Thursday, April 26, 2018

Religiosity of non-directed kidney donors

Here's an online early view of a paper from the Journal of Clinical Nursing (and see some related blog posts at the end of this post):

Spirituality and religiosity of non‐directed (altruistic) living kidney donors
Ariella Maghen BA  Grecia B Vargas MSPH  Sarah E Connor MPH, CHES Sima Nassiri BS  Elisabeth M Hicks MA  Lorna Kwan MPH  ... See all authors
First published: 5 March 2018

Aims and objectives
To describe the spirituality and religiosity of 30 non‐directed (altruistic) living kidney donors in the USA and explore how they may have affected their motivations to donate and donation process experiences.

The rise in non‐directed donors and their ability to initiate kidney chains offer a novel approach to help alleviate the overextended kidney transplant wait list in the USA. However, little is known about the non‐directed donors’ motivations, characteristics and experiences.

We conducted a qualitative‐dominant study and used a grounded theory approach to analyse data.

Thirty participants completed in‐depth interviews between April 2013–April 2015. Three analysts independently read and coded interview transcripts. Grounded theory techniques were used to develop descriptive categories and identify topics related to the non‐directed donors donation experience.

Sixteen of the 30 non‐directed donorss discussed the topic of spirituality and religiosity when describing their donation experiences, regardless of whether they were actively practising a religion at the time of donation. Specifically, three themes were identified within spirituality and religiosity: motivation to donate, support in the process, and justification of their donation decisions postdonation.

Findings from this study are the first to describe how spirituality and religiosity influenced the experiences of U.S. non‐directed donorss and may help improve non‐directed donors educational resources for future spiritual or religious non‐directed donors, and the overall non‐directed donors donation experience in efforts to increase the living donor pool.

Relevance to clinical practice
Spirituality and religiosity are often overlooked yet potentially influential factors in Western medicine, as demonstrated through the experiences of Jehovah's Witnesses and their religious restrictions while undergoing surgery and the beliefs of Christian Scientists against taking medications and receiving medical procedures. Understanding needs of non‐directed donors specifically with spirituality and religiosity can better position kidney transplant centres and teams to improve predonation screening of non‐directed donor candidates and provide support services during the donation process.

Here are some earlier posts about religion and living kidney donation:

Thursday, September 5, 2013

Wednesday, April 25, 2018

Merit versus financial need in college financial aid

Colleges give discounts. Who knew?  The WSJ has the story:

Prizes for Everyone: How Colleges Use Scholarships to Lure Students
Merit awards are important component of many schools’ enrollment strategies

"At George Washington University, nearly half of all undergraduates receive the school’s Presidential Academic Scholarship. The prizes go to “the most competitive applicants in the pool,” admissions materials say, and include awards of $5,000 to $30,000 for each student.

At some other colleges, a solid majority of students get similarly hefty scholarships. At still others, virtually everyone gets them.

Hundreds of colleges and universities are using academic scholarships and other merit-based financial aid to gain an edge in a battle for students. The scholarships make students feel wanted and let families think they’re getting a good deal, like a shopper who buys an expensive sweater on sale."

Tuesday, April 24, 2018


I am on my way to the auto show in Beijing as a guest of NIO, the Chinese electric car company.

From Google translate:
Here's a picture of me speaking at the auto show, from this news story, in Chinese.

Here's another Chinese news story.

Monday, April 23, 2018

Stanford celebrates Paul Milgrom

Paul Milgrom on challenging the status quo to solve real-world problems

"The author of more than 100 seminal research papers and three books, Milgrom is most admired for his role in 1993 in designing, along with Stanford Professor Robert Wilson, the format used by governments to lease airwaves to mobile phone carriers. To date, "the U.S. Treasury has received more than $100 billion from these spectrum auctions, in which Milgrom and Wilson developed a way for bidders to see prices as they change and adjust the types of licenses they seek. Countries around the world use the format.
In 2017, the U.S. government undertook a novel spectrum auction that may prove to be Milgrom's greatest professional achievement to date. Leading a small team of economists and computer scientists, Milgrom created a simple bidding format for a highly complex problem in which the rights to TV broadcasting airwaves were, for the first time, converted and sold to mobile carriers and broadband providers. The feat was remarkable, not just because it led to $19.8 billion in licenses, but because its success depended on the ability to conduct enormously complex computations instantaneously.
"This [was] by far the most complicated resource allocation ever attempted, anywhere in the world," says Milgrom. It was also his first real encounter with artificial intelligence — and the power of it to transform his work and the entire field of economics has Milgrom thinking about radically new ways of constructing markets in coming decades.
Thanks in part to the team’s work, the FCC received the 2018 Franz Edelman Award for Achievement in Advanced Analytics, Operations Research, and Management Science.

Sunday, April 22, 2018

Deceased donor kidney exchange chain in Italy (and some Italian kidney politics)

First, some excellent transplant news from Italy: A deceased donor kidney exchange transplant chain has been conducted there. Here's some of the (English language) press release.

"On March 14th, for the first time in the world, the first live kidney transplantation chain between incompatible donor-recipient pairs (the so-called "cross over" program) triggered by a deceased donor was successfully launched in Italy.
The complex study phase for implementing the program, presented by Dr. Lucrezia Furian, member of the kidney transplant team of Padua University hospital, during the General Meeting of the Transplant Network, requested a careful retrospective evaluation of the data related to incompatible donors-recipient couples, a scrupulous analysis of the aspects related to efficacy, ethical and logistical problems and the development of algorithms for optimization of crossover chains. This study was conducted as part of an interdisciplinary research project funded by the University of Padua which involved, together with the transplant center team, researchers from the Department of Economics and Business Sciences and the Padua University Mathematics Department, led by Prof. Antonio Nicolò, scientific director of the research project. "

Antonio NicolòProfessor of Economics at the University of Padua, has written about kidney exchange.
Here are some of my earlier posts about starting kidney exchange chains with deceased donors:

Tuesday, June 14, 2016

The announcement also drew from the depths some curious parts of transplant politics in Italy (and in Europe more generally), where Global Kidney Exchange (GKE) has received both strong support, and organized opposition.
Here's an article from Corriere Della Sera (MARCH 16, 2018), which quotes the director of the Italian National Transplant Center as celebrating that the chain did not benefit any patient-donor pairs from poor countries, as in the proposal for GKE, which he condemns. In particular, he attacks one of the transplant surgeons involved in GKE, Ignazio Marino, a former Mayor of Rome.

