Analysis of Electroviscous Effect for Flow of Micropolar Fluids in a Nanochannel with Overlapping Electric Double Layers at High Zeta Potential.

Flows in nanofluidic channels under the influence of pressure gradient often lead to the overlapping of the electrical double layers (EDLs) augmenting the electroviscous effect. In this work, we analyze the electroviscous effect for the flow of a micropolar fluid in a parallel plate nanochannel, considering EDL overlapping and interfacial slip. Closed-form expressions of EDL potential, velocity, microrotation, yielded streaming potential, and volumetric flow rate are derived semi-analytically for high zeta potential without accounting for the Boltzmann distribution. We observe a significant change in streaming potential with inverse ionic Peclet number (R) for its lower values, and the range of streaming potential is more for thicker EDL. The micropolarity parameter does not have any influence on the streaming potential for weaker EDL overlapping at a lower R value. For thicker EDL, velocity decreases with the micropolarity parameter, while it increases drastically with interfacial slip. However, velocity shows a non-monotonic behavior with interfacial slip and micropolarity parameter for thinner EDL. The microrotation remains invariant with interfacial slip for thicker EDL, whereas its magnitude decreases with slip length for thinner EDL. Although the sensitivity of the flow rate on slip (Qs*) increases with R for thicker EDL, the behavior is non-monotonic for thinner EDL. Furthermore, Qs* varies non-monotonically with the micropolarity parameter at higher couple stress parameter values and vice versa. In fact, the volumetric flow rate is highly sensitive to slip for thicker EDL overlapping.

IPA and WPA-SOAP position statement on deprivation of liberty of older persons with mental health conditions.

In recognition of the challenges faced by older persons deprived of their liberty, a call was made for input into the 2022 report to the United Nations Human Rights Council (HRC) on older persons. This Position Statement outlines the views of two global organizations, the International Psychogeriatric Association (IPA) and the World Psychiatric Association Section of Old Age Psychiatry (WPA-SOAP), working together to provide rights and dignity-based mental health services to older persons and it was sent to the Independent Expert on the enjoyment of all human rights by older persons at HRC.

Perceived Barriers in the Assessment and Management of Female Sexual Dysfunction: a Survey Among Resident Trainees in Psychiatry.

OBJECTIVE: The authors examined the perceived barriers in the assessment and management of female sexual dysfunction among resident trainees in psychiatry. METHODS: An online survey was conducted among 148 resident trainees in psychiatry at a tertiary academic psychiatry center in India. It consisted of nine items with responses rated on a Likert scale. The anonymity of the responses was maintained. RESULTS: A total of 73 residents (49.3%) responded to the survey. Spontaneous reporting of sexual functioning, which is patient-driven, and spontaneous inquiry, which is resident-driven, were lacking. Specific barriers identified in the majority were lack of time, privacy, linguistic challenges, limited knowledge, and sociocultural background of the patient. The gender of the resident was not perceived as a major barrier in a majority. Marital discord appeared as a common response for inquiries into sexual functioning, while the use of psychotropics, the presence of medical comorbidities, and the postmenopausal state did not attract a majority to inquire about the same. Furthermore, a response that there was a lack of intervention in those reporting sexual dysfunction was commonly noted. Only 5.5% of the participants reported having received adequate formal training in the management of female sexual dysfunction. CONCLUSION: Female sexual dysfunction is common, adds to psychiatric morbidity, and affects the quality of life. It is important to impart training on female sexual dysfunction as a part of their residency program with cultural appropriateness. A future direction would be to evaluate the effectiveness of a formal training program for assessing and managing female sexual dysfunction.

Role of Dignity in Mental Healthcare: Impact on Ageism and Human Rights of Older Persons.

The global demographic shift toward an aging population is predicted to result in a significant burden of mental health conditions and psychosocial disability. There has been a greater awareness of ageism and its toxic effects creating a paradigm shift to include a human right, ethical, and social justice-based approach to augment the biomedical model of mental healthcare. The concept of dignity lies at the heart of human rights and must be a central concept integrated into public health and mental healthcare. Dignity denotes the self-respect and worthiness of an individual as well as social consideration of his/her identity. Dignity in older persons is multi-dimensional and includes several factors such as privacy, independence, inclusion, autonomy, etc. There are several determinants such as frailty, dependence, sensory, cognitive impairment and socioeconomic vulnerabilities, which tend to compromise dignity in the elderly and hence their fundamental rights. One such construct is that of ageism which comprises stereotypes, prejudice and discrimination based on age. Ageism and related forms of stigma impair dignified healthcare in older persons and deprive them of their rights. Mental health professionals are uniquely positioned to incorporate the strategies to promote dignity in their clinical care and research as well as advocate for related social/health policies based on a human rights approach. These intersections are discussed in this paper in light of the United Nations Convention on Rights of the Older Persons.

