Search results for: health awareness

Authors: Qing Wu, Xuchun Ye, Kirsten Corazzini

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Objective: It is increasingly recognized that patients’ rational and meaningful engagement in healthcare could make important contributions to their health care and safety management. However, recent evidence indicated that patients' actual roles in healthcare didn’t match their desired roles, and many patients reported a less active role than desired, which suggested that patient engagement in healthcare may be influenced by various factors. This study aimed to analyze influencing factors on patient engagement and explore the influence mechanism, which will be expected to contribute to the strategy development of patient engagement in healthcare. Methods: On the basis of analyzing the literature and theory study, the research framework was developed. According to the research framework, a cross-sectional survey was employed using the behavior and willingness of patient engagement in healthcare questionnaire, Chinese version All Aspects of Health Literacy Scale, Facilitation of Patient Involvement Scale and Wake Forest Physician Trust Scale, and other influencing factor related scales. A convenience sample of 580 patients was recruited from 8 general hospitals in Shanghai, Jiangsu Province, and Zhejiang Province. Results: The results of the cross-sectional survey indicated that the mean score for the patient engagement behavior was (4.146 ± 0.496), and the mean score for the willingness was (4.387 ± 0.459). The level of patient engagement behavior was inferior to their willingness to be involved in healthcare (t = 14.928, P ＜ 0.01). The influencing mechanism model of patient engagement in healthcare was constructed by the path analysis. The path analysis revealed that patient attitude toward engagement, patients’ perception of facilitation of patient engagement and health literacy played direct prediction on the patients’ willingness of engagement, and standard estimated values of path coefficient were 0.341, 0.199, 0.291, respectively. Patients’ trust in physician and the willingness of engagement played direct prediction on the patient engagement, and standard estimated values of path coefficient were 0.211, 0.641, respectively. Patient attitude toward engagement, patients’ perception of facilitation and health literacy played indirect prediction on patient engagement, and standard estimated values of path coefficient were 0.219, 0.128, 0.187, respectively. Conclusions: Patients engagement behavior did not match their willingness to be involved in healthcare. The influencing mechanism model of patient engagement in healthcare was constructed. Patient attitude toward engagement, patients’ perception of facilitation of engagement and health literacy posed indirect positive influence on patient engagement through the patients’ willingness of engagement. Patients’ trust in physician and the willingness of engagement had direct positive influence on the patient engagement. Patient attitude toward engagement, patients’ perception of physician facilitation of engagement and health literacy were the factors influencing the patients’ willingness of engagement. The results of this study provided valuable evidence on guiding the development of strategies for promoting patient rational and meaningful engagement in healthcare.

Keywords: healthcare, patient engagement, influencing factor, the mechanism

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Authors: Poteet Frances, Glovinski Ira

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INTRODUCTION: The interoceptive nervous system continuously senses chemical and anatomical changes and helps you recognize, understand, and feel what’s going on inside your body so it is important for energy regulation, memory, affect, and sense of self. A newborn needs predictable routines rather than confusion/chaos to make connections between internal experiences and emotions. AIM: Current legal protocols of removing babies from drug-addicted mothers impact the critical window of bonding. The newborn’s brain is social and the attachment process influences a child’s development which begins immediately after birth through nourishment, comfort, and protection. DESCRIPTION: Our project aims to educate drug-addicted mothers, and medical, nursing, and social work professionals on interoceptive concepts and practices to sustain the mother/newborn relationship. A mother’s interoceptive knowledge predicts children’s emotion regulation and social skills in middle childhood. CONCLUSION: When mothers develop an awareness of their inner bodily sensations, they can self-regulate and be emotionally available to co-regulate (support their newborn during distressing emotions and sensations). Our project has enhanced relationship preservation (mothers understand how their presence matters) and the overall mother/newborn connection.

Keywords: drug-addiction, interoception, legal, mothers, newborn, self-regulation

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Authors: Kristy Howells, Catherine Meehan

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This position paper presents current research findings into the proposed gap between teachers’ and practitioners’ thinking and acting about physical activity health and well-being in childhood. Within the new Primary curriculum, there is a focus on sustained physical activity within a Physical Education and healthy lifestyles in Personal, Health, Social and Emotional lessons, but there is no curriculum guidance about what sustained physical activity is and how it is defined. The current health guidance on birth to five suggests that children should not be inactive for long periods and specify light and energetic activities, however there is the a suggested period of time per day for young children to achieve, but the guidance does not specify how this should be measured. The challenge therefore for teachers and practitioners is their own confidence and understanding of what “good / moderate intensity” physical activity and healthy living looks like for children and the children understanding what they are doing. There is limited research about children from birth to eight years and also the perceptions and attitudes of those who work with this age group of children, however it was found that children at times can identify different levels of activity and it has been found that children can identify healthy foods and good choices for healthy living at a basic level. Authors have also explored teachers’ beliefs about teaching and learning and found that teachers could act in accordance to their beliefs about their subject area only when their subject knowledge, understanding and confidence of that area is high. It has been proposed that confidence and competence of practitioners and teachers to integrate ‘well-being’ within the learning settings has been reported as being low. This may be due to them not having high subject knowledge. It has been suggested that children’s life chances are improved by focusing on well-being in their earliest years. This includes working with parents and families, and being aware of the environmental contexts that may impact on children’s wellbeing. The key is for practitioners and teachers to know how to implement these ideas effectively as these key workers have a profound effect on young children as role models and due to the time of waking hours spent with them. The position paper is part of a longitudinal study at Canterbury Christ Church University and currently we will share the research findings from the initial questionnaire (online, postal, and in person) that explored and evaluated the knowledge, competence and confidence levels of practitioners and teachers as to the structure and planning of sustained physical activity and healthy lifestyles and how this progresses with the children’s age.

