Virtual reality-based dementia educational programmes for formal and informal caregivers of people with dementia: A scoping review.

AIM: To map evidence of the existing virtual reality-based dementia educational programmes and the effects of these educational programmes on dementia formal and informal caregivers. DESIGN: A scoping review. METHODS: A comprehensive search of nine databases was conducted to find studies from the inception of the databases to October 2023. Two authors independently screened the titles and abstracts related to the eligibility criteria. Full texts of potentially relevant studies were read by one author and checked by a second. Data extraction and synthesis using NVivo 12 were undertaken by one author and checked by two other authors. RESULTS: Nineteen studies published between 2002 and 2022. The four randomised controlled studies and five qualitative studies were of moderate to good methodological quality. The 10 quasi-experimental studies were of weak to moderate quality. Fifteen virtual reality-based educational programmes had a positive influence on formal and informal caregivers, including improving caregivers' perceptions changing attitudes towards people with dementia, while the nursing competence of formal caregivers did not improve in short term. Educational programmes that covered dementia-related information and care strategies better improved the knowledge level of dementia formal and informal caregivers. CONCLUSIONS: The qualitative and quantitative studies of moderate to good quality included in this study support the idea that virtual reality-based dementia educational programmes may be a safe and effective way and have potential benefits for improving knowledge, perceptions, attitudes and nursing competence. IMPACT: This scoping review will provide an emerging teaching model for formal and informal caregivers of people with dementia and help them better understand the types and the influence of virtual reality-based dementia educational programmes. REPORTING METHOD: PRISMA-ScR. NO PATIENT OR PUBLIC CONTRIBUTION: Not required as this review in accordance with the aim to map existing literature from the dementia formal and informal caregivers' perspective.

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.

The influence of web-based decision aids on informal caregivers of people with dementia: A systematic mixed-methods review.

Caring for people with dementia is considered one of the most stressful and difficult forms of care. Informal caregivers constantly face high physical and emotional burdens. Therefore, it is essential to provide them with effective and practical support. Web-based decision aids can provide convenient and effective decision support for informal caregivers. The aim of this study was to assess and synthesize the influence of web-based decision aids on informal caregivers of people with dementia. Searches of electronic databases (CINAHL, MEDLINE, Web of Science Core Collection, Embase, PsycINFO, CNKI, Open Grey and Baidu Wenku) and reference lists of relevant studies were conducted in July 2022. Qualitative, quantitative and mixed-methods studies published in Chinese and English on the use of web-based decision aids by informal caregivers of people with dementia were included. The studies were selected by screening titles, abstracts and full texts, and the quality of each study was assessed by two researchers independently. Fourteen studies were published between 2010 and 2022, including five qualitative studies, four quantitative studies and five mixed-methods studies. Web-based decision aids have a positive influence on informal caregivers of people with dementia by providing decision support, satisfying needs, promoting psychological health, improving communication ability and reducing caregiver burden. Informal caregivers of people with dementia are receptive to web-based decision aids and expect their functionality to be optimized further. Web-based decision aids offer potential benefits to informal caregivers by providing effective decision-making support and improving their psychological health and ability to communicate.

Physical restraints applied to people diagnosed with dementia in home care from the perceptions of family caregivers: A qualitative study in China.

