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Behera G, Vijayan N, Murugesan R, Sangaraju S, Kasturi N, Sahi A, Jayasri P, Babu KR. Impact of an educational video in improving awareness of eye donation among non-medical health care workers in a tertiary health centre. Int Ophthalmol 2024; 44:289. [PMID: 38937283 DOI: 10.1007/s10792-024-03189-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 06/15/2024] [Indexed: 06/29/2024]
Abstract
PURPOSE To evaluate the impact of an educational video in improving awareness of eye donation among non-medical healthcare workers at a tertiary health centre. METHODS A socio-behavioural study on knowledge and attitude towards eye donation was conducted among 373 non-medical healthcare workers through a printed semi-structured questionnaire before and after viewing a bilingual educational video. The responses were evaluated and scored. RESULTS Pre-intervention, only 5.4% of the participants had adequate knowledge, which improved significantly to 71.6% after watching the video (P < .001). Respondents with elementary school education showed the greatest change in knowledge. Pre-intervention, 72.4% were willing to donate their eyes, which significantly increased to 89.5% after watching the video. Pre-intervention, 66.22% showed a "highly favourable" attitude, which improved to 97.86% after watching the video. CONCLUSION The 25 min video about eye donation and eye banking significantly changed the participants' knowledge, willingness, and attitude. Hence, media-based (video) awareness platforms may be valuable for improving the general public's knowledge and attitude towards eye donation. This may help in enhancing the eye donation rate in the long term.
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Affiliation(s)
- Geeta Behera
- Department of Ophthalmology, Jawaharlal Institute of Post-Graduate Medical Education and Research (JIPMER), Puducherry, India.
| | - Niranjan Vijayan
- Department of Ophthalmology, Jawaharlal Institute of Post-Graduate Medical Education and Research (JIPMER), Puducherry, India
| | - Rajeswari Murugesan
- Department of Biostatistics, All India Institute of Medical Sciences (AIIMS), Mangalagiri, India
| | - Suneel Sangaraju
- Department of Ophthalmology, Jawaharlal Institute of Post-Graduate Medical Education and Research (JIPMER), Puducherry, India
| | - Nirupama Kasturi
- Department of Ophthalmology, Jawaharlal Institute of Post-Graduate Medical Education and Research (JIPMER), Puducherry, India
| | - Arun Sahi
- Department of Ophthalmology, Jawaharlal Institute of Post-Graduate Medical Education and Research (JIPMER), Puducherry, India
| | - P Jayasri
- Department of Ophthalmology, Jawaharlal Institute of Post-Graduate Medical Education and Research (JIPMER), Puducherry, India
| | - Krishna Ramesh Babu
- Department of Ophthalmology, Jawaharlal Institute of Post-Graduate Medical Education and Research (JIPMER), Puducherry, India
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Allen N, Niederer R, Brookes N, McGhee C. Trends in Corneal Donation From 2013 to 2022 in Aotearoa-New Zealand: Impact of Donor Age, Gender, Ethnicity, and COVID-19. Cornea 2024:00003226-990000000-00592. [PMID: 38923472 DOI: 10.1097/ico.0000000000003608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 05/11/2024] [Indexed: 06/28/2024]
Abstract
PURPOSE To evaluate corneal donation demographics in New Zealand (NZ) and explore changes over time. METHODS Data were collected from all donated corneas processed by the New Zealand National Eye Bank over a 10-year period from January 2013 until December 2022. Demographic data including age, self-identified ethnicity, and gender were collected, along with location and cause of death. National death data for the corresponding period were collected online from Statistics New Zealand. RESULTS A total of 1842 donors were processed; 1414 (76.8%) were sourced from Aotearoa-New Zealand and the remainder from Australia/United States. There was a small but statistically significant median age difference between NZ donors (68 years, interquartile range 55-76) and overseas donors [66 years (interquartile range) 51-70]. Most (n = 1151 81.4%) of NZ donors died in hospital settings, with the most common cause of death being cerebrovascular (n = 444 31.4%). Individuals were less likely to donate their cornea if they were female, [incidence rate ratio (IRR) 0.746, P < 0.001] older age (IRR 0.968, P < 0.001), or if they were of Māori (IRR 0.178, P < 0.001) or Pasifika ethnicity (IRR 0.125, P < 0.001). There was also a statistically significant decrease in donation rates over time (IRR 0.945, P < 0.001). CONCLUSIONS There remains a profound gap between the demand for corneal transplantation and corneal tissue donation, which is worsening with time. Donor age, gender, and ethnicity seem to influence corneal donation rates. These demographic differences may be ameliorated by increased education, cultural safety, further research into those willing to donate, and the establishment of an organ/tissue donation registry.
