Chekib Zedini - Academia.edu (original) (raw)

Papers by Chekib Zedini

Research paper thumbnail of Massive Influx of Victims: Staff Preparedness and Facility Readiness of Tunisian General University Hospitals

Prehospital and Disaster Medicine, May 1, 2023

Research paper thumbnail of Intravenous lidocaine as adjuvant to general anesthesia in renal surgery

Libyan Journal of Medicine, 2018

Research paper thumbnail of Evaluating the Level of Disaster Preparedness of Tunisian University Hospitals Using the Hospital Safety Index: A Nationwide Cross-sectional Study

Prehospital and Disaster Medicine, May 1, 2023

Introduction: Postgraduate education is important in preparing and enhancing health professionals... more Introduction: Postgraduate education is important in preparing and enhancing health professionals for the practice of disaster and terror medicine. The World Association for Disaster and Emergency Medicine (WADEM) has formulated a standardized international perspective for education and training in disaster medicine and health. Notwithstanding, there continues to be a reported gap in competency-based training in disaster and terror medicine internationally, particularly across Asia Pacific, which is a known vulnerable region. We report on a new Graduate Diploma in Disaster and Terror Medicine, to be expanded to Master level in 2024. The course is delivered mainly online to a multidisciplinary international audience. This paper summarizes the development of the course and outlines the key influences that have contributed to the design of the course. Method: A survey of the critical care workforce conducted by the Department of Critical Care at the University of Melbourne in early 2020 identified the need to develop education in disaster and terror medicine. A market and competitor analysis identified there was a gap in clinician focused courses offered in Australia and internationally. Based upon these results, a new course was developed to meet these needs. Results: Based on the results of the survey and feedback from expert stakeholders, the new postgraduate courses in disaster and terror medicine were developed. They offer both core and elective subjects, utilizing a modular approach with supervised simulation and practical training. The courses incorporate problem-based learning, the principles and practices of online education and advances in simulation-based learning, providing both a public health and clinical lens. Conclusion: The nested suite of postgraduate disaster and terror medicine courses at the University of Melbourne is at the forefront of learning within this field and meets the contemporary needs of health professionals who practice disaster and terror medicine

Research paper thumbnail of Assessment of patient safety culture in intensive care units and factors affecting it

European journal of public health, Sep 1, 2020

Background: Primary healthcare centers provide the first contact for patients and it goes without... more Background: Primary healthcare centers provide the first contact for patients and it goes without saying that quality and patient safety in these facilities are vital goals and challenges. In fact, it has been identified that a significant proportion of safety incidents caught in hospitals had originated in the earlier levels of care, and some studies have found that errors in primary care can result in severe consequences. Hence why, a developed Patient Safety Culture is a component key to improve patient safety and healthcare quality in these settings. Thus, this study aimed to assess patient safety culture in Tunisian primary healthcare centers and to explore its associated factors. Methods: It is a cross-sectional descriptive multicenter study, conducted from January to April 2016 in all the 30 primary healthcare settings of the Tunisian center, partners of the Faculty of Medicine of Sousse. The measurement instrument used was the validated French version of the Hospital Survey on Patient Safety Culture Questionnaire. The data analysis was conducted using the Statistical Package for Social Sciences (SPSS 20.0) and Epi info 6.04d for windows. Results: A total of 214 professionals participated in the study, corresponding to a response rate of 85%. The ''Teamwork within units'' dimension had the highest score (71.5%). The lowest scores were for the dimensions related to ''Frequency of events reported'' and the ''Non-punitive response to errors'' (31.4% and 35.4% respectively). Additionally, the ''Frequency of reported events'' dimension was significantly higher among professionals involved in risk management committees (p = 0.01). Conclusions: This study demonstrates that the level of patient safety culture needs to be improved in primary healthcare centers in Tunisia. Strategies to nurture patient safety culture should focus upon building leadership capacity that supports open communication, blame-free environment, teamwork and continuous organizational learning. Key messages: Patient safety culture in primary healthcare settings is not as strong to ensure the provision of safe care. A well-designed patient safety initiatives, with organizational policies, must be integrated in order to enhance patient safety and quality of care.

Research paper thumbnail of Adolescent’s substance use and suicidal thoughts in Tunisia

