Austrian Red Cross Research Articles

Personalized medicine comes to a blood center near you

Personalized medicine comes to a blood center near you

The impact of temporary deferrals on future blood donation behavior across the donor life cycle.

Donor retention is essential for blood banks because acquiring new donors is more expensive than retaining existing ones. Previous studies show that the temporary deferral of donors negatively impacts future donation likelihood. In this study, we analyze the impact of temporary deferrals on future donation behavior while correcting for potential endogeneity, depending on the level of donor experience and number of previous deferrals. We use data from more than 123,000 whole blood donors of the Austrian Red Cross over a period of 5.5 years. We estimate logit models to analyze how a deferral affects future donation behavior while controlling for potential selection biases because donors are not deferred randomly. We control for gender, blood type, years since first donation, and number of previous donations and deferrals. We analyze the direct deferral effect, its interaction with donor experience, and the number of previous deferrals. Our results confirm that temporary deferrals hurt future donation behavior. This effect varies with donor experience and the number of previous deferrals. The effect is weaker with a higher number of previous donations and is stronger with a higher number of previous deferrals. The results suggest that donors learn to cope with deferrals the more they donate. However, the negative effect of deferrals amplifies over time, and each additional deferral decreases donation likelihood. Blood banks that seek to overcome the negative effect of deferrals should be aware that this effect varies with donor experience and with the number of previous deferrals. Our results suggest that blood banks should focus on early-stage donors who are deferred because the negative deferral effect is stronger for more experienced donors. At the same time, blood banks should be careful with donor groups who have experienced deferrals in the past because every additional deferral demotivates future donation behavior. Overall, researchers should be careful to correct for endogeneity because our results suggest that ignoring these effects could lead to substantial underestimation of the negative deferral effect.

Safeguarding Public Values in Cooperation with Big Tech Companies: The Case of the Austrian Contact Tracing App Stopp Corona

In April 2020, at the beginning of the COVID-19 pandemic, the Austrian Red Cross announced it was encouraging a cooperation with Google and Apple’s Exposure Notification Framework to develop the so-called Stop Corona app – a contact tracing app which would support health personnel in monitoring the spread of the virus to prevent new infections (European Commission, 2020a). The involvement of Google and Apple to support combating a public health emergency fueled controversy over addressing profit-driven private interests at the expense of public values. Concerns have been raised about the dominant position of US based big tech companies in political decision concerning public values. This research investigates how public values are safeguarded in cooperation with big tech companies in the Austrian contact tracing app Stop Corona. Contact tracing apps manifest a bigger trend in literature, signifying power dynamics of big tech companies, governments, and civil society in relation to public values. The theoretical foundation of this research form prevailing concepts from Media and Communication Studies (MCS) and Science and Technology Studies (STS) about power dynamics such as the expansion of digital platforms and infrastructures, the political economy of big tech companies, dependencies, and digital platforms and infrastructure governance. The cooperative responsibility framework guides the empirical investigation in four main steps. First steps identify key public values at stake and main stakeholders. After, public deliberations on advancing public values and the translation of public values based on the outcome of public deliberation are analyzed. This research applies a qualitative case study, including document analysis and expert interviews. In total, 52 documents were analyzed and six expert interviews conducted. Findings show that key public values at stake concerning Stop Corona involve data protection and privacy, (cyber-)security and safety, accuracy, voluntariness and consent, accessibility, inclusiveness, transparency, trust, etc. Public deliberations of multiple stakeholders about public values can help to safeguard public values. While an involvement of EU, state, civil society, and science and research can be witnessed in defining and advancing public values, Google and Apple, ultimately, translate the outcome of public deliberations through technological design choices. Therefore, public deliberations require a public-value oriented process which is transparent and involves a strong civil society and science and research community, and a unified EU voice. There is a clear need for technical alternatives and policy frameworks to organize the cooperation with big tech companies at EU level.

Glycerophosphodiester Phosphodiesterase Identified as Non-Reliable Serological Marker for Borrelia miyamotoi Disease.

