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Adams, William P. "Thyroid Hormone as a Method of Reducing Damage to Donor Hearts after Circulatory Arrest." VCU Scholars Compass, 2017. http://scholarscompass.vcu.edu/etd/4766.
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There is a chronic lack of donor hearts to meet the need for heart transplant both in the US and worldwide. Further, the use of available hearts is limited by the short period between collection and implantation during which the heart can be safely preserved ex vivo. Using mid-thermic Langendorff machine perfusion, we have been able to preserve the metabolic function of a healthy heart for up to 8 hours, twice the limit for current static cold storage. We have also been able to preserve the metabolic function of a damaged DCD Heart collected 30 minutes after cardiac arrest for a period of 8 hours. We further investigated whether it was possible to improve the preservation of DCD heart using treatment with 10 μM Triiodothyronine to stimulate the tissue metabolism and we did find a reduction in damage markers in the treated DCD hearts as compared to the untreated group.
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Satur, Christopher Michael Raymond. "An experimental investigation of the potential of radioisotope infarct markers to quantify injury in donor hearts." Thesis, Queen Mary, University of London, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.338432.
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White, Christopher W. "Resuscitation, preservation, and evaluation of hearts donated after circulatory death: an avenue to expand the donor pool for transplantation." John Wiley and Sons, 2013. http://hdl.handle.net/1993/32171.
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Cardiac transplantation is the treatment of choice for eligible patients with advanced heart failure; however, it is limited by a critical shortage of suitable organs from traditional brain-dead donors. Organs donated following circulatory death (DCD) have been used to successfully expand the pool of organs available for kidney, liver, and lung transplantation; however, concerns regarding the severity of injury sustained by the heart following withdrawal of life sustaining therapy have deterred the clinical transplantation of DCD hearts. Investigations aiming to optimize the resuscitation, preservation, and evaluation of DCD hearts may facilitate the development of an evidence based protocol for DCD heart transplantation that can be translated to the clinical area and expand the donor pool. Therefore, the objectives of this thesis are to develop a clinically relevant large animal model of DCD and gain a greater understanding regarding the physiologic impact of donor extubation on the DCD heart, demonstrate as a ‘proof-of-concept’ that utilizing an approach to donor heart resuscitation, preservation, and evaluation that is tailored to the DCD context can facilitate successful transplantation, and finally to investigate ways to optimize the resuscitation, preservation, and evaluation of DCD hearts for transplantation. The results of this thesis may then be used to inform the development of an evidence-based protocol for DCD heart transplantation that can be translated to the clinical area. The clinical adoption of such a protocol has the potential to expand the donor pool and improve outcomes for patients with end-stage heart failure.May 2017
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Pauls, Jo Philipp. "Development of a Passive Control System for Ventricular Assist Devices." Thesis, Griffith University, 2017. http://hdl.handle.net/10072/365268.
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Cardiovascular diseases are a leading cause of death throughout the developed world. With the demand for donor hearts far exceeding the supply, a bridge-to-transplant or permanent solution is required. This can be achieved with rotary ventricular assist devices (VADs). Rotary VADs show a weaker response to preload than the native heart. This may lead to ventricular suction or pulmonary congestion, which can be deleterious to the patient’s recovery. A physiological control system which optimizes responsiveness of VADs may reduce adverse events. Active physiological control systems rely either on pressure and flow measurements or on estimated data. However these controllers may be limited by the low reliability of long term blood pressure and flow sensors or potential of inaccurate estimators due to changes in the VAD circuit (e.g. thrombus formation resulting in false estimation). A passive physiological control system might be able to overcome the limitation of active physiological control systems. This research project had three key aims: • Investigation of the steady state and time response of the healthy heart and circulatory system to changes in patient state (e.g. active postural changes and exercise). • In-vitro development and in-vivo validation of novel compliant inflow cannulae for rotary LVADs and RVADs to improve preload sensitivity of RBPs and provide a passive physiological control system for ventricular suction prevention. • Rigorous in-vitro evaluation of the compliant inflow cannulae together with various active physiological control systems previously presented in the literature under identical conditions.Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
Griffith School of Engineering
Science, Environment, Engineering and Technology
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Wiegemann, Thomas. "Analyse der Morphologie des Myokards, der Koronararterien und der großen Gefäße von Spenderherzen für Klappenhomografts." Doctoral thesis, Humboldt-Universität zu Berlin, Medizinische Fakultät - Universitätsklinikum Charité, 2000. http://dx.doi.org/10.18452/14533.
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317 pathologisch-anatomische Befundberichte über die Morphologie des Myokards, der Koronararterien, der Aorta und der Pulmonalarterien von Herzen, die in der Homograftbank des Deutschen Herzzentrums Berlin in den Jahren 1996 bis 1998 für eine potentielle Klappenspende (Aorten- und Pulmonalklappen) seziert worden waren, wurden ausgewertet. 178 dieser Herzen stammten von Herztransplantatempfängern und zeigten naturgemäß schwere pathologische Veränderungen. Sechs Herzen stammten von Leichen. 133 Herzen waren hirntoten Menschen entnommen worden. Ursprünglich hatte bei vielen dieser 133 Spenderherzen die Absicht bestanden, sie für die Transplantation zu verwenden, was aus verschiedenen Gründen nicht möglich war. Ziel der retrospektiven Studie war die Erfassung der morphologischen Situation der Organe, wobei der Schwerpunkt auf der Gruppe der Spenderherzen lag.This work contains an analysis of 317 records with a detailed description of the morphology of myocardium, coronary arteries, aortas and pulmonary arteries of hearts dissected for the purpose of harvesting the aortic and pulmonary valves as allografts in the Heart Valve Bank of the German Heart Institute, Berlin, from 1996 through 1998. 178 hearts stemmed from patients who recieved heart transplants. Naturally these organs revealed severe pathologic findings. Cadaveric organs (non beating hearts) amounted to six. 133 hearts were taken from brain dead human beings. Many of these 133 donor organs were originally considered to be potentially usable for transplantation, but were discarded for various reasons. The objective of this retrospective study was to ascertain the morphologic state of the hearts with special focus on the 133 donor hearts.
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Wheeldon, Dereck Ronald. "Donor heart preservation for heart transplantation." Thesis, Open University, 1997. http://oro.open.ac.uk/57723/.
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Heart transplantation has enjoyed a spectacular success over the past 25 years. Prior to 1980 less than 350 operations were carried out with an overall one year survival of less than 60%. In 1995 more than 3,000 transplants were performed with a one year survival of 83%. However, growth and improved survival have both plateaued over the last few years; the former because of the falling donor supply and the latter, in part, because of the use of less suitable donors in an effort to offset the problem of supply. Much attention has been focused on the drama of the surgery and the intricacies of immunological manipulation whilst little effort has been devoted to the area of donor management, despite the fact that primary graft failure is responsible for as many post transplant deaths as either infection or rejection. Optimum preservation of the donor heart has also provided a difficult challenge, such that, despite a considerable scientific effort little advance has been achieved to extend the 4 hour safe storage limit which has remained in place over the past 20 years. In this dissertation the problem has been approached by combining laboratory based preservation models with an objective regime of donor management. A sensitive isolated small animal working heart model was developed and used to characterise cardioplegic induction. Subsequently, the model was used to examine the interaction of oxygen content with the mode of delivery, during preservation. Finally, a number of representative solutions were combined with the most promising oxygen delivery method. These studies served to illustrate the utility of controlled laboratory studies and offer the prospect of more than doubling post storage function. The development of a rigorous donor management regime was also shown to be capable of reducing the variance in haemodynamic parameters by up to 44% whilst safely increasing the donor pool by approximately 30%. It is the contention of this thesis that the only prospect of improving the current impasse with the supply of donor hearts in sufficient quantity and of acceptable quality, is by the combination of appropriate laboratory models with controlled clinical trials.
