CDERN actively participates in conference presentations to share its research findings, exchange knowledge with experts, and stay informed about the latest developments in its field. Presenting at conferences helps increase the visibility of its work, build professional networks, and establish collaborations with researchers, healthcare professionals, and organizations. These events also provide valuable feedback on ongoing projects, support professional development, and contribute to the advancement of evidence-based practices and innovation.
Introduction: Te parallel existence of obesity and climate change presents two escalating global threats affecting human well-being and environmental stability. Small nations face heightened vulnerability due to geographic isolation, reliance on imported food, and susceptibility to climate events. While a syndemic framework has been proposed globally, empirical data on these interactions in small states remains scarce. This systematic review aims to identify, and evaluate the existing evidence on the bi-directional relationship between obesity and climate change in small countries.
Methods: A systematic review (PROSPERO: CRD420251011029) was conducted following PRISMA 2020 and SWiM guidelines. Five databases were searched for studies examining the interplay between obesity risk and climate change in small countries. Eligible studies were narratively synthesized, with quality assessed using established criteria.
Results: Of 3,471 records screened, only four studies met the inclusion criteria (Figure 1, Table 1)1-4. These focused solely on Pacific and Caribbean small island developing states (Table 2). Shared systemic drivers were identified, linking the crises via disrupted agriculture, food insecurity, and reduced physical activity, while rising obesity contributes to environmental stress through demand for high-carbon, ultra-processed foods and strain on healthcare, as illustrates in reciprocal feedback loops adapted from An et al.(2017) (Figure 2).
Conclusions: Te co-occurrence of obesity and climate change in small countries functions as a syndemic, rooted in complex ecological, social, and cultural determinants. Te stark absence of research on this topic, especially outside of the Pacific and Caribbean regions, is a critical gap that demands immediate attention. Effectively tackling this dual crisis necessitates implementing integrated and culturally appropriate policy responses aimed at restoring traditional food knowledge, encouraging sustainable agroecological practices, and designing co-benefit strategies that simultaneously advance public health outcomes and climate adaptation efforts. Future research must urgently expand to other small-countries.
Introduction: Obesity represents a major public health challenge in Europe and is strongly influenced by dietary behaviours and the food environment. In Malta, where the prevalence of obesity and obesity-related non-communicable diseases remains among the highest in Europe, population-level strategies that support healthier food choices are essential. Front-of-pack labelling (FOPL) is designed to provide accessible nutritional information at the point of purchase and has been proposed as a key policy tool to support obesity prevention. Tis study explored awareness, comprehension and attitudes towards FOPL among adults living in Malta, with a focus on its potential role in promoting healthier dietary choices relevant to obesity prevention.
Methods: A mixed-method, cross-sectional study was conducted using an anonymous online questionnaire distributed via social media. Adults aged 18 years and older were invited to participate. Te survey collected demographic information and assessed familiarity with, understanding of and attitudes towards commonly used FOPL systems in Malta, namely Nutri-Score and Guideline Daily Amounts (GDA). Participants’ ability to interpret FOPL and apply this information when comparing food products was evaluated. Statistical analyses examined associations between demographic characteristics and engagement with FOPL.
Results: A total of 600 adults participated. While most participants recognised the importance of FOPL for guiding food choices, 62.17% reported not routinely consulting FOPL during grocery shopping. Participants generally demonstrated good understanding of the Nutri-Score system, whereas interpretation of GDA labels was more variable and dependent on educational attainment. Females and individuals with higher education levels were more likely to review nutritional information. When interpreting GDA labels, participants most frequently prioritised calorie and fat content, reflecting awareness of dietary factors associated with obesity risk. However, fewer than half of participants reported that FOPL information was easy to understand, highlighting potential barriers to effective use.
Conclusion: Front-of-pack labelling has the potential to support healthier food choices and contribute to obesity prevention efforts in Malta, but its impact is limited by inconsistent use and varying levels of comprehension across population groups. Strengthening FOPL literacy through targeted public health education and adopting intuitive, easily interpretable labelling formats may enhance its effectiveness, particularly for individuals living in environments with a high burden of obesity. Integrating FOPL within broader, equity-focused obesity prevention strategies may help translate nutritional awareness into sustained behavioural change.
