Blood transfusion is the process of transferring blood products into a person's circulation intravenously. Transfusions are used for various medical conditions to replace lost components of the blood. Early transfusions used whole blood, but modern medical practice commonly uses only components of the blood, such as red blood cells, white blood cells, plasma, platelets, and other clotting factors.

Red blood cells (RBC) contain hemoglobin, and supply the cells of the body with oxygen. White blood cells are not commonly used during transfusion, but they are part of the immune system, and also fight infections. Plasma is the "yellowish" liquid part of blood, which acts as a buffer, and contains proteins and important substances needed for the body's overall health. Platelets are involved in blood clotting, preventing the body from bleeding. Before these components were known, doctors believed that blood was homogeneous. Because of this scientific misunderstanding, many patients died because of incompatible blood transferred to them.

Medical uses

Red cell transfusion

Historically, red blood cell transfusion was considered when the hemoglobin level fell below 100g/L or hematocrit fell below 30%. Because each unit of blood given carries risks, a trigger level lower than that, at 70 to 80g/L, is now usually used, as it has been shown to have better patient outcomes. The administration of a single unit of blood is the standard for hospitalized people who are not bleeding, with this treatment followed with re-assessment and consideration of symptoms and hemoglobin concentration. Patients with poor oxygen saturation may need more blood. The advisory caution to use blood transfusion only with more severe anemia is in part due to evidence that outcomes are worsened if larger amounts are given. One may consider transfusion for people with symptoms of cardiovascular disease such as chest pain or shortness of breath. In cases where patients have low levels of hemoglobin due to iron deficiency, but are cardiovascularly stable, parenteral iron is a preferred option based on both efficacy and safety. Other blood products are given where appropriate, e.g., to treat clotting deficiencies.

Procedure

Before a blood transfusion is given, there are many steps taken to ensure quality of the blood products, compatibility, and safety to the recipient. In 2012, a national blood policy was in place in 70% of countries and 69% of countries had specific legislation that covers the safety and quality of blood transfusion.

Blood donation

The source of blood to be transfused can either be the potential recipient (autologous transfusion), or someone else (allogeneic or homologous transfusion). The latter is much more common than the former. Using another's blood must first start with donation of blood. Blood is most commonly donated as whole blood obtained intravenously and mixed with an anticoagulant. In first-world countries, donations are usually anonymous to the recipient, but products in a blood bank are always individually traceable through the whole cycle of donation, testing, separation into components, storage, and administration to the recipient. This enables management and investigation of any suspected transfusion related disease transmission or transfusion reaction. In third-world countries, the donor is sometimes specifically recruited by or for the recipient, typically a family member, and the donation occurs immediately before the transfusion.

It is unclear whether applying alcohol swab alone or alcohol swab followed by antiseptic is able to reduce contamination of donor's blood.

Processing and testing

Donated blood is usually subjected to processing after it is collected, to make it suitable for use in specific patient populations. Collected blood is then separated into blood components by centrifugation: red blood cells, plasma, platelets, albumin protein, clotting factor concentrates, cryoprecipitate, fibrinogen concentrate, and immunoglobulins (antibodies). Red cells, plasma and platelets can also be donated individually via a more complex process called apheresis.
 The World Health Organization (WHO) recommends that all donated blood be tested for transfusion-transmissible infections. These include HIV, hepatitis B, hepatitis C, Treponema pallidum (syphilis) and, where relevant, other infections that pose a risk to the safety of the blood supply, such as Trypanosoma cruzi (Chagas disease) and Plasmodium species (malaria). According to the WHO, 10 countries are not able to screen all donated blood for one or more of: HIV, hepatitis B, hepatitis C, or syphilis. One of the main reasons for this is because testing kits are not always available. However the prevalence of transfusion-transmitted infections is much higher in low income countries compared to middle and high income countries.
 All donated blood should also be tested for the ABO blood group system and Rh blood group system to ensure that the patient is receiving compatible blood.
 In addition, in some countries platelet products are also tested for bacterial infections due to its higher inclination for contamination due to storage at room temperature. Presence of cytomegalovirus (CMV) may also be tested because of the risk to certain immunocompromised recipients if given, such as those with organ transplant or HIV. However, not all blood is tested for CMV because only a certain amount of CMV-negative blood needs to be available to supply patient needs. Other than positivity for CMV, any products tested positive for infections are not used.
 Leukocyte reduction is the removal of white blood cells by filtration. Leukoreduced blood products are less likely to cause HLA alloimmunization (development of antibodies against specific blood types), febrile non-hemolytic transfusion reaction, cytomegalovirus infection, and platelet-transfusion refractoriness.
 Pathogen Reduction treatment that involves, for example, the addition of riboflavin with subsequent exposure to UV light has been shown to be effective in inactivating pathogens (viruses, bacteria, parasites and white blood cells) in blood products. By inactivating white blood cells in donated blood products, riboflavin and UV light treatment can also replace gamma-irradiation as a method to prevent graft-versus-host disease (TA-GvHD).

Compatibility testing

Before a recipient receives a transfusion, compatibility testing between donor and recipient blood must be done. The first step before a transfusion is given is to type and screen the recipient's blood. Typing of recipient's blood determines the ABO and Rh status. The sample is then screened for any alloantibodies that may react with donor blood. It takes about 45 minutes to complete (depending on the method used). The blood bank scientist also checks for special requirements of the patient (e.g. need for washed, irradiated or CMV negative blood) and the history of the patient to see if they have previously identified antibodies and any other serological anomalies.

A positive screen warrants an antibody panel/investigation to determine if it is clinically significant. An antibody panel consists of commercially prepared group O red cell suspensions from donors that have been phenotyped for antigens that correspond to commonly encountered and clinically significant alloantibodies. Donor cells may have homozygous (e.g. K+k+), heterozygous (K+k-) expression or no expression of various antigens (K−k−). The phenotypes of all the donor cells being tested are shown in a chart. The patient's serum is tested against the various donor cells. Based on the reactions of the patient's serum against the donor cells, a pattern will emerge to confirm the presence of one or more antibodies. Not all antibodies are clinically significant (i.e. cause transfusion reactions, HDN, etc.). Once the patient has developed a clinically significant antibody it is vital that the patient receive antigen-negative red blood cells to prevent future transfusion reactions. A direct antiglobulin test (Coombs test) is also performed as part of the antibody investigation.

If there is no antibody present, an immediate spin crossmatch or computer-assisted crossmatch is performed where the recipient serum and donor rbc are incubated. In the immediate spin method, two drops of patient serum are tested against a drop of 3–5% suspension of donor cells in a test tube and spun in a serofuge. Agglutination or hemolysis (i.e., positive Coombs test) in the test tube is a positive reaction and the unit should not be transfused.

If an antibody is suspected, potential donor units must first be screened for the corresponding antigen by phenotyping them. Antigen negative units are then tested against the patient plasma using an antiglobulin/indirect crossmatch technique at 37 degrees Celsius to enhance reactivity and make the test easier to read.

In urgent cases where crossmatching cannot be completed, and the risk of dropping hemoglobin outweighs the risk of transfusing uncrossmatched blood, O-negative blood is used, followed by crossmatch as soon as possible. O-negative is also used for children and women of childbearing age. It is preferable for the laboratory to obtain a pre-transfusion sample in these cases so a type and screen can be performed to determine the actual blood group of the patient and to check for alloantibodies.

Compatibility of ABO and Rh system for Red Cell (Erythrocyte) Transfusion
This chart shows possible matches in blood transfusion between donor and receiver using ABO and Rh system.

Adverse effects
In the same way that the safety of pharmaceutical products is overseen by pharmacovigilance, the safety of blood and blood products is overseen by haemovigilance. This is defined by the World Health Organization (WHO) as a system "...to identify and prevent occurrence or recurrence of transfusion related unwanted events, to increase the safety, efficacy and efficiency of blood transfusion, covering all activities of the transfusion chain from donor to recipient." The system should include monitoring, identification, reporting, investigation and analysis of adverse events near-misses and reactions related to transfusion and manufacturing. In the UK this data is collected by an independent organisation called SHOT (Serious Hazards Of Transfusion).

Transfusions of blood products are associated with several complications, many of which can be grouped as immunological or infectious. There is controversy on potential quality degradation during storage.

