Tae Jun Kim, Department of Medical Sociology, University Medical Center Hamburg-Eppendorf
Re: “Income and Obesity: what is the direction of the relationship? A systematic review and meta-analysis”
Respected Editor,
This letter serves as a response to the article published on January 5, 2018, titled “Income and Obesity: what is the direction of the relationship? A systematic review and meta-analysis”. Firstly I would like to acknowledge the talented and intelligent authors of this research article and acknowledge their hard work with this research. Reviewing this article I was able to grasp an understanding of how low income environments contribute to obesity. On the downfall of this article it was made known that research covered the western societies excluding other regions thus leaving the possibility of assumption that risk and cause of obesity may differ in other regions.
According to the article and the cultivation theory by George Gerbner it is proposed that there is an ongoing stigma created by watching television and the media and getting the idea of being slim. Although the study focused on low income contributing and being a factor of obesity this research could have also looked at other factors that can be a risk factor of obesity.
Researchers did a good job executing this article topic, taking these points into consideration would he...
Tae Jun Kim, Department of Medical Sociology, University Medical Center Hamburg-Eppendorf
Re: “Income and Obesity: what is the direction of the relationship? A systematic review and meta-analysis”
Respected Editor,
This letter serves as a response to the article published on January 5, 2018, titled “Income and Obesity: what is the direction of the relationship? A systematic review and meta-analysis”. Firstly I would like to acknowledge the talented and intelligent authors of this research article and acknowledge their hard work with this research. Reviewing this article I was able to grasp an understanding of how low income environments contribute to obesity. On the downfall of this article it was made known that research covered the western societies excluding other regions thus leaving the possibility of assumption that risk and cause of obesity may differ in other regions.
According to the article and the cultivation theory by George Gerbner it is proposed that there is an ongoing stigma created by watching television and the media and getting the idea of being slim. Although the study focused on low income contributing and being a factor of obesity this research could have also looked at other factors that can be a risk factor of obesity.
Researchers did a good job executing this article topic, taking these points into consideration would help the article even more.
Thank You
Yours Sincerely,
Shanae Davis
University of The Bahamas Nursing Student
To the Editor: This response is in reference to the 2022 article entitled “Acupuncture for low back and/pelvic pain during pregnancy”. I am currently a nursing student enrolled at the University of The Bahamas and I found your article very intriguing. As a future nurse any advancements that can be made in the field of nursing and allied health profession is admirable. As we all know and you explained, pregnancy can be a very painful and tedious process so any advancement in medical treatment or procedures that can be done to reduce pain is considerably beneficial research in my opinion. The article was very informative and insightful especially considering that I knew very little about acupuncture prior to reading this article. The procedure not only relieves lower back and pelvic pain (LBPP) but it also will allow for expecting mothers to carry out activities of daily living (ADLS) without feeling pain closer to their expected due dates. I am not a mother myself however, my mother went through IVF a very painful process and she suffered from severe LBPP while carrying 3 babies without any relief, so thinking about her experience the acupuncture method of pain relief would have been beneficial to her and many others in the past. Your hard work in advancing the medical management of patients and their health is commendable. Thank you.
To the editor: This response is relevant to the earlier-mentioned 2017 article. I want to emphasise how important this subject is as a nursing student, who is concerned about the overall health of healthcare professionals. According to the article, the purpose is to estimate the obesity prevalence in healthcare workers. This is important because obesity can lead to many other health complications, like musculoskeletal disorders and mental health issues. From the investigation it indicated that obesity among nurses and other unregistered healthcare workers were more prevalent compared to other health professionals. The main question now is "Why is it most prevalent in nurses and unregistered care workers?". Whether it be lack of access to healthy food options, shift working etc, as health care providers one must take accountability. As nurses, they are aware of the complications of obesity, so being healthy should be one's priority.
We appreciate Chante' B Deal reading and commenting on our on our article titled "Social determinants of diabesity and its association with multimorbidity among older adults in India: a population-based cross-sectional study". We were intrigued to know about the linkages between diabetes and mortality among the population in The Bahamas. Deal has highlighted a few observations in our paper, which we would like to address on a point-by-point basis.
