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Introduction: At the outbreak of infectious diseases, the response of different communities to the disease varies, and children are most affected by the collective anxiety and grief that consequently arises. In this research, the behavior of children and their parents in terms of hygiene and precautions before and during the COVID-19 pandemic was investigated., Methodology: The focus of the present research was on sanitation facilities, particularly access to end-use of water for hand washing. The research was conducted in Barika Camp, Kurdistan, Iraq and 311 parents and children were interviewed. A data collection team consisting of two females and one male was responsible for gathering data, primarily from women who served as the main respondents. Questionnaires consisted of three main parts: demography, COVID-19 pandemic effects, and sanitary shelter specifications., Result: The results demonstrated that the behavior of refugees during the COVID-19 pandemic regarding the priority of child protection, type of disinfectants, and water consumption has significantly altered. These changes mainly depended on the women's age and education level., Discussion: Overall results showed that in 61.09% of the participants, the number of hand washes and in 58.58%, the washing time increased, leading to water shortage in the refugee camp., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Aims: To examine maternal fear of hypoglycaemia, glycaemia and pregnancy outcomes in women with impaired and normal awareness of hypoglycaemia., Methods: A pre-planned sub-study of 214 pregnant women with type 1 diabetes who participated in the CONCEPTT trial. Participants completed hypoglycaemia fear surveys (HFS-II) at baseline. Logistic regression and Poisson regression analyses were used to obtain an adjusted estimate for the rate ratio relating awareness to the number of severe hypoglycaemic episodes, and for several neonatal outcomes in relation to the total HFS-II score. The role of continuous glucose monitoring (CGM) use was examined., Results: Overall, 30% of participants reported impaired awareness of hypoglycaemia (n = 64). Women with impaired awareness of hypoglycaemia had more episodes of severe hypoglycaemia (mean 0.44 vs. 0.08, p < 0.001) (12-34 weeks gestation) and scored higher on the HFS-II scale (43.7 vs. 36.0, p 0.008), indicating more fear of hypoglycaemia. They spent more time below range (CGM <3.5 mmol/L) and exhibited more glycaemic variability at 12 weeks gestation. Higher overall HFS-II scores were associated with a higher risk of maternal severe hypoglycaemia episodes (Rate Ratio 1.78, 95% CI 1.39-2.27). Women with impaired awareness of hypoglycaemia had less maternal weight gain but there were no differences in neonatal outcomes between women with impaired awareness of hypoglycaemia and normal hypoglycaemia awareness. Higher HFS-II scores were associated with more nephropathy (Odds Ratio 1.91, 95% CI 1.06-3.4). CGM use after 12 weeks was not associated with the number of episodes of severe hypoglycaemia (RR 0.75, 95% CI 0.49-1.15; p = 0.18)., Conclusions: In pregnant women with type 1 diabetes, impaired awareness of hypoglycaemia is associated with more maternal severe hypoglycaemia episodes and more fear of hypoglycaemia. Having impaired awareness of hypoglycaemia and/or fear of hypoglycaemia should alert clinicians to this increased risk. Reassuringly, there was no increase in adverse neonatal outcomes., (© 2022 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.)

The Dehgolan aquifer, which lies in semiarid western Iran, was evaluated using a multi-influencing factor (MIF) analysis to determine groundwater sustainability. Eight indicators, including climatic variability, groundwater exploitation (pumping), groundwater quality, groundwater vulnerability, public participation, legal framework, water productivity, and occupation related to groundwater, were quantified and placed into a series of thematic maps within a GIS framework. Each factor was weighted based on the analyses obtained from the MIF model and the stacked maps were summed to yield a final map showing the degree of sustainability within the groundwater basin. The final groundwater sustainability map showed that 4% of the basin was in a critically unsustainable zone, 30% in an unsustainable zone, 40% in a semisustainable zone, 25% in a sustainable zone, and 1% in an ideally sustainable zone. The final map was validated using a receiver operating characteristic (ROC) method, cross-tabulation, and chi-square tests using groundwater-level decline as a test proxy. The analysis assessed the correlation between water levels that exhibited declines versus the degree of unsustainability of water levels and sustainable water use. The area under the curve was calculated to be 88%, cross-tabulation 64.4%, and the chi-square value was 260.5 with 4 degrees of freedom and values <0.05 (3.627E -55 ), which suggest that the final map has statistical significance. The sustainability analysis developed is useful as a baseline for development of governance laws to implement management methods in groundwater basins and it can be applied to a wide range of aquifer types in variable climates worldwide., (© The Author(s), under exclusive licence to International Association of Hydrogeologists 2022, Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Groundwater quality monitoring is a critical part of water management in all groundwater basins. In order to be effective and to meet the required needs, groundwater quality monitoring networks (GQMNs) must be designed to be able to operate long-term and economically without minimal disruption. The analytical hierarchical process (AHP), a multi-criteria decision-making program, was used to design a GQMN for an alluvial aquifer located in the Islam Abad plain west of Kermanshah province, Iran. This semi-arid area is subject to groundwater depletion and water quality changes. The model used 8 primary criteria sub-divided with 5 sub-criteria based on a combination of empirical data and expert opinion. The primary criteria included density of wells, well discharge, well depth, water quality (conductivity), flow direction, annual groundwater extraction, water level declines, and accessibility. The model showed that 59 of 254 production wells in the basin could provide optimal monitoring locations. When a second screening of the wells was used to determine constraints (physical conditions of the wells and pumps, owner permission of use, type of the pump, etc.), the number of wells was reduced to 13 wells. An initial round of water sampling and chemical analysis demonstrated that the design of the GQMN met the goals of the water management agency of the region.