Spike, J
2001-01-01
Living organ donation will soon become the source of the majority of organs donations for transplant. Should mentally handicapped people be allowed to donate, or should they be considered a vulnerable group in need of protection? I discuss three cases of possible living organ donors who are developmentally disabled, from three different cultures, the United States, Germany, and India. I offer a brief discussion of three issues raised by the cases: (1) cultural diversity and cultural relativism; (2) autonomy, rationality, and self-interest; and (3) the proper use and role for clinical ethics consults.
A systematic review and meta-analysis of antecedents of blood donation behavior and intentions.
Bednall, Timothy C; Bove, Liliana L; Cheetham, Ali; Murray, Andrea L
2013-11-01
This meta-analysis sought to identify the strongest antecedents of blood donation behavior and intentions. It synthesized the results of 24 predictive correlational studies of donation behavior and 37 studies of donation intentions. The antecedents were grouped into six research programs: (1) the Theory of Planned Behavior (TPB) and its extensions, (2) prosocial motivation, (3) affective expectations, (4) donor site experience, (5) past donation behavior, and (6) donor demographics. Antecedent categories were cross-validated by multiple coders, and combined effect sizes were analyzed using a random-effects model. For donation behavior, medium positive associations were found with five of the constructs from the extended TPB: intentions to donate, perceived behavioral control, attitude toward donation, self-efficacy and donor role identity. Other antecedents displaying a positive association with donation behavior included anticipated regret for not donating, number of past donations and donor age. Donor experiences at the collection site in the form of temporary deferral or adverse reactions had a medium negative association with behavior. For donation intentions, strong positive associations were observed for perceived behavioral control, attitude, self-efficacy, role identity and anticipated regret. Medium positive associations were observed for personal moral norm, subjective norm, satisfaction, and service quality. All other potential antecedents had weak or non-significant associations with behavior and intentions. Several of these associations were moderated by between-study differences, including donor experience, the period of data collection in which donation behavior was observed, and the use of a nominal (yes/no return) versus a ratio measure of donation behavior. Collectively, the results underscore the importance of enhancing donors' attitudes towards donation and building their perceived behavioral control and self-efficacy to donate. Further, minimizing the risk of adverse reactions and enacting re-recruitment policies for temporarily deferred donors will help protect future donation behavior. Implications of these findings for blood collection agencies and researchers are discussed. Copyright © 2013 Elsevier Ltd. All rights reserved.
Tenza, E; Valero, R; Arraez, V
2017-04-01
To evaluate the number and characteristics of potential organ donors among cardiocirculatory death cases. A retrospective observational study was made of individuals between 15-65 years of age who died in the period 2006-2014 in Elche University General Hospital (Alicante, Spain). A univariate analysis and binary logistic regression predictive model were performed to discriminate factors related to donation contraindication. Identification of patients with donation contraindication. Of the 1510 patients who died in the mentioned period, 1048 were excluded due to the application of exclusion criteria; 86 due to evolution towards brain death; and 20 due to losses. A total of 356 patients were analyzed, divided into two groups: 288 in non-heart beating donation II and 68 in non-heart beating donation III. Seventy patients were found to be potential non-heart beating donation II and 10 were found to be potential non-heart beating donation III, which could increase donation activity by 8-9 donors a year. The patients died in the ICU, Resuscitation, Emergency Care, Internal Medicine, Digestive Diseases and Neurology. The following protective factors against organ donation contraindication were identified: death in Emergency Care, cardiorespiratory arrest before or during admission, and heart, respiratory and neurological disease as the cause of admission. Death in Internal Medicine was associated to an increased risk of donation contraindication. Implementing a non-heart beating donation protocol in our hospital could increase the donation potential by 8-9 donors a year. Copyright © 2016 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.
A practical Israeli strategy for appealing for organ donation.
Ashkenazi, Tamar; Klein, Moti
2013-06-01
CONTEXT-Most reports on organ donation have been related to the importance of support for families, explanations of brain death, and the appeal for organ donation. In contrast, no reports have addressed organ donation from the perspective of intervention in cases of "sudden mourning" and the practical aspects of how to facilitate donation in such cases. OBJECTIVE-To develop a specific strategy for professional intervention in cases of imminent death to bring the family to a state of cognitive and emotional preparedness that will enable them to accept the tragic news, donate organs, and then take leave of the deceased. METHOD-The strategy presented here was developed on the basis of the records of donor coordinators who documented their interaction with families; consultations with professionals in the fields of marketing, persuasion, and negotiating; research conducted on families who did or did not donate organs; and statements made by family members of donors in focus and support groups in more than 10 years. RESULTS-The strategic approach includes early-stage rules such as staff self-awareness, and then later, critical stages of the process that take place before and at the time of determination of brain death: preparation for and the notification of death itself and the request for organ donation, including persuasion skills, coping with resistance and expressions of anger, and physical leave-taking from the deceased. CONCLUSIONS-The flexible, strategic approach set out here is designed to maximize the chances of procuring organ donation while protecting the family's rights and welfare.
Testa, Giuliano; Siegler, Mark
2014-12-01
At the present time, increasing the use of living donors offers the best solution to the organ shortage problem. The clinical questions raised when the first living donor kidney transplant was performed, involving donor risk, informed consent, donor protection, and organ quality, have been largely answered. We strongly encourage a wider utilization of living donation and recommend that living donation, rather than deceased donation, become the first choice for kidney transplantation. We believe that it is ethically sound to have living kidney donation as the primary source for organs when the mortality and morbidity risks to the donor are known and kept extremely low, when the donor is properly informed and protected from coercion, and when accepted national and local guidelines for living donation are followed.
Effect of electron donating groups on polyphenol-based antioxidant dendrimers.
Lee, Choon Young; Nanah, Cyprien N; Held, Rich A; Clark, Amanda R; Huynh, Uyen G T; Maraskine, Marina C; Uzarski, Rebecca L; McCracken, John; Sharma, Ajit
2015-04-01
Numerous studies have reported the beneficial effects of antioxidants in human diseases. Among their biological effects, a majority of antioxidants scavenge reactive radicals in the body, thereby reducing oxidative stress that is associated with the pathogenesis of many diseases. Antioxidant dendrimers are a new class of potent antioxidant compounds reported recently. In this study, six polyphenol-based antioxidant dendrimers with or without electron donating groups (methoxy group) were synthesized in order to elucidate the influence of electron donating groups (EDG) on their antioxidant activities. Syringaldehyde (2 ortho methoxy groups), vanillin (1 ortho methoxy group), and 4-hydroxybenzaldehyde (0 methoxy group) were derivatized with propargylamine to form building blocks for the dendrimers. All the six dendrimers contain polyether cores, which were synthesized by attaching pentaerythritol and methyl α-d-glucopyranoside to in-house prepared spacer units. To prepare generation 1 antioxidant dendrimers, microwave energy and granulated metallic copper catalyst were used to link the cores and building blocks together via alkyne-azide 1,3-cycloaddition click chemistry. These reaction conditions resulted in high yields of the target dendrimers that were free from copper contamination. Based on DPPH antioxidant assay, antioxidant dendrimers decorated with syringaldehyde and vanillin exhibited over 70- and 170-fold increase in antioxidant activity compared to syringaldehyde and vanillin, respectively. The antioxidant activity of dendrimers increased with increasing number of EDG groups. Similar results were obtained when the dendrimers were used to protect DNA and human LDL against organic carbon and nitrogen-based free radicals. In addition, the antioxidant dendrimers did not show any pro-oxidant activity on DNA in the presence of physiological amounts of copper. Although the dendrimers showed potent antioxidant activities against carbon and nitrogen free radicals, EPR and DNA protection studies revealed lack of effectiveness of these dendrimers against hydroxyl radicals. The dendrimers were not cytotoxic to CHO-K1 cells. Copyright © 2015 Elsevier B.V. and Société Française de Biochimie et Biologie Moléculaire (SFBBM). All rights reserved.
Changes in pre- and post-donation platelet function in plateletpheresis donors.
Zhou, Q; Yu, X; Cai, Y; Liu, L
2017-11-01
This study aimed to investigate the changes of platelet (PLT) function and coagulation time before and after plateletpheresis donation. The healthy donors were divided into four groups according to the annual number of plateletpheresis donation: 20 times group, 15 times group, 10 times group and 5 times group. The healthy non-blood donors were selected as controls. The donation interval was 14 days. The blood samples were collected before plateletpheresis donation and after 30min, 7 d, and 14 d of donation for determination of coagulation time, PLT function, plasma protein, serum iron and blood routine change. After 30min of plateletpheresis donation, the PLT function decreased and the coagulation time was prolonged. However, PLT function recovered to the pre-collection after 7 d of plateletpheresis donation and coagulation time recovered to the pre-collection after 14 d of plateletpheresis donation. Additionally, there was no difference regarding blood coagulation time and PLT function among blood donors and controls. The plasma protein and serum iron levels in 20 times and 15 times groups were within the normal reference range. The frequency of plateletpheresis donation will not affect PLT function, coagulation time, plasma protein and serum iron in donors. Copyright © 2017 Elsevier Masson SAS. All rights reserved.
Brailsford, S R; Kelly, D; Kohli, H; Slowther, A; Watkins, N A
2015-08-01
An important element in the development of voluntary blood donation schemes throughout the world has been the attention given to minimising the risk to recipients of donated blood, primarily the risk of transfusion transmitted infections. In response to the appearance of human immunodeficiency virus (HIV) in the 1980s a range of national policies emerged that excluded populations at high risk of contracting HIV from donating blood, with a particular focus on men who have sex with men (MSM), the primary reason being the protection of recipients of donated blood. Recently some countries, including the UK, have revised their policies, informed by advances in screening tests, epidemiological evidence of transmission rates and an increasing concern about unfair discrimination of specific groups in society. Policy makers face a difficult task of balancing safety of recipients; an adequate blood supply for those who require transfusion; and societal/legal obligations to treat everyone fairly. Given that no transfusion is risk free, the question is what degree of risk is acceptable in order to meet the needs of recipients and society. Decisions about acceptance of risk are complex and policy makers who set acceptable risk levels must provide ethically justifiable reasons for their decisions. We suggest it is possible to provide a set of reasons that stakeholders could agree are relevant based on careful evaluation of the evidence of all relevant risks and explicit acknowledgement of other morally relevant values. We describe using such a process in the Safety of Blood Tissue and Organs (SaBTO) review of donor deferral criteria related to sexual behaviour. © 2015 British Blood Transfusion Society.
Pierre, Leif; Lindstedt, Sandra; Ingemansson, Richard
2016-11-01
The use of donation after cardiac death (DCD) to overcome organ shortage is slowly moving into the clinic. In this study, we compare the protective effect of warm ischaemia versus cold ischaemia on thrombotic formation in non-heparinized pulmonary grafts. Twelve Landrace pigs were randomized into two groups: warm ischaemia and cold ischaemia. Ventricular fibrillation without the administration of heparin was induced to mimick an uncontrolled DCD situation. The animals were then exposed to either 1 h of cold ischaemia (insertion of drain and installation of cold fluid in the pleuras) or warm ischaemia (body temperature). After 1 h, the pulmonary artery was opened and the pulmonary arterial branches were then macroscopically studied for thrombotic material. After 60 min, the temperature was 36.6 ± 0.0°C in the warm ischaemic group and 14.6 ± 0.1°C in the cold ischaemic group (P < 0.001). In the warm ischaemic group, no thrombotic material could be found in the pulmonary artery in the animals examined and in the cold ischaemic group 6.8 ± 0.2 ml thrombotic material was found in the pulmonary artery (P < 0.001). In the warm ischaemic group, no thrombotic material could be found in the arterial branches of the pulmonary artery and in the cold ischaemic group 2.3 ± 0.1 ml thrombotic material was found in the arterial branches of the pulmonary artery (P < 0.001). Warm ischaemia rather than cold ischaemia seems to protect the pulmonary graft from thrombosis in uncontrolled non-heparinized DCD pigs. © The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
Donors' blood group declaration before donation can be used as a tool for electronic crossmatching.
Arslan, O
2005-12-01
Electronic crossmatching (E-XM) is used to detect ABO incompatibility. In developing countries, as many of the donations are from first-time donors, it is difficult to guarantee the accuracy of the ABO/Rh label on these units to use them for E-XM. This problem was overcome with a new software 'hemosoft', using donors' blood group declaration before donation as a tool for E-XM. During registration, donors either declare their blood group or give no comment. For, ABO/Rh grouping, either two results from different donations or only one in concordant with the declaration before donation is needed. If there is a conflict, second typing is performed from the unit segment. If donors give no declaration, two different technicians perform typing, one from the sample tube and the other from the unit segment. Of 18,618 donations performed, 640 (3%) were repeated and the rest were first-time donations. In 16,327, typing was performed once, as the blood group declaration and the typing results were identical. In 2407, grouping was performed twice, as donors gave no declaration or conflicts between declaration and typing results were found. No labelling or wrong unit-release errors were detected in units donated, typed and labelled in our centre. In 26,402 donations, 16,314 (61.8%) E-XMs were performed. No major haemolytic transfusion reaction was recorded. Donors' ABO/Rh declaration before donation can be used as a tool for E-XM, instead of the requirement for serological confirmation or a second donation to guarantee grouping.
Wong, L P
2010-06-01
In-depth understanding of cultural and religious factors limiting organ donation of three ethnic populations (Malay, Chinese, and Indian) in Southeast Asia is lacking. Identification of factors limiting organ donation among these three ethnic groups will provide insights into culturally appropriate strategies to promote acceptance of organ donation in a multiethnic Asian community. A total of 17 focus group discussions (105 participants) were conducted between September and December 2008. Participants were members of the general public aged 18 to 60 years, recruited through convenient sampling around the Klang Valley area of Malaysia. Although the majority had favorable attitudes toward deceased organ donation and transplantation, a diversity of myths and misinformation were unearthed from the discussions across the ethnic groups. These include perceived religious prohibition, cultural myths and misperceptions, fear of disfigurement, fear of surgery, distrust of the medical system, and family disapproval. Culture and religious beliefs played important prohibitive roles among those opposed to organ donations. There were distinctive ethnic differences in cultural and religious concerns regarding organ donation. Less-educated and rural groups appeared to have more misconceptions than the well-educated and the urban groups. Our findings may assist organ donation and transplantation organizations to reach diverse sociodemographic and ethnic communities with culture-specific information about organ donation. The involvement of community and religious leaders is critical in organ donation requests.
Iron balance in the red blood cell donor.
Brittenham, G M
2005-01-01
Phlebotomy of a unit of blood produces a loss of 200 to 250 mg of iron in haemoglobin. Because of physiological differences in iron balance between women of childbearing age and men, the loss of similar amounts of iron at donation has divergent consequences for committed donors. Women of childbearing age have an increased risk of iron deficiency if they donate more than one unit per year while men are usually able to maintain iron balance while donating four or more units of blood per year. Lack of iron is the most important medical reason for deferral from repeat donation and primarily affects women of childbearing age. Deferral of these women discourages them from further donation and may lead to their loss as donors. Provisions for blood donation should protect those who give blood from adverse consequences of their altruism. Safe and effective approaches to iron replacement after donation have been developed that can prevent iron deficiency in women who give blood repeatedly. Blood centres should consider incorporating programmes of iron replacement for women of childbearing age who give blood repeatedly to protect these donors against iron deficiency and to enhance their retention and commitment as dedicated donors.
Financial Burden Associated with Time to Return to Work After Living Kidney Donation.
Larson, Dawn B; Wiseman, Jennifer F; Vock, David; Bergund, Danielle M; Roman, Ashley; Ibrahim, Hassan Nimer; Matas, Arthur J
2018-05-25
Many living kidney donors undertake a significant financial burden in order to donate. We studied the association between time to return to work and reported financial burden. Kidney donors, who donated from 2/2005 - through 12/2015 (n=1012) were surveyed 6 months postdonation, and asked about occupation; time to return to work; and financial burden (on a 10-point Likert scale). Of 856 donors working for pay, 629 (73%) responded. After adjusting for donor characteristics, increased length of time to return to work was a significant predictor of financial burden (p<0.001). Importantly, those in manual/skilled trade occupations, compared with all other occupations, experienced greater financial burden for each week away from work (p=0.003). Older age at donation and nondirected (vs directed) donation were associated with significantly decreased financial burden. These observations provide additional information to better inform donor candidates, and further emphasize the need to develop policies so that living kidney donation can be financially neutral. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
Bou Monsef, Jad; Buckup, Johannes; Mayman, David; Marx, Robert; Ranawat, Amar; Boettner, Friedrich
2013-10-01
Preoperative donation of autologous blood has been widely used to minimize the potential risk of allogeneic transfusions in total knee arthroplasty. A previous study from our center revealed that preoperative autologous donation reduces the allogeneic blood exposure for anemic patients but has no effect for non-anemic patients. The current study investigates the impact of a targeted blood donation protocol on overall transfusion rates and the incidence of allogeneic blood transfusions. Prospectively, 372 patients undergoing 425 unilateral primary knee replacements were preoperatively screened by the Blood Preservation Center between 2009 and 2012. Anemic patients with a hemoglobin level less than 13.5 g/dL were advised to donate blood, while non-anemic patients did not donate. Non-anemic patients who did not donate blood required allogeneic blood transfusions in 5.9% of the patients. The overall rate of allogeneic transfusion was significantly lower for anemic patients who donated autologous blood (group A, 9%) than those who did not donate (group B, 33%; p < 0.001). Donating autologous blood did increase the overall transfusion rate of anemic patients to 0.84 per patient in group A compared to 0.41 per patient in group B (p < 0.001). This investigation confirms that abandoning preoperative autologous blood donation for non-anemic patients does not increase allogeneic blood transfusion rates but significantly lowers overall transfusion rates.
Mathew, Sunitha M; King, Melissa R; Glynn, Simone A; Dietz, Stephen K; Caswell, Scott L; Schreiber, George B
2007-04-01
Understanding what prevents people from ever donating blood, or having donated, what influenced them to stop, are both equally important in devising recruitment strategies. Enlisting new donors and encouraging previous donors to return are vital to increasing collections. Six racially homogeneous focus groups of never donors and lapsed donors were conducted. Both sexes and a range of age groups were represented. The importance of blood donation as a volunteer activity, deterrents, motivations, awareness of need, and effective recruitment messages were topics discussed. Never donors do not see blood donation as an important volunteer activity on par with others like volunteering at hospitals, schools, and support groups. Fear and inconvenience were major barriers to donating. Better education campaigns to allay fears about donating and workplace drives were considered important motivators. Participants were unaware of the need for blood. Media messages that combine safety of the process along with who it benefits were considered most effective. Messages that target the specific needs of minority communities were considered good motivators for their recruitment. Blood collection agencies should increase awareness that blood donation is a worthwhile and important volunteer activity. Another strategy would be to capitalize on the existing perception that donating blood is like donating money or used clothing, by focusing on the concept of giving something tangible. Along with providing convenient opportunities to donate, blood centers need to effectively convey the need for blood and allay fears about the donation process to increase the current donor pool.
An Adapted Post-Donation Motivational Interview Enhances Blood Donor Retention
Sinclair, Kadian S.; Campbell, Tavis S.; Carey, Patricia M.; Langevin, Eric; Bowser, Brent; France, Christopher R.
2010-01-01
Background Blood donors may hold conflicting thoughts about future donation. While they may perceive the direct benefit to themselves and others, they often report compelling reasons not to give again. As a result the standard encouragements to return may not be sufficient to motivate some donors. The present study examined the effects of a post-donation adapted motivational interview on blood donor attitudes and repeat donation behavior. Study Design and Methods Donors (n=215) were randomly assigned to either an adapted motivational interview (AMI) or a no-interview control group. Approximately one month after their index donation, donors in the AMI group completed a brief telephone interview to clarify individual-specific motivations and values concerning blood donation and address potential barriers. They were then asked to complete questionnaires regarding donation attitudes, anxiety, self-efficacy and intention to donate. Donors in the control group were also contacted one month post-donation and asked to complete the same series of questionnaires. Results Donors in the AMI group reported greater intention to provide a future donation, F = 8.13, p < 0.05, more positive donation attitudes, F = 4.59, p < 0.05, and greater confidence in their ability to avoid adverse reactions, F = 10.26, p < 0.01. Further, AMI was associated with higher rates of attempted donation at 12 months (OR, 2.48; 95% CI, 1.27–4.87). Conclusion Application of an adapted motivational interview may be an effective strategy to increase the donor pool by enhancing retention of existing donors. PMID:20456674
Ralph, Angelique F; Alyami, Ali; Allen, Richard D M; Howard, Kirsten; Craig, Jonathan C; Chadban, Steve J; Irving, Michelle; Tong, Allison
2016-01-19
To describe the beliefs and attitudes to organ donation in the Arabic-speaking community. Arabic-speaking participants were purposively recruited to participate in 6 focus groups. Transcripts were analysed thematically. 53 participants, aged 19-77 years, and originating from 8 countries, participated in 1 of 6 focus groups. Participants identified as Christian (73%), Islam (26%), Buddhist (2%) or did not identify with any religion (2%). 6 themes (with subthemes) were identified; religious conviction; invisibility of organ donation; medical suspicion; owning the decision; and reciprocal benefit. Although organ donation is considered a generous life-saving 'gift', representative members of the Arabic-speaking community in Australia were unfamiliar with, unnerved by and sceptical about the donation process. Making positive decisions about organ donation would likely require resolving tensions between respecting family, community and religious values versus their individual autonomy. Providing targeted education about the process and benefits of organ donation within the Arabic community may clarify ambiguities surrounding cultural and religious-based views on organ donation, reduce taboos and suspicion towards donation, and in turn, lead to increased organ donation rates. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Qu, Haiyan; Shewchuk, Richard; Mannon, Roslyn B.; Gaston, Robert; Segev, Dorry L.; Mannon, Elinor C.; Martin, Michelle Y.
2015-01-01
Background and objectives African Americans are disproportionately affected by ESRD, but few receive a living donor kidney transplant. Surveys assessing attitudes toward donation have shown that African Americans are less likely to express a willingness to donate their own organs. Studies aimed at understanding factors that may facilitate the willingness of African Americans to become organ donors are needed. Design, setting, participants, & measurements A novel formative research method was used (the nominal group technique) to identify and prioritize strategies for facilitating increases in organ donation among church-attending African Americans. Four nominal group technique panel interviews were convened (three community and one clergy). Each community panel represented a distinct local church; the clergy panel represented five distinct faith-based denominations. Before nominal group technique interviews, participants completed a questionnaire that assessed willingness to become a donor; 28 African-American adults (≥19 years old) participated in the study. Results In total, 66.7% of participants identified knowledge- or education-related strategies as most important strategies in facilitating willingness to become an organ donor, a view that was even more pronounced among clergy. Three of four nominal group technique panels rated a knowledge-based strategy as the most important and included strategies, such as information on donor involvement and donation-related risks; 29.6% of participants indicated that they disagreed with deceased donation, and 37% of participants disagreed with living donation. Community participants’ reservations about becoming an organ donor were similar for living (38.1%) and deceased (33.4%) donation; in contrast, clergy participants were more likely to express reservations about living donation (33.3% versus 16.7%). Conclusions These data indicate a greater opposition to living donation compared with donation after one’s death among African Americans and suggest that improving knowledge about organ donation, particularly with regard to donor involvement and donation-related risks, may facilitate increases in organ donation. Existing educational campaigns may fall short of meeting information needs of African Americans. PMID:25635038
Locke, Jayme E; Qu, Haiyan; Shewchuk, Richard; Mannon, Roslyn B; Gaston, Robert; Segev, Dorry L; Mannon, Elinor C; Martin, Michelle Y
2015-02-06
African Americans are disproportionately affected by ESRD, but few receive a living donor kidney transplant. Surveys assessing attitudes toward donation have shown that African Americans are less likely to express a willingness to donate their own organs. Studies aimed at understanding factors that may facilitate the willingness of African Americans to become organ donors are needed. A novel formative research method was used (the nominal group technique) to identify and prioritize strategies for facilitating increases in organ donation among church-attending African Americans. Four nominal group technique panel interviews were convened (three community and one clergy). Each community panel represented a distinct local church; the clergy panel represented five distinct faith-based denominations. Before nominal group technique interviews, participants completed a questionnaire that assessed willingness to become a donor; 28 African-American adults (≥19 years old) participated in the study. In total, 66.7% of participants identified knowledge- or education-related strategies as most important strategies in facilitating willingness to become an organ donor, a view that was even more pronounced among clergy. Three of four nominal group technique panels rated a knowledge-based strategy as the most important and included strategies, such as information on donor involvement and donation-related risks; 29.6% of participants indicated that they disagreed with deceased donation, and 37% of participants disagreed with living donation. Community participants' reservations about becoming an organ donor were similar for living (38.1%) and deceased (33.4%) donation; in contrast, clergy participants were more likely to express reservations about living donation (33.3% versus 16.7%). These data indicate a greater opposition to living donation compared with donation after one's death among African Americans and suggest that improving knowledge about organ donation, particularly with regard to donor involvement and donation-related risks, may facilitate increases in organ donation. Existing educational campaigns may fall short of meeting information needs of African Americans. Copyright © 2015 by the American Society of Nephrology.
The effect of repeated blood donations on the iron status of male Saudi blood donors
Abdullah, Saleh M.
2011-01-01
Background. Regular blood donation can lead to iron deficiency. Screening donors’ serum ferritin levels at the time of first donation and subsequently once every year is a very rational way to pick up iron deficiency in a voluntary blood donor population. The aim of this study was to determine the effect of blood donation and the prevalence of erythropoiesis with iron deficiency (sideropenia) in Saudi male blood donors. Materials and methods. The study was prospectively conducted, between December 2008 and March 2009, on 182 male native Saudi blood donors at King Fahd Central Hospital in Jazan region, Saudi Arabia. Each donor gave 450±50 mL of whole blood. Following the donation, samples were removed into 2.5 mL EDTA tubes for measurement of mean cell volume (MCV) and mean corpuscular haemoglobin (MCH) and into 7.5 mL plain tubes for estimation of iron and serum ferritin concentrations. The blood donors were divided into five groups, according to the number of donations they had given in the preceding 3 years. The blood donors in group I were first-time donors, with no previous history of blood donation. Group II donors had donated once in the last 3 years. Subjects in groups III, IV and V had donated more than once in the preceding 3 years and were considered regular donors. Results. The mean serum iron was significantly higher among subjects with no previous history of blood donation (group I) than among regular donors who had donated twice or more. The difference in serum ferritin concentration was statistically significant (p<0.05) when comparing regular donors in group III (72.4 μg/L), group IV (67.4 μg/L) and group V (26.2 μg/L) with first-time blood donors (131.4 μg/L). In contrast, the difference in the concentration of serum ferritin between subjects in group II (98.9 μg/L), who had donated once in the last 3 years, and in first-time blood donors (131.4 μg/L) was not statistically significant (p<0.131). None of the group I donors suffered from iron deficiency, whereas 2.8% of the donors who had donated between two to five times had iron deficiency. The prevalence of erythropoiesis with iron deficiency in regular blood donors was 4.3%. Conclusion. The results of this study show that an increase in the number of donations results in an increase in the frequency of depleted iron stores and subsequently in erythropoiesis with iron deficiency, although the level of haemoglobin remained acceptable for blood donation. This result may indicate the need to review the guidelines on acceptance of donors. PMID:21084007
Mamatya, A; Prajapati, R; Yadav, R
2012-12-01
College students form a large and important group of population eligible for blood donation. Studies report that students do not donate much, and medical students' blood donation rate is less as compared to non-medical students. To assess and compare the knowledge, attitude, and practice of blood donation among medical and non-medical Nepalese students. A cross-sectional descriptive study using structured self-administered questionnaire was conducted in students of medical (MBBS) and non-medical programs of different colleges of Nepal. Total 456 students, 177 non-medical and 279 medical, participated; 28.5% students were donors. More medical students donated blood, more often, and were more knowledgeable in all aspects of blood and blood donation related knowledge (p values 0.01 or less). In both groups, proportionately more boys donated than girls. Common reasons for not donating included no request, medically unfit, no information about blood collection services, fear of weakness, and fear related to venepuncture. Moral satisfaction was the commonest reason to donate. Among Nepalese students, medical students donate more and are more knowledgeable than non-medical students. Lack of information and lack of direct requests are important causes of fewer donors in the non-medical group and girls.
Religion and organ donation: the views of UK faith leaders.
Randhawa, Gurch; Brocklehurst, Anna; Pateman, Ruth; Kinsella, Suzannah; Parry, Vivienne
2012-09-01
This article reports the findings from the one-to-one interviews with the main UK faith and belief leaders which were commissioned by the Organ Donation Taskforce as part of its evidence gathering. Interviews were arranged with the main faith and belief organisations within the UK. Interviews covered a range of issues related to organ donation. Although some faith groups had some reservations regarding organ donation, interviews with these leaders demonstrated that none of these faith groups have reached a consensus against organ donation. The interviewees stated that the majority opinion in their faith or belief group is to permit organ donation, with some actively supporting it. Interviewees were keen to stress that there is a broad spectrum of opinion on organ transplantation within each faith and belief group and that consequently it is difficult to speak on behalf of an entire group. One complication mentioned by interviewees is that as organ transplantation is a relatively new medical procedure, there is no explicit reference to it in many original religious texts. Consequently, positions on the receipt and donation of organs are based on interpretation. It was felt that a much greater level of engagement is needed, as organ donation is currently not a priority for many faith and belief groups.
BLISS: A Computer Program for the Protection of Blood Donors
1982-06-28
EXAMPLE 5 LIST OUTPUT -OC: I L. SECU F I T NO.: 111-11-1111 NAME: ALFRED RENTA NO. OF DONATIONS: 4 VDISK; 1 DONATION NO. : 1 DATE: 81-13-81 METHOD OF...DISK # I N-.’ SOCIAL SECURITY NO.: 111-11-1111 NAME: ALFRED RENTA .,, DONATION DATE: 04-23-81 -p SOCIAL SECURITY NO.: 222-22-2222 NAME: MILO BENDER
ERIC Educational Resources Information Center
Small, Deborah A.; Loewenstein, George; Slovic, Paul
2007-01-01
When donating to charitable causes, people do not value lives consistently. Money is often concentrated on a single victim even though more people would be helped, if resources were dispersed or spent protecting future victims. We examine the impact of deliberating about donation decisions on generosity. In a series of field experiments, we show…
Ralph, Angelique F; Alyami, Ali; Allen, Richard D M; Howard, Kirsten; Craig, Jonathan C; Chadban, Steve J; Irving, Michelle; Tong, Allison
2016-01-01
Objectives To describe the beliefs and attitudes to organ donation in the Arabic-speaking community. Design Arabic-speaking participants were purposively recruited to participate in 6 focus groups. Transcripts were analysed thematically. Participants 53 participants, aged 19–77 years, and originating from 8 countries, participated in 1 of 6 focus groups. Participants identified as Christian (73%), Islam (26%), Buddhist (2%) or did not identify with any religion (2%). Results 6 themes (with subthemes) were identified; religious conviction; invisibility of organ donation; medical suspicion; owning the decision; and reciprocal benefit. Conclusions Although organ donation is considered a generous life-saving ‘gift’, representative members of the Arabic-speaking community in Australia were unfamiliar with, unnerved by and sceptical about the donation process. Making positive decisions about organ donation would likely require resolving tensions between respecting family, community and religious values versus their individual autonomy. Providing targeted education about the process and benefits of organ donation within the Arabic community may clarify ambiguities surrounding cultural and religious-based views on organ donation, reduce taboos and suspicion towards donation, and in turn, lead to increased organ donation rates. PMID:26787253
Regioselective copper-catalyzed N(1)-(hetero)arylation of protected histidine.
Sharma, Krishna K; Mandloi, Meenakshi; Jain, Rahul
2016-09-26
We report regioselective N(1)-arylation of protected histidine using copper(i) iodide as a catalyst, trans-N,N'-dimethylcyclohexane-1,2-diamine as a ligand and readily available aryl iodides as coupling partners under microwave irradiation at 130 °C for 40 min. The reaction provides rapid access to electron-donating, electron-withdrawing and bulky group substituted N-arylated histidines in high yields, including previously inaccessible N-heteroaryl histidines. These N(1)-(hetero)aryl histidines are promising building blocks in peptide-based drug design and discovery.
The Effect of Standardized Interviews on Organ Donation.
Corman Dincer, Pelin; Birtan, Deniz; Arslantas, Mustafa Kemal; Tore Altun, Gulbin; Ayanoglu, Hilmi Omer
2018-03-01
Organ donation is the most important stage for organ transplant. Studies reveal that attitudes of families of brain-dead patients toward donation play a significant role in their decision. We hypothesized that supporting family awareness about the meaning of organ donation, including saving lives while losing a loved one, combined with being informed about brain death and the donation process must be maintained by intensive care unit physicians through standardized interviews and questionnaires to increase the donation rate. We retrospectively evaluated the final decisions of families of 52 brain-dead donors treated at our institution between 2014 and 2017. Data underwent descriptive analyses. The standard interview content was generated after literature search results were reviewed by the authors. Previously, we examined the impact of standardized interviews done by intensive care unit physicians with relatives of potential brain-dead donors regarding decisions to donate or reasons for refusing organ donation. After termination of that study, interviews were done according to the intensivist's orientation, resulting in significantly decreased donation rates. Standardized interviews were then started again, resulting in increased donation rates. Of 17 families who participated in standardized interviews, 5 families (29.4%) agreed to donate organs of their brain-dead relatives. In the other group of families, intensivists governed informing the families of donation without standardized interviews. In this group of 35 families, 5 families (14.3%) approved organ donation. The decision regarding whether to agree to organ donation was statistically different between the 2 family groups (P < .05). Conducting a standard interview between relatives of brain-dead donors and the intensivists, facilitating visits between relatives and the brain-dead patients, and informing relatives about the donation process resulted in an increased rate of organ donation compared with routine protocols.
Hyde, Melissa K; Knowles, Simon R; White, Katherine M
2013-12-01
Due to the critical shortage and continued need of blood and organ donations (ODs), research exploring similarities and differences in the motivational determinants of these behaviors is needed. In a sample of 258 university students, we used a cross-sectional design to test the utility of an extended theory of planned behavior (TPB) including moral norm, self-identity and in-group altruism (family/close friends and ethnic group), to predict people's blood and OD intentions. Overall, the extended TPB explained 77.0% and 74.6% of variance in blood and OD intentions, respectively. In regression analyses, common contributors to intentions across donation contexts were attitude, self-efficacy and self-identity. Normative influences varied with subjective norm as a significant predictor related to OD intentions but not blood donation intentions at the final step of regression analyses. Moral norm did not contribute significantly to blood or OD intentions. In-group altruism (family/close friends) was significantly related to OD intentions only in regressions. Future donation strategies should increase confidence to donate, foster a perception of self as the type of person who donates blood and/or organs, and address preferences to donate organs to in-group members only.
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Hyperprolactinemia (Prolactin Excess)
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Aldridge, Alicia; Guy, Bonnie; Roggenkamp, Susan
2003-01-01
This article presents a theoretical analysis of attitude formation and the relationship to stated behavioral intentions as it relates to the decision to donate organs. This analysis reveals the presence of three distinct paths to behavior of potential donors, groups differing in their involvement with organ donation. Promotional objectives and campaign strategies designed to influence attitudes and behaviors should differ according to the behavioral path in operation and the involvement of the audience. Mass media campaigns are likely to reach high involvement groups only. Therefore, personal selling, underutilized in previous donation campaigns, should be brought into the donation strategy to appeal to low involvement groups. By recognizing differences in audience involvement and implementing different strategies, overall donation rates could substantially increase.
Ozer, A; Ekerbicer, H C; Celik, M; Nacar, M
2010-11-01
To establish the knowledge, attitudes, and behaviors of the officials of religion, a group with potentially powerful influence on the society, in particular regarding organ donation. This study, performed in Kahramanmaras Province, Turkey, included 416 of 641 officials of religion (64.9%): 295 of 492 imams (59.9%) and 121 of 149 Koran course educators (81.2%). The mean (SD) age of the study group was 37.2 (8.2) years. Only 1.4% had stated that carried organ donation cards. Of participants who had not donated organs asked whether they thought of donation, 14.1% answered yes, 17.1% answered no, and 68.8% were undecided. Of the study group, 88.2% considered organ donation appropriate according to their religion. The imams compared with Koran course educators, and men compared with women demonstrated higher rates of considering organ donation appropriate according to their religion (P < .05). Among participants who stated they had knowledge about organ donation, the 3 leading information sources were television, newspapers or journals, and in-service training by the Directorate of Religious Affairs. The 3 primary organs the study group stated they were aware of being transplanted were kidneys, liver, and heart. Although 88.2% of religious officials in the present study stated that organ donation was appropriate according to their religion, only 1.4% agreed to donate organs. Officials of religion hold an important place in society, and should be well informed and educated about organ donation via in-service training courses, and encourage organ donation by members of society. Copyright © 2010 Elsevier Inc. All rights reserved.
Medications for Inducing Ovulation
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Intracytoplasmic Sperm Injection (ICSI)
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Sexual Dysfunction and Infertility
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Hao, Jian
2017-01-01
Inhibitory control may play an important part in prosocial behavior, such as donating behavior. However, it is not clear at what developmental stage inhibitory control becomes associated with donating behavior and which aspects of inhibitory control are related to donating behavior during development in early to middle childhood. The present study aimed to clarify these issues with two experiments. In Experiment 1, 103 3- to 5-year-old preschoolers completed cool (Stroop-like) and hot (delay of gratification) inhibitory control tasks and a donating task. The results indicated that there were no relationships between cool or hot inhibitory control and donating behavior in the whole group and each age group of the preschoolers. In Experiment 2, 140 elementary school children in Grades 2, 4, and 6 completed cool (Stroop-like) and hot (delay of gratification) inhibitory control tasks and a donating task. The results showed that inhibitory control was positively associated with donating behavior in the whole group. Cool and hot inhibitory control respectively predicted donating behavior in the second and sixth graders. Therefore, the present study reveals that donating behavior increasingly relies on specific inhibitory control, i.e., hot inhibitory control as children grow in middle childhood.
The role of women in the donation consent decision: building on previous research.
Dodd-McCue, Diane; Tartaglia, Alexander; Cowherd, Robin
2007-09-01
Recently published findings emphasize the dominant role of women in the donation discussion. With some noteworthy exceptions, the empirical literature on gender and donation, and the role of gender in healthcare decisions as well as donation, is limited. To provide preliminary information needed to begin theoretical or framework development and to initiate more rigorous research on the role of gender in donation discussions. This exploratory study is a descriptive qualitative retrospective study using focus group methodology. Two focus groups were conducted in 2 major cities in the organ procurement organization's service area. Participants were women who were involved in the donation discussion within the past 5 years; 6 participated in 1 session, 8 in the other. The focus group discussions highlight the role of women in the donation process relative to information needs, information usage, and the ensuring dynamics of the donation discussion. Compared to men, women tend to seek more information and reframe this information for others. Because women are frequently central in family communication networks, they serve as a communication conduit for other family members and may influence others. Involving key women decision makers in the early stages of the donation discussion and providing information elaboration build on women's central placement and role in family communication network processes. The significance of women's central placement may carry cultural implications, particularly for racial or ethnic groups with strong matriarchal or extended kinship structures.
[Lack of donor organs as an argument for living donors?].
Kirste, G
2010-09-01
In Germany more than 12,000 patients are presently waiting for an organ donation. Living donation makes sense for the long waiting time for a kidney, but it is not a permanent solution for the lack of organ donations. In the future topics which should be discussed are intensified public relations, a better family care and the allocation of rights and duties at the German coordinating agency. For all the prospects of success after a living donation the high standards of quality and security, which are targeted by the German donor organization in recipient protection, responsible evaluation of the expanded donor criteria and immunosuppressive therapy are all in favor of post-mortem organ donation. For all the phenomenal chance of success the priority of the post-mortem organ donation is regulated by law. The living donation remains an individual decision of the donor and the personal situation of life.
Diagnostic Testing for Male Factor Infertility
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Noncontraceptive Benefits of Birth Control Pills
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Side Effects of Injectable Fertility Drugs (Gonadotropins)
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Endometriosis and Infertility: Can Surgery Help?
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Focus group study of public opinion about paying living kidney donors in Australia.
Tong, Allison; Ralph, Angelique F; Chapman, Jeremy R; Wong, Germaine; Gill, John S; Josephson, Michelle A; Craig, Jonathan C
2015-07-07
The unmet demand for kidney transplantation has generated intense controversy about introducing incentives for living kidney donors to increase donation rates. Such debates may affect public perception and acceptance of living kidney donation. This study aims to describe the range and depth of public opinion on financial reimbursement, compensation, and incentives for living kidney donors. Twelve focus groups were conducted with 113 participants recruited from the general public in three Australian states in February 2013. Thematic analysis was used to analyze the transcripts. Five themes were identified: creating ethical impasses (commodification of the body, quandary of kidney valuation, pushing moral boundaries), corrupting motivations (exposing the vulnerable, inevitable abuse, supplanting altruism), determining justifiable risk (compromising kidney quality, undue harm, accepting a confined risk, trusting protective mechanisms, right to autonomy), driving access (urgency of organ shortage, minimizing disadvantage, guaranteeing cost-efficiency, providing impetus, counteracting black markets), and honoring donor deservingness (fairness and reason, reassurance and rewards, merited recompense). Reimbursement and justifiable recompense are considered by the Australian public as a legitimate way of supporting donors and reducing disadvantage. Financial payment beyond reimbursement is regarded as morally reprehensible, with the potential for exploitative commercialism. Some contend that regulated compensation could be a defensible strategy to increased donation rates provided that mechanisms are in place to protect donors. The perceived threat to community values of human dignity, goodwill, and fairness suggests that there could be strong public resistance to any form of financial inducements for living kidney donors. Policy priorities addressing the removal of disincentives may be more acceptable to the public. Copyright © 2015 by the American Society of Nephrology.
Focus Group Study of Public Opinion About Paying Living Kidney Donors in Australia
Ralph, Angelique F.; Chapman, Jeremy R.; Wong, Germaine; Gill, John S.; Josephson, Michelle A.; Craig, Jonathan C.
2015-01-01
Background and objectives The unmet demand for kidney transplantation has generated intense controversy about introducing incentives for living kidney donors to increase donation rates. Such debates may affect public perception and acceptance of living kidney donation. This study aims to describe the range and depth of public opinion on financial reimbursement, compensation, and incentives for living kidney donors. Design, setting, participants, & measurements Twelve focus groups were conducted with 113 participants recruited from the general public in three Australian states in February 2013. Thematic analysis was used to analyze the transcripts. Results Five themes were identified: creating ethical impasses (commodification of the body, quandary of kidney valuation, pushing moral boundaries), corrupting motivations (exposing the vulnerable, inevitable abuse, supplanting altruism), determining justifiable risk (compromising kidney quality, undue harm, accepting a confined risk, trusting protective mechanisms, right to autonomy), driving access (urgency of organ shortage, minimizing disadvantage, guaranteeing cost-efficiency, providing impetus, counteracting black markets), and honoring donor deservingness (fairness and reason, reassurance and rewards, merited recompense). Reimbursement and justifiable recompense are considered by the Australian public as a legitimate way of supporting donors and reducing disadvantage. Financial payment beyond reimbursement is regarded as morally reprehensible, with the potential for exploitative commercialism. Some contend that regulated compensation could be a defensible strategy to increased donation rates provided that mechanisms are in place to protect donors. Conclusions The perceived threat to community values of human dignity, goodwill, and fairness suggests that there could be strong public resistance to any form of financial inducements for living kidney donors. Policy priorities addressing the removal of disincentives may be more acceptable to the public. PMID:25908793
Lewis, Celine; Clotworthy, Margaret; Hilton, Shona; Magee, Caroline; Robertson, Mark J; Stubbins, Lesley J; Corfield, Julie
2013-01-01
Objective A mixed methods study exploring the UK general public's willingness to donate human biosamples (HBSs) for biomedical research. Setting Cross-sectional focus groups followed by an online survey. Participants Twelve focus groups (81 participants) selectively sampled to reflect a range of demographic groups; 1110 survey responders recruited through a stratified sampling method with quotas set on sex, age, geographical location, socioeconomic group and ethnicity. Main outcome measures (1) Identify participants’ willingness to donate HBSs for biomedical research, (2) explore acceptability towards donating different types of HBSs in various settings and (3) explore preferences regarding use and access to HBSs. Results 87% of survey participants thought donation of HBSs was important and 75% wanted to be asked to donate in general. Responders who self-reported having some or good knowledge of the medical research process were significantly more likely to want to donate (p<0.001). Reasons why focus group participants saw donation as important included: it was a good way of reciprocating for the medical treatment received; it was an important way of developing drugs and treatments; residual tissue would otherwise go to waste and they or their family members might benefit. The most controversial types of HBSs to donate included: brain post mortem (29% would donate), eyes post mortem (35%), embryos (44%), spare eggs (48%) and sperm (58%). Regarding the use of samples, there were concerns over animal research (34%), research conducted outside the UK (35%), and research conducted by pharmaceutical companies (56%), although education and discussion were found to alleviate such concerns. Conclusions There is a high level of public support and willingness to donate HBSs for biomedical research. Underlying concerns exist regarding the use of certain types of HBSs and conditions under which they are used. Improved education and more controlled forms of consent for sensitive samples may mitigate such concerns. PMID:23929915
The impact of knowledge and religion on organ donation as seen by immigrants in Sweden.
Krupic, Ferid; Sayed-Noor, Arkan S; Fatahi, Nabi
2017-12-01
Transplantation of organs is one of the most successful medical advances of the past 60 years and transplantation is the treatment of choice for severe organ failure worldwide. Despite this situation, and the general acknowledgement of organ donation as a global priority, demand for organs outstrips supply in virtually every country in the world. The aim of the study was to elucidate factors that influence immigrant's decisions regarding organ donation. Data were collected through three group interviews using open-ended questions and qualitative content analysis. 32 participants, 16 men and 16 women from Bosnia and Herzegovina, Somalia, Lebanon and Kosovo participated in focus group interviews (FGI). Analysis of the collected data resulted in two main categories: 'Information about organ donation' and 'Religious aspects of organ donation and a number of subcategories'. Some of the influencing factors concerning organ donation were mainly related to limited information from society as well as limited information from healthcare professionals. Religious aspects, fear and prejudices about organ donation were other factors that mentioned by participants as hamper regarding organ donation. In order to improve immigrants' attitude towards organ donation, information about this issue and identification of the hampering factors, particularly culturally related factors such as the religious aspect, is essential. In this context, different intervention studies are needed to increase monitories groups' attitude towards organ donations. © 2016 Nordic College of Caring Science.
Exploring Donation Decisions: Beliefs and Preferences for Organ Donation in Australia
ERIC Educational Resources Information Center
Hyde, Melissa K.; White, Katherine M.
2010-01-01
The authors explored common beliefs and preferences for posthumous and living organ donation in Australia where organ donation rates are low and little research exists. Content analysis of discussions revealed the advantage of prolonging/saving life whereas disadvantages differed according to donation context. A range of people/groups perceived to…
Meurrens, Julie; Steiner, Thomas; Ponette, Jonathan; Janssen, Hans Antonius; Ramaekers, Monique; Wehrlin, Jon Peter; Vandekerckhove, Philippe; Deldicque, Louise
2016-12-01
The aims of the present study were to investigate the impact of three whole blood donations on endurance capacity and hematological parameters and to determine the duration to fully recover initial endurance capacity and hematological parameters after each donation. Twenty-four moderately trained subjects were randomly divided in a donation (n = 16) and a placebo (n = 8) group. Each of the three donations was interspersed by 3 months, and the recovery of endurance capacity and hematological parameters was monitored up to 1 month after donation. Maximal power output, peak oxygen consumption, and hemoglobin mass decreased (p < 0.001) up to 4 weeks after a single blood donation with a maximal decrease of 4, 10, and 7%, respectively. Hematocrit, hemoglobin concentration, ferritin, and red blood cell count (RBC), all key hematological parameters for oxygen transport, were lowered by a single donation (p < 0.001) and cumulatively further affected by the repetition of the donations (p < 0.001). The maximal decrease after a blood donation was 11% for hematocrit, 10% for hemoglobin concentration, 50% for ferritin, and 12% for RBC (p < 0.001). Maximal power output cumulatively increased in the placebo group as the maximal exercise tests were repeated (p < 0.001), which indicates positive training adaptations. This increase in maximal power output over the whole duration of the study was not observed in the donation group. Maximal, but not submaximal, endurance capacity was altered after blood donation in moderately trained people and the expected increase in capacity after multiple maximal exercise tests was not present when repeating whole blood donations.
A political analysis of corporate drug donations: the example of Malarone in Kenya.
Shretta, R; Walt, G; Brugha, R; Snow, R
2001-06-01
This paper describes the introduction of the Malarone Donation Programme in KENYA: Using a policy analysis approach it illustrates the political nature of donation programmes and how they are affected by a large and varied group of national, regional and international stakeholders, with different levels of influence and experience. The paper shows that interaction between these different groups may affect the development and implementation of the donation programme. It ends by raising some more general questions about public/private partnerships and corporate donation programmes, and their potential impact on national drug policies.
Infertility Counseling and Support: When and Where to Find It
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Rucinski, Dianne; Jones, Risé; Reyes, Brenda; Tidwell, Lawon; Phillips, RoiAnn; Delves, Denise
2010-05-01
Despite higher birth rates among non-Hispanic blacks and Hispanics, the availability of umbilical cord blood from these groups is lower due to lower donation rates than that of non-Hispanic whites. Similar racial and ethnic disparities in donation rates have been found for blood and organ donation. This study is among the first to explore beliefs and attitudes toward umbilical cord blood donation among Hispanic and non-Hispanic black women. Five focus groups composed of Hispanic and non-Hispanic black women were conducted to explore how women conceptualize information needs about umbilical cord blood donation and from whom women want to receive information about donation. Participants were adult women who had given birth within the past year or were pregnant. Lack of basic information regarding umbilical cord blood, its harvesting and use, and the steps and conditions necessary to donate were primary barriers to donation. Women expressed confusion over the differences between "donation" and "banking." The social value of donation was explicitly weighed in terms of the cost of the donation effort. Doctors were viewed as critical sources for information about donation, although women expressed skepticism about doctors' ability to convey sufficient information during short office visits. Efforts to increase donation rates among Hispanic and non-Hispanic black women should include information about both the technical aspects and the social value of donation. The specific terms "umbilical" and "donation" should be used consistently to prevent misunderstanding. Information should be provided by physicians with follow-up by other health providers.
Switzer, Galen E.; Bruce, Jessica; Kiefer, Deidre M.; Kobusingye, Hati; Drexler, Rebecca; Besser, RaeAnne M.; Confer, Dennis L.; Horowitz, Mary M.; King, Roberta J.; Shaw, Bronwen E.; Riches, Marcie; Hayes-Lattin, Brandon; Linenberger, Michael; Bolwell, Brian; Rowley, Scott D.; Litzow, Mark R.; Pulsipher, Michael A.
2016-01-01
The increasing number of older adults with blood-related disorders and the introduction of reduced intensity conditioning regimens has led to increases in hematopoietic stem cell (HSC) transplantation among older adults and a corresponding increase in the age of siblings who donate HSCs to these patients. Data regarding the donation-related experiences of older donors is lacking. The Related Donor Safety Study (RDSafe) aimed to examine/compare health-related quality of life (HRQoL) of older versus younger HSC donors. 60 peripheral blood stem cell (PBSC) donors ages 18–60 and 104 PBSC donors age >60 completed validated questionnaires at pre-donation, 4 weeks and 1 year post-donation. Prior to donation, older donors had poorer general physical health (t=−3.27; p=.001) but better mental health (t=2.11; p<.05). There were no age differences in multiple other donation-related factors. At 4 weeks post-donation, there were no group differences in general physical/mental health, but older donors were less likely to report donation-related pain (t=−2.26; p<.05) and concerns (t=−3.38; p=.001). At both 4 weeks and 1 year post-donation, there were no significant differences in the percentage of each age group feeling physically back to normal or in the number of days it took donors to feel completely well. There was no evidence that increasing age within the older donor group was associated with poorer donation-related HRQoL. Taken together, these data support the current practice of HSC donation by sibling donors above age 60, providing no evidence of worsening HRQoL up to one year after donation in individuals up to age 76. PMID:27751935
A national minority transplant program for increasing donation rates.
Callender, C; Burston, B; Yeager, C; Miles, P
1997-01-01
Since 1982, our group efforts demonstrated statistically significant improvements in minority donation rates which have applicability to all minority populations. As we continue to reach out to the various ethnic communities, we must listen to the needs of the community understanding that all ethnic communities have various beliefs and cultural barriers that will need to be addressed. For instance, the African-American population revealed the previously mentioned five obstacles to donation. The Hispanic population has revealed relatively the same fears to donation as the African-American population. In addition, the tribes within the Native-American population each have their own belief systems which will have to be addressed appropriately. The fears and obstacles toward donation within the Asians and Pacific Islanders and the Alaska Native groups are being defined. However, initial research reveals that all of the minority groups have very similar, if not the same, fears that were identified with the initial focus group in 1978. This simple methodology that has been established can ultimately help achieve the overall desired goal--an increase in minority donation rates.
Radtke, Hartmut; Mayer, Beate; Röcker, Lothar; Salama, Abdulgabar; Kiesewetter, Holger
2004-10-01
The benefits of 2-unit red blood cell (RBC) apheresis are evident, but iron depletion may be a limiting factor in using this technology. Regular iron supplementation may allow a better utilization of this technique. In this study, 260 regular blood donors donated 2-unit RBCs on each of a total of seven visits at intervals of 8 to 10 weeks. The volunteers were randomly assigned to receive 100 mg of iron(II) or placebo daily. Group A received iron capsules after the first three donations, and Group B after the second three donations, respectively. Hemoglobin, serum ferritin, and serum iron were measured before each donation. Mean serum ferritin concentration decreased after each donation in the placebo phase of both treatment groups, but it remained largely constant during the iron phase in Group A, and even increased during the iron phase in Group B. Regular iron supplementation prevents iron depletion in the majority of donors after 2-unit RBC apheresis within an 8- to 10-week period.
The 'donations for decreased ALT (D4D)' prosocial behavior incentive scheme for NAFLD patients.
Sumida, Yoshio; Yoshikawa, Toshikazu; Tanaka, Saiyu; Taketani, Hiroyoshi; Kanemasa, Kazuyuki; Nishimura, Tekeshi; Yamaguchi, Kanji; Mitsuyoshi, Hironori; Yasui, Kohichiroh; Minami, Masahito; Naito, Yuji; Itoh, Yoshito
2014-12-01
Physicians often experience difficulties in motivating patients with non-alcoholic fatty liver disease (NAFLD) to undergo lifestyle changes. The aim of this study is to examine whether 'Donations for Decreased alanine aminotransferase (ALT)' (D4D) prosocial behavior incentive can serve as an effective intrinsic motivational factor in comparison with conventional dietary and exercise intervention alone for NAFLD patients. Twenty-five NAFLD patients with elevated ALT were randomly assigned to a control group that received conventional dietary and exercise intervention alone, or a donation group whereby, as an incentive, we would make a monetary donation to the United Nations World Food Programme (WFP) based on the decrease in their ALT levels achieved over 12 weeks, in addition to receiving control intervention. In a donation group, we would donate US$1 to the WFP for every 1 IU/l of decrease in their ALT levels. There were no differences of pre-treatment clinical characteristics between the two groups. Significant reductions of ALT levels were achieved only in a donation group, although post-treatment ALT levels were not different between the two groups. These patients raised a total of $316 for the WFP. Promoting patients' intrinsic motivation by incorporating 'D4D' prosocial behavior incentive into conventional dietary and exercise intervention may provide a means to improve NAFLD. © The Author 2013. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Tran, Sheri; Lewalski, Eva A.; Dwyre, Denis M.; Hagar, Yolanda; Beckett, Laurel; Janatpour, Kim A.; Holland, Paul V.
2009-01-01
Background and Objectives Emergency situations often elicit a generous response from the public. This occurred after attacks on the US on September 11, 2001 when many new blood donors lined up to donate. This study was performed to compare return rates for first time donors (FTD) after September 11th, 2001 to FTD during a comparable period in 2000. Materials and Methods 3315 allogeneic whole blood donations from FTD at a regional blood center were collected between September 11th and 30th, 2001. Subsequent donations by the FTD before March 31, 2002 were reviewed. This (test) group was compared to 1279 FTD(control group) donating during the same time period in September 2000 and to their return rate in the subsequent six months. Results Following September 11, 2001, 1087/3315 (32.8%) FTD returned by March 31, 2002. This return rate was similar to the control group (427/1279 (33.4%)). The deferral rate during the donor screening process for the control group was significantly higher than the deferral rate for the September 11–30, 2001 group (p < 0.01). The odds of an individual FTD returning increased with age, and the chance of a female donor returning was 1.13 times higher than a male (p = 0.06). There was a carryover effect after Sept. 11, 2001 too. Conclusion A national emergency, September 11, 2001, inspired people to donate blood for the first time. However, the proportion of return donations amongst them was not increased. Females and males in certain age groups were more likely to become repeat donors due to the residual effect of September 11, 2001. Additional efforts are needed to retain eligible FTD in donor pools. PMID:20002621
Bedenko, Ramon Correa; Nisihara, Renato; Yokoi, Douglas Shun; Candido, Vinícius de Mello; Galina, Ismael; Moriguchi, Rafael Massayuki; Ceulemans, Nico; Salvalaggio, Paolo
2016-09-01
To evaluate the knowledge and acceptance of the public and professionals working in intensive care units regarding organ donation after cardiac death. The three hospitals with the most brain death notifications in Curitiba were selected, and two groups of respondents were established for application of the same questionnaire: the general public (i.e., visitors of patients in intensive care units) and health professionals working in the same intensive care unit. The questionnaire contained questions concerning demographics, intention to donate organs and knowledge of current legislation regarding brain death and donation after cardiac death. In total, 543 questionnaires were collected, including 442 from family members and 101 from health professionals. There was a predominance of women and Catholics in both groups. More females intended to donate. Health professionals performed better in the knowledge comparison. The intention to donate organs was significantly higher in the health professionals group (p = 0.01). There was no significant difference in the intention to donate in terms of education level or income. There was a greater acceptance of donation after uncontrolled cardiac death among Catholics than among evangelicals (p < 0.001). Most of the general population intended to donate, with greater intentions expressed by females. Education and income did not affect the decision. The type of transplant that used a donation after uncontrolled cardiac death was not well accepted in the study population, indicating the need for more clarification for its use in our setting.
The self-protective altruist: terror management and the ambivalent nature of prosocial behavior.
Hirschberger, Gilad; Ein-Dor, Tsachi; Almakias, Shaul
2008-05-01
Three studies examined the hypothesis that mortality salience (MS) will increase prosocial behaviors when the prosocial cause promotes terror management processes. However, when the prosocial cause interferes with these processes, MS will reduce prosocial behavior. In Study 1, following a MS procedure, participants indicated their willingness to donate money to charity or to donate to an organ donation organization. In Study 2, a research assistant randomly distributed fliers with reminders of death or back pain, and another research assistant solicited participants' assistance from either a charitable fund booth or an organ donation booth. Study 3 examined the impact of MS on helping a wheelchair-bound confederate or a walking confederate. The results indicated that MS increased charitable donations and increased help to a walking confederate. However, MS significantly decreased organ donation card signings and decreased help to a wheelchair-bound confederate. The discussion examines the tension between personal fear and worldview validation.
Impact of a Full-Time Donor Management Protocol on Donors' Liver Biopsy Findings: Progress to Date.
Mojtabaee, Meysam; Shamsaeefar, Alireza; Gholami, Siavash; Mohsenzadeh, Mojtaba; Sadegh Beigee, Farahnaz
2017-02-01
This study investigated a fixed coordinator-directed donor management strategy's impact on donated liver quality, as determined by definitive biopsy results. We collected donated liver biopsy results from donations both before and after implementing a fixed coordinator-directed donor management strategy. This strategy involved full-time attendance by a donor coordinator and continued resuscitation of brain-dead donors. All donations took place in a single organ procurement unit. We also followed up results of biopsies from the Liver Transplantation Center database of Namazi Hospital in Shiraz, Iran. We compared biopsy findings of 192 livers donated from 2012 to 2013 (group A) with 276 livers donated from 2015 until August 2016 (group B). Data analysis showed that 67 livers (34.9%) in group A were rejected for transplant owing to severe steatosis in 17 (8.9%), moderate/severe fibrosis in 9 (4.7%), moderate/severe necrosis in 28 (14.6%), and 13 (6.8%) rejected for other pathologies. Among group B livers, 59 (21.4%) were not deemed suitable for transplant owing to severe steatosis in 37 (13.5%), moderate/severe fibrosis in 6 (2.1%), and moderate/ severe necrosis in 16 (5.7%). Overall, steatosis was found in 94 livers (49.2%) in group A versus 175 livers (63.3%) in group B (P = .007). Donor age in group A averaged 36.5 years versus 47.9 years in group B (P = .02). Necrosis was found in 33 livers (17.2%) in group A and 22 livers (7.9%) in group B (P = .008). One-month survival rates were 95.3% and 96.3% for groups A and B (P = .08). Donated liver disqualification before transplant noticeably decreased despite the shift in demographic patterns from 2012 to 2016. In group A, brain-dead liver donors were younger and more often died from trauma, whereas group B donors had more cerebrovascular accident-induced deaths. This achievement took place alongside increased rates of steatosis and decreased rates of necrosis.
Gare, Rebecca; Gogalniceanu, Petrut; Maple, Hannah; Burnapp, Lisa; Clarke, Alexis; Williams, Lynsey; Norton, Sam; Chilcot, Joseph; Gibbs, Paul; Mitchell, Annie; McCrone, Paul; Draper, Heather; Mamode, Nizam
2017-01-01
Introduction Living donation accounts for over one-third of all kidney transplants taking place in the UK. 1 The concept of anonymously donating a kidney to a stranger (non-directed altruistic or unspecified kidney donation (UKD)) remains uncomfortable for some clinicians, principally due to concerns about the motivations and long-term physical and psychological outcomes in this donor group. Aims The research programme aims to provide a comprehensive assessment of the unspecified donor programme in the UK. It aims to identify reasons for variations in practice across centres, explore outcomes for donors and ascertain barriers and facilitators to UKD, as well as assess the economic implications of unspecified donation. Methods The research programme will adopt a mixed-methods approach to assessing UKD nationally using focus groups, interviews and questionnaires. Two study populations will be investigated. The first will include transplant professionals involved in unspecified kidney donation. The second will include a 5-year prospective cohort of individuals who present to any of the 23 UK transplant centres as a potential unspecified living kidney donor. Physical and psychological outcomes will be followed up to 1 year following donation or withdrawal from the donation process. A matched sample of specified donors (those donating to someone they know) will be recruited as a control group. Further qualitative work consisting of interviews will be performed on a purposive sample of unspecified donors from both groups (those who do and do not donate). Dissemination The findings will be reported to NHS Blood and Transplant and the British Transplant Society with a view to developing national guidelines and a protocol for the management of those presenting for unspecified donation. Trial registration number ISRCTN23895878, Pre-results. PMID:28939572
Gare, Rebecca; Gogalniceanu, Petrut; Maple, Hannah; Burnapp, Lisa; Clarke, Alexis; Williams, Lynsey; Norton, Sam; Chilcot, Joseph; Gibbs, Paul; Mitchell, Annie; McCrone, Paul; Draper, Heather; Mamode, Nizam
2017-09-21
Living donation accounts for over one-third of all kidney transplants taking place in the UK. 1 The concept of anonymously donating a kidney to a stranger (non-directed altruistic or unspecified kidney donation (UKD)) remains uncomfortable for some clinicians, principally due to concerns about the motivations and long-term physical and psychological outcomes in this donor group. The research programme aims to provide a comprehensive assessment of the unspecified donor programme in the UK. It aims to identify reasons for variations in practice across centres, explore outcomes for donors and ascertain barriers and facilitators to UKD, as well as assess the economic implications of unspecified donation. The research programme will adopt a mixed-methods approach to assessing UKD nationally using focus groups, interviews and questionnaires. Two study populations will be investigated. The first will include transplant professionals involved in unspecified kidney donation. The second will include a 5-year prospective cohort of individuals who present to any of the 23 UK transplant centres as a potential unspecified living kidney donor. Physical and psychological outcomes will be followed up to 1 year following donation or withdrawal from the donation process. A matched sample of specified donors (those donating to someone they know) will be recruited as a control group. Further qualitative work consisting of interviews will be performed on a purposive sample of unspecified donors from both groups (those who do and do not donate). The findings will be reported to NHS Blood and Transplant and the British Transplant Society with a view to developing national guidelines and a protocol for the management of those presenting for unspecified donation. ISRCTN23895878, Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Three proposals to increase Australia's organ supply.
Isdale, William; Savulescu, Julian
2015-01-01
In 2008 the Australian Government introduced a national reform agenda to increase organ and tissue donation. Australia continues to perform poorly by international standards on measures of organ procurement, however. This paper outlines three proposals to improve donation rates and considers the empirical evidence available for each. A number of ethical objections frequently given to resist such proposals are also addressed. Firstly, it is recommended that Australia implement an 'opt-out' system of organ donation. Secondly, the existing veto rules should be changed to better protect the wishes of those who wish to donate. Finally, a numer of incentives should be offered to increase donation rates; these could include incentives of financial value, but also non-financial incentives such as prioritisation for the receipt of organs for previous donors.
Preaubert, Lise; Vincent-Rohfritsch, Aurélie; Santulli, Pietro; Gayet, Vanessa; Goffinet, François; Le Ray, Camille
2018-03-01
Women increasingly resort to oocyte donation to become pregnant. The high risk of preeclampsia found in oocyte donation pregnancies and the separate risk of preeclampsia associated with sperm donation may be cumulative in double donation pregnancies. We aimed to study the obstetrical and perinatal outcomes of pregnancies obtained by double donation (both oocyte and sperm) in comparison with those obtained by oocyte donation alone (oocyte donation and partner's sperm). This cohort study included all women aged 43 and older who became pregnant after oocyte donation and gave birth between 2010 and 2016 in a tertiary maternity center. Primary outcomes were preeclampsia and hypertensive gestational disorders. Secondary outcomes were gestational diabetes, placental abnormalities, postpartum hemorrhage, perinatal death, and preterm delivery. We used univariate and multivariate analysis to compare IVF with double donation and IVF with oocyte donation alone for obstetric and perinatal outcomes. 247 women, 53 with double donations and 194 with oocyte donations alone, gave birth to 339 children. We observed no significant differences between groups for any obstetric or perinatal complications, except for the risk of gestational diabetes, which was more frequent in women with double donations compared with oocyte donation alone (26.4% vs. 12.9%, P = 0.02) and remained significant after adjustment (aOR = 2.80 95%CI[1.26-6.17]). Rates of gestational hypertension and preeclampsia were high, but similar between groups (20.7% vs. 26.3%, P = 0.41, and 18.9% vs. 17.5%, P = 0.82). Women undergoing oocyte donation should be fully informed of its high rates of obstetric and perinatal risks. However, except for a higher observed risk of gestational diabetes, double donation does not appear to be associated with a higher risk of complications than oocyte donation alone. Copyright © 2017 Elsevier B.V. All rights reserved.
Donations as an alternative to wilderness user fees: the case of the desolation wilderness
Steven R. Martin
2000-01-01
Day-use visitors to the Desolation Wilderness were asked about making voluntary donations at the trailhead. Of the 111 visitors who used one of the four trailheads at which voluntary donations were requested, 55% reported making a donation, with an average reported donation amount of $4.20. Subjects were categorized into three groups: donors, would-be donors, and...
Doherty, Sally; Dolan, Elizabeth; Flynn, Jennifer; O’Carroll, Ronan E.; Doyle, Frank
2017-01-01
Objectives: Including or excluding certain questions about organ donation may influence peoples’ intention to donate. We investigated the effect of omitting certain affective attitudinal items on potential donors’ intention and behavior for donation. Design: A cross-sectional survey with a subgroup nested randomized trial. Methods: A total of 578 members of the public in four shopping centers were surveyed on their attitudes to organ donation. Non-donors (n = 349) were randomly assigned to one of three groups: Group 1 completed items on affective and cognitive attitudes, anticipated regret, intention, subjective norm and perceived behavioral control. Group 2 completed all items above but excluded affective attitudes. Group 3 completed all items but omitted negatively worded affective attitudes. The primary outcome was intention to donate, taking a donor card after the interview was a secondary behavioral outcome, and both were predicted using linear and logistic regression with group 1 as the reference. Results: Mean (SD) 1–7 intention scores for groups 1, 2 and 3 were, respectively: 4.43 (SD 1.89), 4.95 (SD 1.64) and 4.88 (SD 1.81), with group 2 significantly higher than group 1 (β = 0.518, 95% confidence interval [CI] 0.18 to 0.86).At the end of the interview, people in group 2 (66.7%; OR = 1.40, 95% CI 0.94 to 2.07, p = 0.096) but not those in group 3 (61.7%; OR = 1.10, 95% CI 0.69 to 1.75, p = 0.685), were marginally more likely to accept a donor card from the interviewer than people in group 1 (59.7%). Conclusion: Omitting affective attitudinal items results in higher intention to donate organs and marginally higher rates of acceptance of donor cards, which has important implications for future organ donation public health campaigns. PMID:28894429
Passarinho, Lúcia Eugênia Velloso; Gonçalves, Maura Pedroso; Garrafa, Volnei
2003-01-01
This study aimed to know the opinion of five different social segments (public prosecutors, judges, general population, recipients of the awaiting list for kidney transplants and the crew involved in the organ transplantation process of a hospital in Brasília--Hospital de Base) about the present organ transplant legislation, with an emphasis on the donation of kidney by unrelated living donors, and the new determination given by Law #10.211, in March 23rd, 2001, specifically in its article 9, that enlarges the criteria for donation of organs between unrelated living people. A questionnaire with six objective questions was used in order to know the opinion of five groups of people of the Federal District about the present organ transplant legislation in Brazil. For 80% of the people interviewed, when Brazilian legislation allows donation of organs between unrelated living people, it makes possible the existence of rewarded donation and 81% of them consider that the requirement for judicial authorization is not an effective instrument to prevent organ commercialism. The present research indicates that Brazilian legislation fails concerning the utilization of kidneys for transplantation from unrelated living donors, making possible the commerce of organs in the country. Considering that poor people are the most vulnerable ones in this context, the authors suggest changes in the legislation in force, aiming to protect them and, therefore, attain more justice.
__________________________________________________ Nobel Prize funds will be donated to Fellowships: Berkeley Nobel laureates donate prize money to charity SF Gate New Nobel Laureate Donates Prize Money to Local Charity The Daily Californian Nobel laureate
Sadic, Sahmir; Sadic, Jasna; Krupic, Rasim; Fatahi, Nabi; Krupic, Ferid
2016-10-01
Transplantation of organs is the treatment of choice for severe organ failure worldwide. The aims of the present study were to determine the influence of religion on attitudes towards organ donation among staff at schools in Tuzla. In the Tuzla region there are 42 schools and 1580 school staff. A total of 21 schools were selected randomly, which were stratified by geographical location. 499 employees were invited to participate in the study, and 475 agreed to participate. According to the definition of their attitude towards religion the subjects were divided into three groups: non-religious, only religious and practical believers. None of the subjects possesses a donor card. To the question whether the subjects support the idea of organ transplantation, most replied that they support the idea of donating organs both during life and after death. Regarding this question there is a significant difference between the groups (p = 0.0063). To the question whether they are prepared to donate an organ of a deceased family member, most replied that they would consent to donating an organ, whilst a significant number also replied that they were not sure. The results show that there is no significant difference between the replies given by the groups (p = 0.7694). To the question regarding to whom they were prepared to donate an organ, most said they were prepared to donate one to a member of their family, then to a close relative, whilst the least would donate to a stranger. The results show that there is a significant difference between the groups (p = 0.0002). In order to reduce the wide disparity between the need and organ donation amongst other things a more active relationship is necessary between health workers, religious officials and school staff.
Boise, Linda; Hinton, Ladson; Rosen, Howard J; Ruhl, Mary
2017-08-01
Studying the brain through autopsy is an essential component of Alzheimer's disease research. Racial and ethnic minorities are underrepresented in Alzheimer's research generally and, in particular, in the number of completed brain autopsies. We explored beliefs about and attitudes toward brain donation among African American, Chinese, Caucasian, and Latino research subjects and their family members through focus groups at 4 NIH-funded Alzheimer's Disease Centers. Eighteen focus groups were conducted with 61 research subjects and 34 family members. Because the primary purpose of the focus groups was to identify the range of considerations that may influence the decision to participate in brain donation, data from focus groups were pooled and then analyzed. We found that many of the concerns, attitudes, and beliefs about brain donation were similar across the 4 ethnic groups. Concerns and attitudes fell into 3 categories: (a) concerns and misconceptions about brain research and the process of brain removal, (b) religious beliefs, and (c) the role of the family. Our findings suggest that interventions to enhance enrollment in brain donation that target factors identified in this study are likely to be relevant to people from a broad range of backgrounds and ethnicities. Nonetheless, we observed some potential differences among racial/ethnic groups that may affect how research volunteers and their families approach a decision about donating their brain for research. Further study is warranted to explore these and other possible culturally distinct attitudes and beliefs about brain donation. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Majeed, Farrukh
2016-01-01
Objectives Proper awareness among health professionals about organ donation is important for increasing organ procurement. Personal commitment and attitude of nurses are imperative as they have key role in identifying potential donors. The aim of this study was to compare prevailing knowledge and attitude of undergraduate female Saudi nursing and medical students’ toward organ donation. Methodology A cross sectional questionnaire using 29 item were filled by nursing (n=46) and medical (n=63) students’ at University of Dammam (KSA) during academic year 2014–15, to check and compare their knowledge and attitude about organ donation. The data were analyzed by descriptive statistics; chi square test and bivariate analysis to find out correlation. Results Level of knowledge of nursing group were significantly lower (p=0.000) than medical group while no significant difference in attitude score (p=0.591) between the two groups were found. Major source of knowledge for nursing was media (65.2%) and college/university for medical (50.8%) group. Both groups chose “anyone in need” as preferred recipients’ upon donation (nursing 60.3% and medical 52.2%) and opted “anyone” as donor in case of recipient (nursing 52.2% and medical 49.2%). The results indicate positive correlation between level of knowledge and attitude toward organ donation. Conclusions Nursing students have low knowledge toward organ donation as compared to medical students although they shows positive attitude toward this issue. This study ascertains the need of an effective educational program for nursing students of Saudi Arabia to improve their knowledge regarding organ donation and to raise organ procurement. PMID:27103903
Attitudes and beliefs about organ donation among different racial groups.
Yuen, C. C.; Burton, W.; Chiraseveenuprapund, P.; Elmore, E.; Wong, S.; Ozuah, P.; Mulvihill, M.
1998-01-01
Many people on the waiting list for organ donation die each year without receiving organs. The shortage of organs is even more pronounced in minority communities. Despite the fact that minorities are at higher risk, they may be less likely to support or consent to organ donation. This investigation was undertaken to study racial factors in organ donation, by focusing on differences in awareness, attitudes, and behavior. Three family practice centers in the Bronx with racially diverse but socioeconomically homogenous communities were studied. The study population consisted of a convenience sample of 163 patients who were approached for participation while they waited to see a doctor. Respondents filled out a 25-item survey that measured demographic information; their exposure to, awareness of, and attitudes toward organ donation; and whether they had signed an organ donor card. The results demonstrated overwhelming support for organ donation across all racial groups. Racial differences were found on awareness of and attitudes toward organ donation, and in the signing of organ donation cards. In contrast to other studies, racial minorities were not less likely than whites to support organ donation. These results suggest that making it easier for racial minorities to obtain organ donor cards could increase their rates of consenting to donate organs. PMID:9473924
Influence of Children's Positive Self-Perceptions on Donating Behavior in a Naturalistic Setting.
ERIC Educational Resources Information Center
Holte, Carol S.; And Others
1984-01-01
Investigated the effects of self-perceptions on the donating behavior of 43 fourth-grade students who had two opportunities to donate gum to another class. Students who received feedback after the first donation period indicating that they were particularly generous subsequently gave more than children in the control group. (JAC)
Livitz, Irina E; Fox, Kristen R; Himawan, Lina K; France, Christopher R
2017-06-01
Recruitment and retention of first-time and repeat donors is essential to maintain a stable blood supply. Recent evidence has shown that promoting internal motivation may be an effective strategy to enhance donation behavior. We tested the efficacy of an in-person motivational interview at increasing internal motivation and intention to donate. A sample of 219 donors and nondonors (69.4% female; mean ± SD age, 19.2 ± 1.1 years; 52.1% nondonors) were randomly assigned to either a motivational or a knowledge interview. Immediately before and after the interview participants completed a measure of donation intention and the Blood Donor Identity Survey, which is a multidimensional measure of donor motivation. A latent profile analysis revealed three distinct latent classes, which were identified as low internal motivation, mid internal motivation, and high internal motivation. Comparison of change in latent class from pre- to postinterview revealed that a higher proportion of participants in the motivational interview group moved to a more internally motivated class compared to the knowledge interview group (i.e., 34% vs. 4%, respectively). Further, relative to the knowledge interview group, participants in the motivational interview group reported greater increases in intention to donate. A brief motivational interview may enhance donation intention and intrinsic motivation among both experienced donors and nondonors alike. © 2017 AABB.
