Bakgrund: Njurtransplantation är det medicinskt bästa behandlingsalternativet vid terminal njursvikt. 'Quality of life’ ökar efter en transplantation men når inte upp till samma nivåer som hos en frisk befolkning. Mottagaren av en njure kan även uppleva ångest och depression. En djupare inblick i vad som orsakar dessa känslor, samt vilka andra känslor en njurtransplanterad patient kan uppleva, är av värde för att sjuksköterskan ska kunna bemöta och stötta dessa individer.  Syfte: Syftet var att beskriva känslor och upplevelser efter att ha genomgått njurtransplantation från en levande eller avliden donator. Metod: En allmän litteraturöversikt baserad på 12 vetenskapliga artiklar, med kvalitativ ansats, publicerade i PubMed eller CINAHL. Samtliga artiklar kvalitetsgranskas med SBU:s mall för kvalitativa studier och analyserades med en induktiv ansats. Resultat: Resultatet i denna litteraturöversikt baseras på 12 kvalitativa originalartiklar utförda i 7 olika länder. Tre huvudkategorier med 7 underkategorier återfanns. Huvudkategorierna var: 1. Den inre resans toppar och dalar, 2. En bergochdalbana av känslor gentemot donatorn, 3. Integrering och isolering i sociala relationer. Arbetet fann att deltagarna upplevde en bred variation av känslor som hopp, frihet, nedstämdhet och rädsla. Det var vanligt förekommande med komplexa känslor gentemot donatorn där både tacksamhet och skuld kunde existera samtidigt. I relation till omgivningen upplevde många avsaknad av stöd, medan andra kände stöd från familj, vänner eller andra njurtransplanterade. Slutsats: Njurtransplanterade patienter kan uppleva en bred variation av känslor. Återkommande utmaningar i livet efter transplantation kan vara förändringar kring ens identitet, rädslor för framtiden, skuld gentemot donatorn och upplevelser av att inte känna sig förstådd av omgivningen. Sjuksköterskan har en viktig roll i att bemöta och stötta dessa patienter. / Background: Kidney transplantation is the best medical treatment option for end-stage renal failure. Quality of life improves after a transplant but does not reach the same levels as in a healthy population. Kidney recipients may also experience anxiety and depression. A deeper understanding of the causes of these emotions, as well as the range of other emotions experienced by kidney transplant patients, is valuable for nurses to be able to address and support these individuals. Aim: The aim was to describe the emotions and experiences following kidney transplantation from a living or deceased donor. Method: A general literature review based on 12 scientific articles, using a qualitative approach, published in PubMed or CINAHL. All articles were assessed for quality using the SBU’s template for qualitative studies and analyzed using an inductive approach. Result: The findings in this literature review are based on 12 qualitative original articles conducted in 7 different countries. Three main categories with 7 subcategories were identified. The main categories were: 1. Highs and lows of the inner journey, 2. A rollercoaster of emotions towards the donor, 3. Integration and isolation in social relationships. The study found that participants experienced a wide range of emotions including hope, freedom, distress, and fear. Complex emotions towards the donor, where both gratitude and guilt could coexist simultaneously, were common. In relation to the surroundings, many experienced a lack of support, while others felt supported by family, friends, or other kidney transplant recipients. Conclusion: Kidney transplant patients may experience a wide range of emotions. Recurring challenges in life after transplantation can include changes in one’s identity, fears for the future, guilt towards the donor, and experiences of not feeling understood by others. The nurse plays a crucial role in acknowledging and supporting these patients.

