Engaging with peers to integrate community care: Knowledge synthesis and conceptual map.

CONTEXT: Engaging with peers is gaining increasing interest from healthcare systems in numerous countries. Peers are people who offer support by drawing on lived experiences of significant challenges or 'insider' knowledge of communities. Growing evidence suggests that peers can serve as a bridge between underserved communities and care providers across sectors, through their ability to build trust and relationships. Peer support is thus seen as an innovative way to address core issues of formal healthcare, particularly fragmentation of care and health inequalities. The wide body of approaches, goals and models of peer support speaks volumes of such interest. Navigating the various labels used to name peers, however, can be daunting. Similar terms often hide critical differences. OBJECTIVES/BACKGROUND: This article seeks to disentangle the conceptual multiplicity of peer support, presenting a conceptual map based on a 3-year knowledge synthesis project involving peers and programme stakeholders in Canada, and international scientific and grey literature. SYNTHESIS/MAIN RESULTS: The map introduces six key questions to navigate and situate peer support approaches according to peers' roles, pathways and settings of practice, regardless of the terms used to label them. As a tool, it offers a broad overview of the different ways peers contribute to integrating health and community care. DISCUSSION: We conclude by discussing the map's potential and limitations to establish a common language and bridge models, in support of knowledge exchange among practitioners, policymakers and researchers. PATIENT OR PUBLIC CONTRIBUTION: Our team includes one experienced peer support worker. She contributed to the design of the conceptual map and the production of the manuscript. More than 10 peers working across Canada were also involved during research meetings to validate and refine the conceptual map.

Discipline and punishment in panoptical public goods games.

In Public Goods Games (PGG), the temptation to free-ride on others' contributions poses a significant threat to the sustainability of cooperative societies. Therefore, societies strive to mitigate this through incentive systems, employing rewards and punishments to foster cooperative behavior. Thus, peer punishment, in which cooperators sanction defectors, as well as pool punishment, where a centralized punishment institution executes the punishment, is deeply analyzed in previous works. Although the literature indicates that these methods may enhance cooperation on social dilemmas under particular contexts, there are still open questions, for instance, the structural connection between graduated punishment and the monitoring of public goods games. Our investigation proposes a compulsory PGG framework under Panoptical surveillance. Inspired by Foucault's theories on disciplinary mechanisms and biopower, we present a novel mathematical model that scrutinizes the balance between the severity and scope of punishment to catalyze cooperative behavior. By integrating perspectives from evolutionary game theory and Foucault's theories of power and discipline, this research uncovers the theoretical foundations of mathematical frameworks involved in punishment and discipline structures. We show that well-calibrated punishment and discipline schemes, leveraging the panoptical effect for universal oversight, can effectively mitigate the free-rider dilemma, fostering enhanced cooperation. This interdisciplinary approach not only elucidates the dynamics of cooperation in societal constructs but also underscores the importance of integrating diverse methodologies to address the complexities of fostering cooperative evolution.

Political participation among deaf youth in Great Britain.

Variations in political participation are linked to demographic factors, socioeconomic disparities, and cultural-ethnic diversity. Existing research has primarily explored reduced political involvement among individuals with disabilities, particularly in electoral politics. However, little research has attended the involvement of deaf people specifically. This is of interest because deaf youth are at an intersection of disability, language and cultural identity with their language affiliations and rejection or acceptance of disability evolving through childhood. This study draws from original data collected via an online survey, comprising 163 deaf young respondents aged 16-19 in Great Britain. We compare their levels of political participation with those of general population peers to explore how sociodemographic factors, alongside variations in self-identification as deaf, and meaningful interactions with other deaf people contribute to explain their political engagement. The results challenge conventional wisdom by demonstrating that deaf youth participate more actively in politics than their hearing peers in various forms of political involvement, including collective, contact, and institutional activism. We also recognize differences among deaf youth and propose that social aspects of identity formation, particularly embracing a deaf identity and having deaf friends, can boost certain forms of political engagement. In summary, this study underscores the importance of acknowledging the diversity of deaf youth in terms of affiliation with various forms of deaf identity, rendering their experience different from both disabled and hearing youth. By identifying the factors driving heightened political participation, policymakers and advocates can develop strategies to enhance political engagement among all young people, regardless of their hearing status.

