RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

BANGALORE, KARNATAKA

SYNOPSIS PROFORMA FOR THE REGISTRATION OF

SUBJECTS FOR DISSERTATION

SUBMITTED BY:

Mr. KANTARAJU.S

I YEAR M.Sc. NURSING

COMMUNITY HEALTH NURSING

[2012-2014 BATCH]

ADICHUNCHANAGIRI COLLEGE OF NURSING,

B.G.NAGARA, NAGAMANGALA TALUK,

MANDYA DISTRICT-571448

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RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCESBANGALORE, KARNATAKA

01. NAME OF THE CANDIDATE

AND ADDRESSMR.KANTHARAJU.S1ST YEAR M.SC. NURSING,

ADICHUNCHANAGIRI COLLEGE OF NURSING,

B.G.NAGAR,MANDYA(D)

02. NAME OF THE INSTITUTION

ADICHUNCHANAGIRI COLLEGE OF NURSING,

B.G.NAGAR,MANDYA(D)

03. COURSE OF THE STUDY AND

SUBJECT MASTER OF SCIENCE IN NURSING

(COMMUNITY HEALTH NURSING)

04.

DATE OF ADMISSION TO THE

COURSE

14-08-2012

05. TITLE OF THE STUDY

“EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME REGARDING GLOBAL WARMING AND ITS IMPACT ON HEALTH”.

5.1 STATEMENT OF THE

PROBLEM

“A STUDY TO ASSESS THE EFFECTIVENESS OF STRUCTERED TEACHING PROGRAMME ON KNOWLEDGE REGARDING GLOBAL WARMING AND ITS IMPACT ON HEALTH AMONG B.Ed STUDENTS IN SELECTED COLLEGE,NAGAMANGALA.”

PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION

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6.0 BRIEF RESUME OF THE INTENDED WORK.

INTRODUCTION

“Global warming is too serious for the world any longer to ignore its danger or split into opposing factions on it”.

-TONY BLAIR

The term global warming was probably first used in its modern sense on 8 august 1975 in a science

paper by Wally broecker in the journal science called “Are we on the brink of a pronounced global

warming”. Global warming is the increase of earth’s average surface temperature due to effect of

greenhouse gases, such as carbon dioxide emission from burning fossil fuels or from deforestation, which

trap heat that would otherwise escape from earth. This is a type of green house effect.1

Global warming is all about adverse climate change caused by trapping of green house gases (CO2)

in the earth atmosphere that affects biodiversity and causes a serious health hazards. Counter measures to

facilitate living in hotter temperature like air conditioning and refrigeration will unfortunately consume more

electricity from power plants that burn coal, releasing CO2 .This will further spike global warming and have

a seriously damaging influence on human health. External forces refer to processes external to the climate

system that influence climate. Climate responds to several types of external forcing, such as radiative

forcing due to changes in atmospheric composition; change in solar luminosity, volcanic eruption and

variation in earth’s orbit around sun.2

The greenhouse effect is the process by which absorption and emission of infrared radiation by gases

occurs in atmosphere and surface. It was proposed by Joseph Fourier in 1824 and was first investigated

quantitatively by Svante Arrhenius in 1896. Naturally occurring amounts of green house gases have a mean

warming effect of about 330C.The major greenhouse gases are water vapor, which causes about 36 to 70%

of the green house effect; CO2 which causes 9-26%, methane (CH4) which causes 4-9% and Ozone (O3)

which causes 3-7% of greenhouse effect. Cloud also affects the radiation balance, through cloud forcing

similar to green house gases. Human activity since the industrial revolution has increased the amount of

green house gases in atmosphere leading to increased radiative forces from CO2, Methane, trophospheric