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Stocks, Lisa Marie 1964. "Organ donor family experience." Thesis, The University of Arizona, 1993. http://hdl.handle.net/10150/291391.
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An exploratory-descriptive design was used to explore and describe knowledge and perceptions about the organ donation process of persons who had consented for their relatives organs to be donated. A 19 question mailed survey was administered to 110 people who met study criteria. Descriptive methods were used to analyze the data. Less than half of the respondents had discussed organ donation previously or knew if their relative carried a donor card, they indicated that they understood the concept of brain death and its cause. These families were positive about their decision to donate and perceived altruism as the most positive aspect of the process. The most difficult aspect of the donation process emerged as "reality of death." Nurses are a critical link in the organ donation process. Results of this study are useful for nursing assessment, diagnosis, and formulation of care plans for families in the position to donate organs.
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Tapson, J. S. "Prognosis after donor nephrectomy." Thesis, University of Newcastle Upon Tyne, 1987. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.382508.
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Aitchison, J. Douglas. "Functional assessment of the non-heart-beating donor lung." Thesis, University of Newcastle upon Tyne, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.397348.
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Zafar, Farhan. "Risk Scoring Tool Based on Donor Characteristics in Pediatric Heart Transplantation and its Impact on Patient Survival." University of Cincinnati / OhioLINK, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1470753184.
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Uduji, Ifeoma Edna. "Donor Coordination and Health Aid Effectiveness in the Nigerian Health Sector." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2510.
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Development partners and donors increasingly acknowledge the importance of coordinating their activities to achieve the outcome of the official development assistance to developing countries. Although stakeholders have recognized the importance of harmonizing donors and development partners' efforts in the Nigerian health sector, little research has addressed the influence of coordination on the health aid effectiveness. This qualitative case study determined the influence of coordination among the donors and development partners involved in the HIV/AIDS, malaria, and nutrition program on the outcome of these programs in Nigeria. Data were collected through interviews with 22 program officers participating in the health programs and through document review. The document reviewed were reports of coordination efforts, and outcome evaluation reports. Data were managed using NVivo, while coding and themes were adopted for data analysis. Findings revealed the partial coordination efforts in the health system development. Coordination efforts should be at both national and state level to ensure adequate implementation of the health program. Most participants reported a need for the government of the recipient country to strengthen their commitment and own coordination process for development partners to adhere to the guidelines of the coordination platforms. These results could have implications for positive change by identifying the bases to achieve sustainable effectiveness of health aid in Nigeria through development of Country Coordination Mechanism for all health programs to provide guideline of harmonizing activities of development partners.
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Reddy, Mettu. "Improving the preservation of the non-heart-beating-donor pancreas." Thesis, University of Sunderland, 2010. http://sure.sunderland.ac.uk/3539/.
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Successful pancreatic islet transplantation depends on the number of islets transplanted, islet viability and extent of early islet loss due to ischaemia reperfusion injury. Novel pancreas preservation techniques which can improve these variables can increase the utilisation of non-heart-beating-donor pancreases for islet transplantation. A non-heart-beating-donor rat pancreas preservation model was developed. Pancreases preserved by either static cold storage, hypothermic machine perfusion or portal venous oxygen persufflation underwent islet isolation and purification. The yield, viability and in vitro function of isolated islets were compared. Portal venous oxygen persufflation improved the islet yield, viability and morphology as compared to static cold storage. The percentage of pancreases with functional islets (stimulation index greater than 1.0) was also higher after oxygen persufflation as compared to static cold storage. Severity of reperfusion injury in pancreases preserved by static cold storage or portal venous oxygen persufflation was compared after in vitro warm reperfusion. Amylase, lipase and glycerol levels in the portal effluent were measured. Lipid peroxidation and apoptosis in reperfused pancreas were measured using thio-barbituric acid reactive substances assay and caspase 3 assay respectively. Expression of genes relevant to ischaemia reperfusion was compared using RNA microarrays. Severity of ischaemia reperfusion injury was similar in both groups. Microarray analysis revealed increased expression of genes related to apoptosis in the portal venous oxygen persufflation group. This group also showed up-regulation of pro-survival cellular pathways and over-expression of genes related to cellular repair as compared to static cold storage. This project has for the first time evaluated oxygen persufflation as a method of pancreas preservation and investigated changes in global gene expression after this form of preservation. Overall, the project suggests that portal venous oxygen persufflation improves the recovery of non-heart-beating-donor rat pancreas. Further investigation to examine its role in the preservation of large animal pancreases is needed.
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Dubois, Nancy E. "Identification of Optimal Stool Donor Health and Intestinal Microbiome Characteristics for Fecal Microbiota Transplantation:." Thesis, Boston College, 2019. http://hdl.handle.net/2345/bc-ir:108352.
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Thesis advisor: Catherine Y. ReadBackground. Clostridium difficile infections (CDI) account for 20-30% of healthcare-acquired infections, resulting in serious patient and economic burdens. CDI incidence has grown rapidly due to overuse of antibiotics and an aging population, posing a significant public health threat. Fecal microbiota transplantation (FMT) using donor stool has demonstrated clinical efficacy rates up to 94% and long-term restoration of a healthy intestinal microbiome. Challenges with donor screening, lack of research about optimal stool donor characteristics and intestinal microbiome composition, and a poorly fit screening model, create barriers to the availability of FMT. Purpose. This study aimed to generate essential information about FMT donor characteristics predictive of passing the screening and donor intestinal microbiome compositions associated with FMT clinical efficacy. The primary aims were to 1) identify previously unstudied characteristics of prospective FMT donors that are predictive of passing a stool bank’s screening process; and 2) determine whether donor intestinal microbial diversity is related to FMT clinical efficacy in preventing recurrent CDI. Methods. This study was conducted as a secondary analysis on a cohort of previously screened donors (n=770). Aim 1 was tested through a logistic regression of donor characteristics (gender, age, body mass index, frequency of bowel movements, diet, tobacco and alcohol use, and seasonality) with screening outcomes. Aim 2 was tested through a simple regression evaluating donor intestinal microbial diversity and rates of FMT clinical efficacy. Results. One donor characteristic in the logistic regression, frequency of bowel movements (p = 0.018), was significantly predictive of whether a donor passed the screening. Specifically, donors who had fewer than two bowel movements per day were more likely to pass. All other characteristics were not predictive. Similarly, the linear regression evaluating alpha diversity and FMT clinical efficacy was not significantly predictive of clinical efficacy (p = 0.140). Conclusion. Findings were used to support recommendations for improving prospective donor screening that nurses and other clinicians can implement to decrease challenging logistics, reduce costs and barriers, and potentially increase FMT clinical efficacy
Thesis (PhD) — Boston College, 2019
Submitted to: Boston College. Connell School of Nursing
Discipline: Nursing
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Daemen, Jan-Willem Henri Catharina. "Non-heart-beating kidney donors clinical implications /." [Maastricht : Maastricht : Universiteit Maastricht] ; University Library, Maastricht University [Host], 1998. http://arno.unimaas.nl/show.cgi?fid=8432.
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Dronavalli, Vamsidhar Bharadwaz. "Identification of heart donors using biochemical probes." Thesis, University of Birmingham, 2015. http://etheses.bham.ac.uk//id/eprint/6096/.
