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Over the past few years antipsychotic medication are increasingly being used for non psychotic illnesses in young people. These have severe side effects and the long term consequences are unknown.
Identify the non psychotic conditions where an antipsychotic medication had been prescribed.
A survey was carried out in a community Child and Adolescent Mental Health Service to find the non psychotic conditions where an antipsychotic medication was prescribed and the reason and choice of the medication.
38 young people were identified from the electronic system that did not meet the criteria for a psychotic illness but had at least one DSM IV TR diagnosis of a non psychotic illness where an antipsychotic medication had been prescribed over the previous 6 months. the case notes of these patients were referred to identify;
▪ The reason for prescribing an antipsychotic.
▪ The antipsychotic that has been prescribed.
• Most common non psychotic condition where an antipsychotic was used was Attention Deficit Hyperactivity Disorder (25). Other conditions were Autism Spectrum disorder (2), Tourette's Disorder (2), Anxiety Disorder (1) and Obsessive Compulsive Disorder (1).
• It was mostly used to manage behavioural problems (22).
• Most common medication used was Risperidone (20) followed by Aripiprazole (7) and Haloperidol (3).
Antipsychotic medications are primarily being used to treat behaviour problems in young people who do not have psychotic illness. Further studies required to see if any other non pharmacological intervention may limit its use.
Science and imperialism emerged as dynamic and significant fields of inquiry within the history of science, the history of imperialism, and postcolonial studies in the 1970s. There is now a clear understanding that the work of scientists in and for European colonies was not a marginal aspect of modern Western science but was integral to its development overall, and especially so in the biological and environmental sciences. At the same time, the impact of science in colonial territories has become a key theme in histories of imperialism, the histories of different colonies, histories of the Third World countries, and postcolonial studies, which is a diverse field of cultural analysis that explores new perspectives on the previously dominant historical narratives.
In today's aggressive global market, innovation is key for success and design solutions require not only to achieve competitive edge, but also to address the growing environmental, social, and economic needs of the community at large. Consideration of these three pillars of sustainability makes a design inclusive, and life cycle thinking is found to be a promising approach across the literature. However, most supports for design address certain facets or aid singular tasks, and the use of design methods and tools, which have the potential to significantly improve the design process, is low due to inappropriate use and selection of these methods. InDeaTe (Innovation Design database and Template) is a holistic, knowledge-driven, computer-based tool for design of sustainable systems, such as products, manufacturing systems andservice systems and has been developed to address and integrate the aspects of sustainability on a singular design platform. It comprises of the generic design process Template that imbibes life cycle thinking into the process by incorporating consideration of every life cycle phase in each design stage, where design activities are performed iteratively. It further supports the design process by aiding the use and selection of appropriate design methods and tools in concurrence with the primary motivation of improving sustainability of the system with the aid of the InDeaTe Design Database. This paper discusses the ontological underpinnings behind the conceptualization of the InDeaTe methodology and the development of the supporting tool. The paper further reports empirical findings from six different case studies conducted for evaluating the effectiveness of InDeaTe tool in supporting design for sustainability (DfS). The results show that InDeaTe tool has potential in supporting DfS.
Design is a decision-making process for which knowledge is a prerequisite. Most decisions are taken at the conceptual stage and have pronounced influence on the final design. The literature, therefore, recommends the incorporation of sustainability criteria, such as environment, at this stage. Difficulty in performing life cycle assessment (LCA) due to low availability of information at the conceptual stage for evaluation and highly abstract nature of solutions, inadequate incorporation of DfE (Design for Environment) guidelines and LCA reports into the design process, and a lack of effective communication of the same to the designers for prompt decision-making are major motivations for the development of a support. This paper discusses a “conceptual Tool for environmentally benign design” – concepTe – that supports designers in decision-making during the conceptual design stage, by offering environmental impact (EI) estimates of abstract solutions with associated uncertainty, for evaluation and selection of the most environmentally benign solution as concept. The EI estimates are calculated by a module in the tool based on a proposed EI estimation method, which requires the support of a knowledge base to fetch appropriate LCA information corresponding to the design element being conceptualized. This knowledge base is grounded in the domain-agnostic SAPPhIRE model ontology, allows semantic operability of the knowledge, and offers the results to the designers in a familiar domain language to aid decision-making. A “proof of concept” of the tool is developed for application in design of building in the AEC (Architectural design, Engineering, and Construction) domain. Further, empirical studies are conducted to evaluate the effectiveness of the “proof of concept” to support decision-making and results are found favorable. The paper also discusses the future scope for further development of the tool into a holistic design decision-making platform.
