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Context End-stage renal disease (ESRD) is more common among Blacks, but Blacks are less likely to receive a live donor kidney transplant (LDKT). Objective The objective of this study is to identify barriers and coping mechanisms that Black LDKT recipients and donors experienced while receiving or donating a kidney. Design A qualitative study was conducted using structured interviews. Thematic analysis was used for data interpretation. Participants All 20 participants identified as Black, with two participants identifying themselves as multiracial. The mean age for the 14 recipients was 60, and the average age for the 6 living donors was 47. Results Themes emerging from the data suggest both recipients and donors faced barriers in the LDKT experience. Recipients faced barriers associated with their denial and avoidance of the severity of their ESRD, their desire to maintain the privacy of their health status, and their refusal to approach potential donors. Donors encountered negative responses from others about the donors’ desire to donate and the initial refusal of recipients to accept a LDKT offer. Recipients identified faith as a coping mechanism, while donors identified normalization of donation as their method of coping. Various types of social support helped donors and recipients navigate the transplant process. Conclusion Black LDKT recipients and donors must overcome barriers prior to receiving or donating a kidney. Most of these barriers arise from communication and interactions with others that are either lacking or undesirable. Future interventions to promote LDKT among Blacks may benefit by specifically targeting these barriers.
Context End-stage renal disease (ESRD) is more common among Blacks, but Blacks are less likely to receive a live donor kidney transplant (LDKT). Objective The objective of this study is to identify barriers and coping mechanisms that Black LDKT recipients and donors experienced while receiving or donating a kidney. Design A qualitative study was conducted using structured interviews. Thematic analysis was used for data interpretation. Participants All 20 participants identified as Black, with two participants identifying themselves as multiracial. The mean age for the 14 recipients was 60, and the average age for the 6 living donors was 47. Results Themes emerging from the data suggest both recipients and donors faced barriers in the LDKT experience. Recipients faced barriers associated with their denial and avoidance of the severity of their ESRD, their desire to maintain the privacy of their health status, and their refusal to approach potential donors. Donors encountered negative responses from others about the donors’ desire to donate and the initial refusal of recipients to accept a LDKT offer. Recipients identified faith as a coping mechanism, while donors identified normalization of donation as their method of coping. Various types of social support helped donors and recipients navigate the transplant process. Conclusion Black LDKT recipients and donors must overcome barriers prior to receiving or donating a kidney. Most of these barriers arise from communication and interactions with others that are either lacking or undesirable. Future interventions to promote LDKT among Blacks may benefit by specifically targeting these barriers.
Background: In recent years, many literatures have pointed out that the fruit of Prunus cerasifera Ehrhar f. has anti-oxidation effect. Based on the anti-oxidation principle of traditional Chinese medicine in antiviral aspect the antiviral effect of the fruit was studied herein and the problem of the toxicity of the fruit has not been systematically investigated yet. To clarify the toxic effects of the fruit and its material basis, the toxicity test of the fruit was carried out. Methods:The fruit was percolated with water and the percolated liquid was concentrated to collect the concentrated liquid. Viral infection model in vitro was used to evaluate the antiviral effects of different viruses in vitro. CPE was observed under a microscope to determine the inhibitory effects of different viruses. The best type of macro-porous resin was determined by the method of macro-porous resin adsorption. The types of active ingredients were determined by physical and chemical identification, and their contents were determined by UV. By intragastric administration the long-term toxicity of percolating juice of the fruit to rats was observed including the nature severity, dose-toxicity relationship, time-toxicity relationship, main target organs, toxicity reversible degree, delayed toxicity, etc.Results: showed that percolation solution of the fruit had obvious inhibitory effect on HSV-1 virus, and the TI value was 109.22. The inhibition effect of 60% ethanol precipitation on HSV-1 was the best, and the TI value was 148.84. D101 macro-porous resin presented an excellent separation effect at the volume of the first column eluted by 25% ethanol and TI value was 200.85. Chemical polyphenols were determined by physical and chemical identification and the content was 18.15 mg/g. Comparison of each dose group of percolation of the fruit and blank group there were not abnormalities in appearance signs, behavioral activities, body weight, food intake, hematological examination, serum biochemistry, organ quality and organ coefficient; Morphological examination of organs such as heart, liver, spleen, lung, kidney, ovary, testis, etc. didn't show pathological changes related to medication; Reversible observation showed that the fruit did not cause delayed toxicity to rats. There was not statistically significant difference in the above indicators. Conclusion:Polyphenols from 25% alcohol elution site of percolation of the fruit may have good anti-HSV-1 activity. The large dose of percolation of the fruit and long-term use don't have obvious toxicity which provides a basis for clinical application.
Kidney transplantation (KTx) in end-stage renal disease is associated with a significant increase in quality of life (QoL) and self-perceived health, optimally leading to the maintenance of employment or return to work (RTW) in working-age patients. The aim of this study was to assess individual factors including the QoL and mental health of kidney transplant recipients (KTRs) associated with employment after transplantation. A cross-sectional study including working-age patients with a history of KTx after 2012 was conducted at two Austrian study centers (Vienna and Graz). Brief Symptom Inventory (BSI-18), World Health Organization Quality of Life (WHOQOL-Bref) and Workability Index (WAI) were assessed along with detailed questionnaires on employment status. Out of n = 139 KTRs (43.2 ± 9.07 years; 57.6% male), 72 (51.8%) were employed. Employed patients were more frequently in a partnership (p = 0.018) and had higher education levels (p = 0.01) and QoL scores (<0.001). Unemployed KTRs reported fatigue and mental health issues more often (p < 0.001), and had significantly higher anxiety, depression and somatization scores (BSI-18). In unadjusted logistical regression, workability score (WAS; odds ratio (OR) = 3.39; 95% confidence interval (CI) = 1.97–5.82; p < 0.001), partnership (OR = 5.47; 95% CI 1.43–20.91; p = 0.013) and no psychological counseling after KTx (OR = 0.06; 95% CI = 0.003–0.969; p = 0.048) were independently associated with employment. Self-assessed mental health, workability and QoL were significantly associated with employment status after KTx. Thus, in order to facilitate RTW after KTx in Austria, vocational rehabilitation and RTW programs addressing KTRs should focus on increasing social support and care for their mental health.
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