https://www.um.edu.mt/library/oar/handle/123456789/691 2026-08-10T12:06:12Z https://www.um.edu.mt/library/oar/handle/123456789/148452 Title: Survey assessing the reproductive healthcare and information needs of women in Europe of childbearing age living with epilepsy Authors: Baker, Gus A.; Brodie, Martin; Davies, Erin; Jedrzejczak, Joanna; Lally, Lorraine; Mifsud, Janet; Mostacci, Barbara; Okujava, Natela; Sofia, Francesca; Winterbottom, Janine; Wollscheid, Leonie Abstract: Objectives: To understand the extent to which women of childbearing age (WoCBA) are aware of the issues associated with epilepsy and pregnancy and identify unmet reproductive healthcare and information needs.; Methods: WoCBA with epilepsy completed a 34-question online survey (January to March 2021), including sections on demographics, clinical information, and access to reproductive health care. The survey was available in English, Croatian, Czech, Georgian, German, Italian, Polish, Russian and Spanish.; Results: Overall, 865 responses were received and included in the analysis. Most respondents were aged 20–39 years (77.0 %), were married (43.6 %) and 63.2 % had been diagnosed with epilepsy for more than 10 years. Over half of respondents (53.9 %) had previously been pregnant, with 75.5 % reporting that they took antiseizure medication (ASMs) during pregnancy. Most (67.6 %) respondents had received information about epilepsy and pregnancy with 43.4 % of respondents receiving this information before their first pregnancy. Although 71.5 % found the information ‘very helpful’ or ‘somewhat helpful’, some respondents found the information frightening, confusing, or difficult to access. Most respondents (74.1 %) had been made aware of the risks of taking some ASMs while pregnant; 59.8 % had been advised to consider pregnancy planning, however, 52.7 % were not provided with information on contraception while taking ASMs. Over half (56.9 %) of respondents felt that clear and concise information was not available for women with epilepsy who were considering becoming pregnant.; Conclusions: There is a need to improve education and support for WoCBA with epilepsy to help them with decision-making, planning and managing pregnancy. 2025-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/148451 Title: Adult poisoning-related admissions to the intensive care unit at the Mater Dei Hospital, Malta (2015–2021) Authors: Pereira, Melina; Chircop, Robert; Mifsud, Janet Abstract: Introduction: Studies worldwide have demonstrated an increasing number of intensive care unit admissions due to intentional and unintentional poisoning. However, data on the characteristics and demographics of such patients in Malta remain limited.; Methods: A retrospective study of fully anonymized patient records was conducted following ethics and data protection approval. Adult patients (over 18 years old) admitted to the intensive care unit at the Mater Dei Hospital, Malta, as a result of acute poisoning between 1 January 2015 and 31 December 2021 were included. Data collected included the type of drug toxicity or poisoning, reason for admission, management, length of stay and patient outcome.; Results: Among 3,394 adult intensive care unit admissions during the study period, 252 (7.4%) were related to poisoning. Patient ages ranged from 18 years to 87 years, with a median age of 39.5 years. There were 94 females (37.3%) and 158 males (62.7%). The seven most frequently involved causes of poisonings were recreational drugs (19.9%, most commonly cocaine), sedatives (13.9%, benzodiazepines), antidepressants (11.3%, mainly tricyclic antidepressants), antipsychotics (11.3%, mainly atypical antipsychotics), ethanol taken alone (10.7%), analgesics (6.9%, mainly paracetamol) and antihypertensives (4.6%, mainly diuretics). The patient survival rate was 97.6%.; Discussion: These findings, consistent with other international studies, offer valuable insights into the demographics, types, and outcomes of poisoning-related admissions in Malta. The data may assist clinicians, toxicologists, and public health officials to identify risks, improve patient management and guide prevention strategies.; Conclusions: There were 252 adult poisoning-related admissions to the intensive care unit, Mater Dei Hospital, Malta, between 2015 and 2021, and males accounted for 62.7% of these cases. Overall, intentional poisonings accounted for 50.4% of admissions. The seven most frequently occurring poisonings were due to recreational drugs (19.9%), sedatives (13.9%), antidepressants (11.3%), antipsychotics (11.3%), ethanol taken alone (10.7%), analgesics (6.9%), and antihypertensives (4.6%). The survival rate was 97.6%. 2026-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/148450 Title: GLP-1 receptor agonist safety in a perioperative setting : more questions than answers Authors: Aquilina, Graziella; Casha, Sarah Valerie; Cordina, Maria; Debono, Ivan; Fenech, Anthony; Mifsud, Janet; Petroni-Magri, Vanessa; Vassallo, Cesca; Sultana, Janet Abstract: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are among the latest class of drugs to be approved for the management of type 2 diabetes mellitus (T2DM). Their use has rapidly increased as their indications were expanded to include obesity management (Table 1). In 2005, the United States Food and Drug Administration (FDA) approved exenatide, and since then, GLP-1 RA use has expanded to include agents such as liraglutide (Saxenda), semaglutide (Ozempic, Wegovy), and the dual GLP-1/GIP agonist tirzepatide (Mounjaro). In 2021, semaglutide became the first GLP-1 RA approved for chronic weight management, with similar authorizations following in the European Union. Their increasing use has prompted questions on their safety in certain scenarios such as the perioperative setting. The same pharmacological properties that confer therapeutic benefits may inadvertently create challenges in this setting. [excerpt] 2026-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/148448 Title: Pharmacology educators as leaders of programmatic assessment for safe prescribing in competency-based medical education Authors: Zagaar, Munder; Karpa, Kelly; Szarek, John L.; Koenig, Jennifer; Cormier, Lindsay; Mifsud, Janet; Venderova, Katerina; Restini, Carolina Abstract: Unsafe prescribing remains a persistent source of preventable patient harm despite extensive pharmacology instruction in medical curricula. This gap likely reflects not a lack of content in the curricula, but a failure of structured curriculum integration, accountability, and longitudinal assessment. We argue that competency-based medical education (CBME), particularly through Entrustable Professional Activity 4 (EPA 4), requires a fundamental redefinition of the pharmacology educator’s role - from content expert to leader of programmatic assessment for prescribing competence. We propose a model of pharmacology thread leadership grounded in cognitive integration (spiraling, spacing, and interleaving), governance authority, and fidelity metrics to ensure consistency between what is taught, assessed, and practiced. This model aligns pharmacological reasoning with clinical decision-making through multi-method programmatic assessment, which may include written assessments, prescribing Objective Structured Clinical Examinations, workplace-based observations, and simulation. We further outline the structural enablers necessary for implementation, including faculty development, equity-focused design, and institutional support. While centered on pharmacology, this framework provides a transferable template for other foundational sciences seeking to achieve measurable impact on clinical competence. This paper reinforces the key role pharmacology educators have in integrated medical curricula by claiming explicit leadership in the EPA-aligned system of assessment, advancing multi-institutional research on prescribing outcomes, explicitly highlighting pharmacology as a discipline essential to well-supported decisions about readiness for practice, in other words, entrustment decisions, and patient safety. 2026-01-01T00:00:00Z