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PubMedDate not supplied

ADA compliance and the accessibility of physical activity facilities in western Oregon.

OBJECTIVES: One of the mandates of Title III of the Americans With Disabilities Act (ADA) is to address the accessibility of public facilities for all people. The aim of this study was to determine how compliant physical activity facilities in western Oregon were with regard to Title III of the ADA. Comparisons were also made with the findings of a study conducted 5 years prior in a different geographic region. METHODS: On the basis of direct observations and physical measurements taken during on-site visits to 50 physical activity facilities located in western Oregon during 2000-2001, facility compliance with Title III of the ADA was characterized in terms of 10 structural domains. RESULTS: No facility was found to be 100% ADA-compliant. Exterior entrance/doors (90%) and telephone accessibility (88%) were the areas where compliance was highest, whereas accessibility to and around exercise equipment (8%) and customer service desk (37%) were areas lowest in compliance. Relative to a previously published study, the facilities in western Oregon showed greater rates of ADA compliance in six of the 10 structural domains evaluated. CONCLUSIONS: There is an on-going need and legal mandate for increasing the accessibility of physical activity facilities. Furthermore, from a social-ecological perspective, the environmental constraints identified in this study might be limiting factors in efforts aimed at increasing individuals with disabilities' physical activity involvement.

Architectural Accessibility↗
PubMed1999

Oregon's low in-hospital death rates: what determines where people die and satisfaction with decisions on place of death?

Where Americans die is much more influenced by what part of the country they live in than by what their preferences are for location of death. Although most Americans report a preference for death at home, a majority still die in acute care hospitals. We describe the experiences of patients who died in Oregon (the state that currently has the lowest in-hospital death rate in the United States--31%) and the views of their families. We examine the factors influencing respect for dying patients' preferred location of death. Data from Oregon studies confirm that decisions to avoid hospital admission are far more common than discharge of the actively dying. Do-not-resuscitate orders were reported for 91% of nursing home residents in one study and living wills were reported for 67% of a random sample of adult Oregon decedents in a second study. In the second study, decisions not to start treatment were far more common than decisions to stop treatment (79% compared with 21%). Only 2.4% of families reported that "too little" treatment was given. Throughout the United States, use and availability of beds in acute care hospitals have been confirmed to be the principal determining factors in location of death. Within that constraint, however, the availability of other resources and services both facilitates the process of arranging for patients to die outside the hospital and improves satisfaction with the quality of terminal care.

Advance Care Planning↗
PubMed2006

Parelaphostrongylus odocoilei in Columbian black-tailed deer from Oregon.

Documenting the occurrence of Parelaphostrongylus odocoilei has historically relied on the morphological examination of adult worms collected from the skeletal muscle of definitive hosts, including deer. Recent advances in the knowledge of protostrongylid genetic sequences now permit larvae to be identified. Dorsal-spined larvae (DSLs) collected in 2003-2004 from the lung and feces of six Columbian black-tailed deer (Odocoileus hemionus columbianus) from Oregon were characterized genetically. The sequences from unknown DSLs were compared to those from morphologically validated adults and larvae of P. odocoilei at both the second internal transcribed spacer (ITS-2) of ribosomal DNA and the mitochondrial cytochrome oxidase II gene. We provide the first unequivocal identification of P. odocoilei in Columbian black-tailed deer from Oregon. The broader geographic distribution, prevalence, and pathology of P. odocoilei are not known in populations of Oregon deer.

Animals↗
PubMed1986

Oregon's Psychiatric Security Review Board: a comprehension system for managing insanity acquittees.

The insanity defense is a particularly controversial aspect of the interaction between law and mental health. During the past decade, many states have revised or abolished their insanity defenses. Oregon, however, chose in 1974 to retain its existing defense and create a new, unique system for the post-adjudication management of insanity acquitees. Oregon's legislature established the Psychiatric Security Review Board (PSRB), which is composed of five part-time members drawn from different disciplines, to conduct periodic hearings to determine the placement and supervision of defendants who successfully raise the insanity defense and remain mentally ill and dangerous. The PSRB has received national attention as a promising approach to managing mentally ill offenders. The authors first describe the structure and operation of the Oregon system. Then they summarize the empirical studies they have conducted of the PSRB in action.

Forensic Psychiatry↗
PubMed1999

A retrospective histopathological survey of capillariasis in raccoons (Procyon lotor) from Oregon.

