Search

Geriatric patients are commonly exposed to multimorbidity, polypharmacy, and potentially inappropriate medication use, with prevalence increasing over time. We seek to illustrate this risk to older adults through a case report of an older woman presenting with irritability to psychiatric emergency services in the context of potentially inappropriate medication use. On evaluation, the irritability was found to be associated with hip pain due to osteoarthritis and gastric irritation due to the use of analgesics, antacids, and other micronutrient supplements. She was diagnosed with analgesic-induced syndrome of inappropriate antidiuretic hormone production with dilutional hyponatremia and hypochloremia, iatrogenic upper gastrointestinal mucosal ulceration with melena and anemia due to blood loss, analgesic-induced coagulation disorder, acute kidney injury, impending hepatic injury, and hyponatremia-induced second-degree atrioventricular block. She recovered with treatment rationalization, pain management, and supportive care. We wish to highlight that an innocuous presentation such as increased irritability in the absence of a mental illness in an older adult may often overlie multimorbidity and potentially inappropriate medication use. We would also like to use this case report to illustrate the barriers to comprehension and compliance that may occur in geriatric patients, with the need for frequent pharmacological assessments including prescription checks and pill counts.

Conventional scientific definitions of dementia, or its newer proposed alternate—neurocognitive disorders place emphasis upon cognitive function, particularly memory. The changes in thought, emotion, behavior, personality, and biological function are usually considered only of secondary importance. At the core of the illness, however, lies a progressive loss of self, and by extension, of personhood, identity, autonomy, and agency. The identity of the person living with dementia, and the deterioration of a sense of self assumes significance in planning end of life care, including palliative care. A consideration of self and identity is also significant where physician assisted death, incorporating euthanasia, has legal sanctity. As dementia progresses, there is usually a progressive loss of personal decision making capacity and legal competence. Shared decision making, advance care directives and proxy representatives are options available to safeguard autonomy and agency in such cases. Advance care directives are often treated as static documents. The loss of self and deterioration of identity in persons with dementia means, that there is a psychological discontinuity across time and space, though biological continuity is retained. The discontinuity in self and identity however, imply that the person with dementia changes considerably and so too may values and beliefs. A document which best reflected the wishes of the person with dementia in the past, may not always do so now. Advance directives and proxy representatives may need to be dynamic and evolve over time, particularly where end of life care and physician assisted death is being invoked.

The COVID-19 pandemic and the global/local response to it have placed the mental health of older adults disproportionately at risk. We illustrate the challenges in geriatric mental health care during the COVID-19 lockdown in India using a case report. Mr. S, a 65-year-old man, developed very late-onset schizophrenia-like psychoses in January 2020. While his illness is not novel, the pandemic accentuated his distress and led to barriers in accessing elective mental health care. Social inequity including economic disparity and digital literacy amplified barriers in accessing care. In the meantime, he developed suicidal ideation and attempted self-harm, which was averted. Mr. S was finally able to access subsidized government mental health care in June 2020 and is recovering. However, we argue that the barriers to treatment and consequent delay in care in the context of the pandemic are worth addressing.

This quantitative and qualitative cohort study of adolescents who have experienced sexual assault offers valuable, nuanced and sensitive insights into their mental health, physical health and social outcomes 13 to 15 months post-trauma. As in other studies, external stigma and internalized shame, as well as the subjective meaning of sexual assault, often mediate the relationship between assault and prospective health/functioning [[4]]. The concept of being a "survivor" of sexual assault has been criticised, for the implication of placing the trauma at the centre of the person's identity and their being defined by the sexual assault [[7]]. [Extracted from the article]

Research on terahertz radiation is examined in detail, with a focus on tremperature and magnetic field dependence, when femtosecond laser pulses are applied.

The magnetic field (0–5 T) and temperature (10–300 K) dependence of terahertz radiation from InAs surfaces excited by femtosecond laser pulses has been studied in detail. The radiation intensity is strongly enhanced under the magnetic field and at low temperatures, which is explained based on simple classical motion of photoexcited electrons under a built-in surface electric field and Lorentz force undergoing scattering. The radiation spectra are broad even at low temperatures under high magnetic fields, which suggests that strong electron scattering mechanisms exist for photoexcited electrons at InAs surfaces. © 2001 American Institute of Physics. [ABSTRACT FROM AUTHOR]

Presents a study which fabricated p-n junction in nitrogen-doped p-type zinc selenide/undoped n-type zinc selenide on n-type gallium arsenide. Utilization of metalorganic molecular-beam epitaxy; Formation of a zinc selenide p-n junction; Emission observed from the p-n junction.