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Biomedical subjects

W Reitsma

Publications and source records attributed to W Reitsma.

10 recordsLinked to original sources
PubMed1998

Requesting organ donation: an interview study of donor and nondonor families.

BACKGROUND: Approximately half of the families asked to consider donation of a relative's organs decline to give consent. Understanding the difference between stated public support of organ donation and actual behavior is key to decreasing the shortage of donor organs. OBJECTIVES: To gain insight into the experiences of potential donor families and to define features of the donation-request process and other factors that are associated with consent for organ donation. METHODS: A structured telephone interview was conducted with the immediate next of kin of 164 medically suitable potential organ donors. Interviews 30 to 60 minutes long were held with members of both donor and nondonor families 4 to 6 months after the death of the study participant's relative. RESULTS: Several factors were associated with consent for organ donation: characteristics of the patient and the patient's family, beliefs and attitudes about organ donation and transplantation, whether the family knew the deceased's wishes about donation, the family's satisfaction with the hospital care that their relative received, specific aspects of the donation-request process, and the family's understanding of brain death. CONCLUSIONS: Organ donation rates could be increased by enhancing the quality of hospital care and ensuring that the request for donation is handled in a way that meets the families' informational and emotional needs.

Adolescent↗
PubMed1997

Explaining brain death: a critical feature of the donation process.

To examine how a family's understanding of brain death may affect the decision to donate, an interview study was conducted with the immediate next of kin of 164 medically suitable organ donor candidates. Telephone interviews were conducted with members of both donor and nondonor families 4 to 6 months after the relative's death. Only 61% of the donor and 53% of the nondonor respondents said they had received an explanation of brain death. Few respondents reported that the hospital or organ procurement organization staff used visual aids to clarify or reinforce the information they were given. Next of kin who decided against donation had far less understanding of brain death than did those who decided in favor of it. Before making an organ donation request, healthcare providers must inquire about and address common misunderstandings people have about brain death. Healthcare teams should develop and be trained on a clear protocol for communicating with the families of patients who may be potential organ donors.

Adolescent↗
PubMed1995

The relation between muscle oscillations and alternating movements.

The present article studies the influence of the muscle tension on the frequency of the muscle oscillations, using an accelerometer. During a weak isometric contraction, the frequency of the muscle oscillations was found to be 10 Hz, and during a maximum voluntary contraction 17 Hz. As a result of this study of the boundaries of the frequency of muscle oscillations, it has been possible to determine a relationship between involuntary muscle oscillations and voluntary alternating movements, and between muscle oscillations and FR motor units. In a previous article it was made plausible that muscle oscillations can be considered to be the primary source of physiological tremor. This article makes plausible that the contractions of the FR motor units can be considered to be the primary source of the muscle oscillations. The author has attempted to integrate these data about the muscle oscillations and alternating movements into the framework of muscle physiology.

Animals↗
PubMed1988

[Food hygiene and the prevalence of diarrhea and vomiting in independent elderly].

Food hygiene and the prevalence of diarrhea and vomiting were investigated in a population of self-supporting elderly aged 65 to 80 years. Two hundred and fourteen of them were interviewed at home. During this interview the temperature of the refrigerator and the cellar was measured. The prevalence of diarrhea in the 3 months preceding the interview was 20%, the prevalence of vomiting was 13%. By means of the interview at the respondents' homes and the temperature measurement, food hygiene was evaluated. Seventy percent of the respondents appeared to act in a hazardous way on one or more of the selected items. After excluding those who might have been vomiting or suffering from diarrhea due to certain chronic conditions, a statistically significant association between food hygiene evaluation and diarrhea in the preceding 3 months was found. The 3-month prevalence of the 90 persons with hazardous practices was 22%; in the group of 35 persons without such practices the prevalence was 6%. It is hard to compare these results with those of other studies because of different definitions and different methods. The impression that this age-category is a high risk group for food hygiene cannot be confirmed nor ruled out.

Aged↗
PubMedDate not supplied

Basic aspects of action tremors in the human M. brachioradialis.

Since the first measurements of tremors it was obvious that the tremor signal originates from very complicated and continuously changing nervous and mechanical factors. However, the tremors originate in the beginning from the action tremors of the skeletal muscles. In this study the basic structure of the action tremors, regular 13-Hz oscillations, was revealed (measured by an accelerometer fixed on the distal end of the muscle belly of the m. brachioradialis). The mechanical oscillations measured with this technique had a linear relationship to the electrical oscillations of the EMG. Further, harmonic interference of isometric contraction with faradic contraction was observed. During simultaneous contraction of neighbouring muscles, completely synchronous but exactly out-of-phase oscillations were observed.

Adult↗
PubMedDate not supplied

Impact of medical examiner/coroner practices on organ recovery in the United States.

OBJECTIVE: The object of this research is to determine the nature and extent of the loss of donor organs during a 3-year period that are otherwise medically suitable for organ transplantation owing to nonrelease by a local medical examiner or coroner. DESIGN AND DATA SOURCES: In a retrospective study of the effects of medical examiner/coroner donor release practices, a detailed survey was mailed to every organ procurement organization (OPO) in the United States. This survey collected specific data (eg, number of cases denied per year), as well as descriptive information. RESULTS: Of the 2670 organ donors reported by 39 OPO respondents in 1990, 62.1% were medical examiner cases, and 129 (7.2%) of these cases were denied recovery by the local medical examiner/coroner. The number of denials increased to 181 (9.6% of medical examiner cases) in 1991 and to 251 (11.4% of medical examiner cases) in 1992. It is estimated that the population of medical examiner/coroner denials from 1990 through 1992 may be as many as 884. Twenty percent of the OPO respondents reported that no cases were denied recovery by a local medical examiner/coroner. A comparative analysis reveals that the proportion of total reported potential medical examiner/coroner cases that were denied increased by 65% from 1990 to 1992, while medical examiner/coroner cases released declined slightly. CONCLUSIONS: Since an average of 3.37 organs were recovered per donor in 1992, it is possible that as many as 2979 people may have been denied transplants from 1990 through 1992 owing to medical examiners'/coroners' denials. There were no donor denials in 10 geographical areas of the United States, nor was there any instance of violation of case law or any documentation of flawed autopsies or collection of forensic evidence in donor cases released. These two factors suggest that the loss of human life from denials is not needed to protect the judicial process. Increased cooperation between medical examiner offices and OPOs could significantly increase the availability of transplantable organs.

Coroners and Medical Examiners↗