1142 e-Letters

  • Re: Screening Nursing Students to Identify Those at High-Risk of Poor Mental Health: A Cross-Sectional Survey

    Dear Editor: This response is in relations to the article captioned above, published on June 9, 2019. I opt to initiate by noting how pertinent, and utterly engaging such information relayed are; especially since I, myself, am a nursing student. Results from this study indicated that there were existing participants who were identified as being at-risk regarding their mental health, which is very much expected. Just as it was mentioned within this article, when compared to other non-nursing affiliated undergraduates or major programs, nursing students have a greater vulnerability regarding matters like depression and stress due to encounters with skills examinations, mandated clinical practicums, and other heavy loads that come with being a baccalaureate nursing student (Cheung et. al 2016). I found myself agreeing that early identification and intervention executions are indeed critical aspects, and that ensuring the well-being of such individuals presently ensures their well-being of the future. The article listed several factors which increase an individuals’ likelihood of undergoing mental health symptoms such as academic stress, poor relationships with both parents, not having clear college goals etc. Though valid, I would have liked to see the aspect of social relations regarding other interpersonal forces, meaning the negative relations between nursing students and staff members, patients, lecturers and other nursing peers especially. (Pulido-Criollo et. al. 2018)....

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  • Protect future nurses

    Dear Editor,
    I write to express my views on the article “Prevalence of bullying in the nursing workplace and determinant factors: a nationwide cross-sectional Polish study survey” by Serafin, LI and Czarkowska-Pączek, B. Published on December 19, 2019. I found this article to be quite interesting and timely as I am a 4th year nursing student that may or may not be subjected to this in the near future. The article entailed pertinent information regarding the pervasiveness of Polish nurses bullying, the risk factors that influence bullying and their poor outcomes.
    According to the study, one may perceive that nurse bullying is indeed prevalent in Poland as more than half of the participants admitted having experienced some act of bullying on the job. Additionally, it is stated that seniority was notably congruent with workplace bullying. Similarly, in another article, Simons and Mawn (2010) notes that some nurse supervisors exhibit bullying by unjust scheduling and unmanageable nurse- patient workloads to which they classified as ‘structural bullying’. These actions not only adversely affect nurses but may ultimately impact the level of care a patient receives. As your article suggests, prolonged bullying can lead to physical and/ or psychological symptoms. The concept of ‘nurses eating their young’ is a relevant implication in nurse bullying. Nurse managers and other staff nurses tend to treat young graduate nurses unfairly as a strategy to prepare them for the...

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  • RE: How do nursing students experience the clinical learning environment and respond to their experiences? A qualitative study

    Dear Editor,
    I am writing in response to your article discussing nursing students’ experience in the clinical learning environment. I found this article immensely enlightening and interesting. I am currently a fourth-year nursing student and can concur that this is an imperative subject that needs explication and evaluation. The results of this study provided a detailed standpoint, from nursing students, on the difficulties faced during clinical rotations. The fear experienced during clinicals and inappropriate treatment toward nursing students result in the loss of motivation to continue a profession that is ever in demand and simultaneously in shortage.
    As a nursing student who has personally experienced hostile attitudes in a clinical setting, I can relate to many of the responses given in the interviews of this study. I would appreciate this issue being addressed within nursing educational programs among those responsible. The negative attitude and willingness to assist promising nurses affects students’ learning, mental health, and most importantly, relationship with their patients. As stated in another research, Bradbury-Jones et al., (2011) empowerment of nursing students in clinical practice is essential for nursing students to foster the confidence and self-efficacy necessary to care for their patients. Other studies have mentioned that nurses displaying a negativing attitude and bullying student nurses is a common occurrence without a practical solu...