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Affiliation(s)
- Natalie Allen
- Department of Ophthalmology, Faculty of Medical & Health Sciences, University of Auckland, Auckland, New Zealand
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Szkodny D, Wróblewska-Czajka E, Stryja M, Gara F, Wylęgała E. Exploring the Potential of an Eye Tissue Donor Reporting App in Enhancing the Procurement of Corneal Donors: Mixed Methods Observational Study. JMIR Form Res 2024; 8:e50398. [PMID: 38748474 PMCID: PMC11137423 DOI: 10.2196/50398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 01/15/2024] [Accepted: 02/09/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND The availability of donated eye tissue saves and enhances vision in transplant recipients; however, the current demand for tissue surpasses the available supply. Corneal donor shortages lead to increased wait times, delayed surgeries, prolonged visual impairment, and increased inconvenience to patients requiring eye tissue transplantation. A web-based application was previously developed to facilitate easy and intuitive submission of potential donor information. OBJECTIVE The primary objectives of this study were to assess health care professionals' attitudes toward the potential application and evaluate its effectiveness based on user feedback and donor registrations through the application. METHODS Researchers used a mixed methods approach, commencing with a literature review to identify challenges associated with donor procurement. Stakeholder interviews were conducted to gauge health care professionals' perspectives regarding the application. User feedback was collected through questionnaires, surveys, and interviews to assess the application's usability and impact. An assessment of the reported potential donors and questionnaire responses were analyzed. RESULTS The final version of the application successfully reported 24 real cornea donors. Among 64 health care providers who used the application to communicate about potential donors, 32 of them submitted trial entries exclusively for testing purposes. The remaining 8 health care professionals reported potential donors; however, these individuals did not meet the donor qualification criteria. The majority of participants found the application user-friendly and expressed their readiness to use it in the future. Positive ratings were assigned to the layout, appearance, purpose, and specific features of the application. Respondents highlighted the automatic sending of notifications via SMS text messages and the integration of all necessary documents for donor qualification and tissue collection as the most valuable functions of the application. CONCLUSIONS The study indicates that donor reporting applications offer promising solutions to enhance tissue donor procurement. This application streamlined the reporting process, reduced paperwork, facilitated communication, and collected valuable data for analysis.
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Affiliation(s)
- Dominika Szkodny
- Chair and Clinical Department of Ophthalmology, Faculty of Medical Sciences, Zabrze Medical University of Silesia, Katowice, Poland
- Department of Ophthalmology, District Railway Hospital, Katowice, Poland
| | - Ewa Wróblewska-Czajka
- Chair and Clinical Department of Ophthalmology, Faculty of Medical Sciences, Zabrze Medical University of Silesia, Katowice, Poland
- Department of Ophthalmology, District Railway Hospital, Katowice, Poland
| | | | | | - Edward Wylęgała
- Chair and Clinical Department of Ophthalmology, Faculty of Medical Sciences, Zabrze Medical University of Silesia, Katowice, Poland
- Department of Ophthalmology, District Railway Hospital, Katowice, Poland
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Szkodny D, Wróblewska-Czajka E, Stryja M, Gara F, Wylęgała E. A Web Application for Reporting Eye Donors: Idea, Development and Doctor's Opinion. Transplant Proc 2023; 55:2003-2008. [PMID: 37863668 DOI: 10.1016/j.transproceed.2023.07.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 07/04/2023] [Indexed: 10/22/2023]
Abstract
BACKGROUND Obtaining corneas in a country of 38 million, Poland, is extremely inefficient. In Poland, about 1000 corneas are transplanted annually, of which over 500 come from multi-organ donations. To our knowledge, such a low percentage of donations is in the absence of reporting of potential corneal donors. There is no computer system in our country for tissue donor reporting. The aim of the work is to present an innovative application developed for this purpose. MATERIAL AND METHODS It was a cross-sectional, observational study. The questionnaires were collected from doctors who had access to the app. RESULTS Almost all participants (47/52) answered that they would use this app if it was available in the hospital, 46 acknowledged that the application could encourage doctors to report tissue donors, and 48 confirmed it should be integrated with the IT system of hospitals and should be available in all of them. CONCLUSION Despite advances in medicine and technology and increased awareness of organ donation and transplantation, the gap between supply and demand is constantly growing. Due to the large number of patients awaiting corneal transplants in Poland, it is necessary to introduce changes aimed at improving this situation. The newly developed app may contribute to increasing donor reporting.