Keywords: health, perceptions, physical activity, well-being

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Authors: Said S. Almaiuof

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Integration Program Through Physical Education Lessons for The Influence of Some Physical Fitness Health-Related Components in Visual Handicapped Children. Propose of the study: The aim of this study is to design and evaluate a program for the physical education lesson to improve the cardio-respiratory endurance, considering the lesson of physical education as one of the educational means to achieve the society aims toward health and fitness, concerning the importance of the cardio-respiratory endurance as an essential one of the physical fitness health-related components. And this program tried to give them hand of help as a part of the society having the same rights as the rest of the society. Methodology: The researcher used the experimental method as a suitable method for this study and tested its hypothesis. The subject of the research selected randomly of the two classes from primary education in TRIPOLI-LIBYA, it was 28 boys (14-15) years old, then divided into groups, experimental group, n=13, which practiced the special exercises program and control group, n=15, which only practiced the normal school program. The selected child subjected to a medical examination in order to make sure that they are healthy, and the Vo2max measured by cycle ergometry and test some physical fitness makers before and after the program. Results: The study cleared that the experimental group developed in all physical variation in comparison with the control group which has a little development in a general balance only. Results are following: 1. The experimental group was successful more than the control group in all the research variation. 2. There were some improvements in time of keeping Balance in control group only. Discussion /conclusion: According to statistical analysis of data related to the values of the variables in this study; the suggested exercise program according to development the cardio respiratory endurance (CRE), and some physical fitness more than the program which already implemented in the school was less effective, just there is developing on keep balancing. It’s statistically significant (p<0.05) after applying this program. Improving the experimental group on (CRE), balance, running, sit and reach, from the suggested exercise program of what indicate the partaking program positive in improve those physical variables, and the selected exercises may contributed in improving the (CRE) for visual impairment and its pivotal in visual impairment children’s life. A health-related physical education curriculum can provide students with substantially more physical activity during physical education classes. The results show that the physical rehabilitation program for visual impairment children helped them in developing their defects due to the injury which means that this program should be in every organization having this part of people to increase their production and give them hand of help as a part of the society having the same rights as the rest of the society and to establish the idea of sport for all.

Keywords: visual handicapped, cardio-respiratory endurance, health, ergometry, education

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Authors: Ari Istiany, Guspri Devi Artanti, M. Si

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Based on the results Riskesdas, it is known that breastfeeding awareness about the importance of exclusive breastfeeding is still low at only 15.3 %. These conditions resulted in a very infant at risk for infectious diseases, such as diarrhea and acute respiratory infection. Therefore, the aim of this study to evaluate the video development about exclusive breastfeeding as a nutrition education media for posyandu cadre. This research used development methods for making the video about exclusive breastfeeding. The study was conducted in urban areas Rawamangun, East Jakarta. Respondents of this study were 1 media experts from the Department of Educational Technology - UNJ, 2 subject matter experts from Department of Home Economics - UNJ and 20 posyandu cadres to assess the quality of the video. Aspects assessed include the legibility of text, image display quality, color composition, clarity of sound, music appropriateness, duration, suitability of the material and language. Data were analyzed descriptively likes frequency distribution table, the average value, and deviation standard. The result of this study showed that the average score assessment according to media experts, subject matter experts, and posyandu cadres respectively was 3.43 ± 0.51 (good), 4.37 ± 0.52 (very good) and 3.6 ± 0.73 (good). The conclusion is on exclusive breastfeeding video as feasible as a media for nutrition education. While suggestions for the improvement of visual media is multiply illustrations, add material about the correct way of breastfeeding and healthy baby pictures.

Keywords: exclusive breastfeeding, posyandu cadre, video, nutrition education

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Authors: Nunik Junara, Sugeng Triyadi

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Sustainable Housing in Islamic perspective, can be defined as a multi-dimensional process that seeks to achieve a balance between economic and socio-cultural aspects on the side, and environmental aspect on the other. There are many quotes verses in the Quran and Hadith that leads to the belief that Islam as a Rahmatan lil Alamin, where men are encouraged to act wisely in treating nature and all living things in it. One aspect of the natural environment that closed to human is plants. In the settlement, the availability of plants or also called green open space is highly recommended. The availability of green open space in the neighborhood, both the public and private green open spaces is expected to reduce the effects of global warming that has engulfed various parts of the world. Green open space that can be viewed from the angle of eco-aestetic and eco-medical in sustainable architecture, is expected to increase the temperature and provide aesthetic impression to the surrounding environment. This paper attempts to discuss the principles of Islamic values related to the natural environment as a major resource for sustainability. This paper also aims to raise awareness of the importance of the theme of sustainability in settlements, especially in big cities. Analysis of the availability of green open space in kampung Kauman Malang is one example of the effort to apply the principles of sustainable housing.

Keywords: green open space, sustainable housing, Islamic values, Kampung Kauman Malang

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Authors: Amin Amani, Masomeh Reihany Shirvan, Mahla Nabizadeh Mashizi, Mohadese Khoshtinat, Mohammad Elyas Ansarinia

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The purpose of this study is the relationship between a healthy lifestyle and risky behavior in physical education students of Bojnourd schools. The study sample consisted of teenagers studying in second and third grade of Bojnourd's high schools. According to level sampling, 604 students studying in the second grade, and 600 students studying in third grade were tested from physical education schools in Bojnourd. For sample selection, populations were divided into 4 area including north, East, West and South. Then according to the number of students of each area, sample size of each level was determined. Two questionnaires were used to collect data in this study which were consisted of three parts: The demographic data, Iranian teenagers' risk taking (IARS) and prevention methods with emphasize on the importance of family role were examined. The Central and dispersion indices, such as standard deviation, multiple variance analysis, and multivariate regression analysis were used. Results showed that the observed F is significant (P ≤ 0.01) and 21% of variance related to risky behavior is explained by the lack of awareness. Given the significance of the regression, the coefficients of risky behavior in teenagers in prediction equation showed that each of teenagers' risky behavior can have an impact on healthy lifestyle.

Keywords: healthy lifestyle, high-risk behavior, students, physical education

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Authors: Betsy H. Edwards

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Background: Public Health England recognises unprotected sex and consequent transmission of sexually transmitted infections (STIs) as significant problems within student populations. Government surveys show that 50% of sexually-active young adults engage in unprotected sex with new partners, with 10% never using condoms. The recent Channel Four mini-series ‘It’s a Sin’ dramatises the 1980s AIDS epidemic and has been praised for its educational value and for promoting safe sexual practices to its viewers. This mixed-methods questionnaire study aims to investigate whether the series can change attitudes towards safe sex in student populations, can promote the use of condoms in student populations, and whether television, in general, is a useful tool for promoting health education. Methods: A questionnaire, created on Microsoft Forms, was distributed to students at the University of Birmingham via Facebook groups between September 2021 and May 2022. To consent, participants had to be aged 18 or over, a student at the university, have seen the entire series of ‘It’s a Sin’, and read the study information. Data was confidentially stored within the University’s secured OneDrive in accordance with the study’s approved ethics application. Quantitative questions measured participants’ attitudes and behaviours using Likert scales. Qualitative data was analysed using thematic analysis. Quantitative Results: 78 students completed the questionnaire. 43 participants (55%) felt that the series ‘It’s a Sin’ promoted safe sex. 74 participants (96%) and 31 participants (39%) said they were ‘very likely’ or ‘likely’ to use condoms with a casual partner during penetrative sex and oral sex respectively. 27 participants (35%) felt that watching ‘It’s a Sin’ made them more likely to use condoms; of these 27 participants, all were ‘very likely’ or ‘likely’ to use condoms during penetrative sex, and 9 were ‘very likely’ or ‘likely’ to during oral sex. 49 participants (63%) and 53 participants (68%) felt that television is a good way to provide health education and to promote healthy behaviours respectively. Qualitative Results: 56 participants (72%) gave reasons why the series had been associated with an increased uptake in HIV testing. Three themes emerged: increased education and attention, decreased stigmatisation, and relatability of characters on screen. Conclusions: This study suggests that the series ‘It’s a Sin’ can influence attitudes towards and the uptake of safe sexual practices. It would be useful for further research - using larger, randomised samples - to explore impacts upon populations lesser-educated about sexual health, who potentially have more to gain from watching series such as ‘It’s a Sin’.

