The migration crisis : no human is illegal

The migrants seeking to enter Europe—we surely cannot blame them for leaving their homeland. What would we not do to save our families or ourselves from economic ruin, religious or political persecution, civil strife, poverty, or long-term unemployment? Many make a rational choice. They move to close havens: thousands of Syrians shelter in Jordan, Lebanon and Turkey. But desperation and aspiration drive thousands to the cluster of safe and affluent European states that lie temptingly close, and who need skilled eager workers to secure the future of their economies and welfare regimes. Such a ‘push–pull’ scenario has driven human mobility throughout the ages.peer-reviewe

The road to women’s suffrage and beyond : women’s enfranchisement and the nation-building project in Malta

Although there is little doubt that Maltese women emerged from World War II with a stronger awareness of the intolerable gap between their potential and the harsh reality of their social condition, the road to 1947 began early in the first half of the 20th century and certainly did not end in 1947. As a matter of fact the journey has by no means ended; indeed it continues. The struggle for universal suffrage in Malta, and specifically for the vote for women, cannot be understood separately from the country’s social, cultural, economic and political development. The debates inside the National Assembly (1945-1946) reveal the sharp confrontation of views in favour and against the right to vote for women. Indeed, a very significant element in the National As- sembly fought tooth and nail to prevent women’s very presence in the National Assembly. Contrast this with Dr Paul Boffa’s proposal to enfranchise all men and women over the age of 18. Finally, the National Assembly voted 145 for and 137 against for universal suffrage at age 21. A motion by Josephine Burns de Bono and Hélène Buhagiar (who had to strug- gle to be allowed to participate in the National Assembly as representatives of the Women of Malta Association, the third woman being Mabel Strickland who was admitted as the representative of the Times of Malta) for women’s right to stand for public office, was also passed. It is pertinent to recall that the Women of Malta Association was founded early in 1944. Within a few months the Association twice requested the National Congress for representation in the National Assembly. Twice it was turned down. The Women of Malta Association’s request was finally accepted in 1945 by the National Assembly. These achievements became law with the promulgation of the 1947 Constitution in September 1947. The first elections under the new constitution took place on 25-27 October of the same year. 54% of the 140,703 persons eligible to vote were women. Around 75% of the electorate turned out to vote. Of 76,745 registered female voters, 54,565 actually voted. Of the two women candidates, one – Agatha Barbara (1923-2002) – was elected for the Labour Party. She would successfully contest ten consecutive elections, be appointed cabinet minister five times, and would be the first Maltese woman to become president of the Republic in 1982. With the issue of a €10 silver coin to celebrate the 70th anniversary of the achieve- ment of Maltese women’s right to vote, the Central Bank of Malta continues a tradition of issuing coins to commemorate important constitutional developments (see First Elected Representatives 1849 issued 2011, Majority Representation 1887 issued 2012, Self-Government 1921 issued 2013, Independence 1964 issued 2014, Republic of Malta 1974 issued 2015). Dr Carmen Sammut’s study The Road to Women’s Suffrage and Beyond: Women’s Enfranchisement and the Nation-Building Project in Malta is a significant scholarly contribution to counter what she correctly calls “the prevalent collective amnesia about women’s place in history”.peer-reviewe

Malta and the 2019 EP elections – maximising popular engagement with “Europe”

The purpose of this paper is to analyse why Malta continues to show the highest level of turnout for European Parliament (EP) elections in a country where voting is not obligatory. By analysing the Maltese EP elections from 2004 to 2019, the paper seeks to understand why the Maltese engage with a second order election to the degree that they do.peer-reviewe

The ‘gender balance reform’ for the Maltese Parliament : a historical, sociological justification from a feminist perspective

In my presentation I will discuss positive measures that were introduced to address the under-representation of women in Maltese politics, taking into consideration the historical backdrop and the islands’ cultural traits. Positive measures are aimed to extend the pool of diverse individuals who will contribute towards inclusive decision-making at the top levels of power. [Excerpt]peer-reviewe

Multiculturalism, integration and contact amongst socio-ethnic groups in Malta

Migration has always been a way of life for islands. At the crossroads of the Mediterranean Sea, Malta was always open to regional cross-fertilisation. There is biological evidence of this contact by geneticists who observed in Malta lineages similar to those of southern Italy, North Africa and the Middle East. These links are corroborated by influences on the Maltese language, place names and surnames that vividly illustrate solid interconnections with the Arab Muslim world.peer-reviewe

Aspirations and accommodations for students with disability to equitably access higher education: a systematic scoping review

IntroductionSeveral international conventions have recognized the importance of equal access to higher education on the basis of ‘capacity’. However, inequalities persist for various groups. This paper presents a systematic scoping review of studies on the aspirations and access needs of students with disability, medical and mental health conditions to equitably participate in tertiary education.MethodsA search of ERIC, PsycINFO and Web of Science databases identified 133 relevant research articles from across the world covering the experiences of students with all types of disability. These were subjected to thematic analysis.ResultsThree main themes were identified. Firstly, the findings showed that a crucial component of the student higher education experience was the development of their own self-identity, addressing stigma and enhancing self-advocacy skills, autonomy, and career prospects. Secondly, the studies described how students struggled for full membership in the university community, calling for a transformation of university physical, social and teaching environments for them to access and participate in academic and social activities. Thirdly, the analysis showed that students valued individual accommodations in both coursework and assessment.DiscussionThese findings constitute a newly comprehensive framework for inclusive tertiary education systems and individual accommodations which is grounded in empirical research from a wide variety of contexts. This can serve higher education institutions to develop policy and procedures to ensure equitable participation of students with disability

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Supplement: "Localization and broadband follow-up of the gravitational-wave transient GW150914" (2016, ApJL, 826, L13)

This Supplement provides supporting material for Abbott et al. (2016a). We briefly summarize past electromagnetic (EM) follow-up efforts as well as the organization and policy of the current EM follow-up program. We compare the four probability sky maps produced for the gravitational-wave transient GW150914, and provide additional details of the EM follow-up observations that were performed in the different bands