A whole-health-economy approach to antimicrobial stewardship: Analysis of current models and future direction.

Antimicrobial stewardship (AMS) strategies are widely implemented in single healthcare sectors and organisations; however, the extent and impact of integrated AMS initiatives across the whole health economy are unknown. Assessing degree of integration of AMS across the whole health economy and its impact is essential if we are to achieve a ‘One Health’ approach to addressing antimicrobial resistance (AMR), and therefore we searched systematically for and analysed published examples of integrated AMS initiatives to address this gap. Application of a system-level framework to analyse integration of AMS initiatives across and within healthcare sectors shows that integration is emerging but needs strengthening. Findings from a small number of evaluations in high-income countries suggest that antimicrobial prescribing and healthcare-associated infections can be reduced using a multisectoral integrated AMS approach. More robust research designs to evaluate and understand the impact of multisectoral integrated AMS are needed, particularly with respect to differing health systems in different countries and local organisational contexts. Our analysis highlights a number of challenges and ways forward for enhancing the delivery of AMS through an integrated approach

integration of an organic rankine cycle and a photovoltaic unit for micro scale chp applications in the residential sector

Abstract The purpose of this work is to analyse the performance of a novel system for combined heat and power (CHP) generation in small-scale applications. The system is based on an Organic Rankine Cycle (ORC) fed with biomass and a photovoltaic (PV) unit. The ORC and PV sub-systems operate in parallel to produce the required electrical energy. A preliminary investigation is performed to define the proper size of the photovoltaic unit. Afterwards, the analysis is focused on the hybrid system and a comparison between the two configurations is carried out. This work demonstrates the potential for integrating biomass and solar energy resources: during daylight, solar radiation is significant and the ORC system can be switched off or operated at partial load. Furthermore, the adoption of biomass makes it possible to overcome the intermittency of solar resource, increase the self-consumed electrical energy, and produce thermal energy, thereby saving natural gas for heating purposes

La tigdibx

Ġabra ta’ poeżiji u proża li tinkludi: Pax Brittanica – Ħajr u Talb ta’ Dun Karm – Londra ta’ Ġużè Chetcuti – Iż-Żmien ta’ Ġużè Chetcuti – Ix-Xatt t’Għawdex ta’ Ġorġ Pisani – Progress ta’ Dun Karm – La tigdibx ta’ C. Micallef Decaro.N/

Tallaba

Ġabra ta’ poeżiji u proża li tinkludi: Lill-Kittieba tal-“Malti” ta’ P. – Bejn Żewġt Iqlub ta’ A. C. – Lill-Qamar ta’ V. M. B. – It-Tallaba minn ta’ Matilde Serao ta’ Ġużè Micallef GoggiN/

Is physical inactivity related to body mass index and waist circumference in a sample of Maltese adult population?

Physical inactivity and excess weight are two major public health problems (World Health Organisation [WHO], 2000, 2006). In 2008, the worldwide prevalence of overweight and obesity was estimated to be more than 1.4 billion adults (over 20 years), of these over 200 million men and almost 300 million women were obese (WHO, 2008). Furthermore, WHO (2013) estimated that in 2008, globally, 31% of adults aged 15 and over were insufficiently active (28% men and 34% women). This unhealthy behaviour was estimated to cause 600,000 deaths annually and lead to a loss of 5.3 million years of healthy life due to premature death and disability (WHO, 2002). If physical inactivity were to be reduced by 10‐25%, more than 1.3 million lives could be saved annually (Lee et al., 2012). In Malta, the situation is similarly grim. It is troubling to note that Maltese men rank top in European obesity chart and Maltese women place third (Eurostat, 2011). Furthermore, Malta is labelled as one of the most sedentary populations on earth (Stagno‐Navarro, 2012), with 71.9% of the population failing to meet recommended levels of PA (Hallal et al., 2012). It was estimated that Malta could gain an increase of 1.2% years in life expectancy if physical inactivity were eliminated (Lee et al., 2012). Lee et al. (2012) revealed that Malta has the highest estimate for coronary heart disease (CHD), type 2 diabetes, breast cancer, colon cancer and all‐cause mortality, compared to other European countries, almost double to the European and Worldwide median in all variables (Table 1)

Lower limb muscle activity during first and second tennis serves: a comparison of three surface electromyography normalisation methods.

We assessed lower limb muscle activity during the execution of first and second tennis serves, exploring whether the extent of these differences is influenced by the chosen method for normalising surface electromyography (EMG) data. Ten male competitive tennis players first completed three rounds of maximal isometric voluntary contractions (MVC) of knee extensors and plantar flexors for the left (front) and right (back) leg separately, and three squat jumps. Afterward, they executed ten first and ten-second serves. Surface EMG activity of four lower limb muscles (vastus lateralis, rectus femoris, gastrocnemius lateralis, and soleus muscles) on each leg was recorded and normalised in three different ways: to MVC; to peak/maximal activity measured during squat jump; and to the actual serve. For the rectus femoris and soleus muscles of the left leg, and the gastrocnemius lateralis and soleus muscles of the right leg, EMG amplitude differed significantly between normalisation techniques (P ≤ 0.012). All muscles showed greater activity during the first serve, although this difference was only statistically significant for the right vastus lateralis muscle (P = 0.014). In conclusion, the EMG normalisation method selected may offer similar information when comparing first and second serve, at least for leg muscles studied here

Reactive power sharing and voltage harmonic distortion compensation of droop controlled single phase islanded microgrids

When paralleling multiple inverters that are capable of operating as an island, the inverters typically employ the droop control scheme. Traditional droop control enables the decentralized regulation of the local voltage and frequency of the microgrid by the inverters. The droop method also enables the inverters to share the real and reactive power required by the loads. This paper focuses on some of the limitations of parallel islanded single phase inverters using droop control. Algorithms with the aim to address the following limitations in islanded operation were proposed: reactive power sharing and reduction of the voltage harmonic distortion at the point of common coupling (PCC). Experimental results were then presented to show the suitability of the proposed algorithms in achieving reactive power sharing and in improving the voltage harmonic distortion at the PCC.peer-reviewe

Tallaba

Ġabra ta’ poeżiji u proża li tinkludi: Il-Bravi fid-Dar ta’ Luċija ta’ Dun Pawl – X’Qasma ta’ Qalb ta’ C. M. D – Innu ta’ G. M. A. – Ġens il-Malti ta’ R. Briffa – It-Tallaba minn ta’ Matilde Serao ta’ Ġużè Micallef GoggiN/