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At least 163 records · Page 9Linked to original sources
PubMed1996

Population estimates of household firearm storage practices and firearm carrying in Oregon.

OBJECTIVES: To examine statewide data on exposure of adults and children to loaded and unlocked household firearms, and to estimate the prevalence of firearm carrying among adults in Oregon. DESIGN: Analyses of 1992 and 1993 telephone survey data from 6202 adults aged 18 years and older using the Oregon Behavioral Risk Factor Surveillance System. MAIN OUTCOME MEASURES: Number of adults and children exposed to household firearms always or sometimes stored loaded and unlocked. Adjusted odds ratios (ORs) for exposure to loaded and unlocked firearms and firearm carrying among adults by demographic and alcohol use patterns. RESULTS: Ten percent of adults (197 400 persons) lived in households with firearms that were always or sometimes stored loaded and unlocked. An estimated 6.2% of households with children had firearms that were loaded and unlocked, and about 40 000 children lived in these households. Overall, 4.4% of adults carried loaded firearms in the past month. Rural residence, male sex, and less than a college education were associated with living in a household with loaded and unlocked firearms and with firearm carrying. Drinking 5 or more alcoholic beverages on 1 or more occasions in the past month (OR, 1.7; 95% confidence interval, 1.3-2.3) or drinking 60 or more alcoholic beverages in the past month (OR, 1.8; 95% confidence interval, 1.2-2.7) were independently associated with living in households with loaded and unlocked firearms. CONCLUSIONS: Many adults and children are exposed to unsafely stored firearms in Oregon, and many adults carry loaded firearms. Improved public health surveillance of firearm storage and firearm carrying using standardized questions and definitions is needed at the national, state, and local levels.

Adolescent↗
PubMed1996

A new paradigm for increasing access to dental care: the Oregon Health Plan.

The Oregon Health Plan, one of the most controversial health care proposals to emerge in recent years, was implemented on February 1, 1994. The plan's intent was to control cost and increase access to health care for Oregon's low-income and Medicaid population. A key feature was limiting covered services to a state-approved list created by an open public process. Services were ranked from most important to least important, with covered services to be determined by available funding. For the first time, the listing included a merged set of medical and dental services, with many dental services ranked higher than medical services. Oregon's Medicaid program, which previously did not cover any adult dental care, now has one of the most generous set of Medicaid dental benefits in the United States. From the perspective of increasing access to dental care, this article suggests that the dental profession should re-examine its current policy supporting the separation of medical and dental benefit packages.

Adolescent↗
PubMed1997

Seroprevalence of antibodies to Sarcocystis neurona in horses residing in Oregon.

OBJECTIVE: To determine seroprevalence of antibodies to Sarcocystis neurona in neurologically normal horses residing in 4 regions of Oregon and to describe the effects of age, gender, breed, and housing on seroprevalence within each region. DESIGN: Prevalence survey. SAMPLE POPULATION: Serum samples from 334 horses systematically selected by practicing veterinarians. PROCEDURE: Antibodies to S neurona were measured in sera, using a western blot. Information including age, gender, breed, housing, geographic location, and duration of residence was obtained for each horse. Data were analyzed, using descriptive statistics. RESULTS: 45% (149/334) of horses evaluated were seropositive for antibodies to S neurona with significant differences in the percentage of seropositive horses from different regions of the state. Seroprevalances of antibodies to S neurona in horses in regions I and II, west of the Cascade Range, were 65 and 60%, respectively; whereas seroprevalances in central and eastern Oregon, regions III and IV, were 43 and 22%, respectively. Seroprevalence consistently increased with age of horse for each region. Gender, breed, and housing were not associated with significant differences in seroprevalence of antibodies to S neurona in the overall sample population, or in comparisons of samples obtained from horses within a particular region, or among samples obtained from horses residing in different regions. CLINICAL IMPLICATIONS: The high seroprevalence of antibodies to S neurona in neurologically normal horses indicates that analysis of serum alone would not be useful for definitive diagnosis of equine protozoal myeloencephalitis in horses in Oregon.

Age Distribution↗
PubMed1998

[No "unnecessary" care when measured by American standards. The Oregon list tested at a department of otorhinolaryngology in Halmstad].