WHAT IS KNOWN ON THE SUBJECT?: Physical restraint is widely used in the elderly at home, and cognitive impairment is an important risk factor. Family caregivers of people with dementia are the main decision makers and implementers of physical restraint at home. Most people with dementia in China receive home care, and family caregivers face enormous care and moral pressures influenced by Confucian culture. Current research on physical restraints focuses on quantitative analysis of its prevalence and reasons within the institutions. There is little research on how family caregivers perceive physical restraints in home care context, especially under Chinese culture. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: Many family caregivers face approach - avoidance conflict and moral dilemmas when making decisions to restrain, and they make difficult choices in these dilemmas. In China, family caregivers are influenced by many unique factors, including traditional Confucian culture, family affection, and rural home environment. Inadequate laws and policies provide the ground for abuse of physical restraints, and family caregivers rarely consider legal and policy restrictions when using physical restraints. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: With limited medical resources, nurse-led dementia management is the hope to reduce physical restraints in home. Mental health nurses need to assess for the appropriateness of physical restraints associated with psychiatric symptoms in people with dementia. At both organizational and community levels, improving effective communication and relationships between professionals and family caregivers are important to address. Improvements in this context require education and time for staff to develop skills and experience which is necessary to provide family caregivers with ongoing information and psychological support within their communities. Considering Confucian culture will be of value for mental health nurses working in other countries where there are Chinese communities to better understand perceptions of family caregivers. ABSTRACT: INTRODUCTION: The use of physical restraints is a common practice in home care. Family caregivers face care-related and moral pressures due to the influence of Confucian culture in China. The use of physical restraints in the Chinese cultural environment may differ from the use of such restraints in other cultures. SCIENTIFIC RATIONALE: Current research on physical restraints focuses on quantitative analysis of its prevalence and reasons within the institutions. However, there is little research on how family caregivers perceive physical restraints in home care context, especially under Chinese culture. AIM: To explore the perceptions of family caregivers on physical restraints in people diagnosed with dementia receiving home care. METHOD: A descriptive, qualitative study of Chinese family caregivers of people diagnosed with dementia in home care. Framework method analysis was adopted using the multilevel socio-ecological model. RESULTS: Beliefs about benefit lead to a dilemma for family caregivers. Cherishing family's affection encourages caregivers to reduce physical restraints, but lack of help from family members, professionals and the community forces them to restrain their loved ones. DISCUSSION: Future research should explore the complex issue of culturally specific physical restraints decisions. IMPLICATIONS FOR PRACTICE: Mental health nurses must receive education regarding the negative outcomes of the use of physical restraints for family members of people diagnosed with dementia. A more liberal approach to mental health and relevant legislation, which is an emerging global phenomenon that is currently in an early phase of development in China, grants human rights to people diagnosed with dementia. Effective communication and relationships between professionals and family caregivers can contribute to the establishment of a dementia-friendly community in China.

How to manage comorbidities in people with dementia: A scoping review.

BACKGROUND: People with dementia experience a high prevalence of comorbidities that seriously affect patient outcomes. The aim of this study was to map the evidence and components related to comorbidity management, including interventions to facilitate and support the practice of management. METHODS: A scoping review was conducted. In June 2022, PubMed, Web of Science, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), The National Institute of Health and Care Excellence (NICE), Open grey, and the Cochrane Library were searched to identify relevant literature. The inclusion criteria were outlined to identify studies on comorbidity management in people with dementia. RESULTS: We found 43 items that met the inclusion criteria. The majority of the studies were published since 2010. Most research focused on medication management, health care service use and provision, and comorbidity-related monitoring and management; there were a small number of studies that involved decision-making. Only 6 studies developed interventions to support dementia care, which included comorbidity management. Studies involving the comorbidity management process were mainly based on qualitative methods, which make it difficult to quantify the impact of these processes on comorbidity management. CONCLUSIONS: Given the serious impact of dementia on managing comorbidities, there is a need to develop systematic interventions targeting the management of comorbidities.

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.

Predictors of complete oral feeding resumption after feeding tube placement in patients with stroke and dysphagia: A systematic review.

AIMS: The aim was to synthesise and discuss predictors of complete oral feeding resumption after feeding tube placement in stroke patients with dysphagia. DESIGN: This was a systematic review, following the PRISMA 2020 checklist. DATA SOURCES: Eight databases (PubMed, Web of Science, Embase, Cochrane, CINAHL, CNKI, WanFang and Vip) were searched for eligible studies from inception up to June 2021. REVIEW METHODS: The JBI Manual for Evidence Synthesis was used to guide this systematic review. Any cross-sectional survey, longitudinal study, cohort study or case-control study that explored the recovery from tube feeding to complete oral feeding in patients with dysphagia after stroke was included. Qualitative studies, review articles, case reports and conference abstracts were excluded. Two reviewers independently screened and appraised the studies. The Newcastle-Ottawa scale was used for quality assessment. Content analysis was used to categorise factors predicting feeding tube removal in stroke patients with dysphagia. RESULTS: This review included a total of 15 studies consisting of 1746 participants, of which 2 were case-control studies and 13 were cohort studies. Four studies were rated as having low risk of bias, and the other 11 had high risk of bias. The factors examined in the studies were categorised into demographic characteristics (age and sex), swallowing function (instrumental assessments and non-instrumental assessments), stroke characteristics (stroke severity, past stroke history and location of the stroke), functional status (cognitive function and physical function) and clinical measures (body mass index, geriatric nutritional risk index, white blood cell count and C-reactive protein level). CONCLUSIONS: The major limitation of this review is the failure to identify predictors of different tube feeding types. Although the current evidence is insufficient to support or oppose the predictive effect of any single factor, these factors are still valuable data for clinical staff that provide information that researchers can use in developing prognostic models. Rigorously designed and high-quality research is needed to further explore the predictive value of these factors. REGISTRATION: This review was registered prospectively with PROSPERO [CRD42021272552]. RELEVANCE TO CLINICAL PRACTICE: Healthcare providers should strengthen the monitoring of swallowing function in patients with stroke to promote complete oral feeding resumption. As the predictive value of the identified factors is still uncertain, large, well-designed, studies are needed to better clarify the importance of these predictors. NO PATIENT OR PUBLIC CONTRIBUTION: No patient or public was involved in the design, analysis, preparation or writing of this review.

