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Autor u svome prilogu obrađuje prva tri teorijska djela o poredbenoj književnosti na svijetu, objavljena tridesetih godina XX. stoljeća. Nakon monografije "La littérature comparée" Paula Van Tieghema (1931) već iduće godine uslijedila je knjiga "Poredbena ili komparativna književnost" Ive Hergešića, koji je prije toga pohađao seminar Fernanda Baldenspergera na pariškoj Sorboni. Obje knjige detaljno je poznavao Anton Ocvirk, slovenski doktorand, koji je 1936. godine nakon dvogodišnjeg studija na Sorboni i Collège de France objavio i vlastitu "Teoriju poredbene povijesti književnosti" ("Teorija primerjalne literarne zgodovine"). Hrvatski i slovenski komparatist podosta slijede francusku knjigu. U sačuvanom Ocvirkovu primjerku Hergešićeve knjige nalazimo zanimljive opaske slovenskog komparatista. Baš kao Van Tieghem, Hergešić i Ocvirk također proučavaju tematologiju ("Stoffgeschichte"), spram koje su manje suzdržani nego francuski komparatist. Valja istaknuti kako Hergešić također preuzima Van Tieghemovo trojstvo pošiljatelj ("émetteur") – posrednik ("transmetteur") – primatelj ("récepteur"), a koje nalazimo i kod Ocvirka. On Van Tieghemovu doksologiju naziva linearnim ispitivanjem, koje se također bavi uspjehom i utjecajem nekog autora ili djela u inozemstvu. Jednako kao Van Tieghem, i Hergešić proučava strane izvore nekog pisca, ali za to ne upotrebljava pojam krenologija, koji Ocvirk pak zamjenjuje pojmom koncentrično proučavanje. Hergešićevo naročito domišljato navođenje hrvatskih književnih primjera zasigurno je plodno utjecalo na Ocvirka da za svoju knjigu potraži brojne slovenske primjere.

Background and aim: Many children with an FH mutation also exhibit elevated lipoprotein(a) levels, which is an independent risk factor for atherosclerotic cardiovascular disease. Studies have reported higher levels of lipoprotein(a) in adult and middle-aged women than men. There is limited knowledge on the concentration and change of lipoprotein(a) levels in children with genetic FH, and therefore we investigated sex-differences in lipoprotein(a) level and change in lipoprotein(a) in girls and boys with genetically confirmed FH. Methods: Medical records were reviewed retrospectively in 438 subjects with heterozygous FH that started follow-up below the age of 19 years at the Lipid Clinic, Oslo University Hospital in Norway, and of these we included 386 subjects with at least one Lp(a) measurement. Results: Mean (SD) age at baseline was 13.8 (7.3) years and the age was similar between sexes. Girls had a higher lipoprotein(a) level than boys at baseline: median (25–75 percentile) 223 (108–487) vs. 154 (78–360) mg/L, respectively (p 0.05). Conclusions: We found an increase in Lp(a) levels in children with genetic FH with age, and higher levels in girls than boys, which could impact risk assessment and future ASCVD. Further research is needed to elucidate whether subjects with FH could benefit from lipoprotein(a)-lowering therapies that are under current investigations.

Tema i artikkelen er praksisperiodene i det siste semesteret av lengre profesjonsutdanninger. Det empiriske materialet er hentet fra et større prosjekt om nyutdannede prester i Danmark, Norge og Sverige som følger disse fra siste semester i utdanningen og ca. tre år inn i jobb. Artikkelen bygger på fokusgrupper og individuelle intervjuer hvor særlig praksisperiodene er tematisert, og hvor vi spør deltakerne om erfaringer av mestring og tilkortkommenthet i disse. Forskningsspørsmålet er hvordan praksisperioder kan forstås som læringsarenaer, og hvilke betingelser som muliggjør og begrenser profesjonslæringen i disse aktivitetene. Både likheter og forskjeller mellom landene bidrar til at vi identifiserer tre kritiske spenninger i fasiliteringen av praksisperioder: forholdet mellom å øve på profesjonsrollen og å øve på praksisstudentrollen, forholdet mellom å øve på profesjonsoppgaver og å utvikle egen profesjonsidentitet og forholdet mellom å øve på yrke og å utøve yrket. Disse tre funnene blir utdypet og diskutert ved hjelp av perspektiver fra liminalitetsteori og boundary theory. Med artikkelen nyanserer vi forståelsen av praksisperiodene som liminal sone og viser hvordan ulike læringsmekanismer åpner og lukker for studentenes bevegelse mellom studium og profesjon. Vi diskuterer også betydningen av veileders posisjonering og kompleksiteten i forholdet mellom profesjonsoppgaver og profesjonsrolle.

Prispevek predstavlja drobec iz slovenske gledališke zgodovine, pri čemer se osredotoča na dogajanje na odru nemškega Stanovskega gledališča v Ljubljani v sezoni 1833/34. Najprej je predstavljeno Amalija Mašek, operna pevka z mnogimi izkušnjami tudi v gledališki praksi, ki je v tem času vodila ljubljanski oder, nato pa je natančneje obravnavan repertoar omenjene sezone. Pri tem se osredotočamo zgolj na dramsko produkcijo in se ne posvečamo opernim predstavam. Iz prispevka je razvidno, da ljubljanski repertoar, v katerem so bile romantične igre reševanja, klasične komedije, vodvilske komedije (comédie-vaudeville) in čarobne pravljice, ni zelo zaostajal za dunajskimi in celo za pariškimi uprizoritvami v prvi polovici 19. stoletja ter da si je občinstvo v Ljubljani predstave velikokrat lahko ogledalo samo nekaj let po praizvedbah.

Current educative practices have given rise to the predominant pressure to increase production and speed in academic work and education in general. Educators need to ask whether conceiving of education in such terms is what we really want our children and youth to experience. In this paper, we aim to interrogate the question of how a deceleration of education is possible, and why this would be desirable for students and teachers. We do this in a circuitous way, by exploring four exercises in pedagogical deceleration. These exercises are inspired by philological, didactical, pedagogical, and phenomenological practices.

Editorial

Book review of N. Friesen's (Ed.) (2022). Tact & the Pedagogical Relation. Introductory Readings. Published by Peter Lang.

