Dissertations / Theses on the topic 'Donor and recipient'

We present a simple argument which proves a general version of the scaling phenomenon recently observed in donor-recipient games by Tanimoto [Tanimoto, J., 2009. A simple scaling of the effectiveness of supporting mutual cooperation in donor-recipient games by various reciprocity mechanisms. BioSystems 96, 29-34].

Live kidney transplants are a successful and efficient means of treating those with chronic renal failure. However, the procedure is associated with potential physical and psychosocial risks, such as operative complications and pressure to donate and receive. Recipients also often feel grateful, even 'indebted', to the donors and, consequently, this can affect their relationship with each other. Despite these issues, few studies have focused on the experiences of those involved in live transplantation. This study was, therefore, undertaken to provide an in-depth insight into this process from the participants' perspectives. Therefore, the aims of this qualitative, longitudinal study were to explore: > The experiences of donors and recipients throughout the live transplantation process > The relevance of the anthropological theory of 'gift exchange' as a framework for exploring and understanding the live kidney transplantation process > How a theoretically informed insight into these experiences may be used to inform and develop future research and clinical practice A qualitative, phenomenological approach was used to explore the experiences of 11 live kidney donors and their recipients in South-West England. Data were collected through a series of three semi-structured interviews, conducted pre- transplant and at three and ten months post-transplant. Interviews were transcribed verbatim and data coded into categories arising from participants' accounts. These findings were also considered within a theoretical framework of gift exchange. Live transplantation was the treatment of choice for all participants, especially recipients. All donors initially made an instantaneous, voluntary decision to donate and found the decision relatively easy to make. In contrast, recipients found accepting the donors' offer emotionally burdensome because of concern for their wellbeing. They were only really able to accept the transplant after discussing the matter with their donor and establishing that it was something that they really wanted to do. Recipients' lives were transformed by a successful transplant and they were subsequently very grateful to the donors for donating. Donors derived immense personal satisfaction from this outcome and it helped to confirm to them that what they had done had been worthwhile. However, the transplant rejected in one recipient and the effects of this failure were devastating. The provision of transplant services throughout this process were generally positively evaluated by participants, although several recommendations were suggested. Data from this study show that the experiences of participants interviewed, closely resembled the fundamental dynamics of the gift exchange process, thus supporting the hypothesis that this theory provides an appropriate framework for understanding the live transplantation process in these participants. The findings from this study have implications for clinical practice and future research in this area.

Includes bibliographical references (leaves 54-62).
Living donor liver transplantation (LDLT) is now well established and performed on a routine basis in many major centres around the world. LDLT is feasible because of the capacity of both the remnant donor liver and the transplanted partial liver to undergo liver regeneration. However it has been demonstrated that liver regeneration in the recipient is rapid, whereas restoration of liver mass in the donor is delayed. This discrepancy in the rate of regeneration could be due to the presence of hepatotrophic factors and the use of immunosuppression in the recipient. The aims of the studies were to determine if hepatotrophic factors and immunosuppression (Cyclosporine) could modify the restoration of the liver mass after partial hepatectomy in rats.

Since the early 1990s electricity reforms across Sub-Saharan Africa have been marked by controversy. Despite the World Bank's major role in driving electricity reform as part of its conditional lending strategy in the electricity sector, its relationship with recipient countries has received little attention within the electricity reform literature. This is surprising given the increasing pressure on the World Bank to improve the effectiveness of its conditional lending more generally. This thesis contributes to filling this gap by exploring how World Bank-recipient country relations shape and constrain the direction of reform. The donor-recipient relationship is commonly espoused in the academic literature as a principal-agent relationship, whereby international aid organisations (principals) delegate authority for implementing their development policies to recipient countries (agents). I develop this framework by incorporating refined concepts of power, partnership, ownership and knowledge, prominent features in development studies literature and recent donor discourse. The analytical framework developed is applied to the process of electricity reform in two countries: Tanzania and Ghana. While the impetus for reform in these two countries was similar, the way in which the reform process unfolded was different. The analysis is based on in-depth, semi-structured interviews and documentary evidence. It uses a process-tracing method, combining within-case and cross-case analysis. A number of insights emerge from the analysis. I find that availability of reform expertise plays a significant role in determining the strength of power relations between donors and recipient countries. It also appears that reform ownership lies within different ‘domains'. Uneven ownership across domains accounts for the inconsistent reform implementation noted in both cases. And knowledge asymmetry provides a useful concept to analyse the impact of decentralised donor staff. In conclusion, this thesis argues that a modified principal-agent framework offers additional insight into the workings of the donor-recipient relationship.

Choosing a mate is one of the largest (economic) decisions humans make. This thesis investigates this large scale decision and how the process is changing with the advent of the internet and the growing market for online informal sperm donation. This research identifies individual factors that influence female mating preferences. It explores the roles of behavioural traits and physical appearance, preferences for homogamy and hypergamy, and personality, and how these impact the decision to choose a donor. Overall, this thesis makes contributions to both the literature on human behaviour, and that on decision-making in extreme and highly important situations.

It is known that secondary transfer of DNA can occur in different forms: skin to skin contact, skin to object contact and object to skin contact. Until now, the secondary transfer that has been studied concerns the transfer of the DNA from one individual via the skin of another individual. DNA transfer between two surfaces and which does not involve skin contact has not been studied but has been accepted as a possibility. In this project, we investigated such a DNA transfer resulting from the contact between different donor surfaces and recipient fabrics. The aim was to establish experimentally an evidential basis that enables pre assessment in casework by giving ore data about secondary transfer for particular scenarios. For instance, contact between an attacker's gloves bearing the attacker's DNA and the victim's clothes. To answer this question we studied static DNA transfer between two pieces of fabric with an applied pressure similar to that which may be involved in an actual case. The results of these experiments were not conclusive and we extended the nature of the DNA donor surfaces to the non-absorbent surfaces (glass and linoleum) using the same experimental conditions. The significance of friction during contact was also explored and it was found that very little transfer took place in the absence of friction.

The increasing demand for organs has stimulated the necessity in xenotransplantion, which promises an unlimited supply of organs for clinical use. However, coagulopathy of xenografts remains a major hurdle to successful pig-to-primate xenotransplantation. The ability to generate pigs expressing a human complement-regulatory protein (hCRP) and/or pigs in which the α1,3-Galactosyltransferase gene has been knocked-out (GT-KO) has largely overcome the barrier of hyperacute rejection (HAR) of a pig organ transplanted into a primate. However, acute humoral xenograft rejection (AHXR), presenting as microvascular thrombosis with/without consumptive coagulopathy (CC), ensures and results in graft failure. The causes of coagulopathy were believed to be humoral response-dependent. Xenoreactive antibodies (Abs) and activation of complement provoke porcine endothelial cells (ECs) from an anticoagulant to a procoagulant phenotype. In this study, I demonstrated that recipient platelets and monocytes were activated to express tissue factor (TF), an initiator of the coagulation cascade, after incubation with porcine ECs through humoral immune response-independent process. These observations were mirrored in the animal studies. Kidneys or livers from GT-KO pigs that express a hCRP transplanted into nonhuman primates were not susceptible to HAR. Nevertheless, most recipients developed CC, even when the grafts were still functioning. Activation of graft ECs and the measurable immune response were minimal. TF expression on recipient platelets plays a pivotal role in initiating CC. Therefore, understanding the interactions between porcine ECs and primate platelets may be crucial to prevent coagulopathy. On the other hand, the generation of GT-KO pigs has directed interest to the role of anti-nonGal Abs in intravascular thrombosis. My study revealed that anti-nonGal Abs activated porcine ECs to express TF, independent of complement activation. I also demonstrated that anti-P-selectin and vWF Abs and some anti-platelet agents, such as clopidogrel and eptifibatide, prevented TF expression on platelets after incubation with porcine ECs. Porcine ECs from pigs that expressed tissue factor pathway inhibitor (TFPI) were resistant to the activation induced by primate serum even with high titre anti-nonGal Abs. Atorvastatin not only inhibited this activation of platelets but also prevented the activation of porcine ECs induced by primate serum. Coagulopathy is increasingly recognized as barriers to successful xenotransplantation, many mechanisms of which are not associated with humoral immune response. Further manipulation of the immune response alone, with the risk of inducing infection and other complications, does not appear likely to resolve the challenge of xenograft coagulopathy. My results provide evidence for further genetic manipulation or systemic pharmaceutical treatment to prevent coagupolpathy seen after pig-primate xenotransplantation.

