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PubMed2000

Total quality management in blood transfusion.

Quality management is an ongoing development resulting in consistency products and services and ever increasing customer satisfaction. The ultimum is Total Quality Management. Quality systems and quality management in transfusion medicine have gained considerable attention since the outbreak of the AIDS epidemic. Where product orientation has long been applied through quality control, Good Manufacturing Practice (GMP) principles were introduced, shifting the developments in the direction of process orientation. Globally, and particularly in the more industrialised world people and system orientation has come along with the introduction of the ISO9001 concept. Harmonisation and a degree of uniformity are needed to implement a universally applicable Quality System and related Quality Management. Where the American Association of Blood Banks (AABB) is the professional organisation with the most extensive experience in quality systems in blood transfusion, the European Union and the Council of Europe now are in the process to design a quality system and management applicable to a larger variety of countries, based on a hybrid of current GMP and ISO9001 principles. The International Federation of Red Cross and Red Crescent Societies has developed a more universally to implement Quality Manual, with a pilot project in Honduras. It is recommendable to harmonise the various designs and bring the approaches under one common denominator.

Blood Banks↗
PubMed1992

[The need for national transfusion services].

Continuing advances in medical and surgical treatment have resulted in increasing demands for blood and blood derivatives. In most developed countries and in many developing ones, the blood transfusion services are organised centrally either as National Blood Transfusion Services or under the auspices of organisations such as the League of Red Cross or Red Crescent Societies. Centrally organised services have been shown clearly to be superior to hospital based transfusion services. Although hospital based services may be a convenient alternative under certain circumstances, in most cases there is inefficient use of resources and difficulties in setting, achieving and enforcing quality standards. This is so particularly in developing countries. The need to change from a remunerated or replacement donor system is emphasised, with the ultimate goal being national self-sufficiency in blood and blood derivatives. Attention is also drawn to the importance of education and motivation of staff working in the blood transfusion services if these objectives are to be met.

Blood Banks↗
PubMedDate not supplied

The nurse, the Geneva Conventions and human rights.

Alleged reports from the warfronts over the past few years have been shocking: bombing of hospitals and ambulances, health workers refusing to care for wounded members of the opposition, medical involvement in the torture of prisoners, etc. Such conduct is in violation of professional codes of conduct and the Geneva Conventions. Yet the combatants and health care personnel in too many instances remain impervious. In many economically and politically unstable countries, where uprisings and war can explode any day, anyone can become involved, but particularly health care professionals because of the nature of their work. When confronted with a dilemma in a conflict situation, nurses must remember that they are accountable for their own professional actions and as such must be aware of patient/client rights and of their rights and obligations under the terms of the Geneva Conventions of 1949 and the Additional Protocols of 1977. To assist nurses in making the right decisions, ICN developed a Code for Nurses and in 1984, with the League of Red Cross and Red Crescent Societies, prepared an educational package for nurses on the Geneva conventions and the principles of humanitarian law. Subsequently ICN, with its member nurses' associations, developed position papers on the role of nurses in caring for prisoners and detainees and in safeguarding human rights. And today in face of daily reports of humanitarian violations, ICN urges NNAs to reconfirm their commitment and to take concrete moves to assure that their members fully understand what is expected of nurses in conflict situations. Extracts of the Geneva Conventions' essential provisions and ICN's position statements are provided below as one step in bringing about this awareness.

Codes of Ethics↗
PubMed2006

In honour of Lothar Spillmann - filling-in, wiggly lines, adaptation, and aftereffects.

I have studied a number of visual phenomena that Lothar Spillmann has already elucidated. These include: Neon spreading: when a small red cross is superimposed on intersecting black lines, the red cross seems to spread out into an illusory disk. Unlike the Hermann grid, neon spreading is relatively unaffected when the black lines are curved or wiggly. This suggests that the Hermann grid, but not neon spreading, involves long-range interactions. Neon spreading can be shown in random-dot patterns, even without intersections. It is strongest when the red crosses are equiluminous with the gray background. Adaptation, aftereffects, and filling-in: direct and induced aftereffects of color, motion, and dimming. Artificial scotomata and filling-in: the "dam" theory is false. Staring at wiggly lines or irregularly scattered dots makes them gradually appear straighter, or more regularly spaced. I present evidence that irregularity is actually a visual dimension to which the visual system can adapt. Conjectures on the nature of peripheral fading and of motion-induced blindness. Some failed experiments on correlated visual inputs and cortical plasticity.