Background: In 2016, a national Health Examination Survey performed in Malta showed that 70% of adults aged 18–70 years were overweight or obese [1]. From a patient-centred public health perspective, understanding how body weight evolves over time, particularly during major societal disruptions such as the COVID-19 pandemic, is essential to inform effective prevention strategies [2].
Methods: We followed a nationally derived sub-cohort of adults (n=215) over a 10-year period to examine longitudinal changes in body mass index (BMI), COVID infection status, and selected health behaviours. Analyses focused on changes in BMI trajectories and behavioural transitions. Paired and independent T-tests were used to analyse appropriately. Tis included COVID infection status and behavioural changes.
Results: Across the 10-year follow-up, 55.81% of participants experienced an increase in BMI, 16.74% remained stable, and 27.44% showed a decrease, with an overall significant increase in BMI (p < 0.001). A confirmed COVID-19 infection was associated with an increase in BMI over time (p=0.037); however, this association was no longer statistically significant after adjustment for age and sex in linear regression analyses (p = 0.079). Among males, an increase in BMI was associated with a significant shift toward more frequent alcohol consumption over time (p=0.009), whereas females with increasing BMI demonstrated a reduction in alcohol intake (p=0.004). Participants with increasing BMI also reported a decline in smoking prevalence over time, observed in both males (p < 0.001) and females (p< 0.0001).
Conclusions and Public Health Implications: Our findings indicate that bodyweight trajectories are dynamic and shaped by interacting biological, behavioural, and contextual factors. Te observed association between COVID-19 infection and BMI over time is suggestive but inconclusive, underscoring the need for further research before informing metabolic health surveillance in pandemic preparedness and recovery planning. The coexistence of favourable behaviours, such as reduced smoking, alongside less favourable patterns, including increased alcohol consumption among men, emphasises the need for integrated, sex-sensitive public health interventions. Malta and other European small-states with a high obesity burden require prevention strategies which adopt a life-course approach. Weight management together with broader lifestyle behaviours need to be addressed over time, ensuring that care pathways remain responsive to patients’ evolving needs. Tis will tie in to the European Union’s cardiovascular health plan: The Safe Hearts Plan which aims to significantly reduce the burden of cardiovascular diseases in Europe [3].
Background: Diabetes mellitus (DM) is an established risk factor for fragility fractures, yet its role in spinal fractures, particularly in small-state populations, is less studied. Malta, a small Mediterranean island with a multi-cultural population of 500,000 adults, with a known high diabetes prevalence rate, has only one-state hospital, making national studies feasible and relatable to surrounding countries and regions. We investigated national fracture patterns among DM patients in Malta and the relationship between DM and single-level vertebral fractures.
Methods: We retrospectively analyzed spinal fracture admissions (2019–2024) at Mater Dei Hospital, Malta. Data on demographics, fracture type (cervical, thoracic, lumbar or sacral), fracture level (single vs. multiple), and underlying comorbidities were extracted from hospital records. Patients were stratified whether they suffered from DM or not. Binary logistic regression assessed associations between DM and single level versus multi-level fractures, adjusting for age and sex.
Results: Among 640 spinal fractures (Table 1), 18.9% occurred in individuals living with DM, with the majority affecting women (p=0.001). Single-level lumbar fractures were commonest among individuals living with DM (41.3%), with 44.9% being women. Comparable fracture patterns were seen among individuals without diabetes (37.6%), including women (43.2%). Regression analyses indicated that living with diabetes was positively associated with single-level fractures (OR: 2.23, 95% CI 1.36–3.66, p=0.002). This association remained statistically significant, although attenuated, after adjustment for age and sex (odds ratio 1.92, 95% CI 1.15–3.19, p=0.013).
Conclusion: DM independently increases the risk of single-level spinal fractures, particularly lumbar vertebral fractures, with female predominance. These findings reinforce the link between diabetes and skeletal fragility, suggesting the need for enhanced bone health monitoring, fracture risk screening, and targeted prevention strategies in diabetic populations.