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Heart transplantation provides a substantial survival benefit for selected patients with advanced heart failure, achieving a 1 year survival rate of ≥80%. Up to two thirds of hearts offered for transplantation are rejected before detailed organ inspection as being likely to fail if transplanted. The decision to discount these organs is based on clinical factors (e.g. blood pressure, electrocardiographic changes, prior cardiopulmonary resuscitation, drug history, history of hypertension and the need for inotropic support). However, none of these factors necessarily preclude successful transplantation. Thus, there is a pool of unused hearts, for which permission for heart donation has been granted, from which additional transplants could be generated if we could be more confident about their current and future function. My research prospectively validated a definition of primary allograft dysfunction following heart transplantation that is suitable for use in multicentre studies. I then investigated the role of biomarkers in the evaluation of potential cardiac donors with objective of increasing the number of donor hearts that will be assessed by direct inspection. This lead to the design of a scoring system to guide donor evaluation.
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Busque, Stephan. "Contribution of donor T-lymphocytes to graft immunogenicity." Thesis, McGill University, 1995. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=23871.
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We used genetically T-lymphopenic rats as donors to probe the contribution of T-lymphocytes to graft immunogenicity. Graft survival (GS) of lymphopenic donors was significantly increased as compared to normal donors (median (M) = 17 days vs M = 7d, n = 10). To confirm this observation, we reconstituted 7 lymphopenic rats before organ retrieval with $10 sp7-10 sp8$ purified T-lymphocytes. GS was significantly shorter than with lymphopenic donors (M = 7d, n = 7 vs M = 17d, n = 10). Conversely, we treated 6 normal donors with R7.3 (mouse anti-rat TCR $ alpha/ beta$) monoclonal antibody (mab). GS was significantly increased as compared to normal donors (M = 23d, n = 6 vs M = 7d, n = 10). These experiments demonstrate that grafts of T-lymphopenic donors have a longer survival time. This advantage is lost after reconstitution with normal T-lymphocytes. GS is similarly prolonged after treatment of normal donors with anti-T-lymphocytes mab. Thus, donor T-lymphocytes contribute to the graft immunogenicity in this model.
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Kassahun, Walelign M. "HIV Prevalence and Donor Funding in Ethiopia." Thesis, Walden University, 2019. http://pqdtopen.proquest.com/#viewpdf?dispub=13806354.
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Many researchers have documented the trend of decreasing financial support from donors for human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) responses in Ethiopia. Less information is available regarding the correlation between trends of HIV prevalence and external funding and ways to address the impact that funding scarcity could cause. The purpose of this study was to examine the trend of HIV prevalence and donor funding levels, analyzing how the 2 are correlated, and opportunities to improve responses. Using the proximate determinant framework, the research questions examined the changes in HIV prevalence in Ethiopia during the past 10 years; the association between the trends of HIV prevalence, funding levels, and services provided; and the effect of different characteristics on the trend of the prevalence. A paired sample t-test, time series forecasting, Pearson correlation, chi-square test, and multiple regression were employed using a secondary data of sampled 1,067 people from the Demographic and Health Surveys and data from donors. Results indicated that the change in prevalence was statistically significant (t [10] = 4.59, p = .001), and correlated with the funding levels(r (10) = .635*, p = .027), a significant relationship between funding level and type of services, χ2 (2, N = 1067) = 1425.7, p < .001 and a significant regression equation to predict HIV prevalence (F (9, 1056) = 12.639, p < .001). The results from this study could be used to inform the Ministry of Health of Ethiopia and HIV project implementers to plan for domestic sustainable financing initiatives, invest based upon evidence-based HIV prevention strategies that could most directly impact quality of life and guide future research.
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Stonienė, Laimutė. "Kraujo donorų požiūris į donorystę." Master's thesis, Lithuanian Academic Libraries Network (LABT), 2005. http://vddb.library.lt/obj/LT-eLABa-0001:E.02~2005~D_20050610_141430-65709.
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SUMMARY
Importance of blood safety by voluntary and altruistic blood donation is presented in the Master degree thesis. The major theoretical and practical solution of blood donations adopted during the analysis of Lithuanian and foreign legislation, results of analysis of society blood donor’s motivation and blood donors focusing problems.
Master degree thesis consists of four main parts: analysis of the problem, background literature review, practical research and final conclusions.
The first part of the thesis emphasizes the necessity for EU member states to ensure the provision for safe blood products which quality must fulfil the same EU standards, to restore public confidence. The main problem is transition from paid and relative’s blood donations to unpaid (voluntary) donations, which is revealed in the first part of thesis.
The legislation regulating blood donations, the types of current donors and factors influencing on donors motivation are discussed in the second part. The second part consists of three chapters.
The review of Lithuanian legislation about donor ship in Lithuania is considered in the first chapter. It is possible to state that till the year 2004 in Lithuania legal paid blood donations system was established which today barrier in transition is from paid and relatives blood donation to unpaid (voluntary) process. The second chapter describes the changing during last 3 year among Lithuanian blood donors and in donations.
on process. And the last... [to full text]
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Potter, Charles David Ogilvy. "A biomechanical viewpoint of human haemodynamic function." Thesis, University of Cambridge, 1995. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.361450.
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Kimber, Rachel M. "A preclinical assessment of the non-heart beating donor pancreas for islet transplantation." Thesis, University of Leicester, 2005. http://hdl.handle.net/2381/29497.
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The results of islet transplantation have been significantly improved in recent years following major advances made by the Edmonton group in Canada. These included transplanting fresh islets from more than one donor combined with a new less diabetogenic immunosuppressive protocol. Clinical islet transplant programs will be limited by the declining numbers of organ donors. Non-heart beating donors have been used to expand the renal donor pool, however the pancreas in particularly susceptible to warm ischaemia and may therefore not be suitable for islet transplantation.;The aim of this thesis was to evaluate the use of islets from non-heart beating donors in pre-clinical animal models. Different preservation methods were used including new and old preservation solutions along with the two-layer method (TLM) to attempt rodent pancreas resuscitation. However, even a short period of warm ischaemia led to poor islet yields and viability. A proportion of this work was to examine the use of ADP:ATP ratio as a potential viability test to estimate the degree of warm ischaemic damage.;Pulsatile machine perfusion has been a promising method for kidney preservation. A Waters RM3 perfusion machine was compared to both conventional cold storage and TLM for porcine pancreas preservation. Unfortunately, islet fragmentation and poor islet yields were a problem following machine perfusion suggesting that cold storage should remain the gold standard preservation method. In conclusion, the use of the non-heart beating donor pancreas for islet transplantation still remains a problem until more effective preservation methods are developed.
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Vilkelienė, Skaidra. "Infekcinių ligų žymenų paplitimo tarp kraujo donorų nacionaliniame kraujo centre įvertinimas." Master's thesis, Lithuanian Academic Libraries Network (LABT), 2008. http://vddb.library.lt/obj/LT-eLABa-0001:E.02~2008~D_20080612_150153-97307.
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Šiame darbe nagrinėjamos aktualios mūsų šalyje saugaus donorinio kraujo ir kraujo produktų surinkimo problemos. Per kraujo perpylimą plintančios ligos yra didžiausia kraujo tarnybų problema visame pasaulyje. Ši problema yra tiesiogiai proporcinga kraujo donorų bendruomenėje paplitusioms infekcijoms. Atsižvelgiant į pagrindinius saugaus kraujo užtikrinimo kriterijus darbe rekomenduojamos konkrečios galimos priemonės infekcinių ligų prevencijai.
Darbo tikslas: Palyginti ir įvertinti infekcinių ligų žymenų paplitimą tarp atlygintinų ir neatlygintinų kraujo donorų. Darbe keliami uždaviniai yra šie: išsiaiškinti motyvaciją kraujo donorų tarpe; išsiaiškinti infekcinių ligų ��ymenų paplitimą tarp atlygintinų ir neatlygintinų kraujo donorų; pasiūlyti galimas priemones infekcinių ligų plitimo prevencijai kraujo donorų tarpe.