Expanding capacity for publication in nursing: Experiences from a writing for publication group.

Nurses have valuable knowledge and expertise to share. Yet, for a variety of reasons, many nurses do not write for publication. Members in one Sigma Theta Tau International chapter requested information about publishing so a writing for publication program (WPP) was convened. Ten nurses from diverse clinical and academic backgrounds participated. The goal of the WPP was to support a small group of nurses to advance knowledge and develop practical skills through the development of a manuscript with mentorship from doctorally-prepared nurses with publishing experience. The anticipated effect was that participants would share what they learned with colleagues or mentor others to publish in the future. Beginning with informational sessions to lay the foundation for writing and publishing, the WPP included biweekly, two-hour online sessions over a seven-month period whereby individual and group writing with embedded peer and WPP leader feedback occurred. WPP participants gained proficiency in searching online databases, synthesizing published literature, and working as a member of a writing team. The group successfully published a manuscript based on a topic of interest. This current article describes the structured support and mentorship provided during the WPP with recommendations for overcoming publication barriers commonly described in the literature.

Learning with our peers: peer-led versus instructor-led debriefing for simulated crises, a randomized controlled trial.

BACKGROUND: Although peer-assisted learning is known to be effective for reciprocal learning in medical education, it has been understudied in simulation. We aimed to assess the effectiveness of peer-led compared to instructor-led debriefing for non-technical skill development in simulated crisis scenarios. METHODS: Sixty-one undergraduate medical students were randomized into the control group (instructor-led debriefing) or an intervention group (peer debriefer or peer debriefee group). After the pre-test simulation, the participants underwent two more simulation scenarios, each followed by a debriefing session. After the second debriefing session, the participants underwent an immediate post-test simulation on the same day and a retention post-test simulation two months later. Non-technical skills for the pre-test, immediate post-test, and retention tests were assessed by two blinded raters using the Ottawa Global Rating Scale (OGRS). RESULTS: The participants' non-technical skill performance significantly improved in all groups from the pre-test to the immediate post-test, with changes in the OGRS scores of 15.0 (95% CI [11.4, 18.7]) in the instructor-led group, 15.3 (11.5, 19.0) in the peer-debriefer group, and 17.6 (13.9, 21.4) in the peer-debriefee group. No significant differences in performance were found, after adjusting for the year of medical school training, among debriefing modalities (P = 0.147) or between the immediate post-test and retention test (P = 0.358). CONCLUSIONS: Peer-led debriefing was as effective as instructor-led debriefing at improving undergraduate medical students' non-technical skill performance in simulated crisis situations. Peer debriefers also improved their simulated clinical skills. The peer debriefing model is a feasible alternative to the traditional, costlier instructor model.

A Mixed-Methods Exploration of Competencies and Professional Development Needs Among Chief Certified Registered Nurse Anesthetists.

This project sought to explore the experiences, self-perceived preparation, professional development needs, and preferred learning methods of certified registered nurse anesthetists (CRNAs) in a management role. A sample of 10 current chief CRNAs responded to a demographics survey and participated in one-on-one interviews using a 14-question, semi-structured interview framework modified from a previous study. Interview responses were deidentified and qualitatively analyzed for common themes by two content experts and one qualitative analysis expert. Results suggest that CRNAs entering the management field feel somewhat unprepared to perform the administrative tasks associated with their role. Qualitative analysis of interview responses elicited multiple key themes including interpersonal communication and handling crucial conversations, time and organizational management skills, team building and motivation, and financial management skills. Themes related to preferred learning methods of chief CRNAs included mentorship, peer networking, and experiential learning to obtain the required knowledge and skills for the role. The authors recommend incorporating each of the identified themes to guide development of CRNA management-specific educational programs. Establishing such a program will serve to better prepare aspiring CRNA managers and further develop the knowledge and skillset of current chief CRNAs.

