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The uptake of green infrastructure is challenged by a lack of access to financing. Studies have investigated individuals' economic valuation of green infrastructure but understanding public perceptions of a range of potential funding mechanisms is a fundamental step in developing funding measures. Using data collected from a sample of residents in the Oxford–Cambridge Arc, England, this study addresses a gap in our understanding of public perceptions of green infrastructure funding by investigating support for several funding mechanisms, and the extent to which support is associated with attitudinal, contextual and personal capability variables. Results indicate that respondents prefer the funding of small and large-scale infrastructure to be covered by developers, with most opposition being levelled at those involving additional financial obligations from citizens. Altruistic-biospheric values, pro-environmental behaviour and trust in the government significantly affected support. These findings provide valuable insight to policymakers attempting to introduce sustainable green infrastructure funding streams. [ABSTRACT FROM AUTHOR]

Background: Falls are the most common safety incident reported by acute hospitals. In England national guidance recommends delivery of a multifactorial falls risk assessment (MFRA) and interventions tailored to address individual falls risk factors. However, there is variation in how these practices are implemented. This study aimed to explore the variation by examining what supports or constrains delivery of MFRAs and tailored interventions in acute hospitals. Methods: A realist review of literature was conducted with searches completed in three stages: (1) to construct hypotheses in the form of Context, Mechanism, Outcome configurations (CMOc) about how MFRAs and interventions are delivered, (2) to scope the breadth and depth of evidence available in Embase to test the CMOcs, and (3) following prioritisation of CMOcs, to refine search strategies for use in multiple databases. Citations were managed in EndNote; titles, abstracts, and full texts were screened, with 10% independently screened by two reviewers. Results: Two CMOcs were prioritised for testing labelled: Facilitation via MFRA tools, and Patient Participation in interventions. Analysis indicated that MFRA tools can prompt action, but the number and type of falls risk factors included in tools differ across organisations leading to variation in practice. Furthermore, the extent to which tools work as prompts is influenced by complex ward conditions such as changes in patient condition, bed swaps, and availability of falls prevention interventions. Patient participation in falls prevention interventions is more likely where patient directed messaging takes individual circumstances into account, e.g., not wanting to disturb nurses by using the call bell. However, interactions that elicit individual circumstances can be resource intensive and patients with cognitive impairment may not be able to participate despite appropriately directed messaging. Conclusions: Organisations should consider how tools can be developed in ways that better support consistent and comprehensive identification of patients' individual falls risk factors and the complex ward conditions that can disrupt how tools work as facilitators. Ward staff should be supported to deliver patient directed messaging that is informed by their individual circumstances to encourage participation in falls prevention interventions, where appropriate. Trial registration: PROSPERO: CRD42020184458. [ABSTRACT FROM AUTHOR]

Background: Multiple changes are made to older patients' medicines during hospital admission, which can sometimes cause confusion and anxiety. This results in problems with post‐discharge medicines management, for example medicines taken incorrectly, which can lead to harm, hospital readmission and reduced quality of life. Aim: To explore the experiences of older patients and their family carers as they enacted post‐discharge medicines management. Design: Semi‐structured interviews took place in participants' homes, approximately two weeks after hospital discharge. Data analysis used the Framework method. Setting and participants: Recruitment took place during admission to one of two large teaching hospitals in North England. Twenty‐seven participants aged 75 plus who lived with long‐term conditions and polypharmacy, and nine family carers, were interviewed. Findings: Three core themes emerged: impact of the transition, safety strategies and medicines management role. Conversations between participants and health‐care professionals about medicines changes often lacked detail, which disrupted some participants' knowledge and medicines management capabilities. Participants used multiple strategies to support post‐discharge medicines management, such as creating administration checklists, seeking advice or supporting primary care through prompts to ensure medicines were supplied on time. The level to which they engaged with these activities varied. Discussion and conclusion: Participants experienced gaps in their post‐discharge medicines management, which they had to bridge through implementing their own strategies or by enlisting support from others. Areas for improvement were identified, mainly through better communication about medicines changes and wider involvement of patients and family carers in their medicines‐related care during the hospital‐to‐home transition. [ABSTRACT FROM AUTHOR]

A research-active healthcare workforce contributes to improved quality of care. Clinicians may be unaware that they are applying early research skills during their everyday practice. Greater understanding of their level of research attainment may improve their awareness and confidence in their research skills. This article describes the development of the Clinicians Skills, Capability, and Organisational Research Readiness (SCORR) Tool, a simple innovation that assesses and captures research skills and attainment at 1) clinician, and 2) organisational level. The SCORR Tool was initially developed to assess levels of research attainment and to promote discussion during annual appraisals for podiatrists working across secondary and community care in a northern region of England. The levels (1 to 5) of attainment recognise UK Health and Care Professions Council (HCPC) registration requirements for chiropodists/podiatrists (Standards 12 to 14). Following testing and feedback, research levels were adapted (Levels 0 to 5) to accommodate all healthcare professionals (with the exception of doctors and dentists). The SCORR Tool may be used individually by clinicians, or in collaboration with their manager, to better understand the level of research attainment and to prompt discussion to increase research activity. It may also be used across a workforce (e.g. during an appraisal) to understand the organisational research readiness. The SCORR Tool requires additional testing and evaluation to validate it as a tool for use across a variety of organisational environments. [ABSTRACT FROM AUTHOR]

