Organ Donation and Transplantation in India: An Inquiry in Kerala

Until recently, financial incentive was the prime motivation in transplantation of kidneys from nonrelated living donors in India. Prior to the Human Organ Transplantation Act of 1994, it was legal in all states of India to purchase and merchandise organs, eliminating the opportunity for black markets currently created by the enormous demand for organs. Eight years later, the question remains on how if at all The Act has changed the way organ donation is viewed and conducted in India. This study reveals attitudes and beliefs about organ donation in India from the perspectives of the doctors and the public. Interviewees expressed concerns and fears over the implementation of The Act. Mistrust of the medical profession and concerns about illegal buying and selling of organs were some major issues brought forth by the public. Additional issues were the need for public education, advertisement, and role models to promote organ donation in India. All interviewees had prior knowledge of organ donation and did not require explanation of the concept. No one interviewed was opposed to organ donation. Many participants were aware of organ donation through Ashwaria Roy, a former Miss World who does advertising campaigns promoting cornea donation in India.     

Changing college student perceptions and participation in organ donation: A classroom and service learning intervention

Each day an average of 18 people die from the lack of available organs for transplantation and the demand for organ, eye and tissue donation continues to vastly exceed the number of available donors. The single most effective method in addressing this issue remains programmatic efforts to encourage and support organ donation. The purpose of this article is to introduce a creative and comprehensive approach to enhance awareness, participation and organ donor registry among young adults. The programmatic intervention utilized a service learning model within a Freshman Year Seminar course focused on organ donation. The partnership between classroom-based curriculum and experiential learning served to increase knowledge and enhance positive attitudes toward organ donation, as measured by pre-post tests and student reflections in portfolio assessments. The number of organ donor registrants was increased as a result of student outreach activities. Results are discussed in terms of implications for increasing donation.     

Human Organ Donation: Does Knowledge Correlate with Intention?

Abstract

One increasing form of social distress in the USA today is the increasing number of ill Americans who die while awaiting a life-saving organ (Satel, 2008). While organ donation is a life saving practice supported by 95 per cent of Americans, only half of the U.S. population is registered to donate organs. To explore this discrepancy between attitudes and behaviors relating to organ donation, 135 New Yorkers completed an anonymous 25-item survey to assess individuals' accurate knowledge of organ donation and their organ donor practices. Results support the researchers' two hypotheses: (a) individuals who possess more accurate information about organ donation practices are more likely to be organ donors (r=.225, p<.01) and (b) are more likely to have had experience with organ donation, either directly or indirectly (r =.247, p <.01). These findings have implications for the organ donation community, specifically the focus of campaigns that seek to increase the number of registered organ donors.     

Our bodies, our families. The family's role in organ donation

The 1968 Uniform Anatomical Gift Act--in keeping with a legal (and medical) concern for individual autonomy--bypassed the family in establishing the legal requirements for cadaveric organ donation, but current practice wisely recognizes a role for families in the decision making.     

Cultures of the soul: spiritual beliefs about organ donation in China and the United States

Spiritual beliefs shape ideas about the meaning of life, the moment of death, and the care that must be taken to deliver the body of the loved one to the spiritual realm. This study investigated spiritual beliefs about organ donation for participants in China (n = 364) and the United States (n = 384). Results showed that spiritual connection with the transplant recipient, spiritual concern about removing organs, and attitudes toward organ donation significantly predicted willingness to become an organ donor for participants in both countries. Americans reported being significantly more religious compared to Chinese. However, altruism and religiosity were not significant predictors of willingness to donate organs. Chinese participants showed significantly higher levels of spiritual connection with the potential recipient of transplanted organs. Even so, Chinese participants exhibited more reluctance to become organ donors compared to Americans. Gender differences in organ donation behaviors are also reported. The study discusses the implications of the findings for structuring organ procurement campaigns that will address spiritual beliefs about organ donation.     