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ozone, CFCs and Nitrous oxide. The concentration of CO2 and Methane have increased by 56% and 148%

respectively since 1750.These values are much higher than at any time during the last 800000 years, the

period of which reliable data have been extracted from ice cores. The fossil fuel burning has produced about

three quarters of increase in CO2 from human activity over the past 20 years.1

Human beings have increased the CO2 concentration in the atmosphere by about thirty percent,

which is an extremely significant increase, even on inter-glacial timescales.  It is believed that human beings

are responsible for this because the increase is almost perfectly correlated with increases in fossil fuel

combustion, and also due other evidence, such as changes in the ratios of different carbon isotopes in

atmospheric CO2 that are consistent with "anthropogenic" (human caused) emissions. Deforestation is

responsible for 25% of all carbon emissions entering the atmosphere, by the burning and cutting of about 34

million acres of trees each year.2

6.1 Need for Study

Nowadays global warming is considered as a burning problem and it is being a challenge to

the entire world and its scientific society. Global warming is a worldwide environmental problem by which

there is an abnormal increase to the level of temperature, particularly in a natural environment. Global

Warming is the observed and projected increase in the average temperature of earth’s atmosphere and

oceans due to greenhouse gas emissions like CFC, CH4, N2O, CO, Hydro carbons on account of human

activities. The effects of Green house gas due to increase in Green House Gas warms the planet; decrease in

Green House Gas cools the planet. Unfortunately there is a steep increase of the temperature in the last three

decades. Global warming is not only affecting the nature, but it affects the life and homes of millions of

people.10

. The U N Intergovernmental panel on climate change [IPCC] which draws upon the collective wisdom

of many hundreds of scientist from around the world. The IPCC projects global temperature increases of 3-

10 degree F in the next 100 years and says that human activity is the cause of most of the observed and

projected warming. Warmer temperatures lead to greater concentrations of ground level ozone, which forms

on hot, sunny days when pollution from cars and sources mix. 4

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Higher temperature over the coming decades are excepted to cause more smoggy days and heat waves,

contributing to a greater number of illness and deaths in the united states, according to international climate

scientist. Smog can damage lung tissue, increasing respiratory and heart disease and death. Even modest

increase in smog can cause asthma in children. Smog related death from climate change is projected to

increase by about 4.5 % from the 1990s to 2050s, According studies at Columbia and Johns Hopkins

universities. A scientist at Yale University, Michelle Bell, looked at the 50 largest cities in eastern United

States and found that the health alert days would go up by 68 percent over the next decades.3

Increased frequency and severity of heat waves will lead to more heat stroke and other heat related

illness and death. Senior citizens and children are particularly vulnerable to these effects. The word has

already seen the effects of heat on human health. The summer 2003 heat wave in Europe that claimed

35,000 was likely made worse by global warming and in the summer of 2007, Greece suffered massive heat

waves and recorded wildfire.Airpollution worsens as temperature increase and higher levels of ozone smog

and other pollutants have been directly linked with increased rates of respiratory and cardiovascular disease

and cardiac dysrryhthmia.5

Currently malaria, diarrhea, malnutrition flows related to climate change cause about 150,000world

death annually, according to WHO. With warming temperature, the breeding cycle of malaria-mosquitoes is

shortening, which means more mosquitoes and malaria each year. The same effect will likely be seen with

other vector borne disease such as dengue fever, which has infected 60,000people in one outbreak in

brazil’sriode feneiro this year alone. Rising temperature and varying rainfall patterns could affect staple-crop

production and food security.5

Rising sea levels make coastal areas more susceptible to storm surges and flooding that result from

severe weather. Just last year almost 7million people were displaced by flooding in dhaka.Bangladesh and in

2004, floods there killed more than 700.1990s, more than 16,000 deaths occurred world wide as a result of

weather related disasters. WHO now says that 150,000 deaths are attributable to the effect of climate

change. Many people are under the mistaken impression that only if the polar ice caps melt will sea level

rise. In fact average sea level around the world has already risen 4-8 inches in the past 100 years due to

global warming and is expected to rise another 4-35 inches by 2100.the primary reason for this rise is that

