Prevalence of obstructive sleep apnea and its associated factors in primary health care in Morocco.

OBJECTIVE: Obstructive sleep apnea is a common respiratory disorder that is still underdiagnosed in Morocco. This study aims to determine the prevalence of obstructive sleep apnea and its associated factors in primary healthcare. METHODS: In this cross-sectional study, 815 adults aged 18 years and older consulting in the primary health care services in Marrakech, Morocco, were included. We evaluated the risk of obstructive sleep apnea syndrome using the modified STOP-BANG questionnaire. RESULTS: The prevalence of the high risk of obstructive sleep apnea in our sample is 24.8% (CI 95%: 21.7 - 27.6%). The variables independently associated with the high suspicion of obstructive sleep apnea were: gender male (p = 0.001), age ≥ 45 years (p = 0.001), high blood pressure (p = 0.005), hyperlipidemia (p = 0.042), daytime sleepiness (p = 0.003), snoring (p = 0.001), tiredness (p = 0.001) and mandibular retrognathia (p = 0.025). CONCLUSION: This survey revealed a significant prevalence of obstructive sleep apnea in Morocco. Therefore, we propose to generalize the screening of obstructive sleep apnea in hypertensive patients who report symptoms including daytime sleepiness, snoring, nocturnal choking, and tiredness that are unexplained by other known factors.

Gender norms and access to sexual and reproductive health services among women in the Marrakech-Safi region of Morocco: a qualitative study.

INTRODUCTION: Improving access to sexual and reproductive health remains a public health challenge, especially for women, whose access is affected by several determinants, such as gender inequality, which is the underlying barrier to all other determinants. Many actions have been carried out, but much remains to be done before all women and girls can exercise their rights. This study aimed to explore how gender norms influence access to sexual and reproductive health services. METHOD: A qualitative study was conducted from November 2021 to July 2022. The inclusion criteria were women and men aged over 18 years old, living in the urban and rural areas of the Marrakech-Safi region in Morocco. A purposive sampling method was used to select participants. Data were obtained through semi-structured interviews and focus groups with selected participants. The data were coded and classified using thematic content analysis. RESULTS: The study highlighted inequitable, restrictive gender norms that lead to stigmatization and affect the sexual and reproductive healthcare-seeking behavior and access of girls and women in the Marrakech-Safi region. These most common gender norms for women include parental refusal, stigmatization, and social exclusion of girls from sexual and reproductive health education services; strong decision-making power of family members over contraceptive use and women's adherence to pregnancy monitoring and access to supervised delivery; and culturally constructed role allocation, assigning a reproductive role to women and making them responsible for the health of new-borns. CONCLUSION: Sexual and reproductive health projects must strive to be gender sensitive. Gender-blind projects are missed opportunities to improve health outcomes and advance gender equality.

General practitioners' knowledge, attitudes and practices towards health promotion in Morocco.

Background: Health promotion (HP) is a part of the general practitioners' (GPs) competencies defined by the World Organization of Family Doctors. The implementation of HP in their practice is unsatisfactory. Aims: The aim of this study was to explore GPs knowledge, attitudes and practices in Morocco about HP at the primary healthcare services. Methods: A cross-sectional study was conducted using an online self-administrated questionnaire including, knowledge, attitudes and practices of GPs toward HP. Descriptive and bivariate analyses were conducted. Results: Two hundred and forty GPs responded to our questionnaires, the sex ratio was 1.12 with an average age of 40.46 ± 9.05 years. More than half of our participants perceived HP as a concept indistinct from prevention, 70.4% believed that HP refers to the biomedical model. On a Likert scale of 1-5, the level of HP knowledge was 2.71 ± 1.13. The most discussed topics with the population were tobacco, alcohol, overweight and obesity. Statistically significant association was found between the competencies of GPs in lifestyle behaviours and the practice of this competence. Conclusion: The knowledge of GPs remains insufficient, and their practices focus more on the areas in which they feel competent, which requires the implementation of specific training for the development of GPs skills in HP.

