Donation

捐赠
  • 文章类型: Journal Article
    目的:母乳是所有婴儿的最佳营养来源。当母亲自己的牛奶不可用时,世界卫生组织建议对有或没有医疗并发症的早产儿使用供体母乳。探索母乳捐赠的障碍和促进因素及其可接受性对于制定这种干预措施至关重要。根据Arksey和O\'Malley(IntJSocResMethodol8:19-32,2005)开发的方法框架进行了范围审查。在PubMed(NCBI)进行了搜索,CINAHL(EBSCO),和WebofScience(Elsevier)。采用两阶段顺序筛选过程。使用试点数据提取表格进行数据提取。
    结果:我们纳入了20篇叙事综合文章。捐赠和接受母乳的障碍和促进者分为六个主题:个人,家庭,社区,workplace,卫生系统,与政策相关。常见的个人障碍是BMD的时间要求,个人不喜欢这个过程,缺乏知识,牛奶不足,负面意见,缺乏信息。家庭耻辱,负面谣言,受教育程度较低的家庭成员,家庭成员的疾病被确定为与家庭有关的障碍。与社区有关的障碍包括不可接受的文化或宗教习俗,社会禁忌,和距离牛奶银行。与卫生系统有关的主要障碍是缺乏实际和心理支持,缺乏信息,储存和运输问题,HCWs缺乏知识,以及建立牛奶实验室的后勤挑战。与工作相关的常见障碍是缺乏足够的时间,哲学上的反对,对重返工作岗位感到不理解。确定的与政策相关的障碍包括对卫生要求的需求,捐赠费用,缺乏标准化的指导方针。让捐赠过程更快,为捐助者提供接送服务,社区教育和男性伙伴参与母乳捐赠可能有助于提高母乳捐赠的可接受性。
    Human milk is the best source of nutrients for all infants. When a mother\'s own milk is unavailable, the World Health Organization suggests using donor human milk for premature neonates with or without medical complications. Exploring the barriers and facilitators for breast milk donation and its acceptability is essential for developing this intervention. A scoping review was conducted based on a methodological framework developed by Arksey and O\'Malley (Int J Soc Res Methodol 8:19-32, 2005). A search was conducted in PubMed (NCBI), CINAHL (EBSCO), and Web of Science (Elsevier). A two-stage sequential screening process was adopted. Data extraction was done using a piloted data extraction form.
    We included 20 articles for narrative synthesis. Barriers and facilitators for donating and accepting breast milk were categorized under six themes: individual, family, community, workplace, health system, and policy-related. The common individual barriers were time requirements for BMD, personal dislike of the process, lack of knowledge, insufficient milk, negative opinions, and lack of information. Family stigma, negative rumors, less educated family members, and illness of a family member were identified as family-related barriers. Community-related barriers include cultural or religious unacceptable practices, societal taboos, and distance to milk banks. The major barriers identified in relation to the health system were lack of practical and psychological support, lack of information, storing and transportation issues, lack of knowledge among HCWs, and logistical challenges of creating a milk lab. The common work-related barriers were the lack of adequate time, philosophical objections, and incomprehension at returning to work. Policy-related barriers identified include the need for hygiene requirements, donation costs, and lack of standardized guidelines. Making the donation process faster, providing pick-up services for donors, and community education and male partner engagement regarding breast milk donation could help to boost the acceptability of breast milk donation.
