Bio-demographic characteristics of children with Down syndrome, their siblings, and their parents in Moroccan population.

OBJECTIVE: In this study, we present the results of bio-demographic characteristics of households and associated factors with Down syndrome (DS) birth in Morocco. METHODS: We conducted a retrospective survey between 2014 and 2017 addressed to 277 families with 925 siblings and at least one child with DS (279 with DS). The data are collected using a standardized questionnaire in Marrakech-Safi region. Data were entered and analyzed using the statistical program SPSS statistics software for Windows (version 20.0). Chi-square (χ2) and student t tests were used for testing statistical significance. Differences were considered significant when the p-value <0.05. RESULTS: The binary logistic regression analysis between DS and non-DS children in their bio-demographic characteristics studied (sex, breastfeeding, duration of exclusive breastfeeding, birth weight, maternal age at birth, paternal age at birth, oral contraceptive use, duration of oral contraceptive use before pregnancy, child age and rank of birth) showed that only maternal age and paternal age at birth, duration of exclusive breastfeeding, birth weight and child age (OR= 1.08; 95%Cl: 1.04-1.13, OR= 1.04; 95%Cl: 1.00-1.08, OR= 0.95; 95%Cl: 0.92-0.98, OR= 0.31; 95%Cl: 0.22-0.44 and OR= 0.90; 95%Cl: 0.87-0.93, respectively). In the other hand, the comparison between some of socio and bio-demographic characteristics of households studied with data from National Population Survey and Family health (2018) showed a higher level of education in women and men in our sample. Similar results were shown in proportion of men and women in paid employment, the proportion of smoking and alcohol consumption among men and the rate of oral contraceptive use before pregnancy among women. CONCLUSION: Highlighting the bio-demographic characteristics of people with DS will help families to take good care of this group. .

Parents' perceptions of morbidities and some functional abilities in people with down syndrome in Morocco.

Objective: This study aimed to assess parental perceptions of morbidity and certain functional abilities in people with Down syndrome (DS) and their variability according to age and sex in Morocco. Material and Methods: A retrospective and analytical survey was conducted between May 2014 and November 2017, and addressed to the parents of 279 individuals with DS, including 161 boys (57.7%) aged 1-40 years. The sample was subdivised to tree age groups, children under 10 years old, adolescents aged 10-18 years and adults aged ≥ 18 years. Information about the identity of parents, age and sex of people with DS, their morbidity during the two years preceding the survey, and some functional abilities was collected. Data were entered and analyzed using the statistical program SPSS statistics software for Windows (version 20.0). Chi-square (χ2) test was used for testing statistical significance. Differences were considered significant when the p-value < 0.05. The multivariate analysis were used to identify the causes of morbidies independently associated with age and sex of child. Associations were measured in Odds ratio (OR) with 95% confidence intervals (95% Cl). Results: The most common factors of morbidity registered in the study sample with DS, included respiratory infections, visual disturbances, oral pathologies, and cardiac problems (75.4%, 72.1%, 59.3%, and 44.9%, respectively). The hearing deficit, cardiac problems, respiratory infections, and oral pathologies showed statistically significant differences among the three age groups. According to the participants parents' perceptions, half of them (50%) were able to walk at 30 months, talk at 72 months, sit at 16 months, crawl at 16 months and eat alone at 48 months old. Conclusion: People with DS at different ages present a set of potentially treatable diseases that require multidisciplinary medical monitoring. They also need early paramedical care to improve their functional abilities.

Factors influencing older adults' satisfaction with caregivers' communication.

