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1.

Introduction

Organ refusal rates among Gypsies is much higher than that of any other social group in Spain. However, their attitude toward new therapies related to transplantation, such as the xenotransplantation, is not known. This is especially important in countries such as Spain, where there are research and development units for xenotransplantation.

Objective

To analyze the attitude toward xenotransplantation among the Gypsy population living in Spain.

Method

Type of study: Observational sociological study. Population under study: Adult Gypsy population currently residing in Spain. Sample: A random sampling of 230 adult Gypsies. Assessment instrument: A validated attitude questionnaire for xenotransplantation—PCID–XenoTx Ríos. Fieldwork: Random selection based on stratification. Anonymity and self-administered fulfillment. Statistics: Student t test, χ2, Fisher, and a logistic regression analysis.

Results

A sample of 206 Gypsies was obtained. Forty-five percent (n = 93) would accept a solid organ xenotransplantation if they needed it, and the results were similar to those currently obtained with human organs; 24% (n = 49) have doubts, and 31% (n = 64) would not accept the xenotransplantation. If the results were worse than with human organs, only 9% would accept the xenotransplantation (n = 19). Respondents with a favorable attitude toward xenotransplantation presented a more favorable attitude toward cadaveric organ donation (55% vs 34%, P = .01).

Conclusions

Gypsies do not present a very favorable attitude toward xenotransplantation, especially compared with other Spanish population groups. A favorable sensitivity is presented by the population group in favor of it to cadaveric organ donation, which could be used to sensitize this social group and promote donation campaigns with the aim of increasing donation rates.  相似文献   

2.

Introduction

The refusal to consider death and the donation and transplantation of organs make Gypsies one of the subpopulation groups with the lowest donation rates in Europe. The approach of this social group implies the support of the most favorable social groups within their own ethnic group. In this sense, the young population with a high level of education is usually the most favorable toward organ donation.

Objective

To analyze the attitude toward the donation of one's own organs for transplantation among the Gypsy population under 45 years and with secondary or university studies.

Method

Population under study: The Gypsy population under 45 years old with secondary or university studies who currently reside in Spain. Assessment instrument: The attitude questionnaire for organ donation for transplantation PCID–DTO Ríos. Fieldwork: A random selection based on stratification. Anonymity and self-administered fulfillment. Statistics: Student t test and χ2.

Results

A total of 44 Gypsy people under 45 years of age were surveyed (mean age 31 ± 8.9 years); 66% were women, and the rest were men. Of these, 20 had university studies, and 24 had secondary or vocational studies. The attitude is favorable toward organ donation in 64% of the respondents, with 80% among university students and 50% among those with secondary or vocational education (P < .005).

Conclusions

The young Gypsy population with university studies has a very favorable attitude toward organ donation. This population subgroup must be key in the promotion of organ donation in the Gypsy population, so the transplant coordinators must request their collaboration in the promotion campaigns of organ donation and transplantation.  相似文献   

3.

Introduction

The knowledge of the brain death (BD) concept is important when determining the attitude toward organ donation.

Objective

To analyze the level of knowledge of the BD concept among the population in Santiago de Cuba and determine the factors that condition it.

Methods

From the Collaborative International Donor Project, we obtained a sample of Cubans living in the area of Santiago de Cuba (n = 455). The attitude was assessed using a validated questionnaire (PCID-DTO-RIOS). The survey was self-administered and completed anonymously. Student t test, χ2, Fisher, and logistic regression analysis were used.

Results

Forty percent (n = 180) of the respondents know the BD concept and consider it as the death of an individual. Of the rest, 43% (n = 199) do not know about it, and the remaining 17% (n = 76) consider that it does not mean the death of a patient. The variables significantly related to the correct knowledge of BD in the multivariate analysis and considered as independent are: level of studies; the opinion of the couple toward organ donation; the religion of the respondent; having offspring; and a favorable attitude toward organ donation.

Conclusion

There is ignorance about the brain death concept among the population of Santiago de Cuba. This lack of knowledge has a direct relationship with various psychosocial factors.  相似文献   

4.

Introduction

Religious factors have conditioned the attitude toward organ donation and transplantation (ODT) since the beginning of transplantation, despite the fact that most religions are in favor of transplantation.

Objective

To assess the impact of religious beliefs of medical students on their attitude toward ODT.

Method

Population under study: Medical students in Spanish universities. Study sample: Stratified by geographical area and academic course. Assessment instrument: Attitude ODT questionnaire PCID-DTO-Ríos, anonymous and self-administered.

