Knowledge, attitude and use of hydroxuyrea among adult sickle cell disease patients

Introduction: Hydroxyurea is the only cytotoxic drug approved for use in the care of sickle cell disease patients. It has been found to be effective in fixed low dose in low resource economy where the cost of the drug and frequent monitoring may be a barrier. This study looked at the knowledge, attitude and use of hydroxyurea in a low resource country with a high burden of the disease.Methods: Data was obtained using a self-administered questionnaire in 101 consecutive adult sickle cell disease patients in a tertiary health care facility.Results: All the patients responded to the questionnaire, majority (67%) of the respondents were below 40years with equal numbers of male and female patients. Of the respondents, 15.5% have > 3 painful crises in a year. Half of the respondents were not admitted in the preceding year with 6 (5.9%) of them having had >3 admissions. Less than a quarter (21.2%) had knowledge of hydroxyurea, but 52.5% were willing to use the drug while 4.3% had previously or are currently using it. Only 11 respondents were aware of the side effects and the information was mostly through their Physicians. Those willing to use the drug were also willing to attend follow-up clinic monthly.Conclusion: Though the awareness about hydroxyurea is low in our group of patients, many are willing to use the medication and attend follow up clinics. There is a need to create more awareness about the drug especially by Physicians who care for the patients. Keywords: Attitude, Hydroxyurea, Knowledge, Sickle cell disease, Low-income-countr

Fostering Effective Workforce Diversity Management in Nigerian Organizations: The Challenge of Human Resource Management

The paper provides a conceptual understanding and significance of diversity and especially workplace diversity in Nigeria, drawing on previous studies. Naturally, the practice of human resource management (HRM) cannot be divorced from the socio-cultural, economic, political and legal environments of the nation. As the giant of Africa, with a population of about 180 million, about half of whom are of working age, Nigeria is an attractive market for multinationals from across the globe, and simultaneously fast becoming a melting pot of cultures and a nation where businesses should be booming but for the gross mismanagement, corruption and inept leadership. One of Nigeria’s most critical challenges, therefore, is the effective management of its workforce diversity, a litmus test for the maturity of HRM. The role and the capacity of function HRM in managing workplace diversity in Nigeria is critically assessed and based on an integrated conceptual framework, the challenges of managing workplace diversity in Nigeria is discussed and future research directions are indicated

Work-Family Conflicts: Assessing a South African Sample of Urban Employees

The article explores the scope and impact of employees’ work responsibilities on the family life and vice-versa. It describes the coping styles adopted by a sample of urban employees and the efficacies of these styles. A semi-structured questionnaire and in-depth interviews were the means of collecting data from 48 respondents who were either dual career couples or single parents. The findings reveal that virtually all the respondents experience serious work-family conflicts, especially with managing their time, domestic chores, and stress. The challenge is for the employer, the employee, trade unions and partners to support each other to alleviate work-family conflicts. The findings are important given the focus of South African government on emancipating and empowering women through legislation and the setting up of national women. The contributions of women would be undermined, if family-work conflicts such as identified here were not addressed

Associations of a-thalassemia and BCL11A with stroke in Nigerian, United States, and United Kingdom sickle cell anemia cohorts

a-Thalassemia and the BCL11A rs1427407 T allele are commonly observed in sickle cell anemia (SCA) patients and are associated with reduced hemolysis and higher hemoglobin F levels, respectively. We investigated whether a high-risk genetic profile, defined as SCA patients who did not inherit either a-thalassemia or the BCL11A rs1427407 T allele, had stronger associations with clinical and laboratory variables than the individual genetic components in the University of Ibadan cohort (N 5 249). We then replicated our findings in SCA cohorts from the University of Illinois at Chicago (UIC) (N 5 260) and the Walk-Treatment of Pulmonary Hypertension and Sickle Cell Disease with Sildenafil Therapy study (Walk-PHaSST) (N 5 387). A high-risk genetic profile was associated with higher reticulocytes (15.0% vs 7.8%, P 5 .08) and stroke history (6% vs 1%, P 5 .02) than standard-risk patients, and these associations were more significant than the individual genetic components in the University of Ibadan cohort. These findings were replicated in high-risk patients from UIC and Walk-PHaSST for reticulocytes (UIC: 13.5% vs 11.8%, P 5 .03; Walk-PHaSST: 9.6% vs 8.2%, P 5 .0003) and stroke history (UIC: 32% vs 22%, P 5 .07; Walk-PHaSST: 14% vs 7%, P 5 .01). On combined analysis, a high-risk genetic profile had strong associations with increased markers of hemolysis (hemoglobin b 5 –0.29, 95% confidence interval [CI]: 20.50 to 20.09; P5.006; reticulocyte% b 5 2.29, 95% CI: 1.31-3.25; P 5 1 3 1025) and stroke history (odds ratio 5 2.0, 95% CI: 1.3-3.0; P 5 .0002), but no association with frequent vaso-occlusive crises ($3 per year). A high-risk genetic profile is associated with increased hemolysis and stroke history in 3 independent cohorts. This profile may help identify patients to prioritize for hydroxyurea and for closer monitoring strategies for stroke

Cholesterol Stabilizes TAZ in Hepatocytes to Promote Experimental Non-alcoholic Steatohepatitis.

Incomplete understanding of how hepatosteatosis transitions to fibrotic non-alcoholic steatohepatitis (NASH) has limited therapeutic options. Two molecules that are elevated in hepatocytes in human NASH liver are cholesterol, whose mechanistic link to NASH remains incompletely understood, and TAZ, a transcriptional regulator that promotes fibrosis but whose mechanism of increase in NASH is unknown. We now show that increased hepatocyte cholesterol upregulates TAZ and promotes fibrotic NASH. ASTER-B/C-mediated internalization of plasma membrane cholesterol activates soluble adenylyl cyclase (sAC; ADCY10), triggering a calcium-RhoA-mediated pathway that suppresses β-TrCP/proteasome-mediated TAZ degradation. In mice fed with a cholesterol-rich NASH-inducing diet, hepatocyte-specific silencing of ASTER-B/C, sAC, or RhoA decreased TAZ and ameliorated fibrotic NASH. The cholesterol-TAZ pathway is present in primary human hepatocytes, and associations among liver cholesterol, TAZ, and RhoA in human NASH liver are consistent with the pathway. Thus, hepatocyte cholesterol contributes to fibrotic NASH by increasing TAZ, suggesting new targets for therapeutic intervention