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PubMed2002

Oregon State University's Steer-a-Year program: integrating classroom learning and hands-on experience.

The Steer-a-Year course is designed to provide classroom and hands-on experience, industry-student interaction, and student group problem-solving opportunities. It is a cooperative agreement between the Department of Animal Sciences and the Oregon Cattlemen's and Cattlewomen's Associations. Steers are donated to the program by beef producers, fed a high concentrate ration to a target BW and condition, and marketed as either carcass or retail beef. After feed and management expenses are deducted, the Department of Animal Sciences retains one-half of the profit to be used for beef facilities improvements, and the other half is distributed to the donor's choice of either the Oregon Cattlemen's or Cattlewomen's Association. Approximately 30 steers have been donated to the program annually each of the past eight years. The donor receives updates regarding steer performance during the feeding period and carcass data following harvest of the animal. Students and instructors feed and manage the steers. The instructor uses classroom time to provide information to enable students to make informed management decisions. Officers are elected from within the class each term. Student officers are responsible for ensuring that cattle are managed and fed appropriately, and they lead the class in writing and sending producer updates. An evolving facet of the program is processing and marketing. Steers are sold locally through the Clark Meat Science Center. Students are encouraged to participate in a separate course in which they process the steers into retail product. In this manner, students can be involved in procurement, management, processing, and marketing. The course is challenging for the instructor since it requires management of lecture material, cattle health and feeding, producer and employee rapport, and student participation to ensure annual success of the program in terms of student learning and public relations. The course is very well received by students, most of whom have labeled it as a great learning experience.

Agriculture↗
PubMedDate not supplied

Tracking drug-resistant Streptococcus pneumoniae in Oregon: an alternative surveillance method.

With the emergence of drug-resistant Streptococcus pneumoniae, community-specific antimicrobial susceptibility patterns have become valuable determinants of empiric therapy for S. pneumoniae infections. Traditionally, these patterns are tracked by active surveillance for invasive disease, collection of isolates, and centralized susceptibility testing. We investigated whether a simpler and less expensive method aggregating existing hospital antibiograms--could provide community-specific antimicrobial susceptibility data. We compared 1996 active surveillance data with antibiogram data from hospital laboratories in Portland, Oregon. Of the 178 S. pneumoniae active surveillance isolates, 153 (86% [95% confidence interval (CI) = 80% to 91%]) were susceptible to penicillin. Of the 1,092 aggregated isolates used by hospitals to generate antibiograms, 921 (84% [95% CI = 82%-87%]) were susceptible to penicillin. With the exception of one hospital's erythromycin susceptibility results, hospital-specific S. pneumoniae susceptibilities to penicillin, cefotaxime, trimethoprim-sulfamethoxazole, and erythromycin from the two methods were statistically comparable. Although yielding fewer data than active surveillance, antibiograms provided accurate, community-specific drug-resistant S. pneumoniae data in Oregon.

Community-Acquired Infections↗
PubMed2003

A challenge to meet the future: nursing education in Oregon, 2010.

Nursing leadership in Oregon has united behind a plan to address the nursing shortage, setting forth five strategic goals. Two of these are specific to nursing education--to double enrollment by 2004 and redesign nursing education to more directly meet the changing health care needs of Oregonians. This article describes the Oregon Nursing Leadership Council plan and the processes used to develop it. Controversial issues, challenges, and future directions also are discussed.

Curriculum↗
PubMed2003

Prevalence of hepatitis A, hepatitis B, and HIV among hepatitis C-seropositive state hospital patients: results from Oregon State Hospital.

BACKGROUND: Multiple studies have shown that individuals with severe mental illness are at increased risk for acquiring infection from human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV). Moreover, patients with chronic HCV infection are at risk for fulminant hepatitis from acquired infection with hepatitis A virus (HAV) or HBV, but there are limited data on the prevalence of HIV, HAV, and HBV in chronically hospitalized U.S. psychiatric patients without mental retardation who are HCV-seropositive. To address this issue, a comprehensive screening program was commenced at Oregon State Hospital (Salem, Ore.) beginning in 1999. METHOD: The computerized records of all non-geriatric adult inpatients at Oregon State Hospital on April 23, 2001, were reviewed to assess physician compliance with screening and the prevalence of infection with HIV, HAV, HBV, and HCV. RESULTS: Among the 535 patient records reviewed, 94.8% of patients were screened for HCV, of whom 20.3% were seropositive. Among HCV-seropositive patients, only 1.9% were not screened for HAV and HBV, but 23.3% were not tested for HIV. In the HCV-seropositive group, 35.9% were HAV-positive, 49.5% HBV-positive, and 2.6% HIV-positive. CONCLUSION: Chronic psychiatric inpatients have high HCV prevalence rates. Hepatitis C-seropositive individuals may be at risk for complications unless vaccinated for HAV and HBV.

