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Improvement in Nocturia Frequency After Holmium Laser Enucleation of the Prostate (HoLEP)
Get PDFBackground/Objective: Benign prostatic hyperplasia (BPH) is a common urinary pathology in older men resulting in lower urinary tract symptoms such as nocturia, urinary frequency and urgency, and outlet obstruction. Holmium enucleation of the prostate (HoLEP) is a bladder outlet procedure used to improve BPH symptoms by enucleating the prostate’s transitional zone. HoLEP has been demonstrated to improve obstructive urinary symptoms, but little research has investigated the improvement of irritative symptoms like nocturia.
Methods: A retrospective chart review of Indiana University HoLEP procedures between October 2018 and November 2021 was conducted. Participants were men with a pre-operative American Urology Association Symptom Score (AUASS). At least six months after surgery, patients completed the AUASS to compare pre- and post-operative symptoms. We identified participants with high frequency nocturia (HFN), a nocturia frequency ≥ 3, low frequency nocturia (LFN), a nocturia frequency < 3, and dominant nocturia (DN), a nocturia frequency ≥ 3 and an AUASS score < 20. Averages and paired two-tailed t-tests were conducted.
Results: We identified 220 patients who completed surveys and follow-up. Overall, nocturia was reduced by 0.92 points and quality of life (QOL) scores improved by 2.51 points post-HoLEP (p<0.05). HFN patients experienced a 2.01-point decrease in nocturia scores (p<0.001) compared to a 0.12 increase in LFN patients (p=0.43) and a 0.85 decrease in DN patients’ scores (p=0.002) after HoLEP. When comparing QOL scores, HFN patients displayed a 2.98-point improvement, LFN participants improved by 2.34, and DN patients indicated a 2.12-point improvement after surgery (p<0.001).
Conclusion/Implications: In patients with high occurrences of nocturia pre-operatively, HoLEP demonstrated significant improvements in nocturia frequency. LFN patients did not demonstrate a significant improvement in nocturia scores. Despite this, all groups displayed improved QOL scores post-operatively. This suggests that HoLEP helps reduce irritative symptoms such as nocturia. Further investigation is needed to evaluate this on a larger scale
Modeling and Cultivating Critical Global Citizenship Skills in the Online Space:: Lessons from Responsive Remote Project-Based Global Learning
Get PDFThe COVID-19 pandemic brought unprecedented challenges to the function of higher education. For community-based global learning, these barriers might have felt insurmountable. How does one create a meaningful learning experience that was originally conceptualized as a place-based, urban, project-based international experience in the online space? This was the challenge for the authors and one that, while difficult, ultimately led to a number of insights. These insights were not only helpful for sustaining us during the quarantine but have proven to be important innovations for future engagement in a changed world. One of our greatest concerns is that we as a field and movement will fall back to our old ways, forgetting that “normal” was not particularly equitable, just, or sustainable, and that what was learned in the pandemic could go a long way to reorienting our compass towards justice. In the following paper, we focus on a review of authentic learning, global learning, and pedagogical constructs that build accountability, empathy, and humility - critical global citizenship skills - in learners. We share insights from shifting a traditionally face-to-face (F2F), immersive international experience to a fully online modality. Finally, we posit some promising practices and recommendations that could shape future online global citizenship education and the opportunities it affords, especially as natural disasters, pandemics, and sustainability concerns complicate the future of these project-based global learning endeavors
The Case Studies of Place-Based Education as Action to Address Health Inequities: The Health Commons
No full textPlaced-based education, grounded in collaborative learning opportunities with minoritized communities, is vitally needed to change the health crises that impact our communities. Many current learning models focus on engaging in communities in ways that are centered on focusing on the deficits of certain populations or name issues that impact individuals’ health that fall short of teaching students to be inclusive of the people who are impacted by injustices such as health inequities. Also, many times, these learning experiences are once-a-semester activities that are not sustainable over time. Thus, universities, as anchor institutions, have a responsibility to use innovative learning strategies to allow students to gain skills to take action on these issues while also partnering with other organizations. This paper will present the Health Commons model which provides an example of means to address the issues and responsibilities named above. The lessons learned from engaging in this model of learning over the last thirty years, especially in terms of duplication for similar placed-based community partnerships include: (1) knowledge is fluid (2) humility is required, (3) get comfortable with being ambiguous, (4) health is membership, (5) there is always more to it, (6) suspend judgment, and (7) making time for self-reflection.  
A Welcome and Call for Collaborators
Get PDFThe initial seed of what would later become the Place-Based Justice Network (PBJN) was planted a decade ago when a group of like-minded higher education leaders came together to interrogate the multi-layered relationships between campuses and their intrinsically linked communities. Eventually, a learning community committed to transforming higher education and our communities by deconstructing systems of oppression through place-based community engagement formalized as the Network and has since grown to represent dozens of institutions