<p>FRAGMENTERAD SAMMANFATTNING</p><p>Aktörerna i Stockholms läns landsting simulerar marknad och konkurrens och är väl medvetna om att de gör detta (Den Stora Upphandlingen; en inre marknad inom ramen för en förvaltningsstyrd struktur). Det är inte det denna alternativa berättelse om konkurrens avslöjar. Aktörerna vet precis vad de försöker göra när de försöker organisera hälso- och sjukvården i Stockholms läns landsting genom att låta sig influeras av andra ”världar”. En särskilt relevant ”annan värld” är ekonomen och ekonomisk teori. Men i den till synes medvetna processen händer något, det uppstår komplexitet; det uppträder många olika världar som cirkulerar i Stockholms läns landsting. Men översättningsprocessen av konkurrens stannar inte här. Aktörerna intensifierar sina ansträngningar för att komma tillrätta med det som blivit komplicerat. Nya förslag på hur hälso- och sjukvården ska organiseras konstrueras, där var och en för fram Det Bästa Sättet för att komma till rätta med de observerade problemen. Situationen och tillvaron blir fördunklad och ekonomisk teori har nu översatts så många gånger, av så många olika aktörer, att det cirkulerar otaliga kopior av den. Det är processen av förenkling, komplexitet och fördunkling som är essensen i min re-presentation och i mina anspråk på att försöka förstå konkurrensprocesser. En essens som jag fångar och illustrerar med hur aktörer i aktörsnätverk översätter (associerar, enrollerar och etiketterar) den neoklassiska marknaden.</p><p>Men annat står också på spel. Aktörer översätter såväl människor som ting samtidigt som ting i sin tur influerar mänskliga föreställningar och ageranden. Men tings förmåga att konstruera människor är begränsat eftersom ting agerar utifrån givna koder, en given Ordning, (som givetvis kan bryta samman och ta oanade vägar, till exempel dataprogram), men som i sig är fyllda av mänskliga avsikter och intentioner. Vissa ”sociotekniska” ting är designade att centrera ”världar”, exempelvis Stockholms läns landsting uttryckt i siffror i en årsredovisning. Likafullt är det bara människor som, i processerna av förenkling, komplexitet och fördunkling, kan träda fram och konstruera och centrera heterogent materiella världar, men genom att centrera mängder av heterogena material (såväl människor som ting) förmår ting visa epistemologiska möjligheter för mänskligt agerande. Människor kan med andra ord färdas långt ut i världen med hjälp av ting. En empirisk observation är att ju längre aktörerna, i hälso- och sjukvården i Stockholms läns landsting, reser i de centrerade heterogent materiella världarna desto mer närsynta blir de samtidigt som potentialen att orsaka allvarliga sidoeffekter blir större och större. En annan empirisk observation i studien är att sidoeffekter hanteras på samma sätt i den nationalekonomiska neoklassiska teorin som i hälso- och sjukvårdens praktik, där internaliserade och väl avgränsade ekonomiska transaktioner antas utgöra normen och sidoeffekter undantagen på marknaden. Istället förhåller sig det precis tvärtom: Sidoeffekter är normen och internaliserade och väl avgränsade ekonomiska transaktioner utgör undantagen.</p>