Student and faculty member perspectives on public health education at the Marrakech Medical School / Perceptions de la santé publique par les étudiants et les enseignants de la faculté de médecine de Marrakech

BACKGROUND: The COVID-19 pandemic has highlighted the pivotal role of public health. The aim of this study was to explore the perception of public health among medical students and faculty members (teachers). METHODS: A cross-sectional study was conducted at the medical school of Marrakech (FMPM) in May 2020. Data collection regarding the place of public health (during the training and in the practice) was done by electronic questionnaire. The analysis was descriptive and bivariate. RESULTS: 259 responses were received (78.4% were students). The female / male sex ratio = 1.27. Almost 98.5% believed that public health knowledge and experiences were relevant for clinical practice. The main activities that reflect public health were prevention and health promotion (81%), epidemiological surveillance and epidemic management (89.6%) (98.2% among teachers versus 87.2% among students, p = 0.009). During the pandemic, 85.7% of teachers and 77% of students developed an interest in public health (p = 0.196). Only 6.6% were interested in a career in public health. Compared to teachers, students had a positive perception during the pandemic (p = 0.001). CONCLUSION: The results highlight the lack of knowledge about the fields of application despite heightened sensitivity at the onset of the pandemic. Lessons can be learned in terms of improving public health training, raising awareness of the choice of this specialty and actions in favor of better visibility.

Introduction: La pandémie COVID-19 a remis en lumière le rôle pivot de la santé publique. L'objectif de cette étude était d'explorer la perception de la santé publique auprès des étudiants et des enseignants en médecine. Méthodologie: Nous avons mené une étude transversale à la faculté de médecine de Marrakech (FMPM) en Mai 2020. La collecte des données sur la place de la santé publique (dans la formation et sur le terrain) a été par questionnaire électronique. L'analyse était descriptive et bivariée. Résultats: Nous avons reçu 259 réponses (78,4 % étaient des étudiants). Le sexe ratio Femme/homme=1,27. Près de 98,5 % pensaient que les connaissances et les expériences en santé publique sont pertinentes pour la pratique clinique. Les principales activités qui reflètent la santé publique étaient la prévention et la promotion de la santé (81 %), la surveillance épidémiologique et la gestion des épidémies (89,6 %) (98,2 % chez les enseignants contre 87,2 % chez les étudiants, p=0,009). Au cours de la pandémie, 85,7 % des enseignants et 77 % des étudiants ont développé un intérêt pour la santé publique (p=0,196). Seulement 6,6 % étaient intéressés par une carrière en santé publique. Comparés aux enseignants, les étudiants avaient une perception différente positive au cours de la pandémie (p=0,001). Conclusion: Les résultats mettent en exergue la méconnaissance des champs d'application de la santé publique malgré un intérêt à l'avènement de la pandémie. Des enseignements sont à tirer en termes d'amélioration de la formation de la santé publique, la sensibilisation au choix de cette spécialité et d'actions en faveur d'une meilleure visibilité.

Impact of the COVID-19 pandemic on the activity of private medical practices in Morocco.

INTRODUCTION: The aim of this study was to assess the impact of the COVID-19 pandemic on the activity of private medical practices in Morocco. METHODS: An online survey was carried out in June 2020. The study population consisted of physicians (General practitioners and specialists) who run private practices in different regions of Morocco. The questionnaire comprised three sections: demographic and professional data, the impact noticed by the physicians and the strategies they adopted to tackle this impact. RESULTS: We analysed 225 responses. Specialists represented 71.6% of the respondents. The majority (94.2%) of the private practices were located in urban areas. Almost all respondents have noticed a change in the demand for medical services, mainly a decrease (96.4%). There was an increase in urgent consultations (30.7%) and consultations for acute motives (39.1%). Respondents also reported less (69.3%) or no (23.1%) regular follow-up visits for patients with chronic diseases. Decreased incomes concerned 97.3% of the practices. Practitioners reacted by working less hours (87.6%), delaying some procedures (78.2%) and applying recommended safety measures (100%). Telemedicine was used in an informal way to facilitate the communication with patients. DISCUSSION AND CONCLUSION: During this pandemic, private practices were challenged to contribute to the continuity of healthcare services while ensuring the safety of the staff and the patients. Several strategies were adopted to cope with the new situation and to survive its many challenges.

