Homes England

Somaesthetic design focuses on making people more aware of their felt bodily experiences. To design for somaesthetics, designers must develop their own somaesthetic expertise. Somaesthetic design holds great promise, but more examples of how to translate from abstract theory into design practice are needed.

BACKGROUND: While all healthcare workers are exposed to occupational hazards, workers in sub-Saharan Africa have higher rates of occupational exposure to infectious diseases than workers in developed countries. Identifying prevalence and context of exposure to blood and bloodborne pathogens may help guide policies for prevention. OBJECTIVE: This systematic review examined occupational exposure rates to blood and bloodborne pathogen among healthcare workers in sub-Saharan Africa. METHODS: In November 2017, a comprehensive literature search was conducted to identify studies reporting exposure of health workers in African coutnries to blood and bodily fluids. Title, abstract and full text screening were used to narrow our search. Studies more than 10 years old, or published in non-English languages were excluded. FINDINGS: Fifteen studies reported a variety of exposures. The lifetime prevalence of needlestick injury ranged from 22-95%, and one-year prevalence ranged from 39-91%. Studies included a range of descriptive statistics of knowledge, attitudes, practice and access factors related to exposures. Two studies reported 21-32% of respondents linked poor knowledge or training with prevention of needlestick injuries. Rates of recapping needles ranged from 12-57% in four studies. Attitudes were generally positive toward occupational safety procedures while access was poor. CONCLUSIONS: The high burden of blood and bloodborne pathogen exposures demonstrated here indicates a high risk for contracting bloodborne illnesses. Although the data are sparse, implementation of preventative policies based on current knowledge remains critical to minimize risk and reduce exposure. There remains a pressing need for high quality data on occupational hazards to identify the burden of exposures and inform preventive policies in Sub-Saharan Africa. Additional studies are needed to determine whether differential exposures exist between professions and the associations with knowledge, attitudes, practices, and access factors to create targeted strategies to diminish occupational hazards.

The scale of land-contamination problems, and of the responses to them, makes achieving sustainability in contaminated land remediation an important objective. The Sustainable Remediation Forum in the UK (SuRF-UK) was established in 2007 to support more sustainable remediation practice in the UK. The current international interest in 'sustainable remediation' has achieved a fairly rapid consensus on concepts, descriptions and definitions for sustainable remediation, which are now being incorporated into an ISO standard. However the sustainability assessment methods being used remain diverse with a range of (mainly) semi-quantitative and quantitative approaches and tools developed, or in development. Sustainability assessment is site specific and subjective. It depends on the inclusion of a wide range of considerations across different stakeholder perspectives. Taking a tiered approach to sustainability assessment offers important advantages, starting from a qualitative assessment and moving through to semi-quantitative and quantitative assessments on an 'as required' basis only. It is also clear that there are a number of 'easy wins' that could improve performance against sustainability criteria right across the site management process. SuRF-UK has provided a checklist of 'sustainable management practices' that describes some of these. This paper provides the rationale for, and an outline of, and recently published SuRF-UK guidance on preparing for and framing sustainability assessments; carrying out qualitative sustainability assessment; and simple good management practices to improve sustainability across contaminated land management activities.

Sustainability considerations have become widely recognised in contaminated land management and are now accepted as an important component of remediation planning and implementation around the world. The Sustainable Remediation Forum for the UK (SuRF-UK) published guidance on sustainability criteria for consideration in drawing up (or framing) assessments, organised across 15 “headline” categories, five for the environment element of sustainability, five for the social, and five for the economic. This paper describes how the SuRF-UK indicator guidance was developed, and the rationale behind its structure and approach. It describes its use in remediation option appraisal in the UK, and reviews the international papers that have applied or reviewed it. It then reviews the lessons learned from its initial use and the opinions and findings of international commentators, and concludes with recommendations on how the indicator categories might be further refined in the future. The key findings of this review are that the SuRF-UK framework and indicator guidance is well adopted into practice in the UK. It is widely recognised as the most appropriate mechanism to support sustainability-based decision making in contaminated land decision making. It has influenced the development of other national and international guidance and standards on sustainable remediation. However, there is room for some fine tuning of approach based on the lessons learned during its application.

