The efficacy of team-based learning in developing the generic capability of problem-solving ability and critical thinking skills in nursing education: A systematic review.

BACKGROUND: The gaps between employers' expectations, theory and practice are the most prominent and universal issues in nursing education. New graduate nurses seem to be academically equipped but cannot integrate their knowledge into practice as they enter the clinical settings. Employers expressed limited critical thinking skills are a common problem among new graduate nurses. OBJECTIVES: To examine the efficacy of team-based learning (TBL) in developing problem-solving ability and critical thinking skills among nursing students and to identify the strategies used and obstacles to TBL in nursing education. DESIGN: Systematic review (SR) of experimental and quasi-experimental studies. DATABASE SOURCES: A thorough database search was done on 19 April 2022 with four electronic databases: Academic Search Premier, CINAHL Complete, ERIC, Medline/PubMed. Eligible studies from the 1990s to 2022 were selected according to the inclusion and exclusion criteria of this SR. REVIEW METHODS: The PRISMA 2020 guideline was applied in this SR. The JBI Critical Appraisal Checklists were used to evaluate the quality of the selected studies. Four reviewers participated in the review process to ensure rigour and credibility of the study. RESULT: The six studies reviewed included one randomised control trial, one crossover study, and four quasi-experimental studies. Two studies assessed the effectiveness of TBL in developing critical thinking skills and had shown in favour of TBL with statistically significant differences. Five studies evaluated the effectiveness of TBL in enhancing problem-solving ability. Three of five studies showed favour in TBL groups. The teaching strategies and obstacles in TBL use in nursing education were identified. CONCLUSION: TBL may be considered a potential active-learner-centred approach to develop critical and problem-solving skills in nursing education. Further research is needed to identify the optimal duration of implementing TBL to develop nursing students' critical thinking skills and problem-solving abilities.

A Theory-Based and Culturally Aligned Training Program on Breast and Cervical Cancer Prevention for South Asian Community Health Workers: A Feasibility Study.

BACKGROUND: Cancer screening uptake among South Asian ethnic minorities is reported to be relatively low. An outreach program, led by community health workers (CHWs), may increase the minority group's awareness of the importance of cancer screening. OBJECTIVE: The aim of this study was to assess the feasibility and effectiveness of a theory-based, culturally sensitive program to train South Asian women in Hong Kong as CHWs. METHODS: A CHW training program, guided by the Empowerment Model and the Health Belief Model, was developed and implemented. Its feasibility was evaluated through the recruitment of South Asian women to the program and their satisfaction with it. Its effectiveness was assessed by a test of knowledge, the participants' self-efficacy and competence, and their readiness to work as CHWs. RESULTS: Five South Asian women were recruited to the training program. Outcomes included increased participants' knowledge of cancer and improved self-efficacy and competence in working as CHWs. All participants were highly satisfied with the program, although the addition of practical sessions in the South Asian community was suggested as a further improvement. CONCLUSION: It seems to be feasible to train South Asian CHWs to deliver interventions to promote their peers' awareness of breast and cervical cancer prevention, although challenges exist in recruitment of trainees. More hands-on practical opportunities as CHWs would likely increase their effectiveness. IMPLICATIONS FOR PRACTICE: The theoretical framework of our CHW training program and the incorporated cultural components could be useful for the development of future programs for training South Asian CHWs in delivering interventions on cancer prevention.

Effects of Promotional Materials on Attitudes and Fear towards Colorectal Cancer Screening among Chinese Older Adults: An Experimental Study.

Colorectal cancer (CRC) screening is a cost-effective prevention and control strategy. However, the promotion of CRC screening for older adults may be difficult because reading CRC prevention information may evoke embarrassment, fear, and anxiety towards the screening procedure and cancer diagnosis. This study aims to (1) examine the effects of three promotional materials for CRC screening on the attitudes toward CRC screening tests (screening interest, screening effectiveness, and trust in the screening results) and cancer fear, and (2) to explore the interaction effect of cancer fear with screening effectiveness and trust in the screening results on screening interest of the three screening tests (fecal occult blood test (FOBT), flexible sigmoidoscopy, and colonoscopy) among Chinese older adults. A total of 114 community-dwelling older adults were asked to look at the corresponding promotional materials (pamphlet, cartoon, and video) of one of the three study groups. The pamphlet and video represent convention strategies and the cartoon represents an innovative strategy. No significant difference was observed in the screening interest and cancer fear across groups. FOBT was the most preferred screening modality. The video group has a large proportion agreed screening effectiveness of flexible sigmoidoscopy than pamphlet and cartoon groups and trusted in the screening results for FOBT and flexible sigmoidoscopy than the pamphlet group. Logistic regression results showed that the effect of trust in the screening results on screening interest for colonoscopy was greater among participants with higher cancer fear than those with lower cancer fear level. In conclusion, the three promotional groups had produced similar results in their attitudes toward CRC screening and cancer fear. The use of cartoons may be a comparable approach with conventional methods in the promotion of CRC screening. Additional components that can arouse fear and boost response efficacy simultaneously might also be useful for the effective promotion of colonoscopy among Chinese older adults.

