A multi-hazard historical catalogue for the city-island-state of Malta (Central Mediterranean)

The city-island-state of Malta is traditionally viewed as a low-hazard country with the lack of a long historical catalogue of extreme events and their impacts acting as an obstacle to formulating evidence-based policies of disaster risk reduction. In this paper, we present the first multi-hazard historical catalogue for Malta which extends from the Miocene to 2019 CE. Drawing on over 3,500 documents and points of reference, including historical documentary data, official records and social media posts, we identify at least 1,526 hazard events which collectively have caused the loss of at least 661 lives. Recognising that historical materials relating to Malta are complicated by the presence of a strong temporal bias, we establish a four-point reliability indicator and apply this to each of the 1,062 recordings, with the result that some 78 % show a high degree of reliability. For an island state where there are significant gaps in the knowledge and understanding of the environmental extremes and their impacts over time, this paper addresses and fills these gaps in order to inform the development of public-facing and evidence-based policies of disaster risk reduction in Malta.peer-reviewe

A multi-hazard historical catalogue for the city-island-state of Malta (Central Mediterranean)

This is the final version. Available on open access from Springer via the DOI in this recordThe city-island-state of Malta is traditionally viewed as a low-hazard country with the lack of a long historical catalogue of extreme events and their impacts acting as an obstacle to formulating evidence-based policies of disaster risk reduction. In this paper, we present the first multi-hazard historical catalogue for Malta which extends from the Miocene to 2019 CE. Drawing on over 3500 documents and points of reference, including historical documentary data, official records and social media posts, we identify at least 1550 hazard events which collectively have caused the loss of at least 662 lives. Recognising that historical materials relating to Malta are complicated by the presence of a strong temporal bias, we establish a four-point reliability indicator and apply this to each of the 1065 recordings, with the result that some 79% show a high degree of reliability. For an island state where there are significant gaps in the knowledge and understanding of the environmental extremes and their impacts over time, this paper addresses and fills these gaps in order to inform the development of public-facing and evidence-based policies of disaster risk reduction in Malta.Liverpool Hope UniversityUniversity of Malt

The city‐island‐state, wounding cascade and multi‐level vulnerability explored through the lens of Malta

In this paper, we introduce the concept of “city‐island‐state” into a discussion of small highly urbanised islands. We place the “city” at the forefront of our analysis by bringing together the geographies of the “city” and “state”, together with a wider discussion of factors that may cause both the wounding of the city and increase the precariousness of the “island”. We apply this concept to the advanced city‐island‐state of Malta (Central Mediterranean), which is a densely populated, urbanised small island archipelago with ca. 500,000 inhabitants and operates as a single city with: an urban core; suburbs and a rural hinterland which is rapidly decreasing in size. This city‐island‐state is frequently considered as being “safe” from external geophysical, climatic and anthropogenic wounding, but, in reality, Malta, as a city, an island, and an independent nation‐state, is faced with multiple internal and external pressures that increase its precariousness and vulnerability to such externalities. Some of these are socio/economic, but others are environmental. We argue that the potential for wounding is particularly marked in Malta, is exacerbated by the contemporary globalised neoliberal world of flows and interconnectivities and that this represents a multi‐level wounding cascade: wounding the city, wounds the island and, by extension, the state

School de-segregation and the Politics of ‘Forced Integration’

Using the programme for creating the controversial school academies, local governments in the UK have attempted to force an integration of schools with majority white and ethnic minority pupil cohorts via new mergers. This has largely been as a response to analysts’ fears about self-segregation and insufficient community cohesion, following riots in northern towns in 2001 and the spectre of radicalisation among young Muslims following 9/11 and 7/7. An examination of school mergers in Burnley, Blackburn, Leeds and Oldham reveals how they have amplified racial attacks on Muslim pupils and their feelings of insecurity, while also fuelling a backlash against what is perceived by some members of the white working class as a form of social engineering that endangers white privilege

Demographic data in asthma clinical trials: a systematic review with implications for generalizing trial findings and tackling health disparities

