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Aim The main purpose of the survey is to discover practices about deprescribing of potentially inappropriate polypharmacy among doctors working within the Department of Geriatric Medicine in Malta. Methods An online questionnaire was distributed via electronic mail to all doctors more senior than foundation year 1 working within the mentioned department between August and September 2021. Results A response rate of 54% was obtained. Just over half of the participants admitted to deprescribe at every opportunity, with psychiatric medications being mostly deprescribed. One of the commonest reasons for deprescribing included medication not indicated. Lack of knowledge about the reason for prescription and being prescribed by others were primary barriers to deprescribing. The role of a clinical pharmacist and need for a guideline was reflected in the results. Conclusion The importance of deprescribing is appreciated by many doctors working in geriatrics in Malta, but there is still room for improvement. [ABSTRACT FROM AUTHOR]

Este artículo presenta The Interpretation of Murder, de Jed Rubenfeld, como un estudio de caso ideal para el análisis crítico de las representaciones de la masculinidad en la literatura estadounidense contemporánea. Ambientada en Manhattan en 1909, en el momento en el que tuvo lugar la única visita de Freud a los Estados Unidos, Rubenfeld usa la llegada de Freud y sus teorías del psicoanálisis como punto de partida para una investigación de la metaficción historiográfica en este punto clave de la historia de la masculinidad estadounidense. Al focalizar su crítica a través del protagonista de la novela, el Dr. Stratham Younger, en concreto a través de la interpretación que hace Younger del complejo de Edipo de Freud, Rubenfeld adopta una posición crítica hacia los procesos que dieron forma al patrón hegemónico en la década inicial de la modernidad. En última instancia, acercarse a una lectura de The Interpretation of Murder desde una perspectiva de género señala el poder de la novela en el estudio sociológico de la construcción social de la masculinidad en la sociedad contemporánea. Palabras clave: ficción norteamericana; masculinidad; Nueva York; psicoanálisis; complejo de Edipo; Sigmund Freud; Jed Rubenfeld This article presents Jed Rubenfeld's The Interpretation of Murder as an ideal case study for the critical analysis of representations of masculinity in contemporary American fiction. Set in Manhattan in 1909, at the time of Freud's one and only visit to the United States, Rubenfeld uses the arrival of Freud and his theories of psychoanalysis as his point of departure for a historiographic metafictional investigation of this key moment in the history of American masculinity. Focalising his critique through the protagonist of the novel, Dr Stratham Younger, more specifically through Younger's reinterpretation of Freud's Oedipus complex, Rubenfeld endeavours to critique the processes that shaped the pattern of hegemony in the opening decade of modernity. Ultimately, approaching a reading of The Interpretation of Murder from a gender(ed) perspective points at the power of the novel in the sociological study of the social construction of masculinity in contemporary society. Keywords: American fiction; masculinity; New York; psychoanalysis; the Oedipus complex; Sigmund Freud; Jed Rubenfeld, An Interpretation of Masculinity in Manhattan: Reading Jed Rubenfeld's The Interpretation of Murder 1. INTRODUCING THE INTERPRETATION OF MURDER Jed Rubenfeld's debut novel, The Interpretation of Murder (2006), begins with [...]

Josep M. Armengol 2010: Richard Ford and the Fiction of Masculinities. New York: Peter Lang. xi+138 pp. ISBN 978-1433110511 In an interview with The Paris Review in 1996, Richard Ford [...]

Vitamin D deficiency is reaching alarming levels worldwide and it is highly prevalent in older adults. The association of vitamin D deficiency and osteoporosis has been well studied but in the last decade numerous studies have been exploring the efficacy of treating vitamin D deficiency in order to prevent or treat other common conditions found in the older population. There is robust evidence that vitamin D supplementation together with calcium prevents fracture risk, but there is equivocal evidence with regards to falls reduction. There is no substantial evidence that it decreases frailty, sarcopenia, cognitive impairment, depression and the risk of cardiovascular or diabetes. Research is showing that vitamin D supplementation may prevent acute respiratory tract infections and COPD exacerbations and it might also decrease cancer mortality. Screening for vitamin D deficiency is recommended in all older adults with musculoskeletal diseases and in COPD patients hospitalised with an exacerbation. There is still controversial evidence for the optimal recommended supplementation dose, but most guidelines recommend around 800 IU of vitamin D daily as a maintenance dose for bone health. Despite the established benefits that vitamin D has on musculoskeletal health, it is still unclear if sufficient vitamin D and vitamin D supplementation will benefit the other common conditions. Therefore, future well-designed randomised controlled studies are still needed. [ABSTRACT FROM AUTHOR]

