Historical development and current status of organ procurement from death-row prisoners in China.

PubMed

Allison, Kirk C; Caplan, Arthur; Shapiro, Michael E; Els, Charl; Paul, Norbert W; Li, Huige

2015-12-03

In December 2014, China announced that only voluntarily donated organs from citizens would be used for transplantation after January 1, 2015. Many medical professionals worldwide believe that China has stopped using organs from death-row prisoners. In the present article, we briefly review the historical development of organ procurement from death-row prisoners in China and comprehensively analyze the social-political background and the legal basis of the announcement. The announcement was not accompanied by any change in organ sourcing legislations or regulations. As a fact, the use of prisoner organs remains legal in China. Even after January 2015, key Chinese transplant officials have repeatedly stated that death-row prisoners have the same right as regular citizens to "voluntarily donate" organs. This perpetuates an unethical organ procurement system in ongoing violation of international standards. Organ sourcing from death-row prisoners has not stopped in China. The 2014 announcement refers to the intention to stop the use of organs illegally harvested without the consent of the prisoners. Prisoner organs procured with "consent" are now simply labelled as "voluntarily donations from citizens". The semantic switch may whitewash sourcing from both death-row prisoners and prisoners of conscience. China can gain credibility only by enacting new legislation prohibiting use of prisoner organs and by making its organ sourcing system open to international inspections. Until international ethical standards are transparently met, sanctions should remain.

42 CFR 413.200 - Payment of independent organ procurement organizations and histocompatibility laboratories.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Payment of independent organ procurement... SKILLED NURSING FACILITIES Payment for End-Stage Renal Disease (ESRD) Services and Organ Procurement Costs § 413.200 Payment of independent organ procurement organizations and histocompatibility laboratories. (a...

Marketing human organs: the autonomy paradox.

PubMed

Marshall, P A; Thomasma, D C; Daar, A S

1996-03-01

The severe shortage of organs for transplantation and the continual reluctance of the public to voluntarily donate has prompted consideration of alternative strategies for organ procurement. This paper explores the development of market approaches for procuring human organs for transplantation and considers the social and moral implications of organ donation as both a "gift of life" and a "commodity exchange." The problematic and paradoxical articulation of individual autonomy in relation to property rights and marketing human body parts is addressed. We argue that beliefs about proprietorship over human body parts and the capacity to provide consent for organ donation are culturally constructed. We contend that the political and economic framework of biomedicine, in western and non-western nations, influences access to transplantation technology and shapes the form and development of specific market approaches. Finally, we suggest that marketing approaches for organ procurement are and will be negotiated within cultural parameters constrained by several factors: beliefs about the physical body and personhood, religious traditions, economic conditions, and the availability of technological resources.

Tissue procurement system in Japan: the role of a tissue bank in medical center for translational research, Osaka University Hospital.

PubMed

Ohkawara, H; Fukushima, N; Kitagawa, T; Ito, T; Masutani, Y; Sawa, Y

2010-01-01

Although organ procurement has been regulated by The Organ Transplantation Law (brain-dead donors since 1997, donors after cardiac death since 1979), there has been no law or governmental procurement network (except for cornea) in Japan. Since the late 1980s, some university hospitals have developed original banks. Finally, in 2001 guidelines for tissue procurement were established by The Japanese Society of Tissue Transplantation and Japan Tissue Transplant Network (JTTN) to coordinate tissue harvesting. Five tissue banks were joined to the tissue transplant network (skin in one, heart valves in two, and bone in two). As the number of tissue banks is small, each bank cooperates on procurement, but cannot cover the entire country. With regard to skin transplantation, only one skin bank-The Japan Skin Bank Network (JSBN), which is located in Tokyo-has organized skin procurement. Therefore, it has been difficult to procure skin in areas distant from Tokyo, especially around Osaka. In order to improve such a situation, a tissue bank collaborating with the JSBN was established at The Medical Center for Translational Research (MTR), Osaka University Hospital in April 2008. The bank has played a role in skin procurement center in western Japan and supported procurement and preservation at the time of the skin procurement. Between April 2008 and September 2009, the bank participated in eight tissue procurements in the western area. In the future, the bank is planning to procure and preserve pancreatic islets and bones. Moreover, there is a plan to set up an induced pluripotent stem cells center and stem cell bank in MTR. This tissue bank may play a role to increase tissue procurement in Japan, especially in the western area. .

The model and moral justification for organ procurement in Japan.

PubMed

Bagheri, Alireza; Shoji, Shin'ichi

2005-01-01

Organ replacement therapy is a part of medical practice in today's world and many countries have adopted the required guidelines and regulations. Establishing the basis on which organs can be removed, is still one of the most controversial issues of health policy making in the debate. The critical disparity between supply and demand in organ replacement therapy, even with the existence of social acceptance and organ transplantation law, turns attention towards the importance of an appropriate model of organ procurement. This model should be able to expand the donor pool and increase the organ retrieval rate by converting potential donors to actual ones. In Japan the organ transplantation law which was enacted in 1997 allows organ procurement from brain death as well as non-heart beating cadavers according to restricted conditions. One such condition includes the necessity of both the donor's and the family's written consent. Under current organ procurement policy, organs from only 29 brain death cases have been so far procured. In this paper after examining the current organ procurement system in Japan and the moral justifications behind different organ procurement models we conclude that the Japanese system does not clearly fall into one of the popular organ procurement models.

Improving donation outcomes: hospital development and the Rapid Assessment of Hospital Procurement Barriers in Donation.

PubMed

Siminoff, Laura A; Traino, Heather M

2009-06-01

Deficiencies in the donation process continue to contribute to the shortage of organs available for transplant. Continuous quality improvement of hospitals' donation processes is needed to identify and correct the problems. To test the Rapid Assessment of Hospital Procurement Barriers in Donation (RAPiD), a direct observation technique with a focused ethnographic strategy, for assessing hospitals' donation processes and identifying areas in need of continuous quality improvement interventions. A pre-post assessment of hospitals' barriers to patient identification and referral, and family consent to donation. Seventeen hospitals within the catchment area of a Northeastern organ procurement organization were assessed by using the RAPiD method. Hospital administrators, health care providers, and staff (N = 537) were interviewed as part of the assessments. Interventions, including on-site training and education, and the use of in-house coordinators, were specifically tailored to each hospital's unique set of barriers to donation. The interventions were delivered to the hospitals in the form of recommendations. The participating organ procurement organization was responsible for implementation of the interventions. The RAPiD hospital evaluations revealed gaps in respondents' knowledge of organ donation, brain death, and referral criteria; a reluctance to declare brain death; and a rocky relationship between the hospitals and the organ procurement organization. As a result of the interventions, 9 hospitals' environments for organ donation improved, 7 showed no change, and 1 was worse.

The potential supply of organ donors. An assessment of the efficacy of organ procurement efforts in the United States.

PubMed

Evans, R W; Orians, C E; Ascher, N L

1992-01-08

To estimate the potential supply of organ donors and to measure the efficiency of organ procurement efforts in the United States. A geographic database has been developed consisting of multiple cause of death and sociodemographic data compiled by the National Center for Health Statistics. All deaths are evaluated as to their potential for organ donation. Two classes of potential donors are identified: class 1 estimates are restricted to causes of death involving significant head trauma only, and class 2 estimates include class 1 estimates as well as deaths in which brain death was less probable. Over 23,000 people are currently awaiting a kidney, heart, liver, heart-lung, pancreas, or lung transplantation. Donor supply is inadequate, and the number of donors remained unchanged at approximately 4000 annually for 1986 through 1989, with a modest 9.1% increase in 1990. Between 6900 and 10,700 potential donors are available annually (eg, 28.5 to 43.7 per million population). Depending on the class of donor considered, organ procurement efforts are between 37% and 59% efficient. Efficiency greatly varies by state and organ procurement organization. Many more organ donors are available than are being accessed through existing organ procurement efforts. Realistically, it may be possible to increase by 80% the number of donors available in the United States (up to 7300 annually). It is conceivable, although unlikely, that the supply of donor organs could achieve a level to meet demand.

Sequential improvements in organ procurement increase the organ donation rate.

PubMed

Billeter, Adrian T; Sklare, Seth; Franklin, Glen A; Wright, Jerry; Morgan, Gary; O'Flynn, Paul E; Polk, Hiram C

2012-11-01

Organ demand exceeds availability of transplantable organs. Organ procurement continues to suffer from failures to identify potential donors, inability to obtain consent for donation, as well as failures to retrieve certain organs as donor demographics change. The purpose of this article is to propose how sequentially introduced measures can increase organ donation rates as well as improve organ procurement. We analysed the effect of stepwise improvements in the organ procurement process patients in a university-based surgical intensive care unit over a 20-year period. We related newly introduced measures in the organ retrieval process with changes in donation rates. We specifically targeted these three main steps in the donation process: donor identification, conversion of potential donors to actual donors, and organ protection during the procurement process. Finally, we assessed the effect of the same measures on organ procurement after introduction in other hospitals of the same organ procurement region. Introduction of quality improvement steps increased all of the observed parameters. The number of organ donors was stabilised due to a better identification of potential donors, a major increase in conversion from potential to actual donors, and an increase in extended criteria donor. Improvements in organ protection led to higher rates of organs transplanted per donor and increased recovery of lungs and hearts despite increasing donor age. The same measures were introduced successfully in other hospitals in our organ procurement region. Sequential improvements in organ procurement can increase the yield of retrieved organs. The same measures can be applied to other hospitals and lead to comparable improvements in organ donation. Published by Elsevier Ltd.

Total Face, Eyelids, Ears, Scalp, and Skeletal Subunit Transplant Research Procurement: A Translational Simulation Model.

PubMed

Sosin, Michael; Ceradini, Daniel J; Hazen, Alexes; Sweeney, Nicole G; Brecht, Lawrence E; Levine, Jamie P; Staffenberg, David A; Saadeh, Pierre B; Bernstein, G Leslie; Rodriguez, Eduardo D

2016-05-01

Cadaveric face transplant models are routinely used for technical allograft design, perfusion assessment, and transplant simulation but are associated with substantial limitations. The purpose of this study was to describe the experience of implementing a translational donor research facial procurement and solid organ allograft recovery model. Institutional review board approval was obtained, and a 49-year-old, brain-dead donor was identified for facial vascularized composite allograft research procurement. The family generously consented to donation of solid organs and the total face, eyelids, ears, scalp, and skeletal subunit allograft. The successful sequence of computed tomographic scanning, fabrication and postprocessing of patient-specific cutting guides, tracheostomy placement, preoperative fluorescent angiography, silicone mask facial impression, donor facial allograft recovery, postprocurement fluorescent angiography, and successful recovery of kidneys and liver occurred without any donor instability. Preservation of the bilateral external carotid arteries, facial arteries, occipital arteries, and bilateral thyrolinguofacial and internal jugular veins provided reliable and robust perfusion to the entirety of the allograft. Total time of facial procurement was 10 hours 57 minutes. Essential to clinical face transplant outcomes is the preparedness of the institution, multidisciplinary face transplant team, organ procurement organization, and solid organ transplant colleagues. A translational facial research procurement and solid organ recovery model serves as an educational experience to modify processes and address procedural, anatomical, and logistical concerns for institutions developing a clinical face transplantation program. This methodical approach best simulates the stressors and challenges that can be expected during clinical face transplantation. Therapeutic, V.

Ethics and regulation in organ procurement research.

PubMed

Ackerman, Terrence F; Winsett, Rebecca P

2002-12-01

This article explores the role of ethics and regulation in human research conducted by organ procurement agencies; basic ethical principles for human research are outlined. Organ procurement agencies are not required to observe federal regulations; however, voluntary adherence will ensure that procurement research is conducted according to current standards of ethical practice. Although most organ procurement research will qualify for exempt status, this determination should be made by an institutional review board. Even if studies qualify for exempt status, there is a moral presumption that informed consent should be sought, unless certain narrow conditions for waiver of consent are satisfied. Finally, when future research utilizing organ procurement records is anticipated, procurement coordinators should provide sufficiently detailed information to families about such plans to permit their advance informed consent to research activities.

Experiential learning not enough for organ procurement surgery: implications for perioperative nursing education.

PubMed

Smith, Zaneta; Leslie, Gavin; Wynaden, Dianne

2015-12-01

Perioperative nurses play a vital role in assisting in surgical procedures for multiorgan procurement, receiving little education apart from on-the-job experiential learning when they are asked to participate in these procedures. Within an Australian context and as part of a larger study, this article describes issues that hindered perioperative nurses' participatory experiences as a result of lacking education, previous exposure, and preparation for assisting in surgical procedures for organ procurement. The grounded theory method was used to develop a substantive theory of perioperative nurses' experiences of participating in surgical procedures for multiorgan procurement. Thirty-five perioperative nurses who had experience in surgical procedures for organ procurement from regional, rural, and metropolitan hospitals of 2 Australian states, New South Wales and Western Australia, participated in the research. Levels of knowledge and experience emerged from the data as an influencing condition and was reported to affect the perioperative nurses' participatory experiences when assisting in procurement surgical procedures. Six components of levels of knowledge and experience were identified and are described. The findings from this study provide a unique contribution to the existing literature by providing an in-depth understanding of the educational needs of perioperative nurses in order to assist successfully in multiorgan procurement procedures. These findings could guide further research with implications for clinical initiatives or education programs specifically targeting the perioperative nursing profession both locally and internationally.

22 CFR 226.43 - Competition.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Competition. 226.43 Section 226.43 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ADMINISTRATION OF ASSISTANCE AWARDS TO U.S. NON-GOVERNMENTAL ORGANIZATIONS Post-award Requirements Procurement Standards § 226.43 Competition. All procurement transactions...

Professional education and hospital development for organ donation.

PubMed

Fukushima, N; Konaka, S; Kato, O; Ashikari, J

2012-05-01

Because of the strict Organ Transplantation Act, only 81 brain dead (BD) organ donations had been performed in Japan for 13 years since 1997. The Act was revised on July 17, 2010, allowing, organs to be donated after BD with consent from the family, if the subject had not denied organ donation previously. This act has lead to an expectation of a 6-7-fold increase in BD donation. The 82 organ procurement coordinators (OPC) in Japan include 32 belonging to the Japanese Organ Network (JOT) and the others to each administrative division. JOT has guideline manuals of standard roles and procedures of OPC during organ procurement from BD and cardiac death donors. To manage the increased organ donations after the revision of the act, we have modified the education system. First, we modified the guideline manuals for OPC to correspond to the revised Transplant Act and governmental guidelines. Second, all OPC gathered in a meeting room to learn the new organ procurement system to deal with the revised Transplant Act and guidelines. Third, a special education program for 2 months was provided for the 10 newcomers. Last, the practical training in each donor case for newcomers was performed by older OPC. Topics of the education program were the revised transplant act and guidelines, family approach to organ donation, BD diagnosis, donor evaluation and management, organ procurement and preservation, allocation system, hospital development and family care. In the future, each OPC will be divided into special categories, such as the donor family OPC, the donor management OPC, and the operating room OPC. Therefore, we need to construct separate special education programs for each category. Copyright © 2012 Elsevier Inc. All rights reserved.

77 FR 31041 - Draft Standards and Best Practices for Interaction Between Medical Examiner/Coroner and Organ and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-24

... Best Practices for Interaction Between Medical Examiner/Coroner and Organ and Tissue Procurement... titled ``Organ and Tissue Procurement Committee Standards and Best Practices for Interaction Between Medical Examiner/Coroner Offices and Organ Tissue Procurement Organizations'' from May 12, 2012, to June...

78 FR 19269 - Medicare and Medicaid Programs; Announcement of Application From a Hospital Requesting Waiver for...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-29

... Procurement Service Area AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Notice with... require the hospital to enter into an agreement with its designated Organ Procurement Organization (OPO... Organ Procurement Organizations (OPOs) are not-for-profit organizations that are responsible for the...

Lung Focused Resuscitation at a Specialized Donor Care Facility Improves Lung Procurement Rates.

PubMed

Chang, Stephanie H; Kreisel, Daniel; Marklin, Gary F; Cook, Lindsey; Hachem, Ramsey; Kozower, Benjamin D; Balsara, Keki R; Bell, Jennifer M; Frederiksen, Christine; Meyers, Bryan F; Patterson, G Alexander; Puri, Varun

2018-05-01

Lung procurement for transplantation occurs in approximately 20% of brain dead donors and is a major impediment to wider application of lung transplantation. We investigated the effect of lung protective management at a specialized donor care facility on lung procurement rates from brain dead donors. Our local organ procurement organization instituted a protocol of lung protective management at a freestanding specialized donor care facility in 2008. Brain dead donors from 2001 to 2007 (early period) were compared with those from 2009 to 2016 (current period) for lung procurement rates and other solid-organ procurement rates using a prospectively maintained database. An overall increase occurred in the number of brain dead donors during the study period (early group, 791; late group, 1,333; p < 0.0001). The lung procurement rate (lung donors/all brain dead donors) improved markedly after the introduction of lung protective management (early group, 157 of 791 [19.8%]; current group, 452 of 1,333 [33.9%]; p < 0.0001). The overall organ procurement rate (total number of organs procured/donor) also increased during the study period (early group, 3.5 organs/donor; current group, 3.8 organs/donor; p = 0.006). Lung protective management in brain dead donors at a specialized donor care facility is associated with higher lung utilization rates compared with conventional management. This strategy does not adversely affect the utilization of other organs in a multiorgan donor. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Donor conversion and procurement failure: the fate of our potential organ donors.

PubMed

Branco, Bernardino C; Inaba, Kenji; Lam, Lydia; Salim, Ali; Barmparas, Galinos; Teixeira, Pedro G R; Talving, Peep; Demetriades, Demetrios

2011-02-01

Donor availability remains the primary limiting factor for organ transplantation today. The purpose of this study was to examine the causes of procurement failure amongst potential organ donors. After Institutional Review Board approval, all surgical intensive care unit (SICU) patients admitted to the LAC+USC Medical Center from 01/2006 to 12/2008 who became potential organ donors were identified. Demographics, clinical data, and procurement data were abstracted. In non-donors, the causes of procurement failure were documented. During the 3-year study period, a total of 254 patients were evaluated for organ donation. Mean age was 44.8±18.7 years; 191 (75.2%) were male, 136 (53.5%) were Hispanic, and 148 (58.3%) were trauma patients. Of the 254 patients, 116 (45.7%) were not eligible for donation: 34 had multi-system organ failure, 24 did not progress to brain death and had support withdrawn, 18 had uncontrolled sepsis, 15 had malignancy, 6 had human immunodeficiency virus or hepatitis B or C, and 19 patients had other contraindications to organ donation. Of the remaining 138 eligible patients, 83 (60.2%) did not donate: 56 because the family denied consent, 9 by their own choice. In six, next of kin could not be located, five died because of hemodynamic instability before organ procurement was possible, four had organs that could not be placed, and three had their organs declined by the organ procurement organization. The overall consent rate was 57.5% (n=67). From the 55 donors, 255 organs were procured (yield 4.6 organs/donor). Of all patients screened for organ donation, only a fifth actually donated. Denial of consent was the major potentially preventable cause of procurement failure, whereas hemodynamic instability accounted for only a small percentage of donor losses. With such low conversion rates, the preventable causes of procurement failure warrant further study.

Benchmarking organ procurement organizations: a national study.

PubMed Central

Ozcan, Y A; Begun, J W; McKinney, M M

1999-01-01

OBJECTIVE: An exploratory examination of the technical efficiency of organ procurement organizations (OPOs) relative to optimal patterns of production in the population of OPOs in the United States. DATA SOURCES: A composite data set with the OPO as the unit of analysis, constructed from a 1995 national survey of OPOs (n = 64), plus secondary data from the Association of Organ Procurement Organizations and the United Network for Organ Sharing. STUDY DESIGN: The study uses data envelopment analysis (DEA) to evaluate the technical efficiency of all OPOs. PRINCIPAL FINDINGS: Overall, six of the 22 larger OPOs (27 percent) are classified as inefficient, while 23 of the 42 smaller OPOs (55 percent) are classified as inefficient. Efficient OPOs recover significantly more kidneys and extrarenal organs; have higher operating expenses; and have more referrals, donors, extrarenal transplants, and kidney transplants. The quantities of hospital development personnel and other personnel, and formalization of hospital development activities in both small and large OPOs, do not significantly differ. CONCLUSIONS: Indications that larger OPOs are able to operate more efficiently relative to their peers suggest that smaller OPOs are more likely to benefit from technical assistance. More detailed information on the activities of OPO staff would help pinpoint activities that can increase OPO efficiency and referrals, and potentially improve outcomes for large numbers of patients awaiting transplants. PMID:10536974

Computerized engineering logic for procurement and dedication processes

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tulay, M.P.

1996-12-31

This paper summarizes the work performed for designing the system and especially for calculating on-line expected performance and gives some significant results. In an attempt to better meet the needs of operations and maintenance organizations, many nuclear utility procurement engineering groups have simplified their procedures, developed on-line tools for performing the specification of replacement items, and developed relational databases containing part-level information necessary to automate the procurement process. Although these improvements have helped to reduce the engineering necessary to properly specify and accept/dedicate items for nuclear safety-related applications, a number of utilities have recognized that additional long-term savings can bemore » realized by integrating a computerized logic to assist technical procurement engineering personnel.« less

Vaccine procurement and self-sufficiency in developing countries.

PubMed

Woodle, D

2000-06-01

This paper discusses the movement toward self-sufficiency in vaccine supply in developing countries (and countries in transition to new economic and political systems) and explains special supply concerns about vaccine as a product class. It traces some history of donor support and programmes aimed at self-financing, then continues with a discussion about self-sufficiency in terms of institutional capacity building. A number of deficiencies commonly found in vaccine procurement and supply in low- and middle-income countries are characterized, and institutional strengthening with procurement technical assistance is described. The paper also provides information about a vaccine procurement manual being developed by the United States Agency for International Development (USAID) and the World Health Organization (WHO) for use in this environment. Two brief case studies are included to illustrate the spectrum of existing capabilities and different approaches to technical assistance aimed at developing or improving vaccine procurement capability. In conclusion, the paper discusses the special nature of vaccine and issues surrounding potential integration and decentralization of vaccine supply systems as part of health sector reform.

Lives and choices, give and take: Altruism and organ procurement.

PubMed

Thornton, Vicky

2017-01-01

In 2015, Wales introduced a deemed consent: soft opt-out system for organ procurement in order to address the chronic shortage of organs for transplant. Early statistical evidence suggests that this has had a positive impact on cadaveric organ donation. Such a system for procurement has previously been dismissed by the Organ Donation Taskforce, who suggested that opting out could potentially undermine the concept of donated organs as gifts and this could then negatively impact the number of organs offered for transplant. Considerable weight was placed upon the need to retain the altruistic gift element associated with an opt-in system. This article will consider the role of altruism in an organ procurement policy. A broad utilitarian approach will be taken when putting forward the arguments in favour of adopting a weak altruism position in a soft opt-out system for procurement with a combined registry.

The organization of organ procurement.

PubMed

Prottas, J M

1989-01-01

The American organ procurement system has improved and matured in the last five years. At the same time, the basic challenges facing it have remained substantially the same because the moral and legal framework of the system has not changed. Success at organ procurement continues to depend on the voluntary cooperation of medical professionals and the families of potential organ donors. The generosity of the American public is so great that the primary challenge facing organ procurement agencies is obtaining cooperation from hospitals and medical professionals. This calls for a "marketing" orientation aimed at those hospitals and professionals who are most likely to treat potential donors. The last five years have seen a more general acceptance of this appreciation of the central task of organ procurement. As a result, the overall effectiveness of the system has improved, as measured by the number of organs procured on a per capita basis and by the number of multiorgan donors obtained. Much of this improvement can be attributed to the diffusion of organizational techniques and approaches, and this diffusion has been encouraged by the involvement of national organizations and public bodies in the organ procurement community. The system remains uneven in its effectiveness and further improvement is possible. It is also possible that the next general round of improvement will result from the application of businesslike information management and marketing techniques.

75 FR 33195 - Defense Federal Acquisition Regulation Supplement; New Designated Country-Taiwan-DFARS Case 2009...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-11

... Organization Government Procurement Agreement. DATES: Effective date: June 11, 2010. FOR FURTHER INFORMATION..., Taiwan became a designated country under the World Trade Organization Government Procurement Agreement... World Trade Organization Government Procurement Agreement countries in the trade agreement provisions...

Association between Organ Procurement Organization Social Network Centrality and Kidney Discard and Transplant Outcomes1

PubMed Central

Butala, Neel M.; King, Marissa D.; Reitsma, William; Formica, Richard N.; Abt, Peter L.; Reese, Peter P.; Parikh, Chirag R.

2015-01-01

Background Given growth in kidney transplant waitlists and discard rates, donor kidney acceptance is an important problem. We used network analysis to examine whether organ procurement organization (OPO) network centrality affects discard and outcomes. Methods We identified 106,160 deceased-donor kidneys recovered for transplant from 2000–2010 in SRTR. We constructed the transplant network by year with each OPO representing a node and each kidney-sharing relationship between OPOs representing a directed tie between nodes. Primary exposures were the number of different OPOs to which an OPO has given a kidney or from which an OPO has received a kidney in year preceding procurement year. Primary outcomes were discard, cold-ischemia time, delayed graft function, and 1-year graft loss. We used multivariable regression, restricting analysis to the 50% of OPOs with highest discard and stratifying remaining OPOs by kidney volume. Models controlled for kidney donor risk index, waitlist time, and kidney pumping. Results An increase in one additional OPO to which a kidney was given by a procuring OPO in a year was associated with 1.4% lower likelihood of discard for a given kidney (odds ratio, 0.986; 95% confidence interval, 0.974-0.998) among OPOs procuring high kidney volume, but 2% higher likelihood of discard (OR:1.021, CI:1.006, 1.037) among OPOs procuring low kidney volume, with mixed associations with recipient outcomes. Conclusions Our study highlights the value of network analysis in revealing how broader kidney sharing is associated with levels of organ acceptance. We conclude interventions to promote broader inter-OPO sharing could be developed to reduce discard for a subset of OPOs. PMID:26102610

Current status of in-hospital donation coordinators in Japan: nationwide survey.

PubMed

Konaka, S; Shimizu, S; Iizawa, M; Ohkawara, H; Kato, O; Ashikari, J; Fukushima, N

2013-05-01

When the Japanese Organ Transplantation Act was issued, the Japanese Organ Transplantation Network (JOT) was established in 1997. JOT lists recipients, assesses and manages organ donors, and educates publics and headquarters for organ donations. JOT procurement transplant coordinators (PTC) play roles in obtaining consent from relatives for organ donation, donor evaluation and management, organ recovery management, organ transport, and care of donor families during and after donation. Every prefecture has at least one PTC who is mainly working in public education and hospital development. They also help the JOT PTC at the time of organ procurement. Most prefectures commission hospital staff in the procurement hospital to be an in-hospital PTC (In-Hp PTC), who make their hospital staff aware of organ donation and support organ procurement. Although the Act was revised in 2010 with brain-dead organ donation increased from 13 to 44 cases yearly, the number was still extremely smaller than other developed countries. In these circumstances, In-Hp PTC may play greater roles to increase donation and smooth procurement procedures Our primary aim was to describe the current status of In-Hp PTC in Japan. Between December 15, 2011, and January 31, 2012, we invited 1889 In-Hp PTC to complete a letter survey using a self-designed questionnaire. In all, 56 In-Hp PTC (40%) completed and returned it. The occupation of the respondents was nurse (66%), physician (18%), or other (16%). Although 52% of respondents belonged to the hospital, which was designated for brain-death organ donation by the government, only 46% had any experience with a cadaveric donor. Only 2% were full-time In-Hp PTC. They mainly played a role in preparing their own manual for organ procurement (57%), providing in-hospital lectures (44%) or their own simulation exercise (29%), as well as coordinating donation cases. Although 77% had attended seminar about organ donation provided by JOT or the prefecture PTC, 93% wanted more professional education. However, it was difficult for them to attend these activities, to manage a rare and sudden donation case, and to find time to learn about organ donation because they had another post. The topics that they wanted to learn were donor family care (72%), overall organ/tissue donation procedures (65%), the role of In-Hp PTC (67%), simulations of donation (65%), legislation and social system of organ donation (61%), medical indications for donation (61%), current status of donation and transplantation in Japan (57%), donor management (56%), and case studies (49%). There were significant variations in the topics of interest among the occupations. As they had another post, they could find only a short period (1 or 2 days) to take professional education, such as lectures. Therefore, it was difficult for them to attend practical on-the-job training. To establish an organ procurement system and increase organ donation, In-Hp PTC have important roles in Japan. However, none is a full-time In-Hp PTC. Most In-Hp PTC require more professional education. A systematic education program for each occupation must be established soon. Copyright © 2013 Elsevier Inc. All rights reserved.

17 CFR 200.13 - Executive Director.

Code of Federal Regulations, 2010 CFR

2010-04-01

... AND ETHICS; AND INFORMATION AND REQUESTS Organization and Program Management General Organization... procurement regulations, enters into contracts, designates contracting officers, and makes procurement...-specific application of performance measures, procurement reforms, personnel reductions, financial...

42 CFR 486.320 - Condition: Participation in Organ Procurement and Transplantation Network.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Condition: Participation in Organ Procurement and Transplantation Network. 486.320 Section 486.320 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES....320 Condition: Participation in Organ Procurement and Transplantation Network. After being designated...

42 CFR 486.320 - Condition: Participation in Organ Procurement and Transplantation Network.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 5 2011-10-01 2011-10-01 false Condition: Participation in Organ Procurement and Transplantation Network. 486.320 Section 486.320 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES....320 Condition: Participation in Organ Procurement and Transplantation Network. After being designated...

Strategies for success among OPOs: a study of three organ procurement organizations.

PubMed

Shafer, T J; Kappel, D F; Heinrichs, D F

1997-03-01

Productivity among organ procurement organizations varies widely in the US, and the pressure to determine critical success factors increases as the organ pool shrinks and managed care expands. This study compared three successful organ procurement organizations, identified commonalities among them in cost of doing business, and examined direct and indirect expenses, staffing, specialized requestor programs, and professional and public education programs. The three organ procurement organizations were chosen because of their performance in terms of donors per million population, complexity, and size. The following key indicators were compared and analyzed: annual operating budget, size and composition of staff, funds and resources invested in professional education versus public education, tissue recovery operations, results of minority initiatives, and employee compensation programs.

Optimizing Eco-Efficiency Across the Procurement Portfolio.

PubMed

Pelton, Rylie E O; Li, Mo; Smith, Timothy M; Lyon, Thomas P

2016-06-07

Manufacturing organizations' environmental impacts are often attributable to processes in the firm's upstream supply chain. Environmentally preferable procurement (EPP) and the establishment of environmental purchasing criteria can potentially reduce these indirect impacts. Life-cycle assessment (LCA) can help identify the purchasing criteria that are most effective in reducing environmental impacts. However, the high costs of LCA and the problems associated with the comparability of results have limited efforts to integrate procurement performance with quantitative organizational environmental performance targets. Moreover, environmental purchasing criteria, when implemented, are often established on a product-by-product basis without consideration of other products in the procurement portfolio. We develop an approach that utilizes streamlined LCA methods, together with linear programming, to determine optimal portfolios of product impact-reduction opportunities under budget constraints. The approach is illustrated through a simulated breakfast cereal manufacturing firm procuring grain, containerboard boxes, plastic packaging, electricity, and industrial cleaning solutions. Results suggest that extending EPP decisions and resources to the portfolio level, recently made feasible through the methods illustrated herein, can provide substantially greater CO2e and water-depletion reductions per dollar spend than a product-by-product approach, creating opportunities for procurement organizations to participate in firm-wide environmental impact reduction targets.

Roles of sex and ethnicity in procurement coordinator--family communication during the organ donation discussion.

PubMed

Baughn, Daniel; Auerbach, Stephen M; Siminoff, Laura A

2010-09-01

Interpersonal relations with health care providers influence families' decisions to consent to solid-organ donation. However, previous research has been based on retrospective interviews with donation-eligible families and has not directly examined the interpersonal interactions between families and organ procurement coordinators. To increase understanding of the interpersonal interaction between procurement coordinators and families during the organ donation discussion, with special attention to the influence of the sex and race of the procurement coordinator and the race of the potential donor's family. A descriptive study in which standardized patients portrayed family members interacting with actual procurement coordinators in simulated donation request scenarios. Thirty-three videotaped interactions between standardized patients and 17 procurement coordinators involving 2 different scenarios depicting deceased donation were evaluated. Video recordings were rated by independent coders. Coders completed the Impact Message Inventory-Form C, the Participatory Style of Physician Scale, and the Siminoff Communication and Content and Affect Program-Global Observer Ratings scale. African American procurement coordinators, particularly African American women, were rated as more controlling and work-oriented than white procurement coordinators. Male procurement coordinators were more affiliative with the white family than the African American family, whereas female procurement coordinators were slightly less affiliative with the white family. African American procurement coordinators expressed more positive affect when interacting with the African American family than the white family, whereas the opposite was true for white procurement coordinators. Research is needed to cross-validate these exploratory findings and further examine cultural mistrust between procurement coordinators and families of ethnic minorities, especially given the negative attitudes of many minorities toward donation.

Attitudes to brain death and organ procurement among university students and critical care physicians in poland.

PubMed

Kubler, A; Lipinska-Gediga, M; Kedziora, J; Kubler, M

2009-06-01

The practice of retrieving vital organs from brain-dead heart-beating donors is legally and medically accepted in Poland, but public beliefs and opinions regarding these matters have not been sufficiently explored. The purpose of this study was to evaluate the attitude of university students to the concepts of brain death and organ retrieval, compared with the attitude of critical care physicians. The cohorts of 989 students and 139 physicians completed a questionnaire based on a survey instrument developed in an earlier reported study on Ohio residents. Participants assessed 3 scenarios: (1) brain death, (2) coma, and (3) vegetative state. More than 48% of students classified the patient from the brain death scenario as alive, and 51% of them were willing to donate organs of this patient. Ninety percent of students classified the patients in coma and in a vegetative state as alive, but still 34% of them would donate organs of those patients. The group of physicians properly determined the patients' diagnoses, but 10% of them accepted organ procurement from patients in coma and in a vegetative state. Our results supported the earlier observations of low public knowledge and inadequate understanding of brain death criteria and organ procurement processes. The majority of students were willing to accept organ procurement from severely ill but alive patients, in contrast with physicians. A considerable increase in public educational activity in this field is urgently recommended.

Human rights violations in organ procurement practice in China.

PubMed

Paul, Norbert W; Caplan, Arthur; Shapiro, Michael E; Els, Charl; Allison, Kirk C; Li, Huige

2017-02-08

Over 90% of the organs transplanted in China before 2010 were procured from prisoners. Although Chinese officials announced in December 2014 that the country would completely cease using organs harvested from prisoners, no regulatory adjustments or changes in China's organ donation laws followed. As a result, the use of prisoner organs remains legal in China if consent is obtained. We have collected and analysed available evidence on human rights violations in the organ procurement practice in China. We demonstrate that the practice not only violates international ethics standards, it is also associated with a large scale neglect of fundamental human rights. This includes organ procurement without consent from prisoners or their families as well as procurement of organs from incompletely executed, still-living prisoners. The human rights critique of these practices will also address the specific situatedness of prisoners, often conditioned and traumatized by a cascade of human rights abuses in judicial structures. To end the unethical practice and the abuse associated with it, we suggest to inextricably bind the use of human organs procured in the Chinese transplant system to enacting Chinese legislation prohibiting the use of organs from executed prisoners and making explicit rules for law enforcement. Other than that, the international community must cease to abet the continuation of the present system by demanding an authoritative ban on the use of organs from executed Chinese prisoners.

Organ procurement after euthanasia: Belgian experience.

PubMed

Ysebaert, D; Van Beeumen, G; De Greef, K; Squifflet, J P; Detry, O; De Roover, A; Delbouille, M-H; Van Donink, W; Roeyen, G; Chapelle, T; Bosmans, J-L; Van Raemdonck, D; Faymonville, M E; Laureys, S; Lamy, M; Cras, P

2009-03-01

Euthanasia was legalized in Belgium in 2002 for adults under strict conditions. The patient must be in a medically futile condition and of constant and unbearable physical or mental suffering that cannot be alleviated, resulting from a serious and incurable disorder caused by illness or accident. Between 2005 and 2007, 4 patients (3 in Antwerp and 1 in Liège) expressed their will for organ donation after their request for euthanasia was granted. Patients were aged 43 to 50 years and had a debilitating neurologic disease, either after severe cerebrovascular accident or primary progressive multiple sclerosis. Ethical boards requested complete written scenario with informed consent of donor and relatives, clear separation between euthanasia and organ procurement procedure, and all procedures to be performed by senior staff members and nursing staff on a voluntary basis. The euthanasia procedure was performed by three independent physicians in the operating room. After clinical diagnosis of cardiac death, organ procurement was performed by femoral vessel cannulation or quick laparotomy. In 2 patients, the liver, both kidneys, and pancreatic islets (one case) were procured and transplanted; in the other 2 patients, there was additional lung procurement and transplantation. Transplant centers were informed of the nature of the case and the elements of organ procurement. There was primary function of all organs. The involved physicians and transplant teams had the well-discussed opinion that this strong request for organ donation after euthanasia could not be waived. A clear separation between the euthanasia request, the euthanasia procedure, and the organ procurement procedure is necessary.

Strategic contracting practices to improve procurement of health commodities

PubMed Central

Arney, Leslie; Yadav, Prashant; Miller, Roger; Wilkerson, Taylor

2014-01-01

ABSTRACT Public-sector entities responsible for procurement of essential medicines and health commodities in developing countries often lack the technical capacity to efficiently ensure supply security. Under strict public scrutiny and pressures to be transparent, many agencies continue to use archaic procurement methods and to depend on inflexible forecasts and cumbersome tendering processes. On the basis of semi-structured literature reviews and interviews, we identified framework agreements as a strategic procurement practice used by the U.S. federal government that may also be suitable for global health supply chains. Framework agreements are long-term contracts that provide the terms and conditions under which smaller repeat purchasing orders may be issued for a defined period of time. Such agreements are common in U.S. and United Nations procurement systems and in other developed countries and multilateral organizations. In contrast, framework agreements appear to be seldom used in procurement of health commodities in countries of sub-Saharan Africa. The current practice of floating tenders multiple times a year contributes to long lead times and stock-outs, and it hampers the manufacturer's or supplier's ability to plan and respond to the government's needs. To date, government's use of strategic contracting practices in public procurement of health commodities has not received much attention in most developing countries. It may present an opportunity for substantial improvements in procurement efficiency and commodity availability. Enabling legislation and strengthened technical capacity to develop and manage long-term contracts could facilitate the use of framework contracts in sub-Saharan Africa, with improved supply security and cost savings likely to result. PMID:25276589

Strategic contracting practices to improve procurement of health commodities.

PubMed

Arney, Leslie; Yadav, Prashant; Miller, Roger; Wilkerson, Taylor

2014-08-01

Public-sector entities responsible for procurement of essential medicines and health commodities in developing countries often lack the technical capacity to efficiently ensure supply security. Under strict public scrutiny and pressures to be transparent, many agencies continue to use archaic procurement methods and to depend on inflexible forecasts and cumbersome tendering processes. On the basis of semi-structured literature reviews and interviews, we identified framework agreements as a strategic procurement practice used by the U.S. federal government that may also be suitable for global health supply chains. Framework agreements are long-term contracts that provide the terms and conditions under which smaller repeat purchasing orders may be issued for a defined period of time. Such agreements are common in U.S. and United Nations procurement systems and in other developed countries and multilateral organizations. In contrast, framework agreements appear to be seldom used in procurement of health commodities in countries of sub-Saharan Africa. The current practice of floating tenders multiple times a year contributes to long lead times and stock-outs, and it hampers the manufacturer's or supplier's ability to plan and respond to the government's needs. To date, government's use of strategic contracting practices in public procurement of health commodities has not received much attention in most developing countries. It may present an opportunity for substantial improvements in procurement efficiency and commodity availability. Enabling legislation and strengthened technical capacity to develop and manage long-term contracts could facilitate the use of framework contracts in sub-Saharan Africa, with improved supply security and cost savings likely to result.

An Analysis of Organ Donation Policy in the United States.

PubMed

Ahmad, Ghazi; Iftikhar, Sadia

2016-05-02

There is currently an organ shortage crisis in the United States. This paper analyzes the magnitude of the problem, the organ procurement programs in other developed countries as compared to the US, and discusses the changes that can be made to address this problem. With the opt-in or explicit-consent method currently practiced in the US, less that one third of the population consents to organ donation. In order to narrow the gap between the demand and supply of organs, steps need to be taken to improve the organ procurement infrastructure. The public needs to be educated about the dire need, the benefits and risks in organ donation, and living vs. deceased donation. [Full article available at http://rimed.org/rimedicaljournal-2016-05.asp, free with no login].

Transplant ethics under scrutiny – responsibilities of all medical professionals

PubMed Central

Trey, Torsten; Caplan, Arthur L.; Lavee, Jacob

2013-01-01

In this text, we present and elaborate ethical challenges in transplant medicine related to organ procurement and organ distribution, together with measures to solve such challenges. Based on internationally acknowledged ethical standards, we looked at cases of organ procurement and distribution practices that deviated from such ethical standards. One form of organ procurement is known as commercial organ trafficking, while in China the organ procurement is mostly based on executing prisoners, including killing of detained Falun Gong practitioners for their organs. Efforts from within the medical community as well as from governments have contributed to provide solutions to uphold ethical standards in medicine. The medical profession has the responsibility to actively promote ethical guidelines in medicine to prevent a decay of ethical standards and to ensure best medical practices. PMID:23444249

Transplant ethics under scrutiny - responsibilities of all medical professionals.

PubMed

Trey, Torsten; Caplan, Arthur L; Lavee, Jacob

2013-02-01

In this text, we present and elaborate ethical challenges in transplant medicine related to organ procurement and organ distribution, together with measures to solve such challenges. Based on internationally acknowledged ethical standards, we looked at cases of organ procurement and distribution practices that deviated from such ethical standards. One form of organ procurement is known as commercial organ trafficking, while in China the organ procurement is mostly based on executing prisoners, including killing of detained Falun Gong practitioners for their organs. Efforts from within the medical community as well as from governments have contributed to provide solutions to uphold ethical standards in medicine. The medical profession has the responsibility to actively promote ethical guidelines in medicine to prevent a decay of ethical standards and to ensure best medical practices.

Study of education program of in-hospital procurement transplant coordinators in Japan.

PubMed

Fukushima, N; Konaka, S; Yasuhira, M; Izawa, M

2014-01-01

As the number of donated organs is still extremely small in Japan compared with other developed countries, in-hospital procurement transplant coordinators (In-Hp PTC) may play an important role in increasing organ donation and making the procurement procedure smoother. In this study, our education program of In-Hp PTC is described. In May 2012, our department started the In-Hp PTC Education Program. In the first semester, a 2-hour lecture is provided every 2 weeks for 5 months to 15 In-Hp PTCs working near Osaka. In the second semester, 20 lectures were provided for 3 consecutive days to 31 In Hp PTCs, more than 80% of whom work far from Osaka. Lecture topics were the history and current status of organ donation in Japan, social regulation of organ donation, care of transplant recipients, overall procedures of organ donation, the role of In-Hp PTC, donor family care, donor indications, and donor assessment and management. Lectures also included simulations of the organ donation process. Participants were surveyed for their opinions after the program, Most participants were satisfied with the program, topics and duration. As most of them are not full-time In-Hp PTCs, they preferred to attend the 3-day program. Many participants are currently working as main In-Hp PTCs and establishing their own organ donation system in their hospital. In-Hp PTCs have an important role to play in establishing an organ procurement system and increasing organ donation in Japan. This program may help establish a systematic education program for this occupation in Japan. Copyright © 2014 Elsevier Inc. All rights reserved.

Financial aspects of organ procurement from deceased donors in the USA-Relevance to xenotransplantation.

PubMed

Saari, Ryan J; Cooper, David K C

2017-07-01

When clinical xenotransplantation is introduced, the costs associated with acquisition of a genetically engineered pig organ are as yet unknown. How will these costs compare with those currently associated with the acquisition of deceased human organs? An understanding of the financial aspects of deceased organ and tissue procurement in the USA is therefore worthwhile. We have therefore attempted to review certain economic aspects of non-profit and for-profit organizations that provide cadaveric organs and/or tissues for purposes of transplantation into patients with end-stage organ failure, cellular deficiencies, or in need of reconstructive procedures. We briefly consider the laws, organizations, and business practices that govern the acquisition, processing, and/or distribution of cadaveric organs and tissues, and the economic implications of industry practices. In particular, we explore and highlight what we perceive as a lack of transparency and oversight with regard to financial practices, and we question whether donor families would be entirely happy with the business environment that has developed from their altruistic donations. Until xenotransplantation becomes established clinically, which will negate the need for any system of organ procurement and allocation, we suggest that those involved in organ and cell transplantation, as well as those who participate in reconstructive surgery, should take responsibility to ensure that the financial practices associated with procurement are transparent, and overseen/regulated by a responsible authority. We suggest the major transplant societies should take a lead in this respect. The ability to acquire a genetically engineered pig organ whenever required through a simple commercial transaction (as in the acquisition of a life-saving drug) will be greatly to the patient's benefit. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Killing by organ procurement: brain-based death and legal fictions.

