Tommaso Chetcuti : the man in the light of his times

This paper describes the life of the pioneer Maltese Psychiatrist, Tommaso Chetcuti as depicted by his esteemed friend and biographer Gavino Gulia and explores the advances in local psychiatric practice which he established in the Maltese Islands in the light of advances being made in Europe during his time, especially the prime works of Philippe Pinel and Etienne Esquirol.peer-reviewe

A review of certain recent advances in primary health care

A strong primary health care system is the keystone of health care and helps patients manage their health conditions in the community, whilst also providing disease prevention services. Primary care is a continuously evolving specialty, with recent exciting innovations, aiming to improve all aspects of care and to meet people’s needs and expectations. A search for articles focusing on the specific aspects of recent advances in primary health care was done using internet search engines. Articles were selected from primary and secondary literature sources, which included original research articles, review articles and other epidemiological studies. Recent advances in information technology, services and access, dealing with multimorbidity, academic family medicine, equity and outcome measures have all made an impact on the primary health care system and on meeting the ever-increasing challenges of modern society. Primary health care is of extreme importance in having an efficient and effective health care system. As primary health care improves with recent advances, a positive effect is seen on the population’s health, cost savings and health care disparities.peer-reviewe

Using antiepileptic drugs in children : recent developments and recommendations

Epilepsy is one of the most common neurological disorders, with approximately 45 per 100,000 children developing new-onset epilepsy every year. Children are a vulnerable population with unique health needs and a correct diagnosis and thus correct treatment of epilepsy in children, particularly a diagnosis of early onset epilepsy, is important in order to ensure better quality of life, neurodevelopmental outcomes, cognition, education, improved level of function and future employment. Therapy with antiepileptic drugs (AEDs) aims to minimize the frequency of epileptic seizures with minimal side effects. The first generation AEDs (such as phenytoin, carbamazepine and valproic acid) are still widely used, although they are associated with serious side effects and pharmacokinetic problems (narrow therapeutic indices, nonlinear kinetics, and drug-drug interactions due to enzyme inhibition and enzyme induction properties). The novel AEDs (such as lamotrigine, levetiracetam, rufinamide, and zonisamide) have expanded the treatment options of epilepsy, however they are also associated with severe pharmacokinetic shortcomings, especially for paediatric populations. This educational article will discuss how the correct use of these drugs can lead to improved quality of life measures. This paper also provides an overview of ongoing research on the use of population pharmacokinetics in addressing the challenges paediatric populations offer to drug and dose individualisation.peer-reviewe

A review of GP trainees’ evaluations of placements in hospital and community medicine during 2020-21 within Malta’s specialist training programme in family medicine

BACKGROUND: One of the major speciality rotations in Malta’s Specialist Training Programme in Family Medicine (STPFM) is in medicine. From 2020, changes were implemented in the logistics of this post regarding sub-speciality assignments and out-of-hours exposure.OBJECTIVE: A review of GP trainees’ evaluations of their medicine training placements during 2020-21 was carried out to identify how satisfied the GP trainees were with the effectiveness of teaching provided, what major difficulties they experienced and how the educational value of the post could be improved.METHOD: After completion of clinical rotations, GP trainees fill in evaluation forms on an ePortfolio. Feedback given for medicine posts during 2020-21 was exported to Microsoft Excel. After the information was anonymised, quantitative and qualitative analyses were carried out.RESULTS: Nine of out ten GP trainees were satisfied with the effectiveness of teaching provided during medicine posts. While difficulties experienced included the transition from family to hospital medicine, the challenges of night duties and the lack of learning during ward rounds, proposed improvements comprised increased emphasis on outpatient sessions for training, placements in more than just one sub-specialty and close guidance and supervision during duties.CONCLUSION: Despite high satisfaction ratings for teaching during medicine rotations during 2020-21, a number of important difficulties were identified and crucial improvements suggested by GP trainees.RECOMMENDATIONS: Medicine posts during the STPFM can be improved as teaching experiences for GP trainees through enhanced supervision, hands-on outpatient teaching, wider sub-specialty exposure and the introduction of training in telemedicine to complement face-to-face clinical practice.peer-reviewe

Mediterran

Ġabra ta’ poeżiji u proża li tinkludi: Għal Ġorġ Pisani ta’ Joe Zammit Tabona – Din gżira niexfa ta’ Clare Azzopardi – Ersaqt lejn il-baħar ta’ Charles Bezzina – Passaġġi ta’ Ġorġ Borg – Firenze ta’ Louis Briffa – Riħet ix-xemgħa ta’ John Caruana – Jum ir-riflessjoni ta’ Antoine Cassar – Fjura fqajra ta’ Carmel Ġ. Cauchi – Qatra ta’ Maria Grech Ganado – Lill-bufula ta’ fuq iz-zuntier ta’ Maurice Mifsud Bonnici – Tinsinix! ta’ Joe Zammit Tabona – In-nanna lbieraħ u jien illum! – tifkiriet ta’ Lina Brockdorff – L-għaddas ta’ Alex Vella Gera – Għassa ta’ Adrian Grima – It-tfajla tal-ħolm ta’ Anne Marie Scerri – Meta tagħmel l-ewwel xita ta’ Trevor Żahra – Ħajta deni ta’ Jordi Punti, traduzzjoni ta’ Immanuel Mifsud – Arnarstapi, l-Iżlanda ta’ Susan Richardson, traduzzjoni ta’ Simone Inguanez – Ħuta ta’ Aki Salmela, traduzzjoni ta’ Simone Inguanez – Ma kellniex triq oħra ta’ Roman Simic, traduzzjoni ta’ Immanuel Mifsud – Mediterran ta’ Cruciani Valerio, traduzzjoni ta’ Antoine Cassar.peer-reviewe