Background: The increasing prevalence of metabolic diseases such as obesity, hypertension and diabetes pose a serious public health challenge in Malta. ‘SAHHTEK - The University of Malta Health and Wellbeing study’ (2014 – 2016), was the last representative national cross-sectional study conducted locally. Establishing temporal relationships between different risk factors and lifestyle choices that may lead to or exacerbate metabolic diseases requires a longitudinal cohort study. This study aims to determine the temporal relationships between various contributing factors, such as age, sociodemographic and socioeconomic characteristics, and lifestyle habits, and the development of metabolic diseases, with an emphasis on overweight and obesity. It will also provide evidence-based data that can be used for primary health care intervention protocols for prevention and management for some of the most common morbidities affecting the Maltese population in the post-COVID era.
Methods: The original SAHHTEK population sample was obtained using data from the identity cards and passport registry targeting people living in Malta and Gozo for at least 6 months. A single stage randomisation and stratification process according to age (18 – 70 years), gender and locality was carried out. The current longitudinal cohort study follows a subset of the SAHHTEK population 10 years after the original study and is still ongoing. The sample size was calculated based on the original study population of 1861, a 95% confidence interval and a ±5% margin of error to give a sample size of 319. This was rounded up to 455 to account for attrition. Informed written consent is obtained on arrival. A validated questionnaire which collects data on lifestyle, medical history and long COVID symptoms is administered. A physical examination is then conducted which includes measuring participants’ blood pressure, waist circumference, height, and weight. Finally, blood samples for complete blood count, renal profile, fasting blood glucose, lipid profile, HbA1C and liver function tests are collected. The main limitation of this method is that the selection of a small sub-sample from the original study population results in a limited overall study size, which may reduce the statistical power of the study and increase its vulnerability to participant refusal or loss to follow-up.
Results: 400 participants out of the 455 total sample population have been contacted. 234 have attended the study, 47 have accepted to attend but have not yet had an appointment, 37 were lost to follow up, 5 passed away during the data collection period and 88 refused to participate. The majority of those who accepted to participate were female (59%). The largest proportion of participants were aged 55-64 (26.9%). At 30.3%, secondary school was the most commonly attained highest level of education. The majority of attendees were employed (64.4%). NUTS statistical regions of Malta were used, with the largest proportions from the Northern Harbour (24.4%), Southern Harbour (21.4%), and Northern districts (18.8%).
Conclusion: This study will investigate the lifestyle, demographic, medical, and environmental determinants of overweight and obesity as well as other metabolic conditions in Maltese adults over 10 years.
Background: Front-of-pack labelling (FOPL) provides accessible nutritional information that can guide consumers towards healthier food choices and help reduce the risk of non-communicable diseases. However, no prior research has examined FOPL understanding in Malta. This study assessed Maltese adults; attitudes, perceptions, and knowledge of FOPL.
Methods: An anonymous, online cross-sectional survey was distributed via social media platforms. Collected data included demographic variables, self-reported familiarity with FOPL, and specific knowledge related to the Nutri-Score and Guideline Daily Amount (GDA) systems. Statistical analyses, including Chi-square and Fisher’s exact tests, were conducted to examine associations between FOPL usage, engagement frequency, and familiarity, with stratification by gender and educational level.
Results: Among the 600 participants, 62.17% reported not reading FOPL during shopping, with significant variations across demographics. Women reported examining nutritional information more frequently than men (p=0.007) and demonstrated greater familiarity with GDA, whereas men showed a preference for the Nutri-Score (p=0.031). Participants with higher education levels reported more frequent use of FOPL (p=0.006) and consulted GDA more often, while those with lower education relied more on Nutri-Score (p=0.014). Despite 85.83% of participants acknowledging the importance of FOPL, only 43.67% found them easy to understand. Participants demonstrated proficient understanding of the Nutri-Score, with 79.67% accurately interpreting its letter grades and 71.17% correctly identifying the healthier product from two options. When interpreting GDA, nearly half of the respondents (46.00%) prioritized calorie content as the principal determinant of a products
healthfulness.