Results

Of all students, 42% (n = 3907) declare themselves atheists or agnostics. The remaining 58% (n = 5368) declare themselves to be religious, the majority being Catholic (55%, n = 5102). Of the rest, 0.2% are Muslims (n = 8), 0.1% Protestants (n = 1), and the remaining 2.7% (n = 257) indicate other religious doctrines but do not want to specify it. Regarding their attitude toward ODT, those who consider themselves atheists or agnostics have a more favorable attitude than those who consider themselves religious (84% versus 76%; P < .001). Among those who follow some kind of religion, Catholics are more in favor of ODT than non-Catholics (77% vs 64%, P < .001). Note that among the religious, only 57% (n = 3050) know which religion is in favor of transplantation, while 22% (n = 1,152) consider that it has not been pronounced on the matter, 13% (n = 723) think the religion is against donation, and the remaining 8% (n = 443) do not know.

Conclusion

The religion professed by medical students conditions their attitude toward donation, with the atheists and agnostics being more in favor of donation.  相似文献   

5.
The involvement of health professionals from their training period is important for the promotion of living liver donation. There are data that indicate that the awareness of living donation is lower in areas with high rates of deceased donation.

Objective

To analyze the attitude toward living liver donation among Spanish medical students, according to donation rates of their regions.

Method

Population under study: Medical students in Spanish universities. Database of the Collaborative International Donor Project, stratified by geographic area and academic course. The completion was anonymous and self-administered. Groups under study: group 1 (n = 1136): students in universities of regions with >50 donors per million population (pmp); group 2 (n = 2018): students in region universities with <40 donors pmp. Assessment instrument: the attitude questionnaire for living liver donation Proyecto Colaborativo Internacional Donante sobre Donación de Vivo Hepático-Ríos (PCID-DVH Ríos).

Results

The attitude toward related liver donation is more favorable among the students of regions with <40 donors pmp than among those of >50 donors pmp. Thus, in group 1, a total of 88% (n = 1002) of students are in favor compared with 91% (n = 1831) of group 2 (P=.02). The psychosocial profile of each study group about their attitude toward living related liver donation is analyzed. There is a similar profile between the 2 groups, although there are differences in some variables such as age, a belief that one might need a transplant, family discussion about donation and transplantation, discussion with friends about donation and transplantation, and knowing about a donor.

Conclusions

The awareness of living related donation among Spanish medical students is greater among the regions with lower organ donation rates.  相似文献   

6.

Introduction

The sensitization of the population toward organ donation is fundamental; for that reason, it is important to determine the factors that condition the opinion toward donation on the population scope in order to carry out cost-effective campaigns.

Objective

To analyze the attitude toward the donation of the proper organs for transplantation among the population residing in Cienfuegos, Cuba.

Method

Population under study: Population who reside in Cienfuegos, Cuba. Inclusion criteria: Population over 15 years old as stratified by age and sex. Assessment instrument: The attitude questionnaire for organ donation for transplant—PCID–DTO Ríos. Fieldwork: A random selection based on stratification. The available data from the census were used. The completion was anonymous and self-administered. Verbal consent was requested to collaborate in the study. Statistics: Student t test, χ2, Fisher, and a logistic regression analysis.

Results

A sample of 636 respondents was included in the study, of which 71% (n = 453) are in favor of donating their organs after death, 16% (n = 103) are against, and 13% (n = 80) are undecided. This attitude is associated with different psychosocial variables (P < .001): age, marital status, having offspring, level of studies, carrying out prosocial activities, discussing with the family the subject of donation and transplantation, knowledge of the concept of brain death, the attitude toward the manipulation of the corpse, the religion of the respondent, and the attitude of the couple toward organ transplantation. The main independent factors obtained in the multivariate analysis (odds ratio >2.5): knowledge of the brain death concept, attitude toward the manipulation of the corpse, religion, and attitude of the couple toward transplantation.

Conclusions

The attitude toward organ donation among the population of Cienfuegos, Cuba, is favorable and is conditioned by several psychosocial factors.  相似文献   

7.
8.
9.
10.
The awareness of organ donation among health professionals is important at the time of transplant promotion. In this sense, the training and awareness of the professionals in training is fundamental.

Objective

To analyze the differences in the attitude toward organ donation and the factors that condition it among medical students of regions with donation rates >50 donors per million population (pmp) with respect to those with rates <40 donor pmp.

Method

Population under study: medical students in Spanish universities. Database of the Collaborative International Donor Project, stratified by geographic area and academic course. The completion was anonymous and self-administered. Groups under study: Group 1 (n = 1136): students in universities of regions with >50 donors pmp. Group 2 (n = 2018): university students in regions with <40 donors pmp. Assessment instrument: attitude questionnaire for organ donation for transplant PCID-DTO-Ríos.

