ORCID Profile
0000-0003-0216-5805
Current Organisations
Canadian Blood Services
,
Edith Cowan University
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Publisher: Wiley
Date: 16-03-2021
DOI: 10.1111/TRF.16349
Abstract: The use of pre− ost‐exposure prophylaxis (PrEP/PEP) may interfere with routine HIV screening. As a result, blood services worldwide have adopted a variety of deferral policies to mitigate increased residual risk. In this study, we evaluated the operational impact of modifying the donor health questionnaire (DHQ) to include explicit questions to assess PrEP/PEP exposure. We conducted a retrospective study between June 2019 and October 2020 of all blood donors attempting to donate at Canadian Blood Services. Sixteen‐months post‐implementation, we summarized self‐reported PrEP/PEP rates and their indications for use. We also assessed deferral rates and the sensitivity of using existing risk questions to defer people exposed to PrEP/PEP. Of 1,122,075 donations, 89 people (eight per 100,000 donations) reported PrEP (64%)/PEP (34%) use in the last 4 months. People exposed to PrEP were more likely to be men (94%) and taking PrEP for lifestyle reasons (87%). In contrast, indications for PEP use included occupational exposure (50%) and sexual assault (27%). Most donors who answered affirmatively to PrEP/PEP exposure were deferred (96%). If potential donors were not directly asked about their PrEP/PEP use, the majority would not have been deferred for any other reasons (PrEP 32/57 (56%) and PEP 15/30 (50%)). Not all blood services have adopted direct questions to identify PrEP/PEP exposure some rely on existing DHQ questions. In Canada, despite DHQ questions such as medication use in the last 3‐days, more than half of people exposed to PrEP/PEP would not have been identified and deferred.
Publisher: Wiley
Date: 28-04-2020
DOI: 10.1111/TRF.15777
Publisher: Wiley
Date: 09-05-2023
DOI: 10.1111/TRF.17393
Abstract: In Canada the time deferral for gay, bisexual, and other men who have sex with men (gbMSM) was progressively shortened (lifetime, 5 years, 1 year, 3 months). Here we describe trends in syphilis rates (a potential sexual risk marker) and risk behaviors from blood donors in the past 12 years. Syphilis positivity in 10,288,322 whole blood donations (January 1, 2010–September 10, 2022) and gbMSM deferral time periods, donation status, age, and sex were analyzed with logistic regression. Overall, 26.9% syphilis positive and 42.2% controls (matched 1:4) participated in risk factor interviews analyzed by logistic regression. Syphilis rates were higher in first‐time donors (OR 27.0, 95% CI 22.1–33.0), in males (OR 2.3, 1.9–2.8) and with the 3‐month deferral (OR 3.4, 2.6–4.3) during which the increase was greater for first‐time males ( p .001) but similar for male and female repeat donors ( p .05). Among first‐time donors, histories of intravenous drug use (OR 11.7, 2.0–69.5), male‐to‐male sex 7.8 (2.0–30.2) and birth in a high prevalence country (OR 7.6, 4.4–13.0) predicted syphilis positivity among repeat donors, history of male‐to‐male sex (OR 33.5, CI 3.5–317.0). All but 1 gbMSM syphilis‐positive donors were noncompliant with the gbMSM deferral. About a quarter of first‐time interviewed case donors had history of syphilis 44% were born in a high‐prevalence country. Rising syphilis rates in donors correlates with the general population epidemic. Recent infection rates rose similarly in males and females. GbMSM history may contribute to donor syphilis rates but shortening time deferrals appears unrelated.
Publisher: Australasian Society for Computers in Learning in Tertiary Education
Date: 19-09-2013
DOI: 10.14742/AJET.187
Abstract: Mobile handheld devices are spreading rapidly in education. iPads, especially, are increasingly being adopted by different educational sectors, but there is currently little empirical evidence on whether, or how, they facilitate student learning. This paper reports on how iPads contributed to pre-service teachers' learning, including their learning about teaching. Case studies of eight pre-service teachers were developed based on semi-structured interviews and non-participant observations to determine how they used the iPad 2 in their learning. Focus group interviews of the larger cohort were also used to support findings. It was found that iPads supported pre-service teachers' learning in four ways: developing understanding of content, developing understanding of pedagogy, staying connected, and staying organised. More broadly, iPads helped them develop a new sense of learning spaces and learning networks. Three types of obstacles to using iPads as learning tools were also identified: device limitations, time limitations, and attitudinal limitations. Based on these findings, recommendations are made for developing pedagogical best practice for the use of iPads. These recommendations are relevant to pre-service teacher education in particular but also to higher education in general.
