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Donation efter cirkulatorisk död : Intensivvårdssjuksköterskans kunskap och erfarenhet / Donation after circulatory death : Intensive care nurses´ knowledge and experiencePeterson, Malin, Häll, Martina January 2024 (has links)
Bakgrund: Donation efter primär hjärnskada (DBD) har utförts i Sverige sedan 1981 och ärden vanligaste formen av donation. Donation efter cirkulationsstillestånd (DCD) infördes iSverige 2020 och ökar i omfattning. I länder där DCD redan är etablerat beskrivskunskapsnivån som låg i förhållande till DBD vilket leder till en känsla av otrygghet hosvårdpersonalen.Syfte: Att kartlägga hur intensivvårdssjuksköterskans skattar sina kunskaper och erfarenheter ivården av potentiella donatorer över 18 år enligt DCD processen.Metod: Enkätundersökning med kvantitativ design genomfördes. Enkäten skickades ut till 11intensivvårdsavdelningar i Sverige.Resultat: Består av svar från 58 respondenter. Majoriteten av respondenterna har fått teoretiskoch praktisk utbildning i att vårda en potentiell donator i DCD processen. Över 50% svararockså att de fått utbildning i att stödja donatorns närstående. Samband finns mellan kunskapoch utbildning men även mellan utbildning och skattad trygghet.Konklusion: Tydliga samband ses i studien mellan utbildning och kunskap. Kunskapen i sintur visar tydliga samband med intensivvårdssjuksköterskans skattade erfarenhet av trygghet ivården av den potentiella donatorn men även erfarenheten av att stödja/bemöta och besvarafrågor från närstående. Utbildningen är en viktig faktor för att förberedaintensivvårdssjuksköterskan i vården av en DCD. / Background: Donation after brain death (DBD) has been performed in Sweden since 1981 andis the most common type of donation. Donation after circulatory death (DCD) was introducedin Sweden in 2020 and is increasing in scope. In countries where DCD already is establishedthe level of knowledge is described as low in relation to DBD which leads to a feeling ofinsecurity of healthcare professionals.Purpose: To map how intensive care nurses estimate their knowledge and experiences in thecare of potential donors over the age of 18 according to the DCD-process.Method: Survey study with a quantitative design. The Survey was sent to eleven intensive careunits in Sweden.Result: Consist of answers from 58 respondents. The majority of the respondents receivedtheoretical and practical education in the care of a potential donor in the DCD process. Morethan 50% also received education to support the donors’ relatives. Correlations were shownbetween knowledge and education but also between education and a feeling of security.Conclusion: A clear correlation is seen in the study between education and knowledge.Knowledge in turn shows correlation to the intensive care nurse ́s valued experience in the careof a potential donor but also to the experience of supporting and answering questions from itskin. Education is an important factor to prepare the intensive care nurses in the care of a DCD.
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In-kind donation practices, challenges and strategies for NGOs and donorsIslam, Md. Moinul 13 January 2014 (has links)
This thesis focuses on developing a comprehensive framework for understanding the challenges NGOs face with in-kind donations in disaster relief. The overwhelming problem of inappropriate material donations, often referred to as the second disaster, has plagued disaster relief operations for decades now in both domestic and international disaster response. Despite efforts to promote ``cash only'' giving in disaster relief, unsolicited and mostly inappropriate in-kind giving continues to challenge NGOs in every major disaster. Researchers have identified this as one of the most pressing yet understudied challenges in disaster relief to date.
This thesis is divided into three parts. In the first part, we conduct a multidisciplinary literature review from philanthropy, economics, public policy, corporate philanthropy and corporate social responsibility to understand why donors donate in-kind and why NGOs accept those donations. We describe the roles of the various players involved and explain the structure of the distribution channels in-kind donations follow both in disaster and non-disaster contexts. We then explain the challenges NGOs and their donors face with in-kind donations in the context of these channels. We identify systemic issues in the distribution channels and highlight current policies and practices that contribute to the second disaster.
In the second part of this thesis, we propose a comprehensive framework to help donors, NGOs and policy makers comprehend the scope of the problem and identify strategies to address the challenge of unsolicited donations in disaster relief. Our framework provides a succinct representation of the main issues and players involved in the process in a format that is simple to work with and easy to understand. It supports comprehension of the many related issues and can help NGOs and policy making bodies (e.g., FEMA, NVOAD, USAID) assess current strategies and devise new approaches and solution strategies.
