Introduction
The attitude of medical students towards living kidney donation (LKD) is of great interest given that they will become promoters of this technique in the near future.
Objective
To ...analyse the attitude of Spanish medical students towards related and unrelated LKD and to determine the factors affecting this attitude.
Materials and methods
Type of study:
A sociological, interdisciplinary, multicentre, and observational study.
Study population:
Medical students enrolled in Spain (
n
= 34.000).
Sample size:
A sample of 9598 students (99 % confidence and precision of ±1 %), stratified by geographical area and academic year.
Measurement instrument:
A validated questionnaire (PCID-DVR RIOS) was administered and completed anonymously.
Results
There was a completion rate of 95.7 % (
n
= 9275); 93 % (
n
= 8630) were in favour of related LKD, and 30 % (
n
= 2784) were in favour of unrelated LKD. The following factors were associated with this attitude: (1) age (
p
= 0.008); (2) sex (
p
< 0.001); (3) year of university degree (
p
< 0.001); (4) a belief that a transplant might be necessary in the future (
p
< 0.001); (5) attitude towards deceased organ donation (
p
< 0.001); (6) a willingness to accept a kidney from a living donor (
p
< 0.001); (7) attitude towards living liver donation (
p
< 0.001); (8) a partner’s attitude towards donation (
p
< 0.001); (9) having spoken about the subject with one’s family (
p
< 0.001), or friends (
p
< 0.001); (10) pro-social behaviour (
p
< 0.001); (11) the respondent’s religious attitude (
p
< 0.001); and (12) fear of possible mutilation of the body after donation (
p
< 0.001).
Conclusions
The attitude of medical students towards LKD is very favourable when it is the related kind of donation, and it is associated with factors of general knowledge about organ donation and transplantation and social interaction and religion.
The present work provides a review of two widely used approaches in educational research: action research and case study. Action research aims to improve educational practice by means of reflective ...cycles and shows variants according to a predominant paradigm, from technical to critical visions. A case study, described as an umbrella term, focuses on understanding classroom situations in real contexts. Although it seems that the defining characteristics of the case study are common among different authors, there are numerous classifications, which sometimes overlap. Based on a review of the ideas forming the main cornerstones of these two research types, we have analysed their common points and differences and considered the methodological possibility of relating both approaches in educational research projects taking place in non-controllable situations. In the present work, two joint approaches are proposed: action research as collective case study and action research as a set of case studies. The possibilities and limitations of both methodological perspectives are also discussed.
p‐Toluenesulfonyl (Tosyl) and nitrobenzenesulfonyl (Nosyl) are two of the most common sulfonyl protecting groups for amines in contemporary organic synthesis. While p‐toluenesulfonamides are known ...for their high stability/robustness, their use in multistep synthesis is plagued by difficult removal. Nitrobenzenesulfonamides, on the other hand, are easily cleaved but display limited stability to various reaction conditions. In an effort to resolve this predicament, we herein present a new sulfonamide protecting group, which we term Nms. Initially developed through in silico studies, Nms‐amides overcome these previous limitations and leave no room for compromise. We have investigated the incorporation, robustness and cleavability of this group and found it to be superior to traditional sulfonamide protecting groups in a broad range of case studies.
p‐Toluenesulfonyl (Tosyl) and nitrobenzenesulfonyl (Nosyl) are two of the most common sulfonyl protecting groups for amines in contemporary organic synthesis. While p‐toluenesulfonamides are known for their high stability and robustness, their use in multistep synthesis is plagued by difficult removal. Nitrobenzenesulfonamides, on the other hand, are easily cleaved but display limited stability to various reaction conditions. In an effort to resolve this conundrum, we herein present Nms‐amides, initially developed through in silico studies, which overcome these previous limitations and leave no room for compromise, enabling a range of transformations that are not possible with traditional sulfonamide protecting groups.
Abstract Objective Hepatitis C virus (HCV)-cirrhosis is the most frequent indication for orthotopic liver transplantation (OLT) among adults in most European and American transplant centers. The aim ...of this study was to analyze the impact of donor age on graft survival among HCV-positive cirrhotic transplant patients. Materials and Methods We performed an observational, retrospective study between March 1997 and December 2004, analyzing 340 liver transplantations. The patients were divided into 4 groups, considering whether the HCV infection was the indication for OLT and whether the age of the donor was older or younger than 48 years: group 1 (HCV, <48 years); group 2 (HCV, >48 years); group 3 (non-HCV, <48 years); and group 4 (non-HCV, >48 years). Results A univariate analysis showed that posttransplantation graft survival was clearly influenced by recipient HCV serologic status ( P = .018). However, no graft survival differences were found when the analysis variable was age (>48 or <48 years). When both variables were studied, a positive HCV serology did not modify graft survival when the donor age was <48 years ( P = .32), but had a statistically significant negative impact when the age was >48 years ( P = .02). Conclusions The use of older donors for HCV recipients resulted in worse graft and patient survivals in our study. This difference in survival was not present in non-HCV recipients or when grafts for HCV recipients were procured from younger donors. Donor age <30 years was a protective factor for graft survival among HCV recipients.