The relapsing fever group Borrelia miyamotoi is an emerging tick-borne pathogen. Diagnosis of infection is currently mainly based on serological methods detecting antibodies against B. miyamotoi glycerophosphodiester phosphodiesterase (GlpQ). Here, we scrutinized the reliability of GlpQ as a diagnostic marker and compared the seroprevalence in different study populations and by applying various immunoblotting methods. Antibodies were detected in the sera of 7/53 hunters and in 1/11 sera of Lyme neuroborreliosis patients. Furthermore, 17/74 sera of persons with high concentrations of anti-Borrelia burgdorferi sensu lato (α-Bbsl) antibodies reacted strongly with B. miyamotoi GlpQ in immunoblots. The B. miyamotoi GlpQ seroprevalence was 7/50 in α-Bbsl negative persons. In healthy blood donors from commercial suppliers and from the Austrian Red Cross, seroprevalences were 5/14 and 10/35, respectively. Strikingly, two B. miyamotoi PCR-positive cases from Austria had negative GlpQ serology, indicating poor sensitivity. Finally, when we analyzed sera of dogs, we found α-B. miyamotoi GlpQ antibody seroprevalence in tick-free dogs (n = 10) and in tick-exposed dogs (n = 19) with 2/10 and 8/19, respectively. Thus, our results indicate that GlpQ-based B. miyamotoi serology holds neither specificity nor sensitivity.

Association of ABO Blood Group with Bleeding Severity in Patients with Bleeding of Unknown Cause

Introduction: Antigens of the ABO blood group system have an impact on the hemostatic balance. The association of blood group non-O and thrombosis risk is well known. In patients with different bleeding manifestations, an overrepresentation of blood group O has been previously reported (Dentali et al, Semin.Thromb. Hemost, 2013). Nevertheless, the independent effect of the ABO blood group on bleeding severity, when considering VWF as a major contributing factor, has not yet been thoroughly investigated. Patients with bleeding of unknown cause (BUC) have a similar bleeding phenotype as patients with a diagnosis of an established bleeding disorder, but the causes underlying their bleeding tendency are currently unclear and might be multifactorial (Gebhart et al, Haemophilia, 2018). Thus, we investigated the prevalence of blood group O and its role as an independent risk factor for increased bleeding severity in a thoroughly characterized cohort of patients with BUC. Methods: For this analysis, we selected all patients with normal results in the assessments of plasmatic coagulation and platelet function consecutively recruited between October 2009 and April 2019 within the Vienna bleeding biobank study (Figure 1; Gebhart et al, Haemophilia, 2018). After informed consent, all patients underwent a structured interview on their previous medical and bleeding history including the assessment of the bleeding severity with the Vicenza bleeding assessment tool (BAT). Biomaterial was processed and stored according to standard operating procedures at the Biobank facility (http://www.biobank.at/). A thorough hemostatic laboratory assessment and measurements of thrombin generation, plasma clot properties, and rotational thromboelastometry (ROTEM), as well as platelet function tests (PFA-100, light transmission aggregometry) were performed. Data on the blood group distribution of 23,145 healthy first-time blood donors were provided by the Austrian Red Cross for comparison. Results: We observed an overrepresentation of blood group O in 199 out of 422 BUC patients (47.2%) compared to 8709 out of 23,145 healthy blood donors (37.6%), odds ratio for blood group O 1.48; 95% CI=1.22-1.79, p<0.001 (Table 1). Blood group O in comparison to non-blood group O was independently associated with an increased bleeding severity (least square mean [95% CI]: 6.2 [5.8-6.6] vs. 5.3 [4.9-5.7], p=0.006) and a higher number of bleeding symptoms (least square (LS) mean [95% CI] 3.5 [3.2-3.7] vs. 3.0 [2.8-3.2], p=0.016), after adjustment for sex, VWF:Ag, VWF:RCo and FVIII activity (Table 2). The prevalence of oral mucosal bleeding was significantly higher in blood group O than in patients with a non-O blood group (26.1% vs. 14.3%), even after adjustment for sex, VWF and FVIII, and multiple testing (p=0.013). When analyzing the influence of blood group O on tests of global hemostatic capacity, results indicated increased clot firmness and reduced lysis in blood group O patients. In ROTEM, the maximum clot firmness was higher (LS mean [95% CI]: 57.4 [56.5-58.3] vs. 55.8 [55.0-56.6] mm, p<0.05) and the maximal lysis lower (LS mean [95% CI]: 13.3 [12.5-14.1] vs. 15.1 [14.4-15.9] %, p<0.05) in patients with blood group O compared to non-O patients, after adjustment for sex, VWF and FVIII, and correction for multiple testing. Also in the analysis of plasma clot properties, the maximum clot absorbance was increased in patients with blood group O after adjustment for sex, VWF and FVIII (LS mean [95% CI]: 0.77 [0.74-0.79] vs 0.71 [0.69-0.74] OD, p<0.05), whereas there was no difference in plasma clot lysis. There was no difference in thrombin generation between BUC patients with blood group O and non-O. We could not identify any differences in platelet function, as assessed by the platelet function analyser-100 and light transmission aggregometry between patients with blood group O in comparison to non-O patients after adjustment for sex, VWF and FVIII, and correction for multiple testing. Conclusion : Blood group O is a risk factor for a more severe bleeding phenotype, especially oral mucosal bleeding, independent of VWF and FVIII levels in patients with BUC. Alterations in global hemostatic capacity in BUC patients with blood group O were identified, whereas platelet function was not different. Our data are important for a better understanding of underlying mechanisms of bleeding in BUC patients, which are most probably multifactorial. Disclosures Jilma: True North Therapeutics: Consultancy, Other: reimbursement for travel costs for scientific presentations; Bioverativ: Consultancy, Other: reimbursement for travel costs for scientific presentations.

