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This dissertation is a critical ethnographic study of institutional, ideological, and cultural factors influencing the educational pathways of low-income Latino/a students. The study lasted for nine months, and research was conducted in two field sites: a public high school and a public university in the Southwest. There were eighteen research participants--seventeen students and one teacher. A funds of knowledge approach combined with a Latino/a Critical Theory lens and best practices in college access allow a consideration of these factors in public schooling. I balanced institutional data with interviews, writing samples, and class discussions, and I found that factors hindering students' persistence included material conditions such as overcrowding, ideological constraints such as low expectations, and a cultural disconnect between students' values and the values embedded in school curricula and policies. Although these Latino/a students demonstrate experiential critical literacy, the students are not given an opportunity to connect their lived experiences to theory in school, which can hinder college-going attitudes. To foster critical democracy, practitioners of First-Year Composition have an opportunity to rethink our purpose and goals to make sure that what we advocate in theory--college persistence for all students--matches up with our practice. This study suggests remedies to ensure that in a system in which social, economic, and political inequities are fed by and feed our inequitable educational system, we can take an active role in reshaping the educational pipeline by working in partnership with public schools and communities to bring equity to college access and retention efforts.

Background Health and social care provision for an ageing population is a global priority. Provision for those with dementia and hip fracture has specific and growing importance. Older people who break their hip are recognised as exceptionally vulnerable to experiencing confusion (including but not exclusively, dementia and/or delirium and/or cognitive impairment(s)) before, during or after acute admissions. Older people experiencing hip fracture and confusion risk serious complications, linked to delayed recovery and higher mortality post-operatively. Specific care pathways acknowledging the differences in patient presentation and care needs are proposed to improve clinical and process outcomes. Methods This protocol describes a multi-centre, feasibility, cluster-randomised, controlled trial (CRCT) to be undertaken across ten National Health Service hospital trusts in the UK. The trial will explore the feasibility of undertaking a CRCT comparing the multicomponent PERFECTED enhanced recovery intervention (PERFECT-ER), which acknowledges the differences in care needs of confused older patients experiencing hip fracture, with standard care. The trial will also have an integrated process evaluation to explore how PERFECT-ER is implemented and interacts with the local context. The study will recruit 400 hip fracture patients identified as experiencing confusion and will also recruit “suitable informants” (individuals in regular contact with participants who will complete proxy measures). We will also recruit NHS professionals for the process evaluation. This mixed methods design will produce data to inform a definitive evaluation of the intervention via a large-scale pragmatic randomised controlled trial (RCT). Discussion The trial will provide a preliminary estimate of potential efficacy of PERFECT-ER versus standard care; assess service delivery variation, inform primary and secondary outcome selection, generate estimates of recruitment and retention rates, data coll