"Hunger Hurts, but Starving Works". The Moral Conversion to Eating Disorders.

This article aims to shed light on the self-perceptions of people with eating disorders in Malta and Italy through a deep understanding of their narratives. In contrast to the biomedical perception of the phenomenon and in opposition with the prevalent feminist theories on the subject, I consider eating disorders as the result of self-transformative processes. I suggest that anorexics, bulimics and binge eaters are actively and deliberately engaged in a project of moral self-transformation that is culturally defined. The moral transformations of women with eating disorders in Malta and Italy, the two considered contexts of this research, reflect the social expectations of women in these societies. The drastic changes in personal attitudes towards both food and the body that characterise eating disorders are the result of a complete dedication to the moral values embodied in thinness, namely the control of bodily needs and pleasure. The self-transformative process of people with eating disorders can be understood as a form of moral conversion along a continuum of increasing control over hunger: the higher the control, the higher the level of satisfaction and the degree of moral conversion achieved. Considering the general low recovery rates of people with eating disorders, this approach helps in the understanding of why people who are diagnosed with an eating disorder accept medical definitions and treatments to different extents.

Nurses' and caregivers' definition of spirituality from the Christian perspective: a comparative study between Malta and Norway.

AIM: The aim of this cross-sectional comparative exploratory study was to explore the term spirituality as defined by four groups of nurses and two groups of caregivers from Malta and Norway. BACKGROUND: Spirituality is a complex subjective concept which may or may not contain religiosity. Several factors may influence the individual's interpretation with implications to nursing care and nursing management. METHODS: Data were collected from six purposive samples using focus group discussions in Malta and Norway. The Taxonomy of Spirituality guided the study. RESULTS: Four themes defined the term 'spirituality'. Two differences were found between Malta and Norway. Connectedness with family and nature was emphasized more by the Maltese group while the Norwegian group identified both the positive and the negative energies of spirituality. IMPLICATIONS TO NURSING CARE AND NURSING MANAGEMENT: A clinical environment conducive to holistic care is needed. Inclusion of spirituality in the continuous professional development programmes may enhance understanding of spirituality and foster spiritual growth. CONCLUSIONS: Irrespective of differences in cultures between Malta and Norway, commonalities were found in the definition and essence of spirituality in nursing care. Trans-cultural longitudinal research is recommended to explore further the definition of spirituality.

Representations from the past: social relations and the devolution of social representations.

Psychological life is subject to the influence of a constructed and potentially reconstituted past, as well as to future anticipated outcomes and expectations. Human behaviour occurs along a temporal trajectory that marks the projects individuals adopt in their quests of human action. Explanations of social behaviour are limited insofar as they exclude a historical concern with human purpose. In this paper, we draw on Bartlett's notion of collective remembering to argue that manifest social relations are rooted in past events that give present behaviours meaning and justification. We further propose an epidemiological time-series framework for social representations, that are conceptualised as evolving over time and that are subject to a 'ratchet effect' that perpetuates meaning in a collective. We argue that understanding forms of social behaviour that draw on lay explanations of social relations requires a deconstructive effort that maps the evolutionary trajectory of a representational project in terms of its adaptation over time. We go on to illustrate our proposal visiting data that emerged in an inquiry investigating Maltese immigrants' perspectives towards their countries of settlement and origin. This data reveals an assimilationist acculturation preference amongst the Maltese in Britain that seems incongruous with the current climate of European integration and Maltese communities in other countries around the world. We demonstrate that a historical concern with regard to this apparent behaviour helps explain how Maltese immigrants to Britain opt for certain forms of intercultural relations than others that are normally preferable. We demonstrate that these preferences rely on an evolved justification of the Maltese getting by with foreign rulers that other scholars have traced back to the medieval practice of chivalry.

Marriage and the family in a Maltese parish: St. Mary's (Qrendi) in the eighteenth century.

