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.

Survey : The design studio now

In this book for the AASA I provide a response to the question asked by the editors: What is Architecture Studio?

PREPARE Study: Patient satisfaction survey with care provided in the low clearance clinic

Background Formalised predialysis care has been shown to extend the wellness of individuals with advanced chronic kidney disease, slow disease progression and increase the uptake of home dialysis. Predialysis care, incorporating multidisciplinary input is also vital in delaying the onset of end-stage kidney disease and reducing hospital admissions; thereby decreasing financial demands on health budgets. Predialysis care should include comprehensive information provision and predialysis education. This empowers patients to choose self-care strategies and therapies.

ISPCAN child abuse screening tool children's version (ICAST-C): Instrument development and multi-national pilot testing

Objective To develop a child victimization survey among a diverse group of child protection experts and examine the performance of the instrument through a set of international pilot studies. Methods The initial draft of the instrument was developed after input from scientists and practitioners representing 40 countries. Volunteers from the larger group of scientists participating in the Delphi review of the ICAST P and R reviewed the ICAST C by email in 2 rounds resulting in a final instrument. The ICAST C was then translated and back translated into six languages and field tested in four countries using a convenience sample of 571 children 12–17 years of age selected from schools and classrooms to which the investigators had easy access. Results The final ICAST C Home has 38 items and the ICAST C Institution has 44 items. These items serve as screeners and positive endorsements are followed by queries for frequency and perpetrator. Half of respondents were boys (49%). Endorsement for various forms of victimization ranged from 0 to 51%. Many children report violence exposure (51%), physical victimization (55%), psychological victimization (66%), sexual victimization (18%), and neglect in their homes (37%) in the last year. High rates of physical victimization (57%), psychological victimization (59%), and sexual victimization (22%) were also reported in schools in the last year. Internal consistency was moderate to high (alpha between .685 and .855) and missing data low (less than 1.5% for all but one item). Conclusions In pilot testing, the ICAST C identifies high rates of child victimization in all domains. Rates of missing data are low, and internal consistency is moderate to high. Pilot testing demonstrated the feasibility of using child self-report as one strategy to assess child victimization. Practice implications The ICAST C is a multi-national, multi-lingual, consensus-based survey instrument. It is available in six languages for international research to estimate child victimization. Assessing the prevalence of child victimization is critical in understanding the scope of the problem, setting national and local priorities, and garnering support for program and policy development aimed at child protection.

Using smartphones for cycling safety: A survey of riders preferences and interest in new technologies

Cyclists are among the most vulnerable road users. Many recent interventions have aimed at improving their safety on the road, such as the minimum overtaking distance rule introduced in Queensland in 2014. Smartphones offer excellent opportunities for technical intervention for road safety at a limited cost. Indeed, they have a lot of available processing power and many embedded sensors that allow analysing a rider's (or driver's) motion, behaviour, and environment; this is especially relevant for cyclists, as they do not have the space or power allowance that can be found in most motor vehicles. The aim of the study presented in this paper is to assess cyclists’ support for a range of new smartphone-based safety technologies. The preliminary results for an online survey with cyclists recruited from Bicycle Queensland and Triathlon Queensland, with N=191, are presented. A number of innovative safety systems such as automatic logging of incidents without injuries, reporting of dangerous area via a website/app, automatic notification of emergency services in case of crash or fall, and advanced navigation apps were assessed. A significant part of the survey is dedicated to GoSafeCycle, a cooperative collision prevention app based on motion tracking and Wi-Fi communications developed at CARRS-Q. Results show a marked preference toward automatic detection and notification of emergencies (62-70% positive assessment) and GoSafeCycle (61.7% positive assessment), as well as reporting apps (59.1% positive assessment). Such findings are important in the context of current promotion of active transports and highlight the need for further development of system supported by the general public.

Support services for higher degree research students: A survey of three Australian universities

A survey was conducted across three Australian universities to identify the types and format of support services available for higher degree research (HDR, or MA and Ph.D.) students. The services were classified with regards to availability, location and accessibility. A comparative tool was developed to help institutions categorise their services in terms of academic, administrative, social and settlement, language and miscellaneous (other) supports. All three universities showed similarities in the type of academic support services offered, while differing in social and settlement and language support services in terms of the location and the level of accessibility of these services. The study also examined the specific support services available for culturally and linguistically diverse (CALD) students. The three universities differed in their emphases in catering to CALD needs, with their allocation of resources reflecting these differences. The organisation of these services within the universities was further assessed to determine possible factors that may influence the effective delivery of these services, by considering HDR and CALD student specific issues. The findings and tools developed by this study may be useful to HDR supervisors and university administrators in identifying key support services to better improve outcomes for the HDR students and universities.

