Architecture and health care: a place for sociology.

Sociologists of health and illness have tended to overlook the architecture and buildings used in health care. This contrasts with medical geographers who have yielded a body of work on the significance of places and spaces in the experience of health and illness. A review of sociological studies of the role of the built environment in the performance of medical practice uncovers an important vein of work, worthy of further study. Through the historically situated example of hospital architecture, this article seeks to tease out substantive and methodological issues that can inform a distinctive sociology of healthcare architecture. Contemporary healthcare buildings manifest design models developed for hotels, shopping malls and homes. These design features are congruent with neoliberal forms of subjectivity in which patients are constituted as consumers and responsibilised citizens. We conclude that an adequate sociology of healthcare architecture necessitates an appreciation of both the construction and experience of buildings, exploring the briefs and plans of their designers, and observing their everyday uses. Combining approaches and methods from the sociology of health and illness and science and technology studies offers potential for a novel research agenda that takes healthcare buildings as its substantive focus.

Disorder and disconnection: parent experiences of liminality when caring for a dying child

Parents caring for a child with a life threatening or life limiting illness experience a protracted and largely unknown journey, as they and their child oscillate somewhere between life and death. Using an interpretive qualitative approach, interviews were conducted with parents (n = 25) of children who had died. Findings reveal parents’ experiences to be characterised by personal disorder and transformation as well as social marginalisation and disconnection. As such they confirm the validity of understanding these experiences as, fundamentally, one of liminality, in terms of both individual and collective response. In dissecting two inter-related dimensions of liminality, an underlying tension between how transition is subjectively experienced and how it is socially regulated is exposed. In particular, a structural failure to recognise the chronic nature of felt liminality can impede parents’ effective transition.

Dealing with the Legacy of Ethnic Conflict: Confronting ‘Othering’ through Transformative Adult Education—A Northern Ireland Case Study

Despite its peace process, Northern Ireland remains a deeply divided society. The legacy of a 30-year conflict has ensured that the state continues to be prone to outbreaks of violence over contentious issues such as Orange Order parading and the flying of national flags. This paper argues that in order to address this legacy, there is a need to confront the Othering processes that have helped to generate and sustain division. It will argue that programmes of adult education can play an important role in helping the conflicting groups to reimagine their ‘exclusive’ notions of the nation to one capable of incorporating the Other.

Quand la manifestation tourne à l'émeute : les affrontements violents entre forces de l'ordre et manifestants en Côte d'Ivoire.