European journal of public health, Nov 1, 2019

Background: Care for victims of sexual violence is fragmented in Belgium. Therefore, sexual assau... more Background: Care for victims of sexual violence is fragmented in Belgium. Therefore, sexual assault care centers (SACCs) were piloted in three cities from November 2017 onwards. The SACCs offer forensic, medical and acute psychological care through a forensic nurse, while vice inspectors perform an interrogation at the SACC for those wishing to report. The nurse coordinates the follow-up care and a psychologist provides mental health support. A quantitative prospective study was carried out assessing the characteristics of SACC patients, the sexual violence they experienced and the care received, in order to inform the national scale-up of the model. Methods: Data on SACC patients was routinely collected in the electronic patient files by the SACC personnel between November 1st 2017 and October 31th 2018. Data was analyzed in SPSS. Results: Within the first year SACCs were attended by 930 victims. Mean age was 24,5 years (SD = 12.8), and one third were minors. Eighty-eight percent of victims was female and 67% presented for rape. Fifty-seven percent of the assailants were known to the victim. Thirty-five percent of the victims selfreferred to SACC, 41% were referred by the police, and 66% of victims attended services within 72 hours. Respectively 75%, 61%, 47% and 68% of victims received medical care, a forensic examination, psychological care and reported to the police. Conclusions: Without big publicity the SACCs received a higher than expected number of victims. Expansion of the collaboration with police and targeted communication strategies should further increase the number of victims receiving appropriate care. Qualitative research assessing the acceptability of the SACC model will further inform the scale-up of the model. Key messages: The quantitative study led to a better understanding of the population using the SACCs. The study allowed to improve the training of the staff members, adapt the SACC procedures before scale-up and define targeted service-promotion strategies.

Research paper thumbnail of Prevalence and associated factors of perinatal depression among working pregnant women: a hospital-based cross-sectional study

Libyan Journal of Medicine, Aug 24, 2022

Research paper thumbnail of A Qualitative Study on the Use of the Hospital Safety Index and the Formulation of Recommendations for Future Adaptations

Prehospital and Disaster Medicine, May 1, 2023

Introduction: There is a consensus that there lacks a standard for primary triage during mass cas... more Introduction: There is a consensus that there lacks a standard for primary triage during mass casualty incidents. This is further compounded by a dearth of high quality research on the topic. Some studies suggest the superiority of SALT triage versus other triage systems, however, findings have not widely transitioned to clinical practice. We believe that despite specialized training including that in emergency medicine or emergency medical services (EMS), there will be significant variability amongst triage determination and use of triage methods. This study intends to analyze various provider skill levels and their accuracy of triage determination. Method: In a disaster exercise, a group of providers trained to use START triage were expected to triage, treat and determine transport order of the patients from a scenario of a simulated intentional radiological dispersal device (RDD) detonation with multiple casualties. Another group of providers trained to use SALT triage were expected to triage, treat, and determine transport order of patients from a scenario of a building collapse after a hurricane to assess SALT triage with the participating officers. Additional cohorts of EMS clinicians will be given the same case scenarios and asked to triage, treat when necessary, and determine transport order of the patients. Results: The initial data from the RDD exercise includes 102 patient case scenarios with 27 minimal (green), 40 delayed (yellow), and 35 immediate (red) patients. The providers involved in the exercise are trained at minimum to NREMT EMT level. Results showed an under-triage rate of 7.8%, an over-triage rate of 20.6% and overall accuracy of 71.6% when using START triage. Conclusion: The undertriage rate with START is 7.8% is higher than the generally acceptable rate of less than 5%. Our research is ongoing and we anticipate completion in 2023. We hope that our research provides future direction to improve triage in disaster scenarios.

Research paper thumbnail of Suicidal ideation among Tunisian adolescents and the association with adverse life experiences

European journal of public health, Nov 1, 2019

Youth suicidality is a significant public health problem. Understanding the factors leading to su... more Youth suicidality is a significant public health problem. Understanding the factors leading to suicide is essential to implement effective preventive efforts. In this context, this study was conducted to assess the link between suicidal ideation and adverse life experiences among Tunisian school aged youth. Methods: A cross-sectional survey was conducted among a sample of 2020 secondary school adolescents in 2016. An anonymous self-administered questionnaire was used to collect data. The adverse life events measured were: domestic violence, parental divorce, physical aggression, sexual abuse and a familial antecedent of suicide. Results: Overall, 17.0% (95% CI [15.3%-18.6%]) reported having suicide ideation during the past 12 months with no gender difference (16.3% among girls and 17.3% among boys, p = 0.62). Among the participants, 26.7% experienced at least one adverse life experience. Those who reported domestic violence (Odds Ratio = 8.93; 95% CI = 6.84-11.66), parental divorce (Odds Ratio = 3.02; 95% CI = 1.57-5.79), physical aggression (Odds Ratio = 6.97; 95% CI = 5.14-9.46), sexual abuse (Odds Ratio = 8.69; 95% CI = 3.94-19.15), familial antecedent of suicide (Odds Ratio = 8.17; 95% CI = 5.75-11.60) were associated with increased odds of suicide ideation. Conclusions: The prevalence of suicidal ideation observed in the survey area was relatively high and associated with all the measured life adverse events. These factors should be included in a suicide screening tool to be integrated in a suicide prevention program. Key messages: Suicidal ideation among adolescents was associated with all the measured life adverse events. Identifying adolescents at higher risk of suicide and help them to cope with their adverse experiences could be effective to prevent taking action to attempt suicide.

