A quantitative study of Maltese primary school teachers and their perceptions towards education for sustainable development

The study aims to explore Maltese primary school teachers’ perceptions towards Education for Sustainable Development (ESD). The research focused on 3-6 years old Maltese educators’ level of ESD awareness and knowledge, their attitudes towards ESD, and their willingness to adopt ESD within the classroom setting. Primary teachers’ ESD methodological skills were investigated as were issues that hinder ESD adoption as a regular teaching tool. The quantitative research involved the collection and analysis of 271 questionnaires. This data was plotted on graphs and analysed through Statistic Package for Social Science (SPSS) statistical tests. The findings show that in general, junior years’ primary school teachers show interest in implementing ESD and exhibit a positive attitude towards the area. However, it was noted that the participants’ level of awareness and knowledge of the various ESD concepts are rather low or unclear. Notwithstanding, many educators integrate ESD values and skills in their teaching methodology unconsciously. Several obstacles are shown to impede educators in their attempt to integrate ESD to its full potential. The main findings from the research were used to construct a model that visually illustrates the relationships between the variables and drafts a list of recommendations.peer-reviewe

Orthogeriatrics in Malta : a 3 year experience

The orthogeriatric service in Malta started in 2012 and expanded in 2014. From admission, the patient is offered a ward based hip fracture programme that includes orthogeriatric assessment, management and co-ordinated multidisciplinary review. 457 patients were seen by the orthogeriatric service when this study was done. Mean age was 83 and 69% of patients were female. The Nottingham Hip Fracture Score (NHFS) is a scoring system that reliably predicts 30-day and 1-year mortality for patients after hip fracture. It is made up of seven independent predictors of postoperative mortality that have been incorporated into a risk score. The score ranges from 0-10 and the mean score for this cohort was 5.1. There was a statistically significant correlation between age and high NHFS scores. 30 day mortality was 5.9% and 1 year mortality was 24.4%. Compared with the Nottingham data both 30 day and 1 year mortality were less for the orthogeriatric department in Malta. The orthogeriatric service in Malta achieved better results when comparing mortality with the UK. In the future expansion of data collected should be considered to better evaluate standards of care in the department.peer-reviewe

Hip fractures in older persons in Malta : an epidemiological study

BACKGROUND: Hip fractures are a common cause of morbidity and mortality in older adults, and may sometimes be the result of the inability to cope with arising medical problems. The purpose of this study is dual; it is primarily a local epidemiological study of hip fractures in older persons in Malta. The secondary purpose of this study is to identify the number of patients who have had a significant hospital visit in the three months preceding the hip fracture.METHOD: Data was collected over a period of 6 months from the national general hospital of Malta; Mater Dei Hospital. Patients included were 70 years and older, and sustained a proximal hip fracture.RESULTS: The incidence of hip fractures in Malta in persons aged 70 and over is 7.29 per 1000 persons per year in females and 4.66 per 1000 persons per year in males. The 1 year mortality rate was found to be 22%. In over one quarter of the cases, there was a significant hospital visit within the 3 months prior to the hip fracture incident, one fifth of whom had a falls related visit.CONCLUSION: Hip fractures in older persons in Malta resulted in a high mortality rate and rate of admission to care homes. Incidence rate in Malta matched incidence rates in central Europe. While case prevention is still limited, we suggest an age and sex-matched control study to assess the significance of hospital visits occurring prior to hip fractures, in order to guide a direction for case prevention.peer-reviewe