Tyrimas buvo atliktas 2007 metų liepos – rugpjūčio mėnesiais viešojoje įstaigoje Nacionalinis kraujo centras, atsitiktinai pasirenkant 500 respondentų - kraujo donorų - imtį. Metodikos tinkamumui įsitikinti, tyrimui buvo sudaryta anketa – klausimynas. Statistinė gautų duomenų analizė buvo atliekama personaliniu kompiuteriu, panaudojant statistinės analizės SPSS programinį paketą versija “16.0” ir statistinę programą “5.0”. Statistinių duomenų reikšmingumas buvo įvertintas pagal χ2 kriterijų. Skirtumai tarp atitinkamų rodiklių laikomi reikšmingais, kai klaidos tikimybė p≤0,05 (kai p>0,05 – rezultatų skirtumai statistiškai nereikšmingi).
Tyrimo metu nustatyta, kad... [toliau žr. visą tekstą]This study analyses the safety of blood and blood products, which is the global problem, particularly, problematic in our country. The diseases spreading through blood transfusion is the biggest problem of Blood Transfusion Services in the world. The problem is directly proportionate to the prevalence of infection markers among blood donors. Taking into consideration the criteria of safe blood assurance definite possible measures are recommended to prevent the spread of infection diseases. The aim of the study is to compare and assess infection markers prevalence among payable and non-remunerated donors. The objectives of this study are the following: to determine donors motivation, viral infections prevalence among payable and non-remunerated donors, to give recommendations for the prevention of infection markers prevalence in the donors community. Methods. The study has been accomplished during July – August 2007 in the National Blood Centre, randomly choosing 500 respondents – the donors of blood. To evaluate the appropriation of the method a questionnaire was introduced. The statistical analysis of the results was made by personal computer using SPSS programme package version 16.0 and the statistical programme 5.0. The significance of the statistical data was evaluated according χ² criteria. The difference between the indicators is statistically significant when the error probability is p ≤ 0. Results. Non-remunerated donor is the only way to sustainable donorship, and... [to full text]
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Mitchell, Therese. "The sustainability of donor funded projects in the health sector / T. Mitchell." Thesis, North-West University, 2013. http://hdl.handle.net/10394/10173.
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The need for donor funding has increased significantly over the last decade. Without donor funding millions of people wouldn’t be alive today. Thanks either to research finding a cure, successful treatment, funds donated for food, aid toward building infrastructure, or giving people the opportunity to further their education. Donor funding thus facilitates a better future. A literature review was conducted to give background on the health sector and how these funds were distributed, ethical clearance, different types of reporting, the role project managers pays in a project and the sustainability of projects. Expenses in different countries were evaluated by gathering data from the internet, while two international funded projects are also used to state how funders divide their line items into different categories. The empirical study used a qualitative research approach by collecting and analysing data obtained from the MDG 2010 report and other freely available data on the web. The main findings from this thesis are: *The Millennium Development Goals (MDG’s) influence donor funding as it gives donors a guide towards funding needs. Donors are also influenced by their own preferences or what poses a burden to them individually. *The different types of reporting required for funding received, delay a project and the bureaucratic structures thereof are a hindrance. *Ethical clearance plays a fundamental role in the outcome of a project, as without ethical clearance a project cannot commence. *The objectives of a project play a critical role when applying for funding. This can change the focus of a project.
*Expenses differ from country to country and funders need to take this into account when giving funding to recipient countries. *Project Managers and community involvement plays a critical role in ensuring sustainability of projects. THE SUSTAINABILITY OF DONOR FUNDED PROJECTS IN THE HEALTH SECTOR *The MDG’s are not on track and aid are focus on singular goals instead of multiple goals, to ensure an overall improved result. There is a major gap between needed funds and given funds. A single injection of funds will not be the solution to our health problem; different sectors need to collaborate together as we are facing a multi-dimensional problem. Trade and reform must also form part of this aid, ensuring a sustainable progression in the life’s of people. Donor funded projects may have a sustainable future, when taking in account the abovementioned findings. With the world trend in reporting changing rapidly, cost and management accountants as well as financial accountants and project managers have to equip them to adhere to the new way of reporting, namely integrated and sustainability reporting. South Africa is way behind and needs to catch up fast if they want to stay competitive in the “global donor funding market”. The limitations in this study were that not all expenses were evaluated and only 15 countries were looked at. An indebt look was taken into Africa with the empirical review, while Asia is also combating poor health issues. Some African countries like Sierra Leone and Zimbabwe did not have sufficient data to compare with other countries. From the research conducted, the following topics were identified that require further research: *Why are most projects in Third World countries not sustainable? *What plans are put into action to ensure that the MDG goals are reached? *Investigate what works for First World countries health systems and consider how that can be applied to Third World countries to ensure that they also get the best health care available. *Do donors take into account the different costs of countries when allocating funding to that specific country? *Establishing models to evaluate the sustainability of pilot projects and normal projects. *Establishing a model on how to distribute donor funds across different needs and not only one specific need.MCom (Management Accountancy), North-West University, Vaal Triangle Campus, 2013
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Kwan, Jair Chau Clinical School St Vincent's Hospital Faculty of Medicine UNSW. "Pharmacological activation of pro-survival pathways as a strategy for improving donor heart preservation." Awarded by:University of New South Wales. Clinical School - St Vincent's Hospital, 2009. http://handle.unsw.edu.au/1959.4/44663.
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Despite the development and use of specialised cardiac preservation solutions, the quality of the donor heart may still be compromised by its obligatory exposure to periods of ischaemia (both cold and warm) followed by reperfusion upon reintroduction of the recipient circulation. This is reflected in Transplant Registry data showing increased primary allograft failure as a function of increasing ischaemic time. The research described in this thesis is designed to further the understanding of the mechanisms by which the donor heart may be adapted to these prolonged periods of ischaemia and reperfusion by the activation of endogenous pro-survival signalling pathways by the addition of pharmacological agents to Celsior, a clinical preservation solution. Studies were conducted in an isolated working rat heart model of donor heart preservation. The first study investigated the cardioprotective effects of a novel inhibitor of poly(ADP-ribose) polymerase 1, INO-1153. Maximum protective effect (after a 6 hour storage period) was observed when the PARP inhibitor was administered prior to cardiac arrest and storage and when the agent was added to the Celsior cardioplegic / storage solution. This protective affect was associated with activation of the Akt signalling pathway and could be prevented by inhibition of Akt phosphorylation and activation. The second study examined functional protection and pro-survival signalling pathway activation in hearts arrested and stored for 6 hours in Celsior supplemented with glyceryl trinitrate (an exogenous source of nitric oxide) and Cariporide (an inhibitor of sodium hydrogen exchange). Here, cardiac protection was accompanied by activation of the ERK 1/2 pro-survival pathway as well as a decrease in apoptosis. The third study examined the cardioprotective effect of supplementation of Celsior with all three agents after an extended (10 hour) period of hypothermic storage. Significant recovery of function was only observed in the triply supplemented hearts, being accompanied by activation of both the Akt and ERK pathways. These studies demonstrate for the first time the feasibility of recruitment of endogenous pro-survival pathways as an approach to increasing the post-storage function of the donor heart. Importantly, for the logistics of clinical transplantation, these pathways can be recruited by addition of appropriate pharmacological agents to the arresting and storage solution.
