bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reflections on the health system response to COVID-19 in the Western Cape Province
Authors: Vallabhjee Krish , Gilson Lucy , Davies Mary A , Boulle Andrew , Pienaar David , Reagon Gavin , Mahomed Hassan , Kaye Simon , Kariem Saadiq , Cloete Keith 
Published: September 2023

In the Western Cape Province, as elsewhere in the country, the COVID-19 crisis has required an intense multi-pronged response by the provincial Government. With the aim of encouraging wider reflection, this chapter presents our experiences, focusing specifically on surveillance and planning, the outbreak and health platform response including corporate support services, and leadership and governance. During the inter-wave periods, the Department of Health convened a series of facilitated conversations with staff to consider our responses and identify lessons that can inform our future strategy. The Western Cape COVID-19 response showed that government can be adroit and responsive to shocks. We drew on the pre-existing health system foundations of trusting relationships, collaboration and networking. The responses were also underpinned by decisive and distributed leadership and stewardship − mobilising a range of actors within, across and outside government around a common purpose; using routine information and evidence in continuously adapting to emergent conditions; and decentralised approaches that enabled local responsiveness. Responsive corporate support services (infrastructure provision, oxygen supply and staffing support) have been critical. Developing agile inter-disciplinary and cross-functional mechanisms for rapid decision-making, such as huddles, were instrumental. We also specifically sought to: address staff safety in all sectors; use digital technologies to do business differently; and develop a culture of learning and constant improvement. Areas for future improvement include strengthening community connectedness, managing ‘policy overload’ on frontline managers, and empowering middle management in their mediating role between frontline staff, the community and senior management. It is critical to strengthen the health system to manage both everyday challenges and extraordinary adverse events like COVID-19. Organisational muscle and resilience are built through collaborative relationships, flexibility and agility, and the ability to learn, improve and adapt.
Leveraging Community Health Workers for intensified case-finding: experience from South Africa’s COVID-19 response
Authors: Madikizela Lindiwe , Matlala Marang , Mosikare Ofentse 
Published: September 2023

On 30 March 2020, the South African President proclaimed the need for intensive community screening and testing, utilising community health workers to curb the spread of COVID-19 and to scale up and expand local, district and provincial case investigation. The objectives of community screening and testing were to: facilitate early identification of probable COVID-19 cases and early referral for testing; identify people sick at home and facilitate their referral to Primary Health Care facilities or hospitals; and provide health education on COVID-19 so as to increase awareness and promote behaviour change and prevention. CST included a series of approaches, namely door-to-door-screening, a cluster approach, and a targeted-area approach. The targeted-area approach was the last to be introduced, with screening and testing teams deployed to identified COVID-19 hotspot areas and individuals with medical needs prioritised for clinical diagnosis, including contacts of confirmed COVID-19 cases. Implementation of the targeted screening approach was effective in identifying a higher yield of positive COVID-19 cases, and in strengthening the integration of CHWs into facilities for service delivery at community level. The Community Screening and Testing programme has provided evidence that Community Health Workers play a crucial role in undertaking community-based activities to address behaviour change, case-identification, and referrals for testing and linkage to health facilities. This chapter provides a descriptive analysis of South Africa’s community screening and testing strategy, and outlines the impact of its implementation on case-finding at community level. A comparison of active and passive case-finding was used to illustrate the outcomes of using community health workers to conduct screening in the community.
Towards Housing First and harm reduction: addressing opioid dependence and homelessness in Tshwane during the COVID-19 pandemic
Authors: Scheibe Andrew , Gloeck Natasha , Madela-Mntla Edith , Renkin Wayne , Shelly Shaun , Lalla Sasha , Kroukamp Lorinda , de Beer Stephan , Hugo Jannie 
Published: September 2023

