Probable pain on the pain assessment in impaired cognition (PAIC15) instrument: assessing sensitivity and specificity of cut-offs against three standards

Observational pain scales can help to identify pain in persons with dementia who may have difficulty expressing pain verbally. The Pain Assessment in Impaired Cognition-15 (PAIC15) covers 15 items that indicate pain, but it is unclear how probable pain is, for each summed score (range 0-45). We aimed to determine sensitivity and specificity of cut-offs for probable pain on the PAIC15 against three standards: (1) self-report when able, (2) the established Pain Assessment in Advanced Dementia (PAINAD) cut-off of 2, and (3) observer's overall estimate based on a series of systematic observations. We used data of 238 nursing home residents with dementia who were observed by their physician in training or nursing staff in the context of an evidence-based medicine (EBM) training study, with re-assessment after 2 months in 137 residents. The area under the ROC curve was excellent against the PAINAD cut-off (>= 0.8) but acceptable or less than acceptable for the other two standards. Across standards and criteria for optimal sensitivity and specificity, PAIC15 scores of 3 and higher represent possible pain for screening in practice, with sensitivity and specificity against self-report in the 0.5 to 0.7 range. While sensitivity for screening in practice may be too low, a cut-off of 4 is reasonable to indicate probable pain in research.Geriatrics in primary carePublic Health and primary car

High power targets for cyclotron production of 99mTc‡

Introduction Technetium-99m, supplied in the form of 99Mo/99mTc generators, is the most widely used radioisotope for nuclear medical imaging. The parent isotope 99Mo is currently produced in nuclear reactors. Recent disruptions in the 99Mo supply chain [1] prompted the development of methods for the direct accelerator-based production of 99mTc. Our approach involves the 100Mo(p,2n)99mTc reaction on isotopically enriched molybdenum using small medical cyclotrons (Ep ≤ 20 MeV), which is a viable method for the production of clinically useful quantities of 99mTc [2]. Multi-Curie production of 99mTc requires a 100Mo target capable of dissipating high beam intensities [3]. We have reported the fabrication of 100Mo targets of both small and large area tar-gets by electrophoretic deposition and subsequent sintering [4]. As part of our efforts to further enhance the performance of molybdenum targets at high beam currents, we have developed a novel target system (initially de-signed for the GE PETtrace cyclotron) based on a pressed and sintered 100Mo plate brazed onto a dispersion-strengthened copper backing. Materials and Methods In the first step, a molybdenum plate is produced similarly to the method described in [5] by compacting approximately 1.5 g of commercially available 100Mo powder using a cylindrical tool of 20 mm diameter. A pressure between 25 kN/cm2 and 250 kN/cm2 is applied by means of a hydraulic press. The pressed molybdenum plate is then sintered in a reducing atmosphere (Ar/2% H2) at 1,700 oC for five hours. The resulting 100Mo plates have about 90–95 % of the molybdenum bulk density. The 100Mo plate is furnace brazed at ~750 oC onto a backing manufactured from a disperse on strengthened copper composite (e.g. Glidcop AL-15) using a high temperature silver-copper brazing filler. This process yields a unique, mechanically and thermally robust target system for high beam power irradiation. Irradiations were performed on the GE PETtrace cyclotrons at LHRI and CPDC with 16.5 MeV protons and beam currents ≥ 100 µA. Targets were visually inspected after a 6 hour, 130 µA bombardment (2.73 kW/cm2, average) and were found fully intact. Up to 4.7 Ci of 99mTc have been produced to date. The saturated production yield remained constant between 2 hour and 6 hour irradiations. Results and Conclusion These results demonstrate that our brazed tar-get assembly can withstand high beam intensities for long irradiations without deterioration. Efforts are currently underway to determine maximum performance parameters

[WORKING DOCUMENT DISCARDED ELECTR(ON)IC (HOUSEHOLD) APPLIANCES.]

Abstract niet beschikbaarThis report provides information on the amount, the composition and the destination of discarded electr(on)ic (household) appliances (in Dutch known as 'wit- en bruingoed'). Electr(on)ic household appliances are divided in 3 main streams, namely: * white goods (dishwasher, washing machine, etc.) * other household appliances (vacuum cleaner, iron, etc.). * brown goods (audio, video and communication equipment). About 95 percent of the discarded electric (household) appliances originate from households, the remaining 5 percent from companies. Based on the penetrationgrade, the average weight and the average life span of specific appliances, an estimation of the discarded amount by households is made for the present (1992) as well as the future (about 2005). The total amount discarded by households between 1992 and approximately 2005 will grow from approximately 117 to 185 kiloton per year.DGM/

[Informative document bulky domestic waste.]

