Disclosing donation decisions : the role of organ donor prototypes in an extended theory of planned behaviour

This study explored the role of donor prototype evaluations (perceptions of the typical organ donor) in organ donation communication decisions using an extended theory of planned behaviour (TPB) model. The model incorporated attitude, subjective norm, perceived behavioural control, moral norm, self-identity, and donor prototype evaluations to predict intentions to record consent on an organ donor register and discuss the organ donation decision with significant others. Participants completed surveys assessing the extended TPB constructs related to registering (n = 359) and discussing (n = 282). Results supported a role for donor prototype evaluations in predicting discussing intentions only. Both extended TPB structural equation models were a good fit to the data, accounting for 74 and 76% of the variance in registering and discussing intentions, respectively. Participants’ self-reported discussing behaviour (but not registering behaviour given low numbers of behavioural performers) was assessed 4 weeks later, with discussing intention as the only significant predictor of behaviour (Nagelkerke R2 = 0.11). These findings highlight the impact of people's perceptions of a typical donor on their decisions to discuss their organ donation preference, assisting our understanding of the factors influencing individuals' communication processes in efforts to bridge the gap between organ supply and demand.

Exploring donation decisions: Beliefs and preferences for organ donation in Australia

We explored common beliefs and preferences for posthumous and living organ donation in Australia where organ donation rates are low and little research exists. Content analysis of discussions revealed the advantage of prolonging/saving life whereas disadvantages differed according to donation context. A range of people/groups perceived to approve and disapprove of donation were identified. Barriers for posthumous donation included a family’s objection, with the type of organ needed important for living donation. Motivators included knowledge about potential organ recipients. Donation preferences favored loved ones, with weaker preferences for recipients who were perceived as morally questionable or responsible for their illness.

Minimising speaker verification utterance length through confidence based early verification decisions

This paper presents a novel approach of estimating the confidence interval of speaker verification scores. This approach is utilised to minimise the utterance lengths required in order to produce a confident verification decision. The confidence estimation method is also extended to address both the problem of high correlation in consecutive frame scores, and robustness with very limited training samples. The proposed technique achieves a drastic reduction in the typical data requirements for producing confident decisions in an automatic speaker verification system. When evaluated on the NIST 2005 SRE, the early verification decision method demonstrates that an average of 5–10 seconds of speech is sufficient to produce verification rates approaching those achieved previously using an average in excess of 100 seconds of speech.

Mobility and safety are conflicting goals for transport policy makers when making decisions about graduated driver licensing

Policy decisions are frequently influenced by more than research results alone. This review examines one road safety countermeasure, graduated driver licensing, in three jurisdictions and identifies how the conflict between mobility and safety goals can influence policy decisions relating to this countermeasure. Evaluations from around the world of graduated driver licensing have demonstrated clear reductions in crashes for young drivers. However, the introduction of this countermeasure may be affected, both positively and negatively, by the conflict some policy makers experience between ensuring individuals remain both mobile and safe as drivers. This review highlights how this conflict in policy decision making can serve to either facilitate or hinder the introduction of graduated driver licensing systems. However, policy makers whose focus on mobility is too strong when compared with safety may be mistaken, with evidence suggesting that after a graduated driver licensing system is introduced young drivers adapt their behaviour to the new system and remain mobile. As a result, policy makers should consciously acknowledge the conflict between mobility and safety and consider an appropriate balance in order to introduce these systems. Improvements to the licensing system can then be made in an incremental manner as the balance between these two priorities change. Policy makers can achieve an appropriate balance by using empirical evidence as a basis for their decisions.

Advance Directives Refusing Treatment as an Expression of Autonomy: Do the Courts Practise What They Preach?

The principle of autonomy is at the heart of the right of a competent individual to make an advance directive that refuses life-sustaining medical treatment, and to have that directive complied with by medical professionals. That right is protected by both the common law and, to an extent, by legislation that has been enacted in the United Kingdom and many jurisdictions in Australia. The courts have a critical role in protecting that autonomy, both in those jurisdictions in which the common law continues to operate, and in those jurisdictions which are now governed by statute, and in which judicial determinations will need to be made about legislative provisions. The problem explored in this article is that while the judiciary espouses the importance of autonomy in its judgments, that rhetoric is frequently not reflected in the decisions that are reached. In the United Kingdom and Australia, there is a relatively small number of decisions that consider the validity and applicability of advance directives that refuse life-sustaining medical treatment. This article critically evaluates all of the publicly available decisions and concludes that there is cause for concern. In some cases, there has been an unprincipled evolution of common law principles, while in others there has been inappropriate adjudication through operational irregularities or failure to apply correct legal principles. Further, some decisions appear to be based on a strained interpretation of the facts of the case. The apparent reluctance of some members of the judiciary to give effect to advance directives that refuse treatment is also evidenced by the language used in the judgments. While the focus of this article is on common law decisions, reference will also be made to legislation and the extent to which it has addressed some of the problems identified in this article.