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water expands as it warms. The second reason is that glaciers all over the world are melting and land based

ice melts, the water runs to the sea and increases its level. Thousands of small islands are threatened by the

projected sea level rise for the 21st century.6

Each of us can reduce our contribution to global warming by using less greenhouse-gas-producing

energy: driving less, choosing fuel efficient cars and appliances (like refrigerators and water heaters), and

using solar energy where feasible for water and space heat. We can encourage our political and business

leaders to institute policies that will save energy and develop alternative energy sources that do not release

carbon dioxide. We can preserve existing forests and plant new ones. But even if we take aggressive action

now, we cannot completely prevent climate change because once carbon dioxide is in the atmosphere, it

remains there for about a century, and the climate system takes a long time to respond to changes. But our

actions now and in the coming decades will have enormous implications for future generations 6

Here the researcher would like to assess the knowledge of B.Ed students regarding global warming

and its impact on health using structured questionnaire .A structured teaching program will be conducted to

increase knowledge on global warming and its impact on health. If the B.Ed students gain adequate

knowledge regarding global warming, they will be able to teach students and their relatives in home.

6.2 REVIEW OF LITERATURE

Review of literature is defined as broad, comprehensive in depth systematic and critical review of

scholarly publications unpublished scholarly print materials, audiovisual materials and personal

communications. Review of literature is a key step in research process. Review of literature refers to an

extensive, exhaustive and systemic examination of publications relevant to research project.7

Martiello MA, in division of public health, university of Siena, Italy conducted a study

regarding “High temperature and health outcomes”. The aim of the study was to analysis the relationship

between high temperature and population health impacts, in terms of mortality and morbidity. A literature

search was conducted using midline to collect data from studies on heat waves temperature health impacts

curves, risk factors and preventive measures. The result of the study showed an increase in deaths may relate

that a forward shift of deaths may only explain a very quantity of the excess mortality observed during major 6

heat waves. Moreover, the results seem to exclude that ozone acts as a confounding variable, whilst it

remains a potential effect modifier8

Walker R School of Public Health, La Trobe University Victoria conducted a study regarding health

promotion intervention to address the climate change using a primary health care approach. This project

explored the literature in which key concepts in primary health care and promotion are overtly applied to the

problem of climate change. This paper contains a discussion of the literature relevant to health promotion

principles and intervention strategies for addressing climate change mitigation and adaption in primary

health care sector. The review of literature indentified in electronic database using two sets of search term.

Set A consisted of climate change (or) global warming (or) green house effect and set B Consisted of 11-key

concepts in primary health care and health promotion. the result of the study show that discussion of major

categories of health promotion intervention, namely health communication ,community building and setting

approaches uses examples drawn from literature on community resilience and summer heat. These

interventions are all applicable to the primary health care sector9

N.Sasikumar conducted a study regarding awareness of global warming the graduate teacher trainees. To

identify the level of awareness regarding global warming and to enhance the same among future secondary

school teachers. The study was conducted in graduate trainees of college of education, Karaikudi Town,

Sivagangi District, Tamilnadu state. The authors used purposive sampling and samples are collected only

from graduate teacher trainees. The total respondent of the graduate teacher training colleges is 300.out of

300 the authors selected only 290 samples from the respondent of graduate teacher training and result of the

study shows that graduate teacher training of government college of education have awareness on global

warming which is more than the private graduate teacher trainees. It is suggest that the above study may be

undertaken with all the government colleges of education graduate teacher trainees. The same present study

can be conducted to high school students and diploma teacher trainees. The authors conclude that students

belong to arts group graduate trainees have low awareness on global warming than the students of graduate

trainees.10

Sharmila, Conducted a study regarding college students knowledge about global warming, physical

science and engineering. The study was intended to find out the knowledge of global warming among the

