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Background: The association between appendectomy and multiple sclerosis (MS) is unknown. In this study, we explored the association between appendectomy and MS and neuromyelitis optica spectrum disorder (NMOSD).Patients and Methods: MS and NMOSD patients older than 40 were identified from neurology records from hospitals in Malaysia. The diagnoses were based on the Revised McDonald (2010) and Wingerchuk (2015) criteria. Controls were sampled from Malaysia's normal population. Individuals were interviewed telephonically or face-to-face. The age inclusion criterion (over 40) differentiated high or low lifetime risk of appendicitis, as appendicitis incidence is rare after 40.Results: 49 MS, 71 NMOSD, and 880 controls met the inclusion criteria. Seventy-two individuals (9 MS, 4 NMOSD, 59 control) had undergone appendectomy. Appendectomy rates were 18.37% in the MS group (95% CI 7.5-29.2%), 5.6% in the NMOSD group (0.3%, 11%), and 6.7% among controls (5.1%, 8.4%), (MS vs NMOSD P = 0.036, MS vs controls P = 0.007). Binary regression analysis showed that MS was an independent risk factor for appendectomy (OR 2.938, 95% CI 1.302, 6.633, P = 0.009). NMOSD showed no association with appendectomy.Conclusion: MS is positively associated with appendectomy, unlike ulcerative colitis, which is negatively associated. We hypothesize that there is a commonality in the microflora in persons who have had these two illnesses. [ABSTRACT FROM AUTHOR]

Video-based person re-identification (ReID) aims to exploit relevant features from spatial and temporal knowledge. Widely used methods include the part- and attention-based approaches for suppressing irrelevant spatial–temporal features. However, it is still challenging to overcome inconsistencies across video frames due to occlusion and imperfect detection. These mismatches make temporal processing ineffective and create an imbalance of crucial spatial information. To address these problems, we propose the Spatiotemporal Multi-Granularity Aggregation (ST-MGA) method, which is specifically designed to accumulate relevant features with spatiotemporally consistent cues. The proposed framework consists of three main stages: extraction, which extracts spatiotemporally consistent partial information; augmentation, which augments the partial information with different granularity levels; and aggregation, which effectively aggregates the augmented spatiotemporal information. We first introduce the consistent part-attention (CPA) module, which extracts spatiotemporally consistent and well-aligned attentive parts. Sub-parts derived from CPA provide temporally consistent semantic information, solving misalignment problems in videos due to occlusion or inaccurate detection, and maximize the efficiency of aggregation through uniform partial information. To enhance the diversity of spatial and temporal cues, we introduce the Multi-Attention Part Augmentation (MA-PA) block, which incorporates fine parts at various granular levels, and the Long-/Short-term Temporal Augmentation (LS-TA) block, designed to capture both long- and short-term temporal relations. Using densely separated part cues, ST-MGA fully exploits and aggregates the spatiotemporal multi-granular patterns by comparing relations between parts and scales. In the experiments, the proposed ST-MGA renders state-of-the-art performance on several video-based ReID benchmarks (i.e., MARS, DukeMTMC-VideoReID, and LS-VID).

Abstract Diabetes Mellitus is a worldwide metabolic disease and becomes a challenge for the health practitioner. Unfortunately, less than half of these diabetic individuals are aware of their conditions, and less than 1% of those receiving medical treatment achieve their therapeutic targets. Acupressure is an alternative method that is believed to be an effective way of treating diabetic patients with reducing symptoms and complications. This research aims to discover the effect of period acupressure therapy on blood sugar levels in type two diabetes mellitus patients in Lumajang Acupressure Clinic. It uses an observational analytic design with pre-test and post-test approach. It involved 36 participants who were split into two groups and contained 18 participants for each group. The first group received acupressure therapy for three weeks, while the second group received eight weeks. Both groups underwent acupressure at the San Yin Jiao (SP-6) acupoint for 20 minutes three times a week. All participants in both groups had their blood glucose checked before and after acupressure therapy. The results showed that the two groups were significantly different for the paired t-test and the independent t-test. The acupressure therapy period has an effect on decreasing blood sugar levels in type two diabetes mellitus patients at Lumajang acupressure clinic. Keywords : Acupressure, the period of therapy, blood glucose level, type two diabetes mellitus Correspondence : Anungputri113@gmail.com

There is increasing interest in the theoretical underpinning of interprofessional education (IPE) and writers in this field are drawing on a wide range of disciplines for theories that have utility in IPE.While this has undoubtedly enriched the research literature, for the educational practitioner, whose aim is to develop and deliver an IPE curriculum that has sound theoretical underpinnings, this plethora of theories has become a confusing, and un-navigable quagmire. This article aims to provide a compass for those educational practitioners by presenting a framework that summarizes key learning theories used in IPE and the relationship between them. The study reviews key contemporary learning theories from the wider field of education used in IPE and the explicit applications of these theories in the IPE literature to either curriculum design or programme evaluation. Through presenting a broad overview and summary framework, the study clarifies the way in which learning theories can aid IPE curriculum development and evaluation. It also highlights areas where future theoretical development in the IPE field is required. [ABSTRACT FROM AUTHOR]

