Suchergebnisse

One of the Maltese Government's objectives in improving the health status of the population is 'To add health to life by increasing years lived free from ill-health, reducing or minimising the adverse effects of illness and disability, promoting healthy lifestyles, healthy physical and social environments and overall, improving quality of life' ; peer-reviewed

The magnitude of childhood obesity has reached alarming levels. Approximately, 40% of the global population suffers from overweight or obesity. The EU Action Plan on Childhood Obesity 2014-2020 has an overarching goal to halt the rise in overweight and obesity in children and young people by 2020. Notwithstanding the various actions at both EU and national levels, the problem of overweight and obesity remains high. Urgent action needs to be stepped up. Towards this end the Maltese Presidency of the Council of the European Union placed childhood obesity as one of its priority areas. During its Presidency, a midterm evaluation on the EU Action Plan on Childhood Obesity 2014-2020 was carried out in order to derive with a status update on the extent of implementation by each Member State in the eight policy areas identified within the said Action Plan. The presidency output also focused on the development of food procurement guidelines in schools in order to facilitate the procurement of food for health. To this effect, the presidency produced a technical report elaborating on public procurement guidelines of food for health within school settings. This provides a useful tool for member states when issuing procurement tenders for food in schools. Progressive and targeted public procurement of food for health can reward food business operators who provide nutritionally balanced meals and food products, prompting innovation, food reformulation and social responsibility to achieve better diets and positively impact public health. In addition, with a view to stepping actions to end the childhood obesity epidemic health ministers adopted Council Conclusions on halting the rise in childhood overweight and obesity. The Council Conclusions call upon Member States to integrate in their national action plans and strategies cross-sectoral measures, enabling environments that encourage healthy diets and adequate health-enhancing physical activity amongst others. The scale and consequences of childhood obesity demand bold and urgent actions. Collaborative actions between European Member States and intersectoral concerted actions at national level are required to tackle the burden of childhood obesity. ; peer-reviewed

A high intake of salt is detrimental to health as it causes high blood pressure thus increasing the risk of cardiovascular disease (CVD) and renal disease. Such conditions, mostly hypertension, are common in Malta. A framework for a National Salt Initiative was proposed by the European Union (EU) to establish a common vision for a general European approach towards salt reduction. Since the initiative partly targets reformulation actions with industry and catering, a study done in collaboration with the World Action on Salt and Health (WASH) exploring the use and perceptions of salt amongst chefs and caterers was carried out. A validated questionnaire developed by WASH was sent via email to 66 restaurants together with a covering letter. These included first, second and third class restaurants registered with the Malta Hotels and Restaurants Association (MHRA). 31 restaurants responded to the questionnaire to give a response rate of 47%. The main outcome of the study showed that 90% of the participants added salt to dishes to enhance flavour and improve taste. Although 99% of the respondents were aware which foods are low or high in salt, salt in dishes was replaced by soy sauce and stock cubes. 58% of the respondents were ready to consider reducing salt in their dishes as long as taste was not compromised. Due to the poor response rate, the study cannot be generalised to the Maltese population thus repeating the study with the aim of increasing the response rate so that further recommendations for salt reduction can be made within the population as well as for the catering industry. ; peer-reviewed

Sexual health is an important global public health concern. Planning effective strategies to improve sexual health requires a high degree of attention to the local epidemiological trends and cultural context where the strategy is to be implemented. The paper by Chemtob et al. describes the process to develop a plan that aims to reduce the burden of Sexually Transmitted Infections in Israel by 2025. This commentary argues that increased attention to planning and implementation of sexual health policy is required in order to address the real burden of disease. Sexual health should not be merely addressed from a communicable disease control perspective but should comprehensively address health and wellbeing of all population groups through a positive approach in line with the WHO current definition of sexual health. As even traditionally culturally conservative societies are experiencing rapid changes in attitudes and practices towards sexual lifestyles, the challenge is to ensure that sexual health strategies combine evidence-informed measures and good practices with culturally appropriate communication and implementation approaches. ; peer-reviewed

With 40 to 48% of children and 58% of adults being overweight and obese, excess weight in both children and adults in Malta has become a major concern. Obesity has considerable effects on mortality and morbidity. The excess direct cost on the Maltese health service associated with overweight and obese individuals as compared with persons of normal weight is estimated to be nearly 20 million Euro per year (in 2008), accounting for 5.7% of total health expenditure. ; peer-reviewed