Adhesion and Stability of Nanocellulose Coatings on Flat Polymer Films and Textiles.

Renewable nanocellulose materials received increased attention owing to their small dimensions, high specific surface area, high mechanical characteristics, biocompatibility, and compostability. Nanocellulose coatings are among many interesting applications of these materials to functionalize different by composition and structure surfaces, including plastics, polymer coatings, and textiles with broader applications from food packaging to smart textiles. Variations in porosity and thickness of nanocellulose coatings are used to adjust a load of functional molecules and particles into the coatings, their permeability, and filtration properties. Mechanical stability of nanocellulose coatings in a wet and dry state are critical characteristics for many applications. In this work, nanofibrillated and nanocrystalline cellulose coatings deposited on the surface of polymer films and textiles made of cellulose, polyester, and nylon are studied using atomic force microscopy, ellipsometry, and T-peel adhesion tests. Methods to improve coatings' adhesion and stability using physical and chemical cross-linking with added polymers and polycarboxylic acids are analyzed in this study. The paper reports on the effect of the substrate structure and ability of nanocellulose particles to intercalate into the substrate on the coating adhesion.

Determinants of Maternal Health Services Use among Vulnerable Women in a Rural Community in the Moroccan High Atlas.

Several factors affect the use of maternal health care services in developing countries. The aim was to describe the knowledge and attitudes of women in a rural area of the Moroccan High Atlas regarding aspects of maternal health, and to identify the determinants of use of maternal health care services. A cross-sectional study of 87 participants was conducted in a mountainous area near Marrakech utilizing two sampling methods (a door-to-door approach, and a mobile health caravan). Fisher test was used to compare two proportions, and the non-parametric Mann-Whitney test to compare two means (p value was 0.05). Median participants' age was 24 years old [15-60]. Findings indicated that husband's education (p=0.005), woman's age (p=0.011), awareness of warning signs during pregnancy (p=0.01) and use of health center for other purposes other than pregnancy (p=0.007) were important influencing factors for use of prenatal consultation services. Factors that influenced supervised birth outcomes were the age of the woman (p=0.013), her education (p=0.027) and a positive attitude towards monitoring her pregnancy by a health professional (p=0.006). To improve utilization rates for maternal health services, these factors must be considered when designing interventions that aim to improve the quality of these services in the community.

Regenerative Capacity of Adipose Derived Stem Cells (ADSCs), Comparison with Mesenchymal Stem Cells (MSCs).

Adipose tissue is now on the top one of stem cell sources regarding its accessibility, abundance, and less painful collection procedure when compared to other sources. The adipose derived stem cells (ADSCs) that it contains can be maintained and expanded in culture for long periods of time without losing their differentiation capacity, leading to large cell quantities being increasingly used in cell therapy purposes. Many reports showed that ADSCs-based cell therapy products demonstrated optimal efficacy and efficiency in some clinical indications for both autologous and allogeneic purposes, hence becoming considered as potential tools for replacing, repairing, and regenerating dead or damaged cells. In this review, we analyzed the therapeutic advancement of ADSCs in comparison to bone marrow (BM) and umbilical cord (UC)-mesenchymal stem cells (MSCs) and designed the specific requirements to their best clinical practices and safety. Our analysis was focused on the ADSCs, rather than the whole stromal vascular fraction (SVF) cell populations, to facilitate characterization that is related to their source of origins. Clinical outcomes improvement suggested that these cells hold great promise in stem cell-based therapies in neurodegenerative, cardiovascular, and auto-immunes diseases.

[An update for the treatment of osteoid osteoma]. / Le point sur le traitement percutané des ostéomes ostéoïdes.

Osteoid osteoma is frequent benign tumor, descripted initially by Bergstrand in 1930 followed by Jaffe in 1935. The painful feature of the osteoid osteoma explains the specific consideration by the medical community for this entity. The debate was focused on pathologic and imaging pattern as well as the treatment modalities. Currently, the treatment options are varied and percutaneous treatment is increasingly used. The radiofrequency is widely validated as efficient method without serious adverse and with low rate of recurrence. We hope through this this work to revue the current knowledge of the treatment of osteoid osteoma.

