Search

Thesis (Masters by research(Health Sciences))--University of South Australia, 2021. Includes bibliographical references (pages 77-91) Living organ donation is a major life event and due to the concentration of specialist services in major metropolitan hospitals, may result in additional burdens for people who choose to donate a kidney or partial liver if they reside in rural, regional or remote locations. This research aimed to gain a better understanding of the emotional, medical, social, financial and practical impacts of this experience for rural people, and explore strategies through which they could be better supported through this experience. A systematic review and in-depth interviews highlighted a unique population willing to undergo a major surgery to help save, or improve the quality of a life; but would benefit from additional emotional, instrumental and educational support to help them navigate the donation process.

Purpose: Clinical transplantation has proven to be a lifesaving method since the last century. The shortage of donors and organs pool for transplantation is a worldwide subject of discussion and legislation. Design/Methodology/Approach: Authors did a critical review and identified actual donation models in individual European countries. Findings: Critical revision of the distribution of donation models in individual European countries were presented: no country has chosen the model of strict consent, 18 countries adopted a model of opt-out, of which 13 were based on a strict model of opposition, and five decided to use an extended opposition system. The extended consent model was adopted in 1/3 of European countries (14 countries), three European countries adopted the information solution, Bulgaria is the only country adopting a higher necessity model. Authors identified in European countries opt-in to opt-out movement trend and “hard” presumed consent paradox. Practical implications: Different models adopted in European countries and the shortage of organs for transplantation implicate some countries' transfer from opt-in to an opt-out model. It can benefit in increasing organ pool. Originality/value: The article includes the first complex and critical analysis of effective organ procurement and legislation models in European countries., peer-reviewed

Introduction: Bone marrow transplantation may be the only hope for those diagnosed with leukemia or other blood diseases. According to data from the Josep Carreras Foundation, the probability of these patients to have a compatible sibling is only 25%, and the probability of finding a relative who is one is 5%. When they do not have a related donor, the goal is to find a compatible unrelated voluntary donor. The existence of myths and beliefs in relation to the bone marrow donation process can develop into a limitation towards obtaining a high number of donors that will be essential to save many lives. The participation of nursing professionals is essential to give visibility and success in donation campaigns, and consequently, an increase in awareness among students of the Degree in Nursing could lead to a better attitude towards bone marrow donations. Objective: To identify the knowledge and attitudes of the Nursing Degree students of the University of Girona regarding bone marrow donation. Methodology: Descriptive, quantitative and cross-sectional study. The study population will be the 1st, 2nd, 3rd and 4th year students of the Nursing Degree at the University of Girona, made up of a total of 545 people. The instrument used is an ad hoc questionnaire with 3 sections: sociodemographic data, knowledge test, and attitude test. The data will be processed with the SPPS computer program, where the quantitative data will be analysed using frequency and percentage tables, and the usual centrality (mean and median) and variability tools (standard deviation and total range). For the crossing of categorical variables, the Chi square independence test and the Student T will be used Introducció: El trasplantament de medul·la òssia pot ser l’única esperança per aquelles persones diagnosticades de leucèmia o altres malalties de la sang. Segons dades de la Fundació Josep Carreras, la probabilitat d’aquests pacients de tenir un germà compatible és de tan sols un 25%, i la de trobar un familiar que ho sigui és d’un 5%. Quan no disposen d’un donant emparentat, l’objectiu és aconseguir un donant voluntari no emparentat que sigui compatible. L’existència de mites i creences en relació al procés de donació de medul·la òssia poden esdevenir una limitació a l’hora d’aconseguir un nombre elevat de donants que seran indispensables per a salvar moltes vides. La participació dels professionals d’infermeria és essencial per a donar visibilitat i èxit a les campanyes de donació, i per tant, un increment de la conscienciació entre els estudiants del Grau en Infermeria podria comportar una millor actitud cap a les donacions de medul·la òssia. Objectiu: Identificar els coneixements i les actituds dels i de les estudiants del Grau d’Infermeria de la Universitat de Girona davant la donació de medul·la òssia. Metodologia: Estudi descriptiu, quantitatiu i transversal. La població d’estudi seran els estudiants de 1r, 2n, 3r i 4t curs del Grau d’Infermeria de la Universitat de Girona, integrada per un total de 545 persones. L’instrument utilitzat és un qüestionari ad hoc amb 3 apartats: dades sociodemogràfiques, test de coneixements, i test d’actituds. Les dades seran tractades amb el programa informàtic SPPS, on les dades quantitatives seran analitzades emprant taules de freqüència i percentatge, i les eines habituals de centralitat (mitjana i mediana) i de variabilitat (desviació estàndard i rang total). Per a l’encreuament de variables categòriques, s’utilitzarà la prova d’independència Khi quadrat i l’Student T

