Sexual Orientation Change Efforts Among LGBT+ People of Kerala: Prevalence, Correlates, and Mental Health Aspects

Sexual Orientation Change Efforts (SOCE) have been reported worldwide and have adverse psychiatric consequences. However, no data are available for India or Kerala. We assessed the prevalence of SOCE, its characteristics, and mental health aspects among LGBT+ individuals in Kerala. This cross-sectional survey used snowball sampling. An online questionnaire collected sociodemographic information and history and characteristics of SOCE. Religiosity and SOCE-associated distress were evaluated using 6-point Likert scales. Patient Health Questionnaire (PHQ-9) screened for depressive symptoms; its ninth question assessed death wishes and self-harm thoughts. Generalized Anxiety Disorder Assessment (GAD-7) screened for anxiety symptoms. Participants' (n = 130) mean age was 26.80 ± 7.12 years. Most common biological sex (63.1%) and gender identity (50.8%) were male, and sexual orientation was gay(42.3%). Prevalence of SOCE was 45.4%. In SOCE group, 39% reported very severe distress. SOCE was most commonly self-prompted (47.5%), performed through psychotherapy (28.8%), and performed by doctors (28.8%). SOCE group had significantly higher religiosity scores (t = 2.61, p = .01). Among cisgender men, 48.48% had SOCE history, against 28.57% among cisgender women (χ2 = 3.19, p = .07). SOCE is highly prevalent among the LGBT+ community in Kerala, with high associated distress. Multi-level approaches are necessary to mitigate this problem.

Erectile Dysfunction in Alcohol Use Disorder and the change in erectile function after one month of abstinence

OBJECTIVE

The association between alcohol use and erectile dysfunction (ED) has not been explored adequately. The aim of this study is (i) to determine the prevalence of ED in patients with Alcohol use disorder (AUD), (ii) the association of ED with sociodemographic and clinical variables, (iii) the association between severity of drinking and sociodemographic and clinical variables, and (iv) the assess the change in ED after one month of abstinence from alcohol.

METHODS

203 consecutive patients were recruited into the study after taking written informed consent. Sociodemographic data was collected using a proforma and ED was assessed using International Index of Erectile Function-5 (IIEF-5). The patients were also followed up after 1 month of abstinence to assess the change in erectile function.

RESULTS

The prevalence of ED was 68.5%. Out of the 203 subjects, 28.1% had mild ED, 24.1% had mild to moderate ED, 9.9% had moderate ED and 6.4% had severe ED. Significant association were seen between ED and age, marital status, diabetes mellitus, hypertension, total duration, and severity of drinking. A significant association was seen between severity of drinking and age, diabetes mellitus, hypertension, alcoholic liver disease, tobacco use and duration of drinking. The improvement in ED after 1 month abstinence was found to be significant.

CONCLUSIONS

ED is a common problem in patients with AUD. Routine assessment of sexual functioning is warranted in patients with AUD and the information that ED improves with abstinence can provide an impetus to change.

Earthship buildings: stakeholder opinions of their contribution towards sustainable alternative housing in the United Kingdom

Society requires additional affordable housing to meet its growing demands. Further, people expect their homes to meet sustainability targets and for the lifestyles they proffer to accord with low impact living. Earthship buildings are marketed as being an epitome of sustainable alternative housing. Built by reusing or repurposing mostly reclaimed urban waste products, their design includes the utilization of low embodied energy materials, passive solar heating and cooling, photovoltaic power systems, rainwater harvesting, solar hot water heating, along with black and grey water treatment systems. Thus, Earthship buildings are considered exemplars for contributions to both the sustainability and climate change agendas. This study explores stakeholder opinions of whether Earthship buildings can contribute towards the future of alternative housing in the United Kingdom (UK). Opinions were sought through questionnaire survey completed by UK members of online social media groups whose shared focus is related to sustainability (n=50). Results reveal that the public believe the main benefits are their minimal environmental impact and also their reliance on renewable energy resources; whilst the main barriers are identifying suitable building plots and obtaining the necessary planning permissions to build. Notwithstanding the participants included in this study already have an interest in sustainability issues, it is surmised that the general public deem the general principles of Earthships are an acceptable choice of alternative home/living. However, whilst the uptake of Earthship homes are proving increasing popular in some parts of the world, the upmost concern within the UK setting is the reality of finding somewhere suitable to build an Earthship and then being given the required authorisations to construct the building. Therefore, the study recommends a need for future Earthship investigations to review the bureaucratic obstacles encountered during land searches and acquisitions and, alongside this, appraise the challenges of gaining the necessary planning permissions.

