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The California State University Library successfully improved its library’s hours, including introducing 24-hour access, thanks in part to an assessment process that helped the University Library to develop a partnership with the students. The paper aims to discuss this issue.

In order to understand the need for expanded operational hours, students’ were surveyed on their satisfaction with current library hours, suggestions on how best to meet their actual hour needs, and interest in 24-hour access. Efforts to solicit student input included involving the student government in promoting the survey and reviewing its results, a decision that later had a major impact on the success of the project.

The survey identified days with problematic hours and which hours student suggested changes to that would best fit most students’ needs. In response to the findings, the library immediately implemented incremental changes that fit within current library resources. The survey’s most significant finding was that 94 percent of students wanted 24-hour study in the library.

An unexpected benefit of the library making immediate, incremental changes was that students could see the results of their input and feel a sense of ownership. The findings also led to the library making 24-hour access a top priority. When university funding was not available, the university’s student government approached the library with a unique proposal to include funding for 24-hour library access in their proposed student fee increase. The student body showed its willingness to invest in the library by passing the fee increase. California State University San Marco’s library began 24/5 hours in Fall 2017.

Many cases of food poisoning originate in the domestic environment and can be associated with improper food handling and ineffective cleaning by consumers. These practices could lead to the introduction and spread of bacterial contamination in the kitchen and if not subsequently removed could present an infection risk. This study proposes investigating changes in levels of bacterial contamination at five key sites in ten domestic kitchens during a period of 24 hours.

Microbiological swabs were used to provide an aerobic colony count and an Enterobacteriacea count. A record was kept of cooking, cleaning and other activities within the kitchen.

Results showed that contamination levels varied during the day, peaking after meal preparation and generally falling overnight. There was also indirect evidence of cross contamination, particularly from hands to other surfaces. Sites such as the refrigerator handle, kettle handle and taps, which generally only come into contact with hands, show increases in the levels of contamination recorded. Levels of microbiological contamination were lower in vegetarian than non‐vegetarian households. A variety of data showed that non‐food preparation activities also take place in the kitchen. These could also introduce bacterial contamination into the kitchen and facilitate their spread.

The implications of these results are that the most important time for cleaning in the kitchen is immediately after food has been prepared, with attention focussing on high risk areas such as the work surface, chopping board, taps and other hand contact surfaces.

The paper aims to explore the characteristics of night shoppers at a large, out of centre UK supermarket which is “open 24 hours”.

An exploratory study of one such store based on short interviews with a stratified random sample of shoppers who completed their shopping between 22.00 and 08.00. Data were collected on customer demographics and shopping patterns.

It is shown that shopping is concentrated in the late evening and early morning with only low sales in the midnight to 6 a.m. time period. Shoppers, predominantly car users, are split equally between males and females although the females tend to be younger. Few people over 50 use the night shopping facility. Virtually all shoppers are in employment and many are engaged in shift working. The shoppers can be dichotomised into two groups: the weekly shoppers and the essential shoppers. A further categorisation of these two broad groups is proposed.

Provides retail management with a profile of the night shopper.

One of the first detailed studies of the night shopper in large supermarkets which are open 24 hours.

Twenty‐four hour pH monitoring is an expensive, time‐consuming and uncomfortable investigation only necessary in a small proportion of patients with gastro‐oesophageal reflux disease. Guidelines have been published by the British Society of Gastroenterology, in order to clarify those patients likely to benefit. Aims to assess whether these guidelines are being followed in a large teaching hospital. A random selection of the notes of all patients referred for 24‐hour pH monitoring at the Queens Medical Centre were assessed for the appropriateness of referral. A total of 114 patients were referred for pH monitoring, and the notes of 77 of them reviewed. This audit shows that in the majority of cases guidelines are being followed. Referrals from non‐gastrointestinal specialties accounted for 50 per cent of cases where they were not. In addition, 40 per cent of all referrals from non‐gastrointestinal specialties failed to follow guidelines, suggesting that this group is either educated further as to their contents, or that all patients referred for 24‐hour pH monitoring see a medical or surgical gastroenterologist prior to the investigation.

Venous thromboembolism (VTE) prophylaxis guidelines were originally published by the National Institute of Clinical Excellence (NICE) in April 2007. Controversy eclipsed their release. Consequently, the VTE prophylaxis publication was reviewed and republished in January 2010. The NICE guidelines recommend that all patients are assessed for risk before pharmacological prophylaxis is offered and reassessed at 24 hours to check adverse reactions; and that prophylaxis is appropriate. This paper aims to look at their implementation.

A prospective audit and re‐audit in one orthopaedic department was completed to see how well the new guidelines were adhered to, find out first‐hand what problems there were, and how they might be remedied.

Audit and re‐audit highlighted that attaching an assessment tool to drug charts is plausible.

The study was limited to one centre and used a relatively weak research design.

As a process, the clinical impact of risk assessment for VTE is questionable as many patients will be high risk. Removing reassessment at 24 hours from the NICE guidance is recommended.

