Search results for: academic programs

Authors: Diana Flores Galindo, Richard Gil Herrera

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Nowadays, Lean Manufacturing and Industry 4.0 are very important in every country. One of the main benefits is continued market presence. It has been identified that there is a need to change existing educational programs, as well as update the knowledge and skills of existing employees. It should be borne in mind that behind each technological improvement, there is a human being. Human talent cannot be neglected. The main objectives of this article are to review the link between Lean Manufacturing, the incorporation of Industry 4.0 and the steps to follow to implement it; analyze the current situation and study the implications and benefits of this new trend, with a particular focus on Mexico. Lean Manufacturing and Industry 4.0 implementation waves must always take care of the most important capital – intellectual capital. The methodology used in this article comprised the following steps: reviewing the reality of the fourth industrial revolution, reviewing employees’ skills on the journey to become world-class, and analyzing the situation in Mexico. Lean Manufacturing and Industry 4.0 were studied not as exclusive concepts, but as complementary ones. The methodological framework used is focused on motivating companies’ collaborators to guarantee common results, innovate, and remain in the market in the face of new requirements from company stakeholders. The key findings were that both trends emphasize the need to improve communication across the entire company and incorporate new technologies into everyday work, from the shop floor to administrative staff, to help improve processes. Taking care of people, activities and processes will bring a company success. In the specific case of Mexico, companies in all sectors need to be aware of and implement technological improvements according to their specific needs. Low-cost labor represents one of the most typical barriers. In conclusion, companies must build a roadmap according to their strategy and needs to achieve their short, medium- and long-term goals.

Keywords: lean management, lean manufacturing, industry 4.0, motivation, SWOT analysis, Hoshin Kanri

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Authors: M. Ahmadi, Sh. Damanabi, F. Sadoughi

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National Health Information System plays an important role in ensuring timely and reliable access to Health information which is essential for strategic and operational decisions that improve health, quality and effectiveness of health care. In other words, by using the National Health information system you can improve the quality of health data, information and knowledge used to support decision making at all levels and areas of the health sector. Since full identification of the components of this system for better planning and management influential factors of performance seems necessary, therefore, in this study, different attitudes towards components of this system are explored comparatively. Methods: This is a descriptive and comparative kind of study. The society includes printed and electronic documents containing components of the national health information system in three parts: input, process, and output. In this context, search for information using library resources and internet search were conducted and data analysis was expressed using comparative tables and qualitative data. Results: The findings showed that there are three different perspectives presenting the components of national health information system, Lippeveld, Sauerborn, and Bodart Model in 2000, Health Metrics Network (HMN) model from World Health Organization in 2008 and Gattini’s 2009 model. All three models outlined above in the input (resources and structure) require components of management and leadership, planning and design programs, supply of staff, software and hardware facilities, and equipment. In addition, in the ‘process’ section from three models, we pointed up the actions ensuring the quality of health information system and in output section, except Lippeveld Model, two other models consider information products, usage and distribution of information as components of the national health information system. Conclusion: The results showed that all the three models have had a brief discussion about the components of health information in input section. However, Lippeveld model has overlooked the components of national health information in process and output sections. Therefore, it seems that the health measurement model of network has a comprehensive presentation for the components of health system in all three sections-input, process, and output.

Keywords: National Health Information System, components of the NHIS, Lippeveld Model

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Authors: Ana Paola Echavarria, Mariuxi Medina, Haydelba D'Armas, Carmita Jaramillo, Diana San Martin

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The use of medicinal plants is one of the oldest and most extended medical therapies that goes back to prehistoric times, and nowadays, they are also used in the preparation of phytopharmaceuticals with options to cure diseases. The test for the determination of fungi was carried out in the Pharmacy Pilot Plant (treatment of the leaves of the plant species) and the Microbiology Laboratory (determination of fungi of the plant species, using growth medium called Sabouraud agar plus the vegetal sample), of the Academic Unit of Chemical Sciences and Health, of the Universidad Tecnica de Machala. Subsequently, colony counting was performed, both macroscopic, which is determined in the growth medium of the seeding, and microscopic, to identify the germinative forms using blue lactophenol. The procedure was repeated in duplicate to replicate the results data. The determination of the total fungal content of the following plant species was evaluated: Cymbopogon citratus (lemon verbena), Melissa officinalis (lemon balm), Taraxacum officinale (dandelion), Artemisia absinthium (absinthe), Piper carpunya (guaviduca), Moringa oleifera (moringa), Coriandrum sativum (coriander), Momordica charantia (achochilla), Borago officinalis (borage), Aloysia citriodora (cedron), Ambrosia artemisifolia (altamisa) and Ageratum conyzoides (mastrante). The results obtained showed that all the samples of the twelve plant species studied developed filamentous fungi, with great variability of them, within the permissible limits and contemplated by the Ecuadorian Institute of Normalization (INEN), being suitable as raw material for its use in the preparation of nutraceuticals and medicinal products or phytodrugs; with the exception of A. conyzoides (mastranto) which is the only species that exceeds the regulation in the average of dilutions.

Keywords: colonies, fungi, medicinal plants, microbiological quality, Sabouraud agar

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Authors: Hasanzadeh Tahraband F., Kheirkhah M.

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The trauma resulting from abortion causes fear, frustration, inability, lack of self-confidence, and psychological distress in women. The present study was conducted to determine the effect of midwifery counseling based on the Gamble approach on coping strategies of women with abortion. This randomized controlled clinical trial was conducted on women with abortions in April–October 2021, Karaj, Iran. Ninety-six eligible women were randomly assigned to two 48-member groups with 4, 6, and 8 blocks. The women in the intervention group participated in two 45-75-minute Gamble counseling programs. They were asked to fill out the demographic and fertility information questionnaire before the intervention and the cope operations preference inquiry questionnaire before, immediately (in the 4-6th week of the study), and three months after the intervention. The analysis of the data was done through Chi-square, independent sample t-test. The significance level was considered P<0.05. The results showed that the differences between the two groups before the intervention were not statistically significant in terms of demographic and fertility variables (P>0.05). However, the total mean score of the problem-focused dimension in 3-month post-abortion (97/34±8/69) and the emotion-focused dimension in 4-6 weeks and 3-month post-abortion (34/14±3/48 and 32/41±3/41) in the intervention group was significantly different from the control group (P<0.001). According to the results of the repeated measures ANOVA, the level of coping and its dimensions significantly changed in the intervention group over time (P<0.001). The results of the present study showed that Gamble counseling promoted the problem-focused dimension score and reduced the emotion-focused dimension score in women with abortion. It is recommended that Gamble counseling should be used as midwife-led counseling to increase coping strategies and reduce the psychological distress of women who have experienced abortion.

