Aim
To explore and provide understanding of the barriers to quality of work life among registered nurses in Bangladesh.
Background
Globally, there is growing interest in the working environments of ...nurses, especially at a time of nursing shortages and with the focus on safety and care quality in health systems. In a low socio‐economic country like Bangladesh, nurses struggle in a grossly underfunded healthcare system to deliver care to the people but no studies have been conducted on their quality of work life.
Methods
This qualitative descriptive study was conducted at three Bangladeshi tertiary hospitals in May 2015–January 2016. Three focus group discussions were held with 30 registered nurses exploring their perceived barriers to quality of work life. Data were analysed with content analysis.
Findings
Seven barriers to their work‐life arose: heavy workloads; lack of government accommodation and transportation; poor health status; lack of support from nursing supervisors; lack of promotion opportunities; incomplete hospital policies and procedures; and lack of night shift and risk allowances.
Discussion
Participants described many issues and barriers impacting on their work‐life. They perceived little reward for their hard work, felt that their health suffered from their working conditions and described a low QWL.
Conclusion and policy implications
Findings provide information for nursing and health policymakers and leaders to reduce barriers to improve work‐life quality among nurses that can contribute better to quality of nursing care, and nursing retention and satisfaction. Work policies and practices, and funding and other resources need to be scrutinized to ensure better working conditions for Bangladeshi nurses.
Limitations
Interviews were conducted with nurses only in tertiary hospitals in the Bangladeshi capital, and understanding of barriers to work‐life quality of nurses in other health settings and regions needs to be explored.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK, VSZLJ
Objective
To estimate the effect of estrogen‐only and combined hormone replacement therapy (HRT) on the hazards of overall and age‐specific all‐cause mortality in healthy women aged 46–65 at first ...prescription.
Design
Matched cohort study.
Setting
Electronic primary care records from The Health Improvement Network (THIN) database, UK (1984−2017).
Population
105 199 HRT users (cases) and 224 643 non‐users (controls) matched on age and general practice.
Methods
Weibull‐Double‐Cox regression models adjusted for age at first treatment, birth cohort, type 2 diabetes, hypertension and hypertension treatment, coronary heart disease, oophorectomy, hysterectomy, body mass index, smoking and deprivation status.
Main outcome measures
All‐cause mortality.
Results
A total of 21 751 women died over an average of 13.5 years follow‐up per participant, of whom 6329 were users and 15 422 non‐users. The adjusted hazard ratio (HR) of overall all‐cause mortality in combined HRT users was 0.91 (95% CI 0.88−0.94), and in estrogen‐only users was 0.99 (0.93−1.07), compared with non‐users. Age‐specific adjusted HRs for participants aged 46–50, 51–55, 56–60 and 61–65 years at first treatment were 0.98 (0.92−1.04), 0.87 (0.82−0.92), 0.88 (0.82−0.93) and 0.92 (0.85−0.98) for combined HRT users compared with non‐users, and 1.01 (0.84−1.21), 1.03 (0.89−1.18), 0.98 (0.86−1.12) and 0.93 (0.81−1.07) for estrogen‐only users, respectively.
Conclusions
Combined HRT was associated with a 9% lower risk of all‐cause mortality and estrogen‐only formulation was not associated with any significant changes.
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Estrogen‐only HRT is not associated with all‐cause mortality and combined HRT reduces the risks.
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Estrogen‐only HRT is not associated with all‐cause mortality and combined HRT reduces the risks.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
An experiment was conducted to investigate the supplementation of direct-fed microbials (DFM) as an alternative to antibiotics on growth performance, immune response, cecal microbial population, and ...ileal morphology of broiler chickens. A total of 800 one-day-old male broiler chicks (Ross × Ross) were randomly allotted to 4 dietary treatments with 4 replicate pens per treatment (50 birds/replicate pen). The 4 dietary treatments fed for 35 d were a corn-soybean meal basal diet (control); control plus 0.1% virginiamycin, as an antibiotic growth promoter (AGP); control plus 0.1% direct-fed microbials that contained Lactobacillus reuteri (DFM 1); and control plus 0.1% direct-fed microbials that contained a mixture of L. reuteri, Bacillus subtilis, and Saccharomyces cerevisiae (DFM 2). Results showed that dietary AGP and DFM supplementation significantly increased (P < 0.05) the BW gain of broilers during 0 to 21 d. The feed intake was reduced, whereas the feed conversion was improved significantly when birds were fed DFM 2 at 0 to 7 d of age. The white blood cell and monocyte levels were significantly higher in the DFM 2 group compared with the control. In addition, feeding DFM significantly (P < 0.05) increased the plasma immunoglobulin levels where a higher level was observed in DFM 2 compared with those of the other treatments. Neither DFM nor AGP treatments affected the cecal Lactobacillus and Salmonella content; however, cecal Escherichia coli content significantly decreased in broiler chickens fed DFM and AGP. The ileal villus height, and width and total thickness of muscularis externa were significantly increased when birds were fed DFM compared with AGP and control. These results indicate that the dietary supplementation of DFM increases the growth performance of birds at an early age, stimulates the immune response, decreases the number of E. coli, and improves the ileal morphology of broiler chickens. Thus, DFM that contained a mixture of several beneficial microorganisms could be a viable alternative to antibiotics in the broiler diets.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Aim
This study examined the level of quality of work life and predictability of years of education, monthly income, years of experience, job stress, organizational commitment and work environment on ...quality of work life among nurses in tertiary‐level hospitals in the People's Republic of Bangladesh.
