Qalb ommu

Ġabra ta’ poeżiji u proża li tinkludi: Il-għanja tal-ħamsa u tletin sena ta’ Patri Mattew – Meta lbist il-ġlekk ta’ ħija ta’ George Vella – Tliet poeżiji qosra ta’ John Sciberras – Għada jisbaħ xorta waħda – Ġejjin id-dgħajjes – Il-kotra u ż-żmien – Ferħa bla temma ta’ A. Guillaumier – Qalb ommu ta’ Jos. M. Manara.N/

Major coastal engineering works : monitoring and management of environmental impacts and risks : a case study from the Central Mediterranean (Malta)

Coastal tourism and related developments of the past decades have significantly altered parts of the Mediterranean coastline. These include major coastal engineering works and alterations such as marina developments which lead not only to habitat loss but also to risks of degradation of water and sediment quality and of benthic communities. Being the smallest island-state in the region with the highest population density, Malta is an ideal case-study to assess such impacts.The paper presents data from a long-term compliance marine monitoring programmerelated to the development and operation of a major marina in Malta, involving major excavation works to develop a new marina basin able to hold 130 berths, complete with breakwater and other facilities. The monitoring programme(1996 to 2003)aimed at identifying and managing associated risks to the marine environment (including Posidonea oceanica meadows).For management purposes, a set of environmental objectives and quality standards were initially set for various water and sediment parameters and then subsequent monitoring of these parameters served as surveillance against risks of environmental deterioration. The paper provides useful information on the dynamics and trends in water and sediment quality resulting from such major coastal engineering works, and on how such trends may be related to associated changes (and possible recovery) of P. oceanica meadows.peer-reviewe

On the fallibility of human memory for future actions

Human memory is a system that is inherently fallible and prone to distortion, and our memory for future actions is no exception. Prospective memory is defined either as remembering to carry out a task at a particular moment in the future or as the timely execution of a previously formed intention. For a variety of reasons, one may miss this prearranged moment and thus fail to fulfill an intention. This thesis focuses on the factors that may affect the fulfilment of a delayed intention and contribute to prospective memory failures. As the rather scant literature on the effect of stress on prospective memory functioning has produced contradictory findings, Part One of this Thesis investigates the role of stress in prospective memory failures in a strict sense, namely forgetting to carry out intended actions at the appointed time and place. One study involving healthy participants examines the disruptive effect of daily stress on prospective memory functioning and explores the moderating role of individual factors in modulating the harmful consequences associated with stress in everyday life. Another study carried out with healthcare workers investigates how work stress and burnout may contribute to forgetting clinical tasks, which may result in potential adverse events jeopardizing patient safety. Besides stress, misremembering future intentions may also arise from the lingering effect of misinformation on our memory, attitudes, and behaviors. Part Two of this Thesis, encompassing 6 experiments on healthy participants, shows how inaccurate and invalid information survive despite sophisticated correction attempts, influencing memory and reported future intentions. Overall, the results of the studies presented in this Thesis prove the fallibility of our memory for future actions. Various techniques to reduce the risks associated with memory failures are discussed

Addressing tobacco in Australian alcohol and other drug treatment settings: A cross-sectional survey of staff attitudes and perceived barriers

© 2017 The Author(s). Background: Within alcohol and other drug (AOD) services, staff attitudes and beliefs are important influences determining provision of smoking cessation care. This study of AOD staff aimed to examine: a) current attitudes toward smoking cessation care; b) service and staff characteristics associated with unsupportive smoking cessation care attitudes, and c) perceived barriers to providing smoking cessation care. Methods: Between July-October 2014, 506 staff from 31 Australian AOD services completed an online cross-sectional survey which assessed agreement with 6 attitudinal statements (supportive and unsupportive) and 10 perceived barriers to smoking cessation care in the AOD setting. Logistic regressions examined service (sector) and staff (age, gender, smoking status and number of years in AOD field) characteristics associated with unsupportive smoking cessation care attitudes. Results: A large proportion agreed with supportive statements: Smoking cessation care should be part of usual care (87%), smoking cessation care is as important as counselling about other drugs (72%) and staff have the organisational support to provide smoking cessation care (58%). Some respondents agreed with unsupportive statements: AOD clients are not interested in addressing their smoking (40%), increasing smoking restrictions would lead to client aggression (23%), smoking is a personal choice and it is not the service's role to interfere (16%). Respondents from non-government managed services, current tobacco smokers (compared to ex-smokers) and those with less AOD experience had higher odds of agreeing with unsupportive smoking cessation care statements. The most frequently identified barriers to providing smoking cessation care were: client inability to afford cessation medicines, insufficient funding and lack of a coordinated treatment approach (all 61%). Conclusions: Overall, staff hold largely supportive smoking cessation care attitudes but perceive a large number of barriers to providing smoking cessation care

'The lesser of two evils': A qualitative study of staff and client experiences and beliefs about addressing tobacco in addiction treatment settings.

