The demand for local bus services in England

This paper examines the demand for local bus services in England. The study is based on a dynamic model relating per capita bus patronage to bus fares, income, and service level, and is estimated using a combination of time-series and cross-section data for English counties. The results indicate that patronage is relatively fare-sensitive, with a wide variation in the elasticities

Volatility of car ownership, commutingmode and time in the UK

This paper has two objectives: to examine the volatility of travel behaviour over timeand consider the factors explaining this volatility; and to estimate the factors determiningcar ownership and commuting by car. The analysis is based on observations of individualsand households over a period of up to eleven years obtained from the British HouseholdPanel Survey (BHPS). Changes in car ownership, commuting mode and commuting timeover a period of years for the same individuals/households are examined to determine theextent to which these change from year to year. This volatility of individual behaviour is ameasure of the ease of change or adaptation. If behaviour changes easily, policy measuresare likely to have a stronger and more rapid effect than if there is more resistance tochange. The changes are ?explained? in terms of factors such as moving house, changingjob and employment status. The factors determining car ownership and commuting by carare analysed using a dynamic panel-data models

Land use and mobility

This paper analyses the effects of land use characteristics on mode choice and carownership. The study is based on a large sample of individuals from the National TravelSurvey of Great Britain for the years 1989-91 and 1999-2001. Land use characteristics aredefined as population density, size of the municipality, accessibility to public transport andlocal amenities, such as shops and services. Mode choice (shares of total travel by car,public transport and walking) and car ownership are modelled using multinomial andbinomial logit models respectively, which include a large number of socio-economicfactors (income, age, gender, household structure and employment status) as well as landuse indicators. The estimation results strongly support the importance of the land usefactors considered on mode choice and car ownership

Short-term effects of deep ploughing on soil C stocks following renewal of a dairy pasture in New Zealand

In New Zealand’s high producing permanent pastures the topsoil constitutes a large reservoir of soil organic carbon (SOC), which shows a marked stratification with depth. As consequence, sub-surface layers can contain 10 times less carbon than the surface soil. In permanent pastures with high carbon inputs, the formation and decomposition of these surface SOC stocks are often at equilibrium and C storage shows little change over time. Pastoral based dairy systems utilising ryegrass plus clover cultivars require renewal every 7-10 years to avoid reversion to less productive grasses. This may involve spring cultivation (either no-till, shallow till or full cultivation), summer forage cropping and autumn re-grassing. It has been hypothesised that SOC stocks can be increased by inverting the soil profile at pasture renewal through infrequent (once in 25-30 years) deep mouldboard ploughing (up to 30 cm depth). Increased C sequestration occurs when the new grass quickly rebuilds SOC stocks in the new topsoil (exposed low C sub-soil) at a rate faster than the decomposition of SOC in the rich former topsoil transferred to depth (now below 15 cm). However, benefits form accelerated C storage may be offset if crop and pasture production is adversely affected by the ploughing event (e.g., as result of compaction or excessive drainage). Hence, the aim of this work was to assess the short-term effects of infrequent inversion tillage of long-term New Zealand pastoral-based dairy soils under summer crop management and autumn re-grassing. An imperfectly drained Typic Fragiaqualf under dairy grazing was deep ploughed (approx. 25 cm) and re-sown with turnip in October 2016; other treatments included were shallow (< 10 cm) cultivation and no-till. The site was core sampled (0-40 cm) before cultivation and after 5 months of turnip growth to assess changes in SOC. Plant growth, herbage quality, and nutrient leaching were monitored during the 5-month period; root growth was assessed at the end of the crop rotation. Full cultivation transferred SOC below 10 cm depth, as expected. Soil bulk density decreased whereas root mass increased (10-20 cm depth; P < 0.05) under deep cultivation only. Besides, losses of mineral N were attenuated under deep tillage, resulting in a relative increase in crop yield. The potential for infrequent inversion tillage increasing soil C sequestration as a greenhouse gas (GHG) mitigation tool is currently being tested at other sites in New Zealand

