Everything should be as simple as possible, but no simpler : towards a protocol for accumulating evidence regarding the active content of health behaviour change interventions

Supplemental data for this article can be accessed here: 10.1080/17437199.2013.848409Peer reviewedPublisher PD

Will climate change increase ozone depletion from low-energy-electron precipitation?

We investigate the effects of a strengthened stratospheric/mesospheric residual circulation on the transport of nitric oxide (NO) produced by energetic particle precipitation. During periods of high geomagnetic activity, energetic electron precipitation (EEP) is responsible for winter time ozone loss in the polar middle atmosphere between 1 and 6 hPa. However, as climate change is expected to increase the strength of the Brewer-Dobson circulation including extratropical downwelling, the enhancements of EEP NO<sub>x</sub> concentrations are expected to be transported to lower altitudes in extratropical regions, becoming more significant in the ozone budget. Changes in the mesospheric residual circulation are also considered. We use simulations with the chemistry climate model system EMAC to compare present day effects of EEP NO<sub>x</sub> with expected effects in a climate change scenario for the year 2100. In years of strong geomagnetic activity, similar to that observed in 2003, an additional polar ozone loss of up to 0.4 μmol/mol at 5 hPa is found in the Southern Hemisphere. However, this would be approximately compensated by an ozone enhancement originating from a stronger poleward transport of ozone from lower latitudes caused by a strengthened Brewer-Dobson circulation, as well as by slower photochemical ozone loss reactions in a stratosphere cooled by risen greenhouse gas concentrations. In the Northern Hemisphere the EEP NO<sub>x</sub> effect appears to lose importance due to the different nature of the climate-change induced circulation changes

Stratospheric dryness: model simulations and satellite observations

The mechanisms responsible for the extreme dryness of the stratosphere have been debated for decades. A key difficulty has been the lack of comprehensive models which are able to reproduce the observations. Here we examine results from the coupled lower-middle atmosphere chemistry general circulation model ECHAM5/MESSy1 together with satellite observations. Our model results match observed temperatures in the tropical lower stratosphere and realistically represent the seasonal and inter-annual variability of water vapor. The model reproduces the very low water vapor mixing ratios (below 2 ppmv) periodically observed at the tropical tropopause near 100 hPa, as well as the characteristic tape recorder signal up to about 10 hPa, providing evidence that the dehydration mechanism is well-captured. Our results confirm that the entry of tropospheric air into the tropical stratosphere is forced by large-scale wave dynamics, whereas radiative cooling regionally decelerates upwelling and can even cause downwelling. Thin cirrus forms in the cold air above cumulonimbus clouds, and the associated sedimentation of ice particles between 100 and 200 hPa reduces water mass fluxes by nearly two orders of magnitude compared to air mass fluxes. Transport into the stratosphere is supported by regional net radiative heating, to a large extent in the outer tropics. During summer very deep monsoon convection over Southeast Asia, centered over Tibet, moistens the stratosphere

Older people's attitudes towards deprescribing cardiometabolic medication

Abstract Background Overtreatment with cardiometabolic medication in older patients can lead to major adverse events. Timely deprescribing of these medications is therefore essential. Self-reported willingness to stop medication is usually high among older people, still overtreatment with cardiometabolic medication is common and deprescribing is rarely initiated. An important barrier for deprescribing reported by general practitioners is the patients’ unwillingness to stop the medication. More insights are needed into the influence of patients’ characteristics on their attitudes towards deprescribing and differences in these attitudes between cardiometabolic medication groups. Methods A survey in older people using cardiometabolic medication using the revised Patients’ Attitudes Towards Deprescribing (rPATD) questionnaire was performed. Participants completed the general rPATD and an adapted version for four medication groups. Linear and ordinal logistic regression were used to assess the influence of age, sex, therapeutic area and number of medications used on the patients’ general attitudes towards deprescribing. Univariate analysis was used to compare differences in deprescribing attitudes towards sulfonylureas, insulins, antihypertensive medication and statins. Results Overall, 314 out of 1143 invited participants completed the survey (median age 76 years, 54% female). Most participants (80%) were satisfied with their medication and willing to stop medications if their doctor said it was possible (88%). Age, sex and therapeutic area had no influence on the general attitudes towards deprescribing. Taking more than ten medicines was significantly associated with a higher perceived medication burden. Antihypertensive medication and insulin were considered more appropriate than statins, and insulin was considered more appropriate than sulfonylureas not favouring deprescribing. Conclusions The majority of older people using cardiometabolic medication are willing to stop one of their medicines if their doctor said it was possible. Health care providers should take into account that patients perceive some of their medication as more appropriate than other medication when discussing deprescribing

Oxygenated compounds in aged biomass burning plumes over the Eastern Mediterranean: evidence for strong secondary production of methanol and acetone

International audienceAirborne measurements of acetone, methanol, PAN, acetonitrile (by Proton Transfer Reaction Mass Spectrometry), and CO (by Tunable Diode Laser Absorption Spectroscopy) have been performed during the Mediterranean Intensive Oxidants Study (MINOS August 2001). We have identified ten biomass burning plumes from strongly elevated acetonitrile mixing ratios. The characteristic biomass burning signatures obtained from these plumes reveal secondary production of acetone and methanol, while CO photochemically declines in the plumes. Mean excess mixing ratios - normalized to CO - of 1.8%, 0.20%, 3.8%, and 0.65% for acetone, acetonitrile, methanol, and PAN, respectively, were found. By scaling to an assumed global annual source of 663-807Tg CO, biomass burning emissions of 25-31 and 29-35 Tg/yr for acetone and methanol are estimated, respectively. Our measurements suggest that the present biomass burning contributions of acetone and methanol are significantly underestimated due to the neglect of secondary formation within the plume. Median acetonitrile mixing ratios throughout the troposphere were around 150pmol/mol, in accord with current biomass burning inventories and an atmospheric lifetime of ~6 months

Fire effects on soils: the human dimension

Soils are among the most valuable non-renewable resources on the Earth. They support natural vegetation and human agro-ecosystems, represent the largest terrestrial organic carbon stock, and act as stores and filters for water. Mankind has impacted on soils from its early days in many different ways, with burning being the first human perturbation at landscape scales. Fire has long been used as a tool to fertilize soils and control plant growth, but it can also substantially change vegetation, enhance soil erosion and even cause desertification of previously productive areas. Indeed fire is now regarded by some as the seventh soil-forming factor. Here we explore the effects of fire on soils as influenced by human interference. Human-induced fires have shaped our landscape for thousands of years and they are currently the most common fires in many parts of the world. We first give an overview of fire effect on soils and then focus specifically on (i) how traditional land-use practices involving fire, such as slash-and-burn or vegetation clearing, have affected and still are affecting soils; (ii) the effects of more modern uses of fire, such as fuel reduction or ecological burns, on soils; and (iii) the ongoing and potential future effects on soils of the complex interactions between human-induced land cover changes, climate warming and fire dynamics. This article is part of the themed issue ‘The interaction of fire and mankind’