Simulation-based training and assessment of mobile pre-hospital SARS-CoV-2 diagnostic teams in Styria, Austria.

The World Health Organization has declared coronavirus disease 2019 (COVID-19) a pandemic. Polymerase chain reaction testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the diagnostic gold standard of COVID-19. We have developed a simulation-based training program for mobile prehospital diagnostic teams in the province of Styria, Austria, and performed a prospective observational study on its applicability and effectivity.The 1-day curriculum uses theoretical instruction, technical skills training, and simulator-based algorithm training to teach and train prehospital patient identification and communication, donning the personal protective equipment, collection of naso-/oropharyngeal swabs for SARS-CoV-2 polymerase chain reaction testing, doffing the personal protective equipment, and sample logistics. Trainings were conducted at the SIM CAMPUS simulation hospital, Eisenerz, using high-fidelity patient simulation. To ensure achievement of predefined learning outcomes, participants had to undergo a final simulator-based objective structured clinical examination.In March 2020, 45 emergency medical assistants and 1 physician of the Austrian Red Cross participated on a voluntary basis. Forty-five of the 46 participants (97.8%) completed the curriculum successfully, with mean objective structured clinical examination ratings of 98.6%.Using several proven educational concepts, we have successfully drafted and implemented a training program for mobile prehospital SARS-CoV-2 diagnostic teams. Based on simulation-based objective structured examinations, it has prepared participants effectively for preclinical duties.

Sense of coherence is linked to post-traumatic growth after critical incidents in Austrian ambulance personnel

