Dr Dorothee Amelung

Background

It is now universally acknowledged that climate change constitutes a major threat to human health. At the same time, some of the measures to reduce greenhouse gas emissions, so-called climate change mitigation measures, have significant health co-benefits (e.g., walking or cycling more; eating less meat). The goal of limiting global warming to 1,5° Celsius set by the Conference of the Parties to the United Nations Framework Convention on Climate Change in Paris in 2015 can only be reached if all stakeholders, including households, take actions to mitigate climate change. Results on whether framing mitigation measures in terms of their health co-benefits increases the likelihood of their implementation are inconsistent. The present study protocol describes the transdisciplinary project HOPE (HOuseholds’ Preferences for reducing greenhouse gas emissions in four European high-income countries) that investigates the role of health co-benefits in households’ decision making on climate change mitigation measures in urban households in France, Germany, Norway and Sweden.

Methods

HOPE employs a mixed-methods approach combining status-quo carbon footprint assessments, simulations of the reduction of households’ carbon footprints, and qualitative in-depth interviews with a subgroup of households. Furthermore, a policy analysis of current household oriented climate policies is conducted. In the simulation of the reduction of households’ carbon footprints, half of the households are provided with information on health co-benefits of climate change mitigation measures, the other half is not. Households’ willingness to implement the measures is assessed and compared in between-group analyses of variance.

Discussion

This is one of the first comprehensive mixed-methods approaches to investigate which mitigation measures households are most willing to implement in order to reach the 1,5° target set by the Paris Agreement, and whether health co-benefits can serve as a motivator for households to implement these measures. The comparison of the empirical data with current climate policies will provide knowledge for tailoring effective climate change mitigation and health policies.

It is a truism, but unfortunately not true: policy-relevant climate information should be communicated such that non-scientists can understand. Through their assessment reports, the Intergovernmental Panel on Climate Change (IPCC) periodically assesses global climate research, and creates “Summaries for Policymakers” (SPM) which constitute a synopsis of the most policy-relevant findings. The SPMs' main principles include being “audience-appropriate” and “policy-relevant but not policy-prescriptive” (IPCC, 1998). To do justice to these principles, the communicated climate science must deliver an optimal basis for decision-making by non-scientists. However, SPMs are written in a highly scientific style. In a recent linguistic analysis, SPMs' readability proved to be extremely low, scoring even below scientific publications (Barkemeyer et al., 2015). There is, however, reason to believe that more effective climate communication is possible. Recent research has shown that despite a long-held skepticism (e.g., Sterman, 2008), accessible presentation formats can increase understanding of the dynamically complex determinants of climate change (Fischer et al., 2015). Importantly, the communication of highly scientific topics such as climate change or health is generally either intended to promote predefined behavior change in the recipient (e.g., anti- smoking-campaigns; messages that aim at the reduction of red meat consumption), or may induce premature closure around specific strategies by unintentionally shaping public discourse and opinion (Amelung and Funke, 2015). Because SPMs should not be policy-prescriptive, however, they should enable informed decision-making without promoting specific response strategies or unintentionally and prematurely narrowing down public debates.

This article therefore is concerned with how to improve understanding—the accuracy of the recipient's reasoning—to allow for informed decision-making. A central aspect of improved communication is to reduce the amount of detail covered in the SPMs to a cognitively manageable degree, and to ensure that key information is conveyed. We selectively review cognitive process theories and findings derived from the area of health communication meant as starting points for empirical research toward more effective climate communication.

Background

The concept of attachment is relevant for the onset and development of chronic pain. Insecure attachment styles negatively affect therapeutic outcome. Insecurely attached patients seem to be less able to sustain positive effects of a multimodal treatment program. However, it has never been tested before if an attachment-oriented approach can improve treatment results of insecurely attached patients in a multimodal outpatient setting. To test this assumption, we compare the short- and long-term outcomes for pain patients who will receive multidisciplinary, attachment-oriented treatment with the outcomes for patients in a control group, who will receive the multidisciplinary state-of-the-art treatment.

Methods

Two patient groups (baseline, attachment intervention) are assessed before treatment, after treatment, and at a 6 month follow-up. The study is conducted in a block design: After data collection of the first block (controls) and before as well as during data collection for the second block (treatment group), the health care personnel of the outpatient pain clinic receives training on attachment theory and its use in the therapeutic context. Pain intensity as measured with visual analogue scales and physical functioning will serve as the primary outcome measures.

Discussion

The design of our study allows for a continuous exchange of experienced team members, which may help bring about concrete attachment related guidelines for the enhancement of therapeutic outcome. This would be the first attempt at an attachment-oriented improvement of multimodal pain programs.

Conclusion

An attachment-based approach may be a promising way to enhance long-term treatment outcomes for insecurely attached pain patients

This study explores the development of laypeople’s preferences for newly emerging

climate engineering technology (CE). It examines whether laypeople perceive

CE to be an acceptable back-up strategy (plan B) if current efforts to mitigate CO2

emissions were to fail. This idea is a common justification for CE research in the

scientific debate and may significantly influence future public debates. Ninety-eight

German participants chose their preferred climate policy strategy in a quasi-realistic

scenario. Participants could chose between mitigation and three CE techniques as

alternative options. We employed a think-aloud interview technique, which allowed

us to trace participants’ informational needs and thought processes. Drawing on

Huber’s risk management decision theory, the study addressed whether specific CE

options are more likely to be accepted if they are mentally represented as a back-up

strategy. Results support this assumption, especially for cloud whitening. This result

is especially relevant considering the high prevalence of the plan B framing in CE

appraisal studies and its implications for public opinion-formation processes.

