International, National, and Local Notions of the Public Library: An extended case study in Namibia

This dissertation is a study of library use in a poor neighborhood in Windhoek, Namibia, to understand the diffusion of public libraries around the world. I used a sociological approach and the Extended Case Method (Burawoy, 1991; 1998). Two theories framed the research: World Society Theory (Meyer et al. 1997) and New Institutional Theory (Powell and DiMaggio, 1991). World Society Theory was developed from evidence of similarities in governmental, health and educational organizations globally that demonstrates the growth of a world culture based on a rationalistic and scientific approach to knowledge. The findings show that international notions of public libraries do influence national and local notions of them. Local and national notions of the library also have influence, however, and the libraries are ultimately an amalgamation of local and international notions, reflecting in part the needs of the community for education and self-development

Mid-Proterozoic Ferruginous Conditions Reflect Postdepositional Processes

To evaluate the mechanics of mid‐Proterozoic environmental iron transport and deposition, we coupled microscale textural and bulk rock magnetic techniques to study the ~1.4‐Ga lower Belt group, Belt Supergroup, Montana and Idaho. We identified a pyrrhotite‐siderite isograd that marks metamorphic iron‐bearing mineral reactions beginning in subgreenschist facies samples. Even in the best‐preserved parts of the basin, secondary overprints were common including recrystallization of iron‐bearing sulfides, base metal sulfides, and nanophase pyrrhotite. Despite these overprints, a record of redox chemistry was preserved in the early diagenetic framboidal pyrite and detrital iron oxides including trace nanoscale magnetite that remained after sulfidization in anoxic and sulfidic sedimentary pore fluids. Based on these results, we interpret the Belt Basin as having oxic waters, at least in shallow‐water environments, with no indication of abundant ferrous iron in the water column; this is consistent with the cooccurrence of early eukaryotic fossils within the same strata

Iron mineralogy and redox conditions during deposition of the mid-Proterozoic Appekunny Formation, Belt Supergroup, Glacier National Park

The redox state of the mid-Proterozoic oceans, lakes, and atmospheres is still debated, but it is vital for understanding the emergence and rise of macroscopic organisms and eukaryotes. The Appekunny Formation, Belt Supergroup, Montana, contains some of these early macrofossils dated between 1.47 Ga and 1.40 Ga and provides a well-preserved record of paleoenvironmental conditions. We analyzed the iron chemistry and mineralogy in samples from Glacier National Park, Montana, by pairing bulk rock magnetic techniques with textural techniques, including light microscopy, scanning electron microscopy, and synchrotron-based X-ray absorption spectroscopy. Field observations of the Appekunny Formation combined with mineralogical information allowed revised correlations of stratigraphic members across the park. However, late diagenetic and/or metasomatic fluids affected primary iron phases, as evidenced by prevalent postdepositional phases including base-metal sulfides. On the west side of the park, pyrrhotite and chlorite rims formed during burial metamorphism in at least two recrystallization events. These complex postdepositional transformations could affect bulk proxies for paleoredox. By pairing bulk and textural techniques, we show primary records of redox chemistry were preserved in early diagenetic and often recrystallized framboidal pyrite, submicron magnetite grains interpreted to be detrital in origin, and red-bed laminae interpreted to record primary detrital oxides. Based on these observations, we hypothesize that the shallow waters of the mid-Proterozoic Belt Basin were similar to those in modern marine and lacustrine waters: fully oxygenated, with detrital reactive iron fluxes that mineralized pyrite during organic diagenesis in suboxic, anoxic, and sulfidic conditions in sedimentary pore waters

Climate Risk in the Electricity Sector: Legal Obligations to Advance Climate Resilience Planning by Electric Utilities

Electricity generation, transmission and distribution, and load are all impacted by weather patterns. Electric system assets have been designed for historic weather conditions, with the goal of ensuring reliability and quick recovery following extreme events. However, climate change is causing major shifts in historic weather patterns and more frequent and severe extremes, which are creating new risk profiles for the electric system. Proactive climate resilience planning by electric utilities to identify, respond, and rationally allocate these climate risks is thus increasingly salient. This paper argues that it is also legally required. Recently published industry studies demonstrate that accurate, specific, and actionable climate resilience planning is possible. Nevertheless, and despite the significant benefits of climate resilience planning, relatively few electric utilities have engaged in the process. This paper explores two legal doctrines, public utility law and tort law, which we argue obligate electric utilities to plan for the impacts of climate change on their assets and operations. Public utility law requires electric utilities to meet, among other things, prudent investment and reliability standards. Tort law establishes a duty of care that obligates electric utilities to, among other things, avoid foreseeable harm when performing acts that could injure others. We argue that, as climate science becomes more precise and predictive, these legal standards take on new meaning and require electric utilities to engage in climate resilience planning

Effects of vitamin D deficiency on neurobehavioural outcomes in children: a systematic review