Results

The attitude toward organ donation for transplantation is similar among students from the autonomous communities with >50 donors pmp and with <40 donors pmp. In group 1, 79% (n = 897) of students are in favor compared with 81% (n = 1625) of group 2 (P=.29). The psychosocial profile toward donation is similar in both groups relating to the following variables (P < .05): sex, having discussed transplantation with family and as a couple, considering the possibility of needing a transplant, involvement in prosocial activities, attitude toward the manipulation of corpses, knowledge of the brain death concept, and religion.

Conclusions

The awareness of organ donation in Spanish medical students is quite homogeneous and is not related to the local donation rates of each region.  相似文献   

11.
12.
Puerto Rican and Cuban populations are 2 of the most important migration groups in Florida. Awareness about organ donation among them is fundamental. It is important to determine the factors that influence attitudes toward organ donation.

Objective

To analyze the attitude toward living kidney donation (LKD) among Florida's Puerto Rican residents.

Methods

Study population: Population born in Puerto Rico resident in Florida (United States). Inclusion criteria: A sample of population older than 15 years was obtained randomly and stratified by age and sex. Instrument valuation: LKD attitude questionnaire Proyecto Colaborativo Internacional Donantesobre Donación de Vivo Renal, Rios.

Setting

for the study: Random selection based on stratification. Immigration support associations in Florida were needed to locate potential respondents. Anonymized and self-administered with verbal consent completion.

Results

Of the 259 respondents, 55% (n = 143) are in favor of related LKD (family or friends). The following factors were associated with this attitude: marital status (P = .008); educational level (P < .001); personal experience with organ donation and transplantation (P < .001); attitude toward deceased organ donation (P < .001); realization of prosocial activities (P = .02); family comments about organ donation (P < .001) and comments within couples (P < .001); not being concerned about possible mutilation of the body after donation (P < .001); believing that one's own religion was in favor of donation and transplantation (P < .001); economic incentives of donation (P < .001), and evaluation of the risk from living kidney donation (P < .001). In the multivariate analysis, only marital status is featured as an independent variable (odds ratio, 32.258; P < .001).

Conclusions

The attitude toward related LKD among the Puerto Rican population who resides in Florida is not very favorable; only 55% would do it.  相似文献   

13.
The Latin American population has a double way of immigration, one toward the United States by proximity and another toward Spain by sociocultural affinity. This population increase is affecting organ donation and transplantation in receiving countries.

Objective

To analyze the brain death (BD) concept knowledge in the Dominican Republic immigrant population in Florida (United States) and Spain.

Method

Population under study: Population born in the Dominican Republic, resident in Florida (United States) and in Spain. Inclusion criteria: Population older than 15 years stratified by age and sex. Assessment instrument: Donation attitude questionnaire PCID-DTO-Ríos. Fieldwork: Random selection based on stratification. Immigration support association collaboration in Florida and Spain was needed to locate potential respondents. Completion was anonymous and self-administered, with verbal consent.

Results

A total of 123 respondents, 57 residents in Spain and 66 in Florida, have been included in the study. The 27% (n = 33) of the respondents knowledgeable of the BD concept consider it the death of an individual. Of the remainder, 52% (n = 64) do not know about it, and the remaining 21% (n = 26) believe it does not mean the death of a patient. No differences were observed regarding migration countries (P > .05). There was no association of the BD concept with other psychosocial factors analyzed or with the attitude toward organ donation.

Conclusions

Knowledge of the BD concept among the Dominican immigrant population is similar in Spain and Florida, and, unlike most studies, there is no objective association with the attitude toward organ donation.  相似文献   

14.

Purpose

Creating a trough on the anterior glenoid rim is one of the methods used for arthroscopic Bankart repair with suture anchors. The purpose of this study was to analyze clinical and radiological outcomes of arthroscopic Bankart repair with suture anchors; to compare between the outcomes of surgical procedures with and without trough.

Methods

Clinical and radiological outcomes were evaluated for 116 patients who underwent arthroscopic Bankart repair at our institute from 2005 to 2011. The mean follow-up was 5.2 years (range, 2–8.8 years). All data were divided into trough group (n = 62) and non-trough group (n = 71). Clinical and functional outcomes were assessed pre- and postoperatively as range of motion (ROM), pain on the visual analog scale (p-VAS), function on the visual analog scale (f-VAS), and Rowe score. Radiological outcomes were also evaluated.

