Ensuring public health neutrality Roberts, Les F; VanRooyen, Michael J
The New England journal of medicine,
2013-Mar-21, Letnik:
368, Številka:
12
Journal Article
BACKGROUND: The number of apheresis collections increased significantly in recent years; however, data on viral marker rates among these collections are lacking.
STUDY DESIGN AND METHODS: Apheresis ...collection data for 2004 to 2008 were analyzed. All collections were tested for antibodies and viral RNA for human immunodeficiency virus (HIV) and hepatitis C virus (HCV), hepatitis B surface antigen (HBsAg), antibody to hepatitis B core antigen (anti‐HBc), antibody to human T‐lymphotropic virus (anti‐HTLV), and other markers. HBsAg‐confirmed‐positive but anti‐HBc–nonreactive units were further verified by HBV DNA testing.
RESULTS: From 2004 to 2008, apheresis collections for double red blood cells (R2) increased by 294% to a total of 37% of all apheresis collections. Marker rates (/100,000) among all apheresis collections were 1.41, 7.83, 2.04, and 0.28, for HIV, HCV, HBsAg, and HTLV. Among R2 collections, rates (/100,000) were 6‐ to 13‐fold higher than among non‐R2 collections for HIV (3.50 vs. 0.53), HCV (21.84 vs. 1.96), and HBsAg (5.83 vs. 0.44), but not HTLV (0.53 vs. 018). First‐time male R2 donors accounted for 25% to 100% of positivity but only 1% to 5% of the total number of apheresis collections. Incidence (/100,000 person‐years) and residual risk estimates among repeat apheresis donors between 2007 and 2008 for HIV were 3.82 and 1:1.0 million, for HCV were 1.53 and 1:3.2 million, and for HBsAg were 4.85 and 1:200,000. These estimates were comparable to those among repeat whole blood donors.
CONCLUSION: The risk of major blood‐borne infections among current apheresis collections was low; however, an upward trend in the viral marker frequency among apheresis donations was attributable to the contribution of first‐time, male R2 donors.
ObjectivesPersons with disabilities, especially those with a severe disability, have a vague anxiety about future disasters; however, the measures of self-assistance for disaster preparedness have ...not been standardised. The present study aimed to describe disaster-related anxiety and behaviours related to disaster preparedness among persons who have cervical cord injury in Japan.DesignQualitative study.SettingTokyo Metropolitan area, Japan.Participants16 persons with cervical cord injury participated. Inclusion criteria were being 20 years old and older, being diagnosed with cervical cord injury, being able to communicate verbally, having an interest in disaster preparedness, and belonging to a self-help group of persons with cervical cord injury in the Tokyo Metropolitan area.ResultsParticipants usually had ‘anxiety about health management’ and it became more serious once they thought about a disaster. We identified three themes in relation to their anxiety: ‘storing needed items,’ ‘staying in a safe place’ and ‘having reliable caregivers.’ We also identified three other themes that were the reasons behind these themes: ‘travel experiences,’ ‘experiences of failure’ and ‘information from peers.’ConclusionsTo buffer the anxiety about health management in a disaster, it would be important for persons with cervical cord injury to store needed items, stay in a safe place and have reliable caregivers. Various daily experiences, including experiences of failure, would encourage such behaviours.
The history of both the Red Cross and the Japanese Red Cross is based on a teleological and eurocentric narrative which is strongly shaped by national histories and focused on persons. To assume 1863 ...as the founding date of the Red Cross is highly debatable, considering that most national relief organisations were renamed 'Red Cross Societies' only in the 1880s. In this Japan is no exception, since first a Haku-Ai-Sha (Philanthropic Society) was founded in 1877 and then turned into the Japanese Red Cross Society in 1887. Japanese actors must be regarded as intrinsically motivated and active participants in the Red Cross movement who saw an ideal and a model in the Euro-American 'way of civilisation' and humanity. It has taken about 30 years to turn the Haku-Ai-Sha in Japan into a humanitarian society which is accepted both at home and abroad and, with its 728,507 members in 1900, which constituted the largest Red Cross Society in the world.
Purpose
After eight years of reforms, the French Red Cross (FRC) changed status from humanitarian association to nonprofit organization (NPO). This in-depth study of the organization’s recent past ...(2005-2013) aims to highlight several identity threats linked to the ongoing process of organizational rationalization and managerialization. The main contribution of this paper is based on the responses provided by this NPO to deal with it.
Design/methodology/approach
This communication has been produced as part of a three-year research contract (2010-2013) for the FRC. A total of 39 semi-structured interviews conducted between February and June 2013, participatory observation and documentary study. Of the 39 interviews, 29 were usable, and these were analyzed using ALCESTE software. This software enabled the authors to quantify and extract the strongest signifying structures.
Findings
The “Red Cross” meta-identity has so far enabled FRC to change its identity, not without difficulty, but without major organizational crises. In this case, the results confirm the Ravasi at Schultz model (2006) by underlining the difficulty to create a “giving sense process.” At managerial level, the choice of “self-regulated” professionalization seems to have made the most impact in changing the members’ identity understanding. In response to the threat of the fragmentation of social links, the implementation of an important internal communication policy around the idea of a “community of actors” has not had the expected results.
Research limitations/implications
This study is based on a unique case with unusual dimensions (18,025 employees and 56,136 volunteers).
Practical implications
The example of the FRC is indicative of what happens in the nonprofit sector. The answers provided by this extraordinary association may inspire other organizations facing an identity crisis.