State fish and wildlife agencies are increasingly expected to meet accelerating wildlife conservation needs while addressing systemic problems that limit who has historically been able to access wildlife and conservation. To effectively address both of these needs, agencies need to better understand their constituencies, including both long-standing supporters and those who have been historically excluded. This thesis set out to achieve this through three chapters. (i) Using a nationwide panel survey, we sought to understand how patterns of wildlife viewing differ between Black, Indigenous, and people of color (BIPOC) and White viewers, as well as what most strongly supports this participation. We found that participation rates differ across ethnoracial groups, with most BIPOC viewers participating less than White viewers, especially around their homes. Additionally, BIPOC viewers indicated that social support was a key factor in encouraging participation. Finally, despite wildlife viewing being of similar or greater importance to BIPOC participants, they generally self-identified less as viewers, suggesting historic exclusion from wildlife viewing locales may impact contemporary participation. (ii) Through a questionnaire of Minnesotans engaged with the MN Department of Natural Resources and their Nongame Wildlife Program, we examined what most encourages donations and volunteer participation. The findings of this chapter suggest that donors had specific motivations, namely supporting biodiversity and conservation, whereas volunteer motivations were more varied, such as place-based preferences and access to conservation professionals. (iii) Using a series of focus groups with outdoor recreation and community science practitioners and participants, we aimed to understand what encouraged BIPOC Minnesotans to participate in nature-based community science programs. We found that participants rely on numerous forms of cultural capital to persist in community science, especially in inhospitable environments. Often, this included utilizing social relationships and continuing to participate despite negative interactions. Overall, this research contributes to a growing body of literature aiming to understand diverse engagement in wildlife viewing and nature-based community science, as well as general engagement with state agencies. By laying a foundation for sustainable engagement and support of diverse communities, particularly BIPOC groups, this thesis provides insights and recommendations for fostering equitable conservation practices in an era of environmental change and social evolution. / Master of Science / North America and the world are witnessing unprecedented environmental changes, including biodiversity loss, climate change, and urbanization, impacting both human and wildlife communities. Concurrently, shifts in public engagement with state wildlife agencies and outdoor recreation are evident, with historic constituencies of hunters and anglers declining, posing challenges to conservation efforts. To address these challenges, state agencies strive to understand and diversify their supporters. Against this backdrop, this thesis investigates wildlife viewing patterns among ethnoracial groups, constituent engagement with state wildlife agencies, and factors motivating participation in community science initiatives among Black, Indigenous, and people of color (BIPOC) communities. Using a nationwide survey of wildlife viewers, we found significant differences in participation, both around and away from home. We also found that social support from friends, family, mentors, and peers was associated with increased participation. Additionally, despite wildlife viewing being of similar or greater importance to BIPOC participants, they generally self-identified less as viewers, suggesting historic exclusion from wildlife viewing locales may impact contemporary participation. Through a questionnaire of Minnesotans engaged with the MN Department of Natural Resources and their Nongame Wildlife Program, we examined what most encourages donations and volunteer participation. The findings of this chapter suggested that donors had specific motivations, namely supporting biodiversity and conservation, whereas volunteer motivations were more varied, such as place-based preferences and access to conservation professionals. Finally, using a series of focus groups with outdoor recreation and community science practitioners and participants, we aimed to understand what encouraged BIPOC Minnesotans to participate in nature-based community science programs. Our results suggested that social support, community-specific and community-led programs, and programs co-produced with community groups may facilitate participation in community science. Overall, this thesis provides vital recommendations for state agencies aiming to increase BIPOC participation in programs and better engage their constituencies. Through guidance on developing sustainable engagement strategies and how to best support diverse communities, particularly BIPOC groups, this thesis provides insights and recommendations for fostering equitable conservation in an era of environmental change and social evolution.

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal.

