Over the last four decades, STEM industries have risen to great heights. Scientific, technological, engineering, and mathematical minds have been called to rally. And the demand continues. How can you contribute?
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If you had a rich malleable canvas that could flip rules on their heads and expose truths we take for granted, wouldn’t you use it? Jasper Schellekens writes about the games delving deep into some of our most challenging philosophical questions.
Continue readingDeclining mental health is a global burden. Anxiety, depression, and substance abuse are on the increase. Current estimates from the World Health Organization report that one in every four of us will experience some form of mental health challenge during their lifetime. By 2020, these figures are expected to double. And while support services do exist, their accessibility can be difficult.
There is no one explanation for this. The issue is complex and multifaceted. A lack of information on such services is a major contributing factor, however, stigma continues to be the main reason people refrain from seeking support and advice. Just a decade ago, discussing depression, eating disorders, self-harm, and suicide in Maltese public fora was unimaginable. And while things have improved—social media provides plenty of evidence—we cannot become complacent.
As part of my PhD, I looked into the attitudes of Maltese nurses and midwives towards mental illness. As people working in caring professions within medical settings, they are on the front lines of community health, seeing people from all walks of life, day in day out.
What I found was that while local nurses and midwives hold a positive attitude towards individuals with a mental illness, continued education, public engagement, and mental health literacy promotion are imperative.
Nurses and midwives who followed specific mental health nursing training held the highest positive attitudinal scores. This finding highlights the important correlation between education and mental health literacy to the attitudes towards those with a mental health condition. Without adequate mental health literacy, stigmatising attitudes will prevail, and people will not receive the care they need.
With this knowledge in hand, I wanted to raise awareness around mental health. To do this, I combined my goal with my love for art, collaborating with local artist Anthony Calleja to explore the lived experiences of living with mental illness.
Calleja produced 18 works of art, all of them depicting mental illness based on first hand accounts from people living with the diseases. The idea was to increase awareness and generate discussion without the need for text. Visual art allows for nuanced personal interpretation, empowering the individual to reflect and absorb the messages within the art they are viewing. People use metaphors to relate to their life situations, especially when things become difficult to explain. Like metaphors, art can be used to express things that cannot be stated in words. Art can be a therapeutic medium that helps people reach out. But this was not all we planned to do with the initiative.
Calleja’s pieces were collocated into a book titled Living with Mental Illness. The publication was launched at an exhibition of the original works. On the night, I conducted a study through questionnaires investigating people’s own interpretations of the works and the emotions they conveyed.
Although data analysis is still at a preliminary stage, findings seem to agree with the national survey on health literacy carried out in 2014 by the Maltese National Statistics Office on behalf of the Office of the Commissioner of Mental Health. In 2014, research showed that 42.5% of the Maltese population have a problematic level of health literacy. This further highlights the importance of education and health promotion campaigns.
We’ve all heard someone around us say that mental health is as important as physical health, and we need to act on that adage. We cannot shy away from giving it the attention it deserves. Now is the time to speak out and collaborate as a collective. We need to listen closely to those among us who are struggling, especially to those who use our community’s mental health services. Only they can help us revamp and address the challenges that lie ahead.
Mental health professional ‘Joe’ works in the Maltese hospital’s services. He feels emotionally drained and at the end of his rope. In the morning, he wakes up dreading his workday. The passion for it has dissipated. Maybe, he thinks, it’s time to quit.
Dr Aloisia Camilleri and I explored the concept of burnout in professionals working within our mental health system. The research project itself was born from the notion that to support those who need care, service providers themselves need to have good mental health.
To understand job-related burnout, it is best to see it as a spectrum. People can be happy, satisfied, and fully engaged, or they can be completely disinterested and disengaged. This framing helps us understand that there are differing degrees of burnout, while also highlighting that different definitions of burnout can lead to different results.
In our research, burnout was defined as a process where a person’s psychological resources are gradually depleted as a result of prolonged stress at work. This then manifests in emotional exhaustion, depersonalisation, and loss of personal accomplishment. The person feels worn out, fatigued, detached, and cynical about their job. Ultimately there’s a sense of inability to cope, and low morale sets in. This is the ultimate lose-lose situation where both the employee and the patients suffer as the organisation loses efficiency.
For the study, we invited 322 professionals to participate anonymously. The roles they occupied varied and included psychiatry doctors, nurses, occupational therapists, psychologists, psychotherapists, and social workers. In the end, 230 agreed to answer our standardised questionnaires. The results were in line with those of similar studies conducted abroad.
