Spatial clustering of mental disorders and associated characteristics of the neighbourhood context in Malmö, Sweden, in 2001

Study objective: Previous research provides preliminary evidence of spatial variations of mental disorders and associations between neighbourhood social context and mental health. This study expands past literature by (1) using spatial techniques, rather than multilevel models, to compare the spatial distributions of two groups of mental disorders (that is, disorders due to psychoactive substance use, and neurotic, stress related, and somatoform disorders); and (2) investigating the independent impact of contextual deprivation and neighbourhood social disorganisation on mental health, while assessing both the magnitude and the spatial scale of these effects. Design: Using different spatial techniques, the study investigated mental disorders due to psychoactive substance use, and neurotic disorders. Participants: All 89 285 persons aged 40–69 years residing in Malmö, Sweden, in 2001, geolocated to their place of residence. Main results: The spatial scan statistic identified a large cluster of increased prevalence in a similar location for the two mental disorders in the northern part of Malmö. However, hierarchical geostatistical models showed that the two groups of disorders exhibited a different spatial distribution, in terms of both magnitude and spatial scale. Mental disorders due to substance consumption showed larger neighbourhood variations, and varied in space on a larger scale, than neurotic disorders. After adjustment for individual factors, the risk of substance related disorders increased with neighbourhood deprivation and neighbourhood social disorganisation. The risk of neurotic disorders only increased with contextual deprivation. Measuring contextual factors across continuous space, it was found that these associations operated on a local scale. Conclusions: Taking space into account in the analyses permitted deeper insight into the contextual determinants of mental disorders

International Labor Standards, Soft Regulation, and National Government Roles

[Excerpt] In this article, we briefly describe the different approaches to the regulation of international labor standards, and then argue for a new role for national governments based on soft rather than hard regulation approaches. We argue that this new role shows potential for significantly enhancing progress in international labor standards, since it enables governments to articulate a position without having to deal with the enforcement issues that hard regulation mandates. We justify this new role for governments based on the increasing use of soft regulation in the international arena. Of course, this approach is not without its own problems, but given that existing approaches have all provided imperfect solutions to the problem of improving labor standards globally, re-visiting the role of national governments is in our view, highly important

The question of EU legitimacy in the Social OMC peer review process

This paper examines the structural kand relational factors that affect perceptions of legitimacy in the EU's Social Open Method of Coordination, particularly in its peer review process. Using multi-level governance as its analytical framework, the paper uses network analysis to examine the actor networks and relations within the peer review process over time, and links this with different conceptions of input and throughput legitimacy, and the findings show that the peer reviews do not significantly feed into either input or throughput legitimacy. While input legitimacy is improved somewhat by the inclusion of additional actors in the policy process, these actors do not have a clear role to play and the peer reviews remain driven by traditional actors. In terms of throughput, the process does positively address issues of transparency, procedure and information provision, there is no clear path for translating these processes into an increase in perceptions of legitimacy

Moebius strip enterprises and expertise in the creative industries: new challenges for lifelong learning?

The paper argues that the emergence of a new mode of production – co-configuration is generating new modes of expertise that EU policies for lifelong learning are not designed to support professionals to develop. It maintains that this change can be seen most clearly when we analyse Small and Medium Size (SMEs) enterprises in the creative industries. Drawing on concepts from Political Economy - ‘Moebius strip enterprise/expertise’ and Cultural Historical Activity Theory - project-object’ and the ‘space of reasons’, the paper highlights conceptually and through a case study of an SME in the creative industries what is distinctive about the new modes of expertise, before moving on to reconceptualise expertise and learning and to consider the implications of this reconceptualisation for EU policies for lifelong learning. The paper concludes that the new challenge for LLL is to support the development of new forms expertise that are difficult to credentialise, yet, are central to the wider European goal of realising a knowledge economy

Fixing the Climate with Experimentalist Governance? How?