It is often asserted in the health care debate that stricter priority setting would be one way of solving some of the economic problems. However, comparison of the workload at a Swedish ENT department with the Oregon list, one of the strictest prioritisation instruments yet devised, suggests that this is not the case. After adaptation of the Oregon list to the norms of Swedish practice (e.g., current policy regarding tonsillectomy, as elicited from Scandinavian studies), very little of the remaining workload would not be approved according to the Oregon list. Thus the scope for economy would appear to derive from professional skill in the internal planning of diagnostic investigation and treatment, rather than from the application of prioritisation systems devised by others.

Decision Making↗
PubMedDate not supplied

The Oregon priority-setting exercise: quality of life and public policy.

In 1989 the Oregon State legislature passed the Oregon Basic Health Services Act, which created a Health Services Commission charged with "developing a priority list of health services, ranging from the most important to the least important for the entire population to be served." The goal of this legislation was to permit the expansion of Medicaid to 100 percent of all Oregonians living in poverty by covering only services deemed to be of sufficient importance or priority...Instead, the OHSC developed a set of seventeen health service "categories," which described either a specific type of service...or, more generically, the expected outcomes of care... Commissioners formally ranked these seventeen categories in order of importance according to three subjective criteria: value to the individual, value to society, and whether the category seemed "necessary." Each treatment was then assigned to the single most appropriate category, based on Commissioners' judgment. Services were ranked within categories according to the degree of benefit expected from treatment... Estimates of how treatments affect quality of life were by far the single most important factor in determining the priority order on that list....

Biomedical Technology↗
PubMedDate not supplied

What happens now? Oregon and physician-assisted suicide.

With assisted suicide now legally sanctioned, health care professionals in Oregon face the challenge of implementing Oregon's Death with Dignity Act. Physicians, hospice professionals, pharmacists, and other caregivers may find their relationships with patients, families, and fellow professionals changing in unanticipated ways as all learn what it means to make aid in dying openly and compassionately available to patients at the end of life.

Aged↗
PubMed1998

Physician-assisted suicide: reflections on Oregon's first case.

The authors analyze Oregon's first reported assisted suicide of Mrs. A as a real life application of the Oregon Death with Dignity Act. They critique the effectiveness of the Act's safeguards as illustrated by the case of Mrs. A. They point out that the Act does not require that physicians be adequately trained in palliative care in order to participate in assisted suicide. Most physicians do not have such training. Without it, they are not able to effectively present alternatives to patients requesting assisted suicide. Most physicians also lack the expertise to assess patients' decision-making capacity. Nor does the Act ensure that physicians will be in a position to assess coercion of patients' decisions. The Act requires physicians to report only minimal information about their cases, and there are no enforcement provisions to see that even this is done. Under the Act, a good faith standard rather than the more usual negligence standard immunizes physicians from civil or criminal liability even when they act negligently. The authors demonstrate that the Act protects physicians more than patients, and encourages secrecy. The authors conclude that secrecy will need to be replaced by openness to permit the kind of examination the practice of assisted suicide warrants.

Confidentiality↗
PubMed1991

Prioritization of health care services. A progress report by the Oregon Health Services Commission.

The Oregon Health Services Commission is composed of a group of 11 consumers and health care professionals. It was appointed by the governor as required by the "Oregon Basic Health Services Act" to produce a prioritized list of health services ranked on the basis of their relative importance to populations served. Following actuarial analysis, the legislature will determine the extent to which the "list" of services can be funded to provide health care access for Medicaid recipients earning up to the 100th percentile of the federal poverty level. Prioritization will be based on a cost-benefit formula applied to each treatment/condition unit and assignment of each of these to a general category, which itself has been ranked on the basis of "public value."

Advisory Committees↗
PubMed1999

Vancomycin in Oregon: who's using it and why.

OBJECTIVE: To determine the proportion of vancomycin orders that are appropriate according to national guidelines and to identify targets for educational messages. DESIGN: Population-based study of vancomycin use in Oregon during a 3-week period. Survey of pharmacists, prospective flagging of vancomycin orders, and data abstraction from patient charts using standardized forms. SETTING: Nonpsychiatric hospitals in Oregon. RESULTS: Four (6%) of the 66 Oregon hospitals had pharmacy restrictions on initial vancomycin orders. Sixty-four (97%) of the hospitals participated in the study of indications for use; 293 vancomycin orders were reported; 3.8 courses were initiated per 1,000 patient-days. Indications for use were determined for 266 (91%); of these, 159 (60%) were deemed appropriate. Of uses for prophylaxis, empirical treatment of suspected gram-positive infection, and treatment of documented gram-positive infection, 57%, 56%, and 65%, respectively, were appropriate. Of hospitals with <250, 251-475, and >475 licensed beds, 65%, 58%, and 57% of vancomycin orders were appropriate. No single medical specialty accounted for >16% of inappropriate vancomycin use. CONCLUSIONS: Vancomycin was used inappropriately by physicians of many different specialties, in hospitals of all sizes, and in sundry clinical situations. The problem of inappropriate vancomycin use does not lend itself to solution by educational strategies targeted at specific subgroups; restrictions by hospital pharmacies may be required.

