Cardiac transplantation is the treatment of choice for eligible patients with advanced heart failure; however, it is limited by a critical shortage of suitable organs from traditional brain-dead donors. Organs donated following circulatory death (DCD) have been used to successfully expand the pool of organs available for kidney, liver, and lung transplantation; however, concerns regarding the severity of injury sustained by the heart following withdrawal of life sustaining therapy have deterred the clinical transplantation of DCD hearts. Investigations aiming to optimize the resuscitation, preservation, and evaluation of DCD hearts may facilitate the development of an evidence based protocol for DCD heart transplantation that can be translated to the clinical area and expand the donor pool. Therefore, the objectives of this thesis are to develop a clinically relevant large animal model of DCD and gain a greater understanding regarding the physiologic impact of donor extubation on the DCD heart, demonstrate as a ‘proof-of-concept’ that utilizing an approach to donor heart resuscitation, preservation, and evaluation that is tailored to the DCD context can facilitate successful transplantation, and finally to investigate ways to optimize the resuscitation, preservation, and evaluation of DCD hearts for transplantation. The results of this thesis may then be used to inform the development of an evidence-based protocol for DCD heart transplantation that can be translated to the clinical area. The clinical adoption of such a protocol has the potential to expand the donor pool and improve outcomes for patients with end-stage heart failure. / May 2017

Using an analogue format, the present study evaluated the viability of relationship and interactional concepts that have been applied to the physician-patient interaction to the field of organ donation by examining the donation request process between procurement coordinators and simulated families. Interpersonal processes were assessed using behavioral ratings by independent observers. Procurement coordinators were viewed as being more submissive than dominant and more friendly than hostile. Family members were viewed as being more hostile than friendly, more dominant and hostile than submissive or friendly, disclosing slightly more personal information than medical information, and engaging in slightly more shared decision making than providing medical information. Procurement coordinator gender and ethnicity and family ethnicity influenced interpersonal behavior. Several interpersonal variables were associated with measures of the “decision to donate” obtained from raters and simulated families. Implications for the field of organ donation and the training of procurement coordinators are discussed.

<p>Varje år föds barn runt om i världen som ett resultat av ägg- och spermiedonation. I Sverige är äggdonation laglig sedan 2003. Spermiedonation är reglerat i lag sedan 1984. Syftet med denna studie var att undersöka graden av oro och nedstämdhet som rapporteras från heterosexuella par som genomgår behandling med ägg- eller spermiedonation. Deltagarna i studien var män och kvinnor som genomgått ägg- eller spermiedonation vid ett av de sju infertilitetscentra som finns i Sverige. Det var totalt 348 män och kvinnor som besvarade två enkäter, den första vid behandlingens början och den andra ca 10 veckor efter avslutad behandlingen. Bortfallet var 16 %. Datainsamlingen gjordes med HADS – Hospital Anxiety and Depression scale. Efter att datan bearbetats statistiskt visade resultaten följande signifikanta skillnader. 1. Kvinnorna rapporterade högre grad av oro än männen både före och efter behandlingen samt högre grad av nedstämdhet efter behandlingen. 2. Både kvinnornas och männens grad av nedstämdhet var högre hos de par där behandlingen inte resulterade i graviditet jämfört med de par som blev gravida. 3. De kvinnor som inte blev gravida visade mer oro efter ett negativt behandlingsresultat än de kvinnor som blev gravida.</p><p>Slutsatsen från föreliggande studie är att kvinnor som genomgår behandlingar med ägg- eller spermiedonation känner mer oro och nedstämdhet än sina partners. Känslorna är av övergående natur och minskar då behandlingarna resulterar i graviditet.</p> / <p>Every year children all over the world are born as a result of gamete donation. In Sweden oocyte donation has been legally used since 2003 and sperm donation has been regulated in law since 1984. The aim of this study was to investigate the extent of anxiety and depression in couples going through treatments with oocyte- or sperm donation. Participants of the study were men and women who received treatment with oocyte- and sperm donation at one of the seven fertility centers in Sweden. A total of 348 men and women answered two questioners, the first one at the beginning of the treatment and the second one around 10 weeks after the end of the treatment. The drop-out rate was 16 percent. Data collection was made with the HADS – Hospital Anxiety and Depression scale. When the data had been statistically processed the results showed following significant differences: 1.The women reported a higher degree of anxiety than the men before as well as after the treatment and a higher degree of depression after the treatment. 2. The extent of depression was higher among those women and men who didn´t become pregnant compared to those who did. 3. The women who didn´t become pregnant were more anxious after failed treatment than the women who became pregnant. The conclusion is that women who receive treatment with oocyte- or sperm donation are more anxious and depressed than their partners. The feelings are temporary and seem to decrease when the treatment results in pregnancy.</p>

