/library/oar/handle/123456789/104027 2025-11-11T04:40:13Z /library/oar/handle/123456789/101907 Title: The impact on health of a war in Europe Abstract: No sooner than the pandemic appeared to have reached some semblance of control (barring the emergence of yet another, and potentially more aggressive variant), Russia launched an all-out invasion of its neighboring country, Ukraine. The dire impact on lives, infrastructure and property to the Ukrainian people has already been enormous and shows no signs of abating. Indeed, the possibility of this war (how else can it be described?) escalating and ‘spilling over’ to other adjoining countries is very real and seriously raises the spectre of yet another world war, again with its epicentre in Europe. Even without further escalation, the destabilisation of the Ukrainian population has already resulted in the greatest refugee crisis facing Europe, presently being ‘managed’ by the impressive rallying of support being offered by many European countries, within and outside of the EU. Unless there is a timely cessation of hostilities and the senseless loss of life and wanton destruction in Ukraine stops, this refugee crisis threatens to overwhelm the support services. Poland, geographically a direct neighbour of Ukraine and, to-date, the greatest recipient of refugees has asked other countries to offload some of its burden 1. To-date, this has occurred, for example, for specific subgroups with special health needs such as children receiving treatment for malignant diseases who have been transferred onwards to other countries including Malta.2 The continued disruption or total breakdown of community-based health services such as vaccination programmes in Ukraine (for now) will risk the emergence of hitherto controlled infections and encourage the emergence of new pathogens.3 New COVID variants are certainly not exempt from this scenario. 2022-01-01T00:00:00Z /library/oar/handle/123456789/101901 Title: Sharp increase in traffic fatalities in first quarter of 2022 in Malta Authors: Piscopo, Tonio; Borg Myatt, Jeremy; Grech, Victor Abstract: INTRODUCTION: Road traffic accidents (RTAs) are a leading cause of death and disease burden worldwide. Malta experienced a declining trend in RTA mortality over the past years albeit with a surge at the time of writing. This study was carried out to analyse trends in RTAs in Malta.; METHODS: RTA statistics by quarter were obtained from the website of the National Statistics Office for 2013-2021. Records for Quarter1 (Q1) 2022 were compiled from media publications. Regression was used to estimate expected values for RTA fatalities for Q1 2022 and 2022 totals, particularly in relation to the targets laid out in the Road Safety Strategy Malta 2014-2024. The type of accident was also analysed from 2017.; RESULTS: From 2013, a transient dip in annual fatalities occurred in 2014, with a steep incline to 2016, followed by a highly significant decline which was reversed sharply in Q1 of 2022. For Q1 2022, expected fatalities were <1 but there were actually 10 fatalities (13 by April 2022), when expected fatalities for all of 2022 were <8. The highest fatalities were aged 18-40 years (n=47), followed by age >59 years (n=38). In some years, up to 75% of all fatalities were motorcycle/e-bicycle riders.; CONCLUSION: Road safety should be a national priority until Vision Zero is reached. Better data collection and analysis should shed light on causes and solutions to prevent RTAs. The current National Road Safety Strategy, with emphasis on education, engineering and enforcement remains relevant, but there is little evidence that its targets are being achieved. More must be done to guarantee road safety to users in Malta. 2022-01-01T00:00:00Z /library/oar/handle/123456789/101891 Title: Myocarditis in Malta in the COVID-19 vaccination era : a population-based study Authors: Grech, Victor; Distefano, Sandra; Grech, Elizabeth; Calleja, Neville Abstract: BACKGROUND: Vaccination against COVID-19 is crucial for controlling this scourge. COVID/vaccination deniers often rationalise their unfounded fears by citing rare vaccination side-effects. One of the most frequently cited side effects is myocarditis, especially in younger persons. Malta has very high vaccination rates. This study was carried out to ascertain whether admissions to hospital for myocarditis changed in any during the vaccination rollout, up to October 2021, when 83.4% of Malta’s population of circa half a million had had their first 1st dose.; METHODS: Malta is served by one large regional hospital (Mater Dei Hospital). Anonymous data for admissions with a diagnosis of myocarditis (ICD I40, I41, I51.4) were obtained for 01/2016-10/2021. Myocarditis discharges and 95% confidence intervals were plotted for 2016-2020. Myocarditis discharges for Jan-Oct 2021 were plotted separately.; RESULTS: There were no outlier values for myocarditis discharges in either direction for any age for any of the two sexes.; CONCLUSION: Myocarditis, independent of vaccination, is commonest in young males, half resolving and some developing dilated cardiomyopathy, possibly leading to transplantation or death. The ongoing mass vaccination with novel messenger RNA vaccines resulted in reports of myocarditis in male teens, this being a rare side effect. The lack of significantly increased rates of myocarditis admission in any age age/sex group in Malta confirms that only rarely, myocarditis may be temporally associated with COVID vaccination which almost invariably runs a benign course and that this risk is very low, far lower than myocarditis due to actual COVID infection. 2022-01-01T00:00:00Z /library/oar/handle/123456789/101884 Title: An analysis of the effect of educational environment on burnout : a cross-sectional observational study of trainee doctors at the Malta Foundation Programme Authors: Grech, Marco Abstract: BACKGROUND: A suboptimal educational environment has been associated with effects on both patient care and trainee wellbeing. Burnout is associated with negative effects at both the personal and the institutional level. The role of the educational environment in the development of burnout has been studied in many countries. This is the first such study in a Maltese population.; METHODS: The aim of this study was to analyse the effect of the educational environment on the prevalence of burnout among doctors within the Malta Foundation Programme. A cross-sectional observational methodology using Google Forms was adopted. The questionnaire was distributed to all Foundation and Extended Foundation doctors. The Postgraduate Hospital Educational Environment Measure (PHEEM) was used to assess the educational environment as perceived by the Foundation doctors. The Copenhagen Burnout Inventory (CBI) was used to analyse burnout among Foundation doctors. SPSS v25.0 was used for statistical analysis using a threshold for statistical significance of p < 0.05 and 95% confidence interval.; RESULTS: Both PHEEM and CBI showed good reliability scores. The educational environment was deemed as more positive than negative with ample room for improvement. High burnout rates were recorded. There was a highly significant negative correlation between autonomy, teaching and social support, and personal, work-related and client-related burnout. The results show that there is a significant association between the learning environment and burnout.; CONCLUSION: The high level of burnout identified is a cause for concern and calls for action aimed at improving the wellbeing of these young doctors. An improved educational environment can improve the quality and safety of patient care, as well as improve the mental and physical health of the trainees. 2022-01-01T00:00:00Z