Living life: mottos and logos on renal transplantation designed by high school students

Giorgina Barbara Piccoli1, Giorgio Soragna1, Elisabetta Mezza1, Manuel Burdese1, Valentina Consiglio1, Massimo Gai1, Franca Giacchino2 and Giuseppe Paolo Segoloni1

1 Section of Nephrology, University of Turin and 2 SC Nephrology and Dialysis, Ivrea Hospital, Italy

Correspondence and offprint requests to: Giorgina Barbara Piccoli, Cattedra di Nefrologia, Dipartimento di Medicina Interna, Corso Dogliotti 14, 10126 Torino, Italy. Email: gbpiccoli{at}hotmail.com

Keywords: kidney transplantation; organ donation; patient education



   Introduction
 Top
 Introduction
 Subjects and methods
 Results
 Discussion
 Conclusion
 References
 
The discrepancy between the supply of organs for transplantation and the clinical demand for them is a crucial issue in nephrology. To overcome this gap, several policies have been implemented to increase the general public's knowledge and awareness of the problem; accordingly, Italian law requires that transplantation medicine and end of life issues be discussed in high school [1,2].

In publicity or educational campaigns, the use of images to communicate core concepts is crucial to the success of any such initiative [3,4]. Furthermore, a commercial advertising campaign is usually preceded by a detailed market analysis and a study of the best way to present the product [5]. This approach is commonly employed by medical suppliers, and great attention (possibly too great) is paid to carefully advertising new drugs and products—with the extensive use of gadgets, gimmicks and colourful brochures in the process. In contrast, educational campaigns on crucial social issues, such as renal transplantation or organ donation, often are planned without help from experts working directly in the relevant professional fields and without analysing the opinions of the target population or ‘consumers’ (in this case, the patients and donors), often also without substantial help from public relation experts.

Few of us nephrologists have the opportunity to learn and discuss how our work is ‘viewed’ by persons not affected by renal disease or by those linked to us only socially (i.e. friends or non-professional relationships). With the preceding as background, the present experiment was conducted in an artistic high school in conjunction with its participation in a city-wide educational programme for high school students that was run by the Section of Nephrology of the University of Turin. This was an appropriate occasion to evaluate the way young people conceptualize the ‘idea’ of renal transplantation and how they would choose to communicate the ‘life and death’ concepts of renal replacement therapy, a crucial point in educational campaigns [6]. For this purpose, we organized a competition that was included in that school's programme.

Here we report on the results of the competition.



   Subjects and methods
 Top
 Introduction
 Subjects and methods
 Results
 Discussion
 Conclusion
 References
 
The school
The ‘Albe Steiner’ High School is oriented toward graphic arts. Like all Italian high schools, it provides a 5 year curriculum that includes general educational subjects plus specific programmes—in this particular case dedicated to graphic art, computer art and photography. The school promotes the participation of its students in art competitions to prepare them for the job market.

Every year, several competitions are organized in the school. Each student is free to enter as many as he or she wants. Usually no more than 20–25% of the students participate in each competition, while those who do not participate choose to do other work during the same school hours and as homework.

The competition was proposed by the Section of Nephrology to the teachers of the six classes of the 4th and 5th years of the high school (grades 12 and 13). Three of the six classes took part (median age 17 and 18 years). The students could choose to participate in the competition, or in others offered during the year. The theme of the competition was to create a motto or a logo on renal transplantation. The students were free to decide on the format, the medium and the subject of the work. The students were supported by the art teachers in the technical preparation of their works.

The educational campaign
The background educational campaign was run by the Section of Nephrology, University of Turin, in all the high schools of the city. It consisted of a 4 h programme (divided into two modules) that focused on renal diseases, dialysis and transplantation. The lessons informally described the major steps of the clinical and ethical decision-making pathways in the care of renal patients, from the diagnosis of renal disease to renal replacement therapy. Participants in the educational programme included practising nephrologists, nephrologists in training, patients and their relatives [7].

The award
The works were judged (independent scores on a 0–10 scale) by a jury composed of six patients, three patients' relatives, two nephrology trainees, one psychologist and one nephrologist, all of whom were also involved in the educational programme.