Effective communication skills are crucial for caregivers to provide quality care and meet the unique needs of patients of all ages. However, older patients have specific communication requirements, and their satisfaction depends on several factors. Objective: This study aimed to evaluate the level of satisfaction among older adults in Marrakech, Morocco, regarding the communication skills of their caregivers, and to identify the factors influencing this satisfaction. Methods: This is a cross-sectional study conducted between March and July 2022 among 204 people aged 60 years and older who presented to the Mouhamed VI University Hospital of Marrakech, Morocco, for various care services. The older adults' satisfaction with caregivers' communication was assessed by the American Board of Internal Medicine (ABIM) patient satisfaction questionnaire. Sociodemographic and clinical characteristics of the participants were collected through interview and consultation of medical records. Multiple linear regression was used to determine potential factors influencing the total satisfaction score. Results: The total satisfaction score of older adults with caregiver' communication was 2.55±0.95 and the mean scores of the lowest subscales were answering questions, greeting and listening. Analysis revealed that having visual disorders (B=-0.276±0.12; p=0.029) and receiving affective touch from caregivers (B=0.745±0.12; p=0.001) were the main factors associated with older adults' satisfaction with caregiver' communication. Conclusion: Older people are not sufficiently satisfied with caregivers' communication skills, especially those with vision problems and those who have not received affective touch from caregivers. Caregivers need to be aware of the specific needs of older patients and use appropriate communication techniques.

Habilidades de comunicação eficazes são fundamentais para que os profissionais de saúde ofereçam atendimento de qualidade e atendam às necessidades específicas de pacientes de todas as idades. No entanto, os pacientes mais velhos têm necessidades específicas de comunicação, e sua satisfação depende de vários fatores. Objetivo: Este estudo teve como objetivo avaliar a satisfação da pessoa idosa com a comunicação dos cuidadores e identificar os fatores de influência. Métodos: Este é um estudo transversal realizado entre março e julho de 2022 com 204 pessoas com 60 anos ou mais que se apresentaram ao Hospital Universitário Mouhamed VI de Marrakech para receber diversos cuidados. A satisfação da pessoa idosa com a comunicação dos cu idadores foi avaliada pelo questionário de satisfação do paciente do American Board of Internal Medicine (ABIM). As características sociodemográficas e clínicas dos participantes foram coletadas por meio de entrevista e consulta aos registros médicos. A análise dos dados foi realizada com o software Statistical Package for the Social Sciences (SPSS), versão 25. Resultados: A pontuação total de satisfação da pessoa idosa com a comunicação do cuidador foi de 2,55±0,95, e as pontuações médias das subescalas mais baixas foram responder a perguntas, cumprimentar e ouvir. A análise revelou que ter distúrbios visuais (B=-0,276±0,12; p=0,029) e receber toque afetivo dos cuidadores (B=0,745±0,12; p=0,001) foram os principais fatores associados à satisfação dos pessoa idosa com a comunicação do cuidador. Conclusão: As pessoas idosas não estão suficientemente satisfeitas com as habilidades de comunicação dos cuidadores, especialmente aquelas com problemas de visão e as que não receberam o toque afetivo dos cuidadores. Os cuidadores precisam estar cientes das necessidades específicas dos pacientes mais velhos e usar técnicas de comunicação adequadas.

Bio-demographic characteristics of households and risk factors for Down Syndrome in Morocco.

Background: The most studied risk factors for Down Syndrom (DS) were: region of residence, exposure to chemicals, parents' education level, cigarette and alcohol use by father or mother or both, and oral contraceptive (OC) use. Objective: The aim of this study was to compare certain variables considered as risk factors on DS such as parental age at birth, OC use, child's sex, and rank of birth between children with DS and their siblings without DS as well as to determine the socio-bio-demographic characteristics of the families studied compared with the general Moroccan population. Material and Methods: We conducted a cross-sectional analysis of 277 families with 925 siblings and at least one child with DS (279 with DS) between 2014 and 2017. The data are collected using a standardized questionnaire in MarrakechSafi region. Data were entered and analyzed using the statistical program SPSS statistics software for Windows (version 20.0). Chi-square (χ2) and Student t tests were used for testing statistical significance. Differences were considered significant when the p-value <0.05. Results: The binary logistic regression analysis between DS and non-DS children in their bio-demographic characteristics studied (sex, maternal age at birth, paternal age at birth, oral contraceptive (OC) use, length of oral contraceptive use before pregnancy and rank of birth) showed that only maternal age and paternal age at birth and OC use were associated with DS birth (OR= 1.16; 95% CL: 1.11-1.21, OR= 1.05; 95%CL: 1.01-1.09 and OR= 0.01; 95%CL: 0.00-0.003, respectively). In the other hand, the comparison between socio and bio-demographic characteristics of households studied with data from National Population Survey and Family health (2018) showed a higher level of education in women and men in our sample. Similar results were shown in rate of men and women in paid employment, the rate of smoking and alcohol consumption among men and the rate of OC use before pregnancy among women. Conclusion: These results will help to sensitize the Moroccan population about risk factors for DS.