Keywords: GUM, It's a sin, media, sexual health, students, television, tv

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Authors: Hasneet K. Kalsi, Julie K. Kilgariff

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Introduction: Within dentistry, the process for gaining informed consent has become more complex. To consent for treatment, patients must understand all reasonable treatment options and associated risks and benefits. Consenting is therefore deeply embedded in health literacy. Patients attending for dental consultation are often presented with an array of information and choices, yet studies show patients recall less than half of the information provided immediately after. Appropriate and comprehensible patient information leaflets (PILs) may be useful aid memories. In 2016 the World Health Organisation set improving health literacy as a global priority. Soon after, Scotland’s 2017-2025 Making it Easier: A Health Literacy Action Plan followed. This project involved the review of Restorative PILs used within Dundee Dental Hospital to assess the Content and Readability. Method: The current PIL on Root Canal Treatment (RCT) was created in 2011. This predates the Montgomery vs. NHS Lanarkshire case, a ruling which significantly impacted dental consenting processes, as well as General Dental Council’s (GDC’s) Standards for the Dental Team and Faculty of General Dental Practice’s Good Practice Guidance on Clinical Examination and Record-Keeping. Current evidence-based guidance, including that stipulated by the GDC, was reviewed. A 20-point Essential Content Checklist was designed to conform to best practice guidance for valid consenting processes. The RCT leaflet was scored against this to ascertain if the content was satisfactory. Having ensured the content satisfied medicolegal requirements, health literacy considerations were reviewed regarding readability. This was assessed using McLaughlin’s Simple Measure of Gobbledygook (SMOG) formula, which identifies school stages that would have to be achieved to comprehend the PIL. The sensitivity of the results to alternative readability methods were assessed. Results: The PIL was not sufficient for modern consenting processes and reflected a suboptimal level of health literacy. Evaluation of the leaflet revealed key content was missing, including information pertaining to risks and benefits. Only five points out of the 20-point checklist were present. The readability score was 16, equivalent to a level 2 in National Adult Literacy Standards/Scottish Credit and Qualification Framework Level 5; 62% of Scottish adults are able to read to this standard. Discussion: Assessment of the leaflet showed it was no longer fit for purpose. Reasons include a lack of pertinent information, a text-heavy leaflet lacking flow, and content errors. The SMOG score indicates a high level of comprehension is required to understand this PIL, which many patients may not possess. A new PIL, compliant with medicolegal and health literacy guidance, was designed with patient-driven checklists, notes spaces for annotations/ questions and areas for clinicians to highlight important case-specific information. It has been tested using the SMOG formula. Conclusion: PILs can be extremely useful. Studies show that interactive use can enhance their effectiveness. PILs should reflect best practice guidance and be understood by patients. The 2020 leaflet designed and implemented aims to fulfill the needs of a modern healthcare system and its service users. It embraces and embeds Scotland’s Health Literacy Action Plan within the consenting process. A review of further leaflets using this model is ongoing.

Keywords: consent, health literacy, patient information leaflet, restorative dentistry

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Authors: Ling-Lang Huang

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Background: The holistic health care should ideally cover physical, mental, spiritual, and social aspects of a patient. With very constrained time in current clinical practice system, medical decisions often tip the balance in favor of evidence-based medicine (EBM) in comparison to patient's personal values. Even in the era of competence-based medical education (CBME), when scrutinizing the items of entrustable professional activities (EPAs), we found that EPAs of establishing doctor-patient relationship remained incomplete or even missing. This phenomenon prompted us to raise this project aiming at advocating value-based medicine (VBM), which emphasizes the importance of patient’s values in medical decisions. A true and effective doctor-patient communication and relationship should be a well-balanced harmony of EBM and VBM. By constructing VBM into current EPAs, we can further promote genuine shared decision making (SDM) and fix the missing link in holistic health care. Methods: In this project, we are going to find out EPA elements crucial for establishing an ideal doctor-patient relationship through three distinct pairs of doctor-patient relationships: patients with pulmonary arterial hypertension (relatively young but with grave disease), patients undergoing surgery (facing critical medical decisions), and patients with terminal diseases (facing forthcoming death). We’ll search for important EPA elements through the following steps: 1. Narrative approach to delineate patients’ values among 2. distinct groups. 3.Hermeneutics-based interview: semi-structured interview will be conducted for both patients and physicians, followed by qualitative analysis of collected information by compiling, disassembling, reassembling, interpreting, and concluding. 4. Preliminarily construct those VBM elements into EPAs for doctor-patient relationships in 3 groups. Expected Outcomes: The results of this project are going to give us invaluable information regarding the impact of patients’ values, while facing different medical situations, on the final medical decision. The competence of well-blending and -balanced both values from patients and evidence from clinical sciences is the missing link in holistic health care and should be established in future EPAs to enhance an effective SDM.

