Referral tickets to secondary healthcare : is communication effective?

Communication between primary and secondary health care relies primarily on referral tickets. They determine how patients’ details are conveyed and hence the quality of care. The aim of this study was to assess the quality of referral tickets at the Surgical Outpatients at Mater Dei Hospital in Malta and to develop recommendations for improvement. Consecutive referral tickets between the 7th February and 4th March 2015 were prospectively included in the study and analysed for completeness. The data was entered into a proforma which was revised after the first ten entries. A total of 351 referral tickets were included in the study. Names and surnames were present in all reports and identification number in 99.42% of cases. 44.16% of referrals were inappropriate according to clinical details. The majority of the forms had a history of presenting complaint (98.29%) while the past history, drug history / allergies and examination findings were available in 69.23%, 67.81% and 76.64% respectively. The source of referral was not clear in 56.13%. Only 69.23% of all referral tickets were completely legible while 30.77% were partly legible. This study shows the need for an overhaul in the referral system. Recommendations include the use of electronic referrals and the introduction of feedback letters by hospital specialists.peer-reviewe

Quelques réflexions sur des pratiques d’utilisation des médicaments hors cadre médical

La progression de l’utilisation « non médicale » des médicaments, que ceux-ci soient disponibles avec ou sans ordonnance, apparaît aujourd’hui comme une préoccupation d’importance croissante dans le champ de la santé publique. Cette tendance, qui touche particulièrement les adolescents et les jeunes adultes, englobe une multitude de pratiques, allant du détournement à l’automédication en passant par « l’abus » et le dopage, pratiques qui seront définies ici et qui peuvent conduire au développement d’une dépendance au médicament. S’appuyant sur une revue de la littérature en sciences sociales et en santé publique, cet article met en évidence les problèmes que soulève la catégorisation des pratiques, notamment parce que les frontières entre les usages licites et illicites du médicament semblent de plus en plus brouillées dans les sociétés contemporaines. L’utilisation « non médicale » du médicament s’inscrit dans un contexte social marqué par un plus grand accès aux produits pharmaceutiques et aux savoirs qui s’y rapportent ainsi que par une tendance à la banalisation du recours chimique dans la vie quotidienne. Cet usage de l’assistance chimique à la vie quotidienne soulève la question de l’autonomie du sujet en santé et du rapport des individus à l’expertise médicale.The increase in non-medical use of prescription drugs and OTCs is becoming a serious public health issue. Non-medical use of medicines is more common among adolescents and young adults and includes practices such as drug diversion, self-medication, drug abuse, and doping. Using the literature published in public health and social sciences, this paper shows that categorizing drug-taking practices can be problematic as the distinction between illicit and licit use of medicines is becoming blurred in contemporary societies. Non medical use of prescription drugs is situated within a broader social context where greater access to prescription drugs and health information is provided and where the use of medicines is integrated into everyday life. It raises issues related to autonomy in healthcare and to the lay-expert relationship.La progresión del uso “no médico” de los medicamentos, ya sea que estén disponibles con o sin receta, constituye en la actualidad un problema cada vez más importante en el campo de la salud pública. Esta tendencia, que toca particularmente a los adolescentes y los adultos jóvenes, engloba una cantidad de prácticas que van de la utilización indebida a la automedicación, pasando por “el abuso” y el dopaje, prácticas que se definirán aquí y que pueden conducir al desarrollo de una dependencia al medicamento. Apoyándose en una revisión de la bibliografía de las ciencias sociales y la salud pública, este artículo pone en evidencia los problemas que representa la categorización de las prácticas, principalmente porque las fronteras entre los usos lícitos e ilícitos del medicamento parecen ser cada vez menos claras en las sociedades contemporáneas. El uso “no médico” del medicamento se inscribe en un contexto social marcado por un mayor acceso a los productos farmacéuticos y a los conocimientos con ellos relacionados, así como por una tendencia a la banalización del recurso a químicos en la vida cotidiana. Esta ayuda química para la vida de todos los días plantea la cuestión de la autonomía del sujeto saludable y de la relación de los individuos con el conocimiento médico

Gender equality, human development, and PISA results over time

Gender equality through the empowerment, representation, and provision of equal opportunities for all, regardless of gender, is increasingly recognised as a driver of social outcomes and a fundamental human right. This study explores the longitudinal (2006–2018) relationship between gender equality, human development, and education results as measured by PISA. Gender equality and human development are consistently correlated with PISA scores at each time point; however, when controlling for starting values and country effects only change in gender equality positively predicts change in PISA scores (F = 22.6, p < 0.001, R2 = 0.58). Research and policy implications for the longitudinal interpretation of the relationship of PISA results with system-level factors as well as the relationship between gender equality and education are discussed in this paper. In consideration of the impact of COVID-19 on education and gender equality, the findings from this study support continued political effort towards gender-equal human development in a post-COVID-19 world.publishedVersio

Benefits of Green Seaweed as Protein Source for Broiler: A Review

Poultry production contributes significantly to the agricultural economy. Nutrition is one important factor in having competent poultry production. Currently, there is a lot of research about natural alternatives or feed additives that are low in cost and can help increase the overall performance and improve poultry health conditions without any adverse effects. Macroalgae such as green seaweeds can meet these parameters. It is easily available and is considered a rich source of proteins, polysaccharides, carbohydrates, vitamins, minerals, pigments, and antioxidants. Most often, seaweeds are used as feed additives for broiler chickens as they can induce a beneficial impact on production parameters (body weight (BW), average daily gain (ADG), feed consumption (FC), and feed conversion ratio (FCR) and meat quality. However, there are several challenges in using green seaweed as a protein alternative for broiler chickens such as its toxic and antinutritional components, as well as varying available supply due to seasonal effects, diseases, location, and environmental pollution. Furthermore, the main objective of this review is to evaluate the different research conducted on green seaweed as a potential protein source in broilers

Enhancement of the Enzymatic Biosensor Response through Targeted Electrode Surface Roughness

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Identification of a Cell Surface Protein with a Role in Stimulating Human Keratinocyte Proliferation, Expressed During Development and Carcinogenesis

In an attempt to define cell surface molecules with an important role in the development of squamous cell carcinomas (SCCs), we generated monoclonal antibodies (MoAbs) to a human keratinocyte cell line (FEP18-11-T1) capable of giving rise to SCCs in nude mice. MoAb 10G7 was selected for further study because it bound to a cell surface component preferentially expressed by this cell line as compared with normal human foreskin keratinocytes. This MoAb recognizes a cell surface protein (10G7 antigen) that is not detectable on normal keratinocytes in the foreskin in vivo, but whose expression is induced when the keratinocytes are dissociated from this tissue and placed in culture. Interestingly, the 10G7 antigen is downregulated upon keratinocyte differentiation in vitro. Consistent with its expression in hyper-proliferative epithella in vitro, 10G7 antigen exhibited a classic oncofetal pattern of expression in vivo. Thus, although no reactivity was obtained with MoAb 10G7 in the epithelia of normal foreskin or cervical tissue, strong reactivity was detected in epithelia from genital lesions ranging from benign warts to invasive SCCs. Epidermis from developing fetal tissue also exhibited strong reactivity with MoAb 10G7. We have been able to demonstrate that this MoAb is capable of stimulating FEP18–11-T1 keratinocyte proliferation in vitro in a concentration-dependent manner in the absence of growth factors, suggesting that the 10G7 antigen may play an important role in regulating cellular proliferation during development and in carcinogenesis in epithelial tissues