Thank you for your interest, comments, and questions in our study!
In our study, there was a relatively good adherence for postpartum glucose test or attend the postpartum OGTT as compared to evidence from other literatures (1, 2). It was happening due to frequent contact and closely following of study participants from pregnancy to postnatal period and sending a reminder for post-partum oral glucose test. However, for few women who did not attend the postpartum OGTT, we found the major reasons are changed their usual residence or left the city, perceived they will not have postpartum glucose intolerance, or it will be very mild, some of women delivered outside the study area, women either declined to participate, women could not be contacted (unreachable by phone contact) because they changed their contact information and some unknown reasons. We have also checked the presence or absence baseline differences among the two groups, we found that there is no any statistically baseline difference between the two groups (attended vs did not attend the postpartum OGTT). Though there is evidence that women with higher cardiovascular risk factors tend not to attend for the OGTT, but as we clearly stated in our baseline survey (3), pregnant women who had chronic diseases including known cardiovascular disorder were excluded at initial commencement. Hence, our participants had not any revealed higher cardiovascular risk factors tend not to attend the OGTT.
Regarding...
Thank you for your interest, comments, and questions in our study!
In our study, there was a relatively good adherence for postpartum glucose test or attend the postpartum OGTT as compared to evidence from other literatures (1, 2). It was happening due to frequent contact and closely following of study participants from pregnancy to postnatal period and sending a reminder for post-partum oral glucose test. However, for few women who did not attend the postpartum OGTT, we found the major reasons are changed their usual residence or left the city, perceived they will not have postpartum glucose intolerance, or it will be very mild, some of women delivered outside the study area, women either declined to participate, women could not be contacted (unreachable by phone contact) because they changed their contact information and some unknown reasons. We have also checked the presence or absence baseline differences among the two groups, we found that there is no any statistically baseline difference between the two groups (attended vs did not attend the postpartum OGTT). Though there is evidence that women with higher cardiovascular risk factors tend not to attend for the OGTT, but as we clearly stated in our baseline survey (3), pregnant women who had chronic diseases including known cardiovascular disorder were excluded at initial commencement. Hence, our participants had not any revealed higher cardiovascular risk factors tend not to attend the OGTT.
Regarding your question related to the positive impact of breastfeeding on postpartum glucose intolerance, we found out that that it was very interesting question. We agreed that there is a positive impact of breastfeeding on postpartum glucose intolerance which could potentially improve glucose intolerance and elevated lipid levels. Interestingly evidence showed breastfeeding is one strategy to reduce the risk of progression to subsequent diabetes mellitus in women who have had recent GDM is an important public health priority. Mothers with GDM who breastfeed have improved lipid and glucose metabolic profiles after birth, but the physiological mechanisms underlying the protective effects of breastfeeding are not clear. The effective use of exclusive breastfeeding might serve as a simple and potentially effective intervention in preventing the development of persistent diabetes mellitus. As you clearly stated in your comments the rate of exclusive breastfeeding in Ethiopia as well as in our setting is too low. We also agreed that recommending exclusive breast feeding has a high potential metabolic benefit in the post-partum period and enable healthcare professionals to encourage women to breastfeed for their own metabolic benefit. But, our research hypothesis focused on using antenatal characteristics would improve the identification of women with GDM at high risk for postpartum glucose intolerance. In addition to it was recommended to evaluate the postpartum glucose tolerance status for women who had recent GDM at 6–12 weeks after delivery (4, 5), but exclusive breast feeding should be extended till 6 months. Therefore, it is difficult to include exclusive breast feeding as major predictors unless we extended our post-partum glucose tolerance test beyond six months. We acknowledged encourage exclusive breastfeeding to control postpartum glucose intolerance.
We are also grateful to Dr. Shivashri Chockalingam, and other contributors for their questions regarding gestational weight gain during pregnancy and treatment modality for managing GDM. As a result of most of the pregnant women could not recall their weight before conception and poor early booking of ANC services, it was difficult to determine BMI. We have used the mid-upper arm circumference (MUAC) as it was a reliable measure due to quite stable during the course of pregnancy and highly correlated to the BMI before conception (6, 7). Hence, MUAC ≥ 28 cm were considered as having overweight and/or obesity (8). Since we use MUAC and could not change through the pregnancy we don’t have any data on gestational weight gain during pregnancy. Concerning on treatment modality for managing GDM, we have a treatment modality for managing GDM, but only seven (6.2%) of them have taken insulin treatment according to the health facility standard protocol.