Both Kyrgyzstan and Turkmenistan were part of the former Soviet Union and were integrated into its political, economic and governance systems. As Union republics, they remained isolated from the outside world, with little direct interaction with external actors. Following the collapse of the Soviet Union in 1991, both Kyrgyzstan and Turkmenistan established relations with a number of bilateral donors and multilateral development agencies. Despite their many similarities (e.g., social, cultural, religious, linguistic, geographic) and a shared history, the two countries’ post-Soviet development trajectories diverged dramatically. While Kyrgyzstan quickly launched transition reforms, liberalizing its economy and polity with support from external donors, Turkmenistan adopted a more gradual approach to political and economic reform and managed to minimize the influence of external actors in domestic affairs. This thesis analyzes the donor-recipient interaction in Kyrgyzstan and Turkmenistan across three sectors: governance, rural development, and environment. The analysis focuses on the management of aid through an anthropological, political economy-directed inquiry of relations between foreign donors and aid recipients at the micro level (daily interactions in managing aid). Collective action theory, evolutionary theory and adaptive behavior approaches are utilized to analyze the interaction on micro-level. However, the analysis is also situated in a broader, macro-level context of development and security priorities of the two states, for which the realist branch of the international relations theories is applied. Methodologically, the study is based on the triangulation of findings from various sources, including the content analysis of primary and secondary sources as well as the analysis of over 60 semi-structured interviews involving government and donor officials from the two countries. The thesis does not attempt to analyze whether development aid was effective. Instead, using similar analyses of aid interactions (Mosse, 2005; Swedlund, 2017), this thesis aims to investigate how aid interactions ‘happen’ (Wedel, 1998). While I agree that the sustainability of development aid is hampered by the inability of both donors and recipients to ‘make credible commitments’ (Swedlund, 2017), in this thesis I argue that aid interactions are also influenced by other factors, namely the political sensitivity of the sectors to which the aid is given (governance, rural development, environment), regime characteristics, availability or absence of natural resource-based revenues, and geopolitics. These factors, taken together, affect the aid bargaining process in important ways. The thesis makes a three-fold contribution to the existing knowledge on aid relations. First, it expands the knowledge on the agency of recipient governments by putting them at the core of the analysis. Second, it contributes to the very limited number of cross-sectoral and cross-country comparative studies on both aid management and on public policy making in general and in Central Asia in particular. Thirdly, it provides a detailed account of how development aid has been managed in Turkmenistan, a country on which no serious academic literature related to aid management has been produced to date.

This portfolio consists of three sections: a qualitative research study, a case study and an article, with the overall aim of exploring women’s psychological experience of their fertility and reproductive health. The aim has been, across the three sections, to depict how women try to make sense of their fertility issues, the complexity of this experience, and how this impacts on other areas of their life. Fertility issues have been medicalised due to the rise of and focus on developing artificial reproductive techniques to assist people in conceiving: The focus has been on solving a medical problem with a medical solution, and less on the more psychosocial elements of infertility and artificial reproductive techniques. It is hoped that these three sections will help extend our understanding and insight into the experience of the psychosocial repercussions that fertility issues and egg donation can have for women.

Since the 1970s, the number and variety of states providing bilateral aid has grown. In 1973, 16 states provided aid; in 2013, 31 provided aid. This growth may not appear substantial, but it greatly outstrips growth in the number of states in the international system over the same time period (~46% versus 94%). Given states commit aid for a variety of reasons – prominently, including their own geopolitical self-interests – this growth in the bilateral aid donor community suggests donors are likely to encounter increased competition for any given recipient’s foreign policy cooperation. In the face of this increased competition, this dissertation asks: under what conditions will some bilateral aid donors experience greater foreign policy cooperation as a result of their aid efforts than other donors? To answer this question, this dissertation develops and contributes a framework for better understanding when bilateral donors – in the context of a competitive aid-for-policy "marketplace" – will experience greater geopolitical gain. The donor-recipient aid and cooperation framework suggests each component of the aid-for-policy exchange – the donor, the recipient, and the aid itself – is likely to influence the success any given donor experiences utilizing aid to promote foreign policy cooperation. At its core, the framework argues any given donor’s ability to use aid to promote foreign policy cooperation is a function of their own decision-making and policy process; in particular, their abilities to interpret information and adjust policies. This function, however, is likely to be conditioned by the recipient’s set of donor relationships, the donor's ability to overcome friction and resistance in their policy process, and the on-the-ground experience of the aid’s consumers. In developing this argument, the donor-recipient aid and cooperation framework draws upon a variety of theories from international relations, foreign policy decision-making, public policy, and organization theory. Overall, I find elements related to the donor and the recipient condition the success any given donor experiences utilizing aid to promote foreign policy cooperation. The results indicate that donors who possess dependence-based power advantages, or higher levels of mutual dependence, with their recipients are likely to experience improved foreign policy cooperation, but this experience substantively varies across different levels of aid giving. Additionally, some donors – due to their power status, regime type, or organizational memberships and normative adherences – are likely to experience more cooperation than others as a result of lower decision costs and institutional costs in their policy processes. The third element of the donor-recipient aid and cooperation framework, the aid itself, remains untested and is left for analysis in future work.

