Living kidney donation and reasons for denial: A report from a Brazilian single-center cross-sectional study

Chronic kidney disease is increasingly more prevalent worldwide, and kidney transplant remains the best option for patient survival. Living kidney transplants (LKT) pose advantages over deceased donor transplants, such as longer graft survival, lower ischemia time, and better HLA match. However, LKT is not always attainable for multiples reasons, with the absence of a suitable living donor being a significant barrier. Therefore, meticulous donor screening must be performed in order to guarantee donation safety. We examined medical appointments of living kidney donors evaluated at Hospital do Rim, São Paulo, between January and December 2020. Reasons for not proceeding with the donation were evaluated and were categorized as medical, surgical, immunological, psychosocial, or other. A total of 506 donor -receptor pairs were enrolled for evaluation during the study period. More than half of screened donor -receptor pairs (N=296, 58.5%) were not considered feasible for LKT. The primary cause for refusal was medical contraindication (32.1%), followed by immune (21.3%) and social (19.3%) causes. In addition, a considerable proportion of patients voluntarily withdrew themselves at variable time points during the evaluation process (N=79). In our center, most patients did not meet the criteria for kidney donation owing to medical reasons, similarly to other centers, and this reflects the importance of meticulous donor screening. In addition, the current Covid -19 pandemic affected the living transplant program, contributing to delayed complete donor and receptor evaluation.

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What Determines The Migration Intentions Of University Students?

Balkan Region Conference on Engineering and Business Education ◽

10.2478/cplbu-2014-0042 ◽

2014 ◽

Vol 1 (1) ◽

pp. 193-198

Author(s):

Heiko Haase ◽

Arndt Lautenschläger

Keyword(s):

University Students ◽

Career Choice ◽

Cross Sectional Study ◽

Demographic Characteristics ◽

Migration Decision ◽

Considerable Proportion ◽

Sectional Study ◽

Intention To Stay ◽

Cross Sectional ◽

The University

AbstractThe paper aims at exploring determinants of the university students' intentions to stay within their university region. At this, we presume that students' career choice motivations are related to their professional intentions, which again, along with demographic characteristics, affect their migration decision. Our analysis is based on a cross-sectional study of 2,353 students from three different higher education institutions, two of them located in Germany and one in Namibia. Results indicate that in Germany migration matters because a considerable proportion of students intend to leave the university region after graduation. At this, we found that the students' geographical provenance exerts the most significant effect on the intention to stay. Moreover, certain professional intentions were directly and some career choice motivations were indirectly linked with the intention to remain at the university location. We present several conclusions and implications.

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Characteristics of Confidence and Preparedness in Paramedics in Metropolitan, Regional, and Rural Australia to Manage Mental-Health-Related Presentations: A Cross-Sectional Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18041882 ◽

2021 ◽

Vol 18 (4) ◽

pp. 1882

Author(s):

Kate Emond ◽

Melanie Bish ◽

Michael Savic ◽

Dan I. Lubman ◽

Terence McCann ◽

...

Keyword(s):

Mental Health ◽

Rural Areas ◽

Cross Sectional Study ◽

Categorical Variables ◽

Considerable Proportion ◽

Sectional Study ◽

Cross Sectional ◽

Health Related ◽

Manage Mental ◽

Manage Mental Health

Mental-health-related presentations account for a considerable proportion of the paramedic’s workload in prehospital care. This cross-sectional study aimed to examine the perceived confidence and preparedness of paramedics in Australian metropolitan and rural areas to manage mental-health-related presentations. Overall, 1140 paramedics were surveyed. Pearson chi-square and Fisher exact tests were used to compare categorical variables by sex and location of practice; continuous variables were compared using the non-parametric Mann–Whitney and Kruskal–Wallis tests. Perceived confidence and preparedness were each modelled in multivariable ordinal regressions. Female paramedics were younger with higher qualifications but were less experienced than their male counterparts. Compared to paramedics working in metropolitan regions, those working in rural and regional areas were generally older with fewer qualifications and were significantly less confident and less prepared to manage mental health presentations (p = 0.001). Compared to male paramedics, females were less confident (p = 0.003), although equally prepared (p = 0.1) to manage mental health presentations. These results suggest that higher qualifications from the tertiary sector may not be adequately preparing paramedics to manage mental health presentations, which signifies a disparity between education provided and workforce preparedness. Further work is required to address the education and training requirements of paramedics in regional and rural areas to increase confidence and preparedness in managing mental health presentations.

