The varved succession of Crawford Lake, Milton, Ontario, Canada as a candidate Global boundary Stratotype Section and Point for the Anthropocene series.

An annually laminated succession in Crawford Lake, Ontario, Canada is proposed for the Global boundary Stratotype Section and Point (GSSP) to define the Anthropocene as a series/epoch with a base dated at 1950 CE. Varve couplets of organic matter capped by calcite precipitated each summer in alkaline surface waters reflect environmental change at global to local scales. Spheroidal carbonaceous particles and nitrogen isotopes record an increase in fossil fuel combustion in the early 1950s, coinciding with early fallout from nuclear and thermonuclear testing - 239+240Pu and 14C:12C, the latter more than compensating for the effects of old carbon in this dolomitic basin. Rapid industrial expansion in the North American Great Lakes region led to enhanced leaching of terrigenous elements by acid precipitation during the Great Acceleration, and calcite precipitation was reduced, producing thin calcite laminae around the GSSP that is marked by a sharp decline in elm pollen (Dutch Elm disease). The lack of bioturbation in well-oxygenated bottom waters, supported by the absence of fossil pigments from obligately anaerobic purple sulfur bacteria, is attributed to elevated salinities and high alkalinity below the chemocline. This aerobic depositional environment, highly unusual in a meromictic lake, inhibits the mobilization of Pu, the proposed primary stratigraphic guide for the Anthropocene.

Experience of living near a highway in Nepal: Community perceptions of road dangers in Makwanpur district.

Introduction: Road traffic injuries are a major but neglected global challenge. There are high and rising rates of road traffic injuries in Nepal. Most of the studies reporting these injuries in Nepal have used quantitative methods to describe the injury burden. Little qualitative research has been conducted to describe the contexts and social processes surrounding crashes, or public perceptions of risks and potential solutions. The aim of this study was to explore the perceptions of road dangers from communities living alongside a major highway in Nepal. Methods: In this qualitative study we recruited members of neighbourhood development committees and a mother's group to take part in focus groups exploring their views. Data were audio-recorded, transcribed, translated and analysed thematically. Results: Four focus groups were conducted involving 34 participants aged 24-65. Our study findings highlight the challenges faced by people living near a major highway and their fear of getting injured on the road. Five themes that emerged were: risky behaviours of road users, infrastructure for safer behaviour, poor condition and maintenance of roads and vehicles, limited adherence and enforcement of traffic laws, and the need for road safety awareness programmes. Conclusion: The community groups expressed multiple concerns regarding the safety of members of their communities and lived-in fear of death and injury on the road where they lived. There is an urgent need for government agencies to understand these concerns and to take action in relating to infrastructure provision, regulation and behavioural change programmes.

Completeness of police reporting of traffic crashes in Nepal: Evaluation using a community crash recording system.

OBJECTIVE: Accurate road crash reporting is essential for evaluating road safety interventions and plans. Under-reporting of road traffic crashes, injuries, and fatalities in police records has been widely described. The aim of this study was to apply and evaluate a community crash recording system, and assess the quality of the data in comparison with traffic police data in Nepal. METHODS: The crash data collection methodology involved recruiting Local Record Keepers working and living at locations known to be at a high risk of crashes. Six shopkeepers were recruited at three crash locations and trained to complete collision incident forms for crashes occurring over one year on the section of road visible from their premises. Manual traffic volume and pedestrian counts, and spot speed surveys were conducted. Data were compared with District police records for the same period and locations. RESULTS: Over 12 months, 110 crashes were recorded by the Local Record Keepers. Of these, 70 resulted in 145 injuries (5 fatalities, 62 severe, and 78 minor injuries), while 40 resulted only in property damage. Comparable police data recorded 23 crashes, of which 18 crashes resulted in 27 injuries (8 fatalities, 13 serious, and 6 minor injuries), and 5 crashes in property damage only. The difference in recording of fatal and serious injuries was statistically significant (χ2(1) = 19.94, p < 0.001). The police reporting rate was highest for fatalities (62.5%) but only 11.6% and 7.1% for property damage cases and minor injuries respectively, and 3.8% for single-vehicle crashes. Compared to the Local Record Keeper data, the overall police crash reporting rate was 19.7%. CONCLUSIONS: Local Record Keepers' recording of road traffic crashes and casualties is feasible and provides a more complete record than routinely collected police data. The low reporting rate in the police records of minor injury, property damage, and single-vehicle crashes suggest significant underestimation and bias in the reporting of the actual burden of road traffic crashes. Local Record Keeper recording is a viable method for validating police reports.