PubMed

Veatch, Robert M

2015-06-01

The dead donor rule (DDR) governs procuring life-prolonging organs. They should be taken only from deceased donors. Miller and Truog have proposed abandoning the rule when patients have decided to forgo life-sustaining treatment and have consented to procurement. Organs could then be procured from living patients, thus killing them by organ procurement. This proposal warrants careful examination. They convincingly argue that current brain or circulatory death pronouncement misidentifies the biologically dead. After arguing convincingly that physicians already cause death by withdrawing treatment, they claim no bright-line differences preclude organ removal from the living. The argument fails for those who accept the double effect doctrine or other grounds for distinguishing forgoing life support from active, intentional killing. If the goal is determining irreversible loss of somatic function, they correctly label current death pronouncement a "legal fiction." Recognizing a second, public policy meaning of the term death provides grounds for maintaining the DDR without jeopardizing procurement. © The Author 2015. Published by Oxford University Press, on behalf of the Journal of Medicine and Philosophy Inc. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

34 CFR 80.36 - Procurement.

Code of Federal Regulations, 2013 CFR

2013-07-01

..., including the definition, development, practice, and expression of its religious beliefs; (C) Use its... on the basis of religion or religious belief. (6) A religious organization's exemption from the... for or against a private organization on the basis of the organization's religious character or...

34 CFR 80.36 - Procurement.

Code of Federal Regulations, 2012 CFR

2012-07-01

..., including the definition, development, practice, and expression of its religious beliefs; (C) Use its... on the basis of religion or religious belief. (6) A religious organization's exemption from the... for or against a private organization on the basis of the organization's religious character or...

Improving organ procurement practices in Michigan

PubMed Central

Lynch, RJ; Mathur, AK; Hundley, JC; Kubus, J; Pietroski, RE; Mattice, BJ; Punch, JD; Englesbe, MJ

2015-01-01

Travel to procure deceased donor organs is associated with risk to transplant personnel. In many instances, multiple teams are present for a given operation. We studied our statewide experience to determine how much excess travel this redundancy entails, and generated alternate models for organ recovery. We reviewed our organ procurement organization’s experience with deceased donor operations between 2002 and 2008. Travel was expressed as cumulative person-miles between procurement team origin and donor hospital. A model of minimal travel was created, using thoracic and abdominal teams from the closest in-state center. A second model involved transporting donors to a dedicated procurement facility. Travel distance was recalculated using these models, and mode and cost of travel extrapolated from current practices. In 654 thoracic and 1469 abdominal donors studied, mean travel for thoracic teams was 1066 person-miles, and for abdominal teams was 550 person-miles. The mean distance traveled by thoracic and abdominal organs was 223 miles and 142 miles, respectively. Both hypothetical models showed reductions in team travel and reliance on air transport, with favorable costs and organ transport times compared to historical data. In summary, we found significant inefficiency in current practice, which may be alleviated using new paradigms for donor procurement. PMID:19656129

Scientific, legal, and ethical challenges of end-of-life organ procurement in emergency medicine.

PubMed

Rady, Mohamed Y; Verheijde, Joseph L; McGregor, Joan L

2010-09-01

We review (1) scientific evidence questioning the validity of declaring death and procuring organs in heart-beating (i.e., neurological standard of death) and non-heart-beating (i.e., circulatory-respiratory standard of death) donation; (2) consequences of collaborative programs realigning hospital policies to maximize access of procurement coordinators to critically and terminally ill patients as potential donors on arrival in emergency departments; and (3) ethical and legal ramifications of current practices of organ procurement on patients and their families. Relevant publications in peer-reviewed journals and government websites. Scientific evidence undermines the biological criteria of death that underpin the definition of death in heart-beating (i.e., neurological standard) and non-heart-beating (i.e., circulatory-respiratory standard) donation. Philosophical reinterpretation of the neurological and circulatory-respiratory standards in the death statute, to avoid the appearance of organ procurement as an active life-ending intervention, lacks public and medical consensus. Collaborative programs bundle procurement coordinators together with hospital staff for a team-huddle and implement a quality improvement tool for a Rapid Assessment of Hospital Procurement Barriers in Donation. Procurement coordinators have access to critically ill patients during the course of medical treatment with no donation consent and with family or surrogates unaware of their roles. How these programs affect the medical care of these patients has not been studied. Policies enforcing end-of-life organ procurement can have unintended consequences: (1) erosion of care in the patient's best interests, (2) lack of transparency, and (3) ethical and legal ramifications of flawed standards of declaring death. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

Disclosure of information to organ, tissue and eye procurement organizations. Final rule.

PubMed

2008-11-03

This document adopts, with changes, a Department of Veterans Affairs (VA) interim final rule that implemented provisions of the Veterans Benefits, Health Care, and Information Technology Act of 2006 concerning disclosure of information to organ, tissue and eye procurement organizations. The regulation will provide authority for VA to provide individually-identifiable VA medical records of veterans or dependents of veterans who are deceased or whose death is imminent to representatives of organ procurement organizations, eye banks, and tissue banks to determine whether the patients are suitable potential donors. This document modifies the interim final rule to clarify the definition of "near death" and to correct a grammatical error in the definition of "procurement organization." This document also clarifies that eye bank and tissue bank registration with FDA must have an active status.

Organ procurement from executed prisoners in China.

PubMed

Sharif, A; Singh, M Fiatarone; Trey, T; Lavee, J

2014-10-01

Organ procurement from executed prisoners in China is internationally condemned, yet this practice continues unabated in 2014. This is despite repeated announcements from Chinese authorities that constructive measures have been undertaken to conform to accepted ethical standards. While there is unanimous agreement on the unethical nature of using organs from executed prisoners, due to its limitations on voluntary and informed consent, there is insufficient coverage of forced organ procurement from prisoners of conscience without consent. Strategies to influence positive change in China over the last few decades have failed to bring this practice to an end. While organ donation and transplantation services in China have undergone considerable structural changes in the last few years, fundamental attempts to shift practice to ethically sourced organs have floundered. In this article, we discuss the organ trade in China, reflect upon organ procurement from executed prisoners (including both capital prisoners and prisoners of conscience) and provide an overview of contradictory Chinese efforts to halt forced organ procurement from executed prisoners. Finally, we highlight current actions being taken to address this issue and offer comprehensive recommendations to bring this ethically indefensible practice to an immediate end. © Copyright 2014 The American Society of Transplantation and the American Society of Transplant Surgeons.

42 CFR 486.344 - Condition: Evaluation and management of potential donors and organ placement and recovery.

Code of Federal Regulations, 2011 CFR

2011-10-01

... donors and organ placement and recovery. 486.344 Section 486.344 Public Health CENTERS FOR MEDICARE... Designation and Conditions for Coverage: Organ Procurement Organizations Organ Procurement Organization... placement and recovery. The OPO must have written protocols for donor evaluation and management and organ...

42 CFR 486.344 - Condition: Evaluation and management of potential donors and organ placement and recovery.

Code of Federal Regulations, 2010 CFR

2010-10-01

... donors and organ placement and recovery. 486.344 Section 486.344 Public Health CENTERS FOR MEDICARE... Designation and Conditions for Coverage: Organ Procurement Organizations Organ Procurement Organization... placement and recovery. The OPO must have written protocols for donor evaluation and management and organ...

78 FR 40033 - Organ Procurement and Transplantation Network

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-03

... regarding OPTN policy development for VCAs. They noted that VCA transplantation remains an experimental... best use of organs; shall be specific for each organ type; shall be designed to avoid wasting organs... suggested that, as an experimental field and given the small number of VCA transplants at this time, VCA...

Monitoring What Governments “Give for” and “Spend on” Vaccine Procurement: Vaccine Procurement Assistance and Vaccine Procurement Baseline

PubMed Central

Nelson, E. A. S.; Bloom, David E.; Mahoney, Richard T.

2014-01-01

Background The Global Vaccine Action Plan will require, inter alia, the mobilization of financial resources from donors and national governments – both rich and poor. Vaccine Procurement Assistance (VPA) and Vaccine Procurement Baseline (VPB) are two metrics that could measure government performance and track resources in this arena. VPA is proposed as a new subcategory of Official Development Assistance (ODA) given for the procurement of vaccines and VPB is a previously suggested measure of the share of Gross Domestic Product (GDP) that governments spend on their own vaccine procurement. Objective To determine realistic targets for VPA and VPB. Methods Organization for Economic Co-Operation and Development (OECD) and World Bank data for 2009 were analyzed to determine the proportions of bilateral ODA from the 23 Development Assistance Committee (DAC) countries disbursed (as % of GDP in current US$) for infectious disease control. DAC country contributions to the GAVI Alliance for 2009 were assessed as a measure of multilateral donor support for vaccines and immunization programs. Findings In 2009, total DAC bilateral ODA was 0.16% of global GDP and 0.25% of DAC GDP. As a percentage of GDP, Norway (0.013%) and United Kingdom (0.0085%) disbursed the greatest proportion of bilateral ODA for infectious disease control, and Norway (0.024%) and Canada (0.008%) made the greatest contributions to the GAVI Alliance. In 2009 0.02% of DAC GDP was US$7.61 billion and 0.02% of the GDP of the poorest 117 countries was US$2.88 billion. Conclusions Adopting 0.02% GDP as minimum targets for both VPA and VPB is based on realistic estimates of what both developed and developing countries should spend, and can afford to spend, to jointly ensure procurement of vaccines recommended by national and global bodies. New OECD purpose codes are needed to specifically track ODA disbursed for a) vaccine procurement; and b) immunization programs. PMID:24586899

Monitoring what governments "give for" and "spend on" vaccine procurement: Vaccine Procurement Assistance and Vaccine Procurement Baseline.

PubMed

Nelson, E A S; Bloom, David E; Mahoney, Richard T

2014-01-01

The Global Vaccine Action Plan will require, inter alia, the mobilization of financial resources from donors and national governments - both rich and poor. Vaccine Procurement Assistance (VPA) and Vaccine Procurement Baseline (VPB) are two metrics that could measure government performance and track resources in this arena. VPA is proposed as a new subcategory of Official Development Assistance (ODA) given for the procurement of vaccines and VPB is a previously suggested measure of the share of Gross Domestic Product (GDP) that governments spend on their own vaccine procurement. To determine realistic targets for VPA and VPB. Organization for Economic Co-Operation and Development (OECD) and World Bank data for 2009 were analyzed to determine the proportions of bilateral ODA from the 23 Development Assistance Committee (DAC) countries disbursed (as % of GDP in current US$) for infectious disease control. DAC country contributions to the GAVI Alliance for 2009 were assessed as a measure of multilateral donor support for vaccines and immunization programs. In 2009, total DAC bilateral ODA was 0.16% of global GDP and 0.25% of DAC GDP. As a percentage of GDP, Norway (0.013%) and United Kingdom (0.0085%) disbursed the greatest proportion of bilateral ODA for infectious disease control, and Norway (0.024%) and Canada (0.008%) made the greatest contributions to the GAVI Alliance. In 2009 0.02% of DAC GDP was US$7.61 billion and 0.02% of the GDP of the poorest 117 countries was US$2.88 billion. Adopting 0.02% GDP as minimum targets for both VPA and VPB is based on realistic estimates of what both developed and developing countries should spend, and can afford to spend, to jointly ensure procurement of vaccines recommended by national and global bodies. New OECD purpose codes are needed to specifically track ODA disbursed for a) vaccine procurement; and b) immunization programs.

Energy-efficient Public Procurement: Best Practice in Program Delivery

DOE Office of Scientific and Technical Information (OSTI.GOV)

Payne, Christopher; Weber, Andrew; Semple, Abby

2013-02-15

This document illustrates the key issues and considerations involved in implementing energy-efficient public procurement. Our primary sources of information have been our partners in the Super Efficient Equipment and Appliance Deployment (SEAD) Initiative Procurement Working Group. Where applicable, we have highlighted specific ways in which working group participants have successfully overcome barriers to delivering effective programs. The following key points emerge from this analysis of programs for energy-efficient public procurement. Lessons for both developed and developing programs are highlighted throughout the guide. 1. Policy: Policy provides the initiative to begin a transition from first cost to life-cycle cost based purchasingmore » methods and culture. Effective policy is well-communicated, establishes accountability from top to bottom of organizations and simplifies the processes necessary to comply. Flexibility and responsiveness are essential in policy development and implementation. Mandatory and voluntary policies may complement one another. 2. Procurement Criteria: Procurement staff must be confident that energy-efficient procurement criteria offer the best long-term value for their organization’s money and represent real environmental gains. Involving multiple stakeholders at the early stages of the criteria creation process can result in greater levels of cooperation from private industry. Criteria should make comparison of products easy for purchasers and require minimal additional calculations. Criteria will need to be regularly updated to reflect market developments. 3. Training: Resources for the creation of training programs are usually very limited, but well-targeted training is necessary in order for a program to be effective. Training must emphasize a process that is efficient for purchasers and simplifies compliance. Purchaser resources and policy must be well designed for training to be effective. Training program development is an excellent opportunity for collaboration amongst public authorities. 4. Procurement Processes: Many tools and guides intended to help buyers comply with energy-efficient procurement policy are designed without detailed knowledge of the procurement process. A deeper understanding of purchasing pathways allows resources to be better directed. Current research by national and international bodies aims to analyze purchasing pathways and can assist in developing future resources.« less

Variation in Pediatric Organ Donor Management Practices Among US Organ Procurement Organizations.

PubMed

Ream, Robert S; Armbrecht, Eric S

2018-03-01

Reports of actual pediatric organ donor management practice among US organ procurement organizations are sparse, and the use of standardized management guidelines is unknown. A recent consensus statement from the Society of Critical Care Medicine, the American College of Chest Physicians, and the Association of Organ Procurement Organizations offers guidelines for the management of the pediatric organ donor. To describe the use of guidelines and routine practices in the management of the pediatric organ donor with respect to hemodynamics, lung and ventilator management, fluid and electrolytes, hormonal replacement therapy, the use of blood products, thermoregulation, and prophylactic antibiotics. Cross-sectional observational study using a survey and follow-up telephone interview with respondents from all 58 US organ procurement organizations. All 58 US Organ Procurement Organizations participated. A majority employed written guidelines for the management of pediatric donor hemodynamics, thermoregulation, fluids, and electrolytes. Management of blood products, the lung, and mechanical ventilation were less commonly committed to written guidelines, but common practices were described. All used various forms of hormonal replacement therapy and the majority administered empiric antibiotic therapy. Wide variation was observed in the management of the lung, mechanical ventilation, and glycemic control. Most OPOs used forms of standardized donor management for the pediatric organ donor although variation in the content of that management exists. Barriers to an evidence-based approach to the pediatric donor need to be determined and addressed.

14 CFR § 1201.400 - NASA procurement program.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 5 2014-01-01 2014-01-01 false NASA procurement program. § 1201.400... ORGANIZATION AND GENERAL INFORMATION General Information § 1201.400 NASA procurement program. (a) The Office of... contact for NASA procurements. Although the procurements may be made by the field installations, selected...

The First 2 Years of Activity of a Specialized Organ Procurement Center: Report of an Innovative Approach to Improve Organ Donation.

PubMed

Marsolais, P; Durand, P; Charbonney, E; Serri, K; Lagacé, A-M; Bernard, F; Albert, M

2017-06-01

The number of patients requiring organ transplants continues to outgrow the number of organs donated each year. In an attempt to improve the organ donation process and increase the number of organs available, we created a specialized multidisciplinary team within a specialized organ procurement center (OPC) with dedicated intensive care unit (ICU) beds and operating rooms. The OPC was staffed with ICU nurses, operating room nurses, organ donor management ICU physicians, and multidisciplinary staff. All organ donors within a designated geographic area were transferred to and managed within the OPC. During the first 2 years of operation, 126 patients were referred to the OPC. The OPC was in use for a total of 3527 h and involved 253 health workers. We retrieved 173 kidneys, 95 lungs, 68 livers, 37 hearts, and 13 pancreases for a total of 386 organs offered for transplantation. This translates to a total of 124.6 persons transplanted per million population, which compares most favorably to recently published numbers in developed countries. The OPC clearly demonstrates potential to increase the number of deceased donor organs available for transplant. Further studies are warranted to better understand the exact influence of the different components of the OPC on organ procurement. © 2016 The American Society of Transplantation and the American Society of Transplant Surgeons.

The effect of inhalational anaesthesia during deceased donor organ procurement on post-transplantation graft survival.

PubMed

Perez-Protto, S; Nazemian, R; Matta, M; Patel, P; Wagner, K J; Latifi, S Q; Lebovitz, D J; Reynolds, J D

2018-03-01

Many deceased by neurologic criteria donors are administered inhalational agents during organ recovery surgery-a process that is characterised by warm and cold ischaemia followed by warm reperfusion. In certain settings, volatile anaesthetics (VA) are known to precondition organs to protect them from subsequent ischaemia-reperfusion injury. As such, we hypothesised that exposure to VA during organ procurement would improve post-graft survival. Lifebanc (organ procurement organisation [OPO] for NE Ohio) provided the investigators with a list of death by neurologic criteria organ donors cared for at three large tertiary hospitals in Cleveland between 2006 and 2016-details about the surgical recovery phase were extracted from the organ donors' medical records. De-identified data on graft survival were obtained from the United Network for Organ Sharing (UNOS). The collated data underwent comparative analysis based on whether or not VA were administered during procurement surgery. Records from 213 donors were obtained for analysis with 138 exposed and 75 not exposed. Demographics, medical histories, and organ procurement rates were similar between the two cohorts. For the primary endpoint, there were no significant differences observed in either early (30-day) or late (five-year) graft survival rates for kidney, liver, lung, or heart transplants. Our findings from this retrospective review of a relatively small cohort do not support the hypothesis that the use of VA during the surgical procurement phase improves graft survival. Reviews of larger datasets and/or a prospective study may be required to provide a definitive answer.

Resource Utilization Associated with Procurement of Transplantable Organs from Donors that do not meet OPTN Eligible Death Criteria

PubMed Central

DuBay, Derek A.; Redden, David T.; Bryant, Mary K.; Dorn, David P; Fouad, Mona N.; Gray, Stephen H.; White, Jared A.; Locke, Jayme E.; Meeks, Christopher B.; Taylor, Garry C.; Kilgore, Meredith L.; Eckhoff, Devin E.

2014-01-01

Background The strategy of evaluating every donation opportunity warrants an investigation into the financial feasibility of this practice. The purpose of this investigation is to measure resource utilization required for procurement of transplantable organs in an organ procurement organization (OPO). Methods Donors were stratified into those that met OPTN-defined eligible death criteria (ED Donors, n=589) and those that did not (NED Donors, n=703). Variable direct costs and time utilization by OPO staff for organ procurement were measured and amortized per organ transplanted using permutation methods and statistical bootstrapping/resampling approaches. Results More organs per donor were procured (3.66 ± 1.2 vs. 2.34 ± 0.8, p<0.0001) and transplanted (3.51 ± 1.2 vs. 2.08 ± 0.8, p<0.0001) in ED donors compared to NED donors. The variable direct costs were significantly lower in NED donors ($29,879.4 ± 11590.1 vs. $19,019.6 ± 7599.60, p<0.0001). In contrast, the amortized variable direct costs per organ transplanted were significantly higher in the NED donors ($8,414.5 ± 138.29 vs. $9,272.04 ± 344.56, p<0.0001). ED donors where thoracic organ procurement occurred were 67% more expensive than in abdominal-only organ procurement. The total time allocated per donor was significantly shorter in NED donors (91.2 ± 44.9 hours vs. 86.8 ± 78.6, p=0.01). In contrast, the amortized time per organ transplanted was significantly longer in the NED donors (23.1 ± 0.8 hours vs. 36.9 ± 3.2, p<0.001). Discussion The variable direct costs and time allocated per organ transplanted is significantly higher in donors that do not meet the eligible death criteria. PMID:24503760

Resource utilization associated with procurement of transplantable organs from donors that do not meet OPTN eligible death criteria.

PubMed

DuBay, Derek A; Redden, David T; Bryant, Mary K; Dorn, David P; Fouad, Mona N; Gray, Stephen H; White, Jared A; Locke, Jayme E; Meeks, Christopher B; Taylor, Garry C; Kilgore, Meredith L; Eckhoff, Devin E

2014-05-27

The strategy of evaluating every donation opportunity warrants an investigation into the financial feasibility of this practice. The purpose of this investigation is to measure resource utilization required for procurement of transplantable organs in an organ procurement organization (OPO). Donors were stratified into those that met OPTN-defined eligible death criteria (ED donors, n=589) and those that did not (NED donors, n=703). Variable direct costs and time utilization by OPO staff for organ procurement were measured and amortized per organ transplanted using permutation methods and statistical bootstrapping/resampling approaches. More organs per donor were procured (3.66±1.2 vs. 2.34±0.8, P<0.0001) and transplanted (3.51±1.2 vs. 2.08±0.8, P<0.0001) in ED donors compared with NED donors. The variable direct costs were significantly lower in the NED donors ($29,879.4±11590.1 vs. $19,019.6±7599.60, P<0.0001). In contrast, the amortized variable direct costs per organ transplanted were significantly higher in the NED donors ($8,414.5±138.29 vs. $9,272.04±344.56, P<0.0001). The ED donors where thoracic organ procurement occurred were 67% more expensive than in abdominal-only organ procurement. The total time allocated per donor was significantly shorter in the NED donors (91.2±44.9 hr vs. 86.8±78.6 hr, P=0.01). In contrast, the amortized time per organ transplanted was significantly longer in the NED donors (23.1±0.8 hr vs. 36.9±3.2 hr, P<0.001). The variable direct costs and time allocated per organ transplanted is significantly higher in donors that do not meet the eligible death criteria.

Legal briefing: organ donation and allocation.

PubMed

Pope, Thaddeus Mason

2010-01-01

This issue's "Legal Briefing" column covers legal developments pertaining to organ donation and allocation. This topic has been the subject of recent articles in JCE. Organ donation and allocation have also recently been the subjects of significant public policy attention. In the past several months, legislatures and regulatory agencies across the United States and across the world have changed, or considered changing, the methods for procuring and distributing human organs for transplantation. Currently, in the U.S., more than 100,000 persons are waiting for organ transplantation. In China, more than 1.5 million people are waiting. Given the chronic shortage of available organs (especially kidneys and livers) relative to demand, the primary focus of most legal developments has been on increasing the rate of donation. These and related developments are usefully divided into the following 12 topical categories: 1. Revised Uniform Anatomical Gift Act. 2. Presumed Consent and Opt-Out. 3. Mandated Choice. 4. Donation after Cardiac Death. 5. Payment and Compensation. 6. Donation by Prisoners. 7. Donor Registries. 8. Public Education. 9. Other Procurement Initiatives. 10. Lawsuits and Liability. 11. Trafficking and Tourism. 12. Allocation and Distribution.

Using a standardized donor ratio to assess the performance of organ procurement organizations.

PubMed

Stogis, Sheryl; Hirth, Richard A; Strawderman, Robert L; Banaszak-Holl, Jane; Smith, Dean G

2002-10-01

To develop a Standardized Donor Ratio (SDR) as an outcome measure for evaluating the effectiveness of organ procurement organizations (OPOs). All deaths by cause in the United States during 1993-1994 as reported in the Vital Mortality Statistics, Multiple Cause of Death files. The OPO-specific data were provided by the United Network for Organ Sharing (UNOS). Each OPO's expected number of donors was calculated by applying national donation rates to deaths with potential for donation in 24 age, sex, and race cells. The SDR was calculated by dividing the observed number of donors by the expected number. The chi2 tests of the hypothesis that the OPO's performance differed from the national norm of 1.0 were performed. The SDR was compared to the existing performance standard based on the unadjusted number of donors per million live population in the OPO's service area. An ordinary least squares (OLS) regression assessed predictors of the SDR. The SDRs ranged from 0.41 to 1.99. Twenty-nine of 64 OPOs had SDRs significantly different than 1.0. The SDRs were positively associated with the percent of white living population and the number of organ types transplanted per transplant center served by the OPO. The SDRs can be used by Centers for Medicare and Medicaid Services (CMS), UNOS, and OPOs to target quality improvement initiatives, present more accurate comparisons of OPO performance, and develop public policy on the evaluation of the effectiveness of organ procurement efforts.

A Novel Approach to High-Quality Postmortem Tissue Procurement: The GTEx Project.

PubMed

Carithers, Latarsha J; Ardlie, Kristin; Barcus, Mary; Branton, Philip A; Britton, Angela; Buia, Stephen A; Compton, Carolyn C; DeLuca, David S; Peter-Demchok, Joanne; Gelfand, Ellen T; Guan, Ping; Korzeniewski, Greg E; Lockhart, Nicole C; Rabiner, Chana A; Rao, Abhi K; Robinson, Karna L; Roche, Nancy V; Sawyer, Sherilyn J; Segrè, Ayellet V; Shive, Charles E; Smith, Anna M; Sobin, Leslie H; Undale, Anita H; Valentino, Kimberly M; Vaught, Jim; Young, Taylor R; Moore, Helen M

2015-10-01

The Genotype-Tissue Expression (GTEx) project, sponsored by the NIH Common Fund, was established to study the correlation between human genetic variation and tissue-specific gene expression in non-diseased individuals. A significant challenge was the collection of high-quality biospecimens for extensive genomic analyses. Here we describe how a successful infrastructure for biospecimen procurement was developed and implemented by multiple research partners to support the prospective collection, annotation, and distribution of blood, tissues, and cell lines for the GTEx project. Other research projects can follow this model and form beneficial partnerships with rapid autopsy and organ procurement organizations to collect high quality biospecimens and associated clinical data for genomic studies. Biospecimens, clinical and genomic data, and Standard Operating Procedures guiding biospecimen collection for the GTEx project are available to the research community.

The question of organ procurement: beyond charity.

PubMed

Kreis, Henri

2005-07-01

Over the past 15 years, the shortage of organs for transplantation has worsened. This has forced clinicians to review alternative approaches to organ procurement. These new approaches, however, may have serious implications both for patients and for society as a whole. Ever since the first cadaver organs were used for transplantation, organ procurement has relied on the altruism and goodwill of donors. It now appears that this 40-year-old policy is proving unsuccessful. In order to increase the availability of suitable organs and allow cadaver organ transplantation to continue, it is time to consider new strategies other than donation. Among all the potential methods of organ procurement, including donation, abandonment, sale and societal appropriation, only the latter has never been ethically discussed or implemented. This article considers a variant of this approach defined as 'conditional societal appropriation' as an ethically acceptable possibility. It has the potential to become the principle method for obtaining the necessary organs for transplantation in the near future.

Organ procurement after cardiocirculatory death: a critical analysis.

PubMed

Rady, Mohamed Y; Verheijde, Joseph L; McGregor, Joan

2008-01-01

To shorten the transplantation waiting time in the United States, federal regulations have been introduced requiring hospitals to develop policies for organ donation after cardiac (or circulatory) death (DCD). The practice of DCD is invoked based on the validity of the University of Pittsburgh Medical Center (UPMC) protocol and relies on the accuracy of the University of Wisconsin (UW) evaluation tool to appropriately identify organ donors. There is little evidence to support the position that the criteria for organ procurement adopted from the UPMC protocol complies with the dead donor rule. A high false-positive rate of the UW evaluation tool can expose many dying patients to unnecessary perimortem interventions because of donation failure. The medications and/or interventions for the sole purpose of maintaining organ viability can have unintended negative consequences on the timing and quality of end-of-life care offered to organ donors. It is essential to address and manage the evolving conflict between optimal end-of-life care and the necessary sacrifices for the procurement of transplantable organs from the terminally ill. The recipients of marginal organs recovered from DCD can also suffer higher mortality and morbidity than recipients of other types of donated organs. Finally, transparent disclosure to the public of the risks involved to both organ donors and recipients may contribute to open societal debate on the ethical acceptability of DCD.

Transplant Tourism to China: The Impact on Domestic Patient Care Decisions

PubMed Central

Biggins, Scott W.; Bambha, Kiran; Terrault, Norah; Inadomi, John; Roberts, John P.; Bass, Nathan

2009-01-01

Organ procurement in China has been criticized because of its reliance on executed prisoners as donors. We aimed to assess the influence of perceptions about organ procurement practices in China on domestic patient care decisions. Methods An anonymous Internet administered case-based questionnaire was used to survey an sample of healthcare professionals with affiliations to hepatology and transplantation professional societies. Results Of 674 completed surveys, the vast majority (93%) of the respondents were physicians, surgeons or allied transplant professionals actively caring for liver transplant patients and 81% practiced in the United States (US). A strong majority believed procurement practices were ethically sound in the US and Europe (87% and 73%) but fare fewer believed that procurement practices were ethically sound in China (4%, p<0.001). In case-based questions, lack of confidence in the ethical standards of organ procurement in China predicted patient-care decisions. The majority would provide post-transplantation care for patients who underwent liver transplantation at another domestic center, in a foreign country and in China (90%,78%,63%, respectively, p<0.001) yet respondents who suspected unethical procurement practices in China were more reluctant to do so (p<0.001). Conclusions Transplant professionals expressed concern about organ procurement practices in China which influenced their patient care decision-making. PMID:19191815

Transplant tourism to China: the impact on domestic patient-care decisions.

PubMed

Biggins, Scott W; Bambha, Kiran; Terrault, Norah; Inadomi, John; Roberts, John P; Bass, Nathan

2009-01-01

Organ procurement in China has been criticized because of its reliance on executed prisoners as donors. We aimed to assess the influence of perceptions about organ procurement practices in China on domestic patient-care decisions. An anonymous internet administered case-based questionnaire was used to survey a sample of healthcare professionals with affiliations to hepatology and transplantation professional societies. Of 674 completed surveys, the vast majority (93%) of the respondents were physicians, surgeons or allied transplant professionals actively caring for liver transplant patients and 81% practiced in the US. A strong majority believed procurement practices were ethically sound in the US and Europe (87% and 73%) but fare fewer believed that procurement practices were ethically sound in China (4%, p < 0.001). In case-based questions, lack of confidence in the ethical standards of organ procurement in China predicted patient-care decisions. The majority would provide post-transplantation care for patients who underwent liver transplantation at another domestic center, in a foreign country and in China (90%, 78%, and 63%, respectively, p < 0.001) yet respondents who suspected unethical procurement practices in China were more reluctant to do so (p < 0.001). Transplant professionals expressed concern about organ procurement practices in China which influenced their patient-care decision-making.

Non-heart-beating donors: a case study in procurement.

PubMed

Lewis, D D; Valerius, W; Sommerville, M A

1998-12-01

To help meet the increasing need for transplantable organs, especially kidneys, organ procurement organizations are recovering organs from non-heart-beating patients. This article outlines the successful recovery and transplantation of kidneys from such a donor. Consent issues and historical background are also discussed.

An Analysis of Internal Controls and Procurement Fraud Deterrence

DTIC Science & Technology

2013-12-01

might keep the organization from achieving its objectives and analyze risks , including fraud risk , so as to decide how the risk should be managed ( COSO ...internal control to adequately manage the risk ( COSO , 2013). Risk management involves developing the effective internal control targeted at a...structure and management . While the risk of fraud cannot be eliminated entirely, it can be greatly reduced with an appropriate procurement fraud prevention

Transplant Ethics.

PubMed

Altınörs, Nur; Haberal, Mehmet

2016-11-01

The aim of this study was to review and discuss the great variety of ethical issues related to organ donation, organ procurement, transplant activities, and new ethical problems created as a result of technologic and scientific developments. An extensive literature survey was made, and expert opinions were obtained. The gap between demand and supply of organs for transplant has yielded to organ trafficking, organ tourism, and commercialism. This problem seems to be the most important issue, and naturally there are ethical dilemmas related to it. A wide number of ideas have been expressed on the subject, and different solutions have been proposed. The struggle against organ trafficking and commercialism should include legislation, efforts to increase deceased-donor donations, and international cooperation. China's policy to procure organs from prisoners sentenced to death is unethical, and the international community should exert more pressure on the Chinese government to cease this practice. Each particular ethical dilemma should be taken separately and managed.

25 CFR 900.47 - When procuring property or services with self-determination contract funds, can an Indian tribe...

Code of Federal Regulations, 2013 CFR

2013-04-01

... 25 Indians 2 2013-04-01 2013-04-01 false When procuring property or services with self-determination contract funds, can an Indian tribe or tribal organization follow the same procurement policies and procedures applicable to other Indian tribe or tribal organization funds? 900.47 Section 900.47...

25 CFR 900.47 - When procuring property or services with self-determination contract funds, can an Indian tribe...

Code of Federal Regulations, 2011 CFR

2011-04-01

... 25 Indians 2 2011-04-01 2011-04-01 false When procuring property or services with self-determination contract funds, can an Indian tribe or tribal organization follow the same procurement policies and procedures applicable to other Indian tribe or tribal organization funds? 900.47 Section 900.47...

25 CFR 900.47 - When procuring property or services with self-determination contract funds, can an Indian tribe...

Code of Federal Regulations, 2014 CFR

2014-04-01

... 25 Indians 2 2014-04-01 2014-04-01 false When procuring property or services with self-determination contract funds, can an Indian tribe or tribal organization follow the same procurement policies and procedures applicable to other Indian tribe or tribal organization funds? 900.47 Section 900.47...

25 CFR 900.47 - When procuring property or services with self-determination contract funds, can an Indian tribe...

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 2 2010-04-01 2010-04-01 false When procuring property or services with self-determination contract funds, can an Indian tribe or tribal organization follow the same procurement policies and procedures applicable to other Indian tribe or tribal organization funds? 900.47 Section 900.47...

25 CFR 900.47 - When procuring property or services with self-determination contract funds, can an Indian tribe...

Code of Federal Regulations, 2012 CFR

2012-04-01

... 25 Indians 2 2012-04-01 2012-04-01 false When procuring property or services with self-determination contract funds, can an Indian tribe or tribal organization follow the same procurement policies and procedures applicable to other Indian tribe or tribal organization funds? 900.47 Section 900.47...

Achieving donor management goals before deceased donor procurement is associated with more organs transplanted per donor.

PubMed

Malinoski, Darren J; Daly, Michael C; Patel, Madhukar S; Oley-Graybill, Chrystal; Foster, Clarence E; Salim, Ali

2011-10-01

There is a national shortage of organs available for transplantation. Implementation of preset donor management goals (DMGs) to improve outcomes is recommended, but uniform practices and data are lacking. We hypothesized that meeting DMGs before organ procurement would result in more organs transplanted per donor (OTPD). The eight organ procurement organization in United Network for Organ Sharing Region 5 selected 10 critical care end points as DMGs. Each organ procurement organization submitted retrospective data from 40 standard criteria donors. "DMGs met" was defined as achieving any eight DMGs before procurement. The primary outcome was ≥4 OTPD. Binary logistic regression was used to determine independent predictors of ≥4 OTPD with a p<0.05. Three hundred twenty standard criteria donors had 3.6±1.6 OTPD. Donors with DMGs met had more OTPD (4.4 vs. 3.3, p<0.001) and were more likely to have ≥4 OTPD (70% vs. 39%, p<0.001). Independent predictors of ≥4 OTPD were age (odds ratio [OR]=0.94), serum creatinine (OR=0.65), thyroid hormone use (OR=2.0), "DMGs met" (OR=4.4), and achieving the following individual DMGs: central venous pressure 4 mm Hg to 10 mm Hg (OR=1.9), ejection fraction>50% (OR=4.0), Pao2:FIO2>300 (OR=4.6), and serum sodium 135 to 160 mEq/L (OR=3.4). Meeting DMGs before procurement resulted in more OTPD. Donor factors and critical care end points are independent predictors of organ yield. Prospective studies are needed to determine the true impact of each DMG on the number and function of transplanted organs.

Maximizing donor potential: evolving organ procurement organization metrics and optimizing organ distribution and allocation in the United States.

PubMed

Washburn, Kenneth

2012-11-01

1. Comprehend the basis for liver allocation and distribution in the United States. 2. Understand potential solutions to organ inequalities in the United States. 3. Understand the metrics used to assess the performance of organ procurement organizations. Copyright © 2012 American Association for the Study of Liver Diseases.

42 CFR 121.9 - Designated transplant program requirements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... RESOURCES DEVELOPMENT ORGAN PROCUREMENT AND TRANSPLANTATION NETWORK § 121.9 Designated transplant program...) Has immediate access to microbiology, clinical chemistry, histocompatibility testing, radiology, and...

42 CFR 121.9 - Designated transplant program requirements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... RESOURCES DEVELOPMENT ORGAN PROCUREMENT AND TRANSPLANTATION NETWORK § 121.9 Designated transplant program...) Has immediate access to microbiology, clinical chemistry, histocompatibility testing, radiology, and...

42 CFR 121.9 - Designated transplant program requirements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... RESOURCES DEVELOPMENT ORGAN PROCUREMENT AND TRANSPLANTATION NETWORK § 121.9 Designated transplant program...) Has immediate access to microbiology, clinical chemistry, histocompatibility testing, radiology, and...

75 FR 63187 - Agency Information Collection Activities: Proposed Collection: Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-14

.... Information is needed to match donor organs with recipients, to monitor compliance of member organizations... techniques or other forms of information technology. Proposed Project: Data System for Organ Procurement and Transplantation Network (42 CFR Part 121, OMB No. 0915-0184): Extension The operation of the Organ Procurement and...

Integrating team resource management program into staff training improves staff's perception and patient safety in organ procurement and transplantation: the experience in a university-affiliated medical center in Taiwan.

PubMed

Hsu, Ya-Chi; Jerng, Jih-Shuin; Chang, Ching-Wen; Chen, Li-Chin; Hsieh, Ming-Yuan; Huang, Szu-Fen; Liu, Yueh-Ping; Hung, Kuan-Yu

2014-08-11

The process involved in organ procurement and transplantation is very complex that requires multidisciplinary coordination and teamwork. To prevent error during the processes, teamwork education and training might play an important role. We wished to evaluate the efficacy of implementing a Team Resource Management (TRM) program on patient safety and the behaviors of the team members involving in the process. We implemented a TRM training program for the organ procurement and transplantation team members of the National Taiwan University Hospital (NTUH), a teaching medical center in Taiwan. This 15-month intervention included TRM education and training courses for the healthcare workers, focused group skill training for the procurement and transplantation team members, video demonstration and training, and case reviews with feedbacks. Teamwork culture was evaluated and all procurement and transplantation cases were reviewed to evaluate the application of TRM skills during the actual processes. During the intervention period, a total of 34 staff members participated the program, and 67 cases of transplantations were performed. Teamwork framework concept was the most prominent dimension that showed improvement from the participants for training. The team members showed a variety of teamwork behaviors during the process of procurement and transplantation during the intervention period. Of note, there were two potential donors with a positive HIV result, for which the procurement processed was timely and successfully terminated by the team. None of the recipients was transplanted with an infected organ. No error in communication or patient identification was noted during review of the case records. Implementation of a Team Resource Management program improves the teamwork culture as well as patient safety in organ procurement and transplantation.

Integrating team resource management program into staff training improves staff’s perception and patient safety in organ procurement and transplantation: the experience in a university-affiliated medical center in Taiwan

PubMed Central

2014-01-01

Background The process involved in organ procurement and transplantation is very complex that requires multidisciplinary coordination and teamwork. To prevent error during the processes, teamwork education and training might play an important role. We wished to evaluate the efficacy of implementing a Team Resource Management (TRM) program on patient safety and the behaviors of the team members involving in the process. Methods We implemented a TRM training program for the organ procurement and transplantation team members of the National Taiwan University Hospital (NTUH), a teaching medical center in Taiwan. This 15-month intervention included TRM education and training courses for the healthcare workers, focused group skill training for the procurement and transplantation team members, video demonstration and training, and case reviews with feedbacks. Teamwork culture was evaluated and all procurement and transplantation cases were reviewed to evaluate the application of TRM skills during the actual processes. Results During the intervention period, a total of 34 staff members participated the program, and 67 cases of transplantations were performed. Teamwork framework concept was the most prominent dimension that showed improvement from the participants for training. The team members showed a variety of teamwork behaviors during the process of procurement and transplantation during the intervention period. Of note, there were two potential donors with a positive HIV result, for which the procurement processed was timely and successfully terminated by the team. None of the recipients was transplanted with an infected organ. No error in communication or patient identification was noted during review of the case records. Conclusion Implementation of a Team Resource Management program improves the teamwork culture as well as patient safety in organ procurement and transplantation. PMID:25115403

NASA's Electronic Procurement System and the Impact on Small Business

NASA Technical Reports Server (NTRS)

Dozier, Ken

1998-01-01

Three workshops, held in Lancaster, Orange County and Compton, were produced by the Los Angeles Regional Technology Alliance (LARTA) and NASA Far West Technology Transfer Center (FWRTTC). The workshops were held on December 12, 1997, February 5, 1998, and March 30, 1998, respectively. The purpose behind these workshops was to spread information regarding NASA procurement opportunities to small businesses in the region. This was accomplished by inviting economic and business development organizations to the three workshops, presenting NASA procurement resources to them, and asking them to distribute this information to the small businesses in their communities. With the assistance of LARTA, marketing and publicity in the form of direct mail, telemarketing, and promotion via a web site was implemented to publicize the workshops. These methods were remarkably effective because they enabled the workshops to attain its full capacity. Further publicity was provided by Wendy Reed of Valley Focus Magazine, an Antelope Valley Magazine aimed at business people. Her article entitled, "Doing Business with the Government" recapped the Lancaster workshop that she had attended and made references to several presentations. In the article, she discussed selling to the government via electronic commerce, and specifically mentioned Robert Medina, the NASA Dryden Small Business Specialist, as a contact person for those interested in pursuing procurement opportunities. The feedback provided by the participants is illustrated by the enclosed graphs and charts. These figures represent the number of participants who have frequented web sites presented at workshops, specifically the NASA procurement resources, and how extensive information dissemination was. Input from participants was favorable and encouraged more NASA Dryden workshops directly to the small business communities. There was an overwhelming response to the benefit of the NASA procurement opportunities presented at the workshops. Ninety-nine percent of participants who responded to surveys expressed that the NASA procurement information was beneficial. By the fifth month after the start of the workshops, NASA procurement resource inquiries peaked at 100%. Also during this time, 100% of respondents to a survey mentioned that they had passed along information from workshops to other small businesses or organizations that could benefit from it. These results indicate successful implementation of the Dryden Workshops. The objective of spreading NASA procurement opportunities throughout small businesses in the region was achieved through the three workshops. In conclusion, we recommend that further NASA procurement workshops be funded to continue the education and outreach that has been started. We also feel that in addition to targeting economic development service providers, Dryden procurement should also be provided directly to small business communities.

Using a Standardized Donor Ratio to Assess Organ Procurement Organizations

PubMed Central

Stogis, Sheryl; Hirth, Richard A; Strawderman, Robert L; Banaszak-Holl, Jane; Smith, Dean G

2002-01-01

Objective To develop a Standardized Donor Ratio (SDR) as an outcome measure for evaluating the effectiveness of organ procurement organizations (OPOs). Data Sources/Study Setting All deaths by cause in the United States during 1993–1994 as reported in the Vital Mortality Statistics, Multiple Cause of Death files. The OPO-specific data were provided by the United Network for Organ Sharing (UNOS). Study Design Each OPO's expected number of donors was calculated by applying national donation rates to deaths with potential for donation in 24 age, sex, and race cells. The SDR was calculated by dividing the observed number of donors by the expected number. The X2 tests of the hypothesis that the OPO's performance differed from the national norm of 1.0 were performed. The SDR was compared to the existing performance standard based on the unadjusted number of donors per million live population in the OPO's service area. An ordinary least squares (OLS) regression assessed predictors of the SDR. Principal Findings The SDRs ranged from 0.41 to 1.99. Twenty-nine of 64 OPOs had SDRs significantly different than 1.0. The SDRs were positively associated with the percent of white living population and the number of organ types transplanted per transplant center served by the OPO. Conclusions The SDRs can be used by Centers for Medicare and Medicaid Services (CMS), UNOS, and OPOs to target quality improvement initiatives, present more accurate comparisons of OPO performance, and develop public policy on the evaluation of the effectiveness of organ procurement efforts. PMID:12479499

Improving Foreign Military Sales Procurement: An Analysis of Turkish Navy’s Spare Part Procurements, Discrepancies, and Repairs

DTIC Science & Technology

2016-03-01

capabilities to cover the FMS supporting activities. 14. SUBJECT TERMS Republic of Turkey , Security Assistance, Foreign Military Sales, Direct...Agency IPO International Program Office JSUMMAT Joint United States Military Mission for Aid to Turkey LOA Letter of Acceptance LOAD Letter of...employment, capital formation, as well as research and development (Perfilio, 2007, p. 3). As a North Atlantic Treaty Organization (NATO) member, Turkey

29 CFR 95.44 - Procurement procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 1 2011-07-01 2011-07-01 false Procurement procedures. 95.44 Section 95.44 Labor Office of the Secretary of Labor GRANTS AND AGREEMENTS WITH INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS, AND WITH COMMERCIAL ORGANIZATIONS, FOREIGN GOVERNMENTS, ORGANIZATIONS...