BackgroundAmbulance personnel, as well as other emergency services like fire-fighters or the police force, are regularly confronted with experiences of extreme psychological distress and potentially traumatizing events in the line of their daily duties. As a consequence, this occupational group is exposed to an elevated risk of developing symptoms of Post-Traumatic Stress (PTSS). Subsequently, symptoms of Post-Traumatic Stress have been observed as potentially co-occurring with Post-Traumatic Growth (PTG) in ambulance personnel as well. Therefore, in this study we hypothesized that Sense of Coherence (SOC) might play an important role as an underlying feature in enabling growth after stressful experiences in Austrian ambulance personnel.MethodsIn this study, voluntary and full-time ambulance personnel (n = 266) of the Austrian Red Cross ambulance service completed an online survey including the Sense of Coherence Scale (SOC-29), the Post-Traumatic Growth Inventory (PTGI) and the Impact of Event Scale Revised (IES-R) for the assessment of PTSS. In line with theoretical considerations, a two-step cluster analysis limited to four clusters and further ANOVAs were conducted.ResultsFour clusters were confirmed and labelled PTSS-low/PTG-low, PTSS-low/PTG-high, PTSS-high/PTG-high and PTSS-high/PTG-low. Further ANOVAs revealed substantial cluster differences in SOC, with higher SOC-levels in PTSS-high/PTG-high than in PTSS-high/PTG-low (p < .01), in PTSS-low/PTG-high than in PTSS-low/PTG-low (p < .01) and in PTSS-low/PTG-high than in PTSS-high/PTG-low (p < .01).ConclusionsOur findings point to a significant association between SOC and the development of PTG in ambulance personnel. Furthermore, the results suggest that growth and stress after critical incidents are independent from each other and can co-exist. Therefore, promoting SOC (e.g., meaningfulness) in ambulance personnel – e.g., through psychological interventions – might preserve and enhance psychological health after critical incidents.

An empirical analysis of the organisational structure and processes in a refugee collection centre

In the last few years, foresight and systemic thinking have become increasingly important. Migration studies need to analyse issues from a holistic perspective as well, which also means including conclusions about the future and learning processes. In order to look at a rather important interface in the context of the migration crisis, an empirical study on the collection centre in Spielfeld at the southern border of Austria was performed. The findings were obtained by conducting expert interviews within a case study. The study indicated four key actors: police, Austrian Armed Forces, Caritas and Austrian Red Cross. Despite the reduction in staff, there are no current plans for the closure of the collection centre. The challenges and problems are divided into three categories: the construction phase, the period of operation and the pressure from asylum seekers, who want to continue their travels. Furthermore, there seems to have occurred a phase of overextension.

An empirical analysis of the organisational structure and processes in a refugee collection centre

In the last few years, foresight and systemic thinking have become increasingly important. Migration studies need to analyse issues from a holistic perspective as well, which also means including conclusions about the future and learning processes. In order to look at a rather important interface in the context of the migration crisis, an empirical study on the collection centre in Spielfeld at the southern border of Austria was performed. The findings were obtained by conducting expert interviews within a case study. The study indicated four key actors: police, Austrian Armed Forces, Caritas and Austrian Red Cross. Despite the reduction in staff, there are no current plans for the closure of the collection centre. The challenges and problems are divided into three categories: the construction phase, the period of operation and the pressure from asylum seekers, who want to continue their travels. Furthermore, there seems to have occurred a phase of overextension.

Effects of word-of-mouth on the behavior of Austrian blood donors: a case study of the Red Cross Blood Donation Service.

The procurement of blood is an essential challenge of today's health care. Current studies emphasize the influence of word-of-mouth (WOM) on health care behavior, including blood donation. Still, there exists no study which systematically investigates how WOM affects the behavior of blood donors. Therefore, this paper aims to contribute to this lack of research by focusing on Austrian blood donors as possible receivers and senders of WOM. A survey was distributed to 300 donors of the Austrian Red Cross with a return of 245 surveys. The results highlight the strong influence of WOM on the awareness of the blood service and the willingness to donate blood. Further, structured and organized procedures, friendly employees and respectful interaction were found to be important factors determining willingness to recommend blood donation. Family members as well as friends are the preferred WOM-receivers and the personal face-to-face contact is the favored channel of communication. The results also show that WOM-behavior is strongly influenced by factors such as age, gender and donation frequency. By helping blood bank managers to better understand how WOM affects donation intention and behavior, this study provides a new approach to attract blood donors.

