Decisions and justifications by community mental health providers about hypothetical ethical dilemmas

OBJECTIVE: Community-based treatment of persons with serious mental illness requires providers to become involved in clients' personal lives to a greater degree than does hospital-based treatment. The study examined attendant ethical dilemmas, especially for staff who lack professional training or work in rural communities. METHODS: A total of 95 staff members from five community mental health centers read 14 vignettes describing ambiguous ethical dilemmas involving professional role boundaries or client confidentiality. Twenty-seven staff members were from rural agencies, and 68 from urban-suburban agencies; 60 were direct care staff, and 35 were supervisory. Participants were asked to make and justify a more conservative or a less conservative decision in response to each dilemma. RESULTS: Years of experience as a mental health provider and previous ethics training correlated positively with staff having experienced more situations similar to those in the vignettes; however, these variables were not related to the decision made or the type of ethical justification for it. When the analysis controlled for experience and previous ethics training, staff made fewer conservative decisions in boundary dilemmas than in confidentiality dilemmas. Compared with nonrural providers, rural providers had experienced more boundary dilemmas and made fewer conservative decisions in response to them. CONCLUSIONS: Boundary problems occur frequently in community-based services, especially in rural settings, and may or may not be handled conservatively. With the expansion of case management and other in vivo services, better understanding of ethical risks and informal practices will help improve services and provide appropriate training and supervision of staff.     

Flow and void characterization of stitched structural composites using resin film infusion process (RFIP)

The resin film infusion process (RFIP), which is similar to resin transfer molding (RTM), was applied to investigate the possibility of manufacturing high performance stitched composites. With the objective of understanding the resin flow mechanisms and void formation in stitched fibrous perform, two recent technological developments in homogeneous tough resin and bendable stitching fibers were incorporated in producing stituched composites with RFIP. These included new lightly crosslinked thermosets (LXT) that were phenolic or amine based. Second, bendable carbon stitching reinforcement (T-900) was utilized as a stitching fiber. Flow characteristics were inferred by ultrasonic C-scan analysis of cured panels. Microscopic studies indicated that voids were distrubuted along the stitching fiber because of low consolidation pressure in the resin-rich area (stitching fiber region) where the fiber volume content was lower. In contrast to stitched composites, non-sitiched composites contained lower void content and irregular void distribution because of uniform fiber compaction. Microscopic studies of partially resin infused quasi-istropic stitched composites demonstrated that the resin flows along the stitching fiber region and then infuses into the fibrous preform. These infusion phebnomena were the result of anistropic permeability in the preform. Consequently, anisotropic resin flow in the stitched fibrous preform was found to be related to the heterogenous textile structure caused by the stitching process.     

Macro-/mesoporous Metal–Organic Frameworks Templated by Amphiphilic Block Copolymers Enable Enhanced Uptake of Large Molecules

The first synthesis of hierarchical porous metal–organic frameworks (HP-MOFs) is reported through a solvent evaporation-induced co-assembly of polystyrene-block-poly(ethylene oxide) (PS-b-PEO) and MOF building blocks. The growth of MOFs is restricted to confined spaces formed by self-assembled PS-b-PEO, and mesopores and/or macropores are created after removing PS-b-PEO by solvent rinsing. This approach avoids phase separation and competitive interactions between templates and MOF building blocks. Both amorphous and crystalline HP-MOFs can be synthesized by finely controlling MOF growth conditions. Additionally, HP-MOFs (ZIF-L sheets) with honeycomb-like channels show significantly enhanced incorporation of large guest molecules compared to microporous MOFs. This study establishes an efficient synthetic strategy for preparing HP-MOFs with highly accessible mesopores and macropores for applications involving large molecules.