Urban mobility: preparing for the future, learning from the past - CREATE project summary and recommendations

Transport decisions, and their resulting impacts on land use patterns, fundamentally shape and define a city, both physically and through the daily living patterns of its citizens and visitors. As policy priorities change, so do the types of measures that are introduced, with resulting shifts in travel behaviour and lifestyles. What at one point in a city’s history is often seen as the ‘inevitable’ need to adapt the urban fabric to accommodate the growing use of the motor car, may later be replaced by a focus on people movement and sustainable mobility, and a growing interest in urban quality and vitality – a city of places for people. CREATE (Congestion Reduction in Europe: Advancing Transport Efficiency) charts these changes in policy priorities and travel behaviour through the experiences of five Western European capital cities over the last 50 years, noting the policy tensions and competing city visions, the triggers leading to change and the evolving governance arrangements that have facilitated, or sometimes retarded, such developments. As policy priorities change, so do measures of success; in a car-focused city congestion is the dominant concern, but this becomes less important as more people travel by rail or on foot or by cycle, and when cities put a greater value on high quality places. Alongside this there have been technical changes, in the types of methods used to model behaviour and appraise schemes, and in the ways in which these tools are used. This document provides an introduction to the CREATE project, focusing on findings and lessons of value to practitioners, and those developing or updating their Sustainable Urban Mobility Plans. It is underpinned by extensive qualitative and quantitative research, which is fully documented in several deliverables, and summarised in a series of Technical Notes. A more comprehensive set of Guidelines is also available

What Drives Different Types of Capital Flows and their Volatilities in Developing Asia?

Understanding the determinants of capital inflows is essential to designing an effective policy framework to manage volatile capital flows and their disruptive potential. This paper aims to identify factors that explain the size and volatility of various types of capital flows to developing Asia, vis-à-vis other emerging market economies. The estimates for a panel dataset show that per capita income growth, trade openness, and change in stock market capitalization are important determinants of capital inflows to developing Asia. Trade openness increases the volatility of all types of capital inflows; while change in stock market capitalization, global liquidity growth and institutional quality lowers the volatility. A regional factor plays an important role in determining the size and volatility of capital inflows in emerging Europe and emerging Latin America, suggesting that regional economic cooperation and policy coordination may be an important element in designing a policy framework to manage capital inflows

A constructive role for social science in the development of automated vehicles

Automated vehicles (AVs) have the potential to cause profound shifts across a wide range of areas of human life, including economic structures, land use, lifestyles and personal well-being. Most current social science on AVs is narrowly framed. Research on public attitudes has focused on whether people are likely to accept and use AVs. We contend that failing to anticipate a wider range of profound social implications may have serious negative consequences, and that social scientists from a range of disciplinary perspectives can provide invaluable insights. Our conclusions are the product of a workshop in London held in 2018 to discuss the place of social science research in relation to the development of AVs. This paper summarises a core selection of our concerns, interests, theoretical and substantive points of reference and aspirations for a constructive role in this field of research and development

Landscape of alcohol-related hepatocellular carcinoma in the last 15 years highlights the need to expand surveillance programs

Background & Aims: Alcohol abuse and metabolic disorders are leading causes of hepatocellular carcinoma (HCC) worldwide. Alcohol-related aetiology is associated with a worse prognosis compared with viral agents, because of the lower percentage of patients diagnosed with HCC under routine surveillance and a higher burden of comorbidity in alcohol abusers. This study aimed to describe the evolving clinical scenario of alcohol-related HCC over 15 years (2006–2020) in Italy. Methods: Data from the Italian Liver Cancer (ITA.LI.CA) registry were used: 1,391 patients were allocated to three groups based on the year of HCC diagnosis (2006–2010; 2011–2015; 2016–2020). Patient characteristics, HCC treatment, and overall survival were compared among groups. Survival predictors were also investigated. Results: Approximately 80% of alcohol-related HCCs were classified as cases of metabolic dysfunction-associated fatty liver disease. Throughout the quinquennia, <50% of HCCs were detected by surveillance programmes. The tumour burden at diagnosis was slightly reduced but not enough to change the distribution of the ITA.LI.CA cancer stages. Intra-arterial and targeted systemic therapies increased across quinquennia. A modest improvement in survival was observed in the last quinquennia, particularly after 12 months of patient observation. Cancer stage, HCC treatment, and presence of oesophageal varices were independent predictors of survival. Conclusions: In the past 15 years, modest improvements have been obtained in outcomes of alcohol-related HCC, attributed mainly to underuse of surveillance programmes and the consequent low amenability to curative treatments. Metabolic dysfunction-associated fatty liver disease is a widespread condition in alcohol abusers, but its presence did not show a pivotal prognostic role once HCC had developed. Instead, the presence of oesophageal varices, an independent poor prognosticator, should be considered in patient management and refining of prognostic systems. Impact and Implications: Alcohol abuse is a leading and growing cause of hepatocellular carcinoma (HCC) worldwide and is associated with a worse prognosis compared with other aetiologies. We assessed the evolutionary landscape of alcohol-related HCC over 15 years in Italy. A high cumulative prevalence (78%) of metabolic dysfunction-associated fatty liver disease, with signs of metabolic dysfunction, was observed in HCC patients with unhealthy excessive alcohol consumption. The alcohol + metabolic dysfunction-associated fatty liver disease condition tended to progressively increase over time. A modest improvement in survival occurred over the study period, likely because of the persistent underuse of surveillance programmes and, consequently, the lack of improvement in the cancer stage at diagnosis and the patients’ eligibility for curative treatments. Alongside the known prognostic factors for HCC (cancer stage and treatment), the presence of oesophageal varices was an independent predictor of poor survival, suggesting that this clinical feature should be carefully considered in patient management and should be included in prognostic systems/scores for HCC to improve their performance