Simultaneous air transportation of the harvested heart and visceral organs for transplantation.

PubMed

Aydin, U; Yazici, P; Kazimi, C; Bozoklar, A; Sozbilen, M; Zeytunlu, M; Kilic, M

2008-01-01

The purpose of this study was to evaluate the duration for organ procurement including both heart and visceral organs and outcomes of the simultaneous transportation of the teams back to the recipient hospitals. Between March 2005 and March 2007, 37/82 organ procurement was performed in the district hospitals and transported to our institution for organ transplantation. Combined heart and visceral organ procurement which was simultaneously transported to the recipient hospitals by one air vehicle was reviewed. After both the thoracic and abdominal cavities were entered, all intra-abdominal organs were mobilized allowing exposure of the inferior mesenteric vein and aorta. The supraceliac abdominal aorta was elevated. The attachments of the liver in the hilar region were incised and both kidneys and pancreas prepared for removal. After the inferior mesenteric vein and aorta were cannulated, simultaneous aortic cross-clamping was performed and cold preservation solution infused. Harvested organs were packed with ice and removed to the back table for initial preparation and packaging for air transport. The mean duration of 6 procurement procedures was 63 minutes (range 50-75 minutes) to aortic clamping, and 27.5 minutes (range, 20-40 minutes) between clamping and harvesting. Mean cold ischemia times for 6 hearts, 6 livers, 12 kidneys, 2 pancreas, and 1 small intestine were 2.4 hours (range, 2-3.5 hours), 5 hours (range, 3-8 hours), 10.3 hours (range, 8-15 hours), 6.7 hours, and 9.5 hours, respectively. No graft complication was observed to be associated with the procurement procedure. Better collaborations between surgical teams and rapid procurement techniques provide simultaneous air transportation back to the recipient hospital with reduced cold ischemia times of the visceral organs.

78 FR 18876 - Defense Federal Acquisition Regulation Supplement: United States-Korea Free Trade Agreement...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-28

... Agreement. The Republic of Korea is already party to the World Trade Organization Government Procurement...) Agreement on Government Procurement (GPA). Although the rule now opens up Government procurement to the... 48 CFR Parts 225 and 252 Government procurement. Kortnee Stewart, Editor, Defense Acquisition...

The dead donor rule: can it withstand critical scrutiny?

PubMed

Miller, Franklin G; Truog, Robert D; Brock, Dan W

2010-06-01

Transplantation of vital organs has been premised ethically and legally on "the dead donor rule" (DDR)-the requirement that donors are determined to be dead before these organs are procured. Nevertheless, scholars have argued cogently that donors of vital organs, including those diagnosed as "brain dead" and those declared dead according to cardiopulmonary criteria, are not in fact dead at the time that vital organs are being procured. In this article, we challenge the normative rationale for the DDR by rejecting the underlying premise that it is necessarily wrong for physicians to cause the death of patients and the claim that abandoning this rule would exploit vulnerable patients. We contend that it is ethical to procure vital organs from living patients sustained on life support prior to treatment withdrawal, provided that there is valid consent for both withdrawing treatment and organ donation. However, the conservatism of medical ethics and practical concerns make it doubtful that the DDR will be abandoned in the near future. This leaves the current practice of organ transplantation based on the "moral fiction" that donors are dead when vital organs are procured.

Outcome of organs procured from donors on extracorporeal membrane oxygenation support: an analysis of kidney and liver allograft data.

PubMed

Carter, Timothy; Bodzin, Adam S; Hirose, Hitoshi; West, Sharon; Hasz, Richard; Maley, Warren R; Cavarocchi, Nicholas C

2014-07-01

Extracorporeal membrane oxygenation has become rescue therapy for adults with overwhelming cardiac and/or respiratory failure. Not all patients are saved, creating a new cohort of potential organ donors. This study examines the outcomes of liver and kidney allografts procured from donors on extracorporeal membrane oxygenation (ECMO). A retrospective review was conducted through the local organ procurement organization. Donors on ECMO prior to notification were classified into donation after brain death (DBD) and donation after cardiac death (DCD). We compared short-term outcome data against published standards. Between 1995 and 2012, 97 organs were procured from 41 donors supported on ECMO. There were 68 kidneys donated, 51 were transplanted and 17 discarded. Excluding extended criteria donors, 29 DBD and 13 DCD kidneys were transplanted from donors supported on ECMO. Delayed graft function occurred in 34% of DBD kidneys and 38% of DCD kidneys. Kidney allograft survival at one yr was 93%. Twenty-four livers were procured, nine discarded, and 15 transplanted. Ninety-three percent of liver transplant recipients were alive with graft function at one yr. Donation after brain death kidneys procured from donors on ECMO perform similarly to non-ECMO organs with regard to delayed graft function (DGF), one-yr graft survival and function. Livers from ECMO donors have a higher discard rate than non-ECMO donors, but function similarly at six months and one yr. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Annual report: Purchasing and Materials Management Organization, Sandia National Laboratories, fiscal year 1992

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zaeh, R.A.

1993-04-01

This report summarizes the purchasing and transportation activities of the Purchasing and Materials Management Organization for Fiscal Year 1992. Activities for both the New Mexico and California locations are included. Topics covered in this report include highlights for fiscal year 1992, personnel, procurements (small business procurements, disadvantaged business procurements, woman-owned business procurements, New Mexico commercial business procurements, Bay area commercial business procurements), commitments by states and foreign countries, and transportation activities. Also listed are the twenty-five commercial contractors receiving the largest dollar commitments, commercial contractors receiving commitments of $1,000 or more, integrated contractor and federal agency commitments of $1,000 ormore » more from Sandia National Laboratories/New Mexico and California, and transportation commitments of $1,000 or more from Sandia National Laboratories/New Mexico and California.« less

IPPF firm reconciles money with mission.

PubMed

1991-01-01

Despite its seemingly conflicting goals, the Family Health Management Service (FHMS) has become an important middleman agency for contraceptives. A for-profit subsidiary of the International Planned Parenthood Federation (IPPF), FHMS has established itself by helping fill the funding gap left by large international donor agencies. FHMS acts as consulting and procurement firm of contraceptives for smaller family planning programs around the world. These organizations, whether government or private, are generally too small to qualify extensive assistance from major donor groups. Although FHMS is a for-profit organization, its leadership stresses that its main goal is to make family planning knowledge and skills available to everyone. FHMS makes a determination whether the organization seeking contraceptives is a charitable or commercial enterprise. If the organization is charitable, FHMS charges only a handling fee. If the organization is commercial, FHMS adds a percentage to make the cost of the contraceptive reflect the market value. Since it begun operating in 1988, FHMS has assisted hundreds of customers. When Action Aid needed 6000 contraceptive products (a figure too small to attract funding from large donor organizations but too large to buy in the open market) for its rural development program in sierra Leone, FHMS procured them at an affordable cost. Last year, the organization spent about $1 million in procuring, shipping, and managing contraceptive sales, and netted a profit of about $45,000. All profits are channeled back to IPPF's altruistic programs.

Routine recovery: an ethical plan for greatly increasing the supply of transplantable organs.

PubMed

Spital, Aaron; Taylor, James S

2008-04-01

All current organ procurement policies require some form of consent. Many families refuse to permit organ recovery from a recently deceased relative; therefore, the major cost of requiring consent is the loss of some lives that could have been saved through transplantation. Here, we argue for a much more efficient approach to organ procurement from brain dead individuals - routine recovery of all transplantable organs without consent. Careful analysis of the relevant literature shows that, compared with its competitors, routine recovery has the greatest potential to increase cadaveric organ procurement and save lives while causing very little harm. Furthermore, a recent survey suggests that 30% of the US public would already accept routine recovery even though the respondents were not educated regarding the value of this approach. Patients on the transplant waiting list are dying while organs that could have saved them are being buried or burned because of family refusal to allow posthumous organ procurement. Routine recovery would eliminate this tragic loss of life-saving organs without violating ethical principles. Indeed, we argue that of all the proposals designed to increase the supply of transplantable cadaveric organs, routine recovery is the best.

[Critical appraisal of organ procurement under Maastricht 3 condition].

PubMed

Puybasset, L; Bazin, J-E; Beloucif, S; Bizouarn, P; Crozier, S; Devalois, B; Eon, B; Fieux, F; Gisquet, E; Guibet-Lafaye, C; Kentish, N; Lienhart, A; Nicolas-Robin, A; Otero Lopez, M; Pelluchon, C; Roussin, F; Beydon, L

2012-05-01

The ethics committee of the French Society of Anesthesia and Intensive Care (Sfar) has been requested by the French Biomedical Agency to consider the issue of organ donation in patients after a decision of withdrawing life supporting therapies has been taken. This category of organ donation is performed in the USA, Canada, United Kingdom, the Netherlands and Belgium. The three former countries have published recommendations, which formalize procedures and operations. The Sfar ethics committee has considered this issue and envisioned the different aspects of the whole process. Consequently, it sounds a note of caution regarding the applicability of this type of organ procurement in unselected patient following a decision to withdraw life supporting therapies. According to the French regulation concerning organ procurement in brain dead patients, the committee stresses the need to restrict this specific way of procurement to severely brain injured patients, once confirmatory investigations predicting a catastrophic prognosis have been performed. It suggests that the nature of the confirmatory investigation required should be formalized by the French Biomedical Agency on behalf of the French parliamentarians. This should help preserving population trust regarding organ procurement and provide a framework to medical decision. This text has been endorsed by the Sfar. Copyright © 2012. Published by Elsevier SAS.

Incidence of bacterial contamination and predisposing factors during bone and tendon allograft procurement.

PubMed

Terzaghi, Clara; Longo, Alessia; Legnani, Claudio; Bernasconi, Davide Paolo; Faré, Maristella

2015-03-01

The aim of this study was to analyze factors contributing to bacteriological contamination of bone and tendon allograft. Between 2008 and 2011, 2,778 bone and tendon allografts obtained from 196 organ and tissue donors or tissue donors only were retrospectively analysed. Several variables were taken into account: donor type (organ and tissue donors vs. tissue donor), cause of death, time interval between death and tissue procurement, duration of the procurement procedure, type of allografts, number of team members, number of trainees members, associated surgical procedures, positivity to haemoculture, type of procurement. The overall incidence of graft contamination was 23 %. The cause of death, the procurement time, the duration of procurement, the associated surgical procedures were not associated with increased risk of contamination. Significant effect on contamination incidence was observed for the number of staff members performing the procurement. In addition, our study substantiated significantly higher contamination rate among bone allografts than from tendon grafts. According to these observations, in order to minimize the contamination rate of procured musculoskeletal allografts, we recommend appropriate donor selection, use of standard sterile techniques, immediate packaging of each allograft to reduce graft exposure. Allograft procurement should be performed by a small surgical team.

Benchmarking in national health service procurement in Scotland.

PubMed

Walker, Scott; Masson, Ron; Telford, Ronnie; White, David

2007-11-01

The paper reports the results of a study on benchmarking activities undertaken by the procurement organization within the National Health Service (NHS) in Scotland, namely National Procurement (previously Scottish Healthcare Supplies Contracts Branch). NHS performance is of course politically important, and benchmarking is increasingly seen as a means to improve performance, so the study was carried out to determine if the current benchmarking approaches could be enhanced. A review of the benchmarking activities used by the private sector, local government and NHS organizations was carried out to establish a framework of the motivations, benefits, problems and costs associated with benchmarking. This framework was used to carry out the research through case studies and a questionnaire survey of NHS procurement organizations both in Scotland and other parts of the UK. Nine of the 16 Scottish Health Boards surveyed reported carrying out benchmarking during the last three years. The findings of the research were that there were similarities in approaches between local government and NHS Scotland Health, but differences between NHS Scotland and other UK NHS procurement organizations. Benefits were seen as significant and it was recommended that National Procurement should pursue the formation of a benchmarking group with members drawn from NHS Scotland and external benchmarking bodies to establish measures to be used in benchmarking across the whole of NHS Scotland.

Vascularized Composite Allografts: Procurement, Allocation, and Implementation.

PubMed

Rahmel, Axel

Vascularized composite allotransplantation is a continuously evolving area of modern transplant medicine. Recently, vascularized composite allografts (VCAs) have been formally classified as 'organs'. In this review, key aspects of VCA procurement are discussed, with a special focus on interaction with the procurement of classical solid organs. In addition, options for a matching and allocation system that ensures VCA donor organs are allocated to the best-suited recipients are looked at. Finally, the different steps needed to promote VCA transplantation in society in general and in the medical community in particular are highlighted.

An official American Thoracic Society/International Society for Heart and Lung Transplantation/Society of Critical Care Medicine/Association of Organ and Procurement Organizations/United Network of Organ Sharing Statement: ethical and policy considerations in organ donation after circulatory determination of death.

PubMed

Gries, Cynthia J; White, Douglas B; Truog, Robert D; Dubois, James; Cosio, Carmen C; Dhanani, Sonny; Chan, Kevin M; Corris, Paul; Dark, John; Fulda, Gerald; Glazier, Alexandra K; Higgins, Robert; Love, Robert; Mason, David P; Nakagawa, Thomas A; Shapiro, Ron; Shemie, Sam; Tracy, Mary Fran; Travaline, John M; Valapour, Maryam; West, Lori; Zaas, David; Halpern, Scott D

2013-07-01

Donation after circulatory determination of death (DCDD) has the potential to increase the number of organs available for transplantation. Because consent and management of potential donors must occur before death, DCDD raises unique ethical and policy issues. To develop an ethics and health policy statement on adult and pediatric DCDD relevant to critical care and transplantation stakeholders. A multidisciplinary panel of stakeholders was convened to develop an ethics and health policy statement. The panel consisted of representatives from the American Thoracic Society, Society of Critical Care Medicine, International Society for Heart and Lung Transplantation, Association of Organ Procurement Organizations, and the United Network of Organ Sharing. The panel reviewed the literature, discussed important ethics and health policy considerations, and developed a guiding framework for decision making by stakeholders. A framework to guide ethics and health policy statement was established, which addressed the consent process, pre- and post mortem interventions, the determination of death, provisions of end-of-life care, and pediatric DCDD. The information presented in this Statement is based on the current evidence, experience, and clinical rationale. New clinical research and the development and dissemination of new technologies will eventually necessitate an update of this Statement.

Issues in organ procurement, allocation, and transplantation.

PubMed

Nierste, Deborah

2013-01-01

Organ transplantation extends lives and improves health but presents complex ethical dilemmas for nurses caring for donors, recipients, and their families. This article overviews organ procurement and allocation, discusses ethical dilemmas in transplantation, and offers strategies from professional and biblical perspectives for coping with moral distress and maintaining compassionate care.

76 FR 5389 - Agency Information Collection Activities: Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-31

...) and in carrying out other statutory responsibilities. Information is needed to match donor organs with... Act of 1995: Proposed Project: Data System for Organ Procurement and Transplantation Network (42 CFR Part 121, OMB No. 0915-0184)--[Extension] The operation of the Organ Procurement and Transplantation...

22 CFR 226.42 - Codes of conduct.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ADMINISTRATION OF ASSISTANCE AWARDS TO U.S. NON-GOVERNMENTAL ORGANIZATIONS Post-award Requirements Procurement Standards § 226.42 Codes of conduct. The recipient shall... immediate family, his or her partner, or an organization which employs or is about to employ any of the...

Abandon the dead donor rule or change the definition of death?

PubMed

Veatch, Robert M

2004-09-01

Research by Siminoff and colleagues reveals that many lay people in Ohio classify legally living persons in irreversible coma or persistent vegetative state (PVS) as dead that additional respondents, although classifying such patients as living, would be willing to procure organs from them. This paper analyzes possible implications of these findings for public policy. A majority would procure organs from those in irreversible coma or in PVS. Two strategies for legitimizing such procurement are suggested. One strategy would be to make exceptions to the dead donor rule permitting procurement from those in PVS or at least those who are in irreversible coma while continuing to classify them as living. Another strategy would be to further amend the definition of death to classify one or both groups as deceased, thus permitting procurement without violation of the dead donor rule. Permitting exceptions to the dead donor rule would require substantial changes in law--such as authorizing procuring surgeons to end the lives of patients by means of organ procurement--and would weaken societal prohibitions on killing. The paper suggests that it would be easier and less controversial to further amend the definition of death to classify those in irreversible coma and PVS as dead. Incorporation of a conscience clause to permit those whose religious or philosophical convictions support whole-brain or cardiac-based death pronouncement would avoid violating their beliefs while causing no more than minimal social problems. The paper questions whether those who would support an exception to the dead donor rule in these cases and those who would support a further amendment to the definition of death could reach agreement to adopt a public policy permitting organ procurement of those in irreversible coma or PVS when proper consent is obtained.

Improving Evaluation in Nonprofit Organizations: A Study of How Evaluation Requests for Proposals Are Developed, Responded to, and Fulfilled

ERIC Educational Resources Information Center

Matthews, Nakia S.

2015-01-01

It is often necessary for nonprofit organizations (NPOs) to formulate a Request for Proposal (RFP) to procure essential contracted services. This is most common when seeking the services of an external evaluator. Since most NPOs do not have internal evaluation staff, developing an appropriate RFP can be quite challenging. With limited literature…

Framing life and death on YouTube: the strategic communication of organ donation messages by organ procurement organizations.

PubMed

VanderKnyff, Jeremy; Friedman, Daniela B; Tanner, Andrea

2015-01-01

Using a sample of YouTube videos posted on the YouTube channels of organ procurement organizations, a content analysis was conducted to identify the frames used to strategically communicate prodonation messages. A total of 377 videos were coded for general characteristics, format, speaker characteristics, organs discussed, structure, problem definition, and treatment. Principal components analysis identified message frames, and k-means cluster analysis established distinct groupings of videos on the basis of the strength of their relationship to message frames. Analysis of these frames and clusters found that organ procurement organizations present multiple, and sometimes competing, video types and message frames on YouTube. This study serves as important formative research that will inform future studies to measure the effectiveness of the distinct message frames and clusters identified.

75 FR 33760 - Information Collection; Virtual Incident Procurement (VIPR) System Existing Vendor Survey

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-15

... DEPARTMENT OF AGRICULTURE Forest Service Information Collection; Virtual Incident Procurement... from all interested individuals and organizations on the new information collection, Virtual Incident....t., Monday through Friday. SUPPLEMENTARY INFORMATION: Title: Virtual Incident Procurement (VIPR...

48 CFR 970.2803-1 - Workers' Compensation Insurance.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Management, within the Headquarters procurement organization, other officials, and the Heads of Contracting... Office of Resource Management, within the Headquarters procurement organization, is responsible for... SUPPLEMENTARY REGULATIONS DOE MANAGEMENT AND OPERATING CONTRACTS Bonds and Insurance 970.2803-1 Workers...

48 CFR 970.2803-1 - Workers' Compensation Insurance.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Management, within the Headquarters procurement organization, other officials, and the Heads of Contracting... Office of Resource Management, within the Headquarters procurement organization, is responsible for... SUPPLEMENTARY REGULATIONS DOE MANAGEMENT AND OPERATING CONTRACTS Bonds and Insurance 970.2803-1 Workers...

48 CFR 970.2803-1 - Workers' Compensation Insurance.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Management, within the Headquarters procurement organization, other officials, and the Heads of Contracting... Office of Resource Management, within the Headquarters procurement organization, is responsible for... SUPPLEMENTARY REGULATIONS DOE MANAGEMENT AND OPERATING CONTRACTS Bonds and Insurance 970.2803-1 Workers...

48 CFR 970.2803-1 - Workers' Compensation Insurance.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Management, within the Headquarters procurement organization, other officials, and the Heads of Contracting... Office of Resource Management, within the Headquarters procurement organization, is responsible for... SUPPLEMENTARY REGULATIONS DOE MANAGEMENT AND OPERATING CONTRACTS Bonds and Insurance 970.2803-1 Workers...

48 CFR 970.2803-1 - Workers' Compensation Insurance.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Management, within the Headquarters procurement organization, other officials, and the Heads of Contracting... Office of Resource Management, within the Headquarters procurement organization, is responsible for... SUPPLEMENTARY REGULATIONS DOE MANAGEMENT AND OPERATING CONTRACTS Bonds and Insurance 970.2803-1 Workers...

The Dead Donor Rule: Can It Withstand Critical Scrutiny?

PubMed Central

Miller, Franklin G.; Truog, Robert D.; Brock, Dan W.

2010-01-01

Transplantation of vital organs has been premised ethically and legally on “the dead donor rule” (DDR)—the requirement that donors are determined to be dead before these organs are procured. Nevertheless, scholars have argued cogently that donors of vital organs, including those diagnosed as “brain dead” and those declared dead according to cardiopulmonary criteria, are not in fact dead at the time that vital organs are being procured. In this article, we challenge the normative rationale for the DDR by rejecting the underlying premise that it is necessarily wrong for physicians to cause the death of patients and the claim that abandoning this rule would exploit vulnerable patients. We contend that it is ethical to procure vital organs from living patients sustained on life support prior to treatment withdrawal, provided that there is valid consent for both withdrawing treatment and organ donation. However, the conservatism of medical ethics and practical concerns make it doubtful that the DDR will be abandoned in the near future. This leaves the current practice of organ transplantation based on the “moral fiction” that donors are dead when vital organs are procured. PMID:20439355

Giving until it hurts: prisoners are not the answer to the national organ shortage.

PubMed

Hinkle, Whitney

2002-01-01

This Note argues that prisoners, whether executed or living, should not become organ donors. The introduction acknowledges the shortage of transplantable organs in the United States and the steps that have been taken to ameliorate the crisis. Part I discusses the procurement of organs from executed prisoners, beginning with a brief examination of China, a country where this type of procurement is routinely practiced. Part I also examines organ procurement legislation pertaining to executed prisoners. Finally, Part I asserts the reasons that prisoners should not become donors, including the dead donor rule, the ban against physicians as executioners, the Oath of Hippocrates, the risk of transmissible diseases, and the negative perception that would result if organ procurement was tied to executions. Part II of this Note discusses prisoners donating their organs in return for mitigated sentences. Part II then argues that this practice should not be adopted because of the lack of informed consent and voluntary choice. Finally, Part III of this Note introduces potential solutions to the possibility of maintaining a voluntary system, moving to a presumed consent system, and using financial inducements to create a larger supply of transplantable organs.

The Development of a Mathematical Foundation for Cellular Image Processing.

DTIC Science & Technology

1984-02-01

PERFORMING ORGANIZATION REPORT NUMBERIS) 5. MONITORING ORGANIZATION REPORT NUMBER(S) AFOSR-TR. 407 6&. NAME OF PERFORMING ORGANIZATION 5b. OFFICE...SYMBOL 7s. NAME OF MONITORING ORGANIZATION University of Florida (it appicable) Air Force Office of Scientific Research 6c. ADDRESS (City. State and ZIP...Bolling AFB DC 20332 84. NAME OF FUNDING/SPONSORING IBb. OFFICE SYMBOL 9. PROCUREMENT INSTRUMENT IDENTIFICATION NUMBER ORGANIZATION J(If applicablej FS

38 CFR 1.514b - Disclosures to procurement organizations.

Code of Federal Regulations, 2012 CFR

2012-07-01

... verify annually in January of each calendar year with FDA that an eye bank or tissue bank has complied... before permitting an eye bank or tissue bank to receive protected health information. (Authority: 38 U.S... procurement organization of whether the individual is a suitable potential organ, eye, or tissue donor if: (a...

38 CFR 1.514b - Disclosures to procurement organizations.

Code of Federal Regulations, 2013 CFR

2013-07-01

... verify annually in January of each calendar year with FDA that an eye bank or tissue bank has complied... before permitting an eye bank or tissue bank to receive protected health information. (Authority: 38 U.S... procurement organization of whether the individual is a suitable potential organ, eye, or tissue donor if: (a...

38 CFR 1.514b - Disclosures to procurement organizations.

Code of Federal Regulations, 2014 CFR

2014-07-01

... verify annually in January of each calendar year with FDA that an eye bank or tissue bank has complied... before permitting an eye bank or tissue bank to receive protected health information. (Authority: 38 U.S... procurement organization of whether the individual is a suitable potential organ, eye, or tissue donor if: (a...

38 CFR 1.514b - Disclosures to procurement organizations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... procurement organization of whether the individual is a suitable potential organ, eye, or tissue donor if: (a... verify annually in January of each calendar year with FDA that an eye bank or tissue bank has complied... before permitting an eye bank or tissue bank to receive protected health information. (Authority: 38 U.S...

42 CFR 485.643 - Condition of participation: Organ, tissue, and eye procurement.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 5 2011-10-01 2011-10-01 false Condition of participation: Organ, tissue, and eye... participation: Organ, tissue, and eye procurement. The CAH must have and implement written protocols that: (a... absence of alternative arrangements by the CAH, the OPO determines medical suitability for tissue and eye...

38 CFR 1.514b - Disclosures to procurement organizations.

Code of Federal Regulations, 2011 CFR

2011-07-01

... procurement organization of whether the individual is a suitable potential organ, eye, or tissue donor if: (a... verify annually in January of each calendar year with FDA that an eye bank or tissue bank has complied... before permitting an eye bank or tissue bank to receive protected health information. (Authority: 38 U.S...

42 CFR 482.45 - Condition of participation: Organ, tissue, and eye procurement.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Condition of participation: Organ, tissue, and eye... HOSPITALS Basic Hospital Functions § 482.45 Condition of participation: Organ, tissue, and eye procurement... medical suitability for tissue and eye donation, using the definition of potential tissue and eye donor...

42 CFR 482.45 - Condition of participation: Organ, tissue, and eye procurement.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 5 2011-10-01 2011-10-01 false Condition of participation: Organ, tissue, and eye... HOSPITALS Basic Hospital Functions § 482.45 Condition of participation: Organ, tissue, and eye procurement... medical suitability for tissue and eye donation, using the definition of potential tissue and eye donor...

42 CFR 485.643 - Condition of participation: Organ, tissue, and eye procurement.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Condition of participation: Organ, tissue, and eye... participation: Organ, tissue, and eye procurement. The CAH must have and implement written protocols that: (a... absence of alternative arrangements by the CAH, the OPO determines medical suitability for tissue and eye...

48 CFR 25.403 - World Trade Organization Government Procurement Agreement and Free Trade Agreements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false World Trade Organization Government Procurement Agreement and Free Trade Agreements. 25.403 Section 25.403 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION SOCIOECONOMIC PROGRAMS FOREIGN ACQUISITION Trade Agreements 25.403 World Trade Organization...

48 CFR 25.403 - World Trade Organization Government Procurement Agreement and Free Trade Agreements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 48 Federal Acquisition Regulations System 1 2012-10-01 2012-10-01 false World Trade Organization Government Procurement Agreement and Free Trade Agreements. 25.403 Section 25.403 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION SOCIOECONOMIC PROGRAMS FOREIGN ACQUISITION Trade Agreements 25.403 World Trade Organization...

48 CFR 25.403 - World Trade Organization Government Procurement Agreement and Free Trade Agreements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 1 2011-10-01 2011-10-01 false World Trade Organization Government Procurement Agreement and Free Trade Agreements. 25.403 Section 25.403 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION SOCIOECONOMIC PROGRAMS FOREIGN ACQUISITION Trade Agreements 25.403 World Trade Organization...

48 CFR 25.403 - World Trade Organization Government Procurement Agreement and Free Trade Agreements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 48 Federal Acquisition Regulations System 1 2014-10-01 2014-10-01 false World Trade Organization Government Procurement Agreement and Free Trade Agreements. 25.403 Section 25.403 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION SOCIOECONOMIC PROGRAMS FOREIGN ACQUISITION Trade Agreements 25.403 World Trade Organization...

48 CFR 25.403 - World Trade Organization Government Procurement Agreement and Free Trade Agreements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 48 Federal Acquisition Regulations System 1 2013-10-01 2013-10-01 false World Trade Organization Government Procurement Agreement and Free Trade Agreements. 25.403 Section 25.403 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION SOCIOECONOMIC PROGRAMS FOREIGN ACQUISITION Trade Agreements 25.403 World Trade Organization...

Green Power Partnership Resource Library: Solicitations

EPA Pesticide Factsheets

Green Power Partnership Resource Library includes documents meant to aid organizations and individuals in navigating the renewable energy procurement and renewable energy project development processes. It includes guidance documents, templates and actual e

42 CFR 121.4 - OPTN policies: Secretarial review and appeals.

Code of Federal Regulations, 2010 CFR

2010-10-01

... RESOURCES DEVELOPMENT ORGAN PROCUREMENT AND TRANSPLANTATION NETWORK § 121.4 OPTN policies: Secretarial... Social Security Act. The OPTN shall also continuously maintain OPTN policies for public access on the...

An analysis of disruptions in aerospace/defense organizations that affect the supply chain

NASA Astrophysics Data System (ADS)

Dickerson, Toscha L.

The purpose of this quantitative study was to determine whether or not functions of procurement organizations structures' and aerospace suppliers were perceived as disruptions and to identify their effects on lead time and costs within a supply chain. An analysis of employees' perception of centralized and decentralized procurement functions, aerospace and defense suppliers, lead times of goods and services, price increases, and schedule delays was conducted. Prior studies are limited in regards to understanding how specific procurement functions affects an organization procurement structure. This non-experimental quantitative study allowed for a survey to be administered to aerospace and defense companies throughout the United States to obtain information from sourcing and procurement professionals with 5 or more years of experience. The current study utilized a 10 question survey based on the 5- point Likert -type scale to determine the findings. Through descriptive and inferential statistics, using regression analysis, standard deviation, and P-value; findings indicated that the majority of the participants surveyed perceived both centralized and decentralized procurement functions affected lead time and cost of goods and services resulted in a positive effect and were considered as supply chain disruptions.

Evolution of quality at the Organ Center of the Organ Procurement and Transplantation Network/United Network for Organ Sharing.

PubMed

Brown, Roger S; Belton, A Matthew; Martin, Judith M; Simmons, Dee Dee; Taylor, Gloria J; Willard, Ellie

2009-09-01

One of the goals of the Organ Center of the Organ Procurement and Transplantation Network/United Network for Organ Sharing is to increase the efficiency of equitable organ allocation in the United States. Recognizing the ever-growing need for organ donors and transplants, leaders at the Organ Center increased its commitment to quality improvement initiatives through the development of a quality management team in 2001. The Organ Center began to focus on ways to capture data on processes and pinpoint areas for improvement. As the collection and analysis of data evolved, the Organ Center embraced formal quality standards, such as improvement cycles. Using these cycles, the Organ Center has seen significant improvement. One initiative involving lifesaving heart, lung, and liver placement showed success by doubling the Organ Center's organ placement rate. Another project involving the validation of donor information demonstrated that the accuracy of organ allocation can be improved by 5% on a consistent basis. As stewards for the gift of life and leaders in organ allocation, the Organ Center uses continuous quality improvement to achieve the goal of increasing the efficiency of equitable organ allocation.

38 CFR 41.305 - Auditor selection.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Auditor selection. 41.305... OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Auditees § 41.305 Auditor selection. (a) Auditor procurement. In procuring audit services, auditees shall follow the procurement standards...

Organ procurement expenditures and the role of financial incentives.

PubMed

Evans, R W

To evaluate the billed charges for organ procurement and to consider the role of financial incentives to encourage organ donation. Observational study. Data were obtained on donor organ acquisition charges from a random sample of kidney, heart, liver, heart-lung, and pancreas transplants. The data were based on 28.7% of all transplants performed in the United States in 1988. Total charges for donor organ acquisition. The median charges (1988 dollars) for donor organs were as follows: kidney, $12,290; heart, $12,578; liver, $16,281; heart-lung, $12,028; and pancreas, $15,400. Since 1983, kidney acquisition charges have increased by 12.9%, heart charges by 64.1%, and liver charges by 61.8%, after adjusting for inflation. Between 9% and 31% of total transplant procedure-specific charges were associated with donor organ acquisition. There is wide unexplained variation in organ procurement charges. Data on actual costs are required to establish the appropriateness of current charges. Prevailing billing and payment methods should be reevaluated in an effort to address a variety of issues related to reimbursement. Current payment methods may actually contribute to cost inefficiency. Finally, while financial incentives may enhance the efficiency of organ procurement efforts, they will adversely affect the cost-effectiveness of transplantation.

Organ procurement: let's presume consent

PubMed Central

Moustarah, F

1998-01-01

IN WINNING FIRST PRIZE in the Logie Medical Ethics Essay Contest in 1997, Dr. Fady Moustarah made a strong and compelling argument in favour of presumed consent in the procurement of donor organs. He stressed that a major education campaign will be needed when such a policy is adopted lest some people begin to regard physicians as "organ vultures." PMID:9469147

Australian perioperative nurses' experiences of assisting in multi-organ procurement surgery: a grounded theory study.

PubMed

Smith, Zaneta; Leslie, Gavin; Wynaden, Dianne

2015-03-01

Multi-organ procurement surgical procedures through the generosity of deceased organ donors, have made an enormous impact on extending the lives of recipients. There is a dearth of in-depth knowledge relating to the experiences of perioperative nurses working closely with organ donors undergoing multi-organ procurement surgical procedures. The aim of this study was to address this gap by describing the perioperative nurses experiences of participating in multi-organ procurement surgical procedures and interpreting these findings as a substantive theory. This qualitative study used grounded theory methodology to generate a substantive theory of the experiences of perioperative nurses participating in multi-organ procurement surgery. Recruitment of participants took place after the study was advertised via a professional newsletter and journal. The study was conducted with participants from metropolitan, rural and regional areas of two Australian states; New South Wales and Western Australia. Thirty five perioperative nurse participants with three to 39 years of professional nursing experience informed the study. Semi structured in-depth interviews were undertaken from July 2009 to April 2010 with a mean interview time of 60 min. Interview data was transcribed verbatim and analysed using the constant comparative method. The study results draw attention to the complexities that exist for perioperative nurses when participating in multi-organ procurement surgical procedures reporting a basic social psychological problem articulated as hiding behind a mask and how they resolved this problem by the basic social psychological process of finding meaning. This study provides a greater understanding of how these surgical procedures impact on perioperative nurses by providing a substantive theory of this experience. The findings have the potential to guide further research into this challenging area of nursing practice with implications for clinical initiatives, management practices and education. Copyright © 2014 Elsevier Ltd. All rights reserved.

42 CFR 121.1 - Applicability.

Code of Federal Regulations, 2011 CFR

2011-10-01

... PROCUREMENT AND TRANSPLANTATION NETWORK § 121.1 Applicability. (a) The provisions of this part, with the exception of § 121.13, apply to the operation of the Organ Procurement and Transplantation Network (OPTN... Social Security Act, hospitals in which organ transplants are performed and which participate in the...

42 CFR 121.1 - Applicability.

Code of Federal Regulations, 2010 CFR

2010-10-01

... PROCUREMENT AND TRANSPLANTATION NETWORK § 121.1 Applicability. (a) The provisions of this part, with the exception of § 121.13, apply to the operation of the Organ Procurement and Transplantation Network (OPTN... Social Security Act, hospitals in which organ transplants are performed and which participate in the...

Healthy food procurement and nutrition standards in public facilities: evidence synthesis and consensus policy recommendations

PubMed Central

Kim D., Raine; Kayla, Atkey; Dana Lee, Dana Lee; Alexa R., Ferdinands; Dominique, Beaulieu; Susan, Buhler; Norm, Campbell; Brian, Cook; Mary, L’Abbé; Ashley, Lederer; David, Mowat; Joshna, Maharaj; Candace, Nykiforuk; Jacob, Shelley; Jacqueline, Street

2018-01-01

Abstract Introduction: Unhealthy foods are widely available in public settings across Canada, contributing to diet-related chronic diseases, such as obesity. This is a concern given that public facilities often provide a significant amount of food for consumption by vulnerable groups, including children and seniors. Healthy food procurement policies, which support procuring, distributing, selling, and/or serving healthier foods, have recently emerged as a promising strategy to counter this public health issue by increasing access to healthier foods. Although numerous Canadian health and scientific organizations have recommended such policies, they have not yet been broadly implemented in Canada. Methods: To inform further policy action on healthy food procurement in a Canadian context, we: (1) conducted an evidence synthesis to assess the impact of healthy food procurement policies on health outcomes and sales, intake, and availability of healthier food, and (2) hosted a consensus conference in September 2014. The consensus conference invited experts with public health/nutrition policy research expertise, as well as health services and food services practitioner experience, to review evidence, share experiences, and develop a consensus statement/recommendations on healthy food procurement in Canada. Results: Findings from the evidence synthesis and consensus recommendations for healthy food procurement in Canada are described. Specifically, we outline recommendations for governments, publicly funded institutions, decision-makers and professionals, citizens, and researchers. Conclusion: Implementation of healthy food procurement policies can increase Canadians’ access to healthier foods as part of a broader vision for food policy in Canada. PMID:29323862

Transformation of fraud activities in procurement system in Indonesia

NASA Astrophysics Data System (ADS)

Setiani, N.; Huda, S. N.; Pulungan, R.; Winarko, E.

2017-03-01

E-procurement has been applied in Indonesia since 2008 through the adoption of Electronic Procurement System (SPSE). The purpose of the use of SPSE in the procurement process is to improve the efficiency of goods or services procurement. In the bidding process, intensive communication and data exchange between providers and organizers are urgently needed. Through SPSE, the frequency of face to face meetings between providers and the committee can be reduced. This is expected to minimize potential fraud behaviors in the goods or services procurement conducted through the tender process. There exists a transformation of activities in the procurement through SPSE from the tender process that was previously done manually. In this paper, we analyze this transformation between manual procurement process and SPSE-based procurement process. The result of the analysis is exploited for investigating the possibility of fraud behavior transformations in every phase of e-procurement activities.

Procurement Cards Pave the Way to Efficient Purchasing.

ERIC Educational Resources Information Center

Enos, Eileen D.

1999-01-01

As educators battle restricted budgets, inflation, and enrollment changes, strategic sourcing management is replacing traditional transaction-based procurement. Procurement-card programs, allowing organizations to use credit cards for small purchases or low-value items, save time and enhance controls over merchants, credit limits, issuance limits,…

Twenty Years After Enactment of the Organ Transplant Law in Japan: Why Are There Still So Few Deceased Donors?

PubMed

Akabayashi, A; Nakazawa, E; Ozeki-Hayashi, R; Tomiyama, K; Mori, K; Demme, R A; Akabayashi, A

2018-06-01

Twenty years have passed since the 1997 enactment of the Organ Transplant Law in Japan, but the number of deceased donors remains extremely low. In this study we examine why deceased donation has continued to remain so infrequent. This investigation was a secondary analysis of published data from the Japan Organ Transplant Network, 2016 Fact Book of Organ Transplantation in Japan, and International Registry on Organ Donation and Transplantation. In the past 20 years, donation intent declarations, knowledge, and respect for family member's wishes have increased, whereas resistance toward transplantation has decreased. Despite this, the traditional perspective on corpses of gotai manzoku (ie, the soul cannot be put to rest without being physically intact and without defect), the family-centricism, and reward-seeking altruism have not changed much. Living organ transplants have alleviated the organ deficiency somewhat, and the law requiring family consent seems to have contributed to the observed small increase in deceased donors. The number of deceased donors is unlikely to increase suddenly. However, 8 strategies are proposed to increase the number of deceased donors, including: increasing the number of donor procurement coordinators and establishing a training system; increasing the number of organ procurement facilities; creating hub transplant centers and training transplant surgeons; implementing radical reform in public education; reducing workload and improving education of emergency physicians, neurosurgeons, and pediatricians; revisiting the stringent standards of brain-death determination; revisiting the registration process; and considering development of a Japanese version of organ procurement organizations as well as revisions to the Organ Transplant Law. The Japanese government and academic societies must work together to increase the number of deceased donors in Japan. Copyright © 2018 The Author(s). Published by Elsevier Inc. All rights reserved.

Critical appraisal of organ procurement under Maastricht 3 condition.

PubMed

Puybasset, L; Bazin, J-E; Beloucif, S; Bizouarn, P; Crozier, S; Devalois, B; Eon, B; Fieux, F; Gisquet, E; Guibet-Lafaye, C; Kentish, N; Lienhart, A; Nicolas-Robin, A; Otero Lopez, M; Pelluchon, C; Roussin, F; Beydon, L

2014-02-01

The ethics committee of the French Society of Anesthesia and Intensive Care (Sfar) has been requested by the French Biomedical Agency to consider the issue of organ donation in patients after the decision to withdraw life-supportive therapies has been taken. This type of organ donation is performed in the USA, Canada, the United Kingdom, the Netherlands and Belgium. The three former countries have published recommendations formalizing procedures and operations. The French Society of Anesthesia and Intensive Care (Société française d'anesthésie et de reanimation [Sfar]) ethics committee has considered this issue and envisioned the different aspects of the whole process. Consequently, it sounded a note of caution regarding the applicability of this type of organ procurement in unselected patients following a decision to withdraw life-supportive therapies. According to French regulations concerning organ procurement in brain-dead patients, the committee stresses the need to restrict this specific way of procurement to severely brain-injured patients, once confirmatory investigations predicting a catastrophic prognosis have been performed. This suggests that the nature of the confirmatory investigation required should be formalized by the French Biomedical Agency on behalf of the French parliamentarians, which should help preserve population trust regarding organ procurement and provide a framework for medical decision. This text has been endorsed by the Sfar. Copyright © 2013 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier SAS. All rights reserved.

75 FR 34282 - Federal Acquisition Regulation; FAR Case 2009-014, New Designated Country-Taiwan

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-16

... Government Procurement. DATES: Effective Date: June 16, 2010. FOR FURTHER INFORMATION CONTACT: Ms. Lori... Government Procurement. The interim rule added Taiwan to the list of World Trade Organization Government... seq., because, although this rule opens up Government procurement to the goods and services of Taiwan...

77 FR 76941 - Defense Federal Acquisition Regulation Supplement: New Qualifying Country-Poland (DFARS Case 2012...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-31

... discriminatory barriers to procurements of supplies and services produced by industrial enterprises of the other... a designated country under the World Trade Organization Government Procurement Agreement. II..., the U.S. Secretary of Defense signed a new reciprocal defense procurement agreement with the Polish...

77 FR 15736 - Procurement List; Proposed Additions

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-16

... additions to the Procurement List. SUMMARY: The Committee is proposing to add a product and services to the... identified in this notice will be required to procure the product and services listed below from nonprofit... entities other than the small organizations that will furnish the product and services to the Government. 2...

76 FR 37069 - Procurement List; Proposed Additions and Deletion

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-24

... products and a service to the Procurement List that will be furnished by nonprofit agencies employing... will be required to procure the products and service listed below from nonprofit agencies employing... other than the small organizations that will furnish the products and service to the Government. 2. If...

The effectiveness of the Danish Organic Action Plan 2020 to increase the level of organic public procurement in Danish public kitchens.

PubMed

Sørensen, Nina N; Tetens, Inge; Løje, Hanne; Lassen, Anne D

2016-12-01

To measure the effect of organic food conversion projects on the percentage of organic food used in Danish public kitchens participating in the Danish Organic Action Plan 2020. The current longitudinal study was based on measurements of organic food percentages in Danish public kitchens before and after kitchen employees participated in conversion projects. Public kitchens participating in the nine organic food conversion projects under the Danish Organic Action Plan 2020, initiated during autumn 2012 and spring 2013 and completed in summer 2015. A total of 622 public kitchens. The average (median) increase in organic food percentage from baseline to follow-up was 24 percentage points (P<0·001) during an overall median follow-up period of 1·5 years. When analysing data according to public kitchen type, the increase remained significant for seven out of eight kitchens. Furthermore, the proportion of public kitchens eligible for the Organic Cuisine Label in either silver (60-90 % organic food procurement) or gold (90-100 % organic food procurement) level doubled from 31 % to 62 %, respectively, during the conversion period. Conversion project curriculum mostly included elements of 'theory', 'menu planning', 'network' and 'Organic Cuisine Label method' to ensure successful implementation. The study reports significant increases in the level of organic food procurement among public kitchens participating in the Danish Organic Action Plan 2020. Recommendations for future organic conversion projects include adding key curriculum components to the project's educational content and measuring changes in organic food percentage to increase the chances of successful implementation.

