As resistance to chemical acaricides increases amongst tick populations, investigations of natural remedies that have acaricidal or tick-repellent effects have become essential in the search for alternatives for sustainable tick control. Garlium GEM HC (Garlium), a natural concentrated garlic product, was supplemented in-feed to beef cattle to determine if it could assist in reducing the number of attached ticks on cattle. Two grams of Garlium was supplemented daily to eight Bonsmara steers over 43 days. A second group of eight steers served as controls. All animals were infested with a similar number of Rhipicephalus appendiculatus adults and Rhipicephalus microplus larvae. Subsequently, the number of attached engorged ticks and the hatchability of the tick eggs were determined. Blood samples were collected from the steers for whole blood analyses. The results were analysed using a two-sample t-test procedure. Due to large standard deviations observed, most of the tick parameters were only numerically improved. Although not significant, the number of larvae produced by female R. appendiculatus ticks per host was reduced by 23%. Estimated number of R. microplus larvae produced from ticks harvested from Garlium supplemented cattle were reduced by 42.3% (p = 0.10). No adverse effect was observed on haematocrits or haemoglobin concentrations. Garlium reduced segmented neutrophil count in the treatment group, suggesting that the immune system was less challenged. Although not statistically significant, the effect of reducing the number of larvae produced per host for the two tick species by approximately 20% and 40% respectively, may be of economic benefit to commercial cattle farmers.

BACKGROUND: Total hip arthroplasty (THA) is one of the most performed and most researched procedures worldwide, and there is an ever-growing demand for THA in an already resource-constrained system in South Africa. Early dislocation after THA remains a serious and costly problem; however, few THA outcome studies have been performed locally. This study therefore aimed to calculate the incidence of dislocation after THA and to identify risk factors for dislocation after THA in a South African academic hospital METHODS: In this retrospective cohort review, files and radiographs of 543 patients were reviewed for dislocation during the first year after primary THA. The reason for the THA, the surgical data, the implant data, and whether and when dislocation occurred were recorded for each patient. Fisher's exact tests and independent t-tests were done to analyse the association between variables and a patient's odds of experiencing a dislocation after THA RESULTS: Twenty (3.7%) out of 543 THAs dislocated during the first year, 17 of these within the first three months. The surgical approach used was not shown to be a significant risk factor (p = 0.650) for dislocation, although the Hardinge approach had been used for all 20 cases of dislocation. Similar dislocation rates (p = 0.967) were found for THAs done for displaced neck of femur (NOF) fractures (3.6%) and for elective THAs (3.7%). Trauma THAs made up more than half (55%) of our study population. Femoral head sizes < 32 mm (p = 0.390 for neck of femur THA and p = 0.451 for elective THA) and a single mobility design (p = 0.494) both produced a higher dislocation rate, although this was not statistically significant. Surgeon experience did not prove to be significant for our study population (p = 0.570 CONCLUSION: The dislocation rate after THA at our institution is lower than rates reported in the literature for NOF THA and similar to rates reported for elective THA. This was found despite the dislocation rate for the Hardinge approach being nearly eight times higher than expected. Minimal surgeon experience, implant coupling and smaller femoral head size did not prove to be significant risk factors for dislocation after THA Level of evidence: Level 4