In the third part of the thesis, we exploit our framework to propose a tiered strategy consisting of a set of solutions ranging from decision tools to help NGOs better screen in-kind donation offers to entire new channels for more productive in-kind giving in disaster relief. Each of these solutions may deter only a small fraction of the inappropriate flows, but together they can dramatically diminish the problem. Our proposed NGO decision tools both allow quick screening of donation offers in disaster relief and provide a framework for strategic management of corporate in-kind donations in the long term. We also propose a ``retail donation model" which can transform a portion of the current stream of unwanted and unusable in-kind donations from individuals and community groups into a valuable source of needed relief supplies through an entirely new donation channel. We document a successful implementation of an on-line retail donation model in the 2012 Sandy response.
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Développement et évaluation d’une activité de formation continue pour les infirmières et infirmiers œuvrant en soins critiques pédiatriques concernant le processus de don d’organesTremblay, Pierre-Luc January 2016 (has links)
Introduction. Le don d’organes chez la clientèle pédiatrique demeure un domaine peu étudié. Malgré que la population pédiatrique représente moins de 10 % de l’ensemble des donneurs au Québec, il demeure que des donneurs potentiels ne sont pas identifiés et le taux de refus des familles demeure élevé. Les infirmières sont les seules professionnelles constamment au chevet des patients et, selon leurs dires, elles manquent de connaissances sur ce sujet. La formation des infirmières pourrait amener une meilleure connaissance du processus de don d’organes et un meilleur accompagnement des familles dans ce contexte. Par ailleurs, les formations sont peu nombreuses, coûteuses et ne sont pas basées sur une évaluation des besoins de formation identifiés par les infirmières elles-mêmes. Objectifs. Cette recherche avait pour but de développer et d’évaluer une activité de formation continue concernant le don d’organes pédiatrique et destinée aux infirmières de ce domaine de soins. Les objectifs étaient : 1) de décrire les composantes essentielles d’une formation continue concernant le processus de don d’organes, 2) valider ces composantes essentielles auprès des détenteurs d’enjeux, 3) construire une activité de formation basée sur ces composantes, 4) d’évaluer les connaissances et les intérêts avant et après l’activité de formation continue, et 5) d’évaluer la satisfaction des participants après la formation. Méthodologie. Le modèle de Michaud, Dionne et Beaulieu (2007) a servi de cadre conceptuel de la compétence dans cette étude et s’inspire du devis qualitatif évaluatif de 4e génération de Guba et Lincoln (1989). D’abord, pour l’évaluation des besoins, des données quantitatives issues d’un questionnaire préliminaire en ligne, suivi d’un forum de discussion virtuel, furent utilisés. Une activité de formation continue modulaire en ligne fut créée, combinée à un pré-test et post-test. À ce dernier était greffé un questionnaire de satisfaction des participants. Résultats. Au départ, 51 participants contribuèrent à l’établissement des besoins de formation. Pour la formation, 13 infirmières l’ont suivie et ont montré une amélioration de leurs connaissances, notamment au niveau du soutien aux familles et sur le concept de mort cérébrale. Le sentiment augmenté d’auto-efficacité, associé aux ressources internes furent partagés par les participants lors du questionnaire de satisfaction.
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Genetic and epidemiological aspects of implantation defects : Studies on recurrent miscarriage, preeclampsia and oocyte donationElenis, Evangelia January 2016 (has links)
Implantation requires complex molecular and cellular events involving coagulation, angiogenesis and immunological processes that need to be well regulated for a pregnancy to establish and progress normally. The overall aim of this thesis was to study different models associated with atypical angiogenesis, impaired implantation and/or placentation, such as recurrent miscarriage (RM), oocyte donation (OD) and preeclampsia. Histidine-rich glycoprotein (HRG), a serum protein with angiogenic potential has been previously shown to have an impact on implantation and fertility. In two retrospective case-control studies, women suffering from RM (Study I) and gestational hypertensive disorders (GHD) (Study IV) have been compared to healthy control women, regarding carriership of HRG genotypes (HRG A1042G and C633T SNP, respectively). According to the findings of this thesis, heterozygous carriers of the HRG A1042G SNP suffer from RM more seldom than homozygous carriers (Study I). Additionally, the presence of the HRG 633T allele was associated with increased odds of GHD (GHD IV). Studies II and III comprised a national cohort of relatively young women with optimal health status conceiving singletons with donated oocytes versus autologous oocytes (spontaneously or via IVF). We explored differences in various obstetric (Study II) and neonatal (Study III) outcomes from the Swedish Medical Birth Register. Women conceiving with donated oocytes had a higher risk of GHD, induction of labor and cesarean section, as well as postpartum hemorrhage and retained placenta, when compared to autologously conceiving women. OD infants had higher odds of prematurity and lower birthweight and length when born preterm, compared to neonates from autologous oocytes. With regard to the indication of OD treatment, higher intervention but neverthelss favourable neonatal outcomes were observed in women with diminished ovarian reserve; the risk of GHD did not differ among OD recipients after adjustment. In conclusion, HRG genetic variation appears to contribute to placental dysfunction disorders. HRG is potential biomarker that may contribute in the prediction of the individual susceptibility for RM and GHD. Regarding OD in Sweden, the recipients-despite being of optimal age and health status- need careful preconceptional counselling and closer prenatal monitoring, mainly due to increased prevalence of hypertensive disorders and prematurity.
