'Learning together': Sharing international experience on new models of primary care

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Public understanding of solar radiation management

We report the results of the first large-scale international survey of public perception of geoengineering and solar radiation management (SRM). Our sample of 3105 individuals in the United States, Canada and the United Kingdom was recruited by survey firms that administer internet surveys to nationally representative population samples. Measured familiarity was higher than expected, with 8% and 45% of the population correctly defining the terms geoengineering and climate engineering respectively. There was strong support for allowing the study of SRM. Support decreased and uncertainty rose as subjects were asked about their support for using SRM immediately, or to stop a climate emergency. Support for SRM is associated with optimism about scientific research, a valuing of SRM's benefits and a stronger belief that SRM is natural, while opposition is associated with an attitude that nature should not be manipulated in this way. The potential risks of SRM are important drivers of public perception with the most salient being damage to the ozone layer and unknown risks. SRM is a new technology and public opinions are just forming; thus all reported results are sensitive to changes in framing, future information on risks and benefits, and changes to context.Physic

ECONOMICALLY OPTIMAL WILDFIRE INTERVENTION REGIMES

Wildfires in the United States result in total damages and costs that are likely to exceed billions of dollars annually. Land managers and policy makers propose higher rates of prescribed burning and other kinds of vegetation management to reduce amounts of wildfire and the risks of catastrophic losses. A wildfire public welfare maximization function, using a wildfire production function estimated using a time series model of a panel of Florida counties, is employed to simulate the publicly optimal level of prescribed burning in an example county in Florida (Volusia). Evaluation of the production function reveals that prescribed fire is not associated with reduced catastrophic wildfire risks in Volusia County Florida, indicating a short-run elasticity of -0.16 and a long-run elasticity of wildfire with respect to prescribed fire of -0.07. Stochastic dominance is used to evaluate the optimal amount of prescribed fire most likely to maximize a measure of public welfare. Results of that analysis reveal that the optimal amount of annual prescribed fire is about 3 percent (9,000 acres/year) of the total forest area, which is very close to the actual average amount of prescribed burning (12,700 acres/year) between 1994-99.Resource /Energy Economics and Policy,

Places and people: the perceptions of men who have sex with men concerning STI testing: a qualitative study.

OBJECTIVES: To explore the experiences and views of men who have sex with men (MSM) on attending clinical sexual health services and their preferences regarding service characteristics in the context of the disproportionate burden of STIs experienced by this group. The wider study aim was to develop a risk assessment tool for use in sexual health clinics. METHODS: Qualitative study comprising eight focus group discussions with 61 MSM in four English cities. Topics included: experience of attending sexual health services, perceptions of norms of attendance among MSM, knowledge of, and attitudes towards, STIs and views on 'being researched.' Discussions were audio-recorded and transcribed and a thematic data analysis conducted. RESULTS: Attending sexual health services for STI testing was described as embarrassing by some and some clinic procedures were thought to compromise confidentiality. Young men seeking STI testing were particularly sensitive to feelings of awkwardness and self-consciousness. Black and ethnic minority men were concerned about being exposed in their communities. The personal qualities of staff were seen as key features of sexual health services. Participants wanted staff to be friendly, professional, discreet, knowledgeable and non-judgemental. CONCLUSIONS: A range of opinion on the type of STI service men preferred was expressed with some favouring generic sexual and reproductive health clinics and others favouring specialist community-based services. There was consensus on the qualities they would like to see in healthcare staff. The knowledge, conduct and demeanour of staff could exacerbate or ameliorate unease associated with attending for STI testing

Anhydrous Liquid Line of Descent of Yamato 980459 and Evolution of Martian Parental Magmas