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college students in Madurai district, Tamilnadu, India.Random sampling technique was used to compose a

sample of 1168 college students. The result revealed that male and female students, rural and urban area

students, arts and science group students exhibited significant difference but nuclear and joint family

students had no significant difference in respect of their knowledge of global warming.11

Joyce A Dixons s. the department of each social and community health, Australia conducted a study

regarding reducing the environmental impact of dietary choice: prospective from a behavioural and social

change approach. Climate change is recognized as a significant public health issue that will impact on food

security. Increased consumption of plant based food is a recommended strategy to reduce human impact on

the environment and is also now recognized as a potential strategy to reduce the high rates of some chronic

disease .Formative research under taken in this study discovered that people realized the benefit of fruit and

vegetable consumption, but there were barriers related to incorrect perception of recommended serving size,

and lack of time and knowledge about how to prepare meals with vegetables. This study shows that a well

developed messages based on a thorough understanding of the determinants of that behavior can influence

dietary practice.12

Raoloz V School of population health, university of Queensland, Brisbane, conducted a study on

surveillance of dengue fever virus: a review of epidemiological models and early warning systems. This

study AIMS at analyzing the different modeling methods and their output in terms of act as an early warning

system.Epidemological models attempt to predict future outbreak using information on the risk factor of

disease. In the context, modeling focuses on transmission patterns between the different animal, human (or)

vector components as well as including parameters which affect these pathways such as environmental,

climatic (or) geographic ones. The output of model can help in decision making processes concerning

control purpose, surveillance methods and hopefully also as a good predictive tools. This study shows that

Varity and depth of models for dengue fever surveillance and their use as early warning tools.13

Sokolow S conducted a study regarding effects of a changing climate on the dynamics of coral

infectious disease; a close examination of the coral disease literature reveals many hypothesized

mechanisms for how coral disease may be linked to climate change. However, evidence has been largely

circumstantial, and much uncertainty remains. The published evidence supports the hypothesis that coral

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infectious diseases are emerging and demonstrates that coral disease research has been exponentially

expanding over the last few decades. Current research suggests that environmental factors, such as ocean

warming, altered rainfall, increased storm frequency, sea level rise, altered circulation, and ocean

acidification may play a role in coral disease. These climate variables likely alter coral epidemiology

through effects on pathogen growth rates, transmission, virulence, and susceptibility. In a rapidly changing

global environment, the consequences of increasing coral disease may be severe, leading to elevated

extinction risk and loss of critical reef habitat. Current evidence is still preliminary but is increasingly

suggestive that mitigating the effects of climate change may help reduce the emergence of disease and

improve the health of coral reef ecosystems.14

Stuen S,Seksjon for smafeforking,Institute for produksjonsdyrmedisin,Norges veterinaerhogskole,4325

Sandnes conducted a study regarding human anaplasmosis- a hidden disease in Norway.tick and tick borne

infections will most probably increase in Norway due to global warming,regrowth of pasture and increase

number of cervids.The article provides a review of A.phagocytophilum infection in mammals, with a special

focus on human anaplasmosis.It is based on relevant literature and the author’s extensive research on this

bacterium. The result of the study shows that infection is widespread in animal along the coast of southern

Norway, only few human cases have been reported so for. Even though infection with A phagocytophilum

mainly presents as a influenza-like disease it may have a fatal out come.human-ana+plasmosis should be

considered as a differential diagnosis when faced with a patient with influenza-like symptoms 1-3 weeks

after a tick-bite.15

Mr.Wassel JJ Novant health concord North Carolina, USA; conducted study regarding “Public health

preparedness for the impact of global warming on human health” ;Objectives of the study was to assess the

changes in weather and weather associated disturbances related to global warming. The impact on human

health of these changes; and the public health preparedness mandated by this impact. In this study they

reviewed sixty-seven journal articles and concluded that the projections and signs of Global environmental

changes are worrisome, and there are reasons to believe that related information may have been

conservatively interpreted and presented in the recent past. We must begin greening our own lives and

clinical practice and start talking about these issues with patients. As we build walk able neighborhoods,