76 FR 60370 - Consolidation of the Office of the Executive Director With the Office of the Chief Operating Officer

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-29

... Executive Director) the functions of prescribing procurement regulations, entering into contracts, designating contracting officers, and making procurement determinations. We believe it is appropriate to...: PART 200--ORGANIZATION; CONDUCT AND ETHICS; AND INFORMATION AND REQUESTS Subpart A--Organization and...

48 CFR 225.403 - World Trade Organization Government Procurement Agreement and Free Trade Agreements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false World Trade Organization Government Procurement Agreement and Free Trade Agreements. 225.403 Section 225.403 Federal Acquisition Regulations System DEFENSE ACQUISITION REGULATIONS SYSTEM, DEPARTMENT OF DEFENSE SOCIOECONOMIC PROGRAMS FOREIGN ACQUISITION Trade Agreements...

48 CFR 225.403 - World Trade Organization Government Procurement Agreement and Free Trade Agreements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 48 Federal Acquisition Regulations System 3 2014-10-01 2014-10-01 false World Trade Organization Government Procurement Agreement and Free Trade Agreements. 225.403 Section 225.403 Federal Acquisition Regulations System DEFENSE ACQUISITION REGULATIONS SYSTEM, DEPARTMENT OF DEFENSE SOCIOECONOMIC PROGRAMS FOREIGN ACQUISITION Trade Agreements...

48 CFR 225.403 - World Trade Organization Government Procurement Agreement and Free Trade Agreements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 48 Federal Acquisition Regulations System 3 2012-10-01 2012-10-01 false World Trade Organization Government Procurement Agreement and Free Trade Agreements. 225.403 Section 225.403 Federal Acquisition Regulations System DEFENSE ACQUISITION REGULATIONS SYSTEM, DEPARTMENT OF DEFENSE SOCIOECONOMIC PROGRAMS FOREIGN ACQUISITION Trade Agreements...

48 CFR 225.403 - World Trade Organization Government Procurement Agreement and Free Trade Agreements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 3 2011-10-01 2011-10-01 false World Trade Organization Government Procurement Agreement and Free Trade Agreements. 225.403 Section 225.403 Federal Acquisition Regulations System DEFENSE ACQUISITION REGULATIONS SYSTEM, DEPARTMENT OF DEFENSE SOCIOECONOMIC PROGRAMS FOREIGN ACQUISITION Trade Agreements...

48 CFR 225.403 - World Trade Organization Government Procurement Agreement and Free Trade Agreements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 48 Federal Acquisition Regulations System 3 2013-10-01 2013-10-01 false World Trade Organization Government Procurement Agreement and Free Trade Agreements. 225.403 Section 225.403 Federal Acquisition Regulations System DEFENSE ACQUISITION REGULATIONS SYSTEM, DEPARTMENT OF DEFENSE SOCIOECONOMIC PROGRAMS FOREIGN ACQUISITION Trade Agreements...

Liver Procurement for Orthotopic Transplantation: An Analysis of the Pittsburgh Experience

PubMed Central

Van Thiel, David H.; Schade, Robert R.; Hakala, Thomas R.; Starzl, Thomas E.; Denny, Donald

2010-01-01

The incidence of prospective organ donors in the United States and the techniques which are to used to guarantee their optimal use after identification are analyzed. Attitudes of the public and health professionals toward organ donation are discussed. The organization of the Pittsburgh Organ Procurement Agency and its relationship to other such agencies is described. Finally, the presently used techniques of liver salvaging and preservation are outlined. PMID:6363261

Compulsory licensing often did not produce lower prices for antiretrovirals compared to international procurement.

PubMed

Beall, Reed F; Kuhn, Randall; Attaran, Amir

2015-03-01

Compulsory licensing has been widely suggested as a legal mechanism for bypassing patents to introduce lower-cost generic antiretrovirals for HIV/AIDS in developing countries. Previous studies found that compulsory licensing can reduce procurement prices for drugs, but it is unknown how the resulting prices compare to procurements through the Global Fund to Fight AIDS, Tuberculosis, and Malaria; UNICEF; and other international channels. For this study we systematically constructed a case-study database of compulsory licensing activity for antiretrovirals and compared compulsory license prices to those in the World Health Organization's (WHO's) Global Price Reporting Mechanism and the Global Fund's Price and Quality Reporting Tool. Thirty compulsory license cases were analyzed with 673 comparable procurements from WHO and Global Fund data. Compulsory license prices exceeded the median international procurement prices in nineteen of the thirty case studies, often with a price gap of more than 25 percent. Compulsory licensing often delivered suboptimal value when compared to the alternative of international procurement, especially when used by low-income countries to manufacture medicines locally. There is an ongoing need for multilateral and charitable actors to work collectively with governments and medicine suppliers on policy options. Project HOPE—The People-to-People Health Foundation, Inc.

The optimal hormonal replacement modality selection for multiple organ procurement from brain-dead organ donors

PubMed Central

Mi, Zhibao; Novitzky, Dimitri; Collins, Joseph F; Cooper, David KC

2015-01-01

The management of brain-dead organ donors is complex. The use of inotropic agents and replacement of depleted hormones (hormonal replacement therapy) is crucial for successful multiple organ procurement, yet the optimal hormonal replacement has not been identified, and the statistical adjustment to determine the best selection is not trivial. Traditional pair-wise comparisons between every pair of treatments, and multiple comparisons to all (MCA), are statistically conservative. Hsu’s multiple comparisons with the best (MCB) – adapted from the Dunnett’s multiple comparisons with control (MCC) – has been used for selecting the best treatment based on continuous variables. We selected the best hormonal replacement modality for successful multiple organ procurement using a two-step approach. First, we estimated the predicted margins by constructing generalized linear models (GLM) or generalized linear mixed models (GLMM), and then we applied the multiple comparison methods to identify the best hormonal replacement modality given that the testing of hormonal replacement modalities is independent. Based on 10-year data from the United Network for Organ Sharing (UNOS), among 16 hormonal replacement modalities, and using the 95% simultaneous confidence intervals, we found that the combination of thyroid hormone, a corticosteroid, antidiuretic hormone, and insulin was the best modality for multiple organ procurement for transplantation. PMID:25565890

Organ donor screening practices for Strongyloides stercoralis infection among US organ procurement organizations.

PubMed

Abanyie, Francisca A; Valice, Emily; Delli Carpini, Kristin W; Gray, Elizabeth B; McAuliffe, Isabel; Chin-Hong, Peter V; Handali, Sukwan; Montgomery, Susan P; Huprikar, Shirish

2018-03-07

Targeted donor screening for strongyloidiasis performed at the time of organ procurement can prevent this life-threatening donor-derived infection. The Association of Organ Procurement Organizations surveyed members to determine the number of US organ procurement organizations (OPOs) performing donor screening for Strongyloides infection and their screening practices. All 58 OPOs responded to the survey. Only 6 (10%) currently screen donors for strongyloidiasis; most OPOs started 6-36 months before the survey and one started 6 years prior. All used risk-based criteria to determine which donors to screen, though the criteria varied among OPOs. A median of 56 donors have been screened at each OPO since initiating their screening programs, with a median of 2 infected donors (range 0-13) identified. Overall, 53 organs have been transplanted from 22 infected donors, including hearts, lungs, kidneys, and livers. Of 52 OPOs not currently screening, 20 had considered screening and one plans to start screening in the near future. Of those considering risk-based screening, most had not decided on the criteria. Uncertainty about the benefits of and guidelines for screening and misconceptions about the interpretation of test results were concerns shared by non-screening OPOs. Continued education and advocacy on the importance of targeted donor screening are needed. Published 2018. This article is a U.S. Government work and is in the public domain in the USA.

Food commodity pipeline management in transitional settings: challenges and lessons learned from the first USAID food development program in South Sudan

PubMed Central

Tappis, Hannah; Doocy, Shannon; Amoako, Stephen

2013-01-01

ABSTRACT Despite decades of support for international food assistance programs by the U.S. Agency for International Development (USAID) Office of Food for Peace, relatively little is known about the commodity pipeline and management issues these programs face in post-conflict and politically volatile settings. Based on an audit of the program's commodity tracking system and interviews with 13 key program staff, this case study documents the experiences of organizations implementing the first USAID-funded non-emergency (development) food assistance program approved for Sudan and South Sudan. Key challenges and lessons learned in this experience about food commodity procurement, transport, and management may help improve the design and implementation of future development food assistance programs in a variety of complex, food-insecure settings around the world. Specifically, expanding shipping routes in complex political situations may facilitate reliable and timely commodity delivery. In addition, greater flexibility to procure commodities locally, rather than shipping U.S.-procured commodities, may avoid unnecessary shipping delays and reduce costs. PMID:25276532

Acquisition of Scientific Literature in Developing Countries. 3: Pakistan.

ERIC Educational Resources Information Center

Haider, Syed Jalaluddin

1989-01-01

Summarizes the development of science and technology in Pakistan and the existing library resources in science and technology. The organization of acquisitions work is described, including acquisitions policy, book selection, financial support, procurement of books and periodicals, import restrictions, book order work, and gifts and exchanges.…

Computerized engineering logic for nuclear procurement and dedication processes

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tulay, M.P.

1996-12-31

In an attempt to better meet the needs of operations and maintenance organizations, many nuclear utility procurement engineering groups have simplified their procedures, developed on-line tools for performing the specification of replacement items, and developed relational databases containing part-level information necessary to automate the procurement process. Although these improvements have helped to reduce the engineering necessary to properly specify and accept/dedicate items for nuclear safety-related applications, a number of utilities have recognized that additional long-term savings can be realized by integrating a computerized logic to assist technical procurement engineering personnel. The most commonly used logic follows the generic processes containedmore » in Electric Power Research Institute (EPRI) published guidelines. The processes are typically customized to some extent to accommodate each utility`s organizational structure, operating procedures, and strategic goals. This paper will discuss a typical logic that integrates the technical evaluation, acceptance, and receipt inspection and testing processes. The logic this paper will describe has been successfully integrated at a growing number of nuclear utilities and has produced numerous positive results. The application of the logic ensures that utility-wide standards or procedures, common among multi-site utilities, are followed.« less

36 CFR 1210.44 - Procurement procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... dimensioned in the metric system of measurement. (vi) Preference, to the extent practicable and economically... EDUCATION, HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Procurement Standards...

36 CFR 1210.44 - Procurement procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

... dimensioned in the metric system of measurement. (vi) Preference, to the extent practicable and economically... EDUCATION, HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Procurement Standards...

36 CFR 1210.44 - Procurement procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... dimensioned in the metric system of measurement. (vi) Preference, to the extent practicable and economically... EDUCATION, HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Procurement Standards...

The role of clinical nurse educators in organ procurement organizations.

PubMed

Swain, Sharon

2011-12-01

Clinical nurse educators are advanced practice nurses with preparation at the master's level or higher. Such nurses play an important role in organ procurement organizations. As leaders and members of the team, they provide structure and design to the training process. These educators oversee orientation of new employees, serve as mentors to preceptors, assess the learning needs of the organization, and provide ongoing training to veteran staff. Clinical nurse educators also contribute to continuous quality improvement for the organization and help to comply with regulatory standards.

National Association of State Procurement Officials - Sustainable Purchasing Guidance Profile

EPA Pesticide Factsheets

To help you find the resource that is right for your organization, EPA conducted a scan of the landscape and developed summary profiles of some of the leading sources of sustainable purchasing guidance around the globe.

Factors influencing global antiretroviral procurement prices.

PubMed

Wirtz, Veronika J; Forsythe, Steven; Valencia-Mendoza, Atanacio; Bautista-Arredondo, Sergio

2009-11-18

Antiretroviral medicines (ARVs) are one of the most costly parts of HIV/AIDS treatment. Many countries are struggling to provide universal access to ARVs for all people living with HIV and AIDS. Although substantial price reductions of ARVs have occurred, especially between 2002 and 2008, achieving sustainable access for the next several decades remains a major challenge for most low- and middle-income countries. The objectives of the present study were twofold: first, to analyze global ARV prices between 2005 and 2008 and associated factors, particularly procurement methods and key donor policies on ARV procurement efficiency; second, to discuss the options of procurement processes and policies that should be considered when implementing or reforming access to ARV programs. An ARV-medicines price-analysis was carried out using the Global Price Reporting Mechanism from the World Health Organization. For a selection of 12 ARVs, global median prices and price variation were calculated. Linear regression models for each ARV were used to identify factors that were associated with lower procurement prices. Logistic regression models were used to identify the characteristics of those countries which procure below the highest and lowest direct manufactured costs. Three key factors appear to have an influence on a country's ARV prices: (a) whether the product is generic or not; (b) the socioeconomic status of the country; (c) whether the country is a member of the Clinton HIV/AIDS Initiative. Factors which did not influence procurement below the highest direct manufactured costs were HIV prevalence, procurement volume, whether the country belongs to the least developed countries or a focus country of the United States President's Emergency Plan For AIDS Relief. One of the principal mechanisms that can help to lower prices for ARV over the next several decades is increasing procurement efficiency. Benchmarking prices could be one useful tool to achieve this.

36 CFR § 1210.44 - Procurement procedures.

Code of Federal Regulations, 2013 CFR

2013-07-01

... dimensioned in the metric system of measurement. (vi) Preference, to the extent practicable and economically... HIGHER EDUCATION, HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Procurement...

22 CFR 145.44 - Procurement procedures.

Code of Federal Regulations, 2012 CFR

2012-04-01

... metric system of measurement. (vi) Preference, to the extent practicable and economically feasible, for... EDUCATION, HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Procurement Standards § 145...

Organ donation in the Hispanic population: dondé estan ellos?

PubMed Central

René, A. A.; Viera, E.; Daniels, D.; Santos, Y.

1994-01-01

Few studies have investigated organ donation among Hispanics, although in major US cities, Hispanics, like African Americans, make up a large percentage of the general population. In fact, the 1990 census reports that of all Hispanics in the country, 90% live in urban areas. The tendency for Hispanics to use hospital emergency rooms rather than visit a physician's office may result in an inadequate exchange of information between minority patients and health-care providers. Hospitals that serve minority populations have been reported to have the lowest organ procurement rates. These hospitals are often funded by local, county, or state funds and are usually dedicated to a patient mix that is largely indigent. The heavy work load of health-care providers who often have limited resources does not lend itself to an adequate exchange of information between patients and health-care providers. The existence of this type of environment impacts on patient communication, increases the fear of complication, and may diminish the discussion of potential organ procurement. There are multiple individual and structural reasons for the high family refusal rates among Hispanics. Procurement specialists may see a proportionally small number of Hispanic families, mainly due to a lack of referrals from hospital staff concerning possible Hispanic donors. White procurement workers may not be familiar with the Hispanic family makeup and cultural attitudes. Organ procurement workers may not pursue the issue of donation with Hispanic families as much as they do with white families. Whatever the reason, if we are to increase organ donation in the Hispanic community, these complex issues will need to be addressed. PMID:8151717

Summitville Procurement Protection Act

THOMAS, 111th Congress

Rep. Wilson, Charles A. [D-OH-6

2010-04-27

House - 05/26/2010 Referred to the Subcommittee on Government Management, Organization, and Procurement. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Collaborative Procurement Initiative

EPA Pesticide Factsheets

GPP's Clean Energy Collaborative Procurement Initiative provides a platform for deploying clean energy technologies across multiple government and educational organizations for maximum impact on installed solar system capacity and local economic activity.

24 CFR 84.44 - Procurement procedures.

Code of Federal Regulations, 2013 CFR

2013-04-01

... dimensioned in the metric system of measurement. (vi) Preference, to the extent practicable and economically... EDUCATION, HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Procurement Standards § 84...

24 CFR 84.44 - Procurement procedures.

Code of Federal Regulations, 2014 CFR

2014-04-01

... dimensioned in the metric system of measurement. (vi) Preference, to the extent practicable and economically... EDUCATION, HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Procurement Standards § 84...

24 CFR 84.44 - Procurement procedures.

Code of Federal Regulations, 2012 CFR

2012-04-01

... dimensioned in the metric system of measurement. (vi) Preference, to the extent practicable and economically... EDUCATION, HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Procurement Standards § 84...

24 CFR 84.44 - Procurement procedures.

Code of Federal Regulations, 2011 CFR

2011-04-01

... dimensioned in the metric system of measurement. (vi) Preference, to the extent practicable and economically... EDUCATION, HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Procurement Standards § 84...

Donor management parameters and organ yield: single center results.

PubMed

Marshall, George Ryne; Mangus, Richard S; Powelson, John A; Fridell, Jonathan A; Kubal, Chandrashekhar A; Tector, A Joseph

2014-09-01

Management of organ donors in the intensive care unit is an emerging subject in critical care and transplantation. This study evaluates organ yield outcomes for a large number of patients managed by the Indiana Organ Procurement Organization. This is a retrospective review of intensive care unit records from 2008-2012. Donor demographic information and seven donor management parameters (DMP) were recorded at admission, consent, 12 h after consent, and before procurement. Three study groups were created: donors meeting 0-3, 4, or 5-7 DMP. Active donor Organ Procurement Organization management began at consent; so, data analysis focuses on the 12-h postconsent time point. Outcomes included organs transplanted per donor (OTPD) and transplantation of individual solid organs. Complete records for 499 patients were reviewed. Organ yield was 1415 organs of 3992 possible (35%). At 12 h, donors meeting more DMP had more OTPD: 2.2 (0-3) versus 3.0 (4) versus 3.5 (5-7) (P < 0.01). Aggregate DMP met was significantly associated with transplantation of every organ except intestine. Oxygen tension, vasopressor use, and central venous pressure were the most frequent independent predictors of organ usage. There were significantly more organs transplanted for donors meeting all three of these parameters (4.5 versus 2.7, P < 0.01). Initial DMP met does not appear to be a significant prognostic factor for OTPD. Aggregate DMP is associated with transplantation rates for most organs, with analysis of individual parameters suggesting that appropriate management of oxygenation, volume status, and vasopressor use could lead to more organs procured per donor. Copyright © 2014 Elsevier Inc. All rights reserved.

77 FR 13013 - Defense Federal Acquisition Regulation Supplement; Technical Amendments

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-05

... Organization Government Procurement Agreement and the Free Trade Agreements, as determined by the United States... 252 Government procurement. Ynette R. Shelkin, Editor, Defense Acquisition Regulations System...

40 CFR 30.46 - Procurement records.

Code of Federal Regulations, 2010 CFR

2010-07-01

... competition when competitive bids or offers are not obtained; and basis for award cost or price. ..., HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Procurement Standards § 30.46...

Outcome of referrals for deceased organ donation to the government organ procurement organization.

PubMed

Suguitan, G A; Cabanayan-Casasola, C B; Danguilan, R A; Jaro, J M A

2014-05-01

The Human Organ Preservation Effort is a government organ procurement organization that pioneered the Deceased Organ Donation Program in the Philippines. Deceased organ donation comprises only 20% of kidney transplantation in the Philippines in the last 3 years. Various measures were implemented to improve deceased organ donor referrals and organ retrieval. To compare outcome of deceased organ donor referrals from 2002 to 2008 and 2009 to 2012 in the Philippines. This retrospective study reviewed the deceased organ donor referrals from 2002 to 2008 and 2009 to 2012. There were 437 referrals for potential deceased organ donors from 2009 to 2012, compared to 434 referrals from 2002 to 2008. Referrals were mainly trauma victims (76%) followed by those with cerebrovascular accidents (12%). In the recent cohort, 81% were approached and 60% consented for donation, but only 23% were retrieved and transplanted. Among those not retrieved, the majority (19%) were medically unsuitable and 6% retracted their consent. Although there was an increasing trend of organ donation referrals in the last 4 years, only 25% were procured. The reasons for nonprocurement should be addressed. Copyright © 2014 Elsevier Inc. All rights reserved.

22 CFR 226.41 - Recipient responsibilities.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Recipient responsibilities. 226.41 Section 226.41 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ADMINISTRATION OF ASSISTANCE AWARDS TO U.S. NON-GOVERNMENTAL ORGANIZATIONS Post-award Requirements Procurement Standards § 226.41 Recipient...

20 CFR 641.856 - What functions and activities constitute administrative costs?

Code of Federal Regulations, 2012 CFR

2012-04-01

..., including: (i) Accounting, budgeting, financial, and cash management functions; (ii) Procurement and... management, accounting, and payroll systems) including the purchase, systems development, and operating costs of such systems and; (6) Costs of technical assistance, professional organization membership dues...

20 CFR 641.856 - What functions and activities constitute administrative costs?

Code of Federal Regulations, 2014 CFR

2014-04-01

..., including: (i) Accounting, budgeting, financial, and cash management functions; (ii) Procurement and... management, accounting, and payroll systems) including the purchase, systems development, and operating costs of such systems and; (6) Costs of technical assistance, professional organization membership dues...

20 CFR 641.856 - What functions and activities constitute administrative costs?

Code of Federal Regulations, 2011 CFR

2011-04-01

..., including: (i) Accounting, budgeting, financial, and cash management functions; (ii) Procurement and... management, accounting, and payroll systems) including the purchase, systems development, and operating costs of such systems and; (6) Costs of technical assistance, professional organization membership dues...

20 CFR 641.856 - What functions and activities constitute administrative costs?

Code of Federal Regulations, 2013 CFR

2013-04-01

..., including: (i) Accounting, budgeting, financial, and cash management functions; (ii) Procurement and... management, accounting, and payroll systems) including the purchase, systems development, and operating costs of such systems and; (6) Costs of technical assistance, professional organization membership dues...

Preliminary design activities for solar heating and cooling systems

NASA Technical Reports Server (NTRS)

1978-01-01

Information on the development of solar heating and cooling systems is presented. The major emphasis is placed on program organization, system size definition, site identification, system approaches, heat pump and equipment design, collector procurement, and other preliminary design activities.

The metaphysical basis of a liberal organ procurement policy.

PubMed

Hershenov, David B; Delaney, James J

2010-08-01

There remains a need to properly analyze the metaphysical assumptions underlying two organ procurement policies: presumed consent and organ sales. Our contention is that if one correctly understands the metaphysics of both the human body and material property, then it will turn out that while organ sales are illiberal, presumed consent is not. What we mean by illiberal includes violating rights of bodily integrity, property, or autonomy, as well as arguing for or against a policy in a manner that runs afoul of Rawlsian public reason.

Facilitators and barriers to implementing a local policy to reduce sodium consumption in the County of Los Angeles government, California, 2009.

PubMed

Gase, Lauren N; Kuo, Tony; Dunet, Diane O; Simon, Paul A

2011-03-01

This qualitative study explores facilitators and barriers to a proposed food procurement policy that would require food purchasers, distributors, and vendors of food service in the County of Los Angeles government to meet specified nutrition standards, including limits on sodium content. We conducted 30 key informant interviews. Interviewees represented 18 organizations from the County of Los Angeles government departments that purchased, distributed, or sold food; public and private non-County entities that had previously implemented food procurement policies in their organizations; and large organizations that catered food to the County. Study participants reported 3 key facilitators: their organization's authority to impose nutrition standards, their organization's desire to provide nutritious food, and the opportunity to build on existing nutrition policies. Eight key barriers were identified: 1) unique features among food service settings, 2) costs and unavailability of low-sodium foods, 3) complexity of food service arrangements, 4) lack of consumer demand for low-sodium foods, 5) undesirable taste of low-sodium foods, 6) preference for prepackaged products, 7) lack of knowledge and experience in operationalizing sodium standards, and 8) existing multiyear contracts that are difficult to change. Despite perceived barriers, several participants indicated that their organizations have successfully implemented nutritional standards that include limits on sodium. Developing or changing policies for procuring food represents a potentially feasible strategy for reducing sodium consumption in food service venues controlled by the County of Los Angeles. The facilitators and barriers identified here can inform the formulation, adoption, implementation, and evaluation of sodium reduction policies in other jurisdictions.

7 CFR 1778.22 - Planning development and procurement.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 12 2011-01-01 2011-01-01 false Planning development and procurement. 1778.22 Section 1778.22 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE... Planning development and procurement. Planning development and procurement for grants made under this part...

A registry analysis of damage to the deceased donor pancreas during procurement.

PubMed

Ausania, F; Drage, M; Manas, D; Callaghan, C J

2015-11-01

Surgical injury to the pancreas is thought to occur commonly during procurement. The UK Transplant Registry was analyzed to determine the frequency of pancreatic injuries, identify factors associated with damage, and assess the impact of injuries on graft survival. Twelve hundred ninety-six pancreata were procured from donation after brain death donors, with 314 (19.5%) from donation after circulatory death donors. More than 50% of recovered pancreata had at least one injury, most commonly a short portal vein (21.5%). Liver donation, procurement team origin, hepatic artery (HA) arising from the superior mesenteric artery (SMA), and increasing donor BMI were associated with increased rates of pancreas damage on univariate analyses; on multivariate analysis only the presence of an HA from the SMA remained significant (p = 0.02). Six hundred forty solid organ pancreas transplants were performed; 238 had some form of damage. Overall, there was no difference in graft survival between damaged and undamaged organs (p = 0.28); however, graft loss was significantly more frequent in pancreata with arterial damage (p = 0.04) and in those with parenchymal damage (p = 0.05). Damage to the pancreas during organ recovery is more common than other organs, and meticulous surgical technique and awareness of damage risk factors are essential to reduce rates of procurement-related injuries. © Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.

Analysis of potential factors affecting microbiological cultures in tissue donors during procurement.

PubMed

Lannau, B; Van Geyt, C; Van Maele, G; Beele, H

2015-03-01

During the procurement of musculoskeletal grafts contamination may occur. As this might be detrimental for the acceptor, it is important to know which variables influence this occurrence and to alter procurement protocols accordingly. From 2004 to 2012 we gathered information on 6,428 allografts obtained from 291 donors. Using a multiple regression model we attempted to determine the factors that influence the contamination risk during procurement. We used the following variables: cause of death, type of hospital (i.e. university hospital vs. general hospital), previous blood vessel donation, previous organ donation, donor age, time between death and the start of the procurement, duration of the procurement, number of people attending the procurement and the number of procured grafts. The multiple regression model was only able to explain 5 % of the variability of the used outcome variable. None of the variables examined appear to have an important influence on the contamination risk.

25 CFR 900.49 - What procurement standards apply to subcontracts?

Code of Federal Regulations, 2012 CFR

2012-04-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES CONTRACTS UNDER THE INDIAN SELF-DETERMINATION AND EDUCATION ASSISTANCE ACT Standards for Tribal or Tribal Organization Management Systems Procurement Management System...

25 CFR 900.49 - What procurement standards apply to subcontracts?

Code of Federal Regulations, 2010 CFR

2010-04-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES CONTRACTS UNDER THE INDIAN SELF-DETERMINATION AND EDUCATION ASSISTANCE ACT Standards for Tribal or Tribal Organization Management Systems Procurement Management System...

25 CFR 900.49 - What procurement standards apply to subcontracts?

Code of Federal Regulations, 2014 CFR

2014-04-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES CONTRACTS UNDER THE INDIAN SELF-DETERMINATION AND EDUCATION ASSISTANCE ACT Standards for Tribal or Tribal Organization Management Systems Procurement Management System...

25 CFR 900.49 - What procurement standards apply to subcontracts?

Code of Federal Regulations, 2013 CFR

2013-04-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES CONTRACTS UNDER THE INDIAN SELF-DETERMINATION AND EDUCATION ASSISTANCE ACT Standards for Tribal or Tribal Organization Management Systems Procurement Management System...

25 CFR 900.49 - What procurement standards apply to subcontracts?

Code of Federal Regulations, 2011 CFR

2011-04-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES CONTRACTS UNDER THE INDIAN SELF-DETERMINATION AND EDUCATION ASSISTANCE ACT Standards for Tribal or Tribal Organization Management Systems Procurement Management System...

14 CFR 1260.146 - Procurement records.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Higher Education, Hospitals, and Other Non-Profit Organizations Procurement Standards § 1260.146... of competition when competitive bids or offers are not obtained, and (c) Basis for award cost or price. ...

7 CFR 3019.46 - Procurement records.

Code of Federal Regulations, 2010 CFR

2010-01-01

...) Justification for lack of competition bids or offers are not obtained, and (c) Basis for award cost or price. ... HIGHER EDUCATION, HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Procurement...

42 CFR 413.202 - Organ procurement organization (OPO) cost for kidneys sent to foreign countries or transplanted...

Code of Federal Regulations, 2011 CFR

2011-10-01

... kidneys sent to foreign countries or transplanted in patients other than Medicare beneficiaries. 413.202... (OPO) cost for kidneys sent to foreign countries or transplanted in patients other than Medicare beneficiaries. An OPO's total costs for all kidneys is reduced by the costs associated with procuring kidneys...

42 CFR 413.202 - Organ procurement organization (OPO) cost for kidneys sent to foreign countries or transplanted...

Code of Federal Regulations, 2010 CFR

2010-10-01

... kidneys sent to foreign countries or transplanted in patients other than Medicare beneficiaries. 413.202... (OPO) cost for kidneys sent to foreign countries or transplanted in patients other than Medicare beneficiaries. An OPO's total costs for all kidneys is reduced by the costs associated with procuring kidneys...

7 CFR 2.93 - Director, Office of Procurement and Property Management.

Code of Federal Regulations, 2012 CFR

2012-01-01

... agricultural sciences, related to establishing and implementing Federal biobased procurement and voluntary... available to organizations excess or surplus computers or other technical equipment of the Department for...

7 CFR 2.93 - Director, Office of Procurement and Property Management.

Code of Federal Regulations, 2014 CFR

2014-01-01

... agricultural sciences, related to establishing and implementing Federal biobased procurement and voluntary... available to organizations excess or surplus computers or other technical equipment of the Department for...

7 CFR 2.93 - Director, Office of Procurement and Property Management.

Code of Federal Regulations, 2013 CFR

2013-01-01

... agricultural sciences, related to establishing and implementing Federal biobased procurement and voluntary... available to organizations excess or surplus computers or other technical equipment of the Department for...

7 CFR 2.93 - Director, Office of Procurement and Property Management.

Code of Federal Regulations, 2011 CFR

2011-01-01

... agricultural sciences, related to establishing and implementing Federal biobased procurement and voluntary... available to organizations excess or surplus computers or other technical equipment of the Department for...

22 CFR 209.2 - Application of this part.

Code of Federal Regulations, 2010 CFR

2010-04-01

... organization, or (e) any procurement of goods or services, including the procurement of training. This part... limitation nor does not bar special treatment including special courses of training, orientation or...

Asking the difficult questions: message strategies used by organ procurement coordinators in requesting familial consent to organ donation.

PubMed

Anker, Ashley E; Feeley, Thomas Hugh

2011-07-01

The present study provides an in-depth examination of the messages used by organ procurement coordinators (OPCs) in shaping familial requests for organ donation. OPCs (N = 102), recruited from a national sample of 16 organ procurement organizations, participated in a structured interview designed to uncover the communication strategies used in obtaining familial consent for donation. Analysis of interviews indicates OPCs' messages cover 4 domain areas. Specifically, OPCs report use of messages intended to (a) provide education, (b) discuss the benefits to donation, (c) learn about potential donor families, and (d) persuade families to engage in donation. Within the 4 domain areas, OPCs report use of 15 specific messages (e.g., "positively framing the donor," "social proof," "discuss the benefit of donation to grieving") in requesting consent. The present study provides a detailed examination of strategies and offers recommendations for using message strategies to explore the effectiveness of the consent process from the perspective of OPCs in approaching donor families.

Modified mandated choice for organ procurement

PubMed Central

Chouhan, P; Draper, H

2003-01-01

Presumed consent to organ donation looks increasingly unlikely to be a palatable option for increasing organ procurement in the UK following the publication of the report into events at Alder Hey and elsewhere. Yet, given that the alternative to increasing the number of cadaveric organs available is either to accept a greater number of live donations, or accept that people will continue to die for the want of an organ, public policy makers remain obliged to consider other means of increasing the procurement rate. In this paper, we meet the main objections to mandated choice (namely that it undermines autonomy and that mandated donation is preferable). We have modified the traditional approach to mandated choice to take into account the force of the objection that mandated donation is preferable, by accepting that people can and do make bad decisions about organ donation and proposing that all accompanying public education and information about cadaveric donation should be directed in favour of donation. PMID:12796435

Latest development of legal regulations of organ transplant in China.

PubMed

Ding, Chunyan

2008-12-01

Organ transplant practice has developed greatly in last two decades in China. In response to the practical need, the State Council released the Regulations on Human Organ Transplant 2007, replacing the previous Interim Provisions on Administration of Clinical Application of Human Organ Transplant Technology 2006. This article first examines the latest development of legal regulations of organ transplant by comparing the differences between the two pieces of legislation. It then analyzes the impact of the new rules set forth in the 2007 Regulations upon three problems existing in the current organ transplant practice, that is, organ procurement from executed prisoners, organ trade, and organ tourism. The article finally discusses the deficiencies of the 2007 Regulations, which are supposed to be remedied in the next legal reform.

22 CFR 226.47 - Contract administration.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Contract administration. 226.47 Section 226.47 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ADMINISTRATION OF ASSISTANCE AWARDS TO U.S. NON-GOVERNMENTAL ORGANIZATIONS Post-award Requirements Procurement Standards § 226.47 Contract administration. A...

22 CFR 226.48 - Contract provisions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Contract provisions. 226.48 Section 226.48 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ADMINISTRATION OF ASSISTANCE AWARDS TO U.S. NON-GOVERNMENTAL ORGANIZATIONS Post-award Requirements Procurement Standards § 226.48 Contract provisions. The...

48 CFR 2403.602 - Policy.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 48 Federal Acquisition Regulations System 6 2012-10-01 2012-10-01 false Policy. 2403.602 Section 2403.602 Federal Acquisition Regulations System DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT GENERAL... Organizations Owned or Controlled by Them 2403.602 Policy. The Senior Procurement Executive must approve...

48 CFR 2403.602 - Policy.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 48 Federal Acquisition Regulations System 6 2014-10-01 2014-10-01 false Policy. 2403.602 Section 2403.602 Federal Acquisition Regulations System DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT GENERAL... Organizations Owned or Controlled by Them 2403.602 Policy. The Senior Procurement Executive must approve...

48 CFR 2403.602 - Policy.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Policy. 2403.602 Section 2403.602 Federal Acquisition Regulations System DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT GENERAL... Organizations Owned or Controlled by Them 2403.602 Policy. The Senior Procurement Executive must approve...

16 CFR 6.152 - Program accessibility: Electronic and information technology.

Code of Federal Regulations, 2011 CFR

2011-01-01

... information technology. 6.152 Section 6.152 Commercial Practices FEDERAL TRADE COMMISSION ORGANIZATION... information technology. (a) When developing, procuring, maintaining, or using electronic and information... electronic and information technology allows, regardless of the type of medium of the technology: (1...

16 CFR 6.152 - Program accessibility: Electronic and information technology.

Code of Federal Regulations, 2014 CFR

2014-01-01

... information technology. 6.152 Section 6.152 Commercial Practices FEDERAL TRADE COMMISSION ORGANIZATION... information technology. (a) When developing, procuring, maintaining, or using electronic and information... electronic and information technology allows, regardless of the type of medium of the technology: (1...

16 CFR 6.152 - Program accessibility: Electronic and information technology.

Code of Federal Regulations, 2012 CFR

2012-01-01

... information technology. 6.152 Section 6.152 Commercial Practices FEDERAL TRADE COMMISSION ORGANIZATION... information technology. (a) When developing, procuring, maintaining, or using electronic and information... electronic and information technology allows, regardless of the type of medium of the technology: (1...

16 CFR 6.152 - Program accessibility: Electronic and information technology.

Code of Federal Regulations, 2013 CFR

2013-01-01

... information technology. 6.152 Section 6.152 Commercial Practices FEDERAL TRADE COMMISSION ORGANIZATION... information technology. (a) When developing, procuring, maintaining, or using electronic and information... electronic and information technology allows, regardless of the type of medium of the technology: (1...

48 CFR 14.409-1 - Award of unclassified contracts.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Government Procurement Agreement or a Free Trade Agreement (see 25.408(a)(5)), agencies must include in notices given unsuccessful bidders from World Trade Organization Government Procurement Agreement or Free...

36 CFR 1210.46 - Procurement records.

Code of Federal Regulations, 2010 CFR

2010-07-01

... EDUCATION, HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Procurement Standards...) Justification for lack of competition when competitive bids or offers are not obtained, and (c) Basis for award cost or price. ...

2 CFR 215.46 - Procurement records.

Code of Federal Regulations, 2010 CFR

2010-01-01

... NON-PROFIT ORGANIZATIONS (OMB CIRCULAR A-110) Post Award Requirements Procurement Standards § 215.46... of competition when competitive bids or offers are not obtained; and (c) Basis for award cost or price. ...

Remote sensing procurement package: A management report for state and local governments

NASA Technical Reports Server (NTRS)

1981-01-01

An overview of the remote sensing procurement process is presented for chief executives, senior administrators, and other local and state officials responsible for purchasing remote sensing products, services, or equipment. Guidelines are provided for planning, organizing, staffing, and implementing such a procurement project. Other sections of the four-volume package are described and their benefits examined.

The logistics management and coordination in procurement phase of organ transplantation.

PubMed

Genç, Ruhet

2008-12-01

The number of organ transplantation surgeries has increased particularly in the last decade due to technological and scientific advances in medicine. Despite this increase, many patients, however, remain in waiting lists for transplantation surgery. Main reasons for these waiting lists are that there are limited number of organ donations and specifically problems in the management of organ transplantation activities. An efficient management of the allocation and transportation of organs (in other words, logistics management of organ transplantation) are thus extremely important. The aim of the paper is to review current practices of logistics management in the procurement phase of organ transplantation. It initially reviews the organizational structures of the international and national coordination centres, which are founded to coordinate organ transplantation activities and to enhance collaboration among physicians and medical staff. The paper, then, focuses on the possible managerial problems encountered during the procurement phase of organ transplantation. With this respect, common transportation difficulties from global and local perspective are also analyzed. This paper tries to take attention to a systematic regard of the organ transplantation from logistics point of view, thus providing applicable solutions to managerial problems in terms of allocation and transportation of organs.

Presumed consent for organ preservation in uncontrolled donation after cardiac death in the United States: a public policy with serious consequences

PubMed Central

Verheijde, Joseph L; Rady, Mohamed Y; McGregor, Joan

2009-01-01

Organ donation after cessation of circulation and respiration, both controlled and uncontrolled, has been proposed by the Institute of Medicine as a way to increase opportunities for organ procurement. Despite claims to the contrary, both forms of controlled and uncontrolled donation after cardiac death raise significant ethical and legal issues. Identified causes for concern include absence of agreement on criteria for the declaration of death, nonexistence of universal guidelines for duration before stopping resuscitation efforts and techniques, and assumption of presumed intent to donate for the purpose of initiating temporary organ-preservation interventions when no expressed consent to donate is present. From a legal point of view, not having scientifically valid criteria of cessation of circulation and respiration for declaring death could lead to a conclusion that organ procurement itself is the proximate cause of death. Although the revised Uniform Anatomical Gift Act of 2006 provides broad immunity to those involved in organ-procurement activities, courts have yet to provide an opinion on whether persons can be held liable for injuries arising from the determination of death itself. Preserving organs in uncontrolled donation after cardiac death requires the administration of life-support systems such as extracorporeal membrane oxygenation. These life-support systems can lead to return of signs of life that, in turn, have to be deliberately suppressed by the administration of pharmacological agents. Finally, allowing temporary organ-preservation interventions without expressed consent is inherently a violation of the principle of respect for a person's autonomy. Proponents of organ donation from uncontrolled donation after cardiac death, on the other hand, claim that these nonconsensual interventions enhance respect for autonomy by allowing people, through surrogate decision making, to execute their right to donate organs. However, the lack of transparency and the absence of protection of individual autonomy, for the sake of maximizing procurement opportunities, have placed the current organ-donation system of opting-in in great jeopardy. Equally as important, current policies enabling and enhancing organ procurement practices, pose challenges to the constitutional rights of individuals in a pluralistic society as these policies are founded on flawed medical standards for declaring death. PMID:19772617

Presumed consent for organ preservation in uncontrolled donation after cardiac death in the United States: a public policy with serious consequences.

PubMed

Verheijde, Joseph L; Rady, Mohamed Y; McGregor, Joan

2009-09-22

Organ donation after cessation of circulation and respiration, both controlled and uncontrolled, has been proposed by the Institute of Medicine as a way to increase opportunities for organ procurement. Despite claims to the contrary, both forms of controlled and uncontrolled donation after cardiac death raise significant ethical and legal issues. Identified causes for concern include absence of agreement on criteria for the declaration of death, nonexistence of universal guidelines for duration before stopping resuscitation efforts and techniques, and assumption of presumed intent to donate for the purpose of initiating temporary organ-preservation interventions when no expressed consent to donate is present. From a legal point of view, not having scientifically valid criteria of cessation of circulation and respiration for declaring death could lead to a conclusion that organ procurement itself is the proximate cause of death. Although the revised Uniform Anatomical Gift Act of 2006 provides broad immunity to those involved in organ-procurement activities, courts have yet to provide an opinion on whether persons can be held liable for injuries arising from the determination of death itself. Preserving organs in uncontrolled donation after cardiac death requires the administration of life-support systems such as extracorporeal membrane oxygenation. These life-support systems can lead to return of signs of life that, in turn, have to be deliberately suppressed by the administration of pharmacological agents. Finally, allowing temporary organ-preservation interventions without expressed consent is inherently a violation of the principle of respect for a person's autonomy. Proponents of organ donation from uncontrolled donation after cardiac death, on the other hand, claim that these nonconsensual interventions enhance respect for autonomy by allowing people, through surrogate decision making, to execute their right to donate organs. However, the lack of transparency and the absence of protection of individual autonomy, for the sake of maximizing procurement opportunities, have placed the current organ-donation system of opting-in in great jeopardy. Equally as important, current policies enabling and enhancing organ procurement practices, pose challenges to the constitutional rights of individuals in a pluralistic society as these policies are founded on flawed medical standards for declaring death.

Reciprocal Government Procurement with China Creates American Jobs Act

THOMAS, 111th Congress

Rep. Schauer, Mark H. [D-MI-7

2010-05-13

House - 05/26/2010 Referred to the Subcommittee on Government Management, Organization, and Procurement. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

22 CFR 145.46 - Procurement records.

Code of Federal Regulations, 2010 CFR

2010-04-01

... EDUCATION, HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Procurement Standards § 145... for lack of competition when competitive bids or offers are not obtained, and (c) basis for award cost or price. ...

24 CFR 84.46 - Procurement records.

Code of Federal Regulations, 2010 CFR

2010-04-01

... EDUCATION, HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Procurement Standards § 84... for lack of competition when competitive bids or offers are not obtained; and (c) Basis for award cost or price. ...

32 CFR 32.46 - Procurement records.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Procurement Standards § 32.46... for lack of competition when competitive bids or offers are not obtained; and (c) Basis for award cost or price. ...

Potential Organ-Donor Supply and Efficiency of Organ Procurement Organizations

PubMed Central

Guadagnoli, Edward; Christiansen, Cindy L.; Beasley, Carol L.

2003-01-01

The authors estimated the supply of organ donors in the U.S. and also according to organ procurement organizations (OPOs). They estimated the number of donors in the U.S. to be 16,796. Estimates of the number of potential donors for each OPO were used to calculate the level of donor efficiency (actual donors as a percent of potential donors). Overall, donor efficiency for OPOs was 35 percent; the majority was between 30- and 40-percent efficient. Although there is room to improve donor efficiency in the U.S., even a substantial improvement will not meet the Nation's demand for organs. PMID:14628403

Potential organ-donor supply and efficiency of organ procurement organizations.

PubMed

Guadagnoli, Edward; Christiansen, Cindy L; Beasley, Carol L

2003-01-01

The authors estimated the supply of organ donors in the U.S. and also according to organ procurement organizations (OPOs). They estimated the number of donors in the U.S. to be 16,796. Estimates of the number of potential donors for each OPO were used to calculate the level of donor efficiency (actual donors as a percent of potential donors). Overall, donor efficiency for OPOs was 35 percent; the majority was between 30- and 40-percent efficient. Although there is room to improve donor efficiency in the U.S., even a substantial improvement will not meet the Nation's demand for organs.

Evaluating Software Assurance Knowledge and Competency of Acquisition Professionals

DTIC Science & Technology

2014-10-01

of ISO 12207 -2008, both internationally and in the United States [7]. That standard documents a comprehensive set of activities and supporting...grows, organizations must ensure that their procurement agents acquire high quality, secure software. ISO 12207 and the Software Assurance Competency...cyberattacks grows, organizations must ensure that their procurement agents acquire high quality, secure software. ISO 12207 and the Software Assurance

Urban Operations, Untrained on Terrain.

