German Red Cross Research Articles

The Works of the German Red Cross (Salib-i Ahmer) Society in the Tripoli War

Cenevre Sözleşmesi’yle (1864) birlikte savaş meydanlarında yaralanan veya esir düşen askerlerin din, dil ve milliyetine bakılmaksızın korunması düsturu benimsenmiş ve bunun için uluslararası düzeyde tanınan kızılhaç/kızılay toplulukları kurulmaya başlanmıştı. Alman Kızılhaç Topluluğu da bunlardan birisidir ve Osmanlı Devleti’nin İtalya ile yaptığı Trablusgarp Savaşı’nda (1911-1912) Osmanlı cephesinde sağlık hizmeti vermiştir. Savaşın patlak vermesiyle Hilal-i Ahmer Cemiyeti’nin yardım çağrısına olumlu cevap veren Alman Kızılhaç’ı 1912 yılının Şubat-Haziran ayları arasında, yaklaşık beş ay süreyle Aziziye yakınlarında yer alan Garyan Kasabası’nda bir askerî hastane kurarak sağlık çalışması yürütmüştür.Bu çalışmada, evvelâ Trablusgarp Savaşı’nın nedenleri kısaca açıklanacak, daha sonra Osmanlı Hilal-i Ahmer Cemiyeti’nin yaptığı yardım çağrısı neticesinde Alman Kızılhaç Merkez Komitesinin bu çağrı karşısındaki tutumu hakkında bilgi verilecektir. Ayrıca, Trablusgarp’a gönderilen sağlık ekibinin kimlerden teşekkül ettiği, personelin ve bölgeye gönderilecek malzemelerin hangi vasıtalarla Trablusgarp’a ulaştırıldığı detaylı bir şekilde ortaya konacaktır. Sağlık ekibinin Garyan Alman Askerî Hastanesi’ni kurduktan sonra yürüttüğü çalışmalar ve karşılaşılan güçlükler ayrı ayrı değerlendirilecek; doktorların tutuğu kayıtlar ışığında, bölgenin sağlık haritası ve hastalıklara göre tedavi edilenlerin sayısı tablolar halinde verilecektir. Son olarak yaralanan (mermi veya şarapnel parçasıyla) Türk askerleri ve bunların tedavileri ile ilgili örnekler verilecek; Alman sağlık ekibinin Garyan’dan ayrılışıyla bölgedeki çalışmaların hangi kuruluş tarafından yürütüldüğü izah edilecektir.

Altruistic values, satisfaction and loyalty among first‐time blood donors

This article is related to the recently initiated discussion on mechanisms of charitable giving and the lack of research on the mix of those mechanisms. On the basis of a comprehensive and interdisciplinary literature review in the area of blood donation management (1970–2010), the authors found that pure altruism, respectively altruistic values, is very often seen as the most important mechanism for giving blood the first time and, moreover, for building blood donor loyalty. This study argues that more knowledge on the mix of mechanisms in blood giving is needed. Therefore, this research examined the impact of altruistic values and the donors' satisfaction with the treatment on blood donor loyalty. Using survey data of the German Red Cross (N = 2149), the authors found that the impact of satisfaction with the treatment on blood donor loyalty is higher compared with altruistic values. Consequently and as one managerial implication, satisfaction measurement and management systems should be reflected more critically by blood donation centres in order to increase blood donations in the future. Copyright © 2011 John Wiley & Sons, Ltd.