A 2-yr retrospective survey (1995-1998) of 63 adult raccoons (Procyon lotor) from Oregon, northwestern United States, was conducted by histopathological examination of various tissues. An overall prevalence of capillariasis was recorded in 52% of the raccoons. Highest prevalence of nematodes (29/30, 97.7%) was present in the anal sacs, where variable numbers of nematodes, their ova, and extensive diffuse inflammatory cellular infiltrate were evident. Lesser numbers of nematodes were also seen in the mucosa of the anterior alimentary tract (mouth 2/63, tongue 10/62, esophagus 2/63) and in the urinary bladder (7/63). However, at these sites, there was a paucity of inflammatory infiltrate. The findings of this study indicate that capillariasis of the anal sacs is commonly seen in free-ranging raccoons in Oregon, and the infection is essentially subclinical because only 1 case of anal sac impaction has been reported. Measurements of the nematode and their ova from the anal sacs indicate that it is most likely a new capillariid species, which to date has not been fully described in raccoons. It is speculated that the high prevalence of anal sac infection by a Capillaria sp. in Oregon raccoons may also be true for raccoons in other parts of North America and in parts of Europe and Asia where this species has been introduced.

Animals↗
PubMed2000

Oregon's Toxic Household Products Law.

In 1991, Oregon became the first state in the U.S. to require the addition of an aversive agent to ethylene glycol-containing antifreeze and methanol-containing windshield wiper fluid. This new law, entitled "Toxic Household Products (THP) Act," was designed to reduce pediatric and animal poisonings from accidental ingestion of these two potentially lethal consumer automotive products. While not the stated intention of the law, addition of aversive agents to consumer automotive products could also reduce adult poisonings associated with intentional (suicides or alcoholics ingesting methanol-containing windshield wiper fluid) or accidental exposures. This law went into effect April 30, 1995, following settlement of a lawsuit brought by the Chemical Manufacturing Specialties Association (CSMA), a trade group representing the five largest manufacturers of ethylene glycol-based antifreeze in the U.S. This paper discusses the major policy issues that arose following the passage of Oregon's THP Act. Major provisions of the law are provided along with a discussion of CSMA's opposition to the Act's implementation. A description of the eventual settlement that was reached with CSMA as well as the major components of Oregon Health Division's (OHD) enforcement program are also highlighted. Data are presented for 1987 through 1998 on the number of exposures and severity of effects for pediatric cases (children < 6 years old) following exposure to both of these potentially lethal automotive products. However, because of the low incidence of exposures each year, these data are insufficient to draw any conclusions on the impact of the THP Act.

Adult↗
PubMed2002

Level and extent of mercury contamination in Oregon, USA, lotic fish.

We conducted a probability survey of 154 Oregon, USA, stream and river sites to assess the spatial extent of mercury (Hg) contamination in fish tissue. Samples consisted of whole-fish analyses of both small (<120 mm) and large (>120 mm) fish at each site, when both were present. Overall, Hg levels (microgram/g) in small fish (mean = 0.031; standard deviation [SD] = 0.029), large piscivores (mean = 0.284; SD = 0.175), and large invertivores (mean = 0.055; SD = 0.047) were found within fairly narrow ranges; always above detection (0.0025 microgram/g) and almost always below 0.4 microgram/g. Given the great ecoregion diversity across Oregon, the narrow range in fish tissue Hg levels suggests that atmospheric transport is an important vehicle for Hg distribution. In small fish, Hg levels were almost always low and showed little meaningful difference among fish taxa. In large fish, Hg levels were significantly related to fish length. Piscivores (pikeminnow and bass) had significantly higher Hg levels, and the slope of their Hg level/length relationship was much steeper than for invertivores. Salmonids, the most commonly occurring fish taxon in Oregon, exceeded 0.1 microgram Hg/g (deemed protective for fish-eating mammals) in an inferred 15% of stream lengths where they occurred. Pikeminnows and bass were found at fewer sites, but they exceeded 0.1 microgram Hg/g in an inferred 96 and 70%, respectively, of stream lengths where they occurred.

Animals↗
PubMed2004

The Oregon Health Plan.

The OHP has been successful in its goal of decreasing the number of uninsured in the state of Oregon and providing them with quality medical care at an affordable rate. When the plan started, nearly one-third of those individuals falling at or below the federal poverty level had no health insurance, and the plan has provided for these individuals. Furthermore, approximately 18% of all Oregonians had no health insurance in 1990. In 1997, the uninsured population fell to about 8%3. Also, the prioritization list has established an effective basic Medicaid benefit package that could be used by other state Medicaid programs and by insurance companies. Also, the use of Managed Care Plans and setting priorities for health care services has made the cost of health care for more customers affordable. The OHP is not perfect and will always be in a constant state of flux, because of changes in the financial state of Oregon and/or changes in the health care needs of the state. Therefore, the OHP will need to be continually evaluated on periodic bases for any needed changes. However, the state of Oregon should be commended for their attempt to explore uncharted waters, and to try to find an answer to the Nation's biggest health care concern/problem, which is to provide medical coverage for everyone in an affordable manner.