The prevalence of asthma, and the morbidity, adverse events, mortality and healthcare utilisation of asthmatic patients vary widely among racial/ethnic and other socio-demographic groups. Debates over the meanings of race and ethnicity and the strategic need to resolve health inequalities have prompted extensive recommendations for reporting and analyzing racial/ethnic and demographic information in clinical trials. We conducted a systematic review to determine the extent to which race/ethnicity, socio-economic status and other demographic variables are analyzed and reported in publications from randomized controlled trials of asthma interventions. Randomized controlled trials of inhaled corticosteroids and long-acting ?-agonists in asthmatic patients were identified by systematically searching 12 electronic bibliographic databases. We identified peer-reviewed papers reporting 87 relevant trials published during 1985–2006, from which we extracted data on patients' race/ethnicity, ancestry, gender, socio-economic variables and geographical attributes. The proportion of the papers reporting the race/ethnicity of their participants was lower than would be expected by chance and has recently declined. None of the papers included race/ethnicity or gender in statistical analyses or reported socio-economic variables, ancestry, or genetic data for their participants, and few discussed the generalizability of their findings. The frequency of reporting race/ethnicity was statistically significantly lower in trials conducted in the UK than in the US, but 23 of the 87 papers did not identify countries. Despite extensive recommendations in the literature, guidance from health agencies on analyzing and reporting demographic data in clinical trials still appears inconsistent and vague. There remains a need to improve guidance on the representation and analysis of minority populations in asthma clinical trials, in order to encourage transparent reporting of population selection, analysis approaches, and trial generalizability. To assist this process, asthma clinical trials should be based on clear hypotheses that link both to existing demographic evidence and to demographic healthcare goals.<br/

Subjective right ventricle assessment by echo qualified intensive care specialists: assessing agreement with objective measures

International audienceBackgroundRight ventricle (RV) size and function assessment by echocardiography (echo) is a standard tool in the ICU. Frequently subjective assessment is performed, and guidelines suggest its utility in adequately trained clinicians. We aimed to compare subjective (visual) assessment of RV size and function by ICU physicians, with advanced qualifications in echocardiography, vs objective measurements.MethodsICU specialists with a qualification in advanced echocardiography reviewed 2D echo clips from critically ill patients on mechanical ventilation with PaO2:FiO(2) <300. Subjective assessments of RV size and function were made independently using a three-class categorical scale. Agreement (B-score) and bias (p value) were analysed using objective echo measurements. RV size assessment included RV end-diastolic area (EDA) and diameters. RV function assessment included fractional area change, S, TAPSE and RV free wall strain. Binary and ordinal analysis was performed.ResultsFifty-two clinicians reviewed 2D images from 80 patients. Fair agreement was seen with objective measures vs binary assessment of RV size (RV EDA 0.26 [p<0.001], RV dimensions 0.29 [p=0.06]) and function (RV free wall strain 0.27 [p<0.001], TAPSE 0.27 [p<0.001], S 0.29 [p<0.001], FAC 0.31 [p=0.16]). However, ordinal data analysis showed poor agreement with RV dimensions (0.11 [p=0.06]) and RV free wall strain (0.14 [p=0.16]). If one-step disagreement was allowed, agreement was good (RV dimensions 0.6 [p=0.06], RV free wall strain 0.6 [p=0.16]). Significant overestimation of severity of abnormalities was seen with subjective assessment vs RV EDA, TAPSE, S and fractional area change.ConclusionSubjective (visual) assessment of RV size and function, by ICU specialists trained in advanced echo, can be fairly reliable for the initial exclusion of significant RV pathology. It seems prudent to avoid subjective RV assessment in isolation

The Hazard Exposure of the Maltese Islands

International comparisons of disaster risk frequently classify Malta as being one of the least hazard exposed countries. Such rankings may be criticised because: (1) they fail to take into account historic increases in population and its seasonal variation; (2) they are based on inadequately researched and incomplete historical catalogues of damaging events and (3), for small island states like Malta, they do not take into account the implications of restricted land area, which can be disproportionately impacted by even small hazardous events. In this paper, we draw upon a variety of data to discuss disaster risk in the Maltese Islands. In particular, the notion that Malta is one of the ‘safest places on earth’ is not only misleading, but also potentially dangerous because it engenders a false sense of security amongst the population. We argue that Malta is exposed to a variety of extreme events, that include: the distal effects of major earthquakes originating in southern Italy and Greece, plus their associated tsunamis; major ash producing eruptions of Mount Etna (Sicily), and their putative impacts on air transport; storm waves; coastal/inland landslides; karstic collapse; flooding and drought. In criticising international rankings of the islands’ exposure, we highlight the issues involved in formulating hazard assessments, in particular incomplete catalogues of extreme natural events. With Malta witnessing swelling resident, seasonal (i.e. tourist) plus foreign-born populations, and increases in the urban area, further research into hazards is required in order to develop evidence-based policies of disaster risk reduction (DRR)