L'ostéome ostéoïde est une tumeur osseuse bénigne relativement fréquente initialement décrite par Bergstrand en 1930, puis comme une entité propre grâce aux recherches de Jaffe en 1935. Malgré sa bénignité, elle a concentré toute l'attention des radiologues comme des cliniciens car très symptomatique. Dès lors, l'ostéome ostéoïde a fait l'objet de nombreux débats dans la communauté scientifique en particulier concernant son étiologie, ses caractéristiques pathologiques, son bilan d'imagerie et son traitement. C'est sur cette dernière question que les avancées ont été les plus marquantes et c'est ainsi que les possibilités thérapeutiques bien décrites dans la littérature apparaissent variées. Toutefois, les résultats très favorables des traitements percutanés et en particulier de la radiofréquence, de même que le faible taux de récidives et de complications de ces traitements, ont amené de nombreux pays à les considérer comme le meilleur traitement en première intention. A travers cette revue de la littérature et de notre pratique clinique, nous souhaitons rapporter les connaissances actuelles thérapeutiques en perpétuelle progression grâce au progrès technique.

Nebivolol enhances the effect of alendronate against methylprednisolone-induced osteoporosis in rats.

This study aimed to assess the possible modulatory effect of nebivolol against methylprednisolone-induced osteoporosis in rats. Weekly administration of methylprednisolone (7 mg/kg), for six consecutive weeks caused significant increases in serum calcium, bone malondialdehyde, and hydroxyproline as well as serum alkaline phosphatase, but it significantly decreased serum phosphorous and osteocalcin, bone reduced glutathione, and nitric oxide (NO) as well as bone antioxidant enzymes activities compared with the control group. The results were confirmed by histopathological findings of femur bone. On the other hand, administration of alendronate (1 mg/kg) with nebivolol (1.5 mg/kg) orally and daily for seven consecutive days after methylprednisolone treatment caused marked mitigation in the above-mentioned parameters compared with methylprednisolone group. In conclusion, nebivolol proved to enhance the effect of alendronate in modulating methylprednisolone osteoporotic effect, which might be attributed to its release of NO together with its profound reducing capability in the oxidative cascade of bone tissue.

Lymphoepithelial carcinoma: a case report of a rare tumor of the larynx.

BACKGROUND: Lymphoepithelial carcinoma is a tumor mostly diagnosed in the nasopharynx, but it has also been described in a variety of nonnasopharyngeal sites. It is extremely rare in the larynx and should be distinguished from squamous cell carcinoma. Therefore, it must be known by clinicians, pathologists and oncologists. In this case report, we discuss its etiopathogeny, its epidemiological, clinical, pathological and therapeutic aspects, and its outcome. CASE PRESENTATION: An 81-year-old Morrocan man, smoker for 40 years, presented with a 1 year history of dysphonia, dyspnea and dysphagia. Laryngoscopy showed a mass occupying supraglottic, glottic and subglottic levels of the larynx. Cervico-thoracic computed tomography scan showed a laryngeal wall thickening with cervical lymphadenopathy. Laryngeal biopsy was performed. Microscopic analysis and immunohistochemistry confirmed the diagnosis of laryngeal lymphoepithelial carcinoma. Immunostaining for LMP1 was negative. CONCLUSION: Laryngeal lymphoepithelial carcinoma is an extremely rare and an aggressive tumor. It is rarely associated with the EBV. It must be regarded as a distinct entity. Radiotherapy is advisable as the unique therapy for local tumor. A correct diagnosis and a close collaboration between the pathologist and clinicians is mandatory for an optimal treatment strategy.

Pathogenicity and phenotypic characterization of enterotoxigenic Escherichia coli isolates from a birth cohort of children in rural Egypt.

