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Alpha-1 adrenergic receptor (α1-AR) antagonists are commonly used for management of benign prostatic hyperplasia or hypertension. Some studies have shown a potential link between α1-AR antagonist use and cognitive impairment. Given the conflicting data surrounding α1-AR antagonists association with cognitive dysfunction, we aim to systematically review the association of cognitive dysfunction with α1-AR antagonist use to aid clinician decision both with medication initiation and continuation. A systematic review was performed following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. We searched Ovid Cochrane, Ovid Embase, Ovid MEDLINE, Scopus, and Web of Science on March 7, 2023, with an update run on January 22, 2024. The primary outcome was cognitive dysfunction. We used Cochrane risk of bias for randomized controlled trials (RCTs) and MINORS (Methodological Index for Non-Randomized Studies) criteria for non-RCTs to evaluate study quality. This study was registered with PROSPERO (CRD42024505751). We identified 7 studies for our systematic review (3 RCTs, 4 non-RCTs). Tamsulosin was the most studied medication (6 of 7 studies). Tamsulosin was associated with no cognitive dysfunction in 2 RCTs, increased risk for dementia in 2 non-RCTs, no change in cognition in 1 non-RCT, and decreased risk for dementia in 1 non-RCT. Among 3 non-RCTs analyzing alfuzosin, it was associated with decreased risk of or no association with dementia in 2 studies and increased risk for dementia in 1 study. Doxazosin, prazosin, and terazosin were neutral or showed a negative risk for dementia. Our systematic review did not show a convincing causal association between α1-AR antagonists, including tamsulosin, and cognitive dysfunction. Considering the existing literature, it is appropriate to use α1-AR antagonists without concern for cognitive dysfunction. Future research, through robust study designs considering the multifactorial nature of cognitive dysfunction, is required to further evaluate this association.

This paper aims to synthesize previous user innovation policy proposals into an adapted system of innovation framework, on which a future holistic user innovation policy for the household sector can be based. We do this in three steps. First, we introduce the systems of innovation framework as a comprehensive basis for a holistic approach to innovation policy. Second, we identify and review policy proposals made by user innovation researchers and categorize them according to ten key activities in the systems of innovation framework. Third, from a system of innovation perspective, we synthesize the policy proposals identified into an adapted framework, including determinants specific to user innovation in the household sector. The synthesized proposals are intended to strengthen the systemic and multi-causal effects of policy on household sector user innovation in a country, region, or sector. Future policies for user innovation may, on this basis, be instrumental in avoiding mono-causality, or the concentration on only a few policy instruments in a proposed policy.

Over the past three decades, processes of assessing and governing mental healthcare have emerged at the European Union level. Consisting almost entirely of ‘soft law’ instruments, EU mental health governance (EUMHG) has incorporated policy-makers, mental healthcare providers, research scientists, non-governmental organizations, and patients and families across Europe in processes of mental health governance. This paper explores the role of the European Commission in EUMHG. It proposes that recent attempts to theorise the Commission’s role in European integration over-emphasise EU-level institutional relations and thus neglect the knowledge relations that are central to policy areas such as mental health. It therefore adopts an analytic framework based on Actor Network Theory that enables more accurate understanding of those relations. Applying this framework to EUMHG over time, it identifies three distinct networks that have emerged in EUMHG, all built via Commission initiatives. This analysis reveals the Commission’s central but not independent role in EUMHG’s survival, and illustrates how different kinds of actors held ‘expert’ roles in EUMHG depending on the way in mental (ill) health was problematised in EUMHG. The paper therefore suggests a new concern regarding the nature of ‘soft’ EU law, namely, its influence on knowledge and authority in transnationally constructed policy.

By analysing the regulating mechanisms of state subsidies to Swedish institutions generally considered mediating “popular education” during the twentieth century, it is argued that a tension has been developed between two parallel notions of popular education. A narrower ideal popular education—emphasising non-formality and independence—has been discursively nurtured along with a broader organisational popular education, denoting the de facto institutions that have received government funding, primarily the folk high schools and study associations. It is argued that the organisational popular education is a reality in itself, spanning over border zones between, for example, non-formal and formal education. Furthermore, an argument against using “popular education” as an analytical concept is put forth, since it is overly contested. Rather, it is promoted as a discursive construct that has formed real organisational structures with their own logic, which cannot be denoted by words such as non-formal adult education.

Since the early 1970s, in an effort to improve road safety, Australian railway authorities have made a concerted effort to reduce the number of level road-rail crossings, particularly those controlled by passive devices such as ‘give way’ or ‘stop’ signs. Despite this effort, approximately 1400 passive-controlled level crossings in Victoria remain in operation. To improve this situation, passive level crossings are often ‘upgraded’ with active traffic controls devices. Consequently, the question arises as to which of the available options represents the most effective active traffic control device at level crossings. The main objective of the present study was to compare the efficacy, and drivers’ subjective perception, of different traffic control devices at level crossings. Twenty-five fully-licensed drivers aged between 20 and 50 years participated in a high fidelity driving simulator study that compared three level crossing traffic control devices. A stop sign-controlled level crossing served as the passive referent, while two different active level crossing traffic control devices were also assessed: flashing lights and standard traffic lights. Because traffic lights are believed to be more recognisable and to convey more salient information to drivers than flashing lights, it was hypothesised that drivers would report a preference for traffic lights over flashing lights at level crossings, and that this preference would correlate with safer driving behaviour. In fact, however, the majority (56%) of drivers reported preferring flashing lights to traffic lights, and were less likely to commit a crossing violation at one equipped with flashing lights than one with traffic lights. Forty per cent of participants made violations at the stop sign-controlled level crossing. Collectively, results indicate that the installation of traffic lights at real-world level crossings may not offer safety benefits over and above those provided by flashing lights. Furthermore, the high rate of violations at passively controlled crossings strongly supports the continued practice of upgrading level crossings with active traffic control devices.

