Patientenverfügung und Behandlungsvereinbarung als Instrumente der Vorausplanung in der forensischen Psychiatrie

Definition of the problem

In Germany as well as in many other countries, mentally ill criminals who are not guilty by reasons of insanity can be sentenced to psychiatric treatment in forensic clinics. In 2011, the German Constitutional Court substantially strengthened these patients’ right to self-determination in case of treatment refusal.

Arguments

In this context, we discuss the significance of instruments of advance healthcare planning. First, we describe the context of psychiatric treatment in forensic clinics and the changes the new German legal regulations brought about. A case study helps to illustrate the consequences of treatment refusal for both patient and healthcare personnel.

Conclusion

Eventually, we discuss if and how advance directives and joint crisis plans can be useful in forensic clinics and how additional measures can help to facilitate patient self-determination.

     

Effects of annealing processes on Cu<Subscript><Emphasis Type="Italic">x</Emphasis></Subscript>Si<Subscript>1-<Emphasis Type="Italic">x</Emphasis></Subscript> thin films

The Cu _x Si_1-x thin films have been grown by pulsed laser deposition (PLD) with in situ annealing on Si (001) and Si (111), respectively. The transformation of phase was detected by X-ray diffraction (XRD). The results showed that the as-deposited films were composed of Cu on both Si (001) and Si (111). The annealed thin films consisted of Cu + η”-Cu₃Si on Si (001) while Cu + η’-Cu₃Si on Si (111), respectively, at annealed temperature (T _a) = 300-600 °C. With the further increasing of T _a, at T _a= 700 °C, there was only one main phase, η”-Cu₃Si on Si (001) while η’-Cu₃Si on Si (111), respectively. The annealed thin films transformed from continuous dense structure to scattered-grain morphology with increasing T _a detected by field emission scanning electron microscope (FESEM). It was also showed that the grain size would enlarge with increasing annealing time (t _a).     

Influence of coal fly ash particle size on structure and adsorption properties of forming adsorbents for Cr<Superscript>6+</Superscript>

Forming adsorbents FFA-R, FFA-A and FFA-B were prepared from different particle size coal fly ashes FA-R, FA-A and FA-B, their average particle sizes (d ₅₀) were 15.75, 3.61 and 1.73 μm respectively. The structure and adsorption properties for Cr⁶⁺ of forming adsorbents from aqueous solution were studied. The results show that forming adsorbent prepared from the coal fly ash with smaller particle size exhibits higher specific surface area, higher pore volume and better adsorption properties for Cr⁶⁺.The adsorption kinetics of Cr⁶⁺ on FFA-R, FFA-A and FFA-B fitts the second order kinetic model and the second adsorption rate constants are 7.523, 3.197 and 2.187 mg·g^-1· min^-1/2, respectively. The adsorption of Cr⁶⁺ on FFA-R, FFA-A and FFA-B can be described in terms of Langmuir isotherms better, and the adsorption processes are spontaneous and exothermic.     

First-Principles Study of the High-Temperature Behaviors of the Willemite-Ⅱ and Post-Phenacite Phases of Silicon Nitride

The structural and elastic properties of the recently-discovered wⅡ- and δ-Si_3N_4 are investigated through the plane-wave pseudo-potential method within ultrasoft pseudopotentials.The elastic constants show that wⅡ- and δ-Si_3N_4 are mechanically stable in the pressure ranges of 0-50 GPa and 40-50 GPa,respectively.The α→wⅡ phase transition can be observed at 18.6 GPa and 300 K.The β→δ phase transformation occurs at pressures of 29.6,32.1,35.9,39.6,41.8,and 44.1 GPa when the temperatures are100,200,300,400,500,and 600 K,respectively.The results show that the interactions among the N-2s,Si-3s,3p bands(lower valence band) and the Si-3p,N-2p bands(upper valence band) play an important role in the stabilities of the wⅡ and S phases.Moreover,several thermodynamic parameters(thermal expansion,free energy,bulk modulus and heat capacity) of δ-Si_3N_4 are also obtained.Some interesting features are found in these properties.δ-Si_3N_4 is predicted to be a negative thermal expansion material.The adiabatic bulk modulus decreases with applied pressure,but a majority of materials show the opposite trend.Further experimental investigations with higher precisions may be required to determine the fundamental properties of wⅡ- andδ-Si_3N_4.     

