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In this article the author invites readers of the periodical to submit articles on social theories of risk and uncertainty.

In this editorial, I explore the contribution of the recent special issue ofHealth, Risk & Society(Volume 16, Issue 1), and three related papers published in the current volume (Volume 16, Issue 6), and identify themes and concepts which are consistent across these papers. The aims of the special issue were twofold; the call for papers invited articles on the topic of risk in relation to pregnancy and childbirth, and which sought to explore risk theorisation in this field. Looking at these papers as a body of work, I explore the breadth of this collective endeavour, and identify areas which have been researched at some depth, whilst drawing attention to other areas which manage to evade our theoretical gaze. I also reflect on the ways in which these papers have, independently and together, added to the field of risk theorisation, and propose some future directions which might usefully help move beyond the current limits of our enquiry. The combined body of work in these issues represents a considerable resource, and one which makes a clear contribution to contemporary understandings of risk, pregnancy and birth, however I argue that of late, the focus of enquiry has become narrowed, with much of our research providing new evidence from the perspective of relatively privileged women from high-income countries, who have good access to safe, high quality maternity care. The sum of this work is now such that it is possible to synthesise themes across studies and settings, which is valuable to our understanding, but the lack of research amongst women from developing nations, or amongst those with less privilege in high-income countries, means that our resource is incomplete, and fails to do justice to women’s broader experience of pregnancy and birth. Developments of risk theorisation are evident in the collected papers; authors have interrogated the positioning of individuals as subjects, and drawn new conclusions about historicised risk, and practices of resistance to risk discourse. I review these developments in this editorial, and also propose that the collection generates many new dimensions to our initial understanding of the ‘virtual object’ of risk in the context of pregnancy and birth. I conclude by outlining potential new directions and approaches to meet some of the identified gaps in our exploration and theorisation of risk in pregnancy and birth. [ABSTRACT FROM PUBLISHER]

The relationship between risk and inequality has become a key area of research and theoretical debate in sociology and risk studies more broadly. My aim in this paper is to explore the role culture plays in the (re)production of inequalities of risk exposure. More specifically, I examine the ways cultural systems shape and animate judgements about acceptable standards of risk exposure for different groups within a society. The case study examines divergent policy judgements about acceptable risk exposure to road accident injury and death between a group of temporary visa workers and all other private passengers in Singapore. A key objective of the paper is to demonstrate the conceptual and empirical utility of Mary Douglas' cultural perspective for studying interconnections between risk and inequality. In particular, how taking up the problem of 'risk acceptability' is an effective way of approaching and studying the ways risk and inequality operate as mutually constitutive relations. In the discussion I show that what counts as risk and how acceptable or not risk is judged to be depends on the cultural system of classification used and the stratified social order it (re)produces. In the conclusion I consider the broader utility and significance of this critical approach for studying relations between risk and inequality through the problem of risk acceptability. A utility that may take on a particular significance in the present time of the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

This special issue is the second in a four-part series Health Care Through the ‘Lens of Risk’ focussing on risk categorisation, valuing, expecting and time-framing, respectively, and published or to be published in 2012–2013. The present editorial introduces the issue of risk valuing in relation to an interview-based article and five substantial research papers (one appearing in a subsequent issue (14.6) due to space limitations). It will be argued that the notion of ‘adverse event’ projects negative value onto events themselves, directing attention away from the observer's active judgemental role. The relocation of value judgements in the perspectives of social actors allows their potential variability to be more clearly recognised. This issue will be explored in the editorial which introduces papers concerned with hard drug consumption, self-hurting, the community rehabilitation of forensic mental health service users who have committed serious offences against other persons, the treatment of anal cancer and the perspectives of young pregnant women. A common theme linking these papers is the positive valuing of risk-taking officially designated as unacceptable. [ABSTRACT FROM PUBLISHER]

In Britain, there has been an increased emphasis on the use of risk assessments in mental health services over the past 20 years. Mentally disordered offenders subject to Section 41 of the Mental Health Act 1983 (England and Wales) are defined as posing a serious risk of harm to others. They are thus dealt with by forensic mental health services, which are often seen as specialists in risk assessments. This paper is based on original research in three mental health trusts in the South of England which was carried out between March 2009 and September 2011. The paper examines mentally disordered offenders’ awareness and attitude to formal risk assessments in relation to theories of governmentality. Service users subject to Section 41 of the Mental Health Act 1983 were aware that their level of risk was being assessed by professionals caring for them but were commonly unaware of the content of these assessments. These risk assessments were viewed by participants as a means through which professionals measured and monitored behaviour. Although participants often referred to levels of risk, they did not view risk screening schedules as objective, but rather emphasised the need to persuade staff that their risk had reduced. Despite showing a limited awareness of the content of these risk assessments, participants generally identified more risks, in relation to their vulnerability, than did the professional assessments. However, participants generally identified fewer risks in relation to the dangers they posed to others than did professional staff. [ABSTRACT FROM PUBLISHER]

Although uncertainty is a key characteristic of epilepsy, and despite the close relationship between uncertainty and risk, our understanding of individuals' experiences of childhood epilepsy in relation to risk is limited. In this paper I explore family members' perceptions of the risks associated with the condition by drawing on qualitative data collected during 2013 and 2014 from 24 families with a child with epilepsy (including data from 28 parents, 13 children with epilepsy and 14 siblings). The diagnosis of childhood epilepsy provided parents and children with a new framework that they used to evaluate risks posed by the physical environment. Indeed, roads, water and heights were reconceptualised when viewed through an 'epilepsy lens' and were seen to present more risk to the child with epilepsy in comparison to the level of risk the same hazards posed to their siblings or peers. Furthermore, while parents described prioritising new and reconceptualised physical risks to their child, the children with epilepsy were more concerned about being stigmatised by their peers. The children's discussions surrounding stigma suggest that this results from interactions with their peers, rather than stigma being learnt within the family, as previous studies have suggested. Overall, I demonstrate that risk is a central feature of contemporary experiences of epilepsy for children with the condition and their parents, but that parents and children perceive and prioritise risks differently. [ABSTRACT FROM AUTHOR]

In this paper, we examine discourse in public deliberations in pre-development locales in the UK and US about advantages and disadvantages of future shale development ('fracking'). We aimed to understand how people anticipate potential health effects, broadly construed, of environmental toxicity and disturbance in the context of planned, but not yet implemented, energy development. In day-long deliberations with small, diverse groups in two cities in each country (London, Cardiff in the UK; Los Angeles, Santa Barbara in the US), participants discussed impacts on health and well-being using three main rubrics: 'It's money or health', 'Why take chances?' and 'Beyond the tipping point'. Throughout, participants framed health as an intrinsically moral issue, with collective responsibility as a dominant normative frame. We identify the concept of compound risk to underscore effects of multiple risks and hazards on people's sensibilities about anticipated future health and environmental harm. The findings demonstrate how and why diverse publics in pre-impact sites in both countries saw shale extraction as high stakes development that poses significant, often unacceptable, risks to human and environmental health and well-being. Risks extended beyond toxicity to broad threats to health, including, for some, the end of life as we know it on the planet. Overall, participants' discussions of health were more connected to social categories and their underlying moral principles than to technological details. This work contributes evidence of blurred boundaries between environment and health as well as the importance people place on social risks in the context of proposed energy system change. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses various reports within the issue on topics including health risks, risk perceptions and social science of health.