As the EU awaits the adoption of the proposed Directive on Corporate Sustainability Due Diligence, several European countries have already implemented obligations on human rights due diligence at national level. One of these countries is Norway, where the Transparency Act entered into force in July 2022. The Act serves as one of the frontrunners to the expected EU legislation on social sustainability, largely inspired by international frameworks on business and human rights, as well as other countriesʼ regulations of similar matters. Binding legislation in this area, such as the Transparency Act, is an important development as experience has shown that soft law alone is not enough to efficiently combat human rights violations in global supply chains. This article presents the core obligations and principles of the Transparency Act. The aim of the article is to highlight the distinctive characteristics of the Norwegian Act and reflect on where the road of transparency has lead Norway so far, and where it will lead us next.

Objective To develop a general and internationally applicable template of data variables for reporting interhospital neonatal intensive care transports.Design A five-step Delphi method.Setting A group of experts was guided through a formal consensus process using email.Subjects 12 experts in neonatal intensive care transports from Canada, Denmark, Norway, the UK and the USA. Four women and eight men. The experts were neonatologists, anaesthesiologists, intensive care nurse, anaesthetic nurse, medical leaders, researchers and a parent representative.Main outcome measures 37 data variables were included in the final template.Results Consensus was achieved on a template of 37 data variables with definitions. 30 variables to be registered for each transport and 7 for annual registration of the system of the transport service. 11 data variables under the category structure, 20 under process and 6 under outcome.Conclusions We developed a template with a set of data variables to be registered for neonatal intensive care transports. To register the same data will enable larger datasets and comparing services.

IntroductionThe Norwegian Directorate of Health approved the Norwegian Hearing Register for Children in 2022. The main objective of the register is to improve the quality of treatment for children with permanent hearing loss, by measures, follow-ups and monitoring the quality and results of the health care system.MethodsInclusion criteria are children who do not pass universal newborn hearing screening and/or children with permanent hearing loss 20 dB in at least one ear. Data are registered at the Ear, Nose and Throat departments at inclusion and at follow-ups at the age of 3, 6, 10, and 15 years. The register collects information about the child within a holistic perspective. The key elements of the register are (a) data concerning newborn hearing screening; (b) data concerning hearing, medical information, hearing amplification and intervention (c) patient reported outcome measures registered by caregivers using three questionnaires; Pediatric Quality of Life Inventory, Strengths and Difficulties Questionnaire and Parents’ Evaluation of Aural/Oral Performance of Children.ResultsThe register has established four quality indicators regarding newborn hearing screening and early intervention (a) the rate of false positive neonatal screens; (b) testing for congenital cytomegalovirus within 3 weeks of age for children who do not pass newborn hearing screening; (c) audiological evaluation to confirm the hearing status no later than 3 months of age and (d) initiated intervention within 3 months after confirmation of hearing status.DiscussionThe register will include the total population of hearing impaired children over long time periods. Thus, the register enables each hospital to monitor their quality indicator scores continuously and compare them with national levels in real time. This facilitates and accelerates identification of improvement areas in the hospitals and will be an important contributor for quality improvement in NHS, diagnostics and hearing intervention for children in Norway. In addition, data from the register will be a unique source for research, and study designs with a long follow-up time can be applied.

Moments of moral disquiet encounter clock time as well as lived time, and thus professional human practices are existential and take place in time and space. Professional practices as existential involve human bodies and relationships, and are based on trust, responsibility, and vulnerability. The paper explores the relation between lived time and moments of disquiet. We borrow lived experience descriptions from students in professional practices and analyse them phenomenologically. Our informants are students in profession studies of nursing, social work and education interviewed individually in or after external institutional practice during their education. In the interviews they share their experiences of personal responsibility in situations orienting to others in professional practices. As a life existential, time shapes and organises our bodies and activities from birth to grave and is lived and experienced in a variety of ways in daily life and life as such. Time is thus a precondition of human life and life itself. Our interest in this paper is to show and argue phenomenological-pedagogically why and how it is of professional significance to teach students to take the required time to care, and to encourage them to be attentively present in situations when other persons’ lives take place.

Human life has always been understood as an inner tension between the mortality of the human body and the desire of the soul to attain immortality. The tension between mortality and immortality has reached new dimensions with the developments in medicine, technology and artificial intelligence that have the potential to extend our lives in many ways. In this paper, the authors first present a philosophical consideration of the body, which has often been seen as the prison of the soul, and then the modern quest for immortality. In the fourth chapter, they present the good news of Christianity, which is, among other things, that the body enables human beings to live their life in integral relationships and fulfil their vocations, and then the Christian understanding of immortality. They conclude by pointing to the new questions raised by the immense investment in the development of technology, especially artificial intelligence, which deep down is an expression of man’s desire for immortal life. At the same time, they point out that man can overcome his fear of death and discern multiple ways to avoid it if he is willing to accept death as an integral part of his life.

BackgroundLiving with type 1 diabetes is challenging, and to support self-management, repeated consultations in specialist outpatient care are often required. The emergence of new digital solutions has revolutionized how health care services can be patient centered, providing unprecedented opportunities for flexible, high-quality care. However, there is a lack of studies exploring how the use of digital patient-reported outcome measures (PROMs) for flexible specialist care affects diabetes self-management. To provide new knowledge on the relevance of using PROMs in standard care, we have designed a multimethod prospective study. ObjectiveThe overall aim of this protocol is to describe our prospective multimethod observational study designed to investigate digital PROMs in a routine specialist outpatient setting for flexible patient-centered diabetes care (DigiDiaS). MethodsThis protocol outlines the design of a multimethod prospective observational cohort study that includes data from electronic health records, self-reported questionnaires, clinical consultation field observations, and individual in-depth interviews with patients and diabetes health care personnel. All patients with type 1 diabetes at a designated outpatient clinic were invited to participate and use the digital PROM implemented in clinical care. Both users and nonusers of the digital PROM were eligible for the prospective study, allowing for a comparison of the two groups. Data were collected at baseline and after 12 months, including self-management as the primary outcome assessed using the Patient Activation Measure, along with the secondary outcomes of digital health literacy, quality of life, health economy, and clinical variables such as glycated hemoglobin. ResultsThe digital solution was implemented for routine clinical care in the department in November 2021, and data collection for the prospective study started in October 2022. As of September 6, 2023, 84.6% (186/220) of patients among those in the digital PROM and 15.5% (34/220) of patients among the nonusers have consented to participate. We expect the study to have enough participants by the autumn of 2023. With 1 year of follow-up, the results are expected by spring 2025. ConclusionsIn conclusion, a multimethod prospective observational cohort study can offer valuable insights into the relevance, effectiveness, and acceptability of digital tools using PROMs in diabetes specialist care. Such knowledge is crucial for achieving broad and successful implementation and use of these tools in a large diabetes outpatient clinic. International Registered Report Identifier (IRRID)DERR1-10.2196/52766