Health Priorities↗
PubMed2004

Oregon: does physician-assisted suicide work?

Since November 1997, Oregon, a State in the United States of approximately 3.3 million people, has allowed physician-assisted suicide, although not euthanasia, by virtue of the Death with Dignity Act. Before the Act, physician-assisted suicide, as in Australia and other common law jurisdictions, was illegal. Under the Act, the Oregon Department of Human Services is required to collect information and provide an annual report. The Sixth Annual Report on Oregon's Death with Dignity Act was released on 10 March 2004.

Attitude of Health Personnel↗
PubMed2004

Salmonella serotype Typhimurium outbreak associated with commercially processed egg salad--Oregon, 2003.

On September 24, 2003, Oregon epidemiologists noted an increase in Salmonella enterica serotype Typhimurium isolates tested during September at the Oregon State Public Health Laboratories. Of 16 isolates, six had matching pulsed-field gel electrophoresis (PFGE) patterns. The laboratory findings prompted an investigation by Oregon Health Services and CDC that identified 18 cases of infection with S. Typhimurium linked to kits for making egg salad that were distributed by a vendor to a supermarket chain. The Food and Drug Administration (FDA) conducted an environmental investigation but was unable to determine the mechanism of contamination. This was the first reported S. Typhimurium outbreak associated with a commercially processed, widely distributed, hard-boiled egg product. Epidemiologists and other public health staff should continue to investigate apparent clusters of salmonellosis and be aware that even commercially processed egg products can be a source of Salmonella.

Adolescent↗
PubMed2005

Varicella surveillance in public elementary schools--Multnomah County, Oregon, 2002-2004.

Varicella vaccination of school-aged children reduces the number of varicella cases and lost days of school. In 1996, the Advisory Committee on Immunization Practices (ACIP) recommended routine vaccination of all children aged 12-18 months, catch-up vaccination of all susceptible children before age 13 years, and vaccination of susceptible persons who have close contact with persons at high risk for serious complications and susceptible persons at high risk for exposure. In 1999, ACIP updated these recommendations to include vaccination requirements for child care and school entry. Since 2000, in accordance with ACIP recommendations, varicella vaccination requirements have been phased in for Oregon children who have not had varicella before starting out-of-home child care, kindergarten, or seventh grade; elementary school children will be fully covered by school year (SY) 2006-07. To monitor changes in varicella incidence, Oregon Health Services (OHS) and Multnomah Education Service District (MESD) started routine, individual, case-based varicella surveillance in Multnomah County public elementary schools (kindergarten through 5th grade) beginning SY 2002-03. This report describes the surveillance system, the incidence of varicella during SY 2002-03 and SY 2003-04, and the results of active surveillance for unidentified cases during SY 2002-03. The findings indicate that the number of varicella cases has decreased in Oregon and that establishing public elementary school-based varicella surveillance is feasible and useful.

Chickenpox↗
PubMed1992

Testing for HIV in the public and private sectors--Oregon, 1988-1991.

Counseling and testing persons for human immunodeficiency virus (HIV) infection is a key component of the public health strategy for reducing transmission of HIV in the United States (1,2). In 1991, the federal government allocated $100 million to state and local health agencies to provide counseling and testing programs in public clinics for at-risk persons, including persons who may not otherwise use public health services. However, the relative contribution of HIV-testing in public clinics to HIV testing in the private sector is unknown. To compare HIV testing in Oregon public clinics to overall HIV testing, the Health Division (HD) of the Oregon Department of Human Resources, in cooperation with CDC, reviewed data collected from September 1, 1988, through August 31, 1991, on public and private HIV testing in Oregon. This report summarizes findings for HIV testing rates and assesses the importance of publicly funded testing in identifying HIV-seropositive persons.

Adolescent↗
PubMed1993

A study of the dietary counseling practices among Oregon dental hygienists.

PURPOSE: The purpose of the study was to identify the dietary counseling practices of Oregon dental hygienists. Factors which affect the extent of dietary counseling were examined, including the dental hygienists' attitude, confidence, personal dietary practices, and perception of practice constraints. METHODS: A 25-item survey was mailed in summer 1989 to a random sample of 300 Oregon licensed dental hygienists. Likert-scaled statements were used to measure the extent of dietary counseling activities and the factors which affect their extent. Multiple-choice questions measured nutrition knowledge and quality of dietary counseling. Descriptive statistics were computed for each variable. Data were analyzed at the p<.05 significance level. Hypotheses testing included Pearson product-moment correlation, one-way analysis of variance (ANOVA), and chi-square. RESULTS: Of the 212 respondents (72% adjusted response rate), 52% reported providing dietary counseling. Ninety-six percent reported that they did not obtain dietary intake records and 82% did not evaluate their patients' diets for nutritional adequacy. A significant positive relationship (r=.19) was found between the hygienists' nutrition knowledge and quality of dietary counseling. Extent of counseling and the dental hygienist's confidence in nutrition knowledge and dietary counseling skills were found to be significantly related (r=-.31). A significant negative relationship (r= -.29) was found between extent of counseling and the dental hygienist's perception of practice constraints, most notably lack of time and cost-effectiveness. CONCLUSIONS: Dietary counseling is provided to a limited extent by dental hygienists in Oregon oral healthcare practices. Dental hygienists should provide this service based on patients' needs and, when necessary, refer patients to nutrition professionals. Further study could assess the nutrition and dietary counseling content and application in dental hygiene curricula.