DTIC Science & Technology

1998-06-05

plans at the unit level, a more flexible organization, and procurement of new equipment. 19980731 069 14. SUBJECT TERMS Urban Terrain, Military...doctrine, a training facility and training plans at the unit level, a more flexible organization, and procurement of new equipment in ACKNOWLEDGMENTS...increased, decentralized execution, these operations must be planned and executed to enable leaders at the lowest levels to seize and exploit the

Manager’s Guide to Technology Transition in an Evolutionary Acquisition Environment

DTIC Science & Technology

2005-06-01

program managers, product managers, staffs, and organizations that manage the development , procurement, production, and fielding of systems...rapidly advancing technologies. Technology transitions can occur during the development of systems, or even after a system has been in the field ...Documentation Evolutionary acquisition is an acquisition strategy that defines, develops , produces or acquires, and fields an initial hardware or software

Impact of Introducing Full-time In-house Coordinators on Referral and Organ Donation Rates in Rio de Janeiro Public Hospitals: A Health Care Innovation Practice.

PubMed

Sarlo, R; Pereira, G; Surica, M; Almeida, D; Araújo, C; Figueiredo, O; Rocha, E; Vargas, E

2016-09-01

Establishing an organization to promote organ donation and a good organ procurement team assure quality and improve performance on organ donation rates. Brazil's organ procurement structure is based on 2 models disseminated worldwide: the "Spanish model," based on in-house coordinators, and the "American organ procurement organization (OPO) model," with extra-hospital coordinators. In 2006, Brazil's Federal Government had formally introduced the in-house coordination model for every hospital equipped with a mechanical ventilator bed. In January 2012, the Rio de Janeiro State OPO, Programa Estadual de Transplantes, introduced an innovation in the organization of the in-house coordination model in 4 selected public hospitals with high organ donation potential. It consisted in launching full-time in-house coordination teams, with ≥1 physician and 2 nurses per hospital fully dedicated to organ procurement. The objectives were to observe the impact of this innovation in referral and organ donor conversion rates and to analyze the importance of middle managers in health care innovation implementation. Comparing the year before implementation (2011) and the year of 2014 showed that this innovation led to an overall increase in referrals-from 131 to 305 per year (+132%) and conversion rates-from 20% to 42% per year-resulting in an increase in number of donors from 26 to 128 per year (+390%). Despite wide variations among hospitals in the outcomes, our results seem very encouraging and express a positive impact of this model, suggesting that dissemination to other hospitals may increase the number of donors and transplants in our region. Copyright © 2016 Elsevier Inc. All rights reserved.

The deceased organ donor with an "open abdomen": proceed with caution.

PubMed

Watkins, A C; Vedula, G V; Horan, J; Dellicarpini, K; Pak, S-W; Daly, T; Samstein, B; Kato, T; Emond, J C; Guarrera, J V

2012-06-01

In solid organ transplantation, the disparity between donor supply and patients awaiting transplant continues to increase. The organ shortage has led to relaxation of historic contraindications to organ donation. A large percentage of deceased organ donors have been subjected to traumatic injuries, which can often result in intervention that leads to abdominal packing and intensive care unit resuscitation. The donor with this "open abdomen" (OA) presents a situation in which the risk of organ utilization is difficult to quantify. There exists a concern for the potential of a higher risk for both bacterial and fungal infections, including multidrug-resistant (MDR) pathogens because of the prevalence of antibiotic use and critical illness in this population. No recommendations have been established for utilization of organs from these OA donors, because data are limited. Herein, we report a case of a 21-year-old donor who had sustained a gunshot wound to his abdomen, resulting in a damage-control laparotomy and abdominal packing. The donor subsequently suffered brain death, and the family consented to organ donation. A multiorgan procurement was performed with respective transplantation of the procured organs (heart, liver, and both kidneys) into 4 separate recipients. Peritoneal swab cultures performed at the time of organ recovery grew out MDR Pseudomonas aeruginosa on the day after procurement, subsequently followed by positive blood and sputum cultures as well. All 4 transplant recipients subsequently developed infections with MDR P. aeruginosa, which appeared to be donor-derived with similar resistance patterns. Appropriate antibiotic coverage was initiated in all of the patients. Although 2 of the recipients died, mortality did not appear to be clearly associated with the donor-derived infections. This case illustrates the potential infectious risk associated with organs from donors with an OA, and suggests that aggressive surveillance for occult infections should be pursued. © 2012 John Wiley & Sons A/S.

Donation after circulatory death: burying the dead donor rule.

PubMed

Rodríguez-Arias, David; Smith, Maxwell J; Lazar, Neil M

2011-08-01

Despite continuing controversies regarding the vital status of both brain-dead donors and individuals who undergo donation after circulatory death (DCD), respecting the dead donor rule (DDR) remains the standard moral framework for organ procurement. The DDR increases organ supply without jeopardizing trust in transplantation systems, reassuring society that donors will not experience harm during organ procurement. While the assumption that individuals cannot be harmed once they are dead is reasonable in the case of brain-dead protocols, we argue that the DDR is not an acceptable strategy to protect donors from harm in DCD protocols. We propose a threefold alternative to justify organ procurement practices: (1) ensuring that donors are sufficiently protected from harm; (2) ensuring that they are respected through informed consent; and (3) ensuring that society is fully informed of the inherently debatable nature of any criterion to declare death.

Why liberals should accept financial incentives for organ procurement.

PubMed

Veatch, Robert M

2003-03-01

Free market libertarians have long supported incentives to increase organ procurement, but those oriented to justice traditionally have opposed them. This paper presents the reasons why those worried about justice should reconsider financial incentives and tolerate them as a lesser moral evil. After considering concerns about discrimination and coercion and setting them aside, it is suggested that the real moral concern should be manipulation of the neediest. The one offering the incentive (the government) has the resources to eliminate the basic needs that pressure the poor into a willingness to sell. It is unethically manipulative to withhold those resources and then offer payment for organs. Nevertheless, the poor have been left without basic necessities for 20 years since the passage of the prohibition on incentives. As long as the government continues to withhold a decent minimum of welfare, liberals should, with shame, cease opposing financial incentives for organ procurement.

Disclosure of information to organ procurement organizations. Interim final rule.

PubMed

2007-08-23

This document amends the Department of Veterans Affairs (VA) regulations to implement section 204 of the Veterans Benefits, Health Care, and Information Technology Act of 2006. This regulatory change will provide authority for VA to provide individually-identifiable VA medical records of veterans or dependents of veterans who are deceased or whose death is imminent to representatives of organ procurement organizations (OPOs) as defined in section 371(b) of the Public Health Service Act (PHS Act), eye banks, and tissue banks to determine whether the patients are suitable potential donors.

Keys to successful organ procurement: An experience-based review of clinical practices at a high-performing health-care organization

PubMed Central

Wojda, Thomas R.; Stawicki, Stanislaw P.; Yandle, Kathy P.; Bleil, Maria; Axelband, Jennifer; Wilde-Onia, Rebecca; Thomas, Peter G.; Cipolla, James; Hoff, William S.; Shultz, Jill

2017-01-01

Organ procurement (OP) from donors after brain death and circulatory death represents the primary source of transplanted organs. Despite favorable laws and regulations, OP continues to face challenges for a number of reasons, including institutional, personal, and societal barriers. This focused review presents some of the key components of a successful OP program at a large, high-performing regional health network. This review focuses on effective team approaches, aggressive resuscitative strategies, optimal communication, family support, and community outreach efforts. PMID:28660162

42 CFR 121.10 - Reviews, evaluation, and enforcement.

Code of Federal Regulations, 2014 CFR

2014-10-01

... RESOURCES DEVELOPMENT ORGAN PROCUREMENT AND TRANSPLANTATION NETWORK § 121.10 Reviews, evaluation, and... and Board of Directors meetings in which transplant hospital and OPO compliance with these regulations or OPTN policies is considered. (c) Enforcement of OPTN rules—(1) OPTN recommendations. The Board of...

42 CFR 121.10 - Reviews, evaluation, and enforcement.

Code of Federal Regulations, 2013 CFR

2013-10-01

... RESOURCES DEVELOPMENT ORGAN PROCUREMENT AND TRANSPLANTATION NETWORK § 121.10 Reviews, evaluation, and... and Board of Directors meetings in which transplant hospital and OPO compliance with these regulations or OPTN policies is considered. (c) Enforcement of OPTN rules—(1) OPTN recommendations. The Board of...

42 CFR 121.10 - Reviews, evaluation, and enforcement.

Code of Federal Regulations, 2012 CFR

2012-10-01

... RESOURCES DEVELOPMENT ORGAN PROCUREMENT AND TRANSPLANTATION NETWORK § 121.10 Reviews, evaluation, and... and Board of Directors meetings in which transplant hospital and OPO compliance with these regulations or OPTN policies is considered. (c) Enforcement of OPTN rules—(1) OPTN recommendations. The Board of...

16 CFR 6.152 - Program accessibility: Electronic and information technology.

Code of Federal Regulations, 2010 CFR

2010-01-01

... information technology. 6.152 Section 6.152 Commercial Practices FEDERAL TRADE COMMISSION ORGANIZATION... information technology. (a) When developing, procuring, maintaining, or using electronic and information technology, the Commission shall ensure, unless an undue burden would be imposed on the agency, that the...

24 CFR 84.43 - Competition.

Code of Federal Regulations, 2010 CFR

2010-04-01

... NON-PROFIT ORGANIZATIONS Post-Award Requirements Procurement Standards § 84.43 Competition. All... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Competition. 84.43 Section 84.43... free competition. The recipient shall be alert to organizational conflicts of interest as well as...

41 CFR 105-72.506 - Procurement records.

Code of Federal Regulations, 2010 CFR

2010-07-01

... EDUCATION, HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS 72.50-Post-Award Requirements/Procurement Standards...) Justification for lack of competition when competitive bids or offers are not obtained, and (c) Basis for award cost or price. ...

Development of Fracture Mechanics Maps for Composite Materials. Volume 1.

DTIC Science & Technology

1985-12-01

A________________________ N 4. PERFORMING ORGANIZATION REPORT NUMBER (S) 5. MONITORING ORGANIZATION REPORT NUMBER (S) None AFWAL-TR-85-4150, Vol 1 6. NAME OF ... OF FUNDING/SPONSORING Sb. OFFICE SYMBOL 9. PROCUREMENT INSTRUMENT IDENTIFICATION NUMBER ORGANIZATION if appplicable) European Space Technology Comm...ttee N/A ESTEC/ Contract No 4825/81/ML/AK(SC) B:. ADDRESS (City. State a=d ZIP Codel 10. SOURCE OF FUNDING NOS. ROG RAM’ PR OJE CT TASK WORK UNIT

Government Furnished Property: Management and Accounting.

DTIC Science & Technology

1986-06-01

PROCUREMENT INSTRUMENT IDENTIFICATION NUMBER ORGANIZATION I(if applicable) %J 8c ADDRESS (City. State, anid ZIP Code) 10 SOURCE OF FUNDING NUMBERS e...DAR), Armed Services Procurement Regulation (ASPR), GAO aid service comptroller guidelines, and contract administration procedures. D. SCOPE OF STUDY...Contractor-acquired property is property procured or otherwise provided by the contractor for the performance of a . contract, title to which is vested in

Lessons Learned from Outsourcing the Pearl Harbor MK-48 Intermediate Maintenance Activity

DTIC Science & Technology

2008-03-01

transfer of ownership of assets. However, outsourcing is not simply a procurement decision. All organizations procure elements of their operations...systems, commercialization, and franchising (Office of Management and Budget, 2004). Strengths of Outsourcing Outsourcing is more efficient than...operating the IMA with organic resources vs . the cost of a comparable service provided by a contractor. Activity-based costing would also help managers

To repeal a requirement with respect to the procurement and acquisition of alternative fuels.

THOMAS, 111th Congress

Rep. Hensarling, Jeb [R-TX-5

2009-02-13

House - 05/04/2009 Referred to the Subcommittee on Government Management, Organization, and Procurement. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Outcomes of Solid Organ Transplants After Simultaneous Solid Organ and Vascularized Composite Allograft Procurements: A Nationwide Analysis.

PubMed

Aycart, Mario A; Alhefzi, Muayyad; Sharma, Gaurav; Krezdorn, Nicco; Bueno, Ericka M; Talbot, Simon G; Carty, Matthew J; Tullius, Stefan G; Pomahac, Bohdan

2017-06-01

Current knowledge of the impact of facial vascularized composite allograft (VCA) procurement on the transplantation outcomes of the concomitantly recovered solid organs is limited to isolated case reports and short-term results. Here we report on a nationwide analysis of facial allograft donor surgery experience and long-term outcomes of the concomitantly recovered solid organs and their recipients. There were 10 facial VCA procurements in organ donors between December 2008 and October 2014. We identified the population of subjects who received solid organs from these 10 donors using the Scientific Registry of Transplant Recipients. We retrospectively reviewed operative characteristics, intraoperative parameters, and postoperative outcomes. Six of 10 donor surgeries were performed at outside institutions, all on brain-dead donors. Mean operative duration for facial VCA recovery was 6.9 hours (range, 4-13.25 hours). A total of 36 solid organs were recovered and transplanted into 35 recipients. Survival rates for kidney and liver recipients were 100% and 90% at a median follow-up of 33 and 27.5 months, respectively (range, 6-72 months). Graft survival rates for kidneys and livers were 15 of 16 (94%) and 9 of 10 (90%), respectively. Recipient and graft survival rates for hearts and lungs were 75% (n = 4) and 100% (n = 3) at mean follow-up time of 14.75 and 16 months, respectively. A liver recipient died at 22 months from unknown causes and a heart recipient died of leukemia at 10 months. Facial VCA procurement does not appear to adversely affect the outcomes of transplant recipients of concomitantly recovered solid organ allografts.

Factors influencing global antiretroviral procurement prices

PubMed Central

2009-01-01

Background Antiretroviral medicines (ARVs) are one of the most costly parts of HIV/AIDS treatment. Many countries are struggling to provide universal access to ARVs for all people living with HIV and AIDS. Although substantial price reductions of ARVs have occurred, especially between 2002 and 2008, achieving sustainable access for the next several decades remains a major challenge for most low- and middle-income countries. The objectives of the present study were twofold: first, to analyze global ARV prices between 2005 and 2008 and associated factors, particularly procurement methods and key donor policies on ARV procurement efficiency; second, to discuss the options of procurement processes and policies that should be considered when implementing or reforming access to ARV programs. Methods An ARV-medicines price-analysis was carried out using the Global Price Reporting Mechanism from the World Health Organization. For a selection of 12 ARVs, global median prices and price variation were calculated. Linear regression models for each ARV were used to identify factors that were associated with lower procurement prices. Logistic regression models were used to identify the characteristics of those countries which procure below the highest and lowest direct manufactured costs. Results Three key factors appear to have an influence on a country's ARV prices: (a) whether the product is generic or not; (b) the socioeconomic status of the country; (c) whether the country is a member of the Clinton HIV/AIDS Initiative. Factors which did not influence procurement below the highest direct manufactured costs were HIV prevalence, procurement volume, whether the country belongs to the least developed countries or a focus country of the United States President's Emergency Plan For AIDS Relief. Conclusion One of the principal mechanisms that can help to lower prices for ARV over the next several decades is increasing procurement efficiency. Benchmarking prices could be one useful tool to achieve this. PMID:19922690

75 FR 15403 - Information Collection, Procurement of Agricultural Commodities for Foreign Donation

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-29

... Credit Corporation (CCC) is requesting comments from all interested individuals and organizations on an... opportunities for potential vendors while allowing CCC to efficiently acquire commodities. DATES: Comments on... sells or donates commodities to promote economic development. To accommodate these donations, CCC issues...

Coping and caring: support resources integral to perioperative nurses during the process of organ procurement surgery.

PubMed

Smith, Zaneta; Leslie, Gavin; Wynaden, Dianne

2017-11-01

To discuss and explore the levels of support provided to perioperative nurses when participating in multi-organ procurement surgery and the impact to their overall well-being. Assisting within multi-organ procurement surgical procedures has been recognised to impact on the well-being of perioperative nurses leaving little opportunity for them to recover from their participation or to seek available support resources. To date, this area has remained largely unexplored with limited evidence of how nurses manage and cope with these procedures, in addition to the support received in the workplace. A qualitative grounded theory method. The study was informed by perioperative nurses (n = 35) who had previous participatory experience in these surgical procedures from two Australian states. Theoretical sampling directed the collection of data via semistructured in-depth interviews. Data were analysed using the constant comparative method. Three components of levels of support were identified from the data: lacking support within the operating room organisation; surgical team support and access to external professional support. These findings offer new insights into how nurses manage and cope with their participation in organ procurement surgical procedures and what types of support resources can be seen as barriers or enablers to their overall experiences. The need for timely and adequate support is vital to their overall well-being and future participation in organ procurement surgery. These findings have the potential to guide further research with implications for clinical initiatives and practices, looking at new ways of supporting perioperative nurses within the clinical environment both locally and internationally. Healthcare organisations need to acknowledge the emotional, psychosocial and psychological health and well-being of nurses impacted by these surgical procedures and provide appropriate and timely clinical support within the work environment. © 2016 John Wiley & Sons Ltd.

Entrepreneurial ventures and whole-body donations: a regional perspective from the United States.

PubMed

Anteby, Michel; Hyman, Mikell

2008-02-01

Human cadavers are crucial to medical science. While the debate on how to secure sufficient cadavers has focused primarily on donors' behaviors, procuring organizations' roles in increasing donations remain less explored. The United States offers a unique setting in which to examine this question since entrepreneurial ventures supplying cadavers for medical science have recently emerged alongside traditional academic-housed programs, raising both hopes and fears about their impact on whole-body donations. To assess their potential impact, an archival survey of voluntary, in-state whole-body donors to two programs procuring in the same U.S. state was conducted. The programs' specimen recipients were also analyzed. One program is academic-housed and the other is an entrepreneurial venture. Both offered equal levels of financial support to donating parties. Eighty donations and 120 specimen shipping invoices from 2005 were analyzed in each program. Donations to the two programs did not significantly differ in terms of donors' sex, marital status, maximum educational level, and estimated hourly wage. The entrepreneurial venture's donors were, however, significantly younger, more likely to be from a minority group, and more likely to have died from cancer. For-profit organizations, continuing medical training organizations, and medical device companies were more likely recipients of the entrepreneurial venture's specimens. Non-profit and academic organizations were more likely recipients of the academic-housed program's specimens. These findings suggest that although the programs procured from a somewhat similar pool of donors, they also complemented one another. The entrepreneurial program procured donations that the academic-housed program often did not attract. Specimen recipients' distinct demands partly explain these procurement behaviors. Thus, organizational efforts to meet demands seem to shape the supply. Examining organizations alongside donors might provide new answers to secure donations.

When organ donation from living donors serves as the main source of organ procurement: a critical examination of the ethical and legal challenges to Turkey's recent efforts to overcome organ shortage.

PubMed

Sert, G; Guven, T; Gorkey, S

2013-01-01

Despite the fact that Turkey has implemented a number of legislative and regulatory efforts to increase cadaveric donations, live donors still serve as the main source of organ procurement in this country. To address this problem, Turkey's regulatory authorities have sought to increase the number of brain death declarations. A new regulation issued in 2012 repeats the criteria for brain death that were first issued in 1993. This paper argues that these efforts are far from adequate owing to a number of complicated, ethical, and legal challenges that must be addressed to increase cadaveric organ donations. After examining these factors, which are completely neglected in current policies, we conclude that Turkey needs a realistic ethically justifiable organ procurement policy that must be supported by a framework of patient rights to implement the concept of patient autonomy and respect for human dignity in health care services as the primary goal. Copyright © 2013 Elsevier Inc. All rights reserved.

31 CFR Appendix C to Part 560 - Eligible Procurement Bodies

Code of Federal Regulations, 2011 CFR

2011-07-01

... procurement bodies of the Government of Iran identified by the Office of Foreign Assets Control as not being affiliated with the coercive organs of the state. See § 560.531(e). Government Trading Corporation (a.k.a...

38 CFR 49.46 - Procurement records.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Procurement Standards § 49.46... of competition when competitive bids or offers are not obtained, and (c) Basis for award cost or price. (Authority: Pub. L. 104-156; 110 Stat. 1396) ...

Power Exercise in the Institutionalization of an eProcurement System in Indonesian Local Government

NASA Astrophysics Data System (ADS)

Wahid, Fathul

2017-03-01

Power possessed by institutional entrepreneur is believed to have an influential role in navigating the institutionalization process of an idea. However, only few studies that have examined how the institutional entrepreneur exercise his power throughout the institutionalization process. This study aims at examining this phenomenon in the context of developing countries with special reference to the implementation of an eProcurement system in Indonesia. It finds that the power has been exercised by the institutional entrepreneur differently along the process. Smart power was exercised by combining soft power at the early stage of institutionalization process. At this stage level of reluctance among organizational members was high, no authorization from higher-level agencies, and the benefits of adopting the system were opaque. Hard power was then exercised at the later stage, when the legal support was well formulated, and the system’s benefits were confirmed. The study also reveals that value-based power that is used wisely make organization change runs smoothly until it becomes institutionalized. Keywords: Institutionalization, smart power, soft power, hard power, value-guided power, eGovernment, eProcurement, Indonesia, developing countries.

Cardiac transplantation. Organ procurement to patient discharge.

PubMed

Rudolphi, D M; Nagy, K M; Verne, D J

1987-01-01

The care of the cardiac transplant patient is complex, yet rewarding. During the hospital stay, the patients, families, and nurses develop close-knit relationships that last after discharge. The cardiac transplant patients at Hershey Medical Center have formed a support group. To promote organ donation, they wear T-shirts, hats, and coats with the logo, "I got my heart at HMC," (Hershey Medical Center). This not only increases awareness of the need for organ donation, but also gives Hershey Medical Center recognition for its cardiac transplantation program.

Transplant Medicine in China: Need for Transparency and International Scrutiny Remains.

PubMed

Trey, T; Sharif, A; Schwarz, A; Fiatarone Singh, M; Lavee, J

2016-11-01

Previous publications have described unethical organ procurement procedures in the People's Republic of China. International awareness and condemnation contributed to the announcement abolishing the procurement of organs from executed prisoners starting from January 2015. Eighteen months after the announcement, and aligned with the upcoming International Congress of the Transplantation Society in Hong Kong, this paper revisits the topic and discusses whether the declared reform has indeed been implemented. China has neither addressed nor included in the reform a pledge to end the procurement of organs from prisoners of conscience, nor has the government initiated any legislative amendments. Recent reports have discussed an implausible discrepancy of officially reported steady annual transplant numbers and a steep expansion of the transplant infrastructure in China. This paper expresses the viewpoint that, in the current context, it is not possible to verify the veracity of the announced changes, and it thus remains premature to include China as an ethical partner in the international transplant community. Until we have independent and objective evidence of a complete cessation of unethical organ procurement from prisoners, the medical community has a professional responsibility to maintain the academic embargo on Chinese transplant professionals. © 2016 The Authors. American Journal of Transplantation published by Wiley Periodicals, Inc. on behalf of American Society of Transplant Surgeons.

A Framework for Usability Evaluation in EHR Procurement.

PubMed

Tyllinen, Mari; Kaipio, Johanna; Lääveri, Tinja

2018-01-01

Usability should be considered already by the procuring organizations when selecting future systems. In this paper, we present a framework for usability evaluation during electronic health record (EHR) system procurement. We describe the objectives of the evaluation, the procedure, selected usability attributes and the evaluation methods to measure them. We also present the emphasis usability had in the selection process. We do not elaborate on the details of the results, the application of methods or gathering of data. Instead we focus on the components of the framework to inform and give an example to other similar procurement projects.

22 CFR 226.45 - Cost and price analysis.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Cost and price analysis. 226.45 Section 226.45 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ADMINISTRATION OF ASSISTANCE AWARDS TO U.S. NON-GOVERNMENTAL ORGANIZATIONS Post-award Requirements Procurement Standards § 226.45 Cost and price analysis. Some...

23 CFR 1350.8 - Use of grant funds.

Code of Federal Regulations, 2010 CFR

2010-04-01

... training to both urban and rural areas, including— (i) Procurement or repair of practice motorcycles; (ii... messages developed using Share-the-Road model language required under section 2010(g) of SAFETEA-LU, Public... grant to a nonprofit organization incorporated in that State to carry out grant activities under this...

42 CFR 121.10 - Reviews, evaluation, and enforcement.

Code of Federal Regulations, 2010 CFR

2010-10-01

... RESOURCES DEVELOPMENT ORGAN PROCUREMENT AND TRANSPLANTATION NETWORK § 121.10 Reviews, evaluation, and... carry out her/his responsibilities under the Public Health Service Act and the Social Security Act. (b... noncompliance is with a policy designated by the Secretary as covered by section 1138 of the Social Security Act...

Towards the Development of a Model for Hardware Standards in Information Technology Procurement: Factors for Consideration

ERIC Educational Resources Information Center

Ryan, David L.

2010-01-01

While research in academic and professional information technology (IT) journals address the need for strategic alignment and defined IT processes, there is little research about what factors should be considered when implementing specific IT hardware standards in an organization. The purpose of this study was to develop a set of factors for…

Pancreas Center Data Profile

MedlinePlus

... Composite Allograft Organ Transport Living Donation Informing Patients Ethics Guidance Calendar of Events Glossary Organ Procurement and Transplantation Network Pancreas Home Data Organ Datasource ...

7 CFR 3201.84 - Inks.

Code of Federal Regulations, 2013 CFR

2013-01-01

... biobased carbon in the product as a percent of the weight (mass) of the total organic carbon in the... of the Department of Agriculture (Continued) OFFICE OF PROCUREMENT AND PROPERTY MANAGEMENT, DEPARTMENT OF AGRICULTURE GUIDELINES FOR DESIGNATING BIOBASED PRODUCTS FOR FEDERAL PROCUREMENT Designated...

7 CFR 3201.84 - Inks.

Code of Federal Regulations, 2014 CFR

2014-01-01

... biobased carbon in the product as a percent of the weight (mass) of the total organic carbon in the... of the Department of Agriculture (Continued) OFFICE OF PROCUREMENT AND PROPERTY MANAGEMENT, DEPARTMENT OF AGRICULTURE GUIDELINES FOR DESIGNATING BIOBASED PRODUCTS FOR FEDERAL PROCUREMENT Designated...

20 CFR 435.46 - Procurement records.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Procurement records. 435.46 Section 435.46 Employees' Benefits SOCIAL SECURITY ADMINISTRATION UNIFORM ADMINISTRATIVE REQUIREMENTS FOR GRANTS AND AGREEMENTS WITH INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, OTHER NON-PROFIT ORGANIZATIONS, AND COMMERCIAL...

22 CFR 145.41 - Recipient responsibilities.

Code of Federal Regulations, 2010 CFR

2010-04-01

... HIGHER EDUCATION, HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Procurement... responsible authority, without recourse to the Department, regarding the settlement and satisfaction of all contractual and administrative issues arising out of procurements entered into in support of an award or other...

36 CFR 1210.41 - Recipient responsibilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... HIGHER EDUCATION, HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Procurement... responsible authority, without recourse to the NHPRC, regarding the settlement and satisfaction of all contractual and administrative issues arising out of procurements entered into in support of an award or other...

Pharmacists' guide to the management of organ donors after brain death.

PubMed

Korte, Catherine; Garber, Jennifer L; Descourouez, Jillian L; Richards, Katelyn R; Hardinger, Karen

2016-11-15

This article reviews organ donor pathophysiology as it relates to medication use with the goal of maximizing the successful procurement and transplantation of donor organs. The number of patients requiring organ transplantation continues to grow, yet organ donation rates remain flat, making it critical to appropriately manage each organ donor in order to ensure viability of all transplantable organs. The care given to one organ donor is tantamount to the care of several transplant recipients. Aggressive donor management ensures that the largest number of organs can be successfully procured and improves the organs' overall quality. Hospital pharmacists are responsible for processing orders and preparing the medications outlined in donor management algorithms developed by their respective medical systems. It is important that pharmacists understand the details of the medications used in these protocols in order to critically evaluate each medication order and appropriately manage the donor. Typical medications used in organ donors after brain death include medications for blood pressure management and fluid resuscitation, medications necessary for electrolyte management, blood products, vasopressors, hormone replacement therapy, antiinfectives, anticoagulants, paralytics, and organ preservation solutions. It is essential to provide optimal pharmacotherapy for each organ donor to ensure organ recovery and donation. Typical medications used in organ donors include agents for blood pressure management and fluid resuscitation, medications necessary for electrolyte management, blood products, vasopressors, hormone replacement therapy, antiinfectives, anticoagulants, paralytics, and organ preservation solutions. Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Small Business Procurement Event

DTIC Science & Technology

2014-08-13

Small Business Procurement Event 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK...NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Department of the Navy,Office of Small Business Programs,720 Kennon...distribution unlimited 13. SUPPLEMENTARY NOTES NDIA 27th Navy Gold Coast Small Business Procurement Event, 12-13 Aug 2014, San Diego, CA. 14. ABSTRACT

Absence of significant dissent should be sufficient for deceased donor organ procurement in New Zealand.

PubMed

Douglas, Thomas M; Douglas, Nicholas M

2009-10-01

New Zealand's organ donation rates are among the lowest in the OECD. In a bid to increase organ availability, the New Zealand Human Tissue Act 2008 introduces new consent arrangements for deceased donor organ procurement. This article assesses these new arrangements and presents the case for further reform. Our assessment and arguments are based on philosophical analysis informed by empirical data on the effectiveness of alternative consent systems. We: 1) Identify widely held ethical judgments about policies and practices relevant to organ donation (e.g. those relating to coronial post-mortems), 2) Assess the implications of these judgments for the Human Tissue Act and the assumptions that underpin it, and 3) Derive policy recommendations that are consistent with the judgments. The Human Tissue Act 2008 retains a strong consent requirement for organ procurement: organs may not be transplanted unless either the deceased or the family consents. We argue that organ availability could and should be increased by shifting from a model that requires consent to one that requires the absence of significant dissent. We recommend that New Zealand adopt either 1) an organ donation system similar to the existing system for ordering coronial post-mortems, or 2) a variant of the 'opt-out' system already in place in several other countries.

20 CFR 435.40 - Purpose of procurement standards.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Purpose of procurement standards. 435.40 Section 435.40 Employees' Benefits SOCIAL SECURITY ADMINISTRATION UNIFORM ADMINISTRATIVE REQUIREMENTS FOR GRANTS AND AGREEMENTS WITH INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, OTHER NON-PROFIT ORGANIZATIONS...

2 CFR 215.41 - Recipient responsibilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... NON-PROFIT ORGANIZATIONS (OMB CIRCULAR A-110) Post Award Requirements Procurement Standards § 215.41... contractual responsibilities arising under its contract(s). The recipient is the responsible authority... contractual and administrative issues arising out of procurements entered into in support of an award or other...

7 CFR 3019.43 - Competition.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 15 2010-01-01 2010-01-01 false Competition. 3019.43 Section 3019.43 Agriculture... EDUCATION, HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Procurement Standards § 3019.43 Competition. All procurement transactions shall be conducted in a manner to provide, to the...

28 CFR 70.43 - Competition.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Competition. 70.43 Section 70.43 Judicial... (INCLUDING SUBAWARDS) WITH INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Procurement Standards § 70.43 Competition. All procurement transactions must be...

49 CFR 19.43 - Competition.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 1 2010-10-01 2010-10-01 false Competition. 19.43 Section 19.43 Transportation... WITH INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Procurement Standards § 19.43 Competition. All procurement transactions shall be conducted in a...

15 CFR 14.43 - Competition.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Competition. 14.43 Section 14.43... GRANTS AND AGREEMENTS WITH INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, OTHER NON-PROFIT, AND COMMERCIAL ORGANIZATIONS Post-Award Requirements Procurement Standards § 14.43 Competition. All procurement transactions...

Analysis of procurement processes and development of recommendations for intelligent transportation systems (ITS) procurements : final report.

DOT National Transportation Integrated Search

2007-09-01

Traditional state procurement processes are not well-suited to the procurement of Intelligent Transportation Systems (ITS). The objective of this study was to analyze Kentuckys existing procurement processes, identify strengths and weaknesses of e...

U.S. FMS (Foreign Military Sales) and ROK (Republic of Korea) Economic Acquisition of Weapon Systems.

DTIC Science & Technology

1987-06-01

of Defense sells military equipment and services to foreign governments and international organizations. DOD may order and buy ( procure ) the... procurement , the U.S. government agency or military department assigned cognizance for this "case" is authorized to enter into a subsequent contractional...the item but are handled in the same way as regular U.S. government procurement , with program directors and systems managers as needed dealing with the

A review of public policies to procure and distribute kidneys for transplantation.

PubMed

Singer, P A

1990-03-01

The purpose of this article is to provide an up-to-date review of the current status of frequently changing public policies for the procurement and distribution of donor kidneys for transplantation. Issues in procurement involve the Uniform Anatomical Gift Act, criteria for brain death, routine inquiry/required request policies, and the use of living kidney donors. Issues in distribution involve access to the transplant waiting list and use of the new national point system to select recipients from the list. These public policies are relevant for internists, who often care for potential organ donors and patients with end-stage renal disease. The issues are also relevant for policy-minded physicians because renal transplantation is the paradigm for organ transplant policy.

Identifying Potential Ventilator Auto-Triggering Among Organ Procurement Organization Referrals.

PubMed

Henry, Nicholas R; Russian, Christopher J; Nespral, Joseph

2016-06-01

Ventilator auto-trigger is the delivery of an assisted mechanical ventilated breath over the set ventilator frequency in the absence of a spontaneous inspiratory effort and can be caused by inappropriate ventilator trigger sensitivity. Ventilator auto-trigger can be misinterpreted as a spontaneous breath and has the potential to delay or prevent brain death testing and confuse health-care professionals and/or patient families. To determine the frequency of organ donor referrals from 1 Organ Procurement Organization (OPO) that could benefit from an algorithm designed to assist organ recovery coordinators to identify and correct ventilator auto-triggering. This retrospective analysis evaluated documentation of organ donor referrals from 1 OPO in central Texas during the 2013 calendar year that resulted in the withdrawal of care by the patient's family and the recovery of organs. The frequency of referrals that presented with absent brain stem reflexes except for additional respirations over the set ventilator rate was determined to assess for the need of the proposed algorithm. Documentation of 672 organ procurement organization referrals was evaluated. Documentation from 42 referrals that resulted in the withdrawal of care and 21 referrals that resulted in the recovery of organs were identified with absent brain stem reflexes except for spontaneous respirations on the mechanical ventilator. As a result, an algorithm designed to identify and correct ventilator auto-trigger could have been used 63 times during the 2013 calendar year. © 2016, NATCO.

Regulatory change for organ procurement organizations: certifying the success of transplantation in America.

PubMed

Alexander, Charles E

2006-09-01

In June 2006, the Centers for Medicare & Medicaid Services released the final rule for the conditions of participation for organ procurement organizations in the United States. The new guidelines change the way OPOs are measured, shifting from a population-based set of performance measures to a system that is based on eligible donors and conversion rates. In addition to the change in measurement philosophy, CMS has included statements, regarding organizational structure, staffing, and research as standard measures for OPOs. The change from solely donation and transplantation measures is significant for the community, and will result in changes in the way OPOs structure their organizations and governing and clinical boards.

42 CFR 486.328 - Condition: Reporting of data.

Code of Federal Regulations, 2011 CFR

2011-10-01

...: (1) Kidneys procured. Each kidney recovered will be counted individually. En bloc kidneys recovered will count as two kidneys procured. (2) Kidneys transplanted. Each kidney transplanted will be counted individually. En bloc kidney transplants will be counted as two kidneys transplanted. (3) Extra-renal organs...

42 CFR 486.328 - Condition: Reporting of data.

Code of Federal Regulations, 2010 CFR

2010-10-01

...: (1) Kidneys procured. Each kidney recovered will be counted individually. En bloc kidneys recovered will count as two kidneys procured. (2) Kidneys transplanted. Each kidney transplanted will be counted individually. En bloc kidney transplants will be counted as two kidneys transplanted. (3) Extra-renal organs...

34 CFR 80.3 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... the grantee or subgrantee by other public agencies and institutions, and private organizations and... definitions for grant and subgrant in this section and except where qualified by Federal) a procurement contract under a grant or subgrant, and means a procurement subcontract under a contract. Cost sharing or...

Sustainable Procurement: Integrating Classroom Learning with University Sustainability Programs

ERIC Educational Resources Information Center

Goldschmidt, Kyle; Harrison, Terry; Holtry, Matthew; Reeh, Jeremy

2013-01-01

Organizations are facing increased pressure from various stakeholders to address issues of sustainability, resulting in a growing demand for sustainability education and training. Procurement groups remain the key drivers of many sustainability-related strategies, placing pressure on universities to integrate sustainability concepts into the…

22 CFR 145.40 - Purpose of procurement standards.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Purpose of procurement standards. 145.40 Section 145.40 Foreign Relations DEPARTMENT OF STATE CIVIL RIGHTS GRANTS AND AGREEMENTS WITH INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements...

14 CFR 1260.143 - Competition.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., Hospitals, and Other Non-Profit Organizations Procurement Standards § 1260.143 Competition. All procurement... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Competition. 1260.143 Section 1260.143... competition. The recipient shall be alert to organizational conflicts of interest as well as noncompetitive...

34 CFR 74.43 - Competition.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 1 2010-07-01 2010-07-01 false Competition. 74.43 Section 74.43 Education Office of... HIGHER EDUCATION, HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Procurement Standards § 74.43 Competition. All procurement transactions shall be conducted in a manner to provide, to...

22 CFR 518.43 - Competition.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 2 2010-04-01 2010-04-01 true Competition. 518.43 Section 518.43 Foreign... INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Procurement Standards § 518.43 Competition. All procurement transactions shall be conducted in a manner to...

22 CFR 145.43 - Competition.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Competition. 145.43 Section 145.43 Foreign..., HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Procurement Standards § 145.43 Competition. All procurement transactions shall be conducted in a manner to provide, to the maximum extent...

36 CFR 1210.43 - Competition.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Competition. 1210.43 Section..., HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Procurement Standards § 1210.43 Competition. All procurement transactions shall be conducted in a manner to provide, to the maximum extent...

[Organ procurement and transplantation from non-heart-beating donors].

PubMed

Antoine, Corinne; Brun, Frédéric; Tenaillon, Alain; Loty, Bernard

2008-02-01

Despite a significant increase in procurement and transplantation activities observed in France in the last eight years, the shortage in grafts is on the rise and demand keeps being much higher than supply. Since 1968 and until now, procurement was limited to heart beating brain donors. The results of kidneys transplanted from non-heart-beating donors have significantly improved and are nowadays comparable to those of kidney transplantations from brain death donors, thanks to a more accurate selection of donors and recipients, to better respect of preventing cold and warm ischemia times and to several major therapeutic innovations. Procurement on non-heart-beating donors are therefore being reconsidered under considerations of feasibility, results and ethical and legal consequences, under a specific medical protocol issued by the agency of biomedicine with the pilot hospital center agreement to comply with the protocol. Referring to foreign experiences, this program is likely to decrease the organ shortage, which is jeopardizing the treatment of a large number of patients awaiting transplantation.

Contracting and Procurement for Evidence-Based Interventions in Public-Sector Human Services: A Case Study.

PubMed

Willging, Cathleen E; Aarons, Gregory A; Trott, Elise M; Green, Amy E; Finn, Natalie; Ehrhart, Mark G; Hecht, Debra B

2016-09-01

Sustainment of evidence-based interventions (EBIs) in human services depends on the inner context of community-based organizations (CBOs) that provide services and the outer context of their broader environment. Increasingly, public officials are experimenting with contracting models from for-profit industries to procure human services. In this case study, we conducted qualitative interviews with key government and CBO stakeholders to examine implementation of the Best Value-Performance Information Procurement System to contract for EBIs in a child welfare system. Findings suggest that stakeholder relationships may be compromised when procurement disregards local knowledge, communication, collaboration, and other factors supporting EBIs and public health initiatives.

Modification of the education system for organ procurement coordinators in Japan after the revision of the Japanese Organ Transplantation Act.

PubMed

Konaka, S; Kato, O; Ashikari, J; Fukushima, N

2012-05-01

From October 1997 to July 2010, only 86 brain-dead (BD) organ donations were obtained and no organs were retrieved from children under 15 years of age because of the strict Japan Organ Transplantation Act. The Act was revised on July 17, 2010, allowing organs to be donated after BD with family consent. To manage the increased donations after the revision, the Japan Organ Transplant Network (JOT) employed 10 organ procurement coordinators (OPCs) and modified its education systems. We retrospectively reviewed the modified education programs to evaluate whether they were effective and whether the processes of organ donation were promptly performed after the revision of the Act. The modifications of education program were: changing OPC to guideline manuals to correspond to the revised Transplant Act; OPCs were taught the new organ procurement system; and a special education program was provided for the 10 newcomers for 2 months. After 12 months of the revision, 58 BD organ donations were accomplished, whereas they had averaged 6.6 in a year before the revision. Two pediatric BD organ donations were accomplished without problem. One priority organ donation to a relative was performed uneventfully. After applying the modified education program, skilled JOT OPCs and leader JOT OPCs increased. To manage increased organ donations after the revision of the Act, the educational system was modified and 58 brain dead organ donations were performed safely. Copyright © 2012 Elsevier Inc. All rights reserved.

Should consent be required for organ procurement?

PubMed

Zambrano, Alexander

2018-06-08

Must we obtain a patient's consent before posthumously removing her organs? According to the consent requirement, in order to permissibly remove organs from a deceased person, it is necessary that her prior consent be obtained. If the consent requirement is true, then this seems to rule out policies that do not seek and obtain a patient's prior consent to organ donation, while at the same time vindicating policies that do seek and obtain patient consent. In this paper, however, I argue that once we recognize the difference between consent, on the one hand, and wishing or desiring, on the other, we will see that obtaining consent before organ removal is neither necessary nor sufficient to respect patient autonomy in organ procurement. © 2018 John Wiley & Sons Ltd.

Resistance to Information Technology in Public Procurement in Tanzania

ERIC Educational Resources Information Center

Nditi, Christopher

2010-01-01

Organizations have become more dependent on information technology (IT) in the 21st century. But IT implementation and use is resisted in certain sectors of Tanzania, particularly in government-run enterprises. The purpose of this study was to investigate the causes and consequences of resistance to IT development and implementation in the…

42 CFR 482.45 - Condition of participation: Organ, tissue, and eye procurement.

Code of Federal Regulations, 2012 CFR

2012-10-01

... and the notification protocol developed in consultation with the tissue and eye banks identified by the hospital for this purpose; (2) Incorporate an agreement with at least one tissue bank and at least... in conjunction with the tissue and eye bank community in the methodology for approaching potential...

42 CFR 482.45 - Condition of participation: Organ, tissue, and eye procurement.

Code of Federal Regulations, 2014 CFR

2014-10-01

... and the notification protocol developed in consultation with the tissue and eye banks identified by the hospital for this purpose; (2) Incorporate an agreement with at least one tissue bank and at least... in conjunction with the tissue and eye bank community in the methodology for approaching potential...

42 CFR 482.45 - Condition of participation: Organ, tissue, and eye procurement.

Code of Federal Regulations, 2013 CFR

2013-10-01

... and the notification protocol developed in consultation with the tissue and eye banks identified by the hospital for this purpose; (2) Incorporate an agreement with at least one tissue bank and at least... in conjunction with the tissue and eye bank community in the methodology for approaching potential...

Donor Indocyanine Green Clearance Test Predicts Graft Quality and Early Graft Prognosis After Liver Transplantation.

PubMed

Tang, Yunhua; Han, Ming; Chen, Maogen; Wang, Xiaoping; Ji, Fei; Zhao, Qiang; Zhang, Zhiheng; Ju, Weiqiang; Wang, Dongping; Guo, Zhiyong; He, Xiaoshun

2017-11-01

Transplantation centers have given much attention to donor availability. However, no reliable quantitative methods have been employed to accurately assess graft quality before transplantation. Here, we report that the indocyanine green (ICG) clearance test is a valuable index for liver grafts. We performed the ICG clearance test on 90 brain-dead donors within 6 h before organ procurement between March 2015 and November 2016. We also analyzed the relationship between graft liver function and early graft survival after liver transplantation (LT). Our results suggest that the ICG retention rate at 15 min (ICGR15) of donors before procurement was independently associated with 3-month graft survival after LT. The best donor ICGR15 cutoff value was 11.0%/min, and we observed a significant increase in 3-month graft failure among patients with a donor ICGR15 above this value. On the other hand, a donor ICGR15 value of ≤ 11.0%/min could be used as an early assessment index of graft quality because it provides additional information to the transplant surgeon or organ procurement organization members who must maintain or improve organ function to adapt the LT. An ICG clearance test before liver procurement might be an effective quantitative method to predict graft availability and improve early graft prognosis after LT.

2 CFR 215.40 - Purpose of procurement standards.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Section 215.40 Grants and Agreements OFFICE OF MANAGEMENT AND BUDGET CIRCULARS AND GUIDANCE Reserved..., HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS (OMB CIRCULAR A-110) Post Award Requirements Procurement... ensure that such materials and services are obtained in an effective manner and in compliance with the...

