Massive influx of victims: staff preparedness and facility readiness of Tunisian general University Hospitals.

Introduction: Hospital preparedness for a massive influx of victims relies, to a certain extent, on actions, programs, and systems that are created and executed ahead of time, but also on the knowledge, skills, and professional competences of the hospital's staff. Aim: This study aims to understand the factors influencing the preparedness of Tunisian University Hospital staff in facing a massive influx of victims. Methods: This is a multi-method qualitative descriptive study conducted in nine general University Hospitals in Tunisia. The first component was a phenomenological design via open-ended interviews. The second component was a qualitative observational non-participatory design via field observations. Results: 17 participants were recruited in an intentional, non-probabilistic way. Participants to this study discussed issues related to the material and financial resources of their hospitals as well as the psychological impact of managing an influx of victims. They also discussed their training, their involvement in the process, and the norm versus the circumstances in the field which led to the conclusion that: ''For multiple reasons, the Tunisian University Hospitals are not ready to properly manage a massive influx of victims''. Conclusions: This multi-method qualitative study discussed the factors that affected the preparedness of staff and readiness of University Hospitals included, which were mainly resources (material and financial), psychological burden, lack of training, lack of involvement in the process, and issues related to evidence-based practice. These findings support the idea that more research and more practical interventions needs to be performed to increase the preparedness level of Tunisian University Hospitals and their staff

FIReS Webinar 2 Fostering innovative resilience in healthcare: support services and infrastructure (Flyer)

FIReS Webinar 2 Fostering innovative resilience in healthcare: support services and infrastructure. Event flyer, agenda and speaker and organiser biographies

FIReS webinar 1: Fostering innovative resilience of clinical services to major disasters

The COVID-19 pandemic stretched for the first time ever modern healthcare systems globally. Hospitals were forced to cancel elective operations, develop new work approaches and redeploy staff to treat infected patients, limit infection rates while maintaining most urgent operations. Although this approach is often adopted during disasters, its adoption for pandemic has caused tremendous disruption for healthcare systems in the forms of backlog and reduction in the ability of hospitals to provide care to millions of patients as reported by the British Medical Association (BMA) and questioned the resilience of healthcare service to major disasters. Healthcare staff stress has increased dramatically and many decided to leave their professions or took long sick leave adding more pressure. Healthcare services are now in challenging but also potentially ground-breaking position to re-think the way they operate. This webinar brings together international healthcare professionals and researchers to discuss, debate and provide facts to explain the reasons for which clinical service are vulnerable and identify areas to enhance resilience.This unique webinar is one of series of free events sponsored by the Royal Academy of Engineering to rethink healthcare resilience from a global perspective. The webinar is designed to represent the complexity of healthcare and will provide information for professionals, major emergency planners and policy makers.Eight (8) speakers from different medical backgrounds present their international experience, knowledge and opinion about different aspects of healthcare resilience. They discussed and answered questions of the general public who joined the webinar in the 2 Q&A sessions and Panel Discussion.The webinar was held on 15 February 2022 and it involved experts and speakers from 5 countries, Italy, Sweden, Turkey, UK and USA.</p

FIReS Webinar 2: Fostering innovative resilience in healthcare: support services and infrastructure (Recording)

The COVID-19 pandemic stretched for the first time every modern healthcare system globally. Hospitals were forced to cancel elective operations, develop new work approaches, and redeploy staff to treat infected patients, limit infection rates whilst maintaining most urgent operations. Healthcare services are now in challenging but also potentially ground-breaking position to re-think the way they operate. This webinar brought together international hospital professionals and researchers to discuss, debate and provide facts to explain the reasons for which hospital support services and infrastructure are vulnerable and identify areas to enhance resilience. This unique webinar is one of series of free events sponsored by the Royal Academy of Engineering to rethink healthcare resilience from a global perspective. The webinar designed to represent the complexity of healthcare and provided information for professionals, major emergency planners and policy makers. Five (5) speakers from different backgrounds present their international experience, knowledge and opinion about different aspects of healthcare resilience. They discussed and answered questions of the general public who joined the webinar in the 2 Q&A sessions and Panel Discussion. The webinar was held on 17 March 2022 and it involved experts and speakers from 4 countries, Italy, Turkey, UK and USA. To access the e-proceedings of Webinar 1, which looked at the resilience of clinical services, please use this link: https://doi.org/10.25411/aru.c.5873864.</p

FIReS Webinar 1_Flyer

FIReS Webinar 1 Flye

FIReS Webinar 2 Transcript

Auto-generated transcript of the FIReS 2 webinar held on 17 March 2022.<br

Assessing primary healthcare disaster preparedness: a study in Northern Italy

Aim: The aim of this paper is to outline the steps taken to develop an operational checklist to assess primary healthcare (PHC) all-hazards disaster preparedness. It then describes a study testing the applicability of the checklist.Background: A PHC approach is an essential foundation for health emergency and disaster risk management (H-EDRM) because it can prevent and mitigate risks prior to disasters and support an effective response and recovery, thereby contributing to communities' and countries' resilience across the continuum of the disaster cycle. This approach is in line with the H-EDRM framework, published by the World Health Organization (WHO) in 2019, which emphasizes a whole-of-health system approach in disaster management and highlights the importance of integrating PHC into countries' H-EDRM. Nevertheless, literature focusing on how to practically integrate PHC into disaster management, both at the facility and at the policy level, is in its infancy. As of yet, there is no standardized, validated way to assess the specific characteristics that render PHC prepared for disasters nor a method to evaluate its role in H-EDRM.Methods: The checklist was developed through an iterative process that leveraged academic literature and expert consultations at different stages of the elaboration process. It was then used to assess primary care facilities in a province in Italy.Findings: The checklist offers a practical instrument for assessing and enhancing PHC disaster preparedness and for improving planning, coordination, and funding allocation. The study identified three critical areas for improvement in the province's PHC disaster preparedness. First, primary care teams should be more interdisciplinary. Second, primary care services should be more thoroughly integrated into the broader health system. Third, there is a notable lack of awareness of H-EDRM principles among PHC professionals. In the future, the checklist can be elaborated into a weighted tool to be more broadly applicable

