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C Wight

Publications and source records attributed to C Wight.

At least 19 recordsLinked to original sources
PubMed2001

Donor Action: an international initiative to alleviate organ shortage.

CONTEXT: Donor Action, an international initiative to alleviate organ shortage, provides a comprehensive state-of-the-art methodology that helps critical care units develop a tailor-made approach to optimize donation practices and performance. OBJECTIVE: To report the impact of the Donor Action methodology on organ donation rates in 8 countries (70 critical care units) in North America and Europe. DESIGN: Baseline data on the clinical potential for donation, staff attitudes, knowledge toward donation, self-reported confidence in performing a range of donation roles, and educational requirements were gathered. These data were analyzed using the Donor Action database and improvement measures were introduced to address identified weaknesses. RESULTS: Following introduction of the program's improvement measures, which addressed identified weaknesses, donations increased on average by 53% (P = .0017) per country at 1 year. Sustained improvements settled at 70% to 160% increases at 3 years. Although Donor Action is at various stages of implementation in different countries, the number of centers and countries demonstrating an immediate awareness effect is increasing and sustained effects in centers with the longest follow-up promise a significant impact on donation rates as more countries implement this methodology.

Chi-Square Distribution↗
PubMed1999

A European perspective on organ procurement: breaking down the barriers to organ donation.

A worldwide shortage of donor organs has led to the development of national and international systems for organ procurement and allocation. Such systems promote organ donation and ensure fair distribution of available donor organs through a combination of legislation, organ exchange organizations (OEOs), transplant coordinators, publicity campaigns, donor cards, and professional training programs. The development of national and international OEOs is central to this process because they maintain waiting lists and allocate organs in the most appropriate way. Most countries also employ transplant coordinators whose role involves promoting links between transplant centers and intensive care units, establishing protocols for organ donation, and helping hospital staff deal with the sensitive issues involved in organ donation. Educational initiatives, such as the European Donor Hospital Education Programme developed by Eurotransplant is now used in over 30 countries worldwide. The program aims to improve professionals' understanding of the legal and ethical issues involved in transplantation, to help them communicate effectively and sympathetically with bereaved families, and to increase organ donation rates. Other initiatives include programs such as the Donor Action Programme, which was set up by professional organizations in the US and Europe aiming to help hospitals establish tailor-made organ procurement policies to ensure that all potential donors can be identified and reported and the needs of unfortunate families can be met in a caring and sensitive manner.

Ethics, Medical↗
PubMed1999

The European Donor Hospital Education Programme (EDHEP): addressing the training needs of doctors and nurses who break bad news, care for the bereaved, and request donation.

The competence of critical care staff when it comes to death and organ donation can make the difference between a family's agreeing to or refusing the latter. Doctors and nurses often feel uncomfortable approaching relatives about donation and attribute this to a lack of training. Bereaved relatives express dissatisfaction with inappropriate communication and support when brain death is announced and thereafter when a request for donation is made. The European Donor Hospital Education Programme (EDHEP) was designed to meet the training needs of critical care staff in breaking bad news, caring for the bereaved, and requesting donation. EDHEP is a two-part educational package consisting of a presentation about the donor shortage followed by a one-day workshop. The implementation of EDHEP throughout the world has been facilitated through effective national working groups and standardised "train the trainer" courses. Several countries anecdotally report increases in donation following implementation. Controlled evaluation of the effect(s) of EDHEP, which started at the end of 1995, focuses on the satisfaction of the participants with EDHEP, on the competence of the participants in breaking bad news and requesting donation, on the teamwork regarding death and donation, on the satisfaction of bereaved relatives, and on organ donation rates.

Attitude of Health Personnel↗
PubMed1998

Hospital attitudes: preliminary findings from donor action pilot projects.