Keywords: value-based medicine, shared decision making, entrustable professional activities, holistic health care

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Authors: Bharti Arora, Michael Chen, Steven Lun

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Plasmacytoid urothelial carcinoma (PUC) of the bladder is a rare and aggressive subtype of urothelial carcinoma that usually presents at an advanced clinical stage, has a predilection for early metastatic potential and is associated with poor prognosis. The first reported case of PUC was in 1991 and approximately 100 cases were reported in the literature worldwide. We present a case of a 43 year old female presenting with a 3-month history of urgency and frequency. Failing medical management of her urinary symptoms with anticholinergic medication, she underwent a diagnostic cystoscopy which revealed an erythematous and indurated bladder. Bladder biopsies of these regions revealed plasmacytoid urothelial carcinoma. Pre-operative staging scans were clear of any metastatic disease and the patient subsequently underwent a radical cystectomy and pelvic clearance with the formation of ileal conduit for urinary diversion. Histology confirmed plasmacytoid urothelial carcinoma with involvement of right upper vagina and focally positive margins in soft tissue at right and left sides of bladder. She received adjuvant chemotherapy but passed away within a year from disease progression. PUC can present atypically and our case highlights the role of cystoscopy in patients with persistent urinary symptoms. By reviewing the literature on PUC, we aim to raise awareness and improve understanding of this rare bladder cancer subtype amongst urologists.

Keywords: urology, bladder cancer, plasmacytoid urothelial cancer, literature review

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Authors: Arezoo Fallahi, Siamak Derakhshan, Parvaneh Taymoori, Babak Nematshahrbabaki

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Background: Osteoporosis, the most common metabolic bone disease, is an important health care issue. Not only the cost of disease is high but also is one of the causes of disability and mortality and effect on quality of life. Although self-care is effective on disease, s control and treatment but still effective factors on self-care of patient, s viewpoint have not been survey. The aim of this study was to explore effective factors on self-care in women with osteoporosis. Materials and methods: This study was done by conventional content analysis approach in year 2014. Through purposeful sampling 15 women referred to bone mass densitometry centers participated in this study. Inclusion criteria were: Women older than 50 years old with osteoporosis, final diagnosis of osteoporosis for over six –month period, T-score index below -2.5 (lower back or hip), drug use by patients with a physician’s prescription, ability in speaking and attending to participate in the study. Data was collected by face to face and group semi-structure deep interviews and analyzed via content analysis method. To support of rigor of data, criteria credibility, confirmability and transferability were used. Results: during data analysis five categories developed: “hope and disability in the face of illness”, “mutual roles of physician”, “role of family” and “administrative centers and organizations”. To perform self-care behaviors, the participations of this study emphasized on pay attention to their own healthy, regarding patients' rights by physician, pay attention to women's health by men, and the role of media especially radio and television. Conclusion: the finding of the study showed that women’s responsibility with osteoporosis for their health is not a factor but it is multifactorial. Increasing life expectancy in patients, attention to patients needs by physician, increasing health promotion programs in the media and enhancing role of family may provide conditions and infrastructure to empowerment women in doing self-care behavior.

Keywords: women, osteoporosis, self-care, content analysis

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Authors: Guliz Kolburan

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Juvenile delinquency studies has a special place and importance in criminality researches. Young adolescents, have not reached psychological, mental and physical maturity, and they cannot understand their roles and duties in society. In this case, if such an adolescent turns into a crime machine as a gang leader, he has the least responsibility of this result. All institutions, like family, school, community and the state as a whole have duties and responsibilities in this regard. While planning the studies about prevention of juvenile delinquency, all institutions related with the development of the children, should be involved in the center of the study. So that effective goals for prevention studies can be determined only in this way. Most of youth who commit homicide feel no attachment to anybody or society except for themselves. Children who committed homicide generally developed defense mechanisms about their guilt, sadness, fear and anger. For this reason, treatment of these children should be based on the awareness of these feelings and copying with them. In the movie, events making the youth realize his own feelings and responsibilities were studied from a theoretical perspective. In this study, some of the dialogs and the scenes in the movie were analyzed and the factors cause the young gang leader to be drawn to crime were evaluated in terms of the science of psychology. The aim of this study is to analyze the process of the youth to being drawn into criminal behavior in terms of social and emotional developmental phases in a theoretical perspective via the movie produced in 2005 (94. Min.). The method of this study is discourse analysis.

Keywords: crime, child, evaluation (development), psychology

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Authors: S. P. Rana

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Objectives: For the manufacture of a very thin strip or a strip with a high-quality finish, the stainless steel sheet that is called billet is re-rolled in re-rolling mill to make stainless steel sheet of 18 gauges. The rolls of re-rolling mill exert tremendous pressure over the sheet and there is likely chance of breaking of stainless steel strip from the sheet. The objective of the study was to minimise the number of accidents in steel re-rolling mills due to ejection of stainless steel strip and to minimize the pollution caused by the pickling process used in these units. Methods: Looking into the high rate of frequency and severity of accidents as well as pollution hazard in re-rolling and pickling mills, it becomes essential to make necessary arrangements for prevention of accidents in such type of industry. The author carried out survey/inspections of a large number of re-rolling and pickling mills and allied units. During the course of inspection, the working of these steel re-rolling and pickling mills was closely studied and monitored. A number of accidents involving re-rolling mills were investigated and subsequently remedial measures to prevent the occurrence of such accidents were suggested. Assessment of occupational safety and health system of these units was carried out and compliance level of the statutory requirements was checked. The workers were medically examined and monitored to ascertain their health conditions. Results: Proper use of safety gadgets by workers, machine guarding and regular training brought down the risk to an acceptable level and discharged effluent pollution was brought down to permissible limits. The fatal accidents have been reduced by 83%. Conclusions: Effective enforcement and implementation of the directions/suggestions given to the managements of such units brought down the no. of accidents to a rational level. The number of fatal accidents has reduced by 83% during the study period. The effective implementation of pollution control device curtailed the pollution level to an acceptable level.

Keywords: re-rolling mill, hazard, accident, health hazards

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Authors: Shekh Shadi Rahaman

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In Bangladesh, basic human rights more specifically right to food and right to shelter are being adversely affected by the consequences of climate change. Over the last two decades, a considerable number of environmental studies revealed that basic human rights, more specifically, the right to food and right to a shelter are going to be seriously affected by climate change. Agriculture, forestry, and fisheries and livestock, which are most sensitive to climate change, are key sources interconnected with food security and the security of shelter. Consequences of climate change affecting these key sources, and with the change of time, climate change is turning into a gigantic challenge towards ensuring basic human rights in Bangladesh. This study was carried out by employing a general review of literature on climate change, focusing on effects of climate change on basic two major human rights in Bangladesh. Upon analysis of existing researches, it is found very few researches focused on correlating climate change and right to food and right to shelter. This study shows how the consequences of climate change affects food production and abode of people of Bangladesh. This study recommends that tree plantation, floating agricultural practice, co-operation with international organization, developing environment friendly institutions, increased use of renewable energy, proper management of wetlands and forests, shelter for climate induced migrated people, encouraging research and public awareness are key issues to be followed for combating climate change and protecting basic human right to food and shelter.