Conclusion: Familiarity and use of FOPL in Malta vary significantly across different demographic groups. These findings highlight the need for targeted public health campaigns to improve understanding of these labels, support better food choices, and ultimately improve health outcomes in the population. It is therefore recommended to implement standardised FOPL systems to promote equitable comprehension across diverse demographic groups.
Aim: To evaluate the prevalence of anxiety and depression among Doctor of Medicine and Surgery (MD) students in Malta and examine their help-seeking behaviours.
Methods: A cross-sectional anonymous online survey was distributed to all students enrolled in the MD course at the University of Malta. Standardised tools (GAD-7 and PHQ-9) were used to assess anxiety and depression. Descriptive and inferential statistics (Chi-square tests, prevalence ratios, and confidence intervals) were used to analyse the data.
Results: Out of 263 respondents (response rate: 55%), 46% had moderate-to-severe anxiety and 34.6% had moderate-to-severe depression. The highest levels of anxiety and depression were reported by MD2 (25.5% anxiety; 9.8% depression) and MD5 students (29.3% anxiety; 12.9% depression). Female students reported significantly higher mean anxiety (GAD-7: 9.68) and depression (PHQ-9: 9.02) scores compared to males. Help-seeking behaviour was limited: only 28.6% had accessed psychological support during medical school, only 6.8% used national mental health help-lines, and 12.4% were on psychiatric medication, despite over 60% of participants reporting feeling a failure. Reported barriers of help-seeking included perceived stigma, lack of time, and institutional disorganisation. Fifth-year students demonstrated the highest help-seeking rates.
Conclusion: This study highlights the need for improved early screening, better promotion of mental health services, and structural reforms within the Maltese medical education system. Despite the availability of on-campus support, barriers persist, reflecting wider systemic and cultural issues that hinder help-seeking.
Background: SAHHTEK 2.0 is a longitudinal follow up study of the ‘SAHHTEK Study’ carried out between 2014 and 2016 which aims to explore the development of obesity and its associated risk factors within the Maltese adult population and assist in building scientific evidence to direct preventive public health policies. Carrying out a longitudinal cohort study in a small country is not without its particular set of challenges. This abstract outline participants’ barriers to engagement and strategies used to mitigate these.
Methods: The original SAHHTEK population sample was randomly obtained using data from the identity cards and passport registry targeting people living in Malta and Gozo for at least 6 months that were aged between 18 and 70 years. The current longitudinal cohort study follows a subset of the SAHHTEK population 10 years after the original study and is still ongoing. Participation involves answering a validated questionnaire which collects data such as lifestyle, medical history and long COVID symptoms, measuring participants’ blood pressure, waist circumference, height, and weight and finally, bloodletting. Participants are contacted by post and asked to confirm or cancel their appointment by contacting the primary investigator by phone. Reasons for refusal to attend were recorded.
Results: 51.5% (n=234) participants out of the 455 total sample population have attended the study thus far. 8.1% (n=37) of the total sample population were lost to follow up, 1.0% (n=5) passed away during the data collection period and 19.3% (n=88) refused to participate. 33.0% (n=29) of those who refused had taken blood tests close to their proposed appointment and did not wish to attend, 28.4% (n=25) did not give a reason for nonparticipation, 12.5% (n=11) had ongoing medical issues, 8.0% (n=7) had work commitments and another 8.0% (n=7) refused due to caregiving duties. 2.3% (n=2) invitees refused in view of personal reasons and another 2.3% (n=2) refused as they were care home residents. 1.2% (n=1) experienced vasovagal syncope in the previous study and declined to participate in this study for that reason, and another 1.2% (n=1) refused on the basis that bloods would be drawn. 3.4% (n=3) of potential participants had issues with transportation and could not be accommodated. 30.7% (n=27) of refusals were over the age of 70 and 59.0% (n=52) were female. According to data from the initial SAHHTEK study, 27.3% (n=24) of those who refused were from the Southern Harbour region, 43.2% (n=38) had completed secondary school and 43.2% (n=38) were obese and 31.8% (n=28) were overweight.
