Search results for: Stuart Gibson
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 84

Search results for: Stuart Gibson

54 A Randomised, Single-Dose, Two-Period, Cross-Over Phase I Pharmacokinetic Study to Compare TDS®-Diazepam with Rectal Diazepam in Healthy Adult Subjects

Authors: Faisal O. Al-Otaibi, Arthur T. Tucker, Richard M. Langford, Stuart Ratcliffe, Atholl Johnston, Terry D. Lee, Kenneth B. Kirby, Chandan A. Alam

Abstract:

The Transdermal Delivery System (TDS®) is a proprietary liquid formulation that can be applied to intact skin via a metered pump spray to facilitate drug delivery to the circulation. The aim of this study was to assess the ability of the TDS preparation to deliver diazepam systemically, and to characterize the pharmacokinetic profile of the drug in healthy adult subjects. We conducted a randomized, single-dose, two-period, crossover phase I (pharmacokinetic) comparative study in twelve healthy volunteers. All volunteers received both 10 mg TDS-diazepam topically to the upper chest and 10 mg of the rectal diazepam preparation (Diastat®, 10 mg diazepam gel), with a minimum washout of 14 days between dosing episodes. Both formulations were well tolerated in all volunteers. Following topical application of TDS-diazepam, the mean AUC0-72h was 1241 ng/mL.h and the Cmax 34 ng/mL. The values for rectal Diastat were 4109 ng/mL.h and 300 ng/mL respectively. This proof of concept study demonstrates that the TDS preparation successfully delivered diazepam systemically to adults. As expected, the concentration of diazepam following the TDS application was lower and not bioequivalent to rectal gel. Future development of this unique system is required.

Keywords: transdermal delivery system, diazepam, seizure, bioequivalence, pharmacokinetic

Procedia PDF Downloads 422
53 On the Role of Cutting Conditions on Surface Roughness in High-Speed Thread Milling of Brass C3600

Authors: Amir Mahyar Khorasani, Ian Gibson, Moshe Goldberg, Mohammad Masoud Movahedi, Guy Littlefair

Abstract:

One of the important factors in manufacturing processes especially machining operations is surface quality. Improving this parameter results in improving fatigue strength, corrosion resistance, creep life and surface friction. The reliability and clearance of removable joints such as thread and nuts are highly related to the surface roughness. In this work, the effect of different cutting parameters such as cutting fluid pressure, feed rate and cutting speed on the surface quality of the crest of thread in the high-speed milling of Brass C3600 have been determined. Two popular neural networks containing MLP and RBF coupling with Taguchi L32 have been used to model surface roughness which was shown to be highly adept for such tasks. The contribution of this work is modelling surface roughness on the crest of the thread by using precise profilometer with nanoscale resolution. Experimental tests have been carried out for validation and approved suitable accuracy of the proposed model. Also analysing the interaction of parameters two by two showed that the most effective cutting parameter on the surface value is feed rate followed by cutting speed and cutting fluid pressure.

Keywords: artificial neural networks, cutting conditions, high-speed machining, surface roughness, thread milling

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52 Atlantic Sailfish (Istiophorus albicans) Distribution off the East Coast of Florida from 2003 to 2018 in Response to Sea Surface Temperature

Authors: Meredith M. Pratt

Abstract:

The Atlantic sailfish (Istiophorus albicans) ranges from 40°N to 40°S in the Western Atlantic Ocean and has great economic and recreational value for sport fishers. Off the eastern coast of Florida, charter boats often target this species. Stuart, Florida, bills itself as the sailfish capital of the world. Sailfish tag data from The Billfish Foundation and NOAA was used to determine the relationship between sea surface temperature (SST) and the distribution of Atlantic sailfish caught and released over a fifteen-year period (2003 to 2018). Tagging information was collected from local sports fishermen in Florida. Using the time and location of each landed sailfish, a satellite-derived SST value was obtained for each point. The purpose of this study was to determine if sea surface warming was associated with changes in sailfish distribution. On average, sailfish were caught at 26.16 ± 1.70°C (x̄ ± s.d.) over the fifteen-year period. The most sailfish catches occurred at temperatures ranging from 25.2°C to 25.5°C. Over the fifteen-year period, sailfish catches decreased at lower temperatures (~23°C and ~24°C) and at 31°C. At ~25°C and ~30°C there was no change in catch numbers of sailfish. From 26°C to 29°C, there was an increase in the number of sailfish. Based on these results, increasing ocean temperatures will have an impact on the distribution and habitat utilization of sailfish. Warming sea surface temperatures create a need for more policy and regulation to protect the Atlantic sailfish and related highly migratory billfish species.

Keywords: atlantic sailfish, Billfish, istiophorus albicans, sea surface temperature

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51 Informing Lighting Designs Through a Comprehensive Review of Light Pollution Impacts

Authors: Stephen M. Simmons, Stuart W. Baur, William L. Gillis

Abstract:

In recent years, increasing concern has been shown towards the issue of light pollution, especially with the spread of brighter, more blue-rich LED bulbs. Much research has been conducted in order to study the effects of artificial light at night, and many adverse impacts have been discovered, such as circadian disruption, degradation of the night sky, and interference oftheprocesses and behaviors of plants and animals. Despite a plethora of informationin the literature regarding the numerous illeffects of this type of pollution, there does not appear to be a complete summary of these impacts, including their magnitudes, which would facilitate the balancing of risks and benefits in the design of an exterior lighting system. This paperprovides a comprehensive review of the known impacts of light pollution, divided into four categories - human health, night sky, plants, and animals; additionally, it includes a synopsis of what likely remains unknown at this point in time. This review will attempt to showcase the relative significance of differentimpacts within each category, as well as their sensitivity to changes in lighting specifications (brightness, color temperature, shielding, and mounting height). Methods to be employed in this research include an extensive literature review and the gathering of expert knowledge and opinions. The findings of this review will be used to inform the creation of an optimized lighting design for the Missouri University of Science and Technology campus. It is hoped that future research willexplore the known impacts of light pollution further, as well as search for what still remains to be found regarding the consequencesof artificial light at night.