Keywords: midwife-led counseling, coping strategies, post-abortion, psychological distress, Iran

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Authors: Yu-Sheng Lin, Sheng-Teng Huang

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In recent years, the issue of corporate social responsibility has become an enthusiastic discussion and hottest issue around the world. To make the enterprises be sustainable management and sustainable development, more and more enterprises realize that fulfill its corporate social responsibility is the good choice. It is an essential, important issue that the leader needs know how to lead the staff in balance benefit, also emphasize on economic, social and environmental aspects to impact the company, then enhance the consensus. The leader needs to improve cohesion of personnel, and implement the corporate social responsibility in staff behavior, in order to show a performance in the effort of corporate social responsibility of enterprises. The previous literature mostly is committed to comparison of corporate social responsibility in the industry and service industry, regarding to literature of shipping companies were relatively rare. This paper aims to take the domestic and foreign shipping companies of corporate social responsibility reports as the data analysis, and refer to the international convention (GRI) such as association and organization of CSR standard values. Overall comparison with shipping companies of CSR reports, annual reports and other public information, and taking Taiwan shipping companies as the target, respectively, with the international conventions and the world's top ten leading shipping companies to do the comparison and analysis. Shipping companies in Taiwan are bound to the standard that set by the international convention for the first goal diligently and following step is contend with the world's top ten leading shipping companies. There are 3 ~ 5 experts to be involved in interview after the result is completed. They will indicate the superiority and inferiority then provide the opinion, recommendation in the needed action. Through this study, we can explore the importance of corporate social responsibility report for shipping companies, and also provide the clear orientation to external providers to improve corporate social responsibility. In addition, it can provide the academic research and business experts as a reference; finally, serving shipping companies to complete another contribution.

Keywords: Corporate social responsibility (CSR), CSR reports, statistical methods, expert interview method

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Authors: Arben Murtezani, Shefqet Mrasori, Vančo Spirov, Bukurije Rama, Oliver Dimitrovski, Visar Bunjaku

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Overview: Temporomandibular disorders (TMDs) are chronic musculoskeletal pain conditions. Clinical indicators of discomfort are related to the use of the joint stiffness during first motions after extended rest and restricted joint range of motion can cause substantial pain and disability. There is little evidence that physical therapy methods of management cause long-lasting reduction in signs and symptoms. Exercise programs premeditated to improve physical fitness have beneficial effects on chronic pain and disability of the musculoskeletal system. Objective: The aim of this study was to assess the effectiveness of physical therapy interventions in the management of temporomandibular disorders. Materials and Methods: A prospective comparative study with a 2-month follow-up period was conducted between April 2016 and June 2016 at the Physical Medicine and Rehabilitation Clinic in Prishtina. Forty six patients with TMDs, (more than three months duration of symptoms) were randomized into two groups: the TENS therapy group (n=24) and combination of active exercise and manual therapy group (n=22). The TENS therapy group patients were treated with twelve sessions of TENS. The treatment period of both groups was 3 weeks at an outpatient clinic. Following main outcome measures were evaluated: (1) pain at rest (2) pain at stress (3) impairment (4) mouth opening at base-line, before and after treatment and at 3 month follow-up. Results: Significant reduction in pain was observed in both treatment groups. In the TENS group 73% (16/22) achieved at least 80% improvement from baseline in TMJ pain at 2 months compared with 54% (13/24) in the exercise group (difference of 19%; 95% confidence interval 220 to 30%). Active and passive maximum mouth opening has been greater in the TENS group (p < 0.05). Conclusion: Exercise therapy in combination with TENS seems to be useful in the treatment of temporomandibular disorders.

Keywords: temporomandibular joint disorders, TENS, manual therapy, exercise

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Authors: Van Truong Pham

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Background: Self-management was described as a potential strategy for blood pressure control in patients with hypertension. However, the effects of self-management interventions on blood pressure, self-efficacy, medication adherence, and body mass index (BMI) in older adults with hypertension have not been systematically evaluated. We evaluated the effects of self-management interventions on systolic blood pressure (SBP) and diastolic blood pressure (DBP), self-efficacy, medication adherence, and BMI in hypertensive older adults. Methods: We followed the recommended guidelines of preferred reporting items for systematic reviews and meta-analyses. Searches in electronic databases including CINAHL, Cochrane Library, Embase, Ovid-Medline, PubMed, Scopus, Web of Science, and other sources were performed to include all relevant studies up to April 2019. Studies selection, data extraction, and quality assessment were performed by two reviewers independently. We summarized intervention effects as Hedges' g values and 95% confidence intervals (CI) using a random-effects model. Data were analyzed using Comprehensive Meta-Analysis software 2.0. Results: Twelve randomized controlled trials met our inclusion criteria. The results revealed that self-management interventions significantly improved blood pressure control, self-efficacy, medication adherence, whereas the effect of self-management on BMI was not significant in older adult patients with hypertension. The following Hedges' g (effect size) values were obtained: SBP, -0.34 (95% CI, -0.51 to -0.17, p < 0.001); DBP, -0.18 (95% CI, -0.30 to -0.05, p < 0.001); self-efficacy, 0.93 (95%CI, 0.50 to 1.36, p < 0.001); medication adherence, 1.72 (95%CI, 0.44 to 3.00, p=0.008); and BMI, -0.57 (95%CI, -1.62 to 0.48, p = 0.286). Conclusions: Self-management interventions significantly improved blood pressure control, self-efficacy, and medication adherence. However, the effects of self-management on obesity control were not supported by the evidence. Healthcare providers should implement self-management interventions to strengthen patients' role in managing their health care.

