This study highlights major gaps in the implementation of a comprehensive approach to NCDs, which is an urgent task across the region. In strategic planning, research on the health system is vital; but the capacity within Ministries of Health to use research has first to be built, with a commitment to grounding policy change in evidence.
We highlight two main themes. One was nostalgia for a recent past when 'pure' and 'natural' food, 'proper' meals and less stressful lives meant less chronic illness, with demanding and costly treatment. The other concerned communication in the clinic, and the recurrent dismay patients felt at what they saw as the cursory attention and guidance they received from clinic staff in public facilities.
INTRODUCTION The World Health Organization (WHO) had launched the Framework convention on Tobacco Control (FCTC) in 2003 in order to curve the epidemic of tobacco use worldwide. Since most smokers begin to smoke before the age of 18 years, Global Youth Tobacco Survey (GYTS) has been developed in order to monitor tobacco smoking among adolescents. Our aim was to assess smoking among Tunisian youth using GYTS 2017 data. METHODS GYTS is cross-sectional, two cluster school-based survey to produce a representative sample of students aged 13-15 years. It was conducted in 2017 in 67 secondary schools in Tunisia. The investigation tool was an anonymously answered questionnaire, which contained core questions about six majors tobacco related topics. RESULTS Lifetime cigarettes and waterpipe prevalence were 7.8% (14.4% of boys, 1.6% of girls, p<0.001) and 7.2% (13% of boys, 2.8% of girls, p<0.001), respectively. Among cigarette smokers, 62.5% were able to buy their own cigarettes. Overall, 23.5% of cigarette smokers and 41.5% of waterpipe smokers were not able to buy their products because of their age. Sixty percent of smokers wanted to quit and 56.4% had already tried to stop. Half of the respondents were exposed to SHS in their homes and 62.1% in indoor public places. CONCLUSIONS In Tunisia, tobacco prevalence among youth is high. Youth have free access to tobacco products and smoke-free regulations are only partially respected.
Introduction
Les conduites suicidaires sont en augmentation en Tunisie et touchent une population de plus en plus jeune. Le but de notre étude était de décrire le profil sociodémographique et clinique des tentatives de suicide chez l'enfant et l'adolescent.
Méthodes
Cette étude était transversale et descriptive, incluant 50 suicidants, recrutés au service de pédopsychiatrie de l'Hôpital Razi de la Manouba et dans deux services de réanimation et de pédiatrie de Tunis, entre juillet 2012 et juin 2013. Ont été relevés les facteurs sociodémographiques et cliniques, les antécédents de maltraitance, la scolarité, les caractéristiques de la TS, l'intentionnalité suicidaire évaluée par le Suicide Intent Scale, et les troubles psychopathologiques à l'aide du Mini-International Neuropsychiatric Interview.
Résultats
Le sex-ratio était de 0,56, la moyenne d'âge était de 12,4 ans avec des extrêmes de 7 à 16 ans. Un échec ou un fléchissement scolaire a concerné 86% des suicidants. Dans 38% des cas il s'agissait de récidive; des antécédents d'automutilations ont été retrouvés dans les mêmes proportions. Un contexte de maltraitance a été signalé dans 46% des cas. L'ingestion médicamenteuse était le moyen le plus fréquent, les psychotropes étant les plus représentés. Une différence significative entre le genre a été retrouvée dans le recours aux moyens suicidaires, ainsi les garçons ont eu davantage recours aux moyens physiques (p=0,04) et les filles aux intoxications (p=0,001). L'intentionnalité suicidaire était élevée dans 44%. Un épisode dépressif majeur et le trouble de l'adaptation étaient les troubles les plus fréquemment retrouvés dans respectivement 58% et 24% des cas.
Conclusion
Les troubles dépressifs et la maltraitance se dégagent comme des facteurs de risque des TS chez les enfants et les adolescents, ces facteurs doivent être pris en considération dans les stratégies de prévention du suicide dans cette population.
Introduction
Morbid over-weight is associated with adverse health outcomes such as cardio-vascular diseases, diabetes, hyperlipidemia, hypertension… Obesity treatment needs special and personalized care. Moderate loss weight from 5% to 10% is beneficial for primary reduction of these disorders.
Aim
Identify predictive factors of weight loss of at least 5% of baseline weight and describe improvement of metabolic syndrome
Methods
We performed a retrospective evaluative study in Obesity Research Unit in the National Institute of Nutrition of Tunis from October 2016 to March 2018. We included adult women, whose BMI was > =30 kg/m2. Anthropometric and biological parameters were taken in the first consultation (T0). Then, adequate and personalized care (diet, physical activity, and psychological support) was received. Monthly check-ups were done to detect eventual diet errors. Evaluations were done in 3 and 6 months (T1) and (T2). We performed univariate and then, logistic regression to determine predictive factors of successful loss weight by at least 5%.
Results
We included 73 obese women. Mean age was 42.63 +/- 11.8 yo. One third of the patients were in menopause. At T0: 83.1% have had a weak physical activity while mean BMI was 39.98 +/- 6.47 kg/m2. Fourteen patients had had hypertriglyceridemia and 43 had hypo-HDLemia. Eighteen were hypertensive. Eighteen were diabetic. At T2: mean weight loss was 5.92 +/- 4.34 kg. Fifty-seven percent of patients have successfully lose more than 5% of their baseline weight. Mean BMI was 37.59 +/- 6.51 Kg/m2. A significant improvement of rates of cholesterol and triglycerides was found. Logistic regression found that predictive factors to weight loss were successful loss weight at 1 month, diminution of TSH hormone and augmentation of Phosphorus intake.
Conclusions
A large proportion of obese women may be sensitive to moderate weight loss but a further effort is necessary to maintain effective weight loss on long term.
Key messages
Moderate weight loss is beneficial for health. Personnalized care is required to help obese women.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.