Indian Psychiatric Society multicentre study: Diagnostic patterns, comorbidity and prescription practices for patients with Dementia.

Background: There are more than 5 million people with dementia in India. Multicentre studies looking at details of treatment for people with dementia In India are lacking. Clinical audit is a quality improvement process which aims to systematically assess, evaluate, and improve patient care. Evaluating current practice is the key to a clinical audit cycle. Aim: This study aimed to assess the diagnostic patterns and prescribing practices of psychiatrists for patients with dementia in India. Method: A retrospective case file study was conducted across several centers in India. Results: Information from the case records of 586 patients with dementia was obtained. Mean age of the patients was 71.14 years (standard deviation = 9.42). Three hundred twenty one (54.8%) were men. Alzheimer's disease (349; 59.6%) was the most frequent diagnosis followed by vascular dementia (117; 20%). Three hundred fifty five (60.6%) patients had medical disorders and 47.4% patients were taking medications for their medical conditions. Eighty one (69.2%) patients with vascular dementia had cardiovascular problems. Majority of the patients (524; 89.4%) were on medications for dementia. Most frequently prescribed treatment was Donepezil (230; 39.2%) followed by Donepezil-Memantine combination (225; 38.4%). Overall, 380 (64.8%) patients were on antipsychotics. Quetiapine (213, 36.3%) was the most frequently used antipsychotic. Overall, 113 (19.3%) patients were on antidepressants, 80 (13.7%) patients were on sedatives/hypnotics, and 16 (2.7%) patients were on mood stabilizers. Three hundred nineteen (55.4%) patients and caregivers of 374 (65%) patients were receiving psychosocial interventions. Conclusions: Diagnostic and prescription patterns in dementia which emerged from this study are comparable to other studies both nationally and internationally. Comparing current practices at individual and national levels against accepted guidelines, obtaining feedback, identifying gaps and instituting remedial measures help to improve the standard of care provided.

Comparison of Traditional and Embedded DTT on Problem Behavior and Responding to Instructional Targets.

Embedded discrete trial training (DTT) involves the presentation of instructional targets in an activity-based situation, and serves as an alternative to traditional, table-top instruction (Geiger, Carr, LeBlanc, Hanney, Polick, et al. Behavior Analysis in Practice 5, 49-59, 2012). The current study compared the effects of Traditional and Embedded DTT on responding to instructional targets and problem behavior for one child with autism. Although the results showed similar levels of accuracy for instructional targets across both conditions, there were more target exposures and no problem behavior during Embedded DTT. The results are discussed along with future directions for research and clinical practice.

Copper antimony sulfide thin films for visible to near infrared photodetector applications.

Ternary chalcostibite copper antimony sulfide (CuSbS2) is an emerging semiconductor material having applications in photovoltaics, energy storage and optoelectronics due to its high absorption coefficient, suitable bandgap, and it consists of non-toxic and earth abundant elements. CuSbS2 thin films are prepared by combining chemical bath deposition (antimony sulfide (Sb2S3)) and thermal evaporation (copper (Cu)) followed by a heat treatment and their application as visible to near infrared photodetectors is reported. Crystalline structure, elemental composition, chemical state, morphology and optoelectronic properties of the films were characterized by various techniques. The effect of three different Cu thicknesses (CAS 20, CAS 30 and CAS 40 nm) on the photodetection properties are evaluated under illumination using light emitting diodes (LEDs) and a laser. The photodetectors fabricated are successfully tested under different wavelengths, power densities and applied voltage and their photoresponse cyclic stability for each wavelength of illumination was recorded. From the sensitivity calculations, the sample with 20 nm Cu thickness (CAS 20) showed higher detection sensitivity for visible to near infrared wavelengths. Better responsivity results were obtained for CAS 40 because of its improved crystallinity and phase purity. Photodetector properties such as sensitivity and responsivity are evaluated for all the samples. These results are beneficial for cost effective and environment friendly photodetectors and optoelectronic devices based on CuSbS2 thin films.

Synthesis of surfactant free stable nanofluids based on barium hexaferrite by pulsed laser ablation in liquid.