Click to increase image sizeClick to decrease image size Notes 1. The Social Infrastructure Matrix is part of the website ATLAS Guide: Planning for Large Scale Development www.atlasplanning.com/page/topic/index.cfm?coArticleTopic_articleId = 47&coSiteNavigation_articleId = 47 (accessed on 1 October 2009).

Ethan Seltzer & Armando Carbonell (Eds), Cambridge, MA, Lincoln Institute of Land Policy, 2011, 296 pp., $35.00 (pbk), ISBN 9781558442153 In this survey of the current state of regional planning in...

Evidence for case management in dementia care in the United Kingdom is inconclusive; however, case management has been successful in other countries such as the Netherlands. An important aspect of case management is working collaboratively; this article explores the importance of multidisciplinary working in dementia care, ensuring that persons living with dementia and their families are supported appropriately.

Photoanodes comprising Au nanoparticles (GNPs) and thin TiO2 layers with a stacked structure were fabricated by repeating the application of TiO2 paste and GNP solutions on conductive glass to vary the distribution of GNPs in the TiO2 layer. The plasmon-enhanced characteristics of dye-sensitized solar cells (DSSCs) with such photoanodes were investigated. Both the absorption of the TiO2 layer and the performance of the DSSC are found to be most increased by plasmonic enhancement when GNPs are concentrated near the position in the TiO2 layer, which is the penetration depth of the incident light of wavelength corresponding to the maximum absorption of the N719 dye (~ 520 nm). When a GNP layer with a relatively high density of 1.3 μg/cm2 density was formed at its position, and two GNP layers with a relatively low density of 0.65 μg/cm2 were formed near the front side of the incident light, the short-circuit current density (Jsc) and energy conversion efficiency (η) of the DSSC were found to be 10.8 mA/cm2 and 5.0%, increases of 15 and 11%, respectively, compared with those of the DSSC without GNPs. Our work suggests that optimization of the distribution of GNPs in the TiO2 layer is very important for improving the performance of DSSCs fabricated by utilizing GNPs.

BACKGROUND: Prescribing, monitoring and administration of medicines in care homes could be improved. Research has identified the need for one person to assume overall responsibility for the management of medicines within each care home. and shown that a pharmacist independent prescriber service is feasible in this context. AIMS AND OBJECTIVES: To conduct a cluster randomised controlled trial to determine the effectiveness and cost-effectiveness of a pharmacist-independent prescribing service in care homes compared to usual general practitioner (GP)-led care. OBJECTIVES: To perform a definitive randomised controlled trial (RCT) with an internal pilot to determine the intervention's effectiveness and cost-effectiveness and enable modelling beyond the end of the trial. METHODS: This protocol is for a cluster RCT with a 3-month internal pilot to confirm that recruitment is achievable, and there are no safety concerns. The unit of randomisation is a triad comprising a pharmacist-independent prescriber (PIP) based in a GP practice with sufficient registered patients resident in one or more care homes to allow recruitment of an average of 20 participants. In the intervention group, the PIP will, in collaboration with the GP: assume responsibility for prescribing and managing residents' medicines including medication review and pharmaceutical care planning; support systematic ordering and administration in the care home, GP practice and supplying pharmacy; train care home and GP practice staff; communicate with GP practice, care home, supplying community pharmacy and study team. The intervention will last 6 months. The primary outcome will be resident falls at 6 months. Secondary outcomes include resident health-related quality of life, falls at 3 months, medication burden, medication appropriateness, mortality and hospitalisations. A full health economic analysis will be undertaken. The target sample size is 880 residents (440) in each arm) from 44 triads. This number is sufficient to detect a decrease in fall rate from 1.5 per individual to 1.178 (relative reduction of 21%) with 80% power and an ICC of 0.05 or less. DISCUSSION: Recruitment is on-going and the trial should complete in early 2020. The trial results will have implications for the future management of residents in care homes and the ongoing implementation of independent pharmacist prescribing. TRIAL REGISTRATION: ISRCTN, ID: 17847169. Registered on 15 December 2017.

