/library/oar/handle/123456789/1035 Sat, 07 Nov 2026 06:21:20 GMT 2026-11-07T06:21:20Z /library/oar/handle/123456789/150457 Title: Risk factors for complications in cutaneous squamous cell carcinoma and proposal of a simplified follow-up strategy, making use of available healthcare resources Authors: Micallef, Daniel; Dimech, Alicia; Pisani, David; Camilleri, Liberato; Scerri, Lawrence Abstract: Cutaneous squamous cell carcinoma (cSCC) is a common malignancy, generally cured by surgical excision. A minority of such tumours recur, metastasize or even cause death. The 2021 British Association of Dermatologists (BAD) guidelines outline high-risk features that are used to guide the follow-up of patients after a primary cSCC. The aims of this study were to identify histological features of cSCC that are significantly associated with the development of complications, and to compare the sensitivity, specificity and number of appointments required to follow-up patients using different follow-up criteria. [extract] Sun, 01 Jan 2023 00:00:00 GMT /library/oar/handle/123456789/150457 2023-01-01T00:00:00Z /library/oar/handle/123456789/148842 Title: The referral incidence of otitis media in Maltese children with the developmental difficulties Abstract: Introduction: Otitis media (OM) is a common condition of childhood characterised by inflammation of the mucous membrane of the middle ear cleft. Since the condition is not life-threatening it may not be given its due attention. Late and missed diagnosis of OM increases the risk of medical complications, hearing, speech and/or language acquisition difficulties, learning and behavioural challenges as well as social interaction issues. It is estimated that at least 2 out of 3 children will have at least one episode of OM by 3-years of age. There is evidence that children with developmental impairment such as craniofacial dysmorphias, are more at risk of having OM. This paper reports on the referral incidence of OM in children with a developmental condition.; Methods: Data was collected retroactively from a database of routine referrals of around 300 children to the Audiology Department at the State general Hospital, by the Child Development Assessment Unit in Malta. The age of the children ranged between 5 to 151 months (mean age 50.01).; Results: The referral incidence of OM in the children with developmental challenges was more than 50%. The condition was more present in younger than older children and the associated hearing acuity worse in the subgroup of children with OM.; Conclusion: The findings confirm the expected high incidence of OM in children with developmental difficulties as well as associated hearing difficulties. This calls for an awareness programme and a protocol for early detection of children suffering from OM, particularly those with co-morbidities, and to provide timely intervention. Mon, 01 Jan 2018 00:00:00 GMT /library/oar/handle/123456789/148842 2018-01-01T00:00:00Z /library/oar/handle/123456789/148793 Title: Development, content validation and pilot reliability testing of the midwives' perspectives towards birth plans questionnaire Authors: Agius, Elisa; Borg Inguanez, Monique; Spiteri, Georgette Abstract: Introduction: A birth plan is a fundamental tool for promoting autonomy during childbirth and woman-centred care. Despite its recognised benefits, there is a notable gap in the literature addressing midwives' perspectives and attitudes towards their use, with research being predominantly qualitative and quantitative data remaining scarce due to a lack of rigorously developed quantitative instruments addressing this topic. To address this, the Midwives' Perspectives Towards Birth Plans Questionnaire (MBPQ) was developed to provide a content-validated descriptive instrument to profile midwives' perspectives regarding the development and implementation of birth plans into clinical practice. Methods: The MBPQ was conceptualised as a multidimensional descriptive inventory comprising formative content domains, rather than a reflective psychometric scale intended to generate a single aggregate score. Instrument development followed a structured three-stage process. Following item generation from a critical literature review, face validity was established through review by academic professionals. Content validity was then quantified by six subject-matter experts using the Content Validity Index (CVI), the modified Kappa statistic to assess inter-rater agreement, and the Content Validity Ratio (CVR). A pilot study at a public hospital in Malta assessed feasibility (n = 15) and test-retest reliability (n = 13) using Kappa and Kendall's tau-b statistics. Results: Pilot testing demonstrated satisfactory feasibility, with a 100% response rate and an average completion time of approximately 10 min. Most closed-ended items demonstrated acceptable temporal stability across the test-retest interval, with moderate-to-excellent agreement coefficients observed for the majority of items. Conclusions: The MBPQ represents an initial content-validated descriptive framework for exploring midwives perspectives and attitudes regarding the development and implementation of birth plans. The instrument demonstrated strong content validity, high expert agreement, satisfactory feasibility and acceptable temporal stability across most items. The MBPQ may support clinical auditing, service evaluation, and exploratory research examining factors that influence birth plan implementation within maternity care settings. Further testing in broader and more diverse populations may support future refinement and contextual adaptation of the instrument. Thu, 01 Jan 2026 00:00:00 GMT /library/oar/handle/123456789/148793 2026-01-01T00:00:00Z /library/oar/handle/123456789/148374 Title: Lessons learned : building the architecture for a legionella impact spectrum for Malta Authors: Rahimpour, Layla; Camilleri, Liberato; Gary, Lee P. Jr. Abstract: Our study was planned and launched with explicit motivation to identify the triggers that could launch a Legionella Disease outbreak in Malta, enjoying a boon with tourism. The triggers would be used to prepare a first-ever Legionella Impact Spectrum. Our research has generated early surprises, and we share them as Lessons Learned, but not easily. Our first Lesson Learned was that our work was stymied by missing data in the Maltese Annual Notifiable Infectious Disease Reports (2010-2024), a vital database, essential for surveillance and adequate preparedness. We have undertaken a search to fill the data gaps. We share our early analysis of Legionnaire cases and deaths in the Maltese Annual Reports for 2010-2024. Our surprise finding is a latent spike in Legionnaire cases for 2023-2024 --and gaps in deaths for the same years. Using data from the Maltese Annual Reports, we can project that the likelihood of someone dying (our Chance of Death) after contracting Legionnaire’s Disease in Malta falls in the range of 3.9% to 12.4%. Thu, 01 Jan 2026 00:00:00 GMT /library/oar/handle/123456789/148374 2026-01-01T00:00:00Z