Sputter sample preparation for ion beam delivery of radium-223 at ATLAS

A radium-223 ion beam was delivered to an experiment from the electron cyclotron resonance ion source, ECR2, at the Argonne Tandem Linac Accelerator System (ATLAS). The radium-223 material was in a nitrate salt form within a vial, prior to being converted to a usable sputter sample. The sputter sample was produced using a new sample preparation method, where the radium nitrate was dissolved into a solution and pipetted onto pressed aluminum powder. This sample was then allowed to dry, distributing the radium-223 material throughout the sputter sample. Ion source operation using the radium sputter sample is described with the operating parameters listed. The intensity and energy requirements for this ion beam were 1 × 106 particles/s and 1.07 GeV, respectively. Because the intensity is relatively low compared to most experiments at ATLAS, previously developed accelerator mass spectrometry methods were used Scott et al. [Rev. Sci. Instrum. 87, 02A732 (2016)] to avoid the need for tuning of the low-intensity beam of interest. Handling of the radium material, as well as loading and unloading of the sputter sample from ECR2, required collaboration with Health Physics. Procedures were used and dry runs were carried out before, during, and after the experiment to ensure the safety of the workers. The processes used and lessons learned are described within.

Excitation function of 54Fe(p,α)51Mn from 9.5 MeV to 18 MeV

Excitation function of the ⁵⁴Fe(p,α)51Mn reaction was measured from 9.5 to 18 MeV E 0 , p + by activating a foil stack of ⁵⁴Fe electrodeposited on copper substrates. Residual radionuclides were quantified by HPGe gamma ray spectrometry. Both ⁵¹Mn (t _1/2 = 46.2 min, 〈 E β + 〉 = 963.7  keV , I β + = 97 % ; E _γ = 749.1 keV, I _γ = 0.265%) and its radioactive daughter, ⁵¹Cr (t _1/2 = 27.704d, E _γ = 320.1 keV, I _γ = 9.91%), were used to indirectly quantify formation of ⁵¹Mn. Results agree within uncertainty to the only other measurement in literature and predictions of default TALYS theoretical code. Final relative uncertainties are within ±12%.

Production, Collection, and Purification of 47Ca for the Generation of 47Sc through Isotope Harvesting at the National Superconducting Cyclotron Laboratory

An experiment was performed at the National Superconducting Cyclotron Laboratory using a 140 MeV/nucleon ⁴⁸Ca beam and a flowing-water target to produce ⁴⁷Ca for the first time with this production route. A production rate of 0.020 ± 0.004 ⁴⁷Ca nuclei per incoming beam particle was measured. An isotope harvesting system attached to the target was used to collect radioactive cationic products, including ⁴⁷Ca, from the water on a cation-exchange resin. The ⁴⁷Ca collected was purified using three separation methods optimized for this work: (1) DGA extraction chromatography resin with HNO₃ and HCl, (2) AG MP-50 cation-exchange resin with an increasing concentration gradient of HCl, and (3) AG MP-50 cation-exchange resin with a methanolic HCl gradient. These methods resulted in ≥99 ± 2% separation yield of ⁴⁷Ca with 100% radionuclidic purity within the limits of detection for HPGe measurements. Inductively coupled plasma-optical emission spectrometry (ICP-OES) was used to identify low levels of stable ions in the water of the isotope harvesting system during the irradiation and in the final purified solution of ⁴⁷Ca. For the first time, this experiment demonstrated the feasibility of the production, collection, and purification of ⁴⁷Ca through isotope harvesting for the generation of ⁴⁷Sc for nuclear medicine applications.

