Kristofer Hansson

Framing the public: the policy process around xenotransplantation in Latvia and Sweden 1970–2004

A crucial debate is under way concerning the publics participation in biotechnology decision-making processes. This study, concerning the policy process around xenotransplantation (XTP) in Latvia and Sweden in the period 1970–2004, focuses on how scientific experts and politicians view the public and the publics participation in the process of developing policy regarding XTP. Drawing on interviews with actors involved in XTP in each country, we analyse and explain the inclusion and exclusion of publics in policy decision-making processes. In particular, we highlight the significance of the role of scientists and politicians in generating discourses which exclude the public from participation in policy decision-making. Copyright , Beech Tree Publishing.

How dislocation and professional anxiety influence readiness for change during the implementation of hospital-based home care for children newly diagnosed with diabetes – an ethnographic analysis of the logic of workplace change

BackgroundIn 2013–14, the evidence based care model Hospital-based Home Care for children newly diagnosed with diabetes was implemented at a large paediatric diabetes care facility in the south of Sweden. The first step of the implementation was to promote readiness for change among the professionals within the diabetes team through regular meetings. The aim was to analyse the implicit facilitators and barriers evident on a cultural micro level in discussions during the course of these meetings. What conceptions, ideals and identities might complicate, or facilitate, implementation?MethodsA case study was conducted during the implementation process. This article draw on ethnographic observations carried out at team meetings (n = 6) during the introductory element of implementation. From a discourse theoretical perspective, the verbal negotiations during these meetings were analysed.ResultsThree aspects were significant in order to understand the dislocation during this element of implementation: an epistemological disagreement that challenged the function of information within care practice; a paradoxical understanding of the time-knowledge intersection; and expressions of professional anxiety. More concretely, the professionals exhibited an unwillingness to give up the opportunity to provide structured, age-independent information; a resistance against allowing early discharge; and a professional identity formed both by altruistic concern and occupational guardiancy. The findings suggest the necessity of increased awareness of the conceptions and ideals that constitute the basis of a certain professional practice; a deeper understanding of the cultural meaning that influences care practice within a specific logic in order to predict in what way these ideals might be challenged by the implemented evidence.ConclusionsOur main contribution is the argument that the implemented evidence in itself needs to be examined and problematized from a cultural analytical perspective before initiation in order to be able to actively counter negative connotations and resistance.

Taking ownership of gaming and disability

ABSTRACT Gaming among young people with disabilities is often understood within a habilitation frame, as if video and computer games primarily should help to exercise and ‘improve’. Little is known about how these games are used within a private frame, and how young people with disabilities operate their gaming as concrete persons rather than as treatment-receiving clients. Through the use of stories, descriptions, and demonstrations from Swedish youth and young adults with disabilities (muscle diseases, cerebral palsy, and Asperger’s syndrome), we explore these gamers’ practical maneuvers, verbal accounts, and biographical-narrative concerns in relation to digital games. As they strive to bypass or overcome digital inaccessibility, various challenges find their way into their gaming practices, not only to complicate, distract, or disturb them but also to give them extra meaning. Gamer–game identifications turn multifaceted, with disabilities serving as paths both around and into the games’ ‘magical circles’. We suggest partly new concepts – beyond a habilitation frame – to capture how young people struggle to take ownership of gaming and disability: engrossment maintenance, vicarious gamers and biographical as well as situational refuge.

An ethnographic observation study of the facilitator role in an implementation process

BackgroundEven though the importance of a facilitator during an implementation process is well described, the facilitator’s role is rarely problematized in relation to the organizational context in terms of power and legitimacy; themes which have recently been brought to the fore when studying change in health care organizations. Therefore, in this article, we present a qualitative study with the aim of identifying key aspects of the experience of being in a facilitator role. The data collection involved ethnographic fieldwork encompassing observations and field notes, as well as two qualitative interviews with the facilitator. The data were analysed using a phenomenological hermeneutical method in order to formulate thematic aspects of the implementation process. The study was conducted in southern Sweden between January 2013 and August 2014.ResultsOne main theme, “walking a tightrope”, and four sub-themes, all of which involved balancing acts of different levels and different ways, were identified. These included: being in control, but needing to adjust; pushing for change, but forced to stand back; being accepted, but dependent; and being reasonable, but culturally sensitive.ConclusionInstead of listing the desirable qualities and conditions of a facilitator, this study shows that being a facilitator can be described more completely by applying the concept of role, thus allowing a more holistic process of reflection and analysis. This in turn makes it possible to move from the reactive stance of balancing to a more proactive stance of negotiating.