Official climate data tell us with a very low degree of uncertainty that global temperatures for the months of September and October 2023 represent the highest anomaly ever recorded. The challenge before us, of large and timely phasing out of greenhouse gas emissions is enormous in scale and complexity. There appear to be no ready and fast solutions but there is a need for profound technological changes in several different production sectors. Finally, these solutions must be adopted quickly and promptly to reduce the magnitude of irreversible changes to the planet’s climate. The good news, the most reputable studies tell us, is that the technical knowledge available to us allows us to have real solutions. In the latest International Energy Agency report, World Energy Outlook 2023 released just a few days ago, institute director Fatih Birol writes in the preface that ‘[t]oday, solar power, wind power, efficiency and electric cars are all well established and readily available. We have at our disposal the lasting solutions to today’s energy dilemmas.’ We can thus truly aspire to have the opportunity to be the first generation to have transformed their lifestyles into fully sustainable modes. On October 26, 2023, the Law department of Roma Tre University hosted a special event within the ‘Inequality in Rome Seminar Series’, hosting Prof. Charles Sabel of Columbia University School of Law to discuss his new volume Fixing the Climate: Strategies for an Uncertain World, co-authored with Prof. David Victor of the University of California San Diego. This special event was organized in collaboration with the Forum Disuguaglianze and Diversità, an Italian organization that brings together researchers and civil society members to design and advocate for public policies that aim at reducing the levels of inequality in the country. Sabel and Victor’s book proposes an innovative method that can work in the context of radical and pervasive uncertainty about the solutions to be undertaken to make the energy and ecological transition more affordable. How? The core of the book lies in the model of global governance of climate change that it promotes. The overall premise is clear – no response to climate change will succeed without international cooperation (p. 153).The problem is what type of cooperation international law should embrace. The answer is, according to the authors, ‘experimentalist governance’ (hereinafter EG), a system that goes beyond the Paris Agreement (2015). They argue that such Agreement has failed to achieve its goals. The book instead puts forward the model of governance endorsed by the 1987 Montreal Protocol on Substances that Deplete the Ozone Layer – a history of success, as the Authors rightly maintain (see pp. 4 to 7 and Ch 2). The book forcefully suggests that we need to reward those who innovate and destabilize the status quo and penalize those who do not want to change through experimental and concrete processes of collaboration between business, between State, business, and citizens, and between States. The states should set ambitious standards and broad goals that are able to incentivize economic agents to act. Moreover, those who set standards interact with those who must solve problems on the ground and implement solutions, following an iterative process of mutual correction of the roadmap and concrete goals to achieve. Such solutions aim at complementing classical marketbased approaches. Indeed, the experimentalist governance approach operates in a decentralized manner, coordinating myriads of individuals, institutions, and economic agents just as happens in markets but not by means of prices, but by setting standards that are continually revised by accumulating new information, if necessary, through deliberative and discussion processes. A form of deliberation that uses doubt, disagreement, and a peer review process to advance the technological frontier even in an environment of profound uncertainty. In this article, we propose the main issues and questions that were raised during the seminar by the panelists Prof. Barbara Annicchiarico, Prof. Roberto Baratta, Prof. Tommaso di Marcello, as well as from the coordinator Prof. Salvatore Morelli. Prof. Charles Sabel provides his responses in turn

Alveolar Soft Part Sarcoma Metastatic to Small Bowel Mucosa Causing Polyposis and Intussuseption

A report of alveolar soft part sarcoma metastatic to the small bowel is presented. Hematogenous metastases to the small bowel from primary tumors outside the abdominal cavity are uncommon, and most remain asymptomatic and are not discovered until autopsy. However, small bowel metastases can lead to intestinal obstruction, intussuseption or even perforation. While metastases to the small bowel have been described for other tumor types, including melanoma and lung cancer, this is extremely uncommon for sarcoma, especially alveolar soft part sarcoma. We describe a 42-year-old male with a long history of alveolar soft part sarcoma, metastatic to the lung and brain, who developed an intussuseption from metastases to the small bowel