The exploration of the universe has recently entered a new era thanks to the multi-messenger paradigm, characterized by a continuous increase in the quantity and quality of experimental data that is ...obtained by the detection of the various cosmic messengers (photons, neutrinos, cosmic rays and gravitational waves) from numerous origins. They give us information about their sources in the universe and the properties of the intergalactic medium. Moreover, multi-messenger astronomy opens up the possibility to search for phenomenological signatures of quantum gravity. On the one hand, the most energetic events allow us to test our physical theories at energy regimes which are not directly accessible in accelerators; on the other hand, tiny effects in the propagation of very high energy particles could be amplified by cosmological distances. After decades of merely theoretical investigations, the possibility of obtaining phenomenological indications of Planck-scale effects is a revolutionary step in the quest for a quantum theory of gravity, but it requires cooperation between different communities of physicists (both theoretical and experimental). This review, prepared within the COST Action CA18108 “Quantum gravity phenomenology in the multi-messenger approach”, is aimed at promoting this cooperation by giving a state-of-the art account of the interdisciplinary expertise that is needed in the effective search of quantum gravity footprints in the production, propagation and detection of cosmic messengers.
Information provided by health care professionals is crucial to create a climate of social opinion. This is important in organ donation and transplantation (ODT), where the participation of the ...general public is essential to obtain organs.
To determine the attitude toward the Law of Presumed Consent (LPC) among Spanish university students and to analyze their relation with attitude toward ODT.
and design. The type of study was a sociologic, multicenter, observational study. The population included medical and nursing students in Spanish universities. Database of Collaborative International Donor Project was used stratified by geographic area and academic course. A validated questionnaire (Collaborative International Donor Project, organ donation and transplantation questionnaire in Spanish PCID-DTO-RIOS) was self-administered and completed anonymously. A sample of 9598 medical and 10,566 nursing students was analyzed (99% confidence and precision of ±1%) and stratified by geographic area and year of study.
Completion rate was 90%. Regarding attitude toward LPC, 66% of the students were against the law, whereas 34% accepted it. Of the students surveyed, 9% considered the law as a gesture of solidarity, 25% as an effective way of not wasting organs, 48% as an abuse of power, and 18% as offenses against the family. Those students who were in favor of LPC also had a more favorable attitude toward ODT (86% vs 76%; P < .001).
Comparing groups, nursing students were less in favor of LPC than medical students (32% vs 36%; P < .000).
Sixty-six percent of Spanish university medical and nursing students were against the LPC. The favorable attitude toward ODT is associated with considering the law as a gesture of solidarity or as an effective way of not wasting organs.
•Sixty-six percent of Spanish university medical and nursing students were against the Law of Presumed Consent.•Nursing students were less in favor of the Law of Presumed Consent than medical students.•A favorable attitude toward organ donation and transplantation is associated with the views that LPC is a gesture of solidarity or an effective way of not wasting organs.
The knowledge acquired during university education about organ donation and transplantation (ODT) decisively influences the information future health professionals transmit. This is important in ODT ...where the participation of the general public is essential to obtain organs.
To determine notions of Spanish medicine and nursing students on ODT and its relationship with attitude toward ODT.
and design. We conducted a sociologic, multicenter, and observational study. The population for our study consisted of medical and nursing students in Spanish universities. Our database was the Collaborative International Donor Project, stratified by geographic area and academic course. A validated questionnaire (PCID-DTO-RIOS) was self-administered and completed anonymously. Our sample consisted of 9598 medical and 10,566 nursing students (99% confidence interval; precision of ±1%), stratified by geographic area and year of study.
The completion rate for our study was 90%. Only 20% (n=3640) of students thought their notions on ODT were good; 41% (n=7531) thought their notions were normal; 36% (n=6550) thought their notions were scarce. Comparing groups, there were differences between those who believed that their notions on ODT were good (44% nursing vs 56% medical students; P < .000), and those who believed it scarce (54% nursing vs 46% medical students; P < .000). Notions on ODT were related with attitude toward the donation of one's own organs: those who considered their notions were good were more in favor then those who considered it scarce (88% vs 72%; P < .000).
Only 20% of Spanish medical and nursing students thought their notions on ODT were good. Having good knowledge is related to a favorable attitude towards ODT. Receiving specific information on the subject could improve their knowledge about ODT during their training.
