The Malta Foundation programme : one year on : part I

The Malta Foundation programme was launched in July 2009, In July 2010 the first group of foundation doctors were awarded their Foundation Achievement of Competence Document allowing them to proceed to the next step of their career, basic specialist training. The programme was set p with two main objectives: A. t improve the first two years of postgraduate training of doctors and to ensure that doctors achieved a level of competence enabling provision of safe patient care; and B. to reverse the exodus of Maltese medical graduates and retain an adequate proportion of doctors to allow the local health service to provide a good quality service. we present the results of the introduction of the Foundation programme to Malta and ask whether the main objectives have been achievedpeer-reviewe

The Malta Foundation Programme : one year on : pt.II

Part 1 of this article can be found in this link : https://www.um.edu.mt/library/oar//handle/123456789/12739Part 2 of the article. The Malta Foundation programme was launched in July 2009, In July 2010 the first group of foundation doctors were awarded their Foundation Achievement of Competence Document allowing them to proceed to the next step of their career, basic specialist training. The programme was set p with two main objectives: A. to improve the first two years of postgraduate training of doctors and to ensure that doctors achieved a level of competence enabling provision of safe patient care; and B. to reverse the exodus of Maltese medical graduates and retain an adequate proportion of doctors to allow the local health service to provide a good quality service. we present the results of the introduction of the Foundation programme to Malta and ask whether the main objectives have been achieved.peer-reviewe

Clinical practice guidelines : the way ahead

A seminar entitled `Clinical Practice Guidelines - The Way Ahead' was organised jointly by the Office of the Director General and the Department of Medicine on 5th March 2005. The aim of the seminar was to introduce the concept of Clinical Practice Guidelines into the framework of the medical and paramedical professions in Malta. It was well attended by around 80 delegates from most of the healthcare professions. The seminar was co-chaired by Dr Alfred Caruana Galizia, Chairman Department of Medicine and Dr Mariella Borg Buontempo, Consultant in Public Health, Office of the Director General.peer-reviewe

Tetanus : forgiven, not forgotten

Tetanus is an illness that is still prevalent although the incidence has markedly decreased largely due to immunisation programmes. The latest four cases managed at St. Luke's hospital over 2001-2002 are presented. All of these patients survived. We give an overview of the illness and discuss the cases and management. The potential benefit of using dual antibiotic therapy is questioned.peer-reviewe

Crusted (Norwegian) scabies treated with oral ivermectin : a case report and overview

Crusted (Norwegian) scabies is a severe and highly contagious form of infestation caused by the mite Sarcoptes scabiei var. hominis. It occurs in a subgroup of patients who are either immunocompromised or physically or mentally debilitated. Due to its atypical clinical presentation as well as difficulties associated with its management it presents a number of challenges both from a therapeutic aspect as well as from public health perspective. Failure to diagnose this condition may give rise to a massive epidemic when the patient is in an institutional setting. We describe a case of crusted scabies which occurred in a nursing home leading to an institutional outbreak. She received a combination of oral ivermectin and topical scabicidal with good results. This case highlights the importance of being alert to the possible diagnosis of crusted scabies and gives an overview of the condition as well as management strategies.peer-reviewe

Adult immunisation : an overview

This year in particular saw the potential influenza pandemic fuel the uptake of immunisation against annual influenza. Judging from reports that both public and private sector vaccines ran out beforehand, the uptake must have been higher than usual, although no official reports are available to date. There were no significant reports of influenza illness in the community probably as a result of this.peer-reviewe

Incidence of Pitting Corrosion Wastage on the Hull Girder Ultimate Strength

AbstractThe paper focuses on the assessment of the hull girder ultimate strength, combined with random pitting corrosion wastage, by the incremental-iterative method. After a brief review about the state of art, the local ultimate strength of pitted platings under uniaxial compression is preliminarily outlined and subsequently a closed-form design formula is endorsed in the Rule incremental-iterative method, to account for pitting corrosion wastage in the hull girder ultimate strength check. The ISSC bulk carrier is assumed as reference ship in a benchmark study, devoted to test the effectiveness of the incremental-iterative method, by a comparative analysis with a set of FE simulations, performed by Ansys Mechanical APDL. Four reference cases, with different locations of pitting corrosion wastage, are investigated focusing on nine combinations of pitting and corrosion intensity degrees. Finally, a comparative analysis between the hull girder ultimate strength, combined with pitting corrosion wastage, and the relevant values, complying with the Rule net scantling approach, is performed. Based on current results, the modified incremental-iterative method allows efficiently assessing the hull girder ultimate strength, combined with pitting corrosion wastage, so revealing useful both in the design process of new vessels and in the structural health monitoring of aged ships

The dependency premium based on a multifactor model for dependent mortality data

As shown in the literature, the dependence structure in mortality data cannot be ignored in projecting future trends, in particular for a group of similar populations characterized by common long run relationships. We propose a new multifactor model for capturing common and specific features of the trend over time. We implement the model and investigate its impact on actuarial valuations, through the introduction of the concept of the dependency premium

Comparative analysis among deterministic and stochastic collision damage models for oil tanker and bulk carrier reliability

Abstract The incidence of collision damage models on oil tanker and bulk carrier reliability is investigated considering the IACS deterministic model against GOALDS/IMO database statistics for collision events, substantiating the probabilistic model. Statistical properties of hull girder residual strength are determined by Monte Carlo simulation, based on random generation of damage dimensions and a modified form of incremental-iterative method, to account for neutral axis rotation and equilibrium of horizontal bending moment, due to cross-section asymmetry after collision events. Reliability analysis is performed, to investigate the incidence of collision penetration depth and height statistical properties on hull girder sagging/hogging failure probabilities. Besides, the incidence of corrosion on hull girder residual strength and reliability is also discussed, focussing on gross, hull girder net and local net scantlings, respectively. The ISSC double hull oil tanker and single side bulk carrier, assumed as test cases in the ISSC 2012 report, are taken as reference ships

Contribution of the Darwin operator to non-leptonic decays of heavy quarks

We compute the Darwin operator contribution (1/m3b correction) to the width of the inclusive non-leptonic decay of a B meson (B+, Bd or Bs), stemming from the quark flavour-changing transition b → q1q¯¯2q3, where q1, q2 = u, c and q3 = d, s. The key ideas of the computation are the local expansion of the quark propagator in the external gluon field including terms with a covariant derivative of the gluon field strength tensor and the standard technique of the Heavy Quark Expansion (HQE). We confirm the previously known expressions of the 1/m3b contributions to the semi-leptonic decay b → q1ℓν¯¯¯ℓ, with ℓ = e, μ, τ and of the 1/m2b contributions to the non-leptonic modes. We find that this new term can give a sizeable correction of about −4 % to the non-leptonic decay width of a B meson. For Bd and Bs mesons this turns out to be the dominant correction to the free b-quark decay, while for the B+ meson the Darwin term gives the second most important correction — roughly 1/2 to 1/3 of the phase space enhanced Pauli interference contribution. Due to the tiny experimental uncertainties in lifetime measurements the incorporation of the Darwin term contribution is crucial for precision tests of the Standard Model