Establishing a deceased donor program in north Indian region: lessons learnt

Analysis of Wellbeing in Nongovernmental Organizations' Workplace in a Developed Area Context

An extremely useful theoretical approach to understanding the nature of work, health, and wellbeing is the job demand-control (JDC) model and the job demand-control-support (JDCS) model. In order for professional workers in the nongovernmental organization (NGO) sector to do their job, it is necessary for them to have a feeling of wellbeing. Despite this, in Europe, studies regarding the effects of the JDCS model in relation to workers' wellbeing have not been carried out. This study is expected to fill this important gap in research by analyzing the relationship of wellbeing with work demands, work control, and social support. In order to corroborate the proposed hypotheses, an analysis of these constructs in employees in European nongovernmental organizations (NGOs) was developed and, using structural equation models, these relationships were tested. The results confirm the main hypothesis of the job demand-control-support (JDCS) model and the causal relationship among physical and psychological demands, work control, and support from supervisors and colleagues with the level of employee wellbeing.

Criteria to Identify a Potential Deceased Organ Donor: A Systematic Review

OBJECTIVES

To systematically review the global published literature defining a potential deceased organ donor and identifying clinical triggers for deceased organ donation identification and referral.

DATA SOURCES

Medline and Embase databases from January 2006 to September 2017.

STUDY SELECTION

All published studies containing a definition of a potential deceased organ donor and/or clinical triggers for referring a potential deceased organ donor were eligible for inclusion. Dual, independent screening was conducted of 3,857 citations.

DATA EXTRACTION

Data extraction was completed by one team member and verified by a second team member. Thematic content analysis was used to identify clinical criteria for potential deceased organ donation identification from the published definitions and clinical triggers.

DATA SYNTHESIS

One hundred twenty-four articles were included in the review. Criteria fell into four categories: Neurological, Medical Decision, Cardiorespiratory, and Administrative. Distinct and globally consistent sets of clinical criteria by type of deceased organ donation (neurologic death determination, controlled donation after circulatory determination of death, and uncontrolled donation after circulatory determination of death) are reported.

CONCLUSIONS

Use of the clinical criteria sets reported will reduce ambiguity associated with the deceased organ donor identification and the subsequent referral process, potentially reducing the number of missed donors and saving lives globally through increased transplantation.

The development and current status of Intensive Care Unit management of prospective organ donors

Introduction:

Despite continuous advances in transplant medicine, there is a persistent worldwide shortage of organs available for donation. There is a growing body of research that supports that optimal management of deceased organ donors in Intensive Care Unit can substantially increase the availability of organs for transplant and improve outcomes in transplant recipients.

Methods:

A systematic literature review was performed, comprising a comprehensive search of the PubMed database for relevant terms, as well as individual assessment of references included in large original investigations, and comprehensive society guidelines.

Results:

In addition to overall adherence to catastrophic brain injury guidelines, optimization of physiologic state in accordance with established donor management goals (DMGs), and establishment of system-wide processes for ensuring early referral to organ procurement organizations (OPOs), several specific critical care management strategies have been associated with improved rates and outcomes of renal transplantation from deceased donors. These include vasoactive medication selection, maintenance of euvolemia, avoidance of hydroxyethyl starch, glycemic control, targeted temperature management, and blood transfusions if indicated.

Conclusions:

Management of deceased organ donors should focus first on maintaining adequate perfusion to all organ systems through adherence to standard critical care guidelines, early referral to OPOs, and family support. Furthermore, several specific DMGs and strategies have been recently shown to improve both the rates and outcomes of organ transplantation.