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BackgroundType 2 diabetes mellitus (T2DM) has been associated with infectious diseases; however, whether T2DM is associated with bacterial-resistant infections has not been thoroughly studied. We ascertained whether people with T2DM were more likely to experience resistant infections in comparison to T2DM-free individuals.MethodsSystematic review and random-effects meta-analysis. The search was conducted in Medline, Embase and Global Health. We selected observational studies in which the outcome was resistant infections (any site), and the exposure was T2DM. We studied adult subjects who could have been selected from population-based or hospital-based studies. I2 was the metric of heterogeneity. We used the Newcastle-Ottawa risk of bias scale.ResultsThe search retrieved 3370 reports, 97 were studied in detail and 61 (449 247 subjects) were selected. Studies were mostly cross-sectional or case–control; several infection sites were studied, but mostly urinary tract and respiratory infections. The random-effects meta-analysis revealed that people with T2DM were twofold more likely to have urinary tract (OR=2.42; 95% CI 1.83 to 3.20; I2 19.1%) or respiratory (OR=2.35; 95% CI 1.49 to 3.69; I2 58.1%) resistant infections. Although evidence for other infection sites was heterogeneous, they consistently suggested that T2DM was associated with resistant infections.ConclusionsCompelling evidence suggests that people with T2DM are more likely to experience antibiotic-resistant urinary tract and respiratory infections. The evidence for other infection sites was less conclusive but pointed to the same overall conclusion. These results could guide empirical treatment for patients with T2DM and infections.

The use of biomass to produce biofuels can lead to both direct and indirect Land Use Change (LUC). While the causes underlying LUCs are complex their quantification is a scientific challenge that hinders decision-making. Here we demonstrate the application of participatory modelling in combination with System Dynamics techniques to the analysis of the land-change dynamics associated with biofuel supply chains. The ambition is to provide decision-makers with useful and credible knowledge of direct and indirect LUCs. We illustrate the application of the approach by applying it to a real‐world project for the production of advanced biofuels in Sardinia (Italy). The results show that the land use displacements vary in intensity and persistence depending on the crop management regime applied and the future development of the market of sheep cheese. The results were considered credible by actors with direct knowledge of the ‘real’ system and useful by decision makers .

Driven by the necessity to increase utilisation of the existing networks and accommodation of volatility in renewable energy generation, the energy sector is undergoing a shift from an unconstrained infrastructure expansion to accommodate growth in demand towards demand management strategies. Such strategies, for example nudging demand using incentives such as price signals, or Demand Side Response (DSR), rely on the ability to accurately understand and harness flexibility in demand. Activity-based demand modelling frameworks can provide this capability, as they enable the detailed modelling and simulation of individuals and their activities. However, to date, no modelling approach has been proposed that can link energy consumption of a household to the activities undertaken, heterogeneity of the household residents, presence and use of household appliances and devices as well as weather and energy system-related variables. This paper addresses the gap by proposing a log-linear mixed-effects model of energy consumption based on reported household activities alongside a comprehensive set of attributes and contextual variables that might influence household energy consumption. Application of the model is demonstrated using joint time-use and residential electricity consumption data from 160 households, collected between 2016 and 2018 in the UK. The modelling results prove the value of incorporating time-use (activities) in modelling residential electricity demand, when compared against modelling without such considerations. Furthermore, the model provides (semi-)elasticities of demand and marginal changes in electricity consumption due to activities, which are of direct policy value or serve as inputs into activity-based energy demand simulation.

BackgroundIn 2011, England introduced the Public Health Responsibility Deal (RD), a public-private partnership (PPP) which gave greater freedom to the food industry to set and monitor targets for salt intakes. We estimated the impact of the RD on trends in salt intake and associated changes in cardiovascular disease (CVD) and gastric cancer (GCa) incidence, mortality and economic costs in England from 2011–2025.MethodsWe used interrupted time series models with 24 hours' urine sample data and the IMPACTNCD microsimulation model to estimate impacts of changes in salt consumption on CVD and GCa incidence, mortality and economic impacts, as well as equity impacts.ResultsBetween 2003 and 2010 mean salt intake was falling annually by 0.20 grams/day among men and 0.12 g/d among women (P-value for trend both < 0.001). After RD implementation in 2011, annual declines in salt intake slowed statistically significantly to 0.11 g/d among men and 0.07 g/d among women (P-values for differences in trend both P < 0.001). We estimated that the RD has been responsible for approximately 9900 (interquartile quartile range (IQR): 6700 to 13,000) additional cases of CVD and 1500 (IQR: 510 to 2300) additional cases of GCa between 2011 and 2018. If the RD continues unchanged between 2019 and 2025, approximately 26 000 (IQR: 20 000 to 31,000) additional cases of CVD and 3800 (IQR: 2200 to 5300) cases of GCa may occur.InterpretationPublic-private partnerships such as the RD which lack robust and independent target setting, monitoring and enforcement are unlikely to produce optimal health gains.

Drawing on peer-reviewed and grey literature, Powell et al argue the dominant narrative of personal self-care during the COVID-19 pandemic must be supplemented with a collectivist approach that addresses structural inequalities and fosters a more equitable society. Compliance with self-care and risk mitigation strategies to tackle COVID-19 has been chequered in the UK, fuelled partly by social media hoaxes and misinformation, virus denialism, and policy leaders contravening their own public health messaging. Exploring individual non-compliance, and reflecting on wider societal inequities that can impact it, can help build critical normative resilience to future pandemics. From the outset, COVID-19 public health messaging was, and remains, primarily aimed at modifying individual lifestyles and behaviours to flatten the infectivity curve by following ‘common sense’ approaches captured by the hands–face–space mantra.1 A culture of practice and new social norms of acceptable behaviour subsequently emerged,2 with concordance premised on cooperation between the public and government. However, as the pandemic worsened and movement restrictions continued, norms were contested by a small but vocal segment of society. This normative contestation was founded on conflict between individual agency, government paternalism and regulatory diktat, and echoed Kant’s epistemology of altruism and the need to sacrifice individual liberties for the ‘greater good’. This conflict was exacerbated by multiple lockdowns that significantly impacted individuals’ …