Automated vehicles: exploring possible consequences of government (non)intervention for congestion and accessibility

Academic research on automated vehicles (AVs) has to date been dominated by the fields of engineering and computer science. Questions of how this potentially transformative technology should be governed remain under-researched and tend to concentrate on governing the technology’s early development. We respond in this paper by exploring the possible longer-term effect of government (lack of) intervention.The paper tests the hypothesis that a “laissez-faire” governance approach is likely to produce less desirable outcomes in a scenario of mass uptake of AVs than would a well-planned set of government interventions. This is done using two prominent themes in transport policy – traffic flow and accessibility – in a scenario of high market penetration of Level-5 automated vehicles in capitalist market economies. The evidence used is drawn from a literature review and from the findings of a set of workshops with stakeholders.We suggest that a laissez-faire approach will lead to an increase in traffic volume as a result of a growing population of “drivers” and a probable increase in kilometres driven per passenger. At the same time, the hoped-for increases in network efficiency commonly claimed are not guaranteed to come about without appropriate government intervention. The likely consequence is an increase in congestion. And, with respect to accessibility, it is likely that the benefits of AVs will be enjoyed by wealthier individuals and that the wider impacts of AV use (including sprawl) may lead to a deterioration in accessibility for those who depend on walking, cycling or collective transport.We consider the range of possible government intervention in five categories: Planning/land-use; Regulation/policy; Infrastructure/technology; Service provision; and Economic instruments. For each category, we set out a series of interventions that might be used by governments (at city, region or state level) to manage congestion or protect accessibility in the AV scenario described. Many of these (e.g. road pricing) are already part of the policy mix but some (e.g. ban empty running of AVs) would be new. We find that all interventions applicable to the management of traffic flow would also be expected to contribute to the management of accessibility; we define a small number of additional interventions aimed at protecting the accessibility of priority groups.Our general finding is that the adoption of a package of these interventions could be expected to lead to better performance against generic traffic-flow and accessibility objectives than would a laissez-faire approach, though questions of extent of application remain.In our conclusions, we contrast laissez-faire with both anticipatory governance and “precautionary” governance and acknowledge the political difficulty associated with acting in the context of uncertainty. We point out that AVs do not represent the first emerging technology to offer both opportunities and risks and challenge governments at all levels to acknowledge the extent of their potential influence and, in particular, to examine methodically the options available to them and the potential consequences of pursuing them

Automation of the Driving Task: Some possible consequences and governance challenges

The possible consequences of the advent of fully automated vehicles (AVs) for personal transport are assessed. A shared-user model is considered preferable to an owner-user model; public-sector intervention is considered necessary to secure the successful integration of AVs with mass transit. Interurban expressways are found to offer a better opportunity than urban roads of capturing the vehicles’ potential traffic and safety benefits. AVs’ performance in a mixed-fleet scenario is highly dependent on segregation from other road users, but segregation poses significant challenges. The governance of a range of themes (such as demand management and security) is considered. In each case, challenges to achieving a socially desirable outcome are identified. Both laissez-faire and more interventionist styles of governance with respect to AVs present problems but laissez faire may carry greater risk. Decisions on governance should be based on meaningful dialogue with those who stand to be affected