Awareness and perceptions of advanced practice pharmacists among health care providers in New Mexico.

OBJECTIVE: The purpose of this study was to evaluate health care provider awareness and perceptions of the 2 types of advanced practice pharmacists (APPhs) in New Mexico: pharmacist clinicians (PhCs) and community pharmacists with independent prescriptive authority (iRPhs). METHODS: A cross-sectional electronic survey was administered to health care providers in New Mexico to describe awareness and perceptions of APPhs and benefits and barriers to collaborative practice with APPhs. RESULTS: A total of 5905 providers received the emailed survey, and 634 (11%) completed the survey, with 68% of the respondents indicating that they were not aware of the 2 types of APPhs in New Mexico. The top benefits of working with a PhC identified by the respondents were access to medication knowledge, enhanced clinical outcomes, and increased access to patient care. The barriers to employing a PhC at their practice included cost, difficulty in billing for services, and limited reimbursement. Importantly, 80% of the respondents felt that PhCs should be recognized as providers for insurance reimbursement. Awareness of iRPhs varied by prescriptive authority service, ranging from 34% for tuberculin skin testing to 84% for adult vaccinations. Overall, 80%-92% indicated that iRPhs should be reimbursed, depending on the prescriptive authority service. CONCLUSION: Provider awareness of APPhs in New Mexico was low; however, the willingness to refer patients to APPhs for clinical services was high. Cost, difficulty in billing for services, and reimbursement for PhC services were the primary identified barriers to adding a PhC into practice. Most of the respondents indicated that both types of APPhs should be granted provider status and reimbursed by third-party payers for their services.

Complementary and Alternative Medicine and Therapy Use in a Diverse New Mexican Population.

OBJECTIVE: To describe differences, attitudes, and experiences in use of complementary and alternative medicines and therapy (CAMT) in people living in New Mexico (NM). DESIGN: Cross-sectional survey study. SETTING: Clinics staffed by the University of New Mexico College of Pharmacy faculty between September 2009 and August 2011 in Albuquerque, NM. PARTICIPANTS: Patients 18 years of age or older or parents of patients younger than age 18 years. OUTCOME MEASURES: Descriptive statistics for survey results and mean scores for attitudinal items. Chi-square, t-test, and analysis of variance were used to compare differences between groups across demographic variables. RESULTS: A convenience sample yielded 263 completed surveys. Of the respondents, 62% were male, 39% were single, and 50% were Hispanic. Nearly 56% of respondents used CAMT in the previous 6 months; 38% used CAMT in addition to and 11% used CAMT instead of prescription medications. Average number of CAMT used per respondent was 2.3 ± 1.6. A majority of respondents indicated that their CAMT use in the previous 6 months was useful, a good idea, easy to use, and likely to continue. CAMT use was significantly higher in female respondents (p = 0.03), those with a higher education level (p < 0.01), and those with a higher household income level (p = 0.03). CONCLUSION: Prevalence of CAMT is high in a diverse population of patients. Older respondents were more likely to use CAMT in addition to prescription medications, and younger respondents were more likely to use CAMT instead of prescription medications. Providers need to consider CAMT use when discussing treatment options with patients.

Quitting patterns and predictors of success among participants in a tobacco cessation program provided by pharmacists in New Mexico.

BACKGROUND: Tobacco use causes hundreds of thousands of deaths in the United States each year. Pharmacists are available in the community to provide tobacco cessation interventions. Between 2004 and 2010, the New Mexico Pharmaceutical Care Foundation (NMPCF) provided a pharmacist-led tobacco cessation program to residents in New Mexico. OBJECTIVES: To (a) obtain point prevalence quit rates at 1 month, 3 months, and 6 months follow-up for participants enrolled in the NMPCF program; (b) differentiate between the quitting patterns of enrolled participants; and (c) identify predictors associated with the quitting patterns. METHODS: Seven-year data were combined for the pattern analysis. Four quitting patterns were defined, including immediate quitters, delayed quitters, once quitters, and never quitters. Multinomial logistic regression was used to identify characteristics of participants with different quitting patterns. RESULTS: The analysis included 1,437 participants. The average point prevalence quit rate at 1 month, 3 months, and 6 months was 29.3%, 23.3%, and 18.0%, respectively. Based on our definition for quitting patterns, the study sample consisted of 145 (10.1%) immediate quitters, 113 (7.9%) delayed quitters, 298 (20.7%) once quitters, and 881 (61.3%) never quitters. Multinomial logistic regression identified associations between quitting patterns and demographics, tobacco use and restrictions, baseline confidence in successful quitting, and pharmacotherapy aids used to quit. Relationships varied between quitting patterns. CONCLUSIONS: The study findings showed that having community pharmacists provide smoking cessation interventions resulted in quitting success rates similar to other health care professionals, which ranged from 9.9% to 26.0%. Since pharmacists are a widely available resource for their patients, managed care organizations may be able to improve the health, and avoid subsequent tobacco-related adverse health outcomes, of their members by implementing a program similar to the NMPCF Tobacco Cessation Program.