This paper provides a preliminary examination of individual self-provision of housing in Scotland; that is, instances where individuals are directly involved in the production of their own house, rather than buying a house on the market. After a brief overview of the history of individual self-provision in Britain, the characteristics of the sector in Britain, and particularly in Scotland, are outlined. The core of the paper reports the results of a pilot survey of self-provision in Scotland. Four issues are examined: the type of self-provision; land availability; relationships with commercial interests; and local housing systems and access. It is concluded that self-provision is an important but mostly unrecognised source of new housing provision, whose incidence depends crucially on the nature of local housing systems and the extent to which planning policies are favourable in terms of land release and development control.

The term “being” has featured frequently in publications about the role of chaplains in health and social care. Generally, this has described the physical presence of chaplains among people either during routine pastoral encounters or at critical moments in their lives. The COVID-19 pandemic has led to differentiated practices for chaplains in the UK’s largest charitable care provider for older people. Some chaplains continued to be present in residential care facilities; some provided at-distance support; and some were absent, both physically and virtually. This article begins by discussing the significance of “being” in the context of chaplaincy. It goes on to offer examples of analysis, drawing on chaplaincy experience during the pandemic based on six interviews conducted in the final week of May 2020. From these interviews, an evaluation is made of chaplaincy during the crisis as: being present; virtually being present; and being absent. It is noted that questions about the chaplain’s location in a crisis are not unprecedented. A discussion of pastoral care during the pandemic suggests that presence and in-person encounter remain key aspects of being, and that recent experience has clarified the importance of embodied support for those who are suffering. However, it is also noted that under certain conditions a virtual pastoral encounter has value, can convey impact, and is of consequence.

In this paper, a roadmap for reducing upfront carbon emissions of steel-framed modular housing has been laid out. In order to generate the required data for the appraisal of the roadmap, embodied carbon assessments have been carried out on two versions of a 2-bedroom 4-person 81 m 2 modular house. A standard version is adopted as a benchmark house and an upgraded version entitled “Refresh” in which improvements in material design efficiency have been made. The Refresh design has 12% lower upfront carbon emissions as this has been designed to minimise materials, and when extrapolated across 2000 homes per year produced, it results in 6000 tCO2e upfront emissions saving. Further material design efficiency and specifying low carbon materials were explored which led to a further 43% lower upfront carbon emissions. Subsequently, supply chain and replacement materials decarbonisation projections, as well as improvements in the transportation of materials and construction site practices, have been modelled to forecast the upfront emissions up to 2050. The results shed light on the importance of removing the reliance on materials that have a large amount of carbon capture and storage in their decarbonisation strategies and reducing upfront carbon emissions today rather than waiting for the materials industries to act in the future. The above-described outcomes have equipped ilke Homes with a commercially viable and scalable solution with low upfront carbon emissions to deliver net-zero carbon houses while helping to achieve the UK Government's housing targets (i.e. 300 000 new homes per year by mid-2020s). • A roadmap for reducing upfront carbon emissions of steel-framed modular housing. • Establishing steps to design with the minimum amount of materials. • Minimising the carbon footprint with a strategic supply of materials. • Modelling of supply chain and replacement materials decarbonisation projections. • Modelling of improvements in transportation and construction site practices.

To date, research on the socio-economic characteristics of the social renting population in the Republic of Ireland has focused on the national level and has found that in common with many other Western European countries the years since the mid-1980s have seen an increased concentration of low income and socially excluded households in this tenure. Drawing on data on the incomes and socio-demographic status of the households who rent their dwellings from Ireland's largest social landlord, Dublin City Council, this paper explores the impact of this macro-process of residualisation on tenants in this region, and also on different localities within it. It demonstrates that residualisation has resulted in higher concentrations of poor households in social rented accommodation in Dublin compared to the general social renting population of the country and at the micro-level has impacted differently on different districts of the city and contemplates the factors which have contributed to this uneven pattern of residualisation.