IntroductionFor teachers working in multi-ethnic early childhood education and care settings, a strong collaboration with parents may be an important mechanism for supporting young children's language development. However, little research has investigated how teachers perceive their communication with parents from diverse backgrounds and what centre-level factors predict the quality of teacher-parent collaboration.MethodsThis study sought to explore teacher-parent collaboration within early childhood education and care in urban multi-ethnic areas of Norway, using survey data from 266 teachers across 56 centres and 198 classrooms. We examined whether teacher characteristics (education, experience and self-efficacy) and centre linguistic diversity were related to teacher perceived communication with parents regarding ways of supporting children's dual language development and teacher experienced challenges in parent collaboration.ResultsResults revealed that teachers with higher self-efficacy communicated more with parents and experienced less challenges in collaboration with them. Furthermore, more experienced teachers working in more linguistically diverse centres identified more challenges in parent collaboration, while these characteristics were not related to communication. Teacher education was not associated with communication nor challenges in parent collaboration.DiscussionOur results indicate that professional development measures targeted at strengthening teacher self-efficacy might be an important mechanism to promote parent collaboration, particularly in multi-ethnic education settings.

Die dramatischen Werke des deutschen Dramatikers, Schriftstellers und Librettisten August von Kotzebue (1761–1819) gehörten in der ersten Hälfte des 19. Jahrhunderts nicht nur zum festen Repertoire des Ständischen Theaters in Laibach (Ljubljana), sondern Kotzebue gehörte in den 1830er-Jahren, wie aus den Spielplänen ersichtlich, zu den meistgespielten Dramatikern auf der Laibacher Bühne. Es wurden sowohl seine ernsteren Schauspiele als auch Werke komischen Inhalts aufgeführt. Vor allem bei den Letzteren ist eine rege Vielfalt an komischen dramatischen Formen (z. B. Lustspiel, Schwank, Posse) zu verzeichnen, was bei den gespielten Werken anderer Autoren und Autorinnen zu dieser Zeit nicht der Fall war. Im vorliegenden Beitrag werden in Hinblick auf die in Laibach aufgeführten Stücke von Kotzebue die verschiedenen komischen dramatischen Formen dargestellt und erörtert.

This is a review of Michael van Manen's & Max van Manen's (Eds.) Classic Writing for a Phenomenology of Practice, published by Routledge.

Background Patient-reported outcome (PRO) measures are increasingly used in clinical diabetes care to increase patient involvement and improve healthcare services. The objectives were to identify instruments used to measure PROs in outpatient diabetes clinics and to investigate the use of these PRO measures alongside the experiences of patients and healthcare personnel in a clinical setting.Research Design and Methods A scoping review was conducted according to the framework of Arksey and O’Malley with scoping searches of Cinahl, EMBASE, Medline and Health and Psychosocial Instruments. Studies reporting on adults with diabetes in a clinical setting where the PRO measure response directly affected patient care were eligible for inclusion.Results In total, 35 197 citations were identified, of which 7 reports presenting 4 different PRO measures were included in the review. All four of the included items measured psychosocial aspects of diabetes, and three included elements of the Problem Areas in Diabetes scale. All the patients were satisfied with the use of PRO measures in clinical care, whereas the level of satisfaction among healthcare personnel with PRO measures varied within and among studies.Conclusions The limited number of eligible studies in this review suggests that research on PRO measures for diabetes outpatient care is scarce. Patients welcome the opportunity to express their concerns through the systematic collection of PRO measures, and some healthcare personnel value the broader insight that PRO measures provide into the impact of diabetes on patients’ lives. However, the heterogeneity among services and among patients challenges the implementation of PRO measures. Research is needed to explore how PRO measures in clinical outpatient care affect healthcare personnel workflow.Review registration https://doi.org/10.17605/OSF.IO/46AHC

Artikkelen tar utgangspunkt i temaet sosialistisk fotografi og hvordan dette blir forklart og praktisert i Norge i siste del av 1930-årene. Arbeidernes Fotolag kommer raskt fram som en forening og et aktivitetssenter for denne politiske fotoretningen. Foreningen var en av mange som ble etablert på denne tiden – litteratur, teater, kor og idrett gikk også inn i en ny satsing fra arbeiderbevegelsen. Klassebevisstheten skulle økes ved å utdanne og styrke arbeiderne for den sosialistiske sak. Arbeidernes Fotolag holdt kurs, drev med praktisk veiledning, inviterte til diskusjoner og utflukter og gjorde fotografering relevant i en aktuell debatt. Med kamera skulle amatørfotografene synliggjøre sin livssituasjon og sitt arbeid for allmenheten. Arbeiderbladet i Oslo hadde en sentral rolle både som fødselshjelper og samarbeidspartner. Et mål for Arbeidernes Fotolag var å bygge opp en kapasitet, et arkiv med bilder som skulle dokumentere folks levekår og arbeiderbevegelsens aktiviteter i hele landet. Artikkelen plasserer også disse fotoaktivitetene i et internasjonalt nettverk av politikk, kunst og fotohistorie.

Et studie blandt nyuddannede præster viser, at mødet med menighedslivet i Den norske kirke for nogle enkelte har været ganske krævende. De pågældende tilkendegiver et oplevet mismatch mellem indhold og vægtlægning i uddannelsen og hverdagens opgaver og krav. Ud fra et praktisk teologisk perspektiv og med inddragelse af kundskabs- og praksisteori drøfter artiklen, hvordan denne problemstilling kan forstås. Der argumenteres for, at det ikke primært handler om utilstrækkelige kundskabsressourcer, men i nok så høj grad om en normativ diskrepans mellem de teologiske og liturgiske idealer, som den nye præst bringer med sig fra uddannelsesforløbet, og den stedlige kirkelige virkelighed. Afslutningsvist drøftes det, hvordan uddannelsen kan forholde sig til denne udfordring.