Digital gaming interventions: a novel paradigm in mental health? Perspectives from India.

The mental health gap has been a persistent concern globally, especially in low and middle-income countries (LMIC). In an attempt to mitigate resource limitations, the psychiatric practice has been undergoing a paradigm shift into digitalized mental health interventions. One such innovation involves digital gaming utilizing the principles of 'gamification' to incorporate both the playfulness component of online gaming as well as the domain-targeted design of gaming elements. Digital gaming-based interventions have been to deliver psychotherapy, biofeedback, cognitive training and rehabilitation, as well as behavioural modification and social skills training. Research shows their utility in autism spectrum disorders, attention deficit disorders, schizophrenia, depression, anxiety disorders, post-traumatic stress, eating disorders, neurocognitive disorders and also to promote healthy aging. Though promising in scope, these interventions face pragmatic challenges for implementation in developing countries. Even though increased use of technology, internet penetration and growing digital literacy have enhanced their accessibility and feasibility, various factors like socio-cultural diversity, lack of standardization, poor infrastructural support, bandwidth issues and lack of practice can impair their use and acceptability. Keeping this in the background, this commentary critically discusses the scope, applications and challenges of digital gaming in mental healthcare delivery in one of the rapidly globalizing LMIC nations, India.

When Dhat Syndrome is Delusional: A Case Series.

The Dhat syndrome is a culture-bound syndrome associated with anxiety and somatic and mood symptoms related to semen loss. It sometimes occurs in women, in whom it comes with vaginal discharge. Only a single case has been reported whereby Dhat delusion was associated with schizophrenia. In this case report, we dwell on two individuals suffering from a somatic-type delusional disorder with Dhat-like symptoms who had initially presented classical symptoms of the Dhat syndrome. Further studies are needed to explore the intersections of Dhat syndrome and psychoses, as well as the risk factors involved in mutual predisposition.

Endoxifen in Treatment of Individuals with Borderline Personality Disorder with Predominant Impulsivity: A Case Series.

Endoxifen, a protein kinase C inhibitor, has been approved for use in manic episodes in India. One of the symptom traits that it predominantly targets is impulsivity. Impulsivity can also be a symptom dimension of other mental health conditions, one of which is Borderline Personality Disorder (BPD). Management of BPD is challenging, with limited pharmacological options that are symptom-directed and psychotherapy sessions that are fraught with early dropouts and lack of compliance. Impulsive behaviors represent a major reason for seeking help in BPD, especially with regard to non-suicidal self-injury, substance abuse, high-risk sexual behavior, aggression, etc. Here, we present a case series comprising five individuals with a diagnosis of BPD whose treatment regimens were changed and endoxifen added at a dose of 8 mg once daily. Clinical improvement was monitored using the Borderline Evaluation of Severity Over Time (BEST). All the subjects improved in the impulsivity domains as well as with regard to attention deficits, mood fluctuations, and overall functioning. Endoxifen is thus potential promising in terms of the management of BPD, but needs more extensive study to fully substantiate its clinical benefits.

Revisiting Social Stigma in Non-suicidal Self-injury: A Narrative Review.

Non-suicidal self-injury (NSSI) is highly prevalent in our community. Yet, there is a significant discrepancy between the number of individuals engaging in NSSI and those who seek treatment for NSSI. This discrepancy can be due to the high social stigma associated with the behavior. The impact of NSSI stigma is significant and can impair the quality of life in the individuals engaging in NSSI, delay help-seeking, reduce access to mental health care and further fuel misinformation. Even though the symptomatology, risks, and demographics of NSSI have received attention in terms of research, there is limited literature on NSSI stigma and its consequences. With that background set, this review provides a bird's-eye view of the different levels of stigma in NSSI (public, self, and health care), associated discrimination, the various aspects of such stigmatization (NSSI-related language, physical scarring, misinformation, the media), and, finally, the collaborative clinical-outreach interventions for mitigating NSSI-associated social stigma. If NSSI is indeed recognized as a clinical disorder, future research would need to focus on these constructs of stigma and treat them with the same importance as the one given to clinical studies of intervention and symptomatology in NSSI.