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.

Cognitive complaints in older adults in primary care and associated factors.

Cognitive complaints are common in older people. They can progress into a more severe cognitive decline and then deterioration of quality of life. They are associated with several factors. Objective: This study aimed to determine the factors associated with cognitive complaints in older adults in the city of Marrakech, Morocco. Methods: This study was conducted between March and June 2022 among 281 people aged 50 years and older who attended primary health care centers in the city of Marrakech. Cognitive complaints were measured using the McNair-Kahn scale. Data on sociodemographic and clinical characteristics were collected through interviews with the participants and consultation of their medical records. Analysis was done using Statistical Package for Social Sciences (SPSS) version 25, Ink software. Results: Of the total participants, 51.6% had cognitive complaints. Multivariate analysis showed that people aged 75 years and over had a sevenfold higher risk of cognitive complaints than people aged 50-64 years (p=0.033; OR=7.64; 95%CI 1.17-49.72), and that illiteracy (p=0.004; OR=3.39; 95%CI 1.48-7.76), cardiovascular disease (p=0.018; OR=4.30; 95%CI 1.29-14.32), diabetes (p=0.001; OR=3.14; 95%CI 1.64-6.04), visual impairment (p=0.017; OR=2.22; 95%CI 1.15-4.19), depression (p= 0.027; OR=2.36; 95%CI 1.10-5.05) and sleepiness (p=0.034; OR=1.96; 95%CI 1.05-3.66) are associated variables. Conclusions: Cognitive complaints are frequent in older adults and are associated with several sociodemographic and health factors. Some measures could help maintain stable memory performance in old age and prevent severe cognitive declines, such as regular follow-up of at-risk individuals, and cognitive, physical and leisure activities.

Queixas cognitivas são comuns em pessoas idosas. Elas podem evoluir para um declínio cognitivo mais grave e, em seguida, deterioração da qualidade de vida. Elas estão associadas a vários fatores. Objetivo: Este estudo teve como objetivo determinar os fatores associados às queixas cognitivas em idosos da cidade de Marrakech, Marrocos. Métodos: Este estudo foi realizado entre março e junho de 2022 entre 281 pessoas com 50 anos ou mais que se apresentaram em centros de atenção primária à saúde na cidade de Marrakech. As queixas cognitivas foram medidas usando a escala de McNair-Kahn. Os dados sobre características sociodemográficas e clínicas foram coletados por meio de entrevista com os participantes e consulta aos seus prontuários. A análise foi feita usando o software Pacote Estatístico para as Ciências Sociais (SPSS), versão 25. Resultados: Do total de participantes, 51,6% apresentaram queixas cognitivas. A análise multivariada mostrou que pessoas com 75 anos ou mais tiveram risco sete vezes maior de queixas cognitivas do que pessoasentre 50­64 anos (p=0,033; OR=7,64; IC95% 1,17­49,72), e que analfabetismo (p=0,004; OR=3,39; IC95% 1,48­7,76), doenças cardiovasculares (p=0,018; OR=4,30; IC95% 1,29­14,32), diabetes (p=0,001; OR=3,14; IC95% 1,64­6,04), comprometimento visual (p=0,017; OR=2,22; IC95% 1,15­4,19), depressão (p=0,027; OR=2,36; IC95% 1,10­5,05) e sonolência (p=0,034; OR=1,96; IC95% 1,05­3.66) são variáveis associadas. Conclusões: Queixas cognitivas são frequentes em idosos e estão associadas a diversos fatores sociodemográficos e de saúde. Algumas medidas poderiam ajudar a manter o desempenho estável da memória na velhice e prevenir declínios cognitivos graves, como o acompanhamento regular de indivíduos em risco e atividades cognitivas, físicas e de lazer.

