Search results for: knowledge management definitions

Authors: Frederick Huie, Lauren Fusfeld, William Burchenal, Scott Howell, Alyssa McVey, Thomas F. Goss

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Alzheimer’s Disease (AD) is a degenerative brain disease characterized by memory loss and cognitive decline that presents a substantial economic burden for patients and health insurers in the US. This study evaluates the payer budget impact of the DISCERN™ test in the diagnosis and management of patients with symptoms of dementia evaluated for AD. DISCERN™ comprises three assays that assess critical factors related to AD that regulate memory, formation of synaptic connections among neurons, and levels of amyloid plaques and neurofibrillary tangles in the brain and can provide a quicker, more accurate diagnosis than tests in the current diagnostic pathway (CDP). An Excel-based model with a three-year horizon was developed to assess the budget impact of DISCERN™ compared with CDP in a Medicare Advantage plan with 1M beneficiaries. Model parameters were identified through a literature review and were verified through consultation with clinicians experienced in diagnosis and management of AD. The model assesses direct medical costs/savings for patients based on the following categories: •Diagnosis: costs of diagnosis using DISCERN™ and CDP. •False Negative (FN) diagnosis: incremental cost of care avoidable with a correct AD diagnosis and appropriately directed medication. •True Positive (TP) diagnosis: AD medication costs; cost from a later TP diagnosis with the CDP versus DISCERN™ in the year of diagnosis, and savings from the delay in AD progression due to appropriate AD medication in patients who are correctly diagnosed after a FN diagnosis.•False Positive (FP) diagnosis: cost of AD medication for patients who do not have AD. A one-way sensitivity analysis was conducted to assess the effect of varying key clinical and cost parameters ±10%. An additional scenario analysis was developed to evaluate the impact of individual inputs. In the base scenario, DISCERN™ is estimated to decrease costs by $4.75M over three years, equating to approximately $63.11 saved per test per year for a cohort followed over three years. While the diagnosis cost is higher with DISCERN™ than with CDP modalities, this cost is offset by the higher overall costs associated with CDP due to the longer time needed to receive a TP diagnosis and the larger number of patients who receive a FN diagnosis and progress more rapidly than if they had received appropriate AD medication. The sensitivity analysis shows that the three parameters with the greatest impact on savings are: reduced sensitivity of DISCERN™, improved sensitivity of the CDP, and a reduction in the percentage of disease progression that is avoided with appropriate AD medication. A scenario analysis in which DISCERN™ reduces the utilization for patients of computed tomography from 21% in the base case to 16%, magnetic resonance imaging from 37% to 27% and cerebrospinal fluid biomarker testing, positive emission tomography, electroencephalograms, and polysomnography testing from 4%, 5%, 10%, and 8%, respectively, in the base case to 0%, results in an overall three-year net savings of $14.5M. DISCERN™ improves the rate of accurate, definitive diagnosis of AD earlier in the disease and may generate savings for Medicare Advantage plans.

Keywords: Alzheimer’s disease, budget, dementia, diagnosis.

Procedia PDF Downloads 141

Authors: Tamara Roma, Emma Capulli

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Pregnancy and fertility, in other words, reproduction, has become, in the last half of the century, increasingly and globally controlled, medicalized, and regulated. The reflection proposed starts from the consequences of the inscription of reproduction into the neoliberal economic paradigm. The new biotechnologies developments have raised a new patriarchal justification for State’s control of uterus bodies and a new construction of knowledge about reproductive health. Moral discussion and juridification remove reproduction and non-reproduction from their personal and intimate context and frame them under words like “duties”, “rights”, “family planning”, “demography”, and “population policy”, reinvent them as “States business” and ultimately help to re/confirm a specific construct of fertility, motherhood, and family. Moreover, the interaction between the neoliberal economy and medical biotechnologies brought about a new formulation of the connection between feminine generative potential and value production. The widespread and contemporary debates on Medically Assisted Reproduction (MAR), surrogacy and abortion suggest the need for a “feminist/queer global bioethical discourse” capable of inserting itself into the official bioethical debate characterized by the traditional dichotomy of laic bioethics/Catholic bioethics. The contribution moves from a feminist bioethics perspective on reproductive technologies to introduce a feminist/queer global bioethics point of view on reproductive health. The comparison between reproduction and non-reproduction debates is useful to analyze and demonstrate how restrictive legislations, dichotomic bioethical discussion and medical control confirm and strengthens gender injustice in reproductive life. In fact, MAR, surrogacy, and abortion restrictions stem from a shared social and legal paradigm that depends on traditional gender roles revealing how the stratification of reproduction is based on multiple discrimination along the lines of gender, race, and class. In conclusion, the perspective of feminist/queer global bioethics tries to read the concept of universal reproductive justice, introducing an original point of view on reproductive health access.

Keywords: queer bioethics, reproductive health, reproductive justice, reproductive technologies

Procedia PDF Downloads 129

Authors: Panas Gerasimos, Kotidou Varvara, Halkiopoulos Constantinos, Gkintoni Evgenia

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As a result of growing technology and briefing by the internet, users resort to the internet and subsequently to the opinion of an expert. In many cases, they take control of their health in their hand and make a decision without the contribution of a doctor. According to that, this essay intends to analyze the confidence of searching health issues on the internet. For the fulfillment of this study, there has been a survey among doctors in order to find out the reasons a patient uses the internet about their health problems and the consequences that health information could lead by searching on the internet, as well. Specifically, the results regarding the research of the users demonstrate: a) the majority of users make use of the internet about health issues once or twice a month, b) individuals that possess chronic disease make health search on the internet more frequently, c) the most important topics that the majority of users usually search are pathological, dietary issues and the search of issues that are associated with doctors and hospitals. However, it observed that topic search varies depending on the users’ age, d) the most common sources of information concern the direct contact with doctors, as there is a huge preference from the majority of users over the use of the electronic form for their briefing and e) it has been observed that there is large lack of knowledge about e-health services. From the doctor's point of view, the following conclusions occur: a) almost all doctors use the internet as their main source of information, b) the internet has great influence over doctors’ relationship with the patients, c) in many cases a patient first makes a visit to the internet and then to the doctor, d) the internet significantly has a psychological impact on patients in order to for them to reach a decision, e) the most important reason users choose the internet instead of the health professional is economic, f) the negative consequence that emerges is inaccurate information, g) and the positive consequences are about the possibility of online contact with the doctor and contributes to the easy comprehension of the doctor, as well. Generally, it’s observed from both sides that the use of the internet in health issues is intense, which declares that the new means the doctors have at their disposal, produce the conditions for radical changes in the way of providing services and in the doctor-patient relationship.