Keywords: comprehensive review, impacts, light pollution, lighting design, literature review

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50 Thermally Stimulated Depolarization Current (TSDC) and Transient Current Study in Polysulfone (PSF) and Polyvinylidenefluoride (PVDF) Blends

Authors: S. Patel, T. Mitra, R. Dubey, J. Keller

Abstract:

In the present investigations, an attempt has been made to study the charge storage mechanism and mechanism for the flow of transient charging and discharging current in an amorphous polymer (Polysulfone) (PSF) and a semi-crystalline polar Polyvinylidene fluoride (PVDF) blends in ratio PSF: PVDF: 80:20;85:15;90:10 and 95:05 at various poling temperatures (i.e. 60, 75, 90 and 1150C) and with field strength (100, 150, 200 and 250kVcm⁻¹). Thermally stimulated depolarizing current TSDC thermograms for (Polysulfone (PSF) and Polyvinylidene fluoride (PVDF) Blends sample have been obtained under different polarizing conditions. Peaks are found at high-temperature side. The variation of structure on blending and poling condition affects the magnitude of TSDC. The activation energy values have been calculated using the initial rise method of Garlick and Gibson. The transient current with the similar polarizing condition has been investigated over a period of 3X10³ sec. The observed characteristics obey Curie-Von Schweidler law in the studied temperature range. The charging current versus polarizing temperature curves at a constant time, i.e., isochronal current characteristics were studied and the activation energies were calculated. The activation energy in transient thermograms calculated by different methods is in good agreement with the values obtained from TSDC studies.

Keywords: activation energy, polysulfone (PSF), polyvinylidenefluoride (PVDF), thermally stimulated depolarizing current (TSDC)

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49 Functional Profiling of a Circular RNA from the Huntingtin (HTT) Gene

Authors: Laura Gantley, Vanessa M. Conn, Stuart Webb, Kirsty Kirk, Marta Gabryelska, Duncan Holds, Brett W. Stringer, Simon J. Conn

Abstract:

Trinucleotide repeat disorders comprise ~20 severe, inherited human neuromuscular and neurodegenerative disorders, which are a result of an abnormal expansion of repetitive sequences in the DNA. The most common of these, Huntington’s disease, results from the expansion of the CAG repeat region in exon 1 of the HTT gene via an unknown mechanism. Non-coding RNAs have been implicated in the initiation and progression of many diseases; thus, we focus on one circular RNA (circRNA) molecule arising from non-canonical splicing (back splicing) of HTT pre-mRNA. This circRNA and its mouse orthologue were transgenically overexpressed in human cells (SHSY-5Y and HEK293T) and mouse cells (Mb1), respectively. High-content imaging and flow cytometry demonstrated the overexpression of this circRNA reduces cell proliferation, reduces nuclear size independent of cellular size, and alters cell cycle progression. Analysis of protein by western blot and immunofluorescence demonstrated no change to HTT protein levels but altered nuclear-cytoplasmic distribution without impacting the expansion of the HTT repeat region. As these phenotypic and genotypic changes are found in Huntington’s disease patients, these results may suggest that this circRNA may play a functional role in the progression of Huntington’s disease.

Keywords: cell biology, circular RNAs, Huntington’s disease, molecular biology, neurodegenerative disorders

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48 Motivation to Ride in the Hotter 'N Hell Hundred Bicycling Event

Authors: Karen J. Polvado, Betty Bowles, Jansen Lauren, Gibson Martha, Robin Lockhart

Abstract:

The purpose of this study was to identify motivation to participate in the Hotter ‘n Hell Hundred (HHH) bicycling event, and the participants’ demographics, health risk factors, and preparation to ride in the event. A convenience sample of adults pre-registered for non-competitive cycling events (N = 7,472) were requested to complete a survey. Of these, 2,645 (35%) responded. Questions identified the participants’ demographics, preparation, previous experience with HHH, and motives for riding. The HHH attracted riders of all ages (18-80), genders, ethnicities, and educational levels. The majority were males, 40-59 years old, married, college graduates, and identified themselves as non-Hispanic whites. The majority (68%) reported no existing medical conditions, and were normal weight (70%), although 52% had been overweight or obese in the past. Preparation to ride in the HHH varied from riding more than five times a week for the last year, to riding 1-2 times per week one month before the event. Most (93%) had ridden in the HHH an average of 5 times. Motivations to ride included: personal challenge (75%); to experience the HHH ride (57%); a chance to ride with family/friends/coworkers (52%); improving health (47%); fun (33%); challenge by others (15%); part of a weight loss plan (11%); training for another event (10%); and raising money for a cause (2%). The motivation to participate appeared to move from extrinsic to intrinsic motivation as age increased. Exploration of the exercise habits and motivations of older adults (70+) is suggested by this study.

Keywords: cycling, motivation, physical activity, training

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47 The Genetic Architecture Underlying Dilated Cardiomyopathy in Singaporeans

Authors: Feng Ji Mervin Goh, Edmund Chee Jian Pua, Stuart Alexander Cook

Abstract:

Dilated cardiomyopathy (DCM) is a common cause of heart failure. Genetic mutations account for 50% of DCM cases with TTN mutations being the most common, accounting for up to 25% of DCM cases. However, the genetic architecture underlying Asian DCM patients is unknown. We evaluated 68 patients (female= 17) with DCM who underwent follow-up at the National Heart Centre, Singapore from 2013 through 2014. Clinical data were obtained and analyzed retrospectively. Genomic DNA was subjected to next-generation targeted sequencing. Nextera Rapid Capture Enrichment was used to capture the exons of a panel of 169 cardiac genes. DNA libraries were sequenced as paired-end 150-bp reads on Illumina MiSeq. Raw sequence reads were processed and analysed using standard bioinformatics techniques. The average age of onset of DCM was 46.1±10.21 years old. The average left ventricular ejection fraction (LVEF), left ventricular diastolic internal diameter (LVIDd), left ventricular systolic internal diameter (LVIDs) were 26.1±11.2%, 6.20±0.83cm, and 5.23±0.92cm respectively. The frequencies of mutations in major DCM-associated genes were as follows TTN (5.88% vs published frequency of 20%), LMNA (4.41% vs 6%), MYH7 (5.88% vs 4%), MYH6 (5.88% vs 4%), and SCN5a (4.41% vs 3%). The average callability at 10 times coverage of each major gene were: TTN (99.7%), LMNA (87.1%), MYH7 (94.8%), MYH6 (95.5%), and SCN5a (94.3%). In conclusion, TTN mutations are not common in Singaporean DCM patients. The frequencies of other major DCM-associated genes are comparable to frequencies published in the current literature.

