BACKGROUND. The Faculty of Health Sciences (FHS), University of Cape Town (UCT) adopted the primary healthcare (PHC) approach as its lead theme for teaching, research and clinical service in 1994. A PHC working group was set up in 2017 to build consensus on indicators to monitor and evaluate the PHC approach in health sciences education in the FHS, UCT. OBJECTIVE. To develop a set of indicators through a Delphi technique for monitoring and evaluating the PHC approach in health sciences curricula in the FHS, UCT. METHODS. A national multidisciplinary Delphi panel was presented with 61 indicators of social accountability from the international Training for Health Equity Network (THEnet) for scoring in round 1. Nineteen PHC indicators, derived from a mnemonic used in the FHS, UCT for teaching core PHC principles, were added in round 2 to the 20 highest ranked THEnet indicators from round 1, on recommendation of the panel. Scoring criteria used were relevance (in both rounds), feasibility/measurability (round 1 only) and application of the PHC indicators to undergraduate and postgraduate teaching and assessment (round 2 only). RESULTS. Of the 39 indicators presented in the second round, 11 had an overall relevance score >85% based on the responses of 16 of 20 panellists (80% response rate). These 11 indicators have been grouped by learner needs (safety of learners - 88%, teaching is appropriate to learners' needs and context - 86%); healthcare user needs (continuity of care - 94%, holistic understanding of healthcare - 88%, respecting human rights - 88%, providing accessible care to all - 88%, providing care that is acceptable to users and their families - 87%, providing evidence-based care - 87%); and community needs (promoting health through health education - 88%, education programme reflects communities' needs - 86%, teaching embodies social accountability - 86%). CONCLUSION. The selected indicators reflect priorities relevant to the FHS, UCT and are measurable and applicable to undergraduate and postgraduate curricula. They provided the basis for a case study of teaching the PHC approach to our undergraduate students.

This study presents a comparative literature examination of the pharmaceutical industry in Japan, Europe, and the United States, focusing on quality culture, which historically has impacted operations in these regions. It aims to highlight generic pitfalls that result from cultural influences so that these can be avoided when designing a conceptual model of quality management practices for South African organisations. Simultaneously, the literature illuminates areas where culture promotes operational excellence (OpEx) in production. Quadrants of the organisational cultural analysis instrument (OCAI) are used to collect and examine research data from 72 literature sources. An activity theory research approach is adopted to perform a comparative study to ensure a consistent formal examination of the three geographical regions. During this analysis, industry traits presumed to be supported by culture types are highlighted and examined. Findings from this examination will be used in a future study to develop an OpEx model for South Africa, based on quality culture.

Hierdie studie bied 'n vergelykende literatuurondersoek van die farmaseutiese industrie in Japan, Europa en die Verenigde State, met die fokus op die kwaliteitskultuur, wat histories bedrywighede in hierdie streke beinvloed het. Dit het ten doel om generiese valstrikke wat ontstaan as gevolg van kulturele invloede uit te lig, sodat die valstrikke vermy kan word wanneer 'n konseptuele model van kwaliteitbestuurspraktyke vir Suid-Afrikaanse organisasies ontwerp word. Terselfdertyd het die literatuur gebiede belig waar kultuur operasionele uitnemendheid (OpEx) in produksie bevorder. Kwadrante van die organisatoriese kultuuranalise-instrument (OCAI) word gebruik om navorsingsdata uit 72 literatuurbronne in te samel en te ondersoek. 'n Aktiwiteitsteoretiese navorsingsbenadering is gebruik om die vergelykende studie uit te voer en dus 'n konsekwente formele ondersoek van die drie geografiese streke te verseker. Tydens hierdie ontleding, word veronderstel dat bedryfseienskappe ondersteun word deur kultuurtipes wat uitgelig en ondersoek is. Bevindinge van hierdie ondersoek sal in 'n toekomstige studie gebruik word om 'n operasionele uitnemendheidsmodel vir Suid Afrika te ontwikkel wat gebaseer is op kwaliteitskultuur.