Adaptation, Physiological↗
PubMed1992

Computer-based interview for screening blood donors for risk of HIV transmission.

OBJECTIVE: To test the ability of a computer-based interview to detect factors related to the risk of the human immunodeficiency virus (HIV) among potential blood donors and to determine donor reactions to the use of the interview. DESIGN: A comparison of the rate of detection of HIV-related factors elicited by a computer interview with that obtained by standard American Red Cross procedures for assessment of donor suitability, including a randomized crossover trial in which the order of the two methods was reversed. Information obtained by the computer was not available to influence the use of blood components for transfusion. SETTING: The computer interview was administered to donors at an American Red Cross blood donor center and at a mobile blood drive at a hospital. SUBJECTS: Consecutive sample of 294 male and female blood donors 18 to 75 years of age. MAIN OUTCOME MEASURES: Subjects' responses to the computer-based interview as well as responses to the standard Red Cross written questionnaires and face-to-face interviews were used for donor assessment. RESULTS: The interview took an average of 8 minutes to complete. From among 272 donors who provided complete data, the computer identified 12 donors who reported either behaviors associated with a risk of HIV acquisition or symptoms compatible with the acquired immunodeficiency syndrome; none of these donors had been so identified either by routine written questionnaires or by face-to-face interviews used to screen potential blood donors. Only one of the 12 identified donors used the confidential unit exclusion procedure to prevent use of his donated unit. The rate of elicitation of HIV-related factors by the computer interview was 12 (4.4%) of 272 (95% confidence interval [CI], 2.3% to 7.6%), compared with two (0.13%) of 1536 (95% confidence upper bound, 0.28%) using the standard Red Cross procedure (P less than .0001). Tests for antibodies to HIV were negative in blood samples from all of the 272 subjects studied. The subjects enjoyed the computer interview and judged it to be more private than the standard donor assessment method. They also predicted that donors would be more honest with the computer interview than with a human interviewer. CONCLUSIONS: Computer-based screening elicits more HIV-related factors in the health histories of blood donors than do the standard questionnaire and interviewing methods currently in use. Computer-based screening is also acceptable to blood donors.

Adolescent↗
PubMed1989

[Social structure of the donor sample of a district blood donation and transfusion institute].

The change from paid blood donation to that made within the Red Cross Organization at the Erfurt District Institute for Blood Donation and Transfusion Service is reflected in the altered composition of the donor population. Team A (n = 4903) consists of "traditional" paid blood donors and Red Cross blood donors. It is characterized as follows: - approximately equal percentage of men and women, - high percentage of working class people with skilled worker's certificate. Women are relatively less frequent among blood donors than men, they are more frequently represented, however, as Red Cross blood donors. Team B (n = 759) covers all new blood donors since 1986, exclusively Red Cross blood donors. It is characterized as follows: - women are represented by 69% (predominantly female students), - the highest percentage (42%) of the team is made up of students. The percentage of blood donors from working class people with a skilled worker's certificate correspond to GDR average. Among the donors graduates from technical colleges and universities are overrepresented, whereas trained working class people with a skilled worker's certificate and those without it are underrepresented. Members of the staff of the municipal health service and Medical Academy as well as students of medicine and education made up the highest percentage of blood donors. About 17% of all members of the medical health service are blood donors, far more than in other branches of Erfurt.

ABO Blood-Group System↗
PubMed1989

Mechanical hemolysis of cross-bonded red cells in the microcirculation.

In favic crises the effective surface area of red cells is reduced by a mechanism called membrane cross bonding (Fischer et al., Brit. J. Haematol. 59, 159, 1985). In these crises massive intravascular hemolysis is observed the cause of which is unknown. One possibility is mechanical hemolysis of cross-bonded red cells that cannot negotiate the microcirculation due to their decreased effective surface area. To investigate this possibility critical phenomena of red cell behavior in the microcirculation were studied using Laplace's law. In model calculations an idealized vessel geometry was used: a funnel in which the angle of the conical part and the radius of the cylindrical part were varied. A map of these two parameters was established showing where red cells either enter the funnel or get stuck and where they would hemolyse under a pressure difference of 3 mm Hg. Adopting a teleological point of view it was assumed that red cell and vessel geometry are mutually adapted. Based on this assumption those combinations of the two parameters cone angle and radius were found that allow the passage of the complete population of normal red cells without hemolysis. Assuming a reduction in red cell surface area similar to that observed in favic crises it was found that only a small portion of the population would hemolyse. Therefore, mechanical hemolysis may not suffice to explain the observed intravascular hemolysis.

