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BackgroundClinical nursing education provides opportunities for students to learn in multiple patient care settings, receive appropriate guidance, and foster the development of clinical competence and professionalism. Nurse preceptors guide students to integrate theory into practice, teach clinical skills, assess clinical competencies, and enhance problem-solving and critical thinking skills. Previous research has indicated that the teaching competencies of nurse preceptors can be transferred to students’ clinical learning to enhance their clinical competencies. ObjectiveThis study aimed to develop a clinical teaching blended learning (CTBL) program with the aid of web-based clinical pedagogy (WCP) and case-based learning for nurse preceptors and to examine the effectiveness of the CTBL program on nurse preceptors’ clinical teaching competencies, self-efficacies, attitudes toward web-based learning, and blended learning outcomes. MethodsA quasi-experimental single-group pretest and posttest design was adopted. A total of 150 nurse preceptors participated in the CTBL program, which was conducted from September 2019 to December 2019. A set of questionnaires, including the clinical teaching competence inventory, preceptor self-efficacy questionnaire, attitudes toward web-based continuing learning survey, and e-learning experience questionnaire, was used to assess the outcomes before and after the CTBL program. ResultsCompared with the baseline, the participants had significantly higher total mean scores and subdomain scores for clinical teaching competence (mean 129.95, SD 16.38; P

Context Current osteoporosis pharmacological treatment has undesirable side effects. There is increasing focus on naturally derived food substances that contain phytonutrients with antioxidant effects in promoting health and regulating immune response. Objective This review aims to systematically evaluate the effectiveness of anthocyanin-rich foods on bone remodeling biomarkers in middle-aged and older adults (≥40 y old) at risk of osteoporosis. Data Sources Randomized controlled trials were searched on 8 bibliographic databases of PubMed, Embase, Scopus, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Food Science and Technology Abstracts, Cochrane Library, and ProQuest. Data Extraction and Analysis Thirteen studies were included in the meta-analysis. Receptor activator of nuclear factor kappa-B ligand (RANKL) is exhibited from osteoblastic cells that gathered osteoclasts to bone sites for bone resorption, accelerating bone loss. Anthocyanin-rich food consumption showed statistically nonsignificant effects, with no substantial heterogeneity on bone remodeling biomarkers. However, there was a significant increase in lumbar spine L1–L4 bone mineral density. Mild-to-small effects were seen to largely favor the consumption of anthocyanin-rich foods. Berries (d = –0.44) have a larger effect size of RANKL than plums (d = 0.18), with statistically significant subgroup differences. Random-effects meta-regression found body mass index, total attrition rate, total energy, and dietary carbohydrate and fat intake were significant covariates for the effect size of RANKL. All outcomes had low certainty of evidence. Conclusion Anthocyanin-rich foods may improve bone health in middle-aged and older adults at risk of osteoporosis. This review contributes to the growing interest in nutrient-rich foods as a low-cost and modifiable alternative to promote human health and reduce disease burden. Future high-quality studies with larger sample sizes and longer treatment durations are required to fully understand the effect of anthocyanin-rich foods on bone health. Systematic Review Registration PROSPERO registration no. CRD42022367136. [ABSTRACT FROM AUTHOR]

Lactic acid bacteria (LAB) fermented foods are reported to have potential in managing glycemic control. This systematic review aimed to evaluate the effectiveness of LAB-fermented foods on improving glycemic control in adults with prediabetics or type 2 diabetes mellitus (T2DM). Randomized controlled trials (RCTs) on LAB fermentation-related foods were searched on PubMed, Cochrane, Excerpta Medica database (EMBASE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science. Sixteen RCTs were included, and the results concluded LAB-fermented food had significant effects in HbA1c (Z = 6.24, MD = −0.05, CI: −0.07 to −0.04, p ≤ 0.00001), fasting plasma glucose (Z = 2.50, MD = −0.16, CI: −0.29 to −0.04, p = 0.01) and fasting serum insulin (Z = 2.51, MD = −0.20, CI: −0.35 to −0.04, p = 0.01). There were significant effects on lipid profile, inflammatory markers, and body mass index in secondary analyses. Subgroup analysis suggests LAB-fermented consumption with a longer duration, younger age group and adults with T2DM, had a larger effect size. Clinicians could offer LAB-fermented food as dietary recommendations for prediabetic and diabetic adults. Larger trials are warranted to verify LAB-fermented food benefits on glycemic control. Systematic Review Registration: PROSPERO Registration No. CRD42022295220 [ABSTRACT FROM AUTHOR]