BACKGROUND: There is a dearth of published evidence related to understanding oral health needs for patients undergoing therapy for cancer of the head and neck region in South Africa Aim and objectives: This study aimed to assess perceived oral health status of patients undergoing therapy for cancer of the head and neck region, in eTthekwini district, KwaZulu-Natal. METHODS: This was a cross-sectional case study using quantitative data to determine patients' perspectives of oral health status and need. The study population comprised 235 voluntary patients (aged between 20-70 years old), undergoing treatment or follow up for cancer therapy of the head and neck region, in a public tertiary referral hospital in the eThekwini district, KwaZulu-Natal. Purposive sampling technique was used for participant selection. The research instrument comprised a combination of two previously validated questionnaires: a core questionnaire (EORTC QLQ-C30, Version 3.0) and the head and neck cancer specific module (EORTC H). Data was analysed using the statistical package for software sciences (SPSS), version 24 RESULTS: More than half of the study population were male (60%; n= 141). The mean age was 54.38 (SD= 12.30). The results indicate that 14.5% (n=34) were employed, 46.4% (n=109) were unemployed because of cancer and 39.1% (n=92) were unemployed due to other reasons (old age, housewife). Oral cavity cancer was the most common (n=91; 38.7%), followed by laryngeal cancer (n= 53; 22.6%) among all the other head and neck cancers. Males (n=50; 21.3%) were more affected by oral cavity cancer as compared to females (n=41; 17.4%). With reference to treatment, 20.4% (n=48) were on radiotherapy, 28.5% (n=67) were on chemotherapy and 9.8% (n=23) were on CCRT, 17.4% (n=41) had surgery, 8.5% (n=20) were recently diagnosed with cancer of the head and neck and 23.4% (n=55) were on follow up. Oral health-related symptoms were experienced to varying degree by the participants The majority of participants (n=125; 53.2%) did not report any pain and discomfort. More female participants (n=7; 7.4%) in the age group of 41-60 reported of severe difficulty in swallowing liquids than males of the same age group. Most participants (n=148; 63.0%) had difficulty in swallowing solid foods. Similarly, the majority of participants experienced problems with their teeth (n=162; 69.0%), reported xerostomia (n=159; 67.7%). With reference to trismus, a higher proportion of females (n=27; 28.7%) reported severe trismus compared to male participants (n=33; 23.4%). With reference to increased viscosity of saliva, 34.0% (n=32) of females reported extremely sticky saliva as compared to 29.8% males (n=42). CONCLUSION: It is apparent from the findings that oral health-related complications are present in varying degrees in the study participants with head and neck cancer. It is important to educate patients to seek treatment for these complications. It is equally important that dentists and dental health care providers with specific skills-mix, assess and manage such complications efficiently and timely so as to improve the quality of life of patients with head and neck cancer.