Factors influencing older adults' satisfaction with caregivers' communication / Fatores que influenciam a satisfação das pessoas idosas com a comunicação dos cuidadores

ABSTRACT. Effective communication skills are crucial for caregivers to provide quality care and meet the unique needs of patients of all ages. However, older patients have specific communication requirements, and their satisfaction depends on several factors. Objective: This study aimed to evaluate the level of satisfaction among older adults in Marrakech, Morocco, regarding the communication skills of their caregivers, and to identify the factors influencing this satisfaction. Methods: This is a cross-sectional study conducted between March and July 2022 among 204 people aged 60 years and older who presented to the Mouhamed VI University Hospital of Marrakech, Morocco, for various care services. The older adults' satisfaction with caregivers' communication was assessed by the American Board of Internal Medicine (ABIM) patient satisfaction questionnaire. Sociodemographic and clinical characteristics of the participants were collected through interview and consultation of medical records. Multiple linear regression was used to determine potential factors influencing the total satisfaction score. Results: The total satisfaction score of older adults with caregiver' communication was 2.55±0.95 and the mean scores of the lowest subscales were answering questions, greeting and listening. Analysis revealed that having visual disorders (B=-0.276±0.12; p=0.029) and receiving affective touch from caregivers (B=0.745±0.12; p=0.001) were the main factors associated with older adults' satisfaction with caregiver' communication. Conclusion: Older people are not sufficiently satisfied with caregivers' communication skills, especially those with vision problems and those who have not received affective touch from caregivers. Caregivers need to be aware of the specific needs of older patients and use appropriate communication techniques.

RESUMO. Habilidades de comunicação eficazes são fundamentais para que os profissionais de saúde ofereçam atendimento de qualidade e atendam às necessidades específicas de pacientes de todas as idades. No entanto, os pacientes mais velhos têm necessidades específicas de comunicação, e sua satisfação depende de vários fatores. Objetivo: Este estudo teve como objetivo avaliar a satisfação da pessoa idosa com a comunicação dos cuidadores e identificar os fatores de influência. Métodos: Este é um estudo transversal realizado entre março e julho de 2022 com 204 pessoas com 60 anos ou mais que se apresentaram ao Hospital Universitário Mouhamed VI de Marrakech para receber diversos cuidados. A satisfação da pessoa idosa com a comunicação dos cu idadores foi avaliada pelo questionário de satisfação do paciente do American Board of Internal Medicine (ABIM). As características sociodemográficas e clínicas dos participantes foram coletadas por meio de entrevista e consulta aos registros médicos. A análise dos dados foi realizada com o software Statistical Package for the Social Sciences (SPSS), versão 25. Resultados: A pontuação total de satisfação da pessoa idosa com a comunicação do cuidador foi de 2,55±0,95, e as pontuações médias das subescalas mais baixas foram responder a perguntas, cumprimentar e ouvir. A análise revelou que ter distúrbios visuais (B=-0,276±0,12; p=0,029) e receber toque afetivo dos cuidadores (B=0,745±0,12; p=0,001) foram os principais fatores associados à satisfação dos pessoa idosa com a comunicação do cuidador. Conclusão: As pessoas idosas não estão suficientemente satisfeitas com as habilidades de comunicação dos cuidadores, especialmente aquelas com problemas de visão e as que não receberam o toque afetivo dos cuidadores. Os cuidadores precisam estar cientes das necessidades específicas dos pacientes mais velhos e usar técnicas de comunicação adequadas.

Cognitive complaints in older adults in primary care and associated factors / Queixas cognitivas em idosos na atenção básica de saúde e fatores associados

