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.

Improving a robot's posture enables it to perform with greater accuracy and repeatability. A stiffer posture also protects the robot from unnecessary vibrations and deflections that may be induced by an applied load. This paper presents a method for choosing high stiffness robot postures. The method is demonstrated on a six-degree-of-freedom Fanuc M10-iA serial manipulator. The posture identification and stiffness modelling were achieved by a reliable and cost-effective alternative to deflection measurement using IEPE accelerometers.

Deur 'n robot se postuur te verbeter kan beter akkuraatheid en herhaalbaarheid behaal word. 'n Stywer postuur beskerm ook die robot teen onnodige vibrasies en defleksies wat deur 'n toegepaste lading induseer mag word. Hierdie artikel bied 'n metode aan om hoë styfheid robot posture te kies. Die metode word aan die hand van 'n ses vryheidsgrade Fanuc M10-iA serie manipulator gedemonstreer. Die postuur identifikasie en styfheidsmodellering is behaal deur middel van n betroubare en koste-effektiewe alternatief wat gebruik maak van IEPE versnellingsmeters eerder as defleksiemeting.

BACKGROUND. The comprehensive primary healthcare (PHC) approach has been a lead theme in the University of Cape Town Faculty of Health Sciences (FHS) since 1994. A 2014 institutional academic review recommended that indicators be developed for monitoring and evaluating the PHC theme. OBJECTIVE. To evaluate PHC teaching and learning of final-year health and rehabilitation sciences and medical students at three community-based education (CBE) sites of the faculty, two in Cape Town and one in a distant and largely rural district. METHODS. Course documents were analysed for evidence and alignment of nine indicators of the PHC approach in the documented learning outcomes, activities and assessments of final-year health sciences students. Clinical educators and students were interviewed to identify factors that facilitate or impede PHC teaching and learning on site. RESULTS. Final-year health sciences disciplines engage inconsistently with PHC principles at the CBE sites. Alignment appears to be strongest between learning outcomes and teaching activities, but the available data are insufficient to judge whether there is also strong alignment between outcomes and teaching, and formal graded assessment. PHC teaching and learning at the CBE sites are facilitated by good multiprofessional teamwork, educator role-modelling and good infrastructural and logistical support. Language barriers, staff shortages and high workloads are significant and prevalent barriers. CONCLUSION. Strong faculty leadership is required to promote the PHC lead theme and to achieve better departmental and multiprofessional collaboration in teaching the PHC approach. This study provides evidence from well-established CBE sites to inform future work and participatory action research in promoting the PHC approach in teaching and learning in the FHS.

AIM: This study aimed to evaluate the erosive potential of sour candy at a different time of exposure within a laboratory-based setting. MATERIALS AND METHODS: Fifty human anterior tooth samples were randomly assigned into three groups, namely: sour candy, regular candy A, and deionized water (n=15). Each tooth samples was exposed to a solution containing the sample groups at different time intervals. Vickers hardness tester was used to measure the surface hardness pre- and postexposure. The mean surface hardness value measured was compared using a paired sample test (α = .05). Raman spec-troscopy was used to study the change in the enamel structure in all sample groups. RESULTS: A significant difference in the surface hardness value was measured pre and post-exposure in all the sample groups (P<0.01). The samples exposed to sour candy had the highest tooth surface loss. In terms of the time of exposure, it was found that prolonged exposure had a significant effect on the surface hardness (P<0.01). The Raman intensity change confirmed that samples exposed to sour candy, after 2hrs of exposure, had the highest loss of structural integrity. CONCLUSION: The study conclude that sour candies are very erosive and its impact enhances with time.

