Correlations between demographics, knowledge, beliefs, and attitudes regarding organ transplantation among academic students in Poland and their potential use in designing society-wide educational campaigns.

BACKGROUND: Family objection precludes 10% of cadaveric donations in Poland. Academic students represent a socially influential demographic group. Educational campaigns improving their attitudes may increase overall donation rates. The aim of this study was to assess correlations between knowledge, beliefs, and attitudes regarding organ transplantation and the identification of the most critical factors affecting one's donation preferences. METHODS: Eight hundred students from 4 public universities in Krakow, Poland, participated in the study; participants were diverse in age, sex, hometown population, and academic discipline (400 medical, 400 non-medical). This cross-sectional study was conducted with the use of a group-administered questionnaire inquiring into demographics, general and professional knowledge, beliefs, and attitudes toward organ transplantation. RESULTS: Attitudes toward organ donation correlate positively with beliefs (ρ = 0.36), general knowledge (ρ = 0.48), and professional knowledge (ρ = 0.23) scores. Beliefs were proven to correlate with general (ρ = 0.21) and professional (ρ = 0.26) knowledge as well. Misconceptions about the medical criteria allowing cadaveric organ recovery, distrust for brain death reliability, fear of "do not resuscitate" approach toward Organ Donor Card holders, a strong belief in organ trafficking, and unawareness of family members' attitudes are the most important factors influencing one's refusal/uncertainty to donate. CONCLUSIONS: Knowledge, attitudes, and refusal rates differ, depending on the academic discipline as well as other demographics, indicating a need for a specifically targeted approach in designing educational campaigns. Sources of knowledge are related to donation rates, with pre-academic education evaluated as unfavorable, as opposed to healthcare providers and the media.

Current state of knowledge, beliefs, and attitudes toward organ transplantation among academic students in Poland and the potential means for altering them.

INTRODUCTION: Students manifest a high level of social commitment. Improving their knowledge and developing more positive attitudes toward organ transplantation may increase the number of organ donations. This study was an assessment of the knowledge and attitudes toward organ transplantation among young people in Poland, with an overview of current beliefs and potential methods for improving transplantology awareness. SUBJECTS AND METHODS: The study included 400 medical students and 400 nonmedical students from public universities in Kraków, Poland. Data were collected by using an anonymous questionnaire examining demographic factors and transplantology issues. RESULTS: Despite the overall positive attitude toward transplantology among academic students in Poland, the state of knowledge of the nonmedical population remains relatively low. The most important issues for social education to focus on are the role of presumed consent and brain death diagnosis, actual hazards of living donations, recipient qualification criteria, and the attitudes of religious authorities. The overall level of knowledge and the number of positive attitudes were significantly higher among medical students than among nonmedical students, proving that formal educational programs are more efficient than the more accessible but less reliable sources of knowledge. CONCLUSIONS: Introduction of transplantology issues in schools and churches, promoting the positive outcomes of organ transplantation rather than negating false beliefs, and eliminating misleading information from the media may significantly increase young people's knowledge and result in more positive attitudes toward transplantology in a society-wide fashion. This outcome could create a favorable background for introducing an opt-in system of consent for organ donation.

Organ Donor Cards--concepts versus reality: a study among academic students in Poland.

INTRODUCTION: Organ Donor Cards (ODCs), despite presenting no legal value in Poland, are considered an important mean of expressing one's intent toward organ donation. This study was an assessment of the effectiveness of ODCs in social communication and their connection to one's transplantology knowledge, attitude, and beliefs. SUBJECTS AND METHODS: The study included 400 medical students and 400 nonmedical students from public universities in Kraków, Poland. Data were collected by using an anonymous questionnaire with attached ODCs examining demographic factors and transplantology issues. RESULTS: Approximately 41% of students possess an ODC, and the majority of the remaining group are willing to sign one. The main reasons for not having an ODC originate from a positive or neutral interest in organ donation (eg, previous conversation with the family, lack of knowledge about ODCs and how to obtain them) rather than a negative one (fear of "do not resuscitate" approach or organ trade) and remain open for modification. Eighty-three percent of ODC holders are aware of its ethical rather than legal value, and 3 of 4 have informed their family about their attitude, proving ODCs are an effective way of expressing one's intent toward organ donation. An actual ODC holder presents a more explicit positive attitude than a potential one, and his or her level of transplantology knowledge is significantly higher. CONCLUSIONS: The support for informed consent for organ donation is particularly strong among students presenting with the highest level of transplantology awareness, with a good/very good state of knowledge and extremely positive attitudes, already owning an ODC, and using it correctly. Thus, such a decision will have the status of a truly conscious and thoroughly considered choice.

