The relationship between emotional intelligence, anxiety, and performance in physical education and sport students.

Emotional intelligence (EI) has been recently the main target in research on sports psychology. The objectives of this study were to investigate the relation between self-report measures of emotional intelligence, pre-competitive anxiety, and performance among students during the physical education exam of the high school final year. This cross-sectional study was conducted on a sample of 350 students attending the physical education exam in the year 2021-2022. Analysis of the correlations between the scores of Emotional intelligence and anxiety showed that self-confidence was positively correlated with all dimensions of Emotional intelligence (Beta = 0.524; p = 0.000). Multivariate linear regression analysis showed that the most related items to performance were self-confidence in a positive direction (r = 0.56; p = 0.000) and negatively with somatic anxiety (r = -0, 39; p = 0.000). Considering the Emotional intelligence subscales, hetero-emotional management was significantly positively associated with performance (p = 0.000) however emotional perception was negatively correlated with performance (p = 0.003). These results demonstrate the importance of social and emotional learning programs for improving self-confidence and better management of emotions during physical education and sports.

Factors Associated with Diagnostic Delays among Tunisian Breast Cancer Patients.

BACKGROUND: Breast cancer (BC) remains one of the most common and deadliest cancer among women worldwide and in Tunisia. The lethality of BC is particularly high in developing countries, such as Tunisia, due to late diagnosis in the majority of cases. The objective of this study was to analyze factors associated with delayed presentation among women followed at the Salah Azaiez institute of Tunis during the year 2021. METHODS: It was a retrospective cohort study, including patients with primary BC, consulting at the Salah Azaeiz institute of Tunis over a period of six months, from january 1st to june, 30th, 2021. The total diagnostic interval (DI) was divided into patient interval (PI) and healthcare system interval (HSI). Diagnosis delay due to patient (PD) was defined as a delay more than three months between the discovery of symptoms and the first medical consultation. Data were collected using a valid questionnaire "the breast cancer questionnaire delay" and from patients' medical records. The calculation of crude and adjusted Odds Ratios using a stepwise descending binary logistic regression model was performed to measure the association of the studied factors with the delayed presentation. RESULTS: A total, 146 patients were included. The mean age of the patients was 50.1 ± 10.9 years.  More than a half of patients had a primary education (56.8%). Majority of patients were married (86.3%) and unemployed (90.4%).  The median of patient interval (PI) and HSI were 31 days [IQR: 12.5-151.5] and 53 days [IQR: 33.0-88.7] respectively. About three quarter of patients (76.4%) presented a healthcare system delay (HSD). After univariate analysis, factors significantly associated with PD were the low level of education (illiterate/primary) (RR: 2.7; 95% CI [1.1-6.4]; p=0.02) and the lack of knowledge about BC symptoms by patients (RR: 15.0; 95% CI [6.0-37.4]; p<10-3). The only variable that remained associated with PD, after multivariate analysis, was lack of initial knowledge of symptoms (OR: 15.0; 95% CI [6.0-37.4]; p<10-3). CONCLUSION: Lack of knowledge of symptoms was the main factor associated with delayed presentation among BC women.This study shows the need to inform women about performing breast self-examination as well as clinical signs of BC.

Prognostic impact of tumor-infiltrating lymphocytes in non-small cell lung carcinomas.

INTRODUCTION: Tumor-infiltrating lymphocytes represent a pivotal component of the host anti-tumor response. Thus, they considerably influence the evolution of cancers including non-small cell lung carcinomas. Even if, this important role is consensual, many discordant results are published in the literature about the prognostic role of the different populations of tumor-infiltrating lymphocytes. The aim of our work was to evaluate the prognostic impact of CD8+, CD4+, and forkhead box protein P3+ lymphocytes in the tumor microenvironment of non-small cell lung carcinomas. METHODS: We conducted a retrospective descriptive study, which included non-small cell lung carcinomas diagnosed in the department of pathology and followed in the medical oncology department of the same hospital between 2011 and 2015. Tumor-infiltrating lymphocytes were analyzed by the immunohistochemical method for forkhead box protein P3, CD4, and CD8. Intratumoral and stromal-labeled lymphocytes were quantified by manual counting at high magnification (×400). Forkhead box protein P3+/CD8+, forkhead box protein P3+/CD4+, and CD8+/CD4+ ratios were subsequently calculated. The prognostic value of tumor-infiltrating lymphocytes was assessed in respect of overall survival, recurrence-free survival, and relapse-free survival. RESULTS: Thirty-nine patients were included. The mean age of patients was 59.6 years. A complete surgical resection (p = 0.009), and a CD8/CD4 ratio (p = 0.008) were prognostic factors for overall survival. Complete surgical resection (p = 0.003), the forkhead box protein P3/CD8 (p = 0.005), and forkhead box protein P3/CD4 (p = 0.037) ratios were prognostic factors for recurrence-free survival. The CD8+ tumor-infiltrating lymphocytes rate (p = 0.037) was a prognostic factor for relapse-free survival with a threshold of 67.8/high power field. Microscopic subtype (p = 0.037) was a prognostic factor for relapse-free survival when only adenocarcinoma and squamous cell carcinoma were considered. In multivariate analysis, age (p = 0.004) and a CD8/CD4 ratio (p = 0.016) were independent predictors of overall survival. CONCLUSION: Despite the limitations of our study, our results confirm the prognostic value of tumor-infiltrating lymphocytes in non-small cell lung carcinomas and the importance of the combined quantification of their different subpopulations.

