María Campos

This paper examines how alternative forms of organising integration in resource-scarce environments expand across settings, by considering the role of local embeddedness and an ethic of care in enabling this expansion. It builds on theories of imitation in organization studies in combination with theories of ethics of care and bricolage applied to welfare and migration studies. The paper is informed by the case of Yalla Trappan, a work cooperative of immigrant women in the city of Malmö, Sweden, and the attempts to diffuse this organization and its methods to other cities in the country. The findings indicate that the expansion of alternative forms of integration into resource-scarce contexts is enabled by simultaneous practices of imitation and bricolage, ingrained in an ethic of care. The article shows, first, how many important practices were developed by imitating accounts of the original ideas, through a broadcasting mode of imitation. Next, it explains why the local translation of these practices in resource-scarce contexts, consisting of ‘bricolage work’ based on material, market, institutional, human, and cultural elements, was necessary. The conclusion is that the expansion of novel forms of integration requires imitation, but of a kind that involves the bricolage of local translations. Such bricolage is always collective (which does not diminish the importance of individual agency), multi-spatial and not just local, and wrapped in an ethic of care, rather than in an economic logic. The article concludes by discussing the implications of these findings with the ethics of migration.

BackgroundResearch on prevalence of cognitive frailty phenotypes in community-dwelling older adults in different countries is important to estimate their prevalence and to determine the influence of cognitive reserve and mental health in order to prevent frailty. The aims of this study were to estimate the prevalence of reversible and potentially reversible cognitive frailty in a Portuguese sample of old adults and explore the associations between these phenotypes and demographic, comorbidity, social support, cognitive reserve and mental health factors.MethodsWe assessed frailty in 250 community-dwelling older adults aged 60 years or over without dementia, neurological or psychiatric disorders. Subjective cognitive decline and Mild cognitive impairment were diagnosed according to standard criteria. The questionnaires Charlson Index, Medical Outcomes Study Social Support, Cognitive Reserve Index and General Health were used for assessing comorbidity, social support, cognitive reserve and mental health, respectively.ResultsPrevalence of R-CF was 14%, and that of PR-CF, 15.2%. Cognitive frailty profiles differed significantly in relation to education, comorbidity, mental health, and cognitive reserve, but not in age or sex. Multivariate logistic regression showed that age, sex, comorbidity, social support, mental health, and cognitive reserve together predicted R-CF and PR-CF with significant OR for mental health and cognitive reserve.DiscussionCognitive reserve and mental health are important factors predicting R-CF and PR-CF. We recommend assessing these factors for early detection of cognitive frailty and promoting psychological well-being and lifestyles that increase cognitive reserve in adults.

Chronic pain affects a large part of the population causing functional disability, being often associated with coexisting psychological disorders, such as depression and anxiety, besides cognitive deficits, and sleep disturbance. The world elderly population has been growing over the last decades and the negative consequences of chronic pain for these individuals represent a current clinical challenge. The main painful complaints in the elderly are related to neurodegenerative and musculoskeletal conditions, peripheral vascular diseases, arthritis, and osteoarthritis, contributing toward poorly life quality, social isolation, impaired physical activity, and dependence to carry out daily activities. Organ dysfunction and other existing diseases can significantly affect the perception and responses to chronic pain in this group. It has been proposed that elderly people have an altered pain experience, with changes in pain processing mechanisms, which might be associated with the degeneration of circuits that modulate the descending inhibitory pathways of pain. Aging has also been linked to an increase in the pain threshold, a decline of painful sensations, and a decrease in pain tolerance. Still, elderly patients with chronic pain show an increased risk for dementia and cognitive impairment. The present review article is aimed to provide the state-of-art of pre-clinical and clinical research about chronic pain in elderly, emphasizing the altered mechanisms, comorbidities, challenges, and potential therapeutic alternatives.