Anti-Bacterial Agents↗
PubMed1998

Bovine viral diarrhea virus strain Oregon: a novel mechanism for processing of NS2-3 based on point mutations.

Bovine viral diarrhea virus (BVDV) isolates can either be cytopathogenic (cp) or noncytopathogenic (noncp). While both biotypes express the nonstructural protein NS2-3, generation of NS3 strictly correlates with the cp phenotype. The production of NS3 is usually caused by cp specific genome alterations, which were found to be due to RNA recombination. Molecular analyses of the cp BVDV strain Oregon revealed that it does not possess such genome alterations but nevertheless is able to generate NS3 via processing of NS2-3. The NS3 serine protease is not involved in this cleavage, which, according to protein sequencing, occurs between amino acids 1589 and 1590 of the BVDV Oregon polyprotein. Transient-expression studies indicated that important information for the cleavage of NS2-3 is located within NS2. This was verified by expression of chimeric constructs containing cDNA fragments derived from BVDV Oregon and a noncp BVDV. It could be shown that the C-terminal part of NS2 plays a crucial role in NS2-3 cleavage. These data, together with results obtained by site-specific exchanges in this region, revealed a new mechanism for NS2-3 processing which is based on point mutations within NS2.

Amino Acid Sequence↗
PubMed2000

A 36-year history of fatal road rage in Marion County, Oregon: 1963-1998.

This paper documents the 36-year history, with five examples, of fatal road rage in Marion County, Oregon. Relevant details (all that were available) from each case are presented. Alcohol intoxication was present in four of our five cases. We include two deaths by gunshot at close range, two deaths as a result of a motor vehicle traffic accident, and one natural death. All subjects were males. Three were Caucasian and two were Hispanic. The three subjects in Cases 1, 2 and 3 were complete strangers to the occupants of the other involved vehicles. The subjects in Cases 4 and 5 (along with the occupants of their own vehicles) were acquaintances of the occupants of the involved vehicle. There appears to be no previous forensic, medical or psychiatric literature on road rage as such. We present an initial psychiatric evaluation of the perpetrators of this type of fatal assault. There are no specific statutes in Oregon, at the state or county levels, regarding road rage. However, the city of Gresham, Oregon, recently enacted an ordinance regarding road rage. We stress the need for further study of this phenomenon, especially through the use of the psychological-psychiatric autopsy.

Accidents, Traffic↗
PubMed2004

Oregon physicians' responses to requests for assisted suicide: a qualitative study.

In 1997, the Oregon Death with Dignity Act was enacted, allowing physicians to prescribe lethal dosages of medication to competent, terminally ill patients who request them. To improve our understanding of physicians' reactions to requests for assisted suicide, we performed semistructured interviews of 35 Oregon physicians who had received requests from patients. Interviews were completed in 2000, and audiotaped, transcribed, and analyzed using qualitative techniques. Requests for assisted suicide had a powerful impact on physicians and their practices. Physicians often felt unprepared, and experienced apprehension and discomfort before and after receiving requests. Prominent sources of discomfort included concerns about adequately managing symptoms and suffering, not wanting to abandon patients, and incomplete understanding of patients' preferences, especially when physicians did not know patients well. Participation in assisted suicide required a large investment of time and was emotionally intense. Regardless of whether they prescribed or not, physicians did not express major regrets about their decisions. Requests often facilitated discussion of important issues, and many physicians felt that the process increased their confidence and assertiveness in discussing end-of-life issues with other patients. Physicians rarely sought support from colleagues; instead, they tended to discuss emotional aspects of their experiences with their spouses.

Attitude of Health Personnel↗
PubMed2000

Life after death with dignity: the Oregon experience.