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Booster, Maurits Harm. "The Non-Heart Beating donor, a new source of kidneys for transplantation clinical and experimental studies /." Maastricht : Maastricht : Universitaire Pers Maastricht ; University Library, Maastricht University [Host], 1995. http://arno.unimaas.nl/show.cgi?fid=6644.
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Kassahun, Walelign Meheretu. "HIV Prevalence and Donor Funding in Ethiopia." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6446.
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Many researchers have documented the trend of decreasing financial support from donors for human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) responses in Ethiopia. Less information is available regarding the correlation between trends of HIV prevalence and external funding and ways to address the impact that funding scarcity could cause. The purpose of this study was to examine the trend of HIV prevalence and donor funding levels, analyzing how the 2 are correlated, and opportunities to improve responses. Using the proximate determinant framework, the research questions examined the changes in HIV prevalence in Ethiopia during the past 10 years; the association between the trends of HIV prevalence, funding levels, and services provided; and the effect of different characteristics on the trend of the prevalence. A paired sample t-test, time series forecasting, Pearson correlation, chi-square test, and multiple regression were employed using a secondary data of sampled 1,067 people from the Demographic and Health Surveys and data from donors. Results indicated that the change in prevalence was statistically significant (t [10] = 4.59, p = .001), and correlated with the funding levels(r (10) = .635*, p = .027), a significant relationship between funding level and type of services, Ï?2 (2, N = 1067) = 1425.7, p <.001 and a significant regression equation to predict HIV prevalence (F (9, 1056) = 12.639, p < .001). The results from this study could be used to inform the Ministry of Health of Ethiopia and HIV project implementers to plan for domestic sustainable financing initiatives, invest based upon evidence-based HIV prevention strategies that could most directly impact quality of life and guide future research.
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Hunter, Ian. "The Potential Role of Microdialysis in the Viability Assessment of Non-Heart-Beating Donor Kidneys." Thesis, St George's, University of London, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.517187.
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Edgren, Gustaf. "Blood donors' long-term health : implications for transfusion safety /." Stockholm : Karolinska institutet, 2007. http://diss.kib.ki.se/2007/978-91-7357-340-5/.
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Billen, A. "The impact of donor health and psychosocial factors on the donation experience and recovery." Thesis, University College London (University of London), 2015. http://discovery.ucl.ac.uk/1471401/.
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Donation of haematopoietic stem cells (HSCs), either through bone marrow (BM) or peripheral blood stem cell (PBSC) collection, is a generally safe procedure for healthy donors, although adverse reactions (ARs) are a known and definable risk. The physical reactions to donation have been established for some time, but less is known about factors predicting poorer experiences. In my thesis, I explore the donation experience in a prospective study involving 275 PBSC and 37 BM donors and focus attention on health-related quality of life (HRQOL) factors associated with recovery. Detailed interviews of 14 PBSC donors explore these findings using qualitative methodology. In addition, I characterise donors at risk of not meeting the HSC dose requested by transplant centres and therefore at risk of additional procedures and associated ARs. My key finding was that pre-donation HRQOL markers were the strongest predictors of time to recovery; poorer pre-donation physical health was associated with longer recovery (p = 0.017) and certain side-effects in PBSC donors, and poorer mental health was associated with longer recovery in BM donors (p = 0.03) and pain following PBSC donation (p = 0.003). Physical HRQOL scores declined significantly from pre-donation to 4 weeks post-donation, but returned to pre-donation values at 3 months. This decline was greater for BM donors. Mental HRQOL scores remained high throughout for PBSC donors, this may be explained by the strong, intrinsic motivation as well as remarkable determination donors described in the qualitative analysis.
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Saracino, Giovanna. "Impact of Community Factors on the Donor Quality Score in Liver Transplantation." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7074.
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An increasing prevalence of metabolic syndrome and obesity has been linked to the rise in transplant indication for cryptogenic cirrhosis and nonalcoholic fatty liver disease (NAFLD), creating a growing challenge to public health. NAFLD liver transplant (LT) candidates are listed with low priority, and their waiting mortality is high. The impact of community/geographic factors on donor risk models is unknown. The purpose of this study was to develop a parsimonious donor risk-adjusted model tailored to NAFLD recipients by assessing the impact of donor, recipient, transplant, and external factors on graft survival. The theoretical framework was the social ecological model. Secondary data were collected from 3,165 consecutive recipients from the Scientific Registry of Transplant Recipients and Community Health Scores, a proxy of community health disparities derived from the Robert Wood Johnson Foundation's community health rankings. Data were examined using univariate and multivariate analyses. The donor risk-adjusted model was developed using donor-only factors and supplemented with recipient and transplant factors, classifying donors as low, medium, and high risk. NAFLD residents in high-risk counties had increased likelihood of liver graft failure. Findings may be used to allocate high-risk donors to a subset of NAFLD with excellent outcomes, increasing the donor pool and decreasing mortality on the wait list.
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Wells, Matthew A. "Peri-transplant cardiovascular dynamics in an ovine model of heart transplantation following 24-hrs donor brain stem death." Thesis, Griffith University, 2021. http://hdl.handle.net/10072/405633.
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Background: Heart transplantation (HTx) for end-stage heart failure is one of the most challenging complex health problems faced in intensive care units across the globe. This is partly due to the shortage of viable donor hearts and primary graft failure post-transplant. The mechanisms behind these shortfalls are diverse and arise from donor brain stem death (BSD), a significant stressor on the heart and the main pool from which donor hearts are sourced. A compromised myocardium is then preserved in cold preservation solution on ice (CSS), as per the current clinical standard, initiating significant ischaemia. The final stage of HTx is implantation in the recipient, which induces both warm ischaemia during the procedure and reperfusion injury. These multifarious injuries contribute to both non-viable donor hearts, reducing the number of available hearts, and graft dysfunction post-HTx. This doctoral project aims to utilise a clinically relevant model of transplantation to investigate 3 main aspects of cardiovascular function, 1) cardiac adrenergic excitation-contraction-coupling and perfusion, 2) mitochondrial function and 3) metabolic regulation.
Methods: Sheep were semi-randomised, influenced by blood group matching, into 2 main groups. Group A consisted of heart donors with confirmed BSD or sham operated controls (SHAM). Group B consisted of a separate group of heart donors both BSD (BSD-Tx) and SHAM (SH-Tx), which progressed through to CSS and consecutive HTx in a healthy recipient animal. The healthy recipient (HR) heart was excised and used as a healthy control following the establishment of cardio-pulmonary bypass (CPB). Heart collection occurred at end-points, defined as 24 hrs after BSD confirmation for Group A and 6 hrs after weaning the healthy recipient off CPB for Group B. Heart tissue was collected in ice cold oxygenated Krebs solution for in-vitro analyses, mitochondrial respiration and metabolic assessment.
In-vitro analyses: Briefly, left and right ventricular trabeculae were dissected and mounted on Blinks tissue blocks. Trabeculae were stimulated at 1 Hz intervals and the force of contraction was recorded over a concentration-effect curve to -(-)Noradrenaline. Potency at the β1-adrenoceptor was determined and expressed as the concentration required to elicit a 50% maximum response in log units (pEC50).
Mitochondrial respiration: Tissue homogenate was injected into an Oroboros Oxygraph and respiration was measured using both carbohydrate and fatty acid substrates. Mitochondrial membrane potential (MMP) was measured fluorometrically. Respiration was measured during 3 respiratory states; LEAK state, non-phosphorylative oxygen utilisation, ATP producing Complex I oxidative phosphorylative state (OXPHOS) and Complex II OXPHOS. Tissue levels of 3-nitrotyrosine and the glutathione to reduced glutathione ratio (GSH:GSSG) were assessed using plate based assays.