Enterotoxigenic Escherichia coli (ETEC) has consistently been the predominant bacterial cause of diarrhea in many birth cohort- and hospital-based studies conducted in Egypt. We evaluated the pathogenicity of ETEC isolates in a birth cohort of children living in a rural community in Egypt. Between 2004 and 2007, we enrolled and followed 348 children starting at birth until their second year of life. A stool sample and two rectal swabs were collected from children during twice-weekly visits when they presented with diarrhea and were collected every 2 weeks if no diarrhea was reported. From routine stool cultures, five E. coli-like colonies were screened for ETEC enterotoxins using a GM1 enzyme-linked immunosorbent assay (ELISA). The isolates were screened against a panel of 12 colonization factor antigens (CFAs) by a dot blot assay. A nested case-control study evaluated the association between initial or repeat excretion of ETEC and the occurrences of diarrhea. The pathogenicity of ETEC was estimated in symptomatic children compared to that in asymptomatic controls. ETEC was significantly associated with diarrhea (crude odds ratio, 1.37; 95% confidence interval [CI], 1.24 to 1.52). The distribution of ETEC enterotoxins varied between the symptomatic children (44.2% heat-labile toxin [LT], 38.5% heat-stable toxin [ST], and 17.3% LT/ST) and asymptomatic children (55.5% LT, 34.6% ST, and 9.9% LT/ST) (P < 0.001). The CFAs CFA/I (n = 61), CS3 (n = 8), CS1 plus CS3 (n = 24), CS2 plus CS3 (n = 18), CS6 (n = 45), CS5 plus CS6 (n = 11), CS7 (n = 25), and CS14 (n = 32) were frequently detected in symptomatic children, while CS6 (n = 66), CS12 (n = 51), CFA/I (n = 43), and CS14 (n = 20) were detected at higher frequencies among asymptomatic children. While all toxin phenotypes were associated with diarrheal disease after the initial exposure, only ST and LT/ST-expressing ETEC isolates (P < 0.0001) were associated with disease in repeat infections. The role of enterotoxins and pathogenicity during repeat ETEC infections appears to be variable and dependent on the coexpression of specific CFAs.

The views of general practitioners in Morocco about health promotion at the primary health care services: Qualitative study.

BACKGROUND: Health promotion (HP) is one of the key skills that every general practitioner (GP) should have, according to The World Organization of Family Doctors, but for several reasons, his practice remains insufficient. However, a gap would exist between the GPs' knowledge and their practices about HP. The aims of our study were to explore GPs' perceptions, knowledge, and practices in Morocco about HP and identify their barriers and needs to best practice HP actions. MATERIALS AND METHODS: A qualitative case study was conducted among GPs, via semi-structured interviews following an interview guide. Purposive and snowball sampling were used to select our sample. It contained four themes, perceptions, practices, barriers and needs, and proposals for improvement. The interviews were recorded and then transcribed. Thematic content data analysis was done manually. Favorable ethical approval was obtained from the local ethics committee. RESULTS: Fourteen GPs participated in this study. The sex ratio was at one. GPs' practices were focused on the biomedical model with wide confusion of HP with prevention and therapeutic education. Their roles in HP were considered paramount. The number of patients during consultations, structures' care, and knowledge were the main barriers. The main cited needs were material resources and HP training. CONCLUSION: Our study has made it possible to make an inventory of the practice of HP in Morocco. Participants' practices were based on the curative aspect. There is a crucial need to implement continuing and contextualized training for general practitioners to strengthen their skills in HP. This training will help to succeed in the health-promoting hospital's strategy.

Clinical Supervision of Medical Students in Primary Health Care Services: General Practitioners' Perspectives in Morocco.

Introduction: Clinical supervision is crucial to establish a learning climate in which the supervisor guides the supervised. Clinical supervisors might have numerous barriers and motivations. Our study aimed to explore the clinical supervision practices among general practitioners and to describe their motivations, barriers, and needs. Methods: A qualitative study was conducted using purposive sampling which is a non-probabilistic sampling method. The population was the general practitioners who were working at the primary health care centers either in the public or the private sectors (N=16). Individual semi-structured interviews were conducted by two authors, using an interview guide. All interviews were recorded, transcribed, and coded. A thematic content analysis was done manually based on an inductive approach. Results: Sixteen general practitioners participated. Three main themes emerged from the study: 1) General practitioners' practices in clinical supervision, 2) the enablers to adequate clinical supervision in general practice, and 3) the general practitioners' fundamental barriers and needs in clinical supervision. Despite their lack of clinical supervision training, they could describe the different clinical supervision steps without giving their exact names. We found that their teaching skills must be reinforced. General practitioners were mainly motivated by personal and professional interests as well as moral obligations. Numerous barriers and needs were identified at the organizational, relational, and financial levels. The principles barriers and needs were the lack of clinical supervision training, lack of equipment, and remuneration. Conclusion: The current study highlighted the motivations and challenges of general practitioners concerning clinical supervision. These results are helpful for all responsible institutions involved in clinical supervision and upcoming programs in Morocco.