FRAGMENTERAD SAMMANFATTNING Aktörerna i Stockholms läns landsting simulerar marknad och konkurrens och är väl medvetna om att de gör detta (Den Stora Upphandlingen; en inre marknad inom ramen för en förvaltningsstyrd struktur). Det är inte det denna alternativa berättelse om konkurrens avslöjar. Aktörerna vet precis vad de försöker göra när de försöker organisera hälso- och sjukvården i Stockholms läns landsting genom att låta sig influeras av andra ”världar”. En särskilt relevant ”annan värld” är ekonomen och ekonomisk teori. Men i den till synes medvetna processen händer något, det uppstår komplexitet; det uppträder många olika världar som cirkulerar i Stockholms läns landsting. Men översättningsprocessen av konkurrens stannar inte här. Aktörerna intensifierar sina ansträngningar för att komma tillrätta med det som blivit komplicerat. Nya förslag på hur hälso- och sjukvården ska organiseras konstrueras, där var och en för fram Det Bästa Sättet för att komma till rätta med de observerade problemen. Situationen och tillvaron blir fördunklad och ekonomisk teori har nu översatts så många gånger, av så många olika aktörer, att det cirkulerar otaliga kopior av den. Det är processen av förenkling, komplexitet och fördunkling som är essensen i min re-presentation och i mina anspråk på att försöka förstå konkurrensprocesser. En essens som jag fångar och illustrerar med hur aktörer i aktörsnätverk översätter (associerar, enrollerar och etiketterar) den neoklassiska marknaden. Men annat står också på spel. Aktörer översätter såväl människor som ting samtidigt som ting i sin tur influerar mänskliga föreställningar och ageranden. Men tings förmåga att konstruera människor är begränsat eftersom ting agerar utifrån givna koder, en given Ordning, (som givetvis kan bryta samman och ta oanade vägar, till exempel dataprogram), men som i sig är fyllda av mänskliga avsikter och intentioner. Vissa ”sociotekniska” ting är designade att centrera ”världar”, exempelvis Stockholms läns landsting uttryckt i siffror i en årsredovisning. Likafullt är det bara människor som, i processerna av förenkling, komplexitet och fördunkling, kan träda fram och konstruera och centrera heterogent materiella världar, men genom att centrera mängder av heterogena material (såväl människor som ting) förmår ting visa epistemologiska möjligheter för mänskligt agerande. Människor kan med andra ord färdas långt ut i världen med hjälp av ting. En empirisk observation är att ju längre aktörerna, i hälso- och sjukvården i Stockholms läns landsting, reser i de centrerade heterogent materiella världarna desto mer närsynta blir de samtidigt som potentialen att orsaka allvarliga sidoeffekter blir större och större. En annan empirisk observation i studien är att sidoeffekter hanteras på samma sätt i den nationalekonomiska neoklassiska teorin som i hälso- och sjukvårdens praktik, där internaliserade och väl avgränsade ekonomiska transaktioner antas utgöra normen och sidoeffekter undantagen på marknaden. Istället förhåller sig det precis tvärtom: Sidoeffekter är normen och internaliserade och väl avgränsade ekonomiska transaktioner utgör undantagen.

The backdrop of this dissertation is one ubiquitous element of everyday life: the stock market. Traditionally, accounting and stock markets are logically coordinate entities and this thesis analyzes how accounting supports private investors in their role as shareholders – as investors in shares and owners of companies. This analysis is carried out in four independent essays. The first two essays analyze the privatization of Telia, a former state-owned Telecommunication Company in Sweden that went public in 2000. The field material for the two essays consisted of newspaper articles, government bills and interviews. Qualitative and quantitative analyses demonstrate how accounting is used among different actors to realize the privatization. Theoretically, the first two essays lend themselves to the governmentality debate as introduced to accounting research by Miller and Rose (1990). The third and fourth essays are analyses of annual general meetings (AGMs). The field material was generated from a study of participants at 36 AGMs during the spring of 2004. The choice of these two seemingly unrelated cases was done deliberately. Both cases are stock market events that typically involve an audience of a large number of non-professional investors. In the privatization of Telia over 1 million people took part in the offer. The AGMs are typically seen as the single event by which non-professional investors have an opportunity to meet with top management. Thus, each event represents an instance in which accounting is confronted by a predominantly non-professional audience. The contribution of this study is two-fold. First, earlier work inspired by the Miller and Rose framework (1990) has favored an analysis of the programmatic. This study develops the technological aspect of the theoretical framework by means of a rich empirical description. In addition the two essays on the privatization of Telia contribute with an analysis of how once a specific technology translates to become and becomes understood at the site of intervention. Second, the two studies of AGMs contest earlier criticism against the meeting as a corporate governance mechanism detached from the overall corporate governance system. The argument here is that the AGM offers a valuable setting for private investors to discuss stewardship issues. That this opportunity is taken advantage of is suggested by the present field material.