This paper explores the contribution of script theory to understandings of animal health risks. Script theory has long played an important role in studies of health and risk, yet the application of script theories is often vague and confused. Theories from different ontological perspectives are conflated resulting in an overly cognitive and asocial understanding of health behaviour with the potential to misinform health promotion strategies. The paper addresses these problems by applying the concept of script formulations to an analysis of farmers' understandings of bovine tuberculosis in farmed cattle. Drawing on interviews with 61 farmers in England and Wales, the paper argues that farmers reveal animal disease to be a scripted event, but that these scripts also order identity and provide a form of moral accountability for farmers' behaviour. This has implications for attempts to communicate animal disease risks and suggests that a more productive approach is to reorganise governance structures and relationships between farmers and government. [ABSTRACT FROM AUTHOR]

There is widespread concern among people living in some parts of Altai territory in Siberia about potential health effects from fallout from rockets launched from the Baikonur cosmodrome in Kazakhstan. Extensive research has so far failed to provide evidence to support these concerns. As a consequence, the problem has been labelled by Russian scientists as 'collective psychosocial distress' or 'raketophobia'. The aim of this paper is to provide an understanding of the factors underlying popular concerns about rockets. The paper is based on data collected in 2006 using multiple methods (individual semi-structured interviews, natural group discussions, round tables and participant observation). Concerns related to the impact of the rocket launches among the local population were explored. The analytical framework is informed by discourse analysis and discursive psychology. The findings are that the processes of collective social construction amplify risks perceived to be associated with rocket launches. In the Altai context, this social amplification builds on a societal vulnerability triggered by the collapse of the Soviet ideology. The environmental concern provides opportunities for repressed debates to be expressed that emerge from culturally embedded frustrations and fears that would otherwise be ignored by the political agenda. Moreover, the signals that shape the perception of risk are intrinsic components of local information flows, so that the communication process between experts and policy-makers and the local population itself contributes to the amplification of perceived risks. Concern about the health effects of rockets can be traced to the conditions that existed when the USSR ceased to exist. An effective response must address these deep-seated issues. [ABSTRACT FROM AUTHOR]

This paper examines the possible responses for resistance to health information among women. The data are drawn from a broader qualitative study of how 60 women in Finnmark, a region of Norway, which examined how the participants responded to health information related to coffee, exercise, smoking and diet. This paper focuses on responses to health information about smoking. The study suggests that health information challenges the women's conception of their selves. This may make them take a distance to health information which then makes health information less effective. [ABSTRACT FROM AUTHOR]

In this article, we examine how injection drug users who do not attribute their HIV infection to engaging in HIV risk behaviours take up and critique discourses of individual responsibility and citizenship relating to HIV risk and HIV prevention. We draw on data from a study in Vancouver, Canada (2006–2009) in which we interviewed individuals living with HIV who had a history of injection drug use. In this paper, we focus on six cases studies of participants whodid notattribute their HIV infection to engaging in HIV risk behaviours. We found that in striving to present themselves as responsible HIV citizens who did not engage in HIV risk behaviours, these participants drew on individually focused HIV prevention discourses. By identifying themselves in these ways, they were able to present themselves as ‘deserving’ HIV citizens and avoid the blame associated with being HIV positive. However, in rejecting the view that they and their risk behaviours were to blame for their HIV infection and by developing an explanation that drew on broader social, structural and historical factors, these individuals were developing a tentative critique of focus on individual responsibility in HIV transmission as opposed to dangers of infection arising from the socio-economic environment. By framing the risk of infection in environmental rather than individual risk-behaviour terms, these individuals redistributed responsibility to reflect the social-structural realities of their lives. In this article, we reflect on the implications of these findings for public health measures such as risk prevention messages. We argue that it is important that such messages are not restricted to individual risk prevention but also include a focus of broader shared responsibilities of HIV. [ABSTRACT FROM AUTHOR]

In this paper, we examine why risk-based policy instruments have failed to improve the proportionality, effectiveness, and legitimacy of healthcare quality regulation in the National Health Service (NHS) in England. Rather than trying to prevent all possible harms, risk-based approaches promise to rationalise and manage the inevitable limits of what regulation can hope to achieve by focusing regulatory standard-setting and enforcement activity on the highest priority risks, as determined through formal assessments of their probability and consequences. As such, risk-based approaches have been enthusiastically adopted by healthcare quality regulators over the last decade. However, by drawing on historical policy analysis and in-depth interviews with 15 high-level UK informants in 2013–2015, we identify a series of practical problems in using risk-based policy instruments for defining, assessing, and ensuring compliance with healthcare quality standards. Based on our analysis, we go on to consider why, despite a succession of failures, healthcare regulators remain committed to developing and using risk-based approaches. We conclude by identifying several preconditions for successful risk-based regulation: goals must be clear and trade-offs between them amenable to agreement; regulators must be able to reliably assess the probability and consequences of adverse outcomes; regulators must have a range of enforcement tools that can be deployed in proportion to risk; and there must be political tolerance for adverse outcomes. [ABSTRACT FROM PUBLISHER]

A central tenet in the sociology of risk is that risk-taking is inherently linked to masculinity. Recent research, however, demonstrates gender identity is only one of the many social contexts that influence professional risk-taking. The interaction between the various occupational social contexts – such as social class, occupational socialisation, institutions, and gender identity – contributes to the development of risk-taking occupational identities. These occupational identities are associated with unique understandings of risk which influence whether workers are likely to embrace or avoid risk. While there has been a plethora of research exploring how occupational identities encourage risk-taking, relatively little research has explored how occupational identities determine thetypesof risks embraced by workers. After all, there is substantial occupational variation in the types of risks workers take. In this paper I draw on data from a series of interviews conducted in 2010 and 2011 with US electrical construction workers to explore perceptions of job site safety procedures to understand how electrical workers view various job site hazards. I argue that the proximity of a hazard to the occupation’s core competencies determines the level of support the safety procedure receives from those within the occupation. [ABSTRACT FROM PUBLISHER]