Chen, Guodong; Wang, Chang; Ko, Dicken Shiu-Chung; Qiu, Jiang; Yuan, Xiaopeng; Han, Ming; Wang, Changxi; He, Xiaoshun; Chen, Lizhong
2017-11-01
There are three categories of deceased donors of kidney transplantation in China, donation after brain death (DBD), donation after circulatory death (DCD), and donation after brain death followed by circulatory death (DBCD) donors. The aim of this study was to compare the outcomes of kidney transplantation from these three categories of deceased donors. We retrospectively reviewed 469 recipients who received deceased kidney transplantation in our hospital from February 2007 to June 2015. The recipients were divided into three groups according to the source of their donor kidneys: DBD, DCD, or DBCD. The primary endpoints were delayed graft function (DGF), graft loss, and patient death. The warm ischemia time was much longer in DCD group compared to DBCD group (18.4 minutes vs 12.9 minutes, P < .001). DGF rate was higher in DCD group than in DBD and DBCD groups (22.5% vs 10.2% and 13.8%, respectively, P = .021). Urinary leakage was much higher in DCD group (P = .049). Kaplan-Meier analysis showed that 1-, 2-, and 3-year patient survivals were all comparable among the three groups. DBCD kidney transplantation has lower incidences of DGF and urinary leakage than DCD kidney transplant. However, the overall patient and graft survival were comparable among DBD, DCD, and DBCD kidney transplantation. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Switzer, Galen E; Bruce, Jessica; Kiefer, Deidre M; Kobusingye, Hati; Drexler, Rebecca; Besser, RaeAnne M; Confer, Dennis L; Horowitz, Mary M; King, Roberta J; Shaw, Bronwen E; Riches, Marcie; Hayes-Lattin, Brandon; Linenberger, Michael; Bolwell, Brian; Rowley, Scott D; Litzow, Mark R; Pulsipher, Michael A
2017-01-01
The increasing number of older adults with blood-related disorders and the introduction of reduced-intensity conditioning regimens has led to increases in hematopoietic stem cell (HSC) transplantation among older adults and a corresponding increase in the age of siblings who donate HSCs to these patients. Data regarding the donation-related experiences of older donors are lacking. The Related Donor Safety Study aimed to examine/compare health-related quality of life (HRQoL) of older versus younger HSC donors. Sixty peripheral blood stem cell (PBSC) donors ages 18 to 60 years and 104 PBSC donors age >60 years completed validated questionnaires before donation and 4 weeks and 1 year after donation. Before donation, older donors had poorer general physical health (t = -3.27; P = .001) but better mental health (t = 2.11; P < .05). There were no age differences in multiple other donation-related factors. At 4 weeks after donation, there were no group differences in general physical/mental health, but older donors were less likely to report donation-related pain (t = -2.26; P < .05) and concerns (t = -3.38; P = .001). At both 4 weeks and 1 year after donation, there were no significant differences in the percentage of each age group feeling physically back to normal or in the number of days it took donors to feel completely well. There was no evidence that increasing age within the older donor group was associated with poorer donation-related HRQoL. Taken together, these data support the current practice of HSC donation by sibling donors above age 60, providing no evidence of worsening HRQoL up to 1 year after donation in individuals up to age 76. Copyright © 2017 The American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.
Prosocial Conformity: Prosocial Norms Generalize Across Behavior and Empathy.
Nook, Erik C; Ong, Desmond C; Morelli, Sylvia A; Mitchell, Jason P; Zaki, Jamil
2016-08-01
Generosity is contagious: People imitate others' prosocial behaviors. However, research on such prosocial conformity focuses on cases in which people merely reproduce others' positive actions. Hence, we know little about the breadth of prosocial conformity. Can prosocial conformity cross behavior types or even jump from behavior to affect? Five studies address these questions. In Studies 1 to 3, participants decided how much to donate to charities before learning that others donated generously or stingily. Participants who observed generous donations donated more than those who observed stingy donations (Studies 1 and 2). Crucially, this generalized across behaviors: Participants who observed generous donations later wrote more supportive notes to another participant (Study 3). In Studies 4 and 5, participants observed empathic or non-empathic group responses to vignettes. Group empathy ratings not only shifted participants' own empathic feelings (Study 4), but they also influenced participants' donations to a homeless shelter (Study 5). These findings reveal the remarkable breadth of prosocial conformity. © 2016 by the Society for Personality and Social Psychology, Inc.
Attitude toward blood donation among medical and nonmedical students across Karachi
Anwer, Muhammad Osama; Ul Fawwad, Shaikh Hamiz; Anwer, Sanam; Ali, Arif
2016-01-01
Aim: To evaluate the factors that motivate and discourage medical and nonmedical students from donating blood voluntarily and to assess the level of awareness and knowledge regarding blood donation. Materials and Methods: We conducted a cross-sectional descriptive study from August 2011 to May 2012 across different universities of Karachi covering both private and public sector. Predesigned questionnaires were filled by students. A total of 690 students participated in the study, 345 from each. Data collected was analyzed using SPSS Version 17.0. Simple frequencies and percentages were calculated, and Pearson Chi-square and Fisher's exact tests were applied to calculate association between different variables with P value set as significant when <0.05. Results: Mean age of the students was found to be between 21 and 23 (64.6%) in medical, whereas in nonmedical, 66.7% fell in this age group. Astonishingly, blood donors in nonmedical (27%) were quite more than that in medical group, where they were only 18%. Males constituted the majority in both of the groups. Most commonly reported factor that motivated blood donation in medical group was feeling of self-satisfaction (40.2%), whereas in nonmedical group, 32.9% reported that they had only donated blood when their friends/family were in need. When asked about the adverse effects after blood donation, weakness was common among both medical and nonmedical, i.e. 46.8% and 46.7%, respectively. Among the factors that impeded our subjects from donating blood were primarily health concerns in medical students (19%), whereas in nonmedical students they claimed they were not approached by anyone and were unaware of the importance of blood donation (34.8%). Conclusion: Proportion of blood donors was significantly low in both medical and nonmedical students, especially in females. Most important motivating factor in medical students was feeling of self–satisfaction, whereas in nonmedical students, it was family/friend in need of blood transfusion. Never approached by anyone/awareness about the importance of donating blood was the major discouragement factor seen in both medical and nonmedical groups. PMID:27605846
Attitude toward blood donation among medical and nonmedical students across Karachi.
Anwer, Muhammad Osama; Ul Fawwad, Shaikh Hamiz; Anwer, Sanam; Ali, Arif
2016-01-01
To evaluate the factors that motivate and discourage medical and nonmedical students from donating blood voluntarily and to assess the level of awareness and knowledge regarding blood donation. We conducted a cross-sectional descriptive study from August 2011 to May 2012 across different universities of Karachi covering both private and public sector. Predesigned questionnaires were filled by students. A total of 690 students participated in the study, 345 from each. Data collected was analyzed using SPSS Version 17.0. Simple frequencies and percentages were calculated, and Pearson Chi-square and Fisher's exact tests were applied to calculate association between different variables with P value set as significant when <0.05. Mean age of the students was found to be between 21 and 23 (64.6%) in medical, whereas in nonmedical, 66.7% fell in this age group. Astonishingly, blood donors in nonmedical (27%) were quite more than that in medical group, where they were only 18%. Males constituted the majority in both of the groups. Most commonly reported factor that motivated blood donation in medical group was feeling of self-satisfaction (40.2%), whereas in nonmedical group, 32.9% reported that they had only donated blood when their friends/family were in need. When asked about the adverse effects after blood donation, weakness was common among both medical and nonmedical, i.e. 46.8% and 46.7%, respectively. Among the factors that impeded our subjects from donating blood were primarily health concerns in medical students (19%), whereas in nonmedical students they claimed they were not approached by anyone and were unaware of the importance of blood donation (34.8%). Proportion of blood donors was significantly low in both medical and nonmedical students, especially in females. Most important motivating factor in medical students was feeling of self-satisfaction, whereas in nonmedical students, it was family/friend in need of blood transfusion. Never approached by anyone/awareness about the importance of donating blood was the major discouragement factor seen in both medical and nonmedical groups.
Willingness to Be a Brain Donor: A Survey of Research Volunteers From 4 Racial/Ethnic Groups.
Boise, Linda; Hinton, Ladson; Rosen, Howard J; Ruhl, Mary C; Dodge, Hiroko; Mattek, Nora; Albert, Marilyn; Denny, Andrea; Grill, Joshua D; Hughes, Travonia; Lingler, Jennifer H; Morhardt, Darby; Parfitt, Francine; Peterson-Hazan, Susan; Pop, Viorela; Rose, Tara; Shah, Raj C
2017-01-01
Racial and ethnic groups are under-represented among research subjects who assent to brain donation in Alzheimer disease research studies. There has been little research on this important topic. Although there are some studies that have investigated the barriers to brain donation among African American study volunteers, there is no known research on the factors that influence whether or not Asians or Latinos are willing to donate their brains for research. African American, Caucasian, Asian, and Latino research volunteers were surveyed at 15 Alzheimer Disease Centers to identify predictors of willingness to assent to brain donation. Positive predictors included older age, Latino ethnicity, understanding of how the brain is used by researchers, and understanding of what participants need to do to ensure that their brain will be donated. Negative predictors included African/African American race, belief that the body should remain whole at burial, and concern that researchers might not be respectful of the body during autopsy. The predictive factors identified in this study may be useful for researchers seeking to increase participation of diverse ethnic groups in brain donation.
Concern for Group Reputation Increases Prosociality in Young Children.
Engelmann, Jan M; Herrmann, Esther; Tomasello, Michael
2018-02-01
The motivation to build and maintain a positive personal reputation promotes prosocial behavior. But individuals also identify with their groups, and so it is possible that the desire to maintain or enhance group reputation may have similar effects. Here, we show that 5-year-old children actively invest in the reputation of their group by acting more generously when their group's reputation is at stake. Children shared significantly more resources with fictitious other children not only when their individual donations were public rather than private but also when their group's donations (effacing individual donations) were public rather than private. These results provide the first experimental evidence that concern for group reputation can lead to higher levels of prosociality.
Shemie, Sam D; Simpson, Christy; Blackmer, Jeff; MacDonald, Shavaun; Dhanani, Sonny; Torrance, Sylvia; Byrne, Paul
2017-05-01
Donation physicians are specialists with expertise in organ and tissue donation and have been recognized internationally as a key contributor to improving organ and tissue donation services. Subsequent to a 2011 Canadian Critical Care Society-Canadian Blood Services consultation, the donation physician role has been gradually implemented in Canada. These professionals are generally intensive care unit physicians with an enhanced focus and expertise in organ/tissue donation. They must manage the dual obligation of caring for dying patients and their families while providing and/or improving organ donation services. In anticipation of actual, potential or perceived ethical challenges with the role, Canadian Blood Services in partnership with the Canadian Medical Association organized the development of an evidence-informed consensus process of donation experts and bioethicists to produce an ethics guide. This guide includes overarching principles and benefits of the DP role, and recommendations in regard to communication with families, role disclosure, consent discussions, interprofessional conflicts, conscientious objection, death determination, donation specific clinical practices in neurological determination of death and donation after circulatory death, end-of-life care, performance metrics, resources and remuneration. Although this report is intended to inform donation physician practices, it is recognized that the recommendations may have applicability to other professionals (eg, physicians in intensive care, emergency medicine, neurology, neurosurgery, pulmonology) who may also participate in the end-of-life care of potential donors in various clinical settings. It is hoped that this guidance will assist practitioners and their sponsoring organizations in preserving their duty of care, protecting the interests of dying patients, and fulfilling best practices for organ and tissue donation.
Ferreira, Rui R F; Gopegui, Rafael R; De Matos, Augusto J F
2015-03-01
There is no consensus regarding the blood volume that could be safely donated by dogs, ranging from 11 to 25% of its total blood volume (TBV). No previous studies evaluated sedated donors. To evaluate the hemodynamic effects of blood collection from sedated and non-sedated dogs and to understand if such effects were volume-dependent. Fifty three donations of 13% of TBV and 20 donations of 15% TBV were performed in dogs sedated with diazepam and ketamine. Additionally, a total of 30 collections of 13% TBV and 20 collections of 15% TBV were performed in non-sedated dogs. Non-invasive arterial blood pressures and pulse rates were registered before and 15 min after donation. Post-donation pulse rates increased significantly in both sedated groups, with higher differences in the 15% TBV collections. Systolic arterial pressures decreased significantly in these groups, while diastolic pressures increased significantly in 13% TBV donations. Non-sedated groups revealed a slight, but significant, SBP decrease. No clinical signs related to donations were registered. These results suggest that the collection of 15% TBV in sedated donors induces hemodynamic variations that may compromise the harmlessness of the procedure, while it seems to be a safe procedure in non-sedated dogs.
Ríos, A; Carrillo, J; López-Navas, A I; Martínez-Alarcón, L; Ayala, M A; Garrido, G; Ramis, G; Hernández, A M; Ramírez, P; Parrilla, P
2018-03-01
The Guinean population is an emerging group in Europe, but the group's awareness of organ donation and transplantation has not been studied. To analyze the attitude toward organ donation among the population born in Guinea living in Spain. The population older than 15 years, born in Guinea, and resident in Spain was studied, stratified by age and sex, according to census data and immigrant assistance associations. The valuation tool used was the attitude questionnaire toward organ donation PCID-DTO RIOS (questionnaire on "Donor International Collaborative Project" on organ donation and transplantation developed by Dr Ríos). A random selection of people to survey was based on stratification. Support from African immigration support associations was needed to advise on the location of potential respondents. The completion was anonymous and self-administered. A descriptive statistic was performed, and Student t, χ 2 , and Fisher tests and a logistic regression analysis were applied. In all, 181 Guineans were surveyed, of whom 32% (n = 58) were in favor of the donation of their own organs after death, 32% (n = 57) were against, and 36% (n = 66) were undecided. The variables that are associated with attitude toward donation are separated mainly into 4 large groups (P < .001): (1) knowledge about the process of donation and organ transplantation; (2) attitude toward the manipulation of the body; (3) religious variables; and (4) sociofamily variables, especially in relation to the couple. The Guinean population emigrant to Spain has an unfriendly attitude toward organ donation. Copyright © 2017 Elsevier Inc. All rights reserved.
The Public Face of Transplantation: The Potential of Education to Expand the Face Donor Pool.
Plana, Natalie M; Kimberly, Laura L; Parent, Brendan; Khouri, Kimberly S; Diaz-Siso, J Rodrigo; Fryml, Elise M; Motosko, Catherine C; Ceradini, Daniel J; Caplan, Arthur; Rodriguez, Eduardo D
2018-01-01
Despite the growing success of facial transplantation, organ donor shortages remain challenging. Educational health campaigns can effectively inform the general public and institute behavioral modifications. A brief educational introduction to facial transplantation may positively influence the public's position on facial donation. The authors anonymously surveyed 300 participants, gathering basic demographic information, donor registration status, awareness of facial transplantation, and willingness to donate solid organs and facial allografts. Two-hundred of these participants were presented an educational video and subsequently resurveyed on facial donation. Factorial parametric analyses were performed to compare exposure responses before and after watching video exposure. Among participants completing the survey alone (control group), 49 percent were registered donors, 78 percent reported willingness to donate solid organs, and 52 percent reported willingness to donate facial allograft. Of participants who watched the video (video group) 52 percent were registered; 69 and 51 percent were willing to donate solid organs and face, respectively. Following educational intervention, 69 percent of participants in the video group reported willingness to donate facial tissue, an 18 percent increase (p < 0.05), that equated to those willing to donate solid organs. The greatest increase was observed among younger participants (23 percent); women (22 percent); Jewish (22 percent), Catholic (22 percent), and black/African American (25 percent) participants; and respondents holding a higher degree. No significant differences according to gender or ethnicity were observed. Educational interventions hold much promise for increasing the general public's awareness of facial transplantation and willingness to participate in donation of facial allografts.
Harms of unsuccessful donation after circulatory death: An exploratory study.
Taylor, Lauren J; Buffington, Anne; Scalea, Joseph R; Fost, Norman; Croes, Kenneth D; Mezrich, Joshua D; Schwarze, Margaret L
2018-02-01
While donation after circulatory death (DCD) has expanded options for organ donation, many who wish to donate are still unable to do so. We conducted face-to-face interviews with family members (N = 15) who had direct experience with unsuccessful DCD and 5 focus groups with professionals involved in the donation process. We used qualitative content analysis to characterize the harms of nondonation as perceived by participants. Participants reported a broad spectrum of harms affecting organ recipients, donors, and donor families. Harms included waste of precious life-giving organs and hospital resources, inability to honor the donor's memory and character, and impaired ability for families to make sense of tragedy and cope with loss. Donor families empathized with the initial hope and ultimate despair of potential recipients who must continue their wait on the transplant list. Focus group members reinforced these findings and highlighted the struggle of families to navigate the uncertainty regarding the timing of death during the donation process. While families reported significant harm, many appreciated the donation attempt. These findings highlight the importance of organ donation to donor families and the difficult experiences associated with current processes that could inform development of alternative donation strategies. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.
van Berkel, D; Candido, A; Pijffers, W H
2007-06-01
The object of the study was to investigate secrecy in non-anonymous egg donation, to explore some characteristics of this kind of egg donation arrangement and the relationship of the recipient with her non-genetic child. Forty-four egg recipients and 62 IVF patients with a child conceived through egg donation and/or IVF were recruited. A semi-structured questionnaire was sent to all the participants. Chi-square and T-tests were used to examine the differences between the groups. There were no significant differences on the following aspects. The same high proportion of egg donation mothers (77%) and IVF mothers (87%) had the intention of telling their child about the conception but most women thought disclosure at a later time preferable. Two thirds of the recipients and IVF mothers said the way of conception had no influence on the relationship with their child. The two groups differed however in their argumentation about secrecy and named different feelings. Egg donation mothers expressed more denial and showed more defensive reactions, anxieties and uncertainty. It is suggested that recognition of a certain difference between a natural conception and egg donation could be helpful in early disclosure and could help to diminish anxieties in egg donation mothers.
Past, present and future of kidney paired donation transplantation in India
Kute, Vivek B; Patel, Himanshu V; Shah, Pankaj R; Modi, Pranjal R; Shah, Veena R; Rizvi, Sayyed J; Pal, Bipin C; Modi, Manisha P; Shah, Priya S; Varyani, Umesh T; Wakhare, Pavan S; Shinde, Saiprasad G; Ghodela, Vijay A; Patel, Minaxi H; Trivedi, Varsha B; Trivedi, Hargovind L
2017-01-01
One third of healthy willing living kidney donors are rejected due to ABO blood group incompatibility and donor specific antibody. This increases pre-transplant dialysis duration leading to increased morbidity and mortality on the kidney transplantation waiting list. Over the last decade kidney paired donation is most rapidly increased source of living kidney donors. In a kidney transplantation program dominated by living donor kidney transplantation, kidney paired donation is a legal and valid alternative strategy to increase living donor kidney transplantation. This is more useful in countries with limited resources where ABO incompatible kidney transplantation or desensitization protocol is not feasible because of costs/infectious complications and deceased donor kidney transplantation is in initial stages. The matching allocation, ABO blood type imbalance, reciprocity, simultaneity, geography were the limitation for the expansion of kidney paired donation. Here we describe different successful ways to increase living donor kidney transplantation through kidney paired donation. Compatible pairs, domino chain, combination of kidney paired donation with desensitization or ABO incompatible transplantation, international kidney paired donation, non-simultaneous, extended, altruistic donor chain and list exchange are different ways to expand the donor pool. In absence of national kidney paired donation program, a dedicated kidney paired donation team will increase access to living donor kidney transplantation in individual centres with team work. Use of social networking sites to expand donor pool, HLA based national kidney paired donation program will increase quality and quantity of kidney paired donation transplantation. Transplant centres should remove the barriers to a broader implementation of multicentre, national kidney paired donation program to further optimize potential of kidney paired donation to increase transplantation of O group and sensitized patients. This review assists in the development of similar programs in other developing countries. PMID:28507916
Past, present and future of kidney paired donation transplantation in India.
Kute, Vivek B; Patel, Himanshu V; Shah, Pankaj R; Modi, Pranjal R; Shah, Veena R; Rizvi, Sayyed J; Pal, Bipin C; Modi, Manisha P; Shah, Priya S; Varyani, Umesh T; Wakhare, Pavan S; Shinde, Saiprasad G; Ghodela, Vijay A; Patel, Minaxi H; Trivedi, Varsha B; Trivedi, Hargovind L
2017-04-24
One third of healthy willing living kidney donors are rejected due to ABO blood group incompatibility and donor specific antibody. This increases pre-transplant dialysis duration leading to increased morbidity and mortality on the kidney transplantation waiting list. Over the last decade kidney paired donation is most rapidly increased source of living kidney donors. In a kidney transplantation program dominated by living donor kidney transplantation, kidney paired donation is a legal and valid alternative strategy to increase living donor kidney transplantation. This is more useful in countries with limited resources where ABO incompatible kidney transplantation or desensitization protocol is not feasible because of costs/infectious complications and deceased donor kidney transplantation is in initial stages. The matching allocation, ABO blood type imbalance, reciprocity, simultaneity, geography were the limitation for the expansion of kidney paired donation. Here we describe different successful ways to increase living donor kidney transplantation through kidney paired donation. Compatible pairs, domino chain, combination of kidney paired donation with desensitization or ABO incompatible transplantation, international kidney paired donation, non-simultaneous, extended, altruistic donor chain and list exchange are different ways to expand the donor pool. In absence of national kidney paired donation program, a dedicated kidney paired donation team will increase access to living donor kidney transplantation in individual centres with team work. Use of social networking sites to expand donor pool, HLA based national kidney paired donation program will increase quality and quantity of kidney paired donation transplantation. Transplant centres should remove the barriers to a broader implementation of multicentre, national kidney paired donation program to further optimize potential of kidney paired donation to increase transplantation of O group and sensitized patients. This review assists in the development of similar programs in other developing countries.
Hispanic/Latino concerns about living kidney donation: a focus group study.
Gordon, Elisa J; Mullee, Jack O; Ramirez, Daney I; MacLean, Jessica; Olivero, Maria; Feinglass, Joseph; Carney, Paula; O'Connor, Kate; Caicedo, Juan Carlos
2014-06-01
Given the shortage of kidneys for transplant, living kidney donation (LKD) is increasingly used to expand the organ donor pool. Although Hispanics/Latinos need disproportionately more kidney transplants, they receive a smaller proportion of living donor kidney transplants than other ethnic/racial groups. To assess Hispanics' awareness, perceptions, misconceptions, cultural beliefs, and values about and barriers to LKD. Nine focus groups were conducted with 76 adult Hispanics in Chicago, Illinois, between January and March 2012. Focus groups included kidney transplant recipients, living kidney donors, dialysis patients, and the general Hispanic public. Several themes emerged as perceived barriers to LKD. Many participants identified knowledge deficits about LKD, expressing uncertainty about the differences between LKD and deceased donation, and whether kidney disease simultaneously afflicts both kidneys. Many believed that donors experience dramatically shorter life expectancies, are unable to have children, and are more susceptible to kidney disease after donating. Recipients and donors reported that family members were involved in discussions about the donor's decision to donate, with some family members discouraging donation. Financial barriers cited included fear of becoming unable to work, losing one's job, or being unable to pay household bills while recovering. Participants also identified logistic barriers for undocumented immigrants (eg, the inability to obtain government insurance for transplant candidates and uncertainty about their eligibility to donate). Donors desired information about optimizing self-care to promote their remaining kidney's health. Culturally competent interventions are needed to redress Hispanics' knowledge deficits and misconceptions and reduce LKD disparities among Hispanics.
The beauty of the gift: the wonder of living organ donation.
Spital, Aaron; Jacobs, Cheryl L
2007-01-01
In a recent opinion piece, Nancy Scheper-Hughes provides a sweeping indictment of living organ donation, even in cases where the gift is directed to a close family member. She describes the process with caustic powerful phrases such as "sacrificial violence" and a "call to 'self-sacrifice.'" She concludes that living organ donation "should be consigned to a back seat as an exceptional back-up to deceased donation." But her conclusions are based on anecdotes and data that are not representative of donor practice and motivation in the United States and other developed countries. At reputable transplant centers great care is taken to identify genuine volunteers and to protect their interests. Under these circumstances living organ donation remains a generally safe and beneficial procedure for the donor as well as the recipient, and a wonderful example of the goodness of people.
Modelling antecedents of blood donation motivation among non-donors of varying age and education.
Lemmens, K P H; Abraham, C; Ruiter, R A C; Veldhuizen, I J T; Dehing, C J G; Bos, A E R; Schaalma, H P
2009-02-01
Understanding blood donation motivation among non-donors is prerequisite to effective recruitment. Two studies explored the psychological antecedents of blood donation motivation and the generalisability of a model of donation motivation across groups differing in age and educational level. An older well-educated population and a younger less well-educated population were sampled. The studies assessed the role of altruism, fear of blood/needles and donation-specific cognitions including attitudes and normative beliefs derived from an extended theory of planned behaviour (TPB). Across both samples, results showed that affective attitude, subjective norm, descriptive norm, and moral norm were the most important correlates of blood donation intentions. Self-efficacy was more important among the younger less well-educated group. Altruism was related to donation motivation but only indirectly through moral norm. Similarly, fear of blood/needles only had an indirect effect on motivation through affective attitude and self-efficacy. Additional analyses with the combined data set found no age or education moderation effects, suggesting that this core model of donation-specific cognitions can be used to inform future practical interventions recruiting new blood donors in the general population.
Ali, Hussein M; Ali, Isra H
2018-03-15
Antioxidant activity of anthocyanidins is greatly affected by the 3-hydroxyl group and/or a catecholic moiety. The two-hydrogen atom donation process is frequently used to explain the high antioxidant activity of polyphenolic compounds leading to the formation of stable diketones e.g. 1,2-quinones. Thermodynamic parameters, HOMO and spin density were computed to identify the favoured path, either through the 3-hydroxyl group or through the catecholic moiety in a series of catecholic and non-catecholic 3-oxy- (and deoxy)-anthocyanidins. DFT calculations showed that the donation process in non-catecholic anthocyanidins depended on the substituents on ring B. Anthocyanidins with 3',5'-diOMe groups showed donation through 3,4'-OH or, otherwise, through 3,5-OH groups. Catecholic 3-oxyanthocyanidins, on the other hand, showed donation through the 3,4'-OH path rather than the catecholic path (4',3'-path). The 3,4'-path was favoured by the formation of planar 3-radicals in the first step and the stabilization of 4'-radicals in the second step by H-bonding with the 3'-OH group. Copyright © 2017 Elsevier Ltd. All rights reserved.
Sequential improvements in organ procurement increase the organ donation rate.
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.
Organ donation after euthanasia, morally acceptable under strict procedural safeguards.
van Dijk, Gert; van Bruchem-Visser, Rozemarijn; de Beaufort, Inez
2018-05-23
In this paper, we will present a case of organ donation after active euthanasia (ODE) in The Netherlands from a patient who had his life ended at his explicit and voluntary request. The form of ODE we describe here concerns patients who are not unconscious and on life support, but who are conscious and want to have their life ended because of their hopeless and unbearable suffering, for instance due to a terminal illness such as Amyotrophic Lateral Sclerosis (ALS) or Multiple Sclerosis (MS). This form of ODE is of course only possible in jurisdictions where euthanasia is allowed. In these jurisdictions, organ donation after euthanasia is an option that may be considered. We believe ODE is worthwhile to pursue, as it can strengthen patient autonomy, can give meaning to the inevitable death of the patient, and be an extra source of much needed donor organs. To ensure voluntariness of both euthanasia and organ donation and avoid conflict of interest by physicians, ODE does need strict procedural safeguards however. The most important safeguard is a strict separation between the two procedures. The paper discusses several ethical issues such as who should broach the subject of organ donation and who should perform the euthanasia, and how a conflict of interest can be avoided. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
Living organ donation: the effect of message frame on an altruistic behaviour.
McGregor, Lesley M; Ferguson, Eamonn; O'Carroll, Ronan E
2012-09-01
This experimental study investigates the impact of message frame and risk perceptions upon willingness to consider living organ donation. A 2 (gain vs. loss) by 2 (liver vs. kidney) by 2 (involved vs. not involved) between-group study was conducted. Eighty-seven participants completed a questionnaire after reading a vignette designed to invite participants to consider living kidney or liver donation. Within a gain frame scenario, willingness to donate was significantly higher when the risk of donating was lower. The results have important implications for the generalizability of framing theories and the promotion of living organ donation.
Ross, Samuel Wade; Christmas, A Britton; Fischer, Peter E; Holway, Haley; Seymour, Rachel; Huntington, Ciara R; Heniford, B Todd; Sing, Ronald F
2018-06-04
The concept of hemodilution after blood loss and crystalloid infusion is a surgical maxim that remains unproven in humans. We sought to quantify the effect of hemodilution after crystalloid administration in voluntary blood donors as a model for acute hemorrhage. A prospective, randomized control trial was conducted in conjunction with community blood drives. Donors were randomized to receive no IV fluid(noIVF), two liters normal saline(NS), or two liters lactated ringers(LR) after blood donation. Blood samples were taken before donation of 500 mL of blood, immediately after donation, and following IV fluid administration. Hemoglobin(Hgb) was measured at each time point. Hgb between time points were compared between groups using standard statistical tests and the Bonferroni correction for multiple comparisons. Statistical significance was set at p≤0.0167. Of 165 patients consented, 157 patients completed the study. Average pre-donation Hgb was 14.3 g/dL. There was no difference in the mean Hgb levels after blood donation between the three groups(p>0.05). Compared to the control group, there was a significant drop in Hgb in the crystalloid infused groups from the post-donation level to post-resuscitation(13.2 vs 12.1 vs 12.2 g/dL, p<0.0001). A formula was created to predict hemoglobin levels from a given estimated blood loss(EBL) and volume replacement(VR): Hemodilution Hgb=(MeanPre-donation Hgb - hemorrhage Hgb drop - equilibration hemoglobin drop - resuscitation Hgb drop)=MeanPre-donation Hgb - [(EBL/TBV)*l] - [(EBL/TBV)*h] - [(VR/TBV)*r], l = 5.111g/dL = blood loss coefficient, h=6.722 g/dL=equilibration coefficient, r= 2.617g/dL= resuscitation coefficient. This study proves the concept of hemodilution and derived a mathematical relationship between blood loss and resuscitation. This data may help to estimate response of hemoglobin levels to blood loss and fluid resuscitation in clinical practice. Copyright © 2018. Published by Elsevier Inc.
Complex Contagion of Campaign Donations.
Traag, Vincent A
2016-01-01
Money is central in US politics, and most campaign contributions stem from a tiny, wealthy elite. Like other political acts, campaign donations are known to be socially contagious. We study how campaign donations diffuse through a network of more than 50,000 elites and examine how connectivity among previous donors reinforces contagion. We find that the diffusion of donations is driven by independent reinforcement contagion: people are more likely to donate when exposed to donors from different social groups than when they are exposed to equally many donors from the same group. Counter-intuitively, being exposed to one side may increase donations to the other side. Although the effect is weak, simultaneous cross-cutting exposure makes donation somewhat less likely. Finally, the independence of donors in the beginning of a campaign predicts the amount of money that is raised throughout a campaign. We theorize that people infer population-wide estimates from their local observations, with elites assessing the viability of candidates, possibly opposing candidates in response to local support. Our findings suggest that theories of complex contagions need refinement and that political campaigns should target multiple communities.
Complex Contagion of Campaign Donations
2016-01-01
Money is central in US politics, and most campaign contributions stem from a tiny, wealthy elite. Like other political acts, campaign donations are known to be socially contagious. We study how campaign donations diffuse through a network of more than 50000 elites and examine how connectivity among previous donors reinforces contagion. We find that the diffusion of donations is driven by independent reinforcement contagion: people are more likely to donate when exposed to donors from different social groups than when they are exposed to equally many donors from the same group. Counter-intuitively, being exposed to one side may increase donations to the other side. Although the effect is weak, simultaneous cross-cutting exposure makes donation somewhat less likely. Finally, the independence of donors in the beginning of a campaign predicts the amount of money that is raised throughout a campaign. We theorize that people infer population-wide estimates from their local observations, with elites assessing the viability of candidates, possibly opposing candidates in response to local support. Our findings suggest that theories of complex contagions need refinement and that political campaigns should target multiple communities. PMID:27077742
Moving closer to understanding the risks of living kidney donation.
Steiner, Robert W
2016-01-01
Recent studies from the United States and Norway have suggested an unexpected 8- to 11-fold relative risk of ESRD after kidney donation, but a low long-term absolute risk. Abundant renal epidemiologic data predict that these studies have underestimated long-term risk. The 1% lifetime post-donation risk in the US study requires medical screening to predict ESRD in 96 of 100 candidates. This is particularly unlikely in the 30-35% of candidates under age 35, half of whose lifetime ESRD will occur after age 64. Many experts have attributed the increased relative risks in these studies to loss of GFR at donation, which ultimately means that high-normal pre-donation GFRs will reduce absolute post-donation risks. The 8- to 11-fold relative risks predict implausible risks of uninephrectomy in the general population, but lower estimates still result in very high risks for black donors. Young vs. older age, low vs. high-normal pre-donation GFRs, black race, and an increased relative risk of donation all predict highly variable individual risks, not a single "low" or "1%" risk as these studies suggest. A uniform, ethically defensible donor selection protocol would accept older donors with many minor medical abnormalities but protect from donation many currently acceptable younger, black, and/or low GFR candidates. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Attitude towards organ donation in German medical students.
Terbonssen, Tobias; Settmacher, Utz; Wurst, Christine; Dirsch, Olaf; Dahmen, Uta
2016-12-01
It is well known that personal decision making in respect to organ donation is highly dependent on the balance of knowledge, trust, and fear. We wanted to explore the attitude of German medical students towards organ donation and investigate the relationship between knowledge, trust, and fear in this special subgroup. We conducted an online survey utilizing (1) the snowball effect of using Facebook groups and advertisement as well as (2) mailing lists of medical faculties in Germany for distribution. We surveyed 1370 medical students. 75.8 % (N = 988) of the participants stated to carry an organ donor card and allowed their organs to be donated. 1.8 % (N = 23) refused donation. 22.5 % (N = 293) did not carry an organ donor card. Analysis of the "decided" versus the "undecided" group revealed substantial differences regarding transplantation knowledge (mean knowledge score of 4.23 vs. 3.81; P < 0.001), trust in (mean trust score 4.11 vs. 3.39; P < 0.001), and fear of (mean fear score 1.63 vs. 2.22; P < 0.001) organ donation. 45.9 % of the undecided group (N = 134) opted for accessing additional information material. After reading the info material, 22.7 % (N = 29) stated their willingness to sign a donor card, whereas 76.6 % (N = 98) still could not reach a decision. The willingness to potentially act as organ donor was related to the pre-existent knowledge, trust, and fear. Access to information material did promote the decision towards organ donation in a group of previously undecided medical students. This advocates initiating information campaigns even in population groups with strong medical background.
Community Preferences for the Allocation & Donation of Organs--the PAraDOx Study.
Howard, Kirsten; Jan, Stephen; Rose, John; Chadban, Steven; Allen, Richard D M; Irving, Michelle; Tong, Allison; Wong, Germaine; Craig, Jonathan C; Cass, Alan
2011-05-25
Transplantation is the treatment of choice for people with severe organ failure. However, demand substantially exceeds supply of suitable organs; consequently many people wait months, or years to receive an organ. Reasons for the chronic shortage of deceased organ donations are unclear; there appears to be no lack of 'in principle' public support for organ donation. The PAraDOx Study examines community preferences for organ donation policy in Australia. The aims are to 1) determine which factors influence decisions by individuals to offer their organs for donation and 2) determine the criteria by which the community deems the allocation of donor organs to be fair and equitable. Qualitative and quantitative methods will be used to assess community preferences for organ donation and allocation.Focus group participants from the general community, aged between 18-80, will be purposively sampled to ensure a variety of cultural backgrounds and views on organ donation. Each focus group will include a ranking exercise using a modified nominal group technique. Focus groups of organ recipients, their families, and individuals on a transplant waiting list will also be conducted.Using the qualitative work, a discrete choice study will be designed to quantitatively assess community preferences. Discrete choice methods are based on the premise that goods and services can be described in terms of a number of separate attributes. Respondents are presented with a series of choices where levels of attributes are varied, and a mathematical function is estimated to describe numerically the value respondents attach to different options. Two community surveys will be conducted in approximately 1000 respondents each to assess community preferences for organ donation and allocation. A mixed logit model will be used; model results will be expressed as parameter estimates (β) and the odds of choosing one option over an alternative. Trade-offs between attributes will also be calculated. By providing a better understanding of current community preferences in relation to organ donation and allocation, the PAraDOx study will highlight options for firstly, increasing the rate of organ donation and secondly, allow for more transparent and equitable policies in relation to organ allocation.
Abandoning the dead donor rule? A national survey of public views on death and organ donation.
Nair-Collins, Michael; Green, Sydney R; Sutin, Angelina R
2015-04-01
Brain dead organ donors are the principal source of transplantable organs. However, it is controversial whether brain death is the same as biological death. Therefore, it is unclear whether organ removal in brain death is consistent with the 'dead donor rule', which states that organ removal must not cause death. Our aim was to evaluate the public's opinion about organ removal if explicitly described as causing the death of a donor in irreversible apneic coma. We conducted a cross-sectional internet survey of the American public (n=1096). Questionnaire domains included opinions about a hypothetical scenario of organ removal described as causing the death of a patient in irreversible coma, and items measuring willingness to donate organs after death. Some 71% of the sample agreed that it should be legal for patients to donate organs in the scenario described and 67% agreed that they would want to donate organs in a similar situation. Of the 85% of the sample who agreed that they were willing to donate organs after death, 76% agreed that they would donate in the scenario of irreversible coma with organ removal causing death. There appears to be public support for organ donation in a scenario explicitly described as violating the dead donor rule. Further, most but not all people who would agree to donate when organ removal is described as occurring after death would also agree to donate when organ removal is described as causing death in irreversible coma. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Milaniak, I; Wilczek-Rużyczka, E; Wierzbicki, K; Sadowski, J; Kapelak, B; Przybyłowski, P
2016-06-01
Improvement of the consent rate for solid organ donation from deceased donors is a key component of strategies applied in many countries aiming to increase the availability of organs for transplantation. Attitudes toward living and posthumous donation are favorable. Research shows that the outlook on organ donation and the degree of the willingness to become an organ donor are associated with a wide range of variables. The main objective of this study was to identify factors that influence the willingness to donate organs and the reasons for refusing consent. The study included 191 participants (135 female and 56 male) aged 16 to 61 years (mean age 26.86 ± 12.88). A cross-sectional study was conducted during educational meetings concerning organ donation that was addressed to students, teachers, and nurses. Survey tools included the Individual Questionnaire: Study of attitudes toward transplantation, consisting of 26 closed questions (with the consent of the Statistical Office in Krakow). In all, 97.4% of the respondents accepted transplantation from living donors, and 95.8% accepted deceased donations. Of the respondents, 78.5% agreed to posthumous life-saving organ donation. There was a significant difference between the respondents' sex, age, social group, place of living, and the reasons for their willingness to donate organs both posthumously and during their lifetime, as well as reasons for refusal. Our findings showed that the study group in general had favorable views on treatment involving transplantation and declared willingness to make a posthumous organ donation. These views vary depending on demographic variables. The education on the subject of organ and tissue donation has a positive impact on donation and transplantation rates. Copyright © 2016 Elsevier Inc. All rights reserved.
[Demography and donation frequencies of blood and plasma donor populations in Germany].
Ritter, Sabine; Willand, L; Reinhard, B; Offergeld, R; Hamouda, O
2008-08-01
According to Article 22 of the Transfusion Act, the Robert Koch Institute collects and evaluates nationwide data on the prevalence and incidence of transfusion-relevant infections among blood and plasma donors in Germany. Due to revision of the Transfusion Act in 2005 not only the number of donations but also the number of donors has become available for analysis. Here we give a detailed account on the demographic profile and donation frequencies of German whole blood, plasma and platelet donors in 2006. Overall, 4 % of the German population eligible to donate were active as repeat whole blood donors in 2006; 0.3 % repeatedly donated plasma or platelets. Irrespective of the type of donation, the percentage of donors among the general population was highest among the youngest age group (18 to 24 years). While the age distribution of whole blood repeat donors roughly resembled that of the general population, with the greatest number among those aged 35 to 44, younger age groups were overrepresented among repeat plasma donors. Donation frequency varied depending on donor age and sex, with an average of 1.9 per year for whole blood donations, 11.9 for plasmapheresis and 4.0 for plateletpheresis. With the exception of the latter, men donated more frequently than women. For both sexes, donation frequency increased with age. Detailed knowledge of the demographic profile and changes in the composition of donor populations are essential for planning adequate blood supply. The data presented may serve as reference for assessing the consequences of measures that affect the number of donors and/or donations (for example changing deferral criteria) in Germany.
Ethical Issues in Live-Donor Reimbursement Program.
Voo, T C; Koh, S; Campbell, A V
2016-04-01
Reimbursement of expenses and costs incurred by live organ donation is permitted in many countries to encourage donation and to protect the welfare of live donors. Potential ethical issues may arise with reimbursement programs and their implementation, which vary across countries. This paper discusses some ethical issues with live donor reimbursement to stimulate discussion on how to ethically enhance its implementation to improve outcomes for both donors and recipients. In addition, we will consider whether reimbursement should be supplemented with compensation for nonfinancial losses, such as pain and suffering, to encourage live donation. Copyright © 2016 Elsevier Inc. All rights reserved.
Moloney, Gail; Hayman, Jane; Gamble, Marguerite; Smith, Geoff; Hall, Rob
2017-06-01
Retaining blood donors is a cost-effective way of ensuring a safe blood supply, yet despite the plethora of research, only 5.1% of the eligible population in Australia donate blood and 40% of these do not make a second donation. We offer an alternative to traditional approaches by conceptualizing blood donation within social representations theory as socially derived symbolic knowledge with a specific focus on cognitive polyphasia and Guimelli's (1998) normative and functional dimensions. An online survey, completed by 703 residents from NSW Australia, comprised a blood donation word association task, Likert-style questions constructed from previous word association data and contextualized blood donation statements. Individual difference scaling analysis revealed all donor groups (including non-donors) associated blood donation with a few central, albeit contradictory ideas/beliefs. Exploratory factor analysis and confirmatory factor analysis performed on a split data set of the Likert-style items reiterated this finding. Interpreted through Guimelli's dichotomy, all donor groups were aware of these contradictory normative and functional ideas/beliefs but when explicitly asked, it was the functional aspect that differentiated the groups. We argue the key to retaining donors is understanding the interdependence between how blood donation is socially understood at the societal level of discourse and donor behaviour. Translational strategies for recruitment and retention are discussed. © 2017 The British Psychological Society.
Increased incidence of preeclampsia in mothers of advanced age conceiving by oocyte donation.
Dior, Uri P; Laufer, Neri; Chill, Henry H; Granovsky-Grisaru, Sorina; Yagel, Simcha; Yaffe, Haim; Gielchinsky, Yuval
2018-05-01
The aim of this study was to evaluate the risk of preeclampsia in women of advanced age who conceived through donated oocytes as compared with natural conceptions. A historical prospective study of singleton live births of parturients ≥ 45 years of age at four university hospitals was conducted. For the purpose of the study, the population was divided by the mode of conception into two groups: oocyte donation and natural conception. The main outcome variable in this study was preeclampsia. Secondary outcomes included pregnancy-induced hypertension and Small for Gestational Age. Two hundred and seventy pregnancies were achieved naturally and 135 women conceived by oocyte donation. Mean age at delivery for the natural conception and oocyte donation groups was 45.7 and 47.8, respectively. Preeclampsia complicated 3 out of 270 (1.1%) natural conception pregnancies and 17 out of 135 (12.6%) oocyte donation conceptions. After adjusting for confounders, oocyte donation pregnancies were found to be associated with a 12-fold increased risk for preeclampsia (P = 0.001). Among oocyte donation pregnancies, the risk of preeclampsia was not affected by parity or age. A substantially increased risk for preeclampsia was found in oocyte donation pregnancies, suggesting that the foreign oocyte may play a specific biologic role in the development of preeclampsia after the age of 45.
Are Data Sharing and Privacy Protection Mutually Exclusive?
Joly, Yann; Dyke, Stephanie O M; Knoppers, Bartha M; Pastinen, Tomi
2016-11-17
We review emerging strategies to protect the privacy of research participants in international epigenome research: open consent, genome donation, registered access, automated procedures, and privacy-enhancing technologies. Copyright © 2016 Elsevier Inc. All rights reserved.
Factors influencing the decision to donate: racial and ethnic comparisons.
Glynn, Simone A; Schreiber, George B; Murphy, Edward L; Kessler, Debra; Higgins, Martha; Wright, David J; Mathew, Sunitha; Tu, Yongling; King, Melissa; Smith, James W
2006-06-01
Understanding factors that encourage different racial and ethnic groups to donate is crucial for donor recruitment and retention. A 28-item self-administered questionnaire was completed in 2003 by 1862 Asian, 1479 black, 1641 Hispanic, and 2940 White US donors who had given whole blood within the past year. With a 1 to 5 scale, donors were asked to rate the importance of 17 factors in their last donation decision. Logistic regression was conducted to compare the odds of a factor being important or very important (score of 4 or 5) in one's decision to donate between race or ethnic groups, stratified by first-time and repeat status. More than 90 percent of each respondent group cited a desire, responsibility, or perceived duty to help others as an important or very important motivator. Being asked to donate at work was also an important motivator for all race and ethnic groups (56-70%). Getting the results of a health screen appealed to many (approx. 30% found it important or very important) and was most important to Black and Hispanic donors (odds ratios of 1.3-1.9 compared to White donors; p<0.003). Recruitment and retention programs should build on people's sense of social responsibility. Direct requests to donate are particularly effective motivators. Of a variety of incentives evaluated, offering more comprehensive health screens may motivate many donors, especially Black and Hispanic donors.
Decision making on organ donation: the dilemmas of relatives of potential brain dead donors.
de Groot, Jack; van Hoek, Maria; Hoedemaekers, Cornelia; Hoitsma, Andries; Smeets, Wim; Vernooij-Dassen, Myrra; van Leeuwen, Evert
2015-09-17
This article is part of a study to gain insight into the decision-making process by looking at the views of the relatives of potential brain dead donors. Alongside a literature review, focus interviews were held with healthcare professionals about their role in the request and decision-making process when post-mortal donation is at stake. This article describes the perspectives of the relatives. A content-analysis of 22 semi-structured in-depth interviews with relatives involved in an organ donation decision. Three themes were identified: 'conditions', 'ethical considerations' and 'look back'. Conditions were: 'sense of urgency', 'incompetence to decide' and 'agreement between relatives'. Ethical considerations result in a dilemma for non-donor families: aiding people or protecting the deceased's body, especially when they do not know his/her preference. Donor families respect the deceased's last will, generally confirmed in the National Donor Register. Looking back, the majority of non-donor families resolved their dilemma by justifying their decision with external arguments (lack of time, information etc.). Some non-donor families would like to be supported during decision-making. The discrepancy between general willingness to donate and the actual refusal of a donation request can be explained by multiple factors, with a cumulative effect. Firstly, half of the participants (most non-donor families) stated that they felt that they were not competent to decide in such a crisis and they seem to struggle with utilitarian considerations against their wish to protect the body. Secondly, non-donor families refused telling that they did not know the deceased's wishes or contesting posthumous autonomy of the eligible. Thirdly, the findings emphasise the importance of Donor Registration, because it seems to prevent dilemmas in decision-making, at least for donor families. Discrepancies between willingness to consent to donate and refusal at the bedside can be attributed to an unresolved dilemma: aiding people or protect the body of the deceased. Non-donor families felt incompetent to decide. They refused consent for donation, since their deceased had not given any directive. When ethical considerations do not lead to an unambiguous answer, situational factors were pivotal. Relatives of unregistered eligible donors are more prone to unstable decisions. To overcome ambivalence, coaching during decision-making is worth investigation.
Do the myths still exist? Revisiting people's negative beliefs about organ donation upon death.
Hyde, Melissa K; Wihardjo, Kylie R; White, Katherine M
2012-01-01
The prevalence of myths preventing people partial to donation in Australia from consenting is unknown. Respondents (N = 468: 381 donors, 26 non-donors, 61 undecided) were surveyed about their (negative) donation beliefs. Approximately 30% of donors were neutral or supported negative beliefs about organ allocation, especially donation to undesirable organ recipients and a black market organ trade. Confusion about brain death, lack of family and religious support, and discomfort with donation were negative beliefs endorsed by some respondents irrespective of donor preference. Proportionally, donors had greater trust in hospitals/doctors than other groups. Some myths still exist but may vary with donation preference.
Willingness to communicate organ donation intention.
McDonald, Deborah Dillon; Ferreri, Ruth; Jin, Carol; Mendez, Anthea; Smail, Julie; Balcom, Patricia; Shoemaker, Sheila; Kamuzora, Paul Lwekaza; Durham, Rebecca; Dibble, Jaqueline
2007-01-01
The study tested an intervention exposing people who planned to donate organs to written information about communicating with family their intention to donate organs. A pretest posttest double-blind experiment compared participants given written information about communicating with family and basic organ donation information, with participants given written information about only basic organ donation information. Participants included 109 adults who had not yet communicated their plans with family. Participants first responded to previous experience with organ donation, thoughts about organ donation, willingness to communicate with family about organ donation, and knowledge about organ donation. After reading the respective pamphlet, participants again responded to thoughts about communicating with their family and willingness to communicate with family. Both groups responded with the same high willingness to communicate before the intervention and a small but significant increase in willingness to communicate afterwards. Participants expressed a high degree of willingness to communicate about their organ donation intentions even though they had thus far not communicated their intentions. Factors in addition to willingness to communicate need to be identified in order to encourage better communication about organ donation intentions.
Stress influences environmental donation behavior in men.
Sollberger, Silja; Bernauer, Thomas; Ehlert, Ulrike
2016-01-01
Stress has been found to have both positive and negative effects on prosocial behavior, suggesting the involvement of moderating factors such as context and underlying motives. In the present study, we investigated the conditions under which acute stress leads to an increase vs. decrease in environmental donation behavior as an indicator of prosocial behavior. In particular, we examined whether the effects of stress depended on preexisting pro-environmental orientation and stage of the donation decision (whether or not to donate vs. the amount to be donated). Male participants with either high (N=40) or low (N=39) pro-environmental orientation were randomly assigned to a social stress test or a control condition. Salivary cortisol was assessed repeatedly before and after stress induction. At the end of the experiment, all subjects were presented with an opportunity to donate a portion of their monetary compensation to a climate protection foundation. We found that stress significantly increased donation frequency, but only in subjects with low pro-environmental orientation. Congruously, their decision to donate was positively associated with cortisol response to the stress test and the emotion regulation strategy mood repair, as well as accompanied by an increase in subjective calmness. In contrast, among the participants who decided to donate, stress significantly reduced the donated amount of money, regardless of pro-environmental orientation. In conclusion, our findings suggest that acute stress might generally activate more self-serving motivations, such as making oneself feel better and securing one's own material interests. Importantly, however, a strong pro-environmental orientation partially prevented these effects. Copyright © 2015 Elsevier Ltd. All rights reserved.
Boulware, L Ebony; Ratner, Lloyd E; Cooper, Lisa A; Sosa, Julie Ann; LaVeist, Thomas A; Powe, Neil R
2002-02-01
Recent efforts to recruit blood and organ donors have only marginally improved demographic disparities in willingness to donate. Few studies have examined which factors are most important in explaining race and gender disparities in willingness to donate. To assess race and gender differences in willingness to donate blood and cadaveric organs, and to determine the extent to which several factors (including sociodemographic characteristics and attitudes about religion and mistrust of hospitals) might explain differences in willingness to donate. Cross-sectional telephone survey of Maryland households contacted via random-digit dialing. Past blood donation, organ-donor status on driver's license, and measures of medical mistrust and religious and spiritual salience. Persons age 18 to 75 living in the Baltimore, Maryland metropolitan area. Of 385 respondents (84% of randomized households), 114 were black females, 46 were black males, 110 were white females, and 69 were white males. Before adjustment, black females were least willing to donate blood (41%), and black males were least willing to become cadaveric donors (19%) among all race-gender groups. Adjustment for respondent concerns about mistrust of hospitals and discrimination in hospitals explained most differences in willingness to donate blood, whereas adjustment for respondents' beliefs regarding the importance of spirituality and religion explained most differences in willingness to donate cadaveric organs. Both race and gender are important identifiers of those less willing to donate. To maximize efficiency, donor recruitment efforts should focus on race-gender groups with lowest levels of willingness. Potential donor concerns regarding mistrust in hospitals and religion/spirituality may serve as important issues to address when developing programs to improve donation rates.
Downing, Kimberly; Jones, Linda L
2018-01-01
Older adults (50-70 years old) have lower organ donor registration rates than younger adults. Older adults have different informational needs and donor registration behavior than younger age groups. The objective of this qualitative study was to understand insights of older adults about organ donation to effectively address the barriers to becoming an organ donor. This study identified turning points as "Aha!" moments that occurred during a dialogue intervention where older adults discussed benefits, barriers, and process to organ donation. Dialogues were held with small groups of older adults in 11 communities in a Midwestern organ procurement organization service area. Participants were positive to organ donation, but not registered as an organ donor. Methods/Approach: Qualitative analysis of verbatim comments from the dialogue and a follow-up survey were used to examine turning points or "Aha!" moments of participants' decision-making about organ donation and organ donor registration. Twenty-one separate in-depth dialogues were conducted with 198 participants, with mean age of 60.57 years. There were 2757 separate comments coded with 465 of the comments (17%) identified as providing Aha! moments during the dialogue. Three themes include benefits of organ donation (30%), barriers about organ donation (39%), and organ donation process (31%). The research identified moments in the dialogue where possible learning about organ donation may have occurred. After participation in the dialogue process, there was an increase in intent to register to be an organ donor, organ donation discussion with family and friends, and organ donor registration.
Living donation decision making: recipients' concerns and educational needs.
Waterman, Amy D; Stanley, Sara L; Covelli, Tonie; Hazel, Erik; Hong, Barry A; Brennan, Daniel C
2006-03-01
Despite the advantages of living donor transplantation, evidence suggests that some potential recipients with living donors have psychological concerns that prevent them from pursuing living donation. Addressing these concerns through education may increase the rates of living donation. To understand the psychological barriers and educational needs of potential kidney recipients regarding living donation. Qualitative focus group study of kidney transplant recipients, donors, and family members to explore their assessment of the advantages of dialysis and deceased donor transplantation over living donation, their concerns about living donation, and what types of living donation education would be most helpful. Kidney recipients reported that they might not pursue living donation because they felt guilty and indebted to the donor, did not want to harm or inconvenience the donor, did not want to accept a kidney that a family member might need later, and did not want to disappoint the donor if the kidney failed. Recipients were generally unaware that donors could personally benefit from donating and would rather wait for donor volunteers than ask anyone directly. Both donors and recipients thought that training on how to make the donation request and education about living donors' motivations for donation and transplant experience could help more renal patients pursue living donation.
Siminoff, Laura A; Wilson-Genderson, Maureen; Mosavel, Maghboeba; Barker, Laura; Trgina, Jennifer; Traino, Heather M; Nathan, Howard M; Hasz, Richard D; Walters, Gary
2018-01-01
Genomic research projects that collect tissues from deceased organ and tissue donors must obtain the authorization of family decision makers under difficult circumstances that may affect the authorization process. Using a quasi-experimental design, the Ethical, Legal, and Social Issues (ELSI) substudy of the Genotype-Tissue Expression (GTEx) project compared the recall and understanding of the donation authorization process of two groups: family members who had authorized donation of tissues to the GTEx project (the comparison group) and family members who had authorized organ and tissue donations in years previous, who subsequently participated in two different mock-authorization processes that mimicked the GTEx authorization process (the intervention groups). Participants in the comparison and intervention groups were matched on key demographic characteristics. We found that participants in the intervention groups who experienced a mock-authorization process demonstrated better recall of the tissue donation request than members of the comparison group. Our data indicate that the stress associated with the loss of a loved one limited the ability of family members to recall details about the GTEx project. However, we found a similar lack of knowledge in both the comparison and the intervention group participants, suggesting lack of knowledge may be due to the complexity and unfamiliarity of the information presented to them during the authorization process. We discuss these findings in the context of everyday clinical decision making in cognitively challenging conditions. Copyright 2018 The Journal of Clinical Ethics. All rights reserved.
Murakami, Minoru; Fukuma, Shingo; Ikezoe, Masaya; Iizuka, Chizuko; Izawa, Satoshi; Yamamoto, Yosuke; Yamazaki, Shin; Fukuhara, Shunichi
2016-11-01
Little is known about the effect of education programs on changing attitudes and behaviors of participants and their families toward deceased organ donation. The subjects of this randomized trial were Japanese nursing students who were not previously designated organ donors. They were randomly assigned to either the education program or information booklet group. The program comprised a lecture followed by group discussion and information booklet. The primary outcome was self-reported organ donor designation. Outcomes were assessed by questionnaire. Data of 203 (99.0%) students were analyzed. At study end, seven of 102 students (6.9%) of the program group and one of 101 students (1.0%) of the booklet group consented to donate organs (proportion ratio 6.93 [95% CI 0.87-55.32]). There were significant between-group differences in willingness to consent for donation (54.9% vs 39.6%; proportion ratio 1.39 [95% CI 1.03-1.87]), family discussion (31.4% vs 15.9%; 1.98 [1.16-3.38]), and organ donor designation of family members (11.8% vs 2.0%; 5.94 [1.36-25.88]). No group differences were found in willingness for organ donation by students and family members. Although there were no significant between-group differences in organ donor designation, the program seems to indirectly promote consent to organ donation by their families. © 2016 The Authors. Clinical Transplantation Published by John Wiley & Sons Ltd.
Stevens, Jack; Keim, Sarah A
2015-08-01
Many hospitalized preterm infants do not exclusively receive mother's own milk, so milk from another mother may be sought. Previous research indicated that just 1% of US women who express breast milk actually donate it for another family. Therefore, strategies to boost donation rates should be identified. We draw upon the experimental literature on charitable giving of monetary donations to offer 6 strategies to promote breast milk donations to milk banks in North America. These strategies include (1) highlighting a potential identifiable recipient of donated breast milk as opposed to highlighting groups of potential recipients; (2) emphasizing similarities between the potential donor and potential beneficiaries; (3) emphasizing similarities between the potential donor and previous donors; (4) using negative arousal to promote donations; (5) emphasizing the self-interest of those asking for breast milk donations; and (6) highlighting the specific effect of breast milk donations. Potential limitations of these strategies are discussed. © The Author(s) 2015.
Reduced social preferences in autism: evidence from charitable donations
2012-01-01
Background People with autism have abnormal preferences, ranging from an apparent lack of preference for social stimuli to unusually strong preferences for restricted sets of highly idiosyncratic stimuli. Yet the profile of preferences across social and nonsocial domains has not been mapped out in detail, and the processes responsible remain poorly understood. Methods To assess preferences across a range of stimuli, we measured real monetary donations to 50 charities spanning categories pertaining to people, mental health, animals, or the environment. We compared the donations made by 16 high-functioning adults with autism to those made by neurotypical controls matched on age, gender and education. We additionally collected ratings of how people evaluated the different charities. Results Compared with controls, high-functioning adults with autism donated less overall and also showed a significantly disproportionate reduction in donations to people charities compared with donations to the other charities. Furthermore, whereas controls discriminated strongly between different people charities, choosing to donate a lot of money to some and very little to others, much less discrimination was seen in the autism group. Ratings that probed how participants constructed their preferences did not differ between groups, except for a difference in the perceived impact of pictures and text information about people charities. Strikingly, there were some charities related to mental health, and autism in particular, to which the autism group donated considerably more than did the controls. Conclusions People with autism were found to have reduced preference and sensitivity towards charities benefiting other people. The findings provide evidence for a domain-specific impairment in social cognition in autism spectrum disorder, and in particular in linking otherwise intact social knowledge to the construction of value signals on which preferences regarding other people are based. PMID:22958506
Reduced social preferences in autism: evidence from charitable donations.
Lin, Alice; Tsai, Karin; Rangel, Antonio; Adolphs, Ralph
2012-05-17
People with autism have abnormal preferences, ranging from an apparent lack of preference for social stimuli to unusually strong preferences for restricted sets of highly idiosyncratic stimuli. Yet the profile of preferences across social and nonsocial domains has not been mapped out in detail, and the processes responsible remain poorly understood. To assess preferences across a range of stimuli, we measured real monetary donations to 50 charities spanning categories pertaining to people, mental health, animals, or the environment. We compared the donations made by 16 high-functioning adults with autism to those made by neurotypical controls matched on age, gender and education. We additionally collected ratings of how people evaluated the different charities. Compared with controls, high-functioning adults with autism donated less overall and also showed a significantly disproportionate reduction in donations to people charities compared with donations to the other charities. Furthermore, whereas controls discriminated strongly between different people charities, choosing to donate a lot of money to some and very little to others, much less discrimination was seen in the autism group. Ratings that probed how participants constructed their preferences did not differ between groups, except for a difference in the perceived impact of pictures and text information about people charities. Strikingly, there were some charities related to mental health, and autism in particular, to which the autism group donated considerably more than did the controls. People with autism were found to have reduced preference and sensitivity towards charities benefiting other people. The findings provide evidence for a domain-specific impairment in social cognition in autism spectrum disorder, and in particular in linking otherwise intact social knowledge to the construction of value signals on which preferences regarding other people are based.
3 CFR 8491 - Proclamation 8491 of April 1, 2010. National Donate Life Month, 2010
Code of Federal Regulations, 2011 CFR
2011-01-01
... of circumstances through organ, tissue, stem cell, and blood donation. During National Donate Life... groups, and private organizations to join forces to boost the number of organ, tissue, blood, and stem cell donors throughout our Nation. IN WITNESS WHEREOF, I have hereunto set my hand this first day of...
Javadzadeh Shahshahani, H
2007-12-01
The most important aim of all blood transfusion centres is to recruit blood donors from low-risk groups of society to donate blood voluntarily and regularly. In the city of Yazd, Iran, only 5% of blood donors are women. The aim of this study was to assess barriers of donation of blood by women and the level of knowledge, attitude and practice regarding blood donation. In this cross-sectional study, 1602 women were selected by cluster sampling method and asked to fill a specially formatted questionnaire. Data were analysed by ANOVA and the t-test. Levels of knowledge were different between the various groups. Illiterate women and housewives had the least levels of knowledge. Fifteen per cent of the women had donated blood at least once in the past. The most important motivational factor was sense of moral duty with a spiritual reward and the most important barriers for donating blood were anaemia, fear, lack of time and difficulty in access to donation sites. A significant percentage of women had false beliefs about blood donation. Increase in the level of knowledge of women and correction of false beliefs should be the topmost priority. Further studies are needed to determine whether addressing anaemia and women's health can tend to increase the number of female blood donors.
Yushin Ding; Fowler, J.S.; Wolf, A.P.
1993-10-19
A method for synthesizing no-carrier-added (NCA) aryl [.sup.18 F] fluoride substituted aromatic aldehyde compositions bearing an electron donating group is described. The method of the present invention includes the step of reacting aromatic nitro aldehydes having a suitably protected hydroxyl substitutent on an electron rich ring. The reaction is The U.S. Government has rights in this invention pursuant to Contract Number DE-AC02-76CH00016, between the U.S. Department of Energy and Associated Universities Inc.
Ding, Yu-Shin; Fowler, Joanna S.; Wolf, Alfred P.
1993-01-01
A method for synthesizing no-carrier-added (NCA) aryl [.sup.18 F] fluoride substituted aromatic aldehyde compositions bearing an electron donating group is described. The method of the present invention includes the step of reacting aromatic nitro aldehydes having a suitably protected hydroxyl substitutent on an electron rich ring. The reaction is The U.S. Government has rights in this invention pursuant to Contract Number DE-AC02-76CH00016, between the U.S. Department of Energy and Associated Universities Inc.
Diarra, A; Kouriba, B; Baby, M; Murphy, E; Lefrere, J-J
2009-01-01
Good data on background seroprevalence of major transfusion transmitted infections is lacking in Mali. We gathered data on the rate of positive donations of human immunodeficiency virus (HIV), hepatitis C virus (HCV), hepatitis B virus (HBV) and syphilis among blood donations in Mali for calendar year 2007. Donations with repeatedly reactive results on screening enzyme immunoassay (EIA) were considered to be seropositive. Rate of positive donations per blood unit collected was 2.6% for HIV, 3.3% for HCV, 13.9% for hepatitis B surface antigen (HBsAg) and 0.3% for syphilis. For HIV, HBsAg and syphilis, rate of positive donations was significantly (p<0.001) higher among donations from replacement donors than those from volunteer donors, while HCV rate of positive donations was similar in the two groups. Rate of positive donations was also significantly (p<0.0001) lower in blood units from regular than from first-time donors. These data reinforce WHO recommendations for increasing the number of regular, volunteer blood donors in Africa.
Wind, Jentina; van Mook, Walther N K A; Willems, Monique E C; van Heurn, L W Ernest
2012-11-01
Refusal to consent to organ donation is an important cause of the persisting gap between the number of potential organ donors and effectuated donors. In the Netherlands, organ donors include both uncontrolled donors: donors who die unexpectedly after cardiac death (DCD), after failed resuscitation and donors in whom death can be expected and donors after brain death, and controlled DCD donors: those who die after the withdrawal of treatment. Different donor type implies a different setting in which relatives are requested to consent to organ donation. It is unknown whether the setting influences the eventual decision for donation or not. Therefore, we compared the consent rate in potential donors who died unexpectedly (UD group) and in whom death was expected. A total of 523 potential organ donors between 2003 and 2011 in the 715-bed Maastricht University Medical Centre, the Netherlands were included. Both the patients' registration in the national donor register (DR) and the relatives' refusal rate in the two groups were retrospectively assessed using data from the donation application database. There were 109 unexpected and 414 expected potential donors The potential donors in the UD group were younger (mean age 52 versus 55 years, P = 0.032) and more often male (68 versus 52%, P = 0.003). There were no significant differences in registration in the DR between the groups. The relatives' consent rate in non-registered potential donors, or those who mandated the relatives for that decision, was higher in the UD group (53 versus 29%, P < 0.001). Less than 50% of the potential donors were registered in the national DR. Therefore, the relatives have an important role in the choice for organ donation. The relatives of potential donors who died unexpectedly consented more often to donation than those in whom death was expected.
2011-01-01
Background Many individuals are unwilling to become posthumous organ donors, resulting in a disparity between the supply and demand for organ transplants. A meta-synthesis of the qualitative literature was therefore conducted to determine how the general public views posthumous organ donation. Methods Three online databases (PubMed, PsycINFO, Scopus) were searched for articles published between January 1990 and May 2008 using the following search terms: organ donation, qualitative, interview. Eligibility criteria were: examination of beliefs about posthumous organ donation; utilization of a qualitative research design; and publication in an English peer-reviewed journal. Exclusion criteria were examining how health professionals or family members of organ donors viewed posthumous organ donation. Grounded theory was used to identify the beliefs emerging from this literature. Thematically-related beliefs were then grouped to form themes. Results 27 articles from 24 studies met the inclusion criteria and were reviewed. The major themes identified were: religion, death, altruism, personal relevance, the body, the family, medical professionals, and transplant recipients. An altruistic motivation to help others emerged as the most commonly identified motivator for becoming an organ donor, although feeling a sense of solidarity with the broader community and believing that donated organs are put to good use may be important preconditions for the emergence of this motivation. The two most commonly identified barriers were the need to maintain bodily integrity to safeguard progression into the afterlife and the unethical recovery of organs by medical professionals. The influence of stakeholder groups on willingness to become an organ donor was also found to vary by the level of control that each stakeholder group exerted over the donation recovery process and their perceived conflict of interest in wanting organ donation to proceed. Conclusions These findings afford insights into how individuals perceive posthumous organ donation. PMID:21988839
Aull, Meredith J.; Afaneh, Cheguevara; Charlton, Marian; Serur, David; Douglas, Melissa; Christos, Paul J.; Kapur, Sandip; Del Pizzo, Joseph J.
2014-01-01
Few prospective, randomized studies have assessed benefits of laparoendoscopic single site donor nephrectomy (LESS-DN) over laparoscopic donor nephrectomy (LDN). Our center initiated such a trial in January 2011, following subjects randomized to LESS-DN vs. LDN from surgery through 5 years post-donation. Subjects complete recovery/satisfaction questionnaires at 2, 6, and 12 months post-donation; transplant recipient outcomes are also recorded. 100 subjects (49 LESS-DN, 51 LDN) underwent surgery; donor demographics were similar between groups, and included a predominance of female, living unrelated donors, mean age of 47 years who underwent left donor nephrectomy. Operative parameters (overall time, time to extraction, warm ischemia time, blood loss) were similar between groups. Conversion to hand-assist laparoscopy was required in 3 LESS-DN (6.1%) vs. 2 LDN (3.9%; P=0.67). Questionnaires revealed 97.2% of LESS-DN vs. 79.5% of LDN (P=0.03) were 100% recovered by two months after donation. No significant difference was seen in satisfaction scores between the groups. Recipient outcomes were similar between groups. Our randomized trial comparing LESS donor nephrectomy to LDN confirms that LESS-DN offers a safe alternative to conventional LDN in terms of intra- and post-operative complications. LDN and LESS-DN offer similar recovery and satisfaction after donation. PMID:24934732
Mellish, Sarah; Sanders, Ben; Litchfield, Carla A; Pearson, Elissa L
2017-05-01
Modern zoos are uniquely positioned to educate the public about environmental issues and promote conservation action. This report investigates the introduction of a donation request during an interactive fur seal presentation (as part of Melbourne Zoo's "Seal-the-Loop" initiative) on visitor satisfaction, perceptions of donation as a way to help wild fur seals, and donation behaviors. Comparisons are made between three groups surveyed upon exit: (1) viewed the interactive fur seal presentation prior to the donation request implementation (pledge-presentation: N = 86; see Mellish, Pearson, Sanders, and Litchfield []; International Zoo Yearbook 129:129-154); (2) viewed the interactive fur seal presentation including the donation request (donate-presentation: N = 82); and (3) viewed the fur seal exhibit and donation point but not the presentation and were not directly asked to make a donation (donate-exhibit: N = 82). Findings demonstrate visitor satisfaction with the interactive fur seal presentation was not negatively impacted following the implementation of the donate request (with >92% of pledge-presentation and donate-presentation visitors providing a "satisfied" or "very satisfied" rating). Only the donate-presentation visitors reported donation as a conservation action to help wild fur seals (19.18%; 0% for pledge-presentation visitors). While both donate-exhibit (39.51%) and donate-presentation visitors (60.75%) self-reported making donations or intending to do so, donation behavior was significantly increased for visitors who had viewed the fur seal presentation. Findings provide preliminary support that zoos may utilize interactive educational presentations to effectively ask visitors for donations to support specific conservation projects, without negatively impacting on satisfaction and with a relatively high level of visitor engagement. © 2017 Wiley Periodicals, Inc.
Vanatta, Jason M; Dean, Amanda G; Hathaway, Donna K; Nair, Satheesh; Modanlou, Kian A; Campos, Luis; Nezakatgoo, Nosratollah; Satapathy, Sanjaya K; Eason, James D
2013-04-01
Organ donation after cardiac death remains an available resource to meet the demand for transplant. However, concern persists that outcomes associated with donation after cardiac death liver allografts are not equivalent to those obtained with organ donation after brain death. The aim of this matched case control study was to determine if outcomes of liver transplants with donation after cardiac death donors is equivalent to outcomes with donation after brain death donors by controlling for careful donor and recipient selection, surgical technique, and preservation solution. A retrospective, matched case control study of adult liver transplant recipients at the University of Tennessee/Methodist University Hospital Transplant Institute, Memphis, Tennessee was performed. Thirty-eight donation after cardiac death recipients were matched 1:2, with 76 donation after brain death recipients by recipient age, recipient laboratory Model for End Stage Liver Disease score, and donor age to form the 2 groups. A comprehensive approach that controlled for careful donor and recipient matching, surgical technique, and preservation solution was used to minimize warm ischemia time, cold ischemia time, and ischemia-reperfusion injury. Patient and graft survival rates were similar in both groups at 1 and 3 years (P = .444 and P = .295). There was no statistically significant difference in primary nonfunction, vascular complications, or biliary complications. In particular, there was no statistically significant difference in ischemic-type diffuse intrahepatic strictures (P = .107). These findings provide further evidence that excellent patient and graft survival rates expected with liver transplants using organ donation after brain death donors can be achieved with organ donation after cardiac death donors without statistically higher rates of morbidity or mortality when a comprehensive approach that controls for careful donor and recipient matching, surgical technique, and preservation solution is used.
Bialkowski, W.; Bryant, B. J.; Schlumpf, K. S.; Wright, D. J.; Birch, R.; Kiss, J. E.; D’Andrea, P.; Cable, R. G.; Spencer, B. R.; Vij, V.; Mast, A. E.
2014-01-01
Background and Objectives Repeated blood donation produces iron deficiency. Changes in dietary iron intake do not prevent donation-induced iron deficiency. Prolonging the interdonation interval or using oral iron supplements can mitigate donation-induced iron deficiency. The most effective operational methods for reducing iron deficiency in donors are unknown. Materials and Methods ‘Strategies To Reduce Iron Deficiency’ (STRIDE) was a two-year, randomized, placebo-controlled study in blood donors. 692 donors were randomized into one of two educational groups or one of three interventional groups. Donors randomized to educational groups either received letters thanking them for donating, or, suggesting iron supplements or delayed donation if they had low ferritin. Donors randomized to interventional groups either received placebo, 19-mg or 38-mg iron pills. Results Iron deficient erythropoiesis was present in 52.7% of males and 74.6% of females at enrolment. Adverse events within 60 days of enrolment were primarily mild gastrointestinal symptoms (64%). The incidence of de-enrolment within 60 days was more common in the interventional groups than in the educational groups (P = 0.002), but not more common in those receiving iron than placebo (P = 0.68). Conclusion The prevalence of iron deficient erythropoiesis in donors enrolled in the STRIDE study is comparable to previously described cohorts of regular blood donors. De-enrolment within 60 days was higher for donors receiving tablets, although no more common in donors receiving iron than placebo. PMID:25469720
Bialkowski, W; Bryant, B J; Schlumpf, K S; Wright, D J; Birch, R; Kiss, J E; D'Andrea, P; Cable, R G; Spencer, B R; Vij, V; Mast, A E
2015-02-01
Repeated blood donation produces iron deficiency. Changes in dietary iron intake do not prevent donation-induced iron deficiency. Prolonging the interdonation interval or using oral iron supplements can mitigate donation-induced iron deficiency. The most effective operational methods for reducing iron deficiency in donors are unknown. 'Strategies To Reduce Iron Deficiency' (STRIDE) was a two-year, randomized, placebo-controlled study in blood donors. 692 donors were randomized into one of two educational groups or one of three interventional groups. Donors randomized to educational groups either received letters thanking them for donating, or, suggesting iron supplements or delayed donation if they had low ferritin. Donors randomized to interventional groups either received placebo, 19-mg or 38-mg iron pills. Iron deficient erythropoiesis was present in 52·7% of males and 74·6% of females at enrolment. Adverse events within 60 days of enrolment were primarily mild gastrointestinal symptoms (64%). The incidence of de-enrolment within 60 days was more common in the interventional groups than in the educational groups (P = 0·002), but not more common in those receiving iron than placebo (P = 0·68). The prevalence of iron deficient erythropoiesis in donors enrolled in the STRIDE study is comparable to previously described cohorts of regular blood donors. De-enrolment within 60 days was higher for donors receiving tablets, although no more common in donors receiving iron than placebo. © 2014 International Society of Blood Transfusion.
Motivations to donate blood: demographic comparisons.
Glynn, Simone A; Kleinman, Steven H; Schreiber, George B; Zuck, Thomas; Combs, Suzanne Mc; Bethel, James; Garratty, George; Williams, Alan E
2002-02-01
Understanding blood donor motivations is crucial to improving effectiveness of donor recruitment and retention programs. Data from a 1998 survey of 92,581 U.S. blood donors were used to evaluate factors influencing the decision to donate in various demographic groups. Data were weighted to adjust for response and sample design. Of 52,650 respondents, 45,588 gave whole-blood (WB) donations. Among all demographic groups, the major reasons to donate were altruism (75-87%) and awareness of the need for blood (34-43%). Except for first-time donors and those
Alfouzan, Najd
2014-01-01
Background. Blood donation is remarkably safe medical procedure. However, attitudes, beliefs, and level of knowledge may affect it. Objectives. To measure the level of knowledge regarding blood donation, find out positive and negative attitudes, identify the obstacles, and suggest some motivational factors. Methodology. A cross-sectional study was conducted at King Abdulaziz Medical City (KAMC). Participants were selected by convenient nonrandom sampling technique. A self-created questionnaire was used for data collection. Results. The study included 349 individuals. About 45.8% of the participants claimed that they have a history of blood donation. Reported causes for not donating blood were blood donation not crossing their mind (52.4%), no time for donation (45%), and difficulty in accessing blood donation center (41.3%). Reported motivating factors for donating blood were one day off (81.4%), mobile blood donation caravans in public areas (79.1%), token gifts (31.5%), and finally paying money (18.9%). Conclusion. People in the age group 31-50 years, males, higher education and military were more likely to donate blood as well as People who showed higher knowledge level and positive attitude towards blood donation. More educational programs to increase the awareness in specific targeted populations and also to focus on some motivational factors are recommended.
2014-01-01
Background. Blood donation is remarkably safe medical procedure. However, attitudes, beliefs, and level of knowledge may affect it. Objectives. To measure the level of knowledge regarding blood donation, find out positive and negative attitudes, identify the obstacles, and suggest some motivational factors. Methodology. A cross-sectional study was conducted at King Abdulaziz Medical City (KAMC). Participants were selected by convenient nonrandom sampling technique. A self-created questionnaire was used for data collection. Results. The study included 349 individuals. About 45.8% of the participants claimed that they have a history of blood donation. Reported causes for not donating blood were blood donation not crossing their mind (52.4%), no time for donation (45%), and difficulty in accessing blood donation center (41.3%). Reported motivating factors for donating blood were one day off (81.4%), mobile blood donation caravans in public areas (79.1%), token gifts (31.5%), and finally paying money (18.9%). Conclusion. People in the age group 31–50 years, males, higher education and military were more likely to donate blood as well as People who showed higher knowledge level and positive attitude towards blood donation. More educational programs to increase the awareness in specific targeted populations and also to focus on some motivational factors are recommended. PMID:25431668
Understanding the Role of Clergy in African American Organ and Tissue Donation Decision-Making
Jacob Arriola, Kimberly R.; Perryman, Jennie P.; Doldren, Michelle A.; Warren, Carmen M.; Robinson, Dana H. Z.