INTRODUCTION: The presence of a donor-specific alloimmune response negatively impacts allograft outcomes, being associated to risk of rejection and premature graft loss. Alloimmunity can be both preformed (memory) or can develop de novo after transplantation. The immune assays currently used in clinical practice to evaluate alloimmunity have several limitations and do not allow a complete and precise assessment of those two responses at time of transplantation. The hypothesis of this doctoral thesis is that at the time of kidney transplantation, an accurate characterization of pretransplant anti-donor alloimmune sensitization using highly sensitive assays tracking both serological memory and circulating donor-reactive memory T cells together with the assessment of the susceptibility to de novo alloimmune activation assessing the degree of donor/recipient HLA matching at the molecular level, would improve current immune-risk stratification and ultimately guide transplant physicians individualizing immunosuppressive therapies. OBJECTIVES: - To compare the accuracy of different immune-assays evaluating the preformed serological immunity (circulating donor(HLA)-specific antibodies), either individually or in combination and their value predicting distinct kidney graft outcomes. - To investigate the development and kinetics of primary T-cell alloreactivity after transplantation by detection of alloreactive IFN-γ producing T cells using an Enzyme-link ImmunoSpot (ELISPOT) assay and evaluate their predominant antigen presenting pathways. - To analyze the impact of donor/recipient HLA molecular mismatching on the generation of de novo donor-specific alloimmunity both at humoral and T-cell level after transplantation using distinct bioinformatic algorithms. - To evaluate the value of assessing preformed donor-reactive IFN-γ-producing T cells and donor/recipient Molecular HLA mismatching to identify kidney transplant recipients at low risk of rejection when receiving reduced immunosuppression based on tacrolimus monotherapy. METHODS: we performed two retrospective clinical studies and one prospective multicenter biomarker-guided study (CELLIMIN). The predictive capacity of different assays to detect pretransplant donor-specific antibodies (DSA) has been evaluated: flow cytometry crossmatch, solid phase assays and complement activating (C3d) capacity of DSA in vitro. Furthermore, the presence of alloreactive T cells in vitro has been assessed by Interferon-γ ELISPOT before and after transplantation. Donor/recipient HLA incompatibility has been evaluated with different informatic algorithms: Amino acid mismatch score, HLA-Matchmaker eplet mismatches and PIRCHE-II scores. It has been assessed the impact of the results of those algorithms on the prediction of primary alloimmunity both at the serological and T-cell level. Last, in a prospective study guided by biomarkers assessing both pretransplant serological and T-cell alloimmunity we randomized low-risk patients to receive either immunosuppression based on tacrolimus monotherapy or standard of care (steroids, Mycophenolate mofetil and tacrolimus). MAIN RESULTS: DSA with high mean fluorescence intensity (MFI) and those fixing complement in vitro predict higher rejection risk. The most accurate serological assays to predict transplant outcomes were a combination of DSA detected by solid phase assay and flow cytometry crossmatch. All the informatic HLA molecular mismatch algorithms precisely predicted risk of humoral primary alloimmunity. Similarly, a higher molecular incompatibility (especially by PIRCHE-II score) predicted risk of de novo T-cell activation. Finally, in the CELLIMIN trial, we observed that patients without preformed alloreactivity (neither serological or T cell-mediated) displayed significantly lower risk of acute rejection as compared to patients with preformed cellular alloreactivity and receiving the same standard of care immunosuppression. However, patients without serological/T cell preformed alloreactivity receiving minimized immunosuppression with tacrolimus monotherapy showed significantly higher incidence of acute rejection especially those with high molecular HLA mismatch at the DQ level. CONCLUSIONS: A complete and accurate study of the donor-specific preformed immune responses both at the serological and T-cell level, together with the assessment of the molecular HLA incompatibility, could improve stratification of the alloimmune risk in a more precise way, finally allowing adapted individualization of immunosuppression.
Las respuestas inmunológicas donante-especificas impactan negativamente en la evolución del aloinjerto renal. Estas pueden ser preformadas o activarse de novo tras el trasplante. Las técnicas inmunológicas disponibles en la clínica presentan limitaciones que no permiten una evaluación completa y precisa de esas respuestas. La hipótesis de esta tesis doctoral es que una evaluación de la memoria inmunológica mediante nuevas herramientas diagnosticas junto con estudios de compatibilidad HLA donante/receptor a nivel molecular para predecir el riesgo de aloinmunidad de novo, mejorarían la estratificación del riesgo inmunológico y permitirían personalizar la terapia inmunosupresora. Se han usado diferentes metódicas de detección de anticuerpos donante-específicos (DSA) pre-trasplante: cross-match por citometría de flujo, técnicas de fase solida y capacidad de los DSA de fijar complemento (C3d) in vitro y se ha medido la presencia de células T aloreactivas in vitro mediante ELISPOT Interferon(IFN)-y antes y después del trasplante. La incompatibilidad molecular HLA se ha valorado mediante algoritmos informáticos: incompatibilidad de aminoácidos, HLAMatchmaker y PIRCHE-II. Por ultimo, en un ensayo clínico prospectivo, guiado por biomarcadores de alorespuesta pre-trasplante (serológica y celular T) se han aleatorizado pacientes de bajo riesgo a recibir monoterapia con tacrolimus o tratamiento inmunosupresor convencional y comparado el riesgo de rechazo. La combinación de DSA (por fase solida) y cross-match por citometría son las técnicas que mejor se asocian el riesgo de pérdida del injerto, mientras que los DSA con elevado índice de fluorescencia y los que fijan complemento se asocian al riesgo de rechazo. Todos los algoritmos de incompatibilidad molecular HLA se asocian al riesgo de aloreactividad humoral primaria post-trasplante. De forma parecida, la incompatibilidad molecular (sobretodo por PIRCHE-II) se relaciona al riesgo de generar respuesta T donante-especifica de novo. En el ensayo CELLIMIN, los pacientes sin aloreactividad pre-trasplante (DSA/aloractividad T) presentaron inferior riesgo de rechazo. Sin embrago, aquellos pacientes que recibieron tacrolimus monoterapia presentaron una mayor incidencia de rechazo, especialmente en presencia de elevada incompatibilidad de epletos HLA-DQ. Un estudio completo de las respuestas de memoria tanto serológica como celular T donante-específica, junto con la evaluación de la incompatibilidad HLA a nivel molecular, podrían estratificar más precisamente el riesgo inmunológico de cada receptor frente a su donante y permitir adaptar el tratamiento inmunosupresor de una forma personalizada.

Concentrations of trace minerals within the body are known to impact reproductive processes. Thus, the current study analyzed the effects of using an injectable trace mineral supplement containing selenium, zinc, copper, and manganese during a superovulation protocol on embryo outcomes in donor beef cows and further effects on pregnancy rate in recipient females. We hypothesized that an injectable trace mineral (TM) supplement provided to cows fed to meet known nutrient requirements would increase TM status and influence superovulation, embryo characteristics, and enhance pregnancy rates. Our findings indicate that the injectable TM increased concentration of Se within the liver. However, superovulatory response, embryo production, quality grade, and developmental stage were not influenced by TM status. In addition, embryo treatment did not influence pregnancy rate, gestation length, or calf body weight.

This research investigates the foreign aid policies and practices of donor countries and of Jordan, a middle-income aid recipient country, through an examination of case studies of recent aid provision to Jordan. It examines the bearing of these policies on the effectiveness and efficiency of aid projects. The research concentrated on four case studies carefully chosen by the criteria of different donor nations and policies; and the different nature of the projects that cover the four main areas of development needs for Jordan. The case studies consisted of analysis of documentation and outcomes, and significant interviews with the selected participants. The case studies were chosen to explore the different mission statements, policies and practices and included the GTZ- funded Petra Stone Preservation Project, the USAIDfunded ICT Initiative, the DFID-funded Capacity Building in the Management of Jordan’s Education Services Project, and the JICA-funded Improvement of Water Supply System to Greater Amman Project. The study examines the effectiveness of aid in poor policy environments. It shows that the role of donors in ensuring the effectiveness of the aid they present goes beyond selecting recipients based on their policies and governance. Indeed, foreign aid is not donor-neutral and its effectiveness is not only dependent on the quality of governance and institutions of the recipients. The research demonstrates that a donor’s national interests and the influence of stakeholders determine the course and benefits of aid, and that judgements of success or failure vary between the standpoints of the donor and the recipient. The study investigates the impact of a number of variables on the effectiveness of foreign aid. Those variables include aid project design and delivery mechanisms, and institutional capacity and cultural constraints of aid recipients. The research focuses on relationships between donors and recipients and the differences in interests and objectives. It also looks at the impact of conditionality and tied aid on the sustainable benefits of the aid intervention. ii Although existing literature does address some of these considerations, there is very little direct evidence which links development theory with detailed practical examples. Where such examples are available, they are invariably weighted heavily by evidence which originates with, and is interpreted through, donor perceptions. This study provides a balanced analysis of four initiatives taking account of both donor and recipient expectations, experiences and assessments.

