https://www.um.edu.mt/library/oar/handle/123456789/343 Tue, 07 Jul 2026 18:47:19 GMT 2026-07-07T18:47:19Z https://www.um.edu.mt/library/oar/handle/123456789/147877 Title: Maternal health literacy in nutrition and food safety during pregnancy and its role in emotional appraisal and decision-making Authors: Zahra, Nina; Jones, Petra; Spiteri, Georgette Abstract: Optimal nutrition and food safety during pregnancy are central to maternal and foetal health; however, engagement with dietary guidance involves more than access to information. Framed through a health literacy lens, this qualitative study explored how pregnant women in Malta access, understand, appraise, and apply nutrition and food safety information within emotional, social, and structural contexts. Semistructured interviews were conducted with 11 purposely selected pregnant women across varying stages of pregnancy and gravidity, and data were analysed using reflexive thematic analysis. Findings suggest that participants demonstrated strong awareness of dietary recommendations and food safety risks, yet understanding was largely procedural and rule-based, with limited explanatory depth. Decision-making extended beyond knowledge to include emotional appraisal, moral responsibility towards the foetus, and risk-avoidance strategies. Health literacy was enacted relationally and influenced by gravidity, prior obstetric experiences, digital information environments, timing of professional guidance, and access to resources. Participants frequently relied on self-directed digital inquiry to compensate for perceived gaps in early antenatal care, highlighting both the importance of digital health literacy and the challenges of navigating inconsistent information. Socio-demographic factors, including professional background, financial capacity, and time constraints, further shaped confidence and engagement. These findings suggest that maternal nutrition and food safety practices reflect functional, interactive, and critical health literacy processes embedded within socio-structural conditions. Strengthening early, equitable, and context-sensitive antenatal education may support informed decisionmaking while reducing anxiety and improving maternal and foetal wellbeing. Description: Supplementary information is provided within this record. Thu, 01 Jan 2026 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/147877 2026-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/147785 Title: Global landscape of locally produced alcohol-based handrub in health care settings : a scoping review Authors: Saito, Hiroki; Tartari, Ermira; Garlasco, Jacopo; Pittet, Didier; Allegranzi, Benedetta Abstract: Background: Reliable access to alcohol-based handrub (ABHR) is essential for hand hygiene and infection prevention, yet many low- and middle-income countries (LMICs) continue to face supply constraints. A 2011 WHO global assessment demonstrated that WHO-recommended ABHR formulations produced locally at low cost, were well accepted by healthcare workers, but also highlighted persistent barriers, including challenges in procuring ingredients and dispensers and in ensuring adequate quality control. This review aimed to provide an updated global synthesis of evidence on local ABHR production in healthcare settings. Methods: Following the Joanna Briggs Institute framework and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines, we systematically searched Embase, Medline, and CINAHL from inception to 19 March 2025. Two reviewers independently conducted title-abstract screening, full-text screening and data extraction. Primary research articles reporting local ABHR production in healthcare settings in LMICs were eligible for data extraction and descriptive synthesis. Results: Of 2343 articles screened, 31 studies from 19 countries were included (2006–2023). Over half (n = 18, 58%) were conducted during the COVID-19 pandemic; 22 described health-facility production and 9 described factorylevel manufacturing. Of the 22 health-facility production studies, 12 (55%) used WHO Formulation 1 (ethanol-based) or modifications thereof. Pharmacists most commonly led production at the health-facility level. Only 6% (two articles) reported the source of alcohol, and less than half evaluated efficacy or organoleptic properties (13 and 12, respectively). Most funded studies relied on high-income-country (HIC) grants (17 of 24, 71%). Conclusions: Local ABHR production remains infrequently reported in the literature, although publications increased during the COVID-19 pandemic. Heavy reliance on short-term, HIC-funded initiatives raises concerns about the longterm scalability and sustainability of local ABHR production in LMICs. Strengthening national regulatory capacity, quality-control laboratories, and sustainable financing is critical to maintain safe ABHR access beyond pandemic contexts, for resilient national supply chains and in-country quality control capacity. Thu, 01 Jan 2026 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/147785 2026-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/147784 Title: Designing interdisciplinary education in digital public health : a position paper Authors: Attard, Conrad; Macedo Silva, Anabelle; Ahmed, Syed; Li Han Wong, Brian; Sultana, Roberta; Albanese, Emiliano; Tartari, Ermira Abstract: The rapid digital transformation of health systems worldwide demands an interdisciplinary public health workforce proficient in digital technologies, ethical frameworks and systems-level thinking. However, current public health curricula remain largely discipline-specific and fail to systematically embed digital competencies or foster collaboration across sectors such as technology, ethics, law, and policy. This position paper emerges from a high-level workshop held during the Digital Public Health Conference 2025, where international experts and educators debated strategies for advancing interdisciplinary education. Drawing on multilevel evidence, including participant reflections, international frameworks, and case studies, we identify and analyse five critical challenges shaping the future of digital public health education: (1) embedding ethics and regulation into digital public health education; (2) strengthening digital public health literacy with a salutogenic approach; (3) defining interdisciplinary competencies for the future workforce; (4) integrating real-world applications into classroom learning; and (5) enabling long-term, crossborder collaboration in education. For each theme, we propose actionable goals rooted in pedagogical innovation, policy alignment, and institutional governance. Designing inclusive, ethical, and practice-informed education models is essential to prepare a digitally fluent and socially accountable public health workforce. Thu, 01 Jan 2026 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/147784 2026-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/147767 Title: Acupressure in perinatal care : results of a cross-sectional study in Malta Authors: Galea, Chanelle; Pace Parascandalo, Rita Abstract: INTRODUCTION: Acupressure, the application of firm pressure to specific acupoints, has been associated with benefits during the perinatal period, including reducing nausea, alleviating pain, inducing labor, supporting lactation and decreasing anxiety. While research has explored its effectiveness, little is known about midwives’ knowledge and views regarding acupressure and its integration into practice. This study aimed to explore midwives’ knowledge, perspectives and factors influencing their use of acupressure during the perinatal period.; METHODS: A quantitative, cross-sectional survey design was employed using a selfadministered online and paper-based questionnaire. This was a total population study utilizing a non-probability sampling technique where the entire population of 240 midwife members of the Malta Midwives Association (MMA) was included. Eligible participants included practicing members in any maternity care setting across the Maltese Islands and these were invited to complete the survey. After conducting a pilot study, data collection took place between July and September 2024, where a total of 94 responses were received. Quantitative data were analyzed using descriptive and inferential statistics, while open-ended responses underwent thematic analysis.; RESULTS: While midwives demonstrated a strong interest in acupressure, their hesitation to practice stemmed primarily from insufficient training (20.7%; n=87), education (19.5%; n=82) and a lack of evidence-based guidelines (16.7%; n=70). Less than half of the respondents reported practicing acupressure (12.8%; n=12), with most expressing uncertainty about the location of various acupoints and acupoints contraindicated before 37 weeks of gestation (61.7% to 87.2% across all acupoints). Findings from thematic analysis highlighted that increased maternal interest in natural approaches, creates a corresponding need for enhanced midwifery expertise in acupressure.; CONCLUSIONS: The findings revealed midwives’ lack of adequate knowledge, education and training in using acupressure during the perinatal period. These themes mirrored the quantitative findings, reinforcing that interest in acupressure is present among Maltese midwives but is constrained by gaps in knowledge, training and policy support. Thu, 01 Jan 2026 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/147767 2026-01-01T00:00:00Z