[Anxiety, depression and stress-related disorders in post Covid-19: A Tunisian study]. / Anxiété, dépression et troubles liés au stress en post Covid-19: étude tunisienne.

OBJECTIVES: - Our study aimed to assess anxiety, depression, and post-traumatic stress disorder in post coronavirus disease 2019 (Covid-19) and identify associated factors. PATIENTS AND METHODS: - Our study is a descriptive and analytical cross-sectional study carried out during the period from March 1 to May 15th 2021 on patients who were hospitalized and discharged from the Covid-19 unit in the pneumology department at the Hedi Chaker hospital in Sfax (Tunisia). Patients who met all of the following criteria were included: aged 18 and over; having a diagnosis of Covid-19 by polymerase chain reaction (PCR) and/or by CT scan; monitored at the Covid-19 unit and who their clinical conditions did not require intensive care; survivors after 3 months of leaving the service; and having given their informed and informal consent to participate in the study. RESULTS: - Our study included 154 patients. The prevalence of anxiety, depression and post-traumatic stress disorder was 24.7%, 11% and 13.6% respectively. We found an association between depression and female gender (p= 0.025), gastrointestinal involvement (p= 0.002) and stigma (p= 0.002). We found an association between anxiety and grade level (p= 0.034), and between anxiety and asthenia (p= 0.032). CONCLUSIONS: - Anxiety, depression, and post-traumatic stress disorder were independent of the majority of disease characteristics including the severity of Covid-19.

LoRaChainCare: An IoT Architecture Integrating Blockchain and LoRa Network for Personal Health Care Data Monitoring.

Over the past several years, the adoption of HealthCare Monitoring Systems (HCS) in health centers and organizations like hospitals or eldery homes growth significantly. The adoption of such systems is revolutionized by a propelling advancements in IoT and Blockchain technologies. Owing to technological advancement in IoT sensors market, innovations in HCS to monitor patients health status have motivated many countries to strength their efforts to support their citizens with such care delivery systems under the directives of a physician who has access to patient's data. Nevertheless, secure data sharing is a principal patient's concern to be comfort to use such systems. Current HCS are not able to provide reassuring security policies. For that, one of our focus in this work, is to provide security countermeasures, likewise cost-efficient solution for HCS by integrating storage model based on Blockchain and Interplanetary File Systems (IPFS). Blockchain technology is an emerging solution in pharmaceutical industry and starts to take place for HCS and allows HealthCare providers to track connected devices and control access to shared data, hence protecting patients' privacy. Furthermore, the addition of Edge and Fog computing has improved HCS to react in real-time and enhance their reliability. A variety of communication protocols can connect sensor devices to edge/Fog layer and the best choice will depend upon connectivity requirements: range, bandwidth, power, interoperability, security, and reliability. Instead, systems efficiency would decline and hurt if communication protocol is inconsistent. LoRa (Long Range) communications technology is emerging as the leader among Low-Power Wide-Area Networks (LPWANs) entering the IoT domain benefiting from many features such as long-range distances and low power consumption. This work proposes LoRaChainCare, an architecture model for HCS which combines the technologies Blockchain, Fog/Edge computing, and the LoRa communication protocol. A real implementation of LoRaChainCare system is presented and evaluated in terms of cost, run time and power consumption.

Psychological responses of Tunisian general population during COVID-19 pandemic.