Keywords: self-management, meta-analysis, blood pressure control, self-efficacy, medication adherence, body mass index

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Authors: Zarina Othman, Bakri Mat, Aini Fatihah Roslam

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The Burmese ethnic known as Rohingya is one of the world’s most persecuted ethnic minorities on earth. They have been massacred, discriminated, humiliated, gang-raped, trafficked, abused and neglected. More than one million Rohingyas have been displaced internally and overseas. Currently, Rohingya asylum seekers can be found in India, Bangladesh, Thailand, Malaysia, and Indonesia. This forced migration is unacceptable since the Rohingya are stateless although they have been part of Myanmar for more than one century. Why the Rohingyas crisis is important to be analyse from human security perspectives? Understanding the human security of the Rohingya is important because the crisis may have implication on the regional stability in South and South-East Asia. The objectives of the research are to provide an explanation to the current human security situation in Myanmar, to analyse the regional implication of the Rohingya’s crisis and to recommend the workable solution that may help to reduce the tension. To analyze and demonstrate the case, the research has adopted the BAGHUS or Bangi Human Security Approach, a Southeast Asian human security model, designed to protect the weakest and the vital core of human life across national borders. Based on a qualitative research, and a review of literature from secondary sources of books, reports and academic journals, the research has conducted interviews with 1) Rohingya respondents in Cox’s Baza in February 2017; 2) experts and scholars in the field in Bangladesh, Myanmar and Malaysia. Preliminary findings suggest that conflicts lead to displacement and migration across borders, human insecurity is an issue where the implementation of human rights is too slow to take place even in sovereign state like Myanmar. The political and economic interests of many extraregional powers have further contributed to the current crisis. Human security perspectives is suggested as the workable solution for stability and peace in the region.

Keywords: human security, migration, Myanmar, regional security, Rohingya

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Authors: Mukhtar Raban

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As part of Nelson Mandela University’s journey of repositioning its learning and teaching agenda, the university adopted and foregrounded a humanizing pedagogy-aligning with institutional goals of critically transforming the academic project. The university established the Humanizing Pedagogy Praxis and Research Niche (HPPRN) as a centralized hub for coordinating institutional work exploring and advancing humanizing pedagogies and tasked the unit with developing and enacting a model for humanizing pedagogy exploration. This investigation endeavored to report on the development and enactment of a model that sought to institutionalize a humanizing pedagogy at a South African university. Having followed a qualitative approach, the investigation presents the case study of Nelson Mandela University’s HPPRN and the model it subsequently established and enacted for the advancement towards a more common institutional understanding, interpretation and application of the humanizing pedagogy. The study adopted an interpretive lens for analysis, complementing the qualitative approach of the investigation. The primary challenge that confronted the HPPRN was the development of a ‘living model’ that had to complement existing institutional initiatives while accommodating a renewed spirit of critical reflection, innovation and research of continued and new humanizing pedagogical exploration and applications. The study found that the explicit consideration of tenets of humanizing and critical pedagogies in underpinning and framing the HPPRN Model contributed to the sense of ‘lived’ humanizing pedagogy experiences during enactment. The multi-leveled inclusion of critical reflection in the development and enactment stages was found to further the processes of praxis employed at the university, which is integral to the advancement of humanizing and critical pedagogies. The development and implementation of a model that seeks to institutionalize the humanizing pedagogy at a university rely not only on sound theoretical conceptualization but also on the ‘richness of becoming more human’ explicitly expressed and encountered in praxes and application.

Keywords: humanizing pedagogy, critical pedagogy, institutional implementation, praxis

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Authors: Maria Pratt, Lynn Martin

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Context: In nursing education, clinical instructors are crucial in assessing and evaluating students' performance in clinical courses. However, instructors often struggle when assigning failing grades to students at risk of failing. Research Aim: This qualitative study aims to understand clinical instructors' experiences evaluating students with unsatisfactory performance, including how reflection and collegial support impact this evaluation process. Methodology, Data Collection, and Analysis Procedures: This study employs Gadamer's Hermeneutic Inquiry as the research methodology. A purposive maximum variation sampling technique was used to recruit eight clinical instructors from a collaborative undergraduate nursing program in Southwestern Ontario. Semi-structured, open-ended, and audio-taped interviews were conducted with the participants. The hermeneutic analysis was applied to interpret the interview data to allow for a thorough exploration and interpretation of the instructors' experiences evaluating failing students. Findings: The main findings of this qualitative research indicate that evaluating failing students was emotionally draining for the clinical instructors who experienced multiple challenges, uncertainties, and negative feelings associated with assigning failing grades. However, the analysis revealed that ongoing reflection and collegial support played a crucial role in mitigating the challenges they experienced. Conclusion: This study contributes to the theoretical understanding of nursing education by shedding light on clinical instructors' challenges in evaluating failing students. It emphasizes the emotional toll associated with this process and the role that reflection and collegial support play in alleviating those challenges. The findings underscore the need for ongoing professional development and support for instructors in nursing education. By understanding and addressing clinical instructors' experiences, nursing education programs can better equip them to effectively evaluate struggling students and provide the necessary support for their professional growth.

Keywords: clinical instructor, student evaluation, nursing, reflection, support

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Authors: Sara Cumming, Julianne DiSanto, Leah Burton

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Homelessness in Canada is a persistent problem. It has been widely argued that the best tactic for eradicating homelessness is to approach social issues from a Housing First perspective—an approach that centers on quickly moving people into permanent and independent housing and then providing them additional support and services as needed. It is recognized that life skills training is both necessary and an effective way to reduce cyclical homelessness; however, there is a scarcity of research on effective ways to teach life skills; this problem was exacerbated in a pandemic context, where in-person delivery was severely restricted or no longer possible. Very little attention has been paid to the diverse cultural needs of clients in a multicultural context and the need to foster cultural knowledge/awareness in individuals to successfully contribute to the cultural safety of communities. This research attempts to fill these gaps in the literature and in practice by employing a community-engaged research (CER) approach. Academic, government, funders, front-line staff, and clients at 15 not-for-profits from across the Greater Toronto Area in Ontario, Canada, collaborated to co-create a virtual, client-centric, equity, diversity, and inclusion (EDI) informed life skill learning management system. We employed a triangulation methodology for this research. An environmental scan was conducted for best practices. Two separate Creative Problem Solving Sessions were held with over 100 front-line workers, managers, and executive directors who work with homeless populations. Quantitative and open-ended surveys were completed by over 200 individuals with experience with homelessness. All sections of this research aimed to discover the areas of skills that individuals need to maintain housing and to ascertain what a more client-driven EDI approach to life skills training should include. This research will showcase which life skills are deemed essential for homeless and precariously housed individuals.