Capillary Resistance↗
PubMedDate not supplied

[Nursing contribution to the celebration of 50 years since the epic war 1940-41].

The Hellenic National Graduate Nurses Association presents the participation of the Greek nurses to the titanic effort of the nation to confront -for six months- two great military -then enemy- forces, of Italy and Germany, with inconceivable bravery and heroism, on the occasion of the fiftieth anniversary from the glorious period of the recent history of our country. The atmosphere and the spirit of enthusiasm and dedication is described, as well as the faith, the bravery and the self abnegation with which the Greek soldiers fought in the Albanian mountains and the Greek nurses in their own battle field, in the health care Army establishments for the treatment and relief of the brave wounded and sick warriors. Statistical data are given, concerning the numbers of graduate and volunteer nurses, who were mobilized at that time by the Army, under the flag and the responsibility of the Hellenic Red Cross, with the guidance and the co-ordination of a great Greek nurse, the late Athena Messolora, a leading figure of history of nursing in Greece. The ten, graduate and volunteer, Red Cross nurses who offered the highest sacrifice of their life for our country during this war are mentioned. Reference is also made to the recognition and appreciative acknowledgements for the great contribution, the devoted services and the sacrifices the Greek nurses rendered to their country, by the Army, the Academy of Athens, the Hellenic Red Cross and the International Committee of Red Cross as well as the Greek society. This article, the speeches of Mrs. M. Eleftheriou and Mrs. Chr. Koletti and also the selected reports of graduate and volunteer nurses, on their war experiences, which follow, are offered by the Association to the younger generations of nurses and to those who will come after them, as a greatly indebted obligation. At the same time all this material is presented, as a tribute of deep gratitude, to those heroic nurses who wrote with their generous hearts and their heroic lives a glorious page in the history of nursing of our country.

Greece↗
PubMed1977

Adult mortality rates in Leghorn X Red reciprocal crosses at three North Central stations.

Adult mortality rates among progeny of Leghorn X Red reciprocal crosses were observed concurrently at three North Central Region experiment stations. Female mortality rates were significantly (P less than or equal to .05) higher at all locations among progeny of the Leghorn male parent. Male mortality rates (observed at two locations) between crosses were not different and thus suggested a sex chromosome involvement with mortality rates in these crosses.

Animals↗
PubMed2003

Superlite Plasma Collection System.

The Japanese Ministry of Health, Labor and Welfare launched a national initiative to become plasma self-sufficient by reducing reliance on imported plasma products and increasing plasma collections to enable plasma-derived pharmaceuticals, including albumin, globulin, and Factor VIII products to use plasma collected within Japan. In order to realize this goal, plasma collections from volunteer donors must increase to about 1.5 million litres of plasma per year (1) or about 50% more than what the Japan Red Cross currently collects. A mobile device, such as the Superlite system, will make it easier and more efficient for Japan's sole blood collection agency, the Japan Red Cross, to add plasma collection to mobile blood drives. Haemonetics Corporation (Braintree, MA, USA) has combined many years of apheresis experience with up-to-date technology to create the Superlite Plasma Collection System (PCS) for the Japan Red Cross. This new device, which is expected to greatly contribute to the Red Cross's national source plasma collection program, is even smaller than the Ultralite PCS and offers several advanced features and benefits. Light, compact, and very portable, the Superlite has a Japanese language friendly user interface that continually displays collection status, including time remaining in the collection procedure. The device features a protocol that limits extra-corporeal blood volume for low-weight donors; a program used in conjunction with a reduced volume disposable bowl. Superlite, designed for use in both fixed-site and mobile applications, combines the portable ease-of-use of the Ultralite with the collection process calculation abilities of the CCS to provide a state-of-the-art collection device that will help define the future of Japan plasma collection.

Blood Transfusion, Autologous↗
PubMed1995

The role of gender, phrenology, discrimination and nervous prostration in Clara Barton's career.

