Meteorological factors and climate change impact on asthma: a systematic review of epidemiological evidence.

OBJECTIVE: This systematic review aimed to investigate the epidemiological data about meteorological factors and climate change (CC) impact on asthma. DATA SOURCES: A search was performed using three databases (Web of Science, Science Direct, and MEDLINE) for all relevant studies published from January 1, 2018, to December 31, 2022. STUDY SELECTIONS: This systematic review complied with the PRISMA document's requirements, including studies related to meteorological factors and CC impact on asthma. The search included studies published in English or French language, and was based on title, abstract, and complete text. Documents not meeting inclusion requirements were excluded. RESULTS: We identified 18 studies published in the last five years that were eligible for inclusion in this review. We found that these studies concerned European, Asian, American, and Oceanic cities. Extreme variations in temperature, humidity, wind speed, exceptional incidents like hurricanes, cold and heat waves, and seasonal shifts were strongly correlated with the worsening of asthmatic symptoms, particularly in childhood. In addition, excessive concentrations of air pollutants and aeroallergens were linked to pediatric asthma emergency hospital admissions. CONCLUSIONS: A significant association between the consequences of CC and asthma in adults particularly in children has been demonstrated. Future research should quantify the impact of global change in climate regarding the aeroallergens' distribution in terms of geography and time. It is also necessary to research the impact of air pollution on asthmatic health, like sulfur dioxide (SO2), nitrogen dioxide (NO2), ozone (O3), and particles having an aerodynamic diameter lower than 2.5 µm (PM2.5).

Translation and pilot validation of the Moroccan version of Stroke Impact Scale (SIS) 3.0.

INTRODUCTION: The Stroke Impact Scale 3.0 appears to be a promising measure of health-related quality of life for stroke patients. However, the lack of a cross-cultural adaptation in Arabic dialect may limit its use in the Moroccan context. The objective of this study was to carry out a transcultural adaptation and pilote validation of the Stroke Impact Scale 3.0 in Moroccan Arabic dialect, commonly called « Darija ¼. PATIENTS AND METHODS: A cross-sectional design was used for this study. The cross-cultural adaptation of the SIS 3.0 scale into Moroccan Darija was carried out following the guidelines proposed by Beaton et al (2000). Ceiling and floor effects were calculated for all scales. The internal consistency of multi-item scales was assessed using Cronbach's α coefficient. Convergent and divergent validity were evaluated using the Multi-Trait Multi-Method Correlation Matrix method. RESULTS: A total of 102 patients, with a mean age of 49 ± 12.9 years, participated in the study. The results revealed that the dimensions of the translated scale had no floor effect and no ceiling effect. The internal consistency of SIS 3.0 (Cronbach's alpha) was calculated, and all dimensions had good reliability, above the threshold of 0.70 (between 0.705 and 0.945). The results showed that the dimensions and their own items had correlation coefficients greater than 0.4, with good convergent and divergent validity. CONCLUSION: The darija version appears to be culturally acceptable with good psychometric properties and can be used to measure the quality of life of stroke survivors in Morocco.

Mortality and morbidity assessment attributed to short- and long-term exposure to fine particles in ambient air of Agadir city, Morocco: The AirQ model approach.

It is well established that respiratory mortality and morbidity are associated with high concentrations of fine particles such as PM2.5. The aim of this study was to evaluate the long- and short-term impacts of PM2.5 on the population of Agadir, Morocco, using AirQ 2.1.1 software. The mean PM2.5 values were obtained from data collected at three sites. Baseline incidence data were obtained from the literature, and relative risk (RR) values were referenced from the World Health Organization. This study quantified long-term total mortality (LT-TM), lung cancer mortality (LT-LC), morbidity from acute lower respiratory tract infections (LT-ALRI), and morbidity from chronic obstructive pulmonary disease (LT-COPD), as well as short-term total mortality (ST-TM). The attributable proportions (AP) of LT-TM and LT-LC were estimated to 14.19% and 18.42%, respectively. Their excess deaths were estimated to 279 and 11 persons, respectively, and their RRs to 1.16 (95% CI: 1.10-1.22) and 1.23 (95% CI: 1.12-1.37), respectively. Furthermore, the AP of LT-ALRI and LT-COPD were estimated to 14.36% and 15.68%, respectively, their excess deaths to 33 and 4, and their RRs to 1.17 (95% CI: 1.11-1.31) and 1.19 (95% CI: 1.00-1.02), respectively. In comparison, the AP of ST-TM was estimated to 1.27%, with a 25-person excess death rate. This study was conducted to inform decision-making and to promote local policies on ambient air quality.

Comparison of Biochemical, Haematological and Plasmatic Butyrylcholinesterase Parameters in Farmers and Non-Farmers, Morocco.