Abstract Background Depression is highly prevalent in general practice, and organisation of primary health care probably affects the provision of depression care. General practitioners (GPs) in Norway and the Netherlands fulfil comparable roles. However, primary care teams with a mental health nurse (MHN) supplementing the GP have been established in the Netherlands, but not yet in Norway. In order to explore how the organisation of primary mental care affects care delivery, we aimed to examine the provision of GP depression care across the two countries. Methods Registry-based cohort study comprising new depression episodes in patients aged ≥ 18 years, 2011–2015. The Norwegian sample was drawn from the entire population (national health registries); 297,409 episodes. A representative Dutch sample (Nivel Primary Care Database) was included; 27,362 episodes. Outcomes were follow-up consultation(s) with GP, with GP and/or MHN, and antidepressant prescriptions during 12 months from the start of the depression episode. Differences between countries were estimated using negative binomial and Cox regression models, adjusted for patient gender, age and comorbidity. Results Patients in the Netherlands compared to Norway were less likely to receive GP follow-up consultations, IRR (incidence rate ratio) = 0.73 (95% confidence interval (CI) 0.71–0.74). Differences were greatest among patients aged 18–39 years (adj IRR = 0.64, 0.63–0.66) and 40–59 years (adj IRR = 0.71, 0.69–0.73). When comparing follow-up consultations in GP practices, including MHN consultations in the Netherlands, no cross-national differences were found (IRR = 1.00, 0.98–1.01). But in age-stratified analyses, Dutch patients 60 years and older were more likely to be followed up than their Norwegian counterparts (adj IRR = 1.21, 1.16–1.26). Patients in the Netherlands compared to Norway were more likely to receive antidepressant drugs, adj HR (hazard ratio) = 1.32 (1.30–1.34). Conclusions The observed differences indicate that the organisation of primary mental health care affects the provision of follow-up consultations in Norway and the Netherlands. Clinical studies are needed to explore the impact of team-based care and GP-based care on the quality of depression care and patient outcomes.

Abstract Background There is growing evidence of variation in treatment for patients with depression, not only across patient characteristics, but also with respect to the organizational and structural framework of general practitioners’ (GPs') practice. However, the reasons for these variations are sparsely examined. This study aimed to investigate associations of practice characteristics with provision of depression care in general practices in Norway. Methods A nationwide cohort study of residents aged ≥ 18 years with a new depression episode in general practice during 2009–2015, based on linked registry data. Exposures were characteristics of GP practice: geographical location, practice list size, and duration of GP-patient relationship. Outcomes were talking therapy, antidepressant medication and sick listing provided by GP during 12 months from date of diagnosis. Associations between exposure and outcome were estimated using generalized linear models, adjusted for patients’ age, gender, education and immigrant status, and characteristics of GP practice. Results The study population comprised 285 113 patients, mean age 43.5 years, 61.6% women. They were registered with 5 574 GPs. Of the patients, 52.5% received talking therapy, 34.1% antidepressant drugs and 54.1% were sick listed, while 17.3% received none of the above treatments. Patients in rural practices were less likely to receive talking therapy (adjusted relative risk (adj RR) = 0.68; 95% confidence interval (CI) = 0.64–0.73) and more likely to receive antidepressants (adj RR = 1.09; 95% CI = 1.04–1.14) compared to those in urban practices. Patients on short practice lists were more likely to receive medication (adj RR = 1.08; 95% CI = 1.05–1.12) than those on long practice lists. Patients with short GP-patient relationship were more likely to receive talking therapy (adj RR = 1.20; 95% CI = 1.17–1.23) and medication (adj RR = 1.08; 95% CI = 1.04–1.12), and less likely to be sick-listed (RR = 0.88; 95% CI = 0.87–0.89), than patients with long GP-patient relationship. Conclusions Provision of GP depression care varied with practice characteristics. Talking therapy was less commonly provided in rural practices and among those with long-lasting GP-patient relationship. These differences may indicate some variation, and therefore, its reasons and clinical consequences need further investigation.

Background: Critical Care Nurses (CCNs) provide care to acutely and critically ill patients and their families. Psychological and social factors at work are potential contributors to the health and wellbeing of employees such as critical care nurses working in intensive care units. Studies shows that poor working environments may lead to stress and impaired health for the CCNs, and that work factors may affect both level of competence and patient safety. Aim: The aim of this study was to investigate critical care nurses' perceptions of psychological and social factors at work. Method: A survey to investigate Critical Care Nurses' (CCNs') perceptions of psychological and social factors at work. All the CCNs (n = 240) working in 15 ICUs in four Norwegian hospitals were invited to answer the General Nordic Questionnaire for Psychological and Social Factors at Work (QPSNordic). Data was collected during three weeks in Spring 2016 and analysed with descriptive statistics, and parametric and non-parametric tests. Results: In total 103 CCN completed the questionnaire (43%). The participants responded that they sometimes or rather often faced high job demands (3,09). They very often met positive challenges at work (4,41), though they rather seldom controlled decisions about their work (2,44) or control of work pace (2,32). They rather often had a perception of mastery of work (4,12). Conclusion: The result of this study suggests that participants experienced high expectations regarding quantitative- and decision demands, but less control at work. They rather seldom or sometimes got information about the quality of the work they performed. Nevertheless, they found their work challenging in a positive way and experienced a strong sense of mastery.

The recent and still ongoing COVID-19 pandemic has highlighted the vulnerability of an education system built around in-door teaching. Worldwide, schools closed down to reduce the spread of the virus and where it was possible students and teachers were forced to switch to Emergency Remote Teaching (ERT), described as “a temporary shift of instructional delivery to an alternate delivery mode due to crisis circumstances” (Hodges et al., 2020).

AbstractObjective To investigate patient experiences and preferences regarding depression care in general practice.Design and setting A qualitative study based on free-text responses in a web-based survey in 2017. Participants were recruited by open invitation on the web page of a Norwegian patient organization for mental health. The survey consisted of four open-ended questions concerning depression care provided by general practitioners (GPs), including positive and negative experiences, and suggestions for improvement. The responses were analysed by Template Analysis.Subjects 250 persons completed the web-based survey, 86% were women.Results The analysis revealed five themes: The informants appreciated help from their GP; they wanted to be met by the GP with a listening, accepting, understanding and respectful attitude; they wanted to be involved in decisions regarding their treatment, including antidepressants which they thought should not be prescribed without follow-up; when referred to secondary mental care they found it wrong to have to find and contact a caregiver themselves; and they thought sickness certification should be individualised to be helpful.Conclusions Patients in Norway appreciate the depression care they receive from their GP. It is important for patients to be involved in decision-making regarding their treatment.KEY POINTSDepression is common, and GPs are often patients’ first point of contact when they seek help. • Patients who feel depressed appreciate help from their GP. • Patients prefer an empathetic GP who listens attentively and acknowledges their problems. • Individualised follow-up is essential when prescribing antidepressants, making a referral, or issuing a sickness absence certificate.