Clara Barton was 39 years old before she became involved in Civil War humanitarian activities. Prior to that time, three factors shaped her personality and her future: phrenology gave her philosophical principles to live by, especially "Know Thyself"; sex discrimination on her first two jobs steeled her for living in a male dominated Victorian era; and psychohygienic therapy for her long term nervous prostration changed her behavioral approach to illness and to life. With these three influences in hand, Barton went on to gain world-wide adulation. During the Civil War, she was revered as the American Florence Nightingale, although she was not really a nurse. At age 55, Barton first embarked on the lengthy struggle to found the American Red Cross. She was president of the Red Cross for 23 years and rendered aid and comfort at a host of national and international calamities. She died at age 90 in her Glen Echo, Maryland home on April 12, 1912.

Female↗
PubMed2002

[A systematic analysis of the Ottoman Red Crescent periodical (Part III)].

Founded in 1877, the Ottoman Red Crescent Society rendered a lot of important services in military and civil areas in the Ottoman Empire. The Ottoman Red Crescent Society not only gave health services for the soldiers, but it also attempted to obey the international acts signed for the war captives and to rescue them together with the countries involved under the supervision of the international Red Cross. In the civilian area, the Ottoman Red Crescent Society also played an active role to meet the casualties' needs, such as food, clothes, and accommodation following natural disasters like earthquake, flood, fire etc. The Ottoman Red Crescent Society published a monthly newsletter called Osmanli Hilâl-i Ahmer Mecmuasi to announce its services more effectively to the public since 15 September 1921 (12 Muharrem 1340). The publication of the newsletter continued as Türkiye Hilâl-i Ahmer Mecmuas' after the 15th issue. Starting with the 85th issue on September 15th, 1928 (30 Rebiülevvel 1347) it was printed with Latin alphabet instead of Arabic letters. A brief translation in French and in English exist in the end of each issue. In the second part of this research, news about the Red Crescent Society's organization; financial supports for the Society and, in return, material and financial aids by the Society; local organizations providing aid to the Society; money collected during Bairams; plays and balls arranged by the Society; and the activities of the womens' branch of the Red Crescent Society, are introduced. The third and last part of the study deals with the comments of visitors about the Red Crescent Society; and news and activities of the European Red Cross Societies.

History, 19th Century↗
PubMed1997

Autologous donation error rates in Canada.

BACKGROUND: Although certain transfusion risks are eliminated by the use of autologous blood, clerical errors may still occur. In addition, because of differences in donor selection criteria and donor-patient expectations, the consequences of certain errors may be different in autologous and allogeneic donations. STUDY DESIGN AND METHODS: In January 1996, autologous donation error rates in Canada from 1989 to November 1995 were estimated by 1) a detailed questionnaire sent to hospitals supplied by the Canadian Red Cross, Blood Services, Transfusion Center of Quebec at Montreal autologous donation program (n = 31), 2) a review of that institution's quality assurance non-compliance reports, and 3) a detailed questionnaire sent to other Canadian Red Cross centers with autologous donation programs (n = 16) and hospital-based autologous programs in Canada (n = 3). The total number of autologous donations collected was determined from Canadian Red Cross annual reports and information supplied by hospital-based programs. RESULTS: There were 113 errors reported for 16,873 units collected by the Montreal center (1/149 units) based on collection center and hospital data. The most frequent errors were the late receipt of units for surgery (25% of errors) or the receipt of units in the wrong hospital (23%). Other Canadian programs reported 166 errors for approximately 53,500 units collected (1/322 units). However, this figure was based mainly on collection center, and not hospital, data. The most frequent errors were in labeling (48%) and component preparation (25%). One unit of autologous fresh-frozen plasma was transfused to the wrong recipient. Errors were more frequent if components were produced, if units were drawn in hospitals for interhospital transfer, or it units were shipped between Red Cross centers. CONCLUSION: Errors are not infrequent in autologous donation programs. Autologous transfusion should not be considered as being without risk.

Blood Donors↗
PubMed1994

Use of blood donation history of people with HIV infection to identify recipients at risk.

