The importance of sustainability development for developing countries and their tourism is a major issue. This study presents a new approach and framework for spatial modelling of tourism products potentials (TPP) in their sustainability evaluation. The approach was developed based on the GIS multi-criteria DECISION analysis (MCDA) and its performance was evaluated for spatial TPP mapping in Tabriz city, Iran. To achieve this purpose, we recognized the main Components of Tourism Development indicators (CTDI) such as attractions, accommodation, services and infrastructures facilities to improving sustainable tourism, and determined their significance using the Geographic information systems (GIS). Furthermore, the uncertainty analyze was applied to diminish the inherent error in criteria weights. A GIS-based aggregation function was applied to discern the TPP map. Finally, the emphasis in this paper investigates the practical usage of GIS for the benefit of sustainable tourism development. In particular, it inquired the possible opportunities and challenges facing the adoption of GIS to assist sustainable tourism development. The purpose of this article is to map and explore existing and potential attractions, tourism services and facilities in Tabriz and to ensure that potential opportunities are available for all tourists to enjoy enjoyable experiences in order to reveal their diverse economic, social, political and cultural benefits. Build on the positive and negative aspects of their construction and present them with appropriate solutions for tourism development that lead to sustainable tourism development and infrastructure improvement.

Background & Objectives: Clinical DECISION-making is a basic part of professional nursing; nurses’ DECISIONs have profound effects on course of treatment, which can lead to expectedoutcomsand patient’s satisfaction. Morever, such a DECISION-making process may influence the analysis of patient’s needs that can help adopt the best alternatives for interventions. This study was conducted to determine the nurses’ PARTICIPATION in clinical DECISION-making process.Materials & Methods: Stratified random sampling was employed to carry out this descriptive study, in which 285 nurses, working at Tabriz Medical Science University wards were participated. A PDAQ5 used to collect data. The collected data were analyzedby using SPSS 15.Results: Findings of the research showed that nurses’ clinical DECISION-making in three phases of DECISION-making process: clarifying the problem (30.35±15.01), evaluating alternatives (29.23±14.64) and selecting alternatives (27.13±14.15) was in average condition.Conclusion: According to research findings & considering clinical DECISION-making as a basic part of professional nursing, the educational system and professional organizations should provide the background for empowerment and development of DECISION-making skills among nurses. They should also determine obstacles and facilitate the nurses’ independence in DECISION-making process.

Background & Aims: Collaboration of health care team in clinical dicision making is a key factor to provide safe and efficient care. Since nurses have the most continous contact with patients, they could have great influences on diagnostic and therapeutic DECISIONs. The aim of this study was to determine nurses’ collaboration in clinical DECISION-makings and its related factors.Material & Methods: This descriptive, cross-sectional study was conducted among nursing staff of educational hospitals of Rasht-Iran. A total of 193 nurses were selected by stratified random sampling. Data was collected by DECISION-making Activities Questionnaire (PDAQ) and analyzed by descriptive and inferential statistics including pearson corrolation test, Independent T test, One-way ANOVA and Generalized Estimating Equations (GEE) using SPSS-PC (v. 16).Results: The mean score of nurses' collaboration in clinical DECISION-makings in all three dimentions (clarifying the problem, suggesting and evalutiong possible methos and selecting from one of suggested ways) was more than 50. Moreover, the findings revealed that the PARTICIPATION score of those with master degree, intersted in continuing their job at current ward, worked in intensive care units or in morning shifts have been significantly higher than other nurses (P<0.05). There was also a significant relationship between nurses' DECISION-making scores, their age and work experinces (P<0.05). Level of education, and present job experiance had the most positive effect, and high job experince and having no responsibility in working place had the most negative effect on nurses' level of clinical PARTICIPATION (P=0.00).Conclusion: Regarding the importance of nurses’ collaboration in DECISION making and the influence of higher leveles of education and working in ICU, providing appropriate context for more PARTICIPATION of nurses in DECISION making processes is suggested.