Effect of wafer size on the film internal stress measurement by wafer curvature method

Wafer curvature method has been applied to determine the internal stress in the films using Stoney’s equation. During the film deposition, the wafer fixation on the sample holder will restrict the deformation of the rectangle-shaped wafer, which may result in the stress datum difference along length and width direction. In this paper, the effect of wafer size and the wafer fixation on the TiN film internal stress measured by wafer curvature method was discussed. The rectangle-shaped wafers with different length/width ratios (L/W=1:1, 2:1, 3:1 and 4:1) were fixed as a cantilever beam. After the TiN films deposition, the profiles of the film/wafer were measured using a stylus profilometer and then the internal stress was calculated using the Stoney equation in the film. The results showed that the fixed end of the wafers limited to some degree the curvature of the wafers along the width direction. For film internal stress measured by wafer curvature method, the wafer profile should be scanned along the length direction and the scan distance should be greater than or equal to half of wafer length. When the length/width ratio of the wafer reached 3:1, the wafer curvature and the calculated stress were basically the same at different positions along the length direction. For film internal stress measured by wafer curvature method, it was recommended that the length/width ratio of wafer should be considered to be greater than or equal to 3:1, and the deformed profile was scanned along the length direction.     

Characterization and methanol adsorption of walnut-shell activated carbon prepared by KOH activation

Walnut-shellactivated carbons(WSACs)were prepared by the KOH chemicalactivation.The effects of carbonization temperature,activation temperature,and ratio of KOH to chars on the pore development of WSACs were investigated.Fourier transform infrared spectroscopy(FTIR),X-ray powder diffraction(XRD),and scanning electron microscopy(SEM)were employed to characterize the microstructure and morphology of WSACs.Methanoladsorption performance onto the optimalWSAC and the coal-based AC were also investigated.The results show that the optimalpreparation conditions are a carbonization temperature of 700 ℃,an activation temperature of 700 ℃,and a mass ratio of 3.The BET surface area,the micropore volume,and the micropore volume percentage of the optimalWASC are 1636 m~2/g,0.641 cm~3/g and 81.97%,respectively.There are a lot of micropores and a certain amount of meso-and macropores.The characteristics of the amorphous state are identified.The results show that the optimalWSAC is favorable for methanoladsorption.The equilibrium adsorption capacity of the optimalWSAC is 248.02mg/g.It is shown that the equilibrium adsorption capacity of the optimalWSAC is almost equivalent to that of the common activated carbon.Therefore the optimalWSAC could be a potentialadsorbent for the solar energy adsorption refrigeration cycle.     

Rheological behaviors of fresh cement pastes with polycarboxylate superplasticizer

The rheologicalbehaviors of fresh cement paste with polycarboxylate superplasticizer were systematically investigated.Influentialfactors including superplasticizer to cement ratio(Sp/C),water to cement ratio(w/c),temperature,and time were discussed.Fresh cement pastes with Sp/Cs in the range of 0 to 2.0% and varied W/Cs from 0.25 to 0.5 were prepared and tested at 0,20 and 40 °C,respectively.Flowability and rheologicaltests on cement pastes were conducted to characterize the development of the rheologicalbehavior of fresh cement pastes over time.The exprimentalresults indicate that the initialflowability and flowability retention over shelf time increase with the growth in superplasticizer dosage due to the plasticizing effect and retardation effect of superplasticizer.Higher temperature usually leads to a sharper drop in initialflowability and flowability retention.However,for the cement paste with high Sp/C or w/c,the flowability is slightly affected by temperature.Yield stress and plastic viscosity show similar variation trends to the flowability under the abovementioned influentialfactors at low Sp/C.In the case of high Sp/C,yield stress and plastic viscosity start to decline over shelf time and the decreasing rate descends at elevated temperature.Moreover,two equations to roughly predict yield stress and plastic viscosity of the fresh cement pastes incorporating Sp/C,w/c,temperature and time are developed on the basis of the existing models,in which experimentalconstants can be extracted from a database created by the rheologicaltest results.     

