Setting an integrated soil monitoring system for Malta : strategy, feasibility and recommendations

Chapter 6Since 2010, MEPA has embarked on a project (which attracted co-funded ERDF assistance) (1) to develop a multi-thematic environment strategy that would lead to updating of its data/ information monitoring capabilities for a number of environmental sectors. The monitoring and continuous evaluation of soil properties is one important sector within this project. Essentially, a multi-criterion assessment of existing available information has been carried out with a view to objectively chart the most appropriate process to carry out a pilot field sampling by testing a pre-agreed set of indicators. The latter were established after taking into consideration all degradation pressures threatening the continued sustainability of this resource. Multi-criterion analysis was carried out by means of a limited set of soil-related datasets published in past editions of Malta’s State of the Environment Report in order to support a number of objectives stipulated within the Project’s ambitious Terms of Reference. Information was derived from earlier attempts to establish a soil information system for Malta. All soil degradation threats, officially determined by the European Commission’s Technical Working Groups, have been taken into consideration within the aforementioned project and its research methodology with a view of establishing a shared GIS environment in accordance with state-of-the-art information dissemination standards.peer-reviewe

An evaluation of type 2 diabetes care in the primary care setting

Objectives: To assess the clinical outcome of type 2 diabetes care currently provided at the primary healthcare centres. Method: A clinical audit was performed among 110 type 2 diabetes patients in the two major primary healthcare centres. The measurements of fasting blood glucose, HbA1c, serum lipid profile, blood pressure, serum creatinine, body mass index and waist circumference were carried out during a clinical examination. Knowledge, behaviour and attitude among the participants were assessed via a questionnaire composed of four sections concerning diabetes and its complications, physical activity, nutrition and smoking. Results: The ideal standards recommended by the International Diabetes Federation were employed for data analysis. HbA1c level was controlled in 37. 3%, systolic blood pressure was controlled in 44. 5%, cholesterol was controlled in 30% while LDL was controlled in 10.9 % of patients. Body Mass Index was above the normal threshold in 72.7% of participants while waist circumference was abnormally high in 96.3% of females and 64.7% of males. Serum creatinine level was controlled in 60% of patients. Significant correlations with HbA1c were registered for BMI (p-value 0.038) and serum creatinine (p-value 0.04). Patients showed limited knowledge on diabetes, its complications and exercise but were better informed on nutrition and smoking. Inappropriate eating habits were evident among participants while better behaviour was demonstrated in relation to the adherence to medication, physical activity and smoking. Conclusion: The framework for structured care is in place at the primary healthcare centres and compliance with process measures was confirmed. The present local care is based on good practice and is compatible with that provided in developed countries. However the health status of these patients is under imminent threat by a cluster of risk factors. This necessitates improvement in all components of present care while additional efforts must address the inadequacies in cardiovascular risk and lifestyle management.peer-reviewe

New methods for the treatment of renal calculi : the St. Luke’s Hospital experience

The last decade has seen extraordinary advances in the management of urinary tract calculi. With the introduction of minimally invasive techniques, like percutaneus nephrolithotomy (PCN), and non-invasive ones, like extra-corporeal shock wave lithotripsy (ESWL), major surgery for urinary tract calculi is becoming obsolete. The indications, methodology and complications of these techniques are briefly discussed. The results of the first fifty PCNs carried out by the Department of Urology and Urological Endoscopy at St. Luke’s Hospital, Malta are described. A 90% success rate with no mortality is claimed. During the same period open surgery for renal calculi was less than 5%.peer-reviewe

The Malta Red Cross

The beginning of the Malta Red Cross occurred in response to a refugee crisis that hit the Maltese shores in 1991, when two ships entered our seas with Albanian refugees. The Malta Red Cross was established on the 24th October 1991. By Act of Parliament it was recognised as an autonomous voluntary Relief Society auxiliary to the Public Authorities and allowed to carry out its activities in the Maltese islands in accordance with the rules and principles of the International Red Cross movement.peer-reviewe

