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Abdelkader Jalil El Hangouche,1–3 Asmaa Jniene,1 Souad Aboudrar,1 Leila Errguig,1 Hanan Rkain,1 Mohammed Cherti,2 Taoufiq Dakka1 1Exercise Physiology and Autonomic Nervous System Team “EPE-SNA”, Laboratory of Physiology, Faculty of Medicine and Pharmacy of Rabat, Mohamed V University, Rabat, Morocco; 2Department of Cardiology, Ibn Sina Hospital, Faculty of Medicine and Pharmacy of Rabat, Mohamed V University, Rabat, Morocco; 3Laboratory of Physiology, Faculty of Medicine and Pharmacy of Tangier, Abdelmalek Essaadi University, Tangier, Morocco Purpose: Poor quality of sleep and excessive daytime sleepiness affect cognitive ability and have a negative impact on the academic performance of medical students. This study aims to determine the prevalence of excessive daytime sleepiness, sleep quality and psychological distress as well as assess their association with low academic performance in this population.Participants and methods: A cross-sectional study was conducted among 457 medical students from the Faculty of Medicine and Pharmacy of Rabat, Morocco, who completed the Pittsburgh Sleep Quality Index (PSQI) questionnaire and the Epworth Sleepiness Scale to determine the quality of sleep and excessive daytime sleepiness, respectively. Sociodemographic variables and psychological distress (Kessler Psychological Distress Scale) were also measured. Multivariate linear regression was performed in order to evaluate the link between low academic performance and sleep quality after adjusting for other covariates.Results: Among the included students, the median age was 20 (19; 21) years; 70.7% of the participants were females. Almost one-third of the students (36.6%) had excessive daytime sleepiness and this was more frequently observed in female students (43% vs 20.1%,

This meta-analysis was conducted to investigate the effects of exercise training on heart rate variability (HRV) parameters associated with the autonomic nervous system (ANS) activity. Randomized controlled trials (RCTs) involving healthy adults (aged ≥ 18 years) were included. We searched PubMed, Scopus, Web of Science, and EBSCO databases to identify relevant studies. A random-effects meta-analysis was performed using the standardized mean difference (SMD) and 95% confidence interval (CI). Sixteen RCTs with a total of 623 participants were selected for the final analysis. The analysis showed that exercise training improved the standard deviation of normal-to-normal intervals (SDNN) (SMD: 0.58 (0.16, 1.00); p = 0.007), the root mean square of successive differences in heart period series (RMSSD) (SMD: 0.84 (0.36, 1.31); p = 0.0005), and the absolute power of high-frequency band (HF) (SMD: 0.89 (0.27, 1.51); p = 0.005) parameters compared to the control group. Analysis of the moderator variables showed that the effect of exercise on HRV indices may be influenced by sex, age, and type of exercise used, specifically in HF band, absolute power of low-frequency band (LF), and LF/HF ratio parameters. Despite the limited number of existing RCTs related to the subject, the results suggest that exercise training enhances HRV parameters associated with vagal-related activity (RMSSD and HF) and both sympathetic and parasympathetic activities (SDNN). This study overcomes the lack of meta-analyses on the effects of exercise training on autonomic modulation among healthy adults and may bridge the gap in understanding the potential physiological underpinnings of the acknowledged positive health benefits of exercise., Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Amekran et al.)

Introduction: Cardiovascular diseases (CVDs) are the primary cause of mortality worldwide. Numerous factors can indicate the likelihood of developing CVDs. Gaining a comprehensive understanding of these risk factors is the initial step towards implementing successful preventive measures to defy the prevalence of CVDs across all demographics. The aim of this study is to evaluate the Moroccan population's level of knowledge regarding cardiovascular risk factors (CVRF)., Methods: This questionnaire-based cross-sectional study was conducted among 744 participants. Their knowledge of CVD risk factors was assessed by the Heart Disease Facts Questionnaire (HDFQ). Socio-demographic characteristics were collected and statistical analyses were performed using Statistical Package for the Social Sciences (IBM SPSS Statistics for Windows, IBM Corp., Version 26.0, Armonk, NY)., Results: Among 744 participants, 475 (63%) were male and 409 (55%) were young adults. The mean HDFQ score was 64.36%. Overall, 47.4% of the respondents were aware of CVD risk factors, 27% had moderate knowledge and 25.6% had poor knowledge. The most commonly identified factors were smoking (86.8%), obesity (85.6%), and aging (80.5%). Age was the only factor that showed a significant association with the awareness of CVD risk factors., Conclusion: The level of knowledge of CVRF is moderate among the Moroccan population. Effective health education about CVRF and adequate prevention measures is certainly essential to minimize the burden of CVD., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Taiek et al.)

