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Despite good clinical evidence, depot antipsychotics are only seldom prescribed to patients with first episode schizophrenia. The present study aims at investigating psychiatrists’ reasons for this reservation.
We surveyed 198 psychiatrists on their attitude toward offering depot treatment to first episode patients (FEP). Participants scored the extent of influence of individual factors on their decision on a seven-point-scale, additional data on their prescription practice and estimation of the relapse risk of FEP were collected.
Psychiatrists reported that only three out of 12 factors were of influence. These were the limited availability of different second generation antipsychotic depot drugs, the frequent rejection of the depot offer by the patients and the patients’ skepticism based on the lack in experience of a relapse.
There is actually little specific reason for not prescribing depot to FEP according to the current survey. For those factors being reported to be of influence, psychoeducation, including profound information on depot treatment, the development of additional SGA depot drugs and the standard offer of depot treatment to all FEP in a shared-decision-making may be considered.
Classical Wolf-Rayet stars are evolved, hydrogen depleted massive stars that exhibit strong mass-loss. In theory, these stars can form either by intrinsic mass loss (stellar winds or eruptions), or via mass-removal in binaries. The Wolf-Rayet stars in the Magellanic Clouds are often thought to have originated through binary interaction due to the low ambient metallicity and, correspondingly, reduced wind mass-loss. We performed a complete spectral analysis of all known WR binaries of the nitrogen sequence in the Small and Large Magellanic Clouds, as well as additional orbital analyses, and constrained the evolutionary histories of these stars. We find that the bulk of Wolf-Rayet stars are luminous enough to be explained by single-star evolution. In contrast to prediction, we do not find clear evidence for a large population of low-luminosity Wolf-Rayet stars that could only form via binary interaction, suggesting a discrepancy between predictions and observations.
Wolf-Rayet (WR) stars are the most advanced stage in the evolution of the most massive stars. The strong feedback provided by these objects and their subsequent supernova (SN) explosions are decisive for a variety of astrophysical topics such as the cosmic matter cycle. Consequently, understanding the properties of WR stars and their evolution is indispensable. A crucial but still not well known quantity determining the evolution of WR stars is their mass-loss rate. Since the mass loss is predicted to increase with metallicity, the feedback provided by these objects and their spectral appearance are expected to be a function of the metal content of their host galaxy. This has severe implications for the role of massive stars in general and the exploration of low metallicity environments in particular. Hitherto, the metallicity dependence of WR star winds was not well studied. In this contribution, we review the results from our comprehensive spectral analyses of WR stars in environments of different metallicities, ranging from slightly super-solar to SMC-like metallicities. Based on these studies, we derived empirical relations for the dependence of the WN mass-loss rates on the metallicity and iron abundance, respectively.
The B fields in OB stars (BOB) survey is an ESO large programme collecting spectropolarimetric observations for a large number of early-type stars in order to study the occurrence rate, properties, and ultimately the origin of magnetic fields in massive stars. As of July 2014, a total of 98 objects were observed over 20 nights with FORS2 and HARPSpol. Our preliminary results indicate that the fraction of magnetic OB stars with an organised, detectable field is low. This conclusion, now independently reached by two different surveys, has profound implications for any theoretical model attempting to explain the field formation in these objects. We discuss in this contribution some important issues addressed by our observations (e.g., the lower bound of the field strength) and the discovery of some remarkable objects.
To study whether employees who disclose a psychiatric diagnosis, such as depression risk stigmatisation and discrimination at the workplace.
Randomised experimental study with 748 managers from German companies incorporating four case vignettes displaying an employee with different ‘diagnoses’ (depression, burnout, private crisis and thyroid dysfunction), but identical unspecific complaints. Main outcome measures were the managers' attitudes and their impact on stigmatisation with respect to job performance.
In nearly all aspects of job performance, the diagnosis depression (psychiatric disorder) was seen as more critical than the diagnosis of a thyroid dysfunction (somatic disease). The diagnosis ‘burnout’ did not prove to be less stigmatising than ‘depression’. Likewise ‘private crisis’ was rated less favourably than thyroid dysfunction.
Therefore, employees have to evaluate if they disclose their psychiatric disorder or if they conceal it as a somatic illness.