Editorial

What does moral disquiet mean to professional human practices? The phenomenon of moral disquiet comes to awareness in concrete lived human experiences and might be described with the help of examples from practice. The article explores lived moral disquiet in nursing, teaching and caring practices. It highlights moral disquiet from direct descriptions in which the phenomenon arises as an event in students’ lifeworlds including professional human relationships in societal institutions like a hospital, nursing home and kindergarten. We suggest that moral disquiet, expressed as the human sensitivity toward others, does not depend on success or failure of outcome, but is a quality of belief and hope in the lives of others that offers possible moments of humanness.

This article highlights the lived experience of the relationship between the mental health nurse and the patient in institutional treatment. The premise for a relationship between persons in professional settings is the awareness of the responsibility that the relationship is a possibility rather than a tool, and that the relationship is a lived encounter additional to being a factual experience. Any relationship – personal and professional – in this understanding is an action as well as a re-action, as both parties are at mercy of each other and thus they can only partly plan and predict the process and the outcome of their relationship. We explore the relationship between nurse and patient, in terms of the tension between difference and togetherness, and suggest solicitude to be a core quality in mental health relations.

BackgroundDiabetes self-management is crucial for patients with type 1 diabetes, and digital services can support their self-management and facilitate flexible follow-up. The potential of using digital patient-reported outcome (PRO) measures in routine outpatient care is not fully used owing to a lack of adapted PRO measures. ObjectiveThis study presents the process of identifying and adapting a digital PRO measure for use in clinical diabetes practice and describes the preferred item topics of the adapted PRO measure, as reported by patients and diabetes specialist nurses. MethodsWith the involvement of patients, diabetes specialist nurses, management, and researchers, we hosted a series of workshops and 2 dialogue conferences. Scoping searches to identify relevant PRO measures formed the foundation for the process. An in-person dialogue conference was conducted with diabetes specialist nurses as participants, and a digital dialogue conference was conducted with patients with type 1 diabetes as participants. A diabetes-specific PRO measure was translated and adapted to our digital platform. Notes and summaries from the dialogue conferences were imported into NVivo (QSR International) and thematically analyzed as a single combined data set. ResultsThe thematic analysis of the 2 dialogue conferences aimed to explore the views of patients with type 1 diabetes and diabetes specialist nurses on the outcomes necessary to measure. An overarching theme, Ensuring that the PRO measure captures the patients’ needs precisely and accurately, in a way that facilitates care and communication with health care personnel, was identified and supported with data from both the patients and diabetes specialist nurses. This theme contained four categories: The need for explanatory text after questions to ensure understanding and accurate response, Capturing individual needs in standardized questions, getting to the heart of the patient’s problem, and The questions increase patient reflection. ConclusionsWe successfully conducted an iterative process that identified a PRO measure aligned with the topics raised by the diabetes specialist nurses. Similarly, the patients found the PRO measure to be relevant and one that was addressing their needs. Only minor adjustments were necessary when programming the PRO measure in the digital platform. Our management, patients, and diabetes specialist nurses had a valuable impact on the results. User involvement facilitated a specific focus on the clinical requests to be met by PRO measures and how they must be adapted to local and digital platforms. Overall, this has facilitated the current implementation of the adapted digital PRO measure.

Masahiro Hasegawa, Shine Tone, Yohei Naito, Akihiro Sudo Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Tsu City, Mie, 514-8507, JapanCorrespondence: Masahiro HasegawaDepartment of Orthopaedic Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu City, Mie, 514-8507, JapanTel +81-59-231-5022Fax +81-59-231-5211Email masahase@clin.medic.mie-u.ac.jpPurpose: Although the pain of osteoarthritis (OA) is traditionally considered to be nociceptive, some patients also have neuropathic pain. The objective of this study was to evaluate the presence of neuropathic pain in the knees of OA patients using the painDETECT questionnaire (PDQ).Methods: A total of 180 knees in 158 consecutive patients who underwent total knee arthroplasty (TKA) were enrolled prospectively. The prevalence of neuropathic pain, unclear pain, and nociceptive pain in the knee was determined before and after TKA using a numerical rating scale (NRS). All patients were evaluated preoperatively and 6 months postoperatively. Neuropathic pain and unclear pain were grouped together as possible neuropathic pain. The relationship between possible neuropathic pain and pain intensity was evaluated.Results: Before TKA, neuropathic pain and unclear pain were found in 10 and 30 knees, respectively. The remaining 140 knees were categorized as nociceptive pain. After TKA, the numbers of knees with neuropathic and unclear pain decreased to one and five, respectively. The prevalence of possible neuropathic pain decreased significantly from 22.2% to 3.3% after surgery. Among the six knees with possible neuropathic pain postoperatively, four had possible neuropathic pain preoperatively as well, while the remaining two patients had been classified as nociceptive pain preoperatively. Knees with possible neuropathic pain postoperatively had higher postoperative NRS scores than those with nociceptive pain.Conclusion: Although the prevalence of possible neuropathic pain decreased significantly after TKA, the preoperative presence of possible neuropathic pain might be associated with the development of persistent postoperative pain following TKA.Keywords: neuropathic pain, nociceptive pain, osteoarthritis, total knee arthroplasty, persistent postoperative pain

