scholarly journals P1716MULTI-NATIONAL SURVEY AMONG NEPHROLOGISTS & TRANSPLANT SURGEONS ABOUT THE SUITABILITY & ACCEPTANCE OF MARGINAL LIVE KIDNEY DONORS REGARDING AGE DISCREPANCY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Ziad Arabi ◽  
Kaysi Saleh ◽  
Abdullah Hamad ◽  
Mohammad Bukhari ◽  
Atif Mateen ◽  
...  
Keyword(s):  
Waiting Time ◽  
Deceased Donor ◽  
Donor Age ◽  
Cross Sectional Survey ◽  
Kidney Donors ◽  
Young Donor ◽  
Alternative Donor ◽  
Old Donor ◽  
The Impact ◽  
Age Discrepancy

Abstract Background and Aims Living donor kidney transplantation is the best option for patients on dialysis. There are no guidelines or generally accepted consensus about the acceptable kidney donor age and what is the acceptable donor-recipient age discrepancy. Method This is a cross sectional survey of nephrologists and transplant surgeons about acceptable age of living kidney donors. The survey was sent to participants in different countries and through AST and ERA/EDTA. Results 122 respondents from 22 countries answered 4 questions related to donor age. Most respondents (N=86, 70%) would allow an 18-years old man to donate to his older sibling. However, this percentage would fall to (N=69, 57%) if the donor was an 18-years old woman (P=0.02), reflecting the impact of childbearing period as a major criterion in considering kidney donation. On the opposite side, up to 20% of respondents will decline a very young donor regardless of the gender of the donor. The acceptance rate of a very young donor drops to only 37% if the recipient is 75-year-old (versus 70% in case of younger recipient, P = 0.004). In case of old donor( > 65 years old) old to an 18 year old recipient with expected prolonged waiting time for deceased donor, ( N= 80, 65%) will advise to find an alternative donor but will allow the donation if no alternative donor is available. Conclusion The majority of the nephrologists and transplant surgeons will allow a very young donor to donate to a sibling especially if the donor is a male. However up to 20% will decline this donation regardless of the gender of the donor. The transplant community is divided about allowing a very young donor to donate to a very old recipient. However, the majority will accept > 65 years old donor to donate to an 18 years old recipient with expected prolonged waiting time for deceased donor.

scholarly journals P1698MULTI- NATIONAL SURVEY AMONG NEPHROLOGISTS AND TRANSPLANT SURGEONS ABOUT THE SUITABILITY AND ACCEPTANCE OF MARGINAL LIVE KIDNEY DONORS WITH MILD HYPERTENSION

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Ziad Arabi ◽  
El Waleed El Hassan ◽  
Abdulrahman Altheaby ◽  
Abdullah Hamad ◽  
Kaysi Saleh
Keyword(s):  
Blood Pressure ◽  
Gestational Hypertension ◽  
Blood Pressure Monitoring ◽  
White Coat Hypertension ◽  
Kidney Donation ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Kidney Donors ◽  
Increased Risk ◽  
Alternative Donor