Immunologic reaction
 Acute hemolytic reactions are defined according to Serious Hazards of Transfusion (SHOT) as "fever and other symptoms/signs of haemolysis within 24 hours of transfusion; confirmed by one or more of the following: a fall of Hb, rise in lactate dehydrogenase (LDH), positive direct antiglobulin test (DAT), positive crossmatch" This is due to destruction of donor red blood cells by preformed recipient antibodies. Most often this occurs because of clerical errors or improper ABO blood typing and crossmatching resulting in a mismatch in ABO blood type between the donor and the recipient. Symptoms include fever, chills, chest pain, back pain, hemorrhage, increased heart rate, shortness of breath, and rapid drop in blood pressure. When suspected, transfusion should be stopped immediately, and blood sent for tests to evaluate for presence of hemolysis. Treatment is supportive. Kidney injury may occur because of the effects of the hemolytic reaction (pigment nephropathy). The severity of the transfusion reaction is depended upon amount of donor's antigen transfused, nature of the donor's antigens, the nature and the amount of recipient antibodies.
 Delayed hemolytic reactions occur more than 24 hours after a transfusion. They usually occur within 28 days of a transfusion. They can be due to either a low level of antibodies present prior to the start of the transfusion, which are not detectable on pre-transfusion testing; or development of a new antibody against an antigen in the transfused blood. Therefore, delayed haemolytic reaction does not manifest until after 24 hours when enough antibodies are available to cause a reaction. The red blood cells are removed by macrophages from the blood circulation into liver and spleen to be destroyed, which leads to extravascular haemolysis. This process usually mediated by anti-Rh and anti-Kidd antibodies. However, this type of transfusion reaction is less severe when compared to acute haemolytic transfusion reaction.
 Febrile nonhemolytic reactions are, along with allergic transfusion reactions, the most common type of blood transfusion reaction and occur because of the release of inflammatory chemical signals released by white blood cells in stored donor blood or attack on donor's white blood cells by recipient's antibodies. This type of reaction occurs in about 7% of transfusions. Fever is generally short lived and is treated with antipyretics, and transfusions may be finished as long as an acute hemolytic reaction is excluded. This is a reason for the now-widespread use of leukoreduction – the filtration of donor white cells from red cell product units.
 Allergic transfusion reactions are caused by IgE anti-allergen antibodies. When antibodies are bound to its antigens, histamine is released from mast cells and basophils. Either IgE antibodies from the donor's or recipient's side can cause the allergic reaction. It is more common in patients who have allergic conditions such as hay fever. Patient may feel itchy or having hives but the symptoms are usually mild and can be controlled by stopping the transfusion and giving antihistamines.
 Anaphylactic reactions are rare life-threatening allergic conditions caused by IgA anti-plasma protein antibodies. For patients who have selective immunoglobulin A deficiency, the reaction is presumed to be caused by IgA antibodies in the donor's plasma. The patient may present with symptoms of fever, wheezing, coughing, shortness of breath, and circulatory shock. Urgent treatment with epinephrine is needed.
 Post-transfusion purpura is an extremely rare complication that occurs after blood product transfusion and is associated with the presence of antibodies in the patient's blood directed against both the donor's and recipient's platelets HPA (human platelet antigen). Recipients who lack this protein develop sensitization to this protein from prior transfusions or previous pregnancies, can develop thrombocytopenia, bleeding into the skin, and can display purplish discolouration of skin which is known as purpura. Intravenous immunoglobulin (IVIG) is treatment of choice.
 Transfusion-related acute lung injury (TRALI) is a syndrome that is similar to acute respiratory distress syndrome (ARDS), which develops during or within 6 hours of transfusion of a plasma-containing blood product. Fever, hypotension, shortness of breath, and tachycardia often occurs in this type of reaction. For a definitive diagnosis to be made, symptoms must occur within 6 hours of transfusion, hypoxemia must be present, there must be radiographic evidence of bilateral infiltrates and there must be no evidence of left atrial hypertension (fluid overload). It occurs in 15% of the transfused patient with mortality rate of 5 to 10%. Recipient risk factors includes: end-stage liver disease, sepsis, haematological malignancies, sepsis, and ventilated patients. Antibodies to human neutrophil antigens (HNA)  and human leukocyte antigens (HLA) have been associated with this type of transfusion reaction. Donor's antibodies interacting with antigen positive recipient tissue result in release of inflammatory cytokines, resulting in pulmonary capillary leakage. The treatment is supportive.
 Transfusion associated circulatory overload (TACO) is a common, yet underdiagnosed, reaction to blood product transfusion consisting of the new onset or exacerbation of three of the following within 6 hours of cessation of transfusion: acute respiratory distress, elevated brain natriuretic peptide (BNP), elevated central venous pressure (CVP), evidence of left heart failure, evidence of positive fluid balance, and/or radiographic evidence of pulmonary edema.
 Transfusion-associated graft versus host disease frequently occurs in immunodeficient patients where recipient's body failed to eliminate donor's T cells. Instead, donor's T cells attack the recipient's cells. It occurs one week after transfusion. Fever, rash, diarrhoea are often associated with this type of transfusion reaction. Mortality rate is high, with 89.7% of the patients dead after 24 days. Immunosuppressive treatment is the most common way of treatment. Irradiation and leukoreduction of blood products is necessary for high risk patients to prevent T cells from attacking recipient cells.

Infection

The use of greater amount of red blood cells is associated with a high risk of infections. In those who were given red blood only with significant anemia infection rates were 12% while in those who were given red blood at milder levels of anemia infection rates were 17%.

On rare occasions, blood products are contaminated with bacteria. This can result in a life-threatening infection known as transfusion-transmitted bacterial infection. The risk of severe bacterial infection is estimated, , at about 1 in 50,000 platelet transfusions, and 1 in 500,000 red blood cell transfusions. Blood product contamination, while rare, is still more common than actual infection. The reason platelets are more often contaminated than other blood products is that they are stored at room temperature for short periods of time. Contamination is also more common with longer duration of storage, especially if that means more than 5 days. Sources of contaminants include the donor's blood, donor's skin, phlebotomist's skin, and containers. Contaminating organisms vary greatly, and include skin flora, gut flora, and environmental organisms. There are many strategies in place at blood donation centers and laboratories to reduce the risk of contamination. A definite diagnosis of transfusion-transmitted bacterial infection includes the identification of a positive culture in the recipient (without an alternative diagnosis) as well as the identification of the same organism in the donor blood.

Since the advent of HIV testing of donor blood in the mid/later 1980s, ex. 1985's ELISA, the transmission of HIV during transfusion has dropped dramatically. Prior testing of donor blood only included testing for antibodies to HIV. However, because of latent infection (the "window period" in which an individual is infectious, but has not had time to develop antibodies) many cases of HIV seropositive blood were missed. The development of a nucleic acid test for the HIV-1 RNA has dramatically lowered the rate of donor blood seropositivity to about 1 in 3 million units. As transmittance of HIV does not necessarily mean HIV infection, the latter could still occur at an even lower rate.

The transmission of hepatitis C via transfusion currently stands at a rate of about 1 in 2 million units. As with HIV, this low rate has been attributed to the ability to screen for both antibodies as well as viral RNA nucleic acid testing in donor blood.

Other rare transmissible infections include hepatitis B, syphilis, Chagas disease, cytomegalovirus infections (in immunocompromised recipients), HTLV, and Babesia.

Comparison table

Inefficacy
Transfusion inefficacy or insufficient efficacy of a given unit(s) of blood product, while not itself a "complication" per se, can nonetheless indirectly lead to complications – in addition to causing a transfusion to fully or partly fail to achieve its clinical purpose. This can be especially significant for certain patient groups such as critical-care or neonatals.

For red blood cells (RBC), by far the most commonly transfused product, poor transfusion efficacy can result from units damaged by the so-called storage lesion – a range of biochemical and biomechanical changes that occur during storage. With red cells, this can decrease viability and ability for tissue oxygenation. Although some of the biochemical changes are reversible after the blood is transfused, the biomechanical changes are less so, and rejuvenation products are not yet able to adequately reverse this phenomenon. There has been controversy about whether a given product unit's age is a factor in transfusion efficacy, specifically about whether "older" blood directly or indirectly increases risks of complications. Studies have not been consistent on answering this question, with some showing that older blood is indeed less effective but with others showing no such difference; these developments are being closely followed by hospital blood bankers – who are the physicians, typically pathologists, who collect and manage inventories of transfusable blood units.

Certain regulatory measures are in place to minimize RBC storage lesion – including a maximum shelf life (currently 42 days), a maximum auto-hemolysis threshold (currently 1% in the US, 0.8% in Europe), and a minimum level of post-transfusion RBC survival in vivo (currently 75% after 24 hours). However, all of these criteria are applied in a universal manner that does not account for differences among units of product. For example, testing for the post-transfusion RBC survival in vivo is done on a sample of healthy volunteers, and then compliance is presumed for all RBC units based on universal (GMP) processing standards (RBC survival by itself does not guarantee efficacy, but it is a necessary prerequisite for cell function, and hence serves as a regulatory proxy). Opinions vary as to the "best" way to determine transfusion efficacy in a patient in vivo. In general, there are not yet any in vitro tests to assess quality or predict efficacy for specific units of RBC blood product prior to their transfusion, though there is exploration of potentially relevant tests based on RBC membrane properties such as erythrocyte deformability and erythrocyte fragility (mechanical).

Physicians have adopted a so-called "restrictive protocol" – whereby transfusion is held to a minimum – in part because of the noted uncertainties surrounding storage lesion, in addition to the very high direct and indirect costs of transfusions. However, the restrictive protocol is not an option with some especially vulnerable patients who may require the best possible efforts to rapidly restore tissue oxygenation.

Although transfusions of platelets are far less numerous (relative to RBC), platelet storage lesion and resulting efficacy loss is also a concern.

Other

 A known relationship between intra-operative blood transfusion and cancer recurrence has been established in colorectal cancer. In lung cancer intra-operative blood transfusion has been associated with earlier recurrence of cancer, worse survival rates and poorer outcomes after lung resection. Also studies shown to us, failure of the immune system caused by blood transfusion can be categorized as one of the main factors leading to more than 10 different cancer types that are fully associated with blood transfusion and the innate and adaptive immune system. Allogeneic blood transfusion, through five major mechanisms including the lymphocyte-T set, myeloid-derived suppressor cells (MDSCs), tumor-associated macrophages (TAMs), natural killer cells (NKCs), and dendritic cells (DCs) can help the recipient's defense mechanisms. On the other hand, the role for each of the listed items includes activation of the antitumor CD8+ cytotoxic T lymphocytes (CD8+/CTL), temporal inactivation of Tregs, inactivation of the STAT3 signaling pathway, the use of bacteria to enhance the antitumor immune response and cellular Immunotherapy.
 Transfusion-associated volume overload is a common complication simply because blood products have a certain amount of volume. This is especially the case in recipients with underlying cardiac or kidney disease. Red cell transfusions can lead to volume overload when they must be repeated because of insufficient efficacy (see above). Plasma transfusion is especially prone to causing volume overload because large volumes are usually required to give any therapeutic benefit.
 It has been proved that blood transfusion produce worse outcomes after cytoreductive surgery and HIPEC.
 Hypothermia can occur with transfusions with large quantities of blood products which normally are stored at cold temperatures. Core body temperature can go down as low as 32 °C and can produce physiologic disturbances. Prevention should be done with warming the blood to ambient temperature prior to transfusions.
 Transfusions with large amounts of red blood cells, whether due to severe hemorrhaging and/or transfusion inefficacy (see above), can lead to an inclination for bleeding. The mechanism is thought to be due to disseminated intravascular coagulation, along with dilution of recipient platelets and coagulation factors. Close monitoring and transfusions with platelets and plasma is indicated when necessary.
 Metabolic alkalosis can occur with massive blood transfusions because of the breakdown of citrate stored in blood into bicarbonate.
 Hypocalcemia can also occur with massive blood transfusions because of the complex of citrate with serum calcium. Calcium levels below 0.9 mmol/L should be treated.
 Blood doping is often used by athletes, drug addicts or military personnel for reasons such as to increase physical stamina, to fake a drug detection test or simply to remain active and alert during the duty-times respectively. However a lack of knowledge and insufficient experience can turn a blood transfusion into a sudden death. For example, when individuals run the frozen blood sample directly in their veins this cold blood rapidly reaches the heart, where it disturbs the heart's original pace leading to cardiac arrest and sudden death.

