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The study utilises the ‘natural experiment’ of COVID-19 to explore how disruption affected individuals’ perceptions and experiences of cycling, through semistructured interviews with eight cycle-shop owners and 30 residents in the Liverpool City Region, UK. It provides an account of the rapidly changing conditions that helped to support greater participation in cycling. Primarily this was due to reduced conflict between cyclists and others for road space. This was supported, though less significantly, by the provision of temporary cycling infrastructure as well as diminished competition for an individual’s time and energy from alternative leisure activities which were outlawed through COVID-19-related regulations. By disrupting car-dominated environments, the change in infrastructure and reduction in traffic flows contributed towards reducing the skills and confidence required to begin cycling. Nevertheless, as traffic rebounded to pre-pandemic volumes it was evident that the opportunity offered by disruption failed to be fully realised within the region. Despite this, the period has illustrated the potential for broader participation in cycling, though the paper finds that significant disruption to the infrastructures and traffic flows within the urban environment is required if a long-term modal shift is to occur following the surge in participation in cycling observed during the COVID-19 pandemic. To do so, the paper identifies several interventions that can be implemented to imitate the disruption observed in our study, and in doing so support a transition towards a low-carbon mobility system. [ABSTRACT FROM AUTHOR]

Whilst urban areas are thriving in trialling new mobility services (NMS), rural environments, often perceived as areas of low demand for travel, struggle to attract investments for creating more mobility solutions alongside traditional public transport (PT) services, making residents more reliant on private cars. This paper describes how policy interventions for introducing NMS in rural areas should be guided by big data to capture real and accurate travel behaviours, therefore avoiding perceived biases and potentially underestimating demand. In the UK, the provision of transport in rural areas is solely linked to population density and does not consider differences between places and residents' travel habits. The proposed data‐driven decision‐making process used trip‐chains from mobile network data (MND) to derive recent and accurate travel patterns from residents and provide the right mix of on‐demand mobility services alongside existing fixed scheduled public transport (PT). The manuscript describes the steps carried out to study three rural areas at low, medium and high population density in the UK: a data landscape to select study areas; the development of an activity‐based model, which uses anonymised mobile network data (MND) aggregated at trip‐chains level to derive travel patterns; and the development of an on‐line questionnaire and focus groups with rural communities to co‐designing solutions based on attitudes towards NMS. Results demonstrated that a data‐driven decision making process to introduce NMS is a viable solution for updating demand for travel in rural areas, offering a broad understanding of mobility needs and the relationship of interdependency with nearby areas, therefore allowing policy makers to create users‐centric transport solutions. The study concludes by drawing recommendations for NMS for passengers and goods for the NMS proposed for a rural areas [Demand Responsive Transport (DRT), Micro‐mobility and delivery drones]. [ABSTRACT FROM AUTHOR]

Access to urban green and blue spaces (UGBSs) has been associated with positive effects on health and wellbeing; however, the past decades have seen a decline in quality and user satisfaction with UGBSs. This reflects the mounting challenges that many UK cities face in providing appropriate public facilities, alongside issues such as health inequalities, an ageing population, climate change, and loss of biodiversity. At present, little is known about the preferences of different population subgroups and, specifically, the UGBSs they visit and the spaces they avoid. Using a public participatory geographic information system (PPGIS), the overall aim of the research presented here was to investigate the preferences of different population subgroups in urban areas, and the UGBSs they visit, using Edinburgh, Scotland as a case study. We created a baseline visitor demographic profile for UGBS use, and highlighted how visitors perceive, physically access, use, and engage with UGBSs. The results revealed considerable variation in UGBS preference: one person's favourite UGBS may be one that someone else dislikes and avoids. It is clear that adapting UGBSs to suit local communities should not be a 'one-size-fits-all' approach. The conflicting views and preferences of different groups of respondents point to the importance of developing policies and park management plans that can accommodate a variety of uses and experiential qualities within individual parks. PPGIS approaches, such as those utilised in this study, offer opportunities to address this issue and provide evidence to increase equitable UGBS usage. [ABSTRACT FROM AUTHOR]