2012-01-01
Objectives To describe and understand the attitudes, beliefs, and experiences towards organ and tissue donation among African American clergy in Atlanta, Georgia, USA. The secondary objective is to understand what messages clergy are providing to their parishioners relative to organ and tissue donation, and what their perceived role is in donation education. Design A qualitative study in which African American clergy (n = 26) participated in four focus groups. Results African American clergy, though generally supportive of organ and tissue donation in principle, have serious reservations about donation due to perceived inequalities in the donation and transplantation system. The clergy did not personally hold religious concerns about donation, but expressed that these concerns were a major barrier to donation among their parishioners. None of the clergy knew the written position that their religion took on donation; they acknowledged the need for more education for them and their parishioners on this topic. They also felt that as religious leaders, they could play an important role in promoting organ and tissue donation among African American parishioners. Conclusions African American clergy and religious leaders may play an important role towards improving willingness to donate among African American parishioners, but more education and advocacy is needed to prepare them for this role. PMID:17978944
Weiss, Matthew J; Hornby, Laura; Rochwerg, Bram; van Manen, Michael; Dhanani, Sonny; Sivarajan, V Ben; Appleby, Amber; Bennett, Mary; Buchman, Daniel; Farrell, Catherine; Goldberg, Aviva; Greenberg, Rebecca; Singh, Ram; Nakagawa, Thomas A; Witteman, William; Barter, Jill; Beck, Allon; Coughlin, Kevin; Conradi, Alf; Cupido, Cynthia; Dawson, Rosanne; Dipchand, Anne; Freed, Darren; Hornby, Karen; Langlois, Valerie; Mack, Cheryl; Mahoney, Meagan; Manhas, Deepak; Tomlinson, Christopher; Zavalkoff, Samara; Shemie, Sam D
2017-11-01
Create trustworthy, rigorous, national clinical practice guidelines for the practice of pediatric donation after circulatory determination of death in Canada. We followed a process of clinical practice guideline development based on World Health Organization and Canadian Medical Association methods. This included application of Grading of Recommendations Assessment, Development, and Evaluation methodology. Questions requiring recommendations were generated based on 1) 2006 Canadian donation after circulatory determination of death guidelines (not pediatric specific), 2) a multidisciplinary symposium of national and international pediatric donation after circulatory determination of death leaders, and 3) a scoping review of the pediatric donation after circulatory determination of death literature. Input from these sources drove drafting of actionable questions and Good Practice Statements, as defined by the Grading of Recommendations Assessment, Development, and Evaluation group. We performed additional literature reviews for all actionable questions. Evidence was assessed for quality using Grading of Recommendations Assessment, Development, and Evaluation and then formulated into evidence profiles that informed recommendations through the evidence-to-decision framework. Recommendations were revised through consensus among members of seven topic-specific working groups and finalized during meetings of working group leads and the planning committee. External review was provided by pediatric, critical care, and critical care nursing professional societies and patient partners. We generated 63 Good Practice Statements and seven Grading of Recommendations Assessment, Development, and Evaluation recommendations covering 1) ethics, consent, and withdrawal of life-sustaining therapy, 2) eligibility, 3) withdrawal of life-sustaining therapy practices, 4) ante and postmortem interventions, 5) death determination, 6) neonatal pediatric donation after circulatory determination of death, 7) cardiac and innovative pediatric donation after circulatory determination of death, and 8) implementation. For brevity, 48 Good Practice Statement and truncated justification are included in this summary report. The remaining recommendations, detailed methodology, full Grading of Recommendations Assessment, Development, and Evaluation tables, and expanded justifications are available in the full text report. This process showed that rigorous, transparent clinical practice guideline development is possible in the domain of pediatric deceased donation. Application of these recommendations will increase access to pediatric donation after circulatory determination of death across Canada and may serve as a model for future clinical practice guideline development in deceased donation.
Li, Cheukfai; Zhao, Qiang; Zhang, Wei; Chen, Maogen; Ju, Weiqiang; Wu, Linwei; Han, Ming; Ma, Yi; Zhu, Xiaofeng; Wang, Dongping; Guo, Zhiyong; He, Xiaoshun
2017-01-01
Background Poor transplant outcome was observed in donation after brain death followed by circulatory death (DBCD), since the donor organs suffered both cytokine storm of brain death and warm ischemia injury. MicroRNAs (miRNAs) have emerged as promising disease biomarkers, so we sought to establish a miRNA signature of porcine DBCD and verify the findings in human liver transplantation. Material/Methods MiRNA expression was determined with miRNA sequencing in 3 types of the porcine model of organ donation, including donation after brain death (DBD) group, donation after circulatory death (DCD) group, and DBCD group. Bioinformatics analysis was performed to reveal the potential regulatory behavior of target miRNA. Human liver graft biopsy samples after reperfusion detected by fluorescence in situ hybridization were used to verify the expression of target miRNA. Results We compared miRNA expression profiles of the 3 donation types. The porcine liver graft miR-146b was significantly increased and selected in the DBCD group versus in the DBD and DCD groups. The donor liver expression of human miR-146b-5p, which is homologous to porcine miR-146b, was further examined in 42 cases of human liver transplantations. High expression of miR-146b-5p successfully predicted the post-transplant early allograft dysfunction (EAD) with the area under the ROC curve (AUC) 0.759 (P=0.004). Conclusions Our results revealed the miRNA signature of DBCD liver grafts for the first time. The miR-146b-5p may have important clinical implications for monitoring liver graft function and predicating transplant outcomes. PMID:29227984
Dew, Mary Amanda; DiMartini, Andrea F.; Ladner, Daniela P.; Simpson, Mary Ann; Pomfret, Elizabeth A.; Gillespie, Brenda W.; Merion, Robert M.; Zee, Jarcy; Smith, Abigail R.; Holtzman, Susan; Sherker, Averell H.; Weinrieb, Robert; Fisher, Robert A.; Emond, Jean C.; Freise, Chris E.; Burton, James R.; Butt, Zeeshan
2016-01-01
Background Studies of liver donors’ psychosocial outcomes focus on the short-term and rely largely on quality-of-life measures not specific to donation. We sought to examine long-term donation effects on three psychosocial domains: perceived physical, emotional, and socioeconomic outcomes. Methods Individuals donating 3–10 years previously at nine centers were eligible for telephone surveys. Survey responses were examined descriptively. Cluster analysis was used to identify distinct donor groups based on response profiles across psychosocial domains. Potential predictors of response profiles were evaluated with regression analysis. Results 517 donors (66%) participated (M=5.8 years postdonation, SD=1.9). 15%–48% of donors endorsed current donation-related physical health problems and concerns, and 7%–60% reported socioeconomic concerns (e.g., insurance difficulties, financial expenditures). However, on average, donors experienced high psychological growth, and 90% felt positively about donation. Cluster analysis revealed five donor groups. One group showed high psychological benefit, with little endorsement of physical or socioeconomic concerns (15% of donors). Four groups showed less favorable profiles, with varying combinations of difficulties. The largest such group showed high endorsement of physical concerns and financial expenditures, and only modest psychological benefit (31% of donors). Men and non-Hispanic whites were most likely to have unfavorable response profiles (p<.01). Compared with donors aged 19–30, older donors were less likely to have unfavorable profiles; these differences were significant for donors aged >40–50 (p’s<.008). Conclusions Even many years postdonation, donors report adverse physical and socioeconomic effects, but positive emotional effects as well. Identification of response profiles and predictors may improve targeting of postdonation surveillance and care. PMID:27152918
Female College Students' Perceptions of Organ Donation
ERIC Educational Resources Information Center
Boland, Kathleen; Baker, Kerrie
2010-01-01
The current process of organ donation in the U.S. relies on the premise of altruism or voluntary consent. Yet, human organs available for donation and transplant do not meet current demands. The literature has suggested that college students, who represent a large group of potential healthy organ donors, often are not part of donor pools. Before…
France, Janis L.; France, Christopher R.; Carlson, Bruce W.; Kessler, Debra A.; Rebosa, Mark; Shaz, Beth H.; Madden, Katrala; Carey, Patricia M.
2015-01-01
First-time blood donors are essential to the US donor pool, providing nearly a third of all donations. Unfortunately, there are a wide variety of obstacles to repeat donation and new donors are extremely difficult to retain. Because each donor experiences a unique set of deterrents, we developed a post-donation interview based on motivational interview principles in order to flexibly address individual barriers. The primary aim of this randomized clinical trial is to examine retention of first-time, group O blood donors who are randomly assigned to receive either a telephone-delivered interview with motivational and action planning components or a standard-of-care control call approximately six weeks after their donation. Measures of donation attitude, perceived behavioral control, intention, and motivational autonomy will be measured before and after the telephone contact using online surveys, and donation attempts will be tracked for one year using blood center donor databases. We hypothesize that, compared to controls, donors who receive the telephone interview will be more likely to make a donation attempt over the following year. In addition, we will examine possible mechanisms of action of the interview using key predictors of donation behavior as described by Self Determination Theory (i.e., motivational autonomy) and the Theory of Planned Behavior (i.e., attitude, perceived behavioral control, and intention). Results of this intervention may help to support a novel strategy to enhance retention of selected blood donors in an effort to better meet the nation’s blood supply needs. PMID:26247570
Use of "excess" human embryos for stem cell research: protecting women's rights and health.
Cohen, C B
2000-01-01
Proposed National Institutes of Health guidelines for stem cell research are too narrowly drawn and do not adequately protect the freedom of choice and health of women who donate embryos. They need to be expanded to cover not only the point of embryo donation, but also that of embryo creation. Guidelines are provided to ensure that donors undergoing hyperstimulation and egg retrieval gave voluntary informed consent to the production of embryos that might later prove in excess. A standard for determining when embryos have been overproduced is presented to address the possibility that additional embryos will be created for stem cell research in violation of the guidelines and at risk to women's health.
Trimmel, Michael; Lattacher, Helene; Janda, Monika
2005-10-01
To establish if voluntary whole-blood donors and compensated platelet donors and plasma donors may differ in their motivation to donate, altruism, aggression and autoaggression. Whole-blood (n=51), platelet (n=52) and plasma donors (n=48) completed a battery of validated questionnaires while waiting to donate. Bivariate and multivariate analyses of variance and t-tests were performed to detect differences between groups as noted. Altruism (mean=40.2) was slightly higher in whole-blood donors than in platelet (mean=38.3) and plasma donors (mean=39.1) (p=0.07). Blood donors (mean=2.8) scored lower in the spontaneous aggression measure than platelet (mean=4.1) and plasma donors (mean=4.4) (p=0.01). Plasma donors (mean=4.9) had higher auto-aggression than whole-blood donors and platelet donors (mean for both groups=3.4) (p=0.01). Differences between the three groups were mediated by sociodemographic variables (MANCOVA). Whole-blood donors donated to help others, platelet and plasma donors mostly to receive the compensation. However, those platelet and plasma donors, who would continue to donate without compensation were similar in altruism and aggression to whole-blood donors. While most platelet donors and plasma donors were motivated by the compensation, those who stated that they would continue to donate without compensation had altruism and aggression scores similar to voluntary whole-blood donors.
2014-01-01
In countries where presumed consent for organ donation does not apply, health professionals (HP) are key players for identifying donors and obtaining their consent. This systematic review was designed to verify the efficacy of interventions aimed at HPs to promote organ and tissue donation in clinical settings. CINAHL (1982 to 2012), COCHRANE LIBRARY, EMBASE (1974 to 2012), MEDLINE (1966 to 2012), PsycINFO (1960 to 2012), and ProQuest Dissertations and Theses were searched for papers published in French or English until September 2012. Studies were considered if they met the following criteria: aimed at improving HPs’ practices regarding the donation process or at increasing donation rates; HPs working in clinical settings; and interventions with a control group or pre-post assessments. Intervention behavioral change techniques were analyzed using a validated taxonomy. A risk ratio was computed for each study having a control group. A total of 15 studies were identified, of which only 5 had a control group. Interventions were either educational, organizational or a combination of both, and had a weak theoretical basis. The most common behavior change technique was providing instruction. Two sets of interventions showed a significant risk ratio. However, most studies did not report the information needed to compute their efficacy. Therefore, interventions aimed at improving the donation process or at increasing donation rates should be based on sound theoretical frameworks. They would benefit from more rigorous evaluation methods to ensure good knowledge translation and appropriate organizational decisions to improve professional practices. PMID:24628967
Impact of non-welfare interests on willingness to donate to biobanks: an experimental survey.
Gornick, Michele C; Ryan, Kerry A; Kim, Scott Y H
2014-10-01
The ethical debate surrounding biobanks has focused on protecting donors' welfare and privacy. However, little attention has been given to the ethical significance of donor interests that go beyond privacy and welfare (non-welfare interests [NWIs]), such as their concerns about the moral or religious implications of researchers using their donated samples. Using an experimental survey design with 1,276 participants recruited via Amazon Mechanical Turk (MTurk), we studied the potential impact of eight NWI scenarios on people's attitudes toward research studies being performed on samples donated to biobanks by assessing willingness to donate, attitudes toward disclosure of NWIs, impact of timing and format of disclosure (number of NWIs disclosed on a page), and participant factors associated with willingness to donate. Baseline willingness to donate to biobanks prior to any mention of NWIs was comparable with previous studies, at 85% to 89%. Most participants wanted NWI disclosures prior to donation to biobanks, but far fewer favored specific consent. Overall pattern of responses showed that as participants receive more information about NWIs, willingness to donate decreases in a scenario dependent manner. Specifically, NWI concerns about profit seeking research and insurance risk assessment had the strongest impact, even greater than controversial issues such as reproductive research, regardless of political, religious, and most other characteristics of respondents. Based on the results, a schema of NWI types is proposed that could be used for further research and policy discussions. © The Author(s) 2014.
Patel, Shaneel Rajendra; Chadha, Priyanka; Papalois, Vassilios
2011-06-01
In renal transplant, there is a well-known deficiency in organ supply relative to demand. Live donation provides superior results when compared with deceased donation including a better rate of graft success and fewer immunologic complications. This deficiency in organs leads to significant morbidity and mortality rates. Alternative avenues have been extensively explored that may expand the live donor pool. They include altruistic donation as well as paired and pooled exchange programs. Altruistic donation is a truly selfless act from a donor unknown to the recipient. Kidney paired donation involves 2 incompatible donor-recipient pairs swapping donors to produce compatibility. Pooled donation involves at least 2 pairs, and can take the form of domino chains in which altruistic input sets up a chain of transplants, in which each recipient's incompatible donor makes a donation for the next recipient. Despite application of these various methods, there lie extensive ethical issues surrounding them. Misconceptions frequently occur; for instance, the perceived benefit that donating an organ to a loved one is greater for a related donor than for an altruistic one. Additionally, it is frequently believed that immunologic incompatibility offers coerced donors liberation from surgery, and that overcoming these barriers by introducing exchange programs provides vulnerable donors less protection. This article explores these and other complex ethical issues surrounding the various methods of expanding the donor pool. The authors offer opinions that challenge the ethical issues and attempt to overcome those views that hinder progress in the field.
Morgan, Myfanwy; Adams, O Peter; Seed, Paul T; Jones, Roger
2010-05-21
Black minority ethnic groups in the UK have relatively low rates of deceased donation and report a higher prevalence of beliefs that are regarded as barriers to donation. However there is little data from migrants' countries of origin. This paper examines community attitudes to deceased kidney donation in Barbados and compares the findings with a survey conducted in a disadvantaged multi-ethnic area of south London. Questionnaires were administered at four public health centres in Barbados and at three private general practices. Adjusted odds ratios were calculated to compare attitudinal responses with a prior survey of 328 Caribbean and 808 White respondents in south London. Questionnaires were completed by 327 respondents in Barbados (93% response); 42% men and 58% women, with a mean age of 40.4 years (SD 12.6). The main religious groups were Anglican (29%) and Pentecostal (24%). Educational levels ranged from 18% not completing 5th form to 12% with university education. Attitudes to the notion of organ donation were favourable, with 73% willing to donate their kidneys after their death and only 5% definitely against this. Most preferred an opt-in system of donation. Responses to nine attitudinal questions identified 18% as having no concerns and 9% as having 4 or more concerns. The highest level of concern (43%) was for lack of confidence that medical teams would try as hard to save the life of a person who has agreed to donate organs. There was no significant association between age, gender, education or religion and attitudinal barriers, but greater knowledge of donation had some positive effect on attitudes. Comparison of attitudes to donation in south London and Barbados (adjusting for gender, age, level of education, employment status) indicated that a significantly higher proportion of the south London Caribbean respondents identified attitudinal barriers to donation. Community attitudes in Barbados are favourable to deceased donation based on a system of informed consent. Comparison with south London data supports the hypothesis that the relatively high prevalence of negative attitudes to deceased donation among disadvantaged ethnic minorities in high income countries may reflect feelings of marginalization and lack of belonging.
Economic crisis and blood donation: How are donors' motivations changing?
Alfieri, Sara; Guiddi, Paolo; Marta, Elena; Saturni, Vincenzo
2016-06-01
The economic crisis has exasperated people's feelings of loneliness; job instability often does not allow people to commit to voluntary work. The present work proposes to examine whether the motivations to donate blood have changed before and during the period of economic crisis, taking into consideration donors' gender. We adopted Omoto & Snyder's functionalist approach, which states that blood donation serves different functions for any one person, who may have different motivations from those held by other people. We compared six-year pre-post (t1 "pre-crisis": 2008 - t2 "during the crisis": 2014) data on a sample of blood donors in a single blood donation center situated in Northern Italy. T-test was used for data analysis. Three hundred thirty donors (age range 18-60, M = 32.6, SD = 9.53; 54.5% male) were administered a survey at t1 and 444 (age range 18-60, M = 37.8, SD = 10.16; 68% male) six years later at t2. In both surveys, participants were administered a questionnaire with socio-demographic items and a version of Omoto & Snyder's Motivations to Volunteer scale adapted to blood donation. Donors' motivation priorities did not vary over time. Values and Self-enhancement motivations are the most prevalent. Knowledge and Ego-protection motivations decreased with the upsurge of the crisis. Women, in general, report higher mean values than men do for Values and Ego-protection motivations. These results can offer valuable clues for the agencies that manage blood collection. Copyright © 2016. Published by Elsevier Ltd.
Unit asking: a method to boost donations and beyond.
Hsee, Christopher K; Zhang, Jiao; Lu, Zoe Y; Xu, Fei
2013-09-01
The solicitation of charitable donations costs billions of dollars annually. Here, we introduce a virtually costless method for boosting charitable donations to a group of needy persons: merely asking donors to indicate a hypothetical amount for helping one of the needy persons before asking donors to decide how much to donate for all of the needy persons. We demonstrated, in both real fund-raisers and scenario-based research, that this simple unit-asking method greatly increases donations for the group of needy persons. Different from phenomena such as the foot-in-the-door and identifiable-victim effects, the unit-asking effect arises because donors are initially scope insensitive and subsequently scope consistent. The method applies to both traditional paper-based fund-raisers and increasingly popular Web-based fund-raisers and has implications for domains other than fund-raisers, such as auctions and budget proposals. Our research suggests that a subtle manipulation based on psychological science can generate a substantial effect in real life.
Wong, Shui Hung; Chow, Amy Yin Man
2017-08-01
In view of the general support for organ donation but low registration rate in Hong Kong, the present research attempted to understand the attitude-behavior inconsistency by identifying the underlying beliefs for organ donation through employing the theory of reasoned action. A qualitative approach using semi-structured focus groups was adopted and 19 students from three universities in Hong Kong participated; 10 constructs were identified: attitude, subjective norm, helping, continuation, contribution, body intact, distrust to the medical system, indifference to organ donation, negative affect, and family burden. Findings suggested that their attitudes toward organ donation were of both the cognitive and affective nature; subjective norm of family, friends, and people they respect were identified as influential to students' views on organ donation. The study provided insight in promoting organ donation, that the cognitive concerns about keeping the body intact, and the negative affects introduced should also be addressed.
Freeman, Dan; Aquino, Karl; McFerran, Brent
2009-01-01
Three studies examined the relationship between social dominance orientation (SDO), the experience of moral elevation, and Whites' donations to charitable organizations. Study 1 used video clips depicting acts of moral excellence to elicit a state of moral elevation (a distinctive feeling of warmth and expansion, which is accompanied by admiration, affection, and even love for people whose exemplary moral behavior is being observed). Results show that moral elevation increased participants' willingness to donate to a Black-oriented charity and attenuated the negative effect of the group-based dominance (GBD) component of SDO on donation behavior. Studies 2 and 3 replicate and extend these findings by using a written story to elicit a state of moral elevation and examining actual donations to a Black-oriented charity. Results show that moral elevation increased donations to the Black-oriented charity and neutralized the negative influence of GBD.
[Attitude and opinion of medical students about organ donation and transplantation].
Galvao, Flavio H F; Caires, Renato A; Azevedo-Neto, Raimundo S; Mory, Eduardo K; Figueira, Estela R R; Otsuzi, Thiago S; Bacchella, Telesforo; Machado, Marcel C C
2007-01-01
We analyzed the opinion and understanding of medical students about organ donation and transplantation. 347 students voluntarily completed a questionnaire with 17 queries concerning organ donation and transplantation. They were analyzed to identify general tendencies and divided into five groups, according to their year of study (first through sixth year), to assess differences among the years. Students of the fifth and sixth years were placed in the same group. Results were analyzed by the Chi-square test. The intention to become a post mortem or living donor was of 89% and 90% respectively; however, only 62% were aware of living donation risks. 70% of the 347 students admitted regular or little knowledge of the subject, 90.2% considered organ transplantation an important issue for a medical graduation program, 76.9% considered informed/expressed consent the best organ donation criterion and 64.3% of them chose severity of patient disease as the best allocation condition. As students progressed in their studies their understanding about transplantation improved. Students of the fourth, fifth and sixth year manifested a negative attitude about organ donation to alcohol addicts, non donors, drug users, law offenders and foreigners. This data show the great interest and positive attitude of medical students toward organ donation and transplantation, despite the fact that most of them admitted having insufficient knowledge on the subject. A negative attitude by students of the fourth, fifth and sixth year on organ donation to alcohol addicts, non donors, drug users, law offenders and foreigners was also observed.
The untimely death of the UK Donation Ethics Committee.
Shaw, David
2017-01-01
This brief report describes the contribution of the UK Donation Ethics Committee to organ donation and transplantation in the UK, and explains why the committee has met an early demise. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Outcomes of organ donation in brain-dead patient's families: Ethical perspective.
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.
Does quality improvement work? Evaluation of the Organ Donation Breakthrough Collaborative.
Howard, David H; Siminoff, Laura A; McBride, Virginia; Lin, Monica
2007-12-01
The Organ Donation Breakthrough Collaborative is a quality improvement initiative to encourage adoption of "best practices" for identifying potential donors and obtaining consent for deceased organ donation. We evaluate the impact of the first phase on organ donation rates. We study donation rates in the 95 hospitals that participated in the first phase and a control group of 125 hospitals. We use a controlled pre/post design. The preperiod is the year before the start of the Collaborative (September 2002 to August 2003), the postperiod is the final 6 months of the first phase (March 2004 to August 2004). We use administrative data from the Organ Procurement and Transplantation Network to compute the conversion rate in each hospital group and time period. The conversion rate is the proportion of eligible donors who became actual donors. Preperiod conversion rates in Collaborative and control hospitals were similar: 52 and 51 percent, respectively. In the postperiod, the conversion rate increased to 60 percent among Collaborative hospitals and remained at 51 percent among control hospitals. The relative change was 8 percentage points (95 percent confidence interval: 2-13: p<.001). Our findings suggest that the Breakthrough Collaborative led to an increase in donation rates at participating hospitals.
Sharp, Chloe; Randhawa, Gurch
2014-01-17
Incentives and reciprocity have been widely debated within the literature as an alternative to altruism to motivate the public to register and consent to organ donation. This pilot study was the first to examine the views of the UK Polish migrant community toward these issues. One-to-one and small group interviews were conducted in English and Polish to collect data. The interviews were recorded and transcribed and interviews in Polish were translated into English. All transcripts were coded, codes were grouped by theme and emergent themes were constantly compared to the new data until saturation. Participants were motivated to donate altruistically but would accept reciprocity for organs once consent was given. Payment for organs was viewed as unfavourable but participants would accept contribution toward funeral expenses. Deceased organ donation was viewed as an 'altruistic gift'. 'Altruism' and 'gift' are problematic in deceased organ donation and could explain the challenges that arise in the incentives and reciprocity debate. Mauss's gift exchange theory could frame incentives as forming the 'obligation to give' and could encourage registration but could lead to coercion. Reciprocity could benefit families and be viewed as 'fair' and a token of gratitude.
Eliassen, Håkon S; Hervig, Tor; Backlund, Sebastian; Sivertsen, Joar; Iversen, Vegard Vereide; Kristoffersen, Morten; Wengaard, Eivind; Gramstad, Arne; Fosse, Theodor; Bjerkvig, Christopher K; Apelseth, Torunn; Doughty, Heidi; Strandenes, Geir
2018-06-01
The success of implementing damage control resuscitation principles pre-hospital has been at the expense of several logistic burdens including the requirements for resupply, and the question of donor safety during the development of whole blood programs. Previous studies have reported effects on physical performance after blood donation; however, none have investigated the effects of blood donation on cognitive performance. We describe a prospective double-blinded, randomized, controlled study comprised of a battery of tests: three cognitive tests, and VO2max testing on a cycle ergometer. Testing was performed 7 days before blinded donation (baseline day), immediately after donation (Day 0), and 7 days (Day 7) after donation. The inclusion criteria included being active blood donors at the Haukeland University Hospital blood bank, where eligibility requirements were met on the testing days, and providing informed consent. Participants were randomized to either the experimental (n = 26) or control group (n = 31). Control group participants underwent a 'mock donation" in which a phlebotomy needle was placed but blood was not withdrawn. In the experimental group, mean ± SEM VO2max declined 6% from 41.35 ± 1.7 mLO2/(min·kg) at baseline to 39.0 ± 1.6 mLO2/(min·kg) on Day 0 and increased to 40.51 ± 1.5 mLO2/(min·kg) on Day 7. Comparable values in the control group were 42.1 ± 1.8 mLO2/(min·kg) at baseline, 41.6 ± 1.8 mLO2/(min·kg)) on Day 1 (1% decline from baseline), and 41.8 ± 1.8 mLO2/(min·kg) on Day 7.Comparing scores of all three cognitive tests on Day 0 and Day 7 showed no significant differences (p > 0.05). Our main findings are that executive cognitive and physical performances were well maintained after whole blood donation in healthy blood donors. The findings inform postdonation guidance on when donors may be required to return to duty. Randomized, controlled, double-blinded prospective trial study, level 1.
Sekoni, A O; Balogun, M R; Odukoya, O O; Inem, V; Onigbogi, O O
2014-03-01
This study was carried out to assess the blood donation practices and willingness to donate among residents of an urban slum. Cross sectional descriptive study design with a qualitative and quantitative component. Multistage sampling was used to select 400 respondents for the questionnaire interview while three FGD sessions were conducted guide among three groups of participants namely youths, men and women. The information collected was analyzed manually (FGD) and with Epi info version 3.5.3. Majority of the questionnaire respondents were female, married, traders, had at least secondary school education, with mean age of 37.6 years. Only 12.0% had donated in the past, the main reason given by non donors was that they had never been asked to donate; this was also a key finding in the FGD. Willingness to donate was positively associated with being a male, single and Christian, age was a significant predictor of previous donation while more of the previous donors were still willing to donate, more for family/friends (p=0.036) than voluntarily (p=0.001) this view was supported by the participants at the FGD. Members of this urban slum had poor practice of blood donation,had positive attitude and were willing to donate, there is need to mobilise and organise outreach blood donation programs to convert attitude into actual practice.
2014-01-01
Background Effectiveness of the donation request is generally measured by consent rates, rather than by relatives’ satisfaction with their decision. Our aim was to elicit Dutch ICU staffs’ views and experiences with the donation request, to investigate their awareness of (dis)satisfaction with donation decisions by relatives, specifically in the case of refusal, and to collect advice that may leave more relatives satisfied with their decision. Methods Five focus groups with a total of 32 participants (IC physicians, IC nurses and transplant coordinators) from five university hospitals in the Netherlands. Transcripts were examined using standard qualitative methods. Results Four themes (donation request perceived by ICU staff from the perspective of relatives; donation request perceived by ICU staff from their own perspective; aftercare; donation in society) divided into 14 categories were identified. According to ICU staff, relatives mentioned their own values more frequently than values of the potential donor as important for the decision. ICU staff observed this imbalance, but reacted empathically to the relatives’ point of view. ICU staff rarely suggested reconsideration of refusal and did not ask relatives for arguments. ICU staff did not always feel comfortable with a request in the delicate context of brain death. Sometimes the interests of patient, relatives and those on the waiting list were irreconcilable. ICU staff were mostly unaware of relatives’ regret following their decisions. Aftercare did not provide this type of information. Donation request by IC physicians was influenced by the way organ donation has been regulated in society (law, donor register, education, media). Conclusions Our findings lead to the hypothesis that giving relatives more time and inviting them to reconsider their initial refusal will lead to a more stable decision and possibly more consent. PMID:25057260
Xue, Wujun; Tian, Puxun; Xiang, Heli; Ding, Xiaoming; Pan, Xiaoming; Yan, Hang; Hou, Jun; Feng, Xinshun; Liu, Linjuan; Ding, Chenguang; Tian, Xiaohui; Li, Yang; Zheng, Jin
2017-04-04
The cases of donation after brain death followed by circulatory death (DBCD) and donation after cardiac death (DCD) have been increased year by year in China. Further research is needed to understand in the outcomes and risk factors of delayed graft function (DGF) in order to minimize the risk of DGF and ameliorate its potential impact on long-term outcomes. This study was to explore the differences in outcomes between DBCD and DCD transplant and the main risk factors for DGF in DBCD. Retrospective analysis of the clinical data of 367donations after citizens' death kidney transplant procedures (donors and recipients) between July 2012 and August 2015 at our center. During the study period, the donation success rate was 25.3%. 164 cases of DBCD and 35 cases of DCD had been implemented and 367 kidneys were transplanted. The incidence of DGF in DBCD group were significantly lower than that of DCD group (12.0% vs. 27.0%, p = 0.002). The 1-year percent freedom from acute rejection (AR) was significantly higher in DBCD group compared with it of DCD group (94% vs. 82%, p = 0.036). Multivariate logistic regression analysis of the kidney transplants revealed that the high risk factors for DGF after renal transplantation in DBCD were history of hypertension (Odds Ratio [OR] = 5.88, 95% CI: 1.90 to 18.2, p = 0.002), low blood pressure (BP < 80 mmHg) (OR = 4.86, 95% CI: 1.58 to 14.9, p = 0.006) and serum creatinine of donor (OR = 1.09, 95% CI: 1.03 to 1.16, p = 0.003) before donation. The outcomes of DBCD could be better than DCD in DGF and AR. The main risk factors for DGF in DBCD kidney transplants are donors with a history of hypertension, low blood pressure, and serum creatinine of donor before donation.
Why Do Blood Donors Lapse or Reduce Their Donation's Frequency?
Charbonneau, Johanne; Cloutier, Marie-Soleil; Carrier, Élianne
2016-01-01
Finding effective ways to retain blood donors is crucial. This study seeks to compare, in a context of a voluntary and nonremunerated system, donor demographics and deterrents to blood donation among plasma/platelet donors (PPDs), regular whole blood donors (WBDs), and lapsed whole blood donors (LWBD). Among 1879 participants to a survey on motivations, time use, and blood donation, 207 WBDs (26%) and 148 PPDs (31%) said that they reduced their donation frequency over the last 5 years. Participants to this survey also included 609 LWBDs, who did not donate in the past 5 years. We asked about reasons why they reduce or cease to donate blood and demographic variables. χ(2) Tests were completed to determine which deterrents stand out across the 3 blood donor groups. The deterrent indicating the highest percentage was "time constraints related to work or studies" (43% for all respondents). Comparison of WBDs, LWBDs, and PPDs shows that results for 7 deterrents were statistically different between the 3 groups. Obstacles to donating blood also vary based on sex, age (life course), and level of education. Blood collection agencies should consider developing new retention strategies tailored to blood donors, taking into account the specific profiles of female/male donors, events that typically occur at various stages of life, and particular challenges associated with differences in levels of education. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.
A Strategic Planning Tool for Increasing African American Blood Donation.
Singleton, Ashley; Spratling, Regena
2018-05-01
Historically, African Americans (AAs) have been underrepresented as blood donors. Having a lack of racially diverse blood donors contributes to transfusion complications, particularly in patients with sickle cell disease, who are both disproportionately AA and the recipients of frequent transfusions. Increasing AA blood donation is a complex public health issue. This review article serves to fill a gap in translating research regarding known hindrances and facilitators of AA blood donation to improve real-world donation practice and ultimately, patient outcomes. We incorporate findings from a literature review to develop a tool that blood centers, provider organizations, and patient advocacy groups can use to aid strategic planning efforts aimed at increasing AA blood donation.
Morgan, Myfanwy; Kenten, Charlotte; Deedat, Sarah
2013-01-01
A systematic review and synthesis of quantitative and qualitative research were undertaken to examine attitudes to deceased donation and registration as an organ donor among ethnic minorities in the U.K. and North America. A systematic search and assessments of relevance and quality were conducted. Parallel syntheses were then undertaken of 14 quantitative and 12 qualitative papers followed by their integration. The synthesis was organised around five barriers that emerged as key issues: (1) knowledge regarding deceased donation and registration as a donor; (2) discussion of donation/registration with family members; (3) faith and cultural beliefs; (4) bodily concerns including disfigurement and intactness; and (5) trust in doctors and the health care system. In all countries, knowledge of organ donation and registration remained low despite public campaigns, with African-Americans and Black African and Black Caribbean populations in the U.K. often regarding organ donation as a 'white' issue. Each of the four attitudinal barriers was also more prevalent among ethnic minorities compared with the majority population. However, the significance of trust and uncertainties regarding religion/faith differed between groups, reflecting salient aspects of ethnic identity and experiences. Differences were also identified within ethnic groups associated with age and generation, although respect for the views of elders often influenced younger peoples' willingness to donate. There is a need for a more nuanced understanding of ethnicity and of variations in attitudes associated with country of origin, age/generation, socio-economic status and area of residence, to inform public campaigns and promote sensitive discussions with bereaved ethnic minority families. The traditional focus on knowledge and attitudes also requires to be complemented by a greater emphasis on organisational and service-related barriers and changes required to enhance ethnic minorities' access to registration as a donor and consent to deceased donation.
Armsworth, Paul R.; Cantú-Salazar, Lisette; Parnell, Mark; Booth, Josephine E.; Stoneman, Rob; Davies, Zoe G.
2013-01-01
Efforts to expand protected area networks are limited by the costs of managing protected sites. Volunteers who donate labor to help manage protected areas can help defray these costs. However, volunteers may be willing to donate more labor to some protected areas than others. Understanding variation in volunteering effort would enable conservation organizations to account for volunteer labor in their strategic planning. We examined variation in volunteering effort across 59 small protected areas managed by Yorkshire Wildlife Trust, a regional conservation nonprofit in the United Kingdom. Three surveys of volunteering effort reveal consistent patterns of variation across protected areas. Using the most detailed of these sources, a survey of site managers, we estimate that volunteers provided 3200 days of labor per year across the 59 sites with a total value exceeding that of paid staff time spent managing the sites. The median percentage by which volunteer labor supplements management costs on the sites was 36%. Volunteering effort and paid management costs are positively correlated, after controlling for the effect of site area. We examined how well a range of characteristics of the protected areas and surrounding communities explain variation in volunteering effort. Protected areas that are larger have been protected for longer and that are located near to denser conurbations experience greater volunteering effort. Together these factors explain 38% of the observed variation in volunteering effort across protected areas. PMID:23383176
Armsworth, Paul R; Cantú-Salazar, Lisette; Parnell, Mark; Booth, Josephine E; Stoneman, Rob; Davies, Zoe G
2013-01-01
Efforts to expand protected area networks are limited by the costs of managing protected sites. Volunteers who donate labor to help manage protected areas can help defray these costs. However, volunteers may be willing to donate more labor to some protected areas than others. Understanding variation in volunteering effort would enable conservation organizations to account for volunteer labor in their strategic planning. We examined variation in volunteering effort across 59 small protected areas managed by Yorkshire Wildlife Trust, a regional conservation nonprofit in the United Kingdom. Three surveys of volunteering effort reveal consistent patterns of variation across protected areas. Using the most detailed of these sources, a survey of site managers, we estimate that volunteers provided 3200 days of labor per year across the 59 sites with a total value exceeding that of paid staff time spent managing the sites. The median percentage by which volunteer labor supplements management costs on the sites was 36%. Volunteering effort and paid management costs are positively correlated, after controlling for the effect of site area. We examined how well a range of characteristics of the protected areas and surrounding communities explain variation in volunteering effort. Protected areas that are larger have been protected for longer and that are located near to denser conurbations experience greater volunteering effort. Together these factors explain 38% of the observed variation in volunteering effort across protected areas.
Body donation in India: social awareness, willingness, and associated factors.
Rokade, Shrikant A; Gaikawad, Anjana P
2012-01-01
With the attendant rise of the number of medical colleges in India over past few decades, the demand for cadavers used in medical education and research is growing. However, there is an insufficient supply of donated cadavers available for dissection. This study was undertaken to assess the general population's awareness of body donation programs and willingness to donate in the State of Maharashtra, India. The willingness of participants to donate was compared with age, gender, and education of the respondents. A total of 625 adult individuals from the State of Maharashtra participated in a survey composed of questions about age, sex, education, awareness of body donation programs, and willingness to donate. It was found that 90.9% of the medical colleges surveyed reported an inadequate supply of cadavers. Of the general population, 32.1% of respondents were aware of body donation, compared to 95.83% of health care professionals. However, only 19.5% of the general population and 44.9% of health care professionals were willing to donate their bodies for anatomical education. Younger age groups, males, graduates, and postgraduates were found more willing to donate their bodies. Organ donation was preferred over body donation. A lack of awareness about body donation was the main factor responsible for respondents' "no body donation" response in the general population, along with firm religious beliefs and customs, the fear that the donated body will not be treated with respect and dignity, and the unacceptability of the dissection of one's own body. To overcome the current shortage of donated cadavers, efforts should be undertaken to change the mindset of the wider Indian society toward body donation. The authors believe this is possible through awareness campaigns and that prospective donors' concerns should be addressed appropriately. Proper guidance and assistance regarding body donation should be easily available for potential donors. Copyright © 2012 American Association of Anatomists.
Kuruvatti, J; Prasad, V; Williams, R; Harrison, M A; Jones, R P O
2011-11-01
Blood donors' motivations and reasons for lapsing and never donating were determined from a questionnaire completed by 489 adults (89 regular donors, 105 lapsed donors, 295 never donors) in Leeds, UK. The free text responses were classified according to themes that arose. Altruistic motivations including reciprocation and kinship towards family, friends, and unknowns were most numerous. Other motivations related to the NHS or National Blood Service, obligation, occupation, self-interest, convenience, peer-influence, health benefits, a rare blood group, donations being useful, a TV programme, or ethnicity. Reasons for non-donation were personal, medical, donation centre- or procedure-related, exclusions, and age-related. Suggestions are offered to increase the blood supply. © 2011 The Author(s). Vox Sanguinis © 2011 International Society of Blood Transfusion.
Impact of organ donation education on US undergraduate nursing students.
Kurz, Jane McCausland
2014-06-01
Experts advocate educational programs addressing misinformation regarding donation decisions to increase the potential donor pool. However, few researchers have measured outcomes with nursing students. The purpose of this study was to evaluate the impact of an educational intervention on nursing students' knowledge, attitudes, registering as an organ donor, and family discussions. This quasi-experimental study used a pretest-posttest design with a control group. The research group consisted of 42 volunteers and the control group consisted of 73 volunteers. The written survey included 15 true-false knowledge items and 8 Likert items asking about attitude toward donation, registering as an organ donor, and family discussion. Normally distributed data showed no significant differences between groups on the pretest. The research group had no change in knowledge level 3 months later, but the control group had a significantly decreased knowledge level at that point. More members of the research group than the control group registered as organ donors after the intervention (χ2 = 4.5, P= .03). The control group had no change in registering as an organ donor between the pretest and posttest. Family discussions did not differ significantly from pretest to posttest in either group. One lecture/laboratory experience did make a difference in registering as an organ donor but not in discussing the decision with family members. Students can learn about organ donation from more than one specific class. Recommendations for educators and future research are provided.
Post-operative course of coronary artery bypass surgery patients who pre-donate autologous blood.
Jovin, Ion S; Stelzig, Georg; Strelitz, Joachim C; Taborski, Uwe; Jovin, Angelika; Heidinger, Kathrin; Klövekorn, Wolf-Peter; Müller-Berghaus, Gert
2003-12-01
Pre-operative autologous blood donation is used to reduce the need of allogeneic blood in patients undergoing coronary bypass surgery operations, but it is not clear what impact the blood donation has on the post-operative course of these patients. We studied the post-operative course of 210 patients who pre-donated autologous blood before their coronary bypass operation (donors) and of 67 patients who were eligible to pre-donate but did not (controls). The clinical variables and the technical operative parameters of the patients in the two groups were similar. There was no significant difference between the duration of assisted ventilation post-operatively (756 +/- 197 vs. 802 +/- 395 min; P=0.54) or length of stay in the intensive care unit (1.8 +/- 1.1 vs. 1.7 +/- 0.9 days; P=0.52) of the two groups. The number of autologous units of packed red cells and of fresh frozen plasma (FFP) received by the donors was significantly higher than the number of units of allogeneic packed red cells (1.5 +/- 0.9 vs. 0.3 +/- 0.9; P=0.001) and the units of homologous FFP received by the controls (2.3 +/- 0.8 vs. 0.6 +/- 1; P=0.001). We found no evidence that autologous blood donation exerted a negative influence on the post-operative course of patients undergoing coronary bypass surgery. Patients who pre-donated blood received no allogeneic blood products, but the number of autologous blood products received by donors was higher than the number of blood products received by patients who did not pre-donate.
Kadhum, Murtaza; Abbas, Madiha; Ghazanfar, Abbas
2017-04-01
This study aimed to assess whether donor age would increase the risk of cardiovascular comorbidities during the first few years after donation. Cardiovascular risk was calculated using the QRISK tool (University of Nottingham and EMIS, Nottingham, UK). Data were collected from 221 living renal transplant donors at St. George's University Hospital NHS Foundation Trust between 2008 and 2012 before and after donation (at 6, 12, and 24 mo). QRISK scores were calculated for each patient at these time points before stratifying our patients into 2 cohorts: cohort A (age ≤ 59 y) and cohort B (age ≥ 60 y). QRISK scores were then compared using unpaired t tests. Before donation, mean QRISK scores were 3.4% in cohort A and 12.4% in cohort B (P < .001). At 6, 12, and 24 months after kidney donation, the risks were 3.3% and 12.2% (P < .001), 3.8% and 13.6% (P < .001), and 5% and 15.4% (P < .001) in cohort A versus cohort B. When we analyzed risk before donation, both age groups showed a significant increase in cardiovascular risk at 24 months. This subtle increase in cardiovascular risk in the 2 groups may be attributed to changing patient demographics, such as the increasing age of patients, rather than the donation itself. Elderly kidney donors, therefore, are a key source of donation after satisfactory cardiovascular work-up. However, elderly kidney donors will require long-term postoperative follow-up care and specific counseling aimed at reducing modifiable cardiovascular risk factors.
Rothwell, Erin; Botkin, Jeffrey R; Cheek-O'Donnell, Sydney; Wong, Bob; Case, Gretchen A; Johnson, Erin; Matheson, Trent; Wilson, Alena; Robinson, Nicole R; Rawlings, Jared; Horejsi, Brooke; Lopez, Ana Maria; Byington, Carrie L
2018-01-01
This study assessed the short-term impact of the play "Informed Consent" by Deborah Zoe Laufer (a fictionalized look at the controversy over specimens collected from the Havasupai Tribe for diabetes research in 1989) on perceptions of trust, willingness to donate biospecimens, and attitudes toward harm and privacy among the medical and undergraduate students, faculty, and the public in the Intermountain West. Surveys were administered before and after a staged reading of the play by professional actors. Survey items included the short form Trust in Medical Researchers, and single-item questions about group identity, ethics of genetic testing in children, and willingness to donate biospecimens. In addition, respondents were given the option to answer open-ended questions through e-mail. Out of the 481 who attended the play, 421 completed both the pre and post surveys, and 166 participants completed open-ended questions online approximately 1 week after the play. Across all participants, there were significant declines for trust in medical researchers and for the survey item "is it ethical for investigators to test children for adult onset diseases" (p < .001 for both) following the play. There was a significant increase in agreement to improve group identity protections (p < .001) and there were no differences on willingness to donate biospecimens to research (p = .777). Qualitative data provided extensive contextual data supporting these perspectives. This is one of the first studies to document short-term impacts of a theatrical performance on both attitudes and behavioral intentions toward research ethics and clinical research participation. Future research should continue to explore the impact of theatrical performances among public and investigators on the ethical issues and complexities in clinical research.
Hornby, Laura; Rochwerg, Bram; van Manen, Michael; Dhanani, ; Sonny; Sivarajan, V. Ben; Appleby, Amber; Bennett, Mary; Buchman, Daniel; Farrell, Catherine; Goldberg, Aviva; Greenberg, Rebecca; Singh, Ram; Nakagawa, Thomas A.; Witteman, William; Barter, Jill; Beck, Allon; Coughlin, Kevin; Conradi, Alf; Cupido, Cynthia; Dawson, Rosanne; Dipchand, Anne; Freed, Darren; Hornby, Karen; Langlois, Valerie; Mack, Cheryl; Mahoney, Meagan; Manhas, Deepak; Tomlinson, Christopher; Zavalkoff, Samara; Shemie, Sam D.
2017-01-01
Objectives: Create trustworthy, rigorous, national clinical practice guidelines for the practice of pediatric donation after circulatory determination of death in Canada. Methods: We followed a process of clinical practice guideline development based on World Health Organization and Canadian Medical Association methods. This included application of Grading of Recommendations Assessment, Development, and Evaluation methodology. Questions requiring recommendations were generated based on 1) 2006 Canadian donation after circulatory determination of death guidelines (not pediatric specific), 2) a multidisciplinary symposium of national and international pediatric donation after circulatory determination of death leaders, and 3) a scoping review of the pediatric donation after circulatory determination of death literature. Input from these sources drove drafting of actionable questions and Good Practice Statements, as defined by the Grading of Recommendations Assessment, Development, and Evaluation group. We performed additional literature reviews for all actionable questions. Evidence was assessed for quality using Grading of Recommendations Assessment, Development, and Evaluation and then formulated into evidence profiles that informed recommendations through the evidence-to-decision framework. Recommendations were revised through consensus among members of seven topic-specific working groups and finalized during meetings of working group leads and the planning committee. External review was provided by pediatric, critical care, and critical care nursing professional societies and patient partners. Results: We generated 63 Good Practice Statements and seven Grading of Recommendations Assessment, Development, and Evaluation recommendations covering 1) ethics, consent, and withdrawal of life-sustaining therapy, 2) eligibility, 3) withdrawal of life-sustaining therapy practices, 4) ante and postmortem interventions, 5) death determination, 6) neonatal pediatric donation after circulatory determination of death, 7) cardiac and innovative pediatric donation after circulatory determination of death, and 8) implementation. For brevity, 48 Good Practice Statement and truncated justification are included in this summary report. The remaining recommendations, detailed methodology, full Grading of Recommendations Assessment, Development, and Evaluation tables, and expanded justifications are available in the full text report. Conclusions: This process showed that rigorous, transparent clinical practice guideline development is possible in the domain of pediatric deceased donation. Application of these recommendations will increase access to pediatric donation after circulatory determination of death across Canada and may serve as a model for future clinical practice guideline development in deceased donation. PMID:28925929
National evaluation of healthcare provider attitudes toward organ donation after cardiac death.
Mandell, M Susan; Zamudio, Stacy; Seem, Debbie; McGaw, Lin J; Wood, Geri; Liehr, Patricia; Ethier, Angela; D'Alessandro, Anthony M
2006-12-01
Organ donation after cardiac death will save lives by increasing the number of transplantable organs. But many healthcare providers are reluctant to participate when the withdrawal of intensive care leads to organ donation. Prior surveys indicate ethical concerns as a barrier to the practice of organ donation after cardiac death, but the specific issues that characterize these concerns are unknown. We thus aimed to identify what barriers healthcare providers perceive. We conducted a qualitative analysis of focus group transcripts to identify issues of broad importance. Healthcare setting. Participants included 141 healthcare providers representing critical care and perioperative nurses, transplant surgeons, medical examiners, organ procurement personnel, neurosurgeons, and neurologists. Collection and analysis of information regarding healthcare providers' attitudes and beliefs. All focus groups agreed that increased organ availability is a benefit but questioned the quality of organs recovered. Study participants identified a lack of standards for patient prognostication and cardiopulmonary death and a failure to prevent a conflict between patient and donor interests as obstacles to acceptance of organ donation after cardiac death. They questioned the practices and motives of colleagues who participate in organ donation after cardiac death, apprehensive that real or perceived impropriety would affect public perception. Healthcare providers are uncomfortable at the clinical juncture where end-of-life care and organ donation interface. Our findings are consistent with theories that care providers are hesitant to perform medical tasks that they consider to be outside the focus of their practice, especially when there is potential conflict of interest. This conflict appears to impose moral distress on healthcare providers and limits acceptance of organ donation after cardiac death. Future research is warranted to examine the effect of standardized procedures on reducing moral distress. The hypothesis generated by this qualitative study is that use of neutral third parties to broach the subject of organ donation may improve acceptance of organ donation after cardiac death.
Randhawa, G; Neuberger, J
2016-04-01
At a national policy level, the United Kingdom is at the forefront of recognizing the role of faith and its impact on organ donation. This is demonstrated by the recommendations of the Organ Donation Taskforce, National Institute for Clinical Excellence guidelines on organ donation, All-Party Parliamentary Kidney Group, and National Black, Asian and Minority Ethnic Taskforce Alliance. Evidence to date shows that further thought is required to ensure the active engagement of faith communities with organ donation in the UK. The "Taking Organ Transplantation to 2020" strategy was launched in July 2013 by National Health Service Blood and Transplant (NHSBT) in collaboration with the Department of Health and Welsh, Scottish, and Northern Irish governments and seeks to increase the number of people, from all sections of the UK's multiethnic and multifaith population, who consent to and authorize organ donation in their life. NHSBT seeks to work in partnership with faith leaders and this culminated in a Faith and Organ Donation Summit. Faith leaders highlight that there is a need for engagement at both national and local levels concerning organ donation as well as diagnosis and definition of death. Copyright © 2016 Elsevier Inc. All rights reserved.
Fostering repeat donations in Ghana.
Owusu-Ofori, S; Asenso-Mensah, K; Boateng, P; Sarkodie, F; Allain, J-P
2010-01-01
Most African countries are challenged in recruiting and retaining voluntary blood donors by cost and other complexities and in establishing and implementing national blood policies. The availability of replacement donors who are a cheaper source of blood has not enhanced repeat voluntary donor initiatives. An overview of activities for recruiting and retaining voluntary blood donors was carried out. Donor records from mobile sessions were reviewed from 2002 to 2008. A total of 71,701 blood donations; 45,515 (63.5%) being voluntary donations with 11,680 (25%) repeat donations were collected during the study period. Donations from schools and colleges contributed a steady 60% of total voluntary whilst radio station blood drives increased contribution from 10 to 27%. Though Muslim population is less than 20%, blood collection was above the 30-donation cost-effectiveness threshold with a repeat donation trend reaching 60%. In contrast Christian worshippers provided <25 unit/session and 30% repeat donations. Repeat donation trends amongst school donors and radio blood drives were 20% and 70% respectively. Repeat donations rates have been variable amongst different blood donor groups in Kumasi, Ghana. The impact of community leaders in propagating altruism cannot be overemphasized. Programs aiming at motivating replacement donors to be repeat donors should be developed and assessed. Copyright 2009 The International Association for Biologicals. All rights reserved.
Marketing blood drives to students: a case study.
Leigh, Laurence; Bist, Michael; Alexe, Roxana
2007-01-01
The aim of this paper is to motivate blood donation among international students and demonstrate the applicability of marketing techniques in the health care sector. The paper uses a combination of focus groups and a questionnaire-based survey. The paper finds that donors primarily find gratification from their altruistic acts through awareness of their contribution to saving lives. Receiving information on how each individual donation is used is seen as a powerful means of reinforcement. Practical benefits such as receiving free blood test information are also useful motivators, while communicating the professionalism of the blood collection techniques are important for reassuring the minority of prospective donors who expressed fears about possible risks associated with blood donation. Since this was a small-scale study among Hungarian and international students in Budapest, further research is necessary to validate its results among other demographic groups. Findings were reported to the International Federation of Red Cross and Red Crescent Societies in Hungary in order to increase blood donations among students in Hungary. Subject to validation through further research, applying recommended approaches in different countries and other demographic groups is suggested. This is the first research paper on motivation toward blood donation among international students and offers new and practical suggestions for increasing their level of participation in blood drives.
Munsterman, K A; Grindon, A J; Sullivan, M T; Trouern-Trend, J; Blackmon, M J; Watkins, J; Williams, A E
1998-01-01
The recent addition of a computerized donor deferral registry to American Red Cross blood donation procedures has enabled blood center staffs to identify, before donation, persons who attempt to donate despite previous deferral. The current study investigated reasons that deferred donors return to donate, despite having been notified that they are ineligible. Anonymous mail surveys requesting demographic information, details of last donation or attempted donation, and assessments of incentives for donating were sent to 311 donors presenting inappropriately at blood drives and 849 matched controls in three American Red Cross regions between April and July 1996. Responses were received from a total of 113 deferred donors and 388 matched controls. Analysis of the 49 permanently deferred donors indicated that they were more likely than controls to donate blood to receive test results or to be awarded community service credit. Responses also revealed that some deferred donors may return to donate blood because of a misunderstanding of the deferral message or erroneous recruitment by blood center staff. There is a need before donation for the provision of educational materials regarding the window period of infection and for careful consideration of the use of incentives to attract donors to blood centers. It is also important to provide to donors a clear and consistent message regarding their test results and deferral status.
NASA Astrophysics Data System (ADS)
Karabıyık, Hasan; Kırılmış, Cumhur; Karabıyık, Hande
2017-08-01
The molecular and crystal structure of the title compound in which two thiazole-2-amine rings are linked to each other by disulfide bridge (sbnd Csbnd Ssbnd Ssbnd Csbnd) were studied by single-crystal X-ray diffraction, FT-IR, NMR spectroscopy, quantum chemical calculations and topological analyses on the electron density. A novel synthesis route for the compounds having symmetrical disulfide bridge is reported. The most important result regarding the compound is about electron donating or accepting properties of the terminal amine groups. Planar amine group acts as an electron-donating group, while pyramidal amine behaves as electron-accepting group. This inference was confirmed by scrutiny of crystallographic geometry and quantum chemical studies. To ascertain underlying reasons for this fact, intermolecular interactions (Nsbnd H⋯N type H-bonds and Csbnd H···π interactions) were studied. These interactions involving aromatic thiazole rings are verified by topological electron density and Hirshfeld surface analyses. Intermolecular interactions do not have an effect on the differentiation in electron donating or accepting ability of amine groups, because both amine groups are involved in Nsbnd H⋯N type H-bonds. In methodological sense, it has been understood that Ehrenfest forces acting on electron density are useful theoretical probe to analyze intra-molecular charge transfer processes.
Organ donation among undocumented hispanic immigrants: an assessment of knowledge and attitudes.
Baru, Joshua S; Lucas, Brian R; Martinez, Carmen; Brauner, Daniel
2013-01-01
Undocumented immigrants can donate their organs, but lack access to organ transplantation.This challenges foundational principles of organ donation: fairness and informed consent. Little is known about undocumented immigrants' knowledge of barriers to their access to organ transplantation or how this might affect their decision to donate their organs. The study was performed in an urban, university-affiliated, safety-net hospital.We interviewed hospitalized patients who self-identified as undocumented immigrants and were unaware of having any contraindication to organ donation (for example, cancer). We first recorded their demographic characteristics and knowledge and attitudes regarding organ donation. We then assessed the effects of informing participants about limits to their access to organ transplants on their willingness to donate. This group of 59 uninsured Hispanic immigrants had adequate knowledge about organ donation. Participants were suspicious about inequality within the medical system, but most were willing to donate their organs (74 percent). Most participants (74 percent) were aware that they would have to pay to receive an organ, but they dramatically underestimated the out-of-pocket expenses.Yet willingness to donate their organs was unaffected by participants being explicitly informed of the low likelihood that they would be able to afford to receive an organ transplant. Despite being well informed about the organ donation system, undocumented Hispanic immigrants underestimate the costs and overestimate their likelihood of receiving an organ. Even when they are given this information, they remain willing to donate their own organs.
How regular blood donors explain their behavior.
Belda Suárez, Isabel Maria; Fernández-Montoya, Antorio; Rodríguez Fernández, Andrés; López-Berrio, Antorio; Cillero-Peñuela, Manuel
2004-10-01
To understand repeated donation, it is crucial to know its meaning. This issue was explored by asking a sample of regular donors to explain why they maintain this behavior. Discourse analysis was conducted in five groups of regular donors, selected according to the setting and number of their donations (from 1990 to 2001), on their motivation, attitudes, commitment to donation, personality, and self-concept. Three discursive positions were distinguished in relation to the different cultural meanings attributed to blood donation. Blood donation was understood in a rational and evaluative manner by the majority but in an emotional, personalized, and stereotyped manner by a minority. Continual donation as a form of help was rationalized as a function of internal and external factors, notably personal convenience in comparison to other helping behaviors and ease of access to collection points. The discourse referents offered to the donor greatly influence the meanings they attribute to their behavior. Some promotional materials should be revised because they may not connect with the reasons for donating that people find most comprehensible.
Motivating Factors and Potential Deterrents to Blood Donation in High School Aged Blood Donors
Phan-Tang, Michelle
2016-01-01
Background. To ensure an adequate supply of blood, collection centers must design campaigns that successfully recruit and maintain an active donor pool. Understanding factors that motivate and deter individuals from donating may help centers develop targeted recruitment campaigns. These factors among high school aged blood donors have not yet been fully investigated. Study Design and Methods. A voluntary, anonymous survey was administered to student donors at high school mobile blood drives. The survey instrument asked the students to rate several potential motivating factors in their importance in the decision to donate blood and several potential deterring factors in their future decision whether or not to donate blood again. The survey also asked the students to rate the desirability of several potential incentives. Results. Motivating factors that reflected prosocial, empathetic, and altruistic thoughts and beliefs were rated highly by students. Pain from phlebotomy was most commonly chosen as potential deterrent. Movie tickets and cookies/snacks at the drive were rated as the most attractive incentives. Conclusion. High school aged blood donors are similar to other donor groups in their expressed motives for donating blood. This group may be unique in the factors that deter them from donating and in their preferences for different incentives. PMID:27293985
Factors Associated With Medical and Nursing Students' Willingness to Donate Organs.
Tumin, Makmor; Tafran, Khaled; Tang, Li Yoong; Chong, Mei Chan; Mohd Jaafar, Noor Ismawati; Mohd Satar, NurulHuda; Abdullah, Nurhidayah
2016-03-01
Malaysia suffers from a chronic shortage of human organs for transplantation. Medical and nursing students (MaNS) are future health professionals and thus their attitude toward organ donation is vital for driving national donation rates. This study investigates MaNS' willingness to donate organs upon death and the factors influencing their willingness. A cross-sectional design was used with a sample of 500 students (264 medical and 236 nursing) at the University of Malaya. A self-administrated questionnaire was used. The responses were analyzed by using descriptive statistics and multiple logistic regression. Of all respondents, 278 (55.6%) were willing to donate organs upon death, while the remaining 222 (44.4%) were unwilling to donate. Only 44 (8.8%) had donor cards. The multiple logistic regression revealed that the minorities ethnic group was more willing to donate organs than Malay respondents (adjusted odds ratio [aOR] = 1.98, P = 0.010). In addition, medical students were more willing to donate than nursing students (aOR = 2.53, P = 0.000). Respondents who have a family member with a donor card were more willing to donate than respondents who do not (aOR = 3.48, P = 0.006). MaNS who believed that their religion permits deceased donation were more willing to donate than their counterparts (aOR = 4.96, P = 0.000). Household income and sex were not significant predictors of MaNS' willingness to donate organs upon death. MaNS have moderate willingness, but low commitment toward deceased organ donation. Strategies for improving MaNS' attitude should better educate them on organ donation, targeting the most the Malay and nursing students, and should consider the influence of family attitude and religious permissibility on MaNS' willingness.
Factors Associated With Medical and Nursing Students’ Willingness to Donate Organs
Tumin, Makmor; Tafran, Khaled; Tang, Li Yoong; Chong, Mei Chan; Mohd Jaafar, Noor Ismawati; Mohd Satar, NurulHuda; Abdullah, Nurhidayah
2016-01-01
Abstract Malaysia suffers from a chronic shortage of human organs for transplantation. Medical and nursing students (MaNS) are future health professionals and thus their attitude toward organ donation is vital for driving national donation rates. This study investigates MaNS’ willingness to donate organs upon death and the factors influencing their willingness. A cross-sectional design was used with a sample of 500 students (264 medical and 236 nursing) at the University of Malaya. A self-administrated questionnaire was used. The responses were analyzed by using descriptive statistics and multiple logistic regression. Of all respondents, 278 (55.6%) were willing to donate organs upon death, while the remaining 222 (44.4%) were unwilling to donate. Only 44 (8.8%) had donor cards. The multiple logistic regression revealed that the minorities ethnic group was more willing to donate organs than Malay respondents (adjusted odds ratio [aOR] = 1.98, P = 0.010). In addition, medical students were more willing to donate than nursing students (aOR = 2.53, P = 0.000). Respondents who have a family member with a donor card were more willing to donate than respondents who do not (aOR = 3.48, P = 0.006). MaNS who believed that their religion permits deceased donation were more willing to donate than their counterparts (aOR = 4.96, P = 0.000). Household income and sex were not significant predictors of MaNS’ willingness to donate organs upon death. MaNS have moderate willingness, but low commitment toward deceased organ donation. Strategies for improving MaNS’ attitude should better educate them on organ donation, targeting the most the Malay and nursing students, and should consider the influence of family attitude and religious permissibility on MaNS’ willingness. PMID:27015207
ERIC Educational Resources Information Center
Reubsaet, A.; Brug, J.; Kitslaar, J.; Van Hooff, J. P.; van den Borne, H. W.
2004-01-01
The present paper describes the impact and evaluation of two intervention components--a video with group discussion and an interactive computer-tailored program--in order to encourage adolescents to register their organ donation preference. Studies were conducted in school during regular school hours. The video with group discussion in class had a…
ERIC Educational Resources Information Center
Russell, Heather Gordy
2010-01-01
The mixed method study focused on increasing blood donations from staff who work in a blood collecting organization and relies on Gilbert's Behavior Engineering Model as a framework. The qualitative phase of the study involved focus groups. Information from the focus groups and the literature review were used to create hypotheses. A survey was…
Ethical, legal, and societal issues and recommendations for controlled and uncontrolled DCD.
Haase, Bernadette; Bos, Michael; Boffa, Catherine; Lewis, Penney; Rudge, Chris; Valero, Ricard; Wind, Tineke; Wright, Linda
2016-07-01
This report deals with organ retrieval procedures in both controlled and uncontrolled DCD, looking at the ethical, legal, and psychosocial aspects during the different phases of the process. A recently published report by the UK Donation Ethics Committee (UKDEC) has served as an important reference document to outline the steps in the controlled DCD patient-donor pathway (Academy of Medical Royal Colleges. UK Donation Ethics Committee. An ethical framework for controlled donation after circulatory death. December 2011). For uncontrolled DCD, the UKDEC pathway description was adapted. At the 6th International Conference in Organ Donation held in Paris in 2013, an established expert European Working Group reviewed the UKDEC reports, which were then considered along with the available published literature. Along this pathway, the crucial ethical, legal, and psychosocial aspects have been flagged, and relevant recommendations have been formulated based on a consensus of the working group. © 2015 Steunstichting ESOT.
A mass mediated intervention on Hispanic live kidney donation.
Alvaro, Eusebio M; Siegel, Jason T; Crano, William D; Dominick, Alexander
2010-06-01
This research examines the impact of a Spanish language mass media campaign on living organ donation attitudes and behavioral intentions among Spanish dominant Hispanics in Tucson, Arizona. Impact was assessed via a pretest/posttest control group quasiexperimental design with Tucson, Arizona, as the intervention community and Phoenix, Arizona, as the control. Preintervention focus groups provided qualitative data to guide intervention development, while telephone surveys in both communities provided quantitative data to assess campaign impact. Analyses reveal pretest/posttest differences in the intervention community such that posttest intentions regarding living organ donation behaviors increased from pretest. No such differences were observed in the control community. Subsequent analyses revealed differences between respondents in the intervention community exposed to the campaign vs. those in the same community not exposed to the campaign. Exposed respondents reported more positive living organ donation behavioral intentions than nonexposed respondents. Implications for research and practice are discussed.
An inventory of reasons for sperm donation in formal versus informal settings.
Bossema, Ercolie R; Janssens, Pim M W; Treucker, Roswitha G L; Landwehr, Frieda; van Duinen, Kor; Nap, Annemiek W; Geenen, Rinie
2014-03-01
The shortage of sperm donors in formal settings (i.e., assisted reproduction clinics) and the availability of sperm donors in informal settings (such as through contacts on the internet) motivated us to investigate why men may prefer either a formal or an informal setting for sperm donation. Interviews with ten sperm donors and non-sperm donors yielded 55 reasons for sperm donation in the two settings. These reasons were categorized according to similarity by 14 sperm donors and non-sperm donors. These categorizations were then structured by means of hierarchical cluster analysis. Reasons favouring formal settings included being legally and physically protected, evading paternal feelings or social consequences, and having a simple, standardized procedure in terms of effort and finances. Reasons favouring informal settings related to engagement, the possibility to choose a recipient, lack of rules and regulations, having contact with the donor child, and having an (intimate) bond with the recipient. The overview of reasons identified may help potential sperm donors decide on whether to donate in a formal or informal setting, and may fuel discussions by professionals about the most appropriate conditions and legislation for sperm donation in formal settings.
Zhang, Jiabin; Ren, Hui; Sun, Yanling; Li, Zhijie; Wang, Hongbo; Liu, Zhenwen; Zhou, Shaotang
2018-05-01
BACKGROUND Organ donation from a deceased donor, which is donation after brain death followed by circulatory death, is a unique transplantation practice in China. Pathological features of grafts help guide the utilization of grafts. MATERIAL AND METHODS We retrospectively reviewed our experiences in 188 DBCD allografts from May 2014 to April 2017. We divided 183 transplanted allografts into 3 groups according to pretransplant histology: the good quality graft group (n=62), the preservation injury group (n=27), and the steatotic graft group (n=94). Univariate and multivariate analyses were performed to identify factors in the steatotic graft group predicting the prognoses. RESULTS The prevalence rates of allografts in the good quality, steatotic liver, and preservation injury groups were 33.0% (62/188), 50.0% (94/188), and 14.4%(27/188), respectively, and the discarded rate was 2.7% (5/188). The 1- and 3-year overall survival rates were 92.1% and 88.1%, respectively. There were no differences in 1- and 3-year patient survival among the 3 groups (p=0.615). Some complications occurred: acute rejection in 7 cases, lung infection in 11 recipients, biliary stricture and bile leak in 9 patients, and portal thrombosis in 1 recipient; 17 recipients died of various causes. Cox multivariate analysis revealed that longer cold storage time was associated with worse outcome in the steatotic graft group. CONCLUSIONS Clinical outcomes of adult liver transplantation from deceased donation in China are acceptable.
Donors to charity gain in both indirect reciprocity and political reputation.
Milinski, Manfred; Semmann, Dirk; Krambeck, Hans-Jürgen
2002-01-01
Darwinian evolution can explain human cooperative behaviour among non-kin by either direct or indirect reciprocity. In the latter case one does not expect a return for an altruistic act from the recipient as with direct reciprocity, but from another member of the social group. However, the widespread human behaviour of donating to poor people outside the social group, for example, to charity organizations, that are unlikely to reciprocate indirectly and thus are equivalent to defectors in the game is still an evolutionary puzzle. Here we show experimentally that donations made in public to a well-known relief organization resulted both in increased income (that the donors received from the members of their group) and in enhanced political reputation (they were elected to represent the interests of their group). Donations may thus function as an honest signal for one's social reliability. PMID:12028769
International collaborative donor project.
Ríos Zambudio, Antonio
2018-02-01
The International Donor Collaborative Project (PCID) research group was created in 1996 in Spain with the aim of promoting research in the field of organ donation and transplantation, led by Spanish surgeons. During this period they have developed the questionnaires of the PCID, both the attitude towards cadaver and live donation, which are the most used questionnaires in publications in indexed journals. They have been the driving group of stratified studies representative of the populations under study, and of the performance of multivariate statistical analyzes in the field of psycho-social research in organ donation and transplantation. The main contributions of the group focus on the analysis of health center professionals and emerging migrant groups. In recent years, studies have been extended to the United States, Latin America (mainly Mexico) and Europe. Copyright © 2017 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.
Physician perceptions about living organ donation in patients with Amyotrophic Lateral Sclerosis.
Ansari, S; Bromberg, M B; Gibson, S B
2017-09-01
Patients with Amyotrophic Lateral Sclerosis (ALS) have expressed desire to become living organ donors but are unable to do so with current organ donation policies. Our objective is to assess ALS patient's interest in organ donation, and perceived concerns of this practice by ALS neurologists. An electronic survey was administered to ALS neurologists across the United States regarding living organ donation in ALS patients prior to respiratory failure. 52 complete responses were received from 121 invites. 67% (35/52) of neurologists expressed no concerns about living organ donation in ALS patients, and 33% had concerns. The concerns related to respiratory failure, anesthesia exposure and renal dysfunction. With their concerns addressed, 71% of neurologists reported that they would endorse living organ donation. 49% of neurologists reported being asked by a patient for information regarding living organ donation. ALS neurologists felt that 22.8% of ALS patients (median 19%) would be interested in learning more about organ donation, while only 6% of neurologists broach this subject with their patients. Our results indicate that 1 in every 4 ALS patients may be interested in exploring options for living organ donation, and this topic is not routinely addressed by ALS clinics. These results indicate an unexplored area of patient interest. To honor a patient's wishes to donate, the transplant community will have to accommodate living organ donation from terminally ill patients, and address neurologist concerns. Such a practice could benefit two groups of patients. Copyright © 2017 Elsevier B.V. All rights reserved.
Enhancing blood donation intentions using multimedia donor education materials.
France, Christopher R; France, Janis L; Wissel, Mary Ellen; Kowalsky, Jennifer M; Bolinger, Elizabeth M; Huckins, Jamie L
2011-08-01
Prior research has shown that education materials that directly address prospective donor concerns and provide specific coping suggestions are particularly effective at enhancing donation attitudes and intentions to give blood. This study compared the effect of donor coping materials, provided in written and audiovisual formats, as potential tools to enhance recruitment of prospective blood donors. The role of initial attitudes toward blood donation on responses to these materials was also considered. Young adults (62% female; mean [SD] age=19.1 [1.4]; mean [range] prior blood donations=1.32 [0-13]) were randomly assigned to 1) read a brochure addressing common blood donor concerns and suggesting specific coping strategies, 2) view a video addressing blood donor concerns and illustrating coping techniques, 3) read the brochure and view the video, or 4) read a control brochure on healthy eating and exercise. Measures of blood donation attitudes, anxiety, confidence, and intentions to give blood were completed before and after the intervention. Relative to the control brochure, all the intervention groups showed larger reductions in anxiety, more positive changes in attitude, and greater increases in donation confidence and intentions. The combination of the brochure and video outperformed either intervention alone in further improving donation attitudes among participants with high initial donation attitudes. Blood donation coping materials, presented in either written or audiovisual formats, significantly enhance willingness to donate blood among young adults regardless of their initial attitudes toward blood donation. © 2011 American Association of Blood Banks.
Characteristics of donors who do or do not return to give blood and barriers to their return
Wevers, Anne; Wigboldus, Daniël H.J.; de Kort, Wim L.A.M.; van Baaren, Rick; Veldhuizen, Ingrid J.T.
2014-01-01
Background In the Netherlands about 50% of whole blood donors return to give blood after an invitation to donate. This study aimed to investigate the characteristics of donor return behaviour and to gain insight into the barriers to blood donation reported by the donors themselves. Materials and methods A total of 4,901 whole blood donors were invited to donate in week 39 of 2009. Barriers mentioned by donors who informed the blood bank for not donating were registered for 1 month. Logistic regression analyses assessed relevant characteristics of return behaviour, such as age and blood type, in men and women separately. Results Of the invited donors, 55% returned to give a donation, whereas 45% did not return. Male donors were more likely to return when they were older, had a higher previous return rate and had no past deferrals. The same pattern was found among women, but was less strong. The main barriers were: time constraints (35%), preference to postpone donation due to general physical problems although being eligible to donate (29%), and being ineligible to donate due to medical deferral criteria (9%). Discussion Specific donor characteristics are associated with return behaviour. Not donating due to time constraints could mean that donors do not feel the urgency of donating blood. Interventions targeted to increase commitment among specific donor groups should be tested further. PMID:23522891
Characteristics of donors who do or do not return to give blood and barriers to their return.
Wevers, Anne; Wigboldus, Daniël H J; de Kort, Wim L A M; van Baaren, Rick; Veldhuizen, Ingrid J T
2014-01-01
In the Netherlands about 50% of whole blood donors return to give blood after an invitation to donate. This study aimed to investigate the characteristics of donor return behaviour and to gain insight into the barriers to blood donation reported by the donors themselves. A total of 4,901 whole blood donors were invited to donate in week 39 of 2009. Barriers mentioned by donors who informed the blood bank for not donating were registered for 1 month. Logistic regression analyses assessed relevant characteristics of return behaviour, such as age and blood type, in men and women separately. Of the invited donors, 55% returned to give a donation, whereas 45% did not return. Male donors were more likely to return when they were older, had a higher previous return rate and had no past deferrals. The same pattern was found among women, but was less strong. The main barriers were: time constraints (35%), preference to postpone donation due to general physical problems although being eligible to donate (29%), and being ineligible to donate due to medical deferral criteria (9%). Specific donor characteristics are associated with return behaviour. Not donating due to time constraints could mean that donors do not feel the urgency of donating blood. Interventions targeted to increase commitment among specific donor groups should be tested further.
Complications associated with blood donations in a blood bank at an Indian tertiary care hospital.
Meena, Monika; Jindal, Tarun
2014-09-01
Blood donation, though safe, has a few potentially avoidable complications associated with it. They are important reasons for the failure of the donors to return for repeat donations. The aim of this study was to assess the frequency and identify the possible factors associated with increased risk of blood donation related complications so that they can be minimized. A prospective study was done over a period of four months in the blood bank of an Indian tertiary care hospital to record the donation related complications. Out of 7450 blood donations, total donation associated complications were 74, of which majority were vasovagal reactions (VVRs) (n=48), followed by venous hematomas (n=24) and arterial punctures (n=2). The incidence of VVRs was more, though not statistically significant, in females, replacement/repeat donors, donors between 21-30 y of age and who had a body-mass-index (BMI) of 18.5-24.9. VVRs were more common in April (p=0.002) and in those who donated 450ml of blood (p<0.001). Though hematomas were more frequent in females, voluntary donors, donors in age-group of 41-50, those with BMI<18.5 and in those who donated 350ml of blood, statistically significant association was seen only in repeat donors (p<0.001). Our study emphasizes that blood donation in our country has a complication rate of nearly 1%.
Hildebrand, Lee; Melchert, Timothy P; Anderson, Rebecca C
2014-08-01
Many healthcare providers have been concerned about the extent to which potential kidney donors use impression management or concealment of important information regarding their medical history, current functioning, or other circumstances that could affect whether they are accepted as donors. To date, however, there has been very little empirical examination of these questions. It is also not known whether donors' use of impression management pre-donation is related to their reactions and adjustment post-donation. This study surveyed 76 individuals who had donated a kidney one to six yr previously regarding their use of impression management and their concealing of information during their psychological evaluations. They were also asked about their reactions to the donation and whether they would make the same decision again. In addition, 21 of these donors participated in focus groups that explored these questions in depth. Many of the kidney donors reported that they possessed very strong motivation to donate and consequently used impression management in their interactions with medical professionals pre-donation. Very few donors, however, indicated that they concealed information during their pre-donation evaluations. The donors' psychological reactions post-donation were generally positive, and nearly all indicated that they would make the same decision again. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Dynamics in charity donation decisions: Insights from a large longitudinal data set
Leliveld, Marijke C.; Risselada, Hans
2017-01-01
Despite the vast body of research on charitable giving and its drivers, no research has investigated the longitudinal dynamics of individual donation decisions. We analyzed unique data with nearly 300,000 real donation decisions made by more than 20,000 individuals for a period of 10 months. Each decision entailed a choice of what to do with money received for completing a survey (on average, €0.67 per survey): keep it or donate to charity. We found that most of the participants (89%) always chose to keep the money. Within the group of people who sometimes kept and sometimes donated the money (that is, Switchers), we find that people do not change their decision very often (cf. moral consistency). However, the likelihood of donating increases when people kept the money the previous time, and the amount at stake differs substantially (both positively and negatively). Finally, once Switchers donated, they are more likely to keep the money next time if they can earn more (for example, €2 now versus €0.50 last time), signaling moral compensation. These longitudinal data provide a first step to better understand charity donation decisions, not only in terms of a more nuanced description of decision-makers but also in terms of the dynamics of charity donations. PMID:28948218
Attitudes Toward Living Donation in the Bolivian Population Residing in Spain.
Rios, A; Lopez-Navas, A; Fernández-Olivares, P; Martinez-Alarcón, L; Mikla, M; Ramis, G; Ramirez, P; Parrilla, P
2015-11-01
Living donation is increasingly necessary to address the shortage of organs for transplantation. Analyzing attitudes and influences toward living donation is essential. This study sought to analyze the attitude toward living donation in the population of Bolivians residing in Spain, and the variables that influence their attitude. We selected a sample of Bolivians living in Spain. Respondents were selected using a stratified sampling by age and sex. We used a validated questionnaire of psychosocial aspects (the questionnaire of Proyecto Colaborativo Internacional Donante about Living Kidney Donation [Donación de Vivo Renal in Spanish]), which is self-administered and anonymous. The Student t test, χ(2), and Fisher tests, as well as logistic regression analysis, were used to analyze the gathered data. Of all respondents (n = 206), 83% (n = 170) were in favor of living-related donation, and 32% (n = 66) were in favor of living-unrelated donation. The rest, 8.5% (n = 18) were not in favor of living donation and 8.5% (n = 18) were undecided. Acceptance of the living donation was associated with the religious beliefs of the respondent (P = .014), with no worry about the scars that may remain after the donation (P = .016), and with the risk evaluation of living donation (P = .029). On multivariate analysis, the most important variable was the risk associated with living donation (odds ratio, 6.329; 95% CI, 30.303-1.328; P = .021). Attitudes toward living donation among the Bolivian population residing in Spain is favorable, and represents a group that may be encouraged to become donors. Copyright © 2015 Elsevier Inc. All rights reserved.