Keywords: heart failure, dilated cardiomyopathy, genetics, next-generation sequencing

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46 The Reception of Disclosure of Sexual Teens in Media

Authors: Rizky Kertanegara

Abstract:

Reception studies is one of the cultural studies lately evolved in the realm of communication science. This qualitative study was pioneered by Stuart Hall who initiated the dominant, negotiation, and opposition of audience reading to the text of the media. In its development, this reception studies is developed by Kim Christian Schroder become multidimensional reception studies. In this update, Schroder aware that there has been a bias between readings made by the informant with readings conducted by researchers over the informant. Therefore, he classifies the reception into two dimensions, namely the dimension of reading by informants and implications dimensions conducted by researcher. Using Schroder approach, these studies seek to describe the reception of adolescent girls, as research subjects, to the elements contained sexual openness in the music video Cinta Laura as the object of research. Researcher wanted to see how they interpret the values of Western culture based on the values of their culture as a teenager. Researchers used a descriptive qualitative research method by conducting in-depth interviews to the informants who comes from a religious school. The selection of informants was done by using purposeful sampling. Collaboration with the school, the researchers were able to select informants who could provide rich data related to the topic. The analysis showed that there is permissiveness informants in addressing sexual openness in the music video. In addition, informants from Catholic schools were more open than the informant derived from Islamic schools in accepting the values of sexual openness. This permisiveness is regarded as a form of self-actualization and gender equality.

Keywords: cultural studies, multidimensional reception model, sexual openness, youth audience

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45 Commercial Automobile Insurance: A Practical Approach of the Generalized Additive Model

Authors: Nicolas Plamondon, Stuart Atkinson, Shuzi Zhou

Abstract:

The insurance industry is usually not the first topic one has in mind when thinking about applications of data science. However, the use of data science in the finance and insurance industry is growing quickly for several reasons, including an abundance of reliable customer data, ferocious competition requiring more accurate pricing, etc. Among the top use cases of data science, we find pricing optimization, customer segmentation, customer risk assessment, fraud detection, marketing, and triage analytics. The objective of this paper is to present an application of the generalized additive model (GAM) on a commercial automobile insurance product: an individually rated commercial automobile. These are vehicles used for commercial purposes, but for which there is not enough volume to apply pricing to several vehicles at the same time. The GAM model was selected as an improvement over GLM for its ease of use and its wide range of applications. The model was trained using the largest split of the data to determine model parameters. The remaining part of the data was used as testing data to verify the quality of the modeling activity. We used the Gini coefficient to evaluate the performance of the model. For long-term monitoring, commonly used metrics such as RMSE and MAE will be used. Another topic of interest in the insurance industry is to process of producing the model. We will discuss at a high level the interactions between the different teams with an insurance company that needs to work together to produce a model and then monitor the performance of the model over time. Moreover, we will discuss the regulations in place in the insurance industry. Finally, we will discuss the maintenance of the model and the fact that new data does not come constantly and that some metrics can take a long time to become meaningful.

Keywords: insurance, data science, modeling, monitoring, regulation, processes

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44 Creating Risk Maps on the Spatiotemporal Occurrence of Agricultural Insecticides in Sub-Saharan Africa

Authors: Chantal Hendriks, Harry Gibson, Anna Trett, Penny Hancock, Catherine Moyes

Abstract:

The use of modern inputs for crop protection, such as insecticides, is strongly underestimated in Sub-Saharan Africa. Several studies measured toxic concentrations of insecticides in fruits, vegetables and fish that were cultivated in Sub-Saharan Africa. The use of agricultural insecticides has impact on human and environmental health, but it also has the potential to impact on insecticide resistance in malaria transmitting mosquitos. To analyse associations between historic use of agricultural insecticides and the distribution of insecticide resistance through space and time, the use and environmental fate of agricultural insecticides needs to be mapped through the same time period. However, data on the use and environmental fate of agricultural insecticides in Africa are limited and therefore risk maps on the spatiotemporal occurrence of agricultural insecticides are created using environmental data. Environmental data on crop density and crop type were used to select the areas that most likely receive insecticides. These areas were verified by a literature review and expert knowledge. Pesticide fate models were compared to select most dominant processes that are involved in the environmental fate of insecticides and that can be mapped at a continental scale. The selected processes include: surface runoff, erosion, infiltration, volatilization and the storing and filtering capacity of soils. The processes indicate the risk for insecticide accumulation in soil, water, sediment and air. A compilation of all available data for traces of insecticides in the environment was used to validate the maps. The risk maps can result in space and time specific measures that reduce the risk of insecticide exposure to non-target organisms.

Keywords: crop protection, pesticide fate, tropics, insecticide resistance

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43 Perspectives of charitable organisations on the impact of the COVID-19 pandemic on family carers of people with profound and multiple intellectual disabilities.

Authors: Mark Linden, Trisha Forbes, Michael Brown, Lynne Marsh, Maria Truesdale, Stuart Todd, Nathan Hughes

Abstract:

Background The COVID-19 pandemic resulted in a reduction of health care services for many family carers of people with profound and multiple intellectual disabilities (PMID). Due to lack of services, family carers turned to charities for support during the pandemic. We explored the views of charity workers across the UK and Ireland who supported family carers during the COVID-19 pandemic and explored their views on effective online support programmes for family carers. Methods This was a qualitative study using online focus groups with participants (n = 24) from five charities across the UK and Ireland. Questions focused on challenges, supports, coping and resources which helped during lockdown restrictions. Focus groups were audio recorded, transcribed verbatim, and analysed through thematic analysis. Findings Four themes were identified (i) ‘mental and emotional health’, (ii) ‘they who shout the loudest’ (fighting for services), (iii) ‘lack of trust in statutory services’ and (iv) ‘creating an online support programme’. Mental and emotional health emerged as the most prominent theme and included three subthemes named as ‘isolation’, ‘fear of COVID-19’ and ‘the exhaustion of caring’. Conclusions The withdrawal of many services during the COVID-19 pandemic further isolated and placed strain on family carers. Even after the end of the pandemic family cares continue to report on the struggle to receive adequate support. There is a critical need to design services, including online support programmes, in partnership with family carers which adequately address their needs.