Firstly, Deal suggested that NCDs are an essential component of diabesity as their presence plays a vital role in the development and prognosis of diabetes and obesity; however, this was not emphasized in our work. The primary aim of our research was to identify the social determinants of diabesity; it is worth mentioning that all the regression models presented in our study were adjusted for the prominently occurring co-morbidities of diabetes and obesity. These included cancer, chronic heart disease, chronic obstructive pulmonary disorder, chronic renal failure, gastrointestinal disorders, high cholesterol, hypertension, stroke, and thyroid disorders. Also, for the secondary objective, the disease-specific relative risk estimates are presented after adjusting for other co-morbidities. Thus, we ensured that the co-morbidities were foregrounded in our work.
The second issue highlighted was the timing of the comorbid diseases that might have affected the prevalence of diabetes and obesity. We refrained f...
We appreciate Chante' B Deal reading and commenting on our on our article titled "Social determinants of diabesity and its association with multimorbidity among older adults in India: a population-based cross-sectional study". We were intrigued to know about the linkages between diabetes and mortality among the population in The Bahamas. Deal has highlighted a few observations in our paper, which we would like to address on a point-by-point basis.
Firstly, Deal suggested that NCDs are an essential component of diabesity as their presence plays a vital role in the development and prognosis of diabetes and obesity; however, this was not emphasized in our work. The primary aim of our research was to identify the social determinants of diabesity; it is worth mentioning that all the regression models presented in our study were adjusted for the prominently occurring co-morbidities of diabetes and obesity. These included cancer, chronic heart disease, chronic obstructive pulmonary disorder, chronic renal failure, gastrointestinal disorders, high cholesterol, hypertension, stroke, and thyroid disorders. Also, for the secondary objective, the disease-specific relative risk estimates are presented after adjusting for other co-morbidities. Thus, we ensured that the co-morbidities were foregrounded in our work.
The second issue highlighted was the timing of the comorbid diseases that might have affected the prevalence of diabetes and obesity. We refrained from adding temporality to our study, primarily because LASI is a cross-sectional dataset and provides a current body mass index status. As a result, more information on the onset of diabetes was required. Furthermore, the timings for all co-morbidities were not included in the dataset. We would love to explore temporal and directional networks for diabesity and its co-morbidities when data from the second wave of LASI is released.
Finally, we agree that the genetic predisposition is a primary determinant of diabesity, and it is essential to include it in any analysis related to NCDs. However, gathering this information is extremely difficult for any nationally representative survey. When dealing with a populous country like India, the problem becomes unfeasible and logistically impossible to address. We want to reaffirm that the data used in our work has been taken from a secondary cross-sectional dataset, the Longitudinal Ageing Study in India (LASI), 2017–18, which does not provide any information on genetic predisposition or other biological factors.
We are grateful that you brought up the points and gave us a chance to respond. It will also make our readers more aware of the reasons some crucial components were left out of our research. We value Chante's contributions and eagerly anticipate her further studies.
The authors have conducted a long-term follow-up study and collected valuable data. Unfortunately, the statistical analysis of these data does not do justice to their careful clinical work.
Subjective rating scales (including patient-reported or clinician-rated outcome measures - PROMs and CROMs) require 'psychometric' validation - because they tap people's opinions, not machine-measurable facts. However, "the psychometric measurement properties of KOOS are insufficient for use on patients 20 weeks subsequent to ACL reconstruction" (https://doi.org/10.1111/j.1600-0838.2007.00724.x)
'Psychometric' analysis of PROMs and CROMs also requires a form of estimation that takes into account the nature of their ratings (ordinal for scales which constrain answers to certain categories, such as 'none', 'mild', 'moderate', 'severe'; bounded for visual analogue scales). When researchers use 'ordinary least squares' methods, as here, the results may not be reliable (e.g. Liddell & Kruschke, 2018 "Analyzing ordinal data with metric models: What could possibly go wrong?", https://doi.org/10.1016/j.jesp.2018.08.009).
One appropriate form of analysis would be to construct a repeated-measures item-response-theory model (e.g....
The authors have conducted a long-term follow-up study and collected valuable data. Unfortunately, the statistical analysis of these data does not do justice to their careful clinical work.
