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

A survey of energy drinks consumption amongst medical students and foundation year doctors in Malta

Objectives: To explore the consumption patterns of energy drinks and associated factors, amongst medical students and foundation year doctors in Malta. Methods: Data was collected from medical students and foundation year doctors from the Faculty of Medicine and Surgery, University of Malta, by means of an electronically administered cross-sectional, self-reported survey. The response rate was 42% (n=305). IBM SPSS 23 was used for statistical analysis. Results: Energy drinks consumption amongst the sample was 68.2% (n= 208). Most participants (60.1%) started consuming energy drinks between 16-20 years, followed by those between 11-15 years (34.6%). Males are more likely to consume energy drinks than females. Participants who consume energy drinks are more likely to also drink coffee (85.1%), alcohol (88.0%) and smoke tobacco (18.3%). Common reasons for drinking energy drinks were for mixing with alcohol (37.5%) and during studying/major projects (30.8%). The majority of the participants (52.1%) experience psychological side effects due to energy drinks, the most common being stimulating/hyperactivity (42.6%), followed by anxiety (14.8%). Over half of the participants (54.8%) claimed to suffer from physical side effects Conclusions: Energy drink consumption is common amongst this population and certain aspects of consumption are a cause for concern. Greater public education of the risks of these drinks is recommended especially to young age groups. Legislation may be required to control the marketing and sales and accessibility of these drinks.peer-reviewe

A qualitative exploration of parental views when comparing individual to group sports in children with autism spectrum disorder - a pilot study

(1) Background: Physical activity is important for children with autism spectrum disorder. This study aimed to analyse autistic children’s and their parents’ preferences between group and individual physical activity, while exploring potential social barriers that they might encounter.(2) Methods: Retrospective analysis identified 701 new referrals received by the Maltese national child and adolescent mental health service, between 2016 and 2017. Of them, 24 received a sole diagnosis of autism and 10 were chosen via purposive sampling. A semi-structured interview guide was created, including readability testing, translation/back-translation, inter-rater agreements, and focus group testing. Parents were informed, consented, interviewed and thematic analysis carried out. Further quantitative data were tabled accordingly.(3) Results: Only one child met World Health Organisation recommendations for physical activity. More children preferred individual sports while parents described more benefits with group sports. Parents’ perceived benefits with group sports included better socialization, while improved levels of self-esteem and coping with anxiety were highlighted benefits for individual sports. Parents felt misunderstood, burnt out, and described a lack of autism-friendly sports facilities, including geographical disproportionation of adequate facilities on the island. Too much screen time was a major parental concern.(4) Conclusion: Recommendations aim to develop sport therapy systems and well-resourced services in Malta. Staff training is recommended to improve service quality.peer-reviewe

A qualitative exploration of the mental wellbeing of Maltese LGBTQ+ university students and acceptance within family, peers, and social circles

Mental health issues have been shown to be more common in LGBTQ+ youths when compared to heterosexual cisgender youths. This study aimed to understand the process of disclosure of sexuality and gender identity in Maltese LGBTQ+ university students and explored dynamics within the individual’s family and social circles during this process. Furthermore, it aimed to elucidate insight into the views of the LGBTQ+ community on the social perception of sexualities and gender identities. 17 individuals from a University of Malta LGBTQ+ association were interviewed. The key finding from this study showed that the period of disclosure was frequently associated with anxiety or depression and that family acceptance may act as a protective factor which reduces anxiety and depression. Furthermore, transgender individuals appear to face more discrimination than gay people. This study concluded that more public awareness is needed to decrease LGBTQ+ stigma. Members within the LGBTQ+ community require more specialised support and counselling services. Further studies need to be carried out to analyse the importance of healthy family dynamics from an earlier age.peer-reviewe

A qualitative exploration of the mental wellbeing of Maltese LGBTQ+ university students and acceptance within family, peers, and social circles

Mental health issues have been shown to be more common in LGBTQ+ youths when compared to heterosexual cisgender youths. This study aimed to understand the process of disclosure of sexuality and gender identity in Maltese LGBTQ+ university students and explored dynamics within the individual’s family and social circles during this process. Furthermore, it aimed to elucidate insight into the views of the LGBTQ+ community on the social perception of sexualities and gender identities. 17 individuals from a University of Malta LGBTQ+ association were interviewed. The key finding from this study showed that the period of disclosure was frequently associated with anxiety or depression and that family acceptance may act as a protective factor which reduces anxiety and depression. Furthermore, transgender individuals appear to face more discrimination than gay people. This study concluded that more public awareness is needed to decrease LGBTQ+ stigma. Members within the LGBTQ+ community require more specialised support and counselling services. Further studies need to be carried out to analyse the importance of healthy family dynamics from an earlier age