Variability in Organ Procurement Organization Performance by Individual Hospital in the United States.

Importance: Availability of organs inadequately addresses the need of patients waiting for a transplant. Objective: To estimate the true number of donor patients in the United States and identify inefficiencies in the donation process as a way to guide system improvement. Design, Setting, and Participants: A retrospective cross-sectional analysis was performed of organ donation across 13 different hospitals in 2 donor service areas covered by 2 organ procurement organizations (OPOs) in 2017 and 2018 to compare donor potential to actual donors. More than 2000 complete medical records for decedents were reviewed as a sample of nearly 9000 deaths. Data were analyzed from January 1, 2017, to December 31, 2018. Exposure: Deaths of causes consistent with donation according to medical record review, ventilated patient referrals, center acceptance practices, and actual deceased donors. Main Outcomes and Measures: Potential donors by medical record review vs actual donors and OPO performance at specific hospitals. Results: Compared with 242 actual donors, 931 potential donors were identified at these hospitals. This suggests a deceased donor potential of 3.85 times (95% CI, 4.23-5.32) the actual number of donors recovered. There was a surprisingly wide variability in conversion of potential donor patients into actual donors among the hospitals studied, from 0% to 51.0%. One OPO recovered 18.8% of the potential donors, whereas the second recovered 48.2%. The performance of the OPOs was moderately related to referrals of ventilated patients and not related to center acceptance practices. Conclusions and Relevance: In this cross-sectional study of hospitals served by 2 OPOs, wide variation was found in the performance of the OPOs, especially at individual hospitals. Addressing this opportunity could greatly increase the organ supply, affirming the importance of recent efforts from the federal government to increase OPO accountability and transparency.

Mental health and spiritual well-being in humanitarian crises: the role of faith communities providing spiritual and psychosocial support during the COVID-19 pandemic.

Across the globe, people's reactions to the COVID-19 pandemic and its accompanying lockdowns highlighted, and continued to stress, the relevance of mental health and psychosocial support (MHPSS) in responding to crises, including in low-income and emergency settings. They also demonstrated the importance of faith practices and communities of faith as core needs and important coping mechanisms for many affected people in times of crisis. Drawing on data collected by World Vision International, the world's largest child-focused humanitarian and development organisation, in the course of its response to COVID-19 in 70 different countries, this article explores the ways in which faith groups and faith leaders responded to the perceived needs of their communities. While keen to offer psychosocial support to people suffering anxiety and fear in the context of the crisis, this has often been integrated with spiritual support. Analysing their work from the framework of a rights-based approach to mental health, we conclude that they did contribute to psychosocial support through their MHPSS, in part through their provision of spiritual care. However, spiritual well-being should not be conflated with psychosocial well-being. While faith groups play an important role in MHPSS, their primary role is to offer spiritual care.

"Miscommunication" and Undergraduate Women's Conceptualizations of Sexual Assault: A Qualitative Analysis.

Approximately 60% of legally defined rape victims do not label their experiences as "rape," most of whom label the experience as "a serious miscommunication." However, little research has examined why women choose this label. Labeling rape as a miscommunication could be problematic if chosen due to stereotypical conceptions that one's experience is not "real" rape. The present study used a mixed-methodological approach to understand why women might refer to rape as a "miscommunication," and how their reasons for labeling might differ from those who label their experiences and those who are nonlabeled (i.e., unequivocally state that they were "not victimized"). Participants included 123 undergraduate women who experienced rape. Participants responded to how they labeled rape and answered questions regarding assault characteristics, disclosure, reporting, and self- and perpetrator blame. Chi-square analyses assessed labeling group differences. Responses to an open-ended question about factors contributing to their labeling decision were content analyzed. Whereas miscommunication-labeled and nonlabeled victims reported similar assault characteristics in the quantitative analyses, qualitative content analyses revealed varying reasons for labeling rape as miscommunication, not victimization, and rape. Over three quarters of miscommunication-labeled victims reported that one or more of the following factors influenced their labeling: victim and perpetrator substance use, sexual activity prior to the rape, and perceptions that one did not express nonconsent strongly enough and that the perpetrator "did not realize" their lack of desire. Whereas miscommunication-labeled and nonlabeled victims reported similar assault characteristics, the extent to which those assault characteristics affected their labeling differed. Those who labeled their experiences as miscommunication gave reasons for their label that centered on factors which reflect inconsistencies between their experiences and "stereotypical rape." Misperceptions of rape can be addressed via prevention programming and clinical work.

Resisting Unwanted Sexual and Social Advances: Perspectives of College Women and Men.

This study examines college men's (N = 635) and women's (N = 650) reports of women's resistance against unwanted sexual and social advances. Men completed surveys to assess (a) initiation of unwanted sexual contact with a female partner, (b) initiation of unwanted sexual intercourse with a female partner, (c) sexual situations where a female partner decided she did not want to proceed, (d) encouraging a woman to drink when they were aware that the woman did not want to, and (e) attempting to take a woman to an isolated location against her will. Women completed corresponding questionnaires regarding the receipt of such unwanted advances, the outcome of the situation, and the resistance tactics utilized. Many men (5%-46%) and women (15%-38%) initiated or experienced, respectively, at least one of the five unwanted sexual or social advances. Unwanted sexual and social advances most often stopped as a result of women's verbal and physical resistance. Few advances (0%-8%) stopped as a result of bystander intervention. In addition to decreasing men's likelihood of engaging in unwanted sexual and social advances, these data highlight the importance of educating women on the effectiveness of verbal and physical resistance tactics, and increasing the frequency of prosocial bystander action on college campuses.

Between international donors and local faith communities: Intermediaries in humanitarian assistance to Syrian refugees in Jordan and Lebanon.

This paper explores the crucial part that faith-based organisations (FBOs) play in acting as intermediaries between international donors and local faith communities (LFCs) implementing humanitarian relief projects for Syrian refugees. Humanitarian responses to the mounting Syrian refugee crisis have coincided with greater collaboration between international donors and LFCs. This cooperation often is facilitated by a complex web of non-state intermediaries at the international, national, and local level. This study probes the breadth of roles of these intermediaries, drawing on primary data from case studies of two Christian intermediaries supporting Christian LFCs as they deliver aid primarily to Muslim Syrian refugees in Jordan and Lebanon. The results of the study are connected to the wider literature on LFCs in humanitarian response, revealing how intermediaries address issues of accountability, capacity-building, impartiality, neutrality, and professionalism. The paper concludes by offering suggestions for further research on intermediaries as key actors in the localisation of humanitarian assistance.

Hippotherapy in Rehabilitation Care for Children With Neurological Impairments and Developmental Delays: A Case Series.

PURPOSE: This report assesses functional mobility in children with neurological impairments and documented gross motor delays, before and after receiving either hippotherapy or standard outpatient physical therapy (PT). SUMMARY OF KEY POINTS: This is a case-series report using data previously collected for a discontinued randomized controlled trial, in which participants received hippotherapy or standard outpatient clinic PT for a 12-week treatment period. Results demonstrated both subjective and objective functional mobility improvements after treatment in participants receiving hippotherapy and standard outpatient PT, as determined by the Peabody Developmental Motor Scales-2, the Pediatric Evaluation of Disability Inventory, and the Goal Attainment Scaling. STATEMENT OF CONCLUSION AND RECOMMENDATIONS FOR CLINICAL PRACTICE:: When compared with standard outpatient PT, hippotherapy appears to be a viable treatment strategy for children aged 2 to 5 years with neurological impairments and gross motor delays, but additional research in this area is needed to validate findings.