<p>Involuntary childlessness is a big problem around the world. One way to solve the problem is to receive oocytes or semen from a donor. In Sweden, semen donation has been regulated by law since 1985 and oocyte donation since 2003. The aim of this study was to investigate what motivations women and men in Sweden have to donate gametes, if they feel any ambivalence to donate, and to compare if there is any difference in motivation and ambivalence between women and men. Motivation was measured with eight statements based on previous results and clinical experience. Ambivalence was measured with a scale consisting of seven statements that addressed thoughts and feelings about the donation. The participants in the study were donors at some of the seven infertility clinics in Sweden. The dropout rate for the sperm donors was 19 %. For the egg donors the dropout rate was 17 %.. The main result showed that the main motivation for donating oocytes or semen was helping childless couples. The significant differences between women’s and men’s motivations for donating oocytes or semen were that the women were keener to helping others, while the men to a higher extent wanted to do something important, spread their genes and find out about their own fertility. The oocyte and semen donors did not feel any particular ambivalence about the decision to donate, most of them did not find it difficult to make the decision, and they would have been disappointed if they had not been allowed to donate for some reason. The conclusions to be drawn from this study are that once the donors have decided to donate, they don’t feel any particular ambivalence about the donation, and women and men have different motivations to why they are donating, even if the main motivation is the same.</p> / <p>Ofrivillig barnlöshet är ett stort problem världen över. Ett sätt att lösa problemet är att ta emot ägg eller spermier ifrån en donator. I Sverige har spermiedonation varit reglerat i lag sedan 1985 och äggdonation sedan 2003. Syftet med denna studie var att undersöka vilka motiv kvinnor och män i Sverige har till att donera ägg respektive spermier, om de känner någon ambivalens till att donera, samt att jämföra om det är någon skillnad i motiv och ambivalens mellan kvinnor och män. Motiv mättes med åtta påståenden konstruerade utifrån tidigare resultat och klinisk erfarenhet. Ambivalens mättes med en skala som bestod av sju påståenden som behandlade tankar och känslor kring donationen, Deltagarna i studien var donatorer vid någon av de sju infertilitetscentra i Sverige. Bortfallet för spermiedonatorerna var 19 %. För äggdonatorerna var bortfallet 17 %. Huvudresultatet visade att det främsta motivet hos kvinnor och män till att donera ägg respektive spermier i Sverige var att hjälpa barnlösa par. De signifikanta skillnaderna mellan kvinnors och mäns motiv till att donera ägg respektive spermier var att kvinnor var mer måna om att hjälpa andra, medan männen i högre grad ville göra något betydelsefullt, sprida sina gener och få reda på hur det stod till med den egna fertiliteteten. Ägg- och spermiedonatorerna kände ingen större ambivalens inför beslutet om att donera, de flesta tyckte inte att beslutet var svårt att ta, och de skulle ha blivit besvikna om de inte fick donera av någon anledning. Slutsatser som har dragits är att när ägg- respektive spermiedonatorer väl har bestämt sig för att donera känner de ingen större ambivalens inför donationen, och män och kvinnor har skilda motiv till varför de donerar även om huvudmotivet är detsamma.</p>