Background: Sleep is vital for physical and mental health. The nursing profession is often associated with unique challenges when it comes to sleep quality. Nurses are often faced with irregular work schedules, including night shifts and rotations, high-stress levels, and significant job demands that can contribute to sleep problems and hinder their productivity at work. This study aimed to assess sleep quality in Moroccan nurses and to investigate the relationship between sleep quality and shift work., Materials and Methods: This was a cross-sectional study carried out between August 8, 2022 and September 30, 2022 among 260 nurses working day or night shifts in the province of Tétouan, northern Morocco. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality in day and night shift nurses. Data on sociodemographic characteristics and shift work were also collected. Descriptive and inferential statistical analyses were performed. Regression models were used to study the association between participant characteristics and sleep quality., Results: Among all participants, 60.4% had poor sleep quality. The results of the study revealed that there was no significant association between shift work and sleep quality among nurses in Morocco., Conclusion: Given that the majority of nurses suffer from sleep disorders, an action plan to raise awareness and promote good sleep in this population should be implemented., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Education and Health Promotion.)

Background: Due to the COVID-19 pandemic, online learning has become the main method of instruction. This study aimed to evaluate Moroccan medical students' perceptions of medical online learning experience and to list its probable related advantages and barriers., Materials and Methods: A cross-sectional study on 400 medical students randomly selected from the different national medical institutions was conducted. A questionnaire evaluating the online learning experience during the pandemic was distributed via institutional e-mails. Statistical analyses were carried out using Statistical Package for the Social Sciences (SPSS)., Results: 51.2% of students were satisfied with the online learning experience and reported several benefits including no need to travel (35.8%), cost savings (20.7%), and flexibility of home studying (32.3%). Technical issues related to the use of platforms or internet connection, limited interaction between students and their instructors, and lack of motivation were the major barriers to online learning. Moreover, results also showed a significant difference when comparing the attendance frequency between presential classes and online learning (i.e., before vs. during the COVID-19 pandemic) ( P < 0.001)., Conclusions: The experience of medical online learning was reported in our study to be associated to several advantages and disadvantages. Hence, students' perceptions should be considered to evaluate and improve the quality of this instructional method for a successful and more active approaches implementation., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of Education and Health Promotion.)

While the acute illness of COVID-19 was the initial focus of concern, there are increasing reports of patients with chronic symptoms, known as long-COVID. Dysautonomia may be a possible post-acute neurological complication explaining the persistent symptoms observed in long COVID. Postural tachycardia syndrome (POTS), a form of dysautonomia characterized by sustained tachycardia and orthostatic intolerance, has been increasingly reported in patients after SARS-CoV-2 infection. In this context, this review aimed to report and discuss the available literature pertaining to post COVID-19 POTS., (Copyright ©2022 The Author(s).)

Background: Coronavirus disease (COVID-19) and resulting restrictions have impacted populations' lifestyles and posed a challenge regarding their behaviors, including physical activity (PA). This study aimed to evaluate PA patterns of university students during the COVID-19 outbreak. We also analyzed the association of participants' characteristics, including their level of anxiety, under the pandemic conditions, with adherence to the world health organization (WHO) recommendations for PA., Materials and Methods: This cross-sectional study comprised 717 Moroccan university students recruited during the COVID-19 pandemic. The Global Physical Activity Questionnaire (GPAQ V.2) was used to evaluate PA. Data on sociodemographic characteristics and anxiety levels were also collected. Anxiety was assessed using State-Trait Anxiety Inventory (STAI). Descriptive and inferential statistical analysis was carried out. The association between participants' characteristics and PA was studied using regression models., Results: Of all participants, 33.2% did not achieve the recommended levels of PA. The daily median (25 th -75 th percentile) time spent in PA was 34.3 min (12.7-98.6), whereas the median time of sedentariness was 10 h per day (6-14). Multivariate analysis showed that female sex (OR = 0.63; 95% CI: 0.44-0.90; P < 0.05) and high level of state anxiety (OR = 0.43; 95% CI: 0.20-0.92; P < 0.05) were negatively associated with the achievement of the WHO recommended PA., Conclusion: The reported PA patterns of university students during the current outbreak should be taken into account and evoke the necessity of encouraging this population to adhere to the recommended PA levels. Targeting state anxiety related to the conditions we are facing may have a promising effect on the promotion of PA., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Journal of Education and Health Promotion.)

