Hicham Khabbache

Ramadan Fasting and Patients with Cancer: State-of-the-Art and Future Prospects

Ramadan fasting represents one of the five pillars of the Islam creed. Even though some subjects (among which patients) are exempted from observing this religious duty, they may be eager to share this particular moment of the year with their family and peers. However, there are no guidelines or standardized protocols that can help physicians to properly address the issue of patients with cancer fasting in Ramadan and correctly advising them. Moreover, in a more interconnected and globalized society, in which more and more Muslim patients live in the Western countries, this topic is of high interest also for the general practitioner. For this purpose, we carried out a systematic review on the subject. Our main findings are that (1) very few studies have been carried out, addressing this issue, (2) evidence concerning quality of life and compliance to treatment is contrasting and scarce, and (3) generally speaking, few patients ask their physicians whether they can safely fast or not. For these reasons, further research should be performed, given the relevance and importance of this topic.

Infodemiological data of high-school drop-out related web searches in Canada correlating with real-world statistical data in the period 2004–2012

The present data article describes high-school drop-out related web activities in Canada, from 2004 to 2012, obtained mining Google Trends (GT), using high-school drop-out as key-word. The searches volumes were processed, correlated and cross-correlated with statistical data obtained at national and province level and broken down for gender. Further, an autoregressive moving-average (ARMA) model was used to model the GT-generated data. From a qualitative point of view, GT-generated relative search volumes (RSVs) reflect the decrease in drop-out rate. The peak in the Internet-related activities occurs in 2004 (56.35%, normalized value), and gradually declines to 40.59% (normalized value) in 2007. After, it remains substantially stable until 2012 (40.32%, normalized value). From a quantitative standpoint, the correlations between Canadian high-school drop-out rate and GT-generated RSVs in the study period (2004–2012) were statistically significant both using the drop-out rate for academic year and the 3-years moving average. Examining the data broken down by gender, the correlations were higher and statistically significant in males than in females. GT-based data for drop-out resulted best modeled by an ARMA(1,0) model. Considering the cross correlation of Canadian regions, all of them resulted statistically significant at lag 0, apart from for New Brunswick, Newfoundland and Labrador and the Prince Edward island. A number or cross-correlations resulted statistically significant also at lag −1 (namely, Alberta, Manitoba, New Brunswick and Saskatchewan).

Ramadan fasting and infectious diseases: a systematic review

Ramadan represents the fourth of the five pillars of the Islamic creed. Although patients are exempted from observing this duty, they may be eager to share this moment of the year with their peers. However, there are no guidelines that can help physicians to address the concerns of patients with infectious diseases fasting during Ramadan. For this purpose, we performed a systematic review. of 51 articles. Our main findings are that: 1) patients suffering from diabetes at risk of developing infectious complications should not fast; 2) Ramadan fasting has little impact on diarrheal patients; 3) HIV represents a challenge, and ad hoc drug combinations should be recommended to patients, and the patients should be advised not to take fatty meals that could interfere with the treatment; 4) Ramadan has no effect on the effectiveness of anti-helminthic therapy; and 5) patients with active ulcers should not fast, as they have a higher probability of developing complications.

Mind the gap between high school and university! A field qualitative survey at the National University of Caaguazú (Paraguay)

Paraguay has eight public universities and 45 private universities. The National University of Caaguazú (Universidad Nacional de Caaguazú or UNCA), with its main campus located in Coronel Oviedo, is one of the most recently founded public universities, being established in 2007. The UNCA has launched a project aiming at exploring the potentiality of its educational system, as well as its gaps. In particular, the UNCA wants to assess the effectiveness of preparatory courses for preparing students for admission to the degree course in medicine (Cursos Probatorios de Ingreso or CPI), in order to identify the main strong and weak points of the system, the popularity and usefulness of CPI as perceived by the students, the students’ and teachers’ opinions regarding the limits of school, and their suggestions. This paper is based on a field survey and highlights the care that must be taken in order to develop conditions respectful of the wellbeing of those participating in the educational context.