This article addresses the Maltese traditional family, taking St. Mary's (Qrendi) as a test case. It results that couples married in their early twenties, while a high proportion of men and women never married at all. Marriage was not popular so that one-fifth of all marriages were remarriages. Very few widows remarried and it was only for some economic reason that they sought another man. There is no evidence though that a high rate of celibacy resulted in flagrant promiscuity even if there is evidence that the Qrendin were not so particular about their sex life. No birth control was practiced within marriage and children followed one another regularly. This brings into relief the parents' unconcern for their offspring's future as well as the inferior status of women because husbands made their wives several offspring. Relations between the spouses were poor so that dissatisfied couples went their own ways.

Lexical mixing in the early productive vocabularies of Maltese children: implications for intervention.

Since norms for vocabulary acquisition in Maltese children do not yet exist, documentation of productive vocabulary acquisition may contribute to establishing a baseline of lexical development. Clinical implications may thus be derived. The current study is a small-scale investigation of the proportions of Maltese and English lexemes in the vocabularies of ten normally-developing Maltese children aged between 12 and 30 months. The participants were primarily exposed to Maltese within their immediate environments, while receiving indirect exposure to English. Outcomes of parental report and language sampling were analysed for evidence of a bilingual dimension in these children's productive vocabularies. Translation equivalents were reported on by parents, but negligible evidence of equivalents emerged in conversational language use. In contrast, lexical borrowings were both reported and sampled. A substantial proportion of English lexemes were reported by the parents in the absence of Maltese equivalents.

HLA-DRB1 and multiple sclerosis in Malta.

BACKGROUND: By comparison with the neighboring island of Sicily, the frequency of multiple sclerosis (MS) in Malta is remarkably low. METHODS: To explore whether the relative rarity of MS in Malta might be the result of lower population frequencies of major histocompatibility complex susceptibility alleles, we genotyped the HLA-DRB1 locus in 77 Maltese-born patients (97% of the prevalent unrelated native cases) and 206 Maltese controls. We made comparisons with previously published data for Sicily and other European countries. RESULTS: The anticipated association with HLA-DRB1*15, the main susceptibility allele in most other populations, was confirmed (p(c) = 0.009) but, in addition, we also observed an equally strong, and apparently protective, effect of the HLA-DRB1*11 allele (p(c) = 0.016). In comparison with previously published data from Sicily, we found that all HLA-DRB1 risk alleles were more common in Malta, whereas HLA-DRB1*11 was slightly less common. CONCLUSIONS: The difference in prevalence seen between the neighboring islands of Malta and Sicily cannot be explained by differences in background HLA-DRB1 population allele frequencies, which if anything would predict a higher rate of disease in Malta than in Sicily.

TNFRSF11B gene variants and bone mineral density in postmenopausal women in Malta.

UNLABELLED: A number of polymorphisms in various genes have been identified and associated with bone mineral density (BMD) and with an increased risk of osteoporosis. OBJECTIVE: In this study, three single nucleotide polymorphisms (SNPs) within the TNFRSF11B gene were studied for association with an increased risk of osteoporosis in postmenopausal Maltese women (n=126). METHODOLOGY: Analysis was performed by PCR restriction fragment length polymorphism (RFLP) while BMD at the lumbar spine, femoral neck, Ward's triangle and trochanter was measured by DEXA. RESULTS: No significant association was observed between genotypes and BMD for all polymorphisms studied within this gene. Homozygotes CC (T(950)-C) were observed to have the highest BMD at all anatomical sites although statistical significance was not reached when comparing the three genotypes. A statistical significant difference was observed in the distribution of genotype frequencies for this polymorphism between normal individuals and those that were either osteopenic or osteoporotic at one or both anatomical sites, with the TT genotype associated more frequently with low BMD. The T(950)-C and G(1181)-C polymorphisms were in strong linkage disequilibrium with each other but not with the A(163)-G polymorphism further upstream in the OPG promoter. Statistical significance was reached when constructing haplotypes, where the A-T-G haplotype was found to be more frequent in individuals with low BMD. CONCLUSIONS: These results indicate the possible role of TNFRSF11B gene variants in postmenopausal bone loss in women in Malta.

