Justify or die? - using contingent valuation of service provision in a UK public library

The public library service in the UK is currently under pressure to justify its existence. An Audit Commission report suggested that if current borrowing rates for libraries continue into the future, libraries would be effectively issuing no books by 2020. Recently the Coates Report asserted about book loans that, "in simple terms, if a service is without separate charge and the public decides not to use it, then the service is de facto without any value to these individuals". Yet Coates' simplistic notions of the services public libraries provide lies at the heart of the problem. Performance indicators based on book loans are unable to assess 'the totality of library effectiveness'. Conversely, qualitative analysis, interviewing users about service impact, shows that libraries 'promote social cohesion and community confidence'. However qualitative findings are by nature not quantitative and not comparable. To try to produce a measure for service quality, contingent valuation was chosen. It elicits economic value judgements from users on both services they use and services they do not use. A major independent study using contingent valuation was conducted by the Department of Computer and Information Sciences at the University of Strathclyde on East Renfrewshire Library Services, near Glasgow, which is recognised as an exemplary public library service. The study revealed the inability of contingent valuation to adequately assess the complex mix of services provided. The study concludes that an urgent rethink is required regarding measures for public library service evaluation

Smoking, dementia and cognitive decline in the elderly, a systematic review.

Background. Nicotine may aid reaction time, learning and memory, but smoking increases cardiovascular risk. Cardiovascular risk factors have been linked to increased risk of dementia. A previous meta-analysis found that current smokers were at higher risk of subsequent dementia, Alzheimers disease, vascular dementia and cognitive decline. Methods. In order to update and examine this further a systematic review and meta-analysis was carried out using different search and inclusion criteria, database selection and more recent publications. Both reviews were restricted to those aged 65 and over. Results. The review reported here found a significantly increased risk of Alzheimers disease with current smoking and a likely but not significantly increased risk of vascular dementia, dementia unspecified and cognitive decline. Neither review found clear relationships with former smoking. Conclusion. Current smoking increases risk of Alzheimers disease and may increase risk of other dementias. This reinforces need for smoking cessation, particularly aged 65 and over. Nicotine alone needs further investigation. © 2008 Peters et al; licensee BioMed Central Ltd

Your OERs will outlive you: Open Education in the long term

This keynote presentation was made by Martin Poulter of the University of Bristol at RepoFringe 2016. The following introduction appeared on the RepoFringe website: "Dr Martin Poulter is the past Wikimedian In Residence at the Bodleian Libraries, Oxford, past Wikimedia Ambassdor for Jisc, and promotes open education in the Economics Network based at the University of Bristol. * “Your OERs will outlive you: Open Education in the long term” – Day 1 at 09.45. This talk is about the seeming paradox of the long-term sustainability of educational resources which need continuous evolution to stay relevant. The preservation of the utility of educational content is more challenging than just preserving that content. I will defend a web-of-knowledge approach rather than an atomistic approach. In the increasing ubiquity of these webs of knowledge justifies optimism about the sustainability of open educational resources and communities.

Energy gap of the bimodal two-dimensional Ising spin glass

An exact algorithm is used to compute the degeneracies of the excited states of the bimodal Ising spin glass in two dimensions. It is found that the specific heat at arbitrary low temperature is not a self-averaging quantity and has a distribution that is neither normal or lognormal. Nevertheless, it is possible to estimate the most likely value and this is found to scale as L^3 T^(-2) exp(-4J/kT), for a L*L lattice. Our analysis also explains, for the first time, why a correlation length \xi ~ exp(2J/kT) is consistent with an energy gap of 2J. Our method allows us to obtain results for up to 10^5 disorder realizations with L <= 64. Distributions of second and third excitations are also shown.Comment: 4 pages, 4 figure

Is it time to reappraise blood pressure thresholds and targets? Statement from the international society of hypertension - a global perspective

No abstract available

Co-located Heroin Assisted Treatment within primary care: A preliminary analysis of the implications for healthcare access, cost, and treatment delivery in the UK.

