Co-producing knowledge on the use of urban natural space: Participatory system dynamics modelling to understand a complex urban system.

Decision-makers are increasingly asked to act differently in how they respond to complex urban challenges, recognising the value in bringing together and integrating cross-disciplinary, cross-sectoral knowledge to generate effective solutions. Participatory modelling allows to bring stakeholders together, enhance knowledge and understanding of a system, and identify the impacts of interventions to a given problem. This paper uses an interdisciplinary and systems approach to investigate a complex urban problem, using a participatory System Dynamics modelling process as an approach to facilitate learning and co-produce knowledge on the factors influencing the use of urban natural space. Stakeholders used a Systems Dynamics model and interface, as a tool to collectively identify pathways for improving the use of space and simulating their impacts. Under the lens of knowledge co-production, the paper reflects how such mechanisms can lead to the co-production of knowledge and social learning. The findings also contribute to identify ways of increasing the value of urban natural space focusing on urban areas undergoing physical and social transformation, such as the Thamesmead case study, London, UK.

Barriers and enablers to local active travel during COVID-19: A case study of Streetspace interventions in two London boroughs.

Background: During the coronavirus disease 2019 (COVID-19) pandemic, UK local authorities increased emergency active travel interventions. This study aimed to understand what aspects of temporary Streetspace for London schemes represent barriers or enablers to walking and cycling for short local journeys. Methods: Focusing on two Inner London boroughs, we conducted 21 semi-structured stakeholder interviews and sampled 885 public comments about Streetspace schemes. We triangulated the data in a thematic analysis to identify barriers and enablers, which were categorised using the Capability, Opportunity, Motivation, Behaviour (COM-B) model. Results: Opportunity and motivation factors were reflected in the barriers (accessibility and integration of the schemes; controversy, dissatisfaction, and doubt) and enablers (new routes and spaces; sustainability and health beliefs) and mixed themes (changes to traffic and appeal of the area; feelings of safety). Capability was not reflected in the main themes. Conclusions: Although aspects of Streetspace schemes were seen to enable active travel, our findings suggest that additional processes to address the acceptability, fairness, and unintended consequences of emergency interventions will be important to their long-term success for health and sustainability.

Decarbonising existing homes in Wales: a participatory behavioural systems mapping approach.

To reduce carbon emissions, urgent change is needed to high-carbon human behaviours including home energy use. Previous policy failures point to insufficient integration of systemic and behavioural approaches which are too often seen as alternative and incompatible approaches to bring about change. A novel behavioural systems mapping approach was used to inform national policy recommendations for energy-saving retrofit of homes in Wales. Three participatory workshops were held with the independent Welsh residential decarbonisation advisory group ('the Advisory Group') to: (1) map relationships between actors, behaviours and influences on behaviour within the home retrofit system; (2) provide training in the Behaviour Change Wheel (BCW) framework and (3) use these to develop policy recommendations for interventions. Recommendations were analysed using the capability, opportunity and motivation (COM-B) model of behaviour to assess whether they addressed these factors. Two behavioural systems maps (BSMs) were produced, representing privately rented and owner-occupied housing tenures. The main causal pathways and feedback loops in each map are described. Necessary interventions to achieve national-scale retrofit included: government-led investment, campaigns and awareness-building, financial-sector funding mechanisms, enforcement of regulations and creating more streamlined and trusted supply chain services. Of 27 final policy recommendations, six addressed capability, 24 opportunity and 12 motivation. Participatory behavioural systems mapping can be used in conjunction with behaviour change frameworks to develop policy recommendations that address the behavioural determinants of complex environmental problems in a systemic way. Research is underway to refine and extend the approach through application to other sustainability challenges and methods of constructing systems maps.

The wicked problem of waste management: An attention-based analysis of stakeholder behaviours.