Este artículo se encuentra disponible en la siguiente URL: https://www.sciencedirect.com/science/article/abs/pii/S0041134519311832?via%3Dihub En este artículo de investigación también participan: Carmen Bárcena-Calvo, Catalina Perelló-Campaner, Juan Manuel Arribas-Marin, Silvia García-Mayor, Maria Nelia Soto-Ruíz, Juan Carlos Navalón, Carme Bertran-Noguer, Maria Pilar Peña-Amaro, Maria Francisca Jiménez-Herrera, Rafaela Blanco-Sánchez, Maria Dolores Calvo-Sánchez, María Carmen Prado-Laguna, Alberto González-García, Adelina Martínez-Rodríguez, Pilar Bas-Sarmiento, Francisco Faus-Gabandé, Alicia Muiños-Alvarez, Loreto Peyró-Gregori, Hernández-Martínez Helena, Aida Saez, Álvaro Sánchez, Ana López-Navas, Pablo Ramírez y Pascual Parrilla. This is the pre-peer reviewed version of the following article: Martínez-Alarcón, L., Ríos, A., Santainés-Borredá, E., Agras-Suarez, M. C., Cañadas-De la Fuente, G. A., Hurtado-Pardos, B. et al. (2019). Nursing students' knowledge about organ donation and transplantation: a Spanish multicenter study. Transplantation Proceedings, vol. 51, i. 9 (nov.), pp. 3008?3011, which has been published in final form at https://doi.org/10.1016/j.transproceed.2019.08.019. Este es el pre-print del siguiente artículo: Martínez-Alarcón, L., Ríos, A., Santainés-Borredá, E., Agras-Suarez, M. C., Cañadas-De la Fuente, G. A., Hurtado-Pardos, B. et al. (2019). Nursing students' knowledge about organ donation and transplantation: a Spanish multicenter study. Transplantation Proceedings, vol. 51, i. 9 (nov.), pp. 3008?3011, que se ha publicado de forma definitiva en https://doi.org/10.1016/j.transproceed.2019.08.019 Healthcare professionals and the information that they provide to the public on organ donation and transplantation (ODT) influence attitudes toward this option. Objective: to analyze the knowledge of university nursing students at Spanish universities toward ODT and the factors affecting it. METHODS AND DESIGN: A multicenter, sociological and observational study including university nursing diploma students in a complete academic year. PARTICIPANTS: A sample of 10,566 students was selected stratified by geographical area and year. Instrument: a validated questionnaire of knowledge toward ODT (PCDI-DTO RIOS), self-administered and completed anonymously. RESULTS: Questionnaire completion rate: 85% (n=9001). Only 18% (n=1580) believed that their knowledge about ODT was good, 40% (n=3578) believed that the information they had was normal and 39% that their knowledge was sparse. Of the students, 96% believed that organ needs are not covered and 79% that one might need a transplant in the future. Only 39% (n=3493) had attended a talk about ODT. Furthermore, 83% (n=7435) believed that attending a talk, would it be interesting. The following variables were associated with having a more adequate knowledge: gender (62% men vs. 57% women; P