BACKGROUND: Impact forces during rugby can contribute to scapula dysfunction and shoulder pain. Reliable assessment of static and dynamic scapula position is paramount in managing athletes with, and those at risk of developing, shoulder pain. OBJECTIVES: To determine the reliability of static scapular posture (SP), clavicular tilt angle (CTA) and the scapular dyskinesis (SD) assessments by expert and student therapists. METHODS: The study design was an inter-rater and intra-rater reliability study in male university level rugby union players. Four sport rehabilitation students and one experienced physiotherapist evaluated the position of the scapular and clavicle of male university-level rugby union players (interrater participants: session 1: n=17, session 2: n=12 and session 3: n=16; (intra-rater participants: n = 12). Participants attended 3 testing sessions, each 1 week apart. Scapular orientation and motion were assessed in five planes of movement and using the Scapular Dyskinesis Test (SDT) respectively. The interrater analysis included all participants from each session, while in the intra-rater analysis included only the 12 participants who attended all three testing sessions. RESULTS: Kappa coefficient values and percentage agreement ratings for students compared to the experienced therapist were: SP=poor to fair (-0.01 to 0.33), (27% - 94%); SDT=slight (0.16; 41%); CTA=fair (0.21; 59%). Test-retest (intra-rater) agreement was fair to moderate (0.22 - 0.44; 69% - 95%), slight (0.12; 47%), and fair (0.39; 77%) for the SP, SDT, and CTA, respectively. CONCLUSION: Static and dynamic evaluation of the shoulder by students and an experienced therapist has poor to moderate reliability and should not be used to make clinical decisions based on observation alone.

ABSTRACT Objective: To determine whether or not Jamaican coaches’ knowledge and practices of fluid replacement are on par with that of the National Athletic Association's and the American College of Sports Medicine Standards. Methods: A descriptive survey of 90 high-school track and field coaches in Jamaica was conducted. Coaches were given a 29-item survey questionnaire which adapted the content from previous surveys and also based on the National Athletic Trainers’ Association guidelines for fluid replacement and information sources of fluid replacement. A pass score of 80% was employed. Results: Approximately 26.6% of participants passed the knowledge-based assessment with the minimum requirement of 80% and 73.4% of participants had an unacceptable level of knowledge about fluid replacement and hydration. Only 26 (28.9%) coaches received training in fluid replacement therapy. Most of them therefore relied on reading materials ranging from magazines to journals, or learnt it on the job from other coaches. Conclusion: Findings suggest that the level of knowledge in Jamaican track and field high-school coaches about fluid replacement and hydration is very poor. However, their attitudes towards fluid replacement and hydration are very good, and this will facilitate their acceptance and adoption of correct fluid replacement guidelines. Tapping into this positive attitude and implementing workshops, seminars and onsite promotion should improve the coaches’ knowledge significantly.

The SARS-CoV-2 pandemic has presented clinicians with an enormous challenge in managing a respiratory virus that is not only capable of causing severe pneumonia and acute respiratory distress syndrome, but also multisystem disease. The extraordinary pace of clinical research, and particularly the surge in adaptive trials of new and repurposed treatments, have provided rapid answers to questions of whether such treatments work, and has resulted in corticosteroids taking centre stage in the management of hospitalised patients requiring oxygen support. Some treatment modalities, such as the role of anticoagulation to prevent and treat potential thromboembolic complications, remain controversial, as does the use of high-level oxygen support, outside of an intensive care unit setting. In this paper, we describe the clinical management of COVID-19 patients admitted to Groote Schuur Hospital, a major tertiary level hospital at the epicentre of South Africa's SARS-CoV-2 epidemic during its first 4 months.

The SARS-CoV-2 pandemic has challenged the provision of healthcare in ways that are unprecedented in our lifetime. Planning for the sheer numbers expected during the surge has required public hospitals to de-escalate all non-essential clinical services to focus on COVID-19. Western Cape Province was the initial epicentre of the COVID-19 epidemic in South Africa (SA), and the Cape Town metro was its hardest-hit geographical region. We describe how we constructed our COVID-19 hospital-wide clinical service at Groote Schuur Hospital, the University of Cape Town's tertiary-level teaching hospital. By describing the barriers and enablers, we hope to provide guidance rather than a blueprint for hospitals elsewhere in SA and in low-resource countries that face similar challenges now or during subsequent waves.