More than 30,000 children and adults are diagnosed with life-threatening blood diseases such as leukemia, anemia and lymphomas in the U.S. every year. A transplant of stem cells, obtained from the bone marrow of a healthy donor, can be a cure for these diseases. The National Marrow Donor Program's registry comprises almost five million potential donors, however, many ethnic minorities are still underrepresented in comparison to their percentage in the overall U.S. population. Since patients are more likely to find a matching donor within their own ethnic community, recruitment efforts have been focusing on minority donors since a number of years. A number of other studies are currently examining the psychosocial and physical effects of the donation experience, as well as identifying barriers against and reasons for donating bone marrow, using questionnaires and health models. However, none has yet looked at which recruitment settings work well for college campuses, to what extent the target group should be educated, and how the study results should be incorporated into the recruitment efforts to improve retention. Potential donor education was therefore the most important focus of a Bone Marrow Donor Registration Drive organized by the author on the OSU campus in January. 150 potential donors registered at the OSU drive, one third of them from ethnic minorities. This study examines if the drive's extensive education and outreach component had any impact on the number of newly recruited volunteer donors in comparison to OSU's peer institutions. Using the Chi square test, a proportion comparison was performed between the percentage of newly registered volunteer donors (both in total and broken down by ethnicity) among the eligible OSU student body, and the total eligible student body at each peer institution. While the hypothesis that the extensive education and promotion activities increased the number of recruited donors could not be confirmed, targeting the minorities on campus was successful, since a significantly higher proportion of minority students registered at the BMDRD than the proportion of minority students registered at OSU. Besides data on the impact of the promotional activities and the recruitment results, which can also be used for further research, the drive also yielded a protocol that can serve as a guideline for organizing future drives at OSU and other schools with similar resources. / Graduation date: 2003

Varje år föds barn runt om i världen som ett resultat av ägg- och spermiedonation. I Sverige är äggdonation laglig sedan 2003. Spermiedonation är reglerat i lag sedan 1984. Syftet med denna studie var att undersöka graden av oro och nedstämdhet som rapporteras från heterosexuella par som genomgår behandling med ägg- eller spermiedonation. Deltagarna i studien var män och kvinnor som genomgått ägg- eller spermiedonation vid ett av de sju infertilitetscentra som finns i Sverige. Det var totalt 348 män och kvinnor som besvarade två enkäter, den första vid behandlingens början och den andra ca 10 veckor efter avslutad behandlingen. Bortfallet var 16 %. Datainsamlingen gjordes med HADS – Hospital Anxiety and Depression scale. Efter att datan bearbetats statistiskt visade resultaten följande signifikanta skillnader. 1. Kvinnorna rapporterade högre grad av oro än männen både före och efter behandlingen samt högre grad av nedstämdhet efter behandlingen. 2. Både kvinnornas och männens grad av nedstämdhet var högre hos de par där behandlingen inte resulterade i graviditet jämfört med de par som blev gravida. 3. De kvinnor som inte blev gravida visade mer oro efter ett negativt behandlingsresultat än de kvinnor som blev gravida. Slutsatsen från föreliggande studie är att kvinnor som genomgår behandlingar med ägg- eller spermiedonation känner mer oro och nedstämdhet än sina partners. Känslorna är av övergående natur och minskar då behandlingarna resulterar i graviditet. / Every year children all over the world are born as a result of gamete donation. In Sweden oocyte donation has been legally used since 2003 and sperm donation has been regulated in law since 1984. The aim of this study was to investigate the extent of anxiety and depression in couples going through treatments with oocyte- or sperm donation. Participants of the study were men and women who received treatment with oocyte- and sperm donation at one of the seven fertility centers in Sweden. A total of 348 men and women answered two questioners, the first one at the beginning of the treatment and the second one around 10 weeks after the end of the treatment. The drop-out rate was 16 percent. Data collection was made with the HADS – Hospital Anxiety and Depression scale. When the data had been statistically processed the results showed following significant differences: 1.The women reported a higher degree of anxiety than the men before as well as after the treatment and a higher degree of depression after the treatment. 2. The extent of depression was higher among those women and men who didn´t become pregnant compared to those who did. 3. The women who didn´t become pregnant were more anxious after failed treatment than the women who became pregnant. The conclusion is that women who receive treatment with oocyte- or sperm donation are more anxious and depressed than their partners. The feelings are temporary and seem to decrease when the treatment results in pregnancy.