BACKGROUND: No guidelines for ethical coding practice of commonly performed soft tissue knee procedures exist in South Africa. The aim of our study was to establish and prioritise codes for these procedures via a consensus of knee surgeons. METHODS: Fifty-nine South African Knee Society (SAKS) members were approached for a blinded Delphi consensus process. In the first survey round, a list of codes was generated which was prioritised in subsequent rounds. Agreement of 70% or more was defined as consensus. These codes were then moderated during a fourth round by the SAKS committee. RESULTS: Sixteen SAKS members, performing a median of 200 knee procedures (interquartile range [IQR] 115-312) annually, participated in each round. Consensus was achieved for codes 0667, 0614 and 0673 when coding for meniscus and cartilage surgery. For anterior cruciate ligament reconstruction 0667, 0614, 0679, 0673 and 0775 all reached consensus. Here, some codes (0593) did not achieve consensus although their inclusion was promoted by the SAKS committee round. Furthermore, 88% of the participants agreed that rule 0005 should be used for multiple knee ligament reconstruction, and each should be seen as a separate procedure. Code 0592 (36%) should not be routinely used for minor debridement. No code exists to code for increased complexity in meniscal root repairs and therefore 0677 was proposed to be reassigned for meniscus repair, as well as 0296 to code for the major technical nature of the procedure. For medial patellofemoral ligament reconstructions, 0679 (88%) and 0579 (63%) were proposed along with 0667 (100%), 0775 (94%) and 0614 (69%). For osteotomy of the knee region, codes 0527 (94%) and modifier 0051 were put forth, as well as 0667 (75%), 0614 (75%) and 0673 (56%). When bone is harvested and/or grafted, 0507 (56%) and 0499 (44%) respectively are also thought to be appropriate. CONCLUSION: This consensus study is based on the coding practice of 16 members of the South African Knee Society performing a median of 200 knee procedures annually. A variety of techniques are available, some without specific allocated codes which called for moderation and reallocation of certain codes. With this work we hope to achieve transparent and consistent coding for soft tissue knee procedures. Level of evidence: Level 4

The gap between university legal education and legal practice significantly contributes to the view that most law graduates are substantially underprepared for entry into legal practice.1 Consequently, this article suggests that an improvement in the training of law students, as far as preparing them for entry into legal practice is concerned, is necessary. It is argued that this preparation is supported by transformative constitutionalism - that is, after graduation, graduates will be expected to possess certain attributes that will ensure that they are ready for entry into legal practice. It is therefore necessary to investigate and evaluate such graduate attributes, as well as to ascertain the source of the need for such attributes. In this article, the Qualification Standard for the LLB degree, as the source stipulating the standard of proficiency for which the LLB degree should prepare graduates, is also discussed. This is followed by an evaluation of a baseline study into graduate attributes from the perspective of employers. Holistically seen, the qualification standard, as well as the graduate-attributes study, should provide an indication as to whether the LLB degree is adequately preparing law graduates for entry into legal practice. The qualification standard is set out and evaluated on whether, and to what extent, it aligns with the arguments put forth in this article. The research in this article has been conducted by way of a desktop study.

Temperature extremes vary across Africa. A continent-wide examination of the impacts of heat on health in Africa, and a synthesis of Africa-informed evidence is, however, lacking. A systematic review of articles published in peer-reviewed journals between January 1992 and April 2019 was conducted. To be eligible, articles had to be Africa-specific, in English, and focused on how heatwaves and high ambient temperatures affect morbidity and mortality. A secondary systematic analysis on policies and interventions comprising 17 studies was also conducted, and the findings synthesised together with those of the 20 primary studies. Eleven studies showed that high ambient temperatures and heat waves are linked with increased mortality rates in Africa. These linkages are characterised by complex, linear and non-linear (J or U) relationships. Eight of the nine primary studies of morbidity outcome reported that an increase in temperature was accompanied by raised disease incidence. Children and the elderly were the population groups most vulnerable to extreme heat exposure. Location-specific interventions and policy suggestions include developing early warning systems, creating heat-health plans, changing housing conditions and implementing heat-health awareness campaigns. In summary, this review demonstrates that, while heat-health relationships in Africa are complex, extreme temperatures are associated with high mortality and morbidity, especially amongst vulnerable populations. As temperatures increase across Africa, there is an urgent need to develop heat-health plans and implement interventions. Future studies must document intervention effectiveness and quantify the costs of action and inaction on extreme heat-related mortality and morbidity. SIGNIFICANCE: • Empirical evidence shows that the relationship between heat and human health is complex in the African context. This complexity has implications for the development of interventions and policies for heat-health on the continent. • This review is important for African policymakers, practitioners and others who support Africa's adaptation to climate change. Through this review, a compendium of Africa-specific and relevant empirical information is aggregated and made readily available to various interested and affected parties.

