I enjoyed reading this article on clinician's View on their role in
self management approaches. Nowadays a large number of people are living
with chronic illnesses. Often, one living with chronic illness needs to be
assisted with some skills to take care themselves better, applying the
approach of self management.
The findings of this study showed that clinicians may find it difficult to
shift some tasks to or share contro...
I enjoyed reading this article on clinician's View on their role in
self management approaches. Nowadays a large number of people are living
with chronic illnesses. Often, one living with chronic illness needs to be
assisted with some skills to take care themselves better, applying the
approach of self management.
The findings of this study showed that clinicians may find it difficult to
shift some tasks to or share control in health care with the patient or
family care givers. However there is need for change in position moved
from the more traditional approach of provider dominated care to a
partnership as innovative approach to patient centered care.
The method used to gather the data for this article were clearly
explained. Metasynthesis as the methodology to synthesize data from
several studies. Complete articles included in the study, on experiences,
or views on clinicians' roles on self management approach were recaptured.
The approach of synthesizing findings coming from different opinions can
be complex, in generating harmonized results.
Synthesis could be used as the primary study while qualitative design can
used as secondary to explore how they applied the self management
approach. Self management approach have many advantages in improving
patients' wellbeing in the community, in coping with chronic illness. In
low income settings where there is lack of health professionals,
primary care teams may have difficulty finding time to provide patient
education sessions and to monitor health indicators to ensure safety
even when patients and their caretakers have been trained.
Thus the needed change cannot be effected by the clinicians alone. It also
needs community education, where education depends on the curiosity,
educational background and socio economic status of those to included in a
programme of education about self management .
The Lisbon Cohort of men who have sex with men (MSM) identified gays,
bisexuals and MSM aged between 20-29 years as key populations most
affected by HIV/AIDS1 and key contributors to the epidemic in Portugal.
The study identified the need to establish instruments for monitoring HIV
and syphilis incidence, determinants of infection and risk-taking
behaviors in MSM.
A community-based walk-in centre was used to recruit MSM a...
The Lisbon Cohort of men who have sex with men (MSM) identified gays,
bisexuals and MSM aged between 20-29 years as key populations most
affected by HIV/AIDS1 and key contributors to the epidemic in Portugal.
The study identified the need to establish instruments for monitoring HIV
and syphilis incidence, determinants of infection and risk-taking
behaviors in MSM.
A community-based walk-in centre was used to recruit MSM as participants
of a cohort study despite the obvious limitation of recruiting only men
that walked into the centre. Chinese and European studies recommended the
Internet as an effective avenue for recruiting study subjects, and other
authors have used formal health or academic institutions to recruit
participants2.
The article highlighted several cultural, anthropological and sociological
challenges in the conduct of community-based studies with MSM. The use of
community-based or Internet strategies for recruiting participants from
vulnerable populations such as MSM may be difficult in low-income
countries; this is related to the reality that MSM is still not accepted
in these countries. Conducting such a study in low-income settings may
yield evidence which may not be generalized across populations. However,
the Lisbon cohort provides a good foundation for researchers that would
like to conduct research around MSM in similar settings.
The association of child stunting and water, sanitation and hygiene
is an eye opening study. Concentration has been on what the child is
missing from their diet, without really auditing how their surrounding
would affect the ultimate absorption of these nutrients in their bodies.
The study identifies diarrhoea and other water borne, water washed and
other contact diseases as affecting the alimentary canal of the children...
The association of child stunting and water, sanitation and hygiene
is an eye opening study. Concentration has been on what the child is
missing from their diet, without really auditing how their surrounding
would affect the ultimate absorption of these nutrients in their bodies.
The study identifies diarrhoea and other water borne, water washed and
other contact diseases as affecting the alimentary canal of the children
and even their appetites. Thus a child who is constantly affected by these
diseases has a higher chance of stunting due to malnutrition which the
parent may not notice and would simply attribute the child's wasting to
the effects of the illness. The association of stunting and water and
sanitation and hygiene would definitely explain the many deaths and ill
health among the vulnerable communities.
The study highlights many pertinent issues surrounding water and
sanitation in India which also affect Sub Saharan African households. It
would be interesting to see if a similar study among sub-Saharan African
households would reveal the same outcomes.
The study revealed a relationship between stunting of the children and the
level of formal education of their care givers in regards to WASH. I would
like to know if the following considerations were made;
1. Were the care givers exposed to informal education systems on WASH and
stunting through media campaigns?
2. Were the caregivers exposed to informal education systems using the
informal health workers in their homes?
3. Were the caregivers exposed to informal education systems at the health
facilities when they go to seek medical attention for the conditions
related to WASH.?
Finally the overall presentation of the paper was very concise. The
key points were articulated clearly. The organization of the paper was
good. I was able to follow the train of thought of the authors and enjoyed
reading the paper. It had new knowledge on the relationship between
childhood stunting and water sanitation and the personal hygiene of the
caregivers. It opens up other follow up researches that may be of interest
to many. The reference to previous studies gave a strong background to
their case findings and therefore was very compelling.
