The oversight of solid organ transplantation in the United States.

The publication of the Organ Procurement and Transplantation Network (OPTN) Final Rule in 2000 resulted in a new and different regulatory environment for solid organ transplantation in the United States. In this review the role of the OPTN in providing oversight is clarified, differentiating the powers of enforcement the OPTN and HHS possess compared to the importance of confidential peer review in promoting compliance with OPTN policies. The function of the OPTN's Membership and Professional Standards Committee (MPSC) in adjudicating center performance and investigating alleged violations is described as well as the type and impact of adverse actions that the MPSC can recommend. The role of the OPTN Board compared to that of the Secretary of HHS in determining adverse actions is differentiated. We describe MPSC's broad scope of work in the ongoing evaluation of performance of all transplant centers. Finally, the relationship between the OPTN oversight and other entities charged with safe health care practices in the United States is considered.

Direction of the Organ Procurement and Transplantation Network and United Network for Organ Sharing regarding the oversight of live donor transplantation and solicitation for organs.

The Organ Procurement and Transplantation Network (OPTN) operated by United Network for Organ Sharing (UNOS) has taken recent steps to address public solicitation for organ donors and its oversight of live donor transplantation. This report provides the direction of the OPTN regarding deceased donor solicitation. The OPTN has authority under federal law to equitably allocate deceased donor organs within a single national network based upon medical criteria, not upon one's social or economic ability to utilize resources not available to all on the waiting list. The OPTN makes a distinction between solicitations for a live donor organ versus solicitations for directed donation of deceased organs. As to live donor solicitation, the OPTN cannot regulate or restrict ways relationships are developed in our society, nor does it seek to do so. OPTN members have a responsibility of helping protect potential recipients from hazards that can arise from public appeals for live donor organs. Oversight and support of the OPTN for live donor transplantation is now detailed by improving the reporting of live donor follow-up, by providing a mechanism for facilitating anonymous live kidney donation, and by providing information for potential live kidney donors via the UNOS Transplant Living website.

Multivariate Relationships Between Job Characteristics And Job Satisfaction In The Public Sector: A Triple Cross-Validation Study.

This study investigated multivariate relationships between task characteristics, measured by the Job Diagnostic Survey, and satisfaction with work outcomes, measured by the Triple Audit Opinion Survey, for 1,972 workers in the public sector. The obtained canonical correlations were high and stable across independent samples of public employees as indicated by a triple cross-validation design. The results support the predictions derived from the Hackman and Oldham model that job characteristics are more important for feelings of intrinsic job satisfaction than feelings of extrinsic job satisfaction, and that job characteristic - job satisfaction relationships are higher for high self-actualization need strength employees than for low self-actualization need strength employees. It was concluded that previous job characteristic - job satisfaction relationships established for private sector employees can be generalized to public sector employees.