Les manifestations de crise, en Côte d'Ivoire, ont été extrêmement violentes. Au cours des quinze dernières années, plus de 400 personnes sont mortes, tuées dans des affrontements avec les forces de sécurités ou des contre-manifestants. Malgré la gravité du problème, peu d’études scientifiques y sont consacrées et les rares analyses et enquêtes existantes portent, de façon unilatérale, sur l’identité et la responsabilité pénale des auteurs et commanditaires putatifs de cette violence. La présente étude s’élève contre le moralisme inhérent à ces approches pour aborder la question sous l’angle de l’interaction : cette thèse a pour objectif de comprendre les processus et logiques qui sous-tendent l’usage de la violence au cours des manifestations. Le cadre théorique utilisé dans cette étude qualitative est l’interactionnisme symbolique. Le matériel d’analyse est composé d’entrevues et de divers documents. Trente-trois (33) entrevues semi-dirigées ont été réalisées avec des policiers et des manifestants, cooptés selon la technique de la boule de neige, entre le 3 janvier et le 15 mai 2013, à Abidjan. Les rapports d’enquête, de l’ONG Human Rights Watch, sur les manifestations de crise, les manuels de formation de la police et divers autres matériaux périphériques ont également été consultés. Les données ont été analysées suivant les principes et techniques de la théorisation ancrée (Paillée, 1994). Trois principaux résultats ont été obtenus. Premièrement, le système ivoirien de maintien de l'ordre est conçu selon le modèle d’une « police du prince ». Les forces de sécurité dans leur ensemble y occupent une fonction subalterne d’exécutant. Elles sont placées sous autorité politique avec pour mandat la défense inconditionnelle des institutions. Le style standard de gestion des foules, qui en découle, est légaliste et répressif, correspondant au style d’escalade de la force (McPhail, Schweingruber, & Carthy, 1998). Cette « police du prince » dispose toutefois de marges de manœuvre sur le terrain, qui lui permettent de moduler son style en fonction de la conception qu’elle se fait de l’attitude des manifestants : paternaliste avec les foules dites calmes, elle devient répressive ou déviante avec les foules qu’elle définit comme étant hostiles. Deuxièmement, à rebours d’une conception victimaire de la foule, la violence est une transaction situationnelle dynamique entre forces de sécurité et manifestants. La violence suit un processus ascendant dont les séquences et les règles d’enchainement sont décrites. Ainsi, le premier niveau auquel s’arrête la majorité des manifestations est celui d’une force non létale bilatérale dans lequel les deux acteurs, protestataires et policiers, ont recours à des armes non incapacitantes, où les cailloux des premiers répondent au gaz lacrymogène des seconds. Le deuxième niveau correspond à la létalité unilatérale : la police ouvre le feu lorsque les manifestants se rapprochent de trop près. Le troisième et dernier niveau est atteint lorsque les manifestants utilisent à leur tour des armes à feu, la létalité est alors bilatérale. Troisièmement, enfin, le concept de « l’indignité républicaine » rend compte de la logique de la violence dans les manifestations. La violence se déclenche et s’intensifie lorsqu’une des parties, manifestants ou policiers, interprète l’acte posé par l’adversaire comme étant en rupture avec le rôle attendu du statut qu’il revendique dans la manifestation. Cet acte jugé indigne a pour conséquence de le priver de la déférence rattachée à son statut et de justifier à son encontre l’usage de la force. Ces actes d’indignités, du point de vue des policiers, sont symbolisés par la figure du manifestant hostile. Pour les manifestants, l’indignité des forces de sécurité se reconnait par des actes qui les assimilent à une milice privée. Le degré d’indignité perçu de l’acte explique le niveau d’allocation de la violence.

Juridik eller socialpedagogik? : Skolors strategier för att hantera kränkningar

Legal perspectives or Social Pedagogy? Schools strategies of handling harassments The present study explores how Swedish schools define and categorize situations when students have been exposed to different forms of abusive acts and violence at school. The empirical study is designed as case studie of two urban secondary schools situated in areas with different socioeconomic conditions. One of the schools is located in a suburb in one of the most economically disadvantaged areas in a greater city area. The other school is located in a small town municipality, where the students are relatively privileged in respect to their socio-economic backgrounds. The results indicate that different socio-economic conditions influence how professional’s describe and categorize violence and harassment and the types of strategies chosen. In the suburban school professionals talk and collaborate with the police, reporting cases of violence and harassment. In the small town school the professionals talk about the importance of collaborating with parents.

“Refugee Voices,” New Social Media and Politics of Representation: Young Congolese in the Diaspora and Beyond

This article examines the role of new social media in the articulation and representation of the refugee and diasporic “voice.” The article problematizes the individualist, de-politicized, de-contextualized, and aestheticized representation of refugee/diasporic voices. It argues that new social media enable refugees and diaspora members to exercise agency in managing the creation, production, and dissemination of their voices and to engage in hybrid (on- and offline) activism. These new territories for self-representation challenge our conventional understanding of refugee/diaspora voices. The article is based on research with young Congolese living in the diaspora, and it describes the Geno-cost project created by the Congolese Action Youth Platform (CAYP) and JJ Bola’s spoken-word piece, “Refuge.” The first shows agency in the creation of analytical and activist voices that promote counter-hegemonic narratives of violence in the eastern Democratic Republic of Congo, while the second is an example of aesthetic expressions performed online and offline that reveal agency through authorship and ownership of one’s voice. The examples highlight the role that new social media play in challenging mainstream politics of representation of refugee/diaspora voices.