This article offers a framework for examination and overview of Oregon's Death with Dignity Act after its first year of implementation. This law became public policy on October 27, 1997, when all legal barriers were lifted. The law allows a terminally ill person to request a prescription to end life if she or he qualifies under the law's requirements. According to records, 23 Oregonians have received such a prescription, and 15 have used it. The effect of physician-assisted suicide (PAS) on clients and families, professional health care providers and agencies, and society and culture is explored through two questions: (1) What is known about PAS? and (2) What needs discovery and exploration? The reality of this end-of-life option has forever changed care of terminally ill individuals, and social workers may benefit from the Oregon experience.

Death↗
PubMed2001

Genetic privacy and academic medicine: the Oregon experience.

Legislators are considering the conflicting concerns of consumers, researchers, health care providers, and business in the rapidly developing area of genetics. The Oregon Genetic Privacy Act of 1995 was written to protect the individual's right to genetic privacy by providing legal protection for medical information, tissue samples, and DNA samples. This legislation has had an impact on the academic medical center of Oregon Health Sciences University (OHSU) with its teaching hospital and associated clinics, both in providing medical services and in research. This impact has occurred in several areas: (1) informed consent, (2) ownership of genetic information, and (3) security of medical information. It affects both patient care and research. OHSU and other academic medical centers have a mandate to provide leadership in the education of medical students, residents, and physicians about genetic privacy and the issues and areas affected by it. As genetic privacy legislation is developed and enacted at state and federal levels, the needs of individuals must be balanced with the needs of institutions and of research in the larger context of societal needs.

Academic Medical Centers↗
PubMed1997

The Oregon Death With Dignity Act: implementation issues.

Passage of the Oregon Death With Dignity Act in 1994 raises nationally relevant questions for health care organization, state agencies, and clinicians. As debate over physician-assisted suicide continues in the United States, the experiences in Oregon may offer insight into the clinical complexities of legalizing physician-assisted suicide.

Government Regulation↗
PubMed1998

Getting key players to work together and defending against diversion--Oregon.

In this report, the author, Executive Vice President of the American Cancer Society in Oregon, reviews the key factors in the crafting of the coalition leading to passage of a tobacco tax in Oregon. Mr. North also emphasizes the importance of institutionalizing the coalition after passage to provide the required leadership for future efforts.

Humans↗
PubMed1998

Designing an effective statewide tobacco control program--Oregon.

In this report, the author documents the first stages in the development and implementation of Oregon's tobacco control program. She briefly reviews the history of tobacco control coalitions in Oregon prior to the passage of Ballot Measure 44 and attributes much of the success to earlier coalition-building efforts.

Communication↗
PubMed2005

Mercury levels and relationships in water, sediment, and fish tissue in the Willamette Basin, Oregon.

In Oregon's Willamette River Basin (the Basin), health advisories currently limit consumption of fish that have accumulated methylmercury (MeHg) to levels posing a significant human health risk. These advisories created the requirement for a mercury total maximum daily load for the Basin, which required a greater understanding of the behavior, distribution, and levels of mercury and MeHg in the Basin. In 2002, the Oregon Department of Environmental Quality initiated a study to measure (using ultraclean techniques) mercury and MeHg levels in water, sediment, and fish samples collected throughout the Basin. Results from the Middle Fork (nominal background) suggested that naturally occurring surface-water concentrations of mercury and MeHg would on an annual average basis be expected in the range of 0.5 to 1.0 and 0.04 to 0.06 ng L(-1), respectively. Concentrations in the Coast Fork (Cottage Grove), which were markedly higher, are likely the result of historical mining discharges. The possibility exists that wetlands alone could contribute the dissolved MeHg levels (approximately 0.04 ng L(-1)) observed in the Main Stem. Mercury levels in sediment were similar, and near background, in the Main Stem, Coast Fork (Row River), and Middle Fork but significantly increased in the Coast Fork (Cottage Grove). Fish tissue mercury levels were typically highest in piscivorous and lowest in invertivorous species but highest in the Coast Fork (Cottage Grove). In the Coast Fork and Cottage Grove Reservoir, discharges from historical mercury mining activities appear to have significantly impacted water, sediment, and fish tissue levels; however these impacts do not appear to extend into the Main Stem. Basinwide mercury data are at present too spottily distributed to determine whether significant mercury point sources exist along the Main Stem.

Animals↗