Keywords: cognitive models, health marketing, e-health, psychological factors, digital marketing, e-health services

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Authors: Fasanmi Samuel Sunday

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The study examines the relationship between procedural justice and turnover intent among survivors in a consolidated Nigeria bank. Opinions of eight hundred and eighty five staff of First City Monumental Bank and Finbank who survived the consolidated process were conveniently sampled using battery of tests. Two hypotheses were tested for this study. Results revealed that procedural justice and demographic variables (sex, age, previous banking job experience, and year of work experience) were significantly, independently and jointly influence turnover intent among survivors in consolidated banks in Nigeria. Also, there was a significant relationship between procedural justice and turnover intent among survivors in a consolidated bank in Nigeria. It was recommended that if the workers perceived the process of downsizing to be fair, they tend to reason with their management and coast along with the process rather than increasing in their turnover intent which will eventually drastically reduce the profitability matrix which the banks desired so desperately.

Keywords: bankers, procedural justice, sex, turnover intent

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Authors: Swapna N., Deepthy Ann Joy

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One of the major causes of communication disorders in pediatric population is Motor speech disorders. These disorders which affect the motor aspects of speech articulators can have an adverse effect on the communication abilities of children in their developmental period. The motor aspects are dependent on the sensory abilities of children with motor speech disorders. Hence, oral sensorimotor evaluation is an important component in the assessment of children with motor speech disorders. To our knowledge, the importance of oral motor examination has been well established, yet the sensory assessment of the oral structures has received less focus. One of the most common motor speech disorders seen in children is developmental dysarthria. The present study aimed to assess the orosensory aspects in children with developmental dysarthria (CDD). The control group consisted of 240 children in the age range of four and eight years which was divided into four subgroups (4-4.11, 5-5.11, 6-6.11 and 7-7.11 years). The experimental group consisted of 15 children who were diagnosed with developmental dysarthria secondary to cerebral palsy who belonged in the age range of four and eight years. The oro-sensory aspects such as response to touch, temperature, taste, texture, and orofacial sensitivity were evaluated and profiled. For this purpose, the authors used the ‘Oral Sensorimotor Evaluation Protocol- Children’ which was developed by the authors. The oro-sensory section of the protocol was administered and the clinical profile of oro-sensory abilities of typically developing children and CDD was obtained for each of the sensory abilities. The oro-sensory abilities of speech articulators such as lips, tongue, palate, jaw, and cheeks were assessed in detail and scored. The results indicated that experimental group had poorer scores on oro-sensory aspects such as light static touch, kinetic touch, deep pressure, vibration and double simultaneous touch. However, it was also found that the experimental group performed similar to control group on few aspects like temperature, taste, texture and orofacial sensitivity. Apart from the oro-motor abilities which has received utmost interest, the variation in the oro-sensory abilities of experimental and control group is highlighted and discussed in the present study. This emphasizes the need for assessing the oro-sensory abilities in children with developmental dysarthria in addition to oro-motor abilities.

Keywords: cerebral palsy, developmental dysarthria, orosensory assessment, touch

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Authors: Georges Ghazi, Magali Gelhaye, Ruxandra Botez

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Over the years, the Flight Management System (FMS) has experienced a continuous improvement of its many features, to the point of becoming the pilot’s primary interface for flight planning operation on the airplane. With the assistance of the FMS, the concept of distance and time has been completely revolutionized, providing the crew members with the determination of the optimized route (or flight plan) from the departure airport to the arrival airport. To accomplish this function, the FMS needs an accurate Aircraft Performance Model (APM) of the aircraft. In general, APMs that equipped most modern FMSs are established before the entry into service of an individual aircraft, and results from the combination of a set of ordinary differential equations and a set of performance databases. Unfortunately, an aircraft in service is constantly exposed to dynamic loads that degrade its flight characteristics. These degradations endow two main origins: airframe deterioration (control surfaces rigging, seals missing or damaged, etc.) and engine performance degradation (fuel consumption increase for a given thrust). Thus, after several years of service, the performance databases and the APM associated to a specific aircraft are no longer representative enough of the actual aircraft performance. It is important to monitor the trend of the performance deterioration and correct the uncertainties of the aircraft model in order to improve the accuracy the flight management system predictions. The basis of this research lies in the new ability to continuously update an Aircraft Performance Model (APM) during flight using an adaptive lookup table technique. This methodology was developed and applied to the well-known Cessna Citation X business aircraft. For the purpose of this study, a level D Research Aircraft Flight Simulator (RAFS) was used as a test aircraft. According to Federal Aviation Administration the level D is the highest certification level for the flight dynamics modeling. Basically, using data available in the Flight Crew Operating Manual (FCOM), a first APM describing the variation of the engine fan speed and aircraft fuel flow w.r.t flight conditions was derived. This model was next improved using the proposed methodology. To do that, several cruise flights were performed using the RAFS. An algorithm was developed to frequently sample the aircraft sensors measurements during the flight and compare the model prediction with the actual measurements. Based on these comparisons, a correction was performed on the actual APM in order to minimize the error between the predicted data and the measured data. In this way, as the aircraft flies, the APM will be continuously enhanced, making the FMS more and more precise and the prediction of trajectories more realistic and more reliable. The results obtained are very encouraging. Indeed, using the tables initialized with the FCOM data, only a few iterations were needed to reduce the fuel flow prediction error from an average relative error of 12% to 0.3%. Similarly, the FCOM prediction regarding the engine fan speed was reduced from a maximum error deviation of 5.0% to 0.2% after only ten flights.