This led to the following reply (in Italian, of which I am a coauthor:)

Here's the google translate of our letter:
"On 16/3 the Corriere described the transplant a Padova of a kidney taken from one deceased person for a patient who he had the wife's willingness to donate the organ but could not do it being incompatible from the immune point of view.
The lady then donated one kidney to another patient, thus helping another person. Congratulations to the living donor and to the family of the deceased donor: they are the real heroes of transplant surgery. They go also praised the doctors who performed the interventions. We must however rectify several incorrect information. It is important that the team by Paolo Rigotti has turned into reality an idea, but it is not true what the Corriere and, apparently also the Head of the National Transplant Center, that "so far nobody had thought of it". The concept was known to the whole scientific world since 2016 because published, by two signatories of this letter, on the American Journal of Transplantation. It is not even true that there are no algorithms or studies.
They have existed for years and on their basis one of the signatories of this letter received in 2012 the Nobel Prize. It is also false as written that "in the US the hypothesis among the polemics is the recourse to living Filipino donors who in exchange could take advantage of a transplant free for the sick relative ». And then defamatory to affirm that "ours surgeon Ignazio Marino "(our of whom?) would support this practice. It is true instead that there is a project (Global Kidney Exchange) that in the US has not seen any conflict, but the endorsement, in 2017, of the American Society for Transplant Surgeons, the society which brings together all the transplant surgeons. Furthermore, on January 22, 2018, the President of the Istituto Superiore di Sanità, Prof. Walter Ricciardi, in his role as a member of the Executive Board of the Organization World Health Organization has promoted this idea which has since been viewed on the WHO website. Is an idea born from the desire to help the the largest possible number of patients. In practice, if one of us wanted to give a kidney a a loved one, but can not because he has a blood group B, and the person who loves needs a kidney from a donor with a blood group A, that transplant impossible can be achieved because in there are two others in the world people who love each other and have groups opposing blood. Making them meet yes they can transplant patients otherwise they will not transplantable. This is what we illustrated in Rome, in a conference promoted by the Italian NIH, January 15, 2018. Yes it is a revolutionary project if one thinks that only in sub-Saharan Africa every year about 5 million people die because they have no access to hemodialysis or to kidney transplantation.
Ignazio R. Marino Professor of Surgery,
Jefferson University
Cataldo Doria Professor of Surgery,
Jefferson University
Michael Rees, Professor of Urology,
University of Toledo
Alvin E. Roth Professor of Economics, University
of Stanford and Harvard, Nobel Economics 2012
And here are some previous blog posts relating to kidney exchange politics in Italy, as discussed in the letter.

Monday, January 29, 2018

Saturday, April 21, 2018

FCC receives Edelman award for incentive spectrum auction

Advancing wireless communication: FCC awarded the 2018 INFORMS Edelman Award, the leading award in analytics and operations research

"The FCC conducted the world’s first two-sided “Incentive Auction” to meet the exploding demand for wireless services by reclaiming valuable low-band electromagnetic spectrum from TV broadcasters. By purchasing spectrum from TV broadcasters and reselling it to wireless providers, the auction repurposed 84 MHz of TV spectrum for mobile broadband, next-generation “5-G,” and other wireless uses, raised nearly $20 billion in revenue, and contributed over $7 billion to reduce the federal deficit. In addition, operations research enabled many TV stations to remain on their original channels, saving an estimated $200 million in relocation costs.  "

I have written quite a number of posts focusing on the incentive auction, and on the dream team led by Paul Milgrom; here's one of the first:

Monday, April 21, 2014

Friday, April 20, 2018

Parag Pathak wins the American Economic Association's Clark Medal

Should (government) economists be licensed? (Replies from a panel of academic economists)

The question below, on Occupational Licensing for Economists, is the latest question answered by the distinguished panel of (academic) economists who make up Chicago Booth's IGM Forum.  (IGM = Initiative on Global Markets.)

It took me a moment to parse the question, i.e. to figure out that "disagree" means that requiring a Ph.D. would be a good thing. (A number of those who did disagree nevertheless noted that the word "requiring" was perhaps stronger than they would like.)

For no particular reason, I'm reminded of the old Soviet joke about the party chairman reviewing the Victory Day Parade of troops marching and flying and riding before him in the Kremlin. At the end of the parade comes a jeep full of men in suits, and he inquires of the Field Marshall next to him on the grandstand: "Comrade Field Marshall, who are those people, and why are they in the parade?" To which the Field Marshall replies: Comrade Secretary, those are the economists. You have no idea the damage they can do."

I say it's a Soviet joke, but of course I heard in English, as a child in New York. So, during a visit to Moscow, I took the opportunity of saying to one of my local colleagues "I know a joke that I was told was an old Soviet joke." He listened to me tell it, and before I could identify the men in suits, he jumped in with the equivalent punchline he knew "they are Gosplan!"    So it turns out to be an old Soviet joke in Moscow as well as in NY.

That said, and to the point of the IGM question above, here in the U.S. I find myself missing the government economists of yore...