The Sendai Framework for Disaster Risk Reduction (2015–2030) mandates stronger inclusion of persons with disability in DRR. Yet pathways to achieving new targets for disability-inclusive disaster risk reduction (DiDRR) and their feasibility remain unclear and are under-researched. To redress this gap, we undertake a three-step longitudinal assessment that: (i) examines the challenges the d/Deaf community, a cultural and linguistic minority with an invisible disability, in New South Wales, Australia face in accessing the support they need to effectively respond to risk; (ii) presents a range of community-driven resilience-building solutions that derived from the research; and most critically (iii) follows the implementation and outcomes of key resilience building solutions over a 6-year period and the impact these ‘system feedbacks’ may have on future initiatives. Our findings show that the d/Deaf community's vulnerability and resilience levels are influenced by insufficient levels of human capital in the d/Deaf community and emergency services, limited and uneven access to social capital (most notably information in accessible forms) and unsupportive governance structures that inhibit access to resources and inclusion in DRR processes that erodes trust. But the greatest inhibitors to building resilience over time are: (i) the absence of funds and clear directives to support long term sustainable change; and (ii) failures in understanding, engaging with and overcoming deeply embedded cultural divides that exist within the d/Deaf community and between the d/Deaf and hearing worlds.

Extreme and impactful weather events of the recent past provide a vital but under-utilised data source for understanding present and future climate risks. Extreme event attribution (EEA) enables us to quantify the influence of anthropogenic climate change (ACC) on a given event in a way that can be tailored to stakeholder needs, thereby enhancing the potential utility of studying past events. Here we set out a framework for systematically recording key details of high-impact events on a national scale (using the UK and Puerto Rico as examples), combining recent advances in event attribution with the risk framework. These ‘inventories’ inherently provide useful information depending on a user’s interest. For example, as a compilation of the impacts of ACC, we find that in the UK since 2000, at least 1500 excess deaths are directly attributable to human-induced climate change, while in Puerto Rico the increased intensity of Hurricane Maria alone led to the deaths of up to 3670 people. We also explore how inventories form a foundation for further analysis, learning from past events. This involves identifying the most damaging hazards and crucially also vulnerabilities and exposure characteristics over time. To build a risk assessment for heat-related mortality in the UK we focus on a vulnerable group, elderly urban populations, and project changes in the hazard and exposure within the same framework. Without improved preparedness, the risk to this group is likely to increase by ~50% by 2028 and ~150% by 2043. In addition, the framework allows the exploration of the likelihood of otherwise unprecedented events, or 'Black Swans’. Finally, not only does it aid disaster preparedness and adaptation at local and national scales, such inventories also provide a new source of evidence for global stocktakes on adaptation and loss and damage such as mandated by the Paris Climate Agreement.

Background Disparities in invasive cervical cancer (ICC) incidence exist globally, particularly in HIV positive women who are at elevated risk compared to HIV negative women. We aimed to determine the spatial, temporal, and spatiotemporal incidence of ICC and the potential risk factors among HIV positive women in South Africa. Methods We included ICC cases in women diagnosed with HIV from the South African HIV cancer match study during 2004–2014. We used the Thembisa model, a mathematical model of the South African HIV epidemic to estimate women diagnosed with HIV per municipality, age group and calendar year. We fitted Bayesian hierarchical models, using a reparameterization of the Besag-York-Mollié to capture spatial autocorrelation, to estimate the spatiotemporal distribution of ICC incidence among women diagnosed with HIV. We also examined the association of deprivation, access to health (using the number of health facilities per municipality) and urbanicity with ICC incidence. We corrected our estimates to account for ICC case underascertainment, missing data and data errors. Results We included 17,821 ICC cases and demonstrated a decreasing trend in ICC incidence, from 306 to 312 in 2004 and from 160 to 191 in 2014 per 100,000 person-years across all municipalities and corrections. The spatial relative rate (RR) ranged from 0.27 to 4.43 in the model without any covariates. In the model adjusting for covariates, the most affluent municipalities had a RR of 3.18 (95% Credible Interval 1.82, 5.57) compared to the least affluent ones, and municipalities with better access to health care had a RR of 1.52 (1.03, 2.27) compared to municipalities with worse access to health. Conclusions The results show an increased incidence of cervical cancer in affluent municipalities and in those with more health facilities. This is likely driven by better access to health care in more affluent areas. More efforts should be made to ensure equitable access to health services, including mitigating physical barriers, such as transportation to health centres and strengthening of screening programmes.

ObjectiveContact tracing is a central public health response to infectious disease outbreaks, especially in the early stages of an outbreak when specific treatments are limited. Importation of novel coronavirus (COVID-19) from China and elsewhere into the UK highlights the need to understand the impact of contact tracing as a control measure.DesignDetailed survey information on social encounters from over 5800 respondents is coupled to predictive models of contact tracing and control. This is used to investigate the likely efficacy of contact tracing and the distribution of secondary cases that may go untraced.ResultsTaking recent estimates for COVID-19 transmission we predict that under effective contact tracing less than 1 in 6 cases will generate any subsequent untraced infections, although this comes at a high logistical burden with an average of 36 individuals traced per case. Changes to the definition of a close contact can reduce this burden, but with increased risk of untraced cases; we find that tracing using a contact definition requiring more than 4 hours of contact is unlikely to control spread.ConclusionsThe current contact tracing strategy within the UK is likely to identify a sufficient proportion of infected individuals such that subsequent spread could be prevented, although the ultimate success will depend on the rapid detection of cases and isolation of contacts. Given the burden of tracing a large number of contacts to find new cases, there is the potential the system could be overwhelmed if imports of infection occur at a rapid rate.

