Exploring expectations and lived experiences of Low Traffic Neighbourhoods in Birmingham, UK

In the UK, urban environments suffer disproportionately from pollution and community severance due to private vehicle use and related infrastructure. During the COVID-19 pandemic, local authorities implemented Low Traffic Neighbourhoods (LTN) to encourage active travel and improve urban residential environments. This research explored people’s expectations and lived experience of two LTNs in Birmingham, a large city, providing insights for future schemes. Birmingham City Council held pre-LTN (July-November 2020) and post-LTN consultations (February-April 2021). A qualitative thematic analysis of respondents’ responses explored thoughts on local transport issues, expectations, and lived experiences of LTNs. There were 3751 and 791 responses to pre- and post-LTN consultations. Most respondents were female local residents; with 45-54 years olds the most frequent responders. Overarching categories: (i) Pre-LTN transport concerns and proposed solutions; (ii) Anticipated and reported benefits from the LTN and (ii) Anticipated and reported disadvantages from the LTN. Cited benefits included reduced traffic and safety concerns, increased active transport and an improved sense of community. Disadvantages included frustration, inconvenience and great resentment between residents of roads with and without filters. Both support and opposition to LTNs was found. LTNs addressed some, but not all local traffic concerns. Feelings of discrimination were noted by residents of streets without filters; high street residents encountering displaced traffic and disabled car users. Piecemeal LTN implementation may undermine community cohesion. Networks of modal filters across neighbouring residential areas with measures addressing the interplay between residential, business, school and faith environments and additional measures supporting boundary roads may maximise LTN benefits

The treatment of postnatal depression with exercise: a randomised controlled trial, qualitative study and systematic review

This thesis investigated the effectiveness of exercise in the treatment of postnatal depression (PND). PND is highly prevalent, affecting mothers, families and child development. Exercise is currently recommended to mothers with PND, potentially offering fewer side effects than antidepressants and wider accessibility than psychological treatments. This thesis reported three studies. A randomised controlled trial (RCT) investigated the effectiveness of an exercise counselling intervention, in addition to usual care, in treating PND. This intervention provided a moderate, non-significant decrease in depression compared to usual care alone. A qualitative study found that exercise was viewed as acceptable and often preferable to antidepressants in the treatment of PND. A range of mechanisms via which exercise produced psychosocial benefits were proposed, including improving self-confidence and supporting personal identity after childbirth. A systematic review with meta-analysis of RCTs of exercise interventions for PND concluded that exercise can be effective in reducing depression in general and depressed postnatal populations. Preliminary findings suggested the importance of social support within such interventions. Exercise is likely to be effective in the treatment of PND and should therefore be recommended to mothers. However, further research investigating the relative effectiveness of different intervention designs would be valuable

Does aerobic exercise reduce postpartum depressive symptoms? A systematic review and meta-analysis

Background There is currently no specific guidance on the role of exercise in managing postpartum depression in the UK and US, and international guidance is inconsistent. Aim To assess the effectiveness of aerobic exercise on postpartum depressive symptoms. Design and setting Systematic review and meta-analysis. There was no restriction to study site or setting. Method The databases MEDLINE, EMBASE, Cochrane Library, PsycINFO, SportDiscus, Clinical Trials.gov, and the World Health Organization International Clinical Trials Registry Platform were searched. Titles and abstracts, then full-text articles, were screened against inclusion criteria: RCTs measuring depressive symptoms in mothers ≤1 year postpartum; and interventions designed to increase aerobic exercise compared with usual care or other comparators. Included studies were assessed using the Cochrane Collaboration's risk of bias tool. Meta-analysis was conducted. Pre-planned subgroup analyses explored heterogeneity. Results Thirteen RCTs were included, with 1734 eligible participants. Exercise significantly reduced depressive symptoms when all trials were combined (standardised mean difference -0.44; 95% confidence interval = -0.75 to -0.12). Exploration of heterogeneity did not find significant differences in effect size between women with possible depression and in general postpartum populations; exercise only and exercise with co-interventions; and group exercise and exercise counselling. Conclusion This systematic review provides support for the effectiveness of exercise in reducing postpartum depressive symptoms. Group exercise, participant-chosen exercise, and exercise with co-interventions all may be effective interventions. These results should be interpreted with caution because of substantial heterogeneity and risk of bias