Current concepts in serological testing – TTID

Introduction Blood components play a major part in a huge number of therapeutic interventions in oncology, haematology, surgery and other medicine disciplines. Therefore, the supply of safe blood products is a major ongoing challenge for blood transfusion services. Serology screening tests were developed to improve blood safety. As screening for antibodies reflects an immune reaction in response to infection, the diagnostic window period is longer for antibody tests than for direct screening assays, such as nucleic amplification tests (NAT). The introduction of mini‐pool NAT (MP‐NAT) and individual donation NAT (ID‐NAT) as well as the development of antigen screening assays, such as the hepatitis C virus antigen test (which detects the NS3 antigen) and the p24 antigen assay for HIV‐1, have been able to reduce the diagnostic window period.Methods Currently, blood donor screening for HBsAg, anti‐HBc, anti‐HCV, anti‐HIV‐1/2 and syphilis antibodies is mandated by the German authority (the Paul Ehrlich Institute). All blood donations must also be screened for HCV and HIV‐1 using MP‐NAT. The German Red Cross Blood Donor Services Baden‐Württemberg‐Hessen has implemented additional blood donor screening for anti‐CMV (for platelet products from repeat donors) and MP‐NAT screening for HBV, HAV and Parvovirus B19 on a voluntary basis.Results The epidemiology data within the last 4 years have found that 98% and 89% of hepatitis B and hepatitis C positive donors belonged to the first time donor population. Between 1997 and 2005, the German Red Cross Blood Donor Services detected hepatitis B, hepatitis C and HIV‐1 in 43, 23 and 7 donors, respectively, using NAT. About 50% (22 out of 43) of these HBV‐infected donors were in the acute phase of infection, while 21 were in the occult phase. Improvements in NAT technology, especially the introduction of full‐automated extraction robot systems (e.g. the Zelos × 100), have been able to reduce the diagnostic window period, especially for hepatitis B, by improving the 95% level of detection. Nevertheless, five cases of NAT failures in detecting HIV‐1 have been reported to the Paul‐Ehrlich‐Institute within the last decade. In 2010 in particular, three cases occurred in Germany due to mutations in the primer and probe binding regions. These cases restarted a discussion about risk analysis for NAT screening tests and serology methods in general.Conclusion In Germany, blood donor screening is performed using parallel serological assays (antigen and antibody detection) and by MP‐NAT for hepatitis B, hepatitis C and HIV‐1. The risk of false‐negative test results due to mutations in primer and probe binding regions is higher for NAT systems than for antibody/antigen detection tests. Therefore, the manufactures of the NAT systems are advised to improve their systems by utilising amplification in at least two conserved regions (dual‐ or triple‐targeting). The diagnostic window period for new screening strategies (e.g., antigen screening for HCV)

The safety of blood donation by elderly blood donors

BACKGROUND Due to the ageing population, blood donation by the elderly is necessary to maintain blood supply. We initiated a prospective study, to assess whether there is an increased risk of donor reactions in elderly donors. STUDY DESIGN AND METHODS In this prospective study, regular donors aged from 66 to 68 and 69 to 71 years were invited to continue blood donation on mobile collection sites of the German Red Cross Blood Service West. A control group (50-52 years) was established. Admission of donors in all groups followed the German national guidelines for blood donation. Donor deferrals and all kinds of donor reactions during donation (on-site) and in the 48 h following donation (off-site) were monitored. RESULTS A total of 64 260 valid cases were entered in the study. Donor deferrals increased with age from 1·12% in the control group up to 8·74 in female donors aged 69-71 years. Adverse reactions to blood donation were rare with an overall reaction rate of 0·63% (0·05% on-site; 0·58% off-site). Off-site reactions significantly decreased with increasing age. The relative risk (RR) for adverse reactions in elderly donors compared to the control group (50-52 years) was slightly increased for on-site reactions in the 69- to 71-year-old donors (RR 1·0309; 95% CI 1·0292-1·0325). In all other comparisons, the RR for adverse reactions was distinctively lower in elderly donors (RR 0·3785 - 0·7778). CONCLUSIONS Our data confirm that elderly regular blood donors may safely continue blood donation at least to the age of 71. Based on these data, we increased the upper age limit.

A spatial regression analysis of German community characteristics associated with voluntary non‐remunerated blood donor rates

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. 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. 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. 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.