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Long-term risks after kidney donation: how do we inform potential donors? A survey from DESCARTES and EKITA transplantation working groups

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfab035 ◽

2021 ◽

Author(s):

Geir Mjøen ◽

Umberto Maggiore ◽

Nicos Kessaris ◽

Diederik Kimenai ◽

Bruno Watschinger ◽

...

Keyword(s):

Evaluation Process ◽

Kidney Donation ◽

Kidney Donors ◽

Living Kidney Donors ◽

Relative Risks ◽

Written Information ◽

The Difference ◽

Stage Renal Disease ◽

End Stage

Abstract Background Publications from the last decade have increased knowledge regarding long-term risks after kidney donation. We wanted to perform a survey to assess how transplant professionals in Europe inform potential kidney donors regarding long-term risks. The objectives of the survey were to determine how they inform donors and to what extent, and to evaluate the degree of variation. Methods All transplant professionals involved in the evaluation process were considered eligible, regardless of the type of profession. The survey was dispatched as a link to a web-based survey. The subjects included questions on demographics, the information policy of the respondent and the use of risk calculators, including the difference of relative and absolute risks and how the respondents themselves understood these risks. Results The main finding was a large variation in how often different long-term risks were discussed with the potential donors, i.e. from always to never. Eighty percent of respondents stated that they always discuss the risk of end-stage renal disease, while 56% of respondents stated that they always discuss the risk of preeclampsia. Twenty percent of respondents answered correctly regarding the relationship between absolute and relative risks for rare outcomes. Conclusions The use of written information and checklists should be encouraged. This may improve standardization regarding the information provided to potential living kidney donors in Europe. There is a need for information and education among European transplant professionals regarding long-term risks after kidney donation and how to interpret and present these risks.

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Prevalence and factors associated to depression among Debrebirhan University students: a cross-sectional study

10.21203/rs.3.rs-776940/v1 ◽

2021 ◽

Author(s):

(MD

Keyword(s):

University Students ◽

Associated Factors ◽

Sampling Technique ◽

Cross Sectional Study ◽

Considerable Proportion ◽

P Value ◽

Sectional Study ◽

Cross Sectional ◽

Prevalence Of Depression ◽

Debre Birhan

Abstract Background: Undiagnosed depression among university students has an adverse effect on the wellbeing and academic performance of students. This study aimed to assess the prevalence of depression and associated factors among Debre Birhan university students. Methodology: Institutional based cross-sectional study design is conducted in Debre Birhan University from April to June 2013 E.C. Three hundred sixty nine students participated in this study which was selected by simple random sampling technique. Data were collected by using a self-administered PHQ-9 standard depression questionnaire. First the data was entered into in Epidata 3.1 and then was exported to SPSS version 20 for analysis. Associated factors were identified using binary logistic regression and variables with a p-value < 0.05 were declared as statistically significant factors with the outcome variables. Result: All of the study subjects were between ages 18 and 33 with a mean age of 22.65 9 ± 2.78. The overall prevalence of depression is 17.1%. Among this according to PHQ-9 scores cut scores, 161(43.6 %) scored as normal (0–4), 145(39.3%) scored as mild (5–9), 53(14.4%) scored as moderate (10–14), 4(1.1%) scored as moderately severe (15–19) and 6(1.6%) students scored as sever (> 20). In multivariate analysis being female AOR = 9.28[3.47–24.81], academic year AOR = 0.236[0.059–0.936], smoking 26.3[9.33–74.1] and alcohol use AOR of 2.62[0.95–7.21] are significantly associated with depression. Conclusion and recommendation: This study found a considerable proportion of undergraduate students with depression. Higher institutions need to pay special attention to students especially those who are female, junior students, smokers and alcohol users.

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Impact of the 2019 European Guidelines on Diabetes in Clinical Practice: Real and Simulated Analyses of Lipid Goals

Journal of Cardiovascular Development and Disease ◽

10.3390/jcdd7010006 ◽

2020 ◽

Vol 7 (1) ◽

pp. 6

Author(s):

Walter Masson ◽

Melina Huerín ◽

Lorenzo Martin Lobo ◽

Gerardo Masson ◽

Graciela Molinero ◽

...