Barium hexaferrite nanofluids based on five different solvents have been prepared by employing Pulsed Laser Ablation in Liquid (PLAL) at two different wavelengths of 532 nm and 1064 nm. They were then characterized using Transmission Electron Microscopy (TEM), Scanning Electron Microscopy (SEM), X-ray Photoelectron Spectroscopy (XPS), UV-Vis spectroscopy, and Vibrating Sample Magnetometry (VSM). The chemical states of the ablated nanoparticles were identified from XPS analysis and found to be matching with that of the target. The crystallinity of the nanoparticles were confirmed from high resolution TEM (HRTEM) images and SAED patterns. It is found that different liquid environments lead to the formation of barium ferrite nanoparticles with different particle diameters. The plausible mechanism involved in this process is discussed. This study can pave way for the synthesis of stable magnetic nanofluids of permanent magnets. Further, this technique could be utilized for tailoring the morphology of nanoparticles with a judicious choice of the solvents and other ablation parameters.

Employing a Fixed-Lean Multiple Schedule in the Treatment of Challenging Behavior for Children With Autism Spectrum Disorder.

Despite its utility, there is limited applied research on employing fixed-lean (FL) schedules of reinforcement in treatment packages to address challenging behavior. One potential reason is that abrupt shifts to terminal schedules of reinforcement have been associated with immediate increases in challenging behavior before subsiding to clinically acceptable levels. The purpose of the present study was to (a) provide evidence demonstrating the utility of a FL multiple schedule (MS) in the treatment of challenging behavior in applied settings, (b) examine the potential effects of alternative stimuli on challenging behavior during a FL MS, and (c) assess the social validity of this treatment package with participants and caregivers. The results of this study showed low levels of challenging behavior and discriminated mands during the FL MS, but no evidence to support the inclusion of alternative stimuli. In addition, caregivers of both participants reported high levels of satisfaction with the treatment package. Implications for research and clinical practice are discussed.

Evaluating the effects of massed and distributed practice on acquisition and maintenance of tacts and textual behavior with typically developing children.

This study evaluated the effects of massed and distributed practice on the acquisition of tacts and textual behavior in typically developing children. We compared the effects of massed practice (i.e., consolidating all practice opportunities during the week into a single session) and distributed practice (i.e., distributing all practice opportunities across 4 sessions during the week) on the acquisition of textual behavior in English, tacting pictures of common nouns in Spanish, and textual behavior in Spanish using an adapted alternating treatments design embedded within a multiple probe design. We also examined correct responding during probes that (a) excluded prompts and reinforcement and (b) occurred 48 hr after training each week. The results indicated that distributed practice was the more efficient training format. Maintenance data collected up to 4 weeks after training also indicated that the participants consistently displayed higher levels of correct responding to targets that had been trained in distributed format. We discuss implications for practice and potential areas for future research.

Comparing the effects of massed and distributed practice on skill acquisition for children with autism.

We replicated and extended the findings of Haq and Kodak (2015) by evaluating the efficiency of massed and distributed practice for teaching tacts and textual and intraverbal behavior to 3 children with autism. Massed practice included all practice opportunities conducted on 1 day during each week, and distributed practice included practice opportunities conducted across several days during the week. The results indicated that distributed practice was more efficient for all participants. Suggested areas for future research and implications for practice are discussed.

Vibrational overtone spectra of chloroanilines--evidence for intramolecular hydrogen bonding in o-chloroaniline.

The near infrared vibrational overtone absorption spectra of liquid phase aniline and chloroanilines are reported. The analysis of the observed CH and NH local mode mechanical frequency values shows that intramolecular hydrogen bonding occurs between NH2 group and chlorine atom in o-chloroaniline. This observation supports the conclusion drawn from microwave spectroscopic studies reported earlier.

NIR vibrational overtone spectra of N-methylaniline, N,N-dimethylaniline and N,N-diethylaniline--a conformational structural analysis using local mode model.

