Pharmacists prescribing of non-steroidal anti-inflammatory drugs

OBJECTIVE: To develop, implement and validate a framework and protocol directed to pharmacists regarding prescription of non-steroidal anti-inflammatory drugs (NS AIDs) and to propose a documentation system to be used when prescribing NS AIDs. METHOD: A module highlighting the information on NS AID use and on pharmacists prescribing of NS AIDs was developed to be used as a tool for development of pharmacists’ knowledge to participate in the framework of pharmacist prescribing of NS AIDs. A protocol to be used when prescribing NS AIDs was developed. The developed protocol is concise and includes all relevant data. Evaluation of the proposed module and protocol was carried out by an expert panel consisting of 14 professionals. The readability of the module was assessed. A documentation system was set up using Microsoft Excel® 2007. KEY FINDINGS: A module named ‘Supplementary Prescribing for Pharmacists’ was developed as a Power point Presentation using Microsoft PowerPoint® 2007. The final version of the module scored 55 in the Flesch Reading Ease formula. The expert panel rated the overall presentation as very good. The module was considered a good tool of information for its intended purpose. Eleven healthcare professionals found the module very helpful and 7 found it very practical for its intended use. A protocol named: ‘Protocol for Prescribing NS AIDs’ was developed. Twelve health care professionals found the protocol easy to use while 5 of the participants thought it was time consuming. CONCLUSION: The module and protocol were very well accepted by the expert panel. Up till now there was a lack of protocols regarding NS AID use in Malta and that some potential side effects pertaining to this class of drugs were not always taken into consideration while dispensing. This study is now proposing a module to establish a safe and standard practice for recommendation of use of NS AIDs.peer-reviewe

Pharmacist intervention in patient monitoring in a psychiatric setting

OBJECTIVES: To develop a ‘Patient Monitoring Tool’ (PMT) to evaluate the quality of pharmaceutical care provided to patients in a psychiatric setting and to determine benefits of ward-based pharmacist services in this setting. METHOD: A PMT consisting of ‘Patient Monitoring Guidelines’ (PMG) and a ‘Pharmaceutical Care Issues Documentation Sheet’ (PCIDS) was developed. The tool was tested for validity, applicability, practicality and reliability and used to monitor 30 patients in an acute psychiatric ward. The PMT was implemented and evaluation was carried out after 4 weeks using a self-administered evaluation questionnaire. KEY FINDINGS: The developed PMT was found to be valid, applicable, practical and reliable for use in the psychiatric setting. A total of 75 pharmaceutical care issues (PCIs) were identified; 55 involved psychotropic medications. A positive evaluation of the tool was obtained. CONCLUSION: This study demonstrated that the proposed tool can be implemented in an acute psychiatric setting and patient monitoring may lead to optimisation of patient care. Pharmacist incorporation into the multidisciplinary healthcare team and direct patient involvement may further enhance the value of such services.peer-reviewe

The management of patients positive to hepatitis C virus antibody in Malta

Hepatitis C virus (HCV) infection is one of the main causes of chronic liver disease and hepatocellular carcinoma worldwide and is an important public health concern. A retrospective analysis of the demographics and management of patients who had a positive anti-HCV detected by enzyme immunoassay test done at Mater Dei Hospital was carried out to analyse the epidemiology of HCV infection in Malta and assess our management when compared to the European Association for the Study of the Liver (EASL) guidelines. 72% of patients were male. The majority of patients were aged 21-50 years. The main mode of infection was via intravenous drugs use, accounting for 68% of cases. Only 56% of patients found to be HCV Ab positive had a scheduled appointment with an infectious diseases specialist or gastroenterologist documented on the MDH online appointment system. 58% of patients had HCV RNA testing done and 45% had genotype testing. 7.3% with HCV infection were given treatment, of which 43% had a Sustained Virological Response (SVR).peer-reviewe

Attitudes and knowledge of parents on vaccination

Despite vaccinations being a breakthrough in preventive care, parents’ decisions on vaccination programmes may be difficult. This study investigated parents’ attitudes and knowledge on vaccines and vaccine-preventable illnesses. This was done with a view to identify discrepancies between the perceived and actual knowledge on vaccination schedules as well as to determine the main reasons for missing vaccinations. Following a review of the needs and concerns of parents, an information resource which best meets those needs was compiled.peer-reviewe

Benchmarking local practice in view of introduction of thrombolysis for stroke in Malta

The aim of the study was to benchmark the quality of local stroke care in view of introduction of thrombolysis. Stroke patients admitted to Mater Dei Hospital over 6 weeks in 2008 were recruited. A questionnaire based on the 2006 Royal College of Physicians (RCP) National Sentinel Stroke Audit phase II (Clinical Audit) was used. Results were compared to the 2008 RCP National Sentinel Stroke Audit phase II (Clinical Audit) report. 42 confirmed strokes were admitted. All patients underwent CT scanning within 24 hours. 97% received aspirin within 48 hours. 26.2% spent >50% of their stay in the neurology ward. 81% were discharged alive. At 24 hours from admission, 54.7% were not screened for swallowing. 47.6% were not assessed by an occupational therapist. 81% were assessed by physiotherapy at 72 hours of admission. None of the patients had documented goals set by a multi- disciplinary team. If thrombolysis were available, 16.7% would have been eligible. The commonest contraindications were late presentation (52.4%) and age >80 years (35.7%). Local results compared well to the RCP 2008 results in initiation of aspirin, imaging, and nutrition. However, we noted need for improvement in the assessment of swallowing, mood and cognitive function as well as involvement of a multidisciplinary team. Since then, adherence to international guidelines has improved by the introduction of thrombolysis, a dedicated multidisciplinary service and the use of local guidelines for stroke.peer-reviewe

