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1.
Eur Rev Med Pharmacol Sci ; 26(10): 3771-3786, 2022 05.
Article in English | MEDLINE | ID: mdl-35647860

ABSTRACT

OBJECTIVE: The two-year long epidemic situation around the world has resulted in an increasing number of people experiencing "pandemic fatigue". The aim of this study was to examine the correlation between a sense of self-efficacy and fatigue experienced in everyday life by nursing students in Poland, Spain and Slovakia during the COVID-19 pandemic. PATIENTS AND METHODS: The study was conducted by the diagnostic survey method on a group of 756 nursing students of the first-cycle degree program, from 20 March to 15 May 2021, in the University of Warmia and Mazury in Olsztyn, Pomeranian Medical University in Szczecin (Poland), as well as in Murcia University (Spain) and in the Catholic University in Ruzomberok (Slovakia). RESULTS: The sense of self-efficacy was significantly lower among the students in Poland than in those in Spain (p < 0.0001) and in Slovakia (p < 0.0001). Students in Slovakia showed symptoms of general, physical, cognitive and psychosocial fatigue much less frequently than those in Poland (p < 0.001) and Spain (p < 0.001). Especially students in Spain acutely felt physical health issues as a result of COVID-19 pandemic-imposed restrictions. CONCLUSIONS: A high level of a generalized sense of self-efficacy among the nursing students participating in the study was identified. However, it was significantly differentiated with respect to the country of residence. The fatigue severity experienced by the students during the COVID-19 pandemic was determined by a sense of self-efficacy.


Subject(s)
COVID-19 , Students, Nursing , COVID-19/epidemiology , Fatigue/epidemiology , Humans , Pandemics , Poland/epidemiology , Self Efficacy , Slovakia/epidemiology , Spain/epidemiology , Students, Nursing/psychology
2.
Transplant Proc ; 48(7): 2476-2478, 2016 Sep.
Article in English | MEDLINE | ID: mdl-27742327

ABSTRACT

BACKGROUND: The shortage of organs has made it necessary to look for new alternatives as xenotransplantation. The objective of this study was to analyze the attitudes of Polish nursing students toward organ donation of nonhuman origin, and to determine the factors that affect them. METHODS: Year 2011-2012. Nursing students of the University of Poland. Sampling points in 5 compulsory-attendance nursing courses with a completion rate of fulfillment of 80%. Validated questionnaire (PCID-XenoTx Rios) filled out anonymously and self-administered. RESULTS: The completion rate was 81% (325/402): 55% in favor (n = 179), 7% (n = 24) against, and 38% (n = 122) do not know. There were significant associations between: 1) the academic year, with 1st-year students presenting the more favorable attitude than those in the 3rd year (68% vs 41%; P = .039); 2) discuss the topic with friends (59% vs 41%; P = .043); 3) being in favor of cadaver organ donation (64% vs 41%; P < .001); and 4) consider the option of needing a transplant in the future (63%) compared with those who do not consider this option (40%; P = .040). In multivariate analysis, the relationship with being in favor of cadaver organ donation remained (odds ratio, 2.577; 95% confidence interval, 4.081-1.631; P < .001). CONCLUSIONS: Almost one-half of the nursing students had an unfavorable attitude toward xenotransplantation.


Subject(s)
Attitude , Students, Nursing , Transplantation, Heterologous/psychology , Transplants/supply & distribution , Adult , Animals , Female , Humans , Male , Poland , Students, Nursing/psychology , Surveys and Questionnaires , Universities
3.
Transplant Proc ; 48(7): 2482-2484, 2016 Sep.
Article in English | MEDLINE | ID: mdl-27742329