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Právní aspekty asistované reprodukce / Legal aspects of assisted reproductionThalerová, Nicol January 2017 (has links)
Reproductive Medicine currently represents one of the fastest growing medical fields. The birth of Louise Joy Brown as the first baby conceived in vitro fertilization or in vitro, is considered being the historic milestone in development of the treatement methods in assised reproducion. Ethical discussions regarding the admissibility of these methods have developed as a result of technological advance of the infertility treatment. Adequate response of applicable law was required on the currant state of medicine which resulted in the need to regulate legally this field whether it's about establishing of assumption of fatherhood with regard to determination of fatherhood of a child conceived through artificial insemination, as well as determination of the basic conditions for the access to assisted reproductive techniques. Originally, the legislation of artificial insemination was defined only in the implementing regulation of the Ministry of Health, as the reproductive technologies were entirely new area. Today, the area of assisted reproduction is regulated in Act no. 373/2011. This thesis deals with the regulation of the assisted reproduction and it focuses on the controversial methods and procedures which are based on child sex selection, gamete donation and donor anonymity and also it deals with...
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Marketingový výzkum důvodů firem ke sponzorování sportu v době ekonomické krize / Marketing research of reasons of companies to sports sponzorship in times of economic crisisDvořák, Josef January 2011 (has links)
Marketing research of reasons of companies to sports sponzorship in times of economic crisis Objectives: The aim of this work is using marketing research to determine how reasons of companies to sports sponsorship are changed in times of economic crisis. In assessing the reason of companies we observe whether size and regional focus of the company have an impact on sports sponsorship. Work shows differences in sponsorship of sport before the crisis and during crisis. Methods: Gain of necessary information has been made by questionnaire. Questionnaires were sent by emails to participated companies. Results: Financial crisis didn't touched sport branch so much how it was expected. Results show that companies sponsored more sport branches than in past. This doesn't mean there were more financial resources in sport. For smaller companies amount of money increased in percent for sponsoring, but for bigger companies is situation opposite. We can say just the same in absolute amount also. It's thus possible that sport gained less financial resources during financial crisis, because degradation affected bigger companies. We can say smaller companies were hit by crises in smaller extent than bigger companies. Key words: marketing communication, communication mix, sponsorship, sports advertising,...
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Analýza firemního dárcovství jako nástroje společenské odpovědnosti firem v České republice a ve Francii / Analysis of corporate philanthropy as a strategic tool of corporate social responsibility in the Czech Republic and FrancePrjachová, Vendula January 2009 (has links)
The subject of this thesis is to point out the growing importance of the corporate social responsibility and the sustainable business concept of firms in the Czech Republic and abroad, integrating corporate philanthropy into their long-term strategy. The basic terms and close connection of the corporate donation policy and social responsibility are explained. Corporate foundations present the strategic tool. First chapter is an introduction to philanthropy with the definition of basic terms. Second chapter deals in detail with importance of social responsibility in the Czech Republic and France, focusing on the role of corporate foundations, their activities and comparing the situation in both countries. Practical chapter analyzes the activities of selected corporate foundations in order to capture examples of good and bad practice. Subsequently, the observation is summarized and future developments are outlined. Last chapter provides practical advice and considerations for companies considering establishing their own foundation. Implementing and improving proposals of the efficiency and quality of their management are finally submitted.
