An investigation of container train service provision and load factors in Great Britain

The continued growth in the volume of international trade poses considerable economic and sustainability challenges, particularly as transport routes become more congested and concern grows about the role of transport movements in accelerating climate change. Rail freight plays a major role in the inland transport of containers passing through the main British container ports, and potentially could play a more significant role in the future. However, there is little detailed understanding of the nature of this particular rail market, especially in terms its current operating efficiency. This paper examines container train service provision to/from the four main ports, based on analysis of a representative survey of more than 500 container trains between February and August 2007. The extent to which the existing capacity is utilised is presented, and scenarios by which the number of containers carried could be increased without requiring additional train service provision are modelled, to identify the theoretical potential for greater rail volumes. Finally, the paper identifies the challenges involved in achieving higher load factors, emphasising the importance both of wider supply chain considerations and government policy decision-making.

Making a difference? Public service broadcasting, distinctiveness and children’s provision in Italy and Spain

This article evaluates the performance of public service broadcasters in the area of children’s television in Italy and Spain. It asks: how distinctive is the output of public service children’s channels? As core area of public service provision, children’s television represents an important testing ground for wider debates about the distinctiveness of public service broadcasting in a digital age. Public broadcasters in Southern Europe have historically been more vulnerable to market pressure than their counterparts in continental and Northern Europe, and this is believed to have impacted negatively on their ability to maintain a distinctive public service profile. After engaging with debates on distinctiveness in order to develop a framework for the analysis, the article presents the results of a two-week analysis of the TV schedules of the main children’s channels operating in the two countries. It finds evidence that in both countries the output of public service children’s channels is distinctive to a degree, but also that there are important gaps in public service provision as well as some significant differences between the public service children’s channels analysed.

Using a whole person approach to support people with cancer: a longitudinal, mixed methods service evaluation

Introduction: Improved models of care are needed to meet all the support needs of people with cancer, which encompass psychological, emotional, physical, spiritual, sexual, occupational, social and existential needs. The aim of this paper is to (1) evaluate short and long-term impacts of using a whole person approach to support people with cancer on the Living Well with the Impact of Cancer Course (LWC); (2) use these data to inform strategic decisions about future service provision at Penny Brohn UK. Methods: Longitudinal mixed-methods service evaluation (n=135). Data collected included health related quality of life (HRQoL) (FACIT-SpEx); Concerns (types and severity - MYCaW); lifestyle behaviour (bespoke questionnaire) and participants’ experiences over 12 months post course. Results: Statistically and clinically significant improvements from baseline - 12 months in severity of MYCaW Concerns (n=64; p<0.000) and mean total HRQoL (n=66; p<0.000). The majority of MYCaW concerns were ‘psychological and emotional’ and about participants’ wellbeing. Spiritual, emotional and functional wellbeing contributed most to HRQoL improvements at 12 months. Barriers to maintaining healthy lifestyle changes included lack of support from family and friends, time constraints, and returning to work. 3-6 months post-course was identified as the time when more support was most likely to be needed. Conclusions: Using a whole person approach for the LWC enabled the needs of participants to be met, and statistically and clinically significant improvements in HRQoL and MYCaW Concerns were reported. Qualitative data analysis explored how experiencing whole person support enabled participants to make and sustain healthy lifestyle changes associated with improved survivorship. Barriers experienced to making health behaviour change were also identified. These data then informed wider and more person-centred clinical provision to increase the maintenance of positive long-term behaviour changes. Comparison of whole person approaches to cancer treatment and support and standard care are now urgently needed.