Background In rural China, mortality surveillance data may be an alternative to primary data collection in clinical trials; SmartVA (verbal autopsy) is also a potential alternative for endpoint adjudication. The feasibility and validity of both need to be assessed. Methods We used mortality data from the first 24 months of the China Salt Substitute and Stroke Study (SSaSS) trial and assessed the agreement between (1) mortality surveillance data and face-to-face visits for fact of death; (2) mortality surveillance data and SSaSS adjudication for causes of death; (3) SmartVA and SSaSS adjudication for causes of death; (4) cause-specific mortality fraction of different methods. Face-to-face visits and SSaSS adjudication were taken as reference methods. The agreement was measured by sensitivity, specificity and positive predictive value (PPV) across different 10th Revision of International Statistical Classification of Diseases chapters. Results One thousand three hundred and sixty-five deaths were included. Mortality surveillance data had 82% sensitivity for fact of death and 81% sensitivity for causes of death, with substantial variances across different disease types and reasonable quality for circulatory death (91% sensitivity and 94% PPV). The sensitivity of SmartVA for causes of death was 61%, with reasonable quality for deaths of external causes of morbidity (90% sensitivity). The leading causes of death from different sources were the same with some variances in the fractions. Conclusion Using mortality surveillance data for fact of death in clinical trials need to account for under-reporting. A face-to-face visit to all participants at the completion of trials may be warranted. Neither mortality surveillance data nor SmartVA provided valid data source for endpoint events.

Author(s): Makuch, Karen E; Aczel, Miriam R; Zaman, Sunya | Abstract: In this paper, we argue for the importance of application and safeguarding of the ‘environmental rights of children,’ and further argue that an understanding of children’s perspectives towards nature and their rights to a viable and healthy environment can help both educational and policy development. To that end, we present a case study of preliminary qualitative research conducted in the United Kingdom that asks children themselvestheir views and degree of exposure to the natural environment. This research is underpinned by an environmental rights-based approach for environmental education, and a novel argument for incorporating children’s own understandings and perspectives in application of environmental rights. We conclude with recommendations for strengthening children’s environmental engagement, protection of rights, and education, and recognize that there is a need for further research to better understand children’s perspectives to their own environmental rights.

The COVID-19 pandemic sent the oil industry into turmoil on a scale not seen since the 1970s. While the sector appears to be recovering, questions remain about the extent to which the pandemic has offered a glimpse into the possible future of the industry. This future is critical to the success of climate change mitigation, which requires significant cuts to the carbon dioxide emissions from using oil for energy. Therefore, it makes sense to consider future scenarios in which global oil demand peaks and then declines alongside scenarios of continued demand growth. This is a significant departure from historical development of oil demand and the dominant discussion of many decades about “peak oil” and the fear of demand outstripping readily available supply. The implications of peaking oil demand would be massive, not only for the oil industry but also for society as whole. There is not enough understanding of what the impacts would be, or how to prepare for them. The research community needs to take a clear-eyed view of potential futures of oil, which includes considering scenarios in which demand goes into long-term decline.

BackgroundWe assessed impacts of a large, nationwide cardiovascular disease (CVD) risk assessment and management programme on sociodemographic group inequalities in (1) early identification of hypertension, type 2 diabetes (T2D) and chronic kidney disease (CKD); and (2) management of global CVD risk among high-risk individuals.MethodsWe obtained retrospective electronic medical records from the Clinical Practice Research Datalink for a randomly selected sample of 138 788 patients aged 40–74 years without known CVD or diabetes, who were registered with 462 practices between 2009 and 2013. We estimated programme impact using a difference-in-differences matching analysis that compared changes in outcome over time between attendees and non-attendees.ResultsNational Health Service Health Check attendance was 21.4% (29 672/138 788). A significantly greater number of hypertension and T2D incident cases were identified in men than women (eg, an additional 4.02%, 95% CI 3.65% to 4.39%, and 2.08%, 1.81% to 2.35% cases of hypertension in men and women, respectively). A significantly greater number of T2D incident cases were identified among attendees living in the most deprived areas, but no differences were found for hypertension and CKD across socioeconomic groups. No major differences in CVD risk management were observed between sociodemographic subgroups (eg, programme impact on 10-year CVD risk score was −1.13%, −1.48% to −0.78% in male and −1.53%, −2.36% to −0.71% in female attendees).ConclusionDuring 2009–2013, the programme had low attendance and small overall impacts on early identification of disease and risk management. The age, sex and socioeconomic subgroups appeared to have derived similar level of benefits, leaving existing inequalities unchanged. These findings highlight the importance of population-wide interventions to address inequalities in CVD outcomes.

This paper draws on findings from an Australia-wide survey with data collected in three waves throughout 2020 to explore the impact of COVID-19 on public transport trends in metropolitan areas of Australia. Following consideration of the public transport sector response to the pandemic and the emerging literature context, we explore three principal questions: (i) How has weekly travel composition changed across the waves? (ii) How has level of concern with using public transport changed over the course of the pandemic given new bio-security concerns? and (iii) How has attitudes to risk been associated with the changes in PT use? A key finding is that concerns over bio-security issues around public transport are enduring, that concern about hygiene is significantly negatively related to public transport use and that those with higher concern about the hygiene of public transport also held higher concern about COVID-19 at work. Even as COVID-19 restrictions are eased, both concern about crowds and hygiene have a significant and negative correlation with public transport use. Concluding remarks are offered on what might need to happen for public transport patronage to start returning.