BACKGROUND: Hip and knee arthroplasty procedures are successful surgical procedures, with total hip arthroplasty being named the operation of the 20th century. With there being an estimated rate globally of periprosthetic joint infection of 1% for hips and 2% for knees, this minimal infection rate represents a large global concern. The successful management of periprosthetic joint infection remains controversial with multiple proposed strategies. Our aim is to present our short-term data for a two-stage revision protocolMETHODS: A single centre retrospective review of an existing database starting from January 2013 and including April 2019 was conducted looking at patients having undergone two-stage revision for periprosthetic joint infection. The unit utilised a standard approach to two-stage revisions. Data was collected from the existing database to ascertain short-term success based on the Delphi-based international multidisciplinary consensus criteriaRESULTS: A total of 2 125 entries were reviewed from the database comprising 1 912 primary arthroplasty procedures. From all revision cases 19 patients were identified to have undergone a two-stage revision by our unit. Of these patients we managed to collect sufficient data to gauge treatment success in 12 patients. Of these 12 patients with a mean follow-up of 25.6 months, ten reported complete wound healing, pain improvement and no subsequent surgery. One patient demised from septic complications and one required subsequent arthrodesis which controlled the sepsisCONCLUSION: Our results showed a high infection eradication rate following our two-staged revision protocol despite frequent delays between first and second stages as a result of resource constraints and limitationsLevel of evidence: Level 4

INTRODUCTION: Head and neck space infections remain one of the most commonly encountered conditions at Maxillofacial clinics countrywide. Patients admitted with these infections tend to have prolonged hospital stays and often require intensive care support. This places financial and logistic constraints on our health care system. There are also growing concerns, worldwide, regarding antibiotic resistance AIMS AND OBJECTIVES: To determine the microbial spectrum of head and neck space infections in patients admitted to the Maxillo-Facial clinic at Livingstone Hospital in the Eastern Cape over a period of 5 years. METHODS: Demographic, clinical and laboratory data was retrieved from the medical records of 140 patients presenting with head and neck space infections RESULTS: Most patients were males aged 21-40 years. The most common cause of head and neck infections was non-odontogenic. The submandibular space was the most commonly implicated. Gram positive facultative anaerobes were most commonly identified. Bacteroides species and Staphylococcus aureus displayed sensitivity to clindamycin and amoxicillin with clavu-lanic acid. Viridans streptococci were sensitive to both penicillin and clindamycin CONCLUSION: Bacteroides species were the most commonly isolated bacteria, followed by Viridans streptococci and Staphy-lococcus aureus.

Abstract Objective: To compare the fluoride release from Conventional Glass Ionomer Cement (GIC), Resin Modified GIC (RMGIC), and Cention N Alkasite Material. Material and Methods: Forty- five disc-shaped specimens of three different restorative materials (Conventional GIC, RMGIC, and Alkasite material) were made and divided into 3 groups (n=15). Fluoride release was evaluated at the end of Day 1, 7, 14, and Day 28 using fluoride ion-selective electrode. Intergroup and Intra-group analysis was done using One-way ANOVA with a Post-hoc test. A p-value of <0.05 was considered statistically significant. Results: Cention showed more fluoride release (in parts per million) than GIC and RMGIC at increased time duration. However, at the end of day 1, there was lesser fluoride release with Cention, as compared with the other groups. Conclusion: The new Alkasite restorative material showed promising results in terms of fluoride release and is better than GIC and RMGIC at increased time duration.