Pandemics can increase mortality and drug-related harms among people experiencing homelessness. The Housing First approach prioritises housing and service access. Harm reduction, a principle of Housing First, minimises the consequences of drug use. This chapter presents lessons learnt from the application of Housing First and harm reduction principles with homeless people in Tshwane, South Africa, between April 2020 and March 2021. Quantitative service delivery data were retrospectively reviewed and analysed using descriptive statistics. Accounts by authors who participated in the COVID-19 response were collectively discussed in relation to the Housing First and harm reduction actors and process. Issues were synthesised in relation to two six-month periods. A task team was established to co-ordinate Tshwane’s response. In the first six months, 1 440 temporary bed-spaces were created at 25 shelters, and 2 066 people at shelters received food, social support and on-site healthcare services. Across shelters, 1 076 residents were started on methadone to manage opioid withdrawal. By the second six-month period, many gains were lost. Changes in political leadership stalled plans to reintegrate people housed in temporary shelters, and reduced funding led to shelter closures. By April 2021, more shelters operated than in pre- COVID-19 times, harm reduction capacitation for shelter staff continued, and local government committed to establish a street homelessness unit. Through a combination of funding and collaboration, progress was made towards Housing First and harm reduction for homeless people in Tshwane. A national policy on homelessness should be developed, funded and implemented. This should be informed by additional research, developed in partnership with affected populations, and built on a common understanding of Housing First and harm reduction.
Effect of the COVID-19 pandemic on women’s, maternal and child health services in Tshwane District, South Africa
Authors: Kruger Annelet , Letebele-Hartell Manei , Tshukudu Mphailele , Moshime-Shabangu Mpho , Manyane Tabea , Van der Westhuizen Maria , Mlangeni Mary , Phoshoko Setlola , Makau Rebecca , Mfolo Vivian , Masha Maureen , Ramokolo Vundli , Botha Tanita , Feucht Ute 
Published: September 2023

Background The COVID-19 pandemic severely impacted healthcare service delivery globally. The aim of this study was to assess effects of the COVID-19 pandemic on the uptake of routine healthcare services related to maternal, newborn, child, and women’s health (MNCWH) in Tshwane District, an urban locality in Gauteng Province, South Africa. Methods As part of the observational Tshwane Maternal-Child COVID-19 study, routine data sources, including the District Health Information System and other district-based datasets, were studied from April 2019 to March 2022, to describe the impact of the first four COVID-19 waves in Tshwane District. The year pre-pandemic was used as a baseline. Data included MNCWH data elements/indicators, child health data elements/indicators, and COVID-19 surveillance data. Data analysis included descriptive statistics, together with visual analysis of trends over time. Statistical investigation included testing of differences between data from the pre-pandemic year (as baseline) and data from the following two pandemic years (2020/2021 and 2021/2022), as per the National Department of Health’s financial years (from April to March of the following year). Results Multiple MNCWH health elements/indicators showed major decreases during the COVID-19 pandemic period, with preventive services rendered at primary healthcare and community level more severely affected than facility-based clinical services. The most significant decreases were recorded during the first pandemic year, most notably during the first strict lockdown period, with partial or complete recovery in the second pandemic year, while selected indicators saw large impacts during the actual COVID-19 waves. Conclusions The COVID-19 pandemic severely impacted the ability of women and children to access healthcare services in this large urban district in South Africa. Health system strengthening measures and adequate planning for future emergency situations are crucial to mitigate the negative impact on maternal and child health, as South Africa strives to move towards reaching its Sustainable Development Goals.
The Western Cape Surgical Recovery Project: experience at Groote Schuur Hospital
Authors: Peters Shrikant M. , Nel Daniel , Cairncross Lydia , Hofmeyr Ross , Arends Pierre , Chigumadzi Farai , Watson Janine , Anthony Deidre , Davids Melinda , Ganief Zainap , Panieri Eugenio , Patel Bhavna , Eick Bernadette , Jacobs Belinda , Evans Kristy , Strathie Grant , Van Dyk Dominique , Nejthardt Marcin Bartosz , Llewellyn Richard , Biccard Bruce M. 
Published: September 2023