Frequency of use
Globally around 85 million units of red blood cells are transfused in a given year.

In the United States, blood transfusions were performed nearly 3 million times during hospitalizations in 2011, making it the most common procedure performed. The rate of hospitalizations with a blood transfusion nearly doubled from 1997, from a rate of 40 stays to 95 stays per 10,000 population. It was the most common procedure performed for patients 45 years of age and older in 2011, and among the top five most common for patients between the ages of 1 and 44 years.

According to the New York Times: "Changes in medicine have eliminated the need for millions of blood transfusions, which is good news for patients getting procedures like coronary bypasses and other procedures that once required a lot of blood." And, "Blood bank revenue is falling, and the decline may reach $1.5 billion a year this year [2014] from a high of $5 billion in 2008." Job losses will reach as high as 12,000 within the next three to five years, roughly a quarter of the total in the industry, according to the Red Cross.

History
Beginning with William Harvey's experiments on the circulation of blood, recorded research into blood transfusion began in the 17th century, with successful experiments in transfusion between animals. However, successive attempts by physicians to transfuse animal blood into humans gave variable, often fatal, results.

Pope Innocent VIII is sometimes said to have been given "the world's first blood transfusion" by his physician Giacomo di San Genesio, who had him drink (by mouth) the blood of three 10-year-old boys. The boys subsequently died, as did the Pope himself. The evidence for this story, however, is unreliable and considered a possible anti-Jewish blood libel.

Early attempts

The Incas

The first reported successful blood transfusions were performed by the Incas as early as the 1500s. Spanish conquistadors witnessed blood transfusions when they arrived in the sixteenth century. The prevalence of type O blood among Indigenous people of the Andean region meant such procedures would have held less risk than blood transfusion attempts among populations with incompatible blood types, which contributed to the failures of early attempts in Europe.

Animal blood

Working at the Royal Society in the 1660s, the physician Richard Lower began examining the effects of changes in blood volume on circulatory function and developed methods for cross-circulatory study in animals, obviating clotting by closed arteriovenous connections. The new instruments he was able to devise enabled him to perform the first reliably documented successful transfusion of blood in front of his distinguished colleagues from the Royal Society.

According to Lower's account, "...towards the end of February 1665 [I] selected one dog of medium size, opened its jugular vein, and drew off blood, until its strength was nearly gone. Then, to make up for the great loss of this dog by the blood of a second, I introduced blood from the cervical artery of a fairly large mastiff, which had been fastened alongside the first, until this latter animal showed ... it was overfilled ... by the inflowing blood." After he "sewed up the jugular veins", the animal recovered "with no sign of discomfort or of displeasure".

Lower had performed the first blood transfusion between animals. He was then "requested by the Honorable [Robert] Boyle ... to acquaint the Royal Society with the procedure for the whole experiment", which he did in December 1665 in the Society's Philosophical Transactions.

The first blood transfusion from animal to human was administered by Dr. Jean-Baptiste Denys, eminent physician to King Louis XIV of France, on June 15, 1667. He transfused the blood of a sheep into a 15-year-old boy, who survived the transfusion. Denys performed another transfusion into a labourer, who also survived. Both instances were likely due to the small amount of blood that was actually transfused into these people. This allowed them to withstand the allergic reaction.

Denys's third patient to undergo a blood transfusion was Swedish Baron Gustaf Bonde. He received two transfusions. After the second transfusion Bonde died. In the winter of 1667, Denys performed several transfusions on Antoine Mauroy with calf's blood.  On the third account Mauroy died.

Six months later in London, Lower performed the first human transfusion of animal blood in Britain, where he "superintended the introduction in [a patient's] arm at various times of some ounces of sheep's blood at a meeting of the Royal Society, and without any inconvenience to him." The recipient was Arthur Coga, "the subject of a harmless form of insanity." Sheep's blood was used because of speculation about the value of blood exchange between species; it had been suggested that blood from a gentle lamb might quiet the tempestuous spirit of an agitated person and that the shy might be made outgoing by blood from more sociable creatures. Coga received 20 shillings () to participate in the experiment.

Lower went on to pioneer new devices for the precise control of blood flow and the transfusion of blood; his designs were substantially the same as modern syringes and catheters. Shortly after, Lower moved to London, where his growing practice soon led him to abandon research.

These early experiments with animal blood provoked a heated controversy in Britain and France. Finally, in 1668, the Royal Society and the French government both banned the procedure. The Vatican condemned these experiments in 1670. Blood transfusions fell into obscurity for the next 150 years.

Human blood

The science of blood transfusion dates to the first decade of the 20th century, with the discovery of distinct blood types leading to the practice of mixing some blood from the donor and the receiver before the transfusion (an early form of cross-matching).

In the early 19th century, British obstetrician Dr. James Blundell made efforts to treat hemorrhage by transfusion of human blood using a syringe. In 1818 following experiments with animals, he performed the first successful transfusion of human blood to treat postpartum hemorrhage. Blundell used the patient's husband as a donor, and extracted four ounces of blood from his arm to transfuse into his wife. During the years 1825 and 1830, Blundell performed 10 transfusions, five of which were beneficial, and published his results. He also invented a number of instruments for the transfusion of blood. He made a substantial amount of money from this endeavour, roughly $2 million ($50 million real dollars).

In 1840, at St George's Hospital Medical School in London, Samuel Armstrong Lane, aided by Blundell, performed the first successful whole blood transfusion to treat haemophilia.

However, early transfusions were risky and many resulted in the death of the patient. By the late 19th century, blood transfusion was regarded as a risky and dubious procedure, and was largely shunned by the medical establishment.

Work to emulate James Blundell continued in Edinburgh. In 1845 the Edinburgh Journal described the successful transfusion of blood to a woman with severe uterine bleeding. Subsequent transfusions were successful with patients of Professor James Young Simpson after whom the Simpson Memorial Maternity Pavilion in Edinburgh was named.

Various isolated reports of successful transfusions emerged towards the end of the 19th century. The largest series of early successful transfusions took place at the Edinburgh Royal Infirmary between 1885 and 1892. Edinburgh later became the home of the first blood donation and blood transfusion services.

20th century

Only in 1901, when the Austrian Karl Landsteiner discovered three human blood groups (O, A, and B), did blood transfusion achieve a scientific basis and become safer.

Landsteiner discovered that adverse effects arise from mixing blood from two incompatible individuals. He found that mixing incompatible types triggers an immune response and the red blood-cells clump. The immunological reaction occurs when the receiver of a blood transfusion has antibodies against the donor blood-cells. The destruction of red blood cells releases free hemoglobin into the bloodstream, which can have fatal consequences. Landsteiner's work made it possible to determine blood group and allowed blood transfusions to take place much more safely. For his discovery he won the Nobel Prize in Physiology and Medicine in 1930; many other blood groups have been discovered since.

George Washington Crile is credited with performing the first surgery using a direct blood transfusion in 1906 at St. Alexis Hospital in Cleveland while a professor of surgery at Case Western Reserve University.

Jan Janský also discovered the human blood groups; in 1907 he classified blood into four groups: I, II, III, IV. His nomenclature is still used in Russia and in states of the former USSR, in which blood types O, A, B, and AB are respectively designated I, II, III, and IV.

Dr. William Lorenzo Moss's (1876–1957) Moss-blood typing technique of 1910 was widely used until World War II.

William Stewart Halsted, M.D. (1852–1922), an American surgeon,  performed one of the first blood transfusions in the United States. He had been called to see his sister after she had given birth. He found her moribund from blood loss, and in a bold move withdrew his own blood, transfused his blood into his sister, and then operated on her to save her life.

Blood banks in WWI

While the first transfusions had to be made directly from donor to receiver before coagulation, it was discovered that by adding anticoagulant and refrigerating the blood it was possible to store it for some days, thus opening the way for the development of blood banks. John Braxton Hicks was the first to experiment with chemical methods to prevent the coagulation of blood at St Mary's Hospital, London in the late-19th century. His attempts, using phosphate of soda, however, proved unsuccessful.

The Belgian doctor Albert Hustin performed the first non-direct transfusion on March 27, 1914, though this involved a diluted solution of blood. The Argentine doctor Luis Agote used a much less diluted solution in November of the same year. Both used sodium citrate as an anticoagulant.

The First World War (1914-1918) acted as a catalyst for the rapid development of blood banks and transfusion techniques. Francis Peyton Rous and Joseph R. Turner at the Rockefeller University (then The Rockefeller Institute for Medical Research) made the first important discoveries that blood typing was necessary to avoid blood clumping (coagulation) and blood samples could be preserved using chemical treatment. Their first report in March 1915 showed that gelatine, agar, blood serum extracts, starch and beef albumin proved to be useless preservatives.

