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Background and Objectives: Cardiovascular magnetic resonance imaging (CMRI) is the noninvasive technique of choice for early detection of cardiac involvement in Duchenne and Becker muscular dystrophy (DMD and BMD, respectively), but is seldom used in routine clinical practice in the Indian context. We sought to determine the prevalence of CMRI abnormalities in patients with DMD and BMD and to compare the CMRI parameters with the phenotypic and genotypic characteristics. Methods: A prospective, observational study was conducted on patients genetically diagnosed with DMD and BMD who could complete CMRI between March 2020 and March 2022. Abnormal CMRI was the presence of any late gadolinium enhancement (LGE) that signifies myocardial fibrosis (LGE positivity), regional wall motion abnormality, or reduced left ventricular ejection fraction (LVEF Results: A total of 46 patients were included: 38 patients with DMD and eight with BMD. Cardiac abnormality was seen in 23 (50%) patients. LGE was more common than impaired LVEF in DMD (16, 42.1%), while impaired LVEF was more common in BMD (5, 62.5%). LGE was most frequently found in lateral wall (18/19) followed by inferior (6/19), septal (5/19), anterior (2/19), and apex (1/19). Among the various clinicodemographic parameters, only age (r = 0.495, P = 0.002) and disease duration (r = 0.407, P = 0.011) were found to significantly correlate with LGE in patients with DMD. No association was found between the various CMRI parameters and the genotype. Conclusions: The current study highlights the differences in myocardial fibrosis and LV dysfunction between DMD and BMD, along with other CMRI parameters. Notably, a genotype-CMRI correlation was not found in the current cohort, which needs to be further explored. Keywords: Dystrophinopathy, Duchenne muscular dystrophy, Becker muscular dystrophy, cardiomyopathy, cardiac MRI, Author(s): Manu Santhappan Girija [1]; Deepak Menon (corresponding author) [1]; Kiran Polavarapu [1,2]; Veeramani Preethish-Kumar [1]; Seena Vengalil [1]; Saraswati Nashi [1]; Madassu Keertipriya [1]; Mainak Bardhan [1]; Priya Treesa [...]

Byline: Tanushree. Chawla, Nishanth. Reddy, Rahul. Jankar, Seena. Vengalil, Kiran. Polavarapu, Gautham. Arunachal, Veeramani. Preethish-Kumar, Saraswati. Nashi, Mainak. Bardhan, Jamuna. Rajeshwaran, Mohammad. Afsar, Manjusha. Warrier, Priya. Thomas, Kandavel. Thennarasu, Atchayaram. [...]

Byline: Manu. Girija, Deepak. Menon, Kiran. Polavarapu, Veeramani. Preethish-Kumar, Seena. Vengalil, Saraswati. Nashi, Madassu. Keertipriya, Mainak. Bardhan, Priya. Thomas, Valasani. Kiran, Vikas. Nishadham, Arun. Sadasivan, Akshata. Huddar, Gopi. Unnikrishnan, Ganagarajan. [...]

Duchenne muscular dystrophy (DMD), a progressive genetic neuromuscular disease, affects all major muscle groups in the body. Academic functioning is affected by the progressive nature of DMD and physical fatigue. To explore the experiential account of schooling and the barriers in schooling among children with DMD in India and to develop recommendations for school accommodation, a descriptive cross-sectional study was conducted with thirty-three male children who were diagnosed with DMD and receiving treatment from a tertiary center. A sociodemographic data sheet and a semi-structured questionnaire were used for data collection. The data were subjected to descriptive statistical and thematic analysis to derive the results. Eighty percent of the children received support from teachers and friends, and 28 percent reported their school as disability friendly. Themes derived from qualitative thematic analysis were physical difficulties, environmental barriers, and emotional difficulties. Based on the study results and review of the existing literature, recommendations for school accommodation will be proposed. Despite the difficulties they face in the school setting, active participation in school is important for children with progressive conditions such as DMD. Families and schools have a responsibility to ensure that children have an inclusive life, the barriers they face are minimized, and their time at school enhances their range of experiences and quality of life.

Byline: Upasana. Baruah, Prerna. Sharma, Priya. Thomas, Rajinder. Dhamija Neuropalliative care is an emerging sub-specialty of neurology and palliative care that aims to relieve suffering from symptoms, reduce distress and [...]