Smoking cessation and its predictors: results from a community-based pharmacy tobacco cessation program in New Mexico.

BACKGROUND: The New Mexico Pharmaceutical Care Foundation received funding through the Tobacco Use Prevention and Control Program (TUPAC) to provide support for pharmacist-delivered tobacco cessation services. The goal of the program was to increase the availability of tobacco cessation services to residents of New Mexico. Program outcomes are presented, using data from the first 2 fiscal years. OBJECTIVE: To assess tobacco quit rates among smokers who participated in the community pharmacist-based program and identify the predictors of quitting at the end of a 6-month program. METHODS: Pharmacists, who had received Rx for Change training, provided tobacco cessation services. Patients were scheduled for an initial visit and then were seen at regularly scheduled follow-up visits at 1 month, 3 months, and 6 months from the initial visit. Data collected at the initial visit included demographics, smoking history, and readiness for quitting. Smoking status was collected at each of the follow-up visits. Data were analyzed using SAS (SAS Institute) and STATA (StataCorp LP) statistical software. Tobacco quit rates were calculated at 1, 3, and 6 months. Multivariate regression analysis was performed to assess predictors of quitting. Standard errors were adjusted for repeated observation. RESULTS: Data were available for 346 participants. The average quit rate at the end of 6 months was 25%. Significant predictors of quitting were high confidence levels in quitting at baseline, individuals who had first cigarettes at least 30 minutes after waking up, first cessation attempt, and nonwhite patients. CONCLUSIONS: A smoking cessation program delivered through trained community pharmacists with prescriptive authority is an effective approach to reducing smoking. Further research should be conducted to compare the effectiveness of pharmacists with that of other providers of tobacco cessation services.

Salinity and sodicity of weathered minesoils in northwestern new Mexico and northeastern Arizona.

Evolving relationships between electrical conductivity (EC) and sodium adsorption ratio (SAR) in reconstructed soils at surface mines have been insufficiently documented in the literature. Some minesoils (i.e., rootzone material) are classified as saline, sodic, or saline-sodic and are considered unsuitable for revegetation. Weatherable minerals such as calcite and gypsum are common in alkaline minesoils and on dissolution tend to mitigate elevated SAR levels by maintaining or increasing electrolytes in the soil and providing sources of exchangeable calcium and magnesium. Topsoils (i.e., coversoils) contribute to mitigation of sodic conditions when soluble cations are translocated from coversoils into the underlying minesoils. This study evaluated the weathering characteristics of minesoils sites from three surface coal mines in northwestern New Mexico and northeastern Arizona. Minesoils were grouped into 11 classes based on EC and SAR. After 6 to 14 yr, differences between upper and lower halves of the coversoils suggest general increases occurred with EC, SAR, chloride (Cl(-)), and sulfate (SO(4)(2-)) with depth. Within the reclaimed minesoils, there were several significant (P < 0.05 or < 0.10) relationships among EC and SAR that related to Minesoil Class. Lower SAR levels with corresponding increases in EC compared to baseline minesoils were more apparent in upper minesoil depths (0-5 and 5-15 cm). Minesoil anion concentrations suggested coversoil leachates and gypsum dissolution influenced EC and SAR chemistry. Over time, chemical changes have increased the apparent stability of the saline and sodic reclaimed minesoils studied thereby reducing risks associated with potential aggregate slaking and clay particle dispersion.

TRYPNET. New hemoparasite information network.

Although Guyana, Suriname, and French Guiana share borders and climatic and geographic similarities, the countries have maintained little contact, due to language, political, and administrative differences. In 1993, two international organizations involved in the improvement of animal health, the Inter-American Institute for Cooperation on Agriculture (IICA) and CIRAD-EMVT (Centre de Cooperation Internationale en Recherche Agronomique pour le Developpement-Elevage et Medecine Veterinaire des Pays Tropicaux), jointly developed a collaborative project between the veterinary services of the three countries entitled "Hemoparasite Network for the Guianas." This project seeks to pool livestock, laboratory, and technical resources between the three countries in order to generate and exchange information on hemoparasites of livestock. A Hemoparasite Reference Laboratory for the Guianas has been created at the CIRAD-EMVT laboratory in Cayenne, French Guiana. Besides processing ruminant serum samples from the three countries, specialists from this organization conduct training in hemoparasite diagnostic techniques for laboratory personnel from Guyana and Suriname. A large-scale epidemiologic study of hemoparasites of cattle in the three countries is under way, to determine the prevalence, distribution, and clinical and economic significance of hemoparasites in the three countries, particularly Trypanosoma vivax and T. evansi. Preliminary results are presented and discussed. A Hemoparasite Information Network (TRYPNET) has been initiated, including a quarterly hemoparasite newsletter (TRYPNEWS), published in English and Spanish and disseminated to researchers in the Americas, Europe, and Africa. In 1995/96, it is proposed to expand the network's scope to include Venezuela and Brazil.

