Aim. This study seeks to review the psychosocial factors affecting patients with end-stage kidney disease (ESKD) from a tertiary hospital in Australia. Methods. We audited patients with ESKD, referred to social work services from January 2012 to December 2014. All patients underwent psychosocial assessments by one, full-time renal social worker. Patient demographics, cumulative social issues, and subsequent interventions were recorded directly into a database. Results. Of the 244 patients referred, the majority were >60 years (58.6%), male (60.7%), born in Australia (62.3%), on haemodialysis (51.6%), and reliant on government financial assistance (88%). Adjustment issues (41%), financial concerns (38.5%), domestic assistance (35.2%), and treatment nonadherence (21.3%) were the predominant reasons for social work consultation. Younger age, referral prior to start of dialysis, and unemployment were significant independent predictors of increased risk of adjustment issues (p = 0.004, <0.001, and =0.018, resp.). Independent risk factors for treatment nonadherence included age and financial and employment status (p = 0.041, 0.052, and 0.008, resp.). Conclusion. Psychosocial and demographic factors were associated with treatment nonadherence and adjustment difficulties. Additional social work support and counselling, in addition to financial assistance from government and nongovernment agencies, may help to improve adjustment to the diagnosis and treatment plans as patients approach ESKD.

We investigate the impact of financing and legal obstacles on firm growth across different firm sizes before and after the global financial crisis (GFC). Using two enterprise surveys in Vietnam, we find firms facing higher financing obstacles have lower sales and employment growth. The smallest firms are the most adversely affected by financing obstacles. The legal obstacles impede the employment growth of SMEs more than large enterprises, which is attributable to the tendency of firms to avoid tall poppy syndrome and the scrutiny of tax officials. Furthermore, we find that the negative effects of financing obstacles on small firms' sales and employment growth reduce in the post-GFC period. We attribute it to a higher proportion of small firms being able to borrow from commercial banks after the financial crisis, partly due to the introduction of new policies supporting SMEs from the Vietnamese Government. Overall, our findings recommend to policymakers that improvement in access to finance is imperative for productivity increases and job creation for small and medium firms.

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