Randomized intervention to assess the effectiveness of an educational video on organ donation intent among Hispanics in the New York metropolitan area

BACKGROUND The Hispanic community has a high demand for organ donation but a shortage of donors.Studies investigating factors that could promote or hinder organ donation have examined emotional video interventions.Factors acting as barriers to organ donation registration have been classified as:(1)Bodily integrity;(2)medical mistrust;(3)“ick”-feelings of disgust towards organ donation;and(4)“jinx”-fear that registration may result in one dying due to premeditated plans.We predict that by providing necessary information and education about the donation process via a short video,individuals will be more willing to register as organ donors.AIM To determine perceptions and attitudes regarding barriers and facilitators to organ donation intention among Hispanic residents in the New York metropolitan area.METHODS This study was approved by the Institutional Review Board at Northwell Health.The approval reference number is No.19-0009(as presented in Supplementary material).Eligible participants included Hispanic New York City(NYC)residents,18 years of age and above,who were recruited voluntarily through Cloud Research and participated in a larger randomized survey study of NYC residents.The survey an 85-item Redcap survey measured participant demographics,attitudes,and knowledge of organ donation as well as the intention to register as an organ donor.Attention checks were implemented throughout the survey,and responses were excluded for those who did fail.Participants were randomly assigned two-between subject conditions:To view a short video on organ donation and then proceed to complete the survey(i.e.,video first)and view the same video at the end of the survey(video last).No intra-group activities were conducted.This study utilized an evidenced-based emotive educational intervention(video)which was previously utilized and was shown to increase organ donation registration rates at the Ohio Department of Motor Vehicles.Results were analyzed using Jamovi statistical software.Three hundred sixty-five Hispanic individuals were included in the analysis.Once consent was obtained and participants entered the survey(the survey sample is presented in Supplementary material),participants were asked to report on demographic variables and their general impression of organ donation after death.The video depicted stories regarding organ donation after death from various viewpoints,including from the loved ones of a deceased person who died waiting for a transplant;from the loved ones of a deceased person whose organs were donated upon death;and,from those who were currently waiting for a transplant.RESULTS Using a binomial logistic regression,the analysis provides information about the relationship between the effects of an emotive video and the intention to donate among Hispanic participants who were not already registered as donors.The willingness to go back and register was found to be significantly more probable for those who watched the emotive video before being asked about their organ donation opinions(odds ratio:2.05,95%confidence interval:1.06-3.97).Motivations for participation in organ donation were also captured with many stating the importance of messages coming from“people like me”and a message that highlights“the welfare of those in need”.Overall,the findings suggest that using an emotive video that addresses organ donation barriers to prompt organ donation intentions can be effective among the Hispanic populous.Future studies should explore using targeted messaging that resonates with specific cultural groups,highlighting the welfare of others.CONCLUSION This study suggests that an emotive educational intervention is likely to be effective in improving organ donation registration intent among the Hispanic population residing in NYC.

Success Factors for Social Systems to Increase the Number of Organ Donations—From the Perspectives of Mechanisms and Organizational Behaviors

Deceased organ donation is much less prominent in Japan than it is in Western and other Asian countries. Because a shortage of organ donation is a serious social issue in Japan, various solutions to the issue have been considered. Although it was believed that the most critical factor in the organ shortage was the absence of a well-established social system, no prior studies attempted to analyze the issue from the perspective of the mechanisms and organizational behaviors. To identify common success factors of increasing organ donation, we conducted a qualitative survey in 5 countries promoting organ donations on a national level and increasing the number of organ donations. We found several important common factors: 1) to change from an explicit consent system to a presumed consent system with establishment of an appropriate in-hospital system, 2) to increase the level of job satisfaction of healthcare professionals and help them generating better results, 3) to demonstrate managements’ leadership for all staff to realize the importance of organ donations, 4) to establish an environment where medical professionals engaged in organ donations can appreciate autonomous working styles, the recognition of the importance of the work. It is suggested that these successful factors are introduced into Japan with long-, mid-term strategy to enhance organ donation.