Projecting productivity losses for cancer-related mortality 2011 - 2030

© 2016 The Author(s). Background: When individuals stop working due to cancer this represents a loss to society - the loss of productivity. The aim of this analysis was to estimate productivity losses associated with premature mortality from all adult cancers and from the 20 highest mortality adult cancers in Ireland in 2011, and project these losses until 2030. Methods: An incidence-based method was used to estimate the cost of cancer deaths between 2011 and 2030 using the Human Capital Approach. National data were used for cancer, population and economic inputs. Both paid work and unpaid household activities were included. Sensitivity analyses estimated the impact of assumptions around future cancer mortality rates, retirement ages, value of unpaid work, wage growth and discounting. Results: The 233,000 projected deaths from all invasive cancers in Ireland between 2011 and 2030 will result in lost productivity valued at €73 billion; €13 billion in paid work and €60 billion in household activities. These losses represent approximately 1.4 % of Ireland's GDP annually. The most costly cancers are lung (€14.4 billion), colorectal and breast cancer (€8.3 billion each). However, when viewed as productivity losses per cancer death, testis (€364,000 per death), cervix (€155,000 per death) and brain cancer (€136,000 per death) are most costly because they affect working age individuals. An annual 1 % reduction in mortality reduces productivity losses due to all invasive cancers by €8.5 billion over 20 years. Conclusions: Society incurs substantial losses in productivity as a result of cancer-related mortality, particularly when household production is included. These estimates provide valuable evidence to inform resource allocation decisions in cancer prevention and control

Роль корпоративной культуры в системе мотивации труда

OBJECTIVES: Multimorbidity is common in the older population, but the impact of combinations of chronic conditions on disability and quality of life (QoL) is not well known. This analysis explores the effect of specific combinations of chronic diseases on disability, QoL and self-rated health (SRH). DESIGN: We used data from two population representative cross-sectional studies, the Northern Ireland Health and Social Wellbeing Survey (NIHSWS) 2005 and the Survey of Lifestyle, Attitudes and Nutrition (SLAN) 2007 (conducted in the Republic of Ireland). SETTING: Randomly selected community-living participants were interviewed at home. PARTICIPANTS: A total of 6159 participants aged 50 years and older were included in the analysis. OUTCOME MEASURES: Chronic conditions were classified as cardiovascular disease, chronic pain, diabetes or respiratory disease. Interaction terms estimated by logistic regression were used to examine the effects of multiple chronic conditions on disability, SRH and QoL. RESULTS: Each chronic condition group was correlated with each of the others after adjusting for sociodemographic factors. Those from Northern Ireland were more likely to report a limitation in daily activities (45%) compared to those from the Republic of Ireland (21%). Each condition had an independent effect on disability, SRH and QoL, and those with multiple chronic conditions reported the worst outcomes. However, there were no statistically significant positive interactions between chronic condition groups with respect to any outcome. CONCLUSIONS: Chronic conditions affect individuals largely independent of each other with respect to their effect on disability, SRH and QoL. However, a significant proportion of the population aged 50 years and over across the island of Ireland lives with multimorbidity, and this group is at the highest risk of disability, poor SRH and poor QoL

Public attitudes to transport: Knowledge review of existing evidence

Report for Department for Transpor

Pharmacokinetic studies in children: recommendations for practice and research.

