Effectiveness Of Environmental Interventions Research Articles

Walking to School: What Streets Do Children Prefer?

Active school travel provides children with a daily opportunity to engage actively with their local urban environments. Despite widespread recognition that understanding the underlying factors of children’s navigation choices is crucial for developing effective environmental interventions to promote active school travel, there is limited evidence on children’s experiences regarding their school journeys. This is due in part to the fact that most studies rely on GIS-calculated routes which may not adequately represent children’s actual home-school journeys, and hence actual experiences. This study aims to identify specific environmental attributes influencing children’s navigation choices based on children’s (9–10 year olds) actual walking routes to school in Newcastle upon Tyne, UK. 45 pairs of selected and avoided streets were compared using a range of urban form (e.g., street connectivity measured through space syntax variables) and street design (e.g., footpath width) characteristics. Statistical analysis highlighted significant design attributes as potential determinants of navigation selections. In-depth street-level observations provided insight into the urban character of these street pairs, identifying the environmental qualities that could offer opportunities for active and safe commuting among children. This study contributes to the literature by broadening our understanding of the environmental attributes that may promote active school travel. Our findings, based on children’s actual experiences, may also inform urban planners and designers on designing inclusive child-friendly cities.

Comparing the impacts of built environment across different objective life neighborhoods on the out-of-home leisure activities of employed people using massive mobile phone data

An adequately-designed built environment can prompt willingness of employed people to carry out out-of-home leisure activities. However, since much of the literature relies on static or perceived residential neighborhoods which may have substantial deviations from realistic environmental exposure, some associations between out-of-home leisure activities and built environment may be biased. In this study, we develop three kinds of objective life neighborhood measurements (residential space, job-housing space, and activity space) using massive mobile phone data, to distinguish the differentiated impacts of built environment across different objective life neighborhoods on the out-of-home leisure activities. According to the results, the activity space makes the exploratory models far more reasonable and persuasive than other life neighborhoods, especially in urban development areas, and the benefits of activity space cannot be attained solely by expanding the distance parameters of residential space or job-housing space. Furthermore, the results demonstrate the relative importance of built environment for out-of-home leisure activities, especially the factors of population density, proportion of urban green space, and metro coverage rate, may be underestimated if the ordinary life neighborhoods are applied. This study provides some references for urban planners to formulate effective environmental intervention strategies to maintain active and healthy lifestyles of employed people.

How does visual environment affect outdoor jogging behavior? Insights from large-scale city images and GPS trajectories

Understanding the relationships between visual environment (VE) and outdoor jogging is crucial to facilitating effective environmental interventions. However, how the visual environment affects jogging behavior remains unclear due to data and technology limitations. This study aimed to explore the spatially and temporally varying effects of visual environment on jogging behavior. Specifically, street view images and geotagged photos were used to measure the visual environment outside and inside the traffic analysis zone (TAZ), respectively; and massive GPS trajectories collected from a fitness application were utilized to estimate jogging activities. Furthermore, random forest and multiscale geographically weighted regression (MGWR) models were established to examine the impacts of VE on jogging flow in Beijing, China. Results showed that visual greenery, openness, and walkability play an important role in determining jogging behaviors. Effects of some VE variables display distinct scale effects and spatial non-stationarity. Notably, the dual effects or synergistic effects of specific VE factors, such as visual greenery, walkability, between inside and outside the TAZ were identified. Effects of certain VE factors, e.g., visual greenness, openness, on jogging behavior vary across peak-hours, weekdays and weekends, and seasons, respectively. These findings have practical implications in city planning design for building jogging-friendly urban environment.