Abstract Background and Aims There is variability among transplant centers in the acceptance of living donor candidates with well-controlled hypertension. Increased gestational hypertension and preeclampsia are more common in donors than in the general population especially if the donor is hypertensive at baseline. The purpose of this survey is to form a consensus about the evaluation of marginal live kidney donors (women and men) with hypertension. Method This is a cross-sectional survey of nephrologists and transplant surgeons about Suitability and Acceptance of The Marginal live Kidney Donors. The survey was sent to nephrologists in different countries and it was also distributed through AST & ERA-EDTA. Results A total of 122 practitioners from 22 countries responded to the survey. Of those, (N=96, 80.2%) were nephrologists and (n=23 19.83%) were transplant surgeons. The majority (45%) of the respondents were from USA. Most of the respondents (N=85, 69.7%) would allow a multiparous female (MPW) with mild and controlled hypertension (on a single blood pressure medication) who is not planning to have more children to donate. The rest would either advise against donation unless there is no alternative donor (n=23, 18.85%), or decline it altogether (n=14, 11.5%). In contrast, more respondents would reject a primiparous donor woman (PPW) with the same clinical scenario who considers having children (n=51, 42.2%, P=0.00001 ), or accept it only if there is no alternative donor (n=46, 38.0%, P=0.0009). Furthermore, most would not allow donation of a 20 years old male ( M) with an apparent white coat hypertension if his 24-hour ambulatory blood pressure monitoring shows non-dipping nocturnal pattern (n=67, 54.9%), or only accept it if there is no alternative donor (n=36, 29.5%). When comparing the rejection rate among the three donors: 11% for MPW, 41% for PPW and 54% for M. (P = 0.0001 for MPW vs PPW; P=0.00001 for MPW vs M; P=0.04 for PPW vs M). Conclusion Most of the nephrologists and transplant surgeons will clear mulptiparous women with mild and controlled hypertension for kidney donation as long as there no further plans for pregnancy. However, the majority of respondents will not clear a hypertensive primiparous due to the increased risk of gestational hypertension and preeclampsia after kidney donation. Most would be also reluctant to accept very young male donors if they show indicators of higher risk of developing hypertension in future.

scholarly journals P1684MULTI-NATIONAL SURVEY AMONG NEPHROLOGISTS AND TRANSPLANT SURGEONS ABOUT THE SUITABILITY AND ACCEPTANCE OF MARGINAL LIVE KIDNEY DONORS WITH HEAVY SMOKING OR INTERMITTENT DRUG ABUSE

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Ziad Arabi ◽  
Abdullah Hamad ◽  
Kaysi Saleh ◽  
Mohammad Bukhari
Keyword(s):  
Drug Use ◽  
Illegal Drug ◽  
Illegal Drugs ◽  
Kidney Donor ◽  
Cross Sectional Survey ◽  
Kidney Donors ◽  
Heavy Smoking ◽  
Illegal Drug Use ◽  
Active Smoker ◽  
Alternative Donor

Abstract Background and Aims Potential kidney donors who actively smoke heavily or had intermittent illegal drug use (IIDU) are mostly excluded from donating a kidney. Tobacco use in kidney donor has been linked to worse outcomes for donors and while less evidence exists for IIDU as they mostly excluded from donation. We conducted a short survey about the suitability of these marginal living kidney donors. The purpose of this survey is to form a consensus on live kidney donor with using smoking or illegal drugs. Method This is a cross-sectional survey of nephrologists and transplant surgeons about suitability and acceptance of marginal live kidney donors. We asked physicians about accepting kidney donors who are actively smoking or using illegal drugs. The survey was mainly distributed through AST and ERA-EDTA. The role of these organization is limited to facilitate the distribution of the survey as an external study. We excluded in-training nephrologists or transplant surgeons. Results One hundred twenty-two physicians from 22 countries (80% nephrologists and 20% transplant surgeons (TS)) participated in the survey. Most physicians were experienced in pre-transplant evaluation (72% over 6 years’ experience and 68.5% of responders perform donors’ evaluation on weekly or monthly bases). Interestingly, most physicians would allow donation in active smoker with advice to quit later (56.2%) (62% of nephrologists versus only 29% of TS (p=0.002). TS would decline active smoker patients than nephrologists (42% versus 25%, p=0.09). Less physicians considered donors with IDU (after psychiatric counselling) than active smoking (30% versus 56.2%, p=0.00003). There was no difference in acceptance rate for donors with IIDU between TS and nephrologists (33.3% versus 29% respectively, p=NS) or in declining these donors (37.5% versus 45.3%, p=0.4). TS would accept more active smokers to donate if no alternative donor available than nephrologists (29.2% vs. 12.3%, p=0.04) but not IDU (29.2% vs. 25.8%, p=ns). Conclusion Active heavy smoking and intermittent illegal drug use are not viewed as solo contraindications for kidney donation by most physicians. Nephrologists and TS did not differ in attitude regarding donors with IIDU. Nephrologist seems more confident to accept donors who are actively smoking with advice to quit afterward while TS would accept them more if no alternative donor available or would decline them completely.

