General Abstract Objective: In April 2006, the Scottish Liver Transplant Unit (SLTU) became the first NHS transplant unit in the UK to offer the option of Living Donor Liver Transplantation (LDLT). This represented a unique opportunity to evaluate the functional and psychosocial impact of LDLT upon healthy donors and their recipients. Subsequent aims were to investigate the challenge of introducing LDLT in Scotland and to establish the perceived deterrents and attractions of the procedure. An additional aim was to evaluate the impact of Living Donor Kidney Transplantation (LDKT) upon donors and recipients. Design: A series of cross sectional and longitudinal studies were designed for the purpose of this thesis (3 quantitative, 2 qualitative, and 1 mixed methods). Method: Self report questionnaires were used in each of the quantitative studies, with the addition of neuropsychological computerized tests in two studies. Semi-structured interviews were employed in the qualitative studies. Main Findings: •Prior to its introduction general support for the option of LDLT was found, although it was highlighted that the risk involved was not well understood by the general public. •Since becoming available LDLT has not been a readily acceptable treatment option from the perspective of patients due to the perceived risk for the donor, but it may be considered as a “last option”. Family members were motivated to save their loved one’s life but the personal implications of donating resulted in reconsideration of LDLT. • Staff at the SLTU perceived a lack of family commitment in relation to LDLT, which is explained as a cultural factor contributing to the slow uptake of LDLT. In Scotland, a donation from a younger to an older generation is not easily accepted. This, in addition to patients’ optimism that a deceased donation will arrive, and the poor health of potential donors, is thought to have affected the uptake of LDLT. As has the unit’s conservative approach to the promotion of LDLT. This approach is the result of a perceived reduction in the need for LDLT and a preference to avoid the risk to a healthy donor and conduct transplants with deceased donations. • In over 3 years, only one couple completed LDLT. The recipient showed functional and psychosocial improvement from pre to post procedure, whilst the donor showed slight deterioration in aspects of quality of life 6 weeks post donation, which did not always completely return to a baseline level by 6 months. The donor made sacrifices to provide her husband with a fresh start to life and unmet expectations were found to effect quality of life. •Willingness to become a liver donor is not thought to be influenced by the frame of the information provided. •Like the LDLT donor, LDKT donors experience some functional and psychosocial deterioration at 6 weeks post donation, but donors largely recover by 6 months post donation. However, the anticipated benefit to recipients was not evident and may not be quantifiable until after 6 months post operation. Conclusion: This thesis has added to current knowledge on living organ donation and specifically represents the first psychological evaluation of a UK LDLT programme. The slow uptake of LDLT was unexpected and has resulted in informative, novel research.

No description available.

A escala Blood Donation Reactions Inventory (BDRI) foi originalmente proposta por Meade et al. (1996) como parte de um estudo dos preditores psicológicos de reações em doadores voluntários. É composta por 11 itens respondidos pelo doador, cada um correspondendo a uma reação ou sensação referente à doação de sangue mais recente. Na literatura, a escala BDRI é associada à probabilidade de retorno de doadores de sangue, o que sugere que o instrumento é uma ferramenta efetiva para predizer se um doador realizará novas doações. O objetivo do presente estudo é traduzir para a língua portuguesa o BDRI e estudar a confiabilidade e consistência interna desta versão traduzida, bem como sua validade de critério e de constructo. O BDRI traduzido apresentou CVI superior a 80% em todos os itens e razoável consistência interna, além de mostrar que grande parte dos doadores que apresentaram pelo menos um sintoma eram primodoadores (42%) e que mais mulheres (32%) que homens (20%) relataram algum sintoma. Concluímos que os objetivos do trabalho de traduzir para a língua portuguesa e validar o BDRI foram atingidos. Esta pesquisa traz para a língua e cultura brasileiras um instrumento útil em pesquisas na área de hemoterapia. / The Blood Donation Reactions Inventory ( BDRI ) was originally proposed by Meade et al . (1996) as part of a study of the predictors of psychological reactions volunteer donors. It consists of 11 items answered by the donor , each corresponding to a reaction or feeling related to blood donation lately. In the literature , the scale BDRI is associated with the probability of return of blood donors , suggesting that the instrument is an effective tool to predicting whether a donor will carry out further donations . The aim of this study is to translate into Portuguese languagethe BDRI and study the reliability and internal consistency of this translated version, as well as its criteria validity and construct validity. The translated BDRI showed CVI more than 80 % on all items and reasonable internal consistency and showed that most of the donors who had at least one symptom were donating blood for the first time (42%), beyond showing that women reported more symptoms (32%) than men (20%). We conclude that the objectives of the work to translate into Portuguese and validate BDRI been achieved. This research brings to the Brazilian language and culture a useful tool for research in hematology.

