Suchergebnisse

Star Trek is a fictional future history that spans the twenty second to twenty-fourth centuries. This narrative places humanity within the United Federation of Planets, a polity of allied worlds that comprises a "(l)iberal, post-capitalist, almost perfectly socialist utopian democracy . a constitutional republic". The Federation behaves like a Kantian "league of nations," a supranational grouping that facilitates amicable internal relations, permits defence against external threats, and attempts to respect the ideals of national sovereignty outlined in the Peace of Westphalia of 1648. These ideals are based on (1) the right of political self-determination, (2) the tenet of legal equality between states, and (3) the principle of non-intervention in the internal affairs of other states. In this utopian future, per Gene Roddenberry's guide for writers of Star Trek: The Next Generation, "most (if not all) of the major problems facing the human species have been resolved and the Earth has since been transformed into a human paradise, with . a literate and compassionate population that has learned to appreciate life as a grand adventure". The explicit mission statement of the starships that constitute Starfleet, the exploratory arm of the Federation, prefaces the 257 episodes of The Original Series and Next Generation: "to explore strange new worlds, to seek out new life and new civilizations, to boldly go where no [man/one] has gone before." It's a "diplomatic mission. one of [Starfleet's] primary functions [is] negotiations". But "Starfleet isn't just about diplomacy, exploration. A lot of the time, it's just hard work", requiring extremely dedicated members. This paper deals with the diplomats and diplomacy in Star Trek. ; N/A

Warfare is an indissoluble aspect of humanity, and is an equally indissoluble part of mythology. Greek mythology is replete with strife between the gods themselves, allegories of human strife, and the most epic aspects were the succession myths, with the primordial couple Gaia and Ouranos overthrown by the Titans, who were, in their turn, overthrown by the Olympians. Warfare is a common trope in all branches of fiction, including science-fiction (SF), and the old pulp magazines were replete with such stories, narratives that featured exotic weapons and that often had Faustian implications, with devastating consequences. Military organisations take technological advances very seriously, as several military works show, to the extent that the 'line between science and science fiction […] has never been totally clear. One of the earliest and most famous SF novels dealing with atomic warfare was Herbert George Wells's The World Set Free (1914), which prefigures the misuse of atomic energy as a weapon of mass destruction. Wells was cognizant of the fact that technological development would lead to such deadly weapons as '[t]he history of mankind is the history of the attainment of external power. Man is the tool-using, fire-making animal'. Warfare can be nuclear, biological, chemical or cyberwarfare. And it is abundantly clear that the entire corpus of work dealing with warfare and SF is too vast to be discussed. Reginald Bretnor has made inroads into this lacuna with three anthologies that assemble both fiction and essays with regard to potential future trends in warfare of all types. Furthermore although the author of this paper is a medical doctor, even the health aspects are too great to realistically discuss in one paper. Hence, only the intersection of infertility in warfare within the genre will be analysed. The approach will thematic, and will attempt to list and taxonomise all narratives that deal with infertility inflicted by warfare in the SF. Many of the narratives now appear dated with entirely new ways of waging warfare that were too far-fetched for 'that Buck Rogers stuff', such as electronic warfare, since for the 'present and for the foreseeable future, electronic systems serve and will continue to serve as the foundation of systems for the control of forces and weapons […] in all branches of the armed forces'. What follows is a brief reading of key texts, a necessarily concise exercise due to the multitude of narratives that have delved into this intersection. ; peer-reviewed

SummaryMales are usually born in excess of females. The sex ratio at birth (SR) is often expressed as the ratio of male to total births. A wide variety of factors have been shown to influence SR, including terrorist attacks, which have been shown to reduce SR. This paper reviews the effects on SR outcomes of the stressful events in France in 1968 (in association with the student and worker riots) and in Japan following the Aum Shinrikyo religious cult's attack on the Tokyo subway using sarin nerve gas in 1995. Both countries displayed seasonal variation in SR. France exhibited a decline in SR in 1968 (p=0.042), with a particularly strong dip in May of that year (p=0.015). For Japan, there was no statistically significant dip for 1995 but there was a significant dip in June of that year (p=0.026). The SR dips follow catastrophic or tragic events if these are perceived to be momentous enough by a given populace. It is believed that SR slumps may be caused by population stress, which is known to lead to the culling of frail/small male fetuses. It has been observed that these fluctuations are comparable in intensity to a substantial proportion of quoted values for perinatal mortality, potentially making this a public health issue.

