Life Social Functioning Research Articles

Psychometric validation of the adapted Traditional Chinese version of the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ)

BackgroundLow back pain is a common health problem encountered by various populations among different countries. This prospective study aimed to translate and cross-culturally adapt the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) into Traditional Chinese and to assess its validity, reliability and sensitivity in Chinese patients experiencing low back pain. MethodsDouble forward and single back translation of the JOABPEQ was performed with cross-cultural adaptation. By convenience sampling, the final version of the translated JOABPEQ was administered to Chinese patients attending a specialty outpatient clinic with a history of back pain, followed by the traditional Chinese versions of Oswestry Disability Index (ODI) and Short Form-12 version 2 (SF-12v2). Construct validity of the domains were assessed using Spearman's correlation test. Internal consistency was assessed by Cronbach's alpha (α). Sensitivity of the adapted JOABPEQ was determined by known group comparisons. ResultsA total of 100 patients were recruited. The translated JOABPEQ demonstrated excellent overall internal consistency (α: 0.912); and good internal consistency for the domains of Lumbar Function, Walking Ability, Social Life Function and Mental Health (α: 0.811, 0.808, 0.788, and 0.827 respectively). Scores of all domains of the translated JOABPEQ had significant correlations (p < 0.01) with ODI at all domains, as well as with almost all domains of SF-12v2 (p < 0.01–0.05). The translated JOABPEQ was sensitive in detecting differences in patients with/without a history of previous spine surgery, and also between patients with acute/acute on chronic versus chronic pain in specific domains. ConclusionsThe Traditional Chinese version of JOABPEQ has satisfactory psychometric properties in general, including adequate clinical and construct validity, and internal consistency in assessing Southern-Chinese patients with low back pain. It is demonstrated as a sensitive outcome measure. The translated JOABPEQ is verified for its use in the local clinical setting for patient assessment and future research.

Cultural Preservation: Rediscovering the Endangered Oral Tradition of Maluku (A Case Study on Kapata of Central Maluku)

Language and culture are two aspects which interchange each other where the language is a medium to get information about the culture. As the product of language and culture, oral tradition plays a vital role in Maluku not only as the most powerful and sacred chant that regulate the life of people but also as the folk song that contains history, advice, and prayer. Kapata nowadays is assumed as the endangered oral traditions in Maluku. To rediscover the endangered oral traditions, descriptive qualitative research by using interview and library study in gaining the supporting information was implemented. Furthermore, this research was aimed (1) to figure out the history of Kapata and the way to preserve it (2) to map out the categories of Kapata and its function in social life, and (3) to elaborate the meaning of language expression conveyed in Kapata. Through this research, it is hoped that Kapata can be preserved by implementing it in formal education, art performance and framing in an advanced documentation so that all generations of Maluku are able to not only to recognize and make use it in social life as the way to preserve the Kapata as an endangered oral tradition.

Determination of minimally clinically important differences for JOABPEQ measure after discectomy in patients with lumbar disc herniation.

It is crucial to define if changes in patient-reported outcome (PRO) measure correspond to relevant clinical improvements. Aim of this study was to determine minimally clinically important differences (MCID) of the Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ) in patients with lumbar disc herniation (LDH) to assess surgical success. A total of 127 patients with LDH consecutively referred to our clinic were enrolled into this prospective study between March 2012 and August 2015. All participants completed the JOABPEQ and the Oswestry Disability Index (ODI) score before surgery, and at 1 year after surgery. Surgical success was defined based on clinical consensus of the team and be used as anchor. The MCID value of the JOABPEQ subscales were estimated using two anchor-based methods: (I) average change procedure (responsiveness); and (II) receiver operating characteristic (ROC) curve analysis. The mean age of patients was 51.2±9.4 years, and there were 68 (53.5%) male. A total of 83.5% (106 cases) showed improvement based on the clinical consensus of the spine surgeon team at last follow-up. To assess surgical success, the two MCID calculation methods generated two optimal prediction thresholds on the JOABPEQ subscales (low back pain: 19.1, 22.4; lumbar function: 21.3, 24.2; walking ability: 24.5, 27.9; social life function: 14.3, 17.1; and mental health: 12.8, 14.8) for ROC analysis and average change procedure, respectively (P<0.002 for all of subscales in two methods). For all five subscales, the sensitivity and specificity were between 61.2 and 81.1 with AUC greater than 0.70. These findings support the value of the MCID to assess surgical success for the JOABPEQ subscales in patients with LDH. This estimate may be a useful tool in clinical practice.