Correction: Nanomolar LL-37 induces permeability of a biomimetic mitochondrial membrane.

Correction for 'Nanomolar LL-37 induces permeability of a biomimetic mitochondrial membrane' by Xin Jiang et al., Nanoscale, 2022, https://doi.org/10.1039/d2nr05409d.

Nanomolar LL-37 induces permeability of a biomimetic mitochondrial membrane.

LL-37, the only human host cathelicidin peptide, is proposed to be able to induce host cell apoptosis through mitochondrial membrane permeabilization (MMP). Detailed pathways of the LL-37-triggered MMP are however still disputed. It is generally believed that cationic peptides permeate a membrane mostly in conditions of micromolar peptide concentrations and negatively charged membranes, which are not usually satisfied in the mitochondrial circumstance. Herein, using a variety of single-molecule techniques, we show that nanomolar LL-37 specifically induces permeability of a phosphoethanolamine (PE)-rich biomimetic mitochondrial membrane in a protein-independent manner. The insertion dynamics of single LL-37 molecules exhibit different metastable states in bilayers composed of different lipids. Moreover, the PE lipids significantly facilitate adsorption and accumulation of LL-37 on the PE-rich bilayer, and produce deeper insertion of peptide oligomers, especially tetramers, into the bilayer. This work offers an alternative pathway of the LL-37-triggered MMP and apoptosis.

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.

'It is my turn to raise her' - Decision-making regarding physical restraint in home care in China: A descriptive qualitative study.

BACKGROUND: The phenomenon of physical restraint applied to people with dementia in home care is receiving increasing interest from nursing scholars. Although family caregivers play key roles in caring for people with dementia, little is known regarding the ways in which family caregivers make decisions with respect to physical restraint. OBJECTIVES: The aim of this study was to explore Chinese family caregivers' decision-making regarding physical restraint in home care for persons living with dementia. DESIGN: A descriptive qualitative study was employed. METHODS: Using maximum variation sampling and purposive sampling, 18 family caregivers were recruited. Semistructured interviews were conducted in a memory clinic in northeast China between July 2020 and September 2020; the interviews were transcribed verbatim and analysed via thematic analysis. RESULTS: 'It is my turn to raise her' is a strong thread, which links three themes: (a) identifying culture-based family and filial ties; (b) maintaining culture-based family and filial ties; and (c) decision-making between belief and reality. The quote reflects the context of a Confucian and filial piety culture, which children care for their parents to repay the kindness of being provided an upbringing. Decisions based on this point are aimed at providing good personal care for people with dementia. Evaluating whether physical restraint is beneficial to people with dementia in general is an important factor in decisions regarding physical restraint. To repay the kindness of being provided an upbringing, children in the context of a Confucian culture cannot bear imposing physical restraint on their parents. CONCLUSIONS: This qualitative study provides new insight into the substantial influence of culture on family caregivers' decision-making. Perpetuating Confucian culture and improving the home care system can help reduce the use of physical restraint for people with dementia at home.

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).

Application of the OMAHA System in the education of nursing students: A systematic review and narrative synthesis.

AIM: The aim of this systematic review was to synthesize evidence on the application of the Omaha System in the education of nursing students and to provide advice for educators to apply the Omaha System to practice and research effectively and meaningfully. BACKGROUND: It is a necessary part of nursing education to provide students with informatics experience. The Omaha System is a standardized nursing terminology designed to enhance practice, documentation, and information management. DESIGN: A systematic review and narrative synthesis. METHODS: Studies from eight databases (PubMed, Web of Science, Embase, CINAHL, PsycINFO, China Biology Medicine disc, CNKI, Wanfang Data) were systematically retrieved. Twenty-three articles were found and synthesized. RESULTS: Existing studies showed that the Omaha System was mainly applied in student community practice as a tool for guiding practice and collecting information, and the practice data were used by educators to analyse the outcomes of nursing education. Recently, the Omaha System was introduced into the classroom environment and achieved positive results in terms of teaching. Students' feedback on the use of the Omaha System was generally positive. CONCLUSIONS: The Omaha System can be an active teaching and learning tool for nursing education, and further research is needed to explore and realize its potential in the field of education.

