Critical Design Ethnography as Action Research

"Critical Design Ethnography: Designing for Change" is reviewed in terms of action research under five dimensions: knowledge in practice, participation and democracy, many ways of knowing, emergence, and worthwhile purposes. Particular attention is paid to the tensions between the design agenda and the empowerment agenda.     

Focus: Preventive Medicine: Leveraging Organizational Health Literacy to Enhance Health Promotion and Risk Prevention: A Narrative and Interpretive Literature Review

Organizational health literacy involves the health care organizations’ ability to establish an empowering and co-creating relationship with patients, engaging them in the design and delivery of health services in collaboration with health professionals. Although scholars agree that organizational health literacy contributes to health promotion and risk prevention via patient empowerment, literature is not consistent in depicting the interplay between organizational health literacy and preventive medicine. The article intends to shed light into this issue, summarizing current knowledge about this topic and advancing avenues for further development. A narrative literature review was performed through a systematic search on PubMed^®, Scopus^®, and Web of Science^™. The review focused on 50 relevant contributions. Organizational health literacy triggers the transition towards a patient-centered approach to care. It complements individual health literacy, enabling patients to actively participate in health promotion and risk prevention as co-producers of health services and co-creators of value. However, many obstacles – including lack of time and limited resources available – prevent the transition towards health literate health care organizations. Two initiatives are required to overcome extant barriers. On the one hand, a health literate workforce should be prepared to increase the institutional ability of health care organizations to empower and engage patients in health co-creation. On the other hand, increased efforts should be made to assess organizational health literacy and to make its contribution to preventive medicine explicit.     

Rethinking patient involvement in healthcare priority setting

With healthcare systems under pressure from scarcity of resources and ever-increasing demand for services, difficult priority setting choices need to be made. At the same time, increased attention to patient involvement in a wide range of settings has given rise to the idea that those who are eventually affected by priority setting decisions should have a say in those decisions. In this paper, we investigate arguments for the inclusion of patient representatives in priority setting bodies at the policy level. We find that the standard justifications for patient representation, such as to achieve patient-relevant decisions, empowerment of patients, securing legitimacy of decisions, and the analogy with democracy, all fall short of supporting patient representation in this context. We conclude by briefly outlining an alternative proposal for patient participation that involves patient consultants.     

国外生态旅游对当地社区生计的影响研究综述

生态旅游因具备实现生物多样性保护和减轻贫困双重目标的潜力,成为全球学术界关注的焦点。鉴于生态旅游在影响社区生计方面的研究争议,论文综览国外大量相关文献,在界定生态旅游内涵的基础上,从经济影响、社区参与、能力建设、社会文化和公共设施4个方面系统梳理国外生态旅游对目的地社区生计的影响。研究发现旅游发展对目的地生计的影响存在不确定性,社区资源控制权、旅游收益规模、地方介入旅游产业供应链能力、自身能力、旅游管理等因素对旅游扶贫效应起着关键性作用。最后,对当前研究展开评述并对未来研究提出三点展望,以期为中国未来生态旅游影响研究和生态旅游开发提供借鉴和指导。     

Transformative Knowledge Transfer Through Empowering and Paying Community Researchers

Environmental research is often conducted independently of the community in which the environment is situated, with transfer of results into policy and on-ground action occurring independently of the community's interests or aspirations. Increasingly the need for greater community involvement in the research process has been recognized. For community members, however, such engagement usually involves trade-offs. While it is often assumed that community members should participate voluntarily because they will gain from the research, any benefits from knowledge, understanding and a capacity to influence the research have to be offset against time and potential loss of unremunerated intellectual property. We argue, using case studies from tropical Australia and Africa, that a more effective means of engagement and knowledge transfer is training and remuneration of community members as coresearchers. This engagement is much more than payment for labor—it is investment in local intellectual property and requires researcher humility, power-sharing and recognition that access to research funding provides no moral or intellectual authority. Further, we argue that, for effective adoption of research results, community members need to be part of negotiated agreements on the initial nature of the research to ensure it answers questions of genuine local relevance and that local researchers have the capacity to place locally conducted research into a wider context. We argue that immediate rewards for involvement not only secure engagement but, where appropriate, are likely to lead to effective implementation of research results, enhanced local capacity and greater equity in intellectual power-sharing.     