L’efficacité de l’aide au développement est aujourd’hui largement débattue au sein de la communauté des donateurs et dans la littérature académique (Rajan and Subramanian, 2008). Le contexte institutionnel des pays récipiendaires est au cœur de ce débat puisqu’il conditionnerait l’efficacité de l’aide en termes de croissance économique (Dalgaard and Hansen (2001), Collier and Dollar (2002) and Burnside and Dollar, 2004). L’aide serait efficace dans les pays pauvres et bien gouvernés. L’objet de ce travail de recherche est d’expliquer l’apparition de critères institutionnels dans l’allocation de l’aide au développement et de déterminer leurs effets en matière d’efficacité de l’aide. Il vise donc à appréhender le rôle joué par la gouvernance dans les pays receveurs (pays en développement) et dans les pays donateurs (pays de l’OCDE essentiellement) à la fois dans l’allocation et dans l’efficacité de l’aide au développement. Ce travail tente donc de répondre à plusieurs interrogations : (1) la reconnaissance de la nature institutionnelle de l’aide est-elle appropriée ? (2) l’aide est-elle- intrinsèquement politique ? (3) quelles sont les implications économiques de l’aide allouée selon des critères institutionnels ?
The recognition that political institutions matter is relatively recent and is the result of several interacting factors. The purpose of our research is to explain how foreign aid is related to governance issues both in recipient countries (developing countries) and in donor countries. Development aid is provided by: bilateral donors (29 DAC3 donors and 19 non-DAC donors), multilateral donors and private donors (e.g. Bill & Melinda Gates Foundation). Foreign aid differs according to the intended purposes: reforming national policies (economic policies or other types) and political institutions, and providing humanitarian assistance. The focus of our dissertation is on the emergence of non-strictly economic criteria (mainly institutional criteria) within the donor community as well as their impact on aid allocation and effectiveness. Therefore, we will address several questions: (1) Is the recognition of the institutional nature of aid appropriate?(2) Is aid political? (3) What are the economic implications of political aid (or aid based on institutional performance) ?

General Abstract Objective: In April 2006, the Scottish Liver Transplant Unit (SLTU) became the first NHS transplant unit in the UK to offer the option of Living Donor Liver Transplantation (LDLT). This represented a unique opportunity to evaluate the functional and psychosocial impact of LDLT upon healthy donors and their recipients. Subsequent aims were to investigate the challenge of introducing LDLT in Scotland and to establish the perceived deterrents and attractions of the procedure. An additional aim was to evaluate the impact of Living Donor Kidney Transplantation (LDKT) upon donors and recipients. Design: A series of cross sectional and longitudinal studies were designed for the purpose of this thesis (3 quantitative, 2 qualitative, and 1 mixed methods). Method: Self report questionnaires were used in each of the quantitative studies, with the addition of neuropsychological computerized tests in two studies. Semi-structured interviews were employed in the qualitative studies. Main Findings: •Prior to its introduction general support for the option of LDLT was found, although it was highlighted that the risk involved was not well understood by the general public. •Since becoming available LDLT has not been a readily acceptable treatment option from the perspective of patients due to the perceived risk for the donor, but it may be considered as a “last option”. Family members were motivated to save their loved one’s life but the personal implications of donating resulted in reconsideration of LDLT. • Staff at the SLTU perceived a lack of family commitment in relation to LDLT, which is explained as a cultural factor contributing to the slow uptake of LDLT. In Scotland, a donation from a younger to an older generation is not easily accepted. This, in addition to patients’ optimism that a deceased donation will arrive, and the poor health of potential donors, is thought to have affected the uptake of LDLT. As has the unit’s conservative approach to the promotion of LDLT. This approach is the result of a perceived reduction in the need for LDLT and a preference to avoid the risk to a healthy donor and conduct transplants with deceased donations. • In over 3 years, only one couple completed LDLT. The recipient showed functional and psychosocial improvement from pre to post procedure, whilst the donor showed slight deterioration in aspects of quality of life 6 weeks post donation, which did not always completely return to a baseline level by 6 months. The donor made sacrifices to provide her husband with a fresh start to life and unmet expectations were found to effect quality of life. •Willingness to become a liver donor is not thought to be influenced by the frame of the information provided. •Like the LDLT donor, LDKT donors experience some functional and psychosocial deterioration at 6 weeks post donation, but donors largely recover by 6 months post donation. However, the anticipated benefit to recipients was not evident and may not be quantifiable until after 6 months post operation. Conclusion: This thesis has added to current knowledge on living organ donation and specifically represents the first psychological evaluation of a UK LDLT programme. The slow uptake of LDLT was unexpected and has resulted in informative, novel research.

The effects of foreign aid in the process of economic growth in developing countries is a subject of intense debate. While its favorable effects in the struggle with poverty are undeniable, its determining factor for economic development has positions in favor and against. This article presents a review of the literature on foreign aid, focusing on the fundamental aspects to facilitate its analysis. Other aspects that are addressed are the main arguments used to support the granting and receiving of foreign aid towards a developing country, as well as those arguments that criticize its suitability. The final part includes some conclusions about the presented arguments.
Los efectos de la cooperación internacional en el proceso de crecimiento económico de los países en desarrollo es un tema de intenso debate. Si bien sus efectos favorables en la lucha contra la pobreza resultan innegables, su condición de factor determinante para el desarrollo económico tiene posiciones a favor y en contra. En este artículo se hace una revisión de la literatura sobre la cooperación internacional, concentrándose en los factores fundamentales para facilitar su análisis. Otro aspecto tratado son los principales argumentos utilizados para respaldar el otorgamiento y recepción de cooperación internacional hacia un país en desarrollo, así como aquellos argumentos que critican su conveniencia. La parte final incluye algunas conclusiones sobre los argumentos expuestos.

Adopting a Strategic Sustainable Development (SSD) approach to official bilateral development assistance could result in more effective development planning that yields lasting results in developing countries. A Framework for Strategic Sustainable Development Assistance (FSSDA) based on SSD and customised to the needs of a development agency offers guidance in planning for development towards sustainability. This it does by directing donor and recipient planners in generating holistic perspectives, setting the goal of development as an attractive and sustainable society, and providing a flexible decision-making framework to guide strategic planning. Development assistance donor agencies face several difficulties in ensuring aid effectiveness. The FSSDA offers support in addressing these challenges by: positioning the creation of sustainable societies as the fundamental goal of development; allowing progress against imminent sustainability threats while minimizing the risk of unforeseen negative impacts; balancing economic, environmental and social considerations; and providing a fairer basis for aid conditionality.

A phenomenon called donor-specific hyporesponsiveness (DSH) has been described in some renal allograft recipients, in which there is progressive loss of responsiveness to donor tissues and this has been shown to be associated with a favourable long-term outcome. Despite its potential clinical importance, the mechanisms of DSH are unknown and there are no laboratory tests that accurately predict its development in individual patients which might allow the reduction of immunosuppressive therapy. Here I test the hypothesis that renal allograft recipients with DSH can be identified by analysis of the mixed lymphocyte reactivity in-vitro and that this state will be accompanied by the production of inhibitory cytokines such as IL-10 and TGF-β. The study comprised 78 patients from a single centre, 60 of whom were studied retrospectively and 18 prospectively over a one-year period. DSH was detected by donor specific mixed lymphocyte reactions and cytokine production was analysed by ELISA and PCR. Overall, DSH was found in 61% of cadaveric and 57% of livingrelated recipients in the retrospective cohort and in 36% of cadaveric and 25% of living-related recipients at one year post-transplant in the prospective cohort. DSH was associated with a lower incidence of late acute rejection in cadaveric and livingrelated recipients in both arms of the study. Chronic rejection was found in some patients, even in the presence of DSH, indicating that DSH is not exclusive to patients with a good allograft outcome. DSH correlated with a good graft outcome in long-term cadaveric recipients and was associated with low donor-specific IL-2 and high IL-4 production. Similarly, good graft outcome and DSH was associated with a trend towards low donor-specific IL-2 and high IL-4 production within the first year post-transplant. However, in long-term living-related recipients, DSH did not correlate with graft outcome and was associated only with low IL-2 production. A sub-group of cadaveric recipients with a de-novo solid organ malignancy shared many similar clinical and immunological features with their counterparts who did not have malignancy. This included good graft outcome, low acute rejection rate and a high incidence of DSH. Patients with malignancy produced low levels of IL-2, but also produced high levels of IL-10. However, there was no evidence of immune regulation mediated by IL-10 or TGF-β in any part of the study. My results suggest that it may be possible to select patients for tailoring of immunosuppression on the basis of detection of DSH, together with the production of a favourable cytokine profile at one year post-transplant. Potential candidates include cadaveric recipients with stable graft function who show DSH and produce four-fold higher levels of donor-specific IL-4 than IL-2, as well as HLA-ID living-related recipients with stable graft function who produce low levels of donor-specific IL-2.

