159 research outputs found
Bioreactor analyses of tissue ingrowth, ongrowth and remodelling around implants: an alternative to live animal testing
Get PDFIntroduction: Preclinical assessment of bone remodelling onto, into or around novel implant technologies is underpinned by a large live animal testing burden. The aim of this study was to explore whether a lab-based bioreactor model could provide similar insight. Method: Twelve ex vivo trabecular bone cylinders were extracted from porcine femora and were implanted with additively manufactured stochastic porous titanium implants. Half were cultured dynamically, in a bioreactor with continuous fluid flow and daily cyclic loading, and half in static well plates. Tissue ongrowth, ingrowth and remodelling around the implants were evaluated with imaging and mechanical testing. Results: For both culture conditions, scanning electron microscopy (SEM) revealed bone ongrowth; widefield, backscatter SEM, micro computed tomography scanning, and histology revealed mineralisation inside the implant pores; and histology revealed woven bone formation and bone resorption around the implant. The imaging evidence of this tissue ongrowth, ingrowth and remodelling around the implant was greater for the dynamically cultured samples, and the mechanical testing revealed that the dynamically cultured samples had approximately three times greater push-through fixation strength (p < 0.05). Discussion: Ex vivo bone models enable the analysis of tissue remodelling onto, into and around porous implants in the lab. While static culture conditions exhibited some characteristics of bony adaptation to implantation, simulating physiological conditions with a bioreactor led to an accelerated response
Involvement of patients in The Compulsory Mental Healthcare Act according to health care professionals
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Involvement of patients in The Compulsory Mental Healthcare Act according to health care professionals
Get PDFInvolvement of patients in The Compulsory Mental Healthcare Act according to health care professionals
Get PDFBACKGROUND: In January 2020 the Compulsory Mental Healthcare Act (Dutch: Wvggz) was implemented. The Wvggz details the rights of patients with mental illness who require compulsory care. The law aims, amongst others, to improve the legal rights of patients and those close to them, for example by enabling the possibility to draw up their own action plan (AP) or care card.AIM: To explore what health care professionals think of the possibilities for involvement by patients and those close to them, enabled by the Wvggz.METHOD: A qualitative study in which health care professionals were interviewed about the possibilities for involvement by patients and those close to them. We used thematic analysis to study the data from the interviews.RESULTS: Health care professionals were positive about the idea to involve patients and those close to them, though they indicated that patients and those close to them were already involved before the law came into effect. The main difference was that their involvement was more documented, for instance patients can write their own AP or fill out a care card. Health care professionals mentioned that both the AP and the care card offer the possibility for patients and those close to them to express and realize their wishes. On the downside, not all patient groups were able to draw up their own plan of action. Furthermore, according to the health care professionals, both the action plan and care card could give patients the false impression that their wishes can always be acknowledged.CONCLUSION: Health care professionals mention that patients and those close to them were already involved before the law came into effect. However, the ways in which their involvement is arranged and documented are different.</p
Involvement of patients in The Compulsory Mental Healthcare Act according to health care professionals
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