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13 pages, 951 KiB

Open AccessArticle

Hospital-Related Determinants of Refusal of Organ Donation in France: A Multilevel Study

by Régis Bronchard, Gaëlle Santin, Camille Legeai, Anne Bianchi, Séverine Grelier, Caroline Bogue, Olivier Bastien and François Kerbaul

Int. J. Environ. Res. Public Health 2025, 22(4), 618; https://doi.org/10.3390/ijerph22040618 - 15 Apr 2025

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Abstract

In a worldwide context of organ shortage, refusal of organ donation remains the main reason for the non-procurement of organs from deceased donors. Many studies have characterized the clinical or psychological factors of refusal but not organizational and structural factors in healthcare centers. We used multilevel logistic regression models with hospitals as a random effect to analyze organ procurement among 6734 potential brain-dead donors recorded in the national register in France in 2018 and 2019. According to the opt-out law, 29% of the potential donors refused to donate. Among hospital-related factors, low probability of refusal was related to hospitals audited for the organ donation process by the national program (adjusted odds ratio [aOR] 0.74, 95% confidence interval [CI]: 0.58–0.94), hospitals with high inpatient satisfaction scores for care (aOR 0.95, 95% CI 0.92–0.99) and facilities with a high ratio of nurse donor coordinators to donors (aOR: 0.78; 95% CI: 0.64–0.95). Among clinical factors, the odds of refusal were associated with age younger than 65 years (18–49 years; aOR 1.58, 95% CI 1.37–1.83) and donors with blood group B (aOR 1.32, 95% CI: 1.10–1.59). Hospital-related factors are just as important as individual factors in the procurement of organs from potential brain-dead donors. Full article

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19 pages, 1099 KiB

Open AccessArticle

Against Food Waste: CSR for the Social and Environmental Impact through a Network-Based Organizational Model

by Sara Moggi, Sabrina Bonomi and Francesca Ricciardi

Sustainability 2018, 10(10), 3515; https://doi.org/10.3390/su10103515 - 30 Sep 2018

Cited by 64 | Viewed by 12665

Abstract

This article inductively develops a model of how farmers market organizations can contribute to reduce food waste, fight poverty, and improve public health through innovative Corporate Social Responsibility (CSR) practices enabled by networked activity systems. To this aim, a ten-year longitudinal case study of one of the biggest Italian farmers markets has been conducted, based on triangulated data from participant observation, interviews, and internal documents collection. This study suggests that farmers market organizations are in the position to leverage their inter-organizational relationships, institutional role, and power to build collaborative networks with businesses, government bodies, and charities, so that concrete CSR-based virtuous circles on surplus food donation are triggered at the organizational field level. Answering the call from United Nation Goals for successful examples on SDG 12, this case presents how several CSR levers can have a social and environmental impact allowing farmers and their market organizations to increase their efficiency and accountability to the local community, improve processes, reduce food waste, and contribute to public health and social inclusion. CSR actions have co-evolved with significant changes in organizational logics and identity, thus enabling accountability to the local community and innovative network-level auditing of the relevant organizational processes. Full article

(This article belongs to the Section Economic and Business Aspects of Sustainability)

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