Exploration of the process of interprofessional collaboration among nurses and physicians in Iran

Introduction: The development of interprofessional collaboration is of great significance for facilitating the flow of information and provision of collaborated services. In fact, only one single profession cannot respond to all demands. Thus, this study was aimed to investigate clinical nurse-physician collaboration in Iran. Methods: This study was performed with nurses and physicians of university hospitals affiliated to Mashhad University of Medical Sciences, Mashhad, Iran, during September 2013-March 2015, using grounded and synthesis theory. The data were obtained using semi-structured interviews and field notes, and MAXQ DA version 10 was employed for data analysis. Results: The core variable was defined as “management of strategic goals”, and the main categories included perception of challenging organizational structures, providing a comprehensive supportive net for patients, seeking professional communication, and building solid confidence. Based on views of the participants, they were aiming to apply a stress management strategy, while maintaining their position in the organization, by making passive compromises to protect themselves against the perceived threats. Conclusion: The participants were trying to overcome barriers through reducing and managing the tension, while maintaining their position in the organization using forced, passive coping strategies to protect themselves against the perceived threat

Neonatal varicella pneumonia, surfactant replacement therapy

Background: Chickenpox is a very contagious viral disease that caused by varicella-zoster virus, which appears in the first week of life secondary to transplacental transmission of infection from the affected mother. When mother catches the disease five days before and up to two days after the delivery, the chance of varicella in neonate in first week of life is 17%. A generalized papulovesicular lesion is the most common clinical feature. Respiratory involvement may lead to giant cell pneumonia and respiratory failure. The mortality rate is up to 30% in the case of no treatment, often due to pneumonia. Treatment includes hospitalization, isolation and administration of intravenous acyclovir. The aim of this case report is to introduce the exogenous surfactant replacement therapy after intubation and mechanical ventilation for respiratory failure in neonatal chickenpox pneumonia and respiratory distress. Case Presentation: A seven-day-old neonate boy was admitted to the Neonatal Intensive Care Unit at Amirkola Children’s Hospital, Babol, north of Iran, with generalized papulovesicular lesions and respiratory distress. His mother has had a history of Varicella 4 days before delivery. He was isolated and given supportive care, intravenous acyclovir and antibiotics. On the second day, he was intubated and connected to mechanical ventilator due to severe pneumonia and respiratory failure. Because of sever pulmonary involvement evidenced by Chest X-Ray and high ventilators set-up requirement, intratracheal surfactant was administered in two doses separated by 12 hours. He was discharged after 14 days without any complication with good general condition. Conclusion: Exogenous surfactant replacement therapy can be useful as an adjunctive therapy for the treatment of respiratory failure due to neonatal chickenpox

Temporal distribution and zoning of nitrate and fluoride concentrations in Behbahan drinking water distribution network and health risk assessment by using sensitivity analysis and Monte Carlo simulation

International audienceThe present study aimed to investigate the spatial distribution and zoning of nitrate and fluoride concentrations in the drinking water distribution network of Behbahan city and the health risk caused by their concentration using sensitivity analysis and the Monte Carlo simulation during 2018 to 2019.In this cross-sectional study, 90 samples were collected from 45 points of the city's drinking water distribution network in the two high-rainy and low-rainy seasons.Nitrate and fluoride concentration was measured byDR 5000 spectrophotometer and its non-carcinogenic impacts were calculated using EDI and HQ.The results showed that the average nitrate concentrations in high and low rainy seasons in the study area were 15.05 and 13.35 mg l(-1), respectively.Also, the average concentrations of fluoride in high and low-rainy seasons were 0.67 and 0.76 mg L-1, respectively.The fluoride concentration in the high-rainy season showed a decreasing trend from north to south.The nitrate concentration decreased from north to south and southwest.The amount of nitrate HQ in the age groups corresponding to children, adolescents, adults and infants were 0.5, 0.4, 0.34, and 0.07, respectively.The fluoride HQ levels in the age groups corresponding to children, adolescents, adults and infants were 0.7, 0.5, 0.05, and 0.1, respectively.These results showed that children were the significant at-risk group due to these ions.According to the Monte Carlo simulator, 95th percentile caused by exposure to nitrate and fluoride ions in all age groups was more than one.Based on the sensitivity analysis, the most efficient factor in the health risk caused by nitrate and fluoride ions was the concentration of these ions in the drinking water distribution network

Chronic stress alters the expression levels of longevity-related genes in the rat hippocampus

The molecular mechanisms underlying the negative effects of psychological stress on cellular stress during aging and neurodegenerative diseases are poorly understood. The main objective of this study was to test the effect of chronic psychological stress, and the consequent increase of circulating glucocorticoids, on several hippocampal genes involved in longevity. Sirtuin-1, p53, thioredoxin-interacting protein, and heat shock protein 70 were studied at the mRNA and protein levels in stressed and non-stressed animals. Stress treatment for 10 days decreased sirtuin-1 and heat shock protein 70 levels, but increased levels of p53, thioredoxin-interacting protein and the NADPH oxidase enzyme. Examination of protein expression following two months of stress treatment indicated that sirtuin-1 remained depressed. In contrast, an increase was observed for thioredoxin-interacting protein, heat shock protein 70, p53 and the NADPH oxidase enzyme. The effect of stress was reversed by mifepristone, a glucocorticoid receptor antagonist. These data suggest that chronic stress could contribute to aging in the hippocampus.Junta de Andalucía P09-CTS-5244, P10-CTS-6494Ministerio de Economía y Competitividad SAF2012-390