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.