Microstructure and erosion resistance of in-situ SiAlON reinforced BN-SiO<Subscript>2</Subscript> composite ceramics

BN-SiO₂-SiAlON composite ceramics were successfully prepared by the means of hot pressed sintering. Xe plasma flow generated by Hall Thruster was used for sputtering the surface of the samples in order to evaluate the plasma erosion resistance. XRD, TEM, SEM, and LSCM were used to characterize the phase composition and morphologies of as-made composite ceramics before and after Xe plasma erosion. The ceramics were composed of h-BN, fused silica, and SiAlON, which maintained structural stability during the process of Xe plasma sputtering. In conclusion, comparing with BN-SiO₂ composite ceramics, the plasma erosion rate of BN-SiO₂-SiAlON composite ceramics decreases significantly at first then rises with the increase of AlN addition. Erosion pits can be observed by using SEM on the surface after plasma sputtering, which demonstrates that the BN grains have dropped off the surface. In addition, mechanical denudation by high-speed Xe ions is recognized as the injury mechanism for the BN-matrix composite materials.     

Morphology study of oriented SmBCO film deposited by MOCVD

c-axis-oriented SmBa_2Cu_3O_7(SmBCO) films have been deposited on(100)- LaA1O_3(LAO)substrate by metal organic chemical vapor deposition(MOCVD) technique.The effects of deposition temperature(T_(dep)) and total pressure(P_(tot)) on the orientation and microstructure of SmBCO films were investigated.The orientation of SmBCO films transformed from α-axis to c-axis with increasing of T_(dep) from 900 to 1 100℃.At T_(dep)=1 050℃,SmBCO films had c-axis orientation and tetragon surface.At P_(tot)~(dep)=400-800 Pa and T_(dep)=1 050 ℃,totally c-axis-oriented SmBCO films were obtained.The R_(dep) of SmBCO films increased firstly and then decreased with increasing P_(tot).The surface of SmBCO films exhibited tetragon morphology at 1 050 ℃ and400 Pa.Maximum thickness of SmBCO film deposited was 1.2μm at P_(tot)= 600 Pa,and the corresponding R_(dep)was 7.2 μm·h~(-1).     

Influencing mechanism and interaction of muscovite on thermal decomposition of ammonium polyphosphate

The interaction mechanism and phase evolution of ammonium polyphosphate(APP)mixed with muscovite(APP/muscovite)were studied by TG,XRD and SEM,respectively,during heating.When the temperature is not higher than 300 ℃,muscovite has no effect on the thermaldecomposition of APP,and the initialdecomposition temperature of APP/muscovite at 283 ℃ is basically the same as the APP at 295 ℃,and the main thermaldecomposition products are polyphosphoric acid and NH_4H_2PO_4 at 300 ℃.The polyphosphoric acid,the decomposition products of APP,can enable K and Siout of muscovite and interact with muscovite chemically to generate Al_2O_3·2SiO_2,α-SiO_2 and phosphates(AlPO_4 and K_5P_3O_(10))compounds during 400 ℃-800 ℃,which own obvious adhesive phenomenon and porous structure with the apparent porosity of 58.4%.Further reactions between phosphates other than reactions among Al_2O_3·2SiO_2 and α-SiO_2 can generate KAlP_2O_7 at 1 000 ℃ and the density of residualproduct is improved by low melting point phosphate filling pore to form relatively dense structure and decrease the apparent porosity to 44.4%.The flame resistant and self-supported ceramic materials are expected to enhance the fire-retarding synergistic effect between APP and muscovite.