RESUMO
The purpose of this study was to assess the validity and reproducibility of an interviewer-administered, semi-quantitative food frequency questionnaire (FFQ) among 132 volunteer New Mexico Hispanic (H) and non-Hispanic white (NHW) women, aged 35-74 years, with (n = 47) and without (n = 85) a breast cancer history, and to add to the limited data presently available on the performance of FFQs among different ethnic groups. Validity was measured at one month and six months from baseline against four-day food records, and reproducibility was tested by comparing FFQs. Unadjusted validity correlation coefficients were highest at one month, ranging from 0.38 (polyunsaturated and monounsaturated fat) to 0.57 (calcium); energy-adjusted correlation coefficients were highest at six months, ranging from 0.15 (polyunsaturated fat) to 0.68 (calcium). Energy-adjusted correlation coefficients were statistically significant by ethnicity for vitamins A and C, protein, carotene and calcium, and by case status for saturated fat, folate, fiber, and vitamins A and E. Reproducibility correlation coefficients (unadjusted) ranged from 0.40 (polyunsaturated fat) to 0.71 (carbohydrate, retinol); energy-adjusted correlation coefficients ranged from 0.42 (vitamin E) to 0.78 (fiber), and differed significantly by ethnicity for saturated fat and retinol, and by case status for carbohydrate. Overall, our FFQ has comparable characteristics to other FFQs and is suitable for use with New Mexico's H and NHW women.
Assuntos
Comportamento Alimentar/etnologia , Hispânico ou Latino , Inquéritos e Questionários/normas , População Branca , Adulto , Idoso , Neoplasias da Mama/etnologia , Distribuição de Qui-Quadrado , Ingestão de Energia , Feminino , Humanos , Pessoa de Meia-Idade , New Mexico/epidemiologia , Reprodutibilidade dos Testes , Medição de RiscoRESUMO
PURPOSE: To survey graduates in practice from the first four classes of the University of New Mexico School of Medicine's (UNMSOM's) parallel curricular tracks, and compare data about the graduates' practice patterns, learning behaviors, and satisfaction with the profession of medicine. METHOD: Between 1979 and 1993, the UNMSOM had two tracks for the first two years of medical school: a conventional track and the Primary Care Curriculum (PCC), a community-oriented, problem-based track. In 1990, a survey was conducted of the 140 graduates from the first four classes (1983-1986) who had completed their postgraduate training: 40 from the PCC and 100 from the conventional track. Statistical methods included two-way analyses of variance, logistic regression, and chi-square, adjusted by Bonferroni methods. Comparisons between tracks are reported after adjustments were made for specialty effects. RESULTS: Thirty-three graduates (83%) from the PCC and 87 (87%) from the conventional tracks responded. The PCC graduates were much more likely to work in medically underserved areas, practice in publicly funded health care settings, and care for non-paying patients. The PCC graduates more often identified patient problems and curiosity as providing motivation for their learning. They more frequently studied clinical medicine and community health topics and spent time in community activities. The PCC graduates felt better prepared for practice by their undergraduate medical education. There was no difference between the graduates of the two tracks in the sizes of the populations in which they practiced, in the criteria they used for deciding on referrals to other physicians, in the ranges of community resource utilization, or in the degrees of satisfaction within their chosen professions. Large percentages of graduates from both tracks (67% conventional and 79% PCC) considered themselves to be practicing either primary care or a combination of primary care and non-primary care. In addition, 38% of all the graduates practiced in the state of New Mexico. More PCC graduates chose careers in family practice; however, no significant difference was found in a comparison between the proportions of PCC and conventional-track graduates who chose primary care careers. CONCLUSION: Track differences favorable to the PCC were evident in relation to the two major goals established by the program: to attract graduates to careers in primary care in rural and underserved areas and to provide graduates with self-directed, lifelong learning skills. Some expected track effects were not found.