Background: The long-term use of pesticides can cause harmful consequences to both human health and the environment. In the present research, we aimed to compare biochemical, hematological, and plasmatic measurements of butyrylcholinesterase (BChE) between farmers and non-farmers. Materials and Methods: The study is cross-sectional and included 270 participants, with 135 farmers using pesticides and a control population of 135 non-farmers. The recruitment of the participants was conducted from August 2017 to the end of December 2019. Blood samples from participants were collected for the evaluation of biochemical markers of the function of the liver and determination of BChE activity. A whole blood sample with ethylenediamine tetraacetic anticoagulant (EDTA) was also taken for a complete blood count. Results: The results showed a statistically significant (P = 0.03) decrease in mean corpuscular hemoglobin (MCH) in the cases (28.45 ± 2.94 pg) as compared with controls (29.17 ± 2.54 pg). The statistical analysis of the renal parameters between the two groups determined that the uremia value was significantly higher in cases (34 ± 12 mg/dL) when compared to the control group (29 ± 8 mg/dL) P < 0.001. The cases recorded a significant increase in aspartate aminotransferase (AST) (26.22 ± 11.59 U/L) and alanine aminotransferase (ALT) (25.63 ± 13.47 U/L) enzyme activities among cases versus controls. The results obtained showed a significantly decreased BChE activity in the group of cases exposed to pesticides (7554.52 ± 2107 U/l) compared to the unexposed control group (10135.58 ± 1909 U/l) (t-test, P < 0.001). Conclusion: The education of the farmers on correct practices concerning phytosanitary use has the potential of reducing their exposure to these products.

Factors affecting nursing and health technician students' satisfaction with distance learning during the COVID-19 pandemic in Morocco: a descriptive study

PURPOSE: Distance learning describes any learning based on the use of new multimedia technologies and the internet to allow students to acquire new knowledge and skills at a distance. This study aimed to determine satisfaction levels with distance learning and associated factors among nursing and health technician students during the coronavirus disease 2019 pandemic in Morocco. METHODS: An descriptive study was conducted between April and June 2022 among nursing and health technician students using a self-administered instrument. The student satisfaction questionnaire consists of 24 questions categorized into 6 subscales: instructor, technology, course setup, interaction, outcomes, and overall satisfaction. It was based on a 5-point Likert scale, ranging from 1 (strongly disagree) to 5 (strongly agree). Univariate and multivariate logistic regression analyses were conducted to identify factors associated with student satisfaction during distance learning. RESULTS: A total of 330 students participated in this study, and 176 students (53.3%) were satisfied with the distance learning activities. A mean score higher than 2.8 out of 5 was obtained for all subscales. Multiple regression analysis showed that students' year of study (adjusted odds ratio [aOR], 2.34; 95% confidence interval [CI], 1.28­4.27) and internet quality (aOR, 0.47; 95% CI, 0.29­0.77) were the significant factors associated with students' satisfaction during distance learning. CONCLUSION: This study highlights the satisfaction level of students and factors that influenced it during distance learning. A thorough understanding of student satisfaction with digital environments will contribute to the successful implementation of distance learning devices in nursing.

Awareness and knowledge associated to Human papillomavirus infection among university students in Morocco: A cross-sectional study.

Worldwide, cervical cancer is a real health issue, however, gaps exist in the public's awareness of the causal role of Human papillomavirus (HPV) in the development of this disease. This study aims to determine the level of awareness, knowledge and the associated factors on HPV among university students in Morocco. A cross-sectional study was conducted with a descriptive and analytical aim, among students attending Ibn Zohr University, in Agadir, Morocco. An interview questionnaire was used to collect information about the participants: demographic data, awareness and level of knowledge on HPV infection, and awareness of cervical cancer. Logistic regression analyses were used to determine the associated factors with awareness and level of knowledge on HPV. A total of 479 students participated in this study (mean age 21.82 ± 2.091). Most participants n = 391 (81.6%) were aware of cervical cancer, while only n = 7 (1.5%) identified HPV as a sexually transmitted infection. Among students, 10.0% (n = 48) were aware of HPV but only half of them n = 23 (47.9%) confirmed that HPV is associated with cervical cancer, and n = 29 (60.4%) showed low knowledge on HPV. Multivariate analysis revealed that HPV awareness has a strong association with a higher level of education (OR 4.04; 95% CI: 1.92-8.52), and with being a biology student (OR 5.20; 95% CI: 2.12-12.73), while high HPV knowledge was only associated with the female gender (OR 3.76; 95% CI: 1.01-13.92). The data suggest that university students in Morocco did not show sufficient knowledge of HPV infection and its consequences. This supports that earlier incorporation of sexual health education programs, especially related to HPV and cervical cancer, must be implemented in the university to reduce the burden of HPV-associated diseases among the population at risk.

COVID-19 prevention and control interventions: What can we learn from the pandemic management experience in Morocco?

COVID-19 is one of the worst outbreaks in infectious disease history. Through a succession of significant preventative and control interventions, Morocco has accumulated pandemic control experience. This study examines the available evidence on lessons learnt from the COVID-19 pandemic management experience in Morocco. Social lockdown measures have helped restrain the exponential spread of new cases. These interventions appear to be reasonably successful. Their effectiveness must be confirmed by an assessment of other factors. This experience can help all countries develop effective pandemic prevention and control measures.