Microwave plasma chemical vapor deposition (MPCVD) was used to diffuse boron into tantalum using plasma initiated from a feedgas mixture containing hydrogen and diborane. The role of substrate temperature and substrate bias in influencing surface chemical structure and hardness was investigated. X-ray diffraction shows that increased temperature results in increased TaB2 formation (relative to TaB) along with increased strain in the tantalum body-centered cubic lattice. Once the strained tantalum becomes locally supersaturated with boron, TaB and TaB2 precipitate. Additional boron remains in a solid solution within the tantalum. The combination of precipitation and solid solution hardening along with boron-induced lattice strain may help explain the 40 GPa average hardness measured by nanoindentation. Application of negative substrate bias did not further increase the hardness, possibly due to etching from increased ion bombardment. These results show that MPCVD is a viable method for synthesis of superhard borides based on plasma-assisted diffusion.
Mycetoma is a chronic granulomatous, suppurative and progressive inflammatory disease that usually involves the subcutaneous tissue and bones after traumatic inoculation of the causative organism. In India, actinomycotic mycetoma is prevalent in south India, south-east Rajasthan and Chandigarh, while eumycetoma, which constitutes one third of the total cases, is mainly reported from north India and central Rajasthan. The objective was to determine the epidemiological profile and spectrum of eumycetoma from a tertiary care hospital in Delhi, North India. Thirty cases of eumycetoma were diagnosed by conventional methods of direct microscopy, culture and species-specific sequencing as per standard protocol. The spectrum of fungal pathogens included Exophiala jeanselmei, Madurella mycetomatis, Fusarium solani, Sarocladium kiliense, Acremonium blochii, Aspergillus nidulans, Fusarium incarnatum, Scedosporium apiospermum complex, Curvularia lunata and Medicopsis romeroi. Eumycetoma can be treated with antifungal therapy and needs to be combined with surgery. It has good prognosis if it is timely diagnosed and the correct species identified by culture for targeted therapy of these patients. Black moulds required prolonged therapy. Its low reporting and lack of familiarity may predispose patients to misdiagnosis and consequently delayed treatment. Hence health education and awareness campaign on the national and international level in the mycetoma belt is crucial.
Patients with major depressive disorder (MDD) display cognitive deficits in acutely depressed and remitted states. Childhood maltreatment is associated with cognitive dysfunction in adults, but its impact on cognition and treatment related cognitive outcomes in adult MDD has received little consideration. We investigate whether, compared to patients without maltreatment and healthy participants, adult MDD patients with childhood maltreatment display greater cognitive deficits in acute depression, lower treatment-associated cognitive improvements, and lower cognitive performance in remission.
Healthy and acutely depressed MDD participants were enrolled in a multi-center MDD predictive marker discovery trial. MDD participants received 16 weeks of standardized antidepressant treatment. Maltreatment and cognition were assessed with the Childhood Experience of Care and Abuse interview and the CNS Vital Signs battery, respectively. Cognitive scores and change from baseline to week 16 were compared amongst MDD participants with (DM+, n = 93) and without maltreatment (DM−, n = 90), and healthy participants with (HM+, n = 22) and without maltreatment (HM−, n = 80). Separate analyses in MDD participants who remitted were conducted.
DM+ had lower baseline global cognition, processing speed, and memory v. HM−, with no significant baseline differences amongst DM−, HM+, and HM− groups. There were no significant between-group differences in cognitive change over 16 weeks. Post-treatment remitted DM+, but not remitted DM−, scored significantly lower than HM− in working memory and processing speed.