Assuntos
Currículo , Educação de Graduação em Medicina/métodos , Padrões de Prática Médica/estatística & dados numéricos , Centros Médicos Acadêmicos , Adulto , Atitude do Pessoal de Saúde , Escolha da Profissão , Coleta de Dados , Feminino , Humanos , Satisfação no Emprego , Masculino , New Mexico , Atenção Primária à Saúde , Aprendizagem Baseada em Problemas , Inquéritos e QuestionáriosRESUMO
A survey of persons soliciting sex in an area known to be frequented by prostitutes in Albuquerque, NM, included 43 females and 66 males. Seroprevalence rates found in this population-based study were as follows: human immunodeficiency virus type 1 (HIV-1), 3%; hepatitis B, 39%; hepatitis C, 45%. Increased age, intravenous drug use, and condom use were independent risk factors for hepatitis B. Female gender and intravenous drug use were independent risk factors for hepatitis C. Neither sharing injection equipment nor engaging in receptive anal intercourse was independently associated with hepatitis B or C.
Assuntos
Soroprevalência de HIV , HIV-1 , Hepatite B/epidemiologia , Hepatite C/epidemiologia , Trabalho Sexual , Adulto , Feminino , Hepatite B/etnologia , Hepatite C/etnologia , Humanos , Masculino , New Mexico/epidemiologia , Razão de Chances , Fatores de Risco , Fatores SexuaisRESUMO
A biologically motivated breast cancer incidence rate function was fit to data from a published case-control study conducted in countries whose incidence is high (Wales and the United States), moderate (Brazil, Greece, and Yugoslavia), and low (Japan and Taiwan). The data include personal characteristics of 3,925 breast cancer cases and 11,327 controls interviewed in selected hospitals in 1964-1968. Parameters in the function specify the dependence of age-specific breast cancer incidence rates on age at menarche, age at menopause, occurrence and timing of full-term pregnancies, and body mass. Parameters were estimated separately for high-, moderate-, and low-risk countries. Examination of residuals provided little evidence of inadequacy of the fitted function in describing combined effects of the characteristics studied. The following patterns were seen in all three risk groups: 1) Incidence rates jump to a higher level after first childbirth, but then increase with age more slowly thereafter. 2) Rates increase with age more slowly after menopause than before. 3) Rates change quadratically with body mass index among all women, although the main trend varies: Rates decrease with body mass among premenopausal women in high-risk countries, but increase with body mass in all other groups of women. Similarities of parameter estimates across countries suggest that reproductive events and body fat exert similar effects on all women, regardless of breast cancer rates in their country of residence.
Assuntos
Neoplasias da Mama/epidemiologia , Neoplasias da Mama/fisiopatologia , Adulto , Fatores Etários , Idoso , Intervalo entre Nascimentos , Índice de Massa Corporal , Brasil/epidemiologia , Estudos de Casos e Controles , Feminino , Grécia/epidemiologia , Humanos , Incidência , Japão/epidemiologia , Funções Verossimilhança , Modelos Logísticos , Idade Materna , Menarca , Menopausa , Pessoa de Meia-Idade , Obesidade/epidemiologia , Paridade , Fatores de Risco , Taiwan/epidemiologia , Estados Unidos/epidemiologia , País de Gales/epidemiologia , Iugoslávia/epidemiologiaRESUMO
A cohort of 3469 males with at least 1 y of underground uranium mining experience in New Mexico was assembled and mortality followed up through 31 December 1985. The mean and median cumulative exposures for the cohort were 0.39 J h m-3 and 0.12 J h m-3 (111.4 and 35.0 Working Level Months [WLM]), respectively. Overall, mortality in the cohort was significantly increased (standardized mortality ratio [SMR] = 1.1, 95% confidence interval [CI] = 1.02-1.2) relative to the general population of the state. By cause, significant increases were observed for lung cancer (SMR = 4.0, 95% CI 3.1-5.1) and for external causes of death (SMR = 1.5, 95% CI 1.3-1.7). The risk of lung cancer increased for exposure categories above 100 WLM; the excess relative risk increased by 0.5% per mJ h m-3, 95% CI 0.2-1.5 (1.8% per WLM, 95% CI 0.7-5.4). Data were consistent with a multiplicative interaction between smoking and exposure to Rn progeny in an exponential relative risk model. The risk of lung cancer varied substantially with age at observation; the odds ratios rose more steeply with exposure to Rn progeny for those less than age 55 y at observation.