The bone marrow is a tissue of the organism that is inside of some bones, such as iliac crests and sternum. It is responsible for synthesizing cells called hematopoietic progenitors, known colloquially as stem cells, which give rise to the blood cells that are found in the veins and arteries. The involvement of this tissue due to a haematological disease is reflected in the malfunction of the marrow and, as a result, the anomalies on blood cells. The donation of hematopoietic progenitors allows the treatment of these diseases, but the lack of information disclosure causes real donors to be few. Objective: To create an application (APP) for healthy young people, from 18 to 40 years old, in order to raise awareness of the importance of the donation of hematopoietic progenitors, based on the necessary information, without the need of particular cases. Methodology: To carry out this project, a bibliographic research was carried out during the process, surveys, interviews and social networks were used to verify the response of the population to the possible creation of an application on the donation of the bone marrow. Finally, two computer programs have been used to design the different screens of the application. Results: The needs of the population have been explored about the lack of bone marrow information through different resources. Social networks allow reaching a wide range of people, whether they are interested in the specific topic or not. Finally, the model of the application initially considered has been created, but it would be convenient to carry out a thorough and exhaustive study of the real information needs that are lacking in the population

Donating your organs, is not only about giving but also receiving, Many people await organs on a daily basis to ensure a longer and healthier life. For some, it is a matter of life or death., N/A

Introducció: La conscienciació sobre la donació i trasplantaments d’òrgans en els futurs professionals d’infermeria és primordial ja que són un grup generador d’opinió. L’actitud positiva i els coneixements adequats dels estudiants d’infermeria poden esdevenir un factor important per a la promoció de la donació i trasplantament d’òrgans. Objectiu: L’objectiu d’aquest estudi va ser descriure els coneixements, informació i actitud sobre la donació i transplantaments d’òrgans en els estudiants d’infermeria de la Universitat de Girona. Material i mètodes: Es van seleccionar estudiants de segon, tercer i quart curs als qual se’ls va distribuir una enquesta de 34 preguntes per mesurar l’actitud i coneixements dels estudiants. Es van utilitzar els estadístics descriptius per analitzar els resultats obtinguts. Resultats: Es van obtenir 188 qüestionaris: 76 de 2n curs, 87 de 3r curs i 25 de 4t curs. La mitja d’edat va ser de ±22,56 anys i el rang d’edat entre els 19-46 anys. La distribució per sexe va ser de 158 dones/30 homes. El 57,45% dels estudiants tenien una actitud favorable al tema, el 41,49% tenien una actitud indiferent i el 1,06% ha tingut una actitud desfavorable. La postura sobre la donació i trasplantament d’òrgans ha estat del 96,3% a favor d’aquesta pràctica. El 26,1% dels estudiants tenen coneixements adequats, el 63,2% suficients i bàsics i el 11,7% coneixements insuficients. Conclusió: Els estudiants d’infermeria de la Universitat de Girona disposen d’actitud i coneixements favorables a la donació i trasplantament d’òrgans, tot i que seria necessària la millora sobre el tema per donar eines i autoconfiança en aquesta àrea als futurs infermers Introduction: The awareness about organ donation and transplantation in the future nursing professionals is essential because they are an influential group. The positive attitude and appropriate knowledge of nursing students can become an important factor for promoting organ donation and transplantation. Objective: The objective of this study was to describe the knowledge, attitude and information of organ donation and transplantation in nursing students at the University of Girona. Material and methods: We choose students in second, third and fourth grade to whom we gave a survey about 34 questions so as to measure the students’ attitude and knowledge. We used descriptive statistics to analyze the results. Results: We collected 188 questionnaires: 76 in second year, 87 in third year and 25 in the fourth year. The average age was ±22, 56 years and the ages ranging from 19-46 years. Gender distribution was 158 women/30 men. In this study 57.45% of the students had a positive attitude on the issue, 41.49% had an indifferent attitude and 1.06% had an unfavorable attitude. Their position on organ donation and transplantation was 96.3% in support of this practice. The 26.1% of the students had appropriate knowledge, 63.2% had sufficient and basic knowledge and 11.7% had insufficient knowledge. Conclusions: Nursing students at the University of Girona have favorable attitude and knowledge on organ donation and transplantation, although it would need to improve on this issue to give self-confidence and tools to the future nurses on this area