Under the Nazi regime in Germany (1933-1945) a calculated killing of chronic “mentally ill” patients took place that was part of a large biopolitical program using well-established, contemporary scientific standards on the understanding of eugenics. Nearly 300,000 patients were assassinated during this period. Nurses executed this program through their everyday practice. However, suspicions have been raised that psychiatric patients were already assassinated before and after the Nazi regime, suggesting that the motives for these killings must be investigated within psychiatric practice itself. My research aims to highlight the mechanisms and scientific discourses in place that allowed nurses to perceive patients as unworthy of life, and thus able to be killed. Using Foucauldian concepts of “biopower” and “State racism,” this discourse analysis is carried out on several levels. First, it analyzes nursing notes in one specific patient record and interprets them in relation to the kinds of scientific discourses that are identified, for example, in nursing journals between 1900 and 1945. Second, it argues that records are not static but rather produce certain effects; they are “performative” because they are active agents. Psychiatry, with its need to make patients completely visible and its desire to maintain its dominance in the psychiatric field, requires the utilization of writing in order to register everything that happens to individuals, everything they do and everything they talk about. Furthermore, writing enables nurses to pass along information from the “bottom-up,” and written documents allow all information to be accessible at any time. It is a method of centralizing information and of coordinating different levels within disciplinary systems. By following this approach it is possible to demonstrate that the production of meaning within nurses’ notes is not based on the intentionality of the writer but rather depends on discursive patterns constructed by contemporary scientific discourses. Using a form of “institutional ethnography,” the study analyzes documents as “inscriptions” that actively interven in interactions in institutions and that create a specific reality on their own accord. The question is not whether the reality represented within the documents is true, but rather how documents worked in institutions and what their effects were. Third, the study demonstrates how nurses were actively involved in the construction of patients’ identities and how these “documentary identities” led to the death of thousands of humans whose lives were considered to be “unworthy lives.” Documents are able to constitute the identities of psychiatric patients and, conversely, are able to deconstruct them. The result of de-subjectification was that “zones for the unliving” existed in psychiatric hospitals long before the Nazi regime and within these zones, patients were exposed to an increased risk of death. An analysis of the nursing notes highlights that nurses played a decisive role in constructing these “zones” and had an important strategic function in them. Psychiatric hospitals became spaces where patients were reduced to a “bare life;” these spaces were comparable with the concentration camps of the Holocaust. This analysis enables the integration of nursing practices under National Socialism into the history of modernity. Nursing under Nazism was not simply a relapse into barbarism; Nazi exclusionary practices were extreme variants of scientific, social, and political exclusionary practices that were already in place. Different types of power are identifiable in the Nazi regime, even those that Foucault called “technologies of the self” were demonstrated, for example, by the denunciation of “disabled persons” by nurses. Nurses themselves were able to employ techniques of power in the Nazi regime.

Under the Nazi regime in Germany (1933-1945) a calculated killing of chronic “mentally ill” patients took place that was part of a large biopolitical program using well-established, contemporary scientific standards on the understanding of eugenics. Nearly 300,000 patients were assassinated during this period. Nurses executed this program through their everyday practice. However, suspicions have been raised that psychiatric patients were already assassinated before and after the Nazi regime, suggesting that the motives for these killings must be investigated within psychiatric practice itself. My research aims to highlight the mechanisms and scientific discourses in place that allowed nurses to perceive patients as unworthy of life, and thus able to be killed. Using Foucauldian concepts of “biopower” and “State racism,” this discourse analysis is carried out on several levels. First, it analyzes nursing notes in one specific patient record and interprets them in relation to the kinds of scientific discourses that are identified, for example, in nursing journals between 1900 and 1945. Second, it argues that records are not static but rather produce certain effects; they are “performative” because they are active agents. Psychiatry, with its need to make patients completely visible and its desire to maintain its dominance in the psychiatric field, requires the utilization of writing in order to register everything that happens to individuals, everything they do and everything they talk about. Furthermore, writing enables nurses to pass along information from the “bottom-up,” and written documents allow all information to be accessible at any time. It is a method of centralizing information and of coordinating different levels within disciplinary systems. By following this approach it is possible to demonstrate that the production of meaning within nurses’ notes is not based on the intentionality of the writer but rather depends on discursive patterns constructed by contemporary scientific discourses. Using a form of “institutional ethnography,” the study analyzes documents as “inscriptions” that actively interven in interactions in institutions and that create a specific reality on their own accord. The question is not whether the reality represented within the documents is true, but rather how documents worked in institutions and what their effects were. Third, the study demonstrates how nurses were actively involved in the construction of patients’ identities and how these “documentary identities” led to the death of thousands of humans whose lives were considered to be “unworthy lives.” Documents are able to constitute the identities of psychiatric patients and, conversely, are able to deconstruct them. The result of de-subjectification was that “zones for the unliving” existed in psychiatric hospitals long before the Nazi regime and within these zones, patients were exposed to an increased risk of death. An analysis of the nursing notes highlights that nurses played a decisive role in constructing these “zones” and had an important strategic function in them. Psychiatric hospitals became spaces where patients were reduced to a “bare life;” these spaces were comparable with the concentration camps of the Holocaust. This analysis enables the integration of nursing practices under National Socialism into the history of modernity. Nursing under Nazism was not simply a relapse into barbarism; Nazi exclusionary practices were extreme variants of scientific, social, and political exclusionary practices that were already in place. Different types of power are identifiable in the Nazi regime, even those that Foucault called “technologies of the self” were demonstrated, for example, by the denunciation of “disabled persons” by nurses. Nurses themselves were able to employ techniques of power in the Nazi regime.