Comparison Study of Uptake of Colorectal Cancer Testing between Ethnic Minorities and the General Population in Hong Kong.

BACKGROUND: Colorectal cancer (CRC) is one of the most common cancers. This study aimed to compare the uptake of CRC testing in the general public and in ethnic minorities in Hong Kong. MATERIALS AND METHODS: This cross-sectional survey covered 2,327 South Asian and Chinese adults aged over 50, recruited from two separate studies. A structured questionnaires were administered by research staff over the telephone or in face- to-face interviews. RESULTS: The uptake rate of CRC testing among South Asians was significantly lower than that of the general population in Hong Kong. Factors associated with the uptake rate were health professional's recommendation, perception of regular visits to doctor, use of complementary therapy, ethnicity, perceived susceptibility to cancer, presence of chronic illness, and education level. In addition, a significant interaction (p<0.05) between ethnicity and health professionals' recommendations was found, after adjustment for the main independent factors identified. CONCLUSIONS: Older people with lower educational attainment, without chronic illness and those have lower perceived susceptibility to cancer may be targeted for CRC testing promotion in the society. In addition, health professionals can play a highly influential role in promoting such testing, particularly among ethnic minorities.

Quality of life in head and neck cancer survivors at 1 year after treatment: the mediating role of unmet supportive care needs.

PURPOSE: The aim of the study was to test a hypothesised model that supportive care needs (SCNs) have a mediating effect on the relationship between characteristics of (Chinese) head and neck cancer (HNC) survivors and their quality of life (QoL). METHODS: A total of 285 Chinese HNC survivors who had finished cancer treatment 1 year earlier completed a self-reported survey covering demographic and clinical characteristics, the Chinese version of the Short-Form Supportive Care Needs Questionnaire (SCNS-SF34-C), the supplementary module of access to healthcare and ancillary support services and the Functional Assessment of Cancer Therapy for Head and Neck Cancer (FACT-H&N). RESULTS: The final path model showed that optimism, educational level, any coexisting disease, number of somatic symptoms, household income, eating ability, support from others, whether the cancer is under control or not and travelling time from home to hospital have direct or indirect effects, or both, on the QoL of HNC survivors, by way of unmet SCNs in the psychological, physical and/or health system information domains, which account for 64 % of the variance in the total FACT-H&N score. CONCLUSIONS: Our study demonstrated the mediating effects of SCNs in the association between HNC survivors and their QoL. Early needs assessment may help healthcare professionals to identify the actual needs of these survivors, and providing the information that HNC survivors want is a significant factor in meeting their psychological needs and thereby improving their overall QoL.

Genome-wide mapping of RELA(p65) binding identifies E2F1 as a transcriptional activator recruited by NF-kappaB upon TLR4 activation.

NF-kappaB is a key mediator of inflammation. Here, we mapped the genome-wide loci bound by the RELA subunit of NF-kappaB in lipopolysaccharide (LPS)-stimulated human monocytic cells, and together with global gene expression profiling, found an overrepresentation of the E2F1-binding motif among RELA-bound loci associated with NF-kappaB target genes. Knockdown of endogenous E2F1 impaired the LPS inducibility of the proinflammatory cytokines CCL3(MIP-1alpha), IL23A(p19), TNF-alpha, and IL1-beta. Upon LPS stimulation, E2F1 is rapidly recruited to the promoters of these genes along with p50/RELA heterodimer via a mechanism that is dependent on NF-kappaB activation. Together with the observation that E2F1 physically interacts with p50/RELA in LPS-stimulated cells, our findings suggest that NF-kappaB recruits E2F1 to fully activate the transcription of NF-kappaB target genes. Global gene expression profiling subsequently revealed a spectrum of NF-kappaB target genes that are positively regulated by E2F1, further demonstrating the critical role of E2F1 in the Toll-like receptor 4 pathway.