Evaluating burnout in an institutional setting

In a research project, 183 medical and paramedical staff, each with at least 5 years of service in a large psychiatric hospital in Malta, were interviewed to find out any burnout effects. It was found that the longer the years of service, the more staff felt they were taking their work problems home. Nevertheless irrespective of length of employment, 78% considered their objectives at work fulfilled. Only 22% gave importance to improved salaries, while 77% opted for more staff meetings and in-service training.peer-reviewe

Treating a case of Savant syndrome

Memory and artistic prodigies among the population at large are uncommon; among the mentally retarded, they are rarer still. This article describes the treatment of such a case, technically known as the Savant Syndrome, seen by occupational therapists at Mount Carmel Psychiatric Hospital and treated over a period of 18 years.peer-reviewe

Occupational therapy in Malta today : an enabling profession

Occupational Therapy can be described as the use of purposeful activity or intervention designed to achieve functional outcomes which promote health, prevent injury or disability and which develop, improve, sustain or restore the highest possible level of independence of any individual who has an illness, injury, cognitive impairment, psychosocial dysfunction, mental illness, developmental learning disability, or other disorder. Occupational Therapy departments are to be found in the main hospitals in Malta and Gozo, as well as in the community. This article looks at the origins and developments of Occupational Therapy and the present rehabilitation service delivery.peer-reviewe

Brain damage following whooping cough vaccination : is it time to lay the myth to rest?

Whooping cough causes significant morbidity and mortality, especially in early infancy. Although an effective vaccine exists, vaccine uptake in Malta was previously disappointing due to the general public’s and the medical community’s doubts regarding vaccine efficacy and safety. The aim of this study was to review population-based studies which have analysed the potential short and long term neurological sequelae following pertussis and pertussis vaccination, to describe vaccine uptake globally and in Malta over the past 15 years, and to analyse the effect of vaccine uptake on pertussis epidemics in Malta. This study found that pertussis vaccine uptake has only become satisfactory in recent years, with a resulting attenuation in the most recent pertussis outbreak. Uptake has increased progressively all over the world, and no study has ever incriminated pertussis vaccination as a cause of permanent neurological disability, both locally and abroad. This should encourage the present continuing trend of pertussis uptake.peer-reviewe

A Surgical Perspective on Targeted Therapy of Hepatocellular Carcinoma.

Hepatocellular carcinoma (HCC), the second leading cause of cancer deaths worldwide, is difficult to treat and highly lethal. Since HCC is predominantly diagnosed in patients with cirrhosis, treatment planning must consider both the severity of liver disease and tumor burden. To minimize the impact to the patient while treating the tumor, techniques have been developed to target HCC. Anatomical targeting by surgical resection or locoregional therapies is generally reserved for patients with preserved liver function and minimal to moderate tumor burden. Patients with decompensated cirrhosis and small tumors are optimal candidates for liver transplantation, which offers the best chance of long-term survival. Yet, only 20%-30% of patients have disease amenable to anatomical targeting. For the majority of patients with advanced HCC, chemotherapy is used to target the tumor biology. Despite these treatment options, the five-year survival of patients in the United States with HCC is only 16%. In this review we provide a comprehensive overview of current approaches to target HCC. We also discuss emerging diagnostic and prognostic biomarkers, novel therapeutic targets identified by recent genomic profiling studies, and potential applications of immunotherapy in the treatment of HCC

Simple measures can improve care in our hospitals : an audit of venous thromboembolism practice

Abstract: Venous thromboembolism (VTE) is a serious but preventable complication of hospitalisation. Doctors still sometimes fail to adhere to them, thus putting patients at risk and incurring considerable expense for the national health service. We chose to audit the practice of doctors in our geriatric facility, and assessed the effect of a memoire to increase compliance. We also explore how our hospitals can learn from the experience of other centres, where the risk of litigation has brought this condition to the forefront. Compliance improved from 30.7% to 63.3%, which was statistically significant. We would suggest that a centralised and organised approach could produce even greater levels of compliance.peer-reviewe