Electronic swallowing intervention package to support swallowing function in patients with head and neck cancer: development and feasibility study

Background: Many patients undergoing treatment for head and neck cancer (HNC) experience significant swallowing difficulties, and there is some evidence that swallowing exercises may improve outcomes, including quality of life. This feasibility study developed an evidence-based, practical Swallowing Intervention Package (SiP) for patients undergoing chemo-radiotherapy (CRT) for HNC. As part of the study, an electronic version of SiP (e-SiP) was concurrently developed to support patients to self-manage during treatment. This paper reports on the e-SiP component of this work. Objective: To develop and conduct preliminary evaluation of an electronic support system (e-SiP) for patients undergoing CRT for head and neck cancer. Methods: The study involved health professionals and patients who were undergoing CRT for head and neck cancer. The scoping stage of e-SiP development involved investigated the potential usefulness of e-SiP, exploring how e-SiP would look and feel and what content would be appropriate to provide. Patient and carer focus groups and a health professionals’ consensus day were used as a means of data gathering around potential e-SiP content. A repeat focus group looked at an outline version of e-SIP and informed the next stage of its development around requirements for tool. This was followed by further development and a testing stage of e-SiP involved the coding of a prototype which was then evaluated using a series of steering group meetings, semi-structured interviews with both patients and health care professionals, and analysis of e-SiP log data. Results: Feedback from focus groups and health professional interviews was very positive and it was felt e-SiP use would support and encourage patients in conducting their swallowing exercises. However, of the ten patients offered e-SIP, only two opted to use it. For these patients, aspects of the e-SIP application were considered useful, in particular the ease of keeping a diary of exercises performed. Interviews with users and non-users suggested significant barriers to its use. Most significantly the lack of flexibility of platform on which e-SiP could be accessed appeared a dominant factor in deterring e-SiP use. Conclusions: Results suggest a need for further research to be conducted around the implementation of e-SiP. This involves evaluating how e-SiP can be better integrated into usual care, and through patient training and staff engagement, can be seen as a beneficial tool to help support patients in conducting swallowing exercises

A24 Electrically-assisted bikes: understanding the health potential

Electrically­-assisted bikes (shortened here to ‘e-­bikes’), which require the user to pedal but have a motor that the user can choose to use to reduce the effort required, are becoming increasingly popular. There are estimated to be over a million such bikes in use across Europe. Various studies suggest the effort required to use them constitutes at least ‘moderate’ physical activity, with potential health benefits for those who increase their physical activity by using them. Method This research included survey work with two major employers in Brighton, and two years of monitored trials, where 80 employees were loaned an e-­bike (with an associated support package). Trial participants were advised to use the bikes as much, or as little, as they wished. Results Initial workplace surveys revealed high levels of interest, with about 40% of those replying being keen to participate in the trials. This included interest from groups which are traditionally less likely to cycle, as assessed using Chi­square tests of independence on both our evidence and National Travel Survey data. Nearly half the respondents who classified themselves as doing less than 30 min of physical activity (moderate or vigorous) per week asked to be part of the trial. Of all respondents who asked to be part of the trial, 42% had a BMI indicating that they were overweight or obese. For the 80 participants who borrowed bikes, three ­quarters chose to use them at least once a week during their 6­8 week trial period. Across all participants, the average mileage cycled was 15­20 miles per week; car mileage was reduced by 20%; and 59% reported that their overall physical activity increased (including 29 of the 43 participants who reported doing less than 2.5 h weekly physical activity before the trial). At the end of the trial, 73% said they would cycle to work at least one day a week ‘if they had an e­-bike available to use’. Conclusions The study indicated that e­-bikes can stimulate interest in cycling amongst people who are typically less likely to do so. Furthermore, when an e-­bike is made available, many people choose to use it, and it has substantial effects on their travel behaviour. As such, these bikes could help to encourage active travel amongst groups who traditionally undertake less exercise, or who feel unable to use a conventional bike, either due to personal physical limitations, or because of the geography of where they live

MOToring along: The lives of cars seen through licensing and test data

For the past few years, the authors of this report have applied their expertise in transport studies, mathematical modelling, emissions analytics, statistics and geography to undertake innovative analysis of a dataset consisting of all registered light-duty vehicles in Great Britain and their annual mileages.Box 1 explains how this dataset has been created from two different sources to provide a unique information resource. It comprises a database of over 30 million vehicles in any given year. Statistical analysis of this database at the vehicle level allows for exploration of relationships between a large number of vehicle characteristics such as age, body type, changes in keepership, registered location and levels of vehicle usage – all of which was previously impossible. The dynamics of the car fleet can also be examined longitudinally,and monitored on an ongoing basis as the data comes on stream each year.In this report, we focus on analysis at the area level for one year: 2011. The data allows vehicles and their annual mileages to be attributed to the location of the registered keeper. When linked with other data about each local area such as the economic and demographic profiles, the availability of publictransport, collision rates and even the weather, it is possible to generate original insights about the distribution of cars, motorcycles, vans and other light duty vehicles, and about how the fleet and its usage varies across the country.In these uncertain times of changing vehicle purchasing patterns, possible shifts in attitudes to travel and in actual travel behaviour amongst younger generations, and the rapid growth in van traffic, this work has the potential to contribute to many policy and business objectives.In this report, we offer a selection of some of the topic areas we have investigated in our research to date. Whilst there is significant technical detail behind the generation of the MOT dataset and many of the additional variables that we have linked with it from sources such as the Census, we concentrate here on some key findings and why we believe these are novel and important. Technical details are saved for the final section of this report and in the further publications from the research team, which are detailed in the references section

