Social sustainability and smart mobility : exploring the relationship

In this article the relationship between two broad concepts will be explored. The first concept is social sustainability, a concept still in discussion. The second concept is smart mobility, a new concept, related to IT- related mobility options and solutions. How social sustainable is smart mobility ? This article offers a clarification of both concepts and of the relationships between the concepts. The conclusion is that whether smart mobility will be social sustainable depends on the route smart mobility will take; only related to cars, and to higher segments of the fleet, or broader in scope and more related to mobility services.Keywordssocial sustainability; smart mobility; mobility services; equity; accessibility; social cohesio

The future of car mobility 2014-2030 ; material for a debate on framing smart mobility

Smart mobility, seen as car based solutions with greater fuel efficiency and shifts to cars that are essentially information technology-products, is sometimes presented as the way forward for car mobility. This article presents developments, visions and scenarios for a debate on the role and the frame of smart mobility in the future of car mobility. Sustainability and life style issues are introduced as important backgrounds. As for a majority of households smart mobility solutions are important, it can be concluded that an important minority of households is searching for other solutions than technological framed smart mobility

Equity in mobility : learning from health care, education and especially housing

The objective of the paper is, first, to identify the principles of justice that guide the policy domains of health care, education and housing, and, second, to explore what lessons could be drawn for the domain of transportation. Like policies in the three other domains, interventions in the transportation system aim to provide citizens with an essential service. Not all households are able to purchase an adequate share of the relevant service at the marktplace. An explicit and systemic comparison of the equity principles underpinning these policy domains is thus expected to deliver new insights regarding the transportation domain.As a hypothesis we expect that equity principles in a policy domain depend to a large part on "statistics"; when a majority of households can pay a service themselves, households unable to purchase the service in the marketplace receive a substantially lower level of service through government interventions than that majority.<br/

Indications for incisional hernia repair: An international questionnaire among hernia surgeons

Background: Incisional hernia repair can be a significant challenge for both surgeon and patient. Despite the growing amount of literature describing various methods of surgical techniques, little has been published regarding the natural course of incisional hernia and the opinions about indications for incisional hernia repair. Methods: A questionnaire was sent to a group of surgeons internationally renowned in incisional hernia surgery and research. Results: Pain and limitations of daily activities were considered the most important indications for repair. Cosmetic complaints were seen as least important. About 23% of patients were asymptomatic. More than 20% did not receive surgical treatment. Conclusions: A large proportion of patients with incisional hernia is not operated. Despite this large group of patients, valid data describing the natural course are absent. A prospective trial monitoring incisional untreated hernias as well as comparing conservative treatment with repair should be performed

The feasibility of local anesthesia for the surgical treatment of umbilical hernia: a systematic review of the literature

Background: Yearly approximately 4500 umbilical hernias are repaired in The Netherlands, mostly under general anesthesia. The use of local anesthesia has shown several advantages in groin hernia surgery. Local anesthesia might be useful in the treatment of umbilical hernia as well. However, convincing evidence is lacking. We have conducted a systematic review on safety, feasibility, and advantages of local anesthesia for umbilical hernia repair. Methods: A systematic review was conducted according to the PRISMA guidelines. Outcome parameters were duration of surgery, surgical site infection, perioperative and postoperative complications, postoperative pain, hernia recurrence, time before discharge, and patient satisfaction. Results: The systematic review resulted in nine included articles. Various anesthetic agents were used, varying from short acting to longer acting agents. There was no consensus regarding the injection technique and no conversions to general anesthesia were described. The most common postoperative complication was surgical site infection, with an overall percentage of 3.4%. There were no postoperative deaths and no allergic reactions described for local anesthesia. The hernia recurrence rate varied from 2 to 7.4%. Almost 90% of umbilical hernia patients treated with local anesthesia were discharged within 24 h, compared with 47% of patients treated with general anesthesia. The overall patient satisfaction rate varied from 89 to 97%. Conclusion: Local anesthesia for umbilical hernia seems safe and feasible. However, the advantages of local anesthesia are not sufficiently demonstrated, due to the heterogeneity of included studies. We, therefore, propose a randomized controlled trial comparing general versus local anesthesia for umbilical hernia repair

Evaluation of a new suture material (Duramesh™) by measuring suture tension in small and large bites techniques for laparotomy closure in a porcine model

_Purpose:_ After closure of laparotomies, sutures may pull through tissue due to too high intra-abdominal pressure or suture tension, resulting in burst abdomen and incisional hernia. The objective of this study was to measure the suture tension in small and large bites with a new suture material. _Methods:_ Closure of the linea alba was performed with small bites (i.e., 5 mm between two consecutive stitches and 5 mm distance from the incision) and large bites (i.e., 10 mm × 10 mm) with Duramesh™ size 0 (2 mm) and PDS II 2-0 in 24 experiments on six porcine abdominal walls. The abdominal wall was fixated on an artificial computer-controlled insufflatable abdomen, k