INTRODUCTION AND AIMS: The aim of this study was to explore beliefs about tobacco dependence treatment from the perspective of staff and clients in addiction treatment settings. DESIGN AND METHODS: A qualitative study was conducted between August and November 2013 using grounded theory methodology. Participants were recruited from four government-funded drug and alcohol services in a regional centre of New South Wales, Australia. Treatment centre staff (n = 10) were interviewed using a semistructured interview guide and two focus groups (n = 5 and n = 6) were held with clients of the same treatment centres. RESULTS: Both clients and staff wish to do more about tobacco use in addiction treatment services, but a number of barriers were identified. Staff barriers included lack of time, tobacco-permissive organisational culture, lack of enforcement of smoke-free policies, beliefs that tobacco is not a treatment priority for clients and that clients need to smoke as a coping strategy, and perceptions that treatment was either ineffective or not used by clients. Clients reported smoking as a habit and for enjoyment or stress relief, seeing staff smoking, nicotine replacement therapy unaffordability and perceptions that nicotine replacement therapy may be addictive, and inability to relate to telephone cessation counselling as barriers to quitting smoking. DISCUSSION AND CONCLUSIONS: Client and staff perceptions and attitudes about the treatment of tobacco, particularly those relating telephone support and nicotine replacement therapy, provided information, which will inform the design of smoking cessation programs for addiction treatment populations. [Wilson AJ, Bonevski B., Dunlop A., Shakeshaft A, Tzelepis F., Walsberger S., Farrell M., Kelly PJ, Guillaumier A. 'The lesser of two evils': A qualitative study of staff and client experiences and beliefs about addressing tobacco in addiction treatment settings. Drug Alcohol Rev 2015]

QuitNic: A Pilot Randomized Controlled Trial Comparing Nicotine Vaping Products With Nicotine Replacement Therapy for Smoking Cessation Following Residential Detoxification

INTRODUCTION: The QuitNic pilot trial aimed to test the feasibility of providing a nicotine vaping product (NVP) compared with combination nicotine replacement therapy (NRT) to smokers upon discharge from a smoke-free residential substance use disorder (SUD) treatment service. METHODS: QuitNic was a pragmatic two-arm randomized controlled trial. At discharge from residential withdrawal, 100 clients received telephone Quitline behavioral support and either 12-week supply of NRT or an NVP. Treatment adherence and acceptability, self-reported abstinence, cigarettes smoked per day (CPD), frequency of cravings, and severity of withdrawal symptoms were assessed at 6 and 12 weeks. Results are reported for complete cases and for abstinence outcomes, penalized imputation results are reported where missing is assumed smoking. RESULTS: Retention on was 63% at 6 weeks and 50% at 12 weeks. At 12 weeks, 68% of the NRT group reported using combination NRT while 96% of the NVP group used the device. Acceptability ratings for the products were high in both groups. At 12 weeks, 14% of the NVP group and 18% of the NRT group reported not smoking at all in the last 7 days. Mean CPD among continued smokers decreased significantly between baseline to 12 weeks in both groups; from 19.91 to 4.72 for the NVP group (p < .001) and from 20.88 to 5.52 in the NRT group (p < .001). Cravings and withdrawal symptoms significantly decreased for both groups. CONCLUSIONS: Clients completing residential withdrawal readily engaged with smoking cessation post-treatment when given the opportunity. Further research is required to identify the most effective treatments postwithdrawal for this population at elevated risk of tobacco-related harm. TRIAL REGISTRATION NUMBER: ACTRN12617000849392. IMPLICATIONS: This pilot study showed that smoking cessation support involving options for nicotine replacement and Quitline-delivered cognitive behavioral counseling is attractive to people after they have been discharged from SUD treatment. Both nicotine vaping products and nicotine replacement therapies were highly acceptable and used by participants who reported reductions in cravings for cigarettes and perceptions of withdrawal symptoms and reductions in number of cigarettes smoked. Some participants self-reported abstinence from cigarettes-around one in five reported having quit smoking cigarettes at 12 weeks postdischarge. The results have significant public health implications for providing quit support following discharge from SUD treatment