Designing healthier neighbourhoods: a systematic review of the impact of the neighbourhood design on health and wellbeing.

Several studies have investigated the impact of neighbourhood design on health and wellbeing, yet there are limited reviews investigating the quality of the evidence and the most effective interventions at a population level. This systematic review aims to clarify the impact of the neighbourhood design on health and wellbeing and evaluate the quality of the evidence underpinning such associations. Eight electronic databases were searched for studies conducted between 2000 and 2016. Additional searches were conducted on Google to identify potentially eligible grey literature. A total of 7694 studies were returned from the literature search, and a final selection of 39 studies were deemed eligible for inclusion. Quality appraisal was conducted using the Quality Assessment Tool for Quantitative Studies. Findings from the studies showed important associations between neighbourhood design principles such as walkability, access to green space and amenities on health and wellbeing. Findings from this review also highlight areas with inconsistent findings and gaps in the evidence for future research.

Views of professional stakeholders on readiness for a safe road system in Nepal; an exploratory qualitative study.

Road traffic injuries in Nepal are increasing despite being largely preventable. Little evidence exists regarding the barriers and facilitators to a safer road system. This study aimed to explore the perspectives of professionals whose jobs had the potential to influence road safety in Nepal regarding challenges and potential solutions. Semi-structured interviews with eight informants from diverse roles were analysed thematically. Three themes were identified: Modifying behaviours of road users; Road planning, construction and maintenance; and the Governance of roads and traffic. All participants considered the primary cause of crashes to be the negligent behavior of the road users, suggesting that improved knowledge would influence their decisions. Poor road design, building and maintenance, together with poor vehicle standards, and lack of investment and enforcement of existing road safety legislation, needed to be addressed through greater coordination of the agencies. The study identified a range of areas for future inquiry and action.

Overcoming Systemic Barriers Preventing Healthy Urban Development in the UK: Main Findings from Interviewing Senior Decision-Makers During a 3-Year Planetary Health Pilot.

This paper sets out the main findings from two rounds of interviews with senior representatives from the UK's urban development industry: the third and final phase of a 3-year pilot, Moving Health Upstream in Urban Development' (UPSTREAM). The project had two primary aims: firstly, to attempt to value economically the health cost-benefits associated with the quality of urban environments and, secondly, to interview those in control of urban development in the UK in order to reveal the potential barriers to, and opportunities for, the creation of healthy urban environments, including their views on the use of economic valuation of (planetary) health outcomes. Much is known about the 'downstream' impact of urban environments on human and planetary health and about how to design and plan healthy towns and cities ('midstream'), but we understand relatively little about how health can be factored in at key governance tipping points further 'upstream', particularly within dominant private sector areas of control (e.g. land, finance, delivery) at sub-national level. Our findings suggest that both public and private sector appeared well aware of the major health challenges posed by poor-quality urban environments. Yet they also recognized that health is not factored adequately into the urban planning process, and there was considerable support for greater use of non-market economic valuation to help improve decision-making. There was no silver bullet however: 110 barriers and 76 opportunities were identified across a highly complex range of systems, actors and processes, including many possible points of targeted intervention for economic valuation. Eight main themes were identified as key areas for discussion and future focus. This findings paper is the second of two on this phase of the project: the first sets out the rationale, approach and methodological lessons learned.

