“Title:- Starry Night- Incidence of Delight. A Policy Innovation? A gateway[1] to a planetary-sense-of-coherence [2]. “

Problem i] – urban light pollution – didn’t change despite great opportunity.
Problem ii] traffic noise + air pollution, it’s resumption following lockdown plus emissions of particulate matter, NOx, etc.
Problem iii] -lack of public trust -in those with ability to address this. In other words, in 2021, it’d be fair to say, globally, public trust in policy maker’s and public health practioner’s …hings by a shoogly peg. To governing/medical communities COVID’s a pandemic:_ an opportunity to unite us all! For the remainder, it’s a job-costing, isolating, syndemic. Listen, carefully, you’ll hear: IT JUST ALL TOO MUCH!!
The solution = creating a Planetary Sense of Coherence.
A sense of i] comprehensibility* ii] meaningfulness*, and iii] manageability* over people’s own planetary-health[*Antovskys’s salutogenic traits [2]. Planet Earth: N =1, needs precision medicine [3].
Achieved by capitalizing on COVID’s gift of engrained rapid-co-ordination of nation’s behaviour. And brave, blue-ocean strategies, that British public health was once renowned for.

Starry Night mechanism to achieve Planetary Sense of Coherence
• The first step is achieved by adapting current COVID social milieu and yearly #lockdown-light-pollution.
• A #planetary-health-prescription of UNSDG’s.
• A deep blue-ocean[4] proposal for Xmas or thereabouts.
• Whereby, planetary health [urban]hotspots, for example, Central Belt of Scotland create a #Deep-Dark-Sky , for a few hours. From East-West Coast.

• Interim result. Stars on clear winter night [aka Starry Night Over the Rhone- Wikipedia[5].