Towards cleaner air in Siliguri: A comprehensive study of PM2.5 and PM10 through advance computational forecasting models for effective environmental interventions

This research addresses the escalating concern of air pollution, primarily due to fine particulate matter (PM2.5) and coarse particulate matter (PM10), in Siliguri city, West Bengal, India. Using a comprehensive dataset of daily 24-h average concentrations from February 2018 to February 2023, procured from the Central Pollution Control Board, six advanced computational models i.e., Artificial Neural Networks (ANN), Autoregressive Integrated Moving Averages (ARIMA), Extreme Learning Machine (ELM), Exponential Smoothing State Space Models (ETS), Naïve, and Trigonometric Seasonality, Box-Cox Transformation, ARMA Errors, Trend, and Seasonality (TBATS) were rigorously tested for predicting particulate matter concentrations. Daily data from 2018 to 2021 was used for training and the remaining for testing. The models in the testing phase were evaluated using Root Mean Squared Error (RMSE), Mean Absolute Error (MAE), and Mean Absolute Percentage Error (MAPE) along with R2. In the testing phase, the TBATS model emerged as the most accurate with the lowest RMSE values of 8.11 for PM2.5 and 12.33 for PM10, followed by the ARIMA model with an RMSE of 10.72 for PM2.5 and 18.10 for PM10. The ETS model also demonstrated reliable performance. In addition, by using the advantages of the most effective models, namely ARIMA and TBATS, the research makes forecasts for PM2.5 and PM10 levels from 2023 to 2025, on a monthly basis. These findings are helpful for air quality management in Siliguri and underscore the importance of using advanced computational models for pollution forecasting, encouraging further research on hybrid models with meteorological parameters.

Association Between Natural/Built Campus Environment and Depression Among Chinese Undergraduates: Multiscale Evidence for the Moderating Role of Socioeconomic Factors After Controlling for Residential Self-Selection.

AimEvidence on the association between natural-built environments and depression is largely derived from the general population and prone to residential self-selection bias because of the nature of cross-sectional research design. Despite emerging adulthood, which includes the university years, is a critical stage for forming life-long health habits, studies on this topic focusing on undergraduate students are limited. The current study aims to illustrate the underlying mechanisms for how the campus-based environments affect depression in undergraduate students.MethodsBased on a nationwide representative analytical sample of 22,009 Chinese undergraduates in 2018, we examined participants' reports of depression and campus-centered natural/built environments within multiple buffer sizes including 0.5, 1.0, and 2.5 km. After disentangling residential self-selection, we explored the moderating role of the socioeconomic attributes of undergraduates. The depression outcome was measured by the nine-item Patient Health Questionnaire (PHQ9). Indicators of exposure to green and blue space, transportation infrastructure, and food environments were objectively assessed using different circular buffers around each campus address.ResultsModeling results indicated that campus neighborhoods with more scattered trees (0.5 km), water (0.5, 1.0, and 2.5 km), and street intersections (1.0 and 2.5 km) were protective against depression. In contrast, those living near denser distributions of outlets serving take-away sweets and fast food (0.5, 1.0, and 2.5 km) were susceptible to depression. These associations were modified by undergraduates' socioeconomic attributes (e.g., grade, Hukou status, and ethnicity) and varied according to geographical scales and exposure metrics.ConclusionTo deliver effective environmental interventions to curb the prevalence of depression among undergraduate students, further planning policies should focus on the careful conception of the campus-based environment, especially regarding different spatial scales.

Randomized trial of a portable HEPA air cleaner intervention to reduce asthma morbidity among Latino children in an agricultural community

BackgroundData on pediatric asthma morbidity and effective environmental interventions in U.S. agricultural settings are few. We evaluated the effectiveness of HEPA air cleaners on asthma morbidity among a cohort of rural Latino children.MethodsSeventy-five children with poorly controlled asthma and living in non-smoking homes were randomly assigned to asthma education alone or along with HEPA air cleaners placed in their sleeping area and home living room. The Asthma Control Test (ACT) score, asthma symptoms in prior 2 weeks, unplanned clinical utilization, creatinine-adjusted urinary leukotriene E4 (uLTE4 [ng/mg]), and additional secondary outcomes were evaluated at baseline, six, and 12 months. Group differences were assessed using multivariable-adjusted generalized estimating equations. Incident rate ratios of ever experiencing the metrics of poorer asthma health during follow-up (suboptimal asthma management) were estimated using Poisson regression models in secondary analysis.ResultsMean child age was 9.2 and 8.6 years in intervention and control groups, respectively, and two-thirds of participants were male. Primary analysis of repeated measures of ACT score did not differ between groups (HEPA group mean change compared to controls 10% [95% CI: − 12-39%]). A suggestion of greater decrease in uLTE4 (ng/mg creatinine) was observed (− 10% [95% CI: − 20 -1%]). Secondary analysis showed children with HEPAs were less likely to have an ACT score meeting a clinically defined cutoff for poorly controlled asthma using repeated measures (IRR: 0.45 [95% CI: 0.21–0.97]). In Poisson models, intervention participants had reduced risk of ever meeting this cutoff (IRR: 0.43 [95% CI: 0.21–0.89]), ever having symptoms in the past 2 weeks (IRR: 0.71 [95% CI: 0.52–0.98]), and lower risk of any unplanned clinical utilization (IRR: 0.35 [95% CI: 0.13–0.94]) compared to control participants.DiscussionThe HAPI study showed generally improved outcomes among children in the HEPA air cleaner group. However, primary analyses did not meet statistical significance and many outcomes were subjective (self-report) in this unblinded study, so findings must be interpreted cautiously. HEPA air cleaners may provide additional benefit for child asthma health where traditional asthmagens (traffic, tobacco smoke) are not prominent factors, but larger studies with more statistical power and blinded designs are needed.Trial registrationClinicalTrials.gov Identifier: NCT04919915. Date of retrospective registration: May 19, 2021.

