889 research outputs found

    The 'weight of evidence' concerning tobacco harm: beliefs in mid-twentieth century America

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    We present a version of Chern et al.'s (1995) Bayesian model of `health risk belief' to track the evolution of the `weight' of epidemiological evidence concerning tobacco harm that was in the possession of the U.S. Tobacco Industry Research Committee (T.I.R.C.) and the U.S. Public Health Service and related groups during the 1950s and early 1960s. We compare our results with public statements assessing the evidence that were made by the organisations during the same period. The results from the models for the U.S. Public Health Service and related groups are not in disagreement with the public statements of these organisations; the results from the lung cancer model for the T.I.R.C. are in disagreement with the assessments of the evidence made by the T.I.R.C.'s Scientific Director in his annual reports. We discuss possible reasons for this, relating our findings to present-day academic and legal debates about the `controversy' surrounding tobacco harm during the mid-twentieth century.

    ENHANCING RURAL PUBLIC TRANSPORT ACCESSIBILITY THROUGH IMPLEMENTING A SMART SCAN-ON M-TICKETING SOLUTION: : A UNITED KINGDOM CASE STUDY APPROACH WITHIN RURAL DEREGULATED ENVIRONMENTS

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    Scott Copsey, Sue Walsh, Liam Fassam, Richard Southern, ‘Enhancing Rural Public Transport Accessibility Through Implementing a Smart Scan-on M Ticketing Solution: A United Kingdom Case Study Approach Within Rural Deregulated Environments’, paper presented at the European Transport Conference, Barcelona, Spain, 5-7 October, 2016.The aim of this paper is to demonstrate how two UK Local Authorities (Hertfordshire and Northamptonshire), the two Universities of Hertfordshire and Northampton and public transport providers have worked in partnership to develop a smart scan-on m-ticketing solution, that integrates into a wider ‘smart city’ solution delivering social good through connected value propositions. Based on the initial success of a Hertfordshire pilot, a specific objective of this work is to establish smart integrated multi-operator/modal solutions. This pilot is subsequently being collaboratively expanded upon, through the UK Department for Transport funded ‘Network Northamptonshire Total Transport’ initiative, a transformative project to improve connectivity, integration and accessibility for rural transport networks. This forms part of the recently signed ‘Heart of England’ economic tri-county alliance agreement, which aims to work collaboratively across three local authority regions (Buckinghamshire, Oxfordshire and Northamptonshire), consolidating £3bn of spending. This provides a further future platform for innovative transport solutions being rolled out across wider geographical areas. The initial Hertfordshire demonstrator pilot project explored how a ‘smart’ m-ticketing platform could provide a sustainable financial business model for implementing ticketing solutions for small and medium bus operators within rural Shires, outside of large urban settings. This unique project was the first scan-on bus mobile ticket product used in the UK (outside of London). It offers a partnership model and governance structure for local authorities, commercial operators and other stakeholders with an interest in integrated sustainable transport to take forward, and leads to the possibility of new, socially innovative models for procuring and delivering transport solutions. Initial user reactions have been positive, generating large digital data sets, analysis of which indicates rapid user uptake in comparison to other schemes. This data enables detailed analysis such as precise user geo-spatial distribution, supporting targeted marketing and route-specific promotions to encourage further service uptake. A critical success factor of the project was to target a reduction of on-bus cash handling by five per cent within the first 12 months. This would aid in reducing bus loading times, improve reliability and operator efficiencies. After an initial 16 month operational use, uptake growth in excess of 7 per cent of total revenue has been achieved, on specific routes the transfer to m-ticket has exceeded 12 per cent, with targets of 10 per cent of total cash to mobile conversion predicted by the middle of 2017, likely to be realised. The effectiveness of marketing campaigns, technical development aspects and implementation issues will be reported. These projects have a wider context. Public transport services in rural areas in England are deregulated, and have at present no effective statutory backing or ring-fenced funding. As a result, with reductions in funding to local authorities, funding for non-commercial bus services is being sharply reduced and many authorities are proposing to cease all funding for local bus services (Campaign for Better Transport, 2016). These projects may offer alternative cost-effective ways of providing local transport services in non-metropolitan areas, and thus provide the potential for unique future research opportunities. These include understanding the uptake of smart multi-modal solutions in rural areas to improve accessibility and connectivity through enhanced services for new users and for those with restricted or reduced mobility networks, whilst also offering efficiencies for operators. This research has added importance, because the UK Government is proposing legislation on bus services in England, which would confer significant extra powers on local authorities to intervene in the bus market in various ways. These projects may act as pathfinders for the use of these powers in non-metropolitan areas. Structures supporting a partnership approach involving all those with an interest in public transport are a critical part of improving rural connectivity and accessibility. Through the experience of establishing quality partnership models in Hertfordshire, this paper will go on to detail the subsequent work now underway developing a Social Enterprise model involving local government, universities, operators, health and education services in Northamptonshire, which will form the basis of the transformation of rural integrated sustainable transport delivery.Non peer reviewedSubmitted Versio