However, building on the same experiment, they discovered that a mixture sodium citrate and glucose (dextrose) solution was a perfect preservative; as they reported in February issue of the Journal of Experimental Medicine, the preserved bloods were just like fresh bloods and that they "function excellently when reintroduced into the body." Blood could be preserved for up to four weeks. An accompanying experiment using citrate-saccharose (sucrose) mixture was also a success which could maintain blood cells for two weeks. This use of citrate and sugars, sometimes known as Rous-Turner solution, was the foundation for the development of blood banks and improvement of transfusion method.

Another discovery of Rous and Turner was the most critical step in the safety of blood transfusion. Rous was well aware that Landsteiner's concept of blood types had not yet find practical value, as he remarked: "The fate of Landsteiner's effort to call attention to the practical bearing of the group differences in human bloods provides an exquisite instance of knowledge marking time on technique. Transfusion was still not done because (until at least 1915), the risk of clotting was too great." In June 1915, they made a crucial report in the Journal of the American Medical Association that agglutination could be avoided if the blood samples of the donor and recipient were tested before. Which they called a rapid and simple method for testing blood compatibility, sodium citrate was used to dilute the blood samples, and after mixing the recipient's and donor's blood in 9:1 and 1:1 parts, blood would either clump or remain watery after 15 minutes. According to their advice, blood without clumping "should always be chosen if possible."

Canadian doctor and Lieutenant Lawrence Bruce Robertson became instrumental in persuading the Royal Army Medical Corps to adopt the use of blood transfusion at the Casualty Clearing Stations for the wounded. In October 1915, Robertson performed his first wartime transfusion with a syringe to a patient who had multiple shrapnel wounds. He followed this up with four subsequent transfusions in the following months, and his success was reported to Sir Walter Morley Fletcher, director of the Medical Research Committee.

Robertson published his findings in the British Medical Journal in 1916 and, with the help of a few like-minded individuals (including the eminent physician Edward William Archibald), was able to persuade the British authorities of the merits of blood transfusion. Robertson went on to establish the first blood-transfusion apparatus at a Casualty Clearing Station on the Western Front in the spring of 1917. Robertson did not test crossmatching so that one died of hemolysis in his 1916 transfusion, and three in 1917.

Oswald Hope Robertson, a medical researcher and U.S. Army officer, was attached to the RAMC in 1917, where he became instrumental in establishing the first blood banks in preparation for the anticipated Third Battle of Ypres. He used sodium citrate as the anticoagulant; blood was extracted from punctures in the vein and was stored in bottles at British and American Casualty Clearing Stations along the Front. Robertson also experimented with preserving separated red blood cells in iced bottles. Geoffrey Keynes, a British surgeon, developed a portable machine that could store blood to enable transfusions to be carried out more easily.

Expansion

The secretary of the British Red Cross, Percy Lane Oliver, established the world's first blood-donor service in 1921. In that year, Oliver was contacted by King's College Hospital, where they were in urgent need of a blood donor.
 After providing a donor, Oliver set about organizing a system for the voluntary registration of blood donors at clinics around London, with Sir Geoffrey Keynes appointed as a medical adviser. Volunteers were subjected to a series of physical tests to establish their blood group. The London Blood Transfusion Service was free of charge and expanded rapidly in its first few years of operation. By 1925 it was providing services for almost 500 patients; it was incorporated into the structure of the British Red Cross in 1926. Similar systems developed in other cities, including Sheffield, Manchester and Norwich, and the service's work began to attract international attention. France, Germany, Austria, Belgium, Australia and Japan established similar services.

Alexander Bogdanov founded an academic institution devoted to the science of blood transfusion in Moscow in 1925. Bogdanov was motivated, at least in part, by a search for eternal youth, and remarked with satisfaction on the improvement of his eyesight, suspension of balding, and other positive symptoms after receiving 11 transfusions of whole blood. Bogdanov died in 1928 as a result of one of his experiments, when the blood of a student with malaria and tuberculosis was given to him in a transfusion. Following Bogdanov's lead, Vladimir Shamov and Sergei Yudin in the USSR pioneered the transfusion of cadaveric blood from recently deceased donors. Yudin performed such a transfusion successfully for the first time on March 23, 1930, and reported his first seven clinical transfusions with cadaveric blood at the Fourth Congress of Ukrainian Surgeons at Kharkiv in September. However, this method was never used widely, even in the Soviet Union. Nevertheless, the Soviet Union was the first to establish a network of facilities to collect and store blood for use in transfusions at hospitals.

Frederic Durán-Jordà established one of the earliest blood banks during the Spanish Civil War in 1936. Duran joined the Transfusion Service at the Barcelona Hospital at the start of the conflict, but the hospital was soon overwhelmed by the demand for blood and the paucity of available donors. With support from the Department of Health of the Spanish Republican Army, Duran established a blood bank for the use of wounded soldiers and civilians. The 300–400 mL of extracted blood was mixed with 10% citrate solution in a modified Duran Erlenmeyer flask. The blood was stored in a sterile glass enclosed under pressure at 2 °C. During 30 months of work, the Transfusion Service of Barcelona registered almost 30,000 donors, and processed 9,000 liters of blood.

In 1937 Bernard Fantus, director of therapeutics at the Cook County Hospital in Chicago, established the first hospital blood-bank in the United States. In setting up a hospital laboratory that preserved, refrigerated and stored donor blood, Fantus originated the term "blood bank". Within a few years, hospital and community blood-banks were established across the United States.

Frederic Durán-Jordà fled to Britain in 1938 and worked with Dr Janet Vaughan at the Royal Postgraduate Medical School at Hammersmith Hospital to establish a system of national blood banks in London. With the outbreak of war appearing imminent in 1938, the War Office created the Army Blood Supply Depot (ABSD) in Bristol, headed by Lionel Whitby and in control of four large blood-depots around the country. British policy through the war was to supply military personnel with blood from centralized depots, in contrast to the approach taken by the Americans and Germans where troops at the front were bled to provide required blood. The British method proved more successful in adequately meeting all requirements, and over 700,000 donors were bled over the course of the war. This system evolved into the National Blood Transfusion Service established in 1946, the first national service to be implemented.

Stories tell of Nazis in Eastern Europe during World War II using captive children as repeated involuntary blood-donors.

Medical advances

A blood-collection program was initiated in the US in 1940 and Edwin Cohn pioneered the process of blood fractionation. He worked out the techniques for isolating the serum albumin fraction of blood plasma, which is essential for maintaining the osmotic pressure in the blood vessels, preventing their collapse.

Gordon R. Ward, writing in the correspondence columns of the British Medical Journal, proposed the use of blood plasma as a substitute for whole blood and for transfusion purposes as early as 1918. At the onset of World War II, liquid plasma was used in Britain. A large project, known as "Blood for Britain", began in August 1940 to collect blood in New York City hospitals for the export of plasma to Britain. A freeze-dried plasma package was developed by the Surgeons General of the Army and Navy, working with the National Research Council, which reduced breakage and made transportation, packaging, and storage much simpler.

The resulting dried plasma package came in two tin cans containing 400 mL bottles. One bottle contained enough distilled water to reconstitute the dried plasma contained within the other bottle. In about three minutes, the plasma would be ready to use and could stay fresh for around four hours. Dr. Charles R. Drew was appointed medical supervisor, and he was able to transform the test-tube methods into the first successful technique for mass production.

Another important breakthrough came in 1937–40 when Karl Landsteiner (1868–1943), Alex Wiener, Philip Levine, and R.E. Stetson discovered the Rhesus blood group system, which was found to be the cause of the majority of transfusion reactions up to that time. Three years later, the introduction by J.F. Loutit and Patrick L. Mollison of acid–citrate–dextrose (ACD) solution, which reduced the volume of anticoagulant, permitted transfusions of greater volumes of blood and allowed longer-term storage.

Carl Walter and W.P. Murphy Jr. introduced the plastic bag for blood collection in 1950. Replacing breakable glass bottles with durable plastic bags made from PVC allowed for the evolution of a collection system capable of safe and easy preparation of multiple blood components from a single unit of whole blood.

In the field of cancer surgery, the replacement of massive blood-loss became a major problem. The cardiac-arrest rate was high. In 1963 C. Paul Boyan and William S. Howland discovered that the temperature of the blood and the rate of infusion greatly affected survival rates, and introduced blood warming to surgery.

Further extending the shelf-life of stored blood up to 42 days was an anticoagulant preservative, CPDA-1, introduced in 1979, which increased the blood supply and facilitated resource-sharing among blood banks.

 about 15 million units of blood products were transfused per year in the United States. By 2013 the number had declined to about 11 million units, because of the shift towards laparoscopic surgery and other surgical advances and studies that have shown that many transfusions were unnecessary. For example, the standard of care reduced the amount of blood transfused in one case from 750 to 200 mL.

Special populations

Neonate
To ensure the safety of blood transfusion to pediatric patients, hospitals are taking additional precautions to avoid infection and prefer to use specially tested pediatric blood units that are guaranteed negative for Cytomegalovirus. Most guidelines recommend the provision of CMV-negative blood components and not simply leukoreduced components for newborns or low birthweight infants in whom the immune system is not fully developed. These specific requirements place additional restrictions on blood donors who can donate for neonatal use.

Neonatal transfusions typically fall into one of two categories:
 "Top-up" transfusions, to replace losses due to investigational losses and correction of anemia.
 Exchange (or partial exchange) transfusions are done for removal of bilirubin, removal of antibodies and replacement of red cells (e.g., for anemia secondary to thalassemias and other hemoglobinopathies).

Significant blood loss
A massive transfusion protocol is used when significant blood loss is present such as in major trauma, when more than ten units of blood are needed. Packed red blood cells, fresh frozen plasma, and platelets are generally administered. Typically higher ratios of fresh frozen plasma and platelets are given relative to packed red blood cells.

Unknown blood type
Because blood type O negative is compatible with anyone, it is often overused and in short supply. According to the  Association for the Advancement of Blood and Biotherapies, the use of this blood should be restricted to persons with O negative blood, as nothing else is compatible with them, and women who might be pregnant and for whom it would be impossible to do blood group testing before giving them emergency treatment. Whenever possible, the AABB recommends that O negative blood be conserved by using blood type testing to identify a less scarce alternative.