Surging amounts of waste are reported globally and especially in lower-income countries, with negative consequences for health and the environment. Increasing concern has been raised for the limited progress achieved in practice by diverse sets of policies and programmes. Waste management is a wicked problem characterised by multilayered interdependencies, complex social dynamics and webs of stakeholders. Interactions among these generate unpredictable outcomes that can be missed by decision makers through their understanding and framing of their context. This article aims to identify possible sources of persistent problems by focussing on what captures, shapes and limits the attention of stakeholders and decision-makers, drawing on the attention-based view from organisation theory. The theory describes the process through which issues and opportunities are noticed and how these are translated into actions, by focussing on the influencers at the individual, organisational and context scale. Views on issues and opportunities for waste management were collected in a series of fieldwork activities from 60 participants representing seven main types of stakeholders in the typical lower-middle income Kenyan city of Kisumu. Through a thematic analysis guided by the attention-based view, we identified patterns and misalignment of views, especially between government, community-based organisations and residents, which may contribute to persistent waste problems in Kisumu. Some point to detrimental waste handling practices, from separation to collection and treatment, as the main cause of issues. For others, these practices are due to a poor control of such practices and enforcement of the law. This study's major theoretical contribution is extending the application of attention theory to multi-stakeholder problems and to non-formalized organisations, namely residents and to the new field of waste management. This novel lens contributes a greater understanding of waste issues and their management in Africa that is relevant to policy and future research. By revealing the "wickedness" of the waste problem, we point to the need for a holistic and systems-based policy approach to limit further unintended consequences.

Evidence-informed urban health and sustainability governance in two Chinese cities.

Sustainable development is best supported by intersectoral policies informed by a range of evidence and knowledge types (e.g. scientific and lay). Given China's rapid urbanisation, scale and global importance in climate mitigation, this study investigates how evidence is perceived and used to inform urban health and sustainability policies at central and local levels. Well-informed senior professionals in government/scientific agencies (12 in Beijing and 11 in Ningbo) were interviewed. A thematic analysis is presented using deductive and inductive coding. Government agency participants described formal remits and processes determining the scope and use of evidence by different tiers of government. Academic evidence was influential when commissioned by government departments. Public opinion and economic priorities were two factors that also influenced the use or weight of evidence in policymaking. This study shows that scientific evidence produced or commissioned by government was routinely used to inform urban health and sustainability policy. Extensive and routine data collection is regularly used to inform cyclical policy processes, which improves adaptive capacity. This study contributes to knowledge on the 'cultures of evidence use'. Environmental governance can be further improved through increased data-sharing and use of diverse knowledge types.

Developing a programme theory for a transdisciplinary research collaboration: Complex Urban Systems for Sustainability and Health.

Background: Environmental improvement is a priority for urban sustainability and health and achieving it requires transformative change in cities. An approach to achieving such change is to bring together researchers, decision-makers, and public groups in the creation of research and use of scientific evidence. Methods: This article describes the development of a programme theory for Complex Urban Systems for Sustainability and Health (CUSSH), a four-year Wellcome-funded research collaboration which aims to improve capacity to guide transformational health and environmental changes in cities. Results: Drawing on ideas about complex systems, programme evaluation, and transdisciplinary learning, we describe how the programme is understood to "work" in terms of its anticipated processes and resulting changes. The programme theory describes a chain of outputs that ultimately leads to improvement in city sustainability and health (described in an 'action model'), and the kinds of changes that we expect CUSSH should lead to in people, processes, policies, practices, and research (described in a 'change model'). Conclusions: Our paper adds to a growing body of research on the process of developing a comprehensive understanding of a transdisciplinary, multiagency, multi-context programme. The programme theory was developed collaboratively over two years. It involved a participatory process to ensure that a broad range of perspectives were included, to contribute to shared understanding across a multidisciplinary team. Examining our approach allowed an appreciation of the benefits and challenges of developing a programme theory for a complex, transdisciplinary research collaboration. Benefits included the development of teamworking and shared understanding and the use of programme theory in guiding evaluation. Challenges included changing membership within a large group, reaching agreement on what the theory would be 'about', and the inherent unpredictability of complex initiatives.

The CUSSH programme: supporting cities' transformational change towards health and sustainability.

