This paper explores empirical ontology by arguing that realities are enacted in practices. Using the case of Atlantic salmon, it describes a series of scientific and fish-farming practices. Since these practices differ, the paper also argues that different salmon are being enacted within those different practices. The paper explores the precarious choreographies of those practices, considers the ways in which they enact agency and also work to generate Otherness. Finally it emphasises the productivity of practices and notes that they generate not simply particular realities (for instance particular salmon), but also enact a penumbra of not quite realised realities: animals that were almost but not quite created.

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This article explores Pakistani-born persons' expectations regarding health encounters and health-worker style, and consequences for communication. It is part of a larger qualitative study involving both health workers and Pakistani-born persons in Oslo. An earlier publication based on interviews with health workers revealed dilemmas around role enactment, and described how they perceived Pakistani-born patients to expect an authoritarian health-worker style. The present article is based on interviews with patients and reveals that Pakistani-born diabetics expect empathy and care rather than an authoritarian style. The interviews indicate that lack of trust and diverging role expectations may be understood in the context of class and level of education, as well as ethnicity. Responding to theories about empowerment work and the dual impact of ethnicity and class, the study indicates that health workers should admit their professional expert role, and combine this role with a caring attitude in order to build trust.

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A possible explanation for such ways of responding to the patient may be that the health workers, in their articulation of patient-centredness, draw on a repertoire of social conduct that involves an effort to level out, or tacitly deny, hierarchic structures, and that this becomes more pronounced in cross-cultural encounters. Patient-centredness and empowerment are results of long ongoing processes in Western countries, based on ideals of equality and individual freedom. The results from this study indicate that these approaches may pose intricate dilemmas for the health workers in their cross-cultural encounters, and need further attention.