Brain death versus irreversible cardiac arrest--the background and consequences of young people's opinions on stating death in Polish transplantology.

BACKGROUND: Brain death and irreversible cardiac arrest (ICA) are legally valid diagnoses obligatory for stating organ donors' death in Poland. Their misinterpretation may affect one's attitude toward organ donation. We assessed young people's knowledge and attitudes toward stating death in transplantology and their impact on attitude toward organ transplantation. METHODS: A total of 400 medical and 400 nonmedical students from public universities in Kraków, Poland, participated. Data were collected with a questionnaire examining demographic factors and transplantologic issues. RESULTS: Brain death diagnosis has a stronger association with stating death in transplantology than ICA, although the level of trust for this diagnosis remains relatively low among nonmedical respondents (38.5% vs 78.5%). Professional knowledge about stating brain death did not correlate with the level of trust for said diagnosis as strongly as it was expected, suggesting the presence of alternate contributing factors, some identified as doubts about brain death criteria (31.5%), distrust for the medical staff's education (25%), and objectivity (20%). CONCLUSIONS: The number of nonpositive attitudes toward organ transplantation was significantly higher among respondents unwilling to accept brain death as the death of a human being, a statement proven to be related to one's opinion about the reliability of said diagnosis, one's awareness of an alternative diagnosis of ICA, and one's general transplantologic knowledge. However, a low number of respondents acknowledging ICA as the only diagnosis valid for stating death of a cadaveric donor (7.6%) suggests that the majority of young Poles are willing to accept brain death as an equally valid, if not more significant, diagnosis.

Nɛ-homocysteinyl-lysine isopeptide is associated with progression of peripheral artery disease in patients treated with folic acid.

OBJECTIVE: Folic acid (FA) administration can reduce plasma total homocysteine (tHcy); however, it fails to decrease cardiovascular events and progression of peripheral artery disease (PAD). Nɛ-homocysteinyl-lysine isopeptide (Nɛ-Hcy-Lys) is formed during catabolism of homocysteinylated proteins. We sought to investigate factors that determine the presence of Nɛ-Hcy-Lys in PAD patients with hyperhomocysteinemia receiving FA. PATIENTS AND METHODS: We studied 131 consecutive PAD patients with tHcy > 15 µmol l(-1) taking FA 0.4 mg d(-1) for 12 months. Serum Nɛ-Hcy-Lys was determined by high-performance liquid chromatography (HPLC). We also measured interleukin-6 (IL-6), plasminogen activator inhibitor-1 (PAI-1), asymmetric dimethylarginine (ADMA) and 8-iso-prostaglandin F(2α) (8-iso-PGF(2α)). RESULTS: FA administration resulted in a 70.5% decrease in tHcy (p < 0.0001). However, serum Nɛ-Hcy-Lys was detectable in 28 (21.4%) patients on FA who were more frequently current smokers and survivors of ischaemic stroke (p < 0.001). They had higher tHcy by 46.0%, PAI-1 by 51.7%, 8-iso-PGF(2α) by 59.1% and ADMA by 26.4% (all, p < 0.0001). The presence of Nɛ-Hcy-Lys was associated with lower ankle-brachial index (ABI) values (p < 0.001) and higher prevalence of cardiovascular events (p < 0.001) following therapy. CONCLUSION: The presence of Nɛ-Hcy-Lys in one-fifth of hyperhomocysteinemic individuals with PAD despite FA treatment is associated with progression of PAD and with increased ADMA formation, oxidative stress and hypofibrinolysis.