Cities for children: the effects of car use on their lives

9-11 June 2004 In Britain, children are walking less than they used to. A major factor causing this decrease is the growth in car use. These trends are reducing children’s quantity of physical activity, with serious implications for their health. The purpose of this paper is to explore these themes using results from a 3-year research project entitled ‘Reducing children’s car use: the health and potential car dependency impacts’ which has been carried out in the Centre for Transport Studies at University College London in collaboration with others including Hertfordshire County Council, with fieldwork being carried out in Hertfordshire, an area immediately north of London. A major component of the project was a study of 200 children aged between 10 and 13 years of age using motion sensors coupled with the use of a travel and activity diary over four days. The sensors measured movement in three dimensions which was converted to activity calories, a measure of physical activity. Events from the travel and activity diaries were mapped onto the data from the sensors so that it was possible to isolate and analyse specific time periods, events and journeys. From these data, the comparative effects of different forms of transport on children’s physical activity have been established, producing clear evidence of the benefits of walking compared with car travel. It is found that the use of the car is linked to particular types of activity. For example, structured out-of-home activities, such as clubs and sports lessons tend to be reached by car while informal activities such as playing, are associated more with walking. This means that the shift from the latter to the former is one of the factors underlying children’s increasing use of the car. The motion sensors have facilitated the calculation of the intensity of various activities in terms of using activity calories. Walking is second only to physical education (PE) or games lessons in intensity. It was found that, for the older children, walking to and from school for a week used more activity calories than two hours of PE or games lessons, which is the recommended standard in Britain. It was also found that children who walk to activities are more active when they arrive at activities than those who travel by car, particularly in the more energetic activities, which suggests that walking brings wider health benefits than is generally recognised. Another strand of the project upon which this paper is based is the evaluation of walking buses. From the various surveys in the study it appears that about half of the trips on walking buses were previously walked, but there is not an equivalent decrease in the number of car trips because many of the children were being dropped at school in the course of a longer trip by a parent

Social criticism and comment in the novels of Howard Spring

Howard Spring, an English newspaperman turned novelist, can, perhaps be best described as a traditionalist. He lived and wrote in the twentieth century, was always sensitive to change in popular attitudes, but remained constant to his own convictions. His work is still worth reading for his insight into the values he considered basic to a full, complete, and rewarding life

Increasing the amount of walking by children

Children’s car use is increasing. As a result of this, they are walking less. This has serious implications for their quantity of physical activity and consequently for their health. In this paper, findings are presented from a research project being carried out in the Centre for Transport Studies at University College London to examine these effects. A major element of the research involved fitting 200 children with portable motion sensors for a period of four days to measure their quantity of physical activity. In parallel with this, they kept travel and activity diaries, so that it was possible to establish how much energy they consumed in various activities, including walking. It is shown that walking to school for a week consumes more calories than one week’s worth of physical education (PE) and games lessons, and that children who walk to events tend to use more energy in participating in them than children who are driven by car. The effectiveness of a specific initiative to encourage children to shift from the car to walking, namely the walking bus, is examined in detail, and found to be effective in helping to achieve this objective

Identification of potential diagnostic markers of prostate cancer and prostatic intraepithelial neoplasia using cDNA microarray

The identification of novel genes or groups of genes expressed in prostate cancer may allow earlier diagnosis or more accurate staging of the disease. We describe the assembly and use of a 1877-member microarray representing cDNA clones from a range of prostate cancer stages and grades, precursor lesions and normal tissue. Using labelled cDNA from tumour samples obtained from TURP or radical prostatectomy, analysis of expression patterns identified many up-regulated transcripts. Cell lines were found to over-express fewer genes than diseased tissue samples. 17 known genes were found to over-express more than 4-fold in 4 or more cancers out of 15 cancers. Only 2 genes were over-expressed in 6 out of 15 cancers or more, whilst no genes were consistently found to be over-expressed in all cancer samples. Novel prostate cancer associations for several well characterized genes or full length cDNAs were identified, including PLRP1, JM27, human UbcM2, dynein light intermediate chain 2 and human homologue of rat sec61. Novel associations with high-grade PIN include: breast carcinoma fatty acid synthase and cDNA DKFZp434B0335. We shortlist and discuss the most significant over-expressed genes in prostate cancer and PIN, and highlight expression differences between malignant and benign samples. © 2001 Cancer Research Campaign http://www.bjcancer.co

Exploring the treatment burden of disease-modifying anti-rheumatic drug monitoring in people with rheumatoid arthritis

This is the final version. Available on open access from Oxford University Press via the DOI in this recordData availability: The data underlying this article are available in the article and in its own online supplementary material.OBJECTIVES: People with RA taking DMARDs require safety monitoring to identify potential side effects. The aim of this study was to explore the perspectives of patients and family members on DMARD monitoring and how the associated treatment burden could be minimized to optimize concordance and safety. METHODS: Thirteen adults with RA on DMARDs and three family members participated in semi-structured telephone interviews between July 2021 and January 2022. Data were analysed using a framework method. Findings were discussed with a group of stakeholders to develop implications for practice. RESULTS: Two main themes were identified: (i) making sense of drug monitoring; and (ii) work involved in drug monitoring. Participants perceived DMARDs as necessary to reduce symptoms, with drug monitoring providing an opportunity for a holistic assessment of wellbeing. Participants expressed a preference for face-to-face consultations, which allowed them to share their concerns, rather than remote, often transactional, care. The limited availability of convenient appointment times, travel requirements and parking increased the work involved for patients and family members. CONCLUSION: Drug monitoring was accepted as a necessity of DMARD treatment, but increased the work for people with RA related to organizing and attending appointments. The potential for treatment burden needs to be assessed proactively by clinicians when a DMARD is commenced. Where identified, strategies for minimizing the treatment burden can form part of a shared management plan, including the offer of regular contact with health professionals, with an emphasis on person-centred care.General Nursing Council for England and Wales Trust (GNCT)National Institute for Health and Care Research (NIHR

Experience of implementing and delivering group consultations in UK general practice: a qualitative study

BACKGROUND: Group consultations are a relatively new concept in UK primary care and are a suggested solution to current workload pressures in general practice. Little is known about the experience of implementing and delivering this approach from staff and organisational perspectives. AIM: To explore the experience of implementing and delivering group consultations in general practice. DESIGN AND SETTING: Qualitative telephone interview study. METHOD: Topic guides explored the perspectives and experiences of general practice staff on the implementation and delivery of group consultations. Data analysis adopted principles of the Framework Method underpinned by Normalisation Process Theory. RESULTS: Interviews were conducted with 8 GPs, 8 practice nurses, 1 nurse associate, 1 practice pharmacist, 1 deputy practice manager, and 1 healthcare assistant. Four themes were identified: sense making of group consultations; the work associated with initiating group consultations; the experiences of operationalising group consultations; and sustaining change. Group consultations made sense to participants as a mechanism to reduce burden on primary care, enhance multidisciplinary working, and provide patient-centred care. Implementation required strong leadership from a 'champion', and a facilitator had a pivotal role in operationalising the approach. The associated workload was often underestimated. Barriers to embedding change included achieving whole practice buy-in, competing practice priorities, and system-level flexibility. CONCLUSION: General practice clinicians enjoyed group consultations, yet significant work is required to initiate and sustain the approach. An implementation plan considering leadership, roles and responsibilities, and wider organisational support is required at the outset. Further research or evaluation is needed to measure process outcomes