Childhood maltreatment was associated with cognitive deficits in depressed and remitted adults with MDD. Maltreatment may be a risk factor for more severe and persistent cognitive deficits in adult MDD.
Melatonin-rich and 1,8-cineole-rich extracts have been successfully obtained from yellow mustard (YM) and small cardamom (SC) seeds, respectively, employing green technology of supercritical CO2 (SC-CO2) extraction. Chemical profiling confirmed the presence of melatonin and 1,8-cineole and co-extractants in the respective extracts. Electron paramagnetic resonance spectroscopy attested strong antioxidant activities of the extracts foregoing pan-assay interference compounds involved in spectroscopic analysis. These extracts also exhibited synergistic efficacies greater than unity confirming antioxidant synergy among the co-extracted bioactives therein. To ascertain hypocholesterolaemic efficacies, these extracts were co-administered orally with Triton X (at the pre-optimised dose of 175 mg/kg body weight (BW)) to Wistar albino rats at doses of 550, 175 and 55 mg/kg BW. Serum total cholesterol levels in the rats were monitored on days 3, 7, 15 and 21. On day 21, total cholesterol level reduced appreciably by 49·44 % in rats treated with YM seed extract and by 48·95 % in rats treated with SC seed extract, comparable with atorvastatin-administered rats (51·09 %). Either extract demonstrated inhibitory effects on hepatic 3-hydroxy-3-methyl-glutaryl-CoA (HMG-CoA) reductase activity. A molecular docking exercise identified specific compounds in the extracts which possessed binding affinities comparable with therapeutically used HMG-CoA reductase inhibitors. In silico and in vivo studies concertedly concluded that the consortium of bioactive components in the extracts cannot be considered as invalid metabolic panaceas and therefore these ‘green’ extracts could be safely subjected to clinical studies as preventive biotherapeutics for hypercholesterolaemia. These extracts could be consumed per se as hypocholesterolaemic supplements or could be ingredients of new spice-based therapeutic foods.
To assess whether disparities in energy consumption and insufficient energy intake in India have changed over time across socio-economic status (SES).
This cross-sectional, population-based survey study examines the relationship between several SES indicators (i.e. wealth, education, caste, occupation) and energy consumption in India at two time points almost 20 years apart. Household food intake in the last 30 d was assessed in 1993–94 and in 2011–12. Average dietary energy intake per person in the household (e.g. kilocalories) and whether the household consumed less than 80 % of the recommended energy intake (i.e. insufficient energy intake) were calculated. Linear and relative risk regression models were used to estimate the relationship between SES and average energy consumed per day per person and the relative risk of consuming an insufficient amount of energy.
Rural and urban areas across India.
A nationally representative sample of households.
Among rural households, there was a positive association between SES and energy intake across all four SES indicators during both survey years. Similar results were seen for energy insufficiency vis-à-vis recommended energy intake levels. Among urban households, wealth was associated with energy intake and insufficiency at both time points, but there was no educational patterning of energy insufficiency in 2011–12.
Results suggest little overall change in the SES patterning of energy consumption and percentage of households with insufficient energy intake from 1993–94 to 2011–12 in India. Policies in India need to improve energy intake among low-SES households, particularly in rural areas.
In today's highly competitive market, product success is determined by two critical factors - innovation and sustainability. While innovation looks to rampantly satisfy the consumers' ever growing requirements with creative solutions, sustainability attempts to rationalise the precarious demands of desired requirements on economy, society and environment.
InDeaTe - Innovation Design database and Template, a web-based, design process guidance tool, supports design of sustainable systems by incorporating sustainability requirements into the design process. This paper investigates the potential of the tool to improve the usefulness of a design, one of the indicators of the creativity of the solutions, apart from its novelty. Comparative studies are conducted to assess the improvement of ‘requirement-satisfaction’,a proxy measure for usefulness. Upon introduction of the tool into the design process, significant improvements are reported, thereby reflecting the ability of InDeaTe to increase the usefulness of solutions and foster creativity in design.