TRYPNET: new hemoparasite information network

Although Guyana, Suriname and French Guiana share borders and climatic and geographic similarities, the countries have maintained little contact, due to language, political, and administrative differences. In 1993, two international organizations involved in the improvement of animal health, the Inter-American Institute for Cooperation on Agriculture (IICA) and CIRAD-EMVT (Centre de Cooperation en Recherche Agronomique pour le Developement-Elevage et Medicine Veterinaire des Pays Tropicaux), jointly developed a collaborative project between the veterinary services of the three countries entitled Hemoparsite Network of the Guianas. This project seeks to pool livestock, laboratory, and technical resources between the three countries in order to generate and exchange information on hemoparasites of livestock. A Hemoparasite Reference Laboratory for the Guianas has been created at the CIRAD-EMVT laboratory in Cayenne, French Guiana. Besides processing ruminant serum samples for the three countries, specialists from this organization conduct training in hemoparasite diagnostic techniques for laboratory personnel from Guyana and Suriname. A large-scale epidemiologic study of cattle in the three countries is under way, to determine the prevalence, distribution, and clinical and economic significance of hemoparasites in the three countries, particularly Trypanosoma vivax and T. envansi. Preliminary results are presented and discussed. A hemoparasite information Network (TRYPNET) has been initiated, including a quarterly hemoparasite newsletter (TRYPNEWS), published in English and Spanish and disseminated to researchers in the Americas, Europe, and Africa. In 1995/96, it is proposed to expand the network's scope to include Venezuela and Brazil. (AU)

Epidemiologia de las enfermedades del ganado bovino en Suriname / Epidemiology of cattle diseases in Suriname

The prevalence of certain cattle diseases in Suriname was studied over the period June-August 1985. The diseases were selected for their economic importance and association observed in the cattle with respiratory diseases, reproductive inefficiency, and neonatal mortality. Random samples were taken at two cattle-raising ranches, a dairy farm, and an abattoir in the District of Suriname. The study included a total of 478 animals, which were tested by indirect immunofluorescence for each of the diseases selected. Basically the serologic study revealed the presence of brucellosis, bovine viral diarrhea, parainfluenza 3, bovine infectious rhinotracheitis, and bovine coronavirus but not respiratory syncytial virus. The prevalence of parainfluenza 3 and bovine viral diarrhea was low compared with rates in other countries. It is recommended that a system, specially designed to meet the needs of this country, be established for the ongoing surveillance of data on animal health

Epidemiologic survey of bovine diseases in Suriname.

A seroepidemiologic survey of cattle diseases was undertaken in Suriname in 1985 to help assess the livestock disease situation in that country. The six diseases covered by the survey were bovine coronavirus infection, bovine rhinotracheitis, bovine virus diarrhea, brucellosis, parainfluenza-3 infection, and respiratory syncytial virus infection. The results indicated relatively low prevalences of these diseases compared to the prevalences found in most developed countries. The reasons for this are uncertain, but the finding suggests that the cattle population in Suriname could lack extensive exposure to these diseases and so could be highly susceptible to them. In addition, the evident need for more thoroughgoing survey data points up the need to establish a continuous animal data health monitoring system in Suriname--as well as in other developing countries where there is a need to objectively assess the livestock disease picture.

In vitro synthesis of immunoglobulins in cutaneous leishmaniasis.

In an in vitro study, IgG was synthesized in large amounts by tissue from cutaneous leishmaniasis lesions. IgA and IgM were produced in the minority of the cultures in distinct and small amounts, respectively. Synthesis of complement (C3 and C4) could not be detected, but lysozyme was produced sporadically. The significance of these findings is discussed.

Dirofilaria in dogs of Surinam

Five hundred and twenty-one dogs, at least one year of age, visiting a private veterinary clinic in Paramaribo, were examined from August 1977 till August 1978. Twenty-six per cent had microfilariae of Dirofilaria immitis in their peripheral blood. The mean number per infected dog was 9.689 per ml of blood (range 14 to 78.984 per ml). Microfilaria positivity rates were significantly higher in older dogs, and there were significantly more abnormal SGPT values in positive than in negative dogs, but there were no significant associations between positivity rate and alcalic phosphatase, ureum, or creatinin values, presence of clinical symptoms, presence of antibodies to Dirofilaria immitis (measured by the direct immuno fluoroscent antibody test), sex, breed nor neighbourhood of the dogs.(AU)

Epidemiologia de las enfermedades del ganado bovino en Suriname / Epidemiology of cattle diseases in Suriname

The prevalence of certain cattle diseases in Suriname was studied over the period June-August 1985. The diseases were selected for their economic importance and association observed in the cattle with respiratory diseases, reproductive inefficiency, and neonatal mortality. Random samples were taken at two cattle-raising ranches, a dairy farm, and an abattoir in the District of Suriname. The study included a total of 478 animals, which were tested by indirect immunofluorescence for each of the diseases selected. Basically the serologic study revealed the presence of brucellosis, bovine viral diarrhea, parainfluenza 3, bovine infectious rhinotracheitis, and bovine coronavirus but not respiratory syncytial virus. The prevalence of parainfluenza 3 and bovine viral diarrhea was low compared with rates in other countries. It is recommended that a system, specially designed to meet the needs of this country, be established for the ongoing surveillance of data on animal health