Linking Relief and Development in Pakistan-administered Kashmir

In response to the devastating earthquake that hit northern Pakistan on 8 October 2005, the German Red Cross (GRC), in partnership with the Economic Security Unit of the International Committee of the Red Cross (ICRC), implemented a complex livestock restocking program combined with structural interventions in the basic animal health sector. Livestock restocking, which was a new experience for both GRC and ICRC, indicates a shift from the relief operations that are traditionally the main domain of both organizations toward development approaches that aim to provide sustainable support for affected populations. The project activities are an example of an agency's move to facilitate a transition from relief measures to lasting development, with the aim of reducing the frequency, intensity, and impact of livelihood shocks, while simultaneously reducing the need for emergency relief. The question remains whether the project's rehabilitation efforts succeeded in connecting the end of relief with the establishment of sustainability in the livestock sector, including the support of local livestock production, processing, and marketing systems. Overall, the livestock intervention project helped restore rural livelihoods in a remote mountain area and heightened coping capacities in households that succeeded in making productive and sustainable use of the animals.

Lyophilised plasma: evaluation of clotting factor activity over 6 days after reconstitution for transfusion

AimsLittle is known about long-term stability of clotting factors in dissolved human lyophilised plasma. This study evaluated clotting factor and inhibitor activity in reconstituted lyophilised plasma after storage for up...

Response to Zimmermann et al

Dear Editor, We appreciate the opportunity to respond to Zimmermann et al. They refer to publications by Vamvakas [1] and Heuft et al. [2]. Both base their conclusion on mathematical models. Vamvakas presents calculations for additional transfusion transmitted infections (TTI) contracted through platelet transfusions in the United States (US) if pooled platelet concentrate (PPC) would completely replace singledonor apheresis platelet concentrates (APC)[1]. These calculations are based on assumptions which do not all apply for Europe. The calculation is based on the risk of TTI in the US today (1 per 2 135 000 donations for HIV, 1 per 1 935 000 for HCV and 1 per 280 000 for HBV [1]). For the German Red Cross Blood Donor Services, the residual risk for TTI is substantially lower (data 1997–2005): 1 per 4 300 000 donations for HIV, 1 per 10 880 000 for HCV and 1 per 360 000 for HBV [3]. This analysis does not account the effect of anti-HBc testing, which became mandatory in Germany since 2006 and will most likely reduce the risk for HBV. The ‘worst-case scenario’ of Vamvakas who carefully confines the conclusions to the United States assumes that a PPC contains platelets from six whole blood (WB) donations [1]. In many European countries, PPC is pooled from five or four donations. The risk calculation is substantially different if assuming six or four donor exposures per PPC [1]. A significant proportion of APC represents split products so that an infected donor can infect two or even three recipients by one donation and in addition further recipients by subsequent donations during the ‘window period’ because of the potentially short interval of APC donations [4]. A model on GBV-C virus infections takes into account that pooling of a GBV-C RNA positive buffy coat (BC) with a BC containing a GBV-C neutralizing antibody could lead to a non-infectious PPC. A careful sensitivity analysis demonstrates that the number of theoretical GBV-C transmissions depends on the assumed frequency of neutralizing antibodies in the donor population [2]. Many assumptions affect the results of mathematical models and delimit their conclusions [4]. Zimmermann et al. argue that the preparation of PPC affects the quality of red blood cell concentrates (RCC) resulting ‘in a remarkable proportion of underfilled RCC’. The binding German Haemotherapy Guidelines [5] and the ‘Guide to the preparation, use and quality assurance of blood components’ [6] stipulate that at least 95% of the leucocyte-depleted RCC must contain ‡ 40g haemoglobin ⁄unit. The mean haemoglobin of RCC produced by our Blood Service using RCC filtration after BC-removal is 56AE4 g, and only 0AE2% of RCC had haemoglobin content below 40 g ⁄unit, and there is no difference when comparing haemoglobin content in RCC produced from donations without or with concomitant preparation of a PPC. For our Blood Service, we can decline that preparation of PPC by the BC method results in a remarkable proportion of underfilled RCC – and this applies also to other blood services obliged to meet regulatory requirements. Zimmermann et al. refer to the loss of 2,3-DPG during overnight storage at 22 C [7]. Several aspects need to be considered in interpretation of this surrogate parameter: Rapid cooling slowed the loss of 2,3-DPG levels but 2,3DPG levels were undetectable by day 21 irrespective of the initial storage temperature [7]. Wilsher et al. [7] compared processing within 8h versus storage for 24 h at 22 C. In practice, the actual interval between donation and start of processing in most institutions is shorter than 24 h even if overnight storage at 22 C is involved. It has been shown that 2,3-DPG levels return to near normal levels after transfusion [8]. The clinical significance of the observed difference needs to be studied further. Overnight storage at 22 C can increase the efficiency of separation of platelets from WB donations and can reduce bacterial contamination. Zimmermann et al. argue that the processing method affects the levels of platelet-derived cytokines in RCC [9]. It is important to take into account all details of the processing. A high concentration of platelet-derived cytokines was measured in PC prepared with the dock-in Sepacell RBC filter or with platelet-saving WB filters before removing plasma or platelet-rich plasma. In this study, the plasmareduced RCC (still containing platelets) were held overnight at 4 C. Neither a storage at 4 C nor a storage overnight after removal of plasma nor the use of platelet-saving WB filters can be considered as standard procedure for PPC Vox Sanguinis (2010)

