Findings generally support the reliability and validity of the Maltese version of the GHQ-12(WB). Model fit changes over time reflect the dynamic nature of postpartum recovery. Further evaluation of the GHQ-8(WB) is recommended.

a b s t r a c tContext: Today, the use of herbal medicine for primary healthcare has increased considerably. Since local pharmacists graduate with little knowledge on herbal medicine, the majority are ill-equipped to provide pharmaceutical advice. Aims: To develop and evaluate a herbal medicine formulary to aid healthcare professionals (HCPs) in the prescribing, dispensing and counselling responsibilities. Settings and Design: Community pharmacies. Methods and Material: Monographs on all herbal substances available locally were compiled into a formulary. The formulary was then distributed to all, 216, local pharmacies. Subsequently, a questionnaire was distributed to 55 pharmacists and 10 general practitioners (GPs). Statistical analysis used: Descriptive statistical analysis. Results: A total of 177 herbal monographs have been compiled and 612 herbal products listed. Thirty HCPs participated in the questionnaire. The formulary was found to be useful by all participants with 19 claiming to use it frequently and 7 quite frequently. Participants (n ¼ 30) agree that the information contained within the formulary was found to be useful (26), the formulary helped them learn which HMPs are present in the local market (29), the formulary is user friendly (27), information included is upto-date and well referenced (29) and that there is the need for a formulary of this kind in Malta (28). Conclusions: The formulary was found to be a useful tool for HCPs leading to high quality, evidence-based prescribing together with enhanced monitoring and improved patient care.

Customer churn poses a significant challenge in various industries, including motor insurance. Retaining customers within insurance companies is much more challenging than in any other industry as policies are generally renewed every year. The main aim of this research is to identify the risk factors associated with churn, establish who are the churning customers and to model time until churn. The dataset used includes 72,445 policy holders and covers a period of one year. The data comprises information related to premiums, claims, policies and policy holders. The random forest algorithm turns out to be a very effective model for forecasting customer churn, reaching an accuracy rate of 91.18%. On the other hand, survival analysis was used to model time until churn and it was concluded that approximately 90% of the policy holders survived for the first five years while the majority of the policy holders survived till the end of the policy period. These results could be used to target the identified customers in marketing campaigns aimed at reducing the rate of churn while increasing profitability.

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Background Climate & environmental change are disproportionally impacting small states, given higher costs per capita associated with coping with the immediate risks of environmental & climatic events. Climate change has been identified as a serious public health threat. This is especially true for heatwaves in the Mediterranean Basin, with poor air quality worsening the health impacts during periods of extreme heat, often affecting already high levels of chronic diseases. Promoting climate change adaptation measures is crucial to address the negative socio-economic impacts brought by heatwaves, & its interactions with poor air quality. While awareness about the link between poor air quality & heat-waves is gaining momentum, there is still a gap in policy responses, especially in small states. This research assesses the level of preparedness of the European Union, with a focus on adaptation to heat-waves since the extreme European heat-wave of 2003. A case study on Malta is also presented, aiming at discovering what measures the island is adopting to tackle the problems arising from the interaction between poor air quality & heatwaves. Methods A systematic literature review is conducted, investigating the links between heat-waves & air pollution post 2003, followed by a qualitative content analysis to assess the preparedness of climate change adaptation measures in this regard. Results and conclusions The findings of this research show that the link between heat waves & poor air quality has not been sufficiently acknowledged by academia, with evident gaps in applied small states research. Also, a closer look at key adaptation policies & measures in Malta finds that heat waves & poor air quality are hardly been linked, leaving much scope to introduce policy & economic instruments to tackle both public health risks to address growing chronic diseases, & not to compromise current & future socioeconomic wellbeing.