Martian basalts represented by the shergottite meteorites reflect derivation from highly depleted mantle sources (high Nd, strong LREE depletions, low fO2)[1-3], with evidence of mixing with a much more enriched and oxidized reservoir, most likely a late-stage product of crystallization of an initial martian magma ocean [3-6]. The martian basaltic meteorites Yamato 980459 (Y98) and QUE 94201 (QUE) have bulk compositions that appear to represent bonafide liquids, rather than products of protracted crystallization. These two meteorites also represent the most primitive and evolved examples of the depleted basaltic shergottite suite. Magmatic liquids serve as effective probes of their source regions, and thus studying the potential relationship between magmas represented by Y98 and QUE can yield important information on the formation and evolution of martian basalts. Although the ages of these meteorites preclude that they are petrogenetically related to each other, they represent the best existing candidates for genuine liquids (other meteorites are suggested to represent liquid compositions, including LAR 06319 [7] and NWA 5789 [8], but only Y98 and QUE have been verified experimentally). They span much of the bulk-compositional range of martian basaltic meteorites, and represent end-member liquid compositions likely to arise from partial melting of the martian mantle. Recent efforts to model Y98-like parent liquid evolution by fractional crystallization using MELTS [6] produced a derivative liquid composition that closely matches QUE bulk composition, although it required a some-what unusual crystallization sequence. Experimental endeavours to verify this result at 1 bar have, however, been inconclusive [9]

The Acceptability and Feasibility of Implementing a Bio-Behavioral Enhanced Surveillance Tool for Sexually Transmitted Infections in England: Mixed-Methods Study.

BACKGROUND: Sexually transmitted infection (STI) surveillance is vital for tracking the scale and pattern of epidemics; however, it often lacks data on the underlying drivers of STIs. OBJECTIVE: This study aimed to assess the acceptability and feasibility of implementing a bio-behavioral enhanced surveillance tool, comprising a self-administered Web-based survey among sexual health clinic attendees, as well as linking this to their electronic health records (EHR) held in England's national STI surveillance system. METHODS: Staff from 19 purposively selected sexual health clinics across England and men who have sex with men and black Caribbeans, because of high STI burden among these groups, were interviewed to assess the acceptability of the proposed bio-behavioral enhanced surveillance tool. Subsequently, sexual health clinic staff invited all attendees to complete a Web-based survey on drivers of STI risk using a study tablet or participants' own digital device. They recorded the number of attendees invited and participants' clinic numbers, which were used to link survey data to the EHR. Participants' online consent was obtained, separately for survey participation and linkage. In postimplementation phase, sexual health clinic staff were reinterviewed to assess the feasibility of implementing the bio-behavioral enhanced surveillance tool. Acceptability and feasibility of implementing the bio-behavioral enhanced surveillance tool were assessed by analyzing these qualitative and quantitative data. RESULTS: Prior to implementation of the bio-behavioral enhanced surveillance tool, sexual health clinic staff and attendees emphasized the importance of free internet/Wi-Fi access, confidentiality, and anonymity for increasing the acceptability of the bio-behavioral enhanced surveillance tool among attendees. Implementation of the bio-behavioral enhanced surveillance tool across sexual health clinics varied considerably and was influenced by sexual health clinics' culture of prioritization of research and innovation and availability of resources for implementing the surveys. Of the 7367 attendees invited, 85.28% (6283) agreed to participate. Of these, 72.97% (4585/6283) consented to participate in the survey, and 70.62% (4437/6283) were eligible and completed it. Of these, 91.19% (4046/4437) consented to EHR linkage, which did not differ by age or gender but was higher among gay/bisexual men than heterosexual men (95.50%, 722/756 vs 88.31%, 1073/1215; P<.003) and lower among black Caribbeans than white participants (87.25%, 568/651 vs 93.89%, 2181/2323; P<.002). Linkage was achieved for 88.88% (3596/4046) of consenting participants. CONCLUSIONS: Implementing a bio-behavioral enhanced surveillance tool in sexual health clinics was feasible and acceptable to staff and groups at STI risk; however, ensuring participants' confidentiality and anonymity and availability of resources is vital. Bio-behavioral enhanced surveillance tools could enable timely collection of detailed behavioral data for effective commissioning of sexual health services