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.

Determining the psychosocial predictors of living, living-related, and posthumous organ donation

The worldwide organ shortage occurs despite people’s positive organ donation attitudes. The discrepancy between attitudes and behaviour is evident in Australia particularly, with widespread public support for organ donation but low donation and communication rates. This problem is compounded further by the paucity of theoretically based research to improve our understanding of people’s organ donation decisions. This program of research contributes to our knowledge of individual decision making processes for three aspects of organ donation: (1) posthumous (upon death) donation, (2) living donation (to a known and unknown recipient), and (3) providing consent for donation by communicating donation wishes on an organ donor consent register (registering) and discussing the donation decision with significant others (discussing). The research program used extended versions of the Theory of Planned Behaviour (TPB) and the Prototype/Willingness Model (PWM), incorporating additional influences (moral norm, self-identity, organ recipient prototypes), to explicate the relationship between people’s positive attitudes and low rates of organ donation behaviours. Adopting the TPB and PWM (and their extensions) as a theoretical basis overcomes several key limitations of the extant organ donation literature including the often atheoretical nature of organ donation research, thefocus on individual difference factors to construct organ donor profiles and the omission of important psychosocial influences (e.g., control perceptions, moral values) that may impact on people’s decision-making in this context. In addition, the use of the TPB and PWM adds further to our understanding of the decision making process for communicating organ donation wishes. Specifically, the extent to which people’s registering and discussing decisions may be explained by a reasoned and/or a reactive decision making pathway is examined (Stage 3) with the novel application of the TPB augmented with the social reaction pathway in the PWM. This program of research was conducted in three discrete stages: a qualitative stage (Stage 1), a quantitative stage with extended models (Stage 2), and a quantitative stage with augmented models (Stage 3). The findings of the research program are reported in nine papers which are presented according to the three aspects of organ donation examined (posthumous donation, living donation, and providing consent for donation by registering or discussing the donation preference). Stage One of the research program comprised qualitative focus groups/interviews with university students and community members (N = 54) (Papers 1 and 2). Drawing broadly on the TPB framework (Paper 1), content analysed responses revealed people’s commonly held beliefs about the advantages and disadvantages (e.g., prolonging/saving life), important people or groups (e.g., family), and barriers and motivators (e.g., a family’s objection to donation), related to living and posthumous organ donation. Guided by a PWM perspective, Paper Two identified people’s commonly held perceptions of organ donors (e.g., altruistic and giving), non-donors (e.g., self-absorbed and unaware), and transplant recipients (e.g., unfortunate, and in some cases responsible/blameworthy for their predicament). Stage Two encompassed quantitative examinations of people’s decision makingfor living (Papers 3 and 4) and posthumous (Paper 5) organ donation, and for registering and discussing donation wishes (Papers 6 to 8) to test extensions to both the TPB and PWM. Comparisons of health students’ (N = 487) motivations and willingness for living related and anonymous donation (Paper 3) revealed that a person’s donor identity, attitude, past blood donation, and knowing a posthumous donor were four common determinants of willingness, with the results highlighting students’ identification as a living donor as an important motive. An extended PWM is presented in Papers Four and Five. University students’ (N = 284) willingness for living related and anonymous donation was tested in Paper Four with attitude, subjective norm, donor prototype similarity, and moral norm (but not donor prototype favourability) predicting students’ willingness to donate organs in both living situations. Students’ and community members’ (N = 471) posthumous organ donation willingness was assessed in Paper Five with attitude, subjective norm, past behaviour, moral norm, self-identity, and prior blood donation all significantly directly predicting posthumous donation willingness, with only an indirect role for organ donor prototype evaluations. The results of two studies examining people’s decisions to register and/or discuss their organ donation wishes are reported in Paper Six. People’s (N = 24) commonly held beliefs about communicating their organ donation wishes were explored initially in a TPB based qualitative elicitation study. The TPB belief determinants of intentions to register and discuss the donation preference were then assessed for people who had not previously communicated their donation wishes (N = 123). Behavioural and normative beliefs were important determinants of registering and discussing intentions; however, control beliefs influenced people’s registering intentions only. Paper Seven represented the first empirical test of the role of organ transplant recipient prototypes (i.e., perceptions of organ transplant recipients) in people’s (N = 465) decisions to register consent for organ donation. Two factors, Substance Use and Responsibility, were identified and Responsibility predicted people’s organ donor registration status. Results demonstrated that unregistered respondents were the most likely to evaluate transplant recipients negatively. Paper Eight established the role of organ donor prototype evaluations, within an extended TPB model, in predicting students’ and community members’ registering (n = 359) and discussing (n = 282) decisions. Results supported the utility of an extended TPB and suggested a role for donor prototype evaluations in predicting people’s discussing intentions only. Strong intentions to discuss donation wishes increased the likelihood that respondents reported discussing their decision 1-month later. Stage Three of the research program comprised an examination of augmented models (Paper 9). A test of the TPB augmented with elements from the social reaction pathway in the PWM, and extensions to these models was conducted to explore whether people’s registering (N = 339) and discussing (N = 315) decisions are explained via a reasoned (intention) and/or social reaction (willingness) pathway. Results suggested that people’s decisions to communicate their organ donation wishes may be better explained via the reasoned pathway, particularly for registering consent; however, discussing also involves reactive elements. Overall, the current research program represents an important step toward clarifying the relationship between people’s positive organ donation attitudes but low rates of organ donation and communication behaviours. Support has been demonstrated for the use of extensions to two complementary theories, the TPB and PWM, which can inform future research aiming to explicate further the organ donation attitude-behaviour relationship. The focus on a range of organ donation behaviours enables the identification of key targets for future interventions encouraging people’s posthumous and living donation decisions, and communication of their organ donation preference.