ABSTRACT

BACKGROUND: Nursing students, as future professionals, have an enormous impact on the opinion of the rest of the population on topics of organ donation and transplantation (ODT). The objective of this study was to analyze the attitudes of nursing students at the University of Bialystok toward ODT, and to determine the factors that affect ithemt. METHODS: Academic year 2011-2012. STUDY POPULATION: nursing students at the University of Bialystok. Type of sampling: sampling points during 5 compulsory-attendance nursing courses with >80% fulfillment. Measuring instrument: validated questionnaire (PCID-ODT Rios) filled out anonymously and self-administered. RESULTS: Completion rate of 90% (331/367): 58% (n = 191) in favor, 35% (n = 118) undecided, and 7% (n = 22) against. The most important variables were: being in the 1st year (odds ratio [OR], 4.444; 95% confidence interval [CI], 11.627-1.700; P = .002); not knowing any donor (OR, 12.048; 95% CI, 55.555-2.57; P = .018); being in favor of organ donation by a relative (OR, 6.25; 95% CI, 14.705-2.666; P < .001); discussing the topic with friends (OR, 2,785; 95% CI, 5.347-1.447; P = .002); not worried about the possible mutilation of the body after donation (OR, 3.039; 95% CI, 5.882-1.569; P = .001); favorable attitude toward ODT of mother (OR, 3.676 (0.881-1.814; P < .001); accepting other treatment options, such as inhumation (OR, 3.436; 95% CI, 7.092-1.655; P = .001); accepting autopsy after death (OR, 2.141; 95% CI, 4.065-1.126; P = .020); and professing the Catholic religion (OR, 3.436; 95% CI, 8.333-1.410; P = .007). CONCLUSIONS: More than 42% of the nursing students were not in favor of organ donation, their attitudes influenced by various psychosocial factors.


Subject(s)
Attitude , Organ Transplantation/psychology , Students, Nursing/psychology , Tissue and Organ Procurement , Adult , Female , Humans , Male , Odds Ratio , Poland , Surveys and Questionnaires
4.
Transplant Proc ; 48(7): 2479-2481, 2016 Sep.
Article in English | MEDLINE | ID: mdl-27742328

ABSTRACT

BACKGROUND: The knowledge and acceptance of the concept of brain death among future health professionals is essential. The objective of this study was to analyze the knowledge of the concept of brain death among nursing students at the Medical University of Warsaw and determine the factors that affect it. METHODS: Academic year 2011-2012, nursing students of the University of Poland. Sampling points in 5 compulsory-attendance nursing courses with a completion rate >80%. Validated questionnaire (PCID-DTO Rios), anonymous and self-administered. RESULTS: The completion rate was 96% (793/828); 71% (n = 561) knew the concept of brain death, 22% (n = 178) did not know it, and 7% (n = 54) did not know that it implies the death of the patient. Variables related to the correct knowledge: 1) to be studying in 4th year compared with 1st year (85% vs 60%; P ≤ .001); 2) discuss the subject with family (76% vs 61%; P ≤ .001); 3) discuss with friends (73% vs 63%; P = .009); and 4) having a favorable attitude toward organ donation (74% vs 65%; P = .011). In the multivariate analysis, the variables that remained independent were studying in 4th year (odds ratio [OR], 3.809; 95% confidence interval [CI], 2.006-5.823; P ≤ .001) and discussed with family concerning donation and transplantation (OR, 1.718; 95% CI, 1.241-2.381; P ≤ .001). CONCLUSIONS: One-third of the nursing students were unfamiliar with the concept of brain death.


Subject(s)
Attitude , Brain Death , Health Knowledge, Attitudes, Practice , Organ Transplantation/psychology , Students, Nursing , Tissue and Organ Procurement , Adult , Female , Humans , Male , Multivariate Analysis , Poland , Students, Nursing/psychology , Surveys and Questionnaires
5.
Transplant Proc ; 48(7): 2485-2487, 2016 Sep.
Article in English | MEDLINE | ID: mdl-27742330

ABSTRACT

BACKGROUND: Liver transplantation from living donors (LLD) has become a viable and important source of liver grafts. The objective of this study was to analyze the attitude of nursing students at the Pomeranian Medical University in Poland on donation of live liver, and to determine the factors that affect it. METHODS: Academic year 2011-2012, nursing students at a university in Poland, sampling points in 5 compulsory-attendance nursing courses with a completion rate of 80%, validated questionnaire (PCID-DVH Rios) filled out anonymously and self-administered. RESULTS: The completion rate was 89% (227/254). Of the 227 students surveyed, 92% (n = 209) were in favor, 6% (n = 14) undecided, and 2% (n = 4) against. When the LLD is not related, 44% (n = 100) of respondents would be in favor. With a positive attitude toward this type of donation, we associated the following variables: 1) age, with the youngest showing a more favorable attitude (P = .006); 2) attitude in favor of living kidney donation (98% vs 85%; odds ratio, 4.950; 95% confidence interval, 9.259-2.652; P = .002); 3) attitude in favor of accepting a family LLD (96% vs 81%; P = .003); 4) discussing donation and transplantation with family (95% vs 87%; P = .043). CONCLUSIONS: Ninety-two percent of nursing students at the Pomeranian Medical University in Poland were in favor of live organ donation, an attitude conditioned by various psychosocial factors.