ABSTRACT. Cognitive complaints are common in older people. They can progress into a more severe cognitive decline and then deterioration of quality of life. They are associated with several factors. Objective: This study aimed to determine the factors associated with cognitive complaints in older adults in the city of Marrakech, Morocco. Methods: This study was conducted between March and June 2022 among 281 people aged 50 years and older who attended primary health care centers in the city of Marrakech. Cognitive complaints were measured using the McNair-Kahn scale. Data on sociodemographic and clinical characteristics were collected through interviews with the participants and consultation of their medical records. Analysis was done using Statistical Package for Social Sciences (SPSS) version 25, Ink software. Results: Of the total participants, 51.6% had cognitive complaints. Multivariate analysis showed that people aged 75 years and over had a sevenfold higher risk of cognitive complaints than people aged 50-64 years (p=0.033; OR=7.64; 95%CI 1.17-49.72), and that illiteracy (p=0.004; OR=3.39; 95%CI 1.48-7.76), cardiovascular disease (p=0.018; OR=4.30; 95%CI 1.29-14.32), diabetes (p=0.001; OR=3.14; 95%CI 1.64-6.04), visual impairment (p=0.017; OR=2.22; 95%CI 1.15-4.19), depression (p= 0.027; OR=2.36; 95%CI 1.10-5.05) and sleepiness (p=0.034; OR=1.96; 95%CI 1.05-3.66) are associated variables. Conclusions: Cognitive complaints are frequent in older adults and are associated with several sociodemographic and health factors. Some measures could help maintain stable memory performance in old age and prevent severe cognitive declines, such as regular follow-up of at-risk individuals, and cognitive, physical and leisure activities.

RESUMO. Queixas cognitivas são comuns em pessoas idosas. Elas podem evoluir para um declínio cognitivo mais grave e, em seguida, deterioração da qualidade de vida. Elas estão associadas a vários fatores. Objetivo: Este estudo teve como objetivo determinar os fatores associados às queixas cognitivas em idosos da cidade de Marrakech, Marrocos. Métodos: Este estudo foi realizado entre março e junho de 2022 entre 281 pessoas com 50 anos ou mais que se apresentaram em centros de atenção primária à saúde na cidade de Marrakech. As queixas cognitivas foram medidas usando a escala de McNair-Kahn. Os dados sobre características sociodemográficas e clínicas foram coletados por meio de entrevista com os participantes e consulta aos seus prontuários. A análise foi feita usando o software Pacote Estatístico para as Ciências Sociais (SPSS), versão 25. Resultados: Do total de participantes, 51,6% apresentaram queixas cognitivas. A análise multivariada mostrou que pessoas com 75 anos ou mais tiveram risco sete vezes maior de queixas cognitivas do que pessoasentre 50-64 anos (p=0,033; OR=7,64; IC95% 1,17-49,72), e que analfabetismo (p=0,004; OR=3,39; IC95% 1,48-7,76), doenças cardiovasculares (p=0,018; OR=4,30; IC95% 1,29-14,32), diabetes (p=0,001; OR=3,14; IC95% 1,64-6,04), comprometimento visual (p=0,017; OR=2,22; IC95% 1,15-4,19), depressão (p=0,027; OR=2,36; IC95% 1,10-5,05) e sonolência (p=0,034; OR=1,96; IC95% 1,05-3.66) são variáveis associadas. Conclusões: Queixas cognitivas são frequentes em idosos e estão associadas a diversos fatores sociodemográficos e de saúde. Algumas medidas poderiam ajudar a manter o desempenho estável da memória na velhice e prevenir declínios cognitivos graves, como o acompanhamento regular de indivíduos em risco e atividades cognitivas, físicas e de lazer.

The Antioxidant Activities of Ethanolic, Methanolic, Ethyl Acetate, and Aqueous Extracts of the Endemic Species, Lavandula mairei Humbert (A Comparative Study between Cold and Hot Extraction).

Background: Medicinal plants have been used for therapeutic purposes and have shown important biological properties. This study aimed to evaluate for the first time the antioxidant activities, total flavonoid, and total phenolic contents of Lavandula mairei Humbert. The ethanol, methanol, ethyl-acetate, and water extracts were used for this purpose. Methods: The antioxidant activities were assessed in vitro by free radical scavenging activity against 2,2-diphenyl-1-picrylhydrzyl (DPPH), ferric reducing antioxidant power (FRAP), and total antioxidant capacity (TAC). The total flavonoid and phenolic contents were determined spectrophotometrically with gallic acid and Quercetin as standards. Results: In either Soxhlet or maceration methods, the flavonoids and the total phenolic contents were significantly higher in the methanolic extract (P<0.05) compared to other extracts. The total flavonoid content of L. mairei ranged between 119 and 224.6 mg QE/g DW for Soxhlet extracts and from 111.8 to 148.51 mg QE/g DW for maceration extracts. While the total phenolic content was between 35.12 and 99.37 mg GAE/g DW for Soxhlet extracts and 27.63 to 58.99 mg GAE/g DW for maceration extracts. In either the Soxhlet or maceration method, the highest total antioxidant capacity (TAC) was obtained using the ethanolic extract, while the aqueous extract had the highest antioxidant activity for DPPH and FRAP assays. Conclusion: These results showed that Lavandula mairei Humbert has great potential to be a promising candidate for natural plant sources of antioxidants.