Context: Millions of Cambodians suffered profound trauma during the Khmer Rouge era (1975 to 1979). A joint United Nations-Cambodian tribunal (the "Khmer Rouge trials") was empanelled in 2006 to prosecute top Khmer Rouge leaders and began substantive hearings in March 2009.Objectives: To establish the prevalence of probable posttraumatic stress disorder (PTSD) among adult Cambodians and to assess correlates of PTSD symptoms and disability with perceived justice, desire for revenge, and knowledge of and attitudes toward the trials.Design, Setting, and Participants: A national probability sample of 1017 Cambodians was assembled using a multistage, stratified cluster design, including 813 adults older than 35 years who had been at least 3 years old during the Khmer Rouge era and 204 adults aged 18 to 35 years who had not been exposed to the Khmer Rouge era. Face-to-face interviews were conducted between December 2006 and August 2007.Main Outcome Measures: Prevalence of probable PTSD using the PTSD Checklist, Civilian version (cutoff score of 44), and mental and physical disability using the Medical Outcomes Study 12-item Short Form Health Survey.Results: The prevalence of current probable PTSD was 11.2% (95% confidence interval [CI], 8.6%-13.9%) overall and 7.9% (95% CI, 3.8%-12.0%) among the younger group and 14.2% (95% CI, 11.0%-17.3%) in the older group. Probable PTSD was significantly associated with mental disability (40.2% vs 7.9%; adjusted odds ratio [AOR], 7.80; 95% CI, 3.90-15.60) and physical disability (39.6% vs 20.1%; AOR, 2.60; 95% CI, 1.26-5.39). Although Cambodians were hopeful that the trials would promote justice, 87.2% (n = 681) of those older than 35 years believed that the trials would create painful memories for them. In multivariate analysis, respondents with high levels of perceived justice for violations during the Khmer Rouge era were less likely to have probable PTSD than those with low levels (7.4% vs 12.7%; AOR, 0.54; 95% CI, 0.34-0.86). Respondents with high levels of desire for revenge were more likely to have probable PTSD than those with low levels (12.0% vs 7.2%), but the difference was not statistically significant in the multivariate analysis (AOR, 1.76; 95% CI, 0.99-3.11).Conclusions: Probable PTSD is common and associated with disability in Cambodia. Although Cambodians had positive attitudes toward the trials, most were concerned that the trials would bring back painful memories. Now that the trials have begun, longitudinal research is needed to determine the impact of the trials on Cambodians' mental health. [ABSTRACT FROM AUTHOR]

Multi-person pose estimation has been gaining considerable interest due to its use in several real-world applications, such as activity recognition, motion capture, and augmented reality. Although the improvement of the accuracy and speed of multi-person pose estimation techniques has been recently studied, limitations still exist in balancing these two aspects. In this paper, a novel knowledge distilled lightweight top-down pose network (KDLPN) is proposed that balances computational complexity and accuracy. For the first time in multi-person pose estimation, a network that reduces computational complexity by applying a “Pelee” structure and shuffles pixels in the dense upsampling convolution layer to reduce the number of channels is presented. Furthermore, to prevent performance degradation because of the reduced computational complexity, knowledge distillation is applied to establish the pose estimation network as a teacher network. The method performance is evaluated on the MSCOCO dataset. Experimental results demonstrate that our KDLPN network significantly reduces 95% of the parameters required by state-of-the-art methods with minimal performance degradation. Moreover, our method is compared with other pose estimation methods to substantiate the importance of computational complexity reduction and its effectiveness.

This paper describes the curriculum model developed for an ambitious interprofessional education programme for health and social care professions implemented in two universities in the south of England (the New Generation Project). An outline of how the New Generation Project has interpreted the meaning of interprofessional learning is presented first. This is followed by an outline of the structure of the programme, describing both learning in common and interprofessional learning components. The pedagogies underpinning this curriculum initiative are presented and an integrated pedagogical model, facilitated collaborative interprofessional learning, is proposed. The New Generation Project curriculum is then discussed as an extension of an established typology of interprofessional education. [ABSTRACT FROM AUTHOR]

