Inevitably violent? Dynamics of space, governance and stigma in understanding violence against sex workers

Radical feminists position any forms of sex work as gender violence against individuals and more broadly for all women in society. I argue against the ideological stance that sex work is inherently violent and as a result should be outlawed, setting out how this ideology and dogma has allowed structural factors to persist which have lead to inevitable violence. In this paper, I argue that despite the abdominally high levels of violence against sex workers across the globe, violence in sex work in not inevitable. Through a review of the literature as well as drawing on research from the UK, I deconstruct the myth of inevitable violence. In turn I argue that violence is dependent on three dynamics. First, environment: spaces in which sex work happens has an intrinsic bearing on the safety of those who work there. Second, the relationship to the state: how prostitution is governed in any one jurisdiction and the treatment of violence against sex workers by the police and judicial system dictates the very organisation of the sex industry and the regulation, health and safety of the sex work communities. Thirdly, I argue that social status and stigma have significant affects on societal attitudes towards sex workers and how they are treated. It is because of these interlocking structural, cultural, legal, and social dynamics that violence exists and therefore it is these exact dynamics that hold the solutions to preventing violence against sex workers. Towards the end of the paper, I examine the UK’s ‘Merseyside model’ whereby police treat violence against sex workers as a hate crime. It is in these examples of innovative practice despite a national and international criminalisation agenda against sex workers, that human rights against a sexual minority group can be upheld

Beat-by-beat cardiovascular index to predict unexpected intraoperative movement in anesthetized unparalyzed patients: a retrospective analysis

International audienceOBJECTIVE: Unexpected intraoperative movement may be detrimental during delicate surgery. This study tested retrospectively an algorithm based on beat-by-beat circulatory variables (incorporated into a Cardiovascular depth of anesthesia index: CARDEAN in relationship to unexpected movement, and compared its performance to that of the electroencephalogram (EEG)-derived index: BIS-XP 4.0. METHODS: 40 ASA I or II patients presenting for knee surgery had EEG (BIS XP 4.0), beat-by-beat (Finapres) finger non-invasive blood pressure (BP), conventional brachial BP and electrocardiogram (EKG) monitors attached. Anesthesia was induced and maintained with propofol and remifentanil. Before incision, the propofol concentration was set to maintain BIS < 60. From incision to emergence, the anesthesiologist was denied access to BIS or Finapres. Anesthesia adjustment was titrated at the discretion of the anesthesiologist according to conventional signs only: brachial BP, EKG, eyelash reflex, movement. Occurrences of movement and eye signs (divergence of eyeballs, tears, corneal reflex, eyelash reflex) were observed. The CARDEAN algorithm was written retrospectively and tested vs. BIS. RESULTS: 11 movements occurred in 8 patients. CARDEAN > 60 predicted movement in 30% of the cases, 15 to 274 s before movement (sensitivity: 100%, specificity: 95%; relative operating curve ROC = 0.98; prediction probability pk = 0.98). BIS > 60 predicted movement in 19% of cases (sensitivity: 64%; specificity: 94%, ROC: 0.85, pk: 0.85). CONCLUSION: Retrospectively, a cardiovascular index predicted unexpected intraoperative movements. Prospective validation is needed