Publisher: University of KwaZulu-Natal
Date: 12-2021
Publisher: Wiley
Date: 02-12-2020
DOI: 10.1111/TRF.16165
Publisher: Wiley
Date: 23-05-2023
DOI: 10.1111/TRF.17398
Abstract: In 2021, Canada implemented a pilot plasma program allowing some sexually active men who have sex with men (including but not limited to gay and bisexual men gbMSM) to donate plasma. Changes to plasma donation policy could help address inequities in access to plasma donation and increase Canada's domestically collected plasma supply if more gbMSM donate as a result. We aimed to (1) examine views regarding plasma donation and the pilot program prior to implementation and (2) identify modifiable theory‐informed predictors of gbMSM's intention to donate plasma. We developed, piloted, and disseminated a questionnaire informed by the Theoretical Domains Framework (TDF). We recruited gbMSM in London (ON) and Calgary (AB) to an anonymous, online cross‐sectional survey. A total of 246 gbMSM completed the survey. On scales from 1 (strongly disagree) to 5 (strongly agree), general intention to donate was high (mean = 4.24 SD = 0.94). The pilot program itself was mostly acceptable (mean = 3.71, SD = 1.16), but the intention to donate under the unique requirements of the pilot program was lower than general intention (mean = 3.58 SD = 1.26). Two domains from the theoretical domains framework (TDF) (beliefs about consequences of donating plasma and social influences) were independently associated with general intention to donate. The pilot plasma program as an incremental step toward more inclusive policies was mostly viewed as acceptable by the impacted communities. Historical and ongoing exclusions create unique barriers to donation. There are clear opportunities for developing theory‐informed interventions to support gbMSM to donate plasma as policies continue to become more inclusive and more become eligible to donate.
Publisher: Informa UK Limited
Date: 05-02-2023
Publisher: Philosophy of Education Society of Australasia
Date: 10-12-2021
DOI: 10.46786/AC21.5999
Abstract: Since the start of the 21st century, education in Australia and Sweden have seen system level reform efforts change and shape both nations’ schools. In an endeavour to improve the educational outcomes of students, both countries have enacted neoliberal policies that aimed to decentralise education and provide increased autonomy for school leaders. The real-world consequences of these policies have restricted school leader autonomy and academic performance has declined while the gap between advantaged and disadvantaged students has continually grown. When excellence trumps equity as the primary driver of education at the system level, it creates a disadvantage cycle which sees the development of societal status hierarchies and unjust participatory parity for particular social groups. In the current time of COVID-19, when these disadvantages are exacerbated, it is timely to evaluate educational leadership at the system level in terms of its ability to positively affect social justice issues. Social justice leadership at a system level holds the potential to unite schools in competition and empower them to help overcome the unjust reality faced by disadvantaged students. So, the focus of this piece is to provide commentary on whether system leadership can enhance education’s potential in realising a more socially just society.
Publisher: Informa UK Limited
Date: 24-04-2019
Publisher: Wiley
Date: 09-03-2023
DOI: 10.1111/VOX.13419
Abstract: The distribution of rare and specific red cell phenotypes varies between races and ethnicities. Therefore, the most compatible red cell units for patients with haemoglobinopathies and other rare blood requirements are most likely to be found in donors from similar genetic backgrounds. Our blood service introduced a voluntary question asking donors to provide their racial background/ethnicity. Results triggered additional phenotyping and/or genotyping. We analysed the results of additional testing performed between January 2021 and June 2022, and rare donors were added to the Rare Blood Donor database. We determined the incidence of various rare phenotypes and blood group alleles based on donor race/ethnicity. Over 95% of donors answered the voluntary question 715 s les were tested, and 25 donors were added to the Rare Blood Donor database, including five k−, four U−, two Jk(a−b−) and two D− − phenotypes. Asking donors about their race/ethnicity was well received by donors, and the resulting selective testing enabled us to identify in iduals with a higher likelihood of being rare blood donors, support patients with rare blood requirements and better understand the incidence of common and rare alleles and red blood cell phenotypes in the Canadian donor population.