Keywords: achievements, agriculture and forestry, fisheries and livestock, renewable energy

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Authors: Mohanad Elemary, Imose Itua, Rajeswari B. Matam

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Virologists and public health experts have been predicting potential pandemics from coronaviruses for decades. The viruses which caused the SARS and MERS pandemics and the Nipah virus led to many lost lives, but still, the COVID-19 pandemic caused by the SARS-CoV2 virus surprised many scientific communities, experts, and governments with its ease of transmission and its pathogenicity. Governments of various countries reacted by locking down entire populations to their homes to combat the devastation caused by the virus, which led to a loss of livelihood and economic hardship to many individuals and organizations. To revive national economies and support their citizens in resuming their lives, governments focused on the development and use of contact tracing apps as a digital way to track and trace exposure. Google and Apple introduced the Exposure Notification Systems (ENS) framework. Independent organizations and countries also developed different frameworks for contact tracing apps. The efficiency, popularity, and adoption rate of these various apps have been different across countries. In this paper, we present a critical analysis of the different contact tracing apps with respect to their efficiency, adoption rate and general perception, and the governmental strategies and policies, which led to the development of the applications. When it comes to the European countries, each of them followed an individualistic approach to the same problem resulting in different realizations of a similarly functioning application with differing results of use and acceptance. The study conducted an extensive review of existing literature, policies, and reports across multiple disciplines, from which a framework was developed and then validated through interviews with six key stakeholders in the field, including founders and executives in digital health startups and corporates as well as experts from international organizations like The World Health Organization. A framework of best practices and tactics is the result of this research. The framework looks at three main questions regarding the contact tracing apps; how to develop them, how to deploy them, and how to regulate them. The findings are based on the best practices applied by governments across multiple countries, the mistakes they made, and the best practices applied in similar situations in the business world. The findings include multiple strategies when it comes to the development milestone regarding establishing frameworks for cooperation with the private sector and how to design the features and user experience of the app for a transparent, effective, and rapidly adaptable app. For the deployment section, several tactics were discussed regarding communication messages, marketing campaigns, persuasive psychology, and the initial deployment scale strategies. The paper also discusses the data privacy dilemma and how to build for a more sustainable system of health-related data processing and utilization. This is done through principles-based regulations specific for health data to allow for its avail for the public good. This framework offers insights into strategies and tactics that could be implemented as protocols for future public health crises and emergencies whether global or regional.

Keywords: contact tracing apps, COVID-19, digital health applications, exposure notification system

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Authors: Sally Barsoum

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This paper is providing a significant insight into the role of satire in Egyptian politics and how it has been received from the government and viewer’s point of view. It mainly sets out to test whether Bassem Youssef’s satirical program has played a significant role in Egypt recent politics and to investigate what is the nature and extent of this role. In order to test this hypothesis, the researcher chose to critically analyze one episode of Bassem Youssef’s satirical show, El Bernameg. This paper goes further to highlight that the aims of satire is to invite citizens to analyze, criticize and question people in power and the realm of politics rather than remain as untouched subjects by combining humor with critique in order to enhance citizens’ political awareness and perhaps even political engagement. Moreover it identifies that Bassem Youssef’s satire is to use laughter as a medium to communicate his political message. By first informing the public and secondly engaging them through laughter, satire plays a very constructive political role, which have been argued finally that Bassem Youssef has indeed played an important part in the Egyptian political scene of today and this can be measured by the degree of censorship that he has been subject to and the level of international and domestic reaction towards his satirical show. At the end, this paper is suggesting that the measure of a strong government is its ability not only to accommodate satire but also to learn from it.

Keywords: political satirist, Bassem Youssef, capital broadcasting center, TV channel, muslims brotherhood regime, ONTV Egyptian TV channel

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Authors: Jonathan Magala

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Context: Adolescents in Uganda face significant challenges related to sexual health due to inadequate sexual information. This lack of information puts young people at risk of early pregnancies, sexually transmitted infections, and poverty. Therefore, it is essential to understand the sources, content, and challenges of acquiring sexual information among secondary school-going adolescents in Uganda. Research Aim: The aim of this study was to establish the sources, content, and challenges of acquiring sexual information among secondary school-going adolescents in Luwero Town Council, Uganda. Methodology: This study used a cross-sectional approach with both qualitative and quantitative methods. Questionnaires and in-depth interviews were conducted with 384 school-going adolescents aged between 13-19 years in Luwero Town Council, Uganda. Findings: The results of the study revealed that adolescents receive sexual information from various sources, with schools being the most common source, followed by parents and religious institutions being the least utilized. Adolescents received information on various topics related to sexuality, including puberty and sexual changes, pregnancy and reproduction, STD information, abstinence, and family planning. However, the content of sexual information was inadequate in addressing the challenges facing adolescents, and there were generation gaps, lack of role models, peer influence, and government policies. The male character from all the sources was the least in offering sexual information to adolescents. Theoretical Importance: The study's findings highlight the need for policy implementation to strengthen sexual education in school curriculum, as the sources of sexual information and the content are inadequate. The various topics should be addressed in schools to provide comprehensive education on sexual health for adolescents. Data Collection and Analysis Procedures: Data collection involved questionnaires and in-depth interviews with school-going adolescents. The data gathered were analyzed using descriptive statistics and thematic analysis. Questions Addressed: The study aimed to answer questions about the sources of sexual information among school-going adolescents, the content of sexual information provided, the challenges faced in accessing the information, and the importance of sex education policy implementation. Conclusion: The study concludes that schools are a popular source of sexual information among school-going adolescents in Uganda. However, the content of the information provided is inadequate in addressing the challenges that adolescents face regarding their sexual health. Therefore, policy implementation is essential in strengthening sexual education in the school curriculum and addressing various topics related to sexual health.

Keywords: adolescents, sexual information, schools, reproductive health

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Authors: Riccardo Houngbegnon, Loic Chrislin Nguedjio, Valery Doko, José Xavier, Miran Merhar, Rostand Moutou Pitti

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Against a backdrop of heightened awareness of environmental impact and the reduction of space debris, the use of sustainable materials for mobility applications is emerging as a promising solution to minimize the environmental footprint of our technologies. Among recent innovative developments in the use of wood, the Japanese species Magnolia obovata attracted particular interest when it was used in the design of the first wooden satellite launched in November 2024. The aim of this project is to explore new species that could replace M. obovata in a mobile context. Khaya ivorensis, a tropical African species, was selected and compared to M. obovata in terms of resistance to cracking, a key criterion in the durability of mobility infrastructures. Prior to the cracking tests, K. ivorensis and M. obovata were characterized to determine their basic mechanical properties. The results presented here relate to this characterization phase, in particular the four-point bending, compression and BING tests, which provided us with strengths and moduli. These results were compared with those found in the literature, which allowed us to observe a number of differences. CHARPY resilience tests were also performed and compare to critical energy release rate in order to estimate the ability of the two species to absorb energy, particularly following impacts and various shocks.