Conclusion: A relatively small sub-sample from the original study population was selected for practical purposes. The limited study size makes strategies to boost participation essential. Participants were offered various dates and times of day as well as different venues that would make attending the study as convenient as possible. This study is still ongoing and examining the pitfalls
and barriers to participation will benefit similar studies if SAHHTEK 2.0 is to be used as a template
in future both locally, and in countries with a similar population demographic distribution.
Introduction: Adolescent idiopathic scoliosis (AIS) is a condition which predominantly affects10–18-year-olds and is described as a lateral curvature of the spine (Cobb angle >10 degrees) with no underlying cause. This study aims to assess the level of knowledge regarding AIS among secondary school teachers across various subject specializations and years of experience, given their role in interacting with and potentially identifying adolescents at risk.
Methods: A structured online anonymous questionnaire was disseminated among several state, church and independent secondary schools across Malta. The questionnaire included demographic and AIS related questions including development, sex predominance, screening modalities and treatment. Descriptive analysis was carried out to establish frequencies and categorise teachers according to their teaching subjects and years of experience. Analytical analysis was utilized to perform Fisher’s exact test for 2x2 contingency tables. Chi squared test was used for larger values or for tables exceeding 2x2. For both tests, a p value of p <0.05 was considered significant.The teachers were scored based on the amount of AIS related questions they answered correctly. A correct answer rewarded them with 1 point while an incorrect answer received zero points, with a maximum possible score of X. Each teacher was then scored as either having high (≥ 50%) or low knowledge (<50%).
Results: A total of 44 teachers participated, 84.62% of teachers (95% CI: 0.57 to 0.97) scoring low knowledge were non-science teachers. The science teachers answered more AIS knowledge-oriented questions correctly compared to their colleague’s example: age of AIS development (72.73% vs 63.64%, p=0.719), “does untreated scoliosis lead to complications” (81.82% vs 75.76%, p=1.00), what’s the teacher’s role when suspecting scoliosis (72.73% vs 63.64%, p=0.722). Furthermore, non-science teachers were in all cases more likely to choose “I don’t know” in questions concerning AIS when compared to the science teachers. Although only 15.38% of the science teachers scored low knowledge, the majority (72.73%) answered that they are not confident in identifying AIS signs in students (p=0.727). Teachers with <20 years’ experience were more likely to score low knowledge (54.85%) compared to their more experienced colleagues (46.15%). In fact, more teachers with >20 years’ experience had heard about AIS compared to the less experienced teachers (68.42% vs 64% p=0.759). The more experienced teachers also answered more questions correctly compared to their colleagues, example: what is AIS (84.21% vs 80% p=0.861), age of AIS development (84.21% vs 80%, p=0.164), is AIS commoner in boys/girls (42.11% vs 24%, p=0.571) treatment (42.11% vs 36%, p=0.759), screening (68.42% vs 40% p=0.131).
Conclusion: Although limited by a small sample size, the findings suggest that teachers with greater professional experience and a background in science possess higher levels of AIS knowledge. These preliminary results underscore the urgent need for targeted educational interventions and awareness campaigns within the school setting to equip educators with the skills necessary for early identification and referral of AIS cases.
Background: Culinary Medicine (CM) is an emerging, evidence-based discipline that integrates the art of cooking with the science of medicine and nutrition, enabling doctors to support patients’ dietary decisions in practical and context-sensitive ways. While CM programmes have been adopted internationally, including immersive “teaching kitchen” models combining hands-on culinary skills with clinical education, no study has yet evaluated the knowledge, perceptions, and curricular expectations regarding CM among Maltese medical students. This study addresses that gap at the University of Malta’s Medical School, the only state-led medical school in the country.
Methods: An online, 11-item questionnaire consisting of Likert-scale, multiple-choice, and open-text
questions was distributed to clinical-year medical students at the University of Malta. Quantitative responses were analysed descriptively, with subgroup comparisons, while free-text answers underwent thematic analysis to capture nuanced learner perspectives.