Subject(s)
Liver Transplantation/methods , Liver Transplantation/psychology , Living Donors/psychology , Students, Nursing/psychology , Tissue and Organ Procurement/methods , Adult , Attitude , Female , Humans , Male , Poland , Tissue and Organ Harvesting/methods , Tissue and Organ Harvesting/psychology , Universities
6.
Transplant Proc ; 47(9): 2575-7, 2015 Nov.
Article in English | MEDLINE | ID: mdl-26680039

ABSTRACT

BACKGROUND: Investigating the attitude of subgroups of populations living in different countries is useful for establishing whether there are differences in opinion in terms of place of residence. The objective of the study was to analyze attitudes toward deceased organ donation in the population from the Dominican Republic who are residing in the southeast of the United States and Spain. METHODS: A sample was taken of residents of the population from the Dominican Republic residing in Florida (the United States) (n = 63) and in Spain (n = 80), which was stratified by age and sex. A validated questionnaire about psychosocial aspects (PCID-DTO Rios) was self-administered and completed anonymously: the χ(2) test, Student t test, and logistic regression analysis were used. RESULTS: The completion rate was 86% (123 respondents of the 143 selected). Of those surveyed, 54% were in favor, 23% were against, and 23% were undecided. Of the residents in Spain (n = 57) 63% (n = 36) were in favor, 12% (n = 7) were against, and 25% (n = 14) were undecided. Of the residents in the United States (n = 66) 46% (n = 30) were in favor, 33% (n = 22) were against, and 21% (n = 14) were undecided (P < .001). The following factors were found to be associated with attitude: 1) level of education [OR = 12.195 (52.631-2.808); P = .001]; 2) concern about the possible mutilation of the body after donation [OR = 11.363 (47.619-2.695; P = .001]; and 3) rejection of cremation or burial of the body after death [OR = 6.134 (21.276-1.763); P = .004]. CONCLUSIONS: Attitude toward the donation of the respondent's own deceased organs after death was more favorable among Dominican residents in Spain compared with those living in the United States.


Subject(s)
Attitude to Death/ethnology , Organ Transplantation/psychology , Tissue Donors/psychology , Tissue and Organ Procurement , Adult , Burial , Dominican Republic/ethnology , Educational Status , Female , Florida , Humans , Male , Middle Aged , Spain , Surveys and Questionnaires
7.
Transplant Proc ; 47(9): 2578-80, 2015 Nov.
Article in English | MEDLINE | ID: mdl-26680040

ABSTRACT

BACKGROUND: The objective of the present study was to analyze the knowledge and acceptance of the brain death (BD) concept among nursing students. METHODS: The study was undertaken in the academic year of 2011 to 2012 in nursing students from the University of the South of Poland. The sample was carried out in compulsory sessions, in the 5 years of the nursing degree study, with a completion rate of 80%. The questionnaire was validated (PCID-DTO Ríos), self-administered, and completed anonymously. RESULTS: The completion rate was 93% (492 of 530). Of the students surveyed, 75% (n = 369) knew the concept of BD and considered it to mean a person's death. Of the rest, 19% (n = 93) did not know it, and the remaining 6% (n = 30) believed that it did not mean that a person was dead. The following variables were significantly related with the correct knowledge of the BD concept: 1) age (22 ± 2 years; P ≤ .001); 2) academic year (P ≤ .001); 3) discussion with friends about organ donation and transplantation (ODT) (P = .035); 4) partner's favorable attitude toward donation and transplantation (P = .009); and 5) being Catholic (P = .031). In the multivariate analysis, the following variables persisted as independent variables related to the BD concept: a) age [OR = 1.468 (1.247-1.697); P ≤ .001] and b) partner's opinion of ODT [OR = 2.248 (1.255-4.025); P = .006]. No association was found with attitude toward ODT. CONCLUSIONS: More than 25% of the students from the Jagiellonian University of Kraków did not know or accept the concept of brain death.