Keywords: aircraft performance, cruise, trajectory optimization, adaptive lookup tables, Cessna Citation X

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Authors: Michael T. Miller, G. David Gearhart

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Shared governance is an important element in higher education decision making. Through the joint decision making process, faculty members are provided an opportunity to help shape the future of an institution while increasing support for decisions that are made. Presidents, those leaders who are legally bound to guide their institutions, must find ways to collaborate effectively with faculty members in making decisions, and the first step in this process is understanding when and how presidents and faculty leaders interact. In the current study, a national sample of college presidents reported their preparation for the presidency, their perceptions of the functions of a faculty senate, and ultimately, the locations for important interactions between presidents and faculty senates. Results indicated that presidents, regardless of their preparation, found official functions to be the most important for communicating, although, those presidents with academic backgrounds were more likely to perceive faculty senates as having a role in all aspects of an institutions management.

Keywords: college faculty, college president, faculty senate, leadership

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Authors: Ahmed Al-Awthan

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This study addresses the prevalence of English terminology in published Arabic documentation on social media. Although the problem of using English terms in translation instead of existing native ones has been addressed in general by researchers around the world, to the best of the author’s knowledge the attitude of the translators as professionals to this phenomenon in Qatar and Yemen has not received a detailed study. This study examines the impact of the use of English, social media terms in the Arab world on aspiring and professional translators; it explores the benefits and drawbacks of linguistic borrowing as identified by the translators and investigates whether translators consider any means of resisting linguistic borrowing and prioritizing Arabic. It also aims to answer the following questions: i. Is there any prevalence of English, social media terms in Arabic translation? Why or why not? ii. Do Arabic translators prefer using English, social media terms to their equivalents in Arabic? If so, why? iii. Which measures could be adopted to help reduce the frequently observed borrowing of English terms? In particular, how do translators see the role of the Arabic Language Academies in preserving Arabic? iv. This research is descriptive, comparative and analytical in nature. It is both qualitative and quantitative. To validate the problem, the researcher will analyze articles published by Al-Jazeera in 2016-2018 that refer to the use of social media in diplomacy. It will be examined whether the increased international discussion of political events in social media increased the amount of transliterated English terminology referring to this mode of communication.To investigate whether the translators recognize the phenomenon of borrowing, the researcher proposes to use a survey. This survey will use multiple choice questions. It will target 20 aspiring translators from Yemen and 20 participants from Qatar. It will offer 15 English, social media terms used in discourse in 15 sentences. For each sentence, the researcher will provide three different translations and will ask the translators to rate them and offer their rendition. After collecting all the answers online, the researcher will analyze the data. The results are expected to confirm whether there is a prevalence of English terms in translating into Arabic. It is also expected to show what measures the translators used to render the English, social media terms, and it raises awareness of borrowing English terms. It will guide the translator toward using Arabicization methods in order to contribute to preserving Arabic.

Keywords: Arabicization, trans lingual borrowing, social media terms, terminology

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Authors: Jagbir Singh Kadyan, C. A. Suman Kadyan

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The researchers attempts to establish whether a relationship exists between the social activities undertaken & the funds that has been spent by the selected corporate organisations. Corporate listed on the (NSE) National Stock Exchange of India, under different categories shall be selected as a sample for the purpose of this study. The researches shall also study the dynamics of corporate social responsibility funding, financing & management of corporate social responsibility funds by the above selected organisations in the Indian context. The rationale behind selecting & undertaking specific corporate social responsibility activities shall be analysed & interpreted to discover the real drivers of corporate social responsibility. Besides above, an attempt shall further make an effort to understand & analyse the nature of impact on the selected corporate organisations on its overall performances due to the activities undertaken under their specific corporate social responsibility programs.

Keywords: corporate social responsibility, organisational performance, national stock exchange, sustainability, society, health, education, sanitation, environment

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Authors: Divnesh Lingam, Devi Rengamani Seenivasagam, Prashant Chand, Caleb Yee, John Chief, Rajeshkannan Ananthanarayanan

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Telecommuting Post-Pandemic: Barriers, Solutions, and Strategies. Amidst the COVID-19 outbreak in 2020, remote work emerged as a vital business continuity measure. This study investigates telecommuting’s modern work model, exploring its benefits and obstacles. Utilizing Interpretive Structural Modelling uncovers barriers hindering telecommuting adoption. A validated set of thirteen barriers is examined through departmental surveys, revealing interrelationships. The resulting model highlights interactions and dependencies, forming a foundational framework. By addressing dominant barriers, a domino effect on subservient barriers is demonstrated. This research fosters further exploration, proposing management strategies for successful telecommuting adoption and reshaping the traditional workspace.

Keywords: barriers, interpretive structural modelling, post-pandemic, telecommuting

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Authors: Sumattana Glangkarn, Vorapoj Promasatayaprot

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Background: Proportion of population ageing in Thailand has been increased rapidly in the past decades according to living longer and the fertility rates have decreased. The most important challenge related to this situation is to consider how to improve quality and years of healthy of life. This study aimed to implement the older persons’ long term care (LTC) system for elderly care by family and community. Method: The Consolidated Framework for Implementation Research (CFIR) was employed for guiding and evaluating an implementation process in ageing care. The CFIR composed of five major domains: intervention characteristics, outer setting, inner setting, characteristics of the individuals involved, and the process of implementation. Results: most elderly participants were couples, educating primary school and living with children and grandchildren. More than half of them had chronic diseases such as diabetes mellitus and hypertension. Factor analysis revealed factors related to health care of older participants which consisted of exercise, diet, accidental prevention, relaxation, self-care capacity, joyfulness, family relationship, and personal hygiene. A pre-implementation phase showed intervention characteristics included facilities and services of the LTC policy from the Ministry of Public Health. The complexities of the LTC and relative advantages were explained. Community leaders, public health volunteers, care givers and health professionals had participated in the LTC activities. Outer and inner settings consisted of context of community, culture, and readiness. Characteristics of the individuals related to knowledge, self-efficacy, perceptions, and believes. The process consisted of planning, acting, observing, and reflecting. The implementation outcomes and service outcomes had been evaluated during-implementation phase. Conclusion: the participation of caregivers, community leaders, public health volunteers, and health professionals had supported the LTC services. Thus, family and community care could improve quality of life of the ageing.