Involuntary childlessness is a big problem around the world. One way to solve the problem is to receive oocytes or semen from a donor. In Sweden, semen donation has been regulated by law since 1985 and oocyte donation since 2003. The aim of this study was to investigate what motivations women and men in Sweden have to donate gametes, if they feel any ambivalence to donate, and to compare if there is any difference in motivation and ambivalence between women and men. Motivation was measured with eight statements based on previous results and clinical experience. Ambivalence was measured with a scale consisting of seven statements that addressed thoughts and feelings about the donation. The participants in the study were donors at some of the seven infertility clinics in Sweden. The dropout rate for the sperm donors was 19 %. For the egg donors the dropout rate was 17 %.. The main result showed that the main motivation for donating oocytes or semen was helping childless couples. The significant differences between women’s and men’s motivations for donating oocytes or semen were that the women were keener to helping others, while the men to a higher extent wanted to do something important, spread their genes and find out about their own fertility. The oocyte and semen donors did not feel any particular ambivalence about the decision to donate, most of them did not find it difficult to make the decision, and they would have been disappointed if they had not been allowed to donate for some reason. The conclusions to be drawn from this study are that once the donors have decided to donate, they don’t feel any particular ambivalence about the donation, and women and men have different motivations to why they are donating, even if the main motivation is the same. / Ofrivillig barnlöshet är ett stort problem världen över. Ett sätt att lösa problemet är att ta emot ägg eller spermier ifrån en donator. I Sverige har spermiedonation varit reglerat i lag sedan 1985 och äggdonation sedan 2003. Syftet med denna studie var att undersöka vilka motiv kvinnor och män i Sverige har till att donera ägg respektive spermier, om de känner någon ambivalens till att donera, samt att jämföra om det är någon skillnad i motiv och ambivalens mellan kvinnor och män. Motiv mättes med åtta påståenden konstruerade utifrån tidigare resultat och klinisk erfarenhet. Ambivalens mättes med en skala som bestod av sju påståenden som behandlade tankar och känslor kring donationen, Deltagarna i studien var donatorer vid någon av de sju infertilitetscentra i Sverige. Bortfallet för spermiedonatorerna var 19 %. För äggdonatorerna var bortfallet 17 %. Huvudresultatet visade att det främsta motivet hos kvinnor och män till att donera ägg respektive spermier i Sverige var att hjälpa barnlösa par. De signifikanta skillnaderna mellan kvinnors och mäns motiv till att donera ägg respektive spermier var att kvinnor var mer måna om att hjälpa andra, medan männen i högre grad ville göra något betydelsefullt, sprida sina gener och få reda på hur det stod till med den egna fertiliteteten. Ägg- och spermiedonatorerna kände ingen större ambivalens inför beslutet om att donera, de flesta tyckte inte att beslutet var svårt att ta, och de skulle ha blivit besvikna om de inte fick donera av någon anledning. Slutsatser som har dragits är att när ägg- respektive spermiedonatorer väl har bestämt sig för att donera känner de ingen större ambivalens inför donationen, och män och kvinnor har skilda motiv till varför de donerar även om huvudmotivet är detsamma.

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Thesis (D. Min.)--Ashland Theological Seminary, 2006. / Abstract. Includes bibliographical references (leaves 157-162, 222-226).

Thesis (M.N.)--Memorial University of Newfoundland, 2004. / Typescript. Bibliography: leaves 92-100.