Are organ donation communication decisions reasoned or reactive? A test of the utility of an augmented Theory of Planned Behaviour with the Prototype/Willingness Model

Objectives: To explore whether people's organ donation consent decisions occur via a reasoned and/or social reaction pathway. --------- Design: We examined prospectively students' and community members' decisions to register consent on a donor register and discuss organ donation wishes with family. --------- Method: Participants completed items assessing theory of planned behaviour (TPB; attitude, subjective norm, perceived behavioural control (PBC)), prototype/willingness model (PWM; donor prototype favourability/similarity, past behaviour), and proposed additional influences (moral norm, self-identity, recipient prototypes) for registering (N=339) and discussing (N=315) intentions/willingness. Participants self-reported their registering (N=177) and discussing (N=166) behaviour 1 month later. The utility of the (1) TPB, (2) PWM, (3) augmented TPB with PWM, and (4) augmented TPB with PWM and extensions was tested using structural equation modelling for registering and discussing intentions/willingness, and logistic regression for behaviour. --------- Results: While the TPB proved a more parsimonious model, fit indices suggested that the other proposed models offered viable options, explaining greater variance in communication intentions/willingness. The TPB, augmented TPB with PWM, and extended augmented TPB with PWM best explained registering and discussing decisions. The proposed and revised PWM also proved an adequate fit for discussing decisions. Respondents with stronger intentions (and PBC for registering) had a higher likelihood of registering and discussing. --------- Conclusions: People's decisions to communicate donation wishes may be better explained via a reasoned pathway (especially for registering); however, discussing involves more reactive elements. The role of moral norm, self-identity, and prototypes as influences predicting communication decisions were highlighted also.

Proof of causation in informed consent cases : establishing what the plaintiff would have done

A degree of judicial caution in accepting the assertion of a plaintiff as to what he or she would have done, if fully informed of risks, is clearly evident upon a review of decisions applying the common law. Civil liability legislation in some jurisdictions now precludes assertion evidence by a plaintiff. Although this legislative change was seen as creating a significant challenge for plaintiffs seeking to discharge the onus of proof of establishing causation in such cases, recent decisions suggest a more limited practical effect. While a plaintiff’s ex post facto assertions as to what he or she would have done if fully informed of risks may now be inadmissible, objective and subjective evidence as to the surrounding facts and circumstances, in particular the plaintiff’s prior attitudes and conduct, and the assertion evidence of others remains admissible. Given the court’s reliance on both objective and subjective evidence, statistical evidence may be of increasing importance.

Export decisions within Taiwanese electrical and electronic SMEs : the role of management characteristics and attitudes

In this globalized environment, Taiwanese firms have been very successful in achieving growth via international market expansion. In particular, the Taiwanese electronics industry has shown a dynamism lacking in comparable industries around the world. However, in recent years there has been a move by many of the larger Taiwanese manufacturing firms to outsource their manufacturing to low-cost producers such as China in order to remain competitive. Conversely, most Taiwanese small- to medium-sized enterprises (SMEs) have retained their production facilities in Taiwan. These SMEs seek to expand their sales beyond the domestic market by employing an export strategy, making a significant socioeconomic contribution to the domestic and regional economies. This paper highlights the key dimensions such as enhancing factors (benefits/advantages), inhibiting factors (barriers/costs), and managerial factors (characteristics/commitment) that play an important role in the internationalization of SMEs located within the Taiwanese electronics industry. A logistic regression model is used to predict the probability of a firm being an exporter.

Risky business : making decisions off the cuff

In line with accepted decision making theory, individuals engage in rational decision making. Decisions made under conditions of bounded rationality may have serious adverse consequences. Employees making decisions on behalf of their employer are often faced with situations where perfect and complete information is not available, and time is limited. Under such conditions, we posit that employees will make decisions that are increasingly bounded. At its most extreme neither time nor information is available to make a decision and rational decision making, bounded or not, reaches its limits. Many authors suggest that this is the point at which improvisation takes place. Although opinion in the literature is mixed regarding the efficacy of improvised decisions, we argue that improvised decisions place the organisation at considerable risk and as a consequence are undesirable.

How HCI design influences web security decisions

Even though security protocols are designed to make computer communication secure, it is widely known that there is potential for security breakdowns at the human machine interface. This paper reports on a diary study conducted in order to investigate what people identify as security decisions that they make while using the web. The study aimed to uncover how security is perceived in the individual's context of use. From this data, themes were drawn, with a focus on addressing security goals such as confidentiality and authentication. This study is the first study investigating users' web usage focusing on their self-documented perceptions of security and the security choices they made in their own environment.

Source of concern for IT purchasing decisions

The open source juggernaut seems to be gaining pace. The open source model certainly has appeal - cutting costs, while at the same time potentially increasing staff and system efficiencies. However, open source poses a number of significant legal challenges and risks for those that incorporate it. Clients need to look carefully before leaping.