In this study, we investigate how eco-social attitudes are interlinked with various modes of political action aimed at preventing environmental change and promoting social welfare. Using multiple correspondence analysis and cluster analysis, we explore the links between attitudes and political action, and associated socio-political characteristics, in the case of Sweden. Our results show a three-node pattern forming a political action triangle: individuals expressing joint support for social welfare and environmental concerns are most actively engaged in political action, while those supporting environmental concerns are sympathetic to take part in political action without actually participating, and those supporting social welfare or expressing low support for either set of concerns seem overly reluctant towards all types of political action. This pattern, which is also tied to distinctive socio-political characteristics, has wider implications for understanding the agency and the mobilization of support for tackling the multiple ecological and social crises contemporary societies are facing.

We use the Korteweg–de Vries (KdV) equation, supplemented with several forcing/friction terms, to describe the evolution of wind-driven water wave packets in shallow water. The forcing/friction terms describe wind-wave growth due to critical level instability in the air, wave decay due to laminar friction in the water at the air–water interface, wave stress in the air near the interface induced by a turbulent wind and wave decay due to a turbulent bottom boundary layer. The outcome is a modified KdV–Burgers equation that can be a stable or unstable model depending on the forcing/friction parameters. To analyse the evolution of water wave packets, we adapt the Whitham modulation theory for a slowly varying periodic wave train with an emphasis on the solitary wave train limit. The main outcome is the predicted growth and decay rates due to the forcing/friction terms. Numerical simulations using a Fourier spectral method are performed to validate the theory for various cases of initial wave amplitudes and growth and/or decay parameter ranges. The results from the modulation theory agree well with these simulations. In most cases we examined, many solitary waves are generated, suggesting the formation of a soliton gas.

Declining labor force participation of older men throughout the 20th century and recent increases in participation have generated substantial interest in understanding the effect of public pensions on retirement. The National Bureau of Economic Research's International Social Security (ISS) Project, a long-term collaboration among researchers in a dozen developed countries, has explored this and related questions. The project employs a harmonized approach to conduct within-country analyses that are combined for meaningful cross-country comparisons. The key lesson is that the choices of policy makers affect the incentive to work at older ages and these incentives have important effects on retirement behavior.

Background: Non-prescription antibiotic use is defined as taking antibiotics without medical guidance, which includes using leftover antibiotics, obtaining antibiotics from friends or relatives, or purchasing antibiotics without a prescription. This study aimed to (1) determine the symptoms prompting individuals to use non-prescription antibiotics, identify their sources of acquisition, and document the types of antibiotics utilized, (2) identify any associated side effects, and (3) gain insights into antibiotic storage practices, including whether antibiotics were used beyond their expiration date. Methods: A cross-sectional quantitative survey was conducted from January 2020-June 2021 in waiting rooms of six safety-net primary care clinics and two private emergency departments in Houston, Texas. Participants were read survey questions in English or Spanish by a bilingual research coordinator, and their responses to five questions about antibiotic use were recorded. Descriptive analysis was performed. Results: Among the 564 patients surveyed, the median age was 51 (range 19-92). The majority identified as female (72%), Hispanic/Latinx (47%), Black/African American (33%), held a college education (44%), and received public health insurance, such as Medicaid or County Financial Assistance (56%). Of all patients surveyed, 44% (246) reported taking an antibiotic without a prescription and answered questions about associated symptoms. Of all symptoms/illnesses associated with non-prescription use, the most common were sore throat (18%), dental symptoms (16%), and cold/flu (13%). The most common sources for non-prescribed antibiotics were leftover antibiotics (50%), from friends or relatives (31%), and purchased abroad (13%), although 3% had purchased non-prescription antibiotics from a local store or market (Figure 1). The most common antibiotics used were amoxicillin (38%) and penicillin (7%). The reported side effects were stomach pain/upset (24%), nausea and vomiting (19%), allergic reaction (e.g., rash) (14%), and diarrhea (14%). Among 246 participants reporting antibiotic use, 63% reported that the antibiotic they took had been previously prescribed for the same symptom/illness, and 93% had acquired antibiotics in a container, of which 90% reported that the container had an expiration date. Conclusions: Our survey reveals that 63% of individuals who use non-prescription antibiotics were motivated by having received prescribed antibiotics for similar symptoms previously. Leftover antibiotics were the source for half of all non-prescription use. These observations suggest that outpatient antibiotic stewardship campaigns have a window of opportunity at the time of the initial prescription of antibiotics, to focus on providing the shortest course possible, and to deliver antibiotic safe use information at that time. Acknowledgments: Financial Support AHRQ R01HS026901

Disclosure: Barbara Trautner: Stock: Abbvie--sold in December 2023; Abbott Laboratories--sold in December 2023; -Bristol Myers Squibb--sold in December 2023; Pfizer--sold in December 2023; Consultant--Phiogen—consultant. Contracted research through NIAID for STRIVE trial, currently testing Shionogi product; Contracted research--Peptilogics; Contracted research—Genentech

