Hypothermia in the early neonatal period : follow-up study

Background: Thermal care is an essential aspect of the routine care of the newborn because hypothermia is an important and preventable contributor to morbidity. Aim: To evaluate whether the new practice of postponing bathing of the newborn at St Luke's Hospital has resulted in an improvement in neonatal thermal care. Methods: Analysis of the temperature on admission to the nursery from labour ward during 2005 of a consecutive sample of 877 infants, compared to the results obtained from a similar study in 2002. Results: The proportion of babies admitted with normal body temperature (36.5-37.5°C) was 43.4% in 2005, compared to 25.5% in 2002. The proportion of babies admitted with moderate hypothermia was reduced from 32.3% in 2002 to 14.4% in 2005. Implications: Delayed bathing has resulted in a significant improvement in thermal care of the newborn.peer-reviewe

Prevalence of obesity in a paediatric outpatient clinic

This study assessed the rate of overweight and obese children at a general paediatric outpatient clinic, Mater Dei Hospital, Malta, in 2011. This was an observational, prospective study where 220 patients aged 2-14 years attending this clinic, with a preponderance of asthmatic children, had their height and weight measured and their BMI calculated. Overall, 40.5% of the children were either overweight (14.1%) or obese (26.4%). There were more obese boys (31.8%) than girls (18.2%) (p=0.025). Half of the asthmatic patients were overweight or obese (49.6%), compared to a quarter of the non-asthmatic patients (27.5%) (p=0.001). The high rate of obesity in this setting presents an opportunity and challenge for paediatricians to address the most important nutritional problem in children.peer-reviewe

Statement of the Labor Policy Association Before the Commission on the Future of Worker-Management Relations Regarding Alternative Resolution of Private Disputes

Testimony_Vella_092994.pdf: 215 downloads, before Oct. 1, 2020

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

Superior economic performance in a small state: the pharmaceutical industry in Malta

Various academic disciplines have attempted to explain the factors underpinning superior economic performance. Generally they neglect the realities of small states. The literature fails to clearly define a small state . Mainstream theories associate smallness with sub-optimality . Small states studies tend to be conditioned by a vulnerability complex. Yet, a good number of small states have an economic track record which is the envy of much larger states. This thesis adopts an interdisciplinary approach to investigate the theoretical explanations of superior economic performance, at both the state and firm level. Resource-advantage theory, which claims to be a general theory of competition, offers valuable insights in understanding the superior economic performance of small states. The field research follows Porter (1998) in studying the performance of particular industries to understand the competitiveness of nations. A qualitative, case study approach, involving both primary and secondary investigation, explores the performance of the pharmaceutical industry in Malta following the country s decision to join the EU. This work perceives a small state as an organisation with well-defined, but permeable, boundaries. This open system is characterised by both a lack of market power and a small population. Through the secondary field research a small number of higher-order resources, competencies and dynamic capabilities (RCDCs) are identified. The field research s findings affirm the relevance of these arch-RCDCs in creating competitive advantage for the pharmaceutical industry in Malta. It also elucidates the key role played by an external catalyst, foreign direct investment, to circumvent domestic limitations. The study finds that it is still relevant to study small states and that achieving a strategic fit between the resource base and international market opportunities is essential if small states are to enhance their market power and achieve a superior economic performance

The fluid mechanics of floating and sinking

This thesis is concerned with the fluid mechanics of floating and sinking. More specifically, the majority of this thesis considers the role played by surface tension in allowing dense objects to float. We first derive the conditions under which objects can float at an interface between two fluids. We obtain the conditions on density and size for various objects to float and show that being ‘super-hydrophobic’ does not generally help small, dense objects to float. Super-hydrophobicity does, however, dramatically reduce the energy required to remove an object from the interface. We then show that two floating objects can sink if they come into close proximity with one another. We extend this to show that a raft consisting of many interfacial objects can become arbitrarily large without sinking, providing that its density is below a critical value. Above this critical value, there is a threshold size at which sinking occurs. We then consider the surface tension dominated impact of an object onto a liquid–gas interface. We determine a similarity solution, valid shortly after impact, for the shape of the interface and study the asymptotic properties of the capillary waves generated by impact. We also show how the interfacial deformation slows down the impacting body. We use a boundary integral simulation to study the motion at later times and determine the conditions under which the object either sinks or is trapped by the surface. We find that for an object of a given weight there is a threshold impact speed above which it sinks. We study the waterlogging of a floating porous body as a model for the waterlogging of the pumice ‘rafts’ that often form on bodies of open water after a volcanic eruption. We study the inflow of water that is driven by capillary suction and hydrostatic pressure imbalances, and determine the time taken for this inflow to cause the object to sink. Finally, we study the effects of a natural slope on the spreading of carbon dioxide sequestered into aquifers. We use laboratory models and numerical techniques to study the spreading of the resulting gravity current. Initially the current spreads axisymmetrically, while at later times it spreads predominantly along any slope in the overlying cap rock. We show that in industrial settings the time scale over which this asymmetry develops is typically a few years. This effect may have important practical implications since the current propagates faster in the asymmetric state

Atmospheric sulphur dioxide pollution in Malta : a preliminary study

The results of a preliminary survey of the air quality in Malta during May-December 1990 with respect to sulphur dioxide are presented. One-hour-average S02 concentrations as high as 320 ug m-3 have been measured from areas proximate to the Marsa power station. The concentration of S02 in ambient air was found to be strongly dependent on atmospheric conditions and especially on wind direction. At Paola, measured concentrations varied from below the detection limit of 25 ug m-3 to about 160 ug m-3. These preliminary results suggest that specific areas in Malta which are close to the Marsa power station may have an air pollution problem which is significantly more pronounced than that in other areas. The results also indicate the need for a thorough air monitoring programme which would allow the pollution problem to be assessed more accurately and to be followed continually.peer-reviewe

Organizational commitment and users’ perception of ease of use : a study among bank managers

Purpose – The purpose of this paper is to look at the issue of perceived ease of use of a web-based customer relationship management system and consider the role of organizational commitment as a possible antecedent. Design/methodology/approach – Data for this study were collected from among managers of a major player in the community banking sector within the EU. A total of 274 valid responses were obtained from 398 managers. Findings – Results have been mixed and partially conditioned by service providers’ willingness to leverage the possibilities that the technology can provide. Research limitations/implications – The study was limited to a single organization and consequently the results should be generalized with caution. Replication studies with improved measures, in other countries and contexts are desirable. Practical implications – The results can be useful for management, since Web-based customer relationship management systems have been adopted by many service providers in their quest to offer better one-to-one marketing possibilities to their customers. Originality/value – This paper demonstrates the importance of fostering a sense of organizational commitment amongst key service providers, as this in turn seems to enable them to overcome many impediments pertaining to technology use.peer-reviewe