OBJECTIVE: To determine whether previous blood donations from HIV-positive patients posed a threat to recipients. DESIGN: Interviewer-administered questionnaire survey. SETTING: Regional HIV outpatient referral clinic for southern Alberta. PATIENTS: All 478 patients attending the clinic from May 1, 1993, to Mar. 31, 1994; 366 were excluded: 335 had not donated blood, and 31 could not provide reliable information regarding possible donations. INTERVENTIONS: Patients were asked at a routine clinic visit regarding the dates, frequency and location of previous blood donations. The Canadian Red Cross was informed, with patient consent, if the previous donations posed a potential risk of HIV transmission. OUTCOME MEASURES: Number of HIV-positive patients whose donations posed a possible or definite risk to recipients. RESULTS: A total of 545 units of blood had been donated by the 112 patients in the study; 57 units (donated by 29 patients) posed a possible risk, and 12 (given by 11 patients) posed a definite risk of HIV transmission to the recipients. Thirty-two of these donors had been unknown to the Red Cross through its "look-back" and "trace-back" protocols. Only 1 of the 13 patients found to be HIV positive by the Red Cross openly admitted donating blood to undergo HIV antibody testing; the remainder were either ill-informed or did not perceive themselves to be at risk. The patients were highly mobile, 36.7% donating blood at some time in a province other than the one where they had received their positive HIV test result. CONCLUSION: Asking HIV-positive patients about their blood donation history, although subject to recall bias, is a simple and inexpensive method for identifying high-risk blood donations. The Red Cross should routinely be notified, with patient consent, of all donations posing a risk in order to enhance the prospect for identifying HIV-positive blood recipients.

Adult↗
PubMed2005

Her Royal Highness Princess Maha Chakri Sirindhorn: her activities in humanity and medicine.

Her Royal Highness Princess Maha Chakri Sirindhorn, the Executive Vice-President of the Thai Red Cross Society has followed the footsteps of her fore-bears, carrying the noble humanitarian work they began, particularly the work of the Thai Red Cross society and the Faculty of Medicine, Chulalongkorn University. Her contributions have been a benefit to all, and she has earned great love and is held in high esteem by her people. Her ideas, thoughts, words, and activities have been of immense value to the faculty in both tangible and intangible ways. A selfless, dedicated women who is willing to make sacrifices for the common good, Her Royal Highness serves as a model humanitarian for the staff of the Faculty of Medicine, Chulalongkorn University, whose morale she has boosted and whose operations she has planned with the foresight ofa first-class administrator. Her devotion to the Thai Red Cross, and thus her devotion to her people, have indeed made her the royal gem within Thai hearts, with sparkling brilliance of her humanitarian deeds instilling the warmth of her love in our spirits.

Altruism↗
PubMed1997

Anger over HIV questions cancels blood clinic at Ottawa university.

Ottawa's Carleton University cancelled a February blood-donor clinic after the Red Cross failed to hold sensitivity-training sessions for its volunteers. The sessions were requested after students complained that the organization's screening procedures are insensitive and offend gay students. The Red Cross maintains that rigorous screening, including questions about high-risk sexual behaviour, is essential if the blood supply is to be protected. In March a compromise was announced: the Red Cross will begin sensitivity training for its volunteer workers in April and blood-donor clinics will return to Carleton in the fall.

Anger↗
PubMed1989

Caring for people at home.

This series presents advice and interesting tips on caring for sick, elderly and disabled people in their homes. Although it is written mainly for people who care for others at home the advice is useful knowledge for the attending medical practitioner. The topics are reproduced from the Australian Red Cross Society 'Caring For People At Home' manual. The Red Cross programme has three components--the manual, a practical course, and an advisory or information service.

Australia↗
PubMed2002

Henry Dunant and Norman Bethune: a Canadian surgeon who worked with H. Dunant at the Battle of Solferino.

Following a description of both scenarios involved in the Battle of Solferino (1859), and the consequent horrors which spurred Henry Dunant to set up the International Red Cross organisation, for which he received the first Nobel Peace Prize in 1901, the present paper discusses the meeting between Henry Dunant and the Canadian surgeon Norman Bethune (1822-1892). During the days immediately after the battle, they worked together, and Bethune voluntarily operated on the injured soldiers, probably at the hospital of Brescia. In the final part, we describe the life of Norman Bethune, grandfather of the famous Henry Norman Bethune, hero of Maoist China. Norman Bethune was not only a famous surgeon in Toronto, but also Dean of the Medical School at Trinity College in 1856, a colleague of Dr George Ansel Sterling Ryerson, (recognised as founder of the Canadian Red Cross), and other members of the First Central Council of the same organisation. We suggest that Dr Norman Bethune communicated his Italian and European experience with Henry Dunant the founder of the International Red Cross, to his colleagues.

Canada↗