Keyword(s):

High Risk ◽

Simulation Analysis ◽

Cross Sectional Study ◽

Lipid Lowering ◽

Considerable Proportion ◽

Diabetic Patients ◽

Cross Sectional ◽

Lipid Lowering Drugs ◽

European Guidelines ◽

European Society Of Cardiology

Background: Recent European guidelines on diabetes, prediabetes, and cardiovascular disease developed for the European Society of Cardiology (ESC) in collaboration with the European Association for the Study of Diabetes (EASD) significantly changed some concepts on risk stratification, lipid goals, and recommendations for the use of lipid-lowering drugs. The objectives of this work were to describe the lipid-lowering treatment prescribed for patients with diabetes and to determine the percentage of patients that achieved the lipid goals recommended by the 2019 ESC/EASD Guidelines on Diabetes in real and simulated scenarios. Methods: A multicenter, cross-sectional study was performed. Subjects >18 years with type 2 diabetes were included. The recommendations of the 2019 ESC/EASD Guidelines were followed. The real and simulated (ideal setting using adequate doses of statins ± ezetimibe) scenarios were analyzed. Results: Overall, 528 patients were included. In total, 62.5% of patients received statins (17.1% high intensity). Most patients were stratified as “very high risk” (54.2%) or “high risk” (43.4%). Only 13.3% achieved the double lipid goal (LDL-C and non-HDL-C goals according to the risk categories). In the simulation analysis, the proportion of subjects that did not reach the therapeutic objective decreased in all risk strata, although a considerable proportion of subjects persisted outside the target. Conclusion: The difficulty of achieving lipid goals in diabetic patients was considerable when applying the new guidelines. The situation would improve if we optimized treatment, but the prescription of new lipid-lowering drugs could be limited by their high cost.

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Burden and Disease Characteristics of Patients with Psoriatic Arthritis: A Population-based Cross-sectional Study

The Journal of Rheumatology ◽

10.3899/jrheum.180670 ◽

2019 ◽

Vol 46 (7) ◽

pp. 716-720 ◽

Cited By ~ 2

Author(s):

Hasan G. Tekin ◽

Jashin J. Wu ◽

Russel Burge ◽

Julie Birt ◽

Alexander Egeberg

Keyword(s):

Psoriatic Arthritis ◽

Population Based ◽

Cross Sectional Study ◽

Nonsteroidal Antiinflammatory Drugs ◽

Considerable Proportion ◽

Antiinflammatory Drugs ◽

Cross Sectional ◽

Disease Characteristics ◽

Systemic Corticosteroids ◽

Comorbid Diseases

Objective.To describe the prevalence and treatment regimes, disease characteristics, and comorbid diseases among patients with psoriatic arthritis (PsA) in Denmark.Methods.All Danish individuals aged ≥ 18 years with rheumatologist-diagnosed PsA were linked in nationwide administrative registers.Results.Among 4.7 million individuals in Denmark, 10,577 patients with PsA had been diagnosed by a rheumatologist. A female predominance (54.5–59.8%) was seen among patients with PsA, and about half of the patients (53.0%) had received no treatment or treatment only with nonsteroidal antiinflammatory drugs/systemic corticosteroids, while 32.9% had received nonbiological disease-modifying antirheumatic drugs (DMARD) and 14.1% had been treated with biologicals. Cutaneous psoriasis was recorded in 66.2–72.3% of patients with PsA, and patients with severe PsA had the highest prevalences of distal interphalangeal arthropathy, spondylitis, and arthritis mutilans. Smoking and comorbid diseases such as hypertension, diabetes, depression, and anxiety were seen frequently in patients with PsA, but did not significantly differ across severities of PsA.Conclusion.Disease burden appeared to be significant in patients with PsA across all severities. A considerable proportion of patients with PsA did not receive active antipsoriatic treatment, and about 1 out of 3 patients was not diagnosed with psoriasis. Cutaneous symptoms of psoriasis in patients with PsA might be either underreported or undertreated.