Background Data from six Western Cape secondary-level hospitals have shown that during the first wave of the COVID-19 pandemic (which lasted from May to July of 2020), total surgeries decreased by 44%, and elective surgeries by 74%, due to secondment of nursing, anaesthetic and surgical staff to COVID high-care and intensive-care services. At Groote Schuur Hospital, the loss of surgical output over the two years of the pandemic-related surgical service de-escalation (2020-2021) was estimated at 10 000 cases, with 6 000 patients with progressive disease waiting for elective surgical care. Methods In early May 2022, a Surgical Recovery Project was initiated; funding from the Western Cape Department of Health, and donations from the Gift of the Givers Foundation, private individuals, businesses, and other non-governmental organisations were used to build, staff, and equip a Day-Case Surgery Suite. Results By the Project midway point (end October 2022), a total of 800 extra cases had been completed, and the Project is currently on track to exceed the target of 1 500 cases in a calendar year by at least 10%. The largest number of procedures done were eye cases (n = 191), followed by cases involving surgery to the integumentary system (n = 141), and musculoskeletal system cases (n = 123). There were a total of 30 patient cancellations. While the Project expectedly had poorer on-time-start statistics in the first quarter of operation (range 0.0 - 6.9%), the percentage of on-time-start statistics improved markedly over the second quarter (range 43.3 - 56.5%). World Health Organization checklists were completed for 85.1% of operations performed at the Day-Case Surgery Suite, and no adverse incidents or mortalities were recorded at the Unit. Conclusions This project demonstrates that the volume of services provided in the public sector can be escalated with the use of external funding of capital for human resources, equipment and consumables. However, these services become truly effective when there is sufficient multi-disciplinary planning, alignment and support, at operational, strategic and executive levels of healthcare facilities.
Studying the effect of inhaled corticosteroids on the larynx in bronchial asthma patients using videostroboscopy
Authors: Almaraghy Atef AbdAlla , Seliem Ahmed , Khalifa Rana Ahmed 
Published: September 2023

EnAbstract
Introduction
The frequent use of inhaled corticosteroids (ICS), especially at higher doses, has been accompanied by concern about both systemic and local side effects. The systemic complications of ICS have been extensively studied and are well documented in the literature. There are comparatively few studies reporting on the local complications of ICS. Compared with systemic side effects, the local side effects of ICS are considered to constitute infrequent and minor problems. However, although not usually serious, these local side effects are of clinical importance.

Aim of the work
The aim of this study was to demonstrate the effect of ICS on the larynx using videostroboscopy in patients suffering from bronchial asthma in order to avoid these effects on the patients in further protocols of treatment.

Patients and methods
This study was carried out on 50 patients suffering from bronchial asthma. They were divided into two groups. Group A included 25 patients suffering from bronchial asthma treated using ICS (budesonide) for 1 year at a dose of 1600 μg/day. Group B included 25 patients having bronchial asthma and not receiving ICS. Each patient was subjected to the following protocols of assessment: (i) elementary diagnostic procedures such as (a) patient interviews, (b) auditory perceptual assessment, and (c) laryngeal visualization. (ii) Clinical diagnostic aids: laryngovideostroboscopy was carried out using a digitalized stroboscopy system to examine the vocal fold mobility, congestion, hypertrophy, ventricular folds hypertrophy, glottic gap, and glottic closure. The following acoustic parameters were measured: fundamental frequency, jitter (cycle-to-cycle variation in frequency), shimmer (cycle-to-cycle variation in amplitude), and noise-to-harmonic ratio (N/H). (iii) Additional instrumental diagnostic measures: the acoustic signals were recorded from each patient. The results of this study revealed more laryngeal abnormalities in group A than in group B. Dysphonia was found in 76% of the patients in group A, in which voice was perceived as either strained, leaky, or of rough qualities. The following changes in the glottis were observed in some patients: either localized or diffuse congestion of the vocal folds, hypertrophy in the ventricular bands, incomplete glottic closure, and glottic gap. In addition, there were also decreases in glottic wave and amplitude. Acoustic analysis showed significant increase in the jitter and shimmer values.
A case of rhinolaryngoscleroma in a patient with neurofibromatosis type 1
Authors: Effat Kamal G. 
Published: September 2023

EnAbstract
Introduction
Scleroma is a chronic-specific granuloma of the nose and it may involve other parts of the respiratory tract. The condition is endemic in Egypt. Neurofibromatosis type 1 (NF-1) is one of the most common genetic conditions of the nervous system. Before this report, no case had been published documenting scleroma in a patient with NF-1.