Publisher: Wiley
Date: 11-2018
DOI: 10.1111/VOX.12722
Abstract: In Canada, transfusion transmission risk of Human T-cell lymphotropic virus -I/II (HTLV) is addressed by universal leucoreduction and universal antibody testing. We aimed to estimate the risk with the current policy, if testing only first-time donors and if testing were stopped. Monte Carlo simulation was employed to estimate the proportion of red cell concentrate, random donor platelet and apheresis platelet units that would be released into inventory in each scenario (10 billion donors each). The model estimated the number of HTLV-positive donations not intercepted by testing, randomly assigned the number of HTLV particles/100 leucocytes using proportions from published data and randomly selected a postleucoreduction leucocyte count from quality control data. Units were considered infectious if ≥9 × 10 With universal leucoreduction in place, the residual risk of releasing an HTLV potentially infectious unit with universal testing was 1 in 1·2 billion units (0, 1 in 55·9 million), with testing only first-time donors 1 in 7·1 million (0, 1 in 1·05 million) and with no testing 1 in 1·0 million (0, 1 in 178 600). The efficacy of leucoreduction was >99·5% (lower bound 95·7%) for all scenarios. With universal leucoreduction in place, switching from universal testing to testing first-time donors would incur very low risk.
Publisher: Wiley
Date: 13-12-2017
DOI: 10.1111/VOX.12623
Abstract: We review the history and evolution of blood donor criteria for men who have sex with men (MSM). Deferral policies in many jurisdictions, including Australia, New Zealand, Canada, the United States, Brazil and many western European countries are based on a period of abstinence from MSM, often of 12 months duration. Several countries (Italy, Spain and Portugal) defer donors based on sexual behaviours considered to be at high risk, regardless of whether the partner is same sex or opposite sex. Compliance is a key determinant in the efficacy of any deferral policy. We summarize research themes and strategies discussed at a January 2017 meeting held in Toronto, Canada, to provide an evidence basis for future policy changes.
Publisher: Informa UK Limited
Date: 19-10-2023
Publisher: Wiley
Date: 12-2021
DOI: 10.1111/TRF.16753
Abstract: In Canada, the deferral for men who have sex with men (MSM) has been progressively reduced from a permanent deferral for MSM since 1977, to 5 years, 1 year, and, most recently, 3 months. We estimated human immunodeficiency virus (HIV) residual risk and compliance with the MSM time deferral after each change. Four anonymous online compliance surveys were carried out before and after each change. HIV incidence and prevalence were monitored from 2010 to 2021. Residual risk was estimated using the incidence‐window period model. Human immunodeficiency virus prevalence, incidence, and residual risk did not change with incrementally shorter MSM deferrals. The residual risk per million donations post 3‐month deferral was 0.05 (0.001–0.371). Men with temporally remote MSM history became eligible and, therefore, compliant as the deferral periods decreased (Cochran‐Armitage p value = .0001). However, the percentage of men with MSM history in the last 3 months with the indefinite deferral in place was similar to the percentage noncompliant, while the 3‐month deferral was in place. MSM donors did not report high‐risk behaviors for which they would otherwise be deferred in any survey. Following the change, an estimated 4467 MSM per year were eligible to donate, an increase from 2501 estimated eligible MSM donors following the change to the 1‐year deferral. With progressively shorter MSM deferral periods, HIV residual risk was unchanged. The proportion of male donors with deferrable MSM history remained low, while those with temporally remote MSM history became eligible, increasing the number of eligible MSM donors.