China organ donation and transplantation update: the Hangzhou Resolution

The much-anticipated change in the practice of organ donation and transplantation in China is now underway and affirmed by an important Hangzhou Resolution promulgated at the 2013 China Transplant Congress.Support of the National Health and Family Planning Commission On October 29,2013,in a meeting of the National Health and Family Planning Commission (NHFPC)officials with Jie-Fu Huang,Head of National Organ Transplant Committee(OTC), Hai-Bo Wang,Director of China Organ Transplant Response System (COTRS)

Attitudes,awareness,and knowledge levels of the Turkish adult population toward organ donation:Study of a nationwide survey

BACKGROUND The most important factors affecting attitudes on organ donation are socioeconomic, educational, cultural, and religious factors in many countries.AIM To evaluate the attitudes, awareness, and knowledge levels of the Turkish adult population toward organ donation.METHODS This nationwide study surveyed 3000 adults(≥ 18 years) in Turkey. To ensure a representative sample, the Nomenclature of Territorial Units for Statistics-Ⅱ(modified for Turkey) was used. Turkey was divided into 26 regions based on social, economic, and geographic criteria as identified by the Turkish Statistical Institute. A stratified sampling method was used with an even distribution of adults across cities and towns based on population data. Data were collected by the PRP Research and Consultancy Company using computer-assisted personal interviews.RESULTS Out of 3000 individuals represented in the study population, 1465(48.8%) were male and 1535(51.2%) female. The results showed that most participants were under 45 years(59.0%) and married(72.1%), some had a bachelor’s degree or higher(21.9%), and very few(1.5%) had any direct experience with organ transplantation-whether in the family, or a family member on a transplantation waiting list. Most of the study population(88.3%) had not considered donating an organ, however, most(87.9%) said that they would accept an organ from a donor if they needed one. Among the individuals surveyed, 67% were willing to donate an organ to a close relative, while 26.8% would donate an organ to an unrelated person. Only 47.2% said they had adequate information about brain death, and 85.2% refused to consent to donating organs of family members declared brain dead. Only 33.9% thought they had adequate information about organ donation. The main source of information was the television. The two main reasons for refusing organ donation were that it was too soon to think about organ donation and the importance of retaining the integrity of the dead person’s body.CONCLUSION This study showed that Turkey’s adult population has inadequate knowledge about organ donation. The study advocates for public education programs to increase awareness among the general population about legislation related to organ donation.

A New Lease of Life Organ donation gains wider acceptance in China as an efficient donation system raises awareness

Wu Yue, a lung transplant recipi ent. now regards August 31, the day she underwent surgery, as her re-birth day. In the eyes＇ of many people, the 30-year- old woman is an embodiment of love, dili gence and intelligence.

Deceased organ donation for transplantation: Challenges and opportunities

Organ transplantation saves thousands of lives every year but the shortage of donors is a major limiting factor to increase transplantation rates. To allow more patients to be transplanted before they die on the waitlist an increase in the number of donors is necessary. Patients with devastating irreversible brain injury, if medically suitable, are potential deceased donors and strategies are needed to successfully convert them into actual donors. Multiple steps in the process of deceased organ donation can be targeted to increase the number of organs suitable for transplant. In this review, after describing this process, we discuss current challenges and potential strategies to expand the pool of deceased donors.

Attitudes, knowledge levels and behaviors of Islamic religious officials about organ donation in Turkey: National survey study

BACKGROUND The most important factors affecting the decision of organ donation are socioeconomic,educational,cultural,and religious factors.AIM To evaluate Islamic religious officials’attitudes and behaviors toward and level of knowledge on organ donation and transplantation.METHODS This study surveyed 2350 Islamic religious officials in Turkey.To ensure a representative sample,we used and modified the Nomenclature of Territorial Units for Statistics.Based on the Nomenclature of Territorial Units for Statistics-II,Turkey was divided into 26 regions.The number of Islamic religious officials in each city and town in each of the 26 regions was proportionate to the population.A stratified sampling method based on demographic factors,such as age,marital status,and educational level,was used.Data were collected by PRP Research and Consultancy Company using computer-assisted personal interviewing.RESULTS Of the 2350 religious officials surveyed,59.9%were in the age group of 35-54 years;84.7%had either a bachelor’s or a master’s degree;99.7%never donated an organ;and 75.4%were not considering donating in the future.About 22%of the religious officials said religious belief was their reason for not donating;45.3%did not indicate any reason.Although 41.5%of participants considered cadaveric organ donation as the best source of organ transplantation,36.3%deemed living donor transplantation as the best option.Meanwhile,52.9%of participants considered donating an organ from a brain dead relative in case they were asked for permission;80.1%considered donating to a relative,if necessary;81.6%considered undergoing organ transplantation,if necessary.About 83.7%of participants deemed organ donation as a proper human behavior;60.5%believed that it is allowed by Islam;55%said they preach for organ donation at their mosque;and 41.1%said their views of organ donation were influenced by their leaders in society.CONCLUSION Religious officials are unsure whether or not organ donation is respectful of their religious belief,but they consider donating an organ if a relative need to undergo organ transplantation.