Thank you once again for your comments!
Kind regards,
Achenef Asmamaw Muche , Oladapo O Olayemi , Yigzaw Kebede Gete
References
1. Ingram ER, Robertson IK, Ogden KJ, Dennis AE, Campbell JE, Corbould AM. Utility of antenatal clinical factors for prediction of postpartum outcomes in women with gestational diabetes mellitus (GDM). Australian and New Zealand Journal of Obstetrics and Gynaecology. 2017;57(3):272-9.
2. Quaresima P, Visconti F, Chiefari E, Puccio L, Foti DP, Venturella R, et al. Barriers to postpartum glucose intolerance screening in an italian population. International journal of environmental research and public health. 2018;15(12):2853.
3. Muche AA, Olayemi OO, Gete YK. Prevalence of gestational diabetes mellitus and associated factors among women attending antenatal care at Gondar town public health facilities, Northwest Ethiopia. BMC pregnancy and childbirth. 2019;19(1):334.
4. American Diabetes Association (ADA). Classification and diagnosis of diabetes. Sec. 2. in standards ofMedical care in Diabetesd 2017. Diabetes Care 2017;40:S11–24.
5. World Health Organization (WHO). Diagnostic criteria and classification of hyperglycaemia first detected in pregnancy: a World Health Organization Guideline. Diabetes research and clinical practice. 2014;103(3):341-63.
6. Gale CR, Javaid MK, Robinson SM, Law CM, Godfrey KM, Cooper C. Maternal size in pregnancy and body composition in children. The Journal of Clinical Endocrinology & Metabolism. 2007;92(10):3904-11.
7. Ricalde AE, Velásquez-Meléndez G, Tanaka ACdA, de Siqueira AA. Mid-upper arm circumference in pregnant women and its relation to birth weight. Revista de saude publica. 1998;32:112-7.
8. Oza-Frank R, Ali MK, Vaccarino V, Narayan KV. Asian Americans: diabetes prevalence across US and World Health Organization weight classifications. Diabetes care. 2009;32(9):1644-6.
Dear Editor,
I am writing this letter in reference to the article "Missed opportunities for earlier diagnosis of
HIV in patients who presented with advanced HIV disease: a retrospective cohort study". Levy I,
Maor Y, Mahroum N, et al. (2016). The article sufficiently highlights the risk of a patient being
diagnosed with HIV in the advanced or late stages and also emphasizes that the stigma
surrounding the disease proves to be a sizable barrier to early detection and treatment.
The author of this study highlights that a vast majority of patients are diagnosed with HIV at a
late stage. I appreciate that the article used statistical results to support this factor. This late
diagnosis is often due to the misidentification of patients as many of the patients did not present
to their general practitioner with symptoms akin to HIV and are not classified with the common
risk group, thus they were not tested for the disease. These individuals in question repeatably go
through the healthcare system, until they are finally diagnosed with the disease, the author
highlights this in the study as, all patients who had participated within the study frequently
visited the Sheba Medical Centre before their final result. These results from the study
emphasizes the importance of consulting the established risk factors of
What I have found extremely interesting is the stigma around the d...
Dear Editor,
I am writing this letter in reference to the article "Missed opportunities for earlier diagnosis of
HIV in patients who presented with advanced HIV disease: a retrospective cohort study". Levy I,
Maor Y, Mahroum N, et al. (2016). The article sufficiently highlights the risk of a patient being
diagnosed with HIV in the advanced or late stages and also emphasizes that the stigma
surrounding the disease proves to be a sizable barrier to early detection and treatment.