Social-ecological correlates of older adults’ outdoor activity patterns

IntroductionAn understanding of outdoor activity patterns of older adults may help in the development of more tailored physical activity programs for enhancing higher physical activity levels and more effective environmental interventions. This study aimed to identify patterns of outdoor activity of older adults, and to examine their relationships with physical activity levels and correlates of these patterns. MethodsBased on data collected among 363 respondents aged 60 or older in Dalian, China, a two-step cluster analysis approach was adopted to identify outdoor activity patterns; one-way analysis of variance and chi-square tests were performed to examine differences in physical activity levels across activity patterns; and a multinomial logistic regression model was estimated to examine the socio-ecological correlates of each activity pattern. ResultsThe study identified five distinct activity patterns, namely: 1) utilitarian activity pattern; 2) low frequency/short duration leisure-time physical activity pattern; 3) sedentary activity pattern; 4) long duration leisure-time physical activity pattern; and 5) high frequency leisure-time physical activity pattern. The type of activity pattern was associated with older adults' physical activity levels. Older adults’ patterns of outdoor activity participation were associated with their age, gender, education level, physical ability and household type. In addition, neighborhood characteristics such as accessibility to local shops, safety from crime, social capital and social cohesion were also significantly associated with outdoor activity patterns. ConclusionsThe findings can help health professionals to develop tailored physical activity programs for older adults with certain socio-demographic characteristics and urban planners to design suitable environmental interventions supporting the habitual activity pattern of specific subgroups of older adults.

Cooperative conservation: Seven ways to save the world

AbstractThe world faces serious environmental problems. To solve them we must work together. Fortunately, humans are a very cooperative species. We have faced a range of cooperative problems in the past, and have evolved and invented a range of cooperative solutions to them—kin altruism, mutualism, reciprocity, heroism, deference, fairness, and property rights. Here, we illustrate how each of these solutions can be pressed into the service of conservation goals. Unlocking this potential will require overcoming conservationists' current cycloptic focus on only one type of cooperative problem (the prisoner's dilemma) and one type of solution (reciprocity). Only then will policy makers be able draw on the full range of cooperative dispositions and design more systematic and effective environmental interventions.

Impact of Indoor Physical Environment on Learning Efficiency in Different Types of Tasks: A 3 × 4 × 3 Full Factorial Design Analysis.

