COVID-19 Vaccine Uptake Among People Living with HIV.

People living with HIV (PLWH) are at greater risk for severe COVID-19 and are a priority population for COVID-19 vaccination. As of June 15, 2021, 61.6% of PLWH in Oregon received ≥ 1 COVID-19 vaccine dose. Younger PLWH, Hispanic/Latinx PLWH and PLWH who inject drugs or reside in rural and frontier areas had low vaccine uptake while PLWH who were engaged in care, enrolled in the AIDS Drug Assistance Program, and vaccinated against influenza had high vaccine uptake. Greater advocacy, education, and care navigation are required to increase COVID-19 vaccine access and uptake among PLWH.

Automating Case Reporting of Chlamydia and Gonorrhea to Public Health Authorities in Oregon Clinics.

BACKGROUND: Optimizing sexually transmitted disease (STD) reporting to state public health authorities is important to reduce incidence and manage outbreaks of STDs. Electronic laboratory reporting (ELR) is the standard through which local clinics report STDs to state public health authority. Electronic case reporting (eCR) is an alternative approach which automates transmission of case reports to public health jurisdictions using electronic health record (EHR) data. METHODS: Working with 3 community health centers in Oregon between February 3, 2020 and May 15, 2020, we piloted an automated eCR approach for gonorrhea (GC) and chlamydia (CT) from these clinics to the Oregon Health Authority. We compared the eCR approach to the existing ELR approach to determine completeness of case reporting for GC/CT. RESULTS: A total of 365 eCRs from 206 unique patients were generated. Among 154 instances where the case detection logic was satisfied for CT, 37% (54 instances) were based on the presence of a diagnosis and 63% (97 instances) were based on laboratory data. Among 232 instances where logic was satisfied for GC, 44% (102 instances) reflected a diagnosis and 56% (130 instances) reflected laboratory results. Data completeness was uniformly equal or higher for eCRs versus ELRs. CONCLUSIONS: The eCR approach was successful in identifying CT and GC cases and provided a more complete set of information to assist public health authorities when compared with ELRs. Electronic case reporting has the potential to automate and relieve staff burden on an important reporting requirement for clinical providers.

Building a chiropractic academy of educators: A needs assessment of selected faculty educators.

OBJECTIVE: Professional demands have led to health-care educator specialization in research or patient care. The academy movement is an avenue that attempts to return prestige and importance to improved instruction. The authors performed a needs analysis of selected faculty at 3 chiropractic colleges to assess the need for, and willingness to participate in, an academy of educators program. METHODS: An expert-developed, pretested survey was deployed using SurveyMonkey. Analysis of variance and regression analysis were used to address 3 research questions related to the academy of educators program. RESULTS: The study achieved a 53% response rate and reflected that an overwhelming majority of chiropractic faulty members (89%) reported the need for an academy of educators. The study found no significant differences between faculty ranks, years of experience, and participation willingness. CONCLUSION: A structured approach, such as an academy, to foster professional teaching development may create positive outcomes for an institution. Faculty educators were willing to engage in an efficient program that may improve teaching methods and create opportunities for collaborative working relationships, which signals the potential for wide acceptance of the program.

Uterine perforation and migration of an intrauterine contraceptive device in a 24-year-old patient seeking care for abdominal pain.

OBJECTIVE: The purpose of this case report is to describe the case of a 24-year-old woman complaining of diffuse abdominal pain following insertion of an intrauterine contraceptive device (IUC). METHODS: A 24-year-old woman, 8 weeks postpartum, sought chiropractic care for intermittent stabbing pain in her left upper quadrant that had been present for a week. She returned 1 week later with no resolution of her complaint. She then recalled that, at her 6-week gynecological examination, she had undergone insertion of an IUC and that the abdominal pain had begun a week later. She was advised to return to her gynecologist. Subsequent evaluation by the gynecologist revealed that the IUC had perforated her uterus and had migrated to the upper left quadrant of her abdomen, where it was found anterior to the L1-2 vertebral bodies, lying in contact with the anterior surface of the abdominal aorta. To our knowledge, this is the only report of this type of presentation in a chiropractic office. RESULTS: The initial intervention with this patient included chiropractic adjustment and myofascial release. At her subsequent visit, with no resolution of her complaint, she was referred back to her gynecologist for additional evaluation. Because the IUC had perforated her uterus, she underwent emergency laparoscopic surgery. The surgery was successful, and she recovered fully. CONCLUSION: Chiropractic physicians should consider uterine perforation by IUC in the differential diagnosis of a female patient of childbearing age seeking care for abdominal pain.

A case study utilizing Vojta/Dynamic Neuromuscular Stabilization therapy to control symptoms of a chronic migraine sufferer.

INTRODUCTION: Migraine is a complex disorder of the brain characterized by severe headache, photophobia, phonophobia, and nausea. This case report demonstrated the reduction of a 49-year-old female's chronic migraine symptoms after 12 weeks of Vojta/Dynamic Neuromuscular Stabilization (DNS) therapy. METHODS: Vojta/DNS treatment occurred either in the office or at home over a 12-week period. Symptoms were tracked via a patient diary, a VAS pain scale, and a Headache Disability Index (HDI). RESULTS: The patient's migraine symptoms were typically of 3 days duration, a frequency of 8-10 times per month, and an intensity of 10/10 on a VAS pain scale. After a 12-week trial of Vojta/DNS care, subjective improvements were noted, with a reduction in frequency to 1-2 times per month, duration of 12 h at most, and decreased intensity to a 2/10 on a VAS pain scale. HDI scores dropped from 48% to 34%. DISCUSSION: This therapy reduced the patient migraine sysmptoms in frequency, duration and intensity. This therapy is not well-known in North America despite its use for over 40 years in Europe. CONCLUSION: This case demonstrated that Vojta/DNS treatment over a 12-week period helped manage the patient's migraines and could be a possible treatment option for future research.