Since the first importation of influenza A(H1N1)v virus to Europe in late April of this year, surveillance data have been collected in the Member States of the European Union and European Free Trade Association. This is the first preliminary analysis of aggregated and individual data available as of 8 June 2009 at European level. ; 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

Malta, like many other countries, has experienced significant challenges in nutrition over the past 20 years. Given the increasing prevalence of diet-related diseases and overweight and obesity across all ages, nutrition has been high on the Ministry for Health agenda over the past 15 years. Public Health practitioners in Malta have been drivers of public health nutrition reform throughout this period. The Health Promotion and Disease Prevention Directorate was set up to mainly focus on health promotion and non-communicable diseases including healthy nutrition in 2007. Over the years a number of strategies have been outlined targeting nutrition for the Maltese population including the Non Communicable Disease Strategy, the National Cancer Plan, the National Healthy Weight for Life Strategy, the Food and Nutrition Policy and Action Plan for Malta, Diabetes: A National Public Health Priority – A National Strategy for Diabetes 2016-2020, Whole of School Approach to Healthy Lifestyle: Healthy Eating and Physical Activity Policy and Strategy and the National Breastfeeding Policy and Action Plan 2015 – 2020. With input from WHO and the EU, Malta has participated in many surveys allowing for continuous monitoring and evaluation. In 2015, Malta embarked on a first National Food Consumption Survey, results of which will provide a baseline on eating habits to target priority areas for action, inform policy and monitor trends. ; peer-reviewed

Across the world, a multitude of efforts are being undertaken to steer the food environment towards facilitating healthier dietary choices. This paper utilizes public procurement as a powerful policy tool for the promotion of healthier food choices. In the European Union (EU), for example, Member States have developed a framework for initiatives on selected nutrients — mainly salt, sugars and fat — and, together with several food business operators and nongovernmental organizations, have committed to a roadmap for action on food product improvement. We argue that the public procurement of food and food services can further incentivize food reformulation and encourage those involved in the procurement process to consider health alongside economic, social and environmental aspects. Given the number of recipients of food and food services procured, from school children to public service employees to food bank clients, the benefits are likely to be far-reaching. EU public procurement directives offer substantial scope for health considerations while stimulating innovation. Building appropriate monitoring and evaluation efforts into the process will allow for the demonstration of widespread benefits and value for money of successful public procurement of food for health. It is time to use the power of the public purse to innovate our food environment for better health for all. ; peer-reviewed

Malta is at the helm of the EU between January and June 2017. The Maltese Presidency intends to continue to build on the work of previous Presidencies to tackle important priorities for which there is clear added value for action at EU level. To this end Malta has identified childhood obesity and structured cooperation between health systems as its two main thematic priorities. HIV, eHealth, Rare Diseases, medicines, cancer and antimicrobial resistance will also be on the agenda. Through a series of expert and political meetings, the Maltese Presidency aims to bring forward specific actions on the identified health priorities. ; peer-reviewed

European Union (EU) and European Economic Area (EEA) countries reported surveillance data on 2009 pandemic influenza A(H1N1) cases to the European Centre for Disease Prevention and Control (ECDC) through the Early Warning and Response System (EWRS) during the early phase of the 2009 pandemic. We describe the main epidemiological findings and their implications in respect to the second wave of the 2009 influenza pandemic. Two reporting systems were in place (aggregate and case-based) from June to September 2009 to monitor the evolution of the pandemic. The notification rate was assessed through aggregate reports. Individual data were analysed retrospectively to describe the population affected. The reporting peak of the first wave of the 2009 pandemic influenza was reached in the first week of August. Transmission was travel-related in the early stage and community transmission within EU/EEA countries was reported from June 2009. Seventy eight per cent of affected individuals were less than 30 years old. The proportions of cases with complications and underlying conditions were 3% and 7%, respectively. The most frequent underlying medical conditions were chronic lung (37%) and cardio-vascular diseases (15%). Complication and hospitalisation were both associated with underlying conditions regardless of age. The information from the first wave of the pandemic produced a basis to determine risk groups and vaccination strategies before the start of the winter wave. Public health recommendations should be guided by early capture of profiles of affected populations through monitoring of infectious diseases. ; peer-reviewed