Keywords: homelessness, Housing First, life skills, community engaged research

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Authors: M. L. Seretlo-Rangata, T. Sodi, S. Govender

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Despite interventions by various governments to regulate water demand and address water scarcity, literature shows that billions of people across the world continue to struggle with access because not everyone contributes equally to conservation efforts. Behavioral factors such as individual and collective aspects of cognition and commitment have been found to play an important role in water conservation. The aim of the present study was to explore the perceptions of community members in the Lephalale area, Limpopo province, towards water conservation with a view to developing an explanatory psychological model on water conservation. Twenty (20) participants who relied on communal taps to access water in Lephalale Local Municipality, Limpopo province, were selected through purposeful sampling. In-depth, semi-structured, individual face-to-face interviews were used to gather data and were analyzed utilizing thematic content analysis (TCA). The research findings revealed that there are various psychological effects of water scarcity on communities, such as emotional distress, interpersonal conflicts and disruptions of daily activities of living. Additionally, the study results showed that the coping strategies developed by participants to deal with water scarcity included adopting alternative water use behaviors as well as adjusting current behaviors and lifestyles. Derived from the study findings, a psychological model of water conservation was developed. The model incorporates some ideas from the Value-Belief-Norm (VBN) theory and the Afrocentric theory. The model suggests that people’s worldviews, including their values, beliefs and culture, are significant determinants of their pro-environmental behaviors. The study concludes by recommending that authorities and policymakers should consider psychological factors when developing water management programs, strategies and interventions with the consultation of psychology experts.

Keywords: water conservation, psychological model, pro-environmental behaviour, conservation psychology, water-use behaviour

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Authors: Michel Foucault, Friedrich Nietzsche, Max More, Natasha Vita-More, Francesca Ferrando

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During the early part of his intellectual and academic career (1950s and 1960s), Michel Foucault developed an interest for what we can call the ‘anthropological question’, or how our modernity deals with human nature from an epistemological standpoint. The great originality of Foucault’s thought here lies in the fact that he approaches this question not from the perspective of this ‘sovereign subject’ (that has characterized the History of Western thought) he wishes to disclose and ‘denounce’, but rather at the level of discourses and the way they constitute who we are, so to speak. This led him, in turn, to formulate a series of though-provoking statements during his so-called ‘archaeological period’ of the 1960s concerning what we call ‘man’ in the West, such as that he is an ‘invention of recent date’ (as a proper object of concern and reflection), and, perhaps more importantly, that he might disappear in the near future, ‘like a face drawn in sand at the edge of the sea’. Foucault is following on the footsteps of Nietzsche in that regard, who had famously announced in the 19th ce. the ‘death of God’ and the need for the future generations to surpass (so to speak) the traditional ‘Christian-centred’ Western conception of the human. While Foucault exposed such insights more than half a century ago, they appear to be more actual than ever today with the development and rise in popularity of intellectual movements such as Transhumanism and Posthumanism, which seek to question and propose an alternative to the concepts of ‘man’ or ‘human nature’ in our culture. They rely for that on the same assumption as Foucault and Nietzsche that those concepts (and the meaning we attribute to them) have become ‘obsolete’ as it is and thus must be overcome (at a conceptual, but also a more practical level). Hence, those movements not only echo the important Foucauldian reflection of the 1950s and 1960s on the ‘anthropological question’ but seem to have been literally announced by it, so to speak. The aim of this paper will therefore be to show the relevance of Foucault (and in particular his archaeological method) in understanding the nature of Transhumanism (and Posthumanism), for instance, by analysing and assessing it as a form of discourse that is literally reshaping the way we understand ourselves as human beings in our (post)modern age, drawing for that on a number of key texts including from the early productions of Foucault.

Keywords: foucault, nietzsche, archaeology, transhumanism, posthumanism

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Authors: Smriti Pahwa, Karishma Vats, Aditi Macwan, Jija Dutt, Sumukhi Vaid

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Age approporiate complementary feeding has been stressed upon for sound young child nutrition and appropriate growth. National Infant and Young Child Feeding guidelines, policies and programs indicate cognizance of the issue taken by the country’s government, policy makers and technical experts. However, it is important that ordinary people, the caregivers of young children too understand the importance of appropriate feeding. For this, an interface might be required where ordinary people could participate in assessing the gaps in IYCF as a first step to take subsequent action. In this context an attempt was made to extrapolate a citizen led learning level survey that has been involving around 25000 ordinary citizens to reach out to 600,000 children annually for over a decade in India. Based on this philosophy of involving ordinary people in simple assessments to produce understandable actionable evidence, a rapid diet assessment tool was developed and collected from caregivers of 90 < 3year children from two urban clusters in Ahmedabad and Baroda, Gujarat. Target sample for pilot was selected after cluster census. Around half the mothers reported that they had not yet introduced water or other fluids to their < 6 month babies. However, about a third were already feeding them food other than mother’s milk. Although complementary feeding was initiated in almost all (95%) children more than 6 months old, frequency was suboptimal in 60%; in 80% cases no measure was taken to either improve energy or nutrient density; only 33% were fed protective foods; Green Leafy Vegetables consumption was negligible (1.4%). Anganwadi food was not consumed. By engaging ordinary people to generate evidence and understand the gaps, such assessments have the potential to be used to generate useful evidence for action at scale as well as locally.

Keywords: citizen led, grass root engagement, IYCF (Infant and Young Child Feeding), rapid diet assessment, under nutrition

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Authors: Elissar Mansour, Emily Chen, Tracee Fernandez, Mariam Basheti, Christopher Gordon, Bandana Saini

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Sleep is an essential process for the maintenance of several neurobiological processes such as memory consolidation, mood, and metabolic processes. It is known that sleep patterns vary with age and is affected by multiple factors. While non-pharmacological strategies are generally considered first-line, sedatives are excessively used in the older population. This study aimed to explore the management of sleep in residential aged care facilities (RACFs) by nurse professionals and to identify the key factors that impact provision of optimal sleep health care. An inductive thematic qualitative research method was employed to analyse the data collected from semi-structured interviews with registered nurses working in RACF. Seventeen interviews were conducted, and the data yielded three themes: 1) the nurses’ observations and knowledge of sleep health, 2) the strategies employed in RACF for the management of sleep disturbances, 3) the organizational barriers to evidence-based sleep health management. Nurse participants reported the use of both non-pharmacological and pharmacological interventions. Sedatives were commonly prescribed due to their fast action and accessibility despite the guidelines indicating their use in later stages. Although benzodiazepines are known for their many side effects, such as drowsiness and oversedation, temazepam was the most commonly administered drug. Sleep in RACF was affected by several factors such as aging and comorbidities (e.g., dementia, pain, anxiety). However, the were also many modifiable factors that negatively impacted sleep management in RACF. These include staffing ratios, nursing duties, medication side effects, and lack of training and involvement of allied health professionals. This study highlighted the importance of involving a multidisciplinary team and the urge to develop guidelines and training programs for healthcare professionals to improve sleep health management in RACF.