BACKGROUND: Previous studies have reported comorbid disease, including hypertension, diabetes mellitus, chronic cardiac and renal disease, malignancy, HIV, tuberculosis (TB) and obesity, to be associated with COVID-19 mortality. National demographic surveys have reported a high proportion of undiagnosed and untreated comorbid disease in South Africa (SA OBJECTIVES: To determine the number of individuals with previously undiagnosed HIV, TB and non-communicable diseases (NCDs) among patients hospitalised with COVID-19, and the level of medical control of these chronic diseases METHODS: We conducted a sentinel surveillance study to collect enhanced data on HIV, TB and NCDs among individuals with COVID-19 admitted to 16 secondary-level public hospitals in six of the nine provinces of SA. Trained surveillance officers approached all patients who met the surveillance case definition for inclusion in the study, and consenting patients were enrolled. The data collection instrument included questions on past medical history to determine the self-reported presence of comorbidities. The results of clinical and laboratory testing introduced as part of routine clinical care for hospitalised COVID-19 patients were collected for the study, to objectively determine the presence of hypertension, diabetes, HIV and TB and the levels of control of diabetes and HIV RESULTS: On self-reported history, the most prevalent comorbidities were hypertension (n=1 658; 51.5%), diabetes (n=855; 26.6%) and HIV (n=603; 18.7%). The prevalence of self-reported active TB was 3.1%, and that of previous TB 5.5%. There were 1 254 patients admitted with COVID-19 (39.0%) who met the body mass index criteria for obesity. On clinical and laboratory testing, 87 patients were newly diagnosed with HIV, 29 with TB, 215 with diabetes and 40 with hypertension during their COVID-19 admission. There were 151/521 patients living with HIV (29.0%) with a viral load >1 000 copies/mL and 309/570 (54.2%) with a CD4 count <200 cells/μL. Among 901 patients classified as having diabetes, 777 (86.2%) had a glycated haemoglobin (HbA1c) level >6.5% CONCLUSION: The study revealed a high prevalence of comorbid conditions among individuals with COVID-19 admitted to public hospitals in SA. In addition, a significant number of patients had previously undiagnosed hypertension, diabetes, HIV and active TB, and many had poorly controlled chronic disease, as evidenced by high HbA1c levels in patients with diabetes, and high viral loads and low CD4 levels in patients with HIV. The findings highlight the importance of strengthening health systems and care cascades for chronic disease management, which include prevention, screening for and effectively treating comorbidities, and ensuring secure and innovative supplies of medicines in primary healthcare during the COVID-19 pandemic

BACKGROUND. Preventing disease and promoting health call for interprofessional collaboration of health professionals working in a team, making it important for student health professionals to experience collaborative teamwork while in training, rather than learning and working in silos. OBJECTIVES. To describe the opinions of participating students and supervising staff in an intraprofessional community-based initiative involving the disciplines of physiotherapy and dentistry at the University of KwaZulu-Natal (UKZN), Durban, South Africa. METHODS. This was a qualitative descriptive study demonstrating teamwork of students from two health sciences disciplines, giving a joint health education talk to patients at a local community health centre. Data were collected from focus group discussions. Three such discussions were held with purposively selected samples: (i) 5 physiotherapy students; (ii) 6 dental therapy students; and (iii) 6 staff members from both disciplines who supervised the students. These data were analysed using thematic analysis. Ethical approval was obtained from UKZN. RESULTS. By working collaboratively, the students believed that they learnt more about the other health professionals and obtained a deeper understanding of their roles within the healthcare team. Staff believed that the collaborative project could break down professional barriers to work cohesively in the work environment. The main difficulties encountered were the language barrier and rigid timetables. CONCLUSION. This case study provides an example of intraprofessional collaboration and teamwork, capable of positively influencing participating students, emphasising the need for interprofessional learning opportunities for students across all health sciences disciplines while in training.

The COVID-19 pandemic has highlighted the need for renewed conversations in infection control in the context of dental undergraduate learning. OBJECTIVES: This study set out to examine dental therapy and oral hygiene students' knowledge, attitudes and practices related to infection control METHODS: This quantitative survey was conducted at one dental training site in South Africa. The study population comprised 156 full time enrolled students that was stratified into Year 1 (n=55), Year 2 (n=54) and Year 3 (n=47). An online, self-administered questionnaire with closed and open-ended questions was used to collect information. Data were analyzed using SPSS version 25.0 (IBM Corp., USA) and thematic analysis RESULTS: The response rate for the study was 70.5% (n=111). Almost all participants (n=104) strongly agreed/agreed that COVID-19 is transmitted mainly through infected droplets. Most participants (Year 1: n=24, 22.5%; Year 2: n=28, 26.2%; Year 3: 22, 31.2%) strongly disagreed / disagreed that younger people were less susceptible to contracting COVID-19 disease. While 23 first (21.5%) and 16 second-year students (14.9%) strongly agreed/agreed that personal protective gear was sufficient protection against COVID-19, about 16 third-year students (14%) were unsure or disagreed. Almost all participants (n=105, 98.1%) strongly agreed/agreed to washing or sanitizing their hands regularly. The emergent themes from qualitative data analysis included: better access to resources and more coordinated planning for clinical and classroom-based learning CONCLUSION: There were inconsistencies in participants' knowledge and attitudes towards infection control. There is a need for ongoing awareness of infection control in both clinical and class-room based learning

