Large Survey Research Articles

Health seeking behaviours and private sector delivery of care for non-communicable diseases in low- and middle-income countries: a systematic review

BackgroundGlobally, non-communicable diseases (NCDs) are the leading cause of mortality and morbidity placing a huge burden on individuals, families and health systems, especially in low- and middle-income countries (LMICs). This rising disease burden calls for policy responses that engage the entire health care system. This study aims to synthesize evidence on how people with NCDs choose their healthcare providers in LMICs, and the outcomes of these choices, with a focus on private sector delivery.MethodsA systematic search for literature following PRISMA guidelines was conducted. We extracted and synthesised data on the determinants and outcomes of private health care utilisation for NCDs in LMICs. A quality and risk of bias assessment was performed using the Mixed Methods Appraisal Tool (MMAT).ResultsWe identified 115 studies for inclusion. Findings on determinants and outcomes were heterogenous, often based on a particular country context, disease, and provider. The most reported determinants of seeking private NCD care were patients having a higher socioeconomic status; greater availability of services, staff and medicines; convenience including proximity and opening hours; shorter waiting times and perceived quality. Transitioning between public and private facilities is common. Costs to patients were usually far higher in the private sector for both inpatient and outpatient settings. The quality of NCD care seems mixed depending on the disease, facility size and location, as well as the aspect of quality assessed.ConclusionGiven the limited, mixed and context specific evidence currently available, adapting health service delivery models to respond to NCDs remains a challenge in LMICs. More robust research on health seeking behaviours and outcomes, especially through large multi-country surveys, is needed to inform the effective design of mixed health care systems that effectively engage both public and private providers.Trial registrationPROSPERO registration number CRD42022340059.

International Consensus Criteria for Pediatric Sepsis and Septic Shock

Sepsis is a leading cause of death among children worldwide. Current pediatric-specific criteria for sepsis were published in 2005 based on expert opinion. In 2016, the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) defined sepsis as life-threatening organ dysfunction caused by a dysregulated host response to infection, but it excluded children. To update and evaluate criteria for sepsis and septic shock in children. The Society of Critical Care Medicine (SCCM) convened a task force of 35 pediatric experts in critical care, emergency medicine, infectious diseases, general pediatrics, nursing, public health, and neonatology from 6 continents. Using evidence from an international survey, systematic review and meta-analysis, and a new organ dysfunction score developed based on more than 3 million electronic health record encounters from 10 sites on 4 continents, a modified Delphi consensus process was employed to develop criteria. Based on survey data, most pediatric clinicians used sepsis to refer to infection with life-threatening organ dysfunction, which differed from prior pediatric sepsis criteria that used systemic inflammatory response syndrome (SIRS) criteria, which have poor predictive properties, and included the redundant term, severe sepsis. The SCCM task force recommends that sepsis in children be identified by a Phoenix Sepsis Score of at least 2 points in children with suspected infection, which indicates potentially life-threatening dysfunction of the respiratory, cardiovascular, coagulation, and/or neurological systems. Children with a Phoenix Sepsis Score of at least 2 points had in-hospital mortality of 7.1% in higher-resource settings and 28.5% in lower-resource settings, more than 8 times that of children with suspected infection not meeting these criteria. Mortality was higher in children who had organ dysfunction in at least 1 of 4-respiratory, cardiovascular, coagulation, and/or neurological-organ systems that was not the primary site of infection. Septic shock was defined as children with sepsis who had cardiovascular dysfunction, indicated by at least 1 cardiovascular point in the Phoenix Sepsis Score, which included severe hypotension for age, blood lactate exceeding 5 mmol/L, or need for vasoactive medication. Children with septic shock had an in-hospital mortality rate of 10.8% and 33.5% in higher- and lower-resource settings, respectively. The Phoenix sepsis criteria for sepsis and septic shock in children were derived and validated by the international SCCM Pediatric Sepsis Definition Task Force using a large international database and survey, systematic review and meta-analysis, and modified Delphi consensus approach. A Phoenix Sepsis Score of at least 2 identified potentially life-threatening organ dysfunction in children younger than 18 years with infection, and its use has the potential to improve clinical care, epidemiological assessment, and research in pediatric sepsis and septic shock around the world.