Indoor physical environments appear to influence learning efficiency nowadays. For improvement in learning efficiency, environmental scenarios need to be designed when occupants engage in different learning tasks. However, how learning efficiency is affected by indoor physical environment based on task types are still not well understood. The present study aims to explore the impacts of three physical environmental factors (i.e., temperature, noise, and illuminance) on learning efficiency according to different types of tasks, including perception, memory, problem-solving, and attention-oriented tasks. A 3 × 4 × 3 full factorial design experiment was employed in a university classroom with 10 subjects recruited. Environmental scenarios were generated based on different levels of temperature (17 °C, 22 °C, and 27 °C), noise (40 dB(A), 50 dB(A), 60 dB(A), and 70 dB(A)) and illuminance (60 lx, 300 lx, and 2200 lx). Accuracy rate (AC), reaction time (RT), and the final performance indicator (PI) were used to quantify learning efficiency. The results showed ambient temperature, noise, and illuminance exerted significant main effect on learning efficiency based on four task types. Significant concurrent effects of the three factors on final learning efficiency was found in all tasks except problem-solving-oriented task. The optimal environmental scenarios for top learning efficiency were further identified under different environmental interactions. The highest learning efficiency came in thermoneutral, relatively quiet, and bright conditions in perception-oriented task. Subjects performed best under warm, relatively quiet, and moderately light exposure when recalling images in the memory-oriented task. Learning efficiency peaked to maxima in thermoneutral, fairly quiet, and moderately light environment in problem-solving process while in cool, fairly quiet and bright environment with regard to attention-oriented task. The study provides guidance for building users to conduct effective environmental intervention with simultaneous controls of ambient temperature, noise, and illuminance. It contributes to creating the most suitable indoor physical environment for improving occupants learning efficiency according to different task types. The findings could further supplement the present indoor environment-related standards or norms with providing empirical reference on environmental interactions.

Why local air pollution is more than daily peaks: modelling policies in a city in order to avoid premature deaths

We use a predator–prey representation of an urban system to analyse how policy interventions can prevent the adverse effects of air pollution on people’s health. The number of residents is treated as prey variable, and particulate matter that consists of particles with a diameter of up to 10 micrometres (PM10) as predator variable. This representation allows integration of population trends and the effects of environmental interventions on the average level of PM10 concentration (which establishes a baseline for the potential health burden for residents). For the case of Graz, Austria, we illustrate the insights generated regarding the interdependency of market-based and technological pollution controls, and propose an indicator that assesses the cost of delayed interventions by counting additional premature deaths caused by polluted environments.

Effect of Environmental Intervention on the Consumption of Rice without Toxic Metals Based on the Health Belief Model and Ecological-Social Model.

The effect of instructional models on the changing behaviour of consuming contaminated rice with toxic metals has not been investigated in Iran yet. To compare effect of Health Belief Model (HBM) and Ecological (ECO) social model on decreasing the consumption of rice contaminated with toxic metals. The study aimed at implementing a six-month interventionist program among three groups (HBM, ECO and Control). The study population comprised of 240 women, aged 18 to 50. Questionnaires were distributed which consisted of demographic information, knowledge, constructs of the models, performance of rice consumption, and the manner of rice cooking. In HBM group participants were individually provided with instructions based on HBM. However, in ECO group participants received the instruction through social networks consisted of mothers, sisters, family members, and colleagues. The results of Wilcoxon test indicated improvements in people's diet including a significant increase in the number of women consuming rice without toxic metals, a significant reduction in the number of women consuming rice contaminated with toxic metals in both intervention groups. On the other hand, such an improvement was not observed in the control group. The results of repeated measures' analysis of variance suggested further improvement in healthy diet in ECO group rather than HBM group after the completion of the environmental intervention. Both methods of instructional intervention caused changes in the diet of people regarding the consumption of rice free from toxic metals and changes in the manner of cooking from Kateh (steaming rice) to Pilaw (draining rice). Development of social support had probably a more effective role on the improvement of people's diet.

School Environmental Intervention to Reduce Particulate Pollutant Exposures for Children with Asthma

Home-based interventions to improve indoor air quality have demonstrated benefits for asthma morbidity, yet little is known about the effect of environmental interventions in the school setting. We piloted the feasibility and effectiveness of a classroom-based air cleaner intervention to reduce particulate pollutants in classrooms of children with asthma. In this pilot randomized controlled trial, we assessed the effect of air cleaners on indoor air particulate pollutant concentrations in 18 classrooms (9 control, 9 intervention) in 3 urban elementary schools. We enrolled 25 children with asthma (13 control, 12 intervention) aged 6 to 10 years. Classroom air pollutant measurements and spirometry were completed once before and twice after randomization. Asthma symptoms were surveyed every 3 months. Baseline classroom levels of fine particulate matter (particulate matter with diameter of <2.5 μm [PM2.5]) and black carbon (BC) were 6.3 and 0.41 μg/m3, respectively. When comparing the intervention to the control group, classroom PM2.5 levels were reduced by 49% and 42% and BC levels were reduced by 58% and 55% in the first and second follow-up periods, respectively (P < .05 for all comparisons). When comparing the children randomized to intervention and control classrooms, there was a modest improvement in peak flow, but no significant changes in forced expiratory volume in 1 second (FEV1) and asthma symptoms. In this pilot study, a classroom-based air cleaner intervention led to significant reductions in PM2.5 and BC. Future large-scale studies should comprehensively evaluate the effect of school-based environmental interventions on pediatric asthma morbidity.