Posthumous organ donation beliefs of college students:A qualitative study

Objective:To explore the perspectives and beliefs of college students toward posthumous organ donation,and the factors influencing their beliefs.Methods:This was a descriptive phenomenology study conducted with semi-structured indepth interviews.Nine college students attending three universities in Beijing who agreed to participate in this study were interviewed.Data were analyzed following the guideline suggested by Colaizzi(1978).Briefly,statements identified as noteworthy were coded and organized.A description was then written to formalize their meaning and returned to the participants for validation of the description.Results:In general,the participants exhibited positive attitudes toward posthumous organ donation.However,not all subjects indicated that they would become an organ donor.Based on the provided responses,four main themes emerged:(1)knowledge about organ donation,participants reported a general lack of education or understanding of organ transplantation and donation;(2)core beliefs on organ donation,despite believing it is valuable public service,participants were unwilling to go against the cultural beliefs held by parents and elders;(3)factors influencing beliefs on organ donation,including cultural and peer opinion,posthumous care of the body,legal registration,and publicity;(4)institutional and policy context,lack of guarantee for proper use of organs after donation was a concern.Conclusion:Despite positive attitudes towards posthumous organ donation,college students are hesitant to become donors because of lack of knowledge/publicity;cultural disdain;and lack of governmental assurance.

Philosophy of organ donation: Review of ethical facets

Transplantation ethics is a philosophy that incorporates systematizing, defending and advocating concepts of right and wrong conduct related to organ donation. As the demand for organs increases, it is essential to ensure that new and innovative laws, policies and strategies of increasing organ supply are bioethical and are founded on the principles of altruism and utilitarianism. In the field of organ transplantation, role of altruism and medical ethics values are significant to the welfare of the society. This article reviewsseveral fundamental ethical principles, prevailing organ donation consent laws, incentives and policies related to the field of transplantation. The Ethical and Policy Considerations in Organ Donation after Circulatory Determination of Death outline criteria for death and organ retrieval. Presumed consent laws prevalent mostly in European countries maintain that the default choice of an individual would be to donate organs unless opted otherwise. Explicit consent laws require organ donation to be proactively affirmed with state registries. The Declaration of Istanbul outlines principles against organ trafficking and transplant tourism. World Health Organization's Guiding Principles on Human Cell, Tissue and Organ Transplantation aim at ensuring transparency in organ procurement and allocation. The ethics of financial incentives and non-financial incentives such as incorporation of non-medical criteria in organ priority allocation have also been reviewed in detail.

The Role of Attitude Strength in Predicting Organ Donation Behaviour by Implicit and Explicit Attitude Measures

Explicit attitude measures seem to be rather poor predictors of organ donation behaviour. This study examined whether implicit attitude measures acted as better predictors. Special attention was paid to the moderating role played by attitude strength in predicting deliberate donation behaviour. In this study (N = 78), explicit and implicit measures of attitudes towards organ donation, as well as behavioural commitment, were assessed. Implicit associations were measured by an Implicit Association Test;five constructs assessed self-reported—understood as reflected—attitude strength. The explicit attitude measure appeared to be the best single predictor of whether the participant ended up taking an organ donor card. More importantly, test results demonstrated the moderating role of attitude strength. In the case of low attitude strength, the likelihood of taking a donor card increased with an increasing positive implicit association. In contrast, increasing strength was associated with a weaker link between card taking and the implicit attitude measure. The results are discussed in light of the power of implicit associations to predict more deliberate behaviours.

Investigating and Promoting the Decision towards Signing an Organ Donation Card

Using the Health Action Process Approach (HAPA) as a theoretical backdrop, the aim of this research, which consists of two studies, was to understand the process of goal setting and deciding to sign an organ donor card. In Study 1 (N = 550), we tested the HAPA’s stages in terms of discontinuity patterns in the variables predicting goal setting for organ donation. As expected, multigroup structural equation modeling revealed discontinuity patterns in terms of different prediction patterns. In Study 2 (N = 389), the efficacy of a planning intervention that aimed to foster the translation of goals into behavior was tested: participants who received the intervention were more likely to order a donor card than those who did not. Contrary to the HAPA’s predictions, within the intenders group the planning intervention did not stimulate behavior more frequently than in the control condition. In general, the stage-specific planning intervention is of practical importance, as it shows that brief and relatively inexpensive communication can enhance organ donation behavior.

