Better mental health and well-being

Mental ill-health imposes a huge burden on individuals, their families, society, health systems and the economy. Mental health care remains a neglected area of health policy in too many countries. This statement by the Organisation for Economic Co-operation and Development (OECD 2014) confirms the overall bleak assessment of the reaction to mental ill-health that prevails worldwide even in well-developed economies. Mental ill-health has accompanying costs in terms of reduced quality of life, loss of productivity, and premature mortality. Data from the European Union shows that stigma and the fear of its possible effects on personal, family and employment prospects prevents around half of those who need mental health care to come forward and request such care.peer-reviewe

A public health perspective for primary health care

The content and service goals of primary health care must reflect national public health priorities, if primary health care is to retain its traditional role as a relevant contributor to the national health system, as a reliable caregiver promptly responding to the evolving health needs of the Maltese population and as a trustworthy partner providing sustainable and cost-effective services.peer-reviewe

The rights of persons with mental disorders

This article is a reaction paper to a previous article published in The Synapse 2014 Volume 13 Issue 1 which can be found through this link : https://www.um.edu.mt/library/oar//handle/123456789/13822Reference is made to the paper by Dr Anthony Zahra and Dr Nigel Camilleri entitled “An Overview of the New Mental Health Act for the Maltese Islands” published in the The Synapse Magazine, Volume 13 Issue 01. The authors here submit their comments, remarks and clarifications from a patient rights’ perspective. In the previous article, the authors suggest that a specific reference to either the World Health Organisation International Classification of Diseases or the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders could provide more definite guidance to users of the Mental Health Act. However if legislation is too prescriptive or prefers one international classification over another, then it may diminish clinical autonomy and as a result hamper rather than guide the service provider. As a result this may negatively impact the beneficiary of the service.peer-reviewe

The rights of persons with mental disorders

This article is a reaction paper to a previous article published in The Synapse 2014 Volume 13 Issue 1 which can be found through this link : https://www.um.edu.mt/library/oar//handle/123456789/13822Reference is made to the paper by Dr Anthony Zahra and Dr Nigel Camilleri entitled “An Overview of the New Mental Health Act for the Maltese Islands” published in the The Synapse Magazine, Volume 13 Issue 01. The authors here submit their comments, remarks and clarifications from a patient rights’ perspective. In the previous article, the authors suggest that a specific reference to either the World Health Organisation International Classification of Diseases or the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders could provide more definite guidance to users of the Mental Health Act. However if legislation is too prescriptive or prefers one international classification over another, then it may diminish clinical autonomy and as a result hamper rather than guide the service provider. As a result this may negatively impact the beneficiary of the service.peer-reviewe

The development of public mental health in Malta

Public health practitioners in Malta have been drivers of public mental health reform throughout the last twenty-five years. However, early political and financial support for the implementation of policy and strategy dwindled over the years. Whilst services continued to expand, these were not matched with the adequate injection of human and financial resources. Twenty years later, the mental health service is still experiencing problems of underfinancing as reflected by the dire state of the psychiatric hospital infrastructure, poor leadership, management and accountability structures, and a largely insufficient albeit dedicated workforce. In 2012, the enactment of the new Mental Health Act and the establishment of a Commissioner for Mental Health recharged a national focus on mental health. Mental health is now a subject for the local media, the public is more receptive, NGOs and professionals are more vocal, the significance of mental health in schools, homes, and the workplace is taking root, and the subject has gained increasing political will, culminating with the launch of a Mental Health Strategy document for consultation in December 2018. This is our window of opportunity to ensure that policies and strategies are now translated into resources and action that reap sustained improvement in population mental health and well-being for this and future generations.peer-reviewe

Design activity in Malta : a macro-economic analysis

The present economic analysis focuses on design and innovation. It compares Malta to leading design innovators in the EU, namely Germany, Italy, Sweden and Finland. Findings include positioning of Malta in relation to these focus countries, overall, by firm size and by sector. Furthermore, manufacturing fares timidly in design innovation both internally in relation to other sectors, and also when compared to other EU Member States. Within services, IT and consultancy are relatively high design innovation spenders, whereas financial services come in at the lower end. The analysis also evaluates the multiplier effects of design services and the inter-industry linkages involved in design activity.peer-reviewe

Is erectile dysfunction a sentinel symptom for cardiovascular autonomic neuropathy in patients with type 2 diabetes?

