No abstract

The objective of this paper was to explore the challenges identified by four health professionals working with families who misuse drugs in relation to family parenting responsibilities. Participants included a midwife, a public health nurse, a general practitioner and a specialist addiction nurse.The paper explored self reflections by the participants of their practice in a primary care setting.Three challenges were identified: family focused care; ethical considerations; and the need for a supported learning environment.The paper proposes consideration of appropriately funded, mandatory joint training supported through a learning organisation approach within the NHS.

Organ transplantation is a life-saving treatment for patients with end-organ failure. In 2018, there were ≈17 000 living and deceased donors leading to >36 000 transplants performed in the United States. 1 However, the waiting list continues to exceed 100 000 patients, and expansion of the donor pool remains an active issue in the transplant community. Imminent death donation (IDD) has been proposed as an additional option for organ donation that may increase the quantity and quality of organs available for transplant. 2 IDD is described as recovery of a living donor organ immediately prior to an impending and planned withdrawal of ventilator support expected to result in the patient's death. 3 Preliminary studies suggest that IDD would likely increase the available number and quality of organs available for transplantation. One study from a Wisconsin hospital extrapolated a potential of 6000-31 000 kidneys that could be donated annually in the US via IDD based on calculations using number of annual deaths with normal renal function and percentage of those willing