This paper describes a global research programme on the complex systemic connections between urban development and health. Through transdisciplinary methods the Complex Urban Systems for Sustainability and Health (CUSSH) project will develop critical evidence on how to achieve the far-reaching transformation of cities needed to address vital environmental imperatives for planetary health in the 21st Century. CUSSH's core components include: (i) a review of evidence on the effects of climate actions (both mitigation and adaptation) and factors influencing their implementation in urban settings; (ii) the development and application of methods for tracking the progress of cities towards sustainability and health goals; (iii) the development and application of models to assess the impact on population health, health inequalities, socio-economic development and environmental parameters of urban development strategies, in order to support policy decisions; (iv) iterative in-depth engagements with stakeholders in partner cities in low-, middle- and high-income settings, using systems-based participatory methods, to test and support the implementation of the transformative changes needed to meet local and global health and sustainability objectives; (v) a programme of public engagement and capacity building. Through these steps, the programme will provide transferable evidence on how to accelerate actions essential to achieving population-level health and global climate goals through, amongst others, changing cities' energy provision, transport infrastructure, green infrastructure, air quality, waste management and housing.

An ontology-based modelling system (OBMS) for representing behaviour change theories applied to 76 theories.

Background: To efficiently search, compare, test and integrate behaviour change theories, they need to be specified in a way that is clear, consistent and computable. An ontology-based modelling system (OBMS) has previously been shown to be able to represent five commonly used theories in this way. We aimed to assess whether the OBMS could be applied more widely and to create a database of behaviour change theories, their constructs and propositions. Methods: We labelled the constructs within 71 theories and used the OBMS to represent the relationships between the constructs. Diagrams of each theory were sent to authors or experts for feedback and amendment. The 71 finalised diagrams plus the five previously generated diagrams were used to create a searchable database of 76 theories in the form of construct-relationship-construct triples. We conducted a set of illustrative analyses to characterise theories in the database. Results: All 71 theories could be satisfactorily represented using this system. In total, 35 (49%) were finalised with no or very minor amendment. The remaining 36 (51%) were finalised after changes to the constructs (seven theories), relationships between constructs (15 theories) or both (14 theories) following author/expert feedback. The mean number of constructs per theory was 20 (min. = 6, max. = 72), with the mean number of triples per theory 31 (min. = 7, max. = 89). Fourteen distinct relationship types were used, of which the most commonly used was 'influences', followed by 'part of'. Conclusions: The OBMS can represent a wide array of behavioural theories in a precise, computable format. This system should provide a basis for better integration and synthesis of theories than has hitherto been possible.

Do Combinations of Behavior Change Techniques That Occur Frequently in Interventions Reflect Underlying Theory?

BACKGROUND: Behavioral interventions typically include multiple behavior change techniques (BCTs). The theory informing the selection of BCTs for an intervention may be stated explicitly or remain unreported, thus impeding the identification of links between theory and behavior change outcomes. PURPOSE: This study aimed to identify groups of BCTs commonly occurring together in behavior change interventions and examine whether behavior change theories underlying these groups could be identified. METHODS: The study involved three phases: (a) a factor analysis to identify groups of co-occurring BCTs from 277 behavior change intervention reports; (b) examining expert consensus (n = 25) about links between BCT groups and behavioral theories; (c) a comparison of the expert-linked theories with theories explicitly mentioned by authors of the 277 intervention reports. RESULTS: Five groups of co-occurring BCTs (range: 3-13 BCTs per group) were identified through factor analysis. Experts agreed on five links (≥80% of experts), comprising three BCT groups and five behavior change theories. Four of the five BCT group-theory links agreed by experts were also stated by study authors in intervention reports using similar groups of BCTs. CONCLUSIONS: It is possible to identify groups of BCTs frequently used together in interventions. Experts made shared inferences about behavior change theory underlying these BCT groups, suggesting that it may be possible to propose a theoretical basis for interventions where authors do not explicitly put forward a theory. These results advance our understanding of theory use in multicomponent interventions and build the evidence base for further understanding theory-based intervention development and evaluation.

Are You on My Wavelength? Interpersonal Coordination in Dyadic Conversations.

