How to Achieve Acceptance by Considering User Needs in Public Transport

During the last years, the concept of social marketing has become central to part of the research connected to the goal of making public transport, walking, cycling, but also the acceptance of traffic safety measures more attractive. The concept of "marketing" is often used erroneously in the public: the part of the communication with the target groups is taken as pars pro toto by many. However, what is often forgotten by practitioners involved in marketing is that, according to the marketing theories, every measure has to be based soundly on information work: "information work" refers to the efforts made to collect as much information as possible about the target groups. He/she who wants to plan measures does so on basis of what he/she has learned about the users´ characteristics, their situation, their NEEDS and interests. The paper offered here deals with the part of information policy where it is tried to learn about needs and interests. From a psychological point of view the interesting thing is that qualitative methods are needed to learn about needs and interests, and a discussion of different results when using standardised instruments in comparison to qualitative mesures - e.g., narrative interviews - will be lead.Institute of Transport and Logistics Studies. Faculty of Economics and Business. The University of Sydne

Assessment of the quality of life in cities. Environmental conditions and mobility

The main objective of the paper is to provide knowledge about the practice of life quality assessment by different disciplines in connection with different types of public measures in the area of town planning and design, transportation and mobility. In this way we want to improve the understanding of responsible politicians and experts about assessment of quality of life. It is an introductory paper to a research about analysis of how mobility policies affect quality of life. The main product will be advice for improved assessment processes. The developed instruments will be tested in a pilot study

Semaglutide and cardiovascular outcomes in patients with obesity and prevalent heart failure: a prespecified analysis of the SELECT trial

Background: Semaglutide, a GLP-1 receptor agonist, reduces the risk of major adverse cardiovascular events (MACE) in people with overweight or obesity, but the effects of this drug on outcomes in patients with atherosclerotic cardiovascular disease and heart failure are unknown. We report a prespecified analysis of the effect of once-weekly subcutaneous semaglutide 2·4 mg on ischaemic and heart failure cardiovascular outcomes. We aimed to investigate if semaglutide was beneficial in patients with atherosclerotic cardiovascular disease with a history of heart failure compared with placebo; if there was a difference in outcome in patients designated as having heart failure with preserved ejection fraction compared with heart failure with reduced ejection fraction; and if the efficacy and safety of semaglutide in patients with heart failure was related to baseline characteristics or subtype of heart failure. Methods: The SELECT trial was a randomised, double-blind, multicentre, placebo-controlled, event-driven phase 3 trial in 41 countries. Adults aged 45 years and older, with a BMI of 27 kg/m2 or greater and established cardiovascular disease were eligible for the study. Patients were randomly assigned (1:1) with a block size of four using an interactive web response system in a double-blind manner to escalating doses of once-weekly subcutaneous semaglutide over 16 weeks to a target dose of 2·4 mg, or placebo. In a prespecified analysis, we examined the effect of semaglutide compared with placebo in patients with and without a history of heart failure at enrolment, subclassified as heart failure with preserved ejection fraction, heart failure with reduced ejection fraction, or unclassified heart failure. Endpoints comprised MACE (a composite of non-fatal myocardial infarction, non-fatal stroke, and cardiovascular death); a composite heart failure outcome (cardiovascular death or hospitalisation or urgent hospital visit for heart failure); cardiovascular death; and all-cause death. The study is registered with ClinicalTrials.gov, NCT03574597. Findings: Between Oct 31, 2018, and March 31, 2021, 17 604 patients with a mean age of 61·6 years (SD 8·9) and a mean BMI of 33·4 kg/m2 (5·0) were randomly assigned to receive semaglutide (8803 [50·0%] patients) or placebo (8801 [50·0%] patients). 4286 (24·3%) of 17 604 patients had a history of investigator-defined heart failure at enrolment: 2273 (53·0%) of 4286 patients had heart failure with preserved ejection fraction, 1347 (31·4%) had heart failure with reduced ejection fraction, and 666 (15·5%) had unclassified heart failure. Baseline characteristics were similar between patients with and without heart failure. Patients with heart failure had a higher incidence of clinical events. Semaglutide improved all outcome measures in patients with heart failure at random assignment compared with those without heart failure (hazard ratio [HR] 0·72, 95% CI 0·60-0·87 for MACE; 0·79, 0·64-0·98 for the heart failure composite endpoint; 0·76, 0·59-0·97 for cardiovascular death; and 0·81, 0·66-1·00 for all-cause death; all pinteraction>0·19). Treatment with semaglutide resulted in improved outcomes in both the heart failure with reduced ejection fraction (HR 0·65, 95% CI 0·49-0·87 for MACE; 0·79, 0·58-1·08 for the composite heart failure endpoint) and heart failure with preserved ejection fraction groups (0·69, 0·51-0·91 for MACE; 0·75, 0·52-1·07 for the composite heart failure endpoint), although patients with heart failure with reduced ejection fraction had higher absolute event rates than those with heart failure with preserved ejection fraction. For MACE and the heart failure composite, there were no significant differences in benefits across baseline age, sex, BMI, New York Heart Association status, and diuretic use. Serious adverse events were less frequent with semaglutide versus placebo, regardless of heart failure subtype. Interpretation: In patients with atherosclerotic cardiovascular diease and overweight or obesity, treatment with semaglutide 2·4 mg reduced MACE and composite heart failure endpoints compared with placebo in those with and without clinical heart failure, regardless of heart failure subtype. Our findings could facilitate prescribing and result in improved clinical outcomes for this patient group. Funding: Novo Nordisk

