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Objectives : Describe the surgical pathway and identify the different waiting times to surgery of women with a breast cancer in the Gynecology Department of the University Hospital of Sousse in Tunisia. Methods: It is a descriptive prospective study based on an assessment of professional practices using the process approach method. The study focused on the surgical management of women with breast cancer followed and scheduled for surgical treatment. The data were collected using a data collection sheet, developed according to a literature review. Results: The sample consisted of 77 women. Ten waiting times have been calculated. Global time to first treatment (surgical treatment) was 78.5 days with an interquartile range (IIQ) of [55.5–113.25 days]. The information period was 10 days with an IIQ of 3–19 days. The global time of access to surgery was 43.5 days with an IIQ of 40–54.75. Conclusion: Delays in access to care appear to be a potential marker of inequalities in access to care and an indicator of the performance of the healthcare system and can influence patient prognosis. The reduction of these delays must be integrated into a continuous quality improvement approach. Highlights: To our knowledge this is the first study in Tunisia to investigate step by step the surgical pathway of women with breast cancer. This is also the first study to analyze the global and the different waiting times to surgical treatment of women with breast cancer at the same time, making it possible to identify any malfunctions that occur during this process and to investigate the causes. We tried to set up a quality indicator to be used by the decision makers as a key element in the quality and continuity of care. It is also a performance indicator of the healthcare system and a tracer of inequalities in access to healthcare. In addition, to this moment, there are no national healthcare society's recommendations about this quality indicator. The data collected in this study allow us to compare with other society guidelines if the study is conducted elsewhere. It will also help us follow the evolution of this indicator after implementing corrective actions. A good control of waiting times during the treatment process and avoiding delays in breast cancer treatment is obviously crucial to ensure the best possible outcomes for patients diagnosed with breast cancer. [ABSTRACT FROM AUTHOR]

Background Illicit substance use among college students represents one of the most complicated social problems. Studying its predictors could help deal with this problem more efficiently. Aims To determine the prevalence of life time illicit substance use and its predictors among Tunisian college students. Methods A cross-sectional study was conducted in five colleges in the region of Sousse, Tunisia in the 2012-2013 school year. A sample of 556 college students responded to an anonymous self-administrated questionnaire. Collected data concerned socio-demographic characteristics and substances use. Results The mean age of students was 21.8 ± 2.2 years. Females represented 51.8% of participants. Among respondents: 31 (5.6%) had used illicit substance at least once. Cannabis was the main substance used by 26 (4.7%) students. The average age of the illicit substance use initiation was 19 (±2.5) years while it was almost 17 (±3) years for both tobacco and alcohol use initiations. Proportions of male students and academic failure were significantly more important among illicit substance users than among non users. While the most influential factors on illicit substance use were: alcohol use, tobacco use and low socioeconomic level. Conclusion This study highlights the strong association between the other risk behaviors and illicit drug use. Future interventions should focus on the whole risk behaviors simultaneously at late adolescence with regard to the environmental context. [ABSTRACT FROM AUTHOR]