The increase in student enrolment at tertiary institutions in South Africa over the past few years has necessitated the need for group work without sacrificing the standard and integrity of education. Research has shown that group work offers many advantages to both lecturers and students. Interactive attributes such as teamwork, co-operation skills, leadership qualities, communication skills and confidentiality developed during group work are highly sought-after skills by prospective employers. This quantitative study aimed to determine whether students are positively or negatively inclined towards group work, as well as other possible factors influencing group work at a university of technology (UoT) in South Africa. A structured, close-ended questionnaire was administered to 309 students enrolled for the Applied Communication Skills course. The data were analysed using statistical methods. The results revealed that listening skills and mutual respect were crucial to develop good interpersonal skills needed for effective group work. When working in groups, students tend towards collectivism and negative aspects of group work, such as social loafing, are often overseen to maintain harmony and avoid direct confrontation with other individuals in the group. It was also found that male students agreed more strongly with negative conflict resolution than female students. Overall, the study showed that despite several negative aspects, students tended to be positively inclined towards group work.

Interest in greywater reuse is increasing in South Africa, because of the potential to supplement scarce freshwater resources in the face of increasing demand and aridity. This paper aims to inform the water saving-risk trade-off associated with residential untreated greywater use, through a statistical analysis of greywater quality results as sourced from prior South African studies. Greywater sources included in this review were the bathroom, kitchen, laundry, mixed and general residential sources. Variability in terms of each of the reported physical, chemical and microbiological constituents by source and between result sets was noted. Statistically significant differences were evident between the pH, conductivity and phosphorus values of certain sources. A risk assessment undertaken for each of the constituents revealed further variability. The constituent with the highest number of high-risk samples was total dissolved solids. The relatively high risk and negative consequences in greywater practices in terms of public health, the environment, and infrastructure, given this variability, provide insight into the trade-off with potential water savings. It is recommended that a more nuanced view of the potential potable savings associated with greywater reuse and also improved risk management is required by the user.

It is assumed that individuals' cognitions of who they are in a particular social structure influence their behaviour in that space. Likewise, school principals' cognition of who they are in schools as social structures influences how they behave as leaders. In this article, we use the role identity theory as a framework to analyse novice principals' narratives of lived experiences to understand how they construct themselves as principals in schools and how these constructions influence their execution of leadership. Positioned within the interpretivist paradigm, we adopted the narrative inquiry methodology to engage with the lived experiences of 3 purposively selected novice principals from the Pinetown district in KwaZulu-Natal. The narrative interview was employed to generate field texts, which were subsequently analysed using 2 methods: narrative analysis and analysis of narratives. From our analysis of field texts, 4 themes explaining how the participating novice principals construct themselves as school principals were identified; these themes are: a leader as a learner, re-establishing oneself as a leader, spanning boundaries, and leading to inspire. From these themes, we conclude that a principal's conception of self is dynamic and is a blend of multiple meanings generated prior to becoming a principal and meanings generated during the principalship tenure.

INTRODUCTION: Oral diseases are preventable causes of poor health outcomes in people with chronic kidney disease (CKD). AIMS AND OBJECTIVES: Investigate the association between dental and periodontal conditions with kidney function and determine whether inflammation mediate the association between periodontitis and CKD. DESIGN: Cross-sectional analysis of 1551 South African adults of mixed ancestry. METHODS: CKD was classified as estimated glomerular filtration rate (eGFR) <60mL/min/1.73m². Oral profile was captured by decayed, missing, filled teeth index (DMFTi), bleeding on probing (BOP), pocket depth (PD), clinical attachment loss (CAL), and periodontitis classified as PD >4 mm. RESULTS: Overall, 6% had CKD, with 93% and 66% of participants with and without CKD, respectively having a high DMFTi (p<0.0001). Further, 84% (CKD) and 43% (without CKD) were edentulous (p<0.0001). A great proportion of the dentate sub-sample (n=846) had periodontitis, however, BOP, PD >4mm and CAL >4mm were similar between the groups. DMFTi was associated with eGFR and prevalent CKD (p<0.023), with this association driven by the Missing component. Periodontitis was not associated with eGFR nor CKD (p>0.282 CONCLUSION: In routine care of people with CKD, attention should be given to oral health.