Crystal structure, Hirshfeld surface and frontier molecular orbital analysis of 10-benzyl-9-(4-hydroxy-3-methoxyphenyl)-3,3,6,6-tetramethyl-3,4,6,7,9,10-hexahydroacridine-1,8(2H,5H)-dione

In the acridinedione core of the title mol­ecule, C₃₁H₃₅N₁O₄, the central ring adopts a flattened-boat conformation, whereas the cyclo­hexenone rings adopt envelope conformations.

In the fused ring system of the title mol­ecule, C₃₁H₃₅NO₄, the conformation of the central di­hydro­pyridine ring is inter­mediate between boat and envelope with the N and the opposite C atoms lying out of the basal plane. The conformations of terminal rings are close to envelope, with the atoms substituted by two methyl groups as the flaps. In the crystal, the mol­ecules are linked by O—H⋯O hydrogen bonds into helical chains. The Hirshfeld surface analysis indicates that the most important contributions to the crystal packing are from H⋯H (63.2%), O⋯H/H⋯O (20.1%) and C⋯H/H⋯C (14.4%) contacts. Quantum chemical calculations of the frontier mol­ecular orbitals were carried out to characterize the chemical reactivity of the title compound.

Palliative Psychiatry for Patients With Severe and Persistent Mental Illness: A Survey on the Attitudes of Psychiatrists in India Compared to Psychiatrists in Switzerland

OBJECTIVES

Palliative psychiatry is a new approach for the care of patients with severe and persistent mental illness (SPMI) which systematically considers biological, psychological, social, and existential factors of care. To assess the attitudes of psychiatrists in India toward palliative psychiatry for patients with SPMI and to compare these to the attitudes of psychiatrists in Switzerland.

METHODS

In an online survey, data from 206 psychiatrists in India were collected and compared with data from a previous survey among 457 psychiatrists in Switzerland.

RESULTS

Psychiatrists in India generally considered it very important to prevent suicide in SPMI patients (97.6%). At the same time, they considered it very important to reduce suffering (98.1%) and to ensure functionality in everyday life (95.6%). They agreed that palliative psychiatry is important for providing optimal care to SPMI patients without life-limiting illness (79.6%) and considered palliative psychiatry as indicated for patients with SPMI (78.2%). By contrast, curing the illness was considered very important by only 39.8 % of respondents. Relative to psychiatrists in Switzerland, psychiatrists in India were significantly more concerned about preventing suicide and less willing to accept a reduction in life expectancy, even at the expense of quality of life in patients with severe and persistent schizophrenia and recurrent major depressive disorder. At the same time, they were significantly more likely to advocate palliative psychiatry.

CONCLUSION

Most of the participating psychiatrists in India agreed that palliative psychiatry can be indicated for patients with SPMI. The comparison with psychiatrists in Switzerland highlights the need to take account of cultural differences in future studies of this kind. In summary, this study shows the potential of palliative psychiatry as a genuine biopsychosocio-existential approach which systematically integrates biological, psychological, social, and existential factors of care.

An experimental setup to study delayed electron emission upon photoexcitation of trapped polyatomic anions

A Velocity Map Imaging (VMI) spectrometer has been designed and integrated with an electrostatic ion beam trap to study delayed electron emission from trapped polyatomic anions upon photodetachment. The VMI spectrometer is small in size and can record a wide range of photoelectron energies, with variable magnification. Delayed electron emission can be recorded in our experimental setup for any time duration after the photoexcitation of the polyatomic anions. Experiments were carried out with trapped O^- and C₅^- ions to demonstrate the capability of the spectrometer. Delayed electron emissions from C₅^- as well as prompt photoelectrons from O^- were detected by the VMI spectrometer upon photoexcitation. The design and performance of the spectrometer are presented in detail.