Subjective rating scales (including patient-reported or clinician-rated outcome measures - PROMs and CROMs) require 'psychometric' validation - because they tap people's opinions, not machine-measurable facts. However, "the psychometric measurement properties of KOOS are insufficient for use on patients 20 weeks subsequent to ACL reconstruction" (https://doi.org/10.1111/j.1600-0838.2007.00724.x)
'Psychometric' analysis of PROMs and CROMs also requires a form of estimation that takes into account the nature of their ratings (ordinal for scales which constrain answers to certain categories, such as 'none', 'mild', 'moderate', 'severe'; bounded for visual analogue scales). When researchers use 'ordinary least squares' methods, as here, the results may not be reliable (e.g. Liddell & Kruschke, 2018 "Analyzing ordinal data with metric models: What could possibly go wrong?", https://doi.org/10.1016/j.jesp.2018.08.009).
One appropriate form of analysis would be to construct a repeated-measures item-response-theory model (e.g. https://doi.org/10.1016/j.ymeth.2022.01.005), which can include the treatment effects. Many variations of this basic IRT model are possible - e.g. hierarchical (multifactorial or bifactorial) estimation of severity, or treatment x sub-scale interactions.
It is puzzling that the Editors and reviewers of this article appear unaware of the appropriate methods for analysing PROMs and CROMs and did not draw the authors' attention to above difficulties. This points to a structural problem in biomedical research that may underlie the "replication crisis".
I am writing in response to the article “Preventing pressure injury in nursing homes: developing a care bundle using the Behaviour Change Wheel” published on June 3rd, 2019, in Volume 9 Issue 6 on BJM Open.
This study sought to implement a care bundle for nursing care settings’ usage in relation to the deduction in prevalence of pressure injuries. The study sought to identify pressure injury practices that are evidenced based and would reduce negative outcomes in the nursing home setting. This topic is personal to me, and I am an advocate for preventing pressure injuries in all clinical care settings. Pressure injuries have become a global problem resulting in decreased quality of life and high costs for both patient and the health care system. I applaud the authors for raising awareness of pressure injuries and the role of nursing care staff in its prevention.
Despite the many causative factors of pressure injuries, the study seemed to only focus on the behavior of nursing home staff. I do believe that patient’s behavior also plays a role in in the prevention and acquisition of pressure injuries. Encouraging the patient in the participation of their care may improve patient outcomes (Mcinnes, et al., 2014). In collaboration with the nurse the patient can assist by helping to take care of their bodies in their own capacity and voicing their concerns. The authors may perhaps in the future delve into why there is a lack of knowledge about patients’ acuities on...
I am writing in response to the article “Preventing pressure injury in nursing homes: developing a care bundle using the Behaviour Change Wheel” published on June 3rd, 2019, in Volume 9 Issue 6 on BJM Open.
This study sought to implement a care bundle for nursing care settings’ usage in relation to the deduction in prevalence of pressure injuries. The study sought to identify pressure injury practices that are evidenced based and would reduce negative outcomes in the nursing home setting. This topic is personal to me, and I am an advocate for preventing pressure injuries in all clinical care settings. Pressure injuries have become a global problem resulting in decreased quality of life and high costs for both patient and the health care system. I applaud the authors for raising awareness of pressure injuries and the role of nursing care staff in its prevention.
Despite the many causative factors of pressure injuries, the study seemed to only focus on the behavior of nursing home staff. I do believe that patient’s behavior also plays a role in in the prevention and acquisition of pressure injuries. Encouraging the patient in the participation of their care may improve patient outcomes (Mcinnes, et al., 2014). In collaboration with the nurse the patient can assist by helping to take care of their bodies in their own capacity and voicing their concerns. The authors may perhaps in the future delve into why there is a lack of knowledge about patients’ acuities on pressure care management which could possibly enhance their recovery. By incorporating the patients’ ideologies and perceptions, recent research has found that it increases their well-being and gives them peace of mind (García-Sánchez et al., 2019).
The care bundle can be a useful tool not only in nursing homes but in other clinical settings and can be studied in greater depth. It is my hope that the conductors of this study source other clinical settings such as hospitals to further discuss how behavior of hospital staff can influence the reduction of pressure injures and the results of using the care bundle in those settings.