Keywords: ageing, CFIR, long term care, implementation

Procedia PDF Downloads 180

Authors: Manavjit Singh Dhindsa, Ursula Das, Kshirasagar Naik, Marzia Zaman, Richard Purcell, Srinivas Sampalli, Abdul Mutakabbir, Chung-Horng Lung, Thambirajah Ravichandran

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These days, wildland fires, also known as forest fires, are more prevalent than ever. Wildfires have major repercussions that affect ecosystems, communities, and the environment in several ways. Wildfires lead to habitat destruction and biodiversity loss, affecting ecosystems and causing soil erosion. They also contribute to poor air quality by releasing smoke and pollutants that pose health risks, especially for individuals with respiratory conditions. Wildfires can damage infrastructure, disrupt communities, and cause economic losses. The economic impact of firefighting efforts, combined with their direct effects on forestry and agriculture, causes significant financial difficulties for the areas impacted. This research explores different forest fire spread models and presents a comprehensive review of various techniques and methodologies used in the field. A forest fire spread model is a computational or mathematical representation that is used to simulate and predict the behavior of a forest fire. By applying scientific concepts and data from empirical studies, these models attempt to capture the intricate dynamics of how a fire spreads, taking into consideration a variety of factors like weather patterns, topography, fuel types, and environmental conditions. These models assist authorities in understanding and forecasting the potential trajectory and intensity of a wildfire. Emphasizing the need for a comprehensive understanding of wildfire dynamics, this research explores the approaches, assumptions, and findings derived from various models. By using a comparison approach, a critical analysis is provided by identifying patterns, strengths, and weaknesses among these models. The purpose of the survey is to further wildfire research and management techniques. Decision-makers, researchers, and practitioners can benefit from the useful insights that are provided by synthesizing established information. Fire spread models provide insights into potential fire behavior, facilitating authorities to make informed decisions about evacuation activities, allocating resources for fire-fighting efforts, and planning for preventive actions. Wildfire spread models are also useful in post-wildfire mitigation strategies as they help in assessing the fire's severity, determining high-risk regions for post-fire dangers, and forecasting soil erosion trends. The analysis highlights the importance of customized modeling approaches for various circumstances and promotes our understanding of the way forest fires spread. Some of the known models in this field are Rothermel’s wildland fuel model, FARSITE, WRF-SFIRE, FIRETEC, FlamMap, FSPro, cellular automata model, and others. The key characteristics that these models consider include weather (includes factors such as wind speed and direction), topography (includes factors like landscape elevation), and fuel availability (includes factors like types of vegetation) among other factors. The models discussed are physics-based, data-driven, or hybrid models, also utilizing ML techniques like attention-based neural networks to enhance the performance of the model. In order to lessen the destructive effects of forest fires, this initiative aims to promote the development of more precise prediction tools and effective management techniques. The survey expands its scope to address the practical needs of numerous stakeholders. Access to enhanced early warning systems enables decision-makers to take prompt action. Emergency responders benefit from improved resource allocation strategies, strengthening the efficacy of firefighting efforts.

Keywords: artificial intelligence, deep learning, forest fire management, fire risk assessment, fire simulation, machine learning, remote sensing, wildfire modeling

Procedia PDF Downloads 86

Authors: Julianne Viola

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Young people are at a critical stage in their lives, developing from young participants to adult participants in democratic society. At this time, civic engagement is crucial for young people’s sense of belonging and future participation in their communities. In adolescence, individuals form their own identities and associations with others and may accomplish this with the help of technology and social media. In the Digital Age, young people and adults use technology as a platform to discuss political issues, including human rights and social justice but do not always engage in civil discourse. There is an urgent need to investigate this complex interplay of social media, identity formation, and civil discourse as it relates to how teenagers become participants in democratic society and how they engage in civil discourse. This qualitative study draws on theories of identity formation in adolescence and is situated within the literature surrounding teen civic engagement and technology use. Through in-depth interviews with participants ages 14 through 17, this study investigates the ways in which teens conceptualize their civic identities and engagement, presence online, and civil discourse. The context in which the young people in this study have grown up has the potential to impact and inform these processes. Early results of this study illustrate what it means to be a young person in today’s world, and how perceptions of others’ opinions may influence young people’s engagement in their communities and online. Participants in this study often indicated concerns of their age as a constraint on participation in their communities and in society, and a self-imposed restriction around the people with whom they engage in conversation about political and social issues. While the participants shared common concerns and experiences, each participant’s unique perspectives and beliefs are viewed with equal importance. The results from this research will help students, teachers, and community groups learn about the reasons for engagement and disengagement among this age group, and how technology has influenced teens’ dialogue about political issues. With this knowledge, academics and school leaders can devise new ways to best teach citizenship skills and civil discourse to students in the Digital Age.

Keywords: civics, digital age, discourse, sociology of youth, youth studies

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Authors: Fiffy Hanisdah Saikim, Bruce Prideaux

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One of the aims of wildlife tourism is to educate visitors about the threats facing wildlife, in general, and the actions needed to protect the environment and maintain biodiversity. Annually, millions of tourists visit natural areas and zoos primarily to view flagship species such as rhinos and elephants. Venues rely on the inherent charisma of these species to increase visitation and anchor conservation efforts. Expected visitor outcomes from the use of flagships include raised levels of awareness and pro-conservation behaviors. However, the role of flagships in wildlife tourism has been criticized for not delivering conservation benefits for species of interest or biodiversity and producing negative site impacts. Furthermore, little is known about how the connection to a species influences conservation behaviors. This paper addresses this gap in knowledge by extending previous work exploring wildlife tourism to include the emotional connection formed with wildlife species and pro-conservation behaviors for individual species and biodiversity. This paper represents a substantial contribution to the field because (a) it incorporates the role of the experience in understanding how tourists connect with a species and how this connection influences pro-conservation behaviors; and (b) is the first attempt to operationalize Conservation Caring as a measure of tourists’ connection with a species. Existing studies have investigated how specific elements, such as interpretation or species’ morphology may influence programmatic goals or awareness. However, awareness is a poor measure of an emotional connection with an animal. Furthermore, there has not been work done to address the holistic nature of the wildlife viewing experience, and its subsequent influence on behaviors. Results based on the structural equation modelling, support the validity of Conservation Caring as a factor; the ability of wildlife tourism to influence Conservation Caring; and that this connection is a strong predictor of conservation awareness behaviors. These findings suggest wildlife tourism can deliver conservation outcomes. The studies in this paper also provide a valuable framework for structuring wildlife tourism experiences to align with flagship related conservation outcomes, and exploring a wider assemblage of species as potential flagships.

