Key experiences of primary social groups in Unspecified Kidney Donation.

BACKGROUND: The role of family members in directed kidney donation is well documented in the literature from both a physiological and psychosocial perspective. The experiences of families, or primary social groups (PSGs), where one member considers donating a kidney via unspecified altruistic kidney donation route (UKD) is poorly understood. This is pertinent as lack of family support has been identified as a potential contributor to donation withdrawal. OBJECTIVES: This study aimed to explore the relevant psychosocial factors underpinning completed and uncompleted donations. DESIGN: A qualitative study using semi-structured interviews. PARTICIPANTS: Qualitative interviews were conducted in the United Kingdom with 35 individuals comprising of: 11 donors who donated their kidney altruistically and 8 of their PSG members, and 11 donors who withdrew and 5 of their PSG members. APPROACH: Interviews were transcribed verbatim and analysed using Framework Analysis. RESULTS: Two major themes were identified: (1) Supportability, which contained experiences fundamental to proceeding to donate, underpinned by four subthemes Acceptability, Awareness and Information, Family Risk and Ambivalence;(2) Seeking Resolution, contained discussions of experiences following either withdrawal from or completion of the donation, and comprised two sub-themes, Unfinished Business and Resolve. CONCLUSIONS: There are key differences in the experiences between those who completed their donation and those who withdrew. It is clear from this study that UKD operates within a PSG's social framework. Clinical implications suggest interventions at the level of addressing ambivalence within the PSG and the need for promotion of better psychosocial outcomes both following completion or withdrawal from donation.

What a discursive understanding of interprofessional team meetings might reveal: an exploration of intellectual (learning) disability managers' performances.

Clinical and academic understandings of interprofessional working are focused mainly on individual factors such as knowledge about different professional roles, and organisational opportunities for interprofessional working (IPW). Less research has examined what happens between people at an interactional level, that is, how interprofessional working is conducted in everyday face-to-face interactions in clinical practice. The current paper proposes a discursive framework for understanding what constitutes IPW in interprofessional meetings at this interactional level. Clinical effectiveness meetings held in intellectual (learning) disability services were used as an example site for IPW. The analysis explored how agenda change points were negotiated, appropriate as agenda change points require collaboration (or agreement) between practitioners to progress to the next point The study found changes in agenda points were accomplished by practitioners conjointly through using discursive strategies including closing questions, and resources such as professional identity and laughter. The agenda provided a frame for the institutional order of the meetings, invoking a trajectory towards timely completion. However, this institutional order was at times subordinated to an 'order of concern', which seemed to enable challenges by managers to the meeting Chair and the agenda that demonstrated adherence not only to the procedural nature of the meetings, but also to the needs of service users and the services discussed. We suggest discursive strategies, resources, and both institutional orders, and order of concerns might provide a framework for developing future training and research, that is able to illuminate how IPW might be enacted in face-to-face team meetings.

Making Heat Visible: Promoting Energy Conservation Behaviors Through Thermal Imaging.

Householders play a role in energy conservation through the decisions they make about purchases and installations such as insulation, and through their habitual behavior. The present U.K. study investigated the effect of thermal imaging technology on energy conservation, by measuring the behavioral effect after householders viewed images of heat escaping from or cold air entering their homes. In Study 1 (n = 43), householders who received a thermal image reduced their energy use at a 1-year follow-up, whereas householders who received a carbon footprint audit and a non-intervention control demonstrated no change. In Study 2 (n = 87), householders were nearly 5 times more likely to install draught proofing measures after seeing a thermal image. The effect was especially pronounced for actions that addressed an issue visible in the images. Findings indicate that using thermal imaging to make heat loss visible can promote energy conservation.