Attitude of Health Personnel↗
PubMed1988

Further investigation into the recent increase in asthma death rates: a review of 41 asthma deaths in Oregon in 1982.

Vital statistics indicate increasing mortality from asthma since 1978 in the United States, England and Wales, Australia, and New Zealand. In Oregon and Washington, combined asthma mortality increased by 87% between 1977 and 1983. We reviewed the records of all patients (N = 41) (1) who died in hospitals or nursing homes in Oregon in 1982 and (2) whose death certificates listed asthma as the cause. Patients were 34 to 90 years old and half had been smokers. We found that most young patients who died clearly had asthma and died suddenly during severe attacks. Patients aged 55 and over frequently had bronchitis, emphysema, or chronic obstructive pulmonary disease rather than uncomplicated asthma, and were treated less aggressively than young patients. Their cause of death was often due to multisystem disease rather than reversible airflow obstruction. Reported statistics probably overestimate the true asthma mortality rate in the older population in Oregon.

Acute Disease↗
PubMed1985

Control of snow pool mosquitoes with Bacillus thuringiensis serotype H-14 in mountain environments in California and Oregon.

Studies were conducted in mountainous areas of California and Oregon to test the effectiveness of Bacillus thuringiensis serotype H-14 in controlling larvae of snow pool Aedes mosquitoes, and also the effect of such larval control on the density of adult mosquitoes. California and Oregon studies showed that a wettable powder formulation of B.t.i. was effective in controlling mosquito larvae. In Oregon, treatment was effective even at water temperatures as low as 5 degrees C. Sampling of adult mosquitoes at campgrounds where intensive larval control was done failed to demonstrate a lowering of adult mosquito density in comparison with untreated control areas. Flight range studies showed that snow pool Aedes species can fly distances of up to 2 km, suggesting that infiltration from outside the treated area was one cause of failure. Inadequate seasonal timing appeared to be an additional factor. Using a simple computer model, we estimated that larval mosquito control with B.t.i. could be done for about $5,000 per season for a 500 ha area similar to our test area, a cost of $10 per ha ($4 per acre).

Aedes↗
PubMed1995

Serogroup B meningococcal disease--Oregon, 1994.

In Oregon, the incidence of meningococcal disease has increased substantially, more than doubling from 2.2 cases per 100,000 persons in 1992 to 4.6 per 100,000 in 1994--the highest incidence in Oregon since 1943. This incidence was almost fivefold higher than recent estimates for the United States during 1989-1991 (approximately one case per 100,000 persons annually) (1). This report describes meningococcal disease surveillance data from 1994 and summarizes epidemiologic and laboratory data on serogroup B meningococcal disease in Oregon during 1987-1994.

Adolescent↗
PubMed1993

Dental health of school children--Oregon, 1991-92.

Dental caries remains among the most prevalent diseases of both children and adults. To establish a baseline for monitoring oral disease trends in Oregon, the State Health Division, Oregon Department of Human Resources; Oregon Health Sciences University; and Multnomah County Health Department collaborated in a statewide assessment or oral health needs. Phase 1 (1991-92) evaluated Head Start and elementary school children. Phase 2 (1993) is assessing the oral health of adults. This report presents the results of Phase 1.

Child↗
PubMed1993

Prioritization of health services. The Oregon Basic Health Services Act and its implications for dermatologists and patients with dermatologic disease.

The Oregon Basic Health Services Act was passed by the Oregon Legislature in 1989. This act mandates the provision of and payment for health services to Medicaid recipients based on a prioritized list of diseases and treatments. As a result of this legislation, Oregonians with incomes of 100% or less of the federal poverty level are eligible for Medicaid benefits. At present, families with incomes not exceeding 67% of the federal poverty level qualify for Medicaid in Oregon. The definition of prioritized care, how the prioritization was accomplished, and the potential effect of the implementation of this plan for dermatology and patients with dermatologic disease is discussed.

Dermatology↗