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Guidelines on open spaces
Full text linkThe open spaces of Malta and Gozo embody the everyday dimension of community life. They are the settings where heritage, ecology, recreation and social exchange intersect – shaping the collective experience of place and defining the quality of life within our localities. This collection of five Open Spaces guidelines – encompassing Parks and Gardens, Historical Heritage, Urban Cores and Piazzas, Open Markets, Open Space Re-use and Outdoor Sports – forms part of the Local Councils’ Association’s ResidentFirst vision. Together, these documents offer a cohesive framework for reimagining and managing the public realm as a shared and enduring civic asset. At a time when Malta faces the dual pressures of urban densification and environmental vulnerability, the need to reclaim, reconfigure and reinvest in open spaces is both urgent and transformative. Each guide presents actionable frameworks, grounded in research, contextual understanding and local experience, to help Local Councils, policymakers and residents strengthen the quality, diversity and resilience of open spaces in Malta and Gozo. This research is rooted in the Maltese context yet it aligns with broader European and Mediterranean urban agendas. [excerpt]peer-reviewe
Global and regional conservation status of vascular wetland plants in Mediterranean islands : a collaborative network to improve knowledge and awareness
Full text linkMediterranean wetlands are highly sensitive ecosystems, particularly vulnerable to human pressure and shifts in precipitation and temperature regimes. Wetland plants can be particularly threatened in Mediterranean insular contexts, where such habitats are naturally smaller and more fragmented than in their continental counterparts. This study investigated 275 species of vascular wetland plants that were considered to be at least regionally threatened across 2217 islands and islets in the Mediterranean. We provided both global and local IUCN conservation assessments (summarized in a ‘conservation concern’ index) and ‘assessment completion’ (i.e. knowledge level) for each taxon as well as a geographic distribution among islands, wetland types, and life forms. Most of wetland plants were threatened at the regional level, although assessment completion was generally low, except for endemics. Inland and endemic wetland plants were more threatened than the rest. A phylogenetic signal was detected, highlighting that Orchidaceae and Apiaceae were of particularly high conservation concern, while other families, especially Amaranthaceae, exhibited low levels of assessment completion. No geographical patterns were found in terms of conservation concern and assessment completion. Our findings provide critical insights into biodiversity patterns, identify conservation gaps and priorities and contribute to the development of targeted strategies for the protection of wetland plants, which are crucial indicators of the entire natural capital of Mediterranean island ecosystems.peer-reviewe
Person-centred care in congenital heart disease : intercountry variation in patient-reported experiences across 32 countries
Full text linkIntroduction: Person-centred care (PCC) is widely recommended by the World Health Organisation and other leading healthcare organisations. Although individuals with congenital heart disease (CHD) require lifelong follow-up, it remains unclear whether healthcare systems worldwide provide PCC to this population. This study investigated one key component of PCC, autonomy support, using patient-reported experiences in a global sample of adults with CHD. Methods: The study was part of the international cross-sectional APPROACH-IS-II. Data were obtained from 8367 adults with congenital heart disease across 53 centres in 32 countries. Perceived autonomy support was measured using a modified version of the Health Care Climate Questionnaire. A general linear mixed model was used to analyse the data. Results: Autonomy support scores ranged from 27.9 (SD ± 9.4) to 37.7 (SD ± 6.3) on a six - 42 point scale. A significant clinical difference in perceived autonomy was observed, with calculated effect sizes using Cohen's D exceeding eight in several countries. Higher autonomy scores were associated with having a high school diploma and older age. Patient characteristics accounted for 1.4 % of the variance, while geographical location explained 7.5 %. A large proportion of the variance remained unexplained. Conclusion: This study highlights significant global differences in perceived autonomy support from healthcare providers among adults with CHD. Education and age were associated with higher levels of perceived autonomy support. The experience of PCC is challenged by diverse expectations of individuals and families, healthcare providers' beliefs and values, institutional policies, and broader sociocultural contexts.peer-reviewe
Sixty years of diplomatic relations between the Holy See and Malta
No full textHaving considered the Papal speeches on the occasion of the Popes’ visits to Malta, as well as their significance in a changing local context, it is opportune to give due attention to the respective presidents’ discourses. The first two presidents to receive the Pope hailed from the Nationalist Party, whilst the latter two were former members of the Labour Party, which had experienced tensions vis-à-vis the local Church. By the time the latter two presidents were in office, the former tensions had abated. Despite the latter unfortunate situation, the Presidents in question, representing the whole nation, were not in the least influenced by that former animosity. Interestingly, on each side of the political spectrum, one was a medical doctor and the other a lawyer. [excerpt]peer-reviewe
Skip a Rope for Fitness (SkaRF) : a school-based intervention to promote physical activity and fundamental movement skills in Maltese children
No full textPhysical inactivity among children is a growing concern across Europe. In Malta, only 24% of eleven-year-olds meet the WHO’s
recommended 60 minutes of moderate-to-vigorous physical activity (MVPA) daily. The SkaRF (Skip a Rope for Fitness) project
was developed as a school-based intervention to increase physical activity and improve motor competence through rope skipping.
