A. Steinfeld

Sterilization and preservation influence the biophysical properties of human amnion grafts

The introduction of amniotic membrane (AM) transplantation in ophthalmic surgery holds great promise and in many clinical situations it offers an alternative to existing management options. The purpose of this study was to examine the influence of established sterilization and preservation procedures on biophysical and histological properties of AM grafts. Amnion was sterilized by peracetic acid/ethanol sterilization [PES] and preserved by air-drying (sterile laminar flow) [AD] or in glycerol [GLYC]. Unsterilized AM were preserved at -80 degrees C [-80 degrees C] and served as an experimental control. Amnion allografts were characterized by the determination of their thickness, moisture vapour permeability (MVP), oxygen permeability (OPERM), tensile strength and sulphur content. Immunostaining for tissue-specific and basement membrane-related proteins was performed. Differences in biophysical parameters were found between the unsterilized allografts and the sterilized, air-dried or glycerol-preserved allografts. [PES/AD] showed the highest MVP and OPERM, the highest tensile strength and the lowest sulphur content and thickness. [PES/GLYC] exhibited the lowest OPERM and the highest thickness compared to [-80 degrees C] and [PES/AD]. Collagen types V and VII were preserved the best in the control group. Sterilization and preservation affect biophysical properties important for the use of AM as allogenic grafts. It has to be determined if any change, as noted, has a clinical impact.