In this article, we explore the risks associated with direct payments to users enabling them to purchase social care. These payments are intended to enable people with disabilities to make choices and increase their autonomy. However, there is little evidence in the existing literature about the risks involved in direct payments as seen by service users. In this paper, we draw on data from a qualitative study of direct payments for people with disabilities in a federal state of Germany. We interviewed 37 individuals involved in direct payment schemes including individuals receiving payments, care assistants, members of organisations providing care and the administrative officers of the local authorities between December 2011 and January 2014. In this article, we use a governmentality perspective to explore how individuals who received the payments saw and sought to manage the risks associated with the scheme. We found that while users reported that direct payments reduced the risk associated with being directly dependent on the care providers and hence increased their desired self-determination, they identified new risks linked to their liability for the transferred money, problems associated with their liquidity and cash flow, challenges presented by budget cuts, and sanctions resulting from violation of norms of ‘appropriate use’ and the difficulties of negotiating with the funders. To manage these perceived risks users indicated that they had subjected themselves to a new way of active self-control and self-management, normalising their behaviour. We note that risk to service users has been neglected in policy design and should be acknowledged more explicitly. [ABSTRACT FROM AUTHOR]

This article considers how the concept of risk has been variously defined and deployed within research and UK social policy since the 1980s. The article does not present an in-depth historical narrative, but rather presents key trends over this period. The article begins with a short review of policy and risk rationalities from the 1980s onwards with a specific focus on the research ‘discovery’ of the ‘rationality mistake’ by the early 1990s. A short case study from the author’s own research is then presented to illustrate the ‘rationality mistake’ in a particular arena of UK government policy on the management of sexual offenders. The paper concludes by briefly considering actual and potential developments in risk research and relevant recent theorising, and finally the likelihood of social policy understanding the risk subject more fully. [ABSTRACT FROM AUTHOR]

This special issue is the last in a four-part series Health Care Through the ‘Lens of Risk’, which focuses on risk categorisation, valuing, expecting and time-framing, respectively, and has been published in 2012–2013. The present editorial introduces the issue of time-framing in relation to an interview-based article, a guest editorial and six articles reporting findings from empirical research. The central argument of the editorial concerns the increasing abstractness of time within modernity, which renders risk thinking possible and exists alongside shifting subjectivities regarding time, as futures are increasingly reflected upon. The meaning given to contingent futures intensifies experiences of time in relation to the future and, therefore, the present. This argument is then problematised through reference to empirical studies of more passive attitudes to risk and where future considerations are avoided altogether. Different ways in which past, present and future are related to one another are also considered. We explore these themes before introducing the original research articles, interview-based article and guest editorial in this issue. Each original article explores time-framing within a different context including drinking alcohol away from licensed premises, expecting a baby as an older first-time mother, living with an advanced-stage cancer diagnosis, caring for a close-relative as a young person, long-term self-hurting and the journey towards a skin cancer diagnosis. Each of these contexts can be considered ‘risky’, partially depending on the time-framing invoked. The common theme linking these papers is the analysis of how futures are envisaged and how different approaches to time-framing are fundamental to perceptions and experiences of risk and uncertainty. [ABSTRACT FROM AUTHOR]

Increasingly, medical choices involve deciding whether to look for evidence of undetected, asymptomatic conditions, or increased risk of future conditions (i.e. screening). Those who screen at sufficiently high risk face decisions about interventions to prevent or postpone the onset of possible, but not certain, future symptomatic conditions. Other preventive decisions include whether or not to accept population-based intervention, such as vaccination. Using decision trees, we model the normative structures and associated uncertainties that underlie five medical decision situations, each of which involves assessing the probabilistic hypothesis that a person has, or will in the future have, a given symptomatic condition. The probability estimate that results from assessment becomes an input into predicting treatment benefit, with the probability of benefit decreasing as that of the symptomatic condition decreases. The five situations identified in this paper involve assessing: (1) a symptomatic patient; (2) an asymptomatic individual for an undetected condition; (3) an individual for risk of a future condition; (4) an individual for multiple risks simultaneously (shotgun assessment); and (5) an individual for a population-based intervention. Analysis of these situations facilitates examination of intuitive probabilistic reasoning. Drawing on evidence in related literature, we discuss some implications of decision-makers imposing the wrong structure or probabilistic reasoning when making medical choices. In particular, we discuss (1) overestimation of expected benefit due to systematic underestimation of uncertainty in a given decision; (2) overconfidence in probabilistic test results; and (3) failure to understand the implications of cumulative probabilities when ‘shot-gun’ testing. [ABSTRACT FROM PUBLISHER]

This paper illustrates negotiations around risk between lay people and clinicians in relation to gastrostomy interventions for disabled children. These negotiations centre on differing interpretations of what constitutes risk in relation to the safety of oral feeding and a child's need for a feeding tube between parents, carers and clinical specialties. Drawing on Heyman's distinction between risk managers and risk owners, we show that not only do clinicians act as risk managers and parents and carers as risk owners, but that these distinctions often become blurred either because of the shifting dynamics of relations of care or because of the specificity of clinical practice. Parents become risk managers in relation to carers' roles, while clinicians become risk owners in relation to particular procedures which define their practice. This has implications for lay and expert interactions as well as professional accountability for those caring for children with complex medical conditions. Although not an empirical article, we draw on empirical work in the UK. We analyse both parental and professional constructions of risk based on observations of co-ordinating a clinical trial designed to evaluate the effectiveness of gastrostomy surgery. We also examine the diverse value systems used by different groups of professionals and lay carers which inform judgements about risk and feeding. We conclude by arguing that issues of risk in contemporary health care are not just examples of ‘manufactured uncertainty’ or of ‘negotiated power’ but constitute a dialectical relationship which breaks down the essentialist dualism of lay and professional constructions of risk. [ABSTRACT FROM PUBLISHER]

Medical accounts mostly frame non-suicidal self-hurting as an adverse event, the frequency of which has supposedly increased to a current ‘epidemic’ level, and which can be predicted probabilistically in terms of risk factors. This set of presuppositions gives rise to the common stigmatisation of those who present to Accident and Emergency services as a result of self-hurting. It is now being challenged in a small but growing body of social science literature which emphasises the diversity of self-hurting, and its range of socially situated meanings for those who self-hurt, family and health professionals. The present paper contributes to this research strand by discussing the accounts of their self-hurting given by a sample of 25 UK adults who had not been in contact with health or other services for this reason. The analysis focused on three value issues: the positive gains which motivated research participants to self-hurt; their own active efforts to mitigate associated risks; and the longer-term downsides which some respondents identified. [ABSTRACT FROM PUBLISHER]