Made available in DSpace on 2016-01-26T12:51:34Z (GMT). No. of bitstreams: 1 wagnervicensoto_dissert_parte1.pdf: 574820 bytes, checksum: 52b81a5827b47b0dd96036bb137bd216 (MD5) Previous issue date: 2004-06-01 / The oocyte donation and reception program is a technique in which female gametes from a woman (donor) are donated to other woman (recipient) in order to be fertilized with the respective recipient s husband spermatozoa. The present study analyzed fourteen patients who underwent 21 cycles of egg reception by this assisted reproductive medical technique at the Reproductive Medicine Institute (RMI) of São José do Rio Preto-SP, in the period from January 1998 to December 2002. The recipients age ranged between 29 to 49 years; the mean age 40 years. Ten patients (71.5%) did not report previous gestation, therefore considered women with primary infertility. In order to perform the indications to the oocyte reception we classified five patients (35.7%) as having premature menopause, five (35.7%) as ovarian failure, three (21.5%) as physiological menopause, and one (7.1%) as unsuccessful responder to previous treatments. Only six patients (42.9%) had not undergone previous infertility treatments. In 92.9% of the patients, the assisted reproductive technique used was the Intracytoplasmic Sperm Injection (ICSI). The number of embryos transferred per cycle was between two and four. A total of 21 cycles were performed with a rate of 52.4% of gestation per cycle and 71.5% gestation per patient. The rate of multiple gestations was 27.3%. Regarding the gestation evolutions, it was observed a rate of 36.4% of miscarriage and 63.6% of ongoing pregnancies, in which 9.1% had premature delivery, and 54.5% had full term delivery without intercurrences. The rate of home baby was 50%. The oocyte donation and reception program showed to be a successful technique, with excellent results, providing a feasible and ethic way of getting pregnant some selected patients who have otherwise been considered as having an infertility reserved diagnostic. / O programa de doação-recepção de oócítos é técnica pela qual os gametas femininos (oócitos) de uma mulher (doadora) são doados a outra (receptora) para que sejam fertilizados com espermatozóides dos respectivos maridos. Este estudo analisou quatorze pacientes submetidas a 21 ciclos de ovorecepção por técnica de reprodução medicamente assistida no Instituto de Medicina Reprodutiva (IMR) de São José do Rio Preto-SP, no período de janeiro de 1998 a dezembro de 2002. A idade das pacientes receptoras variou de 29 a 49 anos com média de 40 anos. Dez (71,5%) pacientes não referiram gestação anterior, sendo consideradas como infertilidade primária. Como indicações para realização de recepção de oócitos classificamos cinco (35,7%) pacientes como menopausa precoce, cinco (35,7%) como falência ovaríana, três (21,5%) como menopausa fisiológica e uma (7,1 %) como má respondedora. Apenas seis (42,9%) pacientes não haviam sido submetidas a tratamento anterior para infertilidade. Em 92,9% das pacientes foi utilizado a injeção intra-citoplasmática de espermatozóide (lCSl) como técnica de fertilização assistida. Foram transferidos por ciclo entre dois e quatro embriões. Dos 21 ciclos realizados obteve-se taxa de 52,4% de gestação por ciclo e de 71,5% de gestação por paciente. A taxa de gestação múltipla foi de 27,3%. Em relação à evolução das gestações observou-se taxa de abortamento de 36,4% e evolução da gestações em 63,6%, com 9,1% de parto prematuro e 54,5% gestações a termo sem íntercorrêncías. A taxa de "bebê em casa" foi de 50%. O programa de doação-recepção de oócitos mostrou-se técnica de excelentes resultados, representando uma forma viável e ética de se obter gestação em pacientes selecionadas que antes tinham diagnóstico reservado de infertilidade.

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Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal

Cette présente thèse poursuit l’objectif central de mieux comprendre l’expérience vécue par des adolescents ayant reçu une transplantation rénale et celle des parents donneurs et non donneurs. Elle s’inspire d’une perspective développementale, où la construction identitaire des adolescents est évaluée qualitativement ainsi que l’expérience des parents, ceux-ci jouant un rôle important dans le développement de l’adolescent. Les adolescents vivant avec une maladie chronique rénale doivent relever les défis développementaux normaux ainsi que ceux associés à la maladie et aux traitements associés. Dans un contexte de transplantation d’organe, des défis additionnels, tels que le lien qui unit le receveur au donneur et les atteintes à l’image de soi rendent cette période charnière encore plus complexe. L’adolescence pose des défis importants pour la relation parent-enfant, tels que l’indépendance grandissante de l’adolescent, son désir d’autonomie, les changements au niveau de l’investissement et la nécessité du lien avec les figures d’attachement. Les jeunes greffés dénoncent leur impression d’être surprotégé et les parents de ces adolescents, eux aussi, se disent surprotecteurs. Pour certains parents, un deuxième rôle est incarné ; celui de donneur d’organe. Les influences que peut avoir le don sur le développement de l’adolescent sont toutefois inconnues. L’un des éléments centraux de cette thèse est également l’évaluation de la résolution du diagnostic pour les parents, ce processus ayant