Results: Out of the total cohort, 103 responses were received. Virtually all students acknowledged the clinical importance of CM, yet only 35–45% felt moderately confident in discussing dietary
issues with patients and less than 6% felt adequately prepared to provide dietary advice. More than 80 % of students expressed dissatisfaction with both the amount and quality of current nutrition instruction. Thematic analysis revealed three emergent themes: (1) CM learning preferences, (2) perceptions of food and health, and (3) evidence-based clinical practice. Students favoured interactive teaching formats such as case-based learning, small-group seminars, online modules, shadowing dietitians and specifically requested practical training in areas such as weight management counseling, the relationship between nutrition and mental health, and the cultural and socioeconomic dimensions of dietary behaviour.
Conclusions: Despite recognizing the value of CM, Maltese medical students feel underprepared to
integrate nutritional counseling into clinical practice. Their clearly articulated preferences for interactive and practical teaching modalities strongly support the development of a dedicated CM curriculum embedded within clinical-year training, designed to equip future physicians with the skills needed to address diet-related health challenges effectively.
Background: Traditional measures such as BMI are commonly used to define obesity, but they may not capture the complexity of obesity-related risk. This study applied newly proposed definitions of pre-obesity and clinical obesity by the Lancet Diabetes & Endocrinology Commission and compared them with standard anthropometric measures in Malta-a population with a high prevalence of obesity.
Methods: A nationally representative, cross-sectional health examination survey was conducted in Malta between 2014 and 2016 (weighted N = 3,947). Anthropometric, sociodemographic, behavioural, and biochemical data were collected. Obesity was assessed using BMI, waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WtHR), and the newly proposed definitions. Metabolic syndrome (MetS) was used as a clinical complication. Binary logistic regression models were used to examine associations with MetS, adjusting for age, sex, education, and locality.
Results: Obesity prevalence varied by classification: 34.08% (BMI), 34.81% (WC), 68.94% (WHR), 39.17% (WtHR), and 22.40% (clinical obesity). All anthropometric measures showed significant associations with MetS, even after adjustment. Obesity defined by BMI had the strongest association (OR: 18.84, 95% CI: 14.13-25.13), while the newly defined clinical obesity also showed a strong association (OR: 9.89, 95% CI: 8.37-11.67). The pre-obesity category was negatively associated with MetS (OR: 0.16, 95% CI: 0.12-0.22), supporting its distinction as a preclinical state.
Conclusions: Different anthropometric measures identify different subgroups within the population, yet all are significantly associated with MetS. The findings support the utility of the Lancet Commission's refined definitions, particularly the pre-obesity classification, in guiding early intervention strategies.
Background: This study explores the impact of social media on skincare routines and acne perceptions in the digital era among young adults living in Malta. It suggests that understanding these dynamics can inform strategies to promote evidence-based dermatological health information and counter misinformation, ensuring social media platforms are supportive tools in personal health management.
Methods: An anonymous online survey was distributed through social media to young adults aged 18-29 years to assess their engagement with social media for skincare information and its influence on their perceptions of acne. Participants were categorized by gender and acne status.
Results: A total of 300 participants were included, with 41.0% (95% CI: 34.5, 46.8) of females and 14.1% (95% CI:7.3, 23.8) of males reporting social media use for skincare (P < 0.0). Although the majority (69.4% females, 70.5% males) considered social media information somewhat reliable but verified it with other sources (P = 0.9), females (75.7%; 95% CI: 69.5, 81.2) were more likely than males (43.6%; 95% CI: 32.4, 55.3) to come across acne-related content (P < 0.0). Among those with acne, 34.3% (95% CI: 26.9, 42.8) of females and 15.7% (95% CI: 7.0, 29.0) of males reported frequent exposure to acne-related content, compared to 15.9% (95% CI: 8.7, 25.6) of females and 3.7% (95% CI: 0.1, 19.0) of males without acne (P < 0.0).
Conclusions: Findings show that social media can influence acne-related content exposure, especially among acne-prone individuals. Females showed greater reliance on social media and engagement with skincare-related content, likely driven by increased appearance-related awareness and targeted searches. The findings underscore the need for evidence-based dermatological education on social media and collaborations between public health professionals, dermatologists, and content creators to counter misinformation and promote safe skincare practices.
