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Compulsory admission procedures of patients with mental disorders vary between countries in Europe. The Ethics Committee of the European Psychiatric Association (EPA) launched a survey on involuntary admission procedures of patients with mental disorders in 40 countries to gather information from all National Psychiatric Associations that are members of the EPA to develop recommendations for improving involuntary admission processes and promote voluntary care.
The survey focused on legislation of involuntary admissions and key actors involved in the admission procedure as well as most common reasons for involuntary admissions.
We analyzed the survey categorical data in themes, which highlight that both medical and legal actors are involved in involuntary admission procedures.
We conclude that legal reasons for compulsory admission should be reworded in order to remove stigmatization of the patient, that raising awareness about involuntary admission procedures and patient rights with both patients and family advocacy groups is paramount, that communication about procedures should be widely available in lay-language for the general population, and that training sessions and guidance should be available for legal and medical practitioners. Finally, people working in the field need to be constantly aware about the ethical challenges surrounding compulsory admissions.
Selenium (Se) is an essential element for human health. However, our knowledge of the prevalence of Se deficiency is less than for other micronutrients of public health concern such as iodine, iron and zinc, especially in sub-Saharan Africa (SSA). Studies of food systems in SSA, in particular in Malawi, have revealed that human Se deficiency risks are widespread and influenced strongly by geography. Direct evidence of Se deficiency risks includes nationally representative data of Se concentrations in blood plasma and urine as population biomarkers of Se status. Long-range geospatial variation in Se deficiency risks has been linked to soil characteristics and their effects on the Se concentration of food crops. Selenium deficiency risks are also linked to socio-economic status including access to animal source foods. This review highlights the need for geospatially-resolved data on the movement of Se and other micronutrients in food systems which span agriculture–nutrition–health disciplinary domains (defined as a GeoNutrition approach). Given that similar drivers of deficiency risks for Se, and other micronutrients, are likely to occur in other countries in SSA and elsewhere, micronutrient surveillance programmes should be designed accordingly.
The fate of a contracting liquid filament depends on the Ohnesorge number (
), the initial aspect ratio (
) and surface perturbation. Generally, it is believed that there exists a critical aspect ratio
such that longer filaments break up and shorter ones recoil into a single drop. Through computational and experimental studies, we report a transitional regime for filaments with a broad range of intermediate aspect ratios, where there exist multiple
thresholds at which a novel breakup mode alternates with no-break mode. We develop a simple model considering the superposition of capillary waves, which can predict the complicated new phase diagram. In this model, the breakup results from constructive interference between the capillary waves that originate from the ends of the filament.
Accurate models of X-ray absorption and re-emission in partly stripped ions are necessary to calculate the structure of stars, the performance of hohlraums for inertial confinement fusion and many other systems in high-energy-density plasma physics. Despite theoretical progress, a persistent discrepancy exists with recent experiments at the Sandia Z facility studying iron in conditions characteristic of the solar radiative–convective transition region. The increased iron opacity measured at Z could help resolve a longstanding issue with the standard solar model, but requires a radical departure for opacity theory. To replicate the Z measurements, an opacity experiment has been designed for the National Facility (NIF). The design uses established techniques scaled to NIF. A laser-heated hohlraum will produce X-ray-heated uniform iron plasmas in local thermodynamic equilibrium (LTE) at temperatures
eV and electron densities
. The iron will be probed using continuum X-rays emitted in a
diameter source from a 2 mm diameter polystyrene (CH) capsule implosion. In this design,
of the NIF beams deliver 500 kJ to the
mm diameter hohlraum, and the remaining
directly drive the CH capsule with 200 kJ. Calculations indicate this capsule backlighter should outshine the iron sample, delivering a point-projection transmission opacity measurement to a time-integrated X-ray spectrometer viewing down the hohlraum axis. Preliminary experiments to develop the backlighter and hohlraum are underway, informing simulated measurements to guide the final design.
Studies have demonstrated that the effects of two well-known predictors of adolescent substance use, family monitoring and antisocial peers, are not static but change over the course of adolescence. Moreover, these effects may differ for different groups of youth. The current study uses time-varying effect modeling to examine the changes in the association between family monitoring and antisocial peers and marijuana use from ages 11 to 19, and to compare these associations by gender and levels of behavioral disinhibition. Data are drawn from the Raising Healthy Children study, a longitudinal panel of 1,040 youth. The strength of association between family monitoring and antisocial peers and marijuana use was mostly steady over adolescence, and was greater for girls than for boys. Differences in the strength of the association were also evident by levels of behavioral disinhibition: youth with lower levels of disinhibition were more susceptible to the influence of parents and peers. Stronger influence of family monitoring on girls and less disinhibited youth was most evident in middle adolescence, whereas the stronger effect of antisocial peers was significant during middle and late adolescence. Implications for the timing and targeting of marijuana preventive interventions are discussed.