Background: In Morocco, the use of leaded-gasoline is still common even after its ban in 2011, and other sources of contamination by traces elements are not regulated. We aimed to assess blood and urinary cadmium, blood lead, and total blood mercury levels in Moroccan adolescents and to identify determinants and early renal effects of exposure., Methods: The study included 149 school adolescents (12 to 18 years), from urban, industrial, and rural areas in Fez city (north of Morocco). Risk factors were investigated by interviews and questionnaires. Internal doses and early renal effects were evaluated by analyzing blood and urinary samples., Results: The mean of blood lead levels (BLLs) in all adolescents was 47.81μg/l with no difference between boys and girls. Adolescents from the urban area had the highest BLLs mean. The means of blood cadmium levels (BCLs) and urinary cadmium levels (UCLs) were 0.29μg/l and 0.45μg/l respectively, with no differences between living areas or according to sex. The total blood mercury levels (BMLs) mean was 0.52 μg/l. BMLs mean was higher in the industrial area and among boys. This can be associated to the frequency of fish intake, the use of dental amalgams fillings, and the consumption of chewing gum. Rates of early renal effects markers were low, not correlated to the metals, and may indicate that renal effects of this environmental exposure could be limited., Conclusions: There is an urgent need for the limitation of trace elements' sources, particularly the strict application of the laws concerning leaded-petrol prohibition.

Introduction: The use of blue light-emitting devices (smartphones, tablets, and laptops) at bedtime has negative effects on sleep due to light stimulation and/or problematic excessive use. We aimed to evaluate, among young medical students, if the perception of sleep disturbances due to bedtime use of these devices is consistent with healthier habits and a better sleep quality., Materials and Methods: 294 medical students in medicine and pharmacy from the Faculty of Medicine and Pharmacy of Rabat, Morocco, took part in this anonymous and voluntary cross-sectional study and answered an electronic questionnaire. Student and Mann-Whitney U tests were used to compare variables between 2 groups based on their perception of sleep disturbances. The level of significance was p ≤ 0.05., Results: 286 students (97.3%) used a blue light-emitting smart device at bedtime before sleep, and sleep quality was poor (Pittsburgh Sleep Quality Index, PSQI > 5) in 101 students (35.3%). The perception of sleep disturbances due to this night usage was reported by 188 of them (65.7%). In this group, 154 (81.9%) used their device with all the lights turned off in the room ( p =0.02), 34 (18.1%) put devices under pillows ( p =0.04), 114 (60.6%) interrupted sleep to check messages ( p < 0.001), and the mean duration use of these technologies at bedtime was 2 h ± 23 min per night ( p =0.02). Also, the mean sleep duration was 6.3 hours ± 1.25 ( p =0.04), 119 (63.3%) presented fatigue on waking more than one time per week ( p =0.04), and 76 (40.4%) presented poor sleep quality (75.2% of the students with PSQI > 5) ( p =0.005)., Conclusions: Despite the perception of sleep disturbances due to bedtime use of blue light-emitting devices, unhealthy sleep habits tend to be frequent in young medical students and worrying because it is associated to significant poor sleep quality., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2019 Asmaa Jniene et al.)

In any health system, public awareness of organ donation fundamentally affects the organ transplantation programs. The aim of this study was to evaluate the knowledge and perception of the people in Morocco toward organ donation as well as to identify the reasons and determinants for refusal of organ donation. This opinion survey included a representative sample of 2000 participants in Morocco, and data related to sociodemographic characteristics, knowledge and self-opinion about organ donation, and reasons behind refusal were collected. Statistical analysis showed that 55.2% of the participants were women, the median age was 21 years, and 60.8% of included participants had secondary education. Almost two-thirds of surveyed participants (62.3%) showed a low to mid-level of knowledge about organ donation and transplantation in Morocco. About half of the interviewed participants (48.8%) refused to donate their organs. Concern about risk of medical error and the belief in trafficking of procured organs were the main reasons for refusal, seen in 66% and 62% of the interviewees, respectively. Univariate and multivariate logistic regression models showed that the older, the less educated and the less informed a person is, the less he accepted organ donation. Therefore, promotion of organ donation in Morocco should involve a regular information and awareness among the general population., Competing Interests: None

Introduction: in Morocco, Compulsory Medical Insurance (CMI) entered into force in 2005. Insurance first covered health expenses of employees in public and private sectors, then of students. It was gradually expanded to independent workers. This study aims to determine the profile of the population covered by CMI in Morocco., Methods: We conducted a descriptive study of the population covered by CMI based on data collected from the National Health Insurance Agency in Morocco and from the Health Insurance funds., Results: A total of 8.428.218 persons were covered by CMI at the end of 2014, reflecting a rate of 34% of the general population. People having long duration disease (LDD) did not exceed 2.78% of the population covered by CMI. Active insured accounted for 81% of the population covered. In the private sector, gross salary of active affiliates ranged, on average, between $ 140 and $ 500 per month while gross salary pensions was less $280 per month. In the public sector, gross salary of active affiliates ranged, on average, between $ 280 and $ 825 per month while gross salary pensions ranged between $ 140 and $ 500 per month., Conclusion: Knowledge of the characteristics of the population covered by Compulsory Health Insurance in Morocco is necessary to ensure regulation and sustainability in the insurance sector.