Search

Physical activity (PA) reduces the risk of several non-communicable diseases (NCDs). Natural environments support recreational PA. Using data including a representative cross-sectional survey of the English population, we estimated the annual value of nature-based PA conducted in England in 2019 in terms of avoided healthcare and societal costs of disease.Population-representative data from the Monitor of Engagement with the Natural Environment (MENE) survey (n = 47,580; representing 44,386,756) were used to estimate the weekly volume of nature-based recreational PA by adults in England in 2019. We used epidemiological dose–response data to calculate incident cases of six NCDs (ischaemic heart disease (IHD), ischaemic stroke (IS), type 2 diabetes (T2D), colon cancer (CC), breast cancer (BC) and major depressive disorder (MDD)) prevented through nature-based PA, and estimated associated savings using published costs of healthcare, informal care and productivity losses. We investigated additional savings resulting from hypothetical increases in: (a) visitor PA and (b) visitor numbers.In 2019, 22 million adults > 16 years of age in England visited natural environments at least weekly. At reported volumes of nature-based PA, we estimated that 550 cases of IHD, 168 cases of IS, 1,410 cases of T2D, 41 cases of CC, 37 cases of BC and 10,552 cases of MDD were prevented, creating annual savings of £108.7million (95 % uncertainty interval: £70.3million; £150.3million).Nature-based recreational PA in England results in reduced burden of disease and considerable annual savings through prevention of priority NCDs. Strategies that increase nature-based PA could lead to further reductions in the societal burden of NCDs.

Introduction Patients with episodes of supraventricular tachycardia (SVT), a common heart arrhythmia, are often attended by ambulance services. International guidelines advocate treatment with the Valsalva manoeuvre (VM), but this simple physical treatment has a low success rate, with most patients requiring conveyance to hospital. The Valsalva Assist Device (VAD) is a simple device that might help practitioners and patients perform a more effective VM and reduce the need for patients to be taken to hospital.Methods and analysis This stepped wedge cluster randomised controlled trial, conducted within a UK ambulance service, compares the current standard VM with a VAD-delivered VM in stable adult patients presenting to the ambulance service with SVT. The primary outcome is conveyance to hospital; secondary outcomes measures include cardioversion rates, duration of ambulance care and number of subsequent episodes of SVT requiring ambulance service care. We plan to recruit approximately 800 patients, to have 90% power to detect an absolute reduction in conveyance rate of 10% (from 90% to 80%) between the standard VM (control) and VAD-delivered VM (intervention). Such a reduction in conveyance would benefit patients, the ambulance service and receiving emergency departments. It is estimated potential savings would pay for devices for the entire ambulance trust within 7 months.Ethics and dissemination The study has been approved by the Oxford Research Ethics Committee (reference 22/SC/0032). Dissemination will be through peer-reviewed journal publication, presentation at national and international conferences and by the Arrhythmia Alliance, a patient support charity.Trial registration number ISRCTN16145266.

IntroductionMarine biodiversity loss has direct and indirect effects on human health and wellbeing. Recent European data suggest that the public is aware of this, identifying marine biodiversity protection as its top research priority in terms of oceans and human health, rated higher than issues such as plastic, chemical, and microbial pollution.MethodsThe current study aimed to better understand key sociodemographic and personality predictors of concern about marine biodiversity loss and the desire for more research into marine biodiversity protection, in an attempt to support communication efforts targeting specific sectors in society. Data were drawn from nationally representative samples of 14 European countries (n = 14,167).ResultsResults show greater concern about marine biodiversity loss and support for more research into marine biodiversity protection by older adults, females, and individuals: (i) without (vs. with) a university degree; (ii) with lower (vs. middle) incomes; (iii) who identified as politically left-wing; (iv) who visited the coast more often; and (v) those with more open, agreeable and conscientious personalities.DiscussionThese results suggest that, although concern and research support are generally high among European citizens, policy makers and communicators need to take into consideration individual-level variation.

Urban Green Infrastructure (GI) provides multiple benefits to city inhabitants and can be an important component in nature-based solutions (NBS), but the ecosystem services that underpin those benefits are inconsistently quantified in the literature. There remain substantial knowledge gaps about the level of service supported by less studied GI types, e.g. cemeteries, or less-studied ecosystem services, e.g. noise mitigation. Decision-makers and planners in cities often face conflicting or incomplete information on the effectiveness of GI, particularly on their ability to provide a suite of co-benefits. Here, we describe a feature-based typology of GI which combines elements of land cover, land use and both ecological and social function. It is consistent with user requirements on mapping, and with the needs of models which can conduct more detailed ecosystem service assessments which can guide NBS design. We provide an evidence synthesis based on published literature, which scores the ability of each GI type to deliver a suite of ecosystem services. In the multivariate analysis of the typology scores, the main axis of variation differentiates between constructed (or hybrid) GI types designed primarily for water flow management (delivering relatively few services) and more natural green GI with trees, or blue GI such as lakes and the sea, which deliver a more multi-functional set of regulating services. The most multi-functional GI on this axis also score highest for biodiversity. The second element of variation separates those GI which support very few cultural services and those which score highly in enabling physical wellbeing and social interaction and, to a lesser extent, restoring capacities. Together the typology and multi-functionality matrix provide a much needed assessment for less studied GI types, and allow planners and decision-makers to make a-priori assessments of the relative ability of different GI as part of NBS to address urban challenges.