INTRODUCTION: this is the first study assessing the psychological impact on Tunisian general population during the first peak of the COVID-19 pandemic. We aimed to assess the prevalence of anxiety, depressive symptoms and insomnia, as well as associated factors. METHODS: a cross-sectional study was conducted through an online survey of 1615 people during March 23rd to May 5th, 2020. We used the hospital anxiety and depression scale for anxiety and depression screening, and the insomnia severity index to assess sleep disturbances. RESULTS: our study revealed a high prevalence of anxiety and depressive symptoms, and insomnia (70.9%, 71.1% and 60.6% respectively). Multivariable statistics showed that anxiety symptoms were correlated to female gender (adjusted odds ratio [aOR] 1.784, 95% confidence interval (CI 1.252-2.542; p=10-3), history of mental illness (aOR: 1.680, 95% CI: 1.329-2.125; p<10-3), frequently social media exposure (aOR: 1.578, 95%CI: 1.250-1.992; p<10-3), times to focus on COVID-19 ≥ 3hours (aOR: 1.840, 95% CI: 1.433-2.362; p<10-3), consultation with doctor in the clinic in the past 14 days (aOR: 1.821, 95%CI : 1.220-2.718; p=0.003) and recent traumatic event in the past 14 days (aOR: 1.641,95% CI: 1.331-2.024; p<10-3). Principal factors associated with depressive symptoms included female gender (aOR: 1.637, 95% CI: 1.150-2.331; p=0.006), history of mental illness (aOR: 1.498, 95% CI: 1.189-1.888; p=10-3), times to focus on COVID-19 ≥ 3hours (aOR: 1.956, 95% CI: 1.555-2.461; p<10-3), and recent traumatic event in the past 14 days (aOR: 1.558, 95% CI: 1.265-1.919; p<10-3). The main factors correlated to insomnia were younger (age <35years) (aOR: 1.592, 95% CI: 1.17 -2.152; p=0.003), female gender (aOR: 1.864, 95% CI: 1.252-2.775; p=0.002), having organic diseases (aOR: 1.527, 95% CI: 1.131-2.061; p=0.006), history of mental illness (aOR: 1.777, 95% CI: 1.396-2.263; p<10-3), students (aOR: 1.931, 95% CI: 1.495-2.495; p<10-3), times to focus on COVID-19 ≥3hours (aOR: 1.877, 95% CI: 1.467-2.400; p<10-3) and recent traumatic event (aOR: 1.431, 95% CI: 1.144-1.789; p=0.002). CONCLUSION: our study revealed a major mental health burden in Tunisia during COVID-19 pandemic. Many factors were correlated to anxiety, depressive symptoms and insomnia, suggesting the need for greater psychological support in general and in certain vulnerable groups.

[Premature birth: a risk factor for maternal depression?] / L'accouchement prématuré : un facteur de risque de dépression maternelle ?

Premature birth constitutes a major ordeal not only for the child but also the mother. It reveals the psychological capacities of mothers with depressive affects as signs. Hedi Chaker university hospital in Sfax in Tunisia carried out a study on mothers of premature babies. These mothers were significantly more depressed. Certain factors appear to favour the occurrence of postnatal maternal depression and must therefore benefit from specific support.

[Psychological distress in medical and paramedical personnel in anesthesia and intensive care]. / La détresse psychologique du personnel médical et paramédical d'anesthésie-réanimation.

Anesthesia and intensive care medicine is considered one of the specialties involving more professional stress (PS). On this basis, our study aimed to assess the level of anxiety and PS in the personnel in anesthesia and intensive care and to identify the associated factors. We conducted a cross-sectional, descriptive and analytical study including 54 participants (38 technicians and 16 residents) working in the Departments of Anesthesia and Intensive Care at Habib Bourguiba and Hedi Chaker University Hospitals, Sfax, Tunisia. PS assessment was performed using the Karasek questionnaire. The Hamilton Anxiety Rating Scale (HARS) was used to measure the severity of anxiety symptoms. According to the Karasek questionnaire, the average decision latitude score was 69, the average psychological demand score was 23.9 and the average social support score was 19.6. According to this questionnaire, 40.7% of personnel was stressed and 38.9% was in isostrain condition. Average HARS score was 17.8, average psychic anxiety score was 8.7 and average somatic anxiety score was 9, with a significant difference between the medical and paramedical personnel. Severe to very severe anxiety was recorded in 25.9% of cases. HARS score was correlated to female gender (p=0.017) and to psychiatric histories (p=0.003). This study highlights that medical and paramedical personnel in anesthesia and intensive care is exposed to a significant risk of PS. Changes in working environment as well as learning professional stress management techniques should be proposed.