Social capital has become a popular term over the past two decades amongst researchers, policy makers and practitioners from varied disciplines. This popularity, however, has resulted in a great deal of confusion over the nature and application of social capital in different contexts. This confusion has made it difficult to identify and measure social capital within the evaluation of specific social and health programmes, one of the aims of which may be to stimulate social capital. This paper identifies a theoretical model that seeks to capture the dynamic nature of social capital to assist in the development of research methods that will facilitate its measurement and exploration within such programmes. The model reported in the paper identifies the key components of social capital and expresses the relationship between those components in a dynamic system based on Marx's description of the process of capital (economic) exchanges expressed in the M-C-M' cycle. The M-C-M' cycle is the transformation of money (M) into commodities (C), and the change of commodities back again into money (M') of altered value. The emphasis within the paper is on the capital element of the concept and its transactional nature with the aim of avoiding the pitfall of attributing social capital in relation to social behaviours in isolation of context and interaction. Importantly, the paper seeks to distinguish the central elements of social capital from some of the antecedent factors and outcomes often attributed to and confused with social capital adding to the problem of providing valid measurement. The model is presented as the basis for the measurement of social capital within a transactional process involving the investment of social resources in a cyclical process, which may result in net gains or losses. This process is described as the R-C-R' cycle following Marx's model of economic capital, with the focus being on the transfer of social resources (R) rather than money (M). R represents an internal resource held by individuals, C the external resource or commodity they obtain from the network and the R' the internal resource of altered value. The possibilities of the model in assisting in the measurement of social capital specifically in assessing formal networks are explored. [ABSTRACT FROM AUTHOR]

Background: Caring for children with disabilities in Tanzania involves significant challenges, including stigma, limited support and mental health risks. A cultural collective for caretakers of children with disabilities enrolled at a primary school was established to address these issues., Objectives: The study aims to explore the experiences of caregivers who started a cultural collective and to assess its impact on their lives in the short term., Method: This study used a community-based participatory research (CBPR) approach with a sequential mixed-methods design. Data were collected over a period of 8 weeks, while the participants in this study established a collective in Dar es Salaam. Quantitative data were analysed using descriptive statistics, and qualitative data were analysed using Braun and Clarke's method for thematic analysis., Results: As assessed by a validated and normed questionnaire, Patient Health Questionnaire-9 (PHQ-9), 63% of the caregivers showed signs of depression before starting work in the collective. Economic needs, education and the desire for support were the primary motivations for joining. Starting the collective improved social support, fostered agency and began to enhance caregivers' financial conditions., Conclusion: The collective addressed caregivers' needs for economic improvement, social support and mental support, and the experience was vitalising for the caretakers., Contribution: This study deepens our understanding of holistic interventions for children with disabilities and their families in urban Africa. It offers valuable insights into a crucial stage of developing contextually relevant interventions for vulnerable, poverty-stricken populations. It provides a model that can be adapted for similar interventions in comparable contexts., Competing Interests: The authors declare that they have no financial or personal relationships that may have inappropriately influenced them in writing this article., (© 2024. The Authors.)

Purpose: Interprofessional collaboration is necessary for handling the complex psychosocial needs of prisoners. This collaboration must be addressed to avoid high recidivism rates and the human and societal costs linked to them. Challenges are exacerbated by a linear approach to handling prisoners' problems, silo working between welfare agencies and professional boundaries between frontline workers. There are few adequate theoretical frameworks and tools to address these challenges in the prison context. The purpose of this study is to explore the perceptions that frontline staff working in Norwegian prison facilities have regarding interprofessional collaboration in providing mental health services for prisoners., Design/methodology/approach: This study had a non-experimental, cross-sectional design to explore perceptions of interprofessional collaboration in a prison context. Descriptive and multifactorial analyses (exploratory factor analysis and confirmatory factor analysis) were used to explore the data., Findings: The analysis showed that three factors, communication, organizational culture and domain, explained 95% of the variance. Results are discussed using relational coordination, as well as the conceptual PINCOM model, as a theoretical framework., Originality/value: Few studies explicitly explore collaboration between professionals in mental health and prison services despite its being a prerequisite to achieving sufficient services for prisoners. To our knowledge, this current study is one of the first in Norway to explore collaboration in a prison context by analysing quantitative data and focusing on frontline workers perception of the phenomenon., (© Emerald Publishing Limited.)

Reoffending rates may be reduced through efforts to rehabilitate prisoners. A more nuanced understanding is needed of how front-line prison and health care services collaborate during the rehabilitation process. We report an investigation of the organizational dynamics of interprofessional practice among prison, mental health, and welfare services in two Norwegian prison case studies. First, a high security (closed) prison where a coordination network was implemented among prison management, front-line staff, and external service personnel to enhance the prisoners' life management skills. Second, an (open) transitional residence, where interprofessional practice was facilitated by front-line prison staff to increase prisoners' ability to reintegrate into society through their socialization and access to external services. The study demonstrates the demands on prisoners as they move from passive service receivers to active service users/organizer, and how interprofessional practice and models of service integration support them in this process.