Effectiveness of caregiver non-pharmacological interventions for behavioural and psychological symptoms of dementia: An updated meta-analysis.

BACKGROUND: The behavioural and psychological symptoms of dementia (BPSD) have significant negative effects on the health of both patients with dementia and their caregivers. However, the reported effectiveness of non-pharmacological interventions targeting caregivers of patients with dementia for BPSD is inconsistent. METHODS: We systematically searched the databases PubMed, PsycINFO, CINAHL, Embase, Cochrane Library and four Chinese databases from 2010 through April 2021. The Standardised mean difference (SMD) was calculated using random-effects models. Risk of bias in individual studies was assessed using Cochrane Collaboration's tool, and the certainty of evidence was assessed using the five GRADE criteria. RESULTS: Thirty-one randomised controlled trials (RCTs) involving 3501 dyads were included. The meta-analysis indicated that non-pharmacological interventions showed small but significant effects on both BPSD in patients with dementia (SMD = -0.14; 95% CI, -0.22 to -0.06; P = 0.001) and caregiver reactions to BPSD (SMD = -0.16; 95% CI, -0.25 to -0.07; P = 0.001). The effect sizes of BPSD in patients at follow-up (SMD = -0.24; 95% CI, -0.38 to -0.09; P = 0.002) were larger than those at post-test. Tailored interventions were associated with more substantial reductions in BPSD in patients (SMD = -0.24; 95% CI, -0.37 to -0.11; P < 0.001) than standardised interventions (SMD = -0.07; 95% CI, -0.18 to 0.04; P = 0.218). CONCLUSIONS: Non-pharmacological interventions targeting caregivers have the potential to reduce BPSD in patients with dementia and improve caregiver negative reactions to BPSD. Moreover, tailored interventions seemed to be more effective in reducing BPSD, and more significant improvements in BPSD may be observed in long-term follow-up.

Sensory-based approaches in psychiatric care: A systematic mixed-methods review.

AIMS: Sensory-based approaches, including sensory room, sensory cart and specific sensory integration programs, feature various sensory stimulations to focus on a particular space or program. This systematic mixed-methods review describes the impact of sensory-based approaches in psychiatric care and summarizes the important components of sensory interventions. DESIGN: Systematic mixed-methods review was based on the guidelines by Pluye and Hong for comprehensively searching, appraising and synthesizing research evidence. DATA SOURCES: Data were collected from five databases: CINAHL, Embase, Pubmed, Web of Science and Cochrane before March 9, 2020. REVIEW METHODS: Qualitative, quantitative, mixed-methods and original studies published in English on sensory-based approaches in psychiatric care were included. The studies were selected by screening titles, abstracts and full texts, and the quality of each study was assessed by two researchers independently. The data were analysed using thematic analysis. RESULTS: Sixteen studies were chosen for review. Through data integration, four subthemes with positive effects were formed: (1) calming of the patient's mood; (2) calming of the patient's body; (3) improvement of self-care ability; and (4) improvement of the nurse-patient relationship. The sensory-based approach may also lead to negative effects. CONCLUSIONS: Several important components play important roles in the sensory-based approaches: (1) rich, culture-based, personalized sensory stimulation; (2) a quiet, safe, home-based physical environment; (3) a good one-to-one nurse-patient relationship; (4) and the cultivation of patient autonomy and self-management. Sensory-based approaches in a multicultural environment and home environment will be important topics of psychiatric care in the future. IMPACT: There is a lack of synthesis of studies on results of sensory-based approaches in psychiatric care. Four components are important to sensory interventions. It is necessary for mental health service centres and home care for the patients with psychotic disorders to use sensory-based approaches for reference.

Effectiveness of patient-targeted interventions to inform decision making and improve uptake of colorectal cancer genetic evaluation for at-risk individuals: A systematic review.

