https://www.um.edu.mt/library/oar/handle/123456789/690 Tue, 12 May 2026 20:58:50 GMT 2026-05-12T20:58:50Z https://www.um.edu.mt/library/oar/handle/123456789/144850 Title: A preliminary comparative analysis of pesticides residues in illicit and regulated cannabis inflorescence in Malta Abstract: Illicit cannabis consumption presents significant health risks due to the absence of regulatory monitoring in its cultivation, especially with regards to pesticide contamination. In contrast, licensed cannabis produced under regulated frameworks is expected to comply with strict safety standards. This study investigated and compared pesticide residues in illicit cannabis samples seized by law enforcement officers with licensed recreational cannabis inflorescences sourced from Cannabis Associations licensed with the Authority for the Responsible use of Cannabis in Malta. The primary aim was to determine whether illicit cannabis is more likely to contain pesticide contamination. This study thus helped assess public health risks and highlighting the impact of regulatory control. Twenty-four cannabis inflorescence samples were analysed: twelve illicit samples and twelve licensed samples. The methodology employed a QuEChERS (Quick, Easy, Cheap, Effective, Rugged, and Safe) extraction protocol, followed by instrumental analysis using gas chromatography combined with mass spectrometry (GC-MS) and ultra-performance liquid chromatography coupled to tandem mass spectrometry (UPLC-MS/MS). The findings demonstrated that pesticide residues were detected exclusively in illicit cannabis samples, while no pesticide contamination was found in licensed recreational cannabis provided by Cannabis Associations. Two organophosphate pesticides, dichlorvos and chlorpyrifos, were identified across multiple illicit samples. Statistical analysis using Fisher’s exact test confirmed a statistically significant difference in contamination between the two groups (two-sided analysis, p = 0.037). These results highlight the elevated risk associated with illicit cannabis use and emphasise the protective role of regulatory oversight in licensed production. Inhalation of organophosphate pesticide residues may contribute to acute and chronic toxicological effects, presenting a considerable public health concern for consumers of illicit cannabis. These findings support the implementation of strict monitoring frameworks in order to safeguard cannabis quality and strengthen the importance of consumer access to regulated products. Description: M.Sc.(Melit.) Wed, 01 Jan 2025 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/144850 2025-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/144451 Title: Analysis of the calls made to the Malta National Poisons Centre Abstract: Background: The Malta National Poisons Centre (MNPC) commenced operations in October 2023, initially serving Healthcare Professionals (HCP) before extending access to the public in May 2024. Poison centres serve as critical epidemiological resources providing essential data on poisoning incidents while offering expert clinical consultation for exposure management. The centre provides telephone consultation services to both HCP and the public for toxicological emergencies. Aim: To analyse the nature and characteristics of all toxicological exposure calls received by the MNPC during its first months of operation, from October 2023 to May 2025, and examine insights regarding poison types and severity in Malta. Methods: A retrospective quantitative analysis was conducted using anonymised call-log data from the MNPC database. The study included all 654 toxicology-related calls meeting inclusion criteria. Data encompassed caller demographics, patient characteristics, exposure circumstances, substance categories, clinical severity using the Poisoning Severity Score (PSS), and documented outcomes. Statistical analysis employed descriptive methods and chi-square tests using SPSS version 29. Results: HCP constituted 76.6% of callers, with 23.4% from the public. Patient gender distribution was balanced (50.8% male, 48.9% female). The largest age groups exposed were 30-39 years (17.4%) and children under 5 years (16.4%). Accidental exposures predominated (40.1%), followed by deliberate exposures (36.2%). Pharmaceutical agents comprised most exposures, with paracetamol-containing analgesics being most frequently reported (15.1%); 59.6% of paracetamol cases involved deliberate poisoning. Most exposures occurred in domestic settings (85.5%) via oral route (84.4%). PSS distribution showed 34.6% asymptomatic, 40.2% minor, 16.8% moderate, 8.3% severe, and 0.2% fatal outcomes. Hospital admission was required in 52.4% of cases, with 60.7% involving clinical toxicologist consultation. Non-Maltese residents comprised 28.3% of cases, with disproportionate representation in workplace exposures (58.3% of occupational cases). Conclusions: The MNPC has successfully integrated into Malta's healthcare system, demonstrating appropriate utilisation and effective outcomes. The epidemiological profile reveals distinct age-related intentionality patterns requiring targeted prevention strategies. Paracetamol prominence in deliberate exposures and significant non-Maltese representation in occupational exposures indicate specific risk factors requiring public health intervention. These findings provide essential baseline data for evidence-based prevention strategies and clinical protocol optimisation. Description: M.Sc.(Melit.) Wed, 01 Jan 2025 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/144451 2025-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/143590 Title: Towards a digital health competency framework for the workforce abstract; preliminary findings Authors: Azzopardi Meli, Bernice; Bowman, Corinne; Camilleri Sacco, Maya; Fenech, Anthony; Agius Muscat, Hugo; Hamilton, Clayton; Scotter, Cris; Montebello, Matthew; Cordina, Maria Abstract: Background: Technology is reshaping the healthcare (HC) system and the relationship between the patient and the healthcare professional. In healthcare, there is wide agreement that digital competence is essential for professionals. However, what these common competences should specifically include for health professionals is still not clearly identified. Objectives: The aim of this research is to identify a best-practice digital competency framework for healthcare professionals. Methods: A systematic review based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist was conducted. Literature published in English between 2014 and 2024 was searched in MEDLINE, PubMed, CINAHL, PsycINFO, Cochrane Library, Scopus, ProQuest, BASE and the first 10 pages of Google and Google Scholar. The methodological quality of the included studies was assessed using Joanna Briggs Institute tools, while mixed-methods studies were appraised with the Mixed Methods Appraisal Tool. Results: The initial search identified 9362 papers, of which 111 were included. Preliminary findings underscore the importance of developing a robust framework that encompasses technical and enabling competences for practitioners at various levels of the HC infrastructure. It isproposed that the framework includes the following key domains: (i) Leadership competences (ii) Procedural competences and (iii) Enabling competences. Discussion: Competency frameworks link professional practice, education, training, and assessment. Most studies list competences rather than develop structured frameworks, highlighting a gap in the literature. Existing frameworks rely largely on expert consensus, with few developed through rigorous academic methods. Conclusion: Adopting a systems-thinking approach could better capture the complexity of professional practice, guiding the development of more robust and effective competency frameworks for healthcare professionals. Wed, 01 Jan 2025 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/143590 2025-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/143263 Title: The use of fentanyl patches in pain relief : a prospective observational study in chronic pain patients Abstract: Fentanyl is a highly potent synthetic opioid whose marked lipophilicity enables efficient transdermal delivery. The transdermal patch provides continuous plasma concentrations, delivering sustained analgesia and greater convenience than oral opioids. Clinical experience, however, highlights considerable inter-individual variability and a tendency for analgesic efficacy to decrease toward the end of the 72-hour dosing interval. Although fentanyl pharmacokinetics are well characterized, few studies have simultaneously captured objective PK metrics (e.g., urine fentanyl and nor-fentanyl levels) and patient-reported pain outcomes—particularly in Malta, where patch therapy is confined to malignant disease. [excerpt] Mon, 01 Dec 2025 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/143263 2025-12-01T00:00:00Z