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  • 文章类型: Journal Article
    精子和卵母细胞是辅助生殖的组成部分。精子和卵子捐赠允许将生产孩子的生物学行为与养育和抚养孩子的心理过程分开。然而,获得和使用这些配子的艺术充满了道德和法律挑战。有关匿名的相关方面,遗传筛选,血缘,知情同意和风险披露,对捐助者的补偿,和儿童福利的讨论。尽管匿名问题仍然存在争议,由于这场辩论,后代福利的重要性已经凸显出来。呼吁对捐赠的配子进行更严格的基因检测,以避免遗传性疾病的传播,虽然有慈善原则的支持,hastobebalancedbyitspossibledesteriouseffectsonthedonersandtheirrelativesespeciallyiffindingsrevealaseriousgeneticriskthathasnomedicaltreatmentasyet.直接和间接成本的报销,以及对时间损失的公平补偿,建议卵母细胞供体在治疗期间遭受的不便和风险。尽管限制单个配子怀孕次数的不同指南可能会有所帮助,但血缘关系的风险仍然是世界上的一个问题。如果可执行。重要的是,卵子捐赠者在知情同意过程中以简单的语言清楚地理解所涉及的未知健康风险,以便同意可以是真正自愿的。这将保护捐助者免受“VolentiNonFitInjuria”学说的强烈反对。还建议有关配子捐赠的具体立法,为人父母,ART应该在没有这些的国家通过,以避免由于目前的法律空白而可能引发的争议。
    Sperm and oocytes are building blocks in assisted reproduction. Sperm and ovum donation permit separation of the biological act of producing a child from the psychological process of nurturing and raising the child. However, the art of obtaining and use of these gametes are fraught with ethical and legal challenges. Relevant aspects concerning anonymity, genetic screening, consanguinity, informed consent and risk disclosure, compensation for donors, and child welfare are discussed. Though the issue of anonymity remains controversial, the importance of the welfare of the offspring has come to the fore as a result of the debate. Calls for more rigorous genetic testing for donated gametes to avoid genetic disease transmission, though supported by the principle of beneficence, has to be balanced by its possible deleterious effects on the donors and their relatives especially if findings reveal a serious genetic risk that has no medical treatment as yet. Reimbursement for direct and indirect costs, as well as fair compensation for time lost, inconveniences and risks suffered during treatment is recommended for oocyte donors. The risk of consanguinity remains a problem across the world even though the different guidelines limiting the number of pregnancies by a single gamete may be helpful, if enforceable. It is important that egg donors be clearly made to understand in simple language during the informed consent process of the yet unknown health risks involved so that the consent can be truly voluntary. This will protect donors from the backlash of the doctrine of \"Volenti Non Fit Injuria\". It is also suggested that specific legislation with regards to gamete donation, parenthood, and ART should be passed in countries where these are absent, to avoid controversies that may arise due to current gaps in the law.
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  • 文章类型: Journal Article
    肾脏疾病是最普遍的疾病。肾功能衰竭会导致身体问题。因此,患者需要使用透析治疗或肾移植,实际上,人们在等待移植的名单上。这项研究旨在提取预后模型,以评估诊断为脑死亡(DBD)的肾脏供体的准备。这项研究是对PubMed的系统评价,科学直接,和一般探险家直到2020年。它遵循系统审查和荟萃分析-P方案的首选报告项目。文章的评估是由作者完成的。这个评价应该是打分的形式,优先化,并根据捐助者的准备情况对捐助者进行排名。11个信息来源包括来自7个不同国家的9篇学术文章和2篇灰色来源。提取了9种算法和模型,包括,总体10个因素。所有模型由4个因素组成,并且这些模型中约90%考虑4或5个因素来评估肾脏供体DBD的制备。超过60%的模型考虑了年龄,血压史,和肌酐因子。疾病预后有助于医生对疾病出现的决策。肾脏疾病的预后模型可以对患者有很大的帮助。对相关文献的回顾表明,就包含的两个因素而言,所有模型都获得了高分,年龄和血压史。
    Renal disease is the most prevalent disease. Kidney failure can cause physical problems. Hence, patients need to use dialysis therapy or kidney transplantation, and actually, people are in the waiting list for a transplant. This research aimed to extract the prognostic models that evaluate the preparation of kidney donors diagnosed with brain death (DBD). This research was a systematic review of PubMed, Science Direct, and general explorers up until 2020. It followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-P protocol. The assessment of the articles was done by the authors. This evaluation was supposed to be in the form of scoring, prioritizing, and ranking the donors in terms of their preparation. Eleven sources of information included 9 academic articles along with 2 Grey Sources from 7 different countries. 9 algorithms and models were extracted which included, overall 10 factors. All the models were comprised of 4 factors and about 90% of these models considered 4 or 5 factors to evaluate the preparation of kidney donors DBD. Over 60% of the models had taken into account age, blood pressure history, and creatinine factors. Disease prognosis facilitates a doctor\'s decision-making on the emergence of the disease. Prognostic models of renal diseases can be a great help to patients. A review of the related literature revealed that all the models received a high score in terms of the two factors they included, age and history of blood pressure.
