What Future for Protected Areas? Analysing the Mismatch between South Africa's Pre-existing Protected areas System and the Declared vision in Contemporary Conservation Policy.

Designation of protected areas has enjoyed global application as a means of biodiversity conservation for over 100 years. National conservation policy is essential as a means of protecting biodiversity, but is contingent on, amongst others, changing values and international drivers, and remains dynamic in many countries. As conservation policies evolve, the role of pre-existing protected areas within broader strategies for conservation can become unclear, with consequences both for the ability of the conservation policies to achieve their stated goals, and also for biodiversity outcomes within a nation.

A Critical Evaluation of International Agreements Towards a Revised Categorization for Transfrontier Conservation Areas (TFCAs).

Transfrontier Conservation Areas (TFCAs) are widely promoted as an international instrument to achieve certain conservation, cooperation and developmental goals, especially within the Southern African Development Community (SADC). In the SADC context, the status of TFCAs is categorized based on the extent to which international agreements have been signed. These agreements take different forms such as treaties, memorandums of understanding (MoUs), protocols and bilateral agreements.

The effect of inhaled nitric oxide on shunt fraction in mechanically ventilated patients with COVID-19 pneumonia.

Background: Studies in patients with severe acute respiratory distress syndrome (ARDS) with refractory hypoxaemia suggest that inhaled nitric oxide (iNO) can be added to ventilatory strategies as a potential bridge to clinical improvement. However, the potential role of iNO as a management strategy in severe COVID-19 pneumonia remains unclear. The authors describe their clinical findings of using iNO for severe COVID-19 pneumonia in 10 patients with refractory hypoxaemia in a tertiary respiratory intensive care unit.

Clinical characteristics associated with mortality of COVID-19 patients admitted to an intensive care unit of a tertiary hospital in South Africa.

Background: Over 130 million people have been diagnosed with Coronavirus disease 2019 (COVID-19), and more than one million fatalities have been reported worldwide. South Africa is unique in having a quadruple disease burden of type 2 diabetes, hypertension, human immunodeficiency virus (HIV) and tuberculosis, making COVID-19-related mortality of particular interest in the country. The aim of this study was to investigate the clinical characteristics and associated mortality of COVID-19 patients admitted to an intensive care unit (ICU) in a South African setting.

Comparison of patients with severe COVID-19 admitted to an intensive care unit in South Africa during the first and second wave of the COVID-19 pandemic.

Background: The second wave of coronavirus disease 2019 (COVID-19), dominated by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Beta variant, has been reported to be associated with increased severity in South Africa (SA).

Objectives: To describe and compare clinical characteristics, management and outcomes of COVID-19 patients admitted to an intensive care unit (ICU) in SA during the first and second waves.

Methods: In a prospective, single-centre, descriptive study, we compared all patients with severe COVID-19 admitted to ICU during the first and second waves.

Identifying key risks to the performance of privately protected areas (PPAs) through theory of change (ToC).

Privately protected areas (PPAs) are internationally considered to be important policy implementation instruments to augment and strengthen protected area networks. However, there has been limited reflection on the performance of PPAs over time. This paper aims to identify key risks to the performance of PPAs as policy implementation instruments through the application of Theory of Change (ToC).

The role of bronchoscopy in the diagnosis and management of pediatric pulmonary tuberculosis.

Bronchoscopy is useful as a diagnostic and therapeutic procedure in children with Tuberculosis (TB) disease complicated by airway obstruction. It is needed in children when surgical intervention may be required for airway compression, when drug resistance is suspected, and to rule out an alternative diagnosis for airway obstruction. Bronchoscopy with bronchoalveolar lavage (BAL) should be performed when other, less invasive samples cannot be collected, or when they fail to provide useful diagnostic information.

Endobronchial actinomycosis in a child.

Actinomycosis is a rare, indolent and invasive infection caused by Actinomyces species. Pulmonary actinomycosis is very rarely seen in the paediatric population. The classic radiological presentation of thoracic involvement of actinomycosis includes lower lobe consolidation, empyema and periostitis of the ribs.

When is an Offset Not an Offset? A Framework of Necessary Conditions for Biodiversity Offsets.

Biodiversity offsets have become a widely accepted means of attempting to compensate for biodiversity loss from development, and are applied in planning and decision-making processes at many levels. Yet their use is contentious, and numerous problems with both the concept and the practice have been identified in the literature. Our starting point is the understanding that offsets are a kind of biodiversity compensation measure through which the goal of no net loss (or net gain) of biodiversity can be at least theoretically achieved.

Bronchoscopy in children with COVID-19: A case series.

Introduction: The coronavirus disease-2019 (COVID-19) era is a challenging time for respiratory teams to protect their patients and staff. COVID-19 is predominantly transmitted by respiratory droplets; in the clinical setting, aerosol generating procedures pose the greatest risk for COVID-19 transmission. Bronchoscopy is associated with increased risk of patient-to-health care worker transmission, owing to aerosolized viral particles which may be inhaled and also result in environmental contamination of surfaces.

Managing uncertainty, ambiguity and ignorance in impact assessment by embedding evolutionary resilience, participatory modelling and adaptive management.

In the context of continuing uncertainty, ambiguity and ignorance in impact assessment (IA) prediction, the case is made that existing IA processes are based on false 'normal' assumptions that science can solve problems and transfer knowledge into policy. Instead, a 'post-normal science' approach is needed that acknowledges the limits of current levels of scientific understanding. We argue that this can be achieved through embedding evolutionary resilience into IA; using participatory workshops; and emphasising adaptive management.

Akhenaten, a unique pharaoh.

Akhenaten was a unique pharaoh in more ways than one. He initiated a major socio-religious revolution that had vast consequences for his country, and possessed a strikingly abnormal physiognomy that was of note in his time and has interested historians up to the present era. In this study, we attempt to identify the developmental disorder responsible for his eunuchoid appearance.

Breast cancer in antiquity.

Cancer of the breast, seen by Galen as the commonest cancer of his time, was probably first mentioned by Hippocrates in the 5th century BC. A single case history was described but no specific treatment mentioned. For centuries no further cases were described, until Cato, 2nd century BC, advocated cabbage poultices for all tumours and breast cancer in particular.

Mesopotamian medicine.

Although the Mesopotamian civilisation is as old as that of Egypt and might even have predated it, we know much less about Mesopotamian medicine, mainly because the cuneiform source material is less well researched. Medical healers existed from the middle of the 3rd millennium. In line with the strong theocratic state culture, healers were closely integrated with the powerful priestly fraternity, and were essentially of three main kinds: barû (seers) who were experts in divination, âshipu (exorcists), and asû (healing priests) who tended directly to the sick.

Medical practice in Graeco-roman antiquity.

The roots of modern medicine can be traced back to the 5th century BC when Hippocratic rational medicine originated on the Greek islands of Cos and Cnidos. In this study we examine the way in which practitioners conducted their profession in Graeco-Roman times, as well as their training. Medical training was by way of apprenticeship with recognized doctors, but no qualifying examinations existed and the standard of practice thus varied enormously.