Background and objectives Phlebotomy is a central task for blood donation; however, not all blood donors have veins that are easy to see or feel. This study aimed to determine whether use of a surgical skin marker to highlight the donors’ vein location and direction prior to venepuncture increased blood donation success. Methods All blood donors who participated in this study were eligible to donate according to Australian guidelines. Ten donor centres with phlebotomy success rates <95% were selected. A randomized cluster trial design assigned five sites to test the skin marking device and five sites as controls. Single‐use sterile Gentian violet skin marker pens were used to mark donors’ veins. Phlebotomy site skin bacterial load after using the skin marking device was tested on a subset of 100 donors. Phlebotomy success rates and donor adverse events were recorded. Results Of the control donors, 6993 had successful phlebotomies and 225 failed. Of the skin marker donors, 6998 had successful phlebotomies and 248 failed. No statistically significant differences in phlebotomy success were found between the two groups (OR: 0·91, 96·4% CI [96·0, 96·8], P ‐value 0·348). Conclusion The use of skin marker pens did not increase overall phlebotomy success rate. There was no increase in phlebotomy site skin bacterial load, and amendments to standard skin disinfection techniques were not required. Blood donors were not concerned about the pen mark on their arms. Generally, staff indicated that the markers may be valuable to assist with phlebotomies for donors with difficult or deep veins.

Background and ObjectivesOur aim is to present the recent Australian experience in trying to optimise collections from our apheresis program to meet the challenge of increasing demand for intravenous immunoglobulin. This is against a background of decreasing red cell demand, resulting in less recovered plasma from whole blood.Materials and MethodsWe extracted data from our donor and product databases and from targeted internal studies and audits. Data was analysed to determine the effects of donor factors, changes in collection processes and other interventions on the plasma volume, plasma quality, donor safety and donor return rates.ResultsVasovagal reactions remain a key adverse reaction in apheresis with implications not only for donor safety but also for donor return and therefore supply. Many factors influence reaction rates including donor selection and the details of the apheresis procedure. Other apheresis related complications include citrate reactions, iron deficiency and potentially bone health in long‐term donors. Changes in collection procedures can also affect product quality, which may negate benefits of increasing volume. Another key to maintaining supply is to optimise the frequency of donor visits, a major challenge in the non‐remunerated donor setting.ConclusionIn a time of increasing demand it is important to optimise immunoglobulin yield by retaining donors, increasing visit frequency and maximising volumes from each visit, whilst carefully balancing the risk of adverse reactions. Interventions must be assessed in terms of donor safety and also product yield. Both must be optimised if sustainability of plasma supply is to be achieved.

We established a subcohort of HIV‐positive individuals from 10 sexual health clinics within the Australian HIV Observational Database (AHOD). The aim of this study was to assess demographic and other factors that might be associated with an incident sexually transmitted infection (STI).

ObjectivesThe proportion of people living with HIV/AIDS in the ageing population (> 50 years old) is increasing. We aimed to explore the relationship between older age and treatment outcomes in HIV‐positive persons from the Asia Pacific region.MethodsPatients from the Australian HIV Observational Database (AHOD) and the TREAT Asia HIV Observational Database (TAHOD) were included in the analysis. We used survival methods to assess the association between older age and all‐cause mortality, as well as time to treatment modification. We used regression analyses to evaluate changes in CD4 counts after combination antiretroviral therapy (cART) initiation and determined the odds of detectable viral load, up to 24 months of treatment.ResultsA total of 7142 patients were included in these analyses (60% in TAHOD and 40% in AHOD), of whom 25% were > 50 years old. In multivariable analyses, those aged > 50 years were at least twice as likely to die as those aged 30–39 years [hazard ratio (HR) for 50–59 years: 2.27; 95% confidence interval (CI) 1.34–3.83; HR for > 60 years: 4.28; 95% CI 2.42–7.55]. The effect of older age on CD4 count changes was insignificant (p‐trend = 0.06). The odds of detectable viral load after cART initiation decreased with age (p‐trend = < 0.0001). The effect of older age on time to first treatment modification was insignificant (p‐trend = 0.21). We found no statistically significant differences in outcomes between AHOD and TAHOD participants for all endpoints examined.ConclusionsThe associations between older age and typical patient outcomes in HIV‐positive patients from the Asia Pacific region are similar in AHOD and TAHOD. Our data indicate that ‘age effects’ traverse the resource‐rich and resource‐limited divide and that future ageing‐related findings might be applicable to each setting.

ObjectivesThe aim of this study was to describe the long‐term changes in CD4 cell counts beyond 5 years of combination antiretroviral therapy (cART). If natural ageing leads to a long‐term decline in the immune system via low‐grade chronic immune activation/inflammation, then one might expect to see a greater or earlier decline in CD4 counts in older HIV‐positive patients with increasing duration of cART.MethodsRetrospective and prospective data were examined from long‐term virologically stable HIV‐positive adults from the Australian HIV Observational Database. We estimated mean CD4 cell count changes following the completion of 5 years of cART using linear mixed models.ResultsA total of 37 916 CD4 measurements were observed for 892 patients over a combined total of 9753 patient‐years. Older patients (> 50 years old) at cART initiation had estimated mean (95% confidence interval) changes in CD4 counts by year‐5 CD4 count strata (< 500, 500–750 and > 750 cells/μL) of 14 (7 to 21), 3 (–5 to 11) and –6 (–17 to 4) cells/μL/year. Of the CD4 cell count rates of change estimated, none were indicative of long‐term declines in CD4 cell counts.ConclusionsOur results suggest that duration of cART and increasing age do not result in decreasing mean changes in CD4 cell counts for long‐term virologically suppressed patients, indicating that the level of immune recovery achieved during the first 5 years of treatment is sustained through long‐term cART.

A portable diagnostic system is under development and construction for use in commissioning the SSCL linac. This system is being used during the construction of the linac, and will be used to commission each section of the accelerator as assembled. The diagnostic system consists of a portable ultra high vacuum system, high speed actuators, high density (128 channel) diagnostic heads, X-ray detectors, and high density VXI 128 channel amplifier arrays. Various innovative designs will be described. These designs led to high density wire spacing, high frequency, wide bandwidth, low cost amplifiers, and compact systems. State of the art manufacturing techniques were employed as a result of the joint interaction between the SSCL and Allied-Signal

Commissioning diagnostics are described in terms of the beam physics requirements of the SSCL linac. Commissioning diagnostics include current monitors, beam position monitors, spectrometer, foil scattering experiment, wire scanners, Faraday cups, and bunch shape monitors. Two DOE integrated contractors, the Superconducting Super Collider Laboratory and Allied Signal, Kansas City Plant, are developing the commissioning diagnostics. The need to measure bright, short linac beam pulses requires special design considerations. High density harps and collectors with up to 50 wires per cm and 128 wires total, and fast, 3.5-MHz amplifiers have been developed. The diagnostics will be first used and tested during beam commissioning of the RFQ

The performance of a coherent OTDR system operating at 1.3 μm is described. Two sources have been used - a Nd:YAG laser and a semiconductor laser with increased coherence. With the latter source, greater than 24 dB one way range has been achieved with accurate determination of fault magnitude.