Keywords: intellectual disability, family carers, COVID-19, charities

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42 Tracing Digital Traces of Phatic Communion in #Mooc

Authors: Judith Enriquez-Gibson

Abstract:

This paper meddles with the notion of phatic communion introduced 90 years ago by Malinowski, who was a Polish-born British anthropologist. It explores the phatic in Twitter within the contents of tweets related to moocs (massive online open courses) as a topic or trend. It is not about moocs though. It is about practices that could easily be hidden or neglected if we let big or massive topics take the lead or if we simply follow the computational or secret codes behind Twitter itself and third party software analytics. It draws from media and cultural studies. Though at first it appears data-driven as I submitted data collection and analytics into the hands of a third party software, Twitonomy, the aim is to follow how phatic communion might be practised in a social media site, such as Twitter. Lurking becomes its research method to analyse mooc-related tweets. A total of 3,000 tweets were collected on 11 October 2013 (UK timezone). The emphasis of lurking is to engage with Twitter as a system of connectivity. One interesting finding is that a click is in fact a phatic practice. A click breaks the silence. A click in one of the mooc website is actually a tweet. A tweet was posted on behalf of a user who simply chose to click without formulating the text and perhaps without knowing that it contains #mooc. Surely, this mechanism is not about reciprocity. To break the silence, users did not use words. They just clicked the ‘tweet button’ on a mooc website. A click performs and maintains connectivity – and Twitter as the medium in attendance in our everyday, available when needed to be of service. In conclusion, the phatic culture of breaking silence in Twitter does not have to submit to the power of code and analytics. It is a matter of human code.

Keywords: click, Twitter, phatic communion, social media data, mooc

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41 Toward Discovering an Architectural Typology Based on the Theory of Affordance

Authors: Falntina Ahmad Alata, Natheer Abu Obeid

Abstract:

This paper revolves around the concept of affordance. It aims to discover and develop an architectural typology based on the ecological concept of affordance. In order to achieve this aim, an analytical study is conducted and two sources were taken into account: 1- Gibson's definition of the concept of affordance and 2- The researches that are concerned on the affordance categorisation. As a result, this paper concluded 16 typologies of affordances, including the possibilities of mixing them based on both sources. To clarify these typologies and provide further understanding, a wide range of architectural examples are presented and proposed in the paper. To prove this vocabulary’s capability to diagnose and evaluate the affordance of different environments, an experimental study with two processes have been adapted: 1. Diagnostic process: the interpretation of the environments with regards to its affordance by using the new vocabulary (the developed typologies). 2. Evaluating process: the evaluation of the environments that have been interpreted and classified with regards to their affordances. By using the measures of emotional experience (the positive affect ‘PA’ and the negative affect ‘NA’) and the architectural evaluation criteria (beauty, economy and function). The experimental study proves that the typologies are capable of reading the affordance within different environments. Additionally, it explains how these different typologies reflect different interactions based on the previous processes. The data which are concluded from the evaluation of measures explain how different typologies of affordance that have already reflected different environments had different evaluations. In fact, some of them are recommended while the others are not. In other words, the paper draws a roadmap for designers to diagnose, evaluate and analyse the affordance into different architectural environments. After that, it guides them through adapting the best interaction (affordance category), which they intend to adapt into their proposed designs.

Keywords: Affordance theory, Affordance categories, Architectural environments, Architectural Evaluation Criteria (AEC), emotional experience (PA, NA)

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40 Wellbeing Warriors: A Randomized Controlled Trial Examining the Effect of Martial Arts Training on Mental Health Outcomes

Authors: Brian Moore, Stuart Woodcock, Dean Dudley

Abstract:

Mental health problems have significant social and economic consequences; however, many individuals do not seek traditional assistance for mental health difficulties. Martial arts training may provide an inexpensive alternative to traditional psychological therapy. While limited research has suggested martial arts training may be an efficacious intervention, the validity and reliability of this are questionable given the small number of relevant studies and other methodological problems. The study examined the effects of 10-week martial arts-based psycho-social intervention which was evaluated using a randomized controlled trial. The intervention was delivered to 283 secondary school students, aged between 12-14 years, who were recruited from government and catholic secondary schools in New South Wales, Australia. The intervention was delivered in a group format onsite at participating schools and had an intervention dose of 10 x 50-60 minute sessions, once per week for 10 weeks. Data were collected at baseline, post-intervention, and 12-week follow-up. Results found a consistent pattern for strength based wellbeing outcomes. All primary and secondary measures relating to resilience and self-efficacy improved for the intervention group and declined for the control group. As these findings were derived from a robust design and rigorous evaluation, they provide valid and reliable evidence that martial arts-based psycho-social interventions can be considered as an efficacious method of improving strength and wellbeing outcomes.

Keywords: martial arts, mental health, resilience, self-efficacy

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39 Acceptability of the Carers-ID Intervention for Family Carers of People with Intellectual Disabilities

Authors: Mark Linden, Michael Brown, Lynne Marsh, Maria Truesdale, Stuart Todd, Nathan Hughes, Trisha Forbes, Rachel Leonard

Abstract:

Background: Family carers of people with intellectual disabilities (ID) face ongoing challenges in accessing services and often experience poor mental health. Online support programmes may prove effective in addressing the mental health and well-being needs of family carers. This study sought to test the acceptability of a newly developed online support programme for carers of people with intellectual disabilities called Carers-ID. Methods A sequential mixed-methods explanatory design was utilised. An adapted version of the Acceptability of Health Apps among Adolescents (AHAA) Scale was distributed to family carers who had viewed the Carers-ID.com intervention. Following this, participants were invited to take part in an online interview. Interview questions focused on participants’ experiences of using the programme and its acceptability. Qualitative and quantitative data were analysed separately and then brought together through the triangulation protocol developed by Farmer et al (2006). Findings: Seventy family carers responded to the acceptability survey, whilst 10 took part in interviews. Six themes were generated from interviews with family carers. Based on our triangulation, four areas of convergence were identified, these included, programme usability and ease, attitudes towards the programme, perceptions of effectiveness, and programme relatability. Conclusions: In order to be acceptable, online interventions for carers of people with ID need to be accessible, understandable and easy to use, as carers time is precious. Further research is needed to investigate the effectiveness of online interventions for family carers, specifically considering which carers the intervention works for, and for whom it may not.

Keywords: intellectual disability, family carer, acceptability study, online intervention

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38 Experiences of Family Carers of People Intellectual Disabilities During the COVID-19 Pandemic

Authors: Mark Linden, Michael Brown, Lynne Marsh, Maria Truesdale, Stuart Todd, Nathan Hughes, Trisha Forbes, Rachel Leonard

Abstract:

Background: The COVID-19 pandemic exacerbated the already significant strain placed on family carers of people with profound and multiple intellectual disabilities (PMID), given the withdrawal of many services during lockdown. The aim of this study was to explore the experiences of family carers of people with PMID during the COVID-19 pandemic. Methods: Online focus groups were conducted with family carers (n=126) from across the UK and the Republic of Ireland. Participants were asked about their experiences of the COVID-19 pandemic, coping strategies, and challenges faced. Focus groups were audio recorded, transcribed verbatim and analyzed through thematic analysis. Findings: Three themes emerged from our analysis of the data: (i) COVID-19 as a double-edged sword, (ii) The struggle for support (iii) the Constant nature of caring. These included 11 subthemes: (i) ‘COVID-19 as a catalyst for change’, ‘Challenges during COVID-19: dealing with change’, ‘Challenges during COVID-19: fear of COVID-19’, ‘The online environment: the new normal’ (ii) ‘Invisibility of male carers’, ‘Carers supporting carers’, ‘The only service you get is lip service: non-existent services’, ‘Knowing your rights’ (iii) ‘Emotional response to the caring role: Feeling devalued’, ‘Emotional response to the caring role: Desperation of caring’, ‘Multiple demands of the caring role.’ Conclusions: Poor or inconsistent access to services and support has been an ongoing difficulty for many family carers. The COVID-19 pandemic has only further intensified these difficulties, increasing family carers' stress. There is an urgent need to design services, such as online support programs, in partnership with family carers that adequately address their needs.

