Are local guidelines on investigations in children admitted with acute gastroenteritis being adhered to?

The aim of this article is to assess adherence to local guidelines on the investigation of children admitted with acute gastroenteritis. Children admitted to Mater Dei Hospital with a diagnosis of gastroenteritis between December 2012 and February 2013 were selected. Their investigations were retrospectively assessed in relation to the degree of dehydration and the type of management given. Hospital guidelines relating to investigations performed in children admitted with gastroenteritis were reviewed and compliance was assessed. A total of 411 investigations were carried out in 76 children with the most common investigations being serum electrolytes, urea and creatinine and random blood glucose. Guidelines were met in 4/76 (5.3%) of the study population. Serum electrolytes had the greatest impact on management. The conclusion is that the local guideline on gastroenteritis is not being adhered to in the vast majority of cases. There is an urgent need to raise awareness about the availability and utilisation of this guideline amongst doctors working in paediatrics.peer-reviewe

“O mħabba!” : il-poeżiji ta’ Victor Fenech dwar l-imħabba

X’inhi l-imħabba? Liema huma dawk is-sentimenti li tqanqal l-imħabba? L-imħabba bejn tnejn tibqa’ teżisti wara l-mewt? L-imħabba hija tema universali li ilha tiġi diskussa għal żmien twil. Dan l-artiklu se jittratta l-poeżiji ta’ mħabba ta’ Victor Fenech b’bażi teorika ta’ Platun u ta’ filosfi femministi tas-seklu għoxrin, fosthom Simone de Beauvoir, Julia Kristeva u Luce Irigaray.peer-reviewe

Assessment tools for the admission of older adults to inpatient rehabilitation : a scoping review

(1) Objective: To identify the assessment tools and outcome measures used to assess older adults for inpatient rehabilitation. (2) Design: Scoping review. (3) Data sources: ProQuest, PEDro, PubMed, CINAHL Plus with full text (EBSCO), Cochrane Library and reference lists from included studies. (4) Review method: The inclusion of studies covering patients aged >60, focusing on rehabilitation assessments delivered in hospitals in community settings. Studies reporting on rehabilitation specifically designed for older adults—testing for at least one domain that affects rehabilitation or assessments for admission to inpatient rehabilitation—were also included. Results were described both quantitatively and narratively. (5) Results: 1404 articles were identified through selected databases and registers, and these articles underwent a filtering process intended to identify and remove any duplicates. This process reduced the number to 1186 articles. These, in turn, were screened for inclusion criteria, as a result of which 37 articles were included in the final review. The majority of assessments for geriatric rehabilitation were carried out by a multidisciplinary team. Multiple studies considered more than one domain during assessment, with a high percentage evaluating a specific outcome measure used in geriatric rehabilitation. The most common domains assessed were function, cognition and medical status—with communication, vision and pain being the least common. A total of 172 outcome measures were identified in this review, with MMSE, BI, FIM and CCI being the most frequent. (6) Conclusions: This review highlights the lack of standardised approaches in existing assessment processes. Generally, older-adult-rehabilitation assessments struggle to capture rehabilitation potential in a holistic manner. Hence, a predictive model of rehabilitation for assessing patients at the initial stages would be useful in planning a patient-specific programme aimed at maximising functional independence and, thus, quality of life.peer-reviewe

Environment or genetic isolation? An atypical intestinal microbiota in the Maltese honeybee Apis mellifera spp. ruttneri

Apis mellifera evolved mainly in African, Asian and European continents over thousands of years, leading to the selection of a considerable number of honey bees subspecies that have adapted to various environments such as hot semi-desert zones and cold temperate zones. With the evolution of honey bee subspecies, it is possible that environmental conditions, food sources and microbial communities typical of the colonised areas have shaped the honey bee gut microbiota. In this study the microbiota of two distinct lineages (mitochondrial haplotypes) of bees Apis mellifera ruttneri (lineage A) and Apis mellifera ligustica and carnica (both lineage C) were compared. Honey bee guts were collected in a dry period in the respective breeding areas (the island of Malta and the regions of Emilia-Romagna and South Tyrol in Italy). Microbial DNA from the honey bee gut was extracted and amplified for the V3-V4 regions of the 16S rRNA gene for bacteria and for ITS2 for fungi. The analyses carried out show that the Maltese lineage A honey bees have a distinctive microbiota when compared to Italian lineage C honey bees, with the most abundant genera being Bartonellaceae and Lactobacillaceae, respectively. Lactobacillaceae in Maltese Lineage A honey bees consist mainly of Apilactobacillus instead of Lactobacillus and Bombilactobacillus in the lineage C. Lineage A honey bee gut microbiota also harbours higher proportions of Arsenophonus, Bombella, Commensalibacter and Pseudomonas when compared to lineage C. The environment seems to be the main driver in the acquisition of these marked differences in the gut microbiota . However, the influence of other factors such as host genetics, seasonality or geography may still play a significant role in the microbiome shaping, in synergy with the environmental aspects