Bitte um Einverständnis in eine Hornhautspende

INTRODUCTION Because of the gap between the high need for cornea tissue for transplantation and the current lower numbers of donors, there is high pressure to succeed in telephone calls to relatives of deceased for obtaining consent. Besides the attempt to increase the rate of donors, these telephone calls should be gentle for relatives and not overstrain professionals. This study assesses the need and expectations of physicians towards communication training in preparation for their task. METHODS In September-October 2009 a needs assessment for communication training among physicians who currently work or have worked for the eye bank took place. Personal data were recorded and their estimate of the perceived burden as well as needs and potential benefits from a specific communication training for obtaining consent for cornea donation by telephone were assessed using numeric rating scales between 1 (minimum) and 10 (maximum). Results were expressed as mean and range. RESULTS The participants felt only moderately prepared for the task regarding information content, their emotions and personal convictions. They considered a specific training to be highly meaningful, necessary and helpful. Their highest burden during telephone calls previously experienced was documented as 8.4 and the average burden as 6.3. Accordingly, their willingness to continue working at an eye bank after their rotation was moderate. DISCUSSION Physicians involved in obtaining consent for cornea donation by telephone feel highly stressed and only moderately prepared for fulfilling the task both for the information content and on the emotional level. Accordingly, specific communication training is perceived as highly meaningful, necessary and helpful. An educational program was developed to meet the needs and expectations of physicians.ZusammenfassungHintergrundDurch den hohen Bedarf und der deutlich geringeren Verfügbarkeit von Hornhäuten des Auges besteht eine große Hoffnung auf das Gelingen ärztlicher Akquisegespräche mit Angehörigen zum Einverständnis in eine Gewebespende. Neben der Steigerung des Erfolgs in der Spendergewinnung sollen Akquisegespräche schützend für Angehörige verlaufen und die Arbeitsbelastung des Fachpersonals gering gehalten werden. Diese Arbeit erfasst den Bedarf und Erwartungen an ein Kommunikationstraining zur Vorbereitung auf die Akquisetätigkeit.MethodeIm September und Oktober 2009 wurde unter allen Akquiseärzten, die in der Hornhautbank arbeiten bzw. gearbeitet haben, eine Bedarfanalyse für ein Kommunikationstraining vorgenommen. Auf 10-stufigen numerischen Rangskalen wurde das Ausmaß der fachlichen, emotionalen und persönlichen Vorbereitung, das Ausmaß der Einschätzung eines Kommunikationstrainings als sinnvoll, notwendig und hilfreich sowie die durchschnittliche und höchste Belastung und Bereitschaft zur Ausübung der Akquise erfragt.ErgebnisseDie Studienteilnehmer fühlten sich fachlich, emotional und in ihrer persönlichen Überzeugung nur mittelmäßig auf die Tätigkeit vorbereitet und erachteten ein Kommunikationstraining für in hohem Maß sinnvoll, notwendig und hilfreich. Bei mittlerer durchschnittlicher Arbeitsbelastung mit kurzfristigen Hochbelastungsphasen bestand nur eine moderate Bereitschaft zur weiteren Ausführung dieser Tätigkeit.DiskussionDurch klare Hinweise auf eine nicht als ausreichend empfundene Vorbereitung auf die Akquisetätigkeit und als hoch empfundene Arbeitsbelastung wurde ein Kommunikationsseminar mit einem spezifischen Training der Akquisetelefonate entwickelt. Dieses Training entspricht bedarfsgemäß sowohl den Wünschen und Erwartungen des ärztlichen Personals als auch den am ehesten beeinflussbaren Variablen im