589 e-Letters

published between 2017 and 2020

  • Obesity and Stigma

    Sylvenie Fleurimond
    Nursing Student
    University of The Bahamas
    Nassau, The Bahamas
    Other contributor:
    Dr. Terry Campbell Lecture
    November 18th 2020
    Re: Does weight-related stigmatization and discrimination depend on educational attainment and
    level income? A systematic review
    The editor:
    Dear editor am a fourth year nursing student at the University of The Bahamas, it is with gain
    interest of the above caption article. I would to express that how the article made me
    knowledgeable of how obesity within the Bahamian society where it is also a major concerned
    like every elsewhere around the world and how its linked to so many health issues such as non
    communicable diseases for example Hypertension and diabetes. Upon reading the article I was
    able to understand the connection between the levels of education as it relate to obesity. The
    article brought issues to light that persons with high level educational backgrounds always sees
    that an obese person is from a low- income educational background and the stigma and
    discrimination is always felt among them. Unfortunately society sees an obese person as lazy, in
    has a low self-esteem and is of low income social background (Avena 2013). While it can be said
    that persons who have a higher level of achievements do look down on...

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  • The emergence of the digital food market

    Dear Editor,
    This response is to the current approach to food platform that pays little heed to the increasing role of digital technology and the internet in everyday life and to the particularities of the digital world in influencing health and nutrition. Digital food environments encompass the digital components that may be part of food platform and influence health and nutrition.
    Major activities enabled by social media include social interaction and social support, generating new or editing existing content, and engaging with content such as clicking a link, viewing, liking, and commenting on posts. One of the distinctive features of social media is the ability for anyone to create user-generated content and share it, compared to messages that have been traditionally delivered through a limited number of media gatekeepers: production studios, TV networks, and editorial staff. As mentioned in paragraph four (4) of the article, previous systematic reviews have examined how social media use impacts eating disorder outcomes, the digital marketing of unhealthy food and drink, and the use of social media interventions in weight management. Given the dynamic and large variety or social media platforms, there is a lack of standardized tools and methods to conduct social media research.
    Mapping the works will serve to identify the available evidence on food and nutrition-related social media content, identify and analysed critical knowled...

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  • Sleep patterns response changes in adolescents

    In the current climate of the world regarding social media use, adolescents are a group that this phenomenon disproportionately effects. Upon reading, with great interest, the article authored by Scott, Biello, & Woods (2019), I found this study’s results and findings very interesting and provocative. This type of study is especially stimulating given the current social climate of the world, in which social media-use has become an integral part of everyday life. Before this study, there had been little empricial evidence to show that sleep is disrupted by social media use. Most previous studies focused on “screentime” use of adolescents as a opposed to singling out social media use for study. The authors point out the need for this due to the UK’s lack of evidence-based decision making. The problem statement of this study highlights that in paediatric nursing practice, there is a lack of solutions brought forth to address adolescents’ lack of sleep (Hamilton et al., 2020). Thé findings of this study can now be used to address the current issue of adolescents sleeping patterns in public health policy which is usually neglected according to the authors. The culturally based aspect of this problem delineates the need to target this amongst adolescents specifically as opposed to the general public. The data analyses help ensure that the results are valid since they give an accurate depiction of the probability of occurrence for sleep loss due to social media use. The analy...

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  • Thrombocytopenia in COVID-19 patients

    Fumagalli et al. conducted a retrospective cohort study to develop a clinical risk score to predict the in-hospital mortality in COVID-19 patients ≥18 years [1]. Significant predictors of mortality were increasing age, number of chronic diseases, respiratory rate, decreasing PaO2/FiO2, serum creatinine and decreasing platelet count of mortality. I have come concerns about their study with special reference to thrombocytopenia in COVID-19 patients.

    There have been many meta-analyses of presenting severe health hazard of thrombocytopenia in COVID-19 patients. Three papers in British Journal of Haematology [2-4], two papers in European journal of Clinical Investigation [5,6], and one paper n Biomarker Research [7]. Although severe health hazards of thrombocytopenia in COVID-19 patients has been consistently reported by meta-analyses, a cohort study with minimum bias should also be conducted with special reference to comorbidity and aging.