Polygenic Risk Scores for Prediction of Breast Cancer and Breast Cancer Subtypes

Stratification of women according to their risk of breast cancer based on polygenic risk scores (PRSs) could improve screening and prevention strategies. Our aim was to develop PRSs, optimized for prediction of estrogen receptor (ER)-specific disease, from the largest available genome-wide association dataset and to empirically validate the PRSs in prospective studies. The development dataset comprised 94,075 case subjects and 75,017 control subjects of European ancestry from 69 studies, divided into training and validation sets. Samples were genotyped using genome-wide arrays, and single-nucleotide polymorphisms (SNPs) were selected by stepwise regression or lasso penalized regression. The best performing PRSs were validated in an independent test set comprising 11,428 case subjects and 18,323 control subjects from 10 prospective studies and 190,040 women from UK Biobank (3,215 incident breast cancers). For the best PRSs (313 SNPs), the odds ratio for overall disease per 1 standard deviation in ten prospective studies was 1.61 (95%CI: 1.57-1.65) with area under receiver-operator curve (AUC) = 0.630 (95%CI: 0.628-0.651). The lifetime risk of overall breast cancer in the top centile of the PRSs was 32.6%. Compared with women in the middle quintile, those in the highest 1% of risk had 4.37- and 2.78-fold risks, and those in the lowest 1% of risk had 0.16- and 0.27-fold risks, of developing ER-positive and ER-negative disease, respectively. Goodness-of-fit tests indicated that this PRS was well calibrated and predicts disease risk accurately in the tails of the distribution. This PRS is a powerful and reliable predictor of breast cancer risk that may improve breast cancer prevention programs.NovartisEli Lilly and CompanyAstraZenecaAbbViePfizer UKCelgeneEisaiGenentechMerck Sharp and DohmeRocheCancer Research UKGovernment of CanadaArray BioPharmaGenome CanadaNational Institutes of HealthEuropean CommissionMinistère de l'Économie, de l’Innovation et des Exportations du QuébecSeventh Framework ProgrammeCanadian Institutes of Health Researc

Comparison of 6q25 Breast Cancer Hits from Asian and European Genome Wide Association Studies in the Breast Cancer Association Consortium (BCAC)

Peer reviewe

Genetic variation at CYP3A is associated with age at menarche and breast cancer risk : a case-control study

Abstract Introduction We have previously shown that a tag single nucleotide polymorphism (rs10235235), which maps to the CYP3A locus (7q22.1), was associated with a reduction in premenopausal urinary estrone glucuronide levels and a modest reduction in risk of breast cancer in women age ≤50 years. Methods We further investigated the association of rs10235235 with breast cancer risk in a large case control study of 47,346 cases and 47,570 controls from 52 studies participating in the Breast Cancer Association Consortium. Genotyping of rs10235235 was conducted using a custom Illumina Infinium array. Stratified analyses were conducted to determine whether this association was modified by age at diagnosis, ethnicity, age at menarche or tumor characteristics. Results We confirmed the association of rs10235235 with breast cancer risk for women of European ancestry but found no evidence that this association differed with age at diagnosis. Heterozygote and homozygote odds ratios (ORs) were OR = 0.98 (95% CI 0.94, 1.01; P = 0.2) and OR = 0.80 (95% CI 0.69, 0.93; P = 0.004), respectively (P trend = 0.02). There was no evidence of effect modification by tumor characteristics. rs10235235 was, however, associated with age at menarche in controls (P trend = 0.005) but not cases (P trend = 0.97). Consequently the association between rs10235235 and breast cancer risk differed according to age at menarche (P het = 0.02); the rare allele of rs10235235 was associated with a reduction in breast cancer risk for women who had their menarche age ≥15 years (ORhet = 0.84, 95% CI 0.75, 0.94; ORhom = 0.81, 95% CI 0.51, 1.30; P trend = 0.002) but not for those who had their menarche age ≤11 years (ORhet = 1.06, 95% CI 0.95, 1.19, ORhom = 1.07, 95% CI 0.67, 1.72; P trend = 0.29). Conclusions To our knowledge rs10235235 is the first single nucleotide polymorphism to be associated with both breast cancer risk and age at menarche consistent with the well-documented association between later age at menarche and a reduction in breast cancer risk. These associations are likely mediated via an effect on circulating hormone levels

Late outcomes in adults with atrial switch for transposition of the great arteries according to risk factor profile at 30 years of age

Objective: To compare the late outcomes of adults who underwent atrial switch repair for dextro-transposition of the great arteries, based on their risk profile at age 30 years. Methods: We performed a retrospective study of 67 participants who had undergone atrial switch repair. “Low risk” people were defined as those who reached age 30 years or beyond with normal or mildly impaired systemic right ventricular (RV) function with no or mild tricuspid regurgitation (TR). “High risk” people were defined as those who had moderate or severe systemic RV dysfunction, or moderate or severe tricuspid regurgitation by age 30. The primary outcome was transplant-free survival and the secondary outcome was a composite end-point including hospitalisations for heart failure, inotrope requirement, referral for transplantation and transplantation. Results: 52/67 (78%) were classified as “low risk” and 15/67 (22%) were classified as “high risk”. At 45 years, transplant-free survival was 31% for the “high risk” group compared to 87% for “low risk”. All “high risk” people met the composite endpoint at 45 years compared to only 18% of the “low risk” group (hazard ratio 6.3, p = 0.03). Conclusion: Transplant-free survival is markedly reduced in “high risk” atrial switch patients. Risk stratification based on systemic right ventricular function and tricuspid regurgitation at age 30 may predict future health outcomes for atrial switch patients