Syftet med studien var att beskriva vilka attityder som finns bland recipienter och donatorer angående de riktlinjer som bör efterföljas för ägg- och spermiedonation. Syftet var även att undersöka om det finns skillnader i attityder inom grupperna recipienter kvinnor respektive män och donatorer till huruvida barnet har rätt att få kunskap om sitt ursprung.

Studien blev en del av ett stort nationellt projekt. Data samlades in med enkäter som berörde de tidigare beskrivna områdena. Enkäterna var utformade med påståenden att ta ställning till som ”instämmer” eller ”instämmer inte”. Antal deltagare var 333 stycken och data samlades in från april 2005 till och med våren 2008.

Huvudresultatet som framkom i studien var att för donatorernas attityder gällande barnets rätt att få kunskap om sitt ursprung så visade det sig att kvinnorna var i flera påståenden i signifikant högre grad mer positiva än männen. I resultatet angående attityder till riktlinjer som bör efterföljas för könscellsdonation så hade recipienter och donatorer snarlika inställningar, om än inte fullt ut. Gällande för recipienter så var det endast kvinnorna som hade en signifikant skillnad i ett påstående, i övrigt fanns det inga skillnader för de båda grupperna i attityderna till barnets rätt att få kunskap om sitt ursprung.

The purpose of the study was to describe what attitudes there were among recipients and donors about the guiding principles that should comply with oocyte- and sperm donation. The purpose was also to investigate if there were any differences within the groups of recipient women and men and the donor group considering disclosure to the child about their origin.

The study became a part of a national project. Data were collected with questionnaire that included earlier described aspects. It was formed with statements to take stands towards in form of “agree” or “disagree”. Number of participants were 333 and data were collected from April 2005 until spring 2008.

The main results found that among donors and the attitudes toward the child’s right to get knowledge about their origin showed that women was significantly more positive in several aspects then the men. The results also showed that considering the guiding principles that should comply with gametes donation the recipients and donors had just about similar attitudes. For the recipients there was only the women who had a significant difference in one of the statements, otherwise there was no difference in either of both groups for the attitudes about disclosure to the child.

La transplantation pulmonaire permet à des personnes en phase terminale d'une défaillance de leurs poumons, de trouver un second souffle et poursuivre leur vie grâce au don d'un donneur après sa mort. Si elle est une avancée médico-chirurgicale majeure, la transplantation pulmonaire n'en n'est pas moins une intervention qui pose des questions éthiques et sociétales et dont les incidences psychiques sont indéniables. Parce qu'elle fait appel à un donneur mort, la transplantation introduit dans le champ du somatique une altérité et une dette, à vie. Cette altérité via le greffon devra être psychisée par le sujet receveur. La transplantation bouleverse plus ou moins fortement les assises identitaires du receveur dont les manifestations sont diverses (déréalisation, hallucinations, questionnement concernant le donneur, etc.) et mobilise une activité fantasmatique intense autour de la mort (la sienne, celle du donneur) et des origines (la sienne, celle du donneur). Et ce, chez les receveurs, mais aussi les proches et les soignants. La maladie pulmonaire grave chronique aura nécessité des soins récurrents, quotidiens, depuis le début de la vie comme dans la mucoviscidose, ou plus tardivement. Ces soins auront pu être invasifs, voire traumatiques et avoir inscrit chez le sujet une image du corps blessée. La transplantation peut réactiver ces blessures et atteintes corporelles. Au travers d'un entretien de recherche et de tests projectifs (Rorschach et TAT), le vécu de la greffe sera recherché afin de mieux comprendre les incidences psychiques de la greffe et les représentations du donneur et du greffon qui animent le sujet receveur. Et ce afin d'aider les soignants à mieux comprendre les enjeux psychiques de la greffe, et mieux les prendre en charge
Lung transplantation gives the opportunity to lung terminal disease people to continue their lives, thanks to dead donors. But lung transplantation also raises ethical and societal questions and has undeniable psychic implications. Because of the necessity of the dead donor and the graft, lung transplant introduces otherness and debt, for life. This otherness needs to be psyched by the recipient. Lung transplant upsets the identity bases, more or less, which manifestations are diverse: derealization, hallucinations, questioning about the donor, etc. and it mobilizes an intense fantasy activity around the question of death ( it owns and that of the donor) and origins (it owns and that of the donor). These questions come from recipients, but also from care givers and families members. Severe somatic disease requires daily care, from the beginning of life on cystic fibrosis patients, later for the others suffering of other lung diseases. Some of these treatments may have been traumatic, invasive. These patients can have an body image, injured, fragmented. Through a research interview and projective tests (Rorschach and TAT) we try to better understand the experience of transplantation, their psychic implications and the psychic representations of donor and graft. This to help care givers to better understand the psychic implications of lung transplantation, and better take care of them

Introduction: Transfusion of blood products, especially red blood cells (RBC) is the most common medical intervention administered in North-American hospitals. The indications for transfusion are diverse but they largely aim at increasing oxygen delivery to tissues to improve patient clinical outcomes. Transfusion can also have deleterious effects. In fact, there is evidence that RBC transfusion may be ineffective, or even harmful in some populations where its use should in theory be beneficial. Seeking explanations for the beneficial and deleterious effects of red blood cell transfusions is necessary. The primary objective of this research is to investigate the associations between donor characteristics and RBC transfusion recipient outcomes. Methods: My thesis consists of a systematic review and meta-analysis of the literature regarding the association between blood donor characteristics and outcomes of the recipient, and the development of a framework linking the donor-recipient continuum using data collected from blood donors by Canadian Blood Services and clinical outcome data from large hospital and provincial clinical-administrative databases. Based on the framework, an epidemiological analysis was conducted to assess the effect of donor sex, age and ABO-Rh mismatch on RBC recipient outcomes. Results: Our systematic review found 58 studies evaluating 17 different donor characteristics. Five studies evaluated donor age as a risk factor for RBC transfusion outcome and 17 studies evaluated donor sex. We successfully developed an analytical framework allowing for a robust analysis of the impact of donor characteristics on RBC recipient outcomes that included 30,503 RBC recipients, 80,755 blood donors and a total of 187,960 transfusion episodes. We found that young age and female sex are donor characteristics significantly associated with adverse outcomes after RBC transfusion. Our newly developed framework, as well as our epidemiological findings, have the potential to influence future research in transfusion medicine and transfusion practices.