Adult↗
PubMed1980

Dipetalonema from the eye of a man in Oregon, U.S.A. A case report.

A 21-mm filarial worm appeared suddenly in the anterior chamber of the right eye of a 32-year-old man in western Oregon. By a simultaneous irrigation-aspiration procedure, it was removed alive and only slightly damaged and was identified as a female Dipetalonema in the fourth stage of development. It was the third such case to be reported from western Oregon. In this and one other case the worms were morphologically similar to adult worms identified as Dipetalonema arbuta Highby 1943 from the body cavity of the porcupine (Erethizon dorsatum) and a similar species, Dipetalonema sprenti Anderson 1953, from the body cavity of the beaver (Castor canadensis).

Adult↗
PubMed1991

Isolation of Northway serotype and other Bunyamwera serogroup bunyaviruses from California and Oregon mosquitoes, 1969-1985.

Eight previously untyped Bunyamwera serogroup bunyaviruses that had been isolated from mosquitoes collected in California and Oregon between 1969 and 1985, were identified by cross-neutralization tests. Four viruses from Anopheles freeborni and a virus from Aedes sierrensis collected in Butte County in the Central Valley of California in 1970-71 were shown to belong to the Northway serotype. The existence of a Northway serotype virus in California had been inferred from previous serologic surveys of deer and horses, but these are the first Northway serotype viruses to be identified from the contiguous United States or from An. freeborni. This is also the first isolation of any virus from Ae. sierrensis. Two viruses from Culiseta inornata collected in Umatilla County, Oregon in 1969 may represent a new serotype in the Bunyamwera serocomplex of the Bunyamwera serogroup. The name "Stanfield" is proposed for this serotype, which is closely related to the Cache Valley and Northway bunyavirus serotypes. A virus from Ae. taeniorhynchus collected in San Diego County, California in 1985 was confirmed to belong to the Main Drain serotype. Previously, Main Drain serotype viruses in California have been associated principally with Culicoides variipennis.

Aedes↗
PubMed1979

Causes of death in marine mammals stranded along the Oregon coast.

Sixty-eight marine mammals stranded on the Oregon beaches were examined at necropsy. Gunshot was the primary cause of death in 30% of the pinnipeds examined. Bacterial infections (27%) and parasitism (27%) were also of major importance in the death and debilitation of Oregon marine mammals. Traumatic death or debilitation other than gunshot was observed in 11 animals (16%). Predation, starvation due to neonatal abandonment, viral encephalitis (presumptive diagnosis), dystocia and neoplasia were diagnosed as primary or contributory causes of stranding.

Animals↗
PubMed1989

Helminths of California quail (Callipepla californica) and mountain quail (Oreortyx pictus) in western Oregon.

Eighty California quail (Callipepla californica), collected from the E. E. Wilson Wildlife Area near Monmouth, Oregon (USA) during a 22 mo period, were examined for gastrointestinal helminths. Eight birds were infected with three species of nematodes, Heterakis isolonche, Dispharynx nasuta, and Capillaria sp., and two species of cestodes, Rhabdometra odiosa and Davainea sp. Except for D. nasuta, prevalence did not exceed 5% despite mesic conditions in the collection area. Two mountain quail (Oreortyx pictus) were collected from Lane County, Oregon (USA), near Blue River Reservoir; both were infected with the nematode Trichostrongylus tenuis.

Animals↗
PubMed2000

Septicemic pasteurellosis in free-ranging neonatal pronghorn in Oregon.