Publisher: Wiley
Date: 12-12-2022
DOI: 10.1111/VOX.13391
Abstract: Policies regarding medication use vary between blood centres. We evaluated medication use in eligible Canadian Blood Services whole blood donors to inform possible process improvements and allow comparisons between donors and the general population. All donors are asked about medication use in the last 3 days, and medications and their reason for use are documented in our donor computer system. Donor computer records were reviewed from January 1, 2020, to March 31, 2022 to extract information on medications by donor age and sex medications were grouped into therapeutic classes. Stability of medication use over time was determined in a random s le of 100 donors who made at least two donations in the study period. One‐third of successful (eligible) donors were taking medications of these, 80% were on one or two medications. Five classes of medication accounted for 72% of medication use, and 13 classes account for 93% of use. Use remains relatively stable over time. Medication use is common, with a few classes accounting for most use. Drop‐down lists and storage of information from one donation to the next may enhance efficiency.
Publisher: Wiley
Date: 19-10-2022
DOI: 10.1111/VOX.13370
Abstract: Donor criteria for diabetes vary significantly. We describe our evolving policies for donors with diabetes, their contribution to the Canadian blood supply and their rate of syncopal reactions compared to other donors. All donors are asked if they have diabetes and have taken medications in the last 3 days. We assessed donors with diabetes on various medications, the number deferred over time, and syncopal reactions in donors with diabetes and other donors in our donor reaction database. Policy changes allowing type 2 diabetic donors on oral hypoglycaemics alone, type 2 diabetic donors on oral medications and insulin and type 1 diabetic donors (all on insulin) to donate resulted in a decrease in deferrals from 450 to 22 donors annually. Of donors being treated with medication for diabetes, 11% are receiving insulin as part of their treatment. Syncopal reaction rates were low and not statistically different between diabetic and non‐diabetic donors, although confidence intervals (CIs) are large. Policies decreased deferrals while maintaining safety. A longer observation period would strengthen these observations.
Publisher: Springer Science and Business Media LLC
Date: 21-07-2021
Publisher: Wiley
Date: 04-10-2022
DOI: 10.1111/TRF.17140
Abstract: Surveillance of blood donors is fundamental to safety of the blood supply. Such data can also be useful for public health policy but tend to be underutilized. When the COVID‐19 pandemic arrived, blood centers around the world measured blood donor SARS‐CoV‐2 seroprevalence to inform public health policy. There is now a movement toward blood centers becoming more involved in public health research and surveillance post‐pandemic. However, blood donors are a healthy population and not representative of all segments of the general population. In this article, we explain how blood centers can evaluate their donor base to understand which part of the general population they are representative of. Methodologic approaches for evaluating s les relative to the target population were reviewed. Blood donor data that are available to most blood centers were identified and application to assess representativeness of blood donors was evaluated. Key aspects of blood donor data to compare with general population data include donor selection criteria, health indicators, geography, and demographics. In some cases, statistical adjustment can improve representativeness. Comparing key blood donor data with corresponding general population data can define the subset of the general population for which a particular blood center's donors may be representative of. We suggest that donors are an ideal convenience population for surveillance of infectious agents which are frequently asymptomatic and main routes of transmission are not deferrable, for studying the natural history of disease in an initially well population, and for vaccination serology surveillance.
Publisher: SAGE Publications Ltd
Date: 2017
Publisher: Wiley
Date: 26-10-2022
DOI: 10.1111/TRF.17164
Publisher: Wiley
Date: 14-07-2022
DOI: 10.1111/TRF.17000
Abstract: Canadian Blood Services introduced new eligibility criteria that allows some sexually active gay, bisexual, and other men who have sex with men (gbMSM) to donate source plasma, marking a significant change from time‐based deferral criteria. We aimed to identify potential barriers and enablers to implementing the new criteria from the perspective of donor center staff. We conducted Theoretical Domains Framework‐informed interviews with staff from two source plasma donation centers in Canada. We completed 28 interviews between June 2020 and April 2021. Three themes representing eight domains captured key tensions. Valuing inclusive eligibility criteria : staff support inclusive criteria many were concerned the new criteria remained discriminatory. Investing in positive donor experiences : staff wished to foster positive donor experiences however, they worried gbMSM donors would express anger and disappointment regarding the new criteria, staff would experience unease over using stigmatizing criteria and convey nonverbal cues of discomfort, and recurring plasma donors may behave inappropriately. Supporting education , training , and transparency of eligibility criteria : participants believed providing in‐person training (i.e., to explain criteria rationale, address discomfort, practice responding to donor questions) and ensuring donors and the public were well‐informed of the upcoming changes would improve implementation. Participant views emphasize the importance of supporting staff through training and transparent communication to optimize the delivery of world‐class equitable care for a new cohort of donors who have previously been excluded from plasma donation. Findings inform which staff supports to consider to improve implementation as policies continue to shift internationally.