Assuntos
Bismuto , Chumbo , Neoplasias Pulmonares/mortalidade , Mineração , Neoplasias Induzidas por Radiação/mortalidade , Exposição Ocupacional , Polônio , Urânio , Adulto , Estudos de Coortes , Humanos , Neoplasias Pulmonares/etiologia , Masculino , Pessoa de Meia-Idade , Neoplasias Induzidas por Radiação/etiologia , New Mexico , Produtos de Decaimento de Radônio , Fumar/efeitos adversosRESUMO
The impact of the New Mexico safety belt law on patterns of injury, severity, and cost was evaluated (using an emergency department data base). Data collected from November 1985 through February 1986 compared the 2 months before the January 1986 law with 2 months after. Before the law, 22.2% of the 379 injuries included abrasions, contusions, and lacerations to face, neck, and head. Following the law, this category constituted only 13.8% of 356 injuries, representing a reduction of 38% (P less than .05). Cost and injury severity scores (ISS) for 436 injured patients covered by the law were not significantly different between the pre- and post-seatbelt law periods. However, significant cost and severity differences were observed after the law between belted and nonbelted occupants: +2,569 compared with +662; ISS of 3.6 compared with 2.0 (P less than .05). Methodologic problems of an emergency department-based study and the need for E coding (external causes of injury) are discussed.
Assuntos
Saúde Pública/legislação & jurisprudência , Cintos de Segurança , Ferimentos e Lesões/prevenção & controle , Acidentes de Trânsito , Custos e Análise de Custo , Registros Hospitalares , Humanos , New Mexico , Ferimentos e Lesões/classificação , Ferimentos e Lesões/economiaRESUMO
A case-control study was conducted to describe lung cancer risk in a cohort of New Mexico underground U miners. The subjects included 65 cases and 230 age-matched controls, most with exposures below 3.50 J h m-3 (1000 WLM). The risk for lung cancer was increased for all cumulative exposures to Rn progeny of 0.35 J h m-3 (100 WLM) or greater. The odds ratios were unchanged with control for cigarette smoking. With exclusion of subjects with exposures above 3.50 J h m-3 (1000 WLM), the estimated excess relative risk was 0.3% per mJ h m-3 (1.1% per WLM). The risk was greater for younger subjects and the data were consistent with a multiplicative interaction between cigarette smoking and exposure to Rn progeny.
Assuntos
Bismuto , Chumbo , Neoplasias Pulmonares/etiologia , Mineração , Neoplasias Induzidas por Radiação/etiologia , Doenças Profissionais/etiologia , Polônio , Urânio , Adulto , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , New Mexico , Produtos de Decaimento de Radônio , Fatores de RiscoRESUMO
The growth of cross-cultural psychiatry is now occurring at a time when psychiatry in general is emphasizing diagnostic clarity and the use of quantifiable and reliable methods of collecting clinical and research data. It is now imperative that cross-cultural psychiatry also examine its methods for developing instruments for use in cross-cultural research. This paper outlines a method for developing instruments designed in one culture for use in a second, and particular attention is given to cross-cultural validity or equivalence. Five types of equivalence are enumerated and defined: content, semantic, technical, criterion, and conceptual equivalence. These concepts are illustrated by examples from the authors' experience in research on internal migrants in Peru.
Assuntos
Comparação Transcultural , Transtornos Mentais/diagnóstico , Testes Psicológicos , Projetos de Pesquisa , Humanos , Idioma , Transtornos Mentais/epidemiologia , Peru , Escalas de Graduação Psiquiátrica , Psicometria , Ajustamento Social , MigrantesRESUMO
We have used population-based data for the state of New Mexico to calculate cigarette-smoking-specific incidence rates for lung cancer, cumulative incidence rates for lung cancer, and estimates of the proportion of lung cancer cases attributable to smoking. For white New Mexicans, the incidence of lung cancer increased with age and was markedly higher in smokers than in nonsmokers. From 25 through 84 yr of age, the cumulative incidence of lung cancer was 0.9% in nonsmoking males and 0.5% in nonsmoking females. The cumulative incidence rates were much higher for smokers; for males who smoked 20 or more cigarettes daily from age 25, the cumulative risk of lung cancer through age 84 was 31.7%. For females with the same cigarette smoking history, the estimate of cumulative incidence through age 84 years was 15.3%. The population-attributable risks for lung cancer associated with cigarette smoking were 89.5% for males and 85.5% for females.
