Introduction: The literature shows a gap regarding mechanisms and mediators explaining the path from IA and gambling to violence. Our study aimed to investigate the gender-specific difference in the path linking IA and gambling to active violence mediated by substance use among schooled adolescents in the region of Mahdia (Tunisia). Methods: We performed a cross-sectional survey among schooled youth in the region of Mahdia in April 2023. We conducted a mediation analysis using in SPSS the PROCESS macro to examine the relationship between X (IA/Gambling), the mediator M (Substance use), and Y (Active violence). Causal interpretations cannot be definitively established. We used validated Arabic versions of the Internet Addiction Test, the South Oaks Gambling Screen Test, the CDC Health Appraisal section about substance use and the Hospital Anxiety and Depression Scale. We also probed violence perpetration. Data analyses were performed using SPSS version 20. Results: A total of 1594 students completed the questionnaire with a mean age of 17.75 ± 1.34 years. IA was noted in 52.3% of the participants. Gambling was more prevalent among males (12.1% vs 0.9%, p<0.001). Substance use was noted in 18.4% of participants (41.3% males vs 9.5% females, p<0.001). Violence perpetration was reported by 35.3% of the participants (59.9% males vs 25.8% females, p<0.001). After accounting for anxiety and depression, substance use mediated the link between IA and active violence (mediation%= 15.7, p< 0.001) with a higher effect in males (35.8% vs 10.5%). The mediation between gambling and violence via substance use was also significant (28.2%, p < 0.001). This effect was found only among males (27.7%). Conclusion: Implementing preventive strategies and focusing on addictive behaviors such as IA, gambling and substance use is urgently needed to prevent violence perpetration among youth. However, based on our results, the cross-sectional design limits causal interpretations.

Hand hygiene (HH) and Biomedical waste management (BMWM) are fundamental elements of infection prevention and control. Published comparisons of these activ

While the link between intra-familial Adverse Childhood Experiences (ACEs) and recidivism is increasingly supported by evidence, the underlying mechanisms explaining this relationship remain less explored. In the current study, we, for the first time, investigated the path from intra-familial ACEs to recidivism, with a focus on the mediating role of substance use among a sample of male prisoners in Tunisia. We conducted a cross-sectional survey in April 2023 among 403male adult prisoners with a median age of 31 [26; 40] years. Using a self-administered, anonymous questionnaire in Arabic, we asked about ACEs using the World Health Organization (WHO) ACEs questionnaire as well as substance use and criminal history. Participation in the study was voluntary. Mediation analyses investigate the indirect effect of an independent variable on a dependent variable through a mediator. We found that the most prevalent forms of intra-familial ACEs were physical abuse (74.6%) and emotional abuse (73%). Regarding substance use, 76.9% were smokers, 59.1% reported alcohol consumption and 52.1% used cannabis. Recidivism was observed in 52% in our sample, with 18% re-incarcerated twice and 34% at least three times. Mediation analysis indicated that substance use was a mediator between intra-familial ACEs and recidivism. Specifically, emotional neglect and physical abuse were found to mediate recidivism through substance use. These findings underscore the importance of addressing intra-familial ACEs and substance use in efforts to reduce recidivism among incarcerated individuals.