Prevalence of burnout and its correlates among residents in a tertiary medical center in Kerala, India: A cross-sectional study

Background and Rationale:

Residents work in emotionally demanding environments with multiple stressors. The risk for burnout is high in them and it has significant negative consequences for their career. Burnout is also associated with consequences in terms of physical and mental health including insomnia, cardiovascular disease, depression and suicidal ideation. Thus, the study aimed to study the prevalence of burn out and its correlates among interns and residents at Government Medical College, Thiruvananthapuram, Kerala, India.

Settings and Design:

Cross Sectional Study at Government Medical College, Thiruvananthapuram, Kerala, India.

Methods:

It was a cross Sectional study of 558 interns and residents of Government Medical College, Thiruvananthapuram, Kerala, India. Data was collected which included the Copenhagen Burnout Inventory [CBI] which assesses burnout in the dimensions of Personal burnout, Work burnout and Patient related burnout, with a cut off score of 50 for each dimension. Age, sex, year of study, department the resident belonged to, or an intern, junior resident or a super speciality senior resident (resident doing super speciality course after their post graduate masters degree) were the correlates assessed.

Statistical analysis:

Univariate analysis.

Results:

More than one third of the participants were found to have burnout in one or another dimension of the CBI. Burnout was found to be the highest among the interns in the domains of personal burnout (64.05 %) and patient related burnout (68.62 %) and in junior residents for work related burnout (40%). Super specialty senior residents had the least prevalence of burnout in all three dimensions. Among the residents, Non Medical/Non Surgical residents had the least prevalence of burnout in all three dimensions, whereas surgical speciality residents had the highest of personal burnout (57.92 %) and Medical speciality residents had the highest patient related burnout (27.13%). Both medical and surgical specialty residents had equal prevalence of work burnout. The study also showed that as the number of years of residency increased, the burnout also increased in all three dimensions. A between gender difference in burnout was not noticed in our study.

Conclusions:

Burnout was found to be present in a large number of residents in our study. Nationwide studies and assessment of more correlates will be needed to understand this phenomenon and also for formulating measures for preventing and managing it.

Age at Onset of Alcohol Use and Alcohol Use Disorder: Time-trend Study in Patients Seeking De-addiction Services in Kerala

BACKGROUND

Declining age at onset of alcohol consumption over years has been one of the alarming findings in the epidemiology of alcoholism. The study was done to examine whether there was a decline in the age at onset of alcohol use and use disorder in subjects categorized as birth cohorts over the last 60 years seeking de-addiction services from a teaching hospital.

MATERIALS AND METHODS

A time-trend study, based on data collected from records, was done among 700 randomly selected subjects seeking de-addiction services. The study was done in a Government Medical College. Besides birth year, family history of alcohol use disorder and psychiatric comorbidity were the main independent variables studied. Trend was tested by linear regression.

RESULTS

There was a significant linear decline in the age at onset of alcohol use and use disorder. The mean age at onset of alcohol use and alcohol use disorder declined from 24 to 17 years and 46 to 21 years, respectively, from the pre-1950 birth cohort to the post-1985 birth cohort. Surprisingly, there was a plateau for mean age at onset of alcohol use during 1960s. The trend was significant even after adjusting for variables related to age at onset of alcohol consumption.

CONCLUSIONS

The trend of decreasing age at onset of alcohol use and alcohol use disorder over time has policy implications. Further studies are needed for exploring mediating or causal factors for the decline in the age at onset of alcohol use and use disorder.

Prevalence of psychiatric morbidity among cancer patients - hospital-based, cross-sectional survey

AIM

To study the prevalence of Psychiatric disorders in cancer patients and to find out the factors associated with Psychiatric disorders in Cancer Patients.

SETTINGS AND DESIGN

Department of Radiotherapy, Medical College, Thiruvananthapuram, cross sectional survey design was used.

METHODS AND MATERIAL

Adult patients (18 years of age and above), having a diagnosis of carcinoma were selected by consecutive sampling method.A questionnaire which included back ground data, socio economic variables, treatment variables like type of malignancy, exposure to radiation & chemotherapy prior to the evaluation and current treatment, co occurring medical illness & treatment and past & family history of psychiatric illness was used to collect data. Delirium rating scale and MINI International neuropsychiatric interview were used to assess Psychiatric disorders and delirium.