[Blood donation: knowledge and attitudes of a university population in Chile].
Vásquez, Marcela; Ibarra, Patricia; Maldonado, Mónica
2007-11-01
To evaluate the knowledge and attitudes of students, professors, and other staff at the University of Talca, Chile, regarding voluntary blood donation. From June to July 2002 a previously-validated survey was administered to 487 individuals in the university community. The survey sought to measure their understanding of blood donation, i.e., motivators and reasons for becoming a blood donor and the myths and fears that might deter blood donation. Descriptive statistics were used to analyze the data. Only 14% of survey participants had donated blood in the past, and most of these (43.3%) were professors or other academics. Of the participants who were planning to donate blood in the future, students were the majority (88.1%). When the males in the group that was planning to donate were compared to the females, the difference was not statistically significant (90.0% vs. 84.2%, respectively). Of the deterrents to blood donation, 73.4% said the collection instruments might not be sterile. The university population represents a pool of desirable donors; an informative and motivating campaign could successfully convert the 87.3% potential donors into actual volunteer blood donors.
Schneider, Ingrid
2006-01-01
The demand for women's egg cells is increasing and is leading to reproductive tourism and transnational oocyte trafficking. The article considers the regulatory landscape of oocyte donation in Europe and analyses different types, particularly whether oocytes are provided within or outside of the IVF context, and whether anonymity of the donor is legally possible or not. The bifurcation between different purposes of egg extraction, particularly the challenges raised by ova demands for cloning research (SCNT) are highlighted. In emphasizing the need for supranational regulation, nine rules for supranational minimum standards are proposed to protect both donor interests and the public good. A particular focus is directed to the commodification of oocytes with regard to the European principle of non-commercial, voluntary and altruistic donation.
NASA Astrophysics Data System (ADS)
Huang, Liliang; He, Chengxiang; Sun, Zhihua
2015-07-01
Chan-Lam cross coupling allowed efficient synthesis of N,N’-disubstituted ortho-phenylene diamines bearing strong electron donating or withdrawing groups, such as nitro or methoxy groups, with moderate to high yields. These diamines can then be turned into N-heterocyclic carbene precursors after condensation with trimethyl orthoformate. The same strategy can also be utilized for the synthesis of N-monosubstituted aniline derivatives containing a functionalized ortho-aminomethyl group as intermediates for chiral 6-membered ring carbene precursors.
Tran, Nathalie Y L; Charbonneau, Johanne; Valderrama-Benitez, Valeria
2013-01-01
Through the conceptual lens of the archaic and modern gift, this study aims to examine perceived limitations and facilitators to increasing blood donations within Black communities in Montreal, Canada. The overall objective is to support blood agencies, such as Héma-Québec, in understanding the challenges and opportunities they face in promoting blood donation among Black communities in pluralistic societies. Thirty-three semi-structured qualitative interviews were conducted with donors and leaders of ethnocultural groups in Montreal: of these, 6 were Héma-Québec employees; 3 were Caribbean blood drive organizers; 14 were leaders of African, Caribbean or Black multiethnic churches and community groups; and finally, 10 were donors, including 2 African, 4 French-speaking Haitian and 4 English-speaking Caribbean. The existence of multiple Black communities in Montreal reflects the various facilitators and obstacles facing Héma-Québec. Caribbean and African communities have their own experiences with regard to blood donation as well as different relationships with the broader Quebec society, both of which have great impact on how they perceive the cause. Questions of trust, of giving to the family and to the community, as well as perceived social exclusion appear to be fundamental issues for our informants. The current participation of groups interested in bettering the lives of those affected by sickle cell anaemia combined with the fact that leaders felt more comfortable donating to someone close to the community suggests that the promotion of blood donation through this angle would be well received. Trust issues, perceived discrimination and social exclusion have structural and historical roots that can only be partly overcome with long-term efforts to increase awareness, develop collaborative partnerships and increase institutional efforts to adapt to the challenges of blood donation from Black citizens.
Direct and indirect costs incurred by Australian living kidney donors.
Barnieh, Lianne; Kanellis, John; McDonald, Stephen; Arnold, Jennifer; Sontrop, Jessica M; Cuerden, Meaghan; Klarenbach, Scott; Garg, Amit X; Boudville, Neil
2017-12-07
To describe the direct and indirect costs incurred by Australian living kidney donors. We studied 55 living kidney donors from 3 centres in Perth, Australia and 1 centre in Melbourne, Australia (2010-2014); 49 donors provided information on expenses incurred during the donor evaluation period and up to 3 months after donation. We used a micro-costing approach to measure and value the units of resources consumed. Expenses were grouped as direct costs (ground and air travel, accommodation, and prescription medications) and indirect costs (lost wages and lost productivity). We standardized costs to the year 2016 in Australian dollars. The most common direct costs were for ground travel (100%), parking (76%), and post-donation pain medications or antibiotics (73%). The highest direct costs were for air travel (median $1,986 [3 donors]) and ground travel (median $459 [49 donors]). Donors also reported lost wages (median $9,891 [37 donors]). The inability to perform household activities or care for dependants were reported by 32 (65%) and 23 (47%) donors. Total direct costs averaged $1,682 per donor (median $806 among 49 donors). Total indirect costs averaged $7,249 per donor (median $7,273 among 49 donors). Total direct and indirect costs averaged $8,932 per donor (median $7,963 among 49 donors). Many Australian living kidney donors incur substantial costs during the donation process. Our findings inform the continued development of policies and programs designed to minimize costs incurred by living kidney donors. This article is protected by copyright. All rights reserved.
Capron, Alexander Morgan; Delmonico, Francis L; Dominguez-Gil, Beatriz; Martin, Dominique Elizabeth; Danovitch, Gabriel M; Chapman, Jeremy
2016-09-01
Governmental and private programs that pay next of kin who give permission for the removal of their deceased relative's organs for transplantation exist in a number of countries. Such payments, which may be given to the relatives or paid directly for funeral expenses or hospital bills unrelated to being a donor, aim to increase the rate of donation. The Declaration of Istanbul Custodian Group-in alignment with the World Health Organization Guiding Principles and the Council of Europe Convention Against Trafficking in Human Organs-has adopted a new policy statement opposing such practices. Payment programs are unwise because they produce a lower rate of donations than in countries with voluntary, unpaid programs; associate deceased donation with being poor and marginal in society; undermine public trust in the determination of death; and raise doubts about fair allocation of organs. Most important, allowing families to receive money for donation from a deceased person, who is at no risk of harm, will make it impossible to sustain prohibitions on paying living donors, who are at risk. Payment programs are also unethical. Tying coverage for funeral expenses or healthcare costs to a family allowing organs to be procured is exploitative, not "charitable." Using payment to overcome reluctance to donate based on cultural or religious beliefs especially offends principles of liberty and dignity. Finally, while it is appropriate to make donation "financially neutral"-by reimbursing the added medical costs of evaluating and maintaining a patient as a potential donor-such reimbursement may never be conditioned on a family agreeing to donate.
Sufficient blood, safe blood: can we have both?
2012-01-01
The decision in September 2011 in the UK to accept blood donations from non-practicing men who have sex with men (MSM) has received significant public attention. Will this rule change substantially boost the number of blood donations or will it make our blood less safe? Clearly, most European countries have a blood procurement problem. Fewer young people are donating, while the population is aging and more invasive therapies are requiring more blood. Yet if that was the reason for allowing non-practicing MSM to donate, clearly re-admission of some other, much larger populations that are currently deferred from donation should likewise be considered. As far as risks for blood safety are concerned, evidence has been provided that the current quality of infectious disease marker testing significantly mitigates against, although does not completely eradicate, risks associated with admission of donors with a high risk of carrying certain blood-transmissible agents. However, it could be argued that more effective recruitment of the non-donor pool, which is substantially larger than the group of currently ineligible donors, would be a better strategy. Recruitment of this group will benefit the availability of blood without jeopardizing the current excellent safety profile of blood. PMID:22439656
Enhanced subgenual cingulate response to altruistic decisions in remitted major depressive disorder
Pulcu, Erdem; Zahn, Roland; Moll, Jorge; Trotter, Paula D.; Thomas, Emma J.; Juhasz, Gabriella; Deakin, J.F.William; Anderson, Ian M.; Sahakian, Barbara J.; Elliott, Rebecca
2014-01-01
Background Major depressive disorder (MDD) is associated with functional abnormalities in fronto-meso-limbic networks contributing to decision-making, affective and reward processing impairments. Such functional disturbances may underlie a tendency for enhanced altruism driven by empathy-based guilt observed in some patients. However, despite the relevance of altruistic decisions to understanding vulnerability, as well as everyday psychosocial functioning, in MDD, their functional neuroanatomy is unknown. Methods Using a charitable donations experiment with fMRI, we compared 14 medication-free participants with fully remitted MDD and 15 demographically-matched control participants without MDD. Results Compared with the control group, the remitted MDD group exhibited enhanced BOLD response in a septal/subgenual cingulate cortex (sgACC) region for charitable donation relative to receiving simple rewards and higher striatum activation for both charitable donation and simple reward relative to a low level baseline. The groups did not differ in demographics, frequency of donations or response times, demonstrating only a difference in neural architecture. Conclusions We showed that altruistic decisions probe residual sgACC hypersensitivity in MDD even after symptoms are fully remitted. The sgACC has previously been shown to be associated with guilt which promotes altruistic decisions. In contrast, the striatum showed common activation to both simple and altruistic rewards and could be involved in the so-called “warm glow” of donation. Enhanced neural response in the depression group, in areas previously linked to altruistic decisions, supports the hypothesis of a possible association between hyper-altruism and depression vulnerability, as shown by recent epidemiological studies. PMID:24936421
Zou, Shimian; Musavi, Fatemeh; Notari, Edward P; Fujii, Karen E; Dodd, Roger Y
2005-10-01
Health history questions are introduced into the predonation interview to identify blood donors believed to pose a higher risk of infectious diseases to recipients. This study assesses the current impact of some of those questions. Donor deferral and donation data were extracted from a research database of the American Red Cross. The prevalence of hepatitis B surface antigen or antibodies to human immunodeficiency virus, hepatitis C virus, or human T-lymphotropic virus was obtained for different groups of donors who were temporarily deferred in 2000 through 2001 and later returned to donate blood in 2000 through 2003. The results were compared with either first-time or repeat donors in 2000 through 2003, while controlling for differences in sex, age, and year of donation. Of donors temporarily deferred in 2000 through 2001 who had had no donation or deferral during the previous 2 years, only 22.08 percent subsequently returned to donate blood in 2000 through 2003. Donations from returning donors who had been deferred for potential infectious disease risk did not show a higher prevalence for any of the viral markers when those with no donation or deferral during the previous two years were compared with first-time donations, and those with prior donation were compared with repeat donations. Blood donors temporarily deferred in 2000 through 2001 for potential risk of viral infection who later returned to donate blood did not appear to pose a higher risk compared to first-time or repeat donors. The effectiveness of some of the currently used deferral questions in reducing viral risks warrants further study.
Awareness and Attitudes toward Organ Donation in Rural Puducherry, India.
Balajee, K L; Ramachandran, N; Subitha, L
2016-01-01
For many of the end-stage organ diseases, organ transplantation is the most preferred treatment. The need for the organ transplantation is higher than the availability. For the transplantation program to be successful, awareness regarding organ donation is needed and people must have a positive attitude toward donating organs. This study aims to assess the awareness and attitudes regarding organ donation among the rural population and to evaluate the sociodemographic factors associated with their awareness. This community-based cross-sectional study was conducted among 360 people living in 4 villages of Puducherry. Face-to-face interviews were carried out using pretested questionnaire, which included the sociodemographic data. Data were entered into Excel and analyzed using Statistical Package for Social Sciences. Of 360 participants, 88% (317/360) were aware of organ donation. Among these 317 participants, awareness was highest in the age group 18-30 years 98.8% (87/88), male 91% (147/161), higher secondary and above 100% (58/58), and Class 1 socioeconomic status 92% (13/14). Source of awareness about organ donation was primarily through media 83% (263/317). The majority of the participants 88% (281/317) felt that the purpose of organ donation was to save life. Most of the participants 91% (290/317) said that all healthy adults are eligible organ donors and 87% (275/317) of the participants said that monetary benefits could not be accepted for organ donation. Most of the participants 70% (223/317) were willing to donate their organs after death. Among the participants who refused to donate their organs, family refusal 57% (25/44) was the most common reason. This study shows that there is a high level of awareness about organ donation among rural people and most of the participants are willing to donate their organs.
Awareness of eye donation in the rural population of India.
Krishnaiah, Sannapaneni; Kovai, Vilas; Nutheti, Rishita; Shamanna, Bindiganavale R; Thomas, Ravi; Rao, Gullapalli N
2004-03-01
To determine the "awareness of eye donation" and "willingness to pledge eyes for donation" in the rural population of Andhra Pradesh, southern India. A total of 7,775 subjects of all ages, representative of the rural population of Andhra Pradesh, participated in the Andhra Pradesh Eye Disease Study (APEDS). Subjects older than 15 years were interviewed regarding awareness of eye donation and willingness to pledge eyes for donation. Age-gender adjusted prevalence of awareness of eye donation in this population was 30.7% (95% CI: 29.5-31.9) but only 0.1% (age-gender adjusted prevalence) (95% CI: 0.05-0.25) had pledged eyes. On multivariate analysis the awareness of eye donation was significantly less in those subjects > or = 70 years old (OR 0.7; 95% CI: 0.6-0.8), illiterates (OR 0.2; 95% CI: 0.1-0.2), females (OR 0.8; 95% CI: 0.7-0.9), lower socioeconomic status group (OR 0.4; 95% CI: 0.4-0.5) and Christians (OR 0.2; 95% CI: 0.1-0.6). Media comprised the major source of information about eye donation. Of those aware of eye donation, 32.9% were willing to pledge eyes, and 50.6% needed more information to decide whether or not to pledge their eyes. There needs to be more transfer of knowledge if more eyes are to be pledged. One-third of those aware of eye donation have not pledged their eyes, and an additional 50.6% needed more information to decide. This means only about one-fifth of those aware of eye donations have pledged their eyes.
Hyde, Melissa K; White, Katherine M
2009-09-01
To use a theory of planned behaviour (TPB) framework to explore the beliefs underlying communication of the donation decision for people who had not previously registered their consent on a donor register or discussed their decision with significant others. Initially, a focus group study elicited the common TPB (behavioural, normative, and control) beliefs about registering and discussing the organ donation decision. The main study assessed the important TPB belief predictors of intentions to register and discuss the donation decision. University students and community members from Queensland, Australia (N=123) completed items assessing their intentions and the TPB behavioural, normative, and control beliefs for registering and discussing their donation decision. Structural equation modelling (SEM) analyses revealed significant paths between people's intentions to register their donation decisions and underlying behavioural (e.g. enabling efficient donation procedures), normative (e.g. friends, doctors/medical professionals), and control (e.g. lack of motivation, knowing details about transplant recipients) beliefs (R2=.30). There were also significant paths between people's intentions to discuss their donation decision and underlying behavioural (e.g. feeling uncomfortable talking about death related topics) and normative (e.g. partner/spouse, family members) beliefs, but not control beliefs (R2=.33). There was a significant path between intentions to register and intentions to discuss one's donation decision. Results highlight the importance of focusing on behavioural and normative beliefs about communicating the donation decision, specifically for people who have not previously communicated their decision, and suggest potential targets for interventions designed to promote decision communication.
Yazer, Mark H; Vassallo, Ralph; Delaney, Meghan; Germain, Marc; Karafin, Matthew S; Sayers, Merlyn; van de Watering, Leo; Shaz, Beth H
2017-07-01
To meet the needs of a diverse patient population, an adequate supply of red blood cells (RBCs) from ethnic/racial minority donors is essential. We previously described the 10-year changes in minority blood donation in the United States. This study describes donation patterns by donor status, age, and race/ethnicity. Data on the age and the number of unique black/African American, Hispanic/Latino, Asian, and white RBC donors were obtained from eight US blood collectors for 2006, 2009, 2012, and 2015. Donors self-identified their race/ethnicity. First-time (FT) and repeat (R) donors were analyzed separately. Overall, for both FT and R donor groups, whites constituted the majority of unique donors (FT 66.7% and R 82.7%) and also donated the greatest proportion of RBC units (FT 66.6% and R 83.8%). Donors less than 20 years old comprised the greatest proportion of FT donors for all racial/ethnic groups (39.2%) and had the highest mean number of RBC donations per donor (1.12) among FT donors. Conversely, R donors less than 20 years old had some of the lowest mean number of RBC donations per donor (1.55) among R donors, whereas R donors at least 60 years old had the highest mean (1.88). Year by year, the percentage of FT donors who were less than 20 years old increased for all race/ethnicities. For R donors, whites were more frequently older, while Hispanics/Latinos and Asians were younger. Greater efforts to convert FT donors less than 20 years into R donors should be undertaken to ensure the continued diversity of the blood supply. © 2017 AABB.
Ayyadevara, Srinivas; Balasubramaniam, Meenakshisundaram; Kakraba, Samuel; Alla, Ramani; Mehta, Jawahar L; Shmookler Reis, Robert J
2017-12-10
Many progressive neurological disorders, including Alzheimer's disease (AD), Huntington's disease, and Parkinson's disease (PD), are characterized by accumulation of insoluble protein aggregates. In prospective trials, the cyclooxygenase inhibitor aspirin (acetylsalicylic acid) reduced the risk of AD and PD, as well as cardiovascular events and many late-onset cancers. Considering the role played by protein hyperphosphorylation in aggregation and neurodegenerative diseases, and aspirin's known ability to donate acetyl groups, we asked whether aspirin might reduce both phosphorylation and aggregation by acetylating protein targets. Aspirin was substantially more effective than salicylate in reducing or delaying aggregation in human neuroblastoma cells grown in vitro, and in Caenorhabditis elegans models of human neurodegenerative diseases in vivo. Aspirin acetylates many proteins, while reducing phosphorylation, suggesting that acetylation may oppose phosphorylation. Surprisingly, acetylated proteins were largely excluded from compact aggregates. Molecular-dynamic simulations indicate that acetylation of amyloid peptide energetically disfavors its association into dimers and octamers, and oligomers that do form are less compact and stable than those comprising unacetylated peptides. Hyperphosphorylation predisposes certain proteins to aggregate (e.g., tau, α-synuclein, and transactive response DNA-binding protein 43 [TDP-43]), and it is a critical pathogenic marker in both cardiovascular and neurodegenerative diseases. We present novel evidence that acetylated proteins are underrepresented in protein aggregates, and that aggregation varies inversely with acetylation propensity after diverse genetic and pharmacologic interventions. These results are consistent with the hypothesis that aspirin inhibits protein aggregation and the ensuing toxicity of aggregates through its acetyl-donating activity. This mechanism may contribute to the neuro-protective, cardio-protective, and life-prolonging effects of aspirin. Antioxid. Redox Signal. 27, 1383-1396.
Bart, Thomas; Volken, Thomas; Fischer, Yvonne; Taleghani, Behrouz Mansouri
2014-07-01
To obtain a better understanding of factors affecting blood and blood stem cell donation behavior in Switzerland, a series of studies has been performed. In the recent study of this series, which is described here, motivators and barriers in the field of blood and blood stem cell donation were identified. Web-based survey data from a non-random sample of the Swiss population 2012/2013 (n = 3,153) were used to describe and compare the ranking of motives and obstacles to donate blood and to enroll on the Swiss blood stem cell registry. Wilcoxon rank-sum test and Spearman's rank correlations were used to assess differences and associations between ranks and groups. The prospect of saving lives and solidarity were the top two motives to donate blood or to enroll on the blood stem cell registry. The top two obstacles to enroll on the blood stem cell registry were lack of general information on blood stem cell donation and on its risks, whereas the top two obstacles to donate blood were the lack of information where and when to donate and deferral of or exclusion from blood donation. Classical altruistic motives are top drivers for giving blood as well as registering for blood stem cell donation. Recruitment campaigns should focus on these motivators. Similarities in motivational factors as well as in obstacles regarding blood and blood stem cell donation can be found.
Deepika, Chenna; Murugesan, Mohandoss; Shastry, Shamee
2018-02-01
Fluid shifts from interstitial to intravascular space during blood donation helps in compensating the lost blood volume. We aimed to determine the volume of fluid shift following donation in donors with and without pre-donation fluid intake. We studied the fluid shift in 325 blood donors prospectively. Donors were divided in groups- with no fluid intake (GI) and either water (GII) or oral rehydrating fluids (GIII) before donation. Fluid shift following donation was calculated based on the difference between the pre and post donation blood volume. The influence of oral fluid intake, age, gender and body mass index (BMI) on volume of fluid shift was analyzed. The fluid shift was significant between donors without fluids (GI: 127 ± 81 ml) and donors with fluid intake (GII & III: 96 ± 45 ml) (p < 0.05). The difference was not significant between donors with water intake (GII: 106 ± 52 ml) and oral rehydrating fluid intake (GIII: 87 ± 41 ml). The shifted fluid volume increased with increasing BMI and decreased with increasing age in females. The fluid shift increased in females than in males. The age, gender, BMI and VVR did not significantly contribute to the volume of fluid shift following donation. As per our observation, the oral fluids before donation might not contribute to increase in fluid shift in blood donors after donation. Copyright © 2017 Elsevier Ltd. All rights reserved.
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
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.
Models of Charity Donations and Project Funding in Social Networks
NASA Astrophysics Data System (ADS)
Wojciechowski, Adam
One of the key fundaments of building a society is common interest or shared aims of the group members. This research work is a try to analyze web-based services oriented towards money collection for various social and charity projects. The phenomenon of social founding is worth a closer look at because its success strongly depends on the ability to build an ad-hoc or persistent groups of people sharing their believes and willing to support external institutions or individuals. The paper presents a review of money collection sites, various models of donation and money collection process as well as ways how the projects' results are reported to their founders. There is also a proposal of money collection service, where donators are not charged until total declared help overheads required resources to complete the project. The risk of missing real donations for declared payments, after the collection is closed, can be assessed and minimized by building a social network.
Confidential unit exclusion at the regional blood bank in Montes Claros - Fundação Hemominas
Maia, Caroline Nogueira; Ruas, Munic de Oliveira; Urias, Elaine Veloso Rocha
2012-01-01
Objective This study aimed at analyzing the rate of self-exclusion at the Regional Blood Bank in Montes Claros. Methods Data of self-excluding donors from August 2008 to August 2010 were analyzed. The following variables were considered: age, marital status, gender, ethnical background, blood group, Rh factor, number of donations, type of donation and serologic results. Results During the analyzed period, 34,778 individuals donated blood, 215 (0.62%) of which were self-excluded; 12% of donors did not answer, 6.3% ballots were spoilt and 13.6% of the responses were considered non-compliant. The profile of the donors was: male (81.9%), single (50.7%), aged between 19 and 29 years old (52.1%), Mulatto (48.3%), blood group O (32.1%) and positive Rh (32.1%). Most individuals were donating for the 2ndto 5th time (43.7%) and had negative serology (94.4%). Conclusion It was not evident that self-excluding donors had higher rates of seropositivity. PMID:23049378
Terbonssen, T; Settmacher, U; Dirsch, O; Dahmen, U
2018-02-01
Following the organ transplant scandal in Germany in 2011, the willingness to donate organs postmortem decreased dramatically. This was explained by a loss of confidence in the German organ donation system. The aim of this study was to evaluate the relationship between knowledge, trust, and fear in respect to organ donation and the explicit willingness to potentially act as an organ donor by comparing medical students to students of other disciplines. We conducted a Facebook-based online survey (June-July 2013). The participating students were divided into two groups according to their discipline: medical students and other students. Based on questions covering different aspects of organ donation, a knowledge, trust, and fear score was established and calculated. The answers were related to an explicitly expressed decision to donate organs as expressed in a signed organ donor card. In total, 2484 participants took part in our survey. Of these, 1637 were students, 83.7% (N = 1370) of which were medical students and 16.3% (N = 267) other students. As expected, medical students reached a higher knowledge score regarding organ donation compared with other students (knowledge score 4.13 vs. 3.38; p < 0.001). They also demonstrated more confidence in organ donation, resulting in a higher confidence score (3.94 vs. 3.33; p < 0.001) and expressed less fear towards organ donation as indicated by the lower fear score (1.76 vs. 2.04; p < 0.01). Medical students declared their written willingness to donate organs more often than did other students (78.2% vs. 55.2%; p < 0.001). Entries on organ donation cards did not differ significantly between medical students and other students. Medical students possessing an organ donor card showed a higher knowledge and a higher trust score than did medical students without an organ donor card. In contrast, other students possessing an organ donor card showed a higher trust score but did not show a higher knowledge score. The higher level of knowledge and trust demonstrated by the medical students was associated with a higher rate of written decisions to donate organs. In contrast, the lower level of knowledge and trust observed in the non-medical students was associated with a lower rate of organ donor cards. Interestingly, in the group of non-medical students, the decision regarding organ donation was associated with a higher level of trust, but not with a higher level of knowledge. It would appear that knowledge, trust, and the decision to donate organs are closely related. In cases of a low level of knowledge, confidence is even more important. Therefore, organ donation campaigns should focus on increasing knowledge and fostering trust.
NASA Astrophysics Data System (ADS)
Islam, Nasarul; Pandith, Altaf Hussain
2018-01-01
Density functional theory at CAM-B3LYP/6-311G++ (2d, 2p) level was employed to study the Triphenylboroxine derivatives ( TB) containing electron donating and electron substituents, for their charge transfer and nonlinear optical properties. The results reveal that electron donating groups facilitate the rapid electron injection as compared to unsubstituted TB. It was observed that upon substitution with electron donating groups, the TB derivatives show an increased double bond character in the B3-C18 bond indicating an increase in the degree of conjugation. The Frontier molecular orbital studies indicate that highest occupied molecular orbitals of the neutral molecules delocalize primarily over the three phenyl rings and bridging oxygen atoms, whereas the lowest unoccupied molecular orbitals localize largely on the two phenyl rings and the boron atoms. Further, the TD-DFT studies indicate that the maximum absorption band results from the electron transitions from the initial states that are contributed by the HOMO and HOMO-1 to the final states that are mainly contributed by the LUMOs. In addition, we have observed that the introduction of electron donating group to the TB-7 leads to more active nonlinear performance.
Bwititi, P T; Browne, J
2012-09-01
Blood transfusion is an important transmission route of Trypanosoma cruzi (T cruzi), a major parasitic infection in Central and South America. The limited treatment options are most effective in acute Chagas' infection. At present, there is no current data on the prevalence of T cruzi in the blood donor population of Guyana. This information is necessary to protect the supply of the blood donation programme. This study sought to determine the prevalence of T cruzi in the blood supply at the National Blood Transfusion Services of Guyana with the hope of providing knowledge to the on-going surveillance for Chagas' disease worldwide and therefore address the risk of its spread by blood transfusion. Two commercialized ELISAs utilizing crude or recombinant T cruzi antigens were used to study 2000 blood samples voluntarily donated for the purpose of altruistic or family replacement donation retrospectively. The results showed that approximately 1 in 286 donations tested positive for antibodies to T cruzi. These results indicate that T cruzi continues to be a risk in Guyana and there is a need to continue screening donated blood. Trypanosoma cruzi is a life-long infection and infected persons may be asymptomatic chronic carriers of the disease. Education, housing improvement, and controlled use of insecticides should be introduced to contain Chagas' disease.
Bahadur, G; Morrison, M; Machin, L
2010-12-01
Discussion about the ethics of human embryonic stem cell (ESC) research in the UK tends to be dominated by the divisive and potentially intractable issue of the moral status of the embryo. This can have the effect of silencing or marginalizing other concerns, especially in the context of public engagement with science in this field. One such area of potential public concern is the donation of oocytes and embryos to stem cell research. Contemporary research on the views of donors and potential donors about a wide range of biomaterials, from solid organs to gametes and bone marrow, is reviewed and used to illustrate the range and types of ethical concerns articulated by this important group of stakeholders. Attitudes to donation are found to vary according to the type of tissue being donated or collected, the purpose for which donation is being sought and the nature of the recipient of the donation. Pertinently, attitudes towards donating oocytes are found to differ in some respects from donation of embryos or fetal tissue. The implications of these findings for ensuring ethically robust informed consent and publicly acceptable sourcing of human biomaterials for stem cell research are then considered. Copyright © 2010 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.
Sliwowski, Z; Lorens, K; Konturek, S J; Bielanski, W; Zoładź, J A
2001-03-01
Leptin, an ob gene product of adipocytes, plays a key role in the control of food intake and energy expenditure but little is known about leptin response to strenuous exercise in fasted and fed subjects or before and after blood donation. This study was designed to determine the immediate effects of strenuous exercise in healthy volunteers under fasting or fed conditions and before and one day after blood donation (450 ml) on plasma levels of leptin and gut hormones [gastrin, cholecystokinin (CCK), pancreatic polypeptide (PP) and insulin], as well as on "stress" hormones (cortisol, catecholamines and growth hormone. Two groups (A and B) of healthy non-smoking male volunteers were studied. All subjects performed incremental exercise tests until exhaustion (up to maximal oxygen uptake--VO2max), followed by 2 h of rest session. Group A perfomed the tests on a treadmill, while group B on a cycloergometer. In group A, one exercise was performed under fasting conditions and the second following ingestion of a standard liquid meal. In group B, one exercise test was performed as a control test and the second 24 h after blood donation (450 ml). Blood samples were withdrawn 5 min before the start of the test, at the VO2max, and 2 h after finishing the exercise. No significant change in plasma teptin were observed both immediately and 2 h after the exercise in fasted subjects, but after the meal the plasma leptin at VO2max and 2 h after the test was significantly higher, while after blood donation was significantly reduced. The postprandial rise in plasma leptin was accompanied by a marked increment in gut hormones; gastrin, CCK and PP and stress hormones such as norepinephrine, cortisol and GH. These hormonal changes could contribute to the postprandial rise in plasma leptin concentrations, while the fall of leptin after blood donation could be attributed to the inadequate response of stress hormones and autonomic nervous system to exhausting exercise. We conclude that strenuous physical exercise; 1) fails to affect plasma leptin level but when performed after meal but not after blood withdrawal it results in an increase and fall in plasma leptin, and 2) the release of gut hormones (gastrin, CCK and PP) and stress hormones (norepinephrine, cortisol, GH) increase immediately after exercise independently of feeding or blood donation and 3) following blood donation the strenuous exercise resulted in a marked reduction in the plasma leptin, cortisol and GH concentrations, possibly due to the impairment in the autonomic nervous control of these hormones.
Kawamura, Yuta; Kusumi, Takashi
2015-04-01
Advertisements for charity generally employ one of two advertising strategies. The first appeals to the efficacy of support, while the second appeals to the necessity of support. Two experiments investigated the effect of each type of charity advertising on donations and on donors' explicit and implicit evaluations of the recipients. The results indicated that although participants' explicit evaluations of charity recipients were not changed by efficacy-based advertising, they were negatively influenced by necessity-based advertising. Furthermore, Experiment 1 detected moderating effects of empathic concern. The explicit evaluations of participants in the necessity-based advertising group were negatively correlated with their empathic concern. Implicit evaluations were consistently negative in both groups. Both advertising strategies were more effective at securing donations than the control group, which did not use any strategies. These findings suggest practical implications for charity advertising.
Han, Shuai; Chang, Tao; Zhao, Haiping; Du, Huanhuan; Liu, Shan; Wu, Baoshuang; Qin, Shenjun
2017-07-07
In this work, we present the fabrication of highly luminescent carbon dots (CDs) by a double passivation method with the assistance of Ca(OH)₂. In the reaction process, Ca 2+ protects the active functional groups from overconsumption during dehydration and carbonization, and the electron-withdrawing groups on the CD surface are converted to electron-donating groups by the hydroxyl ions. As a result, the fluorescence quantum yield of the CDs was found to increase with increasing Ca(OH)₂ content in the reaction process. A blue-shift optical spectrum of the CDs was also found with increasing Ca(OH)₂ content, which could be attributed to the increasing of the energy gaps for the CDs. The highly photoluminescent CDs obtained (quantum yield: 86%) were used to cultivate fluorescent carnations by a water culture method, while the results of fluorescence microscopy analysis indicated that the CDs had entered the plant tissue structure.
The results of nucleic acid testing in remunerated and non-remunerated blood donors in Lithuania
Kalibatas, Vytenis; Kalibatienė, Lina
2014-01-01
Background In Lithuania, governmentally covered remuneration for whole blood donations prevails. Donors may choose to accept or reject the remuneration. The purpose of this study was to compare the rate of nucleic acid testing (NAT) discriminatory-positive markers for human immunodeficiency virus-1 (HIV-1), hepatitis B virus (HBV) and hepatitis C virus (HCV) in seronegative, first-time and repeat, remunerated and non-remunerated donations at the National Blood Centre in Lithuania during the period from 2005 to 2010. Materials and methods All seronegative whole blood and blood component donations were individually analysed by NAT for HIV-1, HBV and HCV. Only discriminatory-positive NAT were classified. The prevalence of discriminatory-positive NAT per 100,000 donations in the donor groups and the odds ratios comparing the remunerated and non-remunerated donations were determined. Results Significant differences were observed for HBV NAT results: 47.42 and 26.29 per 100,000 remunerated first-time and repeat donations, respectively, compared to 10.6 and 3.58 per 100,000 non-remunerated first-time and repeat, seronegative donations, respectively. The differences were also significant for HCV NAT results: 47.42 and 51.99 for remunerated first-time and repeat donations, respectively, compared to 2.12 and 0 per 100,000 non-remunerated first-time and repeat, seronegative donations, respectively. No seronegative, discriminatory-positive NAT HIV case was found. The odds of discriminatory HBV and HCV NAT positive results were statistically significantly higher for both first-time and repeat remunerated donations compared to first-time and repeat non-remunerated donations. Discussion First-time and repeat remunerated seronegative donations were associated with a statistically significantly higher prevalence and odds for discriminatory-positive HBV and HCV NAT results compared to first-time and repeat non-remunerated donations at the National Blood Centre in Lithuania. PMID:24120587
Hu, H; Wang, T; Fu, Q
2017-10-01
Little is known about the psychological factors currently influencing blood donation in China. This study investigated the structure of psychological factors and their correlation with donation behaviour of adults in a transforming city in China over a 6-month period. Participants were recruited in Nanjing from May 2013 to April 2014. Preliminary focus group interviews with 102 participants were conducted to generate new items for a Theory of Planned Behaviour (TPB) questionnaire. The questionnaires were completed by 300 participants, and responses were subjected to factor analysis. We confirmed the resulting factorial structure with 861 respondents and examined the associations between these factors and donation behaviour during the next 6 months using structural equation modelling. Factor analysis and structural equation modelling of the data supported an extended TPB model with self-reported past donation behaviour as a covariate. After controlling for past donation behaviour, attitudes towards blood donation (β = 0·288), subjective norm (β = 0·149), self-efficacy (β = 0·199), trust in third-party health professionals (β = 0·237), mistrust towards blood collection agencies (BCAs) (β = -0·085) and traditional Chinese beliefs (β = -0·046) were significantly related to donation intention, whilst donation intention was positively (β = 0·212) associated with donation behaviour. These findings confirm that psychological factors such as attitudes are predictors of blood donation. Recruitment efforts using public information campaigns and interpersonal communications should focus on strengthening positive attitudes, increasing trust in third-party health professionals, elevating self-efficacy, changing traditional Chinese beliefs and relieving mistrust in blood collection agencies (BCAs). © 2017 British Blood Transfusion Society.
Nigerian Immigrant Population in Spain Is Little Sensitized to Living-Related Kidney Donation.
Ríos, A; Carrillo, J; López-Navas, A I; Ayala, M A; Garrido, G; Sebastián, M J; Martínez-Alarcón, L; Ramis, G; Hernández, A M; Ramírez, P; Parrilla, P
2018-03-01
The Nigerian population is an emerging group in Spain and in Europe, but their sensitization toward living kidney donation has not been studied. The aim of this work was to analyze the attitude toward related renal donation while alive among the population born in Nigeria resident in Spain. A population older than 15 years born in Nigeria and resident in Spain, stratified by age and sex, was studied with the use of the attitude questionnaire about living kidney donation, "PCID-DVR-Ríos." People were randomly selected based on stratification. African immigration support associations advised on the location of potential respondents. Completion of the questionnaire was anonymous and self-administered. Verbal consent was requested to assist in the study. Statistical methods included Student t test, χ 2 , Fisher exact test, and logistic regression analysis. A total of 179 respondents were included in the study: 70% (n = 125) were in favor of living-related kidney donation, and 30% (n = 54) remained against or undecided. This attitude was associated with different psychosocial factors: marital status (P = .001), having offspring (P = .029), risk assessment of live donation (P < .001), partner's opinion about donation (P < .001), previous relationship with donation and/or transplantation (P < .001), religion (P < .001), and fear of mutilation after donation (P < .001). In the multivariate analysis, the previous relationship with donation and/or transplantation (odds ratio, 8.064) persisted as the main related factor. The Nigerian immigrant population in Spain has a less favorable attitude toward living kidney donation than the native western European and Spanish population. Copyright © 2017 Elsevier Inc. All rights reserved.
Ritter, S; Hamouda, O; Offergeld, R
2012-08-01
The Robert Koch Institute collects and evaluates nationwide data on the incidence and prevalence of transfusion-relevant infections among blood and plasma donors in Germany. Since 2006 data not only on the number of donations tested but also on the number of the respective donors have become available. The demographic profile and donation frequencies of German whole blood, plasma and platelet donors in 2010 and the percentages among the general population are described and compared to data from 2006. Although the general population eligible to donate blood is on the decline since 2003, with a loss of 2% between 2006 and 2010, this has not led to a decrease in the number of blood donors and donations. Instead, the number of new and repeat whole blood donors increased by 8% and 7%, respectively. At the same time, the number of new plasma donors grew by 23%, that of repeat plasma donors by 41%. In 2010 more than 4.3% of the population aged 18-68 years was active as repeat whole blood donors; 0.4% repeatedly donated plasma or platelets. Since 2006 the percentage of donors among the general population increased significantly, especially among the youngest age group (18-24 years). Donation frequency varied depending on donor age and sex, with an average of 1.9 per year for whole blood donations, 12.5 for plasmapheresis and 5.0 for plateletpheresis. While the donation frequency for whole blood remained unchanged since 2006, the frequency of apheresis donations increased, especially among older donors. By recruiting more new donors and retaining and reactivating existing ones more effectively, the number of whole blood and apheresis donations was augmented.
When Opportunity Knocks Twice: Dual Living Kidney Donation, Autonomy and the Public Interest.
Bailey, Phillippa; Huxtable, Richard
2016-02-01
Living kidney transplantation offers the best treatment in terms of life-expectancy and quality of life for those with end-stage renal disease. The long-term risks of living donor nephrectomy, although real, are very small, with evidence of good medium-term outcomes. Who should be entitled to donate, and in which circumstances, is nevertheless a live question. We explore the ethical dimensions of a request by an individual to donate both of their kidneys during life: 'dual living kidney donation'. Our ethical analysis is tethered to a hypothetical case study in which a father asks to donate a kidney to each of his twin boys. We explore the autonomy of the protagonists, alongside different dimensions of the public interest, such as the need to protect not only the recipients, but also the donor and even the wider community. Whilst acknowledging objections to 'dual-donation', not least by reference to the harms that the donor might be expected to endure, we suggest there is a prima facie case for permitting this, provided that both donor and recipients are willing and that due attention is paid to such considerations as the autonomy and welfare of all parties, as well as to the wider ramifications of acting on such a request. We argue for broader interpretations of the concepts of autonomy and welfare, recognizing the importance of relationships and the relevance of more than merely physical well-being. Equipped with such a holistic assessment, we suggest there is a prima facie case for allowing 'dual living kidney donation'. © 2015 The Authors. Bioethics Published by John Wiley & Sons Ltd.
Tushla, Lara; Rudow, Dianne LaPointe; Milton, Jennifer; Rodrigue, James R; Schold, Jesse D; Hays, Rebecca
2015-09-04
Live-donor kidney transplantation (LDKT) is the best treatment for eligible people with late-stage kidney disease. Despite this, living kidney donation rates have declined in the United States in recent years. A potential source of this decline is the financial impact on potential and actual living kidney donors (LKDs). Recent evidence indicates that the economic climate may be associated with the decline in LDKT and that there are nontrivial financial ramifications for some LKDs. In June 2014, the American Society of Transplantation's Live Donor Community of Practice convened a Consensus Conference on Best Practices in Live Kidney Donation. The conference included transplant professionals, patients, and other key stakeholders (with the financial support of 10 other organizations) and sought to identify best practices, knowledge gaps, and opportunities pertaining to living kidney donation. This workgroup was tasked with exploring systemic and financial barriers to living kidney donation. The workgroup reviewed literature that assessed the financial effect of living kidney donation, analyzed employment and insurance factors, discussed international models for addressing direct and indirect costs faced by LKDs, and summarized current available resources. The workgroup developed the following series of recommendations to reduce financial and systemic barriers and achieve financial neutrality for LKDs: (1) allocate resources for standardized reimbursement of LKDs' lost wages and incidental costs; (2) pass legislation to offer employment and insurability protections to LKDs; (3) create an LKD financial toolkit to provide standardized, vetted education to donors and providers about options to maximize donor coverage and minimize financial effect within the current climate; and (4) promote further research to identify systemic barriers to living donation and LDKT to ensure the creation of mitigation strategies. Copyright © 2015 by the American Society of Nephrology.
What population factors influence the decision to donate blood?
Hollingsworth, Bruce; Wildman, John
2004-02-01
Donations of blood in most of the developed world are by nonremunerated volunteers. As such factors, which impact upon the motivation of individuals to donate, are critical to achieving a stable supply, we analyze the factors, which influence the decision to donate. Using data on 130,356 [corrected] individuals from 1999 and 2000, we investigate which factors determine the proportion of blood donors in postcode areas. Variables analyzed include blood donation status and sociodemographic characteristics in order to provide information on donation decisions. We find the proportion of donors in an area is significantly increased by higher proportions of women aged 20-29 and 40-49, and of men aged 60-69. Conversely, a higher proportion of males aged 20-29 significantly reduces proportion of donors. Also, a higher proportion of individuals born overseas significantly reduces the proportion of blood donors in an area. To increase supplies, blood collection agencies should target specific groups. Young men and men and women aged 30-49 need to be encouraged to donate. Collection agencies also need to target individuals who are born overseas to participate in the process. Using these results to aid targeting should help to maintain the blood supply.
Hopkinson, Cathy; Hudson, Cara; Murphy, Paul; Gardiner, Dale; McGowan, Olive; Miller, Cathy
2017-01-01
Between 1 April 2012 and 31 March 2015, 263 of the 2244 families in the UK whose loved ones had registered to donate organs for transplantation after their death on the NHS Organ Donor Register chose to override this decision; an override rate of 11.7%. Multivariable logistic regression analysis was applied to data relating to various aspects of the family approach in order to identify factors associated with such overrides. The factors associated with family overrides were failure to involve the Specialist Nurse for Organ Donation in the family approach (odds ratio 3.0), donation after circulatory death (odds ratio 2.7) and Black, Asian or Minority Ethnicity (odds ratio 2.7). This highlights the need to further engage with these groups in exploring donation as an end of life choice, and suggests that there may be, from the perspective of the family, fundamental differences between donation after brainstem death and circulatory death. It further adds to the body of data linking involvement of the Specialist Nurse for Organ Donation in the family approach to improved UK consent rates.
Morgan, James; Hopkinson, Cathy; Hudson, Cara; Murphy, Paul; Gardiner, Dale; McGowan, Olive; Miller, Cathy
2018-05-01
Between 1 April 2012 and 31 March 2015, 263 of the 2244 families in the UK whose loved ones had registered to donate organs for transplantation after their death on the NHS Organ Donor Register chose to override this decision; an override rate of 11.7%. Multivariable logistic regression analysis was applied to data relating to various aspects of the family approach in order to identify factors associated with such overrides. The factors associated with family overrides were failure to involve the Specialist Nurse for Organ Donation in the family approach (odds ratio 3.0), donation after circulatory death (odds ratio 2.7) and Black, Asian or Minority Ethnicity (odds ratio 2.7). This highlights the need to further engage with these groups in exploring donation as an end of life choice, and suggests that there may be, from the perspective of the family, fundamental differences between donation after brainstem death and circulatory death. It further adds to the body of data linking involvement of the Specialist Nurse for Organ Donation in the family approach to improved UK consent rates.
Galasiński, Dariusz; Sque, Magi
2016-11-01
Studies about the psychosocial issues concerning organ donation and transplantation tend to focus on the experiences of donor or recipient families. Little is known about the part played by correspondence exchanged between these two groups; in particular how they perceive the agency of organ donation. This is the first analysis to address the representation of the act of donation from the viewpoint of both donor and recipient families through interrogation of archived correspondence data, using linguistic techniques. The data was drawn from a collection of letters, from four USA organ procurement organisations, exchanged between donor and transplant recipient families. Donor families consistently linguistically ascribed agency and accountability for donation to the person who died, the donor. For the recipient families, on the other hand, the 'giver' was mainly implied, ambiguous or ascribed to the donor family. © 2016 Foundation for the Sociology of Health & Illness.
Schweda, Mark; Schicktanz, Silke
2009-03-01
Against the background of the increasing academic and political debate on financial incentives for organ donation, we conducted a qualitative investigation on the conditions under which European citizens would actually consider or refuse financial incentives for organ donation. Our paper combines an analysis of data that were collected in eight Focus Group discussions on transplantation medicine with lay people and patients from four European countries (Cyprus, Germany, the Netherlands, and Sweden) with a critical re-assessment of the dichotomy between gift and commodity in the recent political and academic discourse. We find that the distinction between living and post mortem donation on the one hand, and between different models of financial incentives on the other, plays a crucial role for the participants' values and ideas about organ donation. We discuss the significance of our results with particular respect to the central role of reciprocity and draw conclusions for the bioethical and biopolitical debate.
Organ donation video messaging in motor vehicle offices: results of a randomized trial.
Rodrigue, James R; Fleishman, Aaron; Fitzpatrick, Sean; Boger, Matthew
2015-12-01
Since nearly all registered organ donors in the United States signed up via a driver's license transaction, motor vehicle (MV) offices represent an important venue for organ donation education. To evaluate the impact of organ donation video messaging in MV offices. A 2-group (usual care vs usual care+video messaging) randomized trial with baseline, intervention, and follow-up assessment phases. Twenty-eight MV offices in Massachusetts. Usual care comprised education of MV clerks, display of organ donation print materials (ie, posters, brochures, signing mats), and a volunteer ambassador program. The intervention included video messaging with silent (subtitled) segments highlighting individuals affected by donation, playing on a recursive loop on monitors in MV waiting rooms. Aggregate monthly donor designation rates at MV offices (primary) and percentage of MV customers who registered as donors after viewing the video (secondary). Controlling for baseline donor designation rate, analysis of covariance showed a significant group effect for intervention phase (F=7.3, P=.01). The usual-care group had a significantly higher aggregate monthly donor designation rate than the intervention group had. In the logistic regression model of customer surveys (n=912), prior donor designation (β=-1.29, odds ratio [OR]=0.27 [95% CI=0.20-0.37], P<.001), white race (β=0.57 OR=1.77 [95% CI=1.23-2.54], P=.002), and viewing the intervention video (β=0.73, OR=1.54 [95% CI=1.24-2.60], P=.01) were statistically significant predictors of donor registration on the day of the survey. The relatively low uptake of the video intervention by customers most likely contributed to the negative trial finding.
Cárdenas, Vicky; Thornton, John Daryl; Wong, Kristine A.; Spigner, Clarence; Allen, Margaret D.
2010-01-01
School-based health education is a promising approach for improving organ donation rates, but little is known about its efficacy among ethnically diverse youth. The impact of a classroom intervention was examined in a multicultural high school population where students’ ethnicities were 45% African American, 30% Asian American, and 33% Caucasian (allowing for multiracial choices). A baseline survey was administered to all health classes within 2 weeks prior to intervention. On the intervention day, classes randomly assigned to the intervention group received an educational session, followed by a second survey; in control classes, the second survey was taken before the educational session. At baseline, non-Caucasian ethnicity and male gender were each associated with lower levels of willingness to donate. Following the intervention, students in the intervention group demonstrated a significant increase in knowledge scores (p<0.001), as well as positive movement of opinion regarding willingness to donate (p<0.0001). Most importantly, the positive changes in opinion occurred independently of ethnicity and gender, in spite of these both being negative predictors of opinion at baseline. These results demonstrate that even a single classroom exposure can impact knowledge levels, correct misinformation, and effect opinion change on organ donation among an ethnically diverse adolescent population. PMID:20088915
Bitan, Menachem; van Walraven, Suzanna M; Worel, Nina; Ball, Lynne M; Styczynski, Jan; Torrabadella, Marta; Witt, Volker; Shaw, Bronwen E; Seber, Adriana; Yabe, Hiromasa; Greinix, Hildegard T; Peters, Christina; Gluckman, Eliane; Rocha, Vanderson; Halter, Joerg; Pulsipher, Michael A
2016-01-01
Related donors for hematopoietic cell (HC) transplantation are a growing population in recent years because of expanding indications for allogeneic transplantation. The safety and welfare of the donor are major concerns for the transplantation community, especially for related sibling donors of young recipients who are children and, thus, not able to fully consent. Because donation of HC does not improve the donor's own physical health and carries a risk of side effects, careful assessment of medical risks specific to the individual donor, as well as consideration of ethical and legal aspects associated with donation from a child, must be considered. In addition, donor centers must balance the needs of both the donor and the recipient, understanding the inherent conflict parents may have as they can be overly focused on the very sick child receiving a transplant, rather than on the relatively less significant health or emotional problems that a sibling donor may have, which could impact risk with donation. Likewise, consideration must be made regarding the nature of the relationship of the sibling donor to the recipient and also aspects of performing research on pediatric HC donors. In this article, as members of the Donor Issues Committee of the Worldwide Network for Blood and Marrow Transplantation, we review key ethical concerns associated with pediatric donation and then give recommendations for screening potential child donors with underlying health conditions. These recommendations are aimed at protecting the physical and emotional well-being of childhood donors and arise out of the Third International Conference on Health and Safety of Donors sponsored by the Worldwide Network for Blood and Marrow Transplantation. Copyright © 2016 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.
Ríos, A; López-Navas, A I; Sánchez, Á; Ayala, M A; Garrido, G; Sebastián, M J; Martínez-Alarcó, L; Ramis, G; Hernández, A M; Ramírez, P; Parrilla, P
2018-03-01
The Bolivian population is an emerging Latin American immigrant group in Spain, several of whom have been transplanted or are awaiting transplant. We aimed to assess attitudes toward organ donation among Bolivians currently residing in Spain. The population screened was born in Bolivia but living in Spain, stratified by gender and age. The appraisal tool used was a questionnaire that assesses attitudes toward organ donation for transplant ("PCID-DTO Ríos"). Support from immigration associations in Spain was needed for advice on locations of potential respondents. Survey participation was anonymized and the questionnaire was self-administered. Verbal consent was obtained before participation. There were 206 respondents: 49% (n = 101) in favor of donating their organs after death; 21% (n = 44) against donation; and 30% (n = 61) undecided. Their attitudes were found to be associated with level of education (P = .008), previous experience with donation and transplant (P = .011), concern regarding mutilation after donation (P = .002), knowing the attitude of their religion toward transplant (P = .001), the opinion of their partner (P < .001), and the possibility of needing a future transplant (P = .050). In the multivariate study, the main factor was having a partner in favor of organ donation (odds ratio = 16.129; P = .003). Attitudes toward organ donation among Bolivians residing in Spain are far more negative compared with rest of the Spanish population, due to various factors. Copyright © 2017 Elsevier Inc. All rights reserved.
Knowledge and ethical perception regarding organ donation among medical students
2013-01-01
Background To determine the knowledge and ethical perception regarding organ donation amongst medical students in Karachi- Pakistan. Methods Data of this cross sectional study was collected by self administered questionnaire from MBBS students of Ziauddin University from 2010 to 2011. Sample size of 158 (83 First years and 75 Fourth years) were selected by convenient sampling and those students who were present and gave consent were included in the study. The data was analyzed by SPSS version 20. Results A total of 158 participants from Ziauddin Medical University filled out the questionnaire out of which 83(52.5%) were first years and 75(47.5%) were fourth year medical students. Mean age of sample was 20 ± 1.7. Majority of students were aware about organ donation with print and electronic media as the main source of information. 81.6% agreed that it was ethically correct to donate an organ. In the students’ opinion, most commonly donated organs and tissues were kidney, cornea, blood and platelet. Ideal candidates for donating organ were parents (81%). Regarding list of options for preference to receive an organ, most of the students agreed on young age group patients and persons with family. Willingness to donate was significantly associated with knowledge of allowance of organ donation in religion (P=0.000). Conclusion Both 1st year and 4th year students are aware of Organ Donation, but there is a significant lack of knowledge regarding the topic. PMID:24070261
Peltier, James W; D'Alessandro, Anthony M; Dahl, Andrew J; Feeley, Thomas Hugh
2012-09-01
Despite the fact that college students support social causes, this age group has underparticipated in organ donor registration. Little research attention has been given to understanding deeper, higher-order relationships between the antecedent attitudes toward and perceptions of organ donation and registration behavior. To test a process model useful for understanding the sequential ordering of information necessary for moving college students along a hierarchical decision-making continuum from awareness to support to organ donor registration. The University of Wisconsin organ procurement organization collaborated with the Collegiate American Marketing Association on a 2-year grant funded by the US Health Resources and Services Administration. A total of 981 association members responded to an online questionnaire. The 5 antecedent measures were awareness of organ donation, need acknowledgment, benefits of organ donation, social support, and concerns about organ donation. The 2 consequence variables were support for organ donation and organ donation registration. Structural equation modeling indicated that 5 of 10 direct antecedent pathways led significantly into organ donation support and registration. The impact of the nonsignificant variables was captured via indirect effects through other decision variables. Model fit statistics were good: the goodness of fit index was .998, the adjusted goodness of fit index was .992, and the root mean square error of approximation was .001. This sequential decision-making model provides insight into the need to enhance the acceptance of organ donation and organ donor registration through a series of communications to move people from awareness to behavior.
Fan, Chencheng; Zhang, Bao; Li, Yuanchao; Liang, Yuxia; Xue, Xiaodong; Feng, Yaqing
2015-11-11
A series of D-π-A zinc porphyrin sensitizers bearing a substituted iminodibenzyl group at the porphyrin meso position, which is expected to have different electron-donating abilities, were designed. Theoretical studies were performed to examine the photovoltaic properties of these molecules in dye-sensitized solar cells (DSSCs). In particular, the important concepts, the Fukui function and the extended condensed Fukui function, are employed to describe the electron-donating abilities accurately at the quantitative level. Tangui Le Bahers model was adopted to analyze charge transfer (CT) during electron transition. A correlation between the electron donating abilities of the derived iminodibenzyl group and CT was built to evaluate the cell performance based on sensitizers . The theoretical studies showed that porphyrins bearing an extremely strong electron-donating group (EDG) would fail in the generation of photocurrent in the closed circuit when applied in DSSCs due to the higher level of the HOMO energy than the redox potential of the redox couple (I(-)/I3(-)). The one with a weaker EDG () is expected to show better photovoltaic performance than porphyrin with an unsubstituted iminodibenzyl group. This study demonstrates a reliable method involving the employment of the Fukui function, the extended condensed Fukui function and the Tangui Le Bahers model for the evaluation of newly designed D-π-A type porphyrin sensitizers for use in DSSCs, and as guidance for future molecular design.
Neural correlates of prosocial peer influence on public goods game donations during adolescence.
Van Hoorn, Jorien; Van Dijk, Eric; Güroğlu, Berna; Crone, Eveline A
2016-06-01
A unique feature of adolescent social re-orientation is heightened sensitivity to peer influence when taking risks. However, positive peer influence effects are not yet well understood. The present fMRI study tested a novel hypothesis, by examining neural correlates of prosocial peer influence on donation decisions in adolescence. Participants (age 12-16 years; N = 61) made decisions in anonymous groups about the allocation of tokens between themselves and the group in a public goods game. Two spectator groups of same-age peers-in fact youth actors-were allegedly online during some of the decisions. The task had a within-subjects design with three conditions: (1) EVALUATION: spectators evaluated decisions with likes for large donations to the group, (2) Spectator: spectators were present but no evaluative feedback was displayed and (3) Alone: no spectators nor feedback. Results showed that prosocial behavior increased in the presence of peers, and even more when participants received evaluative feedback from peers. Peer presence resulted in enhanced activity in several social brain regions including medial prefrontal cortex, temporal parietal junction (TPJ), precuneus and superior temporal sulcus. TPJ activity correlated with donations, which suggests similar networks for prosocial behavior and sensitivity to peers. These findings highlight the importance of peers in fostering prosocial development throughout adolescence. © The Author (2016). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.
Knowledge, attitude and practices of people towards voluntary blood donation in Uttarakhand.
Agrawal, Amit; Tiwari, Aseem K; Ahuja, Alok; Kalra, Rakesh
2013-01-01
Blood transfusions form a crucial and irreplaceable part in the medical management of many diseases. The collection of blood from voluntary, non-remunerated blood donors from low risk populations is an important measure for ensuring the availability and safety of blood transfusion. In a state like Uttarakhand which is visited by lakhs of visitors during pilgrimage season and where natural calamities and accidents are very common, the availability of blood is of utmost importance. To find out knowledge, attitude and practices of people towards voluntary blood donation to comprehend the situation and find ways to enhance voluntary blood donation in the state of Uttarakhand. Multi stage methodology was designed to target population including general population, influencers (doctors) and supporting organizations (camp organizers, State AIDS Control Society Officials) who were subjected to in-depth interview using pre-structured questionnaires to assess knowledge/awareness about voluntary blood donation, factors preventing and source of knowledge about voluntary blood donation. The sample population consisted of mostly men (67%) in the age-group of 26-35 years. Requirement of blood and the measures to promote voluntary blood donation have a direct relationship with the total population and literacy level of the population. Awareness about blood donation, source of knowledge about blood donation, reasons for not donating blood are particularly stressed. With increase in educational level, the awareness level was also found to increase. While among illiterates 81 percent of the respondents knew about blood donation, among the post graduates the same ratio was found to be almost cent-percent. Among various reasons cited for not donating blood, lack of awareness being the most common reason. People gathered information about blood donation from several different sources with electronic media being the most prominent. This study illustrates how increasing awareness and marketing 'Voluntary blood donation' can enhance adequacy of blood needs of a state or for that matter the entire country. This study also underlines how different media, especially electronic media, can be used to propagate altruistic blood donation.
Legal and ethical aspects of organ donation after euthanasia in Belgium and the Netherlands.
Bollen, Jan; Ten Hoopen, Rankie; Ysebaert, Dirk; van Mook, Walther; van Heurn, Ernst
2016-08-01
Organ donation after euthanasia has been performed more than 40 times in Belgium and the Netherlands together. Preliminary results of procedures that have been performed until now demonstrate that this leads to good medical results in the recipient of the organs. Several legal aspects could be changed to further facilitate the combination of organ donation and euthanasia. On the ethical side, several controversies remain, giving rise to an ongoing, but necessary and useful debate. Further experiences will clarify whether both procedures should be strictly separated and whether the dead donor rule should be strictly applied. Opinions still differ on whether the patient's physician should address the possibility of organ donation after euthanasia, which laws should be adapted and which preparatory acts should be performed. These and other procedural issues potentially conflict with the patient's request for organ donation or the circumstances in which euthanasia (without subsequent organ donation) traditionally occurs. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Lam, W A; McCullough, L B
2000-10-01
The rate of organ donation among minority groups in the United States, including Chinese-Americans, is very low. There is currently very little data in the biomedical literature that builds on qualitative research to quantify the attitudes of Chinese Americans toward organ donation. The present study quantitatively assesses the religious and cultural reasons that Chinese-Americans appear to be less willing to donate their organs than other populations. It also seeks to determine whether Confucian, Buddhist, or Daoist ideals are a significant factor in their overall reluctance to donate organs among respondents in this sample. A questionnaire distributed to Chinese American adults asked about general feelings toward organ donation and Buddhist, Confucian, Christian, Daoist, and other spiritual objections. The results suggest that Chinese-Americans are indeed influenced by Confucian values, and to a lesser extent, Buddhist, Daoist, and other spiritual beliefs, that associate an intact body with respect for ancestors or nature. Another significant finding is that the subjects were most willing to donate their organs after their deaths, to close relatives, and then in descending order, distant relatives, people from their home country, and strangers. This 'negotiable' willingness has enormous implications for clinicians, who may be able to increase organ donation rates among Chinese-Americans by, first, recognizing their diverse spiritual beliefs, and, second, offering a variety of possibilities for the organ procurement and allocation.
Ortiz, Jorge; Feyssa, Eyob L; Parsikia, Afshin; Azhar, Ashaur; Hashemi, Nikroo; Campos, Stalin; Khanmoradi, Kamran; Zaki, Radi; Balasubramanian, Manjula; Araya, Victor
2011-04-01
The rate of hepatitis C virus recurrence after donation after cardiac death liver transplant is not clearly defined. This is a retrospective review of 39 donations after cardiac death-liver transplant recipients. Biopsies were performed at 6, 12, 24, and 36 months for all hepatitis C virus positive donation after cardiac death recipients. The 6-, 12-, 24-, and 36-month severe hepatitis C virus recurrence rates were 60%, 73%, 87%, and 94%. A histologic comparison group of 26 long-surviving hepatitis C virus positive donation after neurologic death recipients had severe hepatitis C virus recurrence 27%, 31%, 42%, and 52% of the time. Six of the 19 hepatitis C virus donation after cardiac death patients developed cirrhosis at a median of 56 months (range, 14-119 months). There was no significant 3-year allograft and patient survival difference between hepatitis C virus and nonhepatitis C virus donation after cardiac death recipients. The factors most associated with decreased survival in the entire cohort included biliary and vascular complications. Organs procured by our institution's attending surgeons were associated with a better 3-year allograft survival. Severe hepatitis C virus recurrence was nearly universal but did not lead to increased graft loss when compared with nonhepatitis C virus donation after cardiac death at 3 years. These data may justify early interferon treatment in these at-risk patients.
Waldby, Catherine; Carroll, Katherine
2012-05-01
We report on a study undertaken with an Australian in vitro fertilisation (IVF) clinic to understand IVF patients' and reproductive donors' perceptions of oocyte (egg) donation for stem cell research. Such perspectives are particularly valuable because IVF patients form a major recruitment group for oocyte donation for research, and because patients and donors have direct experience of the medical procedures involved. Similar studies of oocyte donation have been carried out elsewhere in the world, but to date very little social science research has been published that reports on donation for research, as distinct from donation for reproduction. Our respondents expressed a distinct unwillingness to donate viable oocytes for stem cell research. In our analysis we consider a number of factors that explain this unwillingness. These include the labour of oocyte production, the inscrutability of oocytes (the lack of a test to identify degrees of fertility) and the extent to which the oocytes' fertility sets the parameters for all downstream reproductive possibilities. We draw on the science studies literature on affordances to make sense of the social intractability of oocytes, and compare them with the respondents' much greater willingness to donate frozen embryos for human embryonic stem cells research. © 2011 The Authors. Sociology of Health & Illness © 2011 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.
Organ donation among Malaysian Muslims: the role of mosques.
Tumin, Makmor; Raja Ariffin, Raja Noriza; Mohd Satar, NurulHuda; Abdullah, Nawi; Wan Md Adnan, Wan Ahmad Hafiz; Ismail, Ahmad Zuhdi; Che Soh, Mazlan
2015-04-13
Malaysia, a country of Muslim majority, is suffering from a severe organ shortage due to the lack of donors. Mosques are the main gateways into the Muslim community. Hence, it is imperative to explore their role in facilitating organ donation. A self-administered survey was conducted between October and December 2013. We distributed 700 pilot-tested questionnaires to 82 mosques in Kuala Lumpur and its suburbs. The respondents were stratified into 2 groups: the mosque committees and the Muslim Jama'ah (individuals who come regularly to mosque for prayer). Data collected from a survey on 653 Malaysian Muslims reveals that the main factors that hamper organ donation-related activities at the mosques in Malaysia are the lack of experts and financial resources. The level of autonomy of the mosque is also another main issue. The respondents believe that talks and dialogues are the best methods for organ donation campaigns at the mosques. Conclusions We argue that if the mosques are to play a role in imparting knowledge on organ donation, there should be ample opportunity for the mosque committee to choose the content of religious talks held in their community. The mosques in Malaysia are not sufficiently facilitated to channel the information on organ donation to the Muslim community. Providing financial support and expert campaigners are expected to increase organ donation-related activities at the mosques and subsequently could increase awareness regarding organ donations among Malaysian Muslims.
Naçar, M; Çetinkaya, F; Baykan, Z; Elmalı, F
2015-01-01
The aim of this study is to determine the knowledge, attitude, and behaviors of Erciyes University School of Medicine students regarding organ donation. This descriptive study was conducted in 2014 on Erciyes University School of Medicine first- and sixth-grade students via questionnaire. It was to be conducted on all 490 students; in total, 464 students were enrolled-304 from first grade and 160 from sixth grade. Data were analyzed using descriptive statistics, χ(2) test, and binary logistic regression analysis. The mean age was 20.9 ± 2.8 years and it was found that 48.9% were male, 65.5% were in first grade; 50.0% of the students who participated in the study were considering donating their organs and this rate is 45.4% in the first grade and 58.8% at sixth grade. Those who donated their organs were 3.4% in the entire group and were 1.6% and 6.9% consequently in first and sixth grades. Those who are; at the sixth grade, female gender, those who feel themselves responsible for the donation of society, who think organ donation is appropriate in terms of religion and conversations within family about organ donations significantly want organ donation more statistically. However, grade and gender had no effect on wishing donating organs according to binary logistic regression analysis. The rate of feeling themselves responsible from the donation in society was 73.9% and finding organ donation appropriate in terms of religion was 75.6% and there wasn't significant difference between first and sixth grades. Although there are increases in many variables about this issue at sixth grade, students are unable to gain sufficient attitude and behavior about organ donation. Training can be planned during medical educations in terms of gaining attitudes and behaviors about the issue. Copyright © 2015 Elsevier Inc. All rights reserved.
Davison, Sara N; Jhangri, Gian S
2014-11-01
Organ donation and transplantation rates are low for aboriginal people in Canada, despite a high demand. An explanatory mixed-methods design was used to describe knowledge of and preferences for organ donation and transplantation among First Nations people and identify factors that may influence these preferences. We recruited on- and off-reservation First Nations adults. A 45-item survey was administered to 198 participants, of whom 21 were assessed further with a qualitative interview using a multiple case study approach. In an iterative process, themes were identified from qualitative data using critical realism as the theoretical framework. Critical realism is an approach that describes the interface between natural and social worlds to explain human behavior. Although 83% of participants were in favor of transplantation, only 38% were willing to donate their organs after death, 44% had not thought about organ donation, and 14% did not believe it was important. Only 18.7% of participants reported that their cultural beliefs influenced their views on organ donation and transplantation. In the multivariable analysis, the only factors associated with willingness to donate organs were higher education and considering organ donation important. Four themes emerged from qualitative data: importance of traditional beliefs, recognition of need due to the epidemic of diabetes among Canadian aboriginal people, reconciliation between traditional beliefs and need, and general apathy in the community. Cultural, socioeconomic, and political diversity exist between and within aboriginal groups. Findings may not be generalizable to other aboriginal communities. Willingness to donate organs was lower in these First Nations participants compared to the general population. Education to address knowledge deficits, emphasize the negative impact of organ failure on the community, and contextualize organ donation within the older traditional native beliefs to help First Nations people understand how organ donation may be integrated into native spirituality likely is required to increase donation rates. Copyright © 2014 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.
Awareness and Attitudes toward Organ Donation in Rural Puducherry, India
Balajee, KL; Ramachandran, N; Subitha, L
2016-01-01
Background: For many of the end-stage organ diseases, organ transplantation is the most preferred treatment. The need for the organ transplantation is higher than the availability. For the transplantation program to be successful, awareness regarding organ donation is needed and people must have a positive attitude toward donating organs. Aim: This study aims to assess the awareness and attitudes regarding organ donation among the rural population and to evaluate the sociodemographic factors associated with their awareness. Subjects and Methods: This community-based cross-sectional study was conducted among 360 people living in 4 villages of Puducherry. Face-to-face interviews were carried out using pretested questionnaire, which included the sociodemographic data. Data were entered into Excel and analyzed using Statistical Package for Social Sciences. Results: Of 360 participants, 88% (317/360) were aware of organ donation. Among these 317 participants, awareness was highest in the age group 18–30 years 98.8% (87/88), male 91% (147/161), higher secondary and above 100% (58/58), and Class 1 socioeconomic status 92% (13/14). Source of awareness about organ donation was primarily through media 83% (263/317). The majority of the participants 88% (281/317) felt that the purpose of organ donation was to save life. Most of the participants 91% (290/317) said that all healthy adults are eligible organ donors and 87% (275/317) of the participants said that monetary benefits could not be accepted for organ donation. Most of the participants 70% (223/317) were willing to donate their organs after death. Among the participants who refused to donate their organs, family refusal 57% (25/44) was the most common reason. Conclusion: This study shows that there is a high level of awareness about organ donation among rural people and most of the participants are willing to donate their organs. PMID:28503345
Donation after circulatory death: burying the dead donor rule.
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.
BLISS: a computer program for the protection of blood donors. Technical report
DOE Office of Scientific and Technical Information (OSTI.GOV)
Catsimpoolas, N.; Cooke, C.; Valeri, C.R.
1982-06-28
A BASIC program has been developed for the Hewlett-Packard Model 9845 desk-top computer which allows the creation of blood donor files for subsequent retrieval, update, and correction. A similar modified version was developed for hte HP 9835 Model. This software system has been called BLISS which stands for Blood Information and Security System. In addition to its function as a file management system, BLISS provides warnings before a donation is performed to protect the donor from excessive exposure to radioactivity and DMSO levels, from too frequent of donations of blood, and from adverse reactions. The program can also be usedmore » to select donors who have participated in specific studies and to list the experimental details which have been stored in the file. The BLISS system has been actively utilized at the Naval Blood Research Laboratory in Boston and contains the files of over 750 donors.« less
Ríos, Antonio; López-Navas, Ana; Ayala-García, Marco Antonio; Sebastián, María José; Abdo-Cuza, Anselmo; Alán, Jeannina; Martínez-Alarcón, Laura; Ramírez, Ector Jaime; Muñoz, Gerardo; Suárez-López, Juliette; Castellanos, Roberto; Ramírez, Ricardo; González, Beatriz; Martínez, Miguel Angel; Díaz, Ernesto; Ramírez, Pablo; Parrilla, Pascual
2014-01-01
Hospital personnel are a group which has an influence on the opinion of the rest of the population about healthcare matters. Any unfavorable attitude of this group would be an obstacle to an increase in organ donation. To analyze the attitude of hospital workers toward the donation of one's own organs in Spanish and Latin American hospitals and to determine the factors affecting this attitude. Eleven hospitals from the "International Collaborative Donor Project" were selected, 3 in Spain, 5 in Mexico, 2 in Cuba and one in Costa Rica. A random sample was stratified by the type of service and job category. Attitude toward donation and transplantation was assessed using a validated survey. The questionnaire was completed anonymously and was self-administered. Student's t-test, the χ2 test and logistic regression analysis. Of the 2,785 workers surveyed, 822 were from Spain, 1,595 from Mexico, 202 from Cuba and 166 from Costa Rica and 79% (n=2,191) were in favor of deceased organ donation. According to country, 94% (n=189) of Cubans were in favor, compared to 82% (n=1,313) of the Mexicans, 73% (n=121) of the Costa Ricans and 69% (n=568) of the Spanish (P<.001). In the multivariate analysis, the following variables had the most specific weight: 1) originating from Cuba (odds ratio=8.196; P<.001); 2) being a physician (OR= 2.544; P<.001); 3) performing a job related to transplantation (OR = 1.610; P=.005); 4) having discussed the subject of donation and transplantation within the family (OR= 3.690; P<.001); 5) having a partner with a favorable attitude toward donation and transplantation (OR= 3.289; P<.001); 6) a respondent's belief that his or her religion is in favor of donation and transplantation (OR= 3.021; P=.001); 7) not being concerned about the possible mutilation of the body after donation (OR= 2.994; P<.001); 8) the preference for other options apart from burial for treating the body after death (OR= 2.770; P<.001); and 9) acceptance of carrying out an autopsy if one were needed (OR= 2.808; P<.001). Hospital personnel in Spanish and Latin American healthcare centers had a favorable attitude toward donation, although 21% of respondents were not in favor of donating. This attitude was more favorable among Latin American workers and was very much conditioned by job-related and psychosocial factors. Copyright © 2013 AEC. Published by Elsevier Espana. All rights reserved.
Sakai, Joseph T.; Dalwani, Manish S.; Mikulich-Gilbertson, Susan K.; McWilliams, Shannon K.; Raymond, Kristen M.; Crowley, Thomas J.
2016-01-01
Background Some conduct-disordered youths have high levels of callous unemotional traits and meet the DSM-5’s “with limited prosocial emotions” (LPE) specifier. These youths often do aggressive, self-benefitting acts that cost others. We previously developed a task, the AlAn’s game, which asks participants to repeatedly decide whether to accept or reject offers in which they will receive money but a planned charity donation will be reduced. In our prior work, more "costly helping" (i.e., rejecting the offered money and protecting the donation) was associated with lower callous unemotional traits. Here we extend that prior work in a larger sample of adolescent male patients with serious conduct problems and controls, and test whether this association is mediated specifically by a Moral Elevation response (i.e., a positive emotional response to another’s act of virtue). Methods The adolescent male participants were: 45 patients (23 with LPE) and 26 controls, who underwent an extensive phenotypic assessment including a measure of Moral Elevation. About 1 week later participants played the AlAn’s game. Results All AlAn’s game outcomes demonstrated significant group effects: (1) money taken for self (p = 0.02); (2) money left in the charitable donation (p = 0.03); and, (3) costly helping (p = 0.047). Controls took the least money and did the most costly helping, while patients with LPE took the most money and did the least costly helping. Groups also significantly differed in post-stimulus Moral Elevation scores (p = 0.005). Exploratory analyses supported that the relationship between callous unemotional traits and costly helping on the AlAn’s game may be mediated in part by differences in Moral Elevation. Conclusions The AlAn's game provides a standardized behavioral measure associated with callous unemotional traits. Adolescents with high levels of callous unemotional traits engage in fewer costly helping behaviors, and those differences may be related to blunting of positive emotional responses. PMID:26977935
Impact of the May 12, 2008, Earthquake on blood donations across five Chinese blood centers.
Liu, Jing; Huang, Yi; Wang, Jingxing; Bi, Xinhong; Li, Julin; Lu, Yunlai; Wen, Xiuqiong; Yao, Fuzhu; Dong, Xiangdong; He, Weilan; Huang, Mei; Ma, Hongli; Mei, Heili; King, Melissa; Wright, David J; Ness, Paul M; Shan, Hua
2010-09-01
On May 12, 2008, a severe earthquake struck China's Sichuan Province. The nationwide outpouring of charity resulted in a surge of subsequent blood donations. The quantity and quality of these donations were examined in comparison with routine donations. Whole blood and apheresis donations from five geographically different blood centers collected within 1 week postearthquake were compared with those collected during the rest of the year. Regional differences, demographic characteristics, first-time and repeat donor status, and infectious disease screening markers associated with these donations were compared by earthquake status using chi-square statistics. Poisson regression analysis examined the number of daily donations by earthquake status after adjusting for center, day of week, and seasonal variations. The number of daily donations across five blood centers increased from 685 on a typical day to 1151 in the postearthquake week. The surge was observed in both sexes and across different education levels, age, and ethnicity groups and three blood centers and was significant after adjusting for confounding covariates. The influx of first-time donors (89.5%) was higher than that of repeat donors (34%). There was a significant change in the overall screening reactive marker rates excluding alanine aminotransferase (2.06% vs. 1.72%% vs. 4.96%). However, when the individual screening test was analyzed separately, no significant differences were found. Timely donations in response to a disaster are crucial to ensure emergency blood transfusion. The dramatically increased postearthquake donations suggest that Chinese blood centers are capable of handling emergency blood needs. Measures to maintain blood safety should be taken in times of emergency. © 2010 American Association of Blood Banks.
Butt, Zeeshan; DiMartini, Andrea F; Liu, Qian; Simpson, Mary Ann; Smith, Abigail R; Zee, Jarcy; Gillespie, Brenda W; Holtzman, Susan; Ladner, Daniela; Olthoff, Kim; Fisher, Robert A; Hafliger, Silvia; Freise, Chris E; Mandell, Mercedes Susan; Sherker, Averell H; Dew, Mary Amanda
2018-04-26
Little is known about living liver donors' perceptions of their physical well-being following the procedure. We collected data on donor fatigue, pain, and other relevant physical outcomes as part of the prospective, multi-center Adult-to-Adult Living Donor Liver Transplantation Cohort Study (A2ALL-2) Consortium. A total of 271 (91%) of 297 eligible donors were interviewed at least once at pre-donation and 3, 6, 12, and 24 months after donation using validated measures, when available. Repeated measures regression models were used to identify potential predictors of worse physical outcomes. We found that donors reported more fatigue immediately after surgery that were returning to pre-donation levels by two years post-donation. A similar pattern was seen across a number of other physical outcomes. Abdominal or back pain and interference from their pain were rated relatively low on average at all study points. However, 21% of donors did report clinically significant pain at some point during post-donation study follow-up. Across multiple outcomes, female donors, donors whose recipients died, donors with longer hospital stays after surgery, and those whose families discouraged donation were at risk for worse physical well-being outcomes. While not readily modifiable, we have identified risk factors that may help identify donors at risk for worse physical outcomes for targeted intervention. This article is protected by copyright. All rights reserved. © 2018 by the American Association for the Study of Liver Diseases.