Patients with dental phobia or a history of trauma tend to avoid dental services, which may, over time, lead to poor oral health. In Norway, a specific service targets these patients by providing exposure therapy to treat their fear of attendance and subsequently enable oral restoration. Dental practitioners deliver the exposure therapy, which requires a role change that deviates from their traditional practice. This paper explores how - and under what circumstances - dental practitioners manage this new role of alleviating dental anxiety for patients with a history of trauma or dental phobia. Using a realist evaluation approach, this paper develops theory describing which contexts promote mechanisms that allow practitioners to alleviate dental anxiety for patients with trauma or dental phobia. A multi-method approach, comprising service documents (n = 13) and stakeholder interviews (n = 12), was applied. The data were then analysed through a content analysis and context-mechanism-outcome heuristic tool. Our findings reveal that dental practitioners must adopt roles that enable trust, a safe space, and gradual desensitisation of the patient to their fear triggers. Adopting these roles requires time and resources to develop practitioners' skills - enabling them to adopt an appropriate communication style and exposure pace for each patient., (© 2021 The Authors. European Journal of Oral Sciences published by John Wiley & Sons Ltd on behalf of Scandinavian Division of the International Association for Dental Research.)

In Parkinson's disease (PD), the second most common neurodegenerative disorder, non-motor symptoms often precede the development of debilitating motor symptoms and present a severe impact on the quality of life. Lewy bodies containing misfolded α-synuclein progressively develop in neurons throughout the peripheral and central nervous system, which may be correlated with the early development of non-motor symptoms. Among those, increased fear and anxiety is frequent in PD and thought to result from pathology outside the dopaminergic system, which has been the focus of symptomatic treatment to alleviate motor symptoms. Alpha-synuclein accumulation has been reported in the amygdala of PD patients, a brain region critically involved in fear and anxiety. Here we asked whether α-synuclein overexpression alone is sufficient to induce an enhanced fear phenotype in vivo and which pathological mechanisms are involved. Transgenic mice expressing human wild-type α-synuclein (Thy1-aSyn), a well-established model of PD, were subjected to fear conditioning followed by extinction and then tested for extinction memory retention followed by histopathological analysis. Thy1-aSyn mice showed enhanced tone fear across acquisition and extinction compared to wild-type littermates, as well as a trend to less retention of fear extinction. Immunohistochemical analysis of the basolateral nucleus of the amygdala, a nucleus critically involved in tone fear learning, revealed extensive α-synuclein pathology, with accumulation, phosphorylation, and aggregation of α-synuclein in transgenic mice. This pathology was accompanied by microgliosis and parvalbumin neuron loss in this nucleus, which could explain the enhanced fear phenotype. Importantly, this non-motor phenotype was detected in the pre-clinical phase, prior to dopamine loss in Thy1-aSyn mice, thus replicating observations in patients. Results obtained in this study suggest a possible mechanism by which increased anxiety and maladaptive fear processing may occur in PD, opening a door for therapeutic options and further early biomarker research., (Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)

Introduction: Hepatitis B virus (HBV) infection disproportionately affects the Hmong ethnic group, with reported US prevalence rates up to 20%, but data for Wisconsin's large Hmong community is lacking. We assessed the prevalence of HBV at Hmong screening events and whether small-group counseling affects HBV knowledge., Methods: Free HBV screening events were held in Milwaukee, Wisconsin at a Hmong market, a local church, and annual Hmong New Year festival. Eligible Hmong subjects age 18 years and older also were invited to complete a 15-point survey on HBV knowledge at baseline and after education sessions. Hmong interpreters were available, and free HBV screening was offered., Results: A total of 187 participants were tested for HBV, and 161 completed surveys. After education sessions, the mean knowledge score rose to 10.6 (71%) vs the pre-education score of 6.7 (45%) ( P  <0.0001). Active HBV [HBsAg(+) HBsAb(-)] was diagnosed in 18 participants (9.6%), 53 (28.3%) were susceptible [HBsAg(-) and HBsAb(-)], 5 (3.4%) were in the gray zone [HBsAg(-) with low/inadequate HBsAb(+) titer], and the remaining 110 (58.8%) were immune [HBsAg(-)/HBsAb(+)]. Of the 18 individuals with active HBV, 13 were male and 5 were female [age range 24-66]., Conclusion: Despite evidence that small-group education with visual aids is effective in enhancing HBV knowledge in the Hmong population, a significant knowledge gap remained on post-education scores, suggesting that better tools or repeated interventions may be warranted. While we acknowledge that this convenience sampling may have introduced biases, the rate of active HBV infection in Wisconsin is much higher than general US population reports, and a quarter of those tested were found to be susceptible to HBV., (Copyright© Board of Regents of the University of Wisconsin System and The Medical College of Wisconsin, Inc.)