This paper explores the role of value judgements in personal risk management through an in-depth case study involving a woman's treatment for anal cancer. Julia (pseudonym) agreed to have her pre-treatment medical consultation recorded, and participated in two subsequent interviews. Delving into a single case makes it possible to understand why an individual makes decisions in relation to the overall nexus of risks and benefits which they identify even though their choices may seem irrational to others. According to the colorectal nurse research interviewer, Julia ‘risked exploding’ as a result of ‘absconding’ (Julia's term) from hospital in order to have sex shortly after undergoing surgery. Although not to be interpreted literally, the above phrase encapsulates Julia’s risk blindness from a clinical perspective. The article will address the question of how one person came to put herself at unnecessary risk. The question will be considered in relation to non-communication about the interconnected web of issues which troubled Julia, including cosmology, mortality, being left with an unclean, leaky body, loss of economic viability and harm to family members and to close relationships. This analytical framework complements the more usual one in which attitudes towards a particular risk object are compared across cases. The article makes a contribution, within the limits of a single case study, to advancing knowledge about the neglected topic of individual risk consciousness. It will be argued that, in the absence of such analysis, personal decision-making about risks cannot be fully understood, appropriate advice given or sensitive policies developed. [ABSTRACT FROM PUBLISHER]

This paper examines how risk is perceived by lay populations in response to two aetiologically connected but conceptually divided diseases – malaria and nzoka . Using case study data from an ethnographic study of risk perceptions in north-western Tanzania, we explore the relevance of risk as a concept within a community exposed to traditional and modern value systems, a pluralistic health care system and syncretic treatment-seeking behaviour. We found that the concept of risk was a useful heuristic device, but that what was categorised as risk reflected different social circumstances. The findings reinforce the evidence for risk and risk perception as cultural products. Using empirical examples of experiences with malaria and nzoka , we highlight difficulties in illness recognition, particularly with common symptoms such as high fevers and convulsions in this case. We show how risky decisions over appropriate treatment-seeking were informed by processes of categorisation and re-categorisation as the patient and their family negotiate a solution to illness. We show how this process of risk re-categorisation is framed by social context, hinges on peer and professional advice and responses to treatment, and how this process often continues after treatment ends through recovery or death. We conclude by emphasising the way in which awareness of categorisation as a risky practice in illness management increases the salience of treatment-seeking considered as risk, exacerbating the ‘actual’ risks of experiencing illness. [ABSTRACT FROM PUBLISHER]

The paper is devoted to analysis of the debates on sex education in the Russian press. 'Risk narrative structure' of media articles on sex education was determined. This structure represents a system of mutually constituting elements, which include object of risk, risks themselves, solutions to their prevention, solutions opponents, and type of society these solutions presuppose. It is argued that analysis of risks with the aid of 'risk narrative structures' can be a useful development of sociocultural theory of risk, as competing risk narratives can be fully grasped only when considered not as discrete claims about different 'risks' but as coherent systems of interrelated meanings. On the basis of this structure, competent risk media narratives of proponents and opponents of sex education were reconstructed. In these narratives different definitions of 'children' as objects of risk were constructed, and so were types of risks, and types of society. It would be oversimplifying to consider debates on sex education as a battle of 'enlightened rationality' against 'dark irrationality.' In each risk narrative the solution (introduction or ban of sex education) is a logically following element in the respective risk narrative. While sex education advocates were concerned about negative consequences of children's sexual behaviour and defence of the 'civilised society's moral boundaries, the opposite side was concerned about retaining children's moral purity and defence of 'traditional' moral boundaries. [ABSTRACT FROM AUTHOR]

This paper reports on a qualitative study which explored attitudes to sexual risk-taking among young people in rural and seaside areas in England. The research was undertaken in three sites, each comprising a seaside resort and its rural hinterland. Data were collected through group discussions with 341 young people in secondary schools in England and through individual interviews with young people outside school settings, with young parents and with professionals working in the field of sexual health and education. Data analysis adopted a grounded theory approach and incorporated the views of local young people's advisory groups. Key features of the study which appeared specific to the locales studied were the influence of the seaside entertainment industry on young people's sexual behaviour and the high visibility experienced by young people in rural areas. Gender was also identified as playing a crucial role in determining perceptions of risk and influencing behaviour. Sexual health services and health promotion strategies need to acknowledge the relevance of factors such as gender and stigma for young people as well as being responsive to the specific features of local contexts. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic and the corresponding government measures to prevent the spread of infection have affected children living in socially disadvantaged urban areas in distinctive ways. While their role and responsibility concerning contagion risks are subject to debate, the regulations impact their lives in multiple areas, including peer interactions, family life and education. Understanding their perception and navigation of pandemic risks is therefore crucial to supporting coping strategies and to fostering self-protective behaviour. By employing the concepts of social navigation and emotion – risk assemblage, this study provides a novel perspective on these children's assessment and management of contagion risks in the context of the COVID-19 pandemic. Based on a qualitative field study conducted at two elementary schools in socially disadvantaged neighbourhoods in two different cities in Germany, I show how children negotiated risk through interaction with bodies, places and materials they classified as risky or protective, and how their risk construction was shaped by social and cultural processes. I further demonstrate that uncertainties, such as contradictory information, or desires, like security and freedom, led the participants to lean on combined rational and non-rational tactics. Finally, I demonstrate how situational adjustment of risk assessment and rule adherence became a navigational tactic that allowed the children to balance safety and liberty within an environment of constant change. [ABSTRACT FROM AUTHOR]

In the field of cycling studies, explicit and implicit theories of risk are frequently used for the purposes of research design, data collection, data analysis, and policy. In this article, we argue that this field may benefit from theories and concepts that speak to – but go beyond – theories of risk, and more directly focus on matters of right and recognition. Drawing on grounded theory research involving interviews with 28 cyclists in Dublin, Ireland, we analyse the 'risk talk' from five participant accounts through an application of the rights-orientated perspective of precarious entitlement theory. We argue for its utility as a theory, specifically as a complementary alternative to risk-focused approaches. First, we illustrate how precarious entitlement goes beyond the conceptual limits of understanding cycling experience from perspectives of 'risk' and 'safety', by consolidating a concern with 'right' and 'risk'. Second, we illustrate how interpreting particular cycling practices as patterns of submission and social struggle (privatising vulnerability and provoking responsibility) can transcend individualised interpretations of such practices as 'risk management' and 'risk-taking'. In the discussion, we consider the value of this theory in relation to existing research in this field, with reference to socio-cultural risk theory. In conclusion, we argue for a more transparently rights-based approach to cycle policy in light of the dominance of a specific variety of risk discourse that arguably obscures a consideration of rights to use public space and what a realisation of such rights might require from both the public and the state. [ABSTRACT FROM AUTHOR]

