Acknowledgement to reviewers

No abstract available.

Corrigendum: Occupational noise and age: A longitudinal study of hearing sensitivity as a function of noise exposure and age in South African gold mine workers

No abstract available.

Vulnerable mothers’ experience of feeding their preterm infant in neonatal care

Background: Worldwide, preterm birth is a rising threat to maternal and child health. The universal challenges of being the mother of a preterm infant, combined with context-specific challenges such as poverty and poor linguistic and cultural representation, bring about risks for both mother and infant. This includes poor maternal mental health; poor mother–infant bonding and attachment and potential suboptimal developmental outcomes for the infant.Objective: This article describes how Afrikaans-speaking mothers living in poverty experienced feeding their preterm infants in neonatal care.Method: The study implemented a cross-sectional, qualitative design. Mothers of preterm infants (chronological ages between 3 and 6 months) were selected through a purposive sampling method and participated in individual semi-structured interviews. Nine interviews were thematically analysed. The participants were a vulnerable group, about whom little research literature was available.Results: Feeding was perceived as a progressive task that worked towards the goal of discharge from the hospital. It was stressful because of various factors, but insufficient breastmilk supply was a significant contributor. The hospital setting was perceived as something that added to the participants’ anxiety surrounding feeding, but at the same time, it had the potential to decrease their anxiety. When the mother–infant dyad was able to breastfeed successfully, it made the participants feel like mothers at last after an extended period of anticipation.Conclusion: Feeding their preterm infant was a prominent experience for the mothers, especially whilst in neonatal care. Increased feeding support is required from the healthcare team providing neonatal care in order to optimally use the neonatal period.

Audiologists should not fail with falls: A call to commit to prevention of falls in older adults

Globally, falls are a serious economic and public health concern. While all age groups are impacted by falls, the threats to morbidity and mortality are most severe in older adults. Recent literature has linked hearing loss, and related issues such as an increase in sedentary behaviour, to a greater risk of falls. Therefore, this opinion article aims to raise audiologists’ awareness of falls in ageing patients or clients, and calls for change in terms of having these rehabilitation professionals embrace identification and management of fall risk.

The sensitivity and specificity of wideband absorbance measure in identifying pathologic middle ears in adults living with HIV

Background: Limited research exists on the sensitivity and specificity of wideband acoustic immittance (WAI) in adults living with human immunodeficiency virus (HIV). This study forms part of the bigger study titled ‘wideband acoustic immittance in adults living with HIV’.Objectives: To determine the sensitivity and specificity of the wideband absorbance measure at tympanic peak pressure (TPP), as a screening tool for detecting middle ear pathologies in adults living with HIV.Method: A prospective nonexperimental study comprising 99 adults living with HIV was performed. All participants underwent a basic audiological test battery which included case history, video otoscopy, tympanometry, wideband absorbance at TPP and pure tone audiometry. Middle ear pathologies were established by two otorhinolaryngologists using asynchronous video otoscopic images analysis. The outcomes of the otorhinolaryngologists served as the gold standard against which the wideband absorbance at TPP and tympanometry were measured. The receiver operating characteristics (ROC) curve was calculated.Results: ROC revealed the sensitivity of wideband absorbance at TPP to be higher in low to mid frequencies, but significantly lower in frequencies above 971.53 Hz. The sensitivity of tympanometry was lower. However, there was no difference between the specificity of wideband absorbance at TPP and tympanometry, indicating that when there are no pathologies, tympanometry is equally accurate.Conclusion: The current findings reveal that wideband absorbance at TPP can distinguish middle ear pathologies better than the tympanometry. Incorporating wideband absorbance at TPP in clinical practice may improve early identification and intervention of middle ear pathologies.

Successes and challenges of speech language therapy service provision in Western Kenya: Three case studies

Background: The need for communication-related services in sub-Saharan Africa to support individuals experiencing communication disability is a longstanding and well-documented situation. We posit the inequities highlighted by coronavirus disease 2019 (COVID-19) make this a relevant time for speech language therapists and the professional bodies that govern us to broadly consider our roles and practices in education, health and disability in local, national and global contexts.Objective: To illustrate what services developed with local knowledge can look like in Kenya in order to promote dialogue around alternative speech language therapy models, particularly in contexts where there are insufficient services, few trained speech language therapists and limited structures to support the emerging profession.Method: This article examines three clinical case studies from Western Kenya, using a conceptual framework for responsive global engagement.Results: Service needs in Western Kenya well exceed a direct one-on-one model of care that is common in the minority world. The service delivery models described here emphasise training, skills sharing and engaging the myriad of communication partners available to individuals with communication disabilities.Conclusion: We offer up these case studies of collaborative practice as contextual realities that may be present in any speech language therapy programming in under-resourced communities. We dispel the idea that success in this work has been linear, progressed on planned time frames or come to fruition with targeted goal attainment. The fact that our relationships have endured in these communities since 2007 is our primary success.

