BACKGROUND: Oral self-care health is integral to general health. However limited studies reflect physiotherapy students' dental practices such as frequency of toothbrushing, toothbrush replacement, use of oral rinses, dental flossing, use of Interdental aids or knowledge of dental plaque. STUDY OBJECTIVES: This study assessed knowledge, perceptions and oral self-care practices among physiotherapy students. METHOD: This descriptive cross-sectional survey recruited second-, third-, and fourth-year physiotherapy students at an identified training institution in South Africa by means of a self-administered questionnaire. RESULTS: A total of 137 students participated in the study with a response rate of 83%. Participants indicated that 58% (n=79) had good knowledge and 85% (n=117) reported oral self-care practices. Almost all participants (99%; n=136) used a brush with toothpaste; 76% (n=104) brushed twice daily; 53% (n=72) replaced their toothbrush every 3 months and 48% (n=66) rinsed their mouth after eating. More than two-thirds of the study sample (62%; n= 84) used an interdental aid and (37%; n=50) reported dental visits once a year with (74%; n=100) only when necessary. From these 96% (n=132) experienced barriers such as costs (54%; n=71) and inadequate time (42%; n = 55). The majority of participants (72%; n=98) supported oral self-care be included in the physiotherapy curriculum. CONCLUSION: Although there were inconsistencies in physiotherapy students' reported oral health-related knowledge, perceptions and self-care practices, the majority of participants supported the inclusion of dental health into the undergraduate physiotherapy curriculum. This will enhance interprofessional education and improve oral health outcomes for both students and patients.

INTRODUCTION: Oral healthcare is an important aspect of the general healthcare of individuals residing in long-term care (LTC) facilities. However, it is often neglected in these settings and contributes to oral health disparities and oral diseases among residents. The World Health Organization promotes the reduction of health disparities and diseases through health promotion as an ethical obligation. The utilization of frameworks to promote oral health provides a structured approach to the design, implementation, and evaluation of oral health promotion programs. AIM AND OBJECTIVES: This study proposed a framework to guide the development, implementation, and review of an oral health promotion intervention, so as to ensure that a systematic and evidence-based approach is used for the delivery of oral health promotion activities. METHODS: The framework comprised three stages: needs analysis, implementation and review of an oral health intervention, which was guided by the Precede-Proceed model and Intervention mapping. The empirical aspect involved a 4-phased mixed method exploratory study, based on action research and the plan-act-observe-reflect cycle, which illustrated how the framework was operationalized. RESULTS: The oral health intervention indicated positive outcomes with regard to knowledge and attitudes among caregivers. CONCLUSION: The framework incorporated the key components that influenced oral health provision at LTC facilities.

INTRODUCTION: Globally, the number of people unaware of their HIV status, and the rate of transmission of the disease, remains high. Scaling up of HIV testing opportunities and settings, particularly in the dental clinical setting, is needed to address this major public health concern. AIM AND OBJECTIVES: This study assessed dental patients' knowledge, attitudes and practices in voluntary counselling and rapid HIV testing (VCT) in the dental workplace in the eThekwini district, KwaZulu-Natal to determine their understanding and support for these services. METHODS: This was a cross-sectional, descriptive study. A total of 250 questionnaires were distributed to dental patients located in private and public dental settings in the eThekwini district. Two hundred and fifty (n=250) completed questionnaires were retrieved, yielding a response rate of 100%. RESULTS: More than half of the participants (n=134; 53.6%) indicated not to have heard of rapid HIV testing or were "unsure" of their knowledge regarding rapid HIV testing. The majority of participants (n=209; 83.6%) reported wanting the option to test for HIV at the dental workplace and 76.8% (n=192) indicated that rapid HIV testing should be routinely conducted by the oral healthcare worker. Participants (n=189; 75.6%) indicated to be less willing to partake in HIV testing should there be a cost implication. Some participants (n=104; 41.6%) indicated that they did not want the oral healthcare worker to perform the test due to perceived incompetency in rapid HIV counselling and testing. More participants from urban (n=214; 85.6%) and rural (n=217; 86.8%) areas of living were keen on the option to test for HIV at the dental workplace, with only 46.8% (n=117) of the informal dwellers sharing the same sentiment. CONCLUSION: Participants reported inadequate knowledge and practice of VCT at the dental workplace. Participants had positive attitudes towards VCT implementation in the dental setting, provided that the cost of conducting of the test was free.

Ethical guidance in research is underpinned by the need to show respect for study participants by upholding autonomy in participant decision-making, and confidentiality and protection of individual rights, privacy and interests, yet decision-making could also be influenced by the participant's sociocultural and belief systems. This calls for a more Africanised approach to research ethics where these values and beliefs are upheld. While national and international ethics guidelines do exist, there is little evidence that such a paradigm shift in research ethics is adequately interrogated in the teaching and learning curricula in higher education, where research skills are developed and nurtured. Critical reflection is used to highlight opportunities to stimulate learning and debates underpinned by humanised pedagogy in higher education.