Psychometric evaluation of the Arabic version of the nomophobia questionnaire: confirmatory and exploratory factor analysis – implications from a pilot study in Kuwait among university students

Background In the past decades, thanks to the widespread use of the new information and communication technologies, nomophobia has emerged as a contemporary psychological disorder. More in detail, it has been defined as the modern fear of feeling disconnected, being out of mobile phone contact, and being unable to access information and/or communicate with others. Few authors have used an Arabic version of the Nomophobia Questionnaire, even though its psychometric properties are not well known and have been poorly investigated from a formal rigorous standpoint. Materials and methods Our research objective was to develop and validate the Arabic version, administering it to a sample of adolescents and young adults in a country characterized by a high mobile network coverage. A total of 512 subjects (aged 21.62±4.33 years, median 20 years), equally distributed between males and females, and based in Kuwait, volunteered to take part in the study. Results The confirmatory factor analysis did not show a completely satisfactory fitting with the original factor structure. The exploratory factor analysis showed that four factors had 57.24% variance. Overall Cronbach’s alpha coefficient was 0.879. However, the coefficient increased from 0.645 to 0.849 with respect to the original factor structure. Scores (and mean scores) were 4.25±1.59 (21.23±7.95), 2.95±1.33 (17.68±7.97), 4.48±1.78 (8.96±3.56), and 4.98±1.52 (34.84±10.67) for factors I, II, III, and IV, respectively, whereas the overall score (and mean overall score) was 4.14±1.13 (82.71±22.68). Conclusion In our sample, no subject (0.0%) was without nomophobia, with 92 (18.0%) and 288 individuals (56.2%) reporting mild and moderate nomophobia levels, respectively. Approximately a quarter of the recruited sample (132 subjects, 25.8%) had severe nomophobia level.

To fast or not to fast during the month of Ramadan? A comprehensive survey on religious beliefs and practices among Moroccan diabetic patients

Background Diabetes represents a major public health concern. According to the International Diabetes Federation, about 8%–9% of the population have diabetes, and rates are even higher among Muslim communities. Despite the risks, about half (43%) with type 1 diabetes and most (86%) of those with type 2 diabetes fast during Ramadan. However, there is a dearth of information concerning the determinants that drive diabetic people to fast. Therefore, the present study was designed to fill this gap in knowledge. Materials and methods A sample of 201 subjects volunteered to take part in this study. Mean age was 45.39±15.74 years. Most participants were female, married and had received at least primary education. They fasted for 22.98±8.53 days. Results For the overall questionnaire, the Cronbach’s alpha coefficient was found to be excellent (α=0.910). The coefficient was good, yielding a value of 0.879, for the items concerning Ramadan fasting beliefs and practices, whereas the subscale for religious beliefs and practices obtained a score of 0.847. At the univariate analysis, patients with complicated diabetes (n=66, 32.8% of the sample) fasted for 20.77±9.21 days vs subjects with diabetes (n=135, 67.2% of the interviewees), who fasted for 24.05±7.99 days. The difference was statistically significant (P=0.014). The multivariate analysis indicated that religious beliefs and practices influenced the number of fasting days in a statistically significant way, after adjusting for confounders (beta coefficient =−0.199, t=−2.917, P=0.004). Another variable that impacted on the number of fasting days was the presence of complications (beta coefficient=−0.194, t=−2.775, P=0.006). Conclusion Our results warrant further studies in the field.

“Should I, as a Muslim, join or not Catholics in Churches?” Dilemmas of the Italian Muslim Community

Abstract Italian Muslims represent 2.6% of the entire population and one-third of all foreigners, constituting a fragmented and pluralistic community. Recently, father Jacques Hamel, a French Catholic priest, was killed by two knife-wielding French men pledging allegiance to the Islamic State. The Muslim French community strongly dissociated from this event. Italian Muslim community heeded this call and also sent delegates to French churches. According to the statistics, about 15,000 Muslims (approximately 1–2% of the Italian community) attended the commemorative event. Using a qualitative approach, we aimed at investigating the reasons that led Italian Muslims to join or not such an event. The following themes emerged: 1) public responsibility and accountability; 2) every murder as a crime to mankind; 3) importance of inter-faith dialogue and initiatives; 4) judging actions on the basis of intention; 5) fear of losing identity and roots; 6) innovation of attending churches even for good purposes; 7) dead peoples of series A and B; 8) useless of the action; and, finally, 9) impact of islamophobia. Our research sheds light on the multiple voices and thoughts of a complex, multifaceted community. We believe that our findings could be helpful for policy-makers and stakeholders, in designing inclusive and truly integrative policies.