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Chinese physicians’ attitudes toward eco-directed sustainable prescribing from the perspective of ecopharmacovigilance: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2019-035502 ◽

2020 ◽

Vol 10 (6) ◽

pp. e035502 ◽

Cited By ~ 1

Author(s):

Jun Wang ◽

Shulan Li ◽

Bingshu He

Keyword(s):

Emerging Contaminants ◽

Negative Impact ◽

Drug Evaluation ◽

Evaluation Process ◽

Cross Sectional Study ◽

Willingness To Participate ◽

Sectional Study ◽

Cross Sectional ◽

Environmental Footprints ◽

Chinese Physicians

IntroductionEco-directed sustainable prescribing (EDSP) is an effective upstream way to reduce the environmental footprints of active pharmaceutical ingredients (APIs), a kind of emerging contaminants, from the patients’ excretion. EDSP is one of the key steps in the programme of ecopharmacovigilance (EPV), a drug administration route on API pollution.ObjectiveTo assess the attitudes of physicians prescribing medicines regarding EDSP from the perspective of EPV.DesignA cross-sectional study conducted from March 2019 to June 2019.Setting5 government general hospitals in Hubei province, China.Participants405 physicians were randomly selected and 262 valid questionnaires were obtained.Outcome measuresA self-developed questionnaire, which inquired about the participant characteristics, perceptions and attitudes toward API pollution, EPV and EDSP from an EPV perspective, was emailed to collect data from physicians.ResultsMost physicians agreed the existence of APIs in environment, worried about the potential environmental and ecological risks of API residues, supported the effectiveness and necessity of EDSP under an EPV perspective in decreasing environmental exposure of excreted APIs, and showed their willingness to participate in the EDSP practices. Nevertheless, no respondent identified the environmental impacts as the aspects regarding medicines affecting his(her) prescription decision, none was satisfied with knowledge on EDSP and showed confidence toward EDSP. The most important barrier to the effective implementation of EDSP was identified as ‘poor awareness of EDSP and EPV‘. Most responding physicians (97%) reported that they held the wait-and-see or conservative attitudes towards EDSP practice. The biggest concerns in low-dose prescribing and prescribing of drugs possessing environment-friendly excretion profiles, two EDSP approaches, were the possible negative impact on therapeutic outcomes and too complicated and professional drug evaluation process, respectively.ConclusionsChinese physicians had positive attitudes towards EDSP from the perspective of EPV. However, their environmental consciousness during prescribing and the related education were insufficient.

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Renal Collecting System Anatomy in Living Kidney Donors by Computed Tomographic Urography: Protocol Accuracy Compared to Intravenous Pyelographic and Surgical Findings

Journal of Clinical Imaging Science ◽

10.4103/2156-7514.175079 ◽

2016 ◽

Vol 6 ◽

pp. 1

Author(s):

Mohammad Kazem Tarzamni ◽

Nariman Nezami ◽

Afshar Zomorrodi ◽

Samad Fathi-Noroozlou ◽

Reza Piri ◽

...

Keyword(s):

Sensitivity And Specificity ◽

Cross Sectional Study ◽

Kappa Coefficient ◽

Cross Sectional ◽

Kidney Donors ◽

Living Kidney Donors ◽

Computed Tomographic ◽

Computed Tomography Urography ◽

Collecting System ◽

Urinary Collecting System

Objectives: To evaluate the accuracy of triple-bolus computed tomography urography (CTU) as a surrogate of intravenous pyelography (IVP) for determining the anatomy of the urinary collecting system in living kidney donors. Materials and Methods: In an analytic descriptive cross-sectional study, 36 healthy kidney donors were recruited during 12 months. Preoperative IVP and CTU were utilized to evaluate kidneys’ anatomy; major and minor calyces and variation were used as anatomical indices to compare the accuracy of CTU and IVP; the images were then compared to surgical findings. Results: Thirty-six kidney donors (92% male; mean age: 28 ± 6 years) were enrolled in this study. The kappa coefficient value was significant and almost perfect for the CTU and IVP findings in detecting the pattern of calyces (kappa coefficient 0.92, asymptotic 95% confidence interval 0.86–0.97). Anatomic variations or anomalies of the urinary collecting system included the bifid pelvis (5.6%), duplication (8.3%), and extra-renal pelvis (2.8%). Both the sensitivity and specificity of CTU in the detection of the anatomy and variations were 100%; the sensitivity and specificity of IVP were 83.3% and 100%, respectively. Conclusions: The triple-bolus preoperative CTU can be considered an alternative to IVP for assessing the anatomy of the urinary collecting system.