Espanya és el setè país d’Europa en donació de progenitors hematopoètics i el quinzè de tot el món. Aquesta situació, conjuntament amb l’impacte que pot tenir la Universitat en la captació de donants, han fet que es plantegés una intervenció comunitària anomenada “Apunta’t a la llista de donar vida”, centrada en la donació de medul·la òssia a partir de la comunicació i el màrqueting social com a elements de comunicació en salut. L’objectiu del projecte és avaluar l’efectivitat de la campanya que es portarà a terme a la Universitat de Girona i que està destinada als estudiants, i com a objectius més específics conèixer les característiques socials i educatives dels donants universitaris i identificar el mode i la procedència de la informació rebuda sobre la donació. Aquesta campanya està planificada per tenir una durada de dos mesos i ser realitzada a les instal·lacions de la Universitat de Girona. En la planificació d’aquesta intervenció s’ha emprat una combinació de promoció i comunicació de la salut, i màrqueting social, més concretament, el model SMART, utilitzant material imprès, xarxes socials i activitats informatives i comunitàries. S’espera que la intervenció comporti un increment de donants entre els estudiants universitaris, una major sensibilització sobre la leucèmia i altres malalties les quals requereixen un trasplantament de medul·la òssia, i una millora de la qualitat de vida de les persones afectades per aquest problema de salut Spain is the seventh country in Europe on donation of hematopoietic stem cell and the fifteenth worldwide. This situation, together with the impact that University may have in attracting donors have resulted in the community intervention action plan called "Join the list to give life", focused on the donation of bone marrow through communication and social marketing and health communication elements. The aim of the project is to evaluate the effectiveness of the campaign that will be held at the University of Girona and is aimed for students, and more specifically aims to meet the social and educational characteristics of university donors and identify the way and source of information received about the donation. This campaign is scheduled for a duration of two months and was conducted at the premises of the University of Girona. To plan this intervention a combination of promotion and health communication and social marketing has been used, more specifically, the SMART model, using printed material, social networks and information and community activities. It is expected that the intervention results in an incrementation of donations among university students, a greater awareness of leukemia and other diseases that require bone marrow transplant, and improvements in the quality of life of people affected by this health problem

La consolidación del trasplante de órganos como terapia efectiva para múltiples patologías, ha permitido mejorar la calidad de vida de personas cuya salud se veía seriamente comprometida hace apenas 30 años, cuando no existía tratamiento alternativo y su fallecimiento era inevitable. El presente trabajo se ha realizado durante el periodo de octubre de 2014 hasta mayo de 2015 en Barcelona y pretende determinar cuáles son los factores que influyen en la enfermera para promover la donación de órganos. Enfermería, atiende cada día a pacientes en lista de espera de órganos en diferentes unidades destinadas a ello, este contacto dota a la enfermera de una visión más cercana de la realidad a la que se enfrentan cada día estos pacientes. Los estudios consultados para incrementar las donaciones, vinculan la necesidad de especializar al personal de enfermería para transmitir la información a las familias, determinar las actitudes más beneficiosas que ha de tener el personal y la resolución de dudas de algunos enfermeros acerca del diagnóstico de muerte cerebral. OBJETIVO: Identificar los factores que influyen y repercuten en las enfermeras a la hora de promover la donación de órganos. Método: el estudio será cuantitativo, observacional, descriptivo y transversal. Los datos se recogerán mediante la encuesta validada de Chernenko (anexo D), esta será realizada por las enfermeras del Hospital Universitario de Bellvitge. Conclusión: con la realización de este trabajo he podido conocer la influencia que enfermería posee para promover la donación de órganos y los factores que contribuyen a ello. The consolidation of organ transplantation as an effective therapy for many diseases, has improved the quality of life of people whose health was seriously compromised just 30 years ago, when there was no alternative treatment and death was inevitable. This work was carried out during the period October 2014 to May 2015 in Barcelona and aims to identify the factors that influence the nurse to promote organ donation. Nursing, attends each day to patients on the waiting list for organs in different units to do that, this contact gives to nurse a closer view of the reality that these patients face every day. Studies consulted to increase donations, linked the need to specialize nurses to transmit information to the families, to determine the most beneficial attitudes that must take the staff and the resolution of questions of some nurses on the diagnosis of brain death. OBJECTIVE: To identify factors that influence and impact on nurses to promote organ donation. METHOD: The study will be quantitative, observational, descriptive and transversal. Data will be collected using the validated survey of Chernenko (Annex D), this will be done by nurses at the University Hospital of Bellvitge. CONCLUSION: With the completion of this work I have known the influence that nursing has to promote organ donation and the factors that contribute to it. Grau en Infermeria