The authors put the NICE guideline into clinical practice, demonstrating how effectively it can work with their method, but also highlighting its flaws.

This paper aims to develop an electrochemical dechlorination method for large objects in a short time, which were for a long time in the sea. Traditionally, in conservation, chlorides are extracted from marine iron artifacts using complete immersion of those objects in alkaline solutions with or without electrolysis. However, these techniques are time-consuming and very costly, especially when applied to large marine artifacts such as cannons and anchors.

An appropriate sponge was chosen based on resistance to NaOH and the rate of exacted chlorides. Application of electrochemical dechlorination in situ and removal of chloride were measured by the scanning electron microscope (SEM)-EDAX method on the corrosion products and by titration of the electrolysis solution. X-ray diffraction (XRD) method is used for identification of corrosion products before and after application of electrochemical chloride extraction.

The electrochemical chloride extraction (ECE) method is applied against the corrosion of reinforced concrete. From the authors’ research, it is obvious that ECE can successfully extract chlorides from dried large metallic objects exported from the sea. The method of ECE removes the majority of chlorides from the metal during conservation treatment so that the application of organic coating will allow the object to remain stable over a long period.

A new methodology was developed for dechlorination of metallic objects exported from the sea in a short time and thus the consumption of chemical reagents was cut down.

Cancelled operations are a major drain on health resources: 8 per cent of scheduled elective operations are cancelled nationally, within 24 hours of surgery. The aim of this study is to define the extent of this problem in one Trust, and suggest strategies to reduce the cancellation rate.

A prospective survey was conducted over a 12‐month period to identify cancelled day case and in‐patient elective operations. A dedicated nurse practitioner was employed for this purpose, ensuring that the reasons for cancellation and the timing in relation to surgery were identified. The reasons for cancellation were grouped into patient‐related reasons, hospital clinical reasons and hospital non‐clinical reasons.

In total, 13,455 operations were undertaken during the research period and 1,916 (14 per cent) cancellations were recorded, of which 615 were day cases and 1,301 in‐patients: 45 per cent (n=867) of cancellations were within 24 hours of surgery; 51 per cent of cancellations were due to patient‐related reasons; 34 per cent were cancelled for non‐clinical reasons; and 15 per cent for clinical reasons. The common reasons for cancellation were inconvenient appointment (18.5 per cent), list over‐running (16 per cent), the patients thought that they were unfit for surgery (12.2 per cent) and emergencies and trauma (9.4 per cent).

This study demonstrates that 14 per cent of elective operations are cancelled, nearly half of which are within 24 hours of surgery. The cancellation rates could be significantly improved by directing resources to address patient‐related causes and hospital non‐clinical causes.

This paper is of value in that it is demonstrated that most cancellations of elective operations are due to patient‐related causes and several changes are suggested to try and limit the impact of these cancellations on elective operating lists.

The purpose of this paper is to describe and explain a clinician‐led improvement of a hip fracture care process in a university hospital, and to assess the results and factors helping and hindering change implementation.

The paper has a mixed methods case study design. Data collection was guided by a framework directing attention to the content and process of the change, its context and outcomes.

Using a multiprofessional project team, beneficial changes in the early parts of the care process were achieved, but inability to change surgical staff work practices meant that the original goal of operating patients within 24 hours was not reached. After three years, top management introduced a hospital‐wide process improvement programme, which “took over” the responsibility for improving hip fracture care.

A clear vision why change is needed and what needs to be done, which is well communicated by a respected clinical leader, can motivate personnel, but other influences are also needed to bring about change. Without a plan agreed and supported by top management, changes are likely to be limited to parts of the process and improvements to patient care may be minimal. These and other findings may be applicable to similar situations in other services.

This case study is an illustration of both the strengths and the weaknesses of a “bottom‐up, clinician‐champion‐led improvement initiative” in a complex university hospital.

This paper aims to investigate the performance of estimators of the bid-ask spread in a wide range of circumstances and sampling frequencies. The bid-ask spread is important for many reasons. Because spread data are not always available, many methods have been suggested for estimating the spread. Existing papers focus on the performance of the estimators either under ideal conditions or in real data. The gap between ideal conditions and the properties of real data are usually ignored. The consistency of the estimates across various sampling frequencies is also ignored.

The estimators and the possible errors are analysed theoretically. Then we perform simulation experiments, reporting the bias, standard deviation and root mean square estimation error of each estimator. More specifically, we assess the effects of the following factors on the performance of the estimators: the magnitude of the spread relative to returns volatility, randomly varying of spreads, the autocorrelation of mid-price returns and mid-price changes caused by trade directions and feedback trading.

The best estimates come from using the highest frequency of data available. The relative performance of estimators can vary quite markedly with the sampling frequency. In small samples, the standard deviation can be more important to the estimation error than bias; in large samples, the opposite tends to be true.

There is a conspicuous lack of simulation evidence on the comparative performance of different estimators of the spread under the less than ideal conditions that are typical of real-world data. This paper aims to fill this gap.