Health Insurance Trends in United States Living Kidney Donors (2004 to 2015)

Some transplant programs consider the lack of health insurance as a contraindication to living kidney donation. Still, prior studies have shown that many adults are uninsured at time of donation. We extend the study of donor health insurance status over a longer time period and examine associations between insurance status and relevant sociodemographic and health characteristics. We queried the UNOS/OPTN registry for all living kidney donors (LKDs) between July 2004 and July 2015. Of the 53,724 LKDs with known health insurance status, 8,306 (16%) were uninsured at the time of donation. Younger (18 to 34 years old), male, minority, non-employed, less educated, non-married LKDs and those who were smokers and normotensive were more likely to not have health insurance at the time of donation. Compared to those with no health risk factors (i.e., obesity, smoking, hypertension, eGFR, proteinuria)(14%), LKDs with 1 (18%) or ≥2 (21%) health risk factors at the time of donation were more likely to be uninsured (P<0.0001). Among those with ≥2 health risk factors, blacks (28%) and Hispanics (27%) had higher likelihood of being uninsured compared to whites (19%; P<0.001). Study findings underscore the importance of providing health insurance benefits to all previous and future LKDs

The Instability of Organ Donation Decisions by Next-of-Kin and Factors That Predict It

We examined the instability of organ donation decisions made by next-of-kin and factors that predict whether non-donors wish they had consented to donation. Next-of-kin of donor-eligible individuals from one organ procurement organization participated in a semi-structured telephone interview. Participants were asked if they would make the same decision if they had to make it again today. Of the 147 next-of-kin donors, 138 (94%) would make the same decision again; 6 (4%) would not consent to donation, and 3 (2%) were unsure. Of the 138 next-of-kin non-donors, 89 (64%) would make the same decision again, 37 (27%) would consent to donation, and 12 (9%) were unsure. Regret among non-donors was more likely when the next-of-kin had more favorable transplant attitudes (OR=1.76, CI=1.15, 2.69), had the first donation discussion with a non-OPO professional (OR=0.21, CI=0.13, 0.65), was not told their loved one was dead before this discussion (OR=0.23, CI=0.10, 0.50), did not feel they were given enough time to make the decision (OR=0.25, CI=0.11, 0.55), had not discussed donation with family members (OR=0.30, CI=0.13, 0.72), and had not heard a public serve announcement about organ donation (OR=0.29, CI=0.13, 0.67). OPOs should consider targeting these variables in educational campaigns and donation request approaches

Attitudes Toward Financial Incentives, Donor Authorization, and Presumed Consent Among Next-of-Kin Who Consented vs. Refused Organ Donation

BACKGROUND: Financial incentives, donor authorization, and presumed consent are strategies designed to increase organ donation rates. Surveys designed to assess attitudes toward these initiatives have been conducted with the general public, transplant patients, and transplant professionals. METHODS: To assess attitudes toward financial incentives, donor authorization, and presumed consent and to identify multivariate predictors of such attitudes, we conducted telephone interviews with 561 family members who had recently been asked for consent to donate the organs of a deceased family member (348 donors, 213 nondonors). RESULTS: Financial incentives would have made a difference in the donation decision for 54% of nondonors (vs. 46% of donors, P = 0.02), and a higher percentage of nondonors would themselves become donors if financial incentives were available (P = 0.03). Donors had significantly more favorable attitudes toward donor authorization (P < 0.0001) and presumed consent (P < 0.0001) policies. Overall, 54% of participants thought that family permission for donation was unnecessary when the deceased documented their donation intention, and 24% favored a presumed consent law with an opting out provision. CONCLUSIONS: Of the three initiatives, donor authorization is likely supported by more donor and nondonor families than either financial incentives or presumed consent. Public education efforts should aim to better inform the public regarding existing and proposed donor authorization legislation and its benefits for registered organ donors and their families

Polymer composites based on agave fibres

Low density polyethylene was blended with agave fibres of three sizes: 0.21, 0.81 and 1.11 mm. Fiber concentrations between 10 and 25% were used to produce composites using twin-screw extrusion and injection molding. To determine the effect of processing on mechanical properties, uniaxial traction and impact resistance were obtained, in relation with morphology and density. The results show that there is an optimum concentration and fibre length for each processing technique

Polymer composites based on agave fibres

Low density polyethylene was blended with agave fibres of three sizes: 0.21, 0.81 and 1.11 mm. Fiber concentrations between 10 and 25% were used to produce composites using twin-screw extrusion and injection molding. To determine the effect of processing on mechanical properties, uniaxial traction and impact resistance were obtained, in relation with morphology and density. The results show that there is an optimum concentration and fibre length for each processing technique

Effect of freeze-line position and stretching force on the morphology of LDPE-PA6 blown Films

Blends of low density polyethylene (LDPE) and polyamide-6 (PA6) are produced via blown film extrusion to study the effect of freeze-line position and stretching force on blend morphology. An experimental setup is designed to measure the stretching force as a function of draw ratio (DR) and freeze-line position for 4, 6, and 10 wt% PA6 in LDPE. Numerical simulations of the non-isothermal and viscoelastic process are in good agreement with the experimental data of film dimensions. However, as reported many times in the literature, the calculated stretching force is underestimated and can be predicted more precisely by using a simple correction factor. The results also show that the dispersed phase deformation increases with DR and decreases with freeze-line height. � 2006 SAGE Publications

Film processability, morphology, and properties of polyamide-6/low density polyethylene blends

The processing, morphology, and tensile properties of blown films prepared from polyamide-6 (PA6) and low density polyethylene (LDPE) blends with and without compatibilizer (Surlyn� 9020) are studied. The results indicate that the presence of PA6 and a compatibilizer has a great influence on blend rheology as well as mechanical and barrier properties of LDPE films where the morphology of the dispersed phase (PA6) plays an important role. In this study, film morphology is controlled mainly by variations in draw ratio and bubble pressure. It is shown that biaxial orientation of the films explains the anisotropic behavior of the mechanical properties and improved barrier properties due to the production of a lamellar structure. � SAGE Publications, Inc. 2007