The Vasco da Gama Movement : reflections and experiences of an exchange programme

The Vasco da Gama Movement (VdGM) defines itself as the Network for Young and Future Family Doctors of the European Regional Branch of the World Organisation of Family Doctors (WONCA Europe). The early beginnings of this movement date back to 2002 during preparations for the Junior Doctor Programme initiated by Dr Alphonse Sips, a dedicated Dutch family doctor, as part of the 2003 WONCA Europe Amsterdam Conference. Together with a group of enthusiastic trainees from the Netherlands and support from the European Academy of Teachers in General Practice/Family Medicine (EURACT), Dr Sips went on to develop the first pre-conference meeting for six international groups, each involving trainees and EURACT teachers to serve as guides. This laid the foundations for the development of the VdGM (Vasco Da Gama Movement, 2012; Sloane, 2016)). The ideals of the movement were set out in 2005 during a meeting that took place in Lisbon, the home of Vasco da Gama, from where he set out on a similar voyage of discovery and thus the name was born. Successful pre-conferences preceding the WONCA Europe Conference have been held annually since. Furthermore, VdGM has continued to grow and expand from then on to include a vast range of other events and activities, all with the aim of improving general practitioner (GP) empowerment, connection and support.peer-reviewe

Private sector development and SME’s

This paper seeks to highlight the role of private sector development in the resilience building of small states. It refers to small and medium sized enterprises (SMEs) stressing the extent to which SMEs can enhance economic flexibility, an important element in economic resilience, defined as the ability to withstand and rebound from exogenous shocks. The private sector, compared to the public sector, is generally more exposed and therefore responsive to market realities. As a result, a strong private sector is vital for resilience building, and this is especially so in small states, which tend to be highly exposed to external shocks. However the private sector can be inefficient and characterized by inertia, especially if there is a proliferation of monopolies and oligopolies Therefore the paper contends that the development of this sector should be accompanied by appropriate polices to encourage private sector competitiveness and efficiency. The paper also discusses the role of SMEs in small states and their role in resilience building. It argues that the backbone of the economies of large and small economies are SMEs. In the case of small states most firms are likely to be micro-enterprises, employing fewer than 10 persons. The paper argues that small states should attempt to maximize the contribution of micro-enterprises towards the enhancement of competitiveness, by creating an atmosphere congenial to entrepreneurship, improving access to funds, particularly venture capital, and encouraging clustering. The paper also uses the ‘Doing Business’ Index published by the World Bank to identify the weaknesses of some small states and to highlight area where business reform is required.peer-reviewe

Exchange rate strategies for small island developing

The choice of exchange rate regime is a crucial decision for any economy, with important implications for inflation and long term economic growth. This paper uses conceptual and empirical approaches to show that relatively hard exchange rate arrangements are typically more suited to the particular circumstances of small island states.peer-reviewe

SMEs and economic resilience building

This paper discusses the role of private sector development in the economic resilience building of small states. The private sector is generally more exposed and more responsive to market dynamics, thereby contributing to the flexibility of the economy. However, instances of market failure may be more prevalent in small economies, especially if there is a proliferation of monopolies and oligopolies. This calls for appropriate polices to encourage competition and efficiency, within the context of promoting a business environment that is congenial to small and medium sized enterprises which are the main drivers of economic growth in small states. The paper considers the Doing Business index published by the World Bank and hypothesises that small states which have overcome their vulnerability through the establishment of policies aimed at enhancing economic resilience also register positive performance in the doing business index.peer-reviewe

Economic Vulnerability and Resilience: Concepts and Measurements

In this paper, economic vulnerability is defined as the exposure of an economy to exogenous shocks, arising out of economic openness, while economic resilience is defined as the policy-induced ability of an economy to withstand or recover from the effects of such shocks. The paper briefly reviews the work already carried out on economic vulnerability and extends the research towards the development of a conceptual and methodological framework for the definition and measurement of economic resilience. Towards this end, the paper proposes an index of economic resilience gauging the adequacy of policy in four broad areas, namely macroeconomic stability, microeconomic market efficiency, good governance and social development. The analysis of economic resilience explains how small economies can attain a relatively high level of gross domestic product (GDP) per capita if they adopt appropriate policy stances. In other words, the relatively good economic performance of a number of small states is not because, but in spite of, their small size and inherent economic vulnerability. The results of this study can be used as a tool towards the formulation of policies aimed at overcoming the adverse consequences of economic vulnerability.economic vulnerability, economic resilience, small states

Long-term pension projections for Malta : 2016-2070

The Economic Policy Department within the Ministry for Finance has over the past years developed expertise in the field of pension projections. These projections, prepared also through collaboration with the World Bank, served to inform discussions on the likely evolution of the pension system in light of demographic developments as part of national reviews (2000, 2005, 2010 and 2015) as well as the Ageing Report of the EPC (2006, 2009, 2012 and 2015). The projections presented in this report cover the period 2016 to 2070. Besides extending the period of projection by 10 years, these projections differ from previous projections (Ageing Report 2015) mainly because the new projections take into account the new demographic and macroeconomic assumptions adopted for the Ageing Report of 2018.peer-reviewe

Profiling economic vulnerability and resilience in small states : conceptual underpinnings

Small states are economically vulnerable because of their inherent proneness to exogenous shocks over which they can exercise very little control, if any. Such shocks in the main emanate from the small states’ structural openness to international trade, their high dependence on a narrow range of exports and their reliance on strategic imports, notably fuel and food. The high degree of fluctuations in GDP and in export earnings registered by many small states is considered as one of the manifestations of exposure to exogenous shocks. In spite of this, there are a number of small states that have managed to generate a relatively high GDP per capita. This is ascribed to their economic resilience, which refers to the policy-induced ability of an economy to recover from or adjust to the negative impacts of adverse exogenous shocks.peer-reviewe

Transfusion-related acute lung injury : case report and literature review

Blood transfusion is a common procedure that usually goes without complications. However, adverse transfusion reactions should not be overlooked. Transfusion-related acute lung injury (TRALI) is the leading cause of transfusion-related fatalities and is characterized by the onset of acute respiratory distress in the form of noncardiogenic pulmonary oedema. We hereby report the case of a 28 year old Jamaican lady who developed acute onset dyspnoea, tachycardia and hypoxaemia following transfusion of fresh frozen plasma and red cell concentrates.peer-reviewe

Orthogeriatrics in Malta : a 3 year experience

The orthogeriatric service in Malta started in 2012 and expanded in 2014. From admission, the patient is offered a ward based hip fracture programme that includes orthogeriatric assessment, management and co-ordinated multidisciplinary review. 457 patients were seen by the orthogeriatric service when this study was done. Mean age was 83 and 69% of patients were female. The Nottingham Hip Fracture Score (NHFS) is a scoring system that reliably predicts 30-day and 1-year mortality for patients after hip fracture. It is made up of seven independent predictors of postoperative mortality that have been incorporated into a risk score. The score ranges from 0-10 and the mean score for this cohort was 5.1. There was a statistically significant correlation between age and high NHFS scores. 30 day mortality was 5.9% and 1 year mortality was 24.4%. Compared with the Nottingham data both 30 day and 1 year mortality were less for the orthogeriatric department in Malta. The orthogeriatric service in Malta achieved better results when comparing mortality with the UK. In the future expansion of data collected should be considered to better evaluate standards of care in the department.peer-reviewe