Multimodale Therapie

The efficacy of intensive interdisciplinary pain management programs for patients with chronic low back pain has been repeatedly demonstrated. A controversial issue in previous studies is the cost-effectiveness of this treatment. Between 2001 and 2006, a total of 575 patients with chronic nonspecific back pain took part in an outpatient pain management program at the German Red Cross Pain Center (DRK Schmerz-Zentrum Mainz) in Mainz, Germany. Complete follow-up data were available for 351 patients 1 year after the end of treatment and were included in the study. No differences between these patients and the dropouts were found. Pain, impairment, and mental well-being had significantly improved after 1 year. For employed patients, the number of absent days decreased to almost one-quarter. On the basis of the study by Wenig, who calculated pain-related costs as a function of Von Korff pain grades, the treatment resulted in a savings of euro 3,329.50 per year per patient. Intensive multidisciplinary treatment of chronic back pain is highly effective and, at least for patients with high levels of disability, is also cost-effective.

Blood donor screening with cobas s 201/cobas TaqScreen MPX under routine conditions at German Red Cross institutes

In 1997 the German Red Cross (GRC) blood donor services introduced mini-pool nucleic acid testing (NAT) for human immunodeficiency virus (HIV)-1, hepatitis C virus (HCV) and hepatitis B virus (HBV) to increase blood safety. With the new cobas s 201/cobas TaqScreen MPX, a fully automated extraction method and a multiplex amplification system specifically adapted to the needs of blood donation services is available. The cobas s 201 system was evaluated at the GRC BTS locations Hagen, Springe and Frankfurt. In phase A, the analytical sensitivity for the detection of HBV, HCV and HIV-1 was investigated and in phase B, at least 60,000 samples at each test site were screened in parallel with the MPX test on s 201 system and the existing routine mini-pool NAT system to compare the diagnostic specificity and the diagnostic sensitivity. Comparable analytical sensitivities in a range of 1.6-3.6 IU/ml, 4.9-10.9 IU/ml and 14.7-26.6 IU/ml for HBV, HCV HIV, respectively, for the MPX test on s 201 system (95% probability based on probit analysis) were determined at all test sites. The diagnostic sensitivity was 99.8% and the diagnostic specificity was 99.85%. The MPX test on s 201 system is a fully automated NAT system suitable for routine blood donor screening. The analytical sensitivity as well as the diagnostic sensitivity fulfilled all requirements of the Paul Ehrlich Institute for blood donor screening in mini-pools up to 96 donations per pool. A major benefit of the automated NAT system is the reduced personnel time and the extensive complete barcode-controlled process documentation.