Background: Using antibiotics without medical guidance (non-prescription use) is a potential safety threat to individual and public health. Patients' situations can impact their intentions to use non-prescription antibiotics in the future (intended use). This survey (1) explores the dimensionality of 13 predefined situations to identify ‘summary factor,’ which include conceptually similar situations that influence patients’ intended use of non-prescription antibiotics, and (2) identifies the sociodemographic predictors associated with these summary factors. Methods: A cross-sectional survey was conducted from January 2020–June 2021 in the waiting rooms of six safety-net primary care clinics and two private emergency departments. We used principal component analysis as a data reduction technique and confirmed the factor structure of the situations (identifying three situational summary factors). Multivariate linear regression identified the sociodemographic predictors (e.g., age, gender, race, education, insurance, healthcare system, language preference, birth country, and health literacy) associated with each summary factor. Results: Of the 564 patients surveyed, the majority were female (72%), Hispanic or Latinx (47%), college-educated (44%), and received public health insurance (e.g., Medicaid or County Financial Assistance) (56%). The largest proportion of patients endorsed intended non-prescription antibiotic use for situations involving high doctor visit costs (29.8%), having leftover prescription antibiotics (50.4%), and experiencing symptom relief with prior use of antibiotics (47.5%) (Figure 1). We identified three situational summary factors: (1) perceived barriers to a doctor visit and receiving a prescription (Cronbach’s alpha [α]=0.96), (2) convenience and accessibility of non-prescription antibiotics (α=0.81), and (3) previous symptom relief with antibiotics (α=0.95). After controlling for gender, race, education, insurance, language preference, birth country, and health literacy, our multivariate regression results revealed that younger patients (P < 0 .04) and patients attending the safety-net health system (P < 0 .001) had more intended use of non-prescription antibiotics for all three summary factors (Figure 2). Conclusions: Our study revealed that younger patients and individuals receiving care from the safety-net clinics had an increased risk of intended non-prescription antibiotic use across all summary factors. Future stewardship interventions should consider the types of situations that drive patients' decisions to use antibiotics without a prescription. Interventions aimed at reducing barriers to healthcare (e.g., high costs and long waits associated with doctor appointments) and educating individuals on the risks associated with inappropriate antibiotic use while providing alternative (non-antibiotic) treatment options may reduce antibiotic use and antimicrobial resistance. Acknowledgments: This work is supported by grant number R01HS026901 from AHRQ and NRSA T-32 (6T32HC10031).

Disclosure: Barbara Trautner: Stock: Abbvie--sold in December 2023; Abbott Laboratories--sold in December 2023; -Bristol Myers Squibb--sold in December 2023; Pfizer--sold in December 2023; Consultant--Phiogen—consultant. Contracted research through NIAID for STRIVE trial, currently testing Shionogi product; Contracted research--Peptilogics; Contracted research--Genentech

The article, ‘Have we lost sleep? A reconsideration of segmented sleep in early modern England’, Medical History, 67, 2 (2023), 91–108, by Niall Boyce is devoted to criticising my historical research pertaining to 1) the predominance of segmented sleep in the pre-industrial Western world and 2) the nineteenth-century transition of sleep to today’s pattern of continuous slumber that most people in modern societies seek to achieve, albeit not always successfully. This response addresses Boyce’s reinterpretation of the evidence and indicates whether this is erroneous or selective. My analysis thereby reasserts the predominance of segmented sleep in pre-modern Western Europe. Boyce’s assessment rests not on his original investigation of primary sources but on my first study relating to segmented sleep, published in 2001. Not least of the flaws of ‘Have We Lost Sleep?’ is its surprising inattention to my subsequent works that have expanded, modified, and bolstered this initial publication.

Writing history, in the humblest sense of the word, is above all a process of dating events, inscribing them in a chronology. Yet this framework, empty and elementary though it may appear, possesses nonetheless properties of its own, somewhat as real extension, the domain of orientation and weight, differs from pure geometrical space. Concrete time, too, has certain qualities, qualities which are not necessarily everywhere the same, and which take their configuration from the conception of the world particular to each civilization. These local cosmologies remain implicit for the most part, even though they frequently give rise to doctrines which can be highly complex. Philosophers and theologians have framed such constructions, basing them to a certain extent on the body of astronomical knowledge which they found at their disposal. But these scholarly interpretations do not limit themselves to a mere translation of the factual data that an observation of the stars could provide. The astronomical data serve as simple points of orientation for the elaboration of vast graphs, on whose empty expanses the vicissitudes of history would trace their paths. These constructions are like niches erected in advance, awaiting the events to come, an immutable order of vintages to which the individual is so thoroughly accustomed that he finds it impossible even to conceive of a different disposition.

The progress of knowledge consists in part of avoiding superficial analogies and discovering profound kinships, less apparent perhaps, but far more important and significant. In the eighteenth century there still appeared zoölogical works which classed animals according to the number of their paws, grouping, for example, the lizard with the bat. Today the adder appears under the same rubric—a creature that has no paws at all but that, like the others, is oviparous and covered with scales. These characteristics have appeared, rightly, to be of more consequence than that which was singled out in the beginning—the number of paws. In the same fashion, it is well known that, despite its appearance, the whale is not a fish, nor is the bat a bird.