Public Attitudes Toward the Ethics of Organ Donation

Abstract

This study expanded on previous investigations exploring public attitudes toward the human rights issues involved in organ donation practices and personal support for these practices. Participants included college and graduate students, and senior citizens (N = 99). Attitudes were assessed prior to and following the presentation of a brief informational DVD on major organ donation practices. Results indicated that participants were largely divided in their attitudes toward human rights issues, as well as in personal support for donation practices. Registration status was correlated with education, r = .47, p < .001. Support for donation incentive programs varied. Registered donors showed a change in attitudes toward human rights issues, t(22) = 2.18, p = .04. For non-registered donors, personal support for donation practices decreased after viewing the DVD, t(51) = - 3.06, p = .004. Results are discussed in terms of implications for increasing donation.     

THE EFFECT OF CADAVERIC KIDNEY DONATIONS ON LIVING KIDNEY DONATIONS: AN INSTRUMENTAL VARIABLES APPROACH

Transplantation is notable for the degree to which resources are allocated via administrative rather than market mechanisms. However, non‐monetary incentives still permeate the system. Using instrumental variable regression, we estimate the substitution patterns between cadaveric and living kidney donations in the United States from 1988 to 2008. On average, a decrease of two to five cadaveric donations causes living kidney donations to increase by one. Disaggregating living donors into blood‐related and non‐blood‐related donors, the strongest effect is found among non‐blood‐related donors known to the organ recipient. A 1% increase of cadaveric donations decreases living donations from this group by 1.54%. (JEL D62, D64, I1)     

The independent living movement in Asia: solidarity from Japan

Independent living movements of disabled people are emerging in Asian countries, supported by independent living centres (ILCs) in Japan. A study was conducted in Japan to explore the impact of the training program offered by Japanese ILCs to disabled people from other Asian countries. A sample of 35 people was selected by a snowballing method. The sample included former trainees from Asian countries and Japanese personnel from disability organizations involved with the training program. In‐depth interviews and a focus group were conducted to obtain information about the program, the experiences of the trainees and Japanese hosts and the budding independent living movement in Asia.     

Exploring the Use of the Stages of Change Model to Increase Organ Donations Among African Americans

Abstract

The success of organ transplants is affected by the degree of antigen match between donor and recipient. With organ transplants among African Americans, finding a good antigen match is difficult. While the consent rate for organ donations among Caucasians is 50%, this rate among African Americans is only 12%. The resulting ratio of donors to “recipients” is 1 to 9 in African Americans. The majority of organs received by African Americans come from Caucasian donors, thereby reducing the probability of an antigen match and increasing the probability of organ rejection. These circumstances could be improved if the organ donation rate eamong African Americans was increased. There is some empirical support for the theory that behavior change occurs through identifiable stages. This paper presents evidence for the construct validity of a stage of change measure suitable for use in designing and evaluating attempts to promote organ donations in the African American community. Use of this measure also permits clinicians to assess how receptive a client will be to organ donation promotional material. Use of this measure offers the possibility of refining approaches to organ donations among African Americans. Increases in the donor rate will result in a larger pool of antigen compatible organs in this subpopulation.     

Reducing Public Misinformation About Organ Donation: An Experimental Intervention

Abstract

The shortage of life-saving human organs for transplantation today is a growing and international problem. A recent survey in this Journal found that people with “more accurate information about organ donation practices are more likely to be organ donors (r= .225, p< .01)” (Nickols, Stack, Viviano, & Whitney, 2008, p. 240). How much can a factual 20-minute message about organ donation significantly increase people's knowledge and pro-donation behavior? In this field experiment, 101 students in two urban colleges completed a one-page survey before and after an expert's 20-minute message. The survey assessed participants' knowledge about organ donation from 0 (low) to 40 (high), biodata, self-reported experiences, and behavior in the past (registered organ donor) and future (consider becoming a donor). As hypothesized: (1) Pre-message knowledge about organ donation was moderate (mean = 21.8 on the 0-40 scale), and rose significantly after the message (mean = 28.6, p < .01). (2) This knowledge positively correlated with consideration to register in the future as an organ donor (r = +.41; p < .001 post-presentation). (3) However, there was no significant correlation of prior donor registration with knowledge prior to the message (r = +.08) or after the message (r = +.04). From these findings, it seems a brief FAQ fact-sheet or DVD would be highly useful to increase people's accurate knowledge about donations.     