Lost Children: Displacement, Family, and Nation in Postwar Europe

At the end of the Second World War, hundreds of thousands of children were missing. Their faces adorned Red Cross posters, under the banner “Who knows our parents and our origins?” Whether through bombings, military service, evacuation, deportation, forced labor, ethnic cleansing, or murder, an unprecedented number of children had been separated from their parents during the war. The German Red Cross received over 300,000 requests to trace missing children or parents between 1945 and 1958, while the International Tracing Service traced 343,057 lost children between 1945 and 1956.1 The problem of reuniting families after World War II proved to be more than a daunting logistical puzzle, moreover. Although they represented only a small fraction of the millions of displaced persons (DPs) in postwar Europe, so-called lost children held a special grip on the postwar imagination. They stood at the center of bitter political conflicts between military authorities, German foster parents, social workers, Jewish agencies, East European Communist officials, and DPs themselves, all of whom competed to determine their fates. These battles were linked, in turn, to emerging ideals of human rights, the family, democracy, child welfare, and the reconstruction of European civilization at large. In the words of Vinita A. Lewis, an officer with the International Refugee Organization (IRO) in Germany, “The lost identity of individual children is the Social Problem of the day on the continent of Europe.”2 Following the Second World War, Europe appeared to be a civilization in ruins. American, British, and emigre humanitarian workers often arrived on

Experience of German Red Cross blood donor services with nucleic acid testing: results of screening more than 30 million blood donations for human immunodeficiency virus‐1, hepatitis C virus, and hepatitis B virus

The risk of transfusion-transmitted human immunodeficiency virus-1 (HIV-1), hepatitis C virus (HCV), and hepatitis B virus (HBV) infections is predominantly attributable to donations given during the early stage of infection when diagnostic tests may fail. In 1997, nucleic acid amplification technique (NAT)-testing was introduced at the German Red Cross (GRC) blood donor services to reduce this diagnostic window period (WP). A total of 31,524,571 blood donations collected from 1997 through 2005 were screened by minipool NAT, predominantly with pool sizes of 96 donations. These donations cover approximately 80 percent of all the blood collected in Germany during that period. Based on these data, the WP risk in the GRC blood donor population was estimated by using a state-of-the-art mathematic model. During the observation period, 23 HCV, 7 HIV-1, and 43 HBV NAT-only-positive donations were detected. On the basis of these data and estimated pre-NAT infectious WPs, the residual risk per unit transfused was estimated at 1 in 10.88 million for HCV (95% confidence interval [CI], 7.51-19.72 million), 1 in 4.30 million for HIV-1 (95% CI, 2.39-21.37 million), and 1 in 360,000 for HBV (95% CI, 0.19-3.36 million). Based on observed cases of breakthrough infections, the risk of transfusion-related infections may be even lower. The risk of a blood recipient becoming infected with HCV, HIV-1, or HBV has reached an extremely low level. Introduction of individual donation testing for HCV and HIV-1 would have a marginal effect on interception of WP donations.

Levels of quality management of blood transfusion services in Europe

The European blood legislation has defined several key quality elements to achieve Good Manufacturing Practice (GMP) in the field of blood transfusion. During the recent years, the blood legislation is in the process of implementation throughout its member states. Following the Directive 2002/98/EC, Directive 2005/62/EC has given further requirements for quality‐management systems to be fulfilled by blood establishments. In addition, GMP/Good Laboratory Practice (GLP) and ISO standards are used inter alia by blood establishments. In order to support the implementation of the blood legislation, the European Public Health Work Plan (2005/2007) has cofunded two projects, led by the German Red Cross and supported by the European Blood Alliance, delivering a common European Standard Operating Procedure (SOP) methodology (EU‐Q‐Blood‐SOP) and criteria and standards for the inspection of blood establishments (EUBIS). The EU‐SOP manual will assist blood establishments in preparing for the inspection of their services related to the implementation of quality relevant elements required by the EU Directive 2002/98/EC and its technical annexes. The standards and criteria for inspection of blood establishments will cross‐reference existing quality standards to the directive requirements and define requirements for the structure of quality‐management systems based on the directive 2002/98/EC and its technical annexes. Based on these requirements, inspection standards and criteria are developed to assist in the independent assessment of quality systems established by individual blood establishments. These assessments are done in relation to the requirements defined by the European Union legislation on blood, in order to safeguard the quality of blood and to achieve continuous improvement of its quality throughout Europe.