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change methods of energy production and make water use and food production and distribution more

sustainable, the benefits to improved air quality, a stabilized climate, social support and individual and

community health will be dramatic.16

Emch M, conducted a study regarding Seasonality of cholera from 1974-2005. The seasonality of

cholera is described in various study areas throughout the world. In this study Cholera data are compiled

from 1974 to 2005 from the World Health Organization Weekly Epidemiological Reports, a database that

includes all reported cholera cases in 140 countries. The data are analyzed to measure whether season,

latitude, and their interaction are significantly associated with the country-level number of outbreaks in each

of the 12 preceding months using separate negative binomial regression models for northern, southern, and

combined hemispheres. The results suggest that cholera outbreaks demonstrate seasonal patterns in higher

absolute latitudes, but closer to the equator, cholera outbreaks do not follow a clear seasonal pattern. He

findings suggest that environmental and climatic factors partially control the temporal variability of cholera.

These results also indirectly contribute to the growing debate about the effects of climate change and global

warming. As climate change threatens to increase global temperature, resulting rises in sea levels and

temperatures may influence the temporal fluctuations of cholera, potentially increasing the frequency and

duration of cholera outbreaks. 17

Romero V, conducted a study regarding Kidney stone; global picture of prevalence, incidence, and

associated risk factors. The prevalence and incidence of nephrolithiasis is reported to be increasing across

the world. In this study they review information regarding stone incidence and prevalence from a global

perspective. Data were collected from the identified literature and sorted by demographic factors and time

period. A total of 75 articles were identified containing kidney stone-related incidence or prevalence data

from 20 countries; 34 provided suitable information for review. Data regarding overall prevalence or

incidence for more than a single time period were found for 7 countries (incidence data for 4 countries;

prevalence data for 5 countries). The body of evidence suggests that the incidence and prevalence of kidney

stones is increasing globally. These increases are seen across sex, race, and age. Changes in dietary practices

may be a key driving force. In addition, global warming may influence this trends.18

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A study was conducted in California by D.C.Donaldson and W.R.Keatinge regarding impact of global

warming on health and mortality; the initial concern about the possible effects of global warming on

infectious has declined with the realization that the spread of tropical disease is likely to be limited and

controllable. However the direct effect of heat already causes substantial number of deaths among

vulnerable people in the summer. Action to prevent these deaths from rising is the most obvious medical

challenge presented by a global rise in temperature.19

The centre for health and the global environment, Hayward Medical School, USA conducted a study

regarding “Is global warming harmful to health?”In that study there was a projection from computer models

predict that global warming will expand the incidence and distribution of many serious medical disorders.

Global warming aside from directly causing death by drawing or starvation, promotes by various means by

emergence, resurgence and spread of infection diseases. This article addresses the health effect of global

warming and disrupted climate patterns in detail. Among the greatest health concerns are diseases

transmitted by mosquitoes such as malaria, dengue fever, yellow fever and several kinds of encephalitis.

Such disorders are projected to become increasingly prevalent because their insect carriers are very sensitive

to meteorological conditions. In addition floods and droughts resulting from global warming can each help

trigger out breaks by creating breeding grounds for insects whose desiccated eggs remain viable and hatch in

still water .Other effects of global warming on health include the growth of opportunist populations and the

increase of the incidence of water borne diseases because of lack of clean water.20

United Nations Conference on the Environment and Development (UNCED) in Rio de janerio.A

study was conducted to public health effects of global climate change and ozone depletion. the data were

obtained from articles accessed through the national library of medicine’s Medline data base and from

personal communication with key investigators. The result of the showed that dengue fever, cholera and red

tides may continue to threaten coastal populations as phytoplankton blooms proliferate in warmer, nutrient

rich waters and increased UV-B radiation contributes to cataracts, skin cancer and immunosuppression.The

study recommended that internationally co-ordinate monitoring for the emergence of epidemics, laboratory

and field studies of vector ecology and elaboration of UV-B effect on the human immune system21

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6.3 STATEMENT OF THE PROBLEM

“A STUDY TO ASSESS THE EFFECTIVENESS OF STURCTERED

TEACHING PROGRAMME ON KNOWLEDGE REGARDING GLOBAL

WARMING AND ITS IMPACT ON HEALTH AMONG B.ED STUDENTS IN

SELECTED COLLEGE, NAGAMANGALA”.