Background: An increasing number of couples turn to treatment with oocyte or sperm donation, but there is limited knowledge regarding the consequences of these treatments in a program using identifiable donors. Aim: The overall aim was to study information-sharing among heterosexual couples following identity-release gamete donation. A further aim was to study donors’ attitudes towards future contact with donation offspring. Methods: The four studies were part of The Swedish Study on Gamete Donation; a prospective, longitudinal study of donors and recipients of donated oocytes and sperm. Study I and II had a quantitative approach with recipients of donated oocytes or sperm participating through questionnaires at start of treatment, two months after the first treatment and when their child was 1-4 years old. Study III was a qualitative interview study with 30 parents following sperm donation with school-aged children. Study IV had a quantitative approach with oocyte and sperm donors participating through questionnaires 5-8 years post-donation. Results: Study I revealed that the recipients of donated gametes in general were open about their treatment with the people around them and supported disclosure to offspring regarding his/her genetic origin. Study II reported that most of those who became parents following donor conception intended to share information about the donation with their offspring and some had already started the information-sharing process with their young child. Study III described information sharing with the offspring to be a process of several levels, revealing various amounts of information about the way of conception. The parent was seen to be the owner of the process and moving the process forward with different aspects and the reactions of the offspring serving as driving or impeding forces of the process. Study IV reported that a majority of the gamete donors seem to have a positive or neutral attitude towards a future meeting with a donation offspring. Conclusion: The present thesis suggests that there is a trend towards more openness among recipients of donated gametes in Sweden. It also points out that most recipients and donors within the Swedish gamete donation programme acknowledge the child’s right to his/her genetic origin and have the best interest of the child in mind.