Empowering patients of a mental rehabilitation center in a low-resource context: a Moroccan experience as a case study

Mental, neurological and substance use (MNS) disorders represent a major source of disability and premature mortality worldwide. However, in developing countries patients with MNS disorders are often poorly managed and treated, particularly in marginalized, impoverished areas where the mental health gap and the treatment gap can reach 90%. Efforts should be made in promoting help by making mental health care more accessible. In this article, we address the challenges that psychological and psychiatric services have to face in a low-resource context, taking our experience at a Moroccan rehabilitation center as a case study. A sample of 60 patients were interviewed using a semi-structured questionnaire during the period of 2014–2015. The questionnaire investigated the reactions and feelings of the patients to the rehabilitation program, and their perceived psychological status and mental improvement, if any. Interviews were then transcribed and processed using ATLAS.ti V.7.0 qualitative analysis software. Frequencies and co-occurrence analyses were carried out. Despite approximately 30 million inhabitants within the working age group, Morocco suffers from a shortage of specialized health workers. Our ethnographic observations show that psychiatric treatment can be ensured, notwithstanding these hurdles, if a public health perspective is assumed. In resource-limited settings, working in the field of mental health means putting oneself on the line, exposing oneself to new experiences, and reorganizing one’s own skills and expertise. In the present article, we have used our clinical experience at a rehabilitation center in Fes as a case study and we have shown how to use peer therapy to overcome the drawbacks that we are encountered daily in a setting of limited resources.

Effects of acculturation, coping strategies, locus of control, and self-efficacy on chronic pain: study of Chinese immigrant women in Italy – insights from a thematic field analysis

Chronic pain represents a common public health concern worldwide. It is a complex phenomenon, owing to the interaction of different factors, including biological, physiological, psychological, environmental, and social variables. Some groups, such as women and immigrants, are particularly vulnerable. However, little is known about how Chinese women in Italy live with and face chronic pain. The present study aimed at filling this knowledge gap by examining the burden of chronic pain in Chinese immigrants in Italy in terms of acculturation processes, perceived control over disease, social networks, and coping strategies. A qualitative approach was used, performing a thematic field analysis. We interviewed 82 Chinese women from different Italian towns (Genoa, Milan, Turin, Bologna, Florence, and Prato) in depth. The sense of belonging to the host culture was strong in our sample. However, this did not simply reflect or translate into a linear engagement with medical systems, as health care pathways were more complex and dual (both Chinese and Western). Chinese women who felt deeply rooted in the Italian environment did not discontinue the use of traditional Chinese medicine. Chronic pain extensively and adversely affected daily life, particularly interfering with work. Coping strategies were mainly adaptive behaviors, being problem focused or maladaptive, relying upon “cope and avoid” mechanisms. Chinese women preferred to use traditional Chinese remedies rather than conventional medicine, while using the Italian system in emergencies. Perceived control over chronic pain was usually external. Finally, Chinese women with chronic pain benefit from social networks and support, which were mainly composed of Chinese peers. In conclusion, our findings underline the tremendous burden of chronic pain affecting all aspects of Chinese women’s lives. Health care workers and providers should be aware of the complexity of chronic pain Therefore, a holistic approach, involving different stakeholders, should be adopted when managing chronic pain and approaching immigrant patients.

Data of the Modified Somatic Perception Questionnaire (MSPQ) administered to a sample of immigrants in Genoa (Italy)

This article reports the data of the Modified Somatic Perception Questionnaire (MSPQ) administered to a sample of 143 immigrants accessing an outpatient clinic or the general practitioners offices in Genoa (Italy) compared with 186 Italian patients. For further details and for the interpretation of the data, the reader is referred to the original publication “Somatic perception, cultural differences and immigration: results from administration of the Modified Somatic Perception Questionnaire (MSPQ) to a sample of immigrants” by Bragazzi et al. (2014) [1].