Journal Articles
Permanent URI for this collectionhttps://mro.massey.ac.nz/handle/10179/7915
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Item Food security and disability in South Africa: an analysis of General Household Survey data(informa UK limited, trading as Taylor & Francis Group, 2024-08-14) Pillay M; Kara R; Govindasamy P; Motala RPURPOSE: We investigated the relationship between disability and food security in South Africa using data from the General Household Survey (GHS). MATERIALS AND METHODS: Regression models were utilised with GHS data (2014-2018) to gauge the likelihood of food insecurity (the dependent variable) among individuals with disabilities. Socioeconomic and demographic traits of the 2018 GHS sample were analysed. All estimates were weighted and represented nationally at the individual level. RESULTS: In this study population (32 187) of food insecure people, 9.64% are disabled. Food insecurity impacts more Black people with disabilities (91%) versus those without disabilities (90%), and disabled women (65%) versus nondisabled women (58%). Most reside in KwaZulu-Natal. Those with disability grants lower food insecurity odds, while child support grant recipients face higher odds. Household size and education are significant predictors, while marital status and gender are not. CONCLUSION: This study data justifies the need for disability-inclusive food security programmes in South Africa, especially amid crises like COVID-19. Significantly, there is a nil data finding about people with eating/swallowing disabilities whose needs intersect with food security. This emphasises the need for inclusive data collection that operates within a food sovereignty framework to increase the visibility of people with disabilities.Item "Us versus Them": is the voice of the community heard when planning communication screening programmes for preschoolers?(Elsevier Ltd. on behalf of The Royal Society for Public Health, 2024-09-16) Peter VZ; Rea P; Pillay M; Saman YOBJECTIVES: Community consultation is necessary to ensure the uptake and use of community-based screening intervention to detect early childhood disabilities, as its absence can result in poor service acceptance and usage. To document stakeholders' perspectives regarding planning a community-based communication disorder (an impairment in the ability to receive, send, process and comprehend concepts or verbal, non-verbal and graphic symbol systems) screening programmes for pre-schoolers. STUDY DESIGN: This qualitative research design used purposive and random sampling to recruit 46 participants from eThekwini Municipality, South Africa. These stakeholders consisted of caregivers/parents of children who underwent screening for communication disorders, People who are Deaf, their parents, early childhood development practitioners, health professionals and government officials involved with children with disabilities. All participants were adults aged between 19 and 79 years, with an average age of 39.7 years. METHODS: Data was collected through focus group discussions and individual interviews, which were thematically analysed. RESULTS: The four emergent themes were screening approaches, methods, location and personnel. Service users expected greater access to screening and reliable tests to identify problems by trained personnel at sites within the community. Service providers preferred a targeted approach to screening with parental input. Task shifting and sharing were seen as a solution to address staff shortages and provide services at health facilities, as resource constraints made it challenging to provide outreach services. CONCLUSION: Stakeholder engagement revealed diverging views between service users and providers, with implications for programme provision and uptake. There is a need for ongoing, inclusive discussion to ensure consensus during the planning stage, in order to render services that address issues of equity and accessibility for people with disabilities in marginalised communities.Item Queer Representation in Mandarin Chinese Language Learning Textbooks of the United Kingdom(Elsevier Ltd., 2024-08-31) Arden D; Pillay MThis paper uses a queer theoretical lens and mixed methods conceptual framework for use in assessing the level of queer representation of characters portrayed in Mandarin Chinese language learning textbooks published in the United Kingdom. MFL textbooks largely produce content which reinforces a perceive cisgendered, heteronormative characterisation of individuals within texts. Research that assesses the level of queer representation, tend towards focusing solely on gender or sexuality, and largely through qualitative research methods. Through the development of a mixed methods conceptual framework which allows for consideration of queer diversity along several spectra, the results of this study highlighted a significant lack of queer representation within Mandarin Chinese language learning textbooks. The implication of this is not only a mixed methods approach which accounts for often overlooked minority queer identities, but also identifying the need for a greater variety of queer representation within textbooks to better represent people of the 21st century.Item Dysphagia management in community/home settings: A scoping review investigating practices in Africa.(Taylor & Francis Group, 2024-02-21) Jayes M; Madima V; Marshall J; Pillay MPURPOSE: Little is known about how people living with dysphagia in rural, socioeconomically impoverished contexts in Africa are supported and manage their disability. This scoping review sought to map and synthesise evidence relating to the management of dysphagia in adults in community/home settings in Africa as a starting point for a broader study on this topic. METHOD: A multifaceted search strategy involved searches of electronic databases and grey literature, hand searches, ancestry searches, and consultation with expert advisors. Records were screened by two blinded researchers. Characteristics of included studies were summarised, and their findings synthesised using the Framework approach. RESULT: Six studies were included, relating to services for people with dysphagia secondary to various aetiologies. No grey literature was identified that provided service delivery descriptions or practice guidance. This limited evidence suggests little professional support is available to people living with dysphagia in the community. Individuals and carers use a range of strategies, including choosing different food and drink items and modifying how food is chewed and swallowed. CONCLUSION: Further research is required to understand current practice in managing dysphagia in the community in Africa, and the needs and priorities of community members who experience dysphagia and their carers.Item Who really decides? Feeding decisions 'made' by caregivers of children with cerebral palsy.