Дисертацію присвячено дослідженню змісту й особливостей адміністративно-правового регулювання трансплантації в Україні. Сформульовано авторське визначення понять «адміністративно-правове регулювання трансплантації», «засоби адміністративно-правового регулювання трансплантації», «принципи адміністративно-правового регулювання трансплантації анатомічних матеріалів людини», «форми адміністративно-правового регулювання трансплантації органів», «донорство анатомічних матеріалів». Розкрито основні ознаки донорства і трансплантації як об’єкта адміністративно-правового регулювання: публічно-правовий характер (забезпечуються та враховуються інтереси держави і приватних осіб – донорів, реципієнтів); домінуючий характер імперативного регулювання порівняно з диспозитивним; наявність спеціальних суб’єктів, об’єктів і змісту правовідносин, що характеризують правовідносини як такі, що мають адміністративно-правову природу; наявність адміністративно-правових засобів впливу на суб’єктів правовідносин, пов’язаних із трансплантацією. У результаті змістовного аналізу права на трансплантацію встановлено, що воно є спеціальним, оскільки безпосередньо залежить від медичної діяльності, особливостей хвороби пацієнта. Водночас це право є одним із основних у системі прав на охорону здоров’я, оскільки безпосередньо пов’язане із захистом життя і здоров’я, а тому має забезпечуватися відповідними гарантіями. Такими гарантіями здебільшого повинні бути нормативно-правове регулювання та діяльність відповідних інституцій у державі. До етико-правових проблем діагностики смерті мозку віднесено: проблеми моральної та соціокультурної прийнятності концепції смерті мозку; етико-правові проблеми різних дефініцій смерті мозку; етико-правові проблеми діагностики незворотності припинень усіх функцій головного мозку; проблеми етико-правової регуляції дій лікаря після констатації смерті на підставі діагнозу «смерть мозку»; проблема смерті мозку у зв’язку з розвитком трансплантології; етико-правові проблеми, пов’язані із діагностикою смерті мозку у дітей. Обґрунтовано доцільність класифікації принципів адміністративно-правового регулювання трансплантації анатомічних матеріалів людини на: 1) загальноправові принципи права; 2) галузеві принципи (принципи адміністративного права); 3) спеціальні принципи, властиві виключно трансплантології. Обґрунтовано доцільність створення консультативно-дорадчого органу при Кабінеті Міністрів України – Міжвідомчої координаційної комісії з питань трансплантації. Запропоновано наділити її контрольними, координаційними, аналітичними функціями. Обґрунтовано доцільність унесення змін до ст. 7 Закону України «Про ліцензування видів господарської діяльності». Запропоновано доповнити її таким обов’язковим видом діяльності, що підлягає ліцензуванню, як господарська діяльність з медичної практики, яка передбачає право надання медичної допомоги із застосуванням трансплантації. Здійснено класифікацію дій/бездіяльності, що мають характер адміністративних правопорушень у сфері трансплантації анатомічних матеріалів: 1) залежно від суб’єктного складу: правопорушення, вчинені медичними працівниками, які здійснюють діяльність у сфері трансплантації; правопорушення, вчинені посадовими особами, на яких покладено обов’язок щодо соціального забезпечення донорів, передбаченого ст. 22 Закону України «Про застосування трансплантації анатомічних матеріалів людині»; 2) у сфері функціонування електронних автоматизованих інформаційно-телекомунікаційних систем (Державної інформаційної системи трансплантації гемопоетичних стовбурових клітин, Єдиної державної інформаційної системи трансплантації органів та тканин); 3) правопорушення, що виникають під час вилучення анатомічних матеріалів у донора; 4) правопорушення, що виникають з порушень порядку транспортування анатомічних матеріалів людини, які застосовуються для трансплантації, передбаченого ст. 23 Закону України «Про застосування трансплантації анатомічних матеріалів людині» та Постановою Кабінету Міністрів України «Про затвердження Порядку перевезення анатомічних матеріалів людини в межах України, ввезення таких матеріалів на митну територію України та вивезення їх за межі митної території України». Доведено, що правопорушення у сфері трансплантації анатомічних матеріалів не є цивільно-правовими, а мають правову природу адміністративного правопорушення: по-перше, винною особою є медичний працівник, який виконує професійні функції у сфері трансплантації, або заклад охорони здоров’я незалежно від форми власності, наділений правом надавати медичну допомогу методом трансплантації; по-друге, відбувається порушення винною особою встановленого законом порядку здійснення трансплантації під час виконання нею своїх трудових (службових) обов’язків. Особливість адміністративної відповідальності за порушення порядку організації та надання медичної допомоги методом трансплантації виявляється в тому, що: до адміністративної відповідальності, крім фізичних осіб, можуть бути притягнуті юридичні особи; діяння/бездіяльність суб’єктів, що надають медичну допомогу методом трансплантації, є правопорушенням (порушенням порядку організації та здійснення трансплантації, вилучення, зберігання, транспортування анатомічних матеріалів), проте не мають ознак злочинів, передбачених статтями 143–144 Кримінального кодексу України. З’ясовано, що в зарубіжних країнах сформована інфраструктура у сфері трансплантації, створено органи державної влади, що здійснюють координацію діяльності й управління розподілом, розповсюдженням і трансплантацією донорських органів (Мережа закупівель і трансплантації органів (США); Корейське агентство донорства органів Міністерства охорони здоров’я та соціального забезпечення (Корея); Національна організація трансплантацій (Іспанія) тощо). Виокремлено основні напрями вдосконалення адміністративно-правового регулювання трансплантації в Україні: нормативно-правовий (йдеться про вдосконалення нормативно-правової бази, зокрема Закону України «Про застосування трансплантації анатомічних матеріалів людині», розробку Положення про Комітет з етичних питань Громадської ради МОЗ України, доповнення глави 5 «Адміністративні правопорушення в галузі охорони праці і здоров’я населення» КУпАП новими складами адміністративних правопорушень, Податкового кодексу України (щодо звільнення від оподаткування податком на додану вартість операцій з трансплантації анатомічних матеріалів людині) тощо); організаційно-правовий (спрямований на організацію розвитку та забезпечення реалізації трансплантації в Україні); фінансово-правовий (гарантування дотримання принципу безоплатності для донора та реципієнта на всіх етапах трансплантації та забезпечення фінансування наукових досліджень на основі використання генетичних технологій (терапевтичне клонування органів і тканин)); суб’єктний (формування системи суб’єктів виконавчої влади та інших суб’єктів у сфері застосування трансплантації); охоронний (формування системи засобів адміністративно-правового забезпечення, спрямованої на: гарантування дотримання прав людини та захист людської гідності при застосуванні трансплантації; забезпечення належної якості і безпеки анатомічних матеріалів на всіх етапах трансплантації; запобігання адміністративним правопорушенням у сфері організації та надання медичної допомоги методом трансплантації); координаційний (удосконалення змісту і форм взаємодії з міжнародними організаціями й окремими державами стосовно обміну досвідом щодо застосування трансплантації).
The dissertation is focused on studying the content and peculiarities of administrative and legal regulation of transplantation in Ukraine. The author has formulated own definition of the concepts of “administrative and legal regulation of transplantation”, “means of administrative and legal regulation of transplantation”, “principles of administrative and legal regulation of transplantation of human anatomical materials”, “forms of administrative and legal regulation of organs transplantation”, “donarship of anatomical materials”. The main features of donation and transplantation as an object of administrative and legal regulation are revealed: public-law character (interests of the state and private persons - donors, recipients are provided and taken into account); the dominant nature of imperative regulation compared to dispositive; the presence of special subjects, objects and content of legal relations that characterize legal relations as having an administrative-legal nature; availability of administrative and legal means of influencing the subjects of legal relations related to transplantation. As a result of a meaningful analysis of the right to transplantation, it was established that it is special because it directly depends on the medical activity, the features of the patient's disease. At the same time, this right is one of the main rights in the system of health care, as it is directly related to the protection of life and health, and therefore must be provided with appropriate guarantees. Such guarantees should mostly be legal regulation and the activities of relevant institutions in the state. Ethical and legal problems of brain death diagnosis include: problems of moral and sociocultural acceptability of the concept of brain death; ethical and legal issues of various definitions of brain death; ethical and legal problems of diagnosis of irreversibility of terminations of all brain functions; problems of ethical and legal regulation of the doctor's actions after the statement of death on the basis of the diagnosis "brain death"; the problem of brain death due to the development of transplantation; ethical and legal issues related to the diagnosis of brain death in children. The expediency of classifying the principles of administrative and legal regulation of transplantation of human anatomical materials into: 1) common law principles of law; 2) sectoral principles (principles of administrative law); 3) special principles inherent exclusively in transplantation. The expediency of establishing an advisory body under the Cabinet of Ministers of Ukraine - the Interdepartmental Coordination Commission on Transplantation - is substantiated. It is proposed to endow it with control, coordination, analytical functions. The expediency of making changes to Art. 7 of the Law of Ukraine "On licensing of economic activities". It is proposed to supplement it with such a mandatory activity that is subject to licensing, as a business activity in medical practice, which provides the right to provide medical care through transplantation. The classification of actions / inactions that have the nature of administrative offenses in the field of transplantation of anatomical materials: 1) depending on the subject composition: offenses committed by medical workers who carry out activities in the field of transplantation; offenses committed by officials who are obliged to provide social security for donors under Art. 22 of the Law of Ukraine "On the use of transplantation of anatomical materials to humans"; 2) in the field of functioning of electronic automated information and telecommunication systems (State information system of hematopoietic stem cell transplantation, Unified state information system of organ and tissue transplantation); 3) offenses that occur during the removal of anatomical materials from the donor; 4) offenses arising from violations of the procedure for transportation of human anatomical materials used for transplantation, provided for in Art. 23 of the Law of Ukraine "On the use of transplantation of anatomical materials to humans" and the Resolution of the Cabinet of Ministers of Ukraine "On approval of the Procedure for transportation of human anatomical materials within Ukraine, import of such materials into the customs territory of Ukraine and export outside the customs territory of Ukraine". It is proved that offenses in the field of transplantation of anatomical materials are not civil, but have the legal nature of an administrative offense: first, the culprit is a medical worker who performs professional functions in the field of transplantation, or a health care institution regardless of ownership. , has the right to provide medical care by transplantation; secondly, the guilty person violates the procedure established by law for transplantation while performing his / her work (official) duties. The peculiarity of administrative liability for violation of the order of organization and provision of medical care by transplantation is manifested in the fact that: in addition to individuals, legal entities may be held administratively liable; The act / omission of subjects who provide medical care by transplantation is an offense (violation of the order of organization and implementation of transplantation, removal, storage, transportation of anatomical materials), but do not show signs of crimes under Articles 143-144 of the Criminal Code of Ukraine. It was found that the infrastructure in the field of transplantation has been formed in foreign countries, public authorities have been established to coordinate the activities and management of distribution, distribution and transplantation of donor organs (US Procurement and Transplantation Network); and Social Security (Korea); National Organization of Transplantation (Spain), etc.). The main directions of improvement of administrative and legal regulation of transplantation in Ukraine are singled out: normative-legal (it is about improvement of normative-legal base, in particular the Law of Ukraine "On application of transplantation of anatomical materials to man", development of Regulations on Ethics Committee of the Public Council 5 "Administrative offenses in the field of labor protection and public health" KUpAP new components of administrative offenses, the Tax Code of Ukraine (on exemption from value added tax for transplantation of anatomical materials to humans), etc.); organizational and legal (aimed at organizing the development and implementation of transplantation in Ukraine); financial and legal (guaranteeing compliance with the principle of gratuitousness for the donor and recipient at all stages of transplantation and providing funding for research based on the use of genetic technologies (therapeutic cloning of organs and tissues)); subjective (formation of a system of executive entities and other entities in the field of transplantation); protective (formation of a system of administrative and legal support aimed at: guaranteeing human rights and protecting human dignity in transplantation; ensuring the proper quality and safety of anatomical materials at all stages of transplantation; prevention of administrative offenses in the field of organization and provision of medical care by transplantation) ; coordination (improvement of the content and forms of interaction with international organizations and individual states regarding the exchange of experience in the use of transplantation).
Диссертация посвящена исследованию содержания и особенностей административно-правового регулирования трансплантации в Украине. Сформулировано авторское определение понятий «административно-правовое регулирование трансплантации», «средства административно-правового регулирования трансплантации», «принципы административно-правового регулирования трансплантации анатомических материалов человека», «формы административно-правового регулирования трансплантации органов», «донорство анатомических материалов». Раскрыты основные признаки донорства и трансплантации как объекта административно-правового регулирования: публично-правовой характер (обеспечиваются и учитываются интересы государства и частных лиц - доноров, реципиентов) доминирующий характер императивного регулирования по сравнению с диспозитивным; наличие специальных субъектов, объектов и содержания правоотношений, характеризующие правоотношения как имеющие административно-правовую природу; наличие административно-правовых средств воздействия на субъектов правоотношений, связанных с трансплантацией. В результате содержательного анализа права на трансплантацию установлено, что оно является специальным, поскольку напрямую зависит от медицинской деятельности, особенностей болезни пациента. Одновременно это право является одним из основных в системе прав на охрану здоровья, поскольку непосредственно связано с защитой жизни и здоровья, а потому должна обеспечиваться соответствующими гарантиями. Такими гарантиями части должны быть нормативно-правовое регулирование и деятельность соответствующих институтов в государстве. К этико-правовых проблем диагностики смерти мозга отнесены: проблемы нравственной и социокультурной приемлемости концепции смерти мозга этико-правовые проблемы различных дефиниций смерти мозга этико-правовые проблемы диагностики необратимости приостановок всех функций головного мозга проблемы этико-правовой регуляции действий врача после констатации смерти на основании диагноза «смерть мозга»; проблема смерти мозга в связи с развитием трансплантологии; этико-правовые проблемы, связанные с диагностикой смерти мозга у детей. Обоснована целесообразность классификации принципов административно-правового регулирования трансплантации анатомических материалов человека на: 1) общеправовые принципы права; 2) отраслевые принципы (принципы административного права); 3) специальные принципы, присущие исключительно трансплантологии. Обоснована целесообразность создания консультативно-совещательного органа при Кабинете Министров Украины - Межведомственной координационной комиссии по вопросам трансплантации. Предложено наделить ее контрольными, координационными, аналитическими функциями. Обоснована целесообразность внесения изменений в ст. 7 Закона Украины «О лицензировании видов хозяйственной деятельности». Предложено дополнить ее таким обязательным видом деятельности, подлежащей лицензированию, как хозяйственная деятельность по медицинской практике, которая предусматривает право оказания медицинской помощи с применением трансплантации. Осуществлена ​​классификация действий / бездействия, имеющие характер административных правонарушений в сфере трансплантации анатомических материалов: 1) в зависимости от субъектного состава: правонарушения, совершенные медицинскими работниками, осуществляющими деятельность в сфере трансплантации правонарушения, совершенные должностными лицами, на которых возложена обязанность по социальному обеспечению доноров, предусмотренного ст. 22 Закона Украины «О применении трансплантации анатомических материалов человеку»; 2) в сфере функционирования электронных автоматизированных информационно-телекоммуникационных систем (Государственной информационной системы трансплантации гемопоэтических стволовых клеток, Единой государственной информационной системы трансплантации органов и тканей); 3) правонарушения, возникающие при изъятии анатомических материалов у донора; 4) правонарушения, возникают из нарушений порядка транспортировки анатомических материалов человека, которые применяются для трансплантации, предусмотренного ст. 23 Закона Украины «О применении трансплантации анатомических материалов человеку» и Постановлением Кабинета Министров Украины «Об утверждении Порядка перевозки анатомических материалов человека в пределах Украины, ввоз таких материалов на таможенную территорию Украины и вывоз их за пределы таможенной территории Украины». Доказано, что правонарушения в сфере трансплантации анатомических материалов не является гражданско-правовым, а имеют правовую природу административного правонарушения: во-первых, виновным лицом является медицинский работник, выполняющий профессиональные функции в сфере трансплантации, или учреждение здравоохранения независимо от формы собственности , имеющий право оказывать медицинскую помощь методом трансплантации во-вторых, происходит нарушение виновным лицом установленного законом порядка осуществления трансплантации при исполнении им своих трудовых (служебных) обязанностей. Особенность административной ответственности за нарушение порядка организации и оказания медицинской помощи методом трансплантации проявляется в том, что: к административной ответственности, кроме физических лиц, могут быть привлечены юридические лица; действия / бездействие