Design of decoupling networks for circulant symmetric antenna arrays

Small element spacing in compact arrays results in strong mutual coupling between array elements. Performance degradation associated with the strong coupling can be avoided through the introduction of a decoupling network consisting of interconnected reactive elements. We present a systematic design procedure for decoupling networks of symmetrical arrays with more than three elements and characterized by circulant scattering parameter matrices. The elements of the decoupling network are obtained through repeated decoupling of the characteristic eigenmodes of the array, which allows the calculation of element values using closed-form expressions.

Single-layer decoupling networks for circulant symmetric arrays

Reduced element spacing in antenna arrays gives rise to strong mutual coupling between array elements and may cause significant performance degradation. These effects can be alleviated by introducing a decoupling network consisting of interconnected reactive elements. The existing design approach for the synthesis of a decoupling network for circulant symmetric arrays allows calculation of element values using closed-form expressions, but the resulting circuit configuration requires multilayer technology for implementation. In this paper, a new structure for the decoupling of circulant symmetric arrays of more than four elements is presented. Element values are no longer obtained in closed form, but the resulting circuit is much simpler and can be implemented on a single layer.

Dual-frequency decoupling networks for compact antenna arrays

Decoupling networks can alleviate the effects of mutual coupling in antenna arrays. Conventional decoupling networks can provide decoupled and matched ports at a single frequency. This paper describes dual-frequency decoupling which is achieved by using a network of series or parallel resonant circuits instead of single reactive elements.

Studies on the target conditioning for deposition of $LiCoO_{2}$ films

Deposition of good quality thin films of Lithium Cobalt Oxide (LiCoO2), by sputtering is preceded by target conditioning, which dictates the surface composition, morphology and electrochemical performance of the deposited film. Sputtering from a Virgin target surface, results in films with excess of the more reactive elements. The concentration of these reactive elements in the films decreases until the system reaches a steady state after sufficient sputtering from the target. This paper discusses the deposition kinetics in terms of target conditioning of LiCoO2. The composition, morphology and texturing of deposited film during various hours of sputtering were analyzed using X-ray photoelectron Spectroscopy (XPS) and Field Emission Scanning electron microscopy (FESEM). The compositional stability is not observed in the films formed during the initial hours or Sputtering from the fresh target, which becomes stable after several hours of sputtering. The Li and Co concentration in the Films deposited subsequently is found to be varying and possible causes are discussed. After the compositional stability is reached, electrochemical analysis of LiCoO2 thin films was performed, which shows a discharge capacity of 129 mu Ah/cm(2).

On the study of a third-order mechanical oscillator

In this paper, the study of a third-order mechanical oscillator is presented by demonstrating its equivalence to the well-known R.C. multivibrator with two additional reactive elements. The conditions for the oscillator's possession of periodic solutions are presented. It is also shown that under certain conditions, the study of the given third-order autonomous system can be reduced to the study of an equivalent second-order, non-autonomous system.

Synthesis of positive-real functions with low-complexity series-parallel networks

The purpose of this paper is to continue to develop the recently introduced concept of a regular positive-real function and its application to the classification of low-complexity two-terminal networks. This paper studies five- and six-element series-parallel networks with three reactive elements and presents a complete characterisation and graphical representation of the realisability conditions for these networks. The results are motivated by an approach to passive mechanical control which makes use of the inerter device. ©2009 IEEE.