The Application of 'Elite Interviewing' Methodology in Transdisciplinary Research: a Record of Process and Lessons Learned during a 3-Year Pilot in Urban Planetary Health Research.

This paper sets out the rationale and process for the interviewing methodology utilized during a 3-year research pilot, 'Moving Health Upstream in Urban Development' (UPSTREAM). The project had two primary aims: firstly, to attempt to value economically the health cost benefits associated with the quality of urban environments and secondly, to engage with those in control of urban development in the UK in order to determine what are the barriers to and opportunities for creating healthy urban environments, including those identified through the utilisation of economic valuation. Engagement at senior level with those who have most control over key facets of planning and development implementation-such as land disposal, investment, development delivery and planning permission-was central to the approach, which encompassed the adoption of 'elite interviewing', a method developed in the USA in the 1950s and used in the political sciences but relatively unutilized in the health and environmental sciences [1]. Two rounds of semi-structured interviews were undertaken with 15 senior decision-makers from the UK's main urban development delivery agencies, both public and private. The 'elite interviewing' approach successfully enabled the UPSTREAM project to capture and analyse the information received from the interviewees, all of whom held influential or leadership posts in organisations that are important actors in the process of planning, developing and constructing the built environment in the UK. Having academic and practitioner research leads on an equal footing created some minor tensions, but it also appeared to strengthen the rigor of the approach through a broad knowledge of context 'in-house'. This form of co-production at times challenged academic traditions in qualitative analysis, but it also appeared to build trust with interviewees and provided greater clarity of the real-world context under investigation. Findings from this study are written up in a separate paper.

Adolescent's perception of road risk on their routes to school in Makwanpur, Nepal; a qualitative study.

BACKGROUND: Busy and poor road infrastructure along routes to school poses high risk of traffic injury for children and adolescents. Ensuring every young person's safe journey to and from school is fundamental to achieving reductions in road injuries and Sustainable Development Goal 3.6. However, there is little evidence reporting adolescent's views about their school travel from low and middle income countries. This study aims to understand adolescent's perceptions of injury risks on their journey to school in Nepal. METHODS: We used Photo-Elicitation Interview (PEI) methods to collect data from fourteen purposively identified adolescents (12-16 years) who walk to Tribhuwan Secondary School along the East-West Highway which is known to be at high risk of crashes in Makwanpur, Nepal. The participants used a camera to record parts of their journey, which they perceived as dangerous or safe. Photographs were used as prompts during an interview afterwards. Interviews were audio-recorded, transcribed, translated and analysed thematically. RESULTS: The identified themes were categorised as either environmental or behavioural factors. The adolescents were scared to walk on narrow roadsides because of speeding vehicles. They also found crossing the road dangerous because of the lack of designated pedestrian crossings and disregard shown by drivers. Poor visibility caused by random roadside parking and trees also increased the sense of road danger. CONCLUSION: Adolescents expressed multiple concerns which made their journeys difficult and dangerous. They illustrated issues such as poor road condition, inadequate pedestrian crossings and traffic signs, narrow roadsides, vehicle speeding and overtaking, failing to obey traffic rules and regulation -providing evidence that could be shared with the authorities to improve road safety near schools.

Pandemics, vulnerability, and prevention: time to fundamentally reassess how we value and communicate risk?: CITIES, HEALTH and COVID-19: Initial reflections and future challenges.

For over a decade, pandemics have been on the UK National Risk Register as both the likeliest and most severe of threats. Non-infectious 'lifestyle' diseases were already crippling our healthcare services and our economy. COVID-19 has exposed two critical vulnerabilities: firstly, the UK's failure to adequately assess and communicate the severity of non-communicable disease; secondly, the health inequalities across our society, due not least to the poor quality of our urban environments. This suggests a potentially disastrous lack of preventative action and risk management more generally, notably with regards to the existential risks from the climate and ecological crises.

Tackling Root Causes Upstream of Unhealthy Urban Development (TRUUD): Protocol of a five-year prevention research consortium.