This quasi-experimental study was implemented over three years with students aged 8 to 11. In Phase 1, 60 Year 4 students were
divided into experimental and control groups. The experimental group engaged in 15-minute daily skipping sessions for four
weeks. In Phase 2, the former control group joined the intervention in Year 5. In Phase 3, all students repeated the four-week
intervention in Year 6. Five testing points were recorded: pre- and post-intervention in Phases 1 and 2, and post-intervention in
Phase 3. [excerpt]peer-reviewe
Carbon capture and performance enhancement of lime putty finishes with organic additives : implications for sustainable construction and heritage conservation
No full textThis study investigated the potential of lime putty finishes incorporated with traditional additives, i.e. kadukkai
(Terminalia chebula) and jaggery, to enhance their carbon capture and utilization (CCU) and to produce carbon
neutral material in sustainable construction and heritage conservation. Mechanical and microstructural performances
of modified lime putties were analyzed with reference to compressive strength, x-ray diffraction, infrared
analysis, thermogravimetric analysis, and gas adsorption techniques. These findings confirmed that organic lime
putty finishes improved performance predominantly in the mechanical strength, carbon sequestration, and
microstructural development. Results demonstrated that jaggery mixed putty exhibited a 39.7 % higher
carbonation rate with 36 % higher mechanical performance, 2.5 % higher CCU capacity, and better calcite
crystallization than the reference, driven by enhanced porosity and accelerated CO2 diffusion by fermentation
derived alcohols. Kadukkai modified lime showed moderate carbonation and denser microstructure with
enhanced formation of hydration products with high amorphous content (44.8 %) in the form of amorphous
calcium carbonate (ACC). Microstructural studies revealed that jaggery promotes calcite formation, while
kadukkai improves ACC formations. Lime with both additives achieved balanced strength (33 % high) and CCU
efficiency (2.5 % high), highlighting the synergistic effects of combined organics in promoting uniform
carbonation with both amorphous and crystalline carbonates with controlled porosity. This investigation emphasizes
the lime putty finishes pertinence as sustainable building materials, providing a practical resolution for
use in heritage restoration and potentially in non-load bearing sustainable construction applications.peer-reviewe
Lightweight, heat-insulating, alkali-activated slag composites with carbon-based biochar additive and filler
Full text linkAn alkali-activated slag binder based on biochar was developed in this research. The biochar
was produced from waste wood and is referred to as biochar waste (BW). In the alkali-activated slag system, a small amount of biochar (up to 0.5%) was used as an additive, and
a larger amount (from 1% to 25%) was used as a filler. The influence of the biochar powder
on compressive strength was determined. The hydrated samples were investigated using
X-ray diffraction (XRD) analysis and scanning electron microscopy (SEM), and the thermal,
acoustical properties, and hydration temperature were also determined. The compressive
strength of the alkali-activated slag composite, especially after 7 days, was found to increase
slightly due to the introduction of a small amount (0.05–0.5%) of BW powder. The powder
in the alkali-activated slag matrix was distributed homogenously, resulting in a reduction
in the crack propagation. A larger amount of BW led to a non-homogeneous distribution,
and this resulted in a gradual reduction in compressive strength with increasing BW. The
highest values of compressive strength at 28 days of hydration (44.4 MPa) were recorded for
samples with 0.25% of BW. According to mathematical analysis methods, the compressive
strength is mainly influenced by the specific surface area of the initial mix ingredients and
the amount of BW additive. In the alkali-activated slag matrix, BW acted as an inert micro-filler, with the dilution effect possibly being the reason for the decrease in the hydration
temperature. SEM analysis demonstrated that the BW had a good adhesion with the
alkali-activated slag matrix. The thermal and acoustic insulation performance of samples
with BW improved. These investigations suggest that BW can be successfully incorporated in alkali-activated material, resulting in low thermal conductivity and adequate acoustic
insulation performance.peer-reviewe
Excess mortality in Europe estimated by EuroMOMO during the COVID-19 pandemic and previous influenza seasons