Ye, Hui; Wang, Dong-Ping; Zhang, Chuan-Zhao; Zhang, Long-Juan; Wang, Hao-Chen; Li, Zhuo-Hui; Chen, Zhen; Zhang, Tao; Cai, Chang-Jie; Ju, Wei-Qiang; Ma, Yi; Guo, Zhi-Yong; He, Xiao-Shun
2014-10-01
Donation after brain death followed by circulatory death (DBCD) is a unique practice in China. The aim of this study was to define the pathologic characteristics of DBCD liver allografts in a porcine model. Fifteen male pigs (25-30 kg) were allocated randomly into donation after brain death (DBD), donation after circulatory death (DCD) and DBCD groups. Brain death was induced by augmenting intracranial pressure. Circulatory death was induced by withdrawal of life support in DBCD group and by venous injection of 40 mL 10% potassium chloride in DCD group. The donor livers were perfused in situ and kept in cold storage for 4 h. Liver tissue and common bile duct samples were collected for hematoxylin and eosin staining, TUNEL testing and electron microscopic examination. Spot necrosis was found in hepatic parenchyma of DBD and DBCD groups, while a large area of necrosis was shown in DCD group. The apoptosis rate of hepatocytes in DBD [(0.56±0.30)%] and DBCD [(0.50 ± 0.11)%] groups was much lower than that in DCD group [(3.78±0.33)%] (P<0.05). And there was no significant difference between DBD group and DBCD group (P>0.05)). The structures of bile duct were intact in both DBD and DBCD groups, while the biliary epithelium was totally damaged in DCD group. Under electron microscope, the DBD hepatocytes were characterized by intact cell membrane, well-organized endoplasmic reticulum, mild mitochondria edema and abundant glycogens. Broken cell membrane, mild inflammatory cell infiltration and sinusoidal epithelium edema, as well as reduced glycogen volume, were found in the DBCD hepatocytes. The DCD hepatocytes had more profound cell organelle injury and much less glycogen storage. In conclusion, the preservation injury of DBCD liver allografts is much less severe than that of un-controlled DCD, but more severe than that of DBD liver allografts under electron microscope, which might reflect post-transplant liver function to some extent.
Emergence of social cooperation in threshold public goods games with collective risk
NASA Astrophysics Data System (ADS)
Wang, Jing; Fu, Feng; Wu, Te; Wang, Long
2009-07-01
In real situations, people are often faced with the option of voluntary contribution to achieve a collective goal, for example, building a dam or a fence, in order to avoid an unfavorable loss. Those who do not donate, however, can free ride on others’ sacrifices. As a result, cooperation is difficult to maintain, leading to an enduring collective-risk social dilemma. To address this issue, here we propose a simple yet effective theoretical model of threshold public goods game with collective risk and focus on the effect of risk on the emergence of social cooperation. To do this, we consider the population dynamics represented by replicator equation for two simplifying scenarios, respectively: one with fair sharers, who contribute the minimum average amount versus defectors and the other with altruists contributing more than average versus defectors. For both cases, we find that the dilemma is relieved in high-risk situations where cooperation is likely to persist and dominate defection in the population. Large initial endowment to individuals also encourages the risk-averse action, which means that, as compared to poor players (with small initial endowment), wealthy individuals (with large initial endowment) are more likely to cooperate in order to protect their private accounts. In addition, we show that small donation amount and small threshold (collective target) can encourage and sustain cooperation. Furthermore, for other parameters fixed, the impacts of group size act differently on the two scenarios because of distinct mechanisms: in the former case where the cost of cooperation depends on the group size, large size of group readily results in defection, while easily maintains cooperation in the latter case where the cost of cooperation is fixed irrespective of the group size. Our theoretical results of the replicator dynamics are in excellent agreement with the individual based simulation results.
Charitable Giving for HIV and AIDS: Results from a Canadian National Survey
Allman, Dan; Calzavara, Liviana; Worthington, Catherine; Tyndall, Mark; Adrien, Alix; Walters, Melissa; White, Samantha; Jones, Marcella K.
2014-01-01
Background For the first time, a national survey of adults in Canada posed questions on charitable giving for HIV and AIDS. The objective of this analysis was to explore the behaviour and attitudes of this population in terms of charitable giving. Methods In 2011, individuals in Canada 16 years of age or older were recruited for a survey from an online panel supplemented by random digit dial telephone interviewing. The margin of error was +/−2.1 percentage points (95%). Chi-square tests were used to detect bivariate associations. A multivariate logistic regression model was fit to compare those who had donated to HIV and AIDS in the past 12 months with those who had donated to other disease or illness charities. Results 2,139 participated. 82.5% had donated to a charitable cause in the past 12 months. 22.2% had ever donated to HIV and AIDS, with 7.8% doing so in the past 12 months. Individuals who had donated to HIV and AIDS versus other disease or illness charities tended to be younger (p<0.05), single (p<0.005), more highly educated (p<0.001) and to self-identify as a member of a sexual minority group (p<0.001). Multivariate analysis revealed individuals who self-identified as a member of a sexual minority group were significantly much more likely to have donated to HIV and AIDS than to other disease or illness charities in the past 12 months (OR, 7.73; p<0.001; CI 4.32–13.88). Discussion Despite a generally philanthropic orientation, relatively few respondents had ever been involved in charitable giving for HIV and AIDS. Those who had could be understood relationally as individuals at closer social proximity to HIV and AIDS such as members of sexual minority groups. PMID:25153827
50 CFR 21.48 - Depredation order for double-crested cormorants to protect public resources.
Code of Federal Regulations, 2013 CFR
2013-10-01
... efforts: (i) Individuals may donate birds killed under authority of this order to museums or other such... Regional Migratory Bird Permit Office will then coordinate with the Endangered Species Field Office staff...
50 CFR 21.48 - Depredation order for double-crested cormorants to protect public resources.
Code of Federal Regulations, 2011 CFR
2011-10-01
... efforts: (i) Individuals may donate birds killed under authority of this order to museums or other such... Regional Migratory Bird Permit Office will then coordinate with the Endangered Species Field Office staff...
Knowledge, attitude and practices of people towards voluntary blood donation in Uttarakhand
Agrawal, Amit; Tiwari, Aseem K.; Ahuja, Alok; Kalra, Rakesh
2013-01-01
Introduction: Blood transfusions form a crucial and irreplaceable part in the medical management of many diseases. The collection of blood from voluntary, non-remunerated blood donors from low risk populations is an important measure for ensuring the availability and safety of blood transfusion. In a state like Uttarakhand which is visited by lakhs of visitors during pilgrimage season and where natural calamities and accidents are very common, the availability of blood is of utmost importance. Aim: To find out knowledge, attitude and practices of people towards voluntary blood donation to comprehend the situation and find ways to enhance voluntary blood donation in the state of Uttarakhand. Materials and Methods: Multi stage methodology was designed to target population including general population, influencers (doctors) and supporting organizations (camp organizers, State AIDS Control Society Officials) who were subjected to in-depth interview using pre-structured questionnaires to assess knowledge/awareness about voluntary blood donation, factors preventing and source of knowledge about voluntary blood donation. Result: The sample population consisted of mostly men (67%) in the age-group of 26-35 years. Requirement of blood and the measures to promote voluntary blood donation have a direct relationship with the total population and literacy level of the population. Awareness about blood donation, source of knowledge about blood donation, reasons for not donating blood are particularly stressed. With increase in educational level, the awareness level was also found to increase. While among illiterates 81 percent of the respondents knew about blood donation, among the post graduates the same ratio was found to be almost cent-percent. Among various reasons cited for not donating blood, lack of awareness being the most common reason. People gathered information about blood donation from several different sources with electronic media being the most prominent. Conclusion: This study illustrates how increasing awareness and marketing ‘Voluntary blood donation’ can enhance adequacy of blood needs of a state or for that matter the entire country. This study also underlines how different media, especially electronic media, can be used to propagate altruistic blood donation. PMID:23559768
Trends in US minority red blood cell unit donations.
Yazer, Mark H; Delaney, Meghan; Germain, Marc; Karafin, Matthew S; Sayers, Merlyn; Vassallo, Ralph; Ziman, Alyssa; Shaz, Beth
2017-05-01
To provide the appropriately diverse blood supply necessary to support alloimmunized and chronically transfused patients, minority donation recruitment programs have been implemented. This study investigated temporal changes in minority red blood cell (RBC) donation patterns in the United States. Data on donor race and ethnicity from 2006 through 2015, including the number of unique donors, collections, RBCs successfully donated, and average annual number of RBC donations per donor (donor fraction), were collected from eight US blood collectors. Minority donors were stratified into the following groups: Asian, black or African American, Hispanic or Latino, Native Indian or Alaska Native, Native Hawaiian or other Pacific Islander, white, multiracial/other, and no answer/not sure. Over the 10-year period, white donors annually constituted the majority of unique donors (range, 70.7%-73.9%), had the greatest proportion of collections (range, 76.1%-79.8%), and donated the greatest proportion of RBC units (range, 76.3%-80.2%). These donors also had the highest annual donor fraction (range, 1.82-1.91 units per donor). Black or African American donors annually constituted between 4.9 and 5.2% of all donors during the study period and donated between 4.0 and 4.3% of all RBC units. Linear regression analysis revealed decreasing numbers of donors, collections, and donated RBC units from white donors over time. Although the US population has diversified, and minority recruitment programs have been implemented, white donors constitute the majority of RBC donors and donations. Focused and effective efforts are needed to increase the proportion of minority donors. © 2017 AABB.
Bohorquez, H; Seal, J B; Cohen, A J; Kressel, A; Bugeaud, E; Bruce, D S; Carmody, I C; Reichman, T W; Battula, N; Alsaggaf, M; Therapondos, G; Bzowej, N; Tyson, G; Joshi, S; Nicolau-Raducu, R; Girgrah, N; Loss, G E
2017-08-01
Donation after circulatory death (DCD) liver transplantation (LT) reportedly yields inferior survival and increased complication rates compared with donation after brain death (DBD). We compare 100 consecutive DCD LT using a protocol that includes thrombolytic therapy (late DCD group) to an historical DCD group (early DCD group n = 38) and a cohort of DBD LT recipients (DBD group n = 435). Late DCD LT recipients had better 1- and 3-year graft survival rates than early DCD LT recipients (92% vs. 76.3%, p = 0.03 and 91.4% vs. 73.7%, p = 0.01). Late DCD graft survival rates were comparable to those of the DBD group (92% vs. 93.3%, p = 0.24 and 91.4% vs. 88.2%, p = 0.62). Re-transplantation occurred in 18.4% versus 1% for the early and late DCD groups, respectively (p = 0.001). Patient survival was similar in all three groups. Ischemic-type biliary lesions (ITBL) occurred in 5%, 3%, and 0.2% for early DCD, late DCD, and DBD groups, respectively, but unlike in the early DCD group, in the late DCD group ITBL was endoscopically managed and resolved in each case. Using a protocol that includes a thrombolytic therapy, DCD LT yielded patient and graft survival rates comparable to DBD LT. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.
Living donation and cosmetic surgery: a double standard in medical ethics?
Testa, Giuliano; Carlisle, Erica; Simmerling, Mary; Angelos, Peter
2012-01-01
The commitment of transplant physicians to protect the physical and psychological health of potential donors is fundamental to the process of living donor organ transplantation. It is appropriate that strict regulations to govern an individual's decision to donate have been developed. Some may argue that adherence to such regulations creates a doctor-patient relationship that is rooted in paternalism, which is in drastic contrast with a doctor-patient relationship that is rooted in patients' autonomy, characteristic of most other operative interventions. In this article we analyze the similarities between cosmetic plastic surgery and living donor surgery as examples of surgeries governed by different ethical principles. It is interesting that, while the prevailing ethical approach in living donor surgery is based on paternalism, the ethical principle guiding cosmetic surgery is respect for patients' autonomy. The purpose of this article is not to criticize either practice, but to suggest that, given the similarities between the two procedures, both operative interventions should be guided by the same ethical principle: a respect for patients' autonomy. We further suggest that if living organ donation valued donors' autonomy as much as cosmetic plastic surgery does, we might witness a wider acceptance of and increase in living organ donation.
Shakeri, M T; Vafaee, A; Esmaeily, H; Shafiei, N; Bazargani, R; Khayamy, Me
2012-01-01
Donor recruitment and retention are significant problems in blood collection agencies around the world. The Aim of this study was to determine the causes of lack of interest to blood donation in eligible individu-als in Mashhad, Northeast of Iran. This was a descriptive study. Cases were 1130 non-donor individuals. Participants were selected from eligible individuals in different regions of Mashhad. In this study, surveys included information about age groups, gender, residence area, marriage, education; living situation and job as background variables. Less than 30% of the cases had enough knowledge about blood donation. There was a significant rela-tionship between location, age, education, occupation and social status with knowledge of blood donation, but there was not a correlation between gender and marital status. There are some factors which affect the decision for blood donation. There is a need to change the negative attitude by increasing the knowledge considering the individual and the social status.
Awareness regarding eye donation among stakeholders in Srikakulam district in South India.
Ronanki, Venkata Ramana; Sheeladevi, Sethu; Ramachandran, Brinda P; Jalbert, Isabelle
2014-03-06
There is a huge need for the availability of transplantable donor corneas worldwide to reduce the burden of corneal blindness due to corneal opacity. Voluntary eye donation depends on the awareness levels of various stakeholders in the community. This study aimed to assess the awareness level regarding eye donation among various stakeholders in Srikakulam district in the state of Andhra Pradesh, India. 355 subjects were selected from the district using multi stage random sampling. A pre tested semi structured questionnaire was used to collect information regarding each individual's awareness, knowledge, and perception regarding eye donation. Each response was scored individually and a total score was calculated. Univariate and multivariate regression analysis was used to determine the factors associated with willingness towards eye donation and increased awareness levels. Of the 355 subjects interviewed, 192 (54%) were male and 163 (46%) were female. The mean age of the stakeholders was 35.9 years (SD ±16.1) and all the study subjects were literate. Ninety-three percent of subjects were aware of the concept of eye donation. Knowledge levels were similar among the teaching community and persons engaged in social service, but lower among students (p < 0.05). Among the stakeholders, there was considerable ambiguity regarding whether persons currently wearing spectacles or suffering from a chronic illnesses could donate their eyes. Older age group (p < 0.001), female gender (p < 0.001) and education (p < 0.001) were associated with increased knowledge levels. 82% of the subjects were willing to donate their eyes and this was unaffected by gender or geographical location (rural vs urban). Awareness levels and willingness to donate eyes are high among the stakeholders in Srikakulam district in India. The services of stakeholders could be utilized, in conjunction with other community based eye donation counselors, to promote awareness regarding eye donation among the general population.
Selection strategies for newly registered blood donors in European countries
Lieshout-Krikke, Ryanne W.; Domanovic, Dragoslav; de Kort, Wim; Mayr, Wolfgang; Liumbruno, Giancarlo M.; Pupella, Simonetta; Kurz, Johann; Knutson, Folke; MacLennan, Sheila; Folléa, Gilles
2017-01-01
Background Two selection strategies for newly-registered blood donors are available: a single-visit selection called the standard selection procedure (SSP), and a two-stage selection named predonation and donation screening (PDS). This study reviews the selection strategies for newly-registered donors currently applied in European countries. Material and methods We collected data on donor selection procedures, blood donation, laboratory screening and HIV, HCV and HBV positive donors/donations from 2010 to 2013 in 30 European countries by using questionnaires. We grouped the countries according to the applied selection strategy, and for each country, we calculated the 4-year prevalence of confirmed positive results indicating the presence of overall and recent HIV, HCV and HBV infections among first-time and repeat donations and among newly-registered donors. Results Most of the 24 countries (80%) apply the SSP strategy for selection of newly-registered donors. Twenty-two countries (73.3%) employ a nucleic acid amplification testing in addition to the mandatory serological screening. The survey confirms a higher overall prevalence of HIV, HCV and HBV infections among first-time donations and newly-registered donors than among repeat donations. In contrast, the prevalence of recently acquired HIV and HCV infections was lower among first-time donations and newly-registered donors than among repeat donations, but higher for recent HBV infections (6.7/105 vs 2.6/105 in the SSP setting and 4.3/105 vs 0.5/105 in one country using PDS). The relatively low numbers of infected donors selected by PDS impeded accurate assessment of the prevalence of recent infections in first-time donations. Discussion The data from European countries provide inconclusive evidence that applying PDS reduces the risk of donations being made in the diagnostic window of first-time donors. The impact of PDS on the risk of window-period donations and blood donor management needs further investigation. PMID:27723449
Retention of "safe" blood donors. The Retrovirus Epidemiology Donor Study.
Thomson, R A; Bethel, J; Lo, A Y; Ownby, H E; Nass, C C; Williams, A E
1998-04-01
There are obvious advantages to increasing donor retention. However, for reasons of blood safety, certain donors may, in fact, be more desirable to retain than others. "Safe" donors are defined as those who provided a blood donation that was negative on all laboratory screening tests and who subsequently reported no behavioral risks in response to an anonymous survey. This study identifies the most important factors affecting the intention of "safe" donors to provide another donation. An anonymous survey asking about donation history, sexual history, injecting drug use, and recent donation experience was mailed to 50,162 randomly selected allogeneic donors (including directed donors) who gave blood from April through July or from October through December 1993 at one of the five United States blood centers participating in the Retrovirus Epidemiology Donor Study. Before mailing, questionnaires were coded to designate donors with nonreactive laboratory screening tests at their most recent donation. A total of 34,726 donors (69%) responded, with substantially higher response among repeat donors. According to reported intentions only, the vast majority of "safe" donors indicated a high likelihood of donating again within the next 12 months. Only 3.4 percent reported a low likelihood of donating again. A comparison of those likely to return and those unlikely to return reveals significant differences in demographics and in ratings of the donation experience. A higher proportion of those unlikely to return were first-time donors, minority-group donors, and donors with less education. The highest projected loss among "safe" donors was seen for those who gave a fair to poor assessment of their treatment by blood center staff or of their physical well-being during or after donating. These data suggest that efforts to improve donors' perceptions of their donation experience, as well as attention to the physical effects of blood donation, may aid in the retention of both repeat and first-time donors.
Ríos, Antonio; López-Navas, Ana I; Navalón, Juan C; Martínez-Alarcón, Laura; Ayala-García, Marco A; Sebastián-Ruiz, María J; Moya-Faz, Francisco; Garrido, Gregorio; Ramirez, Pablo; Parrilla, Pascual
2015-04-01
The Latin American (LA) population has similarities with the Spanish population which makes its integration into Spanish society easier. to analyze the attitude toward organ donation among Latin American citizens residing in Spain, to determine the psychosocial variables which affect this attitude, and to examine the correlation between donation rates of LA citizens in Spain and in their countries of origin. A random sample of LA residents in Spain was taken and stratified according to the respondent's nationality (n = 1.314), in the year 2010. Attitude was assessed using a validated questionnaire (PCID-DTO Dr Rios). The survey was self-administered and completed anonymously. Student's t-test, the χ(2) test, and logistic regression analysis. There was a 94% completion rate (n = 1.237). Attitude toward donation was favorable in 60% of cases (n = 745), 12% (n = 145) were against, and 28% (n = 347) were undecided. The following variables were associated with attitude toward donation: sex (P = 0.038), level of formal education (P < 0.001), country of origin (P = 0.002), attitude toward the donation of a family member's organs (P < 0.001), having discussed donation with the family (P < 0.001), carrying out prosocial activities (P = 0.025), attitude toward cremation of the body (P < 0.001), attitude toward burial of the body (P < 0.001), attitude toward having an autopsy carried out (P < 0.001), previous experience of the organ donation and transplantation process (P < 0.001), fear of mutilation after donation (P < 0.001), knowledge that the Church has a positive attitude toward organ donation and transplantation (P < 0.001), knowledge of one's partner's attitude toward organ donation (P < 0.001), and a belief that one might need a transplant in the future (P < 0.001). The donation rates in this population group in Spain are higher than those recorded in their countries of origin (55.76 vs. <10 pmp; P < 0.001). The attitude toward organ donation among LA citizens residing in Spain is slightly worse than that reported in the native Spanish population and is determined by many psychosocial factors. The donation rates of LA citizens in Spain are higher than those in their countries of origin. © 2015 Steunstichting ESOT.
Willingness to Participate in Organ Donation among Black Seventh-Day Adventist College Students
ERIC Educational Resources Information Center
Cort, Malcolm; Cort, David
2008-01-01
Objective and Participants: The authors studied a group of black and white Seventh-Day Adventist (SDA) college students (N = 334) to compare the power of religious socialization with racial socialization. Methods: The authors compared the levels of willingness to donate organs between black and nonblack students in an availability sample. Results:…
Is there a right to donate blood? Patient rights; donor responsibilities.
Franklin, Ian M
2007-06-01
The objective of this study was to analyse and assess critically whether there is a right to donate blood in the UK. The aim was to provide a basis for blood services, in particular within the UK and European Union (EU), to address claims from deferred donors that there is a right to donate. Recent and ongoing campaigns to change the current life-long deferral from blood donation in the UK, Canada and USA of men who have/have had sex with men (MSM) have highlighted issues over whether individuals have a right to donate blood. The issue is complicated by allegations of discriminatory behaviour, and in some countries politicians have contributed to the argument. As anti-discrimination and equality legislation is strengthened in the UK, other groups in addition to MSM may wish to claim a right to donate blood. The methods adopted included discussions with colleagues in UK and European blood services and a review of the medical literature and wider sources using Internet search engines. No clear right to donate blood is apparent, although it is recommended that donor deferral criteria should have a sound basis of evidence. Potential donors have a right to expect a clear explanation of the reason(s) for refusing a donation. Legal safeguards for recipients to receive safe blood transfusions exist. It is concluded that blood recipients in the EU have a right to receive safe blood, and that this should be viewed as the overriding responsibility of blood services.
Barnieh, Lianne; Klarenbach, Scott; Gill, John S; Caulfield, Tim; Manns, Braden
2012-12-01
The acceptability of financial incentives for organ donation is contentious. This study sought to determine (1) the acceptability of expense reimbursement or financial incentives by the general public, health professionals involved with organ donation and transplantation, and those with or affected by kidney disease and (2) for the public, whether financial incentives would alter their willingness to consider donation. Web-based survey administered to members of the Canadian public, health professionals, and people with or affected by kidney disease asking questions regarding acceptability of strategies to increase living and deceased kidney donation and willingness to donate a kidney under various financial incentives. Responses were collected from 2004 members of the Canadian public October 11-18, 2011; responses from health professionals (n=339) and people with or affected by kidney disease (n=268) were collected during a 4-week period commencing October 11, 2011. Acceptability of one or more financial incentives to increase deceased and living donation was noted in >70% and 40% of all groups, respectively. Support for monetary payment for living donors was 45%, 14%, and 27% for the public, health professionals, and people with or affected by kidney disease, respectively. Overall, reimbursement of funeral expenses for deceased donors and a tax break for living donors were the most acceptable. The general public views regulated financial incentives for living and deceased donation to be acceptable. Future research needs to examine the impact of financial incentives on rates of deceased and living donors.
Factors influencing blood donations and the rational use of blood.
Sharma, Rajeev; Madan, Nidhi; Venkatesh, S; Ichhpujani, R L; Lal, S
2010-09-01
A multicentric quasi-experimental study was conducted in Delhi, from March 2007 to September 2007, on i) the factors which stimulate the donors to donate blood, ii) major barriers and myths associated with blood donation and iii) clinicians perception of the rational use of blood. The study design included a face-to-face survey, with a pre-tested questionnaire paper in two leading blood banks of Delhi and by relevant interviewers from the community and medical fraternity. The sample size was 240-blood donors from two different blood banks and the control group included 100 potential donors from community and 50 clinicians from various hospitals. The data generated was analyzed using excel sheet and Epi-Info software. The study revealed the factors which influence the blood donation included replacement credit and family/peer pressure. Regarding myths and barriers, among potential donors, about a quarter of them felt that it is time consuming, and 20% felt it could lead to sexual impairment or is not rewarding. A total of 10% were not aware about the blood donation while 15% said that donation time was inconvenient. Of the 50 clinicians, a quarter of them were not aware of the rational use of blood.
Compagnon, Philippe; Levesque, Eric; Hentati, Hassen; Disabato, Mara; Calderaro, Julien; Feray, Cyrille; Corlu, Anne; Cohen, José Laurent; Ben Mosbah, Ismail; Azoulay, Daniel
2017-07-01
Control of warm ischemia (WI) lesions that occur with donation after circulatory death (DCD) would significantly increase the donor pool for liver transplantation. We aimed to determine whether a novel, oxygenated and hypothermic machine perfusion device (HMP Airdrive system) improves the quality of livers derived from DCDs using a large animal model. Cardiac arrest was induced in female large white pigs by intravenous injection of potassium chloride. After 60 minutes of WI, livers were flushed in situ with histidine-tryptophan-ketoglutarate and subsequently preserved either by simple cold storage (WI-SCS group) or HMP (WI-HMP group) using Belzer-MPS solution. Liver grafts procured from heart-beating donors and preserved by SCS served as controls. After 4 hours of preservation, all livers were transplanted. All recipients in WI-SCS group died within 6 hours after transplantation. In contrast, the HMP device fully protected the liver against lethal ischemia/reperfusion injury, allowing 100% survival rate. A postreperfusion syndrome was observed in all animals of the WI-SCS group but none of the control or WI-HMP groups. After reperfusion, HMP-preserved livers functioned better and showed less hepatocellular and endothelial cell injury, in agreement with better-preserved liver histology relative to WI-SCS group. In addition to improved energy metabolism, this protective effect was associated with an attenuation of inflammatory response, oxidative load, endoplasmic reticulum stress, mitochondrial damage, and apoptosis. This study demonstrates for the first time the efficacy of the HMP Airdrive system to protect liver grafts from lethal ischemic damage before transplantation in a clinically relevant DCD model.
Rao, Vivek; Dhanani, Sonny; MacLean, Janet; Payne, Clare; Paltser, Elizabeth; Humar, Atul; Zaltzman, Jeffrey
2017-01-01
BACKGROUND: To increase the available pool of organ donors, Ontario introduced donation after circulatory determination of death (DCD) in 2006. Other jurisdictions have reported a decrease in donations involving neurologic determination of death (NDD) after implementation of DCD, with a drop in organ yield and quality. In this study, we examined the effect of DCD on overall transplant activity in Ontario. METHODS: We examined deceased donor and organ transplant activity during 3 distinct 4-year eras: pre-DCD (2002/03 to 2005/06), early DCD (2006/07 to 2009/10) and recent DCD (2010/11 to 2013/14). We compared these donor groups by categorical characteristics. RESULTS: Donation increased by 57%, from 578 donors in the pre-DCD era to 905 donors in the recent DCD era, with a 21% proportion (190/905) of DCD donors in the recent DCD era. However, overall NDD donation also increased. The mean length of hospital stay before declaration for NDD was 2.7 days versus 6.0 days before withdrawal of life support and subsequent asystole in cases of DCD. The average organ yield was 3.73 with NDD donation versus 2.58 with DCD (p < 0.001). Apart from hearts, all organs from DCD donors were successfully transplanted. From the pre-DCD era to the recent DCD era, transplant activity in each era increased for all solid-organ recipients, including heart (from 158 to 216), kidney (from 821 to 1321), liver (from 477 to 657) and lung (from 160 to 305). INTERPRETATION: Implementation of DCD in Ontario led to increased transplant activity for all solid-organ recipients. There was no evidence that the use of DCD was pre-empting potential NDD donation. In contrast to groups receiving other organs, heart transplant candidates have not yet benefited from DCD. PMID:28947546
2007-10-04
In accordance with section 431 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA), this final rule sets forth a safe harbor under the anti-kickback statute to protect certain arrangements involving goods, items, services, donations, and loans provided by individuals and entities to certain health centers funded under section 330 of the Public Health Service Act. The goods, items, services, donations, or loans must contribute to the health center's ability to maintain or increase the availability, or enhance the quality, of services available to a medically underserved population.
Effects of helicopter transport on red blood cell components.
Otani, Taiichi; Oki, Ken-ichi; Akino, Mitsuaki; Tamura, Satoru; Naito, Yuki; Homma, Chihiro; Ikeda, Hisami; Sumita, Shinzou
2012-01-01
There are no reported studies on whether a helicopter flight affects the quality and shelf-life of red blood cells stored in mannitol-adenine-phosphate. Seven days after donation, five aliquots of red blood cells from five donors were packed into an SS-BOX-110 container which can maintain the temperature inside the container between 2 °C and 6 °C with two frozen coolants. The temperature of an included dummy blood bag was monitored. After the box had been transported in a helicopter for 4 hours, the red blood cells were stored again and their quality evaluated at day 7 (just after the flight), 14, 21 and 42 after donation. Red blood cell quality was evaluated by measuring adenosine triphosphate, 2,3-diphosphoglycerate, and supernatant potassium, as well as haematocrit, intracellular pH, glucose, supernatant haemoglobin, and haemolysis rate at the various time points. During the experiment the recorded temperature remained between 2 and 6 °C. All data from the red blood cells that had undergone helicopter transportation were the same as those from a control group of red blood cell samples 7 (just after the flight), 14, 21, and 42 days after the donation. Only supernatant Hb and haemolysis rate 42 days after the donation were slightly increased in the helicopter-transported group of red blood cell samples. All other parameters at 42 days after donation were the same in the two groups of red blood cells. These results suggest that red blood cells stored in mannitol-adenine-phosphate are not significantly affected by helicopter transportation. The differences in haemolysis by the end of storage were small and probably not of clinical significance.
Effects of helicopter transport on red blood cell components
Otani, Taiichi; Oki, Ken-ichi; Akino, Mitsuaki; Tamura, Satoru; Naito, Yuki; Homma, Chihiro; Ikeda, Hisami; Sumita, Shinzou
2012-01-01
Background There are no reported studies on whether a helicopter flight affects the quality and shelf-life of red blood cells stored in mannitol-adenine-phosphate. Materials and methods Seven days after donation, five aliquots of red blood cells from five donors were packed into an SS-BOX-110 container which can maintain the temperature inside the container between 2 °C and 6 °C with two frozen coolants. The temperature of an included dummy blood bag was monitored. After the box had been transported in a helicopter for 4 hours, the red blood cells were stored again and their quality evaluated at day 7 (just after the flight), 14, 21 and 42 after donation. Red blood cell quality was evaluated by measuring adenosine triphosphate, 2,3-diphosphoglycerate, and supernatant potassium, as well as haematocrit, intracellular pH, glucose, supernatant haemoglobin, and haemolysis rate at the various time points. Results During the experiment the recorded temperature remained between 2 and 6 °C. All data from the red blood cells that had undergone helicopter transportation were the same as those from a control group of red blood cell samples 7 (just after the flight), 14, 21, and 42 days after the donation. Only supernatant Hb and haemolysis rate 42 days after the donation were slightly increased in the helicopter-transported group of red blood cell samples. All other parameters at 42 days after donation were the same in the two groups of red blood cells. Discussion These results suggest that red blood cells stored in mannitol-adenine-phosphate are not significantly affected by helicopter transportation. The differences in haemolysis by the end of storage were small and probably not of clinical significance. PMID:22153688
Montero Salinas, Alejandro; Martínez-Isasi, Santiago; Fieira Costa, Eva; Fernández García, Antón; Castro Dios, Diana Josefa; Fernández García, Daniel
2018-04-18
The Spanish model is the model adopted by many countries to increase their donation rate, being the implication of the healthcare professionals one of the keys to this success. The attitude of these before the donation is crucial for the hour of influence on the population. Organ transplantation has been established as an effective treatment that has been improving over the years. The objective was to determine the knowledge and attitudes of health professionals before the donation of organs. Cross-sectional descriptive study. An ad hoc questionnaire was conducted and distributed among the health professionals (medical staff, nurses and nursing assistants) of a tertiary hospital during February 2015. A total of 615 potential participants were estimated in the different areas of the hospital. A total of 342 completed questionnaires were collected (55%). The statistical analysis with SPSS® Statistics for Windows. Version 20.0. A level of significance P lower than 0.05 was used in all the analyses. The average age of the respondents was 43.34 (SD = 10.37) years, being 86.6% women and 60% nurses. 35.5% showed good knowledge about the donation process, being higher in men (51.1% Vs 33.1%, p lower than 0.05), medical personnel (55% vs 34.3% vs 31.9%). %; p lower than 0.05) and lower in those services with a direct relationship with the donation process (36.8% vs 31.9%, p lower than 0.05). 71% of the professionals expressed their willingness to donate their organs, with special sensitivity towards donation those services in direct relation with the donation program (82.2% vs 65.9%, OR: 1.24, p lower than 0.001 ). 50% of the professionals would donate the organs of a family member; the medical group had the highest percentage (70% vs 50.7% vs 40.4%, OR: 3.8, p lower than 0.05). 74.5% knew some Spanish legal document about donation and transplants. Health professionals as a whole have a low level of knowledge; but a good attitude towards donation.
Xie, J-F; Wang, C-Y; He, G-P; Ming, Y-Z; Wan, Q-Q; Liu, J; Gong, L-N; Liu, L-F
Health workers' awareness and knowledge of transplantation medicine can improve people's sensitivity and reduce their degree of opposition to donations. The medical literature contains numerous examples of attitudes toward organ transplantation and donation aimed at university students or medical staff members, but rarely for transplantation nurses. The purposes of the study were to investigate the attitudes toward organ transplantation and donation among transplantation nurses and to explore the impact factors. The study was conducted in 37 transplantation surgery wards in 22 hospitals using cross-sectional approach. SPSS (International Business Machines Corporation, Armonk, New York, USA) 7.0 software was used to analysis descriptive and inferential statistics for data. Five hundred thirty-six effective questionnaires were received and the effective rate was 89.33%. Nurses' mean age was 28.40 years with a mean service length of 6.54 years. Among these nurses, 66.6% and 78.0% were willing to accept organ transplantation surgery for themselves and their relatives, respectively. Of these nurses, 33.4% would donate their organs after death; whereas 39.9% were uncertain. Only 38.2% were willing to register in the national organ donation system. Of these nurses, 28.2% were willing to sign the organ donation consent forms when their relatives became potential organ donors, and 45.7% were uncertain. Eight independent variables that affected nurses' attitudes toward donating their organs from most to least significant were: ratio of nurse to bed, title, employment form, age, length of service, position, monthly income, and the highest educational degree earned. Pearson correlation analysis showed a significant correlation among nurses' attitudes toward organ transplantation, organ donation, and online registration. The attitude toward donation and transplantation in the hospitals was not too optimistic, and an improvement in the training regarding transplantation and donation among nurses in China is necessary. Nurses are an important group who generate opinion in the patient population, and their negative attitudes can have a significant negative impact on society's attitudes toward organ donation. Copyright © 2017 Elsevier Inc. All rights reserved.
Ríos, A; López-Navas, A I; Sánchez, Á; Martínez-Alarcón, L; Ayala, M A; Garrido, G; Sebastián, M J; Ramis, G; Hernández, A M; Ramírez, P; Parrilla, P
2018-03-01
The Puerto Rican population represents one of the largest immigration groups in Florida, and this has an impact on the organ transplant donation process. Our aim was to analyze attitudes toward organ donation among Puerto Ricans who currently reside in the state of Florida (USA). The population screened consisted of individuals >15 years old, who were born in Puerto Rico, living in Florida, and awaiting organs for transplant. All participants completed the "PCID-DTO Rios" questionnaire. Random selection was done according to stratification. Support from immigration associations in Spain was needed for advice on the locations of potential respondents. Study participation was anonymized and self-administered. There were 259 respondents, 37% (n = 95) were in favor of donation, 36% (n = 93) were against donation, and 27% (n = 71) were undecided. The variables associated with these attitudes were: age (P = .017); civil status (P = .021); level of education (P < .001); previous experience with donation and transplant (P < .001); attitude toward organ donation of a relative (P < .001); carrying out pro-social activities (P < .001); discussing the issue of transplant with the family (P < .001) or couple (P < .001); attitude toward incineration (P < .001), burial (P < .001), and autopsy (P < .001); fear of mutilation after donation (P < .001); and religious beliefs (P < .001). In the multivariate study, it remained an independent variable to have discussed the issue at the family level (odds ratio = 11.627; P = .009). The Puerto Rican study population residing in Florida has an unfavorable attitude toward organ donation. Copyright © 2017 Elsevier Inc. All rights reserved.
Ríos, A; López-Navas, A; Ayala-García, M A; Sebastián, M; Febrero, B; Ramírez, E J; Muñoz, G; Palacios, G; Rodríguez, J S; Martínez, M A; Nieto, A; Martínez-Alarcón, L; Ramis, G; Ramírez, P; Parrilla, P
2012-01-01
Healthcare assistants are an important group of workers who can influence public opinion. Their attitudes toward organ donation may influence public awareness of healthcare matters; negative attitudes toward donation and transplantation could have a negative impact on public attitudes. Our objective was analyze the attitudes of healthcare assistants, in Spanish and Mexican healthcare centers toward organ donation and determine factors affecting them using a multivariate analysis. As part of the "International Collaborative Donor Project," 32 primary care centers and 4 hospitals were selected in Spain and 5 hospitals in Mexico. A randomized sample of healthcare assistants was stratified according to healthcare services. Attitudes were evaluated using a validated questionnaire of the psychosocial aspects of donation, which was self-completed anonymously by the respondent. Statistical analysis used the chi-square test, Student t test, and logistic regression analysis. Of 532 respondents, 66% in favored donation and 34% were against it or undecided. Upon multivariate analysis, the following variables had the most weight: 1) country of origin (Mexicans were more in favor than Spanish; odds ratio [OR]) = 1.964; P = .014); 2) a partner with a favorable attitude (OR = 2.597; P = .013); 3) not being concerned about possible bodily mutilation after donation (OR = 2.631; P = .006); 4) preference for options apart from burial for handling the body after death (OR = 4.694; P < .001) and 5) accepting an autopsy if one was needed (OR = 3.584; P < .001). The attitudes of healthcare assistants toward organ donation varied considerably according to the respondent's country of origin. The psycho-social profile of a person with a positive attitude to donation was similar to that described within the general public. Copyright © 2012 Elsevier Inc. All rights reserved.
Attitudes of Scottish residents in the southeast of Spain concerning living donation.
Ríos, A; Martínez-Alarcón, L; López-Navas, A; Febrero, B; Sánchez, J; Ramis, G; Ramírez, P; Parrilla, P
2013-01-01
To reduce the considerable organ deficit, living donation is being promoted. The subset of foreign population living in Spain could be potential patients for transplantation and/or donation. The objective of this study was to analyze the attitudes toward living donation (LD) of the population from the southeast of Spain who are natives of Scotland. Within the "International Collaborative Donor Project," a random representative sample was obtained of the adult population residing in the southeast of Spain and who were born in Scotland (n = 350). Attitudes were evaluated with the use of a validated questionnaire that was completed anonymously and was self-administered. The Student t test, χ(2) test, and Fisher exact test were applied. The completion rate was 93% (n = 324); 90% of the respondents (n = 290) were in favor of related LD, decreasing to 26% (n = 85) if it was unrelated. In the analysis of variables affecting attitude toward LD, differences were found in: 1) attitude toward deceased donation (P < .001); 2) having had previous experience of the donation and transplantation process (P = .049); 3) a respondent's belief that his or her religion was in favor of LD (P < .001); and 4) a partner's attitude toward donation and transplantation (P = .007). The attitude toward related LD among Scottish residents in the southeast of Spain is very favorable, and is very closely related to attitude toward deceased donation, family attitude, and religious attitude. Patients on the waiting list of Scottish origin will be one of the most appropriate groups for promoting LD when living donation is being promoted in Spain. Copyright © 2013 Elsevier Inc. All rights reserved.
Patterson, Chris
2015-01-01
Human biological samples (biosamples) are increasingly important in diagnosing, treating and measuring the prevalence of illnesses. For the gay and bisexual population, biosample research is particularly important for measuring the prevalence of human immunodeficiency virus (HIV). By determining people’s understandings of, and attitudes towards, the donation and use of biosamples, researchers can design studies to maximise acceptability and participation. In this study we examine gay and bisexual men’s attitudes towards donating biosamples for HIV research. Semi-structured telephone interviews were conducted with 46 gay and bisexual men aged between 18 and 63 recruited in commercial gay scene venues in two Scottish cities. Interview transcripts were analysed thematically using the framework approach. Most men interviewed seemed to have given little prior consideration to the issues. Participants were largely supportive of donating tissue for medical research purposes, and often favourable towards samples being stored, reused and shared. Support was often conditional, with common concerns related to: informed consent; the protection of anonymity and confidentiality; the right to withdraw from research; and ownership of samples. Many participants were in favour of the storage and reuse of samples, but expressed concerns related to data security and potential misuse of samples, particularly by commercial organisations. The sensitivity of tissue collection varied between tissue types and collection contexts. Blood, urine, semen and bowel tissue were commonly identified as sensitive, and donating saliva and as unlikely to cause discomfort. To our knowledge, this is the first in-depth study of gay and bisexual men’s attitudes towards donating biosamples for HIV research. While most men in this study were supportive of donating tissue for research, some clear areas of concern were identified. We suggest that these minority concerns should be accounted for to develop inclusive, evidence-informed research protocols that balance collective benefits with individual concerns. PMID:26053741
Patterson, Chris; McDaid, Lisa M; Hilton, Shona
2015-01-01
Human biological samples (biosamples) are increasingly important in diagnosing, treating and measuring the prevalence of illnesses. For the gay and bisexual population, biosample research is particularly important for measuring the prevalence of human immunodeficiency virus (HIV). By determining people's understandings of, and attitudes towards, the donation and use of biosamples, researchers can design studies to maximise acceptability and participation. In this study we examine gay and bisexual men's attitudes towards donating biosamples for HIV research. Semi-structured telephone interviews were conducted with 46 gay and bisexual men aged between 18 and 63 recruited in commercial gay scene venues in two Scottish cities. Interview transcripts were analysed thematically using the framework approach. Most men interviewed seemed to have given little prior consideration to the issues. Participants were largely supportive of donating tissue for medical research purposes, and often favourable towards samples being stored, reused and shared. Support was often conditional, with common concerns related to: informed consent; the protection of anonymity and confidentiality; the right to withdraw from research; and ownership of samples. Many participants were in favour of the storage and reuse of samples, but expressed concerns related to data security and potential misuse of samples, particularly by commercial organisations. The sensitivity of tissue collection varied between tissue types and collection contexts. Blood, urine, semen and bowel tissue were commonly identified as sensitive, and donating saliva and as unlikely to cause discomfort. To our knowledge, this is the first in-depth study of gay and bisexual men's attitudes towards donating biosamples for HIV research. While most men in this study were supportive of donating tissue for research, some clear areas of concern were identified. We suggest that these minority concerns should be accounted for to develop inclusive, evidence-informed research protocols that balance collective benefits with individual concerns.
Ethical aspects of organ donation activities.
Stephan, Antoine; Barbari, Antoine; Younan, Farida
2007-12-01
Renal transplant remains the treatment of choice for patients with end-stage renal disease. Human organs can be harvested from 2 main sources: living and deceased donors. Preference should be given to deceased-donor transplants since they represent the only source of organs for several nonrenal solid-organ transplants and the only modality where there is no risk to the donor. Unfortunately, even the most well-developed deceased-donor program (eg, the Spanish program) can barely cover 50% of its waiting list because the demand for deceased-donor organs far exceeds supply. The success of transplant surgery has created a waiting list dilemma. Despite all efforts, deceased-donor donation cannot meet current needs and therefore, living donation demands serious consideration. This is supported by the fact that the risk to live donors is minimal, graft survival is significantly better than that of deceased-donor kidneys regardless of HLA matching, and professional ethical philosophers have fewer difficulties with voluntary living donations than with the removal of an organ from a cadaver. This is especially true in our region. Living-related donation has always been acceptable ethically. It is, however, limited by the number of willing and qualified donors, the high incidence of familial renal diseases, and donor coercion (especially in our area). Living-unrelated donation increases the availability of donors, decreases the chances of coercion, and eliminates the problem of consanguinity. It raises, however, the ethical issues of commercialism, transplant tourism, and organ trafficking. The arguments for and against living-unrelated donation are innumerable. They have been the subject of several international forums and have raised endless discussions. We have set long ago a series of rules and regulations that are in close agreement with the recent Amsterdam and Kuwait resolutions. We have been continually modifying them over the last 15 years to try to implement our ideal, which is to protect the interest of the living donor and avoid commercialism.
A population-based longitudinal study on the implications of demographics on future blood supply.
Greinacher, Andreas; Weitmann, Kerstin; Lebsa, Anne; Alpen, Ulf; Gloger, Doris; Stangenberg, Wolfgang; Kiefel, Volker; Hoffmann, Wolfgang
2016-12-01
Changes in demographics with increases in older age groups and decreases in younger age groups imply an increased demand for blood transfusions paralleled by a decrease in the population eligible for blood donation. However, more restrictive transfusion triggers and the patient blood management initiative also reduce the demand for red blood cells (RBCs). Eastern Germany is a model region for the impact of demographic changes, which manifest in this region approximately 10 years earlier than in other regions due to the 50% birth rate decline after 1989. We report the 2010 longitudinal 5-year follow-up of the study assessing all whole blood donations and RBC transfusions in Mecklenburg-West Pomerania. We compared the projections that were made 5 years ago with: 1) the current age structure of the blood donor and transfusion recipient populations and 2) its impact on blood demand and blood donation numbers in specific age groups. Transfusion rates were lower and blood donation rates were higher than predicted in 2005. Although transfusion rates/1000 decreased in nearly all age groups, the overall annual transfusion rate increased to 66.4 RBC units/1000 (in 2005, 62.2/1000) due to the absolute increase in the elderly population. Despite a 7.4% decline in the population 18 to 65 years of age, whole blood donations increased by 11.7% between 2005 and 2010, but thereafter decreased by 21% (first-time donors by 39.4%), reflecting the effect of the post-1990 birth rate decline on the donor population. Changes in demography and medical practice impact the delicate balance between available blood supply and potential future transfusion needs. In times of pronounced demographic changes, regular monitoring of the blood demand and age structure of blood recipients and donors is required to allow strategic planning to prevent blood shortages or overproduction. © 2016 AABB.
From altruism to monetisation: Australian women's ideas about money, ethics and research eggs.
Waldby, Catherine; Kerridge, Ian; Boulos, Margaret; Carroll, Katherine
2013-10-01
We report the results of a qualitative study carried out in metropolitan Australia between 2009 and 2011 that canvassed the issue of payment for research oöcyte donation with participants drawn from three potential donor groups; fertility patients, reproductive donors and young, non-patient women. Research oöcytes are controversial tissues because women around the world have proved largely unwilling to donate them altruistically. In the ensuing international debate about procurement, the issue of money and its appropriate and inappropriate uses in tissue donation has taken centre stage. While there is now an abundance of expert commentary on this matter, there are almost no studies that probe this issue with potential donor populations. Our study asked the three groups of women about their understandings of altruistic, reimbursed, subsidised, compensated and paid donation for both reproductive and research eggs. We identify a resistance to the introduction of money into the sphere of reproductive donation, which the majority of respondents felt should remain an area of personalised gift relations. In the area of research donation we find a strong relationship between degrees of liquidity (the extent to which money is constrained or unconstrained) and a sense of ethical appropriateness. We also describe a culturally specific sense of fairness and equity among participants, associated with the relatively high public subsidisation of fertility treatment in Australia, which they used to benchmark their sense of appropriate and inappropriate uses of money. While the participant responses reflect the regulatory environment in Australia, particularly the absence of a US style market in reproductive oöcytes, they also make an important contribution to the global debate. Copyright © 2013 Elsevier Ltd. All rights reserved.
Factors Associated with Health Care Professionals' Attitude Toward the Presumed Consent System.
Tumin, Makmor; Tafran, Khaled; Satar, NurulHuda Mohd; Peng, Ng Kok; Manikam, Rishya; Yoong, Tang Li; Chan, Chong Mei
2018-05-16
This paper explores health care professionals' potential attitude toward organ donation if the presumed consent system were to be implemented in Malaysia, as well as factors associated with this attitude. We used self-administered questionnaires to investigate the attitude of 382 health care professionals from the University of Malaya Medical Center between January and February 2014. The responses were analyzed using logistic regression. Of the 382 respondents, 175 (45.8%) stated that they would officially object to organ donation if the presumed consent system were to be implemented, whereas the remaining 207 (54.2%) stated that they would not object. The logistic regression showed that health care professionals from the Malay ethnic group were more likely to object than those from Chinese (adjusted odds ratio of 0.342; P = .001) and Indian and other (adjusted odds ratio of 0.341; P = .003) ethnic groups. Health care professionals earning 3000 Malaysian Ringgit or below were more likely to object than those earning above 3000 Malaysian Ringgit (adjusted odds ratio of 1.919; P = .006). Moreover, respondents who were initially unwilling to donate organs, regardless of the donation system, were more likely to object under the presumed consent system than those who were initially willing to donate (adjusted odds ratio of 2.765; P < .001). Health care professionals in Malaysia have a relatively negative attitude toward the presumed consent system, which does not encourage the implementation of this system in the country at present. To pave the way for a successful implementation of the presumed consent system, efforts should be initiated to enhance the attitude of health care professionals toward this system. In particular, these efforts should at most target the health care professionals who are Malay, earn a low income, and have a negative default attitude toward deceased donation.
Whole Blood Donation Affects the Interpretation of Hemoglobin A1c
Lenters-Westra, Erna; de Kort, Wim; Bokhorst, Arlinke G.; Bilo, Henk J. G.; Slingerland, Robbert J.; Vos, Michel J.
2017-01-01
Introduction Several factors, including changed dynamics of erythrocyte formation and degradation, can influence the degree of hemoglobin A1c (HbA1c) formation thereby affecting its use in monitoring diabetes. This study determines the influence of whole blood donation on HbA1c in both non-diabetic blood donors and blood donors with type 2 diabetes. Methods In this observational study, 23 non-diabetic blood donors and 21 blood donors with type 2 diabetes donated 475 mL whole blood and were followed prospectively for nine weeks. Each week blood samples were collected and analyzed for changes in HbA1c using three secondary reference measurement procedures. Results Twelve non-diabetic blood donors (52.2%) and 10 (58.8%) blood donors with type 2 diabetes had a significant reduction in HbA1c following blood donation (reduction >-4.28%, P < 0.05). All non-diabetic blood donors with a normal ferritin concentration predonation had a significant reduction in HbA1c. In the non-diabetic group the maximum reduction was -11.9%, in the type 2 diabetes group -12.0%. When eligible to donate again, 52.2% of the non-diabetic blood donors and 41.2% of the blood donors with type 2 diabetes had HbA1c concentrations significantly lower compared to their predonation concentration (reduction >-4.28%, P < 0.05). Conclusion Patients with type 2 diabetes contributing to whole blood donation programs can be at risk of falsely lowered HbA1c. This could lead to a wrong interpretation of their glycemic control by their general practitioner or internist. PMID:28118412
Siqueira, Marina Martins; Araujo, Claudia Affonso; de Aguiar Roza, Bartira; Schirmer, Janine
2016-08-01
To search the literature and identify indicators used to monitor and control the organ donation and transplantation process and to group these indicators into categories. In November 2014, a systematic review of the literature was carried out in the following databases: Biblioteca Virtual em Saúde (BVS), EBSCO, Emerald, Proquest, Science Direct, and Web of Science. The following search terms (and the corresponding terms in Brazilian Portuguese) were employed: "efficiency," "indicators," "organ donation," "tissue and organ procurement," and "organ transplantation." Of the 344 articles retrieved, 23 original articles published between 1992 and 2013 were selected and reviewed for analysis of efficiency indicators. The review revealed 117 efficiency indicators, which were grouped according to similarity of content and divided into three categories: 1) 71 indicators related to organ donation, covering mortality statistics, communication of brain death, clinical status of donors and exclusion of donors for medical reasons, attitude of families, confirmation of donations, and extraction of organs and tissues; 2) 22 indicators related to organ transplantation, covering the surgical procedure per se and post-transplantation follow-up; and 3) 24 indicators related to the demand for organs and the resources of hospitals involved in the process. Even if organ transplantation is a recent phenomenon, the high number of efficiency indicators described in the literature suggests that scholars interested in this field have been searching for ways to measure performance. However, there is little standardization of the indicators used. Also, most indicators focus on the donation step, suggesting gaps in the measurement of efficiency at others points in the process. Additional indicators are needed to monitor important stages, such as organ distribution (for example, organ loss indicators) and post-transplantation aspects (for example, survival and quality of life).
Ralph, Angelique F; Butow, Phyllis; Hanson, Camilla S; Chadban, Steve J; Chapman, Jeremy R; Craig, Jonathan C; Kanellis, John; Luxton, Grant; Tong, Allison
2017-05-01
Many donors and recipients report an improved relationship after transplantation; however, tension, neglect, guilt, and proprietorial concern over the recipient can impede donor and recipient well-being and outcomes. We aimed to describe donor and recipient expectations and experiences of their relationship in the context of living kidney donation. Thematic synthesis of qualitative studies. Living kidney donors and recipients. Electronic databases were searched to October 2015. Thematic synthesis. From 40 studies involving 1,440 participants (889 donors and 551 recipients) from 13 countries, we identified 6 themes. "Burden of obligation" described the recipient's perpetual sense of duty to demonstrate gratitude to the donor. "Earning acceptance" was the expectation that donation would restore relationships. "Developing a unique connection" reflected the inexplicable bond that donor-recipient dyads developed postdonation. "Desiring attention" was expressed by donors who wanted recognition for the act of donation and were envious and resentful of the attention the recipient received. "Retaining kidney ownership" reflected the donor's inclination to ensure that the recipient protected "their" kidney. "Enhancing social participation" encompassed relieving both the caregiver from the constraints of dialysis and the recipient from increased involvement and contribution in family life. Non-English articles were excluded. Living kidney donation can strengthen donor-recipient relationships but may trigger or exacerbate unresolved angst, tension, jealousy, and resentment. Facilitating access to pre- and posttransplantation psychological support that addresses potential relationship changes may help donors and recipients better adjust to changes in the relationship dynamics, which in turn may contribute to improved psychosocial and transplantation outcomes following living kidney donation. Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.
Rudow, Dianne LaPointe; Milton, Jennifer; Rodrigue, James R.; Schold, Jesse D.; Hays, Rebecca
2015-01-01
Live-donor kidney transplantation (LDKT) is the best treatment for eligible people with late-stage kidney disease. Despite this, living kidney donation rates have declined in the United States in recent years. A potential source of this decline is the financial impact on potential and actual living kidney donors (LKDs). Recent evidence indicates that the economic climate may be associated with the decline in LDKT and that there are nontrivial financial ramifications for some LKDs. In June 2014, the American Society of Transplantation’s Live Donor Community of Practice convened a Consensus Conference on Best Practices in Live Kidney Donation. The conference included transplant professionals, patients, and other key stakeholders (with the financial support of 10 other organizations) and sought to identify best practices, knowledge gaps, and opportunities pertaining to living kidney donation. This workgroup was tasked with exploring systemic and financial barriers to living kidney donation. The workgroup reviewed literature that assessed the financial effect of living kidney donation, analyzed employment and insurance factors, discussed international models for addressing direct and indirect costs faced by LKDs, and summarized current available resources. The workgroup developed the following series of recommendations to reduce financial and systemic barriers and achieve financial neutrality for LKDs: (1) allocate resources for standardized reimbursement of LKDs' lost wages and incidental costs; (2) pass legislation to offer employment and insurability protections to LKDs; (3) create an LKD financial toolkit to provide standardized, vetted education to donors and providers about options to maximize donor coverage and minimize financial effect within the current climate; and (4) promote further research to identify systemic barriers to living donation and LDKT to ensure the creation of mitigation strategies. PMID:26002904
Rogers, Charles R.; Jeon, Kwon Chan; Rosen, Brittany
2014-01-01
Introduction For those with certain blood or bone cancers, bone marrow donation can mean the difference between life and death. The National Marrow Donor Program® (NMDP) operates the largest bone marrow registry of potential donors; however, at times when potential matches are identified, many donors opt not to donate. The purpose of this study was to describe perspectives from college-aged students on recruitment to a bone marrow donation registry and retention to the registry/follow-through with the donation process. Methods Researchers employed a one-time qualitative study using 7 focus groups comprised of 10 – 11 college students each (n = 76). Results Results yielded three overarching themes: donor recruitment, donor retention, and factors contributing to the overall donation process. More specifically, this study identified key factors affecting bone marrow donation in an essential population: facilitators, barriers, knowledge, and ‘goodness’. Additionally, marketing and communication were found to be major determinants of potential donors staying with the NMDP. Conclusion Better explanations and awareness/promotion campaigns are necessary for recruiting potential donors to the NMDP and to increase the likelihood that the donor will follow through with the donation should a potential match be identified. Recommendations from this study may improve recruitment and retention rates among the NMDP campaigns targeting college students. PMID:25632376
Bajor, Grzegorz; Likus, Wirginia; Kuszewski, Piotr; Kostro, Karol; Łoś, Andrzej; Kłakus, Piotr
2015-01-01
The Conscious Body Donation Program conducted since 2003 by the Department of Human Anatomy, Medical University of Silesia in Katowice was the first innovative project aimed at obtaining informed donors' bodies for the purpose of teaching anatomy in Poland. The aim of this prospective study was to determine the declared donors' characteristics and to establish the possible motivation for body donation. A total of 244 application files were reviewed and the following information was analyzed: donor's age, age at which the decision to donate the body was made, donor's place of residence and declared nationality, family background, education and profession, family structure and religion. Our results showed that mainly elderly people decided to donate their bodies (68.5 ± 11.84 years), living mostly in large and medium-sized cities. Men--donors often lived in small towns. Most of the donors were of blue-collar parentage, completed secondary education and at the time of taking decision to donate where married and retired. Widows were more likely to make the decision to donate than widowers. Most of our donors were Catholic. Our analysis of the profile of Polish donors may be useful to understand better for which groups of people death is not to be perceived as the end, and may become a value, which can be beneficial to living people.
Gómez-Rázuri, Katherine; Ballena-López, José; León-Jiménez, Franco
2016-03-01
To explore the myths regarding organ donation at a national hospital in Lambayeque, Peru during 2014. A qualitative-phenomenological study was performed using 24 unstructured in-depht interview of health personnel, potential recipients and relatives of potential donors. Sampling was intentional opinion-based, completed by theoretical saturation in each group. An interview guide was used, which was assessed by five experts, and data triangulation was performed. Twenty-three interviewees (95,8%) reported a favorable attitude towards organ donation. On their National Identification Document, thirteen (54,2%) had marked "no" for donation. The myths were: age or illness can preclude donation; that the recipient may experience the donor's behaviours and lives in it; brain death is undestood as the immobility of the body and a reversible state; religions do not accept organ donation because it affects physical integrity and resurrection; and that there are preferences on the organ donor waiting list and that organ trafficking taxes place. Myths explored in this study involved religious, socio-cultural, psychological and ethical misperceptions. The apparent lack of knowledge of the brain death diagnosis is the starting point of the donation process. Therefore, the presence of a hospital coordinator, the role of spiritual leaders and the correct information provided by media would be key parts to dispell these myths.
Du, Xu; Hao, Jian
2018-04-01
Specific emotions, especially guilt, are considered to facilitate children's prosocial behavior. The current study differentiated moral stories with a helping theme in terms of the valence and source of emotions and aimed to clarify the effect of these stories on preschoolers' helping intentions and behavior. A total of 322 preschoolers between 4 and 6 years old were randomly assigned to four experimental groups and one control group. A specific type of moral story was presented to each of the experimental groups, whereas a nonmoral story was presented to the control group. The preschoolers were also asked to answer relevant questions to examine their story comprehension. The preschoolers' donating intentions and behavior were then measured. The results showed that all the experimental groups expressed more donating intentions than the control group. However, only the group that read the moral story emphasizing the actor's negative emotions toward his nonhelping behavior displayed more donating behavior than the control group. Therefore, the current study reveals that various moral stories dealing with a helping theme can facilitate helping intentions among preschoolers and that only certain stories can promote their helping behavior. Thus, it indicates the specificity of moral stories that facilitate prosocial behavior in terms of the valence and source of emotions in those stories. Copyright © 2017 Elsevier Inc. All rights reserved.
The History and Challenges of Blood Donor Screening in China.
Li, Ling; Li, Ka Yi; Yan, Ke; Ou, Guojin; Li, Wenhui; Wang, Jue; Song, Ning; Tian, Li; Ji, Xin; Chen, Yongjun; Liang, Xiaohua; Liu, Zhong; Wu, Yanyun
2017-04-01
Since the establishment of People's Republic of China in 1949, the Chinese government has encountered several catastrophes related to transfusion transmitted diseases. The government's increasing attention to blood safety has prompted the initiation of a series of policies and measures that have enhanced the level of safety for the blood supply and met the basic clinical demands of blood for 1.3 billion people in the country. Blood donation screening strategies in China predominantly comprise donor screening and donor testing. Donor screening includes selection of low-risk blood donors by the use of a donor history questionnaire, predonation physical examination, and initial rapid donor testing. Donor testing includes direct pathogen detection and serology tests. The year 1998 marked the most transformative change in blood donor selection and screening policies in China. Before 1998, paid donation was the predominant mode of blood donation. Donor screening and donor testing were conducted before donation, and only those who were eligible were allowed to donate. To ensure the safety of blood, donor testing was performed again after donation. After the implementation of the Blood Donation Law in 1998, to promote voluntary and unpaid donation, predonation donor testing was eliminated to reduce the amount of waiting time and to provide a more convenient donation experience for blood donors. However, it is the national requirement that donated blood should undergo 2 rounds of testing using different equipment or reagents, conducted by different personnel. Donor selection has transitioned from paid donation and obligatory donation to voluntary donation with fixed volunteer groups, as the latter mode of donation provides the lowest risks. Donations are currently screened for syphilis, hepatitis C virus, HIV, and hepatitis B virus (HBV). Units, previously typed only for ABO, are now routinely tested for both ABO and Rh(D). Innovations in testing technologies and methods have also brought changes to screening parameters. For instance, screening for HBV pathogens evolved from the early use of hemagglutination method to the later use of radioimmunoassay, independent enzyme-linked immunosorbent assay, and now the widespread application of nucleic acid test (NAT). Since 2010, the Chinese government has established NAT capacity in several blood centers; and in 2015, the government invested 900 million RMB on the nationwide expansion of NAT. Although the Chinese government has worked to enhance blood safety, many challenges remain. Concern exists for rising rates of HIV infection. The existence of occult HBV infection and the transmission of emerging blood-borne diseases continue to challenge the safety of the blood supply. Copyright © 2017 Elsevier Inc. All rights reserved.
[Gamete donation contracts: gift of life or sale of genetic material?].
Raposo, Vera Lúcia
2012-01-01
When science made possible to overcome the biological limitation to infertility, gamete had become a "valuable good". Therefore, lawyers are asked to define their juridical status, their modality of transference, their possible uses and the legal protection reserved to them.
Federal Register 2010, 2011, 2012, 2013, 2014
2012-03-13
... Incidence Surveillance Group. Estimated HIV Incidence in the United States, 2006-2009. PLoS One. 2011;6(8... donors who meet all other donor eligibility criteria, and have negative pre-donation test results, would...' disease), and a serologic test for syphilis. A pre-donation testing strategy would focus on the prevalence...
ERIC Educational Resources Information Center
Reubsaet, A.; Reinaerts, E. B. M.; Brug, J.; van Hooff, J. P.; van den Borne, H. W.
2004-01-01
This paper describes the process evaluation of an organ donation education program for high school students aged 15-18 years of which the effectiveness was established. The program consisted of three components: a video with group discussion, an interactive computer-tailored program and a registration training session. A cross-sectional survey was…
The World Health Organization, the drugs company, and the $10,000 funding offer.
Day, Michael; Boseley, Sarah
2007-01-01
The World Health Organization faces allegations that it attempted to secure a $10,000 donation from a pharmaceutical company by asking a patients' group to act as a covert channel for the funds, an arrangement that would break the WHO's own rules on accepting money from the pharmaceutical industry. The WHO denies attempts to bend its donation rules.
Blasi, A; Hessheimer, A J; Beltrán, J; Pereira, A; Fernández, J; Balust, J; Martínez-Palli, G; Fuster, J; Navasa, M; García-Valdecasas, J C; Taurá, P; Fondevila, C
2016-06-01
Unexpected donation after circulatory determination of death (uDCD) liver transplantation is a complex procedure, in particular when it comes to perioperative recipient management. However, very little has been published to date regarding intraoperative and immediate postoperative care in this setting. Herein, we compare perioperative events in uDCD liver recipients with those of a matched group of donation after brain death liver recipients. We demonstrate that the former group of recipients suffers significantly greater hemodynamic instability and derangements in coagulation following graft reperfusion. Based on our experience, we recommend a proactive recipient management strategy in uDCD liver transplantation that involves early use of vasopressor support; maintaining adequate intraoperative levels of red cells, platelets, and fibrinogen; and routinely administering tranexamic acid before graft reperfusion. © Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.
Hagen, Bas; Ali, Sara; Overkleeft, Herman S; van der Marel, Gijsbert A; Codée, Jeroen D C
2017-01-20
The synthesis of complex oligosaccharides is often hindered by a lack of knowledge on the reactivity and selectivity of their constituent building blocks. We investigated the reactivity and selectivity of 2-azidofucosyl (FucN 3 ) donors, valuable synthons in the synthesis of 2-acetamido-2-deoxyfucose (FucNAc) containing oligosaccharides. Six FucN 3 donors, bearing benzyl, benzoyl, or tert-butyldimethylsilyl protecting groups at the C3-O and C4-O positions, were synthesized, and their reactivity was assessed in a series of glycosylations using acceptors of varying nucleophilicity and size. It was found that more reactive nucleophiles and electron-withdrawing benzoyl groups on the donor favor the formation of β-glycosides, while poorly reactive nucleophiles and electron-donating protecting groups on the donor favor α-glycosidic bond formation. Low-temperature NMR activation studies of Bn- and Bz-protected donors revealed the formation of covalent FucN 3 triflates and oxosulfonium triflates. From these results, a mechanistic explanation is offered in which more reactive acceptors preferentially react via an S N 2-like pathway, while less reactive acceptors react via an S N 1-like pathway. The knowledge obtained in this reactivity study was then applied in the construction of α-FucN 3 linkages relevant to bacterial saccharides. Finally, a modular synthesis of the Staphylococcus aureus type 5 capsular polysaccharide repeating unit, a trisaccharide consisting of two FucNAc units, is described.
Tison, Geoffrey H; Liu, Changli; Ren, Furong; Nelson, Kenrad; Shan, Hua
2007-10-01
For the past several decades, Chinese blood centers have relied on blood donations from employer-organized donors (blood donors who donate blood in groups with coworkers as prearranged by the employer and the local blood center). Recently the government has decided to phase out employer-organized donors and transition to the use of only volunteer donors (blood donors who donate individually independent of employers). Evaluating the beliefs and attitudes of employer-organized and volunteer donors is critical to maintain an adequate blood supply after this transition. The study population consisted of 431 volunteer donors and 527 employer-organized donors who completed a structured questionnaire in July 2005. Employer-organized donors tended to be older, male, and married, with higher education and higher income compared to volunteer donors. Volunteer donors were more often motivated by altruism (p < 0.001) and more likely to donate larger volumes (400 mL vs. 200 mL) of blood (volunteer 70.5% vs. employer-organized 7%; p < 0.001). Employer-organized donors were more inhibited by factors related to traditional Chinese beliefs, such as the belief that blood donation affects life energy "Qi" (volunteer 3.1% vs. employer-organized 12.7%; p < 0.001), and requested more time off from work after donating. Employer-organized donors also express a greater concern about contracting disease from donating blood. To recruit voluntary donors effectively in China and other countries with traditional cultures, efforts need to counteract traditional beliefs and perceptions of risk that discourage donation by emphasizing the benefits, safety mechanisms, physiology, and epidemiology of blood donation. In China, there is a rich opportunity to convert prior employer-organized donors into volunteer donors, and the institution of a confidential predonation screening system may help to facilitate truthful risk factor disclosure.
What would encourage blood donation in Ireland?
Harrington, M; Sweeney, M R; Bailie, K; Morris, K; Kennedy, A; Boilson, A; O'Riordan, J; Staines, A
2007-05-01
Recent changes have resulted in the loss of 4% of the donor panel in the Republic of Ireland and 3% in Northern Ireland. In order to increase the number of donors in these two regions, it is important that transfusion service providers explore and understand the reasons, which prevent individuals from donating. The aim of this study was to explore these issues particularly in non-donors and those who had lapsed. This 7-month all-Ireland study was conducted by computer-assisted telephone interview. Data collected included sociodemographic history, donation status, as well as barriers/deterrents to donation. There were 4166 completed questionnaires (44% donors; 56% non-donors). Of the donors, 13% had donated blood within the last 2 years. Current donors cited 'awareness of patients needs' (88%), 'trust in the blood transfusion service' (70%), and 'an advertising campaign' (70%) as reasons encouraging them to donate blood. Lapsed donors and non-donors cited 'more frequent mobile clinics/sessions' (30% lapsed donors; 53% non-donors), 'if I was asked' (28% lapsed donors; 53% non-donors), and 'more flexible opening hours' (23% lapsed donors; 44% non-donors) as reasons that would encourage them to donate. The main reasons cited by non-donors for never having donated included 'medical reasons' (41% Republic of Ireland; 43% Northern Ireland), 'lack of information' (20% Republic of Ireland; 22% Northern Ireland), 'fear of needles' (15% Republic of Ireland; 17% Northern Ireland), and 'time constraints' (12% Republic of Ireland; 13% Northern Ireland). Among the non-donor group, 10% (Republic of Ireland) and 6% (Northern Ireland) claimed that they are not permitted to donate. Replacing regular donors is a major challenge for the transfusion service providers. This study shows that by facilitating the general public by introducing more mobile clinics/sessions, more flexible opening hours and having a better level of knowledge in the community about blood donation may encourage lapsed donors and new donors to become regular donors.
Grief Symptoms in Relatives who Experienced Organ Donation Request in the ICU.
Kentish-Barnes, Nancy; Chevret, Sylvie; Cheisson, Gaëlle; Joseph, Liliane; Martin-Lefèvre, Laurent; Si Larbi, Anne Gaelle; Viquesnel, Gérald; Marqué, Sophie; Donati, Stéphane; Charpentier, Julien; Pichon, Nicolas; Zuber, Benjamin; Lesieur, Olivier; Ouendo, Martial; Renault, Anne; Le Maguet, Pascale; Kandelman, Stanislas; Thuong, Marie; Floccard, Bernard; Mezher, Chaouki; Galon, Marion; Duranteau, Jacques; Azoulay, Elie
2018-03-19
In the case of organ donation, the family is highly involved in the decision process. To assess experience of organ donation process and grief symptoms in relatives of brain dead patients who discussed organ donation in the ICU. Multicentre cross-sectional study in 28 ICUs in France. Participating subjects were relatives of brain dead patients who were approached to discuss organ donation. Relatives were followed-up by phone at 3 time points: at 1 month to complete a questionnaire describing their experience of organ donation process; At 3 months to complete the Hospital Anxiety and Depression Scale and the Impact of Event Scale-Revised; At 9 months, to complete the IES-R and the Inventory of Complicated Grief. 202 relatives of 202 patients were included, of whom 158 consented and 44 refused organ donation. Interviews were conducted at 1, 3 and 9 months for 157, 137 and 117 relatives respectively. Experience was significantly more burdensome for relatives of non-donors. However there were no significant differences in grief symptoms measured at 3 and 9 months between the 2 groups. Understanding of brain death was associated with grief symptoms with higher prevalence of complicated grief symptoms in relatives who did not understand (75% vs 46.1%, p=0.026). Experience of the organ donation process varies between relatives of donor vs non-donor patients with relatives of non-donors experiencing lower quality communication, but the decision was not associated with subsequent grief symptoms. Importantly, understanding of brain death is a key element for relatives.
Klarenbach, Scott; Gill, John S.; Caulfield, Tim; Manns, Braden
2012-01-01
Summary Background and objective The acceptability of financial incentives for organ donation is contentious. This study sought to determine (1) the acceptability of expense reimbursement or financial incentives by the general public, health professionals involved with organ donation and transplantation, and those with or affected by kidney disease and (2) for the public, whether financial incentives would alter their willingness to consider donation. Design, setting, participants, & measurements Web-based survey administered to members of the Canadian public, health professionals, and people with or affected by kidney disease asking questions regarding acceptability of strategies to increase living and deceased kidney donation and willingness to donate a kidney under various financial incentives. Results Responses were collected from 2004 members of the Canadian public October 11–18, 2011; responses from health professionals (n=339) and people with or affected by kidney disease (n=268) were collected during a 4-week period commencing October 11, 2011. Acceptability of one or more financial incentives to increase deceased and living donation was noted in >70% and 40% of all groups, respectively. Support for monetary payment for living donors was 45%, 14%, and 27% for the public, health professionals, and people with or affected by kidney disease, respectively. Overall, reimbursement of funeral expenses for deceased donors and a tax break for living donors were the most acceptable. Conclusion The general public views regulated financial incentives for living and deceased donation to be acceptable. Future research needs to examine the impact of financial incentives on rates of deceased and living donors. PMID:23024166
Li, Alvin Ho-ting; McArthur, Eric; Maclean, Janet; Isenor, Cynthia; Prakash, Versha; Kim, S. Joseph; Knoll, Greg; Shah, Baiju; Garg, Amit X.
2015-01-01
Objective For various reasons, people of Chinese (China, Hong Kong or Taiwan) and South Asian (Indian subcontinent) ancestry (the two largest ethnic minority groups in Ontario, Canada) may be less likely to register for deceased organ donation than the general public, and their families may be less likely to consent for deceased organ donation at the time of death. Methods We conducted two population-based studies: (1) a cross-sectional study of deceased organ donor registration as of May 2013, and (2) a cohort study of the steps in proceeding with deceased organ donation for patients who died in hospital from October 2008 to December 2012. Results A total of 49 938 of 559 714 Chinese individuals (8.9%) and 47 774 of 374 291 South Asians (12.8%) were registered for deceased organ donation, proportions lower than the general public (2 676 260 of 10 548 249 (25.4%). Among the 168 703 Ontarians who died in a hospital, the families of 33 of 81 Chinese (40.1%; 95% CI: 30.7%-51.6%) and 39 of 72 South Asian individuals (54.2%; 95% CI: 42.7-65.2%) consented for deceased organ donation, proportions lower than the general public (68.3%; 95% CI: 66.4%-70.0%). Conclusions In Ontario, Canada Chinese and South Asian individuals are less likely to register and their families are less likely to consent to deceased organ donation compared to the remaining general public. There is an opportunity to build support for organ and tissue donation in these two large ethnic communities in Canada. PMID:26230320
Altruism or solidarity? The motives for organ donation and two proposals.
Saunders, Ben
2012-09-01
Proposals for increasing organ donation are often rejected as incompatible with altruistic motivation on the part of donors. This paper questions, on conceptual grounds, whether most organ donors really are altruistic. If we distinguish between altruism and solidarity--a more restricted form of other-concern, limited to members of a particular group--then most organ donors exhibit solidarity, rather than altruism. If organ donation really must be altruistic, then we have reasons to worry about the motives of existing donors. However, I argue that altruism is not necessary, because organ donation supplies important goods, whatever the motivation, and we can reject certain dubious motivations, such as financial profit, without insisting on altruism. Once solidaristic donation is accepted, certain reforms for increasing donation rates seem permissible. This paper considers two proposals. Firstly, it has been suggested that registered donors should receive priority for transplants. While this proposal appears based on a solidaristic norm of reciprocity, it is argued that such a scheme would be undesirable, since non-donors may contribute to society in other ways. The second proposal is that donors should be able to direct their organs towards recipients that they feel solidarity with. This is often held to be inconsistent with altruistic motivation, but most donation is not entirely undirected in the first place (for instance, donor organs usually go to co-nationals). While allowing directed donation would create a number of practical problems, such as preventing discrimination, there appears to be no reason in principle to reject it. © 2012 Blackwell Publishing Ltd.
Spasovski, Goce; Busic, Mirela; Delmonico, Francis
2016-01-01
Due to the limited access to kidney transplantation (KTx) in developing countries, desperate patients have engaged in the purchase and sale of kidneys. In 2004, the World Health Assembly urged member states to protect the poor and vulnerable from being exploited through practices of illegal organ trafficking that had become widespread throughout the world. In 2008, the international transplant community convened a summit of transplant professionals, legal experts and ethicists to combat organ trafficking, transplant tourism and transplant commercialism that resulted in the Declaration of Istanbul (DOI). The South-Eastern Europe Health Network (SEEHN) represents a nine country multigovernmental collaboration on health systems. The Regional Health Development Centre on Organ Donation and Transplant Medicine (RHDC) was established in 2011 in Croatia to facilitate cooperation among south-eastern European countries to improve organ transplantation within the Balkan region. Since 2011, a collaboration between the RHDC, the Custodian Group of the DOI (DICG) and SEEHN professionals has enhanced strategic planning and definition of country-specific action plan priorities on organ donation and transplantation. Data of kidney transplantation provided in this report show a significant increase in transplantation activities in a 4-year period in Macedonia, Moldova, Bosnia and Hercegovina, Romania and Montenegro. The success of the donation and transplantation programmes was influenced by the engagement of key professionals and the establishment of organizational infrastructure with the implementation of an appropriate funding model. In conclusion, the DOI has provided an ethical framework for engagement of health professionals from south-eastern European countries. The newly established SEEHN RHDC as a technical coordinating body greatly contributed in building institutional capacity and strengthening regional collaboration between health authorities and professionals within these countries for improvement of transplant activities in the Balkans. PMID:26798481
Spasovski, Goce; Busic, Mirela; Delmonico, Francis
2016-02-01
Due to the limited access to kidney transplantation (KTx) in developing countries, desperate patients have engaged in the purchase and sale of kidneys. In 2004, the World Health Assembly urged member states to protect the poor and vulnerable from being exploited through practices of illegal organ trafficking that had become widespread throughout the world. In 2008, the international transplant community convened a summit of transplant professionals, legal experts and ethicists to combat organ trafficking, transplant tourism and transplant commercialism that resulted in the Declaration of Istanbul (DOI). The South-Eastern Europe Health Network (SEEHN) represents a nine country multigovernmental collaboration on health systems. The Regional Health Development Centre on Organ Donation and Transplant Medicine (RHDC) was established in 2011 in Croatia to facilitate cooperation among south-eastern European countries to improve organ transplantation within the Balkan region. Since 2011, a collaboration between the RHDC, the Custodian Group of the DOI (DICG) and SEEHN professionals has enhanced strategic planning and definition of country-specific action plan priorities on organ donation and transplantation. Data of kidney transplantation provided in this report show a significant increase in transplantation activities in a 4-year period in Macedonia, Moldova, Bosnia and Hercegovina, Romania and Montenegro. The success of the donation and transplantation programmes was influenced by the engagement of key professionals and the establishment of organizational infrastructure with the implementation of an appropriate funding model. In conclusion, the DOI has provided an ethical framework for engagement of health professionals from south-eastern European countries. The newly established SEEHN RHDC as a technical coordinating body greatly contributed in building institutional capacity and strengthening regional collaboration between health authorities and professionals within these countries for improvement of transplant activities in the Balkans.