A life cycle assessment (LCA)-based approach to guiding an industry sector towards sustainability: the case of the Swedish apparel sector

The environmental challenges associated with consumption of textiles have generally been investigated on product level in Life Cycle Assessment (LCA) studies. For social sustainability aspects, social hotspot analysis has instead been applied on the textile sector level. The aim with the industry sector approach developed by the authors was to enable assessment of different interventions in terms of how they contribute to reaching targets for environmental and social sustainability, on the sector level. The approach was tested in a case study on the Swedish apparel sector.The industry sector approach consists of three steps that address three different questions: 1) What is the current sustainability performance of the sector? 2) What is an acceptable sustainability performance for the sector? 3) Are proposed interventions enough to reach an acceptable sustainability performance?By answering these questions, it is possible to measure performance in relation to sector level targets and learn which types of interventions (technical improvements, behavioral changes, new business models, etc.), and which actors (manufacturers, retailers, consumers, authorities, etc.) that can potentially provide the greatest improvements. By applying the approach in the case study, conclusions could be drawn on whether specific interventions appear to be sufficient or not in relation to the set environmental targets. The influence of the interventions in relation to reaching targets for social sustainability was found to be the most difficult to measure due to lack of data. To spur the industry sector's stakeholders to actualize the full potential of the most effective environmental interventions, a scheme for structured evaluation of LCA results directed towards these prospective actors was developed. Based on the results from the study, actor-oriented advice could be provided.

Effects of environmental intervention on sedentary time, musculoskeletal comfort and work ability in office workers

Sit–stand workstations offer a potential strategy to reduce prolonged occupational sitting. This controlled intervention study examined the effects of an environmental intervention on occupational sedentary time, musculoskeletal comfort and work ability, and the usability of sit–stand workstations in office work via a self-reported questionnaire. The intervention group (n = 24) used sit–stand workstations during the 6-month intervention period, and the control group (n = 21) used traditional sitting workstations. The results showed that working at sit–stand workstations can reduce sitting time significantly compared to control workstations (−6.7% vs. 5.0%, p = .019), which is reallocated mostly to standing (r = −0.719, p < .001). Sit–stand workstations improved perceived musculoskeletal comfort in the neck and shoulders (p = .028), as well as work ability (p = .022). The majority of intervention subjects rated sit–stand workstation adjustability as good (83.3%), and 75.0% were satisfied with the workstation. About 41.7% of the intervention participants, who were exclusively female, used the sit–stand function on a daily basis. While the environmental change alone was effective, it is likely that promoting the daily use of sit–stand workstations with counselling would lead to even more substantial positive effects.

Estimating Natural Environmental Characteristics of Subsidized Households: A Case Study of Austin, Texas

Compared to the traditional public housing program, the Low-Income Housing Tax Credit (LIHTC) program has been regarded as a better tool to ensure the quality of housing structure for subsidized households and the mixing of incomes in neighborhoods. Previous studies related to LIHTC developments have solely focused on the relationships between subsidized households and socioeconomic environments, such as income, race, poverty, etc. Beyond the socioeconomic environments where subsidized households are located, there is a limited understanding about whether subsidized households experience healthier natural environments in their neighborhoods. This study aims to investigate whether LIHTC-subsidized housing neighborhoods provide adequate natural environments to the subsidized households in Austin, Texas, compared to the public housing households. We employ comparison t-tests and binomial logistic regression models. The results show that LIHTC households are significantly exposed to unhealthy natural environmental settings such as a lack of green vegetation and steep slopes while no statistical evidence is reported for public housing neighborhoods. Findings from this study may help policymakers and planners improve their understanding of whether subsidized housing developments offer better natural environments for disadvantaged populations and help them develop effective environmental intervention strategies to improve the quality of life of subsidized households.