Purpose: Many offenders struggle when attempting to reintegrate into society after release from prison, and the conditions they face after release often lead to reoffending. The purpose of this paper is to present a conceptual model on reintegration after prison. The model has the potential to guide practitioners in their understanding of the relationships between welfare services and the agency of the offender., Design/methodology/approach: The model was developed from a small-scale study in the Norwegian Criminal Justice system, which is well known for its emphasis on rehabilitation and crime prevention. Data collection aimed to explore the reintegration process from the perspective of the hard-to-reach and vulnerable population of serial offenders. Nine prisoners in two different prisons were interviewed. A thematic analysis identified two main themes that related, first, to the personal challenges the offenders faced in the rehabilitation and reintegration process and, second, to the factors in the welfare services that interacted with the prisoners' psychosocial issues in the reintegration process., Findings: Findings suggest that the interaction between the psychosocial needs of the prisoners and the organization of the welfare services is complex and does not harmonize. The findings underpin the argument that the current reintegration strategies for certain groups of inmates need to be questioned and challenged., Research Limitations/implications: The model is a conceptual model intended to provide a lens from which to reinterpret offenders' experiences of reintegration and applied to only the small and exploratory study described in this paper. As such, it requires further testing and substantiation, and the model and the study's findings should be regarded as tentative and cannot be generalized to a larger population. The prisoners were selected by the first author for convenience, and it is possible that this also influenced the findings. Other inmates may have presented other experiences., Originality/value: There are few studies looking into reintegration from the reoffenders' perspective, and this study also presents a model that serves as a reflective and analytical tool to developing new approaches to supporting offenders in their reintegration into society from prison in the future.

Aims and Objectives: To present a new etemic model of vulnerability., Background: Despite vulnerability being identified as a core consequence of health and health experiences, there has been little research exploring the meaning of vulnerability as a concept. Yet, being vulnerable is known to have dire physical/mental health consequences. It is therefore a fundamental issue for nurses to address. To date, the meaning of the term vulnerability has been influenced by the work of Spiers (Journal of Advanced Nursing, 31, 2000, 715, The Essential Concepts of Nursing: Building Blocks for Practice, 2005, Elsevier, London). Spiers identified two aspects of vulnerability: the etic (external judgment of another persons' vulnerability) and the emic (internal lived experience of vulnerability). This approach has led to a plethora of research which has explored the etic (external judgment) of vulnerability and rendered the internal lived (or emic) experience invisible. Consequences of this, for marginalised communities such as Gypsy Roma Travellers include a lack of culturally sensitive services compounding health inequalities., Design: Position paper., Method: Drawing upon a qualitative phenomenological research study exploring the lived experience of vulnerability from a Gypsy Roma Travelling community (published previously), this paper presents a new model of vulnerability. This etemic model of vulnerability values both external and internal dimensions of vulnerability and argues for a fusion of these two opposing perspectives., Conclusions: If nurses and other health- and social care professionals wish to develop practice that is successful in engaging with Gypsy Roma Travellers, then there is a need to both understand and respect their community. This can be achieved through an etemic approach to understanding their vulnerability achieved by eliciting lived experience alongside the appreciation of epidemiological studies., Relevance to Clinical Practice: If nurses and health practitioners used this etemic approach to practice then it would enable both the development and delivery of culturally sensitive services facilitating health access to this community. Only then, will their poor health status be successfully addressed., (© 2016 John Wiley & Sons Ltd.)

Purpose Effective collaboration between mental health services (MHS) and criminal justice services (CJS) impacts on mental illness and reduces reoffending rates. This paper proposes the change laboratory model (CLM) of workplace transformation as a potential tool to support interagency collaborative practice that has potential to complement current integration tools used in this context. The purpose of this paper is to focus specifically on the theoretical dimension of the model: the cultural historical activity systems theory (CHAT) as a theoretical perspective that offers a framework with which interactions between the MHS and CJS can be better understood. Design/methodology/approach The structure and rationale behind future piloting of the change laboratory in this context is made. Then CHAT theory is briefly introduced and then its utility illustrated in the presentation of the findings of a qualitative study of leaders from MHS and CJS that explored their perspectives of the characteristics of collaborative working between MHS and prison/probation services in a Norwegian context and using CHAT as an analytical framework. Findings Leaders suggested that interactions between the two services, within the Norwegian system at least, are most salient when professionals engage in the reintegration and rehabilitation of the offender. Achieving effective communication within the boundary space between the two systems is a focus for professionals engaging in interagency working and this is mediated by a range of integration tools such as coordination plans and interagency meetings. Formalised interagency agreements and informal, unspoken norms of interaction governed this activity. Key challenges limiting the collaboration between the two systems included resource limitations, logistical issues and differences in professional judgments on referral and confidentiality. Originality/value Current tools with which MHS/CJS interactions are understood and managed, fail to make explicit the dimensions and nature of these complex interactions. The CLM, and CHAT as its theoretical underpinning, has been highly successful internationally and in other clinical contexts, as a means of exploring and developing interagency working. It is a new idea in prison development, none as yet being applied to the challenges facing the MHS and CJS. This paper addresses this by illustrating the use of CHAT as an analytical framework with which to articulate MHS/CJS collaborations and the potential of the CLM more widely to address current challenges in a context specific, bottom-up and fluid approach to interagency working in this environment.