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Darování pro případ smrti / Donation mortis causaDrachovský, Ondřej January 2019 (has links)
Donation mortis causa Abstract Inheritance law, in its broader concept donation mortis causa falls, is being referred to as the hearth of civil law since it interconnects both proprietary (contractual) and personal (family) aspects. Czech civil law recodification meant significant change of inheritance law legislation, including renaissance of wide range of legal institutions including donation mortis causa. This thesis aims to comprehensively and critically assess legal regulation of donation mortis causa in the Czech Civil Code. The emphasis is primarily put on problematic aspects of this regulation. The submitted thesis endeavours to find answer to the question of practical usability of the donation mortis causa. Its author attempts to provide a reasonable interpretation of provisions of lex lata concerning the subject matter of this thesis. The solution of the most serious legislative problems is proposed within the summary of the submitted text. As for the structure, this diploma thesis is divided into six parts, with each part being split in chapters and sub-chapters. The first part depicts the genesis and further evolution of the legal institution of donation mortis causa. The second part defines the terms fundamental for the thesis. This part also includes the answer to the ancient question, how to...
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Custo-efetividade das ferramentas de captação / Cost-effectiveness of the tools for donors recruitmentOliveira, Leonardo Scalon de 09 August 2018 (has links)
A sociedade tem se tornado cada vez mais instruída e exigente, na qual os clientes possuem grande influência nas estruturas da organização, fazendo com que as empresas busquem aumentar a satisfação dos clientes, atendendo-os de modo a superar as suas expectativas. Nesse contexto, estão inseridos os doadores de sangue. No Brasil, a lei que regulamenta o funcionamento dos serviços hemoterápicos preconiza que a doação de sangue deve ser um ato voluntário e altruísta, no qual o doador não deve receber nenhum tipo de vantagem para realizar a doação de sangue. Segundo dados da Coordenação Geral de Sangue e Hemoderivados, no ano de 2014, a região Sudeste, na qual está concentrada a maior parte da população brasileira, registrou uma das menores taxas de doação: a cada 1.000 habitantes, apenas 17,22 % doaram sangue. É fundamental para os hemocentros identificarem a maneira mais convincente e estimulante de convocar/captar doadores de sangue, de modo a manter os estoques suficientes, além de atender os doadores conforme suas expectativas. Portanto, o objetivo desse estudo foi avaliar qual a ferramenta de abordagem individual e coletiva que apresenta o melhor custoefetividade somado à preferência dos doadores, a qual será essencial para o aumento do número de doações. Para isso, os dados utilizados abrangem um período de 4 anos (2012 a 2015) e representam o número de candidatos à doação de sangue de duas instalações do Hemocentro RP, ambos localizados na cidade de Ribeirão Preto (Sede e Posto de Coleta). Valores-p para o teste de Dickey e Fuller de estacionariedade sugerem que as séries analisadas não são estacionárias, sendo então diferenciadas, passando a apresentar p<0,01. Foi observado que existe correlação (p = 0,31) entre o número de malas diretas e o retorno dos doadores seis meses após o envio das mesmas. No Posto de Coleta, não foi constatada essa correlação. Além disso, as ferramentas para captação que trabalham com os doadores de reposição apresentaram melhores resultados, tais como as ferramentas com atendimento mais personalizado (contato telefônico) juntamente com as campanhas realizadas pelo Facebook Inc. / Society has become increasingly educated and demanding, in which the customers have a strong influence on the organization\'s structures, causing companies to seek to increase the customer satisfaction, meeting them in a way that exceeds their expectations. In this context, blood donors are inserted. In Brazil, the law that regulates the operation of hemotherapy services recommends that blood donation should be a voluntary and altruistic act in which the donor should not receive any type of advantage in order to donate blood. According to data from the \"Coordenação Geral de Sangue e Hemoderivados\", in 2014, the Southeast region, where most of the Brazilian population is concentrated, had one of the lowest rates of donation: for every 1,000 inhabitants, only 17.22% donated blood. It is essential for blood centers to identify the most convincing and stimulating way to recruit and invite blood donors, to maintain sufficient stocks by serving donors according to their expectations. Therefore, the aim of this study was to evaluate which tool of individual and collective approach presents the best cost-effectiveness besides to donor preference, which will be essential for increasing the number of donations. To do so, the data cover a period of 4 years (2012 to 2015) and represent the number of candidates for blood donation from two Hemocentro RP facilities, both located in the city of Ribeirão Preto (\"Sede\" and \"Posto de Coleta\"). p-values for the test of Dickey and Fuller of stationarity suggest that the series analyzed are not stationary, being then differentiated, with p <0.01. It was observed that there is a correlation (p = 0.31) between the number of direct mailings and the donors return six months after sending them. No correlation was verified at the \"Posto de Coleta\". Moreover, recruitment tools for replacement donors present better results, such as the tools with more personalized service (telephone contact) along with the campaigns carried out by Facebook Inc.