Investigations on the gut microbiota of the Maltese honeybee (Apis mellifera ruttneri)

In this study, the gut microbiota of Apis mellifera ruttneri was studied through microbial dependent and independent techniques, hypothesising particular distinctive differences from the rest of the European honeybees.peer-reviewe

Investigations on the gut microbiota of the Maltese honeybee (Apis mellifera ruttneri)

In this study, the gut microbiota of Apis mellifera ruttneri was studied through microbial dependent and independent techniques, hypothesising particular distinctive differences from the rest of the European honeybees.peer-reviewe

The impact of the COVID-19 pandemic on the Mediterranean region over 18 months: bridging the health outcomes and sustainable development goals

Abstract Background: The COVID-19 pandemic spread across the globe, including across the Mediterranean basin. This region presents diversity in economy, culture, and societal affairs. We attempted to evaluate the impact of COVID-19 on the population and on the Sustainable Development Goals (SDGs), our aim being to aid in the development of COVID-19 national plans. Methods: Epidemiological data was obtained from ‘Our World in Data’ databases (January 2020 – July 2021). Case, mortality, and vaccination incidence comparisons were made across neighbouring countries. The SDG index, universal health coverage (UHC) and health workforce targets were collected for each country. Correlations between SDG targets and COVID-19 outcomes were analysed. Results: Similarities in morbidity and mortality outcomes were present across neighbouring countries, with a bidirectional relationship between cumulative fully vaccinated population and infectivity fatality rates. Positive relationships were present between SDG indexes, UHC and health workforces and COVID-19 cases, deaths, and vaccinations. Conclusion: At prima face, high-income countries seem to have sustained worse morbidity and mortality outcomes, despite having had better UHC and a greater health workforce in the pre-COVID-19 era however, one must also consider that factors such as health-seeking behaviour and underdiagnosis may have influenced this. Cross-border infectivity was, however, evident. Pan-Mediterranean action must therefore be taken to ensure COVID-19 transmissibility and mortality are reduced across borders, while ensuring an equitable health outcome across populations. Keywords: COVID-19; Mediterranean; Morbidity; Mortality; Vaccination; Sustainable Development Goals; Outcome Assessment

Inactivated Influenza Vaccine That Provides Rapid, Innate-Immune- System-Mediated Protection and Subsequent Long-Term Adaptive Immunity

The continual threat to global health posed by influenza has led to increased efforts to improve the effectiveness of influenza vaccines for use in epidemics and pandemics. We show in this study that formulation of a low dose of inactivated detergent-split influenza vaccine with a Toll-like receptor 2 (TLR2) agonist-based lipopeptide adjuvant (R4Pam2Cys) provides (i) immediate, antigen-independent immunity mediated by the innate immune system and (ii) significant enhancement of antigendependent immunity which exhibits an increased breadth of effector function. Intranasal administration of mice with vaccine formulated with R4Pam2Cys but not vaccine alone provides protection against both homologous and serologically distinct (heterologous) viral strains within a day of administration. Vaccination in the presence of R4Pam2Cys subsequently also induces high levels of systemic IgM, IgG1, and IgG2b antibodies and pulmonary IgA antibodies that inhibit hemagglutination (HA) and neuraminidase (NA) activities of homologous but not heterologous virus. Improved primary virus nucleoprotein (NP)-specific CD8! T cell responses are also induced by the use of R4Pam2Cys and are associated with robust recall responses to provide heterologous protection. These protective effects are demonstrated in wild-type and antibody-deficient animals but not in those depleted of CD8! T cells. Using a contact-dependent virus transmission model, we also found that heterologous virus transmission from vaccinated mice to naive mice is significantly reduced. These results demonstrate the potential of adding a TLR2 agonist to an existing seasonal influenza vaccine to improve its utility by inducing immediate short-term nonspecific antiviral protection and also antigen-specific responses to provide homologous and heterologous immunity

More fodder for the oven? Dealing with forest-related conflicts arising from the production and use of energy wood in Europe

Results from the COOL project201