Keywords: intellectual disabilities, family carer, COVID-19, disability

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37 Night Shift Work as an Oxidative Stressor: A Systematic Review

Authors: Madeline Gibson

Abstract:

Night shift workers make up an essential part of the modern workforce. However, night shift workers have higher incidences of late in life diseases and earlier mortality. Night shift workers are exposed to constant light and experience circadian rhythm disruption. Sleep disruption is thought to increase oxidative stress, defined as an imbalance of excess pro-oxidative factors and reactive oxygen species over anti-oxidative activity. Oxidative stress can damage cells, proteins and DNA and can eventually lead to varied chronic diseases such as cancer, diabetes, cardiovascular disease, Alzheimer’s and dementia. This review aimed to understand whether night shift workers were at greater risk of oxidative stress and to contribute to a consensus on this relationship. Twelve studies published in 2001-2019 examining 2,081 workers were included in the review. Studies compared both the impact of working a single shift and in comparisons between those who regularly work night shifts and only day shifts. All studies had evidence to support this relationship across a range of oxidative stress indicators, including increased DNA damage, reduced DNA repair capacity, increased lipid peroxidation, higher levels of reactive oxygen species, and to a lesser extent, a reduction in antioxidant defense. This research supports the theory that melatonin and the sleep-wake cycle mediate the relationship between shift work and oxidative stress. It is concluded that night shift work increases the risk for oxidative stress and, therefore, future disease. Recommendations are made to promote the long-term health of shift workers considering these findings.

Keywords: night shift work, coxidative stress, circadian rhythm, melatonin, disease, circadian rhythm disruption

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36 Hedgerow Detection and Characterization Using Very High Spatial Resolution SAR DATA

Authors: Saeid Gharechelou, Stuart Green, Fiona Cawkwell

Abstract:

Hedgerow has an important role for a wide range of ecological habitats, landscape, agriculture management, carbon sequestration, wood production. Hedgerow detection accurately using satellite imagery is a challenging problem in remote sensing techniques, because in the special approach it is very similar to line object like a road, from a spectral viewpoint, a hedge is very similar to a forest. Remote sensors with very high spatial resolution (VHR) recently enable the automatic detection of hedges by the acquisition of images with enough spectral and spatial resolution. Indeed, recently VHR remote sensing data provided the opportunity to detect the hedgerow as line feature but still remain difficulties in monitoring the characterization in landscape scale. In this research is used the TerraSAR-x Spotlight and Staring mode with 3-5 m resolution in wet and dry season in the test site of Fermoy County, Ireland to detect the hedgerow by acquisition time of 2014-2015. Both dual polarization of Spotlight data in HH/VV is using for detection of hedgerow. The varied method of SAR image technique with try and error way by integration of classification algorithm like texture analysis, support vector machine, k-means and random forest are using to detect hedgerow and its characterization. We are applying the Shannon entropy (ShE) and backscattering analysis in single and double bounce in polarimetric analysis for processing the object-oriented classification and finally extracting the hedgerow network. The result still is in progress and need to apply the other method as well to find the best method in study area. Finally, this research is under way to ahead to get the best result and here just present the preliminary work that polarimetric image of TSX potentially can detect the hedgerow.

Keywords: TerraSAR-X, hedgerow detection, high resolution SAR image, dual polarization, polarimetric analysis

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35 Remote Vital Signs Monitoring in Neonatal Intensive Care Unit Using a Digital Camera

Authors: Fatema-Tuz-Zohra Khanam, Ali Al-Naji, Asanka G. Perera, Kim Gibson, Javaan Chahl

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Conventional contact-based vital signs monitoring sensors such as pulse oximeters or electrocardiogram (ECG) may cause discomfort, skin damage, and infections, particularly in neonates with fragile, sensitive skin. Therefore, remote monitoring of the vital sign is desired in both clinical and non-clinical settings to overcome these issues. Camera-based vital signs monitoring is a recent technology for these applications with many positive attributes. However, there are still limited camera-based studies on neonates in a clinical setting. In this study, the heart rate (HR) and respiratory rate (RR) of eight infants at the Neonatal Intensive Care Unit (NICU) in Flinders Medical Centre were remotely monitored using a digital camera applying color and motion-based computational methods. The region-of-interest (ROI) was efficiently selected by incorporating an image decomposition method. Furthermore, spatial averaging, spectral analysis, band-pass filtering, and peak detection were also used to extract both HR and RR. The experimental results were validated with the ground truth data obtained from an ECG monitor and showed a strong correlation using the Pearson correlation coefficient (PCC) 0.9794 and 0.9412 for HR and RR, respectively. The RMSE between camera-based data and ECG data for HR and RR were 2.84 beats/min and 2.91 breaths/min, respectively. A Bland Altman analysis of the data also showed a close correlation between both data sets with a mean bias of 0.60 beats/min and 1 breath/min, and the lower and upper limit of agreement -4.9 to + 6.1 beats/min and -4.4 to +6.4 breaths/min for both HR and RR, respectively. Therefore, video camera imaging may replace conventional contact-based monitoring in NICU and has potential applications in other contexts such as home health monitoring.