Subject(s)
Attitude of Health Personnel , Brain Death , Health Knowledge, Attitudes, Practice , Organ Transplantation/psychology , Students, Nursing/psychology , Adult , Female , Humans , Male , Poland , Surveys and Questionnaires , Tissue and Organ Procurement , Young Adult
8.
Transplant Proc ; 47(9): 2581-3, 2015 Nov.
Article in English | MEDLINE | ID: mdl-26680041

ABSTRACT

BACKGROUND: Living donor kidney transplantation (LDKT) is the best treatment option in the late stage of chronic kidney disease. The objective of the study was to analyze the attitudes of nursing students at the Medical University of Poznan toward living donation of kidney. METHODS: Sampling points were compulsory attendance in the 5 nursing courses of the degree of fulfilment of 80%. The validated questionnaire (PCID-DVR Rios) was self-administered and anonymous. RESULTS: The completion rate was 92% (324 of 354). Among the students, 91% (n = 296) were in favor of LDKT, 5% (n = 15) were undecided, and 4% (n = 11) remained is against. When the living kidney donor is not related, 57% (n = 185) of respondents were in favor. The factors that are associated with a more favourable attitude are 1) the needs of organs for transplantation are covered (P = .012); 2) attitude in favor of organ donation and transplantation (P ≤ .001); 3) attitude toward living liver donation (P = .001); 4) attitude in favor of acceptance of LDKT for a relative (P ≤ .001); 5) discussing organ donation and transplantation with friends (P = .002); and 6) attitude in favor of organ donation from a family member (P = .011). In the multivariate analysis, highlights are acceptance of the donation of a living kidney donor from a family member [OR = 9.900 (35.714-2.770); P ≤ .001] and donating a piece of liver in life [OR = 50 (166.666-14.492); P ≤.001]. CONCLUSIONS: Among the nursing students, 91% are in favor of living kidney donation.


Subject(s)
Attitude of Health Personnel , Kidney Transplantation/psychology , Living Donors/psychology , Students, Nursing/psychology , Tissue and Organ Harvesting/psychology , Adult , Female , Humans , Male , Poland , Surveys and Questionnaires , Tissue and Organ Procurement , Young Adult
9.
Transplant Proc ; 47(9): 2590-2, 2015 Nov.
Article in English | MEDLINE | ID: mdl-26680044

ABSTRACT

BACKGROUND: The opinion of future nursing professionals can influence the number of transplants. The objective of this study was to analyze the attitude of nursing students at the Medical University of Warsaw in the center of Poland toward organ donation and determine the factors that affect this attitude. METHODS: The study was conducted in the 2011 to 2012 academic year. The study population consisted of nursing students. Type of sampling consisted of sampling in points of compulsory attendance, in the 5 nursing courses with the higher degree of fulfillment of 80%. Measuring instrument used was the validated questionnaire (PCID-DTO Rios). The questionnaire was completed anonymously and was self-administered. RESULTS: The completion rate was 96% (793 of 828). Of the students surveyed (n = 793), 69% (n = 547) were in favor of organ donation and transplantation, 25% (n = 201) were undecided, and 6% (n = 45) were against. This attitude was related to being in favor of donating the organs of a relative (OR = 3.174; P < .001); discussion of the subject with the family (OR = 2.188; P < .001); positive attitude toward donation and transplantation of the father (OR = 3.039; P = .001); considered to having good information on the subject (OR = 8.695; P < .001); being a regular donor blood (OR = 3.597; P = .001); not worried by the possible mutilation of the body after donation (OR = 6.802; P < .001); and accepting other treatment options of the body such as the burial (OR = 1.683; P = .015). CONCLUSIONS: More than 30% of the nursing students are not in favor of organ donation, but this attitude is conditioned by several psychosocial factors.