This dissertation presents three essays on foreign aid effectiveness. Chapter 1 presents the role of monitoring procedures in improving the effectiveness of foreign aid. It analyzes how monitoring procedures influence the government’s effort and improve the effectiveness of foreign aid. The chapter considers two cases, the case in which the donor has unrestricted aid budget and the case where the donor has a fixed aid budget. The main concern in this chapter is determining the optimal contract for the donor that maximizes the effectiveness of the aid given her aid budget when she dealing with aid-recipients in the presence of moral hazard problem. The model analyzes the monitoring procedures between two players, donor and recipient in a one-shot game. It assumes that the decision to monitor and the choice of the recipient's action are taken simultaneously. It suggests that with a fixed aid budget the donor is unlikely to invest heavily in monitoring cost and reward payment since the primary purpose of such aid is to help the poor in the recipient country. The reward payment which provides incentives for the recipient to work does indeed have a stronger effect on the likelihood of project success. It also shows that both the probability of monitoring and the optimal reward respond differently to change in monitoring cost. Chapter 2 studies the effect of aid-recipient governance on the allocation of foreign aid. It examines the hypothesis that better governance can reduce aid transaction cost which increases the assistance received by developing countries. The following questions were the main concern of this chapter, does better governance increase the amount of foreign aid delivered to developing countries? Do donors consider the levels of recipient’s governance when they allocate their funding? The chapter adopts annual data on a group of 67 developing countries covering Africa, and South Asia for the period from 2003 to 2014. It shows a positive relationship between two of our six governance indicators and the quantity of foreign aid. In fact, only control of corruption and voice and accountability have statistically significant effect on the amount of aid. It also shows that control variables have important effect in the determinate of foreign aid expect GDP per capita. Chapter 3 studies the impact of aid-recipient governance on aggregate welfare in developing countries. It investigates whether the effect of foreign aid on human development depends on the level of governance in recipient countries. These relationships are explored in an econometric analysis, 2SLS estimation, of panel data for the period from 2003 to 2014 in a sample of 67 developing countries. Our hypothesis is that better governance provides a better environment for foreign aid donor to achieve their goals. The main findings show that aid has a positive impact on human development only when it interacts with two out of the six indicators of governance: control of corruption and political stability. Aid by itself and military expenditures have a negative impact on the human development index.

The last half a century of Foreign Aid disbursal to Sub-Sahara Africa had been dominated by the need to address the perennial problem of its effectiveness. This has provided to a great number of stakeholders a premise for dismissal of foreign aid to be an instrument for economic growth and poverty reduction as initially thought. Drawing from recent literature, a conceptual framework was designed to capture and investigate various contextual factors that would contribute or initiate particular characteristics of the donor-recipient relationship. From a perspective of aid recipients, this study assumes that a management approach to aid would provide an understanding of mismatches between donors and recipients as a possible reason for aid effectiveness standards being unsatisfactory to many. A qualitative case study of two idiosyncratic countries: Cameroon and Tanzania was conducted utilizing a retroductive analysis approach. To provide additional internal validation, a stakeholders’ analysis and a business appraisal were also conducted. A number of explanatory mechanisms were constructed and answered positively the research preoccupation of identifying donor-recipient mismatches as well as showing that these mismatches affected to a very large extent the effective management of foreign aid. Further research is recommended chiefly in the donor-recipient relationship vis-vis foreign aid quality looking at the history, current and future international interactions. Also, researches in new and meaningful ways of assessing foreign aid impacts.

This thesis explores aspects of kidney transplantation across three papers. A systematic literature review focuses on the sexual functioning of women following kidney transplant (KTx). A review of quantitative studies found that having a KTx improved sexual functioning when compared to other renal replacement therapies. However, as the studies were methodologically flawed it was difficult to conclude how much improvement in sexual functioning is gained. Some studies found sexual functioning was restored and is comparable to general population whereas others found problems continued following KTx. An empirical study explores the lived experience of living non-couple donors. Using interpretative phenomenological analysis, six living donors agreed to share their stories. Three themes evolved from the data which revealed complexities in the decision making process, difficulties regarding loss and adjustment during and following the donation and donors’ minimisation of their difficulties. This appeared to contribute to the donors’ perception of a lack of care and support during their donation. Clinical recommendations include enhancing information and further preparation during the assessment process, access to psychological support and independent advocates and increasing clinician awareness of the barriers that prevent donors sharing any difficulties. A final paper considers the impact of the findings in both research and clinical fields. This paper highlights the lack of good quality research investigating psychological aspects of donating and receiving a kidney. The implications and recommendations for renal services are discussed, focusing on the increased utility of advocacy, psychology involvement and increasing clinicians’ awareness of the emotional impact of donating. In addition, this paper contains personal reflections regarding the research process and findings.