UK flockdown: A survey of smallscale poultry keepers and their understanding of governmental guidance on highly pathogenic avian influenza (HPAI)

The scale of the current outbreak of highly pathogenic avian influenza (HPAI) due to the A/H5N1 virus in the United Kingdom is unprecedented. In addition to its economic impact on the commercial poultry sector, the disease has devastated wild bird colonies and represents a potential public health concern on account of its zoonotic potential. Although the implementation of biosecurity measures is paramount to reducing the spread of HPAI in domestic and commercial settings, little is known about the attitudes and perspectives of backyard poultry keepers, who often keep their flocks in close proximity to the public. A large nationwide survey of backyard poultry keepers was undertaken in December 2021–March 2022, contemporaneous with the enforcement of an Avian Influenza Prevention Zone (AIPZ) and additional housing measures in England, Scotland and Wales. The survey explored keepers’ understanding of the clinical manifestations of HPAI, compliance with housing and biosecurity measures, attitudes towards obligatory culling on confirmation of HPAI in their flocks, and the potential use of vaccination to control HPAI. Summary statistical analysis of the closed question responses was supplemented with qualitative data analysis and corpus linguistic approaches to draw out key themes and salient patterns in responses to open text questions. Survey responses were received from 1559 small-scale poultry keepers across the United Kingdom. Awareness of the HPAI outbreak was very high (99.0%). The majority of respondents learned of it via social media (53%), with Defra (49.7%), British Hen Welfare Trust (33.8%) and the APHA (22.0%) identified as the principal sources of information. Analysis revealed that backyard keepers lacked knowledge of the clinical signs of avian influenza and legal requirements relating to compliance with biosecurity measures. Some respondents dismissed the seriousness of HPAI and were unwilling to comply with the measures in force. The issue of obligatory culling proved highly emotive, and some expressed a lack of trust in authorities. Most respondents (93.1%) indicated a willingness to pay for vaccination if the option was available. Communications on biosecurity measures that are relevant to large-scale industrial setups are inappropriate for backyard contexts. Understanding the barriers that backyard keepers face is essential if official agencies are to communicate biosecurity information effectively to such groups. Lack of trust in authorities is likely to make elimination of the virus in the UK difficult. We make recommendations for tailoring HPAI-related information for backyard contexts, to aid future HPAI control measures in the UK.

Drinking, Diversity, and Discrimination: Campus-Level Factors that Influence Students' Risk of Experiencing Sexual Assault.

College students' individual-level risk factors for sexual assault victimization have been studied for decades, but fewer studies have looked at whether and how campus-level factors, such as campus-level rates of discrimination and campus diversity, might also influence student victimization risk. Identifying these broader factors can inform efforts to develop more effective campus-level sexual assault preventive interventions. We conducted a secondary analysis of data from a large, multi-campus health and well-being survey (N = 309,171 students across 474 US campuses) to explore how campus-level factors shape students' risk of experiencing sexual assault after accounting for students' individual-level risk factors. Using mixed-effects logistic regression, we examined the influence of campus-level factors (e.g., campus sexual orientation demographics and gender diversity) on students' odds of experiencing sexual assault, after accounting for individual risk factors (e.g., sexual and gender minority status). Although some campus characteristics, such as enrollment size, had small significant effects on students' odds of experiencing sexual assault, we found larger significant effects from aggregated campus-level rates of binge drinking, campus diversity (particularly regarding sexual orientation and gender), and discrimination. These findings suggest that comprehensive campus sexual violence prevention would benefit from strategies that promote safe and inclusive campuses, especially for students with marginalized sexual and gender identities.

Public support for more stringent vaccine policies increases with vaccine effectiveness

Under what conditions do citizens support coercive public policies? Although recent research suggests that people prefer policies that preserve freedom of choice, such as behavioural nudges, many citizens accepted stringent policy interventions like fines and mandates to promote vaccination during the COVID-19 pandemic—a pattern that may be linked to the unusually high effectiveness of COVID-19 vaccines. We conducted a large online survey experiment (N = 42,417) in the Group of Seven (G-7) countries investigating the relationship between a policy’s effectiveness and public support for stringent policies. Our results indicate that public support for stringent vaccination policies increases as vaccine effectiveness increases, but at a modest scale. This relationship flattens at higher levels of vaccine effectiveness. These results suggest that intervention effectiveness can be a significant predictor of support for coercive policies but only up to some threshold of effectiveness.