6.4 OBJECTIVES OF THE STUDY

1. To assess the existing knowledge regarding Global warming and its impact on health among the

B.Ed students.

2. To assess the post test knowledge regarding global warming and its impact on health among the

B.Ed students.

3. To assess the effectiveness of a structured teaching programme on Global warming and its impact

on health among the B.Ed students.

4. To associate the knowledge regarding Global warming and its impact on health with demographic

variables.

6.5 HYPOTHESIS

H1. There will be a significant difference between the mean pre test and post test knowledge score

regarding Global warming and its impact on health among the B.Ed students in selected college.

H2. There will be a significant association between level of knowledge regarding Global warming

and its impact on health among the B.Ed students in selected college with their selected

demographic variables.

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6.6 OPERATIONAL DEFINITIONS

1. Effectiveness:

It refers to the way by which an action produces an intended or desired outcome. In this study it

refers to an extent to which the structured teaching programme regarding global warming and its

impact on health has achieved the desired effect and improves the knowledge of B.Ed students in

selected college.

2. Structured Teaching programme:

It refers to a systematically developed instructional aids designed to impart knowledge regarding

Global warming and its impact on health.

3. Global warming:

Global warming is all about adverse climate change. Global warming is an increase in the earth’s

average atmospheric temperature that causes corresponding changes in climate and that may results

from the green house effect.

4. Knowledge:

It refers the response and level of understanding of B.Ed students regarding global warming and its

impact on health.

5. Impact:

A high force or a shock over a short time or a long time periods.

6. Health

Health is a complete state of physical, mental and social well being and not merely the absence of

disease or infirmity

7. B.Ed students:

Those students who are studying bachelor of education in selected college.

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6.7 ASSUMPTIONS

1. B.Ed students in selected college may have inadequate knowledge regarding Global warming and

its impact on health.

2. Knowledge regarding Global warming and its impact on health can be measured by questionnaire.

3. Knowledge regarding Global warming and its impact on health will be enhanced among B.Ed

students in selected college after conducted of structured teaching programme.

6.8 MATERIALS AND METHODS

1. Sources of data

The data will be collected from the B.Ed students in selected college, Nagamangala.

2. Method of collection of data

Structured Questionnaire.

3. Research design

Quasi experimental-one group pretest posttest design.

4. Research approach

An evaluative research approach.

5. Setting of the study

The study will be conducted among B.Ed students in selected college, Nagamangala.

6. Population

The population of the present study comprises of all B.Ed students in Nagamangala.

7. Sample size

The sample size will be 60 B.Ed students.

8. Sampling technique

Simple random sampling technique will be used.

7.1 Sampling Criteria

Inclusive criteria

a) All male and female B.Ed students studying in selected college.

b) B.Ed students who are willing to participate.14

Exclusive criteria

a) B.Ed students who are not willing to participate.

b) B.Ed students who are not present at the time of study.

6.9 LIMITATIONS OF THE STUDYStudy is limited to

1) 60 B.Ed students in selected college of Namangala, Mandya(D) Karnataka

2) A period of 4-6 weeks

7.0 SIGNIFICANCE OF THE STUDY Increases the knowledge of B.Ed students regarding global warming and its impacts on health

7.1 TOOL FOR DATA COLLECTION

The tool consists of the following sections.

Section A- Demographic variables

Section B- Structured questionnaire to assess the knowledge of B.Ed students regarding Global

warming and its impact on health.

