Social capital, health and place : the two sides of the same coin

Research on social capital, health and place has increasingly expanded, however relatively little research has explored how social capital can impact on health both in a positive and negative manner, within a place. There is a general understanding that features of social cohesion, bonding, reciprocity ties, and trust operating with- in a place all help to increase positive health and wellbeing. Yet, very few studies analyse that the theory of social capital in practice has its risks and can be damaging for the health and wellbeing of individuals. This study, through qualitative in-depth interviews, explores how social capital is truly beneficial for the health and well- being of certain social groups, and argues that it may not always be the case that a deprived neighbourhood suffers from low social cohesion. However, this study brings out more to the attention that these same features of social capital can exert negative effects through features of social exclusion, reporting, jealousy and antiso- cial behaviour.peer-reviewe

Assessment for learning in the Maltese state primary classroom : the Blue Creek College case study

This research paper investigates how and to what extent is assessment for learning (AfL) being used and what is influencing its integration in the teaching and learning process in the Maltese state primary classroom. This study presents the teachers’ viewpoints and perceptions, and provides insights into possible implications that AfL could have on the teaching and learning phenomenon. Data was collected through a series of one-to-one interviews and classroom observation. The research found that some AfL strategies such as the sharing of the learning intention, effective questioning techniques and the provision of quality feedback are generally being employed in the classroom. However, this study also revealed that crucial strategies such as the sharing of the success criteria and self-and peer-assessment were very rarely implemented. The data analysis also revealed that many teachers did not pass responsibility to the learners during the learning process. Possible implications for the development of formative assessment practices that enhance the child’s learning experience and progress are finally discussed.peer-reviewe

Blue therapeutic spaces on islands : coastal landscapes and their impact on the health and wellbeing of people in Malta

This paper emphasises that the coastal environment is important for the health and wellbeing of inhabitants living in deprived neighbourhoods in the small island state of Malta. Using qualitative research, it explores how the respondents experience their interaction with the coast and the sea in diverse ways and how this impacts on their health and wellbeing. Making use of qualitative in-depth interviews it analyses the symbolic connections that the respondents have with the sea, the potential that the natural, coastal environment has in enhancing physical activity and mental wellbeing, feelings of embodiment, social interaction and the aspect of temporality. Yet, some nostalgic memories also referred to the aspect of loss and the importance of protection of the natural coastline. This paper acknowledges the deep emotions and strong loving connections that Maltese inhabitants have with the coastal environment and how valuable these spaces are for their health and wellbeing. The fluid, dynamic landforms at sea are greatly important for the health and wellbeing of these individuals and are highly valued therapeutic landscapes within a densely built up environmental island context.peer-reviewe

Places, People and Health: A socio-geographical perspective on wellbeing of mothers and their children in deprived neighbourhoods of Malta

This study explores socio-geographical processes influencing health and wellbeing in deprived Maltese neighbourhoods, contributing new knowledge on how these compare with those reported in research on Anglo-American cultures. This qualitative research obtained data from three deprived neighbourhoods in Malta through in-depth interviews with 31 mothers (of diverse marital status) and their children. Some of these families were followed across a period of time thus obtaining longitudinal data. The research employed a grounded theory approach, and constant comparative approach was used to explore how social processes differed across neighbourhoods. Familial and neighbourhood ties, networks and other aspects of social capital emerge as highly significant, and often beneficial for health and wellbeing. However, divisive processes in these social networks also had negative impacts, less often reported in other research. This thesis emphasises that there is a strong connection between material neighbourhood factors and social relations, as the physical built environment, housing conditions, service provision, welfare benefits, and employment opportunities influence social processes and impact on health and wellbeing in diverse ways. The history of the place, as well as individual life histories, together with a cross-generational and longitudinal approach the significance of the ‘time’ dimension, thus contributing to the complexities of health and wellbeing in neighbourhoods. This study adds to literature on social determinants of health operating in a Maltese, Mediterranean context. It emphasises that there are traditional norms that still determine the health and wellbeing of inhabitants in their neighbourhoods, however, social and economic changes are also transforming these neighbourhoods. It further reveals how individual agency interacts with the social and material environment to affect wellbeing outcomes, albeit within limits on individuals’ power and resources. The findings therefore highlight the importance of a relational approach in order to understand the connection between people, place and health

Incidence of Corrective Procedures After Nonoperatively Managed Distal Radius Fractures in the Elderly.