This in-depth exploratory case study examines the real estate decision-making processes in four small, charitable organizations through the lens of Actor Network Theory (ANT). While decision-makers in these cases followed logical pathways and criteria in searching for and evaluating alternatives, this investigation also found these processes were often lengthy, complex, bounded rational, and political. The analysis looked at the relative roles played by various internal and external actors (including influential non-human actors such as feasibility studies, renderings, budgets, and plans) and the resulting fragile, but acceptable outcomes. From the presented engaged scholarship, practical implications emerged that can aid nonprofit managers and their boards in their real estate decision-making processes. Lastly, in addition to helping understand the process of creating real estate decisions in the context of nonprofit organizations, the analysis demonstrates how ANT with its focus on how heterogeneous human and non-human actors interact and come together to act as a whole, can be a valuable framework in examining the socio-technical, political process of real estate decision-making.

This paper investigates, through an actor-network theory perspective, how the recreation area Lövsta-Kyrkhamn-Riddersvik northwest of Stockholm has developed from being a dumping site into becoming a nature reserve. This investigation also tries to describe and explain which values that have been promoted in the area by the local voluntary associations and companies. Lövsta-Kyrkhamn-Riddersvik has been inhabited for more than 3000 years, originally with farming as the most important business. The area served as Stockholm’s waste disposal site from the late 1890’s and has today become an important area for recreational use. The actor- network theory perspective is used to identify different actors, both human and non-human, that has worked for the protection of the area and thus gained power over the decision-making.

Thesis (Ph.D.)--Saint Mary's University, 2009. / Includes abstract. Advisor: Albert J. Mills. Includes bibliographical references (leaves 325-352).

The wolf is an endangered animal in Sweden and the issue of conserving the species is a polarizing one. Specific attention has been given to this issue in environmental social sciences with studies focusing on the divide between wolf support and opposition. These studies include looking at historical interactions with the wolf, contemporary attitudes about the issue, and the way the law shapes policy. Following this focus on the disputed nature of wolf conservation, this thesis addresses whether polarization over the issue occurs between several stakeholders in large carnivore management in Sweden. Using Actor Network Theory, this thesis examines the similarities and divergences in the stakeholders’ conservation practices and maps their interactions with one another. Emphasis is placed on how the European Union’s regulations and the Swedish State’s policies conflict and/or influence the stakeholders. Overall results show that despite a discourse of polarization surrounding wolf management in Sweden, the actors in this study cannot be easily positioned against each other, and despite some divergences, share many similarities in their large carnivore management practices.

När det offentliga väljer att upphandla välfärden och köpa in tjänsteutförandet från fristående vårdbolag följer ett behov av nya verktyg för att driva välfärden i önskad riktning. Den här uppsatsen söker beskriva hur kommunala tjänstemän bemöter konsekvenserna av trenden att omvandla de byråkratiska välfärdssystemen till marknader för välfärdstjänster och utvecklar nya verktyg för styrning. Utgångspunkten för undersökningen är de förfrågningsunderlag tjänstemännen formulerar och som utgör grunden för upphandlingsprocessen. Fördjupad kunskap om hur upphandlingsprocessen utformas i praktiken samlas genom intervjuer med ansvariga tjänstemän vid Uppsala Kommun samt marknadschefen vid ett av kommunens utförarbolag. Undersökningen visar att tjänstemännen lägger stor vikt vid formuleringen av obligatoriska krav som utförarna måste leva upp till för att maximera de boendes välmående. Dessa krav utformas för att stärka tydlighet, uppföljningsbarhet och standardisering. Detta görs genom att öka mängden krav, använda och skapa normer för hur verksamheten bör bedrivas och att stärka professionella yrkesgruppers roll.