Publisher: Wiley
Date: 20-04-2021
DOI: 10.1111/TRF.16375
Abstract: There are several strategies to reduce donor reactions. We report donor participation and reaction rates before and after implementing multiple measures at Canadian Blood Services. We introduced a structured program of 500 mL of water and a salty snack pre‐donation and applied muscle tension (AMT) during donation. Donors were not deferred for out of range blood pressure (BP) however, BP was measured in first time donors. Time on the donation chair post‐donation was decreased from 5 to 2 min for repeat donors. We assessed participation rates using our quarterly survey of 10,000 recent donors. We extracted vasovagal reactions with loss of consciousness (LOC) from our operational database and compared pre‐implementation (Oct 12,018‐March 31,2019) and post‐implementation (Oct 12,019‐March 31,2020) periods. Survey response rates varied from 11% to 16%. The percentage of donors who drank the water and ate the salty snack increased from 58% to 82% and 44% to 70% over 4 quarters those performing AMT increased from 24% to 41%. Reactions decreased from 19.07 per 10,000 (744 reactions in 390,123 donations) to 14.04 per 10,000 (537 in 382,382 donations) ( p .0001). No first‐time donors with high BP (n = 684) but 5 with low BP (n = 718) had reactions, CI were very large. Achieving optimal participation was challenging. After implementation of a donor wellness initiative based on best practice, rates of vasovagal reactions with LOC decreased by 25%. A larger dataset is necessary to assess the safety contribution of BP deferrals when other mitigation measures are in place.
Publisher: Informa UK Limited
Date: 19-11-2009
Publisher: Informa UK Limited
Date: 17-03-2022
Publisher: SAGE Publications
Date: 03-11-2021
Publisher: Emerald
Date: 21-10-2021
Abstract: This paper presents a review of empirical research on educational leadership during times of crises in K–12 schools. This review aimed to map the recent literature and identify key characteristics of educational leadership during crises to understand how this type of leadership is different from current understandings. A scoping review of empirical research from 2010 to 2020 on how school leaders have managed and responded to crises in K-12 was completed. The empirical research was analysed and synthesised by using the preview, question, read and summarise (PQRS) system. The findings draw attention to the fact that the notion of crisis leadership has been a neglected aspect of educational leadership research. Additionally, the review reveals six emerging characteristics which depict how school leadership has been enacted during different types of crisis across a range of contexts and crisis phases. The findings add to current practical understandings of educational leadership by illustrating the complexity and multi-layered nature of leading during times of crisis. Furthermore, these findings contribute to the field by identifying how leading during a crisis is different from current understandings. Lastly, they highlight the need to develop theories and models that account for how leadership is used to deal with the unpredictable nature of crises that schools across the globe face today and into the future.
Publisher: Elsevier BV
Date: 03-2022
Publisher: Wiley
Date: 15-06-2022
DOI: 10.1111/VOX.13328
Abstract: To protect transfusion recipients from transfusion‐transmissible infections, blood donors are deferred from donating after recent tattooing or piercing. To explore to what extent and how this deferral impacts donor availability, we performed an international study to investigate how many donors were deferred for a recent tattoo or piercing and how many of these donors returned to donate. We surveyed blood centre members of the Biomedical Excellence for Safer Transfusion (BEST) Collaborative and the European Blood Alliance Donor Studies Working Group on their numbers of donations, tattoo and piercing deferrals, and return rates in the year 2017. Eight blood centres participated. Overall, deferral rates were lower for repeat donors compared to new donors. Repeat donors were more likely to return than new donors. Women and young donors were more often deferred than male and older donors. Men were more demotivated by tattoo or piercing deferral, resulting in lower return rates compared to women. Return rates differed greatly between blood centres. Tattoo and piercing deferrals lead to missed donations and result in lower return rates. However, the numbers vary largely internationally, probably due to cultural and policy differences. Shortening deferral periods after tattooing or piercing may reduce the impact on donor availability, which should be investigated in single‐centre studies.