State Requirements for Educational Facilities, 1999.

ERIC Educational Resources Information Center

Florida State Dept. of Education, Tallahassee. Office of Educational Facilities.

This updated, two-volume document provides guidance for those involved in the educational facilities procurement process, and includes recent legislative changes affecting the state of Florida's building code. The first volume is organized by the sequence of steps required in the facilities procurement process and presents state requirements for…

Law and medical ethics in organ transplantation surgery

PubMed Central

Woodcock, Tom; Wheeler, Robert

2010-01-01

This article in the series describes how UK law and medical ethics have evolved to accommodate developments in organ transplantation surgery. August committees have formulated definitions of the point of death of the person which are compatible with the lawful procurement of functioning vital organs from cadavers. Some of the complexities of dead donor rules are examined. Live donors are a major source of kidneys and the laws that protect them are considered. Financial inducements and other incentives to donate erode the noble concept of altruism, but should they be unlawful? PMID:20501013

The impact of e-Procurement practice in Indonesia government: A Preliminary Study (The case of Electronic Procurement Service at Bekasi District)

NASA Astrophysics Data System (ADS)

Candra, S.; E Gunawan, F.

2017-01-01

In digital economy, government of Indonesia uses the internet to deliver services and to communicate with citizens and organizations. One of applications are e-Procurement and LPSE is a unit to hold the service system of e-Procurement. Procurement of goods and services electronically in addition will increase transparency and accountability, improve market access and healthy competition, as well as improving the efficiency of the procurement process. Based on the background and specific objectives to be achieved, then the research will be viewed from e-Marketplace participation, Trust and its impact on the performance of existing procurement within the institution. Methods of data analysis used in this research is by using analysis of Structural Equation Modelling (SEM) by using the program Partial Least Square (PLS) to examine the relationship between variables. The population used in this study is an enterprise as well as other clients using the system LPSE Bekasi District. There are three part in this study population, namely the provision of a company, customer, and supplier of LPSE users amounted to 60 users. From data analysis, there are one hypothesis that rejected. The implication of this study are implementation of e-procurement and e-marketplace participation giving impact to procurement performance.

Developing trends in public procurement and auditing - a unique symposium for space and defence procurement

NASA Astrophysics Data System (ADS)

Morel de Westgaver, Eric; van Beekhuizen, Pieter; Fiorilli, Stefano M.

2007-02-01

Space projects are marked by their high technologies and their lengthy development and operations. The procurement process is a critical element that must adapt to a changing industrial landscape and new methods and tools, such as electronic procurement. ESA will host an international symposium in May [2007] to bring all the major players together.

Potential fraudulent behaviors in e-procurement implementation in Indonesia

NASA Astrophysics Data System (ADS)

Huda, S. N.; Setiani, N.; Pulungan, R.; Winarko, E.

2017-03-01

Corruptions in public procurement have occurred in various parts of the world, especially in developing countries. Implementation of SPSE (electronic procurement system) as the e-procurement system in Indonesia is based on the government’s intentions towards clean and good governance by fighting corruption, collusion, and nepotism. Procurement in Indonesia is carried out through SPSE, which is developed by LKPP (Government Policy on Procurement of Goods/Services). Although this system has brought many positive effects, there are still found many practices of fraud occurring in the implementation of the system. In this paper, we try to identify these practices and then to systematically categorize and analyze them.

76 FR 14570 - Federal Acquisition Regulation; Trade Agreements Thresholds

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-16

... application of the World Trade Organization Government Procurement Agreement and the Free Trade Agreements, as... Parts 22, 25, and 52 Government procurement. Dated: March 4, 2011. Millisa Gary, Acting Director, Office... (NASA). ACTION: Final rule. SUMMARY: DoD, GSA, and NASA have adopted as final, without change, an...

77 FR 13951 - Federal Acquisition Regulation; Federal Acquisition Circular 2005-57; Introduction

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-07

... Trade Organization Government Procurement Agreement (WTO GPA). This Free Trade Agreement now covers acquisition of supplies and services between $100,000 and the current WTO GPA threshold of $202,000. This... effective March 15, 2012. Dated: March 1, 2012. Richard Ginman, Director, Defense Procurement and...

76 FR 58856 - Determination Regarding Waiver of Discriminatory Purchasing Requirements With Respect to Goods...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-22

... Representative, (202) 395-9476. SUPPLEMENTARY INFORMATION: On December 7, 2010, the WTO Committee on Government Procurement approved the accession of Armenia to the World Trade Organization (``WTO'') Agreement on Government Procurement (``GPA''). Armenia submitted its instrument of accession to the Secretary-General of...

42 CFR 121.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... PROCUREMENT AND TRANSPLANTATION NETWORK § 121.2 Definitions. As used in this part— Act means the Public Health... means an entity so designated by the Secretary under section 1138(b) of the Social Security Act. Organ procurement and transplantation network or OPTN means the network established pursuant to section 372 of the...

7 CFR 2902.40 - Laundry products.

Code of Federal Regulations, 2010 CFR

2010-01-01

.... The minimum biobased content shall be based on the amount of qualifying biobased carbon in the product as a percent of the weight (mass) of the total organic carbon in the finished product. The applicable... May 14, 2009, procuring agencies, in accordance with this part, will give a procurement preference for...

40 CFR 247.2 - Applicability.

Code of Federal Regulations, 2010 CFR

2010-07-01

... apply to purchases made by private party recipients (e.g., individuals, non-profit organizations) of... competition, considering such guidelines. Procuring agencies may decide not to procure such items if they are...; or are only available at an unreasonable price. [60 FR 21381, May 1, 1995, as amended at 62 FR 60973...

[Marketing role of corneal graft tissue donation to an eye bank and donors' socioeconomic profile].

PubMed

Farias, Roberta Jansen de Mello; Sousa, Luciene Barbosa de

2008-01-01

Penetrating keratoplasty has been the leading and the most successful type of transplant in the world, however corneal deficiency is a commom problem usually presented to corneal surgeons. Impact evaluation of the number of corneal graft donations to the Sorocaba Eye Bank after the implementation of a corneal graft procurement system; to draw the socioeconomic profile of corneal graft donors of the Sorocaba Eye Bank (SEB). Retrospective study on donations to SEB from its creation and after the development of media marketing. Prospective analysis of the socioeconomic profile of corneal graft donors by a questionnaire sent as letters to the families of the donors in a certain month. SEB began its work in 1971 by spreading need of organ donation through lectures in churches, shopping malls, community meetings, radio programs, television programs, etc. In the 70s, the number of retrieved corneal grafts was 1 or 2/month. Between 1984 - 1989 a procurement coordination team was trained to act in mortuaries and by 2000 they also began to work in public hospitals. In 1984 only 260 corneal grafts were retrieved. This number has been increasing to 2,778 corneal graft donations in 2004. The questionnaire was answered by 76 of the 93 donor families, with a response rate of 81.7%. Donor age had a mean of 65.1 +/- 14.7 y/o, forty-two (55.3%) were men. Educational level of the donor families was an important factor for organ donation, once 36.8% had concluded high school and 34.2% completed university. The great majority, sixty-three (82.9%) of the corneal grafts were donated through the efforts of the procurement coordination team. The role of the media and institutional credibility are mandatory for public commitment to organ donation. The proficiency of the procurement coordination team requires intensive training, as the results show that 82.9% donations were made thanks to their efforts.

Policy statement--pediatric organ donation and transplantation.

PubMed

2010-04-01

Pediatric organ donation and organ transplantation can have a significant life-extending benefit to the young recipients of these organs and a high emotional impact on donor and recipient families. Pediatricians, pediatric medical specialists, and pediatric transplant surgeons need to be better acquainted with evolving national strategies that involve organ procurement and organ transplantation to help acquaint families with the benefits and risks of organ donation and transplantation. Efforts of pediatric professionals are needed to shape public policies to provide a system in which procurement, distribution, and cost are fair and equitable to children and adults. Major issues of concern are availability of and access to donor organs; oversight and control of the process; pediatric medical and surgical consultation and continued care throughout the organ-donation and transplantation process; ethical, social, financial, and follow-up issues; insurance-coverage issues; and public awareness of the need for organ donors of all ages.

Contracting and Procurement for Evidence-Based Interventions in Public-Sector Human Services: A Case Study

PubMed Central

Willging, Cathleen E.; Aarons, Gregory A.; Trott, Elise M.; Green, Amy E.; Finn, Natalie; Ehrhart, Mark G.; Hecht, Debra B.

2016-01-01

Sustainment of evidence-based interventions (EBIs) in human services depends on the inner context of community-based organizations (CBOs) that provide services and the outer context of their broader environment. Increasingly, public officials are experimenting with contracting models from for-profit industries to procure human services. In this case study, we conducted qualitative interviews with key government and CBO stakeholders to examine implementation of the Best Value-Performance Information Procurement System to contract for EBIs in a child welfare system. Findings suggest that stakeholder relationships may be compromised when procurement disregards local knowledge, communication, collaboration, and other factors supporting EBIs and public health initiatives. PMID:26386977

The DOE Program Guide for Universities and Other Research Groups. Part I - DOE Research and Development Programs. Part II - DOE Procurement and Assistance Policies/Procedures.

ERIC Educational Resources Information Center

Department of Energy, Washington, DC. Procurement and Contracts Management Directorate.

This guide is intended to orient research organizations interested in establishing a program relationship with the United States Department of Energy (DOE). The publication is divided into two parts. Part I describes DOE research and development programs, summarizes budget data, and lists contact persons for DOE programs. In addition, this section…

[Deceased donation in renal transplantation].

PubMed

Thuret, R; Kleinclauss, F; Terrier, N; Timsit, M O

2016-11-01

To review epidemiologic data's and medical results of deceased donation in renal transplantation. Relevant publications were identified through Medline (http://www.ncbi.nlm.nih.gov) and Embase (http://www.embase.com) database using the following keywords, alone or in association, "brain death; cardiac arrest; deceased donation; organ procurement; transplantation". Articles were selected according to methods, language of publication and relevance. The reference lists were used to identify additional historical studies of interest. Both prospective and retrospective series, in French and English, as well as review articles and recommendations were selected. In addition, French national transplant and health agencies (http://www.agence-biomedecine.fr and http://www.has-sante.fr) databases were screened using identical keywords. A total of 2498 articles, 8 official reports and 17 newspaper articles were identified; after careful selection 157 publications were eligible for our review. Deceased donation may involve either brain death or non-heartbeating donors (NHBD). Organ shortage led to the procurement of organs from expanded-criteria donors, with an increased age at donation and extended vascular disease, leading to inferior results after transplantation and underlining the need for careful donor management during brain death or cardiac arrest. Evolution of French legislation covering bioethics allowed procurement from Maastricht categories II and recently III non-heartbeating donors. The increase of organ shortage emphasizes the need for a rigorous surgical technique during procurement to avoid loss of transplants. A history or current neoplasm in deceased-donors, requires attention to increase the pool of organs without putting the recipients at risk for cancer transmission. French NHBD program, especially from Maastricht category III, may stand for a potential source of valuable organs. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Industrial Arts Resource Supplement to the Consumer Education Curriculum Guide for Ohio.

ERIC Educational Resources Information Center

Ohio State Dept. of Education, Columbus. Div. of Vocational Education.

The consumer education guide for industrial arts teachers was developed by a group of experienced teachers using the Consumer Education Curriculum Guide for Ohio, Grades K-12 as a reference. The guide is organized in six sections, each dealing with one of the following basic concepts: (1) the economic system, (2) income procurement, (3) consumer…

OAS - Organization of American States: Democracy for peace, security, and

Science.gov Websites

Elections Environment Equity G General Assembly Governance H Human Development Human Rights I Indigenous Quarterly Reports of the General Secretariat Procurement Human Resources Evaluation Internal Audit Real programmatic results. The full texts may be found here. Here you will find data on the Human Resources of the

77 FR 28607 - Advisory Committee on Organ Transplantation; Request for Nominations for Voting Members

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-15

... bioethics, behavioral sciences, economics and statistics, as well as representatives of transplant...; law and bioethics; behavioral sciences; economics and econometrics; organ procurement organizations...

Financial Impact of Liver Sharing and Organ Procurement Organizations' Experience With Share 35: Implications for National Broader Sharing.

PubMed

Fernandez, H; Weber, J; Barnes, K; Wright, L; Levy, M

2016-01-01

The Share 35 policy for organ allocation, which was adopted in June 2013, allocates livers regionally for candidates with Model for End-Stage Liver Disease scores of 35 or greater. The authors analyzed the costs resulting from the increased movement of allografts related to this new policy. Using a sample of nine organ procurement organizations, representing 17% of the US population and 19% of the deceased donors in 2013, data were obtained on import and export costs before Share 35 implementation (June 15, 2012, to June 14, 2013) and after Share 35 implementation (June 15, 2013, to June 14, 2014). Results showed that liver import rates increased 42%, with an increased cost of 51%, while export rates increased 112%, with an increased cost of 127%. When the costs of importing and exporting allografts were combined, the total change in costs for all nine organ procurement organizations was $11 011 321 after Share 35 implementation. Extrapolating these costs nationally resulted in an increased yearly cost of $68 820 756 by population or $55 056 605 by number of organ donors. Any alternative allocation proposal needs to account for the financial implications to the transplant infrastructure. © Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.

Quality medicines for the poor: experience of the Delhi programme on rational use of drugs.

PubMed

Chaudhury, R Roy; Parameswar, R; Gupta, U; Sharma, S; Tekur, U; Bapna, J S

2005-03-01

Prior to 1994, most Delhi hospitals and dispensaries experienced constant shortages of essential medicines. There was erratic prescribing of expensive branded products, frequent complaints about poor drug quality and low patient satisfaction. Delhi took the lead in developing a comprehensive Drug Policy in 1994 and was the only Indian state to have such a comprehensive policy. The policy's main objective is to improve the availability and accessibility of quality essential drugs for all those in need. The Delhi Society for the Promotion of Rational Use of Drugs (DSPRUD), a non-governmental organization, worked in close collaboration with the Delhi Government and with universities to implement various components of the policy. The first Essential Drugs List (EDL) was developed, a centralized pooled procurement system was set up and activities promoting rational use of drugs were initiated. In 1997, the Delhi Programme was designated the INDIA-WHO Essential Drugs Programme by the World Health Organization. The EDL was developed by a committee consisting of a multidisciplinary group of experts using balanced criteria of efficacy, safety, suitability and cost. The first list contained 250 drugs for hospitals and 100 drugs for dispensaries; the list is revised every 2 years. The pooled procurement system, including the rigorous selection of suppliers with a minimum annual threshold turnover and the introduction of Good Manufacturing Practice inspections, resulted in the supply of good quality drugs and in holding down the procurement costs of many drugs. Bulk purchasing of carefully selected essential drugs was estimated to save nearly 30% of the annual drugs bill for the Government of Delhi, savings which were mobilized for procuring more drugs, which in turn improved availability of drugs (more than 80%) at health facilities. Further, training programmes for prescribers led to a positive change in prescribing behaviour, with more than 80% of prescriptions being from the EDL and patients receiving 70-95% of the drugs prescribed. These changes were achieved by changing managerial systems with minimal additional expenditure. The 'Delhi Model' has clearly demonstrated that such a programme can be introduced and implemented and can lead to a better use and availability of medicines.

24 CFR 963.12 - Alternative procurement process.

Code of Federal Regulations, 2010 CFR

2010-04-01

... URBAN DEVELOPMENT PUBLIC HOUSING-CONTRACTING WITH RESIDENT-OWNED BUSINESSES Contracting With Resident-Owned Businesses § 963.12 Alternative procurement process. (a) Method of procurement. In contracting with resident-owned businesses, the PHA shall follow the applicable method of procurement as set forth...

Organ procurement organization compliance with 21 CFR 1271: a challenge for allogeneic pancreatic islet cell transplantation programs.

PubMed

Winters, J L; Tran, S A; Gastineau, D A; Padley, D J; Dean, P G; Kudva, Y C

2009-06-01

In order to protect tissue recipients, the Food and Drug Administration drafted Title 21, Section 1271 of the Code of Federal Regulations 1271 (21 CFR 1271) to address infectious disease risk. These regulations apply to tissues but not vascularized organs. Pancreatic islet cells are regulated under 21 CFR 1271. These regulations require qualification of suppliers of critical materials and services with regard to 21 CFR 1271 compliance. As part of supplier qualification, all organ procurement organizations (OPOs) in the United States were sent a questionnaire covering the key components of these regulations. Of the 57 OPOs, 29 (51%) were in compliance based upon survey results. Twelve (21%) were not compliant in one or more areas. All indicated plans to become compliant. The remaining 15 (27%) either failed or refused to complete the survey, some indicating 21 CFR 1271 did not apply to OPOs. Using 2006 data, OPOs compliant with 21 CFR 1271 recovered 50% of the organs procured in the United States. These findings represent a challenge for allogeneic islet cell transplant programs whose raw material must comply with 21 CFR 1271. OPOs should work toward understanding and complying with 21 CFR 1271. Regulatory agencies should work toward enhancing safety of the pancreas supply by facilitating compliance through harmonization of requirements.

75 FR 66680 - Defense Federal Acquisition Regulation Supplement; Trade Agreements-New Thresholds (DFARS 2009-D040)

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-29

... Trade Organization Government Procurement Agreement and the Free Trade Agreements, as determined by the... of Subjects in 48 CFR Part 225 Government procurement. Ynette R. Shelkin, Editor, Defense Acquisition...: DoD is adopting as final, without change, the interim rule that amended the Defense Federal...

28 CFR 70.45 - Cost and price analysis.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Cost and price analysis. 70.45 Section 70... NON-PROFIT ORGANIZATIONS Post-Award Requirements Procurement Standards § 70.45 Cost and price analysis. Some form of cost or price analysis must be made and documented in the procurement files in connection...

15 CFR 14.45 - Cost and price analysis.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Cost and price analysis. 14.45 Section... COMMERCIAL ORGANIZATIONS Post-Award Requirements Procurement Standards § 14.45 Cost and price analysis. Some form of cost or price analysis shall be made and documented in the procurement files in connection with...

22 CFR 226.45 - Cost and price analysis.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Cost and price analysis. 226.45 Section 226.45...-GOVERNMENTAL ORGANIZATIONS Post-award Requirements Procurement Standards § 226.45 Cost and price analysis. Some form of cost or price analysis shall be made and documented in the procurement files in connection with...

Secretary | Center for Cancer Research

Cancer.gov

We are looking for a pleasant, organized, dependable person to serve as a full-time secretary in the Basic Science Program (BSP) at the Frederick National Laboratory for Cancer Research (FNCLR).  The BSP provides procurement and logistical support to the laboratories of the Center for Cancer Research.  Tasks include high volume procurement (blanket orders, purchase requests,

77 FR 13952 - Federal Acquisition Regulation; United States-Korea Free Trade Agreement

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-07

...DoD, GSA, and NASA are issuing an interim rule amending the Federal Acquisition Regulation (FAR) to implement the United States- Korea Free Trade Agreement. The Republic of Korea is already party to the World Trade Organization Government Procurement Agreement, but this trade agreement implements a lower procurement threshold.

48 CFR 702.170-13 - Procurement Executive.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Procurement Executive. 702.170-13 Section 702.170-13 Federal Acquisition Regulations System AGENCY FOR INTERNATIONAL DEVELOPMENT GENERAL DEFINITIONS OF WORDS AND TERMS Definitions 702.170-13 Procurement Executive. “Procurement...

Trends in organ donor management: 2002 to 2012.

PubMed

Callahan, Devon S; Kim, Dennis; Bricker, Scott; Neville, Angela; Putnam, Brant; Smith, Jennifer; Bongard, Frederic; Plurad, David

2014-10-01

Refinements in donor management have resulted in increased numbers and quality of grafts after neurologic death. We hypothesize that the increased use of hormone replacement therapy (HRT) has been accompanied by improved outcomes over time. Using the Organ Procurement and Transplant Network donor database, all brain-dead donors procured from July 1, 2001 to June 30, 2012 were studied. Hormone replacement therapy was identified by an infusion of thyroid hormone. An expanded criteria donor was defined as age 60 years or older. Incidence of HRT administration and number of donors and organs recovered were calculated. Using the Organ Procurement and Transplant Network thoracic recipient database transplant list, wait times were examined. There were 74,180 brain-dead donors studied. Hormone replacement therapy use increased substantially from 25.6% to 72.3% of donors. However, mean number of organs procured per donor remained static (3.51 to 3.50; p = 0.083), and the rate of high-yield donors decreased (46.4% to 43.1%; p < 0.001). Incidence of traumatic brain injury donors decreased (42.1% to 33.9%; p < 0.001) relative to an increased number of expanded criteria donors (22.1% to 26%). Despite this, there has been an increase in the raw number of donors (20,558 to 24,308; p < 0.001) and organs (5,857 to 6,945; p < 0.001). There has been an increase in organs per traumatic brain injury donor (4.02 to 4.12; p = 0.002) and a decrease in days on the waiting list (462.2 to 170.4 days; p < 0.001) for a thoracic transplant recipient. The marked increase in the use of HRT in the management of brain-dead donors has been accompanied by increased organ availability overall. Potential mechanisms might include successful conversion of previously unacceptable donors and improved recovery in certain subsets of donors. Copyright © 2014 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Department of the Navy Justification of Estimates for Fiscal Year 1983 Submitted to Congress February 1982. Procurement. Book 2. Shipbuilding and Conversion, Navy; Other Procurement, Navy; Procurement, Marine Corps

DTIC Science & Technology

1982-02-01

two increments . Increment 1 provides the austere essential ofticer in Tactical Conatana (Uu) co,.manac center organic data display and communications...and a large screen display group. Equipment in Increment 2 has been chosen trom inventory or tnavy stauu- aros and provides a stand alone austere...installation or increment I on 19 designated flagships (14 carriers and five cruisers) and installation or Increment 2 on six carriers auG and the

29 CFR 95.41 - Recipient responsibilities.

Code of Federal Regulations, 2012 CFR

2012-07-01

..., AND OTHER NON-PROFIT ORGANIZATIONS, AND WITH COMMERCIAL ORGANIZATIONS, FOREIGN GOVERNMENTS, ORGANIZATIONS UNDER THE JURISDICTION OF FOREIGN GOVERNMENTS, AND INTERNATIONAL ORGANIZATIONS Post-Award... of all contractual and administrative issues arising out of procurements entered into in support of...

29 CFR 95.41 - Recipient responsibilities.

Code of Federal Regulations, 2013 CFR

2013-07-01

..., AND OTHER NON-PROFIT ORGANIZATIONS, AND WITH COMMERCIAL ORGANIZATIONS, FOREIGN GOVERNMENTS, ORGANIZATIONS UNDER THE JURISDICTION OF FOREIGN GOVERNMENTS, AND INTERNATIONAL ORGANIZATIONS Post-Award... of all contractual and administrative issues arising out of procurements entered into in support of...

29 CFR 95.41 - Recipient responsibilities.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., AND OTHER NON-PROFIT ORGANIZATIONS, AND WITH COMMERCIAL ORGANIZATIONS, FOREIGN GOVERNMENTS, ORGANIZATIONS UNDER THE JURISDICTION OF FOREIGN GOVERNMENTS, AND INTERNATIONAL ORGANIZATIONS Post-Award... of all contractual and administrative issues arising out of procurements entered into in support of...

Allocating scarce financial resources for HIV treatment: benchmarking prices of antiretroviral medicines in Latin America.

PubMed

Wirtz, Veronika J; Santa-Ana-Tellez, Yared; Trout, Clinton H; Kaplan, Warren A

2012-12-01

Public sector price analyses of antiretroviral (ARV) medicines can provide relevant information to detect ARV procurement procedures that do not obtain competitive market prices. Price benchmarks provide a useful tool for programme managers and policy makers to support such planning and policy measures. The aim of the study was to develop regional and global price benchmarks which can be used to analyse public-sector price variability of ARVs in low- and middle-income countries using the procurement prices of Latin America and the Caribbean (LAC) countries in 2008 as an example. We used the Global Price Reporting Mechanism (GPRM) data base, provided by the World Health Organization (WHO), for 13 LAC countries' ARV procurements to analyse the procurement prices of four first-line and three second-line ARV combinations in 2008. First, a cross-sectional analysis was conducted to compare ARV combination prices. Second, four different price 'benchmarks' were created and we estimated the additional number of patients who could have been treated in each country if the ARV combinations studied were purchased at the various reference ('benchmark') prices. Large price variations exist for first- and second-line ARV combinations between countries in the LAC region. Most countries in the LAC region could be treating between 1.17 and 3.8 times more patients if procurement prices were closer to the lowest regional generic price. For all second-line combinations, a price closer to the lowest regional innovator prices or to the global median transaction price for lower-middle-income countries would also result in treating up to nearly five times more patients. Some rational allocation of financial resources due, in part, to price benchmarking and careful planning by policy makers and programme managers can assist a country in negotiating lower ARV procurement prices and should form part of a sustainable procurement policy.

Debating Organ Procurement Policy Without Illusions.

PubMed

Hippen, Benjamin

2015-10-01

In this perspective, I review and critique claims that the transplant waiting list overstates the demand for kidneys and correct a few mischaracterizations of some structural barriers to increasing rates of transplantation. The solutions to the shortage of organs proffered by opponents of financial incentives fail to account for a panoply of clinical, regulatory, and financial realities of transplantation centers in the United States in ways that undermine the thesis that a trial of financial incentives for organ procurement is not warranted at this time. I conclude with some personal pessimistic reflections on the progress of this debate. Copyright © 2015 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Variability in donation after cardiac death protocols: a national survey.

PubMed

Fugate, Jennifer E; Stadtler, Maria; Rabinstein, Alejandro A; Wijdicks, Eelco F M

2011-02-27

As donation after cardiac death practices expand, the number of institutional policies is increasing. We contacted organ procurement organizations throughout the United States and requested protocols in hospitals in their donor service areas. Sixty-four protocols were obtained with representation from 16 different states. The terminology and recommended practices varied substantially. The methods for death determination were not specified in 28 (44%) protocols. Most adhered to a 2- to 5-min observation time between circulatory arrest and organ procurement, but 10 (16%) provided no information. This variability reveals a need to define a uniform standard in donation after cardiac death protocols and death determination practices.

Kidney transplantation after previous liver transplantation: analysis of the organ procurement transplant network database.

PubMed

Gonwa, Thomas A; McBride, Maureen A; Mai, Martin L; Wadei, Hani M

2011-07-15

Patients after liver transplant have a high incidence of chronic kidney disease and end-stage renal disease (ESRD). We investigated kidney transplantation after liver transplantation using the Organ Procurement Transplant Network database. The Organ Procurement Transplant Network database was queried for patients who received kidney transplantation after previous liver transplantation. These patients were compared with patients who received primary kidney transplantation alone during the same time period. Between 1997 and 2008, 157,086 primary kidney transplants were performed. Of these, 680 deceased donor kidney transplants and 410 living donor kidney transplants were performed in previous recipients of liver transplants. The number of kidney after liver transplants performed each year has increased from 37 per year to 124 per year in 2008. The time from liver transplant to kidney transplant increased from 8.2 to 9.0 years for living donor transplants and from 5.4 to 9.6 years for deceased donor. The 1, 3, and 5 year actuarial graft survival in both living donor kidney after liver transplant and deceased donor kidney after liver transplant are less than the kidney transplant alone patients. However, the death-censored graft survivals are equal. The patient survival is also less but is similar to what would be expected in liver transplant recipients who did not have ESRD. In 2008, kidney after liver transplantation represented 0.9% of the total kidney alone transplants performed in the United States. Kidney transplantation is an appropriate therapy for selected patients who develop ESRD after liver transplantation.

Management of the Potential Organ Donor in the ICU: Society of Critical Care Medicine/American College of Chest Physicians/Association of Organ Procurement Organizations Consensus Statement.

PubMed

Kotloff, Robert M; Blosser, Sandralee; Fulda, Gerard J; Malinoski, Darren; Ahya, Vivek N; Angel, Luis; Byrnes, Matthew C; DeVita, Michael A; Grissom, Thomas E; Halpern, Scott D; Nakagawa, Thomas A; Stock, Peter G; Sudan, Debra L; Wood, Kenneth E; Anillo, Sergio J; Bleck, Thomas P; Eidbo, Elling E; Fowler, Richard A; Glazier, Alexandra K; Gries, Cynthia; Hasz, Richard; Herr, Dan; Khan, Akhtar; Landsberg, David; Lebovitz, Daniel J; Levine, Deborah Jo; Mathur, Mudit; Naik, Priyumvada; Niemann, Claus U; Nunley, David R; O'Connor, Kevin J; Pelletier, Shawn J; Rahman, Omar; Ranjan, Dinesh; Salim, Ali; Sawyer, Robert G; Shafer, Teresa; Sonneti, David; Spiro, Peter; Valapour, Maryam; Vikraman-Sushama, Deepak; Whelan, Timothy P M

2015-06-01

This document was developed through the collaborative efforts of the Society of Critical Care Medicine, the American College of Chest Physicians, and the Association of Organ Procurement Organizations. Under the auspices of these societies, a multidisciplinary, multi-institutional task force was convened, incorporating expertise in critical care medicine, organ donor management, and transplantation. Members of the task force were divided into 13 subcommittees, each focused on one of the following general or organ-specific areas: death determination using neurologic criteria, donation after circulatory death determination, authorization process, general contraindications to donation, hemodynamic management, endocrine dysfunction and hormone replacement therapy, pediatric donor management, cardiac donation, lung donation, liver donation, kidney donation, small bowel donation, and pancreas donation. Subcommittees were charged with generating a series of management-related questions related to their topic. For each question, subcommittees provided a summary of relevant literature and specific recommendations. The specific recommendations were approved by all members of the task force and then assembled into a complete document. Because the available literature was overwhelmingly comprised of observational studies and case series, representing low-quality evidence, a decision was made that the document would assume the form of a consensus statement rather than a formally graded guideline. The goal of this document is to provide critical care practitioners with essential information and practical recommendations related to management of the potential organ donor, based on the available literature and expert consensus.

Development of Graft-Site Candidiasis in 3 Solid Organ Transplant Recipients from the Same Donor.

PubMed

El-Bandar, Nasrin; Kroy, Daniela C; Fuller, Tom Florian; Kramer, Jürgen; Liefeldt, Lutz; Budde, Klemens; Blobel, Conrad; Miller, Kurt; Friedersdorff, Frank

2017-07-11

BACKGROUND Graft-site candidiasis rarely develops in solid organ transplant recipients; however, severe life-threatening complications can occur. We report the course of 3 solid organ transplant recipients developing graft-site candidiasis. CASE REPORT All grafts, consisting of 2 kidneys and 1 liver, were procured from a single donor. Patient data were collected from our database. Candida albicans was isolated from a swab taken during multiple-organ recovery. Complications associated with candidiasis occurred in all 3 recipients with preservation of the liver transplant. Both renal transplant recipients had vascular complications, eventually resulting in graft nephrectomy and subsequent return to dialysis. The patients recovered completely without residual effects of their prior fungal infection. CONCLUSIONS Fungal infections in solid organ transplant recipients are rare. Since the sequelae of these infections are serious and usually pertain to more than 1 recipient at a time, antifungal prophylaxis may be warranted in select donors.

The necessity of strengthening the cooperation between tissue banks and organ transplant organizations at national, regional, and international levels.

PubMed

Morales Pedraza, Jorge

2013-12-01

The donation of tissues and organs increases significantly when tissue banks and organ transplant organizations work together in the procurement of organs and tissues at donor sources (hospitals, coroners system, organ procurement agencies, and funeral homes, among others). To achieve this important goal, national competent health authorities should considered the establishment of a mechanism that promote the widest possible cooperation between tissue banks and organ transplant organizations with hospitals, research medical institutions, universities, and other medical institutions and facilities. One of the issues that can facilitate this cooperation is the establishment of a coding and traceability system that could identify all tissues and organs used in transplant activities carried out in any country. The promotion of national, regional, and international cooperation between tissue banks and organ transplant organizations would enable the sharing of relevant information that could be important for medical practice and scientific studies carried out by many countries, particularly for those countries with a weak health care system.

Acquisition-Management Program

NASA Technical Reports Server (NTRS)

Avery, Don E.; Vann, A. Vernon; Jones, Richard H.; Rew, William E.

1987-01-01

NASA Acquisition Management Subsystem (AMS) program integrated NASA-wide standard automated-procurement-system program developed in 1985. Designed to provide each NASA installation with procurement data-base concept with on-line terminals for managing, tracking, reporting, and controlling contractual actions and associated procurement data. Subsystem provides control, status, and reporting for various procurement areas. Purpose of standardization is to decrease costs of procurement and operation of automatic data processing; increases procurement productivity; furnishes accurate, on-line management information and improves customer support. Written in the ADABAS NATURAL.

29 CFR 95.41 - Recipient responsibilities.

Code of Federal Regulations, 2014 CFR

2014-07-01

... OTHER NON-PROFIT ORGANIZATIONS, AND WITH COMMERCIAL ORGANIZATIONS, FOREIGN GOVERNMENTS, ORGANIZATIONS UNDER THE JURISDICTION OF FOREIGN GOVERNMENTS, AND INTERNATIONAL ORGANIZATIONS Post-Award Requirements... contractual and administrative issues arising out of procurements entered into in support of an award or other...

Letter: Can Islamic Jurisprudence Justify Procurement of Transplantable Vital Organs in Brain Death?

PubMed

Rady, Mohamed Y

2018-01-01

In their article, "An International Legal Review of the Relationship between Brain Death and Organ Transplantation," in The Journal of Clinical Ethics 29, no. 1, Aramesh, Arima, Gardiner, and Shah reported on diverse international legislative approaches for justifying procurement of transplantable vital organs in brain death. They stated, "In Islamic traditions in particular, the notion of unstable life is a way to justify organ donation from brain-dead patients that we believe has not been fully described previously in the literature." This commentary queries the extent to which this concept is valid in accordance with the primary source of Islamic law, that is, the Quran. Copyright 2018 The Journal of Clinical Ethics. All rights reserved.

[Ethical considerations of organ transplantation].

PubMed

Steigleder, Klaus

2008-08-01

For the moral evaluation of organ transplantations, it is not only relevant that they are potentially live-saving or significantly life-improving procedures. It is also relevant that they may have an impact on the integrity or even dignity of possible donors and are a potential strain on the donors' relatives. In order to find out how the different impacts of organ transplantation on the parties involved are to be morally weighed against one other, the concepts of dignity and of negative and positive moral rights are clarified. Against the widely held view that the procurement of organs from brain dead donors is morally suspect while living organ donation is the morally superior option, it is argued that there is a prima facie moral duty to postmortem organ donation. On the other hand, since in the procurement of organs from living donors physicians systematically injure and endanger healthy persons, this practice can only be morally justified in well-defined exceptional cases.

The notion of gift-giving and organ donation.

PubMed

Gerrand, Nicole

1994-04-01

The analogy between gift-giving and organ donation was first suggested at the beginning of the transplantation era, when policy makers and legislators were promoting voluntary organ donation as the preferred procurement procedure. It was believed that the practice of gift-giving had some features which were also thought to be necessary to ensure that an organ procurement procedure would be morally acceptable, namely voluntarism and altruism. Twenty-five years later, the analogy between gift-giving and organ donation is still being made in the literature and used in organ donation awareness campaigns. In this paper I want to challenge this analogy. By examining a range of circumstances in which gift-giving occurs, I argue that the significant differences between the various types of gift-giving and organ donation makes any analogy between the two very general and superficial, and I suggest that a more appropriate analogy can be found elsewhere.

The impact of new business approaches derived from the Manned Transportation System Study

NASA Technical Reports Server (NTRS)

Mccandless, B., II; Baillif, F. F.; Lance, N.; Clark, B. C.; Geyer, M. S.; Gaunce, M.; Anson, H. W.; Bienhof, D. G.; Carey, D. A.; Emmet, B. R.

1992-01-01

The results are reported of a survey conducted among senior managers within the government and participating companies to identify the items that could improve industry's way of doing business with NASA. New and recommended practices in management, operations, organization, procurement, and procedures are discussed. The development of multitiered requirement systems for NASA programs is addressed.

77 FR 56739 - Federal Acquisition Regulation; United States-Korea Free Trade Agreement

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-13

...DoD, GSA, and NASA are adopting as final, without change, an interim rule amending the Federal Acquisition Regulation (FAR) to implement the United States-Korea Free Trade Agreement. The Republic of Korea is already party to the World Trade Organization Government Procurement Agreement, but this trade agreement implements a lower procurement threshold.

Development of a Procurement Management Framework in Ghana: A New Paradigm for Interdisciplinary Postgraduate Education

ERIC Educational Resources Information Center

Owusu-Manu, D.; Badu, E.; Edwards, D. J.

2011-01-01

Procurement in the corporate world is increasingly complex, multi-faceted and interdisciplinary. This paper explores existing knowledge specifications relating to procurement management competencies and proposes a new procurement management competency framework (PMCF) and a competency-based postgraduate programme for postgraduate students in…

Making a case for controlled organ donation after cardiac death: the story of Italy's first experience.

PubMed

Vergano, Marco; Magavern, Emma; Baroncelli, Francesca; Frisenda, Valeria; Fonsato, Alessia; Artusio, Diego; Castioni, Carlo Alberto; De Piero, Maria Elena; Abelli, Massimo; Ticozzelli, Elena; Livigni, Sergio

2017-04-01

Donation after circulatory death (DCD) is a valuable option for the procurement of organs for transplantation. In Italy, organ procurement after controlled DCD is legally and ethically conceivable within the current legislative framework. However, although formal impediments do not exist, the health care team is faced with many obstacles that may hinder the implementation of such programs. We report the case of Italy's first controlled DCD, specifically discussing the role of the patient's family in the shared decision-making process. In our case, the death of the patient subsequent to the withdrawal of life-sustaining therapies was consistent with the patient's wishes, showing respect for his dignity and honoring his autonomy, as expressed to his family previously. By making donation possible, the medical team was able to fulfill the family's last request on behalf of the patient. This case should stimulate deliberation regarding the potential to shorten the 20-minute no-touch period currently in place in Italy. Such an action would not have injured this patient and would certainly have increased the quality of the procured organs. Copyright © 2016 Elsevier Inc. All rights reserved.

Interim Results of a National Test of the Rapid Assessment of Hospital Procurement Barriers in Donation (RAPiD)

PubMed Central

Traino, H. M.; Alolod, G. P.; Shafer, T.; Siminoff, L. A.

2012-01-01

Organ donation remains a major public health challenge with over 114 000 people on the waitlist in the United States. Among other factors, extant research highlights the need to improve the identification and timely referral of potential donors by hospital health-care providers (HCPs) to organ procurement organizations (OPOs). We implemented a national test of the Rapid Assessment of hospital Procurement barriers in Donation (RAPiD) to identify assets and barriers to the organ donation and patient referral processes; assess hospital–OPO relationships and offer tailored recommendations for improving these processes. Having partnered with seven OPOs, data were collected at 70 hospitals with high donor potential in the form of direct observations and interviews with 2358 HCPs. We found that donation attitudes and knowledge among HCPs were high, but use of standard referral criteria was lacking. Significant differences were found in the donation-related attitudes, knowledge and behaviors of physicians and emergency department staff as compared to other staff in intensive care units with high organ donor potential. Also, while OPO staff were generally viewed positively, they were often perceived as outsiders rather than members of healthcare teams. Recommendations for improving the referral and donation processes are discussed. PMID:22900761

The OPTN Deceased Donor Potential Study: Implications for Policy and Practice.

PubMed

Klassen, D K; Edwards, L B; Stewart, D E; Glazier, A K; Orlowski, J P; Berg, C L

2016-06-01

The Organ Procurement and Transplantation Network (OPTN) Deceased Donor Potential Study, funded by the Health Resources and Services Administration, characterized the current pool of potential deceased donors and estimated changes through 2020. The goal was to inform policy development and suggest practice changes designed to increase the number of donors and organ transplants. Donor estimates used filtering methodologies applied to datasets from the OPTN, the National Center for Health Statistics, and the Agency for Healthcare Research and Quality and used these estimates with the number of actual donors to estimate the potential donor pool through 2020. Projected growth of the donor pool was 0.5% per year through 2020. Potential donor estimates suggested unrealized donor potential across all demographic groups, with the most significant unrealized potential (70%) in the 50-75-year-old age group and potential Donation after Circulatory Death (DCD) donors. Actual transplants that may be realized from potential donors in these categories are constrained by confounding medical comorbidities not identified in administrative databases and by limiting utilization practices for organs from DCD donors. Policy, regulatory, and practice changes encouraging organ procurement and transplantation of a broader population of potential donors may be required to increase transplant numbers in the United States. © Copyright 2016 The American Society of Transplantation and the American Society of Transplant Surgeons.

Clinical results of an organ procurement organization effort to increase utilization of donors after cardiac death.

PubMed

Whiting, James F; Delmonico, Francis; Morrissey, Paul; Basadonna, Giacomo; Johnson, Scott; Lewis, W David; Rohrer, Richard; O'Connor, Kevin; Bradley, James; Lovewell, Tammy D; Lipkowitz, George

2006-05-27

To stimulate organ donation, an organ procurement organization (OPO)-wide effort was undertaken to increase donors after cardiac death (DCD) over a 5-year period. This included commonality of protocols, pulsatile perfusion of kidneys, centralization of data and a regional allocation variance designed to minimize cold ischemia times and encourage adoption of DCD protocols at transplant centers. In one OPO, eight centers initiated DCD programs in 11 hospitals. A total of 52 DCD donors were procured, increasing from four in 1999 to 21 in 2003. Eleven donors had care withdrawn in the operating room, whereas 41 had care withdrawn in the ICU. In all, 91 patients received renal transplants from these 52 donors (12 kidneys discarded, one double transplant), whereas 5 patients received liver transplants. One-, two-, and three-year kidney graft survival rates were 90%, 90%, and 82%, respectively. Fifty-five percent of patients needed at least one session of hemodialysis postoperatively. Mean recipient hospital length of stay was 11.1+/-6 days. Mean creatinine levels at 3, 6, 12, and 24 months were 1.65, 1.40, 1.41, and 1.40, respectively. DCD donors can be an important source of donor organs and provide excellent overall outcomes. Regional cooperation and a prospectively considered allocation and distribution system are important considerations in stimulating DCD programs.

Greening Operations Management: An Online Sustainable Procurement Course for Practitioners

ERIC Educational Resources Information Center

Walker, Helen L.; Gough, Stephen; Bakker, Elmer F.; Knight, Louise A.; McBain, Darian

2009-01-01

In the Operations Management field, sustainable procurement has emerged as a way to green the purchasing and supply process. This paper explores issues in sustainable procurement training. The authors formed an interdisciplinary team to design, deliver and evaluate a training programme to promote and develop sustainable procurement in the United…

Extinction of chained instrumental behaviors: Effects of consumption extinction on procurement responding

PubMed Central

Thrailkill, Eric A.; Bouton, Mark E.

2015-01-01

Operant behavior is typically organized into sequences of responses that eventually lead to a reinforcer. Response elements can be categorized as those that directly lead to reward consumption (i.e., a consumption response), and those that lead to the opportunity to make the consumption response (i.e., a procurement response). These responses often differ topographically and in terms of the discriminative stimuli that set the occasion for them. We have recently shown that extinction of the procurement response acts to weaken the specific associated consumption response, and that active inhibition of the procurement response is required for this effect. To expand the analysis of the associative structure of chains, the present experiments asked the reverse question of whether extinction of consumption behavior results in a decrease in the associated procurement response in a discriminated heterogeneous chain. In Experiment 1, extinction of consumption alone led to an attenuation of the associated procurement response only when rats were allowed to make the consumption response in extinction. Exposure to the consumption stimulus alone was not sufficient to produce weakened procurement responding. In Experiment 2, rats learned two distinct heterogeneous chains; extinction of one consumption response specifically weakened the procurement response associated with it. The results add to evidence suggesting that rats learn a highly specific associative structure in behavior chains, and emphasize the role of learning response inhibition in extinction. PMID:26276367

Extinction of chained instrumental behaviors: Effects of consumption extinction on procurement responding.

PubMed

Thrailkill, Eric A; Bouton, Mark E

2016-03-01

Operant behavior is typically organized into sequences of responses that eventually lead to a reinforcer. Response elements can be categorized as those that directly lead to reward consumption (i.e., a consumption response) and those that lead to the opportunity to make the consumption response (i.e., a procurement response). These responses often differ topographically and in terms of the discriminative stimuli that set the occasion for them. We have recently shown that extinction of the procurement response acts to weaken the specific associated consumption response, and that active inhibition of the procurement response is required for this effect. To expand the analysis of the associative structure of chains, in the present experiments we asked the reverse question: whether extinction of consumption behavior results in a decrease in the associated procurement response in a discriminated heterogeneous chain. In Experiment 1, extinction of consumption alone led to an attenuation of the associated procurement response only when rats were allowed to make the consumption response in extinction. Exposure to the consumption stimulus alone was not sufficient to produce weakened procurement responding. In Experiment 2, rats learned two distinct heterogeneous chains, and extinction of one consumption response specifically weakened the procurement response associated with it. The results add to the evidence suggesting that rats learn a highly specific associative structure in behavior chains, emphasizing the role of learning response inhibition in extinction.