PURPOSE: As part of the Donor Action collaboration (Eurotransplant Foundation, The Netherlands; Organización National de Transplantes, Spain; and The Partnership for Organ Donation, USA), a hospital survey was administered to gather baseline data on staff attitudes about organ donation and level of self-reported skills/confidence in performing a range of organ donation roles. METHODS: A standard survey instrument was administered in two hospitals in Spain, two in The Netherlands and one in the UK. In four hospitals the survey was administered to all ICU staff; in one hospital it was administered to a random sample of hospital staff. The instrument was created in English, and translated into Spanish and Dutch for the hospitals in each country. RESULTS: Data were analysed by country and showed consistently strong perceptions that organ donation saves lives (97%). Support for donation (95%) and willingness to donate one's own organs (82%) were high in all three country samples. Significant differences in belief were observed when respondents were asked whether they agreed that organ donation helps families with their grief. The UK respondents were more likely to agree (57%), with lower levels of agreement in Spain (47%) and The Netherlands (14%) (P < 0.0001). Average ratings of skills/confidence were highest for notifying the transplant coordinator (49%) and comforting the family (48%) with lower confidence reported regarding explaining brain death (34%), introducing organ donation (32%), and requesting organ donation (26%). Ratings varied widely across countries with UK respondents expressing the highest level of self-reported confidence, and Spanish respondents the lowest level. For example, 77% of UK respondents reported themselves skilled/confident explaining brain death, versus 47% of Dutch respondents and 11% of Spanish respondents (P < 0.0001). Similar results were seen regarding requesting organ donation: UK 53%; The Netherlands 30%; Spain 13% (P < 0.0001). CONCLUSIONS: There has been a lack of data about hospital staff attitudes and skills to allow for comparison across national systems, and to support the targeting of specific strategies to the needs within different countries. These results show the feasibility of collecting and comparing data across national systems. These pilot findings also suggest that there may be important differences in attitudes and self-perceived skills/confidence across countries. Work remains to correlate attitudes and self-perceived skills to actual performance. It is noteworthy that the sense of staff preparedness was lowest in Spain which has the highest donation rates. This may reflect the degree to which role specialization in donation has been successfully integrated into hospital practice. Expansion of the survey to additional hospitals will help to answer such questions.

Attitude↗
PubMed1997

Organ shortages: maximising the donor potential.

Of all the problems foreseen in the pioneering days of organ transplantation, a shortage of donor organs, was not even remotely considered as a barrier to progress. Such has been the success of transplantation over the last two decades, organ shortage is now considered the major limitation. This chapter will concentrate on efforts to increase the donor potential. The development of Organ Exchange Organizations is briefly described with special emphasis on their role in organ allocation systems to avoid wastage of this precious resource, procurement transplant coordinators, the organization of organ procurement and the consent process. We look briefly at the influence of the media and end with some considerations on how to maximise the current supply of organs for transplantation.

Ethics, Medical↗
PubMed1994

Dental caries experience and defects of dental enamel among 12-year-old children in north London, Edinburgh, Glasgow and Dublin.

A multi-center study of caries experience and defects of dental enamel was conducted among 12-yr-old children in north London, Edinburgh, Glasgow and Dublin. None of the cities had water fluoridation except Dublin, which was included in the national program introduced in the Republic of Ireland in 1964. A random sample of children was drawn from state schools in each location and identical methods of clinical examination were used throughout under the same standardized conditions. All examiners were trained and calibrated with a reference examiner and achieved high levels of inter- and intra-examiner consistency. Mean DMFT values for the 4 cities were 1.27 (London), 1.39 (Edinburgh), 2.70 (Glasgow) and 1.48 (Dublin) (P < 0.001). Proportions of subjects free from caries in the same order were, 50, 47, 24 and 43% (P < 0.001), and child prevalence of diffuse opacities, 28, 29, 7 and 17% (P < 0.001), respectively. The relatively low caries levels recorded in London and Edinburgh (lower than Dublin) were considered to be related most probably to fluoride effects other than water fluoridation.

Analysis of Variance↗
PubMed1994

Does dental health education affect inequalities in dental health?

