Information about historical emissions drives the division of climate change mitigation costs.

Despite worsening climate change, the international community still disagrees on how to divide the costs of mitigation between developing countries and developed countries, which emitted the bulk of historical carbon emissions. We study this issue using an economic experiment. Specifically, we test how information about historical emissions influences how much participants pay for climate change mitigation. In a four-player game, participants are assigned to lead two fictional countries as members of either the first or the second generation. The first generation produces wealth at the expense of greater carbon emissions. The second generation inherits their predecessor's wealth and negotiates how to split the climate change mitigation costs. Here we show that when the second generation knows that the previous generation created the current wealth and mitigation costs, participants whose predecessor generated more carbon emissions offered to pay more, whereas the successors of low-carbon emitters offered to pay less.

Change of air quality knowledge, perceptions, attitudes, and practices during and post-wildfires in the United States.

Amid worsening climate change, the recurrent wildfires have substantially worsened air quality in the Western United States (U.S.). Understanding the knowledge, attitudes, perception, and practices (KAPP) over time in response to natural disasters such as wildfires is crucial for public health interventions and disaster preparedness. This is the first study to investigate the change in air quality KAPP over time in response to natural disasters. Previous studies have only assessed KAPP at a fixed time point. Using a two-wave panel survey (during and post-wildfires), we assessed the association between KAPP and respiratory health indicators as well as the changes over time in 212 participants in the U.S. Between the two waves, we found a significant 8% increase in knowledge, which was mainly driven by participants in areas unaffected by the wildfires. In addition, we found differential associations between KAPP and respiratory health indicators between areas affected and unaffected by the wildfires. These findings suggest that experiencing wildfires may affect KAPP and more longitudinal studies are warranted, particularly during periodic air quality crises.

Association of Use of Electronic Appointment Reminders With Waiting Times in the Veterans Affairs Health System.

Importance: Electronic appointment reminder systems are increasingly used across health systems. However, their association with patients' waiting times for their appointments, a measure of timely access to care, has yet to be assessed. Objective: To assess the associations between the introduction of an electronic appointment reminder system and the number of days patients had to wait from appointment booking to appointment completion in patients in the Veterans Affairs Health System. Design, Setting, and Participants: Cohort study of patients who completed appointments from January 1, 2018, to October 13, 2018, inclusive in all 130 Veterans Affairs (VA) health centers in the US. The study population comprised a census of all patients who received care at any VA health center during the period of the study for outpatient, procedural, rehabilitation, or radiology services. Data were analyzed from May 15, 2021, to December 15, 2021. Exposures: Phased introduction of an electronic appointment reminder system (VEText) in 6 waves spread across the study period. Main Outcomes and Measures: The unit of observation in this study was a completed appointment made by any such patients. Observations were excluded if the appointment was booked before but completed after the exposure, or if data were duplicated, missing, or incomplete. For each completed appointment, the number of days between which the appointment was booked and when it was completed. Results: The number of observations after exclusion comprised 39.5 million completed appointments from 5.1 million patients (91.1% male) with a mean (SD) age of 62.57 (16.24) years. The adoption of VEText was associated with an estimated reduction in patient waiting time by a mean of 6.51 days (95% CI, 5.51-7.52 days). Adoption of VEText was also associated with an increase of 8.54 (95% CI, 7.65-9.44) days of additional waiting per incomplete booking. Conclusions and Relevance: Results of this study suggest that appointment reminder systems may be associated with decreases in the mean number of days patients in the VA system have to wait for their appointments but can potentially lengthen waiting times for patients who miss their bookings. Further study is warranted to assess whether these findings may be generalizable to other populations.

Development and validation of a new scale to assess air quality knowledge (AQIQ).

BACKGROUND: Air pollution is a leading public health concern around the world. Assessing the public's knowledge about air quality is critical to calibrate public health interventions. However, previous efforts to measure knowledge about air quality (AQIQ) have not relied on consistent and validated measures, thus precluding cross-country comparisons. We aimed to develop a robust scale to assess AQIQ and tested it in multiple countries. METHODS: To evaluate the psychometric properties and select the best performing items out of 10 AQIQ questions, we used methods from classical test theory and item response theory. We evaluated the scales using several scalability measures, including the Kuder-Richardson Formula 20 (KR-20), Loevinger's H, as well as trace lines. Volunteers from the United States (US, n = 400), India (n = 403), and China (n = 443) were recruited to validate the scale. Multiple linear regression was used to estimate the association between demographic factors and AQIQ. RESULTS: We found that participants from India had the highest AQIQ. In addition, not all questions performed well in each country. The scale was pruned and shorter subscales were validated. In the US, we obtained a 4-item scale (KR20 = 0.53, Loevinger's H = 0.34). In India, we obtained a 6-item scale (KR20 = 0.56; Loevinger's H = 0.48 for just 2 items). In China, we obtained a 5-item scale (KR20 = 0.39; Loevinger's H = 0.41 for just 2 items). Compared to the 10-item scale, the pruned scales showed stronger associations between measures of socioeconomic status and AQIQ. The results were robust to the scale used. CONCLUSIONS: Overall, general knowledge questions measured AQIQ more effectively in the US and India whereas knowledge of the air quality index better measured AQIQ in China. The findings suggest that careful measurement and validation are essential to develop knowledge scales for use in public health and environmental research.

One-way routes complicate cooperation in migrant crises.

How can countries cooperate to shelter migrants? We use experimental economics to study the distinct challenges of cooperation in migrant crises. We designed an economic game, pass the buck, where participants are leaders of countries who decide whether to shelter migrants or pass them to the next country. We examine the difficulties posed by one-way migration and differences in wealth. We find that leaders sheltered migrants less often when they received them first on a one-way route, compared to when everyone received migrants at the same time. Moreover, the first leader became more likely to shelter migrants when the last country could return them to the first. When one country was wealthier, the wealthy leader sheltered more and the other leaders passed more. We discuss the implications for international cooperation in migrant crises.