico (USA), significant declines in populations of native ungulates generally correspond to increases in range and population density of the exotic gemsbok (Oryx gazella gazella), introduced beginning in 1969. We surveyed gemsbok in 2001 for exposure to a variety of diseases potentially important for native ungulates. High seroprevalence was found for malignant catarrhal fever virus (49 [98%] of 50 sera; 43 [96%] of 45 plasma samples), blue-tongue virus (48 [96%] of 50), bovine respiratory syncytial virus (33 [66%] of 50), and parainfluenza-3 virus (10 [20%] of 50). Low numbers of Nematodirus spp. eggs in a few individuals were the only parasites detected in gemsbok. Exposure to the above diseases in gemsbok is of interest to managers because of potential implications for recovery of desert bighorn sheep (Ovis canadensis mexicana) and desert mule deer (Odocoileus hemionus crooki) in the White Sands area because each has been implicated in mortality in these species either in the White Sands area or elsewhere in the western/southwestern United States.

Animals↗

Firearms in New Mexico.

To determine the prevalence of firearm ownership and storage practices in New Mexico, we did a random-digit-dialing survey of New Mexico residents in October 1991. Of 200 households surveyed, 79 (40%) had 1 or more firearms in the home. Rural households were more likely than urban households to have firearms (44% versus 30%), and households with annual incomes of greater than $25,000 were more likely to have a firearm than households with incomes of $25,000 or less (41% versus 33%). Household firearm ownership did not vary with the presence of young (< 15 years old) children (38% with children versus 41% without). Handguns were generally owned for self-protection, and rifles were owned for hunting. Of households with firearms, 24% stored them unsafely (unlocked and loaded or unloaded but with ammunition nearby), including 21% of households with young children. Of the households with handguns only, 40% stored these firearms unsafely compared with 13% of those with rifles only. The prevalence of gun ownership in New Mexico is similar to that reported in national surveys; handguns are stored less safely than rifles; and the presence of young children in the home does not appear to improve firearm storage safety.

Accidents, Home↗

Bionomics and distribution of species of Hystrichopsylla in Arizona and New Mexico, with a description of Hystrichopsylla dippiei obliqua, n. ssp. (Siphonaptera: Hystrichopsyllidae).

More than 450 specimens of Hystrichopsylla were collected from nests and hosts of species of Microtus, Neotoma, Tamiasciurus, and Peromyscus in Arizona and New Mexico from 1981-2004. A new subspecies, Hystrichopsylla dippiei obliqua, is described and a map illustrating the distribution of the three taxa (Hystrichopsylla dippiei truncata Holland, H. d. obliqua, and H. occidentalis sylvaticus Campos and Stark) occurring in Arizona and New Mexico is provided. Hystrichopsylla. o. sylvaticus is reported in New Mexico for the first time and H. d. truncata is a new record in Rio Aribba County, NM. Relationships of Mexican species are also discussed. These large fleas are seldom collected from the fur of their mammalian hosts (usually singly) but are prevalent in moist nests. The maximum number of the new subspecies collected from a single nest was 54. Dry nests, particularly those that are not subterranean or otherwise protected from desiccation, do not support development of Hystrichopsylla fleas. Minimum elevation at which H. dippiei ssp. is found in Arizona and New Mexico appears to be about 2,100 m.

Altitude↗

Venezuelan equine encephalitis vaccination survey in Arizona and New Mexico, 1972.

Field studies were conducted in 1972 to determine the immunization status of equines along the Mexico, Arizona, and New Mexico borders. Interviews with horse owners were conducted along roads selected at random in the counties of Santa Cruz and Yuma, Ariz., and in Dona Ana County, N. Mex. At least 450 horse owners in each county were asked about the vaccination status of their animals, and information was taken on 1,260 animals. Blood specimens were obtained from every third equine, regardless of stated vaccination status, and tested for the presence of Venezuelan equine encephalitis (VEE), western equine encephalomyelitis (WEE), and eastern equine encephalomyelitis (EEE) neutralization antibodies. Serum samples were collected from 446 equines in the 3-county area; only 227 (50.7 percent) had both a history of VEE vaccination in 1971 (including 20 vaccinated in 1972) and serum neutralization antibody against VEE. Of the remaining 220 with no detectable neutralization antibody to VEE, 197 (89.5 percent) had a history of VEE vaccination in 1971 (including 5 revaccinated in 1972), 14 (6.4 percent) had no history of vaccination, and 9 (4.1 percent) had an unknown vaccination status. Eighty-two percent (160 of 1971) of the equines with a history of VEE vaccination and presence of dectectable WEE or EEE antibodies, or both, had no detectable levels of VEE antibody. Therefore, the results of this study suggest that the presence of WEE or EEE antibodies, or both, may suppress the development of dectable vaccine-induced VEE antibody response in the equine. As a result of this investigation, the U.S. Department of Agriculture, as an added precaution, recommended the revaccination of equines in areas of the United States bordering Mexico.

Animals↗

Helminth parasites of unisexual and bisexual whiptail lizards (Teiidae) in North America. II. The New Mexico whiptail (Cnemidophorus neomexicanus).

Twelve of 61 (20%) unisexual New Mexico whiptails (Cnemidophorus neomexicanus) from three counties of central New Mexico (USA) and two counties of extreme southwestern Texas (USA) were found to be infected with one or more endoparasites. These included a linstowiid cestode (Oochoristica bivitellobata) in seven (11%), a larval spirurid nematode (Physaloptera sp.) in three (5%), an oxyurid nematode (Pharyngodon warneri) in two (3%) and an unidentified acanthocephalan cystacanth in a single (2%) lizard. This report constitutes the first record of helminths from C. neomexicanus.

Acanthocephala↗

Cancer incidence in the Zuni Indians of New Mexico.

The total age-adjusted incidence of cancer in the Zuni Indians of New Mexico was significantly lower than that of the New Mexico Anglo population during the period 1969-1982. Specific sites at which the Zunis had a significantly lower number of cases than expected, based on the rates for Anglos, are: colon, rectum and anus, lung, breast, endometrium, melanoma of the skin, pancreas, and the leukemias. Sites at which the Zunis had a higher number of cases than expected are stomach and gallbladder. The Zunis have a pattern of occurrence of cancer that is similar to other American Indians of New Mexico (Navajo, Apache, and Pueblo); however, rates of lung, colonic, and pancreatic cancer among the Zunis are significantly lower. The occurrence and anatomic distribution of cancer among the Zunis may be the result of cultural and environmental conditions or genetic influences. Further studies may clarify the risk factors which contribute to this pattern of disease.

Ethnicity↗