A Quantitative Study on the Ethnobotanical Knowledge about Wild Edible Plants among the Population of Messiwa.

Background: The preservation of traditional knowledge of wild edible plants (WEPs) is one of the challenges to the sustainability of natural resources. Therefore, it is crucial to assess the traditional knowledge of WEPs in relation to some socio-demographic and economic factors. Methods: The survey was conducted among the Messiwapopulationthrough a semi-structured questionnaire. The first part of the questionnaire concerns socio-demographic and economic information, while the second part concerns the plants recognized and used by the informant. The recognition frequency (RF), the use frequency (UF), the general consumption frequency(CF), the recent consumption frequency (RCF), and the correlation between these frequencies were evaluated. A comparison of means was also used to compare informant's knowledge according to their socio-demographic and economic status. Results: The three species;Foeniculum vulgare, Ziziphus lotus, and Malva sylvestris were the most recognized (FR = 1) and the most used (FU = 1). The consumption frequency (CF) and the recent consumption frequency (RCF) for Foeniculum vulgare were 1 and 0.9, respectively. Taraxacum getulum, Calendula arvensis and Cyperus rotundus were the least recognized (FR= 0.16; 0.16; 0.48) and least used (FU = 0.3; 0.3; 0.4) species, respectively. The informants who showed a high level of traditional knowledge on WEPs were housewives, with a low level of schooling and at least 45 years old. Conclusion: Despite the decline in traditional knowledge about wild edible plants, some populations preserve this knowledge, especially among the elderly. Therefore, documentation of this knowledge is necessary through ethnobotanical and ethnomedicinal studies.

[Reorganization of a third-level maternity ward during the COVID-19 pandemic: maternity ward experience at the University Hospital of Marrakech]. / Expérience de réorganisation d'une maternité de troisième niveau face à la pandémie de la COVID-19: étude du cas de la maternité de l´hôpital universitaire de Marrakech.

Introduction: COVID-19 pandemic has put unprecedented pressures on obstetrics and gynecology care services. Maternity hospitals have needed to rapidly prepare to provide quality care while preventing the transmission of the infection. The purpose of this study is to describe the key elements of the response to COVID-19 within the maternity ward of the Mohammed VI University Hospital in Marrakech. Methods: a case study was conducted. Data were collected using various administrative documents related to activities in the maternity ward of the Mohammed VI University Hospital during the COVID-19 pandemic. We also conducted semi-structured interviews with professionals at the maternity ward. Qualitative thematic analysis approach was used for the analysis of transcribed data and triangulation, with the analysis of documentary data. Results: the study highlighted phases of design and organization of two maternity ward access circuits. A new circuit for suspicious or confirmed cases of COVID-19 ensured access to quality care for patients, by guaranteeing isolation measures. The access circuit that was commonly used remained functional to consolidate the right of access to tertiary obstetrics and gynecology care while applying protective measures against COVID-19. Conclusion: this study highlights the necessity to draw on the experience of other health facilities, to contextualize local activities and to anticipate work organization in the face of health crises.

Ethnobotanical study on wild edible plants traditionally used by Messiwa people, Morocco.

BACKGROUND: The traditional knowledge on wild edible plants has been shown in many studies a worrying decline throughout the last few decades. Therefore, the first aim of this study was to document the population knowledge on wild edible plants among the Messiwa people. The second objective was to assess the traditional knowledge of our informants according to their socio-economic status. METHODS: The survey was conducted among 149 informants through a semi-structured questionnaire. The relative importance of the plants was obtained by calculating the relative frequency of citation (RFC) for each species. To compare means, we used Student's t test for two-group comparisons and Snedecor's F-test for multi-group comparisons. The multi-range Duncan test was used for multiple mean comparisons. The correspondence factor analysis (CFA) was also used. RESULTS: A set of 64 species belonging to 56 genera from 34 families has been collected and identified. The species used for nutritional and medicinal purposes represent 56%, while 44% were used exclusively as nutritional plants. The most used parts are, respectively, the aerial parts (58%), the fruits (17%), the underground parts (13%), the seeds (8%), and finally the flowers (5%). On the other hand, the higher level of knowledge on wild edible plants was found among women, the elderly, illiterate, married people, and those engaged in agricultural occupations. CONCLUSION: This work could be a basis to be reproduced on other regions in Morocco and to be widened through pharmacological and nutritional studies in order to promote and valorize these wild edible plants.

