Beliefs of Moroccan patients with chronic inflammatory rheumatic diseases regarding medication: related factors and correlation with therapeutic adherence.

BACKGROUND: Medication adherence is one of the key elements of the management of patients with chronic inflammatory rheumatic diseases (CIRDs), adherence/medication regimes are prone to being influenced by beliefs about medicines; such beliefs can influence the management and quality of life of patients. Several factors may be associated with these beliefs, including demographic and clinical factors, as well as socio-psychological factors. The aim of this study is to assess beliefs regarding medications among Moroccan patients with CIRDs, the factors associated with these beliefs, and the correlation of these factors with medication adherence. MATERIAL AND METHOD: This cross-sectional study included patients with CIRDs. Sociodemographic data, comorbidities, and information about CIRDs (type, disease duration, pain evaluation, disease activity and treatments) were collected. Beliefs regarding medication were assessed by the Belief about Medicine Questionnaire (BMQ). Therapeutic adherence was assessed using the Arabic version of the Compliance Questionnaire in Rheumatology (CQR). Sociopsychological factors, such as catastrophism and trust in physicians, were assessed by the Pain Catastrophizing Scale (PCS) and the Trust in Physicians Scale (TPS), respectively. RESULT: Our sample included 189 patients. The average age was 47.49 ± 13.7; 52.4% had comorbidities; and 49.2% had a low level of education. Of the patients, 49.7% were on glucocorticoids, 61.9% on conventional synthetic disease-modifying antirheumatic drugs and 6.3% on biologics. The median necessity-concern differential was 6 [1-12]. Of the patients, 67.4% strongly believed that medication was essential to maintain their health. The long-term side effects were the main concerns about medicines (51.3%). In a multivariate analysis, there was a statistically significant association between low level of education, catastrophizing, methotrexate use, and trust in the physician as independent factors and the BMQ necessity-concern differential as the dependent factor. There was also a significant correlation between CQR and the BMQ necessity score. CONCLUSION: Moroccan patients with CIRDs have a rather positive perception of their medication. This perception seems to influence their adherence to treatment. Low levels of education, catastrophizing, methotrexate use, and trust in physicians are the most important factors associated with patients' beliefs regarding medication.

Would You Consider Becoming a Rheumatologist? A Survey Regarding the Attractiveness of Rheumatology as a Career Among Moroccan Medical Students.

Objective: To assess the attractiveness of a career in rheumatology among Moroccan medical students and to study factors that motivate or demotivate them to choose rheumatology as a future career. Methods: An electronic survey was distributed among students in medical training, interns, and graduates from the Faculty of Medicine at the University Hospital of Tangier. The questionnaire evaluated the level of clinical exposure to rheumatology, the interest in rheumatology as a specialty, and the motivation or demotivation for choosing or not choosing rheumatology as a career. Results: 318 students responded to the survey. Of these, 57.5% reported that they had already completed a training period in a rheumatology department. Of Moroccan students, 35.6% would consider specialising in rheumatology and 8.5% of these stated that rheumatology was their first specialty choice. The uni- and multi-variate analysis determined that clinical exposure to rheumatology (OR=2.39 IC95% [1.46-3.91]) and female gender (OR=1.95 IC95% [1.2-3.2]) were the main statistically significant factors for the prediction of the choice of rheumatology. Intern status was statistically associated with not choosing rheumatology (OR=0.085 IC95% [0.03-0.24]. The main motivation factors for Moroccan medical students to choose rheumatology were the diversity of musculoskeletal diseases (54.5%) and the good balance work/life (46.6%). The main reasons for not choosing rheumatology were the limited therapeutic aspects of the discipline (30.3%) and an interest in surgical specialties (29.3%). Conclusion: Rheumatology fascinates Moroccan medical students by the diversity of its pathologies and the good balance work/life. Greater clinical exposure to rheumatology is the strongest predictor of medical students choosing rheumatology as a future career.

Use of social media as a source of health information among patients with chronic low back pain.

OBJECTIVE: To evaluate the use of social media (SM) as a source of health information among patients with chronic low back pain (LBP) and to evaluate the factors associated with this use. METHODS: This was a cross-sectional study involving patients with chronic LBP. Information on their sociodemographics, LBP characteristics, and comorbidities was collected. With the use of a questionnaire, we evaluated the use of SM as a source of information, examining the frequency of use, the type of SM used, and degree of confidence and application of information found. Catastrophising, trust in physicians, and concerns regarding medicines were assessed through the Pain Catastrophizing Scale (PCS), Trust in Physician Scale (TPS) and Beliefs about Medicines Questionnaire (BMQ Specific Concerns). A regression analysis was conducted to identify factors associated with the use of SM. RESULTS: A total of 118 patients were included. The mean age was 53.01 ± 14.09 years. Of the sample, 68.6% sought information regarding their LBP on social networks. The main source was YouTube (30%). Eighteen point six percent of patients trusted the information found through SM, and 16.1% have already acted on some of this information. The majority of patients (82%) would prefer to have healthcare professionals in their virtual spaces to answer their questions. In a multivariate analysis, only the degree of trust in the physician was negatively associated with SM use (OR = 0.95 IC 95% [0.91-0.99]; p = 0.03). CONCLUSION: This survey showed that a proportion of patients suffering from chronic LBP use SM, YouTube in particular, as a source of health information. The level of trust in physicians was the strongest factor that impelled people to use SM as a source of health information.

