/library/oar/handle/123456789/32508 2026-06-17T00:54:50Z /library/oar/handle/123456789/43445 Title: Is ADHD a hypo-attentional or hyper-attentional disorder? Abstract: Explanations of attention date back to Aristotle, who considered attention as a "narrowing of the senses H, representing the selective aspect of perception. Attention Deficit Hyperactivity Disorder - (ADHD), is a neurobehavioural developmental disorder showing a marked impairment in the cognitive processes associated with the ability to maintain attention. An emerging alternative explanation for ADHD is that of 'Learned Inattention' - involving the inability to actively suppress the processing of irrelevant stimuli. This model assumes two concepts: Latent Inhibition (LI) (Lubow & Moore, 1959), referring to the delay in conditioning to a stimulus after preexposure and Kamin Blocking Effect (KB) (Kamin, 1969) that refers to the 'unlearning' of a stimulus added during conditioning to another cue. Research has already established a relationship between KB and LI with other neuropsychiatric disorders, such as OCD and schizophrenia. Moreover, this model also incorporates neurochemical (dopamine) abnormalities present in these disorders and hence provides neuropharmacological issues for consideration in the treatment of these disorders. We therefore wanted to explore the effect of KB & LI within a group of Maltese individuals diagnosed with ADHD, aged between 6-14 years. We used software based KB and LI tests comprising of a series of visual discriminatory conditioned association tests in addition to other structured questionnaires. Findings supported a novel 'hyper-attention' model of ADHD that may have implications to both the theoretical and practical management of ADHD, whilst also offering substantial diagnostic utility. Keywords: ADHD; Selective Attention; Associated Learning; Latent Inhibition; Kamin Blocking Effect. Description: M.SC.BIOMED.SCI. 2011-01-01T00:00:00Z /library/oar/handle/123456789/42773 Title: Cognitive neuroscience of cocaine drug use. Abstract: Based on theories, such as the Dopamine Hypothesis, Schultz (1997, 2006), and Hyman's (2005) outlook on addiction as a disease of learning and memory, the main objective of this study was to assess for the first time, whether cognitive performance, with respect to Associative Learning, in a population of Cocaine users, was compromised. Secondary objectives included the identification plus confirmation of additional characteristics that might be related to the development and maintenance of the addiction. This was achieved by employing a quantitative approach, through the use of a battery of cognitive, biopsychosocial and demographic tests. These tests included a computer based Kamin Blocking and Latent Inhibition Test, in addition to a Beck Depression Inventory-Il, and a European Addiction Severity Index. Reported results confirm that in Cocaine-users, cognitive alterations on performance were evident when compared to their age, gender and education matched counterparts. A number of additional characteristics shaping the development and maintenance of the drug addiction in question were also established. Moreover, this work, succeeds in providing reliable data that could eventually facilitate the understanding of why cocaine users are more susceptible to relapse. Keywords: COCAINE ADDICTION, AETIOLOGY, ASSOCIATIVE LEARNING, KAMIN BLOCKING, LATENT INHIBITION, DOPAMINE HYPOTHESIS. Description: M.SC.BIOMED.SCI. 2011-01-01T00:00:00Z /library/oar/handle/123456789/42770 Title: Medication errors in Malta : is there a cause for public health concern? Abstract: Internationally, medication errors are considered to be a burden in hospitals and in the community, causing significant morbidity and mortality and increased healthcare costs (Phillips & Bredder, 2002; Ferner & Aronson, 2006; Bar-Oz et al., 2008). The aim of this research was to gain understanding of the local situation on medication errors to determine if they are a public health concern. After a comprehensive literature review, a mixed method consisting of four different approaches was used to achieve this aim. (1) The use of a pharmacovigilance database in the identification of medication errors has been established (Alj et al., 2007; Kunac & Tatley 2011), so a retrospective analysis of the 600 reports within the national pharmacovigilance database was undertaken. (2) Questionnaires, on the causes and prevention of prescribing and dispensing errors were distributed. (3) Key players in the field were interviewed and (4) inquiry reports from the medical and pharmacy councils were looked at for medication error related litigation. Results showed that 17.9% of all adverse drug reactions were associated with medication errors and could have potentially been prevented. Medication errors occurred most often at the stages of prescribing (52%), therapeutic monitoring (26%), patients' management of their own care (12%), dispensing (7%) and administration (3%). Increasing age was a risk factor with most medication errors occurring in the 80- 89 year old age group. Distribution of results was similar to other studies but not for administration errors. (Bates et aI., 1993; Leape et a1.l995; Kaushal 2002, Alj et al., 2007; Kunac & Tately, 2011). This may be due to differing methods and operational terminology or due to a less developed culture of reporting of ADRs within the hospital setting. Most medication errors in this study originated from the community (65%) and the medication classes most likely to be in error were the anti-inflammatory (28%) and anti-bacterial medications (10%). When errors were classified using the psychological theory most errors were likely to be knowledge-based and memory-based errors or rule-based errors. For the questionnaire 48 doctors and 71 pharmacists responded to the questionnaires. For both professions, human factors prevailed as the perceived cause of errors and included overwork (doctors=29/43, pharmacists=37/69), high patient volume (doctors=29/43 , pharmacists 36169) and fatigue from any cause (doctors=28/43 , pharmacists=38/69). System factors included medications with similar and confusing names (21/43) for doctors and illegible handwriting (55/69) for pharmacists. For both professions, reducing interruptions (doctors=20/43, pharmacists=56168) and for doctors lack of availability of resources to consult with were identified as risk-reducing factors. Both professions thought that keeping knowledge of medicines up to date (doctors=41141, pharmacists 54/69), reducing workload (doctors=36/48 , pharmacists=54/69) and having medicine names that are distinctive (doctors=34/48 , pharmacists=53/69) were perceived as important to prevent errors. 2 key players were queried through a series of open ended questions and information pertaining to patient safety and incident reporting locally was obtained which contextualised the study. From the regulatory council inquiry report it was established that litigation related to doctors and pharmacists for medication error was very low (3 court cases from 154 inquiry cases). The objectives of this study have been met. This study has shown that medication errors do occur and are an emerging challenge to public health. A number of recommendations to address this issue have been made. Description: M.SC. PUBLIC HEALTH 2011-01-01T00:00:00Z /library/oar/handle/123456789/42631 Title: Poverty and health in Malta. Abstract: Objectives: The objective of this study was to assess for the relationship between poverty and health. Poverty and health are intertwined. Studies show that the poorer people are the worst is their health. In all countries, poor or rich, health inequalities exist. It is not enough to meet your basic needs. Being relatively poor in the country you live puts one at a health disadvantage. Those who are in a higher social class, better educated, have superior income and suffer less material deprivation have better health. Method: to reach this objective an ecological cross sectional design was used. Data was collected from national routine sources. These were than analysed statistically; all statistical analyses were adjusted for age and gender. Health measures chosen were self-rated health and having a chronic condition. Poverty was considered from a multidimensional perspective. Linear regression was carried out to check for statistical inferences. To complement the statistics, focus groups with health professionals were carried out. Results: Initially self-rated health and having a chronic condition were related to income, employment, alcohol and smoking. However, in the linear regression models limitations due to a chronic condition and education were found to have the strongest statistical relationship with the health measure. Having a chronic condition was also statistically related to vitality scores. Conclusion: These results support the hypothesis that health is related to poverty, with education being the most important predictor of health. Income was not a strong predictor of health unlike what was expected. Similar to other studies old age increased the risk of poverty and poor health. Geographical differences in health were not found. Description: M.SC. PUBLIC HEALTH 2011-01-01T00:00:00Z