Sustainable transportation development : a framework to determine transportation disadvantaged

Urban sprawl combined with low density development causes unsustainable development patterns including accessibility and mobility problems, especially for those who do not have the capacity to own a vehicle or access to quality public transport services. Sustainable transportation development is crucial in order to solve transport disadvantage problems in urban settlements. People who are affected by these problems are referred to as ‘transportation disadvantaged’. Transportation disadvantage is a multi-dimensional problem that combines socio-economics, transportation and spatial characteristics or dimensions. However, a substantial number of transportation disadvantage studies so far only focus on the socio-economic and transportation dimensions, while the latter dimension of transportation disadvantage has been neglected. This chapter investigates the spatial dimension of transportation disadvantage by comparing the travel capabilities of residents and their accessibility levels with land use characteristics. The analysis of the study identifies significant land use characteristics with travel inability, and is useful for identifying the transportation disadvantaged population.

Does the use of store-and-forward telehealth systems improve outcomes for clinicians managing diabetic foot ulcers? : A pilot study

Diabetic foot ulcers are one of the most hospitalised diabetes complications and contribute to many leg amputations. Trained diabetic foot teams and specialists managing diabetic foot ulcers have demonstrated reductions in amputations and hospitalisation by up to 90%. Few such teams exist in Australia. Thus, access is limited for all geographical populations and may somewhat explain the high rates of hospitalisation. Aim: This pilot study aims to analyse if local clinicians managing diabetic foot complications report improved access to diabetic foot specialists and outcomes with the introduction of a telehealth store-and-forward system. Method: A store-and-forward telehealth system was implemented in six different Queensland locations between August 2009 and February 2010. Sites were offered ad hoc and/or fortnightly telehealth access to a diabetic foot speciality service. A survey was sent six months following commencement of the trial to the 14 eligible clinicians involved in the trial to gauge clinical perception of the telehealth system. Results: Eight participants returned the surveys. The majority of responding clinicians reported that the telehealth system was easy to use (100%), improved their access to diabetic foot speciality services (75%), improved upskilling of local diabetes service staff (100%), and improved patient outcomes (100%). Conclusion: This pilot study suggests that clinicians found the use of a telehealth store-and-forward system very useful in improving access to speciality services, clinical skills and patient outcomes. This study supports the recommendation that telehealth systems should be made available for diabetic foot ulcer management.