Religious objections
Jehovah's Witnesses may object to blood transfusions because of their belief that blood is sacred.

Research into alternatives

Although there are clinical situations where transfusion with red blood cells is the only clinically appropriate option, clinicians look at whether alternatives are feasible. This can be due to several reasons, such as patient safety, economic burden or scarcity of blood. Guidelines recommend blood transfusions should be reserved for patients with or at risk of cardiovascular instability due to the degree of their anaemia. In these cases parenteral iron is recommended.

Thus far, there are no available oxygen-carrying blood substitutes, which is the typical objective of a blood (RBC) transfusion; however, there are widely available non-blood volume expanders for cases where only volume restoration is required. These are helping doctors and surgeons avoid the risks of disease transmission and immune suppression, address the chronic blood donor shortage, and address the concerns of Jehovah's Witnesses and others who have religious objections to receiving transfused blood.

The research in this area is ongoing. A number of blood substitutes have been explored, but thus far they all have serious limitations. Most attempts to find a suitable alternative to blood thus far have concentrated on cell-free hemoglobin solutions. Blood substitutes could make transfusions more readily available in emergency medicine and in pre-hospital EMS care. If successful, such a blood substitute could save many lives, particularly in trauma where massive blood loss results. Hemopure, a hemoglobin-based therapy, is approved for use in South Africa.

Other uses
Minor blood transfusions are used by a minority of nyaope drug addicts in South Africa to economically share the high the drug induces in a practice colloquially known as Bluetoothing, named after the wireless technology of the same name.

Veterinary use

Veterinarians also administer transfusions to other animals. Various species require different levels of testing to ensure a compatible match. For example, cats have 3 known blood types, cattle have 11, dogs have at least 13, pigs have 16, and horses over 30. However, in many species (especially horses and dogs), cross matching is not required before the first transfusion, as antibodies against non-self cell surface antigens are not expressed constitutively – i.e. the animal has to be sensitized before it will mount an immune response against the transfused blood.

The rare and experimental practice of inter-species blood transfusions (xenotransfusion) is a form of xenograft.

See also
 Anemia
 Arnault Tzanck
 Blood transfusion in Sri Lanka
 Blood type (non-human)
 Young blood transfusion, a pseudoscientific practice involving the transfusion of blood taken from young donors to older recipients that is claimed to have health benefits
 AIDS

References

Further reading

 "Milk as a Substitute for Blood Transfusion", historical account, Scientific American, 13 July 1878, p. 19

External links

 Transfusion Evidence Library searchable source of evidence for transfusion medicine.

Blood transfusion societies
 American Association of Blood Banks (AABB)
 British Blood Transfusion Society (BBTS)
 International Society of Blood Transfusion (ISBT)

Books
 Blood Groups and Red Cell Antigens Free online book at NCBI Bookshelf ID: NBK2261
 Handbook of Transfusion Medicine Free book published in the UK 5th edition

Guidelines
 American Association of Blood Banks Clinical Practice Guidelines
 Australian National Blood Authority Patient Blood Management Guidelines
 British Committee for Standards in Haematology
 National Institute for Health and Care Excellence Blood Transfusion Guidance UK Guidance for transfusion.
 Canadian Blood Transfusion Guidelines
 German Medical Association Guidelines (English), published 2014.

Patient information
 Blood Transfusion Leaflets (NHS Blood and Transplant)
 Blood Transfusion Leaflets (Welsh Blood Service)
 Blood Transfusion Information (Scotland)
 Blood Transfusion Information (Australia)
 Blood Transfusion Information (American Cancer Society)

Transfusion medicine
Hematology
Blood

Blood transfusion


Mark Strippel is the former Head of Content Commissioning at BBC Radio 1Xtra and BBC Asian Network.

Early life

Strippel was born in Hounslow, West London and studied at Lampton School, Queen Mary and Westfield and the University of Law.

Career
In 2001, Strippel was a founding member of Panjabi Hit Squad. The group were signed to Def Jam UK, leading to remixes for Ashanti, Mariah Carey, Beenie Man and various compilation albums.

He joined the BBC in 2003 as a DJ on BBC Radio 1Xtra and was part of the original launch line-up, staying until 2007 when he moved into a management role as Head of Music at BBC Asian Network.

In 2017, he was given responsibility for BBC Radio 1Xtra in a leadership role.

He is responsible for strategic direction, content commissioning and talent for BBC Radio 1Xtra with signings including Kenny Allstar, Snoochie Shy, Sir Spyro, Reece Parkinson, Nadia Jae, Big Zuu, Jeremiah Asiamah and Moses Boyd.

In 2018, he defended the BBC's responsibility to play drill music, highlighting the need to balance "a commitment to UK music and the scene with a duty of care to audiences."

In late 2018, Strippel signed Tiffany Calver as the new face of the 1Xtra Rap Show, Europe's biggest hip-hop radio platform.

References

External links
Markie Mark Biography at BBC Press Office
Markie Mark appointment as Head of Music at BBC Asian Network - BBC Press Office

1974 births
Living people
English DJs
BBC Asian Network

Markie Mark


On the evening of 14 November 2017, the Zimbabwe National Army gathered around Harare, the capital of Zimbabwe, and got control of the Zimbabwe's national television station and other areas of the city.

The next day, they issued a statement saying that it was not a coup d'état and that President Robert Mugabe was safe, although the situation would only return to normal after they had dealt with the "criminals" around Mugabe responsible for the socio-economic problems of Zimbabwe. Jacob Zuma, the President of South Africa, phoned Mugabe and confirmed that he was "fine", but under house arrest.

The coup took place amid troubles in the ruling ZANU–PF party between former Vice President Emmerson Mnangagwa, who was backed by the army, and First Lady Grace Mugabe, backed by the younger G40 section, over who would replace the elderly President Mugabe. Grace Mugabe warned to a coup in October 2017.

A week after Mnangagwa was fired and forced to flee the country, and a day before troops moved into Harare, army chief Constantino Chiwenga issued a statement that purges of senior ZANU-PF officials like Mnangagwa had to stop. On November 21, 2017, Mugabe resigned as president. Emmerson Mnangagwa became the President of Zimbabwe on November 24, 2017.

References

2017 in Africa
November 2017 events
Coups d'état
History of Zimbabwe

2017 Zimbabwean coup d'état


The Paddington tram depot fire occurred on the night of 28 September 1962, and was one of the largest fires in Brisbane's history. As well as the depot, 67 trams were destroyed, 20% of the city's fleet. The destruction of the depot is generally seen as the beginning of the end for Brisbane's tram system, providing the justification for the subsequent closure of four tram routes and the gradual encroachment of bus operation on other tram routes, with the final closure of the tram system occurring on 13 April 1969.

Depot

The depot was constructed in 1915 on Latrobe Terrace, Paddington by the Brisbane Tramways Company to service its western suburbs routes.  Initially the depot had 10 roads, but it was subsequently lengthened and widened to 13 roads.

It was on the side of a hill and was largely built of timber and corrugated iron panels.  The front of the depot was at street level, but owing to the slope of the site, the rear of the depot was supported by a forest of timber supports, some over  high.

Fire
It is believed that the fire started in a storage area underneath the depot, although the cause has never been fully determined. Around 7:30 pm depot staff were alerted by nearby residents who had noticed sparks falling from under the depot.  Staff first secured the depot's cash in the depotmaster's car and then attempted to drive some trams out of the depot.  Three trams were rescued before the fire cut the power to the depot.  Firefighting was hampered by very low water pressure.  As the fire progressed, burning trams periodically crashed through the weakened floor to the ground below.  When it became obvious that the building could not be saved, firefighters concentrated on ensuring the fire did not spread to neighbouring homes.  The fire, fuelled by tyres, oil and grease stored under the depot, was visible from many areas of Brisbane.

Impact
The loss of so many trams put considerable strain on the Brisbane City Council Transport Department.  Trams allocated to the depot that were in service at the time of the fire were temporarily stored at the Tramways workshops in Milton.  The City Council admitted that neither the trams nor the depot had been insured.

Initially, older-style trams were brought out of storage from other depots to assist with peak-hour demand, but in December 1962 tram services to Kalinga, Toowong, Rainworth and Bulimba Ferry (in the suburb of Newstead) were converted to diesel bus operation.  These closures were the first significant route closures of the system and within 6½ years, the remainder of Brisbane's tram routes had been converted to diesel bus operation.

The City Council hired a number of buses from the New South Wales government, in a move which some saw as a publicity stunt by the then Lord Mayor, Alderman Clem Jones.  The Courier-Mail newspaper revealed that the City Council had been storing several of its own buses, which could have been made available rather than hiring buses from New South Wales.

Irrespective of the brief and comparatively minor controversy over the use of the Sydney buses, Jones was able to argue that the availability of buses "to fill the breach" left by the fire was evidence of buses' greater operational flexibility compared to trams.  One of the justifications subsequently raised by the Brisbane City Council when it decided in 1967 to abandon the tram system completely was the greater operational flexibility of buses.

After the fire a number of components, particularly trucks and wheels, were salvaged from destroyed trams and incorporated in eight new trams.  These trams had a distinctive pale blue colour scheme and featured a small picture of a phoenix under the driver's windows, signifying that the trams had "risen from the ashes", and were popularly referred to as "phoenix cars".

Aftermath
After the remains of the depot had been cleared, which took some years, the City Council sold the block and a shopping centre, now known as "Paddington Central" was built on the site.  This was redeveloped in the late 1980s, with the new building's roofline echoing the pitched gables of the tram depot.

See also
 Dalsenget fire – a tramway depot fire in Trondheim, Norway
 Woodland trolley depot fire – a trolley depot fire in Philadelphia, Pennsylvania, USA

References

 Brimson, Samuel, The Tramways of Australia, Dreamweaver Books, 1983.
 Clark, Howard R., and David R. Keenan, Brisbane Tramways – The Last Decade, Transit Press, 1977 (Reprinted 1985).

