Cross-cultural adaptation and validation of the Australian National University Alzheimer Disease Risk Index (ANU-ADRI) for Chinese community-dwelling residents: A cross-sectional Study.

OBJECTIVE: To cross-culturally adapt the Australian National University Alzheimer Disease Risk Index (ANU-ADRI) and verify the reliability and validity of its cognitive activity domain. METHODS: According to Beaton's guidelines, the ANU-ADRI was were translated into Chinese. The psychometric properties of ANU-ADRI its cognitive activity was conducted among community-dwelling residents (n = 442) in Changchun, Harbin and Hegang from December 2021 to July 2023. RESULTS: The Chinese version of the ANU-ADRI had good content validity and face validity. Exploratory factor analysis of cognitive activity revealed a 3-factor structure, with a cumulative variance contribution rate of 64.124 %. Confirmatory factor analysis revealed a good model fit (x2/df = 1.664, RMSEA = 0.055, RMR = 0.090, GFI = 0.942, CFI = 0.919, IFI = 0.921, TLI = 0.902, and NFI = 0.824). The internal consistency (Cronbach's α = 0.807) and test-retest reliability (ICC = 0.787) were considered satisfactory. CONCLUSION: The ANU-ADRI showed acceptable reliability and validity for assessing risk factors for Alzheimer's disease among middle-aged and elderly community-dwelling residents.

Dignity-preserving care of people with dementia in different nursing environments: a qualitative systematic review.

AIMS: To systematically identify, evaluate and synthesize qualitative evidence about the dignity-related nursing experiences of people with dementia in families and nursing homes, summarize the similarities and differences and analyse the causes and influencing factors. METHODS: A synthesis of qualitative studies retrieved from eight databases that were published before September 2022. Two reviewers independently screened and selected studies. Inclusion criteria were established according to the PICOS principle. Quality assessment was guided by Joanna Briggs Institute's Qualitative Assessment and Review Instrument and the structured topic synthesis method was used to summarise studies eligible for inclusion. RESULTS: Three key themes were extracted from 14 included studies; the living environment, relationship needs and self-awareness, which focused on improving the dementia-centred nursing environment, meeting the needs of the relationship-centred nursing network, and finally, improving the self-awareness of people with dementia to promote dignity. CONCLUSION: This systematic review shows people with dementia need to integrate into society and maintain their dignity in a dementia-friendly environment that is respectful, inclusive environment that promotes freedom.

Life experience and identity of spousal caregivers of people with dementia: A qualitative systematic review.

BACKGROUND: The number of people with dementia is on the rise worldwide, and dementia care has become the focus of global health services. People with dementia are primarily cared for by informal caregivers, with spouses seen as a particularly vulnerable group. Focusing on the spousal caregiving experience and having a good caregiver identity contributes to group bonding and enhanced social support. OBJECTIVE: To explore the dynamic changes that occur in the caregiving experience of spouse caregivers and explicate the identity of spouses during this process alongside its causes. DESIGN: A qualitative systematic review. DATA SOURCE: The following eight electronic databases were searched: PubMed, Web of Science (Core Collection), The Cochrane Library, Embase, CINAHL and CNKI, WanFang and Vip. REVIEW METHODS: The Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) and Joanna Briggs Institute Reviewer's Manual criteria were used to report the results. Study screening and data extraction were conducted independently by two reviewers, and quality was assessed using the Joanna Briggs Institute's Qualitative Research Standard Assessment tool. Data synthesis was performed using thematic analysis. RESULTS: A total of 15 studies were included and synthesized into three analytical themes: (1) attitudes and emotions toward dementia, (2) emotional ups and downs in dementia care, and (3) who am "I". In binary care, patience and marital responsibilities are identified as facilitators, while care burden and social isolation are identified as hindrances. In addition, gender differences were identified as influencers of identity. CONCLUSIONS: In this review, spouse identity of people with dementia is complex and affects caregiving experience together with dementia cognition. Disease cognition, caregiving burden and social isolation are identified. Interventions for barriers are suggested to enhance social support.

Multidomain interventions based on a life-course model to prevent dementia in at-risk Chinese older adults: A randomized controlled trial.