Metabolomics: Biopsies were collected in a similar manner from similar regions as those used for mitochondrial respiration. Biopsies were pooled per ventricle prior to the detection of polar metabolites via LC/MS. Metabolites were extracted via MassHunter and statistical analyses were performed using MetaboAnalyst 4.0.
Results: Twenty-four sheep weighing on average 47 ± 6 kg were semi-randomised into the donor and transplant groups. There were 6 animals in each donor group, SHAM and BSD and 12 separate donors continued through to transplantation, 6 in each group, SH-Tx and BSD-Tx.
In-vitro analyses: Donor BSD caused a significant reduction in RV contractility, however β1 sensitivity was unchanged. Post-transplanted hearts, regardless of donor BSD injury were characterised by bi-ventricular reductions in both contractility and pEC50 (SH-Tx: 0.59 p=0.04, and BSD-Tx: 0.62 p=0.02, mean difference).
Mitochondrial respiration: Following donor BSD, LEAK respiration in the RV was significantly elevated compared to HR (BSD: 0.11 ± 0.03 FCR, p<0.01). LV levels of 3-NT also trended upward, with a significant reduction in the GSH:GSSG ratio. CII OXPHOS in BSD using fatty acid substrates was significantly lower than HR hearts.
Post-transplantation however, there were bi-ventricular elevations in LEAK respiration and reductions in CII OXPHOS for both SH-Tx and BSD-Tx groups. These data were also in the presence of reduced MMP in LEAK and CII OXPHOS states. Transplantation was also characterised by significant increases in RV 3-NT levels and reduced LV GSH:GSSG ratios.
Metabolomics: Metabolically, BSD increased accumulation of myocardial amino-acids and glycolytic metabolites involved in oxidative and osmotic stress. Post-HTx, particularly in those exposed to donor BSD, there was a significant decrease in metabolites involved in mitochondrial respiration (eg. NAD, Acetyl-CoA) and accumulation of fatty acids and xanthine.
Conclusion: Using a clinically relevant model of HTx following donor BSD, this study focussed on cardiac contractility, mitochondrial function and metabolism in an effort to explain peri-transplant cardiac compromise. Based on these results it appears that donor oxidative stress, mitochondrial function and glycolytic metabolite build up are important determinants in cardiovascular dysfunction. Post-transplantation however, the mitochondrial, oxidative, metabolic and adrenergic systems are significantly impaired. Further research should investigate how best to support the donor heart outside of adrenergic agents, reduce oxidative stress and support metabolism. Whereas strategies to improve heart preservation and targetable mitochondrial/metabolic therapeutics may reduce reperfusion injury. Collectively, these approaches have the potential to increase the quality and quantity of HTx.Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Pharmacy & Med Sci
Griffith Health
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Farooq, Syed Umar. "Determinants of Organ Donor Registration Rates Among Young Americans." Scholarship @ Claremont, 2017. http://scholarship.claremont.edu/cmc_theses/1528.
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In this paper I examine the factors that affect the likelihood an individual is a registered organ donor. Unlike many studies which focus on subpopulations in specific regions, I utilize national data to get a broader assessment of individuals from around the country across a number of racial and religious classifications. Using a probit model and controlling for a variety of parameters, I find that some racial and religious variables are negatively and significantly associated with organ donor registration rates, while education and being female are positively associated with organ donor registration rates. I conclude by discussing the implications of my results and the potential for future research.
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Livitz, Irina E. "Using a Web-Based Motivational Interview to Enhance Donor Motivation, Intention, andBehavior." Ohio University / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1525860038297404.
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Crow, Leah. "Impact of Body Mass Index on Medicare Payments in Renal Transplant Recipients." University of Cincinnati / OhioLINK, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1399276000.
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Wong, Yew Toh. "Pancreatic islet transplantation non-heart-beating donors as a source of islets." Thesis, University of Newcastle upon Tyne, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.438407.
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Gok, Muhammed Asim. "Solid Organ Assessment and Manipulation for Transplantation from Non Heart Beating Donors." Thesis, University of Newcastle upon Tyne, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.484819.
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Whilst kidney transplantation is accepted as a cost effective treabnent ofend stage renal failure, the shortage in the kidney donor pool has recently become critical. Historical series ofNHBD renal transplants have been associated with high rates ofallograft failure and dysfunction due to prolonged warm and cold ischaemia. Machine preservation of NHBD kidneys provides a useful tool to test viability pre-transplant and this PhD thesis was directed at improving the existing Newcastle NHBD programme. Newcastle machine preservation is described in which viability criteria is used to reduced primary non function and discard rates. The sequential allograft failures were critically reviewed to develop the new 'IO-point' criteria. Case failures have become a necesSary painful learning experience that allowed improvements in the selection and screening criteria. The long term function ofNHBD renal transplants are presented to illustrate how the function is affected by warm ischaemic injury and delayed graft function. The early dysfunction ofNHBD kidney transplants was found to be temporary and improved with time. Kidney perfusate GST evaluation is an established criteria in the assessment of viability ofNHBD kidneys. In the search for novel biomarkers, perfusate Ala-AP and FABP have been assessed in relation to GST. The novel biomarkers measured a different aspect of allograft injury and comparable results to GST suggest that these could be developed as an adjunct to perfusate GST. The introduction ofstreptokinase pre-flush of the NHBD is illustrated in a porcine and a subsequent human clinical model. The effect on procurement, machine preservation and transplantation has been evaluated. Thrombolytic therapy ofNHB donor facilitated the clearing ofpremorbid intravascular thrombus, thereby improving the preservation and thus the viability of the NHBD kidneys. Allograft dysfunction is a standard feature of ischaemia reperfusion injury. A clinical model ofkidney transplantation is described to illustrate the biochemical and clinical effects of ischaemia reperfusion. An exaggerated response was observed in NHBD kidney transplants that could be attributed to the warm ischaemia insult at time of cardiac arrest.
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Hu, Terry. "Monitoring success of HIV/AIDS health care delivery : balancing donor requirements with internal management needs." Thesis, Massachusetts Institute of Technology, 2011. http://hdl.handle.net/1721.1/65803.
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Thesis (S.M.)--Massachusetts Institute of Technology, Sloan School of Management, 2011.Cataloged from PDF version of thesis.
Includes bibliographical references (p. 65-66).
Health care delivery organizations bear the burden of meeting monitoring and evaluation requirements set by numerous external organizations often at the cost of implementing internally defined management needs. Monitoring and evaluation in global health delivery has received increasing attention over the last few years. For instance, the World Health Organization and UNAIDS have published guidelines and provided technical assistance for HIV/AIDS monitoring and evaluation programs. In doing so, they establish international standards for performance measures, defining success metrics and related data indicators. Donor organizations, such as the President's Emergency Plan For AIDS Relief (PEPFAR), the Global Fund to Fight AIDS, Tuberculosk and Malaria (GFATM), and the World Bank's Multi-Country AIDS Program (MAP), have also contributed to defining HIV/AIDS success measures and data indicators in the way that they require funding recipients to report on performance. The multitude of players at the global level has made monitoring and evaluation in HIV/AIDS management confusing with regards to coordination, priority-setting, authority, and information clarification. Health care delivery organizations that act as local service providers must balance fulfilling donor requirements with addressing internal management priorities, which considers beneficiary needs, internal strategy, and available resources. This thesis discusses the challenge of obtaining this balance by comparing data indicators set at the global level with data monitoring priorities at the enterprise level. A case study of Kyetume Community Based Health Care Programme, a health care delivery organization in Mukono, Uganda, is presented to illustrate management complexity of data monitoring at the enterprise level. The application of basic data management solutions at a local service provider shows how business management practices can be applied towards improving health care delivery processes. Drawing upon the case study as well as the concepts presented about global and enterprise level contributions to monitoring and evaluation, this paper discusses stakeholder incentives and the implications on monitoring HIV/AIDS care delivery.
by Terry Hu.