Emotional exhaustion scored highly (40.4% of respondents), as did poor personal accomplishment (30.4%). A fifth (18.3%) experienced high depersonalisation levels, while 13.9% scored high on all three features of burnout.
What causes burnout is complex and difficult to explain. The healthcare environment and the systems operating within it do tend to put healthcare workers at risk. They suffer from time pressures, emotional intensity, role conflict, and difficult relationships between employees and management.
Research suggests that people at risk of experiencing burnout often experience a mismatch between their personality and abilities and the role they are in. This mismatch is subjective, depending on the individual as much as it is related to any particular job. So while it can mean that a person has chosen a job outside of their natural abilities, it can also mean that there may be a discrepancy in expectations between the person and the organisation. So this is not just an issue of too much work. Other central elements include control, values, community, fairness, and rewards.
To prevent or resolve some of the issues associated with burnout, people need to have a sense of control at work. They need to feel rewarded (not just financially, but also socially) and treated fairly. They need to feel that they are part of a community that communicates in a civil manner and shares the same or at least similar values. Since this job-person mismatch is a subjective experience, a positive outlook towards work also helps avoid burnout. Our research showed that people who have a better ‘match’ in one factor tend to score better in the other factors as well.
So how can burnout be addressed? Awareness is the first step towards recovery. Education is essential for people to recognise and identify burnout. Practising mindfulness can prove to be an excellent tool for anyone. By becoming more in tune with our own thoughts and emotions, evaluating them in a non-judgemental way, we can avoid falling down the slippery slope towards an unhealthy mental state.
Keeping boundaries and a correct work-life balance is another point. Having time for life outside work and being passionate about other activities is critical. Whether it’s exercise, writing, or creating art, cultivating other interests keeps our worlds varied and occupied. It creates a situation where there are other things to focus on when difficult times come.
From an organisational perspective, we need to work harder to recognise that employees are the most important resource at any workplace. They need to be supported and involved in decision making as much as possible.
Burnout is linked to other mental health conditions such as depression and anxiety. Any employee who experiences mental health problems that impinge on one’s life must feel that they are not alone and help is available. Most people spend the majority of their day and life at work so we need to make sure that it is experienced as positively as possible.
Author: Dr Raquel Medialdea-Carrera
When was the last time you heard about the Ebola virus? Many of you may recall Ebola dominating headlines in global news throughout 2014 and 2015 when it spread explosively across West Africa, claiming more than 11,300 lives.
For the last few years, Ebola has been my focus, passion, and dreaded nightmare rolled into one. In 2015, I joined a wonderful team of physicians, nurses, and scientists, that were leading the fight against Ebola in Sierra Leone. We worked in Ebola hospitals isolating patients and supporting survivors of the virus’ worst epidemic in history. Then, the World Health Organization (WHO) declared that the outbreak was over in 2016. News stations stopped covering our progress. Discussions about the disease dwindled. But the fight to eradicate Ebola was far from over.
Since August 2018, an Ebola epidemic has spread across the Democratic Republic of Congo (DRC), affecting over 2,000 people and becoming the second largest epidemic ever recorded. Over the last few weeks, I have joined the WHO to support the fight against it in Africa.
The latest Ebola outbreak in Congo is affecting people who were already suffering from a major humanitarian crisis. People in the DRC are devastated by years of violence and conflict, resulting in the largest displacement emergency in Africa. Four and a half million are currently fleeing their homes. With over 100 different armed groups in the country, the challenge of ending this Ebola outbreak is on a whole new level. But still, there is hope.
Over the last few years, researchers have toiled hard and developed a powerful vaccine against the Ebola virus. This vaccine is still under evaluation, however, the preliminary results show a wonderful efficiency of over 97.5%. Even so, we have to remain aware. Ebola is a cruel, painful death sentence for most people who get infected, and leaves in its wake a trail of broken families, hundreds of orphans, and shattered hospitals. It decimates economies and destroys societies, leading to even more poverty and hardship. This is why we cannot forget about Ebola.
Author: Clayton Sammut
A considerable amount of endemic species inhabit the Maltese Islands. The Maltese freshwater crab (Qabru in Maltese) is one of them. In the 50s, the invertebrate was so abundant that freshwater crab soup was a common Maltese delicacy. And up until Malta adopted the Euro, it graced the Maltese five cent coin. The Maltese freshwater crab is unique to our heritage, but it is now threatened with extinction.
Under the supervision of Dr Adriana Vella and the University of Malta’s conservation research group, I used various population and biological parameters to analyse the data and produce conservation recommendations.