Aim
To describe a case of rhinolaryngoscleroma in a patient with NF-1.

Methods
Case report and literature review.

Results
Presentation of clinical, imaging and pathological findings, as well as management considerations.

Conclusion
This is the first case to be reported in the literature documenting the coexistence of rhinolaryngoscleroma and NF-1. The biological events in the immune system await further studies.
Rahab, prostituée cananéenne, impulsion décisive pour la conquête de la terre promise
Authors: Vialle Catherine 
Published: September 2023

L’histoire de la prostituée Rahab qui vient au secours de deux espions israélites en les cachant, et qui confesse sa foi en la victoire de YHWH sur Jéricho, est propre à retenir l’attention. Pourtant, ce petit récit parait, à première vue, mal à sa place dans le livre de Josué. Situé au début de la conquête, il interrompt la marche triomphante de Josué et des fils d’Israël par un épisode pour le moins burlesque. Quelle est la fonction de cet épisode ? Qu’apporte-t-il à l’intrigue du récit, à la caractérisation des personnages principaux et à la théologie du livre de Josué ? Cet article propose de relire l’histoire de Rahab sous un angle avant tout synchronique, en essayant de répondre à ces questions.
Jos 10,1-15, le miracle de Gabaon, un salut pour Israël
Authors: Nocquet Dany 
Published: September 2023

L’étude proposée tente de mieux comprendre le miracle de Gabaon (ville étrangère et cananéenne) en Jos 10,1-15 ses intentions narratives suite à Jos 9, et sa visée historique dans le cadre du livre de Josué.
Après Jos 9,1-27 qui raconte l’alliance des Israélites avec les Gabaonites, leur délivrance et leur intégration au service du temple, Jos 10,1-15 montre comment Gabaon, lieu d’une manifestation divine, devient indispensable pour l’installation d’Israël en Canaan. Au salut de Gabaon est lié le salut d’Israël : s’en prendre à Gabaon, c’est s’en prendre à Israël. En soulignant combien ces deux nations sont unies dans un même peuple, Jos 10,1-15 affirme l’unité plurielle d’Israël depuis ses origines.
Discutant l’appartenance rédactionnelle de Jos 10,1-15, et l’étonnante position de Jérusalem opposée à Josué, l’étude montre que ce texte tardif provient de la communauté samarienne, reflétant le climat de l’époque perse, marquée par la reconnaissance de la pluralité linguistique et religieuse. En plus de la victoire spectaculaire d’Israël, ce passage prend une certaine distance avec la théologie deutéronomiste. Il met dès lors en valeur une autre théologie yahwiste plus intégrative avec la légitimation de la cohabitation pacifique entre Israélites et Gabaonites.
Systematic and meta-based evaluation of the relationship between the built environment and physical activity behaviors among older adults
Authors: You Yanwei , Chen Yuquan , Zhang Qi , Hu Xiaojie , Li Xingzhong , Yang Ping , Zuo Qun , Cao Qiang 
Published: September 2023

