Barriers and facilitators to implementing and sustaining peer support in kidney care

Introduction Peer support offers informational, appraisal and emotional support for people with CKD, is recommended in national policy, yet has low engagement levels. This paper reports results of a national survey and qualitative interviews in the UK. Literature review A recent narrative review highlighted the barriers and facilitators to peer support uptake among people with CKD however called on further studies to be conducted. Material and methods The survey, adapted from a 2012 version, was sent to all 83 UK kidney units. Semi-structured interviews were conducted with staff, recipients and supporters from two units. Results 44 units completed the survey, and 10 staff, 7 patients and 2 peer supporters were interviewed. The most common facilitators were promotion with staff and having peer support champions. Barriers included lack of staff time, guidance/information, other projects taking priority and too few supporters. Discussion Little progress has been made since 2012; a proportion of units without peer support has increased, with similar barriers identified in 2020. Services could be designed to limit the time needed for their creation and maintenance through having simpler referrals and designating staff liaisons. Implications for clinical practice Peer support programmes should have passionate staff and volunteers, involve recipients in the design, recruit an array of supporters and establish evaluations to determine the progress/outcomes. A resource toolkit was developed in response to this project. Conclusion Findings from the national survey and qualitative interviews showed that more peer support optimisation and prioritisation is needed to ensure benefits are maximised

A narrative review of peer support barriers and facilitators in kidney care

Introduction Patients with CKD often experience emotional/mental challenges and benefit from peer support as it provides insight/information from others with the same condition. Previous studies show it is effective in improving health outcomes and aids in treatment decisions. Literature review There is low peer support uptake among patients with CKD in the UK and staff do not utilise it fully. Few studies within the UK have focused on peer support barriers/facilitators so this narrative review aimed to understand them from staff and patient perspectives. Material and methods A comprehensive search strategy and inclusion/exclusion criteria was applied with a two-step process of article selection employed, using two reviewers. Thematic analysis was applied. Results Five articles were included and six themes emerged. Low referrals and difficulty matching were staff barriers; concern regarding the relationship dynamic and the format/delivery were patient barriers. Promotion of the service aided the uptake from staff whilst patients valued inclusivity. Discussion Increased promotion of peer support benefits through training/awareness may improve staff referrals and there should be greater exposure nationally. A flexible format is essential to ensure ample opportunity for access. Implications for clinical practice Staff training should include peer support details and potential recipients should be empowered to access it in a way which suits their needs. A programme needs passionate individuals involved in the set-up/delivery. Conclusion This review highlights the current literature on peer support barriers/facilitators. Further study is needed to evidence which approaches best overcome staff- and patient-barriers

2-D and 3-D Radiation Transfer Models of High-Mass Star Formation

2-D and 3-D radiation transfer models of forming stars generally produce bluer 1-10 micron colors than 1-D models of the same evolutionary state and envelope mass. Therefore, 1-D models of the shortwave radiation will generally estimate a lower envelope mass and later evolutionary state than multidimensional models. 1-D models are probably reasonable for very young sources, or longwave analysis (wavelengths > 100 microns). In our 3-D models of high-mass stars in clumpy molecular clouds, we find no correlation between the depth of the 10 micron silicate feature and the longwave (> 100 micron) SED (which sets the envelope mass), even when the average optical extinction of the envelope is >100 magnitudes. This is in agreement with the observations of Faison et al. (1998) of several UltraCompact HII (UCHII) regions, suggesting that many of these sources are more evolved than embedded protostars. We have calculated a large grid of 2-D models and find substantial overlap between different evolutionary states in the mid-IR color-color diagrams. We have developed a model fitter to work in conjunction with the grid to analyze large datasets. This grid and fitter will be expanded and tested in 2005 and released to the public in 2006.Comment: 10 pages, 8 figures, to appear in the proceedings of IAU Symp 227, Massive Star Birth: A Crossroads of Astrophysics, (Cesaroni R., Churchwell E., Felli M., Walmsley C. editors

Engaging Students Engaging Industry Engaging Enterprise

A reflective piece on how a small team of students and academics gained more awareness of their own sense of enterprise and creativity. The case study examines the phases and crisis points of the whole event process and identifies some of the key learning outcomes for all involved

Development of an Accelerated Test Design for Predicting the Service Life of the Solar Array at Mead, Nebraska

Potential long-term degradation modes for the two types of modules in the Mead array were determined and judgments were made as to those environmental stresses and combinations of stresses which accelerate the degradation of the power output. Hierarchical trees representing the severity of effects of stresses (test conditions) on eleven individual degradation modes were constructed and were pruned of tests judged to be nonessential. Composites of those trees were developed so that there is now one pruned tree covering eight degradation modes, another covering two degradation modes, and a third covering one degradation mode. These three composite trees form the basis for selection of test conditions in the final test plan which is now being prepared

The 1981 Argentina ground data collection

Over 600 fields in the corn, soybean and wheat growing regions of the Argentine pampa were categorized by crop or cover type and ancillary data including crop calendars, historical crop production statistics and certain cropping practices were also gathered. A summary of the field work undertaken is included along with a country overview, a chronology of field trip planning and field work events, and the field work inventory of selected sample segments. LANDSAT images were annotated and used as the field work base and several hundred ground and aerial photographs were taken. These items along with segment descriptions are presented. Meetings were held with officials of the State Secretariat of Agriculture (SEAG) and the National Commission on Space Investigations (CNIE), and their support to the program are described

The contribution of selected non-articular conditions to knee pain severity and associated disability in older adults

SummaryObjectiveTo estimate the contribution of selected non-articular conditions (NACs) to pain severity and functional limitation in community-dwelling older adults with knee pain.DesignPopulation-based, cross-sectional study of 745 adults aged 50 years and over with knee pain. Self-complete questionnaires, clinical history and physical examination were used to identify the presence of selected NACs that could cause pain around the knee. Regression analyses were used to compare levels of knee pain severity (0–20) and functional limitation (0–68) (Western Ontario and McMaster Universities osteoarthritis index physical function subscale [WOMAC-PF]), between those with one or more NACs and those with none (NACs-absent).ResultsTwo hundred and seventy-three (36.6%) participants had at least one NAC: widespread pain, n=159; low back pain with index leg referral, n=102; full-leg pain, n=88; hip arthritis, n=65; prepatellar, infrapatellar or pes anserine bursitis, n=35. The NACs group had significantly higher levels of pain severity and functional limitation than the NACs-absent group: 8.2(±4.6) vs 5.4(±3.8) and 27.9(±15.8) vs 16.8(±13.2), respectively. The groups did not differ with respect to severity of radiographic osteoarthritis (ROA). Having one or more NACs accounted for a significant proportion of the variance in WOMAC scores, above that which could be explained by age, gender, body mass index and severity of ROA.ConclusionNACs appear to be common in older adults with knee pain. They make a significant contribution to knee pain severity and functional limitation and are likely to represent additional, rather than alternative, causes of knee pain/functional limitation to osteoarthritis (OA). These factors should be taken into account in epidemiological studies of knee pain and OA