Systematizing Policy Learning: From Monolith to Dimensions

notes: The authors wish to express their gratitude to the Norwegian Political Science Association Annual Conference, 6 January 2010, University of Agder, Kristiansand, participants of the ‘Establishing Causality in Policy Learning’ panel at the American Political Science Association (APSA) annual meeting,2–5 September 2010,Washington DC, and the European Consortium of Political Research (ECPR) Joint Sessions, St Gallen, 12–17 April 2011, workshop 2. Dunlop and Radaelli gratefully acknowledge the support of the European Research Council, grant on Analysis of Learning in Regulatory Governance, ALREG, http://centres.exeter.ac.uk/ceg/research/ALREG/index.php.publication-status: AcceptedThe definitive version is available at www.blackwell-synergy.com and also from DOI: 10.1111/j.1467-9248.2012.00982.xThe field of policy learning is characterised by concept stretching and lack of systematic findings. To systematize them, we combine the classic Sartorian approach to classification with the more recent insights on explanatory typologies. At the outset, we classify per genus et differentiam – distinguishing between the genus and the different species within it. By drawing on the technique of explanatory typologies to introduce a basic model of policy learning, we identify four major genera in the literature. We then generate variation within each cell by using rigorous concepts drawn from adult education research. Specifically, we conceptualize learning as control over the contents and goals of knowledge. By looking at learning through the lenses of knowledge utilization, we show that the basic model can be expanded to reveal sixteen different species. These types are all conceptually possible, but are not all empirically established in the literature. Up until now the scope conditions and connections among types have not been clarified. Our reconstruction of the field sheds light on mechanisms and relations associated with alternatives operationalizations of learning and the role of actors in the process of knowledge construction and utilization. By providing a comprehensive typology, we mitigate concept stretching problems and aim to lay the foundations for the systematic comparison across and within cases of policy learning.European Research Council, grant no 230267 on Analysis of Learning in Regulatory Governance, ALREG

First-line high-dose therapy and autologous blood stem cell transplantation in patients with primary central nervous system non-Hodgkin lymphomas-a single-centre experience in 61 patients

Primary central nervous system non-Hodgkin lymphomas (PCNS-NHLs) are extranodal B-cell lymphomas with poor prognosis. The role of high-dose therapy (HDT) followed by autologous blood stem cell transplantation (ASCT) as first-line therapy is still not clear. We retrospectively collected long-term follow up data of 61 consecutive patients with PCNS-NHL at the University Hospital Düsseldorf from January 2004 to December 2016. Thirty-six patients were treated with conventional chemoimmunotherapy (cCIT) only (CT-group). Seventeen patients received an induction cCIT followed by HDT and ASCT. In the CT-group, the overall response rate (ORR) was 61% (CR 47%, PR 14%), and there were 8% treatment-related deaths (TRD). Progression-free survival (PFS) was 31.8 months, and overall survival (OS) was 57.3 months. In the HDT-group, the ORR was 88% (59% CR, 29% PR), and there were 6% TRD. Median PFS and OS were not reached at 5 years. The 5-year PFS and OS were 64.7%. After a median follow up of 71 months, 10 patients (59%) were still alive in CR/PR following HDT and ASCT, one patient was treated for progressive disease (PD), and 7 had died (41%, 6 PD, 1 TRD). All patients achieving CR prior to HDT achieved durable CR. In the CT-group, 8 patients (22%) were alive in CR/PR after a median follow-up of 100 months. Twenty-eight patients died (78%, 24 PD, 2 TRD, 2 deaths in remission). In the univariate analysis, the HDT-group patients had significantly better PFS (not reached vs 31.8 months, p = 0.004) and OS (not reached vs 57.3 months, p = 0.021). The multivariate analysis showed HDT was not predictive for survival. Treatment with HDT + ASCT is feasible and offers the chance for long-term survival with low treatment-related mortality in younger patients. In this analysis, ORR, PFS and OS were better with HDT than with conventional cCIT alone. This result was not confirmed in the multivariate analysis, and further studies need to be done to examine the role of HDT in PCNSL