RESUMO
A method is proposed to extract the electrical data for surface doping profiles of semiconductors in unison with the chemical profile acquired by secondary-ion mass spectrometry (SIMS)-a method we call SIMSAR (secondary-ion mass spectrometry and resistivity). The SIMSAR approach utilizes the inherent sputtering process of SIMS, combined with sequential four-point van der Pauw resistivity measurements, to surmise the active doping profile as a function of depth. The technique is demonstrated for the case of ion-implanted arsenic doping profiles in silicon. Complications of the method are identified, explained, and corrections for these are given. While several techniques already exist for chemical dopant profiling and numerous for electrical profiling, since there is no technique which can measure both electrical and chemical profiles in parallel, SIMSAR has significant promise as an extension of the conventional dynamic SIMS technique, particularly for applications in the semiconductor industry.
RESUMO
B diffusion measurements are used to probe the basic nature of self-interstitial point defects in Ge. We find two distinct self-interstitial forms--a simple one with low entropy and a complex one with entropy â¼30 k at the migration saddle point. The latter dominates diffusion at high temperature. We propose that its structure is similar to that of an amorphous pocket--we name it a morph. Computational modeling suggests that morphs exist in both self-interstitial and vacancylike forms, and are crucial for diffusion and defect dynamics in Ge, Si, and probably many other crystalline solids.
RESUMO
OBJECTIVE: Coercion during psychiatric admissions has been a topic of debate for many years. Although there has been considerable research on patients' perceptions of coercion, there has been no work on who places pressures on patients to be admitted. METHOD: This article integrates interview data from interviews with patients, admitting staff and family and friends to describe the pressures brought to bear on patients to be admitted. RESULTS: Health-care professionals appear to be the most important source of pressures on patients, and to have the most impact on patients' perceptions of coercion. However, there are differences in type of pressure, and the pressures used by family and friends appear to have the most longstanding impact. CONCLUSION: Legal and clinical efforts to reduce the level of coercive pressures on patients need to recognize the importance of mental-health professionals, including especially those who are not legally mandated to participate in the admission process.
Assuntos
Coerção , Hospitais Psiquiátricos , Transtornos Mentais/psicologia , Transtornos Mentais/terapia , Admissão do Paciente , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Atitude do Pessoal de Saúde , Atitude Frente a Saúde , Escalas de Graduação Psiquiátrica Breve/estatística & dados numéricos , Família , Seguimentos , Psiquiatria Legal , Humanos , Relações Interpessoais , Pessoa de Meia-Idade , Defesa do Paciente , Pennsylvania , Recursos Humanos em Hospital , Polícia , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Gravação em Fita , VirginiaRESUMO
OBJECTIVE: An influential rationale for involuntary hospitalization is that prospective patients who refuse hospitalization at the time it is offered are likely to change their belief about the necessity of hospitalization after receiving hospital treatment. The authors examine how patients changed their evaluations of psychiatric hospitalization following hospital treatment. METHOD: The authors studied 433 patients who were interviewed about their hospitalization within 2 days of their admission to a psychiatric hospital; 267 of these patients were reinterviewed 4-8 weeks following discharge. RESULTS: When reinterviewed at follow-up, 33 (52%) of 64 patients who said at admission that they did not need hospitalization said that, in retrospect, they believed they had needed it. Only 9 (5%) of 198 patients who said at admission that they needed hospitalization shifted to saying that they had not needed it. CONCLUSIONS: Many of the patients who initially judged that they did not need hospitalization revised their belief after hospital discharge and reported that they had needed hospital treatment. However, perceptions of coercion were stable from admission to follow-up, and patients' attitudes toward hospitalization did not become more positive. Coerced patients did not appear to be grateful for the experience of hospitalization, even if they later concluded that they had needed it.
Assuntos
Atitude Frente a Saúde , Internação Compulsória de Doente Mental , Hospitalização , Transtornos Mentais/psicologia , Recusa do Paciente ao Tratamento , Adulto , Escalas de Graduação Psiquiátrica Breve/estatística & dados numéricos , Coerção , Feminino , Seguimentos , Hospitais Psiquiátricos , Humanos , Julgamento , Masculino , Transtornos Mentais/diagnóstico , Aceitação pelo Paciente de Cuidados de Saúde , Admissão do Paciente , Alta do Paciente , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Estudos RetrospectivosRESUMO
Although the recent development of a measure for perceived coercion has led to great progress in research on coercion in psychiatric settings, there still exists no consensus on how to measure the existence of real coercive events or pressures. This article reports the development of a system for integrating chart review data and data from interviews with multiple participants in the decision for an individual to be admitted to a psychiatric hospital. The method generates a "most plausible factual account" (MPFA). We then compare this account with that of patients, admitting clinicians and other collateral informants in 171 cases. Patient accounts most closely approximate the MPFA on all but one of nine dimensions related to coercion. This may be due to wider knowledge of the events surrounding the admission.
Assuntos
Coerção , Internação Compulsória de Doente Mental , Pesquisa sobre Serviços de Saúde/métodos , Hospitais Psiquiátricos , Anamnese/métodos , Adulto , Feminino , Humanos , Masculino , Transtornos Mentais/psicologia , Admissão do Paciente , Pennsylvania , Reprodutibilidade dos Testes , Revelação da Verdade , VirginiaRESUMO
BACKGROUND: Patients' perceptions of coercion in admission may affect their attitude toward subsequent treatment, including their inclination to adhere to treatment plans. This study looks at the determinants of patients' perceptions of coercion. METHODS: A sample of 157 patients admitted to a rural Virginia state hospital and a Pennsylvania community hospital were interviewed within 48 hours of admission about their experience of coming to the hospital. All subjects were 17 years or older. Diagnoses were diverse, and 42% were involuntarily committed. The interview gathered an open-ended description of the admission experience followed by a structured interview that included several measures. RESULTS: Perceptions of being respectfully included in a fair decision-making process ("procedural justice") and legal status were most closely associated with perceived coercion, and a significant relationship was found with perceived negative pressures, ie, force and threats. However, only procedural justice was related to the perception of coercion at both sites and with both voluntary and involuntary patients. CONCLUSIONS: Patients' feelings of being coerced concerning admission appears to be closely related to their sense of procedural justice. It may be that clinicians can minimize the experience of coercion even among those legally committed by attending more closely to procedural justice issues.
Assuntos
Coerção , Testes Diagnósticos de Rotina , Transtornos Mentais/psicologia , Percepção , Adulto , Feminino , Humanos , Entrevistas como Assunto , Masculino , Análise de RegressãoRESUMO
We administered a semi-structured interview to 157 patients shortly after their admission to a psychiatric hospital. In the first, and open-ended, part of the interview, patients were asked to talk about what had been going on in their lives that led to their coming into the hospital. Then, in a more structured format, they were asked more specific details about who was involved, the patients' relationships with those involved, whether any attempts were made to influence the patient to come into the hospital, and whether such attempts were perceived as fair by the patient. This article presents a qualitative review of the transcripts of a subset of these interviews. It attends specifically to patients' perceptions of the morality of attempts by others--primarily family members, friends and mental health professionals--to influence them to be admitted to the hospital, and of the morality of the process by which these influence attempts resulted in admission.