Co-designing grounded visualisations of the Food-Water-Energy nexus to enable urban sustainability transformations

In the past few years, the Food-Water-Energy (FWE) Nexus has emerged as a key concept to address the complex relationships and interdependencies between food, water, and energy systems. Cities are an important context for understanding the FWE nexus given their significant footprints and complex socio-ecological systems, but researchers have only recently started to explore an explicit urban perspective on food, water, and energy interrelationships. This paper tackles a particularly significant knowledge gap in this context by introducing an approach to co-design visualisations of the FWE nexus that are understandable and actionable for the various stakeholders involved in urban governance such as citizens, communities, governments, non-governmental and private-sector organisations. Drawing on user-centred design and inspired by the dialogic pedagogy of Paulo Freire, we present and evaluate the co-design process of a FWE nexus visualisation tool for stakeholders engaged with pre-school education in Słupsk, Poland. Our results provide evidence that this co-design process has been effective to developing a new critical consciousness in the participants about how their everyday choices are related to the FWE nexus, enabling them to change perspectives, leading to more sustainable choices. We propose that our co-design process can be used to develop 'grounded visualisations' of the FWE nexus, i.e., visualisations that are grounded in the experiential situations and lived realities of stakeholders, thus offering an effective support for decision-making that could open pathways to sustainability transformations

Impact of the societal response to COVID-19 on access to healthcare for non-COVID-19 health issues in slum communities of Bangladesh, Kenya, Nigeria and Pakistan : results of pre-COVID and COVID-19 lockdown stakeholder engagements

Abstract Introduction With COVID-19, there is urgency for policymakers to understand and respond to the health needs of slum communities. Lockdowns for pandemic control have health, social and economic consequences. We consider access to healthcare before and during COVID-19 with those working and living in slum communities. Methods In seven slums in Bangladesh, Kenya, Nigeria and Pakistan, we explored stakeholder perspectives and experiences of healthcare access for non-COVID-19 conditions in two periods: pre-COVID-19 and during COVID-19 lockdowns. Results Between March 2018 and May 2020, we engaged with 860 community leaders, residents, health workers and local authority representatives. Perceived common illnesses in all sites included respiratory, gastric, waterborne and mosquitoborne illnesses and hypertension. Pre-COVID, stakeholders described various preventive, diagnostic and treatment services, including well-used antenatal and immunisation programmes and some screening for hypertension, tuberculosis, HIV and vectorborne disease. In all sites, pharmacists and patent medicine vendors were key providers of treatment and advice for minor illnesses. Mental health services and those addressing gender-based violence were perceived to be limited or unavailable. With COVID-19, a reduction in access to healthcare services was reported in all sites, including preventive services. Cost of healthcare increased while household income reduced. Residents had difficulty reaching healthcare facilities. Fear of being diagnosed with COVID-19 discouraged healthcare seeking. Alleviators included provision of healthcare by phone, pharmacists/drug vendors extending credit and residents receiving philanthropic or government support; these were inconsistent and inadequate. Conclusion Slum residents’ ability to seek healthcare for non-COVID-19 conditions has been reduced during lockdowns. To encourage healthcare seeking, clear communication is needed about what is available and whether infection control is in place. Policymakers need to ensure that costs do not escalate and unfairly disadvantage slum communities. Remote consulting to reduce face-to-face contact and provision of mental health and gender-based violence services should be considered

Analysis of OpenStreetMap data quality at different stages of a participatory mapping process : evidence from slums in Africa and Asia

This paper examines OpenStreetMap data quality at different stages of a participatory mapping process in seven slums in Africa and Asia. Data were drawn from an OpenStreetMap-based participatory mapping process developed as part of a research project focusing on understanding inequalities in healthcare access of slum residents in the Global South. Descriptive statistics and qualitative analysis were employed to examine the following research question: What is the spatial data quality of collaborative remote mapping achieved by volunteer mappers in morphologically complex urban areas? Findings show that the completeness achieved by remote mapping largely depends on the morphology and characteristics of slums such as building density and rooftop architecture, varying from 84 in the best case, to zero in the most difficult site. The major scientific contribution of this study is to provide evidence on the spatial data quality of remotely mapped data through volunteer mapping efforts in morphologically complex urban areas such as slums; the results could provide insights into how much fieldwork would be needed in what level of complexity and to what extent the involvement of local volunteers in these efforts is required

International genome-wide meta-analysis identifies new primary biliary cirrhosis risk loci and targetable pathogenic pathways.

Primary biliary cirrhosis (PBC) is a classical autoimmune liver disease for which effective immunomodulatory therapy is lacking. Here we perform meta-analyses of discovery data sets from genome-wide association studies of European subjects (n=2,764 cases and 10,475 controls) followed by validation genotyping in an independent cohort (n=3,716 cases and 4,261 controls). We discover and validate six previously unknown risk loci for PBC (Pcombined<5 × 10(-8)) and used pathway analysis to identify JAK-STAT/IL12/IL27 signalling and cytokine-cytokine pathways, for which relevant therapies exist

Nationwide equity assessment of the 20-minute neighbourhood in the Scottish context: a socio-spatial proximity analysis of residential locations

No abstract available

Primary-care doctor and nurse consultations among people who live in slums : a retrospective, cross-sectional survey in four countries

Objectives To survey on the availability and use of primary care services in slum populations. Design Retrospective, cross-sectional, household, individual and healthcare provider surveys. Setting Seven slum sites in four countries (Nigeria, Kenya, Pakistan and Bangladesh). Participants Residents of slums and informal settlements. Primary and secondary outcome measures Primary care consultation rates by type of provider and facility. Results We completed 7692 household, 7451 individual adult and 2633 individual child surveys across seven sites. The majority of consultations were to doctors/nurses (in clinics or hospitals) and pharmacies rather than single-handed providers or traditional healers. Consultation rates with a doctor or nurse varied from 0.2 to 1.5 visits per person-year, which was higher than visit rates to any other type of provider in all sites except Bangladesh, where pharmacies predominated. Approximately half the doctor/nurse visits were in hospital outpatient departments and most of the remainder were to clinics. Over 90% of visits across all sites were for acute symptoms rather than chronic disease. Median travel times were between 15 and 45 min and the median cost per visit was between 2% and 10% of a household’s monthly total expenditure. Medicines comprised most of the cost. More respondents reported proximity (54%–78%) and service quality (31%–95%) being a reason for choosing a provider than fees (23%–43%). Demand was relatively inelastic with respect to both price of consultation and travel time. Conclusions People in slums tend to live sufficiently close to formal doctor/nurse facilities for their health-seeking behaviour to be influenced by preference for provider type over distance and cost. However, costs, especially for medicines are high in relation to income and use rates remain significantly below those of high-income countries