7.2 VARIABLES

INDEPENDENT VARIABLES:-

o Effectiveness of structured teaching programme regarding global warming

DEPENDENT VARIABLES:-

o Knowledge regarding global warming

7.3 PLAN FOR DATA ANALYSIS

The data collected will be analysed by using descriptive and inferential statistics.

Descriptive statistics

Frequency, percentage distribution mean, median, mode and standard deviation will be used to

analyze the knowledge regarding global warming and its impact on health

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Inferential statistics

Paired‘t’ test will used to compare the pre and post test knowledge regarding global warming and

its impact in health. Chi-square test will be used to analyze association between pre test knowledge

with selected demographic variables.

7.4 Does the study require any investigations or interventions to be conducted on patients or other

human or animals…?

Yes, structured teaching programme will be administration for degree students.

7.5 Has ethical clearance been obtained from your situation…?

1. Permission will be obtained from the research committee of Adichunchanagiri College of nursing,

Nagamangala.

2. Permission will be obtained from the concerned authorities of the colleges.

3. Informed consent will be taken from the samples, confidentiality and privacy of data will be

maintained.

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8.0 LIST OF REFERENCES

1. Introduction of global warming available from: URL:http://www.en.wikipedia.org

2. Adverse climate changes available from: URL:http://www.medindia.net

3. Climate change available from http://www.stgate.com/global warming health effects smog-heat waves.

4. Health effects of global warming available from: URL:http://www.medindia.net

5. The human side of global warming available from http://www.american progress.org

6. Carnegie Mellon university, teacher’s guide to high-quality education material on climate change and

global warming.

7. BT Basavanthappa. Nursing research: Review of literature. New Delhi: Jaypee brothers; 2003. p48

8. Martiello.High temperature and health outcomes, division of public health, University of siena, Italy.

Scand j public health, 38:826-37, 2010 dec

9. Walker R, health promotion intervention to address climate change using a primary health care approach,

La trobe university, Victoria

10. N.Sasikumar, Awareness of global warming among the graduate teacher trainees, research center for

research in education. Journal of education and practice, JSSN2222-1735, Vol 2, No 9, 2011

11. Sharmila V.College student’s knowledge about global warming, physical science and engineering,

International journal of current research

12. Joyce A, Reducing the environmental impact of dietary choce: perspectives from a behavioural and

social approach, each social and community health, vic3134, Australia.

13. Racloz V, Surveillance of dengue fever virus:a review of epidemiological models and early warning

systems, University of queen land,Austtrilia.

14. Sokolow S. Effects of a changing climate on the dynamics of coral infectious disease. Journal for Health

care Quality.2009 Nov; 14(3); p5-18

15. Stuen S, Human anaplamosis – a hidden disease in Norway, Norges veterinaerhogskole.

16. Wassal JJ.Public health preparedness of the impact of global warming on human health. Disaster

medical journal.2009 July; 4(4); p217-225.

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17. Emch M. Seasonality of cholera from 1974 to 2005: a review of global patterns. International journal for

health Geographics.2008 june20 (7); 30-31.

18. Romero V. Kidney stone; global picture of prevalence, incidence, and associated risk factors. A journal

of review on Urology.2010, 12(2-3)86-96

19. W R Keatinge. Impact of global warming on health and mortality. South med Journals.2004,

97(11).p494-582

20. Center for health and global environment, Hayward medical school, USA.Study about is Global

warming harmful to health available from: URL: http://www.ncbi.nlm.nih.gov

21. UNCED.Conducted a study regarding health effects of global climate change and ozone depletion in Rio

De Janerio

22. Denise F Polit, Cherly Tatano Back. Nursing research Data analysis and interpretation. Williams and

Willkims publications: New Delhi; 2008. P506-642.

23. Barbara Hazard Munro. Statistical methods for health care research: Inferential and descriptive

statistics. Philadelphia: Lippincott; 3rdedition. p73.

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