Widening participation in higher education: the role of professional and social class identities and commitments

Since the neoliberal reforms to British education in the 1980s, education debates have been saturated with claims to the efficacy of the market as a mechanism for improving the content and delivery of state education. In recent decades with the expansion and ‘massification’ of higher education, widening participation (WP) has acquired an increasingly important role in redressing the under-representation of certain social groups in universities. Taken together, these trends neatly capture the twin goals of New Labour’s programme for education reform: economic competitiveness and social justice. But how do WP professionals negotiate competing demands of social equity and economic incentive? In this paper we explore how the hegemony of neoliberal discourse – of which the student as consumer is possibly the most pervasive – can be usefully disentangled from socially progressive, professional discourses exemplified through the speech and actions of WP practitioners and managers working in British higher education institutions.

Intimate Partner Violence and Pregnancy Intentions: A Qualitative Study

Aim and Objective In this qualitative study we explored women’s pregnancy intentions and experiences of intimate partner violence before, during and after pregnancy. Background Unintended pregnancies in the context of intimate partner violence can have serious health, social and economic consequences for women and their children. Design Feminist and phenomenological philosophies underpinned the study to gain a richer understanding of women’s experiences. Methods Eleven women who had been pregnant in the previous two years were recruited from community-based women’s refuges in one region of the United Kingdom. Of the eleven women, eight had unplanned pregnancies, two reported being coerced into early motherhood, and only one woman had purposively planned her pregnancy. Multiple in-depth interviews focused on participants’ accounts of living with intimate partner violence. Experiential data analysis was used to identify, analyse and highlight themes. Results Three major themes were identified: men’s control of contraception, partner’s indiscriminate response to the pregnancy, and women’s mixed feelings about the pregnancy. Participants reported limited influence over their sexual relationship and Accepted Article This article is protected by copyright. All rights reserved. birth control. Feelings of vulnerability about themselves and fear for their unborn babies’ safety were intensified by their partners’ continued violence during pregnancy. Conclusion Women experiencing intimate partner violence were more likely to have an unintended pregnancy. This could be attributed to male dominance and fear, which impacts on a woman’s ability to manage her birth control options. The women’s initial excitement about their pregnancy diminished in the face of uncertainty and ongoing violence within their relationship. Relevance to clinical practice Women experiencing violence lack choice in relation to birth control options leading to unintended pregnancies. Interpreting the findings from the victim-perpetrator interactive spin theory of intimate partner violence provides a possible framework for midwives and nurses to better understand and respond to women’s experiences of violence during pregnancy.

The politics of transformative harmony

This paper explores the idea of transformative harmony as a concern of the political. It proposes that the cultivation of harmony as a project of the Self is closely related to the political project of democracy as a quest for social harmony. This is in light of the view that social conflict can be seen as a collective manifestation of individual struggles to establish inner harmony. The paper, firstly, explores the idea that the quest for harmony is an intersubjective, as well as an intra-subjective, undertaking. This is in line with the Gandhian principle that societies ultimately reflect the level of enlightenment of the actors who form them. It also critiques the use of violence as a means of securing transformative harmony and social change. Finally, the paper discusses the way in which transformative harmony, in terms of its focus on the Self as the site for attaining the type of altered consciousness required to bring about social change, shares a philosophical basis with both ideas of ‘deep democracy’ and Habermasian discourse ethics. It is proposed that the project of transformative harmony represents, by default, a project to transform democratic praxis. Keywords: Harmony, politics, ethics, rights, duties, Gandhi, democracy, risk.

