A narrative review of gated communities and the transformative social impact in Middle Eastern Cities

The rise of gated communities in the Middle East is vastly spreading, driven by socioeconomic fluctuations and a desire for exclusivity. This article aims to contribute to the scholarly debates on the socio-spatial impacts of gated communities by presenting a narrative review that synthesises findings from peer-reviewed articles in the Middle East and the Gulf Cooperation Council (GCC). The study suggests that residents of gated communities benefit from positive attributes, including security, lifestyle, and exclusivity. However, negative influences, including segregation and separation, extend beyond the walls, impacting the surrounding communities. This article argues that the spread of gated communities represents a trend of luxury and exclusivity for affluent individuals, largely driven by developers. It concludes that while gated communities offer several positive attributes, these benefits are limited to a specific group residing within their walls. Planners and policymakers are encouraged to leverage these benefits and incorporate them in future designs

Exploring Non-invasive Brain Stimulation Effects on Physical Outcomes in People With Parkinson’s Disease: An Umbrella Evidence Mapping Review With Meta-analyses

Background. Non-invasive brain stimulation (NIBS) is sometimes used alongside medication to alleviate motor symptoms in people with Parkinson’s disease (PD). However, the evidence supporting NIBS’s effectiveness for improving motor function in PD patients is uncertain. Objective. This umbrella review aims to synthesize recent systematic reviews and meta-analyses that have evaluated the effectiveness of NIBS in improving motor function in people with PD, with a key focus being to examine the quality of the evidence presented. Methods. The review protocol was registered in PROSPERO (CRD42022380544) and conducted per Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The search strategy was guided by the Population, Intervention, Comparison, and Outcome framework, focusing on individuals with idiopathic PD (Hoehn and Yahr stages 1-4). The review included studies comparing various NIBS techniques (eg, repetitive transcranial magnetic stimulation and transcranial direct current stimulation) to sham or alternative treatments, targeting motor and cognitive regions. Six databases were searched up to June 2024. Methodological quality was assessed using Assessment of Multiple Systematic Reviews 2 (AMSTAR2), and random-effects meta-analyses were performed to pool standardized mean differences (SMDs). Results. The final analysis included 31 meta-analyses and 10 systematic reviews. Overall, the reviews were rated as moderate quality (54% average for AMSTAR2). NIBS showed a small-to-moderate effect on motor function (Unified Parkinson’s Disease Rating Scale-Section III scores; SMD = −0.80), functional mobility (gait speed and timed-up-and-go; SMD = −0.39), and freezing of gait (SMD = −0.58), but no significant effect on balance. Conclusion. NIBS offers small-to-moderate benefits for motor symptoms and functional movement in PD, though it does not significantly impact balance. Practitioners should consider the variety of techniques and treatment parameters before application

‘Changing the Focus’: Co-Design of a Novel Approach for Engaging People with Dementia in Physical Activity

Background: Promoting physical activity among people living with dementia is critical to maximise physical, cognitive and social benefits; yet the lack of knowledge, skills and confidence among health professionals, informal care partners and people with dementia deters participation. As the initial phase of a larger feasibility study, co-design was employed to develop a new model of community care, ‘Changing the Focus’, to facilitate the physical activity participation of older people living with mild dementia. Methods: Co-design methodology was utilised with nine stakeholders (with experience in referring to or providing physical activity programs and/or contributing to policy and program planning) over three workshops plus individual interviews with four care partners of people with dementia. Insights were gathered on the physical activity for people with mild dementia, referral pathways were explored and ‘personas’ were developed and refined. Materials and resources to support exercise providers and referrers to work effectively with people with mild dementia were finalised. Results: Three ‘personas’ emerged from the co-design sessions, aligned with stages of behaviour change: (1) hesitant to engage; (2) preparing to engage; and (3) actively engaged. Referral pathway discussions identified challenges related to limited resources, limited knowledge, access constraints and individual factors. Opportunities were classified as using champions, streamlining processes, recognising triggers for disengagement, influencing beliefs and attitudes, and means of communication. Conclusion: This study captured the views of physical activity referrers and providers and informal care partners in an inclusive and iterative manner. The use of co-design ensured a robust approach to facilitating participation in formal and informal physical activity options for people living with mild dementia. This study has provided the necessary framework from which to develop and test training and resources for the next stage of intervention (a feasibility trial) to improve physical activity participation for people with dementia