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\"Most of the research into what constitutes effective leadership emanates from the United States and is not very useful in an African context. Africa is a continent of extraordinary cultural, geographic, economic and political diversity, featuring largely emerging economies and rapid political economic and social development. This book seeks to set leadership theory in the African context. It takes into account typical African circumstances, values and beliefs, designed for the development of leaders' skills and provides practical, real-life examples, exercises and case studies. As well as an overview of the extensive research literature about leadership, the book provides practical, real-life examples, exercises and case studies, so it can be used in a range of management development courses and/or leadership course or workshops. The detailed insights into, and information about, how leadership can be effectively applied in the contemporary African context should help to enhance readers' leadership skills.\"--Publisher's description.

Background : Pre-operative planning for reverse shoulder arthroplasty (RSA) poses challenges, particularly when dealing with glenoid bone loss. This modified Delphi study aimed to assess expert consensus on RSA planning processes and rationale, specifically targeting low-resourced institutions. Our objective was to offer pre-operative decision-making algorithms tailored for surgeons practising in resource-constrained hospitals with limited access to computed tomography (CT) scans. Methods : A working group generated statements on pre-operative imaging and glenoid of glenoid morphology and intra-operative decision-making. The study was conducted in three stages, with virtual consensus meetings in between. Stages 2 and 3 consisted only of closed questions/statements. The statements with over 70% were considered consensus achieved and those with less than 10% were considered disagreement consensus achieved. Results : Twelve shoulder surgeons participated, with 67% having over five years of experience in shoulder arthroplasty. In the absence of glenoid bone loss, the sole use of plain radiographs for pre-operative planning reached consensus and is recommended by these groups, while 100% advise using CT scans when bone loss is present. Most surgeons (70%) recommend using patient-specific instrumentation (PSI) in cases of structural bone loss. Most of the statements on intra-operative decision-making related to component placement and enhancing stability failed to reach consensus. Conclusion : While consensus was achieved on most aspects of pre-operative imaging and planning, technical aspects of surgery lacked consensus. Planning for patients with structural glenoid bone loss necessitates CT scans and planning tools.

The overhead throw is a fundamental movement utilised in numerous sports for a variety of reasons such as pitching in baseball, fielding in cricket, and passing or shooting in water polo. In the throwing athlete, the delicate balance of an external rotation gain (ERG) with a reciprocal glenohumeral internal rotation deficit (GIRD) while maintaining a 180° rotational arc is known as the thrower’s paradox, described in baseball pitchers. This narrative review aimed to evaluate research findings and clinical experiences for two popular South African sports, namely cricket and water polo, to determine if these throwing athletes possess similar musculoskeletal and throwing characteristics classically described for baseball pitchers. Cricket and water polo players displayed distinctly different musculoskeletal characteristics to baseball pitchers. Cricketers did not present with the shoulder ERG frequently identified in throwing athletes, while water polo players did not demonstrate the decrease in internal rotation range commonly seen in throwers. A decreased external to internal rotation strength ratio (ER:IR) is a common risk factor in baseball pitchers. Cricketers and water polo players maintained a normal ER:IR ratio but presented with a decrease in both internal and external rotation strength. Finally, both cricketers and water polo players present with a downwardly rotated scapula at rest, which is contrary to previous findings in throwers. Water polo players had a significantly greater upward scapula rotation angle at 90°, which refutes subacromial internal impingement as a mechanism of injury in this group of overhead throwing athletes. Further differences are demonstrated in the throwing biomechanics of both sports, with cricketers using less shoulder external rotation and thoracolumbar range of motion while throwing compared to pitchers. Limited evidence found that water polo players use greater shoulder elevation than baseball pitchers or cricketers during shooting. While the literature documenting the types of shoulder pathology for cricketers and water polo players are scarce, there is clinical evidence that the different throwing athletes may present with a broad spectrum of shoulder injuries. In clinical practice, these insights can be used to enhance both the clinical assessment and management of overhead athletes.

Background Access to healthcare services, particularly surgical interventions, remains a critical challenge in low-to middle-income countries (LMICs). Reverse shoulder arthroplasty (RSA) is the most frequently performed arthroplasty procedure of the shoulder and is recommended for the treatment of complex shoulder conditions in the elderly population. This study investigated the availability and accessibility of RSA within South Africa’s public healthcare system, focusing on equity in surgical care provision. Methods Using a multifaceted research approach, data were collected from 33 professionals across eight provinces, representing a significant proportion of the population. Results Results indicate significant disparities in access to RSA, with urban areas and tertiary hospitals having better resources and capacity. The majority of the tertiary level hospitals are easily accessible to urban compared to rural dwellers. Despite the growing need for RSA, particularly among older demographics, the study reveals a scarcity of skilled shoulder surgeons and inadequate infrastructure, especially in rural regions. Conclusion These findings underscore systemic barriers hindering equitable access to RSA and surgical care in South Africa. Recommendations include increasing resources for training, improving infrastructure, and enhancing referral systems to address these disparities and ensure universal access to essential surgical services.