Hinblick auf die Erfolgsquote bei der Spendenakquise.AbstractIntroductionBecause of the gap between the high need for cornea tissue for transplantation and the current lower numbers of donors, there is high pressure to succeed in telephone calls to relatives of deceased for obtaining consent. Besides the attempt to increase the rate of donors, these telephone calls should be gentle for relatives and not overstrain professionals. This study assesses the need and expectations of physicians towards communication training in preparation for their task.MethodsIn September–October 2009 a needs assessment for communication training among physicians who currently work or have worked for the eye bank took place. Personal data were recorded and their estimate of the perceived burden as well as needs and potential benefits from a specific communication training for obtaining consent for cornea donation by telephone were assessed using numeric rating scales between 1 (minimum) and 10 (maximum). Results were expressed as mean and range.ResultsThe participants felt only moderately prepared for the task regarding information content, their emotions and personal convictions. They considered a specific training to be highly meaningful, necessary and helpful. Their highest burden during telephone calls previously experienced was documented as 8.4 and the average burden as 6.3. Accordingly, their willingness to continue working at an eye bank after their rotation was moderate.DiscussionPhysicians involved in obtaining consent for cornea donation by telephone feel highly stressed and only moderately prepared for fulfilling the task both for the information content and on the emotional level. Accordingly, specific communication training is perceived as highly meaningful, necessary and helpful. An educational program was developed to meet the needs and expectations of physicians.

The Role of Specifically Tailored Communication Training Among Factors Influencing Consent for Cornea Donation Requested Via Telephone.

Background Consent for cornea donation from non–heart-beating donors is often requested by means of telephone interviews with relatives of the deceased. The purpose of this study was to identify the effect of specifically tailored interviewer communications training among other factors related to obtaining consent. Methods A retrospective analysis of consent requests made by the Aachen Cornea Bank was performed. Interviews were conducted via telephone by 26 ophthalmic residents or fellows in accordance with German and European laws and guidelines. Multiple logistic regression was used to identify factors related to the consent. Results were expressed as odds ratios (OR), 95% confidence interval (95% CI), and Wald P value. Results In 1694 interviews, the overall consent rate was 50.12%. Multivariate analysis identified 4 significant factors associated with the donation decision. Completion of a specific communication training seminar increased odds of consent by 1.533 (95% CI, 1.250-1.880; P < 0.0001). The individual interviewer had an impact on the OR of up to 1.255 (95% CI, 1.113-1.417; P = 0.0002). The odds for consent were inversely correlated with the clinical experience of the interviewer (OR, 0.884; 95% CI, 0.831-0.938; P < 0.0001). The consulted family member was 0.894 times less likely to grant consent for donation with each increase in degree of blood relation (95% CI, 0.849-0.940; P < 0.0001). Conclusions A telephone interview is effective for obtaining consent for cornea donation. The consent decision may be associated with factors relating to the interviewer as well as the consulted family member. Specific training for cornea bank staff may increase the odds of obtaining consent.

