‘We Don't Have to Take This’: Zero Tolerance of Violence against Health Care Workers in a Time of Insecurity

Doctors, nurses and other health care workers in the UK are said to be increasingly aware of the ‘risks of the job’ as a result of mounting verbal abuse, threats and assaults from patients and their relatives. In the late 1990s the UK government introduced a policy of ‘zero tolerance’, which it claimed was designed to minimize the risk of such violence. Current policy refers to the need to be tough on offenders and encourage a culture of respect. In this article we review this strategy and the reasons for its introduction and consider some of the potential consequences. The article starts with an account of the policy, the definition of violence that underpins it and how it has been measured, and assesses the evidence regarding prevalence. This is then interpreted in the context of wider policies of zero tolerance to crime, and debates about risk, anxiety and insecurity.     

Towards a Sociology of Disclosure: The Case of Surgical Performance

Despite the increasingly widespread emphasis on the need for transparency in health‐care and elsewhere, there is limited evidence regarding the consequences of disclosing medical performance data. The evidence is disparate and has not been synthesised in a coherent way. This paper focuses on surgical performance, whose measurement is generally often seen as straight forward. It begins by outlining the context for understanding the publication of such data and then presents an analytical framework as a vehicle for conceptualising the nature of disclosure in surgery and health‐care more generally. The framework addresses key dimensions concerning one surgical specialty (cardiac surgery) and its relationship with a range of stakeholders in an English context. In particular, we examine the interaction between surgeons and between surgeons, patients, managers and policy‐makers. These relationships are framed in terms of choice and calculativeness, strategies and tactics, and trust, and need to be understood at micro, meso and macro levels. We conclude by considering how this framework provides a research agenda for a sociology of disclosure.     

Risk, Mental Disorder and Social Work Practice: A Gendered Landscape

Whilst the importance of gender for social work practice, riskand mental health has been recognized theoretically for sometime, few attempts have been made to explore this area empirically.This paper presents findings from a mixed-methods study of socialwork practice in relation to mental health service users perceivedto be ‘high-risk’. Findings suggest, first, thatthe concept ‘high-risk’ was gendered because theprimary focus in social work practice was on the risks posedby male service users to others. Second, female social workersin the present study were found to have more female serviceusers from their caseloads who had been defined as ‘high-risk’compared with their male counterparts. The paper goes on toexplore this apparent congruence between female social workersand female service users and highlights how the management ofrisk could be considered gendered because it reflects a worker’s(perceived) capacity in cultural terms to ‘decode’the nature of the risks that their clients face as genderedsubjects. The paper demonstrates how the intersections betweenrisk, mental disorder and social work practice can thereforebe understood as a gendered landscape. It concludes by highlightingthe implications of these findings for social work practiceand research.     

Generational Peers and Alcohol Misuse

This study investigates the influence of generational peers on alcohol misuse among immigrant youth. We derive hypotheses from sociological theories of generations regarding race/ethnicity, gender, and immigrant generation and test these hypotheses using a measure that accounts for the proportion of peers within a given peer network that are of the same immigrant generation. Results show that generational ties decreased the odds of alcohol misuse for immigrants and that these effects depend partly on race/ethnicity and gender. We conclude that generational ties play a meaningful role in the health and well‐being of immigrant youth, and discuss possible future avenues for research on immigrant generational peers.     

Social media in the 2011 Egyptian uprising

This paper uses Gallup poll data to assess two narratives that have crystallized around the 2011 Egyptian uprising: (1) New electronic communications media constituted an important and independent cause of the protests in so far as they enhanced the capacity of demonstrators to extend protest networks, express outrage, organize events, and warn comrades of real‐time threats. (2) Net of other factors, new electronic communications media played a relatively minor role in the uprising because they are low‐cost, low‐risk means of involvement that attract many sympathetic onlookers who are not prepared to engage in high‐risk activism. Examining the independent effects of a host of factors associated with high‐risk movement activism, the paper concludes that using some new electronic communications media was associated with being a demonstrator. However, grievances, structural availability, and network connections were more important than was the use of new electronic communications media in distinguishing demonstrators from sympathetic onlookers. Thus, although both narratives have some validity, they must both be qualified.     

Global System Theory and ‘Market-friendly’ Religion

This article explores some implications of the interplay of neoliberal economic policy and religion for Leslie Sklair's global system theory (GST), and some implications of Sklair's theory for the study of contemporary religion. We first suggest that Sklair needlessly restricted his theory's scope by analyzing culture in terms of consumerist ideologies without systematic consideration of religious doctrines and practices. Second, based on studies of ‘market Islam’ and our own research on neo-Pentecostal Christianity in Guatemala, we argue that Sklair's notion of a transnational capitalist class is needed for an adequate understanding of the rapid growth of these religious movements. We conclude that GST can benefit from consideration of contemporary religious change, while the study of contemporary religion has perhaps even more to gain from theorizing the influence of transnational elites.     

Tranquillisers as social control?*

In this paper we use findings from an empirical study of the meaning of tranquilliser prescribing and use to examine the contention that these drugs are a means of social control, and to assess the explanatory value of the concept of social control when applied to the doctor-patient relationship. We first outline the historical application of the concept to the health field, specify the cultural mechanisms by which social control is said to be achieved and look at the ways in which the mechanisms are thought to operate through the prescribing of the most widely used kind of tranquilliser/hypnotic-benzodiazepines (e.g. Valium, Mogadon). We then draw on our data to see how far they substantiate the arguments which have been developed. In the final section of the paper we suggest some alternative explanations regarding the nature of doctors' power and of patient dependence. We also discuss problems involved in conceptualizing gender and class ideologies, note an inherent tendency towards an over-socialized view of the person and assess the usefulness of functionalist explanations stemming from the application of the social control concept to the doctor-patient relationship.     

Agency,reflexivity and risk: cosmopolitan,neurotic or prudential citizen?

The purpose of this paper is to critically examine the turn to risk within sociology and to survey the relationship between structure and agency as conceived by popular strands of risk theorizing. To this end, we appraise the risk society, culture of fear and governmentality perspectives and we consider the different imaginings of the citizen constructed by each of these approaches. The paper goes on to explore what each of these visions of citizenship implies for understandings of the structure/agency dynamic as it pertains to the question of reflexivity. In order to transcend uni‐dimensional notions of citizenship and to reinvigorate sociological debates about risk, we call for conceptual analyses that are contextually rooted. Exampling the importance of knowledge contests around contemporary security threats and warnings of the deleterious effects of pre‐emptive modes of regulation that derive from the ‘risk turn’ within social science, we argue for a more nuanced embrace of reflexivity within risk theorising in order to facilitate a more dynamic critique of the images of citizenship that such theorizing promotes.     

‘Race’-education policy as social control?

This paper focuses on the instrumentalist Marxist model which has been used to explain the policies of the British state in the field of ‘race’-education. After discussing the model's core assumptions and its application in this field the paper explores the model's explanatory adequacy through a case study of the role of the quasi-state agencies of the ‘race’-relations industry in developing ‘race’-education policy in initial teacher education. It ends by considering whether a new conceptual framework is needed to understand ‘race’-education policy.