Full text linkImportant questions remain regarding differences in geographical and age-specific mortality patterns as the COVID-19 pandemic evolved in consecutive
waves, and how COVID-19 mortality compares to seasonal influenza. In a
pandemic situation, excess all-cause mortality provides a more complete and
robust measure than cause-specific mortality. Data submitted by 26 countries
participating in the European Mortality Monitoring (EuroMOMO) network
between 2020 and 2023 was analysed to quantify excess all-cause mortality
during the COVID-19 pandemic. Excess mortality from this period was compared to previous influenza seasons from 2014 to 2019. Pooled estimates of
excess mortality showed four main waves during the COVID-19 pandemic
period, most markedly in people aged 65 years and above, with timing and
magnitude that varied between countries. Here we show that prior to implementation of control measures and COVID-19 vaccination, excess mortality
greatly exceeded typical seasonal influenza mortality, but later during the
pandemic was at levels comparable to influenza.peer-reviewe
Impact of different yttrium oxide concentrations and sintering protocols on the flexural strength and optical properties of monolithic zirconia
Full text linkThis study investigates the mechanical and optical properties of monolithic zirconia used
in dentistry, focusing on how different concentrations of yttrium oxide and varied sintering
times affect the material. A critical trade-off in ceramics has been reported in the literature,
in which increased crystalline content (like in zirconia) leads to higher mechanical strength
but lower aesthetic translucency. However, detailed information on this trade-off process
for different types of zirconia is lacking. A total of seven types of zirconia varying in
yttria content (3 mol% to 5 mol%) were tested across four sintering protocols available in a
laboratory zirconia sintering device: Slow (12 h), Standard (8 h), Fast (3.5 h), and Ultrafast
(1.15 h). The primary findings indicate that while a higher yttria concentration correlates
with lower flexural strength and high translucency, the sintering time generally did not
compromise mechanical strength or color variation across most samples. Nevertheless, the
Fast and Ultrafast protocols did significantly reduce the translucency of zirconia with a
high concentration of yttrium oxide.peer-reviewe
Associations between anthropometric characteristics, self-reported musculoskeletal and visceral symptoms, and squat movement quality : a cross-section study
No full textBackground: This study investigated associations between anthropometric characteristics, postural deviations, musculoskeletal and visceral symptoms, and squat movement quality to clarify how individual physical attributes and symptom profiles influence fundamental movement performance. Method(s): A cross-sectional observational study recruited adults aged 18–65 who could ambulate without pain. Anthropometric and body composition measures were collected. Standardized posture images and multi-angle squat videos were obtained, and visual classifications of posture and squat technique were conducted using predefined criteria. Descriptive statistics characterized the sample, and multivariable logistic regression with LASSO regularization examined associations between demographic, postural, and symptom variables and binary squat outcomes. Results: Two hundred participants (57.5% female; median age 26 years) were included. Males showed higher stature, lean mass, and waist circumference, whereas females exhibited higher body fat and reported more neck pain and headaches. Forward head posture was common (62%), while women demonstrated more favorable upper-body alignment. Most participants maintained neutral lumbar posture and grounded heels during squats, with sex differences in foot rotation and knee path. Higher fat mass predicted reduced squat depth (OR = 1.06, 95% CI: 1.00 to 1.11, p = 0.033); heel lift and absent forward knee movement were associated with better spinal neutrality (OR = 0.07 and 0.18, both p ≤ 0.002); and low skeletal muscle mass (OR = 0.87, 95% CI: 0.79 to 0.95, p = 0.004) and heel lift (OR = 7.09, 95% CI: 1.86 to 26.2, p = 0.003) predicted suboptimal knee tracking. Only 8% achieved a fully “perfect” squat. Conclusion(s): Suboptimal squat mechanics were linked to higher fat mass, lower skeletal muscle mass, and compensatory lower-limb strategies, suggesting that squat quality reflects an interaction among body composition, posture, and motor control rather than any single demographic or anthropometric factor.peer-reviewe