Background The aim of this study was to review vitamin D levels in patients who underwent Latarjet procedures at a tertiary teaching hospital and a private clinic. Methods A retrospective review of clinical and radiological records was performed for 22 patients who underwent Latarjet procedure between November 2017 and June 2019. Postoperative vitamin D levels were retrieved and classified into sufficient (> 75 nmol/L), insufficient (25–75 nmol/L), and deficient (< 25 nmol/L) groups. Two observers assessed radiographic images of the patients at six weeks and three months after surgery. Any bone resorption, fracture and nonunion were reported, and interobserver reliability was analysed using the intraclass correlation coefficient (ICC). Results The median age was 20.5 years and was predominantly male. A little more than two-thirds (68.1%) of the patients were found to have insufficient or deficient levels of vitamin D. One patient from the insufficient group had postoperative bone resorption. Good interobserver reliability was observed with the ICC value being 0.86. Conclusion This study found a prevalence of insufficient/deficient vitamin D levels in young patients undergoing a Latarjet procedure. This study serves as a reminder to orthopaedic surgeons that vitamin D deficiency is prevalent among patients undergoing Latarjet. Level of evidence: Level 4

Background: The surgical management of scapula body, neck and glenoid fractures remains a challenge. This study focuses on templating an available anatomical pre-contoured plating system using three-dimensional (3D)-printed scapulae to assess the ability of these plates to address the aforementioned fractures and to determine consensus on classifying scapula body, neck and glenoid fractures. Methods: We used a cohort of 22 3D-printed scapulae prototypes and an available anatomical precontoured plating system to determine anatomical congruency and fit. Nine investigators templated the scapulae using four pre-contoured plates, and the investigators classified the 22 scapulae using the Ideberg and AO/OTA classification systems. Results: Eleven out of 22 fractures were found to be fixable using the plates under study. The long lateral plate addressed 83% of fractures involving the lateral border, while the glenoid plate was unable to adequately address any glenoid fractures. We observed good to excellent (p ≤ 0.001) interobserver reliability for three of the four plates. The interobserver reliability was moderate (ICC = 0.74) for the AO/OTA classification and good (ICC = 0.88) for the Ideberg classification. Conclusion: We believe that the anatomical pre-contoured plating system does not address all the fracture patterns encountered in clinical practice and further development in plate design is required. There is good to moderate interobserver reliability using the Ideberg fracture classification for intra-articular fractures and the AO/OTA classification for extra-articular fractures involving the body. Level of evidence: Level 3

The entry into force of the Nagoya Protocol of the Convention on Biological Diversity will lead to new legislation and regulations that could change international collaborative research in biology. This article suggests a new approach that researchers can use in negotiating international Access and Benefit Sharing agreements under the Protocol. Research on medicinal plants is used as a case study because it is a domain with many competing stakeholders involving non-commercial and commercial research, as well as national and international commercial markets. We propose a decision-based framework to aid all participants as they negotiate ABS agreements for non-commercial biodiversity research. Our proposed approach promotes transparency and builds trust, reflects the principles in the Convention on Biological Diversity , and respects and protects the interests of biodiversity rich developing countries. This approach is an alternative to often-used adversarial approaches.

Attention to epistemological relationships between Indigenous and local knowledges (ILK) and conservation science is increasing. Some approaches for doing so have been developed, but in general, serious engagement between ILK and science still feels experimental and does not have broad uptake. Here we address some of the main issues that arise when considering the epistemological relationships between ILK and conservation or ecological science. A key issue is the relationship between ILK and science that sets the expectations for how they may form dialogues, collaborations, or co-production. After reviewing several perspectives on this relationship, and their limitations, we suggest that a focus on shared meanings within an ‘ethic of equivocation’ is a productive path forward. In an ethic of equivocation, neither ILK nor science validates the other, yet meaning can be created. We explain and develop the concepts of meanings and equivocation in the ILK-science context. We, thus, argue for a broad and rich understanding of the joint roles of ILK and science, which goes beyond treating ILK as a data source. We argue that diverse styles of reasoning exist in science, and scientists may already treat observations, models, and collaborations in the ways that we discuss, providing ready-made analogies for thinking about ILK. We also discuss how to avoid abuses of power while engaging with ILK to co-produce new knowledge.

Violence, crime, and abuse against learners present a grave picture of problems in South African schools and are on the increase, as substantiated in articles. daily newspapers and news bulletins. The problem of violence is a complex one, and has been elevated to a national concern. The study was based on the perceptions and experiences of school principals and school governing bodies (SGB). Semi-structured interviews and observations were used to collect data. The study revealed that the unprofessional conduct of teachers, teacher absenteeism, a weak criminal justice system, dysfunctional family structures, absence of school leadership, and a precarious school environment all contribute to violence. The study also produced evidence of unrealistic expectations of teachers who do not take the individual needs of learners into account. Although schools craft learner codes of conduct to deal with learner discipline, it seems that at most schools, the school management is unable to implement these codes of conduct effectively. Poorly managed schools are likely to experience more violence. This qualitative study was conducted at South African rural schools to obtain insights into the prevalence of violence in schools, and the management thereof. Using purposeful sampling we explored the perceptions and experiences of principals and school governing bodies (SGBs). Semi-structured interviews and observations were used to collect data, and these were analysed using Tech’s method of coding. The article recommends the enhancement of management, school effectiveness, and professional conduct of teachers in South African rural schools. School management teams should take a leading role of curbing learner violence by stringently enforcing learner codes of conduct and providing teachers with professional training so that they can manage learner discipline in schools effectively. Furthermore, learners and educators need to be empowered to manage conflict and to fulfil their education roles.