A large fraction of the Wolf-Rayet stars reside in binary or multiple systems. While multiple systems provide information which is not accessible for single stars, their composite spectra are harder to analyze. For this reason, quantitative spectral analyses of WR binaries have been vastly excluded so far. We present first attempts in analyzing multiple systems using the non-LTE Potsdam Wolf-Rayet (PoWR) model atmosphere code.
The development of infrared observational facilities has revealed a number of massive stars in obscured environments throughout the Milky Way and beyond. The determination of their stellar and wind properties from infrared diagnostics is thus required to take full advantage of the wealth of observations available in the near and mid infrared. However, the task is challenging. This session addressed some of the problems encountered and showed the limitations and successes of infrared studies of massive stars.
Recent studies have claimed the existence of very massive stars (VMS) up to 300 M⊙ in the local Universe. As this finding may represent a paradigm shift for the canonical stellar upper-mass limit of 150 M⊙, it is timely to discuss the status of the data, as well as the far-reaching implications of such objects. We held a Joint Discussion at the General Assembly in Beijing to discuss (i) the determination of the current masses of the most massive stars, (ii) the formation of VMS, (iii) their mass loss, and (iv) their evolution and final fate. The prime aim was to reach broad consensus between observers and theorists on how to identify and quantify the dominant physical processes.
Diagnostic errors can have tremendous consequences because they can result in a fatal chain of wrong decisions. Experts assume that physicians' desire to confirm a preliminary diagnosis while failing to seek contradictory evidence is an important reason for wrong diagnoses. This tendency is called ‘confirmation bias’.
To study whether psychiatrists and medical students are prone to confirmation bias and whether confirmation bias leads to poor diagnostic accuracy in psychiatry, we presented an experimental decision task to 75 psychiatrists and 75 medical students.
A total of 13% of psychiatrists and 25% of students showed confirmation bias when searching for new information after having made a preliminary diagnosis. Participants conducting a confirmatory information search were significantly less likely to make the correct diagnosis compared to participants searching in a disconfirmatory or balanced way [multiple logistic regression: odds ratio (OR) 7.3, 95% confidence interval (CI) 2.53–21.22, p<0.001; OR 3.2, 95% CI 1.23–8.56, p=0.02]. Psychiatrists conducting a confirmatory search made a wrong diagnosis in 70% of the cases compared to 27% or 47% for a disconfirmatory or balanced information search (students: 63, 26 and 27%). Participants choosing the wrong diagnosis also prescribed different treatment options compared with participants choosing the correct diagnosis.
Confirmatory information search harbors the risk of wrong diagnostic decisions. Psychiatrists should be aware of confirmation bias and instructed in techniques to reduce bias.
G. Gräfener, Institut für Physik, Universität Potsdam, Am Neuen Palais 10, D-14469 Potsdam, Germany,
W.-R. Hamann, Institut für Physik, Universität Potsdam, Am Neuen Palais 10, D-14469 Potsdam, Germany
We present new atmosphere models for Wolf–Rayet (WR) stars that include a self-consistent solution of the wind hydrodynamics. We demonstrate that the formation of optically thick WR winds can be explained by radiative driving on Fe-line opacities, implying a strong dependence on metallicity (Z). Our Z-dependent model calculations for late-type WN stars show that these objects are very massive stars close to the Eddington limit, and that their formation is strongly favored for high-metallicity environments.
The central star of the PN LMC-N66 showed an impressive outburst in 1993 - 1994, returning to its initial conditions about 8 years later. Its spectrum resembles that of a WN4.5 star, being the only confirmed central star of planetary nebulae showing such a spectral type. Recent analysis for the central star parameters, performed by Hamann et al. (2003) is presented. They have found that the bolometric luminosity increased by a factor larger than 6, during the outburst. We discuss the possible scenarios which have been proposed to explain the exceptional stellar parameters and the outburst mechanism. The stellar characteristics and the morphology and kinematics of the planetary nebula suggest the presence of binary system (massive star with a less massive companion or, a white dwarf accreting matter in a close-binary system). These cases pose the least severe contradictions with observational constraints.
Background and objective: Spinal cord stimulation has been used successfully for many years in the management of neuropathic pain. Nociceptive pathways are closely integrated into many autonomic reflexes. The aim was to test the hypothesis that pain relief caused by spinal cord stimulation is related to changes in peripheral skin blood flow.