ABSTRACT Introduction: Laparoscopic donor nephrectomy (LDN) has become the standard of care and popular among most of the transplant centres across the globe. Objective of this video is to report different vascular injuries, their management during LDNs and propose risk reduction strategies. Patient and methods: This was a retrospective analysis of all the LDNs performed between January 2011 and March 2016. All donor nephrectomies were performed laparoscopically by transperitoneal route, under ideal operative conditions by expert laparoscopic surgeons and by novice surgeons. Results: 858 LDNs (left, n = 797; right, n = 61) were performed during the study period with 5 cases of vascular injuries. Mean (SD) donor age was 45.5 (± 10.76) years and the operative time was 165 (± 44.4) min. Of these five cases, two had renal vein injury, while the three others had renal artery, inferior vena cava and aortic injury (one each). Four injuries occurred during left LDN and only one during a right LDN. Vascular injuries were managed using the Rescue stitch or metallic clips as indicated. Risk reduction strategy was developed to avoid vascular injuries during LDN, which include - meticulous attention to port placement, addition of fourth port, complete dissection of upper pole and pedicle before clipping, and judicious use of ultrasonic diathermy. Conclusions: Careful evaluation of computed tomography angiography just before surgery will act like a global positioning system (GPS) for the operating surgeon. Rescue stitch is a saviour. Not to panic and being well versed with the risk reduction strategies of laparoscopy and rescue measures is of paramount importance.

Abstract: Fertilizers are one of the costly inputs in agriculture and development of nutrient efficient fertilizers is need of the hour. Keeping in view of the above, slow release coated urea fertilizers are developed and the N loss from different coated urea fertilizers in a Vertisol was studied in comparison with normal urea. The coated fertilizers used were neem, 4% pine oleoresin (POR), 35% nano-rock phosphate and 2% nano-ZnO coated urea. In later two cases nanoparticles were loaded over 4% POR coated urea during preparation. Application of coated urea fertilizers such as neem coated urea and pine oleoresin coated urea in a Vertisol reduced the ammonia volatilization by 27.5% and 41.1%, respectively. Similarly, reduction of NO3-N leaching due to application of neem, resin, nano-rock phosphate and nano-ZnO coated urea were 18.3%, 28.0%, 25.7% and 35.1%, respectively. The reduction of N volatilization and leaching losses imparted by coated urea fertilizers could be a viable N source for crops. However field level validation experiments have to be carried out to assess the efficacy of these coated fertilizers in enhancing crop yield and nutrient use efficiency.

BACKGROUND: Surgical training varies significantly amongst universities within the same country. This trend is reflected in South Africa and provides an opportunity for innovation to improve the quality of general surgical training OBJECTIVE: To assess the perceptions of South African general surgery registrars regarding surgical training METHOD: A prospective descriptive study was performed by means of a confidential questionnaire distributed to general surgical registrars at all eight training centers in South Africa. Participants were asked to give comments regarding adequacy of formal academic teaching, level of supervision during surgical procedures, exposure to and training in minimally invasive surgery (MIS), and preparation for examinations. Descriptive statistics were generated with Microsoft Excel. Ethics clearance was obtained from the University of the Witwatersrand Human Research Ethics Committee RESULTS: Of 200 questionnaires distributed 105 (52.5%) were returned. 44% (105/241) of all registrars from six training institutions participated. 89.5% (94/105) of respondents reported that they attended less than six hours of formal academic teaching per week and 71.4% (75/105) indicated that their institution offered less than six hours of formal academic teaching per week. 76.2% (80/105) of respondents regarded lack of protected academic time as the greatest obstacle to their surgical training and 95.2% (99/105) reported that clinical responsibilities prevented them from attending formal academic teaching regularly. Overall, only 31.4% (33/105), 41.9% (44/105) and 37.1% (39/105) were satisfied with the amount of formal academic teaching, level of supervision during theatre procedures and exposure to minimally invasive surgery respectively. Lack of resources and lack of appropriate skills were identified as a hindrance to MIS training by 47.6% (50/105) and 28.6% (30/105) of respondents respectively CONCLUSION: Surgical registrars are dissatisfied with the amount of formal academic teaching and protected academic time, level of supervision in theatre and their exposure to MIS. These challenges compromise trainees' ability to practice independently after qualification. Numerous interventions are necessary and possible to address these challenges