Surface contamination in operating rooms: a risk for transmission of pathogens?

The role of surface contamination in the transmission of nosocomial pathogens is recognized increasingly. For more than 100 years, the inanimate environment in operating rooms (e.g., walls, tables, floors, and equipment surfaces) has been considered a potential source of pathogens that may cause surgical site infections (SSIs). However, the role of contaminated surfaces in pathogen acquisition in this setting generally is considered negligible, as most SSIs are believed to originate from patients' or healthcare workers' flora. A search of relevant medical literature was performed using PubMed to identify studies that investigated surface contamination of operating rooms and its possible role in infection transmission. Despite a limited number of studies evaluating the role of surface contamination in operating rooms, there is accumulating evidence that the inanimate environment of the operating room can become contaminated with pathogens despite standard environmental cleaning. These pathogens can then be transmitted to the hands of personnel and then to patients and may result in SSIs and infection outbreaks. Contaminated surfaces can be responsible for the transmission of pathogens in the operating room setting. Further studies are necessary to quantify the role of contaminated surfaces in the transmission of pathogens and to inform the most effective environmental interventions. Given the serious consequences of SSIs, special attention should be given to the proper cleaning and disinfection of the inanimate environment in operating rooms in addition to the other established infection control measures to reduce the burden of SSIs.

The association between objective walkability, neighborhood socio-economic status, and physical activity in Belgian children.

BackgroundObjective walkability is an important correlate of adults’ physical activity. Studies investigating the relation between walkability and children’s physical activity are scarce. However, in order to develop effective environmental interventions, a profound investigation of this relation is needed in all age groups. The aim of this study was to investigate the association between objective walkability and different domains of children’s physical activity, and to investigate the moderating effect of neighborhood socio-economic status in this relation.MethodsData were collected between December 2011 and May 2013 as part of the Belgian Environmental Physical Activity Study in children. Children (9–12 years old; n = 606) were recruited from 18 elementary schools in Ghent (Belgium). Children together with one of their parents completed the Flemish Physical Activity Questionnaire and wore an accelerometer for 7 consecutive days. Children’s neighborhood walkability was calculated using geographical information systems. Multilevel cross-classified modeling was used to determine the relationship between children’s PA and objectively measured walkability and the moderating effect of neighborhood SES in this relation.ResultsIn low SES neighborhoods walkability was positively related to walking for transportation during leisure time (β = 0.381 ± 0.124; 95% CI = 0.138, 0.624) and was negatively related to sports during leisure time (β = −0.245 ± 0.121; 95% CI = −0.482, −0.008). In high socio-economic status neighborhoods, walkability was unrelated to children’s physical activity. No relations of neighborhood walkability and neighborhood socio-economic status with cycling during leisure time, active commuting to school and objectively measured moderate- to vigorous-intensity physical activity were found.ConclusionsNo univocal relation between neighborhood walkability and physical activity was found in 9–12 year old children. Results from international adult studies cannot be generalized to children. There is a need in future research to determine the key environmental correlates of children’s physical activity.Electronic supplementary materialThe online version of this article (doi:10.1186/s12966-014-0104-1) contains supplementary material, which is available to authorized users.

An effective environmental intervention for management of the ‘mirror sign’ in a case of probable Lewy body dementia

The term ‘mirror sign’ refers to the inability to recognize the reflection of oneself in a mirror, while the ability to recognize others' faces often remains intact. In this article, we present a case of an 85-year-old woman, with probable Lewy body dementia, who stably exhibited a delusional ‘mirror sign’ for a period of 9 months. Following a straightforward, ecological, non-pharmacological intervention, her ‘mirror sign’ delusion was no longer present.

PL1.1 * EPIGENETICS IN ALCOHOL ADDICTION: NEW MECHANISMS FOR NEW TREATMENTS?