The Effect of Hypnosis on the Intensity of Pain and Anxiety in Cancer Patients: A Systematic Review of Controlled Experimental Trials.

BACKGROUND: Pain is a common symptom in cancer patients. Hypnosis is considered one of the most recognized non-pharmacological techniques in pain management. In oncology, this technique can be used as a complementary treatment to reduce the level of pain and anxiety. The objective of this study is to systematically review and evaluate controlled clinical trials (CCTs) examining the effect of hypnosis on the intensity of pain, and anxiety in cancer patients. METHODS: A systematic review was conducted according to the recommendations of the "Preferred reporting items for systematic reviews and meta-analyses" (PRISMA). The Cochrane systematic review database, the abstract databases, Scopus, PubMed, Google Scholar, and Cochrane Library have been systematically reviewed from 2005 to 2018. RESULTS: Eleven CCT with a total of 1182 participants met the inclusion criteria and were included in this review. The participants were mainly women (n = 968). Their average age alternates between 48 and 58 years. Perceived pain was measured primarily by visual analog scale (VAS)/numerical pain rating scale (NPRS), which showed that anxiety was measured by Hospital Anxiety and Depression scale (HADS). Hypnosis-related anxiety and pain decreased significantly with respect to usual treatment. CONCLUSIONS: Evidence suggests promising results of hypnosis on the management of pain, and anxiety levels in the vast majority of cancer patients. Therefore, because of the exploratory design and high risk of bias, the effectiveness of hypnosis or hypnotherapy in reducing pain and anxiety levels remains unclear. There is a need for more rigorous randomized controlled trials (RCTs).

Covid-19 and Confinement: Effect on Weight Load, Physical Activity and Eating Behavior of Higher Education Students in Southern Morocco.

Background: Pandemic confinement of COVID-19 may influence dietary behaviors and physical activity, and increases the risk of stress, especially among adolescents. This increases the subsequent risk of degenerative diseases such as obesity, diabetes, cardiovascular disease, etc., which can lead to a higher risk of death. This study aims to evaluate the effect of confinement on the weight load, physical activity and dietary behavior of higher education students during the period of confinement. Methods: Data was collected by an anonymous online questionnaire with 406 students. Physical activity was evaluated with the International Physical Activity Questionnaire. A reference score of the National Nutrition and Health Program (PNNS-GS) was used to determine the dietary habits. Stress appreciation was assessed by using a psychological instrument known as the "Perceived Stress Scale" provided by Mind Garden. Results: More than a quarter of the students were overweight or obese. During the confinement of COVID-19, most of the students suffered from nutritional disorders, only one-third were moderately physically active, and the majority of students were at risk of stress. Multivariate analysis showed that the concept of threat of Stress increases the risk of weight gain at a risk level of 2.4 [95% CI 1.09-5.43], low physical activity increases the risk level to 1.9 [95% CI 1.18-3.04]. However, a balanced diet is protective against the occurrence of weight gain (ORa = 0.30, [95% CI 0.15-0.61]). Conclusion: The study showed that confinement appeared to contribute to weight gain and those students were more sedentary than active with unhealthy eating behaviors. Understanding these behaviors during COVID-19 confinement will help public health authorities implement future policies on recommendations when new pandemics arrive and confinement policies are implemented.

Level of Knowledge on Stroke and Associated Factors: A Cross-Sectional Study at Primary Health Care Centers in Morocco.

Background: Stroke is increasingly becoming a major cause of disability and mortality. However, it can be prevented by raising awareness about risk factors and early health care management of patients. Objective: The aim of this study is to assess the level of knowledge on stroke, its risk factors, and warning signs in the population attending urban primary health care centers in the city of Agadir, Morocco. Methods: This is a multicentric cross-sectional study with a descriptive and analytical purpose. The study was conducted at five urban primary health care centers in Agadir in centralwest Morocco. All persons over the age of 18 years who consulted the health centers and who agreed to fill in the questionnaire were recruited, except for the foreign population and health workers. An interview questionnaire was used to assess the level of knowledge on stroke. Findings: A total of 469 participants were involved in the study. The median knowledge score was 8 (Interquartile range 4-13). High blood pressure (55.7%), depression and stress (48.8%) were the most well-known risk factors. Sudden weakness of the face, arms or legs (37.3%) was the main warning sign cited by the participants. Multivariate analysis revealed that illiteracy (OR 1.92; CI95%: 1.08-3.44) primary education (OR 3.43; CI95%: 1.63-7.21), rural residential (OR 1.67; CI95%: 1.07-2.59), no history of stroke among respondents (OR 16.41; CI95%: 4.37-61.59) and no history of stroke among relatives, acquaintances, or neighbors (OR 4.42; CI95%: 2.81-6.96), were independently associated with a lower level of knowledge of stroke (Table 4). Conclusions: The low level of knowledge on stroke among this Moroccan population indicates the importance of implementing stroke education initiatives in the community. More specifically, proximity education and awareness programs ought to be considered to anchor lifestyle preventive behaviors along with appropriate and urgent actions regarding the warning signs of stroke.