Results

The overall postoperative clinical and functional outcomes improved significantly (P < .001). A total of 8 patients (6.8%) showed recurrent instability. Radiologic findings showed mild arthritis in 27 cases (23.1%), moderate arthritis in 6 cases (5.1%), and no severe arthritis. 32 patients showed anterior apprehension after surgery, and 22 out of those 32 patients were from non-trough group. However, no significant difference between the trough and non-trough groups was found with respect to clinical and functional outcomes (P > .05).

Conclusion

The additional procedure of creating a trough did not improve clinical outcomes in terms of frank dislocation; however, at the final follow-up, patients with the trough showed less anterior apprehension. Overall, arthroscopic Bankart repair using suture anchors had relatively good clinical outcome, with a redislocation rate of 6.8%.

Level of evidence

Level III, Case series.  相似文献   

15.

Introduction

We aimed to evaluate if ex vivo machine perfusion could minimize the negative impact of cold ischemia on those renal grafts obtained from controlled donation after circulatory death (cDCD).

Material and methods

Prospective observational paired study of kidney transplants from cDCD performed in our center. The kidney from each pair preserved on ice was transplanted first within the first few hours following procurement, while the contralateral kidney was machine-perfused with a LifePort device (Organ Recovery Systems, Brussels, Belgium) and transplanted the following day.

Results

A total of 12 cDCDs were included. No differences were observed in delayed graft dysfunction or graft survival between the 2 groups.

Conclusion

The use of ex vivo perfusion devices is simple and they do not require any large infrastructural or high economic investments, considering the fact that it allows a better selection of recipients and viable organs no longer need to be discarded because of prolonged warm ischemia times.  相似文献   

16.

Background

The Nigerian transplantation program is evolving but is currently over-reliant on living donors. If deceased donation is to be viable in Nigeria, it is important to ascertain the views of the public. The objective of the study was to explore the knowledge, attitudes, and behavior of Nigerian international students toward organ donation.

Methods

A cross-sectional study was conducted among Nigerian international students of the University of Bedfordshire through the use of a modified self-administered questionnaire. The participants were recruited by means of purposive sampling.

Results

Of the 110 questionnaires distributed, 103 were returned fully completed (response rate = 93.6%). A significant majority (93.2%) of the participants are aware of organ donation, and 76.7% have a good knowledge on the subject. Furthermore, more than half (52.8%) of the participants have a positive attitude toward organ donation, and less than half (42.8%) have favorable behavior toward it. Higher knowledge does not correlate to either positive attitude or behavior, but a positive attitude is correlated with favorable behavior toward donation.

Conclusions

The attitudes and behavior of the respondents toward organ donation is not commensurate with the level of knowledge they possess. This highlights the urgent need for well-structured educational programs on deceased organ donation.  相似文献   

17.

Background

Because the relationship between coaches and athletes is unequal, verbal and physical abuse remains a common problem among sports coaches. We aimed to elucidate the characteristics of baseball coaches who verbally/physically abuse young baseball players.

Methods

A cross-sectional study was conducted on youth sports team coaches in Miyagi prefecture, Japan (n = 380), using a self-reported questionnaire. Multivariate logistic regression models were used for the analyses, evaluating the following variables: sex, age, educational level, smoking habits, years of coaching, level of baseball-playing experience, personal experience with verbal/physical abuse by former coaches, satisfaction with athletes’ attitudes, number of athletes on the team, team competition level, awareness of the recommendations of the Japanese Society of Clinical Sports Medicine, limitations in the total pitch count, difficulty in coaching in other positions, number of games per year, and acceptance of former verbal/physical abuse.

Results

The prevalence of verbal/physical abuse toward young athletes was 74.5% (n = 283) and 6.6% (n = 25), respectively. Verbal abuse was significantly associated with personal experience of verbal abuse by former coaches (odds ratio [OR]: 2.00, 95% confidence interval [95% CI]: 1.04–3.85), and acceptance of verbal/physical abuse (OR: 2.61, 95% CI: 1.34–5.10). Physical abuse was significantly associated with greater than 10 years of coaching experience (OR: 7.16, 95% CI: 1.36–37.78), personal experience with physical abuse by former coaches (OR: 4.25, 95% CI: 1.23–14.70), and acceptance of verbal/physical abuse (OR: 3.85, 95% CI: 1.51–9.84).

Conclusions

Coaches’ experiences with verbal/physical abuse by former coaches negatively affected young athletes. Breaking this cycle is necessary to keep athletes active and interested in playing baseball.

Level of evidence

Level III.  相似文献   

18.
The renal replacement therapy in Saudi Arabia has 3 main modalities: hemodialysis, peritoneal dialysis, and renal transplantation. Hemodialysis is one of the fastest growing industries of health care providers in Saudi Arabia.

