Implicit cognition is impaired and dissociable in a head-injured group with executive deficits

Implicit or non-conscious cognition is traditionally assumed to be robust to pathology but Gomez-Beldarrain et al (1999, 2002) recently showed deficits on a single implicit task after head injury. Laboratory research suggests that implicit processes dissociate. This study therefore examined implicit cognition in 20 head-injured patients and age- and I.Q.-matched controls using a battery of four implicit cognition tasks: a Serial Reaction Time task (SRT), mere exposure effect task, automatic stereotype activation and hidden co-variation detection. Patients were assessed on an extensive neuropsychological battery, and MRI scanned. Inclusion criteria included impairment on at least one measure of executive function. The patient group was impaired relative to the control group on all the implicit cognition tasks except automatic stereotype activation. Effect size analyses using the control mean and standard deviation for reference showed further dissociations across patients and across implicit tasks. Patients impaired on implicit tasks had more cognitive deficits overall than those unimpaired, and a larger Dysexecutive Self/Other discrepancy (DEX) score suggesting greater behavioural problems. Performance on the SRT task correlated with a composite measure of executive function. Head-injury thus produced heterogeneous impairments in the implicit acquisition of new information. Implicit activation of existing knowledge structures appeared intact. Impairments in implicit cognition and executive function may interact to produce dysfunctional behaviour after head-injury. Future comparisons of implicit and explicit cognition should use several measures of each function, to ensure that they measure the latent variable of interest

Mini-Review on Targeted Treatment of Desmoplastic Small Round Cell Tumor.

Desmoplastic small round cell tumor (DSRCT) is a devastating disease which most commonly affects adolescents, with a male predominance. Despite the best multimodality treatment efforts, most patients will ultimately not survive more than 3-5 years after diagnosis. Some research trials in soft-tissue sarcoma and Ewing sarcoma include DSRCT patients but few studies have been tailored to the specific clinical needs and underlying cytogenetic abnormalities characterizing this disease such as the typical EWSR1-WT1 gene fusion. Downstream activation of EWSR1-WT1 gene fusion includes signaling pathways of platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF), and insulin growth factor (IGF)-1. Other biological pathways that are activated and expressed in DSRCT cells include endothelial growth factor receptor (EGFR), androgen receptor pathway, c-KIT, MET, and transforming growth factor (TGF) beta. Investigation of somatic mutations, copy number alterations (CNA), and chromosomes in DSRCT samples suggests that deregulation of mesenchymal-epithelial reverse transition (MErT)/epithelial-mesenchymal transition (EMT) and DNA damage repair (DDR) may be important in DSRCT. This mini review looks at known druggable targets in DSRCT and existing clinical evidence for targeted treatments, particularly multityrosine kinase inhibitors such as pazopanib, imatinib, and sorafenib alone or in combination with other agents such as mTOR (mammalian target of rapamycin) inhibitors. The aim is to increase shared knowledge about current available treatments and identify gaps in research to further efforts toward clinical development of targeted agents