42 CFR 486.342 - Condition: Requesting consent.

Code of Federal Regulations, 2010 CFR

2010-10-01

....342 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION CONDITIONS FOR COVERAGE OF SPECIALIZED SERVICES FURNISHED BY... Organizations Organ Procurement Organization Process Performance Measures § 486.342 Condition: Requesting...

Liver transplantation in Japan.

PubMed

Soyama, Akihiko; Eguchi, Susumu; Egawa, Hiroto

2016-10-01

As of December 31, 2014, 7937 liver transplants (7673 living donor transplants and 264 deceased donor liver transplantations [DDLTs; 261 from heart-beating donors and 3 from non-heart-beating donors]) have been performed in 67 institutions in Japan. The revised Organ Transplant Law in Japan came into effect in July 2010, which allows organ procurement from brain-dead individuals, including children, with family consent if the patient had not previously refused organ donation. However, the number of deceased donor organ donations has not increased as anticipated. The rate of deceased organ donations per million population (pmp) has remained at less than 1. To maximize the viability of the limited numbers of donated organs, a system has been adopted that includes the partnership of well-trained transplant consultant doctors and local doctors. For compensating for the decreased opportunity of on-site training, an educational system regarding quality organ procurement for transplant surgeons has also been established. Furthermore, experts in the field of liver transplantation are currently discussing adoption of the Model for End-Stage Liver Disease score for allocation, promoting split-liver transplantation, arranging in-house coordinators, and improving the frequency of proposing the option to donate organs to the families. To overcome the shortage of donors during efforts to promote organ donation, living donor liver transplantation (LDLT) has been developed in Japan. Continuous efforts to increase DDLT in addition to the successful experience of LDLT will increase the benefits of liver transplantation for more patients. Liver Transplantation 22 1401-1407 2016 AASLD. © 2016 by the American Association for the Study of Liver Diseases.

Critical analysis of procurement techniques in construction management sectors

NASA Astrophysics Data System (ADS)

Tiwari, Suman Tiwari Suresh; Chan, Shiau Wei; Faraz Mubarak, Muhammad

2018-04-01

Over the last three decades, numerous procurement techniques have been one of the highlights of the Construction Management (CM) for ventures, administration contracting, venture management as well as design and construct. Due to the development and utilization of those techniques, various researchers have explored the criteria for their choice and their execution in terms of time, cost and quality. Nevertheless, there is a lack of giving an account on the relationship between the procurement techniques and the progressed related issues, for example, supply chain, sustainability, innovation and technology development, lean construction, constructability, value management, Building Information Modelling (BIM) as well as e-procurement. Through chosen papers from the reputable CM-related academic journals, the specified scopes of these issues are methodically assessed with the objective to explore the status and trend in procurement related research. The result of this paper contributes theoretically as well as practically to the researchers and industrialist in order to be aware and appreciate the development of procurement techniques.

Integrated Procurement Management System, Version II

NASA Technical Reports Server (NTRS)

Collier, L. J.

1985-01-01

Integrated Procurement Management System, Version II (IPMS II) is online/ batch system for collecting developing, managing and disseminating procurementrelated data at NASA Johnson Space Center. Portions of IPMS II adaptable to other procurement situations.

How Can Clients Improve the Quality of Transport Infrastructure Projects? The Role of Knowledge Management and Incentives

PubMed Central

Warsame, Abukar; Borg, Lena; Lind, Hans

2013-01-01

The aim of this paper is to argue for a number of statements about what is important for a client to do in order to improve quality in new infrastructure projects, with a focus on procurement and organizational issues. The paper synthesizes theoretical and empirical results concerning organizational performance, especially the role of the client for the quality of a project. The theoretical framework used is contract theory and transaction cost theory, where assumptions about rationality and self-interest are made and where incentive problems, asymmetric information, and moral hazard are central concepts. It is argued that choice of procurement type will not be a crucial factor. There is no procurement method that guarantees a better quality than another. We argue that given the right conditions all procurement methods can give good results, and given the wrong conditions, all of them can lead to low quality. What is crucial is how the client organization manages knowledge and the incentives for the members of the organization. This can be summarized as “organizational culture.” One way to improve knowledge and create incentives is to use independent second opinions in a systematic way. PMID:24250274

48 CFR 404.203 - Taxpayer identification information.

Code of Federal Regulations, 2012 CFR

2012-10-01

... furnishes taxpayer identification number (TIN) and type of organization information pursuant to solicitation... Office of Procurement and Property Management. (b) Separate submission of the TIN or type of organization...

48 CFR 404.203 - Taxpayer identification information.

Code of Federal Regulations, 2011 CFR

2011-10-01

... furnishes taxpayer identification number (TIN) and type of organization information pursuant to solicitation... Office of Procurement and Property Management. (b) Separate submission of the TIN or type of organization...

48 CFR 404.203 - Taxpayer identification information.

Code of Federal Regulations, 2014 CFR

2014-10-01

... furnishes taxpayer identification number (TIN) and type of organization information pursuant to solicitation... Office of Procurement and Property Management. (b) Separate submission of the TIN or type of organization...

48 CFR 404.203 - Taxpayer identification information.

Code of Federal Regulations, 2013 CFR

2013-10-01

... furnishes taxpayer identification number (TIN) and type of organization information pursuant to solicitation... Office of Procurement and Property Management. (b) Separate submission of the TIN or type of organization...

48 CFR 404.203 - Taxpayer identification information.

Code of Federal Regulations, 2010 CFR

2010-10-01

... furnishes taxpayer identification number (TIN) and type of organization information pursuant to solicitation... Office of Procurement and Property Management. (b) Separate submission of the TIN or type of organization...

How to achieve more accurate comparisons in organ donation activity: time to effectiveness indicators.

PubMed

Deulofeu, R; Bodí, M A; Twose, J; López, P

2010-06-01

We are used to comparisons of activity using donation or transplantation population (pmp) rates between regions or countries, without a further evaluation of the process. But crude pmp rates do not clearly reflect real transplantation capacity, because organ procurement does not finish with the donation step; it is also necessary to know the utilization of the obtained organs. The objective of this study was to present methods and indicators deemed necessary to evaluate the effectiveness of the process. We have proposed the use of simple definitions and indicators to more accurately measure and compare the effectiveness of the total organ procurement process. To illustrate the use and performance of these indicators, we have presented the donation and transplantation activity in Catalonia from 2002 to 2007.

78 FR 49276 - Advisory Committee on Organ Transplantation; Request for Nominations for Voting Members

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-13

...; behavioral sciences; economics and econometrics; organ procurement organizations; transplant candidates..., non-physician transplant professions, nursing, epidemiology, immunology, law and bioethics, behavioral sciences, economics and statistics, as well as representatives of transplant candidates, transplant...

75 FR 57807 - Advisory Committee on Organ Transplantation; Request for Nominations for Voting Members

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-22

... bioethics; behavioral sciences; economics and econometrics; organ procurement organizations; transplant..., non-physician transplant professions, nursing, epidemiology, immunology, law and bioethics, behavioral sciences, economics and statistics, as well as representatives of transplant candidates, transplant...

22 CFR 228.13 - Foreign government-controlled organizations.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Foreign government-controlled organizations... Service Procurement Transactions for USAID Financing § 228.13 Foreign government-controlled organizations... organizations) in which foreign governments or their agents or agencies have a controlling interest are not...

22 CFR 228.13 - Foreign government-controlled organizations.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Foreign government-controlled organizations... Service Procurement Transactions for USAID Financing § 228.13 Foreign government-controlled organizations... organizations) in which foreign governments or their agents or agencies have a controlling interest are not...

Hard to Believe : Produced by Ken Stone and Irene Silber, 2015, Swoop Films and Stone Soup Productions (New York, 56 minutes, unrated).

PubMed

Northam, Holly Louise

2016-06-01

This article presents a review of Hard to Believe, a compelling documentary reporting the forced organ procurement and death of Chinese prisoners of conscience. The documentary is targeted to ignite political and public pressure to stop these practices that are thought to be motivated by financial and political gain. Narrated by journalist and author Ethan Gutmann, the documentary pricks at the collective conscience, as credible witnesses provide evidence that point to an abrogation of every ethical principle ascribed to legitimate organ procurement.

The co-existence of life and death for the perioperative nurse.

PubMed

Perrin, Karen; Jones, Barbara; Winkelman, Cecelia

2013-10-01

Death and life co-exist in organ procurement surgery; untimely death for one provides hope for continued life for others. Drawing from interactionist theory, the impact of personal and environmental forces and functions specific to organ procurement surgery were examined. Seven nurses (6 women, 1 man aged 34-58 years) were provided with an opportunity to describe their experiences. Three core themes emerged from the qualitative analysis of the interviews: existential issues, coping strategies, and support for each other. Nurses spoke of ways in which they contribute to this challenging work and draw on inner resources.

Moving from the HIV Organ Policy Equity Act to HIV Organ Policy Equity in action: changing practice and challenging stigma.

PubMed

Doby, Brianna L; Tobian, Aaron A R; Segev, Dorry L; Durand, Christine M

2018-04-01

The HIV Organ Policy Equity (HOPE) Act, signed in 2013, reversed the federal ban on HIV-to-HIV transplantation. In this review, we examine the progress in HOPE implementation, the current status of HIV-to-HIV transplantation, and remaining challenges. Pursuant to the HOPE Act, the Department of Health and Human Services revised federal regulations to allow HIV-to-HIV transplants under research protocols adherent to criteria published by the National Institutes of Health. The first HIV-to-HIV kidney and liver transplants were performed at Johns Hopkins in March of 2016. Legal and practical challenges remain. Further efforts are needed to educate potential HIV+ donors and to support Organ Procurement Organizations. As of November 2017, there are 22 transplant centers approved to perform HIV-to-HIV transplants in 10 United Network for Organ Sharing regions. To date, 16 Organ Procurement Organizations in 22 states have evaluated HIV+ donors. The National Institutes of Health-funded HOPE in Action: A Multicenter Clinical Trial of HIV-to-HIV Deceased Donor (HIVDD) Kidney Transplantation Kidney Trial will launch at 19 transplant centers in December of 2017. A HOPE in Action Multicenter HIVDD Liver Trial is in development. Significant progress toward full HOPE implementation has been made though barriers remain. Some challenges are unique to HIV-HIV transplantation, whereas others are amplifications of issues across the current transplant system. In addition to a public health benefit for all transplant candidates in the United States, partnership on the HOPE Act has the potential to address systemic challenges to national donation and transplantation.

Binding Procurement

NASA Technical Reports Server (NTRS)

Rao, Gopalakrishna M.; Vaidyanathan, Hari

2007-01-01

This viewgraph presentation reviews the use of the binding procurement process in purchasing Aerospace Flight Battery Systems. NASA Engineering and Safety Center (NESC) requested NASA Aerospace Flight Battery Systems Working Group to develop a set of guideline requirements document for Binding Procurement Contracts.

24 CFR 943.150 - What procurement standards apply to a PHA's joint venture partner?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false What procurement standards apply to... Subsidiaries, Affiliates, Joint Ventures in Public Housing § 943.150 What procurement standards apply to a PHA..., accordingly, is not required to comply with part 84 or part 85 of this title in its procurement of goods and...

Experience of nurses in the process of donation of organs and tissues for transplant.

PubMed

de Moraes, Edvaldo Leal; dos Santos, Marcelo José; Merighi, Miriam Aparecida Barbosa; Massarollo, Maria Cristina Komatsu Braga

2014-01-01

to investigate the meaning of the action of nurses in the donation process to maintain the viability of organs and tissues for transplantation. this qualitative study with a social phenomenological approach was conducted through individual interviews with ten nurses of three Organ and Tissue Procurement Services of the city of São Paulo. the experience of the nurses in the donation process was represented by the categories: obstacles experienced in the donation process, and interventions performed. The meaning of the action to maintain the viability of organs and tissues for transplantation was described by the categories: to change paradigms, to humanize the donation process, to expand the donation, and to save lives. knowledge of the experience of the nurses in this process is important for healthcare professionals who work in different realities, indicating strategies to optimize the procurement of organs and tissues for transplantation.

Use of failure mode and effects analysis for proactive identification of communication and handoff failures from organ procurement to transplantation.

PubMed

Steinberger, Dina M; Douglas, Stephen V; Kirschbaum, Mark S

2009-09-01

A multidisciplinary team from the University of Wisconsin Hospital and Clinics transplant program used failure mode and effects analysis to proactively examine opportunities for communication and handoff failures across the continuum of care from organ procurement to transplantation. The team performed a modified failure mode and effects analysis that isolated the multiple linked, serial, and complex information exchanges occurring during the transplantation of one solid organ. Failure mode and effects analysis proved effective for engaging a diverse group of persons who had an investment in the outcome in analysis and discussion of opportunities to improve the system's resilience for avoiding errors during a time-pressured and complex process.

Against Corporations Organizing to Rip-off the Nation Act

THOMAS, 111th Congress

Rep. McCollum, Betty [D-MN-4

2009-09-30

House - 10/23/2009 Referred to the Subcommittee on Government Management, Organization, and Procurement. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

77 FR 24537 - Draft Standards and Best Practices for Interaction Between Medical Examiner/Coroner and Organ and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-24

... Best Practices for Interaction Between Medical Examiner/Coroner and Organ and Tissue Procurement... Committee Standards and Best Practices for Interaction Between Medical Examiner/Coroner Offices and Organ... coroner/medical examiner office representatives, law enforcement agencies, organizations, and all other...

75 FR 59274 - Medicare and Medicaid Programs; Announcement of Application from Hospital Requesting Waiver for...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-27

...--(1) is expected to increase organ donations; and (2) will ensure equitable treatment of patients...] Medicare and Medicaid Programs; Announcement of Application from Hospital Requesting Waiver for Organ... require the hospital to enter into an agreement with its designated Organ Procurement Organization (OPO...

77 FR 24495 - Medicare and Medicaid Programs; Announcement of Application From a Hospital Requesting Waiver for...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-24

... increase organ donations; and (2) will ensure equitable treatment of patients referred for transplants...] Medicare and Medicaid Programs; Announcement of Application From a Hospital Requesting Waiver for Organ... require the hospital to enter into an agreement with its designated Organ Procurement Organization (OPO...

77 FR 60703 - Medicare and Medicaid Programs; Announcement of Application From Hospital Requesting Waiver for...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-04

... waiver--(1) is expected to increase organ donations; and (2) will ensure equitable treatment of patients...] Medicare and Medicaid Programs; Announcement of Application From Hospital Requesting Waiver for Organ... the requirement to have an agreement with its designated Organ Procurement Organization (OPO). The...

77 FR 51539 - Medicare and Medicaid Programs; Announcement of Application From a Hospital Requesting Waiver for...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-24

... expected to increase organ donations; and (2) will ensure equitable treatment of patients referred for...] Medicare and Medicaid Programs; Announcement of Application From a Hospital Requesting Waiver for Organ... the requirement to have an agreement with its designated Organ Procurement Organization (OPO). The...

76 FR 78926 - Medicare and Medicaid Programs; Announcement of Application From Hospital Requesting Waiver for...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-20

... must determine that the waiver--(1) is expected to increase organ donations; and (2) will ensure...] Medicare and Medicaid Programs; Announcement of Application From Hospital Requesting Waiver for Organ... Hospital to participate in an Organ Procurement Organization (OPO) outside of its designated OPO. The...

HYDRA: A Middleware-Oriented Integrated Architecture for e-Procurement in Supply Chains

NASA Astrophysics Data System (ADS)

Alor-Hernandez, Giner; Aguilar-Lasserre, Alberto; Juarez-Martinez, Ulises; Posada-Gomez, Ruben; Cortes-Robles, Guillermo; Garcia-Martinez, Mario Alberto; Gomez-Berbis, Juan Miguel; Rodriguez-Gonzalez, Alejandro

The Service-Oriented Architecture (SOA) development paradigm has emerged to improve the critical issues of creating, modifying and extending solutions for business processes integration, incorporating process automation and automated exchange of information between organizations. Web services technology follows the SOA's principles for developing and deploying applications. Besides, Web services are considered as the platform for SOA, for both intra- and inter-enterprise communication. However, an SOA does not incorporate information about occurring events into business processes, which are the main features of supply chain management. These events and information delivery are addressed in an Event-Driven Architecture (EDA). Taking this into account, we propose a middleware-oriented integrated architecture that offers a brokering service for the procurement of products in a Supply Chain Management (SCM) scenario. As salient contributions, our system provides a hybrid architecture combining features of both SOA and EDA and a set of mechanisms for business processes pattern management, monitoring based on UML sequence diagrams, Web services-based management, event publish/subscription and reliable messaging service.

Long-Term Implications of the 2016 Future Years Defense Program

DTIC Science & Technology

2016-01-01

operation and maintenance activities; acquisition includes research, development, test, and evaluation as well as procurement of weapon systems and other...group includes procurement and research, development, test, and evaluation (RDT&E). Appropriations for procurement fund the purchase of new weapon...and Evaluation Military Construction Family Housing OCO Funding Actual FYDP Period Beyond the FYDP PeriodDoD’s Estimates For 2017 through 2020 DoD

Joint Improvised Explosive Device Defeat Organization, FY 2009

DTIC Science & Technology

2010-01-01

per incident, IEDs were 14 percent more effective in FY 2009 over FY 2008. Coupled with the significant corresponding increase in IED incidents...Development Testing and Evaluation (RDT&E), procurement, and sustainment of 69 systems. Detect Air Detect Air systems enable the warfighter to detect...Service-oriented centers of excellence (COE): the Army COE at Fort Irwin; the Navy COE at Indian Head, Maryland; the Air Force COE at Lackland Air

Public-Key Cryptography: A Hardware Implementation and Novel Neural Network-Based Approach

DTIC Science & Technology

1992-09-01

FUNDINGISPONSORING 8b. OFFICE SYMBOL 9. PROCUREMENT INSTRUMENT IDENTIFICATION NUMBER ORGANIZATION (if applicable ) 8c. ADDRESS (City, State, and ZIP Code) 10...8217....... ......... 4. .. . . iii TABLE OF CONTENTS I. INTRODUCTION ............................. 1 II. MATHEMATICAL BASIS FOR THE DEVELOPMENT OF PUBLIC-KEY...in the spirit of this future that this thesis is presented. It is an in-depth study of the public-key cryptosystem. First, the mathematical basis

Organ procurement and successful transplantation after malathion poisoning.

PubMed

Dribben, W H; Kirk, M A

2001-01-01

One of the major limitations to organ procurement and donation is the lack of suitable donors. As the demand for suitable organs exceeds the supply, identification of potential donors continues to evolve. Due to perceived risks of transmittable toxins and insufficient understanding of toxicological fate, poisoned patients are often overlooked as organ donors. A 17-year-old white male was found by his mother having a seizure in bed. A strong odor of pesticides was noted and an empty container of malathion was found. He was transported to an outlying hospital and underwent prolonged cardiopulmonary resuscitation. The patient exhibited symptoms consistent with cholinergic poisoning and received a total of 12 mg of atropine and a pralidoxime bolus of 1 g followed by an infusion at 500 mg/h. Initial plasma cholinesterase was 1433 IU/L (normal 7500-14,600). The patient developed aspiration pneumonia and remained comatose. No further treatment for cholinergic toxicity was needed 5 days after admission and a cerebral blood flow scan confirmed brain death. After review of the available literature on the disposition andfate of malathion in human tissues, the patient's liver and kidneys were harvested for transplantation. The recipients were all doing well 1 year posttransplantation. This case of successful transplantation after organophosphate exposure underscores the fact that poisoned patients should not be overlooked as transplant candidates. Decisions should be based on the clinical presentation and knowledge of the properties of the toxin.

BIM-Based E-Procurement: An Innovative Approach to Construction E-Procurement

PubMed Central

2015-01-01

This paper presents an innovative approach to e-procurement in construction, which uses building information models (BIM) to support the construction procurement process. The result is an integrated and electronic instrument connected to a rich knowledge base capable of advanced operations and able to strengthen transaction relationships and collaboration throughout the supply chain. The BIM-based e-procurement prototype has been developed using distinct existing electronic solutions and an IFC server and was tested in a pilot case study, which supported further discussions of the results of the research. PMID:26090518

End-Users' Voice in EHR Selection: Development of a Usability Questionnaire for Demonstrations in Procurement (DPUQ).

PubMed

Tyllinen, Mari; Kaipio, Johanna; Lääveri, Tinja; Nieminen, Marko

2017-01-01

This paper describes the development of a questionnaire for evaluating usability during EHR system procurement (DPUQ). Established usability questionnaires can be used to gather user feedback after using the systems. However, during procurement, experimenting with real system use is practical only with a limited number of system candidates. There is a need for less resource-demanding usability evaluation in the early stages of procurement in cases with several vendors. DPUQ has been designed for usability evaluation by end-users during special scenario-based vendor demonstrations. The questionnaire includes three sets of questions to be used during and after the vendor demonstration. DPUQ delivers specific usability scores and can be used to compare system candidates in procurement complementing other evaluation methods.

Impact of brain death on ischemia/reperfusion injury in liver transplantation.

PubMed

Dziodzio, Tomasz; Biebl, Matthias; Pratschke, Johann

2014-04-01

In liver transplantation, the ischemia/reperfusion injury (IRI) is influenced by factors related to graft quality, organ procurement and the transplant procedure itself. However, in brain-dead donors, the process of death itself also thoroughly affects organ damage through breakdown of the autonomous nervous system and subsequent massive cytokine release. This review highlights the actual knowledge on these proinflammatory effects of brain death on IRI in liver transplantation. Brain death affects IRI either through hemodynamical or molecular effects with proinflammatory activation. Immunological effects are mainly mediated through Kupffer cell activation, leading to TNF-α and TLR4 amplification. Proinflammatory cytokines such as interleukin (IL)-6, IL-10, TNF-β and MIP-1α are released, together with activation of the innate immune system via natural killer cells and natural killer T cells, which promote organ damage and activation of fibrosis. Preprocurement treatment regimens attempt to hamper inflammatory response by the application of methylprednisolone or thymoglobulin to the donor. Selective P-selectin antagonism resulted in improved function in marginal liver grafts. Inhaled nitric oxide was found to reduce apoptosis in liver grafts. Other medications like the immunosuppressant tacrolimus produced conflicting results regarding organ protection. Furthermore, improved organ storage after procurement - such as machine perfusion - can diminish effects of IRI in a clinical setting. Brain death plays a fundamental role in the regulation of molecular markers triggering inflammation and IRI-related tissue damage in liver transplants. Although several treatment options have reached clinical application, to date, the effects of brain death during donor conditioning and organ procurement remain relevant for organ function and survival.

Civil Society Organizations and medicines policy change: a case study of registration, procurement, distribution and use of misoprostol in Uganda.

PubMed

Atukunda, Esther Cathyln; Brhlikova, Petra; Agaba, Amon Ganafa; Pollock, Allyson M

2015-04-01

Misoprostol use for postpartum haemorrhage (PPH) has been promoted by Civil Society Organizations (CSOs) since the early 2000s. Yet, CSOs' role in improving access to misoprostol and shaping health policy at global and national levels is not well understood. We document the introduction of misoprostol in Uganda in 2008 from its registration, addition to treatment guidelines and national Essential Medicines List (EML), to its distribution and use. We then analyse the contribution of CSOs to this health policy change and service provision. Policy documents, procurement data and 82 key informant interviews with government officials, healthcare providers, and CSOs in four Ugandan districts of Kampala, Mbarara, Apac, Bundibugyo were collected between 2010 and 2013. Five key CSOs promoted and accelerated the rollout of misoprostol in Uganda. They supported the registration of misoprostol with the National Drug Authority, the development of clinical guidelines, and the piloting and training of health care providers. CSOs and National Medical Stores were procuring and distributing misoprostol country-wide to health centres two years before it was added to the clinical guidelines and EML of Uganda and in the absence of good evidence. The evidence suggests an increasing trend of misoprostol procurement and availability over the medicine of choice, oxytocin. This shift in national priorities has serious ramifications for maternal health care that need urgent evaluation. The absence of clinical guidelines in health centres and the lack of training preclude rational use of misoprostol. CSOs shifted their focus from the public to the private sector, where some of them continue to promote its use for off-label indications including induction of labour and abortion. There is an urgent need to build capacity to improve the robustness of the national and local institutions in assessing the safety and effectiveness of all medicines and their indications in Uganda. Copyright © 2015 Elsevier Ltd. All rights reserved.

Medical device procurement in low- and middle-income settings: protocol for a systematic review.

PubMed

Diaconu, Karin; Chen, Yen-Fu; Manaseki-Holland, Semira; Cummins, Carole; Lilford, Richard

2014-10-21

Medical device procurement processes for low- and middle-income countries (LMICs) are a poorly understood and researched topic. To support LMIC policy formulation in this area, international public health organizations and research institutions issue a large body of predominantly grey literature including guidelines, manuals and recommendations. We propose to undertake a systematic review to identify and explore the medical device procurement methodologies suggested within this and further literature. Procurement facilitators and barriers will be identified, and methodologies for medical device prioritization under resource constraints will be discussed. Searches of both bibliographic and grey literature will be conducted to identify documents relating to the procurement of medical devices in LMICs. Data will be extracted according to protocol on a number of pre-specified issues and variables. First, data relating to the specific settings described within the literature will be noted. Second, information relating to medical device procurement methodologies will be extracted, including prioritization of procurement under resource constraints, the use of evidence (e.g. cost-effectiveness evaluations, burden of disease data) as well as stakeholders participating in procurement processes. Information relating to prioritization methodologies will be extracted in the form of quotes or keywords, and analysis will include qualitative meta-summary. Narrative synthesis will be employed to analyse data otherwise extracted. The PRISMA guidelines for reporting will be followed. The current review will identify recommended medical device procurement methodologies for LMICs. Prioritization methods for medical device acquisition will be explored. Relevant stakeholders, facilitators and barriers will be discussed. The review is aimed at both LMIC decision makers and the international research community and hopes to offer a first holistic conceptualization of this topic.

Medical device procurement in low- and middle-income settings: protocol for a systematic review

PubMed Central

2014-01-01

Background Medical device procurement processes for low- and middle-income countries (LMICs) are a poorly understood and researched topic. To support LMIC policy formulation in this area, international public health organizations and research institutions issue a large body of predominantly grey literature including guidelines, manuals and recommendations. We propose to undertake a systematic review to identify and explore the medical device procurement methodologies suggested within this and further literature. Procurement facilitators and barriers will be identified, and methodologies for medical device prioritization under resource constraints will be discussed. Methods/design Searches of both bibliographic and grey literature will be conducted to identify documents relating to the procurement of medical devices in LMICs. Data will be extracted according to protocol on a number of pre-specified issues and variables. First, data relating to the specific settings described within the literature will be noted. Second, information relating to medical device procurement methodologies will be extracted, including prioritization of procurement under resource constraints, the use of evidence (e.g. cost-effectiveness evaluations, burden of disease data) as well as stakeholders participating in procurement processes. Information relating to prioritization methodologies will be extracted in the form of quotes or keywords, and analysis will include qualitative meta-summary. Narrative synthesis will be employed to analyse data otherwise extracted. The PRISMA guidelines for reporting will be followed. Discussion The current review will identify recommended medical device procurement methodologies for LMICs. Prioritization methods for medical device acquisition will be explored. Relevant stakeholders, facilitators and barriers will be discussed. The review is aimed at both LMIC decision makers and the international research community and hopes to offer a first holistic conceptualization of this topic. PMID:25336161

Secretary | Center for Cancer Research

Cancer.gov

We are looking for a pleasant, organized, dependable person to serve as a full-time secretary in the Basic Science Program (BSP) at the Frederick National Laboratory for Cancer Research (FNCLR).  The BSP provides procurement and logistical support to the laboratories of the Center for Cancer Research.  Tasks include high volume procurement (blanket orders, purchase requests, credit card), sorting and distributing mail, travel coordination, and spending/budget monitoring. 

Indian Defense Procurements: Advantage Russia or USA?

DTIC Science & Technology

2015-02-17

reaching economic reforms to make India attractive to foreign investments ; ushering globalization.20 The gamble worked , and the Indian economy boomed...5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Air War College,,Air University,,Maxwell AFB,,AL 8... paper argues that India has diversified its defense procurement policy in keeping abreast with the global realities; it’s standing in the world order

Healthy food procurement policy: an important intervention to aid the reduction in chronic noncommunicable diseases.

PubMed

Campbell, Norm; Duhaney, Tara; Arango, Manuel; Ashley, Lisa A; Bacon, Simon L; Gelfer, Mark; Kaczorowski, Janusz; Mang, Eric; Morris, Dorothy; Nagpal, Seema; Tsuyuki, Ross T; Willis, Kevin J

2014-11-01

In 2010, unhealthy diets were estimated to be the leading risk for death and disability in Canada and globally. Although important, policies aimed at improving individual's skills in selecting and eating healthy foods has had a limited effect. Policies that create healthy eating environments are strongly recommended but have not yet been effectively and/or broadly implemented in Canada. Widespread adoption of healthy food procurement policies are strongly recommended in this policy statement from the Hypertension Advisory Committee with support from 15 major national health organizations. The policy statement calls on governments to take a leadership role, but also outlines key roles for the commercial and noncommercial sectors including health and scientific organizations and the Canadian public. The policy statement is based on a systematic review of healthy food procurement interventions that found them to be almost uniformly effective at improving sales and purchases of healthy foods. Successful food procurement policies are nearly always accompanied by supporting education programs and some by pricing policies. Ensuring access and availability to affordable healthy foods and beverages in public and private sector settings could play a substantive role in the prevention of noncommunicable diseases and health risks such as obesity, hypertension, and ultimately improve cardiovascular health. Copyright © 2014 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

Deemed consent: assessing the new opt-out approach to organ procurement in Wales.

PubMed

Albertsen, Andreas

2018-05-01

In December 2015, Wales became the first country in the UK to move away from an opt-in system in organ procurement. The new legislation introduces the concept of deemed consent whereby a person who neither opt in nor opt out is deemed to have consented to donation. The data released by the National Health Service (NHS) in July 2017 provide an excellent opportunity to assess this legislation in light of concerns that it would decrease procurement rates for living and deceased donation, as well as sparking an increase in family refusals. None of these concerns have come to pass, with Wales experiencing more registered donors, fewer family refusals and more living donations. However, as the number of actual donors has dropped slightly from a high level, the situation must be monitored closely in the years to come. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Automated Procurement System (APS): Project management plan (DS-03), version 1.2

NASA Technical Reports Server (NTRS)

Murphy, Diane R.

1994-01-01

The National Aeronautics and Space Administration (NASA) Marshall Space Flight Center (MSFC) is implementing an Automated Procurement System (APS) to streamline its business activities that are used to procure goods and services. This Project Management Plan (PMP) is the governing document throughout the implementation process and is identified as the APS Project Management Plan (DS-03). At this point in time, the project plan includes the schedules and tasks necessary to proceed through implementation. Since the basis of APS is an existing COTS system, the implementation process is revised from the standard SDLC. The purpose of the PMP is to provide the framework for the implementation process. It discusses the roles and responsibilities of the NASA project staff, the functions to be performed by the APS Development Contractor (PAI), and the support required of the NASA computer support contractor (CSC). To be successful, these three organizations must work together as a team, working towards the goals established in this Project Plan. The Project Plan includes a description of the proposed system, describes the work to be done, establishes a schedule of deliverables, and discusses the major standards and procedures to be followed.

Rethinking health sector procurement as developmental linkages in East Africa.

PubMed

Mackintosh, Maureen; Tibandebage, Paula; Karimi Njeru, Mercy; Kariuki Kungu, Joan; Israel, Caroline; Mujinja, Phares G M

2018-03-01

Health care forms a large economic sector in all countries, and procurement of medicines and other essential commodities necessarily creates economic linkages between a country's health sector and local and international industrial development. These procurement processes may be positive or negative in their effects on populations' access to appropriate treatment and on local industrial development, yet procurement in low and middle income countries (LMICs) remains under-studied: generally analysed, when addressed at all, as a public sector technical and organisational challenge rather than a social and economic element of health system governance shaping its links to the wider economy. This article uses fieldwork in Tanzania and Kenya in 2012-15 to analyse procurement of essential medicines and supplies as a governance process for the health system and its industrial links, drawing on aspects of global value chain theory. We describe procurement work processes as experienced by front line staff in public, faith-based and private sectors, linking these experiences to wholesale funding sources and purchasing practices, and examining their implications for medicines access and for local industrial development within these East African countries. We show that in a context of poor access to reliable medicines, extensive reliance on private medicines purchase, and increasing globalisation of procurement systems, domestic linkages between health and industrial sectors have been weakened, especially in Tanzania. We argue in consequence for a more developmental perspective on health sector procurement design, including closer policy attention to strengthening vertical and horizontal relational working within local health-industry value chains, in the interests of both wider access to treatment and improved industrial development in Africa. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Rewarming preservation by organ perfusion system for donation after cardiac death liver grafts in pigs.

PubMed

Matsuno, N; Obara, H; Watanabe, R; Iwata, S; Kono, S; Fujiyama, M; Hirano, T; Kanazawa, H; Enosawa, S

2014-05-01

Use of grafts from donors after cardiac death (DCD) would greatly contribute to the expansion of the donor organ pool. However, this requires the development of novel preservation methods to recover the organ from changes due to warm ischemia time (WIT). Porcine livers were perfused with a newly developed machine perfusion (MP) system. The livers were perfused with modified University of Wisconsin solution (UW) - gluconate. All grafts were procured after acute hemorrhagic shock with the ventilator off. For group 1 (n = 6), grafts were procured after WIT of 60 minutes and preserved by hypothermic MP (HMP) for 3 hours. For group 2 (n = 5), grafts were preserved with 2 hours of simple cold storage (SCS) and HMP for 2 hours. For group 3 (n = 6), grafts were preserved with 2 hours of SCS and rewarming up to 25°C by MP for 2 hours (RMP). The preserved liver grafts were transplanted orthotopically. The alanine aminotransferase level in perfusate in RMP during perfusion preservation was maintained at less than that of HMP. The levels of aspartate aminotransferase and lactate dehydrogenase in the 2 hours after reperfusion were significantly lower in group 3. Histologically, the necrosis of hepatocytes was less severe in group 3. The survival rate in group 3 was 2/4, but 0/4 in the other group. RMP is expected to facilitate the recovery of the DCD liver grafts. Copyright © 2014 Elsevier Inc. All rights reserved.

48 CFR 725.705 - Local procurement-contract clause.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Local procurement-contract... DEVELOPMENT SOCIOECONOMIC PROGRAMS FOREIGN ACQUISITION Source, Origin, and Nationality 725.705 Local procurement—contract clause. Local procurement may be undertaken in accordance with the provisions of 22 CFR...

48 CFR 725.705 - Local procurement-contract clause.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 5 2011-10-01 2011-10-01 false Local procurement-contract... DEVELOPMENT SOCIOECONOMIC PROGRAMS FOREIGN ACQUISITION Source, Origin, and Nationality 725.705 Local procurement—contract clause. Local procurement may be undertaken in accordance with the provisions of 22 CFR...

Family informed consent to organ donation--who performs better: organ procurement organizations, in-hospital coordinators, or intensive care unit professionals?

PubMed

Lenzi, J A; Sarlo, R; Assis, A; Ponte, M; Paura, P; Araújo, C; Rocha, E

2014-01-01

Successful organ donation in countries adopting informed consent legislation depends on adequate interviewing of potential donors' families. As the number of both referral and effective donors in Brazil increases, health care managers argue whether educational efforts should be directed toward training in-hospital coordinators (IHC)--based on the "Spanish model"--or on the creation of extra-hospital-based professionals (Organ Procurement Organizations [OPOs], the "American model"). Meanwhile, many potential donor families are still approached by intensive care unit (ICU) professionals not trained in donation interviews. The aim of our study was to compare performances in obtaining informed consent from potential donors' families, according to the type of health care professional conducting the interviews: OPO, IHC, or ICU staff. In this retrospective 2-year study performed in Rio de Janeiro, Brazil, we observed an increase in referrals (285 to 411) and consent rates (48.1% to 55.7%). Each year, OPO professionals conducted most family interviews (58.6% and 60.4%, respectively) and obtained better consent rates (63.5% and 64.5%, respectively), when compared to IHC (41.8% and 53.7%, respectively) or untrained ICU professionals (22.1% and 13.4%, respectively). Our results show that adequate professional training is necessary for obtaining family consent for organ donation. Both established international policies for organ procurement and donation, namely the "Spanish model" with its IHCs or the "American model" of extra-hospital OPOs, may equally achieve this task. However, family interviews performed by untrained ICU professionals result in low donation rates and should be discouraged. Copyright © 2014 Elsevier Inc. All rights reserved.

75 FR 59272 - Medicare and Medicaid Programs; Announcement of an Application from a Hospital Requesting Waiver...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-27

... waiver--(1) is expected to increase organ donations; and (2) will ensure equitable treatment of patients...] Medicare and Medicaid Programs; Announcement of an Application from a Hospital Requesting Waiver for Organ... require the hospital to enter into an agreement with its designated Organ Procurement Organization (OPO...

78 FR 98 - Medicare and Medicaid Programs; Announcement of Application From a Hospital Requesting Waiver for...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-02

... Secretary must determine that the waiver--(1) is expected to increase organ donations; and (2) will assure...] Medicare and Medicaid Programs; Announcement of Application From a Hospital Requesting Waiver for Organ... require the hospital to enter into an agreement with its designated Organ Procurement Organization (OPO...

75 FR 43177 - Medicare and Medicaid Programs; Announcement of an Application From a Hospital Requesting Waiver...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-23

... waiver, the Secretary must determine that the waiver--(1) is expected to increase organ donations; and (2...] Medicare and Medicaid Programs; Announcement of an Application From a Hospital Requesting Waiver for Organ... require the hospital to enter into an agreement with its designated Organ Procurement Organization (OPO...

75 FR 21337 - Medicare and Medicaid Programs; Announcement of an Application From a Hospital Requesting Waiver...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-23

... waiver--(1) Is expected to increase organ donations; and (2) will ensure equitable treatment of patients...] Medicare and Medicaid Programs; Announcement of an Application From a Hospital Requesting Waiver for Organ... require the hospital to enter into an agreement with its designated Organ Procurement Organization (OPO...

Microelectronics Status Analysis and Secondary Part Procureability Assessment of the THAAD Weapon System

DTIC Science & Technology

1999-10-01

Technical Report 5-20448 & 5- 20449 Contract No. DAAH01-98-D-R001 Delivery Order No. 34 Microelectronics Status Analysis and Secondary Part...Procureability Assessment of the THAAD Weapon System. (5-20448 & 5- 20449 ) Final Technical Report for Period 21 January 1999 through 30 September 1999...Huntsville Huntsville, AL 35899 5. FUNDING NUMBERS 8. PERFORMING ORGANIZATION REPORT NUMBER 5-20448 & 5- 20449 9. SPONSORING/MONITORING AGENCY

Department of Defense Inspector General Semiannual Report to the Congress (5th) 1 April - 30 September 1989

DTIC Science & Technology

1989-09-30

finest procurement fraud investigative organization in the Federal Government , the Defense Criminal Investigative Service, whose work led to over 600...Audit Results contracts was not supported by procurement regulations . The distribution of the preniunts The results of I)CAA auditing for the Federul wis...performance of Government work. Operating under Federal Acquisition Regulations and the audits include the review and evaluation of Government saved

NASA New England Outreach Center

NASA Technical Reports Server (NTRS)

2002-01-01

The NASA New England Outreach Center in Nashua, New Hampshire was established to serve as a catalyst for heightening regional business awareness of NASA procurement, technology and commercialization opportunities. Emphasis is placed on small business participation, with the highest priority given to small disadvantaged businesses, women-owned businesses, HUBZone businesses, service disabled veteran owned businesses, and historically black colleges and universities and minority institutions. The Center assists firms and organizations to understand NASA requirements and to develop strategies to capture NASA related procurement and technology opportunities. The establishment of the NASA Outreach Center serves to stimulate business in a historically underserved area. NASA direct business awards have traditionally been highly present in the West, Midwest, South, and Southeast areas of the United States. The Center guides and assists businesses and organizations in the northeast to target opportunities within NASA and its prime contractors and capture business and technology opportunities. The Center employs an array of technology access, one-on-one meetings, seminars, site visits, and targeted conferences to acquaint Northeast firms and organizations with representatives from NASA and its prime contractors to learn about and discuss opportunities to do business and access the inventory of NASA technology. This stimulus of interaction also provides firms and organizations the opportunity to propose the use of their developed technology and ideas for current and future requirements at NASA. The Center provides a complement to the NASA Northeast Regional Technology Transfer Center in developing prospects for commercialization of NASA technology. In addition, the Center responds to local requests for assistance and NASA material and documents, and is available to address immediate concerns and needs in assessing opportunities, timely support to interact with NASA Centers on a local level, and develop easy access to information. The Center acts in the manner of a "NASA Center or Field Office" with direction from NASA Headquarters, Code K.

Liver procurement from a brain-dead kidney transplant recipient--a case report.

PubMed

Romatowska, Edyta; Woderska, Aleksandra; Kusza, Krzysztof; Słupski, Maciej; Neumann, Małgorzata

2012-01-01

The shortage of organ donors has led to new strategies to increase the availability of allografts for transplantation, such as organ procurement from brain-dead organ transplant recipients. We present the case of a 26 year-old male brain-dead liver donor who had been a kidney transplant recipient six years previously. The liver donor described in this report, as the first in Poland, has paved a new, although as yet narrow, way in the field of organ donation. This is also the first case described in the medical literature of liver recovery from a brain-dead kidney transplant recipient on an immunosuppressive regimen with three immunosuppressive agents. Although transplant recipients represent an uncommon group of deceased organ donors, it is probable that situations when they may be considered as potential organ donors will occur more often. Therefore, although specific criteria for organ donors exist, each reported potential donor should be considered individually, and brain-dead solid organ recipients should not be excluded a priori as organ donors; both their native and allografted organs may be recovered and successfully transplanted. In this study, we also review the current state of knowledge on the reuse of organs.

Questionnaire on Brain Death and Organ Procurement.

PubMed

Hammad, Saleh; Alnammourah, Manal; Almahmoud, Farah; Fawzi, Mais; Breizat, Abdel-Hadi

2017-02-01

The subject of organs for transplant after brain death raises many concerns, including definition and timing of death, how to permit human organ transplant, and the idea of paying for organs. Many ethical concerns are raised regarding regulations and procedures for organ transplant in developing countries. These include where and how to obtain organs and the concept of justice in organ distribution. We administered 2682 questionnaires to 628 men and 2054 women over 24 months (range, 18 to 70 years old). We included people from universities, colleges, and the general public and asked questions on the circumstances of death, the conditions of conversations around organ donation, and reasons for acceptance or refusal of donation. The identical questionnaire, consisting of 8 questions, was administered twice: before and after a teaching session on brain death and organ procurement. The study was approved by our Ethical Review Committee and in accordance with the ethical guidelines of the 1975 Helsinki Declaration. Written informed consent was obtained from all participants. We found that 72.1% understood brain death in the prequestionnaire and 88% understood brain death in the postquestionnaire, with 63.8% versus 68% accepting the concept of brain death, 50.6% versus 58.3% thinking that their religion is against brain death, 11.3% versus 11.3% carrying a donor card, 50.7% versus 58.9% wanting to carry a donor card, 46.4% versus 56.4% agreeing to give consent for organ donation if a relative was diagnosed with brain death, 28.3% versus 50% aware of the laws and regulations concerning brain death and organ donation and transplant in Jordan, and 35.4% versus 40% in agreement with the Presumed Consent Law, respectively. In Jordan, along with legal requirements concerning brain death and organ donation and transplant, there is a lack of acceptance of organ donation after brain death, necessitating further work and activities to achieve self-sufficiency from donated organs.

Navy CG(X) Cruiser Program: Background for Congress

DTIC Science & Technology

2010-06-10

PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e . TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES...Navy’s Top Officer Sees Lessons in Shipbuilding Program Failures,” GovernmentExecutive.com, September 24, 2008) quoted Admiral Gary Roughead, the Chief...procuring CG(X)s was properly aligned with foreign-country ballistic missile development programs. A 2005 defense trade press report, for example, stated

Navy CG(X) Cruiser Program: Background, Oversight Issues, and Options for Congress

DTIC Science & Technology

2008-11-18

ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e . TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES... Lessons in Shipbuilding Program Failures,” GovernmentExecutive.com, September 24, 2008) quoted Admiral Gary Roughead, the Chief of Naval Operations, as...the schedule for procuring CG(X)s is properly aligned with foreign-country ballistic missile development programs. A 2005 defense trade press report

The policies of organ transplantation in Europe: issues and problems.