BACKGROUND: Due to the time-dependent effect of specific risk factors for dementia, multidomain interventions based on a life-course model might achieve optimal preventive effects against dementia. OBJECTIVE: The purpose of this study was to investigate the effectiveness of multidomain interventions based on a life-course model of modifiable risk factors for dementia in at-risk Chinese older adults. DESIGN: This was a two-arm, proof-of-concept, randomized controlled trial. SETTING AND PARTICIPANTS: We randomly assigned 96 community-dwelling at-risk adults aged 60 years or older in a 1:1 ratio to either the 6-month multidomain intervention group (dementia literacy, physical activity, cognitive training, social activity and optional modules) or the control group (health education). METHODS: The primary outcomes were the dementia risk score and cognitive composite Z score. The secondary outcomes included the individual components of the dementia risk score (protective and risk factors) and cognitive composite Z score (global cognition, memory, executive function and language), social isolation (loneliness, social contact, and social participation), dementia literacy and prevention belief. Linear mixed models with maximum likelihood estimation were used to calculate the outcomes between the groups over time. RESULTS: The primary analyses showed that the dementia risk score was significantly lower (p < 0.001) and that the cognitive composite Z score was significantly higher (p = 0.013) in the multidomain intervention group than in the control group. Baseline characteristics did not modify the effects of the multidomain interventions (p value for interaction > 0.05). For secondary outcomes, statistically significant group × time interactions were observed for the protective (p = 0.001) and risk factors (p = 0.049), as well as in executive function (p = 0.020), loneliness (p = 0.029), dementia literacy (p < 0.001) and prevention belief (p < 0.001). CONCLUSIONS: Multidomain interventions based on a life-course model are feasible and have the potential to reduce dementia risk and improve cognitive function in at-risk Chinese older adults. REGISTRATION: The trial was registered at the Chinese Clinical Trials Registry (ChiCTR2100053417).

The impact of education/training on nurses caring for patients with stroke: a scoping review.

BACKGROUND: Stroke survivors have complex needs that necessitate the expertise and skill of well-trained healthcare professionals to provide effective rehabilitation and long-term support. Limited knowledge exists regarding the availability of specialized education and training programs specifically designed for nurses caring for stroke patients. AIM: This review aims to assess the content and methods of training for nurses caring for stroke patients, examine its impact on both nurses and patients, and identify key facilitators and barriers to its implementation. METHODS: We conducted a comprehensive scoping review by reviewing multiple databases, including PubMed, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Embase, Web of Science, Scopus, ProQuest Dissertations and Theses, Google Scholar, and Cochrane databases. Data extraction and narrative synthesis were performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. RESULTS: Seventeen articles were included in this review. We found that education/training not only enhanced patients' self-care abilities, nursing outcomes, and satisfaction, but also had a positive impact on the knowledge, skills, and practices of nurses. The obstacles to education/training included feasibility and cost-effectiveness, while the driving factors were management support and participation, professional education/training, and controlled environment creation. CONCLUSIONS: This review highlights the crucial role of education/training in enhancing stroke care provided by nurses. Effective education/training integrates various educational methods and management support to overcome implementation barriers and optimize clinical practice benefits. These findings indicate the necessity of universal and consistent stroke education/training for nurses to further improve patient outcomes in stroke care.

Gaps in awareness and practice of healthy lifestyles among individuals at high risk of colorectal cancer: A qualitative evidence synthesis.