Using fusion effects to decrease uncertainty in distance sampling models when collating data from different surveys

AbstractEstimates of population abundance are required to study the impacts of human activities on populations and assess their conservation status. Despite considerable effort to improve data collection, uncertainty around estimates of cetacean densities can remain large. A fundamental concept underlying distance sampling is the detection function. Here we focus on reducing the uncertainty in the estimation of detection function parameters in analyses combining data sets from multiple surveys, with known effects on the precision of density estimates. We developed detection functions using infinite mixture models that can be applied on data collating multiple species and/or surveys. These models enable automatic clustering by fusing the species and surveys with similar detection functions. We present a simulation analysis of a multisurvey data set in a Bayesian framework where we demonstrated that distance sampling models including fusion effects showed lower uncertainty than classical distance sampling models. We illustrated the benefits of this new model using data of line transect surveys from the Bay of Biscay and Iberian Coast. Future estimates of abundance using conventional distance sampling models on large multispecies surveys or on data sets combining multiple surveys could benefit from this new model to provide more precise density estimates.

Validation of the Short Dark Tetrad (SD4) in Persian

Abstract: The Short Dark Tetrad of Personality (SD4) is a self-report instrument for screening individuals with dark personality traits, including narcissism, Machiavellianism, psychopathy, and sadism. In the present study, we examined the psychometric properties of the Persian version in an Iranian sample. After translating the instrument, we conducted a large online survey that included 1,696 participants (67% female), aged 18–60 years. We performed a series of confirmatory factor analyses and examined the nomological network to validate the instrument. After assessing five competing structural models, the four-factor model showed the best fit based on standard goodness-of-fit indices. The sub-scales also showed coherent links with risk-taking and pathological personality traits. We conclude that the Persian SD4 has a distinct four-factor structure with adequate reliability and validity. Therefore, it can be used to measure dark personality traits in Farsi-speaking samples.

US public opinion about reproductive health care in school-based health centers

ObjectivesThis study aimed to examine public support for the provision of seven reproductive health services in school-based health centers, including pregnancy testing, over-the-counter contraceptives, prescription (Rx) contraceptives, sexually transmitted disease testing, sexually transmitted disease treatment, gynecological examinations, sexual violence counseling, and an index measure combining all services. Study designWe administered a large national online survey (N = 4196, response rate 31%) of US adults using Lucid, a large, internet-based, opt-in panel to assess public attitudes about offering sexual and reproductive health services in school-based health centers. We then used t tests and weighted linear regression models to carry out our study objectives. ResultsUnadjusted analysis revealed that 60% of respondents supported the provision of all reproductive health services (combined) at school-based health centers. Regression analysis based on the index measure suggested that individuals identifying as Trump voters (p-value = 0.00) or conservatives (p-value = 0.00) reported the lowest support, while those identifying as liberal (p-value = 0.00) reported the highest support, controlling for demographic and health characteristics. ConclusionsRespondents overwhelmingly support the provision of reproductive health services at school-based health centers, including pregnancy testing, over-the-counter contraceptives, prescription contraceptives, testing and treatment for sexually transmitted infections, and sexual violence counseling. ImplicationsAdolescence is an important stage for sexual maturation, and access to appropriate sexual and reproductive health services can support healthy development into adulthood. Findings suggest that most respondents support the provision of reproductive health services at school-based health centers while there are important factors that influence public support.

MIGHTEE polarization early science fields: the deep polarized sky

ABSTRACT The MeerKAT International GigaHertz Tiered Extragalactic Exploration (MIGHTEE) is one of the MeerKAT large survey projects, designed to pathfind SKA key science. MIGHTEE is undertaking deep radio imaging of four well-observed fields (COSMOS, XMM-LSS, ELAIS S1, and CDFS) totaling 20 square degrees to μJy sensitivities. Broad-band imaging observations between 880 and1690 MHz yield total intensity continuum, spectro-polarimetry, and atomic hydrogen spectral imaging. Early science data from MIGHTEE are being released from initial observations of COSMOS and XMM–LSS. This paper describes the spectro-polarimetric observations, the polarization data processing of the MIGHTEE early science fields, and presents polarization data images and catalogues. The catalogues include radio spectral index, redshift information, and Faraday rotation measure synthesis results for 13 267 total intensity radio sources down to a polarized intensity detection limit of ∼20 μJy bm−1. Polarized signals were detected from 324 sources. For the polarized detections, we include a catalogue of Faraday Depth from both Faraday Synthesis and Q, U fitting, as well as total intensity and polarization spectral indices. The distribution of redshift of the total radio sources and detected polarized sources are the same, with median redshifts of 0.86 and 0.82, respectively. Depolarization of the emission at longer-wavelengths is seen to increase with decreasing total-intensity spectral index, implying that depolarization is intrinsic to the radio sources. No evidence is seen for a redshift dependence of the variance of Faraday depth.