•Only 20% of Spanish medical and nursing students thought their notions on ODT were good.•Attitude toward ODT is related with having specific knowledge on the subject.•For improvement in health science students’ curriculum, it is necessary that the curriculum should include topics on basic and ethical aspects of ODT.
A primary care physician (PCP) not only accompanies the patient in the process of an illness, but throughout his or her life. The confidence we have in these health professionals is fundamental, and ...their favorable attitude toward organ donation and transplantation (ODT) has a significant influence on the population.
To analyze trust in PCPs among Spanish medical and nursing students, the relationship with their attitude toward ODT, and the factors that condition it.
A sociologic, multicenter, and observational study. Population: medical and nursing students in Spanish universities. Database: Collaborative International Donor Project, stratified by geographic area and academic course. A validated questionnaire (PCID-DTO-RIOS) was self-administered and completed anonymously. A sample of 9598 medical and 10,566 nursing students (99% confidence and precision of ±1%), stratified by geographic area and year of study.
Completion rate: 90%. With respect to students’ trust in their physician, 18% (n = 3267) of them totally trust (completely), 45% (n = 8101) trust enough, 30% (n = 5478) of them have not enough trust, and 7% not at all. Comparing groups, medical students totally trust more in PCPs than nursing students (55% vs 45%; P < .000), however, nursing students have less than enough trust in their PCP than medical students (53% vs 47%; P < .000). Students that totally trust in their PCP were more in favor toward ODT than students with not enough trust (83% vs 77%; P < .000).
Only 18% of Spanish medical and nursing students totally trust in their PCP. Attitude toward ODT is related to a higher level of trust in PCPs among these students.
•Only 18% of Spanish medical and nursing students have total trust in their primary care physician.•Attitude toward ODT is related to a higher level of trust in primary care physicians among these students.•Information about ODT given by primary care physicians is of great significance in the population.
Successful applications of a conceptually novel setup of Quantum Field Theory, that accounts for all subtheories of the Standard Model (QED, Electroweak Interaction and Higgs, Yang–Mills and QCD) and ...beyond (Helicity 2), call for a perspective view in a broader conceptual context. The setting is “autonomous” in the sense of being intrinsically quantum. Its principles are: Hilbert space, Poincaré symmetry and causality. Its free quantum fields are obtained from Wigner’s unitary representations of the Poincaré group, with only physical and observable degrees of freedom. A “quantization” of an “underlying” classical theory is not needed. It allows renormalizable perturbation theory with interactions whose detailed structure, and in some cases even the particle content, is predicted by internal consistency. The results confirm and extend observable predictions for the interactions of the Standard Model without assuming a “principle” of gauge invariance.
Background and ImportanceDarbepoetin is used to treat symptomatic anaemia associated with chronic kidney failure (CKD) and to increase haemoglobin concentration to a level no higher than 12 ...g/dl.Patients should be closely monitored to ensure that the lowest authorised effective dose of darbepoetin adequately controls the anemia-related symptoms while maintaining a haemoglobin concentration below or equal to 12 g/dl.Aim and ObjectivesTo improve the safety of darbepoetin treatment, this study aimed to identify patients with CKD and haemoglobin levels exceeding 12g/dl.Material and MethodsAn observational, descriptive, and retrospective study was conducted to analyse CKD patients who received treatment with darbepoetin from January 2022 to August 2023.Data collected included gender, date of birth, darbepoetin dosage in mcg, and haemoglobin value in g/dl.For this study, we retrieve the data from Electronic Health Records (HER).ResultsDuring the analysed period, darbepoetin treatment was administered to 567 CKD patients, 56% were man with a median age of 72, and 129/567 (22.7%) had haemoglobin levels above 12 g/dl.Among these 129 patients, 86 (66.7%) had a haemoglobin value between 12 and 13.9 g/dl, 15 (11.6%) patients between 14 and 15.9 g/dl, and 2 (1.5%) patients had a haemoglobin value higher than 16 g/dl.Furthermore, 5 (3.8%) patients with high haemoglobin values still received a dose of darbepoetin higher than 100 mcg.Conclusion and RelevanceAccording to the product information document, there is room to improve the safety of darbepoetin treatments as many patients continue treatment with darbepoetin even when the target haemoglobin level has been reached.It is crucial to closely monitor patients starting darbepoetin treatment and adjust doses to achieve the desired haemoglobin level safely.When patients pick up their medication from the hospital pharmacy, analytical haemoglobin values must be checked, and the attending pharmacists can communicate with nephrologists if patients do not fulfill the treatment criteria for darbepoetin.References and/or AcknowledgementsConflict of InterestNo conflict of interest.
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