Transformation of socio-cultural aspect of gated housing’s residence in Medan City, Indonesia.

Gated Community Housing develops rapidly in Medan City and other big cities in Indonesia. These housing types initially reserved for middle to high-income residents. Transformation can describe as changes from one condition to another condition that can happen continuously in time. Change is affected by internal and external factors. Internal factors include culture, perspective, and social system while external factors include science progress and other cultural influence. This research is a descriptive study which tries to describe the phenomenon that is currently ongoing. Gated housing chosen are Perumahan Taman Setia Budi Indah, Perumahan Bumi Asri dan Perumahan Graha Helvetia. Characteristics of gated housing’s residents transform by the regional or national socioeconomic transformation. The structure and function of human social life are not uniform; meaning in every social life setting each of the structure and function are different. The characteristic of a community will transform in continuity.

Degenerative Lumbar Spondylolisthesis with Spinal Stenosis: A Comparative Study of 5-Year Outcomes Following Decompression with Fusion and Microendoscopic Decompression.

Study DesignRetrospective review of prospectively collected outcome data.PurposeTo compare 5-year outcomes following decompression with fusion (FU) and microendoscopic decompression (MED) in patients with degenerative lumbar spondylolisthesis (DLS) and to define surgical indication limitations regarding the use of MED for this condition.Overview of LiteratureThere have been no comparative studies on mid- or long-term outcomes following FU and MED for patients with DLS.MethodsForty-one consecutive patients with DLS were surgically treated. Sixteen patients first underwent FU (FU group), and 25 then underwent MED (MED group). The 5-year clinical outcomes following the two surgical methods were compared using the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire.ResultsThe degree of improvement (DOI) for social life function was significantly greater in the MED group than in the FU group. Although not statistically significant, DOIs for the other four functional scores were also greater in the MED group than in the FU group. However, patients with a large percentage of slippage in the neutral position might experience limited improvement in low back pain, those with a large percentage of slippage at maximal extension might experience limited improvement in three functional scores, and those with a small intervertebral angle at maximal flexion might have limited improvement in three functional scores after MED for DLS. Therefore, we statistically compared the DOIs between the FU and MED groups regarding the preoperative percentage of slippage in the neutral position among patients with greater than 20% slippage, the preoperative percentage of slippage at maximal extension among patients with greater than 15% slippage, and the intervertebral angle at flexion among patients with angles lesser than −5°; however, there were no statistically significant differences between the two groups.ConclusionsMED is a useful minimally invasive surgical procedure that possibly offers better clinical outcomes than FU for DLS.

＜Editors' Choice＞ Surgical outcomes of decompressive laminoplasty with spinous process osteotomy to treat lumbar spinal stenosis.

ABSTRACTDecompressive laminoplasty with spinous process osteotomy (LSPO) was developed as a less invasive procedure for lumbar decompression by Weiner et al. There are few reports extensively highlighting the surgical outcomes of LSPO. The purpose of this study was to evaluate the surgical outcomes of LSPO for lumbar spinal stenosis (LSS). In total, 23 patients with LSS were studied. All patients were followed up for more than 2 years. The Japanese Orthopedic Association (JOA) scores, the recovery rate (RR) of JOA scores, Visual analog scale (VAS) scores, responses to the JOA Back Pain Evaluation Questionnaire (JOABPEQ), sagittal alignment and segmental motion following LSPO were assessed preoperatively and 2 years postoperatively. Postoperative paravertebral muscle atrophy and bone union rates between the spinous process and the residual laminae were assessed. Preoperative and 2-year postoperative JOA scores were 13.0 points and 24.7 points, respectively (p<0.001). With respect to JOABPEQ, significant improvements were observed in pain-related disorders (p<0.05), walking ability (p<0.01), social life function (p<0.05), and mental health (p<0.05) dimensions. There were no significant differences between preoperative and 2-year postoperative sagittal alignment and range of motion. The degree of the paravertebral muscle atrophy at 2 years postoperatively was 23.0 % at spread side and 9.6 % at nonspread side (p<0.01). The fusion rate of the spinous process with the arcus vertebrae was 87%. This result reveals that LSPO could acquire the reconstruction of posterior supporting structures. We demonstrated that LSPO could be a one of the surgical options for LSS.