AIMS: To systematically examine and review relevant qualitative studies exploring the current lifestyle among individuals at high risk of colorectal cancer (CRC), and their awareness of the role of a healthy lifestyle in CRC prevention. BACKGROUND: The increasing incidence and mortality of CRC have presented a serious threat against the health and life of people. As the major population affected by CRC, the lifestyle of individuals at a high risk of CRC is attracting increasing attention. DESIGN: A qualitative evidence synthesis using the Thomas and Harden method and the PRISMA 2020 checklist provided by the EQUATOR network were used. DATA SOURCES: Literature was retrieved from PubMed, Web of Science, the Cochrane Library, Embase, CINAHL and PsycINFO from the inception to December 2021. REVIEW METHODS: Two reviewers independently screened the titles and abstracts and identified the eligible studies. Critical appraisals of each included study were performed. Thematic analysis was used to guide the data synthesis. RESULTS: The data from nine articles were analysed. Three interpretive themes were extracted that formed an overarching synthesis of the experience with healthy lifestyles among high-risk individuals of CRC. The findings suggested that these individuals with limited awareness of CRC and personal risks lacked sufficient knowledge about the relationship between lifestyle and CRC, and their attitudes and practices towards the role of a healthy lifestyle in CRC prevention were also diversified. CONCLUSION: Professionals can potentially provide personalised guidance for healthy lifestyles based on knowledge of prevention, the actual background and social support of individuals at high risk of CRC. IMPACT: Considering that knowledge gaps and health beliefs among these individuals are the premise blocking their adoption of a healthy lifestyle, the findings of this review may make contributions to the design and content of public health policy and prevention programs. No patient or public contribution.

How tablets/applications enhance social connections and social support in people with dementia: A qualitative systematic review.

The 2020 Lancet issue identified social isolation as one of 12 modifiable risk factors for dementia and revealed that enhanced social connections and social support can effectively reduce the incidence of social isolation. During the COVID-19 pandemic, technology attracted an increasing amount of attention, and it is necessary to synthesize ideas from existing evidence. First, we explored how people with dementia experienced changes in social connection and social support due to tablet/app use. Second, we explored the attitudes of people with dementia towards tablets and mobile applications. Third, we explored the feasibility of using tablets and mobile applications to enhance social connection and social support among people with dementia. We systematically searched the PubMed, Web of Science, Cochrane Library, Embase, CINAHL, CNKI, WanFang, and VIP databases. Two reviewers independently screened the titles and abstracts of studies, extracted the data and performed critical appraisals of each included study. The data synthesis was conducted using thematic analysis. A total of nine studies were included. Eight studies used mobile applications via tablets, and one study collected textual data from Twitter for analysis. Four themes were synthesized: (1) change from the perspective of caregivers; (2) growth of nonsingle aspects; (3) emotional feeling of belonging; and (4) feasibility of using digital technology. Tablet- and mobile application-based interventions can enhance both online and offline social connections and provide multiple types of social support among people with dementia. People with dementia have positive attitudes towards tablets and mobile applications. Overall, it is feasible for people with dementia to use technology.

Nurses' perceptions of night shifts: A qualitative study.

AIM: To describe the experiences and perceptions of emergency nurses regarding the shortening of night shifts and identify aspects of nurses' preferences for night shifts. BACKGROUND: Shift work can be associated with distinct physical and psychological disadvantages for nurses, especially night nurses. Knowledge regarding the factors influencing their perceptions of night shifts is limited. METHODS: A qualitative description design. Fifteen nurses from the emergency setting with 6 to 14 years of work experience participated in interviews. Semistructured interviews were conducted between November 2018 and March 2019. A thematic analysis was performed for the data analysis. FINDINGS: The following three themes emerged: (1) maintaining quality within quantity, (2) maintaining comfort within busyness, and (3) buffering the gap between ideal and reality. CONCLUSIONS: Considering work intensity and patient safety, nurses believe that an 8 h night shift is the most suitable length for the emergency department. Long shifts are probably more suitable for other departments with lower night workloads.

Exploring the role of communication in missed nursing care: A systematic review.

AIMS: To systematically review the literature on relationships between communication issues and missed nursing care. DESIGN: Systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 Statement. DATA SOURCES: EMBASE, Web of Science, CINAHL, PubMed and Cochrane databases were comprehensively searched from inception to December 2021. REVIEW METHODS: Screening, data extraction and initial quality assessment were conducted independently by two reviewers. The JBI quality assessment tool was used for study appraisal and the certainty of evidence was assessed using the five Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. Discrepancies were settled by consulting a third researcher. RESULTS: A total of 18 articles were included. Missed nursing care was common and the status of communication was not optimistic in clinical. Nurses' sociodemographic characteristics and work environment both influenced missed nursing care and communication. Intrateam communication included three parts: doctors-nurses communication, nurses-nurses communication and nurses-patients communication, poor intrateam communication could contribute to missed nursing care. There was an interaction between missed nursing care and communication. CONCLUSION: Promoting efficient intrateam communication, to acknowledge the importance of communication factors in reducing the incidence of missed nursing care in clinics is required. Future research can explore the impact of the internal dimension of communication on missed nursing care and consider interventions aimed at nurses' effective communication. IMPACT: What problem did the study address? This study offers new evidence that the impact of intrateam communication on missed nursing care. What were the main findings? Effective intrateam communication can reduce the incidence of missed nursing care, there is mutual influence between communication and missed nursing care. Where and on whom will the research have an impact? Policymakers can provide positive interventions on communication problems in different populations (e.g. nurses-patients, nurses-nurses and doctors-nurses) to provide high-quality patient care.