Assuntos
Neoplasias Pulmonares/epidemiologia , Fumar/efeitos adversos , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Humanos , Neoplasias Pulmonares/etiologia , Neoplasias Pulmonares/mortalidade , Masculino , Pessoa de Meia-Idade , New MexicoRESUMO
Participants in a population-based case-control study of lung cancer in New Mexico between 1980 and 1982 were asked to identify all locations where they had resided for six months or more. These residential data were coded at the county and state levels and combined with county-level socioeconomic data from the 1910, 1930, 1950, and 1970 decennial censuses to generate indices of time lived in counties or metropolitan areas of different sizes, degrees of urbanization, or extents of employment in manufacturing industries. Urban residence was not associated with employment of male controls in jobs or industries considered to increase lung cancer risk. However, in the non-Hispanic white female controls, urban residence before age 30 years in a county of 500,000 or more residents was associated with a fourfold higher odds ratio for starting to smoke cigarettes. Male and female non-Hispanic controls who had ever lived in more populous counties smoked more cigarettes per day than did those who had not lived in such counties. Residential history patterns were the same in cases and controls; multiple logistic regression showed no consistent associations of the residence history variables with lung cancer risk.
Assuntos
Hispânico ou Latino , Neoplasias Pulmonares/epidemiologia , População Branca , Adulto , Idoso , Exposição Ambiental , Métodos Epidemiológicos , Feminino , Humanos , Neoplasias Pulmonares/etiologia , Masculino , Pessoa de Meia-Idade , New Mexico , Sistema de Registros , Risco , População Rural , Fumar , População UrbanaRESUMO
Although cigarette smoking is the strongest known risk factor for lung cancer, the effects of specific smoking practices have not been completely characterized. The present study examines determinants of lung cancer risk in a population-based, case-control study conducted in New Mexico, 1980-82. The study included 521 cases and 769 controls matched for age, sex, and ethnicity. Either the index subjects or their next-of-kin were interviewed in person to obtain a detailed history of cigarette smoking and information concerning other risk factors. With the use of multiple logistic regression, a model was constructed of the effects of amount smoked, duration of smoking, cigarette type, and smoking cessation on lung cancer risk. Among current smokers, risk increased with each additional cigarette smoked per day (P less than .001). For duration of smoking, the risk per year smoked in individuals 65 years and older was only one-third that in persons under age 65 years. With regard to cigarette type, a somewhat higher risk was found associated with smoking nonfilter cigarettes, but there was no evidence of decreasing risk as the extent of filter smoking increased. Lifelong filter cigarette smokers and smokers of both filter and nonfilter cigarettes were at lower risk than lifelong smokers of nonfilter cigarettes only. In ex-smokers, the pattern of variation of relative risk with amount and duration was similar to that in the current smokers. Excluding those who had stopped for 1 year or less, the relative risk declined exponentially with duration of smoking cessation (P less than .01). These analyses confirm the strong benefits of smoking cessation and indicate possible reduction of risk from smoking filter cigarettes.
Assuntos
Neoplasias Pulmonares/etiologia , Fumar , Adulto , Fatores Etários , Idoso , Feminino , Hispânico ou Latino , Humanos , Neoplasias Pulmonares/epidemiologia , Masculino , Pessoa de Meia-Idade , New Mexico , Risco , Fatores de Tempo , População BrancaRESUMO
The association between dietary intake of vitamin A and lung cancer risk was examined in a population-based, case-control study of 447 patients and 759 control subjects in New Mexico. A food frequency interview was used to measure usual consumption of total vitamin A retinol, preformed vitamin A, and carotene. With all respondents combined, the odds ratios for lung cancer increased as intakes of total vitamin A and carotene declined but did not vary with intake of preformed vitamin A. When the subjects were stratified by ethnic group, Hispanic or non-Hispanic (Anglo) white, significant effects of vitamin A consumption were limited to the Anglos. In the Anglos, the protective effects of total vitamin A and carotene consumption were present in males and females, but varied strongly with cigarette smoking habits. In Anglo smokers, significant increases in the odds ratios with declining intake were observed in former but not in current smokers. Among the former smokers, significant effects of total vitamin A and carotene consumption were present only in those who had stopped smoking for 6 to 15 yr. Limitation of the protective effect of vitamin A and carotene consumption to past smokers has important implications for the design of clinical trials and for cancer control strategies.