Understanding urban freight activity: key issues for freight planning

Using information gathered from some 30 UK surveys undertaken over the last 15 years, this paper provides planners with an understanding of road-based urban retail freight transport activity. The findings suggest that the average High Street business could expect up to 10 core goods and 7.6 service visits per week, in non-peak trading periods with 25% additional activity during the build up to Christmas. Vans (‘light goods vehicles’) were the dominant mode, responsible for 42% of delivery activity with a mean dwell time of 10 min. Where possible, load consolidation should be encouraged by methods such as Delivery and Servicing Plans and using out-of-town freight consolidation centres to bring in goods over the last mile in shared vehicles. Where this is not possible, loading bay monitoring and control, and preferred lorry routes can help manage the movement of vehicles in and out of dense urban areas. Service vehicle activity is a significant contributor to urban freight movements and often requires vehicles to be parked close to the premises being served. Centrally coordinating elements of service provision (e.g. for cleaning, equipment maintenance, recyclate collection), or providing improved, more flexible parking provision for service vehicles could be as or more beneficial in reducing overall freight impacts than focusing on core goods deliveries. In the case of the latter, ‘pay-as-you-leave’ car park charging systems could encourage short-stay service vehicles to park off-street.

Cultural cooperation, institution building, and metropolitan governance in decentralizing Indonesia

The institutional turn in metropolitan governance has been influenced to a considerable degree by a rational choice approach, which views metropolitan governance as essentially created by local actors to reduce the transaction costs of inter-jurisdictional public-service provision. Another influential theoretical route follows a historical approach, which emphasizes the role of the state structure in producing formal institutions to enable governance at the regional level. Both approaches tend to be formalistic, simplistic and deterministic in nature, thus neglecting the dynamic interactions between the actors and their more informal, intangible, yet more basic, legitimate institutions, such as culture. This article examines the dynamic role of culture in metropolitan governance building in the context of decentralizing Indonesia. The analysis focuses on ‘best-practice’ experiences of metropolitan cooperation in greater Yogyakarta, where three neighbouring local governments known as Kartamantul have collaboratively performed cross-border infrastructure development to deal with the consequences of extended urbanization. We draw on sociological institutionalism to argue that building this metropolitan cooperation has its roots in the capacity of the actors to use and mobilize culture as a resource for collaborative action.

Beyond maternal death: improving the quality of maternal care through national studies of ‘near-miss’ maternal morbidity

Knight M, Acosta C, Brocklehurst P, Cheshire A, Fitzpatrick K, Hinton L, Jokinen M, Kemp B, Kurinczuk JJ, Lewis G, Lindquist A, Locock L, Nair M, Patel N, Quigley M, Ridge D, Rivero-Arias O, Sellers S, Shah A on behalf of the UKNeS coapplicant group. Background Studies of maternal mortality have been shown to result in important improvements to women’s health. It is now recognised that in countries such as the UK, where maternal deaths are rare, the study of near-miss severe maternal morbidity provides additional information to aid disease prevention, treatment and service provision. Objectives To (1) estimate the incidence of specific near-miss morbidities; (2) assess the contribution of existing risk factors to incidence; (3) describe different interventions and their impact on outcomes and costs; (4) identify any groups in which outcomes differ; (5) investigate factors associated with maternal death; (6) compare an external confidential enquiry or a local review approach for investigating quality of care for affected women; and (7) assess the longer-term impacts. Methods Mixed quantitative and qualitative methods including primary national observational studies, database analyses, surveys and case studies overseen by a user advisory group. Setting Maternity units in all four countries of the UK. Participants Women with near-miss maternal morbidities, their partners and comparison women without severe morbidity. Main outcome measures The incidence, risk factors, management and outcomes of uterine rupture, placenta accreta, haemolysis, elevated liver enzymes and low platelets (HELLP) syndrome, severe sepsis, amniotic fluid embolism and pregnancy at advanced maternal age (≥ 48 years at completion of pregnancy); factors associated with progression from severe morbidity to death; associations between severe maternal morbidity and ethnicity and socioeconomic status; lessons for care identified by local and external review; economic evaluation of interventions for management of postpartum haemorrhage (PPH); women’s experiences of near-miss maternal morbidity; long-term outcomes; and models of maternity care commissioned through experience-led and standard approaches. Results Women and their partners reported long-term impacts of near-miss maternal morbidities on their physical and mental health. Older maternal age and caesarean delivery are associated with severe maternal morbidity in both current and future pregnancies. Antibiotic prescription for pregnant or postpartum women with suspected infection does not necessarily prevent progression to severe sepsis, which may be rapidly progressive. Delay in delivery, of up to 48 hours, may be safely undertaken in women with HELLP syndrome in whom there is no fetal compromise. Uterine compression sutures are a cost-effective second-line therapy for PPH. Medical comorbidities are associated with a fivefold increase in the odds of maternal death from direct pregnancy complications. External reviews identified more specific clinical messages for care than local reviews. Experience-led commissioning may be used as a way to commission maternity services. Limitations This programme used observational studies, some with limited sample size, and the possibility of uncontrolled confounding cannot be excluded. Conclusions Implementation of the findings of this research could prevent both future severe pregnancy complications as well as improving the outcome of pregnancy for women. One of the clearest findings relates to the population of women with other medical and mental health problems in pregnancy and their risk of severe morbidity. Further research into models of pre-pregnancy, pregnancy and postnatal care is clearly needed.