Multidomain lifestyle interventions for cognition and the risk of dementia: A systematic review and meta-analysis.

BACKGROUND: Cognitive impairment and dementia have emerged as one of the greatest global challenges for health and social care. Multidomain interventions that target several risk factors simultaneously may achieve optimal preventive effects for dementia. OBJECTIVE: This systematic review aimed to evaluate the effectiveness of multidomain lifestyle interventions for improving cognition and reducing the risk of dementia. DESIGN: Systematic review and meta-analysis. METHODS: Five electronic databases, PubMed, Embase, Cochrane Library, CINAHL, and PsycINFO, were systematically searched from inception to April 17, 2021. Randomised controlled trials (RCTs) that assessed multidomain lifestyle interventions on the outcomes of cognition or dementia risk were included. The standardized mean difference (Hedges' g) was calculated using random-effects models. Risk of bias was assessed using the Revised Cochrane risk-of-bias assessment tool for randomised trials (RoB2), and the certainty of evidence was assessed using the five Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. RESULTS: Seventeen RCTs involving 12,312 participants were included. The meta-analysis indicated that multidomain lifestyle interventions showed small but significant effects on both the risk of dementia (SMD = -0.11; 95%CI, -0.18 to -0.05; P <0.001; I2 = 0%; 6RCTs, 1981 participants) and the cognitive composite score (SMD = 0.10; 95%CI, 0.02 to 0.17; P = 0.012; I2 = 27.5%; 7 RCTs, 2643 participants). No significant improvements were found in global cognition (SMD = -0.04; 95% CI, -0.12 to 0.04; P = 0.330; I2 = 38.3%; 9 RCTs, 3740 participants). CONCLUSIONS: Multidomain lifestyle interventions have the potential to reduce the risk of dementia (high-certainty evidence) and improve the cognitive composite score (moderate-certainty evidence). There is no moderate- or high-certainty evidence that multidomain interventions improve global cognition. Future large-scale, high-quality studies are required to determine the effects of multidomain interventions on global cognition or other cognitive domains. REGISTRATION: The systematic review and meta-analysis have been registered in PROSPERO (CRD42021260122).

Catalytic Diastereospecific and Enantioselective (3 + 2) Transannulations of 1,2,3-Thiadiazoles with Strained Norbornene Derivatives.

With the adoption of a ring-strain-release strategy, iridium-catalyzed transannulations with norbornene derivatives are achieved in a diastereospecific and enantioselective manner. The first asymmetric transannulations of 1,2,3-thiadiazoles are reported.

Behavioural and psychological symptoms of early-onset and late-onset Alzheimer's disease among Chinese adults: analysis of modifiable factors.

BACKGROUND: To conduct a comprehensive comparison of behavioural and psychological symptoms of dementia (BPSD) in Chinese people with early-onset Alzheimer's disease (EOAD) and late-onset Alzheimer's disease (LOAD) and analyse the factors of differences. METHODS: A cross-sectional survey of 93 EOAD and100 LOAD and their caregivers in China from November 2018 to May 2019. RESULTS: The total Neuropsychiatric Inventory score was significantly higher in LOAD. A higher level of agitation in EOAD was related to a lower quality of life of caregivers and the emotional expression of ignoring people with dementia. Higher euphoria scores in LOAD were associated with reduced negative coping by caregivers and reduced stability and predictability at home. CONCLUSION: The early identification and management of specific BPSD of EOAD and LOAD by family members and health professionals may improve the quality of care and life for people with dementia and that of caregivers.