Characteristics of Menarcheal Age, Menstrual Hygiene and Socio-Demographic Factors in Girls with Down Syndrome in Morocco.

The purpose of this study was to determine the characteristics of menarcheal age, menstrual hygiene and their associated socio-demographic factors in girls with Down syndrome (DS) in Morocco. An analytical cross-sectional study was conducted between May 2014 and November 2017, including 59 parents/guardians of girls with Down syndrome aged 9-32 years. Data were collected through a standardized questionnaire providing information about socio-demographic and cultural conditions of parents, nutritional status and some functional abilities of girls. The median age at menarche was estimated using retrospective and status-quo methods, respectively. Data were entered and analyzed using the statistical program SPSS statistics software for Windows (version 20.0). Chi-square (χ2) and Mann-Whitney tests were used for testing statistical significance. The age at menarche ranged from 9 to 16 years old. The median was 13.0 (IQR, 11.0-14.0) years. The median age of menarche by probit analysis was 12.55 years. The relationship between menarcheal age, menstrual hygiene and the selected parameters showed a significant difference in age at menarche only regarding the parameter of number of siblings (Z = 2.14; p = .03), and in menstrual hygiene regarding mother's level of education, family size and age of talking (χ2 = 5.04, p = .02; χ2 = 3.75, p = .05 and χ2 = 4.99, p = .02, respectively). Most girls with DS attain menarche at the usual age as their counterparts in the general population and do not have enough knowledge about menstruation. Mobilization of all interventionists is urgent to develop adolescent skills about practices related to menstruation and menstrual hygiene.

Self-reported morbidities, nutritional characteristics, and associated factors in institutionalized and non-institutionalized older adults.

BACKGROUND: As the world's population ages and people live longer, it seems important to ensure that older people have a good quality of life and positive subjective well-being. The objective of this study is to determine socio-economic, health and nutritional characteristics of institutionalized and non-institutionalized elders in the province of Marrakech. METHODS: This study was conducted among 368 older adults in the province of Marrakech between March 2017 and June 2019. Of all participants, 180 older adults reside in a public institution and 188 of them live in their own homes. Data on health conditions, nutritional status, functional and socio-economic characteristics were collected. Data was analyzed using SPSS Statistics for Windows, Version 16.0. Statistical significance was set at p < 0.05. RESULTS: Institutionalized elders were illiterate (80.0%), had low incomes (95.5%), and unmarried (73.3%), they reported also no children (56.1%) and no health insurance (98.9%). Institutional residents suffered from malnutrition (22.2%), hearing impairments (35.6%) and severe edentulism (43.3%). There was no significant difference between both groups on daily activities and depression. A multivariate analysis identified a model with three significant variables associated with non-institutionalized elders: health insurance (P = 0.001; OR = 107.49), number of children (P = 0.001; OR = 1.74) and nutritional status (p = 0.001; OR = 3.853). CONCLUSIONS: This study shows that the institutionalization of older adults is considerably induced by various factors such as nutritional problems, lack of health insurance and family structure. To mitigate the effects of this phenomenon, home care strategies and preventive actions should be implemented to delay the institutionalization of older adults and therefore keep them socially active in their own homes.

[Community mobilization for the improvement of monitoring in pregnant women living in rural areas in Morocco]. / Mobilisation communautaire pour l'amélioration de la surveillance de la grossesse en milieu rural au Maroc.