The author of this study highlights that a vast majority of patients are diagnosed with HIV at a
late stage. I appreciate that the article used statistical results to support this factor. This late
diagnosis is often due to the misidentification of patients as many of the patients did not present
to their general practitioner with symptoms akin to HIV and are not classified with the common
risk group, thus they were not tested for the disease. These individuals in question repeatably go
through the healthcare system, until they are finally diagnosed with the disease, the author
highlights this in the study as, all patients who had participated within the study frequently
visited the Sheba Medical Centre before their final result. These results from the study
emphasizes the importance of consulting the established risk factors of
What I have found extremely interesting is the stigma around the disease and the reasons many
physicians have not caught the disease in the earlier stages. I appreciate the articles usage of the
physicians view to clarify these reasons. Many individuals associate HIV with homosexuality
and uncleanliness, thus limiting conversations surrounding the disease by physician to patient as
the physician does not want to insult the patient. Some physicians also site a lack of knowledge
on the legal necessities. This shows the necessity of thoroughly educating physicians on the
procedure of dealing with a HIV test, to encourage earlier detection of the disease. This can be
done by hosting seminars, and proper training in the hospitals, thus allowing health care
professionals to be fully equipped in all sectors of disease detection.
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)....
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). Being in the Caribbean hemisphere, the latter factor may hit home for many nursing students as this is seemingly of high prevalence which very much impedes academic success, subsequently increasing strains and depressions alike. Although I do agree that clinical interventions are a suitable route for those individuals encompassing risks for mental variability, as the article has pinpointed, a vast number of individuals tend to, or do opt out of wanting to seek clinical help. Therefore, I would like to suggest the following possible strength-based interventions as alternatives to the fact. Nursing students (both affected and non-affected by stress, anxiety etc.) should be provided the opportunity of having immediate access to on-campus counselors to which they can privately vent, and divulge matters that threaten their existing mental-wellbeing and can teach them ways which aid in the coping of stressful circumstances. Recreational activities within the nursing program should be regularly implemented, such as 15-minute karaoke or social media break sessions, as the existing vigorous program does bear a heavy strain mentally. With these suggestions, the nursing environment may stand a chance to be less taxing and seemingly less insurmountable.
References
Cheung, T., Wong, S., Wong, K., Law, L., Ng, K., Tong, M., Wong, K., Ng, M., & Yip, P.
(2016). Depression, Anxiety and Symptoms of Stress among Baccalaureate Nursing Students in Hong Kong: A Cross-Sectional Study. International Journal of Environmental Research and Public Health, 13(8), 779. https://doi.org/10.3390/ijerph13080779
Pulido-Criollo, F., Cueto-Escobedo, J., & Guillén-Ruiz, G. (2018). Stress in Nursing
University Students and Mental Health. Health and Academic Achievement. https://doi.org/10.5772/intechopen.72993
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...
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 job. However, these intentional negative behaviors can destroy one’s confidence level, decrease job motivation and lead to early retirement. Due to targeted bullying behaviors, some nurses expressed wanting to leave their jobs while the others wanted to leave the profession completely (Simons & Mawn, 2010).
“Nurses eat their young” culture is widespread however that does not make it okay. Therefore, it is imperative that writers continue to conduct research on this matter in hopes of developing new approaches to prevent and eliminate it.
References
Serafin, L. I., & Czarkowska-Pączek, B. (2019). Prevalence of bullying in the nursing workplace and determinant factors: a nationwide cross-sectional Polish study survey. BMJ Open, 9(12), 1-8. doi: 10.1136/bmjopen-2019-033819
Simons, S., & Mawn, B. (2010). Bullying in the workplace—A qualitative study of newly licensed registered nurses. American Association of Occupational Health Nurses Journal, 58(7), 305-311. doi:10.3928/08910162-20100616-02
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...
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 solution (Gillespie et al., 2017; & Anthony & Yastik, 2011).
This study has comprehensively described the faults of the nursing educational system from the personal perspective of nursing students, lecturers, and experienced nurses. This research can assist with awareness of negative experiences that hinder growth amongst nursing students in clinical rotations. I would like to applaud the use of direct quotations from nursing students to relay their fears, as it is not easy to speak up to superiors. Speaking up also rarely affects change when superiors possess exclusionary, hostile, and dismissive attitudes such as the ones described in this study. Hopefully, this will then influence the change of policies and standards within the working and learning environment for nursing students. Henceforth, it will increase the motivation of students to finish the program.