Although the majority distal radius fractures in the elderly are initially managed nonoperatively, the true incidence of subsequent corrective surgery is unknown. The purpose of this study was to determine the incidence and predictors of corrective surgery after conservative management. Methods:ICD-9 and Current Procedural Terminology codes were queried from the Medicare 5% sample to select patients aged 65 years and older undergoing nonsurgical treatment of distal radius fractures with a minimum 5-year follow-up. Rates of subsequent ipsilateral wrist surgery were correlated against patient age, sex, geographic region, and initial closed reduction. Results:Five thousand eighty patients with a mean age of 78.3 years were included. Fifty-five patients (1.1%) had undergone subsequent wrist surgery at a median time of 182 days after injury. The youngest cohort (65 to 69 years) had a significantly higher operation rate (1.9%, P = 0.007) than the oldest cohort (80+ years) (0.5%, P = 0.004). There was no notable difference in corrective procedures between sex, geographic region, and initial closed reduction. Discussion:Once surgical intervention is deemed unnecessary per standard guidelines, the data support successful nonsurgical management in a large majority of patients but highlight a small subset of younger patients who remain at increased risk of requiring additional surgery

The therapeutic value of the sea and its impact on health and wellbeing

This review paper synthesises the multiple theories and examines the important relationship that the sea and the coast have on the health and wellbeing of people. Through an analysis of the theories of ‘therapeutic landscapes’ and ‘attention restoration theory’, this study contributes to a better understanding of how much the contact with the sea can enable individuals to enjoy better psychological health from both international and local research. This paper also explores how the coastal environment has the potential to promote health through its connection with nature, through social interaction and through one’s nostalgic memories. Moreover, the coastal environment and the blue spaces are so valuable for people that when such spaces are lost, individuals feel a deep emotional loss. This study suggests the need for greater acknowledgment of people’s appreciation, emotions and shared connections with the sea since it enables them to experience multiple ways of increasing health and wellbeing. Therefore, it is important to recognise the valued therapeutic landscapes that different groups of individuals experience by the sea, and emphasise the need in preserving and protecting these natural spaces due to their universal benefits.peer-reviewe

Predictive value of serial measurements of quality of life on all-cause mortality in prostate cancer patients: data from CaPSURE™ (cancer of the prostate strategic urologic research endeavor) database

Health-related quality of life (HRQOL) is a legitimate construct for evaluating treatment and its side effects. Recently, predictive value of HRQOL on survival also has been of interest. In light of the longer survival in patients with prostate cancer and importance of quality of life, we seek to evaluate the association between HRQOL and survival using traditional and novel techniques. Patients from CaPSURE (Cancer of the Prostate Strategic Urologic Research Endeavor) who were treated within 6 months of diagnosis and had pre-treatment and sufficient post-treatment follow-up information constituted the study population. A sample consisting of 2,899 patients met the study criteria. SF-36 domains were used to measure HRQOL outcomes. Categorical variables were created for HRQOL based on the baseline distribution of the lower 10th percentile and the remainder of the patients. Association between HRQOL and survival (defined by all-cause mortality) in patients with prostate cancer was evaluated using Cox proportional hazards models controlling for age at diagnosis, type of treatment received, clinical risk classification, and number of comorbidities. Sequential bootstrap resampling was implemented to evaluate stability of the model. Univariate and multivariate Cox proportional hazards models were fit using various time points over the course of follow-up. In the analysis looking at association of HRQOL baseline measurements, higher levels of physical function and general health were significantly associated with better survival (HR 0.49 95% CI 0.32–0.78 and HR 0.51 95% CI 0.35–0.75, respectively). Post-treatment analysis demonstrated similar results. In time-dependent analysis, higher levels of physical function, role physical, and general health were significantly associated with better survival (HR ranged from 0.57 to 0.65). In addition, analysis looking at change in HRQOL scores demonstrated an association between higher scores on physical function, role physical, vitality, social function, and general health and longer survival (HR ranged from 0.56 to 0.63). This study demonstrated that several domains of HRQOL were significantly associated with survival in a large group of patients with localized prostate cancer. This association was maintained over the course of disease regardless of the time of the assessment. Results from our study have both research and clinical relevance. They could provide information that enable us to not only improve communication with patients and families, but also to develop interventions and treatments best suited for the patient