Poor quality urban environments substantially increase non-communicable disease. Responsibility for associated decision-making is dispersed across multiple agents and systems: fast growing urban authorities are the primary gatekeepers of new development and change in the UK, yet the driving forces are remote private sector interests supported by a political economy focused on short-termism and consumption-based growth. Economic valuation of externalities is widely thought to be fundamental, yet evidence on how to value and integrate it into urban development decision-making is limited, and it forms only a part of the decision-making landscape. Researchers must find new ways of integrating socio-environmental costs at numerous key leverage points across multiple complex systems. This mixed-methods study comprises of six highly integrated work packages. It aims to develop and test a multi-action intervention in two urban areas: one on large-scale mixed-use development, the other on major transport. The core intervention is the co-production with key stakeholders through interviews, workshops, and participatory action research, of three areas of evidence: economic valuations of changed health outcomes; community-led media on health inequalities; and routes to potential impact mapped through co-production with key decision-makers, advisors and the lay public. This will be achieved by: mapping system of actors and processes involved in each case study; developing, testing and refining the combined intervention; evaluating the extent to which policy and practice changes amongst our target users, and the likelihood of impact on non-communicable diseases (NCDs) downstream. The integration of such diverse disciplines and sectors presents multiple practical/operational issues. The programme is testing new approaches to research, notably with regards practitioner-researcher integration and transdisciplinary research co-leadership. Other critical risks relate to urban development timescales, uncertainties in upstream-downstream causality, and the demonstration of impact.

Road safety and heavy goods vehicle driving in LMICs: Qualitative evidence from Nepal.

BACKGROUND: Heavy goods vehicle drivers are an influential driving population in Nepal, with over 90% of goods in the country are transported by road. Due to the time spent on the road, drivers have long periods of exposure to the risk of crash involvement. The study explores the perceptions and experiences of heavy goods vehicle drivers and representatives from their professional association regarding road danger. METHODS: We conducted semi-structured interviews with fifteen heavy goods vehicle drivers regularly driving on the East-West highway of Makwanpur District, Nepal. A focus group was conducted with eleven members from a major transportation entrepreneur's association in Nepal. The focus group and interviews were audio-recorded, transcribed, translated, and analyzed using thematic analysis. RESULTS: Four themes were developed- assumptions of blame; perceptions of safety culture in the trucking industry; influence of road infrastructure; and behaviours of road users. The road and traffic environment, enforcement, and the safety culture in the heavy vehicle industry not only influenced the attitudes of the road users towards traffic safety but also legitimized and encouraged behaviours that affect safety. General and industry-related road safety improvements suggested by participants included: making provision for heavy good vehicles parking areas, separating the highway with a median strip, improving crash investigation capacity, conducting road safety awareness and training programs, strictly enforcing the speed limit and laws about driving under the influence of alcohol/drugs, and formulating strategies to create a safe, supportive working environment in the heavy vehicle industry. CONCLUSION: Heavy goods vehicle drivers and members of the professional association can provide rich information regarding the barriers and facilitators of road risk in Nepal. Their perceptions and opinions can contribute to devising interventions at individual, societal, organizational, and governmental levels, and inform efforts to develop a positive safety culture within the heavy vehicle transport industry.

Exploring the views of planners and public health practitioners on integrating health evidence into spatial planning in England: a mixed-methods study.

BACKGROUND: This study explored barriers and facilitators to integrating health evidence into spatial planning at local authority levels and examined the awareness and use of the Public Health England 'Spatial Planning for Health' resource. METHODS: A sequential exploratory mixed-methods design utilized in-depth semi-structured interviews followed by an online survey of public health, planning and other built environment professionals in England. RESULTS: Views from 19 individuals and 162 survey responses revealed high awareness and use of the Spatial Planning for Health resource, although public health professionals reported greater awareness and use than other professionals. Key barriers to evidence implementation included differences in interpretation and the use of 'evidence' between public health and planning professionals, lack of practical evidence to apply locally and lack of resource and staff capacity in local authorities. Key facilitators included integrating health into the design of local plans, articulating wider benefits to multiple stakeholders and simplifying presenting evidence (regarding language and accessibility). CONCLUSION: The Spatial Planning for Health resource is a useful resource at local authority level. Further work is needed to maximize its use by built environment professionals. Public health teams need support, capacity and skills to ensure that local health and well-being priorities are integrated into local planning documents and decisions.