Background
There is an acute shortage of nurses worldwide including Bangladesh. Quality of work life is important for quality of patient care and nurse retention. Nurses in Bangladesh are fighting to provide quality care for emerging health problems for the achievement of sustainable development goals.
Methods
We collected data from 288 randomly selected registered nurses, from six tertiary‐level hospitals. All nurses were requested to fill questionnaire consisted of Demographic Data Sheet, Quality of Nursing Work Life Survey, Expanded Nursing Stress Scale, Questionnaire of Organizational Commitment and Practice Environment Scale of the Nursing Work Index. Data were analysed by descriptive statistics and multiple regression.
Results
The quality of work life as perceived by nurses in Bangladesh was at moderate level. Monthly income was found as the best predictor followed by work environment, organizational commitment and job stress.
Discussion
A higher monthly income helps nurses to fulfil their personal needs; positive work environment helps to provide quality care to the patients.
Limitation
Quality of work life and predictors measured by self‐report only may not reflect the original picture of the quality of work life among nurses.
Conclusion and policy implications
Findings provide information for nursing and health policymakers to develop policies to improve quality of work life among nurses that can contribute to quality of nursing care. This includes the working environment, commitment to the organization and measures to reduce job stress.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK, VSZLJ
SUMMARY
A study was conducted to investigate the effect of dietary supplementation of Chlorella (Chlorella vulgaris) to replace antibiotics in the diets of broiler chickens. A total of 600 1-d-old ...male broiler chicks were randomly assigned into 5 treatments with 4 replicate pens per treatment (30 birds/replicate pen) for 4 wk. A corn-soybean meal basal diet (control) was formulated, and 0.1% virginiamycin as antibiotic growth promoters (AGP), 1.0% dried Chlorella powder (DCP), 1.0% Chlorella growth factor (CGF), and 1.0% fresh liquid Chlorella (FLC) were added to the basal diet to form 5 dietary treatments. No significant differences were found among the treatments for feed intake or feed conversion of broiler chickens during the whole experimental period, but the BW gain was significantly higher (P < 0.05) in AGP and Chlorella-supplemented groups compared with the control group. The number of white blood cells was significantly higher (P < 0.05) in broilers fed FLC compared with DCP, and the number of lymphocytes was also significantly higher (P < 0.05) in the FLC treatment compared with AGP and DCP treatments; however, supplemental AGP and Chlorella had no effect on other blood leucocytes of broiler chickens. Dietary supplementation of Chlorella significantly (P < 0.05) increased the plasma IgA concentration of chickens compared with AGP and control. In addition, plasma IgM concentration was higher in DCP and FLC treatments than the control treatment, and plasma IgG concentration was also higher in the FLC treatment compared with other treatments. Supplemental AGP and various forms of Chlorella did not affect the Escherichia coli and Salmonella concentration in the intestinal microflora of broiler chickens, but the population of Lactobacillus was significantly increased (P < 0.05) when birds were fed FLC. It is concluded that dietary supplementation of FLC improves BW gain, immune characteristics, and the production of Lactobacillus bacteria in the intestinal microflora of broiler chickens.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
In Bangladesh, there is a large population of Muslims with type 2 diabetes mellitus (T2DM) who fast during Ramadan. Changes in the pattern of meal and fluid intake during this long-fasting hours may ...increase the risk of hypoglycaemia, hyperglycaemia, and dehydration. Our key point of focus was to evaluate the efficacy and safety of Empagliflozin, a sodium-glucose co transporter 2 inhibitor (SGLT2i), in patients with T2DM while fasting during Ramadan.