ABSTRACT With the expansion of inefficient tissues, "Urban regeneration" has been objectified as a solution for developing cities in different physical, social and economic dimensions. Despite the development of the guidelines for urban regeneration projects, these projects in Iran still have challenges in the stage of realization and implementation. This article aims to identify the "challenges and causes of non-realization of urban regeneration projects in Iran" and analyse the research conducted in this field with a qualitative approach. For this purpose, a meta-analysis of 23 articles in the field of problems of urban regeneration projects in Iran was carried out. The challenges raised in the AtlasTI software were extracted with the help of open and axial coding. In the following, 100 codes were determined in the form of 10 groups or general categories. In the end, the obstacles to the realization of urban regeneration projects in Iran were given. According to the obtained results, the weak presence of non-governmental organizations, the problems of preparing plans, institutional and management problems, and the weakness of PARTICIPATION are the four most important and frequent challenges in the research related to the realization of urban regeneration projects in Iran Extended Abstract Introduction The trend of urban population growth and the expansion of inefficient urban fabrics along with the increasing immigrant population to the cities makes the planners think of filling the existing urban fabrics with excessive density and land use change, instead of the city horizontal development with regard to the urban sustainable development prism. Poor housing, low per capita services, lack of necessary infrastructure, low quality of life, economic stagnation and functional inefficiency, unorganized physical-spatial structure, high vulnerability to earthquakes, loss of social status, and various social problems exemplify the typical challenges of such deteriorated areas. Deterioration of the urban fabric has prompted the emergence of various urban development policies among which regeneration as an overarching approach characterized by its economic, social, environmental, physical, ecological dimensions and components including quality of life, justice, revitalization and PARTICIPATION. This concept, as an urban development policy, has been defined and applied in the vulnerable and deteriorated areas of cities in recent years. Started from physical redevelopment in the Second World War and passing through policies concentrated on social and economic welfare, urban regeneration policies moved towards the PARTICIPATION of local residents and the creation of sustainable places in recent decades. However, taking into consideration the manifestation challenges of urban development plans, in the existing literature, urban regeneration challenges have been less comprehensively investigated. This paper aims to identify the "challenges and causes of lack of urban regeneration plans manifestation in Iran" based on the review and analysis of the research conducted in this field with a qualitative approach in response to this question: "What are the challenges and obstacles to the manifestation of urban regeneration projects in Iran?”   Methodology This research aims to identify "challenges and obstacles to the manifestation of urban regeneration projects in Iran" through a meta-analysis of the research conducted in this field. Conducting a systematic search in Magiran, comprehensive humanities portal, and Google Scholar databases using the Boolean logic search used the keyword (challenges) AND key phrases (‘manifestation of plans’ AND ‘urban regeneration in Iran’) resulted in more than 70 Persian papers, 2 English papers, and 2 English theses. The reviewed studies included research and review papers, case study research, and the special issue of urban regeneration policy of Haft Shahr Journal. The geographical scope of the investigated studies covers the historical contexts of Iran, and metropolises such as Tehran, Tabriz, Shiraz, and Isfahan. Reviewing the abstracts, 23 studies were selected among which the research focusing on the different types of regeneration, and evaluation of urban regeneration indicators were excluded from the research process. To conduct meta-analysis after a comprehensive review of each study, open and focused coding of challenges was done through Atlas.ti software (version 8), and the obstacles to the manifestation of the plans were extracted. Coding process continued until the saturation was reached. Finally, the 115 codes obtained was reduced to 100 through integrating similar codes. Then, all the codes were categorized into 10 categories, and a comprehensive model of "challenges of manifestation of urban regeneration projects in Iran" was presented.   Results and discussion Based on the conducted review, the recognized problems with emphasis on the different aspects of urban regeneration projects are: 1) Weak presence of non-governmental organizations (18 codes); 2) Problems of preparing plans (17 codes); 3) Institutional and managerial problems (14 codes); 4) Weakness of PARTICIPATION (13 codes); 5) Duration and financial problems of urban regeneration plans (10 codes); 6) Problems of urban regeneration plans process (8 codes); 7) loss of identity of fabrics in the preparation of the plan (6 codes); 8) Lack of context-oriented approach (7 codes); 9) inefficient evaluation of plans (4 codes); 10) lack of social and specialized training for citizens and officials (3 codes). The lack of endogenous theory and insufficient knowledge of the environment and residents obstacle the manifestation of urban regeneration plans. Despite pretending the use of non-governmental organizations, the relevant law weaknesses, and the lack of belief in the effectiveness of it has led to disregard of the PARTICIPATION of non-governmental organizations in practice in the process of preparing and implementing development plans resulting in an inadequate context for manifestation of urban regeneration plans. In addition, the government supervision on NGO’s in the way of achieving independence has also caused limitations for their interplay. In terms of the issues in the preparation of plans, more emphasis on the physical and economic dimensions and the purely physical view, and the lack of attention to the social and cultural consequences, along with the loss of the community identity, are the factors of the failure of the plans to achieve the expected results. The lack of coordination between programs and multiple DECISION-makers led to the institutional confrontation instead of interaction. In this regard, the necessity of an integrated and comprehensive approach to urban regeneration has been acknowledged in the reviewed studies. NGO’s can play an effective role in communicating with citizens, educating citizens and informing them. It is also necessary to have the PARTICIPATION of the private sector and other organizations involved in the field of urban development in addition to public PARTICIPATION in all steps of preparation, implementation and occupation of projects and development plans. In the absence of a context-oriented approach in the preparation and implementation of urban regeneration plans in Iran with blind imitation of western models and the existence of limited urban infrastructure, following consequences are inevitable: uncertainty in terms of time, cost and site preparation before the implementation of the plan; lack of definition of urban regeneration plans in the different scales, neighborhood, region and city; and the uncertainty of the relationship between these plans and other urban development plans. As such in the current inadequate conditions driving the process of preparing plans, the possibility of implementing new policies and plans, is low and the implemented plans like many other urban development plans in Iran, are inefficient in the absence of the post occupancy evaluation.   Conclusion Based on the results, four priority challenges in the manifestation of urban regeneration plans in Iran include; the weak presence of non-governmental organizations, the problems of preparing plans, institutional and managerial issues, and the weakness of PARTICIPATION. "The weak presence of non-governmental organizations" has been mentioned as the first challenge in most reviewed studies (Ahmadifar et al., 2014). Regarding the "PARTICIPATION of citizens" even though in the set of laws and regulations of sustainable urban regeneration, promotion of citizenship culture, PARTICIPATION, and cooperation of local institutions are highlighted, the residents are not welcomed in practice. On the other hand, the lack of people's PARTICIPATION in the preparation and implementation of plans has made any urban regeneration actions fail or achieve to its partial goals. In this regard, the results of the previous comparative comparisons have shown that the lack of laws and regulations supporting PARTICIPATION in various fields is of the key factors (Nourian and Ariana, 2011, Shafie Dastjerdi and Sadeghi, 2016). The problems of preparing plans, institutional and managerial issues, ranked as the third and fourth issues in this study, have been emphasized in previous studies as well (Kalantari Khalil Abad et al., Pakro and Sattarzadeh, 2014, Izadi et al., 2019). Therefore, prioritizing the challenges raised by experts and determining operational strategies to solve them are issues that can be addressed in future studies.   Keywords Urban regeneration plans, manifestation, meta-analysis   Funding There is no funding support.   Authors’ Contribution All of the authors approved the content of the manuscript and agreed on all aspects of the work.   Conflict of Interest Authors declared no conflict of interest.