Evaluation of the need for communication training of ophthalmologists for gaining telephone consent for cornea donation

INTRODUCTION Because of the gap between the high need for cornea tissue for transplantation and the current lower numbers of donors, there is high pressure to succeed in telephone calls to relatives of deceased for obtaining consent. Besides the attempt to increase the rate of donors, these telephone calls should be gentle for relatives and not overstrain professionals. This study assesses the need and expectations of physicians towards communication training in preparation for their task. METHODS In September-October 2009 a needs assessment for communication training among physicians who currently work or have worked for the eye bank took place. Personal data were recorded and their estimate of the perceived burden as well as needs and potential benefits from a specific communication training for obtaining consent for cornea donation by telephone were assessed using numeric rating scales between 1 (minimum) and 10 (maximum). Results were expressed as mean and range. RESULTS The participants felt only moderately prepared for the task regarding information content, their emotions and personal convictions. They considered a specific training to be highly meaningful, necessary and helpful. Their highest burden during telephone calls previously experienced was documented as 8.4 and the average burden as 6.3. Accordingly, their willingness to continue working at an eye bank after their rotation was moderate. DISCUSSION Physicians involved in obtaining consent for cornea donation by telephone feel highly stressed and only moderately prepared for fulfilling the task both for the information content and on the emotional level. Accordingly, specific communication training is perceived as highly meaningful, necessary and helpful. An educational program was developed to meet the needs and expectations of physicians.ZusammenfassungHintergrundDurch den hohen Bedarf und der deutlich geringeren Verfügbarkeit von Hornhäuten des Auges besteht eine große Hoffnung auf das Gelingen ärztlicher Akquisegespräche mit Angehörigen zum Einverständnis in eine Gewebespende. Neben der Steigerung des Erfolgs in der Spendergewinnung sollen Akquisegespräche schützend für Angehörige verlaufen und die Arbeitsbelastung des Fachpersonals gering gehalten werden. Diese Arbeit erfasst den Bedarf und Erwartungen an ein Kommunikationstraining zur Vorbereitung auf die Akquisetätigkeit.MethodeIm September und Oktober 2009 wurde unter allen Akquiseärzten, die in der Hornhautbank arbeiten bzw. gearbeitet haben, eine Bedarfanalyse für ein Kommunikationstraining vorgenommen. Auf 10-stufigen numerischen Rangskalen wurde das Ausmaß der fachlichen, emotionalen und persönlichen Vorbereitung, das Ausmaß der Einschätzung eines Kommunikationstrainings als sinnvoll, notwendig und hilfreich sowie die durchschnittliche und höchste Belastung und Bereitschaft zur Ausübung der Akquise erfragt.ErgebnisseDie Studienteilnehmer fühlten sich fachlich, emotional und in ihrer persönlichen Überzeugung nur mittelmäßig auf die Tätigkeit vorbereitet und erachteten ein Kommunikationstraining für in hohem Maß sinnvoll, notwendig und hilfreich. Bei mittlerer durchschnittlicher Arbeitsbelastung mit kurzfristigen Hochbelastungsphasen bestand nur eine moderate Bereitschaft zur weiteren Ausführung dieser Tätigkeit.DiskussionDurch klare Hinweise auf eine nicht als ausreichend empfundene Vorbereitung auf die Akquisetätigkeit und als hoch empfundene Arbeitsbelastung wurde ein Kommunikationsseminar mit einem spezifischen Training der Akquisetelefonate entwickelt. Dieses Training entspricht bedarfsgemäß sowohl den Wünschen und Erwartungen des ärztlichen Personals als auch den am ehesten beeinflussbaren Variablen im Hinblick auf die Erfolgsquote bei der Spendenakquise.AbstractIntroductionBecause of the gap between the high need for cornea tissue for transplantation and the current lower numbers of donors, there is high pressure to succeed in telephone calls to relatives of deceased for obtaining consent. Besides the attempt to increase the rate of donors, these telephone calls should be gentle for relatives and not overstrain professionals. This study assesses the need and expectations of physicians towards communication training in preparation for their task.MethodsIn September–October 2009 a needs assessment for communication training among physicians who currently work or have worked for the eye bank took place. Personal data were recorded and their estimate of the perceived burden as well as needs and potential benefits from a specific communication training for obtaining consent for cornea donation by telephone were assessed using numeric rating scales between 1 (minimum) and 10 (maximum). Results were expressed as mean and range.ResultsThe participants felt only moderately prepared for the task regarding information content, their emotions and personal convictions. They considered a specific training to be highly meaningful, necessary and helpful. Their highest burden during telephone calls previously experienced was documented as 8.4 and the average burden as 6.3. Accordingly, their willingness to continue working at an eye bank after their rotation was moderate.DiscussionPhysicians involved in obtaining consent for cornea donation by telephone feel highly stressed and only moderately prepared for fulfilling the task both for the information content and on the emotional level. Accordingly, specific communication training is perceived as highly meaningful, necessary and helpful. An educational program was developed to meet the needs and expectations of physicians.