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  • 文章类型: Journal Article
    活体肾脏捐献与肾小球高滤过有关,慢性肾脏病发展的诱因。本荟萃分析旨在收集当前的证据,并阐明肾脏捐献者未来妊娠并发症的风险是否增加。Medline,Scopus,WebofScience,CENTRAL和GoogleScholar从成立到2021年8月29日进行了系统搜索。选择比较肾脏供体和非供体中不良妊娠结局率的观察性研究。随机效应模型被拟合以提供荟萃分析估计,虽然证据的质量是通过建议分级评估来评估的,开发和评估方法。包括五项研究,包括430个捐赠者和23,540个非捐赠者。活体供肾与子痫前期风险显著增高相关(OR:2.86,95%CI:1.62-5.05,证据质量中等),妊娠期高血压(OR:2.53,95%CI:1.11-5.74,证据质量低)和早产(OR:1.32,95%CI:1.01-1.74,证据质量中等)。预期的子痫前期绝对发病率,妊娠期高血压和早产分别为7.4%,5.4%和8.3%,分别。妊娠期糖尿病的风险,剖宫产,两组之间的低出生体重和胎儿死亡相似(证据质量低).总之,有肾脏捐献史的女性患先兆子痫的风险显着增加,妊娠高血压和随后怀孕的早产,尽管并发症的绝对发生率仍低于10%。未来的研究应确认这些影响,并通过个性化不良围产期结局的风险来改善潜在的供体咨询。
    Living kidney donation is associated with glomerular hyperfiltration, predisposing for the development of chronic kidney disease. The present meta-analysis aims to gather current evidence and clarify whether kidney donors are at increased risk of future pregnancy complications. Medline, Scopus, Web of Science, CENTRAL and Google Scholar were systematically searched from inception to August 29, 2021. Observational studies comparing the rates of adverse pregnancy outcomes among kidney donors and non-donors were selected. Random-effects models were fitted to provide meta-analysis estimates, while the quality of evidence was appraised with the Grading of Recommendations Assessment, Development and Evaluation approach. Five studies were included, comprising 430 donors and 23,540 non-donors. Living kidney donation was associated with significantly higher risk of preeclampsia (OR: 2.86, 95% CI: 1.62-5.05, moderate quality of evidence), gestational hypertension (OR: 2.53, 95% CI: 1.11-5.74, low quality of evidence) and preterm birth (OR: 1.32, 95% CI: 1.01-1.74, moderate quality of evidence). The anticipated absolute rates of preeclampsia, gestational hypertension and preterm birth were 7.4%, 5.4% and 8.3%, respectively. The risk of gestational diabetes, cesarean delivery, low birthweight and fetal death was similar between the two groups (low quality of evidence). In conclusion, women with history of kidney donation are at significantly increased risk of preeclampsia, gestational hypertension and preterm birth in subsequent pregnancies, although the absolute rate of complications remains below 10%. Future studies should confirm these effects and improve potential donor counseling by individualizing the risk of adverse perinatal outcomes.
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  • 文章类型: Journal Article
    OBJECTIVE: Access to cardiac implantable electronic devices (CIEDs) is limited in developing countries. Postmortem CIED donation from developed countries to developing countries could be an important resource for those who cannot afford a new one. The objective of this paper was to identify and synthesize the perspectives on the donation of CIEDs for potential reuse in patients without resources living in developing countries.
    METHODS: A bibliographic review was carried out in the PubMed, Web of Science and Scopus databases. The search strategy was limited to articles published in English or Spanish.
    RESULTS: 8 publications were analyzed. The main results were grouped into two large frameworks on perceptions, preferences, attitudes and opinions of developed countries and developing countries towards the donation and reuse of CIEDs. Positive perspectives were identified towards the donation of CIEDs for their reuse in the majority of patients with a CIED, relatives, funeral homes and physicians of developed countries, as well as in physicians and potential recipient patients of developing countries.
    CONCLUSIONS: This review highlights the positive perspectives on CIED donation from developed countries to patients in need of developing countries among all studied groups. In view of the feasibility of collecting postmortem devices, we advocate studying the feasibility of more local CIED donation initiatives. This article is protected by copyright. All rights reserved.
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  • 文章类型: Journal Article
    Solid organ transplantation saves and transforms lives. The original type of organ donation from deceased patients was controlled donation after circulatory death, previously referred to as non-heart beating organ donation. The rise of donation after circulatory death in the UK came about through advances in critical care and transplant medicine and support from several key organisations in developing a robust ethical, legal and professional framework. The transplant waiting list reached a historic peak in 2009-2010 of 8000 patients, but fell by 25% to 6000 in 2017-2018. There has also been a steady rise in the number of deceased donors and the number of donations after circulatory death. The contribution of donation after circulatory death to the total number of donations rose steadily between 2000 and 2012 and has remained about 40% since. Although the situation has improved for patients waiting for a transplant, deaths and long waits remain common. Changes to legislative, technical and peri-mortem procedures may greatly change future practices in donation after circulatory death in the UK.
