Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)

ME/CFS is a debilitating condition hardly discussed in the Maltese Islands, and was only recognized in 2009 as a neurological disease in our archipelago despite it being recognized by WHO in 1969. The authors discuss the origin of the combined terminology ME/CFS, the importance of recognizing the condition at an early stage, the appropriate treatment and the potential role of the health services. The authors also highlight the lack of official statistical data available in the Maltese archipelago.peer-reviewe

Canada's Pioneering Experience with a Flexible Exchange Rate in the 1950s:(Hard) Lessons Learned for Monetary Policy in a Small Open Economy

This paper revisits Canada's pioneering experience with floating exchange rate over the period 1950-1962. It examines whether the floating rate was the best option for Canada in the 1950s by developing and estimating a New Keynesian small open economy model of the Canadian economy. The model is then used to conduct a counterfactual analysis of the impact of different monetary policies and exchange rate regimes. The main finding indicates that the flexible exchange rate helped reduce the volatility of key macro-economic variables. The Canadian monetary authorities, however, clearly did not understand all of the implications of conducting monetary policy under a flexible exchange rate and a high degree of capital mobility. The paper confirms that monetary policy was more volatile in the post-1957 period and Canada's macroeconomic performance suffered as a result.

Evolutionary history of the Maltese wall lizard Podarcis filfolensis : insights on the 'expansion-contraction' model of Pleistocene biogeography

The expansion-contraction (EC) model predicts demographic and range contraction of temperate species during Pleistocene glaciations as a consequence of climate-related habitat changes, and provides a paradigm for explaining the high intraspecific diversity found in refugia in terms of long-term demographic stability. However, recent evidence has revealed a weak predictive power of this model for terrestrial species in insular and coastal settings. We investigated the Pleistocene EC dynamics and their evolutionary consequences on temperate species using the Maltese archipelago and its endemic lizard Podarcis filfolensis as a model system. The evolutionary and demographic history of P. filfolensis as inferred from mitochondrial and nuclear sequences data does not conform to the EC model predictions, supporting (i) demographic and spatial stability or expansion, rather than contraction, of the northern and southern lineages during the last glacial period; and (ii) a major role for allopatric differentiation primed by sea-level dynamics, rather than prolonged demographic stability, in the formation of the observed genetic diversity. When combined with evidence from other Mediterranean refugia, this study shows how the incorporation of Pleistocene sea-level variations in the EC model accounts for a reverse demographic and range response of insular and coastal temperate biotas relative to continental ones. Furthermore, this cross-archipelago pattern in which allopatric diversity is formed and shaped by EC cycles resembles that seen between isolated populations within mainland refugia and suggests that the EC model, originally developed to explain population fluctuations into and out-of refugia, may be appropriate for describing the demographic and evolutionary dynamics driving the high genetic diversity observed in these areas.peer-reviewe

Using conversational data to determine lexical frequency in British Sign Language: The influence of text type

This paper presents findings from an objective lexical frequency study in British Sign Language (BSL) based on 24,823 tokens collected as part of the BSL Corpus Project. The BSL study is only the fourth objective frequency study involving sign languages to be reported and is also the first study for any sign language to be based on entirely on spontaneous conversational data. When compared to previous frequency studies (both spoken and signed), some similarities can be observed although differences that may be attributed to text type are also recorded. When compared with subjective frequency ratings collected for BSL, a positive relationship is reported (similar to what has been observed for spoken languages). This is in contrast to a previous study which suggested a much weaker relationship between the two; however, this conclusion was based on a frequency count derived from narratives. These differences highlight the importance of using frequency measures derived from natural and spontaneous data, an opinion that has been emphasised in the spoken language literature

The health impact of residential retreats: A systematic review

Background: Unhealthy lifestyles are a major factor in the development and exacerbation of many chronic diseases. Improving lifestyles though immersive residential experiences that promote healthy behaviours is a focus of the health retreat industry. This systematic review aims to identify and explore published studies on the health, wellbeing and economic impact of retreat experiences. Methods: MEDLINE, CINAHL and PsychINFO databases were searched for residential retreat studies in English published prior to February 2017. Studies were included if they were written in English, involved an intervention program in a residential setting of one or more nights, and included before-and-after data related to the health of participants. Studies that did not meet the above criteria or contained only descriptive data from interviews or case studies were excluded. Results: A total of 23 studies including eight randomised controlled trials, six non-randomised controlled trials and nine longitudinal cohort studies met the inclusion criteria. These studies included a total of 2592 participants from diverse geographical and demographic populations and a great heterogeneity of outcome measures, with seven studies examining objective outcomes such as blood pressure or biological makers of disease, and 16 studies examining subjective outcomes that mostly involved self-reported questionnaires on psychological and spiritual measures. All studies reported post-retreat health benefits ranging from immediately after to five-years post-retreat. Study populations varied widely and most studies had small sample sizes, poorly described methodology and little follow-up data, and no studies reported on health economic outcomes or adverse effects, making it difficult to make definite conclusions about specific conditions, safety or return on investment. Conclusions: Health retreat experiences appear to have health benefits that include benefits for people with chronic diseases such as multipl