Research paper thumbnail of Prevalence of and factors associated with smoking among students in Sousse, Tunisia

PubMed, Apr 19, 2016

Within the framework of the fight against tobacco among young people, we conducted a descriptive ... more Within the framework of the fight against tobacco among young people, we conducted a descriptive cross-sectional study in 2013 to estimate the prevalence of smoking and to identify associated factors among students in Sousse. A questionnaire was administered to a representative sample of 556 students in 5 academic institutions in Sousse randomly drawn. The age of the participants was between 17 and 35 years. The prevalence of tobacco consumption in the past 12 months was 22.1% and consumption during the past 3 months was 65.3%. The average age of starting smoking was 17 years. Smoking prevalence was significantly higher for males (P < 0.001) and those aged over 25 years (P = 0.002). Students from 2 of the institutions were using more tobacco than their colleagues in the other institutions (P = 0.027). The high prevalence of smoking found among the students means that prevention measures are essential; this requires increasing self-esteem and evaluating intervention programmes implemented before smoking the first cigarette.

Research paper thumbnail of School bullying among Tunisian adolescents: prevalence and psychosocial outcomes

European journal of public health, Nov 1, 2019

Research paper thumbnail of Massive influx of victims: staff preparedness and facility readiness of Tunisian general University Hospitals

African Journal of Emergency Medicine, Dec 1, 2022

Research paper thumbnail of Culture de sécurité des soins dans les centres de soins primaires tunisiens : une étude multicentrique

Santé publique, Dec 5, 2017

La reproduction ou représentation de cet article, notamment par photocopie, n'est autorisée que d... more La reproduction ou représentation de cet article, notamment par photocopie, n'est autorisée que dans les limites des conditions générales d'utilisation du site ou, le cas échéant, des conditions générales de la licence souscrite par votre établissement. Toute autre reproduction ou représentation, en tout ou partie, sous quelque forme et de quelque manière que ce soit, est interdite sauf accord préalable et écrit de l'éditeur, en dehors des cas prévus par la législation en vigueur en France. Il est précisé que son stockage dans une base de données est également interdit.

Research paper thumbnail of Tunisian Nurses experiences of their humanitarian mission in the ''Choucha” Refugee Camp

European journal of public health, Sep 1, 2020

Research paper thumbnail of Association between smoking cessation and quality of life among patients with COPD in Tunisia

European journal of public health, Sep 1, 2020

enable low-threshold access to these groups in their everyday life and participatory approaches t... more enable low-threshold access to these groups in their everyday life and participatory approaches that involve the target group in planning and implementation, seem to be promising. Conclusions: The diversity, uniquely portrayed by the various projects from different European countries, provides an overview of the differences and similarities in the strategies used for reaching vulnerable groups from which approaches can be generated that are internationally relevant and transferable. Key messages: Gaining access to vulnerable groups requires special consideration in health promotion. The results of the JAHEE project (WP6) show promising and diverse strategies for dealing with vulnerable groups.

Research paper thumbnail of A picture of the adolescents dietary habits in Tunisia

European journal of public health, Sep 1, 2020

Background: Road traffic injuries impose a substantial health burden among children. Health liter... more Background: Road traffic injuries impose a substantial health burden among children. Health literacy is one of the most important determinants of non-communicable disease prevention. Parent health literacy is connected with their knowledge and behaviors regarding children road traffic injuries (CRTI) prevention. The aim of this study was to explore health literacy, knowledge and behaviors of mothers' in Croatia regarding CRTI prevention. Methods: This population based cross-sectional questionnaire study was done during 2019 in convenient sample of mothers of school aged children. Sociodemographic data and data about knowledge and behaviors of mothers regarding CRTI prevention were collected by the use of specially designed questionnaire. Croatian version of the Newest Vital Sign screening test (NVS-HR) was used for heath literacy determination. Results: There were 814 mothers' median age 36.0 (interquartile range 32.0.-39.0). According to NVS-HR there were 17.7%, 26.5% and 55.8% of mothers with low, intermediate and adequate health literacy level, respectively. The higher levels of health literacy were connected with younger age of mothers (37 years old or less) (P = 0.027); urban area of settlement (P < 0.001); living with a partner (P = 0.018); higher educational level of mothers (P < 0.001) and with better self-perceived economic status (P = 0.009). The study revealed poor positive correlation between mothers' health literacy and their knowledge regarding CRTI prevention (rho=0.170; P < 0.001). The study further showed that there was no correlation between mothers' health literacy and their behavior regarding CRTI prevention (rho=0.072; P = 0.041). Finally, the study revealed poor positive correlation between mothers' knowledge and behavior regarding CRTI prevention (rho=0.193; P < 0.001). Conclusions: The level of health literacy affects mothers' knowledge about CRTI prevention. Further studies are needed to better understand the underlying reasons for established association. Key messages: Low parent health literacy is one of the predictors of poor parent knowledge about children road traffic injuries prevention. It is necessary to identify and to address low parent health literacy in preventive strategies directed towards children road traffic injury prevention.

