Ticking Boxes and Changing the Social World: Data Collection and the New UK General Practice Contract

The new General Medical Services contract was introduced into general practice in the UK in 2004, and it links pay to performance far more than in the past. As a result, accurate data collection about patients and the care that they receive is now not only important for good patient care but also to prove that targets are being met. The use of electronic records and information technology has thus become much more sophisticated. This article reports the results from an ethnographic study of the early stages of the new contract in two general practices. As expected, electronic data collection had increased in importance in both practices, with consequences both for clinician–patient interactions and for the structures and processes in the practices, as uniform data collection instruments are put in place that privilege ‘hard’ biomedical data that can be easily coded above ‘softer’, more patient-centred information. Roles and responsibilities had been changed to reflect the needs of the new systems, and new software applications allowed increased surveillance of both doctors’ and nurses’ performance; both of these had an impact on patterns of authority in our study practices. Furthermore, the structural changes that were found acted to embed the new ways of working, ensuring their reproduction in the future. In spite of these effects, we found little opposition to or critical reflection on the changes, and the doctors in our study continued to view their improved computer systems as neutral recording devices. The implication of these findings is discussed.     

Women, Language and Identity

This paper explores the ways in which women and men use language to mark gender boundaries, and to convey femininity and masculinity in the construction of a gendered identity. The first section of the paper examines evidence that language serves as a gender identity marker not only in the particular phonological variants used more by women than by men, but also in the wider stylistic range evident in women's discourse in some communities. The gender distribution and social meanings associated with particular pragmatic particles and interactional devices provide another indication of the ways in which women and men construct and express femininity and masculinity in interaction. The final section analyses the construction of stereotypical gender identities through conversational interaction, firstly by means of a narrative and secondly through the carefully crafted dialogue of an advertisement. The paper demonstrates the complementary nature of macro-level quantitative studies and qualitative ethnographic analysis in gender research.     

Placing Clinical Social Workers “Between a Legal Rock and a Practice Hard Place”: Reactions to Madden and Parody

The debate about the veracity of incest memories uncovered in therapy is often impassioned and acrimonious. Recent statements by various professional organizations, advising that corroboration of recovered memories is the only method for determining their accuracy, have not decreased the intensity of this debate. This response to Madden and Parody's paper discusses the importance of corroboration of recovered memories of sexual abuse and details the clinical, scientific, and legal foundations for this approach. A point of confusion in Madden and Parody's paper and an important aspect of this response is the difference between clients who uncover completely new memories of childhood sexual abuse and clients who enter therapy with a history of sexual abuse. Those clients with new memories are the focus of this debate and the standard of care proposed in this paper.     

Challenging the Rhetoric of Choice in Maternal Labour‐Force Participation: Preferred Versus Contracted Work Hours

The notion of choice in maternal labour‐force participation (LFP) is a contentious one, with assertions that LFP is a direct result of either personal inclinations, such as employment commitment or external factors, such as historically available opportunities. This article suggests an alternative framework for understanding and testing choice in LFP using preferred versus contracted work hours. It explores these constructs quantitatively in a group of working mothers (N = 275) with dependent children and investigates qualitatively the underlying reasons for discrepant preferred versus contracted work hours in a sub‐sample of these women with under‐school‐aged children (N = 20). The results show that nearly two‐thirds of women working full time would prefer to work part time and the major reasons for not acting on their preferences is because of the nature of the job and the lack of career opportunities available for part‐time employees.     

Multiple forms of violence and other criminal activities as an indicator of severe child maltreatment

Child protection practice still appears to view child maltreatment as an event largely isolated from other family violence and criminal activities. Research undertaken by the authors suggests that children who have been subjected to the more severe forms of abuse are likely to have come from families who engage in several forms of criminal activity, inside and outside the family, which is often severe in nature. The child who has been maltreated may also become a participant in these activities. The authors recommend that these factors should be investigated in families who have maltreated a child, as the presence or absence of several forms of concurrent violence and other criminal activity may provide an important clue about the welfare of the child. Copyright © 2004 John Wiley & Sons, Ltd.     

The impact of gender on gambling attitudes and behavior

Researchers have often attributed the consistent relation of gender and gambling behavior to gender role socialization. If they are correct, gender should affect different sets of gambling attitudes in a manner consistent with at least three aspects of gender role socialization: a double standard of morality, a guardian of the hearth role for women, and a dualism of orientations. A survey measuring gambling attitudes and behavior was sent to a sample of residents in North Dakota after legalization of several games of chance (e.g., blackjack). Gender affects behavior but only some of the specified attitudes. These mixed results may reflect changes in gender role socialization and the increasing legalization of gambling.