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Affiliation(s)
- Dominika Szkodny
- Clinical Department of Ophthalmology Faculty of Medical Sciences, Zabrze Medical University of Silesia in Katowice, Katowice, Poland; Department of Ophthalmology, District Railway Hospital in Katowice, Katowice, Poland.
| | - Ewa Wróblewska-Czajka
- Clinical Department of Ophthalmology Faculty of Medical Sciences, Zabrze Medical University of Silesia in Katowice, Katowice, Poland; Department of Ophthalmology, District Railway Hospital in Katowice, Katowice, Poland
| | | | - Filip Gara
- Artnovation sp. z o.o., 44-100 Gliwice, Poland
| | - Edward Wylęgała
- Clinical Department of Ophthalmology Faculty of Medical Sciences, Zabrze Medical University of Silesia in Katowice, Katowice, Poland; Department of Ophthalmology, District Railway Hospital in Katowice, Katowice, Poland
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Freitas LSM, Rocon PC, de Almeida AV, Erlacher RGN, Paro FM. Corneal Donor Profile and Evolution of Corneal Donation in a Brazilian State Where the Number of Individuals on the Waiting List Reached Zero But Increased Again. Transplant Proc 2018; 50:509-512. [PMID: 29579837 DOI: 10.1016/j.transproceed.2017.12.053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 12/06/2017] [Accepted: 12/18/2017] [Indexed: 10/17/2022]
Abstract
BACKGROUND In most countries, the amount of corneal graft tissue available for transplantation is insufficient to meet demand. In 2010, there were 459 patients on the waiting list for corneal transplantation (WLCT) in Espirito Santo (ES), a Brazilian state with 3,885,000 inhabitants. Several strategies were implemented to reduce the number of individuals on the WLCT, which reached zero in 2011. Studies on the evolution of corneal donation contribute to reducing the WLCT worldwide. The aim of this study was to describe the evolution of corneal donation in ES and the profile of corneal donors from 2010 to 2013. METHODS This was a retrospective study. The data were collected from records referring to donations of corneas and from the archives of the Center for Organ Procurement and Distribution of ES. Statistical software was used to perform descriptive analysis of the data. RESULTS The sample consisted of 1359 donors, aged 46.82 ± 17.32 (mean ± standard deviation), 70.1% of whom were male. Most of the consent forms for donation were signed by the sons of the donors. In 2011, there was a major increase (105%) in the number of corneal transplants compared with 2010; consequently, the number of patients on the WLCT reached zero, but increased again, reaching 139 patients in 2013. CONCLUSION This study shows that strategies to increase corneal donations should be continued even after reduction or elimination waiting time on the WLCT.
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Affiliation(s)
- L S M Freitas
- Departamento de Educação Integrada em Saúde, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil
| | - P C Rocon
- Departamento de Educação Integrada em Saúde, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil
| | - A V de Almeida
- Associação Pró-Vidas Transplantes, Vitória, Espírito Santo, Brazil
| | - R G N Erlacher
- Secretaria Estadual de Saúde, Vitória, Espírito Santo, Brazil
| | - F M Paro
- Departamento de Educação Integrada em Saúde, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil.