Abstract Background Depression is highly prevalent, but knowledge is scarce as to whether increased public awareness and strengthened government focus on mental health have changed how general practitioners (GPs) help their depressed patients. This study aimed to examine national time trends in GP depression care and whether trends varied regarding patient gender, age, and comorbidity. Methods Nationwide registry-based cohort study, Norway. The study population comprised all residents aged 20 years or older with new depression diagnoses recorded in general practice, 2009–2015. We linked reimbursement claims data from all consultations in general practice for depression with information on demographics and antidepressant medication. The outcome was type(s) of GP depression care during 12 months from the date of diagnosis: (long) consultation, talking therapy, antidepressant drug treatment, sickness absence certification, and referral to secondary mental health care. Covariates were patient gender, age, and comorbidity. The data are presented as frequencies and tested with generalized linear models. Results We included 365,947 new depression diagnoses. Mean patient age was 44 years (SD = 16), 61.9 % were women, 41.2 % had comorbidity. From 2009 to 2015, proportions of patients receiving talking therapy (42.3–63.4 %), long consultations (56.4–71.8 %), and referral to secondary care (16.6–21.6 %) increased, while those receiving drug treatment (31.3–25.9 %) and sick-listing (58.1–50 %) decreased. The trends were different for gender (women had a greater increase in talking therapy and a smaller decrease in sick-listing, compared to men), age (working-aged patients had a smaller increase in talking therapy, a greater increase in long consultations, and a smaller decrease in antidepressant drug use, compared to older patients) and comorbidity (patients with mental comorbidity had a smaller increase in talking therapy and a greater increase in long consultations, compared to those with no comorbidity and somatic comorbidity). Conclusions The observed time trends in GP depression care towards increased provision of psychological treatment and less drug treatment and sick-listing were in the desired direction according to Norwegian health care policy. However, the large and persistent differences in treatment rates between working-aged and older patients needs further investigation.

This paper adds to the growing body of literature on digitally mediated preaching by using actor–network theory (ANT) in conjunction with Amanda Lagerkvist’s work on digital media as theoretical lenses to describe and discuss what we term “the paradox of (im)perfection”. This paradox refers to the tension between an ideal of perfection and an ideal of imperfection (or vulnerability) as experienced by church practitioners who were “thrown” online abruptly and unexpectedly due to the pandemic. In our analysis we show how human and non-human actors interact (and act on each other) in ways that assemble their networks towards a mode of visibility and perfection, or towards a mode of authenticity, intimacy, and imperfection. In the former mode, preachers and church practitioners find themselves competing in “a mimetic visibility contest” that is characterized by an ontology of numbers (likes, follower counts, retweets, etc.) and a subsequent ethos of quantification. In the latter mode, an ethos of care affords the opportunity for spiritual intimacy, even among “anonymous” online individuals. Drawing on Deanna A. Thompson’s and Amanda Lagerkvist’s work, we argue that the latter mode enacts “a cruciform media ethics” in which the embodied worshiping community interacting online can be understood as “the virtual body of the suffering Christ”. Here, digital media is enacting as “caring media” rather than “metric media”. While the paper introduces message-oriented, media-oriented, and ontology-oriented approaches as helpful for the study of digitally mediated preaching, it ultimately argues for the superior virtues of ANT as a non-dichotomous approach—overcoming both the message/media and the virtual/real divides which are often inherent to other approaches.

Abstract Background Anorexia nervosa (AN) is a severe eating disorder, recognized by a relentless pursuit for thinness and extreme low body weight. The disorder is often accompanied by comorbid disorders such as anxiety and depression, and altered neuropsychological function in terms of poor set-shifting and reduced central coherence. The aim of this review was to evaluate whether neuropsychological impairments in AN are influenced by body mass index, anxiety or depression. Method A systematic review approach was used, following the PRISMA guidelines for systematic reviews. Literature was identified via searches in PubMed, PsychInfo and Embase database, by using the search words [anorexia nervosa] AND [central coherence], and [anorexia nervosa] AND [set-shifting]. Studies were included if they were written in English, peer-reviewed, included individuals with AN, included tests measuring set-shifting and/or central coherence, investigated associations between set-shifting/central coherence with anxiety and/or depression and/or BMI. Risk of bias was assessed by using a critical appraisal checklist from the Joanna Briggs Institute. Results were summarized in a narrative synthesis. Results Although results are heterogeneous, the majority of studies report that neither body mass index (BMI), anxiety or depression is associated with altered central coherence and set-shifting in individuals with AN. Conclusions Findings indicate that BMI, depression and anxiety does not influence neuropsychological function in AN, suggesting that it could be a characteristic of the disorder. A complete understanding of predisposing, precipitating and maintaining factors in AN needs to be addressed in future research. This could contribute to the development of better and more targeted treatment strategies.

The planetary boundaries concept has profoundly changed the vocabulary and representation of global environmental issues. We bring a critical social science perspective to this framework through the notion of societal boundaries and aim to provide a more nuanced understanding of the social nature of thresholds. We start by highlighting the strengths and weaknesses of planetary boundaries from a social science perspective. We then focus on capitalist societies as a heuristic for discussing the expansionary dynamics, power relations, and lock-ins of modern societies that impel highly unsustainable societal relations with nature. While formulating societal boundaries implies a controversial process ‒ based on normative judgments, ethical concerns, and socio-political struggles ‒ it has the potential to offer guidelines for a just, social-ecological transformation. Collective autonomy and the politics of self-limitation are key elements of societal boundaries and are linked to important proposals and pluriverse experiences to integrate well-being and boundaries. The role of the state and propositions for radical alternative approaches to well-being have particular importance. We conclude with reflections on social freedom, defined as the right not to live at others’ expense. Toward the aim of defining boundaries through transdisciplinary and democratic processes, we seek to open a dialogue on these issues.

Sammendrag Denne artikkelen drøfter hvordan George Eliot i romanen Middlemarch gir en analyse av ekteskapet som fenomen, forbundet med både individuelle tilbøyeligheter og sosiale situasjoner. Artikkelen ser romanens utforsking av sympati som avgjørende for leserens forståelse av personene og spenningen mellom dem. Artikkelen tar utgangspunkt i forholdet mellom Dorothea Brooke og Edward Casaubon, men også andre parkonstellasjoner diskuteres. En særlig plass får Dorotheas valg og hvilken betydning de får for forståelsen av så vel romanen som av Dorothea som romanens hovedperson. Artikkelen argumenterer for at romanen forsvarer Dorothea som en hverdagslivets «heltinne».

Gert J.J. Biesta 2017 New York and London: Routledge 111 pages / 5 chapters + prologue / epilogue / index.

Sammendrag Artikkelen beskriver erfaringer med utvikling og gjennomføring av et seminar i praksisundervisningen for 1.års studenter ved bachelorstudiet i Radiografi ved OsloMet – storbyuniversitetet. Hensikten var å få studentene til å systematisere teoretisk og praktisk kunnskap knyttet til prosedyren for røntgen thorax. Studentene vurderte først gruppevis en video av prosedyren relatert til læringsutbyttene i emnet, og diskuterte den så i plenum. Studentenes opplevelser av undervisningsformen ble innhentet i en kvalitativ, elektronisk spørreundersøkelse. Seminaret ble oppfattet som lærerikt og skapte fruktbare diskusjoner og refleksjon. Dette gjaldt særlig de studentene som allerede hadde gjennomført praksis og hadde tilegnet seg egne erfaringer. Struktur og samarbeid i grupper og i plenum opplevdes som viktig for resultatet. Resultater fra evaluering av undervisningen kan tyde på at video av røntgenprosedyrer har gunstig betydning for studentenes fagforståelse i praksisundervisningen når den benyttes i en studentaktiv læringssituasjon.

