Introduction: Refugees experience a number of difficulties when settling in the United Kingdom and may be faced with occupational injustice due to their restricted occupational engagement. This study explores the value of an allotment group for refugees of working age, aiming to explore the role of horticulture and the social environment on health, wellbeing and social inclusion. Method: This was an exploratory study using qualitative methodology based on ethnographic principles. Data collection included observation of the group, semi-structured interviews with five participants, with four of these participants also taking part in photo-elicitation interviews. Data analysis involved using a ‘framework’ approach to produce three themes and associated sub-themes. Findings: Analysis identified firstly gardening as a meaningful activity; secondly, the importance of the social environment and, lastly, the value of occupational engagement for refugees. Further theoretical analysis led to the conclusion that these themes linked to the dimensions of occupation: doing, being, belonging and becoming. Conclusion: The findings identify how occupational engagement can have a positive impact on the health and wellbeing of refugees, specifically with the use of social and therapeutic horticulture.
BackgroundExtending the scope of practice of allied health professionals has been a strategy adopted in the United Kingdom to address issues within the health system.Australia’s health system is currently undermined by similar issues, heightening government interest in adopting the extended scope health care model. The aim of the current study was to describe the activities and outcomes of a dietitian-led gastroenterology clinic which operated under an extended scope of practice model in an outpatient gastroenterology department at a tertiary hospital in regional Queensland, Australia, and to assess patient satisfaction with the initiative.MethodsA descriptive, cross-sectional case series undertaken over 50 clinics involving 82 category 2 and 3 patients with suspected/confirmed coeliac disease or inflammatory bowel disease; low haemoglobin; gastroesophageal reflux disease, or; malnutrition. Data was analysed using Microsoft Excel 2010, and presented as descriptive statistics.ResultsSixty out of 82 selected patients (median age 51 years) attended an initial appointment with the dietitian. Twenty-four review appointments were attended. Average waiting period for an initial appointment was 148 days (range 31–308 days). A total of 149 management strategies were provided, and 94 (63 %) of these involved the dietitian utilising extended scope of practice. The dietitian managed 47 (78 %) patients without need for gastroenterologist referral, and 25 (42 %) were discharged after dietetic management.Patients reported high levels of satisfaction with the clinic.ConclusionsSeventy-eight percent of category 2 and 3 patients referred to the gastroenterologist could be managed exclusively in the dietitian-led clinic. This extended scope model of care could potentially benefit the efficiency and acceptability of Australia’s public health system.
Extended scope of practice in dietetics may provide positive outcomes for various stakeholders. However, further development of extended scope roles for dietitians requires increased advocacy and support from governments, professional bodies, training institutions and dietitians. We have developed an implementation framework which can be utilised by health professionals interested in embracing an extended scope model of care.
This investigation studied language sampling with normal four- and six-year-old children in three conditions: (1) conversation; (2) picture description with the experimenter and child looking at the stimuli; and (3) picture description with the experimenter unable to view the stimuli with the child. The results show statistically significant differences in Developmental Sentence Score and MLU between the age groups and among the experimental conditions. They suggest that children of these ages are able to alter their linguistic behavior as a result of the listener’s perspective. Implications for language sampling and future research are discussed.
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