La résistance à la sectorisation : exemple du gouvernorat de Nabeul en Tunisie.

Sectorisation was introduced in Tunisia in 1999. The objective of this study was to examine the difficulties and resistance to the sectorisation of psychiatric care in the state of Nabeul. A transversal study was conducted over a period of 5 months from 1 November 2014 to 31 March 2015 on 96 patients resident in the state of Nabeul and treated at Razi hospital. Patients were aged between 18 and 69 years old ( sex ratio equal to one), 55.2% were single and 46% had a low socioeconomic level (n=44). Chronic psychotic disorder was diagnosed in 64.3% , depression in 12.3%, bipolar disorder in 18.8% and mental retardation in 3% of cases. Most of them refused to continue psychiatric treatment in the second or the first line of care. Resistance to sectorisation was associated with a low socioeconomic level (P = 0.039), availability of a companion (P = 0.04), celibacy (P = 0.04), gender (P = 0.05) and negatively correlated to psychotic disorder diagnosis. It was concluded that the environment plays an important role in the choice of the place of care. Subjects treated for mental illness were found to have greater trust in the structures that treated the acute episode of their illness, and paradoxically felt less stigmatized in Razi hospital.

Does financial technology matter in the relationship between CSR and banks' financial stability? a quantile regression approach.

In today's rapidly evolving global financial landscape, the growing importance of corporate social responsibility (CSR) and Fintech demands immediate attention, making it a vital and urgent area for exploration. This study examines whether Fintech plays a moderating role in the relationship between CSR and the financial stability of banks operating in some countries in the MENAT region from 2010 to 2021. Using simultaneous quantile regression analysis, the results show that Fintech positively moderates the effect of CSR on banks' financial stability at the medium and highest financial stability quantiles. This outcome highlights the need for banking institutions to embrace new technologies and responsible practices to bolster their financial stability in the changing financial landscape. Furthermore, Fintech positively moderates the impact of banks' financial stability on CSR across all quantiles. Thus, Fintech adoption helps banks to be more socially responsible regardless of their stability level. To ensure the robustness of our results, we employ the generalized panel method of moments (GMM) and quantile regression method to test whether the relationship between CSR and banks' financial stability varies with the presence of Fintech. The findings reveal that CSR enhances financial stability in the middle and higher Fintech quantiles. Therefore, Fintech adoption can potentially amplify the benefits derived from CSR activities, leading to greater bank stability. In addition, financial stability increases banks' involvement in socially responsible initiatives across all Fintech levels. This study provides policymakers with meaningful insights into the importance of embracing simultaneously technological innovation and socially responsible practices to enhance financial stability and achieve sustainable development goals.

[Socio-demographic and clinical profile of a population of patients coming for consultation to the psychiatric department of a general hospital in southern Tunisia]. / Profil sociodémographique et clinique d'une population de consultants dans un service de psychiatrie d'un hôpital général au Sud tunisien.

Introduction: mental disorders are a very common health condition and a major public health issue. The purpose of this study was to examine the epidemiological and clinical characteristics of patients coming for consultation to the psychiatric department of the Regional Hospital of Gabes, and to identify risk factors for the main mental disorders. Methods: we conducted a retrospective study, including all patients consulting the psychiatry department of Gabes for the first time between 01/01/2010 and 31/12/2013. Diagnoses were classified according to the 10th reversion of the WHO International Classification of Diseases (ICD10). Results: one thousand one hundred and one consultation cases were included in this study. The sex ratio (M/F) was 0.96. The average age of patients was 34 years (IQR=24-47.5 years), the median time between symptom onset and consultation to the psychiatric department was 1 year (IQR=3months-2 years). The three most common diagnosed were depressive disorders (21%), followed by schizophrenia (10.6%) and mental retardation (9.7%). Depressive disorders were significantly more common among female patients (p<0.001), married patients (p<0.001) and middle-aged adults (40-65 years) (p<0.001). The prevalence of these disorders was not significantly associated with either educational level, professional activity or socio-economic level. Conclusion: the knowledge of the socio-demographic and clinical profile of the most frequent mental disorders and factors associated with them would make it possible to better adapt the supply of care to the demand and to identify the needs in terms of mental health training in South-East Tunisia.