scholarly journals P1686MULTI-NATIONAL SURVEY AMONG NEPHROLOGISTS AND TRANSPLANT SURGEONS ABOUT THE SUITABILITY AND ACCEPTANCE OF MARGINAL LIVE KIDNEY DONORS WITH MICROSCOPIC HEMATURIA

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Ziad Arabi ◽  
Kaysi Saleh ◽  
Abdullah Hamad ◽  
Mohammad Bukhari
Keyword(s):  
Kidney Biopsy ◽  
Microscopic Hematuria ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Kidney Donors ◽  
Living Kidney Donors ◽  
Mild Degree ◽  
Alternative Donor ◽  
Isolated Microscopic Hematuria ◽  
American Society

Abstract Background and Aims Potential kidney donors with isolated hematuria are often excluded from donating although there is a wide controversy about the definition and threshold of investigations or exclusion form donation. Many centers use the cut off of > 3 RBC in men and > 5 RBC in women. Some centers consider positive dipstick on urinalysis as the definition of microscopic hematuria. Kidney biopsy in these donors can be borderline and inconclusive. We conducted a short survey about the suitability of these marginal living kidney donors with microscopic hematuria. Method This is a cross-sectional survey of nephrologists and transplant surgeons (TS) about suitability and acceptance of marginal live kidney donors with isolated microscopic hematuria. The question was about a 35-yr. old man non-smoker with isolated microscopic hematuria (4 RBC on repeated UA and trace hematuria on dipstick) and negative imaging. The survey was mainly distributed through American Society of Transplantation, American Society of Transplant Surgeons and European Renal Association-European Dialysis and Transplant Association. In-training nephrologists or transplant surgeons were excluded. Results A total of (n= 122 from 22 countries, 80% nephrologists and 20% TS) responded to the survey. Most respondents were experienced in donor evaluation (72% of physicians have over 6 years’ experience and 68.5% of them perform donors’ evaluation on weekly or monthly bases). Interestingly, at this low level of microscopic hematuria (4 RBC on repeated UA and trace hematuria on dipstick) only very limited number of respondents (7.5%) would allow donation without further work up. Instead, most respondents (n= 75, 63%) would ask for kidney biopsy prior to taking further steps. Many physicians (n=35, 29%) choose to ask for an alternative donor to avoid the hassle of kidney biopsy which may not change the management. There was no difference in acceptance rate for donors between TS and nephrologists (7.2% versus 8.3% respectively, p=NS), requesting kidney biopsy (63.9% vs. 62.5%) or in declining these donors (28.8% versus 29.1%, p=NS). Conclusion Young kidney donors with persistent isolated microscopic hematuria (even at mild degree) require further evaluation with kidney biopsy before donation. However up to one third of the nephrologist and transplant surgeon will ask for an alternative donor to avoid the hassle of kidney biopsy which can be borderline or inconclusive.

Psychological Impacts of COVID-19 During the First Nationwide Lockdown in Vietnam: Web-Based, Cross-Sectional Survey Study (Preprint)

2020 ◽  
Author(s):  
Khanh Ngoc Cong Duong ◽  
Tien Nguyen Le Bao ◽  
Phuong Thi Lan Nguyen ◽  
Thanh Vo Van ◽  
Toi Phung Lam ◽  
...  
Keyword(s):  
Psychological Distress ◽  
General Population ◽  
Psychological Health ◽  
Online Survey ◽  
Survey Study ◽  
Limited Information ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Event Scale ◽  
The Impact