To aid in preparation of military medic trainers for a possible new curriculum in teaching junctional tourniquet use, the investigators studied the time to control hemorrhage and blood volume lost in order to provide evidence for ease of use.
Models of junctional tourniquet could perform differentially by blood loss, time to hemostasis, and user preference.
In a laboratory experiment, 30 users controlled simulated hemorrhage from a manikin (Combat Ready Clamp [CRoC] Trainer) with three iterations each of three junctional tourniquets. There were 270 tests which included hemorrhage control (yes/no), time to hemostasis, and blood volume lost. Users also subjectively ranked tourniquet performance. Models included CRoC, Junctional Emergency Treatment Tool (JETT), and SAM Junctional Tourniquet (SJT). Time to hemostasis and total blood loss were log-transformed and analyzed using a mixed model analysis of variance (ANOVA) with the users represented as random effects and the tourniquet model used as the treatment effect. Preference scores were analyzed with ANOVA, and Tukey’s honest significant difference test was used for all post-hoc pairwise comparisons.
All tourniquet uses were 100% effective for hemorrhage control. For blood loss, CRoC and SJT performed best with least blood loss and were significantly better than JETT; in pairwise comparison, CRoC-JETT (P < .0001) and SJT-JETT (P = .0085) were statistically significant in their mean difference, while CRoC-SJT (P = .35) was not. For time to hemostasis in pairwise comparison, the CRoC had a significantly shorter time compared to JETT and SJT (P < .0001, both comparisons); SJT-JETT was also significant (P = .0087). In responding to the directive, “Rank the performance of the models from best to worst,” users did not prefer junctional tourniquet models differently (P > .5, all models).
The CRoC and SJT performed best in having least blood loss, CRoC performed best in having least time to hemostasis, and users did not differ in preference of model. Models of junctional tourniquet performed differentially by blood loss and time to hemostasis.
KraghJFJr, LunatiMP, KharodCU, CunninghamCW, BaileyJA, StockingerZT, CapAP, ChenJ, AdenJK3d, CancioLC. Assessment of Groin Application of Junctional Tourniquets in a Manikin Model. Prehosp Disaster Med. 2016;31(4):358–363.
PILOT (the Pathfinder for an International Large Optical Telescope) is a proposed 2.5-m optical/infrared telescope to be located at Dome C on the Antarctic plateau. Conditions at Dome C are known to be exceptional for astronomy. The seeing (above ∼30 m height), coherence time, and isoplanatic angle are all twice as good as at typical mid-latitude sites, while the water-vapour column, and the atmosphere and telescope thermal emission are all an order of magnitude better. These conditions enable a unique scientific capability for PILOT, which is addressed in this series of papers. The current paper presents an overview of the optical and instrumentation suite for PILOT and its expected performance, a summary of the key science goals and observational approach for the facility, a discussion of the synergies between the science goals for PILOT and other telescopes, and a discussion of the future of Antarctic astronomy. Paper II and Paper III present details of the science projects divided, respectively, between the distant Universe (i.e. studies of first light, and the assembly and evolution of structure) and the nearby Universe (i.e. studies of Local Group galaxies, the Milky Way, and the Solar System).
A survey of the Milky Way disk and the Magellanic System at the wavelengths of the 21-cm atomic hydrogen (H i) line and three 18-cm lines of the OH molecule will be carried out with the Australian Square Kilometre Array Pathfinder telescope. The survey will study the distribution of H i emission and absorption with unprecedented angular and velocity resolution, as well as molecular line thermal emission, absorption, and maser lines. The area to be covered includes the Galactic plane (|b| < 10°) at all declinations south of δ = +40°, spanning longitudes 167° through 360°to 79° at b = 0°, plus the entire area of the Magellanic Stream and Clouds, a total of 13 020 deg2. The brightness temperature sensitivity will be very good, typically σT≃ 1 K at resolution 30 arcsec and 1 km s−1. The survey has a wide spectrum of scientific goals, from studies of galaxy evolution to star formation, with particular contributions to understanding stellar wind kinematics, the thermal phases of the interstellar medium, the interaction between gas in the disk and halo, and the dynamical and thermal states of gas at various positions along the Magellanic Stream.
