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Background: Results have been varied regarding the effect of donor age on the outcome of unrelated donor haemopoietic cell transplantation (HCT). Aims: To determine the influence of donor age on adult unrelated donor HCT outcome in Australia. Methods: Patients were included in the study if they were aged 16 years or above and underwent first allogeneic unrelated donor HCT in Australia for the indications of acute lymphoblastic leukaemia (ALL), acute myelogenous leukaemia (AML), chronic myelogenous leukaemia (CML) or myelodysplastic syndromes (MDS) between the years of 2001 and 2014 inclusive. The main outcome measure was overall survival (OS), which was tested against independent variables using univariate Kaplan–Meier methods and multivariate Cox regression. Results: A total of 1158 unrelated donor HCT were represented in the data. Cumulative incidences of engraftment, transplant related mortality (TRM), acute graft‐versus‐host disease (GvHD), chronic GvHD and relapse were not significantly affected by donor age. OS probability at 5 years post‐transplant was 48.3%. In multivariate analysis of OS, year of transplant 2001–2007, recipient age 40 years or greater, poor risk disease, human leukocyte antigen (HLA) match less than 6/6 and poor performance status at transplant (Karnofsky scale) were independently significant adverse OS risk factors. Donor age was not a significant risk factor for OS in univariate or multivariate analysis. Conclusions: The conclusion from this study was that donor age (up to 59 years) did not influence post‐transplant outcome among adult unrelated donor HCT performed in Australia for haematologic malignancies. [ABSTRACT FROM AUTHOR]

Abstract: Background: Temporal artery biopsy is considered the investigation of choice to diagnose definitively giant cell arteritis (GCA) in patients with compatible symptoms. However it is invasive and not completely sensitive. Serum markers, particularly erythrocyte sedimentation rate (ESR), can be supportive, but are not definitive in individual cases. Aims: To investigate whether indices derived from the full blood count, including neutrophil‐to‐lymphocyte ratio (NLR) and platelet‐to‐lymphocyte ratio (PLR) were associated with a positive biopsy in patients with suspected GCA. Methods: The clinical and pathological details of 537 patients undergoing temporal artery biopsy at our institution from 1992 to 2015 were reviewed. Results: In univariate analysis high platelets (odds ratio (OR) 4.44, P < 0.001), NLR (OR 1.81, P = 0.02), PLR (OR 3.25, P < 0.001), C‐reactive protein (CRP) (OR 3.00, P < 0.001), ESR (OR 3.62, P < 0.001) and increased age (OR 1.03, P = 0.006) were strongly associated with a positive biopsy. In multivariate modelling only high platelets (P < 0.001) and ESR (P = 0.049) maintained significance. Conclusions: We conclude that the presence of thrombocytosis and high NLR, PLR, ESR and CRP can all be used clinically to support the diagnosis of GCA prior to biopsy. Of particular note, in multivariate modelling the presence of thrombocytosis is a stronger predictor of a positive temporal artery biopsy than ESR. Therefore, careful consideration of the findings in a full blood count can be used to predict the likelihood of a positive temporal artery biopsy in patients with suspected GCA. [ABSTRACT FROM AUTHOR]

The concept of coastal sediment compartments was first used in the 1960s in the United States. It has since been recognised as appropriate for defining sections of the Australian coast, but had not been uniformly adopted around the nation in the way that has underpinned management, as in other countries. In 2012, the Australian Government supported a project to better understand coastal sediment dynamics using the sediment compartment approach as a framework within which to consider future shoreline behaviour and the impacts of climate change, including rising sea level, changing wave climates and sediment budgets. This paper outlines the sediment compartment project and uses case studies to demonstrate its application. The project consisted of three steps. The first step involved delineation of a hierarchy of coastal sediment compartments following a nationally agreed set of criteria, integrating the onshore/offshore geologic framework with known patterns of sediment movement and those inferred from surface landforms. This identified more than 100 primary compartments bounded by major structural features such as headlands or changes of shoreline orientation. At a finer scale, approximately 350 secondary compartments were identified, many of which encompass smaller scale structural features that define tertiary scale compartments or cells. For verification of this sediment compartments approach to coastal planning and management, the second step of the study comprised case studies of contrasting compartments with different patterns of sediment supply, transport and deposition. The third step, involved embedding all secondary compartments around the continental coast into the Shoreline Explorer, within the CoastAdapt toolbox (National Climate Change Adaption Research Facility). Information regarding the sensitivity of shorelines to change was compiled at the compartment scale, based upon evidence such as substrate, sediment transport attributes and oceanographic forcing, including waves, tides and storm processes. Presentation of information through CoastAdapt within the compartments framework provides a resource to facilitate improved coastal planning and management over different implementation levels, from national strategy scale down to local policy scale. Case studies from several contrasting settings around the Australian coast demonstrated the potential and feasible application of the sediment compartment approach at different spatial and temporal scales. [ABSTRACT FROM AUTHOR]

We conducted a study to analyze and report on indicators of hematopoietic cell transplant (HCT) physician time use and HCT center output measures. HCT centers in Australia and New Zealand (A&NZ) were invited to provide demographic and time use details for physicians participating in HCT patient care (HCT physicians). Resource details for adult and pediatric centers were included. From a total of 46 centers that were invited to participate, completed data were received from 37 centers (80%) representing 185 HCT physicians, with a median age of 48 (range, 33 to 72), of whom 31% were women. Just over half of HCT physicians cited prior work experience in large overseas HCT centers (97, 52%) and over one-third (79, 43%) possessed postgraduate qualifications other than specialist training. Total annual mean HCTs per HCT physician full-time equivalent (FTE) were 14.2 for centers performing both allogeneic and autologous HCT, 6.6 for autologous only centers, and 10.6 for all centers. For all HCT physicians surveyed the mean proportion of time spent on HCT related tasks was 31.7%. In A&NZ, for centers that perform both allografts and autografts, there was a mean of 4.0 allogeneic HCT annually per HCT bed, compared with 2.6 for the United States and 7.1 allogeneic HCT annually per HCT physician FTE (United States, 6.3). Projections of the A&NZ HCT physician workforce indicated that the numbers of HCT physicians are likely to stay within the region of 170 to 190 for the next 10 years, whereas HCT activity will likely continue to climb steadily. Healthcare and government authorities should be prepared to enable and support greater HCT activity in A&NZ in the future. [ABSTRACT FROM AUTHOR]