Keywords: energy release rate, Khaya ivorensis, magnolia obovata, wood for mobility

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Authors: Sebahat Seker

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Since there is a parallel connection between drinking water quality and public health, studies on drinking and domestic water are of vital importance. Ardahan Province is one of the provinces located in the Northeast Anatolian Region, where animal husbandry and agriculture are carried out economically. City mains water uses underground spring water as a source and is chlorinated and given to the city center by gravity. However, mains water cannot be used outside the central district of the city, and the majority of the people meet their drinking and utility water needs from the wells they have opened individually. The water element, which is vital for all living things, is the most important substance that sustains life for humans. Under normal conditions, a healthy person consumes approximately 1.8-2 liters of water. The quality and use of potable water is one of the most important issues in terms of health. The quality parameters of drinking and utility water have been revealed by the scientific world. Scientific studies on drinking water quality in the world and its impact on public health are among the most popular topics. Although our country is surrounded by water on three sides, potable water resources are very few. In the Eastern Anatolia Region, it is difficult for the public to access drinking and utility water due to the difficult conditions both climatically and geographically. In this study, samples taken from drinking and utility water at certain intervals from the stations determined, and water quality parameters will be determined. The fact that such a study has not been carried out in the region before and the knowledge of the local people about water quality is very important in terms of its original and widespread effect.

Keywords: water quality, modelling, evaluation, northeastern anatolia

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Authors: Tuti Haryati Jasimin, Hishamuddin Mohd Ali

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Malaysia’s green building development is gaining momentum and green buildings have become a key focus area especially within the commercial sector with the encouragement of government legislation and policy. Due to the emerging awareness among the market players’ views of the benefits associated with the ownership of green buildings in Malaysia, there is a need for valuers to incorporate consideration of sustainability into their assessments of property market value to ensure the green buildings continue to increase in the market. This paper analyses the valuers’ current perception on the valuation practices with regard to the green issues in Malaysia. The study was based on a survey of registered real estate valuers and the experts whose work related to valuation in the Klang Valley area to rate their view regarding the perception on valuation of green building. The findings present evidence that even though Malaysian valuers have limited knowledge of green buildings, they recognize the importance of incorporating the green features in the valuation process. The inclusion of incorporating the green features in valuations in practice was hindered by the inadequacy of sufficient transactional data in the market. Furthermore, valuers experienced difficulty in identifying what are the various input parameters of green building and how to adjust it in order to reflect the benefit of sustainability features correctly in the valuation process. This paper focuses on the present challenges confronted by Malaysian valuers with regards to incorporating the green features in their valuation.

Keywords: green commercial office building, Malaysia, valuers’ perception, valuation, commercial sector

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Authors: M. Fathy, I. Maarouf, S. El-Sayary

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Our buildings are responsible for around 50% of energy consumption and most of this consumption because of spaces design, low heat isolation building material and occupant presence and behavior in buildings beside non-efficient architectural treatments. It has been shown to have large impact on heating, cooling and ventilation demand, energy consumption of lighting and appliances, and building controls. This paper aims to focus on passive treatments in Wakala Buildings in Cairo and how far it meets the LEED Criteria as the LEED – Leadership in Energy and Environmental Design – considered the widest spread rating system in the world. By studying Wakala buildings in Cairo, there are a lot of environmental potentials in it in the field of passive treatments and energy efficiency that could be found in examples by surveying and analyzing Wakala buildings. Besides the environmental treatments through the natural materials and façade architectural treatments, there is a measuring phase to declare the efficiency of the Wakala building through temperature decline between outdoor and indoor the Wakala building. Also, measuring how far the indoor conditions matched the thermal comfort for occupants. After measuring the Wakala buildings, it is the role of applying the criteria of LEED rating system to find out how fare Wakala buildings meet the LEED rating system criteria. After all, the building technologies used in Wakala buildings in the field of passive design and caused that energy efficiency would be clear and what is needed for Wakala buildings to have a LEED Certification.

Keywords: energy awareness, historical commercial buildings, LEED, Wakala buildings

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Authors: W. Widhiada, D. N. K. P. Negara, P. A. Suryawan

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The technological advances in the field of health to be very important, especially on the safety of the baby. In this case a lot of premature infants death caused by poorly managed health facilities. Mostly the death of premature baby caused by bacteria since the temperature around the baby is not normal. Related to this, the incubator equipment needs to be important, especially in how to control the temperature in incubator. On/Off controls is used to regulate the temperature distribution in the incubator so that the desired temperature is 36 °C to stay awake and stable. The authors have been observed and analyzed the data to determine the temperature distribution in the incubator using program of MATLAB/Simulink. The output temperature distribution is obtained at 36 °C in 400 seconds using an Arduino AT 2560. This incubator is able to maintain an ambient temperature and maintain the baby's body temperature within normal limits and keep the moisture in the air in accordance with the limit values required in infant incubator.

Keywords: on/off control, distribution temperature, Arduino AT 2560, baby incubator

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Authors: Cinthia G. P. Calou, Franz J. Antezana, Ana I. O. Nicolau, Eveliny S. Martins, Paula R. A. L. Soares, Glauberto S. Quirino, Dayanne R. Oliveira, Priscila S. Aquino, Régia C. M. B. Castro, Ana K. B. Pinheiro