A escala Blood Donation Reactions Inventory (BDRI) foi originalmente proposta por Meade et al. (1996) como parte de um estudo dos preditores psicológicos de reações em doadores voluntários. É composta por 11 itens respondidos pelo doador, cada um correspondendo a uma reação ou sensação referente à doação de sangue mais recente. Na literatura, a escala BDRI é associada à probabilidade de retorno de doadores de sangue, o que sugere que o instrumento é uma ferramenta efetiva para predizer se um doador realizará novas doações. O objetivo do presente estudo é traduzir para a língua portuguesa o BDRI e estudar a confiabilidade e consistência interna desta versão traduzida, bem como sua validade de critério e de constructo. O BDRI traduzido apresentou CVI superior a 80% em todos os itens e razoável consistência interna, além de mostrar que grande parte dos doadores que apresentaram pelo menos um sintoma eram primodoadores (42%) e que mais mulheres (32%) que homens (20%) relataram algum sintoma. Concluímos que os objetivos do trabalho de traduzir para a língua portuguesa e validar o BDRI foram atingidos. Esta pesquisa traz para a língua e cultura brasileiras um instrumento útil em pesquisas na área de hemoterapia. / The Blood Donation Reactions Inventory ( BDRI ) was originally proposed by Meade et al . (1996) as part of a study of the predictors of psychological reactions volunteer donors. It consists of 11 items answered by the donor , each corresponding to a reaction or feeling related to blood donation lately. In the literature , the scale BDRI is associated with the probability of return of blood donors , suggesting that the instrument is an effective tool to predicting whether a donor will carry out further donations . The aim of this study is to translate into Portuguese languagethe BDRI and study the reliability and internal consistency of this translated version, as well as its criteria validity and construct validity. The translated BDRI showed CVI more than 80 % on all items and reasonable internal consistency and showed that most of the donors who had at least one symptom were donating blood for the first time (42%), beyond showing that women reported more symptoms (32%) than men (20%). We conclude that the objectives of the work to translate into Portuguese and validate BDRI been achieved. This research brings to the Brazilian language and culture a useful tool for research in hematology.

社會大眾之發票與零錢捐獻是民間社福團體所仰賴的收入來源之一，但近年來由於統一發票新政策的推行，加上大眾的消費行為開始改變，導致民眾捐獻的機會與意願逐漸下滑，而影響社福團體之公益運作。本研究的目的是為了提出一項創新的經營模式解決此捐獻缺乏的社會問題，藉由結合發票、公益彩券制度、零錢捐獻之行為、連鎖零售業者與政府公益組織之資源，賦予公益行為一個報酬機制，提升大眾捐獻意願，以擴大臺灣社會之捐獻基礎與價值。 為了尋求可行之商業模式，本研究透過市場需求分析，調查目前臺灣消費者之生活趨勢、統一發票政策推行現況與社福團體之困境，並藉由問卷調查、訪談社福團體與各類潛在消費者深入確認實際需求與創新服務之可行性。最後，經由前述分析，本研究提出一個能滿足社會需求並能讓服務參與者共同獲益的解決方案，其中包括消費者的參與方式、廠商合作模式、利潤分配方式，以及針對不同時期之目標族群研擬之營運計畫。 / Receipt lottery and donation box play important roles in the source of income for social welfare organizations (SWOs) nowadays. However, after the reform of receipt policies in recent years, the receipt taking behaviors of consumers have changed. In general, the willingness of consumers to donate receipt has been declining. This decrease of donation seriously damaged the operation of the SWOs. The purpose of this research is to propose an innovative business model to solve this social problem. By connecting the resources of retail chain business and government, the business model initiates the incentives of major consumers (self-interested and reputation seeking) to contribute the charity in the process of consumption based on the empirical study of the consumers’ behaviors of donating receipt /change and purchasing lottery.