A Place to Live and to Die: A Qualitative Exploration of the Social Practices and Rituals of Death in Residential Aged Care

In many countries, an increasing proportion of deaths occur in residential aged care (RAC) (nursing homes) meaning that these have become both a place to live - a home- and a place to die. This paper reports on death practices and rituals in 49 RAC facilities in Aotearoa/New Zealand narrated in semi-structured interviews with staff. Themes coalesced around 'good death'. Dying alone was not seen as a good death and the demands of trying to prevent this caused tension for staff. Meeting family wishes, post death decision-making, after death practices and rituals, including communicating and remembrance of the death, were explored as part of good death. Overall, death rituals in RAC were limited. Balancing the needs of the living, the dying and the dead created tension. The rituals and practices facilities are currently enacting in death/post-death require attention, since more people will die in RAC with increasingly diverse needs.

Rhenium and iridium targets prepared using a novel graphene loading technique

For accelerator targets, graphene films are an excellent material choice due to their high thermal conductivity, high temperature tolerance, low outgassing, mechanical integrity, and ease of handling. A variety of targets have been produced using graphene material as a backing or a host matrix. One of the unique advantages of the graphene film fabrication process is the capability to embed target materials, including refractory metals, in the nanoparticle form into a host graphene matrix during target preparation. Targets of natIr and natRe have been fabricated as nanoparticle loaded graphene targets for use in nuclear physics research. We have obtained beam time to evaluate target performance as well as production yields and nuclear decay properties via the natRe(a,2n)186Ir and natIr(a,3n)194Au reactions, respectively. These rhenium and iridium targets will be irradiated using the ATLAS accelerator and gamma rays measured in-place using the high-precision gamma-ray spectroscopy capabilities of Gammasphere and further analyzed using a multi-parameter detector system. Future plans include the preparation of isotopic targets of these two elements.

The Argonne Target Library

As part of the proposal to DOE-NP for the Center for Accelerator Target Science (CATS) initiative, one of the objectives was to develop an inventory of existing targets that will serve as a pool available to the community. Targets collections have been recovered from Yale University due to the closing of their Tandem Accelerator Facility. In addition, accumulated targets from target preparation in the Physics Division over several decades have also been assembled with the intent of providing them to whomever would have a use for them. Space has now become available to compile, catalogue and house these collections. Thus, the Argonne Target Library has been established and its progress and outlook will be discussed in detail.

Second generation degrader foil for the CARIBU project

The Californium Rare Ion Breeder Upgrade (CARIBU) project utilizes 252Cf to provide beams of neutron-rich nuclides with intensities not currently available at other facilities. The electroplated 252Cf source is positioned inside a large helium gas catcher, where the ejected fission fragments lose their energy and are slowed. Prior to entering this gas catcher, the ions first pass through a gold cover foil to contain self-sputtering recoil emissions and then through an aluminium degrader foil, where much of their residual energy is reduced. In the past due to production limitations, a less than ideal cylindrical shaped degrader was utilized. This resulted in non-uniform energy loss as the ions passed through the degrader. With the advent of 3D printing, a new hemispherical degrader was prepared to enable a more uniform energy loss. The design, production, and assembly will be discussed.

Method development for producing thin 14C foils

Thin, isotopic 14C foils are of great interest to the nuclear physics community as neutron-rich targets. Historically, these foils have been extremely difficult to prepare and an effort is underway to make them readily available. The stock material of 14C available at Argonne contains a number of oxide impurities (SiO2, MgO, and Al2O3), which affect the composition and stability of the fabricated foil. A simple, robust method was developed (using natC as a surrogate) to purify the 14C material while minimizing loss and potential spread of the material. Thin foils were fabricated using the purified carbon, the unpurified carbon/oxide mix, and purchased high-purity carbon powder. SEM and EDS of the resulting foils was performed and the efficacy of this purification method was demonstrated.

A 224Ra-labeled polyoxopalladate as a putative radiopharmaceutical

Despite their attractive properties, internal targeted alpha therapies using 223/224Ra are limited to bone-seeking applications. As there is no suitable chelator available, the search for new carriers to stably bind Ra2+ and to connect it to biological target molecules is necessary. Polyoxopalladates represent a class of compounds where Ra2+ can be easily introduced into the Pd-POM core during a facile one-pot preparation. Due to the formation of a protein corona, the connection to other targeting (bio)macromolecules is possible.