The Odyssey of the young female asylum seeker : engaging critically on gendered forced migration

The paper is based on findings of research conducted in Malta towards the end of 2007. In depth interviews were conducted with thirteen young women aged between 20 and 29 hailing from sub-Saharan Africa, who arrived in Malta on a boat that departed from Libya. Each of the young women applied for asylum upon arrival. Our concern in this paper will be what Borg and Mayo (2006) describe as the ‘dominant hegemonic discourse that education and social well-being... are the responsibility not of the state but of the individual.’ In a nutshell, this paper will focus on the social and structural obstacles young female asylum seekers face in continuing their education.peer-reviewe

Understanding the Valletta community

Valletta is the Capital City of Malta. All citizens of this Country are affianced with Valletta. The beauty of this city is second to none. As a Faculty, in collaboration with a number of stakeholders, we attempted to locate some important issues that have potentially impacted the liveability of this community. As per introduction of the report; ‘This paper discusses findings of a mixed-methods case study on community development with special attention to liveability issues of island state communities that would have held the European Capital of Culture (ECoC) title. The case study context is Valletta – capital city of former colony and EU island state Malta. Valletta held the ECoC title during 2018 (European Commission (EC), n.d.). The empirical study was informed by data contributions from Valletta residents; as well as by government and cultural elites who influenced, to varying degrees, how regeneration and development occurred in Valletta between 2014 and 2019. This timeframe covers the period before, during and exactly after 2018 - when Valletta held the ECoC title (V18).’ Notwithstanding we are such a small Island the complexities that one finds from one town or village to another and even within the same locality is incredible and makes it exciting to research. This study we hope has managed to localise a number of issues that if one reads well into the empirical data can inform our decision makers to take the much-needed actions. Kudos to all the team that was involved in this project.peer-reviewe

A review of crimes against the administration of justice

The crimes which we will discuss fall into the wide class of offences against the public administration which more particularly impede or interfere with the proper administration of justice. These crimes are dealt with in our code in Sec 99 to 110; the salient offences being: 1. calumnious accusation; 2. simulation of an offence; 3. perjury; 4. retraction; 5. false swearing. In the course of the discussion we will refer to the writings of Italian jurists which have laid the foundations of these sections in our code.peer-reviewe

Yellow Supergiants in the Small Magellanic Cloud (SMC): Putting Current Evolutionary Theory to the Test

The yellow supergiant content of nearby galaxies provides a critical test of massive star evolutionary theory. While these stars are the brightest in a galaxy, they are difficult to identify because a large number of foreground Milky Way stars have similar colors and magnitudes. We previously conducted a census of yellow supergiants within M31 and found that the evolutionary tracks predict a yellow supergiant duration an order of magnitude longer than we observed. Here we turn our attention to the SMC, where the metallicity is 10x lower than that of M31, which is important as metallicity strongly affects massive star evolution. The SMC's large radial velocity (~160 km/s) allows us to separate members from foreground stars. Observations of ~500 candidates yielded 176 near-certain SMC supergiants, 16 possible SMC supergiants, along with 306 foreground stars and provide good relative numbers of yellow supergiants down to 12Mo. Of the 176 near-certain SMC supergiants, the kinematics predicted by the Besancon model of the Milky Way suggest a foreground contamination of >4%. After placing the SMC supergiants on the H-R diagram and comparing our results to the Geneva evolutionary tracks, we find results similar to those of the M31 study: while the locations of the stars on the H-R diagram match the locations of evolutionary tracks well, the models over-predict the yellow supergiant lifetime by a factor of ten. Uncertainties about the mass-loss rates on the main-sequence thus cannot be the primary problem with the models.Comment: Accepted by the Ap

Factors affecting ICT education among vulnerable minors in Malta : findings of the star kids research project

This paper identifies and discusses needs and gaps among minors aged 5-17 years who, at the time of the study, resided in out-of-home care and/or made use of community-based welfare services. The discussion is informed by mixed-methods study research carried out in 2018 as part of the project ‘Star Kids – Reaching Out: Improving the Life Chances of Vulnerable Children’. Star Kids’ objectives included developing and delivering a nationally accredited ICT training course for vulnerable minors; in a context where digitization is often described as ubiquitous, yet its experience is complex and not universal. In this paper, data analysed include responses to a questionnaire administered to minors; and data from focus groups with minors, their parents/guardians, and professionals working with the cohort under study. The study found high ICT usage, albeit with gender-based and age-based differences. Gaming, streaming and downloading prevailed among boys and 5–11-year-olds; use of social media prevailed among girls. Most minors considered themselves as self-learnt ICT users; yet the study flagged the need for more support for minors with low socio-economic backgrounds. The study identified shortcomings in the infrastructure available. Recommendations include investment in state-of-the-art ICT infrastructure in residential homes and community centres; further research to assess impacts of COVID-19 on this study’s findings; policy development that steers ICT education towards participatory and empowered involvement of parents /guardians; and that dwells on participants’ existing ICT knowledge and skills.peer-reviewe