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  • RE: Long term risk factors for suicide in suicide attempters examined at a medical emergency in patient unit: results from a 32 year follow up study

    Anischka Devilas, Nursing Student at the University of The Bahamas
    Dear Editor,
    It is quite insightful that Probert-Lindstrom et al. (2020) conducted this 21-32-year follow-up study despite the uncertainty whether the manipulation of such variables would alter the overall course of the research. The purpose which was meant to evaluate the differences in risk factors for suicide attempts less than 5 years compared to more than 5 years was evident throughout. However, it is unclear if this purpose is the original aim that prompted the commencement of the original research in 1987- 1998. The article was both informative and brought awareness in correlation to mental illness and suicide. This is something the authors depicted well without bias considering the implication of other variables. Brown et al. (2000) leading risk factors were also linked to mental disorders despite not comparing time.
    Moreover, the authors stressed that the risk factors of suicide beyond the suicide index such as 20 years are not typically assessed in other prospective studies. This insinuates that perhaps extensive research must be conducted so the evaluation of long-term risk can be better understood to provide substantial data required for diagnosing purposes. Although risk factors less than five years and more than five years pose corresponding risk for possible suicide, what is the distinct correlation of risk factors beyond 20 plus years that is problematic?


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  • Costs in the last year of life

    This is yet another study emphasizing the important role of nearness to death in lifetime health care costs. This study looked at the whole of Scotland, however, what is not widely appreciated is that the absolute number of deaths (which drive the costs) are highly variable from one year to the next [1]. This then means that the marginal change in costs is also highly variable [2-4]. When these costs are broken down into smaller areas such as Area Health Boards the deaths become even more volatile and so do the marginal costs arising out of end of life. It has been traditional in the UK NHS to blame the AHB or CCG for the ensuing cost variances, which, is entirely unjustified. It is the inflexibility in the funding formula which is the essential problem.


    1. Jones R. End of life care and volatility in costs. Brit J Healthc Manage 2012; 18(7): 374-381.

    2. Jones R. Why is the ‘real world’ financial risk in commissioning so high? Brit J Healthc Manage 2012; 18(4): 216-217.

    3. Jones R. Volatile inpatient costs and implications to CCG financial stability. BJHCM 18(5): 251-258.

    4. Jones R. Cancer care and volatility in commissioning. Brit J Healthc Manage2012; 18(6): 315-324.

  • Article Review

    I have recently come across this article, “Factors associated with maternity waiting home use among women in Jimma Zone, Ethiopia: a multilevel cross-sectional analysis” and it has piqued my interest. Not only is it a new topic for me in a field I love, but it also broadens my thinking and understanding to another level, exploring challenges in different countries, especially Ethiopia. The study was able to investigate the true background of maternal waiting homes, looking at different standpoints and drawing conclusions based of the data collected. Maternity is a large topic that often gets neglected in the world, and this study helps to shine a brighter light on the peril women suffer through childbirth and pregnancy. Although it was a new topic for me, I was able to gain a sense of understanding on the topic, gathering information and connecting ideas and thoughts as I delve deeper into the study. Hopefully, I would be able to experience more research articles in this field that contains the same raw components as the current article.

  • Contamination and washing of cloth masks and risk of infection among hospital health workers in Vietnam: a post hoc analysis of a randomised controlled trial

    Latavia Ward
    4th year nursing student
    Terry Campbell
    Other Contributor, Associate Lecturer

    Dear Editor,
    I understand the purpose of this study was to analyze unpublished data on mask washing and the performance of two-layered cotton mask used by health care workers compared to the medical mask. However, I want to address the statement “Cotton is not a suitable fabric for the outer layer of the masks, as it is absorbent, can become damp and a pose risk of contamination if not cleaned daily´´According to American Ceramic Society Bulletin (2020), Cotton masks are breathable but only blocks 20% of small particles. However, to show scientific measures or proof of differentiating both the cotton and medical mask, it is noted that a combination of filter effectiveness and pressure drop can determine the effectiveness of both masks. To demonstrate, Surgical mask has 95.4 % of filtration rate, 9.0 initial pressure drop, 5 to 5.5 filter quality factor k/pa. Whereas, cotton mask has 5 to 26 % filtration rate, 14.5 Initial pressure drop, and 5 to 8 filter quality factor k/pa. In terms of addressing the importance of washing the cotton mask to be effective and the need to used fine weave and water resistant fibers it is then important to adress those scientific factors such as filtration rate, initial drop and filter quality factor percentage when determining the effectiveness of both mask in the unpublished data.