As part of a study to determine the cause(s) of population decline and low survival of pronghorn (Antilocapra americana) neonates on Hart Mountain National Antelope Refuge (HMNAR), Oregon (USA), 55 of 104 neonates captured during May 1996 and 1997 were necropsied (n = 28, 1996; n = 27, 1997) to determine cause of death. Necropsies were conducted on fawns that died during May, June, or July of each year. The objectives of this study were to report the occurrence and pathology of pasteurellosis in neonates and determine if the isolated strain of Pasteurella multocida was unique. Septicemic pasteurellosis, caused by P. multocida, was diagnosed as the cause of death for two neonates in May and June 1997. Necropsy findings included widely scattered petechial and ecchymotic hemorrhages found over a large portion of the subcutaneous tissue, meninges of the brain, epicardium, skeletal muscle, and serosal surface of the thorasic and abdominal cavities. Histological examination of lung tissues revealed diffuse congestion and edema and moderate to marked multifocal infiltrate of macrophages, neutrophils, and numerous bacteria within many terminal bronchioles and alveoli. Pasteurella multocida serotypes A:3,4, and B:1 were isolated from several tissues including lung, intestinal, thorasic fluid, and heart blood. Each B:1 isolate had DNA restriction endonuclease fingerprint profiles distinct from isolates previously characterized from domestic cattle, swan (Olor spp.), moose (Alces alces), and pronghorn from Montana (USA). This is the first report of pasteurellosis in pronghorn from Oregon and the B:1 isolates appear to be unique in comparison to DNA fingerprint profiles from selected domestic and wild species.

Animals↗
PubMedDate not supplied

Management. Setting priorities in health: the Oregon experiment (Part 1).

Increasing emphasis on obtaining consumer opinion in relation to needs assessment and decision making has led to interest in this country about the Oregon experiment in the US. Despite controversies over the efficacy of such approaches, it seems likely that future emphasis will be placed on devising systematic means of gathering information about societal preferences for care. In two articles, Ann Bowling reviews the evidence from America and relates it to the ongoing changes in the British health service. Part 1 introduces the ideas behind the Oregon experiment and examines similar initiatives in the UK.

Community Health Services↗
PubMedDate not supplied

Management. Setting priorities in health: the Oregon experiment (Part 2).

Increasing emphasis on obtaining consumer opinion in relation to needs assessment and decision making has led to interest in this country about the Oregon experiment in the US. In spite of controversies over the efficacy of such approaches, it seems likely that future emphasis will be placed on devising systematic means of gathering information about societal preferences for care. In two articles, Ann Bowling reviews the evidence from America and relates it to the ongoing changes in the British health service. Part 2 examines the methods, results and controversies generated by the Oregon experiment.

Community Health Services↗
PubMed1991

Rationing care in Oregon.

As a means of curtailing rising health care costs under Medicaid, Oregon has developed a priority list of some 700 medical conditions. The list will serve as the basis for determining what Medicaid services low-income people in Oregon receive. The plan is being heralded by some as a significant step toward universal access to health care, while others see it as unfairly depriving many of needed services.

Cost Control↗
PubMed1992

The value of health care: what can we learn from Oregon?

The scarcity of health care resources leads to rationing amongst potential users by one means or another. When the market is rejected, rationing should be conducted on the basis of systematic and informed priority setting. It has been widely suggested that these priorities should be based on health benefits measured by quality adjusted life years (QALYs) and recently the US State of Oregon has attempted to use QALYs for setting priorities on a large scale. Values not normally associated with QALY analysis were also incorporated in the process. Their unique experience is of interest in Australia, as no attempt has been made here to prioritize medical interventions on the scale that was undertaken in Oregon.

Australia↗
PubMed1991

Medicaid rationing in Oregon: political wolf in a philosopher's sheepskin.