Healthy buildings for a healthy city: Is the public health evidence base informing current building policies?

Research has demonstrated that housing quality is a key urban intervention in reducing health risks and improving climate resilience, addressing a key ambition of the United Nations Sustainable Development Goals. Yet housing quality remains a problem even in high income countries such as England. In particular, hazards such as excess cold, excess heat and lack of ventilation leading to damp and mould have been identified as a major issue in homes. Research shows that these hazards can lead to a range of health conditions, such as respiratory and cardiovascular disease, infections and mental health problems. This article explores the use of public health research and evidence in policy to regulate new buildings in England to deliver improved public health, climate resilience and a reduced carbon footprint, in particular exploring the policy drivers and awareness of the public health evidence. Findings show that public health evidence is hardly referenced in policy and that the focus on other evidence bases such as on climate mitigation in building regulations results in both positive and negative impacts on health. This reflects a lack of a systems approach around urban interventions leading to weaknesses in standards regulating the private development sector. In conclusion, this paper recommends: 1. the consideration of health impact in future building regulations; 2. the integration and coordination of key policies covering various scales and phases of the development processes and 3. the better education of residents to understand advances in new energy performance technologies.

Effects of city-wide 20 mph (30km/hour) speed limits on road injuries in Bristol, UK.

Twenty miles per hour (32 km/hour) or 30 km/hour speed limits represent a potential strategy to reduce urban road injuries and are becoming increasingly widespread. However, no study has conducted a robust evaluation of the effects of city-wide 20 mph speed limits on road injuries. This study reports the effects of such an intervention, based on a natural experiment that took place in Bristol, UK. Based on a stepped-wedge design using count data, negative binomial regressions showed that between 2008 and 2016, the 20 mph speed limit intervention was associated with a city-level reduction of fatal injuries of around 63% (95% CI 2% to 86%), controlling for trends over time and areas. There was also a general trend of reduction of the total number of injuries at city level and in 20 mph roads. These findings highlight the potential benefits of city-wide 20 mph speed limits. We hypothesise that this city-wide approach may encourage a general behaviour change in drivers that, in turn, may contribute to reducing injuries across the city.

Barriers and facilitators of physical activity among adults and older adults from Black and Minority Ethnic groups in the UK: A systematic review of qualitative studies.

Older adults from Black and Minority Ethnic (BME) groups experience a relatively higher burden of physical inactivity compared with their counterparts from non-BME groups. Despite the increasing number of qualitative studies investigating the barriers and facilitators of physical activity among older adults from BME backgrounds in the UK, there is very limited review-level evidence. The aim of this review is to undertake a synthesis of existing qualitative studies, using a meta-ethnographic approach, to explore the barriers and opportunities for physical activity among adults and older adults from BME communities in the UK. Studies conducted between January 2007 and July 2017 were eligible if they met the following criteria: employed any qualitative method; included participants identified as being BME, aged 50 and above, and living in the UK. In total, 1036 studies were identified from a structured search of six electronic databases combined with hand searching of reference bibliographies. Ten studies met the inclusion criteria for the review and were included. Six key themes emerged from the data: awareness of the links between physical activity and health, interaction and engagement with health professionals, cultural expectations and social responsibilities, suitable environment for physical activity, religious fatalism and practical challenges. There was a substantial gap in research among Black African groups. Interventions aimed at improving physical activity participation among older adults should be acceptable and accessible to minority groups. Further research is needed to investigate the barriers and facilitators of physical activity among older adults from African backgrounds.

Moving Health Upstream in Urban Development: Reflections on the Operationalization of a Transdisciplinary Case Study.