Keywords: registered nurses, residential aged care facilities, sedative use, sleep

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Authors: Hepinda Fajari Nuharini, Sugiarti A. Musabiq

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Background: Various and continuous pressures that exceed individual resources can cause first-year undergraduate college students to experience psychological distress. Psychological distress can occur when individuals use rumination as cognitive coping strategies. Rumination is one of the cognitive coping strategies that can be used by individuals to respond to psychological distress that causes individuals to think about the causes and consequences of events that have occurred. Rumination had two subtypes, such as brooding and reflective. Therefore, the purpose of this study was determining the role of brooding and reflective as subtypes of rumination toward psychological distress in University of Indonesia first-year undergraduate students. Methods: Participants of this study were 403 University of Indonesia first-year undergraduate students aged between 18 and 21 years old. Psychological distress measured using self reporting questionnaire (SRQ-20) and brooding and reflective as subtypes of rumination measured using Ruminative Response Scale - Short Version (RRS - Short Version). Results: Binary logistic regression analyses showed that 22.8% of the variation in psychological distress could be explained by the brooding and reflective as subtypes of rumination, while 77.2% of the variation in psychological distress could be explained by other factors (Nagelkerke R² = 0,228). The results of the binary logistic regression analysis also showed rumination subtype brooding is a significant predictor of psychological distress (b = 0,306; p < 0.05), whereas rumination subtype reflective is not a significant predictor of psychological distress (b = 0,073; p > 0.05). Conclusion: The findings of this study showed a positive relationship between brooding and psychological distress indicates that a higher level of brooding will predict higher psychological distress. Meanwhile, a negative relationship between reflective and psychological distress indicates a higher level of reflective will predict lower psychological distress in University of Indonesia first-year undergraduate students. Added Values: The psychological distress among first-year undergraduate students would then have an impact on student academic performance. Therefore, the results of this study can be used as a reference for making preventive action to reduce the percentage and impact of psychological distress among first-year undergraduate students.

Keywords: brooding as subtypes of rumination, first-year undergraduate students, psychological distress, reflective as subtypes of rumination

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Authors: Aico Nogueira

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This paper examines the interinstitutional dialogues within the Brazilian federal structures, which comprises federal, state and local levels, around the themes of new approaches and interventions aimed to promote sustainable rural development, particularly rural development as part of a territorial approach. The work seeks to understand to what extent the various levels of the state interact with these strategies, particularly with the locally constituted powers, focusing on the importance of the transition of traditional agriculture methods to more sustainable agroecological systems and its effects on food security and sustainable rural development. The research analyses as case studies the Sustainable Rural Territories Development Program (PRONAT) of the Ministry of Agrarian Development at the federal level, as well as the State of São Paulo and the Vale do Ribeira Territory, an area characterized by environmental and social vulnerability, restrictive environmental laws and attempts to promote sustainable development. In order to examine how the interrelationships between different levels of governance and civil society, in addition to the neo-institutionalist polity centered literature, the research uses an adaptation of the concept of arena in Ostrom and Hannigan, produced at different scales of decision-making processes, as well as the multilevel governance literature. Document analysis, interviews, focus groups and direct observation techniques are also used. The main findings of this study are that how different levels of governance understand and organize themselves for this work and have a direct impact on the actions taken. Consequently, programs formulated for this purpose are not associated with the creation of institutions capable of breaking with a traditional sectoral view that has historically prevailed in policymaking. And the transition from traditional agriculture to agroecological production systems is hampered by a sectorial foundation, based on large-scale production and the strengthening of the traditional country's land concentration model.

Keywords: agroecology, food security, inter-institutional dialogue, rural poverty, sustainable rural development, territorial development

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Authors: Damilola Mofikoya

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Developed countries account for a large proportion of greenhouse gas emissions. In the last decade, countries including the United States and China have made a commitment to cut down carbon emissions by signing the Paris Climate Agreement. However, carbon neutrality is a challenging issue to tackle at the country level because of the scale of the problem. To overcome this challenge, cities are at the forefront of these efforts. Many cities in the United States are taking strategic actions and proposing programs and initiatives focused on renewable energy, green transportation, less use of fossil fuel vehicles, etc. There have been concerns about the implications of those strategies and a lack of community engagement. This paper is focused on community-based efforts that help actualize the reduction of carbon footprint through sustained and inclusive action. Existing zero-carbon assessment tools are examined to understand variables and indicators associated with the zero-carbon goals. Based on a broad, systematic review of literature on community strategies, and existing zero-carbon assessment tools, a dashboard was developed to help simplify and demystify carbon neutrality goals at a community level. The literature was able to shed light on the key contributing factors responsible for the success of community efforts in carbon neutrality. Stakeholder education is discussed as one of the strategies to help communities take action and generate momentum. The community-based efforts involving individuals and residents, such as reduction of food wastages, shopping preferences, transit mode choices, and healthy diets, play an important role in the context of zero-carbon initiatives. The proposed community-based dashboard will emphasize the importance of sustained, structured, and collective efforts at a communal scale. Finally, the present study discusses the relationship between life expectancy and quality of life and how it affects carbon neutrality in communities.

Keywords: carbon footprint, communities, life expectancy, quality of life

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Authors: Jana Vermaas, Carien Denner

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Waste has become a global issue and the management regarding it a priority. Some of the main problems in South Africa (SA) include: (1) the lack of information and education, (2) waste collection services, (3) reusing and recycling is not encouraged, (4) illegal dumping, and the biggest problem of all (5) the lack of waste related regulations and enforcement by the government and municipalities. In SA, there are provinces such as Gauteng and the Western Cape that have some recycling programs in place, but nothing yet in the central part of the country. By identifying the barriers preventing these businesses from recycling, the local municipalities and recycling services could create a solution. Owners or employees of eateries and bars completed a self-administered questionnaire. Information were obtained on knowledge of recycling, participation in recycling and to which extent, barriers that prevent them from recycling and motives that would encourage recycling. The data obtained from the questionnaire indicated that most (98%) participants knew only the basics, that recycling is a process of converting waste materials into new materials and objects. Further knowledge questions indicated that individuals were not educated about recycling as almost half (49%) of the participants believe that they can’t reuse plastic bottles. They do not understand which items of their waste could be re-used or recycled. They had limited knowledge about the recycling opportunities or practices in the area. Only a small number (34%) were involved in recycling or sustainable practices. Many did not even know of any collection services or buy-back centres in their vicinity. Most of the participants (94%) indicated that they would be willing to recycle if it would have a financial benefit. Many also stated that they would be more willing to recycle if the recyclable waste will be collected from their establishment, on a regular basis. The enforcement of recycling by municipalities or government by awarding fines for waste offenders was indicated as a significant motive. It could be concluded that the most significant barrier is knowledge and lack of information. These businesses do not comprehend the impact that they can have with their recycling contributions, not only on the environment, but also on the consumers that they serve. Another barrier is the lack of collection services. There are currently no government or municipal services for the collection of recyclable waste. All waste are taken to landfills. Many of the larger recycling initiatives and companies do not reach as far as central SA. Therefore, the buy-back component of recycling is not present.