Comparing Places on Types of Internet Use

The analysis in this paper compares types of Internet use as reported in two places, North Carolina, U.S., North America, and Tolima, Colombia, South America. The Internet has changed the world and some basic functions of social life have become intricately linked to having access to and the ability to use the Internet. Yet, access to this important resource is not universal. Both of the places examined in this study have documented disparities in Internet access that produces a digital divide. With globalization, it is increasingly important to understand the advantages, and by default the disadvantages, that accompany the proliferation of the Internet. Using survey data collected from a random sample of citizens in each place, we compare types of Internet use and activities. Given the known differences of the digital divide, we select those with Internet access and focus on their types of use to understand the ways this resource is used by those who have it. This study contributes to the broader literature by focusing on Internet activities that transcend place and describes the most common ways people engage with the Internet.

Clinical Outcomes After Posterior Lumbar Interbody Fusion: Comparison of Cortical Bone Trajectory and Conventional Pedicle Screw Insertion.

This study is a retrospective cohort study using prospectively collected data. To compare the effectiveness of posterior lumbar interbody fusion (PLIF) using the cortical bone trajectory (CBT) and conventional pedicle screw (PS) techniques. There are few published studies to date comparing PLIF using CBT technique with PLIF using the conventional PS technique. We studied 119 consecutive patients who underwent single-level PLIF between 2010 and 2014 with a minimum 12-month follow-up. Forty-two patients underwent CBT-PLIF (the CBT group) and 77 underwent conventional PS-PLIF (the PS group). Clinical outcomes were assessed by the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) and visual analog scale (VAS). To assess perioperative pain, a 6-point Numeric Rating Scale score and the total amount of diclofenac sodium suppositories used were recorded. The operative time and blood loss were recorded. Muscle damage was evaluated by serum creatine kinase concentrations. Fusion status was evaluated using 3-dimensional computed tomography 12 months postoperatively. We used inverse probability of treatment weighting based on the propensity score to reduce confounding factors. There were no significant between-group differences in operative time or fusion rates, whereas the CBT group experienced significantly less blood loss, lower postoperative creatine kinase levels, less diclofenac sodium suppositories, and lower Numeric Rating Scale scores than the PS group did. The change in the JOABPEQ subdomain score for social life function 1 month postoperatively was the only significantly different factor among the JOABPEQ and VAS scores. Both procedures were comparable in terms of clinical outcomes and fusion rates, but CBT-PLIF provided the additional benefits of less blood loss, less intraoperative muscle damage, less perioperative pain, and earlier recovery to normal activities.

Epigenetic Regulation of the Kappa Opioid Receptor by Child Abuse

BackgroundExperiences of abuse and neglect during childhood are major predictors of the emergence of depressive and suicidal behaviors throughout life. The underlying biological mechanisms, however, remain poorly understood. Here, we focused on the opioid system as a potential brain substrate mediating these effects. MethodsPostmortem samples from three brain structures regulating social bonds and emotions were analyzed. Groups were constituted of depressed individuals who died by suicide, with or without a history of severe child abuse, and of psychiatrically healthy control subjects. Expression of opioid peptides and receptors was measured using real-time polymerase chain reaction. DNA methylation, a major epigenetic mark, was investigated using targeted bisulfite sequencing and characterized at functional level using in vitro reporter assays. Finally, oxidative bisulfite sequencing was used to differentiate methylation and hydroxymethylation of DNA. ResultsA history of child abuse specifically associated in the anterior insula with a downregulation of the kappa opioid receptor (Kappa), as well as decreased DNA methylation in the second intron of the Kappa gene. In vitro assays further showed that this intron functions as a genomic enhancer where glucocorticoid receptor binding regulates Kappa expression, unraveling a new mechanism mediating the well-established interactions between endogenous opioids and stress. Finally, results showed that child abuse is associated in the Kappa intron with a selective reduction in levels of DNA hydroxymethylation, likely mediating the observed downregulation of the receptor. ConclusionsAltogether, our findings uncover new facets of Kappa physiology, whereby this receptor may be epigenetically regulated by stressful experiences, in particular as a function of early social life.

