Changing travel patterns and journeys to health services in Great Britain 1985-2012: An examination health service utilisation using the National Travel Survey

Background This paper examines changing patterns in the utilisation and geographic access to health services in Great Britain using National Travel Survey data (1985-2012). The National Travel Survey (NTS) is a series of household surveys designed to provide data on personal travel and monitor changes in travel behaviour over time. The utilisation rate was derived using the proportion of journeys made to access health services. Geographic access was analysed by separating the concept into its accessibility and mobility dimensions. Methods Variables from the PSU, households, and individuals datasets were used as explanatory variables. Whereas, variables extracted from the journeys dataset were used as dependent variables to identify patterns of utilisation i.e. the proportion of journeys made by different groups to access health facilities in a particular journey distance or time band or by mode of transport; and geographic access to health services. A binary logistic regression analysis was conducted to identify the utilisation rate over the different time periods between different groups. This analysis shows the Odds Ratios (ORs) for different groups making a trip to utilise health services compared to their respective counterparts. Linear multiple regression analyses were conducted to then identify patterns of change in the accessibility and mobility level. Results Analysis of the data has shown that that journey distances to health facilities were signi fi cantly shorter and also gradually reduced over the period in question for Londoners, females, those without a car or on low incomes, and older people. Although rates of utilisation of health services we re Oral Abstracts / Journal of Transport & Health 2 (2015) S5 – S63 S43 signi fi cantly lower because of longer journey times. These fi ndings indicate that the rate of utilisation of health services largely depends on mobility level although previous research studies have traditionally overlooked the mobility dimension. Conclusions This fi nding, therefore, suggests the need to improve geographic access to services together with an enhanced mobility option for disadvantaged groups in order for them to have improved levels of access to health facilities. This research has also found that the volume of car trips to health services also increased steadily over the period 1985-2012 while all other modes accounted for a smaller number of trips. However, it is dif fi cult to conclude from this research whether this increase in the volume of car trips was due to a lack of alternative transport or due to an increase in the level of car-ownership.

Culture and creative industries in Australia

It has been argued that the origins of modern creative industries policies can be found in Australia. The Creative Nation national cultural policy statement released by the Labor government headed by the Prime Minister Paul Keating in 1994 sought an original synthesis of arts and media policies that was outwardly looking, identifying the opportunities presented by what were then new digital media technologies, and clearly stated the economic opportunities presented by promotion of what were referred to at the time as the cultural industries. Several commentators have identified the influence that Creative Nation had on the Blair Labour government when it came to power in the United Kingdom in 1997. Faced with the question of how to revitalise the once-mighty industrial cities of the U.K. after the Conservative government, the Department of Culture, Media and Sport drew upon policy documents such as Australia’s Creative Nation, as well as the experience of local governments in these cities, in looking to the cultural sectors to spearhead new jobs growth, as well as re-branding the cities as cultural or creative cities in a post-industrial economic landscape. This growing alignment of culture and economics, that has been a characteristic of creative industries policies as they have developed in Australia, Britain, East Asia and Europe, marks an interesting shift in the traditional focus of arts and cultural policy as compensatory to the economic domain. The first Chair of what would become the Arts Council of Great Britain (now the Arts Council of England) was the famous economist John Maynard Keynes. In the First Annual Report of the Arts Council for 1945-1946, prepared in the latter stages of the Second World War, Keynes proposed that “the day is not far off when the economic problem will take the back seat where it belongs, and the arena of the heart and the head will be occupied or reoccupied, by our real problems — the problems of life and of human relations, of creation and behaviour and religion”. 中文摘要 1994年工黨執政時期澳洲總理基挺（Paul Keating）發表創意的國家（The Creative Nation）的文化政策聲明堪稱是澳洲現代創意產業的起源，該聲明試圖將藝術與媒體政策結合在一起，其目的在面向海外，為新數位媒體技術尋找機會。聲明中明確指出要推動文化產業為經濟帶來機會。「文化政策也是經濟政策。文化創造財富與附加價值，對創新、行銷與設計有重要貢獻，是我們工業的標誌（badge）。我們創意的層次實際上決定了我們適應新經濟imperatives的能力。文化本身就是項重要出口，是其他產品出口的主要附件（essential accompaniment）。文化吸引觀光與學生，也是我們經濟成功之關鍵。」 創意產業的策略是構建藝術、媒體與資訊電信科技的網絡以利文化產業在國家創新政策策略中擁有一席之地。此一策略最早是由1990年代末英國布萊爾（Tony Blair）的新工黨政府所採行，其後歐洲聯盟、澳洲、紐西蘭、新加坡、台灣、南韓與中國。

Cultural Policy

The development of cultural policy during the twentieth century is underscored by three key developments. First, the formation of the Arts Council of Great Britain in 1946, first headed by the Cambridge economist Lord Keynes, saw the scaffolding developed for ongoing government support for the arts. In doing so, it established the principle of an “arm’s length” relationship between the government of the day and individual artists, through the development of independent arts boards engaged in the peer review of creative works. Second, the formation of the Fifth Republic in France in 1958 saw the creation of a Ministry of Culture, headed by the writer André Malraux. Malraux and his successors have seen three major tasks for a national cultural policy: government support for the creation of new artistic and cultural works; the promotion and maintenance of cultural heritage; and enabling equitable access to creative works and creative opportunities through all segments of society. Finally, at a global level, agencies such as UNESCO have sought to promote national cultural policies as an element of national sovereignty, particularly in the developing world, and this has involved addressing sources of structural inequality in the distribution of global cultural and communications resources...

Targeting ASCT2-mediated glutamine uptake blocks prostate cancer growth and tumour development

Glutamine is conditionally essential in cancer cells, being utilized as a carbon and nitrogen source for macromolecule production, as well as for anaplerotic reactions fuelling the tricarboxylic acid (TCA) cycle. In this study, we demonstrated that the glutamine transporter ASCT2 (SLC1A5) is highly expressed in prostate cancer patient samples. Using LNCaP and PC-3 prostate cancer cell lines, we showed that chemical or shRNA-mediated inhibition of ASCT2 function in vitro decreases glutamine uptake, cell cycle progression through E2F transcription factors, mTORC1 pathway activation and cell growth. Chemical inhibition also reduces basal oxygen consumption and fatty acid synthesis, showing that downstream metabolic function is reliant on ASCT2-mediated glutamine uptake. Furthermore, shRNA knockdown of ASCT2 in PC-3 cell xenografts significantly inhibits tumour growth and metastasis in vivo, associated with the down-regulation of E2F cell cycle pathway proteins. In conclusion, ASCT2-mediated glutamine uptake is essential for multiple pathways regulating the cell cycle and cell growth, and is therefore a putative therapeutic target in prostate cancer.