References
McInnes, E., Chaboyer, W., Murray, E., Allen, T., & Jones, P. (2014). The role of patients in pressure injury prevention: a survey of acute care patients. BMC nursing, 13(1), 41. https://doi.org/10.1186/s12912-014-0041-y
García-Sánchez, F. J., Martínez-Vizcaíno, V., & Rodríguez-Martín, B. (2019). Patients' and Caregivers' Conceptualisations of Pressure Ulcers and the Process of Decision-Making in the Context of Home Care. International journal of environmental research and public health, 16(15), 2719. https://doi.org/10.3390/ijerph16152719
Recently, the article “Estimating the economic costs of Indigenous health inequities in New Zealand: a retrospective cohort analysis” (Reid et al., 2022). I wish to express my positive view of the work. This research is important, but it is mostly unnecessary in a culture that values fairness and compassion. This is because having disparities in health is immoral and unacceptable in society. Human rights and social justice issues should motivate people to work for an equal society. The continued denial of Maori access to healthcare demonstrates that our society is neither just nor humane.
This research is valuable to policymakers and decision-makers because it provides a numerical representation of the expenses associated with health disparities. The cost of preserving health disparities in society is almost certainly substantially higher than the $863 million yearly estimate (Reid et al., 2022). This demonstrates how structural inequality impacts the entire society, not just Maori. Racism is a system of building opportunity and transferring value. It unfairly enriches some people and communities while unfairly disadvantaging others, eroding the fabric of society as a whole by wasting human resources. This study should serve as a reminder that institutional racism, including health inequalities, is harmful to society and results in enormous human potential loss.
According to the report, Mori bears a disproportionate share of the costs associated with health dis...
Recently, the article “Estimating the economic costs of Indigenous health inequities in New Zealand: a retrospective cohort analysis” (Reid et al., 2022). I wish to express my positive view of the work. This research is important, but it is mostly unnecessary in a culture that values fairness and compassion. This is because having disparities in health is immoral and unacceptable in society. Human rights and social justice issues should motivate people to work for an equal society. The continued denial of Maori access to healthcare demonstrates that our society is neither just nor humane.
This research is valuable to policymakers and decision-makers because it provides a numerical representation of the expenses associated with health disparities. The cost of preserving health disparities in society is almost certainly substantially higher than the $863 million yearly estimate (Reid et al., 2022). This demonstrates how structural inequality impacts the entire society, not just Maori. Racism is a system of building opportunity and transferring value. It unfairly enriches some people and communities while unfairly disadvantaging others, eroding the fabric of society as a whole by wasting human resources. This study should serve as a reminder that institutional racism, including health inequalities, is harmful to society and results in enormous human potential loss.
According to the report, Mori bears a disproportionate share of the costs associated with health disparities. In some cases, the public health system can save money. Every year, millions of dollars are saved by underserving Mori in sectors such as primary care, with the costs accidentally shifted to Mori whnau and communities. The New Zealand healthcare system has failed, and fundamental human rights have been violated (Gauld, 2006). Before this study, the cost of health disparities among Indigenous adults was unknown. This study expands on previous research that discovered health disparities among Indigenous children have a substantial social impact and lower healthcare expenditures.
This extremely cautious estimate identifies who is financially accountable for ongoing health disparities and the financial burden these disparities impose on society. Maori health inequities are predicted to cost $863 million each year. Maori whnau bear the brunt of the $823.4 million lost income and $823.4 million lost life years. Irrational hospitalizations cost $66 million annually, irrationally underutilized primary care costs $49 million, and arbitrarily low government expenditure on accident and health insurance costs $26 million (Reid et al., 2022). These statistics are likely low because just a subset of expenditures was evaluated, and it was uncertain whether Maori needed extra healthcare.
This study not only assists policymakers and decision-makers in evaluating economic costs but also supports the human rights and social justice arguments for addressing health disparities. This report abundantly exposes the evident abuses of Indigenous peoples' rights. This study also shows no financial incentives for lowering Indigenous peoples' health disparities in primary care settings or elsewhere. Even when more hospitalizations are factored in, the government health sector saves millions of dollars each year due to underserviced Mori.