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Introduction: As an integral part of the health-disease process, gestation is a period in which the social insertion of women can influence, in a positive or negative way, the course of the pregnancy-puerperal cycle. Thus, evaluating the quality of life of this population can redirect the implementation of innovative practices in the quest to make them more effective and real for the promotion of a more humanized care. This study explores the associations between the obstetric factors with affected areas of health-related quality of life of pregnant women with habitual risk. Methods: This is a cross-sectional, quantitative study conducted in three public facilities and a private service that provides prenatal care in the city of Fortaleza, Ceara, Brazil. The sample consisted of 261 pregnant women who underwent low-risk prenatal care and were interviewed from September to November 2014. The collection instruments were a questionnaire containing socio-demographic and obstetric variables, in addition to the Brazilian version of the Mother scale Generated Index (MGI) characterized by being a specific and objective instrument, consisting of a single sheet and subdivided into three stages. It allows identifying the areas of life of the pregnant woman that are most affected, which could go unnoticed by the pre-formulated measurement instruments. The obstetric data, as well as the data concerning the application of the MGI scale, were compiled and analyzed through the statistical program Statistical Package for the Social Sciences (SPSS), version 20.0. After the compilation, a descriptive analysis was carried out. Then, associations were made between some variables. The tests applied were the Pearson Chi-Square and the Fisher's exact test. The odds ratio was also calculated. These associations were considered statistically significant when the p (probability) value was less than or equal to a level of 5% (α = 0.05) in the tests performed. Results: The variables that negatively reflected the quality of life of the pregnant women and presented a significant association with the polaciuria were: gestational age (p = 0.022) and parity (p = 0.048). Episodes of nausea and vomiting also showed significant with gestational age correlation (p = 0.0001). Evaluating the crossing of stress, we observed a significant association with parity (p = 0.0001). In turn, emotional lability revealed dependence on the variable type of delivery (p = 0.009). Conclusion: The health professionals involved in the assistance to the pregnant woman can understand how the process of gestation is experienced, considering all its peculiar transformations; to meet their individual needs, stimulating their autonomy and their power of choice, envisaging the achievement of a better quality of life related to health in the perspective of health promotion.

Keywords: health-related quality of life, obstetric nursing, pregnant women, prenatal care

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Authors: Niall J. English

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Under- and post-graduate training can benefit from a more active learning style, and most particularly so in engineering. Despite this, outreach to young children in primary and secondary schools is less-developed in terms of its documented effectiveness, especially given new emphasis placed within the third level and advanced research program’s on Education and Public Engagement (EPE). Bearing this in mind, outreach and school visits form the basis to ascertain how active learning, careers stimulus and EPE initiatives for young children can inform the university sector, helping to improve future engineering-teaching standards, and enhancing both quality and practicalities of the teaching-and-learning experience. Indeed, engineering-education EPE/outreach work has been demonstrated to lead to several tangible benefits and improved outcomes, such as greater engagement and interest with science/engineering for school-children, careers awareness, enabling teachers with strong contributions to technical knowledge of engineering subjects, and providing development of general professional skills for engineering, e.g., communication and teamwork. This intervention involved active learning in ‘buzz’ groups for young children of concepts in gas engineering, observing their peer interactions to develop university-level lessons on activity learning. In addition, at the secondary level, careers-outreach efforts have led to statistical determinations of motivations towards engineering education and training, which aids in the redesign of engineering curricula for more active learning.

Keywords: outreach, education and public engagement, careers, peer interactions

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Authors: Tamara Anderson, Neela Badrie

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Plant phenolics which are found in red grape wine, have received considerable attention due to their potential antioxidant activity. Grape by-products contain large amounts of phenolic compounds, mostly flavonoids at high concentrations of 1000-1800 mg/L. Plant phenolics contribute to the flavor, and nutritional value. Sorrel or roselle (Hibiscus sabdariffa L.) belongs to the family Malvaceae. The brilliant red pigments in sorrel calyces contain anthocyanins which are the major sources of antioxidant capacity. Consumers are demanding novel beverages that are healthier, convenient and have appealing consumer acceptance. The objectives of this study were to investigate the effects of adding grape polyphenols and the influence of presenting health claims on the sensory acceptability of the wines. Fresh red sorrel calyces were fermented into wines. The total soluble solids of the pectinase-treated sorrel puree were from 4°Brix to 23.8°Brix. Polyphenol in the form of grape pomace extract was added to sorrel wines (w/v) in specified levels to give 0. 25. 50 and 75 ppm. A focus group comprising of 12 panelists was use to select the level of polyphenol to be added to sorrel wines for sensory preference The sensory attributed of the wines which were evaluated were colour, clarity, aroma, flavor, mouth-feel, sweetness, astringency and overall preference. The sorrel wine which was most preferred from focus group evaluation was presented for hedonic rating. In the first stage of hedonic testing, the sorrel wine was served chilled at 7°C for 24 h prior to sensory evaluation. Each panelist was provided with a questionnaire and was asked to rate the wines on colour, aroma, flavor, mouth-feel, sweetness, astringency and overall acceptability using a 9-point hedonic scale. In the second stage of hedonic testing, the panelist were instructed to read a health abstract on the health benefits of polyphenolic compounds and again to rate sorrel wine with added 25 ppm polyphenol. Paired t-test was used for the analysis of the influence of presenting health information on polyphenols on hedonic scoring of sorrel wines. Focus groups found that the addition of polyphenol addition had no significant effect on sensory color and aroma but affected clarity and flavor. A 25 ppm wine was liked moderately in overall acceptability. The presentation of information on the health benefit of polyphenols in sorrel wines to panelists had no significant influence on the sensory acceptance of wine. More than half of panelists would drink this wine now and then. This wine had color L 19.86±0.68, chroma 2.10±0.12, hue° 16.90 ±3.10 and alcohol content of 13.0%. The sorrel wine was liked moderately in overall acceptability with the added polyphenols.

Keywords: sorrel wines, Roselle Hibiscus sabdariffa L, novel wine, polyphenols, health benefits, physicochemical properties

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Authors: Qirat Naz, Abasiokpon Udoakah

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In developed countries, global migration is diversifying. The minority ethnic population, including refugees and asylum seekers who, fled their home countries due to war, terrorism, oppression, or natural disasters, and returning home is dangerous for them. They need sanctuary and peaceful environment in host countries. They begin the process of acculturation, in which a person adopts the social mores and behavioral patterns of the dominant culture, yet they still have unique multicultural needs that the dominant society fails to address. The aim of this research is to provide a holistic understanding of the living experiences of a minority population, particularly migrants, including asylum seekers and refugees, in the health and social care system of South Wales. The purpose of this study is to investigate three research objectives: the multicultural health care needs of minorities, as well as the barriers to seeking health and social care facilities. There are Welsh policies for promoting cultural competence in the health and social care sectors; this research will explore the implications and impact of these policies on the target population. This research study will be conducted using qualitative research methods, tools, and techniques. This research is an inductive approach to coming up with a grounded theory. The sample will be divided into two groups: migrants and professionals providing any kind of services to migrants; each group will contain 30 participants. Interpretive phenomenological analysis would be utilized during the process of coding and developing the main themes of this research. The positionality of the researcher would be minimized by unloaded and open-ended questions, researcher’s work experience in research, continuous evaluation of her positionality, daily base reflection of fieldwork and seeking the help of male and female gatekeepers. The research findings would be based on emic perspective, and by documenting the emic perspective of minorities, this research will contribute to the knowledge of appropriate channels, including organizations, academics, and policymakers, to discover possible solutions and coping mechanisms to deal with the challenges and meet the multicultural demands of minorities. This research will provide a more in-depth understanding of minorities and will help to promote the diversity of health and social care in South Wales.