Selecting for Masculinity: Women’s Under-Representation in the Republican Party

The gap between women’s representation in the Democratic and Republican parties has grown significantly in the last three decades. We argue existing explanations undervalue voters’ contributions to this trend by focusing on voter responses to candidate sex rather than candidate gender. We theorize that Republican voters (especially the most conservative) prefer masculine candidates in intraparty and entry-level elections. Because sex and gender are correlated, this limits the number of Republican women who advance through the political pipeline. Experimental vignettes from two rounds of the Cooperative Congressional Election Study (N = 2,000) and two large surveys of Republicans (N > 10,000) show that Republican (but not Democratic) voters penalize candidates with “feminine” self-presentation regardless of the candidate’s sex. Original data on the self-presentation of Republican candidates for entry-level office (N = 459) confirm Republican candidates often present themselves in gender-stereotypical ways. In short, voters play an underappreciated role in the partisan gap in women’s representation.

The dynamic universe: realizing the potential of classical time domain and multimessenger astrophysics

In parallel with the multi-messenger revolution, major advances in time-domain astronomy across multiple science disciplines relevant to astrophysics are becoming more urgent to address. Aside from electromagnetic observations of gravitational wave events and explosive counterparts, there are a number of “classical” astrophysical areas that require new thinking for proper exploration in the time domain. How NASA, NSF, ESA, and ESO consider the 2020 USA Decadal Survey within the astronomy community, as well as the worldwide call to support and expand time domain and multi-messenger astrophysics, it is crucial that all areas of astrophysics, including stellar, galactic, Solar System, and exoplanetary science participate in the discussion, and that it not be made into an exclusive preserve of cosmological, high-energy, explosive and transient science. Time domain astronomy is used to explore many aspects of astrophysics–particularly concerning ground- and space-based mission science goals of exploring how the Universe works, understanding how did we get here, and are we alone. Time domain studies are already built into the core operations of many currently operating and future space telescopes (e.g., Roman, PLATO) as well as current and planned large areal ground-based surveys (e.g., Rubin). Time-domain observations designed for one scientific purpose, also lead to great discoveries in many other science areas. The recent advent of user-friendly hardware, software, observational approaches, and online data infrastructure has also helped make time domain observations especially suitable and appealing for citizen science projects. We provide a review of the current state of TDAMM alerts and observational protocols, revealing a wide array of software and applications, much of which is incompatible. Any conversation regarding TDAMM astrophysics should include all aspects of the field, including those aspects seen as classical applications.

The Instrumental Motivation of Teachers: Implications of High-Stakes Accountability for Professional Learning

ABSTRACT This article considers the motivations of teachers to pursue ongoing professional learning. During recent decades, the international policy context has been characterised by high-stakes accountability, but the implications of this agenda for teachers’ motivations toward professional learning remains under-explored. In this mixed methods study, combining a large teacher survey and in-depth teacher interviews, a new and significant concept of ‘instrumental motivation’ is generated to capture how high-stakes performance management policies damage the motivation of teachers to learn professionally. This innovative approach, employing ordinal factor analysis and inductive/deductive hybrid thematic analysis inclusive of self-determination theory, reveals how the ‘instrumental motivation’ of teachers should be constrained and argues for the adoption of alternative motivational strategies to support effective professional learning in schools.

Assessing and Improving Data Integrity in Web-Based Surveys: Comparison of Fraud Detection Systems in a COVID-19 Study.