Prenatal, perinatal and postnatal factors associated with autism spectrum disorder / Fatores pré-natais, perinatais e pós-natais associados ao transtorno do espectrodo autismo

Abstract Objective: To identify prenatal, perinatal and postnatal risk factors in children with autism spectrum disorder (ASD) by comparing them to their siblings without autistic disorders. Method: The present study is cross sectional and comparative. It was conducted over a period of three months (July-September 2014). It included 101 children: 50 ASD's children diagnosed according to DSM-5 criteria and 51 unaffected siblings. The severity of ASD was assessed by the CARS. Results: Our study revealed a higher prevalence of prenatal, perinatal and postnatal factors in children with ASD in comparison with unaffected siblings. It showed also a significant association between perinatal and postnatal factors and ASD (respectively p = 0.03 and p = 0.042). In this group, perinatal factors were mainly as type of suffering acute fetal (26% of cases), long duration of delivery and prematurity (18% of cases for each factor), while postnatal factors were represented principally by respiratory infections (24%). As for parental factors, no correlation was found between advanced age of parents at the moment of the conception and ASD. Likewise, no correlation was observed between the severity of ASD and different factors. After logistic regression, the risk factors retained for autism in the final model were: male gender, prenatal urinary tract infection, acute fetal distress, difficult labor and respiratory infection. Conclusions: The present survey confirms the high prevalence of prenatal, perinatal and postnatal factors in children with ASD and suggests the intervention of some of these factors (acute fetal distress and difficult labor, among others), as determinant variables for the genesis of ASD.

Resumo Objetivo: Identificar fatores de risco pré-natal, perinatal e pós-natal em crianças com transtorno do espectro do autismo (TEA) ao compará-las com irmãos sem transtornos de autismo. Método: Estudo é transversal e comparativo. Foi conduzido em três meses (julho a setembro de 2014). Incluiu 101 crianças: 50 com TEA diagnosticadas de acordo com os critérios do DSM-5 e 51 irmãos não afetados. A gravidade do TEA foi avaliada pela Escala de Avaliação do Autismo na Infância (CARS). Resultados: Nosso estudo revelou uma prevalência maior de fatores pré-natais, perinatais e pós-natais em crianças com TEA em comparação com irmãos não afetados. Também mostrou uma associação significativa entre fatores perinatais e pós-natais e TEA (respectivamente p = 0,03 e p = 0,042). Nesse grupo, os fatores perinatais foram principalmente do tipo sofrimento fetal agudo (26% dos casos), longa duração do parto e prematuridade (18% dos casos em cada fator), ao passo que fatores pós-natais foram representados principalmente por infecções respiratórias (24%). No que diz respeito a fatores dos pais, nenhuma correlação foi encontrada entre a idade avançada dos pais no momento da concepção e o TEA. Da mesma forma, nenhuma correlação foi estabelecida entre a gravidade do TEA e fatores diferentes.Após regressão logística, os fatores de risco de autismo encontrados no modelo final foram: sexo masculino, infecção pré-natal do trato urinário, sofrimento fetal agudo, parto difícil e infecção respiratória. Conclusões: Esta pesquisa confirma a alta prevalência de fatores pré-natais, perinatais e pós-natais em crianças com TEA e sugere a intervenção de alguns desses fatores (sofrimento fetal agudo, parto difícil) como variáveis determinantes para a gênese do TEA.

Prenatal, perinatal and postnatal factors associated with autism spectrum disorder.

OBJECTIVE: To identify prenatal, perinatal and postnatal risk factors in children with autism spectrum disorder (ASD) by comparing them to their siblings without autistic disorders. METHOD: The present study is cross sectional and comparative. It was conducted over a period of three months (July-September 2014). It included 101 children: 50 ASD's children diagnosed according to DSM-5 criteria and 51 unaffected siblings. The severity of ASD was assessed by the CARS. RESULTS: Our study revealed a higher prevalence of prenatal, perinatal and postnatal factors in children with ASD in comparison with unaffected siblings. It showed also a significant association between perinatal and postnatal factors and ASD (respectively p=0.03 and p=0.042). In this group, perinatal factors were mainly as type of suffering acute fetal (26% of cases), long duration of delivery and prematurity (18% of cases for each factor), while postnatal factors were represented principally by respiratory infections (24%). As for parental factors, no correlation was found between advanced age of parents at the moment of the conception and ASD. Likewise, no correlation was observed between the severity of ASD and different factors. After logistic regression, the risk factors retained for autism in the final model were: male gender, prenatal urinary tract infection, acute fetal distress, difficult labor and respiratory infection. CONCLUSIONS: The present survey confirms the high prevalence of prenatal, perinatal and postnatal factors in children with ASD and suggests the intervention of some of these factors (acute fetal distress and difficult labor, among others), as determinant variables for the genesis of ASD.