This article draws on data collected from a qualitative study designed to assess the effectiveness of an early intervention programme aimed to raise awareness of Child Sexual Exploitation (CSE) among young people. The programme was implemented by a large police force area, referred to as Shireland. Drawing on semi-structured interviews with practitioners implementing safeguarding policies within the police service, youth and social welfare work designed to support young people, we focus on the mobilisation of perceptions of risk and vulnerability as they translate in professional practice via a specific preventative initiative. More specifically, we wish to examine the extent to which blurring occurs between constructions of 'risk' and 'vulnerability' in relation to practitioners' understandings of the dangerousness of young people's behaviour. In our analysis, we draw attention to a palpable tension apparent in the interview narratives of those involved in delivering the programme, between expressed understandings which on the one hand universalise vulnerability and, on the other, extricate specific risk factors. [ABSTRACT FROM AUTHOR]

When making decisions about whether to transfer residents to hospital, care home staff consider the possible benefits and risks of different courses of action. However, to date, an in-depth and theoretically informed engagement with these decision-making processes and their associated behaviours has been lacking. We conducted an ethnographic study of care home staff's decision-making about resident hospital transfers in England between May 2018 and November 2019. We combined staff interviews at six care home sites, with 30 members of staff, with 113 hours of ethnographic observation at three care homes sites. 'Risk' and risk management emerged as important overarching themes. In this article we conceptualise staff decision-making about potential hospital transfers for residents as a form of risk work. In doing so, we identify the different forms of risk knowledge that staff used to conceptualise risk and explore the ways staff navigated tensions between different forms of risk knowledge. We highlight the ways individual understandings of risk were influenced by social interactions with others, both at an interpersonal and organisational level, before identifying strategies that staff use to manage risk. By understanding transfer decisions explicitly in terms of the different forms of risk that care home staff manage, our analysis provides new insights into hospital transfers from care homes and contributes to the wider literature around risk work, demonstrating the utility of this concept in researching organisations that fall under the umbrella of social care, which have been previously neglected in academic research. [ABSTRACT FROM AUTHOR]

Lay constructions of risk impact upon public health activities and underpin social reactions to experiences and understandings of infectious diseases. In this article, we explore the social construction of COVID-19 risk and responsibility by citizens of Jakarta and the Greater Jakarta Area, Indonesia. We draw upon digital diaries produced each week by 37 participants across a 5-week period from April to June 2020, a time of substantial policy flux in Indonesia. Key findings reflect the everyday construction of risk within the context of changing government restrictions regarding physical distancing. In the context of perceived confusion around government activity, the participants narrated individualised accounts of risk production, as they reflected upon the transmission of COVID-19. Our findings indicate the emergence of the concept of the 'ignorant imagined other' as underpinning how lay persons locate risks in unknowledgeable others and see themselves as socially protected through their own perceived knowledgeability of COVID-19. Our findings contribute to the literature on the social perception of infectious disease through the examination of the understudied context of urban Indonesia and by demonstrating the social location of risk in relation to a generalised imagined other, within a wider context of public health governance. [ABSTRACT FROM AUTHOR]

There is no consensus on the meaning of risk. Still we see that risk is linked to expected values and objective probability distributions, although the arguments against such perspectives are strong. In this editorial, I make some reflections on the present situation, on the way risk is defined and interpreted in practice and in the research literature. I argue that many common conceptions linked to risk and probability are unfortunate and need to be replaced by other ideas and perspectives. I especially address issues related to controversies between different schools, such as Bayesians and advocates of representations of uncertainty other than probability. [ABSTRACT FROM PUBLISHER]

This article is the first in a series which will appear in 2012 in the special issue series Health Care Through the `Lens of Risk'. It provides a quasi-verbatim transcript of an interview with Nick Pidgeon, one of the main contributors to the social science component of The Royal Society Risk Report (1992). The interview contains a fascinating insider account of the debate about risk between engineers and social scientists who produced the report. It also offers some important reflections on the fissure which has opened up between risk sociology and research concerned with global and local system safety. [ABSTRACT FROM PUBLISHER]

Drawing upon data collected within 20 focus groups with consumers from five European countries, in this article we investigate how perceptions of human health risk and current anxieties regarding agricultural food production affect citizens' acceptance of the use of an emerging biotechnology, synthetic biology, in the development of vaccines for animals bred for food production. In focus group discussions in Austria, the UK, Poland and Denmark, participants tended to value the positive potential of synthetic vaccines if they could solve existing problems. Participants argued that the technology could be beneficial for animal welfare and was a potential solution to the problem of risks to human health posed by the use of antibiotics on livestock. The perceived drawbacks of antibiotic use affected the discussions towards acceptance of synthetic biology and the use of vaccines in meat production despite concerns over the potential risks. The participants from Spain stood out in that their acceptance of the synthetic vaccine appeared to be disconnected from concerns about risks related to the use of antibiotics. Participants from all countries found the vaccine to have potential uses, but also expressed concerns about health risks for consumers. In general consumers were perceived as those bearing the heaviest burden of risk, while pharmaceutical companies were perceived as likely to benefit most from production of the vaccine. We found that institutional trust and national contexts of (dis)engagement with science influenced the participants' understandings of the degree to which the synthetic livestock vaccine had a fair risk-benefit balance. [ABSTRACT FROM AUTHOR]

