Over the past ten years University of New Mexico School Medicine has conducted an educational experiment featuring learner-centered, problem-based, community-oriented learning. The was introduced into established institution by means innovative track running parallel to more conventional curriculum. Students in track, compared with those tract, tended score lower on National Board Medical Examiners (NBME) Part I examination (basic sciences) and higher NBME II (clinical sciences), received...

Fourteen male rape victims treated in a county hospital emergency room over 30-month period are compared with 100 randomly selected female the same period. The as group sustained more physical trauma, were likely to have been victim of multiple assaults from assailants, and held captive longer. They reluctant reveal initially genital component their assault use denial control emotions reaction assault. Proper diagnosis treatment requires high index suspicion sensititivty likelihood major,...

Although it is known that the social determinants of health have a larger influence on outcomes than care, there currently no structured way for primary care providers to identify and address nonmedical needs experienced by patients seen in clinic setting. We developed piloted WellRx, an 11-question instrument used screen 3048 3 family medicine clinics over 90-day period. Results showed 46% screened positive at least 1 area need, 63% those had multiple needs. Most these were previously...

Health systems worldwide are confronted with challenges due to increased demand from their citizens, an aging population, a variety of health risks and limited resources. Key stakeholders, including academic institutions medical schools, urged develop common vision for more efficient equitable sector. It is in this environment that Boelen Heck defined the concept “Social Accountability Medical Schools” – encourages schools produce not just highly competent professionals, but professionals...

Despite yearly advances in life‐saving and preventive medicine, as well strategic approaches by governmental social agencies groups, significant disparities remain health, health quality, access to care within the United States. The determinants of these include baseline status, race ethnicity, culture, gender identity expression, socioeconomic region or geography, sexual orientation, age. In order renew commitment medical community address disparities, particularly at school level, we must...

We describe the impact of community health workers (CHWs) providing community-based support services to enrollees who are high consumers resources in a Medicaid managed care system. conducted retrospective study on sample 448 were assigned field-based CHWs 11 New Mexico's 33 counties. The provided patients education, advocacy and social for period up 6 months. Data was collected provided, accessed. Utilization payments emergency department, inpatient service, non-narcotic narcotic...

To determine the incidence of gasoline sniffing, and characteristics Pueblo Indian children indulging in this practice, a questionnaire was given to 72 attending village school. Forty-five (62%) stated they had sniffed as an intoxicant at least once, many were repeated users. Those who did not appear differ significantly home environment from schoolmates sniff gasoline.

The Affordable Care Act authorized, but did not fund, the Primary Extension Program (PCEP). Much like Cooperative of US Department Agriculture sped modernization farming a century ago, PCEP could speed transformation primary care. It also help achieve other goals such as integrating care with public health and translating research into practice. urgency these their importance to achieving Triple Aim for should increase interest in rapidly building PCEP, much need feed country ago.

The emergence of innovative curricula provides unique opportunities to examine how a modification in the learning environment might influence stress and attitudes among students medicine. In 1979, University New Mexico School Medicine implemented problem‐based, community‐oriented, student‐centered curriculum that runs concurrently with larger traditional track. This longitudinal investigation compares perceptions distress toward these two tracks. Symptom Questionnaire Learning Environment...

The Agricultural Cooperative Extension Service model offers academic health centers methodologies for community engagement that can address the social determinants of disease. University New Mexico Health Sciences Center developed Rural Offices (HEROs) as a vehicle its extension. extension agents are located in rural communities across state and supported by regional coordinators Office Vice President Community at Center. role is to work with different sectors identifying high-priority needs...

The Patient-Centered Medical Home (PCMH) model demonstrated that processes of care can be improved while unnecessary care, such as preventable emergency department utilization, reduced through better coordination. A complementary model, the Integrated Primary Care and Community Support (I-PaCS) which integrates community health workers (CHWs) into primary settings, functions beyond coordination medical to include management social determinants health. However, PCMH puts downward pressure on...

Of all ethnic groups in New Mexico, Native Americans have some of the best screening and treatment for diabetes, yet by far worst outcomes from that disease—kidney failure, amputations, blindness. High-quality care cannot adequately compensate decades low income, educational

Health care extension is an approach to providing external support primary practices with the aim of diffusing innovation. EvidenceNOW was launched rapidly disseminate and implement evidence-based guidelines for cardiovascular preventive in setting. Seven regional grantee cooperatives provided foundational elements health extension—technological quality improvement support, practice capacity building, linking community resources—to more than two hundred each region. This article describes...

Oral health needs are urgent in rural states. Creative, broad-based, and collaborative solutions can alleviate these needs. "Health commons" sites enhanced, community-based, primary care safety net practices that include medical, behavioral, social, public, oral services. Successful intervention requires a comprehensive approach, including attention to enhancing dental service capacity, broadening the scope of skills locally available providers, expanding pool creating new interdisciplinary...

Purpose To determine the impact on rural New Mexico of large, decentralized University (UNM) family medicine residency. Method A cross-sectional study was conducted all 317 residency’s graduates from 1974 to 2004. Location current practice correlated with residents’ gender, ethnicity, medical school origin, and whether most training took place in urban program or one three programs. The communities assessed. Results There no significant gender difference between who went into practice....

The emerging popularity of family medicine and primary care among medical students with an attendant pressure for clinical relevance in pre-clinical coursework early exposure has raised questions the minds many academicians about Students' perceived value basic sciences such educational environment. A comparison was made attitudes toward between two, concurrent, school curricula at University New Mexico School Medicine. conventional curriculum offers a teacher-centered, 2-year taught...

This article considers the changing nature of primary health care in a international context. Four family physicians from four continents and all involved change process, reflect on developments as they perceive them. Jan De Maeseneer was incremental strengthening Belgium has an perspective Chairman European Forum for Primary Care. Shabir Moosa is acting chief specialist District Health Services Gauteng (South Africa) coordinates project medicine training Africa. Yongyuth Pongsupap component...