Conceptualizing Micromobility

While micromobility has seen a significant rise of interest across policy, industry and academia, a detailed conceptualisation of it has so far been missing from the scientific literature. This paper develops a multi-dimensional conceptualisation of micromobility, in conjunction with a new socio-technical definition. To do so, it reviews related concepts; it analyses how the term micromobility has been used; and it critically engages with existing definitions most frequently cited in this literature. Building on these insights, we develop a multi-dimensional conceptualization of micromobility. Our definition of micromobility covers a wide range of mobility options that can typically be manoeuvred by one human without motor assistance, at least for short distances, and that are ‘micro’ in terms of energy demand, environmental impact, and use of road space, relative to automobility. According to our conceptualisation, micromobility modes comprise fully human powered, partially motor assisted and fully powered options. They typically do not exceed 25 kilometres per hour (or 45 for faster ones) and weigh (often significantly) less than 350 kilogram, while often providing some (public) health benefits. Trip lengths are typically less than 15 kilometres and daily distance travelled less than 80 kilometres. This new definition has relevance for future transport and mobility scholarship, as well as policy and evaluation. Advantages of a new and widely accepted definition and conceptualisation of micromobility could include more robust design standards, legislation, as well as evaluation metrics and methods, all leading to greater understanding of, and attention paid to, this form of mobility. This paper highlights the important role that micromobilities could play in moving beyond automobility, to create more sustainable and just mobility futures

Conceptualizing Micromobility:The Multi-Dimensional and Socio-Technical Perspective

Micromobility has gained attention from policymakers, industry stakeholders, and academia; however, a comprehensive conceptualization of micromobility is still missing. Existing definitions are largely vehicle-centric: either listing modes or detailing vehicle characteristics. This paper addresses this gap by developing a ‘beyond vehicles’, multi-dimensional conceptualization of micromobility, accompanied by a novel socio-technical definition. Through a review of related concepts, combined with an analysis of the use and definitions of the term micromobility in publications, this study establishes a new conceptualization of micromobility. It incorporates human, social, and cultural dimensions, considers environmental, economic, infrastructure, vehicle technology, regulatory and policy aspects, and considerations for public health. Our definition of micromobility encompasses a wide range of mobility options typically used for shorter trips and manoeuvrable by an individual without motor assistance, at least for short distances. These modes are characterized by their ‘micro’ attributes, including low energy demand, environmental impact, and road space use relative to automobility. The conceptualization incorporates a range of micromobility modes, including fully human-powered (including walking), partially motor-assisted, and fully powered options. These modes typically operate at speeds not exceeding 25 to 32 kilometres per hour (or 45 km/h for faster options), weigh (typically substantially) below 350 kilograms and often yield significant (public) health benefits. Trip length is generally less than 15 kilometres, and daily distances under 80 kilometres. Importantly, our definition includes the practices, policies, cultures, and infrastructures that emerge around the use of micromobility options and shape their uptake. This proposed conceptualization significantly broadens the prevailing vehicle-focus in micromobility debates towards a socio-technical perspective. Embracing a widely accepted conceptualisation of micromobility would offer several advantages, including robust design standards, legislation, and evaluation metrics and methods. Additionally, this paper highlights the pivotal role micromobilities can play in transcending the limitations of automobility, towards more sustainable and equitable mobility futures

Evaluation of school and workplace travel plan SSA programme

Evaluation of school and workplace travel plan SSA programm

Use of a novel dataset to explore spatial and social variations in car type, size, usage and emissions

© 2015 The Authors. The 'MOT' vehicle inspection test record dataset recently released by the UK Department for Transport (DfT) provides the ability to estimate annual mileage figures for every individual light duty vehicle greater than 3 years old within Great Britain. Vehicle age, engine size and fuel type are also provided in the dataset and these allow further estimates to be made of fuel consumption, energy use, and per vehicle emissions of both air pollutants and greenhouse gases. The use of this data permits the adoption of a new vehicle-centred approach to assessing emissions and energy use in comparison to previous road-flow and national fuel consumption based approaches. The dataset also allows a spatial attribution of each vehicle to a postcode area, through the reported location of relevant vehicle testing stations. Consequently, this new vehicle data can be linked with socio-demographic data in order to determine the potential characteristics of vehicle owners.This paper provides a broad overview of the types of analyses that are made possible by these data, with a particular focus on distance driven and pollutant emissions. The intention is to demonstrate the very broad potential for this data, and to highlight where more focused analysis could be useful. The findings from the work have important implications for understanding the distributional impacts of transport related policies and targeting messaging and interventions for the reduction of car use