Health consequences of sex trafficking: A systematic review

Background: Sex trafficking is one of the most common forms of human trafficking globally. It is associated with health, emotional, social, moral and legal problems. The victims of sex trafficking when returned home are often ignored. This study aimed to explore the health consequences of sex trafficking among women and children. Methods: Medline EMBASE, PsycINFO and CINAHL were systematically searched, from date of inception to July 2016 using a combination of Medical Subject Headings (MeSH) and text words on health risks and consequences of sex trafficking. Electronic searches were supplemented by searching the reference lists of included papers and citation tracking. Both Qualitative and quantitative primary studies published in English and exploring health-related problems among sex trafficked women and children were included in this review. Health outcomes considered were: physical, psychological or social risks and consequences of sex trafficking among women and children. No restrictions were applied to geographical regions as sex trafficking involves victims being trafficked between different countries, and within countries. Data were extracted and study quality independently appraised by two reviewers and narrative synthesis was conducted for this review. Results: A total of fifteen articles were included covering health risks and well-being related to sex trafficking. Sexual and physical violence among victims such as rape and repetitive stress and physical injuries were common. The prevalence of STI (sexually transmitted infections) and HIV (human immunodeficiency virus) was also reported as high. Being trafficked at a young age, having been in brothels for a longer period and sexual violence and forced prostitution were linked with a higher risk for HIV infection. Physical health problems reported included headaches, fatigue, dizziness, back pain, memory problem, stomach pain, pelvic pain, gynaecological infections, weight loss, lesions or warts, unwanted pregnancies and abortions. The studies on mental health reported that depression, anxiety and post-traumatic stress disorder (PTSD) were commonly reported health consequences among sex trafficking victims. Conclusion: there is a compelling need for interventions raising awareness about sex trafficking among young girls and women most at risk of being trafficked. Most studies in this review have focussed on the physical health problems of the trafficked victims although there is also remarkable mental burden amongst those victims. Key policy makers, government officials, public health officials, health care providers, legal authorities and non-governmental organisations (NGOs) should be made aware about the health risks and consequences of trafficking. Trafficking consequences should be recognised as a health issue and all the sectors involved including regulating bodies should collaborate to fight against sex trafficking. Due to the heterogeneity of the articles, no meta-analysis could be conducted

Consumption of rice, acceptability and sensory qualities of fortified rice amongst consumers of social safety net rice in Nepal

INTRODUCTION: Micronutrient deficiencies are prevalent in Nepal where starchy foods constitute a large proportion of diets and consumption of micronutrient-rich foods is inadequate. We conducted a study to determine whether rice would be an appropriate vehicle for micronutrient fortification in Nepal. MATERIALS AND METHODS: In Bajura in remote rural Nepal, we conducted a household survey to characterize rice intakes in 195 households, and a double-blinded acceptability test with 177 social safety net rice consumers ≥18 years of age. Of these, 168 tasted fortified and unfortified rice to assess whether respondents could differentiate between fortified and non-fortified rice and their sensory properties. Rice was fortified by blending hot extruded kernels containing 6 micronutrients together with non-fortified rice at a 1:99 ratio. We used binomial tests to assess whether participants could correctly differentiate fortified rice, from non-fortified rice and paired t-tests to compare scores for sensory qualities of cooked fortified and non-fortified rice. We used multiple regression to test associations between per capita consumption and age, gender, wealth and food security. RESULTS: Per capita consumption of rice (median 216g/day, IQR 144.0, 288.0) did not vary by wealth but was +52.08g, (95% CI 10.43, 93.72) higher amongst moderately to severely food insecure households compared with food secure / mildly food insecure. Most respondents could not differentiate fortified rice from non-fortified rice: 37.5% identified uncooked fortified rice and 39.3% cooked rice, which was not different from the 33% expected by chance (p = 0.22 and p = 0.09 respectively). The sensory qualities of fortified rice were acceptable (scoring 3.9 out of 5) and did not differ from non-fortified rice (p>0.05). CONCLUSION: A rice fortification programme implemented through the Nepal Food Corporation's social safety nets has potential because purchase and consumption of rice is high and fortified rice is acceptable among consumers in remote food insecure areas of Nepal

Factors affecting the uptake of institutional delivery, antenatal and postnatal care in Nawalparasi district, Nepal

© 2019, Kathmandu University. All rights reserved. Background Maternal deaths and complications are highly preventable with good antenatal, postnatal and skilled care during childbirth. Inadequate information on the factors affecting these services could be barrier to a reduction of maternal deaths in low-income countries. Objective To assess the uptake of antenatal, postnatal and skilled care during childbirth. Method A cross-sectional study was conducted in eight villages of Nawalparasi district in southern Nepal. A total of 447 women who had given birth within the preceding 24 months were recruited using multistage random sampling. Data were collected using a pre-tested semi-structured questionnaire. Chi-square tests were used to assess association between variables. Result Over 70% of women had gone for at least four antenatal care check-ups while only 14.3% had at least three postnatal check-ups in their last pregnancies. The proportion of institution delivery was 54%. Women’s literacy was associated with the uptake of antenatal services (p=<0.001), postnatal care (p=0.04) and institutional delivery (p=<0.001). Knowledge of antenatal (p=<0.001) and postnatal care was also associated with uptake of respective services (p=<0.001). Conclusion The uptake and knowledge of antenatal care was much better than of postnatal care. Home delivery rates were still very high. A scaling-up of education and awareness-raising interventions in this community could help improve the uptake of maternal health services