Conversation between two people involves subtle nonverbal coordination in addition to speech. However, the precise parameters and timing of this coordination remain unclear, which limits our ability to theorize about the neural and cognitive mechanisms of social coordination. In particular, it is unclear if conversation is dominated by synchronization (with no time lag), rapid and reactive mimicry (with lags under 1 s) or traditionally observed mimicry (with several seconds lag), each of which demands a different neural mechanism. Here we describe data from high-resolution motion capture of the head movements of pairs of participants (n = 31 dyads) engaged in structured conversations. In a pre-registered analysis pathway, we calculated the wavelet coherence of head motion within dyads as a measure of their nonverbal coordination and report two novel results. First, low-frequency coherence (0.2-1.1 Hz) is consistent with traditional observations of mimicry, and modeling shows this behavior is generated by a mechanism with a constant 600 ms lag between leader and follower. This is in line with rapid reactive (rather than predictive or memory-driven) models of mimicry behavior, and could be implemented in mirror neuron systems. Second, we find an unexpected pattern of lower-than-chance coherence between participants, or hypo-coherence, at high frequencies (2.6-6.5 Hz). Exploratory analyses show that this systematic decoupling is driven by fast nodding from the listening member of the dyad, and may be a newly identified social signal. These results provide a step towards the quantification of real-world human behavior in high resolution and provide new insights into the mechanisms of social coordination.

A tool for assessing the climate change mitigation and health impacts of environmental policies: the Cities Rapid Assessment Framework for Transformation (CRAFT).

Background: A growing number of cities, including Greater London, have set ambitious targets, including detailed policies and implementation plans, to reach global goals on sustainability, health, and climate change. Here we present a tool for a rapid assessment of the magnitude of impact of specific policy initiatives to reach these targets. The decision-support tool simultaneously quantifies the environmental and health impacts of specified selected policies. Methods: The 'Cities Rapid Assessment Framework for Transformation (CRAFT)' tool was applied to Greater London. CRAFT quantifies the effects of ten environmental policies on changes in (1) greenhouse gas (GHG) emissions, (2) exposures to environmental hazards, (3) travel-related physical activity, and (4) mortality (the number of attributable deaths avoided in one typical year). Publicly available data and epidemiological evidence were used to make rapid quantitative estimates of these effects based on proportional reductions in GHG emissions and environmental exposures from current baseline levels and to compute the mortality impacts. Results: The CRAFT tool estimates that, of roughly 50,000 annual deaths in Greater London, the modelled hazards (PM 2.5 (from indoor and outdoor sources), outdoor NO 2, indoor radon, cold, overheating) and low travel-related physical activity are responsible for approximately 10,000 premature environment-related deaths. Implementing the selected polices could reduce the annual mortality number by about 20% (~1,900 deaths) by 2050. The majority of these deaths (1,700) may be avoided through increased uptake in active travel. Thus, out of ten environmental policies, the 'active travel' policy provides the greatest health benefit. Also, implementing the ten policies results in a GHG reduction of around 90%. Conclusions: The CRAFT tool quantifies the effects of city policies on reducing GHG emissions, decreasing environmental health hazards, and improving public health. The tool has potential value for policy makers through providing quantitative estimates of health impacts to support and prioritise policy options.

Maternal and neonatal outcomes in women with history of coronary artery disease.

BACKGROUND: Pregnancy outcomes in women with pre-existing coronary artery disease (CAD) are poorly described. There is a paucity of data therefore on which to base clinical management to counsel women, with regard to both maternal and neonatal outcomes. METHOD: We conducted a retrospective multicentre study of women with established CAD delivering at 16 UK specialised cardiac obstetric clinics. We included pregnancies of 24 weeks' gestation or more, delivered between January 1998 and October 2018. Data were collected on maternal cardiovascular, obstetric and neonatal events. RESULTS: 79 women who had 92 pregnancies (94 babies including two sets of twins) were identified. 35.9% had body mass index >30% and 24.3% were current smokers. 18/79 (22.8%) had prior diabetes, 27/79 (34.2%) had dyslipidaemia and 21/79 (26.2%) had hypertension. The underlying CAD was due to atherosclerosis in 52/79 (65.8%), spontaneous coronary artery dissection (SCAD) in 11/79 (13.9%), coronary artery spasm in 7/79 (8.9%) and thrombus in 9/79 (11.4%).There were six adverse cardiac events (6.6% event rate), one non-ST elevation myocardial infarction at 23 weeks' gestation, two SCAD recurrences (one at 26 weeks' gestation and one at 9 weeks' postpartum), one symptomatic deterioration in left ventricular function and two women with worsening angina. 14% of women developed pre-eclampsia, 25% delivered preterm and 25% of infants were born small for gestational age. CONCLUSION: Women with established CAD have relatively low rates of adverse cardiac events in pregnancy. Rates of adverse obstetric and neonatal events are greater, highlighting the importance of multidisciplinary care.