The study investigated whether there is a significant association between erectile dysfunction (ED) secondary to autonomic failure, and cardiovascular autonomic neuropathy (CAN) in male patients suffering from type 2 diabetes. Twenty‐two patients suffering from type 2 diabetes were recruited for this study after satisfying the stringent exclusion criteria used in the first stage. They had no evidence of overt cardiovascular disease, hypertension, neurological, renal or thyroid disease. Each subject was assessed for ED and CAN using standardized tests. Six patients were suffering from CAN while 10 patients were suffering from ED. There was no significant association between CAN and autonomic ED (P = 1). Three patients with normal erectile function had CAN, whilst three patients with ED had CAN. Further analysis demonstrates a significant increase in association between ED and CAN with age (P = 0.036). These results show that ED secondary to autonomic neuropathy is not significantly associated with CAN in this specific group of patients. Nonetheless, the study reveals that ED is a sentinel symptom for future development of CAN.peer-reviewe

Imaging of the Cytoplasmic Leaflet of the Plasma Membrane by Atomic Force Microscopy

The cytoplasmic face of ventral cell membranes of Madin-Darby canine kidney (MDCK) cells grown on glass coverslips was imaged by atomic force microscopy (AFM) in air and under aqueous medium, in contact mode. Micrometer range scans on air-dried samples revealed a heterogeneous structure with some filaments, likely corresponding to actin filaments that abut the inner leaflet of the membrane, and a few semi-organized lattice structures that might correspond to clathrin lattices. Experiments in phosphate-buffered saline confirmed the heterogeneity of the inner membrane surface with the presence of large (\u3e 100 nm) globular structures emerging from the surface. Using sub-micrometer scan ranges, protruding particles, that occupy most of the membrane surface, were imaged in liquid medium and in air. These particles, 8 to 40 nm x-y size, were still present following ethanol dehydration which extracts a large fraction of membrane lipids, indicating their proteic nature. Due, at least partly, to the presence of some peripheral proteins, high magnification images of the inner membrane surface were heterogeneous with regard to particle distribution. These data compare with those previously reported for the external membrane leaflet at the surface of living MDCK cells. They show that details of the cytosolic membrane surface can be resolved by AFM. Finally, the images support the view of a plasma membrane organization where proteins come into close proximity

La diversidad cultural en la adopción de la educación abierta en las universidades de Oriente Medio: colectivismo y distancia del poder

In this paper, we examine how open education is adopted in the Middle East region in the context of a European-funded project for capacity building in Higher Education. Basing our study on Hofstede’s model, we examine how culture, in particularly collectivism and power distance influence the adoption of open education. In addition, we look at the relationship between internationalisation of tertiary education and open education. Based on indepth interviews, focus group, and participatory action research with experts in the fields from Egypt, Jordan, Lebanon and Palestine, our findings suggest that beyond the technical aspect and the development of content, adoption of open education in the Middle East region is influenced by cultural aspects, which needs to be taken into consideration. As an emerging sub-culture, open education has the potential to transform and change some cultural barriers related to both power distance and collectivist culturesEn este artículo mostramos cómo la adopción de recursos educativos abiertos en las universidades de Oriente Medio depende en parte de factores culturales, tales como el grado de individualismo/colectivismo y la distancia a la autoridad. Utilizando el modelo de Hofstede, describimos el caso de un proyecto Erasmus+ para el desarrollo de capacidades en Educación Superior en el que se promovieron prácticas abiertas en instituciones de educación superior en Egipto, Jordania, Líbano y Palestina. Los resultados muestran cómo el grado de internacionalización es un antecedente directo de la incorporación de prácticas educativas abiertas en el contexto universitari

Mapping the Early Cortical Folding Process in the Preterm Newborn Brain

In the developing human brain, the cortical sulci formation is a complex process starting from 14 weeks of gestation onward. The potential influence of underlying mechanisms (genetic, epigenetic, mechanical or environmental) is still poorly understood, because reliable quantification in vivo of the early folding is lacking. In this study, we investigate the sulcal emergence noninvasively in 35 preterm newborns, by applying dedicated postprocessing tools to magnetic resonance images acquired shortly after birth over a developmental period critical for the human cortex maturation (26-36 weeks of age). Through the original three-dimensional reconstruction of the interface between developing cortex and white matter and correlation with volumetric measurements, we document early sulcation in vivo, and quantify changes with age, gender, and the presence of small white matter lesions. We observe a trend towards lower cortical surface, smaller cortex, and white matter volumes, but equivalent sulcation in females compared with males. By precisely mapping the sulci, we highlight interindividual variability in time appearance and interhemispherical asymmetries, with a larger right superior temporal sulcus than the left. Thus, such an approach, included in a longitudinal follow-up, may provide early indicators on the structural basis of cortical functional specialization and abnormalities induced by genetic and environmental factor