INTRODUCTION: An effective vaccine may help us to exit the COVID-19 pandemic. General Practitioners/Family Doctors (GPs/FDs) play a vital role in public vaccination in most countries and they also serve as role models. However, they may not always follow national vaccination policies. This study was carried out in order to ascertain the degree of vaccine hesitancy of GPs and GP trainees in Malta vis-à-vis influenza vaccination and a putative novel COVID-19 vaccine. ; METHODS: A short, anonymous questionnaire was emailed via the Malta College of Family Doctors. ; RESULTS: There were 123 responses from 288 GPs (33.3%) and 62 trainees (43.5%). Significantly more will take the influenza vaccine, at all ages. Almost two thirds of GPs are likely to take the COVID-19 vaccine but significantly less (a third) of trainees will. Older doctors were likelier to take this vaccine. The likelihood of taking influenza vaccination was significantly associated with that of taking COVID-19 vaccine. The majority of COVID-19 concerns pertained to insufficient knowledge and concern regarding potential long-term side effects. ; DISCUSSION: The vaccination rates for COVID-19 vaccination are less than those for influenza uptake. Vaccine hesitancy in younger doctors is a seemingly global youth phenomenon, an unwise insouchance when the possibility of long-term viral complications is considered. An information drive should be mounted with regard to COVID-19 vaccination as well as campaign to promote annual influenza vaccination. ; peer-reviewed

DOCTORS AND MEDICAL ADVANCES have been fair game since SF's inception with Shelley's Frankenstein (1918), Stevenson's The Strange Case of Dr. Jekyll and Mr. Hyde (1886) and Wells' The Island of Dr. Moreau (1896), often as crucial components, giving birth to the mad scientist/doctor trope, with commensurate appalling and godlike powers, such as the skill to create or transform living beings, including humans. Inevitably powers are not only used but also abused, and inexorably, hubris paves the way for tragedy in all of these narratives. Interestingly, the medical profession has not only been depicted more frequently overall in Campbellian and post-Campbellian SF, but has also been portrayed in a much better light than in mainstream literature. No Cure for the Future: Disease and Medicine in Science Fiction and Fantasy (2002), edited by Gary Westfahl and George Slusser, comprises the first authoritative attempt to appraise this aspect of SF in any detail. This work examines medicine in SF, commencing with the pessimistic axiom that both medicine and doctors have been oddly marginalised within SF. No Cure for the Future includes contributions from two SF authors and several distinguished scholars in the field, who have examined the nature of canon formation, the role of scholarly journals in legitimising academic inquiry, and the cultural politics of intellectual gate-keeping. This book will be considered, along with various depictions of doctors and medicine that feature broadly in SF narratives. An interdisciplinary slant will intrude throughout as the first author of this essay is a medical doctor, such that real-life parallels will be pointed out, as well as excesses that go beyond the bounds of reasonable poetic license. ; N/A

Background: In Malta, off-label prescribing of medicines in children stands at 45%, mainly because of failure by prescribers to follow the dosing recommendations in the product literature. In addition, registration procedures of pharmaceuticals may inadvertently contribute to this high incidence of off-label prescribing. Methods: A literature review was conducted to identify regulatory provisions relating to the registration of medicines in Malta that could give rise to off-label use. Furthermore, the product literature of the 2 classes of medicines most commonly prescribed in children, antibiotics and respiratory medicines, were reviewed. This was done in order to gauge whether the different registration routes implemented in Malta to market these medicines could give rise to off-label use. Results: The national registration procedure relating to Article 126a of Directive 2001/83/EC and, to a lesser extent, line extensions, parallel importation, and the provision detailed in Article 11 of Directive 2001/83/EC were found to lead to discrepancies and potentially misleading inclusions in the product literature. These, in turn, may well contribute to off-label use of medicines in children. Conclusions: Off-label prescribing does not necessarily mean that efficacy and safety data are unavailable. Variances in the product literature of medicines having the same active ingredients but imported from different countries may cause divergent prescribing practices, leading to inadvertent off-label use. The various stakeholders, including member states such as Malta, should devise strategies to harmonize the most recent labeling information in order to support the safe and effective use of pediatric medicines, thereby decreasing off-label use ; peer-reviewed

