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From the late 20th century, economic pressure on public library budgets rises as government funding has declined (Aabø, 2009; Child & Goulding, 2012). Under increasing financial pressure, creating a procedure for how public libraries can provide fulfilling services to residents is one of the essential issues in public library management. As a result, internationally, management models of public libraries have become more diverse in terms of dealing with financial problems. For example, there are management models such as the Designated Manager System (privatisation of public libraries) in Japan, the Community Libraries (managed by volunteers) in England, and the Combined Libraries (hybridisation of different types) in the Nordic Countries. All of these management models are a means to address the financial challenges of public libraries. In the same way in the United States, library districts are receiving much attention as a management model that responds to financial deterioration. Library districts are Special-Purpose Governments that have a tax levy and bond authority for library management. Also, library districts are formed through a referendum. Recent studies have demonstrated that library districts' revenues are more stable over the long term than those of other legal bases, such as General-Purpose Governments and Non-Profit Organisations (NPOs) in the United States (Elliott, 2013; Goldman, 2018). However, forming library districts are not simple, because it means a tax increase for residents. Nevertheless, the number of library districts has increased since the late 20th century. Why do voters allow a tax levy for library management? In this paper, we examined in detail the arguments regarding the formation of library districts through an in-depth case analysis. In this research, we analysed the “voters’ pamphlet” distributed to residents at the time of referendum for forming the Josephine Community library district in the state of Oregon. The “voters’ pamphlet” described detailed opinions of residents regarding formation of library districts. In the analysis, based on the constituents of library district management presented through a comprehensive literature review by Suzuki and Koizumi (2020), we analysed the opinions of the residents through a qualitative content analysis. Specifically, through the analysis of opinions in favour, we illustrated the factors that residents allow to form library districts. Second, through the analysis of opinions in opposition, we illustrated the factors that residents opposed to form library districts. As a result, we showed the following research results. Those in favour emphasised the significance of public libraries in the community. On top of that, they allowed the formation of the library district as a means to provide library services sustainably. In particular, they were satisfied with the current library service and hoped to enhance it further. On the other hand, many opponents opposed the formation of the library district, even though they recognised the value of public libraries. It was against the permanent taxation of the library district. Also, opponents called for donations to public libraries. In other words, the significance of public libraries in the community was a common understanding among residents. The argument is how much the residents are willing to accept the burden of providing library services., Bobcatsss, Bobcatsss 2021: Digital Transformation

Herein we present simple methods to prevent postoperative inguinal hernia (IH) after extraperitoneal and transperitoneal robot-assisted radical prostatectomy (RARP). Among 275 patients who underwent RARP between January 2014 and December 2016 at our institution, we evaluated 143 and 115 patients who underwent extraperitoneal-RARP (e-RARP) and transperitoneal-RARP (t-RARP), respectively, after excluding those with intraoperative detection of IH (17 patients). In the e-RARP group, all 143 patients (286 groins) underwent an IH prevention procedure. In the t-RARP group, the first 22 patients (44 groins) did not undergo an IH prevention procedure, whereas 29 patients (37 groins) with patent processus vaginalis (PPV) among the last 93 patients underwent the procedure. The IH prevention procedure during e-RARP included release of the vas deferens from the peritoneum and spermatic cord, and peritoneal dissection of the spermatic cord at the internal inguinal ring. The IH prevention procedure during t-RARP included release of the vas deferens from the peritoneum and spermatic cord, complete circumferential dissection of the peritoneum around the PPV at the level of the internal inguinal ring, and ligation of the PPV with a Hem-o- Loc○R clip. In the e-RARP group, postoperative IH occurred in 3 of the 143 patients (1.9%) during the follow-up period of 22.0±9.2 months. In the first subgroup of t-RARP, postoperative IH developed in 4 of the 22 patients (18%) during the follow-up period of 33.1±12.1 months, whereas in the last t-RARP group, postoperative IH developed in 3 of the 93 patients (3.3%) during the follow-up period of 20.1±8.6 months. Different IH prevention procedures performed in patients undergoing e-RARP and t-RARP were simple and effective in preventing postoperative IH.

2021, この博士論文は内容の要約のみの公開（または一部非公開）になっています