    State of the Nations : Transport Planning for a sustainable future

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    The State of the Nations 2020 report report reviews travel trends and behaviours, current government policy, regional transport planning, spending and investment and transport taxes and charges to enable the Transport Planning Society to make clear recommendations to government and the sector. The report concludes that the way transport is planned and integrated into society will be key to the UK’s ability to address the major challenges of today, particularly the decarbonisation of transport. Transport spending and taxation needs to support decarbonisation, with objectives set out in transport strategies and spending priorities to address these important national aims. Governments should give transport planners, especially in local and sub-national authorities, the policies, tools, funding, data and freedoms to improve the transport system for all users to provide a better quality of life for people and communities across the nations. Transport for London should serve as a model for well-resourced local and regional authorities, combining spatial and transport planning and with their own revenue raising powers, but with requirements for setting pathways to cut CO2 emissions

    The TiM system: developing a novel telehealth service to improve access to specialist care in motor neurone disease using user-centered design

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    Objectives: Attendance at a specialist multidisciplinary motor neurone disease (MND) clinic is associated with improved survival and may also improve quality of life and reduce hospital admissions. However, patients struggle to travel to clinic and may experience difficulties between clinic visits that may not be addressed in a timely manner. We wanted to explore how we could improve access to specialist MND care. Methods: We adopted an iterative, user-centered co-design approach, collaborating with those with experience of providing and receiving MND care including patients, carers, clinicians, and technology developers. We explored the unmet needs of those living with MND, how they might be met through service redesign and through the use of digital technologies. We developed a new digital solution and performed initial testing with potential users including clinicians, patients, and carers. Results: We used these findings to develop a telehealth system (TiM) using an Android app into which patients and carers answer a series of questions about their condition on a weekly basis. The questions aim to capture all the physical, emotional, and social difficulties associated with MND. This information is immediately uploaded to the internet for review by the MND team. The data undergoes analysis in order to alert clinicians to any changes in a patient or carer’s condition. Conclusions: We describe the benefits of developing a novel digitally enabled service underpinned by participatory design. Future trials must evaluate the feasibility and acceptability of the TiM system within a clinical environment

    Co-Developing an Antibiotic Stewardship Tool for Dentistry: Shared Decision-Making for Adults with Toothache or Infection

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    From MDPI via Jisc Publications RouterHistory: accepted 2021-11-02, pub-electronic 2021-11-04Publication status: PublishedFunder: National Institute for Health Research; Grant(s): DRF-2016-09-148Dentistry is responsible for around 10% of antibiotic prescribing across global healthcare, with up to 80% representing inappropriate use. Facilitating shared decision-making has been shown to optimise antibiotic prescribing (antibiotic stewardship) in primary medical care. Our aim was to co-develop a shared decision-making antibiotic stewardship tool for dentistry. Dentists, patients and other stakeholders prioritised factors to include in the new tool, based on previous research (a systematic review and ethnographic study) about dentists’ decision-making during urgent appointments. Candidate behaviour-change techniques were identified using the Behaviour Change Wheel and selected based on suitability for a shared decision-making approach. A ‘think aloud’ study helped fine-tune the tool design and Crystal Marking ensured clarity of messaging. The resulting paper-based worksheet for use at point-of-care incorporated various behaviour change techniques, such as: ’information about (and salience of) health consequences’, ‘prompts and cues’, ‘restructuring the physical (and social) environment’ and ‘credible sources’. The think aloud study confirmed the tool’s acceptability to dentists and patients, and resulted in the title: ‘Step-by-step guide to fixing your toothache.’ Further testing will be necessary to evaluate its efficacy at safely reducing dental antibiotic prescribing during urgent dental appointments in England and, with translation, to other dental contexts globally
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