Improving compliance with medical fitness to drive reviews: The role of behaviourally-optimised letters

To manage the increased crash risk posed by drivers with medical conditions and impairments, many licensing authorities ask high-risk drivers to undergo medical fitness to drive assessments. Maximising drivers’ compliance and satisfaction with these assessments is an ongoing challenge for these authorities. This study tested whether drivers’ compliance and satisfaction with a licensing authority’s request to provide a medical report could be improved by incorporating two applied behaviour change principles – simplified messaging and procedural fairness – into the authority’s request letter. Drivers undergoing medical review (N = 876) were assigned to receive either a standard request letter currently used by the authority, or a revised letter that incorporated simplified messaging and procedural fairness amendments. Drivers who received the revised letter were significantly more likely to submit a medical report by the due date. Additionally, of the drivers who submitted the report, those who received the revised letter submitted the report an average of four days faster than those who received the standard letter. These findings demonstrate that optimising letters using behavioural principles can improve compliance with licensing authorities’ requests, resulting in substantial time and cost savings for licensing authorities, possible road safety benefits, and potential reductions in the number of licences suspended for failure to provide a report.     

Cycling under the influence of alcohol in Germany

Cyclists have a relatively high risk of being injured in traffic accidents. In Germany, statistics have shown that cyclists injured in police-reported traffic accidents are often found to have cycled with high blood alcohol levels. Relevant research has discussed the ability of the Theory of Planned Behavior (TPB; Ajzen, 1991), deterrence factors, and habitual behavior to predict unsafe and rule-violating behavior in traffic. To promote safer cycling, the relative contributions of these predictors must be determined to design efficient countermeasures. In an online survey, N = 353 participants reported cycling and drinking behaviors for 1 week and answered questions on the TPB, deterrence, and additional predictors. Perceived social norms were quite permissive and perceived behavioral control when cycling under the influence (CUI) of alcohol was quite high. Furthermore, a third of the cyclists reported CUI. Participants with experience of CUI reported having consumed large amounts of alcohol before cycling. High levels of cycling, a permissive attitude, and greater alcohol consumption per drinking episode predicted the number of CUI trips. The amount of alcohol consumed before one CUI trip was predicted by high perceived behavioral control when CUI, a high level of need for stimulation, and higher habitual alcohol consumption per drinking episode. Deterrence factors were found to have no influence on reported CUI. Overall, the findings suggested that Germans who habitually drink a large amount of alcohol are not deterred from CUI in the same manner that they would be from driving under the influence (DUI). The generally permissive perceived social norms did not differentiate between CUI and non-CUI cyclists, which indicated that a societal effort is required to balance the mismatch between CUI and DUI. In addition, changing the general drinking behaviors of highly educated Germans who cycle, would be beneficial for their health.     

Cultural safety in Muslim aged care: Taking the bull by the horns

ABSTRACT

Cultural safety is critical to providing holistic, person-centred care. Where “deep” or core cultural elements are primarily shaped and influenced by religion, it becomes important to recognise and understand the religious values and traditions in planning, designing, and delivering care. Such an approach is significantly important for communities essentially identified by their faith, such as the Muslim community. Muslims living in the West face challenges owing to their minority status and these are increasing in the current geopolitical context. These challenges contribute to individual Muslims and their families feeling vulnerable within an aged-care system that is mostly unfamiliar, and often confusing and frightening to them. This article attempts to make a case for cultural safety in the context of Muslim aged care. It does not offer an answer or a definite solution to the cultural risks Muslims may face in care settings. Rather, the article seeks to explore avenues for creating an environment of cultural safety without delving specifically into culturally safe care practices. It is only possible to offer culturally safe care when the environment in which care is to be delivered is respectful and supportive.     

Constructing Legitimacy in Geoengineering Discourse: The Politics of Representation in Science Policy Literature

Geoengineering, the idea of addressing climate change through large-scale technological projects, is a unique example of a contested emerging technology. It stands out in the degree to which both its scope of possibilities and its premise are characterized by global existential risks. Despite controversy due to inherent and perceived risks, this field has been shifting toward mainstream consideration. Geoengineering science policy reports reflect this shift and influence the subsequent trajectory of research and potential deployment. The two most notable geoengineering policy reports are those by the Royal Society in 2009 and the National Research Council (NRC) in 2015. Discursive strategies recurrent in these reports construct notions of legitimacy and normalcy in regard to geoengineering. These strategies include relative legitimation of actors and approaches, differentiating research from deployment, elevating particular geoengineering methods through comparative evaluation, and normalizing novel geoengineering proposals through analogy. These strategies are present in both the benchmark geoengineering policy reports, with a deepening and entrenchment evident in the later NRC report. Together, these discursive strategies promote the legitimization of geoengineering research.     