S.M.
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Szugye, Nicholas A. M. D. "Comparing Donor and Recipient Total Cardiac Volume Predicts Risk of Short Term Adverse Outcomes following Heart Transplantation." University of Cincinnati / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1627665513045256.
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Asher, John F. "To determine factors affecting outcome and the role of peritoneal cooling in non-heart beating donor renal transplantation." Thesis, University of Newcastle upon Tyne, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.442224.
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Kuhnert, Kira-Leigh. "The impact of private international donor foundations on sexual and reproductive health organisations in South Africa." Master's thesis, University of Cape Town, 2014. http://hdl.handle.net/11427/6813.
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Foundations can subtly redefine or steer organisations in a desired direction, through either bureaucratic 'cherry-picking' the organisations that they want to work with - which could be solicited to submit funding proposals;; or over-time professionalising the organisation and providing capacity-building and skills development, placing the organisation in a new context (Bartley;; 2007: 229). Recent actions by bilateral and independent donors to downsize or withdraw funding from South African civil society, has resulted in the closure of some non-governmental organisations, and placed financial pressure on whole sectors in civil society. These developments have created a renewed interest into the funding relationships and impact of donors on non-governmental organisations, and the issues that they represent. This thesis focuses on philanthropic foundations and how, through their operating procedures, they impact grantee organisations and more broadly non-governmental organisations within a specific sector. By understanding the way independent donors, through their foundations, operate and disburse funding, one can gain insight into how relationships with grantees develop and donors are able to influence the agenda-setting. This thesis provides an overview of philanthropy and the impact it has had on the sexual and reproductive health sector in South Africa, in particular. In so doing, a brief background on the funding history by independent and bilateral donors to South Africa is given. This highlights a close relationship between civil society and foreign based funders. The historical reliance by civil society on independent donors, and the small pool of donors active in funding to sexual and reproductive health rights creates an environment in which organisations that are operating in the sector are influenced by the direction and mission of the donor foundations.
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Sutton, Arnethea L. "A Targeted Approach to Increasing the African American Blood Donor Pool." VCU Scholars Compass, 2017. http://scholarscompass.vcu.edu/etd/4798.
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A continuous need for blood products, specifically for those who require frequent transfusions, such as individuals with sickle cell disease, warrants the need for targeted interventions to increase blood donations from underrepresented populations. One population in particular, African Americans, only account for 1% of blood donors in the United States. Literature indicates numerous reasons why this population is underrepresented amongst donors, including fear, lack of knowledge about the blood donation, and specific to this population, lack of trust in the medical community. This study involves the development, implementation, and assessment of a targeted educational approach, incorporating the Theory of Planned Behavior and various teaching methods, to motivate African Americans non-donors to attempt to donate blood.
Participants attended a 1-hour educational session where they completed two surveys, one before the session and one directly after. A third survey was completed 2 months after the session. Of the 155 individuals enrolled in the study, 142 subjects were included in the data analysis. Sixteen percent of the study participants presented to donate as a result of attending the educational session. This resulted in a statistically significantly higher proportion of African Americans presenting to donate than the current proportion in Virginia. Analysis of results from the first two surveys indicated that subjective norm and attitude were significant predictors of one’s intent to donate blood, while perceived behavioral control was not a factor. The educational session increased survey scores related to intent to donate in comparison to scores obtained prior to the session. While this study resulted in a significant proportion of new donors, there is still a need for interventions that will focus specifically on changing attitudes toward blood donation and a need for methods to motivate African Americans to educate individuals in the community on the importance of becoming blood donors.
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Izamis, Maria-Louisa 1979. "Ex vivo perfusion optimization of donor liver grafts for transplantation and cell isolation." Thesis, Massachusetts Institute of Technology, 2010. http://hdl.handle.net/1721.1/58298.
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Thesis (Ph. D.)--Harvard-MIT Division of Health Sciences and Technology, 2010.Cataloged from PDF version of thesis.
Includes bibliographical references.
There is a constant demand for enormous numbers of high quality hepatocytes in the fields of cell transplantation, pharmacotoxicology, tissue engineering, and bioartificial assist devices. The scarcity of viable hepatocytes necessitates the use of suboptimal sources including damaged donor organs that are not transplantable. Many of these organs have potentially reversible pathologies however, that could be treated via ex vivo perfusion thereby increasing their cell yield. With the intent to translate organ recovery by perfusion into the clinic, we engineered a very simple room temperature-operated ex vivo organ perfusion system to test a rat liver model of uncontrolled non-heart beating donors. Seventeen times as many hepatocytes were recovered from livers exposed to an hour of warm ischemia (WI, 34*C) compared to untreated WI livers in only 3 hours of perfusion. Further, fresh liver hepatocyte yields were also increased by 32% postperfusion, demonstrating that both damaged and healthy donor livers could benefit from this methodology. A linear correlation between cell yield and tissue ATP content was established. This enables an accurate prediction of cell recovery during preservation and can be used as a direct measure of organ viability and the trajectory of organ recovery during perfusion resuscitation. Further, a strong correlation between perfusion flow rate and cell yield was also established supporting the use of flow rates as low as possible without causing hypoperfusion or oxygen deprivation. Morphologically and functionally, perfusion-isolated hepatocytes generally performed comparably or better than fresh hepatocytes in cell suspension and plate culture. Cumulatively, these findings strongly support the ubiquitous use of organ perfusion systems in the clinic for optimal enhancement of donor grafts.
by Maria-Louisa Izamis.
Ph.D.
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Li, Yaqing. "Through the Door: A Passage to a New World and an Entrance to the Heart." Thesis, Högskolan Kristianstad, Sektionen för Lärarutbildning, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:hkr:diva-9011.
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This essay is around C.S Lewis’s classic children’s novel The Lion, the Witch and the Wardrobe and it focuses on the metaphorical meaning of the door and what insights it provides each time it is opened. It argues that the journey into Narnia is also a psychological journey, representing spiritual awakening. It draws conclusion that through this psychological journey in Narnia, the protagonists has undergone spiritual rebirth and their psyche has been raised to new heights.
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Damyanov, Ran [Verfasser], and Torsten [Akademischer Betreuer] Loop. "Wirkung von Prostazyklin bei verlängerter Warmischämie in einem "Non-Heart-Beating Donor"-Modell : Untersuchungen an isoliert perfundierten parakardialen Schweinelungenlappen." Freiburg : Universität, 2016. http://d-nb.info/1120021251/34.
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Nickell, Debra Faith. "SCREEN DOOR MEDICINE: THE INFORMAL MEDICAL CONSULTATION." UKnowledge, 2010. http://uknowledge.uky.edu/gradschool_diss/6.
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This study explores the phenomenon of the informal medical consultation, a communication event in which an individual asks for medical information, advice, or care from an off-duty health professional with whom the individual has no formal patient-provider relationship. Using surveys and interviews, the study describes these consultations from the perspective of the health care professional and the informal patient. The study explores foundational theories that offer explanations for the phenomenon. The theories considered include social support, decision-making, social exchange, perceived partner responsiveness to needs, and uncertainty management.
This study suggests health care providers perceive informal medical consultations to be more problematic than do the informal patients who consult them. The problematic nature of informal consultations increases as the type of request moves from purely informational to a request for treatment. Informal patients do not perceive this distinction. The informal patient’s motivation to pursue an informal consultation instead of a formal consult is affected by the relationship with, trust in, and access to the informal consultant. The willingness of the informal consultant to engage in an informal consultation is affected by the relationship with the informal patient, the type of request made, and perception of risk/benefit for both the provider and the patient.