Although the details of the proposal have shifted since it was first described, the Oregon Medicaid waiver has had one consistent feature: it will reduce benefits to AFDC mothers and children who are currently covered by Medicaid in that state, in the hopes of increasing coverage for other individuals who are now uninsured. Because of the adverse consequences for the AFDC population, there should be strong evidence supporting the purported benefits of the proposal before proceeding with the waiver. One of the most intriguing aspects of the waiver proposal is the claim that the money currently being spent on AFDC beneficiaries could be redistributed to expand coverage to a substantial number of the uninsured. The concept is that far more people could receive the most valuable services if those now being served gave up their coverage of the least valuable services. Other purported benefits of the waiver include enhanced citizen participation in decisionmaking, cost-savings, and improved payment levels and delivery arrangements. Remarkably, this analysis of the proposal reveals that the waiver is likely to achieve none of its stated objectives, and instead will have adverse consequences not identified by its proponents. What the proposal would do is to insulate politicians from visible responsibility for limiting benefits for AFDC children and adults. Finally, the proposal undermines 25 years of Medicaid as an entitlement program. As such, it would establish as a social ethic the principle that the poor can be relegated to inadequate care. Such an extreme measure is not justified by the fiscal situation in Oregon, which is not extraordinarily poor or overtaxed, and does not have a particularly generous or unusually expensive Medicaid program.

Aid to Families with Dependent Children↗
PubMed1993

Hospitals prepare for start of Oregon health plan prototype.

In March, the Clinton administration approved Oregon's controversial Medicaid rationing program, but said the state must revise its ranking of services to eliminate the possibility of bias against disabled people. Under the Oregon system, approximately 688 medical procedures and services were ranked according to their cost effectiveness. Based on projections of available funds, officials decided they wouldn't cover any treatment ranked below 568. But with the savings, the state will be able to provide Medicaid to the 120,000 Oregonians who now live below the poverty line, but don't receive Medicaid benefits.

Financing, Government↗
PubMedDate not supplied

Health care reform in Oregon.

Oregon has led the United States in asking the difficult questions regarding what constitutes basic health care benefits. Oregon's experience in attempting to answer the question "what are basic health care benefits?" offers some learning opportunities for Canada in the face of diminishing financial resources and health care reform.

Community Participation↗
PubMed1997

The Oregon Health Plan: lessons learned.

The widely publicized Oregon Health Plan (OHP) was established in 1989 to provide the residents of Oregon with universal access to health insurance. The OHP encompassed provisions to reform Medicaid, which included relaxing eligibility requirements and requiring Medicaid beneficiaries to enroll in managed care plans. To date, the OHP has improved access to health care facilitated the efficient use of healthcare services. However, problems with the program exist--failure of Medicaid beneficiaries to choose a health plan and primary care physician, inadequate education of the enrollee population, and frequent enrollee turnover, for example. These problems offer lessons to the rest of the nation as Medicaid managed care plans proliferate.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1999

Was the decreasing trend in hospital mortality from heart failure attributable to improved hospital care? The Oregon experience, 1991-1995.

OBJECTIVE: To assess the trend in risk-adjusted hospital mortality from heart failure. STUDY DESIGN: Oregon hospital discharge data from 1991 through 1995 were analyzed. PATIENTS AND METHODS: A total of 29,530 hospitalizations because of heart failure in elderly patients (age > or = 65 years) were identified from International Classification of Diseases, 9th Revision, codes 428.0-428.9. The logistic regression and life table analyses were used to assess the risk-adjusted trend in hospital mortality from heart failure. RESULTS: From 1991 through 1995, 1757 (5.9%) patients with heart failure died in the hospital; 920 (52.4%) of them died within 3 days. The percentage of patients discharged to skilled nursing facilities increased from 6.1% in 1991 to 9.8% in 1995 (P value for trend < .001), whereas the percentage of patients discharged directly to home decreased from 69.2% in 1991 to 62.4% in 1995 (P value for trend < .001). The mean length of stay decreased from 5.15 days in 1991 to 3.97 days in 1995. The age- and sex-standardized mortality rate decreased by 33.8% from 7.4 in 1991 to 4.8 in 1995 (P value for trend < .01). Additional adjustment for comorbidity using multiple logistic regression revealed a greater reduction of 41.0% in the mortality rate (odds ratio = 0.59; 95% confidence interval = 0.50, 0.69) and a reduction of 46.0% in the 3-day mortality rate (odds ratio = 0.54; 95% confidence interval = 0.43, 0.67) across the 5-year period. Life table analysis showed consistently lower cumulative mortality rates during the first week after admission in 1995 compared with those in 1991 (P < .001). CONCLUSION: There was a decreasing trend over time in the risk-adjusted hospital mortality rates from heart failure, which was not an artifact of decreasing length of stay. Our findings raised the possibility of improved hospital care for heart failure in Oregon.

Aged↗