Explorations of the longer-term potential for community energy to contribute to the energy transition can shape policy and practice today. However, much community energy research in Great Britain is currently, and understandably, focussed on short-term responses to the crisis in the sector induced by recent shifts in policy support. Therefore, we held a series of visioning and backcasting workshops with community energy practitioners and other stakeholders, to co-create a vision of a long term future where there is a thriving community energy sector.This paper presents the results of those workshops. Using the concept of business models to interrogate how community energy could be structured in the future, we find that the sector could diversify from its current focus on renewable electricity generation and energy efficiency, into new areas of the energy system: demand-side flexibility, mobility and heat. We also see potential for a Community Energy Confederation to help bridge the gap between the strengths of local organising, and the opportunities offered by larger scale activities. We identify the importance of actions by government – both at national and local level – to realising this vision, in combination with the efforts of the community energy sector itself of course. We conclude that our research highlights the need for change in the institutional and spatial character of community energy; the sector’s pragmatic attitude to the technological aspects of the energy transition; and its focus on community energy’s role in delivering social and environmental co-benefits, in line with the concept of a just transition.

The importance of the liquefied-natural-gas (LNG) in global gas trade has grown steadily over the past decades; the article focuses on this significant form of energy and provides an exhaustive portrait of its trade. LNG trade flows both regionally and by country are described and the future of trade is forecast. Next, the business structure is discussed. The traditional LNG trade on long-term contracts (LTCs) is considered and it is explained how vital these contracts are in distributing the volume and price risks in the industry, furthermore, in securing finance for the LNG projects. The essence of gas market liberalization and its effect on LTCs is considered and it is shown that in liberalized gas markets, risk has migrated to upstream. In the light of this risk redistribution, the suppliers’ intent in moving toward vertical integration of the industry is discussed. Later, various types of LNG spot sale in arbitrage, and for uncommitted product to LTCs, are considered and the biggest spot sale markets are identified. Finally, pricing of LNG for different markets in both LTCs and spot sales is discussed and it is forecast that due to the surge of supply, rather than any change in oil prices, LNG prices are anticipated to decrease globally at least for the next 5 years.

BackgroundUnemployment has been reported to be associated with an increased risk of mortality. While most available studies focused on the effects of temporary unemployment on mortality, it remains unclear whether similar trends can be found in subjects who were never employed or are retirement. Therefore, this study examined the associations between temporary unemployment, never employed and retirement, integrating the risk of all-cause and cause-specific mortality in US adults.MethodsData from the National Health Interview Survey from 2001 to 2013 Linked Mortality files through 31 December 2015 were used. A total of 282 364 participants aged 18 to 65 years were included. Their employment status was categorised into four groups: employed, never employed, temporary unemployed and retired.ResultsDuring the mean follow-up time of 8.2 years, 12 645 subjects died from a variety of causes. Compared with employed participants, temporary unemployed, never employed or retired participants faced an increased risk of mortality for all-cause (temporary unemployed HR 1.76, 95% CI 1.67 to 1.86; never employed HR 1.63, 95% CI 1.47 to 1.81; retired HR 1.27, 95% CI 1.17 to 1.37). Cause-specific mortality analysis showed that compared with employed participants, temporary unemployed or never employed participants faced a significantly increased risk of mortality from cancer, cardiovascular disease, chronic lower respiratory disease, diabetes and kidney disease.ConclusionThis study showed that retired, temporary unemployed and never employed participants aged 18 to 65 years were strongly associated with higher mortality, indicating that both temporary and long-term unemployment are associated with a higher risk of mortality and adversely affect longevity.

Social position is known to play a role in the quality of ageing, notably through the stimulation/dysregulation of key physiological systems in response to external stresses. Using data from one wave of Understanding Society including 9088 participants, we defined, as an extension of the allostatic load, a synthetic Biological Health Score (BHS) capturing the wear-and-tear of four physiological systems (endocrine, inflammatory, cardiovascular and metabolic systems) and two organs (liver and kidney). We used 16 established blood-derived biomarkers of these systems to calculate the BHS and explored the relative contribution of socioeconomic position to the BHS and its main components across age groups. We identified a systematic decreasing education-related gradient of the BHS (p

Sustainability reporting nudges firms into behaving more sustainably by forcing them to account publicly for their wider social and environmental performance. This libertarian paternalist approach to governance through disclosure rather than command-and-control regulation is well established in Anglo-Saxon jurisdictions but comparatively untested in the emerging markets of Asia, where different state traditions and forms of business organization raise questions about its transferability and effectiveness. This article contributes to research on corporate social responsibility, neoliberal environmental governance, and Asian varieties of capitalism by providing the first comparative analysis of the origins, design, and initial impact of new sustainability reporting requirements on the stock markets of Hong Kong and Singapore. In mandating sustainability reporting, both exchanges were similarly concerned with following international norms and competitors but differed in the style and granularity of their company disclosure requirements. These policy design choices reflected different developmental state traditions and the different audiences that market regulators in Hong Kong and Singapore sought to influence through these public accounts. Notwithstanding substantial differences between Hong Kong’s rules-based and Singapore’s principles-based approach to reporting, the response in both markets was remarkably similar. In both cases, sustainability reporting was largely ignored by local market players who dismissed it as a foreign practice of interest to only a small number of Western institutional investors and providing little incentive to go beyond tick box compliance. These findings raise questions about the effectiveness of disclosure requirements at nudging Asian businesses toward sustainability.

The design of alternative urban water supply interventions for a community located in a low-income country requires detailed and precise knowledge of the nature, frequency and intensity of various characteristic water end-uses in the community. Without the availability of this characteristic water use information, high resolution metering experiments are the usually preferred methods to measure the water use volumes. However, in the developing world, these high resolution experiments are not an available option. Leaving the imprecise household interviewing process of data collection as the only option. This paper presents a novel methodology that improves and expands on the socially collected water uses data, through the use of a stochastic modelling process of the water use volumes to estimate the total monthly water use of the community. The methodology not only improves the estimates of water use volumes but also provides a mathematical modelling description of the household water uses in the c...