References
Anthony, M., & Yastik, J. (2011). Nursing students’ experiences with incivility in clinical education. Journal of Nursing Education, 50(3), 140-144. https://doi.org/10.3928/01484834-20110131-04
Bradbury-Jones, C., Sambrook, S., & Irvine, F. (2011). Empowerment and being valued: A phenomenological study of nursing students' experiences of clinical practice. Nurse Education Today, 31(4), 368-372. https://doi.org/10.1016/j.nedt.2010.07.008
Gillespie, G. L., Grubb, P. L., Brown, K., Boesch, M. C., & Ulrich, D. L. (2017). “Nurses eat their young”: A novel bullying educational program for student nurses. Journal of Nursing Education and Practice, 7(7), 11. https://doi.org/10.5430/jnep.v7n7p11
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?
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?
References
Brown, G. K., Beck, A.T., Steer, R. A., & Ghrisham, J. R. (2000). Risk factors for suicide in psychiatric patient: A 20-year prospective study. Journal of Consulting and Clinical Psychology. 68(3), 371-377.
Probert-Lindstrom, S., Berge, J., Westrin, A. Ojehagan, A., & Pavulans, K. A. (2020). 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. BMJ Open. http://dx.doi.org/10.1136/bmjopen-2020-038794
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.
References
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.
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.
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.
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.
References
How effective is that mask? Depends on what materials it is made of. (2020). American Ceramic
Society Bulletin, 99(7), 3–5.
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...
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 to wear dust masks given that they are in direct contact of the smoke emitted from grills. Thus, reducing the amount of particulate matter inhale from the environment. Such precaution may prevent chefs from being at a high risk for respiratory illnesses.
Reference
Öberg, M., Jaakkola, M.S., Woodward, A., Peruga, A., & Prüss-Ustün, A.(2010).Worldwide burden of disease from exposure to second-hand smoke: A retrospective analysis of data from 192 countries. The Lancet, 377(9760), 139-146. https://doi.org/10.1016/S0140-6736(10)61388-8
Thank you for your interest, comments, and questions in our study!
Show MoreIn our study, there was a relatively good adherence for postpartum glucose test or attend the postpartum OGTT as compared to evidence from other literatures (1, 2). It was happening due to frequent contact and closely following of study participants from pregnancy to postnatal period and sending a reminder for post-partum oral glucose test. However, for few women who did not attend the postpartum OGTT, we found the major reasons are changed their usual residence or left the city, perceived they will not have postpartum glucose intolerance, or it will be very mild, some of women delivered outside the study area, women either declined to participate, women could not be contacted (unreachable by phone contact) because they changed their contact information and some unknown reasons. We have also checked the presence or absence baseline differences among the two groups, we found that there is no any statistically baseline difference between the two groups (attended vs did not attend the postpartum OGTT). Though there is evidence that women with higher cardiovascular risk factors tend not to attend for the OGTT, but as we clearly stated in our baseline survey (3), pregnant women who had chronic diseases including known cardiovascular disorder were excluded at initial commencement. Hence, our participants had not any revealed higher cardiovascular risk factors tend not to attend the OGTT.
Regarding...
Dear Editor,
Show MoreI am writing this letter in reference to the article "Missed opportunities for earlier diagnosis of
HIV in patients who presented with advanced HIV disease: a retrospective cohort study". Levy I,
Maor Y, Mahroum N, et al. (2016). The article sufficiently highlights the risk of a patient being
diagnosed with HIV in the advanced or late stages and also emphasizes that the stigma
surrounding the disease proves to be a sizable barrier to early detection and treatment.
The author of this study highlights that a vast majority of patients are diagnosed with HIV at a
late stage. I appreciate that the article used statistical results to support this factor. This late
diagnosis is often due to the misidentification of patients as many of the patients did not present
to their general practitioner with symptoms akin to HIV and are not classified with the common
risk group, thus they were not tested for the disease. These individuals in question repeatably go
through the healthcare system, until they are finally diagnosed with the disease, the author
highlights this in the study as, all patients who had participated within the study frequently
visited the Sheba Medical Centre before their final result. These results from the study
emphasizes the importance of consulting the established risk factors of
What I have found extremely interesting is the stigma around the d...
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)....
Show MoreDear Editor,
Show MoreI 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...
Dear Editor,
Show MoreI 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...
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?
Referen...
Show MoreThis 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.
References
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.
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.
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.
References
Show MoreHow effective i...
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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