Rak, Eniko C; Spencer, Lauren
2016-08-01
This study examined similarities and differences between persons with and without disabilities on volunteering, donations and group participation. A sample of 1548 individuals participated and 60% of the sample were persons with disabilities. Data for this research was drawn from a major statewide survey in a Midwestern state in the United States. Community participation was measured through involvement with civic, religious and other community-based groups, volunteering activities and donations. Logistic regression was pursued to test the effect of disability on community participation. Findings support different trends in participation between persons with and without disabilities. Individuals without disabilities are more likely to volunteer, donate money and participate in civic organisations (e.g. clubs) and other groups. Employment and household income have a significant contribution in explaining these differences. This study found significant differences in community participation between persons with disabilities and persons without disabilities. Regression analysis outcomes underscore the importance of employment and income in eliminating disparities in community involvement between persons with and without disabilities. Implications for Rehabilitation Policy change in rehabilitation agencies to fund supported volunteering services. Improve the representation of persons with disabilities in volunteering pursuits by making volunteering positions accessible to them (educate persons with disabilities to be more aware of these opportunities, provide reasonable accommodations at work sites, etc.). Educate stakeholders about the benefits of volunteering and being part of civic, and other community based groups in improving the quality of life of persons with disabilities. Identification of barriers for persons with disabilities in these pursuits (physical and attitudinal barriers, lack of resources). Identifying and utilising natural supports in the work site for persons with disabilities to receive peer support on the job from full-time employees.
Sälevaara, Mari; Punamäki, Raija-Leena; Poikkeus, Piia; Flykt, Marjo; Tulppala, Maija; Tiitinen, Aila
2016-07-01
The aim of this study was to compare the level of fear of childbirth, pregnancy-related anxiety and experience of childbirth in women who conceived with donated oocytes (OD), with that in women with in vitro fertilization/intra-cytoplasmic sperm injection (IVF/ICSI) and spontaneous conception (SC). This is a prospective cohort study. We compared women who received donated oocytes (n = 26) to matched controls, IVF/ICSI (n = 52) or SC (n = 52). Matching was made according to mothers' age, parity, plurality and the number of returned questionnaires. The participants completed the questionnaires during their second trimester and at 2 months postpartum. The Fear of Delivery Questionnaire and the Pregnancy Anxiety Scale served to study fear of childbirth, and the Delivery Satisfaction Scale served to study experience of childbirth. The level of fear of childbirth was lower in the women who received donated oocytes than in the women who received IVF/ICSI (p = 0.028), but similar to those in the SC group. The level of pregnancy-related anxiety was lower in the OD group than in the IVF/ICSI (p = 0.006) and SC groups (p = 0.019). The experience of childbirth did not differ between the groups. The mode of delivery was associated with the mothers' satisfaction with the delivery only in the OD group. Those who had an acute operative delivery were the most dissatisfied. After receiving adequate support prior to OD treatment, the women require no more support with fear of childbirth than other pregnant women, but they may require support after acute operative deliveries. © 2016 Nordic Federation of Societies of Obstetrics and Gynecology.
Benson, Eric E; Zhang, Hanyu; Schuman, Samuel A; Nanayakkara, Sanjini U; Bronstein, Noah D; Ferrere, Suzanne; Blackburn, Jeffrey L; Miller, Elisa M
2018-01-10
We modify the fundamental electronic properties of metallic (1T phase) nanosheets of molybdenum disulfide (MoS 2 ) through covalent chemical functionalization, and thereby directly influence the kinetics of the hydrogen evolution reaction (HER), surface energetics, and stability. Chemically exfoliated, metallic MoS 2 nanosheets are functionalized with organic phenyl rings containing electron donating or withdrawing groups. We find that MoS 2 functionalized with the most electron donating functional group (p-(CH 3 CH 2 ) 2 NPh-MoS 2 ) is the most efficient catalyst for HER in this series, with initial activity that is slightly worse compared to the pristine metallic phase of MoS 2 . The p-(CH 3 CH 2 ) 2 NPh-MoS 2 is more stable than unfunctionalized metallic MoS 2 and outperforms unfunctionalized metallic MoS 2 for continuous H 2 evolution within 10 min under the same conditions. With regards to the entire studied series, the overpotential and Tafel slope for catalytic HER are both directly correlated with the electron donating strength of the functional group. The results are consistent with a mechanism involving ground-state electron donation or withdrawal to/from the MoS 2 nanosheets, which modifies the electron transfer kinetics and catalytic activity of the MoS 2 nanosheet. The functional groups preserve the metallic nature of the MoS 2 nanosheets, inhibiting conversion to the thermodynamically stable semiconducting state (2H) when mildly annealed in a nitrogen atmosphere. We propose that the electron density and, therefore, reactivity of the MoS 2 nanosheets are controlled by the attached functional groups. Functionalizing nanosheets of MoS 2 and other transition metal dichalcogenides provides a synthetic chemical route for controlling the electronic properties and stability within the traditionally thermally unstable metallic state.
Chang, Tao; Zhao, Haiping; Du, Huanhuan; Liu, Shan; Wu, Baoshuang; Qin, Shenjun
2017-01-01
In this work, we present the fabrication of highly luminescent carbon dots (CDs) by a double passivation method with the assistance of Ca(OH)2. In the reaction process, Ca2+ protects the active functional groups from overconsumption during dehydration and carbonization, and the electron-withdrawing groups on the CD surface are converted to electron-donating groups by the hydroxyl ions. As a result, the fluorescence quantum yield of the CDs was found to increase with increasing Ca(OH)2 content in the reaction process. A blue-shift optical spectrum of the CDs was also found with increasing Ca(OH)2 content, which could be attributed to the increasing of the energy gaps for the CDs. The highly photoluminescent CDs obtained (quantum yield: 86%) were used to cultivate fluorescent carnations by a water culture method, while the results of fluorescence microscopy analysis indicated that the CDs had entered the plant tissue structure. PMID:28686178
Diffendorfer, Jay E.; Loomis, John B.; Ries, Leslie; Oberhauser, Karen; Semmens, Darius; Semmens, Brice; Butterfield, Bruce; Bagstad, Ken; Goldstein, Josh; Wiederholt, Ruscena; Mattsson, Brady; Thogmartin, Wayne E.
2013-01-01
The annual migration of monarch butterflies (Danaus plexippus) has high cultural value and recent surveys indicate monarch populations are declining. Protecting migratory species is complex because they cross international borders and depend on multiple regions. Understanding how much, and where, humans place value on migratory species can facilitate market-based conservation approaches. We performed a contingent valuation study of monarchs to understand the potential for such approaches to fund monarch conservation. The survey asked U.S. respondents about the money they would spend, or have spent, growing monarch-friendly plants, and the amount they would donate to monarch conservation organizations. Combining planting payments and donations, the survey indicated U.S. households valued monarchs as a total one-time payment of $4.78–$6.64 billion, levels similar to many endangered vertebrate species. The financial contribution of even a small percentage of households through purchases or donations could generate new funding for monarch conservation through market-based approaches.
Acceptability of donated breast milk in a resource limited South African setting.
Coutsoudis, Irene; Petrites, Alissa; Coutsoudis, Anna
2011-02-22
The importance of breast milk for infants' growth, development and overall health is widely recognized. In situations where women are not able to provide their infants with sufficient amounts of their own breast milk, donor breast milk is the next preferred option. Although there is considerable research on the safety and scientific aspects of donor milk, and the motivations and experiences of donors, there is limited research addressing the attitudes and experiences of the women and families whose infants receive this milk. This study therefore examined attitudes towards donated breast milk among mothers, families and healthcare providers of potential recipient infants. The study was conducted at a public hospital and nearby clinic in Durban, South Africa. The qualitative data was derived from eight focus group discussions which included four groups with mothers; one with male partners; and one with grandmothers, investigating attitudes towards receiving donated breast milk for infants. There was also one group each with nurses and doctors about their attitudes towards donated breast milk and its use in the hospital. The focus groups were conducted in September and October 2009 and each group had between four and eleven participants, leading to a total of 48 participants. Although breast milk was seen as important to child health there were concerns about undermining of breast milk because of concerns about HIV and marketing and promotion of formula milks. In addition there were concerns about the safety of donor breast milk and discomfort about using another mother's milk. Participants believed that education on the importance of breast milk and transparency on the processes involved in sourcing and preparing donor milk would improve the acceptability. This study has shown that there are obstacles to the acceptability of donor milk, mainly stemming from lack of awareness/familiarity with the processes around donor breast milk and that these could be readily addressed through education. Even the more psychological concerns would also likely be reduced over time as these educational efforts progress. With government and health care worker endorsement and commitment, breast milk donation could have a promising role in improving child health.
van Suylen, V; Luijk, B; Hoek, R A S; van de Graaf, E A; Verschuuren, E A; Van De Wauwer, C; Bekkers, J A; Meijer, R C A; van der Bij, W; Erasmus, M E
2017-10-01
The implementation of donation after circulatory death category 3 (DCD3) was one of the attempts to reduce the gap between supply and demand of donor lungs. In the Netherlands, the total number of potential lung donors was greatly increased by the availability of DCD3 lungs in addition to the initial standard use of donation after brain death (DBD) lungs. From the three lung transplant centers in the Netherlands, 130 DCD3 recipients were one-to-one nearest neighbor propensity score matched with 130 DBD recipients. The primary end points were primary graft dysfunction (PGD), posttransplant lung function, freedom from chronic lung allograft dysfunction (CLAD), and overall survival. PGD did not differ between the groups. Posttransplant lung function was comparable after bilateral lung transplantation, but seemed worse after DCD3 single lung transplantation. The incidence of CLAD (p = 0.17) nor the freedom from CLAD (p = 0.36) nor the overall survival (p = 0.40) were significantly different between both groups. The presented multicenter results are derived from a national context where one third of the lung transplantations are performed with DCD3 lungs. We conclude that the long-term outcome after lung transplantation with DCD3 donors is similar to that of DBD donors and that DCD3 donation can substantially enlarge the donor pool. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.
Wang, Yibin; Fan, Heli; Balakrishnan, Kumudha; Lin, Zechao; Cao, Sheng; Chen, Wenbing; Fan, Yukai; Guthrie, Quibria A.; Sun, Huabing; Teske, Kelly A.; Gandhi, Varsha; Arnold, Leggy A.; Peng, Xiaohua
2017-01-01
Quinone methide (QM) formation induced by endogenously generated H2O2 is attractive for biological and biomedical applications. To overcome current limitations due to low biological activity of H2O2-activated QM precursors, we are introducing herein several new arylboronates with electron donating substituents at different positions of benzene ring and/or different neutral leaving groups. The reaction rate of the arylboronate esters with H2O2 and subsequent bisquinone methides formation and DNA cross-linking was accelerated with the application of Br as a leaving group instead of acetoxy groups. Additionally, a donating group placed meta to the nascent exo-methylene group of the quinone methide greatly improves H2O2-induced DNA interstrand cross-link formation as well as enhances the cellular activity. Multiple donating groups decrease the stability and DNA cross-linking capability, which lead to low cellular activity. A cell-based screen demonstrated that compounds 2a and 5a with a OMe or OH group dramatically inhibited the growth of various tissue-derived cancer cells while normal cells were less affected. Induction of H2AX phosphorylation by these compounds in CLL lymphocytes provide evidence for a correlation between cell death and DNA damage. The compounds presented herein showed potent anticancer activities and selectivity, which represent a novel scaffold for anticancer drug development. PMID:28388522
Being Sherlock Holmes: the Internet as a tool for assessing live organ donors.
Bramstedt, Katrina A; Katznelson, Steven
2009-01-01
Donor advocacy is a critical feature of live donor transplantation. Donor Advocates and Donor Advocate Teams (DAT) are now routine to the practice of live donor evaluation in the USA. Multidisciplinary in nature, DATs gather both medical and psychosocial information about potential live organ donors and then render a decision as to whether or not these individuals are suitable to participate. Because of the critical ethical and psychosocial concerns about live donation, thorough donor evaluations are essential. Additionally, the information gathered must be accurate, and this requires honest disclosure by the donor candidate. In this paper, we describe how DATs can use various forms of free, public content available on the Internet to aid live donor assessments. In this way, the DAT assumes somewhat of an investigative role; however, this is ethically justified in light of the DAT duty to protect the donor. The protective effect can also spread to the transplant program, in general, when inappropriate donors are excluded from the donation process.
Altruism and Religion: A New Paradigm for Organ Donation.
Rabinowich, Aviad; Jotkowitz, Alan
2018-02-01
Activity of NGO's supporting living donor kidney donations can affect the shortage of kidneys. Matnat Chaim is a Jewish orthodox organization active in Israel since 2009. This is a voluntary organization with aims to shorten and eliminate the waiting list for kidneys. Since the beginning of its activity, it has said to play a key role in 379 kidney transplantations. In 2015, out of 174 live donor kidney transplantations that took place in Israel, Matnat Chaim had a key role in 88 of them (50.6%). We found some ethical issues concerning the organization's activity. The donor can restrict his or her donation to specific characteristics of recipient which can result in organs transplanted in a homogeneous group of the population. Another issue is the question of whether nudging people to kidney donation takes place and whether it is valid to do so. We found that Matnat Chaim does a great deal for promotion and intermediation of kidney donations in Israel. This form of promotion can be implemented by other organizations and countries.
Perceptions of donors and recipients regarding blood donation.
Conceição, Vander Monteiro da; Araújo, Jeferson Santos; Oliveira, Rafaela Azevedo Abrantes de; Santana, Mary Elizabeth de; Zago, Márcia Maria Fontão
2016-01-01
The aim of this study was to identify the perceptions of blood donors and recipients regarding the act of donating blood. This descriptive study with a survey design focuses on subjective and cultural aspects. Twenty donors and 20 recipients in the blood bank at the time of data collection participated in the study. Interviews were analyzed according to deductive thematic analysis. Two themes emerged - perceptions of donors and perceptions of recipients. Both groups saw the act of donating blood as something positive, though donors associated their reports with the experiences of people close to them who needed blood transfusions, while the recipients associated donations with the maintenance of their lives as, for them, a blood transfusion was a necessary medical treatment. Perceptions regarding blood donations are culturally constructed, as the participants associated knowledge acquired in the social world with moral issues and their life experiences. Hence, in addition to helping others, these individuals feel socially and morally rewarded. Copyright © 2016 Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular. Published by Elsevier Editora Ltda. All rights reserved.
van den Hoogen, Martijn W F; Kho, Marcia M L; Abrahams, Alferso C; van Zuilen, Arjan D; Sanders, Jan-Stephan; van Dijk, Marja; Hilbrands, Luuk B; Weimar, Willem; Hoitsma, Andries J
2013-04-01
Reducing the incidence of delayed graft function after transplant with donation after cardiac death donor renal allografts would facilitate managing recipients during their first weeks after a transplant. To reduce this incidence, in most studies, induction therapy with depleting anti-T-lymphocyte antibodies is coupled with a reduction of the dosage of the calcineurin inhibitor. The separate effect of anti-T-cell therapy on the incidence and duration of delayed graft function is therefore difficult to assess. We performed a randomized study to evaluate the effect of a single intraoperative high-dose of anti-T-lymphocyte immunoglobulin (ATG)-Fresenius (9 mg/kg body weight) on the incidence of delayed graft function. Eligible adult recipients of a first donation after cardiac death donor renal allograft were randomly assigned to ATG-Fresenius or no induction therapy. Maintenance immunosuppression consisted of tacrolimus, in an unadjusted dose, mycophenolate mofetil, and steroids. The study was prematurely terminated because of a lower-than-anticipated inclusion rate. Baseline characteristics were comparable in the ATG-Fresenius group (n=28) and the control group (n=24). Twenty-two patients in the ATG-Fresenius group (79%) had delayed graft function, compared with 13 in the control group (54%; P = .06). Allograft and patient survival were comparable in both groups. Serious adverse events occurred more frequently in the ATG-Fresenius group than they did in the control group (57% vs 29%; P < .05). Intraoperative administration of a single high-dose of ATG-Fresenius in donation after cardiac death donor renal allograft recipients, followed by triple immunosuppression with an unadjusted tacrolimus dose, seems ineffective to reduce the incidence of delayed graft function. Moreover, this was associated with a higher rate of serious adverse events (EudraCT-number, 2007-000210-36.).
van Walraven, S M; Straathof, L M; Switzer, G E; Lankester, A; Korthof, E T; Brand, A; Ball, L M
2013-01-01
Since 1968, when Leiden undertook the first successful European pediatric BM transplantation with a 7-year-old sibling donor, more than 300 young children have donated BM in our unit. We first retrospectively studied a cohort of 210 donors, younger than 13 years at donation, to survey procedures of donor eligibility and study immediate effects of BM donation. We then performed a long-term follow-up (FU) and health-related quality of life (HRQoL) study. Despite documentation of previous medical conditions, no child was declared unfit to donate. We found that iron deficiency anemia or low-iron stores in BM did not result in treatment or extended FU. Harvest volumes exceeded 15 mL/kg in 65% of donors, with more than half requiring allogeneic blood transfusions. Donors had no structured FU after their first post-donation control. In this study, 25% of donors reported at least one somatic complaint at long-term FU. Finally long-term HRQoL revealed high scores in most subdomains (representing a higher QoL), compared to norm groups. These results indicate the need for development of (inter)national guidelines for pediatric stem cell donor care management.
Mwachaka, Philip Maseghe; Mandela, Pamela; Saidi, Hassan
2016-01-01
The use of unclaimed bodies for anatomical dissection has been the main method of instruction at our institution. There is however a shortage of cadavers for dissection given the increase in the number of medical schools as well as in the number of students enrolling in these schools. This shortage could be mitigated by having voluntary human body donation programs. This study aimed at assessing the attitudes of medical students and surgical residents towards body donation for anatomy learning. We conducted an online survey involving 72 first-year medical students and 41 surgical residents at University of Nairobi who had completed one year of anatomy dissection. For the medical students, this was their first dissection experience while it was the second exposure for the surgery trainees. Most of the surgical trainees (70.7%) and medical students (68.1%) were opposed to self-body donation. This was mainly due to cultural (37%) and religious (20%) barriers. Surprisingly, of those not willing to donate themselves, 67.9% (82.8% surgical trainees, 59.2% medical students) would recommend the practice to other people. Exposure to repeated dissection does not change the perceptions towards body donation. It is noteworthy that culture and religion rank high as clear barriers amongst this “highly informed” group of potential donors. PMID:27190650
Mwachaka, Philip Maseghe; Mandela, Pamela; Saidi, Hassan
2016-01-01
The use of unclaimed bodies for anatomical dissection has been the main method of instruction at our institution. There is however a shortage of cadavers for dissection given the increase in the number of medical schools as well as in the number of students enrolling in these schools. This shortage could be mitigated by having voluntary human body donation programs. This study aimed at assessing the attitudes of medical students and surgical residents towards body donation for anatomy learning. We conducted an online survey involving 72 first-year medical students and 41 surgical residents at University of Nairobi who had completed one year of anatomy dissection. For the medical students, this was their first dissection experience while it was the second exposure for the surgery trainees. Most of the surgical trainees (70.7%) and medical students (68.1%) were opposed to self-body donation. This was mainly due to cultural (37%) and religious (20%) barriers. Surprisingly, of those not willing to donate themselves, 67.9% (82.8% surgical trainees, 59.2% medical students) would recommend the practice to other people. Exposure to repeated dissection does not change the perceptions towards body donation. It is noteworthy that culture and religion rank high as clear barriers amongst this "highly informed" group of potential donors.
Beyond the Officially Sacred, Donor and Believer: Religion and Organ Transplantation.
Messina, E
2015-09-01
Religious concerns might represent an important issue when donation for transplantation is discussed. Even if no religious tradition formally forbids organ donation and transplantation, members of the same religious group may have differing and often conflicting opinions in their own interpretation of how their religion encourages and/or supports organ donation and transplantation, as discussed in this article. It also should be considered that even if a religion refuses to define concrete rules about organ donation and transplantation, there are a great number of factors that may influence the decision-making process. Examples may include negative perceptions of the cutting and removal of organs or ignorance about the transplantation system, both of which would influence the decision-making process concerning transplantation. Knowledge of these facts may provide useful information, perhaps increasing transplant numbers. Copyright © 2015 Elsevier Inc. All rights reserved.
Exploring barriers to organ donation in the African-American communities of California.
Law, Debra R; McNiesh, Susan
2012-07-01
There are a disproportionate number of African-Americans on transplant waiting lists across the country. The outcomes of a transplant are greatly improved when the donor and the recipient are from the same ethnic group. Sadly, the demand for cadaver organs in the African-American community exceeds the supply. Researchers in the past have sought to identify barriers to organ and tissue donation. To date, the studies have been conducted in the eastern and southern regions of the United States. This study examines whether the previously identified barriers are applicable in the African-American communities of California. A revised version of the Bone Marrow Donation Intention Tool was administered both in person and online. A t-test was used for analysis. The findings revealed statistically significant agreement/disagreement statements. These statements indicated that the barriers to organ donation from other areas of the United States were not representative of the respondents on the west coast.
Knowing blood donation surroundings: Implications for nurse service in hemotherapy.
Silva, Gilce Erbe de Miranda; Valadares, Glaucia Valente
2015-01-01
The study aims at discussing the significations apprehended by the non-blood donators, considering the context and the consequences of the acting of the nurse in hemotherapy. It is a qualitative approach, with theoretical frame of Symbolic Interactionism and Grounded Theory method. The data production was carried out by intensive interview with subjects of three sample groups of a University Hospital of Rio de Janeiro City. The phenomenon originated two analysis categories: "Perceiving the blood matter" and "Reflecting about the blood donation campaigns". It was observed that the environment of the donor is not composed by contact with the other and the information that it can achieve, including the media. These were the main basis for the knowledge of blood donation according to their beliefs, culture and values. Therefore, all these aspects must be considered by the nurse acting on donors capture.
Willingness to participate in organ donation among black Seventh-Day Adventist college students.
Cort, Malcolm; Cort, David
2008-01-01
The authors studied a group of black and white Seventh-Day Adventist (SDA) college students (N = 334) to compare the power of religious socialization with racial socialization. The authors compared the levels of willingness to donate organs between black and nonblack students in an availability sample. Black SDA college students were significantly more likely than white SDA students or SDA students of other races to perceive racism in the healthcare system and to believe that doctors would not make heroic efforts to save their lives if they knew they were organ donors; they were 66.9% less likely to donate organs than were white SDA students or SDA students of other races. Despite a common religion with a purposive indoctrination, the racial socialization of black SDA students exerted a stronger influence on willingness to participate in organ donation than did that of white students and students of other races within this religion.
Payment for whole blood donations in Lithuania: the risk for infectious disease markers.
Kalibatas, V
2008-04-01
In Lithuania, remuneration for whole blood donations still prevails, with the government covering payment for the donors. The payment per donation in cash is equal to 40 litas (euro11.6); it is offered to all blood donors and accepted by the majority of them. Donors who gave blood and received the payment are treated as remunerated donors; those who gave blood and did not take the payment are treated as non-remunerated ones. The purpose of this study was to assess the risk of payment for whole blood donations and to analyse the prevalence of infectious diseases markers per 100 remunerated and non-remunerated, first-time and regular whole blood donations, and to compare the risk ratios of infectious disease markers of remunerated and non-remunerated whole blood donations in 2005 and 2006 at the National Blood Center in Lithuania. Whole blood donors were categorized as follows: (i) first-time donor, remunerated; (ii) first-time donor, non-remunerated; (iii) regular donor, remunerated; and (iv) regular donor, non-remunerated. The blood donations were analysed for the presence or absence of the following infectious disease markers: anti-hepatitis C virus (anti-HCV), hepatitis B surface antigen (HBsAg), anti-human immunodeficiency virus (anti-HIV (1)/(2)) and syphilis. Only confirmed infectious disease markers were classified. To assess the risk of payment for whole blood donations, the prevalence of infectious disease markers per 100 donations in the different donor groups and the risk ratios between the remunerated and non-remunerated donations were determined. The prevalence per 100 first-time remunerated donations was: for anti-HCV 1.84 (2005) and 2.98 (2006); for HBsAg 1.73 (2005) and 2.03 (2006); for syphilis 0.67 (2005) and 1.03 (2006). The prevalence per 100 first-time non-remunerated donations was: for anti-HCV 0.93 (2005) and 0.98 (2006); for HBsAg 1.57 (2005) and 1.33 (2006); for syphilis 0.29 (2005) and 0.47 (2006). The first-time donors who were remunerated for whole blood donations had a significantly higher prevalence of infectious disease markers per 100 donations and a higher risk ratio for at least three infectious disease markers (HBsAg, anti-HCV and syphilis) as compared to first-time donors who were non-remunerated. The regular donors who were non-remunerated for whole blood donations had the lowest prevalence of all infectious disease markers: anti-HCV -0.03 (2005) and 0.04 (2005); syphilis -0.06 (2005) and 0.02 (2006); and any positive cases of HBsAg and anti-HIV (1)/(2) were found both in 2005 and 2006. No statistically significance differences in incidence and risk ratio existed when comparing the regular donations who were remunerated and non-remunerated. The payment for whole blood donors provides a higher risk for infectious disease markers of first-time donations at the National Blood Center in Lithuania.
Walker, Tim; Steckler, Del; Spellman, Stephen; Haven, Darlene; Welte, Kathy; Boo, Michael
2012-04-01
This study measured: 1) levels of awareness and understanding among practicing obstetricians regarding umbilical cord blood (UCB) donation and the use of UCB in transplant therapy, 2) motivations for obstetricians to support donation and collection for donation to a public cord blood bank (CBB), and 3) current practices for discussing this option with their patients. Obstetricians practicing in major metropolitan areas in the United States were randomly surveyed in 2009. Of 2041 surveys mailed, 295 were returned, 139 from obstetricians with privileges at hospitals affiliated with a public CBB (affiliated) and 156 from obstetricians without such privileges (nonaffiliated). Cross-tabulation analyses were conducted to compare responses between these two groups. Both affiliated and nonaffiliated obstetricians report being somewhat or very familiar with the use of cord blood in transplant therapy (88% vs. 82%, respectively; p = NS), but some misperceptions concerning clinical application exist. Eighty percent of affiliated obstetricians feel confident discussing cord blood options with their patients; however, 49% indicated that they have insufficient knowledge of cord blood donation to effectively answer patients' questions about donation. Obstetricians are generally familiar with the utility of donated cord blood in transplantation, but could benefit from additional information regarding how cord blood is used in transplantation. Further, obstetricians play an important role in encouraging women to donate their baby's cord blood to a public CBB, are willing to do so, and indicate a desire for more information so they can effectively educate their patients. © 2011 American Association of Blood Banks.
Kuszewski, Piotr; Kostro, Karol; Łoś, Andrzej; Kłakus, Piotr
2015-01-01
The Conscious Body Donation Program conducted since 2003 by the Department of Human Anatomy, Medical University of Silesia in Katowice was the first innovative project aimed at obtaining informed donors' bodies for the purpose of teaching anatomy in Poland. The aim of this prospective study was to determine the declared donors' characteristics and to establish the possible motivation for body donation. A total of 244 application files were reviewed and the following information was analyzed: donor’s age, age at which the decision to donate the body was made, donor’s place of residence and declared nationality, family background, education and profession, family structure and religion. Our results showed that mainly elderly people decided to donate their bodies (68.5 ± 11.84 years), living mostly in large and medium-sized cities. Men - donors often lived in small towns. Most of the donors were of blue-collar parentage, completed secondary education and at the time of taking decision to donate where married and retired. Widows were more likely to make the decision to donate than widowers. Most of our donors were Catholic. Our analysis of the profile of Polish donors may be useful to understand better for which groups of people death is not to be perceived as the end, and may become a value, which can be beneficial to living people. PMID:25790303
Changes in the Whole Blood Donor Population in South-West Germany: 2010 versus 2016
Müller-Steinhardt, Michael; Weidmann, Christian; Klüter, Harald
2017-01-01
Background In the recent past, the discrepancy between blood supply and future demand may have been overestimated. As medical progress develops rapidly, it will be essential to monitor ongoing demographic changes in the donor population regularly and to re-evaluate retention and recruiting strategies. The aim of the current study was to compare first-time donor (FTD) characteristics and their return rates. We therefore compared whole blood (WB) donations in total and the annual donation frequencies in 2010 and in 2015/2016. Furthermore, we evaluated whether over the same observation period, medical reasons for deferral underwent a change (2010 vs. 2015). Methods The return probability of FTD within 12 months was analysed in 2010 and 2015 with respect to successful donation versus deferral and with regard to age. The total number of WB donations was investigated, and age distribution was compared between 2010, 2013 and 2016. WB donation frequencies were calculated with respect to age and gender in 2010 and 2016. In a second analysis, medical reasons for deferral were differentiated into 14 categories and a possible impact of time (2010 vs. 2015) on the respective percentage was studied. Results We observed a significant decline of the FTD return rate from 42.5% to 38.8% in donors that successfully donated WB while the rate remained unchanged in deferred FTD. At the same time the mean FTD age decreased from 29.1 ± 11.6 to 28.5 ± 11.7 years in 2016. Analysis of total WB donations revealed an increase of all donations from donors ≥60 years, a constant percentage from donors <30 years but a declining proportion of donors aged 30–59 years from 2010 to 2013 to 2016. In parallel, annual mean WB donation frequencies decreased over time. Deferrals due to travel history increased significantly from 2010 to 2015 both in FTD and repeat donors. Conclusion There is ongoing demographic change in our WB donor population. Our data prove a need for a re-evaluation of retention and recruitment strategies since previous marketing campaigns seem to have neglected the age group 30–59 years. This must be addressed in further studies as this age group will be highly relevant for assuring future blood supplies since donor recruitment from adolescents will be limited due to declining birth rates. Furthermore, deferral due to travel history is increasing significantly. Thus we will require further studies on the possible impact on donor retention. PMID:28924426
Parent psychological adjustment, donor conception and disclosure: a follow-up over 10 years
Blake, L.; Jadva, V.; Golombok, S.
2014-01-01
STUDY QUESTION What is the relationship between parent psychological adjustment, type of gamete donation (donor insemination, egg donation) and parents' disclosure of their use of donated gametes to their children. SUMMARY ANSWER Disclosure of donor origins to the child was not always associated with optimal levels of psychological adjustment, especially for fathers in donor insemination families. WHAT IS KNOWN ALREADY Cross-sectional analyses have found mothers and fathers who conceived a child using donated sperm or eggs to be psychologically well-adjusted, with few differences emerging between parents in gamete donation families and parents in families in which parents conceived naturally. The relationship between mothers' and fathers' psychological well-being, type of gamete donation (donor insemination, egg donation) and parents' disclosure decisions has not yet been examined. STUDY DESIGN, SIZE, DURATION In this follow-up study, data were obtained from mothers and fathers in donor insemination and egg donation families at 5 time points; when the children in the families were aged 1, 2, 3, 7 and 10. In the first phase of the study, 50 donor insemination families and 51 egg donation families with a 1-year-old child participated. By age 10, the study included 34 families with a child conceived by donor insemination and 30 families with a child conceived by egg donation, representing 68 and 58% of the original sample, respectively. PARTICIPANTS/MATERIALS, SETTING, METHODS Families were recruited through nine fertility clinics in the UK. Standardized questionnaires assessing depression, stress and anxiety were administered to mothers and fathers in donor insemination and egg donation families. MAIN RESULTS AND THE ROLE OF CHANCE Mothers and fathers in both donor insemination and egg donation families were found to be psychologically well-adjusted; for the vast majority of parents' levels of depression, anxiety and parenting stress were found to be within the normal range at all 5 time points. Disclosure of the child's donor origins to the child was not always associated with optimal levels of parental psychological adjustment. For example, disclosure was associated with lower levels of psychological well-being for certain groups in particular (such as fathers in donor insemination families), at certain times (when children are in middle childhood and have a more sophisticated understanding of their donor origins). LIMITATIONS, REASONS FOR CAUTION Owing to small sample sizes, the value of this study lies not in its generalizability, but in its potential to point future research in new directions. WIDER IMPLICATIONS OF THE FINDINGS Donor insemination and egg donation families are a heterogeneous group, and future research should endeavour to obtain data from fathers as well as mothers. Support and guidance in terms of disclosure and family functioning might be most beneficial for parents (and especially fathers) in donor insemination families, particularly as the child grows older. The more that is known about the process of disclosure over time, from the perspective of the different members of the family, the better supported parents and their children can be. STUDY FUNDING COMPETING INTEREST(S) The project described was supported by grant number RO1HD051621 from the National Institute of Child Health and Human Development. The content is solely the responsibility of the authors and does not represent the official views of the National Institute of Child Health and Human Development or the National Institutes of Health. The authors have no conflict of interest to declare. PMID:25240010
Noyes, Jane; Morgan, Karen; Walton, Phillip; Roberts, Abigail; Mclaughlin, Leah; Stephens, Michael
2017-01-01
Introduction The Human Transplantation (Wales) Act 2013 (the Act) introduced a ‘soft opt-out’ system of organ donation on 1 December 2015. Citizens are encouraged to make their organ donation decision known during their lifetime. In order to work, the Act and media campaign need to create a context, whereby organ donation becomes the norm, and create a mechanism for people to behave as intended (formally register their decision; consider appointing a representative; convey their donation decision to their families and friends or do nothing—deemed consent). In addition, family members/appointed representatives need to be able to put their own views aside to support the decision of their loved one. The aim of this study is to evaluate initial implementation, outcomes and impact on families and appointed representatives who were approached about organ donation during the first 18 months. Methods and analysis Prospective mixed-method coproductive study undertaken with National Health Service Blood and Transplant (NHSBT), and multiple patient/public representatives. The study is designed to collect information on all cases who meet specified criteria (≥18 years, deceased person voluntarily resident in Wales and died in Wales or England) whose family were approached between 1 December 2015 and 31 June 2017). Data for analysis include: NHSBT routinely collected anonymised audit data on all cases; Specialist Nurse in Organ Donation (SNOD) completed anonymised form for all cases documenting their perception of the families’ understanding of the Act, media campaign and outcome of the donation approach; questionnaires and depth interviews with any family member or appointed representative (minimum 50 cases). Additional focus groups and interviews with SNODs. Anonymised donation outcomes and registration activity reports for Wales provide additional context. Ethics and dissemination Approved by NHSBT Research, Innovation and Technology Advisory Group on 23 October 2015; Wales Research Ethics Committee 5 (IRAS190066; Rec Reference 15/WA/0414) on 25 November 2015 and NHSBT R&D Committee (NHSBT ID: AP-15–02) on 24 November 2015. Registration The protocol is registered on the Health and Care Research Wales Clinical Research Portfolio. Study ID number 34396, www.ukctg.nihr.ac.uk PMID:29025839
Noyes, Jane; Morgan, Karen; Walton, Phillip; Roberts, Abigail; Mclaughlin, Leah; Stephens, Michael
2017-10-12
The Human Transplantation (Wales) Act 2013 (the Act) introduced a 'soft opt-out' system of organ donation on 1 December 2015. Citizens are encouraged to make their organ donation decision known during their lifetime. In order to work, the Act and media campaign need to create a context, whereby organ donation becomes the norm, and create a mechanism for people to behave as intended (formally register their decision; consider appointing a representative; convey their donation decision to their families and friends or do nothing-deemed consent). In addition, family members/appointed representatives need to be able to put their own views aside to support the decision of their loved one. The aim of this study is to evaluate initial implementation, outcomes and impact on families and appointed representatives who were approached about organ donation during the first 18 months. Prospective mixed-method coproductive study undertaken with National Health Service Blood and Transplant (NHSBT), and multiple patient/public representatives. The study is designed to collect information on all cases who meet specified criteria (≥18 years, deceased person voluntarily resident in Wales and died in Wales or England) whose family were approached between 1 December 2015 and 31 June 2017). Data for analysis include: NHSBT routinely collected anonymised audit data on all cases; Specialist Nurse in Organ Donation (SNOD) completed anonymised form for all cases documenting their perception of the families' understanding of the Act, media campaign and outcome of the donation approach; questionnaires and depth interviews with any family member or appointed representative (minimum 50 cases). Additional focus groups and interviews with SNODs. Anonymised donation outcomes and registration activity reports for Wales provide additional context. Approved by NHSBT Research, Innovation and Technology Advisory Group on 23 October 2015; Wales Research Ethics Committee 5 (IRAS190066; Rec Reference 15/WA/0414) on 25 November 2015 and NHSBT R&D Committee (NHSBT ID: AP-15-02) on 24 November 2015. The protocol is registered on the Health and Care Research Wales Clinical Research Portfolio. Study ID number 34396, www.ukctg.nihr.ac.uk. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Premortem interventions in dying children to optimise organ donation: an ethical analysis.
Brierley, Joe; Shaw, David
2016-07-01
A range of interventions in dying patients can improve both the possibility of successful organ donation and the likely long-term success of transplantation. The ethical and legal issues surrounding such interventions, which most frequently occur in the context of donation after circulatory determination of death, are complex, controversial and many remain unresolved. This is true with adults, but even more so with children, where the issue of organ donation and premortem interventions to facilitate it, are highly sensitive. Essentially, such interventions are being undertaken in dying children who cannot medically benefit from them, though arguments have been advanced that becoming a donor might be in a child's extended best interest. However, certain interventions carry a potential risk, although small, of direct harm and of course overall objections to child donation after circulatory determination of death per se are still expressed in the literature. But, unlike the case in critically ill adults, those giving permission for such interventions are normally able to fully participate in decision-making, and indeed to consent, to both donation and premortem interventions. We review the issue of the use of premortem interventions in dying children to facilitate organ donation, including decision-making and ethical justification. Individual interventions are then considered, including an ethical analyse of their use. Finally, we recommend an approach using a combination of welfare checklist strategy, coupled with the establishment of an agreed zone of parental discretion about individual interventions which might be used in dying children to increase the possibility of successful organ donation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Organ Donation From Deceased Donors: A Proactive Detection Program in Saudi Arabia.
Shaheen, Faissal A M; Souqiyyeh, Muhammad Ziad; Attar, Besher; Ibrahim, Amal; Alsayyari, Abdulla
2015-11-01
Several challenging obstacles remain to increasing the number of organ donations from deceased patients in a hospital setting. These include medical, administrative, and ethical issues. Possible medical obstacles include the failure of early recognition of possible donors and inadequate care of potential and actual donors. To maximize the use of donated organs, proper care of the donors and expedited donor consent cannot be overemphasized. The care rendered to patients should ensure appropriate perfusion and nutrition of the organs, with meticulous follow-up until organ recovery. For example, patients involved in accidents are presumed to be healthy, but many have no available medical history on file. At the time of organ recovery, unexpected infections or malignancies can be minimized by raising the index of suspicion of the presence of serious conditions in donors, especially in donors with unknown medical history. A careful physical examination and an appropriate and aggressive laboratory investigation may disclose the cause of suspected clinical conditions in these potential donors. Individuals who work in intensive care units are the main group of health care providers directly involved in the process of organ donation. Appointing a donor coordinator in each intensive care unit could improve all aspects of organ donation. Such coordination could harmonize efforts toward the goals mentioned above and surmount the obstacles encountered during deceased-donor organ donation. Here, we describe the preliminary results of the Proactive Detection Program, a collaboration between the Saudi Center for Organ Transplantation (the national organ donation and transplant supervising center) and intensive care units of donating hospitals. With its success in Saudi Arabia, it is hoped that it will be widely adopted in other regions.
Entrepreneurial ventures and whole-body donations: a regional perspective from the United States.
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.
Disease registries on the nationwide health information network.
Russler, Daniel
2011-05-01
Donation by individuals of their protected health information (PHI) for evidence-based research potentially benefits all individuals with disease through improved understandings of disease patterns. In the future, a better understanding of how disease features combine into unique patterns of disease will generate new disease classifications, supporting greater specificity in health management techniques. However, without large numbers of people who donate their PHI to disease registries designed for research, it is difficult for researchers to discover the existence of complex patterns or to create more specific evidence-based management techniques. In order to identify new opportunities in disease registry design, an analysis of the current stage of maturity of the newly created U.S. Nationwide Health Information Network (NwHIN) related to large-scale consumer donation of PHI is presented. Utilizing a use-case analysis methodology, the consumer-centric designs of the policies and technologies created for the NwHIN were examined for the potential to support consumer donations of PHI to research. The NwHIN design has placed the enforcement point for the policy-based release of PHI over the Internet into a specialized gateway accessible to consumer authorization. However, current NwHIN policies leave the final decision regarding release of PHI for research to the health care providers rather than to the consumers themselves. Should disease registries designed for research be established on the NwHIN, consumers might then directly authorize the donation of their PHI to these disease registries. However, under current NwHIN policies, consumer authorization does not guarantee release of PHI by health providers. © 2011 Diabetes Technology Society.
Ethical issues surrounding the use of images from donated cadavers in the anatomical sciences.
Cornwall, Jon; Callahan, David; Wee, Richman
2016-01-01
Body donor programs rely on the generosity and trust of the public to facilitate the provision of cadaver resources for anatomical education and research. The uptake and adoption of emerging technologies, including those allowing the acquisition and distribution of images, are becoming more widespread, including within anatomical science education. Images of cadavers are useful for research and education, and their supply and distribution have commercial potential for textbooks and online education. It is unclear whether the utilization of images of donated cadavers are congruent with donor expectations, societal norms and boundaries of established public understanding. Presently, no global "best practices" or standards exist, nor is there a common model requiring specific image-related consent from body donors. As ongoing success of body donation programs relies upon the ethical and institutional governance of body utilization to maintain trust and a positive relationship with potential donors and the community, discussions considering the potential impact of image misuse are important. This paper discusses the subject of images of donated cadavers, commenting on images in non-specific use, education, research, and commercial applications. It explores the role and significance of such images in the context of anatomical science and society, and discusses how misuse - including unconsented use - of images has the potential to affect donor program success, suggesting that informed consent is currently necessary for all images arising from donated cadavers. Its purpose is to encourage discussion to guide responsible utilization of cadaver images, while protecting the interests of body donors and the public. © 2015 Wiley Periodicals, Inc.
How You Can Help Medical Research: Donating Your Blood, Tissue, and Other Samples
... of your name. Your address, phone number, Social Security number, date of birth, and anything else that could identify you will be removed before the records are sent to the researcher. Federal law requires the protection of your private medical information. • Are there any ...
Under multilevel selection: "when shall you be neither spiteful nor envious?".
Garay, József; Csiszár, Villő; Móri, Tamás F
2014-01-07
In this paper, we study the egalitarianism-game in multilevel selection situation. The individuals form reproductive groups. In each group, an egalitarianism-game determines the number of juveniles of different phenotypes (spiteful, envious, neutral and donator). Before the juveniles form the next reproductive group, they have to survive either predators' attacks or a fight between two groups. We adopt the ESS definition of Maynard Smith to multilevel selection. Based on the "group size advantage" assumption (which claims that each juvenile's survival rate depends on the size of his own group, supposing that either the survival rate under predators' attacks is higher in larger groups, or in inter-group aggression usually the larger group wins) we found that when the survival probability has a massive effect on the average fitness, then "group fitness maximizing behavior" (in our case, either neutral or donator) has evolutionary advantage over "competitive behavior" (in our case, either spiteful or envious). © 2013 Elsevier Ltd. All rights reserved.
Knowledge and attitude of ICU nurses, students and patients towards the Austrian organ donation law
2013-01-01
Background A survey on the knowledge and attitudes towards the Austrian organ donation legislation (an opt-out solution) of selected groups of the Austrian population taking into account factors such as age, gender, level of education, affiliation to healthcare professions and health related studies was conducted. Methods An online survey among 3 target groups (ICU nurses, health science students and non health science students) was performed and results were compared to the answers from transplantation patients to a paper questionnaire. A total of 8415 persons were asked to participate in the survey and 2025 (24%) persons correctly completed the questionnaire. 1945 online responses (ICU nurses n = 185; students of health sciences n = 1277; students of non-health science related courses n = 483) were analysed and data were compared to 80 manually filled-in responses from patients from a previous study. Results 84% of participants state that they know the Austrian organ donation legislation; this percentage varies significantly (p < 0.05) within the target groups and is influenced by demographic variables of the participants. 74% think that the law is good and 79% do not favour a change. Opinions and attitudes towards the legal situation are positively influenced by the affiliation to healthcare professions and health-related fields of study. Interviewed persons who were aware of the legislation before the survey had a more positive attitude towards the existing legislation (77% versus 74%, p < 0.05). Conclusions The information level on Austrian organ donation legislation is high. ICU nurses and those who did not know the law before were most critical towards the existing legislation. Therefore education to increase knowledge in the general population and goal-oriented efforts to increase awareness in the target groups should be emphasized. PMID:23948068
Roque, Ana; Lima, João Carlos; Parola, A Jorge; Pina, Fernando
2007-04-01
Useful application of photochromic compounds as optical memories implies the existence of a large kinetic barrier between the forms interconverted by light. In the case of flavylium salts, the ground state isomerization barrier between the photoisomerizable chalcone isomers is shown to correlate with the electron donating ability of the substituents, measured by their effects in the (1)H NMR chemical shifts of the aromatic protons. Substitution with electron donating groups in ring A lowers the barrier while substitution at ring B has the opposite effect. However, in water, the observed increase is higher than expected in the case of compound 4',9-dihydroxychalcone when compared with the analogous 4'-dimethylamino-9-hydroxychalcone, containing a better electron donating group in the same position. Our interpretation is that the water network is providing an efficient pathway to form tautomers. In acetonitrile, unlike water, the expected order is indeed observed: E(a)(4',9-dihydroxychalcone) = 60 kJ mol(-1) < E(a) (4'-dimethylamino-9-hydroxychalcone) = 69 kJ mol(-1).
Yen, Glorian P; Davey, Adam; Ma, Grace X
2015-04-01
Biorepositories have been key resources in examining genetically-linked diseases, particularly cancer. Asian Americans contribute to biorepositories at lower rates than other racial groups, but the reasons for this are unclear. We hypothesized that attitudes toward biospecimen research mediate the relationship between demographic and healthcare access factors, and willingness to donate blood for research purposes among individuals of Korean heritage. Descriptive statistics and bivariate analyses were utilized to characterize the sample with respect to demographic, psychosocial, and behavioral variables. Structural equation modeling with 5000 re-sample bootstrapping was used to assess each component of the proposed simple mediation models. Attitudes towards biospecimen research fully mediate associations between age, income, number of years lived in the United States, and having a regular physician and willingness to donate blood for the purpose of research. Participants were willing to donate blood for the purpose of research despite having neutral feelings towards biospecimen research as a whole. Participants reported higher willingness to donate blood for research purposes when they were older, had lived in the United States longer, had higher income, and had a regular doctor that they visited. Many of the significant relationships between demographic and health care access factors, attitudes towards biospecimen research, and willingness to donate blood for the purpose of research may be explained by the extent of acculturation of the participants in the United States.
Paired kidney donations to expand the living donor pool.
Ferrari, Paolo; de Klerk, Marry
2009-01-01
The shortage of available deceased donors and the longer kidney transplant waiting lists in many countries around the world have placed greater emphasis on living donation (LD) as a means of meeting demand for transplantation in patients with end-stage kidney disease (ESKD). Increased LD rates are also driven by less invasive approaches to donor nephrectomy and by the excellent long-term results. LD kidney transplant outcomes are equivalent, if not superior, to those from deceased donors, even when donor and recipient are not genetically related, as is the case with spousal donations, the most frequent cohort of LD. Approximately 30% of willing and otherwise appropriate kidney donor/recipient pairs are biologically incompatible and do not proceed to live donor transplantation. In recent years, a number of strategies have been introduced to expand living donation programs beyond the classical direct donation, to overcome immunological barriers of blood group or HLA sensitization of recipients. New strategies in LD include paired kidney exchange (PKE), altruistic donation, altruistic donor chains and list exchange programs. Other alternative programs are desensitization and transplantation across the blood-type barrier. Regular PKE programs operate nationally in The Netherlands and the United Kingdom, or regionally in South Korea, Romania, the United States and Australia. If PKE were performed routinely using 2-way or 3-way PKE and altruistic donor chains, the rate of kidney transplants could increase by between 7% and 10%.
Mumtaz, Zubia; Bowen, Sarah; Mumtaz, Rubina
2012-01-01
Contemporary public policy, supported by international arbitrators of blood policy such as the World Health Organization and the International Federation of the Red Cross, asserts that the safest blood is that donated by voluntary, non-remunerated donors from low-risk groups of the population. These policies promote anonymous donation and discourage kin-based or replacement donation. However, there is reason to question whether these policies, based largely on Western research and beliefs, are the most appropriate for ensuring an adequate safe blood supply in many other parts of the world. This research explored the various and complex meanings embedded in blood using empirical ethnographic data from Pakistan, with the intent of informing development of a national blood policy in that country. Using a focused ethnographic approach, data were collected in 26 in-depth interviews, 6 focus group discussions, 12 key informant interviews and 25 hours of observations in blood banks and maternity and surgical wards. The key finding was that notions of caste-based purity of blood, together with the belief that donors and recipients are symbolically knitted in a kin relationship, place a preference on kin-blood. The anonymity inherent in current systems of blood extraction, storage and use as embedded in contemporary policy discourse and practice was problematic as it blurred distinctions that were important within this society. The article highlights the importance—to ensuring a safe blood supply—of basing blood procurement policies on local, context-specific belief systems rather than relying on uniform, one-size-fits-all global policies. Drawing on our empirical findings and the literature, it is argued that the practice of kin-donated blood remains a feasible alternative to the global ideal of voluntary, anonymous donations. There is a need to focus on developing context-sensitive strategies for promoting blood safety, and critically revisit the assumptions underlying contemporary global blood procurement policies. PMID:21372061
Without discrimination for religion, race, or gender.
Ben-David, Orit Brawer; Abu-Rabi, Aref
2002-01-01
The transplantation of organs, which at first sight appears to be just a technical medical procedure, is, first and foremost a sociocultural action that gives expression to existential perceptions. In Israeli society, as in most western societies the donation of the body or parts of it, is interpreted as possible at a societal level, and not as a gift from one individual to another. The medical achievement inherent in organ transplantation brings forward the relationship between the body, death and society. The moment the body ceases to function biologically, its position within the social entity is examined. The donation of organs evinces the acceptance of the idea that the personal body belongs to the society which sanctions the transition of the private body into organs that become national assets. This research is a first attempt to study the motives of people from Muslim society, who donated organs of their dear ones. The ability of these people to enter into a system of exchange flows from a tacit assumption by all of them that the action is approved by their social group. This paper presents the concepts of death and of the body that enable donation in general and the donation of the Muslim population in particular.
Incentivizing Blood Donation: Systematic Review and Meta-Analysis to Test Titmuss’ Hypotheses
2013-01-01
Objectives: Titmuss hypothesized that paying blood donors would reduce the quality of the blood donated and would be economically inefficient. We report here the first systematic review to test these hypotheses, reporting on both financial and nonfinancial incentives. Method: Studies deemed eligible for inclusion were peer-reviewed, experimental studies that presented data on the quantity (as a proxy for efficiency) and quality of blood donated in at least two groups: those donating blood when offered an incentive, and those donating blood with no offer of an incentive. The following were searched: MEDLINE, EMBASE and PsycINFO using OVID SP, CINAHL via EBSCO and CENTRAL, the Cochrane Library, Econlit via EBSCO, JSTOR Health and General Science Collection, and Google. Results: The initial search yielded 1100 abstracts, which resulted in 89 full papers being assessed for eligibility, of which seven studies, reported in six papers, met the inclusion criteria. The included studies involved 93,328 participants. Incentives had no impact on the likelihood of donation (OR = 1.22 CI 95% 0.91–1.63; p = .19). There was no difference between financial and nonfinancial incentives in the quantity of blood donated. Of the two studies that assessed quality of blood, one found no effect and the other found an adverse effect from the offer of a free cholesterol test (β = 0.011 p < .05). Conclusion: The limited evidence suggests that Titmuss’ hypothesis of the economic inefficiency of incentives is correct. There is insufficient evidence to assess their likely impact on the quality of the blood provided. PMID:24001244
Factors Influencing Dental Patient Participation in Biobanking and Biomedical Research.
Hassona, Yazan; Ahram, Mamoun; Odeh, Noorah; Abu Gosh, Mais; Scully, Crispian
To study the willingness of dental patients to donate biospecimens for research purpose and to examine factors that may influence such a decision. A face-to-face interview was conducted using a pretested structured survey instrument on 408 adult dental patients attending a university hospital for dental care. Descriptive statistics were generated, and the x03C7;2 test was used to examine differences between groups. p values ≤0.5 were considered statistically significant. Of the 408 participants, only 71 (17.4%) had heard of the terms biobanking/biospecimens, but 293 (71.9%) approved of the idea of using biospecimens for biomedical research, and 228 (55.9%) were willing to donate biospecimens and give personal information for research purposes. In participants who were unwilling to participate in biobanking, fear of information leakage was the most frequently reported reason, while in participants who were willing to donate biospecimens, the potential to provide more effective and less costly treatments was the most frequently reported reason. The preferences of the 228 participants who were willing to donate biospecimens were as follows: give a sample of removed oral tissues including extracted teeth (n = 105, 46.1%), donate a blood sample (n = 52, 23%), donate a sample of saliva (n = 43, 18.6%), and give a urine sample (n = 28, 12.3%). Dental patients had a generally positive attitude towards biomedical research and biobanking. The most preferred types of biospecimens to donate in a dental setting were removed tissues, including extracted teeth and blood samples. © 2016 S. Karger AG, Basel.
Prediction of hemoglobin in blood donors using a latent class mixed-effects transition model.
Nasserinejad, Kazem; van Rosmalen, Joost; de Kort, Wim; Rizopoulos, Dimitris; Lesaffre, Emmanuel
2016-02-20
Blood donors experience a temporary reduction in their hemoglobin (Hb) value after donation. At each visit, the Hb value is measured, and a too low Hb value leads to a deferral for donation. Because of the recovery process after each donation as well as state dependence and unobserved heterogeneity, longitudinal data of Hb values of blood donors provide unique statistical challenges. To estimate the shape and duration of the recovery process and to predict future Hb values, we employed three models for the Hb value: (i) a mixed-effects models; (ii) a latent-class mixed-effects model; and (iii) a latent-class mixed-effects transition model. In each model, a flexible function was used to model the recovery process after donation. The latent classes identify groups of donors with fast or slow recovery times and donors whose recovery time increases with the number of donations. The transition effect accounts for possible state dependence in the observed data. All models were estimated in a Bayesian way, using data of new entrant donors from the Donor InSight study. Informative priors were used for parameters of the recovery process that were not identified using the observed data, based on results from the clinical literature. The results show that the latent-class mixed-effects transition model fits the data best, which illustrates the importance of modeling state dependence, unobserved heterogeneity, and the recovery process after donation. The estimated recovery time is much longer than the current minimum interval between donations, suggesting that an increase of this interval may be warranted. Copyright © 2015 John Wiley & Sons, Ltd.
Hassall, O; Ngina, L; Kongo, W; Othigo, J; Mandaliya, K; Maitland, K; Bates, I
2008-01-01
Background and Objectives Severe anaemia, for which a blood transfusion can be life saving, is common in hospitalized children in sub-Saharan Africa but blood for transfusion is often in short supply. Umbilical cord blood is usually thrown away but could be a useful source of red cells for small volume transfusions in young children in this setting. The objective of this study was to evaluate the attitudes of women using the maternity services of the provincial hospital in Mombasa, Kenya, towards cord blood donation and transfusion, and essential aspects of this process including informed consent and the acceptability of screening for human immunodeficiency virus (HIV) infection. Materials and Methods A structured questionnaire was developed based on data provided by focus group discussions with women attending the hospital's maternity unit and administered to women who had recently delivered at the hospital. Results Of the 180 women who completed a questionnaire, the donation and transfusion of cord blood were acceptable to 81% and 78%, respectively. Ninety per cent of women who supported cord blood donation were willing to undergo further HIV testing at the time of delivery. Seventy-seven per cent of women wanted informed consent to be sought for cord blood donation and 66% of these felt they could make this decision alone. Conclusion The donation of umbilical cord blood and its transfusion are acceptable to the majority of women delivering at Coast Provincial General Hospital, Mombasa. Findings from the study will benefit the planned cord blood donation programme at this facility. PMID:18067489
Maggiore, Umberto; Budde, Klemens; Heemann, Uwe; Hilbrands, Luuk; Oberbauer, Rainer; Oniscu, Gabriel C; Pascual, Julio; Schwartz Sorensen, Soren; Viklicky, Ondrej; Abramowicz, Daniel
2017-02-01
Two recent matched cohort studies from the USA and Norway published in 2014 have raised some concerns related to the long-term safety of kidney living donation. Further studies on the long-term risks of living donation have since been published. In this position paper, Developing Education Science and Care for Renal Transplantation in European States (DESCARTES) board members critically review the literature in an effort to summarize the current knowledge concerning long-term risks of kidney living donation to help physicians for decision-making purposes and for providing information to the prospective live donors. Long-term risk of end-stage renal disease (ESRD) can be partially foreseen by trying to identify donors at risk of developing ‘de novo’ kidney diseases during life post-donation and by predicting lifetime ESRD risk. However, lifetime risk may be difficult to assess in young donors, especially in those having first-degree relatives with ESRD. The study from Norway also found an increased risk of death after living donor nephrectomy, which became visible only after >15 years of post-donation follow-up. However, these findings are likely to be largely the result of an overestimation due to the confounding effect related to a family history of renal disease. DESCARTES board members emphasize the importance of optimal risk–benefit assessment and proper information to the prospective donor, which should also include recommendations on health-promoting behaviour post-donation. © The Author 2017. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.
Vučetić, Dušan; Kecman, Gorica; Ilić, Vesna; Balint, Bela
2015-01-01
Background Members of armed forces worldwide are considered to be very susceptible to sexually transmitted infections, thus falling into a high-risk group of blood donors regarding transfusion-transmissible infections. In the Serbian Military Medical Academy a significant number (44% for the period 2005–2013) of blood donations were from members of the Serbian Army. The aim of this study was to determine the significance of military blood donors for the safety of blood transfusion. Material and methods Between January 2005 and December 2013, a total of 155,479 blood donations were tested for hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV) and syphilis using serological assays (enzyme immunoassays, chemiluminescent microparticle immunoassay and western blot) and molecular testing (polymerase chain reaction analysis). Results The percentage of blood donations positive for transfusion-transmissible infections in the estimated period was 0.38%, and the percentage of HBV, HCV, HIV and syphilis positive blood donations was 0.20%, 0.12%, 0.005% and 0.06%, respectively. During that period, the percentage of all transfusion-transmissible infections, and in particular of HBV and HCV, declined significantly. In contrast, the percentage of HIV and syphilis positive blood donations remained unchanged. Higher rates of positivity for transfusion-transmissible infections in blood donations from members of the Serbian Army were not found, especially after mandatory military service was abolished in 2009. Discussion The reported rate of positivity for transfusion-transmissible infections in blood donations from the Military Medical Academy was considered low. This information is of great significance for further implementation of public health measures. PMID:26057495
Long-term experiences of Norwegian live kidney donors: qualitative in-depth interviews.
Meyer, Käthe B; Bjørk, Ida Torunn; Wahl, Astrid Klopstad; Lennerling, Annette; Andersen, Marit Helen
2017-02-16
Live kidney donation is generally viewed as a welcome treatment option for severe kidney disease. However, there is a disparity in the body of research on donor experiences and postdonation outcome, and lack of knowledge on long-term consequences described by the donors. This study was conducted to provide insight into donors' subjective meanings and interpretation of their experiences ∼10 years after donation. Qualitative explorative in-depth interviews. The sampling strategy employed maximum variation. Setting Oslo University Hospital is the national centre for organ transplantation and donation in Norway, and there are 26 local nephrology centres. 16 donors representing all parts of Norway who donated a kidney in 2001-2004 participated in the study. The interviews were analysed using an interpretative approach. The analysis resulted in 4 main themes; the recipient outcome justified long-term experiences, family dynamics-tension still under the surface, ambivalence-healthy versus the need for regular follow-up, and life must go on. These themes reflect the complexity of live kidney donation, which fluctuated from positive experiences such as pride and feeling privileged to adverse experiences such as altered family relationships or reduced health. Live kidney donors seemed to possess resilient qualities that enabled them to address the long-term consequences of donation. The challenge is to provide more uniform information about long-term consequences. In future research, resilient qualities could be a topic to explore in live donation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Bani-Ahmad, M A; Khabour, O F; Gharibeh, M Y; Alshlool, K N
2017-11-01
The reduction in blood viscosity and iron store were proposed to be connected to the reduction in the risk of cardiovascular disease (CVD) among multiple blood donors. Herein, we evaluated the modulation of serum lipids levels in accordance with donation events. Furthermore, atherogenic impacts on the risk of CVD were investigated. A total of 100 voluntarily male donors were included in the study. Fifty donors were multiple time donors (MTD) and 50 were single time donors (STD). Levels of serum lipids were determined and atherogenic indices including TG/HDL and CHO/HDL ratios were calculated. QRISK2 parameters were determined to evaluate the 10-years risk of developing CVD. Among MTD, there were significantly higher serum levels of triglycerides (TG) and very low-density lipoproteins (VLDL) combined with significantly lower HDL level. These modulations were significantly correlated to the extent of donation. Both CHO/HDL and TG/HDL ratios were also significantly higher among MTD. However, only TG/HDL ratio was strongly correlated to the donation extent even when controlled for age, BMI and smoking status. Despite the significant difference in QRISK2 parameters between study groups, none of these parameters was correlated to the extent of donation when controlling for age, BMI and smoking status. We demonstrate that multiple blood donation is associated with an unfavorable modulation of serum levels of lipids that is influenced by donation extent. This modulation is not associated with an increased risk of CVD but may weakly contribute in a higher risk for coronary heart disease (CHD). Copyright © 2017 Elsevier Masson SAS. All rights reserved.
Dostanić, J; Lončarević, D; Zlatar, M; Vlahović, F; Jovanović, D M
2016-10-05
A series of arylazo pyridone dyes was synthesized by changing the type of the substituent group in the diazo moiety, ranging from strong electron-donating to strong electron-withdrawing groups. The structural and electronic properties of the investigated dyes was calculated at the M062X/6-31+G(d,p) level of theory. The observed good linear correlations between atomic charges and Hammett σp constants provided a basis to discuss the transmission of electronic substituent effects through a dye framework. The reactivity of synthesized dyes was tested through their decolorization efficiency in TiO2 photocatalytic system (Degussa P-25). Quantitative structure-activity relationship analysis revealed a strong correlation between reactivity of investigated dyes and Hammett substituent constants. The reaction was facilitated by electron-withdrawing groups, and retarded by electron-donating ones. Quantum mechanical calculations was used in order to describe the mechanism of the photocatalytic oxidation reactions of investigated dyes and interpret their reactivities within the framework of the Density Functional Theory (DFT). According to DFT based reactivity descriptors, i.e. Fukui functions and local softness, the active site moves from azo nitrogen atom linked to benzene ring to pyridone carbon atom linked to azo bond, going from dyes with electron-donating groups to dyes with electron-withdrawing groups. Copyright © 2016 Elsevier B.V. All rights reserved.
Abukhaizaran, Nidal; Hashem, Mohammed; Hroub, Osama; Belkebir, Souad; Demyati, Khaled
2018-02-21
Organ transplantation is the treatment of choice for organ failure, but organs are scarce and their availability is affected by relational ties, religious beliefs, cultural influences, body integrity, medical mistrust, and other factors. This aim of this study was to assess the knowledge, attitudes, and practices of Palestinian population with respect to organ donation. In this cross-sectional study, we used a validated questionnaire delivered by land telephone to collect data on the knowledge, attitudes, and practices relating to organ donation in the general population of the West Bank. Stratified sampling and simple random sampling were applied using data obtained from the Palestinian Telecommunication Group in 2016. Stata version 20 was used for statistical analysis, and a p value less than 0·05 was considered significant. Ethics approval was obtained from the Institutional Review Board of An-Najah National University, and all participants gave verbal informed consent. The questionnaire was completed by 385 (68%) of 565 people approached (mean age 42 years [SD 14·13]). 266 (69%) respondents were married, 311 (80%) were employed, and 375 (97%) were Muslim. 136 (35%) respondents were university students or post-graduates. Half of participants lived in urban areas. Local religious clergy were reported as being the source of general information by 150 (40%) participants. 273 (71%) respondents had adequate knowledge about organ donation, TV being the main source of information for 207 (60%) participants. 70 (26%) respondents would consider donation only after death, and 342 (67%) respondents would only consider donating to a close family member, whereas 341 (100%) respondents believed that their organ could be misused and 219 (64%) believed organ donation carries a health risk. 135 (49%) respondents preferred to donate to a recipient of the same religion. 266 (78%) individuals believed that organ donation should be promoted in the occupied Palestinian territory, although 188 (55%) reported organ donation to be culturally unacceptable. Religious beliefs and fears of complications were the main obstacles to organ donation. An adequate level of knowledge was associated with the female sex (p=0·008), level of education (p=0·046), monthly income (p=0·041), and marital status (p=0·012), whereas a positive attitude to organ donation was associated with religious score (p=0·015), marital status (p=0·031), and knowledge score (p=0·003). A high level of knowledge was associated with employment and the perception of organ donation as permitted in religion, whereas a positive attitude was associated with single marital status, high level of knowledge, and residence in cities. Despite adequate knowledge and positive attitudes towards organ donation, a comprehensive study is necessary to fully understand the local characteristics that influence organ donation by Palestinians and to better inform decision makers and future policies. None. Copyright © 2018 Elsevier Ltd. All rights reserved.
Positron annihilation studies in solid substituted aromatic compounds
NASA Astrophysics Data System (ADS)
Oliveira, F. C.; Oliveira, A. M.; Donnici, C. L.; Machado, J. C.; Magalhães, W. F.; Windmöller, D.; Fulgêncio, F. H.; Souza, L. R.
2011-04-01
Positronium formation was investigated in benzene and naphthalene compounds with electron donating (sbnd NH2 and sbnd OH) and electron withdrawing (sbnd CN and sbnd NO2) substituents. The results exhibit an increase in the positronium formation yield whenever donating groups are bound to the ring and a decrease with withdrawing groups. These results can be attributed to the π-system electronic density variation in the aromatic ring. The amount of positronium obtained, I3 parameter, has been correlated with the Hammett (σ) and Brown-Okamoto (σp+) constants and adjusted through the modified Hammett equation, which employs the ratio I3/I3ϕ, yielding a satisfactory fit.
Using an introduction website to start a family: implications for users and health practitioners.
Harper, Joyce; Jackson, Emily; Spoelstra-Witjens, Laura; Reisel, Dan
2017-06-01
Donor insemination treatment offered in licensed clinics protects the donor, recipient and offspring both medically and legally. The Internet has opened up novel, unregulated ways of donating sperm through 'introduction websites' and social media forums. Broadly, three categories of women use introduction websites: those who want to have a child with no further involvement of the donor; those who wish to know the identity of the donor from the start; and those who intend to electively co-parent, that is, to bring up the child together with the donor/father. Donors may choose to donate through introduction websites for altruistic reasons and/or in order to have greater involvement with the child. There are some donors who are motivated by the prospect of a sexual encounter, advertising their preference for 'natural insemination' - i.e. via sexual intercourse or partial intercourse. When people make their own arrangements online, they may do so in the absence of clear, accurate information. This article, sets out some of the issues that recipients and donors ought to consider before embarking on unregulated sperm donation.
2015-05-22
The Food and Drug Administration (FDA) is amending the regulations applicable to blood and blood components, including Source Plasma, to make the donor eligibility and testing requirements more consistent with current practices in the blood industry, to more closely align the regulations with current FDA recommendations, and to provide flexibility to accommodate advancing technology. In order to better assure the safety of the nation's blood supply and to help protect donor health, FDA is revising the requirements for blood establishments to test donors for infectious disease, and to determine that donors are eligible to donate and that donations are suitable for transfusion or further manufacture. FDA is also requiring establishments to evaluate donors for factors that may adversely affect the safety, purity, and potency of blood and blood components or the health of a donor during the donation process. Accordingly, these regulations establish requirements for donor education, donor history, and donor testing. These regulations also implement a flexible framework to help both FDA and industry to more effectively respond to new or emerging infectious agents that may affect blood product safety.
Evaluation of the return rate of volunteer blood donors
Lourençon, Adriana de Fátima; Almeida, Rodrigo Guimarães dos Santos; Ferreira, Oranice; Martinez, Edson Zangiacomi
2011-01-01
Background To convert first-time blood donors into regular volunteer donors is a challenge to transfusion services. Objectives This study aims to estimate the return rate of first time donors of the Ribeirão Preto Blood Center and of other blood centers in its coverage region. Methods The histories of 115,553 volunteer donors between 1996 and 2005 were analyzed. Statistical analysis was based on a parametric long-term survival model that allows an estimation of the proportion of donors who never return for further donations. Results Only 40% of individuals return within one year after the first donation and 53% return within two years. It is estimated that 30% never return to donate. Higher return rates were observed among Black donors. No significant difference was found in non-return rates regarding gender, blood type, Rh blood group and blood collection unit. Conclusions The low percentage of first-time donors who return for further blood donation reinforces the need for marketing actions and strategies aimed at increasing the return rates. PMID:23049294
Zadeh, S; Foster, J
2016-01-01
The use of sperm donation by single women has provoked public, professional and political debate. Newspapers serve as a critical means of both broadcasting this debate and effecting a representation of this user group within the public sphere. This study uses the theory of social representations to examine how single motherhood by sperm donation has been represented in the UK news over time. The study sampled news coverage on this topic in eight British newspapers during three 4-year periods between the years 1988 and 2012. The dataset of news reports ( n = 406) was analysed using a qualitative approach. Findings indicated that UK media reports of single women using donor sperm are underpinned by conventional categories of the 'personal', the 'traditional' and the 'natural' that when paired with their corollaries produce a representation of this user group as the social 'other'. The amount of coverage on this topic over time was found to vary according to the political orientation of different media sources. Using key concepts from social representations theory, this article discusses the relationship between themata and anchoring in the maintenance of representations of the social 'other' in mass mediated communication. Findings are explained in relation to theoretical conceptions of the mass media and its position within the public sphere. It is argued that the use of personal narratives in news reports of single mothers by sperm donation may have significant implications for public understandings of this social group. © 2016 The Authors. Journal of Community & Applied Social Psychology published by John Wiley & Sons Ltd.
Two-photon or higher-order absorbing optical materials for generation of reactive species
NASA Technical Reports Server (NTRS)
Marder, Seth R. (Inventor); Cumpston, Brian (Inventor); Lipson, Matthew (Inventor); Perry, Joseph W. (Inventor)
2003-01-01
Disclosed are highly efficient multiphoton absorbing compounds and methods of their use. The compounds generally include a bridge of pi-conjugated bonds connecting electron donating groups or electron accepting groups. The bridge may be substituted with a variety of substituents as well. Solubility, lipophilicity, absorption maxima and other characteristics of the compounds may be tailored by changing the electron donating groups or electron accepting groups, the substituents attached to or the length of the pi-conjugated bridge. Numerous photophysical and photochemical methods are enabled by converting these compounds to electronically excited states upon simultaneous absorption of at least two photons of radiation. The compounds have large two-photon or higher-order absorptivities such that upon absorption, one or more Lewis acidic species, Lewis basic species, radical species or ionic species are formed.
Two-photon or higher-order absorbing optical materials for generation of reactive species
NASA Technical Reports Server (NTRS)
Perry, Joseph W (Inventor); Cumpston, Brian (Inventor); Lipson, Matthew (Inventor); Marder, Seth R (Inventor)
2007-01-01
Disclosed are highly efficient multiphoton absorbing compounds and methods of their use. The compounds generally include a bridge of pi-conjugated bonds connecting electron donating groups or electron accepting groups. The bridge may be substituted with a variety of substituents as well. Solubility, lipophilicity, absorption maxima and other characteristics of the compounds may be tailored by changing the electron donating groups or electron accepting groups, the substituents attached to or the length of the pi-conjugated bridge. Numerous photophysical and photochemical methods are enabled by converting these compounds to electronically excited states upon simultaneous absorption of at least two photons of radiation. The compounds have large two-photon or higher-order absorptivities such that upon absorption, one or more Lewis acidic species, Lewis basic species, radical species or ionic species are formed.
Two-Photon or Higher-Order Absorbing Optical Materials for Generation of Reactive Species
NASA Technical Reports Server (NTRS)
Perry, Joseph W. (Inventor); Cumpston, Brian (Inventor); Lipson, Matthew (Inventor); Marder, Seth R. (Inventor)
2013-01-01
Disclosed are highly efficient multiphoton absorbing compounds and methods of their use. The compounds generally include a bridge of pi-conjugated bonds connecting electron donating groups or electron accepting groups. The bridge may be substituted with a variety of substituents as well. Solubility, lipophilicity, absorption maxima and other characteristics of the compounds may be tailored by changing the electron donating groups or electron accepting groups, the substituents attached to or the length of the pi-conjugated bridge. Numerous photophysical and photochemical methods are enabled by converting these compounds to electronically excited states upon simultaneous absorption of at least two photons of radiation. The compounds have large two-photon or higher-order absorptivities such that upon absorption, one or more Lewis acidic species, Lewis basic species, radical species or ionic species are formed.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Benson, Eric E.; Zhang, Hanyu; Schuman, Samuel A.
We modify the fundamental electronic properties of metallic (1T phase) nanosheets of molybdenum disulfide (MoS 2) through covalent chemical functionalization, and thereby directly influence the kinetics of the hydrogen evolution reaction (HER), surface energetics, and stability. Chemically exfoliated, metallic MoS 2 nanosheets are functionalized with organic phenyl rings containing electron donating or withdrawing groups. We find that MoS 2 functionalized with the most electron donating functional group (p-(CH 3CH 2) 2NPh-MoS 2) is the most efficient catalyst for HER in this series, with initial activity that is slightly worse compared to the pristine metallic phase of MoS 2. The p-(CHmore » 3CH 2) 2NPh-MoS 2 is more stable than unfunctionalized metallic MoS 2 and outperforms unfunctionalized metallic MoS 2 for continuous H 2 evolution within 10 min under the same conditions. With regards to the entire studied series, the overpotential and Tafel slope for catalytic HER are both directly correlated with the electron donating strength of the functional group. The results are consistent with a mechanism involving ground-state electron donation or withdrawal to/from the MoS 2 nanosheets, which modifies the electron transfer kinetics and catalytic activity of the MoS 2 nanosheet. The functional groups preserve the metallic nature of the MoS 2 nanosheets, inhibiting conversion to the thermodynamically stable semiconducting state (2H) when mildly annealed in a nitrogen atmosphere. We propose that the electron density and, therefore, reactivity of the MoS 2 nanosheets are controlled by the attached functional groups. Functionalizing nanosheets of MoS 2 and other transition metal dichalcogenides provides a synthetic chemical route for controlling the electronic properties and stability within the traditionally thermally unstable metallic state.« less
Benson, Eric E.; Zhang, Hanyu; Schuman, Samuel A.; ...
2017-12-27
We modify the fundamental electronic properties of metallic (1T phase) nanosheets of molybdenum disulfide (MoS 2) through covalent chemical functionalization, and thereby directly influence the kinetics of the hydrogen evolution reaction (HER), surface energetics, and stability. Chemically exfoliated, metallic MoS 2 nanosheets are functionalized with organic phenyl rings containing electron donating or withdrawing groups. We find that MoS 2 functionalized with the most electron donating functional group (p-(CH 3CH 2) 2NPh-MoS 2) is the most efficient catalyst for HER in this series, with initial activity that is slightly worse compared to the pristine metallic phase of MoS 2. The p-(CHmore » 3CH 2) 2NPh-MoS 2 is more stable than unfunctionalized metallic MoS 2 and outperforms unfunctionalized metallic MoS 2 for continuous H 2 evolution within 10 min under the same conditions. With regards to the entire studied series, the overpotential and Tafel slope for catalytic HER are both directly correlated with the electron donating strength of the functional group. The results are consistent with a mechanism involving ground-state electron donation or withdrawal to/from the MoS 2 nanosheets, which modifies the electron transfer kinetics and catalytic activity of the MoS 2 nanosheet. The functional groups preserve the metallic nature of the MoS 2 nanosheets, inhibiting conversion to the thermodynamically stable semiconducting state (2H) when mildly annealed in a nitrogen atmosphere. We propose that the electron density and, therefore, reactivity of the MoS 2 nanosheets are controlled by the attached functional groups. Functionalizing nanosheets of MoS 2 and other transition metal dichalcogenides provides a synthetic chemical route for controlling the electronic properties and stability within the traditionally thermally unstable metallic state.« less
Influencing the Behavior of General Chang Wanquan to Protect United States Space Assets
2009-04-01
story_generic.jsp?channel= awst &id=news/CH I01177.xml. Feng, Huiyun. Chinese Strategic Culture and Foreign Policy Decision-Making: Confucianism...Donates Frw350 Million.” The New Times, 22 May 2007. As collected by AllAfrica, Inc. Samovar, Larry A., Richard E. Porter, and Edwin R . McDaniel
Knowledge, Attitude and Practice of Nurses Regarding Organ Donation
Babaie, Mohadese; Hosseini, Mahdi; Hamissi, Jalaleddin; Hamissi, Zahra
2015-01-01
Introduction: Treatment team charged to help patients and their family making decision about donate organs in the final stage of life. Hence, their knowledge and attitude is important to plan of increasing the rate of organ donation. Materials and Methods: About 150 nurses recruited in this cross-sectional study randomly. After taking informed consent, questionnaires were filled. The data collection tool was a multipart questionnaire including demographic information, 18 questions about attitude and practice and 15 question about knowledge toward organ donation. Data were analyzed by SPSS software using K-squire, Pearson correlation test, T-test, variance analyze on 95% confidence interval. Results: Most of participants (76%) were 25-44 years old. About 81.3% of them were female (n=122). The attitude average score between males and females was 85.25±35.61 and 70.37±46.53, respectively. The practice average score in females was 34.43±47.71 and between males was 29.63±46.53. The knowledge average scores were 50.60±16.19 and 56.54±17.48 for two groups (p>0.05). The knowledge average scores between different age groups was significant (p<0.05). There was a direct and significant relation between attitude and practice (r= +0.33, p<0.05), attitude and Factors influencing attitude and practice (r= 0.866, p<0.05), but the relation between attitude and knowledge was indirect and significant (r= -0.183, p<0.05). Conclusions: Since the medical team are most important adviser for promote activities related to organ donation, it seems that educational curriculum and facilities should applied to enhance attitude and behavior favorable change of personnel towards this issue. PMID:26153179
Knowledge, Attitude and Practice of Nurses Regarding Organ Donation.
