BACKGROUND: Low- and middle-income countries have a critical shortage of specialist anaesthetists. Most patients arriving for surgery are of low perioperative risk. Without immediate access to preoperative specialist care, an appropriate interim strategy may be to ensure that only high-risk patients are seen preoperatively by a specialist. Matching human resources to the burden of disease with a nurse-administered pre-operative screening tool to identify high-risk patients who might benefit from specialist review prior to the day of surgery may be an effective strategy OBJECTIVE: To develop a nurse-administered preoperative anaesthesia screening tool to identify patients who would most likely benefit from a specialist review before the day of surgery, and those patients who could safely be seen by the anaesthetist on the day of surgery. This would ensure adequate time for optimisation of high-risk patients preoperatively and limit avoidable day-of-surgery cancellations METHODS: A systematic review was conducted to identify preoperative screening questions for use in a three-round Delphi consensus process. A panel of 16 experienced full-time clinical anaesthetists representing all university-affiliated anaesthesia departments in South Africa participated to define a nurses' screening tool for preoperative assessment RESULTS: Ninety-eight studies were identified, which generated 79 questions. An additional 14 items identified by the facilitators were added to create a list of 93 questions for the first round. The final screening tool consisted of 81 questions, of which 37 were deemed critical to identify patients who should be seen by a specialist prior to the day of surgery CONCLUSION: A structured nurse-administered preoperative screening tool is proposed to identify high-risk patients who are likely to benefit from a timely preoperative specialist anaesthetist review to avoid cancellation on the day of surgery

INTRODUCTION: Caries and gingival disease are prevalent oral health issues affecting more than 80% of school-going children including those with special needs attending special schools. Schools play a crucial role in promoting oral health, providing education and identifying issues early. These school-based health programmes are essential for addressing these issues and can reach more than 1 billion children worldwide, as well as school staff, families and the community. AIMS AND OBJECTIVES: To determine the current delivery of oral health care programmes in the identified special schools by means of a semi-structured interview with school managers. DESIGN: A descriptive qualitative study design. METHODS: All school managers (principals) who were responsible for the facilitation of the implementation and delivery of oral health services in each of the 22 special schools were invited to participation in the study. Purposive sampling was used to select the managers at the various special schools. Data collection comprised face-to-face, semi-structured interviews to explore the specific provision of oral health-related interventions and programmes (1 interview was conducted per school, n=22). RESULTS: Six emergent themes were present in the study: oral health activities, implementation and evaluation process, implementation challenges, policy content perceptions, dental examinations and oral health prevalence in special schools. Oral hygiene was identified as a priority, with educators and school nurses responsible for school oral health education, supervised teeth brushing programme, pain management, oral examinations in some cases and referral for dental treatments through engaging parents, learners and health workers in oral health promotion, which was supported by the school's health policy with the departmental heads responsible for programme evaluation. However, the implementation of the programmes was impacted by five factors: lack of parental support, lack of professional guidance, lack of resources, lack of support from the oral health department and the Covid-19 pandemic further exacerbated these challenges. CONCLUSION: The study reveals that special schools have preventative and promotive oral health programmes, but they need therapeutic or curative services to address unmet treatment needs. Factors affecting these programmes have led to gaps in implementation processes. Together, these findings point to an urgent need for a review of oral health care programmes in KwaZulu-Natal special schools to ensure proper support and collaboration between key stakeholders to reduce negative effects and improve overall oral health programmes.

