Keeping the doors open in an age of austerity? Qualitative analysis of stakeholder views on volunteers in public libraries

English public libraries are increasingly adopting a hybrid approach to volunteer use, whereby volunteers plug the gaps created by reductions in paid staff, in response to local authority cuts arising from the Conservative Government’s austerity measures. This article builds on an initial phase of research reported in a previous article from 2015, which examined library service managers’ views of volunteering in public libraries using a Delphi study method. The second phase of research uses a case study method to investigate a variety of stakeholder views regarding public library volunteer use, using interviews, focus groups and surveys, thereby providing a complex picture of understandings and meanings. Results indicate that there is a clear mismatch of opinions relating to this phenomenon, in addition to a number of unintended consequences, directly attributable to the challenges identified. Key consequences of volunteer use relate to social exclusion, reductions in service accountability and quality, and a blurring of the boundaries that exist within the library, causing tensions for all stakeholders. Formal and informal strategies for ensuring these consequences are minimized are vital for library professionals who may be managing these volunteers, and a carefully planned volunteer relationship management strategy is suggested, which underpins the volunteer use equation, ensuring a mutually beneficial arrangement for all. A series of key recommendations are discussed that may help to counter some of the challenges identified, and provide a possible way forward for library professionals having to deal with this complex situation

Keeping the doors open in an age of austerity? Qualitative analysis of stakeholder views on volunteers in public libraries

English public libraries are increasingly adopting a hybrid approach to volunteer use, whereby volunteers plug the gaps created by reductions in paid staff, in response to local authority cuts arising from the Conservative Government’s austerity measures. This article builds on an initial phase of research reported in a previous article from 2015, which examined library service managers’ views of volunteering in public libraries using a Delphi study method. The second phase of research uses a case study method to investigate a variety of stakeholder views regarding public library volunteer use, using interviews, focus groups and surveys, thereby providing a complex picture of understandings and meanings. Results indicate that there is a clear mismatch of opinions relating to this phenomenon, in addition to a number of unintended consequences, directly attributable to the challenges identified. Key consequences of volunteer use relate to social exclusion, reductions in service accountability and quality, and a blurring of the boundaries that exist within the library, causing tensions for all stakeholders. Formal and informal strategies for ensuring these consequences are minimized are vital for library professionals who may be managing these volunteers, and a carefully planned volunteer relationship management strategy is suggested, which underpins the volunteer use equation, ensuring a mutually beneficial arrangement for all. A series of key recommendations are discussed that may help to counter some of the challenges identified, and provide a possible way forward for library professionals having to deal with this complex situation

Efficacy of labral repair, biceps tenodesis, and diagnostic arthroscopy for SLAP Lesions of the shoulder: a randomised controlled trial

<p>Abstract</p> <p>Background</p> <p>Surgery for type II SLAP (superior labral anterior posterior) lesions of the shoulder is a promising but unproven treatment. The procedures include labral repair or biceps tenodesis. Retrospective cohort studies have suggested that the benefits of tenodesis include pain relief and improved function, and higher patient satisfaction, which was reported in a prospective non-randomised study. There have been no completed randomised controlled trials of surgery for type II SLAP lesions. The aims of this participant and observer blinded randomised placebo-controlled trial are to compare the short-term (6 months) and long-term (2 years) efficacy of labral repair, biceps tenodesis, and placebo (diagnostic arthroscopy) for alleviating pain and improving function for type II SLAP lesions.</p> <p>Methods/Design</p> <p>A double-blind randomised controlled trial are performed using 120 patients, aged 18 to 60 years, with a history for type II SLAP lesions and clinical signs suggesting type II SLAP lesion, which were documented by MR arthrography and arthroscopy. Exclusion criteria include patients who have previously undergone operations for SLAP lesions or recurrent shoulder dislocations, and ruptures of the rotator cuff or biceps tendon. Outcomes will be assessed at baseline, three, six, 12, and 24 months. Primary outcome measures will be the clinical Rowe Score (1988-version) and the Western Ontario Instability Index (WOSI) at six and 24 months. Secondary outcome measures will include the Shoulder Instability Questionnaire (SIQ), the generic EuroQol (EQ-5 D and EQ-VAS), return to work and previous sports activity, complications, and the number of reoperations.</p> <p>Discussion</p> <p>The results of this trial will be of international importance and the results will be translatable into clinical practice.</p> <p>Trial Registration</p> <p><b>[ClinicalTrials.gov NCT00586742]</b></p

Imagination and Film

This chapter addresses the application of contemporary theories of the imagination—largely drawn from cognitive psychology—to our understanding of film. Topics include the role of the imagination in our learning what facts hold within a fictional film, including what characters’ motivations, beliefs, and feelings are; how our perceptual experience of a film explains our imaginative visualizing of its contents; how fictional scenarios in films generate certain affective and evaluative responses; and how such responses compare to those we have toward analogous circumstances in real life

New Developments in Brief Interventions to Treat Problem Drinking in Nonspecialty Health Care Settings

The delivery of brief interventions (BIs) in health care settings to reduce problematic alcohol consumption is a key preventive strategy for public health. However, evidence of effectiveness beyond primary care is inconsistent. Patient populations and intervention components are heterogeneous. Also, evidence for successful implementation strategies is limited. In this article, recent literature is reviewed covering BI effectiveness for patient populations and subgroups, and design and implementation of BIs. Support is evident for short-term effectiveness in hospital settings, but long-term effects may be confounded by changes in control groups. Limited evidence suggests effectiveness with young patients not admitted as a consequence of alcohol, dependent patients, and binge drinkers. Influential BI components include high-quality change plans and provider characteristics. Health professionals endorse BI and feel confident in delivering it, but training and support initiatives continue to show no significant effects on uptake, prompting calls for systematic approaches to implementing BI in health care

