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This study is a follow-up to our 2012 report for Greener Journeys on Buses and Economic Growth. Now, we drill deeper so as to improve understanding of the links between bus service and the wider economy and how these linkages could be taken into account in bus policy analysis. Among the key facilitating roles of the bus are: providing access to jobs, access to shopping and leisure facilities especially in town and city centres and as a form of social insurance fall back.

This paper presents the results of simulating the effects of introducing competition on a long distance international rail passenger route where there is also a strong domestic market served by high speed trains. We are aware of a number of proposals to introduce new services in such circumstances. It has allowed for the fact that on such a service seat reservations are likely to be compulsory and yield management practiced, so that whatever is initially assumed about fares there will be further endogenous changes in average fares to maintain high load factors. It is found that on-track competition has benefits to consumers, in terms of fares and services, but that it would reduce the profitability of the incumbent and that it would be difficult for the new entrant to attain profitability unless its costs were significantly lower than those of the incumbent. A large part of the revenue of the entrant on this route would come from the domestic market, and if open access competition were permitted then the entrant might seek to run a frequent service offering head on competition on this part of the route. However, again it would appear that both operators would make heavy losses in this situation. One way of restoring profitability might be to reduce track access charges, but that would require additional government subsidy to the infrastructure manager, as the additional train kilometres run would not compensate for the lower charges. An alternative way of seeking to achieve the same result as on track competition in terms of reduced costs and innovation whilst preserving economies of density would be to award a monopoly franchise by means of competitive tendering. Franchising has generally succeeded in raising rail demand and reducing costs, although in the one example where inter-city services were franchised – Britain – costs have actually risen. Thus unless this is due to peculiarities of the British situation which would not exist elsewhere, on track competition may still have a role in reducing costs.

Summary Background Many randomised controlled trials have investigated the effect of adjuvant chemotherapy in operable non-small-cell lung cancer. We undertook two comprehensive systematic reviews and meta-analyses to establish the effects of adding adjuvant chemotherapy to surgery, or to surgery plus radiotherapy. Methods We included randomised trials, not confounded by additional therapeutic differences between the two groups and that started randomisation on or after Jan 1, 1965, which compared surgery plus adjuvant chemotherapy versus surgery alone, or surgery plus adjuvant radiotherapy and chemotherapy versus surgery plus adjuvant radiotherapy. Updated individual patient data were collected, checked, and included in meta-analyses stratified by trial. The primary endpoint was overall survival, defined as time from randomisation until death by any cause. All analyses were by intention to treat. Findings The first meta-analysis of surgery plus chemotherapy versus surgery alone was based on 34 trial comparisons and 8447 patients (3323 deaths). We recorded a benefit of adding chemotherapy after surgery (hazard ratio [HR] 0·86, 95% CI 0·81–0·92, p

The aim of this paper is to examine the feasibility of identifying an appropriate rail scarcity charge which would make operators pay for their use of rail capacity in line with the opportunity cost of the use of these slots and to give some idea of the likely effects of such charges. The way in which we do this is to use a passenger demand forecasting model, PRAISE, to consider a situation on the East Coast Main Line which is characterized by scarce capacity and a degree of competition.

For preliminary evaluation of the temporal bone, a combination of conventional radiographs and hypocycloidal tomography in the frontal projection is advocated. If significant abnormalities are detected in this screening survey, a more in-depth study can then be pursued.

International audience; BackgroundChemotherapy combined with radiotherapy is the standard treatment of “limited-stage” small-cell lung cancer. However, controversy persists over the optimal timing of thoracic radiotherapy and chemotherapy.Material and methodsWe performed a meta-analysis of individual patient data in randomised trials comparing earlier versus later radiotherapy, or shorter vs. longer radiotherapy duration, as defined in each trial. We combined the results from trials using the stratified log-rank test to calculate pooled hazard ratios (HRs). The primary outcome was overall survival.ResultsTwelve trials with 2,668 patients were eligible. Data from nine trials comprising 2,305 patients were available for analysis. The median follow-up was 10 years. When all trials were analysed together, “earlier or shorter” vs. “later or longer” thoracic radiotherapy did not affect overall survival. However, the HR for overall survival was significantly in favour of “earlier or shorter” radiotherapy among trials with a similar proportion of patients who were compliant with chemotherapy (defined as having received 100% or more of the planned chemotherapy cycles) in both arms (HR 0.79, 95% CI 0.69–0.91) and in favour of “later or longer” radiotherapy among trials with different chemotherapy compliance (HR 1.19, 1.05–1.34, interaction test p