/library/oar/handle/123456789/32958 2026-08-12T23:41:53Z /library/oar/handle/123456789/77621 Title: Thyroid dysfunction in the elderly Abstract: This study was performed to demonstrate that screening can detect unsuspected thyroid disease and that some patients may in fact benefit. The objectives of the project were to examine the prevalence of recognized and unrecognized cases of thyroid disease in the elderly in Malta, to determine whether accepted clinical signs and symptoms of thyroid dysfunction correlated with laboratory findings, to investigate the influence of drug therapy on thyroid function and to investigate the possible association between diabetes (and possibly other autoimmune diseases) and thyroid dysfunction. A total of 873 geriatric unselected consecutive admissions to Zammit Clapp hospital, an acute care geriatric hospital and the admission at The Saint Vincent de Paule Residence for the elderly, were specifically assessed for symptoms and signs of thyroid dysfunction. The study encompassed community-dwelling elderly patients who were referred by their general practitioner to the above mentioned clinics. The patient population ranged in age from 41 to 103 years, with a mean age of 78.626 years. 99.427% of the patients were over 60 years of age ; the few remaining patients (0.573%) under 60 years of age were physically and / or mentally disabled. The male : female ratio was 1 : 1.9724. A total of 104 variables for all the patients admitted were finally analysed using the British Medical Data Package (BMDP) method of statistical analysis ; the above variables encompassed any present or past medical condition and nay drug therapy (amounting to a total of 295 different drugs which were later subdivided into their respective classes). Description: M.PHIL. 1997-01-01T00:00:00Z /library/oar/handle/123456789/44870 Title: Perinatal and late neonatal mortality in the Maltese Islands : a socio-biological study. Abstract: In the Maltese islands, the annual still-birth rates and neonatal mortality rates are now below 10 per 1000, so it would seem unnecessary for perinatal and neonatal science to define the relation between pregnancy events and the development of newborns. However one must bear light on the recent trends towards childbearing along with the increasing opportunity provided by assisted reproductive technologies which have increased the number of women considering pregnancy at later ages. This case control study aimed to identify social and biological risk factors which may be associated with these mortalities by comparing these deaths to live births occurring at Karin Grech Hospital between 1993 and 1995. The main information source in this study was the data collected progressively from the Maternity Information System. The total study population was 184 perinatal and late neonatal deaths and 368 controls from live birth survivors. The results of this study show that in Malta advanced maternal age, low birth weight and preterm birth were associated with these deaths as has been established in other countries. The clinico-pathological associations related to these deaths were congenital abnormalities in low and appropriate birthweights, while in very low birthweight conditions originating in the perinatal period were implicated These associations highlight the importance of considering the setting up of a perinatology unit run by obstetricians and neonatologists in KGH. Future studies could focus on a better understanding of the causes of low birth weight and preterm delivery among a population which is a small and relatively homogenous community. Description: M.SC. PUBLIC HEALTH 1997-08-01T00:00:00Z /library/oar/handle/123456789/43446 Title: Vision screening in Maltese 3-year-old kindergarten children. Abstract: This study is an analysis of a pilot vision screening programme of 3 year-old children in Maltese State kindergarten centres. All children, prior to be admitted in the kindergarten of Cospicua, Vittoriosa, Senglea, Kalkara, Paola, Tarxien and St Lucia (N=367). accompanied by their parents were medically examined by the School Health Team. During this visit children were offered to participate in a visual acuity. picture matching test. The screener tool used is The Tokyo Metropolitan Vision Screening Test which is well tested on thousands of children in Japan. Initially. 41 % accepted to participate in this vision screening test. It was found that there was a significant direct relationship between participation and the age of the child (p= 0.00129, correlation coefficient = +0.46) with maximal co-operation occurring after the child is 3 years 1 month of age. In addition, there was a significant relationship between participation and family social class (p=0.016, O.R.=2.0. C.L=l.1 to 3.7) and a significant relationship with the level the mother's education. defined as completion or otherwise of secondary schooling (p=0.04, O.R.=2.0. C.I. 1.0 to 3.8). The acceptance rate of the screening test rose to 960/(' ~hen this was attempted in the . classroom setting with the help of individual kindergarten assistants. Combining the data of the two screening attempts and estimating the false negative cases' from a sample (n= 13) sent for a complete clinical ophthalmic examination. the following are the screener characteristics; Specificity = 96%, Sensitivity = 1000/(', Positive Predictive Value = 56%, and Negative Predictive Value = 100%. The Yield, that is the number of identified cases that benefited by treatment as a result of this screening process, amounted to 5%. Recommendations: If vision screening is to be done on 3-year-old children. 1. The screening test should be held in the classroom setting. 2. The kindergarten assistant preteaches children the matching concept 3. The child should be older than 3 years 1 month. Description: M.SC. PUBLIC HEALTH 1997-01-01T00:00:00Z /library/oar/handle/123456789/43382 Title: Quality of life of survivors following treatment in the early neonatal period. Abstract: Intensive neonatal care has improved the survival rate of critically ill neonates. However there is growing concern about the long-term prospects of these survivors. The objectives of the study was to assess the quality of life of children aged 6 years, who in the early neonatal period required treatment at a special care unit. These children were compared with age matched controls who during the early neonatal period were not exposed to treatment at a special care unit. A retrospective cohort study was carried out with a study population of 413 of which 181 received treatment and 232 were not exposed. The quality of life was assessed subjectively by parents /carers of the study children using a postal questionnaire based on a multiattribute classification system. Eight domains were investigated : hearing, vision, speech, mobility, emotion, learning ability, self care, and pain. 67% of cases compared to 74% of controls had normal function in all eight domains. Chi squared analysis showed no significant difference between cases and controls on a global level of function. For individual attributes, cases had a significantly worse function in speech (P=0.034) and self care (P=0.006). When compared to female cases, males cases had a significantly worse overall function (P=0.004) and poorer function in speech and learning abilities. No significant difference was observed when outcome was assessed according to gestational age at birth and birth weight. This study was able to show that survivors of treatment in the early neonatal period have a favourable quality of life and a good functional outcome indicating an overall beneficial effect. Description: M.SC. PUBLIC HEALTH 1997-01-01T00:00:00Z