A chasm: Consequences of poor collaboration between health and education in paediatric cerebral palsy care in Johannesburg

Background: Nearly 20 years since the establishment of the National Rehabilitation Policy, strides have been made within the health and education sectors to improve accessibility to rehabilitation services as well as the quality of life of children with cerebral palsy (CP). Shortfalls, however, still exist in implementing the policy. An in-depth study into the implementation of policy would be beneficial in identifying and understanding the shortfalls of the rehabilitation process.Objectives: To investigate the perceptions of Speech-Language Therapists (SLTs) working in the Gauteng Department of Health (GDH) and Gauteng Department of Education (GDE), in Johannesburg Region A, about systemic strengths and weaknesses surrounding the service delivery for children with CP, from birth to 6 years.Method: A qualitative study was conducted. Thirty-one (31) SLTs working in public hospitals, clinics and schools for Learners with Special Educational Needs participated in eight focus group interviews. Interviews were audio-recorded for transcription and subsequent thematic analysis.Results: The participants reported a lack of resources and knowledge that contributed to a perceived chasm between the GDH and GDE, resulting in fragmented and uncoordinated service delivery for children with CP leaving the health system and entering the education system.Conclusion: The results suggest that a cohesive plan should be formulated to bridge the perceived chasm between GDH and GDE in the referral process of children with CP from the health setting, into the school environment. This may facilitate communication, collaboration, education, as well as resource-sharing between the departments. Rehabilitation professionals should actively participate in such planning processes.

Pathogenic oral bacteria in hospitalised patients with dysphagia: The silent epidemic

Background: Aspiration pneumonia is a serious and fatal complication of dysphagia, secondary to the ingestion of bacteria-laden secretions. However, no studies have documented the oral hygiene features present in patients who present with dysphagia.Objectives: The purpose of this study was to describe the oral hygiene problems of adults admitted to a sub-acute rehabilitation hospital and who presented with dysphagia.Methods: A descriptive, cross-sectional survey was conducted, during which 40 participants – 57.5% (n = 23) male and 42.5% (n = 17) female – underwent a clinical swallow evaluation using the Mann Assessment of Swallowing Ability (MASA) augmented with cervical auscultation (CA) and pulse oximetry (PO), an oral hygiene assessment using an adapted version of the Oral Health Assessment Tool (OHAT), followed by microbiology laboratory analysis of buccal swab samples to detect bacteria not considered part of the normal oral flora.Results: Results indicated that poor oral hygiene status was a common feature amongst all participants who presented with dysphagia. The most prevalent oral hygiene issues were related to abnormalities concerning saliva (60%), oral cleanliness (82.5%), the tongue (80%) and the use of dentures (71.4%). A high prevalence, 62.5% (n = 25), of opportunistic bacteria was found. The most commonly occurring bacteria groups were: (1) Candida albicans (47.5%) and (2) respiratory pathogens (37.5%) such as Klebsiella pneumoniae and Staphylococcus aureus.Conclusion: Persons with dysphagia have poor oral hygiene which creates favourable environments for bacteria to flourish and increases the prevalence of pathogenic oral bacteria associated with the development of aspiration pneumonia. The management of oral health issues for persons with dysphagia should receive greater attention during hospitalisation.

Contextualising clinical reasoning within the clinical swallow evaluation: A scoping review and expert consultation

Background: This study explored the available literature on the phenomenon of clinical reasoning and described its influence on the clinical swallow evaluation. By exploring the relationship between clinical reasoning and the clinical swallow evaluation, it is possible to modernise the approach to dysphagia assessment.Objectives: This study aimed to contextualise the available literature on clinical reasoning and the CSE to low-middle income contexts through the use of a scoping review and expert consultation.Method: A scoping review was performed based on the PRISMA-ScR framework. The data was analysed using thematic analysis. Articles were considered if they discussed the clinical swallow evaluation and clinical reasoning, and were published in the last 49 years.Results: Through rigorous electronic and manual searching, 12 articles were identified. This review made an argument for the value of clinical reasoning within the clinical swallow evaluation. The results of the study revealed three core themes related to the acquisition, variability and positive impact of clinical reasoning in the clinical swallow evaluation.Conclusion: The results of this review showed that the clinical swallow evaluation is a complex process with significant levels of variability usually linked to the impact of context. This demonstrates that in order to deliver effective and relevant services, despite challenging conditions, healthcare practitioners must depend on clinical reasoning to make appropriate modifications to the assessment process that considers these salient factors.

Sports audiology: Ear hygiene practices of gym users who wear earphones

Background: Technological advancements have facilitated the demand for electronic systems to track and measure progress during exercise activities. Electronic devices with music applications, such as iPods and smartphones, are popular during gym sessions as they support the ambiance to one’s exercise programme. Earphones are the popular choice for the transmission of music to the gym user’s ear. There is a direct correlation between the cardiovascular health and the aural health because of the effect of increased blood supply to the auditory system. Therefore, this research study explores the ear hygiene of gym users.Objectives: This study aimed at determining the ear hygiene and middle-ear status of gym users who wore earphones whilst exercising.Method: A purposive sampling method was adopted. Data were collected in two phases: phase 1 via a questionnaire and phase 2 included an otoscopic examination and tympanometry. Qualitative and quantitative data were analysed.Results: Fifty-four participants were included. Ear hygiene was not a priority for all gym users. The results revealed that 87% of the participants randomly cleaned their ears; however, 59% were cleaning their earphones. The middle ear assessment indicated that 17% of the participants presented with pathological indicators. Participants requested for the implementation of educational programmes pertaining to infection control measures for proper ear hygiene.Conclusion: There is a dearth of health and wellness educational programmes that include ear hygiene practices, necessitating the development of prevention and promotion programmes for this niche area in audiology. The need for guidelines pertaining to ear hygiene practices amongst gym users is vital to ensure that the auditory system is monitored and protected when individuals participate in exercise sessions.