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This quasi-experimental study aimed to assess the impact of a training program on knowledge and practical skills of healthcare professionals(HCPs) regarding healthcare waste(HCW) management in a Teaching Hospital in Southern Tunisia.The total mean knowledge score(KS) and practice score(PS) increased significantly on post training test as opposed to pre-training test with mean changes of 17.9 ± 10.1 and 26.9 ± 2.1, respectively.The mean PS did not significantly change from the first to the final follow-up measurement(p = 0.25).Three predictor factors were found to be independently associated with change in KS:age(β=-0.16;p = 0.006),sanitary staff(β = 0.116;p = 0.038) and administrative staff(β = 0.122;p = 0.032).Training program could therefore be an effective intervention for improving knowledge and practices among HCPs. [ABSTRACT FROM AUTHOR]

Background: Bullying is a serious public health concern remarkably common among youth. Involvement in bullying can lead to deleterious effect on the emotional well-being of pupils. The aim of this study was to assess the prevalence of bullying, its psychosocial associated factors and the perceived involvement of parents, teachers, and classmates to counteract this behavior. Study Design: A cross-sectional study. Methods: We conducted this study in 2015 among a representative multistage sample of 1584 students enrolled in middle schools in the Region of Sousse using the revised Olweus Bully/Victim Questionnaire. It assesses the prevalence of bullying and covers qualitative details of bullying including psychosocial factors and perceived efforts of others to counteract bullying. Results: 11.7% of respondents were classified as pure victims, 7.8% as pure bullies, 3.2% as bully-victims and 75.5% as bystanders. Compared to other groups, the bully-victims were less likely to report a feeling of empathy and liking school. They were more likely to be afraid of being bullied, aggressive and to have fewer friends in the class. Only 30.3% of the victims indicated that they told someone about being bullied. The majority of the middle school students perceived that classmates (54.1%) and teachers (39.5%) did nothing to counteract bullying. Conclusions: Information about bullying is critical and must be gathered before effective intervention is planned. Parents, teachers and students should learn effective ways to handle the bullying problem since the most effective programs are comprehensive targeting students, schools, families and the community. [ABSTRACT FROM AUTHOR]

Background: Internet represents a revolution in the world of technology and communication all over the world including Tunisia. However, this technology has also introduced problematic use, especially among students. The current study aimed to determine the prevalence of Internet addiction among college students and its predictors in the region of Sousse, Tunisia. Study design: A cross-sectional study. Methods: The current study was conducted in the colleges of Sousse, Tunisia in 2012-2013. A self-administrated questionnaire was used to collect data from 556 students in 5 randomly selected colleges from the region. Collected data concerned socio-demographic characteristics, substances use and internet addiction using the Young Internet Addiction Test. Results: The response rate was 96%. The mean age of participants was 21.8 ±2.2 yr. Females represented 51.8% of them. Poor control of internet use was found among 280 (54.0%; 95% CI: 49.7%, 58.3%) participants. Low education levels among parents, the young age, lifetime tobacco use and lifetime illicit drugs use were significantly associated with poor control of internet use among students (P<0.001). While, the most influential factor on internet use among them was undergraduation with an adjusted odds ratio of 2.4 (95% CI: 1.7, 3.6). Conclusions: Poor control of internet use is highly prevalent among the college students of Sousse especially those under graduate. A national intervention program is required to reduce this problem among youth. A national study among both in-school and out-of-school adolescents and young people would identify at-risk groups and determine the most efficient time to intervene and prevent internet addiction. [ABSTRACT FROM AUTHOR]