Strong lensing as a test for Conformal Weyl Gravity

Conformal Weyl Gravity (CWG) predicts galactic rotation curves without invoking dark matter. This makes CWG an interesting candidate theory as an alternative to GR. This removal of the necessity of dark matter arises because the exact exterior solution in CWG for a static, spherically symmetric source provides a linear potential $\gamma r$, which can explain the observed galactic rotation curves with a value for $\gamma$ given by $\sim + 10^{-26} \mathrm{m}^{-1}$. Previous work has also shown that CWG can explain lensing observations, but with $\gamma\sim - 10^{-26} \mathrm{m}^{-1}$ in order to ensure converging rays of light rather than diverging ones. Even though different expressions for the angle of deflection have been derived in CWG in order to remove this inconsistency, this paper shows that the $\gamma$ required to fit the lensing data is several orders of magnitude higher than that required to fit the galactic rotation curves.Comment: 6 pages, 2 tables, 2 figure

Educational reform in the Maltese Islands

The political change in 1964, when the Maltese Islands became an Independent Archipelago, initiated a number of revolutionary reforms that the Maltese Education sector has been going through ever since. These last ten years have been extremely significant for Maltese Education, because of the several major measures and reforms that have been introduced. Their aim was to augment the country’s intellectual capital and provide improved quality education that will help all Maltese children to succeed. Replacing the questionable dichotomy of ‘top-down’ and ‘bottom-up’ has been, for the past decade, part of an extensive drive by the Ministry of Education, Youth and Employment and the Education Division to reform the education system in Malta. This paper will present a historical overview of the educational reforms aimed at devolving greater responsibilities to the schools and in particular the establishment of school networks. It will also treat the kind of leadership that has helped to sustain this transition in Maltese Education, so that schools will ‘provide improved quality education in Malta’ (Galea, 2005: xii), and the implications of educational reform in the Maltese Islands.peer-reviewe

Developing Measures of Severity and Frequency of Reconviction

This report examines the scope for focusing on the seriousness and frequency of recidivism and presents methodology for determining how to measure offence seriousness, and how to measure frequency of offending. It also discusses the advantages and disadvantages of combining these two measures into a combined seriousness/frequency score. However, one needs to recognise that the task of providing alternative measures of recidivism is not simply a technical exercise, for there are both philosophical and practical issues to confront. Hence, while the main body of the report focuses largely on the feasibility of producing the alternative measures and provides some solid evidence of developing these approaches (sections 3-5), the philosophical issues – which embrace definitional, conceptual and moral concerns – are not overlooked (see section 2). Furthermore, some of the practical issues of introducing these measures are recognised in the final section (section 6). First, however, what are the stated aims and objectives of the work

The oral contraceptive pill

n the 1930s the structure of steroids was discovered, together with the notion that high dose oestrogens, progesterones and androgens inhibited ovulation. Naturally, this has led to the development of oral hormonal contraceptives. This can be considered to be one of the epochal events of the 20th century since their direct and indirect effects on hormonal and metabolic pathways have shaped a new era of pharmacological control. This research opened the doors to experimentation and development into an ideal oral contraceptive pill (OCP). The 1950s showed the introduction and marketing of the first combined OCP, Enovid® 10mg (Searle) (9.85 mg norethynodrel and 150 μg mestranol) for menstrual disorders. Following further stage 4 trials, the dose was decreased form a 10mg to a 2.5mg dose.peer-reviewe

Long posterior-flap myoplastic below-knee amputation (Burgess operation) in peripheral vascular disease

Two problems face the surgeon when he decides to amputate. He must try to obtain primary healing of the skin flaps and he must give the patient a strong, mobile and useful stump. These two aims are in part in opposition to each other. The higher up the limb the surgeon amputates the better the chance of primary healing, but with this goes a higher mortality rate and a lower chance of rehabilitation for the patient. Amputations lower down the limb give a stronger stump, and a greater chance of a return to walking but the healing rate is slower. Within this study, fifteen below-knee amputations in fifteen patients were studied. Furthermore, the advantages in relation to long posterior-flap below-knee amputation with myoplasty are described.peer-reviewe

Blind loop syndrome : extensive diverticulosis of the small intestine

A case study of a 53 year old man is described. The patient presented himself at the Surgical Out Patients section, of St. Luke`s Hospital Malta with a history of progressive weight loss and ill-health over the past three years. The present case illustrates an unusual condition of malabsorption due to multiple diverticula of the small intestine. The condition corresponds to the syndrome which develops in association with a blind loop of the intestine. Diagnosis of the diverticula of the small intestine depends mainly on barium studies. Notwithstanding, in 60% of cases the diverticula are discovered accidentally by radiological examination or laparotomy, and there are no symptoms which can be attributed to them, but in the remaining cases they may give rise to genuine, and sometimes disabling, abdominal and other symptoms, as in the present case.peer-reviewe