ObjectiveTo examine primary school and local authority characteristics associated with registration for The Daily Mile (TDM), an active mile initiative aimed at increasing physical activity in children.DesignA cross-sectional linkage study using routinely collected data.SettingAll state-funded primary schools in England from 2012 to 2018 (n=15,815).Results3,502 of all 15,815 (22.1%) state-funded primary schools in England were registered to do TDM, ranging from 16% in the East Midlands region to 31% in Inner London. Primary schools registered for TDM had larger mean pupil numbers compared with schools that had not registered (300 vs 269, respectively). There was a higher proportion of TDM-registered schools in urban areas compared with non-urban areas. There was local authority variation in the likelihood of school registration (intraclass correlation coefficient: 0.094). After adjusting for school and local authority characteristics, schools located in a major urban conurbation (OR 1.46 (95% CI 1.24 to 1.71) urban vs rural) and schools with a higher proportion of disadvantaged pupils had higher odds of being registered for TDM (OR 1.16 (95% CI 1.02 to 1.33)). Area-based physical activity and schools’ educational attainment were not significantly associated with registration to TDM.ConclusionOne in five primary schools in England has registered for TDM since 2012. TDM appears to be a wide-reaching school-based physical activity intervention that is reaching more disadvantaged primary school populations in urban areas where obesity prevalence is highest. TDM-registered schools include those with both high and low educational attainment and are in areas with high and low physical activity.

Urban-led change for sustainability is a key site of intervention in delivering the ambitions of the Sustainable Development Goals. Within this broad discourse, four umbrella concepts have emerged in recent decades: urban sustainability, urban transitions, urban transformation and urban resilience. This literature review aims to offer a qualitative assessment of the types of interventions currently being advocated for in academic-led literature. Firstly, the paper presents an overview of the concepts and summarises current gaps; secondly, it uses Donella Meadows' Leverage Points as analytical framework to categorise and discuss interventions supported in the literature. Our findings indicate that although the literature advocates for systemic change towards sustainability as an outcome of a large palette of urban interventions, less consideration is given to the means of achieving these. The findings highlight the need to focus on processes as much as on outcomes when advocating, devising or implementing interventions. This requires a process of understanding and negotiating trade-offs and the different worldviews and values that underpin them. Addressing this entails going beyond technocratic skills through cultivating reflexivity, effective communities of practice and new forms of organising for knowledge production, as well as interrogate our roles and agency as urban researchers.

BackgroundAn ecological correlation has been observed between licensed premises and alcohol-related violence (ARV). In the UK to date, no evidence directly connects alcohol-related harm to a single premises type. Recent policies have called for a diversified alcohol offer, yet quantitative evidence in support remains sparse. This study aims to inform policy by determining whether diversification of the alcohol economy is desirable and to inform the licensing process and submission of public health evidence.MethodsUsing 11 years of local licensing data from the London Borough of Southwark, alcohol availability over time was approximated by the number of extant alcohol licences, categorised by outlet type: drinking establishments, eateries, takeaways, off-sales and ‘other’. Harm was quantified drawing on law enforcement intelligence that recorded ARV. A linked data set was analysed using negative binomial regression, contrasting cumulative impact zones (CIZ)—a common alcohol control policy—with non-CIZ geographies.ResultsEach licensed drinking establishment was associated with a 1.6% (95% CI 0.7% to 2.6%; p=0.001) increase in ARV, respectively. ‘Other’ outlets had a protective effect and were associated with a 1.8% (95% CI 1.0% to 2.5%; pConclusionThis study provides direct evidence for an association between alcohol-related harm and licensed premises. The varying associations between outlet type and ARV provide local public health stakeholders with an evidence base upon which to advocate for licensing policies that diversify alcohol availability.

BackgroundThere are various maternal prenatal biopsychosocial (BPS) predictors of birth weight, making it difficult to quantify their cumulative relationship.MethodsWe studied two birth cohorts: Northern Finland Birth Cohort 1986 (NFBC1986) born in 1985–1986 and the Generation R Study (from the Netherlands) born in 2002–2006. In NFBC1986, we selected variables depicting BPS exposure in association with birth weight and performed factor analysis to derive latent constructs representing the relationship between these variables. In Generation R, the same factors were generated weighted by loadings of NFBC1986. Factor scores from each factor were then allocated into tertiles and added together to calculate a cumulative BPS score. In all cases, we used regression analyses to explore the relationship with birth weight corrected for sex and gestational age and additionally adjusted for other factors.ResultsFactor analysis supported a four-factor structure, labelled closely to represent their characteristics as ‘Factor1-BMI’ (body mass index), ‘Factor2-DBP’ (diastolic blood pressure), ‘Factor3-Socioeconomic-Obstetric-Profile’ and ‘Factor4-Parental-Lifestyle’. In both cohorts, ‘Factor1-BMI’ was positively associated with birth weight, whereas other factors showed negative association. ‘Factor3-Socioeconomic-Obstetric-Profile’ and ‘Factor4-Parental-Lifestyle’ had the greatest effect size, explaining 30% of the variation in birth weight. Associations of the factors with birth weight were largely driven by ‘Factor1-BMI’. Graded decrease in birth weight was observed with increasing cumulative BPS score, jointly evaluating four factors in both cohorts.ConclusionOur study is a proof of concept for maternal prenatal BPS hypothesis, highlighting the components snowball effect on birth weight in two different European birth cohorts.