Objective

We aimed to review the health indicators of renal replacement therapy.

Materials and Methods

We used the Saudi Center for Organ Transplantation Annual Report 2016.

Results

Patients with end-stage renal disease on hemodialysis and peritoneal dialysis totaled 17,687. Saudi Arabia increased the numbers of dialysis centers and also added 2 more sectors. The Ministry of Health hospitals have 55% of the centers, government non–Ministry of Health has 9%, private and charitable hospitals have 21%, the King Abdullah Hemodialysis Project has 2%, and the outsourcing dialysis programs have 13%. There are 243 dialysis units in Saudi Arabia. Most dialysis centers are in the central region (30%); 27% are in the western region, 19% are in the southern region, 13% are in the eastern region, and 11% are in the northern region. The average net increase of dialysis patients is 6.2% annually and is projected to reach 22,000 by 2020. Causes of renal failure are mainly diabetic nephropathy (40%) and hypertensive nephropathy (38%). Hepatitis C virus positivity is at 12% and hepatitis B surface antigen positivity is at 4%. From the year 2000 renal transplantation from deceased and living donation has tripled in number, with a total of 798 kidneys transplanted.

Conclusion

Renal replacement therapy is increasing and dialysis center numbers are expected to increase. Renal transplantation numbers have improved both from living and deceased donors but further actions toward the promotion of the organ donation in Saudi Arabia is essential.  相似文献   

19.

Purpose

Everolimus, a mammalian target of rapamycin inhibitor, may have a protective role on hepatocellular carcinoma (HCC) recurrence after liver transplantation (LT), but data regarding the impact of its trough serum levels on HCC recurrence are missing.

Methods

Fifty-five patients (43 men, age 55 ± 8 years) who underwent LT for HCC were evaluated. Several demographic and clinical variables were recorded, including radiological and histological characteristics of HCC as well as dosages and trough levels of immunosuppressive regimens.

Results

HCC recurrence occurred in 11 (20%) patients: 5 (25%) of 20 patients under calcineurin inhibitors and 6 (17%) of the 35 patients under everolimus (P = .48). The patients with HCC recurrence (n = 11, group 1), compared to those without recurrence (n = 44, group 2), had significantly more frequent HCC in the explant: outside Milan criteria (P = .001), microvascular invasion (P < .001), and higher number of nodules (P = .001). In multivariate analysis, microvascular invasion was the only independent factor significantly associated with HCC recurrence (OR: 2.3, 95% CI: 1.4–10.5, P = .03). Among the patients who received everolimus-based immunosuppression, the recipients with HCC recurrence, compared to those without HCC recurrence, had significantly lower mean trough levels of everolimus at 7–12 months post-LT (3.9 vs 5.9 ng/mL, P = .001), while the patients with mean trough levels of everolimus >6 ng/mL had decreased HCC recurrence rates (log rank: 2.3, P = .007).

Conclusions

We found for the first time mean concentrations of everolimus between 7–12 months post-LT as the only modifiable variable related with HCC recurrence in LT recipients. However, larger studies are needed for final conclusions.  相似文献   

20.

Background

Living donor kidney transplantation is the best type of renal replacement therapy. However, large numbers of potential living kidney donors (LKDs) are declined because of various reasons. The aim of this study is to define and quantify the reasons for declining potential LKDs.

Methods

All potential LKDs evaluated at our center between September 2008 and December 2016 were reviewed. Data were collected from the electronic database.

Results

A total of 2090 potential LKDs were evaluated, with an average age of 32 years (range, 18–67 years) and men constituting 72.6%. A total of 675 (32.3%) were accepted for donor nephrectomy. Living kidney donation did not proceed in 830 (39.7%): 661 (79.6%) because of donor-related reasons and 169 (20.4%) because of recipient-related reasons. Donor-related reasons included medical contraindications (61.7%), immunological barriers (23.1%), surgical contraindications (7.9%), and psychosocial reasons (7.3%). A total of 585 (28.0%) potential LKDs voluntarily withdrew themselves at variable time points during the evaluation process, even after being accepted for donation. Male and young (18–35 years) potential LKDs were more likely to withdraw compared with female and older (>35 years) potential LKDs (34.3% vs 11.4%, P < .005 and 29.6% vs 24.5%, P = .02, respectively).

Conclusions

Despite the large number of potential LKDs, medically complex donors are increasing, and a significant proportion decided to withdraw at some point during the evaluation process. The latter highlights the need to increase public awareness about living donation, to perform more careful initial screening and targeted educational programs, and to provide continuous support for potential LKDs.  相似文献   

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