Conclusive Reasons and Epistemic Luck

What is it to have conclusive reasons to believe a proposition P? According to a view famously defended by Dretske, a reason R is conclusive for P just in case [R would not be the case unless P were the case]. I argue that, while knowing that P is plausibly related to having conclusive reasons to believe that P, having such reasons cannot be understood in terms of the truth of this counterfactual condition. Simple examples show that it is possible to believe P on the basis of reasons that satisfy the counterfactual, and still get things right about P only as a matter of luck. Seeing where this account of conclusive reasons goes wrong points to an important distinction between having conclusive reasons and relying on reasons that are in point of fact conclusive. It also has wider consequences for whether modal principles like sensitivity and safety can rule out the pernicious kind of epistemic luck, or the kind of luck that interferes with knowledge.     

Improving Fitness to Drive: The Case for Hazard Perception Training

On one hand, individuals who are unfit to drive should not be allowed behind the wheel. On the other hand, being unable to drive can have significant negative consequences for some individuals, including an increased mortality risk. One potential solution to this dilemma is to use training interventions to improve fitness‐to‐drive. The problem is that, in general, post‐licensing driver training and education has a disappointing track record in terms of improving road safety. However, one type of intervention that may have the potential to buck this trend is hazard perception training. Hazard perception, which is the driver's ability to anticipate dangerous situations on the road ahead, has been found to predict both crash risk and on‐road driving performance, and can account for variance in both of these criteria that other key fitness‐to‐drive measures cannot. Crucially, there is evidence that hazard perception competence can be improved by brief computer‐based interventions, even for driver groups who are more likely to face fitness‐to‐drive challenges, such as individuals aged over 65 years or adults with attention deficit hyperactivity disorder. This article puts the case for potentially using such interventions to help individuals with fitness‐to‐drive difficulties.     

Interfaith dialogue: seven key questions for theory,policy and practice

Interfaith dialogue is increasingly being recognised by governments across Europe as crucial to developing cohesive communities. This article critically analyses approaches for developing strategies to promote interfaith dialogue between individuals and/or organisations within civil society. It does this by drawing on a series of theoretical questions concerning those who are involved (and missing), what the dialogue is for, and how the dynamics of participation and representation are handled. In the process, the article considers the conditions, spaces, processes, relationships and understandings of identity that can enable successful interfaith dialogue, and how these might be developed in ways which address the issues raised. The original theoretical analysis presented in this article is supported by examples from the author’s cumulative research with policymakers and practitioners across Europe since 2004.     

There is a 60% probability,but I am 70% certain: communicative consequences of external and internal expressions of uncertainty

Current theories of probability recognise a distinction between external (un)certainty (frequentistic probabilities) and internal (un)certainty (degrees of belief). The present studies investigated this distinction in lay people's judgements of probability statements formulated to suggest either an internal (“I am X% certain”) or an external (“It is X% certain” or “There is an X% probability”) interpretation. These subtle differences in wording influenced participants' perceptions and endorsements of such statements, and their impressions of the speaker. External expressions were seen to signal more reliable task duration estimates, and a lower degree of external than internal certainty was deemed necessary to advise a course of action. In conversations about football, internal expressions were perceived as signalling more personal interest, and were expected to be on the average 10% higher than corresponding external probabilities. Finally, people who reported their outcome expectations for two major sports events let their degree of interest in these events influence their internal but not their external certainty. These results have implications for the communication of uncertainty and probability.     

A hazard-perception test for cycling children: An exploratory study

In car driving, hazard perception tests have revealed important differences in perceptual-cognitive skills between novice and experienced drivers. Although these insights have led to new educational programs for learner drivers, similar research has not yet been done for other road users such as bicyclists. In the current investigation, a first hazard perception test for bicyclists has been developed and tested on both adults and children of ±eight year old. The test consisted of three sections in which visual behaviour, environmental awareness, and risk perception were evaluated respectively. Although only few differences in visual behaviour and environmental awareness were found, adults were found to react earlier on hazards than children. These results suggest that children have difficulties to interpret the necessary information to react timely to hazardous traffic situations. Alternatively, the current set-up of the hazard perception test might not have been suitable to detect differences in visual behaviour between children and adults in traffic situations. Therefore the development and use of future hazard perception tests for bicyclists is discussed.