Fluorescent nanodiamond and lanthanide labelled in situ hybridization for the identification of RNA transcripts in fixed and clarity-cleared central nervous system tissues (conference presentation)

Despite significant advancement in the methodology used to conjugate, incorporate and visualize fluorescent molecules at the cellular and tissue levels, biomedical imaging predominantly relies on the limitations of established fluorescent molecules such as fluorescein, cyanine and AlexaFluor dyes or genetic incorporation of fluorescent proteins by viral or other means. These fluorescent dyes and conjugates are highly susceptible to photobleaching and compete with cellular autofluorescence, making biomedical imaging unreliable, difficult and time consuming in many cases. In addition, some proteins have low copy numbers and/or poor antibody recognition, further making detection and imaging difficult. We are developing better methods for imaging central nervous system neuroinflammatory markers using targeted mRNA transcripts labelled with fluorescent nanodiamonds or lanthanide chelates. These tags have increased signal and photostability and can also discriminate against tissue/cell autofluorescence. Brains and spinal cords from BALB/c mice with a chronic constriction model of neuropathic pain (neuroinflammation group) or that have undergone sham surgeries (control group) were collected. A subset of brains and spinal cords were perfused and fixed with paraformaldehyde (n=3 sham and n=3 pain groups) prior to sectioning and in situ hybridization using nanodiamond or lanthanide chelate conjugated complementary RNA probes. Another subset of brains and spinal cords from the same cohort of animals were perfused and processed for CLARITY hydrogel based clearing prior to in situ hybridization with the same probes. We will present our findings on the photostability, sensitivity and discrimination from background tissue autofluorescence of our novel RNA probes, compared to traditional fluorophore tags.1 page(s

Treatment of segmental pulmonary artery hypertension in adults with congenital heart disease

INTRODUCTION: Pulmonary arterial hypertension (PAH) in patients with congenital heart disease (CHD) usually has a homogeneous pressure distribution. More rarely, complex CHD patients have segmental PAH. This is often post-surgically. The characteristics of these patients and their responsiveness to specific pulmonary vasodilator therapy have not been described. METHODS: Seven adults with segmental PAH complicating CHD were treated at 3 specialized adult CHD centers between January 2006 and December 2010. Clinical characteristics, six minute walking distances (6 MWD), laboratory tests and images were obtained from medical records and the responses to Bosentan, an endothelin-1 receptor antagonist, were assessed. RESULTS: All patients (mean age 32 (23-42) years, five females) had a primary diagnosis pulmonary atresia (PA), four with major aortopulmonary collateral arteries (MAPCAs). Four segmental PAH patients had a right pulmonary artery stenosis, two a left pulmonary artery stenosis and one a unilateral MAPCA stenosis. All patients were symptomatic (functional class II or III) and bosentan was started empirically. Bosentan treatment led to a significant improvement in functional class compared to baseline (1.7 ± 0.5 versus 2.4 ± 0.5; p<0.01). Mean 6 MWD (available in 6 patients) increased by 62 m (22-150 m) from 386 ± 135 to 448 ± 133 m (p=0.03) after 12 months treatment. Most improvement was seen in patients with low baseline 6 MWD. Higher baseline exercise heart rate was significantly associated with lesser improvement in 6 MWD (r=-0.91 p=0.01). Laboratory results did not change after initiation of bosentan treatment. CONCLUSION: This small retrospective case series suggested a significant improvement of functional class and exercise capacity after bosentan treatment in patients with segmental PAH. These findings warrant a prospective study of the potential benefit of selective pulmonary vasodilator therapy in these complex patients. Therefore, we call on treating physicians to share similar cases.status: publishe