M.Cur. (Intensive General Nursing) Knowledge and technological advancement in the field of transplantation has increased the demand for organ donation. However, the supply of organs does not meet this demand, especially, among the black communities. Literature reviewed associate this imbalance with the few sources of organs, the technique of organ retrieval, discrepancies in the allocation of organs and sociocultural factors. The aim of this study was to investigate the extent to which the Zulu cultural norms and social structural dimensions influence an individual's decision to donate an organ or to undergo a transplantation, based on the theoretical assumptions of Leininger and Chrisman. A qualitative approach using an ethno- nursing method was selected, semi-structured interviews were conducted with the transplant co-ordinator representing the professional sector, the religious leaders and traditional healers representing the folk sector and the general public representing the popular sector of the health care system. The respondents were extracted from both the urban and rural settings. The conclusions arrived at were that there is lack of knowledge among the Zulu speaking people on organ donation and transplantation, related mainly to misconceptions associated with their life patterns, beliefs about death, burial and life hereafter, values and social structural dimensions. The recommendations with regard to the promotion of organ donation and transplantation among the Zulu speaking people were made based on culture sensitive and culture congruent principles, namely: • Cultural care preservative or maintenance such as ancestor worship, extended families etc. • Cultural care accommodation or negotiation such as their knowledge of anatomy and physiology of the human body especially the transplantable organs and their fear to discuss death, etc. • Cultural care repatterning and restructuring such as culture sensitive educational campaigns to dispel the fears and correct misconceptions.

Treballs Finals de Grau Antropologia Social i Cultural, Facultat de Geografia i Història, Universitat de Barcelona, Curs: 2013-2014, Tutor: Sílvia de Zordo, El auge de las técnicas de reproducción asistida ha generado una gran demanda de óvulos que desde el año 2009 ascendió un 80%1. Pero no todas las aspirantes podrán finalmente convertirse en donantes de óvulos. Deberán pasar un proceso de selección que admitirá a menos de la mitad de aspirantes y que finalmente donarán sus óvulos para la reproducción o para la investigación. De estas consideraciones, deriva el objetivo central de este artículo que radica en el análisis de los criterios de selección de las donantes de óvulos en las clínicas de reproducción asisti-­‐ da de Barcelona. Paralelamente, se analizan las configuraciones de las concepciones sobre la maternidad que puedan producirse tras la experiencia de la selección de donantes en las clínicas de reproducción asistida de Barcelona, y de la donación.

INTRODUCCIÓN: España pese a ser líder a nivel mundial en donación y trasplante de órganos, en lo que a donación de médula ósea y progenitores hematopoyéticos se refiere, existe un gran desconocimiento por parte de la población. OBJETIVO: Analizar y verificar si al ofrecer herramientas y recursos informativos sobre en qué consiste la donación de progenitores hematopoyéticos a aquellos estudiantes ya donantes de sangre, se obtendrá un incremento de donantes voluntarios, con respecto a los estudiantes que no reciben dicha información. MÉTODO: Se aborda el tema a través de un estudio Analítico Experimental Aleatorizado, en las Escuelas Universitarias de Enfermería Gimbernat Adscrita a la UAB (Sant Cugat del Vallés), en el mes de Junio de 2014. Participarán aquellos estudiantes que asistan a la Unidad Móvil de Donantes de Sangre el día concretado. La recogida de muestra se realizará seleccionando a 30 estudiantes de manera aleatoria, dividiéndolos en dos grupos formados por 15 individuos cada uno. Se abordará actuando sobre uno de los grupos (B) proporcionando información mediante trípticos informativos sobre el proceso y procedimiento de la donación de médula ósea y progenitores hematopoyéticos, mientras que al grupo (A), no se le facilitará ningún tipo de información al respecto. RESULTADOS Y CONCLUSIONES: El estudio realizado indicará qué porcentaje de estudiantes accede voluntariamente a formar parte del registro de donantes de médula ósea a nivel mundial y permitirá evaluar si resulta o no efectiva la información aportada. PALABRAS CLAVES: Donación, médula ósea, progenitores hematopoyéticos, trasplante de médula ósea INTRODUCTION: Nowadays, Spain is the world leader of donation and organs' transplantation, but in what concerns to bone marrow donation and hemathopoyetic parents, there is a big lack of knowledge between people. OBJECTIVE: Analyse and verify if by offering tools and informative sources about in what consists the donation of hemathopoyetic parents to those students who already are blood donors, we could get an increase of voluntary donors, comparing with those students who doesn't get that information. METHODS: The theme is touched through an analytic experimental aleatory study in university school of nursery Gimbernat of UAB (Sant Cugat del Vallés), in June of 2014. Will participate those students who assists to blood donors' mobile unit the day referred. The blood samples will be taken from 30 aleatory students, splitting them into two groups of 15 persons each. The group B will receive information with triptychs about the process and the procedure of bone marrow donation and hemathopoyetic parents, and the group A will not receive any kind of information. RESULTS AND CONCLUSIONS: The study will indicate the percentage of students who accept voluntarily forming part of the world register of bone marrow donors and will allow evaluate if the information is effective or not. KEY WORDS: donation, bone marrow, hemathopoyetic parents, bone marrow transplantation Grau en Infermeria