ANALISIS LAHAN KRITIS DAN ARAHAN REHABILITASI LAHAN DALAM PENGEMBANGAN WILAYAH KABUPATEN KENDAL JAWA TENGAH

The impact of critical land create reduction quality of soil characteristics, which can interfere with the function of conservation, production, economic, and social life of the community. The objectives of this research are to analyzing and mapping of critical land, reviewing relevance of critical land distribution to the spatial pattern and making direction of rehabilitation in regional development in Kendal. The analytical methode which is used in this study were selecting parameters of critical land and overlay using GIS to map the distribution of critical land. The result of this research is the critical land area in modification parameter is 34.317,87 ha, and parameter of P. 4/V-Set/2013 is 19.535,96 ha. General direction for land rehabilitation is vegetative conservation activity and technical civil conservation for erosion and sedimentation control. Direction for regional development in forest area is to develop PHBM through activity of agroforestry, community forest, ecotourism and medicinal plant cultivation in the forest. Direction on the farm cultivation area, especially on abandoned land and yards, is by optimization of community forest, by planting activities using perennials plant, MTPS and fruits plant, to control critical land, soil conservation and water management as well as increase community incomes by selling products from community forests.

Characteristics and Changes in Health Status and Life Function among Female Elderly Participants of Group Exercise.

The purpose of this study was to clarify the characteristics of female elderly participants of a group exercise organized by the participants themselves and the changes in their physical, mental, and social health, and life function. Findings of this study will be used for promoting effective preventive care. The subjects whose characteristics were analyzed were 394 participants and 757 nonparticipants of the group exercise. Those whose changes in health were analyzed were 52 participants and 114 nonparticipants. Locomotion Check and self-rated health score were used as indices of physical health. World Health Organization-Five well-being (S-WHO-5-J) index and self-rated life satisfaction level were used as indices of mental health. Satisfaction level of social activities was one of indices of social health. The Tokyo Metropolitan Institute of Gerontology Index of Competence was used as an index of life function. The health-examination data analyzed were Body Mass Index, waist circumference, blood pressure, lipid profiles, and HbA1c level. In the participant group, the proportions of those who lived alone, who were affluent, and who had no job were higher than those in the nonparticipant group. The indices of physical, mental and social health and life function were higher in the participant group. There was no significant difference in the 5-year trend of health-examination data between the two groups. There was no significant difference in the yearly change in the indices of physical health and life function. The S-WHO-5-J index, self-rated life satisfaction level, and satisfaction level of social activities were maintained or improved in the participant group. The results suggest the possible usefulness of the group exercise for maintaining the mental and social health of elderly women.

Patient-centered quality of life measures after alloplastic temporomandibular joint replacement surgery

The purpose of this study was to evaluate patient-reported outcome measures of quality of life (QoL) for patients with end-stage temporomandibular joint (TMJ) disease who have undergone TMJ prosthetic replacement. The records of 36 patients who had undergone alloplastic total joint replacement procedures were analyzed. Patients were treated using either TMJ Concepts or Biomet/Lorenz prosthetics. Patients were asked to complete a 12-item TMJ-S-QoL survey, which encompassed questions pertaining to pain, speech, chewing function, and various aspects of social life and mental health. The questions were answered on a 5-point scale. Data were analyzed using the Wilcoxon signed-rank test. Among the 36 patients (six male and 30 female), 18 responded to the survey. Markers of QoL after surgery were compared to the preoperative period. Significant improvements were reported for pain (94.4% of patients), chewing (83.3% of patients), speech (55.6% of patients), anxiety (72.2% of patients), activity (66.7% of patients), recreation (61.1% of patients), and mood (66.7% of patients) (all P<0.05). TMJ prosthetic replacement significantly enhanced QoL among patients suffering from chronic pain, limited range of motion, anxiety, impaired speech, and chewing due to end-stage TMJ disease in this sample of surgical patients.

ANALISIS LAHAN KRITIS DAN ARAHAN REHABILITASI LAHAN DALAM PENGEMBANGAN WILAYAH KABUPATEN KENDAL JAWA TENGAH

&lt;div&gt;&lt;p class="AbstractEnglish"&gt;The impact of critical land create reduction quality of soil characteristics, which can interfere with the function of conservation, production, economic, and social life of the community. The objectives of this research are to analyzing and mapping of critical land, reviewing relevance of critical land distribution to the spatial pattern and making direction of rehabilitation in regional development in Kendal. The analytical methode which is used in this study were selecting parameters of critical land and overlay using GIS to map the distribution of critical land. The result of this research is the critical land area in modification parameter is 34.317,87 ha, and parameter of P. 4/V-Set/2013 is 19.535,96 ha. General direction for land rehabilitation is vegetative conservation activity and technical civil conservation for erosion and sedimentation control. Direction for regional development in forest area is to develop PHBM through activity of agroforestry, community forest, ecotourism and medicinal plant cultivation in the forest. Direction on the farm cultivation area, especially on abandoned land and yards, is by optimization of community forest, by planting activities using perennials plant, MTPS and fruits plant, to control critical land, soil conservation and water management as well as increase community incomes by selling products from community forests.&lt;/p&gt;&lt;/div&gt;

