Browsing by Author "Stothers, Lynn"

Now showing 1 - 3 of 3
  • Thumbnail Image
    Item
    Associations between the severity of obstructive lower urinary tract symptoms and care-seeking behavior in rural Africa : a cross-sectional survey from Uganda
    (Public Library of Science, 2017) Stothers, Lynn; Macnab, Andrew J.; Bajunirwe, Francis; Mutabazi, Sharif; Berkowitz, Jonathan
    Background: Global estimates indicate that by 2018 2.3 billion individuals worldwide will suffer from lower urinary tract symptoms (LUTS), with 1.1 billion having LUTS related to bladder outlet obstruction (BOO). Left untreated BOO in men causes irreversible changes to the urinary tract leading to urinary retention, the need for catheterization, renal failure and even death. Estimates suggest that Africa will be one of the continents with the greatest increase in (LUTS) by 2018 however direct measures in Africa are lacking. The objectives were to: (1) measure of prevalence of LUTS/BOO in a community-based sample of men in Africa, (2) compare community-based LUTS/BOO frequency to those seeking care for LUTS in a local clinic (3) quantify bother, interference with daily living, worry and quality of life related to LUTS/BOO between community and clinic settings and (4) examine relationships between socioeconomic and demographics related to LUTS/BOO. Methods and findings: 473 men from a rural Ugandan community (238 residents living with their symptoms and 177 presenting at a clinic for care) completed the International Prostate Symptom Scale (IPSS) and a 53-item validated LUTS symptom, bother and quality of life index. Severity of symptoms was categorized based on reference ranges for mild, moderate and severe levels of the IPSS, comparing those in the community versus those seeking care for symptoms. IPSS indicated that 55.9% of men in the community versus 17.5% of those at the clinic had mild symptoms, 31.5% in the community versus 52.5% of those at the clinic had moderate symptoms and 12.6% of those in the community versus 29.9% of those at the clinic had severe symptoms (p<0.001). Men seeking care for LUTS/BOO had a lower quality of life (p<0.05), were more bothered by their urinary symptoms (p<0.05), had more interference with daily activity and worry (p<0.05) but this did not have an impact on their general sense of wellbeing. Conclusions: The burden of disease of LUTS/BOO in this rural African cohort is high and significantly higher among those seeking care due to the bother of their symptoms. One in 4 men will spend money for transport to clinic due to LUTS/BOO despite low economic resources. Educational tools for patients structured to the level of literacy are justified.
  • Thumbnail Image
    Item
    Development of a near-infrared spectroscopy interface able to assess oxygen recovery kinetics in the right and left sides of the pelvic floor
    (Society of Photo-optical Instrumentation Engineers, 2019) Macnab, Andrew; Stothers, Lynn; Deegan, Emily
    Near-infrared spectroscopy (NIRS) muscle oxygenation data are relied on in sports medicine. Many women with urinary incontinence (UI) have dysfunctional pelvic floor muscles (PFMs) but their evaluation lacks such measures; a transvaginal NIRS interface would enable the PFM to be interrogated. Paired miniature fiber-optic cables were configured on a rigid foam insert so their emitter detector arrays with an interoptode distance of 20 mm apposed the right and left inner sides of a disposable clear plastic vaginal speculum, and linked to a standard commercial NIRS instrument. Measurement capability was assessed through conduct of three maximum voluntary contractions (MVCs) and one sustained maximum voluntary contraction of the PFM with calculation of HbDiff (½RT), a validated muscle reoxygenation kinetic parameter. In all four asymptomatic controls, mean age 40, mean BMI 21.4, MVCs were associated with changes in PFM oxyhemoglobin (O2Hb), deoxyhemoglobin (HHb) concentration, and their difference (HbDiff) comparable to those in voluntary muscle sports medicine studies. NIRS data during recovery (reoxygenation) allowed calculation of HbDiff (½RT). New techniques are called for to evaluate UI. This NIRS interface warrants further development as the provision of quantitative reoxygenation kinetics offers more comprehensive evaluation of patients with PFM dysfunction.
  • Thumbnail Image
    Item
    Photo-essays : a creative format for effective communication
    (African Sun Media, 2020) Stothers, Lynn; Mukisa, Ronald; Macnab, Andrew J.
    Scientists and educators regularly face the challenge of effectively, concisely and interestingly communicating their ideas and findings, and the need to engage readers unfamiliar with the concepts or issues they want to describe. In the context of advancing the developmental origins of health and disease (DOHaD) agenda, effective communication is essential, particularly when aiming to engage government agencies, inform leaders in the health care professions, and motivate organisations able to drive change in the community. Hence, it is important to consider approaches that might make key DOHaD concepts and health promotion strategies more readily accessible to any target population. In this chapter, we share our experience from a collaboration between the Peter Wall Institute for Advanced Studies (PWIAS) at the University of British Columbia, and STIAS at Stellenbosch University to explore ways to make research and global public health issues accessible and meaningful to a broad readership; we identified the genre of photo-essay as an established and valid format, and describe its origins and principles. A photo-essay effectively presents a broad range of facts and data to varied audiences because the format principally relies on the impact visual images have. When well-chosen images are combined with appropriate captions and a concise explanatory text, the resulting composition can engage and inform a wide range of readers, and in a way likely to allow even those unfamiliar with the topic to rapidly gain an overall understanding of the information and recommendations presented. Photographs are a powerful way to furnish evidence because they expand the scope of the information provided and uniquely engage individual readers. The reader cannot be made to look at the images in the presented order, nor can the time spent on each image be indicated. So, we suggest that a photo-essay offers a very individual, informative yet flexible format for sharing ‘what works and why”, and how, and under what circumstances it works in the context of DOHaD.