We considered the relationship between street trees and mental health with the aim of developing systems thinking-informed hypotheses to improve the implementation and evaluation of this popular nature-based solution (NBS). We integrated qualitative and quantitative evidence using causal loop diagraming (CLD), and then further analyzed and extended these diagrams with the aid of systems archetypes to identify key system structures. From these CLDs, we identified three systems thinking-informed hypotheses: 1) although there are many ways in which street trees may improve mental health, tree health is critical in realizing many of these benefits and minimizing dis-benefits; 2) communities which have benefited from street trees in the past are more likely to be able to advocate for additional trees, further entrenching historical inequities in street tree distribution; and 3) efforts to address these inequities through new tree planting initiatives may ultimately fail or even exacerbate existing challenges if they do not include sustained resources for tree maintenance, with direct and indirect impacts on inequities in mental health. Using a systems thinking lens was a useful way to deeply consider a purported but under-theorized co-benefit of a popular nature-based solution and identify policy-relevant hypotheses to guide future research.

Abstract Background Research and policy have identified social cohesion as a potentially modifiable determinant of health and wellbeing that could contribute to more sustainable development. However, the function of social cohesion appears to vary between communities. The aim of this study was to analyse the levels of, and associations, between social cohesion, mental wellbeing, and physical and mental health-related quality of life among a cohort of social housing residents from low socioeconomic status communities in Cornwall, UK. Social housing is below market-rate rental accommodation made available to those in certain health or economic circumstances. These circumstances may impact on the form and function of social cohesion. Methods During recruitment, participants in the Smartline project completed the Short Warwick-Edinburgh Mental Wellbeing Scale, SF-12v2 and an eight item social cohesion scale. Cross sectional regression analyses of these data adjusted for gender, age, national identity, area socioeconomic status, rurality, education, employment, and household size were undertaken to address the study aim. Results Complete data were available from 305 (92.7%) participants in the Smartline project. Univariable analyses identified a significant association between social cohesion, mental wellbeing and mental health-related quality of life. Within fully adjusted multivariable models, social cohesion only remained significantly associated with mental wellbeing. Sensitivity analyses additionally adjusting for ethnicity and duration of residence, where there was greater missing data, did not alter the findings. Conclusions Among a relatively homogeneous cohort, the reported level of social cohesion was only found to be significantly associated with higher mental wellbeing, not physical or mental health-related quality of life. The efforts made by social housing providers to offer social opportunities to all their residents regardless of individual physical or mental health state may support the development of a certain degree of social cohesion. Sense of control or safety in communities may be more critical to health than social cohesion. Additional observational research is needed before attempts are made to alter social cohesion to improve health.

Linking novel real-time sensor data with comprehensive individual baseline survey data, this study estimates the effect of fuel poverty on the physical and mental health of social housing tenants in the southwest of the UK. Structural equation modeling is applied to show that fuel poverty has a significant negative effect on mental health. Other socio-economic characteristics (such as age, household size) and house characteristics (e.g., energy-efficient rating, house type) are associated with fuel poverty. Fuel poverty is also related to poorer mobility. Our results suggest that special attention should be paid to tenants with disabilities and chronic diseases since they are more vulnerable to fuel poverty and health issues.

Abstract Background The social determinants of health have a disproportionate impact on mortality in men. A study into the state of health of the male population in Leeds was undertaken to guide public health commissioning decisions. This paper reports on the data relating to the social lives of men. Methods A cross-sectional study was undertaken, comprising descriptive analysis of data relating to educational attainment, housing, employment (including benefit claimants), marital status and relationships. Data was considered for the whole city and localised at the Middle Super Output Area (MSOA) level and mapped against the Index of Deprivation. Results Boys’ educational attainment was found to be lagging behind girls’ from their earliest assessments (Early Years Foundation Stage Profile, 46% vs. 60%, P = 0.00) to GCSEs (53% vs. 63%, P = 0.00), leaving many men with no qualifications. There were 68% more men than women identified as being unemployed, with more men claiming benefits. Men living in social housing are more likely to be housed in high-rise flats. Almost 50% of men aged 16–64 are single, with 2254 lone fathers. Conclusions There appears to be a lack of sex/gender analysis of current cross city data. In areas of deprivation a complex picture of multiple social problems emerges, with marked gender differences in the social determinants of health, with males seeming to be more negatively affected. There is a need for more focused planning for reaching out and targeting boys and men in the most deprived inner city areas, so that greater efficiency in service delivery can be obtained.