It is estimated that up to ten per cent of people with motor neurone disease (MND) have an inherited form of the disease. Families with a history of inherited MND may face specific issues around managing the condition in relatives and adapting to life knowing that they too could develop the disease, which we refer to as living 'at risk'. This qualitative study is based on a thematic analysis of posts from 37 threads shared on the MND Association Forum between 2010 and 2019. Through this analysis we explore how forum users make sense of, and negotiate, genetic risk in this online space. We unpack how risk is constructed through a tracing and reframing of family history in relation to MND; we draw out the different ways uncertainty is expressed by people living with the threat of the disease; and we outline how future decisions around genetic testing and reproductive choices play out on the forum. Genetic risk was articulated temporally, with posters reflecting on past, present and expected future experiences across posts. This was crosscut by profound uncertainty. How people understood and expressed experiences of living 'at risk' – and the responses they received from others – were grounded in different forms of experiential knowledge, intertwined with biomedical and genetic information. We propose the MND Association forum as an interactional site where uncertainties are negotiated and risk is made sense of by individuals with a family history of MND, alongside those affected by 'sporadic' forms of the disease. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic signifies not only a global health crisis but has also proven to be an infodemic characterised by many conspiracy theories. Prior research informs us that belief in health-related conspiracies can harm efforts to curtail the spread of a virus. Therefore, as the global efforts of mass inoculation are underway, it is crucial to understand which factors shape tendencies to believe in conspiracy theories. In the current study, we explore how Pakistani adults' perceived risk of COVID-19, sense of national identity, and trust in traditional and social media sources, are associated with their belief in conspiracy theories related to the pandemic. The data for this study come from an online survey of 501 adults ages 18–49 conducted in April and May 2020 in Pakistan. Our results show that a perception of risk makes it less likely for the participants to believe in conspiracy theories even when taking into account key demographic factors. Furthermore, trust in social media has a positive association with belief in conspiracy theories, whereas trust in traditional media and people's sense of national identity are not associated with conspiracy beliefs. This study offers important scholarly and policy implications for navigating major global health issues, in Pakistan and other similarly situated countries. [ABSTRACT FROM AUTHOR]

Social workers are at the heart of drives to improve child health and wellbeing, with knowledge sharing between them and other professionals viewed as a way to reduce the uncertainty associated with this area of risk work. We aim to fill a significant gap in the literature by examining how social workers assess, interpret, filter and share knowledge relating to risk and uncertainty – what we call the translation of risk – within their profession. Based on data from a qualitative study with social workers in England between 2012 and 2013, we identify two main approaches social workers employ. We conceptualise them as 1) reluctant translating, and 2) dynamic translating. Our analysis shows that epistemic assumptions such as how social workers conceptualise the fact/value separation; how they view what we call 'grey evidence'; and how they understand the relationship between objectivity and subjectivity, underpin how social workers translate risk. We add a new dimension to the literature on risk by arguing that we need to pay attention to the epistemological values that underpin 'client-facing' risk work. Thus, we aid understanding of not only how knowledge is shared in particular ways, but also why this is the case. We identify reasons why some social workers include valuable 'grey evidence' and prioritise adequacy over accuracy in their translations of risk. We highlight, however, that through an over-emphasis on accuracy and boundaries, evidence-based practice might end up driving out 'grey evidence' and inadvertently hampering effective decision-making, judgement and knowledge sharing on risk. [ABSTRACT FROM AUTHOR]

Older people (OP) living at home alone face several health risks. Health professionals are increasingly called upon to contribute to the prevention of these risks. In this article we to develop an analytical framework to look at volition to risk taking in the ordinary everyday activities of OP living at home alone. We conducted a qualitative study to explore how OP think about risk throughout their actions, how risk influences them in their activities and the place they give to risk in the ordinary activities of their daily lives. Twenty participants (twelve women, eight men) living alone at home in French-speaking Switzerland were interviewed using the specific explicitation interview method. Focusing on micro-action sequences, the participants were asked to convey their subjective experiences while performing these actions. Occupational and activity choices seem to always have underlying motivations rooted in a set of values, such as maintaining a sense of control over one's own existence, competence (perceived self-efficacy), and identity congruence. Risk taking was closely associated with OP's intimate volition to maintain their own personal trajectory. The way in which OP understand the risks they face in their daily lives and what they do to cope with these risks serves as an analytical tool for studying ageing. We consider that a more detailed understanding of which risks affect or benefit OP, and how, makes a valuable contribution to studies of ageing and to studies into the nature and role of risk in everyday life. [ABSTRACT FROM AUTHOR]

Although intimate partnerships where both partners inject drugs have emerged as the focus of research and interventions, the gender dynamics characterising risk behaviours in injecting partnerships have largely been neglected. This study explored qualitative interview accounts focusing on the ways gender dynamics that reflect power differences between male and female injecting partners influenced risk perception and management. It drew upon a qualitative study of risk negotiation practices of injecting partners (n = 16) in Uyo, Nigeria. Analysis highlighted three key themes: 'caring and drug-using partnerships'; 'risk reduction and production', and 'male dominance and gendered violence'. Although the intimate partnerships of PWID provided emotional and social support in a high-risk environment, factors operating within these partnerships, including affection, trust, and gendered violence, undermined agency and risk-reducing behaviours, creating conditions that increased vulnerability to HIV particularly for women. The findings support calls to move beyond individual risk factors and privilege a relationship orientation in HIV prevention work. In particular, the analysis highlights a need for intervention models that build and maintain trust among drug-using partners, while improving communication skills, preventing violence and promoting HIV prevention through the adoption of risk-reducing measures. [ABSTRACT FROM AUTHOR]

Drawing on data from a study with Southern European parents living in Norway, this article discusses the experiences of migrant parents with professional advice on family leisure and outdoor play. The study is situated broadly in research about the contemporary parenting role and the social construction of parents as risk-managers. Within this construction, parents are understood as continually managing a 'double-bind', in which they are asked to both protect children from multiple risks, and expose them to risk to develop resilience. Norway provides an interesting context for further investigation, given its institutionalised emphasis on the importance of outdoor life and play. This is embedded in public provision for children and in dominant understandings of how families should use leisure time and how children should play. We explore how migrant parents respond to the associated discourses of risk in their encounters with kindergarten professionals and community health nurses. Participants navigated risk discourse in professional advice on family leisure and children's outdoor play in three ways: contesting discourses of risk; feigning cooperation; and accepting professional intervention and advice in either collaborative or compliant relationships. Migrant parents experienced professional constructions of risk-management as implying a form of individual responsibility, which typically recognised risks to children's wellbeing linked with their lifestyle choices. Although some found ways to negotiate risk and accommodate, parental experience was characterised by tension and difficulties in encountering the double-bind, which deserves further attention. [ABSTRACT FROM AUTHOR]