Introduction: the objective of this work was to establish the clinical profile of patients consulting in gyneco-obstetrical emergencies and identify the reasons for consultation and the becoming of the consultants., Methods: a one-center retrospective descriptive observational study was performed including patients who consulted between January 1 st and December 31 st , 2018. Obstetric emergencies after 36 weeks of amenorrhea were not included. We drew lots 4 months of the year 2018 (one month per season). Then we drew lots 2 weeks of each month. A data collection sheet was developed for the purposes of this work., Results: a total of 2007 patients were included in our study among 15,553 gynecological emergency room consultants during 2018. We found that the largest number of consultants was recorded at the start of the week and between 7 am and 7 pm. The most frequently obstetric reasons observed for consultation were pelvic pain (39.6%), bleeding (23.8%) and vomiting (8.7%). The most frequently gynecological reasons for consultation were pelvic pain (54.2%), then metrorrhagia (18.8%) and mastodynia (7.1%). Of the study participants, 66.82% received an ultrasound, 23% received a beta HCG test. The majority of emergency room consultants were referred to their home., Conclusion: the majority of patients visiting the emergency room do not have any emergency-related pathologies., Competing Interests: Les auteurs ne déclarent aucun conflit d'intérêts., (Copyright: Imen Bannour et al.)

Introduction: Clopidogrel (clopi) is a prodrug widely prescribed in the management of coronary artery disease and requires the intervention of hepatic cytochrome P450 2C19 (CYP2C19) for its activation. However, there is interindividual variability in response to clopi despite the use of recommended doses. Thus, the studies have highlighted the effect of the CYP2C19 gene polymorphism or Cyp2C19 gene on the response to clopi and particularly Cyp2C19 * 2 which may be associated with an increased risk of major cardiovascular events or MACE., Objective: To evaluate the effect of Cyp2C19 * 2 polymorphism on MACE occurrence and hemorrhagic complications in patients treated with clopi., Methods: We carried out a descriptive longitudinal study including 71 patients placed under clopi for a minimum duration of one month. Genotyping of the Cyp2C19 allele was performed by conventional polymerase chain reaction (PCR). After a follow-up period of 495 ± 183 days, we performed a statistical analysis to evaluate the association between the Cyp2C19 * 2 polymorphism and the occurrence of MACE or hemorrhagic complications., Results: Among our patients, 51% had an angioplasty, 42% medical treatment and 7% a coronary artery bypass surgery. In our study population, 52% were heterozygous (HTZ), 28% homozygous (HMZ) healthy * 1 / * 1 and 20% HMZ had the loss of function allele * 2 / * 2. The allelic frequency of Cyp2C19 * 2 was 46%. Follow-up mean duration was of 495 ± 183 days. During this period, the prevalence of MACE was 11% and that of hemorrhagic complications was 13%. In our study, we did not observe a significant association between the occurrence of MACE or hemorrhagic complications with the genotype carrying the Cyp2C19 * 2 allele., Conclusion: Among patients treated with clopi, wearing a Cyp2C19 * 2 function loss allele didn't seem to be associated with a significantly higher risk of MACE, nor a significantly lower risk of hemorragic complications. This suggests the necessity of larger studies.

Background: Tobacco use among teenagers in an increasing concern for the international community, especially with the fact that early experimentation is now identified as a risk factor for durable consumption and addiction., Aim: To study Tobacco use and its determinants amongteenagers in the city of Sousse., Methods: A descriptive cross-sectionalstudy was carried out among a sample of teenagers enrolled in the city of Sousse (Tunisia) in 2016-2017. A two-stage sampling was conducted for the selection of adolescents. Data were collected using a self-administered questionnaire in Arabic language., Results: The sample consisted of 330 students. The prevalence of smoking was 9.7%(95% CI6,7% ;13%), with a male predominance (14.4% vs 6.3%). The mean age of onset of tobacco was 14.65 ± 1.38 years. 44.8% of parents ignore their children's smoking. The mean dependence score was 4.77 ± 3.6 (HONC test).  Factors significantly associated with smoking were gender, age, educational level, repeating school years, relationship with parents and teachers, presence of smokers in the environment, knowledge about the health risks of tobacco., Conclusion: Sensitizationactions should be strengthened within schools, starting even in primary schools, in collaboration with teachers, family and health professionals. In addition, more effective and rigorous enforcement of legislation is essential.