References
Gauld, R. (2006). Healthcare System Restructuring in New Zealand: problems and proposed solutions. Asia Pacific Journal of Health Management, 11(3). https://doi.org/10.24083/apjhm.2016.12.0027
Reid, P., Paine, S.-J., Te Ao, B., Willing, E. J., Wyeth, E., Vaithianathan, R., & Loring, B. (2022). Estimating the economic costs of Indigenous health inequities in New Zealand: a retrospective cohort analysis. BMJ Open, 12(10), e065430. https://doi.org/10.1136/bmjopen-2022-065430
To the Editor: This response pertains to the 2019 article stated previously. As a nursing student, I want to express how intriguing and pertinent this material is. The article indicates that nursing students may experience mental health issues. As mental health can influence how individuals respond to stress, make decisions, and interact with others, as well as their everyday lives, relationships, and physical health, nursing can be very stressful and demanding. The number of classes needed by a nursing student throughout a semester can be intimidating, as can maintaining academic success. Screening these students for a high risk of poor mental health is critical because early detection and treatment can prevent further mental health issues and ensure their future well-being.
According to the results, students in nursing programs should have access to activities that can help relieve stress and bolster their mental fortitude in preparation for the challenging curriculum they will face. In addition, there should be workshops available to help students deal with their mental health.
This reply is in reference to the above published article. It is evident that extensive research was conducted, and multiple studies were reviewed looking at both home midwife settings (planned homes and freestanding midwifery units) and obstetric units for the purpose of this study. There was also statistical support provided to further support the topic. This article gave insight on intrapartum interventions and the outcomes for both the mother and newborn after being immersed in water during labor and following waterbirth.
Apart from being informative, I found this article rather interesting because in The Bahamas, immersion in water during labor and waterbirths are practices that are not seen. Based on the evidence gathered from this research and the other studies that were referenced, it is clear that both the physiological and psychological benefits of intrapartum immersion in water and waterbirths outweighed the disadvantages for healthy women with noncomplicated pregnancies. Results presented in the article showed decreased use of epidural, injected opioids, maternal pain, episiotomy and postpartum hemorrhage, increased maternal satisfaction and an increased odd of an intact peritoneum. On the other hand, although the risk remained low, the odds of cord avulsion was seen as higher. Otherwise, there were no other adverse neonatal outcomes identified. For these reasons, I believe that intrapartum water emersions and waterbirths should be considered and imple...
This reply is in reference to the above published article. It is evident that extensive research was conducted, and multiple studies were reviewed looking at both home midwife settings (planned homes and freestanding midwifery units) and obstetric units for the purpose of this study. There was also statistical support provided to further support the topic. This article gave insight on intrapartum interventions and the outcomes for both the mother and newborn after being immersed in water during labor and following waterbirth.
Apart from being informative, I found this article rather interesting because in The Bahamas, immersion in water during labor and waterbirths are practices that are not seen. Based on the evidence gathered from this research and the other studies that were referenced, it is clear that both the physiological and psychological benefits of intrapartum immersion in water and waterbirths outweighed the disadvantages for healthy women with noncomplicated pregnancies. Results presented in the article showed decreased use of epidural, injected opioids, maternal pain, episiotomy and postpartum hemorrhage, increased maternal satisfaction and an increased odd of an intact peritoneum. On the other hand, although the risk remained low, the odds of cord avulsion was seen as higher. Otherwise, there were no other adverse neonatal outcomes identified. For these reasons, I believe that intrapartum water emersions and waterbirths should be considered and implemented as an alternative birthing method in The Bahamas; awarding pregnant mothers an alternative labor option and different experience.
Overall, the article was very informative; however, it would have been more beneficial if more articles were used that were related to the midwifery led setting to achieve more balanced results and determine if the interventions produces different outcomes as opposed to using far more articles related to the obstetric unit setting.
Nassau, Bahamas
November 30th 2022
Hamburg, Germany
November 30th 2022
Tae Jun Kim, Department of Medical Sociology, University Medical Center Hamburg-Eppendorf
Re: “Income and Obesity: what is the direction of the relationship? A systematic review and meta-analysis”
Respected Editor,
Show MoreThis letter serves as a response to the article published on January 5, 2018, titled “Income and Obesity: what is the direction of the relationship? A systematic review and meta-analysis”. Firstly I would like to acknowledge the talented and intelligent authors of this research article and acknowledge their hard work with this research. Reviewing this article I was able to grasp an understanding of how low income environments contribute to obesity. On the downfall of this article it was made known that research covered the western societies excluding other regions thus leaving the possibility of assumption that risk and cause of obesity may differ in other regions.
