'Where do we come from and where are we going?' A study about the transformation of knowledge related to long-term care

The care crisis manifests the tensions and profound changes which are taking place in contemporary long-term care systems, leading to new care views and modalities in society. Through 26 interviews conducted with caregivers, family members and elderly people with care needs, this study aims to make visible the transformation in the conceptions of care in the Basque Country. First, the results show the displacement of familiarist ideas and values. Second, we describe the daily management of the social and moral tensions associated with outsourcing and the meaning of care work. Third, the findings indicate the emergence of new perspectives on the modalities of care. The contribution of cognitive polyphasia towards analysing the management and integration of new knowledge associated with care in a specific socio-cultural context is discussed. Finally, we consider the applicability of our findings in terms of relevant solutions for care management and innovation in this field.

Comprehensive sexuality education is 'not for us': Rethinking 'cultural relevance' through Young Tanzanians' identifications with/against intervention knowledge

The need for comprehensive sexuality education (CSE) to be culturally relevant and inclusive is increasingly recognised as a fundamental aspect of supporting young people to live healthy sexual lives. Nevertheless questions remain about how to represent cultures and difference without subtly reinforcing inequalities. This paper makes a case for the need to explore this issue through analyses of how different gendered and demographic groups of young Tanzanian attendees of culturally relevant CSE, identify with (or against) intervention knowledge[s]. Grounded in dialogical social psychological theorising, we present a methodological approach for exploring how processes of belonging and Othering structure young people's negotiations of culturally relevant CSE amongst other knowledges. An adapted version of the 'story completion' method was used with university students and urban-poor young people (aged 18-34) to instigate dialogues about how a fictional protagonist might think, feel, and act in their relationship, looking to see if, and how, young people incorporated CSE knowledge. Twelve single-gendered focus-group discussions were held in September 2014 with 48 young people, and then findings from these were discussed further with 27 returning young people through three mixed-gendered workshops in August 2015. The analyses highlight how young Tanzanians explicitly Other CSE interventions, positioning their knowledge as 'not for us'. More implicitly, difference is also constructed around ideas about change and gendered development, along with trust and support in relationships. The devices used to Other shifted and differed across demographic groups, ranging from complete denials of intervention knowledge to viewing it as unrealistic, dangerous, or self-stigmatised for not being able to use it. We propose that these findings highlight the need to rethink how both 'culture' and 'relevance' are conceptualised in CSE, most specifically necessitating greater recognitions of poverty, transnationality, and the lasting legacies of colonialism and behaviour change interventions that communicated through fear and morality.

Fertility regulation as identity maintenance: Understanding the social aspects of birth control

We take a dialogical approach to exploring fertility regulation practices and show how they can maintain or express social identity. We identify three themes in educated Ghanaian women's accounts of how they navigate conflicting social demands on their identity when trying to regulate fertility: secrecy and silence - hiding contraception use and avoiding talking about it; tolerating uncertainty - such as using unreliable but more socially acceptable contraception; and wanting to be fertile and protecting menses. Family planning programmes that fail to tackle such social-psychological obstacles to regulating fertility will risk reproducing social spaces where women struggle to claim their reproductive rights.

Translation strategies, contradiction, and the theory of social representations: Why discussing needles may improve blood donor retention

Retaining blood donors is a cost-effective way of ensuring a safe blood supply, yet despite the plethora of research, only 5.1% of the eligible population in Australia donate blood and 40% of these do not make a second donation. We offer an alternative to traditional approaches by conceptualizing blood donation within social representations theory as socially derived symbolic knowledge with a specific focus on cognitive polyphasia and Guimelli's (1998) normative and functional dimensions. An online survey, completed by 703 residents from NSW Australia, comprised a blood donation word association task, Likert-style questions constructed from previous word association data and contextualized blood donation statements. Individual difference scaling analysis revealed all donor groups (including non-donors) associated blood donation with a few central, albeit contradictory ideas/beliefs. Exploratory factor analysis and confirmatory factor analysis performed on a split data set of the Likert-style items reiterated this finding. Interpreted through Guimelli's dichotomy, all donor groups were aware of these contradictory normative and functional ideas/beliefs but when explicitly asked, it was the functional aspect that differentiated the groups. We argue the key to retaining donors is understanding the interdependence between how blood donation is socially understood at the societal level of discourse and donor behaviour. Translational strategies for recruitment and retention are discussed.

Exploring intergenerational changes in perceptions of gender roles and sexuality among Indigenous women in Oaxaca

The south of Mexico has traditionally faced disproportionate social, health and economic disadvantage relative to the rest of the country, due in part to lower levels of economic and human development, and barriers faced by Indigenous populations. The state of Oaxaca, in particular, has one of the highest proportions of Indigenous people and consistently displays high rates of maternal mortality, sexually transmitted infections and teenage pregnancy. This study examines how social values and norms surrounding sexuality have changed between two generations of women living in Indigenous communities in Oaxaca. We conducted semi-structured in-depth interviews with 19 women from two generational cohorts in 12 communities. Comparison views of these two cohorts suggest that cultural gender norms continue to govern how women express and experience their sexuality. In particular, feelings of shame and fear permeate the expression of sexuality, virginity continues be a determinant of a woman's worth and motherhood remains the key attribute to womanhood. Evidence points to a transformation of norms, and access to information and services related to sexual health is increasing. Nonetheless, there is still a need for culturally appropriate sex education programmes focused on female empowerment, increased access to sexual health services, and a reduction in the stigma surrounding women's expressions of sexuality.