BACKGROUND: Active commuting to school can be a meaningful contributor to overall physical activity in children. To inform better micro-level urban design near schools that can support active commuting to school, there is a need for measures that capture these elements. This paper describes the adaptation of an observational instrument for use in assessing micro-scale environments around urban elementary schools in the United States.
METHODS: The Micro-scale Audit of Pedestrian Streetscapes for Safe Routes to School (MAPS-SRTS) was developed from existing audit instruments not designed for school travel environments and modifications for the MAPS-SRTS instrument include the structure of the audit tool sections, the content, the observation route, and addition of new subscales. Subscales were analyzed for inter-rater reliability in a sample of 36 schools in Austin, TX. To assess reliability for each subscale, one-way random effects single-measure intraclass correlation coefficients (ICC) were used.
RESULTS: Compared to the 30 original subscales, the adapted MAPS-SRTS included 26 (86.6%) subscales with revised scoring algorithms. Most MAPS-SRTS subscales had acceptable inter-rater reliability, with an ICC of 0.97 for the revised audit tool.
CONCLUSIONS: The MAPS-SRTS audit tool is a reliable instrument for measuring the school travel environment for research and evaluation purposes, such as assessing human-scale determinants of active commuting to school behavior and documenting built environment changes from infrastructure interventions.

Low-income communities often have fewer quality community-level physical activity places (PAPs) or resources (e.g., parks, playgrounds). When present, barriers like traffic, distance, and crime often prevent access. Creative solutions and better understanding of current and potential realistic PAPs are necessary for children and families to be active. Streets are rarely considered potential PAPs despite their ubiquity and accessibility. This article describes street segments as potential PAPs in two low-income Mexican-heritage colonias communities along the Texas-Mexico border. Promotora-researchers conducted PAP assessments of all street segments (n=867) in the two communities to describe the availability and quality of their physical activity features (e.g., basketball hoops, bicycles), amenities (e.g., paved driveways, yard space), and incivilities (e.g., vandalism, loose dogs). Streets in these communities did contain features and amenities associated with physical activity promotion. On average, street segments had 6.10 (SD=7.20) physical activity-promoting features, 27.65 (SD=27.30) physical activity-promoting amenities, and both were assessed as good-to-fair quality. Future physical activity programming should consider incorporating streets as potential PAPs to enhance physical activity and active play. Further, evaluating streets as PAPs in this way may provide insight into locations for temporary place-based programs such as Play Streets. Future research should also examine residents\' perceptions of their streets as PAPs for safe physical activity and active play, not just as places to walk, and which PAP characteristics matter for safe physical activity and active play to occur on streets.

Crime prevention through environmental design (CPTED) suggests an association between micro-scale environmental conditions and crime, but little empirical research exists on the detailed street-level environmental features associated with crime near low-income and minority schools. This study focuses on the neighborhoods around 14 elementary schools serving lower income populations in Seattle, WA to assess if the distribution of crime incidences (2013-2017) is linked with the street-level environmental features that reflect CPTED principles. We used a total of 40 audit variables that were included in the four domains derived from the broken windows theory and CPTED principles: natural surveillance (e.g., number of windows, balconies, and a sense of surveillance), territoriality (e.g., crime watch signs, trees), image/maintenance (e.g., graffiti and a sense of maintenance/cleanness), and geographical juxtaposition (e.g., bus stops, presence of arterial). We found that multiple crime types had significant associations with CPTED components at the street level. Among the CPTED domains, two image/maintenance features (i.e., maintenance of streets and visual quality of buildings) and two geographical juxtaposition features (i.e., being adjacent to multi-family housing and bus stops) were consistently associated with both violent and property crime. The findings suggest that local efforts to improve maintenance of streets and visual quality of buildings and broader planning efforts to control specific land uses near schools are important to improve safety in marginalized neighborhoods near schools that tend to be more vulnerable to crime. Our research on micro-scale environmental determinants of crime can also serve as promising targets for CPTED research and initiatives.

UNASSIGNED: Active school travel is an important way to promote children\'s physical activity, but it requires supportive environments that can safely and comfortably accommodate children\'s walking and biking. Few existing indices explicitly consider school neighborhood environmental factors related to children\'s walking to school. In this study, we used a street audit tool and Geographic Information System (GIS) to evaluate walkability near low-income elementary schools in Seattle, WA.
UNASSIGNED: The audit-based school walkability index was developed based on all street segments (n=841) within a 0.4km network buffer from each study school (n=18). The GIS-based school walkability, a combination of road connectivity, vehicular traffic exposure, and residential density, was also measured in a 2km network buffer around each school. The participants were individuals aged 8-11 years (n=315) who participated in the Walking School Bus randomized controlled trial project. Mixed-effects logistic and linear models were used to examine the association of the index\'s representations of the built environment with children\'s school travel mode (walking or biking to school 1+ times per week) and with objectively measured moderate-to-vigorous physical activity (MVPA, average weekday minutes during the 90-min before-school period). These associations were tested with the total sample as well as the subsample of children living within 1.5km from their schools.
UNASSIGNED: The audit-based school walkability index (WI) was positively associated with both active commuting to school among the subsample living within 1.5km from their schools and with children\'s before-school MVPA among the subsample and the total sample. The GIS-based school WI showed significant associations with children\'s before-school MVPA but no relationships with active school travel among the subsample and the total sample.
UNASSIGNED: The audit-based school walkability index can be used as a complementary tool for measuring walkability near low-income elementary schools along with existing GIS-based school walkability index.

