Message from the Director Institute of Health Care

Fifteen years have passed since the Institute of Health Care was founded within the University of Malta. In line with advances in health care professional education worldwide, and indeed with advances in medical knowledge, technology, health service delivery and care, the University of Malta forged ahead and raised the professional education of nurses, midwives and professions allied to medicine onto an academic platform. The Institute was set up to develop diploma, degree and post-graduate courses in Communication Therapy, Dental Technology, Environmental Health Science, Medical Laboratory Science, Midwifery, Nursing, Occupational Therapy, 2002, Physiotherapy, Podiatry, and Radiography. Furthermore, the Institute earned a sound academic standing in the interdisciplinary Master and Post Qualification Diploma in Health Services Management that has attracted medical and pharmacy graduates in addition to our own health care graduates. It is with great satisfaction to report that fifteen years down the road, the Institute of Health Care has steadily grown in esteem and recognition both within our University as well as Swith our counterparts internationally.peer-reviewe

Current challenges of ageing and ageism with a focus on healthcare and long-term care

The world population is ageing, and the pace at which this is happening is accelerating. Statistics from the United Nations (UN) predict that between 2015 and 2030, the number of people aged 60 years or over is projected to grow by 56 per cent, to 1.4 billion, and by 2050, the global population of older persons is projected to more than double that registered in 2015, reaching nearly 2.1 billion [1]. The fact that society at large has been alerted by these projections for quite some time, mainly because of their impact on financial and economic sustainability, we do expect a more tolerant society toward older people. Nevertheless, there is evidence that ageism – a multifaceted and often undesirable social construction of old age, is widespread across countries and pervasive across sectors.peer-reviewe

Comment on “What Health System Challenges Should Responsible Innovation in Health Address? Insights From an International Scoping Review”

The insights from an international scoping review provided by Lehoux et al challenge health policy-makers, entrepreneurs/innovators and users of healthcare, worldwide, to be aware of equity and sustainability challenges at system-level when appraising responsible innovation in health (RIH) – purposefully designed to better support health systems.The authors manage to extract no less than 1391 health system challenges with those mostly cited pertaining to service delivery, human resources, leadership and governance. Countries were classified according to the Human Development Index (HDI), while the authors decided not to classify according to the types of health systems justifying this on the basis that the articles reviewed studied a specific setting within a broader national or regional health system. The article presents highly powerful and discerning viewpoints, indeed providing numerous standpoints, yet in a comprehensive manner, thereby putting structure to a somewhat highly complex and multidimensional subject. This commentary brings forth several considerations that are perceived on reading this article. First, although innovation strategies are important for the dynamicity of health systems, one should discuss whether or not RIH can adequately address equity and sustainability on a global scale. Secondly, RIH across countries should also be debated in the context of the principles garnered by the type of health system, thereby identifying whether or not the prevailing political goals support equity and sustainability, and whether or not policy-makers are adequately supported to translate system-level demand signals into innovation development opportunities. As key messages, the commentary reiterates the emphasis made by the authors of the need for international policy-oriented fora as learning vehicles on RIH that also address system-level challenges, albeit the need to acknowledge cultural differences. In addition, the public has not only the right for transparency on how equity and sustainability challenges are addressed in innovation decisions, but also the responsibilities to contribute to overcome these challenges.peer-reviewe

An examination of the relationship between authentic leadership and psychological well-being and the mediating role of meaningfulness at work

Previous studies have examined the relationship between charismatic-types of leadership and well-being but not specifically authentic leadership which gives importance to how leaders are intrinsically composed rather than mere behaviours. This study explored whether authentic leadership and well-being are related and whether meaningfulness of work mediates this relationship. Well-being was measured from two perspectives namely hedonic and eudaimonic well-being. 123 participants completed a questionnaire survey while correlational and mediation analyses, using the Sobel Z test with bootstrapped samples, were used to answer the research questions. Results revealed that authentic leadership is both related to subjective well-being and to flow. In addition, meaningfulness of work partially mediated the relationship between leadership and subjective well-being but fully mediated the relationship with flow. The results are discussed in view of their theoretical and practical implications. Finally, a series of limitations are provided to secure the interpretative boundaries of the results obtained.peer-reviewe