The virtual maze: A behavioural tool for measuring trust.

Trusting another person may depend on our level of generalised trust in others, as well as perceptions of that specific person's trustworthiness. However, many studies measuring trust outcomes have not discussed generalised versus specific trust. To measure specific trust in others, we developed a novel behavioural task. Participants navigate a virtual maze and make a series of decisions about how to proceed. Before each decision, they may ask for advice from two virtual characters they have briefly interviewed earlier. We manipulated the virtual characters' trustworthiness during the interview phase and measured how often participants approached and followed advice from each character. We also measured trust through ratings and an investment game. Across three studies, we found participants followed advice from a trustworthy character significantly more than an untrustworthy character, demonstrating the validity of the maze task. Behaviour in the virtual maze reflected specific trust rather than generalised trust, whereas the investment game picked up on generalised trust as well as specific trust. Our data suggest the virtual maze task may provide an alternative behavioural approach to measuring specific trust in future research, and we demonstrate how the task may be used in traditional laboratories.

Testing the relationship between mimicry, trust and rapport in virtual reality conversations.

People mimic each other's actions and postures during everyday interactions. It is widely believed this mimicry acts as a social glue, leading to increased rapport. We present two studies using virtual reality to rigorously test this hypothesis. In Study 1, 50 participants interacted with two avatars who either mimicked their head and torso movements at a 1 or 3 second time delay or did not mimic, and rated feelings of rapport and trust toward the avatars. Rapport was higher towards mimicking avatars, with no effect of timing. In Study 2, we aimed to replicate this effect in a pre-registered design and test whether it is modulated by cultural ingroup-outgroup boundaries. Forty participants from European or East Asian backgrounds interacted with four avatars, two of European appearance and two of East Asian appearance. Two avatars mimicked while the other two did not. We found no effects of mimicry on rapport or trust ratings or implicit trust behaviour in a novel maze task, and no effects of group status or interactions. These null results were calculated in line with our pre-registration. We conclude that being mimicked does not always increase rapport or trust, and make suggestions for future directions.

The Responses of Medical General Practitioners to Unreasonable Patient Demand for Antibiotics--A Study of Medical Ethics Using Immersive Virtual Reality.

BACKGROUND: Dealing with insistent patient demand for antibiotics is an all too common part of a General Practitioner's daily routine. This study explores the extent to which portable Immersive Virtual Reality technology can help us gain an accurate understanding of the factors that influence a doctor's response to the ethical challenge underlying such tenacious requests for antibiotics (given the threat posed by growing anti-bacterial resistance worldwide). It also considers the potential of such technology to train doctors to face such dilemmas. EXPERIMENT: Twelve experienced GPs and nine trainees were confronted with an increasingly angry demand by a woman to prescribe antibiotics to her mother in the face of inconclusive evidence that such antibiotic prescription is necessary. The daughter and mother were virtual characters displayed in immersive virtual reality. The specific purposes of the study were twofold: first, whether experienced GPs would be more resistant to patient demands than the trainees, and second, to investigate whether medical doctors would take the virtual situation seriously. RESULTS: Eight out of the 9 trainees prescribed the antibiotics, whereas 7 out of the 12 GPs did so. On the basis of a Bayesian analysis, these results yield reasonable statistical evidence in favor of the notion that experienced GPs are more likely to withstand the pressure to prescribe antibiotics than trainee doctors, thus answering our first question positively. As for the second question, a post experience questionnaire assessing the participants' level of presence (together with participants' feedback and body language) suggested that overall participants did tend towards the illusion of being in the consultation room depicted in the virtual reality and that the virtual consultation taking place was really happening.