Subject(s)
Attitude , Organ Transplantation/psychology , Students, Nursing/psychology , Tissue and Organ Procurement , Adult , Female , Humans , Male , Poland , Retrospective Studies , Surveys and Questionnaires
10.
Transplant Proc ; 47(9): 2587-9, 2015 Nov.
Article in English | MEDLINE | ID: mdl-26680043

ABSTRACT

INTRODUCTION: Liver transplantation from living liver donation (LLD) has become an important source of liver grafts. MATERIAL AND METHOD: We studied the 2011-2012 academic year attitude of nursing students from a university in Poland. The sampling points were compulsory attendance in the 5 nursing courses. The validated questionnaire was Project Collaborative International Donor-Living Liver Donation Rios. The questionnaire was completed anonymously and was self-administered. RESULTS: The completion rate was 89% (440 of 495); 91% (n = 398) were in favor of the related LLD, 8% (n = 37) were undecided, and 1% (n = 5) were against. When the attitude toward LLD is not related, 40% (n = 177) of respondents were in favor. The favorable attitude was associated with the following: consideration of the needs of organs for transplantations are covered (P ≤ .001); attitude in favor toward organ donation and transplantation (ODT) (P = .001); attitude in favor toward LLD (P = .007); attitude in favor of the acceptance of a LLD by a family member (P = .001); discussion of ODT with the family (P ≤ .001); being in favor of donating organs of a relative (P ≤ .001); and being Catholic (P = .003). After multivariate analysis, we observed the following significant correlations: the thought that the needs of transplantation organs are covered (odds ratio [OR] = 4.608; P = .020); being ready to accept a liver from a LLD (OR = 3.125; P = .038); discussion with the family about the subject of donation and transplantation (OR = 3.215; P = .003); and not belonging to any doctrine or religious belief (OR = 11.363; P = .039). CONCLUSIONS: In this study 91% of nursing students were in favor of living organ donation.


Subject(s)
Attitude of Health Personnel , Liver Transplantation/psychology , Liver , Living Donors , Students, Nursing/psychology , Family , Female , Humans , Poland , Religion , Surveys and Questionnaires , Tissue and Organ Procurement , Transplants/supply & distribution
11.
Transplant Proc ; 47(9): 2593-6, 2015 Nov.
Article in English | MEDLINE | ID: mdl-26680045

ABSTRACT

OBJECTIVE: Because of the shortage of organs, it has become necessary to look for alternative sources of organs, such as xenotransplantation. The aim of this study was to analyze the attitude of nursing students at a university in the Eastern Poland toward xenotransplantation, to determine factors that affect their acceptance. MATERIAL AND METHOD: During the 2011-2012 academic year, nursing students at the University of the Eastern Poland enrolled the 5 nursing courses self-administered a validated questionnaire (the PCID-XenoTx Rios) anonymously. We undertook a descriptive statistical analysis using the Student t test, χ(2) test, and logistic regression analysis. RESULTS: The completion rate was 90% (608 of 672). When asked about the acceptability of organ donation from humans, 62% (n = 379) were in favor, 9% (n = 54) against, and 29% (n = 175) undecided. We found a significant association between the acceptability of transplantation and the university course and the respondents' religion (P ≤ .05). Fourth-year students have a more favorable attitude toward xenotransplantation than third-year students (75% vs 54%; P = .018). Catholics accept this type of donation more readily than those belonging to other faith traditions (63% vs 37%; P = .053). In the multivariate analysis, academic course is a significant influence on attitude toward xenotransplantation (odds ratio, 2.421; 95% CI, 4.347-1.345; P = .003). CONCLUSIONS: Nursing students have an unfavorable attitude toward xenotransplantation. This attitude is influenced by the religious beliefs and their academic year.


Subject(s)
Attitude , Students, Nursing/psychology , Tissue and Organ Procurement , Universities , Female , Humans , Male , Poland , Surveys and Questionnaires , Transplantation, Heterologous/psychology , Young Adult
12.
Transplant Proc ; 47(9): 2597-9, 2015 Nov.
Article in English | MEDLINE | ID: mdl-26680046

ABSTRACT

INTRODUCTION: Living donation is increasingly necessary to address the shortage of organs for transplantation. Analyzing attitudes and influences toward living donation is essential. This study sought to analyze the attitude toward living donation in the population of Bolivians residing in Spain, and the variables that influence their attitude. MATERIAL AND METHODS: We selected a sample of Bolivians living in Spain. Respondents were selected using a stratified sampling by age and sex. We used a validated questionnaire of psychosocial aspects (the questionnaire of Proyecto Colaborativo Internacional Donante about Living Kidney Donation [Donación de Vivo Renal in Spanish]), which is self-administered and anonymous. The Student t test, χ(2), and Fisher tests, as well as logistic regression analysis, were used to analyze the gathered data. RESULTS: Of all respondents (n = 206), 83% (n = 170) were in favor of living-related donation, and 32% (n = 66) were in favor of living-unrelated donation. The rest, 8.5% (n = 18) were not in favor of living donation and 8.5% (n = 18) were undecided. Acceptance of the living donation was associated with the religious beliefs of the respondent (P = .014), with no worry about the scars that may remain after the donation (P = .016), and with the risk evaluation of living donation (P = .029). On multivariate analysis, the most important variable was the risk associated with living donation (odds ratio, 6.329; 95% CI, 30.303-1.328; P = .021). CONCLUSIONS: Attitudes toward living donation among the Bolivian population residing in Spain is favorable, and represents a group that may be encouraged to become donors.