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  • 文章类型: Journal Article
    Background: During the past few decades there has been a growing interest on the part of many governments in the creation of biobanks. Nevertheless, this would be impossible without participation of many donors who offer samples of their biological material for scientific research. Therefore, the aim of this paper is to provide an overview of the existing research on social attitudes towards biobanking. Material and Methods: A literature search was conducted in the database of MEDLINE (PubMed). 61 papers were included in the analysis. The retrieved articles were assessed using a thematic analysis. Results: Eight main themes were identified: (1) public knowledge about biobanks, (2) public views on biobanking, (3) willingness to donate, (4) donors\' motivations, (5) perceived benefits and risks of biobanking, (6) preferred type of consent, (7) trust toward biobanks, and (8) demographic characteristics of potential donors. Conclusions: Although the public lacks knowledge about biobanking, many individuals declare willingness to donate. Their will is influenced by: their knowledge about biobanking, the type of donated tissue, research purpose, concerns over the safety of the data, preferred type of consent, and trust towards biobanks.
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  • 文章类型: Journal Article
    Families of potential post-mortem organ donors face various challenges in the unfamiliar hospital context and after returning home. This review of sources published between 1968 and 2017 seeks to understand their journey as a bereavement experience with a number of unique features. Grief theory was used to identify ways that staff can assist family members to tolerate ambiguities and vulnerabilities while contributing to an environment characterised by compassion and social inclusion. Staff can guide families and create opportunities for meaningful participation, building resilience and developing bereavement-related skills that could assist them in the months that follow.
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  • 文章类型: Journal Article
    背景:对欧洲献血者的概述表明,许多国家的男性和女性献血者的分布相似,意大利是一个例外,因为妇女仅占捐助者的30%。性别医学是这方面的一个关键问题,尽管性别研究在输血领域非常有限,无论是广泛考虑还是具体考虑选择,捐助者的管理和保留。It,因此,比较不同欧洲国家献血者中女性的存在,并研究据报道性别在献血中的作用,以确定与献血者的沟通和管理可能的影响,似乎很重要。
    方法:为了确定欧洲国家捐赠者中女性的比例,数据是从国家协会网站上提供的年度报告或文件中收集的;此外,所有与献血有关的论文发表在该行业的五个主要期刊上(输血,VoxSanguinis,输血和单采术科学,输血医学,考虑输血);选择了约80种出版物,并检查了性别变量。
    结果:发表的研究表明,性别在献血动机中起着关键作用(女性更无私,男性更加个人主义)和不良反应,这是一个特别严重的问题,导致更少的妇女成为定期捐助者。还出现了意大利捐助者管理特有的几个方面。
    结论:性别似乎在所研究的方面发挥了重要作用,因此,关于招募捐赠者的策略和捐赠过程中的重大事件的管理,值得进一步考虑。
    BACKGROUND: An overview of European blood donors shows that the distribution of men and women donors is similar in many countries, with Italy being an exception in that women account for only 30% of donors. Gender medicine is a key issue in this context, even though gender studies are very limited in the transfusion field, whether considered broadly or with specific regards to the selection, management and retention of donors. It, therefore, seemed important to compare the presence of women among blood donors in different European countries and examine the roles that gender is reported to play in the donation of blood in order to identify possible implications for communication with and management of the donor.
    METHODS: To determine the proportion of women among donors in European countries, data were collected from annual reports or documents available on the websites of national associations; furthermore, all papers related to giving blood published in the five main journals in the sector (Transfusion, Vox Sanguinis, Transfusion and Apheresis Science, Transfusion Medicine, Blood Transfusion) were considered; about 80 publications were selected and the gender variable was examined.
    RESULTS: The published studies showed that gender plays key roles in the motivation to give blood (women being more altruistic, men being more individualistic) and in adverse reactions, which was a particularly critical problem leading to fewer women become regular donors. A few aspects specific to the management of donors in Italy also emerged.
    CONCLUSIONS: Gender seems to play an important role in the aspects studied and does, therefore, merit further consideration in relation to strategies to recruit donors and the management of critical events during donation.
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