Keywords: wildlife tourism, conservation caring, conservation awareness, structural equation modelling

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Authors: M. Mohemmed Sha, T. Manesh, A. Ahmed Mohamed Mustaq

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In this corporate world, the technology of Web services has grown rapidly and its significance for the development of web based applications gradually rises over time. The success of Business to Business integration rely on finding novel partners and their services in a global business environment. But the selection of the most suitable Web service from the list of services with the identical functionality is more vital. The satisfaction level of the customer and the provider’s reputation of the Web service are primarily depending on the range it reaches the customer’s requirements. In most cases the customer of the Web service feels that he is spending for the service which is undelivered. This is because the customer always thinks that the real functionality of the web service is not reached. This will lead to change of the service frequently. In this paper, a framework is proposed to evaluate the Quality of Service (QoS) and its cost that makes the optimal correlation between each other. Also this research work proposes some management decision against the functional deviancy of the web service that are guaranteed at time of selection.

Keywords: web service, service level agreement, quality of a service, cost of a service, QoS, CoS, SOA, WSLA, WsRF

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Authors: Melina, Jumardi Jumardi, Erwin Erwin, Sri Nuraminah, Andi Nasruddin

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The rice field rat (Rattus argentiventer Robinson and Kloss) is a pest causing the greatest yield loss of rice plants, especially in lowland agroecosystems with intensive cropping patterns (2-3 plantings per year). Field mice damage rice plants at all stages of growth, from seedling to harvest, even in storage warehouses. Severe damage with yield loss of up to 100% occurs if rats attack rice at the generative stage because the plants are no longer able to recover by forming new tillers. Farmers mainly use rodenticides in the form of poisoned baits or as fumigants, which are applied to rat burrow holes. This practice is generally less effective because mice are able to avoid the poison or become resistant after several exposures to it. In addition, excessive use of rodenticides can have negative impacts on the environment and non-target organisms. For this reason, this research was conducted to evaluate the effectiveness of fences as an environmentally friendly mechanical control method in reducing rice yield losses due to rat attacks. This study used a factorial randomized block design. The first factor was the fence material, namely galvanized zinc plate and plastic. The second factor was the height of the fence, namely 25, 50, 75, and 100 cm from the ground level. Each treatment combination was repeated five times. Data shows that zinc fences with a height of 75 and 100 cm are able to provide full protection to plants from rat infestations throughout the planting season. However, zinc fences with a height of 25 and 50 cm failed to prevent rat attacks. Plastic fences with a height of 25 and 50 cm failed to prevent rat attacks during the planting season, whereas 75 and 100 cm were able to prevent rat attacks until all the crops outside of the fence had been eaten by rats. The rat managed to get into the fence by biting the plastic fence close to the ground. Thus, the research results show that fences made of zinc plate with a height of at least 75 cm from the ground surface are effective in preventing plant damage caused by rats. To our knowledge, this research is the first to quantify the effectiveness of fences as a control of field rodents.

Keywords: rice field rat, Rattus argentiventer, fence, rice

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Authors: T. A. Mona M. Salem, Ali F. Bakr

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Given the potential devastation associated with future climate change related disasters, it is vital to change the way we build and manage our cities, through new strategies to reconfigure them and their infrastructures in ways that help secure their reproduction. This leads to a kaleidoscopic view of the city that recognizes the interrelationships of energy, water, transportation, and solid waste. These interrelationships apply across sectors and with respect to the built form of the city. The paper aims at a long-term climate resilience of cities and their critical infrastructures, and sets out an argument for including an eco-infrastructure-based approach in strategies to address climate change. As these ecosystems have a critical role to play in building resilience and reducing vulnerabilities in cities, communities and economies at risk, the enhanced protection and management of ecosystems, biological resources and habitats can mitigate impacts and contribute to solutions as nations and cities strive to adapt to climate change.

Keywords: ecology, ecosystem, infrastructure, climate change, urban

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Authors: Dimitrios Triantakonstantis, Demetris Stathakis

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Urban areas have been expanded throughout the globe. Monitoring and modeling urban growth have become a necessity for a sustainable urban planning and decision making. Urban prediction models are important tools for analyzing the causes and consequences of urban land use dynamics. The objective of this research paper is to analyze and model the urban change, which has been occurred from 1990 to 2000 using CORINE land cover maps. The model was developed using drivers of urban changes (such as road distance, slope, etc.) under an Artificial Neural Network modeling approach. Validation was achieved using a prediction map for 2006 which was compared with a real map of Urban Atlas of 2006. The accuracy produced a Kappa index of agreement of 0,639 and a value of Cramer's V of 0,648. These encouraging results indicate the importance of the developed urban growth prediction model which using a set of available common biophysical drivers could serve as a management tool for the assessment of urban change.

Keywords: artificial neural networks, CORINE, urban atlas, urban growth prediction

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Authors: Kimberley Kennedy

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The major findings of this study discuss the importance of understanding and applying Systems thinking concepts to ensure an effective Project-Based Learning environment. A pilot project study of a major pedagogical change was conducted over a five year period with the goal to give students real world, hands-on learning experiences and the opportunity to apply what they had learned over the past two years of their business program. The first two weeks of the fifteen week semester utilized teaching methods of lectures, guest speakers and design thinking workshops to prepare students for the project work. For the remaining thirteen weeks of the semester, the students worked with actual business owners and clients on projects and challenges. The first three years of the five year study focused on student feedback to ensure a quality learning experience and continuous improvement process was developed. The final two years of the study, examined the conceptual understanding and perception of learning and teaching by faculty using Project-Based Learning pedagogy as compared to lectures and more traditional teaching methods was performed. Relevant literature was reviewed and data collected from program faculty participants who completed pre-and post-semester interviews and surveys over a two year period. Systems thinking concepts were applied to better understand the challenges for faculty using Project-Based Learning pedagogy as compared to more traditional teaching methods. Factors such as instructor and student fatigue, motivation, quality of work and enthusiasm were explored to better understand how to provide faculty with effective support and resources when using Project-Based Learning pedagogy as the main teaching method. This study provides value by presenting generalizable, foundational knowledge by offering suggestions for practical solutions to assure student and teacher engagement in Project-Based Learning courses.