F. P. Bailey, Assistant Professor, Department of Obstetrics and Gynecology Tufts University School of Medicine Boston,
Heather Z. Sankey, Assistant Professor, Department of Obstetrics and Gynecology Tufts University School of Medicine Boston
This chapter reviews the history and epidemiology of modern pregnancy termination. In this review, the surgical and medical techniques appropriate for various gestational ages are presented, potential complications are considered, and the psychological issues surrounding abortion are discussed. Most women requesting termination of pregnancy are self-referred. Physicians who care for pregnant patients should assess the patient's attitudes toward the gestation at the time of the first prenatal visit. The initial assessment of gestational age is based on the last reported menstrual period and the physical examination. The method chosen for pregnancy termination depends on the period of gestation, the experience and preference of the operator, and the extent to which safe options are available that fit the patient's desires. The most common operative complication of pregnancy termination is uterine perforation. Failure to interrupt an intrauterine pregnancy occurs in less than 0.5 percent of suction-curettage patients.
The failure of glyphosate to control all weeds throughout the entire growing season has sometimes prompted growers to use herbicides other than glyphosate on glyphosate-resistant soybean. Field studies were conducted in 1999 and 2000 to investigate potential crop injury by several herbicides in glyphosate-resistant soybean and to determine the relationships between soybean maturity group, planting date, and herbicide treatment on soybean injury, leaf area index (LAI), and yield. Glyphosate-resistant soybean generally recovered from early-season herbicide injury and LAI reductions; however, some treatments reduced yield. Yield reductions were more common in double-crop soybean than in full-season soybean. In full-season soybean, most yield reductions occurred in the early-maturing ‘RT-386’ cultivar. These yield reductions may be attributed to reduced developmental periods associated with early-maturing cultivars and double-crop soybean that often lead to reduced vegetative growth and limited LAI. Reductions in LAI by some herbicide treatments were not necessarily indicative of yield loss. Further yield reductions associated with herbicide applications occurred, although soybean sometimes produced leaf area exceeding the critical LAI level of 3.5 to 4.0, which is the minimum LAI needed for soybean to achieve maximum yield. Therefore, LAI response to herbicide treatments does not always accurately indicate the response of glyphosate-resistant soybean yield to herbicides.
The ability to determine the in-situ optoelectronic behavior of semiconductor materials has become especially important as the size of device architectures is reduced and the development of complex microsystems has increased. Scanning Tunneling Optical Resonance Microscopy or STORM has the ability to interrogate the optical bandgap as a function of position within a semiconductor microstructure. This technique uses a tunable solid-state Ti sapphire laser whose output is “chopped” using a spatial light modulator and is coupled by a fiber optic to a scanning tunneling microscope in order to illuminate the tip-sample junction. The photoenhanced portion of the tunneling current is spectroscopically measured using a lock-in technique. The capabilities of this technique were verified using semiconductor microstructure calibration standards that were grown by organometallic vapor phase epitaxy (OMVPE) at the NASA Glenn Research Center. Bandgaps characterized by STORM measurements were found to be in good agreement with the bulk values determined by transmission spectroscopy, photoluminescence, and with the theoretical values that were based on x-ray diffraction results.
Experimental conditions and setting up of an electron microprobe is directly linked to the assumption or the knowledge that can make the operator on the results of the measurements. Consequently, there is an increasing interest in modelling the X-ray spectrum in order to predict accurately and rapidly the response of the microprobe when a sample of approximately known composition is submitted to specific excitation conditions. Even if the spectra simulation is a current tool proposed in EDS, it always remains a challenge to create a complete absolute WDS spectrum. Indeed, the definition of the efficiency function was a limit to the calculation of absolute intensities.
In this work, we propose a new generation software for EPMA which uses the absolute simulation spectra to assist the operator in the choices of experimental conditions to achieve accurate measurements in a short time as well as to create new functionalities.
Resolving the true fine structure and behavior of soft bodied organisms such as arthropod larvae, acari, nematodes, annelids and pupae by conventional scanning electron microscopy has been difficult. Classical preparation techniques, involving immersion fixation, dehydration and critical point drying, cause significant deleterious changes in specimen structure due to effects of surface tension, osmotic stress and mechanical damage. The intact exoskeleton, cuticle or other limiting membranes of these organisms, creates a formidable obstacle to the penetration of fixatives and solvents, which are only effective after a long period of time (hours). During this time, behavioral postures and much of the structural integrity are lost and most organisms detach from their hosts.
