Looking Over the Horizon: Transport and Global Warming

A 60 per cent reduction in carbon emissions from UK transport by 2030 is possible, argue Robin Hickman and David Banister, but only if we can we move beyond our complacent car addiction and take radical and concerted action to bring about behavioural, cultural and consumer change

Assessing the energy implications of replacing car trips with bicycle trips in Sheffield, UK

A wide range of evidence supports policies which encourage people to cycle more and drive less, for health and environmental reasons. However, the likely energy implications of such a modal shift have remained relatively unexplored. In this paper we generate scenarios for increasing the cycling rate in Sheffield between 2010 and 2020. This is done through the novel application of a simple model, borrowed from population ecology. The analysis suggests that pro-cycling interventions result in energy savings through reduced consumption of fuel and cars, and energy costs through increased demand for food. The cumulative impact is a net reduction in primary energy consumption, the magnitude of which depends on a number of variables which are subject to uncertainty. Based on the evidence presented and analysed in this paper, we conclude that transport policy has a number of important energy implications, some of which remain unexplored. We therefore advocate the formation of closer links between energy policy and transport policy in academia and in practice; our approach provides a simple yet flexible framework for pursuing this aim in the context of modal shift

Backcasting for Lower Transport Carbon Emissions

Robin Hickman, Olu Ashiru and David Banister examine the technological and social changes ahead if we are to meet targets for carbon dioxide emissions in the transport secto

Diagnostic accuracy of optical coherence tomography for diagnosing glaucoma: secondary analyses of the GATE study

Background/Aims: To assess the diagnostic performance of retinal nerve fibre layer (RNFL) data of optical coherence tomography (OCT) for detecting glaucoma. Methods: Secondary analyses of a prospective, multicentre diagnostic study (Glaucoma Automated Tests Evaluation (GATE)) referred to hospital eye services in the UK were conducted. We included data from 899 of 966 participants referred to hospital eye services with suspected glaucoma or ocular hypertension. We used both eyes’ data and logistic regression-based receiver operator characteristics analysis to build a set of models to measure the sensitivity and specificity of the average and inferior quadrant RNFL thickness data of OCT. The reference standard was expert clinician examination including automated perimetry. The main outcome measures were sensitivity at 0.95 specificity and specificity at 0.95 sensitivity and the corresponding RNFL thickness thresholds. We explored the possibility of accuracy improvement by adding measures of within-eye and between-eye variation, scan quality, intraocular pressure (IOP) and age. Results: Glaucoma was diagnosed in at least one eye in 17% of participants. Areas under the curve were between 0.83 and 0.88. When specificity was fixed at 0.95, the sensitivity was between 0.38 and 0.55, and the highest values were reached with models including the inferior quadrant rather than the average RNFL thickness. Fixing specificity at 0.95, the sensitivity was between 0.36 and 0.58. The addition of age, refractive error, IOP or within-subject variation did not improve the accuracy. Conclusion: RNFL thickness data of OCT can be used as a diagnostic test, but accuracy estimates remain moderate even in exploratory multivariable modelling of aiming to improve accuracy

Amplified ambivalence: having a sibling with juvenile idiopathic arthritis

Despite increased awareness of family responses to chronic illness and disability, there is still a need to understand experiences of well siblings. We begin to address this by asking “What is it like to have a sibling with juvenile idiopathic arthritis?” (JIA).Eight families with an adolescent diagnosed with JIA participated. Four members of each family, including one healthy sibling, were interviewed and transcripts analyzed using grounded theory. Analysis suggests healthy siblings see their family as different to ‘normal’ families, forfeit time with peers, share vicariously adverse experiences of their ill sibling, and feel inadequately informed. Such experiences amplify the ambivalent nature of sibling relationships and are possibly felt most strongly during late childhood and early adolescence. Support from extended family can reduce these negative experiences and facilitate social and emotional adjustment which also occurs over time as the children mature. These findings have implications for healthcare professionals and voluntary organizations