Medicinal cannabis entails evolving dynamics, marked by considerations of therapeutic potential and safety concerns, ambivalent perceptions and scientific evidence, alongside accessibility issues tantamount to limited harmonisation across jurisdictions. Cannabis for medicinal purposes is largely regulated by provisions implemented on a State-by-State basis. The Laws of Malta were amended in 2018, enabling the prescribing of cannabis-based products manufactured under Good Manufacturing Practice (GMP). The national legislative amendments present an opportunity to assess the implications of regulatory requirements for controlled, quality medicinal cannabis products and to examine local predispositions in prescribing and clinical use. ; N/A

This report provides an updated overview of recommended and mandatory vaccinations in the European Union (EU), Iceland and Norway, considering the differences in vaccine programme implementation between countries. In 2010, the Vaccine European New Integrated Collaboration Effort (VENICE) network, conducted a survey among the VENICE project gatekeepers to learn more about how national vaccination programmes are implemented, whether recommended or mandatory. Information was collected from all 27 EU Member States, Iceland and Norway. In total 16* countries do not have any mandatory vaccinations; the remaining 13* have at least one mandatory vaccination included in their programme. Vaccination against polio is mandatory for both children and adults in 11* countries; diphtheria and tetanus vaccination in 10* countries and hepatitis B vaccination in 9* countries. For eight of the 15 vaccines considered, some countries have a mixed strategy of recommended and mandatory vaccinations. Mandatory vaccination may be considered as a way of improving compliance to vaccination programmes. However, compliance with many programmes in Europe is high, using only recommendations. More information about the diversity in vaccine offer at European level may help countries to adapt vaccination strategies based on the experience of other countries. However, any proposal on vaccine strategies should be developed taking into consideration the local context habits. ; peer-reviewed

BACKGROUND: Increased electronic cigarette (ECIG) use has motivated new regulations to address the changing landscape of tobacco use and promote public health. METHOD: This policy scan compares ECIG prevalence and regulations in the European Union (EU), Canada, and the United States (US) at the federal- and local-level to foster a policy dialogue around modern tobacco prevention and control regulations. RESULTS: We find that, among young adults, 40% in the US, 29% in Canada, and 28% in the EU report ever using an ECIG. Results from the policy scan find significant variation in approach to regulating ECIGs. EU member states are subject to the most stringent requirements regarding nicotine concentration regulations, and several member states have also opted to ban flavors and/or require plain packaging or out of sight retail sales. Among EU and US states, taxation is a popular strategy, though taxing strategies vary widely. Regarding youth use, US states have led the way for increasing the legal age of sale to 21 at the federal level, and in Canada recent federal regulations are innovative in their approach to banning advertising that may appeal to youth. CONCLUSION: Strategies to achieve public health goals related to ECIGs vary widely, with federalism playing an important role in policy innovation, offering opportunities to evaluate their effectiveness and inform future regulations.

Tick-borne encephalitis (TBE) is an acute disease of the central nervous system caused by a virus from the Flaviviridae family. The infection, caused by one of the subtypes of TBE virus circulating in Europe, usually progresses biphasically. The first (viremic) phase often is asymptomatic or cause influenza like symptoms. Only about one third of cases progress to the second phase. The disease may present as meningitis, encephalitis, meningoencephalitis, meningoencephalomyelitis or can cause other clinical syndromes. Sequelae are reported in 35-58% of patients. There is no curative treatment for TBE. The only successful method of prevention is active immunization. The first vaccine against TBE was produced in 1937. It was the first vaccine against Flavivirus and the third vaccine against viruses in the world. In Europe two highly effective and safe vaccines are used in preventing TBE infection and its chronic consequences. They typically need three doses of primary immunization at 0-1-6 months, and booster doses every 3-5 years. In spite of presence of effective vaccine, the TBE is growing a public health problem in Central and Northern Europe. From 1974 to 2003 a 400% increase was observed in TBE morbidity in Europe. Each year about 3000 clinical cases are reported in Europe. The aim of the study was to evaluate TBE vaccination strategies and outline localization and modalities of ascertainment of TBE endemic areas in the EU/EFTA countries. The specific objectives of the study were: · Assess TBE incidence data available in countries, · Characterize surveillance systems for TBE in particular countries, · Describe existing information on TBE endemic areas, and methods of their ascertainment; · Summarize vaccination recommendations in particular countries; · Summarize methods used for immunization coverage assessment. ; peer-reviewed