Ties That Bind: Marital Networks and Politics in Punjab, Pakistan

Pakistani politics are characterised by strong corporate social links through kinship and caste that impose reciprocal obligations and rights. Marital maps allow for accurate prediction of allegiances and decision making and contribute to a transparent assessment of political processes in the country. While much of the focus on reciprocal relations has understandably been on descent relations (dynasties), the complex network of marital alliances that cut across lineage and sectarian divides helps explain notable levels of stability despite the fragility of the state and other public institutions. Using the example of one of the most successful political dynasties in post independence Pakistan, we show the extent of cross lineage, region and even party alliances that shape this political kinship network

Paper as a serious method of concern

Comment on Hull, Matthew. 2012. Government of paper: The materiality of bureaucracy in urban Pakistan. Berkeley: University of California Press

Prehospital critical care is associated with increased survival in adult trauma patients in Scotland

Background Scotland has three prehospital critical care teams (PHCCTs) providing enhanced care support to a usually paramedic-delivered ambulance service. The effect of the PHCCTs on patient survival following trauma in Scotland is not currently known nationally. Methods National registry-based retrospective cohort study using 2011-2016 data from the Scottish Trauma Audit Group. 30-day mortality was compared between groups after multivariate analysis to account for confounding variables. Results Our data set comprised 17 157 patients, with a mean age of 54.7 years and 8206 (57.5%) of male gender. 2877 patients in the registry were excluded due to incomplete data on their level of prehospital care, leaving an eligible group of 14 280. 13 504 injured adults who received care from ambulance clinicians (paramedics or technicians) were compared with 776 whose care included input from a PHCCT. The median Injury Severity Score (ISS) across all eligible patients was 9; 3076 patients (21.5%) met the ISS>15 criterion for major trauma. Patients in the PHCCT cohort were statistically significantly (all p < 0.01) more likely to be male; be transported to a prospective Major Trauma Centre; have suffered major trauma; have suffered a severe head injury; be transported by air and be intubated prior to arrival in hospital. Following multivariate analysis, the OR for 30-day mortality for patients seen by a PHCCT was 0.56 (95% CI 0.36 to 0.86, p=0.01). Conclusion Prehospital care provided by a physician-led critical care team was associated with an increased chance of survival at 30 days when compared with care provided by ambulance clinicians

Persistent Cultures: Miskitu Kinship Terminological Fluidity

Kinship is understood dynamically and processually but kinship terminologies are remarkably stable idea systems. They provide cultural continuity over time and are more resistant to modification than many types of cultural instantiations. Miskitu speakers in Nicaragua, however, have adopted new kin terms that appear to have fundamentally changed the idea system used to generate their kin terms historically. The shape of the changes that have occurred in Miskitu kin terminologies over time are the result of powerful economic, political and social forces introduced, in part, as a consequence of the geography of Mosquito Coast economies, migrations and political processes. We argue that the current use of kin terms is atypically hybrid and is not the result of a single, algebraically derivable idea system. Rather than negating the validity of mathematical approaches to kinship terminologies, the case of Miskitu kinship terminology suggests that core idea systems, although subject to change over time, move between informationally economical forms adapted to socioeconomic changes