Background: Low back pain (LBP) is a significant public health issue. Recent literature highlights the substantial burden of low back pain among medical students due to academic demands; however, a comprehensive global perspective on this issue remains lacking. This meta-analysis aims to assess the global prevalence of LBP among medical students and examine the associations.
Methods: A systematic review and meta-analysis were conducted, with searches in five major databases up until February 2025. Studies assessing LBP prevalence using the modified Nordic questionnaire were included. The AXIS tool was used for quality assessment. Random-effects meta-analysis was performed to calculate pooled estimates of LBP prevalence and odds ratios, with subgroup analyses by training stage, gender, and BMI.
Results: Thirty-two studies representing 15,819 medical students, were included which demonstrated a high-quality reporting. Meta-analyses showed significant pooled 12-month (-0.401, 95% CI[-0.402 - -0.401], p < 0.001) and 7-day (-1.339, 95% CI[-1.339 - -1.338], p < 0.001) LBP prevalence, with low heterogeneity (I² = 0%, p = 1). Clinical students had higher odds of LBP compared to preclinical students (OR = 0.924, 95% CI[0.784-1.064], p < 0.001). Female students had significantly higher odds than males (OR = 0.719, 95% CI[0.494-0.944], p < 0.001). Overweight students had elevated odds of LBP (OR = 0.893, 95% CI[-0.379-1.408], p = 0.007), while normal BMI, underweight and obese showed no significant association.
Discussion: LBP is a global public health issue among medical students, with clinical-stage students, females, and those with abnormal BMI (obese, underweight) being at higher risk. These findings underscore the need for targeted interventions, including gender-sensitive strategies to address LBP and reduce its impact on future healthcare professionals.
Background: Adolescent Idiopathic Scoliosis (AIS) affects 0.47%-5.2% of adolescents globally. Early detection prevents severe deformities, chronic pain, and respiratory issues. Gaps in AIS knowledge among future doctors may delay diagnosis, increase healthcare burdens, and hinder timely intervention. This study assesses AIS awareness among Maltese medical students to inform educational and policy strategies for improved early detection and management.
Methods: A cross-sectional survey of 2nd to 5th-year University of Malta medical students (Sept-Oct 2024) used an anonymous online questionnaire to assess AIS knowledge, including aetiology, risk factors, screening, and management. Chi-square tests and logistic regression identified key predictors.
Results: A total of 101 students participated, with 64.36% being female. While 62.38% had heard of AIS, significant knowledge gaps were observed, particularly regarding risk factors, screening, and treatment thresholds. Clinical-year students demonstrated better knowledge (p < 0.001), but gaps in understanding aetiology and conservative management persisted. Prior exposure to AIS was a significant predictor of higher knowledge scores (p = 0.01), while pre-clinical students were more likely to have limited knowledge (OR: 11.59, 95% CI: 2.44-55.06, p = 0.002).
Conclusions: The study highlights a critical gap in AIS education among future doctors, which may contribute to delayed diagnoses and missed opportunities for early intervention, contributing to a public health issue. This increases the burden on healthcare systems, as late-stage AIS cases often require costly surgical interventions and long-term management. Strengthening AIS education in medical curricula through structured training and case-based learning is essential. Public health policies should extend to medical curricula and professional development to improve AIS detection and management.
The COVID-19 pandemic caused a significant burden in Europe, with over 60% of infected individuals developing Long COVID symptoms. Variations in Long COVID prevalence across countries are linked to individual-level factors, but the influence of population-based country-level characteristics remains unclear. Thus, our objective was to assess how country-level characteristics related to: (i) the way European countries responded to the COVID-19 pandemic, (ii) their population-level health status, (iii) provision and access to healthcare services, (iv) human development, governance, and environmental risk factors, are associated with Long COVID. We used a sample of 4,004 middle-aged and older adults from 27 European countries who, in summer 2021, participated in Corona Survey 2 (from Survey of Health, Ageing and Retirement in Europe) and who reported COVID-19 infection one year prior to the survey. To assess the potential role of country-level characteristics, while controlling for key individual-level factors, we estimated three sequential multilevel random intercept logistic regression models. Approximately 70% of respondents who had COVID-19 also experienced Long COVID symptoms and there were significant cross-country differences in Long COVID rates, ranging from 32% to 89%. 今日黑料 13% of the total variance in the risk of having Long COVID can be attributed to cross-country differences and the remaining 87% to individual-level factors. The individual-level characteristics also accounted for 6% of the observed cross-country differences in Long COVID rates (compositional effects) while the country-level characteristics further reduced this variance by over 50%. Both individual and country-level factors influence Long COVID occurrence, emphasizing the need for tailored recovery plans, healthcare planning and resource allocation at the national level to address this condition.