Abstract niet beschikbaarThis "Informative document bulky domestic waste" forms part of a series of "Informative documents waste materials". These documents are conducted by RIVM on the instructions of the Directorate General for the Environment, Directorate Waste Materials, in behalf of the program of action on "prevention and recycling of waste materials". In the documents a survey is given of the main facts and figures on specific waste materials, for example data on sources, amount(s), composition and properties, way of treatment, etc. Besides prognoses of the amount(s) in the year 2000 are made and finally the main options for prevention, recycling and treatment are summarized.DGM/

High power targets for cyclotron production of 99mTc‡

Introduction Technetium-99m, supplied in the form of 99Mo/99mTc generators, is the most widely used radioisotope for nuclear medical imaging. The parent isotope 99Mo is currently produced in nuclear reactors. Recent disruptions in the 99Mo supply chain [1] prompted the development of methods for the direct accelerator-based production of 99mTc. Our approach involves the 100Mo(p,2n)99mTc reaction on isotopically enriched molybdenum using small medical cyclotrons (Ep ≤ 20 MeV), which is a viable method for the production of clinically useful quantities of 99mTc [2]. Multi-Curie production of 99mTc requires a 100Mo target capable of dissipating high beam intensities [3]. We have reported the fabrication of 100Mo targets of both small and large area tar-gets by electrophoretic deposition and subsequent sintering [4]. As part of our efforts to further enhance the performance of molybdenum targets at high beam currents, we have developed a novel target system (initially de-signed for the GE PETtrace cyclotron) based on a pressed and sintered 100Mo plate brazed onto a dispersion-strengthened copper backing. Materials and Methods In the first step, a molybdenum plate is produced similarly to the method described in [5] by compacting approximately 1.5 g of commercially available 100Mo powder using a cylindrical tool of 20 mm diameter. A pressure between 25 kN/cm2 and 250 kN/cm2 is applied by means of a hydraulic press. The pressed molybdenum plate is then sintered in a reducing atmosphere (Ar/2% H2) at 1,700 oC for five hours. The resulting 100Mo plates have about 90–95 % of the molybdenum bulk density. The 100Mo plate is furnace brazed at ~750 oC onto a backing manufactured from a disperse on strengthened copper composite (e.g. Glidcop AL-15) using a high temperature silver-copper brazing filler. This process yields a unique, mechanically and thermally robust target system for high beam power irradiation. Irradiations were performed on the GE PETtrace cyclotrons at LHRI and CPDC with 16.5 MeV protons and beam currents ≥ 100 µA. Targets were visually inspected after a 6 hour, 130 µA bombardment (2.73 kW/cm2, average) and were found fully intact. Up to 4.7 Ci of 99mTc have been produced to date. The saturated production yield remained constant between 2 hour and 6 hour irradiations. Results and Conclusion These results demonstrate that our brazed tar-get assembly can withstand high beam intensities for long irradiations without deterioration. Efforts are currently underway to determine maximum performance parameters

26Al beam production by a solid state laser ion source at TRIUMF

Many experiments carried out at radioactive beam facilities require the production of intense, isotopically clean and isobar free beams of a particular isotope. At TRIUMF the addition of a resonant ionization laser ion source (TRILIS) enables a multitude of new beams and therefore new experiments to be carried out. 26Al was one of the first radioactive ion beams delivered to an experiment using TRILIS. This paper outlines the development of the 26Al ion beam for nuclear astrophysics

Production and Purification of Tc-99m Pertechnetate from Mo-100 Targets Irradiated in a Nirta Solid Target Station on an IBA Cyclone (R) 18 Cyclotron

Direct production of the highly utilized radioisotope 99mTc is a practical approach to self-sufficiency of supply. A TRIUMF-led consortium developed Mo-100 coating technology to manufacture high current targets and demonstrated the routine production and purification of 99mTc. The aim of this work is to implement these processes on an IBA Nirta target station and Synthera® Extension automated synthesis units