Nurses’ Recognition in Nursing for Patients and Families about Organ Donation after Brain Death, Care for Family Members and Supports for Nurses

Background: Globally, there a problem of disequilibrium between donation and organ transplantation, this equilibrium is remarkable in Japan. Especially there are few donations from brain death, and researches from the view point of nurses in clinical situation were needed. Purpose: The purpose of this study was to clarify the recognition of nurses in organ transplantation nursing, required care for families of patients, and required support for nurses to promote quality of nurses in organ donation. Methods: We conducted this research within 2 months in 2019 in Western Japan. A researcher conducted a semi-qualitative interview for nurses in organ transplantation nursing about their recognition of nursing, required care for family members, and required support for nurses once. Results: Nurses recognized that some family members who knew patients’ thoughts made decision easily and some who didn’t know had difficulties. Many nurses felt insufficiency for family cares and some confronted ethical problems. Though some nurses felt conflict about their own thoughts or religion, they took care of patients or family members with responsibility. As for care for families, nurses thought practice of care considering families’ feeling, support of decision making, and care for family to live positively after transplantation as required care. About support for nurses, nurses required education of transplantation, increase of staff members, chance to share dilemma, and mental care. Discussion: Nurses recognized the importance of decision making, and felt an insufficiency for family care or dilemmas. To propose high quality of nursing and organ donation or transplantation, education about transplantation including family care, management about resolution of dilemma or mental health may be required.

Donating in good faith or getting into trouble? Religion and organ donation revisited

There is worldwide shortage of organs for solid-organ transplantation. Many obstacles to deceased and live donation have been described and addressed, such as lack of understanding of the medical process, the issue of the definition of brain death, public awareness of the need for transplants, and many others. However, it is clear that the striking differences in deceased and live donation rates between different countries are only partly explained by these factors and many cultural and social reasons have been invoked to explain these observations. We believe that one obstacle to both deceased and live donation that is less well appreciated is that of religious concerns. Looking at the major faiths and religions worldwide, it is reassuring to see that most of them encourage donation. However, there is also scepticism amongst some of them, often relating to the concept of brain death and/or the processes surrounding death itself. It is worthwhile for transplant teams to be broadly aware of the issues and also to be mindful of resources for counselling. We believe that increased awareness of these issues within the transplant community will enable us to discuss these openly with patients, if they so wish.

Successful Abdominal Organ Donation after Brain Death in a Patient with a Biventricular Assist Device: Extending Extended Criteria

Few studies address the potential for donation after brain death (DBD) in the limited population of patients with ongoing mechanical circulatory support (MCS). A case study was conducted reviewing available records of both donor and recipient, and available literature. The donor was a young female with an acute myocardial infarction precipitating emergent off-pump 2-vessel bypass graft complicated by profound cardiogenic shock refractory to inotropes and intra-aortic balloon pump. A heparin drip was started following percutaneous placement of a left ventricular-assist device (TandemHeart?) which improved her hemodynamics to stabilize for transfer. She ultimately required surgical placement of biventricular assist device (CentraMag?) to normalize hemodynamics. Two days post-operatively, she developed a cerebellar hemorrhage and was declared brain dead. Pre-donation blood chemistry showed adequate end-organ function. Both kidneys were placed locally. The liver was rejected for two regional status 1 patients and by all other local centers. We accepted the liver for a patient with polycystic liver disease with a MELD exception score of 20. The recipient is now 4 years post-transplant with excellent graft function. Extending donor criteria to include MCS patients can result in successful transplantation and should be considered in selected circumstances once satisfactory donor end-organ function is established.

Critical care specialists,the missing link in organ procurement for transplantation

The procurement process for organ donation begins with the identification of potential organ donors in emergency or critical care units(CCU),followed by their clinical evaluation,diagnostic procedures,and therapeutic interventions,mostly conducted in CCUs.It concludes with the request for organ donation and,if accepted,the retrieval of organs.Despite most interventions occurring in detection units,there has been a neglect of the strategic role played by critical care specialists(CCS)in managing and caring for brain-dead or near-brain-death patients.Questions arise:Are they willing to undertake this responsibility?Do they fully comprehend the nature of organ procurement?Are they aware of the specific interventions required to maintain possible organ donors in optimal physiological condition?Our objective is to examine the role of CCS in organ procurement and propose ways to enhance it,ultimately aiming to increase and enhance organ donation rates.