Introduction: Type 2 diabetes mellitus (T2DM) is a significant global health concern, requiring a thorough understanding of its population-level features and impact. This study aims to compare the characteristics of T2DM in Malta and Luxembourg, two European nations with distinctive healthcare systems and societal attributes.
Methods: Data from national health surveys conducted in Malta and Luxembourg, encompassing various factors such as socio-demographics, medical history, biochemical metrics, and anthropometric measurements, were analysed to investigate the features of T2DM. Comparative analyses were conducted utilizing chi-square tests, independent t-tests, and multivariable binary regression.
Results: Malta (8.23%) and Luxembourg (7.82%) shared similar T2DM prevalence, with a predominance of men having T2DM. Malta exhibited a higher prevalence of obesity among the individuals having T2DM. Multivariable analysis showed no significant association between living in Malta or Luxembourg and diabetes. However, being male (OR: 1.49, CI 95%: 1.07–2.08, p = 0.02), an occasional smoker (OR: 2.49, CI 95%: 1.54–4.03, p < 0.01), increasing age (OR: 1.05, CI 95%: 1.03–1.67), and larger waist circumference (OR: 1.02, CI 95%: 1.01–1.04, p = 0.01) were positively associated with diabetes.
Conclusions: Understanding similarities and differences in T2DM between Malta and Luxembourg is crucial for identifying common challenges to formulate effective prevention and management strategies. Despite similar T2DM prevalence rates, notable differences in obesity rates and socioeconomic factors may contribute to disparities in disease burden. The complex interplay of numerous population characteristics underscores the importance of tailored public health interventions. This study accentuates the need for interventions and evidence-based policies to address modifiable risk factors, and advocate for cross-national cooperation to reduce the T2DM epidemic, especially in the context of post-COVID public health planning and resource allocation.
Introduction: Diabesity presents a growing global epidemic. Demographic and socioeconomic associations have been documented, yet, the literature on mortality risk associated with diabesity is scarce. The aim of this study was to assess whether diabetes and/or diabesity increas the risk of all-cause mortality across a period of 7 years at a population level.
Methods: A nation-wide health examination survey in Malta was conducted between 2014 and 2016. This collected sociodemographic information, bio-anthropometric measurements (waist circumference, body mass index [BMI], body adiposity index [BAI]) and blood samples. Mortality information was acquired in 2021 by cross-referencing with the national mortality register. Statistical analysis was conducted using chi-square tests and Cox proportional hazard models.
Results: A mortality rate of 1.67% was observed (n = 3947), with diabetes and obesity being responsible for 6.06% and 3.03% of deaths, respectively. Examining the deceased individuals alongside their baseline characteristics (2014-2015) revealed that 25.76% (CI95%: 16.75 - 37.44) had diabetes, and 30.30% (CI95%: 20.55 - 42.22) were obese. Diabetes was associated with significant mortality risk (HR: 2.65 CI95%: 1.20 - 5.85; p = 0.02), while diabesity showed borderline significance (p = 0.06). After adjustment for potential confounding factors the mortality risk linked to diabetes remained significant and BAI was the only anthropometric measurement positively associated with mortality.
Conclusions: These findings emphasise the urgency for comprehensive public health policies targeting the concurrent prevention and management of diabetes and obesity at a population level. Our results also indicate that incorporating body adiposity index (BAI) into risk assessment protocols may provide valuable insights into mortality risk prediction and inform tailored interventions.