For several decades, enormous progress has been made in terms of understanding the neurobiological mechanisms underlying alcohol addiction. This psychiatric disease has a complex aetiology involving the interaction of inherited pre-dispositions and environmental factors. With the new field of epigenetics, there is now the opportunity to integrate the role of the epigenome not only in the short-term effects of alcohol but also in the enduring neuro-adaptations caused by chronic use of alcohol. Emerging evidence suggests that epigenetic alterations to the genome, including DNA methylation and histone modifications, are important mechanisms underlying addiction. The epigenetic modifications may be part of the neuro-adpatations occurring during the transition from the controlled intake to the loss of control and may explain how alcohol can have such a persistent effect on brain gene expression and functioning. Epigenetic alterations may also be important factors in modulating genetic predisposition, response to treatment and the potential effect of environmental intervention to cure or prevent alcohol addiction. These epigenetic modifications have been studied in animal models and also in alcohol-dependent patients. Interestingly, from clinical studies, some data suggest that epigenetic modifications, possibly due to alcohol consumption, may contribute to alcohol craving. There are now accumulating data showing that pharmacological tools targeting enzymes involved in epigenetic modifications may be useful in reducing or preventing some behavioural responses to alcohol. The advances in the field of epigenetics towards elucidation of the mechanisms underlying alcohol addiction and in terms of therapeutic perspectives will be discussed. # PL3.1 MEDICAL TREATMENT {#article-title-2} In the last decade, there has been an explosion of interest in finding efficacious medicines to treat alcoholism predicated on concomitant major advances in the neurosciences. Even though pharmacological targets that act at single neurotransmitters have been identified in several neuronal systems, the effect size of the active treatment compared with placebo is typically small. Hence, to increase the efficacy of medicines, attention has focused towards either administering medicines that act at multiple neuronal targets (i.e. a poly-system approach) or identifying agents that act at single neurotransmitters and produce medium-to-high effect sizes among individuals in genetic subgroups (i.e. personalized medicine). This plenary session will compare and contrast the merits and disadvantages of both approaches—using the results of studies that have tested medications that act at serotonergic, glutaminergic, GABAergic and opioid systems as examples—and propose a path towards future medications development for alcoholism. B.A. Johnson has served as a consultant to Johnson & Johnson (Ortho-McNeil Janssen Scientific Affairs, LLC), Transcept Pharmaceuticals, Inc., D&A Pharma, Organon, ADial Pharmaceuticals LLC, Psychological Education Publishing Company (PEPCo LLC), and Eli Lilly and Company. # PL4.1 DOES ADDICTION RESEARCH NEED A PARADIGM SHIFT? {#article-title-3} In the last century, a plenitude of addiction research data have been published. Nevertheless, the definition of the disease is still discussed, and new classifications will be presented soon (ICD 11, DSM V). Epidemiology and national care systems are generally reluctant to changes. They support a ‘substance causing dependence’ approach and focus on intake patterns. Basic research, long-term course investigations and treatment trials show the heterogeneity of these patients and also the heterogeneity of different cravings (craving caused by withdrawal syndromes, by anxiety states, by mood disorders, or by compulsion). Onset of addiction, family burden of addiction and different typologies influence the course and treatment results. In brain research, we learned many new interactions of different levels of brain functions. A four-level model will be presented and the results of epidemiological studies, basic research up to treatment will show different possibilities how to influence these four different levels. I believe that we need a change from the focus on substance, e.g. alcohol, related psychological and biological disturbances to an individual-orientated approach. We have to look much more to the heterogeneity of brain functions and especially if we like to translate the results of animal trials we need definitions of subgroups of addiction reflecting the animal model. I hope that the new classification systems give possibilities to define these subgroups. We use the LAT-system (www.LAT-online.at) defining the most important items of these heterogeneities and available in many languages. REFERENCE Lesch OM, Walter H, Wetschka CH, Hesselbrock M, Hesselbrock V (2011) Alcohol and Tobacco, Medical and Sociological Aspects of Use, Abuse and Addiction . Wien, New York: Springer.

P38 The impact of urban renewal on engagement in physical activity in a socio-economically disadvantaged population: a qualitative evaluation

BackgroundMost adults in Europe lead sedentary lives; their physical inactivity is associated with a rising prevalence of obesity and is considered to contribute significantly to health inequalities.A recent NICE (2006)...