Made available in DSpace on 2014-08-13T14:50:47Z (GMT). No. of bitstreams: 0 Previous issue date: 2013-02-28Bitstream added on 2014-08-13T18:00:32Z : No. of bitstreams: 1 000758423.pdf: 387299 bytes, checksum: e1e2ab570b813a368d9fbf9b88984285 (MD5) O transplante de face é um procedimento cirúrgico no qual as estruturas da face de uma pessoa são transplantadas para outra. É uma cirurgia ousada do ponto de vista médico, moral e psicológico, pois, proporciona enorme benefício em termos de melhora da função estética e integração social. Avaliar o conhecimento e a opinião da população sobre o transplante e a doação dos tecidos da face. No período de agosto de 2011 a outubro de 2012 foi aplicado um questionário a 430 pessoas, escolhidas aleatoriamente, na faixa etária acima de vinte e um anos de idade, numa sistemática de coleta seguida em todas as regiões (norte, sul, centro, leste e oeste) da cidade de Botucatu, interior do Estado de São Paulo. O estudo das respostas dos participantes nas diferentes questões objetivas apresentadas foi realizado estabelecendo-se a distribuição frequencial dos dados apresentada por meio de tabelas ou gráficos e analisadas pelo teste do Qui quadrado ( א) para uma amostra. A análise das respostas obtidas foram discutidas ao nível de 5% de significância e consideradas significativas quando o valor de p foi < 0,05, mostrando que a distribuição não é uniforme, mas uma distribuição uniforme das classes. Nas questões dissertativas a análise foi realizada a partir da leitura das mesmas, com elaboração de um resumo das respostas e análise preferencial por região. Dos participantes, 65,8% não possuem conhecimento a respeito da doação dos tecidos da face; 90,1% têm conhecimento que o transplante de face está indicado nos casos de deformidades faciais; 51,7% doariam a face; 67,7% não saberiam como seus familiares reagiriam frente a sua manifestação em vida de doar os tecidos da face; 84% não sabem as implicações sobre as cerimônias fúnebres. Dos participantes, 359 aceitariam conviver com outra face caso fosse necessário e 375 apoiariam se algum familiar manifestasse vontade em ser um doador. A população demonstrou ... The face transplantation is a surgical procedure in which facial structures are transplanted from one person to another. It's a complex procedure on a medical point of view, moral and psychological, therefore provides many benefits in terms of improving aesthetic function and social integration. To evaluate the knowledge and opinion of the population about the donation and transplantation of facial tissues. From August 2011 to October 2012 a questionnaire was administered to 430 people, randomly selected, with twenty-one years of age or older, systematically collected in all regions (north, south, center , east and west) of the city of Botucatu, state of São Paulo. The study of the objective responses of all participants in the different issues was accomplished by establishing a frequential distribution data presented using tables and graphs and analyzed by chi square (à) for a sample. The analysis of the responses were discussed at the 5% level of significance and considered significant when the p value was