External links
Photo of tram 533 at the front of the depot in March 1962
Photo of the aftermath of the fire
Photo of the aftermath of the fire

History of Brisbane
Disasters in Brisbane
Public transport in Brisbane
Fires in Australia
1960s fires in Oceania
1962 fires
1960s in Brisbane
1962 disasters in Australia

Paddington tram depot fire


Cordia sebestena is a shrubby tree in the borage family, Boraginaceae, native to the American tropics.  It ranges from southern Florida in the United States and the Bahamas, southwards throughout Central America and the Greater Antilles. Common names have included siricote or kopté (Mayan) in 19th Century northern Yucatán, scarlet cordia in Jamaica, and Geiger tree (after Key West wrecker John Geiger) in Florida.

Description

Cordia sebestena grows to a maximum height of  at maturity, with a nearly equal spread. The crown is round to vase-shaped. Branches tend to be somewhat drooping, and the tree is naturally multitrunked. When only a single trunk is allowed to develop, it can attain a diameter of .

The dense, evergreen foliage consists of dark green, leathery, alternate, ovate leaves,  long, with wavy margins. These leaves are covered with small hairs, lending them a rough, "sandpapery" texture.

Flowers are produced in clusters at branch ends throughout the year, particularly in the spring and summer. Flowers are  wide, red-orange in color, tubular, flaring (salverform) with 5–7 lobes, bearing 5–7 stamens of similar height. The species is heterostylous and presumably self-incompatible. Pear-shaped fruits follow the flowers, averaging  in length. Fruits are fragrant and edible, but not flavorful.

Cultivation
Cordia sebestena is widely planted throughout the tropics as an ornamental plant in gardens for its showy flowers. It is a slow-growing plant, and sheds enough leaves and fruit to require some upkeep. The wood is rather light in density, but branches are not prone to breakage. The tree should be pruned in its youth to establish a structure, as it is prone to low branching. Soil tolerance is fairly broad, provided the soil drains well. Cordia sebestena tolerates drought, but not frost. It is not particularly susceptible to pests and diseases, other than the geiger tortoise beetle, which can cause occasional defoliation. This plant tolerates salt spray found near the ocean. It enjoys full sun, and can grow in a part-day sun situation as well. Its uses include: street tree, shade tree, even as a container subject in its youth. It is planted in traffic medians and parking lots, and is a useful seaside subject.

Gallery

References

USDA plant Classification Cordia sebestena

External links

sebestena
Plants described in 1753
Taxa named by Carl Linnaeus
Trees of the Caribbean
Trees of Central America
Flora of Florida
Trees of Quintana Roo
Trees of the Yucatán Peninsula
Garden plants of North America
Ornamental trees
Drought-tolerant trees

Cordia sebestena


Urmo Aava (born 2 February 1979) is a former Estonian rally driver who competed in the World Rally Championship between 2002 and 2009. His regular co-driver was Kuldar Sikk, who later became Ott Tänak's co-driver.

Career

Urmo Aava spent five years from 2003 in the Junior World Rally Championship driving for the successful Suzuki Junior World Rally Team. In this time his results improved, culminating in two runner-up positions in the final standings of the JWRC in 2006 and 2007. 2007 also saw sporadic outings in a privately run Mitsubishi Lancer WRC. In two of these events (Finland and New Zealand) he scored points.

For the 2008 season, Aava has negotiated a deal to compete 10 rounds in a Citroën C4 WRC car under the name 'World Rally Team Estonia' and with support from Citroën Sport Technologies. Aava showed promise in 2008 Jordan Rally, when he was running in 5th place before mechanical problems on the final day forced him to retire. Sardinia saw a steady run to 8th place and Aava's first points of the season. The next rally in Greece was even better. Two stage wins (helped by a favourable road position) demonstrated his pace and a 4th-place resulted – his best WRC result to date.
Followed by a 5th place at New Zealand's rally.

WRC results

JWRC results

References

External links

 Stats at Jonkka's World Rally Archive
 Stats at ewrc-results.com

1979 births
Living people
Sportspeople from Tallinn
Estonian rally drivers
World Rally Championship drivers
Citroën Racing drivers
M-Sport drivers

Urmo Aava


Lucilia is believed to have been the wife of the Roman philosopher Lucretius (c. 99 BC – c. 55 BC), though there is little evidence of their relationship, let alone marriage. Moreover, the name 'Lucilia' was not associated with Lucretius until many centuries after his death.  In Walter Map's twelfth century work titled De nugis curialium, 'Lucilia' is the name of a woman who murders her husband by giving him a potion that causes him to go insane.  It wasn't until 1511, in Pius's vita, that the name 'Lucilia' became associated with Lucretius.  Some have even questioned whether this association was made-up for the sake of writing, that is, to maintain literary style.

Chronological development of the story of Lucilia

Fourth century
St. Jerome contributed to our understanding of Lucretius's death when he wrote:The poet Titus Lucretius was born.  In later life he was sent mad by a love potion; in the intervals of his madness he composed a number of books, later edited by Cicero.  He died by his own hand at the age of forty-four.Whether this account of Lucretius's death is historically accurate is a matter of dispute.  What is certain, however, is that St. Jerome's biographical account of Lucretius influenced later writers.

Twelfth century
Walter Map mentioned a woman named 'Lucilia' though he does not mention her in connection with Lucretius.  Instead, he described Lucilia as a woman who accidentally gives her husband a deadly potion when she had intended to give him a love potion.  Map wrote (in Latin):Liuia uirum suum interfecit quem nimis odit; Lucilia suum quem nimis amauit.  Illa sponte miscuit aconiton, hec decepta furorem propinauit pro amoris poculo.  Amice, contrariis contendunt uotis iste; neutra tamen defraudata est fine fraudis feminee, proprio id est malo.  Variis et diuersis incedunt semitis femine; quibuscunque anfractibus errent, quantiscunque deuient inuiis, unicus est exitus, unica omnium viarum suarum meta, unicum caput et conuentus omnium diuersitatum suarum, malicia.  Exemplum harum experimentum cape, quod audax est ad omnia queccunque amat vel odit femina, et artificiosa nocere cum vult, quod est semper; et frequenter cum iuuare parat obest, unde fit ut noceat et nolens.  In fornace positus es; si aurum es, exibis aurum.

Thirteenth and fourteenth centuries
Vincent of Beauvais (Spec. Hist. 5.95), Pseudo-Walter Burley, and Guglielmo da Pastrengo are known to have written about the death of Lucretius.  Though writing after Walter Map, they did not mention Lucretius in connection with Lucilia.  Rather, their accounts of Lucretius's death parallel that of St. Jerome's.

A medieval scholar attributed an epigram to Lucretius on verse 419 of Ovid's Ibis.  In the epigram, Lucretius, speaking through a character named 'Almenicus', talks about a boy named Asterion, who might have been a possible lover. He wrote (in Latin):Cur puer Asterion crudelis?  ne fuge amantem.  Ne fuge, non equidem est effugiendus amor.  Crudeli puero nihil est crudelius umquam.  Crudeli puero nil mihi peius obest.  Vis verum dicam?  Sum mitis: ne fuge amantem.  Ni fugias, nil te mitius esse potest.  Sed iam non puer es, puero nil mitius umquam.  Crudeli puero mihi peius obest.Geoffrey Chaucer, in "The Wife of Bath's Tale", mentioned a woman named 'Lucia' who murdered her husband. He wrote:Of Livia told he me, and of Lucy.
They bothè made their husbands for to die;
That one for love, that other was for hate.
Livia her husband on an evening late
Empoisoned has, for that she was his foe.
Lucia likerous loved her husband so
That for he should always upon her think,
She have him such a manner love-drink
That he was dead ere it were by the morrow... In other versions of the same story, 'Lucilia' appears in place of 'Lucia'.

Fifteenth and sixteenth centuries
Girolamo Borgia was the first to associate Lucretius's death with a female figure.  There was, however, no mention of a woman named 'Lucilia'.  He wrote:[Lucretius] lived forty-four years, and at last, driven mad by the noxious potion of an evil woman, he resolved to take his own life by hanging himself or else, as others think, he fell on his sword.Johannes Baptista Pius was the first to associate a woman named 'Lucilia' with the death of Lucretius.  He wrote (in Latin):Morbi vi, iit fit, consiimtiin esse, sed, ut ejus obitiim faciant, scribunt, eum sibi ipsum manus attulisse: aliitaedio vitae, quod patriara suam ambitionc, avaritia, luxuria, discordia, etsimilibus civitatuin, qiiap diu floruerunt, et jam senescunt, morbis aestuare atque afflictari videret: alii aegritudine animi, quod memmii sui, qui in exilium pulsus erat, tristem casum aequo animo ferre non posset: alii iurore percitum, in quem Lucilia, sive uxor sive amica, amatorio poculo porrecto, eum imprudens adegerat, cum ab eo amari, non ei necem inferre, aut bonam mentem adimere, vallet.  Quoniam autem de numero libronim a nostro poeta scriptorum nonnulli dubitarunt, et, levissiniis argumentis adducti, plures, quam sex, ab eo scriptos esse existimarunt, videturhic error minuendus, atque haec dubitatio tollenda.  Omino igitur sex libros duntaxat de natura rerum scripsit T. Lucretius Carus...Gifanius and Lambin speculated on the nature of the relationship between Lucilia and Lucretius.  Gifanius wrote:According to Eusebius, [Lucretius] died by his own hands, in the forty-fourth year of his age, being dementated by a philtre, which either his mistress, or his wife, Lucilia, for so some call her, though without authority, in a fit of jealousy.Pomponio Leto also speculated on the nature of Lucretius's love life, though he offered a different story.  He wrote:They claim this happened to him for love of a boy, whom for his brightness and extraordinary beauty [Lucretius] called Astericon.Crinitus, Candidus, and Giraldi all discuss the death of Lucretius.