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

Abstract Michoacán-Colima earthquake of 19 September 2022 (M s 7.6, M w7.6) ruptured the NW end of the Cocos-North American plate interface, causing severe damage to many towns and cities in the states of Michoacán and Colima. The damage was further exacerbated by a major aftershock (M w6.7) on 22 September. The mainshock initiated below the coast at a hypocentral distance of 22 km from the seismic station of Maruata (MMIG) where peak ground acceleration and velocity, PGA and PGV, of ~ 1 g and 28 cm/s were recorded. The epicenter of the major aftershock was located ~ 30 km SE of the mainshock. Finite fault modeling of the mainshock by the U.S. Geological Survey reveals a rupture propagation along the strike towards the NW and yields a static stress drop, Δσs, of 3.7 MPa. Our estimated radiated energy, E R, is 3.44×1015J, so that E R /M 0 is 1.27 × 10−5 similar to other large Mexican thrust earthquakes whose rupture areas do not extend to the trench. Aftershocks of the 2022 mainshock overlap that of the Colima earthquake of 30 January 1973 (M w7.6). Galitzin seismograms of the two earthquakes at DeBilt (DBN), The Netherlands, are reasonably similar so that they may be classified as quasi-repeated events. On the other hand, the DBN seismogram of the earthquake of 15 April 1941 (M S 7.7), whose location is poorly known but occurred in the same region, differs greatly from those of the 1973 and 2022 earthquakes, suggesting a different source area for the 1941 event. An analysis of the extensive regional recordings exhibits the effect of the directivity on the ground motion and on the ratio of ground motion during the mainshock to the major aftershock. The directivity explains the observed azimuthal dependence of PGA and PGV ratios, spectral ratios, and PGA and response spectra at 2s, Sa (T = 2 s). Because of the directivity, PGA, PGV, and Sa (T = 2 s) in the Valley of Mexico during the mainshock and the major aftershock were about the same in spite of the magnitude difference of 0.9. At CU (the reference, hard site in Mexico City), PGA and PGV during both events were ~ 6 cm/s2 and 2 cm/s, respectively, lower than expected for the mainshock and higher than expected for the aftershock.

Resumen El sismo de Michoacán-Colima el 19 de septiembre de 2022 (M s7.6, M w 7.6) rompió el límite NW de la interface entre las placas de Cocos y norteamericana, causando daño severo a muchas poblados y ciudades en los estados de Michoacán y Colima. El daño fue además agravado por una réplica de magnitud importante (M w6.7) el 22 de septiembre. El sismo principal inició debajo de la costa a una distancia hipocentral de 22 km de la estación sísmica de Maruata (MMIG) donde las aceleraciones y velocidades máximas registradas, PGA y PGV, fueron de 1g y 28 cm/s, respectivamente. El epicentro de la réplica más grande se localizó a ~30 km al SE del sismo principal. El modelado de falla finita del sismo principal presentado por el Servicio Geológico de los Estados Unidos (USGS), revela una propagación de la ruptura a lo largo del rumbo de la falla hacia la dirección NW con una caída de esfuerzos estáticos Δσs, of 3.7 MPa. Nuestra estimación de energía radiada, E R, es 3.44×1015J, de tal manera que E R /M 0 es de 1.27 × 10−5 valor similar al calculado para otros grandes sismos de subducción cuyas área de ruptura no se extienden hacia la trinchera. El área que contiene las réplicas del sismo principal de 2022 se traslapa con el área de réplicas del sismo del 30 de enero de 1973 (M w7.6). Los sismográmas Galitzin de los dos sismos registrados en la estación DeBilt (DBN) localizada en los Países Bajos son razonablemente similares de tal manera que pueden ser clasificados como eventos quasi-repetidos. Por otro lado, el sismograma DBN del sismo del 15 de abril de 1941 (M S 7.7), cuya localización no se conoce bien del todo, aunque se sabe que ocurre en la misma región, difiere sustancialmente de los sismogramas de 1972 y 2022, sugiriendo que el primero rompió un área diferente de la del sismo de 1941. Un análisis extensivo de registros regionales exhibe el efecto de directividad observada en los datos de movimientos fuertes y en los cocientes de aceleraciones del sismo principal y de las aceleraciones de la réplica mayor. La directividad explica la dependencia azimutal observada en los cocientes de PGA y PGV, los cocientes espectrales, la distribución de PGA y la respuesta espectral a 2s Sa (T = 2 s). Debido a la directividad, los valores de PGA, PGV y Sa (T = 2 s) en el Valle de México durante el sismo principal y la réplica mayor fueron muy similares a pesar de la diferencia en magnitud de 0.9. En CU (el sitio de roca firme de referencia en la Ciudad de México), PGA y PGV durante ambos eventos fueron de ~ 6 cm/s2 and 2 cm/s, respectivamente, valores más bajos que los esperados para el sismo principal y más altos que los esperados para la réplica mayor.

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.

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.

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.

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. 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.

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