Correction: Synthesis, dynamic NMR characterization and XRD studies of novel N,N'-substituted piperazines for bioorthogonal labeling

[This corrects the article DOI: 10.3762/bjoc.12.242.].

Synthesis, dynamic NMR characterization and XRD studies of novel N,N'-substituted piperazines for bioorthogonal labeling

Novel, functionalized piperazine derivatives were successfully synthesized and fully characterized by ¹H/¹³C/¹⁹F NMR, MS, elemental analysis and lipophilicity. All piperazine compounds occur as conformers resulting from the partial amide double bond. Furthermore, a second conformational shape was observed for all nitro derivatives due to the limited change of the piperazine chair conformation. Therefore, two coalescence points were determined and their resulting activation energy barriers were calculated using ¹H NMR. To support this result, single crystals of 1-(4-nitrobenzoyl)piperazine (3a, monoclinic, space group C2/c, a = 24.587(2), b = 7.0726(6), c = 14.171(1) Å, β = 119.257(8)°, V = 2149.9(4) ų, Z = 4, D_obs = 1.454 g/cm³) and the alkyne derivative 4-(but-3-yn-1-yl)-1-(4-fluorobenzoyl)piperazine (4b, monoclinic, space group P2₁/n, a = 10.5982(2), b = 8.4705(1), c = 14.8929(3) Å, β = 97.430(1)°, V = 1325.74(4) ų, Z = 4, D_obs = 1.304 g/cm³) were obtained from a saturated ethyl acetate solution. The rotational conformation of these compounds was also verified by XRD. As proof of concept for future labeling purposes, both nitropiperazines were reacted with [¹⁸F]F^–. To test the applicability of these compounds as possible ¹⁸F-building blocks, two biomolecules were modified and chosen for conjugation either using the Huisgen-click reaction or the traceless Staudinger ligation.

The Radiochemical and Radiopharmaceutical Applications of Radium

This review focuses on the chemistry and application of radium isotopes to environmental monitoring, analytical, and medicinal uses. In recent years, radium has been used primarily as a tracer to study the migration of radioactive substances in environmental systems. Tracing the naturally occurring radium isotopes in mineral and water sources allows for the determination of source location, residence time, and concentrations. An understanding of the concentration of radionuclides in our food and water sources is essential to everyone’s health as alpha particle decay is highly damaging in vivo. Due to this high radiobiological effectiveness, there is increased interest in using alpha-emitting radionuclides to prepare new, therapeutic radiopharmaceutical drugs. Selected studies from the recent literature are provided as examples of these modern applications of radium isotopes.

Transitions to palliative care for older people in acute hospitals: a mixed-methods study

Background

Improving the provision of palliative and end-of-life care is a priority for the NHS. Ensuring an appropriately managed ‘transition’ to a palliative approach for care when patients are likely to be entering the last year of life is central to current policy. Acute hospitals represent a significant site of palliative care delivery and specific guidance has been published regarding the management of palliative care transitions within this setting.

Aims

(1) to explore how transitions to a palliative care approach are managed and experienced in acute hospitals and to identify best practice from the perspective of clinicians and service users; (2) to examine the extent of potentially avoidable hospital admissions amongst hospital inpatients with palliative care needs.

Design

A mixed-methods design was adopted in two hospitals in England, serving diverse patient populations. Methods included (1) two systematic reviews; (2) focus groups and interviews with 58 health-care professionals to explore barriers to, and facilitators of, palliative care transitions in hospital; (3) a hospital inpatient survey examining palliative care needs and aspects of management including a self-/proxy-completed questionnaire, a survey of medical and nursing staff and a case note review; (4) in-depth interviews with 15 patients with palliative care needs; (5) a retrospective case note review of all inpatients present in the hospital at the time of the survey who had died within the subsequent 12 months; and (6) focus groups with 83 key decision-makers to explore the implications of the findings for service delivery and policy.