Academic Communities of Practice as a Response to Institutional Tensions

Our study aims to contribute to the higher education literature by unpacking how academic Communities of Practice (CoP) support development of teaching as a professional skill. In this study, we focus is on a series of case teaching and writing workshops conducted in Turkey for business and management scholars. The purpose of the workshops was to enhance the usage of case studies in business and management education at the university level in Turkey. The data for this study were collected via semi-structured interviews from a theoretical sample among participants of case workshops who succeeded in completing the authorship of at least one teaching case and its associated teaching note. Our findings reveal that these workshops sowed the seeds towards the development of an academic CoP, where social learning and knowledge transfer occurred through group interaction

Status of drowning in Nepal: A study of central police data

Background: Drowning is a serious and mostly preventable injury-related cause of death. Low-and-middle income countries represent 90% of total drowning deaths worldwide. There is lack of epidemiological studies of drowning in Nepal. The aim of this paper is to describe the status of drowning in Nepal. Methods: Cases of drowning, occurring between January 2013 and December 2015 were extracted from the Daily Incident Recording System of Nepal Police. Variables on age, sex of the deceased, types of water bodies, places, season when drowning occurred and activities of deceased were extracted and descriptive analysis was done. Results: A total of 1,507 drowning cases were recorded over a 3 year period. The rate of drowning was 1.9 per 100,000 (2.95 for males and 0.92 for females). Majority of drowning occurred among males (76%) and more than half were (53%) under 20 years of age. Mostly drowning occurred in rivers (natural water bodies). The findings provide strong indication that drowning occurs throughout the year in Nepal. Children were highly vulnerable to drowning. The magnitude of drowning was found to be lower than estimated by global burden of disease (GBD) study. Conclusion: The burden of drowning in Nepal is considerable, but mostly unknown to the public. Despite only having access to a limited data source, this study provides useful evidence that comprehensive research in Nepal is needed urgently

Health and well-being issues of Nepalese migrant workers in the Gulf Cooperation Council countries and Malaysia: a systematic review

Objective To summarise the evidence on health and well-being of Nepalese migrant workers in the Gulf Cooperation Council (GCC) countries and Malaysia. Design Systematic review. Data sources EMBASE, MEDLINE, Scopus and Global Health databases. Eligibility criteria Studies were eligible if they: (1) included Nepalese migrant workers aged 18 or older working in the GCC countries or Malaysia or returnee migrant workers from these countries; (2) were primary studies that investigated health and well-being status/issues; and (3) were published in English language before 8 May 2020. Study appraisal All included studies were critically appraised using Joanna Briggs Institute study specific tools. Results A total of 33 studies were eligible for inclusion; 12 studies were conducted in Qatar, 8 in Malaysia, 9 in Nepal, 2 in Saudi Arabia and 1 each in UAE and Kuwait. In majority of the studies, there was a lack of disaggregated data on demographic characteristics of Nepalese migrant workers. Nearly half of the studies (n=16) scored as ‘high’ quality and the rest (n=17) as ‘moderate’ quality. Five key health and well-being related issues were identified in this population: (1) occupational hazards; (2) sexual health; (3) mental health; (4) healthcare access and (5) infectious diseases. Conclusion To our knowledge, this is the most comprehensive review of the health and well-being of Nepalese migrant workers in the GCC countries and Malaysia. This review highlights an urgent need to identify and implement policies and practices across Nepal and destination countries to protect the health and well-being of migrant workers