Web-based surveys increase access to study participation and improve opportunities to reach diverse populations. However, web-based surveys are vulnerable to data quality threats, including fraudulent entries from automated bots and duplicative submissions. Widely used proprietary tools to identify fraud offer little transparency about the methods used, effectiveness, or representativeness of resulting data sets. Robust, reproducible, and context-specific methods of accurately detecting fraudulent responses are needed to ensure integrity and maximize the value of web-based survey research. This study aims to describe a multilayered fraud detection system implemented in a large web-based survey about COVID-19 attitudes, beliefs, and behaviors; examine the agreement between this fraud detection system and a proprietary fraud detection system; and compare the resulting study samples from each of the 2 fraud detection methods. The PhillyCEAL Common Survey is a cross-sectional web-based survey that remotely enrolled residents ages 13 years and older to assess how the COVID-19 pandemic impacted individuals, neighborhoods, and communities in Philadelphia, Pennsylvania. Two fraud detection methods are described and compared: (1) a multilayer fraud detection strategy developed by the research team that combined automated validation of response data and real-time verification of study entries by study personnel and (2) the proprietary fraud detection system used by the Qualtrics (Qualtrics) survey platform. Descriptive statistics were computed for the full sample and for responses classified as valid by 2 different fraud detection methods, and classification tables were created to assess agreement between the methods. The impact of fraud detection methods on the distribution of vaccine confidence by racial or ethnic group was assessed. Of 7950 completed surveys, our multilayer fraud detection system identified 3228 (40.60%) cases as valid, while the Qualtrics fraud detection system identified 4389 (55.21%) cases as valid. The 2 methods showed only "fair" or "minimal" agreement in their classifications (κ=0.25; 95% CI 0.23-0.27). The choice of fraud detection method impacted the distribution of vaccine confidence by racial or ethnic group. The selection of a fraud detection method can affect the study's sample composition. The findings of this study, while not conclusive, suggest that a multilayered approach to fraud detection that includes conservative use of automated fraud detection and integration of human review of entries tailored to the study's specific context and its participants may be warranted for future survey research.

Mental health disparities between physicians and nurses: Analyzing the impact of occupational stress and work environment fitness using random forest algorithm

BackgroundThe impact of occupational stress and work environment fitness on mental health disparities between physicians and nurses are not well understood. This study aims to identify and rank key determinants of mental health in physicians and nurses in China and compare the differences in their impact on mental health between physicians and nurses. MethodsA large cross-sectional survey with multistage cluster sampling was conducted. The survey included the Self-Rating Anxiety Scale (SAS Scale), the Center for Epidemiologic Studies Depression Scale (CES-D Scale), the Maslach Burnout Inventory–General Survey (MBI-GS) and the Person-Environment (PE) Fit. We applied a principled, machine learning-based variable selection algorithm, using random forests, to identify and rank the determinants of the mental health in physicians and nurses. ResultsIn our study, we analyzed a sample of 9964 healthcare workers, and 2729 (27 %) were physicians. The prevalence of anxiety and depressive disorders among physicians and nurses was 31.0 % and 53.3 %, 30.8 % and 47.9 %, respectively. Among physicians with anxiety disorder, we observed a higher likelihood of cynicism, emotional exhaustion, reduced personal accomplishment, and poor organization fitness, job fitness, group fitness, and supervisor fitness, in order of importance. When comparing the effects on depressive disorder in physicians, group fitness and supervisor fitness did not have significant impacts. For nurses, emotional exhaustion had a more significant effect on depressive disorder compared to cynicism. Supervisor fitness did not have a significant impact on anxiety disorder in nurses. LimitationsCross-sectional design, self-reporting screening scales. ConclusionsCompared to individual and hospital characteristics, the primary factors influencing mental health disorders are occupational burnout and the compatibility of the work environment. Additionally, the key determinants of depressive and anxiety disorders among doctors and nurses exhibit slight variations. Employing machine learning methods proves beneficial for identifying determinants of mental health disorders among physicians and nurses in China. These findings could help improve policymaking aimed at addressing the mental well-being of healthcare professionals.

Patient barriers and facilitators for making environmental and behavioral modifications for dry eye in the United States.

Managing dry eye disease (DED) is expensive. Often, prescribed treatments improve clinical signs but not patient-reported symptoms. In large surveys, clinicians and patients ranked environmental and behavioral modifications among the most important DED-related research priorities. Our purpose was to investigate the barriers to and facilitators of use of these modifications by patients with DED in the United States and how their use may be impacted by socioeconomic status (SES). Using Qualtrics, we conducted an anonymous online survey of adults with DED living in the United States in August to September 2022. Patients were identified through the Dry Eye Foundation, Sjögren's Foundation, and a DED clinic in Colorado. We used an established index for classifying respondent SES based on education, household income, and employment. Outcomes included use of environmental and behavioral modifications and barriers to and facilitators of their use. We included 754 respondents (SES: 382 low, 275 high, and 97 unclear). Most were aged 18 to 49 years (67%), female (68%), and White (76%) and reported dealing with DED for ≤5 years (67%). The most frequent modifications were taking breaks to rest eyes (68%), increasing water intake (68%), and using hot/cold compresses (52%). For these three, the biggest facilitators were as follows: belief that the modification works (27 to 37%), being recommended it (24 to 26%), and ease of use/performance (21 to 32%). Across modifications, the biggest barriers were difficulty of use (55%), lack of family/employer/social/community support (33%), and lack of awareness (32%). The data do not suggest discernible patterns of differences in barriers or facilitators by SES. Greater emphasis should be placed on explaining to patients how environmental and behavioral modifications might mitigate DED. Employers and members of patients' support systems should be guided regarding how best to support patients in managing DED symptoms.