Prevalence of HIV antibodies in blood donors in the West Germany and West Berlin

Since 1985 all donor blood in the Federal Republic of Germany (FRG) and West Berlin (WB) have been routinely tested for HIV antibodies. The blood donor services of the German and Bavarian Red Cross have pooled their anti-HIV test data for the first year of operation (July 1985-June 1986) to obtain information on the prevalence of HIV antibodies in blood donors and in donated blood. Of 2.27 million units of blood, donated by 1.33 million donors, 218 were anti-HIV positive in the Western Blot Test, i.e. a prevalence rate of 10 per 100,000 donors. The prevalence was, as expected, higher in males than females. During the test period the anti-HIV prevalence fell, both as a total and in all subpopulations. In the second quarter of 1986 it had decreased to 6 per 100,000 donated units.

Vertraulicher Spenderselbstausschluß zur Erhöhung der Sicherheit von Blutpräparaten

Since July 1987 the German Red Cross Baden-Württemberg has practised confidential and anonymous self-exclusion of potential blood donours. The answers given by all donours of the Red Cross Blood Donour Service in Baden-Württemberg (n = 297,648) between 23. 2. 1988 and 31. 1. 1989 were analysed. Virological data of self-exclusion donours (n = 1910) and of a control group (n = 1856) were compared. No donour who had excluded himself was anti-HIV positive, but two of the donours who had designated their blood for transfusion. Those that had excluded their blood donation had a significantly higher prevalence of hepatitis B markers. There was no significantly higher prevalence than among other blood donours with respect to anti-CMV antibodies, syphilis and increased GPT levels. The proportion of male first-time donours was twice as high among self-excluders than among those who released their blood for subsequent donation.

Before, We Were Always There—Now, Everything Is Separate: On Nursing Reforms in Western Germany