UNASSIGNED: Health professionals promote transport-related physical activity because travelers oftentimes walk or bike to and from transit stops or stations. Although previous studies have examined the associations between macro-scale built environment features surrounding light rail transit (LRT) stations (e.g., density) and LRT ridership, this study examined the associations between numerous micro-scale features (e.g., street-level noise pollution) and ridership.
UNASSIGNED: This analysis originated from the Houston Travel-Related Activity in Neighborhoods (TRAIN) Study, a project evaluating how an LRT extension impacted adult physical activity in Houston, Texas. In 2014, researchers used the Analytic Audit Tool to quantify 58 micro-scale built environment features within six categories: Land Use Environment, Transportation Environment, Facilities, Aesthetics, Signage, and Social Environment. Feature data were obtained from 590 street segments within 0.25 miles of 22 LRT stations. For each station, separate composite indices were created per category by averaging the computed feature scores (1-7) within each category, with higher scores signifying more physical activity-promoting features. Station-level LRT ridership data were obtained from monthly ridership reports for the 12 months following station opening. Linear mixed models were constructed to examine the associations of the six built environment categories with ridership, adjusting for season, weekday vs. weekend day, and station as a random intercept.
UNASSIGNED: Holding all other variables constant, every one-unit increase in composite index scores for Transportation Environment and Social Environment was associated with an increase in daily ridership by 425 and 488 riders, respectively (p < 0.05). Every one-unit increase in composite index score for Signage was associated with a decrease of 722 riders daily (p < 0.05). The relations of Land Use Environment, Facilities, and Aesthetics with ridership were statistically null (p > 0.05).
UNASSIGNED: Enhancements to the Transportation Environment and Social Environment may slightly increase overall LRT ridership, and consequently, utilitarian physical activity.

UNASSIGNED: Acute widespread lead poisoning took place in Zamfara State, Nigeria in 2010. Over 735 children were reported dead and thousands sickened by the neurotoxin. The source was traced to artisanal gold mining and processing in the villages. An immediate medical response protocol was developed to provide oral chelation therapy to the vulnerable population. In order not to compromise the efficacy of the chelation therapy, immediate remediation of the affected villages was carried out. An over 95% reduction in soil lead levels was reported immediately after the remediation exercise.
UNASSIGNED: The aim of the present study was to perform a general audit of soil lead concentrations, conducted between June and July 2013 in Dareta village (one of the most affected villages), to evaluate the soil pollution status of the village three years after the remediation exercise.
UNASSIGNED: Soil samples were collected from residential compounds, cultivated farmlands and other common areas. Lead contents of the samples were determined using atomic absorption spectrophotometer (Shimadzu, model AA-6800, Japan) after wet digestion. Speciation of lead in soil was done following standard analytical methods.
UNASSIGNED: Mean soil lead concentrations for residential areas were 1029.42±98.50 mg/kg, 1523.99±201.00 mg/kg, 1404.57±141.00 mg/kg and 6724.68±84.00 mg/kg for residential compounds, market square, old grinding mills and new grinding mills, respectively. The concentrations exceeded both the Dutch target and intervention values and US Environmental Protection Agency limit for soil lead levels in residential areas. Based on the index of geo-accumulation, the ranking of intensity of lead (Pb) pollution of Dareta soils ranged from strongly polluted to extremely polluted, indicating they pose a range of moderate to very high potential ecological risk to the other components of the environment. At the current rate of accumulation, by the year 2025, soil Pb levels of Dareta common areas are expected to exceed the pre-remediation levels associated with several deaths.
UNASSIGNED: Findings of this study indicate that the problem of lead poisoning is ongoing in Dareta village. Zamfara State authorities should address the challenge through sustained periodic assessment and cleanup of affected areas. Implementation of safer mining practices should be enforced immediately.
UNASSIGNED: The authors declare no competing financial interests.

Background: Workplace or campus wellness/obesity-prevention policies and initiatives can improve health. Research tools to assess worksite or campus policies/initiatives are scarce. Thus, the aim of this research is to develop and validate the policies, opportunities, initiatives, and notable topics (POINTS) audit. Methods: POINTS was developed and refined via expert review, pilot-testing, and field testing. Trained researchers completed a web-based review from a student-focus or employee-focus regarding 34 health-promoting topics for colleges. Each topic was evaluated on a 0⁻2 scale: 0 = no policy/initiative, 1 = initiatives, 2 = written policy. When a written policy was detected, additional policy support questions (administered, monitored, reviewed) were completed. Results: Cronbach\'s Alpha for the student-focused POINTS audit was α = 0.787 (34 items, possible points = 65), and for the employee-focused POINTS audit was α = 0.807 (26 items, possible points = 50). A total of 115 student-focused and 33 employee-focused audits were completed. Although there was little evidence of policy presence beyond stimulant standards (smoking and alcohol), there were extensive examples of health initiatives. The student-focused POINTS audit was validated using the Healthier Campus Initiative\'s survey. Conclusions: POINTS is a web-based audit tool that is valid and useful for pre-assessment, advocacy, benchmarking, and tracking policies for health and well-being for students (campus) and employees (worksite).