STATISTICAL ANALYSIS USED

Chi square and logistics regression tests were used for analysis.

RESULTS

Of the 384 assessed, 160(41.7%) had psychiatric disorders. Adjustment disorders were seen in 22.6%. 10.9% of subjects had major depressive disorder. Thus a total of 33.5% of patients had a diagnosis of either anxiety or depressive disorder. Proportion of patients having delirium was 6.5%. Hypomania was seen in small (1.6%) of patients. Multivariate analysis for various parameters for psychiatric disorders showed that age, past history of chemotherapy, past history of radiotherapy, & surgical treatment of carcinomas are significant predictors of psychiatric disorders.

CONCLUSIONS

Psychiatric disorders are seen in a significant proportion of Psychiatric patients.

Enhancing the photoluminescence of 1-(naphthalene-1-yl)-2,4,5-triphenyl-1H-imidazole anchored to superparamagnetic nanoparticles

Synthesis and characterization of 1-(naphthalene-1-yl)-2,4,5-triphenyl-1H-imidazole has been carried out by spectral studies. The synthesized phosphated imidazole and phosphated imidazole bound magnetic nanoparticles were characterized using fourier-transform infrared spectroscopy (FT-IR), scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy (EDS) and powder X-ray diffraction (XRD). The photophysical characteristics of the synthesized phosphated imidazole and phosphated imidazole bound magnetic nanoparticles were investigated by steady-state absorption and emission spectra as well as time resolved fluorometry. The intensities of absorption and emission maxima increase in the following order, phosphated imidazole bound Fe2O3>phosphated imidazole>imidazole.

Vibrational spectroscopic study and NBO analysis on tranexamic acid using DFT method

In this work, we reported the vibrational spectra of tranexamic acid (TA) by experimental and quantum chemical calculation. The solid phase FT-Raman and FT-IR spectra of the title compound were recorded in the region 4000 cm(-1) to 100 cm(-1) and 4000 cm(-1) to 400 cm(-1) respectively. The molecular geometry, harmonic vibrational frequencies and bonding features of TA in the ground state have been calculated by using density functional theory (DFT) B3LYP method with standard 6-31G(d,p) basis set. The scaled theoretical wavenumber showed very good agreement with the experimental values. The vibrational assignments were performed on the basis of the potential energy distribution (PED) of the vibrational modes. Stability of the molecule, arising from hyperconjugative interactions and charge delocalization, has been analyzed using Natural Bond Orbital (NBO) analysis. The results show that ED in the σ(*) and π(*) antibonding orbitals and second order delocalization energies E(2) confirm the occurrence of intramolecular charge transfer (ICT) within the molecule. The electrostatic potential mapped onto an isodensity surface has been obtained. The calculated HOMO and LUMO energies show that charge transfer occurs within the molecule. The thermodynamic properties (heat capacity, entropy, and enthalpy) of the title compound at different temperatures were calculated in gas phase.

Serological study of rickettsial diseases in human and rodent population in Chittoor dist. (A.P.)

In India the presence of Rickettsial disease in human is documented in many states however, the data on presence of Rickettsial infection in Andhra Pradesh is very scare. Therefore, a study was undertaken in Chittoor district (A.P.) to see the prevalence of Rickettsial infection in human and rodent population. 3-5 ml of human blood samples were collected from the patients attending the nearest hospitals of Tirumala, Tirupathi, Palmner and Chittoor areas. Live rodents were trapped and blood samples were collected from them during January and February 2008. Sera was separated and tested by Weil Felix test. Two hundred human sera samples were tested. Of these 39 samples were found reactive with Weil Felix antigen. Of the 39 reactive, 31 were male and 8 female. All the human samples were showing reactivity at 1:20 dilution. Out of the 343 rodents samples tested, only 24 samples were showing reactivity. These were reactive at 1:20, 1:40 and 1:80 dilutions with different types of Weil Felix antigens. Eight rodent sera samples were having titer 1:80 with Proteus OXK which is suggestive of presence of Scrub typhus in this region.