In aniline, the lone pair electrons on the nitrogen atom in the amino group interact with the pi electrons of the ring and the mechanical frequency of the ring CH oscillator shows a red shift from that of benzene. This happens because of the parallel orientation of the pi electrons in the two molecules. This effect is observed in N-methylaniline also. But in N,N-dimethylaniline, the addition of two alkyl group to the amino group changes the parallel orientation of pi electrons of the nitrogen. This changes the electron donating nature of the amino substituent and as a result, a blue shift is observed in the mechanical frequency of the ring CH oscillator from that of benzene. The same effect is observed in the ring CH oscillator frequency of N,N-diethylaniline also.

NIR vibrational overtone spectra of toluidines-evidence for steric and electronic effects in o-toluidine.

The near infrared vibrational overtone absorption spectra of liquid phase toluidines are reported. The analysis of the observed CH and NH local mode mechanical frequency values shows that there exists steric and electronic interaction between the amino and methyl groups in o-toluidine. This observation supports the conclusions drawn from structural studies of toluidines by resonance two-photon ionization (R2PI) spectroscopy, ab initio calculations and laser induced fluorescence studies reported earlier.

CH overtone spectrum of nitromethane: a C3V coupled oscillator analysis using local mode parameters.

The near infrared overtone absorption spectrum of liquid phase nitromethane in the spectral region deltaV = 2-5 is reported. The observed spectrum is analysed using local mode model. It is shown that the observed CH local mode overtones and local-local combinations are well predicted by a C(3V) coupled oscillator Hamiltonian.

Behavioral and psychological symptoms of dementia: A study of symptomatology.

BACKGROUND: Behavioral disturbances are integral to the dementing process and contribute adversely to the quality of life of the patients and caregivers. Information regarding the nature of symptoms in Alzheimer's disease is limited in the Indian context. AIM: To study the nature of symptoms in Alzheimer's disease using the Malayalam adaptation of Behavioral Pathology in Alzheimer's disease Rating Scale (BEHAVE-AD). MATERIALS AND METHODS: Forty patients diagnosed as having Alzheimer's disease as per DSM-IV criteria were studied using the Malayalam version of BEHAVE-AD. RESULTS: Delusions and paranoid ideations were present in 53% of the sample studied and 33% had hallucinations. Activity disturbances were seen in 65%, aggressive symptoms in 75% and diurnal rhythm disturbances in 55%. Affective disturbances and anxiety symptoms were present in 37% and 43% respectively. CONCLUSION: The prevalence of behavioral and psychological symptoms of dementia was found to be high.

The International Network on Public Health and Aging (INOPA): introducing a life course perspective to the public health agenda.

In this paper, we present an international network of researchers from projects examining the human aging process and its consequences. It is both vital and urgent to include aging and a life course perspective on the public health agenda, particularly in low-income countries. By announcing the network in a publication, we wish not just to position the network but, more importantly, to attract the attention of other potential collaborators either at the project, institutional, decision making, or applied level.

Prevalence of dementia in an urban population in Kerala, India.

BACKGROUND: Dementia is emerging as an important health problem of elderly people in India. AIMS: To investigate the prevalence, psychosocial correlates and risk factors of various dementing disorders in an urban population in Kerala, southern India. METHOD: A door-to-door survey was conducted in the city of Kochi (Cochin) to identify residents aged > or =65 years using cluster sampling. Of 1934 people screened with a vernacular adaptation of the Mini-Mental State Examination, all those scoring at or below the cut-off of 23 were evaluated further and those with confirmed cognitive and functional impairment were assigned diagnoses according to DSM-IV criteria. Identified cases were categorised by ICD-10 criteria. Ten per cent of those screened as negative were evaluated at each stage. RESULTS: Prevalence of dementia was 33.6 per 1000 (95% CI 27.3-40.7). Alzheimer's disease was the most common type (54%) followed by vascular dementia (39%), and 7% of cases were due to causes such as infection, tumour and trauma. Family history of dementia was a risk factor for Alzheimer's disease and history of hypertension was a risk factor for vascular dementia. CONCLUSIONS: Dementia is an important health problem of the elderly population. Identification of risk factors points towards the possibility of prevention.