Babaie, Mohadese; Hosseini, Mahdi; Hamissi, Jalaleddin; Hamissi, Zahra
2015-04-03
Treatment team charged to help patients and their family making decision about donate organs in the final stage of life. Hence, their knowledge and attitude is important to plan of increasing the rate of organ donation. About 150 nurses recruited in this cross-sectional study randomly. After taking informed consent, questionnaires were filled. The data collection tool was a multipart questionnaire including demographic information, 18 questions about attitude and practice and 15 question about knowledge toward organ donation. Data were analyzed by SPSS software using K-squire, Pearson correlation test, T-test, variance analyze on 95% confidence interval. Most of participants (76%) were 25-44 years old. About 81.3% of them were female (n=122). The attitude average score between males and females was 85.25±35.61 and 70.37±46.53, respectively. The practice average score in females was 34.43±47.71 and between males was 29.63±46.53. The knowledge average scores were 50.60±16.19 and 56.54±17.48 for two groups (p>0.05). The knowledge average scores between different age groups was significant (p<0.05). There was a direct and significant relation between attitude and practice (r=+0.33, p<0.05), attitude and Factors influencing attitude and practice (r=0.866, p<0.05), but the relation between attitude and knowledge was indirect and significant (r=-0.183, p<0.05). Since the medical team are most important adviser for promote activities related to organ donation, it seems that educational curriculum and facilities should applied to enhance attitude and behavior favorable change of personnel towards this issue.
Regalia, Kirsten; Zheng, Patricia; Sillau, Stefan; Aggarwal, Anuj; Bellevue, Oliver; Fix, Oren K.; Prinz, Jennifer; Dunn, Susan; Biggins, Scott W.
2014-01-01
Background Transplant candidate caregivers (TCCs) are an under-utilized but potentially devoted pool of advocates who themselves may be recruited to register for deceased organ donation. Aim To assess and compare recruitment barriers to deceased donor registration efforts in TCCs and health fair attendees (HFAs). Methods A 42-item questionnaire assessing willingness to register as an organ donor and perceptions and knowledge about organ donation was administered to 452 participants (174 in Denver, 278 in San Francisco). Logistic regression, stratified by study site, was used to assess associations between explanatory variables and willingness to register as an organ donor. Results In Denver, 83% of TCCs vs 68% of HFAs indicated a willingness to register (p = 0.03). Controlling for study group (TCC vs HFA), predictors of willingness to register were female gender (OR 2.4), Caucasian race (OR 2.3), college graduate (OR 11.1), married (OR 2.4) and higher positive perception of organ donation (OR 1.2), each p<0.05. In San Francisco, 58% of TCCs vs 70% of HFAs indicated a willingness to register (p = 0.03). Controlling for study group (TCC vs HFA), predictors of willingness to register were Caucasian race (OR 3.5), college graduate (OR 2.2), married (OR 1.9), higher knowledge (OR 1.6) and higher positive perception of organ donation (OR 1.2), each p<0.05. In both locales, Caucasians were more likely to have positive perceptions about organ donation and were more willing to register. Conclusions Demographic characteristics, not personal connection to a transplant candidate, explain willingness to register as an organ donor. PMID:24519521
Ferguson, Eamonn; Atsma, Femke; de Kort, Wim; Veldhuizen, Ingrid
2012-02-01
Using constructs from the Theory of Planned Behavior and theories of altruism, this article explores how multiple motivations and beliefs for blood donation are clustered and change across the donor career. In so doing important distinctions, for blood donation, between impure altruism, pure altruism, and warm glow are explored. Measures of intentions, cognitive and affective attitudes, role merger, pure altruism, trust, self-efficacy, subjective and moral norms, and habit formation were assessed in a sample of 12,580 whole blood donors. Analyses showed that a distinction between first-time, novice (one to four donations), and experienced donors (five or more donations) is justified. Principal components analysis and confirmatory factor analytic Multiple-Indicator Multiple-Causal models were used to compare models across these groups. A cognition-behavior (CB) factor, including intentions, was common to all groups. First-time and novice donors were marked by a newly identified motivational factor: "reluctant altruism" (i.e., the motivation to donate because of a lack of trust in others). First-time donors exhibited an impure altruism factor whereas for experienced donors warm glow and pure altruism factors were observed. For first-time donors impure altruism and reluctant altruism were both associated with the CB factor in females and impure altruism only in males. For both sexes reluctant altruism was associated of the CB factor in novice donors and warm glow and pure altruism for experienced donors. New avenues for intervention are suggested by the emergence of reluctant altruism for novice donors and warm glow for experienced donors. The importance of distinguishing aspects of altruism is highlighted. © 2012 American Association of Blood Banks.
McQuay, J E
1995-09-01
All individuals can expect to encounter some form of crisis and loss. Responses to these experiences are not universal and will be influenced by a person's cultural background and religious beliefs. This appendix provides information about the different responses to health crises, death, and organ donation and transplantation as practiced by various religious and cultural groups.
Saidi, R F; Bradley, J; Greer, D; Luskin, R; O'Connor, K; Delmonico, F; Kennealey, P; Pathan, F; Schuetz, C; Elias, N; Ko, D S C; Kawai, T; Hertl, M; Cosimi, A B; Markmann, J F
2010-11-01
Donation after cardiac death (DCD) has proven effective at increasing the availability of organs for transplantation.We performed a retrospective examination of Massachusetts General Hospital (MGH) records of all 201 donors from 1/1/98 to the 11/2008, including 54 DCD, 115 DBD and 32 DCD candidates that did not progress to donation (DCD-dnp). Comparing three time periods, era 1 (01/98-12/02), era 2 (01/03-12/05) and era 3 (01/06-11/08), DCD’s comprised 14.8,48.4% and 60% of donors, respectively (p = 0.002). A significant increase in the incidence of cardiovascular/cerebrovascular as cause of death was evident in era 3 versus eras 1 and 2; 74% versus 57.1% (p<0.001),as was a corresponding decrease in the incidence of traumatic death. Interestingly, we noted an increase in utilization of aggressive neurological management over time, especially in the DCD group.We detected significant changes in the make-up of the donor pool over the past decade. That the changes in diagnosis over time did not differ between DCD and DBD groups suggests this difference is not responsible for the increase in DCD rates. Instead, we suggest that changes in clinical practice, especially in management of patients with severe brain injury may account for the increased proportion of DCD.
Sriskandakumar, Thamayanthy; Petzold, Holm; Bruijnincx, Pieter C A; Habtemariam, Abraha; Sadler, Peter J; Kennepohl, Pierre
2009-09-23
Thiolate ligand oxygenation is believed to activate cytotoxic half-sandwich [(eta(6)-arene)Ru(en)(SR)](+) complexes toward DNA binding. We have made detailed comparisons of the nature of the Ru-S bond in the parent thiolato complexes and mono- (sulfenato) and bis- (sulfinato) oxygenated species including the influence of substituents on the sulfur and arene. Sulfur K-edge XAS indicates that S(3p) donation into the Ru(4d) manifold depends strongly on the oxidation state of the sulfur atom, whereas Ru K-edge data suggest little change at the metal center. DFT results are in agreement with the experimental data and allow a more detailed analysis of the electronic contributions to the Ru-S bond. Overall, the total ligand charge donation to the metal center remains essentially unchanged upon ligand oxygenation, but the origin of the donation differs markedly. In sulfenato complexes, the terminal oxo group makes a large contribution to charge donation and even small electronic changes in the thiolato complexes are amplified upon ligand oxygenation, an observation which carries direct implications for the biological activity of this family of complexes. Details of Ru-S bonding in the mono-oxygenated complexes suggest that these should be most susceptible to ligand exchange, yet only if protonation of the terminal oxo group can occur. The potential consequences of these results for biological activation are discussed.
Cooperation and conflict: field experiments in Northern Ireland.
Silva, Antonio S; Mace, Ruth
2014-10-07
The idea that cohesive groups, in which individuals help each other, have a competitive advantage over groups composed of selfish individuals has been widely suggested as an explanation for the evolution of cooperation in humans. Recent theoretical models propose the coevolution of parochial altruism and intergroup conflict, when in-group altruism and out-group hostility contribute to the group's success in these conflicts. However, the few empirical attempts to test this hypothesis do not use natural groups and conflate measures of in-group and unbiased cooperative behaviour. We conducted field experiments based on naturalistic measures of cooperation (school/charity donations and lost letters' returns) with two religious groups with an on-going history of conflict-Catholics and Protestants in Northern Ireland. Conflict was associated with reduced donations to out-group schools and the return of out-group letters, but we found no evidence that it influences in-group cooperation. Rather, socio-economic status was the major determinant of cooperative behaviour. Our study presents a challenge to dominant perspectives on the origins of human cooperation, and has implications for initiatives aiming to promote conflict resolution and social cohesion.
Cooperation and conflict: field experiments in Northern Ireland
Silva, Antonio S.; Mace, Ruth
2014-01-01
The idea that cohesive groups, in which individuals help each other, have a competitive advantage over groups composed of selfish individuals has been widely suggested as an explanation for the evolution of cooperation in humans. Recent theoretical models propose the coevolution of parochial altruism and intergroup conflict, when in-group altruism and out-group hostility contribute to the group's success in these conflicts. However, the few empirical attempts to test this hypothesis do not use natural groups and conflate measures of in-group and unbiased cooperative behaviour. We conducted field experiments based on naturalistic measures of cooperation (school/charity donations and lost letters' returns) with two religious groups with an on-going history of conflict—Catholics and Protestants in Northern Ireland. Conflict was associated with reduced donations to out-group schools and the return of out-group letters, but we found no evidence that it influences in-group cooperation. Rather, socio-economic status was the major determinant of cooperative behaviour. Our study presents a challenge to dominant perspectives on the origins of human cooperation, and has implications for initiatives aiming to promote conflict resolution and social cohesion. PMID:25143042
Kuenemann, Melaine A.; Szymczyk, Malgorzata; Chen, Yufei; Sultana, Nadia; Hinks, David; Freeman, Harold S.; Williams, Antony J.
2017-01-01
We present the Max Weaver Dye Library, a collection of ∼98 000 vials of custom-made and largely sparingly water-soluble dyes. Two years ago, the Eastman Chemical Company donated the library to North Carolina State University. This unique collection of chemicals, housed in the College of Textiles, also includes tens of thousands of fabric samples dyed using some of the library's compounds. Although the collection lies at the core of hundreds of patented inventions, the overwhelming majority of this chemical treasure trove has never been published or shared outside of a small group of scientists. Thus, the goal of this donation was to make this chemical collection, and associated data, available to interested parties in the research community. To date, we have digitized a subset of 2700 dyes which allowed us to start the constitutional and structural analysis of the collection using cheminformatics approaches. Herein, we open the discussion regarding the research opportunities offered by this unique library. PMID:28959395
Change of focus: from intensive care towards organ donation.
Meyer, Käthe; Bjørk, Ida T
2008-02-01
To progress from identifying a potential organ donor to implementing the actual organ donation effectively is a challenging process for all involved. The nurses might find the change of focus difficult, as the donor organ acquisition process often starts before the relatives had been informed and have had the time to reorient themselves about the severe situation of the patient and have been briefed on the option of organ donation. The purpose was to investigate the hospital-based education in organ donation at the 28 Norwegian donor hospitals, and elicit the needs of the intensive care nurses for imparting of required knowledge and support in shifting their focus from intensive care towards the process of organ procurement. Hospital-based education and guidelines in organ donation were analyzed by scrutinizing the documents available. Eleven units were found to have their own guidelines and only three hospitals had organ donation in their educational programme. Intensive care nurses at three hospitals participated in focus groups. The main finding was the need for collaboration and mutual understanding within the treatment team. Nurses expounded the multiple responsibilities that they discharged during the course of intensive care. In reorienting their focus from intensive care to donor organ procurement, the time of death was explained as the crucial turning point. The knowledge of intensive care staff and professional competence were crucial in winning the relatives' trust and were central in the communication processes. Donor hospitals should implement systematic training and debriefing, where both nurses and physicians contribute to this process. Well-prepared protocols for organ donation at hospitals can define responsibilities assigned to different members of the donor organ acquisition team.
France, Christopher R; France, Janis L; Carlson, Bruce W; Frye, Victoria; Duffy, Louisa; Kessler, Debra A; Rebosa, Mark; Shaz, Beth H
2017-02-01
The Blood Donor Competency, Autonomy, and Relatedness Enhancement (Blood Donor CARE) project was designed as a practical application of self-determination theory to encourage retention of first-time donors. Self-determination theory proposes that people are more likely to persist with behaviors that are internally-motivated, and that externally-motivated behavior can evolve and become internalized given the appropriate socio-environmental conditions. According to self-determination theory, motivation to engage in blood donation may become increasingly self-determined if the behavior satisfies fundamental human needs for competence (a sense of self-efficacy to achieve specific goals), autonomy (a sense of volitional control over one's behavior), and relatedness (a sense of connection to a larger group). The primary aim of this randomized controlled trial is to examine the effect of competence, autonomy, and/or relatedness interventions on donor retention. Using a full factorial design, first-time donors will be assigned to a control condition or one of seven intervention conditions. Donation competence, autonomy, and relatedness, along with additional constructs associated with return donation, will be assessed before and after the intervention using online surveys, and donation attempts will be tracked for one-year using blood center donor databases. We hypothesize that, compared to the control condition, the interventions will increase the likelihood of a subsequent donation attempt. We will also examine intervention-specific increases in competence, autonomy, and relatedness as potential mediators of enhanced donor retention. By promoting first-time donor competence, autonomy, and relatedness our goal is to enhance internal motivation for giving and in so doing increase the likelihood of future donation. Copyright © 2016 Elsevier Inc. All rights reserved.
France, Christopher R.; France, Janis L.; Carlson, Bruce W.; Frye, Victoria; Duffy, Louisa; Kessler, Debra A.; Rebosa, Mark; Shaz, Beth H.
2016-01-01
The Blood Donor Competency, Autonomy, and Relatedness Enhancement (Blood Donor CARE) project was designed as a practical application of self-determination theory to encourage retention of first-time donors. Self-determination theory proposes that people are more likely to persist with behaviors that are internally-motivated, and that externally-motivated behavior can evolve and become internalized given the appropriate socio-environmental conditions. According to self-determination theory, motivation to engage in blood donation may become increasingly self-determined if the behavior satisfies fundamental human needs for competence (a sense of self-efficacy to achieve specific goals), autonomy (a sense of volitional control over one’s behavior), and relatedness (a sense of connection to a larger group). The primary aim of this randomized controlled trial is to examine the effect of competence, autonomy, and/or relatedness interventions on donor retention. Using a full factorial design, first-time donors will be assigned to a control condition or one of seven intervention conditions. Donation competence, autonomy, and relatedness, along with additional constructs associated with return donation, will be assessed before and after the intervention using online surveys, and donation attempts will be tracked for one-year using blood center donor databases. We hypothesize that, compared to the control condition, the interventions will increase the likelihood of a subsequent donation attempt. We will also examine intervention-specific increases in competence, autonomy, and relatedness as potential mediators of enhanced donor retention. By promoting first-time donor competence, autonomy, and relatedness our goal is to enhance internal motivation for giving and in so doing increase the likelihood of future donation. PMID:27979752
Knowledge and attitudes of health care professionals toward organ donation and transplantation.
Alsaied, Osama; Bener, Abdulbari; Al-Mosalamani, Yousuf; Nour, Bakr
2012-11-01
To identify and assess the level of knowledge and attitudes of health care professionals (HCP) in Qatar toward organ donation and transplantation, this cross-sectional study was carried out from October 2007 to February 2008 in the Accident and Emergency Departments and Intensive Care Units of the hospitals of the Hamad Medical Corporation (HMC). A representative sample of 585 HCP working in the hospitals of the HMC was approached and 418 staff gave consent to participate in the study (71.5%). 36.8% were physicians, 48.6% nurses and 14.6% Emergency Medical Service (EMS) technicians. Of the surveyed HCP, 40.7% were males and 59.3% were females. Majority of the staff were in the age group of 30-39 years (58.6%). More than half of the physicians (59.7%) and technicians (57.4%) assumed that organs can be bought and sold in the State of Qatar. Most of the physicians (76.6%) and nurses (75.9%) knew that brain-dead persons are eligible for organ donation, whereas only 57.4% of the EMS technicians thought so. Majority of the HCP supported organ donation; physicians (89.0%), nurses (82.3%) and technicians (70.5%). The attitude of the physicians (24.0%) and nurses (20.2%) to donate a kidney to a family member was very poor compared with the attitude of the technicians (44.3%). Although the HCP support organ donation (83%), more than half of the physicians (51.3%), nurses (61.6%) and technicians (54.1%) wanted to be buried with all their organs intact. The findings, although they give cause for hope, suggest that there is much work yet to be done before organ donation and transplantation can become fully accepted by the medical community in Qatar.
Survey of pediatricians' opinions on donation after cardiac death: are the donors dead?
Joffe, Ari R; Anton, Natalie R; deCaen, Allan R
2008-11-01
There has been debate in the ethics literature as to whether the donation-after-cardiac-death donor is dead after 5 minutes of absent circulation. We set out to determine whether pediatricians consider the donation-after-cardiac-death donor as dead. A survey was mailed to all 147 pediatricians who are affiliated with the university teaching children's hospital. The survey had 4 pediatric patient scenarios in which a decision was made to donate organs after 5 minutes of absent circulation. Background information described the organ shortage, and the debate about the term "irreversibility" applied to death in donation after cardiac death. Descriptive statistics were used, with responses between groups compared by using the chi(2) statistic. The response rate was 54% (80 of 147). In each scenario, when given a patient described as dead with absent circulation for 5 minutes,
An investigation of the impact of prolonged waiting times on blood donors in Ireland.
McKeever, T; Sweeney, M R; Staines, A
2006-02-01
The aim of this study was to investigate the impact of prolonged queuing times on blood donors, by measuring their satisfaction levels, and positive and negative affects. As donation times have increased over the past number of years within the Irish Blood Transfusion Service, this is an important issue to examine in a climate where voluntary donors are becoming scarce and demands on people's time are increasing. Eighty-five blood donors were sampled from one urban and one rural blood donor clinic. The respondents conducted a questionnaire by means of face-to-face interview, while waiting in the clinic. The questionnaire contained the Positive and Negative Affect Scale (PANAS), and a waiting satisfaction scale. Both actual and perceived waiting times of the donors were noted. Waiting time was found to be negatively related to satisfaction. Inexperienced donors expressed higher levels of negative affect than experienced donors. Urban donors were significantly more satisfied than rural donors. There was a significant difference in perceived waiting time between lone donors and those queuing in a group, with those waiting alone perceiving their wait as shorter. While all respondents stated that they intended to donate again, over one-third stated that prolonged waiting times would be their most likely deterrent. However, only 15% stated that long queuing times might actually prevent them from donating in the future, and almost all respondents said that they would recommend donation to a friend, despite long queuing times. Although our results show that the respondents were not satisfied with current waiting times, it did not seem to affect their future intentions to donate. These findings provide some optimism for the future of blood donation in Ireland, as they suggest a strong sense of commitment to donation within the population sampled. Future research could explore the application of 'the service industry' approach to waiting times to blood donation clinics.
Hernandez-Alejandro, Roberto; Croome, Kris P; Quan, Douglas; Mawardi, Mohamed; Chandok, Natasha; Dale, Cheryl; McAlister, Vivian; Levstik, Mark A; Wall, William; Marotta, Paul
2011-09-27
In hepatitis C virus (HCV) recipients of donation after cardiac death (DCD) grafts, there is suggestion of lower rates of graft survival, indicating that DCD grafts themselves may represent a significant risk factor for severe recurrence of HCV. We evaluated all DCD liver transplant recipients from August 2006 to February 2011 at our center. Recipients with HCV who received a DCD graft (group 1, HCV+ DCD, n=17) were compared with non-HCV recipients transplanted with a DCD graft (group 2, HCV- DCD, n=15), and with a matched group of HCV recipients transplanted with a donation after brain death (DBD) graft (group 3, HCV+ DBD, n=42). A trend of poorer graft survival was seen in HCV+ patients who underwent a DCD transplant (group 1) compared with HCV- patients who underwent a DCD transplant (group 2) (P=0.14). Importantly, a statistically significant difference in graft survival was seen in HCV+ patients undergoing DCD transplant (group 1) (73%) as compared with DBD transplant (group 3) (93%)(P=0.01). There was a statistically significant increase in HCV recurrence at 3 months (76% vs. 16%) (P=0.005) and severe HCV recurrence within the first year (47% vs. 10%) in the DCD group (P=0.004). HCV recurrence is more severe and progresses more rapidly in HCV+ recipients who receive grafts from DCD compared with those who receive grafts from DBD. DCD liver transplantation in HCV+ recipients is associated with a higher rate of graft failure compared with those who receive grafts from DBD. Caution must be taken when using DCD grafts in HCV+ recipients.
Yen, Glorian P.; Davey, Adam
2015-01-01
Objective: Biorepositories have been key resources in examining genetically-linked diseases, particularly cancer. Asian Americans contribute to biorepositories at lower rates than other racial groups, but the reasons for this are unclear. We hypothesized that attitudes toward biospecimen research mediate the relationship between demographic and healthcare access factors, and willingness to donate blood for research purposes among individuals of Korean heritage. Methods: Descriptive statistics and bivariate analyses were utilized to characterize the sample with respect to demographic, psychosocial, and behavioral variables. Structural equation modeling with 5000 re-sample bootstrapping was used to assess each component of the proposed simple mediation models. Results: Attitudes towards biospecimen research fully mediate associations between age, income, number of years lived in the United States, and having a regular physician and willingness to donate blood for the purpose of research. Conclusion: Participants were willing to donate blood for the purpose of research despite having neutral feelings towards biospecimen research as a whole. Participants reported higher willingness to donate blood for research purposes when they were older, had lived in the United States longer, had higher income, and had a regular doctor that they visited. Many of the significant relationships between demographic and health care access factors, attitudes towards biospecimen research, and willingness to donate blood for the purpose of research may be explained by the extent of acculturation of the participants in the United States. PMID:25853387
The symbolic roots of blood donation.
Charbonneau, Johanne; Tran, Nathalie Y-Lang
2013-12-01
Throughout history, blood has been embedded with powerful and paradoxical connotations. In the last decades, a more rational conception based on scientific knowledge has emerged, portraying blood as a "disenchanted" and utilitarian object, hence more apt for donation between strangers. This study aims to examine blood's representations in Quebec, Canada. Data were collected in four separate studies carried out between 2009 and 2011 in Quebec. A total of 234 1 to 1½ hour-long semi-structured qualitative interviews were conducted with: 184 donors (including lapsed donors) and 50 nondonors; 106 women and 128 men from a variety of age groups eligible to donate; 76 minority informants from Asian, Middle-Eastern, Latin American, African, and Caribbean origins; and 158 informants from the majority society. Many respondents donated blood because it was a "useful" substance. Others associated blood donation with a gift of vitality, strength, and energy. Some stressed the irreplaceable nature of blood, its rarity, and preciousness. It can also be associated with worrisome representations and seen as "bad" or carry infections: as a fluid, it has the ability to cross troublesome body boundaries. This overview of contemporary representations of blood in relation to blood donation in Quebec illustrates that though this substance might be disenchanted for many, it still maintains its mysteriousness for others, which underpins the importance of its social, cultural, and religious representations that can potentially lead to useful avenues in improving donor recruitment and retention. © 2013 American Association of Blood Banks.
Improving transplantation programs and patient care.
Shaheen, F A M; Souqiyyeh, M Z
2005-09-01
Organ transplantation is the preferred mode of replacement therapy. Currently acceptable 5-year posttransplantation survival rates are 85% for renal grafts, 70% for liver, and 65% for heart. Organ donation, however, remains a significant factor in organ transplantation, as humans are the only possible donors and the numbers of patients on waiting lists remain high. Several factors affect organ transplantation in countries in the Middle East Society for Organ Transplantation (MESOT) region, including inadequate preventive medicine, differing health infrastructures, poor awareness within the medical community and lay public regarding the importance of organ donation and transplantation, a high level of ethnicity, and poor government support of organ transplantation. Moreover, there is lack of team spirit among transplant physicians, a lack of coordination between groups that manage organ procurement and the transplant centers, and a lack of effective health insurance coverage for many persons. Three models of organ donation and transplantation exist in the MESOT region-the Saudi, Iranian, and Pakistani models. Living-organ donation, the most widely practiced form of donation in countries in the MESOT region, includes kidney and partial liver. Cadaveric organ donation has significant potential in the MESOT region. However, numerous obstacles must be overcome in MESOT countries. Resolution of these obstacles will require continuous work on many fronts. Experiences from all sources must be incorporated into new and improved models that can overcome current inadequacies. Solutions will require continued focus within the medical community, steady support from the lay public and religious institutions, as well as governmental assistance.
Prospective audit to evaluate the potential of the coronial system to increase solid organ donation.
Twamley, Huw; Haigh, Andrew; Williment, Claire; Hudson, Cara; Whitney, Julie; Neuberger, James
2016-07-08
Anecdotal evidence suggests that organ donation from deceased donors referred to the Coroner/Procurator Fiscal (PF) could be increased if all followed best practice. The aim of this prospective audit was to establish how referrals affected organ donation and to develop evidence-based guidelines to ensure that organ donation can be facilitated safely without interfering in the Coroner/PF's investigative process. Prospective audit. All acute National Health Service Hospitals in the UK where deceased organ donation was considered. 1437 deceased patients who met the eligibility criteria for organ donation and were referred to Coroner/PF. Number of cases where permission for transplantation was given, number of organs where permission was refused and number of organs which might have been transplanted if all had followed best practice. Full permission for organ retrieval was given in 87% cases and partial permission in 9%. However, if full permission had been given where no autopsy was performed or restrictions seemed unjustified, up to 77 organs (22 lungs, 22 kidneys, 9 pancreases, 9 livers, 8 hearts and 7 small bowels) could have been available for transplant. Coroners/PFs and their officers show strong support for transplantation but improvement in practice could result in a small but significant increase in life-saving and life-enhancing transplants. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Antioxidant Chemistry of Graphene-Based Materials and its Role in Oxidation Protection Technology
Qiu, Yang; Wang, Zhongying; Owens, Alisa C.E.; Kulaots, Indrek; Chen, Yantao; Kane, Agnes B.; Hurt, Robert H.
2015-01-01
Two-dimensional nanomaterials have potential as a new class of antioxidants that combine physical barrier function with ultrahigh surface area for free radical scavenging. This work presents the first measurements of the chemical reactivities of graphene-based materials toward a set of model free radicals and reactive oxygen species using electron paramagnetic resonance spectroscopy (EPR) and sacrificial dye protection assays. Graphene-based materials are shown to protect a variety of molecular targets from oxidation by these species, and to be highly effective as hydroxyl-radical scavengers. When hydroxyl radical is produced photolytically, the overall antioxidant effect is a combination of preventative antioxidant activity (UV absorption) and ·OH radical scavenging. Few-layer graphene is more active than monolayer graphene oxide, despite its lower surface area, which indicates that the primary scavenging sites are associated with the sp2-carbon network rather than oxygen-containing functional groups. To explain this trend, we propose that GO is a weak hydrogen donor, due to the non-phenolic nature of most OH groups on GO, which reside at basal sp3-carbon sites that do not allow for radical resonance stabilization following hydrogen donation. As an example application of graphene antioxidant behavior, we show that encapsulation of TiO2 nanoparticles in graphene nanosacks reduces undesired photo-oxidative damage to nearby organic target molecules, which suggests graphene encapsulation as a new approach to managing adverse environmental or health impacts of redox-active nanomaterials. PMID:25157875
Sources and Fates of Carbamyl Phosphate: A Labile Energy-Rich Molecule with Multiple Facets.
Shi, Dashuang; Caldovic, Ljubica; Tuchman, Mendel
2018-06-12
Carbamyl phosphate (CP) is well-known as an essential intermediate of pyrimidine and arginine/urea biosynthesis. Chemically, CP can be easily synthesized from dihydrogen phosphate and cyanate. Enzymatically, CP can be synthesized using three different classes of enzymes: (1) ATP-grasp fold protein based carbamyl phosphate synthetase (CPS); (2) Amino-acid kinase fold carbamate kinase (CK)-like CPS (anabolic CK or aCK); and (3) Catabolic transcarbamylase. The first class of CPS can be further divided into three different types of CPS as CPS I, CPS II, and CPS III depending on the usage of ammonium or glutamine as its nitrogen source, and whether N -acetyl-glutamate is its essential co-factor. CP can donate its carbamyl group to the amino nitrogen of many important molecules including the most well-known ornithine and aspartate in the arginine/urea and pyrimidine biosynthetic pathways. CP can also donate its carbamyl group to the hydroxyl oxygen of a variety of molecules, particularly in many antibiotic biosynthetic pathways. Transfer of the carbamyl group to the nitrogen group is catalyzed by the anabolic transcarbamylase using a direct attack mechanism, while transfer of the carbamyl group to the oxygen group is catalyzed by a different class of enzymes, CmcH/NodU CTase, using a different mechanism involving a three-step reaction, decomposition of CP to carbamate and phosphate, transfer of the carbamyl group from carbamate to ATP to form carbamyladenylate and pyrophosphate, and transfer of the carbamyl group from carbamyladenylate to the oxygen group of the substrate. CP is also involved in transferring its phosphate group to ADP to generate ATP in the fermentation of many microorganisms. The reaction is catalyzed by carbamate kinase, which may be termed as catabolic CK (cCK) in order to distinguish it from CP generating CK. CP is a thermally labile molecule, easily decomposed into phosphate and cyanate, or phosphate and carbamate depending on the pH of the solution, or the presence of enzyme. Biological systems have developed several mechanisms including channeling between enzymes, increased affinity of CP to enzymes, and keeping CP in a specific conformation to protect CP from decomposition. CP is highly important for our health as both a lack of, or decreased, CP production and CP accumulation results in many disease conditions.
New Zealand university students' knowledge and attitudes to organ and tissue donation.
Cornwall, Jon; Schafer, Cyril; Lal, Navneet; D'Costa, Rohit; Nada-Raja, Shyamala
2015-08-07
Organ and tissue donation (OTD) rates in New Zealand are low compared to many countries. Young adults are 'tomorrow's donors', yet the attitudes and knowledge of this group to OTD have not been examined locally. Such information is relevant to ODT education and clinical engagement. A random sample of University of Otago students (<25 years, permanent New Zealand resident) was surveyed to examine OTD knowledge and attitudes. This included general knowledge, OTD policy (opt-in, opt-out), donation by self, and donation by loved ones. Questions included yes-no, multiple choice, and Likert-type responses. Analyses by sex, demographic characteristics, supportive attitudes to ODT, and University of Otago student profile were performed. 180 responses were gathered (mean age 20.1 years, 67% female, 68% New Zealand European); there were no age or response differences between sexes, participants were generally not representative of the University of Otago student profile. Outcomes indicated limited OTD knowledge, positive support for OTD, and willingness to engage in donation the decision-making process for loved ones. Differences between supportive and non-supportive OTD attitudes was seen for some questions. Findings highlight areas for strategic OTD public engagement and provide details relevant to guiding appropriate clinical interaction in facilitating decisions about OTD.
Nonsimultaneous chains and dominos in kidney- paired donation-revisited.
Ashlagi, I; Gilchrist, D S; Roth, A E; Rees, M A
2011-05-01
Since 2008, kidney exchange in America has grown in part from the incorporation of nondirected donors in transplant chains rather than simple exchanges. It is controversial whether these chains should be performed simultaneously 'domino-paired donation', (DPD) or nonsimultaneously 'nonsimultaneous extended altruistic donor, chains (NEAD). NEAD chains create 'bridge donors' whose incompatible recipients receive kidneys before the bridge donor donates, and so risk reneging by bridge donors, but offer the opportunity to create more transplants by overcoming logistical barriers inherent in simultaneous chains. Gentry et al. simulated whether DPD or NEAD chains would produce more transplants when chain segment length was limited to three transplants, and reported that DPD performed at least as well as NEAD chains. As this finding contrasts with the experience of several groups involved in kidney-paired donation, we performed simulations that allowed for longer chain segments and used actual patient data from the Alliance for Paired Donation. When chain segments of 4-6 transplants are allowed in the simulations, NEAD chains produce more transplants than DPD. Our simulations showed not only more transplants as chain length increased, but also that NEAD chains produced more transplants for highly sensitized and blood type O recipients. ©2011 The Authors Journal compilation©2011 The American Society of Transplantation and the American Society of Transplant Surgeons.
A case report of embryo donation: ethical and clinical implications for psychologists.
Rizk, Marianne; Pawlak, Stacey
2016-10-01
Third-party reproduction is a growing field, and an increasing body of literature considers the ethics of embryo donation. Due to the psychosocial complexities that generally accompany the donation and/or use of donor embryos, psychologists can play a pivotal role in these specialised fertility cases. While laws in the USA are in place to regulate the medical procedures involved in embryo donation, only unenforceable guidelines exist for psychologists specialising in fertility cases. The presentation of this case study aims to: (1) clarify the ethical concerns that fertility psychologists should consider in similar situations by assessing whether American Society of Reproductive Medicine (ASRM) and the American Psychological Association (APA) guidelines compete or complement one another within this case of embryo donation and (2) consider the interests, obligations and rights of all parties involved. Several principles, standards and guidelines that must be considered are described. Overall, the APA Ethics Code and the ASRM Guidelines appear to complement one another for most aspects of this case. Fertility psychologists should consider the clinical implications of the interests, rights and duties of all involved parties, including themselves. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
An overview on ethical issues about sperm donation.
Gong, Dan; Liu, Yu-Lin; Zheng, Zhong; Tian, Yi-Fei; Li, Zheng
2009-11-01
Beyond the scientific progress in assisted reproductive technologies (ART), it is necessary to discuss the ethical considerations behind these advances. Ethical issues concerning sperm donation have been considered and discussed by government and non-governmental agencies, the public, media and academic institutions in many countries. Recommendations and guidelines concerning sperm donation issues vary from country to country and between professional groups within countries. This paper attempts to present an overview of findings and reports from various agencies concerning the ethics of sperm donation. The following topics are considered: limiting the number of donor offspring; minimizing risk of infection and genetics from sperm donors; age requirements for sperm donors; and anonymity versus non-anonymity of sperm donors. The diversity of policies shows that each country has its unique set of guidelines tailored toward its own specific needs. Similarly, countries designing their own procedures and guidelines concerning reproductive medicine must tailor them toward their own needs and practical considerations. In Mainland China, the anonymous policy for sperm donation should still be carried out, and the number of donor offspring should be revaluated. ART procedures must be conducted in a way that is respectful of those involved. Ethical principles must respect the interests and welfare of persons who will be born as well as the health and psychosocial welfare of all participants, including sperm donors.
Scott, Rosamund; Williams, Clare; Ehrich, Kathryn; Farsides, Bobbie
2012-01-01
This paper analyses elements of the legal process of consent to the donation of ‘spare’ embryos to research, including stem-cell research, and makes a recommendation intended to enhance the quality of that process, including on occasion by guarding against the invalidity of such consent. This is important in its own right and also so as to maximise the reproductive treatment options of couples engaged in in vitro fertilisation (IVF) treatment and to avoid possible harms to them. In Part 1, with reference to qualitative data from three UK IVF clinics, we explore the often delicate and contingent nature of what comes to be, for legal purposes, a ‘spare’ embryo. The way in which an embryo becomes ‘spare’, with its implications for the process of consent to donation to research, is not addressed in the relevant reports relating to or codes of practice governing the donation of embryos to research, which assume an unproblematic notion of the ‘spare’ embryo. Significantly, our analysis demonstrates that there is an important and previously unrecognised first stage in the donation of a ‘spare’ embryo to research, namely: consent to an embryo being ‘spare’ and so, at the same time, to its disuse in treatment. This is not explicitly covered by the Human Fertilisation and Embryology (HFE) Act 1990, as amended by the HFE Act 2008. Having identified this important initial stage in the process of consent to the donation of a ‘spare’ embryo to research in conclusion to Part 1, in Part 2 we analyse the idea of consent to an embryo's disuse in treatment on the basis that it is ‘spare’ with reference to the legal elements of consent, namely information as to nature and purpose, capacity, and voluntariness. We argue that there are in fact three related consent processes in play, of which the principal one concerns consent to an embryo's disuse in treatment. If the quality of this first consent is compromised, in turn this will impact on the quality of the consent to the donation of that ‘spare’ embryo to research, followed by the quality of consent to future cycles of assisted reproduction treatment in the event that these are needed as a result of a donation decision. The analysis overall is of central relevance to the debate as to whether, and if so when, it should be permissible to request the donation of fresh embryos for research, as opposed to those that have been frozen and, for instance, have reached the end of their statutory storage term. This has a particular bearing on the donation of embryos to stem-cell research since there is a debate as to whether fresh embryos are most useful for this. PMID:22647978
Thiaflavan scavenges radicals and inhibits DNA oxidation: a story from the ferrocene modification.
Lai, Hai-Wang; Liu, Zai-Qun
2014-06-23
4-Thiaflavan is a sulfur-substituted flavonoid with a benzoxathiin scaffold. The aim of this work is to compare abilities of sulfur and oxygen atom, hydroxyl groups, and ferrocene moiety at different positions of 4-thiaflavan to trap radicals and to inhibit DNA oxidation. It is found that abilities of thiaflavans to trap radicals and to inhibit DNA oxidation are increased in the presence of ferrocene moiety and are further improved by the electron-donating group attaching to thiaflavan skeleton. It can be concluded that the ferrocene moiety plays the major role for thiaflavans to be antioxidants even in the absence of phenolic hydroxyl groups. On the other hand, the antioxidant effectiveness of phenolic hydroxyl groups in thiaflavans can be improved by the electron-donating group. The influences of sulfur and oxygen atoms in thiaflavans on the antioxidant property of para-hydroxyl group exhibit different manners when the thiaflavans are used to trap radicals and to inhibit DNA oxidation. Copyright © 2014 Elsevier Masson SAS. All rights reserved.
Quantitative studies on structure-DPPH• scavenging activity relationships of food phenolic acids.
Jing, Pu; Zhao, Shu-Juan; Jian, Wen-Jie; Qian, Bing-Jun; Dong, Ying; Pang, Jie
2012-11-01
Phenolic acids are potent antioxidants, yet the quantitative structure-activity relationships of phenolic acids remain unclear. The purpose of this study was to establish 3D-QSAR models able to predict phenolic acids with high DPPH• scavenging activity and understand their structure-activity relationships. The model has been established by using a training set of compounds with cross-validated q2 = 0.638/0.855, non-cross-validated r2 = 0.984/0.986, standard error of estimate = 0.236/0.216, and F = 139.126/208.320 for the best CoMFA/CoMSIA models. The predictive ability of the models was validated with the correlation coefficient r2(pred) = 0.971/0.996 (>0.6) for each model. Additionally, the contour map results suggested that structural characteristics of phenolics acids favorable for the high DPPH• scavenging activity might include: (1) bulky and/or electron-donating substituent groups on the phenol ring; (2) electron-donating groups at the meta-position and/or hydrophobic groups at the meta-/ortho-position; (3) hydrogen-bond donor/electron-donating groups at the ortho-position. The results have been confirmed based on structural analyses of phenolic acids and their DPPH• scavenging data from eight recent publications. The findings may provide deeper insight into the antioxidant mechanisms and provide useful information for selecting phenolic acids for free radical scavenging properties.
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Two-photon or higher-order absorbing optical materials and methods of use
NASA Technical Reports Server (NTRS)
Marder, Seth (Inventor); Perry, Joseph (Inventor)
2012-01-01
Compositions capable of simultaneous two-photon absorption and higher order absorptivities are provided. Compounds having a donor-pi-donor or acceptor-pi-acceptor structure are of particular interest, where the donor is an electron donating group, acceptor is an electron accepting group, and pi is a pi bridge linking the donor and/or acceptor groups. The pi bridge may additionally be substituted with electron donating or withdrawing groups to alter the absorptive wavelength of the structure. Also disclosed are methods of generating an excited state of such compounds through optical stimulation with light using simultaneous absorption of photons of energies individually insufficient to achieve an excited state of the compound, but capable of doing so upon simultaneous absorption of two or more such photons. Applications employing such methods are also provided, including controlled polymerization achieved through focusing of the light source(s) used.
Wu, Xingyu; Jin, Ming; Xie, Jianchao; Malval, Jean-Pierre; Wan, Decheng
2017-11-07
A series of donor-π-acceptor-type sulfonium salt photoacid generators (PAGs) were designed and synthesized by systematically changing electron-donating groups, π-conjugated systems, electron-withdrawing groups, and the number of branches through molecular engineering. These PAGs can effectively decompose under UV/Vis irradiation from a light-emitting diode (LED) light source because of the matching absorption and emitting spectra of the LEDs. The absorption and acid-generation properties of these sulfonium salts were elucidated by UV/Vis spectroscopy and so forth. Results indicated that the PAG performance benefited from the introduction of strong electron-donating groups, specific π-conjugated structures, certain electron-withdrawing groups, or two-branched structures. Most sulfonium salts showed potential as photoinitiators under irradiation by a wide variety of UV and visible LEDs. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.
Cardiac transplantation. Organ procurement to patient discharge.
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.
Omani Samani, Reza; Vesali, Samira; Navid, Behnaz; Vakiliniya, Bahareh; Mohammadi, Maryam
2017-01-01
This study evaluated hope, depression, anxiety, and stress among three groups of infertile couples. This cross-sectional study consisted of three groups of infertile couples-candidates for oocyte donation (n=60), embryo donation (n=60), and normal infertile (n=60). Participants included couples seen at Royan Institute, Tehran, Iran between 2013-2014 who were at least 18 years of age and could read and write in Persian. Participants provided demographic and general characteristics and completed the Persian version of the Adult Trait Hope Scale (hope, agency and pathway) and Depression, Anxiety, and Stress Scale (DASS). Data was analyzed by the paired t test, ANOVA, ANCOVA and Pearson correlation tests using SPSS statistical software. Overall, 180 infertile couples participated in the three groups. There was a significant higher mean score for hope in husbands compared to wives in the normal infertile group (P=0.046). Husbands in the normal infertile group also had a significantly higher mean score for pathway (P=0.032). The frequency of anxiety significantly differed in female subjects (P=0.028). In the normal infertile group, the anxiety distribution significantly differed between wives and husbands (P=0.006). There was a significantly different stress frequency in male subjects (P=0.048). In the embryo donation group, stress significantly differed between wives and husbands (P=0.002). In the normal infertile group, stress also significantly differed between wives and husbands (P=0.05). The results have suggested that hope might be important in reducing psychological symptoms and psychological adjustment in those exposed to infertility problems who follow medical recommendations, which accelerates recovery. It is recommended to hold psychological counseling sessions (hope therapy) during reproduction cycles.
Foster, J.
2016-01-01
Abstract The use of sperm donation by single women has provoked public, professional and political debate. Newspapers serve as a critical means of both broadcasting this debate and effecting a representation of this user group within the public sphere. This study uses the theory of social representations to examine how single motherhood by sperm donation has been represented in the UK news over time. The study sampled news coverage on this topic in eight British newspapers during three 4‐year periods between the years 1988 and 2012. The dataset of news reports (n = 406) was analysed using a qualitative approach. Findings indicated that UK media reports of single women using donor sperm are underpinned by conventional categories of the ‘personal’, the ‘traditional’ and the ‘natural’ that when paired with their corollaries produce a representation of this user group as the social ‘other’. The amount of coverage on this topic over time was found to vary according to the political orientation of different media sources. Using key concepts from social representations theory, this article discusses the relationship between themata and anchoring in the maintenance of representations of the social ‘other’ in mass mediated communication. Findings are explained in relation to theoretical conceptions of the mass media and its position within the public sphere. It is argued that the use of personal narratives in news reports of single mothers by sperm donation may have significant implications for public understandings of this social group. © 2016 The Authors. Journal of Community & Applied Social Psychology published by John Wiley & Sons Ltd. PMID:27867283
Platelet function in whole-blood donors is impaired: the effects of painkillers.
Curvers, Joyce; Dielis, Arne W J H; Heeremans, Judith; van Wersch, Jan W J
2007-01-01
Aspirin (ASA) or non-aspirin-like nonsteroidal anti-inflammatory drugs (NSAIDs) influence platelet (PLT) function by inhibiting cyclooxygenase enzymes. In this study, the aim was to address the use of ASA or NSAIDs before donation and the effect on PLT function. Donors were asked questions about recent use of ASA or NSAIDs. Furthermore, PLT function was evaluated by measurement of the closure time (CT) in a PLT function analyzer (PFA-100, Dade Behring) and by aggregometry (response to ADP or arachidonic acid [AA]). Of 100 questioned donors, 22 percent had used ASA (n = 4), NSAIDs (n = 6), or paracetamol (n = 12) before donation. Upon assessment of the PLT function in the PFA-100, 27 donors showed values of greater than 180 seconds, indicative of impaired PLT function. Of these, only 7 had used pain killers before donation. Furthermore, 15 of 22 users had normal CTs. Aggregation after stimulation with AA was absent in 33 PLT-rich samples. Again only 8 had reported use of ASA (3), NSAIDs (1), or paracetamol (4). Of the 22 users, 14 had normal AA aggregation responses. All donor samples showed ADP-induced aggregation, indicating PLT integrity. There was no difference between the group of donors who reported the intake of ASA or NSAIDs and the group of donors who did not with respect to the tested PLT function assays. It is concluded that there is a considerable group of donors that use PLT-influencing medication before donation. A relation between the reported use and impaired PLT function in blood donors could not be established, however. Impaired PLT function as tested may have other causes than intake of ASA or NSAIDs.
Experimental ex vivo lung perfusion with sevoflurane: effects on damaged donor lung grafts.
Wang, Xingyu; Parapanov, Roumen; Francioli, Cyril; Perentes, Jean Yannis; Letovanec, Igor; Gonzalez, Michel; Kern, Christian; Ris, Hans-Beat; Piquilloud, Lise; Marcucci, Carlo; Krueger, Thorsten; Liaudet, Lucas; Gronchi, Fabrizio
2018-06-01
Volatile anaesthetics can provide significant protection against reperfusion injury in various experimental settings. The aim of this study was to assess the potential of sevoflurane treatment, the most commonly used volatile anaesthetic in modern anaesthesia, in rat lungs donated after circulatory death and reconditioned in an ex vivo lung perfusion (EVLP) system. Fifteen rats were sacrificed and divided into 3 groups. In the control and sevoflurane groups, the heart-lung blocks were exposed to 1 h of warm ischaemia and 2 h of cold ischaemia and were mounted on an EVLP circuit for 3 h, in the absence or in the presence of 2% sevoflurane. In the baseline group, heart-lung blocks were harvested immediately after euthanasia. Physiological data, lung nitro-oxidative stress, lactate dehydrogenase (LDH), expression of cytokines, oedema and histopathological findings were assessed during or post-EVLP. The sevoflurane group showed significantly reduced LDH (8.82 ± 3.58 arbitrary unit vs 3.80 ± 3.02 arbitrary unit, P = 0.03), protein carbonyl (1.17 ± 0.44 nmol⋅mg-1 vs 0.55 ± 0.11 nmol⋅mg-1, P = 0.006), 3-nitrotyrosine (197.44 ± 18.47 pg⋅mg-1 vs 151.05 ± 23.54 pg⋅mg-1, P = 0.004), cytokine-induced neutrophil chemoattractant factor 1 (1.17 ± 0.32 ng⋅mg-1 vs 0.66 ± 0.28 ng⋅mg-1, P = 0.03) and tumour necrosis factor alpha (1.50 ± 0.59 vs 0.59 ± 0.38 ng⋅mg-1, P = 0.02) when compared with the control group. In addition, sevoflurane lungs gained significantly less weight (0.72 ± 0.09 g vs 0.72 ± 0.09 g, P = 0.044), had less perivascular oedema (0.58 ± 0.09 vs 0.47 ± 0.07, P = 0.036), and improved static pulmonary compliance (+0.215 ml⋅cmH2O-1, P = 0.003) and peak airways pressure (-1.33 cmH2O, P = 0.04) but similar oxygenation capacity (+1.61 mmHg, P = 0.77) and pulmonary vascular resistances (+0.078 mmHg⋅min⋅ml-1, P = 0.15) when compared with the control group. These findings suggest that the potential of sevoflurane in protecting the lungs donated after cardiac death and reconditioned using EVLP could improve the outcome of these lungs following subsequent transplantation.
de Groot, Ingrid B; Schipper, Karen; van Dijk, Sandra; van der Boog, Paul J M; Stiggelbout, Anne M; Baranski, Andrzej G; Marang-van de Mheen, Perla J
2012-09-07
Limited data exist on the impact of living kidney donation on the donor-recipient relationship. Purpose of this study was to explore motivations to donate or accept a (living donor) kidney, whether expected relationship changes influence decision making and whether relationship changes are actually experienced. We conducted 6 focus groups in 47 of 114 invited individuals (41%), asking retrospectively about motivations and decision making around transplantation. We used qualitative and quantitative methods to analyze the focus group transcripts. Most deceased donor kidney recipients had a potential living donor available which they refused or did not want. They mostly waited for a deceased donor because of concern for the donor's health (75%). They more often expected negative relationship changes than living donor kidney recipients (75% vs. 27%, p = 0.01) who also expected positive changes. Living donor kidney recipients mostly accepted the kidney to improve their own quality of life (47%). Donors mostly donated a kidney because transplantation would make the recipient less dependent (25%). After transplantation both positive and negative relationship changes are experienced. Expected relationship changes and concerns about the donor's health lead some kidney patients to wait for a deceased donor, despite having a potential living donor available. Further research is needed to assess whether this concerns a selected group.
Neural valuation of environmental resources.
Sawe, Nik; Knutson, Brian
2015-11-15
How do people value environmental resources? To estimate public valuation of natural resources, researchers often conduct surveys that ask people how much they would be willing to pay to preserve or restore threatened natural resources. However, these survey responses often elicit complex affective responses, including negative reactions toward proposed destructive land uses of those resources. To better characterize processes that underlie the valuation of environmental resources, we conducted behavioral and neuroimaging experiments in which subjects chose whether or not to donate money to protect natural park lands (iconic versus non-iconic) from proposed land uses (destructive versus non-destructive). In both studies, land use destructiveness motivated subjects' donations more powerfully than did the iconic qualities of the parks themselves. Consistent with an anticipatory affect account, nucleus accumbens (NAcc) activity increased in response to more iconic parks, while anterior insula activity increased in response to more destructive uses, and the interaction of these considerations altered activity in the medial prefrontal cortex (MPFC). Further, anterior insula activity predicted increased donations to preserve parks threatened by destructive uses, but MPFC activity predicted reduced donations. Finally, individuals with stronger pro-environmental attitudes showed greater anterior insula activity in response to proposed destructive uses. These results imply that negative responses to destructive land uses may play a prominent role in environmental valuation, potentially overshadowing positive responses to the environmental resources themselves. The findings also suggest that neuroimaging methods might eventually complement traditional survey methods by allowing researchers to disentangle distinct affective responses that influence environmental valuation. Copyright © 2015. Published by Elsevier Inc.
Papachristou, Christina; Walter, Marc; Dietrich, Kerstin; Danzer, Gerhard; Klupp, Jochen; Klapp, Burghard F; Frommer, Jörg
2004-11-27
There has been a lack of systematic in-depth research on the motives of living liver donors before transplantation that could contribute to an advanced understanding of their situation and to a more precise psychosocial evaluation, to protect the autonomy for decision, and to prevent psychosocial complications. Twenty-eight living liver donors were assessed preoperatively through a semistructured clinical interview. The taped and transcribed interviews were analyzed using a combination of grounded theory and empirically grounded type construction. Various factors contribute to the donor's motivation for donation: the relationship to the recipient, the personal attitude of the donor, his or her personal history, family dynamics, the donor's personal profit, and the exceptional situation of the recipient's life-threatening disease combined with the life-rescuing possibility of living-donor liver transplantation (LDLT). In reference to this, five "ideal types" of living donors emerged from the authors' data. A complete absence of coercion on the decision to donate seems unrealistic because of the dynamics initiated by the life-threatening condition of the recipient. It is important that donors feel they are gaining something by donation to be sufficiently motivated and that their profit is of an emotional or moral nature (i.e., the donation being set in an emotionally meaningful context). A mature relationship with the recipient usually provides such a context. The role of the clinician as a part of LDLT dynamics has a decisive influence.
Yamashita, Makoto; Cuevas Vicario, Jose V; Hartwig, John F
2003-12-31
To determine the trans effect on the rates of reductive eliminations from arylpalladium(II) amido complexes, the reactions of arylpalladium amido complexes bearing symmetrical and unsymmetrical DPPF (DPPF = bis(diphenylphosphino)ferrocene) derivatives were studied. THF solutions of LPd(Ar)(NMeAr') (L = DPPF, DPPF-OMe, DPPF-CF3, DPPF-OMe,Ph, DPPF-Ph,CF3, and DPPF-OMe,CF3; Ar = C6H4-4-CF3; Ar' = C6H4-4-CH3, Ph, and C6H4-4-OMe) underwent C-N bond forming reductive elimination at -15 C to form the corresponding N-methyldiarylamine in high yield. Complexes ligated by symmetrical DPPF derivatives with electron-withdrawing substituents on the DPPF aryl groups underwent reductive elimination faster than complexes ligated by symmetrical DPPF derivatives with electron-donating substituents on the ligand aryl groups. Studies of arylpalladium amido complexes containing unsymmetrical DPPF ligands revealed several trends. First, the complex with the weaker donor trans to nitrogen and the stronger donor trans to the palladium-bound aryl group underwent reductive elimination faster than the regioisomeric complex with the stronger donor trans to nitrogen and the weaker donor trans to the palladium-bound aryl group. Second, the effect of varying the substituents on the phosphorus donor trans to the nitrogen was larger than the effect of varying the substituents on the phosphorus donor trans to the palladium-bound aryl group. Third, the difference in rate between the isomeric arylpalladium amido complexes was similar in magnitude to the differences in rates resulting from conventional variation of substituents on the symmetric phosphine ligands. This result suggests that the geometry of the complex is equal in importance to the donating ability of the dative ligands. The ratio of the differences in rates of reaction of the isomeric complexes was similar to the relative populations of the two geometric isomers. This result and consideration of transition state geometries suggest that the reaction rates are controlled more by substituent effects on ground state stability than on transition state energies. In addition, variation of the aryl group at the amido nitrogen showed systematically that complexes with more electron-donating groups at nitrogen undergo faster reductive elimination than those with less electron-donating groups at nitrogen.
Aggarwal, V; Prakash, C; Yadav, S; Chattopadhya, D
1997-12-01
Any change in risk behavior related to acquisition of human immunodeficiency virus (HIV) infection is likely to reduce simultaneously the risk for other agents transmitted through identical routes. A study carried out in the city of Delhi, India on the load of transfusion associated infections among multitransfused (MT) children in relation to mandatory screening of HIV infection in donated blood indicated unchanged prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV) and hepatitis D virus (HDV) infections among the group of MT children transfused after the implementation of mandatory screening of HIV infections in blood banks, i.e. post-implementation period (prevalence of HBV, HCV and HDV being 32.8%, 31.3% and 1.6% respectively) compared to a group of MT children transfused over a similar duration before the implementation of mandatory screening i.e. pre-implementation period (prevalence of HBV, HCV and HDV being 28.1%, 26.6% and 1.6% respectively). However, reduction could be recorded in the prevalence of IgM and IgG classes of antibodies to both CMV and HSV-2 infections among MT children receiving transfusion during the post-implementation period (prevalence of 3.1% and 37.1% for CMV IgM and CMV IgG respectively; prevalence of 3.1% and 25% for HSV-2 IgM and HSV-2 IgG, respectively) compared to the group of MT children transfused in the pre-implementation period (prevalence of 15.6% and 56.3% for CMV IgM and CMV IgG respectively; prevalence of 18.8% and 45.2% for HSV-2 IgM and HSV-2 IgG, respectively). These reductions were statistically significant (p values < 0.02 and < 0.05 for CMV IgM and CMV IgG; p values < 0.01 and < 0.02 for HSV-2 IgM and HSV-2 IgG respectively). These observations were in accordance with the recorded reduction in the prevalence of CMV and HSV-2 infections and unaltered prevalence of HBV, HCV and HDV infections in the group of donors donating blood during the post-implementation period compared to those donating in the pre-implementation period. Study of epidemiological risk factors among blood donors showed a change in behavior towards safer sex practice with only 13.0% of donors in the post-implementation period having history of sex with one or more female commercial sex workers during their donation periods compared to 41.5% of donors in the pre-implementation period having similar history (p < 0.001). However no change could be recorded in the proportion of donors donating at frequency higher than the permissible guidelines among the two groups. The present study points out nosocomial transmission as well as limitations in the existing guidelines for screening of infectious agents in blood banks as possible incriminating factors towards acquisition of hepatitis virus infections in blood donors as well as in MT children.
Thapar, Anita; Harold, Gordon; Rice, Frances; Ge, XiaoJia; Boivin, Jacky; Hay, Dale; van den Bree, Marianne; Lewis, Allyson
2007-01-01
Background There is much evidence to suggest that risk for common clinical disorders begins in foetal life. Exposure to environmental risk factors however is often not random. Many commonly used indices of prenatal adversity (e.g. maternal gestational stress, gestational diabetes, smoking in pregnancy) are influenced by maternal genes and genetically influenced maternal behaviour. As mother provides the baby with both genes and prenatal environment, associations between prenatal risk factors and offspring disease maybe attributable to true prenatal risk effects or to the "confounding" effects of genetic liability that are shared by mother and offspring. Cross-fostering designs, including those that involve embryo transfer have proved useful in animal studies. However disentangling these effects in humans poses significant problems for traditional genetic epidemiological research designs. Methods We present a novel research strategy aimed at disentangling maternally provided pre-natal environmental and inherited genetic effects. Families of children aged 5 to 9 years born by assisted reproductive technologies, specifically homologous IVF, sperm donation, egg donation, embryo donation and gestational surrogacy were contacted through fertility clinics and mailed a package of questionnaires on health and mental health related risk factors and outcomes. Further data were obtained from antenatal records. Results To date 741 families from 18 fertility clinics have participated. The degree of association between maternally provided prenatal risk factor and child outcome in the group of families where the woman undergoing pregnancy and offspring are genetically related (homologous IVF, sperm donation) is compared to association in the group where offspring are genetically unrelated to the woman who undergoes the pregnancy (egg donation, embryo donation, surrogacy). These comparisons can be then examined to infer the extent to which prenatal effects are genetically and environmentally mediated. Conclusion A study based on children born by IVF treatment and who differ in genetic relatedness to the woman undergoing the pregnancy is feasible. The present report outlines a novel experimental method that permits disaggregation of maternally provided inherited genetic and post-implantation prenatal effects. PMID:17587444
Attitudes toward transplantation in U.K. Muslim Indo-Asians in west London.
Alkhawari, Fawzi S; Stimson, Gerry V; Warrens, Anthony N
2005-06-01
The worldwide shortage of organs for transplantation makes it important to understand why some oppose donation. Attitudes vary with religion and ethnicity. Accordingly, we undertook a qualitative study of the attitudes of 141 U.K. Muslim Indo-Asians to organ donation. Participants were observed, focus group discussions held and in-depth individual interviews conducted. We identified a high level of alienation from the health care system in general. With respect to organ donation in particular, its importance was generally discounted, often in deference to authority figures within the community who appeared negatively disposed. The culture-specific issues arguing against donation included a sense of the sacredness of the body, a fatalistic approach to illness, a belief that organs took on an independent role as 'witnesses' to an individual's life on Judgement Day and an anxiety that the donor would have no control of the probity of the recipient of an organ. We believe these data suggest a need to improve in a culturally sensitive fashion the provision of health information provided to this community.
Machado, Helena; Silva, Susana
2014-01-01
The creation and expansion of forensic DNA databases might involve potential threats to the protection of a range of human rights. At the same time, such databases have social benefits. Based on data collected through an online questionnaire applied to 628 individuals in Portugal, this paper aims to analyze the citizens' willingness to donate voluntarily a sample for profiling and inclusion in the National Forensic DNA Database and the views underpinning such a decision. Nearly one-quarter of the respondents would indicate 'no', and this negative response increased significantly with age and education. The overriding willingness to accept the inclusion of the individual genetic profile indicates an acknowledgement of the investigative potential of forensic DNA technologies and a relegation of civil liberties and human rights to the background, owing to the perceived benefits of protecting both society and the individual from crime. This rationale is mostly expressed by the idea that all citizens should contribute to the expansion of the National Forensic DNA Database for reasons that range from the more abstract assumption that donating a sample for profiling would be helpful in fighting crime to the more concrete suggestion that everyone (criminals and non-criminals) should be in the database. The concerns with the risks of accepting the donation of a sample for genetic profiling and inclusion in the National Forensic DNA Database are mostly related to lack of control and insufficient or unclear regulations concerning safeguarding individuals' data and supervising the access and uses of genetic data. By providing an empirically-grounded understanding of the attitudes regarding willingness to donate voluntary a sample for profiling and inclusion in a National Forensic DNA Database, this study also considers the citizens' perceived benefits and risks of operating forensic DNA databases. These collective views might be useful for the formation of international common ethical standards for the development and governance of DNA databases in a framework in which the citizens' perspectives are taken into consideration. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
Can donated media placements reach intended audiences?
Cooper, Crystale Purvis; Gelb, Cynthia A; Chu, Jennifer; Polonec, Lindsey
2013-09-01
Donated media placements for public service announcements (PSAs) can be difficult to secure, and may not always reach intended audiences. Strategies used by the Centers for Disease Control and Prevention's (CDC) Screen for Life: National Colorectal Cancer Action Campaign (SFL) to obtain donated media placements include producing a diverse mix of high-quality PSAs, co-branding with state and tribal health agencies, securing celebrity involvement, monitoring media trends to identify new distribution opportunities, and strategically timing the release of PSAs. To investigate open-ended recall of PSAs promoting colorectal cancer screening, CDC conducted 12 focus groups in three U.S. cities with men and women either nearing age 50 years, when screening is recommended to begin, or aged 50-75 years who were not in compliance with screening guidelines. In most focus groups, multiple participants recalled exposure to PSAs promoting colorectal cancer screening, and most of these individuals reported having seen SFL PSAs on television, in transit stations, or on the sides of public buses. Some participants reported exposure to SFL PSAs without prompting from the moderator, as they explained how they learned about the disease. Several participants reported learning key campaign messages from PSAs, including that colorectal cancer screening should begin at age 50 years and screening can find polyps so they can be removed before becoming cancerous. Donated media placements can reach and educate mass audiences, including millions of U.S. adults who have not been screened appropriately for colorectal cancer.
Taner, C Burcin; Bulatao, Ilynn G; Arasi, Lisa C; Perry, Dana K; Willingham, Darrin L; Sibulesky, Lena; Rosser, Barry G; Canabal, Juan M; Nguyen, Justin H; Kramer, David J
2012-01-01
Patients with end stage liver disease may become critically ill prior to LT requiring admission to the intensive care unit (ICU). The high acuity patients may be thought too ill to transplant; however, often LT is the only therapeutic option. Choosing the correct liver allograft for these patients is often difficult and it is imperative that the allograft work immediately. Donation after cardiac death (DCD) donors provide an important source of livers, however, DCD graft allocation remains a controversial topic, in critically ill patients. Between January 2003-December 2008, 1215 LTs were performed: 85 patients at the time of LT were in the ICU. Twelve patients received DCD grafts and 73 received donation after brain dead (DBD) grafts. After retransplant cases and multiorgan transplants were excluded, 8 recipients of DCD grafts and 42 recipients of DBD grafts were included in this study. Post-transplant outcomes of DCD and DBD liver grafts were compared. While there were differences in graft and survival between DCD and DBD groups at 4 month and 1 year time points, the differences did not reach statistical significance. The graft and patient survival rates were similar among the groups at 3-year time point. There is need for other large liver transplant programs to report their outcomes using liver grafts from DCD and DBD donors. We believe that the experience of the surgical, medical and critical care team is important for successfully using DCD grafts for critically ill patients.
Kheirabadi, Ramesh; Izadyar, Mohammad
2018-05-18
The mechanism of action of the selenenamide 1 as a mimic of the glutathione peroxidase (GPx) was investigated by the density functional theory. The solvent-assisted proton exchange procedure was applied to model the catalytic behavior and antioxidant activity of this mimic. To have an insight into the charge transfer effect, different aromatic thiols, including electron donating substituents on the phenyl ring were considered. The catalytic behavior of the selenenamide was modeled in a four-step mechanism, described by the oxidation of the mimic, the reduction of the obtained product, selenoxide, the reduction of the selenenylsulfide and dehydration of selenenic acid. On the basis of the activation parameters, the final step of the proposed mechanism is the rate determining states of the catalytic cycle. Turnover frequency (TOF) analysis showed that the electron donating groups at the para-position of the phenyl ring of the PhSH do not affect the catalytic activity of the selenenamide in contrast to p-methyl thiophenol which indicates the highest nucleophilicity. The evaluation of the electronic contribution of the various donating groups on the phenyl ring of the aromatic thiols shows that the antioxidant activity of the selenenamide sufficiently increases in the presence of the electron-donating substitutions. Finally, the charge transfer process at the rate-determining state was investigated based on the natural bond orbital analysis. Copyright © 2018 Elsevier Ltd. All rights reserved.
A social epidemiological study on HIV/AIDS in a village of Henan Province, China.
Yan, Jin; Xiao, Shuiyuan; Zhou, Liang; Tang, Yong; Xu, Guangming; Luo, Dan; Yi, Qifeng
2013-01-01
The HIV/AIDS epidemic caused by commercial blood donation in rural Henan Province of China in the early- to mid-1990s is the largest known cohort in the world related to blood donation but is not fully described. The objectives of this study were to describe the epidemic, epidemiology, and social epidemiology of commercial blood donation and HIV/AIDS. Both qualitative and quantitative mixed methods were used. A village was randomly selected from the 38 key HIV/AIDS pandemic villages in Henan Province. "Demographic Data Form" was applied to collect demographic information of each resident. Focus groups were held for the managers, some residents, members of "HIV/AIDS Work-Team" (organized by the Henan Provincial Government) in the village. Every village physician, people living with HIV/AIDS (PLWHA), school header, and other stakeholders were interviewed individually. The social epidemiology of HIV/AIDS was analyzed under three perspectives of the framework: individual, social, and structural perspectives. In this village, there were 2335 residents, 484 (20.3%) were former donors, 107 (4.6%) were PLWHA, and 96.3% of PLWHA were infected through commercial blood donation. Individually, low education and plasma donation were the risky factors of HIV/AIDS infection. Socially, the epidemic was geography-, kinship-, and conformity-related. Structurally, the related macrostructure factor was policy endorsement of national blood products. The microstructure factors were poverty and value belief on male child in passing down generations. It is concluded that commercial blood donation and HIV/AIDS epidemic in the village are symbiotically related. The epidemic is temporary and socially determined.
Allard, Julie; Fortin, Marie-Chantal
2017-09-01
In June 2016, following the decision of the Supreme Court of Canada to decriminalise assistance in dying, the Canadian government enacted Bill C-14, legalising medical assistance in dying (MAID). In 2014, the province of Quebec had passed end-of-life care legislation making MAID available as of December 2015. The availability of MAID has many implications, including the possibility of combining this practice with organ donation through the controlled donation after cardiac death (cDCD) protocol. cDCD most often occurs in cases where the patient has a severe neurological injury but does not meet all the criteria for brain death. The donation is subsequent to the decision to withdraw life-sustaining treatment (LST). Cases where patients are conscious prior to the withdrawal of LST are unusual, and have raised doubts as to the acceptability of removing organs from individuals who are not neurologically impaired and who have voluntarily chosen to die. These cases can be compared with likely scenarios in which patients will request both MAID and organ donation. In both instances, patients will be conscious and competent. Organ donation in such contexts raises ethical issues regarding respect for autonomy, societal pressure, conscientious objections and the dead-donor rule. In this article, we look at relevant policies in other countries and examine the ethical issues associated with cDCD in conscious patients who choose to die. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Development and Validation of the Biobanking Attitudes and Knowledge Survey (BANKS)
Wells, Kristen J.; Arevalo, Mariana; Meade, Cathy D.; Gwede, Clement K.; Quinn, Gwendolyn P.; Luque, John S.; Miguel, Gloria San; Watson, Dale; Phillips, Rebecca; Reyes, Carmen; Romo, Margarita; West, Jim; Jacobsen, Paul B.
2014-01-01
Background No validated multi-scale instruments exist that measure community members’ views on biobanking and biospecimen donation. This study describes the development and psychometric properties of the English-language BANKS (Biobanking Attitudes aNd Knowledge Survey). Methods The BANKS was created by item generation through review of scientific literature, focus groups with community members, and input from a community advisory board. Items were refined through cognitive interviews. Content validity was assessed through an expert panel review. Psychometric properties of the BANKS were assessed in a sample of 85 community members. Results The final BANKS includes 3 scales: Attitudes, Knowledge, and Self-Efficacy; as well as 3 single items, which evaluated receptivity and intention to donate a biospecimen for research. Cronbach's alpha coefficients for two scales that use Likert response format indicated high internal consistency (Attitudes: α=.88; Self-Efficacy: α=.95). Content validity indices were moderate, ranging from 0.69 to 0.89. Intention to donate blood and intention to donate urine were positively correlated with attitudes, knowledge, self-efficacy, and receptivity to learning more about biobanking (p's range from .029 to <.001). Conclusions The final BANKS shows evidence of satisfactory reliability and validity, is easy to administer, and is a promising tool to inform biospecimen research. Additional studies should be conducted with larger samples considering biospecimen donation to further assess the instrument's reliability and validity. Impact A valid and reliable instrument measuring community members’ views about biobanking may help researchers evaluate relevant communication interventions to enhance understanding, intention, and actual biospecimen donation. A Spanish-language BANKS is under development. PMID:24609846
Phillipson, Lyn; Larsen-Truong, Karen; Pitts, Leissa; Nonu, Miriam
2015-03-01
Despite the lifesaving benefits of organ and tissue donation, a worldwide shortage of suitable and registered donors exists. Although the reasons for this shortage are multifactorial, it has been recognized that distinct barriers to registration, family discussion, and consent that require targeted intervention and action are present among minority cultural, religious, and immigrant communities. To explore the knowledge, attitudes, and beliefs of 3 orthodox religious communities in Australia (Macedonian, Greek, and Serbian Orthodox) and determine the implications for engaging with these communities to improve knowledge, attitudes, family discussion, and the ability to make an informed decision about donation. Qualitative approach using focus groups moderated by researchers and bicultural health workers with the assistance of accredited interpreters. 98 adult members of the Greek, Macedonian, and Serbian Orthodox communities in the Illawarra region of New South Wales, Australia. Clear barriers to discussing and making an informed decision about organ and tissue donation were identified. Knowledge of processes and procedures was low and discussion about death (and organ and tissue donation) with family members and loved ones was considered taboo. Despite these barriers, all 3 communities expressed a desire for more information and engagement. Of particular interest were the perspectives of 3 types of "experts": medical, religious, and other community members (who had experience with the organ and tissue donation system). Future programs designed for orthodox religious communities should consider the need for active strategies that facilitate information sharing and engagement between community members and these 3 types of experts.
Chakraborty, Mainak; Karmakar, Indrajit; Haldar, Sagnik; Das, Avratanu; Bala, Asis; Haldar, Pallab Kanti
2016-01-01
Introduction: The present study evaluates the antioxidant effect of methanol extract of Hippophae salicifolia (MEHS) bark with special emphasis on its role on oxidative DNA damage in mouse peritoneal macrophages. Material and Methods: In vitro antioxidant activity was estimated by standard antioxidant assays whereas the antioxidant activity concluded the H+ donating capacity. Mouse erythrocytes’ hemolysis and peritoneal macrophages’ DNA damage were determined spectrophotometrically. In vivo antioxidant activity of MEHS was determined in carbon tetrachloride-induced mice by studying its effect on superoxide anion production in macrophages cells, superoxide dismutase in the cell lysate, DNA damage, lipid peroxidation, and reduces glutathione. Results: The extract showed good in vitro antioxidant activities whereas the inhibitory concentrations values ranged from 5.80 to 106.5 μg/ml. MEHS significantly (P < 0.05) attenuated the oxidative DNA damage. It also attenuated the oxidative conversion of hemoglobin to methemoglobin and elevation of enzymatic and nonenzymatic antioxidant in cells. Conclusion: The result indicates MEHS has good in vitro-in vivo antioxidant property as well as the protective effect on DNA and red blood cell may be due to its H+ donating property. PMID:27413349
Siminoff, Laura A.; Alolod, Gerard P.; Wilson-Genderson, Maureen; Yuen, Eva Y. N.; Traino, Heather M.
2016-01-01
Available literature points to healthcare providers’ discomfort with donation after cardiac death (DCD) and their perception of the public’s reluctance toward the procedure. Using a national sample, we report on the communication content of actual DCD and donation after brain death (DBD) approaches by organ procurement organization (OPO) requesters and compare family decision makers’ (FDMs’) experiences of both modalities. We recruited 1,601 FDMs using a validated protocol; 347 (21.7%) were of potential DCD donors. Semi-structured telephone interviews yielded FDMs’ sociodemographic data, predisposition toward donation, assessment of approach, final outcomes, and substantiating reasons. Initial analysis consisted of bivariate analyses. Multilevel mixture models compared groups representing authorization outcome and DCD/DBD status. No significant differences in family authorization were found between DCD and DBD cases. Statistically significant associations were found between sociodemographic characteristics and authorization, with White FDMs more likely to authorize DCD or DBD than Black FDMs. FDMs of both modalities had similar evaluations of requester skills, topics discussed, satisfaction, and reasons for refusal. The findings suggest that the DCD/DBD distinction may not be notable to families. We recommend the use of similar communication skills and strategies during approaches and the development of education campaigns about the public’s acceptance of DCD. PMID:27753206
Autonomy and self-esteem of women who donate to an oocyte cryopreservation bank in the Netherlands.
Bakker, Marjolein R; Maas, Joyce; Bekker, Marrie H; Bredenoord, Annelien L; Fauser, Bart C; Bos, Annelies M
2017-08-01
Worldwide, oocyte donors donate voluntarily or receive varying amounts of money for donation. This raises ethical questions regarding the appropriateness of financial compensation, and the possibility of undue inducement and exploitation of oocyte donors. Are these donors capable of making an independent, well-considered decision? Regarding this matter, it is important to examine aspects such as autonomy-connectedness and self-esteem. In this cross-sectional study, demographic characteristics and donation motivations were assessed in 92 women who attended the University Medical Center (UMC) Utrecht as potential oocyte donors between June 2012 and July 2016. Demographic characteristics were assessed. Motivations were recorded in semi-structured interviews (response rate 59%). The Rosenberg Self-Esteem Scale was used to assess level of self-esteem. The Autonomy-Connectedness Scale was used to measure the level of autonomy-connectedness. The typical oocyte donor at the UMC Utrecht is a well-educated, employed, 31-year-old woman living with her partner in a completed family with two children, and donating on altruistic grounds. The donors showed higher autonomy-connectedness scores than the average female Dutch population and do not lack self-esteem (questionnaire response rate 66%). Concerns regarding exploitation and attraction of women with lower socioeconomic status, with shortcomings in autonomy-connectedness and self-esteem, could not be confirmed in this group. Copyright © 2017 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.
Siminoff, L A; Alolod, G P; Wilson-Genderson, M; Yuen, E Y N; Traino, H M
2017-05-01
Available literature points to healthcare providers' discomfort with donation after cardiac death (DCD) and their perception of public reluctance toward the procedure. Using a national sample, we report on the communication content of actual DCD and donation after brain death (DBD) approaches by organ procurement organization (OPO) requesters and compare family decision makers' (FDMs') experiences of both modalities. We recruited 1601 FDMs using a validated protocol; 347 (21.7%) were of potential DCD donors. Semistructured telephone interviews yielded FDMs' sociodemographic data, donation attitudes, assessment of approach, final outcomes, and substantiating reasons. Initial analysis consisted of bivariate analyses. Multilevel mixture models compared groups representing authorization outcome and DCD/DBD status. No significant differences in family authorization were found between DCD and DBD cases. Statistically significant associations were found between sociodemographic characteristics and authorization, with white FDMs more likely to authorize DCD or DBD than black FDMs. FDMs of both modalities had similar evaluations of requester skills, topics discussed, satisfaction, and refusal reasons. The findings suggest that the DCD/DBD distinction may not be notable to families. We recommend the use of similar approach strategies and communication skills and the development of education campaigns about the public's acceptance of DCD. © 2016 The American Society of Transplantation and the American Society of Transplant Surgeons.
Organ and tissue donation in migrants: advanced course for cross-cultural mediators.
