Association between chronic airflow obstruction and socio-economic position in Morocco: BOLD results.

Objective. Chronic Obstructive Lung Disease (COPD) is the third most common cause of death in the world. Other factors than smoking could be involved in the development of COPD such as socio-economic status. The aim of this study was to investigate the association between chronic airflow obstruction and socio-economic status in Morocco. Design. In the BOLD (Burden of Obstructive Lung Disease) study carried out in Fez Morocco, questionnaires and spirometry tests were performed. Socio-economic status was evaluated using a wealth score (0-10) based on household assets. The forced expiratory volume in 1s (FEV1)/ forced vital capacity (FVC) ratio was used to measure airflow obstruction. Results. In total, 760 subjects were included in the analysis. The mean age was 55.3 years (SD=10.2); the wealth score was on average 7.54 (SD=1.63). After controlling for other factors and potential confounders, the FEV1/ FVC increased by 0.4% (95% CI: 0.01, 0.78; p<0.04) per unit increase in wealth score. Aging, tobacco-smoking, underweight, history of tuberculosis and asthma were also independently associated with a higher risk of airflow obstruction. Conclusion. Our findings suggest that airflow obstruction is associated with poverty in Morocco. Further investigations are needed to better understand the mechanisms of this association

La fracture de Hahn Steinthal traitée par vissage d’Herbert : 3 cas

Les fractures du capitulum sont rares. Leur prise en charge initiale doit être précoce et efficace en raison des risques engendrés sur le coude : rigidité, instabilité, arthrose. De nombreux traitements ont été proposés. Notre étude décrit le vissage par vis d'Herbert pratiqué chez trois patientes recensées entre 2012 et 2013. Elles ont été inclues selon les critères de traumatisme du coude avec douleur exquise externe avec un trait de fracture radiologique frontal du condyle huméral externe emportant la joue externe de la trochlée. Le diagnostic a été orienté par l'examen clinique et confirmé à la radiographie de face, de profil et des ¾ internes. Les lésions ont été classées selon Bryan et Morrey. Les patients ont été opérés en urgence par abord postéro-latéral de Kocher, réduction à ciel ouvert puis stabilisation par vis de Herbert enfouies. Le recul moyen a été de un an. La récupération fonctionnelle totale moyenne a été de 3,6 mois.  L'évaluation fonctionnelle a été jugée excellente selon le score MEPI (Mayo Elbow Performance Index) pour les trois patients. Il n'y a pas eu de  démontage de matériel. La consolidation osseuse moyenne a été de 2,6mois

Development of an international scale of socio-economic position based on household assets.

The importance of studying associations between socio-economic position and health has often been highlighted. Previous studies have linked the prevalence and severity of lung disease with national wealth and with socio-economic position within some countries but there has been no systematic evaluation of the association between lung function and poverty at the individual level on a global scale. The BOLD study has collected data on lung function for individuals in a wide range of countries, however a barrier to relating this to personal socio-economic position is the need for a suitable measure to compare individuals within and between countries. In this paper we test a method for assessing socio-economic position based on the scalability of a set of durable assets (Mokken scaling), and compare its usefulness across countries of varying gross national income per capita.Ten out of 15 candidate asset questions included in the questionnaire were found to form a Mokken type scale closely associated with GNI per capita (Spearmans rank rs = 0.91, p = 0.002). The same set of assets conformed to a scale in 7 out of the 8 countries, the remaining country being Saudi Arabia where most respondents owned most of the assets. There was good consistency in the rank ordering of ownership of the assets in the different countries (Cronbachs alpha = 0.96). Scores on the Mokken scale were highly correlated with scores developed using principal component analysis (rs = 0.977).Mokken scaling is a potentially valuable tool for uncovering links between disease and socio-economic position within and between countries. It provides an alternative to currently used methods such as principal component analysis for combining personal asset data to give an indication of individuals relative wealth. Relative strengths of the Mokken scale method were considered to be ease of interpretation, adaptability for comparison with other datasets, and reliability of imputation for even quite large proportions of missing values

Impact of climate change on potential distribution of Quercus suber in the conditions of North Africa

Climate change, which is expected to continue in the future, is increasingly becoming a major concern affecting many components of the biodiversity and human society. Understanding its impacts on forest ecosystems is essential for undertaking long-term management and conservation strategies. This study was focused on modeling the potential distribution of Quercus suber in the Maamora Forest, the world’s largest lowland cork oak forest, under actual and future climate conditions and identifying the environmental factors associated with this distribution. Maximum Entropy approach was used to train a Species Distribution Model and future predictions were based on different greenhouse gas emission scenarios (Representative Concentration Pathway RCPs). The results showed that the trained model was highly reliable and reflected the actual and future distributions of Maamora’s cork oak. It showed that the precipitation of the coldest and wettest quarter and the annual temperature range are the environmental factors that provide the most useful information for Q. suber distribution in the study area. The computed results of cork oak’s habitat suitability showed that predicted suitable areas are site-specific and seem to be highly dependent on climate change. The predicted changes are significant and expected to vary (decline of habitat suitability) in the future under the different emissions pathways. It indicates that climate change may reduce the suitable area for Q. suber under all the climate scenarios and the severity of projected impacts is closely linked to the magnitude of the climate change. The percent variation in habitat suitability indicates negative values for all the scenarios, ranging –23% to –100%. These regressions are projected to be more important under pessimist scenario RCP8.5. Given these results, we recommend including the future climate scenarios in the existing management strategies and highlight the usefulness of the produced predictive suitability maps under actual and future climate for the protection of this sensitive forest and its key species – cork oak, as well as for other forest species