Geriatrics and gerontology in Malta

Malta has been in the forefront of both Geriatrics and Gerontology since 1988 with the establishment of the International Institute on Ageing. Definitions of Geriatric medicine and gerontology are described, as well as under/postgraduate training opportunities in geriatrics and gerontology in Malta. Description of the two main associations of Geriatrics and Gerontology and the various geriatric services available in Malta are given, both in the public and private sector. The way forward is proposed for both geriatric medicine and gerontologypeer-reviewe

A case of Diogenes Syndrome

Diogenes Syndrome is a syndrome of extreme selfneglect, domestic squalor, excessive hoarding, social withdrawal and refusal of all help and lack of concern regarding one’s personal residential situation. A case report of an 83 year old lady with mild dementia and Diogenes Syndrome is described.peer-reviewe

Social cases?

This was a cross-sectional descriptive study of in-patients over the age of 60 years at St. Luke's hospital who were deemed to be social cases (SC). The majority (58.4%) were female and the mean age was 80 years (range 60-92, SD: 6.7 years). Most (80%) were found in medical wards. The mean length of stay was 22.5 days (range 1-290 days, SD: 36.4 days). Social cases were a frail group with a mean number of co-morbidities of 2.8 (range 0-6, SD:1.5). Dependency level was also high with a mean Barthel score of 6.8 (range 0-20, SD: 7.4). A diagnosis of dementia was documented on the patient's medical record in only 12%. However significant low Abbreviated Mental Test scores were found in 64% (mean AMT 5.0, range 0-9, SD: 2.8). These findings illustrate that most social cases at St. Luke's Hospital are not only there for `social' reasons but also have other factors involved, including a high dependency level in activities of daily living which hamper their discharge to the community. Rehabilitation using an interdisciplinary approach may help the less dependent return to the community.peer-reviewe

A case of neuroleptic malignant syndrome on withdrawal of benzhexol

The neuroleptic malignant syndrome is a rare and potentially lethal reaction which is usually associated with the use of medications with antidopaminergic properties. This article describes the case of an elderly gentleman who developed the neuroleptic malignant syndrome after withdrawal of the anticholinergic agent benzhexol (trihexyphenidyl hydrochloride), which he was taking for Parkinson’s disease. The patient improved rapidly after treatment was restarted. This case adds to the evidence that antidopaminergic agents may not be necessary for the development of this syndrome, and increased awareness of this possibility is advisable in such circumstances.peer-reviewe

A review of the aetiology and management of vocal behaviour in dementia

Vocal behaviour is a common form of agitation displayed by people with dementia. It refers to excessive screaming, abusive language, moaning, perseveration, and repetitive and inappropriate requests. The authors provide a literature review on this form of challenging behaviour, focusing on the aetiological factors and the available treatment options. Emphasis is put on a biopsychosocial approach. The aim of this article is to increase awareness of the condition in elderly nursing residences and hospitals, and to encourage best evidence-based practice.peer-reviewe

Pressure ulcer management

Pressure ulcers are usually the result of sustained pressure on parts of the body such as the heels, trochanteric and sacral areas. The main risk factors contributing to pressure ulcer formation are acute illness, injury or sedation. The two main groups of patients most susceptible of sustaining pressure ulcers are frail older patients and patients with spinal cord injuries. Frail older patients have thinner skin, are more likely to have a lower body mass index, and may be malnourished and immobile due to various neurological and musculoskeletal pathologies. Because of the phenomenon of an ageing population, pressure ulcers are becoming increasingly prevalent.peer-reviewe

Writing Men on the Margins: Joseph Mitchell, Masculinity, and the Flaneur

This study introduces the philosophies of the flâneur—a figure associated with the acts of wandering, observing, and reporting the realities of life on the city streets—to offer a critical reconsideration of a sociological perspective in writings of literary journalism. The study proposes that the literary journalist can be considered as a flâneur, or as a writer who employs the figure of the flâneur as a narrative device, to drive the production of (self-)reflective narratives. This approach is realized with a re-reading of one of New York City’s most widely regarded literary journalists: Joseph Mitchell. Reading Mitchell’s New Yorker profiles through a gendered lens, the article identifies Mitchell’s sociologically charged investigations into the everyday experiences of men from the margins—namely immigrants, Indigenous peoples, and African Americans—as they struggle with the conflicts that shape their masculine identities. The central themes that define these conflicts are identified as the struggle with the dominant ideologies of the self-made man and breadwinner roles, the importance of homosocial relations in the shaping of masculine identity. Possibilities of alternative roles for such men appear in Mitchell’s key profiles, “The Old House at Home” (1939), “The Mohawks in High Steel” (1949), and “Mr. Hunter’s Grave” (1956). By re-conceptualizing Mitchell as a flâneur, that is, a wandering investigator, interpreter, and writer of the discourses of New York society during this period, 1930s–1960s, we can begin to appreciate the sociological value of Mitchell’s profiles and the contribution they make to our understanding of the historical development of masculinity in the United States.publishedVersio

Magnetically controlled current flow in coupled-dot arrays

Quantum transport through an open periodic array of up to five dots is investigated in the presence of a magnetic field. The device spectrum exhibits clear features of the band structure of the corresponding one-dimensional artificial crystal which evolves with varying field. A significant magnetically controlled current flow is induced with changes up to many orders of magnitude depending on temperature and material parameters. Our results put forward a simple design for measuring with current technology the magnetic subband formation of quasi one-dimensional Bloch electrons.Comment: 9 pages, 5 figure

Alzheimer's disease research group (ADRG)

In these last few years, there has been a growing consensus in Europe and beyond on the need of increasing research on neurodegenerative diseases including Alzheimer's disease and other related dementias. The societal impact and financial consequences of these diseases are already being felt and will continue to grow with the projected rise in the elderly population. Currently, there are over 35 million individuals with dementia worldwide, a figure that will treble by the year 2050. It has been estimated that formal and informal dementia care costs a total of €445 billion (2009 data),' equivalent to 1 % of the global gross domestic product. It is therefore not surprising that the European Union supports various funding programmes in the hope of enhancing diagnosis, provide better treatment and improve care pathways and support for individuals with dementia, their caregivers and relatives.peer-reviewe