Blood donation screening for hepatitis B virus core antibodies: The importance of confirmatory testing and initial implication for rare blood donor groups.

BACKGROUND AND OBJECTIVES: Exclusion of blood donors with hepatitis B virus (HBV) core antibodies (anti-HBc) prevents transfusion-transmitted HBV infection but can lead to significant donor loss. As isolated anti-HBc positivity does not always indicate true past HBV infection, we have investigated the effectiveness of confirmatory anti-HBc testing and the representation of rare blood groups in anti-HBc-positive donors. MATERIALS AND METHODS: Three hundred ninety-seven HBV surface antigen-negative and anti-HBc initially reactive blood donor samples were tested by five different anti-HBc assays. RESULTS: Eighty percentage of samples reactive in Architect anti-HBc assay were positive by the Murex assay and anti-HBc neutralization. Eleven out of 397 samples showed discordant results in supplementary testing from the Murex confirmatory test result, and five remained undetermined following extensive serological testing. Thirty-eight percentage of anti-HBc-positive donors identified as minority ethnic groups compared with 11% representation in anti-HBc-negative donors (p < 0.0001); the frequency of the Ro blood group in anti-HBc-positive donors was 18 times higher in non-white ethnic groups. CONCLUSION: Using two anti-HBc assays effectively enabled the identification of HBV-exposed and potentially infectious donors, their deferral and potential clinical follow-up. However, the exclusion of confirmed anti-HBc-positive donors will still impact the supply of rare blood such as Ro.

Perspectives of choice and control in daily life for people following brain injury: A qualitative systematic review and meta-synthesis.

BACKGROUND AND OBJECTIVE: Acquired brain injury (ABI) can result in considerable life changes. Having choice and control over daily life is valued by people following ABI. This meta-synthesis will analyse and integrate international research exploring perspectives of choice and control in daily life following ABI. METHODS: Databases were searched from 1980 to 13 January 2022 for eligible qualitative studies. After duplicates were removed, 22,768 studies were screened by title and abstract, and 241 studies received full-text assessment with 56 studies included after pearling. Study characteristics and findings were extracted that related to personal perspectives on choice and control by people with an ABI (including author interpretation and quotes). Data from each study were coded and then segments of coded data across the studies were compared to create multiple broad categories. FINDINGS: Findings were then reduced from categories into 3 overarching themes with 12 subthemes. These themes were: (1) feeling like a second-class citizen; (2) reordering life and (3) choosing a path. Participants with an ABI tussled between their feelings of loss following brain injury and their thinking about how they start to regain control and become agents of their own choices. The themes describe their sense of self, their changed self and their empowered self in relation to 'choice and control'. CONCLUSIONS: Re-engaging with choice and control after ABI is dynamic and can be challenging. Health professionals and supporters need to facilitate a gradual and negotiated return to agency for people following ABI. A sensitive and person-centred approach is needed that considers the readiness of the person with ABI to reclaim choice and control at each stage of their recovery. Clear service or process indicators that are built on lived experience research are needed to facilitate changes in service delivery that are collaborative and inclusive. PATIENT OR PUBLIC CONTRIBUTION: This review included the voices of 765 people living with ABI and was conducted by a diverse team of allied health professionals with practice knowledge and research experience with people following ABI. Twenty-nine of the 56 included studies had participants contributing to their design or analysis.

A multi-criteria assessment of policies to achieve the objectives of the EU marine litter strategy.

This paper proposes and assesses policy options to achieve the objectives of the EU marine litter strategy, based on the existing EU legislation. A group of experts and stakeholders was involved through a multi-staged workshop organized to generate the information to assess the contribution of the policies to the set of objectives, as well as the relative importance of the objectives, on qualitative scales. The ELECTRE TRI multi-criteria decision analysis method was used to rate the policies, which were subsequently ranked. Per the results, all policies deserve to be considered, even when the more pessimistic assessments (33rd percentile) are used. Revising the Urban Wastewater Treatment Directive, setting legislative targets on marine litter and ensure they are fully monitored, and funding proven clean-up technologies were deemed to be the most potentially impactful policies. The remaining policies assessed can nevertheless play an important role in complementing the higher-ranked policies.

Adoption and diffusion of marine litter clean-up technologies across European seas: Legal, institutional and financial drivers and barriers.

This study reviews existing legal, institutional and policy tools and frameworks, relevant to the introduction and adoption of new marine litter clean-up technologies in two regional European seas, the Mediterranean and the Baltic. A combination of desk studies in six countries bordering the Baltic (Estonia, Germany, Sweden) and the Mediterranean (Greece, Italy, Tunisia), and interviews with experts and stakeholders, is used to identify key drivers and barriers to the adoption and diffusion of marine litter technologies. The main conclusion of the study is that the most influential pieces of legislation relevant to marine litter management are top-down EU policies, often forming the basis of regional and national plans. Moreover, the study finds that several drivers of marine litter technologies may at the same time be critical barriers. These factors include public awareness, consumer behaviour, enforcement of legislation, and the rise of SMEs engaged in recycling and eco-labelling of marine litter.