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Association between dietary calcium intake and BMD in children and adolescents

Endocrine Connections ◽

10.1530/ec-19-0534 ◽

2020 ◽

Vol 9 (3) ◽

pp. 194-200 ◽

Cited By ~ 2

Author(s):

Kaiyu Pan ◽

Chengyue Zhang ◽

Xiaocong Yao ◽

Zhongxin Zhu

Keyword(s):

Children And Adolescents ◽

Mexican Americans ◽

Cross Sectional Study ◽

Dietary Calcium Intake ◽

Considerable Proportion ◽

Childhood And Adolescence ◽

Linear Regression Models ◽

Sectional Study ◽

Mineral Density ◽

Cross Sectional

Aim Ensuring adequate calcium (Ca) intake during childhood and adolescence is critical to acquire good peak bone mass to prevent osteoporosis during older age. As one of the primary strategies to build and maintain healthy bones, we aimed to determine whether dietary Ca intake has an influence on bone mineral density (BMD) in children and adolescents. Methods We conducted a cross-sectional study composed of 10,092 individuals from the National Health and Nutrition Examination Survey (NHANES). Dietary Ca intake and total BMD were taken as independent and dependent variables, respectively. To evaluate the association between them, we conducted weighted multivariate linear regression models and smooth curve fittings. Results There was a significantly positive association between dietary Ca intake and total BMD. The strongest association was observed in 12–15 year old whites, 8–11 year old and 16–19 year old Mexican Americans, and 16–19 year old individuals from other race/ethnicity, in whom each quintile of Ca intake was increased. We also found that there were significant inflection points in females, blacks, and 12–15 year old adolescents group, which means that their total BMD would decrease when the dietary Ca intake was more than 2.6–2.8 g/d. Conclusions This cross-sectional study indicated that a considerable proportion of children and adolescents aged 8–19 years would attain greater total BMD if they increased their dietary Ca intake. However, higher dietary Ca intake (more than 2.6–2.8 g/d) is associated with lower total BMD in females, blacks, and 12–15 year old adolescents group.

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Willingness, beliefs, and barriers regarding the COVID-19 vaccine in Saudi Arabia: a multiregional cross-sectional study

BMC Family Practice ◽

10.1186/s12875-021-01606-6 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Noura Altulahi ◽

Shouq AlNujaim ◽

Azzam Alabdulqader ◽

Abdullah Alkharashi ◽

Assaf AlMalki ◽

...

Keyword(s):

Saudi Arabia ◽

Herd Immunity ◽

Vaccine Safety ◽

Cross Sectional Study ◽

Vaccine Uptake ◽

Vaccine Hesitancy ◽

Considerable Proportion ◽

Cross Sectional ◽

High School Degree ◽

Validated Questionnaire

Abstract Background The coronavirus disease 2019 (COVID-19) has spread worldwide, and the vaccine remains the ultimate cornerstone to overcoming its long-term impact. Vaccine hesitancy might obstruct the effort to achieve herd immunity and eradicate the virus. We assessed Saudi Arabian individuals’ willingness, beliefs, and barriers regarding the COVID-19 vaccine and their adherence to preventive measures during and after the pandemic. Methods A self-administered electronic validated questionnaire was distributed among the five major regions in Saudi Arabia between November and December 2020. The questionnaire addressed the sociodemographic data, beliefs, potential barriers, parents’ acceptance of COVID-19 vaccination for their children, and adherence to protective measures during and after the pandemic. Results Of 8,056 participants, 4,218 (52.4%) of a non-representative sample were willing to be vaccinated against COVID-19. Being a young adult, male, having less than a high school degree, being a smoker, having a chronic disease, and having a history of seasonal influenza vaccine uptake were positive predictors of COVID-19 vaccine acceptance. Hesitant participants reported concerns about vaccine side effects and safety as the main barriers to accepting the COVID-19 vaccine. Some refusers (26.1%) declared that they would reconsider vaccination only if the safety and effectiveness of the vaccine were reported by more studies. Conclusions Our study revealed a promising willingness to accept the vaccine among the population, with positive beliefs and attitudes toward COVID-19 vaccination. However, a considerable proportion of the population was reluctant to accept the vaccine. Thus, publicly providing information about vaccine safety and implementing health education programs is crucial for increasing the public’s confidence in the vaccine.

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