The scope for pavement porters: addressing the challenges of last-mile parcel delivery in London

The UK parcel sector generated almost £9 billion in revenue in 2015, with growth expected to increase by 15.6% in 2019 and is characterized by many independent players competing in an ‘everyone-delivers-everywhere’ culture leading to much replication of vehicle activity. With road space in urban centers being increasingly reallocated to pavement widening, bus and cycle lanes, there is growing interest in alternative solutions to the last-mile delivery problem. We make three contributions in this paper: firstly, through empirical analysis using carrier operational datasets, we quantify the characteristics of last-mile parcel operations and demonstrate the reliance placed on walking which can make up over 60% of the round time; secondly we introduce the concept of ‘portering’ where vans rendezvous with porters who operate within specific ‘patches’ to service consignees on-foot, potentially saving 86% in driving distance on some rounds; finally, we highlight the wider practical issues and optimization challenges associated with operating driving and portering rounds in inner urban areas

Demographic, clinical and antibody characteristics of patients with digital ulcers in systemic sclerosis: data from the DUO Registry

OBJECTIVES: The Digital Ulcers Outcome (DUO) Registry was designed to describe the clinical and antibody characteristics, disease course and outcomes of patients with digital ulcers associated with systemic sclerosis (SSc). METHODS: The DUO Registry is a European, prospective, multicentre, observational, registry of SSc patients with ongoing digital ulcer disease, irrespective of treatment regimen. Data collected included demographics, SSc duration, SSc subset, internal organ manifestations, autoantibodies, previous and ongoing interventions and complications related to digital ulcers. RESULTS: Up to 19 November 2010 a total of 2439 patients had enrolled into the registry. Most were classified as either limited cutaneous SSc (lcSSc; 52.2%) or diffuse cutaneous SSc (dcSSc; 36.9%). Digital ulcers developed earlier in patients with dcSSc compared with lcSSc. Almost all patients (95.7%) tested positive for antinuclear antibodies, 45.2% for anti-scleroderma-70 and 43.6% for anticentromere antibodies (ACA). The first digital ulcer in the anti-scleroderma-70-positive patient cohort occurred approximately 5 years earlier than the ACA-positive patient group. CONCLUSIONS: This study provides data from a large cohort of SSc patients with a history of digital ulcers. The early occurrence and high frequency of digital ulcer complications are especially seen in patients with dcSSc and/or anti-scleroderma-70 antibodies

A History of Discrete Event Simulation Programming Languages

The history of simulation programming languages is organized as a progression in periods of similar developments. The five periods, spanning 1955-1986, are labeled: The Period of Search (1955-1960); The Advent (1961-1965); The Formative Period (1966-1970); The Expansional Period (1971-1978); and The Period of Consolidation and Regeneration (1979-1986). The focus is on recognizing the people and places that have made important contributions in addition to the nature of the contribution. A balance between comprehensive and in-depth treatment has been reached by providing more detailed description of those languages which have or have had major use. Over 30 languages are mentioned, and numerous variations are described in the major contributors. A concluding summary notes the concepts and techniques either originating with simulation programming languages or given significant visibility by them

Whose behavior is it anyway? The broader potential of social marketing

Social marketing has established itself as an effective technology for changing the health behaviors of individual citizens. However, people's behavior is not just determined by their own choices but also by their social context. An unhealthy diet, for instance, may result as much from poverty as poor food choice, and the continued use of tobacco from nicotine addiction rather than self-determination. Social marketing needs to address these "upstream" influences if it is to reach its full potential, as well as avoid intellectual and ethical criticism. These influences occur at two different levels: in the local community (e.g., diet may be determined by what is available in the local shops or exercising by access to sports facilities) -- "the immediate environment"; and in society as a whole (e.g., smoking may be encouraged if it is felt to have tacit endorsement from government) -- "the wider social context." In addition there are other influences on people's health outcomes, such as the addition of fluoride to water or folk acid to bread, that don't involve the individual in any action at all but do require behavior change by policy makers. Four case studies are used to show that social marketing can contribute at each of these levels, using the standard principles of consumer orientation, exchange and strategic planning