Originality/value
This paper reveals two major contributions. First, it validates the appropriateness of the Ravasi and Schultz model (2006) for the study of identity change in social enterprises. Second, it assists managers through its analysis of the appropriateness of procedures and tools used to support identity change. From an international perspective, this paper also contributes by describing the evolution of NPOs in the French context.
One of the lesser known stories of the Gallipoli campaign was the significant support provided to the Australian Imperial Force by the array of voluntary patriotic funds. Mobilized from the beginning ...of the war and operating both on the Home Front and in Egypt, the large support network of individuals and organizations varied from sandbag funds, the provision of recreational equipment and hostel accommodation, to foodstuffs and medical supplies. This article focuses on the Australian Red Cross, formed on the outbreak of war in August 1914 as a branch of the British Red Cross Society. Its considerable contribution as a humanitarian organization concentrating on sick and wounded soldiers in war included Wounded and Missing Bureaux. Using the records of the South Australian Red Cross Information Bureau, this article explores the beginning of this programme and its efforts to trace missing soldiers from the Gallipoli campaign for family members and friends. Through this case study analysis, we find another lens with which to examine the effects of the Gallipoli campaign on the Home Front and explore the broader social and familial effects of the war more generally.
Background and Objectives Previous studies have shown substantial geographical variation in blood donation within developed countries. To understand this issue better, we identified community ...characteristics associated with blood donor rates in German municipalities in an ecological analysis.
Materials and Methods We calculated an aggregated rate of voluntary blood donors from each of 1533 municipalities in south‐west Germany in 2007 from a database of the German Red Cross Blood Service. A multiple linear regression model estimated the association between the municipality‐specific donor rate and several community characteristics. Finally, a spatial lag regression model was used to control for spatial autocorrelation that occurs when neighbouring units are related to each other.
Results The spatial lag regression model showed that a relatively larger population, a higher percentage of inhabitants older than 30 years, a higher percentage of non‐German citizens and a higher percentage of unemployed persons were associated with lower municipality‐specific donor rates. Conversely, a higher donor rate was correlated with higher voter turnout, a higher percentage of inhabitants between 18 and 24 years and more frequent mobile donation sites.
Conclusions Blood donation appears to be a highly clustered regional phenomenon, suggesting the need for regionally targeted recruiting efforts and careful consideration of the value of mobile donation sites. Our model further suggests that municipalities with a decreasing percentage of 18‐ to 24‐year‐olds and an increasing percentage of older inhabitants may experience substantial declines in future blood donations.
BACKGROUND: Bacterial sepsis following whole blood–derived platelet (WBP) transfusion has remained a substantial patient risk, primarily due to a lack of practical and effective means to limit or ...detect bacterial contamination. We describe the risk of reported septic reactions to WBPs and the introduction of prestorage‐pooled whole blood–derived platelets (PSPs) collected using initial sample diversion and cultured for bacterial contamination.
STUDY DESIGN AND METHODS: Product qualification and quality control (QC) testing with the Acrodose PL system (Pall Medical) were evaluated in four regional blood centers. Bacterial contamination risk was assessed by review of reported septic transfusion reactions to WBPs and by aerobic QC culture of leukoreduced PSPs utilizing automated microbial detection system cultures (BacT/ALERT 3D, bioMérieux).
RESULTS: Before implementing PSPs (January 2003‐December 2006), we distributed 2,535,043 WBP units and received 20 reports of septic reactions including 2 fatalities (7.9 per million 1:126,752 reactions and 0.79 per million 1:1,267,522 fatalities). In October 2006, PSPs were effectively implemented with a product qualification success rate of 99.6 percent and a mean yield of 4.0 × 1011 platelets (PLTs) per pool. Whole blood collection sets with sample diversion technology were introduced during the operational trial and decreased the rate of confirmed‐positive bacterial culture of PSPs from 2111 (1:474) to 965 (1:1036) per million (odds ratio, 0.46; 95% confidence interval, 0.22‐0.95). No septic reactions to PSPs were reported (25,936 PSP units distributed).
CONCLUSION: Sample diversion and bacterial culture are effective methods to reduce bacterial risk with WBP transfusion. Bacterial contamination of PSPs was assessed at 5.8‐fold our current rate for apheresis PLTs utilizing comparable culture protocols.
This article analyzes the evolution in international law of the obligation to search for and return the remains of forcibly disappeared and missing persons. Receiving the remains of forcibly ...disappeared and missing persons is one of the primary needs of their families, who bring the issue to international courts and non-judicial mechanisms. This obligation has been incrementally recognized and developed by different human rights courts, which have included the obligation to search for and return the remains of disappeared persons in their remedies. In parallel to the development of the obligation by international courts, the international community has begun to become more involved in assisting in return of the remains of forcibly disappeared and missing persons to their families.
Two decades ago, only a handful of NGOs operated legally in China. Today the sector is thriving. Even with the threat of new restrictions under the Xi Jinping government, private social initiative ...appears poised for even greater expansion in the future. To fully appreciate the significance of these recent developments, this essay presents a wider view of China's long history of civic organisation, comparing the contemporary resurgence of NGOs to the historical development of private charities in the Qing and Republican periods. It finds similarities in the motivations of organisers and donors, as well as in the relationship between civic organisations and the state, but sees other developments, such as the capitalisation of the NGO sector and its ability to mobilise public opinion, as substantively new.
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