BACKGROUND: Globally, medical institutes have seen an increase in female graduates, however surgical disciplines remain male-dominated. An epidemiological shift towards non-communicable diseases and trauma may result in a shortage of surgical specialists. One strategy to improve the surgical workforce is the recruitment of female graduates METHODS: A non-validated questionnaire was administered to females registered for the Master of Medicine (MMED) degree in General and Orthopaedic Surgery at the University of KwaZulu-Natal (UKZN) between 2000 and 2015. The study evaluated reasons for choice of surgery as a career, challenges faced on the domestic and work front, as well as factors that assisted with successful completion of training RESULTS: Seventy-two female trainees in General Surgery and Orthopaedics were identified from the UKZN databases. The contact details for 62 of these trainees were available. The overall response rate was 71.0% (44/62). A total of 95.5% (42/44) of participants selected surgery due to a passion for the field. Major challenges identified were a poor home and work-life balance (72.1%, 31/43) and poor working conditions (62.8%, 27/43). Female trainees perceived that they were viewed as inferior by patients (65.9%, 29/44). Successful trainees had a good home support system (89.3%, 25/28) and mentorship during training (60.7%, 17/28), and 85.7% (24/28) did not regret their career choice CONCLUSION: The recruitment and retention of females in surgery will contribute to maintaining an adequate surgical workforce. Training programmes need to improve work-life balance without compromising on producing competent surgeons. Improved visibility of female surgeons in leadership roles should be encouraged to promote mentorship and recruitment of trainees

SIGNIFICANCE: We elucidate the misinterpretations raised by Thaldar et al. (S Afr J Sci. 2023;119(11/12), Art. #15722) on our previous publication in which we outlined the data sharing governance landscape in selected African countries.

Recent advancements in artificial intelligence (AI) have reignited discussions about the value of the university and its role in producing and facilitating knowledge. The invention of ChatGPT has led to differing responses in the academy, with some welcoming its abilities and others fearing that it may undermine what schools and universities do, calling it "apocalyptic" (Green 2022). These aspects impact the integrity of the academy and are therefore a fundamental contribution to the debate. The impact, as well as the perceived impact, of AI on teaching and learning in higher education has been consistently documented in popular media. Therefore, the aim of this article is to understand the impact of ChatGPT on plagiarism and scholarly writing. It contributes to the under-researched academic discourse of generative artificial intelligence and teaching and learning by garnering the views of three established professors in South Africa. The findings from this qualitative endeavour demonstrate that, for these professors, these kinds of technology are welcome, and students need to be taught how to engage with them rather than vilifying them. Much of the responsibility rests on the lecturers and the university to create a teaching and learning environment that allows for these technologies to enter the classroom, especially in the way we assess.

BACKGROUND: Point-of-care (POC) rapid recency testing can be used as a cost-effective tool to identify recently infected individuals (i.e. infected within the last 12 months) in near-real time, support epidemic control and identify hotspots for transmission as part of recent infection surveillance OBJECTIVE: To evaluate the performance of the Asanté (HIV-1) rapid recency assay as a POC rapid test among blood donors in South Africa (SA METHODS: The study was a cross-sectional and validity study of the Asanté HIV-1 Rapid Recency Assay performed on 715 consecutively archived plasma donor specimens from the SA National Blood Services to determine their recency and established HIV infection status. ELISA and rapid assays for HIV antibody detection were used as the reference-testing standard for confirming an infection, while the Maxim HIV-1 limiting antigen (LAg) avidity assay was used as a reference for comparing HIV recency status. Validity tests (sensitivity, specificity, negative and positive predictive values) and Cohen-Kappa tests of the agreement were conducted to compare the Asanté HIV-1 rapid recency assay results with the reference tests RESULTS: Of the 715 studied blood samples, 63.1% (n=451/715) were confirmed to be HIV-positive based on the reference standard. The sensitivity and specificity of the Asanté HIV-1 rapid recency assay in diagnosing established HIV infection compared to the ELISA were 98.4% (95% CI 96.7 - 99.3) and 99.6% (95% CI 97.6 - 100), respectively. Compared with HIV rapid assay, the sensitivity and specificity of the Asanté HIV-1 rapid recency assay was 98.7% (95% CI 97.0 - 99.4) and 99.2% (95% CI 97.1 - 100), respectively. Of the 451 HIV-positive blood samples, 43% were confirmed as recent HIV infections by the Maxim HIV-1 LAg avidity assay. There was high agreement between the Asanté HIV-1 rapid recency assay and the Maxim HIV-1 LAg avidity assay (94.1%, k=0.879, p<0.0001). The sensitivity and specificity of the Asante HIV-1 assay was 89.4% (95% CI 84.0 - 93.0) and 97.7% (95% CI 94.8 - 99.0), respectively CONCLUSION: The Asanté HIV-1 rapid recency assay test results demonstrated high accuracy (>90%) compared with the HIV ELISA and rapid assays for determining established infection and the Maxim HIV-1 LAg avidity assay for classifying recent HIV-1 infections. The assay's sensitivity for established infections was below the World Health Organization criteria (<99%) for POC devices. The Asanté HIV-1 rapid recency assay can be used to distinguish between recent and long-term infections, but may not be considered a POC test for determining HIV infection