Fugitive methane emissions from the oil and gas sector are typically addressed through periodic leak detection and repair surveys. These surveys, conducted manually using handheld leak detection technologies, are time-consuming. To improve the speed and cost-effectiveness of leak detection, technology developers are introducing innovative solutions using mobile platforms, close-range portable systems, and permanent installations. Many of these new approaches promise faster, cheaper, or more effective leak detection than conventional methods. However, ensuring mitigation targets are achieved requires demonstrating that alternative approaches are at least as effective in reducing emissions as current approaches – a concept known as emissions reduction equivalence. Here, we propose a five-stage framework for demonstrating equivalence that combines controlled testing, simulation modeling, and field trials. The framework was developed in consultation with operators, regulators, academics, solution providers, consultants, and non-profit groups from Canada and the U.S. We present the equivalence framework and discuss challenges to implementation.

Social scientists have been interested in measuring the prosperity, well-being, and quality of life of nations, which has resulted in a multiplicity of country-level indicators. However, little is known about the factor structure of these indicators. We explored the structure of quality of life, using country-level data on tens of subjective and objective indicators. Applying factor analysis, we identified three distinct factors that exhibited both overlap and complementarity. This structure was replicated in data from previous years and with a partially different set of variables. The first factor, 'socio-economic progress', is dominated by socio-political and economic indicators but also includes life satisfaction, which thus appears to reflect objective living conditions. The second factor, 'psycho-social functioning', consists of subjective indicators, such as eudaimonic well-being and positive affective states. The third, 'negative affectivity', comprises negatively-valenced affective states. The three macro-factors of societal quality of life demonstrated moderate intercorrelations and differential associations with cultural and ecological variables, providing support for their discriminant validity. Finally, country and regional rankings based on the three societal factors revealed a complex picture that cautions against over-reliance on any single indicator such as life satisfaction. The results underline the need for a broadly-based approach to the measurement of societal quality of life, and provide an empirically-derived multidimensional framework for conceptualizing and measuring quality of life and well-being at country level. This study is thus an initial empirical step towards systematizing the multiple approaches to societal quality of life.

This mixed-methods study investigates whether and to what extent positive psychology constructs (classroom enjoyment, grit, and growth mindset) and Extramural English predict primary school students' willingness to communicate in a second language (L2 WTC) both in the classroom (a fictitious but common setting for English communication among English as an Foreign Language [EFL] students) and outside the classroom (a natural and increasingly prevalent environment for EFL communication). We collect and analyze survey data from 160 EFL primary school students in Hong Kong (ages 6-13 years old). Hierarchical regression analyses reveal that L2 WTC in the classroom is predicted by classroom enjoyment, grit, and Extramural English. A slightly different picture emerges outside of the classroom, with grit, growth mindset, and Extramural English predicting L2 WTC. Semi-structured interviews (N = 8) confirm and elaborate on the quantitative findings. Our findings suggest that through grit- and Extramural English-integrated intervention programmes, EFL teachers can improve young learners' L2 WTC both inside and outside the classroom. Furthermore, teachers can improve young learners' L2 WTC in the classroom by creating a positive learning environment, while also improving their L2 WTC outside of the classroom by cultivating their growth mindset system.

Increasingly, the potential short and long-term impacts of climate change on human health and wellbeing are being demonstrated. However, other environmental change factors, particularly relating to the natural environment, need to be taken into account to understand the totality of these interactions and impacts. This paper provides an overview of ongoing research in the Health Protection Research Unit (HPRU) on Environmental Change and Health, particularly around the positive and negative effects of the natural environment on human health and well-being and primarily within a UK context. In addition to exploring the potential increasing risks to human health from water-borne and vector-borne diseases and from exposure to aeroallergens such as pollen, this paper also demonstrates the potential opportunities and co-benefits to human physical and mental health from interacting with the natural environment. The involvement of a Health and Environment Public Engagement (HEPE) group as a public forum of “critical friends” has proven useful for prioritising and exploring some of this research; such public involvement is essential to minimise public health risks and maximise the benefits which are identified from this research into environmental change and human health. Research gaps are identified and recommendations made for future research into the risks, benefits and potential opportunities of climate and other environmental change on human and planetary health.