Diabetes in Malta : current findings and future trends

Diabetes is a considerable global problem. Recent projections suggest that at least 194 million people suffer from diabetes worldwide. The World Health Organization suggests this number will increase to 333 million by 2025. Approximately four million deaths each year are caused by diabetes-related complications totaling an astounding 9% of deaths worldwide. Currently, epidemiological studies indicate that 1% of the Maltese population suffer from Type I Diabetes Mellitus and 9% from Type II Diabetes Mellitus. Following global predictions, it is probable that the incidence of Type I diabetes will increase also. This article evaluates the current Maltese diabetic care system and conducts a strategic analysis of diabetic practices. Recommendations for a cost-effective standard of care, legislative support for comprehensive diabetic care, and a national policy are proposed.peer-reviewe

The impact of demographic changes in Malta on health and the health system over the past two decades

Population growth, ageing, changing fertility patterns and net immigration within the working age group have characterised the demographic transformation in Malta over the last twenty years. Life expectancy has continued to increase and is above the EU average. However population growth and ageing were associated with an increase in morbidity and healthcare usage resulting in increased demand on the healthcare system. Net immigration has been associated with an increase in the cultural diversity of the population and has had an impact on the epidemiology of various conditions. Planning and delivery of health care services needs to become more targeted to meet the needs of diverse communities within the population in order to maintain and continue to build on the healthcare gains achieved so far.peer-reviewe

Maternal awareness of health promotion, parental and preschool childhood obesity

Aim: To investigate the association between parental and preschool childhood obesity, as well as maternal awareness of public health promotion on healthy eating with parental and preschool childhood obesity. Methods: Data were collected by measuring the height and weight of two hundred randomly selected three-year old children and their parents. Details of the early feeding and dietary styles and level of health promotion awareness were assessed in faceto-face structured health interviews with the parents. Results: There were statistically significant relationships between childhood obesity and parents’ obesity (r=0.2; p<0.001). A higher proportion of overweight and obese preschool children showed that their mothers lacked awareness of health promotion as compared to children with normally accepted weight (χ2 (6, n=200)=17.32, p=0.008). Maternal awareness of health promotion on healthy eating appeared to have a protective effect against overweight/obesity in three year old children (odds ratio=0.38, 95% CI=0.20 to 0.70). Furthermore, a higher proportion of overweight/obesity mothers had no awareness of health promotion as compared to mothers with normally accepted weight (χ 2 (4, n=200)=13.29, p=0.01). Maternal awareness of health promotion appeared to also have a protective effect against overweight/obesity in mothers (odds ratio=0.51, 95% CI=0.28 to 0.95). Conclusions: This study showed the protective effect of maternal awareness of health promotion on maternal and preschool childhood obesity. Additionally, this study showed that overweight and obese preschool children had parents who were also overweight and obese.peer-reviewe

Comment on “providing value to new health technology: the early contribution of entrepreneurs, investors, and regulatory agencies”

Lehoux et al provide a highly valid contribution in conceptualizing value in value propositions for new health technologies and developing an analytic framework that illustrates the interplay between health innovation supply-side logic (the logic of emergence) and demand-side logic (embedding in the healthcare system). This commentary brings forth several considerations on this article. First, a detailed stakeholder analysis provides the necessary premonition of potential hurdles in the development, implementation and dissemination of a new technology. This can be achieved by categorizing potential stakeholder groups on the basis of the potential impact of future technology. Secondly, the conceptualization of value in value propositions of new technologies should not only embrace business/economic and clinical values but also ethical, professional and cultural values, as well as factoring in the notion of usability and acceptance of new technology. As a final note, the commentary emphasises the point that technology should facilitate delivery of care without negatively affecting doctorpatient communications, physical examination skills, and development of clinical knowledge.peer-reviewe

Business process management in health care : current challenges and future prospects

The emphasis of performance management in health care is shifting from output or outcome-based to a system-based approach. In particular, clinicians and managers are re-focusing their attention on processes so as to achieve better health system performance, as a reaction to the financial crisis. Health care management is increasingly applying systems thinking and business process management (BPM) as philosophies, which have proved to make a difference in organizational performance and competitiveness to the industry at large. This commentary provides answers to five questions that emerged through a reflective exercise and use of secondary data sources and informal interviews. These questions are intended to contribute toward better understanding of the meaning and application of BPM by scholars and practitioners in health care management. The questions are as follows: What is BPM and is it relevant to health care? Has BPM been extensively applied to health care? Why focus on quality in health care delivery? What are the current challenges of health care and can BPM help? What role BPM will play in future to facilitate effective health care management?peer-reviewe

Commentary : comparison of historical medical spending patterns among the BRICS and G7

A commentary on "Comparison of historical medical spending patterns among the BRICS and G7" by Jakovljevic, M.M. (2015). J.Med.Econ. 19, 70–76, doi:10.3111/13696998.2015.109349