Non-Emergency Medical Transportation Needs of Middle-Aged and Older Adults: A Rural-Urban Comparison in Delaware, USA.

Background: Older adults in rural areas have unique transportation barriers to accessing medical care, which include a lack of mass transit options and considerable distances to health-related services. This study contrasts non-emergency medical transportation (NEMT) service utilization patterns and associated costs for Medicaid middle-aged and older adults in rural versus urban areas. Methods: Data were analyzed from 39,194 NEMT users of LogistiCare-brokered services in Delaware residing in rural (68.3%) and urban (30.9%) areas. Multivariable logistic analyses compared trip characteristics by rurality designation. Results: Rural (37.2%) and urban (41.2%) participants used services more frequently for dialysis than for any other medical concern. Older age and personal accompaniment were more common and wheel chair use was less common for rural trips. The mean cost per trip was greater for rural users (difference of $2910 per trip), which was attributed to the greater distance per trip in rural areas. Conclusions: Among a sample who were eligible for subsidized NEMT and who utilized this service, rural trips tended to be longer and, therefore, higher in cost. Over 50% of trips were made for dialysis highlighting the need to address prevention and, potentially, health service improvements for rural dialysis patients

European narratives on remote working and coworking during the COVID-19 Pandemic

The COVID-19 pandemic and the restrictions related to it during the first wave have altered the way people used to operate and work across the world, including that of Malta. This chapter will focus on how the COVID-19 pandemic has impacted coworking spaces in Malta and how this may affect the future of coworking spaces within Malta. Malta is located in the centre of the Mediterranean and is a highly densely populated country. The population of Malta is continuously increasing, yet the highest population increase was mainly due to the increase in foreigners living in Malta for employment purposes. As a matter of fact, the population has increased from 9% of the total population in 2014 to 20% in 2022. Indeed, the idea and use of coworking spaces in Malta started around 2014 when Malta increased its incentives concerning the quaternary industry. The number of Maltese employees working remotely or teleworking until the COVID-19 pandemic was 11.7%, below the average of the European Union. Within the Maltese context, the possibility of remote working highly depends on the employer and the type of work. Yet, during the pandemic months of March and April 2020, around a third of the Maltese population was working from home. Presently, there are around 30 official coworking spaces in Malta, most of which are predominantly located in very central areas: Valletta, Sliema, St Julians and Mosta. Informal coworking spaces such as libraries or cafeterias have been long established in Malta. However, such spaces have not been utilized by employees but by self-employed persons and students. Considering the scenario, this chapter aims to explore how the COVID-19 pandemic may be considered a determinant of change, causing a shift in where people choose to operate and work within the Maltese context. During the COVID-19 soft lockdown that took place between the 12th March and early July 2020, Maltese employees in the public and private sectors worked remotely, mostly from home. Therefore, this chapter aims to explore: (i) if coworking spaces may be considered an alternative space of work and; (ii) if coworking spaces can be utilised as places of work during and following the COVID-19 pandemic.peer-reviewe