Aim. The present study aimed to examine Critical care nurses’ PARTICIPATION in clinical DECISION making with physicians.Background. Regarding to the extent of the responsibilities and scope of nursing science and the need for making accurate and sensitive DECISIONs, nurses should be able to judge on clinical solemn occasions and make DECISIONs to save the patient’s life in complex situations.Method. In this cross-sectional study, 110 critical care nurses working in intensive care units of health care centers in Rasht, Iran, were recruited using census sampling method. The data were collected using the questionnaire “PARTICIPATION in clinical DECISION making” (PDAQ) and demographic form. Data were analyzed in SPSS using descriptive and inferential statistics.Findings. The results showed that the majority of critical care nurses were being participated in clinical DECISIONmakingConclusion. Work experience, marital status, desire to continue work in intensive care unit, and managerial role contributed to greater PARTICIPATION of critical care nurses in clinical DECISION making with physicians.

Background: Patient’s shared DECISION-making (SDM) is an ethical standard for respecting patient autonomy. Objectives: This study aimed to investigate the level of SDM for emergency surgery and its related factors in hospitals affiliated with the Zanjan University of Medical Sciences, Iran. Methods: This cross-sectional study was performed on 306 patients candidates for emergency surgery in 2020. The research instruments included a 9-item SDM Questionnaire and an SDM-related factors questionnaire for surgery. Results: Our results showed that more than 50% of patients did not participate in choosing emergency surgery. Among the related factors, the SDM level of the family members, the patient's marital status, and systolic blood pressure were the main predictors of the patient’s SDM for surgery (P < 0.05). Conclusions: The emergency conditions of patients and the high workload of staff reduced PARTICIPATION in the DECISION-making of patients and their family members.

Although the importance of patient PARTICIPATION in the design and evaluation of health programs and services is well-documented, there is scarcity of research with regard to patient association (PA) PARTICIPATION in health policy DECISION-making processes. To this end, the present study aimed to validate further a previously developed instrument as well as to investigate the degree of PA PARTICIPATION in health policy DECISION-making in Cyprus. A convenient sample of 114 patients-members of patients associations took part in the study. Participants were recruited from an umbrella organization, the Pancyprian Federation of Patient Associations and Friends (PFPA). PA PARTICIPATION in health policy DECISION-making was assessed with the Health Democracy Index (HDI), an original 8-item tool. To explore its psychometric properties, Cronbach α was computed as regards to its internal consistency, while its convergent validity was tested against a self-rated question enquiring about the degree of PA PARTICIPATION in health policy DECISION-making. The findings revealed that the HDI has good internal consistency and convergent validity. Furthermore, PAs were found to participate more in consultations in health-related organizations and the Ministry of Health (MoH) as well as in reforms or crucial DECISIONs in health policy. Lower levels were documented with regard to PARTICIPATION in hospital boards, ethics committees in clinical trials and health technology assessment (HTA) procedures. Overall, PA PARTICIPATION levels were found to be lower than the mid-point of the scale. Targeted interventions aiming to facilitate patients’ involvement in health policy DECISION-making processes and to increase its impact are greatly needed in Cyprus.