Com objetivo de identificar os fatores que influenciam a participação do homem/pai no acompanhamento prénatalem uma Unidade de Saúde da Família de Recife – PE, foi realizado um estudo transversal do tipo descritivo, exploratório,de abordagem quantitativa. A amostra intencional foi constituída por 13 homens/pais companheiros de gestantes, querealizavam o pré-natal em uma unidade de saúde da família. Este estudo mostra que 53,8% (n =7) dos homens entrevistadosnão consideraram a gravidez oportuna e referem o trabalho como motivo para não participar da consulta pré-natal, 61,5%(n =8) consideraram como maior contribuição no processo gestacional o apoio emocional e financeiro e 84,6% (n =11) dospais não participam dos grupos de gestantes na unidade de saúde em estudo. Este estudo evidencia que há baixoenvolvimento paterno no período pré-natal com necessidade dos profissionais de saúde atuarem no processo educacionalcom vistas à aproximação da participação do homem/pai na gestação.

Abstract UK‐wide multivariate neighbourhood classifications have been built using small area population data following every census since 1971, and have been built using Output Area geographies since 2001. Policy makers in both the public and private sectors find such taxonomies, typically arranged into hierarchies of Supergroups, Groups and Subgroups, useful across a wide range of applications in business and service planning. Recent and forthcoming releases of small area census statistics pose new methodological challenges. For example, the 2022 Scottish Census was carried out a year after those in other UK nations, and some of the variables now collected across different jurisdictions do not bear direct comparison with one another. Here we develop a methodology to accommodate these issues alongside the more established procedures of variable selection, standardisation, transformation, class definition and labelling.

Comprehensive sexuality education is an important means of promoting sexual well-being amongst young people and is key to preventing sexually transmitted infections (STIs). However, sexuality education is not currently included in the formal curriculum in Italian schools. The aim of this study was to develop an inventory of school-based sexuality education (SBSE) activities carried out by external providers and implemented in Italy from 2016 to 2020. A desk review and survey were carried out. In the desk review online documents on STI prevention were analysed. The survey investigated the providers, objectives, content and methods used to implement SBSE activities in secondary schools. Findings revealed a highly heterogeneous situation in terms of geographical coverage, service providers, objectives and evaluation. Some SBSE activities were classified as adopting a comprehensive approach to sexuality education, while the majority focused on STI prevention, and many were single-session activities. Although most activities were said to have been evaluated no results were available. The data showed that SBSE is not systematically and equally delivered across Italy. Action is needed to provide young people with evidence-based, age-appropriate and accurate education about sexual and reproductive health and wellbeing.

Abstract The scale of land‐contamination problems, and of the responses to them, makes achieving sustainability in contaminated land remediation an important objective. The Sustainable Remediation Forum in the UK (SuRF‐UK) was established in 2007 to support more sustainable remediation practices in the UK. The prevailing international consensus is that risk assessment is the most rational approach for determining remediation needs and urgency. Sustainability in this context is related to the effective delivery of whatever risk management is necessary to protect human health or the wider environment. SuRF‐UK suggests that decisions made at the project planning stage, and also in the choice of remediation approach used to reach particular objectives decided upon, are both opportunities for sustainability gain. In 2011, SuRF‐UK issued a set of wide‐ranging indicators to support sustainability assessments made during project planning and remediation option appraisal. This advice was reviewed over 2018–2020 and new guidance on process and indicators has been released. Within this guidance, SuRF‐UK has provided a checklist of possible sustainability indicators/criteria that can be used to benchmark the scope of sustainability assessment for remediation projects. These indicators are divided into 15 overarching (“headline”) categories, divided in a balanced way across the three elements of sustainability: Environmental (emissions to air, soil and ground conditions, groundwater and surface water, ecology, and natural resources and waste); social (human health and safety, ethics and equity, neighborhoods and locality, communities and community involvement, and uncertainty and evidence); and economic (direct economic costs and benefits, indirect economic costs and benefits, employment and employment capital, induced economic costs and benefits, and project lifespan and flexibility). The majority of this study explains these categories and their various considerations in more depth and provides the supporting rationale that led to their inclusion in the revised SuRF‐UK guidance.