Healthy Longevity Among the LGBTQIA+ Population: From Neglect to Meeting Their Needs: Здоровое долголетие представителей сообщества ЛГБТКИА+: от игнорирования к удовлетворению потребностей.

The world is facing rapid population aging. This is associated with an increase in the number of older people from the lesbian, gay, bisexual, trans, queer, intersex, or asexual (LGBTQIA+) community. This population faces unique challenges, including ageism, sexual identity stigma, and self-stigma. The older LGBTQIA+ population are neglected by, and invisible to, healthcare interventions, research, and policy changes. In light of the paradigm shift in healthcare towards a rights-based approach, healthy aging has become an important construct. Healthy aging, according to the World Health Organization (WHO), is a "continuous process of optimizing opportunities to maintain and improve physical and mental health, autonomy, and quality of life throughout the life course". This commentary highlights the unique vulnerabilities of the aging LGBTQIA+ population, advocates the inclusion of their voices at all levels of the healthcare system, and discusses the way forward to enable their 'healthy aging'.

"Love in the Later Years ": Perceptions of Sex and Sexuality in Older Indian Adults - a Qualitative Exploration: «Ð›ÑŽÐ±Ð¾Ð²ÑŒ в позднем возрасте... ¼: восприятие секса и сексуальности у Ð¿Ð¾Ð¶Ð¸Ð»Ñ‹Ñ Ð»ÑŽÐ´ÐµÐ¹ в Индии (качественный анализ).

BACKGROUND: The world faces global population ageing. With this demographic shift and increased life-expectancy, healthcare services are focused on healthy ageing. Sexual health is a vital yet neglected dimension of general health and wellbeing in older adults. This study aimed to explore sexual experiences and perceptions of sexuality among older people in India. METHODS: A qualitative approach with social constructivist paradigm was used. 20 participants aged above 60 years were recruited through purposive sampling until thematic saturation was reached. In-person, in-depth interviews were conducted using a semi-structured guide after an initial pilot study. They were audio-recorded, transcribed, and translated verbatim. Thematic analysis was conducted, and rigor ensured through triangulation and respondent validation. RESULTS: The overarching categories were "sexuality as a mode of resilience", "emotional stability and intimacy as attributes of sexual pleasure", and "lack of sexual rights awareness". The main categories (themes) were sexual experiences (intimate touch, non-penile sex, personal meanings of sexuality), partner expectations (companionship, support, continuity of care, proximity), and barriers against sexual expression (social stereotypes, stigma, lack of audience in healthcare services). The older people were accepting of their sexual difficulties and coped through relationship dynamics. Participant voices are discussed with regard to the socio-cultural context. CONCLUSION: Sexual wellbeing is connected with "ageing well". Our findings suggest that older people retain sexual desires and fantasies through changed patterns and expectations. Healthcare services, policymakers and academia need to be informed about older people's sexual needs and rights.

"It seemed like my fault for wanting to become a mother "-Experiences and perceptions related to motherhood in women with severe mental illness.

BACKGROUND: Women with mental illness experience unique challenges during their motherhood. However, little is known about their own perceptions and unmet needs in the process of childbearing. A qualitative study design with a social constructivist paradigm was used to explore lived experiences of mothers with severe mental illness (SMI) during the childbearing period. METHODS: Semi-structured in-depth interviews were conducted with 30 mothers recruited through purposive sampling. This was followed by inductive thematic analysis. Rigor was established through triangulation and respondent validation. This paper focuses on the perceptions during the pre-conception and pregnancy period. RESULTS: Emergent categories (themes) were thoughts/feelings about childbearing (ambivalence about being a mother/having a baby, fantasies about childbearing/rearing, guilt about pregnancy), the impact of mental illness (stigma, effect of symptoms on their self-care including healthcare, concerns about effect of medications on fetus), unmet needs (lack of emotional support, unanswered doubts about effects of illness on pregnancy, child and motherhood, wanting to be considered as "potential mothers"), and caregivers' reactions (discrimination, anger/abuse, selective support). The centrality of motherhood and balancing the "dual role" of a patient and mother were the overarching categories after analysis. CONCLUSION: Mothers with SMI prize motherhood but navigate through it with various adverse experiences. The results of this study, grounded in their voices, provide critical insights for service and policy provisions in perinatal psychiatry.