Variations in party line information requirements for flight crew situation awareness in the datalink environment

Thesis (M.S.)--Massachusetts Institute of Technology, Dept. of Aeronautics and Astronautics, 1994.Includes bibliographical references (leaf 76).by Amy R. Pritchett.M.S

Indonesia Economic and Social Update

http://documents1.worldbank.org/curated/en/556241468268211077/pdf/512020BRI0Box31update0brief0jan2000.pd

The effect of early postnatal discharge from hospital for women and infants: a systematic review protocol

BackgroundThe length of postnatal hospital stay has declined over the last 40 years. There is little evidence to support a policy of early discharge following birth, and there is some concern about whether early discharge of mothers and babies is safe. The Cochrane review on the effects of early discharge from hospital only included randomised controlled trials (RCTs) which are problematic in this area, and a systematic review including other study designs is required. The aim of this broader systematic review is to determine possible effects of a policy of early postnatal discharge on important maternal and infant health-related outcomes.Methods/designA systematic search of published literature will be conducted for randomised controlled trials, non-randomised controlled trials (NRCTs), controlled before-after studies (CBA), and interrupted time series studies (ITS) that report on the effect of a policy of early postnatal discharge from hospital. Databases including Cochrane CENTRAL, MEDLINE, EMBASE, CINAHL and Science Citation Index will be searched for relevant material. Reference lists of articles will also be searched in addition to searches to identify grey literature. Screening of identified articles and data extraction will be conducted in duplicate and independently. Methodological quality of the included studies will be assessed using the Effective Practice and Organisation of Care (EPOC) criteria for risk of bias tool. Discrepancies will be resolved by consensus or by consulting a third author. Meta-analysis using a random effects model will be used to combine data. Where significant heterogeneity is present, data will be combined in a narrative synthesis. The findings will be reported according to the preferred reporting items for systematic reviews (PRISMA) statement.DiscussionInformation on the effects of early postnatal discharge from hospital will be important for policy makers and clinicians providing maternity care. This review will also identify any gaps in the current literature on this topic and provide direction for future research in this area of study.Systematic review registrationPROSPERO CRD42015020545<br/

Can behaviour during immunisation be used to identify attachment patterns? A feasibility study

&lt;b&gt;Background&lt;/b&gt; Infant attachment is a strong predictor of mental health, and current measures involve placing children into a stressful situation in order to observe how the child uses their primary caregiver to assuage their distress.&lt;p&gt;&lt;/p&gt; &lt;b&gt;Objectives&lt;/b&gt; This study aimed to explore observational correlates of attachment patterns during immunisation.&lt;p&gt;&lt;/p&gt; &lt;b&gt;Participants and setting&lt;/b&gt; 18 parent–child pairs were included in the study. They were all recruited through a single general medical practice.&lt;p&gt;&lt;/p&gt; &lt;b&gt;Methods&lt;/b&gt; Infant immunisation videos were observed and coded for parenting behaviours as well as pain promoting and pain reducing strategies. Results were compared between different attachment groups, as measured with the Manchester Child Attachment Story Task. &lt;p&gt;&lt;/p&gt; &lt;b&gt;Results&lt;/b&gt; Parents of securely attached children scored higher on positive Mellow Parenting Observational System behaviours, but not at a statistically significant level. Parents of securely attached children were also significantly more likely to engage in pain reducing behaviours (p &lt;0.01) than parents of insecurely attached children.&lt;p&gt;&lt;/p&gt; &lt;b&gt;Conclusions&lt;/b&gt; Robust composite measures for attachment informative behaviours in the immunisation situation should be developed and tested in a fully powered study

Women’s experiences of exercise as a treatment for their postnatal depression:a nested qualitative study

Women with postnatal depression are often reluctant to take medication postnatally and access to psychological therapies is limited. Exercise offers a freely available treatment option but depressed mothers’ experience of exercise has not been investigated. We conducted a qualitative study nested within a randomised trial of an exercise intervention for women with postnatal depression. Women described deterioration in their sense of identity postnatally and through experiencing depression and described the positive impact exercise had on their sense of self. Views of exercise as treatment for postnatal depression ranged from doubts about its practicality to positive comparisons with other traditional treatments and to improved recovery