Keywords: eateries, recycling, sustainable practices, waste

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Authors: Noemia Bessa Vilela, Jose Caramelo Gomes

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All law student are familiarized, in the first years of their bachelor of laws with the concepts of “public goods” and “ private goods”; often, such legal concept does not exactly match such economic concept, and there are consequences are some sort of confusion being created. The list of goods that follow under each category is not exhaustive, nor are students given proper mechanisms to acknowledge that some legal fields can, on its own, be considered as a “public good”; this is the case of Competition. Legal authors consider that “competition law is used to promote public interest” and, as such, it is a “public good”; in economics theory, Competition is the first public good in a market economy, as the enabler of allocation efficiency. Competition law is the legal tool to support the proper functioning of the market economy and democracy itself. It is fact that Competition Law only applies to economic activities, still, competition is object of private litigation as an integral part of Public Law. Still, regardless of the importance of Competition Law in the economic activity and market regulation, most student complete their studies in law, join the Bar Associations and engage in their professional activities never having been given sufficient tools to deal with the increasing demands of a globalized world. The lack of knowledge of economics, market functioning and the mechanisms at their reach in order to ensure proper realization of their duties as lawyers/ attorneys-at-law would be tackled if Competition Law would be included as part of the curricula of Law Schools. Proper teaching of Competition Law would combine the foundations of Competition Law, doctrine, case solving and Case Law study. Students should to understand and apply the analytical model. Special emphasis should be given to EU Competition Law, namely the TFEU Articles 101 to 106. Damages Directive should also be part of the curriculum. Students must in the first place acquire and master the economic rationale as competition and the world of competition law are the cornerstone of sound and efficient market. The teaching of Competition Law in undergraduate programs in Law would contribute to fulfill the potential of the students who will deal with matters related to consumer protection, economic and commercial law issues both in private practice and as in-house lawyers for companies.

Keywords: higher education, competition law, legal education, law, market economy, industrial economics

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Authors: Yung Yau

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'Little people' are those who have extremely short stature as they suffer from rare bone diseases. They are commonly known as 'dwarves' or 'people with dwarfism'. Dwarfism is generally regarded as a type of rare disease for its extremely small odds (~1 in 15,000). On account of its rarity, dwarfism, unlike other types of disability, has attracted relatively little attention from the general public and in various academic fields (e.g. architecture, psychology and sociology) except medical science. In view of the extant research gaps, this study aims to investigate the physical barriers facing the little people in the built environment in Hong Kong. Between November 2017 and July 2018, ten little people or their family members participated in in-depth interviews. Responses of the interviewees were transcribed (i.e., speech being converted to text word for word). Interview data were then analyzed using the interpretative phenomenological analysis methodology developed by J. Smith and others in 2009. The findings of the project reveal that although Hong Kong's built environment has been designed barrier-free pursuant to the prevailing building standards, those standards do not cater to the special anthropometric characteristics of little people. As a result, little people face a lot of challenges when using built facilities. For example, most water closets, urinals, and wash hand basins are not fit for little people's use. As indicated by the project findings, we are still far away from providing a discrimination-free and barrier-free living environment for the little people in Hong Kong. To make Hong Kong society more inclusive to the little people, there is a need for further tailored building design. A set of building design principles for better inclusion of the little people in our society are highlighted. These principles include 'the building design should accommodate individuals with different heights' and 'the building design should allow individuals to use comfortably and efficiently with a minimum of fatigue'. At the end of the paper, the author also calls for an agenda for further studies. For instance, we need an anthropometric study on little people for developing practical building design guidelines.

Keywords: dwarfism, little people, inclusive buildings, people with disabilities, social sustainability

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Authors: Ahmed Chouari

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Although research methods has been an integral part of the curriculum in Moroccan higher education for decades, it seems that the research methods teaching pedagogy that teachers use suffers from a serious absence of a body of literature in the field. Also, the various challenges that both teachers and students of research methods face have received little interest by researchers in comparison to other fields such as applied linguistics. Therefore, the main aim of this study is to remedy to this situation by exploring one of the major issues in teaching research methods – that is, the phenomenon of students’ dissatisfaction with the research methods course in higher education in Morocco. The aim is also to understand students’ attitudes and perceptions on how to make the research methods course more effective in the future. Three qualitative research questions were used: (1) To what extent are graduate students satisfied with the pedagogies used by the teachers of the research methods course in Moroccan higher education? (2) To what extent are graduate students satisfied with the approach used in assessing research methods in Moroccan higher education? (3) What are students’ perceptions on how to make the research methods course more effective in Moroccan higher education? In this study, a qualitative content analysis was adopted to analyze students’ views and perspectives about the major factors behind their dissatisfaction with the course at the School of Arts and Humanities – University of Moulay Ismail. A semi-structured interview was used to collect data from 14 respondents from two different Master programs. The results show that there is a general consensus among the respondents about the major factors behind the ineffectiveness of the course. These factors include theory-practice gap, heavy reliance on theoretical knowledge at the expense of procedural knowledge, and ineffectiveness of some teachers. The findings also reveal that teaching research methods in Morocco requires more time, better equipment, and more competent teachers. Above all, the findings indicate that today there is an urgent need in Morocco to shift from teacher-centered approaches to learner-centered approaches in teaching the research methods course. These findings, thus, contribute to the existing literature by unraveling the factors that impede the learning process, and by suggesting a set of strategies that can make course more effective.