M.Cur. Various factors influence the process of organ donation. As a result there is a shortage of organs for transplant. Poor communication and cooperation between transplant coordinators and intensive care nursing staff can lead to the non-referral of potential organ donors, which is detrimental to the process. The purpose of the research is to ascertain the attitude and knowledge of the transplant coordinators and intensive care nursing staff who work in intensive care units during organ donation and to draw up guidelines for the improvement of communication and cooperation between them. Contextual descriptive research was done by compiling literature based questionnaires, one each for the transplant coordinators and intensive care nursing staff and then analysing responses. The indications are that problem areas exist between the role players in the organ transplant process. This results in the insufficient referrals from intensive care units which are detrimental to the organ donation process. From this research, the following guidelines can be drawn up to promote organ donation: To provide a policy manual regarding organ donation for every intensive care unit. The respective roles of the transplant coordinator and intensive care nursing staff in the organ donation process must be clarified. Awareness campaigns should be held to promote organ donation. Feedback should be given by transplant coordinators and intensive care nursing staff regarding transplant occurrences. Role models in practical situations should be identified. An education programme regarding organ donation should be implemented. Emotional support programmes should be available to health personnel.

Organ nakli, ancak organ nakli ile iyileşebilecek hastalar için uygulanan çok önemli bir tedavi yöntemidir. Ancak, genel duruma baktığımızda Türkiye'de 2011 yılında toplam 3930 organ bağışlanmış, 2012'nin başında organ bekleyen hasta sayısı 20954 olarak Nisan 2012'de açıklanmıştır. Bağış sayıları ve bekleyen hasta sayısı arasındaki bu fark sadece Türkiye'de değil, Amerika gibi diğer tüm gelişmiş ülkelerde de bu sorunla karşılaşılmaktadır. Bu nedenle bağışlanan bir organın en uygun alıcıyla eşleşme süreci tüm organ nakil süreçlerindeki en önemli süreçlerden biridir. Genel olarak eşleşme yöntemleri iki farklı şekilde yürütülmektedir: merkezi ve hiyerarşik yöntem. Merkezi yöntemde, tüm bağışlanan organlar ve organ bekleyen hastalar merkezi tek bir listeden eşleşmektedirler. Hiyerarşik yöntemde ise bağışlanan organ alt tabandan başlayarak yukarıya doğru (şehir, bölge ve ülke) uygun alıcıyı aramaktadır. Organ nakli süreçleri Türkiye'de bir ulusal koordinasyon merkezi ve buraya bağlı 9 bölge koordinasyon merkezi tarafından yürütülmekte olup hiyerarşik yöntemle eşleşmeler sağlanmaktadır. Hiyerarşik eşleşme yönteminin performansı bölgelerin yapısıyla bağlantılı olduğu için bölgelerdeki bölge koordinasyon merkezlerinin yerleri ve buralara atanan iller büyük önem kazanmaktadır. Organ nakli incelendiğinde soğuk iskemi süresi ? bağışlanan organın içinde kan akışı olmadan dayanabildiği süre ? ameliyat süreleri ve nakil merkezleri ve ekipleri gibi faktörler bulunmaktadır.Bu tezde organ nakli lojistiğinin Türkiye uygulaması üzerine çalıştık. Bu çalışmada matematiksel modelleme ile problemin temel kısıtlar doğrultusunda bölgelerin oluşturulması amaçlanmıştır. Ayrıca iki farklı ulaşım tipinin bir arada dikkate alındığı matematiksel modelleme ile de gerçek sistemde sıkça kullanılan helikopter kullanımı modele yansıtılmıştır. Ayrıca bir benzetim modeli de oluşturarak matematiksel model çıktılarının gerçek hayat uygulamasında nasıl performans göstereceği değerlendirildi. Tüm çalışmada Türkiye'ye ait bilgiler kullanıldı ve sonuçlar mevcut sistemle karşılaştırıldı. Organ transplantation is one of the fundamental and effective treatment techniques for the patients who have critical health problems. However, while 3,930 organs were transplanted to the patients in 2011, there still exist 20,954 people waiting for a suitable organ as of April 2012 in Turkey. Even though the exact numbers are different; the situation of well developed countries like USA is not very different in terms of organ donation and patient ratio. Thus; matching - defined as finding the best recipient for a donated organ- is very crucial for the overall organ transplantation process. There are mainly two different ways of matching in the applications: centralized and hierarchical method. In the centralized method, all patients and donors are monitored and matching is coordinated centrally. In the hierarchical method, the matching process is coordinated via a bottom-up hierarchy. The application in Turkey is also hierarchical, coordinated by nine regional coordination centers and one national coordination center. Due to the nature of the matching application in Turkey, the cluster of each regional coordination center is crucial. There are many dynamics of the transplantation process like cold ischemia time -the duration that the organ survives without blood circulation-, operation times and specialized hospitals and teams.In this thesis, we study the organ transplantation logistics mainly focusing on the Turkish application. We provide mathematical models that consider the problem specific requirements like ischemia time. We also consider two-mode transportation since airplanes or helicopters are also used widely in organ transportation. Finally, we also developed a simulation model to observe the hierarchical nature of the system and to evaluate the performance of the mathematical model outputs. Both mathematical model and simulation model outcomes based on Turkish data were compared with actual regional coordination center locations of Turkey. 125