On using the counting method to constrain the anisotropy of kilonova radiation

ABSTRACT A large number of binary neutron star (BNS) mergers are expected to be detected by gravitational wave (GW) detectors and the electromagnetic (EM) counterparts (e.g. kilonovae) of a fraction of these mergers may be detected in multibands by large area survey telescopes. For a given number of BNS mergers detected by their GW signals, the expected numbers of their EM counterparts that can be detected by a survey with given selection criteria depend on the kilonova properties, including the anisotropy. In this paper, we investigate whether the anisotropy of kilonova radiation and the kilonova model can be constrained statistically by the counting method, i.e. using the numbers of BNS mergers detected via GW and multiband EM signals. Adopting simple models for the BNS mergers, afterglows, and a simple two (blue and red)-component model for kilonovae, we generate mock samples for GW detected BNS mergers, their associated kilonovae, and afterglows detected in multibands. By assuming some criteria for searching the EM counterparts, we simulate the observations of these EM counterparts and obtain the EM observed samples in different bands. With the numbers of BNS mergers detected by GW detectors and EM survey telescopes in different bands, we show that the anisotropy of kilonova radiation and the kilonova model can be well constrained by using the Bayesian analysis. Our results suggest that the anisotropy of kilonova radiation may be demographically and globally constrained by simply using the detection numbers of BNS mergers by GW detectors and EM survey telescopes in multibands.

What helps patients access web-based services in primary care? Free-text analysis of patient responses to the Di-Facto questionnaire

BackgroundThe National Health Service (NHS) and general practice are increasingly adopting digital services. These services can impact both positively and negatively upon patient experiences, and access to digital services is not equal amongst all groups. Within a wider project examining digital facilitation (the Di-Facto study) our team conducted a patient survey amongst English primary care practices aiming to investigate patient views of what supports uptake and use of web-based services. This paper reports on the analysis of the free-text responses from the patient survey.MethodsThe Di-Facto patient survey was distributed to practices in eight clinical commissioning groups (CCGs) in England between 2021–2022. We examined free-text responses to two questions relating to access to primary care web-based and support for web-based services. We used qualitative reflexive thematic analysis based on a six-stage process to analyse responses.ResultsOf the 3051 patients who responded to the Di-Facto survey, 2246 provided a free-text response. We present our findings in two major themes: systems and structures and their impact on use of web-based services, and ‘what works for me’, a description of how respondents described what worked, or did not work in terms of their interactions with web-based services. Respondents described how the technology, such as poor practice website design, confusion over multiple digital apps, data security and concerns about eConsultation offerings impacted on use of web-based services. Respondents described practice level barriers, such as a lack of or inconsistent provision, which prevented optimal use of web-based services. Respondents described personal and technical barriers that impacted on their use of digital services, and described which web-based services worked well for them. Respondents felt that web-based services were not a replacement for face-to-face interactions with a doctor.ConclusionsThis analysis of free-text responses from a large patient survey highlights the system, practice, and person level barriers and facilitators to use of digital services in primary care. With an increasing push towards digital solutions in NHS primary care, practices should consider the design, rollout and communication of their web-based services to support patient access.

