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(2012)ReportAustralia accepts more than 13,000 refugee and humanitarian immigrants annually and young people account for a large overall percentage of the refugee population in New South Wales (NSW). There is evidence that refugee families are highly vulnerable to social isolation in their countries of resettlement. The difficulties of refugee settlement are well documented, including the need to learn new languages, negotiate differing cultural and societal values and address past emotional trauma. Development through sport refers to the use of sporting activities to provide opportunities for personal and community development with effects that go well beyond the sphere of physical activity and [elite] player and game development. In recent years there has been an increase in programs that use sport to foster social development and engagement, however little robust research has been performed to evaluate these efforts. Football United ® was developed from a vision that people’s love for Football (soccer) can be used to build opportunities for belonging, racial harmony and community cohesion. Football United ®’s six years of operations confirms the Crawford report findings, and highlights other effects of inequity in participation: • Gaps in equity of participation in both community and public education sector sport which can contribute to general disaffection within society, including leaving school, aggressive behaviour and unemployment as examples. • Lack of opportunity to interact across cultural groups which can translate to racism and the ensuing problems it provokes. Football United ® addresses these issues basing its foundations on the premise that structural variables and social processes act at multiple levels to impact on health and social behaviour. Results of the study underline Football United ®’s positive impact on participating young people’s sense of self, and appreciation for and engagement with peers from diverse backgrounds. Learning from interviews found unanticipated connections between participating in Football United ® and learning English, positive engagement with school, and building self confidence.
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(2012)ThesisRepeat hospitalisations by frequently readmitted patients (FRPs) are costly and might be avoidable. Many frequent readmissions are due to acute exacerbations of chronic disease treatable outside hospital. FRPs were defined as patients who were admitted three or more times in a year. The aim of this research was to explore the reasons behind frequent readmissions in patients with chronic disease. The study at a regional hospital in NSW, involved analysis of emergency department data to distinguish patient factors associated with three types of frequent hospital users: FRPs, frequent attenders (FAs) with four or more presentations in a year and patients who have an unplanned return visit to hospital within 28 days for the same condition (URVPs). Differences in attitudes to and beliefs about chronic disease self-management were explored by analysing interview data from FRPs compared with data from self-managing patients (SMPs), who had all been FRPs but had adopted self-management. A sample of clinicians treating patients with chronic disease in hospital, general practice and self-management services was interviewed to determine differences in attitudes to and beliefs about self-management. FRPs, FAs and URVPs shared some characteristics, but were discrete groups. The findings confirmed that patients with chronic disease contributed to the FRPs group and provided a basis of developing solutions to frequent use. The qualitative findings indicated that patients adopted self-management in response to encouragement by a proactive clinician. Activation involved acceptance; responding emotionally and changing identity, which was not described by FRPs. Hospital clinicians and general practitioners thought that some patients were resistant to self-management, were less familiar with self-management services and saw their role as being restricted to referral to services. Clinicians involved in self-management had the skills to be proactive and believed that all patients could be activated to self-manage. The findings provide insights into interactions between patients and clinicians leading to patient activation. The implications are that self-management activation in patients presenting to hospital can be increased by improving clinician skills in and understanding of the process of patient activation in self-management. This may help to reduce further reliance on presentation to hospital.