AbstractBackground: This exploratory study examined the associations between sociodemographic factors and past-year counseling or therapy use by depression severity among college students with depression. Participants: This cross-sectional analysis included n = 8090 participants from the Healthy Minds Study Winter 2021 Survey. Methods: Main effects and stratified multivariable logistic regression models assessed the relationship between sociodemographic factors and counseling/therapy independently and by depression severity. Results: Depression severity and counseling or therapy use were not independently associated (χ2 = 1.34, p = 0.77). Fourth + year students showed a graded response for past-year counseling/therapy use across depression severity (aOR range: 0.57–0.78, 95% CI range: 0.49–1.24). Males and students living with relatives, and those with stressful financial situations also showed lower odds of past-year counseling/therapy use. Conclusion: Findings indicate vulnerable subpopulations of college students that need support. Future interventions should identify barriers to treatment and pathways to support these students. [ABSTRACT FROM AUTHOR]

The editorial introduction in Theatre Research in Canada reflects on the journal's past three years under the leadership of Nicole Nolette, Naila Keleta-Mae, Selena Couture, and Priya Thomas. The editorial team aimed to amplify the scholarship and artistic practices of emerging and established scholars from equity-seeking demographics, while ensuring a smooth publishing process and engaging with the journal's mission. The editorial team facilitated the publication of various research articles, forum pieces, and book reviews, including a special issue on Black theatre and performance in Canada. The journal is transitioning to new co-editors and a book review editor to continue its legacy of rigorous, innovative, and ethical research in theatre and performance studies. [Extracted from the article]

AbstractPurposeMethodsResultsConclusion\nIMPLICATIONS FOR REHABILITATIONDuchenne muscular dystrophy (DMD), a genetically linked muscle disease, is one of the most devastating diseases with currently no cure. Developing essential social skills as a child moves into adolescence is particularly problematic in DMD. The present study is an exploration of the social challenges faced by children with DMD.A qualitative study was conducted among ten children diagnosed with DMD receiving treatment in a neuromuscular disorder clinic of a tertiary referral care center in Southern India. Participants were recruited purposively and were interviewed face-to-face and through telephone. The recorded interviews were transcribed and analyzed using reflexive thematic analysis.Mean age of the children was 13.9 (range: 13–15) at the time of the interviews, and six children had stopped schooling. The overarching theme generated from the interviews was struggle to belong, a yearning for normalcy in social spaces. Major identified themes were challenges with schooling, disabling society, feeling of being alone, and feeling of being a burden to the family.The study highlighted the struggles of children that become a complex social problem for them. Efforts need to be made to be child-centric and encourage inclusion by improving accessibility and social support through sensitization programs.This is an addition to the existing body of literature from the Indian context and points toward the need for creating awareness about social inclusion in the healthcare professionals, general public and in schools.Strengthening the social support system with referrals to and liaising with other relevant internal and external services and resources, home support services is important.This can prepare the children with Duchenne muscular dystrophy with adequate information about social connections and prepare them emotionally.Mainstreaming of children with the necessary support of various stakeholders in the society will go a long way to ensure quality of life of the children.This is an addition to the existing body of literature from the Indian context and points toward the need for creating awareness about social inclusion in the healthcare professionals, general public and in schools.Strengthening the social support system with referrals to and liaising with other relevant internal and external services and resources, home support services is important.This can prepare the children with Duchenne muscular dystrophy with adequate information about social connections and prepare them emotionally.Mainstreaming of children with the necessary support of various stakeholders in the society will go a long way to ensure quality of life of the children. [ABSTRACT FROM AUTHOR]

Objectives: Neurodegenerative disorders necessitate comprehensive palliative care due to their progressive and irreversible nature. Limited studies have explored the comprehensive assessment needs of this population. This present study is designed to develop a checklist for evaluating the palliative care needs of individuals with motor neuron disease (MND) and Parkinson's disease (PD). Materials and Methods: The checklist was created through an extensive literature review and discussions with stakeholders in neuropalliative. Feedback from six field experts led to the finalisation of the checklist, which comprised 53 items addressing the unique biopsychosocial needs of MND and PD. Sixty patient-caregiver dyads receiving treatment in a tertiary referral care centre for neurology in south India completed the checklist. Results: People with MND had more identified needs with speech, swallowing, and communication, while people with PD reported needs in managing tremors, reduced movements, and subjective feelings of stiffness. People denying the severity of the illness was found to be a major psychosocial issue. The checklist addresses the dearth of specific tools for assessing palliative care needs in neurodegenerative disorders, particularly MND and PD. By incorporating disease-specific and generic items, the checklist offers a broad assessment of patients' multidimensional needs. Conclusion: This study contributes to the area of neuropalliative care by developing the neuropalliative care needs checklist (NPCNC) as a valuable tool for assessing the needs of individuals with neurodegenerative diseases. Future research should focus on refining and validating the NPCNC with larger and more diverse groups, applicability in different contexts, and investigating its sensitivity to changes over time. [ABSTRACT FROM AUTHOR]