BACKGROUND: Many institutions of higher education transitioned from classroom-based settings to remote settings as a response to the COVID-19 pandemic. However, it is unclear how undergraduate dental therapy and oral hygiene students responded to this transition in the learning environmentOBJECTIVES: To explore undergraduate dental students' knowledge, perceptions, attitudes and practices related to clinical and theory-based learning at a South African universityMETHODS: A mixed-methods approach comprising a concurrent dominant status design (QUAN/qual) was used. Therefore, the study was a cross-sectional quantitative survey with descriptive qualitative data. An online, self-administered questionnaire with open- and closed-ended questions was developed to gain insights into students' knowledge, perceptions, attitudes and learning practices during the COVID-19 pandemicRESULTS: Most respondents (n=86; 80.4%) agreed that they had the necessary skills to engage with online learning (p=0.04). Respondents in the first year (n=25; 76%), second year (n=24; 73%) and third year (n=32; 28%) were either unsure or did not agree that they understood online platform-based lectures better than classroom-based lectures. The major emergent themes included external (internet connectivity) and internal (students' coping skills) barriers to online learningCONCLUSIONS: This study highlighted dental student challenges in embracing the blended approach of teaching and learning. While this may be a new norm for curriculum delivery, it is important to include student input in curriculum-related decision-making processes

INTRODUCTION: Antibiotic resistance is a growing public health concern. Yet, there is a paucity of published data in KwaZulu-Natal on antibiotic prescription trends and patterns related to dental use. STUDY OBJECTIVES: The objectives of this study were to identify the range of dental conditions for which oral antibiotics are prescribed at two public health settings (Institution A and B) in the Pietermaritzburg Complex, KwaZulu-Natal and to explore practitioner understanding of the indications for antibiotic prescription for dental conditions. METHODS: The study used a two-phased approach and collected a combination of qualitative and quantitative data. Phase 1 comprised a retrospective clinical chart review (n=720), while phase 2 comprised a focus-group discussion with purposively selected health care practitioners at each institution. RESULTS: The results of the retrospective clinical chart review indicated that dental abscesses were the most common dental infections requiring oral antibiotic therapy (n= 479; 66%), followed by acute alveolar osteitis (dry socket) (n=110; 15%), dental impactions (n=78; 11%) and dental extractions (n=62; 9%). At Institution A, antibiotic therapy was prescribed for conditions such as trismus (n=13; 6%), soft palate swelling of unspecified origin (n=9; 4%), fibrous epulis (n=6; 3%) and acute herpes simplex (n=2; 1%). Interestingly, antibiotics were not prescribed at Institution B for the same dental conditions. Antibiotic therapy was also prescribed for eruption pain (n=4; 1%) and for cases when patients did not bring their inhaler for asthma treatment (pump) (n=3; 1%). The findings from the focus-group discussions suggested that there is a need to improve practitioner understanding of the indications for antibiotic prescriptions for dental conditions. CONCLUSION: This study showed some differences in antibiotic therapy prescription patterns at the two public health institutions, especially for dental conditions that did not require such management. This suggests a need for consensus-building among health professionals and the provision of more dedicated guidance for antibiotic prescription in the management of dental conditions.