Background: The paper presents an overview of air quality in the 27 member countries of the European Union (EU) and the United Kingdom (previous EU-28), from 2000 to 2017. We reviewed the progress made towards meeting the air quality standards established by the EU Ambient Air Quality Directives (European Council Directive 2008/50/EC) and the World Health Organization (WHO) Air Quality Guidelines by estimating the trends (Mann-Kendal test) in national emissions of main air pollutants, urban population exposure to air pollution, and in mortality related to exposure to ambient fine particles (PM2.5) and tropospheric ozone (O3). Results: Despite significant reductions of emissions (e.g., sulfur oxides: ~ 80%, nitrogen oxides: ~ 46%, non-methane volatile organic compounds: ~ 44%, particulate matters with a diameter lower than 2.5 µm and 10 µm: ~ 30%), the EU-28 urban population was exposed to PM2.5 and O3 levels widely exceeding the WHO limit values for the protection of human health. Between 2000 and 2017, the annual PM2.5-related number of deaths decreased (- 4.85 per 106 inhabitants) in line with a reduction of PM2.5 levels observed at urban air quality monitoring stations. The rising O3 levels became a major public health issue in the EU-28 cities where the annual O3-related number of premature deaths increased (+ 0.55 deaths per 106 inhabitants). Conclusions: To achieve the objectives of the Ambient Air Quality Directives and mitigate air pollution impacts, actions need to be urgently taken at all governance levels. In this context, greening and re‐naturing cities and the implementation of fresh air corridors can help meet air quality standards, but also answer to social needs, as recently highlighted by the COVID-19 lockdowns. [ABSTRACT FROM AUTHOR]

Background: Opioid prescribing has more than doubled in the UK between 1998 and 2016. Potential adverse health implications include dependency, falls and increased health expenditure. Aim: To describe the predictors of long‐term opioid prescribing (LTOP) (≥3 opioid prescriptions in a 90‐day period). Design and setting: A retrospective cross‐sectional study in 41 general practices in South London. Method: Multi‐level multivariable logistic regression to investigate the determinants of LTOP. Results: Out of 320 639 registered patients ≥18 years, 2679 (0.8%) were identified as having LTOP. Patients were most likely to have LTOP if they had ≥5 long‐term conditions (LTCs) (adjusted odds ratio [AOR] 36.5, 95% confidence interval [CI] 30.4‐43.8) or 2‐4 LTCs (AOR 13.8, CI 11.9‐16.1) in comparison to no LTCs, were ≥75 years compared to 18‐24 years (AOR 12.31, CI 7.1‐21.5), were smokers compared to nonsmokers (AOR 2.2, CI 2.0‐2.5), were female rather than male (AOR 1.9, CI 1.7‐2.0) and in the most deprived deprivation quintile (AOR 1.6, CI 1.4‐1.8) compared to the least deprived. In a separate model examining individual LTCs, the strongest associations for LTOP were noted for sickle cell disease (SCD) (AOR 18.4, CI 12.8‐26.4), osteoarthritis (AOR 3.0, CI 2.8‐3.3), rheumatoid arthritis (AOR 2.8, CI 2.2‐3.4), depression (AOR 2.6, CI 2.3‐2.8) and multiple sclerosis (OR 2.5, CI 1.4‐4.4). Conclusion: LTOP was significantly higher in those aged ≥75 years, with multimorbidity or specific LTCs: SCD, osteoarthritis, rheumatoid arthritis, depression and multiple sclerosis. These characteristics may enable the design of targeted interventions to reduce LTOP. [ABSTRACT FROM AUTHOR]

Background: Emerging evidence suggests that walking and cycling for different purposes such as transport or recreation may be associated with different attributes of the physical environment. Few studies to date have examined these behaviour-specific associations, particularly in the UK. This paper reports on the development, factor structure and test-retest reliability of a new scale assessing perceptions of the environment in the neighbourhood (PENS) and the associations between perceptions of the environment and walking and cycling for transport and recreation. Methods: A new 13-item scale was developed for assessing adults' perceptions of the environment in the neighbourhood (PENS). Three sets of analyses were conducted using data from two sources. Exploratory and confirmatory factor analyses were used to identify a set of summary environmental variables using data from the iConnect baseline survey (n = 3494); test-retest reliability of the individual and summary environmental items was established using data collected in a separate reliability study (n = 166); and multivariable logistic regression was used to determine the associations of the environmental variables with walking for transport, walking for recreation, cycling for transport and cycling for recreation, using iConnect baseline survey data (n = 2937). Results: Four summary environmental variables (traffic safety, supportive infrastructure, availability of local amenities and social order), one individual environmental item (street connectivity) and a variable encapsulating general environment quality were identified for use in further analyses. Intraclass correlations of these environmental variables ranged from 0.44 to 0.77 and were comparable to those seen in other similar scales. After adjustment for demographic and other environmental factors, walking for transport was associated with supportive infrastructure, availability of local amenities and general environment quality; walking for recreation was associated with supportive infrastructure; and cycling for transport was associated only with street connectivity. There was limited evidence of any associations between environmental attributes and cycling for recreation. Conclusion: PENS is acceptable as a short instrument for assessing perceptions of the urban environment. Previous findings that different attributes of the environment may be associated with different behaviours are confirmed. Policy action to create supportive environments may require a combination of environmental improvements to promote walking and cycling for different purposes. [ABSTRACT FROM AUTHOR]