New media facilitate adolescents' body dissatisfaction and eating disorders in Mainland China.

New media play a significant role in adolescents' body dissatisfaction and eating disorders in Mainland China, through shaping social standards, peers, and family dynamics. How to mitigate their adverse effects on adolescents, reduce body dissatisfaction, and prevent eating disorders is a significant social issue that demands serious consideration.

Peer perspectives on friendships among peers with and without intellectual and developmental disabilities: A pilot mixed methods study.

BACKGROUND: The benefits of friendships among peers with and without intellectual and developmental disabilities are well supported by research. However, little is known about the nature of these inclusive friendships in inclusive college courses. METHOD: We explored the perspectives of peers on the development of authentic friendships among peers with and without intellectual and developmental disabilities in inclusive college courses in the United States. We used a sequential, explanatory, transformative mixed methods-grounded theory research design. We integrated quantitative (N = 44) and qualitative (N = 8) findings using blended analysis to inform a preliminary grounded theory of inclusive and reciprocal friendships. RESULTS: Quantitative findings suggest two relationships and one predictor of peers' perceived social engagement. Qualitative findings resulted in five themes that promote friendships. CONCLUSIONS: We propose that the context for developing inclusive friendships could be fostered using the preparation and actions stages of the grounded theory model.

Development and implementation of digital peer mentoring in small groups for first-year medical students.

Introduction: Mentoring has become an important educational strategy in medical training. Peer mentoring (PM) can enhance student experience and support transition to higher education. This article documents the implementation of an online peer mentoring program for first year medical students at a newly founded medical school in Germany during the COVID-19 pandemic and its development into in-person PM. Project description: We developed the program in close collaboration between students and teachers. Students were invited to apply as peer mentors via email; they received instructions and reflected on their role and experiences in meetings before, during and after the semester. One or more peer mentors were assigned randomly to a student group. We evaluated the program with an online survey inspired by the "Modified Mentorship Effectiveness Scale". After successful piloting PM was implemented into the core curriculum. Results: In 2020 we assigned 17 peer mentors to 14 groups of 6-7 students. Groups met 3 or more times via Zoom®. Overall satisfaction was high. Both student groups reported benefits for their personal and professional identity formation. Atmosphere in online meetings was excellent. Most important topics were exams/learning strategies. In 2021 meetings were held in person. Overall satisfaction, perceived benefits and learning atmosphere were again rated very positively. Most students preferred many-to-many PM and random matching. Conclusion: The implementation of PM was successful and beneficial for the participating students. PM can help first-year medical students reduce anxiety, improve self-organization and orientation at university. It fosters identity formation and has positive effects on peer mentees as well as on peer mentors.

Pilot study of the effectiveness of a telehealth group for improving peer relationships for adolescents with neurofibromatosis type 1.

BACKGROUND: Interventions for social difficulties have not been investigated in the neurofibromatosis type 1 (NF1) population despite observations of elevated rates of social difficulties. In this pilot study, the effectiveness of a 14-week telehealth PEERS® intervention with nineteen adolescents with NF1 (Mage=13.79 years, SD = 1.32) with social skills difficulties was examined. Measures of social outcomes were completed at three timepoints (before, immediately after, and at 14-week follow-up). RESULTS: Caregiver-reported social-emotional skills, social impairment, caregiver-reported number of adolescent get-togethers, and teen social knowledge showed significant improvement following the intervention. CONCLUSIONS: The PEERS® intervention is promising to support the social and friendship skills of adolescents with NF1 who have social difficulties.

Assessing understandings and perceptions of HIV cure among peer navigators and treatment officers in Australia.

HIV community peer navigators and treatment officers are important sources of information and guidance for people living with HIV. We conducted an anonymous online survey with members of the treatment outreach network of the Australian National Association of People Living with HIV. The survey explored understandings and acceptance of HIV cure research and was disseminated before and following an interactive workshop on HIV cure. We demonstrated an improvement in understandings of HIV cure science and increased willingness to participate in interventional clinical trials after the workshop. Concerns around interrupting HIV treatment and detrimental impacts on health were identified as barriers to participation. Altruism was a motivator to enrol in HIV cure trials, along with endorsement from a trusted member of community.