Children's television: the soft underbelly of public service broadcasting

The provision of children's content should be a key constituent of the public service brand, but has often been viewed as a programme category at risk. Certainly in many countries children's television has moved from the 'scarcity' associated with terrestrial provision, to the 'plenty' of digital (see Ellis 2000). However in spite of a range of dedicated public service children's channels in Europe (CBeebies, Kika, Z@ppelin), domestically produced children's television in Europe is notoriously under-resourced if not marginalised. There is a pronounced reliance on imports (particularly on commercial television) notwithstanding the launch by US-owned multinationals (Disney, Nickelodeon, Cartoon Network) of localised versions of their children's television channels in many European countries. Within the broader context of global developments in children's media, this paper starts by outlining the recent and rapid crisis in British children's television and the factors that caused it. This was a crisis, which caught broadcasters and producers by surprise in the middle of 2006, but reflects many of the challenges faced by the children's television sector in other countries. It clearly demonstrated how a combination of the lack of regulatory protection, a change in commercial priorities among broadcasters, advertising restrictions, budgetary pressures and the competitive environment at home and abroad all combined to reinforce the trend towards a contraction of domestic production. The crisis also served to underline the dominance of the BBC - both as a representative of public service principles, and as the dominant producer and commissioner in the market. With the reasons underpinning the crisis explained, the paper will then analyse how the children's television community responded to the crisis and with what effect. Based on interviews, contemporary accounts and documentary evidence the paper will chart the converging and diverging views of broadcasters, producers, regulatory authority Ofcom, and a range of advocacy groups which represent children's interests and the industry. What arguments were elaborated in favour of protecting children's television as an integral part of the public service media brand? Can lessons be learned about how best to ensure the origination of children's media within a public service environment? Can developments in the UK be used to provide insight into how children's media might develop further?

Linking the ecosystem service approach to social preferences and needs in integrated coastal land use management - a planning approach

Coastal zones with their natural and societal subsystems are exposed to rapid changes and pressures on resources. Scarcity of space and impacts of climate change are prominent drivers of land use and adaptation management today. Necessary modifications to present land use management strategies and schemes influence both the structures of coastal communities and the ecosystems involved. Approaches to identify the impacts and account for (i) the linkages between social references and needs and (ii) ecosystem services in coastal zones have been largely absent. The presented method focuses on improving the inclusion of ecosystem services in planning processes and clarifies the linkages with social impacts. In this study, fourteen stakeholders in decisionmaking on land use planning in the region of Krummhörn (northwestern Germany, southern North Sea coastal region) conducted a regional participative and informal process for local planning capable to adapt to climate driven changes. It is argued that scientific and practical implications of this integrated assessment focus on multifunctional options and contribute to more sustainable practices in future land use planning. The method operationalizes the ecosystem service approach and social impact analysis and demonstrates that social demands and provision of ecosystem services are inherently connected.