In Malta, the health system is hybrid, with similarities to both UK system and the US system, where the National Health Service is supplemented by private practice. This is widely performed either as a primary job or as a supplement to a government salary. This article reviews unfavourable secular trends in Maltese fertility, births, marriages, separations, single parenthood and loans incurred after marriage, and relates them to (equally unfavourable in terms of private practice) escalating numbers of paediatricians working in private practice. Overall, future prospects appear bleak for private practice in this branch of medicine, with a dwindling patient pool being shared by an ever-increasing number of paediatricians. The only identifiable factor that may mitigate is the potential for more private health insurance uptake. This must be coupled with a movement to improve the perception of a substantial proportion of the public that facilities are poorer in the private health sector than in the NHS service. Since Malta is a developed, EU country, these results may (cautiously) be extrapolated to other, larger developed countries.

In Malta, the health system is hybrid, with similarities to both UK system and the US system, where the National Health Service is supplemented by private practice. This is widely performed either as a primary job or as a supplement to a government salary. This article reviews unfavourable secular trends in Maltese fertility, births, marriages, separations, single parenthood and loans incurred after marriage, and relates them to (equally unfavourable in terms of private practice) escalating numbers of paediatricians working in private practice. Overall, future prospects appear bleak for private practice in this branch of medicine, with a dwindling patient pool being shared by an ever-increasing number of paediatricians. The only identifiable factor that may mitigate is the potential for more private health insurance uptake. This must be coupled with a movement to improve the perception of a substantial proportion of the public that facilities are poorer in the private health sector than in the NHS service. Since Malta is a developed, EU country, these results may (cautiously) be extrapolated to other, larger developed countries.

Background: COVID-19 vaccines reduce morbidity and mortality, but mass vaccination faces multiple challenges leading to different vaccination rates in different countries. Malta, a small European country, has achieved a very rapid vaccination rollout. This paper presents a narrative review of Malta's vaccination strategy and its impact on the country's COVID-19 situation. Methods: Data was obtained through a literature review of Maltese newspapers and from Malta's COVID-19 government dashboard. A comprehensive summary of vaccination operations was provided by Malta's COVID-19 vaccination team. Results: Malta comprised part of the European Commission joint procurement and obtained the maximum vac- cines that were eligible from all manufacturers. Four tier priority population groups were set up, with both vaccine doses (where applicable) allocated and stored for each individual. Multiple hubs were set up to simultaneously administer first and eventually second doses accordingly. To date (August 9, 2021) 398,128 of the population are fully vaccinated and 405,073 received the first dose, with both morbidity and mortality declining progressively as vaccination coverage progressed. Conclusion: Malta has successfully implemented a COVID-19 strategy that rapidly covered a substantial proportion of the population over a short period of time, with herd immunity reached by end of May 2021. Low population vaccination hesitancy and high vaccine doses availability were two major factors in this success. ; peer-reviewed