Objective To compare all-cause and cause-specific mortality among 3 distinct groups: within-country, rural-to-urban migrants, and rural and urban dwellers in a longitudinal cohort in Peru. Methods The PERU MIGRANT Study, a longitudinal cohort study, used an age-stratified and sex-stratified random sample of urban dwellers in a shanty town community in the capital city of Peru, rural dwellers in the Andes, and migrants from the Andes to the shanty town community. Participants underwent a questionnaire and anthropomorphic measurements at a baseline evaluation in 2007–2008 and at a follow-up visit in 2012–2013. Mortality was determined by death certificate or family interview. Results Of the 989 participants evaluated at baseline, 928 (94%) were evaluated at follow-up (mean age 48 years; 53% female). The mean follow-up time was 5.1 years, totalling 4732.8 person-years. In a multivariable survival model, and relative to urban dwellers, rural participants had lower all-cause mortality (HR=0.27; 95% CI 0.07 to 0.98), and both the rural (HR=0.07; 95% CI 0.01 to 0.87) and migrant (HR=0.13; 95% CI 0.02 to 0.81) groups had lower cardiovascular mortality. Conclusions Cardiovascular mortality of migrants remains similar to that of the rural group, suggesting that rural-to-urban migrants do not appear to catch up with urban mortality in spite of having a more urban cardiovascular risk factor profile.

Background: Scotland has higher mortality rates than the rest of Western Europe (rWE), with more cardiovascular disease and cancer among older adults; and alcohol-related and drug-related deaths, suicide and violence among younger adults.\ud \ud Methods: We obtained sex, age-specific and year-specific all-cause mortality rates for Scotland and other populations, and explored differences in mortality both visually and numerically.\ud \ud Results: Scotland's age-specific mortality was higher than the rest of the UK (rUK) since 1950, and has increased. Between the 1950s and 2000s, ‘excess deaths’ by age 80 per 100 000 population associated with living in Scotland grew from 4341 to 7203 compared with rUK, and from 4132 to 8828 compared with rWE. UK-wide mortality risk compared with rWE also increased, from 240 ‘excess deaths’ in the 1950s to 2320 in the 2000s. Cohorts born in the 1940s and 1950s throughout the UK including Scotland had lower mortality risk than comparable rWE populations, especially for males. Mortality rates were higher in Scotland than rUK and rWE among younger adults from the 1990s onwards suggesting an age–period interaction.\ud \ud Conclusions: Worsening mortality among young adults in the past 30 years reversed a relative advantage evident for those born between 1950 and 1960. Compared with rWE, Scotland and rUK have followed similar trends but Scotland has started from a worse position and had worse working age–period effects in the 1990s and 2000s.

While social network analysis continues to enjoy considerable attention, literature on social network data collection often lacks explicit attention to methods. This presents special challenges to approaching the problems of undertaking social network analysis and of studying disaster preparedness, planning, and, ultimately, risk reduction. In this paper, we address this issue by presenting our synthesis of several strategies for network analyses from our processes for network identification and data collection in a longitudinal study of multi-jurisdictional, inter-agency wildfire response networks in the American Northwest. In the course of this ongoing project, the process of detecting and collecting data on pre-existing and emergent networks in the real world was not a matter of one theoretical or empirical judgement, but rather several. We alternated between: (1) spatio-ecological detection of jurisdictions adjacent to areas at-risk for large wildfires; (2) a hybrid approach to selecting actors and agencies identified as common participants in wildfire response networks; and (3) event-based detections of parties to specific wildfire response networks. We conclude with steps for thinking through network identification and bounding, integrating networks, conceptualizing rosters and ties in initial and events-based phases, and how to manage longitudinal network data collection. Published version

Background Previous research showed that younger adult males in the USA have, since the 1950s, died at a faster rate than females of the same age. In this paper, we quantify this difference, and explore possible explanations for the differences at different ages and in different years.\ud \ud Methods Using data from the Human Mortality Database (HMD), the number of additional male deaths per 10 000 female deaths was calculated for each year from 1933 to 2010, and for each year of age from 0 to 60 years, for the USA, and a number of other countries for comparison. The data were explored visually using shaded contour plots.\ud \ud Results Gender differences in excess mortality have increased. Coming of age (between the ages of 15 and 25 years of age) is especially perilous for men relative to women now compared with the past in the USA; the visualisations highlight this change as important.\ud \ud Conclusions Sex differences in mortality risks at various ages are not static. While women may today have an advantage when it comes to life expectancy, in the USA, this has greatly increased since the 1930s. Just as young adulthood for women has been made safer through safer antenatal and childbirth practices, changes in public policy can make the social environment safer for men.

The International Agency for Research on Cancer (IARC) Monographs Programme identifies chemicals, drugs, mixtures, occupational exposures, lifestyles and personal habits, and physical and biological agents that cause cancer in humans and has evaluated about 1000 agents since 1971. Monographs are written by ad hoc Working Groups (WGs) of international scientific experts over a period of about 12 months ending in an eight-day meeting. The WG evaluates all of the publicly available scientific information on each substance and, through a transparent and rigorous process,1 decides on the degree to which the scientific evidence supports that substance’s potential to cause or not cause cancer in humans. For Monograph 112,2 17 expert scientists evaluated the carcinogenic hazard for four insecticides and the herbicide glyphosate.3 The WG concluded that the data for glyphosate meet the criteria for classification as a probable human carcinogen. The European Food Safety Authority (EFSA) is the primary agency of the European Union for risk assessments regarding food safety. In October 2015, EFSA reported4 on their evaluation of the Renewal Assessment Report5 (RAR) for glyphosate that was prepared by the Rapporteur Member State, the German Federal Institute for Risk Assessment (BfR). EFSA concluded that ‘glyphosate is unlikely to pose a carcinogenic hazard to humans and the evidence does not support classification with regard to its carcinogenic potential’. Addendum 1 (the BfR Addendum) of the RAR5 discusses the scientific rationale for differing from the IARC WG conclusion. Serious flaws in the scientific evaluation in the RAR incorrectly characterise the potential for a carcinogenic hazard from exposure to glyphosate. Since the RAR is the basis for the European Food Safety Agency (EFSA) conclusion,4 it is critical that these shortcomings are corrected., La lista completa de autores que integran el documento puede consultarse en el archivo, Facultad de Ciencias Naturales y Museo

This paper analyzes the impact of the newly operated Dubai Metro on the sale transaction value of dwellings and commercial properties. The effect is estimated for properties within different catchment zones of a metro station using difference-in-differences and hedonic pricing methods on both repeated cross-sectional data and pseudo panel data. Our estimates show a positive effect of the metro on sale values of both residential and commercial properties, although the effect is stronger for commercial properties. The models also reveal that the effect of the metro on the value of dwellings and commercial properties is largest within 701 to 900 meters of a metro station and is about 13 percent and 76 percent, respectively.