A methodological survey of future mobility literature: Opportunities for design research

This research establishes that the study of mobility and transportation is multi-disciplinary and highly complex, involving the diverse interplay between infrastructural and psychological factors. Coincidently, a new paradigm in personal mobility is developing. A new generation of mobility solutions is becoming widely available in the form of car and ride sharing services. These services build on the assumption that customers no longer need ownership of a product in order to benefit from it. With the emergence of this new paradigm, this paper presents a methodological review of current practises used by the wider research community. Therefore, this research piece aims to explore methodological approaches involved in the study the effect of community on an individual’s attitudes, perceptions and behaviours of future mobility solutions. The results of this review indicate that the majority of published literature uses quantitative methods as opposed to qualitative and even fewer studies have sought to understand the human factors in these new mobility solutions. This gap in knowledge is a valuable opportunity for design. Inherently qualitative and human focused, design research can fill this gap in knowledge by applying distinctly user-centred methods such as persona design, narrative storytelling, and in-depth observations to discover deeper human insights.

Questionnaire design for airport passenger experience survey

Assessing airport service performance requires understanding of a complete set of passenger experiences covering all activities from departures to arrivals. Weight-based indicator models allow passengers to express their priority on certain evaluation criteria (airport domains) and their service attributes over the others. The application of multilevel regression analysis in questionnaire design is expected to overcome limitations of traditional questionnaires, which require application of all indicators with equal weight. The development of a Taxonomy of Passenger Activities (TOPA), which captures all passenger processing and discretionary activities, has provided a novel perspective in understanding passenger experience in various airport domains. Based on further literature reviews on various service attributes at airport passenger terminals, this paper constitutes questionnaire design to employ a weighting method for all activities from the time passengers enter an airport domain at the departure terminal until leaving the arrival terminal (i.e. seven airport domains for departure, four airport domains during transit, and seven airport domains for arrival). The procedure of multilevel regression analysis is aimed not only at identifying the ranking of each evaluation criterion from the most important to the least important but also to explain the relationship between service attributes in each airport domain and overall service performance.

Factors influencing sustainability of health service innovation: Emergency nurse practitioner services

Introduction: Emergency department nurse practitioner services are one of the most frequently implemented service delivery models in Australian hospitals. This research examined factors influencing sustainability of this innovative service delivery model and offers some recommendations for future service integration. Background Many health service innovations have been implemented in an attempt to meet the growing demand for efficient, cost effective health care however, sustainability of many of these innovations has not been evaluated and is poorly understood. Aim The aim of the research was to identify factors that influence sustainability of emergency department nurse practitioner services and to operationalise a theoretical framework for evaluating innovation sustainability. Methodology The research used case study methodology. The case was emergency nurse practitioner services, and units of analysis were emergency department staff, emergency nurse practitioners and documents relating to nurse practitioner services. The data collection methods included, survey, one-on-one interviews, document analysis and telephone survey. Results This research shows that emergency nurse practitioner services partially comply with the factors of sustainability as described in the Sustainability of Innovation theoretical framework: Political, Organisational, Workforce, Financial and Innovation specific factors. Where services do not entirely meet the factors the existing benefits of the service may outweigh the barriers and other means of working around shortfalls are also implemented by staff to ensure patient safety. Conclusion The rapidly expanding emergency nurse practitioner service has been examined using case study methodology to find that certain factors may be threatening the sustainability of this health service innovation. Potentially an innovation may be sustained when only some factors are met in the short term, however, long term sustainability may be challenged if factors are not addressed and supported.

International survey of bicycling exposure, crash involvement, behaviors, and attitudes: Preliminary results

This paper presents some results from preliminary analyses of the data of an international online survey of bicycle riders, who reported riding at least once a month. On 4 July 2015, data from 7528 participants from 17 countries was available in the survey, and were subsequently cleaned and checked for consistency. The median distance ridden ranged from 30 km/week in Israel to 150 km/week in Greece (overall median 54 km/week). City/hybrid bicycles were the most common type of bicycle ridden (44%), followed by mountain (20%) and road bikes (15%). Almost half (47%) of the respondents rode “nearly daily”. About a quarter rode daily to work or study (27%). Overall, 40% of respondents reported wearing a helmet ‘always’, varying from 2% in the Netherlands to 80% in Norway, while 25% reported ‘never’ wearing a helmet. Thus, individuals appeared to consistently either use or not use helmets. Helmet wearing rates were generally higher when riding for health/fitness than other purposes and appeared to be little affected by the type of riding location, but some divergences in these patterns were found among countries. Almost 29% of respondents reported being involved in at least one bicycle crash in the last year (ranging from 12% in Israel to 53% in Turkey). Among the most severe crashes for each respondent, about half of the crashes involved falling off a bicycle. Just under 10% of the most severe crashes for each respondent were reported to police. Among the bicycle-motor vehicle crashes, only a third were reported to police. Further analyses will address questions regarding the influence of factors such as demographic characteristics, type of bicycle ridden, and attitudes on both bi-cycle use and helmet wearing rates.