(AOSIS (Pty) Ltd., 2024-03-18) Naidoo L; Pillay M; Naidoo UBACKGROUND: There are no definitive guidelines for clinical decisions for children with cerebral palsy (CP) requiring enteral feeds. Traditionally, medical doctors made enteral feeding decisions, while patients were essentially treated passively within a paternalistic 'doctor knows best' approach. Although a more collaborative approach to decision-making has been promoted globally as the favoured model among healthcare professionals, little is known about how these decisions are currently made practically. OBJECTIVES: This study aimed to identify the significant individuals, factors and views involved in the enteral feeding decision-making process for caregivers of children with CP within the South African public healthcare sector. METHOD: A single-case research design was used in this qualitative explorative study. Data were collected using semi-structured interviews and analysed using reflexive thematic analysis. RESULTS: Four primary individuals were identified by the caregivers in the decision-making process: doctors, speech therapists, caregivers' families and God. Four factors were identified as extrinsically motivating: (1) physiological factors, (2) nutritional factors, (3) financial factors and (4) environmental factors. Two views were identified as intrinsically motivating: personal beliefs regarding enteral feeding tubes, and feelings of fear and isolation. CONCLUSION: Enteral feeding decision-making within the South African public healthcare sector is currently still dominated by a paternalistic approach, endorsed by a lack of caregiver knowledge, distinct patient-healthcare provider power imbalances and prescriptive multidisciplinary healthcare dialogues.Contribution: This study has implications for clinical practice, curriculum development at higher education training facilities, and institutional policy changes and development, thereby contributing to the current knowledge and clinical gap(s) in the area.Item Decoloniality and healthcare higher education: Critical conversations.(Wiley, 2024-05-08) Pillay M; Kathard H; Hansjee D; Smith C; Spencer S; Suphi A; Tempest A; Thiel LBACKGROUND: We explore the theoretical and methodological aspects of decolonising speech and language therapy (SLT) higher education in the United Kingdom. We begin by providing the background of the Rhodes Must Fall decolonisation movement and the engagement of South African SLTs in the decoloniality agenda. We then discuss the evolution of decoloniality in SLT, highlighting its focus on reimagining the relationships between participants, students, patients and the broader world. OBJECTIVE: The primary objective of this discussion is to fill a gap in professional literature regarding decoloniality in SLT education. While there is limited research in professional journals, social media platforms have witnessed discussions on decolonisation in SLT. This discussion aims to critically examine issues such as institutional racism, lack of belonging, inequitable services and limited diversity that currently affect the SLT profession, not just in the United Kingdom but globally. METHODS: The methods employed in this research involve the engagement of SLT academics in Critical conversations on decolonisation. These conversations draw on reflexivity and reflexive interpretation, allowing for a deeper understanding of the relationship between truth, reality, and the participants in SLT practice and education. The nature of these critical conversations is characterised by their chaotic, unscripted and fluid nature, which encourages the open discussion of sensitive topics related to race, gender, class and sexuality. DISCUSSION POINTS: We present our reflections as academics who participated in the critical conversations. We explore the discomfort experienced by an academic when engaging with decolonisation, acknowledging white privilege, and the need to address fear and an imposter syndrome. The second reflection focuses on the experiences of white academics in grappling with their complicity in a system that perpetuates racism and inequality. It highlights the need for self-reflection, acknowledging white privilege and working collaboratively with colleagues and students toward constructing a decolonised curriculum. Finally, we emphasise that while action is crucial, this should not undermine the potential of dialogue to change attitudes and pave the way for practical implementation. The paper concludes by emphasising the importance of combining dialogue with action and the need for a nuanced understanding of the complexities involved in decolonising SLT education. CONCLUSION: Overall, this paper provides a comprehensive overview of the background, objectives, methods and key reflections related to the decolonisation of SLT higher education in the United Kingdom. It highlights the challenges, discomfort and responsibilities faced by academics in addressing decoloniality and emphasizes the importance of ongoing critical conversations and collective action in effecting meaningful change. WHAT THIS PAPER ADDS: What is already known on this subject Prior to this paper, it was known that the decolonial turn in speech and language therapy (SLT) was a recent focus, building on a history of professional transformation in South Africa. However, there was limited literature on decoloniality in professional journals, with most discussions happening on social media platforms. This paper aims to contribute to the literature and provide a critical conversation on decolonising SLT education, via the United Kingdom. What this paper adds to existing knowledge This paper adds a critical conversation on decolonising SLT higher education. It explores theoretical and methodological aspects of decoloniality in the profession, addressing issues such as institutional racism, lack of sense of belonging, inequitable services and limited diversity. The paper highlights the discomfort experienced by academics in engaging with decolonisation and emphasizes the importance of reflection, collaboration and open dialogue