The aim of the study was to evaluate the Lothian 1991 dental health campaigns on 5-year-old schoolchildren's oral hygiene and gingival health in relation to deprivation. A stratified random sample of 486 children was selected from 92 primary schools in the city of Edinburgh. Clinical examinations took place immediately before (T1), a month after (T2) and 4 months after the campaign (T3). A total of 342 (70 per cent) children received all 3 examinations. Oral hygiene and gingival health were examined using a modified Silness and Löe and the Ainamo and Bay Index. Toothbrushes and take-home materials were distributed to all children. Dental officers provided 20 minute information sessions for each class and encouraged teachers to continue dental health activities within the classes. For the purpose of the evaluation, schools were categorised as deprived and non-deprived according to established social indicators. The results showed a statistically significant improvement in plaque scores at T2 and T3 (P < 0.05, P < 0.01). Also gingival health improved at T2 and T3 (P < 0.01, P = 0.001). However, the improvements took place only in the non-deprived schools. Thirty-one per cent of children in non-deprived schools and 18 per cent in deprived schools had a total plaque score of 0 at T1 and 41 per cent and 19 per cent respectively at T3. The differences in gingival health scores between deprived and non-deprived schools were statistically significant at T2 and T3 but not at T1. The campaign was therefore successful when evaluating the population as a whole.(ABSTRACT TRUNCATED AT 250 WORDS)

Chi-Square Distribution↗
PubMed1992

Assessment of costs to donor hospitals for organ transplantation.

In 1987, die Department of Health in the UK set up a working party to identify reasons contributing to a shortfall in donor organs. One recommendation was reimbursement to the District Health Authorities for costs incurred in providing the donor organs. The figure chosen was not to be seen as an incentive to donate organs, merely as an appropriate compensation for the costs incurred. There would be no direct payment to doctors, trustees or relatives of the donor. With the development of the competitive health care environment in the United Kingdom, the reimbursement of donating hospital costs is being considered with these data.

Costs and Cost Analysis↗
PubMed1991

Organ procurement: the role of the transplant coordinator.

The role of the Transplant Co-ordinator was first established in the United States of America in the early 1960s. For the first time an individual was appointed with a full-time commitment to increasing the number of donor organs made available for transplantation. Simultaneous with the appointment of transplant coordinators was the development of Organ Procurement Agencies (OPAs). The initial function of the OPAs was to assist with the movement of donor kidneys that could not be transplanted in the region of removal. The role of the coordinator has developed in two areas, education and organisation of the donor and recipient procedures, and has become crucial with the increase of multiple organ donation. The OPAs have become national data bases and along with the transplant coordinators have developed strong international links in the effort to increase organ donation and to avoid wastage of this precious resource.

Brain Death↗
PubMed1991

Deprivation and dental health. The benefits of a child dental health campaign in relation to deprivation as estimated by the uptake of free meals at school.

The objectives of the present study were to evaluate the overall effect of the 1989 Lothian dental health education campaign on 8-year-old school children's dental health knowledge and behaviour and to examine the relationship between free meals and the children's benefit from the campaign. Altogether 874 children were randomly selected and included in the study. Sugar-free meals and drinks were provided in all primary schools throughout the campaign week. Dental officers held 30-minute information sessions with each class and encouraged teachers to continue dental health activities. Dental knowledge and behaviour were evaluated by interviews immediately before and after the campaign. The results showed a significant increase in knowledge about diet and dental health and a significantly higher proportion of children claimed to choose non-cariogenic foods and drinks as a result of the campaign. Toothbrushing frequency also increased significantly. Ninety-eight per cent of the children enjoyed the campaign and 66 per cent discussed it with their family. Each school was classified according to the proportion of children receiving free school meals, and this showed a statistically significant negative correlation with the proportion of children who chose non-cariogenic meals and drinks before the campaign but not afterwards. Toothbrushing frequency showed a significant negative correlation with free meals both before and after the campaign. A positive correlation was found between free meals and the proportion of children who claimed to have received new information during the campaign and ate healthier food because of it.(ABSTRACT TRUNCATED AT 250 WORDS)

Beverages↗