été défini comme un important précurseur de l’acceptation de la maladie à travers d’autres populations de parents d’enfants malades. Il est donc significatif de tenter de comprendre si ces parents sont arrivés à résoudre ou non le diagnostic de leur enfant et les pratiques parentales qui découlent du statut de résolution. Des parents étant encore habités par des questions et des émotions liées au moment du diagnostic sont susceptibles d’être envahis par celles-ci lorsque l’adolescent se montre peu adhérent ou par exemple, lorsqu’il s’engage dans des comportements à risque pour la survie du rein. Un devis qualitatif a été choisi, utilisant une entrevue semi-structurée réalisée auprès de chaque membre de la dyade. L’étude a été réalisée auprès de 10 adolescents et de 9 parents. Les analyses ont été guidées par la méthode de l’analyse phénoménologique interprétative (IPA). Au niveau de l’expérience parentale, les premières réactions au diagnostic indiquent la présence de trauma chez les parents au statut non résolu. Le statut de donneur aide la résolution des aspects négatifs de l’expérience, mais n’explique pas complètement le statut de résolution du diagnostic. Les préoccupations quant à l’adhérence sont centrales dans la relation que les parents ont avec leur adolescent. Les résultats appellent à un regard sur les besoins de soutien de ces parents et encore plus pour ceux dont la résolution est incomplète. Au niveau de l’évaluation du développement identitaire des adolescents, les résultats suggèrent que le développement est influencé par des préoccupations similaires chez les adolescents et ce peu importe le statut de donneur : l’image du corps, les relations sociales et l’anxiété par rapport au futur. Pour ceux ayant reçu d’un parent, des émotions uniques face au parent peuvent être un obstacle au développement d’une identité unique. L’évaluation des représentations d’attachement a permis de constater la prévalence élevée de types d’attachement insécurisant chez cet échantillon ainsi que la présence d’éléments traumatiques dans la relation d’attachement pour certains. / The central objective of this thesis is to better understand the experience of adolescents with a kidney transplant and the experience of their donor and non-donor parents. Inspired by a developmental perspective, and using a qualitative design, the thesis evaluates the identity development and the relationships between adolescents and their parents. It is in fact during adolescence that identity development becomes significant and youth living with a chronic kidney disease have to take up challenges related to their condition and its treatment as well as those of normal development. In context of a kidney transplant, additional challenges like the relationship to the donor and the impacts on body image makes the adolescence a more complex period. Adolescence brings significant challenges for the parent-child relationship, like growing needs of becoming more autonomous and independent and the investment and necessity of the proximity with attachment figures. Adolescents with a kidney transplant express their impression of being overprotected from their parents, and parents also consider themselves overprotective. Unique to the field of organ transplants, parents can be the donor for their child, but it is unclear whether this ability to give life for a second time has an impact the adolescent’s development and the experience of parents. One of the central elements of this thesis is the evaluation of diagnosis resolution for parents of adolescents with a kidney transplant, a process that has been recognized as a precursor of accepting the disease and is associated with proactive parental attitudes in other populations of parents with sick children. It is necessary to understand how parents of adolescent kidney recipients resolved the diagnosis and their parental practices according to the type of resolution they portray. Parents who still deal with unresolved emotions may feel overwhelmed when their adolescent is not compliant with the medical regiment or when he engages in risky behaviours for the survival of the graft. A qualitative design was chosen, using semi-structured interviews with each member of the dyads. Participants were 10 adolescents and 9 parents. Analyses were conducted according to the interpretative phenomenological analysis method (IPA). For the article with parents, results show that early reactions to the diagnosis suggest parents experienced trauma. Donor status seems to help resolve the negative aspects of the experience but does not fully explain diagnostic resolution status. For all parents, concerns over adherence are central to their relationship with their youth. Results call for attention to the support needs of all parents and particularly those with an unresolved status. For the article on identity development, results suggest identity development is influenced by similar concerns for all adolescents whether they received from a donor parent or not: body image, social relationships and anxiety for the future. For those who received from a parent donor, feelings toward the parent can be a challenge when building a unique identity. The evaluation of attachment representations informed us on the high presence of insecure attachments types among this specific sample of adolescents and on the presence of traumatic symptoms in the attachment relationship for some.