Research paper thumbnail of Obstetrical complications treated in the maternities of the region of Sousse (Tunisia)

European journal of public health, Nov 1, 2019

Background: The importance of paying attention to personnel satisfaction for the well-being of an... more Background: The importance of paying attention to personnel satisfaction for the well-being of an organization is clearly stated also in healthcare organization. The trend of mergers of healthcare organizations represents an evident case of organizational change that could undermine personnel satisfaction if not adequately managed. The aim of our study was to investigate the impact of hospital merger on personnel perceptions and satisfaction. Methods: A systematic review of the literature was carried out by querying scientific databases and grey literature. A search string was built using keywords including: merger, healthcare, personnel, satisfaction and synonyms. Inclusion criteria were primary studies reporting the outcome of interest and set in hospitals that has undergone a merger. Studies characteristics such country setting, design and time frame of the study, number and role of personnel interviewed and main findings were extracted and narratively synthesized. Results: Search resulted in 3662 studies of which 9 were finally included in the analysis. Studies were mainly represented by post-merger qualitative research (77.8%) of which 55.6% semi and 54.4% structured interviews. Sample size ranged from 14 to 3119 and was represented by unspecified employees (55.6%), nurses and hospital executives (22.2% both). Findings showed that hospital executives consider merger positively especially regarding increased negotiation skills and costs reduction. Conversely, the other personnel mainly expressed critical issues as differences in organization of hospitals merged, goals and confirmation uncertainty, communication impairment and especially no involvement in follow-up in the post-merger phase. Conclusions: The merger process strongly impacts healthcare personnel satisfaction, depending on the role played in the organization. If an initial enthusiasm and staff engagement in pre-merger phase is seen, this is not generally followed by their proper involvement over time. Key messages: As personnel satisfaction and perceptions are strongly related to healthcare quality, they represent a central point in the merger process of healthcare organization. More attention must be paid to follow-up staff satisfaction after the merger in a continuous staff engagement to ensure the success of merger process as well as that of all organizational changes.

Research paper thumbnail of A Qualitative Study on the Use of the Hospital Safety Index and the Formulation of Recommendations for Future Adaptations

International Journal of Environmental Research and Public Health

The Hospital Safety Index is a tool developed by the World Health Organization and the Pan Americ... more The Hospital Safety Index is a tool developed by the World Health Organization and the Pan American Health Organization in 2008 and updated in 2015. Although it is the most widely used instrument of its kind to assess the level of hospital preparedness, scientific literature on its application in real life is scarce. This study aimed to investigate the use of the Hospital Safety Index to assess disaster preparedness in healthcare facilities. A retrospective, qualitative study employing semi-structured online interviews was conducted to gather the opinions and perspectives of professionals who have experience in applying the Hospital Safety Index. Authors of scientific publications using the Hospital Safety Index were recruited. A semi-structured interview guide was developed. It addressed different phases of data collection with the Hospital Safety Index, the challenges and facilitators of using it, and recommendations for future adaptations. Data were analysed using inductive thema...

Research paper thumbnail of Facteurs prédictifs du niveau des connaissances, des attitudes et de la qualité de vie des diabétiques tunisiens — À propos de 1007 cas

Revue d'Épidémiologie et de Santé Publique

Research paper thumbnail of Facteurs de risque de la détérioration de la qualité de vie des diabétiques de type 1 et de type 2 en Tunisie

Annales D Endocrinologie, Oct 1, 2022

Research paper thumbnail of Capacity building in the public health field in the Tunisian medical faculties

European Journal of Public Health, 2020

Over the past years, Tunisia has experienced important reforms in the field of public health. The... more Over the past years, Tunisia has experienced important reforms in the field of public health. The Tunisian medical faculties (Universities of Sfax, Tunis el Manar, Sousse and Monastir) play a key role in this endeavor by training public health professionals who can contribute to the modernization of the health system. Funded by the EC through Erasmus+ programme, the CONFIDE project (coordinated by Babes-Bolyai University, having as EU partners the Universities of Southern Denmark and Trnava, and the above mentioned Tunisian universities) has established the Research into Policy training programme by strengthening their capacity to provide public health training. The Research into Policy training programme has been delivered by the Centres for Evidence into Health Policy (C4EHPs) established within the Tunisian partner universities for the needs of CONFIDE. The training programme was implemented in four steps: (1) train the trainer sessions - the European experts trained 18 Tunisian ...