A Game of Horns: Transnational Flows of Rhino Horn

A multi-sectorial regime of protection including international treaties, conservation and security measures, demand reduction campaigns and quasi-military interventions has been established to protect rhinos. Despite these efforts, the poaching of rhinos and trafficking of rhino horn continue unabated. This dissertation asks why the illegal market in rhinoceros horn is so resilient in spite of the myriad measures employed to disrupt it. A theoretical approach grounded in the sociology of markets is applied to explain the structure and functioning of the illegal market. The project follows flows of rhino horn from the source in southern Africa to illegal markets in Southeast Asia. The multi-sited ethnography included participant observations, interviews and focus groups with 416 informants during fourteen months of fieldwork. The sample comprised of, amongst others, convicted and active rhino poachers, smugglers and kingpins, private rhino breeders and hunting outfitters, African and Asian law enforcement officials, as well as affected local communities and Asian consumers. Court files, CITES trade data, archival materials, newspaper reports and social media posts were also analysed to supplement findings and to verify and triangulate data from interviews, focus groups and observations. Central to the analysis is the concept of “contested illegality”, a legitimization mechanism employed by market participants along the different segments of the horn supply chain. These actors' implicit or explicit contestation of the state-sponsored label of illegality serves as a legitimising and enabling mechanism, facilitating participation in gray or illegal markets for rhino horn. The research identified fluid interfaces between legal, illegal and gray markets, with recurring actors who have access to transnational trade structures, and who also possess market and product knowledge, as well as information about the regulatory regime and its loopholes. It is against the background of colonial, apartheid and neoliberal exploitation and marginalization of local communities that a second argument is introduced: the path dependency of conservation paradigms. Underpinning rhino conservation and regulation are archaic and elitist conservation regimes that discount the potential for harmonious relationships between local communities and wildlife. The increasing militarization of anti-poaching measures and green land grabs are exacerbating the rhino problem by alienating communities further from conservation areas and wild animals. The third argument looks at how actors deal with coordination problems in transnational illegal markets. Resolving the coordination problems of cooperation, value and competition are considered essential to the operation of formal markets. It is argued that the problem of security provides an additional and crucial obstacle to actors transacting in markets. The systematic analysis of flows between the researched sites of production, distribution and consumption of rhino horn shows that the social embeddedness of actors facilitates the flourishing of illegal markets in ways that escape an effective enforcement of CITES regulations.

Sensory work of diagnosis : a crisis of legitimacy

Role of assessment components and recent adverse outcomes in risk estimation and prediction: use of the Short Term Assessment of Risk and Treatability (START) in an adult secure inpatient mental health service

The Short Term Assessment of Risk and Treatability is a structured judgement tool used to inform risk estimation for multiple adverse outcomes. In research, risk estimates outperform the tool's strength and vulnerability scales for violence prediction. Little is known about what its’component parts contribute to the assignment of risk estimates and how those estimates fare in prediction of non-violent adverse outcomes compared with the structured components. START assessment and outcomes data from a secure mental health service (N=84) was collected. Binomial and multinomial regression analyses determined the contribution of selected elements of the START structured domain and recent adverse risk events to risk estimates and outcomes prediction for violence, self-harm/suicidality, victimisation, and self-neglect. START vulnerabilities and lifetime history of violence, predicted the violence risk estimate; self-harm and victimisation estimates were predicted only by corresponding recent adverse events. Recent adverse events uniquely predicted all corresponding outcomes, with the exception of self-neglect which was predicted by the strength scale. Only for victimisation did the risk estimate outperform prediction based on the START components and recent adverse events. In the absence of recent corresponding risk behaviour, restrictions imposed on the basis of START-informed risk estimates could be unwarranted and may be unethical.

Incidence of violent behavior among patients in Psychiatric Intensive Care Units

Background and Objectives: Both psychiatric acute units and psychiatric intensive care units (PICUs) focus on acute treatment of behavioral disturbances such as violence and aggressive threats and acts. The aim of the present study is to describe the frequency of violent behavior; such as verbal or physical threats and physical attacks, among patients admitted to psychiatric intensive care unit (PICU). In addition the relationship between the episodes of threats and/or attacks in relation to time of the day, days of the week, and their seasonal variations was explored. Methods: All violent behavior was continuously assessed at the psychiatric emergency department. Data were collected during the period from May 2010 to May 2012. Results: Patients with only one hospitalization were less violent than those who have had two hospitalizations. There was a statistically significant difference in violence among patients without formal secondary education and those who have not formal education. Violent behavior showed two peaks during the day; the first occurring at 1 pm and the second at 8 pm. In regard to seasonality, summer had a higher incidence of violence. The most peaceful seasons of the year were spring and autumn. Conclusions: Violent behavior shows variation in daytime, days of the week and season in acute psychiatric intensive care. Daytime variation shows two peaks of violence at 1 pm and 8 pm, Sundays and Wednesdays being the quietest days regarding violence both in winter and summer. Patient's level of education and hospitalization status partially explain the variation.

