Struggles of Governance and Autonomy in the Field of Kulturskole

The Norwegian extracurricular schools of music and performing arts, kulturskolen, largely govern themselves. In contrast to other types of law obliged schools, kulturskolen receives no clear signals from either state levels, or municipality/county municipality levels, but rather are left to informal steering mechanisms on individual or collective levels. This leads to a wide diversity of what disciplines that are offered, what collaborations that are conducted, what aims, intentions, profiles, and competences that are managed, and thus to very different conditions for what the pupils might learn and experience. This article is a theoretical discussion of this finding, investigating diverse forms of conduct that are identified on (i) state, (ii) community, and (iii) individual school level. The article particularly looks at the identified steering mechanisms, with Michel Foucault’s thoughts of governmentality and power/knowledge as its basis. This discussion on how the kulturskole regulates itself is a contribution to the body of research about kulturskole, cultural policy, and about extracurricular arts education in the kulturskole that aims to be “for all.”

Mot eit eksplisitt og sjølvbevisst kulturdiplomati

Når blei norsk kulturdiplomati sjølvmedvete og eksplisitt? Har kultur og kulturpolitikk nokon gong vore ein reelt integrert del av norsk utanrikspolitikk eller den utanrikspolitiske diskursen? Det er spørsmålet som blir diskutert i denne artikkelen, som samstundes reflekterer over korleis kultur heilt sidan 1800-talet har vore sentral del av konstruksjonen av Noreg som nasjon, og framleis er det, både i utanriks- og innanrikspolitisk samanheng. Kanskje er ikkje vegen frå norsk deltaking i verdsutstillinga i Paris i 1889 til korleis Noreg profilerer operaen i Bjørvika, teikna av Snøhetta, i dag, særleg lang? Artikkelen konkluderer likevel med at gjennomslaget for eit eksplisitt sjølvmedvete kulturdiplomati paradoksalt nok kan knytast til tida då ansvaret for norsk utanrikskulturell verksemd blei flytta ut av UD og over til sju av kunstfeltets organisasjonar. Artikkelen er ei omarbeiding av prøveførelesinga som var del av forsvaret for PhD-graden i kulturstudiar ved HSN, med tittelen Look to Norway, current Norwegian Foreign Cultural Policy

Cultural policy in the Nordic welfare states: aims and functions of public funding for culture

In this research anthology on public subsidy systems for culture in the Nordic region, researchers from each Nordic country contribute with a chapter on the status and challenges of public subsidy systems for culture in their particular country. In addition, a former civil servant with the Nordic Council of Ministers provides descriptions of Nordic co-operation grants for culture, as well as grants in the Faroe Islands, Greenland, and Åland. While the authors have chosen which issues to focus on in their respective chapters, all in one way or another concern themselves with the question of how Nordic welfare policies are reflected in Nordic cultural policies. The research anthology has been produced by Kulturanalys Norden and edited by Sakarias Sokka, senior researcher at CUPORE

Hedging against biodiversity loss: Forest herbs’ performance in hedgerows across temperate Europe

Questions: How do contrasting environmental conditions among forests and hedgerows affect the vegetative and reproductive performance of understorey forest herbs in both habitats? Can hedgerows support reproductive source populations of forest herbs, thus potentially allowing progressive dispersal of successive generations along these linear habitats? Location: Hedgerows and deciduous forest patches in agricultural landscapes across the European temperate biome. Methods: First, we assessed differences in environmental conditions among forests and hedgerows. Next, we quantified plant performance based on a set of functional life‐history traits for four forest herbs (Anemone nemorosa, Ficaria verna, Geum urbanum, Poa nemoralis) with contrasting flowering phenology and colonisation capacity in paired combinations of forests and hedgerows, and compared these traits among both habitats. Finally, we assessed relationships between plant performance and environmental conditions in both habitats. Results: All study species showed a higher above‐ground biomass in hedgerows than in forests. For Poa nemoralis and Geum urbanum, we also found a higher reproductive output in hedgerows, which was mainly correlated to the higher sub‐canopy temperatures therein. The “ancient forest herb” Anemone nemorosa, however, appeared to have a lower reproductive output in hedgerows than in forests, while for Ficaria verna no reproductive differences were found between the two habitats. Conclusions: This is the first study on such a broad geographical scale to provide evidence of reproductive source populations of forest herbs in hedgerows. Our findings provide key information on strategies by which forest plants grow, reproduce and disperse in hedgerow environments, which is imperative to better understand the dispersal corridor function of these wooded linear structures. Finally, we highlight the urgent need to develop guidelines for preserving, managing and establishing hedgerows in intensive agricultural landscapes, given their potential to contribute to the long‐term conservation and migration of forest herbs in the face of global environmental change

Estimated GFR and the Effect of Intensive Blood Pressure Lowering after Acute Intracerebral Hemorrhage

Background: The kidney-brain interaction has been a topic of growing interest. Past studies of the effect of kidney function on intracerebral hemorrhage (ICH) outcomes have yielded inconsistent findings. Although the second, main phase of the Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial (INTERACT2) suggests the effectiveness of early intensive blood pressure (BP) lowering in improving functional recovery after ICH, the balance of potential benefits and harms of this treatment in those with decreased kidney function remains uncertain. Study Design: Secondary analysis of INTERACT2, which randomly assigned patients with ICH with elevated systolic BP (SBP) to intensive (target SBP < 140 mm Hg) or contemporaneous guideline-based (target SBP < 180 mm Hg) BP management. Setting & Participants: 2,823 patients from 144 clinical hospitals in 21 countries. Predictors Admission estimated glomerular filtration rates (eGFRs) of patients were categorized into 3 groups based on the CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) creatinine equation: normal or high, mildly decreased, and moderately to severely decreased (>90, 60-90, and <60 mL/min/1.73 m2, respectively). Outcomes: The effect of admission eGFR on the primary outcome of death or major disability at 90 days (defined as modified Rankin Scale scores of 3-6) was analyzed using a multivariable logistic regression model. Potential effect modification of intensive BP lowering treatment by admission eGFR was assessed by interaction terms. Results: Of 2,623 included participants, 912 (35%) and 280 (11%) had mildly and moderately/severely decreased eGFRs, respectively. Patients with moderately/severely decreased eGFRs had the greatest risk for death or major disability at 90 days (adjusted OR, 1.82; 95% CI, 1.28-2.61). Effects of early intensive BP lowering were consistent across different eGFRs (P = 0.5 for homogeneity). Limitations: Generalizability issues arising from a clinical trial population. Conclusions: Decreased eGFR predicts poor outcome in acute ICH. Early intensive BP lowering provides similar treatment effects in patients with ICH with decreased eGFRs

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research