Abstract MS effective corrosion inhibition by SVLE has been investigated using electrochemical methods. Tafel polarization measurements suggested that the reaction at the anode occurred with MS dissolution, due to the strong medium aggressiveness, but SVLE addition led to a corrosion IE(%) of 93.6%, at 298 K. SVLE IE(%) still was 86% at an elevated T of 328 K, which was also confirmed by SEM observations that revealed a protective adsorbed film formed by the inhibitor onto the MS surface.

INTRODUCTION: Individuals with special healthcare needs may have poor oral health as a result of systemic and structural issues that make it more difficult to maintain optimal oral health status. As such, these individuals may require specialised, multidisciplinary oral healthcare. Furthermore, determining the severity of oral conditions among these people is necessary to establish the number of people affected and the services required to improve oral healthcare for these affected populations Aims and objectives: To determine the prevalence of dental caries among learners with disabilities attending special schools education in the eThekwini district, using DMFT/dmft and PUFA/pufa indices. DESIGN: A cross-sectional descriptive study design METHODS: A proportional stratified random sampling method was used to select learners from 22 special schools in the eThekwini district (n=435). The sample was divided into subgroups known as strata (schools) and a systematic sampling technique was used in each school. The learners were further categorised according to the classification of Special Health Care according to the Individuals with Disabilities Education Act (IDEA). Data collection comprised an intraoral examination to determine the prevalence of dental caries (using the DMFT/dmft index) and the extent of untreated dental caries using the PUFA/pufa index RESULTS: Out of the 488 students in the special schools approached, 435 consented to participate in the study giving a response rate of 89.14%. The prevalence of dental caries in the permanent and primary dentition was 53.6% and 22.5% respectively. The overall D (decayed) component recorded in permanent teeth was 740 (88%), the F (filled) component was 30 (4%) and M (missing) component was 77 (9%). Females had higher mean DMFT and PUFA scores while males had higher dmft and pufa scores. The DMFT and dmft scores recorded were highest in the 18-20 years age group at 3.70 ± 3.83 and the 6-8 years age group at 4.31 ± 4.00 respectively. The relationship between the DMFT and dmft scores and participants' age was seen as statistically significant, as these increased with age (p <0.001). The highest caries prevalence was found in the intellectual disability group (46.4%; n=393). The "untreated caries to PUFA ratio" was 2.5 to 1, indicating that 26% of the D + d component (in DMFT/dmft) had progressed mainly to pulpal involvement. The PUFA/pufa scores were higher in the 1214 years age group at 0.46 ± 1.33 and 6-8 years age group at 2.06 ± 3.45 respectively when compared to the other age groups in the study sample CONCLUSION: The high number of dental caries recorded in the permanent and primary dentition and the low number of restored teeth in the study sample highlight the need for promotive, preventive and restorative oral healthcare programmes within this population

SIGNIFICANCE: Effective community engagement for the use of large data sets in health research is faced with challenges similar to those in investigator-driven research. The scope of community engagement has evolved in high-income countries to embrace citizen science by communities and regulators to build trust in data science research. In South Africa and other low- and middle-income countries, with varying levels of literacy and the influence of pre-existing beliefs and past negative experiences with research, advisory committees of diverse stakeholder composition still have a role to play in protecting the rights of researched communities.