Research paper thumbnail of Massive Influx of Victims: Staff Preparedness and Facility Readiness of Tunisian General University Hospitals

Prehospital and Disaster Medicine, May 1, 2023

Research paper thumbnail of Intravenous lidocaine as adjuvant to general anesthesia in renal surgery

Libyan Journal of Medicine, 2018

Research paper thumbnail of Evaluating the Level of Disaster Preparedness of Tunisian University Hospitals Using the Hospital Safety Index: A Nationwide Cross-sectional Study

Prehospital and Disaster Medicine, May 1, 2023

Introduction: Postgraduate education is important in preparing and enhancing health professionals... more Introduction: Postgraduate education is important in preparing and enhancing health professionals for the practice of disaster and terror medicine. The World Association for Disaster and Emergency Medicine (WADEM) has formulated a standardized international perspective for education and training in disaster medicine and health. Notwithstanding, there continues to be a reported gap in competency-based training in disaster and terror medicine internationally, particularly across Asia Pacific, which is a known vulnerable region. We report on a new Graduate Diploma in Disaster and Terror Medicine, to be expanded to Master level in 2024. The course is delivered mainly online to a multidisciplinary international audience. This paper summarizes the development of the course and outlines the key influences that have contributed to the design of the course. Method: A survey of the critical care workforce conducted by the Department of Critical Care at the University of Melbourne in early 2020 identified the need to develop education in disaster and terror medicine. A market and competitor analysis identified there was a gap in clinician focused courses offered in Australia and internationally. Based upon these results, a new course was developed to meet these needs. Results: Based on the results of the survey and feedback from expert stakeholders, the new postgraduate courses in disaster and terror medicine were developed. They offer both core and elective subjects, utilizing a modular approach with supervised simulation and practical training. The courses incorporate problem-based learning, the principles and practices of online education and advances in simulation-based learning, providing both a public health and clinical lens. Conclusion: The nested suite of postgraduate disaster and terror medicine courses at the University of Melbourne is at the forefront of learning within this field and meets the contemporary needs of health professionals who practice disaster and terror medicine

Research paper thumbnail of Assessment of patient safety culture in intensive care units and factors affecting it

European journal of public health, Sep 1, 2020

Background: Primary healthcare centers provide the first contact for patients and it goes without... more Background: Primary healthcare centers provide the first contact for patients and it goes without saying that quality and patient safety in these facilities are vital goals and challenges. In fact, it has been identified that a significant proportion of safety incidents caught in hospitals had originated in the earlier levels of care, and some studies have found that errors in primary care can result in severe consequences. Hence why, a developed Patient Safety Culture is a component key to improve patient safety and healthcare quality in these settings. Thus, this study aimed to assess patient safety culture in Tunisian primary healthcare centers and to explore its associated factors. Methods: It is a cross-sectional descriptive multicenter study, conducted from January to April 2016 in all the 30 primary healthcare settings of the Tunisian center, partners of the Faculty of Medicine of Sousse. The measurement instrument used was the validated French version of the Hospital Survey on Patient Safety Culture Questionnaire. The data analysis was conducted using the Statistical Package for Social Sciences (SPSS 20.0) and Epi info 6.04d for windows. Results: A total of 214 professionals participated in the study, corresponding to a response rate of 85%. The ''Teamwork within units'' dimension had the highest score (71.5%). The lowest scores were for the dimensions related to ''Frequency of events reported'' and the ''Non-punitive response to errors'' (31.4% and 35.4% respectively). Additionally, the ''Frequency of reported events'' dimension was significantly higher among professionals involved in risk management committees (p = 0.01). Conclusions: This study demonstrates that the level of patient safety culture needs to be improved in primary healthcare centers in Tunisia. Strategies to nurture patient safety culture should focus upon building leadership capacity that supports open communication, blame-free environment, teamwork and continuous organizational learning. Key messages: Patient safety culture in primary healthcare settings is not as strong to ensure the provision of safe care. A well-designed patient safety initiatives, with organizational policies, must be integrated in order to enhance patient safety and quality of care.

Research paper thumbnail of Adolescent’s substance use and suicidal thoughts in Tunisia

European journal of public health, Nov 1, 2019

Background: Care for victims of sexual violence is fragmented in Belgium. Therefore, sexual assau... more Background: Care for victims of sexual violence is fragmented in Belgium. Therefore, sexual assault care centers (SACCs) were piloted in three cities from November 2017 onwards. The SACCs offer forensic, medical and acute psychological care through a forensic nurse, while vice inspectors perform an interrogation at the SACC for those wishing to report. The nurse coordinates the follow-up care and a psychologist provides mental health support. A quantitative prospective study was carried out assessing the characteristics of SACC patients, the sexual violence they experienced and the care received, in order to inform the national scale-up of the model. Methods: Data on SACC patients was routinely collected in the electronic patient files by the SACC personnel between November 1st 2017 and October 31th 2018. Data was analyzed in SPSS. Results: Within the first year SACCs were attended by 930 victims. Mean age was 24,5 years (SD = 12.8), and one third were minors. Eighty-eight percent of victims was female and 67% presented for rape. Fifty-seven percent of the assailants were known to the victim. Thirty-five percent of the victims selfreferred to SACC, 41% were referred by the police, and 66% of victims attended services within 72 hours. Respectively 75%, 61%, 47% and 68% of victims received medical care, a forensic examination, psychological care and reported to the police. Conclusions: Without big publicity the SACCs received a higher than expected number of victims. Expansion of the collaboration with police and targeted communication strategies should further increase the number of victims receiving appropriate care. Qualitative research assessing the acceptability of the SACC model will further inform the scale-up of the model. Key messages: The quantitative study led to a better understanding of the population using the SACCs. The study allowed to improve the training of the staff members, adapt the SACC procedures before scale-up and define targeted service-promotion strategies.