Kidney adolescent and young adult clinic: A transition model in Africa.

Adolescents and Young Adults (AYAs) with chronic kidney disease (CKD) have challenges unique to this developmental period, with increased rates of high-risk behavior and non-adherence to therapy which may impact the progression of kidney disease and their requirement for kidney replacement therapy (KRT). Successful transition of AYA patients are particularly important in low- and middle-income countries (LMICs) where KRT is limited, rationed or not available. Kidney AYA transition clinics have the potential to improve clinical outcomes but there is a paucity of data on the clinical translational impact of these clinics in Africa. This review is a reflection of the 20-year growth and development of the first South African kidney AYA transition clinic. We describe a model of care for patients with CKD, irrespective of etiology, aged 10-25 years, transitioning from pediatric to adult nephrology services. This unique service was established in 2002 and re-designed in 2015. This multidisciplinary integrated transition model has improved patient outcomes, created peer support groups and formed a training platform for future pediatric and adult nephrologists. In addition, an Adolescent Centre of Excellence has been created to compliment the kidney AYA transition model of care. The development of this transition pathway challenges and solutions are explored in this article. This is the first kidney AYA transition clinic in Africa. The scope of this service has expanded over the last two decades. With limited resources in LMICs, such as KRT, the structured transition of AYAs with kidney disease is not only possible but essential. It is imperative to preserve residual kidney function, maximize the kidney allograft lifespan and improve adherence, to enable young individuals an opportunity to lead productive lives.

Decoding the effects of varied peer victimization forms on depression and anxiety among Chinese adolescents: An exploration through latent transition analysis.

This study aims to examine co-occurrence patterns of depression and anxiety among Chinese adolescents and their associations with various forms of peer victimization. We collected longitudinal data from 1005 middle school students using the Multidimensional Peer Victimization Scale, Center for Epidemiological Studies Depression Scale, and State-Trait Anxiety Inventory. Then we conducted latent profile analysis, latent transition analysis, and logistic regression analysis. The results reveal the presence of three depression-anxiety profiles among participants: low depression-anxiety group, moderate depression-anxiety group, and high depression-anxiety group. As verbal and relational victimization increase, adolescents are more likely to transition to a higher level of depression-anxiety profile. However, an increase in physical and property victimization predicts a transition to a lower level of depression-anxiety profile. The diverse effects resulting from different forms of victimization exhibit gender differences. For boys, an increase in relational victimization made participants in the moderate depression-anxiety group more likely to transition to the high depression-anxiety group, whereas this effect was not significant among girls. This study is theoretically significant for understanding the link between depression, anxiety, and their influencing factors. It suggests that educators, while addressing verbal and relational harm in adolescents, should reconsider the potential impact of physical and property harm. Opportunities to transform negative events into positive ones should be explored. Educators should tailor their focus based on gender, with a particular emphasis on addressing relational harm among male students. This underscores the need for differentiated approaches to effectively support students.

Neural responses to syllable-induced P1m and social impairment in children with autism spectrum disorder and typically developing Peers.

In previous magnetoencephalography (MEG) studies, children with autism spectrum disorder (ASD) have been shown to respond differently to speech stimuli than typically developing (TD) children. Quantitative evaluation of this difference in responsiveness may support early diagnosis and intervention for ASD. The objective of this research is to investigate the relationship between syllable-induced P1m and social impairment in children with ASD and TD children. We analyzed 49 children with ASD aged 40-92 months and age-matched 26 TD children. We evaluated their social impairment by means of the Social Responsiveness Scale (SRS) and their intelligence ability using the Kaufman Assessment Battery for Children (K-ABC). Multiple regression analysis with SRS score as the dependent variable and syllable-induced P1m latency or intensity and intelligence ability as explanatory variables revealed that SRS score was associated with syllable-induced P1m latency in the left hemisphere only in the TD group and not in the ASD group. A second finding was that increased leftward-lateralization of intensity was correlated with higher SRS scores only in the ASD group. These results provide valuable insights but also highlight the intricate nature of neural mechanisms and their relationship with autistic traits.