This was a 24-weeks, multi-centre, open-label, two-arm parallel-group study. In this prospective type of observational study, we enrolled patients taking Empagliflozin and Metformin with or without a DPP-4 inhibitor in one group (n = 274) and a parallel group (n = 219) who were treated with Metformin with or without a DPP-4 inhibitor. The primary endpoint of this study was HbA1c reduction, weight loss and the number of reported or symptomatic hypoglycemic events. In secondary endpoints, we evaluated the changes from baseline in blood pressure, estimated glomerular filtration rate (eGFR), serum creatinine, and serum electrolyte, the proportion of volume depletion (≥1 event) and incidence of other adverse events (AEs) of interest potentially related to SGLT2 inhibitor.
During Ramadan, HbA1c reduction was significant in Empagliflozin arm (-0.49% vs -0.12%); p < 0.001. From before to the end of the study, significant weight reduction was seen in the Empagliflozin arm (-1.4 kg vs -0.09 kg); p < 0.001. We observed no significant increase in the incidence of hypoglycemia (0.7% vs 0.4%, p = 0.267) and volume depletion (2.6% vs 1.8%; p = 0.55) in both arm. All these milder forms events did not require any hospital admission. There was no report of serious adverse events or any discontinuation, or reduction of prescribed doses of empagliflozin during Ramadan.
Empagliflozin is efficacious and safe for treating adults with T2DM during Ramadan.
•A comprehensive framework is developed for the economic evaluations of a residential building in Australia.•The tariff structures are generalized to provide a general solutions for every ...tariff.•Different economic measures are considered to analyze the economic viability for investing on solar PV units and BESSs.•Provide an indication of the profitability from the investment on renewable energy technologies.
This paper presents a comprehensive framework for conducting economic analysis of a residential house along with the integration of solar photovoltaic (PV) units and battery energy storage systems (BESSs). The proposed framework is developed by considering different tariff structures of the existing energy market as well as the investment costs for the solar PV units and BESSs. In this paper, the economic evaluations are carried out based on different economic measures such as replacement cost, electricity bill, simple payback analysis, net present value, discounted payback analysis, and levelized cost of energy along with the reduction in carbon di-oxide (CO2) emissions and grid independency. The proposed framework is implemented on an Australian residential building by considering different real-time operating scenarios. The results from the analysis demonstrate the profitability of a residential building for the investment on solar PV units and BESSs.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
The impact of noise pollution in urban healthy livings are not well documented and is seen often get less attention than it should. The increasing noise in urban settings must be studied further due ...to its site-specific nature for adoption of appropriate control measures or for better zoning of city's land uses. The present study assessed and evaluated the spatiotemporal variability of noise level and noise pollution indices for Chattogram City Corporation (CCC) in Bangladesh as study area. A total of 123 selected points were uniformly distributed to 41 wards under CCC has been taken as measuring sites. An ArcGIS 10.4 software is used to develop and evaluate the variations in noise descriptor and pollution indices in a graphical format. The study found that irrespective of sources, in general, city dwellers experienced moderately high noise with an average noise level of 75 dBA exceeding the limit values set by the Department of Environment (DoE), Bangladesh, World Health Organization (WHO), American Association of State Highway and Transportation Official (AASHTO) for different land uses individually or in combination. With an exception of few wards located far from major roads and with less population and industries, the city dwellers at 14 wards located in the north west, central and few parts of south belt experienced as high as 80 to 90 dBA based on noise equivalent (Leq), noise climate (NC) and noise pollution level (NPL) indices. The higher NPL of its standard value of 88 dBA is found at 14 wards align with the higher Leq and NC located close to major and urban road networks in CCC, while other 12 wards located in the central belt of the city are also with upper bound of limit values. Based on the results and reviewing the recommendations and standards, only three (3) out of the 41 wards or areas considered are under normally acceptable situation, while 12 wards are under normally unacceptable and the noise levels of the rest locations are clearly unacceptable. An immediate zoning of city's land uses and urban settings are to be taken in the identified wards. The outcomes of this study may assist policy makers, regulatory bodies and local council to adopt appropriate measures to ensure healthy living environment for city dwellers.
•A GIS based spatiotemporal variability of noise assessment has been studied.•Substantial temporal & spatial variabilities of noise descriptors are found.•Residential areas in CCC are surprisingly exposed to the highest noise pollution.•Noise map has been developed to illustrate pollution hots spots sites under CCC.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
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