According to the article and the cultivation theory by George Gerbner it is proposed that there is an ongoing stigma created by watching television and the media and getting the idea of being slim. Although the study focused on low income contributing and being a factor of obesity this research could have also looked at other factors that can be a risk factor of obesity.
Researchers did a good job executing this article topic, taking these points into consideration would he...
To the Editor: This response is in reference to the 2022 article entitled “Acupuncture for low back and/pelvic pain during pregnancy”. I am currently a nursing student enrolled at the University of The Bahamas and I found your article very intriguing. As a future nurse any advancements that can be made in the field of nursing and allied health profession is admirable. As we all know and you explained, pregnancy can be a very painful and tedious process so any advancement in medical treatment or procedures that can be done to reduce pain is considerably beneficial research in my opinion. The article was very informative and insightful especially considering that I knew very little about acupuncture prior to reading this article. The procedure not only relieves lower back and pelvic pain (LBPP) but it also will allow for expecting mothers to carry out activities of daily living (ADLS) without feeling pain closer to their expected due dates. I am not a mother myself however, my mother went through IVF a very painful process and she suffered from severe LBPP while carrying 3 babies without any relief, so thinking about her experience the acupuncture method of pain relief would have been beneficial to her and many others in the past. Your hard work in advancing the medical management of patients and their health is commendable. Thank you.
Kind Regards
Christal Adderley
To the editor: This response is relevant to the earlier-mentioned 2017 article. I want to emphasise how important this subject is as a nursing student, who is concerned about the overall health of healthcare professionals. According to the article, the purpose is to estimate the obesity prevalence in healthcare workers. This is important because obesity can lead to many other health complications, like musculoskeletal disorders and mental health issues. From the investigation it indicated that obesity among nurses and other unregistered healthcare workers were more prevalent compared to other health professionals. The main question now is "Why is it most prevalent in nurses and unregistered care workers?". Whether it be lack of access to healthy food options, shift working etc, as health care providers one must take accountability. As nurses, they are aware of the complications of obesity, so being healthy should be one's priority.
We appreciate Chante' B Deal reading and commenting on our on our article titled "Social determinants of diabesity and its association with multimorbidity among older adults in India: a population-based cross-sectional study". We were intrigued to know about the linkages between diabetes and mortality among the population in The Bahamas. Deal has highlighted a few observations in our paper, which we would like to address on a point-by-point basis.
Show MoreFirstly, Deal suggested that NCDs are an essential component of diabesity as their presence plays a vital role in the development and prognosis of diabetes and obesity; however, this was not emphasized in our work. The primary aim of our research was to identify the social determinants of diabesity; it is worth mentioning that all the regression models presented in our study were adjusted for the prominently occurring co-morbidities of diabetes and obesity. These included cancer, chronic heart disease, chronic obstructive pulmonary disorder, chronic renal failure, gastrointestinal disorders, high cholesterol, hypertension, stroke, and thyroid disorders. Also, for the secondary objective, the disease-specific relative risk estimates are presented after adjusting for other co-morbidities. Thus, we ensured that the co-morbidities were foregrounded in our work.
The second issue highlighted was the timing of the comorbid diseases that might have affected the prevalence of diabetes and obesity. We refrained f...
Having read this protocol with great interest, I was wondering status on results?
The authors have conducted a long-term follow-up study and collected valuable data. Unfortunately, the statistical analysis of these data does not do justice to their careful clinical work.
Subjective rating scales (including patient-reported or clinician-rated outcome measures - PROMs and CROMs) require 'psychometric' validation - because they tap people's opinions, not machine-measurable facts. However, "the psychometric measurement properties of KOOS are insufficient for use on patients 20 weeks subsequent to ACL reconstruction" (https://doi.org/10.1111/j.1600-0838.2007.00724.x)
'Psychometric' analysis of PROMs and CROMs also requires a form of estimation that takes into account the nature of their ratings (ordinal for scales which constrain answers to certain categories, such as 'none', 'mild', 'moderate', 'severe'; bounded for visual analogue scales). When researchers use 'ordinary least squares' methods, as here, the results may not be reliable (e.g. Liddell & Kruschke, 2018 "Analyzing ordinal data with metric models: What could possibly go wrong?", https://doi.org/10.1016/j.jesp.2018.08.009).
