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Pan Afr Med J ; 29: 176, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30050640


Introduction: intensive care unit (ICU) beds are a scarce resource, and admissions may require prioritization when demand exceeds supply. However, there are few data regarding both outcomes of admitted patients to intensive care unit (ICU) in comparison with outcomes of not admitted patients. The aim of this study was to assess reasons and factors associated to refusal of admission to ICU as well as the impact on mortality at 28 days and patients' outcomes. Methods: Single-center, cross-sectional descriptive study conducted in 8-bed Medical ICU at a Tunisian University hospital. All consecutive adult patients referred for admission to ICU during 6 months were included. We collected demographic data, ICU admission/refusal reasons, co-morbidity and diagnosis at time of admission, mortality probability model (MPMII0) score, day and time of admission, request for admission and mortality at 28 days. Results: 327 patients were evaluated for ICU admission and 260 were refused to ICU (79.5%). Patients refused because of unavailability of beds represented 50% and patients considered "too sick to benefit" represented 22%. Multivariate analysis showed that the presence of acute respiratory failure and request by direct contact in the unit were independently associated to admission to ICU (OR: 0.15; 95% CI: 0.07-0.31 and OR: 0.16; 95% CI: 0.08-0.31, respectively). Higher mortality rates were shown in patients "too sick to benefit" (80.7%) and unavailable beds (26.56%). Conclusion: Refusal of ICU admission was correlated with the severity of acute illness, lack of ICU beds and reasons for admission request. ICU clinicians should evaluate their triage decisions and, if possible, routinely solicit patient preferences during medical emergencies, taking steps to ensure that ICU admission decisions are in line with the goals of the patient. Ultimately, these efforts will help ensure that scarce ICU resources are used most effectively and efficiently.

Tomada de Decisões , Unidades de Terapia Intensiva/estatística & dados numéricos , Admissão do Paciente/estatística & dados numéricos , Triagem , Adulto , Idoso , Ocupação de Leitos/estatística & dados numéricos , Estudos Transversais , Feminino , Mortalidade Hospitalar , Hospitais Universitários , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Avaliação de Resultados em Cuidados de Saúde , Fatores de Tempo , Tunísia
J Res Health Sci ; 18(2): e00414, 2018 May 05.
Artigo em Inglês | MEDLINE | ID: mdl-29784895


BACKGROUND: Bullying is a serious public health concern remarkably common among youth. Involvement in bullying can lead to deleterious effect on the emotional well-being of pupils. The aim of this study was to assess the prevalence of bullying, its psychosocial associated factors and the perceived involvement of parents, teachers, and classmates to counteract this behavior. STUDY DESIGN: A cross-sectional study. METHODS: We conducted this study in 2015 among a representative multistage sample of 1584 students enrolled in middle schools in the Region of Sousse using the revised Olweus Bully/Victim Questionnaire. It assesses the prevalence of bullying and covers qualitative details of bullying including psychosocial factors and perceived efforts of others to counteract bullying. RESULTS: 11.7% of respondents were classified as pure victims, 7.8% as pure bullies, 3.2% as bully-victims and 75.5% as bystanders. Compared to other groups, the bully-victims were less likely to report a feeling of empathy and liking school. They were more likely to be afraid of being bullied, aggressive and to have fewer friends in the class. Only 30.3% of the victims indicated that they told someone about being bullied. The majority of the middle school students perceived that classmates (54.1%) and teachers (39.5%) did nothing to counteract bullying. CONCLUSIONS: Information about bullying is critical and must be gathered before effective intervention is planned. Parents, teachers and students should learn effective ways to handle the bullying problem since the most effective programs are comprehensive targeting students, schools, families and the community.

Bullying/prevenção & controle , Bullying/estatística & dados numéricos , Estudantes/estatística & dados numéricos , Adolescente , Agressão/psicologia , Criança , Estudos Transversais , Docentes , Feminino , Humanos , Masculino , Pais , Grupo Associado , Prevalência , Estudantes/psicologia , Tunísia/epidemiologia
J Res Health Sci ; 18(1): e00403, 2018 Jan 02.
Artigo em Inglês | MEDLINE | ID: mdl-29445049


BACKGROUND: Internet represents a revolution in the world of technology and communication all over the world including Tunisia. However, this technology has also introduced problematic use, especially among students. The current study aimed to determine the prevalence of Internet addiction among college students and its predictors in the region of Sousse, Tunisia. STUDY DESIGN: A cross-sectional study. METHODS: The current study was conducted in the colleges of Sousse, Tunisia in 2012-2013. A self-administrated questionnaire was used to collect data from 556 students in 5 randomly selected colleges from the region. Collected data concerned socio-demographic characteristics, substances use and internet addiction using the Young Internet Addiction Test. RESULTS: The response rate was 96%. The mean age of participants was 21.8±2.2 yr. Females represented 51.8% of them. Poor control of internet use was found among 280 (54.0%; CI95%: 49.7, 58.3%) participants. Low education levels among parents, the young age, lifetime tobacco use and lifetime illicit drugs use were significantly associated with poor control of internet use among students (P<0.001). While, the most influential factor on internet use among them was under-graduation with an adjusted odds ratio of 2.4 (CI95%: 1.7, 3.6). CONCLUSIONS: Poor control of internet use is highly prevalent among the college students of Sousse especially those under graduate. A national intervention program is required to reduce this problem among youth. A national study among both in-school and out-of-school adolescents and young people would identify at-risk groups and determine the most efficient time to intervene and prevent internet addiction.

Comportamento Aditivo/etiologia , Internet , Estudantes , Universidades , Adulto , Fatores Etários , Comportamento Aditivo/epidemiologia , Estudos Transversais , Escolaridade , Feminino , Humanos , Drogas Ilícitas , Masculino , Pais , Prevalência , Fatores de Risco , Fumar , Transtornos Relacionados ao Uso de Substâncias , Inquéritos e Questionários , Tunísia/epidemiologia , Adulto Jovem