To estimate the crab population size and density, I used two techniques known as the capture–recapture method and distance sampling in a number of repeated surveys in different sites throughout the dry (August to mid-September) and wet season (October to January). I then measured the crabs to determine their life stage and sex. This revealed more information about the reproductive population size and recruitment at each study site.
What we found was that there was an imbalance in the number of female to male breeding adults, which resulted in a small amount of offspring. This means the population cannot sustain itself, putting the species in grave danger.
Beyond health and numbers, we also directed attention to the crabs’ natural habitat. We wanted to find out whether hydrological and chemical parameters, such as water depth and water acidity, are also having an impact. As it happens, the freshwater crab’s population density is affected significantly by a water stream’s depth, width, velocity, and acidity (pH). We also found that specific sites and seasons also had an impact.
Direct water extraction, excessive use of fertilisers, and water stream channelisation are creating severe drought that suffocates the crabs during summer. So much so that adult male crabs were seen preying on their own juvenile crabs.
Looking at the rapid decline of watercourses around the Maltese Islands throughout the years, and the abuse that goes ignored and unchecked, the freshwater crab will not have a future unless we act immediately.
There are three things that we can do to undo some damage. We can fund research to determine if a reintroduction programme would work in sites which previously hosted the crab. We can also create new engineered habitats which can host the crab and bolster the population. Finally, the highly diverse habitats that are now hosting the crab can be turned into protected nature reserves. The nature reserves could engage citizens with Maltese organisms. If run as a social enterprise, it could generate funds to support important research. Protecting the animals that call our islands home is our duty as responsible citizens, but it goes beyond that. Protecting them means protecting our surroundings, our home, from a path that severs us from our roots. Protecting them is protecting ourselves.
Author: Dr Alexander Clayman
Abortion is a criminal offence in Malta. This means Maltese women who wish to end their pregnancy have severely limited choices. Those more affluent can pay to terminate their pregnancy abroad. Those who do not have the money can either continue the pregnancy against their will or terminate locally under unsafe conditions, risking both their health and freedom.
Any woman who undertakes an abortion potentially faces three years in jail. Anybody who assists, such as a doctor, could also be sentenced to four years behind bars. This flies in the face of best medical practice which states that safe abortion services should be accessible to women who need them.
A few weeks ago a group of doctors, including myself, came together to set up Doctors for Choice Malta in order to advocate for sexual and reproductive health. This includes comprehensive sex education (NOT abstinence-only education) and access to free contraception (condoms, pills, and intrauterine devices). Increased use of contraception alone results in fewer unwanted pregnancies and subsequent abortions. Putting contraceptives in the hands of comprehensively sex-educated individuals can do even more. This said, abortion still needs to be available to those people who need it.
As a doctor, I feel I have a duty to use my knowledge and skills to better my community’s health. Together with Doctors for Choice, we are basing our efforts not on opinions or morality, but on years of medical and sociological research which shows that sex education, contraception, and accessible abortions make a society healthier.
The irony was not lost on me when comments accusing me of being a baby-killing-mad-axe-murderer-who-doesn’t-understand-what-a-real-doctor-is started rolling in. Luckily for me, forewarned is forearmed, and the negativity failed to penetrate very deep.
What did strike me was the contrast between the way people communicate their derision and their support. Abusive comments come in fast, prominent, and loud. Supportive comments are usually sent in private. At present, it’s clearly very easy to be openly anti-choice, but very difficult to be openly pro-choice.
To those afraid to raise their voice and speak the truth, I say: whatever dogma, tradition, or a battalion of angry keyboard lieutenants might tell us, those who advocate for reproductive choice have nothing to be ashamed of. We are on the right side of history.
Read more: Marston, C., & Cleland, J. (2003). Relationships between Contraception and Abortion: A Review of the Evidence. International Family Planning Perspectives, 29(1), 6. https://doi.org/10.2307/3180995
Stanger-Hall, K. F., & Hall, D. W. (2011). Abstinence-Only Education and Teen Pregnancy Rates: Why We Need Comprehensive Sex Education in the U.S. PLoS ONE, 6(10), e24658. https://doi.org/10.1371/journal.pone.0024658
Vince Briffa’s contribution to the Venice Biennale in 2019 is OUTLAND. An audio-visual piece inspired by The Odyssey, a story intimately linked to the Maltese islands’ own folklore, the work unfurls over many layers.
On one level, it explores the lure of safety and the numbness that can bring—exhibited through Ulysses’ portrayal, who is caught in a bubble of his own making. ‘The plastic room replaces the island from the story, presenting a different interpretation,’ explains Briffa. Here, it is Ulysses’ own mind and thoughts that keep him trapped.