Bitte um Einverständnis in eine Hornhautspende@@@Evaluation of the need for communication training of ophthalmologists for gaining telephone consent for cornea donation: Bedarfsanalyse für ein Kommunikationstraining mit Augenärzten in der Spendenakquise

INTRODUCTION Because of the gap between the high need for cornea tissue for transplantation and the current lower numbers of donors, there is high pressure to succeed in telephone calls to relatives of deceased for obtaining consent. Besides the attempt to increase the rate of donors, these telephone calls should be gentle for relatives and not overstrain professionals. This study assesses the need and expectations of physicians towards communication training in preparation for their task. METHODS In September-October 2009 a needs assessment for communication training among physicians who currently work or have worked for the eye bank took place. Personal data were recorded and their estimate of the perceived burden as well as needs and potential benefits from a specific communication training for obtaining consent for cornea donation by telephone were assessed using numeric rating scales between 1 (minimum) and 10 (maximum). Results were expressed as mean and range. RESULTS The participants felt only moderately prepared for the task regarding information content, their emotions and personal convictions. They considered a specific training to be highly meaningful, necessary and helpful. Their highest burden during telephone calls previously experienced was documented as 8.4 and the average burden as 6.3. Accordingly, their willingness to continue working at an eye bank after their rotation was moderate. DISCUSSION Physicians involved in obtaining consent for cornea donation by telephone feel highly stressed and only moderately prepared for fulfilling the task both for the information content and on the emotional level. Accordingly, specific communication training is perceived as highly meaningful, necessary and helpful. An educational program was developed to meet the needs and expectations of physicians.ZusammenfassungHintergrundDurch den hohen Bedarf und der deutlich geringeren Verfügbarkeit von Hornhäuten des Auges besteht eine große Hoffnung auf das Gelingen ärztlicher Akquisegespräche mit Angehörigen zum Einverständnis in eine Gewebespende. Neben der Steigerung des Erfolgs in der Spendergewinnung sollen Akquisegespräche schützend für Angehörige verlaufen und die Arbeitsbelastung des Fachpersonals gering gehalten werden. Diese Arbeit erfasst den Bedarf und Erwartungen an ein Kommunikationstraining zur Vorbereitung auf die Akquisetätigkeit.MethodeIm September und Oktober 2009 wurde unter allen Akquiseärzten, die in der Hornhautbank arbeiten bzw. gearbeitet haben, eine Bedarfanalyse für ein Kommunikationstraining vorgenommen. Auf 10-stufigen numerischen Rangskalen wurde das Ausmaß der fachlichen, emotionalen und persönlichen Vorbereitung, das Ausmaß der Einschätzung eines Kommunikationstrainings als sinnvoll, notwendig und hilfreich sowie die durchschnittliche und höchste Belastung und Bereitschaft zur Ausübung der Akquise erfragt.ErgebnisseDie Studienteilnehmer fühlten sich fachlich, emotional und in ihrer persönlichen Überzeugung nur mittelmäßig auf die Tätigkeit vorbereitet und erachteten ein Kommunikationstraining für in hohem Maß sinnvoll, notwendig und hilfreich. Bei mittlerer durchschnittlicher Arbeitsbelastung mit kurzfristigen Hochbelastungsphasen bestand nur eine moderate Bereitschaft zur weiteren Ausführung dieser Tätigkeit.DiskussionDurch klare Hinweise auf eine nicht als ausreichend empfundene Vorbereitung auf die Akquisetätigkeit und als hoch empfundene Arbeitsbelastung wurde ein Kommunikationsseminar mit einem spezifischen Training der Akquisetelefonate entwickelt. Dieses Training entspricht bedarfsgemäß sowohl den Wünschen und Erwartungen des ärztlichen Personals als auch den am ehesten beeinflussbaren Variablen im Hinblick auf die Erfolgsquote bei der Spendenakquise.AbstractIntroductionBecause of the gap between the high need for cornea tissue for transplantation and the current lower numbers of donors, there is high pressure to succeed in telephone calls to relatives of deceased for obtaining consent. Besides the attempt to increase the rate of donors, these telephone calls should be gentle for relatives and not overstrain professionals. This study assesses the need and expectations of physicians towards communication training in preparation for their task.MethodsIn September–October 2009 a needs assessment for communication training among physicians who currently work or have worked for the eye bank took place. Personal data were recorded and their estimate of the perceived burden as well as needs and potential benefits from a specific communication training for obtaining consent for cornea donation by telephone were assessed using numeric rating scales between 1 (minimum) and 10 (maximum). Results were expressed as mean and range.ResultsThe participants felt only moderately prepared for the task regarding information content, their emotions and personal convictions. They considered a specific training to be highly meaningful, necessary and helpful. Their highest burden during telephone calls previously experienced was documented as 8.4 and the average burden as 6.3. Accordingly, their willingness to continue working at an eye bank after their rotation was moderate.DiscussionPhysicians involved in obtaining consent for cornea donation by telephone feel highly stressed and only moderately prepared for fulfilling the task both for the information content and on the emotional level. Accordingly, specific communication training is perceived as highly meaningful, necessary and helpful. An educational program was developed to meet the needs and expectations of physicians.

Bitte um Einverständnis in eine Hornhautspende : Bedarfsanalyse für ein Kommunikationstraining mit Augenärzten in der Spendenakquise (Originalien)