The influence path of caregivers' positive aspects, expressed emotion and coping style on behavioral and psychological symptoms of dementia.

OBJECTIVES: To analyze the correlation and mechanism of action among caregivers' expressed emotion, positive aspects, coping style and the behavioral and psychological symptoms of people with dementia by using the theory of planned behavior as a framework. METHODS: We investigated 193 pairs of people with dementia and caregivers to assess patients' behavioral and psychological symptoms, as well as caregivers' expressed emotion, positive aspects and coping style. Regression analysis and structural equation modeling were used. RESULTS: Dementia severity and psychotropic drug use were influencing factors of behavioral and psychological symptoms. Caregivers' positive aspects predicted expressed emotion and coping style, while expressed emotion predicted behavioral and psychological symptoms. Expressed emotion played a completely mediating role between caregivers' positive aspects and dementia patients' behavioral and psychological symptoms. CONCLUSION: Health care professionals should follow strict guidelines on medication, and focus on the caregiver's emotional state to reduce adverse effects on the person with dementia.

Colorectal cancer survivors' experience of continuity of care provided by different health professionals: A qualitative evidence synthesis.

AIMS AND OBJECTIVES: To systematically identify, synthesise and characterise the available qualitative evidence on the experience of adult colorectal cancer survivors with continuity of care led by different health professionals. BACKGROUND: The limited evidence base for effective continuity of care led by different medical staff who assist colorectal cancer survivors with their unique survivorship care hampers the development of effective interventions. Synthesising the data on survivors' experience of care led by different health professionals is critical to develop such interventions. DESIGN: A qualitative evidence synthesis using the Thomas and Harden method and the PRISMA 2020 checklist provided by the EQUATOR network were used. METHODS: PubMed, Web of Science, Embase, Cochrane, CINAHL and PsycINFO were searched through November 2020 for qualitative and mixed methods studies in English. JBI-QARI was used to undertake a quality review of the identified studies. The review findings were synthesised by a team of researchers, and the level of confidence was evaluated using GRADE-CERQual. RESULTS: Eleven studies met the criteria for inclusion in the review. The identified analytical themes included experience of diversity, preference for health professionals and space for enhancement to facilitate improved medical care delivery. Colorectal cancer survivors report diverse experiences regarding continuity of care led by different providers. Specifically, they attach substantial importance to trusted relationships with providers that are closely associated with their overall care experience. CONCLUSION: Effective communication and good rapport among stakeholders are cornerstones for addressing the complexity of ongoing care. Future interventions should include adjusting the percentage of care from different providers to deliver cost-effective and personalised continuity of care. RELEVANCE TO CLINICAL PRACTICE: Synthesising data on survivors' experience facilitates the development of practical approaches to increase the quality of continuity of care and may also foster the integration of providers' advantages to enable more cost-effective intervention. The limited capacity of primary care providers may be enhanced by better cooperation and communication with specialists and by additional professional cancer-related training.

Dependence of the Heterogeneity of Grain Boundaries on Adjacent Grains in Perovskites and Its Impact on Photovoltage.

In polycrystalline perovskites, grain boundaries (GBs) that isolate grains determine the optoelectronic properties of a semiconductor, and hence affect the photovoltaic performance of a solar cell. Photocurrent and photovoltage are affected by the microscopic structure of perovskites but are difficult to quantify on the intragrain length scale and are often treated as homogeneous within the photoactive layer. Here, the nanoscale through-film and lateral photoresponse of large-grained perovskite are studied by photoconductive atomic force microscopy. Photocurrent collection along GBs relies on the formation of adjacent grains, exhibiting GB to GB heterogeneity. Regarding to the spatially correlated heterogeneity, the photovoltage of grains deduced from the photoresponse curves at specific positions is larger than that of GBs by up to 0.4 V, suggesting that the photovoltage loss mainly originates from the shunting of GBs through the whole perovskite layer. These spatial heterogeneities are alleviated by depositing a capping layer onto the perovskite layer, highlighting the role of the inserted layer between the perovskite and electrode in real solar cells. This research reveals the heterogeneity of GBs and its influence on photovoltage that actually occurs in virtual solar cells, which is crucial for optimizing perovskite-based solar cells.

A systematic review of the application of a diary for people with dementia: how to maximise the effect of diary use?