Endoperoxides kill malaria parasites via cleavage of their endoperoxide bridge by haem or iron, leading to generation of cytotoxic oxygen-centred radicals. In view of the Leishmania parasites having a relatively compromised anti-oxidant defense and high iron content, this study aims to establish the underlying mechanism(s) accounting for the apoptotic-like death of Leishmania promastigotes by artemisinin, an endoperoxide. The formation of reactive oxygen species was confirmed by flow cytometry and was accompanied by inhibition of mitochondrial complexes I–III and II–III. However, this did not translate into a generation of mitochondrial superoxide or decrease in oxygen consumption, indicating minimal impairment of the electron transport chain. Artemisinin caused depolarization of the mitochondrial membrane along with a substantial depletion of adenosine triphosphatase (ATP), but it was not accompanied by enhancement of ATP hydrolysis. Collectively, the endoperoxide-mediated radical formation by artemisinin in Leishmania promastigotes was the key step for triggering its antileishmanial activity, leading secondarily to mitochondrial dysfunction indicating that endoperoxides represent a promising therapeutic strategy against Leishmania worthy of pharmacological consideration.
The biological domain has the potential to offer a rich source of analogies to solve engineering design problems. However, due to the complexity embedded in biological systems, adding to the lack of structured, detailed, and searchable knowledge bases, engineering designers find it hard to access the knowledge in the biological domain, which therefore poses challenges in understanding the biological concepts in order to apply these concepts to engineering design problems. In order to assist the engineering designers in problem-solving, we report, in this paper, a web-based tool called Idea-Inspire 4.0 that supports analogical design using two broad features. First, the tool provides access to a number of biological systems using a searchable knowledge base. Second, it explains each one of these biological systems using a multi-modal representation: that is, using function decomposition model, text, function model, image, video, and audio. In this paper, we report two experiments that test how well the multi-modal representation in Idea-Inspire 4.0 supports understanding and application of biological concepts in engineering design problems. In one experiment, we use Bloom's method to test “analysis” and “synthesis” levels of understanding of a biological system. In the next experiment, we provide an engineering design problem along with a biological-analogous system and examine the novelty and requirement-satisfaction (two major indicators of creativity) of resulting design solutions. In both the experiments, the biological system (analogue) was provided using Idea-Inspire 4.0 as well as using a conventional text-image representation so that the efficacy of Idea-Inspire 4.0 is tested using a benchmark.
It is well-known that creativity is crucial for sustaining a product against competition. Many factors have been proposed in the literature as indicators of creativity, among which outcome-characteristics-based factors are considered the most reliable; among these, the creativity of an outcome is often indicated by two major factors: novelty and usefulness. Only a few studies address as to how creativity assessment methods and their results can be used during the design process. To systematically address the issue of how to influence creativity of design solutions, the following questions have been framed. (1) Which factors should be used as indicators of creativity consistently across different phases of the engineering design process? (2) How can creativity be assessed in terms of these factors during the engineering design process? In this work, we consider novelty and usefulness as the necessary factors for creativity. It is found, however, that it is not possible to directly assess the usefulness of outcomes during the design process. Therefore, requirement satisfaction is used as a proxy for usefulness. We propose a creativity assessment method that uses novelty and requirement satisfaction as indicators for creativity; the method can be used for assessing not only complete products but also ideas or concepts, as they evolve through the phases of the design process. The application of the method in design is explained using a detailed example from a case study.
The National Iodine and Salt Intake Survey (NISI) 2014–2015 was undertaken to estimate household iodised salt coverage at national and sub-national levels in India.
Cross-sectional survey with multistage stratified random sampling.
India was divided into six geographic zones (South, West, Central, North, East and North-East) and each zone was further stratified into rural and urban areas to yield twelve distinct survey strata.
The target respondent from each household was selected as per predefined priority; wife of the household head, followed by women of reproductive age, followed by any adult available during the visit.