Optimising the dosing of medicines for neonates and children remains a challenge. The importance of pharmacokinetic (PK) and pharmacodynamic (PD) research is recognised both in medicines regulation and paediatric clinical pharmacology, yet there remain barriers to undertaking high-quality PK and PD studies. While these studies are essential in understanding the dose-concentration-effect relationship and should underpin dosing recommendations, this review examines how challenges affecting the design and conduct of paediatric pharmacological studies can be overcome using targeted pharmacometric strategies. Model-based approaches confer benefits at all stages of the drug life-cycle, from identifying the first dose to be used in children, to clinical trial design, and optimising the dosing regimens of older, off-patent medications. To benefit patients, strategies to ensure that new PK, PD and trial data are incorporated into evidence-based dosing recommendations are needed. This review summarises practical strategies to address current challenges, particularly the use of model-based (pharmacometric) approaches in study design and analysis. Recommendations for practice and directions for future paediatric pharmacological research are given, based on current literature and our joint international experience. Success of PK research in children requires a robust infrastructure, with sustainable funding mechanisms at its core, supported by political and regulatory initiatives, and international collaborations. There is a unique opportunity to advance paediatric medicines research at an unprecedented pace, bringing the age of evidence-based paediatric pharmacotherapy into sight

Intraoperative frozen section assessment of sentinel lymph nodes in the operative management of women with symptomatic breast cancer

<p>Abstract</p> <p>Background</p> <p>Maximisation of the potential of sentinel lymph node biopsy as a minimally invasive method of axillary staging requires sensitive intraoperative pathological analysis so that rates of re-operation for lymphatic metastases are minimised. The aim of this study was to describe the test parameters of the frozen section evaluation of sentinel node biopsy for breast cancer compared to the gold standard of standard permanent pathological evaluation at our institution.</p> <p>Methods</p> <p>The accuracy of intraoperative frozen section (FS) of sentinel nodes was determined in 94 consecutive women undergoing surgery for clinically node negative, invasive breast cancer (37:T1 disease; 43:T2; 14:T3). Definitive evidence of lymphatic spread on FS indicated immediate level II axillary clearance while sentinel node "negativity" on intraoperative testing led to the operation being curtailed to allow formal H&E analysis of the remaining sentinel nodal tissue.</p> <p>Results</p> <p>Intraoperative FS correctly predicted axillary involvement in 23/30 patients with lymphatic metastases (76% sensitivity rate) permitting definitive surgery to be completed at the index operation in 87 women (93%) overall. All SN found involved on FS were confirmed as harbouring tumour cells on subsequent formal specimen examination (100% specificity and positive predictive value) with 16 patients having additional non-sentinel nodes found also to contain tumour. Negative Predictive Values were highest in women with T1 tumours (97%) and lessened with more local advancement of disease (T2 rates: 86%; T3: 75%). Of those with falsely negative FS, three had only micrometastatic disease.</p> <p>Conclusion</p> <p>Intraoperative FS reliably evaluates the status of the sentinel node allowing most women complete their surgery in a single stage. Thus SN can be offered with increased confidence to those less likely to have negative axillae hence expanding the population of potential beneficiaries.</p

Glucocorticoid use and factors associated with variability in this use in the Systemic Lupus International Collaborating Clinics Inception Cohort

© The Author(s) 2018. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. Objectives. To describe glucocorticoid (GC) use in the SLICC inception cohort and to explore factors associated with GC use. In particular we aimed to assess temporal trends in GC use and to what extent physician-related factors may influence use. Methods. Patients were recruited within 15 months of diagnosis of SLE from 33 centres between 1999 and 2011 and continue to be reviewed annually. Descriptive statistics were used to detail oral and parenteral GC use. Cross sectional and longitudinal analyses were performed to explore factors associated with GC use at enrolment and over time. Results. We studied 1700 patients with a mean (S.D.) follow-up duration of 7.26 (3.82) years. Over the entire study period, 1365 (81.3%) patients received oral GCs and 447 (26.3%) received parenteral GCs at some point. GC use was strongly associated with treatment centre, age, race/ethnicity, sex, disease duration and disease activity. There was no change in the proportion of patients on GCs or the average doses of GC used over time according to year of diagnosis. Conclusion. GCs remain a cornerstone in SLE management and there have been no significant changes in their use over the past 10-15 years. While patient and disease factors contribute to the variation in GC use, between-centre differences suggest that physician-related factors also contribute. Evidence-based treatment algorithms are needed to inform a more standardized approach to GC use in SLE