Explanatory and modifying factors of the association between sex and depression onset during adolescence: An exploratory study.

BACKGROUND: The prevalence of Major Depressive Disorder (MDD) is twice as high in women as in men and this difference already emerges during adolescence. Because the mechanisms underlying this sex-difference remain poorly understood, we took a bottom-up approach to identify factors explaining the sex-MDD relationship. METHODS: Data came from the TRacking Adolescents' Individual Lives Survey (TRAILS), a population study investigating youths' development from age 11 into adulthood. We assessed multiple baseline covariates (e.g., demographic, social and psychological) at ages 11-13 years and MDD onset at ages 19 and 25 years. In regression analyses, each covariate's role in the sex-MDD association as an effect modifier or confounder/explanatory variable was investigated. Replicability was evaluated in an independent sample. RESULTS: The analyses identified no effect-modifiers. Baseline internalizing problems, behavioral inhibition, dizziness, comfort in classroom, physical complaints, attention problems, cooperation, self/effortful control, interpersonal life events and computer use partially explained the association between sex and MDD at age 19. The association between sex and MDD at age 25 was explained by largely the same variables, but also by shyness, acne, antisocial behavior, aggression, affection from peers and time spent shopping. The explanatory roles of internalizing problems, behavioral inhibition, negative events involving gossip/rumors and leisure-time spending (computer-use/shopping) were replicated. LIMITATIONS: Potentially important baseline variables were not included or had low response rates. Gender roles or identification were not considered. Baseline MDD was not adjusted for. CONCLUSION: The sex-MDD association is partially explained by sex differences in symptoms and vulnerability factors already present in early adolescence.

Children teach sensational information-as long as it is true.

When sharing information, teenagers and adults prioritize what is sensational or attention-grabbing, sometimes at the cost of the truth. Nothing is known so far about whether young children prefer to transmit sensational information or what they prioritize when the sensational quality of information conflicts with its truth. In two experiments (N = 136), 4- and 5-year-olds engaged in a forced-choice task in which they selected one of two statements to teach to a peer. In the absence of explicit truth value assignments, children of both ages preferred teaching sensational information over non-sensational (neutral) information (p < .0001). When information was sensational but untrue, truth trumped sensationalism in both age groups (p < .0001). The experiments shed more light on biases that affect the early ontogeny of information exchange. Not only do children prioritize certain kinds of information when teaching, they also actively weigh these preferences against one another and mute their bias for sensationalism when veracity is at stake.

A co-created multimethod evaluation of recovery education in Ireland.

BACKGROUND: This paper aims to explore the impact of recovery education on recovery knowledge, attitudes and the quality of life of students undertaking recovery education, contributing to the evidence base in relation to the impact of recovery education. It also explores the experiences of all stakeholders involved in the co-facilitation, delivery and participation in recovery education. SETTING AND PARTICIPANTS: This study evaluates the experiences of stakeholders involved in the co-facilitation, delivery and participation in recovery education across four recovery colleges in Ireland. Participants included students undertaking recovery education, peer educators, education facilitators, recovery college coordinators and practitioner/service providers. DISCUSSION: Findings from the quantitative survey when compared with extant literature suggest that students had a good understanding of recovery education. The social aspect of empowerment for growth and wellbeing was identified through themes relating to co-production and facilitating student learning. Support for equitable access to recovery education, including co-production for both the public and staff, was identified as a challenge for the future. CONCLUSION: The findings from both the qualitative and quantitative components of the study show the positive impact of recovery education on stakeholders while acknowledging the need for ongoing support for people working in recovery education and the development of services. In particular, there was a high level of recovery knowledge found in students undertaking recovery education. PATIENT OR PUBLIC CONTRIBUTION: This study utilised a co-created study design. From inception a steering group comprising stakeholders (peer educators, recovery education facilitators including past recovery college students and nonpeer staff involved in the co-production of recovery education) directed the conduct of the evaluation. This steering group participated in an iterative process of information sharing, suggestions for evaluation process and language.