BACKGROUND: Active travel to and from a transit station may provide significant amounts of physical activity and improve health. The ease with which people can traverse the distance to the transit station may impede or support active travel. Therefore, transit stations that have features that are supportive of utilitarian physical activity would be desirable. This study aimed to characterize the built environment surrounding new light rail transit (LRT) stations in the City of Houston, Texas.
METHODS: In 2014, we used a series of systematic protocols and a standardized environmental audit instrument, the Analytic Audit Tool, to collect data on segments (streets) that surround 22 LRT stations that were being newly built. Using Geographic Information System (GIS), we assembled all the segments that intersect a 0.25-mile circular buffer around each station for the audit exercise. Several 3- to 4-member teams of trained auditors completed the audit exercise on a subset of these identified segments. Our analysis were descriptive in nature. We provided the frequency distributions of audited features across the study area. We also followed an original algorithm to produce several composite index scores for our study area. The composite index score is indicative of the prevalence of physical activity friendly/unfriendly features in the study area.
RESULTS: In all, we audited a total of 590 segments covering a total of 218 US Census blocks, and eight City of Houston super neighborhoods. Findings suggest the environment around the new LRT stations may not be supportive of physical activity. In general, the audited segments lacked land use integration; had abandoned buildings, had uneven sidewalks; were not bike-friendly, had minimal presence of public-recreational facilities that would support physical activity; and had significant physical disorder. Notably, certain attractive and comfort features were frequently to usually available.
CONCLUSIONS: Current findings, which will be compared to follow-up audit data, can be useful for future researchers and practitioners interested in the built environment around LRT stations.

Park quality and features can contribute to more engaging places for play and recreation. However, assessing park characteristics remains a challenge. This study measured the reliability of GigaPan® as a method for assessing park characteristics as well as the validity of GigaPan® compared to Google Street View (GSV) and direct observation (DO). A total of 65 target areas (16 parks total) in Pittsburgh, PA were assessed using GigaPan®, GSV, and DO from July 2015-January 2016. For reliability and validity, 14 and 28 variables were examined, respectively. Cohen\'s kappa was used to assess inter-rater reliability. Sensitivity and specificity were used to measure validity. Of the 14 variables included in the inter-rater reliability analysis, five variables had almost perfect reliability (kappa > 0.80) and three variables had substantial reliability (kappa > 0.60). Of the 28 variables included in the validity analysis, GigaPan® was able to correctly classify 17 of the 28 variables and GSV was able to correctly classify 15 of the 28 variables with a sensitivity >80%. There were no significant differences between sensitivity and specificity between GSV and GigaPan®. GigaPan® performed similarly to GSV with DO being used as the gold standard. Further, GigaPan overall had high reliability among the features measured. A strength of GigaPan® is the ability to be implemented quickly in the field, making it a viable alternative to GSV particularly when temporality is an important factor.

BACKGROUND: As Nigeria strives to improve health services nationwide, there is a corresponding increase in laboratory testing, care and treatment activities, producing more healthcare waste that must be safely managed. In the past, Nigeria lacked an enabling environment for healthcare waste management, as it did not have a national health care waste management policy. However, in 2013 a policy and strategic plan for healthcare waste management was developed to address this problem.
OBJECTIVE: The present study performed an environmental safeguard audit to determine the level of implementation of the 2013 national policy in the 36 states and Federal Capital Territory in Nigeria. We also sought to determine whether the 2013 national policy has had an impact on healthcare waste management.
METHODS: The present study was conducted in 1921 health facilities, selected using the probability proportional to size sampling method.
RESULTS: The present study found that 44.8% of health facilities surveyed had healthcare waste management work plans adapted from the 2013 national policy. In addition, 89.2% of health facilities segregated waste. This is an important improvement, as previous studies reported that there was little to no waste segregation at health facilities. Furthermore, 41.4% of health facilities had designated persons or units handling healthcare waste, in contrast to previous studies which found no designated person or unit responsible for healthcare waste. However, the quality of healthcare waste management varied across states and health facilities.
CONCLUSIONS: Following the introduction of healthcare waste management policy, health facilities in Nigeria have improved waste management practices. However, training, availability of required tools and functional governance structures are essential to the implementation of an effective healthcare waste management policy.
CONCLUSIONS: The study findings show that safe healthcare waste management can be implemented if the government leads by providing policy and required resources, while health facilities put standard operating procedures in place to guide day to day healthcare waste management operations.
UNASSIGNED: Obtained.
UNASSIGNED: The protocol was approved by the National Health Research Ethics Committee of Nigeria.
UNASSIGNED: The authors declare no competing financial interests.