"The Unheard Voices": Lived Experiences of Sexual Abuse in Male Survivors.

Background: Victims of sexual abuse face unique emotional challenges. Among them, the male survivors of sexual assault have largely been neglected in the literature, being traditionally considered "against the norm" and symbolic of reduced masculinity. Methods: Qualitative approach was used to study the lived experiences of five (three heterosexual and two homosexual) male survivors of sexual abuse. In-depth interviews were conducted with consent, transcribed verbatim, and analyzed using interpretative phenomenological analysis (IPA). Results: Commonality in the experiences of abuse (the identity of the abuser, nature of agony), perspectives of sharing the abuse history (lack of acceptance of "male" victimhood, the openness of the opposite gender, family reactions), and the long-term impact of abuse (withdrawal/change of interest as coping, sexual identity issues) emerged as the main superordinate theme (and subthemes). Conclusion: Society, with its patriarchy, often turns apathetic to male victimization in sexual abuse. Beliefs about masculinity and resultant trauma can cause a chronic social and psychosexual impact on the victims. More systematic research is needed to understand their perceptions, unmet needs, and experiences of recovery.

The national suicide prevention strategy in India: context and considerations for urgent action.

India reports the highest number of suicide deaths in the world. At this time when the Indian Government is formulating a national suicide prevention strategy, we have reviewed the current status of suicides in India, focusing on epidemiology, risk factors, and existing suicide prevention strategies to identify key challenges and priorities for suicide prevention. The suicide rate among Indian girls and women continues to be twice the global rate. Suicide accounts for most deaths in the 15-39 years age group compared with other causes of death. Hanging is the most common method of suicide, followed by pesticides poisoning, medicine overdose, and self-immolation. In addition to depression and alcohol use disorders as risk factors, several social and cultural factors appear to increase risk of suicide. The absence of a national suicide prevention strategy, inappropriate media reporting, legal conflicts in the interpretation of suicide being punishable, and inadequate multisectoral engagement are major barriers to effective suicide prevention. A scaffolding approach is useful to reduce suicide rates, as interventions provided at the right time, intensity, and duration can help navigate situations in which a person might be susceptible to and at risk of suicide. In addition to outlining research and data priorities, we provide recommendations that emphasise multilevel action priorities for suicide prevention across various sectors. We call for urgent action in India by integrating suicide prevention measures at every level of public health, with special focus on the finalisation and implementation of the national suicide prevention strategy.

The WPA-IPS-SPF-AFPA Joint Panel Discussion Organized by the IPA: Voices from South Asia Regarding Older People's Mental Health Advocacy and Services: Дискуссия экспертов WPA-IPS-SPF-AFPA под эгидой Международной Ð¿ÑÐ¸Ñ Ð¾Ð³ÐµÑ€Ð¸Ð°Ñ‚Ñ€Ð¸Ñ‡ÐµÑÐºÐ¾Ð¹ ассоциации: услуги по Ð¾Ñ Ñ€Ð°Ð½Ðµ Ð¿ÑÐ¸Ñ Ð¸Ñ‡ÐµÑÐºÐ¾Ð³Ð¾ здоровья и защита интересов Ð¿Ð¾Ð¶Ð¸Ð»Ñ‹Ñ Ð»ÑŽÐ´ÐµÐ¹ в Южной Азии.

Kicking off on 1 October with the United Nations' International Day of Older Persons (UNIDOP) and concluding on 10 October in conjunction with World Mental Health Day, the OLDER ADULT MENTAL HEALTH AWARENESS WEEK was a brand-new ten-day initiative launched by the International Psychogeriatric Association (IPA). It was focused on raising awareness of the importance of Better Mental Health for Older People with virtual programs from all around the world on each of these ten days. As part of this Awareness Week, the IPA hosted a discussion entitled "Mental healthcare services and advocacy for the older people amidst COVID crisis: Voices from South Asia", organized on October 6th, 2021 in conjunction with the World Psychiatric Association (WPA), Indian Psychiatric Society (IPS), Indian Association of Geriatric Mental Health (IAGMH), SAARC Psychiatric Federation (SPF), and the Asian Federation of Psychiatric Associations (AFPA). This is the event report of the same panel discussion which highlights the unique challenges to old age mental healthcare among the SAARC nations, calls for urgent collaborative action, and focuses on human rights and dignity-based mental healthcare for older adults in these rapidly ageing countries.