Keywords: continuous improvement, project-based learning, systems thinking, teacher engagement

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Authors: Saimir Heta, Kers Kapaj, Rialda Xhizdari, Ilma Robo

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Despite the existence of different dental specialties, the dentist-patient relationship is unique, in the very fact that the treatment is performed by one doctor and the patient identifies the malpractice presented as part of that doctor's practice; this is in complete contrast to cases of medical treatments where the patient can be presented to a team of doctors, to treat a specific pathology. The rules of dental ethics are almost the same as the rules of medical ethics. The appearance of dental malpractice affects exactly this two-party relationship, created on the basis of professionalism, without deviations in this direction, between the dentist and the patient, but with very narrow individual boundaries, compared to cases of medical malpractice. Main text: Malpractice can have different reasons for its appearance, starting from professional negligence, but also from the lack of professional knowledge of the dentist who undertakes the dental treatment. It should always be seen in perspective that we are not talking about the individual - the dentist who goes to work with the intention of harming their patients. Malpractice can also be a consequence of the impossibility, for anatomical or physiological reasons of the tooth under dental treatment, to realize the predetermined dental treatment plan. On the other hand, the dentist himself is an individual who can be affected by health conditions, or have vices that affect the systemic health of the dentist as an individual, which in these conditions can cause malpractice. So, depending on the reason that led to the appearance of malpractice, the method of treatment from a legal point of view also varies, for the dentist who committed the malpractice, evaluating the latter if the malpractice came under the conditions of applying the rules of dental ethics. Conclusions: The deviation from the predetermined dental plan is the minimum sign of malpractice and the latter should not be definitively related only to cases of difficult dental treatments. The identification of the reason for the appearance of malpractice is the initial element, which makes the difference in the way of its treatment, from a legal point of view, and the involvement of the dentist in the assessment of the malpractice committed, must be based on the legislation in force, which must be said to have their specific changes in different states. Malpractice should be referred to, or included in the lectures or in the continuing education of professionals, because it serves as a method of obtaining professional experience in order not to repeat the same thing several times, by different professionals.

Keywords: dental ethics, malpractice, negligence, legal basis, continuing education, dental treatments

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Authors: Katalin Juhasz-Dora

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Several studies have shown that physical environments, milieu, atmosphere and service space play a significant role in the consumer experience. In the case of themed servicescapes, different tangible assets (design, decoration, facilities, amenities), intangible assets (service, activities) contribute to the luxury guest experience. This current study summarizes the literature related to the guest experience in the case of luxury hotels. Based on the results of a case study, additional dimensions of guest experience are explored. The research findings contribute to the extension of literature by providing a conceptual framework in specific themed luxury hotels. Understanding the elements of themed servicescape and dimensions of guest experience play a significant role in consumer behavior. Implications for management and future research directions are presented.

Keywords: atmosphere, guest experience, luxury service, themed hotel

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Authors: Sourour Ramzi, Claudia Sarrico

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Little has been done on network DEA in education, and nobody has attempted to model the whole education supply chain using network DEA. As such the contribution of the present paper is to propose a model for measuring the efficiency of education supply chains using network DEA. First, we use a general survey of data envelopment analysis (DEA) to establish the emergent themes for research in DEA, and focus on the theme of Network DEA. Second, we use a survey on two-stage DEA models, and Network DEA to write a state of the art on Network DEA, particularly applied to supply chain management. Third, we use a survey on DEA applications to establish the most influential papers on DEA education applications, in order to establish the state of the art on applications of DEA in education, in general, and applications of DEA to education using network DEA, in particular. Finally, we propose a model for measuring the performance of education supply chains of different education systems (countries or states within a country, for instance). We then use this model on some empirical data.

Keywords: supply chain, education, data envelopment analysis, network DEA

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Authors: Evija Silina, Maris Taube, Maksims Zolovs

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Background: Type 1 diabetes mellitus (T1D) is the most common chronic endocrine pathology in children. The management of type 1 diabetes requires a strong diet, physical activity, lifelong insulin therapy, and proper self-monitoring of blood glucose and is usually complicated and, therefore, may result in a variety of psychosocial problems for children, adolescents, and their families. Metabolic control of the disease is determined by glycated haemoglobin (HbA1c), the main criterion for diabetes compensation. A correlation was observed between anxiety and depression levels and glycaemic control in many previous studies. It is assumed that anxiety and depression symptoms negatively affect glycaemic control. Parental psychological distress was associated with higher child self-report of stress and depressive symptoms, and it had negative effects on diabetes management. Objective: The main objective of this paper is to evaluate the relationship between parental mental health conditions (depression and anxiety) and metabolic control of their adolescents with T1DM. Methods: This cross-sectional study recruited adolescents with T1D (N=251) and their parents (N=251). The respondents completed questionnaires. The 7-item Generalized Anxiety Disorder (GAD-7) scale measured anxiety level; The Patient Health Questionnaire – 9 (PHQ-9) measured depressive symptoms. Glycaemic control of patients was assessed using the last glycated haemoglobin (HbA1c) values. GLM mediation analysis was performed to determine the potential mediating effect of the parent’s mental health conditions (depression and anxiety) on the relationship between the mental health conditions (depression and anxiety) of a child on the level of glycated hemoglobin (HbA1c). To test the significance of the mediated effect (ME) for non-normally distributed data, bootstrapping procedures (10,000 bootstrapped samples) were used. Results: 502 respondents were eligible for screening to detect anxiety and depression symptoms. Mediation analysis was performed to assess the mediating role of parent GAD-7 on the linkage between a dependent variable (HbA1c) and independent variables (child GAD-7 un child PHQ-9). The results revealed that the total effect of child GAD-7 (B = 0.479, z = 4.30, p < 0.001) on HbA1c was significant but the total effect of child PHQ-9 (B = 0.166, z = 1.49, p = 0.135) was not significant. With the inclusion of the mediating variable (parent GAD-7), the impact of child GAD-7 on HbA1c was found insignificant (B = 0.113, z=0.98, p = 0.326), the impact of child PHQ-9 on HbA1c was found also insignificant (B = 0.068, z=0.74, p = 0.458). The indirect effect of child GAD-7 on HbA1c through parent GAD-7 was found significant (B = 0.366, z = 4.31, p < 0.001) and the indirect effect of child PHQ-9 on HbA1c through parent GAD-7 was found also significant (B = 0.098, z = 2.56, p = 0.010). This indicates that the relationship between a dependent variable (HbA1c) and independent variables (child GAD-7 un child PHQ-9) is fully mediated by parent GAD-7. Conclusion: The main result suggests that glycated haemoglobin in adolescents with Type 1 diabetes is related to adolescents’ mental health via parents’ anxiety. It means that parents’ anxiety plays a more significant role in the level of glycated haemoglobin in adolescents than depression and anxiety in the adolescent.