BACKGROUND: Many institutions of higher education transitioned from classroom-based settings to remote settings as a response to the COVID-19 pandemic. However, it is unclear how undergraduate dental therapy and oral hygiene students responded to this transition in the learning environmentOBJECTIVES: To explore undergraduate dental students' knowledge, perceptions, attitudes and practices related to clinical and theory-based learning at a South African universityMETHODS: A mixed-methods approach comprising a concurrent dominant status design (QUAN/qual) was used. Therefore, the study was a cross-sectional quantitative survey with descriptive qualitative data. An online, self-administered questionnaire with open- and closed-ended questions was developed to gain insights into students' knowledge, perceptions, attitudes and learning practices during the COVID-19 pandemicRESULTS: Most respondents (n=86; 80.4%) agreed that they had the necessary skills to engage with online learning (p=0.04). Respondents in the first year (n=25; 76%), second year (n=24; 73%) and third year (n=32; 28%) were either unsure or did not agree that they understood online platform-based lectures better than classroom-based lectures. The major emergent themes included external (internet connectivity) and internal (students' coping skills) barriers to online learningCONCLUSIONS: This study highlighted dental student challenges in embracing the blended approach of teaching and learning. While this may be a new norm for curriculum delivery, it is important to include student input in curriculum-related decision-making processes

The increasing scope of nuclear medicine imaging as a diagnostic utility is impressive. Plain film radiographs, computed tomography (CT) scans and magnetic resonance imaging (MRI) diagnostically provide high-quality images but provide little physiological information about disease processes. Nuclear medicine imaging modalities advantageously can characterise the early dynamic physiological changes in a diseased environment. Dental professionals working within the arena of integrated holistic health practices are likely to encounter patients having had procedures like conventional scintigraphy, single photon emission computed tomography (SPECT), hybrid SPECT/CT and positron emission tomography computed tomography (PET/CT). The aim of this review is to acquaint the oral health care professional with some commonly utilised nuclear medicine techniques, the principles upon which such modalities are based and their applications in the diagnosis of head and neck pathology to facilitate enhanced multidisciplinary patient management.

INTRODUCTION: The prevalence of malocclusion among school going children in KwaZulu-Natal remains poorly defined despite the known physiological and psychological impact of this dental occurrence. OBJECTIVES: The aim and objectives of this study was to determine the prevalence of malocclusion and possible treatment need in 13-15 year-old school going children in Durban, Kwa-Zulu Natal. METHODS: This was a descriptive, cross-sectional epidemiological study conducted on 270 school-going children aged 13 to 15 years, in the Umlazi and Pinetown school districts. A two-staged clustered and systematic random sampling technique was used to draw the study sample. Data was collected through an intraoral examination of occlusal status and the malocclusion and orthodontic treatment need was assessed through use of the Dental Aesthetic Index (DAI). Questionnaires were developed to collect information on the learners' health status and socio demographic profile. RESULTS: The results indicated that 144 (53.3%) of the 270 learners had DAI scores <25 (no abnormality or minor malocclusion not requiring orthodontic treatment); 26 learners (9.6%) had DAI scores of between 26-30 (definite malocclusion requiring elective orthodontic treatment); 59 learners (21.9%) had DAI scores of between 31-35 (severe malocclusion requiring orthodontic treatment); and 41 learners (15.2%) had DAI scores >36 (very severe or handicapping malocclusion requiring mandatory orthodontic treatment). There was an increase in the proportion of malocclusion in older children. The age group of 15 years old had a mean and standard deviation of 30.02+8.9 when compared to the age group 13 years old (27.76 + 12.17). The association between gender distribution and severity of malocclusion was found to be statistically significant (p=0.01). CONCLUSION: The present study primarily indicated a significant prevalence of malocclusion in the identified children. Although 53.3% of children did not require treatment, 37.1% presented with severe and handicapping malocclusion. This suggests a definite and mandatory treatment need for this group of children. The study could provide useful baseline epidemiological data that could inform oral health planning on the prevalence of malocclusion and orthodontic treatment need for 13-15 year-old school going children in the identified geographical area.