Aims: To evaluate the effectiveness of mindfulness‐based interventions (MBIs) on mental and cognitive outcomes including, anxiety, depression, attention, memory, global cognition and neuroplastic changes in older adults with mild cognitive impairment (MCI). Design: Systematic review and meta‐analysis. Data source: A three‐step search strategy was conducted on eight electronic databases, grey literature and reference lists from inception to February 2022. Review methods: Randomized controlled trials (RCTs) examining MBIs on older adults with MCI were screened and assessed for risk of bias using the Cochrane Risk of Bias Tool. Meta‐analysis was conducted using RevMan using a random‐effect model. Narrative synthesis was performed for studies where results could not be pooled statistically. Results: Ten RCTs were included in the review. Results suggested that right frontal parietal and left inferior temporal gyrus of the brain showed increased cortical thickness after receiving MBIs. There were significant interaction effects for global efficiency and significant interactions in the insular and gyrus regions. Functional connectivity between the posterior cingulate cortex, bilateral medial prefrontal cortex and left hippocampus were increased in participants undergoing MBIs. Nevertheless, meta‐analysis showed non‐significant pooled effects, favouring control groups on anxiety, depression, attention, memory and global cognition. Conclusion: This review suggested the potential effects of MBIs in improving cortical thickness and connectivity in regions associated with memory and attention. Nevertheless, the effects of MBIs compared to active control groups on depression, anxiety, attention, memory and global cognition are inconclusive due to the lack of studies and non‐significant results. Impact: The review advocates for more rigorous studies with larger sample size and utilizing wait‐list controls to evaluate the effects of MBIs. MBIs can be considered as an adjunct with other therapies to further enhance the effect on psychological and cognitive outcomes for older adults with MCI. No Patient or Public Contribution as this is a meta‐analysis. [ABSTRACT FROM AUTHOR]

Context The prevalence of age-related cognitive decline has been on the rise as the global population age, putting the independence and quality of life of elderly at risk. Anthocyanin, as a subclass of dietary flavonoids, may have a beneficial impact on cognitive outcomes. Objectives To examine the effects of dietary anthocyanin supplementation on cognition of the cognitively healthy middle-aged and older adults. Data Sources PubMed, ScienceDirect, CINAHL, EMBASE, ProQuest and Cochrane databases were searched. Data Extraction and Analysis Thirteen studies were included in this meta-analysis. Anthocyanin-rich supplementation was found to significantly improve the processing speed of the older adults (95%CI 0.08, 0.44; P = 0.004). No significant differences were observed between intervention and control groups on memory, attention, executive function and psychomotor performance. Current neuroimaging studies have found promising effects of anthocyanin supplementation on brain activation and cerebral perfusion. Conclusion Anthocyanin-rich supplementation may preserve cognitive processing speed and neuro-activities in older adults, which improves their daily functioning and quality of life. This review provides useful insights to guide direction and methodological designs for future studies to explore the underlying mechanisms of anthocyanins. Systematic Review and Meta-analysis Registration PROSPERO registration No. CRD42021228007. [ABSTRACT FROM AUTHOR]

Background: Peer feedback (PF) has attracted much attention in health profession education with growing evidence on its benefits. However, it lacks a proper framework to guide its operation, which raises concerns about its quality in nursing education. Purpose: To compare the effects of a 3-phase PF versus faculty feedback (FF) on students' reflective abilities and clinical competencies after simulated practice, and its impacts on peer tutors' feedback practices and empowerment level. Methods: This study used a 3-arm pretest-posttest quasi-experimental methodology. Results: Peer verbal feedback significantly increased students' reflective abilities and clinical competencies, while peer video feedback significantly increased clinical competencies. However, FF outcomes did not reach significance. Peer tutors' empowerment level did not significantly improve, but feedback practices were perceived as comparable with FF. Conclusions: Peer feedback can potentially improve students' reflective abilities and clinical competencies. Proper feedback training with a structured framework will likely enhance peer tutors' feedback practices. [ABSTRACT FROM AUTHOR]