Keywords: competencies, learner-centered teaching, research methods, student autonomy, pedagogy

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Authors: S. AlBustan, B. AlGhannam

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This oral presentation discusses a proposal for a study that evaluates the usability of an evidence based application named ProxTalker App. The significance of this study will inform administration and faculty staff at the Department of Communication Sciences Disorders (CDS), College of Life Sciences, Kuwait University whether the app is a suitable tool to use for CDS students. A case study will be used involving a sample of CDS students taking practicum and internship courses during the academic year 2018/2019. The study will follow a process used by previous study. The process of calculating SUS is well documented and will be followed. ProxTalker App is an alternative and augmentative tool that speech language pathologist (SLP) can use to customize boards for their clients. SLPs can customize different boards using this app for various activities. A board can be created by the SLP to improve and support receptive and expressive language. Using technology to support therapy can aid SLPs to integrate this ProxTalker App as part of their clients therapy. Supported tools, games and motivation are some advantages of incorporating apps during therapy sessions. A quantitative methodology will be used. It involves the utilization of a standard tool that was the was adapted to the Arabic language to accommodate native Arabic language users. The tool that will be utilized in this research is the Arabic Standard Usability Scale (A-SUS) questionnaire which is an adoption of System Usability Scale (SUS). Standard usability questionnaires are reliable, valid and their process is properly documented. This study builds upon the development of A-SUS, which is a psychometrically evaluated questionnaire that targets Arabic native speakers. Results of the usability will give preliminary indication of whether the ProxTalker App under investigation is appropriate to be integrated within the practicum and internship curriculum of CDS. The results of this study will inform the CDS department of this specific app is an appropriate tool to be used for our specific students within our environment because usability depends on the product, environment, and users.

Keywords: A-SUS, communication disorders practicum, evidence based app, Standard Usability Scale

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Authors: Francisco Domingos Francisco

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Tropical forests are key providers of many Ecosystem Services (ES), contributing to human wellbeing on a global and local scale. Communities around and within Moribane Forest Reserve (MFR), Manica Province - Mozambique, benefit from ES through the exploitation of non-wood and wood forest products. The objective was to assess the provisioning capacity of the MFR in woody forest products in species and profiles of interest to local communities in the main sources of extraction. Social data relating to the basic needs of local communities for these products were captured through an exploratory study before this one. From that study, it became known about the most collected wood species, the sources of collection, and their availability in the profiles of greatest interest to them. A field survey through 39 rectangular 50mx20m plots was conducted with 13 plots established in each of the three land-use types (LUT), namely Restricted Forest, Unrestricted Forest, and Disturbed areas. The results show that 89 species were identified, of which 28 (31.4%) are assumed to be the most used by the communities. The number of species of local interest does not vary across the LUT (p>0.05). The most used species (MUS) is distributed in 82% in Restricted Forest, 75% in Unrestricted, and also 75% in Disturbed. Most individuals of both general and MUS found in Unrestricted Forest, and Degraded areas have lower end profiles (5-7 cm), representing 0.77 and 0.26%, respectively. The profile of individuals of species of local interest varies by LUT (p<0.05), and their greatest proportion (0.51%) outside the lower end is found in Restricted Forest. There were no similarities between the LUT for the species in general (JCI <0.5) but between the MUS (JCI >0.5). Conclusion, the areas authorized for the exploitation of wood forest products in the MFR tend to reduce their ability to provide local communities with forest products in species and profiles of their interest. This reduction item is a serious threat to the biodiversity of the Restricted Forest. The study can help the academic community in future studies by replicating the methodology used for monitoring purposes or conducting studies in other similar areas, and the results may support decision-makers in designing better strategies for sustainability.

Keywords: ecosystem services, land-use types, local communities, species profile, wellbeing, wood forest product

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Authors: Virginia Chambers, Kamryn York, Mark Marnich

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T.I.M.E. for STEM (Transforming Integrative Maker Education for STEM learning) focuses on improving the quality and effectiveness of STEM education for pre-service teachers through a focus on the integration of maker space pedagogy. This National Science Foundation-funded project primarily focuses on undergraduate pre-service teaching students majoring in elementary education. The study contributes to the knowledge about teaching and learning by developing, implementing, and assessing faculty development, interactive instruction, and STEM lesson plan development. This project offers a valuable opportunity to improve STEM thinking skills by formally integrating STEM concepts throughout the pre-service teacher curriculum using an interdisciplinary approach. T.I.M.E. for STEM utilizes a maker space laboratory at Point Park University in Pittsburgh, PA, USA. However, the project design is such that other institutions of higher education can replicate the program with or without a physical maker space lab as the project’s findings and “maker mindset” are employed. Utilizing qualitative research methodology, the project investigates the following research question: What do pre-service teachers (education students) and faculty members identify as areas of pedagogical growth in STEM learning and teaching in a makerspace environment? This research highlights the impact of makerspace pedagogy on improving STEM education learning outcomes through an interdisciplinary constructivist approach. The project is expected to have a multiplier effect as it impacts STEM disciplinary and higher education faculty, pre-service teachers, and teacher preparation programs at other universities that benefit from what is learned at Point Park University. Ultimately, the future elementary students of the well-prepared pre-service teachers steeped in maker pedagogy and STEM content will have the potential to develop higher-level thinking skills and improve their mathematics and scientific achievement, which are essential for the 21st century STEM workforce.

Keywords: maker education, STEM learning, teacher education, elementary education

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Authors: Tahmina Huq

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Action research equips teachers with the skills needed to work on a particular situation in their classroom. This paper aims to introduce a strategy, visual dialogue between student and teacher, used by the researcher to help autistic students with intellectual disabilities to regulate their immediate emotions to achieve their academic goals. This research has been conducted to determine whether teaching self-regulation strategies can be effective instead of segregating them. The researcher has identified that visual dialogue between the student and teacher is a helpful technique for teaching self-regulation. For this particular research, action research suits the purpose as the findings can be applied immediately in the classroom. Like many autistic students, the teacher had two 15 years old autistic students with intellectual disabilities in class who had difficulty in controlling their emotions and impulses. They expressed their emotions through aggressive behavior, such as shouting, screaming, biting teachers or any adult who was in their sight, and destroying school property. They needed two to four hours to recover from their meltdowns with the help of a psychologist. The students missed the classes as they were often isolated from the classroom and stayed in the calming room until they calmed down. This negatively affected their learning. Therefore, the researcher decided to implement a self-regulation strategy, a visual dialogue between students and teachers, instead of isolating them to recover from the meltdown. The data was collected through personal observations, a log sheet, personal reflections, and pictures. The result shows that the students can regulate their emotions shortly in the classroom (15 to 30 minutes). Through visual dialogue, they can express their feelings and needs in socially appropriate ways. The finding indicates that autistic students can regulate their emotions through visual dialogues and participate in activities by staying in the classroom. Thus it positively impacted their learning and social lives. In this paper, the researcher discussed the findings of exploring how teachers can successfully implement a self-regulation strategy for autistic students in classroom settings. The action research describes the strategy that has been found effective for managing the emotions of autistic students with intellectual disabilities.