PubMed

Defever, M

1990-11-01

Transplantation has evolved from an experiment to a routinely performed procedure for a widening range of organs. Transplantation in Europe is dominated by the scarcity of organs from deceased donors leading to problems of selection criteria for recipients, of legal protection for donors and of the empowerment of agencies for allocative decisions. Although public involvement is very emotional, there has been a benign neglect in several European countries by policy makers, accepting implicitly organ transplantation leading to a variety of programs for diffusion, organization, and financing of transplantation. Non-transplanting hospitals play a key role in organ procurement and transplant centers are increasingly subject to quality assessment, whereby the issue of the relation between improved outcome at higher volumes comes to the forefront. International cooperation is critical for the development of effective transplant programs in Europe.

Pancreas preservation for pancreas and islet transplantation

PubMed Central

Iwanaga, Yasuhiro; Sutherland, David E.R.; Harmon, James V.; Papas, Klearchos K.

2010-01-01

Purpose of review To summarize advances and limitations in pancreas procurement and preservation for pancreas and islet transplantation, and review advances in islet protection and preservation. Recent findings Pancreases procured after cardiac death, with in-situ regional organ cooling, have been successfully used for islet transplantation. Colloid-free Celsior and histidine-tryptophan-ketoglutarate preservation solutions are comparable to University of Wisconsin solution when used for cold storage before pancreas transplantation. Colloid-free preservation solutions are inferior to University of Wisconsin solution for pancreas preservation prior to islet isolation and transplantation. Clinical reports on pancreas and islet transplants suggest that the two-layer method may not offer significant benefits over cold storage with the University of Wisconsin solution: improved oxygenation may depend on the graft size; benefits in experimental models may not translate to human organs. Improvements in islet yield and quality occurred from pancreases treated with inhibitors of stress-induced apoptosis during procurement, storage, isolation or culture. Pancreas perfusion may be desirable before islet isolation and transplantation and may improve islet yields and quality. Methods for real-time, noninvasive assessment of pancreas quality during preservation have been implemented and objective islet potency assays have been developed and validated. These innovations should contribute to objective evaluation and establishment of improved pancreas preservation and islet isolation strategies. Summary Cold storage may be adequate for preservation before pancreas transplants, but insufficient when pancreases are processed for islets or when expanded donors are used. Supplementation of cold storage solutions with cytoprotective agents and perfusion may improve pancreas and islet transplant outcomes. PMID:18685343

Applying e-procurement system in the healthcare: the EPOS paradigm

NASA Astrophysics Data System (ADS)

Ketikidis, Panayiotis H.; Kontogeorgis, Apostolos; Stalidis, George; Kaggelides, Kostis

2010-03-01

One of the goals of procurement is to establish a competitive price, while e-procurement utilises electronic commerce to identify potential sources of supply, to purchase goods and services, to exchange contractual information and to interact with suppliers. Extensive academic work has been extensively devoted to e-procurement in diverse industries. However, applying e-procurement in the healthcare sector remains unexplored. It lacks an efficient e-procurement mechanism that will enable hospitals and healthcare suppliers to electronically exchange contractual information, aided by the technologies of optimisation and business rules. The development and deployment of e-procurement requires a major effort in the coordination of complex interorganisational business process. This article presents an e-procurement optimised system (EPOS) for the healthcare marketplace, a complete methodological approach for deploying and operating such system, as piloted in public and private hospitals in three European countries (Greece, Spain and Belgium) and suppliers of healthcare items in the fourth country (Italy). The efficient e-procurement mechanism that EPOS suggests enables hospitals and pharmaceutical and medical equipment suppliers to electronically exchange contractual information.

75 FR 5599 - Medicare and Medicaid Programs; Announcement of Applications From Hospitals Requesting Waiver for...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-03

...--(1) is expected to increase organ donations; and (2) will ensure equitable treatment of patients...] Medicare and Medicaid Programs; Announcement of Applications From Hospitals Requesting Waiver for Organ... otherwise require the hospitals to enter into an agreement with their designated Organ Procurement...

76 FR 78216 - Organ Procurement and Transplantation Network

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-16

... composite tissue allograft; however, for the purposes of rulemaking, the Health Resources and Services..., Hand transplantation and vascularized composite tissue allografts in orthopaedics and traumatology... vascularized composite allografts, described below, within the definition of organs covered by the rules...

Thyroid hormone therapy in the management of 63,593 brain-dead organ donors: a retrospective analysis.

PubMed

Novitzky, Dimitri; Mi, Zhibao; Sun, Qing; Collins, Joseph F; Cooper, David K C

2014-11-27

Hormonal therapy to the brain-dead potential organ donor can include thyroid hormone (triiodothyronine [T3] or levothyroxine [T4]), corticosteroids, antidiuretic hormone, and insulin. Data on 66,629 donors (2000-2009) were retrospectively reviewed. Documentation on T3/T4 was available in 63,593 (study 1), but 23,469 had incomplete documentation of other hormones. In 40,124, details of all four hormones were recorded (study 2). In this cohort, group A (received T3/T4) consisted of 23,022, and group B (no T3/T4) consisted of 17,102 donors. A multivariate analysis was performed to determine whether age, sex, ethnicity, cause of death, body mass index, Organ Procurement Organization region, or other hormonal therapy influenced procurement. Posttransplantation organ graft survival at 1 and 12 months was compared. In study 1, 30,962 (48.69%) received T3/T4, providing a mean of 3.35 organs per donor, and 32,631 (51.31%) did not receive T3/T4, providing a mean of 2.97 organs per donor, an increase of 12.8% of organs from T3/T4-treated donors (P<0.0001). In study 2, group A provided a mean of 3.31 organs per donor and group B provided a mean of 2.87 organs per donor, an increase of 15.3% in group A (P<0.0001). T3/T4 therapy was associated with procurement of significantly greater numbers of hearts, lungs, kidneys, pancreases, and intestines, but not livers. Multivariate analysis indicated a beneficial effect of T3/T4 independent of other factors (P<0.0001). T3/T4 therapy of the donor was associated with improved posttransplantation graft survival or no difference in survival, except for pancreas recipient (but not graft) survival at 12 months in study 2. T3/T4 therapy results in more transplantable organs, with no detriment to posttransplantation graft survival.

Opportunities and challenges of expanded criteria organs in liver and kidney transplantation as a response to organ shortage.

PubMed

Solomon, Harvey

2011-01-01

In 1989, there were 19,000 patients on the UNOS (United Network of Organ Sharing) wait list for organs compared to 110,000 today. Without an equivalent increase in donors, the patients awaiting these organs for transplant face increasing severity of illness and risk of dying without receiving a transplant. This disparity in supply and demand has led to acceptance of organs with lower than expected success rates compared to previous standard donors variously defined as extended criteria donors in order to increase transplantation. The reluctance to wider use of these types of organs is based on the less than expected transplant center graft and patient survival results associated with their use, as well as the increased resources required to care for the patients who receive these organs. The benefits need to be compared to the survival of not receiving a transplant and remaining on the waiting list rather than on outcomes of receiving a standard donor. A lack of a systematic risk outcomes adjustment is one of the most important factors preventing more extensive utilization as transplant centers are held to patient and graft survival statistics as a performance measure by multiple regulatory organizations and insurers. Newer classification systems of such donors may allow a more systematic approach to analyzing the specific risks to individualized patients. Due to changes in donor policies across the country, there has been an increase in Extended Criteria Donors (ECD) organs procured by organ procurement organizations (OPO) but their uneven acceptance by the transplant centers has contributed to an increase in discards and organs not being used. This is one of the reasons that wider sharing of organs is currently receiving much attention. Transplanting ECD organs presents unique challenges and innovative approaches to achieve satisfactory results. Improved logistics and information technology combined strategies for improving donor quality with may prevent discards while insuring maximal benefit. Transplant centers, organ procurement organizations, third party payers and government agencies all must be involved in maximizing the potential for ECD organs.

76 FR 53938 - Order of Succession for the Office of the Chief Procurement Officer

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-30

... DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT [Docket No. FR-5561-D-02] Order of Succession for the...: Notice of Order of Succession. SUMMARY: In this notice, the Chief Procurement Officer designates the Order of Succession for the Office of the Chief Procurement Officer. DATES: Effective Date: August 19...

Southeast Asia Report

DTIC Science & Technology

1985-10-01

significant contributions to eliminating obstacles in production and business , stimulating the development of production, intensifying procurements in...views or attitudes of the U.S. Government. PROCUREMENT OF PUBLICATIONS JPRS publications may be ordered from the National Technical Information...Washington, D.C. 20402. Correspondence pertaining to matters other than procurement may be addressed to Joint Publications Research Service, 1000

5 CFR 1303.3 - Organization.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Administrative Personnel OFFICE OF MANAGEMENT AND BUDGET ADMINISTRATIVE PROCEDURES PUBLIC INFORMATION PROVISIONS... Procurement Policy, and the Office of Information and Regulatory Affairs. (b) The Office of Management and... the central organization of the Office of Management and Budget follows: (1) The Director's Office...

5 CFR 1303.3 - Organization.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Administrative Personnel OFFICE OF MANAGEMENT AND BUDGET ADMINISTRATIVE PROCEDURES PUBLIC INFORMATION PROVISIONS... Procurement Policy, and the Office of Information and Regulatory Affairs. (b) The Office of Management and... the central organization of the Office of Management and Budget follows: (1) The Director's Office...

Dependence and power in healthcare equipment supply chains.

PubMed

de Jong, Jurriaan L; Benton, W C

2018-03-05

Most healthcare organizations (HCOs) engage Group Purchasing Organizations (GPOs) as an outsourcing strategy to secure their supplies and materials. When an HCO outsources the procurement function to a GPO, this GPO will directly interact with the HCO's supplier on the HCO's behalf. This study investigates how an HCO's dependence on a GPO affects supply chain relationships and power in the healthcare medical equipment supply chain. Hypotheses are tested through factor analysis and structural equation modeling, using primary survey data from HCO procurement managers. An HCO's dependence on a GPO is found to be positively associated with a GPO's reliance on mediated power, but, surprisingly, negatively associated with a GPO's mediated power. Furthermore, analysis indicates that an HCO's dependence on a GPO is positively associated with an HCO's dependence on a GPO-contracted Original Equipment Manufacturer (OEM). HCO reliance on GPOs may lead to a buyer's dependence trap, where HCOs are increasingly dependent on GPOs and OEMs. Implications for HCO procurement managers and recommended steps for mitigation are offered. Power-dependence relationships in the medical equipment supply chain are not consistent with relationships in other, more traditional, supply chains. While dependence in a supply chain relationship typically leads to an increase in reliance on mediated power, GPO-dependent HCOs instead perceive a decrease in GPO mediated power. Furthermore, HCOs that rely on procurement service from GPOs are increasingly dependent on the OEMs.

24 CFR 84.40 - Purpose of procurement standards.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Purpose of procurement standards. 84.40 Section 84.40 Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development UNIFORM ADMINISTRATIVE REQUIREMENTS FOR GRANTS AND AGREEMENTS WITH INSTITUTIONS OF...

Global survey of malaria rapid diagnostic test (RDT) sales, procurement and lot verification practices: assessing the use of the WHO-FIND Malaria RDT Evaluation Programme (2011-2014).

PubMed

Incardona, Sandra; Serra-Casas, Elisa; Champouillon, Nora; Nsanzabana, Christian; Cunningham, Jane; González, Iveth J

2017-05-15

Malaria rapid diagnostic tests (RDTs) play a critical role in malaria case management, and assurance of quality is a key factor to promote good adherence to test results. Since 2007, the World Health Organization (WHO) and the Foundation for Innovative New Diagnostics (FIND) have coordinated a Malaria RDT Evaluation Programme, comprising a pre-purchase performance evaluation (product testing, PT) and a pre-distribution quality control of lots (lot testing, LT), the former being the basis of WHO recommendations for RDT procurement. Comprehensive information on malaria RDTs sold worldwide based on manufacturers' data and linked to independent performance data is currently not available, and detailed knowledge of procurement practices remains limited. The use of the PT/LT Programme results as well as procurement and lot verification practices were assessed through a large-scale survey, gathering product-specific RDT sales and procurement data (2011-14 period) from a total of 32 manufacturers, 12 procurers and 68 National Malaria Control Programmes (NMCPs). Manufacturers' reports showed that RDT sales had more than doubled over the four years, and confirmed a trend towards increased compliance with the WHO procurement criteria (from 83% in 2011 to 93% in 2014). Country-level reports indicated that 74% of NMCPs procured only 'WHO-compliant' RDT products, although procurers' transactions datasets revealed a surprisingly frequent overlap of different products and even product types (e.g., Plasmodium falciparum-only and Plasmodium-pan) in the same year and country (60 and 46% of countries, respectively). Importantly, the proportion of 'non-complying' (i.e., PT low scored or not evaluated) products was found to be higher in the private health care sector than in the public sector (32% vs 5%), and increasing over time (from 22% of private sector sales in 2011 to 39% in 2014). An estimated 70% of the RDT market was covered by the LT programme. The opinion about the PT/LT Programmes was positive overall, and quality of RDTs as per the PT Programme was rated as the number one procurement criteria. This survey provided in-depth information on RDT sales and procurement dynamics, including the largely unstudied private sector, and demonstrated how the WHO-FIND Programme has positively influenced procurement practices in the public sector.

Navy CG(X) Cruiser Program: Background, Oversight Issues, and Options for Congress

DTIC Science & Technology

2008-10-27

ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e . TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Congressional...report (Katherine McIntire Peters, “Navy’s Top Officer Sees Lessons in Shipbuilding Program Failures,” GovernmentExecutive.com, September 24, 2008) quoted...40 A related question is whether the schedule for procuring CG(X)s is properly aligned with foreign-country ballistic missile development programs. A

SRTR center-specific reporting tools: Posttransplant outcomes.

PubMed

Dickinson, D M; Shearon, T H; O'Keefe, J; Wong, H-H; Berg, C L; Rosendale, J D; Delmonico, F L; Webb, R L; Wolfe, R A

2006-01-01

Measuring and monitoring performance--be it waiting list and posttransplant outcomes by a transplant center, or organ donation success by an organ procurement organization and its partnering hospitals--is an important component of ensuring good care for people with end-stage organ failure. Many parties have an interest in examining these outcomes, from patients and their families to payers such as insurance companies or the Centers for Medicare and Medicaid Services; from primary caregivers providing patient counseling to government agencies charged with protecting patients. The Scientific Registry of Transplant Recipients produces regular, public reports on the performance of transplant centers and organ procurement organizations. This article explains the statistical tools used to prepare these reports, with a focus on graft survival and patient survival rates of transplant centers--especially the methods used to fairly and usefully compare outcomes of centers that serve different populations. The article concludes with a practical application of these statistics--their use in screening transplant center performance to identify centers that may need remedial action by the OPTN/UNOS Membership and Professional Standards Committee.

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

The Procurement and Assistance Data System (PADS) provides a mechanism for collecting, assembling, organizing, and presenting acquisition and assistance data for the Department of Energy (DOE). This handbook and associated documents establish a uniform system to report acquisition/assistance data to PADS for the collection, processing, and dissemination of official statistical data on the Department`s acquisition and assistance actions. The data provides, based on information available at the time of request, a basis for any recurring and special reports to the senior procurement executive, Congress, General Accounting Office (GAO), Federal executive agencies, Office of management and Budget (OMB), and the generalmore » public. It provides information for measuring and assessing the extent to which small business firms and small disadvantages business enterprises are sharing in DOE placement, and for other acquisition and assistance policy and management control purposes. The Handbook for the Preparation of the Individual Procurement Action Report (IPAR) has been designed in two sections; Procurement and Financial Assistance to support the individual forms.« less

Food-and-beverage environment and procurement policies for healthier work environments.

PubMed

Gardner, Christopher D; Whitsel, Laurie P; Thorndike, Anne N; Marrow, Mary W; Otten, Jennifer J; Foster, Gary D; Carson, Jo Ann S; Johnson, Rachel K

2014-06-01

The importance of creating healthier work environments by providing healthy foods and beverages in worksite cafeterias, in on-site vending machines, and at meetings and conferences is drawing increasing attention. Large employers, federal and state governments, and hospital systems are significant purchasers and providers of food and beverages. The American Heart Association, federal government, and other organizations have created procurement standards to guide healthy purchasing by these entities. There is a need to review how procurement standards are currently implemented, to identify important minimum criteria for evaluating health and purchasing outcomes, and to recognize significant barriers and challenges to implementation, along with success stories. The purpose of this policy paper is to describe the role of food-and-beverage environment and procurement policy standards in creating healthier worksite environments; to review recently created national model standards; to identify elements across the standards that are important to consider for incorporation into policies; and to delineate issues to address as standards are implemented across the country. © 2014 International Life Sciences Institute.

Significance of ITER IWS Material Selection and Qualification

NASA Astrophysics Data System (ADS)

Mehta, Bhoomi K.; Raval, Jigar; Maheshwari, Abha; Laad, Rahul; Singh, Gurlovleen; Pathak, Haresh

2017-04-01

In-Wall Shielding (IWS) is one of the important components of ITER Vacuum Vessel (VV) which fills the space between double walls of VV with cooling water. Procurement Arrangement (PA) for IWS has been signed with Indian Domestic Agency (INDA). Procurement of IWS materials, fabrication of IWS blocks and its delivery to respective Domestic Agency (DA) and ITER Organization (IO) are the main scope of this PA. Hence, INDIA is the only country which is contributing to VV IWS among all seven ITER partners. The main functions of the IWS are to provide Neutron Shielding with blanket, VV shells and water during plasma operations and to reduce ripple of the Toroidal Magnetic Field. To meet these functional requirements IWS blocks are made up of special materials (Borated Steels SS304 B4 & SS304 B7, Ferritic Steels SS 430, Austenitic Steel SS 316 L (N)-IG, XM-19 and Inconel-625) which are qualified, reliable and traceable for the design assessment. The choice of these materials has a significant influence on performance, maintainability, licensing, detailed design parameters and waste disposal. The main reasons for the materials selected for IWS are its high mechanical strength at operating temperatures, water chemistry properties, excellent fabrication characteristics and low cost relative to other similar materials. All the materials are qualified with respect to their respective codes (ASTM/EN standards with additional requirements as described in RCC-MR code 2007) and ITER requirements. Agreed Notified Body (ANB) has control conformity of materials certificates with approved material specification and traceability procedure for Safety Important Component (SIC). The procurement strategy for all the IWS materials has been developed in close collaboration with IO, ANB and Industries as per Product Procurement Specification (PPS). The R&D for sample, bulk material production, testing, inspection and handling as required are carried out by IN DA and IO. At present almost all IWS materials (∼2500 Tons) has been procured by IN DA with spares to manufacture ∼9000 IWS blocks. This paper summarizes IWS material selection, qualification and procurement processes in detail.

[New conditions for organ donation in France].

PubMed

Antoine, Corinne; Maroudy, Daniel

2016-09-01

The procurement of organs from donors after circulatory death is a reliable technique which gives satisfactory posttransplant results and also represents a potential source of additional organs. In order to meet the growing need for organ donations, the 'anticipated organ donation approach' procedure is currently receiving renewed interest with new conditions for its implementation in France. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

78 FR 10620 - Agency Information Collection Activities: Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-14

... collection; Title of Information Collection: Organ Procurement Organization's (OPOs) Health Insurance Benefits Agreement and Supporting Regulations at 42 CFR 486.301-486.348; Use: The Medicare and Medicaid... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [Document...

A Technical Description of the Officer Procurement Model (TOPOPS). Final Report.

ERIC Educational Resources Information Center

Akman, Allan; And Others

The Total Objective Plan for the Officer Procurement System (TOPOPS) is an aggregate-level, computer-based model of the Air Force Officer procurement system developed to operate on the UNIVAC 1108 system. It is designed to simulate officer accession and training and achieve optimal solutions in terms of either cost minimization or accession…

The diffusion of organ transplantation in Western Europe.

PubMed

Rigter, H; Bos, M A

1990-11-01

The moment of introduction of clinical organ transplantations varied in Western Europe from country to country. In retrospect, one can distinguish pioneering countries (most notably the U.K. and France), and countries that were early or late adopters of the new technologies. An early start did not necessarily lead to extensive diffusion of organ transplantations, as shown by the example of the U.K. In general, Western Europe is lagging behind the U.S.A. In diffusion of organ transplantation technologies. With few exceptions, the introduction and diffusion of organ transplantations in Western Europe have been largely autonomous developments, not regulated by government or third party payers and only slowed down by lack of organs, facilities or funds. The lack of organs has been reduced by the activities of organ procurement and exchange organisations, and perhaps by legislation promoting organ donation. Nevertheless, the growth of the number of patients waiting for an organ is in almost all countries outpacing the increase in availability of organs.

Organ Procurement Organizations and the Electronic Health Record.

PubMed

Howard, R J; Cochran, L D; Cornell, D L

2015-10-01

The adoption of electronic health records (EHRs) has adversely affected the ability of organ procurement organizations (OPOs) to perform their federally mandated function of honoring the donation decisions of families and donors who have signed the registry. The difficulties gaining access to potential donor medical record has meant that assessment, evaluation, and management of brain dead organ donors has become much more difficult. Delays can occur that can lead to potential recipients not receiving life-saving organs. For over 40 years, OPO personnel have had ready access to paper medical records. But the widespread adoption of EHRs has greatly limited the ability of OPO coordinators to readily gain access to patient medical records and to manage brain dead donors. Proposed solutions include the following: (1) hospitals could provide limited access to OPO personnel so that they could see only the potential donor's medical record; (2) OPOs could join with other transplant organizations to inform regulators of the problem; and (3) hospital organizations could be approached to work with Center for Medicare and Medicaid Services (CMS) to revise the Hospital Conditions of Participation to require OPOs be given access to donor medical records. © Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.

The ambiguity about death in Japan: an ethical implication for organ procurement.

PubMed Central

McConnell, J R

1999-01-01

In the latter half of the twentieth century, developed countries of the world have made tremendous strides in organ donation and transplantation. However, in this area of medicine, Japan has been slow to follow. Japanese ethics, deeply rooted in religion and tradition, have affected their outlook on life and death. Because the Japanese have only recently started to acknowledge the concept of brain death, transplantation of major organs has been hindered in that country. Currently, there is a dual definition of death in Japan, intended to satisfy both sides of the issue. This interesting paradox, which still stands to be fully resolved, illustrates the contentious conflict between medical ethics and medical progress in Japan. PMID:10461595

Rational use of medicines - Indian perspective!

PubMed

Mohanta, G P; Manna, P K

2015-01-01

India, the largest democracy in the world, is with a federal structure of 29 states and 7 union territories. With a population of more than 1.2 billion, resource is always a constraint and so is in the health system too. In the federal structure, providing healthcare is largely the responsibility of state governments. Medicines are important component of health care delivery system and quality care is dependent on the availability and proper use of quality medicines. In spite of being known as pharmacy of the third world, poor access to medicines in the country is always a serious concern. Realizing the need of quality use of medicines, several initiatives have been initiated. As early as 1994, seeds of rational use of medicines were sown in the country with two initiatives: establishment of a civil society, Delhi Society for Promoting Rational Use of Drugs (DSPURD) and establishment of government agency in Tamil Nadu, a southern state, called Tamil Medical Services Corporation Limited (TNMSCL). DSPUD was in official association with World Health Organization Country Office for implementing essential medicine programme in the country for two biennia. In addition to organizing sensitising and training programme for healthcare professionals throughout the country, it looked after the procurement and appropriate use of medicines in Delhi government health facilities. TNMSCL has made innovations in medicine management including procurement directly from manufacturers as a part of pooled procurement, establishing warehouses with modern storage facilities and Information Technology enabled management of whole process. TNMSCL Model is now replicated in almost the entire country and even in some small other countries as it is successful in improving access to medicines.The National Government and the State Governments have developed strategies to promote rational use of medicines as a part of improving access and quality care in public health facilities. National Government developed policies and regulations for combating antimicrobial resistance, controlling the prices of medicines, establishing generic medicines stores and advocating for the need for improvement of medicine logistics at state level and prescription auditing system. There is wide variation in medicine procurement and management system among the states. Spending on medicines ranges from as small as 2% of health budget to as high as 17%. The procurement system varies from individual facilities to partial pooled procurement to complete centralised system.There are attempts of developing essential medicine lists, standard treatment guidelines and costing of treatment of common illnesses. Except for the few states, essential medicine list remains an ornamental showpiece. However, with apex court's intervention, the prices are now controlled for all 348 medicines listed in national list. The pharmaceutical companies continue to violate price regulations either through making the medicines at different strengths or new fixed dose combinations (FDCs). Perhaps the largest number of FDCs and many of them with no valid justification are available in the country. Decisions on compulsory licensing have made the new anticancer medicines affordable. Other countries have also benefited from this decision. While some progress has been made for appropriate use of medicines in public health facilities, there are little efforts in private sectors and at community levels. Availability of prescription medicines without much control and free drug advertising are other concerns. Like all other countries irrational use of medicines continues to be of concern in India despite of several attempts of improving use of medicines both in the health system as well as in community. But efforts continue to be made for improving the use of medicines!

Comparing the Effectiveness of Two KC-10 Concepts of Operation - An Examination of Tanker/Airlift Support in a Fighter Deployment to Europe

DTIC Science & Technology

1986-06-01

PROCUREMENT INSTRUMENT IDENTIFICATION NUMBER ORGANIZATION (Ii’ ppticable) Sc. ADDRESS (City, State and ZIP Code) 10. SOURCE OF FUNDING NOS...total of 60 KC-10s were available to support the fighter deployment. This number represented the projected KC-10 procurement for the year 1990 as...search for relevant government studies was accomplished through the Defense Technical Information Center (DTIC). All their 3-9 research related to

The Bioethics and Utility of Selling Kidneys for Renal Transplantation

PubMed Central

Berman, Elisheva; Lipschutz, Jonathan M.; Bloom, Roy D.; Lipschutz, Joshua H.

2008-01-01

In the fifty years since kidney transplantation was first performed, this procedure has evolved from a highly speculative biomedical endeavor to a medically viable and often standard course of therapy (1). Long-term survival is markedly improved among patients who receive a kidney compared with patients who remain on the waiting list for such an organ (2). As outcomes have improved and more clinical indications have emerged, the number of people awaiting transplantation has grown significantly. In stark contrast to the robust expansion of the waiting list, the number of available deceased donors has remained relatively constant over the last several years (1). The current mechanism for procuring kidneys relies on voluntary donations by the general public, with the primary motivation being altruism. However, in light of the ever-increasing waiting list, it is the authors’ belief that the current system needs to be revised if supply is ever going to meet demand. In response to this critical organ shortage, different programs have been developed in an attempt to increase organ donation. At present, however, no solution to the problem has emerged. This paper begins by outlining the scope of the problem and current legislation governing the procurement of transplantable organs/tissues in the United States. It continues with an overview of different proposals to increase supply. It concludes by exploring some of the controversy surrounding the proposal to increase donation using financial incentives. Though the following discussion certainly has implications for other transplantable organs, this paper will focus on kidney transplantation because the waiting list for kidneys is by far the longest of all the solid organs; and, as it carries the smallest risk to living donors, is the least ethically problematic. PMID:18589084

29 CFR 1615.135 - Electronic and information technology requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 29 Labor 4 2013-07-01 2013-07-01 false Electronic and information technology requirements. 1615... INFORMATION TECHNOLOGY § 1615.135 Electronic and information technology requirements. (a) Development, procurement, maintenance, or use of electronic and information technology.—When developing, procuring...

29 CFR 1615.135 - Electronic and information technology requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 29 Labor 4 2012-07-01 2012-07-01 false Electronic and information technology requirements. 1615... INFORMATION TECHNOLOGY § 1615.135 Electronic and information technology requirements. (a) Development, procurement, maintenance, or use of electronic and information technology.—When developing, procuring...

29 CFR 1615.135 - Electronic and information technology requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 29 Labor 4 2014-07-01 2014-07-01 false Electronic and information technology requirements. 1615... INFORMATION TECHNOLOGY § 1615.135 Electronic and information technology requirements. (a) Development, procurement, maintenance, or use of electronic and information technology.—When developing, procuring...

29 CFR 1615.135 - Electronic and information technology requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 4 2011-07-01 2011-07-01 false Electronic and information technology requirements. 1615... INFORMATION TECHNOLOGY § 1615.135 Electronic and information technology requirements. (a) Development, procurement, maintenance, or use of electronic and information technology.—When developing, procuring...

29 CFR 1615.135 - Electronic and information technology requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 4 2010-07-01 2010-07-01 false Electronic and information technology requirements. 1615... INFORMATION TECHNOLOGY § 1615.135 Electronic and information technology requirements. (a) Development, procurement, maintenance, or use of electronic and information technology.—When developing, procuring...

Regional Differences in Communication Process and Outcomes of Requests for Solid Organ Donation.

PubMed

Traino, H M; Molisani, A J; Siminoff, L A

2017-06-01

Although federal mandate prohibits the allocation of solid organs for transplantation based on "accidents of geography," geographic variation of transplantable organs is well documented. This study explores regional differences in communication in requests for organ donation. Administrative data from nine partnering organ procurement organizations and interview data from 1339 family decision makers (FDMs) were compared across eight geographically distinct US donor service areas (DSAs). Authorization for organ donation ranged from 60.4% to 98.1% across DSAs. FDMs from the three regions with the lowest authorization rates reported the lowest levels of satisfaction with the time spent discussing donation and with the request process, discussion of the least donation-related topics, the highest levels of pressure to donate, and the least comfort with the donation decision. Organ procurement organization region predicted authorization (odds ratios ranged from 8.14 to 0.24), as did time spent discussing donation (OR = 2.11), the number of donation-related topics discussed (OR = 1.14), and requesters' communication skill (OR = 1.14). Standardized training for organ donation request staff is needed to ensure the highest quality communication during requests, optimize rates of family authorization to donation in all regions, and increase the supply of organs available for transplantation. © 2016 The American Society of Transplantation and the American Society of Transplant Surgeons.

Organismal death, the dead-donor rule and the ethics of vital organ procurement.

PubMed

Symons, Xavier; Chua, Reginald Mary

2018-06-19

Several bioethicists have recently discussed the complexity of defining human death, and considered in particular how our definition of death affects our understanding of the ethics of vital organ procurement. In this brief paper, we challenge the mainstream medical definition of human death-namely, that death is equivalent to total brain failure-and argue with Nair-Collins and Miller that integrated biological functions can continue even after total brain failure has occurred. We discuss the implications of Nair-Collins and Miller's argument and suggest that it may be necessary to look for alternative biological markers that reliably indicate the death of a human being. We reject the suggestion that we should abandon the dead-donor criteria for organ donation. Rather than weaken the ethical standards for vital organ procurement, it may be necessary to make them more demanding. The aim of this paper is not to justify the dead donor rule. Rather, we aim to explore the perspective of those who agree with critiques of the whole brain and cardiopulmonary definitions of death but yet disagree with the proposal that we should abandon the dead-donor rule. We will consider what those who want to retain the dead-donor rule must argue in light of Nair-Collins and Miller's critique. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Cost effective nuclear commercial grade dedication

DOE Office of Scientific and Technical Information (OSTI.GOV)

Maletz, J.J.; Marston, M.J.

1991-01-01

This paper describes a new computerized database method to create/edit/view specification technical data sheets (mini-specifications) for procurement of spare parts for nuclear facility maintenance and to develop information that could support possible future facility life extension efforts. This method may reduce cost when compared with current manual methods. The use of standardized technical data sheets (mini-specifications) for items of the same category improves efficiency. This method can be used for a variety of tasks, including: Nuclear safety-related procurement; Non-safety related procurement; Commercial grade item procurement/dedication; Evaluation of replacement items. This program will assist the nuclear facility in upgrading its procurementmore » activities consistent with the recent NUMARC Procurement Initiative. Proper utilization of the program will assist the user in assuring that the procured items are correct for the applications, provide data to assist in detecting fraudulent materials, minimize human error in withdrawing database information, improve data retrievability, improve traceability, and reduce long-term procurement costs.« less

[Multivisceral organ procurement for transplantation derived mobilization maneouvres: very helpful auxiliary techniques in the excision of large retroperitoneal masses].

PubMed

González, Javier; Shirodkar, S P; Ciancio, G

2011-04-01

The excision of large retroperitoneal masses poses a challenge for every surgeon. Sometimes the urologist must face situations that do not fit to any conventional approach or technique previously described. Obtaining adequate exposure for safe and oncologically correct management of these masses is based, on many cases, in the mobilization of anatomical adjacent structures to generate a sufficient field in abdominal areas of difficult access. Complex visceral mobilization maneuvers derived from multivisceral transplantation organ procurement surgery provides ancillary techniques that used properly facilitate their successful resolution. The main purpose of this paper is the description of these surgical maneuvers essential to increase both exposure and vascular control in addressing the ever-dreaded high-volume retroperitoneal masses.

The role of the relatives in opt-in systems of postmortal organ procurement.

PubMed

den Hartogh, Govert

2012-05-01

In almost all opt-in systems of postmortal organ procurement, if the deceased has not made a decision about donation, his relatives will be asked to make it. Can this decision power be justified? I consider three possible justifications. (1) We could presume the deceased to have delegated this power to his relatives. (2) It could be argued that, if the deceased has not made a decision, a proxy decision has to be made in his best interests. (3) The relatives could have a standing of their own because they are singled out from the parties whose interests are being affected by the decision by the special relation they had to the deceased. None of these arguments turns out to be convincing.

Industrial application experiment series

NASA Technical Reports Server (NTRS)

Bluhm, S. A.

1981-01-01

Two procurements within the Industrial Application Experiment Series of the Thermal Power Systems Project are discussed. The first procurement, initiated in April 1980, resulted in an award to the Applied Concepts Corporation for the Capital Concrete Experiment: two Fresnel concentrating collectors will be evaluated in single-unit installations at the Jet Propulsion Laboratory Parabolic Dish Test Site and at Capitol Concrete Products, Topeka, Kansas. The second procurement, initiated in March 1981, is titled, "Thermal System Engineering Experiment B." The objective of the procurement is the rapid deployment of developed parabolic dish collectors.

Optimal Black Start Resource Allocation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Qiu, Feng; Wang, Jianhui; Chen, Chen

The restoration of the bulk power system after a partial or complete blackout relies on black-start (BS) resources. To prepare for system restoration, it is important to procure the right amount of BS resources at the right locations in the grid so that the total restoration time can be minimized. Achieving this goal requires that resource procurement planning takes the restoration process into account. In this study, we integrate the BS resource procurement decision with a restoration planning model and develop an optimization model that produces a minimal cost procurement plan that satisfies the restoration time requirement.

34 CFR 74.44 - Procurement procedures.

Code of Federal Regulations, 2013 CFR

2013-07-01

..., practice, and expression of its religious beliefs; (C) Use its facilities to provide services without... in the provision of program services on the basis of religion or religious belief. (6) A religious... private organization on the basis of the organization's religious character or affiliation. (2) The...

34 CFR 74.44 - Procurement procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., practice, and expression of its religious beliefs; (C) Use its facilities to provide services without... in the provision of program services on the basis of religion or religious belief. (6) A religious... private organization on the basis of the organization's religious character or affiliation. (2) The...

34 CFR 74.44 - Procurement procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

..., practice, and expression of its religious beliefs; (C) Use its facilities to provide services without... in the provision of program services on the basis of religion or religious belief. (6) A religious... private organization on the basis of the organization's religious character or affiliation. (2) The...

45 CFR 74.41 - Recipient responsibilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... concerning violation of statute are to be referred to such Federal, State or local authority as may have... ORGANIZATIONS, AND COMMERCIAL ORGANIZATIONS Post-Award Requirements Procurement Standards § 74.41 Recipient... responsibilities arising under its contract(s). The recipient is the responsible authority, without recourse to the...

Can the Brain-Dead Be Harmed or Wronged?: On the Moral Status of Brain Death and its Implications for Organ Transplantation.

PubMed

Nair-Collins, Michael

2017-01-01

The majority of transplantable human organs are retrieved from patients declared dead by neurological criteria, or "brain-dead." Since brain death is considered to be sufficient for death, the procurement of vital organs is not considered to harm or wrong such patients. In this essay I argue that this is not the case. After distinguishing welfare, experiential, and investment interests, and defining precedent autonomy and surviving interests, I argue that brain-dead patients can be, and many are, harmed and wronged by organ procurement as currently practiced. Indeed, with respect to precedent autonomy and surviving investment interests, the brain-dead are morally equivalent to patients with severe dementia, and thus can be harmed and wronged if and only if, and to the extent that, patients with severe dementia can. The "bright line" that separates brain death from all other conditions for clinical and legal purposes is not justified by any morally relevant distinctions.

A microcomputer-based transplantation registry.

PubMed

Anção, M S; Sesso, R; Draibe, S A; Sigulem, D

1996-01-01

We describe a microcomputer-based program developed for the Brazilian Kidney Transplant Registry. The system can construct life tables and survival curves online, without the need to export the database. From 1987 through 1993, 6069 kidney transplants were reported; 3485 (57.4%) were from living donors and 2584 from cadavers. The proportion of cadaveric transplants increased from 28.5% in 1987 to 58.1% in 1993. Overall kidney transplantation activity was 8.1 patients per million population per year. Sixty-four percent of the patients were male, and 71% were white. The mean age was 33.4 years. The primary renal diseases most frequently reported were glomerulonephritis (43.6%) and hypertensive renal disease (13.6%). Only 3.6% of the recipients were diabetic. Patient and graft survival rates have improved in recent years. We expect that cadaveric organ procurement programs will continue to develop in our country, increasing the number of organ transplantations and creating a more equal distribution of cadaveric organs.

Procurement performance measurement system in the health care industry.

PubMed

Kumar, Arun; Ozdamar, Linet; Ng, Chai Peng

2005-01-01

The rising operating cost of providing healthcare is of concern to health care providers. As such, measurement of procurement performance will enable competitive advantage and provide a framework for continuous improvement. The objective of this paper is to develop a procurement performance measurement system. The paper reviews the existing literature in procurement performance measurement to identify the key areas of purchasing performance. By studying the three components in the supply chain collectively with the resources, procedures and output, a model is been developed. Additionally, a balanced scorecard is proposed by establishing a set of generic measures and six perspectives. A case study conducted at the Singapore Hospital applies the conceptual model to describe the purchasing department and the activities within and outside the department. The results indicate that the material management department has already made a good start in measuring the procurement process through the implementation of the balanced scorecard. There are many data that are collected but not properly collated and utilized. Areas lacking measurement include cycle time of delivery, order processing time, effectiveness, efficiency and reliability. Though a lot of hard work was involved, the advantages of establishing a measurement system outweigh the costs and efforts involved in its implementation. Results of balanced scorecard measurements provide decision-makers with critical information on efficiency and effectiveness of the purchasing department's work. The measurement model developed could be used for any hospital procurement system.

7 CFR 1778.22 - Planning development and procurement.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 12 2010-01-01 2010-01-01 false Planning development and procurement. 1778.22 Section 1778.22 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) EMERGENCY AND IMMINENT COMMUNITY WATER ASSISTANCE GRANTS § 1778.22...

DOD-Wide Civilian Career Program for Procurement Personnel.

ERIC Educational Resources Information Center

Office of the Assistant Secretary of Defense for Manpower and Reserve Affairs (DOD), Washington, DC.

The manual, which supersedes the August 4, 1966 manual, is designed to aid in program improvement for career development and advancement opportunities of Department of Defense (DOD) civilian procurement personnel. Program elements covered include: career patterns, career counseling and appraisal, training and development, registration, referral…

Acquisition Regulations and Offshore Software Development: Implications for Cybersecurity of DOD Networks

DTIC Science & Technology

2013-02-14

Kessler, “Protection and Protectionism: The Practicalities of Offshore Software Devleopment in Government Procurement,” Public Contract Law Journal, Volume...Protection and Protectionism: The Practicalities of Offshore Software Development In Government Procurement,” Public Contract Law Journal, Volume 38, No. 1

Ship-Shore Packet Switched Communications System.

DTIC Science & Technology

1986-06-01

PERFORMING ORGANIZATION 6b OFFICE SYMBOL 7a. NAME OF MONITORING ORGANIZATION (If applicable ) Naval Postgraduate School 54 Naval Postgraduate School 6c...OFFICE SYMBOL 9 PROCUREMENT INSTRUMENT IDENTIFICATION NUMBER ORGANIZATION (If applicable ) 8c ADDRESS (City, State, and ZIPCode) 10 SOURCE OF FUNDING...level acknowledgement system. 37 Network Protocol Application P re sen tation Session ____ ____ ____ ___Internet TranportProtocol Network

Developing Statistical Models to Assess Transplant Outcomes Using National Registries: The Process in the United States.

PubMed

Snyder, Jon J; Salkowski, Nicholas; Kim, S Joseph; Zaun, David; Xiong, Hui; Israni, Ajay K; Kasiske, Bertram L

2016-02-01

Created by the US National Organ Transplant Act in 1984, the Scientific Registry of Transplant Recipients (SRTR) is obligated to publicly report data on transplant program and organ procurement organization performance in the United States. These reports include risk-adjusted assessments of graft and patient survival, and programs performing worse or better than expected are identified. The SRTR currently maintains 43 risk adjustment models for assessing posttransplant patient and graft survival and, in collaboration with the SRTR Technical Advisory Committee, has developed and implemented a new systematic process for model evaluation and revision. Patient cohorts for the risk adjustment models are identified, and single-organ and multiorgan transplants are defined, then each risk adjustment model is developed following a prespecified set of steps. Model performance is assessed, the model is refit to a more recent cohort before each evaluation cycle, and then it is applied to the evaluation cohort. The field of solid organ transplantation is unique in the breadth of the standardized data that are collected. These data allow for quality assessment across all transplant providers in the United States. A standardized process of risk model development using data from national registries may enhance the field.

49 CFR 700.2 - Organization and functioning of Amtrak.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., finance and treasurer, personnel, passenger and operating services, government affairs, operations and... presidents, such as corporate communications, safety, real estate, procurement, materials management, police...

SAC Act

THOMAS, 111th Congress

Rep. Scalise, Steve [R-LA-1

2009-09-15

House - 10/23/2009 Referred to the Subcommittee on Government Management, Organization, and Procurement. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Logan's Law

THOMAS, 111th Congress

Rep. Green, Gene [D-TX-29

2009-01-07

House - 02/24/2009 Referred to the Subcommittee on Government Management, Organization, and Procurement. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Outcomes of organ donation in brain-dead patient's families: Ethical perspective.

PubMed

Ahmadian, Shamsi; Rahimi, Abolfazl; Khaleghi, Ebrahim

2017-01-01

The families of brain-dead patients have a significant role in the process of decision making for organ donation. Organ donation is a traumatic experience. The ethical responsibility of healthcare systems respecting organ donation is far beyond the phase of decision making for donation. The principles of donation-related ethics require healthcare providers and organ procurement organizations to respect donor families and protect them against any probable harm. Given the difficult and traumatic nature of donation-related experience, understanding the outcomes of donation appears crucial. The aim of this study was to explore the outcomes of organ donation for the families of brain-dead patients. This was a qualitative descriptive study to which a purposeful sample of 19 donor family members were recruited. Data were collected through holding in-depth semi-structured interviews with the participants. Data analysis was performed by following the qualitative content analysis approach developed by Elo and Kyngäs. The main category of the data was "Decision to organ donation: a challenge from conflict to transcendence." This main category consisted of 10 subcategories and 3 general categories. The general categories were "challenging outcomes," "reassuring outcomes," and "transcending outcomes." Ethical considerations: The study was approved by the regional ethical review board. The ethical principles of informed consent, confidentiality, and non-identification were used. Donor families experience different challenges which range from conflict and doubtfulness to confidence, satisfaction, and transcendence. Healthcare providers and organ procurers should not discontinue care and support provision to donor families after obtaining their consent to donate because the post-decision phase is also associated with different complexities and difficulties with which donor families may not be able to cope effectively. In order to help donor families achieve positive outcomes from the tragedy of significant loss, healthcare professionals need to facilitate the process of achieving confidence and transcendence by them.

Measuring Acquisition Workforce Quality Through Dynamic Knowledge and Performance: An Exploratory Investigation to Interrelate Acquisition Knowledge With Process Maturity

DTIC Science & Technology

2014-04-30

PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Naval Postgraduate School,Graduate School of Business & Public Policy,555 Dyer Rd,Monterey,CA,93943 8...pÅÜççä= The research presented in this report was supported by the Acquisition Research Program of the Graduate School of Business & Public Policy at...big business . The U.S. Department of Defense (DoD) alone routinely executes 12-figure budgets for research, development, procurement, and support of