The participating students ceded the rights of ownership of their works to the Section of Nephrology, University of Turin, which was responsible for publicizing both the educational programme and the competition, and for guaranteeing the appropriate use of the works.

The initiative was supported by the Section of Nephrology and two non-profit organizations (Il Gallo di Esculapio ONLUS and the Fondazione Italiana del Rene) in the form of prizes for the winning students (first prize 500 Euros, second and third prizes 200 and 100 Euros, respectively, plus 12 special prizes consisting of 20 Euro gift vouchers for use in music or book stores).



   Results
 Top
 Introduction
 Subjects and methods
 Results
 Discussion
 Conclusion
 References
 
In total, 45 students entered the competition (out of ~80 in the participating classes) and 53 works were produced. The preferred medium of the entries was computer graphics (37 out of 53 works).

The works submitted by the competing students can be divided into three main groups. (i) Works with an image based on the profile of a kidney (the logos for the Section of Nephrology; the three prize-winning works are shown in Figure 1). The kidney outline was interpreted and used as the basis to design flowers or as a seed—alluding to the concept of incipient or newly flourishing life. The magic bean was chosen for the bottom corner logo of slides used in the university's nephrology courses, while the four-leaf clover logo was chosen as the background of all the presentations and slide shows regarding the educational programme at the schools (Figure 1). (ii) Works using unrelated images to convey a message relevant to renal transplantation. Figure 2 shows the winning entry: red cherries, with the motto, ‘One life leads to another,’ paraphrasing the Italian saying, ‘One cherry leads to another.’ The reason for awarding the first prize to this work was its strong visual impact and the message that emphasized the continuity of life. That entry is on display on the web page dedicated to the competition, at the website hosted by the Section of Nephrology (www.nefrologia.unito.it). (iii) Mainly abstract works in which the focus is not on the image but on the words (the mottos) that accompany it. The entries the jury found most interesting are depicted in Figure 3.



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Fig. 1. Logos for the Section of Nephrology: three prize-winning works. The magic bean: this image, dear to the lovers of fairy tales, was chosen for the bottom corner logo for the slides for the Section of Nephrology, and it is published on the website for university students. The four-leaf clover: this symbol of good luck was chosen as the background of all the public presentations dealing with our educational high school programme on renal diseases, dialysis and transplantation. The Jugendstil image: this image was used as the logo of the Section of Nephrology, University of Torino, in public presentations and slide forums.

 


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Fig. 2. The winner of the competition. One life leads to another.

 


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Fig. 3. Other significant logos. A life to live: two students submitted the same motto and offered two very dynamic graphic interpretations of the continuity of life. The little man profile: with a rounded profile, it is somewhat reminiscent of a kidney outline. It was chosen as the T-shirt logo for the association Il Gallo di Esculapio. To live life well: the small hearts, made of two kidneys, remind us of the universal symbol of love. Living life: this simple motto was chosen as the title of a book of interviews with renal graft patients.

 
The motto, ‘Living life,’ was chosen as the title of a collection of interviews with kidney transplant patients, soon to be published on our website. Two students shared the motto ‘A life to live’, giving it a very dynamic graphic interpretation.



   Discussion
 Top
 Introduction
 Subjects and methods
 Results
 Discussion
 Conclusion
 References
 
The results of the competition (Figures 1–3GoGo) provided the members of the Section of Nephrology with the unique opportunity to evaluate directly how a group of teenaged graphic arts students would ‘advertise’ a programme on renal transplantation. In general, the subject aroused the students' interest, and about half of the students in the participating classes took part in the competition.

The first creative approach that can be discerned in the entries is the choice of strong concepts, without paraphrases.

‘Life’ is the most commonly used word in the mottos, and the concept of continuity of life is underlined in different ways: from the magic bean giving life to a tree, to the spiral of life of the winning motto (Figures 1–3GoGo).