Chronic oedema ( CO) is a major clinical problem worldwide, which has many important secondary consequences for health, activity and participation. Effective treatment planning and organisation of services is dependent on an understanding of the condition and its epidemiology. This cross-sectional study was designed to estimate the point prevalence of CO within the health services of one UK urban population and to determine the proportions that have concurrent leg ulceration. Patients with CO in all anatomic sites were ascertained by health care professionals in one acute and one community hospital, all relevant outpatient and community nursing services, general practices and all nursing/residential homes in one urban catchment area (Derby City). The presence and distribution of oedema was confirmed through a brief clinical examination. A battery of demographic and clinical details was recorded for each case. Within the study population of Derby City residents, 971 patients were identified with CO [estimated crude prevalence 3·93 per 1000, 95% confidence interval ( CI) 3·69-4·19]. The prevalence was the highest among those aged 85 or above (28·75 per 1000) and was higher among women (5·37 per 1000) than men (2·48 per 1000). The prevalence among hospital inpatients was 28·5%. Only five (3%) patients in the community population had oedema related to cancer or cancer treatment. Of the 304 patients identified with oedema from the Derby hospitals or community health services, 121 (40%) had a concurrent leg ulcer. Prevalence statistics and current demographic trends indicate that CO is a major and growing health care problem. [ABSTRACT FROM AUTHOR]

Background: Differences in both Sudden Infant Death Syndrome (SIDS) rates and infant care practices between white British and South Asians in UK are well known, but research has not yet examined how these two groups understand and implement SIDS-reduction guidance. This study aimed to discover how white British and Pakistani mothers in Bradford recall, understand and interpret SIDS-reduction guidance, and to explore whether and how they implement this guidance in caring for their infants.Methods: In-depth narrative interviews with 46 mothers (25 white British origin and 21 Pakistani origin) of 8-12 week old infants recruited from the pool of participants enrolled in the 'Born in Bradford' (BiB) cohort study.Results: All mothers were aware of UK SIDS-reduction guidance from leaflets presented to them during antenatal or postnatal interactions with health care providers. Pakistani mothers tended to dismiss the guidance in toto as being irrelevant to their cultural practices; white British mothers dismissed, adapted and adopted aspects of the guidance to suit their preferred parenting decisions and personal circumstances. Many mothers misunderstood or misinterpreted the guidance given and explained their infant care behaviour according to their social and cultural circumstances.Conclusions: Current SIDS reduction information in the UK does not meet the needs of immigrant families, and is easily misinterpreted or misunderstood by mothers from all sections of the community. Tailored information acknowledging cultural differences in infant care practices is vital, as is greater discussion with all mothers about the reasons for SIDS reduction guidance. [ABSTRACT FROM AUTHOR]

This article re-examines the food consumption of working-class households in 1904 and compares the nutritional content of these diets with modern measures of adequacy. We find a fairly steep gradient of nutritional attainment relative to economic class, with high levels of vitamin and mineral deficiency among the very poorest working households. However, we conclude that the average unskilled-headed working household was better fed and nourished than previously thought. When proper allowance is made for the likely consumption of alcohol, household energy intakes were significantly higher still. We investigate the likely impact of contemporary cultural food distribution norms and conclude on the basis of the very limited evidence available that women may have received, on average, about 80 per cent of a man's share of the available food. We adjust energy requirements for likely higher physical activity rates and smaller stature and find that except among the poorest households, early twentieth-century diets were sufficient to provide energy for reasonably physically demanding work. These results are consistent with recent attempts to relate the available anthropometric evidence to long-run trends in food consumption. We also find that the lower tail of the household nutrition distribution drops away very rapidly, so that few households are estimated to have suffered severe food shortages. [ABSTRACT FROM AUTHOR]

The article considers the poetry of Peter Porter and accusations of ungentlemanliness. The article argues that Porter is a metropolitan poet, whose precise references to London (England) city life makes him an "urbane" poet of the city. Porter is an apologist for the essential truth to be found in modern, city living.