Keywords: neonates, NICU, digital camera, heart rate, respiratory rate, image decomposition

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34 Increasing Sexual Safety Awareness and Capacity for Mental Health Professionals

Authors: Tara Hunter, Kristine Concepcion, Wendy Cheng, Brianna Pike, Jane Estoesta, Anne Stuart

Abstract:

In 2015, Family Planning NSW was contracted by the NSW Ministry of Health to design and deliver Sexual Safety Policy training (SSPT) to mental health professionals across NSW. The training was based on their current guidelines and developed in consultation with an expert reference group. From October 2015 to April 2017 it was delivered to over 2,400 mental health professionals with a view to supporting implementation of consistent prevention and intervention related to sexual safety in the mental health setting. An evaluation was undertaken to determine the knowledge and confidence of participants related to sexual safety before and after the training, and whether any improvements were translated into changes in practice. Participants were invited to complete a survey prior to the training, upon completion and three to six months thereafter. Telephone interviews were conducted among service managers and mental health champions six months post-training. Prior to training, the majority of mental health professionals reported being slightly to moderately confident in identifying a sexual safety incident. When asked on their understanding of sexual safety, gender sensitive practice and trauma informed care, they reported no confidence, slight confidence and moderate confidence. Immediately after the training, 54.5% reported being very confident and 10.9% extremely confident in identifying a sexual safety incident. More than half felt very confident or extremely confident in their understanding of sexual safety principles. The impact survey (six months later) found that the majority of participants (91%) were highly confident in identifying a sexual safety incident. Telephone interviewees reported a change in workplace culture and increased awareness after the training. Mental health professionals experienced increased knowledge and confidence about sexual safety principles following the training and were able to implement positive changes and concrete actions to better address sexual safety issues in their workplace.

Keywords: sexual safety, mental health professionals, trauma informed care, policy training

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33 Sustainable Capacity Building on Tourism Management of Touristic Destinations in Ghana: The Case of James and Ussher Forts in the Accra Metropolis

Authors: Fiona Gibson

Abstract:

This study is on sustainable capacity building in tourism management of the touristic destination of forts and castles within the Accra Metropolis, of the Greater Accra Region of Ghana, notably, the Christianbough Castle, the James and Ussher Forts. These forts and castle mentioned above have a rich colonial historical past that emerged from the 17th century onwards on the Gulf Coast of Guinea of the West Africa Sub-Region. Unfortunately, apart from the Christianbough Castle, which used to be the seat of government until recently, the environment of James and Ussher Forts are in a deployable state of decay due to years of neglect. Jamestown and Usshertown fishing communities with historical colonial past of a rich touristic heritage sites are predominantly indigenous Gas who speak only the Ga language, one of the languages of the six local languages spoken in Ghana, as a medium for sustainable tourism management. The purpose of this study is to investigate the reasons for years of decay and neglect, using both qualitative and quantitative research approach for individual interviews, to develop a rich picture of life situational story of the people of James and Ussher Forts environs and finding solutions to their predicaments through internal generated funds for sustainability of tourism management within the communities. The study recommends nation-wide educational campaigns and programmes on culture of maintenance and management for sustainable tourism development and management at all historical heritage sites in the country, specifically with the aim of promoting tourism in Ghana, using the indigenous local languages. The study also recommends formal and informal education for the residents, especially the youth to help them learn skills, either through local training or the formal education and this call for collaboration between the government of Ghana and other local and international bodies.

Keywords: sustainable capacity building, tourism management, forts, castles

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32 The Carers-ID Online Intervention For Family Carers Of People With Intellectual Disabilities: A Feasibility Trial Protocol

Authors: Mark Linden, Rachel Leonard, Trisha Forbes, Michael Brown, Lynne Marsh, Stuart Todd, Nathan Hughes, Maria Truesdale

Abstract:

Background: Current interventions which aim to improve the mental health of family carers are often face to face, which can create barriers to full participation. Online interventions can offer flexibility in delivery compared to face to face approaches. The primary objective of this study is to determine the feasibility of delivering the Carers-ID online intervention, while the secondary outcome is to improve the mental health of family carers of people with intellectual disabilities. Methods: Family carers (n = 120) will be randomised to receive the intervention (n=60) or assigned to a wait-list control (n=60) group. The intervention (www.Carers-ID.com) consists of fourteen modules which cover topics including promoting resilience, providing peer support, reducing anxiety, managing stress, accessing local supports, managing family conflict and information for siblings who are carers. Primary outcomes for this study include acceptability and feasibility of the outcome measures, recruitment, participation and retention rates and effect sizes. Secondary outcomes will be completed at three time points (baseline, following intervention completion and three months after completion). Secondary outcomes include, depression, anxiety, stress, well-being , resilience and social connectedness. Participants (n=12) who have taken part in the intervention arm of the research will be invited to participate in semi-structured interviews as part of the process evaluation. Discussion: To determine whether a full-scale randomised controlled effectiveness trial is warranted, feasibility testing of the intervention and trial procedures is a necessary first step. The Carers-ID intervention provides an accessible resource for family carers to support their mental health and well-being.

Keywords: intellectual disability, family carer, feasibility trial, online intervention

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31 Smoking and Alcohol Consumption Predicts Multiple Head and Neck Cancers

Authors: Kim Kennedy, Daren Gibson, Stephanie Flukes, Chandra Diwakarla, Lisa Spalding, Leanne Pilkington, Andrew Redfern

Abstract:

Introduction: It is well known that patients with Head and Neck Cancer (HNC) are at increased risk of subsequent head and neck cancers due to various aetiologies. Aim: We sought to determine the factors contributing to an increased risk of subsequent HNC primaries, and also to evaluate whether Aboriginal patients are at increased risk. Methods: We performed a retrospective cohort analysis of 320 HNC patients from a single centre in Western Australia, identifying 80 Aboriginal patients and 240 non-Aboriginal patients matched on a 1:3 ratio by site, histology, rurality, and age. We collected patient data including smoking and alcohol consumption, tumour and treatment data, and data on subsequent HNC primaries. Results: A subsequent HNC primary was seen in 37 patients (11.6%) overall. There was no significant difference in the rate of second primary HNCs between Aboriginal patients (12.5%) and nonAboriginal patients (11.2%) (p=0.408). Subsequent HNCs, were strongly associated with smoking and alcohol consumption however, with 95% of patients with a second primary being ever-smokers, and 54% of patients with a second primary having a history of excessive alcohol consumption. In the 37 patients with multiple HNC primaries, there were a total of 57 HNCs, with 29 patients having two primaries, six patients having 3 HNC primaries, one patient with four, and one with six. 54 out of the 57 cancers were in ever smokers (94.7%). There were only two multiple HNC primaries in a never smoker, non-drinker, and these cases were of unknown etiology with HPV/p16 status unknown in both cases. In the whole study population, there were 32 HPV-positive HNCs, and 67 p16-positive HNCs, with only two 2 nd HNCs in a p16-positive case, giving a rate of 3% in the p16+ population, which is actually much lower than the rate of second primaries seen in the overall population (11.6%), and was highest in the p16-negative population (15.7%). This suggests that p16-positivity is not a strong risk factor for subsequent primaries, and in fact p16-negativity appeared to be associated with increased risk, however this data is limited by the large number of patients without documented p16 status (45.3% overall, 12% for oropharyngeal, and 59.6% for oral cavity primaries had unknown p16 status). Summary: Subsequent HNC primaries were strongly associated with smoking and alcohol excess. Second and later HNC primaries did not appear to occur at increased rates in Aboriginal patients compared with non-Aboriginal patients, and p16-positivity did not predict increased risk, however p16-negativity was associated with an increased risk of subsequent HNCs.