In previous studies, our laboratory utilized methods in low temperature freeze stabilization, to preserve and observe the undisturbed fine structure of biological samples. Plunge freezing, although more rapid, resulted in many parasitic organisms dislodging from hosts and being lost.
Low temperature scanning electron microscopy (LTSEM) avoids many of the artifacts associated with chemical fixation, dehydration and critical point drying. As a result, this technique has had numerous applications ranging from biology to hydrology. Unfortunately, experiments using LTSEM are frequently compromised by the limited sample manipulations that are available on most cryo-stages and by the cost of specimen holders. Whereas the conventional SEM stage enables 360° rotation and tilts as great as 90°, the braids or hoses required for cooling a cryo-stage generally limit rotation to about 30° and tilt to less than 40° from normal. Furthermore, the specimen holders for LTSEM may cost several hundred dollars each, thereby prohibiting experiments that require numerous holders. This study describes an inexpensive specimen holder that solves these problems.
Figure la illustrates a drawing of the specimen holder supplied with the standard transfer device from the Oxford CT 1500 Cryotrans System.
The properties of ceramic oxides being developed for such varied applications as fuel cells, ionic transporting membranes, high-Tc superconductors, ferroelectrics and varistors are dominated by the presence of grain boundaries. Key to controlling the electronic properties of the grain boundaries in these materials is a fundamental understanding of the complex relationship between structure, composition and local electronic structure. The ability to characterize and directly correlate these parameters on the atomic scale is afforded by the combination of Z-contrast imaging and electron energy loss spectroscopy (EELS) in the scanning transmission electron microscope (STEM). Furthermore, the recent development of in-situ heating capabilities in the JEOL 201 OF STEM/TEM permits atomic resolution analysis to be performed at elevated temperatures and the interactions of grain boundaries with the oxygen vacancies determined.
Figure 1 shows an example of the type of experiment that can be performed using these methods.
Due to their ability to undergo a refractive index change (Δn) induced by appropriate UV irradiation and thermal development, Photo-Thermo-Refractive (PTR) glasses are candidate materials for use in optical applications such as hologram recording, optical data storage, or spectral filters. Although this induced index modulation (Δn) has been characterized in terms of its optical ramifications, glass scientists are working to understand more clearly, the underlying mechanisms associated with the photo-induced crystallization process. For example, the phase, concentration and size of crystals responsible for the induced index change, the diffusion and growth process leading to the resultant optical behavior, and the precise role of the active components of PTR glasses, has yet to be completely elucidated. Numerous techniques have been employed to address these questions and this paper reports results of sample preparation and analysis of PTR glasses using Transmission Electron Microscopy (TEM).
In colossal magnetoresistive (CMR) materials, large changes in physical properties stem from the interplay between charge ordering (CO) coupled with orbital and magnetic orderings. Thus detailed microstructural studies are important in understanding these changes in physical properties. In-situTEM observation is a very useful approach to study CO transitions in these CMR compounds. We have recently studied the CO behavior of the three-dimensional perovskite Nd1/2Sr1+2xMnO3. in this work, we report the CO of two-dimensional naturally layered compounds La2-2xSr1+2xMn2O7 (327 phase), where x is the hole doping level and varies from 0.5 to 0.6 in this work.
Thin foil TEM specimens were prepared from polycrystalline bulk samples by conventional thinning and ion milling method at liquid N2 temperature. The in-situ TEM work was carried out in the Electron Microscopy Center at Argonne National Laboratory using a Philips CM30 with a liquid N2 cold stage, and a Hitachi H-9000 with liquid He cold stage.
A promising aspect of ESI is its application in the detection of elemental labels introduced into biomolecules for cell and molecular biological techniques. Even though colloidal gold labeling for electron microscopy (EM) is highly developed, availability of alternative labels, especially for double or triple labeling applications would be helpful because of difficulties with gold concerning i) detection (gold diameters ≤1nm), ii) discrimination due to gold particle size variations in one size class, and iii) different labeling efficiencies depending on gold granule size. An alternative labeling molecule should contain a high concentration of a specific chemical element which is not or in minor concentrations present in the system under surveillance, and has to have the potential to be discriminated from “biological” elements by ESI.
With respect to ESI, one candidate for elemental labeling is boron. It meets the criteria described above and substantial experience in the synthesis of labeling compounds exists. From the chemical point of view, the preferred labeling structure is a so called dendrimer, a highly branched regular three-dimensional monodisperse macromolecule. Dendritic structures offer a large variety of functionalities to incorporate an element detectable by energy filtering transmission electron microscopy (EFTEM).