Thesis (MPH.) -- University of Limpopo, 2012 / The objectives of the study: To determine the knowledge, attitudes and practices of black employees of The University of Limpopo (Turfloop campus) about blood donation. To determine the degree of willingness by blacks to donate as well as suggesting some solutions to improve the performance by the South African National Blood Services. Design: A descriptive study utilizing a self-reported questionnaire was carried out. Setting: The University of Limpopo Turfloop Campus in the Limpopo Province of South Africa. Material and Methods: A total of 138 employees participated in the study. With the aid of Predictive Analytics Software (PASW), 136 male and 101 female participants were randomly selected from the 40 University departments. The mean ages by gender was 36.91, ±10, 06 years for males, and 41.93, ±9, 35 years for females. The mean ages by donor status was 40.24, ±10, 15 years for donors and 37.94, ±9, 9 years for non-donors. Outcome measures: Subjects demographic variables were determined by the use of a pre-tested self-reported questionnaire, which covered personal characteristics such as gender, age, residence, number of household members, marital status, educational background, faculty or department of vi employment, as well as the monthly income bracket. Knowledge, attitudes and practices regarding blood donation were also assessed using the pre-tested self-developed questionnaire. The following information was included: previous practices, current and lifetime practices of blood donation. Results: There was a general lack of practice of blood donation despite the presence of average knowledge relating to matters of blood donation amongst the black employees of the University of Limpopo, (Turfloop campus). There was no difference between black females and males as far as blood donation was concerned. There was a reflection of similar practices of blood donation by both genders. Blood donation generally started at a very late age due to early lack of exposure, information and awareness. Conclusion: Findings from this study showed that the prevalence of non-donors amongst the blacks is high. The attitudes and practices of non-donors towards donation were generally less favourable, but it can be argued that a high percentage of these findings may likely change with the right interventions.

Most of the blood transfusion facilities had adequate space, but lacked some of the basic equipment. Blood collected in these facilities was not adequate to meet the blood needs of the regions. These facilities lacked specialised personnel and some of those practicing blood transfusion were not conversant with blood groups, transfusion reactions and the measures to be taken if a reaction occurs. The findings of this study will be used to strengthen blood transfusion services in these hard to reach regions.

Most of the blood transfusion facilities had adequate space, but lacked some of the basic equipment. Blood collected in these facilities was not adequate to meet the blood needs of the regions. These facilities lacked specialised personnel and some of those practicing blood transfusion were not conversant with blood groups, transfusion reactions and the measures to be taken if a reaction occurs. The findings of this study will be used to strengthen blood transfusion services in these hard to reach regions.

Magister Public Health - MPH / Most of the blood transfusion facilities had adequate space, but lacked some of the basic equipment. Blood collected in these facilities was not adequate to meet the blood needs of the regions. These facilities lacked specialised personnel and some of those practicing blood transfusion were not conversant with blood groups, transfusion reactions and the measures to be taken if a reaction occurs. The findings of this study will be used to strengthen blood transfusion services in these hard to reach regions. / South Africa

The purpose of this action-oriented needs assessment was to ascertain the knowledge, motivation, and culture (KMC) needs of Blacks regarding joining the Be The Match bone marrow registry and participating in the bone marrow donation process. This needs assessment will be utilized to lay the foundation for an educational and research based nonprofit organization, Angels In Disguise, that I developed. This study will also be used to inform the bone marrow registry of the KMC needs of the Blacks who participated in this study. The data collection came from nine observations, four post-observation surveys, five donor interviews, two prototype development groups, and a prototype field test. The formative results from the data collection partially aligned with the literature, which showed that a lack of knowledge resulted in Blacks not joining the Registry. An outlier materialized from the formative data, indicating that all five donor interviewees had joined the bone marrow registry without having knowledge of it, its processes, or the critical need for Blacks to join. On the other hand, the formative data supported the literature when the donor interviewees became a bone marrow match and were faced with the decision to move forward with the bone marrow donation process. All five donor interviewees sought and obtained knowledge about the bone marrow registry prior to being able to move forward with the donation process. In contrast, the formative data around motivation fully aligned with the literature. Blacks who lacked motivation do not join the bone marrow registry or participate in the bone marrow donation process, whereas the literature stated that many Blacks do not join the bone marrow registry due to cultural attitudes and beliefs. Research indicates that the Black community distrusts the medical community due to their being used as medical guinea pigs in the past. Also, Blacks fear pain and their health being compromised due to bone marrow donation. Interestingly, the formative data results did not support or show a lack of support of the literature. Cultural attributes and beliefs did not manifest themselves in the formative data results. The two prototype development groups participated in design thinking utilizing iterative brainstorming exercises, rapid prototyping, and assumption testing. The prototype development groups analyzed the data by categorizing and coding the data into themes through participatory research and collaborative analysis. The results of the two prototype development groups culminated into a final prototype. The final prototype was aimed at addressing the KMC needs of the Black participants, which were two-fold. First, the Registry needs to build a relationship with the Black community. Second, participants required knowledge about the Registry, the matching and donation processes, and the critical need for Blacks to join the Registry and participate in the donation process be provided to them in an educational setting, a symposium. The final prototype culminated into a bone marrow symposium that was tested in the field. The final prototype consisted of three videos about the bone marrow registry, a panel discussion with three Black bone marrow donors who had donated to non-relatives, and a pre- and post-prototype field test survey. The summative findings of this study were the results of the pre- and post-prototype field test surveys and post prototype field test. The findings of the pre-prototype field test survey, regarding knowledge, indicate the participants knew nothing or very little about the bone marrow registry. After being exposed to the prototype, the participants indicated in the post-prototype field test survey they had learned by joining the bone marrow registry they could possibly save a life. They also indicated they did not need any additional information about the bone marrow registry in order to make a decision to join and participate in the bone marrow donation process. Regarding motivation, there was not much change between the pre- and post-prototype field test survey results. The participants had indicated in both the pre- and post-prototype field test surveys that they would be motivated to join the bone marrow registry and participate in the bone marrow donation process if it could save a life. With regard to culture, the participants indicated in both the pre- and post-prototype field test surveys that no beliefs would affect their decision to join the registry and participate in the bone marrow donation process.

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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.

CRISPR/Cas9 induced DNA breaks can be precisely repaired by cellular homology-directed repair (HDR) pathways using exogenously provided template DNA (donor). However, the full potential of precision editing is hindered in many model systems by low cutting efficiencies, low HDR efficiencies and, cytotoxicity related to Cas9 and donor DNA. In this thesis, I address these challenges and present methods that we developed to increase HDR efficiencies in multiple model organisms. In Caenorhabditis elegans, we show that by reducing toxicity high editing efficiencies can be achieved with single stranded oligonucleotide (ssODN) donors. We demonstrate that melting dsDNA donors dramatically improves the knock-in efficiencies of longer (1kb) edits. In addition, we describe 5′-terminal modifications to the donor molecules that further increase the frequency of precision editing. With our methodology a single optimally injected animal can yield more than 100 Green Fluorescent Protein (GFP) positive progeny, dramatically enhancing efficiency of genome editing. Next, we demonstrate the generality of 5′ modified donors by extending our studies to human cell cultures and mice zygotes. In mammalian models, 2′OMe-RNA modifications consistently increase HDR efficiencies by several fold over unmodified donors. Furthermore, end-modified donors exhibited a striking reduction in end-joining reactions including reduced concatemer formation and reduced direct ligation into the host genome. Our study demonstrates that HDR can be improved without inhibiting competing end-joining pathways and provides a platform to identify new chemical modifications that could further increase the potency and efficacy of precision genome editing.