BACKGROUND: Inherited colorectal cancer syndromes increase the risk of contracting colorectal and other cancers. International guidelines recommend the identification of individuals with hereditary colorectal cancer and the supervision of asymptomatic individuals with a family history. However, detection of hereditary colorectal cancer is suboptimal. The prevalence of genetic counselling and testing for individuals with high genetic risk is low. OBJECTIVE: To identify, characterize and summarize patient-targeted interventions on improving the uptake of colorectal cancer genetic evaluation for at-risk individuals and enhancing their informed decision making. DESIGN: Systematic review. DATA SOURCES: Six electronic databases (PubMed, CINAHL, Web of Science, Embase, PsycINFO, and Cochrane library) were searched to identify eligible clinical trials from each database's inception to March 25, 2020. The reference lists of the included studies and reviews were checked for additional articles. REVIEW METHODS: Studies were screened and independently appraised by two reviewers using the standardized critical appraisal checklist for randomized controlled trials and quasi-experimental studies from the Joanna Briggs Institute. The results were tabulated and reported in descriptive format. RESULTS: Based on the inclusion criteria, 8 articles satisfied the inclusion criteria and were included. The studies examined patient-targeted intervention strategies related to risk assessment, education, and decision aids. Outcomes included (1) informed decisions regarding microsatellite instability testing, (2) informed decisions concerning genetic testing, (3) genetic counselling and testing. Most of the included studies revealed that interventions had positive effects on the uptake of colorectal cancer genetic evaluation for at-risk individuals and their informed decision making. CONCLUSIONS: There were few studies included in this review, and the results were inconsistent. Based on this review, the conclusion cannot be made that interventions for risk assessment, education, and decision aids have positive effects on the uptake of colorectal cancer genetic evaluation for at-risk individuals and their informed decision making. However, to our knowledge, this is the first systematic review to summarize the effectiveness of patient-targeted interventions to inform decision making and improve uptake of colorectal cancer genetic evaluation for at-risk individuals. This review provides important evidence for related topics. Future studies with rigorous designs are recommended. Nurses have a crucial role in personalized health care. The involvement of nurses in collaboration with all the stakeholders in the development, implementation and evaluation of cancer genetic screening programs to improve genetic referral of individual at risk.

Job satisfaction, resilience and social support in relation to nurses' turnover intention based on the theory of planned behaviour: A structural equation modelling approach.

BACKGROUND: Many national studies have shown that nurses have a high turnover rate. The key to maintaining the stability of nursing staff is to explore the factors that affect their turnover intention; however, no research has been performed to explore the influencing factors and mechanisms of nurses' turnover intention based on the Theory of Planned Behaviour. AIM: Based on the Theory of Planned Behaviour, examining the relationships among resilience, job satisfaction, social support and turnover intention of nurses, a structural equation model was constructed to examine the mediating role of job satisfaction and social support between resilience and turnover intention. METHODS: In this descriptive cross-sectional study, a total of 350 questionnaires were distributed to participants from three tertiary hospitals in Changchun, Jilin Province, between December 2018 and March 2019. RESULTS: The final model fits well. Job satisfaction and social support directly influences turnover intention. Resilience indirectly influences turnover intention through job satisfaction and social support. CONCLUSION: Turnover intention is a complex variable, which is directly and indirectly affected by many factors. In this study, a new structural equation model was proposed, which laid a foundation for future longitudinal studies.

Modifiable factors associated with behavioural and psychological symptoms of dementia among patients residing at home: The impacts of patient, caregiver and environmental variables.

The present study aimed to explore the modifiable factors of behavioural and psychological symptoms of dementia (BPSD) among patients residing at home in terms of patient, caregiver and environmental factors. A cross-sectional survey of 193 patients with dementia residing at home and their caregivers who visited the memory clinic of the Department of Neurology in a tertiary (the highest level) hospital in China from November 2018 to May 2019 was performed. Exacerbated BPSD were associated with patient (old age, high education level, increased dementia severity, and the use of psychotropic drugs), caregiver (low positive aspects and high expressed emotion) and environmental (poor home environment) factors. The use of psychotropic drugs by the patient, positive aspects and expressed emotions of the caregiver, and home environment were modifiable factors that provided evidence for the direction of intervention for BPSD among patients residing at home.

Real-time imaging of structure and dynamics of transmembrane biomolecules by FRET-induced single-molecule fluorescence attenuation.

Tracking the transmembrane topology and conformational dynamics of membrane proteins is key to understand their functions. It is however challenging to monitor position changes of individual proteins in cell membranes with high sensitivity and high resolution. We review on three single-molecule fluorescence imaging methods - SIFA, LipoFRET and QueenFRET - recently developed in our lab for studying the dynamics of membrane proteins. They can be applied, progressively, to investigate membrane proteins in solid-supported lipid bilayers, artificial liposome membranes and live-cell plasma membranes. The techniques take advantage of the energy transfer from a fluorophore to a cloud of quenchers and are able to extract in real time positions and position changes of a single fluorophore-labeled protein in the direction normal to the membrane surface. The methods have sub-nanometer precision and have proved powerful to investigate biomolecules interacting with bio-membranes.