Migrants include a broad category of individuals moving from one place to another, either forced or voluntarily. Ethnicity and migration are interacting concepts which may act as determinants for migrants' health and access to health care. This access to health care may be measured by studying utilisation patterns or clinical outcomes like morbidity and mortality. Migrants' access to health care may be affected by several factors relating to formal and informal barriers. Informal barriers include economic and legal restrictions. Formal barriers include language and psychological and sociocultural factors.
ReprintIn: Dan Med Bull. 2007 Feb;54(1):48-917349225
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.
Disaster medicine, which is based primarily on military and emergency medicine, is a young branch on the old tree of medicine. It touches on various disciplines within and outside the medical field. The subject is being taught on the academic and postacademic levels at many universities throughout Europe. The first chair in disaster medicine was established in Linkoping, Sweden; the second is now in Amsterdam, The Netherlands. Some aspects of disaster medicine specifically oriented toward Europe are presented.
The c100 hepatitis C virus (HCV) enzyme-linked immunosorbent assay (ELISA) has been used to screen blood donors to prevent transfusion-associated non-A,non-B hepatitis. This test is not specific, and only about 25 percent of c100 HCV ELISA-positive blood samples appear to transmit hepatitis C. However, the intensity of the ELISA (sample/cutoff ratio [S/C], greater than 2) could identify a subpopulation of donors that are at high risk for transmitting hepatitis. Blood samples from 20,186 volunteer blood donors at a Canadian Red Cross blood transfusion center were screened for antibodies to HCV using the c100 HCV ELISA. Fifty-nine (0.3%) of these donors were repeatably reactive on ELISA. When their samples were tested with the c100 recombinant immunoblot assay (RIBA) and second-generation RIBA (RIBA-2), 26 (44%) and 31 (52%) samples, respectively, were found to be positive. Thirty-three of the 59 ELISA-reactive donors had an S/C greater than 2. Of these 33 donors, 30 (91%) had elevated alanine aminotransferase (ALT), 27 (82%) were RIBA-2 positive, and 22 (67%) had risk factors for hepatitis. In contrast, of the 26 ELISA-reactive donors with S/C less than 2, only 7 (27%) had elevated ALT, and 4 (15%) were RIBA-2 positive and also had high risk factors for hepatitis. Thus, while the HCV ELISA may lack specificity, its intensity can serve to identify a subgroup of donors that are at high risk for transmitting hepatitis.
We have used the Optical Character Recognition system B (OCR-B) for automatic identification of blood samples on the Groupamatic 360 and in connection with computerized donor file management and control of blood product processing. For the Groupamatic system a device was constructed that lifts that samples, and during simultaneous rotation and downward movement, the OCR-B identification number on the tube label is read. The results indicate that with appropriate control and check digit design it is possible to achieve an economical and safe machine-readable identification system.