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Book part
Publication date: 28 August 2023

Kathryn Burrows

To understand how parents make the decision to implant their deaf young children with cochlear implants, focusing specifically on the concepts of normality, medicalization, and…

Abstract

Purpose

To understand how parents make the decision to implant their deaf young children with cochlear implants, focusing specifically on the concepts of normality, medicalization, and stigma.

Methodology/Approach

I conducted 33 semi-structured interviews with the hearing parents or parent of children with cochlear implants. In all but two families I interviewed the primary caretaker which in all cases was a mother. In the remaining two interviews, I interviewed both parents together. Because of the relative scarcity of families with children with cochlear implants, and the difficulty in connecting with these families, I used a convenience sample, and I did not stratify it in any way. The only requirement for parents to be interviewed is that they had at least one deaf child who had been implanted with at least one cochlear implant. Although this is a small sample, the findings are transferable to other families with the same sociodemographic characteristics as those in my study.

Findings

Parents in the study focused on three key concepts: normality, risk analysis, and being a good parent. Dispositional factors such as the need to be “normal” and the desire for material success for one's children appeared to moderate the cost-benefit calculus.

Research Limitations/Implications

Limitations

This interview project concentrated on hearing families who had implanted their deaf children with cochlear implants; it does not include culturally Deaf parents who choose to use American Sign Language (ASL) with their Deaf children. Understanding how Deaf families understand the concepts of normality, medicalization, and stigma would shed light on how a distinctly “abnormal” group (by a statistical conception of normal) – ASL-using Deaf people-explain normality in the face of using a non-typical communication method. One can learn a lot by studying the absence of a phenomena, in this case, not implanting children with cochlear implants. It is possible that the existential threat felt by some Deaf people, specifically the demographic problem presented by cochlear implants, led Deaf educators or parents to resist being the subject of research.

Overwhelmingly the sample was female, and white. Only two participants were male, and none of the participants were non-white. The lack of diversity in the sample does not necessarily reflect a lack of diversity of children receiving cochlear implants. Medicaid, which disproportionately covers families of color, covers cochlear implants in most cases, so low SES/racial intersectionality should not have affected the lack of diversity in the sample. However, the oral schools are all private pay, with few scholarships available, so low SES/racial intersectionality in the sampling universe (all children who attend oral schools), may have played a part in the lack of racial diversity within the sample.

Implications

Parents in this study were very specific about the fact that they believed cochlear implants would lead to academic, professional, and personal success. They weaved narratives of normality, medicalization, and stigma through their stories. Normality is an important lens from which to see stories about disability and ability, as well as medical correction. As medical science continues to advance, more and more conditions will become medicalized, leading to more and more people taking advanced medical treatments to address problems that were previously considered “problems with living” that are now considered “medical problems” that can be treated with advanced science.

Originality/Value of Paper

This chapter's contribution to the sociological cochlear implant literature is it's weaving of narratives about normality, stigma, and medicalization into parental stories about the cochlear implant decision-making process. Most literature about the cochlear implant decision-making process focus on cost-benefit analysis, and logical decision-making processes, whereas this paper focuses on decision-making factors stemming from bias, emotions, and values.

Details

Social Factors, Health Care Inequities and Vaccination
Type: Book
ISBN: 978-1-83753-795-2

Keywords

Open Access
Article
Publication date: 9 May 2024

Nabila As’ad, Lia Patrício, Kaisa Koskela-Huotari and Bo Edvardsson

The service environment is becoming increasingly turbulent, leading to calls for a systemic understanding of it as a set of dynamic service ecosystems. This paper advances this…

Abstract

Purpose

The service environment is becoming increasingly turbulent, leading to calls for a systemic understanding of it as a set of dynamic service ecosystems. This paper advances this understanding by developing a typology of service ecosystem dynamics that explains the varying interplay between change and stability within the service environment through distinct behavioral patterns exhibited by service ecosystems over time.

Design/methodology/approach

This study builds upon a systematic literature review of service ecosystems literature and uses system dynamics as a method theory to abductively analyze extant literature and develop a typology of service ecosystem dynamics.

Findings

The paper identifies three types of service ecosystem dynamics—behavioral patterns of service ecosystems—and explains how they unfold through self-adjustment processes and changes within different systemic leverage points. The typology of service ecosystem dynamics consists of (1) reproduction (i.e. stable behavioral pattern), (2) reconfiguration (i.e. unstable behavioral pattern) and (3) transition (i.e. disrupting, shifting behavioral pattern).

Practical implications

The typology enables practitioners to gain a deeper understanding of their service environment by discerning the behavioral patterns exhibited by the constituent service ecosystems. This, in turn, supports them in devising more effective strategies for navigating through it.

Originality/value

The paper provides a precise definition of service ecosystem dynamics and shows how the identified three types of dynamics can be used as a lens to empirically examine change and stability in the service environment. It also offers a set of research directions for tackling service research challenges.

Details

Journal of Service Management, vol. 35 no. 6
Type: Research Article
ISSN: 1757-5818

Keywords

Open Access
Article
Publication date: 30 November 2023

Rahma Isaack Adam, Farha Deba Sufian and Lucy Njogu

Women’s empowerment remains a key development challenge in Kenya. The purpose of this study is to attempt to understand the status of women’s empowerment and the key contributors…

Abstract

Purpose

Women’s empowerment remains a key development challenge in Kenya. The purpose of this study is to attempt to understand the status of women’s empowerment and the key contributors to their disempowerment in Kenya’s aquaculture sector.

Design/methodology/approach

A cross-sectional survey was conducted on 534 male and female fish farmers from 300 households drawn from six counties in Kenya (Kakamega, Kisumu, Kisii, Kiambu, Meru and Nyeri). The Abbreviated Women’s Empowerment in Agriculture Index (A-WEAI) was adapted to Abbreviated Women’s Empowerment in Fisheries and Aquaculture Index (A-WEFI) to suit the aquaculture and fisheries sub-sector. The adapted A-WEFI was then used to estimate and the status of women’s and men’s using five domains of empowerment (5DE) and a gender parity index (GPI). Data were analysed using descriptive statistics, Cramer’s V and sensitivity analysis as test statistics.

Findings

About 86% of the men and 80% of the women were classified as empowered. The mean score of the 5DE was 0.93 and 0.95 for women and men, respectively. In addition, 82% of the households achieved gender parity, suggesting that for such households, empowerment of men was no greater than that of women. Overall, the results suggest no major differences between the empowerment of women and men. Findings suggest areas of improvement in empowerment: when observed separately, women report lack of agency in production, resource, time-use and allocation and leadership.

Originality/value

This paper adapts the A-WEAI to the fisheries and aquaculture context, in bid to bridge the gap in standard women’s empowerment measurement methods in this area. Also, there are limited empirical studies on the multifaceted empowerment of women in aquaculture in Kenya. The findings are meant to serve as a point of reference for policymakers, as they develop gender-responsive intervention programmes, and in implementing gender mainstreaming in Kenya.

Details

International Journal of Development Issues, vol. 23 no. 1
Type: Research Article
ISSN: 1446-8956

Keywords

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