The co-creation of multi-agent social innovations

Purpose– The research fields of service innovation and social innovation have, until now, been largely disconnected. At the most basic level, a great many social innovations are services, often public sector services with social entrepreneurs organizing and delivering service innovations. As well as this overlap in the focus of research, scholars in both research fields address socio-economic concerns using multidisciplinary perspectives. The purpose of this paper is to provide a framework that can bridge the two research fields.Design/methodology/approach– Inter-linkages between service and social innovation are shown by identifying research areas in which both find a joint heuristic field. This approach has been illustrated in a set of case studies in the health sector in Europe.Findings– The bridge between social innovation and service innovation research can be built when social innovation is examined through a multi-agent framework. The authors focus on social innovations where the co-creation of novel services is guided by the prominent position taken by citizens, social entrepreneurs or third sector organizations (NGOs or charities) in the innovation process. Of particular interest are the ways in which the interests of individual users and citizens are “represented” by third sector organizations.Practical implications– The case study of the Austrian nationwide public access defibrillation programme provides an exemplar of the process of co-creation by which this social innovation was developed, implemented and sustained. Here the Austrian Red Cross acted on behalf of citizens, organizing an innovation network capable of creating both the demand and the supply side of a sustainable market for the production and safe application of portable automated external defibrillators (AEDs) in Austria. This process involved, first, raising public awareness of the need for portable defibrillators and acting as a user representative when inducing changes in the design of portable AEDs. Later, there was the institutionalization of AED training in every first aid training in Austria, work with local manufacturers to produce this device, and with large user organizations to install AEDs on their premises.Originality/value– The paper develops multi-agent model of innovation that enables one to synthesize key concepts in social and service innovation literatures and, thereby, examine the dynamics of invention and diffusion of social innovations.

Daily scheduling of home health care services using time-dependent public transport

This paper presents a real-world optimization problem in home health care that is solved on a daily basis. It can be described as follows: care staff members with different qualification levels have to visit certain clients at least once per day. Assignment constraints and hard time windows at the clients have to be observed. The staff members have a maximum working time and their workday can be separated into two shifts. A mandatory break that can also be partitioned needs to be scheduled if the consecutive working time exceeds a certain threshold. The objective is to minimize the total travel- and waiting times of the care staff. Additionally, factors influencing the satisfaction of the clients or the care staff are considered. Most of the care staff members from the Austrian Red Cross (ARC) in Vienna use a combination of public transport modes (bus, tram, train, and metro) and walking. We present a novel model formulation for this problem, followed by an efficient exact solution approach to compute the time-dependent travel times out of the timetables from public transport service providers on a minute-basis. These travel time matrices are then used as input for three Tabu Search based solution methods for the scheduling problem. Extensive numerical studies with real-world data from the ARC show that the current planning can be improved significantly when these methods are applied.

Benchmarking the rescue departments of the Austrian Red Cross using data envelopment analysis and fractional regression models

We performed a radial, input-oriented variable returns-to-scale data envelopment analysis to benchmark 52 rescue departments of the Austrian Red Cross from a single province. Three inputs (working hours of employed personnel/non-employed personnel and number of vehicles) and two output variables (duration-weighted number of two service transportation categories) were selected. First, we assessed the service production process of the Red Cross to obtain an insight into the level of performance, and performance differences among the rescue departments. We found that the average technical efficiency of the rescue departments amounted to almost 88%. The theoretically derived potentials of input reductions for inefficient rescue departments were, among others, restricted by several settings, which were analysed in the second step. Here, several socio-economic, environmental and institutional factors were investigated using a second stage regression analysis based on fractional regression models to find out whether they impacted on the performance of the rescue departments. We found a negative relationship between wintry weather conditions, measured as the number of ice days, and performance, while we identified a positive impact of the number of people aged 64+ and the number of hospital beds in the catchment area on Red Cross performance.

