Impure Hopes

The experiment in China that produced the world's first babies with “edited” DNA comes out of an international research program aimed at producing an HIV cure. An atmosphere of secrecy surrounded this experiment at the edge of the law. Volunteers who signed up for the experiment were HIV-positive tonzghi—gay and bisexual “comrades” already living with closely guarded secrets and conflicted desires. Impure hopes—a mix of heterosexual dreams about reproductive futurity and biotech speculation about an HIV cure—drove the research forward. Volunteers were caught between dreamworlds, harboring hopes that were not entirely their own. The story of these patients is tangled up with CRISPR, a fast and cheap tool for manipulating DNA that contains tantalizing promises of medical breakthroughs for innovators and investors. Speculation in the innovation economy produced an earlier gene-editing experiment in the United States that brought HIV-positive veterans of ACT UP together with biotechnology entrepreneurs. After achieving promising results, a fickle market pushed gene-editing enterprises away from HIV cure research. Building on earlier work about impure science, this article makes an argument against purity to consider the contours of hope in ethically compromised times. Hope demands ongoing articulation work. As powerful political and economic forces threaten to steal queer hopes or simply capitalize on them, it is important to make our own ethical, political, and discursive cuts—to selectively renew some articulations while breaking other connections.

Nurses as Boundary Actors in Sustainable Health Care: A Discussion Paper

The devastating global health impacts of climate change are becoming more apparent and more frequent. Health care systems are increasingly burdened by the response to these impacts. Paradoxically, as they respond to the negative health effects of climate change, these same resource intense health care systems are contributing to further climate change. Organizations and academics have issued a call to action for health care workers to mitigate climate change and promote environmental sustainability. Nurses are an integral part of health care systems but have been delayed in answering this call. In this paper we argue that nurses are particularly well suited to mitigating climate change in health care systems because their existing role is central to patient care, and as a result they interface with other health care providers and have developed proficiency in articulation work.

Documenting multiple temporalities

PurposeThis article explores the varied ways that individuals create and use calendars, planners and other cognitive artifacts to document the multiple temporalities that make up their everyday lives. It reveals the hidden documentary time work required to synchronize, coordinate or entrain their activities to those of others.Design/methodology/approachWe interviewed 47 Canadian participants in their homes, workplaces or other locations and photographed their documents. We analyzed qualitatively; first thematically to identify mentions of times, and then relationally to reveal how documentary time work was situated within participants' broader contexts.FindingsParticipants' documents revealed a wide variety of temporalities, some embedded in the templates they used, and others added by document creators and users. Participants' documentary time work involved creating and using a variety of tools and strategies to reconcile and manage multiple temporalities and indexical time concepts that held multiple meanings. Their work employed both standard “off the shelf” and individualized “do-it-yourself” approaches.Originality/valueThis article combines several concepts of invisible work (document work, time work, articulation work) to show both how individuals engage in documentary time work and how that work is situated within broader social and temporal contexts and standards.

Temporal patient trajectories: long stories in short admissions

PurposeThe purpose of this paper is to explain how trajectory management in hospitals is challenged by the introduction of accelerated discharge schemes. The patient trajectory is formed by short stays within health-care organizations, which requires a substantial effort for professionals to be successful in clarifying each patient's medical situation. The patients, at the same time, often have complicated illness stories, and professionals only see a limited part of the patient's trajectory.Design/methodology/approachThis paper is based on extensive ethnographic studies in a newly established cardiac day unit introducing same-day discharge schemes for patients with ischemic and arrhythmic heart disease.FindingsThe findings demonstrate that the patient trajectory becomes a “temporal patient trajectory” and encounters a short-term reality, where tensions arise between admission time and the trajectory as a whole. In managing temporal patient trajectories, formal organizing and patient experiences intersect in events that emerge from conversations and span past, present and future in relation to patient treatment. Professionals engage in articulation work to maintain coherence by allowing patients to hold different events together over time.Originality/valueThe paper provides new insights into the challenges of managing trajectories in same-day discharge schemes where the pressure to move quickly and ensure patient discharge is intense. The paper offers a novel theoretical perspective on trajectory management as an ongoing temporal process. The analysis displays temporal tensions between patient experiences and the accelerated discharge scheme and how professionals manage to overcome these tensions by bridging the patient's long illness story and the short trajectory within the cardiac day unit.

Mundane work for utopian ends: Freeing digital materials in peer production

This article studies the online encyclopedia Wikipedia as a core example of the storage and sharing of commons-based digital materials. It focuses on the voluntary, day-to-day activities of its editors as they gather and transform digital information goods that are made available free of charge. Using the notion of articulation work, I stress the effort that goes into accommodating the engagement with the encyclopedia within the contributors’ media-suffused daily routines. Then, the article discusses the typical practices of transcribing, republishing, and relicensing through which the transition from non-free ownership to freely shared property is brought about. Finally, the freedom that is inherent in the modification of the legal status of ideas and artifacts and their public circulation requires us to interrogate the ethical implications of the digital commons collected and spread by Wikipedians.

shARe-IT: Ad hoc Remote Troubleshooting through Augmented Reality

Abstract10 years ago, Castellani et al. (Journal of Computer Supported Cooperative Work, vol. 18, no. 2–3, 2009, pp. 199–227, 2009) showed that using just an audio channel for remote troubleshooting can lead to a range of problems and already envisioned a future in which augmented reality (AR) could solve many of these issues. In the meantime, AR technologies have found their way into our everyday lives and using such technologies to support remote collaboration has been widely studied within the fields of Human-Computer Interaction and Computer-Supported Cooperative Work. In this paper, we contribute to this body of research by reporting on an extensive empirical study within a Fab Lab of troubleshooting and expertise sharing and the potential relevance of articulation work to their realization. Based on the findings of this study, we derived design challenges that led to an AR-based concept, implemented as a HoloLens application, called shARe-it. This application is designed to support remote troubleshooting and expertise sharing through different communication channels and AR-based interaction modalities. Early testing of the application revealed that novel interaction modalities such as AR-based markers and drawings play only a minor role in remote collaboration due to various limiting factors. Instead, the transmission of a shared view and especially arriving at a shared understanding of the situation as a prerequisite for articulation work continue to be the decisive factors in remote troubleshooting.

Housekeepings

This chapter focuses on the significant and often invisible forms of “articulation work” (the work to keep things working) needed to maintain digital media in good working order and fit-for-purpose in the domestic media ecology. It considers the labor of investigating options for, making decisions about, and purchasing and setting up new technologies as well as their ongoing maintenance. This chapter examines both the work and who does the work of maintaining and managing digital media. It also examines the relations of power, authority, gender, labor, and expertise that go into decision making, appropriating, maintaining, and using household digital technologies. In doing so, it furthers empirical developments concerning the notion of domestic media ecologies.