Assuntos
Carcinoma/epidemiologia , Dieta , Neoplasias Pulmonares/epidemiologia , Vitamina A/administração & dosagem , Idoso , Carotenoides/administração & dosagem , Feminino , Hispânico ou Latino , Humanos , Masculino , Pessoa de Meia-Idade , New Mexico , Risco , Fumar , População BrancaRESUMO
A population-based case-control study of lung cancer was performed in New Mexico to explain the differing patterns of lung cancer occurrence in the state's "Hispanic" Whites and other Whites. From 1980 through 1982, interviews were completed with 521 cases and 769 controls. In the male controls, the prevalence of current and previous cigarette usage was similar in the two ethnic groups, but Hispanics smoked fewer cigarettes daily. In the female controls, a lower percentage of Hispanics had ever smoked and their usual consumption was less than that of other White women. Older Hispanic female smokers had used hand-rolled cigarettes for an average of 8.8 years, whereas other White women of the same age had used this type for less than one-half year. Both stratified and multiple logistic analysis showed comparable risks of lung cancer in Hispanic White and other White smokers. There was no evidence of interaction between ethnicity and cigarette smoking. These analyses imply that the differences in lung cancer incidence between New Mexico's Hispanic Whites and other Whites are largely explained by the patterns of cigarette smoking of these two groups.
Assuntos
Hispânico ou Latino , Neoplasias Pulmonares/etiologia , Fumar , Adulto , Fatores Etários , Idoso , Métodos Epidemiológicos , Feminino , Humanos , Neoplasias Pulmonares/epidemiologia , Masculino , México/etnologia , Pessoa de Meia-Idade , New Mexico , Fatores Sexuais , População BrancaRESUMO
We assessed the occurrence of malignant melanoma of the skin in New Mexico from 1969-1977. Incidence data, collected by the New Mexico Tumor Registry, were supplemented with mortality data supplied by the State Bureau of Vital Statistics. These data were analyzed for variation by site, sex, and ethnic group. Malignant melanoma occurrence varied with ethnicity. Incidence rates for non-Hispanic whites (Anglos) exceeded comparison US rates, and were approximately six times higher than for other ethnic groups. Annual incidence rates for Hispanics, American Indians, and blacks of both sexes ranged from 0.0-1.8 cases per 100,000. As anticipated from other studies, the lower extremities were the most common site in Anglo women, and the trunk was the most common site in Anglo men. In contrast, the trunk was the most common site for both Hispanic men and women. A statistically significant trend of increasing incidence was demonstrated only for the Anglo women. Mortality rates varied widely during the study period and did not correlate with incidence rates.
Assuntos
Melanoma/epidemiologia , Neoplasias Cutâneas/epidemiologia , Adolescente , Adulto , Fatores Etários , Idoso , Criança , Pré-Escolar , Etnicidade , Extremidades , Feminino , Cabeça , Humanos , Lactente , Masculino , Melanoma/mortalidade , Pessoa de Meia-Idade , Pescoço , New Mexico , Sistema de Registros , Fatores Sexuais , Neoplasias Cutâneas/mortalidadeRESUMO
To characterize the epidemiologic features of respiratory diseases among Hispanics, we conducted a prevalence survey in Bernalillo County, New Mexico. The ATS-DLD-78 respiratory symptoms questionnaire was completed by 633 Hispanics and 1,038 Anglos (non-Hispanic whites) with an overall response rate of 72%. The prevalence of major respiratory diseases differed between the groups. Physician-confirmed chronic bronchitis or emphysema, and asthma were reported less often by Hispanics. Although patterns of cigarette usage (current, previous, never) were similar, current and cumulative cigarette consumption was significantly lower in Hispanics. Most differences in symptom frequency and the lower Hispanic prevalence of chronic bronchitis or emphysema were attributable to lower cigarette consumption by Hispanics. However, the prevalence of asthma remained significantly lower among Hispanics after controlling for cigarette smoking. These results documented differences in the prevalence of respiratory disease between the Hispanics and Anglos, which were partially explained by the distributions of known risk factors.