Objective: The aim of this study was to recognise the preconditions experienced by general practitioners (GPs) in addressing the children’s needs when ill and substance abusing parents consult for their own health problems. Design: Qualitative analysis of 38 case stories told by GPs in focus group interviews. Setting: Focus group interviews of four continuing medical education groups for GPs in western Norway. Subjects: 27 GPs (nine females) with at least 5 years’ experiences in general practice. Results: Different aspects of the GPs’ perceived mandate of trust from the parents was a precondition for the children’s situation to be addressed. In some case stories the participants took an open mandate from the parent for granted, while in others they assumed that the parent did not want to discuss their family situation. Sometimes the participants had faith that by continuing with their ordinary GP tasks, they might obtain a more open mandate of trust. Their evaluation of the mandate of trust seemed to impact on how the GP could adopt a mediating role between the parents and various support agencies, thus supporting children who were at risk. Discussion/conclusion: The children most at risk may remain invisible in GPs’ encounters with their parents, possibly because their parent’s health problems and overall situation overshadow the children’s situation. The mandate of trust from burdened parents to GPs can be a fruitful concept in understanding the interaction regarding the welfare of the parent’s children. Negotiating the mandate of trust with parents by explicitly addressing trust and having an ongoing discussion about the mandate and its limits might be an option to secure the children support if necessary.KEY POINTS Offering children of burdened parents information and support can be crucial for health promotion and illness prevention. A general practitioner’s (GP’s) evaluation of the trust parents have in them can determine the extent of support children receive. Depending on the parents’ level of trust, GPs may take a mediating role between support services and parents for the benefit of the children. A negotiation concerning the trust parents have in the GP may open up possibilities for GPs to offer children necessary support.

Abstract Background The aim of this study was to review the existing literature and evaluate whether deficits in set-shifting, central coherence and decision-making persist in individuals recovered from anorexia nervosa (AN-REC). Method A systematic review approach was used. Literature was identified via searches in PubMed, PsychInfo and Embase database. The main search resulted in 158 articles. After exclusion of 135 articles, 23 articles were included in the review. Results The majority of studies on set-shifting showed that set-shifting difficulties persist after recovery. Central coherence might also be trait related, however findings are inconsistent. Few studies have investigated decision-making in AN-REC, however those studies that do exist suggest that decision-making is not impaired in AN-REC. Conclusions Novel treatment strategies based on neuroscience research are emerging, focusing on targeting the underlying mechanisms of the illness, including neuropsychological functioning. Whether these functions are trait or state related could have implications for how they are targeted in treatment.

Ragnhild Strauman og Bernd Krupka (red.): Sang for livet! Salmene og sangen i Den norske kirkes trosopplæring (IKO-Forlaget 2020) Karlo Meyer: Religion, Interreligious Learning and Education. (Peter Lang 2021)

Background: Antidepressant drugs are often prescribed in general practice. Evidence is conflicting on how patient education influences antidepressant treatment. Aim: To investigate the association between educational attainment and drug treatment in adult patients with a new depression diagnosis, and to what extent sex and age influence the association. Design & setting: A nationwide registry-based cohort study was undertaken in Norway from 2014–2016. Method: The study comprised all residents of Norway born before 1996 and alive in 2015. Information was obtained on all new depression diagnoses in general practice in 2015 (primary care database) and data on all dispensed depression medication (Norwegian Prescription Database [NorPD]) 12 months after the date of diagnosis. Independent variables were education, sex, and age. Associations with drug treatment were estimated using a Cox proportional hazard model and performed separately for sex. Results: Out of 49 967 patients with new depression (61.6% women), 15 678 were dispensed drugs (30.4% women, 33.0% men). Highly educated women were less likely to receive medication (hazard ratio [HR] = 0.93; 95% confidence interval [CI] = 0.88 to 0.98) than women with low education. No such differences appeared among men. Women aged 20–29 years were more likely to be treated with drugs than those aged 30–59 years, and women aged ≥70 years were more likely to receive drugs (HR = 1.65; 95% CI = 1.54 to 1.77) than those aged 20–29 years. The pattern was similar but less pronounced for men. Conclusion: Educational differences in antidepressant therapy among women may reflect different treatment approaches that clinicians should be aware of to avoid unintended variation. Reasons for this variation and consequences for quality of treatment should be explored.

I denne artikkelen ser vi på sammenhengen mellom læringsaktiviteter og innholdet i læringsutbyttebeskrivelser. Vår undersøkelse av læringsutbyttebeskrivelser viser at flere av ferdighetene og de generelle kompetansene inngår i emnene sine læringsaktiviteter, men at de ikke alltid gjenspeiles i læringsutbyttebeskrivelsene på emnene. Læringsutbyttebeskrivelser tydeliggjør for student og underviser hva forventet læring i emnet er og bør derfor vise det reelle innholdet i emnene. Ved utforming av læringsutbyttebeskrivelser er det viktig å se på sammenhengen mellom læringsutbytte, læringsaktivitet og vurdering (constructive alignment) (Biggs og Tang, 2011; Biggs, 2014). Læringsutbyttet gir oversikt over innhold i emner og konkretiserer hvilke emner som har ansvar for ulike deler av gradens samlede læringsutbytte. Læringsutbyttebeskrivelser kan også vise arbeidslivsrelevans gjennom synliggjøring av ferdigheter og generell kompetanse (Smith og Reid, 2018). Bakgrunnen for undersøkelsen er prosjektet Generiske ferdigheter ved Det matematisk- naturvitenskapelige fakultet ved Universitetet i Bergen. Prosjektet inkluderer en emnekartlegging (curriculum mapping) der emnenes innhold av ferdigheter og generell kompetanse uttrykt som samarbeid, skriftlig og muntlig kommunikasjon samt kritisk tenking og informasjonskompetanse ble identifisert. Vi undersøkte om svarene fra emnekartleggingen kan gjenfinnes i læringsutbyttebekrivelsene for utvalgte emner. Gjennomføring av emnekartlegging kan brukes for å se på innholdet av generell kompetanse i utdanningen, men det er lite fokus på den praktiske utførelsen av dette (Sumsion og Goodfellow, 2004; Lam og Tsui, 2014). Derimot er det få artikler som konkretiserer hvordan man bruker resultatene fra en emnekartlegging for å identifisere mangler i læringsutbyttebeskrivelser. Dette paperet vil kunne bidra til en bedre forståelse av hvordan man kan jobbe med dette.