Results

Of the 514 patients in the inpatient survey sample, just over one-third (n = 185, 36.0%) met one or more of the Gold Standards Framework (GSF) prognostic indicator criteria for palliative care needs. The most common GSF prognostic indicator was frailty, with almost one-third of patients (27%) meeting this criteria. Agreement between medical and nursing staff and the GSF with respect to identifying patients with palliative care needs was poor. In focus groups, health professionals reported difficulties in recognising that a patient had entered the last 12 months of life. In-depth interviews with patients found that many of those interviewed were unaware of their prognosis and showed little insight into what they could expect from the trajectory of their disease. The retrospective case note review found that 35 (7.2%) admissions were potentially avoidable. The potential annual cost saving across both hospitals of preventing these admissions was approximately £5.3M. However, a 2- or 3-day reduction in length of stay for these admissions would result in an annual cost saving of £21.6M or £32.4M respectively.

Conclusions

Patients with palliative care needs represent a significant proportion of the hospital inpatient population. There is a significant gap between NHS policy regarding palliative and end-of-life care management in acute hospitals in England and current practice.

Funding

The National Institute for Health Research Health Services and Delivery Research programme.

Perceived risks around choice and decision making at end-of-life: a literature review

BACKGROUND

the World Health Organization identifies meeting patient choice for care as central to effective palliative care delivery. Little is known about how choice, which implies an objective balancing of options and risks, is understood and enacted through decision making at end-of-life.

AIM

to explore how perceptions of 'risk' may inform decision-making processes at end-of-life.

DESIGN

an integrative literature review was conducted between January and February 2010. Papers were reviewed using Hawker et al.'s criteria and evaluated according to clarity of methods, analysis and evidence of ethical consideration. All literature was retained as background data, but given the significant international heterogeneity the final analysis specifically focused on the UK context.

DATA SOURCE

the databases Medline, PsycINFO, Assia, British Nursing Index, High Wire Press and CINAHL were explored using the search terms decision*, risk, anxiety, hospice and palliative care, end-of-life care and publication date of 1998-2010.

RESULTS

thematic analysis of 25 papers suggests that decision making at end-of-life is multifactorial, involving a balancing of risks related to caregiver support; service provider resources; health inequalities and access; challenges to information giving; and perceptions of self-identity. Overall there is a dissonance in understandings of choice and decision making between service providers and service users.

CONCLUSION

the concept of risk acknowledges the factors that shape and constrain end-of-life choices. Recognition of perceived risks as a central factor in decision making would be of value in acknowledging and supporting meaningful decision making processes for patients with palliative care needs and their families.

Barriers to advance care planning in chronic obstructive pulmonary disease

The English End of Life Care Strategy promises that all patients with advanced, life limiting illness will have the opportunity to participate in Advance Care Planning (ACP). For patients with Chronic Obstructive Pulmonary Disease (COPD), the barriers to this being achieved in practice are under-explored. Five focus groups were held with a total of 39 health care professionals involved in the care of patients with COPD. Participants reported that discussions relating to ACP are very rarely initiated with patients with COPD and identified the following barriers: inadequate information provision about the likely course of COPD at diagnosis; lack of consensus regarding who should initiate ACP and in which setting; connotations of comparing COPD with cancer; ACP discussions conflicting with goals of chronic disease management; and a lack of understanding of the meaning of 'end of life' within the context of COPD. The findings from this study indicate that, for patients with COPD, significant service improvement is needed before the objective of the End of Life Care Strategy regarding patient participation in end of life decision-making is to be achieved. Whilst the findings support the Strategy's recommendations regarding an urgent for both professional education and increased public education about end of life issues, they also indicate that these alone will not be enough to effect the level of change required. Consideration also needs to be given to the integration of chronic disease management and end of life care and to developing definitions of end of life care that fit with concepts of 'continuous palliation'.