Background: Interprofessional curricula have often lacked explicit reference to theory despite calls for a more theoretically informed field that illuminates curricular assumptions and justifies curricular practices., Aim: To review the contributions of theory to the design, delivery, and evaluation of interprofessional curricula., Methods: Four databases were searched (1988-2015). Studies demonstrating explicit and a high-quality contribution of theory to the design, delivery or evaluation of interprofessional curricula were included. Data were extracted against a comprehensive framework of curricular activities and a narrative synthesis undertaken., Results: Ninety-one studies met the inclusion criteria. The majority of studies (86%) originated from the UK, USA, and Canada. Theories most commonly underpinned "learning activities" (47%) and "evaluation" (54%). Theories of reflective learning, identity formation, and contact hypothesis dominated the field though there are many examples of innovative theoretical contributions., Conclusions: Theories contribute considerably to the interprofessional field, though many curricular elements remain under-theorized. The literature offers no "gold standard" theory for interprofessional curricula; rather theoretical selection is contingent upon the curricular component to which theory is to be applied. Theories contributed to interprofessional curricula by explaining, predicting, organizing or illuminating social processes embedded in interprofessional curricular assumptions. This review provides guidance how theory might be robustly and appropriately deployed in the design, delivery, and evaluation of interprofessional curricula.

Purpose Interprofessional collaboration is necessary when supporting mentally ill offenders but little is understood of these interactions. The purpose of this paper is to explore prison officers' perceptions of current and desirable levels of interprofessional collaboration (relational coordination (RC)) to understand how collaboration between these systems can be improved. Design/methodology/approach Gittell's RC scale was administered to prison officers within the Norwegian prison system ( n=160) using an adaptation of the instrument in which actual and desired levels of RC are evaluated. This differentiates between prison officers' expectations of optimum levels of collaboration with other professional groups, dependent on the role function and codependence, vs actual levels of collaboration. Findings Prison officers reported different RC levels across professional groups, the lowest being with specialist mental health staff and prison doctors and highest with nurses, social workers and other prison officers. Significant differences between desired and actual RC levels suggest expertise of primary care staff is insufficient, as prison officers request much greater contact with mental health specialists when dealing with the mentally ill offender. Originality/value The paper contributes to limited literature on collaborative practice between prison and health care professionals. It questions the advisability of enforcing care pathways that promote the lowest level of effective care in the prison system and suggest ways in which mental health specialists might be better integrated into the prison system. It contributes to the continued debate on how mental health services should be integrated into the prison system, suggesting that the current import model used in Norway and other countries, may not be conducive to generating the close professional relationships required between mental health and prison staff.

Internationally, mental illness is high in prison populations. Collaboration between the correctional services (CS) and mental health services (MHS) is required to address this. Little is known of the collaborative processes in this context, however. This article presents the findings of a study exploring the characteristics of collaborative practices between the MHS and CS in a Norwegian context. A purposeful sample (n = 12) of MHS and CS leaders was recruited from one region in Norway. Taking a generic qualitative approach, semi-structured interviews with each participant explored specific structures that promoted collaboration, the nature of collaborative relationships, and factors that facilitated or constrained these. The study indicated that leaders are exercised by one dimension of collaborative practice in particular, namely the distribution of responsibility for the care of the offender across systems. This activity is mediated by highly complex external structures as well as the individual characteristics of the professionals involved. They speculate that professionals and organisations who fail to take responsibility for the offender as expected may be constrained from doing so by resource limitations, logistical issues, and poor attitudes towards the offender population. Based on these findings, this study suggests that the MHS and CS workforce would benefit from a great knowledgeability of the roles and responsibility domains of collaborative practice. Improving competence in the workforce in this area would achieve this. However, competency frameworks that address this domain are currently limited. Recommendations on how to extend the remit of this domain in light of the current findings are provided.

Aims and Objectives: To describe the lived experience of vulnerability of individuals within a Gypsy Roma Travelling community., Background: People experience vulnerability whenever their health or usual functioning is compromised. This may increase when they enter unfamiliar surroundings, situations or relationships. One's experience of vulnerability can also be heightened through interactions between the individual and the society within which they live. Gypsy Roma Travellers are often identified as vulnerable owing to increased morbidity and mortality as well as their marginalised status within society. Yet little is known of the experiences of vulnerability by the individuals themselves. Without their stories and experiences, health professionals cannot effectively develop services that meet their needs., Design: This descriptive phenomenological study sought to explore the lived experience of vulnerability in a Gypsy Roma Travelling community., Methods: Seventeen Gypsy Roma Travellers were interviewed in 2013-2014 about their experiences of feeling vulnerable. This paper reports on the findings from the depth phase in which 13 individuals were interviewed. The interviews were conducted and analysed using Giorgi's descriptive phenomenological approach., Findings: Six constituents of the phenomenon of vulnerability were identified as feeling: defined and homogenised as a group; pressurised to conform to live in a particular way; split in one's identity; a loss of one's heritage; discriminated, persecuted and threatened; and powerlessness., Relevance to Clinical Practice: There is a wealth of evidence that Gypsy Roma Travellers experience high levels of morbidity and mortality, which has led to them being identified by health professionals and policy makers as a vulnerable community. Exploring their lived experience of vulnerability presents a different perspective regarding this concept and can help explain why they may experience poorer levels of physical and mental health., (© 2016 John Wiley & Sons Ltd.)