One or two: an examination of the recent case of the conjoined twins from Malta.

The article questions the assumption that conjoined twins are necessarily two people or persons by employing arguments based on different points of view: non-personal vitalism, the person as a sentient being, the person as an agent, the person as a locus of narrative and valuation, and the person as an embodied mind. Analogies employed from the cases of amputation, multiple personality disorder, abortion, split-brain patients and cloning. The article further questions the assumption that a conjoined twin's natural interest and wish is separation. I first contend that separation is such a radical procedure as to render the post-separation person different from the pre-separation one. Therefore, it is not possible to benefit the pre-separation twin by the act of separation. The article concludes with a critical evaluation of the tendency in bioethics to regard ethical challenges as rivalry between individuals competing for scarce resources.

Cancer incidence among migrant populations in South Australia.

South Australian Cancer Registry data for 1977-1986 have been used to compare the incidence of cancer for overseas-born populations and for the State as a whole. British and Irish migrants were found to have a higher incidence of all cancer sites combined, largely because of elevations in the incidence of cancers of the lung, stomach and female breast, whereas southern-European migrants showed a lower incidence of cancer, mostly as a result of low incidence rates for cancers of the colon, prostate, lung (women only), melanoma and female breast. Differences in incidence also were evident by country of birth for cancers of the buccal cavity, oropharynx, nasopharynx, oesophagus, liver, larynx, pleura, testes, uterine body, bladder and kidney, and various lymphohaematopoietic cancers. The aetiological implications of these findings, particularly in relation to environmental and life-style factors, are considered.

Cultural factors and symptoms of schizophrenia, a comparative study in Malta and Poland.

The examinations comprised 120 cases of schizophrenia in Poland and 80 cases on Malta. Clinical analysis showed differences in symptomatology of the disease, delusions and hallucinations content, in methods of the treatment applied and in the prognosis--as a result of pathoplastic effect of cultural-racial and sociodemographic factors. In comparison with Polish patients Maltese schizophrenics showed a less diversified psychotic symptomatology.

Fasting plasma insulin. A risk factor for abnormal electrocardiogram in Maltese residents of Australia.

Analysis of atherogenic risk factors in 493 Maltese-born residents of Melbourne showed that after adjustment for the effects of age, fasting plasma insulin was the only factor with a highly significant (p = less than 0.001) association with electrocardiogram abnormalities suggestive of atherosclerotic coronary artery disease. Absence of peripheral arterial pulses was not correlated with abnormal electrocardiogram but was significantly associated with both age and smoking. Elevation of plasma insulin appears to be a significant risk factor for atherosclerotic heart disease.

Glucose tolerance and mortality in diabetes mellitus in Maltese-born residents of Victoria.

In view of the recognized high prevalence of diabetes mellitus in Malta compared with Australia, 75 g oral glucose tolerance tests were performed on 396 Maltese-born residents of Melbourne. Eighteen (4.5%) were found to have diabetes mellitus and 19 (4.8%) were found to have impaired glucose tolerance by current criteria. Glucose tolerance was correlated with family history of diabetes, with age, with obesity and with parity in women, but not with length of residence in Australia. Analysis of statistical data of death certification showed that Maltese-born residents of Victoria had a higher age-specific mortality from both diabetes mellitus and ischaemic heart disease than did Victorian Italian-born residents or the total Victorian population. This was most marked in women. The results suggest that Maltese immigrants to Australia after years of residence, still run a higher risk of becoming affected with diabetes mellitus or ischaemic heart disease than the average for the Australian population. The relative importance of genetic and environmental factors involved in this difference should be the subject of continuing study in the future.