Det har kommit att bli allt vanligare att företag använder spelifieringselement på sina produkter för att motivera och engagera sina användare. Tidigare studier som undersökte spelifiering visar att dessa element har båda positiva och negativa effekter på användarna, samt att flera forskare har börjat undersöka etiska frågeställningar av användningen av spelifiering. Detta arbete har syftat till att undersöka den påverkan som spelifieringselement kan ha på Twitch-åskådare. Genom kvalitativa enkäter och kompletterande intervjuer undersöktes åskådarnas positiva och negativa upplevelser av spelifieringselement på Twitch. Studien omfattade 34 enkätdeltagare som rekryterades genom att posta enkätformuläret i Twitch-relaterade Facebook grupper, Twitch-relaterade Reddit webbplats samt bland studenterna på Högskolan i Skövde. Med hjälp av enkätanalysen identifierades olika aspekter som undersöktes med två stycken intervjudeltagare som rekryterades genom ett kriteriebaserat bekvämlighetsurval. Genom en kvalitativ analys kom studien fram till ett resultat som visar positiva och negativa effekter som spelifiering har på Twitch-åskådarna. Resultatet kan ligga till grund för fortsatt studie kring hur spelifiering kan användas och vilka aspekter bör designers ta hänsyn till. / It has become increasingly common for businesses to use gamification elements to enhance motivation and engagement with their products. Previous studies examining gamification show that gamification has both positive and negative effects on end-users. Ethical issues have also been raised, as concerning, by some in the scientific community. This study aimed to investigate what effect some gamification elements have on Twitch viewers. Twitch viewer experience has been examined through the use of qualitative surveys and complementary interviews. The study included 34 surveys and two interview participants that were recruited through criterion-based selection. The study findings reflect both the positive and negative effects of some gamification elements that are used on the Twitch platform. The findings of this study can be used as a basis for further research on how gamification effect Twitch viewers. As well as a base guideline for future improvements on usage of gamification elements.

The purpose of this study was to explore and describe the knowledge of clients regarding renal donation at a specific urban health care facility in the Limpopo province. A quantitative, explorative, descriptive and cross-sectional design was used. Data was collected using a structured pre-tested questionnaire. Out of 317 questionnaires, 300 were valid and considered for the study. Analysis was done using Statistical Package for Social Sciences (SPSS) computer software version 25. Data was presented using tables, graphs and charts. The study revealed that 32% (n=95) were males and 68% (n=205) were females. The results showed that there are a significant correlations between the attitudes, knowledge and actions of clients with regards to renal donation. The study revealed inadequate knowledge on the majority 74,7% (n=224) of the respondents on renal donation. A recommendation was that awareness campaigns on renal donation to be planned on world kidney days. Furthermore, the recommendations of the study will be presented to the Limpopo Department of health to take effective measures to educate people with relevant information on renal donation. A policy regarding awareness programme of renal donation should be developed. / Health Studies / M.A. (Public Health)

Indiana University-Purdue University Indianapolis (IUPUI) / Living donors have contributed about 6,000 kidneys per year in the past 10 years, but more than 100,000 individuals are still waiting for a kidney transplant. Living kidney donors undergo a major surgical procedure without direct medical benefit to themselves, but comprehensive follow-up information on living donors’ health is unfortunately limited. Expert recommendations suggest capturing clinical information beyond traditional sources to improve surveillance of co-morbid conditions from living kidney donors. Currently the United Network for Organ Sharing is responsible for collecting and reporting follow-up data for all living donors from U.S. transplant centers. Under policy implemented in February of 2013, transplant centers must submit follow-up date for two years after donation, but current processes often yield to incomplete and untimely reporting. This dissertation uses a statewide Health Information Exchange as a new clinical data source to 1) retrospectively identify a cohort of living kidney donors, 2) understand their follow-up care patterns, and 3) observe selected clinical outcomes including hypertension, diabetes and post-donation renal function.