The challenge of an aging work force: keeping older workers employed and employable

This article reviews labor-force trends and older-worker employment policies in Japan and the United States. Both countries have aging work forces, but Japan's labor force is and for some time has been older than that of the United States. Japan's Ministry of Labor began addressing older-worker issues over 30 years ago and in the ensuing years has promulgated numerous initiatives to extend working life. Mandatory retirement, however, remains both legal and common in Japan, yet labor-force participation rates are higher for older persons in that country than in the United States, where mandatory retirement is illegal. Japan's older-worker programs and policies clearly seem to have an impact on labor-force rates, although those rates are dropping among the elderly in Japan as well as in the United States. The transferability of these programs and policies to the United States is discussed.     

The Challenge of an Aging Work Force

This article reviews labor-force trends and olderworker employment policies in Japan and the United States. Both countries have aging work forces, but Japan's labor force is and for some time has been older than that of the United States. Japan's Ministry of Labor began addressing older-worker issues over 30 years ago and in the ensuing years has promulgated numerous initiatives to extend working life. Mandatory retirement, however, remains both legal and common in Japan, yet labor-force participation rates are higher for older persons in that country than in the United States, where mandatory retirement is illegal. Japan's older-worker programs and policies clearly seem to have an impact on labor-force rates, although those rates are dropping among the elderly in Japan as well as in the United States. The transferability of these programs and policies to the United States is discussed.     

Comparing Public Attitudes towards Aid to Developing Countries between ‘Traditional’ and ‘Emerging’ Donors: The Case of Japan and Korea

This article explores public attitudes towards aid to developing countries in ‘traditional’ donors and ‘emerging’ donors, taking Japan as an example of the former and Korea as one of the latter. Analyses of comparative social survey data show differences and similarities between the attitudes harboured by the respondents in the two countries. Although previous cross‐national studies included only traditional donors in their analyses, the results of this study reveal the need to focus on the attitude towards aid in emerging donors, especially given their increasing presence in the international aid community.     

Profiling Donors of Blood,Money, and Time

Understanding donor profiles is crucial for donor relationship management. Whereas previous research has focused on profiling blood, money, or time donor segments separately, we define seven donor profiles based on their former donation behavior for blood, money, and time donation and compare them to non‐donors. Relying on representative data from the German Socio Economic Panel, we use an extensive set of characteristics that include sociodemographic, psychographic, health‐related, and geographical measures and simultaneously investigate profiles of donors for single and multiple donation forms and non‐donors by means of a multinomial logistic model. Our results reveal valuable insights for donor acquisition and retention strategies of nonprofit organizations along the identified profiling characteristics of donor segments. By this, our findings help nonprofit organization managers to better target single and multiple donors across three donation forms.     

Do values explain the low employment levels of Muslim women around the world? A within‐ and between‐country analysis

Using worldwide data from the World Values Survey (WVS) gathered in 2010–2014, we examine two distinct ways in which Islam may be associated with women's employment. We show that, within their countries, Muslim women are less likely to be employed than women of other religions. We also examine between‐country differences and find that, net of education and family statuses, the employment levels of women living in countries that are 90–100 per cent Muslim are not significantly different than those living in countries that are only 0–20 per cent Muslim. Then we test a prevailing view: that Islam discourages gender egalitarian values, and that these values – held by women themselves or people around them – explain why Muslim women are less likely to be employed than women of other religions within their own countries. Despite the rich measures of values in the WVS and a large sample, we find no evidence that values explain any of the lower employment of Muslim women, mainly because values have little or no effect on women's employment. Thus, we conclude that most of the world's gap in employment between Muslim women and other women is within‐country and is not explained by gender ideology. Future research should examine alternative hypotheses, including ethno‐religious discrimination.     