Original sin: divine and symbolic violence in the turn to the Apostle Paul

When we take a step back from the imposing figure of physical violence, it becomes possible to examine other structurally violent forces that constantly shape our cultural and political landscapes. One of the driving interests in the “turn to Paul” in recent continental philosophy stems from wrestling with questions about the real nature of contemporary violence. Paul is positioned as a thinker whose messianic experience began to cut through the violent masquerade of the existing order. The crucifixion and resurrection of the Messiah (a slave and a God co-existing in one body) exposed the empty grounding upon which power resided. The Christ-event signifies a moment of violent interruption in the existing order which Paul enjoins the Gentiles to participate in through a dedication of love for the neighbour. This divine violence aims to reveal and subvert the “powers,” epitomised in the Roman Empire, in order to fulfil the labour of the Messianic now-time which had arrived. The impetus behind this research comes from a typically enigmatic and provocative section of text by the Slovene philosopher, cultural critic, and Christian atheist Slavoj Žižek. He claims that 'the notion of love should be given here all its Paulinian weight: the domain of pure violence… is the domain of love' (2008a, 173). In this move he links Paul’s idea of love to that of Walter Benjamin’s divine violence; the sublime and the cataclysmic come together in this seemingly perverse notion. At stake here is the way in which uncovering violent forces in the “zero-level” of our narrative worldviews aids the diagnosis of contemporary political and ethical issues. It is not enough to imagine Paul’s encounter with the Christ-event as non-violent. This Jewish apocalyptic movement was engaged in a violent struggle within an existing order that God’s wrath will soon dismantle. Paul’s weak violence, inspired by his fidelity to the Christ-event, places all responsibility over creation in the role of the individual within the collective body. The centre piece of this re-imagined construction of the Pauline narrative comes in Romans 13: the violent dedication to love understood in the radical nature of the now-time. 3 This research examines the role that narratives play in the creation and diagnosis of these violent forces. In order to construct a new genealogy of violence in Christianity it is crucial to understand the role of the slave of Christ (the revolutionary messianic subject). This turn in the Symbolic is examined through creating a literary structure in which we can approach a radical Nietzschean shift in Pauline thought. The claim here, a claim which is also central to Paul’s letters, is that when the symbolic violence which manipulates our worldviews is undone by a divine violence, if even for a moment, new possibilities are created in the opening for a transvaluation of values. Through this we uncover the nature of original sin: the consequences of the interconnected reality of our actions. The role of literature is vital in the construction of this narrative; starting with Cormac McCarthy’s No Country for Old Men, and continuing through works such as Melville’s Bartleby the Scrivener, this thesis draws upon the power of literature in the shaping of our narrative worlds. Typical of the continental philosophy at the heart of this work, a diverse range of illustrations and inspirations from fiction is pulled into its narrative to reflect the symbolic universe that this work was forged through. What this work attempts to do is give this theory a greater grounding in Paul’s letters by demonstrating this radical kenotic power at the heart of the Christ-event. Romans 13 reveals, in a way that has not yet been picked up by Critchley, Žižek, and others, that Paul opposed the biopolitical power of the Roman Empire through the weak violence of love that is the labour of the slaves of Christ on the “now-time” that had arrived.

Whiteness and news: the interlocking social construction of "realities"

This dissertation examines how mainstream U.S. journalism consistently serves white racial interests and the racial status quo, or what I call white incumbency, despite its push for diversity and its stated aims to improve coverage of nonwhite communities. It is based on an in-depth ethnographic study of two daily newspapers and extensive one-on-one interviews with 61 journalists. I found that although journalists strongly identify with the need for more diverse coverage in newspapers, they emphasize individual and personal stories that avoid recognition of historical racial power imbalances, exhibiting what Ruth Frankenberg calls power-evasive race cognizance. Journalists also demonstrate a number of often contradictory identifications and self-understandings about themselves and their work, such as commitments to diversity and not taking sides, but these conflicts are almost always resolved in favor of white incumbency. Journalistic conventions and practices, such as the watchdog function and its emphasis on public institutions, routinely produce stories that replay and reinforce racial hegemony by portraying nonwhites as problems or people seeking “special privileges.” Also, journalistic repertoires about those conventions and practices avoid interrogations of journalists’ ongoing complicity in the maintenance of white incumbency.