The winner of the first prize (Figure 2) used a red image (cherries), which combined two opposite suggestions: red is the colour of blood with a strong and potentially negative impact on the observer, but cherries are a symbol of summer, usually linked with the positive ideas of sunshine and warm weather. Similarly, the motto coupled to this image, ‘One life leads to another,’ is reminiscent of an Italian saying that conveys the idea that once you start eating cherries it is difficult to stop. This explicitly defines the chain of life (one link giving rise to another) in both of its transitional implications (life for a better life, and life from death). This double meaning was clearly understood and highly valued by the jury; interestingly, none of the patients or relatives in the jury found it disturbing. Indeed, the strong impact of the image was considered one of its merits.

The continuity of life was also implicit in the winning motto, ‘Living life’, whose essentiality and straightforwardness were appreciated, together with those of its variants such as ‘A life to live’. As directly confirmed by the students and teachers during the awards ceremony, the choice of these similar, albeit not identical, themes testifies to the vigorous discussions of these subjects among the students in their classes.

Interestingly, none of the mottos or logos mentioned or alluded to death—in contrast to symbols used in several other educational campaigns in Italy and elsewhere (‘Donate the breath of life’; ‘From one broken life another can be healed’).

All the images to which the jury awarded prizes are examples of a positive outlook on renal transplantation. This optimistic attitude probably is the result of several factors: the teaching at the school, where the students learn to focus advertising campaigns on the positive aspects of a product; our educational programme, which exposed students to a vast array of the aspects of dialysis and transplantation, which were seen as a way both to save life and to allow a ‘good’ life for the patients; and the ‘omnipotent’ attitude that teenagers have in these times. Their straightforward approach was shared by those patients and relatives who were part of the jury and who unhesitatingly chose the most cheerful and explicit images and phrases, those which described their own lives.



   Conclusion
 Top
 Introduction
 Subjects and methods
 Results
 Discussion
 Conclusion
 References
 
Through their works, the students who took part in the competition for the best logo and motto on renal transplantation looked on the bright side of the complex and often difficult life of someone on renal replacement therapy. This positive outlook is a precious resource, and it should be considered when planning educational campaigns for teenagers.



   Acknowledgments
 
The prizes for the competition were kindly donated by Il Gallo di Esculapio ONLUS and the Fondazione Italiana del Rene ONLUS. We wish to thank the high school working group: Rosanna Dell'Olio, Daniele Daghero, Luca Gentile, Lino Longo, Bruno Petroni, Enza Macaluso, Carlo Peccarrisi and Antonio Santoro who ran the sensitization programme talking to the students about their experience in the field, the teachers of the ‘Albe Steiner’ High School and, in particular, Daniela Baldini who made this project possible, Carlo Vespertino, who helped us with the exhibition of the art work, and all participating students, whose logos and mottos remind us of their cheerful and direct approach to life and death.

Conflict of interest statement. None declared.



   References
 Top
 Introduction
 Subjects and methods
 Results
 Discussion
 Conclusion
 References
 

  1. Cantarovich F, Fagundes E, Biolcati D, Bacque MC. School education, a basis for positive attitudes toward organ donation. Transplant Proc 2000; 32: 55–56[CrossRef][ISI][Medline]
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  3. Moll JM. Doctor–patient communication in rheumatology: studies of visual and verbal perception using educational booklets and other graphic material. Ann Rheum Dis 1986; 45: 198–209[Abstract]
  4. Videlier P, Pira P. Health in strip cartoons. World Health Forum 1990; 11: 14–31[Medline]
  5. Icard LD, Bourjolly JN, Siddiqui N. Designing social marketing strategies to increase African Americans' access to health promotion programs. Health Soc Work 2003; 28: 214–223[ISI][Medline]
  6. Jasper JD, Harris RJ, Lee BC, Miller KE. Organ donation terminology: are we communicating life or death? Health Psychol 1991; 10: 34–41[CrossRef][ISI][Medline]
  7. Piccoli GB, Soragna G, Putaggio S et al. Efficacy of an educational program on dialysis, renal transplantation and organ donation on the opinions of high school students: a randomized controlled trial. Transplant Proc 2004; 36: 431–432[CrossRef][ISI][Medline]




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