Introduction: Seasonal influenza globally infects 5%-15% annually, with a total of 3-5 million cases of severe illness and ≤500,000 deaths. Hospital-acquired influenza has a particularly high mortality, and healthcare workers are frequently the source of these infections. This study was carried out to ascertain last year's influenza vaccination uptake in Malta's government sector healthcare workers, and estimate the likely vaccine uptake rate in the coming winter season when COVID-19 is expected to be prevalent. --- Methods: A short, anonymous questionnaire was sent via the sector's standard email services (open 30/06-17/072020). --- Results: There were a total of 735 (7.6%) responses from a total workforce of 9,681. The proportion of Maltese healthcare workers who did not take the vaccine last year but who are likely to take the vaccine this winter halved from 41% to 21%. Doctors had the highest baseline uptake (23% refused vaccination in 2019) and the highest likely uptake next winter (6% likely to refuse vaccination in 2020). Analysis by age showed a likely increase in vaccine uptake with increasing age across almost all age brackets. --- Discussion: Influenza vaccination is advantageous and incurs a trivial burden. Clinicians, legislators and ethicists are increasingly aware of this aspect of healthcare, and increasingly mandate compulsory seasonal influenza vaccination for healthcare workers, where vaccine refusal can be taken to equate to maleficent practice. Education with regard to the low risk of side effects may increase voluntary uptake. Institutions are also responsible for ensuring employee vaccination, and this is even more the case for next winter in the setting of the potential co-circulation of novel COVID-19 with influenza. ; peer-reviewed

This study was carried out to quantify secular trends in seasonal variation in births in Malta, a small Mediterranean country where the vast proportion of births occur in wedlock due to a predominantly Roman Catholic population. It also related such variations to seasonal variation in marriages. Annual seasonal peaks of marriages and births were analysed over the period 1950–1996 by X11 ARIMA. A significant peak in marriages (n=111,932) in the third quarter of the year was found for almost the entire period under study. This was paralleled by a peak in births (n=299,558) for the period 1970–1996, which lagged after the peak in marriages by 13–14 months. For the period 1994–1996, when monthly data for monthly pregnancies were available by pregnancy order, the peak in births was caused by first pregnancies only. Seasonal patterns in births occur almost universally due to cultural and/or biometeorological factors. The best known patterns include those of the southern United States, where births decline in April and May, and in northern Europe, where births peak in March and April. In Malta, the late summer peak in births appears to be due to a practical and planned approach by Maltese couples to contraceptive planning, probably influenced by the Roman Catholic ethos and social pressures, with unprotected intercourse occurring only after marriage. In Malta, birth control, albeit by so-called natural methods, was introduced in the 1960s. Prior to this period, births peaked towards the beginning/end of the year, and this may be the more natural seasonality of births in Malta.

In Malta, the health system is hybrid, with similarities to both UK system and the US system, where the National Health Service is supplemented by private practice. This is widely performed either as a primary job or as a supplement to a government salary. This article reviews unfavourable secular trends in Maltese fertility, births, marriages, separations, single parenthood and loans incurred after marriage, and relates them to (equally unfavourable in terms of private practice) escalating numbers of paediatricians working in private practice. Overall, future prospects appear bleak for private practice in this branch of medicine, with a dwindling patient pool being shared by an ever-increasing number of paediatricians. The only identifiable factor that may mitigate is the potential for more private health insurance uptake. This must be coupled with a movement to improve the perception of a substantial proportion of the public that facilities are poorer in the private health sector than in the NHS service. Since Malta is a developed, EU country, these results may (cautiously) be extrapolated to other, larger developed countries. ; peer-reviewed

Objectives: The introduction of laws that make indoor public areas and workplaces smoke-free has resulted in a significant reduction in the incidence of acute coronary syndromes (ACS). Malta was the second European country to introduce the smoking ban legislation in April 2004. The purpose of the study was to investigate the impact of the smoking ban in Malta on ACS morbidity and mortality. Methods: The number of ACS hospital admissions and the number of cardiovascular deaths were retrospectively analysed. The annual data for 5 years prior to and following the introduction of the Tobacco Act were obtained according to age-groups for both genders. Poisson regression analyses were performed to assess for decline in ACS admission and cardiovascular death. Results: The ACS admission rate increased throughout the 5 years following the introduction of the smoking ban. There was no change in mortality rate in the 5 years following the legislation, except in 2007 when a small but significant decline was noted. Conclusions: The Malta smoking ban did not have a significant impact on cardiovascular mortality and ACS admissions rates, indicating the need for proper enforcement of the public smoking ban and increase in public awareness regarding the adverse effects of smoking. ; peer-reviewed