Aims: To assess safety culture in primary healthcare centres and to explore its associated factors., Methods: This multicentre cross-sectional descriptive study was conducted in the 30 primary healthcare centres in central Tunisia and used the validated French version of the Hospital Survey on Patient Safety Culture questionnaire' (HSOPSC)., Results: A total of 214 professionals participated, corresponding to a response rate of 85%. The ?Teamwork within centres? dimension had the highest score (71.5%). However, two safety dimensions had very low scores: ?Frequency of event reporting?, ?Non-punitive response to errors? with percentages of 31.4% and 35.4%, respectively. Among the associated factors, the ?Frequency of reported events? dimension was significantly higher among professionals involved in risk management committees (p = 0.01)., Conclusion: This study demonstrates that the level of safety culture needs to be improved in primary healthcare centres in Tunisia and also highlights the need to implement a quality management system in primary healthcare centres.

Aim: This study was designed to assess the prevalence of alcohol consumption and factors associated with alcohol consumption among students of the Sousse region of Tunisia. Methods: This was a cross-sectional study conducted among 556 students of Sousse universities during the 2012-2013 academic year, using an anonymous self-report questionnaire. Data capture and statistical analysis were performed with SPSS software 18.0. Results: Our study population was composed of 268 males (48.2%) with a mean age of 21.8 ± 2.1 years. Eighty-four students (15.1%) had consumed alcohol at least once. On multivariate analysis, male gender (OR = 6.94; 95%CI = [2.32-20.72]), smoking (OR = 13.21; 95%CI = [6.20-27.78]), drug use (OR = 32.22; 95%CI = [6.73-154.26]) and parental alcohol consumption (OR = 4.31; 95%CI = [1.70-10.91]) were the factors significantly associated with alcohol consumption among students. Conclusion: This study was designed to determine the characteristics of alcohol consumption among Tunisian students. Alcohol consumption levels were comparable to those reported in the general population and were significantly related to smoking and drug use. The next step of this study will consist of developing strategies to prevent risk behaviours in the student population.

The results of this study will help guide public hospital human resource managers in the choice of measures designed to increase the motivation of their employees in order to ensure staff satisfaction as well as quality health care services..

Background Overweight in schools is a worrisome public health problem because they increase medium and long term risks of morbidity and mortality especially with an increased risk of persistence of obesity in adulthood. Aim To estimate the prevalence of overweight among school children and to identify its associated risk factors. Methods this is a descriptive cross-sectional study conducted among school students aged less than 18 years in the area of "Hazoua" (Tozeur). The references of BMI used for overweight and obesity are those of IOTF. The French BMI references are used to establish the prevalence of underweight. Data entry and analysis was performed using SPSS 20. Results Our sample included 445 students. The average BMI was 18.73±3.4 kg/m2. The prevalence of Underweight was 9.7%, while overweight and obesity have been reported among 6.7% of students. Overweight was significantly associated to gender and the practice of sport outside school. Conclusion Obesity in schools in the community of Hazoua is now lower than that reported in other studies. In contrast, we detected a problem of underweight, which deserves as much attention. Intervention programs should be established and whose objectives are to improve students' skills in terms of eating behavior and physical activity, these actions require collaboration at all levels.

Introduction: Nowadays, the circuit of drugs is a plague. This situation may cause serious harm to patients. In this context, we conducted a study with the aim to describe and evaluate the circuit of anticancer drugs in a Tunisian regional hospital., Methods: This is an evaluative study of the risk of anticancer drugs, conducted over a period of 15 days during the year 2014 in the Department of Cancer Research of the Regional Hospital of Gafsa (Tunisia). The evaluation method is based on that conducted by the project "SECURIMED" and developed by the Coordination Committee of the Clinical Evaluation and Quality in Aquitaine (CCECQA) in France., Results: In our study, the observation of anticancer drugs circuit has revealed some deficiencies. We noted that the roles of the various actors are subject sometimes to tasks shifting, which may sometimes be dangerous. The study also revealed a lack and an inadequacy with the standards in terms of the necessary equipment for the preparation of the anticancer drugs., Conclusion: Securing drugs circuit should be a priority included in all national processes and shared by all stakeholders to achieve a premium goal: the quality of care and patient safety.