Aims: To evaluate the effectiveness of technology‐based interventions in reducing psychological morbidities such as depressive symptomology, anxiety, burden and improving quality of life and self‐efficacy in informal caregivers of stroke survivors. Design: A systematic review and meta‐analysis. Data Sources: An extensive search was systematically undertaken at CENTRAL, PubMed, Embase, Scopus, CINHAL, Web of Science and PsycInfo until January 2021. Grey literature and dissertations were searched in Google Scholar, ProQuest & Scholarbank@NUS. Studies involving registered trials were retrieved from Clinicaltrials.gov and CENTRAL, respectively. Review Methods: Two reviewers independently screened the trials, conducted quality appraisal and extracted the data. Quality of the studies included in the review was assessed using Cochrane Risk of bias tool. Meta‐analysis was conducted using RevMan 5.4. Narrative synthesis was performed for studies where results could not be pooled statistically. The results were reported abiding Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. Results: This review included 15 trials with a total of 1276 informal caregivers of stroke survivors. Eleven trials were included in the meta‐analysis. Subgroup analyses revealed that technology‐based interventions with structured educational programs were statistically significant in reducing depressive symptoms (d = −0.27, 95% CI [−0.49 to −0.05], p =.02). Technology‐based interventions with structured educational programs <3‐month revealed significant effects (d = −0.31, 95% CI [−0.49 to −0.13], p =.0009). Results of narrative synthesis reported technology‐based intervention with face‐to‐face training minimized depressive symptoms of informal caregivers. Notably, there were no statistically significant effects on anxiety, burden, quality of life and self‐efficacy outcomes. Conclusion: Technology‐based interventions had beneficial effects in alleviating depressive symptoms among informal caregivers. Impact: Technology‐based interventions serve as a support mechanism for informal caregivers of stroke survivors who face time‐constrains. Further high‐quality randomized controlled trials are warranted to elucidate sustainability, optimal format and dosage of intervention. [ABSTRACT FROM AUTHOR]

Nurse preceptors are key stakeholders in providing quality clinical education. This study aimed to explore the perspectives of nurse preceptors on a web‐based clinical pedagogy program and clinical teaching. A descriptive qualitative design was adopted. The program was made accessible to the nurse preceptors who were assigned nursing students from July 2019 to June 2020. Upon completion of clinical teaching, a total of 19 nurse preceptors participated in four focus group discussions. The discussions were audio recorded and transcribed verbatim, and thematic analysis was conducted. Five themes, with 11 subthemes, emerged: (i) Undergoing the process of self‐awareness and development; (ii) Mastering newly acquired skills to refine own teaching approach; (iii) Implementing consistent evaluation and constructive feedback; (iv) Dual roles and responsibilities of preceptor; and (v) Benefits and barriers of the program. This study highlighted the knowledge and skills preceptors gained through the program which gave them newfound confidence and facilitated their clinical teaching and evaluation. As the shift towards online learning progresses, web‐based learning can be a useful platform for professional development of nurse preceptors. [ABSTRACT FROM AUTHOR]

Population ageing resulting from declining fertility and extended life expectancy has been occurring rapidly throughout the world. Older adults are faced with multiple physical, psychological and social changes that challenge their sense of self and capacity for healthy ageing. Intergenerational programmes (IGP) in communities have been developed to address a variety of social issues brought about by the population ageing. These programmes focus on promoting intergenerational social contact, supporting educational programmes and facilitating intellectual and/or physical activities in the older adults. This study intended to explore the perception of community‐dwelling older adults towards an IGP in a senior day care centre in Singapore. Purposive sampling was adopted to recruit 15 participants for the study. Individual face‐to‐face interviews were conducted until data saturation was achieved. Interviews were audio‐taped and transcribed verbatim. Thematic analysis was carried out. Four themes and 13 sub‐themes emerged: (1) IGP enhances memory and strength; (2) social interaction between older adults and younger generation; (3) emotional responses to IGP; and (4) attitudes and perception towards the younger generation. The current study illustrated the dynamic social interaction between older adults and the younger generation, as well as the perceived benefits of the IGP. The relationship formed between the two generations entailed companionship, mutual care, trust and affection. Participation in the IGP provided the older adults an opportunity for active engagement in society and development. Continuous effort must be put in to ensure continuity of integration and empowerment of older adults, including the removal of obstacles and barriers that exclude or discriminate against them. The study findings will help facilitate the customisation of IGP to meet the needs of the older adults. With a well‐planned and structured IGP, significant physical, emotional and psychosocial outcomes could benefit the older adults and the younger generation. [ABSTRACT FROM AUTHOR]

This review aimed to examine available evidence concerning the effectiveness of psychosocial interventions in improving memory, executive function, depression and activities of daily living (ADL) in older adults with MCI. Eight electronic databases were used to conduct a comprehensive literature search for published and unpublished studies. A primary outcome was cognitive function, including memory and executive function. Secondary outcomes were depression and ADL. Two researchers independently appraised quality of included studies and extracted data. Meta-analysis, heterogeneity test, subgroup analysis and sensitivity analyses were performed. Ten studies (out of 1,265 records) were included in this review. Psychosocial interventions contributed to a significant improvement in memory, not executive function, depression and ADL. Subgroup analyses suggested that interventions with a longer duration, more therapeutic sessions, and individual format had larger effect sizes. Strategies found to enhance memory entailed behavior modification and activation, memory training, visual imagery, storytelling, memory aids, journaling, and exercise. Healthcare providers may offer psychosocial interventions to client with MCI in clinical settings. Higher quality trials should be conducted to increase solid evidence in this domain. [ABSTRACT FROM AUTHOR]