Over the past three decades, a system of European-Union mental health governance (EUMHG) has emerged that incorporates a wide variety of stakeholders and consists of soft law instruments like Green Papers, Joint Actions, and Frameworks for Action. This paper applies actor-network theory (ANT) to EUMHG as it operated between 1999-2018, to understand its operation and significance. ANT is a process of identifying the moments of 'translation'--the means and processes that integrate disparate actors--into networks. Such moments in EUMHG include the problematisation of mental health, the enrolment of actors and actants in EU-level governance processes, and the use of obligatory passage points through which actors must mediate their actions and views to join a network. This analysis shows that three distinct though sometimes concurrent actor-networks have operated within EUMHG from 1999-2018, distinguishable by their core problematisations of mental ill health and its role in European societies: a public health actor-network, a disease-burden actor network, and a de-institutionalisation and Community Mental Health actor-network. This analysis shows that the Commission of the European Union has acted as actor-network builder in the former and last networks, but not the middle, where international health organisations have played that role. In each network, different actors are the recognized experts. The paper therefore indicates that because mental health and mental ill health have not been stable scientific concepts, a specific 'epistemic community', e.g., of psychiatrists or psychologists, has not held a definitive role in EUMHG. Indeed, it shows that EUMHG has produced varying constellations of actors, actions, and expertise at any given time, and that they may contradict each other's purposes. These findings contribute to scholarly understanding of changes in EU governance from the early 2000s, specifically in terms of the Commission's role as an executive body, its engagement of scientific expertise, and its relations to civil society and international organizations. [ABSTRACT FROM AUTHOR]

This paper is concerned with the family as one of the key entrepreneurial and capitalist agents in the colonisation of Australia. Private enterprise has long been understood to be one of the prime factors in this history and Scottish families were particularly active. My case study is the Learmonth family who hailed from the Falkirk area in Stirlingshire, 44 km west of Edinburgh. Their story exemplifies the imbrication of family identity in its dynastic character with the opportunities afforded by the colonial expansion of the British empire and how this was figured in built works. Of significance for the paper is an understanding of what was at stake in Scotland for the Learmonth family and its lineage and how Thomas Learmonth, youngest of four sons, and his sons used colonial acquisitions to embellish their family status and identity at home. Ercildoun, the famous sheep station they established near Ballarat in Victoria was the final achievement of their Australian sojourn and it propelled them from the margins of Scottish life to somewhere much nearer its centre. The paper will show how they, as pastoralists and breeders of the “pure Australian merino” operated in the colonial enterprise-driven and global modality of economic migration that drove the expansion of the Port Phillip District of New South Wales in the 1830s and 1840s.

Carbapenemase-producing Enterobacteriaceae (CPE) are increasing worldwide, and are a major threat to healthcare systems. Recent European data support that many countries have interregional spread of CPE or an endemic situation. In Sweden mandatory laboratory reporting of CPE of both colonisation and infection has been practiced since 2007 and since 2012 also by treating physicians. Between 2007 and 2013, 94 cases of CPE were detected in Sweden, out of which 24 were considered to cause clinical infections (bloodstream infection ( n = 4), urinary tract infection ( n = 12), wound infection ( n = 4), respiratory tract infection ( n = 2) and catheter related ( n = 2). The majority were detected in the hospital setting through faecal screening or as probable colonisers in clinical cultures. Travel abroad was observed in the majority of the patients (81%), and among them 84% had been hospitalised. During the study period only two chains of transmissions in Swedish hospitals were reported, involving four patients. Klebsiella pneumoniae was the primarily isolated species ( n = 57) followed by Escherichia coli ( n = 29). bla NDM was the predominant carbapenemase gene ( n = 36), followed by bla OXA-48-group , bla KPC and bla VIM . In 26/94 cases (28%) isolates were categorised as possible XDR (extensively drug-resistant). CPE are increasing in Sweden, but are still at a comparably low level. [ABSTRACT FROM AUTHOR]

Abstract: The purpose of this article is to discuss the different types of instruments of innovation policy, to examine how governments and public agencies in different countries and different times have used these instruments differently, to explore the political nature of instrument choice and design (and associated issues), and to elaborate a set of criteria for the selection and design of the instruments in relation to the formulation of innovation policy. The article argues that innovation policy instruments must be designed and combined into mixes in ways that address the problems of the innovation system. These mixes are often called “policy mix”. The problem-oriented nature of the design of instrument mixes is what makes innovation policy instruments ‘systemic’. [Copyright &y& Elsevier]

An excerpt from a biography of Australian architect Harold Desbrowe-Annear is presented.

The article reviews the architectural design of the Bird de la Coeur Medical Clinic in Victoria.

The article offers information on the architectural works of Edith C. Ingpen, one of the best known women architects practising solo in Melbourne, Victoria. She graduated from the Melbourne University Atelier in 1933. It explores her partnership with architect Harold Desbrowe-Annear. It discusses the subject, themes and variations on the works of the two architects. It presents the way she creates an architectural work and also highlights the works of Desbrowe-Annear as well as the trainings and seminars he participated as a lecturer. Ingpen believes that the good design lies in the architect's concentration on its aesthetic appeal rather than the logic of the design.