In West Germany in the early 1950s, it was taken for granted that a good nurse would consider her occupation not just a job but a vocation. For her, nursing was not a labor but a service. The large motherhouse sisterhoods of Caritas, the Inner Mission, and the German Red Cross still dominated the nursing vocation in West Germany. When joining a sisterhood, women vowed to subordinate their lives completely to the of the community and to the of the sick and needy. In return, the motherhouse provided training and lifelong support. Food and accommodation apart, the motherhouse sisters received only a minimal amount of pocket money. The beginning of the twentieth century saw the founding-as an alternative to the motherhouse system-of so-called sisterhoods. Their members did not establish a permanent bond with their sisterhood and they did receive a salary for their work.1 Nevertheless, in the early 1950s, the concept of a religious still shaped the working and living conditions of these free nurses. They lived just as the motherhouse sisters did, in hospital residences. It was understood that nurses would be single and be prepared to work, more often than not, seventy to eighty hours a week, and that, even when working in the public service, their income would fall somewhere very near the bottom of the salary scale. However, in the 1960s, this vocational image changed thoroughly. The traditional ethos of dedicated became less and less compatible with the lifestyle expectations of a new generation of women; the formerly celibate and self-sacrificial charity service (Liebesdienst) was revamped into a modern female occupation that could also be engaged in part-time by married women. In addition, medical progress had profoundly changed the demands made of nursing personnel. It was less and less a calling for charity.2 Now the demands were for nurses with far more soundly and theoretically based training and qualifications. The present article has a twofold purpose: to present an overview of this process of transformation, and to explore the history of this reform process as it was manifested in everyday life and experience, using a north German motherhouse-the Henriettenstiftung in Hanover-as an example.3 Christian nursing proves particularly interesting when used as a prism through which to examine the modernization process. The pronounced patient orientation of Christian nursing was hardly compatible with the demands made by a modern-day rational and professional value system. Consequently, the ambivalence of the modernization process can clearly be observed.4 The article deals with three aspects of this phenomenon. First, I outline the traditional concept of nursing as a religious and analyze its basic tenets. I explore the place in the system of sick care that the sisters occupied, and the way they organized their everyday nursing activities. My focus then shifts to the modernization of nursing in the 1960s. By looking at reforms in training and working hours, I show that modernization meant fragmentation-with far-reaching consequences for the self-concept and everyday practice of nursing. Finally, I locate this process of transformation within the general history of society and medicine. The article is based on contemporary publications and health care periodicals, as well as interviews with the deaconesses of the Henriettenstiftung. I have also analyzed the comprehensive archives of the Henriettenstiftung, which contain the personnel files of about 900 sisters belonging to the motherhouse in the post-World War II period. Through these means, the everyday life as well as the self-image of the sisters and their perspectives on modernization can be clearly traced. Nursing as a Religious Calling In the course of the nineteenth century, the motherhouse system developed into the dominant form of nursing organization in Germany, remaining relatively unchanged well into the second half of the twentieth century. …

Comparison of three bacterial detection methods under routine conditions

Since 2004, bacterial screening of platelets has been required in the USA and is also done on a voluntary basis in many European countries. The German Red Cross blood donor services conducted a prospective multicentre study in order to investigate the prevalence of bacterially contaminated pool platelet concentrates and apheresis platelet concentrates. This substudy compares three different bacterial detection systems. Platelet concentrates were tested in parallel with BacT/ALERT, Scansystem and Pall eBDS (n = 6307) in pool platelets. Apheresis platelets were tested in parallel with BacT/ALERT and Pall eBDS (n = 4730). All initially positive results were evaluated by a standardized procedure including evaluation by a microbiology reference laboratory. One in 6307 pool platelets were confirmed positive by BacT/ALERT, whereas Pall eBDS and Scansystem failed to detect these samples. Only three samples were initially reactive with Pall eBDS without proof of any bacteria strains. The rate of false-positive results was substantially higher for BacT/ALERT (0.25%, 28 in 11,037 tested samples) than for eBDS (0.03%, 3 in 11 037 tested samples) or Scansystem (0.0%, 0 in 6307 tested samples). Three of 4730 apheresis platelets were confirmed positive by BacT/ALERT. These were negative with Pall eBDS. Sensitivity was best for BacT/ALERT, whereas specificity was enhanced for Pall eBDS and Scansystem. Scansystem required specially trained staff, whereas BacT/ALERT and Pall eBDS were easy, quick, user-friendly and objective methods.