for meaningful change. Notably we foreground deimperialisation (vs. decolonisation) as necessary for academics oriented in/with the Global North so that both processes enable each other. Deimperialisation is work that focuses the undoing of privilege exercised by academics in/with the Global North not only for localising their research and education agenda but checking their rite of passage into the lives of those in the Majority World. What are the potential or actual clinical implications of this work? The paper highlights the need for SLT practitioners and educators to critically examine their practices and curricula to ensure they are inclusive, decolonised and responsive to the diverse needs of communities. The discussions emphasise the importance of addressing institutional racism and promoting a sense of belonging for research participants, SLT students and patients. This paper offers insights and recommendations that can inform the development of more equitable and culturally responsive SLT services and education programmes.Item A review of interventions for children and youth with severe disabilities in inclusive education(Taylor & Francis Group, 2023-11-12) Dada S; Wilder J; May A; Klang N; Pillay M; Kabir AHChildren with severe disabilities are often excluded from educational opportunities due to inter alia attitudinal barriers and a lack of teacher training. This scoping review paper assessed intervention studies focused on inclusive education for children with severe disabilities. It was found that a total of 13 studies met the review’s inclusion criteria. The results revealed a paucity of literature and highlighted five main areas of focus in the available intervention studies. The majority of intervention studies were found to be focused on increasing engagement, reducing behaviours and improving social inclusion as outcomes. There was limited focus on studies focusing on the improvement of academic outcomes.Item Lived experiences of South African rehabilitation practitioners during coronavirus disease 2019.(African Online Scientific Information Systems (Pty) Ltd t/a AOSIS, 2024-01-12) Balton S; Pillay M; Armien R; Vallabhjee AL; Muller E; Heywood MJ; van der Linde JBACKGROUND: In South Africa, the sharp rise in people with severe illness because of coronavirus disease 2019 (COVID-19) in early 2020, meant that health systems needed to adapt services and operations, including rehabilitation services. Important insights into the lived experiences of rehabilitation personnel enacting these adaptations in an African context are limited. OBJECTIVES: The aim of this study was to explore the lived experiences of rehabilitation practitioners working in the public sector in South Africa during the COVID-19 pandemic. METHOD: A phenomenological approach and a duo-ethnographic design were used. A recruitment letter was circulated requesting volunteers. Maximum variation sampling was used to select the 12 participants of this study. Data were collected through interviews via Zoom, and critical conversations were facilitated by a non-rehabilitation partner who is known for challenging health inequities. The interviews were audio-recorded and transcribed verbatim. Data were analysed through elements of qualitative content and thematic analysis. Data were coded, categorised, clustered into concepts and formulated into themes. RESULTS: Three themes were identified: (1) 'Management became the enemy', (2) 'Tired of being resilient' and (3) 'Think out of the box…think on our feet'. CONCLUSION: The results of this study highlighted new ways of practice, innovative adaptations, and usage of resources and platforms. CONTRIBUTION: This study highlights the re-imagining of accessible rehabilitation services that could lead to deeper onto-epistemological shifts amongst the rehabilitation practitioners.Item Questions of suitability: The Sustainable Development Goals.(Taylor and Francis Group, 2023-02-16) Pillay M; Quigan E; Kathard HPURPOSE: To stimulate critical thought, to challenge how speech-language pathologists (SLPs) achieve Sustainable Development Goals (SDGs) in supporting people with swallowing/communication disabilities, using a critical, political conscientisation approach. RESULT: We generate data from our professional and personal experiences interpreted through a decolonial lens to demonstrate how Eurocentric attitudes and practices are at the core of SLPs' knowledge base. We highlight risks associated with SLPs' uncritical use of human rights, the bases of the SDGs. CONCLUSION: While SDGs are useful, SLPs should take the first steps of becoming politically conscientised to consider whiteness, to ensure that deimperialisation and decolonisation are tightly woven into our sustainable development work. This commentary paper focusses on the SDGs a whole.Item Cisplatin associated ototoxicity: Considerations for the health care professional(2019-01-01) Paken J; Govender CD; Pillay M; Ayele BT; Sewram VCisplatin, the first platinum-based anti-tumour drug, is clinically proven for the treatment of cancers of soft tissue, bones, muscles, blood vessels and sarcomas. Known for its ability to cause apoptosis of cancer cells through changes in DNA structure, thus inhibiting DNA replication, transcription and cell division, this molecule has found its place, unabated, as a mainstream therapeutic for cancer treatment. However its ototoxic potential places cancer patients, exposed to this drug, at risk of hearing loss; thus, negatively affecting further their quality of life. Hence, the awareness of health care practitioners to the ototoxic properties of this drug and the clinical signs and symptoms to identify patients at risk of developing hearing loss is of vital importance. This chapter provides an overview of cisplatin-associated ototoxicity, namely its clinical features, incidence rates, molecular and cellular mechanisms and risk factors, to health care practitioners managing the patient with cancer and highlights the need for a multidisciplinary teambased approach to complement an audiological monitoring programme to mitigate any further loss in the quality of life of affected patients. Propositions for effective policy formulation, methodological approaches in research and strengthening of health systems in limited resource environments are advocated. In addition, recent developments in the management of cisplatin-associated ototoxic hearing loss together with currently available oto-protective strategies are presented.