Effectiveness of cricoid pressure in preventing gastric aspiration during rapid sequence intubation in the emergency department: study protocol for a randomised controlled trial

<p>Abstract</p> <p>Background</p> <p>Cricoid pressure is considered to be the gold standard means of preventing aspiration of gastric content during Rapid Sequence Intubation (RSI). Its effectiveness has only been demonstrated in cadaveric studies and case reports. No randomised controlled trials comparing the incidence of gastric aspiration following emergent RSI, with or without cricoid pressure, have been performed. If improperly applied, cricoid pressure increases risk to the patient. The clinical significance of aspiration in the emergency department is unknown. This randomised controlled trial aims to; 1. Compare the application of the 'ideal" amount of force (30 - 40 newtons) to standard, unmeasured cricoid pressure and 2. Determine the incidence of clinically defined aspiration syndromes following RSI using a fibrinogen degradation assay previously described.</p> <p>Methods/design</p> <p>212 patients requiring emergency intubation will be randomly allocated to either control (unmeasured cricoid pressure) or intervention groups (30 - 40 newtons cricoid pressure). The primary outcome is the rate of aspiration of gastric contents (determined by pepsin detection in the oropharyngeal/tracheal aspirates or treatment for aspiration pneumonitis up to 28 days post-intubation). Secondary outcomes are; correlation between aspiration and lowest pre-intubation Glasgow Coma Score, the relationship between detection of pepsin in trachea and development of aspiration syndromes, complications associated with intubation and grade of the view on direct largyngoscopy.</p> <p>Discussion</p> <p>The benefits and risks of cricoid pressure application will be scrutinised by comparison of the incidence of aspiration and difficult or failed intubations in each group. The role of cricoid pressure in RSI in the emergency department and the use of a pepsin detection as a predictor of clinical aspiration will be evaluated.</p> <p>Trial registration</p> <p>Australian New Zealand Clinical Trials Registry (ANZCTR): <a href="http://www.anzctr.org.au/ACTRN12611000587909.aspx">ACTRN12611000587909</a></p

The effect of a brief social intervention on the examination results of UK medical students: a cluster randomised controlled trial

Background: Ethnic minority (EM) medical students and doctors underperform academically, but little evidence exists on how to ameliorate the problem. Psychologists Cohen et al. recently demonstrated that a written self-affirmation intervention substantially improved EM adolescents' school grades several months later. Cohen et al.'s methods were replicated in the different setting of UK undergraduate medical education.Methods: All 348 Year 3 white (W) and EM students at one UK medical school were randomly allocated to an intervention condition (writing about one's own values) or a control condition (writing about another's values), via their tutor group. Students and assessors were blind to the existence of the study. Group comparisons on post-intervention written and OSCE (clinical) assessment scores adjusted for baseline written assessment scores were made using two-way analysis of covariance. All assessment scores were transformed to z-scores (mean = 0 standard deviation = 1) for ease of comparison. Comparisons between types of words used in essays were calculated using t-tests. The study was covered by University Ethics Committee guidelines.Results: Groups were statistically identical at baseline on demographic and psychological factors, and analysis was by intention to treat [intervention group EM n = 95, W n = 79; control group EM n = 77; W n = 84]. As predicted, there was a significant ethnicity by intervention interaction [F(4,334) = 5.74; p = 0.017] on the written assessment. Unexpectedly, this was due to decreased scores in the W intervention group [mean difference = 0.283; (95% CI = 0.093 to 0.474] not improved EM intervention group scores [mean difference = -0.060 (95% CI = -0.268 to 0.148)]. On the OSCE, both W and EM intervention groups outperformed controls [mean difference = 0.261; (95% CI = -0.047 to -0.476; p = 0.013)]. The intervention group used more optimistic words (p < 0.001) and more "I" and "self" pronouns in their essays (p < 0.001), whereas the control group used more "other" pronouns (p < 0.001) and more negations (p < 0.001).Discussion: Cohen et al.'s finding that a brief self-affirmation task narrowed the ethnic academic achievement gap was replicated on the written assessment but against expectations, this was due to reduced performance in the W group. On the OSCE, the intervention improved performance in both W and EM groups. In the intervention condition, participants tended to write about themselves and used more optimistic words than in the control group, indicating the task was completed as requested. The study shows that minimal interventions can have substantial educational outcomes several months later, which has implications for the multitude of seemingly trivial changes in teaching that are made on an everyday basis, whose consequences are never formally assessed

Orbital Decay in M82 X-2

M82 X-2 is the first pulsating ultraluminous X-ray source discovered. The luminosity of these extreme pulsars, if isotropic, implies an extreme mass transfer rate. An alternative is to assume a much lower mass transfer rate, but with an apparent luminosity boosted by geometrical beaming. Only an independent measurement of the mass transfer rate can help discriminate between these two scenarios. In this paper, we follow the orbit of the neutron star for 7 yr, measure the decay of the orbit ((P) over dot(orb)/(P) over dot(orb) approximate to -8.10(-6) yr(-1)), and argue that this orbital decay is driven by extreme mass transfer of more than 150 times the mass transfer limit set by the Eddington luminosity. If this is true, the mass available to the accretor is more than enough to justify its luminosity, with no need for beaming. This also strongly favors models where the accretor is a highly magnetized neutron star