Instytucjonalizacja współpracy w zakresie grobownictwa wojennego

Resting places of fallen soldiers – war cemeteries – are monuments to soldiers’ heroism, and thus are of special significance not only for those who have lost their loved ones, but also for entire nations, countries and communities. Therefore, such cemeteries are created under the provisions of relevant authorities, and then put under the special protection of the public. These issues are closely regulated by international law established throughout the twentieth century. Cemeteries are protected by the state on whose territory individual objects are placed. However, the problem of cemeteries is more and more often the responsibility of social organizations. According to the international humanitarian law of armed conflict, specific tasks in this respect are assigned to the tracing services of Red Cross and Red Crescent societies, who deal with the registry of exhumation, inhumation and body transfer, hold deposits, establish the fate of victims of war and issue death certificates. Institutions that deal with exploration, keeping records, exhumation of remains and the construction or revaluation of the graves of fallen citizens buried outside the borders of their own countries include the Council for the Protection of Struggle and Martyrdom Sites, the German People’s Union for the Care of War Graves, the Commonwealth War Graves Commission, the Austrian Red Cross (Österreichisches Schwarzes Kreuz), the American Battle Monuments Commission, the US Commission for the Preservation of America’s Heritage Abroad and the Italian Commissariat General for the Memory of Killed in War (Commissariato Generale per le Onoranze Caduti in Guerra). For political reasons, tasks related to war cemeteries are assigned to social organizations, because their actions are believed to be more effective and less bureaucratic than those of states.

Supporting Urban Home Health Care in Daily Business and Times of Disasters

Home health care (HHC) services are of vital importance for today's society. They allow old and frail people a self-determined living in their familiar environment. Due to the current demographic and social developments further increases in demand for HHC must be expected. Additionally, people with limited mobility or relying on medical supply usually need consistent care. Thus, HHC service providers will be faced with two challenges: an increased organizational effort due to the rising demand and the need for an anticipatory risk management. Previous research combining optimization and risk management in the field of HHC limits itself to rural regions, where nurses are solely using cars. The presented work specifically aims to deal with the peculiarities of urban regions. Together with the Austrian Red Cross (ARC), a vulnerability analysis has been conducted in order to identify the critical success factors and processes of HHC as well as potential threats. To support the daily scheduling, a Tabu Search (TS) based metaheuristic has been implemented. As nurses can choose between different transport modes (public transport, car, bike, and walking), time-dependent multimodal transport has been considered. The TS has been tested with real-world data from the ARC in Vienna to support both, daily business and scheduling in times of disasters. Significant reductions of travel and waiting times can be obtained, such that more time remains for serving the clients. Through sensitivity analysis the effects of disasters (esp. blackout, pandemics, and heat waves) are visualized and the operational limits during such events are shown.

A matheuristic for routing real-world home service transport systems facilitating walking

This paper provides a solution procedure for a state-dependent real-world routing and scheduling problem motivated by challenges faced in the urban home service industry. A transport service delivers staff members of different qualification levels to clients and picks them up after completion of their services. The possibility to walk to clients, interdependencies, time windows, assignment constraints as well as mandatory working time and break regulations are considered. The introduced matheuristic consists of two stages, identifying potential walking-routes and optimising the transport system. The presented numerical studies are performed with real-world based instances from the Austrian Red Cross, a major home health care provider in Austria. The results show that implementing walking and pooling of trips in solution procedures decreases the number of required vehicles substantially.

Trends and risks in home health care

PurposeThe number of care‐dependent people will rise in future. Therefore, it is important to support home health care (HHC) providers with suitable methods and information, especially in times of disasters. The purpose of this paper is to reveal potential threats that influence HHC and propose an option to incorporate these threats into the planning and scheduling of HHC services.Design/methodology/approachThis paper reveals the different conditions and potential threats for HHC in rural and urban areas. Additionally, the authors made a disaster vulnerability analysis, based on literature research and the experience of the Austrian Red Cross (ARC), one of the leading HHC providers in Austria. An optimization approach is applied for rural HHC that also improves the satisfaction levels of clients and nurses. A numerical study with real life data shows the impacts of different flood scenarios.FindingsIt can be concluded that HHC service providers will be faced with two challenges in the future: an increased organizational effort and the need for an anticipatory risk management. Hence, the development and use of powerful decision support systems are necessary.Research limitations/implicationsFor an application in urban regions new methods have to be developed due to the use of different modes of transport by the nurses. Additionally, an extension of the planning horizon and triage rules will be part of future research.Practical implicationsThe presented information on developments and potential threats for HHC are very useful for service providers. The introduced software prototype has proven to be a good choice to optimize and secure HHC; it is going to be tested in the daily business of the ARC.Social implicationsEven in the case of disasters, HHC services must be sustained to avoid health implications. This paper makes a contribution to securing HHC, also with respect to future demographic trends.Originality/valueTo the best of the authors’ knowledge there are no comprehensive studies that focus on disaster management in the field of HHC. Additionally, the combination with optimization techniques provides useful insights for decision makers in that area.