Households (n 5717) were surveyed and salt samples (n 5682) were analysed. Household coverage of iodised salt (iodine≥5 ppm) was 91·7 (95 % CI 91·0, 92·7) %. Adequately iodised salt (iodine≥15 ppm) was consumed in 77·5 (95 % CI 76·4, 78·6) % of households. Significant differences in coverage were seen across six geographic regions, with North and North-East zones on the verge of achieving the universal salt iodisation target of >90 % coverage. Coverage of households with adequately iodised salt (adjusted OR; 95 % CI) was significantly less in rural households (0·55; 0·47, 0·64), lower/backward castes (0·84; 0·72, 0·98), deprived households (0·72; 0·61, 0·85) as assessed by multidimensional poverty index, households with non-diverse diet (0·73; 0·62, 0·86) and households using non-packaged salt (0·48; 0·39, 0·59) and non-refined salt (0·17; 0·15, 0·20).
India is within striking reach of achieving universal salt iodisation. However, significant differentials by rural/urban, zonal and socio-economic indicators exist, warranting accelerated efforts and targeted interventions for high-risk groups.
How does the vertical structure of an industry affect the links between cross-border mergers and international trade? To answer this question, we construct a tractable vertical general equilibrium (VGOLE) model of an oligopolistic industry. In a vertically related industry, firms are located at different stages of production or distribution, with some firms supplying inputs used by others. Mergers in vertically related industries have been drawing increasing attention of regulators, anti-trust authorities, as well as those in the media and academics. This is so because cross-border mergers between firms in such industries add more complexities for competition within and across open economies.
Although the theoretical literature on cross-border mergers is still at its infancy, to the best of our knowledge, our VGOLE construct is the first general equilibrium model to explore the implications of vertical structures for the links between cross-border mergers and international trade in oligopolistic industries. The vertical structure of an industry injects a distinction between the foreign and domestic firms, even in the absence of transport costs, because mergers can affect competition in input markets creating, in addition to the usual market power motive, an input-market concentration effect. Our key results, stemming from a direct comparison of the pattern of specialization and the incentives for cross-border mergers with and without the possibility of vertically integration, are that a) the extensive margin of trade shrinks in the face of vertical integration; and b) cross-border mergers mitigate the effect of vertical integration on the extensive margins of trade by facilitating specialization toward the direction of comparative advantage. Intuitively, as the disintegrated home firms become less competitive, it allows foreign firms to compete in a larger subset of sectors, wherein, without vertical integration, home would have a comparative advantage. The impact of a merger, on the extensive margins of trade, is magnified when the merger takes place between two disintegrated firms across borders compared to a merger between a disintegrated firm in one country and a vertically integrated firm in another.
The rest of the chapter is organized as follows. In the next section, we present our VGOLE model and results. In the third section, we discuss the welfare implications of our construct and cover some caveats. In the final section, we draw key conclusions.
Anaemia is a major contributor to the global disease burden and half of pregnant women in India were anaemic in 2016. The aetiology of anaemia is complex, yet anaemia determinants are frequently examined in isolation. We sought to explore how shifts in sociodemographic (wealth, age at pregnancy, education, open defecation, cooking fuel type, household size), programmatic (iron–folic acid tablet consumption, antenatal care visits) and dietary factors (intake of Fe, folic acid, vitamin B12, phytate) predicted changes in anaemia prevalence.
Nutrient levels for eighty-eight food items were multiplied by household consumption of these foods to estimate household-level nutrient supply. A synthetic panel data set was created from two rounds of the District Level Household and Facility Survey (2002–04 and 2012–13) and Household Consumer Expenditures Survey (2004–05 and 2011–12). Ordinary least-squares multivariate regression models were used.
Districts (n 446) spanning north, north-east, central and south India.
Pregnant women aged 15–49 years (n 17 138).
In the model accounting for both non-dietary and dietary factors, increased age at pregnancy (P<0·001), reduced village-level open defecation (P=0·001), consuming more Fe (P<0·001) and folic acid (P=0·018) and less phytate (P=0·002), and urbanization (P=0·015) were associated with anaemia reductions. A 10 mg increase in daily household Fe supply from 2012 levels was associated with a 10 % reduction in anaemia.
Public health interventions to combat anaemia in pregnant women should use a holistic approach, including promotion of delayed marriage, construction and use of toilets, and measures that facilitate adoption of nutrient-rich diets.