Trends in sun exposure awareness and protection practices in Malta : 1999-2004

Rising skin cancer incidence rates have led to sun awareness campaigns in Malta since the early 1990s. The aim of this study is to assess the impact of these campaigns by analysing trends in sun exposure-related knowledge and behaviour amongst the Maltese people. A total of 559 Maltese pedestrians aged 16-50 years were interviewed in 1999. The same questionnaire was used to interview 304 pedestrians in 2004. More people admitted spending leisure time outdoors during peak sunshine hours in 2004 than in 1999 (85.9% vs 62.4%, p<0.001). There was a drop in people regularly wearing a hat during outdoor leisure activities from 32.4% to 18.4% (p<0.001), and from 37.5% to 9.3% (p<0.001) during outdoor work activities. Rates of regular sunscreen use remained constant at about 50% using it for outdoor leisure activities, but dropped from 25.0% to 9.3% for outdoor work (p=0.02). In 2004, 96.1% of participants having children aged less than 12 years stated that they regularly used sunscreen on their children (87.0% in 1999, p=0.01), while 66.2% said that their children regularly wore a hat (78.4% in 1999, p=0.05). More people were regarding a suntan as unhealthy in 2004 than in 1999 (62.8% versus 37.0%, p<0.001). The mass media remained the most important source of health information.peer-reviewe

Treatment of psoriasis with biologic agents in Malta

Introduction: Biologic therapy has revolutionalised the treatment of moderate to severe psoriasis leading to improved clinical outcomes and quality of life scores. This study aims to determine current biologic use in psoriatic patients at our Dermatology department at Sir Paul Boffa hospital, Malta. Method: All patients who were administered biologic therapy for psoriasis in Malta until the end of 2014 were included. Data included demographic details, disease duration and severity, biologic use and duration, previously attempted treatments, side effects, early and late response to biologic using Psoriasis Area Severity Index (PASI) scores and Dermatology Life Quality index (DLQI) scores. Results: A total of 36 patients were started on a biologic between 2009 and 2014 for psoriasis (M:25, F:11) with a mean age of 46.9 years. These included etanercept (n=22), infliximab (n=8), adalimumab (n=4) and ustekinumab (n=2). Secondary failure was the main reason why biologics were stopped and switched. Most patients had an improvement in their PASI scores after 2 to 4 weeks of starting the biologic and had a PASI 90 score improvement. All patients had more than a 5 point improvement in DLQI score. Discussion: Biologic use in our department is on the increase. Our patients had considerable improvements in their PASI and DLQI scores. Secondary failures have occurred usually after 2 to 4 years and switching has yielded positive results. Biologics are expensive drugs and recently we have switched to cheaper biosimilars. Doctors should be aware of the treatment options available for psoriasis patients, their possible side effects and when to refer to our department. In most cases a satisfactory response can be achieved.peer-reviewe

Using appreciative inquiry to implement person-centred dementia care in hospital wards

The quality of care of persons with dementia in hospitals is not optimal and can be challenging. Moreover, staff may find difficulty in translating what they have learned during training into practice. This paper report the development and evaluation of a set of workshops using an Appreciative Inquiry (AI) approach to implement person-centred dementia care in two hospital wards. Staff worked collaboratively to develop a ward vision and to implement a number of action plans. Using AI approach, staff attitudes towards persons with dementia improved, inter-professional collaboration was enhanced and small changes in staff practices were noted. Dementia care in hospitals can be enhanced by empowering staff to take small but concrete actions after they engage in AI workshops, during which they are listened to and appreciated for what they can contribute

Local gradient analysis of human brain function using the Vogt-Bailey Index

In this work, we take a closer look at the Vogt-Bailey (VB) index, proposed in Bajada et al. (NeuroImage 221:117140, 2020) as a tool for studying local functional homogeneity in the human cortex. We interpret the VB index in terms of the minimum ratio cut, a scaled cut-set weight that indicates whether a network can easily be disconnected into two parts having a comparable number of nodes. In our case, the nodes of the network consist of a brain vertex/voxel and its neighbours, and a given edge is weighted according to the affinity of the nodes it connects (as reflected by the modified Pearson correlation between their fMRI time series). Consequently, the minimum ratio cut quantifies the degree of small-scale similarity in brain activity: the greater the similarity, the ‘heavier’ the edges and the more difficult it is to disconnect the network, hence the higher the value of the minimum ratio cut. We compare the performance of the VB index with that of the Regional Homogeneity (ReHo) algorithm, commonly used to assess whether voxels in close proximity have synchronised fMRI signals, and find that the VB index is uniquely placed to detect sharp changes in the (local) functional organization of the human cortex.</p

Prevelance of Tinea Pedis and Onychomycosis in Malta : the Achilles project

The Achilles project was set up because of the general poor awareness of foot disease, espe- cially of fungal foot infections. Foot diseases are often not viewed as a real problem, and the general public has limited knowledge of them. Most previous studies have involved small and specific population groups, such as school children, subjects visiting swimming baths, populations with specific occupations, or patients with underlying diseases like diabetes. Moreo- ver, patients often had to diagnose the condition themselves. The results of these self-assess- ments, was an underestimation of the prevalence of foot infections. (1, 2) The Achilles project was the largest epidemiological study ever to be carried out on foot health in Europe and other countries, related to the part of the body below the Achilles heel (e.g. foot, toes, toenails). Started in 1998, the aim of the project was to gain a better understanding of diseases affecting the feet and their prevalence among different patient groups with a view to improve the timely diagnosis and optimal treatment of this significant medical problem. The project also allowed an insight to be gained into the predisposing factors and quality of life in a large population, and to generate clinical data from a sample of the population. The data also served as the basis for epidemiological studies, allowing both medical professionals and pa- tients to benefit from this knowledge. The ultimate goal is therefore to increase the chance for timely diagnosis and treatment of foot disorders. Several European countries, including Austria, Belgium, the Czech Republic, Germany, Greece, Hungary, Italy, Luxembourg, the Netherlands, Portugal, Poland, Russia, Slovakia, Slovenia, Spain, Sweden, Switzerland and the United Kingdom (UK), have thus far participated in this foot-screening project, which was endorsed by the European Academy of Dermatology and Venerology (EADV) and the European Nail Society. Following the example of these countries, in 1999 Malta, Jordan and Cyprus implemented the Achilles project.peer-reviewe

Archaeological sites and palaeoenvironments of Pleistocene West Africa

African paleoanthropological studies typically focus on regions of the continent such as Eastern, Southern and Northern Africa, which hold the highest density of Pleistocene archaeological sites. Nevertheless, lesser known areas such as West Africa also feature a high number of sites. Here, we present a high-resolution map synthesising all well contextualised Pleistocene archaeological sites present in Sub-Saharan West Africa. A detailed elevation and ecoregional map was developed and correlated with palaeoanthropological sites. This map is supplemented with 1,000- and 2000-year interval climate reconstructions over the last 120,000 years for three subregions of high archaeological interest. The presented archaeological sites were compiled by reviewing published literature, and selected based on: (1) documented archaeological stratification or >10 characteristic artefacts, (2) published coordinates, and (3) published chronometric ages or relative dating. The data presented here elucidates the current state of knowledge of Pleistocene West Africa, highlighting the regional potential for human evolutionary studies.1. Introduction 2. Data and methods 3. Map description 4. Discussio