Background: Rigorous reviews of available information, from a range of resources, are required to support medical and health educators in their decision making., Aim: The aim of this article is to highlight the importance of a review of theoretical frameworks specifically as a supplement to reviews that focus on a synthesis of the empirical evidence alone. Establishing a shared understanding of theory as a concept is highlighted as a challenge and some practical strategies to achieving this are presented. This article also introduces the concept of theoretical quality, arguing that a critique of how theory is applied should complement the methodological appraisal of the literature in a review., Method: We illustrate the challenge of establishing a shared meaning of theory through reference to experiences of an on-going review of this kind conducted in the field of interprofessional education (IPE) and use a high scoring paper selected in this review to illustrate how theoretical quality can be assessed., Findings: In reaching a shared understanding of theory as a concept, practical strategies that promote experiential and practical ways of knowing are required in addition to more propositional ways of sharing knowledge. Concepts of parsimony, testability, operational adequacy and empirical adequacy are explored as concepts that establish theoretical quality., Conclusions: Reviews of theoretical frameworks used in medical education are required to inform educational practice. Review teams should make time and effort to reach a shared understanding of the term theory. Theory reviews, and reviews more widely, should add an assessment of theory application to the protocol of their review method.

Mutation of the lysosomal hydrolase acid-β-glucosidase (GCase), which leads to reduced GCase activity, is one of the most frequent genetic risk factors for Parkinson's disease (PD) and promotes α-synuclein accumulation in the brain, a hallmark of PD and other synucleinopathies. Whether targeting GCase pharmacologically is a valid therapeutic strategy for sporadic PD in the absence of GCase mutation is unknown. We have investigated whether increasing the stability, trafficking, and activity of wild-type GCase could be beneficial in synucleinopathies by administering the pharmacological chaperone AT2101 (afegostat-tartrate, isofagomine) to mice that overexpress human wild-type α-synuclein (Thy1-aSyn mice). AT2101 administered orally for 4 months to Thy1-aSyn mice improved motor and nonmotor function, abolished microglial inflammatory response in the substantia nigra, reduced α-synuclein immunoreactivity in nigral dopaminergic neurons, and reduced the number of small α-synuclein aggregates, while increasing the number of large α-synuclein aggregates. These data support the further investigation of pharmacological chaperones that target GCase as a therapeutic approach for sporadic PD and other synucleinopathies, even in the absence of glucocerebrosidase mutations.

Aim: The aim of this study was to gain insight into the experiences of people aged 65 and older who have learned to live with a pre-existing long-term condition., Method: A qualitative approach and the principles of narrative research were used to learn as much as possible about the individuals' stories. A focus group of five men was interviewed and two women were interviewed as a pair., Findings: Existing skills in condition management and interactions with professionals are transferable to new health needs that older people develop, but additional, age-related problems can affect management of long-term conditions. Progressive long-term conditions may become more difficult to manage with age, and it is difficult to distinguish between ageing processes and deterioration of pre-existing long-term conditions. Age-related social and financial changes and society's perception of older people may also present challenges to condition management., Conclusion: Nurses who care for older people should take into account the effects of the person's long-term condition and the ageing process when assessing their needs; understand that people may be reluctant to ask for practical assistance; explore existing support mechanisms that people have in place and their sustainability; and advocate with people to secure appropriate choices related to their health needs.

Enabling children's wellbeing by supporting their social networks is an important role of children's nurses. This article presents the concept of social capital as a cognitive tool to help nurses reflect on why and how supporting these networks is important. Through three case studies the authors introduce the attributes of social capital and how these may be applied and inform practice in hospital and community healthcare settings.

International policy has emphasized the development of interprofessional education (IPE) to reinforce interprofessional practice. This study explored the extent to which IPE initiatives in the UK are based on sound theoretical frameworks. Findings from semi-structured interviews with lead IPE curriculum developers at eight higher education institutions are presented which identified curriculum developers' developmental approaches to IPE. The findings reveal a notable lack of explicit theoretical basis for models of IPE. In many cases, senior managers determined the institutional approach to IPE which academic staff then needed to deliver. Curriculum developers reported adopting a largely practical approach to IPE curriculum development. However, questioning that focused on learning and teaching methods revealed that a range of learning theories was used implicitly. The significance of these findings is discussed with recommendations to inform future curriculum development of IPE initiatives.