Publisher: Informa UK Limited
Date: 03-11-2020
Publisher: Wiley
Date: 06-2021
DOI: 10.1111/VOX.13126
Abstract: Iron depletion is a side effect of blood donation. Agencies have developed policies to test donors and to extend inter‐donation intervals (IDIs) for in iduals with low ferritin levels. Ferritin testing, however, has an impact on product availability due to longer IDIs and the effect of test results on donor behaviour. In this paper we apply a model to evaluate the impact of ferritin testing in the Canadian donor population on whole blood donations. A discrete event simulation was adopted for the study. The model represents a population of in iduals that donate blood, are tested for ferritin levels, and may exit the system. Data for the simulation was derived from operational data, donor research studies from Canadian Blood Services and previously published sources. Red cell collections will decline by at least 3.1% and could decline by as much as 19.2% after ferritin testing is put in place. Requirements for new donors could rise by as much as 36.0%. The impact of ferritin testing on repeat donor behaviour, rather than extensions to the mandated inter‐donation interval, is the largest factor influencing declines in whole blood donations. Because behaviour changes following the receipt of a low ferritin result, blood agencies must ensure that donors with low ferritin are motivated to modify their lifestyle and, when healthy, return to the donor pool.
Publisher: Wiley
Date: 04-09-2018
DOI: 10.1111/VOXS.12446
Publisher: Wiley
Date: 09-04-2021
DOI: 10.1111/VOX.13107
Abstract: Efficiency in mitigating HIV transmission risk by transfusion may vary internationally. We compared HIV prevalence and incidence in blood donors across different jurisdictions in relation to those rates in the general population and differences in deferral practices. Data from 2007 to 2016 were collected in Australia, Brazil (São Paulo), Canada, England, France, Italy, Ireland, Japan, the Netherlands, New Zealand, Norway, Spain (Basque Country), USA (Vitalant) and Wales. For each country/region, the number of HIV antibody‐positive donations and nucleic acid testing (NAT)‐only‐positive donations was broken down according to first‐time or repeat donor status, along with the relevant denominators. There is a modest correlation between HIV prevalence among first‐time donors and HIV prevalence in the general population. However, rates of HIV‐positive donations in repeat donors, a proxy for incidence, do not correlate with incidence rates in the general population. Rates in donors from Italy and Basque Country, where deferral criteria for men having sex with men are less stringent, are higher compared with most other jurisdictions. Rates of NAT‐only‐positive donations are extremely low and do not differ significantly after adjustment for multiple comparisons. Donor HIV rates are only weakly associated with those observed in the general population. Countries with less stringent deferral criteria have higher HIV rates in their donor population, but the rates remain very low.
Publisher: Wiley
Date: 16-05-2023
DOI: 10.1111/VOX.13443
Abstract: In Canada, the time deferral for gay, bisexual and other men who have sex with men (gbMSM) to donate blood has gradually decreased. In September 2022, this deferral was replaced with sexual behaviour‐based screening for all donors. We investigate how data from targeted research programmes addressed knowledge gaps to support this change. We conducted a scoping review describing the Canadian literature available before the research programmes relating to (1) behavioural indicators of HIV risk and (2) attitudes to blood donation among gbMSM, current donors and the general population. We summarize the targeted research programmes, their outputs and impact to date. For question 1, five projects met inclusion criteria. For question 2, three articles met inclusion criteria. Knowledge gaps identified were insufficient evidence of HIV incidence in gbMSM who met other donor eligibility criteria and scant data on opinions and views of blood donation and screening criteria for sexual risk behaviours. The research programmes funded 19 projects at 11 different research sites involving over 100 in idual researchers/collaborators resulting in 19 peer‐reviewed publications to date. Leveraging existing gbMSM cohorts yielded relevant HIV incidence data to inform safety modelling studies. Findings indicated that sexual behaviour‐based screening was acceptable to gbMSM and donors, and donor discomfort around specific questions could be mitigated with clear explanations. Targeted research programmes filled critical knowledge gaps and informed a change to gender‐neutral, sexual behaviour‐based screening for all donors. Findings supported successful implementation of these changes with research‐informed staff training.
No related grants have been discovered for Michelle Striepe.