Background Idiopathic Non-Specific Interstitial Pneumonia (iNSIP) is a rare interstitial lung disease, diagnosed, by definition, on the basis of a multidisciplinary team discussion (MDD). Association with an autoimmune background has been suggested in iNSIP. Aims To test the feasibility of conducting a multinational MDD to review the diagnosis in iNSIP cases and to estimate the emergence of connective tissue disease (CTD) during follow-up. Methods Investigators from three expert centers (Denmark, Estonia and Norway) met and discussed cases of biopsy-proven iNSIP at an international MDD. The cases were previously diagnosed at a national level between 2004 and 2014. Based on clinical, radiographic and pathological data, the diagnosis of iNSIP was re-evaluated and a consensus diagnosis was made. Cases incompatible with iNSIP were excluded. Relevant data were registered comprising any development of CTD. Results In total, 31 cases were discussed and 23 patients were included with a diagnosis of iNSIP. The mean follow-up time was 57 months. None of the patients developed CTD according to the rheumatologic criteria during the follow up period. Four patients (17.4%) met the criteria for interstitial pneumonia with autoimmune features. Conclusion We found that an international MDD was a feasible and valuable tool in the retrospective diagnostic evaluation of iNSIP. Diagnosis was changed in a statistically significant number of patients by our international MDD team. None of the patients developed CTD during follow-up.

Polycystic ovary syndrome (PCOS) is characterized by the presence of insulin resistance, and women with PCOS have high prevalence of gestational diabetes (GDM). Both conditions have been associated with increased risk for pregnancy complications such as preterm birth, preeclampsia and increased offspring birth weight. We aimed to estimate the prevalence of GDM in women with PCOS using both previous and new diagnostic criteria, and to analyse whether the risk of pregnancy complications increased with the presence of GDM. In addition, we aimed to assess the response to metformin treatment in PCOS women with GDM. We performed post-hoc analysis of three prospective, double blinded studies of altogether 791 pregnant women with PCOS randomized to either metformin or placebo treatment from first trimester to delivery. Glucose data allowing GDM classification after previous (WHO 1999) and new (WHO 2013 and Norwegian 2017) diagnostic criteria were available for 722 of the women. Complications such as preeclampsia, late miscarriage and preterm birth, birth weight and gestational age were correlated to the presence of GDM and metformin treatment. The prevalence of GDM was 28.3% (WHO 1999), 41.2% (WHO 2013) and 27.2% (Norwegian 2017). Having GDM already in first trimester associated with increased risk for late miscarriage (p

Editorial

Introduction Idiopathic pulmonary fibrosis (IPF) and systemic sclerosis-associated interstitial lung disease (SSc-ILD) are fibrotic ILDs with divergent disease populations. Little is known about health-related quality of life (HRQL) in SSc-ILD relative to IPF.Methods We used the Kings Brief Interstitial Lung Disease Questionnaire (K-BILD) to compare HRQL in a cross-sectional study of 57 patients with IPF and 29 patients with SSc-ILD. Analysis of covariance was used to adjust for age, gender and lung function.Results The unadjusted mean K-BILD score was 63.1 (95% CI 57.1 to 69.1) among patients with SSc-ILD, as compared with 54.7 (51.8–57.5) among those with IPF (p=0.005). However, this difference in HRQL was attenuated after adjustment for age, gender and lung function. In a multivariable model, only forced vital capacity was associated with K-BILD scores. K-BILD scores were correlated with both forced vital capacity and with other relevant HRQL measures, regardless of ILD diagnosis.Discussion Patients with SSc-ILD may have better ILD-specific quality of life than patients with IPF, but this difference appears to be driven primarily by better lung function. These results underscore the impact of lung function on HRQL in fibrotic ILD and the utility of K-BILD to assess HRQL in SSc-ILD.

On Storytelling, Teaching, Chance, and Gratitude: In Conversation with Alphonso Lingis

Lingis Special Issue: Travel as the Possibility of Being Brought Back to Ourselves

The amount of rented farmland in Norway has increased steadily since the 1950s. Concerns have been raised questioning whether farmland is treated less well by tenants compared to landowners. This study aims to investigate how farmers perceive their treatment of rented farmland, which factors impact their decision-making related to this and if farmers are concerned about farmland elements that are less important for productivity but mainly of interest for cultural heritage or environmental management reasons. Semi-structured interviews with a group of randomly selected farmers were carried out in an area dominated by intensive agriculture. Independent of, for example, amount of rented land or duration of the rental agreement, all farmers agreed that rented land was treated well. A strong competition for farmland in combination with farmers being dependent on renting land was the most important reason. Results from this study may be transferrable to other farming areas, at least where competition for farmland is comparable. We do suggest, however, that any further research on treatment of rented farmland in Norway should take a regional approach, since national statistics may cover significant regional differences.

The Norwegian welfare system due to human rights is in charge of providing necessary support of life to every citizen in terms of a safe place to live, the opportunity to education or employment and meaningful life accomplishments. We explore how public sustenance is experienced by a group of young receivers of public support. The article is one of three substudies drawing on empirical material from in-depth interviews with 14 young adults with mental health challenges and experiences from being partly or fully out of school or work. The interviews reveal that in particular three aspects of support are significant to the young. These are personal and shared space (e.g., supportive personal and professional relationships), the opportunity of a safe home, and the prospect of not being trapped for a lengthy time in their problems (an effective ‘standstill’ or suspension of agency of life), but be part of the “world out there.” Could public support provide some temporary or permanent help with regard to these basic aspects of life? We explore in this article the potential interrelatedness between space and support in a hermeneutic phenomenological manner with basis in experiences from four of the young in the study. David, Mia, Oda and Simon (all pseudonyms) each in their way, describe moments where support and space seem to be existentially and experientially interconnected. We wonder if analysis of the two phenomena can inform our understanding of the qualities that characterize what we might call a ‘supportive’ environment within public welfare.