Human health risk of nitrate in groundwater of Tehran-Karaj plain, Iran.

Groundwater pollution by nitrate has is a major concern in the Tehran-Karaj aquifer, Iran, where the wells provide up to 80% of the water supply for a population of more than 18 million-yet detailed human health risks associated with nitrate are unknown due to the lack of accessible data to adequately cover the aquifer in both place and time. Here, using a rich dataset measured annually in more than 75 wells, we mapped the non-carcinogenic risk of nitrate in the aquifer between 2007 and 2018, a window with the most extensive anthropogenic activities in this region. Nitrate concentration varied from ~ 6 to ~ 150 mg/L, around three times greater than the standard level for drinking use, i.e. 50 mg/L. Samples with a non-carcinogenic risk of nitrate, which mainly located in the eastern parts of the study region, threatened children's health, the most vulnerable age group, in almost all of the years during the study period. Our findings revealed that the number of samples with a positive risk of nitrate for adults decreased in the aquifer from 2007 (17 wells) to 2018 (6 wells). Although we hypothesized that unsustainable agricultural practices, the growing population, and increased industrial activities could have increased the nitrate level in the Tehran-Karaj aquifer, improved sanitation infrastructures helped to prevent the intensification of nitrate pollution in the aquifer during the study period. Our compilation of annually mapped non-carcinogenic risks of nitrate is beneficial for local authorities to understand the high-risk zones in the aquifer and for the formulation of policy actions to protect the human health of people who use groundwater for drinking and other purposes in this densely populated region.

Inhibitors and facilitators of compliance with professional ethics standards: nurses' perspective.

INTRODUCTION: The clinical practices of nurses should be in accordance with the principles of professional ethics. Respecting professional ethics principles depends on several factors. The present study was conducted to investigate the effective inhibitors and facilitators in compliance with professional ethics and their importance from the nurses' perspective. METHODS: During this cross-sectional descriptive study, 452 nurses were included by the census sampling method. The data were collected via the "inhibitors of compliance with professional ethics standards by the nurses' perspective" and "facilitators of compliance with professional ethics standards by the nurses' perspective" questionnaires. Additionally, by designing the "open-ended question" section, other inhibiting and facilitating factors of professional ethics standards from the nurses' perspective were investigated. The data were analyzed using descriptive and inferential statistics (Wilcoxon signed ranks test). RESULTS: The individual care-related dimension as a facilitator had the highest mean score compared to the other dimensions (76.62 ± 4.92). Furthermore, seven items in the inhibitor section, 19 items in the facilitator section had higher scores. Among them, there were seven items in common. Strong or weak belief in compliance with ethical issues had the highest mean scores in the role of facilitator and inhibitor (90.54 ± 12.13 and 89.54 ± 14.88, respectively). CONCLUSION: Strong or weak belief in compliance with ethical issues was the most important inhibitor and facilitator from the nurses' perspective, which makes it necessary to examine individual beliefs about ethical issues among applicants to enter the nursing profession.

Pre-natal and post-natal anxiety in relation to pre-pregnancy obesity: A cohort study on Iranian pregnant women.

BACKGROUND: To determine the association between pre-conception obesity and screening results of pre-natal and post-natal anxiety in women that referred to the health centers of Tabriz, Iran. METHODS: 62 obese (class 2-3) and 245 normal-weight women were enrolled in the first trimester of pregnancy through the cohort study and followed-up 1 year after childbirth from December 2012 to January 2016. The Beck anxiety inventory scale (BAI-II) was completed in five time points: the first, second, third trimester of pregnancy, 6-8 weeks and 12 months after childbirth. Chi-square, Fisher's exact tests, Independent t-test, Mann-Whitney, and multivariate logistic regression adjusted for confounders were used for data analysis. Statistically significant was considered as p<0.05. RESULTS: The rate of moderate to severe anxiety in 1st, 2nd, 3rd trimesters of gestation, 6-8 weeks and 12 months after birth was 8.6%, 10%, 12.6%, 7.8%, 6.5% in normal weight women versus 18%, 17.9%, 19.2%, 12.5%, 19.4% in obese class II women, respectively. The odds of anxiety in the first trimester of pregnancy for class 2-3 obesity was 2.72-fold greater than normal weight group [adjusted odds ratio (aOR) 2.72, 95% confidence interval (CI) 1.14-6.47; p=0.023]. This odd was 3.30- fold (aOR 3.30, 95%CI 1.13-9.60; p=0.045) for 1 year after birth. CONCLUSION: Obesity remained associated with positive screening for anxiety in the first trimester of pregnancy and one year after birth. Obese women more likely require special medical care during their pregnancy due to its impacts on mood.

The first evidence of an association between a polymorphism in the endocannabinoid-degrading enzyme FAAH (FAAH rs2295633) with attention deficit hyperactivity disorder.

Several single nucleotide polymorphisms (SNPs) of the fatty acid amide hydrolase (FAAH), the degrading enzyme of the endocannabinoids, have been shown to be associated with many neuropsychiatric disorders. Here, FAAH rs2295633 was studied in ADHD and case-control healthy children. There was a significant difference in the allele frequency (P = .04) and genotype distribution (P = .04) of the FAAH rs2295633 between ADHD cases and controls. The ADHD children appeared to have less of TT genotype (OR 0.396, 95% CI 0.178-0.884, p = .024) and T allele (OR 0.658, 95% CI 0.440-0.982, p = .04). To our best knowledge, this is the first statistical significant association between FAAH rs2295633 genotype and ADHD disorder. Larger sample sizes and functional studies are warranted to explore the clinical utility of FAAH genotyping as a possible marker for increased ADHD risk in children.

Neonatal Intensive Care Unit Nurses' Perceptions and Knowledge of Newborn Individualized Developmental Care and Assessment Program: A Multicenter Study.

BACKGROUND: The newborn individualized developmental care and assessment program (NIDCAP) is a new multifaceted approach, which is developmentally and functionally supportive of health especially in premature newborns at the neonatal intensive care unit (NICU). This study is designed for assessing the knowledge and perception of nurses as the most important members of the multidisciplinary team of NIDCAP about this program. MATERIALS AND METHODS: This cross-sectional study was conducted on 120 nurses working in the NICUs of Alzahra, Taleghani, and Children hospitals affiliated to the educational and treatment centers of Tabriz University of Medical Sciences as well as 29 Bahman Hospital affiliated to Tabriz Social Security Organization in 2016 using census sampling method. Three questionnaires were employed to collect demographic data and to explore the nurses' perceptions and knowledge of the NIDCAP program. RESULTS: Findings of the study indicated that the mean (SD) nurses' knowledge and perception scores for NIDCAP were 71.83 (1.64) and 76.80 (0.79), respectively. In the terms of knowledge, significant differences were found with regard to being married (t = -2.39, p < 0.019), having an MSc degree (t = -2.14, p = 0.034), and employment experience (t = -3.38, p = 0.001). However, there was no significant relationship between perception and demographic variables (p > 0.05), nor was there any significant relationship between perception and knowledge (p = 0.275). CONCLUSIONS: The results of this study showed that the majority of nurses participating in the study had high knowledge about NIDCAP.