This paper describes the development, conceptualization, and implementation of a transdisciplinary research pilot, the aim of which is to understand how human and planetary health could become a priority for those who control the urban development process. Key challenges include a significant dislocation between academia and the real world, alongside systemic failures in valuation and assessment mechanisms. The National Institutes of Health four-phase model of transdisciplinary team-based research is drawn on and adapted to reflect on what has worked well and what has not operationally. Results underscore the need for experienced academics open to new collaborations and ways of working; clarity of leadership without compromising exploration; clarification of the poorly understood "impacts interface" and navigation toward effective real world impact; acknowledgement of the additional time and resource required for transdisciplinary research and "nonacademic" researchers. Having practitioner-researchers as part of the research leadership team requires rigourous reflective practice and effective management, but it can also ensure breadth in transdisciplinary outlook as well as constant course correction toward real-world impact. It is important for the research community to understand better the opportunities and limitations provided by knowledge intermediaries in terms of function, specialism, and experience.

The relationship between buildings and health: a systematic review.

BACKGROUND: The built environment exerts one of the strongest directly measurable effects on physical and mental health, yet the evidence base underpinning the design of healthy urban planning is not fully developed. METHOD: This study provides a systematic review of quantitative studies assessing the impact of buildings on health. In total, 7127 studies were identified from a structured search of eight databases combined with manual searching for grey literature. Only quantitative studies conducted between January 2000 and November 2016 were eligible for inclusion. Studies were assessed using the quality assessment tool for quantitative studies. RESULTS: In total, 39 studies were included in this review. Findings showed consistently that housing refurbishment and modifications, provision of adequate heating, improvements to ventilation and water supply were associated with improved respiratory outcomes, quality of life and mental health. Prioritization of housing for vulnerable groups led to improved wellbeing. However, the quality of the underpinning evidence and lack of methodological rigour in most of the studies makes it difficult to draw causal links. CONCLUSION: This review identified evidence to demonstrate the strong association between certain features of housing and wellbeing such as adequate heating and ventilation. Our findings highlight the need for strengthening of the evidence base in order for meaningful conclusions to be drawn.

Exploring the multidisciplinary extent of public health career structures in 12 countries: an exploratory mapping.

Background: While much is known about multidisciplinary public health (MDPH) professional practice in the UK which developed particularly in the 1990s, little is known about it in other settings especially low and middle-income countries (LMICs). This study reports on findings of a mapping review of public health career structures and an examination of how multidisciplinary they are in 12 countries. Methods: A 12-element template was used to collect data from relevant websites and key informants with public health experience in the 12 countries. Results: We found that while countries had similarities such as having MDPH professional organizations, there were differences in terms of public health specialty training programmes and openness of senior public health posts at various administrative levels to non-medical professionals. Conclusion: We conclude that there still gaps in MDPH career structures internationally. While this study provides preliminary knowledge on the subject, we recommend further research to inform debates and policies in MDPH professional practice especially in LMICs.

Music-making for health and wellbeing in youth justice settings: mediated affordances and the impact of context and social relations.

Young people in the criminal justice system experience significant health and wellbeing issues that often stem from poverty and disadvantage and, in turn, are linked with offending and reoffending behaviour. There is ongoing interest in interventions such as participatory music programmes that seek to foster social reintegration, support mental wellbeing and equip young offenders with life skills, competencies and emotional resilience. However, there is a need for a situated understanding of both positive and negative experiences that shape potential outcomes of music projects. This article reports on a research study undertaken between 2010 and 2013 with 118 young people aged 13-21 years across eight youth justice settings in England and Wales. Using mixed methods we explored the experiences of young people and their responses to a participatory music programme led by a national UK arts charity. Here, we explore the impact of young people's encounters with music and musicians with reference to the notion of 'musical affordances' (DeNora , ). We examine the ways that such affordances, including unintended outcomes, are mediated by features of the youth justice environment, including its rules and regulations, as well as issues of power, identity and social relations.