Community-based social marketing: Effects on social norms

Purpose This research investigates whether application of a community-based social marketing principle, namely increasing the visibility of a target behaviour in the community, can change social norms surrounding the behaviour. Design/methodology/approach A repeated measures quasi-experimental design was employed to evaluate the Victorian Health Promotion Foundation’s Walk to School 2013 programme, which increases the visibility of walking to and from school through programme participation to promote active transportation for primary school children. The target population for the survey were caregivers of primary school children aged between 5-12 years old. The final sample size across the three online surveys administered was 102 respondents. Findings The results suggest that the programme increased caregivers’ perceptions that children in their community walked to and from school and that walking to and from school is socially acceptable. Originality/value The study contributes to addressing the recent call for research examining the relationship between community-based social marketing principles and programme outcomes. Further, the results provide insight for enhancing the social norms approach, which has traditionally relied on changing social norms exclusively through media campaigns.

A Survey of autonomous vision-based See and Avoid for Unmanned Aircraft Systems

This paper provides a comprehensive review of the vision-based See and Avoid problem for unmanned aircraft. The unique problem environment and associated constraints are detailed, followed by an in-depth analysis of visual sensing limitations. In light of such detection and estimation constraints, relevant human, aircraft and robot collision avoidance concepts are then compared from a decision and control perspective. Remarks on system evaluation and certification are also included to provide a holistic review approach. The intention of this work is to clarify common misconceptions, realistically bound feasible design expectations and offer new research directions. It is hoped that this paper will help us to unify design efforts across the aerospace and robotics communities.

Osteopenia and rickets in the extremely low birth weight infant: A survey of the incidence and a radiological classification

A review was carried out of the radiographs of twenty-five infants with birth weights under 1000 G, who survived for more than twenty-eight days; eighteen of these had enough suitable films for a survey of the progressive bone changes which occur in these infants, including estimation of humeral cortical cross-sectional area. The incidence of the changes has been assessed and a typical progression of radiographic appearances has been shown, with a suggested system of staging. All infants showed some loss of bone mineral, with frank changes of rickets occurring in forty-four percent. Aetiological factors are mainly concerned with the difficulty of supplying and ensuring absorption of sufficient bone mineral (calcium and phosphate) and vitamin D. Liver immaturity may be another factor. Disease states additional to prematurity accentuate the problem. Rib fractures occurring around 80–90 days post-nataEy commonly draw attention to the bone disorder and are probably the major clinical factor of importance; there is a high incidence of associated lung disease of uncertain pathology. Attention is drawn to possible confusion with other bone disorders in the post-natal period.

Analysis of an inter-centre, web-based radiation oncology peer-review case conference

Purpose Peer-review programmes in radiation oncology are used to facilitate the process and evaluation of clinical decision-making. However, web-based peer-review methods are still uncommon. This study analysed an inter-centre, web-based peer-review case conference as a method of facilitating the decision-making process in radiation oncology. Methodology A benchmark form was designed based on the American Society for Radiation Oncology targets for radiation oncology peer review. This was used for evaluating the contents of the peer-review case presentations on 40 cases, selected from three participating radiation oncology centres. A scoring system was used for comparison of data, and a survey was conducted to analyse the experiences of radiation oncology professionals who attended the web-based peer-review meetings in order to identify priorities for improvement. Results The mean scores for the evaluations were 82·7, 84·5, 86·3 and 87·3% for cervical, prostate, breast and head and neck presentations, respectively. The survey showed that radiation oncology professionals were confident about the role of web-based peer-reviews in facilitating sharing of good practice, stimulating professionalism and promoting professional growth. The participants were satisfied with the quality of the audio and visual aspects of the web-based meeting. Conclusion The results of this study suggest that simple inter-centre web-based peer-review case conferences are a feasible technique for peer review in radiation oncology. Limitations such as data security and confidentiality can be overcome by the use of appropriate structure and technology. To drive the issues of quality and safety a step further, small radiotherapy departments may need to consider web-based peer-review case conference as part of their routine quality assurance practices.

Survey of dental clinic patients: Smoking and preferences for cessation support

Background: Smoking cessation interventions delivered by dental practitioners can be as effective as those delivered by general medical practitioners. However, concern that addressing smoking may cause offence to their patients is a reason cited by dental practitioners for not regularly addressing patient smoking behaviours, despite believing they should play a role in smoking cessation. This study aimed to elicit the smoking behaviour and smoking cessation preferences of dental patients to determine if these concerns accurately reflect patient attitudes. Methods: We surveyed 726 adult dental patients attending the University of Queensland’s School of Dentistry Dental Clinics, Brisbane Dental Hospital, and four private dental practices in South East Queensland. Results: Most (80%) current daily smokers had tried to quit smoking. Smokers and non-smokers both agreed that dentists should screen for smoking behaviour and are qualified to offer smoking cessation advice (99% and 96% respectively). Almost all participants (96%) said they would be comfortable with their dentist asking about their smoking and that if their smoking was affecting their oral health their dentist should advise them to quit. Conclusions: Patients are receptive to dental practitioners inquiring about smoking behaviour and offering advice on quitting. Smoking patients showed considerable motivation and interest in quitting smoking, particularly in the context of health problems related to smoking being identified. These results should encourage dentists to raise the issue with their patients.