Understanding Reproductive Healthcare and Outcomes Among Women Veterans: A Review of Recent Research and Future Opportunities
Presentation focused on reproductive health issues among women Veterans in VA care. In particular, examines patterns of healthcare utilization for gender-specific conditions among women Veterans, as well as beliefs and preferences for reproductive health care services within the VA healthcare system. Then explores innovative new research aimed at better understanding reproductive health services and outcomes among women Veterans.
Presentation looking at pregnancy and mental health care in the VA system. Documents a study examining the prevalence of pregnancy care and comparing the mental health diagnoses among pregnant and non-pregnant women in VA care. Then examining the degree to which pregnant veterans receive VA mental health care during their pregnancy. Concludes that pregnant women veterans using VA care have a substantial mental health burden.
This chapter in the Cancer Concepts textbook describes the principles of multi-disciplinary management, meaning multi-specialty physician management of malignancies. Tumor Boards are the model for multi-disciplinary management. They may be site specific or include the entire spectrum of malignancy. At Tumor Boards, staging workup and treatment recommendations are made collectively, and then the treatments are delivered by the respective modality specialists and their individual teams. Improved clinical decision making leading to superior survival for patients with some diseases and better quality of life has been documented with multi-disciplinary management. Just like curative patients, palliative patients require multi-disciplinary management.
Rapid prototyping amphiphilic polymer/hydroxyapatite composite scaffolds with hydration-induced self-fixation behavior
Two major factors hampering the broad use of rapid prototyped biomaterials for tissue engineering applications are the requirement for custom-designed or expensive research-grade three-dimensional (3-D) printers and the limited selection of suitable thermoplastic biomaterials exhibiting physical characteristics desired for facile surgical handling and biological properties encouraging tissue integration. Properly designed thermoplastic biodegradable amphiphilic polymers can exhibit hydration-dependent hydrophilicity changes and stiffening behavior, which may be exploited to facilitate the surgical delivery/self-fixation of the scaffold within a physiological tissue environment. Compared to conventional hydrophobic polyesters, they also present significant advantages in blending with hydrophilic osteoconductive minerals with improved interfacial adhesion for bone tissue engineering applications. Here we demonstrated the excellent blending of biodegradable, amphiphilic PLA-PEG-PLA (PELA) triblock co-polymer with hydroxyapatite (HA) and the fabrication of high-quality rapid prototyped 3-D macroporous composite scaffolds using an unmodified consumer-grade 3-D printer. The rapid prototyped HA-PELA composite scaffolds and the PELA control (without HA) swelled (66% and 44% volume increases, respectively) and stiffened (1.38-fold and 4-fold increases in compressive modulus, respectively) in water. To test the hypothesis that the hydration-induced physical changes can translate into self-fixation properties of the scaffolds within a confined defect, a straightforward in vitro pull-out test was designed to quantify the peak force required to dislodge these scaffolds from a simulated cylindrical defect at dry vs. wet states. Consistent with our hypothesis, the peak fixation force measured for the PELA and HA-PELA scaffolds increased 6-fold and 15-fold upon hydration, respectively. Furthermore, we showed that the low-fouling 3-D PELA inhibited the attachment of NIH3T3 fibroblasts or MSCs while the HA-PELA readily supported cellular attachment and osteogenic differentiation. Finally, we demonstrated the feasibility of rapid prototyping biphasic PELA/HA-PELA scaffolds for potential guided bone regeneration where an osteoconductive scaffold interior encouraging osteointegration and a non-adhesive surface discouraging fibrous tissue encapsulation is desired. This work demonstrated that by combining facile and readily translatable rapid prototyping approaches with unique biomaterial designs, biodegradable composite scaffolds with well-controlled macroporosities, spatially defined biological microenvironment, and useful handling characteristics can be developed.