BACKGROUND: Walking school buses (WSBs) offer a potentially healthier way for children to get to school while reducing traffic congestion. A number of pressing societal challenges make it timely to evaluate evidence of their value.METHODS: Studies that focused solely on WSBs were identified through online and manual literature searches. Twelve WSB studies involving a total of 9169 children were reviewed. Study aims, designs, methods, outcomes, and barriers and facilitators were examined.RESULTS: WSBs were found to be associated with increased prevalence of walking to school and general activity levels although not always significantly. Time constraints emerged as barriers to WSBs, impacting on recruitment of volunteers and children to the WSBs. Facilitators of WSBs included children enjoying socializing and interacting with the environment.CONCLUSIONS: Preliminary evidence of the health value of WSBs was demonstrated, along with recommendations for the design of future studies. By tackling barriers of time constraints, volunteer recruitment, and parents' safety concerns while at the same time, increasing convenience and time savings for families, future WSBs are likely to be more sustainable and taken up by more schools. Implications for future innovation in school health were identified.

The concept of transporting medical products by drone is gaining a lot of interest amongst the medical and logistics communities. Such innovation has generated several questions, a key one being the potential effects of flight on the stability of medical products. The aims of this study were to quantify the vibration present within drone flight, study its effect on the quality of the medical insulin through live flight trials, and compare the effects of vibration from drone flight with traditional road transport. Three trials took place in which insulin ampoules and mock blood stocks were transported to site and flown using industry standard packaging by a fixed-wing or a multi-copter drone. Triaxial vibration measurements were acquired, both in-flight and during road transit, from which overall levels and frequency spectra were derived. British Pharmacopeia quality tests were undertaken in which the UV spectra of the flown insulin samples were compared to controls of known turbidity. In-flight vibration levels in both the drone types exceeded road induced levels by up to a factor of three, and predominant vibration occurred at significantly higher frequencies. Flown samples gave clear insulin solutions that met the British Pharmacopoeia specification, and no aggregation of insulin was detected.

There is increasing interest in how horizontal collaboration between parcel carriers might help alleviate problems associated with last-mile logistics in congested urban centers. Through a detailed review of the literature on parcel logistics pertaining to collaboration, along with practical insights from carriers operating in the United Kingdom, this paper examines the challenges that will be faced in optimizing multi-carrier, multidrop collection, and delivery schedules. A “freight traffic controller” (FTC) concept is proposed. The FTC would be a trusted third party, assigned to equitably manage the work allocation between collaborating carriers and the passage of vehicles over the last mile when joint benefits to the parties could be achieved. Creating this FTC concept required a combinatorial optimization approach for evaluation of the many combinations of hub locations, network configuration, and routing options for vehicle or walking to find the true value of each potential collaboration. At the same time, the traffic, social, and environmental impacts of these activities had to be considered. Cooperative game theory is a way to investigate the formation of collaborations (or coalitions), and the analysis used in this study identified a significant shortfall in current applications of this theory to last-mile parcel logistics. Application of theory to urban freight logistics has, thus far, failed to account for critical concerns including ( a) the mismatch of vehicle parking locations relative to actual delivery addresses; ( b) the combination of deliveries with collections, requests for the latter often being received in real time during the round; and ( c) the variability in travel times and route options attributable to traffic and road network conditions.

Commercial operations of uncrewed aerial vehicles (UAVs or drones) are expanding, with medical logistics using UAVs as part of health service supply chains being targeted. The ability to transport cargos that include items classified as Dangerous Goods (DG) is a significant factor in enabling UAV logistics to assist medical supply chains, but DG regulations for air transport have developed from the perspective of crewed aircraft and not UAVs. This paper provides an important audit of the current DG regulations, best practice in their application and the development of much-needed new governance that will be required to fully exploit UAVs for the safe transport of DG in medical logistics. Findings from the audit provide a summary of the circumstances and potential challenges resulting from the application of DG regulations as they stand to UAV operations, particularly for medical logistics, and convenient guidance on the practical implications of DG regulations for UAV operators. The main conclusion is that this is an under-researched domain, not yet given full consideration in a holistic way by regulators, governments, industry bodies, practitioners or academia.

The timely distribution of medicines to patients is an essential part of the patient care plan, and maximising efficiency in the logistics systems behind these movements is vital to minimise cost. Before drones can be used for moving medical cargo, medical regulatory authorities require assurance that the transported products will not be adversely affected by in-flight conditions unique to each drone. This study set out to (i) quantify the vibration profile by phases of flight, (ii) determine to what extent there were significant differences in the observed vibration between the phases, and (iii) assess the quality of flown monoclonal antibody (mAb) infusions used in the treatment of cancer. Vibrations emanating from the drone and transmitted through standard medical packaging were monitored with the storage specifications for mean kinematic temperature (2–8 °C) being met. Vibration levels were recorded between 1.5 and 3 g, with the dominant octave band being 250 Hz. After 60 flights, the quality attributes of flown infusions regarding size integrity were found to be no different from those of the control infusions. For example, the particle size had a variation of less than 1 nm; one peak for Trastuzumab was 14.6 ± 0.07 nm, and Rituximab was 13.3 ± 0.90 nm. The aggregation (%) and fragmentation (%) remained at 0.18 ± 0.01% and 0.11 ± 0.02% for Trastuzumab, 0.11 ± 0.01% and 2.82 ± 0.15% for Rituximab. The results indicated that in the case of mAbs, the quality assurance specifications were met and that drone vibration did not adversely affect the quality of drone-flown medicines.