ObjectivesExisting assertions about the relationship between various factors of the built environment and physical activity behaviors are inconsistent and warrant further exploration and analysis.MethodsThis study systematically searched PubMed, Embase, Web of Science, Scopus, the Cochrane Library and Google Scholar for the effect of the built environment on the physical activity behaviors of older adults. R software was used to calculate the meta-estimated odds ratio with a 95% confidence interval. Simultaneously, the quality of included studies was evaluated using an observational study quality evaluation standard recommended by American health care quality and research institutions.ResultsA total of 16 original researches were included in this meta-analysis and eight factors of the built environment were evaluated. These factors which ranked from high to low according to their impact were traffic safety (OR = 1.58, 95% CI [1.14–2.20]), destination accessibility (OR = 1.24, 95% CI [1.06–1.44]), aesthetics of sports venues (OR = 1.21, 95% CI [1.07–1.37]), virescence of sports venues (OR = 1.14, 95% CI [1.06–1.23]), building density (OR = 1.07, 95% CI [1.02–1.13]). Additionally, it seemed that there was no potential association between mixed land use (OR = 1.01, 95% CI [0.92–1.10]), the quality of pedestrian facilities (OR = 1.00, 95% CI [0.92–1.08]) or commercial facilities (OR = 0.94, 95% CI [0.88–1.00]) and physical activity behaviors of older adults.ConclusionsThe built environment has been found to exhibit a significant relationship with the physical activity behaviors of older adults. It is proposed that factors such as traffic safety, destination accessibility, aesthetics of sports venues, virescence of sports venues, and building density be given more consideration when aiming to promote physical activity levels among older adults.
Comparative Assessment of Heavy Metal Concentration in Some Edible Spinach (Amaranthus hybridus) in Southern Taraba (Ibi, Wukari and Donga), Nigeria
Authors: Hosea P. I. , Olowokere J. A. , Odineze M. C. 
Published: September 2023

This study focuses on the assessment and comparative concentrations of some heavy metals in spinach (Amaranthus hybridus), cultivated in Wukari, Ibi, Donga local government area of Taraba State in Nigeria. The research is motivated by the indiscriminate use of bulk chemicals for farming activities in the communities under review. The study employed random sampling techniques in collecting the samples of the spinach. The edible part were digested and analyzed for the following heavy metal content: Lead, Zinc, Copper, Nickel, Iron, Cobalt, Chromium, Manganese, and Cadmium. The Atomic Absorption Spectroscopy (AAS) technique was used to analyze the samples. The results for the main concentration of heavy metal were revealed. The concentration of heavy metals in the spinach obtained from the three different samples varies. It was observed that, the sample obtained from Wukari has the highest accumulation of heavy metals. The concentrations of Pb, Mn and Cr were found to be higher than the permissible limits in Wukari spinach. Cd was not detected in the three (Ibi, Donga and Wukari). Pb was not detected in Ibi and Donga. Cu and Ni were not detected in Donga. Based on the findings from this study, spinach from Ibi and Donga are recommended for consumption compared to Wukari, since most of the heavy metals in this study areas are within the standard permissible limit set by WHO/FAO. Similarly, the daily intake of heavy metal (DIM) and the health risk index (HRI) analysis from the 3 study areas also falls within the acceptable permissible level. Farmers and consumers should be adviced appropriately on the health implications of excessive heavy metal consumption in vegetables.
Climate Control and Irrigation Automation Systems in Turkish Greenhouses: A Comparative Study
Authors: Felek Turgut , Kürklü Ahmet 
Published: September 2023

Today's modern greenhouse agriculture draws attention with its intensive plant production capacity and industrially advanced structure in which soilless agriculture technology is used. Computer, microprocessor-controlled information processing and automation systems are needed for the effective management and operation of greenhouses. In order to meet the demands according to the plant species planned to be produced in soilless modern greenhouses; Equipment such as signal-sensing, heating, ventilation, shading, irrigation, fertilization, fogging-cooling, carbon dioxide fertilization and greenhouse general climate control system are needed. According to the needs of the plant, sub-equipment (suitable for obtaining the correct climate conditions desired in the greenhouse) such as roof windows, heating, irrigation, cooling, shading, fan ventilation should work according to the signals coming from the sensors. In this study, the data of 4 different commercial automation systems (namely Priva, Hortimax, Hoogendoorn and Karaca) in 5 greenhouse enterprises in different parts of Turkey were examined and screenshots were obtained. The data obtained were compared with each other and evaluated in terms of ease of use, performance, measured elements, capacity etc. This research will provide added value to the greenhouse economy of countries in the next stages of undercover agriculture, as it will serve to understand greenhouse automation and subsequently to develop new systems. It will also be helpful to the greenhouse investors to make the right choice while choosing a greenhouse automation system.