Keywords: action research, self-regulation, autism, visual communication

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Authors: Nino KItoshvili

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The family is an integral part of society, which plays a major role in the socialization and the formation of a person as a full member of society. The marital conflict even harms family members and finds a different effect on each member of the family, especially on children. There is a significant difference in the behavior of adolescents in conflict and non-conflict families. In times of marital conflict, adolescent psycho-social well-being is significantly dependent on socio-cultural mediating variables such as; Family income; Parenting style; The functioning of the family, and the existence of psycho-social support. In a family with low economic performance, low psychosocial harassment, family dysfunction, and bad parenting style, marital conflict significantly increases the risk of deteriorating adolescent psycho-social well-being. At this time, to support the well-being of the child, a special role is played by improving the marital relationship, which must be supported by state and community services. There are very few family studies in this field in Georgia, the therapeutic direction of the family is at an early stage, and there are no family-supporting psycho-social programs. This increases the chances of adolescent psycho-social well-being deteriorating amd socialization problems. The study will examine the mediating variables of marital conflict and adolescent psycho-social well-being and will attempt to determine their mediating and moderating role. Research suggests that an increase in the rate of marital conflict is associated with a decrease in child well-being. The well-being of children in conflict families is lower than that of children in non-conflict families and depends on the variables of mediating variables. Quantitative research will be conducted to study this phenomenon through a questionnaire developed and standardized in the research process. The study will be attended by families living in Georgia - spouses (married) and their adolescent children. By analyzing the data obtained from the research, we will be able to determine in which cases the intensity of the relationship between the marital conflict and the well-being of the adolescent increases or decreases; To conclude the mediating and moderating role of mediating variables and also to make relevant recommendations to reduce the negative impact on the psycho-social well-being of a child of marital conflict.

Keywords: adolescent, mediation, moderation, conflict, couple, well-being

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Authors: Preet Gill, Danus Ravindran

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These The COVID-19 pandemic resulted in widespread implications for medical specialist training programs worldwide, including radiology. The objective of this study was to investigate the impact of COVID-19 on the Australian and New Zealand radiology trainee experience and well-being, as well as to compare the Australasian experience with that reported by other countries. An anonymised electronic online questionnaire was disseminated to all training members of the Royal Australian and New Zealand College of Radiologists who were radiology trainees during the 2020 – 2022 clinical years. Trainees were questioned about their experience from the beginning of the COVID-19 pandemic in Australasia (March 2020) to the time of survey completion. Participation was voluntary. Questions assessed the impact of the pandemic across multiple domains, including workload (inpatient/outpatient & individual modality volume), teaching, supervision, external learning opportunities, redeployment and trainee wellbeing. Survey responses were collated and compared with other peer reviewed publications. Answer options were primarily in categorical format (nominal and ordinal subtypes, as appropriate). An opportunity to provide free text answers to a minority of questions was provided. While our results mirror that of other countries, which demonstrated reduced case exposure and increased remote teaching and supervision, responses showed variation in the methods utilised by training sites during the height of the pandemic. A significant number of trainees were affected by examination cancellations/postponements and had subspecialty training rotations postponed. The majority of trainees felt that the pandemic had a negative effect on their training. In conclusion, the COVID-19 pandemic has had a significant impact on radiology trainees across Australia and New Zealand. The present study has highlighted the extent of these effects, with most aspects of training impacted. Opportunities exist to utilise this information to create robust workplace strategies to mitigate these negative effects should the need arise in the future.

Keywords: COVID-19, radiology, training, pandemic

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Authors: Mohammad Ranjbar, Mohammad Bazyar, Blake Angell, Thomas Lung, Yibeltal Assefa

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Background: Current health insurance programs in Iran suffer from low enrolment and are not sufficient to attain the country to universal health coverage (UHC). We hypothesize that improving the enrollment rate and moving towards a more sustainable UHC can be achieved by improving the benefits package and providing new incentives. The objective of this study is to assess public preferences and willingness to pay (WTP) for social health insurance (SHI) in Iran. Methods: A discrete choice experiment (DCE) was conducted in 2021, using a self-administered questionnaire on 500 participants to estimate WTP and determine individual preferences for the SHI in Yazd, Iran. Respondents were presented with an eight-choice set and asked to select their preferred one. In each choice set, scenarios were described by eight attributes with varying levels. The conditional logit regression model was used to analyze the participants' preferences. Willingness to pay for each attribute was also calculated. Results: Most included attributes were significant predictors of the choice of a health insurance package. The maximum coverage of hospitalization costs in the private sector, ancillary services such as glasses, canes, etc., as well as coverage for hospitalization costs in the public sector and drug costs, were the most important determining factors for this choice. Coverage of preventive dental care did not significantly influence respondent choices. Estimating WTP showed that individuals are willing to pay more for higher financial protection, particularly against private sector costs; the WTP to increase the coverage of hospitalization costs in the private sector from 50% to 90% is estimated at 362,068 IR, Rials per month. Conclusion: This study identifies the key factors that the population value with regard to health insurance and the tradeoffs they are willing to make between them. Hospitalization, drugs, and ancillary services were the most important determining factors for their choice. The data suggest that additional resources coming into the Iranian health system might best be prioritized to cover hospitalization and drug costs and those associated with ancillary services.

Keywords: social health insurance, preferences, discrete choice experiment, willingness to pay

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Authors: Saeed M. Alshahrani

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This research integrated blockchain technology to reform medical records management in healthcare informatics. It was aimed at resolving the limitations of centralized systems by establishing a secure, decentralized, and user-centric platform. The system was architected with a sophisticated three-tiered structure, integrating advanced cryptographic methodologies, consensus algorithms, and the Fast Healthcare Interoperability Resources (HL7 FHIR) standard to ensure data security, transaction validity, and semantic interoperability. The research has profound implications for healthcare delivery, patient care, legal compliance, operational efficiency, and academic advancements in blockchain technology and healthcare IT sectors. The methodology adapted in this research comprises of Preliminary Feasibility Study, Literature Review, Design and Development, Cryptographic Algorithm Integration, Modeling the data and testing the system. The research employed a permissioned blockchain with a Practical Byzantine Fault Tolerance (PBFT) consensus algorithm and Ethereum-based smart contracts. It integrated advanced cryptographic algorithms, role-based access control, multi-factor authentication, and RESTful APIs to ensure security, regulate access, authenticate user identities, and facilitate seamless data exchange between the blockchain and legacy healthcare systems. The research contributed to the development of a secure, interoperable, and decentralized system for managing medical records, addressing the limitations of the centralized systems that were in place. Future work will delve into optimizing the system further, exploring additional blockchain use cases in healthcare, and expanding the adoption of the system globally, contributing to the evolution of global healthcare practices and policies.

Keywords: healthcare informatics, blockchain, medical records management, decentralized architecture, data security, cryptographic algorithms

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