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Roque R, Rodríguez-Villar C, Ruíz A, Paredes D, Gelpi R, Rodríguez S, García FJ, Adalia R. Relatives' Perception After Tissue Donation Experience: Results of a Postdonation Phone Survey. Transplant Proc 2018; 49:2296-2298. [PMID: 29198664 DOI: 10.1016/j.transproceed.2017.10.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Postmortem tissue donation (TD) requires the establishment of strategies for family approach to clearly explain the characteristics of multi-tissue donation. In a tertiary university hospital with a long tradition of tissue generation, we designed a survey to be applied to tissue donor families to evaluate global hospital care, care from Transplant Coordinators (TC), quality and content of information given about TD, experience, and motivations after TD process. METHODOLOGY A prospective phone survey of 10 multiple-choice items was conducted to all TD relatives that agreed to donate one or more tissues. RESULTS From the 166 calls made to TD relatives, 75 (45%) were answered: 50 were cornea donors and 25 were multiple-tissues donors. None of the relatives denied participating, the rest were not found. No statistical differences in demographical variables were found between both types of TD. The hospital and TC care perception, the quality of the given information about the processes of TD, the postdonation experiences in terms of procedures, and the impression about body appearance for relatives regardless of the type of donation, corneas or multiple tissues, were evaluated as good or very good for most of the TD relatives. Our study showed that 83% of the family members would agree to donate again; 40% of the relatives were surprised to be offered the option to donate; 10% did not know if they would donate again. Solidarity was the leading reason for TD. CONCLUSION The relatives' perception of care is a critical component of the quality evaluation of the TD process. The global evaluation results support our strategies for family approach.
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Affiliation(s)
- R Roque
- Donation and Transplant Coordination Unit, Hospital Clínic Barcelona, Barcelona, Spain.
| | - C Rodríguez-Villar
- Donation and Transplant Coordination Unit, Hospital Clínic Barcelona, Barcelona, Spain
| | - A Ruíz
- Donation and Transplant Coordination Unit, Hospital Clínic Barcelona, Barcelona, Spain
| | - D Paredes
- Donation and Transplant Coordination Unit, Hospital Clínic Barcelona, Barcelona, Spain
| | - R Gelpi
- Donation and Transplant Coordination Unit, Hospital Clínic Barcelona, Barcelona, Spain
| | - S Rodríguez
- Donation and Transplant Coordination Unit, Hospital Clínic Barcelona, Barcelona, Spain
| | - F J García
- Donation and Transplant Coordination Unit, Hospital Clínic Barcelona, Barcelona, Spain
| | - R Adalia
- Donation and Transplant Coordination Unit, Hospital Clínic Barcelona, Barcelona, Spain
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Williams AM, Muir KW. Awareness and attitudes toward corneal donation: challenges and opportunities. Clin Ophthalmol 2018; 12:1049-1059. [PMID: 29922034 PMCID: PMC5995274 DOI: 10.2147/opth.s142702] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
There is a severe shortage of donor corneas available worldwide for transplantation, with the number of patients in need of transplant greatly exceeding the number of cornea tissues available. Understanding awareness and attitudes about corneal donation worldwide is a critical step toward addressing this shortage. In this review, awareness of corneal donation and reported willingness to donate are summarized from 55 published studies across 13 countries. In general, many more respondents indicated positive attitudes toward eye donation and willingness to donate their eyes than the number of respondents who have pledged their eyes for donation, suggesting an unrealized potential of additional donors. Specifically, of 38,851 respondents across all included studies, 52% endorsed a willingness to donate their eyes after death, yet only 5% reported being a pledged donor. The most commonly cited reason for not being a registered eye donor was lack of awareness about eye donation. The disconnection between the large number of people who expressed willingness to donate and the scarcity of individuals who have pledged their eyes for donation could be addressed through educational media campaigns, collaborations with medical personnel, partnerships with grief counselors and religious leaders, use of social media, and educational sessions with medical students and staff.