Keywords: head and neck cancer, multiple primaries, aboriginal, p16 status, smoking, alcohol

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30 The Association between Antimicrobial Usage and Biosecurity Practices on Commercial Chicken Farms in Bangladesh

Authors: Tasneem Imam, Justine S. Gibson, Mohammad Foysal, Shetu B. Das, Rashed Mahmud, Suman D. Gupta, Ahasanul Hoque, Guillaume Fournie, Joerg Henning

Abstract:

Commercial chicken production is an import livestock industry in Bangladesh. Antimicrobials are commonly used to control and prevent infectious diseases. It was hypothesized that inadequate biosecurity practices might promote antimicrobial usage on commercial chicken farms. A cross-sectional study was carried out to evaluate antimicrobial usage and farm biosecurity practices implemented on 57 layer and 83 broiler farms in eight sub-districts of the Chattogram district in Bangladesh. A questionnaire was used to collect data on antimicrobial usage and biosecurity practices on these farms. A causal framework was used to guide the development of a multi-level mixed-effects logistic regression analysis to evaluate the total and direct effects of practiced biosecurity management on prophylactic and therapeutic administration of antimicrobials. A total of 24 antimicrobials were administered in the current production cycle at the time of the survey. The most administered antimicrobials on layer farms were ciprofloxacin (37.0% of farms), amoxicillin (33.3%), and tiamulin (31.5%); however, on broiler farms, colistin (56.6% of farms), doxycycline (50.6%), and neomycin (38.6%) were most used. Only 15.3% of commercial farmers used antimicrobials entirely for therapeutic purposes, whereas 84.7% administered antimicrobials prophylactically. Inadequate biosecurity practices were more common among commercial broiler farmers compared to layer farmers. For example, only 2.4% of broiler farmers used footbaths before entering sheds compared to 22.2% of the layer farmers (p < 0.001). Farms that used antimicrobials only for therapeutic purposes (vs prophylactic) implemented more frequently adequate disease control measures, such as separating sick birds from healthy birds. This research highlighted that the prophylactic application of antimicrobials is often conducted to substitute poor biosecurity practices on commercial chicken farms. Awareness programs for farmers are crucial to inform them about the risk associated with antimicrobial usage and to highlight the economic benefits of implementing cost-effective biosecurity measures to control infectious poultry diseases.

Keywords: antimicrobial, biosecurity, broiler, layer

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29 Aboriginal Head and Neck Cancer Patients Have Different Patterns of Metastatic Involvement, and Have More Advanced Disease at Diagnosis

Authors: Kim Kennedy, Daren Gibson, Stephanie Flukes, Chandra Diwakarla, Lisa Spalding, Leanne Pilkington, Andrew Redfern

Abstract:

Introduction: The mortality gap in Aboriginal Head and Neck Cancer is well known, but the reasons for poorer survival are not well established. Aim: We aimed to evaluate the locoregional and metastatic involvement, and stage at diagnosis, in Aboriginal compared with non-Aboriginal patients. Methods: We performed a retrospective cohort analysis of 320 HNC patients from a single centre in Western Australia, identifying 80 Aboriginal patients and 240 non-Aboriginal patients matched on a 1:3 ratio by sites, histology, rurality, and age. We collected data on the patient characteristics, tumour features, regions involved, stage at diagnosis, treatment history, and survival and relapse patterns, including sites of metastatic and locoregional involvement. Results: Aboriginal patients had a significantly higher incidence of lung metastases (26.3% versus 13.7%, p=0.009). Aboriginal patients also had a numerically but non-statistically significant higher incidence of thoracic nodal involvement (10% vs 5.8%) and malignant pleural effusions (3.8% vs 2.5%). Aboriginal patients also had a numerically but not statistically significantly higher incidence of adrenal and bony involvement. Interestingly, non-Aboriginal patients had an increased rate of cutaneous (2.1% vs 0%) and liver metastases (4.6% vs 2.5%) compared with Aboriginal patients. In terms of locoregional involvement, Aboriginal patients were more than twice as likely to have contralateral neck involvement (58.8% vs 24.2%, p<0.00001), and 30% more likely to have ipsilateral neck lymph node involvement (78.8% vs 60%, p=0.002) than non-Aboriginal patients. Aboriginal patients had significantly more advanced disease at diagnosis (p=0.008). Aboriginal compared with non-Aboriginal patients were less likely to present with stage I (7.5% vs 22.5%), stage II (11.3% vs 13.8%), or stage III disease (13.8% vs 17.1%), and more likely to present with more advanced stage IVA (42.5% vs 34.6%), stage IVB (15% vs 7.1%), or stage IVC (10% vs 5%) disease (p=0.008). Number of regions of disease involvement was higher in Aboriginal patients (median 3, mean 3.64, range 1-10) compared with non-Aboriginal patients (median 2, mean 2.80, range 1-12). Conclusion: Aboriginal patients had a significantly higher incidence of lung metastases, and significantly more frequent involvement of ipsilateral and contralateral neck lymph nodes. Aboriginal patients also had significantly more advanced disease at presentation with a higher stage at diagnosis. We are performing further analyses to investigate explanations for these findings.