    How effective i...

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  • Assessing the effect of Michigan's smoke-free law on air quality inside restaurants and casinos

    Dear Editors:

    This response is in reference to the study Assessing the Effects of Michigan’s Smoke-free Air Law on Air Quality Inside Restaurants and Casinos. I thoroughly enjoyed this study as it evinced the effectiveness of the law in an organized and detailed manner. Öberg et.al (2010) reported that “ 93% of the world population is still living in countries not covered by smoke-free public health regulations, and exposure to SHS in the home is still common” (para 1). Consequently, I anticipate that the findings of this study should influence countries to enact smoke-free air laws to aid in the reduction of health effects of secondhand smoke cases as these laws are conclusively effective.

    The purpose of the smoke-free air law is to improve the health of employees and patrons; hence, the restriction of smoking in facilities. Since there are three casinos exempted from the law, their employees and patrons are at an incredibly high risk for cardiovascular and respiratory illnesses compared to facilities that were not exempted. This now prompts the question, how are these individuals protected? I wonder, what were the justifications that prompt the exemptions of the casinos? However, I too agree that the only way to ensure improved health of people is to enforce the law without any exemption.

    Lastly, inasmuch as there are various sources that contain particulate matter such as the smoke from grills, I presume restaurants should require chefs t...

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  • A Different Perspective

    To the Editors,

    I have read your article, “So near yet so far: why won’t the UK prescribe medical cannabis?”, and I found it rather informative as well as intriguing. I am from The Bahamas and we, too, have yet to legalize cannabis for medicinal use. I am writing this letter to give my perspective on the legalization of cannabis for medicinal as a nursing student, from a country that still holds the ways in which first world countries do things, very closely.

    Personally, I am in favor of the legalization of cannabis for medicinal as well as recreational use. There have been recent talks in our country by the Prime Minister about the legalization of the hemp industry for economic benefits. In a national address by Prime Minister Minnis (2020), he called the laws about cannabis “outdated” and stated that “there are potentially many opportunities for creative Bahamian businesspeople to get involved in this new industry”. With the Prime Minister speaking publicly about this topic, it gives the country hope that legalization may occur in the future.

    I mentioned being in favor of the legalization of cannabis got recreational use as well because, as a future nurse, it is my duty to be culturally aware. In March, it was reported by Jones (2020) that the Rastafarian Royal Ambassador Priest, Rithmond McKinney, expressed that “the Rastafarian man was being oppressed and being victimized over the years; and stereotyped over the years for the use of cannabis, a...

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  • Letter to the Editor for Understanding lying drivers of obesity in Africa: a scoping review protocol

    The choice of analyzing before submitting was necessary and is considered an acceptable decision when it comes to what was discussed to confirm the validity of the research. The main points of the article are based on obesity causes, specifically, sedentary lifestyle, urbanization, and overconsumption of calorie-dense processed foods. These factors point to the need for more education to the public about the dangers of obesity as well as the possible complications that are associated with obesity. The encouragement of additional programs is also necessary in order to encourage individuals who live more sedentary lifestyles to become more physically active in their day to day lives. Education on proper dietary habits needs to be discussed and pushed in the public as well as taught in schools. Medical professionals need to educate those patients who are at risk, on proper dietary habits. In the study, there was no mention of factors such as the effects of internal diseases and disorders which lead to obesity, such as polycystic ovary syndrome or Cushing's disease. Other factors that were not discussed in the article were those such as stress and lack of sleep. Including data relating to the underrepresented factors that contribute to obesity would have been appreciated because the factors that were discussed are commonly known.