Clinical Correlates Associated with Basic Ability of Social Life in Schizophrenia Inpatients

Objective: The aim of the present study is to explore clinical factors associated with basic ability of social life in schizophrenia inpatients. Methods: The subjects were 50 inpatients with schizophrenia (DSM-IV). Their mean age was 53.08 (SD = 12.08) years. Social life functioning was evaluated using the Rehabilitation Evaluation of Hall and Baker (REHAB). Cognitive function was assessed with the Brief Assessment of Cognition in Schizophrenia (BACS) and clinical symptoms with the Positive and Negative Syndrome Scale (PANSS), the Calgary Depression Scale for Schizophrenia and the Drug-Induced Extrapyramidal Symptoms Scale (DIEPSS). Results: The REHAB deviant behavior score showed a significant correlation with the PANSS positive syndrome score (r = 0.55, p < 0.01) and the REHAB general behavior score had significant correlations with the PANSS positive syndrome score (r = 0.28, p < 0.05), the PANSS negative syndrome score (r = 0.53, p < 0.01), and the DIEPSS score (r = 0.43, p < 0.01). However, there was no significant correlation between the scores of the REHAB and the BACS. Conclusion: These results suggest that negative and drug-induced extrapyramidal symptoms are much more important factors related to lowered basic ability of social life of schizophrenia inpatients than cognitive function.

Bipolar disorder and self-stigma: A comparison with schizophrenia

AimEven though numerous studies have focused on the effects of self-stigma on patients with schizophrenia, little is known about self-stigma of patients with bipolar disorder (BD). In this study, a self-administered scale of self-stigmatising attitudes of patients with BD and schizophrenia was used to explore these attitudes, examine the potential differences between the two groups and study the factors that influence stigma within groups. MethodsSelf-stigma of 120 patients with schizophrenia and BD was assessed with the Self-stigma Questionnaire (SSQ) and the Stigma Inventory for Mental Illness (SIMI). Presence of clinical symptoms, overall functioning and level of self-esteem were also evaluated. ResultsSelf-stigma is present in both groups but differs in its intensity. Patients with BD experience self-stigma in a lesser degree without affecting their social life or overall functioning. Patients with schizophrenia adopt more intense self-stigmatising attitudes leading to social exclusion and lower level of overall functioning. LimitationsThe results are limited by the small sample size, whereas the inclusion of other questionnaires would broaden our insight to self-stigma. ConclusionsSelf-stigma has a direct effect on overall functioning of patients with BD and schizophrenia tampering the clinical outcome of therapeutic interventions. Therefore, it should be incorporated in every treatment plan and be addressed as a clinical symptom of the mental illness.

The Intestinal Gas Questionnaire: development of a new instrument for measuring gas‐related symptoms and their impact on daily life

Although gas-related symptoms (GRS) are common and intrusive, there are no questionnaires to quantitate this problem. This study aimed to develop an instrument to rectify this gap in our knowledge. Concepts were initially identified from the literature and interviews with gastroenterologists. Exploratory one-to-one interviews and focus groups with irritable bowel syndrome (IBS) patients (n = 28) and non-IBS subjects (n = 27) with GRS were conducted in UK, France, and Spain leading to a conceptual framework for the questionnaire. Last, iterative rounds of cognitive debriefing were performed with IBS (n = 16) and non-IBS subjects (n = 14). From the first three steps, nine GRS (bloating, distension, flatulence, odorous flatulence, difficult gas evacuation, stomach rumbling, belching, bad breath, and abdominal movement) were identified although abdominal movement was subsequently excluded. Twelve quality of life domains affected by these symptoms were identified as: Clothing, emotional, physical appearance, diet, daily living, work, social life, physical activity, relationships, sex life, sleep, and cognitive function. A 24-h recall for symptoms and a 7-day recall for impact assessment were supported by the qualitative findings. Cognitive debriefing confirmed the understanding of the instrument. Across the three languages, the instrument was conceptually and linguistically consistent. The International Gas Questionnaire is a 2-part instrument, developed rigorously and simultaneously in three languages assessing seven symptoms (17 items) and their impact on 12 domains (26 items) in IBS and general population. It is now undergoing psychometric validation and should provide a unique tool for epidemiological surveys and clinical trials for developing new treatments for these symptoms.