BACKGROUND: A healthy classroom climate has been related to the socioemotional development of learners. This, in turn, has been associated with an increase in academic success, intrapersonal skills and the quality of interpersonal relationships. AIM: This study aimed to investigate the impact of classroom climate on the emotional intelligence (EI) levels of South African primary school learners. The aim was also to determine which classroom factors promote, and which inhibit the development of EI. SETTING: A purposive sample of 119 primary school learners from six classes in two government schools in Durban, Kwazulu-Natal was drawn. Ethical clearance and permission for the study were obtained from the relevant stake holders. Informed consent was obtained from the parents or guardians as well as the participants. METHODS: The My Class Inventory (short form) (MCI-SF) and the Trait Emotional Intelligence Questionnaire (Child Short Form) (TEIQue-CSF) were administered. The former is a measure of classroom climate. Relations between classroom climate factors and EI were explored by means of Pearson's correlations and stepwise multiple regression analysis. ANOVA and Kruskal-Wallis tests were used to compare the performance of the learners in the different classes in terms of these variables. RESULTS: Results indicated a strong relation between classroom climate and EI; satisfaction and cohesiveness correlated positively with EI levels, whilst friction, competitiveness and difficulty correlated negatively with EI levels. CONCLUSION: The results contribute to the understanding of the development of a positive classroom climate. Intervention at classroom level might be a more viable option in resource-strapped contexts.

BACKGROUND: The direct lateral approach for total hip replacement has been traditionally reserved and described for neck of femur fractures. Advantages of this approach include technically easy access to the acetabulum and femur and low incidence of hip dislocation. Imperfect positioning of the acetabular component leads to increased risk for dislocations, accelerated wear, reduced range of motion and increased revision rate. Freehand technique has been the gold standard for many decades, but newer technologies like computer navigation and robotic-assisted surgery have shown to improve the accuracy of cup placement. This study reports on the accuracy of freehand cup positioning via the direct lateral approach with mention of the dislocation rate METHODS: We retrospectively reviewed 253 patients who had total hip replacements done via the direct lateral approach. The patients' files were evaluated for patient parameters, demographic details, aetiology of hip pathology, confirmation of approach used, comorbidities and history of previous relevant surgery. The postoperative radiographs were analysed for acetabular component position inclination and anteversion. Dislocation rates were calculated as a secondary objective RESULTS: The radiographic analysis was performed using the Liaw method based on trigonometry of the eclipse generated. This showed a mean cup inclination of 42.3° (95% CI: 41.3-43.3°) and anteversion of 12.7° (95% CI: 12.0-13.7°). A total of 57% of the acetabular cups were within the safe zones described by Lewinnek. Of them, 78% were in the 30-50° range for inclination and 73% in the 5-25° range for anteversion. There were ten dislocations within one year from the index procedure: a dislocation rate of 4.0% (95% CI: 2.8-8.5% CONCLUSION: The freehand technique using the direct lateral approach for acetabular cup placement produces a poor overall accuracy of only 57%. Although our study only commented on ten dislocations, the rate (4%) is significantly worse compared to the 0.43% reported in literature for the direct lateral approach. The radiographic results for inclination and anteversion are comparable to other freehand techniques, regardless of the approach used, but significantly worse than results achieved with navigation and robotics Level of evidence: Level 4

The in situ δ-phase formation for a series of yttrium-doped Bi2O3 materials was studied by Raman spectroscopy and high resolution X-ray diffraction under variable temperature conditions. Contrary to previous reports, for dopant concentrations less than 25%, the cubic ô-phase was not fully stabilized at room temperature - tetragonal phase content was evident in both Raman spectra and powder diffractograms. Arrhenius plots also showed evidence of a phase transformation by the distinct large step change in conductivity in the temperature region where the tetragonal-cubic phase transformation was noted. Both the thermal expansion and ionic conductivity of the cubic phase decreased with increasing dopant content.