This research program aimed to identify the factors that influence the Voluntary Donation payment decision in a cohort of parents (N = 250) with a child (or children) at a New Zealand state school. A voluntary donation is a charitable contribution to the running of the school collected from the parents of the school’s students. A survey questionnaire was constructed to examine the attitudes parents hold towards the voluntary donation funding system, the current New Zealand Government and the school the respondent’s child attends. The parents were ‘naturally’ separated into two conditions based on their last voluntary donation payment decision – Paid versus Not Paid – to compare the differences in attitudes on the various statements from the survey and their demographic composition. The results revealed that payment decision was positively correlated with educational achievement, annual household income and age. Individual contributions exhibited strong positive relationships with beliefs about the contributions of others, which was consistent with previous public goods field experiments. The research extended the existing public goods research by examining the social norms of voluntary donation behaviour and assimilating the results with theories of altruism, conditional cooperation and reciprocity. The strongest overall contribution to the prediction of payment decision was parents’ attitudes towards the current Government and the voluntary donation funding system. The results identified that pressures existed in the voluntary donation environment, a result most prevalent in high decile schools. Additionally, a marginal level of comprehension of the voluntary donations characterised the majority of respondents. Overall, the research found that the best predictor of contribution was attitudes towards the voluntary donation funding system.

Gamete donors are actively searched by companies dedicated to assisted reproduction in the Spanish State, and advertising is not only legal but rather common. This thesis provides an overview of the main themes that arise from the analysis of mostly visual materials used to promote ovum donation in public spaces in Barcelona, and critically links them to current debates in intersectional feminist cultural studies of technoscience, bodily theory and visual studies. Conceptual and affective tensions between characterisations of women’s bodies, reproductive function and desires are identified and brought forward in terms that imply tropes of sacralisation, reification of cells/organs/tissues, and fragmentation of the bodily reality. It is argued that egg donation advertisements use an imagery that deeply connects with practices well rooted in Western biomedical traditions when it comes to female bodies, physiology and reproductive function, and that such practices are to be understood against the backdrop of neoliberalism. The analysis supports the idea that the publicity discourse of the assisted reproduction industry in Spain actively engages in a legitimation of the desire of biological parenthood as a right, in ways that value lives conceived in different circumstances and geopolitical contexts in radically different ways, and that can be interpreted as paving the way to prosurrogacy and/or eugenic positions. Future research is encouraged and directed towards exploring issues of agency, particularly in vulnerable groups such as migrant, poor, uneducated or racialised women. Further research is needed in order to build the foundations of a feminist ethical reflection on reproductive technologies and particularly of ovum donation.