Keywords: type 1 diabetes, adolescents, parental diabetes-specific mental health conditions, glycated haemoglobin, anxiety, depression

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Authors: Michelle R. Sullivan

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Positive romantic relationships and marriages offer a buffer against a host of physical and emotional difficulties. Conversely, poor relationship quality and marital discord can have deleterious consequences for individuals and families. Research has described non-monogamy, infidelity, and consensual non-monogamy, as both consequential and causal of relationship difficulty, or as a unique way a couple strives to make a relationship work. Much research on consensual non-monogamy has built on feminist theory and critique. To the author’s best knowledge, to date, no studies have examined the predictive relationship between individual and relationship characteristics and expectations of non-monogamy. The current longitudinal study: 1) estimated the prevalence of expectations of partner non-monogamy and 2) evaluated whether gender, sexual identity, age, education, how a couple met, and relationship quality were predictive expectations of partner non-monogamy. This study utilized the publically available longitudinal dataset, How Couples Meet and Stay Together. Adults aged 18- to 98-years old (n=4002) were surveyed by phone over 5 waves from 2009-2014. Demographics and how a couple met were gathered through self-report in Wave 1, and relationship quality and expectations of partner non-monogamy were gathered through self-report in Waves 4 and 5 (n=1047). The prevalence of expectations of partner non-monogamy (encompassing both infidelity and consensual non-monogamy) was 4.8%. Logistic regression models indicated that sexual identity, gender, education, and relationship quality were significantly predictive of expectations of partner non-monogamy. Specifically, male gender, lower education, identifying as lesbian, gay, or bisexual, and a lower relationship quality scores were predictive of expectations of partner non-monogamy. Male gender was not predictive of expectations of partner non-monogamy in the follow up logistic regression model. Age and whether a couple met online were not associated with expectations of partner non-monogamy. Clinical implications include awareness of the increased likelihood of lesbian, gay, and bisexual individuals to have an expectation of non-monogamy and the sequelae of relationship dissatisfaction that may be related. Future research directions could differentiate between non-monogamy subtypes and the person and relationship variables that lead to the likelihood of consensual non-monogamy and infidelity as separate constructs, as well as explore the relationship between predicting partner behavior and actual partner behavioral outcomes.

Keywords: open relationship, polyamory, infidelity, relationship satisfaction

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Authors: B. Donkova, M. Nedyalkova, D. Mehandjiev

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Sparingly soluble manganese oxalate is an appropriate precursor for the preparation of nanosized manganese oxides, which have a wide range of technological application. During the precipitation of manganese oxalate, three crystal forms could be obtained – α-MnC₂O₄.2H₂O (SG C2/c), γ-MnC₂O₄.2H₂O (SG P212121) and orthorhombic MnC₂O₄.3H₂O (SG Pcca). The thermolysis of α-MnC₂O₄.2H₂O has been extensively studied during the years, while the literature data for the other two forms has been quite scarce. The aim of the present communication is to highlight the influence of the initial crystal structure on the decomposition mechanism of these three forms, their magnetic properties, the structure of the anhydrous oxalates, as well as the nature of the obtained oxides. For the characterization of the samples XRD, SEM, DTA, TG, DSC, nitrogen adsorption, and in situ magnetic measurements were used. The dehydration proceeds in one step with α-MnC₂O₄.2H2O and γ-MnC₂O₄.2H₂O, and in three steps with MnC₂O₄.3H2O. The values of dehydration enthalpy are 97, 149 and 132 kJ/mol, respectively, and the last two were reported for the first time, best to our knowledge. The magnetic measurements show that at room temperature all samples are antiferomagnetic, however during the dehydration of α-MnC₂O₄.2H₂O the exchange interaction is preserved, for MnC₂O₄.3H₂O it changes to ferromagnetic above 35°C, and for γ-MnC₂O₄.2H₂O it changes twice from antiferomagnetic to ferromagnetic above 70°C. The experimental results for magnetic properties are in accordance with the computational results obtained with Wien2k code. The difference in the initial crystal structure of the forms used determines different changes in the specific surface area during dehydration and different extent of Mn(II) oxidation during decomposition in the air; both being highest at α-MnC₂O₄.2H₂O. The isothermal decomposition of the different oxalate forms shows that the type and physicochemical properties of the oxides, obtained at the same annealing temperature depend on the precursor used. Based on the results from the non-isothermal and isothermal experiments, and from different methods used for characterization of the sample, a comparison of the nature, mechanism and peculiarities of the thermolysis of the different crystal forms of manganese oxalate was made, which clearly reveals the influence of the initial crystal structure. Acknowledgment: 'Science and Education for Smart Growth', project BG05M2OP001-2.009-0028, COST Action MP1306 'Modern Tools for Spectroscopy on Advanced Materials', and project DCOST-01/18 (Bulgarian Science Fund).

Keywords: crystal structure, magnetic properties, manganese oxalate, thermal behavior

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Authors: John Masani Nduko, Joseph Wafula Matofari

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Many spontaneously fermented milk products are produced in Kenya, where they are integral to the human diet and play a central role in enhancing food security and income generation via small-scale enterprises. Fermentation enhances product properties such as taste, aroma, shelf-life, safety, texture, and nutritional value. Some of these products have demonstrated therapeutic and probiotic effects although recent reports have linked some to death, biotoxin infections, and esophageal cancer. These products are mostly processed from poor quality raw materials under unhygienic conditions resulting to inconsistent product quality and limited shelf-lives. Though very popular, research on their processing technologies is low, and none of the products has been produced under controlled conditions using starter cultures. To modernize the processing technologies for these products, our study aims at describing the microbiology and biochemistry of a representative Kenyan spontaneously fermented milk product, Mursik using modern biotechnology (DNA sequencing) and their chemical composition. Moreover, co-creation processes reflecting stakeholders’ experiences on traditional fermented milk production technologies and utilization, ideals and senses of value, which will allow the generation of products based on common ground for rapid progress will be discussed. Knowledge of the value of clean starting raw material will be emphasized, the need for the definition of fermentation parameters highlighted, and standard equipment employment to attain controlled fermentation discussed. This presentation will review the available information regarding traditional fermented milk (Mursik) and highlight our current research work on the application of molecular approaches (metagenomics) for the valorization of Mursik production process through starter culture/ probiotic strains isolation and identification, and quality and safety aspects of the product. The importance of the research and future research areas on the same subject will also be highlighted.