INTRODUCTION Because of the gap between the high need for cornea tissue for transplantation and the current lower numbers of donors, there is high pressure to succeed in telephone calls to relatives of deceased for obtaining consent. Besides the attempt to increase the rate of donors, these telephone calls should be gentle for relatives and not overstrain professionals. This study assesses the need and expectations of physicians towards communication training in preparation for their task. METHODS In September-October 2009 a needs assessment for communication training among physicians who currently work or have worked for the eye bank took place. Personal data were recorded and their estimate of the perceived burden as well as needs and potential benefits from a specific communication training for obtaining consent for cornea donation by telephone were assessed using numeric rating scales between 1 (minimum) and 10 (maximum). Results were expressed as mean and range. RESULTS The participants felt only moderately prepared for the task regarding information content, their emotions and personal convictions. They considered a specific training to be highly meaningful, necessary and helpful. Their highest burden during telephone calls previously experienced was documented as 8.4 and the average burden as 6.3. Accordingly, their willingness to continue working at an eye bank after their rotation was moderate. DISCUSSION Physicians involved in obtaining consent for cornea donation by telephone feel highly stressed and only moderately prepared for fulfilling the task both for the information content and on the emotional level. Accordingly, specific communication training is perceived as highly meaningful, necessary and helpful. An educational program was developed to meet the needs and expectations of physicians.ZusammenfassungHintergrundDurch den hohen Bedarf und der deutlich geringeren Verfügbarkeit von Hornhäuten des Auges besteht eine große Hoffnung auf das Gelingen ärztlicher Akquisegespräche mit Angehörigen zum Einverständnis in eine Gewebespende. Neben der Steigerung des Erfolgs in der Spendergewinnung sollen Akquisegespräche schützend für Angehörige verlaufen und die Arbeitsbelastung des Fachpersonals gering gehalten werden. Diese Arbeit erfasst den Bedarf und Erwartungen an ein Kommunikationstraining zur Vorbereitung auf die Akquisetätigkeit.MethodeIm September und Oktober 2009 wurde unter allen Akquiseärzten, die in der Hornhautbank arbeiten bzw. gearbeitet haben, eine Bedarfanalyse für ein Kommunikationstraining vorgenommen. Auf 10-stufigen numerischen Rangskalen wurde das Ausmaß der fachlichen, emotionalen und persönlichen Vorbereitung, das Ausmaß der Einschätzung eines Kommunikationstrainings als sinnvoll, notwendig und hilfreich sowie die durchschnittliche und höchste Belastung und Bereitschaft zur Ausübung der Akquise erfragt.ErgebnisseDie Studienteilnehmer fühlten sich fachlich, emotional und in ihrer persönlichen Überzeugung nur mittelmäßig auf die Tätigkeit vorbereitet und erachteten ein Kommunikationstraining für in hohem Maß sinnvoll, notwendig und hilfreich. Bei mittlerer durchschnittlicher Arbeitsbelastung mit kurzfristigen Hochbelastungsphasen bestand nur eine moderate Bereitschaft zur weiteren Ausführung dieser Tätigkeit.DiskussionDurch klare Hinweise auf eine nicht als ausreichend empfundene Vorbereitung auf die Akquisetätigkeit und als hoch empfundene Arbeitsbelastung wurde ein Kommunikationsseminar mit einem spezifischen Training der Akquisetelefonate entwickelt. Dieses Training entspricht bedarfsgemäß sowohl den Wünschen und Erwartungen des ärztlichen Personals als auch den am ehesten beeinflussbaren Variablen im Hinblick auf die Erfolgsquote bei der Spendenakquise.AbstractIntroductionBecause of the gap between the high need for cornea tissue for transplantation and the current lower numbers of donors, there is high pressure to succeed in telephone calls to relatives of deceased for obtaining consent. Besides the attempt to increase the rate of donors, these telephone calls should be gentle for relatives and not overstrain professionals. This study assesses the need and expectations of physicians towards communication training in preparation for their task.MethodsIn September–October 2009 a needs assessment for communication training among physicians who currently work or have worked for the eye bank took place. Personal data were recorded and their estimate of the perceived burden as well as needs and potential benefits from a specific communication training for obtaining consent for cornea donation by telephone were assessed using numeric rating scales between 1 (minimum) and 10 (maximum). Results were expressed as mean and range.ResultsThe participants felt only moderately prepared for the task regarding information content, their emotions and personal convictions. They considered a specific training to be highly meaningful, necessary and helpful. Their highest burden during telephone calls previously experienced was documented as 8.4 and the average burden as 6.3. Accordingly, their willingness to continue working at an eye bank after their rotation was moderate.DiscussionPhysicians involved in obtaining consent for cornea donation by telephone feel highly stressed and only moderately prepared for fulfilling the task both for the information content and on the emotional level. Accordingly, specific communication training is perceived as highly meaningful, necessary and helpful. An educational program was developed to meet the needs and expectations of physicians.