An update on the current and future demand for care of pelvic floor disorders in the United States

Roughly three million women in the United States give birth vaginally each year [1]. Clinically, the vagina undergoes pronounced adaptations up to the time of delivery, presumably to afford passage of the fetus [2]. Our group has suggested that if these adaptations are not sufficient or if fetus size is too large, an injury to the vagina or its supportive tissues will likely result. Vaginal injury at the time of delivery occurs quite frequently and research examining the levator ani muscle, the major muscular component of the pelvic floor, revealed injury in up to 20% of women who have given birth vaginally [3]. Therefore, vaginal birth is considered one of the greatest risk factors for pelvic floor disorders (i.e. urinary dysfunction and pelvic organ prolapse) later in life.

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Tensile Properties of the Swine Cardinal Ligament

Volume 1B: Extremity; Fluid Mechanics; Gait; Growth, Remodeling, and Repair; Heart Valves; Injury Biomechanics; Mechanotransduction and Sub-Cellular Biophysics; MultiScale Biotransport; Muscle, Tendon and Ligament; Musculoskeletal Devices; Multiscale Mechanics; Thermal Medicine; Ocular Biomechanics; Pediatric Hemodynamics; Pericellular Phenomena; Tissue Mechanics; Biotransport Design and Devices; Spine; Stent Device Hemodynamics; Vascular Solid Mechanics; Student Paper and Design Competitions ◽

10.1115/sbc2013-14294 ◽

2013 ◽

Author(s):

Frances M. Davis ◽

Ting Tan ◽

Suzanne Nicewonder ◽

Raffaella De Vita

Keyword(s):

Public Health ◽

United States ◽

Pelvic Floor Disorders ◽

The United States ◽

Pelvic Organ ◽

Health Concern ◽

Adult Women ◽

Public Health Concern ◽

Connective Tissues ◽

Pelvic Organs

Pelvic floor disorders such as urinary incontinence, fecal incontinence, and pelvic organ prolapse represent a major public health concern in the United States affecting one third of adult women [1]. These disorders are determined by structural and mechanical alterations of the pelvic organs, their supporting muscles and connective tissues that occur mainly during pregnancy, vaginal delivery, and aging [1].

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Workshop for Teachers of Introductory Astronomy

International Astronomical Union Colloquium ◽

10.1017/s0252921100086462 ◽

1990 ◽

Vol 105 ◽

pp. 80-82

Author(s):

George S. Mumford

Keyword(s):

United States ◽

College Students ◽

World Wide ◽

Cosmic Strings ◽

The United States ◽

The Future ◽

Future Demand

As interest in astronomy develops through missions to Mars, SETI, and heaven-only-knows-what earth-shaking new discoveries in the future, demand for astronomy courses at all levels will increase. Without adequate numbers of professional astronomers to teach them, persons from other fields will be thrown into the breech. Already a significant number of college students in the United States are receiving instruction from persons not trained in astronomy. I suspect that this is currently true world-wide, especially as physicists who adopt our field for their research on neutrinos or cosmic strings are assigned or volunteer to teach elementary courses.

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Stress Urinary Incontinence I: Nonsurgical Management

10.2310/obg.19149 ◽

2020 ◽

Author(s):

Svjetlana Lozo ◽

Sylvia M Botros

Keyword(s):

United States ◽

Urinary Incontinence ◽

Stress Urinary Incontinence ◽

Pelvic Floor ◽

The United States ◽

Pharmacologic Therapy ◽

Bulking Agents ◽

Urethral Bulking Agents ◽

Nonsurgical Management ◽

Urethral Bulking

Conservative management of stress urinary incontinence (SUI) is generally offered as first-line treatment. Such treatment options include behavioral therapy, pelvic floor muscle therapy, vaginal devices, pharmacologic therapy, and urethral bulking agents. Weight loss management is an example of an effective behavioral strategy in obese patients. Pelvic floor physical therapy alone or under the supervision of skilled providers can significantly improve SUI; however, long-term effects are harder to maintain. Pessaries, vaginal cones, and vaginal inserts have been widely used for treatment of SUI and are beneficial in patients who are motivated to use them. Currently in the United States, there is no FDA-approved medication for the treatment of SUI. Conversely, the European Union has approved and used duloxetine. Urethral bulking agents are indicated for patients with intrinsic sphincter deficiency and sometimes used in patients who are not able to undergo surgical procedures for SUI or who have failed said procedures. Three materials are currently FDA approved for urethral bulking in the United States. Many options exist for the nonsurgical management of SUI. This review contains 5 tables and 47 references Key words: Stress Urinary Incontinence, conservative treatment, urethral bulking, pelvic floor exercises, incontinence pessaries.

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Socioeconomic and Physician Supply Determinants of Racial Disparities in Colorectal Cancer Screening

Journal of Oncology Practice ◽

10.1200/jop.2011.000511 ◽

2012 ◽

Vol 8 (5) ◽

pp. e125-e134 ◽

Cited By ~ 20

Author(s):

Samir Soneji ◽

Katrina Armstrong ◽

David A. Asch

Keyword(s):

Colorectal Cancer ◽

United States ◽

Health Care ◽

Cancer Screening ◽

Racial Disparities ◽

Colorectal Cancer Screening ◽

Health Care System ◽

The United States ◽

Physician Supply ◽

Future Demand

Whether the United States is able to equitably meet future demand for colorectal cancer screening may depend on access, physician supply, and organization of the health care system.

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