Keywords: lactic acid bacteria, high throughput biotechnology, spontaneous fermentation, Mursik

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Authors: Regina Bowler

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Rationale & Aims: Complementary interventions such as mindfulness-meditation, gratitude, and self-affirmation are often used by therapists to treat stress. Many studies have been conducted using these interventions either individually or adjunctively with regard to stress. However, there has been little work comparing these interventions to investigate which of them is the most effective in treating stress. This study aims to compare these interventions and to determine which of them has the strongest perceived and physiological impact on stress. Participants: 120 law students preparing to take the bar exam: 3 experimental groups of 30 individuals, 1 control group of 30 individuals. Methods: One day prior to administering the interventions, baseline salivary cortisol samples will be taken, and the participants will complete the perceived stress scale (Cohen et al., 1983). Thirty days prior to the bar exam, each experimental group will be given an intervention to practice. Interventions will be practiced once in the morning after waking and once at night at bedtime. In group one, each participant will do a recorded three-minute mindfulness meditation. In group two, each participant will practice gratitude by writing down three things he/she/they are grateful for. In group three, each participant will practice affirmation by writing three sentences affirming his/her/their core values. The control group will not have an intervention to practice. Starting experimental day 1, upon waking and prior to practicing the intervention, the participants will take a salivary cortisol sample. Then they will practice their given intervention. Every night, before going to bed, the participants will practice their given intervention for a second time. The participants will practice their interventions and take salivary cortisol samples for 28 days. After each seven-day period (days 7, 14, 21, 28), the participants will fill out a brief questionnaire about the effects their intervention has on their stress, daily life, and relationships with themselves and others. On day 29, the participants will take a final salivary cortisol sample and will fill out the Perceived Stress Scale (Cohen et al., 1983). Applications of findings: Findings from this study would inform therapists of best practices when working with clients with stress. Moreover, therapists will gain knowledge of how individuals perceive these interventions and their impact on stress, daily life, somatic symptoms, and relationships with self and others. Thus, therapists will be able to administer these interventions with more precision to the stress-related contexts and issues their clients bring.

Keywords: stress, mindfulness-meditation, gratitude, affirmations, complementary interventions

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Authors: Nükhet Konuk, N. Gamze Turan, Yüksel Ardalı

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Cities play a vital role in the social fabric of countries and in national and regional economic growth worldwide; however, the environmental effects of such growth need to be assessed and managed better. The critical and most immediate problems faced by cities of developing countries are the health impacts of urban pollution that derive from inadequate water, sanitation, drainage and solid waste services, poor urban and industrial waste management, and air pollution. As globalization continues, earth's natural processes transform local problems into international issues. The aim of this study is to provide a broad overview of the pollution from urban wastes and emissions in Turkey which is a developing country. It is aimed to underline the significance of reorganizing the institutional tools in a worldwide perspective in order to generate coherent solutions to urban problems, and to enhance urban quality.

Keywords: environmental pollution, developing countries, environmental degradation, urban environmental problems

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Authors: Carolina S. Monteiro, Eugénia Pinto, Miguel A. Faria, Sara C. Cunha

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About half of the world's population eats rice daily, making it the primary food source for billions of people. Besides its nutrition potential, rice can be a significant route of exposure to many contaminants. Mycotoxins are an example of such contaminants that can be present in rice. Among them, ochratoxin (OTA), citrinin (CIT), and zearalenone (ZEN) are frequently reported in rice. During digestion, only a fraction of mycotoxins from food can be absorbed (bioaccessible fraction), influencing their ability to cause toxic effects. Insufficient knowledge of the bioavailability of mycotoxins, alone and in combination, may hinder an accurate risk assessment of contaminants ingested by humans. In this context, two different rice (Oryza sativa) varieties, Carolino white and Carolino brown, both with and without turmeric, were boiled and individually spiked with OTA, CIT, and ZEN plus with its combination. Subsequently, samples were submitted to the INFOGEST harmonized in vitro digestion protocol to evaluate the bioaccessibility of mycotoxins. Afterward, the in vitro intestinal transport of the mycotoxins, both alone and in combination, was evaluated in digests of Carolino white rice with and without turmeric. Assays were performed with a monolayers of of Caco-2 and HT-29 cells. Bioaccessibility of OTA and ZEN, alone and in combination, were similar in Carolino white and brown rice with or without turmeric. For CIT, when Carolino white rice was used, the bioaccessibility was higher alone than in combination (62.00% vs. 25.00%, without turmeric; 87.56% vs. 53.87%, with turmeric); however, with Carolino brown rice was the opposite (66.38% vs. 75.20%, without turmeric; 43.89% vs. 59.44%, with turmeric). All the mycotoxins, isolated, reached the higher bioaccessibility in the Carolino white rice with turmeric (CIT: 87.56%; OTA: 59.24%; ZEN: 58.05%). When mycotoxins are co-present, the higher bioaccessibility of each one varies with the type of rice. In general, when turmeric is present, bioaccessibility increases, except for CIT, using Carolino brown rice. Concerning the intestinal absorption in vitro, after 3 hours of transport, all mycotoxins were detected in the basolateral compartment being thus transported through the cells monolayer. ZEN presented the highest fraction absorbed isolated and combined, followed by CIT and OTA. These findings highlight that the presence of other components in the complex dietary matrix, like turmeric, and the co-presence of mycotoxins can affect its final bioavailability with obvious implications for health risk. This work provides new insights to qualitatively and quantitatively describe mycotoxin in rice fate during human digestion and intestinal absorption and further contribute to better risk assessment.

Keywords: bioaccessibility, digestion, intestinal absorption, mycotoxins

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Authors: Diana Gibson

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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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