BACKGROUND The first nationwide lockdown due to the COVID-19 pandemic was implemented in Vietnam from April 1 to 15, 2020. Nevertheless, there has been limited information on the impact of COVID-19 on the psychological health of the public. OBJECTIVE This study aimed to estimate the prevalence of psychological issues and identify the factors associated with the psychological impact of COVID-19 during the first nationwide lockdown among the general population in Vietnam. METHODS We employed a cross-sectional study design with convenience sampling. A self-administered, online survey was used to collect data and assess psychological distress, depression, anxiety, and stress of participants from April 10 to 15, 2020. The Impact of Event Scale-Revised (IES-R) and the Depression, Anxiety, and Stress Scale-21 (DASS-21) were utilized to assess psychological distress, depression, anxiety, and stress of participants during social distancing due to COVID-19. Associations across factors were explored using regression analysis. RESULTS A total of 1385 respondents completed the survey. Of this, 35.9% (n=497) experienced psychological distress, as well as depression (n=325, 23.5%), anxiety (n=195, 14.1%), and stress (n=309, 22.3%). Respondents who evaluated their physical health as average had a higher IES-R score (beta coefficient [B]=9.16, 95% CI 6.43 to 11.89), as well as higher depression (B=5.85, 95% CI 4.49 to 7.21), anxiety (B=3.64, 95% CI 2.64 to 4.63), and stress (B=5.19, 95% CI 3.83 to 6.56) scores for DASS-21 than those who rated their health as good or very good. Those who self-reported their health as bad or very bad experienced more severe depression (B=9.57, 95% CI 4.54 to 14.59), anxiety (B=7.24, 95% CI 3.55 to 10.9), and stress (B=10.60, 95% CI 5.56 to 15.65). Unemployment was more likely to be associated with depression (B=3.34, 95% CI 1.68 to 5.01) and stress (B=2.34, 95% CI 0.84 to 3.85). Regarding worries about COVID-19, more than half (n=755, 54.5%) expressed concern for their children aged <18 years, which increased their IES-R score (B=7.81, 95% CI 4.98 to 10.64) and DASS-21 stress score (B=1.75, 95% CI 0.27 to 3.24). The majority of respondents (n=1335, 96.4%) were confident about their doctor’s expertise in terms of COVID-19 diagnosis and treatment, which was positively associated with less distress caused by the outbreak (B=–7.84, 95% CI –14.58 to –1.11). CONCLUSIONS The findings highlight the effect of COVID-19 on mental health during the nationwide lockdown among the general population in Vietnam. The study provides useful evidence for policy decision makers to develop and implement interventions to mitigate these impacts. CLINICALTRIAL

scholarly journals COVID-19 Psychological Impact on Health Care Workers in Saudi Arabia

2021 ◽  
Vol 18 (11) ◽  
pp. 6076
Author(s):  
Hasan S. Alamri ◽  
Wesam F. Mousa ◽  
Abdullah Algarni ◽  
Shehata F. Megahid ◽  
Ali Al Bshabshe ◽  
...  
Keyword(s):  
Health Care ◽  
Saudi Arabia ◽  
Health Care Workers ◽  
Psychological Impact ◽  
Psychological Outcomes ◽  
Cross Sectional Survey ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Care Workers ◽  
The Impact

Objective: Little is known about the impact of Coronavirus (COVID-19) among the health care workers in Saudi Arabia. Therefore, the present study aimed to assess the psychological impact of COVID-19 among the health care workers. Methods: A cross-sectional survey was conducted from May till mid-July among 389 health care workers from government and private hospitals in Saudi Arabia. Data was collected using a pre-structured online questionnaire that measured adverse psychological outcomes, including the Patient Health Questionnaire-9 (PHQ-9) scale and the Generalized Anxiety Disorder 7-item (GAD-7) scale. The Pearson chi-square test was used to assess the distribution of depression and anxiety among health care workers. Results: A high level of anxiety was recorded among the health care workers, and 69.3% of health care workers below the age of 40 were found to have depression. There was a significant increase in depression among staff with chronic health problems (72.1% vs. 61.9%; p = 0.048). High anxiety levels were detected among young staff compared to others (68.7% vs. 43.8%; p = 0.001). Moreover, 82.1% of the female staff were anxious, as compared to 55.6% of the males (p = 0.001). Conclusions: We found increased prevalence of adverse psychological outcomes among the health care workers in Saudi Arabia during the outbreak of COVID-19. Therefore, there is a need for proper screening and development of corresponding preventive measures to decrease the adverse psychological outcomes.