Methods: Twelve patients with spinal cord stimulators implanted as a treatment for neuropathic pain were entered into the study. Laser Doppler perfusion scanning was used as a direct method for selective measurement of changes in skin (peripheral) blood flow. Measurements were taken before and after the onset of spinal cord stimulation over the site of its sensory projection. The degree of pain relief due to spinal cord stimulation and the skin temperature of each patient were also recorded.
Results: Apart from one patient, spinal cord stimulation did not change skin blood flow in a statistically significant manner.
Conclusions: Pain relief due to spinal cord stimulation is not related to changes of skin blood flow.
LMC-N66 is an extraordinary planetary nebula whose central star underwent a violent mass loss event which has lasted for 10 years. The outburst reached its maximum in 1994. Since then the star has been slowly fading. During the stellar outburst, the nebular lines have shown no changes.
The nebula shows a complex morphology. Two very bright lobes at both sides of the central star, almost aligned in the E-W direction, constitute the main body of the nebula. Several knots and filaments are conspicuous over the surface lying preferentially on the S-E and N-W directions. A couple of faint, extended loops are also detected in the S-E and N-W directions at both sides of the star. The extension of these loops are larger than 0.5 pc at the LMC distance. A no emitting-zone in the S-W quadrant, seems to be part of a dusty toroid around the central star, although the central star is not obscured by such a dark material (see Blades et ale 1992 for a description of N66 morphology).
We have used fluctuation electron microscopy (FEM) to measure nanoscale mediumrange order in amorphous Al92Sm8. Samples of this amorphous alloy formed by rapid quenching (melt-spinning) show a high density of pure Al nanocrystals (>1020 m-3) after low temperature (< 250 °C) devitrification. In samples amorphized by deformation (cold-rolling), primary Al-crystallization does not occur. This difference in devitrification behavior suggests an underlying structural difference in the amorphous state. FEM is a quantitative microscopy technique for determining nanoscale medium-range order in amorphous materials. Our measurements show that amorphous alloys formed by melt-spinning and cold-rolling have significant structural differences, and that annealing melt-spun alloy under conditions previously shown to modify the devitrification thermodynamics also changes the medium-range structure.
HST UV and optical spectra of the early-type [WC] star SMP 61 in the LMC are analyzed by means of line blanketed non-LTE models for expanding atmospheres. The known distance to the LMC allows a reliable determination of the stellar parameters. The low iron surface abundance of the object possibly indicates a preceding evolution through a very late thermal pulse (VLTP).
Several proposals involving solute effects, phase separation or quenched-in nuclei and heterogeneous nucleation have been advanced to account for the high nanocrystal density that evolves during primary crystallization in marginal glass-forming alloys, but recent crystallization measurements and kinetics analyses provide new evidence for the role of the as-quenched structure on nanocrystal synthesis. Here, isothermal microcalorimetry investigations and quantitative electron microscopy measurements including high-resolution imaging and electron spectroscopy analyses were performed on a model system at different temperatures well below the glass transition to monitor the nanocrystallization isothermally as a function of time. From the combined measurements, the size distribution and the transformed fraction can be determined with a high accuracy for extended ranges of temperatures and times. In addition, calorimetric measurements in the glassy, liquid and crystalline states of the model alloy serves to analyze, for the first time, the fragility characteristics of a marginal glass-former that presents an important parameter in the context of the kinetic stability of the material against premature crystallization.
Among the Central Stars of Planetary Nebulae (CSPN) there are several stars which show Wolf-Rayet-type spectra resembling those of Pop. I Wolf-Rayet (WR) stars of the carbon sequence (WC). Due to progress in computer technology and new solution techniques it became possible ten years ago to calculate models which account for the very complex physical conditions in Wolf-Rayet atmospheres (Hillier 1989, Hamann et al. 1992). These models have been successfully applied to the vast majority of Pop. IWR stars in the Galaxy and the Magellanic Clouds (Hamann et al. 1995) and, in the last three years, to an increasing sample of CSPNs of [WC] type (Koesterke & Hamann 1996, Leuenhagen & Hamann 1996, Leuenhagen this meeting). Here we present the analyses of ten CSPNs of early [WC] type, i.e. from [WC 2] to [WC 4].