Potenza, R; Guermani, A; Grosso, M; Fossarello, L; Fontaneto, C; Casciola, A; Donadio, P P
2013-09-01
Between 2004 and 2010 in Piedmont (Italy Northern Region) 1556 brain-death situations were reported, including 113 (7.3%) in migrants as potential organ and tissue donors. The health staff often has to face migrants, who show great cultural differences and language difficulties. The Molinette Hospital Customer Care Service, the Piedmont Regional Tissue and Organ Procurement Coordination Agency (RPC), and the Cross-Cultural Mediators Association (CMA) organized a special course for intercultural mediators, to decrease misunderstandings between the health staff and the migrants' families and to improve professional communication. In 2011, 28 cultural-linguistic mediators representing different groups of migrants in Piemonte took part in a specific course. Over a 5 month period they were informed about emotional and communicative aspects, proper to the moment of death, as well as organ donation as an intercultural field, the professional role of the mediator, the clinical and forensic aspects of brain death and donation, and the psychological aspects of organ donation. The course was organized by cultural-linguistic mediators of the CMA, the staff of the RPC and the teachers at Turin University. The list of the 21 mediators who passed the final exam was given to organ and tissue donation hospital co-ordinators in Piedmont, so that if necessary, they could obtain the cooperation of these qualified people. Copyright © 2013 Elsevier Inc. All rights reserved.
A pilot iron substitution programme in female blood donors with iron deficiency without anaemia.
Pittori, C; Buser, A; Gasser, U E; Sigle, J; Job, S; Rüesch, M; Tichelli, A; Infanti, L
2011-04-01
Blood donation can contribute to iron deficiency. The possibly resulting anaemia importantly affects donor return rate. The determination of serum ferritin levels revealed iron deficiency in many non-anaemic premenopausal female blood donors at our Institution. We started an iron substitution programme targeting this donor group to prevent anaemia and enhance donor retain. Women aged≤50 with haemoglobin levels adequate for donation and serum ferritin≤10 ng/ml were offered iron supplementation. Substitution lasted 16 weeks and the donation interval was extended. History collection including iron deficiency-related symptoms, whole blood count and serum ferritin determination was performed at baseline and after 2 and 6 months. Data were recorded prospectively and compared with those of 108 female controls with iron deficiency not receiving iron substitution (retrospective data). Of the 116 participating subjects, 60% completed the programme. Significant results were serum ferritin increase (from a mean value of 7.12 to 25.2 ng/ml), resolution of prostration, fatigue, sleep disturbances, tension in the neck, hair loss and nail breakage. No case of anaemia occurred. Sixty per cent of the women completed the programme and donated blood again. Targeted iron substitution prevents the development of anaemia and enhances donation return in premenopausal female blood donors with iron deficiency. © 2010 The Author(s). Vox Sanguinis © 2010 International Society of Blood Transfusion.
Jalalian, Mehrdad; Latiff, Latiffah; Hassan, Syed Tajuddin Syed; Hanachi, Parichehr; Othman, Mohamed
2010-05-01
University students are a target group for blood donor programs. To develop a blood donation culture among university students, it is important to identify factors used to predict their intent to donate blood. This study attempted to develop a valid and reliable measurement tool to be employed in assessing variables in a blood donation behavior model based on the Theory of Planned Behavior (TPB), a commonly used theoretical foundation for social psychology studies. We employed an elicitation study, in which we determined the commonly held behavioral and normative beliefs about blood donation. We used the results of the elicitation study and a standard format for creating questionnaire items for all constructs of the TPB model to prepare the first draft of the measurement tool. After piloting the questionnaire, we prepared the final draft of the questionnaire to be used in our main study. Examination of internal consistency using Chronbach's alpha coefficient and item-total statistics indicated the constructs "Intention" and "Self efficacy" had the highest reliability. Removing one item from each of the constructs, "Attitude," "Subjective norm," "Self efficacy," or "Behavioral beliefs", can considerably increase the reliability of the measurement tool, however, such action is controversial, especially for the variables "attitude" and "subjective norm." We consider all the items of our first draft questionnaire in our main study to make it a reliable measurement tool.
Effect of community educational interventions on rate of organ donation among Hispanic Americans.
Salim, Ali; Ley, Eric J; Berry, Cherisse; Schulman, Danielle; Navarro, Sonia; Zheng, Ling; Chan, Linda S
2014-09-01
The need for suitable organs for transplantation is especially pronounced in minority populations such as Hispanic Americans owing to disproportionately high rates of diabetes mellitus and kidney disease. Considerable barriers exist for Hispanic Americans consent to donation, resulting in significantly lower donation rates compared with white individuals. To investigate the effect of an aggressive outreach intervention during a 5-year period aimed at improving organ donation rates among Hispanic Americans. Prospective longitudinal observation study of organ donors treated at a major metropolitan level I trauma center. The center provides most of the medical care to the 4 Southern California neighborhoods with a high percentage of Hispanic Americans that were included in the study. Television and radio media campaigns and culturally sensitive educational programs implemented at high schools, churches, and medical clinics in the target neighborhoods. Consent rate for organ donation recorded during the study. Outreach interventions started in 2007 and were completed by 2012. Of 268 potential donors, 155 total donors (106 Hispanic Americans) provided consent during this time. A significant increase in consent rate was noted among Hispanic Americans, from 56% in 2005 to 83%in 2011 (P = .004); this increase was not evident in the population that was not Hispanic (67%in 2005 and 79% in 2011; P = .21). Aggressive outreach programs can reduce the disparity between organ supply and demand by improving the consent rate among the target group.
Larsen, Jesper; Sørensen, Søren Schwartz; Feldt-Rasmussen, Bo
2009-08-01
The aim of the study was to identify procedures of maximum importance for acceptance or rejection of kidney donation from a living donor as well as making the process more cost-effective. We identified all potential living related donors who were examined during the period between January 2002 and December 2006 at our department. The cost in euro (euro) for the programme was estimated using the Danish diagnosis-related group-system (DRG). The donor work-up programme was described. One hundred and thirty-three potential donors were identified; 66 male- and 67 female subjects, median age of 52 years (range 22-69). Sixty-four participants were rejected as donors. Abdominal CT-scan with angiography and urography ruled out 22 of the above 64 potential organ donors; thus, 48% of the volunteers for living kidney donation were unsuited for donation. Abdominal CT-scan with angiography and urography was the procedure identifying most subjects who were unsuited for kidney donation. A rearrangement of the present donor work-up programme could potentially reduce the costs from euro6911 to euro5292 per donor--saving 23% of the costs. By changing the sequence of examinations, it might be possible to cut down on time spent and number of tests needed for approving or rejecting subjects for living kidney donation.
Horcajadas, José A; Goyri, Eduardo; Higón, María A; Martínez-Conejero, José A; Gambadauro, Pietro; García, Gabriela; Meseguer, Marcos; Simón, Carlos; Pellicer, Antonio
2008-09-01
Uterine leiomyomas are the most frequent benign tumors during reproductive age. Whether intramural leiomyomas cause infertility and should be removed is controversial because no study has addressed the underlying mechanism of infertility. The objective of the study was to test the effect of intramural leiomyomas on endometrial function by comparing gene during the window of implantation and implantation in an oocyte donation program, in which the quality of the embryos replaced is similar and the endocrine environment of the endometrium is standardized by exogenous steroids. Human endometria of women with single intramural leiomyomas (group A, <5 cm and group B, > or =5 cm) and controls (group C) were collected on day LH+7 and processed for histology and gene expression analysis, using different methods and validated by quantitative RT-PCR. To compare in vitro fertilization outcome, a total of 1035 cases from our oocyte donation database were included, comprising patients with one fibroid less than 5 cm (A1, n = 532); two leiomyomas less than 5 cm (A2, n = 128); three or more leiomyomas less than 5 cm (A3, n = 125); one fibroid 5 cm or greater (B, n = 22); and two control groups: C1 (n = 93), women with previous myomectomy; and C2 (n = 135), women without uterine pathology treated on the same dates as C1. There was a strong positive and negative correlation in the expression profile of 69 genes according to the leiomyomas's size, but only three of the 25 genes related to the window of implantation were dysregulated. Term pregnancy rates after oocyte donation were 36.9, 34.1, 39.0, 36.4, 39.2, and 42.6% (P = 0.769) among the established groups. Similarly, no correlation between implantation and miscarriage with leiomyoma number and size was found. This study provides evidence that intramural leiomyomas not affecting the endometrial cavity alters the expression pattern of some endometrial genes, but the genes involved in implantation are not affected. This is confirmed by leiomyomas having no effect on oocyte donation outcome when the size and number of leiomyomas are analyzed.
Srzentić, Snelana Jovanović; Rodić, Ivana; Knezević, Mirjana
2015-06-01
Given that in each country students represent the most progressive population group, as of 2001, the Blood Transfusion Institute of Serbia (BTIS) has been carrying the program of voluntary blood donation promotion and education of volunteers at the University of Belgrade (UB). In 2011, the BTIS intensified all activities at the UB. The aim of this study was to present activities performed from 2001 at the Blood Donors' Motivation Department (DMD) of the BTIS related with increasing the level of awareness on voluntary blood donation in the Belgrade students' population, enhancing their motivation to become voluntary blood donors (VBDs), increasing the number of blood donations at faculties of the UB, and increasing the number of blood donations in the UB students population compared with the total number of blood units collected by BTIS in Belgrade, with the emphasis on the year 2013. Initially, the applied methodology was based on encouraging students to donate blood through discussions and preparatory lectures, followed by organized blood drives. Appropriate selection of volunteers at each faculty was crucial. Besides their recognisable identity, they had to have remarkable communication skills and ability to positivly affect persons in their environment. The applied principle was based on retention of volunteers all through the final academic year, with the inclusion of new volunteers each year and 1,000 preparatory lectures on the annual basis. The activities were realized using two Facebook profiles, SMS messages and continuous notification of the public through the media. There was an increase in the average number of students in blood drives at the faculties from 2011, when the average number of the students per blood drive was 39, followed by 43 in 2012 and 46 in 2013. The number of students who donated blood in 2013 increased by 21.3% compared with 2012 data. The applied concept highly contributed to generation and retention of future VBDs willing to regularly donate blood in the coming years, with a minimum risk of transmission of transfusion transmissible diseases markers.
Attitudes to kidney donation among primary care patients in rural Crete, Greece.
Symvoulakis, Emmanouil K; Komninos, Ioannis D; Antonakis, Nikos; Morgan, Myfanwy; Alegakis, Athanasios; Tsafantakis, Emmanouil; Chatziarsenis, Marios; Philalithis, Anastas; Jones, Roger
2009-02-10
In Greece, there is limited research on issues related to organ donation, and the low rate of registration as donors requires explanation. This study reports the findings of a survey of knowledge and attitudes to kidney donation among primary care patients in rural Crete, Greece. Two rural primary care settings in the island of Crete, Anogia Health Centre and Vrachasi Practice, were involved in a questionnaire survey. This was conducted among primary care patients (aged 18 years and over) with routine appointments, to assess their knowledge and attitudes to kidney donation. General practitioners (GPs) recruited patients and questionnaires were completed following the patients' medical consultation. Pearson's chi square tests were used and crude odds ratios (OR) with 95% confidence intervals (95% CI) were calculated in order to investigate into the possible associations between the respondents' knowledge, attitudes and specific concerns in relation to their socio-demographic features. Logistic regression analyses were used to examine differences by geographical location. The 224 (92.5%) of the 242 primary care attenders who were approached agreed to participate. Only 2.2% (5/224) of the respondents carried a donor card. Most participants (84.4%, 189/224) did not feel well informed about registering as a kidney donor. More than half of the respondents (54.3%, 121/223) were unwilling to register as a kidney donor and donate kidneys for transplant after death. Over a third of respondents (35.4%, 79/223) were not confident that medical teams would try as hard as possible to save the life of a person who has agreed to donate organs. People with a higher level of education were more likely to be willing to register as kidney donors [(OR: 3.3; 95% CI: 1.8-6.0), p < 0.001)] and to be less worried about their kidneys being removed after death [(OR: 0.3; 95% CI: 0.1-0.5), p < 0.001)] than those having a lower level of education. Lack of knowledge and information regarding organ donation and negative attitudes related to registration as donors were the main findings of this study. Efforts should be based on targeting the attitudes to organ donation of individuals and population groups.
NASA Technical Reports Server (NTRS)
Bauschlicher, Charles W., Jr.
1986-01-01
The bonding in Fe2(CO)9 is analyzed using an self consistend field (SCF) wave function for a large basis set. There is no direct Fe-Fe metal-metal bond. The bridging CO's hold the two Fe(CO)3 fragments together by a sigma donation into the empty Fe-Fe d pi orbital and metal donation from the d pi* orbital into the CO 2pi* orbital. The bonding of the terminal CO is similar to that in Ni(CO)4 and the equatorial groups in Fe(CO)5.
An analysis of first-time blood donors return behaviour using regression models.
Kheiri, S; Alibeigi, Z
2015-08-01
Blood products have a vital role in saving many patients' lives. The aim of this study was to analyse blood donor return behaviour. Using a cross-sectional follow-up design of 5-year duration, 864 first-time donors who had donated blood were selected using a systematic sampling. The behaviours of donors via three response variables, return to donation, frequency of return to donation and the time interval between donations, were analysed based on logistic regression, negative binomial regression and Cox's shared frailty model for recurrent events respectively. Successful return to donation rated at 49·1% and the deferral rate was 13·3%. There was a significant reverse relationship between the frequency of return to donation and the time interval between donations. Sex, body weight and job had an effect on return to donation; weight and frequency of donation during the first year had a direct effect on the total frequency of donations. Age, weight and job had a significant effect on the time intervals between donations. Aging decreases the chances of return to donation and increases the time interval between donations. Body weight affects the three response variables, i.e. the higher the weight, the more the chances of return to donation and the shorter the time interval between donations. There is a positive correlation between the frequency of donations in the first year and the total number of return to donations. Also, the shorter the time interval between donations is, the higher the frequency of donations. © 2015 British Blood Transfusion Society.
Li, Alvin Ho-ting; Al-Jaishi, Ahmed A.; Weir, Matthew; Lam, Ngan N.; Maclean, Janet; Dhanani, Sonny; Kim, S. Joseph; Knoll, Greg; Garg, Amit X.
2017-01-01
Background: Many families choose not to consent to organ donation at the time of their loved one’s death. In Ontario, Canada, whether these decisions vary by ethnicity remains unclear. Objective: To compare the proportion of families of immigrants who consented for deceased organ donation with families of long-term residents. Design: Population-based retrospective cohort study. Setting: Potential donors in Ontario, Canada, between November 2008 and March 2013. Methods: We used linked administrative databases to study the proportion of families who consented for deceased organ donation. Results: Overall, of the 2873 families of potential donors approached, 1912 (67%) provided consent for deceased organ donation. Families of immigrants were less likely to provide consent compared with families of long-term residents (46% [135 of 291] vs 69% [1777 of 2582]; adjusted rate ratio (RR): 0.72; 95% confidence interval [CI]: 0.63-0.81). When examined by the country of birth, families of immigrants from the following regions were less likely to consent to organ donation compared with long-term residents: South Asia (RR: 0.71; 95% CI: 0.55-0.91), East Asia and Pacific (RR: 0.68; 95% CI: 0.53-0.88) and Middle East, North Africa, and sub-Saharan Africa (RR: 0.58; 95% CI: 0.37-0.91). Limitations: We could not determine why consent was not obtained. We had a small sample of immigrants. We only had access to the potential donors’ information and not the family member who was approached for consent. Many characteristics that we examined were nonmodifiable (eg, age, sex). Conclusions: In Ontario, families of immigrants are less likely to consent to deceased organ donation. There is an opportunity to better understand the reasons for lower consent among certain immigrant groups. PMID:29093824
Jacquot, Cyril; Seo, Andrew; Miller, Peter M; Lezama, Niara; Criss, Valli R; Colvin, Camilla; Luban, Naomi L C; Wong, Edward C C
2017-11-01
Directed donation is associated with a higher prevalence of donations that are positive for infectious disease markers; however, little is known about the positive rates among parental-directed, non-parental-directed, and allogeneic donations. We reviewed blood-collection records from January 1997 through December 2008, including infectious disease results, among parental, non-parental, and community donations. Infectious disease rates were compared by Mann-Whitney U test. In total, 1532 parental, 4910 non-parental, and 17,423 community donations were examined. Among parental donors, the median rate of positive infectious disease testing was 8.66% (interquartile range (IQR), 4.49%) for first-time donors and 1.26% (IQR, 5.86%) for repeat donors; among non-parental donors, the rate was 1.09% (IQR, 0.98%) for first-time donors and 0% (IQR, 0.83%) for repeat donors; and, among community donors, the rate was 2.95% (IQR, 1.50%) for first-time donors and 0.45% (IQR, 0.82%) for repeat donors. The mean rate of positive infectious disease testing for first-time parental donors was significantly higher (7.63%), whereas all repeat donors had similar rates. However, the rate of positive infectious disease testing among first-time non-parental donors was significantly lower than that in the other groups, especially for the period from 2001 through 2008. First-time non-parental and community donors had significantly higher infectious disease risk than the respective repeat donors. First-time parental donors had the highest rates of positive infectious disease testing. We suggest that first-time parental blood donation should be discouraged. Repeat community donors or first-time non-parental donors provide a safer alternative. These findings can foster better patient education, donor selection, and possibly a reduced risk of infectious disease. © 2017 AABB.
Squires, Janet E; Grimshaw, Jeremy M; Taljaard, Monica; Linklater, Stefanie; Chassé, Michaël; Shemie, Sam D; Knoll, Gregory A
2014-06-20
A shortage of transplantable organs is a global problem. There are two types of organ donation: living and deceased. Deceased organ donation can occur following neurological determination of death (NDD) or cardiocirculatory death. Donation after cardiocirculatory death (DCD) accounts for the largest increments in deceased organ donation worldwide. Variations in the use of DCD exist, however, within Canada and worldwide. Reasons for these discrepancies are largely unknown. The purpose of this study is to develop, implement, and evaluate a theory-based knowledge translation intervention to provide practical guidance about how to increase the numbers of DCD organ donors without reducing the numbers of standard NDD donors. We will use a mixed method three-step approach. In step one, we will conduct semi-structured interviews, informed by the Theoretical Domains Framework, to identify and describe stakeholders' beliefs and attitudes about DCD and their perceptions of the multi-level factors that influence DCD. We will identify: determinants of the evidence-practice gap; specific behavioural changes and/or process changes needed to increase DCD; specific group(s) of clinicians or organizations (e.g., provincial donor organizations) in need of behaviour change; and specific targets for interventions. In step two, using the principles of intervention mapping, we will develop a theory-based knowledge translation intervention that encompasses behavior change techniques to overcome the identified barriers and enhance the enablers to DCD. In step three, we will roll out the intervention in hospitals across the 10 Canadian provinces and evaluate its effectiveness using a multiple interrupted time series design. We will adopt a behavioural approach to define and test novel, theory-based, and ethically-acceptable knowledge translation strategies to increase the numbers of available DCD organ donors in Canada. If successful, this study will ultimately lead to more transplantations, reducing patient morbidity and mortality at a population-level.
2014-01-01
Background A shortage of transplantable organs is a global problem. There are two types of organ donation: living and deceased. Deceased organ donation can occur following neurological determination of death (NDD) or cardiocirculatory death. Donation after cardiocirculatory death (DCD) accounts for the largest increments in deceased organ donation worldwide. Variations in the use of DCD exist, however, within Canada and worldwide. Reasons for these discrepancies are largely unknown. The purpose of this study is to develop, implement, and evaluate a theory-based knowledge translation intervention to provide practical guidance about how to increase the numbers of DCD organ donors without reducing the numbers of standard NDD donors. Methods We will use a mixed method three-step approach. In step one, we will conduct semi-structured interviews, informed by the Theoretical Domains Framework, to identify and describe stakeholders’ beliefs and attitudes about DCD and their perceptions of the multi-level factors that influence DCD. We will identify: determinants of the evidence-practice gap; specific behavioural changes and/or process changes needed to increase DCD; specific group(s) of clinicians or organizations (e.g., provincial donor organizations) in need of behaviour change; and specific targets for interventions. In step two, using the principles of intervention mapping, we will develop a theory-based knowledge translation intervention that encompasses behavior change techniques to overcome the identified barriers and enhance the enablers to DCD. In step three, we will roll out the intervention in hospitals across the 10 Canadian provinces and evaluate its effectiveness using a multiple interrupted time series design. Discussion We will adopt a behavioural approach to define and test novel, theory-based, and ethically-acceptable knowledge translation strategies to increase the numbers of available DCD organ donors in Canada. If successful, this study will ultimately lead to more transplantations, reducing patient morbidity and mortality at a population-level. PMID:24950719
Czeizler, Amalia; Garbarino, Ellen
2017-01-01
The research extends construal theory by testing if a match between the temporal construal framing of a blood donation decision and a blood donation request leads to higher donation intentions than a mismatch. Results show participants considering future donation who read an abstract donation request have significantly higher donation intentions than those who read a concrete request. Conversely, participants considering donating today who read a concrete donation request have significantly higher donation intentions than those who read an abstract request. This study confirms the importance of matching the construal framing of the communication to the temporal framing of the decision.
Synthesis and Photoluminescent Properties of Arylethynyl substituted 9,10-Anthraquinones
NASA Technical Reports Server (NTRS)
Yang, Jin-Hua; Dass, Amala; Sotiriou-Leventis, Chariklia; Leventis, Nicholas
2003-01-01
A series of arylethynyl substituted anthraquinones were synthesized via Sonogashira coupling reactions of 2,7- dibromo-, 2,6-dibromo- and 2-bromoanthraquinone with para-substituted phenylacetylenes. While the redox properties of those compounds are almost insensitive to substitution, their absorption maxima are linearly related to the Hammett constants for electron donating and electron withdrawing groups separately. All compounds are photoluminescent both in solution (quantum yield of emission approximately 2%) and as solids. X-ray crystallographic characterization of 2,7-bisphenylethynyl anthraquinone indicates a monoclinic p2(l/n) space group and no indication for pi-overlap that would promote self-quenching. The emission maxima are red- shifted by both electron donating and electron withdrawing groups alike. The Stokes shifts of all compounds are significant and are correlated to the electronic properties of the substituents. The reduced forms of these compounds are also photoluminescent and the emission originates from the dihydroanthraquinone core.
Tuning the structural and electronic properties of novel thiophene-pyrrole based 1,2,3,4-tetrazine
NASA Astrophysics Data System (ADS)
Dutta, Rakesh; Kalita, Dhruba Jyoti
2017-04-01
Here, we have studied the structural and optoelectronic behaviour of a series of conjugated heterocyclic polymers. The basic monomer unit of the conjugated polymers contains a backbone of novel thiophene and pyrrole based 1,2,3,4-tetrazine. The other oligomers are designed by substituting the basic monomer unit with different electron-donating and electron-withdrawing groups at the nitrogen and the 3rd C-atom of the pyrrole and the thiophene ring respectively. We have calculated dihedral angles, HOMO-LUMO gaps, excitation energies and oscillator strengths by employing TD-DFT method. Our study reveals that compounds having bulky substituents exhibit larger dihedral angles. This in turn renders an increase in the band gaps (ΔH - L). Presence of the electron-withdrawing substituents also increases the ΔH - L values of the oligomers. However, the electron-donating groups decrease the ΔH - L values of the oligomers. Therefore, small electron-donating substituents have an overwhelming effect on the optoelectronic properties of the conjugated polymers which in turn makes them interesting materials with good conduction properties for fabrication of optoelectronic devices such as OLEDs, OFETs and solar cells.
Effect of media presentations on willingness to commit to organ donation.
Harel, Inbal; Kogut, Tehila; Pinchas, Meir; Slovic, Paul
2017-05-16
We examine how presentations of organ donation cases in the media may affect people's willingness to sign organ donation commitment cards, donate the organs of a deceased relative, support the transition to an "opt-out" policy, or donate a kidney while alive. We found that providing identifying information about the prospective recipient (whose life was saved by the donation) increased the participants' willingness to commit to organ donation themselves, donate the organs of a deceased relative, or support a transition to an "opt-out" policy. Conversely, identifying the deceased donor tended to induce thoughts of death rather than about saving lives, resulting in fewer participants willing to donate organs or support measures that facilitated organ donation. A study of online news revealed that identification of the donor is significantly more common than identification of the recipient in the coverage of organ donation cases-with possibly adverse effects on the incidence of organ donations.
[Syphilis and blood transfusion].
Jenum, Pål A; Flesland, Øystein; Blystad, Hans; Vik, Inger Sofie Samdal; Hervig, Tor; Maeland, Arild; Saeter, Gunnar
2010-04-22
In 2007, previous syphilis infection was diagnosed in a blood donor who had given blood regularly for 15 years. This was discovered when the donor was tested for syphilis, as a new donor in another blood bank. The time of infection is unknown. An expert group, set up by The Norwegian Directorate of Health, was commissioned to evaluate the risk of syphilis transmission through blood products in Norway. The expert group based its evaluation on the epidemiology of syphilis, risk of infection and properties of the syphilis bacterium, especially in relation to blood donation. Specific information about the actual incident, made available by the Norwegian Directorate of Health, was also evaluated. Of 54 blood recipients 21 were alive and 18 (86 %) were tested for syphilis, all with a negative result. For 11 deceased the hospital records were studied without discovering signs of syphilis infection. The risk of transfusion-transmitted syphilis is low for several reasons: The prevalence of syphilis in the population is low, a compulsory interview and completion of a questionnaire before donation in Norway excludes patients who are ill or at risk of being infected; the proportion of fresh blood donations is very low and syphilis bacteria die quickly during normal storage conditions for blood. An incidental infection is symptomatic and easily treated by antibiotics. The expert group recommends to not start syphilis testing of each blood donor but to continue the present routine testing of new donors.
Ossareh, Shahrzad; Karbasi, Arsha
2009-12-01
Living unrelated donors (LURDs) constitute the major source of renal allograft in Iran. LURD transplantation (Tx) is performed in a controlled program, supervised by university Tx teams, and assisted by the Dialysis and Transplant Patient's Association (DATPA). This study evaluated the knowledge of donors about possible short- and long-term complications of kidney donation and the need for regular follow-up. We interviewed 100 consecutive living donors/donation candidates (all called donors), 35 in the postoperative period in the renal Tx ward, and 65 after completion of preoperative assessment in the office of the DATPA, to assess their knowledge about complications of nephrectomy and their intention to participate in the postoperative follow-up. Seventy-nine donors were men and 21 women. Mean age was 27 +/- 4.4 years. Ninety-seven donors were unrelated to the recipient and three were related (LRD). The motivation for donation was altruistic in nine (three LRD and six LURD) and financial in 89. Eighty donors were not aware of the possible short- or long-term complications of nephrectomy. Six donors mentioned the possibility of potential intraoperative complications, and 16 mentioned the risk of renal failure. Only 44 donors knew that they should visit doctors regularly after donation, most of them (61%) from the postoperative group. We conclude that most donors do not have enough knowledge about possible in-hospital and long-term complications of kidney donation and may not participate in regular follow-up after operation. Considering the young age of our renal Tx donors, we suggest that they should receive more preoperative orientation (both verbal and written) about possible complications and the need for regular postoperative medical follow-up.
Dang, Julie H T; Chen, Moon S
2018-04-01
Biospecimens from racially diverse groups are needed to advance cancer research. The Asian American Cancer Education Study was developed to increase the number and proportion of blood biospecimen donations from Asian Americans for cancer research. The authors' targeted approach included 2 types of community engagement, in-reach (within institution to Asian American patients with cancer) and outreach (external to institution to the general Asian American community). Participants received in-language biospecimen education followed by the opportunity to donate blood biospecimens. Outreach participants donated through our community biospecimen blood drives, and in-reach participants consented to donating an extra tube of blood during their routine blood draws as a patient. Donated blood biospecimens were spun down to serum and plasma to be stored in a biorepository or were sent to the laboratory to test for cancer-related risk factors. Three hundred eighty-eight Asian Americans donated 1127 blood biospecimens for cancer research. Four hundred twenty tubes of plasma and serum are currently being stored at the cancer center's biorepository, 39 tubes have been used for cancer genomic research, and 668 tubes were used to characterize cancer-related risk factors. Building upon the past decade of the National Cancer Institute-funded Asian American Network for Cancer Awareness, Research, and Training's foundation of trust and service among Asian Americans, researchers were able to leverage relationships not only to introduce the idea of biospecimen contribution to the community but to also exceed expectations with regard to the quantity of blood biospecimens collected from Asian Americans. Cancer 2018;124:1614-21. © 2018 American Cancer Society. © 2018 American Cancer Society.
Czerwiński, J; Danek, T; Trujnara, M; Parulski, A; Danielewicz, R
2014-10-01
In 2010, the system of donor hospital transplant coordinators was implemented in 200 hospitals in Poland on the basis of contracts with Poltransplant. This study evaluated whether the system (nationwide, maintained and funded by national organization) is sufficient, improved donation after brain death rates, and hospital activities. Donation indicators over a 21-month period of coordinators' work were compared with the 21-month period before their employment. The number of hospitals with a positive effect and with no effect was analyzed overall and in groups of hospitals with specific profiles. The implemented system resulted in increasing the number of potential donors by 27% (effectively, 24%); increasing utilized organs by 20% and multiorgan retrievals from 54% to 56%; decreasing the rate of utilized organs/actual donors from 2.65 to 2.57; and increasing family refusals from 8.5% to 9.3%. A positive effect was achieved in 102 hospitals (51%). Better results were achieved in regions where donation were initially low, namely, 59% in university hospitals, 63% in hospitals in large cities, 77% in hospitals with 2 coordinators, 67% in hospitals for adults, and 52% in hospitals where the coordinator was a doctor and not a nurse. This system resulted globally in increasing donation rates, but was effective only in one half of hospitals. Additional activities should be introduced to improve these results (quality systems, trainings, techniques for monitoring potential of donation, changes in profile of a coordinator). A formal analysis of coordinators' activities gives also the national organization a rational basis for their employment policy, taking into account the characteristics of hospitals and coordination teams.
Wadei, Hani M; Bulatao, Ilynn G; Gonwa, Thomas A; Mai, Martin L; Prendergast, Mary; Keaveny, Andrew P; Rosser, Barry G; Taner, C Burcin
2014-06-01
Limited data are available for outcomes of simultaneous liver-kidney (SLK) transplantation using donation after cardiac death (DCD) donors. The outcomes of 12 DCD-SLK transplants and 54 SLK transplants using donation after brain death (DBD) donors were retrospectively compared. The baseline demographics were similar for the DCD-SLK and DBD-SLK groups except for the higher liver donor risk index for the DCD-SLK group (1.8 ± 0.4 versus 1.3 ± 0.4, P = 0.001). The rates of surgical complications and graft rejections within 1 year were comparable for the DCD-SLK and DBD-SLK groups. Delayed renal graft function was twice as common in the DCD-SLK group. At 1 year, the serum creatinine levels and the iothalamate glomerular filtration rates were similar for the groups. The patient, liver graft, and kidney graft survival rates at 1 year were comparable for the groups (83.3%, 75.0%, and 82.5% for the DCD-SLK group and 92.4%, 92.4%, and 92.6% for the DBD-SLK group, P = 0.3 for all). The DCD-SLK group had worse patient, liver graft, and kidney graft survival at 3 years (62.5%, 62.5%, and 58.9% versus 90.5%, 90.5%, and 90.6%, P = 0.03 for all) and at 5 years (62.5%, 62.5%, and 58.9% versus 87.4%, 87.4%, and 87.7%, P < 0.05 for all). An analysis of the Organ Procurement and Transplantation Network database showed inferior 1- and 5-year patient and graft survival rates for DCD-SLK patients versus DBD-SLK patients. In conclusion, despite comparable rates of surgical and medical complications and comparable kidney function at 1 year, DCD-SLK transplantation was associated with inferior long-term survival in comparison with DBD-SLK transplantation. © 2014 American Association for the Study of Liver Diseases.
Bruno, C; Dudkiewicz-Sibony, C; Berthaut, I; Weil, E; Brunet, L; Fortier, C; Pfeffer, J; Ravel, C; Fauque, P; Mathieu, E; Antoine, J M; Kotti, S; Mandelbaum, J
2016-07-01
In couples who have chosen and confirmed the fate of surplus frozen embryos, which factors influence their decision, with a special emphasis on their symbolic representation of the embryo(s)? Embryo representation and gamete donation use significantly influence the fate of surplus cryopreserved embryos. Previous studies report difficulties for couples to decide whether or not to continue storing their frozen embryo(s) and different factors have been already highlighted which influence their decision, including embryo conceptualization, information and support provided by the medical institution, quality of embryo(s) and life events. Little is known, however, about couples who definitely decided to stop their parental project and finalized the process of decision-making about the fate of their cryopreserved embryo(s). This prospective study was conducted over a period of 3 years (2007-2010) and included IVF/ICSI patients with surplus frozen embryos, who made a final embryo disposition decision. Among the 280 eligible IVF/ICSI patients, 247 agreed to participate in the study. According to the available options, 91 persons chose to 'stop cryopreservation', 77 chose donation to 'research' and 48 'embryo donation' to infertile couples. Furthermore, 31 participants who chose embryo donation for a parental project were refused by the center as not compatible with their mandatory medical conditions. Among them, 27 participants then selected donation to research as a new option and were included in a fourth group: 'donation to research after Refusal of Embryo Donation for parental project' or 'research-RED' (n = 27). Four participants chose 'stop cryopreservation', however, given the small number of subjects this latter group was not included in the analysis. In all, 243 participants who made a final choice concerning the fate of their cryopreserved embryos were included in this study. Participants were sent a letter of invitation to a semi-structured interview of 30 min with a psychologist. Interviews were conducted separately for each partner, including a questionnaire with a common part and a specific part, according to the chosen option, and allowing a quantitative evaluation. A multivariate logistic regression model was used to assess the link between their embryo representation and their decision about their embryos' fate. After adjustment for age, gender, gamete donation, number of children and the different embryo representations, a choice to 'stop cryopreservation' is more frequent if the embryo is represented as a child [odds ratio (OR) adjusted = 3.29, 95% confidence interval (CI) = 1.62-6.66], P = 0.0009. Representing the embryo as a project prompts patients to choose 'donation to research' [OR adjusted = 3.76, 95% CI = 1.56-9.06], P = 0.0032. Respondents are more likely to choose 'embryo donation' if they represent the embryo as a potential person [OR adjusted = 3.77, 95% CI = 1.45-9.80], P = 0.0064. Furthermore, patients who benefited from gamete donation are ∼10 times more likely to donate their embryos to another couple [OR adjusted = 10.62, 95% CI = 3.99-28.30], P < 0.0001. For more than half the participants (57%) the decision-making was easy, however, deciding to stop cryopreservation was significantly more difficult than choosing research or embryo donation (P < 0.0001). Socio-economic status, moral and religious affiliations are known to influence the choice of couples but analyzing these factors was not an aim of the present study. When couples definitely decide to stop their parental project, the embryo symbolic representation remains the main factor that influences the fate of their frozen embryo(s). Moreover, this representation can evolve when influenced by external events and information provided. In order to support patients who are making this difficult decision, it could be helpful to explore this symbolic representation early in the IVF/ICSI procedure, before surplus embryo freezing, as a new tool enhancing the accuracy of counseling. this study was supported by a grant from the 'Agence de la biomedicine (ABM)', the national regulatory ART agency, under the authority of the French Ministry of Health. The authors have no conflict of interest to declare. © The Author 2016. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
Multiple meanings of "gift" and its value for organ donation.
Shaw, Rhonda M; Webb, Robert
2015-05-01
The "gift of life" metaphor is used to promote organ donation where commercialization is prohibited. In this article, we explore how multiple parties involved in organ transfer procedures think of gift terminology by drawing on interview data with transplantation specialists, organ transplant recipients, living directed donors and living nondirected donors. The interviews took place across New Zealand between October 2008 and May 2012, in participants' homes and hospital workplaces. The interviews were transcribed verbatim, coded manually, and thematically analyzed. Although gift language is often viewed as clear-cut, the gift trope has multiple meanings for different constituent and cultural groups, ranging from positive descriptors to obscuring and romanticizing the complexities of transplantation processes. To account for these multiple perspectives, we suggest new ethical models to capture the nuanced phenomenon of organ transfer in ways that recognize the full range of donation and reception experiences. © The Author(s) 2014.
When Opportunity Knocks Twice: Dual Living Kidney Donation, Autonomy and the Public Interest
Huxtable, Richard
2015-01-01
Abstract Living kidney transplantation offers the best treatment in terms of life‐expectancy and quality of life for those with end‐stage renal disease. The long‐term risks of living donor nephrectomy, although real, are very small, with evidence of good medium‐term outcomes. Who should be entitled to donate, and in which circumstances, is nevertheless a live question. We explore the ethical dimensions of a request by an individual to donate both of their kidneys during life: ‘dual living kidney donation’. Our ethical analysis is tethered to a hypothetical case study in which a father asks to donate a kidney to each of his twin boys. We explore the autonomy of the protagonists, alongside different dimensions of the public interest, such as the need to protect not only the recipients, but also the donor and even the wider community. Whilst acknowledging objections to ‘dual‐donation’, not least by reference to the harms that the donor might be expected to endure, we suggest there is a prima facie case for permitting this, provided that both donor and recipients are willing and that due attention is paid to such considerations as the autonomy and welfare of all parties, as well as to the wider ramifications of acting on such a request. We argue for broader interpretations of the concepts of autonomy and welfare, recognizing the importance of relationships and the relevance of more than merely physical well‐being. Equipped with such a holistic assessment, we suggest there is a prima facie case for allowing ‘dual living kidney donation’. PMID:26194324
Improvement in likelihood to donate blood after being offered a topical anesthetic.
Watanabe, Kyle M; Jay, Jeffrey; Alicto, Christopher; Yamamoto, Loren G
2011-02-01
While there are many reasons people choose not to donate blood, pain sustained during the venipuncture portion of the blood donation process is likely one deterrent to volunteer donation. The purpose of this study was to survey the improvement in likelihood of donation if participants were given the option of a topical anesthetic cream prior to venipuncture. Over a three month period 316 adults (convenience sample) completed a one page survey consisting of twelve questions pertaining to blood donation. Participants were asked about their likelihood of donating blood in the near future (No Possibility, Possible, Likely, Certain). They were then informed of the possibility of using a topical anesthetic cream prior to donation. Subsequently, their likelihood of donating blood was reassessed. Fifty (16%) subjects reported an increased likelihood of donating blood if offered a topical anesthetic (p〈0.0001). Of these respondents reporting an increase in donation likelihood, eleven improved by 2 or more likelihood categories. Amongst the 169 participants who never donated blood, 34 (20%) reported an increased likelihood of donation after being told about the topical anesthetic cream, compared to 16 (10%) of the 147 subjects who had previously donated blood (p=0.02). The findings of this study suggest that providing a topical anesthetic had a positive effect on the study participants' likelihood of donating blood. This improvement was greater amongst those who have never donated blood. Hawaii Medical Journal Copyright 2011.
The Blood Donation Ambivalence Survey: measuring conflicting attitudes about giving blood.
Fox, K R; Himawan, L K; France, C R
2017-05-18
This study was designed to develop and conduct initial validation testing for a novel measure of ambivalence about donating blood. Previous studies of living organ, bone marrow and stem cell donors have identified donation-related ambivalence as a predictor of decisions about donation and post-donation outcomes. Ambivalence about blood donation has not received the same attention. In Study 1, a sample of young adults (N = 396) were administered test items of ambivalence, and exploratory (EFA) and confirmatory factor analyses (CFA) were performed to identify the Blood Donation Ambivalence Survey. In Study 2, a separate sample of young adults (N = 241) completed the Blood Donation Ambivalence Survey in addition to questionnaires assessing known predictors of blood donation. Exploratory and confirmatory factor analyses indicated a two-factor structure reflecting commitment to donating blood and indecision about giving blood. The commitment subscale was positively related to known predictors of increased donation behaviour (e.g. donation intention, self-efficacy), whereas the indecision subscale was positively related to known predictors of decreased donation behaviour (e.g. donation anxiety, negative affect). Furthermore, a history of blood donation was associated with greater commitment and less indecision. The present findings provide strong initial support for the reliability and validity of a novel measure of blood donor ambivalence. © 2017 British Blood Transfusion Society.
Haiden, Nadja; Ziegler, Ekhard E
2016-01-01
Human milk banks play an essential role by providing human milk to infants who would otherwise not be able to receive human milk. The largest group of recipients are premature infants who derive very substantial benefits from it. Human milk protects premature infants from necrotizing enterocolitis and from sepsis, two devastating medical conditions. Milk banks collect, screen, store, process, and distribute human milk. Donating women usually nurse their own infants and have a milk supply that exceeds their own infants' needs. Donor women are carefully selected and are screened for HIV-1, HIV-2, human T-cell leukemia virus 1 and 2, hepatitis B, hepatitis C, and syphilis. In the milk bank, handling, storing, processing, pooling, and bacterial screening follow standardized algorithms. Heat treatment of human milk diminishes anti-infective properties, cellular components, growth factors, and nutrients. However, the beneficial effects of donor milk remain significant and donor milk is still highly preferable in comparison to formula. © 2017 S. Karger AG, Basel.
Donor Retention in Online Crowdfunding Communities: A Case Study of DonorsChoose.org
Althoff, Tim; Leskovec, Jure
2016-01-01
Online crowdfunding platforms like DonorsChoose.org and Kick-starter allow specific projects to get funded by targeted contributions from a large number of people. Critical for the success of crowdfunding communities is recruitment and continued engagement of donors. With donor attrition rates above 70%, a significant challenge for online crowdfunding platforms as well as traditional offline non-profit organizations is the problem of donor retention. We present a large-scale study of millions of donors and donations on DonorsChoose.org, a crowdfunding platform for education projects. Studying an online crowdfunding platform allows for an unprecedented detailed view of how people direct their donations. We explore various factors impacting donor retention which allows us to identify different groups of donors and quantify their propensity to return for subsequent donations. We find that donors are more likely to return if they had a positive interaction with the receiver of the donation. We also show that this includes appropriate and timely recognition of their support as well as detailed communication of their impact. Finally, we discuss how our findings could inform steps to improve donor retention in crowdfunding communities and non-profit organizations. PMID:27077139
Attitudes toward reciprocity systems for organ donation and allocation for transplantation.
Burkell, Jacquelyn A; Chandler, Jennifer A; Shemie, Sam D
2013-10-01
Many of those who support organ donation do not register to become organ donors. The use of reciprocity systems, under which some degree of priority is offered to registered donors who require an organ transplant, is one suggestion for increasing registration rates. This article uses a combination of survey and focus group methodologies to explore the reaction of Canadians to a reciprocity proposal. Our results suggest that the response is mixed. Participants are more convinced of the efficacy than they are of the fairness of a reciprocity system. Those more positive about donation (decided donors and those leaning toward donation) rate the system more positively. Although there is general endorsement of the notion that those who wish to receive should be prepared to give (the Golden Rule), this does not translate into universal support for a reciprocity system. In discussions of efficacy, decided donors focus on the positive impact of reciprocity, whereas undecided donors also reflect on the limits of reciprocity for promoting registration. The results demonstrate divided support for reciprocity systems in the Canadian context, with perceptions of efficacy at the cost of fairness. Further studies are warranted prior to considering a reciprocity system in Canada.
Patel, Umang Jash
2013-03-01
A deficit in the number of organs available for transplantation persists even with an increase in donation rates. One possible choice of donor for organs that appears under-referred and/or unaccepted is patients with primary brain tumours. In spite of advances in the treatment of high-grade primary central nervous system (CNS) tumours, the prognosis remains dire. A working group on organs from donors with primary CNS tumours showed that the risk of transmission is small and outweighs the benefits of waiting for a normal donor, in survival and organ life-years, with caveats. This paper explores the possibility that, if information on organ donation were made available to patients and their families with knowledge of their inevitable fate, perhaps some will choose to donate. It would be explained that to achieve this, elective ventilation would be performed in their final moments. This would obviate the consent question because of an advance statement. It is accepted that these are sensitive matters and there will be logistic issues. This will need discussion with the public and other professionals, but it could increase the number of donors and can be extrapolated to encompass other primary CNS tumours.
Maternal organ donation and acute injuries in surviving children.
Redelmeier, Donald A; Woodfine, Jason D; Thiruchelvam, Deva; Scales, Damon C
2014-12-01
The purpose of this study is to test whether maternal deceased organ donation is associated with rates of subsequent acute injuries among surviving children after their mother's death. This is a longitudinal cohort analysis of children linked to mothers who died of a catastrophic brain event in Ontario, Canada, between April 1988 and March 2012. Surviving children were distinguished by whether their mother was an organ donor after death. The primary outcome was an acute injury event in surviving children during the year after their mother's death. Surviving children (n=454) had a total of 293 injury events during the year after their mother's death, equivalent to an average of 65 events per 100 children per year and a significant difference comparing children of mothers who were organ donors to children of mothers who were not organ donors (21 vs 82, P<.001). This difference in subsequent injury rates between groups was equal to a 76% relative reduction in risk (95% confidence interval, 62%-85%). Deceased organ donation was associated with a reduction in excess acute injuries among surviving children after their mother's death. An awareness of this positive association provides some reassurance about deceased organ donation programs. Copyright © 2014 Elsevier Inc. All rights reserved.
Donor Retention in Online Crowdfunding Communities: A Case Study of DonorsChoose.org.
Althoff, Tim; Leskovec, Jure
2015-05-01
Online crowdfunding platforms like DonorsChoose.org and Kick-starter allow specific projects to get funded by targeted contributions from a large number of people. Critical for the success of crowdfunding communities is recruitment and continued engagement of donors. With donor attrition rates above 70%, a significant challenge for online crowdfunding platforms as well as traditional offline non-profit organizations is the problem of donor retention. We present a large-scale study of millions of donors and donations on DonorsChoose.org, a crowdfunding platform for education projects. Studying an online crowdfunding platform allows for an unprecedented detailed view of how people direct their donations. We explore various factors impacting donor retention which allows us to identify different groups of donors and quantify their propensity to return for subsequent donations. We find that donors are more likely to return if they had a positive interaction with the receiver of the donation. We also show that this includes appropriate and timely recognition of their support as well as detailed communication of their impact. Finally, we discuss how our findings could inform steps to improve donor retention in crowdfunding communities and non-profit organizations.
Radtke, Hartmut; Tegtmeier, Joanna; Röcker, Lothar; Salama, Abdulgabar; Kiesewetter, Holger
2004-10-01
A considerable number of regular blood donors develops an iron deficiency, and the exact amount of iron required to compensate for the iron loss from whole-blood donation in males and females is still unknown. A total of 526 regular blood donors (289 male and 237 female) were randomly assigned to treatment with either 40 mg, 20 mg, or 0 mg per day of elemental iron as ferrous gluconate for a period of 6 months, during which one unit of whole blood was collected on four occasions (males) or three occasions (females). Hemoglobin level, serum ferritin, and soluble transferrin receptor levels were measured before each donation. Daily doses of either 40 mg or 20 mg of elemental iron adequately compensated for iron loss in males, who gave blood at 2-month intervals, but did not result in a positive iron balance or an increase in storage iron as reflected by the logarithm of the ratio of transferrin receptor to ferritin concentration. In females, who donated at 3-month intervals, the same daily doses not only restored the iron balance but also led to an increase in storage iron. The number of gastrointestinal side effects due to iron supplementation (12%) was only slightly higher in both iron groups than in the placebo group. The results of this study indicate that 20 mg of elemental iron per day can adequately compensate for iron loss in males and females who donate whole blood up to four (females) or six times per year (males).
Budni, J; Romero, A; Molz, S; Martín-de-Saavedra, M D; Egea, J; Del Barrio, L; Tasca, C I; Rodrigues, A L S; López, M G
2011-09-08
Folic acid (folate) is a vitamin of the B-complex group that is essential for cell replication. Folate is a major determinant of one-carbon metabolism, in which S-adenosylmethionine donates methyl groups that are crucial for neurological function. Many roles for folic acid have been reported, including neuroprotective and antidepressant properties. On the other hand, increased concentrations of corticoids have proven neurotoxic effects and hypersecretion of glucocorticoids has been linked to different mood disorders. The purpose of this study was to investigate the potential protective effect of folic acid on dexamethasone-induced cellular death in SH-SY5Y neuroblastoma cell line and the possible intracellular signaling pathway involved in such effect. Exposure to 1 mM dexamethasone for 48 h caused a significant reduction of cell viability measured as 3-[4,5 dimethylthiazol-2-yl]-2,5-diphenyl-tetrazolium bromide (MTT) reduction. Exposure of SH-SY5Y cells for 72 h to increasing concentrations of folate (1-300 μM) was not cytotoxic. However, pretreatment with folate (10-300 μM) reduced dexamethasone-induced toxicity in a significant manner. To explore the putative intracellular signaling pathways implicated in the protective effect of folate we used different protein kinase inhibitors. The protective effect of folic acid on dexamethasone-induced neurotoxicity was reversed by the phosphatidylinositol-3 kinase/Akt (PI3K/Akt, LY294002), Ca²⁺/Calmodulin-dependent protein kinase II (CaMKII, KN-93), and protein kinase A (PKA, H-89) inhibitors, but not the mitogen-activated protein/extracellular signal-regulated kinase (MEK1/2, PD98059) and protein kinase C (PKC, chelerythrine) inhibitors. In conclusion, the results of this study show that folic acid can protect against dexamethasone-induced neurotoxicity and its protective mechanism is related to a signaling pathway that involves PI3K/Akt, CaMKII, and PKA. Copyright © 2011. Published by Elsevier Ltd.
Brown, J E; Khodr, H; Hider, R C; Rice-Evans, C A
1998-01-01
The flavonoids constitute a large group of polyphenolic phytochemicals with antioxidant properties in vitro. The interactions of four structurally related flavonoids (quercetin, kaempferol, rutin and luteolin) with Cu2+ ions were investigated in terms of the extent to which they undergo complex formation through chelation or modification through oxidation, as well as in their structural dependence. The ortho 3',4'-dihydroxy substitution in the B ring is shown to be important for Cu2+-chelate formation, thereby influencing the antioxidant activity. The presence of a 3-hydroxy group in the flavonoid structure enhances the oxidation of quercetin and kaempferol, whereas luteolin and rutin, each lacking the 3-hydroxy group, do not oxidize as readily in the presence of Cu2+ ions. The results also demonstrate that the reactivities of the flavonoids in protecting low-density lipoprotein (LDL) against Cu2+ ion-induced oxidation are dependent on their structural properties in terms of the response of the particular flavonoid to Cu2+ ions, whether chelation or oxidation, their partitioning abilities between the aqueous compartment and the lipophilic environment within the LDL particle, and their hydrogen-donating antioxidant properties. PMID:9494082
Jiang, Dan; Gao, Fei; Zhang, Yuelin; Wong, David Sai Hung; Li, Qing; Tse, Hung-Fat; Xu, Goufeng; Yu, Zhendong; Lian, Qizhou
2016-11-10
Recent studies have demonstrated that mesenchymal stem cells (MSCs) can donate mitochondria to airway epithelial cells and rescue mitochondrial damage in lung injury. We sought to determine whether MSCs could donate mitochondria and protect against oxidative stress-induced mitochondrial dysfunction in the cornea. Co-culturing of MSCs and corneal epithelial cells (CECs) indicated that the efficiency of mitochondrial transfer from MSCs to CECs was enhanced by Rotenone (Rot)-induced oxidative stress. The efficient mitochondrial transfer was associated with increased formation of tunneling nanotubes (TNTs) between MSCs and CECs, tubular connections that allowed direct intercellular communication. Separation of MSCs and CECs by a transwell culture system revealed no mitochiondrial transfer from MSCs to CECs and mitochondrial function was impaired when CECs were exposed to Rot challenge. CECs with or without mitochondrial transfer from MSCs displayed a distinct survival capacity and mitochondrial oxygen consumption rate. Mechanistically, increased filopodia outgrowth in CECs for TNT formation was associated with oxidative inflammation-activated NFκB/TNFαip2 signaling pathways that could be attenuated by reactive oxygen species scavenger N-acetylcysteine (NAC) treatment. Furthermore, MSCs grown on a decellularized porcine corneal scaffold were transplanted onto an alkali-injured eye in a rabbit model. Enhanced corneal wound healing was evident following healthy MSC scaffold transplantation. And transferred mitochondria was detected in corneal epithelium. In conclusion, mitochondrial transfer from MSCs provides novel protection for the cornea against oxidative stress-induced mitochondrial damage. This therapeutic strategy may prove relevant for a broad range of mitochondrial diseases.
Social support attenuates presyncopal reactions to blood donation.
Hanson, Sarah A; France, Christopher R
2009-05-01
The experience of unpleasant blood donation reactions (e.g., dizziness, nausea, and fainting) has been linked to negative attitudes about donation and decreased likelihood of repeat donation. Consequently, interventions to reduce the adverse effects of blood donation are important and likely to increase donor retention. Based on laboratory studies suggesting that social support attenuates both physical and psychological responses to stress, the present study hypothesized that the presence of a supportive person during the donation process may help reduce reactions. A final sample of 65 men and women with fewer than three prior donations was randomly assigned to either donate blood as usual or donate with a supportive research assistant. Donors in the support condition were accompanied throughout the donation process by a female research assistant who provided encouragement, made reassuring remarks, and engaged in small talk. Donors in both conditions completed a series of questions to assess anxiety, experience of prefaint reactions, and willingness to provide a future donation. Compared to standard donation controls, donors in the social support condition reported fewer prefaint reactions (F(1,61) = 9.15, p = 0.004, eta(2)= 0.13) and greater likelihood of donating again within the next year (Z =-1.70, p < 0.05, one-tailed). Relatively novice donors report reduced reactions to blood donation when accompanied by a supportive individual, suggesting that social support may be a simple strategy to enhance the donation experience and possibly increase donor retention.
Spirituality as a predictive factor for signing an organ donor card.
Bortz, Anat Peles; Ashkenazi, Tamar; Melnikov, Semyon
2015-01-01
To examine differences in spirituality, purpose in life, and attitudes toward organ donation between people who signed and those who did not sign an organ donor card. A descriptive cross-sectional survey conducted in Israel with a sample of 312 respondents from the general population, of whom 220 (70.5%) signed an organ donor card. Data were collected during April-June 2013. Participants completed a paper questionnaire and a Web-based questionnaire consisting of four sections: spiritual health, purpose in life, attitudes toward organ donation, and social-demographic questions. Descriptive statistics, t test, chi-square test, and a logistic regression analysis were performed. Differences in mean scores between respondents who signed an organ donor card and those who did not were indicated in transcendental spirituality (p < .01), purpose in life (p < .05), and attitudes toward organ donation (p < .01). No statistically significant difference was found between the groups in the overall spirituality mean score. The spiritual transcendental dimension, individual's purpose in life, and attitudes toward organ donation explained 34.3% of the variance of signing an organ donor card. Signing an organ donor card was found to be correlated with high purpose in life, positive attitudes toward organ donation, and low level of transcendental spirituality. Nurses should assess the patient's spiritual needs in order to construct appropriate programs for promoting signing an organ donor card. Nurses who signed an organ donor card should be encouraged to share this information with their patients. © 2014 Sigma Theta Tau International.
Shinzato, Takahiro; Kurosawa, Akira; Kubo, Taro; Shimizu, Toshihiro; Kimura, Takaaki; Nanmoku, Koji; Yagisawa, Takashi
2018-06-01
Renal prognosis in living kidney donors with diabetes is currently not known. In this study, we sought to investigate renal prognosis in living kidney donors with diabetes. We retrospectively investigated 241 living kidney donors who underwent nephrectomy at Jichi Medical University Hospital between January 2000 and December 2015. Donors with a follow-up period of less than 1 year were excluded. The remaining donors were divided into a diabetic group and a non-diabetic group. Their clinical parameters before donation and renal prognosis after donation were compared. Of the 241 donors, 16 were excluded due to their follow-up period being less than 1 year. Of the remaining 225 donors, 14 were diabetic and 211 were non-diabetic. There were no significant differences in variables at pre-donation. The median follow-up period was 4.3 (1.5-10.7) and 4.6 (1.0-13.0) years in kidney donors with and without diabetes, respectively. At the end of follow-up, the estimated glomerular filtration rate was 51.7 ± 7.1 ml/min/1.73 m 2 in the diabetic group and 52.1 ± 12.2 ml/min/1.73 m 2 (p = 0.906) in the non-diabetic group; urine albumin excretion was 9.5 (2-251) mg/day (or mg/g creatinine) in the diabetic group and 6 (0-626) mg/day (or mg/g creatinine) in the non-diabetic group (p = 0.130); and urine protein excretion was 0.079 (0-0.41) g/day in the diabetic group and 0.051 (0-3.7) g/day in the non-diabetic group (p = 0.455). There were no significant differences in short-term renal prognosis between kidney donors with and without diabetes.
Abdelqader, Abdelhai; Kabacam, Gokhan; Woreta, Tinsay A; Hamilton, James P; Luu, Harry; Al Khalloufi, Kawtar; Saberi, Behnam; Philosophe, Benjamin; Cameron, Andrew M; Gurakar, Ahmet
2017-02-01
Our goal was to investigate wait times related to hepatitis C virus treatment with direct acting antivirals before versus after liver transplant at a single center as well as wait times for insurance approval for preemptive treatment with these agents after liver transplant. We retrospectively evaluated hepatitis C virus infections in transplant recipients of deceased liver donations in 2014 and 2015. Demographics, hepatocellular carcinoma incidence, Model for End-Stage Liver Disease scores, and transplant wait times were compared between patients treated before or after liver transplant. Wait times to approval of direct-acting antiviral treatment were evaluated in those untreated before transplant. During our study period, of 67 deceased-donor liver transplants, 21 patients received hepatitis C virus treatment pretransplant (treated group) and 46 patients were not treated pretransplant (untreated group). Twenty-five patients in the untreated group received hepatitis C virus-positive donations, with all in this group treated with direct-acting antivirals. We found no statistically significant differences regarding age, sex, race, donation after cardiac death, or incidence of hepatocellular carcinoma between groups. The treated group had a longer median wait time (287 vs 172 days; P = .02). Twelve of the 46 untreated patients (26.1%) developed biopsy-proven hepatitis C virus-related relapse (median 87 days; range, 55-383 days). Preemptive direct-acting antiviral therapy was initiated at a median of 81 days in the untreated group. Although treatment of hepatitis C virus before liver transplant is an attractive option to eliminate the risk of complications, it can limit the donor pool for recipients to uninfected donors, significantly increasing wait times in regions with large hepatitis C virus-positive donor pools. Allocation of Model for End-Stage Liver Disease score was not different between the treated and untreated groups. Insurance companies should revise their policies for rapid approval of preemptive direct-acting antiviral treatment after liver transplant.
Pereira, Jorge F B; Kurnia, Kiki A; Freire, Mara G; Coutinho, João A P; Rogers, Robin D
2015-07-20
The formation of aqueous biphasic systems (ABS) when mixing aqueous solutions of polyethylene glycol (PEG) and an ionic liquid (IL) can be controlled by modifying the hydrogen-bond-donating/-accepting ability of the polymer end groups. It is shown that the miscibility/immiscibility in these systems stems from both the solvation of the ether groups in the oxygen chain and the ability of the PEG terminal groups to preferably hydrogen bond with water or the anion of the salt. The removal of even one hydrogen bond in PEG can noticeably affect the phase behavior, especially in the region of the phase diagram in which all the ethylene oxide (EO) units of the polymeric chain are completely solvated. In this region, removing or weakening the hydrogen-bond-donating ability of PEG results in greater immiscibility, and thus, in a higher ability to form ABS, as a result of the much weaker interactions between the IL anion and the PEG end groups. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
41 CFR 102-37.30 - When does property become available for donation?
Code of Federal Regulations, 2010 CFR
2010-07-01
... become available for donation? 102-37.30 Section 102-37.30 Public Contracts and Property Management... 37-DONATION OF SURPLUS PERSONAL PROPERTY General Provisions Donation Overview § 102-37.30 When does property become available for donation? Excess personal property becomes available for donation the day...
41 CFR 102-37.30 - When does property become available for donation?
Code of Federal Regulations, 2012 CFR
2012-01-01
... become available for donation? 102-37.30 Section 102-37.30 Public Contracts and Property Management... 37-DONATION OF SURPLUS PERSONAL PROPERTY General Provisions Donation Overview § 102-37.30 When does property become available for donation? Excess personal property becomes available for donation the day...
41 CFR 102-37.30 - When does property become available for donation?
Code of Federal Regulations, 2011 CFR
2011-01-01
... become available for donation? 102-37.30 Section 102-37.30 Public Contracts and Property Management... 37-DONATION OF SURPLUS PERSONAL PROPERTY General Provisions Donation Overview § 102-37.30 When does property become available for donation? Excess personal property becomes available for donation the day...
41 CFR 102-37.30 - When does property become available for donation?
Code of Federal Regulations, 2014 CFR
2014-01-01
... become available for donation? 102-37.30 Section 102-37.30 Public Contracts and Property Management... 37-DONATION OF SURPLUS PERSONAL PROPERTY General Provisions Donation Overview § 102-37.30 When does property become available for donation? Excess personal property becomes available for donation the day...
41 CFR 102-37.30 - When does property become available for donation?
Code of Federal Regulations, 2013 CFR
2013-07-01
... become available for donation? 102-37.30 Section 102-37.30 Public Contracts and Property Management... 37-DONATION OF SURPLUS PERSONAL PROPERTY General Provisions Donation Overview § 102-37.30 When does property become available for donation? Excess personal property becomes available for donation the day...
Application of implicit attitude measures to the blood donation context.
Warfel, Regina M; France, Christopher R; France, Janis L
2012-02-01
Past blood donation research has relied on explicit (self-report) measures to understand blood donation motivations, but has not yet considered the inherent implicit or automatic processing involved in decision-making. This study addresses this limitation by introducing and validating two novel implicit measures of blood donation attitudes. Healthy young adults (n = 253) performed both image and word versions of a Single Target Implicit Association Test (ST-IAT) and then completed self-report measures of blood donation attitudes, blood and needle fears, social desirability, and donation intention. These results affirmed the validity of the blood donation ST-IATs in at least three ways. First, as expected, nondonors demonstrated more negative implicit donation attitudes than donors. Second, the implicit measures were significantly related in expected directions with explicit measures of donation attitudes as well as blood and needle fears. Finally, implicit donation attitudes were significantly related to donation intention, and the Image ST-IAT (but not the Word ST-IAT) significantly enhanced prediction of donation intention over and above needle fears and marginally enhanced prediction over and above blood fears. Image and word versions of the blood donation ST-IAT offer a valid method of assessing underlying automatic attitudes toward blood donation. © 2012 American Association of Blood Banks.
Wirken, Lieke; van Middendorp, Henriët; Hooghof, Christina W; Sanders, Jan-Stephan F; Dam, Ruth E; van der Pant, Karlijn A M I; Berendsen, Elsbeth C M; Wellink, Hiske; Dackus, Henricus J A; Hoitsma, Andries J; Hilbrands, Luuk B; Evers, Andrea W M
2017-03-01
Cognitions surrounding living organ donation, including the motivation to donate, expectations of donation and worries about donation, are relevant themes during living donor evaluation. However, there is no reliable psychometric instrument assessing all these different cognitions. This study developed and validated a questionnaire to assess pre-donation motivations, expectations and worries regarding donation, entitled the Donation Cognition Instrument (DCI). Psychometric properties of the DCI were examined using exploratory factor analysis for scale structure and associations with validated questionnaires for construct validity assessment. From seven Dutch transplantation centres, 719 potential living kidney donors were included. The DCI distinguishes cognitions about donor benefits, recipient benefits, idealistic incentives, gratitude and worries about donation (Cronbach's alpha 0.76-0.81). Scores on pre-donation cognitions differed with regard to gender, age, marital status, religion and donation type. With regard to construct validity, the DCI was moderately correlated with expectations regarding donor's personal well-being and slightly to moderately to health-related quality of life. The DCI is found to be a reliable instrument assessing cognitions surrounding living organ donation, which might add to pre-donation quality of life measures in facilitating psychosocial donor evaluation by healthcare professionals. © The Author 2017. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.
Elias, Elionora; Philemon, Rune N.; Damian, Damian J.; Msuya, Sia E.
2016-01-01
Background. Understanding the knowledge and awareness of blood donation among potential blood donors in the population, like young people, and the associated attitudes and practices is important. Methodology. This was a cross-sectional study whereby a self-administered questionnaire was used to collect information from the consenting participants. Results. A total of 422 participants were enrolled. Their mean age was 24.2 (SD 3.6) years. Of the 422, 30% have ever donated blood. 55% of those who had ever donated were repeated blood donors. Majority of the participants (93%) had positive attitudes towards blood donation and 88% were willing to donate in the future. Factors that were significantly associated with ever donating blood were male gender, knowing a person who has donated blood, knowledge of the amount of blood donated, willingness to donate in the future, and not expecting any postdonation reward. Discussion. High awareness, positive attitude, and high intention to donate in the future should be used to underscore the need to educate the young people on the value of blood donation in saving lives and to give them correct information on overall requirements for blood donation. PMID:28070449
Elias, Elionora; Mauka, Wilhellmuss; Philemon, Rune N; Damian, Damian J; Mahande, Michael J; Msuya, Sia E
2016-01-01
Background . Understanding the knowledge and awareness of blood donation among potential blood donors in the population, like young people, and the associated attitudes and practices is important. Methodology . This was a cross-sectional study whereby a self-administered questionnaire was used to collect information from the consenting participants. Results . A total of 422 participants were enrolled. Their mean age was 24.2 (SD 3.6) years. Of the 422, 30% have ever donated blood. 55% of those who had ever donated were repeated blood donors. Majority of the participants (93%) had positive attitudes towards blood donation and 88% were willing to donate in the future. Factors that were significantly associated with ever donating blood were male gender, knowing a person who has donated blood, knowledge of the amount of blood donated, willingness to donate in the future, and not expecting any postdonation reward. Discussion . High awareness, positive attitude, and high intention to donate in the future should be used to underscore the need to educate the young people on the value of blood donation in saving lives and to give them correct information on overall requirements for blood donation.
Bhandary, Sulatha; Khanna, Rajesh; Rao, Krishna A; Rao, Lavanya G; Lingam, Kamala D; Binu, V
2011-01-01
Corneal blindness accounts for 3.42% of blindness in Malaysia; the rate of eye donation is low. The aim of the study was to assess the awareness about eye donation and willingness to donate eyes among attendants of patients at various clinics in Melaka, Malaysia. This observational study was conducted on attendants who accompanied patients (n = 400) visiting various outpatient departments of the General Hospital and two peripheral clinics in Melaka between August and October 2007. The participants answered a questionnaire (Malay and English versions) which included demographic profile, awareness of eye donation, knowledge regarding facts of eye donation, and willingness to donate eyes. Univariate and multivariate logistic regression was performed at 5% level of significance. Awareness of eye donation was observed in 276 (69%) participants. Multivariate analysis showed that awareness was more among females when compared to males (P = 0.009). Of the 276 participants who were aware of eye donation, only 34.42% were willing to donate eyes. Willingness was more among the Indian race (P = 0.02) and males (P = 0.02). Educational status did not influence the willingness to donate eyes. Although majority of participants were aware of eye donation, willingness to donate eyes was poor.
Parameters of infection in replacement and voluntary donors in the western part of Turkey.
Uzun, Berrin; Gungor, Serdar; Demirci, Mustafa
2014-08-01
According to our center's experiences familial/replacement donors (FRDs) frequently donate blood for the first time in their lives. Therefore, results of infection parameters are expected to be different voluntary donors (VDs), at similar rates to the population. The present study aimed to investigate if there were any difference in VDs and FRDs in terms of infection parameters. The blood donation records over 6 years (2004-2010) were reviewed, retrospectively. HBsAg, anti-HCV, anti-HIV screening tests were performed by ELISA and syphilis screening was performed by the RPR method. Out of 71.217, 16.727 donors donated whole blood as FRD. Among the whole blood donated by FRD, the positives for HBsAg, anti-HCV and RPR were 1.23%, 0.37%, and 0.07%, respectively. Confirmed anti-HIV screening test was not observed in this group. Positivities for HBsAg, anti-HCV, anti-HIV and RPR in VD were 1.36%, 0.42%, 0.004%, and 0.04%, respectively. When FRD and VD were analyzed statistically, HBsAg rates were significantly higher among FRD in the years 2004, 2007 and 2008, whereas they were significantly high among VD in year 2005. HBsAg rates stated in the years 2006-2009 were insignificant. Significantly high results were observed in HCV rates in the year 2005 among VD, whereas insignificant levels were observed in other years. HIV rates were insignificant among VD in the years 2004 and 2005, confirmed positivity was established in only one patient. Values in all years in RPR rates were statistically insignificant. Grouping donors as replacement and voluntary has no importance in infection parameters. Grouping donors as replacement and voluntary has no importance in infection parameters. Appropriate donor inquiries and screening of infection parameters by reliable proven tests preserve their significances. Copyright © 2014 Elsevier Ltd. All rights reserved.
A Trial of Financial and Social Incentives to Increase Older Adults' Walking.
Harkins, Kristin A; Kullgren, Jeffrey T; Bellamy, Scarlett L; Karlawish, Jason; Glanz, Karen
2017-05-01
Despite evidence that regular physical activity confers health benefits, physical activity rates among older adults remain low. Both personal and social goals may enhance older adults' motivation to become active. This study tested the effects of financial incentives, donations to charity, and the combined effects of both interventions on older adults' uptake and retention of increased levels of walking. RCT comparing three interventions to control. Data collection occurred from 2012 to 2013. Analyses were conducted in 2013-2016. Ninety-four adults aged ≥65 years from Philadelphia-area retirement communities. All participants received digital pedometers, walking goals of a 50% increase in daily steps, and weekly feedback on goal attainment. Participants were randomized to one of four groups: (1) Control: received weekly feedback only; (2) Financial Incentives: received payment of $20 each week walking goals were met; (3) Social Goals: received donation of $20 to a charity of choice each week walking goals were met; and (4) Combined: received $20 each week walking goals were met that could be received by participant, donated to a charity of choice, or divided between the participant and charity. Mean proportion of days walking goals were met during the 16-week intervention and 4-week follow-up period. After adjusting for baseline walking, the proportion of days step goals were met during the 16-week intervention period was higher in all intervention groups versus controls (relative risk, 3.71; 95% CI=1.37, 10.01). During the 4-week follow up period, the proportion of days step goals were met did not differ in intervention groups compared to control (relative risk, 2.91; 95% CI=0.62, 13.64). Incentive schemes that use donations to a charity of choice, personal financial incentives, or a combination of the two can each increase older adults' initial uptake of increased levels of walking. This study is registered at www.clinicaltrials.gov NCT01643538. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
Fluorine-donating electrolytes enable highly reversible 5-V-class Li metal batteries.
Suo, Liumin; Xue, Weijiang; Gobet, Mallory; Greenbaum, Steve G; Wang, Chao; Chen, Yuming; Yang, Wanlu; Li, Yangxing; Li, Ju
2018-02-06
Lithium metal has gravimetric capacity ∼10× that of graphite which incentivizes rechargeable Li metal batteries (RLMB) development. A key factor that limits practical use of RLMB is morphological instability of Li metal anode upon electrodeposition, reflected by the uncontrolled area growth of solid-electrolyte interphase that traps cyclable Li, quantified by the Coulombic inefficiency (CI). Here we show that CI decreases approximately exponentially with increasing donatable fluorine concentration of the electrolyte. By using up to 7 m of Li bis(fluorosulfonyl)imide in fluoroethylene carbonate, where both the solvent and the salt donate F, we can significantly suppress anode porosity and improve the Coulombic efficiency to 99.64%. The electrolyte demonstrates excellent compatibility with 5-V LiNi 0.5 Mn 1.5 O 4 cathode and Al current collector beyond 5 V. As a result, an RLMB full cell with only 1.4× excess lithium as the anode was demonstrated to cycle above 130 times, at industrially significant loading of 1.83 mAh/cm 2 and 0.36 C. This is attributed to the formation of a protective LiF nanolayer, which has a wide bandgap, high surface energy, and small Burgers vector, making it ductile at room temperature and less likely to rupture in electrodeposition.
Analyzing a multimodal biometric system using real and virtual users
NASA Astrophysics Data System (ADS)
Scheidat, Tobias; Vielhauer, Claus
2007-02-01
Three main topics of recent research on multimodal biometric systems are addressed in this article: The lack of sufficiently large multimodal test data sets, the influence of cultural aspects and data protection issues of multimodal biometric data. In this contribution, different possibilities are presented to extend multimodal databases by generating so-called virtual users, which are created by combining single biometric modality data of different users. Comparative tests on databases containing real and virtual users based on a multimodal system using handwriting and speech are presented, to study to which degree the use of virtual multimodal databases allows conclusions with respect to recognition accuracy in comparison to real multimodal data. All tests have been carried out on databases created from donations from three different nationality groups. This allows to review the experimental results both in general and in context of cultural origin. The results show that in most cases the usage of virtual persons leads to lower accuracy than the usage of real users in terms of the measurement applied: the Equal Error Rate. Finally, this article will address the general question how the concept of virtual users may influence the data protection requirements for multimodal evaluation databases in the future.
Zhang, Q-X; Xie, J-F; Zhou, J-D; Xiao, S-S; Liu, A-Z; Hu, G-Q; Chen, Y; Wang, C-Y
2017-11-01
This study's purpose was to investigate the attitudes toward organ donation among renal transplantation patients and their caregivers. In addition, we sought to explore the impact factors that affect their attitudes toward deceased organ donation. A self-administrated questionnaire was used, which consisted of two parts: 1) demographic data, and 2) transplantation and donation-related data. This study was conducted in three transplantation follow-up centers in three hospitals using a cross-sectional approach. SPSS 17.0 software was used to analysis descriptive and inferential statistics for data. The responses were analyzed using descriptive statistics and logistic regression analysis. We received 426 effective questionnaires. The renal transplantation patients' mean age was 40.84 years. Among these patients, 67.8% were willing to accept the organ transplantation surgery for their relatives, 67.4% were willing to donate a living kidney to a close relative, 62.7% were willing to donate organs after death, 53.5% were willing to register in the national organ donation system, and 51.4% were willing to sign the organ donation consent when facing their relatives becoming a potential organ donor. Age, marriage status, education level, understanding of transplantation procedures and understanding of donation procedures had statistical significance in the difference of the attitudes toward donate their organs after death (P < .05). Renal transplantation patients in our study are more willing to donate organs after death than their caregivers, but both their attitudes toward deceased donation were not very optimistic. There is a significant relationship between participants' willingness and knowledge of organ donation; patients with more understanding of the transplantation and donation procedure were more willing to donate organs after death. Affected by traditional values such as Confucianism, many people still cannot accept registering in the national organ donation system or sign the organ donation consent when facing their relatives becoming potential organ donors. There is a need to give adequate training regarding donation to increase donation rates. The government must provide education from the perspective of scientific knowledge to change the traditional views of the public, which may then increase the donation rate in China. Copyright © 2017 Elsevier Inc. All rights reserved.
Ismail, S Y; Luchtenburg, A E; Timman, R; Zuidema, W C; Boonstra, C; Weimar, W; Busschbach, J J V; Massey, E K
2014-08-01
Our aim was to develop and test an educational program to support well-informed decision making among patients and their social network regarding living donor kidney transplantation (LDKT). One hundred sixty-three patients who were unable to find a living donor were randomized to standard care or standard care plus home-based education. In the education condition, patients and members of their social network participated in home-based educational meetings and discussed renal replacement therapy options. Patients and invitees completed pre-post self-report questionnaires measuring knowledge, risk perception, communication, self-efficacy and subjective norm. LDKT activities were observed for 6 months postintervention. Patients in the experimental group showed significantly more improvements in knowledge (p < 0.001) and communication (p = 0.012) compared with the control group. The invitees showed pre-post increases in knowledge (p < 0.001), attitude toward discussing renal replacement therapies (p = 0.020), attitude toward donating a kidney (p = 0.023) and willingness to donate a kidney (p = 0.039) and a decrease in risk perception (p = 0.003). Finally, there were significantly more inquiries (29/39 vs. 13/41, p < 0.001), evaluations (25/39 vs. 7/41, p < 0.001) and actual LDKTs (17/39 vs. 4/41, p = 0.003) in the experimental group compared with the control group. Home-based family education supports well-informed decision making and promotes access to LDKT. © Copyright 2014 The American Society of Transplantation and the American Society of Transplant Surgeons.
Freeman, T; Jadva, V; Tranfield, E; Golombok, S
2016-09-01
What are the demographic characteristics, motivations, preferences and experiences of heterosexual, gay and bisexual sperm donors on a connection website (i.e. a website that facilitates direct contact between donors and recipients of gametes)? This demographically diverse group of men was donating for altruistic reasons and perceived the website as providing greater choice over donation arrangements: approximately one third favoured anonymous donation, most of whom were heterosexual, whilst gay and bisexual donors were more likely to be in contact with children conceived with their sperm. Despite substantially more sperm donors being registered on connection websites than with clinics, there has been very little research on this population. Current understanding of the impact of sexual orientation on donors' attitudes is also limited. An online survey was conducted over 7 weeks with 383 men registered as sperm donors with Pride Angel, a large UK-based connection website for donors and recipients of sperm. The survey obtained data on participants' demographic characteristics and their motivations, preferences and experiences regarding online sperm donation, including attitudes towards contact with offspring. Differences according to participants' sexual orientation were examined. Most participants (80.4%, 308) were heterosexual, 10.5% (40) were gay and 9.1% (35) were bisexual; ages ranged from 18 to 69 years (median = 36, mean = 37.3, SD = 9.7). A greater proportion of gay and bisexual men desired open-identity donation (P < 0.005) and contact with offspring (P <0.005) than heterosexual men. Approximately one third (28.7%, 110) had donated sperm; 18.3% (70) had conceived at least one child, of whom a minority (25.7%, 18) were currently in contact with the child, comprising significantly more gay and bisexual than heterosexual men (P = 0.001). Heterosexual men were most likely to state a preference for natural insemination, although the large majority (94.3%, 66) of donors who had conceived children had used artificial insemination. Findings may not be representative of all sperm donors using connection websites because members of only one website participated and participants were, by necessity, a self-selected sample. This is the first comprehensive study of donors who connect with recipients via the internet, including a substantial number who have donated and conceived children. The findings indicate that sexual orientation may influence men's donation preferences and raise policy issues concerning donor recruitment and the incorporation of online sperm donation into clinical practice. This study was supported by the Wellcome Trust (097857/Z/11/Z). E.T. is the co-founder of Pride Angel; the remaining authors have no conflicts of interest. © The Author 2016. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology.
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Code of Federal Regulations, 2010 CFR
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Code of Federal Regulations, 2010 CFR
2010-07-01
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