Molecular epidemiology of multidrug-resistant Acinetobacter baumannii in a single institution over a 10-year period

The molecular epidemiology and mechanisms of resistance of carbapenem-resistant Acinetobacter baumannii (CRAB) were determined in hospitals in the states of the Cooperation Council for the Arab States of the Gulf (Gulf Cooperation Council [GCC]), namely, Saudi Arabia, United Arab Emirates, Oman, Qatar, Bahrain, and Kuwait. Isolates were subjected to PCR-based detection of antibiotic resistance genes and repetitive sequence-based PCR (rep-PCR) assessments of clonality. Selected isolates were subjected to multilocus sequence typing (MLST). We investigated 117 isolates resistant to carbapenem antibiotics (either imipenem or meropenem). All isolates were positive for OXA-51. The most common carbapenemases were the OXA-23-type, found in 107 isolates, followed by OXA-40-type (OXA-24-type), found in 5 isolates; 3 isolates carried the ISAba1 element upstream of blaOXA-51-type. No OXA-58-type, NDM-type, VIM-type, or IMP-type producers were detected. Multiple clones were detected with 16 clusters of clonally related CRAB. Some clusters involved hospitals in different states. MLST analysis of 15 representative isolates from different clusters identified seven different sequence types (ST195, ST208, ST229, ST436, ST450, ST452, and ST499), as well as three novel STs. The vast majority (84%) of the isolates in this study were associated with health care exposure. Awareness of multidrug-resistant organisms in GCC states has important implications for optimizing infection control practices; establishing antimicrobial stewardship programs within hospital, community, and agricultural settings; and emphasizing the need for establishing regional active surveillance systems. This will help to control the spread of CRAB in the Middle East and in hospitals accommodating transferred patients from this region

Regulation of surface architecture by symbiotic bacteria mediates host colonization

Microbes occupy countless ecological niches in nature. Sometimes these environments may be on or within another organism, as is the case in both microbial infections and symbiosis of mammals. Unlike pathogens that establish opportunistic infections, hundreds of human commensal bacterial species establish a lifelong cohabitation with their hosts. Although many virulence factors of infectious bacteria have been described, the molecular mechanisms used during beneficial host–symbiont colonization remain almost entirely unknown. The novel identification of multiple surface polysaccharides in the important human symbiont Bacteroides fragilis raised the critical question of how these molecules contribute to commensalism. To understand the function of the bacterial capsule during symbiotic colonization of mammals, we generated B. fragilis strains deleted in the global regulator of polysaccharide expression and isolated mutants with defects in capsule expression. Surprisingly, attempts to completely eliminate capsule production are not tolerated by the microorganism, which displays growth deficits and subsequent reversion to express capsular polysaccharides. We identify an alternative pathway by which B. fragilis is able to reestablish capsule production and modulate expression of surface structures. Most importantly, mutants expressing single, defined surface polysaccharides are defective for intestinal colonization compared with bacteria expressing a complete polysaccharide repertoire. Restoring the expression of multiple capsular polysaccharides rescues the inability of mutants to compete for commensalism. These findings suggest a model whereby display of multiple capsular polysaccharides provides essential functions for bacterial colonization during host–symbiont mutualism

First language acquisition differs from second language acquisition in prelingually deaf signers: Evidence from sensitivity to grammaticality judgement in British Sign Language

Age of acquisition (AoA) effects have been used to support the notion of a critical period for first language acquisition. In this study, we examine AoA effects in deaf British Sign Language (BSL) users via a grammaticality judgment task. When English reading performance and nonverbal IQ are factored out, results show that accuracy of grammaticality judgement decreases as AoA increases, until around age 8, thus showing the unique effect of AoA on grammatical judgement in early learners. No such effects were found in those who acquired BSL after age 8. These late learners appear to have first language proficiency in English instead, which may have been used to scaffold learning of BSL as a second language later in life

Lexicalisation and de-lexicalisation processes in sign languages: Comparing depicting constructions and viewpoint gestures

In this paper, we compare so-called “classifier” constructions in signed languages (which we refer to as “depicting constructions”) with comparable iconic gestures produced by non-signers. We show clear correspondences between entity constructions and observer viewpoint gestures on the one hand, and handling constructions and character viewpoint gestures on the other. Such correspondences help account for both lexicalisation and de-lexicalisation processes in signed languages and how these processes are influenced by viewpoint. Understanding these processes is crucial when coding and annotating natural sign language data