The 4051-Angstroms band of C3 (A 1Piu-X 1Sigmag +, 000-000): perturbed low-J lines and lifetime measurements.

Rotational analyses have been carried out at high resolution for the 000-000 and 000-100 bands of the A (1)Pi(u)-X (1)Sigma(g) (+) transition of supersonic jet-cooled C(3). Two different spectra have been recorded for each band, using time gatings of 20-150 and 800-2300 ns. At the shorter time delay the spectra show only the lines observed by many previous workers. At the longer time delay many extra lines appear, some of which have been observed previously by [McCall et al.Chem. Phys. Lett. 374, 583 (2003)] in cavity ring-down spectra of jet-cooled C(3). Detailed analysis of these extra lines shows that at least two long-lived states perturb the A (1)Pi(u), 000 state. One of these appears to be a (3)Sigma(u) (-) vibronic state, which may possibly be a high vibrational level of the b (3)Pi(g) state, and the other appears to be a P = 1 state with a low rotational constant B. Our spectra also confirm the reassignment by McCall et al. of the R(0) line of the 000-000 band, which is consistent with the spectra recorded towards a number of stars that indicate the presence of C(3) in the interstellar medium. Fluorescence lifetimes have been measured for a number of upper-state rotational levels. The rotational levels of the A (1)Pi(u) state have lifetimes in the range of 230-190 ns, decreasing slightly with J; the levels of the perturbing states have much longer lifetimes, with some of them showing biexponential decays. An improved value has been obtained for the nu(1) vibrational frequency of the ground state, nu(1) = 1224.4933 +/- 0.0029 cm(-1).

An epidemiological study of dementia in a rural community in Kerala, India.

BACKGROUND: This community-based epidemiologic study of dementia in a rural population in India investigated the prevalence of various dementing disorders in the community, psychosocial correlates of the morbidity, and assessment of the risk factors associated with dementia. METHOD: A door to door survey was conducted to identify elderly people aged 60 and above. A total of 2067 elderly persons were then screened with a vernacular adaptation of the MMSE. All those who scored 23 and below had a detailed neuropsychological evaluation by CAMDEX-Section B, and the care-givers of the people with confirmed cognitive impairment were interviewed using CAMDEX-Section H to confirm the history of deterioration or impairment in social or personal functioning. In the third phase the subjects with confirmed cognitive impairment were evaluated at home as to whether they satisfied the DSM-III-R criteria for dementia. Subcategorisation of dementia was done based on ICD-10 diagnostic criteria. Five percent of those whose screening was negative were randomly selected and evaluated during each stage. RESULTS: Sixty-six cases of dementia were identified from 2067 persons aged 60 and above, a prevalence rate of 31.9 per thousand. After correction this rate was 33.9 per thousand. Fifty-eight percent of the dementia cases were diagnosed as vascular dementia and 41% satisfied the criteria for ICD-10 dementia in Alzheimer's disease. There were more women in the Alzheimer's disease group; smoking and hypertension were associated with vascular dementia while a family history of dementia was more likely in the Alzheimer's group. CONCLUSION: Dementia is an important cause of morbidity in the geriatric population in this community, where families take responsibility for the care of relatives with dementia.

Prevalence of priority psychiatric disorders in a rural area in kerala.

The objective of the study was to determine the prevalence rate of priority psychiatric disorders in a rural area in Kerala and to find out the sociodemographic correlates of the morbidity. A door to door survey had been conducted by trained surveyors to identify individuals with priority psychiatric disorders. The detected cases were examined by a psychiatrist at their houses in the village itself, to confirm as to whether they were having any psychiatric disorder. Out of the 1094 households surveyed (having a population of five thousand two hundred and eighty four), seventy seven individuals were found to have priority psychiatric disorders giving a prevalence rate of 14.57 per thousand. Females in general showed increased mental morbidity. An increased prevalence rate has been observed among Scheduled Castes/Scheduled Tribes. An increased morbidity is noticed among the people belonging to the lower socioeconomic status.