The study supports the idea that informal medical consultations are potentially problematic within the current medico-legal-ethical environment. Alternately, these consultations may be viewed as offering positive contributions to the health and well-being of informal patients. The study suggests translational research is needed to guide health professionals in considering requests for informal medical consultations.
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Buhlungu, Simbarashe. "An Analysis of Project Risk Factors for Donor Funded Projects and Programs in the Health Sector in Zimbabwe." Master's thesis, Faculty of Engineering and the Built Environment, 2021. http://hdl.handle.net/11427/32598.
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Like many developing nations, the health sector in Zimbabwe is not adequately funded and has for many years complemented its tight budget with external funding and development assistance (MOHCC, 2016: 11). External funding comes from various partners in the form of donor funds or international development assistance. According to the Ministry of Health and Child Care, for the year 2012, more than 40% of health sector funding was through development assistance (MOHCC, 2016: 11). That corresponds to a dollar value of approximately US$428 million. Since then, the country has continued to face challenges, which implies that current figures for external funding could be at similar levels or higher. In the 2017 budget, development partners were projected to contribute a collective figure of US$229.8 million, complementing US$318.4 million that was partly allocated from the budget and partly raised through user fees (US$281.9 million budget allocation, US$36.5 million user fees) (MOFED, 2016: 86). This would put the proportion of development aid at approximately 42% of the projected expenditure in 2017 (the 2017 budget did not account for the contribution of other levies such as AIDS Levy that usually contribute towards the budget). For 2018, the national budget projected total health expenditure to amount to US$729.4 million, made up of US$489.8 million from budget appropriations and levy funds and US$239.6 million from development partners (MOFED, 2017: 142). These figures show that development aid was projected to constitute approximately 33% of health expenditure in 2018. The national budget accounts for monetary and quantifiable support. Development assistance also comes in non-monetary forms such as equipment, drugs, technical assistance and other sponsored projects whose real value is sometimes not captured by budgets or is just difficult to quantify. When looking at development aid, these forms of support also have to be taken into consideration. This could mean that the real figures for development support may be higher than reflected in budgets. The figures above underscore the importance of development aid hence the need to ensure that it is effectively utilised. 9 Development aid is project oriented business (Ika et al., 2010: 63). Donor funds are commonly channelled into specific purpose programs and projects aimed at achieving specific results in the health sector. This is the common practise with most international development assistance provided to developing countries, it is availed and managed through projects (Diallo and Thuillier, 2005: 237).
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Venkateswaran, R. V. "The role of early management and hormone replacement therapy in potential heart and lung donors." Thesis, University of Birmingham, 2010. http://etheses.bham.ac.uk//id/eprint/1156/.
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Heart and lung transplantation activity is frustrated by the lack of availability of donor organs. The haemodynamic, hormonal and inflammatory changes that follow brain stem death leads to donor organ injury. Appropriate donor management is essential to avoid further damage to already injured donor heart and lungs. Hormone replacement therapy with tri-iodothyronine and methylprednisolone in organ donors has been reported to increase the retrieval rate of heart and lungs with improved function. In a prospective, randomised, double blind, controlled trial the role of hormone replacement therapy and early donor management on the donor heart and lung function and their retrieval rate was studied. Heart donor Outcome Early donor management was associated with significant improvement in donor heart function. It may also increase the retrieval rate of hearts for transplantation. However, administration of hormones neither influenced the donor heart function nor the heart retrieval rate. Serial echocardiography guides in identifying suitable donor hearts for transplantation during intensive management. Lung donor outcomes Early donor management was associated with significant increase in lung retrieval rate for transplantation. Despite management donor lung function deteriorated following brain stem death. Hormone replacement therapy did not increase the lung retrieval rate or affect the donor lung function. However, methylprednisolone administration leads to significant reduction in progressive donor lung water accumulation. Measurement of thermodilution lung water index predicted ultimate lung suitability for transplantation and recipient outcome. Conclusion Early donor management is the cornerstone to improve the donor heart function and to increase the lung retrieval rate. It may also increase the heart retrieval rate. Serial transthoracic echocardiography may guide in identifying suitable hearts that respond to donor management.
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Tay, Jason. "Donor selection for patients undergoing allogeneic hematopoietic stem cell transplantation: Assessment of the priorities of Canadian hematopoietic stem cell transplant physicians." Thesis, University of Ottawa (Canada), 2009. http://hdl.handle.net/10393/28202.
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Allogeneic Hematopoietic Stem Cell Transplantation is applied in the management of cancer. It involves myeloablative chemoradiotherapy followed by infusion of donor stem cells. The characteristics of the donor stern cells influences transplant outcomes which itself, is dependent on the donor characteristics. The purpose of this thesis was to explore preferences over donor characteristics.
A systematic review was performed to identify all donor characteristics associated with outcome. Eight traditional and 5 non-traditional characteristics were identified. The results of the review were used to inform a survey of the Canadian Bone Marrow Transplant Group which primarily includes transplant physicians. An online survey and conjoint analysis of Canadian Bone Marrow Transplant Group members was performed to define relative importance of donor characteristics. Canadian Bone Marrow Transplant Group members, including transplant physicians caring for adults strongly indicate preference for donors related to recipients (HR 2.97) over the donor's age, gender and cytomegalovirus compatibility.
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Hanson, Sarah A. "Subjective Reactions to Blood Donation in Donors With and Without Social Support." View abstract, 2008. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&res_dat=xri:pqdiss&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&rft_dat=xri:pqdiss:3339504.
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Nalin, Emma R. "Building Relationships between a Free Clinic and Its Donors." Thesis, University of North Texas, 2018. https://digital.library.unt.edu/ark:/67531/metadc1404598/.
Full textAbstract:
This thesis presents qualitative research conducted in summer 2017 at the Finger Lakes Free Clinic, which provides free medical and holistic care to people without insurance in upstate New York. The primary goal of this research was to strengthen the relationship between a free clinic and its donors by gathering donor concerns and perceptions regarding federal healthcare policy. Data from 32 interviews with donors, staff, board members, and volunteers, along with 100 hours of participant observation revealed that donors to this clinic were concerned about the potential impact of Congressional healthcare reform yet did not consider federal policy a strong influence on their donations. Rather, donors cited dedication to local giving and personal connections with the clinic as their primary motivations. These motivations suggest the value of viewing the clinic-donor relationship as a relationship of reciprocity. From this framework, the research identifies opportunities for the clinic to reciprocate donor generosity while expanding services in response to a growing need. Insights from the research will guide the clinic's response to federal policy changes and support the clinic's vision of becoming a national model for integrative care.
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Gerlach, Laura A. "Increasing Organ Donations in Maryland: An Interrupted Time Series Analysis." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5707.
Full textAbstract:
The state of Maryland has been unsuccessful in achieving its goal of registering all of its population as organ donors. The purpose of this correlational study was to understand if allowing registered donors to remain anonymous would increase donor registration rates.
The theoretical foundation of this study was the theory of planned behavior. Data were collected from the Motor Vehicle Administration of Maryland and the Division of Motor Vehicle of Virginia. The data were analyzed using regression displacement, interrupted time series analysis, auto correlation analysis, and Arima Box Jenkins methodology. According to the study findings, offering the option to remain anonymous and registering to be an organ donor with no heart icon on the driver's license did not have the immediate effect of encouraging more people to register as an organ donor. Parameter estimates from an Arima autoregression analysis did suggest that the impact of the removal of the heart icon may have a delayed impact, although data availability limited attempts at further investigation.