The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) virus initially appeared in Wuhan, Hubei Province, China has caused a novel coronavirus disease (COVID-19) [1] . The disease is rapidly spread around the world causing thousands of deaths and posing critical challenges for public health and clinical research in the world. The outbreak was declared by the World Health Organization (WHO) as a public health emergency of international concern. Nowadays, there are more than 18 millions of confirmed cases of coronavirus across the world with a total of 702,903 deaths [2] . In Morocco, there are 28,500 confirmed cases and 345 deaths. Forecasts for the cumulative number of confirmed, recovered, active and death cases were recently provided [3] . To manage the pandemic spread several countries adopted proactive and preventive measures including home confinement of the population. However, there is evidence that these measures, particularly home confinement, can cause unprecedented disruption in the well-being of the population. Being forced to stay at home and the daily activities’ restrictions could impact the citizens’ health-related quality of life (HRQoL) and behavior-related lifestyle. It has been reported that the COVID-19 pandemic has an impact on psychological behaviors [4] , mental health [5] and anxiety/depression [6] . The Moroccan population was under home confinement from March 20, 2020. Assessing rapidly and simply the HRQoL during crisis such as the home confinement is a challenge of interest to provide speedy information to authorities which allow best management of damages yielding in crisis situation. The EQ-5D instrument is a generic questionnaire developed by the Euroqol group for measuring the HRQoL by combining five health dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) [7] . The EQ-5D instrument is translated into more than 300 languages and exhibit good reliability and validity in both patients and general population. Herein, we used the EQ-5D-5L instrument to assess for the first time the impact of the home confinement on the HRQoL. Also, we evaluated the changes in behaviors by asking some questions related to lifestyle before and during the home confinement. These data can help the Moroccan authorities and other countries to more understand the impact of this crisis on citizens and therefore to set up adequate protocols for managing the post-confinement or possible future crisis. We provided two datasets: (1) data we collected before confinement from a sample of 484 individuals describing their HRQoL [8] and (2) data we collected during the home confinement period from a sample of 537 individuals describing their HRQoL and behavior-related lifestyle.

Abstract:Purpose: The purpose of this paper is to explore obstacles to ISO 9001 quality management system implementation in Moroccan firms.Design/methodology/approach: A questionnaire survey has been conducted among a heterogeneous sample of 200 organizations, operating in different sectors in Morocco, yielding a response rate of 57.5%. The authors have studied barriers to quality initiatives in general and obstacles to QMS implementation in particular through an extensive literature review. Questions related to profiles of respondents, reasons of seeking certification, external consultancy and barriers to ISO 9001 implementation experienced by surveyed organizations. For the purpose of this study, authors considered three categories of quality inhibiting factors: organizational, technical and costs related barriers. Findings:Results indicate that surveyed companies sought ISO 9001 certification mainly for marketing reasons and experienced many difficulties during the implementation process. Barriers reported by respondents were mostly organizational. Resistance to change headed the list according to participants' opinion. Also, findings highlighted the prominence of bureaucracy and poor interdependence between departments in organizations. Lack of communication, poor top management commitment and insufficient trainings were also ascertained to be obstacles to QMS implementation in Morocco. Originality/value: Earlier studies were led by different researchers in different countries about barriers to quality initiatives in general and to ISO 9001 implementation in particular. Few of those studies were conducted in Arab speaking countries but no research has been carried in Morocco. This study on obstacles to QMS implementation in Morocco will help in completing the jigsaw of difficulties faced by organizations worldwide when preparing to ISO 9001 certification. Research limitations/implications:This research is limited by the geographic context of the study Morocco, although results can be extrapolated to Arab speaking countries in general. Practical implications:The findings of this paper provide Moroccan managers with a practical understanding of the factors that are likely to obstruct ISO 9001 QMS implementation. Managers should overcome these barriers to achieve a successful implementation and higher QMS performance.

The World Health Organization (WHO) declared in March 12, 2020 the COVID-19 disease as pandemic. In Morocco, the first local transmission case was detected in March 13. The number of confirmed cases has gradually increased to reach 15,194 on July 10, 2020. To predict the COVID-19 evolution, statistical and mathematical models such as generalized logistic growth model [1] , exponential model [2] , segmented Poisson model [3] , Susceptible-Infected-Recovered derivative models [4] and ARIMA [5] have been proposed and used. Herein, we proposed the use of the Hidden Markov Chain, which is a statistical system modelling transitions from one state (confirmed cases, recovered, active or death) to another according to a transition probability matrix to forecast the evolution of COVID-19 in Morocco from March 14, to October 5, 2020. In our knowledge the Hidden Markov Chain was not yet applied to the COVID-19 spreading. Forecasts for the cumulative number of confirmed, recovered, active and death cases can help the Moroccan authorities to set up adequate protocols for managing the post-confinement due to COVID-19. We provided both the recorded and forecasted data matrices of the cumulative number of the confirmed, recovered and active cases through the range of the studied dates.

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Background: EQ-5D is generic measure of health-related quality of life. Studies using EQ-5D generate ordinal data that are interpreted as categories ordered by severity. New analytic approaches taking into account the ordinal nature of the health dimension severity and leading to a better interpretation of EQ-5D data are needed to better elucidate differences in health-related quality of life. We propose utilizing the Improved RIDIT statistical method to analyze EQ-5D outcomes. Methods: 556 Moroccan participants aged over 18 years representing four chronic diseases: back pain (n = 158), renal insufficiency (n = 56), diabetes (n = 82) or hypertension (n = 80) and healthy subjects (n = 180). All participants received the two EQ-5D versions. Two other published data sets were included. The first was extracted from a diabetic Spain study and the second was extracted from a clinical trial study. The Improved RIDIT analyses were carried out using an R statistic program we developed. Results: Applying the Improved RIDIT on the EQ-5D data allowed estimating for the first time the ordinal odds, the Absolute Risk Reduction (ARR) or the Absolute Risk Increase (ARI) and the Number Needed to Treat. The ARI values estimated for Moroccan patients showed that (i) hypertension increased anxiety/depression by 66% and reduced mobility by 65%; (ii) back pain increased pain/discomfort by 69%; (iii) renal insufficiency impacts mobility (ARI = 57%, odds ordinal = 9.95) and usual activities (ARI = 44%, odds ordinal = 6.41) and (iv) diabetes acts only on anxiety/depression (ARI = 50%, odds ordinal = 4.8). Also, we demonstrated that the approach works well in clinical trials. Conclusions: Improved RIDIT provides more intuitive and informative interpretation of the EQ-5D data by (1) taking into account the level severity; estimating (2) the odds ordinal, (3) the ARR/ARI and the NNT; (4) analyzing the five dimensions of the EQ-5D separately, which gives clinical teams more precision in understanding the treatment/ pathology impacts on the health status and completes the EQ-5D data analysis based on score utilities.