BACKGROUND Vitamin D deficiency is reaching pandemic levels in Europe. It is important for musculoskeletal health, and doctors are a crucial source of information to their patients. International studies have suggested that there is a knowledge gap amongst doctors with regards to this vitamin that can impact their management of its deficiency. In its attempt to assess the knowledge and management of Maltese doctors with regard to vitamin D in older adults, this study is the first of its kind in Malta. METHODS Cross-sectional survey of 847 Maltese doctors. A questionnaire assessing attitudes, practices, and knowledge about vitamin D was adapted and distributed. Descriptive statistics were used, and knowledge and management scores were devised from the literature. The relationship between knowledge and management scores was correlated, and the mean scores were compared between several independent groups clustered by gender, speciality, training, work experience, and the extent of their confidence in their knowledge of vitamin D. RESULTS The final recruited population was of 138 participants (7.4% margin of error assuming 95% confidence level). The mean knowledge and management scores were 33.22 (one can achieve a minimum score of -24 to a maximum of 68 points) and 23.64 (one can achieve a minimum of -9 to a maximum of 46) respectively. A positive correlation was found between the both of them (p <0.05), and doctors who felt very confident in their knowledge tended to score higher (p =0.010). CONCLUSIONS This study identified there is room for improvement regarding knowledge and management of vitamin D amongst Maltese doctors. Doctors that scored higher in their knowledge and management scores subjectively felt more confident in their knowledge of vitamin D. The majority of doctors (90.6%) believe there is a lack of awareness and acknowledge that more guidance is needed. Further research is required to explore whether clinical guidelines and post-graduate lectures can address this gap in knowledge of this important vitamin. [ABSTRACT FROM AUTHOR]

This study introduces the philosophies of the flâneur--a figure associated with the acts of wandering, observing, and reporting the realities of life on the city streets--to offer a critical reconsideration of a sociological perspective in writings of literary journalism. The study proposes that the literary journalist can be considered as a flâneur, or as a writer who employs the figure of the flâneur as a narrative device, to drive the production of (self-)reflective narratives. This approach is realized with a re-reading of one of New York City's most widely regarded literary journalists: Joseph Mitchell. Reading Mitchell's New Yorker profiles through a gendered lens, the article identifies Mitchell's sociologically charged investigations into the everyday experiences of men from the margins--namely immigrants, Indigenous peoples, and African Americans--as they struggle with the conflicts that shape their masculine identities. The central themes that define these conflicts are identified as the struggle with the dominant ideologies of the self-made man and breadwinner roles, the importance of homosocial relations in the shaping of masculine identity. Possibilities of alternative roles for such men appear in Mitchell's key profiles, "The Old House at Home" (1939), "The Mohawks in High Steel" (1949), and "Mr. Hunter's Grave" (1956). By re-conceptualizing Mitchell as a flâneur, that is, a wandering investigator, interpreter, and writer of the discourses of New York society during this period, 1930s-1960s, we can begin to appreciate the sociological value of Mitchell's profiles and the contribution they make to our understanding of the historical development of masculinity in the United States. [ABSTRACT FROM AUTHOR]

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The neuroleptic malignant syndrome is a rare and potentially lethal reaction which is usually associated with the use of medications with antidopaminergic properties. This article describes the case of an elderly gentleman who developed the neuroleptic malignant syndrome after withdrawal of the anticholinergic agent benzhexol (trihexyphenidyl hydrochloride), which he was taking for Parkinson's disease. The patient improved rapidly after treatment was restarted. This case adds to the evidence that antidopaminergic agents may not be necessary for the development of this syndrome, and increased awareness of this possibility is advisable in such circumstances. [ABSTRACT FROM AUTHOR]