On the theorem of Reichert

This paper reworks and amplifies Reichert's proof of his theorem (1969) which asserts that any impedance function of a one-port electrical network which can be realised with two reactive elements and an arbitrary number of resistors can be realised with two reactive elements and three resistors. © 2012 Elsevier B.V. All rights reserved.

Series-parallel six-element synthesis of biquadratic impedances

The object of this paper is to give a complete treatment of the realizability of positive-real biquadratic impedance functions by six-element series-parallel networks comprising resistors, capacitors, and inductors. This question was studied but not fully resolved in the classical electrical circuit literature. Renewed interest in this question arises in the synthesis of passive mechanical impedances. Recent work by the authors has introduced the concept of a regular positive-real functions. It was shown that five-element networks are capable of realizing all regular and some (but not all) nonregular biquadratic positive-real functions. Accordingly, the focus of this paper is on the realizability of nonregular biquadratics. It will be shown that the only six-element series-parallel networks which are capable of realizing nonregular biquadratic impedances are those with three reactive elements or four reactive elements. We identify a set of networks that can realize all the nonregular biquadratic functions for each of the two cases. The realizability conditions for the networks are expressed in terms of a canonical form for biquadratics. The nonregular realizable region for each of the networks is explicitly characterized. © 2004-2012 IEEE.

A DC-DC converter based on the three-state switching cell for high current and voltage step-down applications

This paper presents a pulsewidth modulation dc-dc nonisolated buck converter using the three-state switching cell, constituted by two active switches, two diodes, and two coupled inductors. Only part of the load power is processed by the active switches, reducing the peak current through the switches to half of the load current, as higher power levels can then be achieved by the proposed topology. The volume of reactive elements, i.e., inductors and capacitors, is also decreased since the ripple frequency of the output voltage is twice the switching frequency. Due to the intrinsic characteristics of the topology, total losses are distributed among all semiconductors. Another advantage of this converter is the reduced region for discontinuous conduction mode when compared to the conventional buck converter or, in other words, the operation range in continuous conduction mode is increased, as demonstrated by the static gain plot. The theoretical approach is detailed through qualitative and quantitative analyses by the application of the three-state switching cell to the buck converter operating in nonoverlapping mode $(D < 0.5)$. Besides, the mathematical analysis and development of an experimental prototype rated at 1 kW are carried out. The main experimental results are presented and adequately discussed to clearly identify its claimed advantages. © 1986-2012 IEEE.

Conversor buck utilizando célula de comutação de três estados

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Célula de comutação de três estados aplicada ao pré-regulador boost de estágio único e elevado fator de potência

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Efeito protetor da flavana extraída da espécie Brosimum acutifolium contra danos causados por hipóxia em células retinianas: um estudo in vitro

O acidente vascular cerebral isquêmico (AVCi) causa danos celulares por provocar intensa excitotoxicidade e estresse oxidativo após privação de oxigênio e glicose para uma região do encéfalo. Neste trabalho, investigamos o potencial neuroprotetor da planta amazônica Brosimum acutifolium que é rica em flavanas como a 4',7-diidroxi-8-(3,3-dimetilalil)flavana (brosimina b, aqui abreviada como Bb) que apresenta elevado potencial antioxidante. Utilizamos cultura de células retinianas de embrião de galinha submetidas a hipóxia experimental, por privação de oxigênio e glicose, para avaliarmos o potencial antioxidante da Bb através da análise do sequestro do radical 2,2-difenil-1-picril-hidrazil (DPPH). Além disso, avaliamos a viabilidade celular (VC) e o perfil oxidativo e antioxidativo após 3, 6 e 24 horas de hipóxia, pela produção de oxigênio reativo (O₂^-) e atividade antioxidante endógena pela enzima catalase, respectivamente. Nossos resultados demonstram que nosso modelo experimental de hipóxia in vitro provoca redução tempo-dependente da VC, acompanhada por intenso estrese oxidativo, devido à excessiva produção de oxigênio reativo (O₂^-). O tratamento com Bb (10μM) protegeu significativamente a viabilidade celular durante 3 e 6 h de hipóxia experimental em células retiniana cultivadas in vitro, além de favorecer o aumento da atividade da enzima catalase em todos os tempos testados. Desta forma, concluímos que a Bb possui ação antioxidante e neuroprotetor por contribuir na defesa contra o estresse oxidativo induzido em condições de hipóxia, tornando-se como uma droga com potencial uso em tratamentos em casos de AVCi in vivo.

Comparative analysis between overlapping and non-overlapping operation modes for the PWM buck converter using the three-state switching cell

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)