Bakgrund: Få donationer sker i Sverige idag, det kan därför vara svårt att erhålla och upprätthålla professionell kompetens. Forskning har visat på en uppfattning att potentiella donatorer ibland förbises på grund av organisationsmässiga brister i struktur och riktlinjer. Även bristande kunskap och ett behov av mer utbildning finns beskrivet i flertal studier. Syfte: Att undersöka hur intensivvårdssjuksköterskor uppfattar sin kunskap och beredskap gällande organdonationsprocessen. Metod: Studien var empirisk med kvalitativ ansats. En fokusgruppintervju genomfördes som datainsamling, urvalet bestod av intensivvårdssjuksköterskor som var verksamma på en allmän intensivvårdsavdelning. Innehållsanalys användes för att bearbeta materialet. Resultat: I resultatet framkom fyra huvudkategorier och nio subkategorier. Huvudkategorierna bestod av begränsad erfarenhet, förhållningssätt och bemötande, stöd från omgivningen samt befintlig kunskap och beredskap. Slutsats: Deltagarna föreföll känna trygghet i att den kunskap och beredskap som fanns på enheten som helhet räckte till även om den inte fanns specifikt hos den enskilde. Stöd fanns från kollegor och organisationen. Ett behov av mer kunskap och praktisk erfarenhet antyddes. Att ha reflekterat över det egna förhållningssättet framkom som en del i beredskapen. Klinisk betydelse: En antydan ges om vissa kunskapsluckor vilket skulle kunna beaktas vid introduktion av nyutexaminerade. Studien visar på att tillfällen till praktisk erfarenhet är få vilket betonar vikten av att regelbundet erbjuda kurser och utbildningar för att stärka intensivvårdssjuksköterskan i sin profession. / Background: Few cases of organ donations occur in Sweden today. Therefore it may be difficult to obtain and maintain professional competence. Research has shown perceptions that potential donors may be missed due to organizational weaknesses such as structure and guidelines. Past research has also unveiled lack of knowledge and a need for education. Aim: To examine how intensive care nurses perceive their knowledge and preparedness regarding the process of organ donation. Methods: An empirical qualitative approach was used. The data collection was conducted through the mean of a focus group interview. The sample consisted of intensive care nurses working in a general intensive care unit. Content analysis was used to process the material. Results: Four main categories and nine subcategories were identified. The main categories were limited experience, approach and attitude, the support of colleagues and existing knowledge and preparedness Conclusions: The participants appeared secure about the knowledge and preparedness that existed in the unit. It was considered as sufficient even if it wasn’t possessed at the individual level. Support from colleagues and organization was available, however a need for more knowledge and practical experience was expressed. Self-reflection about personal attitudes emerged as a part of the preparedness. Relevance to clinical practice: It is suspected that some knowledge gaps exist and an introduction to newly graduates about the issue should be made. The study shows that opportunities for practical experience are few which emphasize the importance of providing intensive care nurses with continuing education about the issue in order to strengthen their professionalism.

Cette étude vise à analyser la place occupée par les moines et les monastères, d’un double point de vue pratique et idéologique, dans la société hispanique du haut Moyen Âge, à l’exclusion de la Catalogne et d’al-Andalus. Les fonctions remplies par les monastères sont, pour une part, traditionnelles et conformes à celles qu’ils exercent à la même époque dans d’autres régions de l’Occident chrétien. Le développement du monachisme – c’est-à-dire la fondation de monastères, leur enrichissement par donation et leur capacité à se nourrir de nouvelles recrues – s’explique par la croyance en la doctrine du salut, qui incite chacun à œuvrer pour sa rédemption et celle de ses proches. Mais la profusion de monastères dans la chrétienté péninsulaire tient aussi à d’autres facteurs : stratégies économiques, politiques et mémorielles des élites ; capacité de communautés rurales solidaires à faire émaner d’elles-mêmes de modestes établissements monastiques ; progression des royaumes septentrionaux aux dépens d’al-Andalus. La prolifération des monastères est favorisée par la souplesse des cadres normatifs dans lesquels ils s’intègrent ; il en résulte une grande adaptabilité de forme et de contenu, si bien que les