Shift contagion and minimum causal intensity portfolio during the COVID-19 and the ongoing Russia-Ukraine conflict.

Using the TYDL causality test, this paper attempts (i) to investigate the existence of shift contagion among a large spectrum of financial markets during recent stress and stress-free periods and (ii) to propose a new approach of portfolio management based on the minimization of the causal intensity. During the COVID-19 crisis period, the shift contagion analysis not only reveal a tripling of the causal links between the markets studied, but also a change in the causal structure. Beyond the initial impact of the COVID-19 crisis on financial markets, policy interventions seem to have helped in reassuring market participants that the further spread of financial stress would be mitigated. However, the Russian-Ukrainian conflict, and the high degree of uncertainty it entailed, has again exacerbated the interdependencies between financial markets. In terms of portfolio analysis, our minimum-causal-intensity approach records a lower (respectively higher) reward-to-volatility ratio than the Markowitz (1952 & 1959) minimum-variance traditional approach during the pre-COVID-19 (respectively pre-war) period. On the other hand, both approaches, the one we propose in this paper and the minimum-variance approach, record negative reward-to-volatility ratios during crisis periods.

Predictive modeling and analysis of air quality - Visualizing before and during COVID-19 scenarios.

Quality air to breathe is the basic necessity for an individual and in recent times, emission from various sources caused by human activities has resulted in substantial degradation in the air quality. This work focuses to study the inadvertent effect of COVID-19 lockdown on air pollution. Pollutants' concentration before- and during- COVID-19 lockdown is captured to understand the variation in air quality. Firstly, multi-pollutant profiling using hierarchical cluster analysis of pollutants' concentration is performed that highlights the differences in the cluster compositions between before- and during-lockdown time periods. Results show that the particulate matter (PM10 and PM2.5) in air that formed the primary cluster before lock-down, came down to close similarity with other clusters during lockdown. Secondly, predicting air quality index (AQI) based on the forecasts of pollutants' concentration is performed using neural networks, support vector machine, decision tree, random forest, and boosting algorithms. The best-fitted models representing AQI is identified separately for before- and during-lockdown time periods based on its predictive power. While deterministic method reactively evaluates present AQI when current pollutants' concentration at a particular time and place are known, this study uses the best fitted data-driven model to determine future AQIs based on the forecasts of pollutant's concentration accurately (overall RMSE<0.1 for before lockdown scenario and <0.3 for during lockdown scenario). The study contributes to visualize the variation in pollutants' concentrations between the two scenarios. The results show that the reduced economic activities during lockdown period had led to the drop in concentration of PM10 and PM2.5 by 27% and 50% on an average. The findings of this study have practical and societal implications and serve as a reference mechanism for policymakers and governing bodies to revise their actions plans for regulating individual air pollutants in the atmospheric air.

The Impact of COVID-19 pandemic on Islamic and conventional financial markets: International empirical evidence.

The current global COVID-19 pandemic is adversely affecting financial markets, including commodities, conventional stocks, and Islamic stocks. This paper empirically investigates the extent to which COVID-19 effects may drive interdependence in markets. We fit copulas to pairs of returns before and during the ongoing epidemic shock, analyze the observed changes in the dependence structure, and discuss asymmetries on the propagation of crisis. We also use the findings to construct portfolios possessing desirable expected behavior. We find that the dependence structure changes significantly during the global pandemic providing valuable information on how the COVID-19 crisis affects inter-dependencies. The selected portfolio, including gold and Islamic return indices, has the best performance outside the COVID-19 crisis, and slightly more performing during the bear markets validating gold's intrinsic characteristic to be a safe haven. However, the portfolio performances, when combining the Brent with Islamic or conventional indices, have the same trend for the whole period. Our findings contribute to help investors better adjust their investment strategies.

The unprecedented reaction of equity and commodity markets to COVID-19.

Using a drifting spillover index approach (Diebold and Yilmaz, 2012) and a continuous time-frequency tool (Torrence and Webster, 1999), this paper attempts an empirical investigation of the spillovers and co-movements among commodity and stock prices in the major oil-producing and consuming countries. While our results point to the existence of a significant interdependence among the markets considered, Chinese and Saudi Arabian stock markets seem to be weakly integrated into the world market. Moreover, the spillovers are time-varying and reached their highest levels during the COVID-19 medical shock.