Shared Decision Making in the Psychiatric Inpatient Setting: An Ethnographic Study about Interprofessional Psychiatric Consultations

Shared decision making is increasingly receiving attention in health care and might improve both the quality of care and patient outcomes. Nevertheless, due to its complexity, implementation of shared decision making in clinical practice seems challenging. This ethnographic study aimed to gain a better understanding of how psychiatric inpatients and the interprofessional care team interact during regular interprofessional psychiatric consultations. Data were collected through participant observation on two different psychiatric wards in a large psychiatric hospital in Switzerland. The observation focused on the contextual aspects of interprofessional patient consultations, the communication and interaction as well as the extent to which patients were involved in decision making. Participants included patients, psychiatrists, junior physicians, nurses, psychologists, social workers and therapists. We observed 71 interprofessional psychiatric consultations and they differed substantially in both wards in terms of context (place and form) and culture (way of interacting). On the contrary, results showed that the level of patient involvement in decision making was comparable and depended on individual factors, such as the health care professionals' communication style as well as the patients' personal initiative to be engaged. The main topics discussed with the patients related to pharmacotherapy and patient reported symptoms. Health care professionals in both wards used a rather unidirectional communication style. Therefore, in order to promote patient involvement in the psychiatric inpatient setting, rather than to focus on contextual factors, consultations should follow a specific agenda and promoting a bidirectional communication style for all parties involved is strongly recommended

'It's a big deal, being given a person': why people who experience infertility may choose not to adopt

This article explores why individuals and couples who experience infertility and undergo treatment through new technologies do not subsequently go on to become parents via adoption. It does this in three ways: a review of the literature; interviews with those affected; and an online survey of views on adoption among people who have experienced infertility. It was found that couples do consider adoption alongside infertility treatment but it is usually a fallback choice. If adoption is to be perceived as an equal option, agencies need to offer support and advice at an earlier stage than is usual. Couples who are emotionally exhausted by medical interventions for their childlessness can then be helped off the infertility treadmill in order to become parents

The spinorial geometry of supersymmetric heterotic string backgrounds

We determine the geometry of supersymmetric heterotic string backgrounds for which all parallel spinors with respect to the connection $\hat\nabla$ with torsion $H$, the NS$\otimes$NS three-form field strength, are Killing. We find that there are two classes of such backgrounds, the null and the timelike. The Killing spinors of the null backgrounds have stability subgroups K\ltimes\bR^8 in $Spin(9,1)$, for $K=Spin(7)$, SU(4), $Sp(2)$, $SU(2)\times SU(2)$ and $\{1\}$, and the Killing spinors of the timelike backgrounds have stability subgroups $G_2$, SU(3), SU(2) and $\{1\}$. The former admit a single null $\hat\nabla$-parallel vector field while the latter admit a timelike and two, three, five and nine spacelike $\hat\nabla$-parallel vector fields, respectively. The spacetime of the null backgrounds is a Lorentzian two-parameter family of Riemannian manifolds $B$ with skew-symmetric torsion. If the rotation of the null vector field vanishes, the holonomy of the connection with torsion of $B$ is contained in $K$. The spacetime of time-like backgrounds is a principal bundle $P$ with fibre a Lorentzian Lie group and base space a suitable Riemannian manifold with skew-symmetric torsion. The principal bundle is equipped with a connection $\lambda$ which determines the non-horizontal part of the spacetime metric and of $H$. The curvature of $\lambda$ takes values in an appropriate Lie algebra constructed from that of $K$. In addition $dH$ has only horizontal components and contains the Pontrjagin class of $P$. We have computed in all cases the Killing spinor bilinears, expressed the fluxes in terms of the geometry and determine the field equations that are implied by the Killing spinor equations.Comment: 73pp. v2: minor change

Charged-Particle Multiplicity in Proton-Proton Collisions

This article summarizes and critically reviews measurements of charged-particle multiplicity distributions and pseudorapidity densities in p+p(pbar) collisions between sqrt(s) = 23.6 GeV and sqrt(s) = 1.8 TeV. Related theoretical concepts are briefly introduced. Moments of multiplicity distributions are presented as a function of sqrt(s). Feynman scaling, KNO scaling, as well as the description of multiplicity distributions with a single negative binomial distribution and with combinations of two or more negative binomial distributions are discussed. Moreover, similarities between the energy dependence of charged-particle multiplicities in p+p(pbar) and e+e- collisions are studied. Finally, various predictions for pseudorapidity densities, average multiplicities in full phase space, and multiplicity distributions of charged particles in p+p(pbar) collisions at the LHC energies of sqrt(s) = 7 TeV, 10 TeV, and 14 TeV are summarized and compared.Comment: Invited review for Journal of Physics G -- version 2: version after referee's comment

Enriching Business Process Models with Decision Rules

Making the right decisions in time is one of the key tasks in every business. In this context, decision theory fosters decision-making based on well-defined decision rules. The latter evaluate a given set of input parameters and utilize evidenced data in order to determine an optimal alternative out of a given set of choices. In particular, decision rules are relevant in the context business processes as well. Contemporary process modeling languages, however, have not incorporated decision theory yet, but mainly consider rather simple, guard-based decisions that refer to process-relevant data. To remedy this drawback, this paper introduces an approach that allows embedding decision problems in business process models and applying decision rules to deal with them. As a major benefit, it becomes possible to automatically determine optimal execution paths during run time

Bremsstrahlung Suppression due to the LPM and Dielectric Effects in a Variety of Materials

The cross section for bremsstrahlung from highly relativistic particles is suppressed due to interference caused by multiple scattering in dense media, and due to photon interactions with the electrons in all materials. We present here a detailed study of bremsstrahlung production of 200 keV to 500 MeV photons from 8 and 25 GeV electrons traversing a variety of target materials. For most targets, we observe the expected suppressions to a good accuracy. We observe that finite thickness effects are important for thin targets.Comment: 52 pages, 13 figures (incorporated in the revtex LaTeX file

Top quark physics in hadron collisions

The top quark is the heaviest elementary particle observed to date. Its large mass makes the top quark an ideal laboratory to test predictions of perturbation theory concerning heavy quark production at hadron colliders. The top quark is also a powerful probe for new phenomena beyond the Standard Model of particle physics. In addition, the top quark mass is a crucial parameter for scrutinizing the Standard Model in electroweak precision tests and for predicting the mass of the yet unobserved Higgs boson. Ten years after the discovery of the top quark at the Fermilab Tevatron top quark physics has entered an era where detailed measurements of top quark properties are undertaken. In this review article an introduction to the phenomenology of top quark production in hadron collisions is given, the lessons learned in Tevatron Run I are summarized, and first Run II results are discussed. A brief outlook to the possibilities of top quark research a the Large Hadron Collider, currently under construction at CERN, is included.Comment: 84 pages, 32 figures, accepted for publication by Reports on Progress in Physic

A Tapestry Of Educational Technology Women Leaders In Higher Education: A Qualitative Study

A qualitative study was used to understand the experiences of 12 women, leaders in Education Technology in higher education. Through interviews, women leaders described their environment as well as personal and behavioral aspects of their work. Findings revealed four threads of descriptive concepts including relationships, leadership, persistence, and advice. Relationships were from workplaces and professional networks. Leadership was defined by vision and teamwork. Persistence was addressed as either values-based or relationship-based. The fourth thread in the findings, advice, was divided into three sub-threads: education, family (both personal and work), and managing emotions. A qualitative approach was used to highlight interview responses to demonstrate the experiences of women leaders in Education Technology in Higher Education