Older people's views of a good death in heart failure: implications for palliative care provision

Palliative care in the UK has been developed to meet the needs of predominantly middle aged and younger old people with cancer. Few data are available regarding the extent to which services respond to the specific needs of an older group of people with other illnesses. This paper draws on in-depth interviews conducted with 40 people (median age 77) with advanced heart failure and poor prognosis to explore the extent to which older people's views and concerns about dying are consistent with the prevalent model of the 'good death' underpinning palliative care delivery. That prevalent model is identified as the "revivalist" good death. Our findings indicate that older people's views of a 'good death' often conflict with the values upon which palliative care is predicated. For example, in line with previous research, many participants did not want an open awareness of death preceded by acknowledgement of the potential imminence of dying. Similarly, concepts of autonomy and individuality appeared alien to most. Indeed, whilst there was evidence that palliative care could help improve the end of life experiences of older people, for example in initiating discussions around death and dying, the translation of other aspects of specialist palliative care philosophy appear more problematic. Ultimately, the study identified that improving the end of life experiences of older people must involve addressing the problematised nature of ageing and old age within contemporary society, whilst recognising the cohort and cultural effects that influence attitudes to death and dying.

Elderly patients compliance and elderly patients and health professional's, views, and attitudes towards prescribed sip- feed supplements

BACKGROUND

Although nutritional supplements are widely prescribed in hospital and community settings compliance with supplements and factors affecting compliance are not well understood.

AIMS

The aims of this study were therefore to examine compliance, factors that influence compliance, views and attitudes of elderly patients and their health professionals on prescribed oral nutritional supplements.

METHODS

Forty medically stable hospitalised elderly patients prescribed nutritional supplements by a hospital dietician after nutritional screening had their compliance with supplement intake measured. Sixteen patients prescribed nutritional supplements and their health professionals had their views and attitudes on the factors that influence compliance with supplements intake explored using qualitative face-to- face interviews and postal questionnaires respectively. Qualitative data analysis adhered to the principles of grounded theory and followed the 'Framework' approach. Quantitative data were entered on to a standard spreadsheet and simple descriptive statistics was examined.

RESULTS

A total of 40 hospitalised elderly patient (Age range 60-91 yrs; mean age 78 years; 20 female); 24 doctors, 13 dietician and 33 nurses were recruited. The main finding of this study was that compliance with prescribed nutritional supplements was low in hospital and in the community. Only 43% of the study population consumed more than 80% of the prescribed amount. Factors that affected compliance included flavour, taste, texture and predictability of the supplements as well as personal preferences and life style. Health professionals dealing with elderly patients have wide-range and different views on the criteria used to prescribe nutritional supplements and factors affecting their subsequent intake.

CONCLUSION

Compliance with prescribed nutritional supplements was low in hospital and in the community. Elderly patients and their health professionals have wide-range and different views on factors that influence compliance with nutritional supplements.

Correlation of hyperforin content of Hypericum perforatum (St John's Wort) extracts with their effects on alcohol drinking in C57BL/6J mice: a preliminary study

Extracts of the herb St John's Wort have been shown to reduce alcohol intake in alcohol-preferring rats, but it is not known which of the constituent(s) are responsible for this effect. In this study, the effect of a crude methanolic extract of Hypericum perforatum (negligible hyperforin content) on alcohol drinking in C57BL/6J alcohol-preferring mice was compared with that of a hyperforin-rich extract (45% hyperforin) prepared by extracting the herb with supercritical carbon dioxide. The dose of the hyperforin-rich extract required to significantly reduce 10% ethanol intake (5 mg/kg) was 125-fold less than that required for the crude extract (625 mg/kg), and was comparable to the dose of fluoxetine (10 mg/kg) required to produce a similar effect. None of these agents significantly affected water intake. These results suggest that the effects of H. perforatum extracts on alcohol drinking behaviour are due to the hyperforin content of the herb rather than to other, more polar constituents. Hyperforin is an unstable compound and this study also highlights the effect of different methods of extract preparation on hyperforin content.