Objective: This research tested the role of traditional rational-cognitive factors and emotional barriers to posthumous organ donation. An example of an emotional barrier is the “ick” factor, a basic disgust reaction to the idea of organ donation. We also tested the potential role of manipulating anticipated regret to increase intention to donate in people who are not yet registered organ donors. Design: In three experiments involving 621 members of the United Kingdom general public, participants were invited to complete questionnaire measures tapping potential emotional affective attitude barriers such as the “ick” factor, the desire to retain bodily integrity after death, and medical mistrust. Registered posthumous organ donors were compared with nondonors. In Experiments 2 and 3, nondonors were then allocated to a simple anticipated regret manipulation versus a control condition, and the impact on intention to donate was tested. Main Outcome Measures: Self-reported emotional barriers and intention to donate in the future. Results: Traditional rational-cognitive factors such as knowledge, attitude, and subjective norm failed to distinguish donors from nondonors. However, in all three experiments, nondonors scored significantly higher than donors on the emotional “ick” factor and bodily integrity scales. A simple anticipated regret manipulation led to a significant increase in intention to register as an organ donor in future. Conclusions: Negative affective attitudes are thus crucial barriers to people registering as organ donors. A simple anticipated regret manipulation has the potential to significantly increase organ donation rates.

176 f. Submitted by Ana Valéria de Jesus Moura (anavaleria_131@hotmail.com) on 2013-08-08T13:06:40Z No. of bitstreams: 1 TACIANA PALMEIRA ANDRADE.pdf: 717253 bytes, checksum: c8857f412a3564ee49e95e9e34112dd5 (MD5) Approved for entry into archive by Ana Valéria de Jesus Moura(anavaleria_131@hotmail.com) on 2013-08-08T13:12:32Z (GMT) No. of bitstreams: 1 TACIANA PALMEIRA ANDRADE.pdf: 717253 bytes, checksum: c8857f412a3564ee49e95e9e34112dd5 (MD5) Made available in DSpace on 2013-08-08T13:12:32Z (GMT). No. of bitstreams: 1 TACIANA PALMEIRA ANDRADE.pdf: 717253 bytes, checksum: c8857f412a3564ee49e95e9e34112dd5 (MD5) Previous issue date: 2009 O presente trabalho tem como objetivo principal demonstrar a possibilidade do ordenamento jurídico brasileiro abarcar a hipótese de escolha pelo doador do destinatário dos seus órgãos na doação de órgãos post mortem. Inicialmente, busca-se enquadrar o direito ao próprio corpo como direito da personalidade, relativizando o caráter de indisponibilidade desses direitos de forma a reconhecer a incidência da autonomia privada em seu campo. Ainda, será analisado o princípio da autonomia na sua concepção bioética e sua influência na determinação da possibilidade da escolha pelo doador de órgãos post mortem. Outrossim, ficará demonstrado que o sistema atual possui falhas e que a compatibilização do modelo atual com a possibilidade de escolha pelo doador é possível,utilizando-se como parâmetro o tratamento dado à doação em vida no direito pátrio, bem como na legislação estrangeira. Salvador