Keywords: migration, migrants, cultural competence, cultural barriers, healthcare challenges

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Authors: Andrew Anis Fakhrey Mosaad

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Objectives: Physiotherapy in the intensive care unit (ICU) improves patient outcomes. We aimed to determine the characteristics of physiotherapy practice and critical barriers to applying physiotherapy in ICUs. Materials and Methods: A 54-item survey for determining the characteristics physiotherapists and physiotherapy applications in the ICU was developed. The survey was electronically sent to potential participants through the Turkish Physiotherapy Association network. Sixty-five physiotherapists (47F and 18M; 23–52 years; ICU experience: 6.0±6.2 years) completed the survey. The data were analyzed using quantitative and qualitative methods. Results: The duration of ICU practice was 3.51±2.10 h/day. Positioning (90.8%), active exercises (90.8%), breathing exercises (89.2%), passive exercises (87.7%), and percussion (87.7%) were the most commonly used applications. The barriers were related to physiotherapists (low level of employment and practice, lack of shift); patients (unwillingness, instability, participation restriction); teamwork (lack of awareness and communication); equipment (inadequacy, non-priority to purchase); and legal (reimbursement, lack of direct physiotherapy access, non-recognition of autonomy) procedures. Conclusion: The most common interventions were positioning, active, passive, breathing exercises, and percussion. Critical barriers toward physiotherapy are multifactorial and related to physiotherapists, patients, teams, equipment, and legal procedures. Physiotherapist employment, service maintenance, and multidisciplinary teamwork should be considered for physiotherapy effectiveness in ICUs.

Keywords: intensive care units, physical therapy, physiotherapy, exercises

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Authors: Nautiyal Ruchira, Nautiyal Hemant, Chaudhury Devnanda, Bhargava Surbhi, Chauhan Nidhi

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Introduction: South East Asian region contributes 2.5 million cases of malaria each year to the global burden of 300 to 500 million of which 76% is reported from India. Government of India launched a national program almost half a century ago, still malaria remains a major public health challenge. Pregnant women are more susceptible to severe malaria and its fetomaternal complications. Inadequate surveillance and under-reporting underestimates the problem. Aim: Present study aimed to analyze the clinical course and pattern of malaria during pregnancy and to study the feto-maternal outcome. Methodology: This is a prospective observational study carried out at Himalayan Institute of Medical Sciences – a tertiary care center in the sub-Himalayan state of Uttarakhand, Northern India. All the pregnant women with malaria and its complications were recruited in the study during 2009 to 2014 which included referred cases from the state of western Uttar Pradesh. A thorough history and clinical examination were carried out to assess maternal and fetal condition. Relevant investigations including haemogram, platelet count, LFT, RFT, and USG was done. Blood slides and rapid diagnostic tests were done to diagnose the type of malaria.The primary outcomes measured were the type of malaria infection, maternal complications associated with malaria, outcome of pregnancy and effect on the fetus. Results: 67 antenatal cases with malaria infection were studied. 71% patients were diagnosed with plasmodium vivax infection, 25% cases were plasmodium falciparum positive and in 3% cases mixed infection was found. 38(56%) patients were primigravida and 29(43%) were multiparous. Most of the patients had already received some treatment from their local doctors and presented with severe malaria with the complications. Thrombocytopenia was the commonest manifestation seen in 35(52%) patients, jaundice in 28%, severe anemia in 18%, and severe oligohydramnios in 10% and renal failure in 6% cases. Regarding pregnancy outcome there were 44 % preterm deliveries, 22% had IUFD and abortions in 6% cases.20% of newborn were low birth weight and 6% were IUGR. There was only one maternal death which occurred due to ARDS in falciparum malaria. Although Plasmodium vivax was the main parasite considering the severity of clinical presentation, all the patients received intensive care. As most of the patients had received chloroquine therapy hence they were treated with IV artesunate followed by oral artemesinin combination therapy. Other therapies in the form of packed RBC’s and platelet transfusions, dialysis and ventilator support were provided when required. Conclusion: Even in areas with annual parasite index (API) less than 2 like ours, malaria in pregnancy could be an alarming problem. Vivax malaria cannot be considered benign in pregnancy because of high incidence of morbidity. Prompt diagnosis and aggressive treatment can reduce morbidity and mortality significantly. Increased community level research, integrating ANC checkups with the distribution of insecticide-treated nets in areas of high endemicity, imparting education and awareness will strengthen the existing control strategies.

Keywords: severe malaria, pregnancy, plasmodium vivax, plasmodium falciparum

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Authors: Sedigheh Salemi, Mahnaz Sanjari, Maryam Aalaa, Mohammad Mirzabeigi

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Clinical governance is the framework within which the health service provider is required to ongoing accountability and improvement of the quality of their services. This cross-sectional study was conducted in 661 nurses who work in government hospitals from 35 hospitals of 9 provinces in Iran. The study was approved by the Nursing Council and was carried out with the authorization of the Research Ethics Committee. The questionnaire included 24 questions in which 4 questions focused on clinical governance defining from the nurses' perspective. The reliability was evaluated by Cronbach's alpha (α=0/83). Statistical analyzes were performed, using SPSS version 16. Approximately 40% of nurses correctly answered that clinical governance is not "system of punishment and rewards for the staff". The most nurses believed that "clinical efficacy" is one of the main components of clinical governance. A few of nurses correctly responded that "Evidence Based Practice" and "management" is not part of clinical governance. The small number of nurses correctly answered that the "maintenance of patient records" and "to recognize the adverse effects" is not the role of nurse in clinical governance. Most "do not know" answer was to the "maintenance of patient records". The most nurses unanimously believed that the implementation of clinical governance led to "promoting the quality of care". About a third of nurses correctly stated that the implementation of clinical governance will not lead to "an increase in salaries and benefits of the medical team". As a member of the health team, nurses are responsible in terms of participation in quality improvement and it is necessary to create an environment in which clinical care will flourish and serve to preserve the high standards.

Keywords: clinical governance, nurses, salary, health team

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