Lower urinary tract symptoms in men: challenges to early hospital presentation in a resource-poor health system

Abstract Background The point at which men seek medical care for lower urinary tract symptoms (LUTS) varies between individuals. Presentation to hospital with complications beyond LUTS appears prevalent in our setting. The aim of this survey is to assess from the community perspective in southeast Nigeria, the challenges to early presentation for medical evaluation for LUTS by men. Methods A questionnaire-based cross-sectional survey of randomly-selected men ≥40 years. The questionnaire captured respondent’s age; presence, duration and severity of LUTS; access to health information; wealth-index; and when (and why) medical care for LUTS was sought. Analysis was with SPSS® version 20. Results In all, responses from 1319 men (mean age 54.2 ± 10.2 years) are analysed. Of these, 267 report LUTS: 58.4% (156) report moderate to severe LUTS and 51.7% (138) are yet to seek medical care. As regards seeking medical care, all the men reporting LUTS of 3 months, 35.7% of 126 men reporting moderate LUTS, and 20.0% of 30 men reporting severe LUTS are yet to seek medical care. LUTS being non-bothersome (not financial constraint) is the most prevalent reason for not seeking medical care early. Delay is encouraged by limited access to health information (OR 3.10; p &lt; 0.001), but discouraged by literacy (OR 0.86; p &lt; 0.001) and aging (OR 0.93; p = 0.002). Conclusion From the community perspective, the prevalent challenge to seeking medical care for LUTS early is absence of bother. Empowering men through formal education and researched health information will influence positively the time that LUTS in men is appreciated as bothersome. </jats:sec

Erectile Function in Men Presenting with Lower Urinary Tract Symptoms from Benign Prostate Enlargement: Association with Quality of Life Scores in the Context of Interviewer-Assisted Questionnaire Administration

Background: Interviewer-assisted administration of International Prostate Symptoms Score (IPSS) and Internal Index of Erectile Function-5 (IIEF-5) questionnaires in men with lower urinary tract symptoms (LUTS) due to benign prostate enlargement (BPE) may generate inconsistent outcomes. Objectives: To assess the correlation between the scores from interviewer-assisted administration of the IPSS questionnaire and the IIEF-5 questionnaire in men with uncomplicated LUTS due to BPE. Materials and Methods: The IPPS and the IIEF-5 questionnaires were administered with interviewer assistance to a cross-section of men presenting to the hospital with symptoms of LUTS due to uncomplicated BPE. The demographics were ascertained, and the association between IPPS and IIEF-5 scores was determined using linear correlation. Results: There were 211 participants in 18 months with a mean age of 66.5 ± 9.5years. The mean prostate volume, prostate-specific antigen, peak flow rate, and post-void residual volume were 55.2 ± 10.1 mL, 3.1 ± 0.7 ng/mL, 20.8 ± 8.2 mL/s, and 38.1 ± 21.5 mL, respectively. One hundred and eighty-six participants (88.2%) attained post-primary level of formal education. Moderate LUTS was reported in 51.7% (n = 109), while severe LUTS was reported in 10.4% (n = 22) participants. The mean storage LUTS (sLUTS) score was 6.25 ± 2.84, the mean voiding LUTS (vLUTS) score was 4.27 ± 4.56, and the mean IPSS was 10.38 ± 6.44. The mean IIEF-5 score was 15.17 ± 6.09. There was a poor correlation between IIEF-5 and sLUTS (Spearman rho –0.02; P = 0.77), vLUTS (Spearman rho –0.058; P = 0.403), IPSS scores (Spearman rho –0.048; P = 0.49), as well as with quality of life (QoL) preferences (F 1.722; P = 0.117). Conclusions: Interviewer-assisted IIEF-5 scores do not relate with sLUTS, vLUTS IPSS, and QoL due to LUTS, as is the case with reports on self-administered IIEF-5 scores

HR’S ROLE IN ORGANIZATIONAL CHANGE WITHIN NIGERIA’S RENEWABLE ENERGY SECTOR: A REVIEW

In the rapidly evolving landscape of Nigeria's renewable energy sector, the role of Human Resources (HR) in driving and managing organizational change is paramount. This systematic review aims to elucidate the specific functions and strategies employed by HR professionals in facilitating such transitions within the sector. Drawing from a comprehensive analysis of empirical studies, industry reports, and case studies, several key insights emerge. Firstly, HR's proactive involvement in strategic planning and decision-making is crucial in anticipating and addressing potential challenges. Secondly, continuous training and development programs are instrumental in equipping employees with the necessary skills and knowledge to adapt to technological and regulatory shifts. Moreover, HR's role in fostering a culture of innovation and resilience cannot be understated, as it directly influences employee morale and retention during periods of change. In conclusion, HR plays a pivotal role in ensuring the seamless integration of change initiatives within Nigeria's renewable energy sector. Their strategic involvement, capacity-building efforts, and emphasis on organizational culture are vital components in navigating the complexities of the industry's transformation. Keywords: Human Resources (HR), Organizational Change, Renewable Energy Sector, Nigeria, Strategic Positioning, Change Management, Workforce Alignment, Capacity Building, Training and Development, Communication, Stakeholder Engagement, Resistance Mitigation, Impact Evaluation, Continuous Improvement, Socio-economic Impact, Sustainability Goals, Innovation, Agile Organizations, Strategic Importance, Sectoral Growth

Defining the relationship between clinician-rated ECOG performance status and patient-reported health-related quality of life scores in men with metastatic hormone-naïve prostate cancer

Abstract Background Performance status and health-related quality of life (HRQoL) are important parameters in the management of metastatic prostate cancer. The clinician-rated Eastern Cooperative Oncology Group performance status (ECOG-PS) may not relate with the patient-reported HRQoL because the later puts into consideration some aspects of health that are not captured by the former. The aim of this study is to define the relationship between clinician-rated ECOG-PS and the patient-reported HRQoL in men with metastatic hormone-naïve prostate cancer (mPCa). Methods An analytical cross-sectional study recruiting patients presenting with mPCa in Enugu, southeast Nigeria. Two clinicians agreed on an ECOG-PS score for each study participant who in turn completed the Functional Assessment in Cancer Therapy – Prostate (FACT-P) and the EuroQol EQ-5D-5 L questionnaires with interviewer-assistance where necessary. Other medical information was retrieved from the records. ANOVA and chi-square tests were used to compare available data across ECOG-PS ratings and ordinal logistic regression was used to determine the FACT-P questionnaire items that related significantly with the ECOG-PS scores. Results Of the 224 participants (mean age: 70.62 ± 7.34), about 60.7% had ≥ 12years of formal education and 84.9% had ISUP grade ≥ 3 cancer. In all, 22.8%, 55.8%, 21.0% and 0.4% were ECOG-PS 1, ECOG-PS 2, ECOG-PS 3 and ECOG-PS 4 respectively. The mean FACT-P score, health utility index (HUI) and visual analogue scale (VAS) scores were 80.18 ± 17.56, 0.524 ± 0.324 and 60.43 ± 9.91% respectively. The FACT-P score (p = 0.002), HUI (p < 0.001) and VAS score (p < 0.001) varied significantly across the ECOG-PS ratings. Within the FACT-P, only questionnaire items GP3 (p = 0.024) and GP7 (p < 0.001) of the PWB domain, and items GF5 (p = 0.009) and GF6 (p = 0.003) of the FWB domain related strongly with the ECOG-PS categories. Conclusion There are indications that HRQoL questionnaire items that have to do with impairment in physical and role functioning relate strongly with ECOG-PS categories