Individuals with different cultural worldviews conceptualise risks in distinct ways, yet this work has not extended to personal illness risk perception. The purpose of this study was to 1) examine the relationships between two types of cultural worldviews (Hierarchy-Egalitarian; Individualism-Communitarianism) and perceived risk (perceived severity and susceptibility) for diabetes and colon cancer, 2) test whether health literacy modifies the above relationships, and 3) investigate whether trust in government health information functions as a putative mediator of the relations between cultural worldviews and disease perceived risk. We recruited (N = 600) participants from a nationally-representative Internet survey panel. Results were weighted so the findings are representative of the general United States population. People with a more hierarchical worldview expressed lower perceived susceptibility to developing both diabetes and colon cancer, and perceived these diseases to be less severe, relative to those with a less hierarchical (more egalitarian) worldview. There was no significant association between individualistic worldview and perceived risk. Health literacy modified the relationships between hierarchical worldview and perceived risk; the associations between hierarchical worldview and lower perceived severity were stronger for those with limited health literacy. We did not observe indirect effects of cultural worldviews on perceived risk through trust in health information from government sources. It may be useful to identify specifically tailored risk communication strategies for people with hierarchical and individualistic worldviews, especially those with limited health literacy, that emphasise their important cultural values. Further research examining cultural components of illness risk perceptions may enhance our understanding of risk-protective behaviours. [ABSTRACT FROM AUTHOR]

Framed both as a solution to and as an additional part of the tobacco problem, e-cigarettes have been the subject of risk controversies since they were launched in 2006, followed by massive divergence in media, public health approaches and regulations across the world. This study explores vapers' risk perceptions and accounts of the public risk communication and regulation of e-cigarettes in a Norwegian context were nicotine-containing e-liquids are prohibited from being sold by domestic retailers. Based on analyses of semi-structured qualitative interviews (n = 30, 17 males) with adult vapers, I find that the participants emphasised three important dimensions related to risk. First, they perceived vaping as harm reduction by substituting for smoking. Second, they devalued much of the risk communication about e-cigarettes from Norwegian health authorities and media. Interlinked with their harm-reduction approach, they perceived the present regulation of nicotine e-liquid and vaporisers as increasing risk by decreasing their availability to smokers. Third, in general they preferred the lay expertise available online to the health authorities' information on e-cigarettes. The analysis displays a lack of trust among the participants in what can be labelled as top-down information. Based on these dimensions, I conclude that the dissonance between vapers risk perceptions and the regulation and mixed messages in risk communication of e-cigarettes has contributed to their preference for bottom-up expertise. From the vapers' point of view, e-cigarettes represent harm reduction, and the vaper community symbolises a bottom-up health movement where peer assistance compensates for a perceived lack of assistance from health authorities. [ABSTRACT FROM AUTHOR]

Research suggests that cultural worldviews bias how and what people think about various societal risks. But how does this mechanism manifest when people receive balanced information about a highly publicised health issue such as cigarette smoking? Using the cultural cognition worldview scales, we demonstrate that despite the considerable interventions post the 1964 landmark Surgeon General's Report, young adults in the U.S. still perceive smoking risks in ways that affirm their cultural worldviews along two dimensions: egalitarianism-hierarchism and individualism-communitarianism. Those who subscribe to hierarchical and individualistic worldviews were more dismissive of the risks associated with cigarette smoking and exposure, while egalitarians and communitarians associated smoking with higher risks. We observed an interaction between the two worldview dimensions. Besides, exposed to balanced information – as is often the case in media coverage based on the journalistic norm of balance – about the risks and benefits of smoking, those who are concurrently hierarchical and individualistic in their outlook assimilated information about benefits while discounting the dangers of smoking. Egalitarian communitarians (on the other end of the continuum) discounted the benefits information vis-à-vis the risk information. Thus, culturally-biased cognition of risk perception does not only apply to novel and abstract risks but also highly publicised ones. Communication and public policy implications are discussed. [ABSTRACT FROM AUTHOR]

Past research has provided evidence of the important role that trust plays in people's decisions regarding food consumption. This study examines the reasons for people's distrust in food production systems and how they conceptualise and handle food-related risks in everyday life in a context in which food scandals have occurred frequently. In-depth interviews were conducted with 39 married Taiwanese women. Our findings indicated that the women believed that collusion commonly occurs between business and government entities and that such collusion frequently leads to food scandals. However, despite their distrust in the food system and suspicion towards the government, the women generally still relied on food labels and certifications when making food purchasing decisions. These 'in-between' strategies were formed by their knowledge and experiences of day-to-day living in Taiwan, and while the strategies may seem somewhat self-contradictory, they can be understood as empowering people to protect themselves and their families in circumstances of general distrust and helplessness. [ABSTRACT FROM AUTHOR]

In this article, we aim to better understand how a personal history of cancer influences perceptions of environmental risk factors for cancers and adoptions of health-related behaviours. Semi-structured individual and group interviews were conducted with French individuals with (n = 21) and without (n = 16) a personal history of cancer using the same topic guide. Interviews were transcribed, coded and analysed using a comparative approach. Our participants with and without a history of cancer tended to perceive the same environmental factors as causes of cancers, in particular pesticides and smoking. However, individuals without a history of cancer emphasised electromagnetic waves and sun exposure as causes of cancers while participants with a history of cancer emphasised unbalanced diet and stress/negative emotions. Our participants with a history of cancer tended to mention more factors than participants without. Finally, participants with a personal history of cancer all described themselves as adopting at least one behaviour mentioned as 'healthier', often following their cancer experience, while very few participants without a history of cancer mentioned adopting these behaviours. Participants with a history of cancer tended to be more concerned about environmental risk factors for cancers and about preventing cancers through adopting risk-reducing health-related behaviours than participants without a history of cancer. Our findings are consistent with and develop the idea that a personal experience of cancer can alter an individual's 'experience and life world'. We also observed similarities between individuals with and without a personal history of cancer. Our contextual findings need to be confirmed by further research. [ABSTRACT FROM AUTHOR]

Despite much ethical debate concerning non-invasive prenatal testing to abort or to detect genes, research on the experience of those who choose this new technology in China is limited, especially after the introduction of the Two-child Policy. In this article I analyse qualitative data from 25 interviews with pregnant women of advanced maternal age (pregnancy after 35) under the Two-child Policy, conducted in 2014 to 2016, as well as observational data from a 6-month, in-hospital participant observation in 2016. These data were collected with the aim to examine how non-invasive prenatal testing affects pregnant women's risk perceptions and why this technology is widely accepted by pregnant women of advanced maternal age in China. I conclude that the women in my study accepted their 'high-risk' identity within prenatal care, and that non-invasive prenatal testing was integrated in this care. Women's interactions with genetic counsellors, their husbands and close friends and community doctors produced anxieties, with women feeling responsible for the health of their foetuses. Consequently, the women in my study were willing to 'buy' this test for reassurance. The consumption of this new technology by pregnant women after the Two-child Policy lays a foundation for the market development of this technology in urban China. [ABSTRACT FROM AUTHOR]