Serial Callers: Communication Technologies and Political Personhood in Contemporary Uganda

ABSTRACT

Together, radio and mobile phones have been the object of many political expectations held by development actors in Africa. Stating that they enable ‘participation’ is, however, not enough to understand what is at stake in a given context. It is necessary to describe exactly the kind of participation taking place. Despite development projects inceptors’ intentions, the way people use ICT (information and communication technologies) objects sometimes leads to a rerouting of their political meaning. This article deciphers these sideway uses and what they imply in the Ugandan context. Based on the example of ‘serial callers' (people who intensively call in during radio talk shows), it demonstrates that ICT objects become the site of the elaboration of particular ways of conceiving one's roles, status and duties in the polity, as an ‘educator’ or a ‘representative’, blurring established distinctions between political representation and participation, and offers a nuanced picture of the complexities of patronage politics.     

包容性治理：中国国家公园治理新思路

模式的选择在自然保护地有效治理过程中起着关键作用,适宜的治理模式是实现自然保护地生态、社会、经济和文化综合效益最优化的重要途径。包容性治理在建立多元共治、全民共享的国家公园治理体制、促进社会公平和容纳边缘群体等方面具有独特优势,是对保护地治理模式的优化与创新,拥有广阔的应用空间。系统总结了全球保护地治理模式,对不同治理模式进行了比较和评价,重点从理论和实践背景阐述了包容性治理的源起;从边缘性和公平性视角两方面分析了现阶段中国国家公园进行包容性治理的必要性与可行性;并对中国国家公园包容性治理框架进行了阐释,提出了中国国家公园包容性治理建议和思考。以治理主体多元化、主体间的合作、促进社会公平、容纳全体社会成员自由发展,尤其是确保边缘群体的利益为特征的包容性治理,可以成为中国国家公园协调保护和当地发展的新思路、新选择。     

Giving the silent majority a stronger voice? Initiatives to empower Muslim women as part of the UK's ‘War on Terror’

Abstract

This article provides a gendered analysis of the ‘War on Terror’ in the UK context. Specifically it looks at initiatives to empower Muslim women, which were part of New Labour's Preventing Violent Extremism (PVE) agenda, the impetus for which stemmed from the idea that, as ‘the silent majority’, women need to be given a ‘stronger voice’. Based on analysis of qualitative interviews, this article situates these initiatives within a broader policy landscape of debates on multiculturalism, community cohesion and Britishness. It explores interviewees' understandings of Muslim women's silence in relation to those suggested by policy discourse, considering the ways in which the state's attempt to ‘give voice’ worked in practice. I argue that the operation of such initiatives continued to constrain Muslim women's voices, restricting ‘voice’ to a narrow range of speakers speaking about a narrow range of issues.     

AIDS Rumour,Intellectual Anxiety,and Discursive Empowerment among Cameroonian Tradipractitioners

This article refines established notions of rumour as a strategy of discursive empowerment by differentiating typologies of empowerment. Specifically, I employ terminology from the anthropological literature on witchcraft to distinguish between ‘levelling’ rumour, which seeks to attack the power of others, and ‘accumulative’ rumour, which seeks to increase the power of rumour-tellers. To exemplify this, I explore a rumour that circulated in 2012 and 2013 among practitioners of traditional medicine in West Cameroon, which claimed that the state would kill tradipractitioners working to cure HIV/AIDS. I first outline the likely sociopolitical roots of practitioners’ anxiety regarding their intellectual labour. I then argue that this narrative was simultaneously levelling and accumulative in a national context, yet became accumulative in the more international context of practitioner–anthropologist relations. Ultimately, both forms of empowerment were key to understanding the rumour's favourable positioning of tradipractitioners in an increasingly uncertain, tense, and multinational part of Cameroon.     

Autonomy is a Right,Not a Feat: How Theoretical Misconceptions have Muddled the Debate on Dynamic Consent to Biobank Research

Should people be involved as active participants in longitudinal medical research, as opposed to remaining passive providers of data and material? We argue in this article that misconceptions of ‘autonomy’ as a kind of feat rather than a right are to blame for much of the confusion surrounding the debate of dynamic versus broad consent. Keeping in mind two foundational facts of human life, freedom and dignity, we elaborate three moral principles – those of autonomy, integrity and authority – to better see what is at stake. Respect for autonomy is to recognize the other's right to decide in matters that are important to them. Respect for integrity is to meet, in one's relationship with the other, their need to navigate the intersection between private and social life. Respect for authority is to empower the other – to help them to cultivate their responsibility as citizens. On our account, to force information onto someone who does not want it is not to respect that person's autonomy, but to violate integrity in the name of empowerment. Empowerment, not respect for autonomy, is the aim that sets patient‐centred initiatives employing a dynamic consent model apart from other consent models. Whether this is ultimately morally justified depends on whether empowerment ought to be a goal of medical research, which is questionable.