Challenges in the management of Phenylketonuria in Malta

Phenylketonuria (PKU) is a rare metabolic disorder comprising a number of different enzyme deficiencies. In Malta, dihydropteridine reductase (DHPR) deficiency appears to be more common than phenylalanine hydroxylase deficiency (classical PKU), and is associated with greater and long term neurodisability. The absence of newborn screening for PKU in Malta results in a later diagnosis and, to-date, all affected patients require medical support for one or several problems including developmental delay, behavioural issues, cognitive impairment, epilepsy and neurodisability. These are compounded by problems in providing and adhering to strict low-phenylalanine diets and, in those with DHPR, the regular provision of neurotransmitter and cofactor supplementation. As a result, although a small cohort, these patients create a disproportionate demand on health services and, in most cases, will continue to require long term support at all levels since most will be unable to lead an independent existence. A radical and comprehensive overhaul of the local care provided to children with rare metabolic diseases is required at all levels, starting with the introduction of newborn screening, followed by effective dietary and pharmaceutical provision throughout childhood and through to later life.peer-reviewe

Drug doping in sports : an overview and recommendations for the Maltese context

The use of legal and illicit medical substances is widespread in international sport and becoming more complex. Serious concern exists about the use of illicit substances, as listed in the list of the World Anti Doping Agency (WADA) of prohibited substances. This phenomenon is also present among Maltese athletes and positive doping cases have been reported in the media among local sportspersons from varying disciplines. In this paper, a review of the current international conventions with respect to drug doping in sport will be given together with an overview of the prohibited substances. The Maltese situation will also be assessed. Limited local data indicate that this is an underground phenomenon which has existed and persisted over the years. The testing programs, with some exceptions, have to date been very poor and most sporting disciplines are not tested regularly. Recommendations will be made in order to readdress the lacuna in data available, as well as the knowledge and education of this subject among local sportspersons, coaches and sports officials, and various health care professionals. In addition, a call is made for Malta to implement the WADA Code as soon as possible, and sign and ratify the UNESCO and Council of Europe conventions, while ensuring that adequate resources are made available for their enforcement.peer-reviewe

Aesthetic properties and their (non-)contribution to artistic value

What makes us experience artworks and their aesthetic properties? Can all aesthetic properties be found in all artworks? What aesthetic qualities are required to evaluate artworks? How do we differentiate between aesthetic and artistic values and is there any relationship between the two? This paper aims to answer these questions by examining influential arguments mainly about aesthetic concepts introduced by Frank Sibley and which were later developed by several other contemporary aestheticians including Robert Stecker, Peter Lamarque and Jerrold Levinson. This paper briefly glances at the historical development of aesthetic properties, from Classical to contemporary times. To avoid speculation and vagueness, the paper proceeds to define some of the aesthetic properties as opposed to non-aesthetic ones and applies them to different literary and visual artworks. Such aesthetic qualities are attributed to a particular experience especially when considering literary works. This aesthetic experience, which includes mainly pleasure, plays an important role in the process of judging and evaluating art. It can also lead to several non-aesthetic values such as the cognitive value which is discussed in this paper. All these conceptions are open to perennial discussion. However, one cannot deny that there is a close connection between the aesthetic and the artistic value which do not exclude one another, especially in the process of identifying and evaluating artworks.peer-reviewe

Herbal medicine : a legal perspective

Although within the European Union, herbal medicines are considered as alternative medicines or are used in adjunct therapies; their use is considered as an important component of the European health care system. This is due to the fact that herbal medicine forms part of the European tradition. In spite of the diversity of options between Member States, herbal medicines used in different therapies should be made available to all European citizens. However, although the efficacy of certain medicines is rather disputable, the European Commission aims at safeguarding the European consumer by ensuring that these medicines are safe and of an adequate quality.peer-reviewe

The safety of herbal medicinal products

The primary aim of the EU, with the registration of herbal medicinal products (HMPs), is the protection of the European citizens from fraudulent and unsafe products. In fact, the EU is rather rigorous on this issue and therefore manufacturers are obliged to deal with safety issues. Although a Traditional Herbal Medicinal Products would have been in circulation for centuries, it is possible that with time, research proves the presence of toxic substances within the product. As herbal remedies are derived from nature, uneven conditions of growth and different varieties of a specific plant species may contribute to the emergence of previously-insignificant plant toxins. This has been also experienced with herbs and plants that are used for culinary purposes. Therefore to ensure the safety of herbal medicines, proof can be demonstrated by employing a battery of in vitro and in vivo tests.peer-reviewe

Herbal medicine : drug interactions

In today’s Western world, herbal medicine is used alongside conventional medicine. Herbal medicines may interefere with conventional medicines by several mechanisms.peer-reviewe

A Price on Volunteerism:The Public Has a Higher Duty to Accommodate Volunteers

This Comment first examines the issues presented in Bauer (including the holding that the Americans with Disabilities Act does not protect these volunteers from discrimination) and the court’s rationale for finding that volunteers are not protected under Title III. Part II explores the requirements and differences between Title I and Title III and provides some history of the definitions of “volunteer” and “employee.” Part III presents a public duty thesis arguing that the responsibility of providing accommodations should not belong solely to employers in the context of employees, or public accommodations in the context of patrons, but to all factions of society. This Comment concludes with an exploration in Part IV of the public duty thesis and how such a thesis may work under our current system