https://www.um.edu.mt/library/oar/handle/123456789/144 2026-10-16T20:26:39Z 2026-10-16T20:26:39Z https://www.um.edu.mt/library/oar/handle/123456789/150156 2026-10-16T12:56:30Z 2026-01-01T00:00:00Z

Title: Revisiting and recalibrating the impact of Legionnaires' disease on Maltese public health awareness and preparedness Abstract: Our study was a return to the Maltese Annual Notifiable Infectious Disease Reports: 2010-2024 (Maltese DataBase) to revisit the gaps, voids, and misclassification flaws we encountered with our initial examination of the Maltese DataBase, focusing on the stats (incidents and deaths) associated with Legionnaires' Disease, a respiratory condition. Specifically, we sought to rewrite our initial examination of the Maltese DataBase and to recalibrate our initial determination (IBM/SPSS) of the potential (current and emerging) impact of Legionnaires' Disease on the public health of the Maltese population. Latent and foreboding trends in the Maltese DataBase were unchanged, remaining worrisome. Our initial determination (with Central Limit Theory) yielded a Maltese Chance of Death at 3.9%-12.4% from Legionnaires' Disease, covering an initial sample of 160 incidents and 13 deaths during 2010-2022. Revisiting the Maltese DataBase with acute curiosity, we began a systematic review by reclarifying content and retracking, reverifying, and unraveling data to reassure validity and accuracy of our initial study, plus the consistency of posted incidents and deaths. We repeated our IBM/SPSS/Central Limit Theory analysis using new data to reassure the integrity and validity of our research. Recalibration revealed an updated Chance of Death at 1.83%-11.1%, using a sample set of 108 incidents and 7 deaths during 2010-2022. We present, also, suggestions for improving the management, standardization, and auditing of the Maltese Annual Notifiable Infectious Disease Reports-which is a vital resource for promoting awareness and readiness, essential for the future of Malta. A strategic step is to consider adopting and installing an AI tool to manage and operate the Maltese Database.

2026-01-01T00:00:00Z Abela, Mark Grech, Neil Degiorgio, Sophie Grech, Victor E. Sammut, Mark Adrian https://www.um.edu.mt/library/oar/handle/123456789/150149 2026-10-16T12:48:25Z 2023-01-01T00:00:00Z

Title: Isolated short PR interval in adolescent athletes and non-athletes : should we worry? Authors: Abela, Mark; Grech, Neil; Degiorgio, Sophie; Grech, Victor E.; Sammut, Mark Adrian Abstract: The PR interval on an electrocardiogram (ECG) mirrors atrial depolarisation and conduction down the atrioventricular node. It is initially shorter in young children than in adolescents, with gradual physiological PR interval prolongation in adolescence.1 The PR interval, however, fails to prolong in several healthy teenagers. There is limited data on isolated short PR interval in adolescent athletes and non-athletes. In the absence of symptoms and ventricular pre-excitation, referral for evaluation does not appear justified.2 An otherwise benign condition may represent a concealed accessory pathway; therefore, it should not be overlooked in cardiac screening programs. The objectives of this study were to assess the prevalence, symptoms, clinical implications and outcomes of an isolated short PR interval in athletic and non-athletic adolescents. [excerpt]

2023-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/150148 2026-10-16T12:59:00Z 2026-01-01T00:00:00Z

Title: The intrepid-13 seminar series : a pilot learning odyssey with public health challenges for rethinking disaster management training - a Maltese curriculum initiative with Ghanaian participation Abstract: The Intrepid-13 was a pilot Seminar Series, composed of thirteen (13) weekly sessions that replaced the traditional course textbook with research articles and business case studies on public health issues, and it substitutes an unabridged approach, called the BreakDown,* to analyze the articles and cases. Purpose of the unabridged approach (BreakDown) was to extract expanded insight from the articles and cases for a comparative learning experience, specifically, to enhance disaster management training for graduate students in public health courses using peer research articles and practical business management case studies with exposure to international issues and global challenges. A pilot of The Intrepid-13 was formalized and launched at the University of Malta during the 2026 Spring Session with sixteen (16) participants (13 with MD degrees). Seminars were held on campus with 13 students, while 3 students in Accra, Ghana participated via a secured virtual connection. This global dimension added vitality to class discourse. Unique to The Intrepid-13, all class instruction and BreakDown presentations of articles and cases were designed and delivered by the participants. The Seminar Sponsor served only as a program moderator. Participant engagement was emphasized, promoted, and recognized. As a first for University of Malta,, The Intrepid-13 provided an opportunity for participants to be certified with the “Incident Command System,” an independent study course offered by the National Disaster & Emergency Management University (USA). Three (3) students earned the Certificate of Completion for the Incident Command System.

2026-01-01T00:00:00Z Micallef, Alexander Tomaselli, Gianpaolo Garg, Lalit Calleja, Neville Buttigieg, Sandra C. https://www.um.edu.mt/library/oar/handle/123456789/150144 2026-10-16T12:27:58Z 2026-01-01T00:00:00Z

Title: Breaking the bottleneck : delayed discharges and their operational implications for healthcare efficiency in a small European acute general hospital Authors: Micallef, Alexander; Tomaselli, Gianpaolo; Garg, Lalit; Calleja, Neville; Buttigieg, Sandra C. Abstract: Delayed discharge represents a persistent challenge in healthcare systems, contributing to inefficiencies in hospital bed utilization, increased costs, and reduced patient flow. In small and centralized healthcare systems, these effects may be further amplified due to limited post-acute care capacity and restricted patient redistribution. This study quantified the prevalence of inappropriate hospital days as a proxy for delayed discharge and examined their relationship with patient demographics, medical specialty, and associated costs in an acute general hospital. A quantitative analysis of 220 medical records was conducted using a modified Appropriateness Evaluation Protocol (AEP). Descriptive statistics and nonparametric tests were applied to identify significant associations between inappropriate hospital days and selected variables. According to the findings, within this intentionally enriched sample of patients with a length of stay exceeding seven days in the selected wards, nearly half of all accumulated inpatient bed days failed to meet acute necessity criteria, with the vast majority of these service backlogs stemming from placement delays in downstream rehabilitation facilities and long-term care institutions. Within this high-risk cohort, inappropriate hospital days, used here as a proxy for delayed discharge, were more common among older patients and among medical specialties than in other specialties, while no consistent relationship was observed with gender. Cost analysis (carried out over a three-month period) indicated an order-of-magnitude estimate of the acute bed day resources associated with inappropriate hospital days in the units studied. These findings are consistent with the interpretation that inappropriate hospital days, used here as a proxy indicator of delayed discharge, may be influenced by a combination of external capacity constraints and internal operational inefficiencies, although causality cannot be established from this observational design. While the findings cannot be generalised to the entire inpatient population or health system, within this intentionally enriched cohort of long stay inpatients the study highlights the need to strengthen post-acute care provision, improve discharge coordination processes, and enhance system integration to optimise hospital efficiency and patient flow in similar operational contexts.

2026-01-01T00:00:00Z