INTRODUCTION: The improvement of maternal health is a health priority in many developing countries. The purpose of this study was to describe the contribution of a community project in the improvement of monitoring during pregnancy in a vulnerable rural commune in the Moroccan High Atlas. METHODS: We conducted an action-research project incorporating an approach for community mobilization conducted in 2014. The project involving several participants such as social actors, local authorities, health professionals and students in medicine helped to ensure the monitoring of a cohort of 283 pregnant women. In the course of antenatal consultations, women were interviewed, assessed and participated in information sessions and education. The interviewers speaking berber were trained to data collection. Bivariate and descriptive statistical analyzes were carried out, with a threshold for significance of 5%. RESULTS: The average age of patients was 27.1± 6.7 years. The majority of them was illiterate, without health coverage and with no career. Nearly 73.4% had no previous contact with the health care system (N = 252). Among 500 planned pregnancies, 56.6% of women were monitored, 30.4% consulted twice and 6.7% underwent three consultations out of a total of 407 antenatal consultations performed. Follow-up compliance by undergoing at least two consultations was 60.3%. Abnormality detection during pregnancy was significantly associated with monitoring (p = 0.04). CONCLUSION: The results reflect the importance of community engagement in the approach to complex health problems as maternal health.

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.

Robust adaptive nonsingular fast terminal sliding-mode tracking control for an uncertain quadrotor UAV subjected to disturbances.

This paper investigates the design of a robust controller for the trajectory tracking problem of an under-actuated quadrotor UAV subject to the modeling uncertainties and unknown external disturbances. A new robust nonlinear adaptive controller is proposed for orientation and translation tracking by using the Adaptive Nonsingular Fast Terminal Sliding-Mode Control (ANFTSMC) algorithms. The ANFTSM control law: (i) ensures fast convergence, i.e. the quadrotor outputs achieve to the original values in a short finite-time; (ii) avoids singularities; (iii) solves the chattering effect; (iv) offers robustness against the unknown external disturbances and uncertainties. Furthermore, the system unknown uncertainty and external disturbances upper bound are coped by the proposed control approach. Online estimation of these upper bounds is only introduced by velocity and position measurements. In addition, the control law applies the Lyapunov theory, guarantees the closed-loop stability of the quadrotor system. Finally, various simulations under different scenarios in terms of external disturbances and parametric uncertainties are carried out to evaluate/emphasize the effectiveness of the ANFTSMC strategy proposed in this work. Moreover, a comparative study is accomplished at the end of the present paper and shows clearly the outperformance of the proposed control scheme.

Thyroglobulin Is Markedly Elevated in 6- to 24-Month-Old Infants at Both Low and High Iodine Intakes and Suggests a Narrow Optimal Iodine Intake Range.

BACKGROUND: In areas with incomplete salt iodization coverage, infants and children aged 6-24 months weaning from breast milk and receiving complementary foods are at risk of iodine deficiency. However, few data exist on the risk of excessive iodine intake in this age group. Thyroglobulin (Tg) is a sensitive marker of iodine intake in school-age children and adults and may be used to estimate the optimal iodine intake range in infancy. The aim of this study was to assess the association of low and high iodine intakes with Tg and thyroid function in weaning infants. METHODS: This multicenter cross-sectional study recruited infants aged 6-24 months (n = 1543; Mage = 12.2 ± 4.6 months) receiving breast milk with complementary foods, from seven countries in areas with previously documented deficient, sufficient, or excessive iodine intake in schoolchildren or pregnant women. Urinary iodine concentration (UIC) and Tg, total thyroxine, and thyrotropin were measured using dried blood spot testing. RESULTS: Median UIC ranged from 48 µg/L (interquartile range 31-79 µg/L) to 552 µg/L (interquartile range 272-987 µg/L) across the study sites. Median Tg using dried blood spot testing was high (>50 µg/L) at estimated habitual iodine intakes <50 µg/day and >230 µg/day. Prevalence of overt thyroid disorders was low (<3%). Yet, subclinical hyperthyroidism was observed in the countries with the lowest iodine intake. CONCLUSIONS: Tg is a sensitive biomarker of iodine intake in 6- to 24-month-old infants and follows a U-shaped relationship with iodine intake, suggesting a relatively narrow optimal intake range. Infants with low iodine intake may be at increased risk of subclinical thyroid dysfunction. In population monitoring of iodine deficiency or excess, assessment of iodine status using UIC and Tg may be valuable in this young age group.