Особливості використання форсайту в передбаченні та розв’язанні проблем у соціальній сфері

The ability of science to generate knowledge of advanced nature is a pre-condition to avoid undesirable social problems in the future. The newest method, which is actively used in the prediction of constructive scenarios and functioning of social life is foresight. As Ukrainian society faces a number of challenges, there is a need for large-scale researches, which assistance determine critical points that could have negative consequences for social life. Most social problems are derived from structural problems, which are defined as basal, as they encourage the actualization of unit the fans derivative social destructions: social anomie, social exclusion, identity crisis, ideological contradiction, virtualization of reality. For their over-coming it is necessary to initiate general social discussions that results in the formation of the desired scenarios of the future state of social systems and identify key technologies aimed at resolving social distortions both at the current situation and for overcoming social problems, the likelihood of which is high enough.

Reason with me : 'Confabulation' and interpersonal moral reasoning

According to Haidt’s ‘social intuitionist model’, empirical moral psychology supports the following conclusion: intuition comes first, strategic reasoning second. Critics have responded by arguing that intuitions can depend on non-conscious reasons, that not being able to articulate one’s reasons does not entail not being responsive to reasons, and that the relations between intuitions and reasoning can be truth-tracking and principled in ways overlooked by Haidt. This debate involves a false dichotomy: that either reasoning is truth-tracking, or else our reasoning is purely strategic and manipulative in nature. Reason-giving also, I argue, performs other important functions in moral and social life. A robust willingness to offer reasons in favour of our convictions is itself a virtue we seek and appreciate in others. Others’ willingness to reason with us is itself a good we enjoy at their hands, or that they confer upon us. What we give each other in being willing and determined to reason together is, among other things, respect for, and good-will towards, each other.

Self-perceived oral function and factors influencing oral health of elderly residents in Bengaluru city, India

Context: Oral health status plays an import role in patient quality of life, affecting mental, physical, and psychological wellbeing and complete social development by interfering with word pronunciation, social life, and alimentary function. Aims: To evaluate self-perception of elderly about the effect of oral health on quality of life using the geriatric oral health assessment index (GOHAI) index. Settings and Design: A cross-sectional study was carried out among 376, elderly individuals aged 60 years and above, residing in residential homes of Bengaluru city. Materials and Methods: The data were collected using GOHAI scale comprising of 12 items to measure the patient-perceived oral functional problems. In addition, a self-reported questionnaire was used to elicit demographic information. Statistical Analysis Used: A descriptive statistics along with Chi-square test was used. Results: Out of 407 individuals, only 376 fulfilled the inclusion criteria and constituted the final number of the participants. GOHAI was statistically significant with age (0.036*), gender (0.045*), dentition status (0.019*), and smoking status (0.042*), which showed a predictor for low oral health functional status. A majority of the subjects (66.1%) were always unhappy with their appearance of their teeth gums or dentures and 74.5% of the subjects were always concerned about their problems with their teeth, gums, or denture. Conclusions: The GOHAI final score was considered low, indicating a low self-perception by the elders of Indian residential homes.

Brokerage in Cross-Border Mobility: Social Mechanisms and the (Re)Production of Social Inequalities

Brokerage is an essential yet understudied function in social life. In one of the classics in the field of sociology, Georg Simmel differentiated three types of the “third” which help to analyse brokerage: the disinterested mediator or arbitrator, &lt;em&gt;tertius gaudens&lt;/em&gt; and &lt;em&gt;divide et impera&lt;/em&gt;. Studies that conceptualise traffickers and smugglers as brokers are extremely rare. Scholars lack a typology which can serve as a basis for comparative research. To advance scholarship on brokerage this article seeks to develop a conceptual-typological matrix by setting out to explore three questions: Why does brokerage exist? What kind of social mechanism is brokerage? What are the implications of brokerage for social inequalities and equalities? The analysis concludes with the consequences of different types of brokerage for the (re)production of social inequalities.