https://www.um.edu.mt/library/oar/handle/123456789/343 Sun, 24 May 2026 03:09:48 GMT 2026-05-24T03:09:48Z https://www.um.edu.mt/library/oar/handle/123456789/146630 Title: Beyond 42 days : a national cohort study of maternal and late maternal deaths in Brazil from 2010 to 2023 Abstract: Background/Objectives: Maternal mortality is a serious public health problem and reflects social, ethnic, racial, and regional inequalities in access to and quality of obstetric care. Despite advances in the surveillance and investigation of maternal deaths in Brazil, late maternal deaths (occurring between 43 days and 1 year after birth) are still underestimated and underexplored. Therefore, the objective of this study was to analyze the distribution and factors associated with maternal deaths and late maternal deaths in Brazil between 2010 and 2023. Methods: This was a population-based, retrospective cohort study with a quantitative approach, using secondary data from the Mortality Information System. All maternal deaths (Chapter XV of ICD-10) and late deaths recorded during the period were included. Sociodemographic, clinical, and administrative variables were analyzed. Statistical tests of association (chi-square, test of proportions, and 95% CI) were used, with a significance level of 5%. Results: A total of 26,953 deaths were identified, of which 24,387 were maternal and 2,566 were late deaths. Most deaths occurred among single, mixed-race women with 8 to 11 years of schooling, and residing in the Southeast region. Late deaths were more frequent in the South and among women aged 40 to 49. The main causes were direct obstetric conditions. A statistically significant association was observed between the type of death and sociodemographic variables. Conclusions: The results highlight structural inequalities in maternal mortality in Brazil and reinforce the importance of expanding postpartum surveillance beyond 42 days, with a focus on equity and continuity of care. Thu, 01 Jan 2026 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/146630 2026-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/143844 Title: Spiritual assessment in childbirth Authors: Attard, Josephine; Prinds, Christina Abstract: There is a growing realization of the need to adopt a lifespan approach to understanding spirituality. This chapter will focus on spirituality within the context of childbirth and parenthood transition, looking at the current evidence and application within this important area of healthcare practice. It will explore firstly how mothers’ and families may experience the need for spiritual care, and secondly on the personal challenges faced by midwives in providing spiritual care and their need for support. The chapter will provide a rationale for how and why spiritual assessment is needed within midwifery practice and the events surrounding childbirth. Wed, 01 Jan 2025 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/143844 2025-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/143842 Title: Cross-cultural adaptation of the EPICC spiritual care education standard into European Portuguese Authors: Sitefane, Sara; Afonso, Ana; De Andrade Alvarenga, Willyane; Mcsherry, Wilfred; Ross, Linda; Attard, Josephine; Rabiais, Isabel; Caldeira, Sílvia Abstract: Background: Spiritual care is a dynamic and multifaceted concept. The EPICC project, launched to improve nurses' competence in spiritual care through innovative education, supports this approach. The EPICC framework includes several tools and resources with the Spiritual Care Education Standard as the core tool. Aim: Translation, validation and cross-cultural adaptation of the EPICC Spiritual Care Education Standard into European Portuguese language and culture. Methods: Validation study using the Cross-Cultural Adaptation method. This method involves a six-step framework: translation, synthesis, back-translation, review by the expert panel (n=6), pre-testing, and concluding with the submission and approval of all documents by the original instrument authors and the expert panel. EQUATOR checklist: GRRAS. Ethical Issues and Approval: Doctoral research project (approved by the Ethics Committee on 19 July 2023). Results: The data were collected between November 2023 and April 2024 and showed 100% agreement and a Content Validity Index (CVI) of 1 for all items among experts. The pre-test, collected in May 2024, with 39 nursing students showed 90% agreement and minimal response variability among the items. Conclusions: The study successfully adapted the EPICC Spiritual Care Education Standard to European Portuguese, highlighting the need for ongoing investment in spiritual care education in nursing curricula. Implications: This study highlights the importance of students' spiritual care competencies in nursing education and practice, emphasising their integration into curricula and the ongoing relevance of healthcare policy in supporting this dimension of holistic care. Thu, 01 Jan 2026 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/143842 2026-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/143630 Title: How ready are we to use artificial intelligence in our fight against antimicrobial resistance? An ESGAID and EAAS perspective Authors: Giacobbe, Daniele Roberto; Ahmad, Rafi; Akilli, Fatih Mehmet; Ascandari, Abdulaziz; Eyre, David W.; Gallardo-Pizarro, Antonio; Garcia-Vidal, Carolina; Lopes, Bruno Silvester; Lyutsova, Ekaterina; Rakhimov, Ruslan; Rizzo, Alberto; Rohde, Holger; Sadeghi, Zahra; Schweitzer, Valentijn; Tartari Bonnici, Ermira; Torres-Sangiao, Eva; Guerrero-López, Alejandro Abstract: Introduction: Antimicrobial resistance (AMR) remains one of the greatest threats to global health, requiring innovative approaches to antibiotic discovery, surveillance, diagnosis, and prescribing. In recent years, artificial intelligence (AI) has increasingly been applied across these domains, with the dual aim of accelerating research and strengthening antimicrobial stewardship. Areas covered: This perspective summarizes current advances and challenges in applying AI for tackling AMR. We examine the role of AI in antibiotic discovery, laboratory surveillance, diagnosis of resistant infections, and clinical decision support systems. Finally, we address the ethical and regulatory landscape, data transparency, and liability concerns. Expert opinion: AI offers unprecedented opportunities across the continuum of our efforts to counteract AMR, yet its adoption faces substantial hurdles. Some central challenges include the balance between model accuracy and explainability, the lack of widespread digital access, quality and transparency of training datasets, and usability for clinicians. Progress will depend on multidisciplinary collaboration, robust regulatory oversight, and the development of training programs equipping future healthcare professionals with AI-aware reasoning skills. Ultimately, AI should not replace but rather augment human reasoning in the fight against AMR, aligning innovation with ethical principles to ensure safer, more equitable AI-enhanced antibiotic prescribing and antimicrobial stewardship. Thu, 01 Jan 2026 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/143630 2026-01-01T00:00:00Z