Aim:To describe the development of the Optimising Health and Learning Program, guided by the only available published framework for the delivery of health services to newly arrived refugee children and report on the evaluation of the programme. Methods: We conducted process and impact evaluation using a mixed methods approach. The sample was 294 refugee young people enrolled in two Intensive English Centres in New South Wales. We collected quantitative data (demographic and clinical information) as well as qualitative data via focus groups, key informant interviews, surveys and programme documentation. Qualitative data were subjected to thematic analysis; programme documents underwent document review. Results: There were high levels of programme participation (90%), and the yield from routine health screening was high (80% of participants screened positive for two or more health conditions). All identified programme development strategies were implemented; programme partners and participants reported satisfaction with the programme. Sixteen programme partners were identified with a high level of intersectoral collaboration reported. Significant in-kind contributions and seed funding enabled the uptake of the programme to increase from one to five Intensive English Centres over a 4-year period. Conclusion: Process and impact evaluation identified that the programme was well implemented and met its stated objectives of increasing the detection of health conditions likely to impact on student health and learning; linkage of newly arrived students and their families with primary health care; and coordination of care across primary health and specialist services.
Background: Complex feeding difficulties requiring enteral (tube) feeding affect everyone around the child. Parents experience additional stress and are at risk of social isolation. This study investigated the strategies families develop and use to adjust and adapt to enteral feeding so they were not just surviving but thriving as a family. Methods: Twenty parents whose children had been or continued to be enterally fed were interviewed, four of them twice as their experience of enteral feeding progressed. Learning theory was used to conceptualize findings in terms of changing use of tools that mediated parents' response to feeding-related challenges. Results: Parents encountered dilemmas relating to enteral feeding: maintaining participation in everyday activities, managing responses to the use of tubes for feeding, and doing what feels right for their child. They used four kinds of mediating tools to overcome these: memory aids and readiness tools, metaphors and narratives, repurposed everyday objects and personalized routines and materialities. Conclusions: This novel account of tool used to resolve dilemmas provides an empirically and theoretically grounded basis for supporting parents to thrive despite the challenges of enteral feeding. Specifically, it can guide information given to help parents anticipate and cope with dilemmas arising from enteral feeding.
Discordant TST and QGIT results were found in a high percentage of refugee children. QGIT is convenient and more specific than TST to diagnose LTBI in BCG-vaccinated children, although a careful tuberculosis exposure history and clinical assessment to rule out active disease remain important.
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