/library/oar/handle/123456789/63469 2026-05-29T17:41:29Z /library/oar/handle/123456789/42004 Title: Prevalence of obesity in Maltese children aged 5 and 9 years Abstract: Reason for research: The steady increase in body weight noted in many developed countries over the last decades has also been noted in the Maltese population. As a result of childhood obesity, an increased burden at all levels of the healthcare system will occur. This study aims to assess by means of an epidemiological investigation of a representative random sample of Maltese schoolchildren aged 5 and 9 years: • The current prevalence of obesity in Maltese children in a given sample and relate it to other developed countries. • The risk factors which may be associated with the development of childhood obesity. Methodology: This study was carried out on a random sample of a total of 431 children: 220 males (51.1 %) and 211 females (48.9%) representative of the target population. Body Mass Index (BMI) and waist circumference were measured from the study population. On calculation of the BMI, the school children were divided into three groups: lean, overweight and obese using the International Obesity Task Force (IOTF) classification (Cole T.J. et aI, 2000). A validated questionnaire was distributed to the children included in the sample population. The questionnaire was filled out by the parents and assessed child lifestyle characteristics including physical activity, nutrition, family general characteristics and birth weight. Both the anthropometric measurements and the variables assessed in the questionnaire were analysed to examine for any possible associations. Results: The prevalence of childhood overweight / obesity in the five year old children was 28.8% for boys and 32.7% for girls while the prevalence rates for the 9 year olds was 48.9% for boys and 45.1 % for girls. Inter-relationships were found between a history of metabolic disease in parents and obesity in the corresponding children. A statistically significant relationship was found between a history of a lack of breast feeding and obesity in the 5 year old children [p=0.04]. Statistically significant observations between birth weight [p=0.002], anthropomorphic measures [p=0.0l] and physical activity [p=0.002] were noted. Certain observations were also found between physical activity and corresponding obesity in both age groups, as were statistically significant relationships between diet and childhood obesity especially in the nine year olds. The overweight/obese nine year children consumed less fruit juice, milk whole fat and flavoured milk [p=0.03, p=0.004, p=0.03] respectively as compared to their lean counterparts. Discussion: The increase of prevalence of overweight and obese children especially in the nine year olds has reached alarming rates. The 'U' odds-risk pattern described in previous studies as the thrifty phenotype hypothesis of obesity was noted in this study. Here the nine year olds born in both the low [<2500g] and high birth weight [>4000g] groups showed to have higher anthropomorphic measures as compared to the children who were born of a normal birth weight [2500-3900g]. Obese children could be spending more time performing passive activities instead of sleeping. It was also noted that the obese nine year olds were deliberately restricting the consumption of energy dense food in order to control weight. Conclusion: The family physician is ideally placed to directly help reduce the impact of childhood obesity on the eventual health of the individual and indirectly reduce the demands placed on the health services. Childhood obesity has to be monitored more closely by the family physician especially with children exhibiting risk factors to becoming obese. These include children born of a low and high birth weights, lack of breast feeding, and a history of metabolic syndrome in the parents. Description: M.SC.FAMILY MEDICINE 2010-01-01T00:00:00Z /library/oar/handle/123456789/41416 Title: Patterns and potentials of information technology use by Maltese family doctors. Abstract: The time and money invested in paper work in the general practice setting and in the healthcare system in general always imposes a question, i.e. why does family practice not fully benefit from what technology can offer, like many other medical fields, or non medical fields such as business? This study reviews existing literature about use of computers by family doctors. Although scarce in quantity and limited, the core contents were grouped and moulded to present what computers are used for in family medicine and how family doctors are using them in different areas of the world. An online questionnaire was distributed to Maltese family doctors who are already using computers in order to study their pattern of use and the potential to grow this use in order to support their development for a continuously improving medical practice. The data collected was grouped and analysed. The results are presented as a thorough description of the participants' pattern and potential of computer use. The results were considered indicative of the current situation in Malta, which was found to be promising. The results suggested that, although the majority of family doctors who own a computer either at home or at their clinic or both, make variable use of technology, they are in continuous search for means and solutions that technology could offer to help them with their professional challenges. An ¸£ÀûÔÚÏßÃâ·Ñ Technology acceleration programme for family doctors is proposed by the researcher; its main features were documented in this study as part of the discussion and recommendation. This study did not aim at exploring the number of Maltese Family doctors who are computer literate but rather to study the pattern of use by the existent IT users. Description: M.SC.FAMILY MEDICINE 2010-01-01T00:00:00Z /library/oar/handle/123456789/39485 Title: Non-urgent emergency department visits: the effect of having a regular family doctor Abstract: Over the past years, there has been an increased incidence of non-urgent visits to the Accident and Emergency Department of Mater Dei Hospitat Malta. This results in severe overcrowding of this department and, hence, substantial decrease in efficiency and inadequate utilisation of resources. Most of these patients were noted to be using the Accident and Emergency department as their primary source of care. The aim of this study is to determine how many of these patients have a regular family doctor or primary care provider, whom they seek advice from prior to attending the Accident and Emergency Department. This would prove to be beneficial in understanding the dynamics associated with inappropriate utilisation of the Accident and Emergency Department and lack of primary care use, providing the basis of a framework which would help to attempt to solve the ever-increasing load on the Accident and Emergency Department and also to improve primary care by making it more accessible and improving it to make it meet patient's demands. This study was based on the Andersen-Newman model of health services utilisation by developing a questionnaire, which was then, administered to patients who had attended the department for non-urgent purposes over a previously determined period of time. This self-reported telephone survey was carried out on one hundred and ninety-eight patients out of a quasi-random sample of two hundred and twenty five patients. Out of the various socio-demographic factors studied, none of these were statistically found to be significant in determining the utilisation of the said-department for non-urgent purposes. Results obtained showed no correlation between non urgent visits to the accident and emergency department and having a regular family doctor. Various other correlating variables including age, level of education and average weekly household income among others were also tested, however none proved to be statistically significant. In future, the same study can be carried out on a larger population sample, thus increasing the chance of statistical significance. Description: M.SC.FAMILY MEDICINE 2010-01-01T00:00:00Z