Understanding the Personal and Clinical Utility of Psychiatric Advance Directives: A Qualitative Perspective

Psychiatric advance directives (PADs) are legal tools that allow competent individuals to declare preferences for future mental health treatment when they may not be capable of doing so as a result of a psychiatric crisis. PADs allow individuals to maintain self–determination during times when they are most vulnerable to loss of autonomy and in need of assistance to make their preferences known and honored. This article describes the content of twenty–eight open–ended, semi–structured qualitative interviews of adults with PADs who have experienced psychiatric crises. The qualitative analysis revealed three major themes from the interviews: (1) PADs as tools for empowerment and self–determination, (2) limited knowledge of PADs among service providers; and (3) difficulties communicating PADs to inpatient staff. In general, many participants expressed enthusiasm of the implementation of PADs but concern regarding clinicians’ general lack of awareness about them. Additionally, some consumers discussed discomfort in even mentioning that they had a PADto clinicians for fear of a negative response from them, or some type of involuntary treatment during their hospitalization. However, participants consistently viewed PADs as a positive tool to promote autonomy with the potential to facilitate stronger patient–provider relationships. Therefore, when working with individuals in psychiatric crisis who have a PAD, and who have never before experienced a sense of control over their own treatment, clinicians must recognize the potential troubling disequilibrium this sense of control may engender. In sum, though the most significant challenges facing the implementation of PADs involve clinicians’ familiarity with and education about PADs, much promise for the future growth of PADs lies in the benefits perceived by the patients

Psychiatric Advance Directives and Social Workers: An Integrative Review

Psychiatric Advance Directives (PADs) are legal documents that allow individuals to express their wishes for future psychiatric care and to authorize a legally appointed proxy to make decisions on their behalf during incapacitating crises. PADs are viewed as an alternative to the coercive interventions that sometimes accompany mental health crises for persons with mental illness. Insofar as coercive interventions can abridge clients’ autonomy and self-determination -- values supported by the Profession’s Code of Ethics -- social workers have a vested interest in finding ways to reduce coercion and increase autonomy and self-determination in their practice. However, PADs are also viewed as having the potential to positively affect a variety of other clinical outcomes, including but not limited to treatment engagement, treatment satisfaction, and working alliance. This article reviews the clinical and legal history of PADs and empirical evidence for their implementation and effectiveness. Despite what should be an inherent interest in PADs, and the fact that laws authorizing PADs have proliferated in the past decade, there is little theoretical or empirical research in the social work literature

On The Interaction Of D0-Brane Bound States And RR Photons

We consider the problem of the interaction between D0-brane bound state and 1-form RR photons by the world-line theory. Based on the fact that in the world-line theory the RR gauge fields depend on the matrix coordinates of D0-branes, the gauge fields also appear as matrices in the formulation. At the classical level, we derive the Lorentz-like equations of motion for D0-branes, and it is observed that the center-of-mass is colourless with respect to the SU(N) sector of the background. Using the path integral method, the perturbation theory for the interaction between the bound state and the RR background is developed. We discuss what kind of field theory may be corresponded to the amplitudes which are calculated by the perturbation expansion in world-line theory. Qualitative considerations show that the possibility of existence of a map between the world-line theory and the non-Abelian gauge theory is very considerable.Comment: LaTeX, 28 pages, 4 eps figures. v2 and v3: eqs. (3.18) and (B.2) are corrected, very small change

Multiloop Calculations in the String-Inspired Formalism: The Single Spinor-Loop in QED

We use the worldline path-integral approach to the Bern-Kosower formalism for developing a new algorithm for calculation of the sum of all diagrams with one spinor loop and fixed numbers of external and internal photons. The method is based on worldline supersymmetry, and on the construction of generalized worldline Green functions. The two-loop QED $\beta$ -- function is calculated as an example.Comment: uuencoded ps-file, 20 pages, 2 figures, final revised version to appear in Phys. Rev.