Cognitive mechanisms for responding to mimicry from others.

Compared to our understanding of neurocognitive processes involved producing mimicry, the downstream consequences of being mimicked are less clear. A wide variety of positive consequences of mimicry, such as liking and helping, have been reported in behavioural research. However, an in-depth review suggests the link from mimicry to liking and other positive outcomes may be fragile. Positive responses to mimicry can break down due to individual factors and social situations where mimicry may be unexpected. It remains unclear how the complex behavioural effects of mimicry relate to neural systems which respond to being mimicked. Mimicry activates regions associated with mirror properties, self-other processing and reward. In this review, we outline three potential models linking these regions with cognitive consequences of being mimicked. The models suggest that positive downstream consequences of mimicry may depend upon self-other overlap, detection of contingency or low prediction error. Finally, we highlight limitations with traditional research designs and suggest alternative methods for achieving highly ecological validity and experimental control. We also highlight unanswered questions which may guide future research.

Better together? The cognitive advantages of synaesthesia for time, numbers, and space.

Synaesthesia for time, numbers, and space (TNS synaesthesia) is thought to have costs and benefits for recalling and manipulating time and number. There are two competing theories about how TNS synaesthesia affects cognition. The "magnitude" account predicts that TNS synaesthesia may affect cardinal magnitude judgements, whereas the "sequence" account suggests that it may affect ordinal sequence judgements and could rely on visuospatial working memory. We aimed to comprehensively assess the cognitive consequences of TNS synaesthesia and distinguish between these two accounts. TNS synaesthetes, grapheme-colour synaesthetes, and nonsynaesthetes completed a behavioural task battery. Three tasks involved cardinal and ordinal comparisons of temporal, numerical, and spatial stimuli; we also examined visuospatial working memory. TNS synaesthetes were significantly more accurate than nonsynaesthetes in making ordinal judgements about space. This difference was explained by significantly higher visuospatial working memory accuracy. Our findings demonstrate an advantage of TNS synaesthesia that is more in line with the sequence account.

Structural basis of murein peptide specificity of a gamma-D-glutamyl-l-diamino acid endopeptidase.

The crystal structures of two homologous endopeptidases from cyanobacteria Anabaena variabilis and Nostoc punctiforme were determined at 1.05 and 1.60 A resolution, respectively, and contain a bacterial SH3-like domain (SH3b) and a ubiquitous cell-wall-associated NlpC/P60 (or CHAP) cysteine peptidase domain. The NlpC/P60 domain is a primitive, papain-like peptidase in the CA clan of cysteine peptidases with a Cys126/His176/His188 catalytic triad and a conserved catalytic core. We deduced from structure and sequence analysis, and then experimentally, that these two proteins act as gamma-D-glutamyl-L-diamino acid endopeptidases (EC 3.4.22.-). The active site is located near the interface between the SH3b and NlpC/P60 domains, where the SH3b domain may help define substrate specificity, instead of functioning as a targeting domain, so that only muropeptides with an N-terminal L-alanine can bind to the active site.

Crystal structure of a novel Sm-like protein of putative cyanophage origin at 2.60 A resolution.

ECX21941 represents a very large family (over 600 members) of novel, ocean metagenome-specific proteins identified by clustering of the dataset from the Global Ocean Sampling expedition. The crystal structure of ECX21941 reveals unexpected similarity to Sm/LSm proteins, which are important RNA-binding proteins, despite no detectable sequence similarity. The ECX21941 protein assembles as a homopentamer in solution and in the crystal structure when expressed in Escherichia coli and represents the first pentameric structure for this Sm/LSm family of proteins, although the actual oligomeric form in vivo is currently not known. The genomic neighborhood analysis of ECX21941 and its homologs combined with sequence similarity searches suggest a cyanophage origin for this protein. The specific functions of members of this family are unknown, but our structure analysis of ECX21941 indicates nucleic acid-binding capabilities and suggests a role in RNA and/or DNA processing.