Contingent Work Rising: Implications for the Timing of Marriage in Japan

Employment has become increasingly precarious in developed countries, meaning that, for many young adults, jobs provide neither benefits nor security, more work is part time, and employers are increasingly hiring workers from temporary help agencies and contract companies rather than as employees of their own company. These changes in employment relations have profound effects on gender roles and on family transitions of young adults, especially young men and in particular in countries such as Japan, where there are rigid family norms and the male‐breadwinner tradition still prevails. The authors examined the effects of the experience of non‐regular work on the timing of marriage and whether this differs by sex. Using recent life history data from Japan, they found that men working in non‐regular jobs are especially likely to postpone marriage. The implications of the growth of precarious work for changes in work and family institutions in Japan are discussed.     

Change in Work‐Family Conflict Among Employed Parents Between 1977 and 1997

Using data from two national surveys (N = 2,050), this paper examines what accounts for the increase in the sense of work‐family conflict among employed parents between 1977 and 1997. Decomposition analysis indicates that the increases in women’s labor force participation, college education, time pressure in completing one’s job, and the decline in free time were related to the increase. Fathers in dual‐earner marriages experienced a particular increase in work‐family conflict. With the same amount of time spent with children, parents felt greater work‐family conflict in 1997 than in 1977. Although masked by the overall increase, some trends, such as the increases in intrinsic job rewards, time with children, and egalitarian gender attitudes, contributed to a decline in work‐family conflict.     

The Well‐Being of Adolescents in Households With No Biological Parents

On the basis of a large, nationally representative sample of 19,071 American middle‐school students, the current study compares adolescents living with neither biological parent with their peers in five other family structures on a wide range of outcome measures. The results reveal some overall disadvantages of living with neither parent, although the disadvantages relative to nontraditional families are limited. Differences in family resources either partially or completely account for outcome differences between non‐biological‐parent and other family structures. Further, boys and girls in non‐biological‐parent families appear to fare similarly. Finally, measurement problems and their implications are discussed.     

Life Satisfaction Among Children in Different Family Structures: A Comparative Study of 36 Western Societies

This paper examines differences in life satisfaction among children in different family structures in 36 western, industrialised countries (n = 184 496). Children living with both biological parents reported higher levels of life satisfaction than children living with a single parent or parent–step‐parent. Children in joint physical custody reported significantly higher levels of life satisfaction than their counterparts in other types of non‐intact families. Controlling perceived family affluence, the difference between joint physical custody families and single mother or mother–stepfather families became non‐significant. Difficulties in communicating with parents were strongly associated with less life satisfaction but did not mediate the relation between family structure and life satisfaction. Children in the Nordic countries characterised by strong welfare systems reported significantly higher levels of life satisfaction in all living arrangements except in single father households. Differences in economic inequality between countries moderated the association between certain family structures, perceived family affluence and life satisfaction.     

Work,Refuge, Transit: An Emerging Pattern of Irregular Immigration South and East of the Mediterranean

Southern and Eastern Mediterranean (SEM) countries have recently turned into receivers of migrants, but they have neither the institutions nor the policies that would allow them to integrate migrants. Therefore, most migrants in SEM countries found themselves in irregular situation. Using a variety of statistical sources, official and non‐official, the article establishes that out of 5.6 million immigrants living in SEM countries in the mid‐2000s, a minimum of 3.6 would be in irregular situation. They belong to three categories: approximately 2 million migrant workers attracted by SEM labour markets where they are employed in the informal sector with no work permit, 1.5 million de facto refugees who cannot obtain the status of refugee and are waiting for resettlement in a third country or return to their homes, and less than 200,000 transit migrants initially bound for Europe, which they are unable to reach for lack of visa. While their reasons to be stranded in the SEM differ, these three categories share the same vulnerable conditions, with no legal access to work, services, or protection.