The character of Calypso is also a reflection of the theme MALETH—port and safe haven. ‘She is both a lover and oppressor,’ Briffa says. ‘Calypso offers a haven for Ulysses during the seven years he spends harboured in her cave. But he is also her prisoner.’
Finally, there is fragmentation and distortion to create new from old. Penelope is Ulysses’ waiting wife, torn between longing for her husband’s safe return and an uncertainty she secretly harbours—is that even what she truly wants? Her presence in the work comes through the use of Emmanuel Mifsud’s poem Penelopi Tistenna (‘Penelope waits’). For Briffa, the Maltese language helps the story ‘take on a different life.’
The work’s duality is apparent. Images are juxtaposed against one another. One can observe two characters simultaneously, living their own truths and challenging each other. However, the conflict is not structured. ‘It’s a contemporary art piece, not film. There is no story. It’s more of a painting. I am, myself, a painter first,’ Briffa notes.
So for those who find a narrative in this piece, know that it is uniquely yours. The question now is: will you share it?
To watch and read more about OUTLAND visit www.vincebriffa.com
People are living longer than ever. But a long life has its price. With age come more diseases and health issues, such as hip problems that can limit a person’s mobility.
Hip replacement procedures have become common, although implants have a lifespan too. It might happen that a hip replacement you get at 60 needs to be replaced at 75. This is not the ideal scenario.
To minimise these cases, researchers are testing new materials and designs to prolong prostheses’ lifespans. These potential solutions need to be tested, but each test costs tens of thousands of euro. Enter, the University of Malta’s hip joint simulator.
The hip joint simulator is a machine that replicates the joint movements and loads imposed on the human hip. To do so, the simulator uses three stainless steel frames, each of which can be controlled independently using motors. These motors act as the ‘muscles’ of the hip, programmed to replicate the walking cycle during testing.
When it comes to simulating load and forces, a mechanism can load the implants with weights of up to 300kg in a fraction of a second. This emulates what happens while walking, when the weight of the body rests on one leg due to the body’s shift in the centre of gravity. While running, inertial forces can cause the hip to sometimes take five times a person’s body weight.
Finally, to simulate the environment inside the human body, researchers use a specialised solution that mimics the bodily fluids surrounding the hip joint. They even warm the fluid to imitate body temperature.
The hip joint simulator forms part of the MaltaHip project that intends to radically redesign hip implants to give them the longer lifespan patients want and need. Watch this space for more.
The MALTAHIP project is funded by the Malta Council for Science and Technology through FUSION: The R&I Technology Development Programme 2016 (R&I-2015-023T).
Author: Michelle Cortis
In recent years, there has been a shift in the relationship between research and commercial industries. Commercial viability almost always comes into question for ongoing research. Commercialisation can be a boon. When a research project has demonstrated its potential to become a viable business, funding opportunities increase, meaning the research can be turned into a product or service that people can use.
In 2018, as part of a Masters in Knowledge-Based Entrepreneurship, I analysed the commercial potential of an ongoing University of Malta project. I conducted an in-depth market feasibility study on Prof. Ing Joseph Cilia’s Smart Micro Combined Heat and Power System, a device that can be fitted into homes and offices to deliver heat as a by-product of electricity, reducing energy costs. Many EU countries are setting up incentives to make these systems more feasible and attractive to consumers.
For my dissertation, I developed a business plan for the research team. An engineer myself, and having earned a Masters by Research back in 2014, this was different to anything I had done before. My supervisors, Prof. Russell Smith and Dr Ing. Nicholas Sammut, helped me find the right balance between utilising my technical knowledge whilst also analysing the product’s commercial potential. Even my language changed through the process; I began to speak of ‘euros per day’ rather than ‘kilowatt hours’. I learnt to differentiate between technological features and what real benefits future users would gain.
Being presented with a physical product, initially one may assume that it is to be sold to customers, or protected through a patent and licensed to the private sector. However, my market analysis revealed new target audiences that had not been thought of before. Selling the device was not the only way to exploit the project’s commercial potential. What if we leased the product instead of selling it? Should we continue developing the product or is it already innovative enough? What if we developed a spin-out—would it be too expensive or is it worth the investment?
By analysing a project through a commercial lens, all these questions arise, pointing out potential ways to make a good project great. But what makes a good business plan great is when all these questions are answered.
The Project ‘A Smart Micro Combined Heat and Power System’ is financed by the Malta Council for Science & Technology, for and on behalf of the Foundation for Science and Technology through the FUSION: R&I Technology and Development Programme.
Are you carrying out research at the University of Malta which you think may have commercial potential? If so, contact the Knowledge Transfer Office on knowledgetransfer@um.edu.mt