Background Little information is available about the geo-economic variations in demographics, management, and outcomes of patients with acute respiratory distress syndrome (ARDS). We aimed to characterise the effect of these geo-economic variations in patients enrolled in the Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure (LUNG SAFE). Methods LUNG SAFE was done during 4 consecutive weeks in winter, 2014, in a convenience sample of 459 intensivecare units in 50 countries across six continents. Inclusion criteria were admission to a participating intensive-care unit (including transfers) within the enrolment window and receipt of invasive or non-invasive ventilation. One of the trial's secondary aims was to characterise variations in the demographics, management, and outcome of patients with ARDS. We used the 2016 World Bank countries classification to define three major geo-economic groupings, namely European high-income countries (Europe-High), high-income countries in the rest of the world (rWORLD-High), and middle-income countries (Middle). We compared patient outcomes across these three groupings. LUNG SAFE is registered with ClinicalTrials.gov, number NCT02010073. Findings Of the 2813 patients enrolled in LUNG SAFE who fulfilled ARDS criteria on day 1 or 2, 1521 (54%) were recruited from Europe-High, 746 (27%) from rWORLD-High, and 546 (19%) from Middle countries. We noted significant geographical variations in demographics, risk factors for ARDS, and comorbid diseases. The proportion of patients with severe ARDS or with ratios of the partial pressure of arterial oxygen (PaO 2) to the fractional concentration of oxygen in inspired air (F I O 2) less than 150 was significantly lower in rWORLD-High countries than in the two other regions. Use of prone positioning and neuromuscular blockade was significantly more common in Europe-High countries than in the other two regions. Adjusted duration of invasive mechanical ventilation and length of stay in the intensive-care unit were significantly shorter in patients in rWORLD-High countries than in Europe-High or Middle countries. High gross national income per person was associated with increased survival in ARDS; hospital survival was significantly lower in Middle countries than in Europe-High or rWORLD-High countries. Interpretation Important geo-economic differences exist in the severity, clinician recognition, and management of ARDS, and in patients' outcomes. Income per person and outcomes in ARDS are independently associated.

The present paper deals with bandwidth allocation and congestion avoidance in a broadband satellite with on‐board switching, oriented towards guaranteeing the Quality of Service (QoS) associated with various traffic/service classes as defined by ATM forum. At the core of the bandwidth allocation a novel uplink (UL) access protocol is proposed, based on a Multi‐Frequency Time Division Multiple Access (MF‐TDMA) primary access scheme, in conjunction with a downlink (DL) access protocol based on a more traditional Time Division Multiplex (TDM) scheme. This UL access protocol is complemented by a rate‐based congestion control protocol (consistent with ATM Forum recommendations), which is an adaptation to GEO satellites environment of the Explicit Rate Indication for Congestion Avoidance (ERICA) algorithm developed for terrestrial networks. The performance of both UL access and congestion avoidance schemes has been evaluated through extensive simulations and the results compared with those obtained with other protocols or by analytical approximations. Copyright © 1999 John Wiley & Sons, Ltd.

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An activity-based approach is used to analyse one specific short-trip purpose that has persistently frustrated transport analysts trying to induce more walk, cycle or public transport based trips. This study of the journey-to-school trip is motivated by a general consensus that, to effect a more sustainable transport system, there is a necessity to reduce car use (especially for short trips). Resistance to modal transfer from cars has been shown to be embedded in various psycho-social obstacles which are not readily teased out in orthodox econometric studies of travel demand. We report on an empirical study which fuses psychometric (construction of coping scales) and econometric analyses (logit analysis) in an attempt to uncover the psychological and sociological factors influencing modal choice, as well as the usual range of economic and demographic factors.

The tax treatment of employer commuting support: an international review his item ws sumitted to voughorough niversity9s snstitutionl epository y theGn uthorF Citation: yiD F FFF et lD PHHTF he tx tretment of employer ommutE ing supportX n interntionl reviewF rnsport reviewsD PT @PAD ppF PPIEPQU Additional Information:• his is journl rtileF st ws pulished in the journlD rnsport reviews ylor 8 prnisF he definitive version is ville tX httpXGGwwwFinformworldFomGsmppGtitle£ ontentatUIQUTTWQU AbstractCorrectly pricing transport behaviour to take account of the 'external' costs such as congestion, and emissions imposed on society by excessive car use has long been a tenet of effective Transportation Demand Management. But while policy makers have striven to increase public transport subsidies, raise petrol taxes, and introduce road user charging schemes to properly price the real costs of car travel, in most cases correcting the wider influences of the personal tax regime has begun only relatively recently. This paper is based on work undertaken for the Department of the Environment, Transport, and the Regions, and the Inland Revenue of the United Kingdom Government, which is currently working on addressing this very issue. In addition to reporting the British situation, it also uses a series of case studies to outline how this same process has been approached in the United States, Ireland, Germany, Netherlands, Switzerland and Norway, and at how successful they have been thus far with respect to TDM objectives. It then draws conclusions as to which direction policy makers should be aiming for in the future. * Corresponding author.Potter, Enoch, Rye, Black and Ubbels 2 Tax and Transport PolicyIn recent years there have been increasingly strong linkages between national fiscal systems and environmental and transport objectives. This initially involved the 'eco-reform' of existing tax instruments, but the policy agenda has since moved on towards additional and replacement tax measures. Such policy developments are most advanced in Europe and some Pacific Rim nations, but have yet to have a serious impact in the Americas. Within the European Union (EU) the policy of the European Commission (EC) has been outlined in documents such as 'Towards Fair and Efficient Pricing' (CEC, 1995), and 'Fair Payment for Infrastructure Use' (CEC, 1998), which broadly advocate that transport infrastructure charges should normally reflect the marginal social costs at the point of use. These marginal social costs should include not only marginal wear and tear costs on infrastructure, but also 'external' costs imposed on society, the environment and the wider economy through accidents, pollution, emission of climate change gasses, congestion etc.. While regulatory and physical design mechanisms are also recognized as having an important role to play, in the long run it is tax and charging instruments that the EC sees as being most effective at encouraging efficient and sustainable transport systems. This economic argument is well known, bu...