This study presents a critical analysis of the state-prescribed teaching standards from 1984 to 2012 in order to reveal discourses of equality imbued within. Critical discourse analysis and critical race theory are employed to explore and explain how the discourses of equality are shaped by the prevailing political ideology of the state. Up to 2007, the analyses revealed the gradual emergence of two seemingly incompatible discourses: recognition of the difference within notions of appropriacy of curriculum input vs. the assertion of a homogenised knowledge valid for all. It is argued that because this tension remained unexamined in the documents, damaging assumptions of deficit were obscured, thereby effecting a failure to critique the hegenomic norms against which such deficit was assumed, with the ultimate effect of maintaining the status quo of inequitable outcomes. The standards of 2012 also operate to maintain the status quo, but do so far less discretely. Here homogeneity appears overtly approved through an overarching assimilationist agenda. Deficit is now more openly articulated as attached to those who need to assimilate. The paper concludes with ideas for an alternative transformative teacher education. [ABSTRACT FROM AUTHOR]

Educational inequities persist in England today. Initial teacher educators are therefore charged with facilitating student teachers’ understanding of the issues pertaining to such inequities so they may work to disrupt them. Two lecturers at opposite ends of England, both with overwhelmingly White student cohorts, have approached this undertaking through the teaching of critical whiteness studies. This article exposes and explains the very different reactions of White student teachers to this approach given that one of the lecturers is Black and the other White. Explanations are viewed through a sociological framework which seeks to deconstruct normalized practices; in tandem with understandings of how whiteness operates to reinforce such normalization in order that inequitable power relations are reified. This revealed that student reactions were underpinned by racialised assumptions of teacher ability and motives, leading to collusion in whiteness for the White teacher and, for the Black teacher, a collision between her teaching and student perceptions of her role and values. [ABSTRACT FROM PUBLISHER]

This paper adds to the small but growing body of literature which probes the complex decision-making processes undertaken by minority ethnic students, and particularly working-class minority ethnic students, when choosing a higher education institution. Previous studies have focussed on areas with ethnically diverse local populations. This article presents the findings of a small-scale study examining the decision-making processes of minority ethnic school, undergraduate and postgraduate (PGCE) students in a predominantly 'white' area of England. Some similarities with the previous research are found, but also some interesting contextual differences, particularly in students' prioritisation of institutions with an ethnic mix. The paper discusses how students in this context make decisions about what is an acceptable choice based on a complex inter-related web of factors relating to ethnicity, class and gender. The level of agency assumed within conceptions of habitus when applied to students' decision-making processes in the context of higher education is also discussed. [ABSTRACT FROM AUTHOR]

Introduction: Slips, trips and falls are common causes of injuries in the workplace. It is estimated that in Great Britain, nearly 1 million days are taken off work due to these injuries. There is some evidence to suggest this accident burden could be reduced by the use of slip resistant footwear. This protocol describes a multicentre trial investigating the effectiveness and cost-effectiveness of slip resistant footwear to prevent slips in National Health Service (NHS) staff working in clinical, general or catering environments., Methods and Analysis: A two-arm, randomised controlled trial conducted within England, with 4400 NHS staff, aged 18 years and above, who adhere to a dress code policy and work in a clinical, catering or general hospital environment. Participants will be randomised 1:1 to the intervention or waiting list control group. The intervention group will be offered a pair of 5-star GRIP rated slip resistant footwear. The control group will be offered the footwear at the end of the trial. The primary outcome is the incidence rate of self-reported slips in the workplace over a 14-week period, as reported via weekly text messages. Secondary outcomes include: time to first slip/fall, proportion of participants who slip and fall over 14 weeks and incidence rate of falls resulting from and not resulting from a slip in the workplace over 14 weeks. An economic evaluation will assess cost-effectiveness, in terms of cost per quality-adjusted life year gained. A nested qualitative study will explore the acceptability of the footwear and compliance., Ethics and Dissemination: This protocol received a favourable ethical opinion from the University of York, Department of Health Sciences Research Governance Committee. The trial results will be published in peer-reviewed journals and at conferences. A summary of the findings will be made available to participants., Trial Registration Number: ISRCTN33051393; Pre results., Competing Interests: Competing interests: CH declares membership of the HTA Commissioning Board. The NIHR grant application included some salary costs for SC, CF, GF, CH, ML, MZ, HI-S, LG, RC-B and DT. The HSE grant included some salary costs for ML, GF and MZ. GF, MZ and ML declare that the HSE run the GRIP rating scheme, which was used to identify the footwear/manufacture to be used in the trial and Shoes for Crews paid the HSE for testing of footwear under the Grip rating scheme., (© Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY. Published by BMJ.)