scholarly journals The Impact of Longer Consultation Time: A Simulation-Based Approach

2020 ◽  
Vol 11 (05) ◽  
pp. 857-864
Author(s):  
Abdulrahman M. Jabour
Keyword(s):  
Waiting Time ◽  
Quality Care ◽  
Working Hours ◽  
Discrete Events ◽  
Simulation Based ◽  
Patient Waiting Time ◽  
Free Environment ◽  
The Impact ◽  
Consultation Time ◽  
Patient Waiting

Abstract Background Maintaining a sufficient consultation length in primary health care (PHC) is a fundamental part of providing quality care that results in patient safety and satisfaction. Many facilities have limited capacity and increasing consultation time could result in a longer waiting time for patients and longer working hours for physicians. The use of simulation can be practical for quantifying the impact of workflow scenarios and guide the decision-making. Objective To examine the impact of increasing consultation time on patient waiting time and physician working hours. Methods Using discrete events simulation, we modeled the existing workflow and tested five different scenarios with a longer consultation time. In each scenario, we examined the impact of consultation time on patient waiting time, physician hours, and rate of staff utilization. Results At baseline scenarios (5-minute consultation time), the average waiting time was 9.87 minutes and gradually increased to 89.93 minutes in scenario five (10 minutes consultation time). However, the impact of increasing consultation time on patients waiting time did not impact all patients evenly where patients who arrive later tend to wait longer. Scenarios with a longer consultation time were more sensitive to the patients' order of arrival than those with a shorter consultation time. Conclusion By using simulation, we assessed the impact of increasing the consultation time in a risk-free environment. The increase in patients waiting time was somewhat gradual, and patients who arrive later in the day are more likely to wait longer than those who arrive earlier in the day. Increasing consultation time was more sensitive to the patients' order of arrival than those with a shorter consultation time.

Are e-learning Webinars the future of medical education? An exploratory study of a disruptive innovation in the COVID-19 era

2020 ◽  
pp. 1-10
Author(s):  
Colin J. McMahon ◽  
Justin T. Tretter ◽  
Theresa Faulkner ◽  
R. Krishna Kumar ◽  
Andrew N. Redington ◽  
...  
Keyword(s):  
Deep Learning ◽  
Carbon Footprint ◽  
Quantitative Research ◽  
Survey Design ◽  
Hybrid Approach ◽  
Disruptive Innovation ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
E Learning ◽  
The Impact

Abstract Objective: This study investigated the impact of the Webinar on deep human learning of CHD. Materials and methods: This cross-sectional survey design study used an open and closed-ended questionnaire to assess the impact of the Webinar on deep learning of topical areas within the management of the post-operative tetralogy of Fallot patients. This was a quantitative research methodology using descriptive statistical analyses with a sequential explanatory design. Results: One thousand-three-hundred and seventy-four participants from 100 countries on 6 continents joined the Webinar, 557 (40%) of whom completed the questionnaire. Over 70% of participants reported that they “agreed” or “strongly agreed” that the Webinar format promoted deep learning for each of the topics compared to other standard learning methods (textbook and journal learning). Two-thirds expressed a preference for attending a Webinar rather than an international conference. Over 80% of participants highlighted significant barriers to attending conferences including cost (79%), distance to travel (49%), time commitment (51%), and family commitments (35%). Strengths of the Webinar included expertise, concise high-quality presentations often discussing contentious issues, and the platform quality. The main weakness was a limited time for questions. Just over 53% expressed a concern for the carbon footprint involved in attending conferences and preferred to attend a Webinar. Conclusion: E-learning Webinars represent a disruptive innovation, which promotes deep learning, greater multidisciplinary participation, and greater attendee satisfaction with fewer barriers to participation. Although Webinars will never fully replace conferences, a hybrid approach may reduce the need for conferencing, reduce carbon footprint. and promote a “sustainable academia”.

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