/library/oar/handle/123456789/317 2026-06-13T18:05:07Z /library/oar/handle/123456789/147350 Title: Editorial : teaching for confidence Authors: Abela Fiorentino, Trevor Abstract: Healthcare education has made substantial strides in ensuring that students develop into competent professionals. The acquisition of knowledge and technical competence have been long prioritised in healthcare education, with students being rigorously examined on their ability to recall information and perform clinical tasks. As such, healthcare curricula and educational frameworks are intentionally designed to ensure that graduates emerge as knowledgeable and competent practitioners (Monrouxe & Bloomfield, 2023). However, despite the strong emphasis on competence within healthcare education, uncertainty and hesitation remain prevalent among new graduates. Many appear to lack the professional confidence required for independent practice, even after being certified as knowledgeable, skilful, and clinically competent (Alharbi et al., 2023; Carpio et al., 2025; Najafi & Nasiri, 2023). [excerpt] 2026-01-01T00:00:00Z /library/oar/handle/123456789/147307 Title: Effects of Pilates on low back pain : a scoping review Authors: Falzon, Jeanette; Agius, Tonio P.; Sciriha, Anabel Abstract: The purpose of this scoping review was to map and synthesise the existing literature on Pilates-based interventions for low back pain (LBP), with particular attention to reported outcome domains, programme characteristics, and delivery context, and to identify gaps to inform future research and clinical practice. This scoping review was conducted in accordance with the Joanna Briggs Institute methodology and the PRISMA-ScR framework. Searches were performed in August 2025 using Google Scholar and HyDi (including Medline, Embase, CINAHL, Cochrane Library, PEDro, and Scopus). Eligible studies included randomised controlled trials and systematic reviews or metaanalyses involving adults with non-specific or subacute LBP in which Pilates was the primary intervention. Data were charted on population characteristics, intervention format, dose, supervision, comparator, and reported outcomes across clinical and psychosocial domains. Findings were synthesised narratively. The literature predominantly reports outcomes related to pain intensity, functional disability, and health-related quality of life, with fewer studies assessing psychosocial variables such as kinesiophobia or fear of movement. Pilates interventions varied substantially in delivery format (mat – versus equipment-based), frequency, duration, and level of supervision. Across studies, Pilates was commonly compared with minimal intervention or other exercise approaches, with short-term improvements in patient-reported outcomes frequently described. However, heterogeneity in intervention protocols, outcome measures, follow-up duration, and reporting of instructor qualifications limited cross-study comparability. Reporting of mechanistic outcomes and long-term follow-up was sparse. This scoping review demonstrates that the current literature on Pilates for LBP is characterised by diverse intervention approaches and outcome reporting, with a primary focus on pain and disability outcomes. While Pilates is commonly positioned as a guideline-consistent exercise option, important gaps remain regarding patient selection, instructor expertise, mechanistic pathways, and longterm outcomes. Future research should prioritise standardised reporting of intervention characteristics, broader biopsychosocial outcome assessment, and clearer description of delivery context to support more definitive evaluations. 2026-01-01T00:00:00Z /library/oar/handle/123456789/147304 Title: Neuromuscular electrical stimulation in respiratory conditions : a systematic review Authors: Debattista, Randall; Agius, Tonio P.; Sciriha, Anabel Abstract: Neuromuscular Electrical Stimulation (NMES) has emerged as a promising adjunctive intervention in the management of respiratory conditions, particularly chronic obstructive pulmonary disease, where skeletal muscle dysfunction contributes to reduced functional capacity and poor quality of life. This systematic review synthesises evidence on Neuro Muscular Electrical Stimulation applications in both acute and chronic respiratory contexts, focusing on its effects on peripheral muscle strength, exercise tolerance, pulmonary function, and health-related quality of life. A structured literature search was conducted across PubMed, Google Scholar and MEDLINE and CINAHL accessed via the HyDi platform, covering publications from inception to 2025. In PubMed, both Medical Subject Headings (MeSH) and free-text terms were used, while database-specific subject headings and keywords were adapted for MEDLINE and CINAHL. Eligible studies included randomised controlled trials, systematic reviews, and meta-analyses investigating NMES in patients with COPD, acute exacerbations, or critical illness. A total of 61 articles were reviewed from which 5 were chosen. Key outcomes extracted included muscle strength, exercise capacity, pulmonary function indices, Health Related Quality of Life, and adverse events. Methodological quality and risk of bias were critically appraised to contextualise findings. Synthesis of the included meta-analyses demonstrated that NMES yields significant improvements in peripheral muscle function and functional capacity. Pooled results indicated a statistically significant increase in the six-minute walk distance (6MWD) of approximately 35–40 m following NMES compared with control interventions and a marked enhancement in quadriceps force production, particularly in severely deconditioned patients. Furthermore, systematic review data confirmed clinically meaningful improvements in health-related quality of life (HRQoL) and a reduction in exertional dyspnoea. A methodological appraisal via AMSTAR-II revealed high confidence in the systematic reviews, although the absence of pre-registered protocols was noted as a minor methodological deficit. NMES represents a safe and feasible adjunct to pulmonary rehabilitation and critical care, particularly for patients unable to engage in conventional exercise training. Nevertheless, long-term effectiveness, cost-effectiveness, and patient-centered outcomes remain underexplored. Future research should focus on protocol standardisation, integration with wearable and tele-rehabilitation technologies, and robust multicenter trials to clarify its role in routine respiratory rehabilitation. 2026-01-01T00:00:00Z /library/oar/handle/123456789/147303 Title: Stress and lifestyle behaviour changes in Maltese university students during exams : a cross-sectional study Authors: D’Aponte, Gabriella; Copperstone, Claire Abstract: Examination periods are known to be stressful for university students, often leading to unhealthy lifestyle behaviour changes. This local study aimed to assess the levels of self-perceived stress and evaluate the potential link between any self-reported dietary and lifestyle changes and stress during one examination period for University of Malta (UM) students. A cross-sectional study was conducted using a quantitative, anonymised survey. design targeting students aged 18 years and above. Data were collected on dietary and lifestyle habits and changes, and perceived stress levels were measured using the Perceived Stress Scale, PSS4, during the January 2024 exam period. Ethical approval was obtained from the Faculty Research Ethics Committee (FREC) at the University of Malta (Approval ID: xxx). Data were analysed using SPSS (IBM®version 29), with Chi-square tests applied to assess potential associations between categorical variables. 196 respondents returned the survey. Mostly were female (79.1%) and aged 18-25 years (80.6%). The majority reported increased consumption of sugary (73%) and salty snacks (54.6%), while 40.3% reported higher sugary drink consumption. Additionally, 50% of students reported meal skipping, and 51.5% indicated decreased physical activity. Adverse sleep patterns were reported by most (81.1%) of participants. During exams, nearly half of the participants sometimes felt unable to control key aspects of their lives, and another 29.1% felt this often. The findings highlight some negative changes in dietary habits and lifestyle behaviours during the examination period. These results underscore the importance of promoting healthy lifestyle strategies to support students during challenging times. 2026-01-01T00:00:00Z