In Australia, Coal Seam Gas (CSG) is a relatively new source of natural gas commonly advocated as a lower greenhouse gas (GHG) emissions alternative to coal. This study investigates how GHG emissions have been, and potentially could be, assessed within the Australian CSG industry. The research involved a document analysis of several Environmental Impact Statements (EISs) and consultant reports prepared as part of the Environmental Impact Assessment (EIA) process for major CSG projects in New South Wales (NSW) and Queensland (Qld). There were found to be inconsistencies in the conduct of greenhouse assessment by the CSG industry, including how complete and transparent assessments were, as well as how effectively they addressed project emission intensity and cumulative impacts. There were also found to be large inconsistencies between assessments carried out for Qld projects and those for NSW projects, likely because of differences in how assessment requirements are applied by planning bodies. This study also highlights how alternative assessment approaches, such as Cumulative Impact Assessment (CIA) and Strategic Environmental Assessment (SEA), have potential to enable a broader and more consistent understanding of emission sources that cross a range of geographical and project boundaries.

BACKGROUND: It is important to understand the local burden of non-communicable diseases including within-country heterogeneity. The aim of this study was to characterise hypertension and type-2 diabetes profiles across different Peruvian geographical settings emphasising the assessment of modifiable risk factors. METHODS: Analysis of the CRONICAS Cohort Study baseline assessment was conducted. Cardiometabolic outcomes were blood pressure categories (hypertension, prehypertension, normal) and glucose metabolism disorder status (diabetes, prediabetes, normal). Exposures were study setting and six modifiable factors (smoking, alcohol drinking, leisure time and transport-related physical activity levels, TV watching, fruit/vegetables intake and obesity). Poisson regression models were used to report prevalence ratios (PR). Population attributable risks (PAR) were also estimated. RESULTS: Data from 3238 participants, 48.3% male, mean age 45.3 years, were analysed. Age-standardised (WHO population) prevalence of prehypertension and hypertension was 24% and 16%, whereas for prediabetes and type-2 diabetes it was 18% and 6%, respectively. Outcomes varied according to study setting (p

Author version made available here in accordance with publisher copyright policy., This article seeks to examine some of the ways in which social networks may contribute to employment outcomes for community and public housing tenants. There is a body of literature that explores the relationship between social networks and employment outcomes, and a separate literature on the relationship between housing and social networks (which is largely concerned with homeowners). However, there has been little research that links all three aspects, especially in relation to social housing. This provides a starting point for this research, which involved interviews with housing organisation staff and focus groups with tenants in two case study areas in metropolitan Adelaide, South Australia. This article reports on the findings through examining the way in which housing tenure may affect social network formation, and considering the ways that these networks can impact on job attainment. It is concluded that, overall, those in community housing appeared to fare better, in terms of employment-conducive networks, than those in public housing. This finding is related not just to the management of the housing, but also to the broader issues of stigma, area-level deprivation and intergenerational unemployment.

Background: \ud The high prevalence of children's asthma symptoms, worldwide, is unexplained. We examined the relation between maternal pre-pregnancy weight and body mass index (BMI), and asthma symptoms in adolescents. \ud \ud Methods: \ud Data from 6945 adolescents born within the Northern Finland Birth Cohort 1986 were used. Prospective antenatal and birth outcome data, including maternal pre-pregnancy weight and BMI, and asthma symptoms in adolescent offspring at age 15–16 years, were employed. Logistic regression analyses were performed to examine the associations between relevant prenatal factors and asthma symptoms during adolescence. \ud \ud Results: \ud Current wheeze (within the past year) was reported by 10.6% of adolescents, and physician-diagnosed asthma by 6.0%. High maternal pre-pregnancy BMI was a significant predictor of wheeze in the adolescents (increase per kilogram per square metre unit; 2.7%, 95% CI 0.9 to 4.4 for ever wheeze; 3.5%, 95% CI 1.3 to 5.8 for current wheeze), and adjusting for potential confounders further increased the risk (2.8%, 95% CI 0.5 to 5.1; 4.7%, 95% CI 1.9 to 7.7, respectively). High maternal pre-pregnancy weight, in the top tertile, also significantly increased the odds of current wheeze in the adolescent by 20% (95% CI 4 to 39), and adjusting for potential confounders further increased the risk (OR=1.52, 95% CI 1.19 to 1.95). Results were similar for current asthma. Furthermore, these significant associations were observed only among adolescents without parental history of atopy but not among those with parental history of atopy. \ud \ud Conclusions: \ud The association demonstrated here between maternal pre-pregnancy overweight and obesity, and asthma symptoms in adolescents suggests that increase in asthma may be partly related to the rapid rise in obesity in recent years.