The local Universe in the era of large surveys – III. Radial activity profiles of S0 galaxies

ABSTRACT Spatially resolved MaNGA’s optical spectra of 1072 present-day lenticular (S0) galaxies, dimensionally reduced from a principal component analysis (PCA), are used to determine their radial activity structure shaped by any possible nebular ionization source. Activity profiles within $1.5\,$Re are examined in tandem with the mass, age, ellipticity, and kinematics of the stars, as well as environmental density. Among the results of this comparison, we find that the sign of the radial activity gradient of S0s is tightly related to their PCA classification, BPT designation, and star formation status. PCA-passive lenticulars often show low-level, flat activity profiles, although there is also a significant number of systems with positive gradients, while their less common active counterparts generally have negative gradients, usually associated with high SSFRs and, sometimes, moderate Seyfert emission. A fraction of the latter also shows radial activity profiles with positive gradients, which become more abundant with increasing stellar mass regardless of environmental density. Our analysis also reveals that the subset of active S0s with negative gradients experiences at all galactocentric radii a systematic reduction in its median activity level with stellar mass, consistent with expectations for main-sequence galaxies. In contrast, passive S0s with positive gradients show the opposite behaviour. Furthermore, systems whose activity is dominated by star formation are structurally rounder than the rest of S0s, while those classified as Seyfert exhibit higher rotational support. The possibility that negative and positive activity gradients in S0s may result from rejuvenation by two distinct types of minor mergers is raised.

Analysis on Driving Factors, Reduction Potential, and Environmental Effect of Inorganic Fertilizer Input in Chongqing

In this study, we sought to quantify the effect of planting structure change on fertilizer input and environmental cost in Chongqing and develop scientific and rational strategies for chemical fertilizer reduction. Based on the crop fertilizer quota standard and large sample farmer survey data under the medium productivity level in Chongqing, we evaluated and analyzed the application reduction potential and environmental benefits of fertilizer with the difference method and life cycle assessment. The results showed that:① since Chongqing became a municipality directly under the central government (1997), Chongqing crop planting structure had greatly changed, and the proportion of food crop (rice, corn, wheat, bean, and potato) decreased by 21%. The area of fruits and vegetables increased from 3.36×105 hm2 to 1.05×106 hm2, and their proportion increased by 20%. ② Nearly 55% of fertilizers had been consumed by vegetable (37%) and citrus production systems, and 11%, 12%, and 12% of fertilizers were consumed by rice, corn, and potato, respectively. ③ The total fertilizer reduction of the Chongqing planting industry could reach up to 1.69×105 tons during the period of "the 14th Five-Year Plan," with a fertilizer reduction potential of 18.6%. The fertilizer reduction potential (reduction amount) of rice, corn, citrus, and vegetables would reach 0.3% (2.9×102 tons), 12% (1.45×104 tons), 21% (3.65×104 tons), and 30% (1.18×105 tons), respectively. On the other hand, the rape system was insufficient in phosphorus potassium fertilizers, and the corn tended to be insufficient in potash fertilizer. ④ The current production level was low, and the nitrogen loss, greenhouse gas emissions, and eutrophication potential in the planting industry of Chongqing reached 1.81×105 tons (N), 1.43×107 tons (CO2-eq), and 1.74×105 tons (PO4-eq). With the increase in the realization degree of the crop quota standard (60%-100%), the reactive nitrogen loss, greenhouse gas emissions, and eutrophication potential decreased by 14.9%-24.9%, 10.1%-16.7%, and 13.8%-23%, respectively. The structure of the planting industry in Chongqing significantly changed, the total fertilizer consumption in Chongqing tended to decline gradually, and the fertilization intensity of commercial crops stayed at a high level. The agricultural fertilizer reduction potential and the reactive nitrogen and greenhouse gas emission reduction potential were large, especially for citrus and vegetable production systems. However, it is also necessary to pay attention to insufficient corn potash fertilizer and rape phosphorus potassium fertilizer investment and carry out collaborative promotion of fertilizer reduction.

The Causal Relationship Between Volunteering and Social Cohesion: A Large Scale Analysis of Secondary Longitudinal Data

It is often taken for granted that social cohesion and volunteering are inextricably related. Previous research suggests both that social cohesion creates a conducive environment for volunteering to emerge and that volunteering itself facilitates feelings of social cohesion. Despite this, much of the existing evidence on this relationship is limited to cross-sectional research that precludes any assessment of potential causality. In this paper we present a secondary analysis of two large scale and longitudinal social surveys in the UK: the Understanding Society Household Longitudinal Study and the Beyond Us and Them project. Using data from these surveys we estimate a cross-lagged longitudinal model to assess the causal relationships between social cohesion and volunteering over time. Across both data sources, involving different time intervals, we find significant cross-lagged bi-directional relationships between social cohesion and volunteering. These findings provide much needed empirical support for the proposition that social cohesion and volunteering are causally related over periods of both months and years. Implications for theory and policy are discussed.