A national health information strategy for Malta

In 1992 a national health information strategy was developed jointly by the Department of Health and the Information Systems Division. A detailed strategy study report was compiled, with recommendations for the development of a number of information systems. The main system proposed was an integrated and comprehensive health care information system encompassing all of Malta’s hospitals and health centres, based on a single Patient Master Index. This system would support the concepts of an integrated health record and of a person-based view for resource management.peer-reviewe

Asset-based approaches, older people and social care: an analysis and critique

Asset-based thinking is increasingly prevalent in health policy and is to be found also in discourses on social care. This article explores and critiques the applicability of asset-based approaches to social care for older people, using Carol Bacchi’s analytical framework to consider developments in the UK especially. The problem construction, assumptions and suggested solutions underpinning an asset-based approach are considered in turn. The paper draws two major conclusions. The first is that, while it has potential application to the field, the key assumptions and objectives of the asset-based approach do not hold well for social care and therefore adopting the approach carries risks. The paper concludes, secondly, that an asset-based approach is ‘over-promised’ in the sense of being insufficiently theorised and lacking empirical evidence. A number of suggestions are made for greater critical interrogation, improved empirical evidence and closer scrutiny of the policy ‘solutions’ associated with assets-related thinking

Characterization of the complications associated with plasma exchange for thrombotic thrombocytopaenic purpura and related thrombotic microangiopathic anaemias: a single institution experience.

Plasma exchange (PEX) is a life-saving therapeutic procedure in patients with thrombotic thrombocytopaenic purpura (TTP) and other thrombotic microangiopathic anaemias (TMAs). However, it may be associated with significant complications, exacerbating the morbidity and mortality in this patient group

A Method of Comparing Differences in Tumour Growth Rates Applied to a Study of the Increasing Growth Capacity of Mouse Carcinomata

A method of comparing differences in growth rates of tumours in small groups of animals is described. A common slope can be fitted to the growth curves of a given tumour in a group of isogeneic animals. Differences between growth potentials can be demonstrated by comparing the common slope for a given tumour against that of another tumour (or the same tumour at a later stage of development)

Kinetic characterisation of arylamine N-acetyltransferase from Pseudomonas aeruginosa

BACKGROUND: Arylamine N-acetyltransferases (NATs) are important drug- and carcinogen-metabolising enzymes that catalyse the transfer of an acetyl group from a donor, such as acetyl coenzyme A, to an aromatic or heterocyclic amine, hydrazine, hydrazide or N-hydroxylamine acceptor substrate. NATs are found in eukaryotes and prokaryotes, and they may also have an endogenous function in addition to drug metabolism. For example, NAT from Mycobacterium tuberculosis has been proposed to have a role in cell wall lipid biosynthesis, and is therefore of interest as a potential drug target. To date there have been no studies investigating the kinetic mechanism of a bacterial NAT enzyme. RESULTS: We have determined that NAT from Pseudomonas aeruginosa, which has been described as a model for NAT from M. tuberculosis, follows a Ping Pong Bi Bi kinetic mechanism. We also describe substrate inhibition by 5-aminosalicylic acid, in which the substrate binds both to the free form of the enzyme and the acetyl coenzyme A-enzyme complex in non-productive reaction pathways. The true kinetic parameters for the NAT-catalysed acetylation of 5-aminosalicylic acid with acetyl coenzyme A as the co-factor have been established, validating earlier approximations. CONCLUSION: This is the first reported study investigating the kinetic mechanism of a bacterial NAT enzyme. Additionally, the methods used herein can be applied to investigations of the interactions of NAT enzymes with new chemical entities which are NAT ligands. This is likely to be useful in the design of novel potential anti-tubercular agents

Paediatric admissions to hospitals in the Cape Town Metro district: A survey

A point prevalence survey of 381 paediatric medical inpatients in the 11 public hospitals in Cape Town in November 2007 showed that 70% of them were in central hospitals, with 39.4% requiring level 3 (sub-specialist) care. Numbers of children in hospital and their levels of health care requirement did not vary by sub-district of residence. Seventy-seven per cent of patients were under 5 years of age; 5% were teenagers. Few patients changed level of care during admission, but 10% did not need to be in hospital at the time of review. Median length of stay was 4 days, with children with level 3 needs having the longest lengths of stay. An under-provision of level 1 beds was demonstrated. HIV infection had been identified in 12% of admissions. While children with level 3 problems were well catered for in terms of bed provision, level 1 and step-down/home care provision were deficient or inefficiently utilised

The Will to Prevail: Inside the Legal Battle to Save Sweet Briar

Despite the school‘s storied past and deep historical roots, on March 3, 2015, the Sweet Briar Board of Directors announced its intention to shut down the college—permanently—the following summer. The Board cited insurmountable financial challenges, including falling enrollment, a lack of unrestricted funds in its endowment, and the century-old school‘s lack of appeal to modern generations of students. The Board claimed the school was no longer financially viable, because though its $84 million endowment was sizeable by most measures, the school needed an endowment three times that size to stay open. Students, faculty, staff, and alumnae were blindsided by the news that their college would abruptly shut its doors. Unanswered questions led to controversy and distrust, and groups of Sweet Briar supporters were galvanized to take action. Immediately following the announcement, a movement to halt the school‘s closure arose and quickly gained momentum, leading to a hotly contested legal battle that went from the circuit court to the Supreme Court of Virginia and back again. Amherst County Attorney, Ellen Bowyer, boldly brought the principal lawsuit in the name of the Commonwealth of Virginia. The lawsuit alleged the College had violated the Virginia Charitable Solicitations Act by using charitable funds, raised to operate the school, for the purpose of closing it instead. The lawsuit also claimed violations of the Virginia Uniform Trust Code. In the end, the supporters of Sweet Briar won. This is their story. Part I provides an in-depth factual overview, beginning with the college‘s founding in the early 1900s. The commentary then turns to the controversial decision to close and discusses the facts and legal theories of the case, the decisions by the circuit court and the Supreme Court of Virginia, and the eventual settlement that kept the school alive. In Part II, the discussion shifts to the landmark nature of this case, not only for Sweet Briar College, but also for other Virginia colleges and non-profits around the country. The essay analyzes the legal questions arising from the case, including whether a Virginia corporation could also be a trustee, and, what were the Board‘s legal obligations in this case