The use of HIV Treatment as Prevention (TasP) has radically changed our understandings of HIV risk and revolutionised global HIV prevention policy to focus on the use of pharmaceuticals. Yet, there has been little engagement with the very people expected to comply with a daily pharmaceutical regime. We employ the concept of HIV citizenship to explore responses by people living with HIV in the UK to TasP. We consider how a treatment-based public health strategy has the potential to reshape identities, self-governance and forms of citizenship, domains which play a critical role not only in compliance with new TasP policies, but in how HIV prevention, serodiscordant relationships and (sexual) health are negotiated and enacted. Our findings disrupt the biomedical narrative which claims an end to HIV through scaling up access to treatment. Responses to TasP were framed through shifting negotiations of identity, linked to biomarkers, cure and managing treatment. Toxicity of drugs – and bodies – were seen as something to manage and linked to the shifting possibilities in serodiscordant environments. Finally, a sense of being healthy and responsible, including appropriate use of resources, meant conflicting relationships with if and when to start treatment. Our research highlights how HIV citizenship in the TasP era is negotiated and influenced by intersectional experiences of community, health systems, illness and treatment. Our findings show that the complexities of HIV citizenship and ongoing inequalities, and their biopolitical implications, will intimately shape the implementation and sustainability of TasP. [ABSTRACT FROM AUTHOR]

Public inactivity has been addressed by scholars across different academic disciplines. Risk communication and behaviour change is difficult and costly due to limited attention to various messages in the public sphere. Crises pose particular challenges if organisations are to communicate effectively with the public to protect them from potential risks. The present study attempts to better understand what makes the public inactive when faced with a crisis. Specifically, I focus on how people perceive a crisis and the reasons they remain inactive during the crisis. Using 28 in-depth interviews with Korean citizens during two food-related crises, this study revealed that people interpreted the crisis within a broader social context, made underlying assumptions in understanding the crisis and believed what the media vividly showed. The findings also showed that people remained inactive because they avoided dealing with risks due to being distracted by their daily lives, they trusted social systems to manage the problem, and they felt they had high efficacy in resolving the crisis although they did not expect to make fundamental changes in the long-run. [ABSTRACT FROM AUTHOR]

HPV-associated anal cancer is one of the most prevalent non-AIDS defining cancers affecting gay men living with HIV. Drawing on interviews with 25 HIV-positive gay men living in Toronto in 2017, we explored their responses to anal cancer as a comorbidity risk and the necessity of preventative screening. These participants had previously been screened for anal cancer through a clinical trial. The majority of our sample did not initially consider anal cancer a health priority. They relied on narratives of living with HIV - that is, on their HIV biographies - to make sense of anal cancer’s significance given their self-described lack of knowledge. This included references to personal-level narratives of the biographical disruption and revision associated with a HIV diagnosis, as well as reflections on community-level and socio-historical trends in the HIV epidemic. Drawing on these narratives, some started to accept anal cancer as a significant comorbidity risk, while others remained ambivalent. Those who began to accept anal cancer as significant integrated it into their HIV biographies to present anal cancer as a threat to the ontological security they have gained managing HIV in an era of effective treatment and to position themselves as pragmatic, responsible health-seekers. Others drew on their HIV biographies to vocalise resistance to chronic risk and medicalisation. Our analysis points to the fundamental role narratives play on everyday risk perception practices, health decision-making and, for those managing a chronic illness, on securing ontological security and presenting a coherent self-identity under conditions of expanding risks and prevention possibilities. [ABSTRACT FROM AUTHOR]

In the UK care sector, as much as other fields of work, managers need to check and monitor the immigration status of their staff. In this article, we examine accounts from care home and home care managers of making decisions about recruitment and employment practices placing these in the context of risk work. We use data from a secondary analysis of interviews with 121 social care managers that took place in four contrasting English local authority areas in two rounds over the period 2009-2014. In the interviews, we explored managers ' views and experiences of employing or deciding not to recruit migrant workers and the extra work this potentially entailed. We identified three major themes in these interviews: vigilance, being caught, and shifting resources. The Vigilance in recruitment and managing staff theme highlighted managers' experiences of and concerns about implementing the regulations around employment permissions and indicated their feelings that it was essential to comply with new government regulations relating to migrant workers. The Being caught theme was based on managers' fears about the risks of being in breach of the regulations and worry about the severity of the penalties. The Shifting sources theme highlighted managers' continued work in reaching out to fresh sources of recruitment as a response to changes in immigration regulations. Our findings expose the potentially stressful nature of managers' roles in implementing new regulations and managing the risks of non-compliance. This new aspect of risk work reveals the tensions of managers' role in performing their obligations to scrutinise documentation and abide by changing regulations while still running their services. As the UK moves to Brexit (leaving the European Union), these tensions look set to increase in the context of further migrant working regulations and amendments to immigration permissions. [ABSTRACT FROM AUTHOR]

Progressive public health authorities in high-income countries have advocated supervised consumption facilities, where people who use illicit drugs can consume them in a hygienic, supervised environment, as a way of reducing drug-related risks to both people who use drugs and communities. However, the planning of such facilities has often met with strong reactions from the local community. ‘Not in my backyard’ (NIMBY) type reactions are frequently encountered and public opinion polling is limited in its ability to provide detailed insights into the reasons why people support or oppose these facilities in Toronto and Ottawa. We explore perceptions of residents and business representatives to the proposed implementation of supervised consumption facilities, and examine their perceptions of risks from these facilities. We collected qualitative data from 2008–2010 using focus groups and interviews with 38 residents and 17 business representatives in these two large Canadian cities lacking supervised consumption facilities. We used thematic analysis to examine expressed benefits and risks regarding supervised consumption facilities amongst community members. These participants saw these facilities as potentially risk-reducing, but recognised that the facilities could also create risks for their communities. While community members accepted that facilities could have positive health effects, they expressed a level of concern regarding the risk of public nuisance associated with supervised consumption facilities that seemed unwarranted based on the existing evidence. Discussions on the risks involved in the establishment of supervised consumption facilities should move beyond a focus on the benefits to facility users, to exploring community-level benefits and risks, and integrate evidence regarding actual risk experiences from other locations. Similar approaches may apply to NIMBY concerns related to other contentious issues. [ABSTRACT FROM AUTHOR]

An introduction to the journal is presented in which the editor discusses articles in the issue on topics including Dealing with Uncertainty and Risk in Everyday Practice, multiple rationalities and study of the sharing of uncertainties among people in the aftermath of cancer recovery.