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Affiliation(s)
- Andrew M Williams
- Department of Ophthalmology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Kelly W Muir
- Department of Ophthalmology, Duke University Medical Center, Durham, NC, USA
- Durham VA Medical Center, Health Services Research and Development, Durham, NC, USA
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Liu Y, Zhang Y, Zhang J, Yu J, Liang Q, Pan Z. Specific demographic factors could predict deceased potential cornea donors: A retrospective study from Beijing Tongren Hospital Eye Bank. Medicine (Baltimore) 2017; 96:e8607. [PMID: 29245222 PMCID: PMC5728837 DOI: 10.1097/md.0000000000008607] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Compared with evident cornea donors (ECDs), deceased potential cornea donors (DPCDs) have no obvious donor identifications to reference, which causes many eligible cornea tissues to be wasted. The demographic characteristics of DPCDs might be different from those of ECDs owing to the following different features: donation consent provided by relatives and willingness to donate before death. Thus, the aim of this study is to reveal the demographic characteristics of DPCDs by comparing DPCDs and ECDs.The demographic factors of 138 donors (both DPCDs and ECDs) were collected from the Beijing Tongren Hospital Eye Bank database and analyzed. To differentiate DPCDs from ECDs using the above-mentioned features, we interviewed the relatives of the donors by telephone. The relatives' attitudes toward cornea donation and their suggestions for our donation service were also acquired during the interview. Two logistic regressions were performed to reveal the demographic factors influencing the 2 features and indicate DPCDs.The donors had certain demographic characteristics (elderly, secondary, or tertiary education level, central district resident), and the most frequent cause of death for the donors was a malignant tumor (n = 56, 43.1%). All the relatives had positive attitudes toward cornea donations, and they hoped to increase publicity efforts to encourage more people to donate and establish more convenient and efficient access for cornea donation. In univariate regressions, age (P = .004, >50 years: odds ratio [OR] = 6.89, 95% confidence interval [CI]: 1.82-26.05), marital status (P = .043, divorced: OR = 9.00,95% CI: 1.33-60.80) significantly influenced relative consent, whereas age (P = .001, >50 years: OR = 15.00, 95% CI: 3.00-74.98), and family address (P = .001, central district: OR = 1) were significant factors influencing the willingness to donate before death. In multivariate regression, age (P = .021, >50 years: OR = 8.14, 95% CI: 1.37-48.41) was the only significant factor influencing relative consent. Similarly, age (P = .02, >50 years: OR = 7.55, 95% CI: 1.21-47.25) was the only factor influencing willingness to donate before death.In conclusion, specific demographic factors could indicate DPCDs and might reveal directions and methods for cornea donation coordination in the future.
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Affiliation(s)
| | | | | | - Jin Yu
- Beijing Tongren Eye Center
| | - Qingfeng Liang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China
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Liu Y, Zhang YN, Liu Y, Zhang J, Li AP, Liang QF, Pan ZQ. Demographic Characteristics of Voluntary Donors Registered in Beijing Tongren Hospital Eye Bank of China: A Retrospective Study From 2007 to 2016. Transplant Proc 2017; 49:1712-1718. [PMID: 28923613 DOI: 10.1016/j.transproceed.2017.06.037] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 06/01/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Lack of willingness to pledge eyes among the general population is the main cause for the shortage of cornea tissue in China. A few studies have implied that general-population adults with specific demographics showed more willingness to donate their eyes. METHODS In this study, we analyzed the demographic characteristics of 918 voluntary donors registered in Beijing Tongren Hospital Eye Bank in the past 10 years for possible predictors that might help us to identify potential donors in Beijing and increase the donation rate. All copies of voluntary eye donation application forms filled by the registrants from 2007 to 2016 were collected. Basic demographics listed in the application form were extracted for analysis. Demographics were described as proportions and compared by means of a χ2 test. Besides that, donor counts and proportions of combining 2 demographics from the 4 main demographics were described and compared. RESULTS Voluntary donors greater than 50 years of age (n = 477, 53.0%) predominated the proportions. Regarding education level and occupation, donors with tertiary education (n = 484, 57.4%) were more numerous than donors with primary and secondary education (n = 355, 42.1%); office clerks, workers, and government officers were more willing to pledge eyes than were donors engaged in other occupations. In addition, donors of the Han race (n = 856, 94.9%) made up the majority and mainly were distributed in 5 central administrative districts of Beijing (n = 629, 77.5%). CONCLUSIONS The present study suggests that older women (>50 years of age), living in a central district, with higher education level and engaged in white-collar work, were possible predictors for potential donors.
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Affiliation(s)
- Y Liu
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China
| | - Y N Zhang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China
| | - Y Liu
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China
| | - J Zhang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China
| | - A P Li
- Department of Ophthalmology, First Hospital of Jilin University, Changchun, Jilin, China
| | - Q F Liang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China
| | - Z Q Pan
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China.
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Vorstius Kruijff P, Huisman-Ebskamp M, de Vos M, Jansen N, Slappendel R. Video-Based E-Learning in Communication Skills for Physicians Provides Higher Agreement to Tissue Donation. Transplant Proc 2016; 48:1867-74. [DOI: 10.1016/j.transproceed.2016.04.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Accepted: 04/25/2016] [Indexed: 10/21/2022]
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