Place of the periodic medical check-up in basic health care in Tunisia.

The objective of primary health care is to reduce mortality and morbidity. This kind of care was very efficient in communicable diseases, malnutrition and maternal and neonatal diseases; however, their impact on non communicable diseases and mental disorders control is not obvious. In Tunisia, primary health care was introduced in the early 1980s; a lot of progress were notified in particular in health of mothers and children in particular, but only slightly in non communicable diseases control and mental health promotion. Therefore, a new approach would be strongly recommended to remedy this situation. The Medical Periodic Check-up (MPC) implemented in North America would have a positive impact in the prevention and management of non communicable diseases. What would be the place of this MPC in primary health care in Tunisia? The MPC has two main objectives: the prevention of specific diseases and health promotion. However, despite its efficiency and usefulness, the MPC could be costly, especially for countries with limited resources. Current evidence suggests that the most appropriate approach would be to take periodic preventive health visits tailored to the level of risk. The frequency of visits depends on the age, sex and state of health of the individual. In conclusion, there are strong arguments in favor of the introduction of MPC in primary health care in Tunisia, especially among adults in non communicable diseases control strategy. However, it's highly be recommended that the BMC should be oriented according to the risk levels in order to optimize resources. It is also important to educate and the public, especially women and young adults, to benefit from periodic medical and dental examinations.

Strategies of the Maghreb countries in the fight against cancer.

OBJECTIVES: Describe the cancer control strategies adopted by the Maghreb countries and identify their main weaknesses. METHODS: Data on cancer epidemiology and "Cancer plans" in the Maghreb were collected through a search in bibliographic databases, on GLOBOCAN and the sites of international and national organizations responsible for surveillance and cancer control. RESULTS: In the Maghreb, cancer registries observed low population coverage (Morocco: 20%; Tunisia: 60%; Algeria: 82%) and a lack of computerization. Primary prevention strategies remains insufficient as evidenced by the high prevalence of smoking in 2018 (Tunisia: 26%; Algeria: 19%; Morocco: 14%). Screening coverage for major cancers are still low in the Maghreb; In Tunisia for example the levels observed for cervical and breast cancers are respectively 14% and 10%. Regarding cancer care, the main problem is a limited access to cancer health services,   due to poorly decentralized infrastructure and equipment (Morocco: six oncology centers; Algeria: three oncology centers; Tunisia: only one institute specializing in cancer care). Palliative care is mainly supported by civil society in the Maghreb countries. CONCLUSION: The resources dedicated to cancer control in the Maghreb are limited, explaining its poor performance. Better governance in cancer control is required, with the adoption of multisectoral approach for prevention, and the strengthening of cancer surveillance and research.

Burden of road traffic accidents in the Greater Maghreb (1990-2017).

OBJECTIVE: To study the burden of Road Traffic Accidents (RTA) in the Maghreb and its evolution during the period 1990 to 2017. METHODS: We described the RTA in the Maghreb region, while analyzing database provided by the Institute for Health Metrics and Evaluation (IHME) for the period1990-2017. RESULTS: The age-standardized incidence rate of RTA has decreased overall across the Maghreb; it went from 719.57/100000 inhabitants in 1990 to 609.49 per 100,000 inhabitants in 2017. In 2017, the highest mortality rate in the region was noted in Tunisia and it was 30.15 / 100,000 inhabitants (CI95% = 24.05-37.08). The highest and lowest standardized rates for disability adjusted life years or DALYs were observed respectively in Tunisia: 1,311.56 per 100,000 inhabitants (CI95%=1,065.28-1588.68) and in Algeria: 962.68 per 100,000 inhabitants (CI95%=789.50- 1460.12). CONCLUSION: The burden of disease from road accidents is high in the Maghreb countries and the downward trend in the incidence of these accidents is relatively low. These results should encourage decision-makers to elaborate an integrated and multisectorial strategy to improve the situation.