Past experiences influence choices, and people's preferences for more similar (habit‐forming) or different (variety‐seeking) experiences are reflected in these choices. We develop a structural estimation framework to capture whether people are habit forming or variety seeking and apply it to the choice of recreation site. This research contributes to the revealed preference literature by demonstrating how to account for habit or variety‐seeking behavior in recreation site choice models in a two‐stage framework. Using this framework, we estimate similarity weights that reflect the birders habit formation and variety seeking preferences. Predicted probabilities from the first stage model are then incorporated into the second stage, a mixed logit recreation site choice model of bird watching trips from eBird, by their members. We find that including the dynamic elements of choice, specifically variety‐seeking behavior, can double the estimated willingness to pay (WTP) for individual sites relative to the static model. Although our sample of bird watching trips taken by eBird members is a sample of convenience, these results suggest that static models of recreation site choice are a lower bound on our recreation demand WTP estimates. We find variety‐seeking preferences are related to land cover and the site's fixed attributes, whereas habit formation appears for seasonality in the bird watching context. [ABSTRACT FROM AUTHOR]

Background Speech and language is the most common form of social interaction and communication. Delay indicates that children are acquiring language skill in a slower rate. Language delayed children may exhibit poor scholastic performances, behavioural problems and impaired psychosocial functioning. Timely screening and identification of speech and language delay can lead to early intervention and better outcome. Aim and objective To assess the prevalence of speech and language delay among 0-3 years old children and to detect the risk factors of language delay. Methodology A cross sectional hospital based descriptive study was conducted among 400 children of 0-3 years. Language delay was assessed using Language evaluation scale Trivandrum (LEST 0-3) and the risk factors were studied. Results Out of 400 children studied, 13.5 % had speech and language delay and 3% had questionable delay. Male gender, prematurity low birth weight, perinatal complications, second born child and rural residence were found to be associated with language delay. Negative home environment and screen time more than 2 hours a day had deleterious association with speech and language development. Conclusion Language evaluation scale Trivandrum (LEST 0-3) is a simple validated screening tool to detect the prevalence of speech and language delay which is a common problem in Paediatric population. The high prevalence of language delay implies the need for routine speech and language screening of children among 0-3 years. Modifiable risk factors of language delay require appropriate interventions to reduce the hazardous effects. [ABSTRACT FROM AUTHOR]

Background: Limited evidence exists on how people living with dementia and their family/unpaid carers navigate care and support in India. Aim: This study used case vignettes to illustrate likely pathways to care for dementia, from receiving a diagnosis to long-term support, in India and to highlight gaps and challenges associated with current care provision for persons living with dementia. Methods: As part of the Strengthening Responses to Dementia in Developing Countries (STRiDE) project, and to contribute to an analysis of dementia care policies and systems in India, case vignettes were used to illustrate the diverse situations that people with dementia and their families may experience when seeking care in the Indian context. Eight hypothetical, but realistic cases of people with dementia were created by a multi-disciplinary team with experience in dementia care in India, to map out the likely care journeys of each case. Results: Investigating eight diverse care trajectories of people living with dementia highlighted important patterns relevant to the Indian context. We identified delays in dementia diagnosis to be attributed to low awareness of dementia among the general public and medical professionals in addition to a critical shortage of specialist services involved in facilitating dementia diagnosis. Post-diagnosis, support was recognized as limited and associated with considerable out-of-pocket (OOP) costs. Families primarily provide long-term care for people with dementia till end of life. Conclusions and Recommendations: Several steps need to be taken in order to improve dementia care in India. Increasing dementia awareness among both medical professionals and general public is essential. Shortages in dementia specialists can be addressed in part through appropriate task shifting. Lastly, more research is needed to develop evidence-based community interventions to support informal care provision for persons with dementia in India. [ABSTRACT FROM AUTHOR]