The UK is experiencing its highest rate of drug related deaths in 25 years. Poor and inconsistent access to healthcare negatively impacts health outcomes for people who use drugs. Innovation in models of care which promote access and availability of physical treatment is fundamental. Heroin Assisted Treatment (HAT) is a treatment modality targeted at the most marginalised people who use drugs, at high risk of mortality and morbidity. The first service-provider initiated HAT service in the UK ran between October 2019 and November 2022 in Middlesbrough, England. The service was co-located within a specialist primary care facility offering acute healthcare treatment alongside injectable diamorphine. Analysis of anonymised health records for healthcare costs (not including drug treatment) took place using descriptive statistics prior and during engagement with HAT, at both three (n=15) and six (n=12) months. Primary outcome measures were incidents of wound care, skin and soft tissue infections (SSTIs), overdose (OD) events, unplanned overnight stays in hospital, treatment engagement (general and within hospital care settings) and ambulance incidents. Secondary outcome measures were costs associated with these events. A shift in healthcare access for participants during HAT engagement was observed. HAT service attendance appeared to support health promoting preventative care, and reduce reactive reliance on emergency healthcare systems. At three and six months, engagement for preventative wound care and treatment for SSTIs increased at the practice. Unplanned emergency healthcare interactions for ODs, overnight hospital stays, serious SSTIs, and ambulance incidents reduced, and there was an increase in treatment engagement (i.e. a reduction in appointments which were not engaged with). There was a decrease in treatment engagement in hospital settings. Changes in healthcare utilisation during HAT translated to a reduction in healthcare costs of 58% within six months compared to the same timeframe from the period directly prior to commencing HAT. This exploratory study highlights the potential for innovative harm reduction interventions such as HAT, co-located with primary care services, to improve healthcare access and engagement for a high-risk population. Increased uptake of primary healthcare services translated to reductions in emergency healthcare use and associated costs. Although costs of HAT provision are substantial, the notable cost-savings in health care should be an important consideration in service implementation planning. [Abstract copyright: Copyright © 2024. Published by Elsevier B.V.

May measurement month 2018: an analyses of blood pressure screening results from Cabo Verde.

Raised blood pressure (BP) is the biggest contributor to mortality and disease burden in Cabo Verde. May Measurement Month (MMM) is a global campaign set up in 2017 to raise awareness of high BP. In 2018, we aimed to expand the campaign by including a greater number of centres to increase awareness. Nine islands participated in MMM 2018. Volunteers (≥18 years) were recruited through opportunistic sampling at a variety of screening sites. Each participant had three BP measurements and completed a questionnaire on demographic, lifestyle, and environmental factors. Hypertension was defined as a systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg, or taking antihypertensive medication. In total, 98.0% of screenees provided three BP readings and multiple imputation using chained equations was used to impute missing readings. A total of 8008 individuals (mean age 40.4 years; 68.5% female) were screened. After multiple imputation, 2666 (33.3%) individuals had hypertension, of whom 74.8% were aware of their previous diagnosis and 55.8% were taking antihypertensive medication. Of those on medication, 39.1% were controlled and of all hypertensives, 21.8% were controlled. We detected 44.2% of individuals with untreated hypertension and 60.9% of treated individuals were inadequately treated. The Cape Verdean population is ageing and consequently cardiovascular disease is increasing, with hypertension being an important risk factor. Corrective actions need to be taken by the government. MMM is an ideal initiative to reach the public by raising awareness of this major cardiovascular risk factor

Finite-Size Scaling of the Domain Wall Entropy Distributions for the 2D ±J\pm J Ising Spin Glass

The statistics of domain walls for ground states of the 2D Ising spin glass with +1 and -1 bonds are studied for $L \times L$ square lattices with $L \le 48$, and $p$ = 0.5, where $p$ is the fraction of negative bonds, using periodic and/or antiperiodic boundary conditions. When $L$ is even, almost all domain walls have energy $E_{dw}$ = 0 or 4. When $L$ is odd, most domain walls have $E_{dw}$ = 2. The probability distribution of the entropy, $S_{dw}$, is found to depend strongly on $E_{dw}$. When $E_{dw} = 0$, the probability distribution of $|S_{dw}|$ is approximately exponential. The variance of this distribution is proportional to $L$, in agreement with the results of Saul and Kardar. For $E_{dw} = k > 0$ the distribution of $S_{dw}$ is not symmetric about zero. In these cases the variance still appears to be linear in $L$, but the average of $S_{dw}$ grows faster than $\sqrt{L}$. This suggests a one-parameter scaling form for the $L$-dependence of the distributions of $S_{dw}$ for $k > 0$.Comment: 13 page