Does the use of double hormone replacement therapy for trauma patient organ donors improve organ recovery for transplant

BACKGROUND With an ongoing demand for transplantable organs,optimization of donor management protocols,specifically in trauma populations,is important for obta-ining a high yield of viable organs per patient.Endocrine management of brain-dead potential organ donors(BPODs)is controversial,leading to heterogeneous clinical management approaches.Previous studies have shown that when levo-thyroxine was combined with other treatments,including steroids,vasopressin,and insulin,BPODs had better organ recovery and survival outcomes were increased for transplant recipients.AIM To determine if levothyroxine use in combination with steroids in BPODs increased the number of organs donated in trauma patients.METHODS A retrospective review of adult BPODs from a single level 1 trauma center over ten years was performed.Exclusion criteria included patients who were not solid organ donors,patients who were not declared brain dead(donation after circulatory death),and patients who did not receive steroids in their hospital course.Levothyroxine and steroid administration,the number of organs donated,the types of organs donated,and demographic information were recorded.Univariate analyses were performed with P<0.05 considered to be statistically significant.RESULTS A total of 88 patients met inclusion criteria,69(78%)of whom received levothyroxine and steroids(ST/LT group)vs 19(22%)receiving steroids without levothyroxine(ST group).No differences were observed between the groups for gender,race,pertinent injury factors,age,or other hormone therapies used(P>0.05).In the ST/LT group,68.1%(n=47)donated a high yield(3-5)of organ types per donor compared to 42.1%(n=8)in the ST group(P=0.038).There was no difference in the total number of organ types donated between the groups(P=0.068).CONCLUSION This study suggests that combining levothyroxine and steroid administration increases high-yield organ donation per donor in BPODs in the trauma patient population.Limitations to this study include the retrospective design and the relatively small number of organ donors who met inclusion criteria.This study is unique in that it mitigates steroid administration as a confounding variable and focuses specifically on the adjunctive use of levothyroxine.

Organ Donation and Obstacles: University Student Survey

Background: Organ transplantation has helped improve the quality of life of patients with lethal terminal organ failure. This success is owed to the progress made in many fields such as surgery, immunology…However, in our country Morocco, we are faced with reluctance to donate. The study’s objective is to evaluate the perception of organ donation among university students. Methods: We conducted this cross-sectional study with descriptive and analytical aims. Our target population consisted of 991 university students from eight higher education structures. An anonymous questionnaire was distributed to those students by a single interviewer. The questions of the survey answered four main themes. Thus, two types of studies were done. The first was a descriptive study of the socio-demographic characteristics of the selected population and their knowledge and attitudes about organ donation. The second was an analytical study of the correlation between the socio-demographic characteristics, type and level of education of the target population and their knowledge and attitudes towards organ donation. Results: 97.2% of the respondents have already heard about organ donation. If 836 of the students (84.4%) thought that transplantation could be an effective therapeutic alternative, 155 of the students (15.6%) were not aware of this possibility. Furthermore, 298 students, which means 30.1% of the students, did not know that organ transplantation was practiced in Morocco. The causes of refusal found in our study were numerous. 68.5% of students blamed the lack of information as the main cause of their reluctance. 64.7% were afraid of organ trafficking. 41.1% refused the idea of mutilating the body of the deceased, which could impact the funeral. 37.3% thought that donation would be a violation of the human body according to religious values. 33.9% were against donation because they hoped that the brain-dead patient could wake up. The main results of our survey showed the very favorable attitude towards organ donation and transplantation, despite the lack of knowledge on the subject. Conclusion: This study revealed the absence of information on the practice of organ transplantation in Morocco and the underestimation of the number of people waiting for transplantation. On the other hand, like the data found in the literature, our study highlights the religious obstacles and the lack of confidence in the legislation governing donation and transplantation in our country.

Generativity of Self-Organizing Processes and Their Correlative Description in Terms of a Formal Language of Meta-Ordinal Generative Nature, in the Light of the Maximum Ordinality Principle and the Explicit Solution to the “Three-Body Problem”

The main objective of this paper is to demonstrate that the internal processes of Self-Organizing Systems represent a unique and singular process, characterized by their specific generativity. This process can be modeled using the Maximum Ordinality Principle and its associated formal language, known as the “Incipient” Differential Calculus (IDC).