Introduction: Vitamin D plays an important role in brain development in experimental studies; however, the effect of vitamin D deficiency on child development remains inadequately characterized. We aimed to estimate the effects of vitamin D deficiency on neurobehavioural outcomes in children up to 18 years of age. Methods: We searched PubMed, EMBASE, PsycINFO, Scopus, Cochrane Library, Web of Science and Open Grey for published studies up to 10th January 2020. We included all studies that assessed the effects of maternal or child vitamin D status or vitamin D supplementation on neurobehavioural outcomes in children. Study findings were synthesized qualitatively as the high level of heterogeneity in study populations and methodologies precluded a quantitative meta-analysis. Results: Our search identified 5,633 studies, of which 31 studies with 31,375 participants from 18 countries were included in the systematic review. Of the studies identified, one was a randomised controlled trial (RCT) of vitamin D supplementation in children, while 30 were observational. The RCT (n=55) reported a beneficial effect of supplementation with lower doses compared to higher doses of vitamin D on motor development. Twelve mother-child studies (n=17,136) and five studies in children (n=1,091) reported an association between low maternal or child 25-hydroxyvitamin D levels and impaired neurobehavioural outcomes in children, while 15 mother-child studies (n=20,778) and eight studies in children (n=7,496) reported no association. Conclusions: Although animal studies point to an effect of vitamin D deficiency on brain development, there are few studies on the effects of vitamin D deficiency on neurobehavioural outcomes in children and their findings are inconsistent. There is a need for well-conducted, adequately powered studies to further determine these effects in children

Options for Breast Cancer Prevention in High-Risk Patients

Breast cancer is the most frequently diagnosed non-skin cancer in women, and one in eight women will develop breast cancer within their Iifetimes. Unfortunately, the strongest risk factors for breast cancer (i.e. age, family history, hormonal factors) are not easily modified. There is some evidence that chemopreventative drugs may be able to prevent breast cancer in high-risk patients. Tamoxifen and raloxifene have been shown to reduce the risk of breast cancer in high-risk women but may be associated with several serious adverse events. Clinical trials are currently in progress to determine if aromatase inhibitors are a viable alternative for breast cancer prevention, as they may be considered effective in the early treatment of breast cancer. For patients with BRCA1 and BRCA2 mutations, a bilateral prophylactic mastectomy may be an option. This article discusses the risks and benefits of available treatment options for breast cancer prevention in high-risk patients

Prevalence and causes of prescribing errors: the prescribing outcomes for trainee doctors engaged in clinical training (PROTECT) study

Objectives Study objectives were to investigate the prevalence and causes of prescribing errors amongst foundation doctors (i.e. junior doctors in their first (F1) or second (F2) year of post-graduate training), describe their knowledge and experience of prescribing errors, and explore their self-efficacy (i.e. confidence) in prescribing. Method A three-part mixed-methods design was used, comprising: prospective observational study; semi-structured interviews and cross-sectional survey. All doctors prescribing in eight purposively selected hospitals in Scotland participated. All foundation doctors throughout Scotland participated in the survey. The number of prescribing errors per patient, doctor, ward and hospital, perceived causes of errors and a measure of doctors' self-efficacy were established. Results 4710 patient charts and 44,726 prescribed medicines were reviewed. There were 3364 errors, affecting 1700 (36.1%) charts (overall error rate: 7.5%; F1:7.4%; F2:8.6%; consultants:6.3%). Higher error rates were associated with : teaching hospitals (p&#60;0.001), surgical (p = &#60;0.001) or mixed wards (0.008) rather thanmedical ward, higher patient turnover wards (p&#60;0.001), a greater number of prescribed medicines (p&#60;0.001) and the months December and June (p&#60;0.001). One hundred errors were discussed in 40 interviews. Error causation was multi-factorial; work environment and team factors were particularly noted. Of 548 completed questionnaires (national response rate of 35.4%), 508 (92.7% of respondents) reported errors, most of which (328 (64.6%) did not reach the patient. Pressure from other staff, workload and interruptions were cited as the main causes of errors. Foundation year 2 doctors reported greater confidence than year 1 doctors in deciding the most appropriate medication regimen. Conclusions Prescribing errors are frequent and of complex causation. Foundation doctors made more errors than other doctors, but undertook the majority of prescribing, making them a key target for intervention. Contributing causes included work environment, team, task, individual and patient factors. Further work is needed to develop and assess interventions that address these.</p

An Update on Gestational Diabetes

Gestational diabetes is a concern for a large number of pregnant women due to the potential for long-term complications for both the mother and the fetus. With the increasing prevalence of obesity and diabetes in the general public, the number of pregnant women with undiagnosed type 2 diabetes mellitus has also increased. In order to adequately educate their patients, it is important for pharmacists to be aware of the general practices of treating gestational diabetes. This review will highlight recent updates to initial screening, the criteria for diagnosing gestational diabetes, and current management strategies