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Qualitätskontrolle von Blutkomponenten nach GMP ("Good Manufacturing Practice")Schüler, Susanne 25 July 2000 (has links)
Um die Qualität von Blutprodukten nach GMP zu überprüfen, wurden 72 Blutspenden bzw. ihre Folgeprodukte Erythrozytenkonzentrat in PAGGS-M, gefiltertes Erythrozytenkonzentrat und Fresh Frozen Plasma untersucht. Zusätzlich wurden an jeweils 12 Blutderivaten, die z.T. nicht zum Routineprogramm des Blutspendedienstes der Abteilung für Klinische Hämostaseologie und Transfusionsmedizin in Homburg/Saar gehören, Messungen durchgeführt, um ihre Qualität am Herstellungstag und am Ende der Haltbarkeit zu bestimmen. Als letztes wurden schließlich auch rheologische Parameter an 21 Erythrozytenkonzentraten in PAGGS-M und Fresh Frozen Plasma über einen Zeitraum von 28 Tagen gemessen und dokumentiert. Die Messung der Parameter, sowohl hämatologische als auch hämostaseologische und hämorheologische, erfolgte nach Standardmethoden. Die Ergebnisse waren insgesamt nicht zufriedenstellend. Ausschlaggebende Grundlage der Untersuchung sind die GMP-Richtlinien, die sich an den europäischen Normen orientieren. Zwar zeigten die Produkte, die routinemäßig hergestellt werden, wie auch die, die nur für diese Untersuchung produziert wurden, in vielen Bereichen ein Übereinstimmen mit den Vorschriften. Speziell auch die Qualität der gefilterten Erythrozytenkonzentrate, die besonders für Immunsupprimierte wegen ihres niedrigen Gehalts an Leukozyten verwendet werden, war in vielen Fällen gut. Die Ergebnisse der rheologischen Messungen glichen denen anderer Studien: so wurde ein Abfall der Fließfähigkeit über den Meßzeitraum hinweg beobachtet, was auf ein leichtes Schwellen der Zellen und eine Zunahme der Rigidität zurückzuführen ist. Fast durchgängig wich der Meßwert für den Hämatokrit der EK von der Richtlinie ab, am stärksten in PAGGS-M. Als Grund hierfür wurde eine Meßungenauigkeit des elektronischen Zellzählers bzw. die Methode der Bestimmung angesehen, so daß eine echte Abweichung als unwahrscheinlich anzusehen ist. Jedoch wurde die vorgeschriebene maximale Hämolyserate mit Ablauf der Haltbarkeit häufig überschritten, ebenso wie die gemessenen Leukozytenzahlen. Eine Vielzahl der Plasmen war durch Erythrozyten und Leukozyten kontaminiert. Durch häufige Waschvorgänge beim Auftauen von tiefgefrorenen EK wurde ein erhöhter Hb-Überstand erzeugt, das geforderte Mindestvolumen wurde dabei unterschritten. Daher ist festzuhalten, daß für jede untersuchte Produktgruppe Abweichungen festgestellt wurden, die in diesem Maße nicht tolerabel sind. Damit ist die Qualität der Produkte insgesamt als unzureichend zu bezeichnen. Der hier geführte Nachweis dieser Abweichungen ermöglichte die Einführung geänderter Herstellungsverfahren, so daß die heute erzeugten Produkte den Qualitätsvorschriften entsprechen. / 72 blood donations and their follow-up products (red blood cell concentrates resuspended in PAGGS-M, leukocyte-reduced red cell concentrates and fresh frozen plasma) were investigated to check their quality. Additionally, tests were performed on blood components of which most were not part of the routine program in the Department of Hemostaseology and Transfusion Medicine in Homburg/Saar. Finally, rheological parameters of red blood cell concentrates in PAGGS-M and of fresh frozen plasma were measured and documented over a period of 28 days. The results were not satisfying. Both the routine products and the blood components which were only produced for this study met the GMP-guidelines in many cases. Especially the quality of leukocyte-reduced red blood cell concentrates which are used especially for the transfusion for immunocompromised patients was good. The results of the rheological measurements were similar to those of other studies: decreasing flow over a period of time which was put down to slight swelling of the cells and to a rise in erythrocyte rigidity. The average hematokrit of red cell concentrates was generally too low especially in PAGGS-M. The reason for this was thought to be the electronic cell counter or rather the method of measuring. Hemolysis after storage and mean leucocyte count often exceeded the official dates. Many samples of the FFP were contaminated with red and white blood cells. Repeated washing after thawing of frozen red blood cell concentrates caused an excess of extracellular haemoglobin and low concentrate volumes. Any deviation from the guidelines is not tolerable. After this study adjustments in the production could be made so blood products now meet all of the requirements.
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