Vicarious Experience Affects Patients' Treatment Preferences for Depression

Depression is common in primary care but often under-treated. Personal experiences with depression can affect adherence to therapy, but the effect of vicarious experience is unstudied. We sought to evaluate the association between a patient's vicarious experiences with depression (those of friends or family) and treatment preferences for depressive symptoms.We sampled 1054 English and/or Spanish speaking adult subjects from July through December 2008, randomly selected from the 2008 California Behavioral Risk Factor Survey System, regarding depressive symptoms and treatment preferences. We then constructed a unidimensional scale using item analysis that reflects attitudes about antidepressant pharmacotherapy. This became the dependent variable in linear regression analyses to examine the association between vicarious experiences and treatment preferences for depressive symptoms.Our sample was 68% female, 91% white, and 13% Hispanic. Age ranged from 18-94 years. Mean PHQ-9 score was 4.3; 14.5% of respondents had a PHQ-9 score >9.0, consistent with active depressive symptoms. Analyses controlling for current depression symptoms and socio-demographic factors found that in patients both with (coefficient 1.08, p = 0.03) and without (coefficient 0.77, p = 0.03) a personal history of depression, having a vicarious experience (family and friend, respectively) with depression is associated with a more favorable attitude towards antidepressant medications.Patients with vicarious experiences of depression express more acceptance of pharmacotherapy. Conversely, patients lacking vicarious experiences of depression have more negative attitudes towards antidepressants. When discussing treatment with patients, clinicians should inquire about vicarious experiences of depression. This information may identify patients at greater risk for non-adherence and lead to more tailored patient-specific education about treatment

Identifying the sources of uncertainty in climate model simulations of solar radiation modification with the G6sulfur and G6solar Geoengineering Model Intercomparison Project (GeoMIP) simulations

We present here results from the Geoengineering Model Intercomparison Project (GeoMIP) simulations for the experiments G6sulfur and G6solar for six Earth system models participating in the Climate Model Intercomparison Project (CMIP) Phase 6. The aim of the experiments is to reduce the warming that results from a high-tier emission scenario (Shared Socioeconomic Pathways SSP5-8.5) to that resulting from a medium-tier emission scenario (SSP2-4.5). These simulations aim to analyze the response of climate models to a reduction in incoming surface radiation as a means to reduce global surface temperatures, and they do so either by simulating a stratospheric sulfate aerosol layer or, in a more idealized way, through a uniform reduction in the solar constant in the model. We find that over the final two decades of this century there are considerable inter-model spreads in the needed injection amounts of sulfate (29±9Tg-SO2/yr between 2081 and 2100), in the latitudinal distribution of the aerosol cloud and in the stratospheric temperature changes resulting from the added aerosol layer. Even in the simpler G6solar experiment, there is a spread in the needed solar dimming to achieve the same global temperature target (1.91±0.44). The analyzed models already show significant differences in the response to the increasing CO2 concentrations for global mean temperatures and global mean precipitation (2.05K±0.42K and 2.28±0.80, respectively, for SSP5-8.5 minus SSP2-4.5 averaged over 2081-2100). With aerosol injection, the differences in how the aerosols spread further change some of the underlying uncertainties, such as the global mean precipitation response (-3.79±0.76 for G6sulfur compared to -2.07±0.40 for G6solar against SSP2-4.5 between 2081 and 2100). These differences in the behavior of the aerosols also result in a larger uncertainty in the regional surface temperature response among models in the case of the G6sulfur simulations, suggesting the need to devise various, more specific experiments to single out and resolve particular sources of uncertainty. The spread in the modeled response suggests that a degree of caution is necessary when using these results for assessing specific impacts of geoengineering in various aspects of the Earth system. However, all models agree that compared to a scenario with unmitigated warming, stratospheric aerosol geoengineering has the potential to both globally and locally reduce the increase in surface temperatures. © 2021 Daniele Visioni et al

The Carbon Dioxide Removal Model Intercomparison Project (CDRMIP): rationale and experimental protocol for CMIP6

The recent IPCC reports state that continued anthropogenic greenhouse gas emissions are changing the climate, threatening "severe, pervasive and irreversible" impacts. Slow progress in emissions reduction to mitigate climate change is resulting in increased attention to what is called geoengineering, climate engineering, or climate intervention – deliberate interventions to counter climate change that seek to either modify the Earth's radiation budget or remove greenhouse gases such as CO2 from the atmosphere. When focused on CO2, the latter of these categories is called carbon dioxide removal (CDR). Future emission scenarios that stay well below 2 °C, and all emission scenarios that do not exceed 1.5 °C warming by the year 2100, require some form of CDR. At present, there is little consensus on the climate impacts and atmospheric CO2 reduction efficacy of the different types of proposed CDR. To address this need, the Carbon Dioxide Removal Model Intercomparison Project (or CDRMIP) was initiated. This project brings together models of the Earth system in a common framework to explore the potential, impacts, and challenges of CDR. Here, we describe the first set of CDRMIP experiments, which are formally part of the 6th Coupled Model Intercomparison Project (CMIP6). These experiments are designed to address questions concerning CDR-induced climate "reversibility", the response of the Earth system to direct atmospheric CO2 removal (direct air capture and storage), and the CDR potential and impacts of afforestation and reforestation, as well as ocean alkalinization.

