Evaluating the level of disaster preparedness of Tunisian University Hospitals using the Hospital Safety Index: a nationwide cross-sectional study

Background: Mid-way through the 'Sendai Framework for Disaster Risk Reduction 2015-2030', many nations are spending time, money and effort to enhance their level of preparedness facing disasters, on the other hand communities, countries and even continents are being left behind. Objectives: This study was conducted aiming at evaluating the level of disaster preparedness and response of Tunisian University Hospitals. Methods: This is a cross-sectional nationwide study conducted in Tunisia, from November 2020 to April 2021. Including 9 Tunisian University Hospitals and using the Hospital Safety Index. The data were analysed using the 'Module and safety index calculator'. Results: This study showed that 7 out of the 9 University Hospitals were assigned the 'B' category of safety with overall safety indexes that ranges between 0.37 and 0.62. Also, 4 out of 9 University Hospitals had safety scores less than 0.20 regarding their emergency and disaster management. Conclusions: This is the first study to evaluate disaster preparedness and response of university hospitals in Tunisia and in north Africa. It showed that the lack of knowledge, resources and willingness, are the most important issues that needs to be addressed in order to enhance the preparedness of Tunisian hospitals

Production and evaluation of children's dietary life safety index data on metropolitan cities and provinces in Korea

This pilot study was performed to produce data of the Children's Dietary Life Safety (CDLS) Index which is required by the Special Act on Safety Management of Children's Dietary Life and to evaluate the CDLS Index for 7 metropolitan cities and 9 provinces in Korea. To calculate the CDLS Index score, data regarding the evaluation indicators in the children's food safety domain and children's nutrition safety domain were collected from the local governments in 2009. For data regarding the indicators in the children's perception & practice domain, a survey was conducted on 2,400 5th grade children selected by stratified sampling in 16 local areas. Relative scores of indicators in each domain were calculated using the data provided by local governments and the survey, the weights are applied on relative scores, and then the CDLS Index scores of local governments were produced by adding scores of the 3 domains. The national average scores of the food safety domain, the nutrition safety domain and the perception and practice domain were 23.74 (14.67-26.50 on a 40-point scale), 16.65 (12.25-19.60 on a 40-point scale), and 14.88 (14.16-15.30 on a 20-point scale), respectively. The national average score of the CDLS Index which was produced by adding the scores of the three domains was 55.27 ranging 46.44-58.94 among local governments. The CDLS Index scores produced in this study may provide the motivation for comparing relative accomplishment and for actively achieving the goals through establishment of the target value by local governments. Also, it can be used as useful data for the establishment and improvement of children's dietary life safety policy at the national level.

Development of Evaluation Indicators for a Children's Dietary Life Safety Index in Korea

This study was performed to develop a children's dietary life safety index required by the Special Act on Safety Management of Children's Dietary Life enacted in 2009. An analytical hierarchy process was used to obtain initial weights of dietary life safety evaluation indicators. The Delphi method was applied to develop the weights along with 98 food and nutrition professionals. Three representative policy indicators, nine strategy indicators, 11 main evaluation indicators, and 20 detailed evaluation indicators were selected for the children's dietary life safety assessment. Three policy indicators and nine strategy indicators were the following: children's food safety indicator (support level of children' safety, safety management level of children's favorite foods, and safety management level of institutional food service), children's nutrition safety indicator (management level of missing meals and obesity, nutrition management level of children's favorite foods, and nutrition management level of institutional food service), and children's perception and practice level indicator ("Dietary Life Law" perception level, perception, and practice level for dietary life safety management, perception, and practice level for nutrition management). Weights of 40%, 40%, and 20% were given for the three representative policy indicators. The relative importance of nine strategic indicators, which were determined by the Delphi method is as follows: For children's food safety, support level of children's safety, safety management level of children's favorite foods, and safety management level of institutional food service were given weights of 12%, 9%, and 19%, respectively. For children's nutrition safety, the missing meals and obesity management level, nutrition management level of children's favorite foods, and the nutrition management level of institutional food service were given weights of 13%, 11%, and 16%, respectively. The "Dietary Life Law" perception level, perception and practice level of dietary life safety management, and perception and practice level of nutrition management were given weights of 4%, 7%, and 9%, respectively.

Comparison of Perception and Practice Levels of Dietary Life in Elementary School Children according to Gender and Obesity Status

This study was performed to analyze children's perceptions and practice levels according to gender and obesity status using a dietary life safety index. A national survey was conducted on fifth grade children (n = 2,400), who were selected using three-stage stratified cluster sampling from 16 provinces. The average height was 144.8 cm, and weight was 38.8 kg. The average body mass index was 18.4 kg/m2 and underweight, overweight, and obese children were identified using the 2009 KHNANES cutoff values, which were 5.3%, 10%, and 5.9%, respectively. The perception and practice scores for hand-washing prior to eating were high and the score for willing to buy at a clean store was also high. However, students answered that the hygiene level of food stores near the school was poor. More students skipped breakfast than lunch or dinner. The frequency scores for fruit and vegetables were significantly higher for girls than those for boys. Students had a good understanding of nutrition labeling but did not frequently check the label. Seventy-five percent of the students tried to avoid high calorie foods with low nutritional value, but only 40% had the appropriate knowledge about high calorie foods with low nutritional value. Girls had better dietary life perception and practice levels than those of boys. No differences in perception or practice levels were observed based on obesity status. Nutrition education on the importance of eating breakfast and having accurate knowledge on nutrition labeling and high calorie foods with low nutritional value is needed. Behavior-centered education should be implemented to improve the perceptions and practice level of student's dietary life.