Theory is essential to understand our interprofessional educational (IPE) practice. As a discipline, IPE has moved from being widely atheoretical to having a plethora of theories imported from the psychosocial disciplines that have utility to understand, articulate and improve IPE practice and evaluation. This paper proposes that when taking this deductive approach to theoretical development in IPE, a greater focus must now be placed on the rigorous testing of these theories within the IPE context. It synthesizes two approaches to achieving this, using the social capital theory as a case study, and focuses on the first two stages of this synthesis: first, the identification of the concepts and propositions that make up a theory within the study context and second, the value-based judgments made by the researcher and other stakeholders on the utility of these propositions. The interprofessional student group is chosen as a possible exemplar of a social network and theory-derived concepts and propositions are identified and classified within this context. With a focus on physical network characteristics, validation of these propositions with a sample of IPE educationalists is described. We present a range of propositions specifically related to the size and mix of IPE student groups, the frequency and level with which students participate in these as well as some of the existing evidence that have explored these propositions to date. Refined propositions and the way forward in the future application and empirical testing of social capital theory in IPE are presented.

Theoretical awareness is essential in the development and delivery of effective interprofessional education and collaborative practice (PECP). The objective of this paper was to explain the origins and purpose of an international network, IN-2-THEORY--interprofessional theory, scholarship and collaboration: a community of practice (CoP) that aims to build theoretical rigor in IPECP. It explains why the network is viewed as a CoP and lays out the way forward for the community based on the principles for developing a CoP outlined by Wenger, McDermott, and Snyder (2002).

The importance of economic well-being is recognised in the recent UK Government policy. Older people may be particularly vulnerable to economic fluctuations as they are reliant on fixed incomes and assets, which are reducing in value. Within the literature, little is understood about the impact of the current economic downturn on people's general quality of life and well-being and, in particular, there is little research on the financial experiences and capability of the older age group, a concern in light of the ageing UK population. This article reports a qualitative research study into the nature of older peoples' vulnerability by exploring their perceptions of the impact of the economic recession on their well-being and quality of life. It explores specifically a group of older people who are not the poorest within the ageing population, but who may be described as the 'asset rich-income poor' group. Key themes relate to the impact of the recession on the costs of essential and non-essential items and dimensions of mental, physical and social well-being. Implications for health and social care practice in meeting the needs of older people during times of economic recession are then explored. The paper adds to the debate by demonstrating that the recession is having adverse consequences for older people's quality of life in terms of economic, mental and social well-being, although there is also evidence that some of them are equipped with certain resilience factors due to their money management and budgeting skills., (© 2012 Blackwell Publishing Ltd.)

From the second quarter of 2008, the UK economy entered a period of economic decline. Older people are particularly vulnerable during these times. To promote ways in which older people can be better supported to maintain their financial well-being, this study explored the sources older people utilize to keep themselves financially informed. Interviews with older people (n = 28) showed that older people access trusted sources of information (e.g. healthcare professionals) rather than specialist financial information providers (e.g. financial advisors) which highlighted the need for interagency working between financial services in the private, public and voluntary sectors. An example of how such interagency partnerships might be achieved in practice is presented with some recommendations on directions for future research into interagency working that spans public, private and voluntary sectors.

In this Guide, we support the need for theory in the practice of interprofessional education and highlight a range of theories that can be applied to interprofessional education. We specifically discuss the application of theories that support the social dimensions of interprofessional learning and teaching, choosing by way of illustration the theory of social capital, adult learning theory and a sociological perspective of interprofessional education. We introduce some of the key ideas behind each theory and then apply these to a case study about the development and delivery of interprofessional education for pre-registration healthcare sciences students. We suggest a model that assists with the management of the numerous theories potentially available to the interprofessional educator. In this model, context is central and a range of dimensions are presented for the reader to decide which, when, why and how to use a theory. We also present some practical guidelines of how theories may be translated into tangible curriculum opportunities. Using social capital theory, we show how theory can be used to defend and present the benefits of learning in an interprofessional group. We also show how this theory can guide thinking as to how interprofessional learning networks can best be constructed to achieve these benefits. Using adult learning theories, we explore the rationale and importance of problem solving, facilitation and scaffolding in the design of interprofessional curricula. Finally, from a sociological perspective, using Bernstein's concepts of regions and terrains, we explore the concepts of socialisation as a means of understanding the resistance to interprofessional education sometimes experienced by curriculum developers. We advocate for new, parallel ways of viewing professional knowledge and the development of an interprofessional knowledge terrain that is understood and is contributed to by all practitioners and, importantly, is centred on the needs of the patient or client. Through practical application of theory, we anticipate that our readers will be able to reflect and inform their current habitual practices and develop new and innovative ways of perceiving and developing their interprofessional education practice.