Editorial

This volume of TOTS deals with three areas. Two of them, traffic and transport safety, and mobility preconditions for people with special needs, are of continuous interest. The third one, the effects of COVID on transport and mobility, came up as a short-term issue only a couple of years ago. It will lose interest, unless another pandemic will haunt us in the near future; then what we have learned this time will hopefully be useful. Concerning traffic safety, Bicaksiz et al. analyse the relationship between positive personality traits - the Light Triad framework represented by humanism, faith in humanity, and Kantianism - and a safe driving style. Ordinary violations, aggressive violations, and positive driver behaviour subscales of the Driver Behaviour Questionnaire DBQ were used to describe the driving style. The Driving Anger Expression Inventory (DAX) was applied to assess aggressive and constructive forms of driving anger expression. After controlling for age, gender, and total mileage, the findings supported the expected associations; some traits of the Light Triad yielded negative associations with aggressive expressions of driving anger, whereas the opposite pattern was found with positive driver behaviour and constructive expression of driving anger. While this paper focussed on safe driving, Chebariachko et al. were interested in improving the safety of passenger road transportation. To this end, they aimed at developing a model of the transport process with minimal risks of incidents by using the Functional Resonance Analysis Method (FRAM) in order to determine the factors that may influence the reliability of transportation. The specialists' professional experience (the transportation organization manager, the mechanic checking a passenger bus before starting work, doctor, driver), significantly affects the safety of the transportation process. However, the main reason for violation of traffic rules by drivers of passenger buses is the psycho-physiological state of the driver, which is strongly affected by the preconditions generated by the other specialists. Thus, the state of the driver needs to be continuous subject of control, but so do the abilities and activities of the other specialists. The originality of the research lies in the established relationship between functions and criteria that have an impact on the safety of the transport process. Its practical significance lies in the recommendations for monitoring all activities along and around the transportation process, including the psycho-physiological state of the driver. Changing the topic, we move on to persons with special needs. Forsblad et al. analysed how children with mild Intellectual disability experience self-driving buses. The degree of inclusiveness of the design strategy and the role of support persons are analysed. Based on this, recommendations of how to mitigate existing problems in these areas are formulated. The outcomes of the study were, among others, practical hints like that the buses need to decelerate less abruptly and have easier and consistently designed seatbelts. Moreover, the children need to understand more clearly what the bus does, what the system "sees" and reacts to. Support persons can be helpful in this respect. Though within a very

Communication between motor vehicles and vulnerable road users (pedestrians and cyclists) not least when considering vehicle automation

Considering that both the scientific community and industry nowadays deal with automation – up to autonomous driving – more and more, this topic should of course be dealt with at any road safety congress. However, there are certain aspects that appear especially interesting and important. One of those aspects is related to vulnerable road users. This is a group of road users the members of which cannot easily be automated. At least, it is difficult to imagine that attempts in that direction will be successful. Members of this group will go on to communicate “analogously“ and not digitally. I.e. interpersonal communication will go on to be important in more densely inhabited areas. These are areas where different modes mix and where higher portions of pedestrians, bicyclists and related types of road users will move about in the public space. How can automation of motor vehicles take “analogous“ communication into consideration? Will it be possible to write software programs for motor vehicles so that they can move about in more densely inhabited areas safely viz. without endangering unprotected road users? From this perspective, this special session will deal with the communication between (highly automated) motor vehicles and vulnerable road users