Anti‐HBc screening of blood donors: a comparison of nine anti‐HBc tests

Since voluntary introduction of hepatitis B virus (HBV) minipool nucleic acid amplification technology (NAT) at the German Red Cross, the expected residual risk of a transfusion-associated HBV infection has been estimated to be 1 : 500,000 - about 10 times higher than for human immunodeficiency virus (HIV) or hepatitis C virus (HCV) infection. Donors demonstrating chronic positivity for antibody to hepatitis B core antigen (anti-HBc), negativity for hepatitis B surface antigen (HBsAg) and polymerase chain reaction (PCR)-negative with a low virus load are a major cause of this increased risk. Ten-thousand blood donors from our blood-donation centre were screened for anti-HBc using the current PRISM HBc and the new PRISM HBcore assay to evaluate the diagnostic sensitivity and specificity of these tests. PRISM HBc- or PRISM HBcore-reactive samples were further analysed using seven additional tests for anti-HBc, two tests for antibody to hepatitis B surface antigen (anti-HBs), one test for antibody to hepatitis B envelope antigen (anti-HBe) and three HBV NAT assays. From a total of 10,000 donors, nine and 14 samples were reactive only in the PRISM HBc and the PRISM HBcore, respectively, whereas 165 samples were reactive in both anti-HBc assays. Further analysis of these 188 anti-HBc-reactive specimens in a total of nine different anti-HBc assays revealed concordant results for 162 (86.2%) specimens. Sample cut-off values for anti-HBc were significantly (P < 0.01) lower for anti-HBc-only reactive samples compared with specimens that were also reactive for anti-HBs or anti-HBe. Both PRISM anti-HBc assays revealed that approximately 1.8% of non-prescreened blood donors from Germany were reactive for anti-HBc. Although sensitivity was comparable between both assays, specificity was increased significantly with the PRISM HBcore. High anti-HBc sample cut-off values were indicative for reactivity in other HBV parameters and for concordant results in the nine different anti-HBc assays. Look-back investigations are necessary to estimate the infection risk both of anti-HBc-only positive and of anti-HBc/anti-HBs-positive blood transfusions.

The belief in ethnic kinship

The belief that members of an ethnic group are blood relatives may seem archaic, but it is still very alive today, and it awakens primordial feelings of affiliation. According to this deep-rooted idea of kinship, individuals are only responsible for members of their own ethnic group, and it is only to them that they are obliged to show solidarity. The effects of this belief were seen at two blood drives that the German Red Cross held at a Turkish mosque in the Ruhr region of Germany and that were studied in an ethnographic research project. An analysis shows that the belief in ethnic kinship represents a major barrier to integration and an important factor in perpetuating social inequality among ethnic groups. The Turkish migrants endeavored to initiate an exchange of gifts among quasi-relatives and based their integration strategy on this objective, but their efforts to establish reciprocal exchange relations provoked resistance in the autochthonous population. Herein lies the broader relevance of the primordial belief in blood relations, which constitutes a deep symbolic dimension of social inequality.

Donor screening for agents of bioterror

TransfusionVolume 46, Issue 4 p. 678-678 Donor screening for agents of bioterror M. Schmidt MD, M. Schmidt MD e-mail: [email protected]Search for more papers by this authorW.K. Roth MD, W.K. Roth MD Institute of Transfusion Medicine and Immunohematology German Red Cross Johann Wolfgang Goethe University Frankfurt, GermanySearch for more papers by this authorE. Seifried MD, E. Seifried MD Institute of Transfusion Medicine and Immunohematology German Red Cross Johann Wolfgang Goethe University Frankfurt, GermanySearch for more papers by this authorM.K. Hourfar MSc, M.K. Hourfar MSc Institute of Transfusion Medicine and Immunohematology German Red Cross Johann Wolfgang Goethe University Frankfurt, GermanySearch for more papers by this author M. Schmidt MD, M. Schmidt MD e-mail: [email protected]Search for more papers by this authorW.K. Roth MD, W.K. Roth MD Institute of Transfusion Medicine and Immunohematology German Red Cross Johann Wolfgang Goethe University Frankfurt, GermanySearch for more papers by this authorE. Seifried MD, E. Seifried MD Institute of Transfusion Medicine and Immunohematology German Red Cross Johann Wolfgang Goethe University Frankfurt, GermanySearch for more papers by this authorM.K. Hourfar MSc, M.K. Hourfar MSc Institute of Transfusion Medicine and Immunohematology German Red Cross Johann Wolfgang Goethe University Frankfurt, GermanySearch for more papers by this author First published: 30 March 2006 https://doi.org/10.1111/j.1537-2995.2006.00781.xCitations: 3Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article.Citing Literature Volume46, Issue4April 2006Pages 678-678 RelatedInformation