One appropriate form of analysis would be to construct a repeated-measures item-response-theory model (e.g....
Show MoreI am writing in response to the article “Preventing pressure injury in nursing homes: developing a care bundle using the Behaviour Change Wheel” published on June 3rd, 2019, in Volume 9 Issue 6 on BJM Open.
This study sought to implement a care bundle for nursing care settings’ usage in relation to the deduction in prevalence of pressure injuries. The study sought to identify pressure injury practices that are evidenced based and would reduce negative outcomes in the nursing home setting. This topic is personal to me, and I am an advocate for preventing pressure injuries in all clinical care settings. Pressure injuries have become a global problem resulting in decreased quality of life and high costs for both patient and the health care system. I applaud the authors for raising awareness of pressure injuries and the role of nursing care staff in its prevention.
Despite the many causative factors of pressure injuries, the study seemed to only focus on the behavior of nursing home staff. I do believe that patient’s behavior also plays a role in in the prevention and acquisition of pressure injuries. Encouraging the patient in the participation of their care may improve patient outcomes (Mcinnes, et al., 2014). In collaboration with the nurse the patient can assist by helping to take care of their bodies in their own capacity and voicing their concerns. The authors may perhaps in the future delve into why there is a lack of knowledge about patients’ acuities on...
Show MoreRecently, the article “Estimating the economic costs of Indigenous health inequities in New Zealand: a retrospective cohort analysis” (Reid et al., 2022). I wish to express my positive view of the work. This research is important, but it is mostly unnecessary in a culture that values fairness and compassion. This is because having disparities in health is immoral and unacceptable in society. Human rights and social justice issues should motivate people to work for an equal society. The continued denial of Maori access to healthcare demonstrates that our society is neither just nor humane.
Show MoreThis research is valuable to policymakers and decision-makers because it provides a numerical representation of the expenses associated with health disparities. The cost of preserving health disparities in society is almost certainly substantially higher than the $863 million yearly estimate (Reid et al., 2022). This demonstrates how structural inequality impacts the entire society, not just Maori. Racism is a system of building opportunity and transferring value. It unfairly enriches some people and communities while unfairly disadvantaging others, eroding the fabric of society as a whole by wasting human resources. This study should serve as a reminder that institutional racism, including health inequalities, is harmful to society and results in enormous human potential loss.
According to the report, Mori bears a disproportionate share of the costs associated with health dis...
To the Editor: This response pertains to the 2019 article stated previously. As a nursing student, I want to express how intriguing and pertinent this material is. The article indicates that nursing students may experience mental health issues. As mental health can influence how individuals respond to stress, make decisions, and interact with others, as well as their everyday lives, relationships, and physical health, nursing can be very stressful and demanding. The number of classes needed by a nursing student throughout a semester can be intimidating, as can maintaining academic success. Screening these students for a high risk of poor mental health is critical because early detection and treatment can prevent further mental health issues and ensure their future well-being.
According to the results, students in nursing programs should have access to activities that can help relieve stress and bolster their mental fortitude in preparation for the challenging curriculum they will face. In addition, there should be workshops available to help students deal with their mental health.
This reply is in reference to the above published article. It is evident that extensive research was conducted, and multiple studies were reviewed looking at both home midwife settings (planned homes and freestanding midwifery units) and obstetric units for the purpose of this study. There was also statistical support provided to further support the topic. This article gave insight on intrapartum interventions and the outcomes for both the mother and newborn after being immersed in water during labor and following waterbirth.
Apart from being informative, I found this article rather interesting because in The Bahamas, immersion in water during labor and waterbirths are practices that are not seen. Based on the evidence gathered from this research and the other studies that were referenced, it is clear that both the physiological and psychological benefits of intrapartum immersion in water and waterbirths outweighed the disadvantages for healthy women with noncomplicated pregnancies. Results presented in the article showed decreased use of epidural, injected opioids, maternal pain, episiotomy and postpartum hemorrhage, increased maternal satisfaction and an increased odd of an intact peritoneum. On the other hand, although the risk remained low, the odds of cord avulsion was seen as higher. Otherwise, there were no other adverse neonatal outcomes identified. For these reasons, I believe that intrapartum water emersions and waterbirths should be considered and imple...
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