Probability distribution of the index in gauge theory on 2d non-commutative geometry

We investigate the effects of non-commutative geometry on the topological aspects of gauge theory using a non-perturbative formulation based on the twisted reduced model. The configuration space is decomposed into topological sectors labeled by the index nu of the overlap Dirac operator satisfying the Ginsparg-Wilson relation. We study the probability distribution of nu by Monte Carlo simulation of the U(1) gauge theory on 2d non-commutative space with periodic boundary conditions. In general the distribution is asymmetric under nu -> -nu, reflecting the parity violation due to non-commutative geometry. In the continuum and infinite-volume limits, however, the distribution turns out to be dominated by the topologically trivial sector. This conclusion is consistent with the instanton calculus in the continuum theory. However, it is in striking contrast to the known results in the commutative case obtained from lattice simulation, where the distribution is Gaussian in a finite volume, but the width diverges in the infinite-volume limit. We also calculate the average action in each topological sector, and provide deeper understanding of the observed phenomenon.Comment: 16 pages,10 figures, version appeared in JHE

Action for the eleven dimensional multiple M-wave system

We present the covariant supersymmetric and kappa-symmetric action for a system of N nearly coincident M-waves (multiple M0-brane system) in flat eleven dimensional superspace.Comment: 4+ pages, RevTeX4, no figures. V2: misprints corrected, discussion extended, references added, LaTeX, 10 pages. V3: misprints corrected. V4, extended version, 1+13 pages, to appear in JHE

The index of the overlap Dirac operator on a discretized 2d non-commutative torus

The index, which is given in terms of the number of zero modes of the Dirac operator with definite chirality, plays a central role in various topological aspects of gauge theories. We investigate its properties in non-commutative geometry. As a simple example, we consider the U(1) gauge theory on a discretized 2d non-commutative torus, in which general classical solutions are known. For such backgrounds we calculate the index of the overlap Dirac operator satisfying the Ginsparg-Wilson relation. When the action is small, the topological charge defined by a naive discretization takes approximately integer values, and it agrees with the index as suggested by the index theorem. Under the same condition, the value of the index turns out to be a multiple of N, the size of the 2d lattice. By interpolating the classical solutions, we construct explicit configurations, for which the index is of order 1, but the action becomes of order N. Our results suggest that the probability of obtaining a non-zero index vanishes in the continuum limit, unlike the corresponding results in the commutative space.Comment: 22 pages, 8 figures, LaTeX, JHEP3.cls. v3:figures 1 and 2 improved (all the solutions included),version published in JHE

Generation of a wave packet tailored to efficient free space excitation of a single atom

We demonstrate the generation of an optical dipole wave suitable for the process of efficiently coupling single quanta of light and matter in free space. We employ a parabolic mirror for the conversion of a transverse beam mode to a focused dipole wave and show the required spatial and temporal shaping of the mode incident onto the mirror. The results include a proof of principle correction of the parabolic mirror's aberrations. For the application of exciting an atom with a single photon pulse we demonstrate the creation of a suitable temporal pulse envelope. We infer coupling strengths of 89% and success probabilities of up to 87% for the application of exciting a single atom for the current experimental parameters.Comment: to be published in Europ. Phys. J.

The impacts of environmental warming on Odonata: a review

Climate change brings with it unprecedented rates of increase in environmental temperature, which will have major consequences for the earth's flora and fauna. The Odonata represent a taxon that has many strong links to this abiotic factor due to its tropical evolutionary history and adaptations to temperate climates. Temperature is known to affect odonate physiology including life-history traits such as developmental rate, phenology and seasonal regulation as well as immune function and the production of pigment for thermoregulation. A range of behaviours are likely to be affected which will, in turn, influence other parts of the aquatic ecosystem, primarily through trophic interactions. Temperature may influence changes in geographical distributions, through a shifting of species' fundamental niches, changes in the distribution of suitable habitat and variation in the dispersal ability of species. Finally, such a rapid change in the environment results in a strong selective pressure towards adaptation to cope and the inevitable loss of some populations and, potentially, species. Where data are lacking for odonates, studies on other invertebrate groups will be considered. Finally, directions for research are suggested, particularly laboratory studies that investigate underlying causes of climate-driven macroecological patterns