SIGNIFICANCE: Data science research involves large volumes of data, often derived from unconventional sources. Given the complex nature of big data research, there is a strong need for the development of ethically appropriate protocols that are sensitive to the complexities of data science and data sources. While reviews of health research by research ethics committees are necessary from an ethical and legal perspective, complementary advisory committees such as ethics advisory committees could be established to advise on ethics challenges more broadly. In this Perspective, we describe a multidisciplinary ethics advisory committee linked to a data science research hub in sub-Saharan Africa.

BACKGROUND: South Africa (SA) has a high prevalence of HIV infection, which has been shown to affect the prevalence and severity of other infections and of sepsis, particularly in gallbladder (GB) disease. Empirical antimicrobial (EA) therapy for acute cholecystitis is based largely on bacterial colonisation of bile (bacteriobilia) and antimicrobial susceptibility patterns (antibiograms) obtained from the developed world, where the prevalence of HIV infection is very low. In an era of ever-increasing antimicrobial resistance, it is of vital importance to monitor and update local antibiograms OBJECTIVES: Owing to the paucity of data available locally to guide treatment, our objectives were to examine GB bile for bacteriobilia and to assess antibiograms in a setting with a high prevalence of HIV infection, in order to determine the need for review of our local antimicrobial policies for both EA therapy for GB infections and preoperative antimicrobial prophylaxis (PAP) for laparoscopic cholecystectomy (LC METHODS: A retrospective observational descriptive study was undertaken at King Edward VIII Hospital, Durban, SA. Hospital records were reviewed for all patients undergoing LC over a 3-year period. GB bacteriobilia and antibiograms were assessed and compared between people living with HIV (PLWH) and people who were HIV uninfected (HIV-U). The preoperative parameters of age, endoscopic retrograde cholangiopancreatography (ERCP), procalcitonin (PCT), C-reactive protein (CRP) and neutrophil-to-lymphocyte ratio (NLR) were assessed as predictors for bacteriobilia. Statistical analyses were performed using R for statistical computing, andp-values <0.05 were considered statistically significant RESULTS: There were no differences in bacteriobilia or antibiograms between PLWH and HIV-U. There was >30% resistance to amoxicillin/ clavulanate and cephalosporins. Aminoglycoside-based therapy had good susceptibility patterns, while carbapenem-based therapy demonstrated the lowest resistance levels. ERCP and age were predictors of bacteriobilia (p<0.001 and p<0.002, respectively), but PCT, CRP and NLR were not CONCLUSION: PLWH should follow the same PAP and EA therapy recommendations as HIV-U. For EA therapy, we recommend a combination of amoxicillin/clavulanate with aminoglycoside-based therapy (amikacin or gentamicin), or piperacillin/tazobactam as monotherapy. Carbapenem-based therapy should be reserved for drug-resistant species. For elective LC, elderly patients or patients who have previously undergone ERCP, we recommend selective use of cefazolin for PAP

INTRODUCTION: Oral health remains a neglected aspect of healthcare among vulnerable populations residing at long-term care (LTC) facilities. Routine oral health education and training for caregivers have the potential to improve oral health provision. AIMS AND OBJECTIVE: To determine the effect of an oral health intervention on caregivers' knowledge and attitudes. METHODS: This cross-sectional study utilised a pre/post-test assessment approach. A total of n=145 caregivers from n=7 LTC facilities in the eThekwini district, participated in a pretest questionnaire. An oral health education intervention in the form of a PowerPoint® presentation was implemented four weeks later. Six months later, a post-test questionnaire was administered. A Paired proportion test was used for statistical analysis. A p-value <0.05 was considered to be statistically significant. RESULTS: A response rate of 77.1% was obtained. In the pre-intervention phase, caregivers (n=68; 46.9%) reported that loose teeth can be a sign of gum and bone disease, compared to 89% (n=129) of caregivers in the postintervention phase. Caregivers (n=124; 85.5%) in the pre-intervention phase felt that they should be trained in providing oral healthcare, compared to 93.8% (n=136) in the post-intervention phase. CONCLUSION: The oral health intervention had a positive effect on caregivers' knowledge and attitudes. This finding necessitates routine oral health education and training for caregivers.