Recently, there has been a resurgence in the adoption of lightweight cold-formed steel (CFS) profiles as structural elements in low- to mid-rise modular construction. Typically, openings for doors and windows are ever-present in the front and rear elevations where shear walls find their optimal position to ensure lateral stability in CFS modular structures. These architectural design features translate into reduced areas for lateral load resistance throughout the structure. This paper discusses the performance of CFS framed shear walls with openings under lateral loads through experimental tests and numerical simulations. Overall, three shear wall typologies were designed for force transfer around opening (FTAO) and tested under monotonic lateral loads (nine tests in total). An advanced finite element analysis (FEA) modelling protocol was elaborated to simulate the lateral behaviour of the tested walls as well as to interpret the physical tests. Evaluation of the numerical and experimental test results validated the FEA modelling protocol that demonstrated to be reliable in predicting the strength and stiffness as well as failure modes of CFS framed shear walls with openings subjected to lateral loads. The effects of sheathing-to-CFS screw spacing, the size and number of openings as well as the geometry of sheathing panels on the lateral behaviour of CFS framed shear walls were scrutinized. Subsequently, load-path mappings from the developed modelling protocol enabled the analysis of the flow of the in-plane lateral loads from the sheathing-to-CFS screw level into the wall system level where insight into a more efficient lateral design of CFS framed shear walls with openings have been highlighted. The obtained results shed light on the conservative nature of the AISI S400-15 design provisions for Type II shear walls and that of the perforated design methods available in the literature.

BACKGROUND: It is well established that the actions and behaviour of care home workers are fundamental to the well-being of the people they care for. They not only deliver basic care but through their day-to-day presence provide an underlying continuity for residents, many of whom will have dementia or other cognitive problems. This can have many positive psychological and social benefits. A variety of ethnographic approaches have been used to explore the broader social and cultural dimensions of dementia care work. Similarly, there is a growing body of work applying micro-level approaches such as conversation analysis (CA) to describe the interactional mechanics of specific care skills. STRATEGY: We outline what ethnography and CA are, how they work as stand-alone methodologies and how they have been used in care work and dementia care settings. A working illustration is given of how the two approaches may be integrated. DISCUSSION: Dementia care workers occupy a uniquely tenuous sociopolitical and professional position within healthcare. If they are to progress to a more professional status there is a pressing need for standardized systems of training to be developed. As has been common practice in most other fully professionalized sectors of healthcare, this training needs to be backed up by an understanding of how effective care work is undertaken at the micro-level. For it to be practically relevant to care workers it also needs to have been informed by the wider social context in which it occurs. CONCLUSION: We argue that elements of ethnography and CA can be usefully combined to provide the fully contextualized micro-level descriptions of care work practice that will be needed if current moves towards the greater professionalization of care work are to continue. PATIENT OR PUBLIC CONTRIBUTION: The authors undertake a significant amount of Patient and Public Involvement and Engagement and study codesign with members of the public, care workers and people living with dementia. Our engagement work with care staff and family carers undertaken as part of a current National Institute for Health Research study exploring naturalistic care worker skills (see acknowledgements) has been particularly relevant in shaping this article.

Abstract Despite the introduction of guidelines and procedures aimed at encouraging and supporting children and young people to complain about the services they receive, children in care still face barriers to doing so in practice. This paper explores what happens when children in care are dissatisfied with the services they receive. Specifically, this study examines the complaints procedure for children in care. The findings are based on semistructured interviews with children in care, social workers, senior managers, and independent reviewing officers from one English local authority. Thematic analysis of these data identified five emergent themes: (a) complaints by children in care are managed at the lowest possible level, (b) senior managers have an overly optimistic view about children in care being informed of complaint procedures and being encouraged to do so, (c) children in care are worried about complaining, which is recognized by professionals, (d) children's voices are often not heard, and (e) when issues are clearly defined, independent reviewing officers have some degree of success in resolving complaints from children in care.