I have enjoyed reading the article which has well highlighted the
fact that tobacco consumption and secondhand smoke (SHS) exposure in
vehicles is indeed a serious health issue because of the high
concentrations especially in confined environments.
The results have global repercussions yet in the discussions the
authors largely ignore low income and more crowded societies like India,
Ni...
I have enjoyed reading the article which has well highlighted the
fact that tobacco consumption and secondhand smoke (SHS) exposure in
vehicles is indeed a serious health issue because of the high
concentrations especially in confined environments.
The results have global repercussions yet in the discussions the
authors largely ignore low income and more crowded societies like India,
Nigeria, Brazil and Kenya and only focus on high income settings like
Spain, Italy and New Zealand. It would create better balance and become
more comprehensive if similar studies were conducted as a matter of
urgency in the developing world.
The impressive results indicating high prevalence of SHS exposure to
young children justify the need for more public education and the need for
legislation to help introduce regulations to reduce exposure.
Dear editor
Addressing issues of sexuality among young people at this point is timely.
Many studies have attributed inadequate sexual information among young
people to their inability to make informed sexual choices which results
into negative sexual outcomes including sexual transmitted diseases and
unintended pregnancies.
The authors in this study attribute sources of information to
transformational change amo...
Dear editor
Addressing issues of sexuality among young people at this point is timely.
Many studies have attributed inadequate sexual information among young
people to their inability to make informed sexual choices which results
into negative sexual outcomes including sexual transmitted diseases and
unintended pregnancies.
The authors in this study attribute sources of information to
transformational change among young people in developed countries. The
study also showed that, implementing sexual education in schools enable
adolescents to make informed choices on sexual matters. This study
suggested that schools and parents are the main source of sexual and
reproductive health information to youths. While this is true in developed
countries, studies done in LMICs show different results in that, in LMICs,
schools have well designed and elaborate sexual education curriculum, but
with inadequate implementation, enforcement of educational guidelines and
un-examinable curriculums. In addition, majority of parents are shy to
openly discuss sexual matters with their Adolescents - owing to socio-
cultural backgrounds. The study could have made comparisons in LMICs and
see the outcome of such findings.
On methodology, this study used cross-sectional design; further research
on this topic in LMICs can employ qualitative design to explore
associations between source of information and sexual health outcomes
among young people this is due to socio- cultural factors.
By Faith Chesire
Dear Editor,
This paper is an interesting article, which addresses the role of
traditional birth attendants in supporting the maternal, newborn and child
health care. Pakistan has made a significant progress in training the
traditional birth attendant to incorporate them into assisting of safe
delivery through deploying them to the health facility to assist in
deliveries.
Based on the study findings in the paper, the stud...
Dear Editor,
This paper is an interesting article, which addresses the role of
traditional birth attendants in supporting the maternal, newborn and child
health care. Pakistan has made a significant progress in training the
traditional birth attendant to incorporate them into assisting of safe
delivery through deploying them to the health facility to assist in
deliveries.
Based on the study findings in the paper, the study focus was based on one
gender rather than involving both genders, other studies have shown that
male partner participation has contributed to uptake of skilled delivery,
a study by Judith Mange et al (2013) showed that male have the key
decision making role at home and often control the finances of the house.
Therefore, it would be my wish if both partners were involved to give a
greater outcome to the study.
It would be important if the authors also included the local authority,
family members to form part of the referral system in order to reduce
deaths that occur as a results of pregnancy.
By Celestine Okang'
Dear Editor,
This article is an important study addressing priority areas of disease
burden particularly in high income settings. The study is well designed
with a large sample size. Unfortunately, the limitations mentioned by the
authors seems rather severe, hindering the validity of conclusions both
due to lack of funds to cover up the study period as intended and loss of
follow up on some of the participants. The too...
Dear Editor,
This article is an important study addressing priority areas of disease
burden particularly in high income settings. The study is well designed
with a large sample size. Unfortunately, the limitations mentioned by the
authors seems rather severe, hindering the validity of conclusions both
due to lack of funds to cover up the study period as intended and loss of
follow up on some of the participants. The tool used also according to
Mathias et al., 2012, gives inadequate information on health-related
quality of life (HRQoL) which differs across the populations. In all, it
is an important study that is worth exploring in other places particularly
in the low and middle income countries on the road towards cancer
prevention.
References
Matthias Vogl, Christina M Wenig, Reiner Leidl and Subhash Pokhrel .
(2012) Smoking and health-related quality of life in English general
population: implications for economic evaluations.
I have read with deeper interest the Occurrence and impact of
negative behavior, including domestic violence and abuse, in men attending
UK primary care health clinics: a cross-sectional survey. The study has
great contribution to behavior change modifiers in UK.
The study on domestic violence on heterosexual partners is timely. The
methods applied for this study were best suited for England and other
developed countrie...
I have read with deeper interest the Occurrence and impact of
negative behavior, including domestic violence and abuse, in men attending
UK primary care health clinics: a cross-sectional survey. The study has
great contribution to behavior change modifiers in UK.
The study on domestic violence on heterosexual partners is timely. The
methods applied for this study were best suited for England and other
developed countries. The nature of our society in Kenya which is greatly
embedded on culture would less likely produce the same results.