Diaries have been widely used among people with dementia as a data collection tool and memory aid. An understanding of their usage is conducive to the subsequent development of intervention measures, but comprehensive evidence is still lacking. This review synthesises the existing literature to obtain an in-depth understanding of the positive and negative effects of diary usage among people with dementia and the influencing factors. The data were collected from eight databases from the inception of each database to November 2020. A thematic synthesis method was used to sort and summarise the included studies. Ten studies were chosen for the review. The following three analytical themes were identified: (i) positive changes; (ii) factors affecting the record; and (iii) negative feelings. Diaries can cause positive changes in people with dementia, but the specific patterns of stimulation and changes over time remain to be explored. Furthermore, researchers should encourage patients and their families to have a correct understanding of the diary, improve their motivation and social support, fully use the positive effects of the diary, and reduce the occurrence of negative effects. Medical staff should help caregivers improve their awareness of the usefulness and ease of the diary and encourage them to provide support and companionship to people with dementia while exhibiting a positive attitude.

Optimizing mealtime care for people with dementia from the perspective of formal caregivers: A systematic review of qualitative research.

BACKGROUND: As dementia progresses, people with dementia experience many problems during mealtimes that seriously affect their physical, psychological, and social health and quality of life. Formal caregivers play an important role in optimizing mealtime care. OBJECTIVE: To systematically review and synthesise relevant qualitative studies exploring the experience and perceptions of formal caregivers regarding optimizing mealtime care for people with dementia. DESIGN: A systematic review of qualitative research. DATA SOURCES: The PubMed, Web of Science, Cochrane Library, Embase, CINAHL, CNKI, WanFang and Vip databases were systematically searched. REVIEW METHODS: Two reviewers independently screened the titles and abstracts, extracted the data and performed critical appraisals of each included study. The data synthesis was conducted using thematic analysis. FINDINGS: A total of 10 studies were included. The formal caregivers included nursing assistants, nurses, speech and language therapists, nursing students, dietitians, a social worker, a professional educator, physiotherapists, health care aides, kitchen staff, diversional therapy assistants and other unidentified care staff. The findings were synthesised into the following 3 analytical themes: (1) tailored rather than standardized; (2) emotional nurturance; and (3) beyond the individual level. CONCLUSIONS: Mealtimes involve complex physiological and psychological processes. Formal caregivers should develop tailored care practices based on individual patients' preferences and needs. Emotional connection plays a key role and has a positive impact on the mealtime experience. Further research is needed to explore the specific effects of emotional connections on optimizing mealtime care.

Comparative Study of the Effects of Customized 3D printed insole and Prefabricated Insole on Plantar Pressure and Comfort in Patients with Symptomatic Flatfoot.

BACKGROUND There are many shortcomings in traditional prefabricated rehabilitation insoles for symptomatic flatfoot patients. This study investigated the effects of customized 3-dimensional (3D) printed insoles on pressure and comfort of the plantar foot in symptomatic flatfoot patients. MATERIAL AND METHODS Eighty patients with bilateral flatfoot participated in this study. At week 0, patients were randomly assigned into 1 of 2 groups. In the control group, the patients wore standardize shoes with prefabricated insoles; and in the experimental group the patients wore standardize shoes and customized insoles. The Footscan® system recorded peak pressure, peak force, and peak contact area in 10 areas of the sole at weeks 0 and at week 8. Patients used visual analogue scale scores at week 0 and at week 8 to assess overall comfort of insoles. RESULTS At week 0, compared with the control group, the peak pressure in the metatarsal was significantly lower in the experimental group (P<0.05) while the peak pressure in the mid-foot was significantly higher than the control group (P<0.05). At week 8, in the experimental group, the peak pressures in the mid-foot were significantly higher than the control group (P<0.05). The comfort scores (measured by pain scale) reported by the experimental group were significantly lower than those reported by the control group (P<0.05). CONCLUSIONS Customized 3D printed insoles reduced the pressure on the metatarsals by distributed it over the mid-foot area, thus reduced the damage from symptomatic flatfoot. Customized 3D printed insoles were more effective than prefabricated insoles and offered better comfort for patients with symptomatic flatfoot.