monasteria les plus modestes se distinguent mal de simples églises rurales, l’une de leurs fonctions essentielles étant de servir aux nécessités du culte. Les grands monastères contribuent également à l’encadrement socio-pastoral par l’emprise qu’ils exercent sur les fonctions épiscopales, par la célébration de cérémonies liturgiques ouvertes aux laïcs, par le contrôle d’églises rurales, par la réception d’immunités qui les placent à la tête de véritables seigneuries. La situation frontalière qui caractérise la péninsule Ibérique du haut Moyen Âge confère aux monastères une couleur spécifique. Victimes des assauts musulmans, ils s’engagent en retour dans la défense des territoires chrétiens. Une partie de leurs fonctions habituelles se trouve réorientée, dans un tel contexte, en des applications particulières dont témoignent l’attention au sort des captifs ou le développement, à la fin du XIe siècle, d’une liturgie belliqueuse. Les fonctions sociales remplies par les monastères et le prestige attaché au genre de vie monastique justifient que les moines occupent, en pratique, une position centrale dans le fonctionnement de la société. Celle-ci n’apparaît pourtant pas telle qu’elle laisse émerger, dans les discours, l’idée promue à la même époque par les grands monastères du nord des Pyrénées selon laquelle les moines formeraient l’élite d’une société chrétienne hiérarchisée en fonction d’un critère de pureté, et pourraient prétendre, à ce titre, occuper le sommet de l’ordre du monde. Ancré dans une tradition wisigothique qui participe à expliquer une durable imperméabilité aux courants monastiques ultra-pyrénéens, le monachisme hispanique connaît à la fin du XIe siècle un processus de normalisation qui le fait entrer dans une nouvelle phase de son histoire. / This study aims to analyse, from a double practical and ideological point of view, the place of monks and monasteries in the early medieval hispanic society, apart from Catalonia and al-Andalus. The functions of monasteries were in part traditional and in keeping with the ones they fulfilled elsewhere in the christian West. The rise of monasticism – that is, the foundation of monasteries, their increase in wealth trough donations, their ability to feed themselves with new recruits – may be explained by the belief in the doctrine of salvation, which incited every one to strive for his own redemption and that of his relatives. However, the abundance of monasteries in the peninsular christendom also depended on other factors : economic, political and memorial strategies of the elite ; ability of rural communities to make appear from themselves small monasteries ; expansion of the northern realms at the expense of al-Andalus. The proliferation of monasteries was boosted by the fluidness of the normative framework in which they took place and which favoured a wide range of formal adaptation, in such a way that many modest monasteria were not easy to distinguish from simple rural churches – one of their essential functions being to serve as places of worship. The big monasteries also took part in the social control and pastoral care, thanks to the hold on the episcopal functions, celebration of liturgical ceremonies opened to lay people, ownership of rural churches and privileges of immunity that put them at the head of authentic seigniories. The border situation of the early medieval Iberian Peninsula gave to monasteries a peculiar tone. As well as they suffered from the muslim assaults, they took part in the defence of the christian territories. In such a context, part of their usual functions were redirected to specific applications, of which the attention to the lot of prisoners or the development of a bellicist liturgy at the end of the 11th century are good examples. The social functions assumed by monasteries and the prestige of the monastic way of life explain that the monks, in practical terms, held a central position in the running of society. However, this role was not enough to make emerge, in discursive terms, the idea – promoted at the same time by some big monasteries north of the Pyrenees – that the monks were the elite of a christian society hierarchically organized by a criterion of purity and claimed, for that very reason, to be at the top of the social order. The visigothic tradition in which hispanic monasticism was rooted may partly explain that it remained for long impervious to the ultra-pyrenean monastic trends. At the end of the 11th century, a process of normalization drove the iberian monasteries into a new phasis of their history.