Research paper thumbnail of Prevalence and associated factors of perinatal depression among working pregnant women: a hospital-based cross-sectional study

Libyan Journal of Medicine, Aug 24, 2022

Research paper thumbnail of A Qualitative Study on the Use of the Hospital Safety Index and the Formulation of Recommendations for Future Adaptations

Prehospital and Disaster Medicine, May 1, 2023

Introduction: There is a consensus that there lacks a standard for primary triage during mass cas... more Introduction: There is a consensus that there lacks a standard for primary triage during mass casualty incidents. This is further compounded by a dearth of high quality research on the topic. Some studies suggest the superiority of SALT triage versus other triage systems, however, findings have not widely transitioned to clinical practice. We believe that despite specialized training including that in emergency medicine or emergency medical services (EMS), there will be significant variability amongst triage determination and use of triage methods. This study intends to analyze various provider skill levels and their accuracy of triage determination. Method: In a disaster exercise, a group of providers trained to use START triage were expected to triage, treat and determine transport order of the patients from a scenario of a simulated intentional radiological dispersal device (RDD) detonation with multiple casualties. Another group of providers trained to use SALT triage were expected to triage, treat, and determine transport order of patients from a scenario of a building collapse after a hurricane to assess SALT triage with the participating officers. Additional cohorts of EMS clinicians will be given the same case scenarios and asked to triage, treat when necessary, and determine transport order of the patients. Results: The initial data from the RDD exercise includes 102 patient case scenarios with 27 minimal (green), 40 delayed (yellow), and 35 immediate (red) patients. The providers involved in the exercise are trained at minimum to NREMT EMT level. Results showed an under-triage rate of 7.8%, an over-triage rate of 20.6% and overall accuracy of 71.6% when using START triage. Conclusion: The undertriage rate with START is 7.8% is higher than the generally acceptable rate of less than 5%. Our research is ongoing and we anticipate completion in 2023. We hope that our research provides future direction to improve triage in disaster scenarios.

Research paper thumbnail of Suicidal ideation among Tunisian adolescents and the association with adverse life experiences

European journal of public health, Nov 1, 2019

Youth suicidality is a significant public health problem. Understanding the factors leading to su... more Youth suicidality is a significant public health problem. Understanding the factors leading to suicide is essential to implement effective preventive efforts. In this context, this study was conducted to assess the link between suicidal ideation and adverse life experiences among Tunisian school aged youth. Methods: A cross-sectional survey was conducted among a sample of 2020 secondary school adolescents in 2016. An anonymous self-administered questionnaire was used to collect data. The adverse life events measured were: domestic violence, parental divorce, physical aggression, sexual abuse and a familial antecedent of suicide. Results: Overall, 17.0% (95% CI [15.3%-18.6%]) reported having suicide ideation during the past 12 months with no gender difference (16.3% among girls and 17.3% among boys, p = 0.62). Among the participants, 26.7% experienced at least one adverse life experience. Those who reported domestic violence (Odds Ratio = 8.93; 95% CI = 6.84-11.66), parental divorce (Odds Ratio = 3.02; 95% CI = 1.57-5.79), physical aggression (Odds Ratio = 6.97; 95% CI = 5.14-9.46), sexual abuse (Odds Ratio = 8.69; 95% CI = 3.94-19.15), familial antecedent of suicide (Odds Ratio = 8.17; 95% CI = 5.75-11.60) were associated with increased odds of suicide ideation. Conclusions: The prevalence of suicidal ideation observed in the survey area was relatively high and associated with all the measured life adverse events. These factors should be included in a suicide screening tool to be integrated in a suicide prevention program. Key messages: Suicidal ideation among adolescents was associated with all the measured life adverse events. Identifying adolescents at higher risk of suicide and help them to cope with their adverse experiences could be effective to prevent taking action to attempt suicide.

Research paper thumbnail of Prevalence of and factors associated with smoking among students in Sousse, Tunisia

PubMed, Apr 19, 2016

Within the framework of the fight against tobacco among young people, we conducted a descriptive ... more Within the framework of the fight against tobacco among young people, we conducted a descriptive cross-sectional study in 2013 to estimate the prevalence of smoking and to identify associated factors among students in Sousse. A questionnaire was administered to a representative sample of 556 students in 5 academic institutions in Sousse randomly drawn. The age of the participants was between 17 and 35 years. The prevalence of tobacco consumption in the past 12 months was 22.1% and consumption during the past 3 months was 65.3%. The average age of starting smoking was 17 years. Smoking prevalence was significantly higher for males (P < 0.001) and those aged over 25 years (P = 0.002). Students from 2 of the institutions were using more tobacco than their colleagues in the other institutions (P = 0.027). The high prevalence of smoking found among the students means that prevention measures are essential; this requires increasing self-esteem and evaluating intervention programmes implemented before smoking the first cigarette.