Background and aim This paper was conceptualised and informed by discussions at the 2nd Workshop in a UKTRC funded series on 'Social Impacts and Equity in Transport'. Presentations made by a range of stakeholders as well as a specially commissioned play stimulated our thoughts on how to encourage better interaction between health and transport researchers. We chose school travel as a case study as it exemplifies two key aspects of the wider transport and health debates; (i) the increasing trend towards reliance on car travel, described here in the context of sedentary lifestyles, traffic congestion, pollution, and parental attitudes, and (ii) school travel occurs at a critical life-stage during which behaviour patterns are formed that are likely to be influential in later life, thus making it an important target point for interventions. Methods We present evidence from four distinct, but complementary, theoretical perspectives: transport, exposure, behaviour and sustainability. We draw common lessons and identify challenges using a range of conceptual frameworks: integrated psychological model of transport choices, Dahlgren and Whitehead's 'layers of influence' model, Hosking et al.'s 'pathways from transport to health', and Hanlon et al.'s integral theory. We demonstrate the benefits and challenges of holistic interaction and collaboration between disciplines to better understand the key issues and develop policy interventions that are meaningful and effective. Results and conclusions None of the pre-existing conceptual models were fully able to encompass the societal and individual level influences on school travel. However, we present an interim model for further discussion and debate.

BACKGROUND: Verbal autopsy is currently the only option for obtaining cause of death information in most populations with a widespread HIV/AIDS epidemic. METHODS: With the use of a data-driven algorithm, a set of criteria for classifying AIDS mortality was trained. Data from two longitudinal community studies in Tanzania and Zimbabwe were used, both of which have collected information on the HIV status of the population over a prolonged period and maintained a demographic surveillance system that collects information on cause of death through verbal autopsy. The algorithm was then tested in different times (two phases of the Zimbabwe study) and different places (Tanzania and Zimbabwe). RESULTS: The trained algorithm, including nine signs and symptoms, performed consistently based on sensitivity and specificity on verbal autopsy data for deaths in 15-44-year-olds from Zimbabwe phase I (sensitivity 79%; specificity 79%), phase II (sensitivity 83%; specificity 75%) and Tanzania (sensitivity 75%; specificity 74%) studies. The sensitivity dropped markedly for classifying deaths in 45-59-year-olds. CONCLUSIONS: Verbal autopsy can consistently measure AIDS mortality with a set of nine criteria. Surveillance should focus on deaths that occur in the 15-44-year age group for which the method performs reliably. Addition of a handful of questions related to opportunistic infections would enable other widely used verbal autopsy tools to apply this validated method in areas for which HIV testing and hospital records are unavailable or incomplete.

This article examines some of the ways in which fear of crime impacts upon opportunities for social interaction among residents in stigmatised suburbs. As we explore in this article, neighbourhoods that are stigmatised by virtue of material disadvantage and poor reputations tend to be associated with a number of social problems, including higher rates of crime. This association with crime, our research suggests, has an impact on social interaction in these neighbourhoods. Specifically, fear of crime may make people less likely to draw on forms of social interaction which enable people to build trust through contact with their fellow residents. In developing this position, the article draws on qualitative data detailing residents’ perceptions of safety in three neighbourhoods in Adelaide, South Australia, two of which are stigmatised as ‘problem neighbourhoods’. The article concludes by considering the public policy implications that arise from the research.

Our health depends on where we currently live, as well as on where we have lived in the past and for how long in each place. An individual’s place history is particularly relevant in conditions with long latency between exposures and clinical manifestations, as is the case in many types of cancer and chronic conditions. A patient’s geographic history should routinely be considered by physicians when diagnosing and treating individual patients. It can provide useful contextual environmental information (and the corresponding health risks) about the patient, and should thus form an essential part of every electronic patient/health record. Medical geology investigations, in their attempt to document the complex relationships between the environment and human health, typically involve a multitude of disciplines and expertise. Arguably, the spatial component is the one factor that ties in all these disciplines together in medical geology studies. In a general sense, epidemiology, statistical genetics, geoscience, geomedical engineering and public and environmental health informatics tend to study data in terms of populations, whereas medicine (including personalised and precision geomedicine, and lifestyle medicine), genetics, genomics, toxicology and biomedical/health informatics more likely work on individuals or some individual mechanism describing disease. This article introduces with examples the core concepts of medical geology and geomedicine. The ultimate goals of prediction, prevention and personalised treatment in the case of geology-dependent disease can only be realised through an intensive multiple-disciplinary approach, where the various relevant disciplines collaborate together and complement each other in additive (multidisciplinary), interactive (interdisciplinary) and holistic (transdisciplinary and cross-disciplinary) manners.

In this paper we report on a South Australian study of perceptions of safety and aspects of neighbourhood life including social capital which involved the analysis of 2400 self-completed questionnaires. A path analysis found that perceptions of safety were directly associated with gender, age, perceptions of neighbourhood pollution and neighbourhood trust, and indirectly associated with age, neighbourhood pollution and neighbourhood connections. We conclude with a discussion of the implications of the findings for public policy.

Background: The aim of this study was to examine the distribution of physical activity facilities by area-level deprivation in Scotland, adjusting for differences in urbanicity, and exploring differences between and within the four largest Scottish cities.\ud \ud Methods: We obtained a list of all recreational physical activity facilities in Scotland. These were mapped and assigned to datazones. Poisson and negative binomial regression models were used to investigate associations between the number of physical activity facilities relative to population size and quintile of area-level deprivation.\ud \ud Results: The results showed that prior to adjustment for urbanicity, the density of all facilities lessened with increasing deprivation from quintiles 2 to 5. After adjustment for urbanicity and local authority, the effect of deprivation remained significant but the pattern altered, with datazones in quintile 3 having the highest estimated mean density of facilities. Within-city associations were identified between the number of physical activity facilities and area-level deprivation in Aberdeen and Dundee, but not in Edinburgh or Glasgow.\ud \ud Conclusions: In conclusion, area-level deprivation appears to have a significant association with the density of physical activity facilities and although overall no clear pattern was observed, affluent areas had fewer publicly owned facilities than more deprived areas but a greater number of privately owned facilities.