Goodhill syndrome: a case report.

Conductive hearing loss with a normal tympanic membrane is a common reason for otolaryngology consultation, with otospongiosis being the most frequent cause and House syndrome being extremely rare, requiring systematic investigation. We report the case of a 31-year-old woman who presented with conductive hearing loss with a normal tympanic membrane. A temporal bone computed tomography (CT) scan confirmed a House-Goodhill syndrome due to fixation of the malleus head. Surgical intervention was considered to remove the attic bone synostosis with the malleus head, resulting in a significant clinical improvement. The Goodhill syndrome is a rare condition that causes hearing loss with a normal eardrum. The surgery can highly improve the hearing function.

Emergency Endoscopic Endonasal Optic Nerve Decompression for Graves' Orbitopathy.

Graves' orbitopathy (GO) is a rare autoimmune disease that affects patients in their fourth to sixth decade, resulting in retro-orbital inflammation and hypertrophy of extraocular muscles and orbital fat. It is the most common disease affecting the orbit globally, and treatment options vary depending on the severity and activity status of the affection, ranging from local measures such as lubricating eye drops and patching, glucocorticoid eye drops, mydriatics, nonsteroid anti-inflammatory medications to systemic glucocorticoids, and emergency orbital decompression surgery. Immunotherapy and orbital radiation may as well be used as a treatment option even though their efficiency remains controversial. This paper presents the cases of two patients with GO who underwent endoscopic endonasal decompressive surgery. These patients' medical records, including symptoms and duration, clinical examination, imaging results, preoperative preparation, surgery steps, and postoperative course and outcomes, were collected from various specialties, including ophthalmologists and endocrinologists. We highlight the importance of a multidisciplinary approach to managing GO and its complications, with endoscopic endonasal techniques emerging as a minimally invasive and effective way to treat compressive optic nerve forms of the disease. However, the timing of decompression remains crucial, and early intervention is recommended to avoid sight-threatening ophthalmopathy when medical therapies are ineffective.

Prevalence of chronic pain with neuropathic characteristics in the Moroccan general population: a national survey.

OBJECTIVE: We conducted a telephonic survey to determine the prevalence of chronic pain with neuropathic characteristics (NC) in the Moroccan general population. DESIGN: We performed a large nationwide telephonic survey based upon a random sampling of households in the 16 administrative regions of Morocco to determine the prevalence of chronic pain with NC in the general population. We used a stratified sampling taking into account the number of residents in each region. A sample of households was drawn for each of the 16 regions using systematic sampling. OUTCOME MEASURES: A questionnaire aimed at identifying chronic pain (defined as daily pain for at least 3 months), evaluating its intensity, duration, and body locations was used. The Moroccan validated version of DN4 questionnaire was used to identify neuropathic characteristics. RESULTS: A total of 5,328 respondents participated in the survey. 21% of the respondents (1,074) (95%CI: 19,9-22,2), reported chronic daily pain for more than 3 months. The point prevalence of chronic pain with NC, was 10.6% (95% CI: 9,75-11,45). The prevalence was higher in women and individuals older than 60. Chronic pain with NC was significantly more prevalent in women, elderly, illiterate respondents, and respondents from lower social class. It was more frequently located in the lower limbs, and its intensity and duration were higher in comparison with chronic pain without neuropathic characteristics. CONCLUSION: Chronic pain with neuropathic characteristics is probably more prevalent in the general population than was previously thought and is generally more severe than other chronic pain.

