Diagnostic and Treatment Challenges of Paroxysmal Nocturnal Hemoglobinuria in Uganda

Introduction. Paroxysmal nocturnal hemoglobinuria (PNH) is a very rare disorder of the hematopoietic stem cells which is often underdiagnosed. Its incidence is about 5 cases per million inhabitants in a year, and currently, there are only 1610 patients in the International PNH Registry. In this report, we describe a case of PNH in southwestern Uganda. Case Presentation. A 34-year-old man, subsistence farmer, with a history of multiple prior presentations with anemia, jaundice, and dark-colored urine requiring blood transfusions presented to us again in July 2018 with a week’s history of palpitations, dizziness, and dark-colored urine. Investigations done suggested a direct antiglobulin test- (DAT-) negative hemolytic anemia, and subsequently, flow cytometry showed a large clone of PNH. He received many blood transfusions and hematinics on several occasions during the course of his admissions. Conclusions. Our report showed diagnostic and treatment challenges of PNH in health resource-limited setting.

Psychological autonomy and hierarchical relatedness as organizers of developmental pathways

The definition of self and others can be regarded as embodying the two dimensions of autonomy and relatedness. Autonomy and relatedness are two basic human needs and cultural constructs at the same time. This implies that they may be differently defined yet remain equally important. The respective understanding of autonomy and relatedness is socialized during the everyday experiences of daily life routines from birth on. In this paper, two developmental pathways are portrayed that emphasize different conceptions of autonomy and relatedness that are adaptive in two different environmental contexts with very different affordances and constraints. Western middle-class children are socialized towards psychological autonomy, i.e. the primacy of own intentions, wishes, individual preferences and emotions affording a definition of relatedness as psychological negotiable construct. Non-Western subsistence farmer children are socialized towards hierarchical relatedness, i.e. positioning oneself into the hierarchical structure of a communal system affording a definition of autonomy as action oriented, based on responsibility and obligations. Infancy can be regarded as a cultural lens through which to study the different socialization agendas. Parenting strategies that aim at supporting these different socialization goals in German and Euro-American parents on the one hand and Nso farmers from North Western Cameroon on the other hand are described. It is concluded that different pathways need to be considered in order to understand human psychology from a global perspective.

Determinants of Yam Postharvest Management in the Zabzugu District of Northern Ghana

Postharvest loss reduction has received attention in many policy documents across nations to ensure global food security, particularly in developing countries. Many researchers have examined various options for reducing postharvest losses. We contribute our quota to this scientific discourse by using a different approach. We argue that the human element of managing postharvest loss is central and therefore poses the question of what are the characteristics of the farmer who manages postharvest losses better. We examine this question by using a cross section of yam farmers in the Zabzugu district in Northern Ghana and generate a proportional variable called postharvest management, which measures how effective a farmer works to reduce storage losses. We then use a fractional logistic regression model to examine the determinants of postharvest management. A significant result is that subsistence farmers manage postharvest losses better than commercial farmers. Characteristically, the farmer who effectively manages postharvest losses is a young, subsistence farmer, living in or close to a district capital with fewer household members, has attained formal education, and produces more yam. Efforts to reduce postharvest losses require the provision of access roads to remote towns or providing effective storage techniques and training on postharvest management practices.