    1. Fumagalli C, Rozzini R, Vannini M, et al. Clinical risk score to predict in-hospital mortality in COVID-19 patients: a retrospective cohort study. BMJ Open. 2020 Sep 25;10(9):e040729.
    2. Zhou M, Qi J, Li X, et al. The proportion of patients with thrombocytopenia in three human-susceptible coronavirus infections: a systematic review and meta-analysis. Br J Haematol. 2020 May;189(3):438-441.
    3. Jiang SQ, Huang QF, Xie WM, et al. The association between severe COVID-19 and low platelet count: eviden...

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  • Re: The influence of time pressure on adherence to guidelines in primary care: an experimental study

    Dear Editor: This response is in reference to the article The influence of time pressure on adherence to guidelines in primary care: an experimental study, published on April 11th 2013. Health professionals' adherence to clinical guidelines has a direct impact on the quality of service delivery. I find the current research highly informative since it offers insights into an area that has limited research. Most of the studies on clinical guidelines and quality care focus on aspects such as training and employee morale. The authors argue that time pressure impacts the professionals' decisions, which can influence their adherence to clinical guidelines (Tsiga et al. 2013). I find the research findings practical in clinical settings; they will help alleviate some of the healthcare issues such as an increase in nosocomial infections. The hospital-acquired infections result mainly from professionals' non-adherence to clinical guidelines such as hand hygiene recommendations. I believe that the quality of findings depends significantly on the nature of the methodology that researchers employ. The experimental design in the study makes the conclusions highly reliable.

    Experimental designs enhance the validity of findings since the researchers can control some variables while manipulating others. Moreover, the high control that the researchers have in experimental techniques allows them to obtain conclusive results. I believe that the experimental design in the...

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  • Re: Duration of gargling and rinsing among frequent mouthwash users: a cross-sectional study

    Dear Editor: This response is in reference to the article Duration of gargling and rinsing among frequent mouthwash users: a cross-sectional study, published on September 29 2020. This study is awakening and shows how vital education, awareness and research is. This study not only presents new evidence but also creates a new pathway for health care professionals to promote oral hygiene. As mentioned in the discussion there is a need for education on this topic especially with those at risk. If more persons were aware that mouthwash, if used correctly can reduce the detection of N. gonorrhoeae and prevent spreading then maybe they would use the mouthwash for the recommended time. Incidence of gonorrhoeae can then be potentially reduced at a population level with the increase in use of mouthwash which then can reduce the potential for resistant strains to develop (Chow et al., 2019). It's interesting to know a common STI can be removed from the tonsils and throat with just a few minutes of gargling and rinsing with mouthwash.

    It would be interesting to see how persons who are at a higher risk for contracting gonorrhea use this information if it is provided to them. A suggestion for future studies could be for participants to be tested longer to identify if the bacteria came back or to find out how long it goes undetected. Being that the participants only consisted of those who use mouthwash four or more times per week in the future a comparison can be done with p...

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  • Re: Do special constables in London feel that they are adequately prepared to meet their first aid responsibilities?

    Dear Sir,
    Special Constables (SC) are not given a fair opportunity in order to have sufficient confidence with responsibility to first aid. First aid is defined as medical assistance provided to a person who has suffered a medical emergency (Webster, 2020). These SC are not medically trained to meet the needs of providing such a challenging task. Most first responders undergo rigorous hands on and theoretical training over a course of six to eighteen months. Your article states that this team of constables are volunteers who hold the prestige of local police officers. With respect to this, they are only trained for a mere 23 days before partaking a probationary period until they are deemed competent. In order to become confident in something, one must continuously be placed into the environment. Only then, will he gain the proficiency to answer even the most challenging emergency as a law enforcement officer. Another point to consider is the job prepares you for the performance but almost often the psychological health of each official and scenario will be diverse. As law enforcement officers, these men also have a duty to uphold in regards to protecting the individual. So in light of this, they may often consider which role plays greatest significance; first aid response or police officer? Based on these findings, I do not feel that they are adequately prepared to meet their first aid responsibilities.
    Sincerely, Ta-Keisha

