Maternal Conjugal Multiplicity and Child Development in Rural Jamaica

Using field‐based observations and standardized measures of the home environment and child development, the authors followed 59 rural Jamaican women and their offspring from birth to age 5. The findings suggest that conjugal multiplicity, a female reproductive pattern characterized by multiple unions, maternal unmarried status, and absent father, does not necessarily result in poorer developmental outcomes for preschool‐aged children. Rather, it is a strategic adaptation to the conditions of poverty that may, in fact, provide developmental advantages for poor children in rural Jamaica. Households in which there are six or more maternal siblings, however, appear to compromise child development regardless of multiple unions, conjugal status, or father's presence.     

Placing care: embodying architecture in hospital clinics for immigrant and refugee patients

This article is part of a hospital ethnography that investigates healthcare architecture as an aspect of an increasingly large, complex, and urgent global health issue: caring for refugees and other immigrants. It argues that hospitals are nodes in transnational social networks of immigrant and refugee patients that form assemblages of human and non‐human objects. These assemblages co‐produce place‐specific hospital care in different hospital spaces. Place‐specific tensions and power dynamics arise when refugees and immigrants come into contact with these biomedical spaces. The argument is developed by analysing waiting rooms and exam rooms in two outpatient clinics in one US hospital. The article draws its analysis from 9 months of fieldwork in 2012 that included following 69 adult immigrant and refugee patients and observing their encounters with interpreters and clinic staff. Its inclusion of a transnational dimension for understanding place‐specific hospital care adds conceptual and empirical depth to the study of how place matters in 21st century hospitals.     

Ethical considerations for research involving boys diagnosed with attention-deficit/hyperactivity disorder

The ‘new sociology of childhood’ has activated a growing interest in children as social actors and their level of involvement in activities that affect their lives. In the field of research, debate is underway regarding the consent processes and methodological activities that support child participation. This paper highlights methodological and ethical considerations that emerged while engaging in research with young boys (aged 9–11 years old) with a formal diagnosis of attention-deficit/hyperactivity disorder (ADHD). Key issues include recruitment, informed consent, and participatory activities for data production. Sociocultural theories of childhood and disability are applied to reflect on the power and privilege operating through the research process. Engaging in research that involves children with disabilities, in which discourses of risk, stigma, and protection are elevated, problematizes the researcher–researched relationship and expands considerations of what constitutes ethical practice and ‘valuable data’.     

Say ‘trouble’s gone’: chronic illness and employability in job training programmes

The concept of biographical disruption has unique relevance for socioeconomically disadvantaged groups who participate in entry‐level job training programmes. In these programmes trainees often suffer from various forms of chronic illness and must arrange these illnesses into a picture of employability. In this article I use ethnographic data and narrative analysis to examine closely two trainees’ illness‐related experiences, expressions and talk, and find that their ability to present their illnesses in ways that are consistent with programmatic goals is strongly influenced by family support, responsibilities and roles, as well as particular aspects of illness, like the interpretability of symptoms. I also find that the concept of biographical disruption has a curious traction in the world of job training, particularly among job training programme staff who would like to see trainees mobilise a variety of resources to help manage their illness. However, for trainees, many of whom have lived with chronic illness for years, the concept of biographical disruption may be more limited as a tool for understanding the experiences of illness. A more meaningful disruptive force in the lives of trainees appears to be the programme itself and the strategies for dealing with illness that programme staff may extend.     

Challenging Pentecostal moralism: erotic geographies,religion and sexual practices among township youth in Cape Town

Research on constructions of sexuality in Pentecostalism often struggles with the fact that the research setting is defined ex ante in terms of church communities, which imposes upon ethnographic accounts the same limitations Pentecostal morality imposes upon church members' discourse. Taking young Pentecostals operating in a space that is not explicitly religious as the methodological entrance to the field, this paper explores negotiations over sexuality, intimate relationships and love among Xhosa-speaking township youth. It introduces the notion of erotic geographies to consider how possible influences of religious discourses on sexuality are refracted by alternative cultural orientations and material contexts. Findings suggest that premarital abstinence appears as a highly exceptional ideal for youth. Even among Pentecostal youth, notions of sexuality are largely severed from religiosity and faithfulness and romanticism are dominant ideals. Future research on Pentecostalism and sexuality should be less religious-centric and rooted more firmly in ethnographies of youth sexual cultures.     

NHS managers as rhetoricians: a case of culture management?

In the wake of Peters and Waterman's In Search of Excellence few NHS managers are unaware of culture management as a tool for shaping organisational change. Yet the first wave of post-Griffiths studies found little evidence of ‘culture management’ in action. This paper draws on data from an ethnographic study carried out in 1988–90 to suggest that the symbolic facet of management action is an important, though neglected, element in the 1991 NHS reforms. It argues that rhetorical skills Iwere a valuable resource for general managers overseeing the change process, and explores some of the ways in which rhetoric may have influenced cultural adaptation. However, many of the specific claims of the ‘excellence genre’, including ideas about the importance of strong, homogeneous cultures, are rejected. Rhetoric is an aspect of micro-political struggles over meaning, which rarely result in straightforward cultural ‘manipulation’, and are more likely to re-shape organisations through pragmatic accommodation than to win the hearts and minds of members.     

The benefits of respectful interactions: fluid alliancing and inter‐occupational information sharing in primary care

Though inter‐occupational interactions in health care have been the focus of increasing attention, we still know little about how such interactions shape information sharing in clinical settings. This is particularly true in primary care where research on teams and collaboration has been based on individual perceptions of work (using surveys and interviews) rather than observing the interactions that directly mediate the inter‐occupational flow of information. To explore how interactions shape information sharing, we conducted a secondary analysis of ethnographic data from 27 primary care practices. Ease of information sharing among nurses and doctors is linked to the degree to which practices feature respectful interactions, with practices in the sample falling into one of three categories (those with low, uneven, and high degrees of respectful interactions). Those practices with the highest degree of respectful interactions demonstrate what we describe as fluid‐alliancing: flexible interactions between individuals from different occupational groups in which bidirectional information sharing occurs for the benefit of patients and the efficacy of the practice community. We conclude by arguing that this process unlocks the strengths of all practice members, and that leadership should encourage respectful interactions to augment organisational efficacy and the ability of individual practice members to provide quality patient care.