The Austrian Red Cross and Austrian bacteriologists in the Balkan wars 1912/13 – Centenary of the first application of the bacteriology in theatres of war

When Austria joined the Geneva Convention the "Patriotischer Hilfsverein" (Patriotic Aid Society) which was founded for the concerns of wounded soldiers, was named "Austrian Society of the Red Cross". It had to stand its first big test in 1912 in the first Balkan war; military surgeons and bacteriologists were deployed to all warring states. The cholera dominated under the infectious diseases among the various forces and the civilian populations. Upon request of the Bulgarian king renowned bacteriologists of the University of Vienna were dispatched. Their work presented the first action of bacteriology for disease control on theatres of war. The great success of the surgical and hygienic measures initiated in 1912 a reform of the Austrian Red Cross. In 1913 Austria made a detailed application to the International Committee of the Red Cross in order to extend the Geneva Convention to war epidemics. The Committee forwarded and recommended this application to all member states, however, the outbreak of the First World War then prevented its resolution.

High‐throughput multiplex PCR genotyping for 35 red blood cell antigens in blood donors

One to two per cent of patients in need of red cell transfusion carry irregular antibodies to red blood cell (RBC) antigens and have to be supplied with specially selected blood units. To be able to respond to those requests, blood centres have to screen a significant number of donors for a variety of antigens serologically, which is a costly and through the shortage of reagents, also limited procedure. To make this procedure more efficient, the Austrian Red Cross has developed a genotyping assay as an alternative approach for high throughput RBC typing. A multiplex polymerase chain reaction (PCR) assay was designed for typing 35 RBC antigens in six reaction mixes. The assay includes both common as well as high-frequency-alleles: MNS1, MNS2, MNS3 and MNS4; LU1, LU2, LU8 and LU14; KEL1, KEL2, KEL3, KEL4, KEL6, KEL7, KEL11, KEL17 and KEL21; FY1, FY2, FYB(WK) and FY0 (FYB(ES)); JK1 and JK2; DI1, DI2, DI3 and DI4; YT1 and YT2; DO1 and DO2; CO1 and CO2; IN1 and IN2. The assay was validated using 370 selected serologically typed samples. Subsequently 6000 individuals were screened to identify high frequency antigen (HFA)-negative donors and to facilitate the search for compatible blood for alloimmunized patients. All controls showed complete concordance for the tested markers. The screening of 6000 donors revealed 57 new HFA-negative donors and the blood group database was extended by approximately 210,000 results. The study shows that in practice, this high-throughput genotyping assay is feasible, fast and provides reliable results. Compared to serological testing, this molecular approach is also very cost-efficient.

Securing home health care in times of natural disasters

The demand for home health care services is rising tremendously. It is important to maintain these services especially in times of natural disasters. Therefore, powerful algorithms are required to assist decision making. This paper presents a model formulation and solution approach for the daily planning of home health care services. In cooperation with the Austrian Red Cross, one of the leading providers of these services in Austria, we defined seven aims for the objective function. It minimizes the sum of driving times and waiting times, and the dissatisfaction levels of clients and nurses. A feasible solution has to observe assignment constraints, working time restrictions, time windows, and mandatory break times. The model formulation is implemented with the solver software Xpress 7.0 and solved for small problem instances. Real life-sized problems are tackled with a variable neighborhood search (VNS)-based heuristic that is capable of solving even large instances covering 512 jobs and 75 nurses. Extensive numerical studies with real life data from three districts in Upper Austria are presented. A sensitivity analysis shows how different natural disasters may influence home health care services. In 2002 a flood disaster devastated the studied areas. Data from this time and standard flood scenarios, namely the 30, 100, and 200 year return period flood discharges, are taken to depict the consequences on these services. Furthermore, a comparison of the heuristic solution values with an actual route plan shows extensive improvements.