The age in question of 18 years still is na?ve. The type of vices they are
involved in are different as compared to the UK i.e. unauthorized
liquor drinking and others are wasted in bhang (cannabis sativa).
Although the study was on males it would be interesting to do a replica on
females who also experience domestic violence and abuse. This would
present a platform for the comparison of the varied experiences.
The idea of community involvement is relevant and ideal since it is recommended as one of the elements of primary health care which would then lead to the achievement of health care for all.
This study has presented interesting findings which are good for the general health care system however, being that this was a qualitative study, the participants should have been given more time to express their understanding of over diagno...
The idea of community involvement is relevant and ideal since it is recommended as one of the elements of primary health care which would then lead to the achievement of health care for all.
This study has presented interesting findings which are good for the general health care system however, being that this was a qualitative study, the participants should have been given more time to express their understanding of over diagnosis and this could have given room for probes which could have produce more information for the study's conclusion.
This is a very good study and it's recommendations are very good and should be taken up by the relevant persons.
Dear Editor,
Ref: Article: Predictors of skilled attendance at delivery among antenatal
clinic attendants in Ghana: a cross-sectional study of population data -
Amoakoh Coleman M, Ansah EK, Agyepong IA, et al
It is interesting to learn about the identified demographic,
maternal, community and contextual predictors of skilled attendance at
delivery among women who attend ANC at least once during their pregnancy
i...
Dear Editor,
Ref: Article: Predictors of skilled attendance at delivery among antenatal
clinic attendants in Ghana: a cross-sectional study of population data -
Amoakoh Coleman M, Ansah EK, Agyepong IA, et al
It is interesting to learn about the identified demographic,
maternal, community and contextual predictors of skilled attendance at
delivery among women who attend ANC at least once during their pregnancy
in Ghana.
Characteristics of the study population on Table 2 could have been
separated into the categories studied for ease of understanding, reference
and also to guide the discussion.
The author indicates that women who are less likely to have skilled
attendance at delivery can be identified during antenatal care using data
using their socio economic and socio demographic data, and can be targeted
with interventions to improve skilled attendance at delivery. Are there
any of such existing interventions around the world and how effective have
they been? Would such interventions be sustainable in the study area
considering the economic constraints faced in developing countries?
I enjoyed reading this article on clinician's View on their role in self management approaches. Nowadays a large number of people are living with chronic illnesses. Often, one living with chronic illness needs to be assisted with some skills to take care themselves better, applying the approach of self management. The findings of this study showed that clinicians may find it difficult to shift some tasks to or share contro...
The Lisbon Cohort of men who have sex with men (MSM) identified gays, bisexuals and MSM aged between 20-29 years as key populations most affected by HIV/AIDS1 and key contributors to the epidemic in Portugal. The study identified the need to establish instruments for monitoring HIV and syphilis incidence, determinants of infection and risk-taking behaviors in MSM. A community-based walk-in centre was used to recruit MSM a...
The association of child stunting and water, sanitation and hygiene is an eye opening study. Concentration has been on what the child is missing from their diet, without really auditing how their surrounding would affect the ultimate absorption of these nutrients in their bodies. The study identifies diarrhoea and other water borne, water washed and other contact diseases as affecting the alimentary canal of the children...
Dear Editor,
I have enjoyed reading the article which has well highlighted the fact that tobacco consumption and secondhand smoke (SHS) exposure in vehicles is indeed a serious health issue because of the high concentrations especially in confined environments.
The results have global repercussions yet in the discussions the authors largely ignore low income and more crowded societies like India, Ni...
Dear editor Addressing issues of sexuality among young people at this point is timely. Many studies have attributed inadequate sexual information among young people to their inability to make informed sexual choices which results into negative sexual outcomes including sexual transmitted diseases and unintended pregnancies.
The authors in this study attribute sources of information to transformational change amo...
Dear Editor, This paper is an interesting article, which addresses the role of traditional birth attendants in supporting the maternal, newborn and child health care. Pakistan has made a significant progress in training the traditional birth attendant to incorporate them into assisting of safe delivery through deploying them to the health facility to assist in deliveries. Based on the study findings in the paper, the stud...
Dear Editor, This article is an important study addressing priority areas of disease burden particularly in high income settings. The study is well designed with a large sample size. Unfortunately, the limitations mentioned by the authors seems rather severe, hindering the validity of conclusions both due to lack of funds to cover up the study period as intended and loss of follow up on some of the participants. The too...
I have read with deeper interest the Occurrence and impact of negative behavior, including domestic violence and abuse, in men attending UK primary care health clinics: a cross-sectional survey. The study has great contribution to behavior change modifiers in UK. The study on domestic violence on heterosexual partners is timely. The methods applied for this study were best suited for England and other developed countrie...
Dear Editor, Ref: Article: Predictors of skilled attendance at delivery among antenatal clinic attendants in Ghana: a cross-sectional study of population data - Amoakoh Coleman M, Ansah EK, Agyepong IA, et al
It is interesting to learn about the identified demographic, maternal, community and contextual predictors of skilled attendance at delivery among women who attend ANC at least once during their pregnancy i...
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