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1.
Am J Transplant ; 8(7): 1451-70, 2008 Jul.
Article in English | MEDLINE | ID: mdl-18510639

ABSTRACT

The effect of state legislation and federal policies supporting living donors on living kidney donation rates in the United States is unknown. We studied living kidney donation rates from 1988 to 2006, and we assessed changes in donation before and after the enactment of state legislation and the launch of federal initiatives supporting donors. During the study, 27 states enacted legislation. Among states enacting legislation, there was no statistically significant difference in the average rate of increase in overall living kidney donations after compared to before state legislation enactment (annual increase in donations per 1 000 000 population [95% confidence interval] 2.39 [1.94-2.84] compared to 1.68 [0.89-2.47] respectively, p > 0.05). Among states not enacting legislation, there was a statistically significantly greater annual increase in overall donation rates from 1997 to 2002 compared to before 1997 when federal initiatives commenced, but there was no growth in annual rates after 2002. State and federal legislation were associated with increases in living-unrelated donation. These findings suggest that although existing public policies were not associated with improvements in the majority of donations from living-related donors, they may have had a selective effect on barriers to living-unrelated kidney donation.


Subject(s)
Kidney Transplantation/legislation & jurisprudence , Kidney Transplantation/statistics & numerical data , Living Donors/legislation & jurisprudence , Living Donors/statistics & numerical data , Female , Humans , Male , United States
2.
Am J Transplant ; 7(7): 1778-87, 2007 Jul.
Article in English | MEDLINE | ID: mdl-17524080

ABSTRACT

The influence of perceptions of organ allocation on willingness to donate organs is unclear. We performed a national study assessing the relation of public perceptions of organ allocation to willingness to donate organs, and we assessed the contribution of beliefs regarding discrimination in health care to observed associations. Among 845 participants, a majority (65%) reported that they less than "mostly" understand allocation, and most (71%) reported that they believe allocation is "unfair" or are "unsure" of its fairness. Participants reporting less understanding were less willing to donate (56%) than persons reporting greater understanding (67%) (p < 0.01). Participants believing allocation is "unfair" or who are "unsure" about fairness were less willing to donate (54%) than persons believing allocation is "fair" (68%) (p < 0.01). Associations were stronger among certain demographic subgroups. Participants with the least favorable perceptions of allocation were more likely than their counterparts to believe that race and income discrimination occur in transplantation and to believe that they personally experienced income discrimination in health care. Adjustment for these beliefs partially attenuated associations between perceptions regarding allocation and willingness to donate. Interventions enhancing transparency and perceived fairness of organ allocation may improve willingness to donate, particularly if they address concerns regarding discrimination in transplantation and health care.


Subject(s)
Resource Allocation/ethics , Tissue Donors/statistics & numerical data , Attitude to Health , Cross-Sectional Studies , Health Care Rationing/ethics , Humans , Income , Racial Groups , Socioeconomic Factors , Surveys and Questionnaires , Tissue Donors/ethics , United States
3.
Am J Transplant ; 6(11): 2774-85, 2006 Nov.
Article in English | MEDLINE | ID: mdl-16952292

ABSTRACT

Attitudes toward monetary and nonmonetary incentives for living (LD) and deceased donation (DD) among the U.S. general public and different racial/ethnic and income groups have not been systematically studied. We studied attitudes via a telephone questionnaire administered to persons aged 18-75 in the continental United States. Among 845 participants (85% of randomized households), less than one-fifth participants were in favor of incentives for DD (range 7-17%). Most persons were in favor of reimbursement of medical costs (91%), paid leave (84%) and priority on the waiting list (59%) for LD. African Americans and Hispanics were more likely than Whites to be in favor of some incentives for DD. African Americans were more likely than Whites to be in favor of monetary incentives for LD. Whites with incomes less than $20 000 were more likely than Whites with greater incomes to be in favor of reimbursement for deceased donors' funeral expenses or medical expenses. The U.S. public is not generally supportive of incentives for DD, but is supportive of limited incentives for LD. Racial/ethnic minorities are more supportive than Whites of some incentives. Persons with low income may be more accepting of certain monetary incentives.


Subject(s)
Attitude to Health , Ethnicity , Living Donors/psychology , Racial Groups , Tissue Donors/psychology , Tissue Donors/statistics & numerical data , Adult , Aged , Cadaver , Female , Humans , Income , Male , Middle Aged , Motivation , Random Allocation , Socioeconomic Factors , Surveys and Questionnaires , Telephone , United States
4.
Conf Proc IEEE Eng Med Biol Soc ; 2004: 2086-9, 2004.
Article in English | MEDLINE | ID: mdl-17272133

ABSTRACT

Initial results of a comprehensive design software that optimizes parameters for fluorescence analysis of a user-defined fluorophore are presented. SLAP (spectral LED aggregation program) automatically selects configurations of LEDs that, in a fluorescence analysis system, maximize the emission signal (useful output) as a function of the excitation signal (interference), optics, photodetection modality, and sample characteristics. Initial results draw on an extensive database of blue, blue-green, green and purple LEDs characterized across a range of nominal and overdrive operating conditions. Overdrive conditions enable spectral shifts of the LED excitation bands to enhance the overall flexibility of SLAP optimization. Representative results show a 70.1% improvement in collected signal for GFPuv fluorophores when compared to conventional LED-based fluorescence operated under nominal operating conditions.

5.
Wien Klin Wochenschr ; 104(22): 692-7, 1992.
Article in German | MEDLINE | ID: mdl-1475975

ABSTRACT

A survey was performed in 1989 by the Institute of Social Medicine and the Austrian Workers Compensation Board(AUVA) to investigated the alcohol problem in 277 factories in which the workers were exposed to hot and dusty atmospheres. As a result of the findings, a further study was undertaken by the same research team to investigate one possible solution to the problem of alcohol consumption at work in a paper-producing factory, predominantly under hot and dusty conditions. The study was well prepared by many activities in the field of health promotion. In this trial, an electrolyte drink especially suited for heat-burdened work places, was introduced for three months as alternative drink to alcohol. Before and after this period the employees answered a questionnaire regarding their alcohol consumption and any changes in consumption habits. One of the main results of the study was the significant increase in electrolyte drink consumption and decrease in wine consumption although that of beer remained practically unchanged. The offered electrolyte drink was accepted as alternative drink by many workers and represents a practical example of health promotion at the place of work. This study should encourage other factories and businesses to experiment with electrolyte drinks especially suited to their particular conditions in an attempt to overcome the problem of alcohol consumption during working hours.


Subject(s)
Alcohol Drinking/prevention & control , Beer , Beverages , Electrolytes/administration & dosage , Fluid Therapy , Hot Temperature/adverse effects , Occupational Exposure , Accidents, Occupational/prevention & control , Adolescent , Adult , Aged , Alcoholism/prevention & control , Austria , Beer/adverse effects , Female , Humans , Male , Middle Aged , Occupational Diseases/prevention & control , Social Environment
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