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Background: The incidence of thyroid cancer in the United States has risen dramatically since the 1970s, driven by an increase in the diagnosis of small tumors. There is a paucity of published New Mexico (NM) specific data regarding thyroid cancer. We hypothesized that due to New Mexico's unique geographic and cultural makeup, the incidence of thyroid cancer and tumor size at diagnosis in this state would differ from that demonstrated on a national level. Methods: The New Mexico Tumor Registry (NMTR) was queried to include all NM residents diagnosed with thyroid cancer between 1992 and 2019. For 2010 to 2019, age-adjusted incidence rates were calculated via direct method using the 2000 United States population as the adjustment standard. Differences in incidence rate and tumor size by race/ethnicity and residence (metropolitan vs non-metropolitan) were assessed with rate ratios between groups. For 1992 to 2019, temporal trends in age-adjusted incidence rates for major race/ethnic groups in NM [Non-Hispanic White (NHW), Hispanic, and American Indian (AI)] were assessed by joinpoint regression using National Cancer Institute software. Results: Our study included 3,161 patients for the time period 2010 to 2019, including NHW (1518), Hispanic (1425), and AI (218) cases. The overall incidence rates for NM AIs were lower than those for Hispanics and NHWs because of a decreased incidence of very small tumors (<1.1 cm). The incidence rates for large tumors (>5.1 cm) was equivalent among groups. In the early 2000s, Hispanics also had lower rates of small tumors when compared to NHWs but this trend disappeared over time. Conclusion: AIs in New Mexico have been left out of the nationwide increase in incidental diagnosis of small thyroid tumors. This same pattern was noted for Hispanics in the early 2000s but changed over time to mirror incidence rates for NHWs. These data are illustrative of the health care disparities that exist among New Mexico's population and how these disparities have changed over time. [ABSTRACT FROM AUTHOR]

The increase in sport participation among adolescents has led to the rise in sport-related injuries, many of which have unique characteristics based on the patient, their perceptions, and the pressures faced when returning to sport. The purpose of this study was to identify the underlying factors that contributed to adolescents’ perceptions of injury and the various pressures they experienced when returning to sport. Two themes emerged from the study: support and fear. Support was provided to participants through development, care, and the environment. Fear was the factor that affected the participant in their return to sport, which came in the form of worry and doubt.

Public lands and waters in the United States traditionally have been managed using frameworks and objectives that were established under an implicit assumption of stable climatic conditions. However, projected climatic changes render this assumption invalid. Here, we summarize general principles for management adaptations that have emerged from a major literature review. These general principles cover many topics including: (1) how to assess climate impacts to ecosystem processes that are key to management goals; (2) using management practices to support ecosystem resilience; (3) converting barriers that may inhibit management responses into opportunities for successful implementation; and (4) promoting flexible decision making that takes into account challenges of scale and thresholds. To date, the literature on management adaptations to climate change has mostly focused on strategies for bolstering the resilience of ecosystems to persist in their current states. Yet in the longer term, it is anticipated that climate change will push certain ecosystems and species beyond their capacity to recover. When managing to support resilience becomes infeasible, adaptation may require more than simply changing management practices—it may require changing management goals and managing transitions to new ecosystem states. After transitions have occurred, management will again support resilience—this time for a new ecosystem state. Thus, successful management of natural resources in the context of climate change will require recognition on the part of managers and decisions makers of the need to cycle between “managing for resilience” and “managing for change.”

A climate-driven water resource model of California's Sacramento River Basin (SACB) is presented, based on the Water Evaluation and Planning model Version 21 (WEAP21). The model's configuration, calibration, testing, and limitations are presented. The major contribution includes an integration of the watershed's surface and subsurface hydrology, consumptive, and nonconsumptive use, and the water management infrastructure and controls that determine how water naturally flows and is managed. The SACB was subdivided into numerous catchments; groundwater basins; irrigated areas; urban/export use; environmental requirements; and canals, diversions, and reservoirs in an attempt to characterize the forces that act on water throughout the basin. A monthly climate time series forced an embedded hydrologic model that simulates runoff, groundwater-surface water interactions, and consumptive agriculture and urban water uses. Results show that the model can reproduce both local and regional water balances, including managed and unmanaged streamflow, reservoir storage, agriculture and urban water uses, and the allocation of ground water and surface water supplies, which should be useful for various California water planning processes. CE Database subject headings: Water resources; Climatology; Hydrology; Water supply; California; River basins.