Climate response to off-equatorial stratospheric sulfur injections in three Earth system models – Part 1: Experimental protocols and surface changes

There is now substantial literature on climate model studies of equatorial or tropical stratospheric SO2 injections that aim to counteract the surface warming produced by rising concentrations of greenhouse gases. Here we present the results from the first systematic intercomparison of climate responses in three Earth system models wherein the injection of SO2 occurs at different latitudes in the lower stratosphere: CESM2-WACCM6, UKESM1.0 and GISS-E2.1-G. The first two use a modal aerosol microphysics scheme, while two versions of GISS-E2.1-G use a bulk aerosol (One-Moment Aerosol, OMA) and a two-moment (Multiconfiguration Aerosol TRacker of mIXing state, MATRIX) microphysics approach, respectively. Our aim in this work is to determine commonalities and differences between the climate model responses in terms of the distribution of the optically reflective sulfate aerosols produced from the oxidation of SO2 and in terms of the surface response to the resulting reduction in solar radiation. A focus on understanding the contribution of characteristics of models transport alongside their microphysical and chemical schemes, and on evaluating the resulting stratospheric responses in different models, is given in the companion paper (Bednarz et al., 2023). The goal of this exercise is not to evaluate these single-point injection simulations as stand-alone proposed strategies to counteract global warming; instead we determine sources and areas of agreement and uncertainty in the simulated responses and, ultimately, the possibility of designing a comprehensive intervention strategy capable of managing multiple simultaneous climate goals through the combination of different injection locations. We find large disagreements between GISS-E2.1-G and the CESM2-WACCM6 and UKESM1.0 models regarding the magnitude of cooling per unit of aerosol optical depth (AOD) produced, which varies from 4.7 K per unit of AOD in CESM2-WACCM6 to 16.7 K in the GISS-E2.1-G version with two-moment aerosol microphysics. By normalizing the results with the global mean response in each of the models and thus assuming that the amount of SO2 injected is a free parameter that can be managed independently, we highlight some commonalities in the overall distributions of the aerosols, in the inter-hemispheric surface temperature response and in shifts to the Intertropical Convergence Zone, as well as some areas of disagreement, such as the extent of the aerosol confinement in the equatorial region and the efficiency of the transport to polar latitudes. In conclusion, we demonstrate that it is possible to use these simulations to produce more comprehensive injection strategies in multiple climate models. However, large differences in the injection magnitudes can be expected, potentially increasing inter-model spreads in some stratospheric quantities (such as aerosol distribution) while reducing the spread in the surface response in terms of temperature and precipitation; furthermore, the selection of the injection locations may be dependent on the models' specific stratospheric transport.</p

Pheromonal and Behavioral Cues Trigger Male-to-Female Aggression in Drosophila

By genetically manipulating both pheromonal profiles and behavioral patterns, we find that Drosophila males showed a complete reversal in their patterns of aggression towards other males and female

Assessing the controllability of Arctic sea ice extent by sulfate aerosol geoengineering

In an assessment of how Arctic sea ice cover could be remediated in a warming world, we simulated the injection of SO2 into the Arctic stratosphere making annual adjustments to injection rates. We treated one climate model realization as a surrogate “real world” with imperfect “observations” and no rerunning or reference to control simulations. SO2 injection rates were proposed using a novel model predictive control regime which incorporated a second simpler climate model to forecast “optimal” decision pathways. Commencing the simulation in 2018, Arctic sea ice cover was remediated by 2043 and maintained until solar geoengineering was terminated. We found quantifying climate side effects problematic because internal climate variability hampered detection of regional climate changes beyond the Arctic. Nevertheless, through decision maker learning and the accumulation of at least 10 years time series data exploited through an annual review cycle, uncertainties in observations and forcings were successfully managed

The Effect of Patients’ Met Expectations on Consultation Outcomes. A Study with Family Medicine Residents

OBJECTIVES: To know the patients’ expectations and the fulfillment of these at family medicine consultations by resident doctors and to assess their effect on some consultation outcomes. DESIGN: A prospective cohort study. PARTICIPANTS: Patients attending family medicine consultations held by 38 resident doctors: 1,301 eligible patients, 702 filled in all questionnaires. MEASUREMENTS: Before each visit, the patients’ expectations about that particular consultation were registered. Right after the visit was over, their perception of several aspects of the communicative interaction with the doctor was measured. Later, patients were interviewed on the phone to know how their expectations had been fulfilled, how satisfied they were about the consultation, how they had followed the doctor’s suggestions, if they were going to seek further care for the same cause later, and the evolution of their clinical problem. Logistic regression was the main analysis used. RESULTS: The most common expectations were the doctor showing interest and listening (30.5%), getting some information about the diagnosis (16.3%), and sharing problems and doubts (11.1%). The rate of main expectations that were met was 76.5%. Satisfaction with the encounter was associated with the clinical evolution [odds ratio (OR) 2.23; confidence interval (CI): 1.32–3.75], and the fulfilling of the patients’ main or two main expectations was significantly related to all the measured outcomes (satisfaction OR 3.51, CI: 1.73–7.8; adherence OR 1.80, CI: 1.11–2.92; clinical evolution OR 1.54, CI: 1.01–2.35; and seeking further care later OR 0.54, CI:0.36–0.81) CONCLUSIONS: Patients prioritize expectations of a more general sort when they attend primary care consultations and residents fulfill these acceptably. The fulfillment of expectations seems to affect the studied outcomes more than other factors