  • Effectiveness of Cloth Mask in Health care workers

    Dear Editors:
    This response is in relation to the captioned above article published in April 2015. Firstly, I would like to commend you guys on a job well done in this trial. Also, I would like to state that this was a very interesting, critical, and timely study of what’s going on in the world. As I begin to read this article, I immediately realized with no doubt the biasness of cloth masks in health care workers explained in this article. However, 2020 has been a year where a global pandemic has tragically affected many healthcare systems. Hence, causing shortages of PPE for healthcare workers. I must agree with some responses made that cloth mask should have been presented as less effective and not high risk in health care workers. Also, to the bias results of cloth mask, there should have been the identification on the types of materials which can be used and not used for the cloth mask.
    It is quite evident that health care workers cannot work this pandemic without protection, however, if there is a shortage of surgical mask what is the next option provided. In the article you state, “compliance was significantly higher in the cloth mask….” (Macintyre et al., 2015) therefore this should be evidence that health care workers have no problem with wearing cloth masks. Conversely, a recommendation if healthcare workers are allowed to wear mask, there should be a place where they can find the filters used inside the surgical mask to be placed in a cloth mask. Th...

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  • Re: A cluster randomised trial of cloth masks compared with medical masks in healthcare workers

    Dear Editor,
    This response is concerning the captioned article above published on April 22, 2015. First of all, I would like to regard how the editorial is informative and insightful, as I've appreciated the study. I started to gain a precise understanding of the primary subject of concern when reading the article. Although assessing the productiveness of cloth masks when operating in high-risk hospital wards and whether they are especially useful compared to surgical masks in preventing the transmission of respiratory infections is something that we should most certainly think about but, it then raises the question, which one of these masks provides the best protection from COVID-19 (SARS-CoV-2), given as it is now 2020 and we are currently in a worldwide pandemic?
    In contrast to a medical mask, this study provided insight only on the detrimental consequences for the use of a cloth mask for healthcare workers, such as results showing that they have the highest incidence of all infection outcomes, but the use of face covers or masks should not be restricted as there is evidence from researchers that its use can help prevent the spread of infection. The majority of virus transmission occurs in bodily fluids from larger particles, either aerosol or droplets, which are directly generated by talking, chewing, coughing, and sneezing. Droplets and aerosols can be blocked by fabric, and layers of this cloth fabric add effectiveness. (Clase et al., 2020).

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  • Re: The impact of healthcare professionals’ personality and religious beliefs on the decisions to forego life sustaining treatments: an observational, multicentre, cross-sectional study in Greek intensive care units

    This reply is in response to the above published article on July 21, 2017. The article was very captivating due to the focus on religious aspects associated with healthcare professionals’ personality. In reading this study, I understood that professional’s personal belief influences whether they are for or against euthanasia. Additionally, the predominant barrier that hinders the healthcare professionals from making end of life decisions.
    The research eludes to the healthcare professional's fear of litigation; however, information about the patient’s diagnosis was withheld from the patient’s family. Although the healthcare professionals are aware of the numerous ethical principles, failure to inform the patient’s family is an issue. The research also speaks to how religion plays a factor in determining whether euthanasia is ethically right.
    Consequently, in The Bahamas, euthanasia is against the law. This is due to The Bahamas being a predominantly Christian nation which views euthanasia as wrong in the eyes of God. As a result, there is a focus on palliative care for persons with terminal illness without the option of euthanasia.
    As it relates to the point on religion within the study, Sharp (2019) had similar points which states that, religion greatly influence the decision of whether to withhold or withdraw life sustaining measures. Hence, this concludes to the attitudes of the Greek healthcare professionals mentioned in the study due to the predo...

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