Keywords: head and neck cancer, Aboriginal, metastases, locoregional, pattern of relapse, sites of disease

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28 Mitigating Self-Regulation Issues in the Online Instruction of Math

Authors: Robert Vanderburg, Michael Cowling, Nicholas Gibson

Abstract:

Mathematics is one of the core subjects taught in the Australian K-12 education system and is considered an important component for future studies in areas such as engineering and technology. In addition to this, Australia has been a world leader in distance education due to the vastness of its geographic landscape. Despite this, research is still needed on distance math instruction. Even though delivery of curriculum has given way to online studies, and there is a resultant push for computer-based (PC, tablet, smartphone) math instruction, much instruction still involves practice problems similar to those original curriculum packs, without the ability for students to self-regulate their learning using the full interactive capabilities of these devices. Given this need, this paper addresses issues students have during online instruction. This study consists of 32 students struggling with mathematics enrolled in a math tutorial conducted in an online setting. The study used a case study design to understand some of the blockades hindering the students’ success. Data was collected by tracking students practice and quizzes, tracking engagement of the site, recording one-on-one tutorials, and collecting data from interviews with the students. Results revealed that when students have cognitively straining tasks in an online instructional setting, the first thing to dissipate was their ability to self-regulate. The results also revealed that instructors could ameliorate the situation and provided useful data on strategies that could be used for designing future online tasks. Specifically, instructors could utilize cognitive dissonance strategies to reduce the cognitive drain of the tasks online. They could segment the instruction process to reduce the cognitive demands of the tasks and provide in-depth self-regulatory training, freeing mental capacity for the mathematics content. Finally, instructors could provide specific scheduling and assignment structure changes to reduce the amount of student centered self-regulatory tasks in the class. These findings will be discussed in more detail and summarized in a framework that can be used for future work.

Keywords: digital education, distance education, mathematics education, self-regulation

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27 Effect of Classroom Acoustic Factors on Language and Cognition in Bilinguals and Children with Mild to Moderate Hearing Loss

Authors: Douglas MacCutcheon, Florian Pausch, Robert Ljung, Lorna Halliday, Stuart Rosen

Abstract:

Contemporary classrooms are increasingly inclusive of children with mild to moderate disabilities and children from different language backgrounds (bilinguals, multilinguals), but classroom environments and standards have not yet been adapted adequately to meet these challenges brought about by this inclusivity. Additionally, classrooms are becoming noisier as a learner-centered as opposed to teacher-centered teaching paradigm is adopted, which prioritizes group work and peer-to-peer learning. Challenging listening conditions with distracting sound sources and background noise are known to have potentially negative effects on children, particularly those that are prone to struggle with speech perception in noise. Therefore, this research investigates two groups vulnerable to these environmental effects, namely children with a mild to moderate hearing loss (MMHLs) and sequential bilinguals learning in their second language. In the MMHL study, this group was assessed on speech-in-noise perception, and a number of receptive language and cognitive measures (auditory working memory, auditory attention) and correlations were evaluated. Speech reception thresholds were found to be predictive of language and cognitive ability, and the nature of correlations is discussed. In the bilinguals study, sequential bilingual children’s listening comprehension, speech-in-noise perception, listening effort and release from masking was evaluated under a number of different ecologically valid acoustic scenarios in order to pinpoint the extent of the ‘native language benefit’ for Swedish children learning in English, their second language. Scene manipulations included target-to-distractor ratios and introducing spatially separated noise. This research will contribute to the body of findings from which educational institutions can draw when designing or adapting educational environments in inclusive schools.

Keywords: sequential bilinguals, classroom acoustics, mild to moderate hearing loss, speech-in-noise, release from masking

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26 A Conceptual Model of Preparing School Counseling Students as Related Service Providers in the Transition Process

Authors: LaRon A. Scott, Donna M. Gibson

Abstract:

Data indicate that counselor education programs in the United States do not prepare their students adequately to serve students with disabilities nor provide counseling as a related service. There is a need to train more school counselors to provide related services to students with disabilities, for many reasons, but specifically, school counselors are participating in Individualized Education Programs (IEP) and transition planning meetings for students with disabilities where important academic, mental health and post-secondary education decisions are made. While school counselors input is perceived very important to the process, they may not have the knowledge or training in this area to feel confident in offering required input in these meetings. Using a conceptual research design, a model that can be used to prepare school counseling students as related service providers and effective supports to address transition for students with disabilities was developed as a component of this research. The authors developed the Collaborative Model of Preparing School Counseling Students as Related Service Providers to Students with Disabilities, based on a conceptual framework that involves an integration of Social Cognitive Career Theory (SCCT) and evidenced-based practices based on Self-Determination Theory (SDT) to provide related and transition services and planning with students with disabilities. The authors’ conclude that with five overarching competencies, (1) knowledge and understanding of disabilities, (2) knowledge and expertise in group counseling to students with disabilities, (3), knowledge and experience in specific related service components, (4) knowledge and experience in evidence-based counseling interventions, (5) knowledge and experiencing in evidenced-based transition and career planning services, that school counselors can enter the field with the necessary expertise to adequately serve all students. Other examples and strategies are suggested, and recommendations for preparation programs seeking to integrate a model to prepare school counselors to implement evidenced-based transition strategies in supporting students with disabilities are included

Keywords: transition education, social cognitive career theory, self-determination, counseling

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25 High Blood Pressure and Type 2 Diabetes Mellitus: A Study on Lay Understandings and Uses of Pharmaceuticals and Medicinal Plants for Treatment in Matzikama Municipal Region, Western Cape, South Africa

Authors: Diana Gibson

Abstract:

Aim: The first aim of the study was to ascertain the percentage of people who had been diagnosed with High Blood Pressure and/ or Type2 Diabetes Mellitus in Matzikama municipal district, Western Cape, South Africa. These two conditions are reportedly very high in this particular province, even though few statistics are available. A second aim was to gain insight into the understanding of these two conditions among sufferers. A third aim was to determine their allopathic use as well as indigenous medicinal plants to manage these conditions. A fourth aim was to understand how users of medicinal plants attend to their materiality and relationality as a continuum between humans and plants. The final aim was to ascertain the conservation status of medicinal plants utilised. Methods: One thousand one hundred and eighty-four (1184) respondents were interviewed. Semi-structured surveys were utilised to gather data on the percentage of people who had been medically diagnosed with High Blood Pressure and/or Type 2 Diabetes Mellitus. Local healers and knowledgeable old people were subsequently selected through a non-probability snowball sampling method. They were helped with plant collection. The plants were botanically identified. Results: The study found that people who have been diagnosed with High Blood Pressure or Type 2 Diabetes Mellitus drew on and continuously moved between biomedical and local understandings of these conditions. While they followed biomedical treatment regimens as far as possible they also drew on alternative ways of managing it through the use of medicinal plants. The most commonly used plant species overall were Lessertia frutescens, Tulbaghia violacea, Artemisia afra and Leonotus leonurus. For the users, medicinal plants were not mere material entities, they were actants in social networks where knowledge was produced through particular practices in specific places. None of the identified plants are currently threatened. Significance: Sufferers had a good understanding of the symptoms of and biomedical treatment regime for both conditions, but in everyday life they adhered to their local understandings and medicinal plants for treatment. The majority used reportedly used prescribed medication as well as plant alternatives.

Keywords: diabetes, high blood pressure, medicine, plants

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