Subject(s)
Attitude to Health/ethnology , Living Donors/psychology , Organ Transplantation/psychology , Adult , Bolivia/ethnology , Female , Humans , Male , Middle Aged , Spain/epidemiology , Surveys and Questionnaires
13.
Transplant Proc ; 47(9): 2600-2, 2015 Nov.
Article in English | MEDLINE | ID: mdl-26680047

ABSTRACT

INTRODUCTION: The attitude toward cadaveric organ donation is modulated by different factors, such as religious beliefs. This study sought to analyze the attitude of nationals of Ecuador resident in Spain regarding deceased organ donation depending on their religious beliefs. MATERIAL AND METHODS: A sample of Ecuadorian population resident in Spain (n = 461) stratified by age and sex was selected. We used a validated questionnaire of psychosocial aspects (PCID-DTO Rios), which is self-administered and anonymous. The χ(2) test, Student t test, and logistic regression analysis were used to analyze data. RESULTS: Of the 461 survey respondents, 86% (n = 395) were Catholic, 7% (n = 31) were believers of other faiths, and 7% (n = 35) declared themselves agnostic or atheist. A significant association between the religious beliefs and attitude toward organ donation among those tested can be objectified: 61% of Catholics (n = 241), 42% of believers in non-Catholic doctrines (n = 13), and 49% of atheists/agnostics (n = 17) were in favor of donation (P = .05). Among religious people, 77% of respondents believed their religion was favorable toward donation and 35%, although in favor of organ cadaveric donation, consider their religion contrary to donation (P < .001). CONCLUSIONS: The attitude toward cadaveric organ donation among the Ecuadorian population resident in Spain is influenced by religious beliefs and considers what their religion says regarding organ donation.


Subject(s)
Attitude to Health/ethnology , Organ Transplantation/psychology , Religion , Tissue and Organ Procurement/standards , Adult , Aged , Ecuador/ethnology , Female , Humans , Male , Middle Aged , Spain/epidemiology , Surveys and Questionnaires
14.
Transplant Proc ; 42(1): 239-42, 2010.
Article in English | MEDLINE | ID: mdl-20172319

ABSTRACT

INTRODUCTION: Training and information for university nursing students about the organ donation and transplantation process is necessary because it will influence their attitudes toward the subject. We analyzed attitudes toward organ donation among nursing students in a donation and transplantation training course and any changes in opinions as a result of the course. MATERIALS AND METHODS: We questioned 48 students in the third year of nursing (University of Murcia, Spain) who were attending a 32-hour training course about donation and transplantation. We used a descriptive concurrent study, through the completion of a validated opinion survey with 27 items before and after the training course. RESULTS: Attitudes toward donation were favorable in 87% of respondents increasing to 94% after course completion. Before starting the course, 87% believed that there were not enough transplantable organs available to cover needs compared to 96% after the course. Before the course, 46% stated that they did not have complete information about the subject. Taking part in the course has encouraged family discussion about the subject (85% to 90%) and improved knowledge about family opinions (64% to 83%; P = .031). Attitudes toward living donation did not change after the course. However, there was an improvement in knowledge of the Spanish organ distribution system. CONCLUSIONS: Attitudes toward organ donation among third-year nursing students were favorable, and increased after undergoing a course about donation and transplantation. The most important part of the course was the increase in theoretical knowledge about the matter as well as the health education.


Subject(s)
Awareness , Education, Nursing , Students, Nursing , Transplantation/psychology , Attitude to Death , Attitude to Health , Cadaver , Curriculum , Health Policy , Health Promotion , Humans , Public Policy , Spain , Tissue Donors , Tissue and Organ Procurement
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