Donors incur many types of costs attributable to kidney donation and the total costs are certainly higher than previously reported. To guide informed consent and fair reimbursement policies, further data on all relevant costs, preferably from a detailed prospective multi-centre cohort study, are required.

Being an organ donor may affect one's ability to obtain life, disability and health insurance. We conducted a systematic review to determine if insurability is affected by living organ donation, and if concern about insurability affects donor decision making. We searched MEDLINE, EMBASE, SCI, EconLit and Cochrane databases for articles in any language, and reviewed reference lists from 1966 until June 2006. All studies discussing the insurability of living organ donors or its impact on donor decision making were included. Data were independently abstracted by two authors, and the methodological quality appraised. Twenty-three studies, from 1972 to 2006, provided data on 2067 living organ donors, 385 potential donors and 239 responses from insurance companies. Almost all companies would provide life and health insurance to living organ donors, usually with no higher premiums. However, concern about insurability was still expressed by 2%-14% of living organ donors in follow-up studies, and 3%-11% of donors actually encountered difficulties with their insurance. In one study, donors whose insurance premiums increased were less likely to reaffirm their decision to donate. Based on available evidence, some living organ donors had difficulties with insurance despite companies reporting otherwise. If better understood, this potential barrier to donation could be corrected through fair health and underwriting policies.

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Living organ donors frequently incur non-medical expenses for travel, accommodation, prescription drugs, loss of income, and child care in conjunction with organ donation. Despite international precedent and widespread public support, Canada currently lacks a unified strategy to reimburse donors for these expenses. In 2005, we communicated with 78 individuals within the field of Canadian transplantation to identify which initiatives for reimbursement of living donors existed in each province. Saskatchewan was the only province in which public employees were granted paid leave for organ donation. Six provincial governments partially reimbursed travel and accommodation. At the federal level, other expenses could be partially reimbursed through an income tax credit, while the Employment Insurance program and the Canada Pension Plan provided funding for donors who become unemployed or develop longterm disability as a result of donation. Charities helped a limited number of patients in financial need through grants and no-interest loans, but funding was generally limited by contributions received. While reimbursing living donors for their non-medical expenses is considered just, existing programs only partially reimburse expenses and are not available in all provinces. Developing future reimbursement policies will remove a disincentive faced by some potential donors, and may increase rates of transplantation in Canada.MeSH terms: Living donors; kidney transplantation; health policy; economics; costs and cost analysis RÉSUMÉLes donneurs vivants engagent souvent des dépenses extramédicales (frais de déplacement et d'hébergement, achat de médicaments sur ordonnance, perte de revenus, frais de garde d'enfants) en liaison avec leurs dons d'organes. Or, malgré les précédents internationaux et l'appui généralisé du public, le Canada n'a pas de stratégie unifiée pour leur rembourser ces dépenses. En 2005, nous avons communiqué avec 78 intervenants du secteur de la transplantation au Canada afin de repérer, dans chaque province, les initiatives de remboursement des dépenses des donneurs vivants. La Saskatchewan est la seule province qui octroie un congé payé aux fonctionnaires faisant un don d'organe. Six administrations provinciales remboursent en partie leurs frais de déplacement et d'hébergement. Dans l'administration fédérale, d'autres frais peuvent être partiellement remboursés par un crédit d'impôt sur le revenu, et le programme d'assurance-emploi et le Régime de pensions du Canada prévoient des fonds pour les donneurs qui ont perdu leur emploi ou qui présentent des limitations fonctionnelles de longue durée en raison d'un don d'organe. Des oeuvres de bienfaisance aident un petit nombre de patients en difficulté financière en leur octroyant des subventions et des prêts sans intérêt, mais le montant du financement est en général limité par les contributions reçues. On considère qu'il est juste de rembourser les dépenses extramédicales des donneurs vivants, mais les programmes existants n'en remboursent qu'une partie, et t...

The presence of women in the United States science and technology professoriate depends on various factors, including the availability of a pool of qualified women with relevant doctorates and the elimination of policy constraints and institutional barriers to professional access. Recognizing that initial hiring in related science, technology, engineering, and mathematics (STEM) fields is a crucial step affecting gender composition and representation at all levels in the academic hierarchy, we focus on hiring profiles in institutions of higher learning to examine related trends and practices. In addition to the significant and inversely proportional influence of initial hiring on future trends, differences were noted relative to public or private control of the university and other institutional characteristics, providing a basis for further analyses of institutional dynamics restricting or enhancing favorable hiring policies and practices for STEM women faculty. Copyright 2010 by The Policy Studies Organization.

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Ignoring the heated morality debates and millions of dollars invested in educational programs, the teenage pregnancy rate (and consequently the adolescent birth rate) in the United States remains the highest among the developed countries, even though it had decreased during the 1990s. Adolescent birth rates are 2.5 times higher than Canada's, and 7.2 times the rate reported by Italy. To account for the differences in teenage pregnancy outcomes among the three developed countries – United States, Canada, and Italy – a complex theoretical model of attitudes, beliefs, values, and policy decisions was constructed. Departing from the rational model approach, the present analysis emphasizes culture and values, and the way in which they influence the political process, and are ultimately reflected in the policy-making decisions. Data used to assess attitudes and beliefs prevalent in each of the three countries were obtained from the most recent release of the World Value Survey. Teenage pregnancy rates and other demographic data were drawn mostly from the World Bank's 2001 World Development Indicators. For the geographical analysis of the variations within the United States, data was obtained from the Center for Disease Control. The methodology combines cross-tabular and logistic regression analysis of individual attitudes and beliefs; a comparative table of social and economic indicators for a country-level analysis; a geographical information analysis (GIS) of the United States data; and a political analysis of the differences observed.