Road Traffic Injury Prevention Initiatives: A Systematic Review and Metasummary of Effectiveness in Low and Middle Income Countries.

BACKGROUND: Road traffic injuries (RTIs) are a growing but neglected global health crisis, requiring effective prevention to promote sustainable safety. Low- and middle-income countries (LMICs) share a disproportionately high burden with 90% of the world's road traffic deaths, and where RTIs are escalating due to rapid urbanization and motorization. Although several studies have assessed the effectiveness of a specific intervention, no systematic reviews have been conducted summarizing the effectiveness of RTI prevention initiatives specifically performed in LMIC settings; this study will help fill this gap. METHODS: In accordance with PRISMA guidelines we searched the electronic databases MEDLINE, EMBASE, Scopus, Web of Science, TRID, Lilacs, Scielo and Global Health. Articles were eligible if they considered RTI prevention in LMICs by evaluating a prevention-related intervention with outcome measures of crash, RTI, or death. In addition, a reference and citation analysis was conducted as well as a data quality assessment. A qualitative metasummary approach was used for data analysis and effect sizes were calculated to quantify the magnitude of emerging themes. RESULTS: Of the 8560 articles from the literature search, 18 articles from 11 LMICs fit the eligibility and inclusion criteria. Of these studies, four were from Sub-Saharan Africa, ten from Latin America and the Caribbean, one from the Middle East, and three from Asia. Half of the studies focused specifically on legislation, while the others focused on speed control measures, educational interventions, enforcement, road improvement, community programs, or a multifaceted intervention. CONCLUSION: Legislation was the most common intervention evaluated with the best outcomes when combined with strong enforcement initiatives or as part of a multifaceted approach. Because speed control is crucial to crash and injury prevention, road improvement interventions in LMIC settings should carefully consider how the impact of improvements will affect speed and traffic flow. Further road traffic injury prevention interventions should be performed in LMICs with patient-centered outcomes in order to guide injury prevention in these complex settings.

Developing “middle leaders” in the public services? The realities of management and leadership development for public managers

Purpose – This paper aims to assess the actual contribution to organisational change of management and leadership development (MLD) activity for middle managers (MMs) in public service organisations (PSOs). Design/methodology/approach – Using the case study approach, the paper compares the content and outcomes of management and leadership training interventions for MMs in two large PSOs. The organisations, a fire brigade and a train operating company, are leaders in their sectors with respect to management development and “modernisation” of their services. Findings – The paper demonstrates how, in one case, MM development was largely an exercise in regulatory compliance, with little effect on individual MMs' performance or organisational outcomes. The second case demonstrates how MMs were effectively trained to enforce specific human resource policies which contributed to the successful implementation of top-down strategy yet paid little attention to the potential leadership role of MMs. Research limitations/implications – The paper highlights the need for further contextualised research at organisational level into the outcomes of MLD, especially in terms of different public service contexts. Practical implications – The paper demonstrates the dangers of designing and implementing development programmes without sufficient regard to professional practice and the realities of managerial discretion in PSOs. Originality/value – The paper provides an in-depth and contextualised insight into the conditions for success and failure in management development interventions in PSOs.

A systematic review of the effect of dietary exposure that could be achieved through normal dietary intake on learning and performance of school-aged children of relevance to UK schools

The aim of the present review was to perform a systematic in-depth review of the best evidence from controlled trial studies that have investigated the effects of nutrition, diet and dietary change on learning, education and performance in school-aged children (4-18 years) from the UK and other developed countries. The twenty-nine studies identified for the review examined the effects of breakfast consumption, sugar intake, fish oil and vitamin supplementation and 'good diets'. In summary, the studies included in the present review suggest there is insufficient evidence to identify any effect of nutrition, diet and dietary change on learning, education or performance of school-aged children from the developed world. However, there is emerging evidence for the effects of certain fatty acids which appear to be a function of dose and time. Further research is required in settings of relevance to the UK and must be of high quality, representative of all populations, undertaken for longer durations and use universal validated measures of educational attainment. However, challenges in terms of interpreting the results of such studies within the context of factors such as family and community context, poverty, disease and the rate of individual maturation and neurodevelopment will remain. Whilst the importance of diet in educational attainment remains under investigation, the evidence for promotion of lower-fat, -salt and -sugar diets, high in fruits, vegetables and complex carbohydrates, as well as promotion of physical activity remains unequivocal in terms of health outcomes for all schoolchildren.

A new 14+: vocational diplomas and the future of schools, colleges and universities. An educational and campaigning pamphlet

Written in an accessible and campaigning style, this pamphlet affords a valuable context to the introduction of the first group of specialist diplomas for 14 year olds in September 2008. The diplomas are the latest in a line of failed initiatives that have sought to provide vocational ‘alternatives’ for those young people staying in full-time education and not considered ‘academic’. Rather than developing any useful employment skills, Allen and Ainley argue that their introduction reflects the changing significance of education in the division and social control of learners that now extends from school to college and on to university. Those who are opposed to the current post-14 agenda, must not only put forward radical alternatives to the current curriculum offer but also, the authors argue, address issues of democracy and accountability. To do this, teacher trade unionists must make new types of alliances with local communities and also with their students.

The Tamaricetea arceuthoidis: a new class for the continental riparian thickets of the Middle East, Central Asia and the subarid regions of the Lower Volga valley

The new class, the Tamaricetea arceuthoidis, is described covering riparian and intermittent shrubby vegetation of the Irano-Turanian Region in the southwestern and Central Asia and the Lower Volga valley. The dominating species are species of the genus Tamarix that refer high water table in arid and semi-arid habitats with high to moderate salinity. This new class is an ecological analogon of the Nerio-Tamaricetea occurring in the Mediterranean Basin.

Sex Education in Northern Ireland Schools: a Critical Evaluation.

To date there has been little research on young people and sexuality in Northern Ireland. This paper draws on the first major study in this area to analyse the delivery of formal sex education in schools. Both quantitative and qualitative methods were used to access young people's opinions about the quality of the sex education they had received at school. Overall, they reported high levels of dissatisfaction, with notable variations in relation to both gender and religious affiliation. In one sense their opinions mesh well with those of young people in other parts of these islands. At the same time the specificity of sexuality in Ireland plays a key role in producing the moral system that underlies much of formal sex education in schools. Underpinned by a particularly traditional and conservative strain of Christian morality, sex education in Northern Ireland schools is marked by conservatism and silence and by the avoidance of opportunities for informed choice in relation to sexuality on the part of young people.

Racist harassment in the white hinterlands: minority ethnic children and parents' experiences in schools in Northern Ireland

This article explores the nature and extent of racist harassment in predominantly white areas. It is based upon a case study of Northern Ireland and draws upon data from indepth interviews with a total of 32 children and 43 parents drawn from the four largest minority ethnic groups in the region: Chinese, Irish Travellers, South Asians and Black Africans. The article demonstrates that racist harassment is a significant problem in schools in Northern Ireland and highlights the varied forms that it can take from overt acts of physical and verbal abuse to more covert and subtle forms of teasing and 'friendly' banter. Following a consideration of the differing responses that schools have made to racist incidents reported to them by children and/or parents, the article concludes by considering the implications of the findings and re-affirming the argument that anti-racist strategies are as relevant and necessary for schools in predominantly white regions as they are in multi-ethnic areas.