Nineteenth century
Tennyson discussed Lucilia's motivation for giving the potion to Lucretius.  He claimed that Lucilia was frustrated with Lucretius because he had become a less passionate lover.  He wrote:She Brook'd it not; but wrathful, petulant,
Dreaming some rival, sought and found a witch
Who'd brew'd the philtre which had power, they said,
To lead an errant passion home again.
And this, at times, she mingled with his drink,
And this destroy'd him; for the wicked broth
Confused the chemic labour of the blood...

References

1st-century BC Roman women
1st-century BC Romans
Lucilii
Poisoners
Ancient murderers
Mariticides

Lucilia (wife of Lucretius)


The red-necked stint (Calidris ruficollis) is a small migratory wader. The genus name is from Ancient Greek kalidris or skalidris, a term used by Aristotle for some grey-coloured waterside birds. The specific ruficollis is from Latin rufus, "red" and collum, "neck".

Description
These birds are among the smallest of waders, very similar to the little stint, Calidris minuta, with which they were once considered conspecific. The red-necked stint's small size, fine dark bill, dark legs and quicker movements distinguish this species from all waders except the other dark-legged stints. It measures  in length,  in wingspan and  in body mass. It can be distinguished from the western sandpiper and the semipalmated sandpiper in all plumages by its combination of a fine bill tip, unwebbed toes, and longer primary projection.

The breeding adult has an unstreaked orange breast, bordered with dark markings below, and a white V on its back. In winter plumage identification is difficult, although it is shorter legged and longer winged than the little stint. Juveniles have more contrasting mantle plumage and weaker white lines down the back than their relative. The call is a hoarse "stit".

Distribution and habitat
Red-necked stints are strongly migratory, breeding along the Arctic littoral of eastern Eurasia and spending the non-breeding season in South East Asia and Australasia as far south as Tasmania and New Zealand. They are rare vagrants to western Europe, with most records from Ireland. They are often seen in western Alaska and occasionally elsewhere in the Americas.

Behaviour
Red-necked stints are highly gregarious and will form flocks with other small Calidris waders, such as sharp-tailed sandpipers and curlew sandpipers in their non-breeding areas.

Breeding
Their breeding habitat is tundra. They nest on the ground and breed from spring to summer.

Diet
They forage in wet grassland and soft mud, mainly picking up food by sight. In their non-breeding habitat they feed on intertidal mudflats and along the muddy margins of freshwater lakes. They mainly eat insects and other small invertebrates.

References

Further reading

External links

 Selected red-necked stint images at Oriental Bird Images

red-necked stint
red-necked stint
Wading birds
Birds of North Asia
Native birds of Alaska
Birds of Southeast Asia
Birds of Oceania
red-necked stint
Articles containing video clips
Taxa named by Peter Simon Pallas

Red-necked stint


David Adams,  (16 November 1928 – 24 October 2007) was a Canadian ballet dancer and a founding member of the National Ballet of Canada.

Early career

After his training under Gweneth Lloyd at the Royal Winnipeg Ballet, David began his performing career with England's Metropolitan Ballet. Here he met Celia Franca, who would become the founding Artistic Director of the National Ballet of Canada. He also shared the stage with Eric Bruhn, Sonia Arova and John Taras, performing Design With Strings, Dances from Galanta and other works in a tour of Scandinavia.

Career

He returned to Canada in 1949 and after a brief musical theatre diversion in Vancouver and California, moved to Toronto to join Celia Franca during the formative years of Canada's National Ballet. He became the company's first principal male dancer in 1951 and remained with the company until 1963. He used his knowledge of classical dance and stagecraft to build an audience for the company, and introducing Canada's first home-grown principal ballerina, his wife Lois Smith. A brilliant amateur cinematographer, his "in-camera" videos from the 1950s are a significant part of the Celia Franca Tour De Force double DVD set. Adams also played a part in the birth of television in his native country, directing and performing in weekly productions for the fledgling Canadian Broadcasting Corporation (CBC).

In 1961, David moved to England, dancing with the London Festival Ballet (1961–69) and Royal Ballet (1970–1976). During his time with Festival Ballet, he became known in Europe as "Peer Gynt" because of the familiarity of ballet audiences with his appearance in that role. He danced with Margot Fonteyn, Galina Samsova, Toni Lander, Lynn Seymour, Svetlana Beriosova and others during a long and distinctive career which brought him to the Middle East, South America and Japan.

David's contributions to "the art" include a body of choreography. Two of his own works, Suite in G and Walpurgisnacht, became part of the repertoire with Festival Ballet.  Pas de deux Romantique (1961), Barbara Allen (1961), Pas de Six (1960), The Littlest One (1959), Pas de Chance (1956), Ballet Behind Us (1952) and Masquerade pas de deux (1951) are part of his contributions to the National Ballet of Canada.

In 1977, David relocated to Edmonton, Alberta, where he turned his talents to choreography and teaching and the occasional performance. He joined the Alberta Ballet Company under Brydon Paige, alternating between the roles of choreographer, ballet master, technical director and principal dancer. In 1980, David played a key role in the creation of both the dance and theatre programmes at Grant MacEwan College. His 1994 version of Don Quixote is unique in its presentation of Quixote's perspective, paralleling a psycho-drama to the dance story.

Adams also worked to preserve Canadian choreography. In 1983 he worked with Lawrence Adams and Miriam Adams, his brother and sister-in-law, to reconstruct and archive Boris Volkoff's Red Ears of Corn.

Adams retired from active teaching in 1998 and began work on a range of historic, artistic and technical memoirs.

Awards

In 1966 Adams won the Festival de la Opera Gold Medal in Madrid for his performance in Giselle.

In 2004, he was made an Officer of the Order of Canada. On 2 September 2005, he was presented the insignia of Officer of the Order of Canada by the Governor General Adrienne Clarkson during a private ceremony held near Stony Plain, Alberta.

References

External links

Archive film of David Adams dancing Lilac Garden in 1953 at Jacob's Pillow

1928 births
2007 deaths
Canadian male ballet dancers
Officers of the Order of Canada
English National Ballet
Dancers of The Royal Ballet
Academic staff of MacEwan University

David Adams (dancer)


The DAF 44 is a small family car that was introduced in September 1966 by the Dutch company DAF.  It was the first car to be built at the company's new plant at Born in Limburg.   Styled by Michelotti, it represented a cautious move upmarket for the company which hitherto had produced, for the passenger car market, only the smaller, slower Daffodil model (subsequently rebadged as the DAF 33 to align with the form of nomenclature introduced with the 44).

The 2 cylinder engine would have been familiar to any driver of the less powerful DAF 33, and the bore remained unchanged at 85.5 mm. Stroke was increased to 73.5 mm, however, giving an increase in engine displacement from 746 cc to 844 cc and an increase in claimed output from 28 bhp to 34 bhp. The compression ratio remained low enough to permit the use of relatively low octane fuel.

Stopping power commensurate with the car's rather leisurely performance came from all-round drum brakes.

An innovative feature for the time was face-level ventilation with adjustable fascia mounted outlets.

The spare wheel was stored under the front hood / bonnet which left more space for luggage at the back and makes the point that the engine was a relatively compact one.

The DAF 44 also provided the underpinnings for the tall-built Swedish specialty vehicle Kalmar KVD 440 ("Tjorven").

The DAF 44, in common with other DAF cars, featured an innovative continuously variable transmission system, the DAF Variomatic. Just like on DAF's smaller 600, 750 and 33, the Variomatic built under the rear seat also served as the differential, thus effectively constituting a transaxle.

In addition to the 2-door saloon, a 2-door estate/hatchback or panel van version were also available. Production ended in November 1974 after 167,902 had been built. While the 44 was replaced by the short-lived DAF 46, leftover cars continued to be available for some time.

Notes

44
Cars powered by boxer engines
Rear-wheel-drive vehicles
Vehicles with CVT transmission
Sedans
1960s cars
1970s cars
Cars introduced in 1966
VDL Nedcar vehicles
Station wagons

DAF 44


Don "Duck" Edwing (1934 – December 26, 2016) was an American gag cartoonist whose work has appeared for years in Mad. His signature "Duck Edwing" was usually accompanied by a small picture of a duck, and duck calls were heard on his answering machine. Mad editor John Ficarra said, "He's exactly how people picture a Mad magazine writer."  In 2007, Edwing told an interviewer, "I always believed that when you choose your field, you should specialize. You never deviate. I chose 'sick puppy'."

Early life and career
Born in Brooklyn, New York, Edwing began drawing at age nine. He started making the rounds with his cartoons after leaving the navy in 1958, receiving $5 for his first sale in 1960. His 49-year tenure with Mad spanned six decades, beginning with his first two gag cartoons for the magazine: an installment of the recurring "Scenes We'd Like to See" feature and a sequence called "Nuclear Jitters," both from Mad #70 (April 1962). His last piece appeared in the 515th issue in 2012.

Before drawing his own cartoons, Edwing was the uncredited writer for many of Don Martin's cartoon gags. During Don Martin's final decade with Mad, Edwing began receiving a writer's byline for many of Martin's cartoons, as well as new material from Martin's paperback books. An example from 1986 is "Early One Evening In Las Vegas," in which a man finds that the only way to summon the fire department is to put a dollar bill in an alarm box which is built like a gambler's slot machine. With the exception of a single page of art, Edwing was exclusively a writer at Mad for more than a dozen years before becoming an occasional illustrative contributor in the early 1980s.  After Martin left Mad in late 1987, Edwing effectively replaced him as the magazine's one-page gag cartoonist.

Following Martin's death in 2000, Edwing was asked about their working relationship:
Martin and I corresponded mostly with phone calls. The Mad editors did all the work by putting us together. I merely cheered Don up on a daily basis by telling him jokes, which had nothing to do with the work in front of him. I marveled at how he would take my chicken scratch sketches of a gag and transform them into a 2-D, animated, spectacular scene. The man was a major talent... l miss him.

