Why we should be more optimistic about the competency of American voters

The traditional view that voters have stable beliefs about what government should do and what policies they prefer has become unstuck, with many commentators and academics now doubting that voters approach politics with any consistent preferences. In new research, Melanie Freeze and Jacob M. Montgomery reject this view, arguing that public opinion is generally stable across many issues, and that the public is getting better at connecting their preferences to their ideology. By removing random and time-dependent errors from election and survey data, they find that preferences on a range of issues such as abortion policy and gay marriage have been relatively stable and have also become more closely correlated with party identification over the past two decades

The impact of co-located NHS walk-in centres on emergency departments

Objectives: To determine the impact of establishing walk-in centres alongside emergency departments on attendance rates, visit duration, process, costs and outcome of care. Methods: Eight hospitals with co-located emergency departments and walk-in centres were compared with eight matched emergency departments without walk-in centres. Site visits were conducted. Routine data about attendance numbers and use of resources were analysed. A random sample of records of patients attending before and after walk-in centres opened were also assessed. Patients who had not been admitted to hospital were sent a postal questionnaire. Results: In most sites, the walk-in centres did not have a distinct identity and there were few differences in the way services were provided compared with control sites. Overall, there was no evidence of an increase in attendance at sites with walk-in centres, but considerable variability across sites. The proportion of patients managed within the four-hour NHS target improved at sites both with and without walk-in centres. There was no evidence of any difference in re-consultation rates, costs of care or patient outcomes at sites with or without walk-in centres. Conclusions: Most hospitals in this study implemented the walk-in centre concept to a very limited extent. Consequently there was no evidence of any impact on attendance rates, process, costs or outcome of care

Comparing care at walk-in centres and at accident and emergency departments: an exploration of patient choice, preference and satisfaction

Objectives: To explore the impact of establishing walk-in centres alongside emergency departments on patient choice, preference and satisfaction. Methods: A controlled, mixed-method study comparing eight emergency departments with co-located walk-in centres with the same number of ‘traditional’ emergency departments. This paper focuses on the results of a cross-sectional questionnaire survey of users. Results: Survey data demonstrated that patients were frequently unable to distinguish between being treated at a walk-in centre or an A&E department, and even where this was the case, opportunities to exercise choice about their preferred care provider were often limited. Few made an active choice to attend a co-located walk-in centre. Patients attending walk-in centres were just as likely to be satisfied overall with the care they received as their counterparts who were treated in the co-located A&E facility, although a small proportion of walk-in centre users did report greater satisfaction with some specific aspects of their care and consultation. Conclusions: Whilst one of the key policy goals underpinning the co-location of walk-in centres next to an A&E department was to provide patients with more options for accessing healthcare and greater choice, leading in turn to increased satisfaction, this evaluation was able to provide little evidence to support this. The high percentage of patients expressing a preference for care in an established emergency department compared to a new walk-in centre facility raises questions for future policy development. Further consideration should therefore be given to the role that A&E focused walk-in centres play in the Department of Health’s current policy agenda, as far as patient choice is concerned

Effect of flue gas composition on deposit induced high temperature corrosion under laboratory conditions mimicking biomass firing. Part II: Exposures in SO₂containing atmospheres

In biomass fired power plants, the fast corrosion of superheaters is facilitatedby the presence of corrosive flue gas species, for example, SO2, which arereleased during combustion. To understand the role of the gas species on thecorrosion process, comparative laboratory exposures of deposit (KCl)-coatedand deposit-free austenitic stainless steel (TP 347H FG) samples to gas mixturescontaining SO2 was carried out, under conditions relevant to biomass-firing.Exposures were conducted isothermally at 560 8C for 72 h, in oxidizingsulphidizing,and oxidizing-sulphidizing-chlorinating gas mixtures containing60 ppmv SO2. Scanning electron microscopy (SEM), energy dispersive X-rayspectroscopy (EDS) and X-ray diffraction (XRD) techniques werecomplimentarily applied to characterize the resulting corrosion products. Apartially molten K2SO4-layer formed on KCl coated specimens, and corrosionresulted in localized broad pits containing sulphides and oxides. The severepitting attack was decreased by the presence of HCl in the gas mixture