Research paper thumbnail of School bullying among Tunisian adolescents: prevalence and psychosocial outcomes

European journal of public health, Nov 1, 2019

Research paper thumbnail of Massive influx of victims: staff preparedness and facility readiness of Tunisian general University Hospitals

African Journal of Emergency Medicine, Dec 1, 2022

Research paper thumbnail of Culture de sécurité des soins dans les centres de soins primaires tunisiens : une étude multicentrique

Santé publique, Dec 5, 2017

La reproduction ou représentation de cet article, notamment par photocopie, n'est autorisée que d... more La reproduction ou représentation de cet article, notamment par photocopie, n'est autorisée que dans les limites des conditions générales d'utilisation du site ou, le cas échéant, des conditions générales de la licence souscrite par votre établissement. Toute autre reproduction ou représentation, en tout ou partie, sous quelque forme et de quelque manière que ce soit, est interdite sauf accord préalable et écrit de l'éditeur, en dehors des cas prévus par la législation en vigueur en France. Il est précisé que son stockage dans une base de données est également interdit.

Research paper thumbnail of Tunisian Nurses experiences of their humanitarian mission in the ''Choucha” Refugee Camp

European journal of public health, Sep 1, 2020

Research paper thumbnail of Association between smoking cessation and quality of life among patients with COPD in Tunisia

European journal of public health, Sep 1, 2020

enable low-threshold access to these groups in their everyday life and participatory approaches t... more enable low-threshold access to these groups in their everyday life and participatory approaches that involve the target group in planning and implementation, seem to be promising. Conclusions: The diversity, uniquely portrayed by the various projects from different European countries, provides an overview of the differences and similarities in the strategies used for reaching vulnerable groups from which approaches can be generated that are internationally relevant and transferable. Key messages: Gaining access to vulnerable groups requires special consideration in health promotion. The results of the JAHEE project (WP6) show promising and diverse strategies for dealing with vulnerable groups.

Research paper thumbnail of A picture of the adolescents dietary habits in Tunisia

European journal of public health, Sep 1, 2020

Background: Road traffic injuries impose a substantial health burden among children. Health liter... more Background: Road traffic injuries impose a substantial health burden among children. Health literacy is one of the most important determinants of non-communicable disease prevention. Parent health literacy is connected with their knowledge and behaviors regarding children road traffic injuries (CRTI) prevention. The aim of this study was to explore health literacy, knowledge and behaviors of mothers' in Croatia regarding CRTI prevention. Methods: This population based cross-sectional questionnaire study was done during 2019 in convenient sample of mothers of school aged children. Sociodemographic data and data about knowledge and behaviors of mothers regarding CRTI prevention were collected by the use of specially designed questionnaire. Croatian version of the Newest Vital Sign screening test (NVS-HR) was used for heath literacy determination. Results: There were 814 mothers' median age 36.0 (interquartile range 32.0.-39.0). According to NVS-HR there were 17.7%, 26.5% and 55.8% of mothers with low, intermediate and adequate health literacy level, respectively. The higher levels of health literacy were connected with younger age of mothers (37 years old or less) (P = 0.027); urban area of settlement (P < 0.001); living with a partner (P = 0.018); higher educational level of mothers (P < 0.001) and with better self-perceived economic status (P = 0.009). The study revealed poor positive correlation between mothers' health literacy and their knowledge regarding CRTI prevention (rho=0.170; P < 0.001). The study further showed that there was no correlation between mothers' health literacy and their behavior regarding CRTI prevention (rho=0.072; P = 0.041). Finally, the study revealed poor positive correlation between mothers' knowledge and behavior regarding CRTI prevention (rho=0.193; P < 0.001). Conclusions: The level of health literacy affects mothers' knowledge about CRTI prevention. Further studies are needed to better understand the underlying reasons for established association. Key messages: Low parent health literacy is one of the predictors of poor parent knowledge about children road traffic injuries prevention. It is necessary to identify and to address low parent health literacy in preventive strategies directed towards children road traffic injury prevention.

