South African speech-language therapists' practices regarding feeding tube placement in people with advanced dementia.

BACKGROUND:  Studies related to tube feeding in people with dementia (PWD) remain a contested topic, neglecting the importance of speech-language therapists' (SLTs) role in dysphagia management. Furthermore, SLT practices and beliefs regarding tube feeding in people with advanced dementia in an upper-middle-income country, such as South Africa, are unexplored. OBJECTIVE:  This study aimed to determine the practices and beliefs of SLTs in South Africa regarding tube feeding placement in PWD. METHOD:  A self-compiled online survey was distributed using social media platforms and was completed by 83 South African SLTs with experience in swallowing and feeding management of PWD. RESULTS:  Most SLTs (78.8%) strongly believed they play a vital role in the decision-making regarding feeding tube insertion in PWD. This role is often met with several challenges, such as limited support from other healthcare professionals. Speech-language therapists with more experience and increased involvement in palliative care appeared to be more confident in supporting and counselling families of PWD on tube feeding. Many SLTs still recommend tube feeding despite its known negative consequences for PWD. CONCLUSION:  The findings indicate a need for continued professional development for South African SLTs on feeding decisions in advanced dementia to increase knowledge and confidence in clinical practice. Speech-language therapists require guidelines by professional bodies and further dialogue amongst healthcare professionals to guide difficult feeding decisions in people with advanced dementia.

The Effect of Hydration on the Voice Quality of Future Professional Vocal Performers.

OBJECTIVES: The application of systemic hydration as an instrument for optimal voice quality has been a common practice by several professional voice users over the years. Although the physiological action has been determined, the benefits on acoustic and perceptual characteristics are relatively unknown. The present study aimed to determine whether systemic hydration has beneficial outcomes on the voice quality of future professional voice users. STUDY DESIGN: A within-subject, pretest posttest design is applied to determine quantitative research results of female singing students between 18 and 32 years of age without a history of voice pathology. METHODS: Acoustic and perceptual data were collected before and after a 2-hour singing rehearsal. The difference between the hypohydrated condition (controlled) and the hydrated condition (experimental) and the relationship between adequate hydration and acoustic and perceptual parameters of voice was then investigated. RESULTS: A statistical significant (P = 0.041) increase in jitter values were obtained for the hypohydrated condition. Increased maximum phonation time (MPT/z/) and higher maximum frequency for hydration indicated further statistical significant changes in voice quality (P = 0.028 and P = 0.015, respectively). CONCLUSION: Systemic hydration has positive outcomes on perceptual and acoustic parameters of voice quality for future professional singers. The singer's ability to sustain notes for longer and reach higher frequencies may reflect well in performances. Any positive change in voice quality may benefit the singer's occupational success and subsequently their social, emotional, and vocational well-being. More research evidence is needed to determine the parameters for implementing adequate hydration in vocal hygiene programs.