Issue link: https://maltatoday.uberflip.com/i/1495215
6 maltatoday | SUNDAY • 19 MARCH 2023 NEWS POSTS FOR TRAINEE LAWYER WITH THE OFFICE OF THE ATTORNEY GENERAL (Jobsplus Vacancy No. 387556, Permit Nos. 429/2022) The Office of the Attorney General Agency is inviting applications for Trainee Lawyers to carry out prosecution and related duties. The selected candidates will be employed on a full-time indefinite term basis, subject to a probation period, and will be required to work for a minimum of forty hours per week. Applicants must be in possession of a Master of Advocacy degree, M.Adv.(Melit.). Applications must quote relevant Jobsplus Vacancy Reference, include a detailed CV, and should be addressed to: The Administration Office of the Attorney General, No. 53, Admiralty House, South Street, Valletta VLT 1101 or emailed to ag@attorneygeneral.mt and should be submitted by not later than Thursday 20 th April 2023. POSTIJIET TA' TRAINEE LAWYER FL-UFFIĊĊJU TAL-AVUKAT ĠENERALI (Jobsplus Vacancy No. 387556, Permit Nos. 429/2022) JAMES DEBONO ANTIBIOTIC prescriptions for children with simple colds, viral infections, minor ail- ments, and to healthy individ- uals without a fever on a "just in case" basis are "routine and the modus operandi of many practitioners". And this may be one of the main contributors to Malta's high obesity rate according to leading paediatrician Simon Attard Montalto. In a hard-hitting editorial on the Malta Medical Journal, At- tard Montalto refers to studies linking the liberal administra- tion of antibiotics to childhood obesity and calls for a more ju- dicious use of the lifesaving but potentially harmful drugs. The abuse of antibiotics is mostly linked to the increased risk of antibiotic-resistance and the potential emergence of superbugs but exposure to an- tibiotics also increases the risk of those children becoming overweight or obese. But the latter risk is still un- der-appreciated locally, even if it has been proven in a local study conducted by Dr Marwa Khaled Grada in 2020 among children aged between three and seven years of age. In the study Dr Grada showed "a sig- nificant association between antibiotic use and increased childhood Body Mass Index. Moreover, in this study, the use of antibiotics during infan- cy was found to be the best pre- dictor of increased BMI. The consumption of antibiot- ics during childhood result in an alteration in gut microbiota and the subsequent alteration of the digestive mechanisms of the bowel resulting in an increase in the absorption of short-chain fatty acids. "In effect, children whose bowel microflora is repeatedly 'altered' by antibiotic exposure, are significantly more likely to change their bowel function to one that is obesogenic". According to Attard Montal- to Malta, like other Mediterra- nean countries has a penchant for antibiotic over-use, "mostly in the context of viral infec- tions" and are often used spu- riously as a 'prophylaxis' (drugs aimed at preventing a disease) without any evidence-base. The leading paediatrician de- nounces that in Malta, antibi- otic prescriptions for children with simple colds/snuffles, vi- ral infections, minor ailments, and to healthy individuals without a fever and "just in case" are "routine and the mo- dus operandi of many practi- tioners". He concludes that a reduction in the injudicious use of anti- biotics to small children will help reduce obesity later in life, which he describes "the great- est nutritional and one of the greatest health care problems in the 'modern' era". According to a Eurobarometer survey published in November 2022 Malta registers the high- est proportion of respondents in the EU, who reported taking antibiotics in the previous 12 months. The proportion of re- spondents who took antibiotics was the highest in Malta (42%) and the lowest in Sweden and Germany (both 15%), Poland (16%) and the Netherlands and Denmark (both 18%). But in an indication that health information campaigns on anti-microbial resistance are making some headway, the survey shows a 15-percentage point (pp) increase in the pro- portion of Maltese who cor- rectly replied that antibiotics are ineffective against colds, and an 18-pp increase in the proportion who believe anti- biotics are ineffective against a virus. Antibiotic use among children linked to high obesity rate 658 women completed medical abortion, more than half already had children Leading paediatrician denounces antibiotic prescriptions for children with simple colds and minor ailments in hard hitting editorial in Malta Medical Journal KURT SANSONE MORE than half of women in Malta who completed a medical abortion after buying pills online already had children, research shows. The findings show that 53% of the 658 women who had a medical abortion between 2017 and 2021, had children and a quarter had two or more children. The research focussed on an- onymised data provided by just one online telemedicine provider, Women on Web. It was carried out by Andrea Dibben, Isabel Sta- bile, Rebecca Gomperts and James Kohout and published on BMJ Sexual & Reproductive Health, an international journal. The number of women who had a medical abortion could be high- er since there are other reputable online telemedicine providers not included in the study. During the five-year period, 1,090 pregnant people requested at-home medical abortion from Women on Web but around 40% cancelled because they chose to continue the pregnancy, had a miscarriage or decided to travel overseas for an abortion. Abortion is illegal in Malta, mak- ing it the only EU member state with an outright ban. Parliament is currently discussing the introduc- tion of two limited exceptions that would allow doctors to terminate a pregnancy if the woman's life or health is in danger. Women who seek an abortion have to travel abroad to get a sur- gical abortion, or procure abortive pills online and self-medicate with the threat of criminal action hang- ing on their head. The study shows that the pills Mifepristone and misoprostol were shipped to 658 women. More than 90% reached out to Women on Web at less than seven weeks' gestation. The analysis found that among those completing a medical abor- tion, 63% did not use contracep- tion, and in 30% of cases there was contraception failure. Just over half (53.3%) were aged between 25 and 34, nearly a quar- ter (22%) were women 35 years and over, and another quarter (24.3%) were under 25. The main reason given for hav- ing a medical abortion was 'not be- ing able to have a child at this point in their life' and 'no money to raise a child, 69% and 34% respectively. "Contrary to the prevailing ste- reotype that most women who ac- cess abortion are young and pro- miscuous, most women seeking abortion through telemedicine in Malta were in their late 20s or ear- ly 30s and were already mothers, and their main reason for access- ing abortion was that they felt their family was complete, or they could not cope with another child," the researchers said. They also noted that lack of use of contraception rather than con- traception failure was the main reason why women within the old- er cohorts became pregnant. "This study highlights the need for better family planning services and the promotion of more reli- able methods of contraception," they added. The study showed a steady year- ly increase in abortive medicine shipped to Maltese recipients with a marked hike during the pandem- ic years 2020 and 2021 when travel restrictions prevented people from going abroad. Abortive medicine shipped to Malta The figures come from Women on Web, an online medicine provider