Other work
Edwing also wrote Spy vs. Spy for about 12 years, as well as the Spy vs. Spy syndicated comic strip, along with his own feature, Tales from the Duckside. As Mad'''s "bizarre biz-artist" he authored and drew 17 Mad paperbacks. He also wrote three "Spy vs. Spy" books and Don Martin's "Captain Klutz" material.

Edwing collaborated with Paul Coker Jr. on two comic strips, Lancelot and Horace and Buggy. His cartoons have appeared in Playboy, Look, The Saturday Evening Post and other magazines. Interviewed in 2002, Edwing was asked about his work outside Mad:
Dave Manak and myself just finished up working on Spy vs. Spy, the comic strip, and in the past I did a strip with Paul Coker called Horace and Buggy, about smart-ass insects, and I did some writing and artwork for Bob Thaves' Frank and Ernest. For Sweden, I did Super Sock and various lunatic Edwing characters that were highly successful adventures.

The short-lived Spy vs. Spy comic strip was a full-color Sunday strip syndicated by Tribune Media Services as part of Mad's year-long 50th-anniversary celebration. Charter subscribers included The Los Angeles Times, Seattle Post-Intelligencer, Denver Post and Atlanta Journal-Constitution''. TMS Director of Creative Services Fred Schecker commented, "We're excited to represent a comic that so many newspaper readers already know and love. It is still as fresh and appealing as ever. In fact, it's aged a whole lot better than I have."

Personal life
Edwing met Clair, who was known as Cluck Edwing, in Virginia in the late 1970s. They married and moved to Florida, where they lived together until her death in 2008.

Edwing created the Golden Gator Award which is given to the wives of cartoonists. In 2003, he began designing slot machines for International Game Technology, the world's largest slot machine developer.

References

External links
 Complete list of Edwing's work for Mad

 Duck Edwing interviewed by Mark Anderson (January 24, 2005)

1934 births
2016 deaths
American comics writers
American comics artists
Mad (magazine) cartoonists
Artists from Brooklyn
Artists from Florida

Duck Edwing


Bridgemary School is an 11-16 secondary school with academy status in Gosport, Hampshire, England.

Bridgemary School takes part of its cohort from the most deprived ward in Gosport. However, it has always been categorised as a failing school by Ofsted. In 2001 staff were given a DfES (Department for Education and Skills) bonus for significant improvement, of more than 7%, in the GCSE A*-C pass rate. Results continued to rise, until a fall of 4% in 2004 brought it back to 25% (DfES, 2004). This was despite Ofsted's assertion, in July 2004, that: 'Results in 2003 were in line with those in similar schools at the end of Year 9, and above average for similar schools at the end of Year 11'. (Ofsted Report, 2004. pg.8)  The school was also identified by DfES as being among 148 nationwide which were likely to have a "high number of persistent truants". It is perhaps to the credit of staff and external agencies, working with the community, that unauthorised absence remained as low as 3.5% during this time.(Dfes, 2004.ibid)

The former principal, Richard Carlyle, introduced some ability-centred no-age-related classes (with year groups: E1, E2, E3, L1 and L2), and by 2006 the GCSE A to C pass rate had risen to 35%.

In September 2006 it was announced that Bridgemary College was to be the first school in the country to offer teaching around the clock with teaching and extra-curricular activities taking place from 7am to 10pm and learning modules being available online at any time. The scheme was to be phased in over four years, beginning in September 2007. In the first and second stages, the school planned to ensure that teaching support was available 24 hours a day and in four different time slots for four different groups of students. Stage three would see teaching expanded to 364 days a year, while stage four envisages community users integrated into the pupils' school experience.

References

External links

Secondary schools in Hampshire
Gosport
Academies in Hampshire

Bridgemary School


John Arthur Porter (November 12, 1921 – June 15, 1979) was a Canadian sociologist from 1950 to the late 1970s. His work in the field of social stratification opened up new areas of inquiry for many sociologists in Canada.

Porter was born in Vancouver and completed his education at the London School of Economics in the United Kingdom. There, he became interested in studies of social class.  On returning to Canada he joined the faculty of Carleton University. He remained at Carleton as a professor, and later, as department chairman, dean and academic vice-president. He was also visiting professor at Harvard and the University of Toronto.

Early life
At 15 John Porter's father lost his job in Vancouver and his family moved to England in search of stable work.  Luck, however, was not found.  The depression had devastated both the Canadian and British economies and, after a short while of wrestling with his own poverty induced depression, Porter's father abandoned his family.  John who had left high school in Vancouver was never able to return as he searched and worked for subsistence.  Known for being a gifted student who had a particular proficiency in creative writing, he continued his studies informally with his mother—a schoolteacher.

War broke out and in 1941 Porter joined the Canadian Army as an Intelligence Officer and, towards the end of the war in 1943, he was part of the Allied invasion of Italy and Sicily.  After the war he worked with a colonel in London writing a history of Canada's involvement in the war while studying for the entrance exam to the London School of Economics—which he passed on his first attempt.  He joined the school at a particularly important ferment: while the university had abandoned its social democratic and Fabian roots, its professors and students were heavily influenced by a liberal reformism which, in the words of one commentator, was "a widely shared belief that the irrationality of war and suffering could be eliminated by the judicious application of humane rationality specifically manifested in the form of a generous and intelligent welfare state." Reflecting upon his time as the LSE Porter notes that he was most animated by "a concern for ethical principles in social life."

In 1949 he graduated and, after a twelve-year hiatus, returned to Canada.  He was offered a job teaching political science at the adolescent Carleton College and, two years later, switched to Sociology – becoming the school's first appointment in the field.  Eventually he was told that to retain his job he would have to get a graduate degree or begin publishing in a meaningful way.  As such, in the early 1950s, he began the project that, fifteen years later, would culminate in the production of The Vertical Mosaic.  The idea for the project had found its genesis at the LSE where, he had told his PhD supervisor, he wanted to "write an interpretation of Canada as a modern democracy."

Vertical mosaic
The Vertical Mosaic: An Analysis of Social Class and Power in Canada, Porter's most important work, was published in 1965 by University of Toronto Press.  It was the study of equality of opportunity and the exercise of power by bureaucratic, economic and political elites in Canada.  Porter was concerned with challenging the image that Canada was a classless society with "no barriers to opportunity."  Porter concludes The Vertical Mosaic with the following observations:

Porter argues that Marxist class analysis, based on ownership of the means of production is a "questionable criterion of class in modern industrial society" (p. 25). Porter rejects power as the basis for social class, with the observation that conflict between those with power and the powerless is nonexistent.  Porter constructs a new model based on the study of elites.

Elites are those who make decisions in the hierarchical institutional systems of modern society.  Porter describes elites in the following way:

Legacy
Porter's analysis is essentially conflict theorist. While some aspects were inspired by Marxist thinking, he was at pains to present a non-Marxian approach. The nature of the Canadian capitalist class led Porter to develop his model. Notably, it was against his work that scholars in the 1970s began to develop a more contemporary, cultural and Marxist idea of class that defined it not in terms of occupational rank but in terms of power relationships.  Indeed, if there is one area of Porter's work which intellectuals are most critical of it is his overly functionalist definition of class and power that closes down other avenues of critical thought: as Pat Armstrong writes, "by conceptualizing class in this manner, Porter left out of the theory many of the ways power is used to ensure male dominance in class relations and how those relations shift over time, often through struggle."

He noted that this class in the 1950s was a tightly knit group of wealthy, predominantly Anglo-Saxon men, centred in Montreal, Quebec and Toronto, Ontario. This group controlled Canada's financial, industrial and political spheres. While there appeared to be one elite, Porter found that there were actually several elite groups, comprising economic, political, labour, and ideological realms. His work thus echoes and expands on United States sociologist C. Wright Mills' study of power elites in the United States.

In 1965, the year The Vertical Mosaic was published, sociology, as a discipline, had virtually no academic or mainstream currency: nationwide there were only 115 university based sociologists.  There was no national sociology textbook, the closest thing being a volume, compiled by Porter, which featured a loose collection of Canadian Sociology readings.  Further, while contemporary Canadian sociology is marked by its breadth of topics and questions – class, power, race, education, ability, work, gender – and, frankly, a commitment to a left-leaning politic, none of this was true in 1965.  The publication of The Vertical Mosaic did, thus, three things: first, it established sociology as a legitimate discipline in the Canadian context; second, it pioneered a macrosociological approach that put class at the centre of its analysis and, third, it constituted an initial offering in the emergent field of inequality studies and diversity studies.  Indeed, Rick Helmes-Hayes argues that the book set the tone, parameters of debate and questions for the next fifteen years in sociology.

The Vertical Mosaic led to the adoption of the term cultural mosaic by Canadian government agencies such as Statistics Canada, but Porter himself was an opponent of Canada's multiculturalism policy.

Porter, along with Peter Pineo, developed the Pineo-Porter index of socioeconomic status.

To honour Porter's importance in developing sociology in Canada, the Canadian Sociology and Anthropology Association initiated an annual award called the Porter award.

Shortly before his death in 1979, he put together ten of his most significant essays in The Measure of Canadian Society: Education, Equality, and Opportunity. He died in Ottawa later that year, due to a heart attack.

References
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.

External links

Canadian Social Approaches Notes from a lecture by Paul Gingrich, University of Regina Department of Sociology and Social Studies (1999).
Interview with John Porter CBC Archives
John Arthur Porter fonds (MG31-D104) at Library and Archives Canada

1921 births
1979 deaths
Canadian sociologists
Canadian university and college faculty deans
Academic staff of Carleton University
Carleton University alumni
Harvard University staff
Academic staff of the University of Toronto
People from Vancouver
Alumni of the London School of Economics
Canadian expatriate academics in the United Kingdom

John Porter (sociologist)