This research focuses on the challenges and opportunities facing local governance agents in advancing an ecosystem approach to conceptualizing and governing community health in Norfolk County, Ontario. Norfolk County is a rural, agriculturally-based community dependent upon tobacco production. This industry has collapsed, triggering widespread socioeconomic impacts and community health pressures. The government is searching for alternative modes of economic development and tensions are high with respect to the direction and nature of these developments. Some citizens are concerned about the security of their rural livelihoods. Others are concerned about ecological integrity. Still others are convinced of the need for aggressive economic growth. Local decision-makers are struggling to meet all of these requirements. An ecosystem approach views health as part of the broader socio-ecological system, recognizing that health outcomes are by-products of complex biophysical, social, political and economic system interactions at nested spatial and temporal scales. The approach contrasts with conventional health models, which tend to be reactionary, narrowly focused, and short-sighted. Such models are typical of the hierarchical, technocratic nature of public administration which renders decision-making structures and processes ill equipped to deal with complex problems. More systemic, integrated, participatory and collaborative approaches to decision-making are needed in order to better address the complexities involved in facilitating healthy and sustainable community development. Additionally, governance agents must also be able to embrace and navigate these evolving approaches to health conceptualization and governance. An investigation into Norfolk County grounds this analysis by revealing the challenges and opportunities facing local governance agents in advancing an ecosystem approach. The case study research effectively tests the utility and feasibility of the ecosystem approach through a qualitative analysis. The research contributes criteria required for advancing an ecosystem approach to community health governance and practice and empirically tests them within the context of Norfolk County.

Human ageing is accompanied by characteristic metabolic and endocrine changes, including altered hormone profiles, insulin resistance and deterioration of skeletal muscle. Obesity and diabetes may themselves drive an accelerated ageing phenotype. Untangling the causal web between ageing, obesity and diabetes is a priority in order to understand their aetiology and improve prevention and management. The role of biological ageing in determining the risk of obesity and associated conditions has often been examined using mean leukocyte telomere length (LTL), a marker of replicative fatigue and senescence. However, considering phenotypes which represent different domains of biological and functional ageing as exposures for obesity and related traits could allow the elucidation of new understudied phenotypes relevant to cardio-metabolic risk in the wider population. This PhD considers the causal role of (1) hand grip strength (HGS), a marker of overall strength and physical functioning, and (2) resting energy expenditure, an indicator of overall energy metabolism and the major component of daily energy expenditure, in cardio-metabolic risk. I also characterise a new and readily-quantifiable marker of age-related genomic instability, mosaic loss of the Y chromosome (mLOY). Observational evidence implicates each of these phenotypes in cardio-metabolic conditions and intermediate phenotypes. However, it is not possible to infer causality from these observational associations due to confounding and reverse-causality. Mendelian randomisation offers a solution to these limitations and can allow the causal nature of these relationships to be investigated. Using population-based data including UK Biobank, this thesis presents the first large-scale genetic discovery effort for each trait and provides new biological insight into their shared and separate aetiology. I used identified variants to investigate the bidirectional causal associations of each trait with cardio-metabolic outcomes, intermediate phenotypes and other related traits such as frailty and mortality. In total I identified 16 loci for hand grip strength, 19 for mLOY, and one signal for REE. I have shown that HGS is likely to be causally linked to fracture risk, and I have identified the important shared genetic architecture between mLOY, glycaemic traits and cancer. I have also demonstrated that at least one known genetic variant contributing to obesity risk acts partially via reduced REE. Overall the findings of my PhD contribute to our wider understanding of the aetiological role of ageing processes in metabolic dysfunction, and have implications for both basic science and translational applications.

No Abstract Provided / Thesis / Bachelor of Arts (BA)

The central aim of this thesis is to provide a detailed ethnographic account of the human ecology of the Broads - a protected wetland region in the East of England - focussing upon how working lives shape and are shaped by this reedy landscape. In conversations about the management of the Broads, the concept of "common sense" is a frequent trope; encompassing a wide range of associated meanings. But what are these meanings of "common sense" in English culture, and how do they influence the peoples of England, and landscapes in which they work? This thesis addresses these questions ethnographically; using academic and lay deployments of common sense as a route into the political economy of rural Norfolk. Based on 12 months of fieldwork in the Broads National Park, this thesis draws together interviews and participant observation with land managers of various kinds - including conservationists, farmers, gamekeepers, volunteers, gardeners, and administrators. Chapter 1 dissects the differences between academic and popular understandings of "common sense" as a phrase, and produces an ethnographically-derived, working definition. Chapter 2 examines the attitudes of farmers, establishing "the common" as a root metaphor for social and practical rectitude, actualised through labouring in a shared landscape. Chapter 3 explores how the common is sensed, reflecting upon the diverse sensoria afforded by different degrees of enclosure on a single nature reserve. Chapter 4 explores how the concept of common sense intersects with a prevailing culture of possessive individualism, creating a fragmented society in the Park, wracked by controversies over management. Chapter 5 examines bureaucracy in Broadland - frequently cast as the very antithesis of common sense. In the conclusion, we return to the title, and ask - what do the reeds have to say about land, labour, and human nature?