The optimum routing of a fleet of trucks of varying capacities from a central depot to a number of delivery points may require a selection from a very large number of possible routes, if the number of delivery points is also large. This paper, after considering certain theoretical aspects of the problem, develops an iterative procedure that enables the rapid selection of an optimum or near-optimum route. It has been programmed for a digital computer but is also suitable for hand computation.

ObjectivesTo investigate whether there is an association between differences in travel time/travel distance to healthcare services and patients' health outcomes and assimilate the methodologies used to measure this.DesignSystematic Review. We searched MEDLINE, Embase, Web of Science, Transport database, HMIC and EBM Reviews for studies up to 7 September 2016. Studies were excluded that included children (including maternity), emergency medical travel or countries classed as being in the global south.SettingsA wide range of settings within primary and secondary care (these were not restricted in the search).Results108 studies met the inclusion criteria. The results were mixed. 77% of the included studies identified evidence of a distance decay association, whereby patients living further away from healthcare facilities they needed to attend had worse health outcomes (eg, survival rates, length of stay in hospital and non-attendance at follow-up) than those who lived closer. 6 of the studies identified the reverse (a distance bias effect) whereby patients living at a greater distance had better health outcomes. The remaining 19 studies found no relationship. There was a large variation in the data available to the studies on the patients' geographical locations and the healthcare facilities attended, and the methods used to calculate travel times and distances were not consistent across studies.ConclusionsThe review observed that a relationship between travelling further and having worse health outcomes cannot be ruled out and should be considered within the healthcare services location debate.

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The availability of food high in fat, salt and sugar through Fast Food (FF) or takeaway outlets, is implicated in the causal pathway for the obesity epidemic. This review aims to summarise this body of research and highlight areas for future work. Thirty three studies were found that had assessed the geography of these outlets. Fourteen studies showed a positive association between availability of FF outlets and increasing deprivation. Another 13 studies also included overweight or obesity data and showed conflicting results between obesity/overweight and FF outlet availability. There is some evidence that FF availability is associated with lower fruit and vegetable intake. There is potential for land use policies to have an influence on the location of new FF outlets. Further research should incorporate good quality data on FF consumption, weight and physical activity.

This paper attempts to quantify patterns of access to food retailing in two urban areas (Leeds/Bradford and Cardiff). We introduce, first, a locally based mapping approach and, secondly, a systematic city-wide modelling approach. This quantifies provision levels in terms of modelling shopping flows, in order to identify areas of poor access to food retailing. The paper then compares these contrasting methods of identifying 'food deserts', using the study areas of Leeds/Bradford and Cardiff. Two 'what if' type analyses are also undertaken (one in Leeds, one in Cardiff) to investigate the impact on 'food deserts' of opening new food retailing stores.

In this paper we present an account of a 3-year research project that is aimed at dynamically simulating urban and regional populations in Britain. In the context of this project we are using data from the 1991 UK Census Small Area Statistics (SAS) and the British Household Panel Survey (BHPS), in order to dynamically simulate the entire population of Britain into 2021 at the small area level. This paper discusses the structure, aims and objectives of SimBritain and presents some preliminary results. Firstly, alternative spatial microsimulation strategies are discussed and their advantages and drawbacks are outlined. Next, the difficulties in calibrating and validating dynamic microsimulation models such as SimBritain are highlighted and ways to tackle these difficulties are explored. The paper then presents some model outputs that highlight the geographical variation of a wide range of socio-economic variables through the 1990s. Moreover, in light of these outputs, the paper discusses the potential of SimBritain for policy analysis.

This study employed the theory of planned behaviour (TPB) and additional variables (descriptive norm, moral norm, self-identity) to investigate the factors underlying breastfeeding intention and subsequent breastfeeding at four time points (during hospital stay, at hospital discharge, 10 days postpartum and 6 weeks postpartum) in a sample of women selected from defined areas of economic hardship (N = 248). A model containing the TPB, additional variables and demographic factors provided a good prediction of both intention (R (2) = 0.72; attitude, perceived behavioural control, moral norm and self-identity significant predictors) and behaviour - breastfeeding at birth (88.6% correctly classified; household deprivation, intention, attitude significant), at discharge from hospital (87.3% correctly classified; intention, attitude significant), 10 days after discharge (83.1% correctly classified; education, intention, attitude, descriptive norm significant) and 6 weeks after discharge (78.0% correctly classified; age, household deprivation, ethnicity, moral norm significant). Implications for interventions are discussed, such as the potential usefulness of targeting descriptive norms, moral norms and perceived behavioural control (PBC) when attempting to increase breastfeeding uptake.

Healthy 18 Dietary pattern 19 Diet cost 20 UK W C Study 21 22Word count = 3028 23 ABSTRACT: 24 Background: 25A healthy diet is important to promote health and wellbeing whilst preventing chronic disease. 26However, the monetary cost of consuming such a diet can be a perceived barrier. This study will 27 investigate the cost of consuming a range of dietary patterns. 28 Methods: 29A cross sectional analysis, where cost of diet was assigned to dietary intakes recorded using a Food 30Frequency Questionnaire. A mean daily diet cost was calculated for seven data driven dietary 31 patterns. These dietary patterns were given a healthiness score according to how well they comply 32 with the UK Department of Health's Eatwell Plate guidelines. This study involved ~35000 women 33 recruited in the 1990s into the UK Women's Cohort Study. 34 Results: 35A significant positive association was observed between diet cost and healthiness of the diet (p for 36 trend >0.001). The healthiest dietary pattern was double the price of the least healthy, £6.63/day and 37 £3.29/day respectively. Dietary diversity, described by the patterns, was also shown to be associated 38