Around one million tonne of food is annually wasted in Sweden, of which 100,000 tonne of surplus foodis wasted in the retail sector. Even if redistribution of surplus food is the second most preferable optionto reduce food waste according to the food waste hierarchy, only 5% of surplus food in retail is donated.At the same time, food insecurity is a global as well as a Swedish concern. In 2017, 6% of the Swedishpopulation had a low-income standard, and food banks are currently reporting an increasing demand forfood support. The goal of the study was to investigate surplus food donations from grocery stores tofood banks as an approach to address the paradox of food waste and food insecurity. It was done byidentifying challenges and potential lock-in factors, and by analysing practices and success factors toidentify potential best-practices. The study was a qualitative case study and used the sustainabilitytransition framework ‘multi-level perspective’ (MLP) for analysis. The study took part in a collaborationproject to produce a handbook for surplus food donations in retail, which aims to guide actors in retailhow to reduce avoidable food waste by increasing donations. The results showed that there are some basic conditions that are needed for surplus food donations totake place in a safe way. These can be fulfilled in diverse ways, which have been analysed together withsuccess factors and learnings from the literature to give examples of ‘good enough’ practices and bestpractises. This division of ‘good enough and ‘best’ was made to address that small, volunteer-led foodbanks and larger, more experienced ones have quite different opportunities and challenges. Grocerystores also seem to face various practical, economic, and managerial challenges to donating their surplus.The analysis of the challenges showed some potential lock-in factors that contribute to obstructingsurplus food donations to be an integrated part of the food regime. These lock-in factors are mainlyrelated to the devaluation of ecological and social costs of food waste and the low political priority,thereby sustaining a lack of funding, and a ‘waste as a resource’-thinking. Even if there are severalpotential lock-ins that might need to be ‘unlocked’ for surplus food donations to be a part of a radicaltransition to a more sustainable food system, there are still several of the ‘good enough’- and bestpractices that can be implemented to incrementally improve the resource efficiency of the current foodsystem. Surplus food donations may, however, be a key component in the transition towards asustainable food system. / Omkring en miljon ton mat slängs årligen i Sverige, varav 100 000 ton överskottsmat slängs idetaljhandeln. Trots att omfördelning av överskottsmat rankas som det näst bästa alternativet för attminska matsvinnet enligt resurshierarkin för livsmedel, doneras endast 5 % av överskottsmaten idetaljhandeln. Samtidigt är matfattigdom såväl ett globalt som svenskt problem, 2017 hade 6 % av densvenska befolkningen en låg inkomststandard, och livsmedelsbanker rapporterar om en ökandeefterfrågan på mathjälp. Målet med studien var att undersöka donationer av överskottsmat frånlivsmedelsbutiker till matbanker som ett tillvägagångssätt för att minska matsvinn samt matfattigdom.Det utfördes genom att identifiera utmaningar och potentiella inlåsningsfaktorer relaterade till dessa,och genom att analysera praxis och framgångsfaktorer för att identifiera bästa praxis. Studien var enkvalitativ fallstudie och för en bredare analys av strävan mot ett mer hållbart livsmedelssystem såanvändes ramverket "multi-level perspective" (MLP). Studien är en del av ett Vinnovafinansieratsamarbetsprojekt för att ta fram en handbok för livsmedelsdonationer i detaljhandeln, som syftar till attvägleda aktörer inom detaljhandeln hur de kan minska matsvinnet genom ökade donationer av överskott. Resultaten visade att det finns vissa grundläggande förutsättningar som generellt sett behöver uppfyllasför att donationer av överskottsmat ska fungera. Dessa kan uppfyllas på olika sätt, dessatillvägagångssätt har analyserats tillsammans med framgångsfaktorer och lärdomar från litteraturen föratt ge exempel på "bra" praxis och bästa praxis. Denna uppdelning gjordes för att det framkom attmindre, volontärledda matbanker och större, mer erfarna matbanker har olika möjligheter ochutmaningar. Livsmedelsbutiker möter också olika praktiska, ekonomiska och administrativa utmaningarnär det gäller att donera sitt överskott. Analysen av utmaningarna visade några potentiellainlåsningsfaktorer som bidrar till att hindra donationer av överskottsmat från att vara en integrerad del iden nuvarande livsmedels-”regimen”. Dessa inlåsningsfaktorer är främst relaterade till att ekologiskaoch sociala kostnader för matsvinn ofta bortses ifrån, och den låga prioriteringen på den politiskadagordningen. Därmed kvarstår brist på finansiering och ett "avfall som en resurs"-tänk. Även om detfinns flera potentiella inlåsningar som kan behöva "låsas upp" för att donationer av överskottsmat skavara en del av en radikal omställning till ett mer hållbart livsmedelssystem, så finns det även flera bra-och bästa praxis som kan genomföras ändå, för att stegvis förbättra resurseffektiviteten i det nuvarandelivsmedelssystemet. Donation av överskottsmat kan dock vara en nyckelkomponent i omställningen tillett hållbart livsmedelssystem.