The Evolutionary History and Diversity of Australian Mammals

Palaeodiversity and relationships of all groups of Australian mammals are reviewed. The fossil record spanning this time is of variable quality. 'Dark Ages' about which nothing is known in terms of Australian mammal evolution include the late Triassic to late Jurassic, late Cretaceous to late Paleocene and middle Eocene to middle Oligocene. Very little is known about the early Cretaceous and late Miocene. The late Oligocene to middle Miocene record documents the highest levels of biodiversity known for the continent, comparable to that which characterises the lowland rainforests of Borneo and Brazil. Order Monotremata spans at least the last 110 million years and includes four families. The enigmatic Ausktribosphenos from 115 million-year-old sediments in Victoria may represent an archaic monotreme, specialised peramurid or previously undocumented order of mammals but is unlikely to represent a placental as suggested in the initial description. Order Microbiotheria is represented in the early Eocene (~55 mya) by two genera similar in morphology to early Eocene taxa from Argentina. Order Peramelemorphia spans the early Eocene to Holocene and includes at least five families. Order Dasyuromorphia spans at least the late Oligocene to Holocene and includes at least three families. Other dasyuromorphian-like marsupials are indeterminate in terms of family-level affinities. Order Notoryctemorphia spans the early Miocene to Holocene with one family. Order Yalkaparidontia spans the late Oligocene to middle Miocene with one genus. Order Diprotodontia spans the late Oligocene to Holocene, represented throughout by three major groups: Phalangerida (eight families), Vombatomorphia (seven families) and Macropodoidea (at least three families). A possible placental condylarth (Tingamarra) has been recorded from the early Eocene. An archaeonycteridid bat (Australonycteris) is known from the early Eocene. Among bats, the late Oligocene to middle Miocene is dominated by rhinolophoids, many of which have European, Asian and African affinities. Mystacinids, megadermatids, hipposiderids and molossids are well-represented in the Oligocene to Miocene deposits. Vespertilionids are uncommon in the Oligocene to Miocene but become more diverse in the Pliocene to Holocene. Emballonurids and rhinolophids appear for the first time in the Plio-Pleistocene. Pteropodids are unknown prior to the Holocene. Murids span the early Pliocene to Holocene. In the oldest assemblage at Riversleigh, one undescribed lineage resembles archaic forms otherwise only known from the fossil records of Africa and Eurasia.

Doctoral education in nursing for practitioner knowledge and for academic knowledge: the University of Adelaide, Australia

Australian nursing has undergone rapid academization in the past 10 years and this radical change has tended to meld the somewhat different academic traditions of North America and Britain. The introduction of doctoral education in nursing in 1987 has led to a massive increase in scholarly activity and to the preparation of talented leaders. We concur with the view expressed by Henry (1997), "I am convinced that the problems we face in the nursing services would be much more creatively solved if the majority of our doctoral programs prepared young, energetic nurses, early in their career, for clinical practice, not for research and teaching" (p. 162).

The quality of community nursing services: report of an exploratory study in a UK health authority

Describes a study of three community nursing services provided by North Staffordshire Health Authority, which was carried out during the summer of 1991. Both the type and focus of quality measurement reported here are fairly unique. While the development of quality measures is yet at an early stage, most measures to date are quantitative. These can inform about volume of use of a service, but not its quality. The measures designed for this study were qualitative. These, when combined with quantitative data (statistics, routinely collected), yield much richer and more complete information as a basis for decision making in service planning. Quality data on the use of community services are also under-represented in the quality literature--most studies to date have used hospital patient services as their source for data collection. Goes some way towards redressing the imbalance.