• Letting folks understand effect light pollution has had on their towns[clouds/weather permitting of course, it is Scotland!].
• People journey toward >comprehensibility< and >meaningfulness< QED planetary coherence by reconnection to a near hidden wonder of the world. • As per planetary health criteria, it requires great interdisciplinary co-ordination. • Which is exactly what COVID lockdown has brought about. • Also stimulates economic opportunity via disaster-resilience practice for all organizations involved. • And as per E4A system [WHO Europe] is in line with UNSDG 9, 11, 12 and 13. • A win-win-win. • A UK 1st. Sounds tricky, is it practical? Build Up to Lights Down. Example:- • Week 1] Announcement of movement restrictions • Week 2] Automobile–Furlough = Try B4 U Don’t Buy. A gentler segue to car-free families, renting cars, proving folk’s >manageability< of circular economies. Use Galileo [6] tracking. • Week 3] Full winter-furlough [helping save lives on miserable winter roads!!] • Week 4.1] Launch of Starry Nights @ The Célébration De L'impossible • Whereby extra planetary-coherence incentives are promoted:- o Free diesel-car recycling o Temporary Dedicated ‘’Fiet-Straats’’ o National Sleep Week o Battery Tech for discreet lighting. o QR-Vouchers for genuinely free 3d-printed food [start-up competitions?] • Week 4.2] Lights Off • Week 4.3] Dark Sky • Week 4.4] Starry Night from one side of the sky to the other…. • Week 4.5] Capturing Delight ** **How to ‘’capture delight’’? • How to measure STARRY NIGHT population-impact? • Screening for epidemiological impact may be inexpensively done by having, for example, folks simply text starry night + smiley faces on exposure to ‘’1234-lights out’’ • And/or texting which may help mitigate digital stigma [an issue raised at Citizens Advice social policy AGM, 2021] • STARRY NIGHT INDEX may be created and based on simple counting of number + location of replies. • Though simplistic, the use of both a] smiley faces and/or b] texting is used in state-of-the-art peer reviewed clinical trial work refs: LSHTM Thesis [7] and NEJM Catalyst [8]. • In epidemiology to assess burden of disease one usually refers to exposure and outcomes [9] e.g. diet and diseases-CVD/asthma.. A focus on pathogenesis. • With Starry Night, we, swap , outcome/disease for ‘’delight’’ • A focus on salutogenisis. • We collect real-time data • On exposures of:- ‘’lights on’’ versus ‘’lights-out’’ • So may calculate:- • QED 1] : Incidence of Delight • QED 2] :- Etiology of planetary-coherence. From this is calculated Attributable Fraction and Population Attributable Fraction. Or if using PAR% the population risk of delight from starlight. But what exactly will be indicators of delight? We must reject imposition of selection from proliferation of current lifestyle indicators. Conveying one’s delight is deeply personal, arguably it’s precision social medicine requiring self-titration of expression. • Now with numeric exposures/outcomes we use correlation and regression for de-novo forecast of… • … Burden of Delight… • A database of global efforts required to maintain planetary sense of coherence • UK-based • A salutogenic twin to the IHME - Global Burden of Disease database [10] • Helpfully salutogenic scores have been suggested for atypical subjects e.g. intrapartum care [11]. • The Global Burden of Delight introduces the World 1st SALY’s. • Salutogenic Adjusted Life Years • Possible life-years gained by working towards salutogenic goals and planetary sense of coherence. • …So …SALY can’t wait … she knows it’s too late…as we’re walking on by.. Discussion Is Starry-Night impactful? • Brief outline of ‘’STARRY NIGHT’’ was 1st disclosed at CFPHS [Committee of Faculty Public Health Scotland] AGM November 2020, garnered arguably best discussion for COP26. • Just the attempt, might Spark public imagination • It may recover public trust in policy makers’. • It may reduce light pollution in urban areas. • But still appears a wooly proposal? • Think longer term. • Attributable Risk, Population Attributable Risk are global, concrete epidemiological standards • So recorded in database. • Then, consider the blue flag initiative [HQ = Denmark] which revolutionized perspective on beaches. Probably first true global environmental yardstick. • Similarly we might construct STARRY NIGHT AWARD [on urban improvement]. • To compare yearly regional attempts. In relation to a gold standard e.g. Gambia night-sky. • Beyond this impact, possible talking points:-  Lowering harmful impact on nocturnal animals [improving One Health [12].  A vaccination by starlight for circadian rhythm disruption.  Stimulating + re-invigorating British hospitality, staycations, businesses, competing to take bookings for best Starry-Night viewings.  Creating BEST PRACTICE guidelines  Creating markets for innovations that decrease green premiums [13].  An antidote to a crashing consumer confidence. The salutogenic GLOBAL BURDEN OF DELIGHT DATABASE, might be based between London’s financial centre + Hague’s human’s rights centre. Forming yardstick for global climate finance and initiatives. To stimulate, quantify, evaluate and fund green tech.. QED we have economic impact from 2021 to 2100 to… References 1] https://www.nasa.gov/in-lunar-orbit 2] https://www.angelfire.com/ok/soc/aberlim.html 3] https://gupta-strategists.nl/en/research/n-1-a-new-paradigm 4] https://www.blueoceanstrategy.com/what-is-blue-ocean-strategy/ 5] Starry Night Over the Rhone - Starry Night Over the Rhône - Wikipedia 6] https://www.esa.int/Applications/Navigation/Galileo/What_is_Galileo 7] Amon-Tanoh, MA; (2020) Design and evaluation of an intervention to increase handwashing with soap after toilet use in Koumassi, Abidjan, Côte d’Ivoire: A cluster randomised trial. PhD thesis, LSHTM. 8] https://catalyst.nejm.org/doi/abs/10.1056/CAT.20.0440 9] Assessing the burden of disease and risk assessment (europa.eu) 10] Global Burden of Disease (GBD 2019)| Institute for Health Metrics and Evaluation (healthdata.org) 11] Protocol for the development of a salutogenic intrapartum core outcome set(SIPCOS)Smith et al. BMC Medical Research Methodology (2017) 17:61 12] https://www.rivm.nl/en/one-health-basics 13] https://www.gatesnotes.com/Energy/Introducing-the-Green-Premiums     3058-11

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