[An audit of type 2 diabetes management in a diabetes center in Marrakech]. / Audit de la prise en charge des patients diabétiques de type 2 suivis dans un centre de diabétologie à Marrakech.

AIM: The purpose of this study was to examine current practices among endocrinologists at the University Hospital of Marrakech (Morocco), focusing on the management of type 2 diabetes in adults. METHODS: A clinical audit of diabetic patient care was performed. The audit was based on a retrospective analysis of 46 medical records during 2011 (including monitoring examinations and non-drug prescriptions during the previous year). 27 medical visits during March 2012 were also observed. Data on physicians' perceptions and proposals for improvement were collected through semi-structured interviews. Quality of care was assessed based on current recommendations. RESULTS: Data analysis revealed a gap between theory and practice. Glycated hemoglobin levels (measured every six months) were recorded in 59% of cases, while patients' hemodynamic status, weight and height were recorded in 30% of cases. The results of complication screening were recorded in half of the cases. Observations of consultations showed that patient adherence was assessed in 97% of the consultations while foot examinations were performed in just 18% of cases. CONCLUSION: The audit was both a challenge for the diabetes unit and an opportunity to promote self-assessment. This new approach may help to improve the quality of care provided to diabetic patients in our hospital.

Job satisfaction of primary healthcare professionals (public sector): A cross-sectional study in Morocco.

Healthcare professionals (HCPs) are indispensable for improving the availability and quality of healthcare services. Therefore, the present cross-sectional study aimed to measure the job satisfaction of HCPs working in primary care (PC) centers in Marrakech, according to the job satisfaction scale. Using census sampling, this study involved HCPs working in PC centers. Data were collected using an electronic questionnaire and analyzes were performed using Jamovi (version 1.6). The Warr-Cook-Wall scale was used to assess the satisfaction of these professionals. Student's t-test, Kruskal-Wallis test and Mann-Whitney non-parametric tests were used for group comparisons (p < 0.05). The lowest satisfaction scores were recorded for general practitioners (GPs) and nurses. These were work safety (1.54 ± 0.85 vs. 1.51 ± 0.82), salary (1.58 ± 0.79 vs. 1.72 ± 0.87), chance of promotion (1.68 ± 0.87 vs. 1.80 ± 0.93), possibility of using its capacities (1.90 ± 1.04 vs. 2.01 ± 1.08), and workload (1.88 ± 1.10 vs. 2.05 ± 1.06). A statistically significant difference was observed between different professional statuses regarding facility management (p = 0.049). The overall job satisfaction of HCPs was low, especially among GPs and nurses: the scores for intrinsic job satisfaction with respect to sociodemographic characteristics were low, whereas they were medium for extrinsic job satisfaction. Further research is warranted to clarify the intrinsic and extrinsic factors of job satisfaction in Morocco's healthcare sector.

Cross-cultural adaptation of the Moroccan Arabic dialect version of the Primary Care Assessment Tool.

OBJECTIVE: To adapt the Primary Primary Care Assessment Tool-Adult Edition into the Moroccan Arabic dialect and to assess its reliability and validity from the perspective of Moroccan adult patients. METHOD: A committee of experts carried out the cross-cultural adaptation of the Primary Care Assessment Tool. The adapted questionnaire was subject to forward and backward translation and a pilot study. Exploratory factor analysis assessed the internal consistency, reliability, and construct validity of items and scales. Finally, descriptive statistics were performed on the final factor structure. RESULTS: A 43-item Moroccan Arabic dialect version of the Primary Care Assessment Tool-Adult Edition was developed. It consisted of six multi-item scales that represented the four main dimensions of primary care: first contact, continuity, comprehensiveness, and coordination. Four derived dimensions were included: cultural competence, communication, advice, and community orientation. All six scales demonstrated robust internal consistency, item-total solid correlations, and construct validity. The calculated Cronbach's alpha coefficients ranged from 0.78 to 0.90. CONCLUSIONS: Comprehensive metric analyses supported the reliability and validity of the Moroccan Arabic dialect version of the Primary Care Assessment Tool-Adult Edition in assessing core primary care domains from the patients' experience. This tool could be used for future research on primary care in Morocco.