Background

Attachment insecurity relates to the onset and course of chronic pain via dysfunctional reactions to pain. However, few studies have investigated the proportion of insecure attachment styles in different pain conditions, and results regarding associations between attachment, pain severity, and disability in chronic pain are inconsistent. This study aims to clarify the relationships between insecure attachment and occurrence or severity of chronic pain with and without clearly defined organic cause. To detect potential differences in the importance of global and romantic attachment representations, we included both concepts in our study.

Methods

85 patients with medically unexplained musculoskeletal pain (UMP) and 89 patients with joint pain from osteoarthritis (OA) completed self-report measures of global and romantic attachment, pain intensity, physical functioning, and depression.

Results

Patients reporting global insecure attachment representations were more likely to suffer from medically unexplained musculoskeletal pain (OR 3.4), compared to securely attached patients. Romantic attachment did not differ between pain conditions. Pain intensity was associated with romantic attachment anxiety, and this relationship was more pronounced in the OA group compared to the UMP group. Both global and romantic attachment anxiety predicted depression, accounting for 15% and 17% of the variance, respectively. Disability was independent from attachment patterns.

Conclusions

Our results indicate that global insecure attachment is associated with the experience of medically unexplained musculoskeletal pain, but not with osteoarthritis. In contrast, insecure attachment patterns seem to be linked to pain intensity and pain-related depression in unexplained musculoskeletal pain and in osteoarthritis. These findings suggest that relationship-informed focused treatment strategies may alleviate pain severity and psychological distress in chronic pain independent of underlying pathology.

The association between attachment style and subjective pain is controversially discussed and the influence of attachment styles on cytokine levels in chronic pain has received little attention in research. In this prospective longitudinal clinical study, we evaluated the relationship between cytokines, attachment style and subjective pain intensity as well as pain-related functioning in patients with fibromyalgia (FM) who underwent a 4-week multidisciplinary pain therapy.The attachment style was determined in 43 patients with FM using the relationship questionnaire (RQ-2) and subjective pain with the German version of the West Haven-Yale multidimensional pain inventory. Serum levels of the proinflammatory cytokines tumor necrosis factor alpha (TNF-α) and interleukin 8 (IL-8) and the anti-inflammatory cytokines IL-4 and IL-10 were assessed before and after treatment and additionally once only in 18 healthy controls (Bio-Plex system).Patients with FM syndrome were significantly more often insecurely attached than healthy controls (p = 0.001). Serum levels of TNF-α (p = 0.001) and IL-10 (p = 0.039) were significantly higher in FM patients compared to controls. Attachment was unrelated to IL-4, IL-8, and IL-10 levels. Insecurely attached FM patients had significantly higher levels of TNF-α (p = 0.002). than securely attached patients. Insecurely and securely attached patients did not differ in subjective levels of pain severity, activity or functional interference. Cytokine levels were not correlated with subjective levels of pain severity or functional interference. Multidisciplinary pain therapy significantly reduced cytokine levels, pain severity, anxiety and depression independent of attachment style.

Decision-makers in the context of climate politics are confronted with considerable uncertainties due to the complexities inherent in the relevant natural and social systems. Nonetheless, pressure on decision-makers to find solutions to dangerous climate change is rising due to the inertia in the climate system. Considering these pressures, technological options (climate engineering) have been proposed to counteract the effects of climatic change. However, introducing options that bear their own scientific uncertainties means further adding to the complexity of the situation. By adopting the psychological perspective of complex problem solving research, we analyze one frequently neglected source of uncertainty with regard to climate engineering: errors of the political problem-solver in his interaction with the situational demands of complex problems. More specifically, we examine the psychological sources for human error that are common in dealing with the uncertainties implied in this type of problem. We will conclude from the complex problem solving perspective that a consideration of climate engineering in the context of climate change can provide a dangerous illusion of controllability.

Decisions in the context of Climate Engineering (CE), the deliberate large-scale manipulation of the Earth’s climate, are decisions made under uncertainty. CE options are associated with a broad range of environmental and societal risks that raise complex questions: How can the risks be assessed and evaluated when balanced against the risks of alternative strategies to counteract climate change? What are the strategic implications for climate politics against the background of insufficient scientific knowledge? Can we estimate the ethical implications of the risks involved for society? Uncertainties and risks represent a central aspect of the issue but cannot be reduced to the traditional technical orientation of risk terminologies. The article elaborates on the specific characteristics of the risks and uncertainties associated with CE technology from six different disciplinary viewpoints. It thereby seeks to reveal chances for a mutual enrichment of these individual viewpoints since each discipline experiences boundaries while examining the complex risks of CE. In this way, the article redefines disciplinary boundaries without entirely dissolving them and without disregarding the valuable contribution every individual viewpoint can make. This aim is realized by means of the identification of new approaches to central questions regarding the risks and uncertainties involved in CE that can only be addressed from an interdisciplinary perspective.