A Nutritional Survey of Local Barley Populations Based on the Mineral Bioavailability, Fatty Acid Profile, and Geographic Distribution of <i>Fusarium</i> Species and the Mycotoxin Zearalenone (ZEN)

Knowledge about the extent of nutrient variability in local barley germplasm is an important prerequisite for efficient crop improvement. The present study is one of the first to assess the potential of Tunisian barley populations (named Testour, Gergis, and Enfidha) as sources of desirable traits for barley improvement and for the prevalence of Fusarium species and the mytoxin zearalenone (ZEN). Analysis of variance revealed highly significant differences between barley populations for nutrients density. The lowest phytate/zinc molar ratios were observed in Testour and Enfidha populations with 7.23 and 9.97, respectively. However, the bioavailability of iron of most barley populations (95.4%) was inhibited mainly by the high phytate content. Oleic acid (15.2–18.7%), linoleic acid (13.8–16.01%), and palmitoleic acid (4.7–14.2%) were identified as predominant fatty acid constituents in all three barley populations. Based on morphologic and molecular characterization, Fusarium graminearum and Fusarium culmorum were the predominant species that infected Testour, Gergis, and Enfidha populations. The concentration of zearalenone ranged between 0 and 140 µg kg−1. The highest levels of zearalenone, 92 μg kg−1 and 60 μg kg−1, were detected in Testour populations that were infected with F. graminearum and F. culmorum, respectively. These relatively low amounts of zearalenone in barley populations can be attributed to the Tunisian climate and the resistance of local genotypes. Testour and Enfidha barley populations could potentially be used to improve breeding programs for biofortification

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

: 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 thematic analysis. Nine participants who were from three countries (Serbia, Sri Lanka, and Indonesia) and had different professional backgrounds (medical doctors, engineers, spatial planners, etc.) participated in this study. A total of 5 themes and 15 subthemes emerged during data analysis. Most of the participants reported their reasons for choosing the Hospital Safety Index as being its comprehensiveness and the fact that it was issued by the World Health Organization. The tool appears to be very specific and allows investigators to spot details in hospitals; however, it is not easy to use, and training is highly encouraged to learn how to navigate the different components of the tool. Governmental support is a crucial facilitator for investigators to be able to enter hospitals and conduct their evaluations. Overall, the tool has a lot of potential, and it should be used to reach a broader audience, such as community members, and assess the preparedness of other facilities that can take part in the response to disasters (hotels, stadiums, schools, etc.). Nevertheless, it still needs more adaptations to be tailored to different contexts and settings

Genotype-Dependent Response of Root Microbiota and Leaf Metabolism in Olive Seedlings Subjected to Drought Stress

© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).Under stress or in optimum conditions, plants foster a specific guild of symbiotic microbes to strengthen pivotal functions including metabolic regulation. Despite that the role of the plant genotype in microbial selection is well documented, the potential of this genotype-specific microbial assembly in maintaining the host homeostasis remains insufficiently investigated. In this study, we aimed to assess the specificity of the foliar metabolic response of contrasting olive genotypes to microbial inoculation with wet-adapted consortia of plant-growth-promoting rhizobacteria (PGPR), to see if previously inoculated plants with indigenous or exogenous microbes would display any change in their leaf metabolome once being subjected to drought stress. Two Tunisian elite varieties, Chetoui (drought-sensitive) and Chemleli (drought-tolerant), were tested under controlled and stressed conditions. Leaf samples were analyzed by gas chromatography–mass spectrometry (GC-TOFMS) to identify untargeted metabolites. Root and soil samples were used to extract microbial genomic DNA destined for bacterial community profiling using 16S rRNA amplicon sequencing. Respectively, the score plot analysis, cluster analysis, heat map, Venn diagrams, and Krona charts were applied to metabolic and microbial data. Results demonstrated dynamic changes in the leaf metabolome of the Chetoui variety in both stress and inoculation conditions. Under the optimum state, the PGPR consortia induced noteworthy alterations in metabolic patterns of the sensitive variety, aligning with the phytochemistry observed in drought-tolerant cultivars. These variations involved fatty acids, tocopherols, phenols, methoxyphenols, stilbenoids, triterpenes, and sugars. On the other hand, the Chemleli variety displaying comparable metabolic profiles appeared unaffected by stress and inoculation probably owing to its tolerance capacity. The distribution of microbial species among treatments was distinctly uneven. The tested seedlings followed variety-specific strategies in selecting beneficial soil bacteria to alleviate stress. A highly abundant species of the wet-adapted inoculum was detected only under optimum conditions for both cultivars, which makes the moisture history of the plant genotype a selective driver shaping microbial community and thereby a useful tool to predict microbial activity in large ecosystems.Spanish Research Council (CSIC).Peer reviewe