Research paper thumbnail of Obstetrical complications treated in the maternities of the region of Sousse (Tunisia)

European journal of public health, Nov 1, 2019

Background: The importance of paying attention to personnel satisfaction for the well-being of an... more Background: The importance of paying attention to personnel satisfaction for the well-being of an organization is clearly stated also in healthcare organization. The trend of mergers of healthcare organizations represents an evident case of organizational change that could undermine personnel satisfaction if not adequately managed. The aim of our study was to investigate the impact of hospital merger on personnel perceptions and satisfaction. Methods: A systematic review of the literature was carried out by querying scientific databases and grey literature. A search string was built using keywords including: merger, healthcare, personnel, satisfaction and synonyms. Inclusion criteria were primary studies reporting the outcome of interest and set in hospitals that has undergone a merger. Studies characteristics such country setting, design and time frame of the study, number and role of personnel interviewed and main findings were extracted and narratively synthesized. Results: Search resulted in 3662 studies of which 9 were finally included in the analysis. Studies were mainly represented by post-merger qualitative research (77.8%) of which 55.6% semi and 54.4% structured interviews. Sample size ranged from 14 to 3119 and was represented by unspecified employees (55.6%), nurses and hospital executives (22.2% both). Findings showed that hospital executives consider merger positively especially regarding increased negotiation skills and costs reduction. Conversely, the other personnel mainly expressed critical issues as differences in organization of hospitals merged, goals and confirmation uncertainty, communication impairment and especially no involvement in follow-up in the post-merger phase. Conclusions: The merger process strongly impacts healthcare personnel satisfaction, depending on the role played in the organization. If an initial enthusiasm and staff engagement in pre-merger phase is seen, this is not generally followed by their proper involvement over time. Key messages: As personnel satisfaction and perceptions are strongly related to healthcare quality, they represent a central point in the merger process of healthcare organization. More attention must be paid to follow-up staff satisfaction after the merger in a continuous staff engagement to ensure the success of merger process as well as that of all organizational changes.

Research paper thumbnail of A Qualitative Study on the Use of the Hospital Safety Index and the Formulation of Recommendations for Future Adaptations

International Journal of Environmental Research and Public Health

The Hospital Safety Index is a tool developed by the World Health Organization and the Pan Americ... more The Hospital Safety Index is a tool developed by the World Health Organization and the Pan American Health Organization in 2008 and updated in 2015. Although it is the most widely used instrument of its kind to assess the level of hospital preparedness, scientific literature on its application in real life is scarce. This study aimed to investigate the use of the Hospital Safety Index to assess disaster preparedness in healthcare facilities. A retrospective, qualitative study employing semi-structured online interviews was conducted to gather the opinions and perspectives of professionals who have experience in applying the Hospital Safety Index. Authors of scientific publications using the Hospital Safety Index were recruited. A semi-structured interview guide was developed. It addressed different phases of data collection with the Hospital Safety Index, the challenges and facilitators of using it, and recommendations for future adaptations. Data were analysed using inductive thema...

Research paper thumbnail of Facteurs prédictifs du niveau des connaissances, des attitudes et de la qualité de vie des diabétiques tunisiens — À propos de 1007 cas

Revue d'Épidémiologie et de Santé Publique

Research paper thumbnail of Facteurs de risque de la détérioration de la qualité de vie des diabétiques de type 1 et de type 2 en Tunisie

Annales D Endocrinologie, Oct 1, 2022

Research paper thumbnail of Capacity building in the public health field in the Tunisian medical faculties

European Journal of Public Health, 2020

Over the past years, Tunisia has experienced important reforms in the field of public health. The... more Over the past years, Tunisia has experienced important reforms in the field of public health. The Tunisian medical faculties (Universities of Sfax, Tunis el Manar, Sousse and Monastir) play a key role in this endeavor by training public health professionals who can contribute to the modernization of the health system. Funded by the EC through Erasmus+ programme, the CONFIDE project (coordinated by Babes-Bolyai University, having as EU partners the Universities of Southern Denmark and Trnava, and the above mentioned Tunisian universities) has established the Research into Policy training programme by strengthening their capacity to provide public health training. The Research into Policy training programme has been delivered by the Centres for Evidence into Health Policy (C4EHPs) established within the Tunisian partner universities for the needs of CONFIDE. The training programme was implemented in four steps: (1) train the trainer sessions - the European experts trained 18 Tunisian ...

Research paper thumbnail of Disaster preparedness level of university hospitals of Sousse -Tunisia

European Journal of Public Health, 2020

Disasters, whether natural or man-made, are unpredictable. The health care systems, represented b... more Disasters, whether natural or man-made, are unpredictable. The health care systems, represented by hospitals, are on the front lines of the emergency and disaster response. Tunisian health structures, must be able to cope with a case of mass influx of victims following any disasters. Therefore, we conducted this study to describe the level of disaster preparedness of University Hospitals of Sousse - Tunisia.

Research paper thumbnail of Evaluation of teamwork and its associated factors in the emergency rooms of Sousse - Tunisia

European Journal of Public Health, 2020

In recent years, patient safety has become a priority and a major target for improvement especial... more In recent years, patient safety has become a priority and a major target for improvement especially in the emergency rooms. According to the French National Authority for Health, 1/3 of serious adverse events could be avoided thanks to better coordination and better communication between the teams. Thus, this study aimed to describe the perceptions of healthcare professionals in the emergency rooms of SousseTunisia regarding teamwork, and to determine the factors influencing it.

Research paper thumbnail of Evaluation of teamwork in operating rooms in a Tunisian university hospital

European Journal of Public Health, 2020