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Attitudes to sharing personal health information in living kidney donation.

https://arctichealth.org/en/permalink/ahliterature144792
Source
Clin J Am Soc Nephrol. 2010 Apr;5(4):717-22
Publication Type
Article
Date
Apr-2010
Author
Patricia Hizo-Abes
Ann Young
Peter P Reese
Phil McFarlane
Linda Wright
Meaghan Cuerden
Amit X Garg
Author Affiliation
London Kidney Clinical Research Unit, Room ELL-101, Westminster, London Health Sciences Centre, 800 Commissioners Road East, London, Ontario N6A 4G5, Canada.
Source
Clin J Am Soc Nephrol. 2010 Apr;5(4):717-22
Date
Apr-2010
Language
English
Publication Type
Article
Keywords
Access to Information - legislation & jurisprudence
Adult
Aged
Attitude of Health Personnel
Confidentiality - legislation & jurisprudence - psychology
Cross-Sectional Studies
Female
Health Knowledge, Attitudes, Practice
Health Policy
Health Records, Personal
Humans
Informed Consent - legislation & jurisprudence - psychology
Kidney Transplantation - legislation & jurisprudence - psychology
Living Donors - legislation & jurisprudence - psychology
Male
Middle Aged
Ontario
Patient Education as Topic
Practice Guidelines as Topic
Questionnaires
Abstract
In living kidney donation, transplant professionals consider the rights of a living kidney donor and recipient to keep their personal health information confidential and the need to disclose this information to the other for informed consent. In incompatible kidney exchange, personal health information from multiple living donors and recipients may affect decision making and outcomes.
We conducted a survey to understand and compare the preferences of potential donors (n = 43), potential recipients (n = 73), and health professionals (n = 41) toward sharing personal health information (in total 157 individuals).
When considering traditional live-donor transplantation, donors and recipients generally agreed that a recipient's health information should be shared with the donor (86 and 80%, respectively) and that a donor's information should be shared with the recipient (97 and 89%, respectively). When considering incompatible kidney exchange, donors and recipients generally agreed that a recipient's information should be shared with all donors and recipients involved in the transplant (85 and 85%, respectively) and that a donor's information should also be shared with all involved (95 and 90%, respectively). These results were contrary to attitudes expressed by transplant professionals, who frequently disagreed about whether such information should be shared.
Future policies and practice could facilitate greater sharing of personal health information in living kidney donation. This requires a consideration of which information is relevant, how to put it in context, and a plan to obtain consent from all concerned.
Notes
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PubMed ID
20299371 View in PubMed
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Cardiovascular disease after Escherichia coli O157:H7 gastroenteritis.

https://arctichealth.org/en/permalink/ahliterature118823
Source
CMAJ. 2013 Jan 8;185(1):E70-7
Publication Type
Article
Date
Jan-8-2013
Author
Patricia Hizo-Abes
William F Clark
Jessica M Sontrop
Ann Young
Anjie Huang
Heather Thiessen-Philbrook
Peter C Austin
Amit X Garg
Author Affiliation
Division of Nephrology, Department of Medicine, Western University, London, Ont., Canada.
Source
CMAJ. 2013 Jan 8;185(1):E70-7
Date
Jan-8-2013
Language
English
Publication Type
Article
Keywords
Cardiovascular Diseases - etiology - microbiology
Chi-Square Distribution
Disease Outbreaks
Escherichia coli Infections - complications - epidemiology - microbiology
Escherichia coli O157
Female
Gastroenteritis - complications - epidemiology - microbiology
Heart Failure - etiology - microbiology
Humans
Male
Middle Aged
Myocardial Infarction - etiology - microbiology
Ontario - epidemiology
Risk factors
Statistics, nonparametric
Stroke - etiology - microbiology
Abstract
Escherichia coli O157:H7 is one cause of acute bacterial gastroenteritis, which can be devastating in outbreak situations. We studied the risk of cardiovascular disease following such an outbreak in Walkerton, Ontario, in May 2000.
In this community-based cohort study, we linked data from the Walkerton Health Study (2002-2008) to Ontario's large healthcare databases. We included 4 groups of adults: 3 groups of Walkerton participants (153 with severe gastroenteritis, 414 with mild gastroenteritis, 331 with no gastroenteritis) and a group of 11 263 residents from the surrounding communities that were unaffected by the outbreak. The primary outcome was a composite of death or first major cardiovascular event (admission to hospital for acute myocardial infarction, stroke or congestive heart failure, or evidence of associated procedures). The secondary outcome was first major cardiovascular event censored for death. Adults were followed for an average of 7.4 years.
During the study period, 1174 adults (9.7%) died or experienced a major cardiovascular event. Compared with residents of the surrounding communities, the risk of death or cardiovascular event was not elevated among Walkerton participants with severe or mild gastroenteritis (hazard ratio [HR] for severe gastroenteritis 0.74, 95% confidence interval [CI] 0.38-1.43, mild gastroenteritis HR 0.64, 95% CI 0.42-0.98). Compared with Walkerton participants who had no gastroenteritis, risk of death or cardiovascular event was not elevated among participants with severe or mild gastroenteritis.
There was no increase in the risk of cardiovascular disease in the decade following acute infection during a major E. coli O157:H7 outbreak.
Notes
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PubMed ID
23166291 View in PubMed
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Discovering misattributed paternity in living kidney donation: prevalence, preference, and practice.

https://arctichealth.org/en/permalink/ahliterature150815
Source
Transplantation. 2009 May 27;87(10):1429-35
Publication Type
Article
Date
May-27-2009
Author
Ann Young
Sang Joseph Kim
Eric M Gibney
Chirag R Parikh
Meaghan S Cuerden
Lucy D Horvat
Patricia Hizo-Abes
Amit X Garg
Author Affiliation
Division of Nephrology, University of Western Ontario, London, ON, Canada.
Source
Transplantation. 2009 May 27;87(10):1429-35
Date
May-27-2009
Language
English
Publication Type
Article
Keywords
Adult
Attitude
Canada
Child
Father-Child Relations
HLA Antigens - genetics
Humans
Kidney
Kidney Transplantation - physiology - psychology
Living Donors
Male
Oregon
Paternity
Registries
Truth Disclosure
United States
Abstract
When evaluating a living kidney donor and recipient with a father-child relationship, it may be discovered that the two are not biologically related. We analyzed data from the United Network for Organ Sharing and the Canadian Organ Replacement Registry to determine how frequently this occurs. We surveyed 102 potential donors, recipients, and transplant professionals for their opinion on whether such information should be disclosed to the donor-recipient pair. We communicated with transplant professionals from 13 Canadian centers on current practices for handling this information. In the United States and Canada, the prevalence of father-child living kidney donor-recipient pairs with less than a one-haplotype human leukocyte antigen match (i.e., misattributed paternity) is between 1% and 3%, or approximately 0.25% to 0.5% of all living kidney donations. Opinions about revealing this information were variable: 23% strongly favored disclosure; whereas, 24% were strongly opposed to it. Current practices are variable; some centers disclose this information, whereas others do not. Discovering misattributed paternity in living donation is uncommon but can occur. Opinions on how to deal with this sensitive information are variable. Discussion among transplant professionals will facilitate best practices and policies. Strategies adopted by some centers can be considered.
PubMed ID
19461476 View in PubMed
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